PrepU-Nutrition

A client is prescribed didanosine (Videx) as part of his highly active antiretroviral therapy (HAART). Which instruction would the nurse emphasize with this client?

"Be sure to take this drug about 1/2 hour before or 2 hours after you eat." Didanosine should be taken 30 to 60 minutes before or 2 hours after meals. Other antiretroviral agents, such as abacavir, emtricitabine, or lamivudine can be taken without regard to meals. High-fat meals should be avoided when taking amprenavir. Atazanavir should be taken with food and not with antacids.

The nurse is caring for a client diagnosed with bulimia. The client is being treated for a serum potassium level of 2.9 mEq/L. Which of the following statements made by the patient indicates the need for further teaching?

"I can use laxatives and enemas but only once a week." The patient is experiencing hypokalemia most likely due to the diagnosis of bulimia. Hypokalemia is defined as a serum K+ level below 3.5 mEq/L [3.5 mmol/L], and usually indicates a deficit in total potassium stores. Patients diagnosed with bulimia frequently suffer increased potassium loss through self-induced vomiting, misuse of laxatives, diuretics, and enemas; thus, the patient should avoid laxatives and enemas. Prevention measures may involve encouraging the patient at risk to eat foods rich in potassium (when the diet allows) including fruit juices and bananas, melon, citrus fruits, fresh and frozen vegetables, lean meats, milk, and whole grains. If the hypokalemia is caused by abuse of laxatives or diuretics, patient education may help alleviate the problem.

A client asks the nurse why vitamin C intake is so important during pregnancy. What should be the nurse's response?

"Vitamin C is required to promote blood clot and collagen formation." Explanation: Vitamin C is required to promote blood clot and collagen formation. Vitamin C deficiency has been associated with premature rupture of the membranes and gestational hypertension. Folic acid supplementation, not vitamin C, is recommended to prevent neural tube defects. High doses of vitamin C are not recommended because neonates exposed to excessive doses of vitamin C have developed symptoms of scurvy after birth. Also, high doses of vitamin C do not prevent the fetus from becoming infected. Vitamin C does not help to metabolize carbohydrates. Thiamine, a B vitamin, is a coenzyme involved with carbohydrate metabolism. Calcium in conjunction with phosphorus, not vitamin C, plays a role in fetal bone growth.

A nurse is preparing instructions for a patient with a lung abscess regarding dietary recommendations. Which of the following statements would be included in the plan of care?

"You must consume a diet rich in protein, such as chicken, fish, and beans." Correct Explanation: For a patient with a lung abscess the nurse encourages a diet that is high in protein and calories to ensure proper nutritional intake. A carbohydrate-dense diet or diets with limited fats are not advisable for a patient with a lung abscess.

A nurse is preparing to administer a 500 mL bolus tube feeding to a patient. The nurse anticipates administering this feeding over which time frame?

10 to 15 minutes Explanation: Typically a bolus tube feeding of 300 to 500 mL requires about 10 to 15 minutes to complete.

A client has been prescribed a protein intake of 0.6 g/kg of body weight. The client weighs 154 pounds. The nurse calculates the daily protein intake to be how many grams? Enter the correct number ONLY.

42 The client's weight of 154 pounds is equal to 70 kg. The client is to receive 0.6 g of protein for each 1 kg of body weight. 0.6 g/kg x 70 kg = 42 grams.

A nurse is establishing an ideal body weight for a 5' 9" healthy female. Based on the rule-of-thumb method, what would be this patient's ideal weight?

A general guideline, often called the rule-of-thumb method, determines ideal weight based on height. This formula is as follows: For adult females: 100 lb (for height of 5 ft) + 5 lb for each additional inch over 5 ft. For adult males: 106 lb (for height of 5 ft) + 6 lb for each additional inch over 5 ft

A client develops chronic pancreatitis. What would be the appropriate home diet for a client with chronic pancreatitis?

A low-fat, bland diet distributed over five to six small meals daily Correct Explanation: A low-fat, bland diet prevents stimulation of the pancreas while providing adequate nutrition. Dietary protein and fiber are not directly related to pancreatitis. Although calcium is important, the low-fat content is more significant. The hyperglycemia of acute pancreatitis is usually transient and does not require long-term dietary modification.

