Chapter 18: Nutrition for Patients with Disorders of the Lower GI Tract & Accessory Organs

A client calls the clinic complaining of diarrhea that has lasted 36 hours. The nurse recommends what as nutrition therapy for this client? A) Liberal fluid intake B) Clear liquids only to decrease bowel stimulation C) Low-potassium foods D) Liberal intake of apple juice to replace nutrients

A

A client has been instructed to start a high-fiber diet to treat her chronic constipation. Which of the following suggestions will help the client make the transition easier? A) Increase the fiber intake gradually. B) Add lots of nuts and seeds to the diet. C) Add 1 cup of bran a day immediately. D) Always peel any fruit before eating.

A

A client suffering from diarrhea asks what might be the cause. The nurse knows that this client suffers from diarrhea secondary to Crohn disease. What type of diarrhea does this client have? A) Secretory B) Osmotic C) Watery D) Infectious

A

The client has come to the office with an exacerbation of his celiac disease. He says he has been reading the labels and making sure he avoids wheat, barley, and rye. After reviewing the labels with the client, the nurse recognizes which listed ingredient as a suspected culprit? A) Malt flavoring B) Sorghum C) Millet D) Carrageenan

A

The nurse is caring for a client with a new ostomy. When planning his discharge teaching, what food would be included that would help thicken his stool and control diarrhea? A) Applesauce B) Buttermilk C) Eggs D) Peas

A

The nurse is counseling a clinic client who has short bowel syndrome on how to change his diet from regular to low fat. What would be the best food to include in the menu plan? A) Sherbet B) Avocado C) Biscuits D) Coconut

A

The nurse is counseling a group of clients who have recently been diagnosed with celiac disease. One of the members in the group wants to know what is safe to use as a thickening agent in cooking. Which of the following would be a safe substitute? A) Arrowroot starch B) Cracked germ C) Durum flour D) Farina

A

The nurse is working with a client who was recently diagnosed to be lactose intolerant. The client needs to adapt to a low-lactose diet. Which of the following should the client avoid? A) Powdered meal replacement supplements B) Rice milk C) Soy sour cream D) Yogurt

A

The nurse is working with a client with lactose intolerance. What can this nurse suggest to this client to increase tolerance to small amounts of milk? A) Consume milk with food. B) Choose skim milk instead of whole milk. C) Drink milk warmed. D) Drink milk over ice.

A

The physician has recommended a low-fat diet for the client with chronic pancreatitis. The client is frustrated because he likes to eat dairy products. Which of the following should the nurse suggest this client follow? A) Choose dairy products that provide less than 1 g fat per serving. B) Switch to soy dairy products. C) Eliminate all milk products from his diet. D) Choose cheese with 5 g or less of fat.

A

The nurse is conducting discharge teaching with a client who is going home with an ileostomy. What will the nurse teach the client to consume more of? A) Salt B) Fiber C) Fat D) Vitamin B12

A - for ileostomy increase salt and limit fat

The nurse is teaching a client with chronic pancreatitis how to plan meals that decrease pancreatic stimulation. What would be the best dessert for someone with chronic pancreatitis? A) Angel food cake C) Chocolate pudding B) Ice cream D) Apple pie

A - low fat

A client has recently found she is lactose intolerant. She is concerned about getting enough calcium in her diet but doesn't want to take supplements. The nurse recommends the client include which of the following foods in her diet? A) Turnip greens B) Broccoli C) Almonds D) Carrots E) Potatoes F) Tomatoes

A, B, C

The nurse is helping the client adjust to a lactose-free diet. The client is learning to read labels to identify which products contain lactose. Which of the following are safe for the client to consume? Select all that apply. A) Lactate B) Lactic acid C) Lactalbumin D) Casein

A, B, C, D

The nurse is admitting a 42-year-old female with colon cancer to the unit. She is scheduled to have a resection with ileostomy. What do ileostomies cause a decrease in? Select all that apply. A) Fat absorption B) Carbohydrates C) Bile acid absorption D) Insoluble fiber E) Vitamin B12 absorption

A, C, E

The nurse is assisting a client with celiac disease to plan a daily menu. What food would be appropriate for this client? A) White bread B) Tapioca pudding C) Wild rice D) Instant cocoa

B

The nurse is discussing a high-fiber diet with a client and his wife. The nurse stresses the need to gradually increase fiber in the diet. The nurse warns the couple that which of the following can be an indication of increasing fiber too quickly? A) Infection B) Cramping C) Nausea D) Electrolyte imbalance

B

The nurse is doing nutritional counseling with a clinic client who complains of constipation. What would the nurse teach this client to increase in his diet? A) MTP oil B) Apples C) White bread D) White rice

B

The nurse is teaching a class on a high-fiber diet. During the discussion, it is mentioned that some clients will need some form of fiber supplement to ensure adequate intake. Which of the following is a reason for that? A) Fiber is bitter and difficult to eat. B) Most fruits, vegetables, and whole wheat breads provide only 1 to 3 g of fiber per serving. C) High-fiber diets are expensive. D) The best sources for high-fiber are only available seasonally.

