Intro to Nursing- Nutrition

Which foods are considered the most allergenic? Select all that apply. One, some, or all responses may be correct. a. milk b. eggs c. apples d. peanuts 5. bananas

A,b,d Milk and eggs contain protein to which the eczematous child may be allergic. Peanuts are highly allergenic. Apples and bananas rarely cause an allergic reaction.

Which daily diet recommendation would the nurse reinforce with a client who has arthritis? a. wheat germ and yeast b. yogurt and blackstrap molasses c. multiple vitamin supplements in large doses d. foods from a variety of food groups

d. foods from a variety of food groups There is no special diet for arthritis. A balanced diet, consisting of foods from all groups of the MyPlate dietary guidelines, is essential in maintaining nutrition. Limiting the diet to particular foods does not provide all the essential nutrients. If nutritional intake is adequate, large doses of multivitamins are unnecessary and are dangerous.

Which dietary restriction will the nurse expect to be included in the plan for a client with left ventricular failure? a. sodium b. calcium c. potassium d. magnesium

a. sodium Restriction of sodium reduces the amount of water retention, thus reducing cardiac workload. Calcium is restricted in individuals who develop renal calculi. Potassium is not restricted, especially if a diuretic is prescribed, because diuresis facilitates the loss of potassium in the urine. Magnesium is not restricted.

Which is the recommended protein intake for preschoolers? a. 1g/day b. 13g/day c. 300 mg/day d. 700mg/day

b. 13g/day The recommended protein intake for preschoolers is 13 to 19 g/day. The recommended protein intake for preschoolers is not 1 g/day. The recommended cholesterol consumption for children over the age of 2 years should be less than 300 mg/day, whereas the recommended daily allowance for calcium for children 1 to 3 years old is 700 mg.

Which is the cause of milk anemia in toddlers? a. drinking skim milk b. drinking fruit juice c. increased milk intake d. increased intake of fruits

c. increased milk intake Toddlers who consume more than 24 ounces of milk daily in place of other foods sometimes develop milk anemia because milk is a poor source of iron. Children are usually not offered low-fat or skim milk until age 2 because they need the fat for satisfactory physical and intellectual growth. Toddlers need to drink whole milk until the age of 2 years to make sure that there is adequate intake of fatty acids necessary for brain and neurological development. Other solid food items are necessary for healthy growth and development in toddlers.

The nurse teaches a pregnant client regarding the necessity for a folic acid supplement. Folic acid taken in the first trimester of pregnancy helps reduce the risk for which neonatal disorder? a. phenylketonuria b. down syndrome c. neural tube defects d. erythroblastosis fetalis

c. neural tube defects A folic acid supplement (0.4 mg/day) greatly reduces the incidence of fetal neural tube defects. Phenylketonuria is a genetic disorder that cannot be prevented by the action of folic acid. Down syndrome is a genetic disorder that also cannot be prevented by the action of folic acid. Erythroblastosis fetalis is related to the Rh factor and is not prevented by the action of folic acid.

When checking placement of a feeding tube, the nurse is unable to hear the air injected because of noisy breath sounds. Which would the nurse do next? a. notify the provider b. advance the tube 1cm c. insert 1mL of formula slowly d. try aspirating stomach contents

d. try aspirating stomach contents Gastric returns indicate correct placement of the feeding tube. Further assessment is necessary before the provider is notified. Advancing the tube even 1 cm may cause undue trauma, regardless of where the tube is located. Inserting even a small amount of formula is unsafe until correct placement is verified; formula may enter the lungs if the tube is not in the stomach.

When assessing a patient for malnutrition, the nurse would monitor for an increase in liver enzymes and a decrease in which water-soluble vitamin? Select all that apply. a. biotin b. niacin c. folic acid d. riboflavin e. vitamin c

a,b,c,d,e Water-soluble vitamins include biotin, niacin, folic acid, riboflavin, vitamin C, thiamine, pyridoxine, cyanocobalamin, and pantothenic acid. These along with fat-soluble vitamins are decreased during malnutrition along with elevated liver enzymes.