You are caring for a patient who had a percutaneous endoscopic gastrostomy (PEG) tube inserted earlier in the day. Which of the following interventions should you plan to perform? Select all that apply.

Administer prescribed analgesics, as needed. • Gently clean around the insertion site using a cotton-tipped applicator dipped in sterile saline. • Measure the length of exposed tube and compare it with the length documented after insertion. • Avoid placing tension on the feeding tube. Explanation: A dressing should be used only if drainage is present.

A nurse is caring for a client who had an appendectomy earlier in the day. The client now has bowel sounds and is passing flatus. Which of the following foods is appropriate for the nurse to serve to the client at this time?

Apple juice Explanation: A postoperative client who has bowel sounds return and is passing flatus is ready to begin a diet. The first diet offered is a clear liquid diet. Apple juice is a clear liquid because it can be seen through. Sherbet and Ensure would belong on a full liquid diet. Chopped fruit is a mechanically altered diet and is typically used when a client has chewing or swallowing difficulty

A home care nurse is teaching a client and family about the importance of a balanced diet. The nurse determines that the teaching was successful when the client identifies which of the following as a rich source of potassium?

Apricots Apricots are a rich source of potassium. Dairy products are rich sources of calcium. Processed meat and bread products provide sodium.

A patient tells the nurse "my heart is skipping beats again; I'm having palpitations." After completing a physical assessment, the nurse concludes the patient is experiencing occasional premature atrial complexes (PACs). The nurse should instruct the patient to complete which of the following?

Avoid caffeinated beverages. Correct Explanation: If PACs are infrequent, no medical interventions are necessary. Causes of PACs include caffeine, alcohol, nicotine, stretched atrial myocardium (e.g., as in hypervolemia), anxiety, hypokalemia (low potassium level), hypermetabolic states (e.g., with pregnancy), or atrial ischemia, injury, or infarction. The nurse should instruct the patient to avoid caffeinated beverages

When caring for a client who is a Mormon, the nurse notices something on the lunch tray that should be removed or substituted out of respect for the client's religion. Which of the following would be an item to remove?

Caffeinated coffee Those who practice Mormonism do not ingest beverages containing caffeine stimulants. Hindus do not allow meat. Jews do not eat pork and shelfish and do not mix milk with meat at the same meal. Muslims do not ingest meat and alcoholic beverages.

Ronald is a 46-year-old who has developed congestive heart failure. He has to learn to adapt his diet and you are his initial counselor. Which of the following should you tell him to avoid?

Canned peas There are a wide variety of foods that Ronald can still eat. The key is they have to have low-salt content. Canned vegetables are usually very high in salt or sodium, unless they have labels such as low-salt or sodium free or salt free. The key is to read the food labels and look for foods that contain <300 mg sodium/serving.

Which nursing action associated with successful tube feedings follows recommended guidelines?

Check the residual before each feeding or every 4 to 8 hours during a continuous feeding. The nurse should check the residual before each feeding or every 4 to 8 hours during a continuous feeding. High gastric residual volumes (200 to 250 mL or greater) can be associated with high risk for aspiration and aspiration-related pneumonia. A closed system is the best way to prevent contamination during enteral feedings. The bowel sounds do not have to be assessed as often as four times per shift. Once a shift is sufficient. Food dye should not be added as a means to assess tube placement or potential aspiration of fluid.

A nurse is providing home care to a patient receiving intermittent tube feedings. The patient wants to take an over-the-counter allergy medication. The medication would need to be given via feeding tube because the patient has difficulty swallowing. The nurse checks the medication and finds that it is a timed-release tablet. Which action by the nurse would be most appropriate?

Check with the pharmacy for an alternative formulation for the drug. Timed-release medications should not be crushed. Rather, the nurse should check with the pharmacy to see if another formulation (eg, liquid) is available that can be used safely with a feeding tube. Dissolving the tablet in water, like crushing it, would affect the drug's action, possibly releasing too much of the drug too quickly. Stating that the patient cannot take the drug anymore is inappropriate. A change in formulation or possibly a change to another drug in an appropriate formulation would be appropriate

Which foods should be avoided following acute gallbladder inflammation?

