Chapter 19: Nutrition for Patients with Diabetes Mellitus
A newly diagnosed diabetic tells the nurse she is using the Exchange Lists for Meal Planning but is having difficulty remembering when a food or beverage is considered to be free. What would be the best response? A) A good guide is the "free food list." B) When the portion size is less than 1 oz C) When it is a nonfat product D) When the client has consumed the recommended number of daily servings from each exchange list
A
The nurse is assessing a client who presents with symptoms that are suspicious for type 2 diabetes. During the discussion of the past medical history, which past diagnosis should the nurse recognize as a potential risk factor? A) Gestational diabetes 7 years ago B) Hypertension C) Yo-yo dieting with weight fluctuations D) A great-grandparent with diabetes
A
The nurse is discussing the different types of groups in the exchange list plan with a newly diagnosed diabetic. The nurse explains that there are three sublists in the fat exchange list. Which of the following would be the reason for the different sublists? A) Type of fat B) Amount of fat C) Amount of cholesterol D) Amount of calories
A
The nurse is discussing the need of some clients with type 2 diabetes to take exogenous insulin. Which of the following would be the correct reason for these clients needing exogenous insulin? A) Lifestyle interventions are not achieving glycemic control. B) The client is not exercising enough. C) The client is not following the caregiver's care plan. D) The client is not eating enough.
A
The nurse is discussing vitamin and minerals and their action in diabetes with the nutrition class. What essential mineral has been studied for its possible role in the prevention and treatment of diabetes? A) Chromium B) Manganese C) Zinc D) Potassium
A
The nurse is providing nutrition education to a group of new diabetics. Today's topic is learning how to read nutrition labels. The nurse recognizes that more discussion is necessary when one of the participants say which of the following? A) "One cup of any canned food equals one carbohydrate exchange." B) "Some products may count in more than one group." C) "If sugar is the first ingredient, there may be too much sugar in this product." D) "It's important to note the serving size."
A
The nurse needs to clarify information on the nutrition recommendations for managing diabetes when she hears one of the students state which of the following? A) A diabetic needs to keep the amount of carbohydrate at each meal in a given day equal. B) A diabetic needs to keep total calories to weight maintenance levels to prevent weight gain. C) A diabetic needs to adjust per-meal doses of insulin based on amount of carbohydrate to be consumed to control postprandial hyperglycemia. D) A diabetic needs to make sure their carbohydrate intake is consistent with the activities of the day and the amount of insulin taken.
A
Many diabetics plan their meals from the exchange lists for meal planning. According to the exchange list, a serving of milk may be exchanged for which of the following? Select all that apply. A) Fruit B) Starch C) Other carbohydrates D) Vegetables E) Meat
A, B
The diabetic class is discussing metabolic syndrome. This can occur with individuals with type 2 diabetes. Which of the following abnormalities make up metabolic syndrome? Select all that apply. A) Hypertension B) Central obesity C) Low triglycerides D) Low high-density lipoprotein (HDL) E) Low low-density lipoprotein (LDL)
A, B, D
The nurse is helping a group of diabetics learn how to use the exchange lists. She asks them to name a food item that represents one carbohydrate choice. Which of the following correctly demonstrates one carbohydrate choice? Select all that apply. A) 1/2 cup of potatoes B) 2 tablespoons of dried apricots C) 1 cup of oatmeal D) 3/4 cup of strawberries E) 1 slice of whole wheat bread F) 1/2 cup of peas
A, B, F
The nurse is doing client education with a newly diagnosed diabetic. One thing the nurse teaches is appropriate initial treatment for a diabetic experiencing hypoglycemia. Which of the following are appropriate initial treatments for hypoglycemia? Select all that apply. A) A regular carbonated beverage B) A chocolate bar C) Life Savers D) Gum drops E) Chocolate cookies
A, C, D
A 19-year-old college student has come to the college health clinic for information on how to decrease his risk for developing diabetes. He is concerned because he is overweight and he just learned his mother has been diagnosed with type 2 diabetes. The nurse provides him with information and makes several suggestions he can do. Which of the following is one of those suggestions? A) Eliminate fats from his diet B) Consume low-saturated fats C) Exercise an average of 250 minutes/week D) Weight loss of at least 15% within the next 6 months
B
In the diabetic class on exercise, the nurse stresses that insulin users should test their blood glucose level before exercising. At what blood glucose level would the diabetic need to eat a carbohydrate snack before exercising? A) 70 mg/dL B) 100 mg/dL C) 110 mg/dL D) 130 mg/dL
B
Nutrient recommendations for the intake of fat are the same for diabetics as for people with preexisting cardiovascular disease. What is this recommendation? A) Keep trans fat as high as possible. B) Limit saturated fat to less than 7% of total calories. C) Polyunsaturated fat should provide up to 20% of total calories. D) The level of monounsaturated fat should be the total daily calorie intake.