B

The nurse is working with a client to try and determine if she has any food tolerances. The client has been keeping a detail food log as well as recording any symptom that happens and when. The nurse is suspecting the client is lactose intolerant. The nurse believes this because the client has a typical symptom how soon after eating dairy products? A) 15 to 30 minutes B) 15 minutes to 2 hours C) 45 minutes to 1 hour D) 2 to 3 hours

B

The nurse is caring for a client who just returned to the unit from following colon surgery. The client has a new colostomy. When the nurse begins client teaching, what should the nurse advise this client to do? A) Limit fluid to help control diarrhea. B) Increase fluid to replenish losses. C) Increase fat intake to slow gastrointestinal motility. D) Increase fiber intake because fiber absorbs water in the gut.

B - increase fluid and reassure patient that fluid does not lead to diarrhea

Celiac disease is a genetic autoimmune disorder that results in a permanent intolerance to certain proteins. What should clients with celiac disease avoid? A) Puffed rice B) Cream of wheat C) Cream of rice D) Corn flakes

B - no wheat, barley, rye

The nurse is admitting a new client to the unit who is complaining of diarrhea. The client is dehydrated and will be receiving hydration. Which of the components of the blood will the nurse expect to see below normal limits? Select all that apply. A) Phosphorus B) Sodium C) Calcium D) Potassium

B, D

A client with malabsorption syndrome is having an exacerbation. What alteration would be recommended to the diet to decrease the stimulation to the bowel? A) High-fiber diet B) High-protein diet C) Low-fiber diet D) Low-protein diet

C

The nurse is assisting a client in making a menu for a low-fiber diet. Which would be the best choice for a breakfast menu? A) Apple juice, coffee, 2 poached eggs, 2 pieces of bacon, and white toast with butter B) Hot cocoa, shredded wheat, and 2% milk C) Coffee with cream and sugar, muffin, and 2 tablespoons of butter D) Hot tea, bagel, and 2 tablespoons of cream cheese

C

The nurse is helping the client order a low-fat meal. Which of the following is the best meal for this client? A) Potato soup, grilled cheese sandwich on whole wheat bread, 2% milk, and fresh peach slices B) 3 oz of grilled hamburger with low-fat cheese slices, tomato, onions, and 2 tablespoons of mayonnaise and whole wheat bun; baked potato chips; and iced tea C) 2 oz of broiled lean chicken, brown rice, steamed vegetables (broccoli, cauliflower, and carrots), tossed salad with raw vegetables and fat-free dressing, and fat-free milk D) 3 oz of tofu burger; mashed potatoes with gravy; tossed salad with avocado slices, tomato, cucumbers, radishes, carrots, olives, onions, and 2 tablespoons of ranch dressing; iced tea with lemon slices, and 1 cup chocolate ice cream

C

In clients with ostomies, specific foods can create odor problems. Which of the following foods are odorproducing foods that clients with ostomies should avoid? Select all that apply. A) Applesauce B) Buttermilk C) Eggs D) Peas E) Asparagus

C, D, E

The nutrition class has been given the assignment of creating a list of interventions that will benefit a person with a colostomy. What interventions would be expected on that list? Select all that apply. A) Limit carbohydrates. B) Avoid foods that thicken stools. C) Limit fiber. D) Chew food thoroughly. E) Avoid odor-causing foods.

C, D, E

People who have lactose intolerance suffer from bloating, gas, and diarrhea. What type of diarrhea is caused by lactose intolerance? A) Secretory diarrhea B) Watery C) No diarrhea D) Osmotic diarrhea

D

The client has just been put on a gluten-free diet. Which foods should the client avoid? A) Corn, oats, and rice B) Wheat, oats, and rice C) Oats, corn, and barley D) Wheat, rye, and barley

D

The nurse is assessing a 39-year-old woman's diet who has been complaining of chronic constipation. The nurse recognizes that this individual should increase her fiber intake to how much each day? A) 15 g/day B) 25 g/day C) 35 g/day D) Depends on individual needs

D

The nurse is doing client teaching with a client going home to finish recovering from a small bowel resection and ileostomy. The client is concerned about what the best diet is for him. What would be the best response? A) A regular diet with no restrictions B) Large meals to produce large amounts of stool C) Increase fat intake for added calories D) Eating small, frequent meals

D

The nurse is helping a client plan menu choices. The client is currently recovering from dehydration from severe diarrhea. The client laboratory results showed hyponatremia and hypokalemia on admission. The client is now eating but refusing to eat bananas. The nurse suggests which of the following as a possible alternative? A) Blueberries B) Pears C) Strawberries D) Cantaloupe

D

The nurse is preparing a client for discharge home. The client has been treated for an impaction due to chronic constipation. The client is trying to understand the high-fiber diet the physician has ordered. The nurse teaches the client that adding a particular "food" can act as a laxative and is easily added to the daily meals. Which of the following is that "food"? A) All whole wheat products B) Substituting beans for meat C) All dried fruit for snacks D) Unprocessed wheat bran

D

The nurse is teaching a nutrition class for nursing students. The discussion for today is about the nutrition therapy for malabsorption disorders. What is the nutrition therapy for malabsorption disorders used to alleviate or control its symptoms? A) Clear liquids with vitamin and mineral supplements B) Small, frequent meals that are low in soluble fiber C) A low-fat, high-fiber diet for all malabsorption disorders D) Individualized therapy according to symptoms and complications

D