Cheese The patient should avoid eggs, cream, pork, fried foods, cheese, rich dressings, gas-forming vegetables, and alcohol. It is important to remind the patient that fatty foods may induce an episode of cholecystitis. Cooked fruits, rice or tapioca, lean meats, mashed potatoes, non-gas-forming vegetables, bread, coffee, or tea may be eaten as tolerated.

A nurse is caring for a patient receiving parenteral nutrition at home. The patient was discharged from the acute care facility 4 days ago. Which of the following would the nurse include in the patient's plan of care? Select all that apply.

Daily weights • Intake and output monitoring • Calorie counts for oral nutrients Explanation: For the patient receiving parenteral nutrition at home, the nurse would obtain daily weights initially, decreasing them to two to three times per week once the patient is stable. Intake and output monitoring also is necessary to evaluate fluid status. Calorie counts of oral nutrients are used to provide additional information about the patient's nutritional status. Transparent dressings are changed weekly. Activity is encouraged based on the patient's ability to maintain muscle tone. Strict bedrest is not appropriate

The nurse is creating a discharge plan of care for a patient with a peptic ulcer. The nurse tells the patient to avoid which of the following?

Decaffeinated coffee

Which of the following is the primary symptom of achalasia?

Difficulty swallowing The primary symptom of achalasia is difficulty in swallowing both liquids and solids. The patient may also report chest pain and heartburn that may or may not be associated with eating. Secondary pulmonary complications may result from aspiration of gastric contents.

The most common symptom of esophageal disease is which of the following?

Dysphagia Dysphagia may vary from an uncomfortable feeling that a bolus of food is caught in the upper esophagus to acute pain on swallowing. Nausea is the most common symptom of GI problems in general. Vomiting is a nonspecific symptom that may have a variety of causes. Odynophagia refers specifically to acute pain on swallowing

Which of the following dietary guidelines would be appropriate for the elderly homebound client with advanced respiratory disease who informs the nurse that she has no energy to eat?

Eat smaller meals that are high in protein

A client resides in a long-term care facility. Which nursing intervention would promote increased dietary intake?

Encourage the client to eat in the dining room. Correct Explanation: Encouraging the client to eat in the dining room will allow for socialization during meal time. This will have a positive effect on the amount of food consumed and provide enjoyment. The other choices would not help with socialization so they are incorrect

A nurse is caring for a patient who is postoperative from a neck dissection. What would be the most appropriate nursing action to enhance the patient's appetite?

Encourage the family to bring in the patient's favored foods. Family involvement and home-cooked favorite foods may help the patient to eat. Having visitors at mealtimes may make eating more pleasant and increase the patient's appetite. The nurse should not place the complete onus for initiating meals on the patient. Oral care after meals is necessary, but does not influence appetite.

What are medium-length nasoenteric tubes are used for?

Feeding Explanation: Placement of the tube must be verified prior to any feeding. A gastric sump and nasoenteric tube are used for gastrointestinal decompression. Nasoenteric tubes are used for feeding. Gastric sump tubes are used to decompress the stomach and keep it empty.

When assessing an older adult's gastrointestinal system, the nurse would identify an increase in which of the following as normal?

Feeling of fullness In an older adult, gastric motility slows modestly, which results in delayed stomach emptying, which in turn leads to early satiety (feeling of fullness). Calcium absorption is also decreased

The nurse is helping a confused client with a large leg wound order dinner. Which is the most appropriate food for the nurse select to promote wound healing?

Fish To promote wound healing, the nurse should ensure that the client's diet is high in protein, vitamin A, and vitamin C. The fish is high in protein and is therefore the most appropriate choice to promote wound healing.

A patient has been prescribed orlistat (Xenical) for the treatment of obesity. When providing relevant health education for this patient, the nurse should ensure the patient is aware of what potential adverse effect of treatment?

Flatus with oily discharge Side effects of orlistat include increased frequency of bowel movements, gas with oily discharge, decreased food absorption, decreased bile flow, and decreased absorption of some vitamins. This drug does not cause bowel incontinence, abdominal pain, or heat intolerance. (

Which of the following is the major carbohydrate that tissue cells use as fuel?

Glucose Glucose is the major carbohydrate that tissue cells use as fuel. Proteins are a source of energy after they are broken down into amino acids and peptides. Chyme stays in the small intestine for 3 to 6 hours, allowing for continued breakdown and absorption of nutrients. Ingested fats become monoglycerides and fatty acids by the process of emulsification

The client with osteoarthritis is seen in the clinic. Which assessment finding indicates the client is having difficulty implementing self-care?

