Exam 3 matching/practice questions

C;

17. A client being treated for leukemia reports that he is "too tired to fix meals, let alone eat." What intervention would the nurse utilize to best assist the client in meeting nutritional goals? A. Try new foods in the diet to add variety. B. Include more favorite foods in the diet. C. Increase the amount of easily prepared foods in the diet. D. Try ginger ale to settle the stomach.

A; slow and steady weight gain is desirable for anorexic clients

17. The nurse is developing the plan of care for a client with anorexia nervosa. An appropriate outcome for the nursing diagnosis of imbalanced nutrition: less than body requirements is that the client will: A. Gain one to two pounds per week. B. Gain five pounds per week. C. Gain one pound daily. D. Gain one half-pound daily.

Low-bacterial diet (neutropenic diet)

Diet used for clients who undergo bone marrow transplants because they are prone to develop infection due to profound immunosuppression treatment regimens; restriction of foods that are high in bacteria sources, such as fresh fruits, vegetables, raw items and black pepper; used when client's absolute neutrophil count is <1,000/mm3

Acute illness

Disease process or traumatic event that has a rapid onset, requiring prompt medical attention to restore balance.

Graft vs. host disease

Disease process that occurs in response to a transplanted organ that leads to acute and chronic changes culminating in possible organ rejection.

Chronic illness

Disesase process that has no defined time limit and is characterized by periods of remission and exacerbation with resultant complications.

Anorexia

Eating disorder characterized by excessive weight loss and refusal to maintain appropriate weight for normal age and height that results in altered body image and multisystem abnormalities.

Bulemia

Eating disorder characterized by repeated cycling behaviors of binging and purging that result in altered body image and mutlisystem abnormalities.

Harris-Benedict equation

Equation used to determine client's basal energy requirement.

Bone-mineral density

Examination of bone mass using radiation methods to determine integrity of bone structure.

Sodium sensitivity

Excessive sodium intake related to increased BP, fluid retention, volume, and SVR.

15-15 rule

Treatment of hypoglycemia if blood glucose <60 mg/dL; consume 15 grams of CHO (2-3 glucose tablets; 6-10 lifesaver candies, 4-6 ounces juice; recheck blood glucose in 15 minutes, repeat if necessary.

Prothrombin time (PT)

Diagnostic laboratory test that measures activity of the intrinsic clotting pathway, denoting the effects of oral anticoagulant therapy.

Acute respiratory failure (ARF)

Clearly defined metabolic parameters (CO2 > 50 mmHg and/or O2 < 60 mmHg) whereby immediate intervention is required to sustain ventilation and perfusion.

Russell's sign

Clincal evidence of self-induced vomiting characterized by abrasions on the dorsal surface of the hand.

Carcinogenesis

The process of cancer, or uncontrolled growth of cells that tend to invade surrounding tissue and metastisize to distant body areas.

C; not B bc milk can cause mucus production and cause respiratory compromise, peanut butter can cause difficult swallowing, coffee increase respiratory rate

1. A 22-year-old client is admitted for an acute exacerbation of asthma. The diet order is "regular diet as tolerated." When the client states that she is very hungry, it would be most appropriate for the nurse to offer which diet selection? A. Clear liquids only B. Milk and crackers C. A turkey sandwich and juice D. A peanut butter sandwich and coffee

D; Eggs yolks are high in cholesterol and should be limited to 2-3 per week

1. When providing discharge instructions for a client diagnosed with coronary artery disease (CAD), the nurse gives dietary recommendations to limit the intake of which of the following foods? A. Dietary fiber B. Tuna and other salt-water fish C. Soybean products D. Egg yolks

C; Hemoglobin A1C that is within normal range reflects that glycemic control has been achieved for the past 3 month period

10. A diabetic client comes into the clinic for a follow-up visit. The nurse best determines the client has been compliant with dietary instructions over the two months since the last visit when which of the following findings are noted? A. Client's skin is warm and dry with no fissures or skin tears. B. Client's fasting blood glucose is within normal limits. C. Client's hemoglobin A1c is within normal range D. Urine testing is negative for ketones.

C; calcium supplementation is expected in clients who have renal failure due to high phosphate levels and need for dialysis therapy.