B
Primary and secondary prevention of diabetes is consistent with the recommendations for the primary and secondary prevention of coronary heart disease. Which of the following are people with diabetes urged to limit their intake of? A) Fiber B) Saturated fat C) Sucrose D) Nonnutritive sweeteners
B
The nurse emphasizes that nutrition therapy is the basis of treatment for all diabetics in the nutrition class. Which of the following nutrition recommendations for diabetics is true? A) Together, total carbohydrate and monounsaturated fat should provide less than 50% of total calories. B) Glycemic control is dependent on matching carbohydrate intake with the action of insulin or other medication. C) Natural sources of fructose (fruits, vegetables) should be restricted. D) Gram for gram, sucrose cannot replace starch without causing a deleterious effect on glucose levels.
B
The nurse is assessing the pregnant client for the risk of developing gestational diabetes. When should women who are at high risk for gestational diabetes be screened for the disease? A) Between 24 and 28 weeks' gestation B) Before or shortly after conception C) At 36 weeks' gestation D) At about 40 weeks' gestation
B
The nurse is teaching a nutrition class with a group of student nurses. One of the students asks why the meat and meat exchange list is divided into four subgroups. Which of the following is the most appropriate answer? A) It is divided due to protein content. B) It is divided due to fat content. C) It is divided due to cholesterol content. D) It is divided due to minerals content.
B
The nurse is working with a client who has had difficulty maintaining adequate control of his type 2 diabetes. During the course of the conversation, the client mentions that he gets tired of adding up all the calories and forgets to do it sometimes. What suggestion can the nurse make to help this client? A) Download an app to his smartphone from the ADA to help count calories. B) Switch to the exchange list system. C) Concentrate on checking his glucose before each meal. D) Make a daily plan and follow it precisely.
B
The client is learning how to plan his meal using the exchange list to maintain a 2000-calorie diet. The client knows that he can choose from a variety of foods as long as he uses the correct number of choices with each meal. Which of the following are correct guidelines for his carbohydrate choices per meal in the 2000-calorie plan? Select all that apply. A) 2 servings from milk group B) 1 serving from the bread, cereal, rice, and pasta group C) 1 serving of fruit D) 3 servings of nonstarchy foods
B, C, D
Children and adolescents with diabetes create unique problems when managing their care. What is the best meal plan for children and adolescents with diabetes? A) High glycemic index B) Carbohydrate counting C) Individualized meal plans D) Exchange lists
C
Recommended daily allowances for diabetics can be different than for the general population. What is the recommended intake of fiber for diabetics? A) Less fiber than currently recommended for the general population B) More fiber than currently recommended for the general population C) The same amount of fiber as currently recommended for the general population D) Most fiber in the form of insoluble fiber
C
The nurse asks a student in the nutrition class to give an example of a medium-fat meat and meat substitute group food. Which of the following is the best response? A) 1 oz of cottage cheese B) 1 tablespoon of peanut butter C) 1 egg D) 1 small hot dog
C
The nurse is caring for a client with chronic, well-controlled diabetes who is post-op for a knee replacement. The client is confused by the menu choices as he has been following the ADA diet. What diet has replaced the traditional standard "ADA diet" for hospitalized clients with diabetes? A) Carbohydrate counting diet B) Exchange lists for meals diet C) Consistent carbohydrate diet D) High glycemic index diet
C
The nurse is teaching a class of newly diagnosed adolescent diabetics. The topic for tonight is hypoglycemia. The nurse asks one young man to name one thing that can cause hypoglycemia in an insulin-dependent diabetic. Which of the following would be an acceptable answer? A) Acute illness B) Stress C) Delaying meal time D) Too much food
C
Type 1 diabetics who are well-controlled can consume alcohol without adversely affecting their blood glucose, if they drink in moderation and drink with meals instead of between meals. Why are they advised to drink with meals? A) They are less likely to consume too much alcohol when it is taken with meals. B) It aids in the digestion of food when consumed at the same time. C) It increases the risk of hypoglycemia when consumed between meals. D) Taken with meals, it tends to cause people to eat less.