Has a weight gain of 5 pounds

During Mrs. Feldman's physical assessment, she informs you that her stools have been red lately. Which of the following will the nurse include in her assessment questioning?

Have you been eating beets?"

The nurse is reinforcing diet teaching for a patient s diagnosed with IBS. The nurse instructs the patient to include which of the following in his diet?

High-fiber diet A high-fiber diet is prescribed to help control diarrhea and constipation. Foods that are possible irritants, such as caffeine, spicy foods, lactose, beans, fried foods, corn, wheat, and alcohol, should be avoided. Fluids should not be taken with meals because this results in abdominal distention.

A nurse consulting with a nutrition specialist knows it's important to consider a special diet for a client with chronic obstructive pulmonary disease (COPD). Which diet is appropriate for this client?

High-protein Breathing is more difficult for clients with COPD, and increased metabolic demand puts them at risk for nutritional deficiencies. These clients must have a high intake of protein for increased calorie consumption. Full liquids, 1,800-calorie ADA, and low-fat diets aren't appropriate for a client with COPD.

A nurse is learning about religious dietary restrictions at a nursing conference. Which of the following religious meal selections should the nurse understand is appropriate?

Hindus: Vegetable plate Dietary restrictions associated with religions are extremely important to provide culturally competent nursing care. Hindus do not consume beef because cows are considered a sacred creature. They are typically vegetarians; therefore, a vegetable plate is appropriate for this client. Orthodox Jews must have Kosher foods. Shrimp and pork are prohibited in this religion. Mormons do not use coffee, tea, or alcohol and they limit their meat consumption.

A nurse is caring for a patient who is acutely ill and has included vigilant oral care in the patient's plan of care. Why are patients who are ill at increased risk for developing dental caries?

Inadequate nutrition and decreased saliva production can cause cavities Many ill patients do not eat adequate amounts of food and therefore produce less saliva, which in turn reduces the natural cleaning of the teeth. Stress response is not a factor, infections generally do not attack the enamel of the teeth, and the fluoride level of the patient is not significant in the development of dental caries in the ill patient.

A severely dehydrated adolescent admitted to the hospital with hypotension and tachycardia undergoes evaluation for electrolyte disturbances. Her history includes anorexia nervosa and a 20-lb (9.1-kg) weight loss in the past month. She is 5′ 7″ (1.7 m) tall and weighs 80 lb (36.3 kg). Which nursing intervention takes highest priority?

Initiating caloric and nutritional therapy as ordered A client with anorexia nervosa is at risk for death from self-starvation. Therefore, initiating caloric and nutritional therapy takes highest priority. Behavioral modification (in which client privileges depend on weight gain) and psychotherapy (which addresses the client's low self-esteem, guilt, anxiety, and feelings of hopelessness and depression) are important aspects of care but are secondary to stabilizing the client's physical condition. Monitoring vital signs and weight is important in evaluating nutritional therapy but doesn't take precedence over providing adequate caloric intake to ensure survival.

Which of the following is the recommended dietary treatment for a client with chronic cholecystitis

Low-fat diet The bile secreted from the gallbladder helps the body absorb and break down dietary fats. If the gallbladder is not functioning properly, then it will not secrete enough bile to help digest the dietary fat. This can lead to further complications; therefore, a diet low in fat can be used to prevent complications. A low-fat diet is recommended because a malfunctioning gallbladder will not secrete sufficient bile to breakdown dietary fats.

The nurse is conducting discharge education for a patient who is to go home with parenteral nutrition (PN). The nurse sees that the patient understands the education when the patient indicates which of the following is a sign and/or symptom of metabolic complications?

Loose, watery stools Explanation: When the patient indicates that loose watery stools are a sign/symptom of metabolic complications, the nurse evaluates that the patient understands the teaching of metabolic complications. Signs and symptoms of metabolic complications from PN include neuropathies, mentation changes, diarrhea, nausea, skin changes, and decreased urine output.

Mrs. R. has developed an abscess following abdominal surgery and her food intake has been decreasing over the past 2 weeks. Which of the following laboratory findings may suggest the need for nutritional support?