10. The nurse determines which of the following client statements indicates that dietary teaching has been successful with regard to renal failure? A. "I can eat bananas and apricots every day." B. "I can have milk and cookies each night before I go to bed." C. "I should take calcium supplements as ordered." D. "I should increase my fluid intake."

A; the formula requires percentage of body surface area of the burns

11. The nurse is caring for a client admitted with severe burns. The institution uses the Parkland formula for intravenous fluid replacement, so the nurse will need to have which of the following information? A. Weight of client and percentage of burns B. Height and weight of client. C. Weight of client and depth of burns D. Percentage and depth of burns

C; Increases in dietary protein can lead to increased uric acid formation in the urine, which will in turn lower urinary pH and cause precipitation of uric acid stones. Clients should be advised not to exceed a protein intake greater than 100 grams a day and monitor purine content of foods

11. Which of the following dietary teaching statements would the nurse provide to a client regarding renal calculi? A. The presence of renal calculi is directly correlated to dietary intake. B. Decreasing calcium intake will prevent the formation of renal calculi. C. An increase in dietary protein can increase the likelihood of renal calculi. D. Decreased dietary intake of complex carbohydrates reduced formation of renal calculi.

D; Dialysate solutions often contain calcium, which can contribute to elevation of serum calcium levels. Use of nonabsorbed phosphate binders or calcitriol (vitamin D active form) may be utilized if high calcium levels continue. In addition, a dialysate solution can be changed to one of lower calcium content. The nurse should be aware that dialysis solutions do normally contain calcium

12. A 58-year-old male client on dialysis therapy does not understand why his calcium levels are high. The client states, "all the time, I've been told that calcium levels would be low." How would the nurse respond to the client? A. "This must be a lab error and we will repeat the test." B. "Clients often experience fluctuations in calcium levels in response to dialysis therapy. This will stop after a few more dialysis treatments." C. "Calcium levels are often high in response to high potassium levels and the treatment of dialysis will decrease both of these levels." D. "The solution used during dialysis may contribute to higher calcium levels, but your calcium level will continue to be monitored and a change in solution or medication therapy may be needed."

B; the DASH diet increases daily servings of vegetables and fruits, and recommends low-fat dairy foods and reduced intake of saturated fats and cholesterol DASH= Dietary Approaches to Stop Hypertension

12. The nurse determines that a hypertensive client understands the DASH diet by choosing which of the following from a sample menu used in dietary teaching? A. Caesar salad, bread sticks, frozen yogurt B. Grilled chicken sandwich, strawberries, and lettuce salad C. Grilled chicken sandwich, pineapple, brownie D. Chicken and vegetable stir fry, rice, egg roll

A; the burn client needs increased amounts of protein and vitamins C and D until the wounds are completely healed

13. A client who is recovering from partial- and full-thickness burns has been advanced to a general diet. Which foods should the nurse encourage the client to eat most often? A. Meats, citrus fruits, and milk B. Vegetables, cheeses, and pastas C. Milkshakes, salads and juice D. Breads, cereals, and yogurts

C; the most important objective is to normalize food intake with close supervision to control purging.

14. The nurse has admitted a bulimic client who has been abusing laxatives and diet pills. What is the first goal of treatment for this client? A. Promote the development of insight into the behaviors B. Promote the acceptance of self and body C. Promote adequate nutrition and retention of food D. Promote the development of realistic expectations for dieting

A; Dialysis places the renal client at risk to develop loss of amino acids and serum proteins in the dialysate

14. Which of the following nutritional recommendations will the nurse plan to institute when a client with renal failure begins dialysis therapy? A. Slight increase in dietary protein to balance protein lost in dialysate. B. Increase fluids in diet to compensate for those lost in dialysis. C. Take megadoses of vitamin A. D. Increase potassium sources in the diet.

C; The exchange or "choice" categories refer to the protein, sodium, potassium, and phosphorus content of foods

15. A client in renal failure is being placed on the National Renal Diet and wants to know how the exchange system works. How would the nurse respond to this client's concern? A. Tell client that renal diet is exactly the same as diabetic exchange diet, since many clients with renal failure also have diabetes. B. Tell client that fat grams will be counted in the diet along with protein intake. C. Explain that renal diet is based on exchanges (or choices) related to categories of protein, sodium, potassium, and phosphorus content of foods. D. Renal diet is used for short periods of time until kidney function is back to normal.