C
Acute episodes of illness can create problems for insulin-dependent diabetics. During these periods of acute illness, what should insulin-dependent diabetics do? A) Insulin-dependent diabetics should not take insulin. B) Insulin-dependent diabetics should not eat. C) Insulin-dependent diabetics should use regular sweetened carbonated beverages, gelatin, ice cream, and popsicles to consume the exact amount of carbohydrate normally allowed. D) Insulin-dependent diabetics should use regular sweetened carbonated beverages, gelatin, ice cream, and popsicles to consume between 45 and 50 g of carbohydrates every 3 to 4 hours.
D
The cause of the long-term complications of diabetes is poorly understood. What is known are interventions that can significantly lower the incidence of these long term complications. Which of the following is one of these interventions? A) Controlling blood lipid level, carbohydrate intake, and blood glucose level B) Controlling protein intake, blood pressure, and blood lipid level C) Controlling blood glucose levels, triglyceride level, and weight D) Controlling blood glucose levels, blood pressure, and blood lipid level
D
The client is a 19-year-old female who appears to be in a prediabetic stage. Anxious to lose weight, she wants to know which diet other diabetics follow to help her lose weight. Which of the following should the nurse recommend? A) 1200-calorie MyPlate plan B) 1400-calorie Exchange Lists plan C) Low-fat, low-carbohydrate diet D) Individualized to each individual
D
The clinic nurse is caring for a diabetic client who has frequent episodes of hypoglycemia. What would be the best intervention for this client? A) Encourage the client to gain weight. B) Encourage the client to eat three large meals per day. C) Counsel the client to limit total carbohydrate intake to less than 100 g/day. D) Counsel the client to encourage better compliance.
D
The nurse has been teaching a client with type 2 diabetes menu planning using the exchange list based on a 2000-calorie diet. The nurse asked the client to plan several dinner menus. Which of the following menus demonstrates the client's understanding of the exchange diet? A) 1 cup of spaghetti noodles, 4 meatballs, 1/2 cup of spaghetti sauce; coleslaw, 1 slice of buttered garlic bread, and 1 cup of milk B) 4 oz of broiled hamburger patty, 1 cup of mashed potatoes with butter, 1 cup of green beans, and 1 cup of low-fat vanilla ice cream C) 1 1/2 cups of chicken noodle soup (1/2 cup of chicken breast, 1 cup of egg noodles, chopped carrots, onions, celery, and broth), 1 oz of saltine crackers, 1 cup of hot tea with 1 teaspoon of honey D) 1 taco shell, 3 oz of taco meat; 1 1/2 cups combined chopped lettuce, tomato, onion; 1/3 cup of rice; and 1 cup of papaya
D
The nurse is caring for a 21-year-old female with type 1 diabetes who is on a 2000-calorie diet. The nurse knows the client understands the diabetic teaching when she states, "I need four carbohydrate choices at breakfast." Which of the following menus indicates her understanding? A) 3/4 cup of low-fat granola, 8 oz of plain yogurt, coffee, and 2 cups of orange juice B) 1 cup of orange juice, 1 waffle topped with 1/2 cup of blueberries, and coffee C) A parfait consisting of 1 1/4 cups of strawberries, 1/2 cup of low-fat granola, 6 oz of plain yogurt, and black coffee D) Black coffee, 1/2 cup of orange juice, 1 low-fat waffle topped with 3/4 cup of blueberries, and 1 teaspoon of light margarine
D
The nurse is teaching a nutrition class and knows the students understand the content of the lecture on nutrition and diabetes when a student is heard to say, "Nutrition therapy is the cornerstone of treatment for" which of the following? A) Pregnant diabetics B) Type 1 diabetics C) Type 2 diabetics D) All diabetics
D
The nurse is teaching a nutrition class for nursing students. The topic for today is nutrition therapy for diabetic older adults. What is the most important factor impacting glycemic control in adults? A) People naturally lose weight as they age. B) Older adults eat less sugar than younger adults. C) Older adults metabolize carbohydrates differently than younger adults. D) Serum blood sugar levels rise with age.
D
The nursing class has been given the assignment of making a 2000-calorie menu for diabetics based on the carbohydrate counting method. What would be the best choice for a bedtime snack on this diet plan? A) 1 cup of shredded wheat and 1 cup of whole milk B) 1 cup of cubed papaya and a mocha latte C) 1 cup of chocolate ice cream and 1 cup of nonfat milk D) 3 cups of no-fat-added popcorn and 1 cup of nonfat milk
D