Low serum albumin levels Serum albumin levels are a good indicator of a patient's nutritional status; decreased levels are suggestive of malnutrition. Protein in the patient's urine, low blood sugars, and increased white blood cells are not necessarily indicative of malnutrition.

A patient has completed induction therapy and has diarrhea and severe mucositis. What is the appropriate nursing goal?

Maintain nutrition. Maintaining nutrition is the most important goal after induction therapy because the patient experiences severe diarrhea and can easily become nutritionally deficient as well as develop fluid and electrolyte imbalance. The patient is most likely not in pain at this point, and this is an intervention not a goal.

Donald, a newly graduated nurse, is working in a pediatric clinic. Today he sees Karen, a 1-month-old infant, and her single mother. The mother is estranged from Karen's father but is marrying her high school sweetheart next week. Donald remembers from nursing school that which of the following will affect an infant's growth and development? Choose all that apply.

Mother's prenatal nutrition • Genetics of mother • Environment of infant

An elderly client has a decubitus ulcer with drainage, dysphagia, and immobility. She consumes less than 300 calories per day and has a large amount of interstitial fluid. She is in a state of

Negative nitrogen balance A negative nitrogen balance exists when excretion of nitrogen exceeds the intake.

A client is receiving continuous tube feedings at 75 mL/hr. The nurse has checked the residual volume 4 hours ago as 250 mL. The nurse now assesses the residual volume as 325 mL. The first action of the nurse is to

Notify the physician The second residual volume is greater than the first. When excessive residual volume (more than 200 mL) of a nasogastric feeding occurs twice, the nurse notifies the physician. The nurse does not discard the aspirate because the client has partially digested this fluid. After discussing with the physician, the nurse may stop the continuous feeding for some time or decrease the rate of infusion.

The nurse is conducting a community health education program on obesity. The nurse includes which of the following diseases/disorders in the program?

Obstructive sleep apnea The nurse includes that obstructive sleep apnea is a disease/disorder associated with obesity as well as asthma; breast, endometrial, prostate, renal, colon, and gallbladder cancer; osteoarthritis, coronary artery disease, cholecystitis, cholelithiasis, chronic back pain, diabetes, hypertension, coronary artery disease, heart failure, and pulmonary embolism.

An athlete wants to increase the intake of complex carbohydrates and asks the nurse about potential sources. Which of the following foods is considered a complex carbohydrate?

Pasta Starches such as grains (e.g., pasta, rice, bread, cereals) are considered complex carbohydrates. Honey belongs in the category of sugars, which is considered a simple carbohydrate. Peanuts and eggs belong in the protein category

You are a student nurse who is assisting the school nurse with a health fair for a middle school. You assess the students' height and weight as they file through your station. You observe that there is a large variation in physical size and emotional maturity. Which of the following factors may affect physical growth of children?

Physical activity • Prenatal nutrition • Heredity

The nurse is teaching an adolescent with celiac disease about dietary changes that will help maintain a healthy lifestyle. Which of the following foods can the nurse safely recommend as part of the adolescent's diet? Select all that apply.

Potatoes • Apples • Corn Explanation: Celiac disease is an intolerance to the gluten factor of protein found in grains. Specific grains to be removed from the diet include wheat, rye, oats, and barley. Clients with a diagnosis of celiac disease can tolerate corn, fruits, and vegetables.

A patient tells the nurse that his stool was colored yellow. The nurse assesses for which of the following?

Recent foods ingested Explanation: The nurse should assess for recent foods that the patient ingested, as ingestion of senna can cause the stool to turn yellow. Ingestion of bismuth can turn the stool black and, when occult blood is present, the stool can appear to be tarry black.

A patient tells the nurse that his stool was colored yellow. The nurse assesses for which of the following?

Recent foods ingested The nurse should assess for recent foods that the patient ingested, as ingestion of senna can cause the stool to turn yellow. Ingestion of bismuth can turn the stool black and, when occult blood is present, the stool can appear to be tarry black.

A patient is receiving continuous tube feedings. The nurse would maintain the patient in which position at all times?

Semi-Fowler's with the head of the bed elevated 30 to 45 degrees

A nurse is reviewing a client's laboratory values. Which laboratory value would be indicative of a client's level of malnutrition?