C; a client with HTN should not be using added salt by seasoning food prior to eating.

15. The nurse has performed an admission assessment on a client with hypertension (HTN). What subjective data should the nurse further discuss with the client? A. Jogs two miles three times a week. B. Has a shot of bourbon each night. C. Uses salt on foods prior to tasting. D. Quit smoking two years ago.

D; elevating the head allows gravity to help with gastric emptying

16. How will the nurse teach a client with gastroesophageal reflux disease (GERD) to control symptoms? A. Space six meals a day between breakfast and bedtime. B. Drink 10-12 ounces of water with each meal. C. Perform daily exercises of weight lifting and situps D. Sleep with the head of the bed elevated six to eight inches

C; Hemodialysis involves the passage of blood via a vascular access device through a machine (artificial kidney) that acts to exchange and remove wastes in the body. Large amounts of protein are lost across the peritoneum in peritoneal dialysis, allowing for greater dietary intake of protein

16. What are the effects on nutrition that the nurse can anticipate when a client begins to consider use of peritoneal dialysis versus hemodialysis as a treatment method for renal failure? A. Peritoneal dialysis can lead to hypoglycemia. B. Hyperkalemia can occur in response to peritoneal dialysis. C. Peritoneal dialysis allows for greater intake of protein foods. D. Calcium restrictions are only needed for clients on peritoneal dialysis.

C; : COPD clients who overeat, in addition to eating increased carbohydrates, have increasing difficulty with the work of breathing due to excessive carbon dioxide levels that place additional stress on the lungs. The client should be educated as to the proper diet and percentages of macronutrients in order to maintain adequate weight

18. A client with chronic obstructive pulmonary disease (COPD), who has been consuming more than 3,000 kilocalories a day in the hopes of gaining weight, now reports increased breathing difficulty. The client states "I thought that if I gained weight by eating more, I would feel better." How would the nurse respond to the client's concern? A. Explain that increases in calories is not as important as increases in fat percentage in the diet. B. Explain that it is not necessary to increase caloric intake as medication therapy can be given to help with desired weight gain. C. Tell client that increase in both calories and carbohydrates can lead to increased respiratory effort and clinical symptoms that client is experiencing. D. Tell client that increase in high-quality proteins will help correct respiratory symptoms.

C; simple sugars and carbohydrates increase the osmolality of the gastric contents and ENHANCE movement of food out of the stomach. Make dumping syndrome worse

18. Which of the following client comments indicates to the nurse that more teaching is needed for the client experiencing dumping syndrome after gastric surgery? A. "I should eat six small meals per day." B. "I should not drink fluids with my meals." C. "I should use honey or jelly instead of butter." D. "I should lie down for 30-60 minutes after eating."

D; A client who has stomatitis will have pain upon ingestion of food due to the inflammatory process. Cold foods are often tolerated better than hot foods, as are milk and creamy products of soft consistency.

19. Which diet selection would be most appropriate for the nurse to recommend to an oncology client who has stomatitis? A. Peanut butter sandwich B. Potato chips C. Tomato soup D. Frozen yogurt

C; clients with type 1 or type 2 diabetes need to space meals throughout the day and eat at a consistent times to avoid hypoglycemia

19. Which of the following is advice that the nurse would give to all clients with diabetes mellitus? A. Restrict calories to lose weight. B. Limit saturated fat to 30% of the daily calories. C. Avoid skipping or delaying meals D. Avoid all use of sucrose and simple sugars.

C; a client with steatorrhea is at risk for fat-soluble vitamin deficiencies. Fat soluble vitamins in water soluble form prevent clinical deficiency

2. A client with a history of liver disease presents with steatorrhea (fat in stool due to malabsorption). The nurse plans dietary modifications to address which altered condition in the client? A. Altered protein metabolism B. An increased absorption of fat soluble vitamins C. A need for fat-soluble vitamins in water-soluble form D. A need for increased fat to reduce the presence of steatorrhea

B; foods that decrease lower esophageal sphincter pressure should be avoided to reduce reflux symptoms

2. The nurse is planning discharge teaching for the client with gastroesophageal reflux disease (GERD). What dietary modification should be included? A. Eat three meals and a bedtime snack B. Avoid intake of caffeine and alcoholic beverages C. Drink 12-16 ounces of water with each meal. D. Lie down for 15-20 minutes after eating.