Which primary feeling would the nurse anticipate that clients with bulimia nervosa experience after an episode of bingeing? a. guilt b. paranoia c. euphoria d. satisfaction

a. guilt

The nurse is helping an adolescent with iron-deficiency anemia make breakfast meal choices. Which food would the nurse suggest? a. apple fruit cup b. bowl of raisin bran c. cup of blueberry yogurt d. slice of wheat toast with butter

b. bowl of raisin bran The iron content in the options is as follows: ¾ cup raisin bran, 13.5 mg; one slice of wheat bread, 0.9 mg; 1 cup of blueberry fruit yogurt, 0.2 mg; and apple fruit cup, 0.2 mg. The best choice is the bowl of raisin bran cereal, which has the highest iron content of all the choices.

Which nutrient deficiency in the pregnant adolescent may result in decreased birthweight as a consequence of low bone mineral density in the fetus? a. zinc b. iron c. calcium d. folic acid

c. calcium Calcium and vitamin deficiency may result in decreased birthweight as a consequence of low bone mineral density. Zinc deficiency may not lead to a decrease in bone mineral density. Iron deficiency may lead to anemia. Folic acid deficiency may result in neural tube defects.

Which responses indicate that the client receiving total parenteral nutrition is experiencing hyperglycemia? Select all that apply. One, some, or all responses may be correct. a. polyuria b. polydipsia c. paralytic ileus d. RR of 26 breaths/min e. serum glucose of 105 mg/dL

a,b,d Glucose that is being filtered in the kidney acts as an osmotic diuretic; glycosuria promotes polyuria. Polydipsia (excessive thirst) and fluid intake are the responses to excess fluid loss related to osmotic diuresis. With hyperglycemia, there may be hyperventilation in an attempt to blow off carbon dioxide if ketones are produced; 24 breaths per minute is characteristic of hyperventilation. Paralytic ileus is not associated with hyperglycemia. Serum glucose of 105 mg/dL (5.8 mmol/L), by most standards, is within the expected range of 60 to 110 mg/dL (3.3-6.1 mmol/L).

A new mother is concerned that her 1-month-old infant is nursing every 2 hours. Which response by the nurse is most appropriate? a. "It's common for newborns to nurse this often. Let's talk about how you're adjusting with the new baby." b. "Breast milk is easily digested; giving your infant a little rice cereal will keep him full longer." c. "It sounds as though your baby is a little spoiled; try to resist feeding more often than every 4 hours." d. "You may not be producing enough milk; it'll be important for you to supplement feedings with formula."

a. "It's common for newborns to nurse this often. Let's talk about how you're adjusting with the new baby." Newborns typically nurse every 2 to 3 hours. Although breast milk is easily digested, feeding solids to an infant is not recommended at this age. Feeding satisfies a fundamental need; one does not spoil an infant by nursing as needed. Adequate intake is evidenced in infant weight gain and adequate urinary and bowel elimination. Supplementing feedings with formula may lead to decreased milk production.

When caring for a client who is receiving enteral feedings, the nurse would take which measure to prevent aspiration? a. Elevate the head of the bed between 30 and 45 degrees. b. decrease flow rate at night c. check for residual daily d. irrigate regularly with warm tap water

a. Elevate the head of the bed between 30 and 45 degrees. To prevent aspiration, the nurse would keep the head of the bed elevated between 30 and 45 degrees. Elevating the head any higher causes increased sacral pressure and increases the risk of skin breakdown. Decreasing flow rate, checking for residual, and irrigating regularly will not prevent aspiration.

The mother of a toddler with celiac disease states, "My neighbor told me that I'll only need to monitor the diet until our child is 8 years old. I'm so relieved. You know how kids are about eating!" Which education would the nurse provide to this mother? a. The basic defect of celiac disease is lifelong. b. Susceptibility to celiac crisis lessens with age. c. The diet is relatively easy to follow for a growing child. d. The child will be able to tolerate small amounts of gluten by school age.

a. The basic defect of celiac disease is lifelong. The diet must continue to be followed because the child will always have an absence of peptidase; some variations in the diet may be allowed, but this should not be promised. Each phase of child development may have problems related to dietary management; follow-up care is needed to prevent crises. A restricted diet is never easy to follow, especially for a growing child. Gluten must be avoided for a prolonged period and perhaps indefinitely.