Serum albumin Explanation: Serum albumin levels can help measure protein levels in the body and are good indicators for nutrition status. The other choices would not reflect malnutrition status

As a nurse educator, you have been invited to your local senior center to discuss health-maintaining strategies for older adults. During your education session on nutrition, you approach the subject of diabetes mellitus, its symptoms, and consequences. One of the women in your lecture group asks if you know the death rate from diabetes mellitus. What is your response?

Seventh cause of death in the United States At present, diabetes is the seventh cause of death in the United States.

A nurse is caring for a client who has a malabsorption disease. The nurse should understand which of the following structures in the gastrointestinal system absorbs the majority of digested food and minerals?

Small intestine Most absorption of digested food and minerals occurs in the small intestines. The stomach is responsible for storing food, secreting digestive enzymes, and digestion. The large intestine forms feces and absorbs water to regulate the consistency of stool. The digestive function of the liver is the production of bile.

Why should total parental nutrition (TPN) be used cautiously in clients with pancreatitis?

Such clients cannot tolerate high-glucose concentration. Total parental nutrition (TPN) is used carefully in clients with pancreatitis because some clients cannot tolerate a high-glucose concentration even with insulin coverage. Intake of coffee increases the risk for gallbladder contraction, whereas intake of high protein increases risk for hepatic encephalopathy in clients with cirrhosis. Patients with pancreatitis should not be given high-fat foods because they are difficult to digest

What recommendation should the nurse give a family about appropriate beverages for children?

Sugary drinks, including juice, should be avoided. Correct Explanation: Sugary drinks contain empty calories and considered to be a major factor in the childhood obesity epidemic. Juice should be limited to no more than 120 to 180 mL per day. Water from community sources is more likely to contain fluoride that promotes dental health than bottled water. Sports drinks are considered sugary drinks. Unless a child has had excessive fluid loss, water is all that is needed to stay hydrated during physical activity. (less)

What are the symptoms a nurse should assess for in a patient with lymphedema as a result of impaired nutrition to the tissue?

Ulcers and infection in the edematous area In a patient with lymphedema, the tissue nutrition is impaired from the stagnation of lymphatic fluid, leading to ulcers and infection in the edematous area. Later, the skin also appears thickened, rough, and discolored. Scarring does not occur in patients with lymphedema, and cyanosis is a bluish discoloration of the skin and mucous membranes.

A nurse is caring for a patient with a diagnosis of trigeminal neuralgia. Which activity is altered as a result of this diagnosis?

Trigeminal neuralgia is a painful condition that involves the fifth (V) cranial nerve (the trigeminal nerve) and is important to chewing. Trigeminal neuralgia involves the fifth (V) cranial nerve (the trigeminal nerve) and is important to chewing. Trigeminal neuralgia involves the fifth (V) cranial nerve (the trigeminal nerve) and is important to chewing. Trigeminal neuralgia involves the fifth (V) cranial nerve (the trigeminal nerve) and is important to chewing

The nurse is caring for a client with chronic gastritis. The nurse monitors the client knowing that this client is at risk for which vitamin deficiency?

Vitamin B12 Clients with chronic gastritis from vitamin deficiency usually have evidence of malabsorption of vitamin B12 caused by the production of antibodies that interfere with the binding of vitamin B12 to intrinsic factor. However, some clients with chronic gastritis have no symptoms. Vitamins A, C, and E are not affected by gastritis.

Which of the following indicates an overdose of lactulose?

Watery diarrhea Correct Explanation: The patient receiving lactulose is monitored closely for the development of watery diarrheal stool, which indicates a medication overdose.

A client is admitted to the health center with chronic diarrhea. When should the nurse begin imparting health teaching about the benefits of proper diet to the client so that the risk of diarrhea is minimized?

When admitting the client Potential teaching needs should be identified from the time when the client is admitted. The client would therefore need to be taught the benefits of a proper diet during admission so as to minimize the risk of diarrhea. There is a greater probability of the client retaining the teaching if the teaching starts during admission. The teaching may be amended during the caring, treatment, and discharge phases.