A; TPN should be administered and the client is kept NPO to allow the gastrointestinal tract to rest

9. Which of the following dietary options would the nurse plan for when caring for a client with an acute exacerbation of ulcerative colitis? A. Total parenteral nutrition (TPN) B. No milk or caffeine in the diet C. Use of bulk-forming agents and fiber to decrease diarrhea D. Clear liquids

A; During acute illness secretion of both glucagon and epinephrine increases, causing an increase and blood glucose levels that may require an adjustment

20. When a client with type 1 diabetes calls to report nausea, vomiting, and diarrhea, the nurse advises the client to: A. Monitor blood glucose levels and adjust insulin accordingly. B. Keep drinking fluids to prevent dehydration. C. Eat 15 grams of carbohydrate every 15 minutes to decrease nausea. D. Come into the clinic immediately for evaluation.

D; an HIV positive client experiencing alterations in fat metabolism has malabsorption problems, Medium chain triglycerides (MCT) provide additional calories, but more importantly, are easier to digest because pancreatic lipase or bile is not needed for their digestion

20. Which of the following dietary measures would the nurse recommend for a client who is HIV-positive and experiencing alterations in fat metabolism? A. Increase amount of fats in diet to stimulate digestive enzymes. B. Increase protein intake to balance effects of altered fat metabolism. C. Increase amount of water-soluble and fat-soluble vitamins in diet. D. Provide fat calories in the form of supplemental medium chain triglycerides

D; the american diabetes association exchange lists divide food into similar content. each food within a list is similar in calories, protein, fat and carbs id eaten in a certain size portion

21. A client recently diagnosed with type 1 diabetes mellitus is learning to use the American Diabetes Association Exchange Lists. The nurse concludes that the teaching has been effective if the client chooses which of the following as an appropriate exchange for white rice? A. Egg B. Tomato C. Orange D. Bread

D; an HIV client is likely to lose weight due to repeated cycles of wasting and malnutrition. the client should be instructed how to maximize quality of intake

21. The nurse reviewing the dietary assessment of an HIV positive female client notes the client has been skipping meals and progressively losing weight. What dietary interventions would be best for the nurse to suggest to promote weight gain? A. Have the client keep a food diary recording food preferences and usual dietary pattern. B. Tell the client that her weight may fluctuate in response to her menstrual cycle so there is no need to worry for now. C. Tell the client that additional salt in the diet will help to increase weight. D. Tell the client that the use of nutrient-dense food and fortified protein shakes will help promote weight gain.

D; Sjorgren's syndrome is an autoimmune disease that destroys exocrine glands in the body and leads to a general "dryness" of the body systems. retraction of fluids is a concern bc fluids help keep the oral cavity moist and there is no immediate information that the client needs the restriction

22. A client is admitted to the hospital with a primary diagnosis of hip fracture and a secondary diagnosis of Sjorgren's syndrome. Which one of the following orders would be of most concern to the nurse with regard to the nutritional status of the client? A. NPO after midnight for surgery for a 7:30am case. B. Intravenous of Lactated Ringer's at 125 mm per hour. C. Maintain diet as tolerated. D. Restrict oral fluids to 1,000 milliliters per day

C; foods that reduce lower esophageal sphincter pressure will increase reflux symptoms. i.e. coffee, fatty foods, alc. chocolate

22. The nurse is setting up the breakfast tray for a client with gastroesophageal reflux disease (GERD) and notices one food that the client should not eat. The nurse should remove which of the following foods? A. Poached egg B. Dried toast C. Coffee with cream D. Skim milk

C; clients should remain NPO upon admission to the clinical setting with a major burn. initial fluid replacement is tarted via the parenteral route. NPO status is maintained because burn injuries may cause internal damage to body structures and aspiration can occur

23. The nurse is admitting a client with thermal burns to both arms and the anterior trunk. When the client asks for a drink of water the most appropriate response for the nurse is? A. "I'll get you a drink as soon as I establish an intravenous line." B. "I can only give you juice to drink, not water." C. "I'm sorry, you cannot have anything to drink right now; let me moisten your mouth instead." D. "Would you also like me to order you a meal tray?"