Which action would the nurse take when interacting with an adolescent client who has anorexia nervosa? a. follow unit guidelines b. maintain constant contact c. demonstrate sympathy d. focus on a healthy intake

a. follow unit guidelines The client's security is increased by following unit guidelines; guidelines help the client be responsible and increase compliance with the regimen. Maintaining constant contact is not therapeutic and increases the power struggle. The client needs structure, not sympathy. Emphasis on dietary intake increases the power struggle between the client and the staff.

Which action by a 70-year-old female client would best limit further progression of osteoporosis? a. taking supplemental Ca and vitamin D b. increasing the consumption of eggs and cheese c. taking supplemental Mg and Vitamin E d. increasing the consumption of milk products

a. taking supplemental Ca and vitamin D Research demonstrates that women past menopause need at least 1500 mg of calcium a day, which is almost impossible to obtain through dietary sources because the average daily consumption of calcium is 300 to 500 mg. Vitamin D promotes the deposition of calcium into the bone. Consumption of eggs and cheese does not contain adequate calcium to meet requirements to prevent osteoporosis; these foods do not contain vitamin D unless fortified. If large amounts of magnesium are present, calcium absorption is impeded because magnesium and calcium absorption are competitive; vitamin E is unrelated to osteoporosis. Milk and milk products may not be consumed in quantities adequate to meet requirements to prevent osteoporosis.

Which foods identified by the mother of a child with celiac disease indicate that she understands which foods to avoid feeding the child? a. bacon and eggs b. Mac and cheese c. tuna salad and rice cakes d. chicken legs and corn on the cob

b. Mac and cheese Children with celiac disease cannot digest the gliadin component of gluten. Foods containing grains such as wheat, rye, oats, and barley should be avoided; macaroni is contraindicated because it is a wheat product. Bacon and eggs, tuna and rice cakes, and chicken and corn are gluten-free foods.

Thick mucous gland secretions, elevated sweat electrolytes, meconium ileus, and difficulty maintaining and gaining weight are associated with which autosomal recessive disorder? a. cerebral palsy b. cystic fibrosis c. muscular dystrophy d. multiple sclerosis

b. cystic fibrosis The early symptom of cystic fibrosis is meconium ileus, which is impacted stool in the newborn. Thick mucous secretions, salty sweat, and difficulty gaining weight because of high caloric demands are characteristics of the condition. Cerebral palsy is a motor disorder caused by damage to the brain. Muscular dystrophy is a muscular disorder. Multiple sclerosis is a condition with progressive disintegration of the myelin sheath.

Which information would the nurse provide to the breast-feeding client asking how human milk compares with cow's milk? a. Lactose content is higher in cow's milk than in human milk. b. Protein content in human milk is higher than in cow's milk. c. Fat in human milk is easier to digest and absorb than the fat in cow's milk. d. Immunological and antiallergenic factors found in human milk are now added to cow's milk.

c. Fat in human milk is easier to digest and absorb than the fat in cow's milk. Fat in human milk is easier to digest because of the arrangement of fatty acids on the glycerol molecule. Also, human milk is not heat treated, as is cow's milk when it is pasteurized. The lactose content is higher in human milk. There is less protein in human milk than in cow's milk; however, it is easier for human beings to digest. Human immunological and antiallergenic factors are found only in human milk, not in cow's milk.

A client has been diagnosed with cholelithiasis. Which fact about the condition would the nurse recall when assessing this client for risk factors? a. men are more likely to be affected than women b. young people are affected more frequently than older people c. Individuals who are obese are more prone to this condition than those who are thin. d. People who are physically active are more apt to develop this condition than those who are sedentary.

c. Individuals who are obese are more prone to this condition than those who are thin. Cholelithiasis occurs more frequently in individuals who are obese and have hyperlipidemia. Women are more likely to develop cholelithiasis. Middle-aged people, usually over 40 years, are more likely to develop this condition than younger people; aging increases risk. People who have sedentary lifestyles are more likely to develop this condition than those who are active.

Which food selection indicates understanding of sources with high biologic value protein? a. apple juice b. raw carrots c. cottage cheese d. whole wheat

c. cottage cheese Cottage cheese contains more protein than the other choices. Apple juice is a source of vitamins A and C, not protein. Raw carrots are a carbohydrate source and contain beta-carotene. Whole wheat bread is a source of carbohydrates and fiber.