A client is admitted with multiple pressure ulcers. When developing the client's diet plan, the nurse should include:

ground beef patties. Explanation: Meat is an excellent source of complete protein, which this client needs to repair the tissue breakdown caused by pressure ulcers. Oranges and broccoli supply vitamin C but not protein. Ice cream supplies only some incomplete protein, making it less helpful in tissue repair.

In evaluating a client's response to nutrition therapy, which laboratory test would be of highest priority to examine?

albumin level

The nurse is preparing to teach a client with a peptic ulcer about the diet that should be followed after discharge. The nurse should explain that the diet should include:

any foods that are tolerated. Diet therapy for ulcer disease is a controversial issue. There is no scientific evidence that diet therapy promotes healing. Most clients are instructed to follow a diet that they can tolerate. There is no need for the client to ingest only a bland or high-protein diet. Milk may be included in the diet, but it is not recommended in excessive amounts. (

After teaching the parent of a child with severe burns about the importance of specific nutritional support in burn management, which selection of foods, if chosen by the parent from the child's diet menu, indicate the need for further instruction?

bacon, lettuce, and tomato sandwich; milk; and celery and carrot sticks Explanation: Hypoproteinemia is common after severe burns. The child's diet should be high in protein to compensate for protein loss and to promote tissue healing. The child will also require a diet that is high in calories and rich in iron. The menu of bacon, lettuce, and tomato sandwich; milk; and celery sticks is lacking in sufficient protein and calories.

A 22-year-old female client has lactose intolerance. After teaching her about foods that will help her maintain adequate calcium intake, which client responses identifying foods to eat or drink indicates to the nurse that the client understands the teaching plan? Select all that apply.

broccoli • canned sardines • soy milk • almonds Persons who have lactose intolerance should avoid dairy products such as milk, most cheeses, yogurt, and ice cream. In order to obtain adequate intake of calcium the client should eat broccoli, canned sardines or salmon (with ground up bones), almonds, soy milk, or calcium-enriched foods such as tofu or orange juic

The client who is receiving chemotherapy is not eating well but otherwise feels healthy. What should the nurse suggest the client eat?

broiled chicken, green beans, and cottage cheese Carbohydrates are the first substance used by the body for energy. Proteins are needed to maintain muscle mass, repair tissue, and maintain osmotic pressure in the vascular system. Fats, in a small amount, are needed for energy production. Chicken, green beans, and cottage cheese are the best selection to provide a nutritionally well-balanced diet of carbohydrate, protein, and a small amount of fat. Cereal with milk and strawberries as well as toast, gelatin dessert, and cookies have a large amount of carbohydrates and not enough protein. Steak and french fries provide some carbohydrates and a good deal of protein; however, they also provide a large amount of fat

Which adverse effects occur when there is too rapid an infusion of TPN solution?

circulatory overload Too rapid infusion of a TPN solution can lead to circulatory overload. The client should be assessed carefully for indications of excessive fluid volume. A negative nitrogen balance occurs in nutritionally depleted individuals, not when TPN fluids are administered in excess. When TPN is administered too rapidly, the client is at risk for receiving an excess of dextrose and electrolytes. Therefore, the client is at risk for hyperglycemia and hyperkalemia.

The nurse is evaluating the client's risk for cancer and recommends changes when the client states she

eats red meat such as steaks or hamburgers every day

The client with a major burn injury receives total parenteral nutrition (TPN). The expected outcome is to:

ensure adequate caloric and protein intake. Explanation: Nutritional support with sufficient calories and protein is extremely important for a client with severe burns because of the loss of plasma protein through injured capillaries and an increased metabolic rate. Gastric dilation and paralytic ileus commonly occur in clients with severe burns, making oral fluids and foods contraindicated. Water and electrolyte imbalances can be corrected by administration of IV fluids with electrolyte additives, although TPN typically includes all necessary electrolytes. Resting the gastrointestinal tract may help prevent paralytic ileus, and TPN provides vitamins and minerals; however, the primary reason for starting TPN is to provide the protein necessary for tissue healing.

The school nurse is concerned about nutrition for school-age children. Which meal plan should be selected for a nutritious lunch?

grilled chicken with celery and carrot sticks and apple slices

What type of diet should the nurse teach the parents to give an older infant with cystic fibrosis (CF)?

high-calorie diet Explanation: CF affects the exocrine glands. Mucus is thick and tenacious, sticking to the walls of the pancreatic and bile ducts and eventually causing obstruction. Because of the difficulty with digestion and absorption, a high-calorie, high-protein, high-carbohydrate, moderate-fat diet is indicated.