A; due to the anorexia and fatigue experienced by clients with SLE, small frequent meals are usually more tolerated

23. The nurse should provide which of the following nutritional suggestions for a client with systemic lupus erythematosus (SLE)? A. Eat small, but frequent meals throughout the day. B. Eat foods high in fat and protein. C. Avoid intake of seasoned and highly spicy foods. D. Limit intake of citric fruits and juices.

B; A client who is recovering from Guillain-Barré syndrome will need a diet that promotes positive nitrogen balance in order to counteract the effects of long periods of immobility on the body

24. A client recovering from Guillain-Barré syndrome is admitted to the rehabilitation unit. Which of the following methods does the nurse anticipate using to provide nutritional support for the client during this time? A. Use a gastrostomy tube for feeding due to high incidence of malabsorption. B. Maintenance of oral intake with adequate calories to maintain positive nitrogen balance. C. Limit of fresh fruit in the diet. D. Use of thickened liquids to prevent aspiration.

A; abuse of laxatives and diuretics is a frequent purging behavior for bulimic clients

24. Which of the following would be an appropriate intervention for the nurse to include in the plan of care for a client with a clinical diagnosis of bulimia? A. Assess for laxative and diuretic possession B. Supervise mealtimes to ensure eating C. Observe for ritualistic eating patterns. D. Reward non-burging behavior with a favorite snack

B; in a low sodium diet, foods high in sodium content should be eliminated

25. A client with congestive heart failure (CHF) has been advised to follow a low-sodium diet. Which statement by the client indicates to the nurse that diet teaching has been effective? A. "If I stop adding table salt I shouldn't have any problems." B. "I need to avoid eating processed foods and canned meats and vegetables." C. "I can still use a small amount of table salt in cooking." D. "I only have to worry about salt-tasting foods like potato chips."

A; although some raw foods could be a source of contamination to the client with HIV who is immunocompromised, it is not necessary to avoid all uncooked foods such as fruits and veggies.

25. Which of the following client statements regarding HIV/AIDS would require further clarification from the nurse? A. "I should avoid eating any raw or uncooked foods." B. "Blood tests will tell me if I have a nutritional anemia." C. "Maintaining adequate fluid and fiber will help me." D. "If I feel sick to my stomach, I should not drink liquids."

C; the disease process has a progressive effect on the clients nutritional status

26. When developing a plan of care for a client with HIV/AIDS, the nurse recognizes the following statement is true concerning the nutritional status of this disorder? A. Clients who are asymptomatic have adequate nutritional stores of nutrients. B. The HIV wasting syndrome is seen in the latter stages of the disease process. C. Malnutrition is seen as a consequence of the immune disease. D. Vitamin and mineral deficiencies occur in the latter stages of the disease process.

C; The American Heart Association recommends a diet with reduced saturated fats and cholesterol for clients with coronary artery disease. Canned peaches are high in concentrated sugars, which increase triglyceride levels. Egg yolks are high in cholesterol and whole milk is high in saturated fats

26. Which breakfast option indicates to the nurse that the client with coronary artery disease (CAD) requires further diet instruction? A. Orange juice, shredded wheat, skim milk, toast and jelly. B. Grapefruit juice, oatmeal, 1% milk, and bagel with jelly. C. Canned peaches, egg omelet, whole milk, and fruit yogurt. D. Applesauce, bagel with margarine, egg-white oatmeal and skim milk.

D;Dry mouth can be a common complaint of clients undergoing radiation therapy. Using sugar-free candies or gum will help to stimulate the flow of saliva and ease the discomfort that the client is experiencing.

27. A client is receiving radiation to the head and neck area for treatment of cancer. What interventions would the nurse use to help the client's complaint of a dry mouth? A. Have client eat prior to radiation therapy. B. Encourage client to eat larger portions of food. C. Advise client to use mouthwash. D. Suggest use of sugar-free candies

C; coffee can relax the lower esophageal sphincter pressure and lead to symptoms

27. Which nutritional measures should the nurse suggest to a client with gastroesophageal reflux disease (GERD) to minimize the risk of symptoms? A. Eat three large meals a day with no snacks. B. Use a lot of garlic to season food rather than salt. C. Limit intake of coffee drinks to two or fewer cups a day. D. Use peppermint candies to take away the bitter taste in the mouth.