A child with cystic fibrosis has been admitted to the pediatric unit. What type of diet should the nurse request for the client?

high-calorie, high-protein A high-calorie, high-protein diet is necessary to ensure adequate growth. Some children require up to two times the recommended daily allowance of calories (increased calorie diet includes foods high in fat and balanced carbohydrates). Pancreatic enzyme activity is lost and malabsorption of fats, proteins, and carbohydrates occurs.

Which diet would be most appropriate for the client with ulcerative colitis?

high-protein, low-residue Correct Explanation: Clients with ulcerative colitis should follow a well-balanced high-protein, high-calorie, low-residue diet, avoiding such high-residue foods as whole-wheat grains, nuts, and raw fruits and vegetables. Clients with ulcerative colitis need more protein for tissue healing and should avoid excess roughage. There is no need for clients with ulcerative colitis to follow low-sodium diets.

A client is receiving total parenteral nutrition (TPN) solution. The nurse should assess a client's ability to metabolize the TPN solution adequately by monitoring the client for which sign?

hyperglycemia During TPN administration, the client should be monitored regularly for hyperglycemia. The client may require small amounts of insulin to improve glucose metabolism. The client should also be observed for signs and symptoms of hypoglycemia, which may occur if the body overproduces insulin in response to a high glucose intake or if too much insulin is administered to help improve glucose metabolism. Tachycardia or hypertension is not indicative of the client's ability to metabolize the solution. An elevated blood urea nitrogen concentration is indicative of renal status and fluid balance.

The nurse should teach the client with hepatitis A to:

increase carbohydrates and protein in the diet. Low-fat, high-protein, high-carbohydrate diet is encouraged for a client with hepatitis to promote liver rejuvenation. Nutrition intake is important because clients may be anorexic and experience weight loss. Activity should be modified and adequate rest obtained to promote recovery. Social isolation should be avoided, and education on preventing transmission should be provided; the client does not need to sleep in a separate room.

What health problem may occur in a person who is on a low-carbohydrate diet for a long period of time?

ketosis Explanation: Although exact requirements for carbohydrates have not been established, at least 50 to 100 g is needed daily to prevent ketosis. Ketosis is an abnormal accumulation of ketone bodies that is often associated with acidosis. (l

A mother who is breastfeeding and has known food sensitivities is asking the nurse what foods she should avoid in her diet. Which foods should the nurse advise the client to avoid? Select all that apply.

peanuts • eggs • shellfish Correct Explanation: Some providers recommend that breastfeeding mothers avoid consuming potentially allergic foods. The top 6 foods known to cause allergies in children are shellfish, peanuts, eggs, milk, soy, and tree nuts

The nurse administers fat emulsion solution during TPN as prescribed based on the understanding that this type of solution:

provides essential fatty acids. The administration of fat emulsion solution provides additional calories and essential fatty acids to meet the body's energy needs. Fatty acids are lipids, not carbohydrates. Fatty acids do not aid in the metabolism of glucose. Although they are necessary for meeting the complete nutritional needs of the client, fatty acids do not necessarily help a client maintain normal body weight. (

When instructing the client with severe burns about proper nutrition, the nurse should encourage the client to choose which menu for lunch?

roast beef sandwich, milkshake, and cottage cheese Explanation: A roast beef sandwich, milkshake, and cottage cheese would provide the burn victim with the extra protein and calories needed for healing. The other meals provide fewer calories and less protein than is optimal and would not be the preferred choice for the client with severe burns.

An older adult has vertigo accompanied with tinnitus as the result of Ménière's disease. The nurse should instruct the client to restrict which dietary element?

sodium Ménière's disease is commonly seen in older women; the disorder is caused by pressure within the labyrinth of the inner ear as a result of excess endolympha resulting in swelling in the cochlea. Therefore, the nurse should instruct the client about dietary restrictions of sodium to reduce fluid retention. Pharmacologic treatment includes antivertiginous drugs and diuretics. If the client is prescribed a diuretic, the fluid and electrolytes are monitored. The amount of protein does not have a direct influence in this disease process.