B; a client recovering from burns requires high protein, high calorie diet

28. The nurse is caring for the client who is recovering from partial thickness burns. Which of the following breakfast options indicates client understanding of the recommended diet? A. Two slices of toast with butter, orange juice, and skim milk. B. Two poached eggs, hash brown potatoes, and whole milk. C. Three pancakes with syrup, two slices of bacon, and apple juice. D. One cup of oatmeal with skim milk, ½ grapefruit and coffee.

D; consistency and firmness allow the client to learn that the nurse will follow through and do what is promised

29. Which approach should the nurse use to develop a trusting relationship with the client who has an eating disorder? A. Set strict limits that are detailed and numerous. B. Encourage use of "testing" behaviors. C. Tell the client how to behave. D. Utilize consistency and gentle firmness

C; Energy requirements are established using the Harris-Benedict equation to determine the resting energy expenditure (REE). Multiplying the REE by 1.3 to 1.5 will provide energy requirements for maintenance and weight gain. Protein intake should be calculated as 1.2-1.5 grams per kilogram of actual body weight.

3. A client with AIDS is admitted for treatment of pneumonia. Laboratory test results reveal albumin of 2.8 grams per deciliter and prealbumin of 18 miligrams per deciliter; height is 62 inches and weight is 104 pounds. The nurse recognizes the dietician will utilize which of the following to establish energy and protein requirements for this client? A. Complete blood count, chemistry profile, and a chest x-ray. B. Calculation of body mass index (BMI) C. Harris-Benedict equation to determine resting energy expenditure (REE) and protein needed per kilogram of body weight D. Calculation of thermal effect of food (TEF)

C; a 2-gram sodium restricted diet requires use of no salt in cooking, no salt added at the table, and avoiding high sodium foods

3. The nurse determines a client is compliant with a 2-gram sodium restricted diet when the client reports following the dietary practices: A. Limiting the use of the salt shaker to two shakes per meal. B. Limiting milk to one cup per day. C. Avoiding the use of salt in cooking. D. Using salt-free butter with meals.

A; regular exercise can help to normalize bowel function

30. A nurse is discussing the home maintenance regimen with a client who has irritable bowel syndrome (IBS). Which of the following statements indicates client understanding? A. "I'll take a walk after dinner each evening." B. "I'll have a cigarette after meals to relax." C. "I'll chew gum between meals to curb my appetite." D. "I'll eat more fresh vegetables and fruits."

C; a client placed on low- bacteria diet is at risk for infection due to immunosuppression. hospital made only by the hospital will ensure the food is cooked thoroughly and prepared according to the standards and inclusive of allowable food items

4. A 58-year-old hospitalized female client is placed on a low-bacteria diet. Which of the following teaching instructions would the nurse provide to the client and family members regarding the prescribed diet therapy? A. Raw carrots as finger food items can be used as a snack. B. Cottage cheese and fruit can be eaten twice a day unless the client is lactose intolerant. C. The client should only eat food that has been prepared by the hospital. D. The client will be allowed to eat fresh fruits because they are a good source of vitamin C

A; Vitamin C is needed for collagen production

4. The nurse is caring for a client with burns who is just being started on food and fluids. What should now be included in the diet plan? A. Increased fluids with vitamin C. B. Reduced protein intake. C. Increased sodium intake. D. Reduced caloric intake.

Gastroparesis

Delayed emptying time and decreased GI motility that can occur as a surgical complication or as a complication of a disease process.

D; It is important to ascertain the client's concerns and allow the client to share feelings related to the diagnosis. Immediate information about diet therapy and medications is also appropriate

5. A collaborative plan of care is being developed for a 52-year-old client recently diagnosed with Parkinson's disease. Which of the following actions would be appropriate for the nurse to take at this time? A. Refer the client to a speech pathologist B. Begin active and passive range of motion exercises three times daily C. Have client return in a month to talk with physician about nutrition needs D. Discuss with client concerns related to diagnosis, nutritional therapy, and effects of medications

D; clients with spinal cord injuries are prone to develop altered elimination patters (urinary and constipation). A high fiber high liquid diet is needed to assist with bowel regulation

6. The nurse develops a plan of care for a client with a spinal cord injury (SCI) recognizing increased fluids are needed for which of the following reasons? A. To maintain weight B. To balance the effects of salt restriction C. Administer 1,000 ml a day to facilitate swallowing D. Balance high-fiber intake

D; these are symptoms of hypoglycemia, when hypoglycemic it is recommended the client ingest 15g of fast acting carb

6. The nurse has completed dietary teaching with a newly diagnosed diabetic client. It is clear that the teaching has been successful when the client states, "I'll drink one-half cup of orange juice when I experience:" A. "Nausea, vomiting, and flushed skin." B. "Fever, fast pulse, and sweating." C. "Increased urination, thirst, and dry skin." D. "Hunger, dizziness, and clammy skin."

D; the development of osteoporosis is multifactorial and the client should be informed that facts such as genetic makeup, diet, and lifestyle play a significant part

7. A 48-year-old female client is concerned about getting osteoporosis as she ages and states that she has "heard a lot about osteoporosis and calcium" but doesn't understand exactly what the relationship is. The nurse can best respond to the client's concerns with the following explanation? A. "There is an established health claim between calcium and osteoporosis." B. "Calcium intake should be maintained throughout life in order to prevent the effects of osteoporosis." C. "Calcium supplementation is advisable because most women do not eat enough calcium in the diet." D. "Calcium is needed to support bone density but that many other factors play a part in the development of osteoporosis."

C; slow, steady weight gain is the best evidence of improved nutrition and has been shown to improve the anorexic's "fat phobia"

7. An 18-year-old anorexic client has been hospitalized for the last two weeks. Which of the following is the best evidence to the nurse that the client is making progress toward improvement? A. Talking about "getting in shape." B. Attending all group sessions. C. Gaining two pounds. D. Asking for a weekend pass.

A; the client with hypoparathyroidism has low calcium and high phosphorus levels, so foods high in calcium should be encouraged.

8. When caring for a client with hypoparathyroidism, the nurse plans to include which of the following foods in the diet? A. Dairy products B. Fresh fruits C. Dark yellow and orange vegetables D. Dried beans and nuts

B; the client with hyperthyroidism has an increase metabolism and may experience fatigue and dyspnea with activity

8. Which of the following nursing diagnoses is appropriate for the nurse to use for a client with hyperthyroidism? A. Imbalance nutrition more than body requirements. B. Activity intolerance C. Constipation D. Impaired skin integrity

C; hemodialysis therapy is used to treat both acute and chronic renal disease and is itself a hyper metabolic event. dietary restrictions will still be placed on phosphorus, protein, sodium, calcium and fluids.

9. A 54-year-old female client who has newly begun hemodialysis states, "Now I can eat anything I want." How would the nurse respond to this client statement? A. "As long as you don't overdo it, there are very few dietary restrictions that you will have to follow." B. "Caloric intake will have to be increased by 3,000 kilocalories in order to meet nutritional goals." C. "You will still have to follow certain dietary restrictions since hemodialysis does not correct the underlying problem of kidney disease." D. "No fluids will be given on the day you receive hemodialysis therapy in order to prevent fluid overload."

International normalized ratio (INR)

Diagnostic laboratory standardized tests used to measure the effect of oral anticoagulant therapy.

D)

A client has been referred for dietary teaching regarding the management of hepatitis. The nurse should base development of nutritional goals on which of the following information? A. Type of hepatitis the client has, as this will affect treatment. B. Need for tube feedings to allow liver to rest and regenerate. C. Dietary fats should be limited. D. Diet should be high in calories and protein

Mutliple Organ Dysfunction Syndrome (MODS)

A continuum disease process that can occur in high acuity clients that affects mutliple organ systems in the body and often leads to vascular collapse and death.

Wasting syndrome

Chronic process whereby the client loses > 10% of body weight in the presence of diarrhea, weakness, or fever; leads to a cycle of malnutrition and wasting; is now classified as an AIDS-defining diagnosis in clients who are HIV +.

Dyslipidemia

Abnormal lipid profile in a clinical setting.

Protein-calorie malnutrition (PCM)

Also known as marasmus, inadequate protein and calorie intake characterized by protein catabolism and resulting in wasting despite normal serum albumin levels.

Homocysteine

Amino acid produced by breakdown of essential amino acids found in dietary proteins that correlates with increased incidence of heart disease and decreased levels of B vitamins

Dysgeusia

An altered sense of taste, may be due to chemotherapy or radiation.

Anemia of chronic disease (ACD)

Anemia associated with the progression of chronic disease processes as a result of decreased erythropoetin production.

Dumping syndrome

Can occur when two-thirds or more of the stomach is removed and intake of concentrated liquid leads to hyperperistalsis, diarrhea, abdominal pain, and vomiting 30-60 minutes after eating.

Parkland formula

Formula used to determine fluid replacement needs after a burn injury; 4ml LR x kg preburn body weight x % of body burned; 1/2 given over first 8 hours, 1/4 given over second 8 hours, 1/4 given over third 8 hours.

Curreri formula

Formula used to determine kilocalorie requirements after a burn injury; adult (25 kcal x kg preburn bodyweight) + (40 kcal x % of body burned); child < 12 (60 kcal x kg preburn bodyweight) + (35 kcal x % of body burned).

Hypermetabolic response

Increased energy and metabolism requirements due to stress, trauma, burns or diseased state.

Systemic inflammatory response syndrome (SIRS)

Inflammatory process that can progress to the development of MODS, occurs through the simulation of chemical mediators to an intial event.

Anticoagulation therapy

Medical therapy whereby clients receive anticoagulants to treat or prevent the risk of thromboembolic events.

Omega-3 fatty acids

Most unsaturated form of fat, decreases triglyceride levels, inflammation, clotting time, and heart arrhythmias; found in coldwater fish (mackeral, albacore tuna, salmon, sardines, lake trout, shellfish), and flaxseed.

Peak bone mass

Period in which bone mineral density and calcium retention is maximum (at 20-30 years of age), after which bone loss begins to take place.

Respiratory quotient (RQ)

Ratio measurement that looks at the volume of CO2 produced to the volume of O2 consumed.

Purine-restricted diet

Restriction of foods, such as organ meats, game, anchovies, herring, macheral, sardines, scallops, and certain grains and vegetables; prescribed primarily for clients with gout.

Cancer cachexia

Starvation syndrome resulting from malabsorption and maldigestion; ultimately there is severe depletion of lean body mass, weight loss, and wasting; end stage of cancer.

High-density lipoproteins

Substances that carry lipids away from arteries to liver for metabolism; decreased level = increased risk for coronary artery disease; level increased with exercise and estrogen.

Very low-density lipoproteins

Substances that carry lipids to tissues for use and storage; direct correlation to coronary artery disease uncertain.

Low-density lipoproteins

Substances that have affinity for artery walls; increased level = increased coronary artery disease.

APACHE criteria

Systematic method that examins physiologic status, age, and presence of chronic disease to monitor the high acuity client and provide prognostic indicators relative to treatment and outcome.

Glycosylated hemoglobin (A1c)

Test that measures degree of glucose control over the previous three months.

Dysphagia

The inability to chew, swallow, digest and absorb nutrients while passing fiber and other substances on for elimination.

Polypharmacy

Use of multiple drug profiles in clients that leads to increased likelihood of drug reactions (DRAPE- Drug related adverse pharmacological events) and hospitalizations.

Immunosuppressive therapy

Utilization of medications to prevent ogan rejection in a client who has received an organ transplant.

C) Dialysis clients are likely to be anemic due to decreased production of erythropoietin caused by renal disease. IV administration of iron is usually given to these clients because iron is not tolerated well by mouth and poorly absorbed

Which of the following methods would be appropriate for the nurse to use to increase the iron stores of a client receiving dialysis? A. Include foods that are high in iron content in the diet. B. Provide iron supplementation by mouth. C. Provide parenteral administration of iron as ordered. D. Have the client take oral iron medication with orange juice.

C; Dialysis clients are likely to be anemic due to decreased production of erythropoietin caused by renal disease. IV administration of iron is usually given to these clients because iron is not tolerated well by mouth and poorly absorbed

Which of the following methods would be appropriate for the nurse to use to increase the iron stores of a client receiving dialysis? A. Include foods that are high in iron content in the diet. B. Provide iron supplementation by mouth. C. Provide parenteral administration of iron as ordered. D. Have the client take oral iron medication with orange juice.