A client is receiving total parenteral nutrition. Which nursing assessment finding would indicate that the client has hyperglycemia? a. paralytic ileus b. RR below 16 c. fruity odor to the breath d. serum glucose 105 mg/dL

c. fruity odor to the breath Hyperglycemia is indicated by a fruity odor to the breath. Paralytic ileus is not associated with hyperglycemia. With hyperglycemia there is hyperventilation (respiration rate greater than 20). Serum glucose of 105 mg/dL is within the expected range.

Which verbalization by the parents of a child who has cystic fibrosis (CF) provides evidence that they understand the child's dietary needs? a. restrict fluids during mealtime b. discontinue the use of salt when cooking c. provide high-cal foods between meals d. add whole-milk products from the diet

c. provide high-cal foods between meals The caloric intake should be 150% to 200% more than the expected intake for size and age because absorption of fats and nutrients is compromised by the disease process. Fluids are encouraged to keep bronchial secretions from becoming too thick and tenacious. Salt is added to the diet to compensate for excessive sodium losses in saliva and perspiration. Whole milk may not be tolerated because of its high fat content; skim milk products should be substituted.

A client who previously resided in a foreign country has a chronic vitamin A deficiency. Which information about vitamin A would the nurse consider when assessing the client? a. Vitamin A is an integral part of the retina's pigment called melanin. b. It is a component of the rods and cones, which control color visualization. c. Vitamin A is the material in the cornea that prevents the formation of cataracts. d. It is a necessary element of rhodopsin, which controls responses to light and dark environments.

d. It is a necessary element of rhodopsin, which controls responses to light and dark environments. Vitamin A is used in the formation of retinol, a component of the light-sensitive rhodopsin (visual purple) molecule. Melanin is a pigment of the skin. Vitamin A does not influence color vision, which is centered in the cones. The cornea is a transparent part of the anterior portion of the sclera; a cataract is opacity of the usually transparent crystalline lens. Vitamin A does not prevent cataracts.

Which statement is true about the diet plan for toddlers? a. Finger foods should be avoided b. toddlers need 4-6 cups of milk per day c. low fat or skim milk should be given until the child is 2 yrs old d. milk should be supplemented with solid food items such as vegetables and fruits

d. Milk should be supplemented with solid food items such as vegetables and fruits Parents of toddlers should supplement their children's milk intake with solid food items; this will ensure a balanced diet for adequate growth. Serving finger foods to toddlers allows them to eat by themselves and satisfy their need for independence and control. The intake of milk should be limited to 2 to 3 cups per day in toddlers. The consumption of more than a quart of milk per day will decrease the child's appetite for essential solid foods and result in inadequate iron intake. Children younger than 2 years of age should not be given low-fat or skim milk because the fat is important for growth.

The parents of a preschooler inform the nurse that their child often develops diarrhea and ask whether there might be anything wrong with the child's stomach. The nurse also finds that the child has poor oral care and has dental caries. Which is the most likely cause for the child's health issues? a. The family often consumes fast foods. b. The parents neglect the child's dietary needs. c. The family does not follow hygienic practices. d. The child consumes excessive amounts of fruit juice.

d. The child consumes excessive amounts of fruit juice. If the child consumes excessive fruit juice or sweetened beverages, it increases the risk for dental caries and gastrointestinal conditions, such as chronic diarrhea. Consuming fast foods often results in childhood obesity, because fast foods are high in fats and starches. Neglecting the dietary needs or not following hygienic practices may cause gastrointestinal problems or make the child susceptible to infections.

For optimum nutrition, which intervention would the nurse implement when determining a client, who sustained a cerebrovascular accident (also known as a "brain attack"), needs assistance with eating? a. request that the clients food be pureed b. feed the client to conserve the client's energy c. have a family member assist the client with each meal d. encourage the client to participate in the feeding process

d. encourage the client to participate in the feeding process As part of the rehabilitative process after a brain attack, clients should be encouraged to participate in their own care to the extent they are able and extend their abilities by establishing short-term goals. A client with a brain attack may or may not have dysphagia; altering the consistency of food without the need to do so may make it less palatable. Making the client feel helpless discourages independence. Having a family member assist the client with each meal is unrealistic; family members may not be available because of other responsibilities.

Which would the nurse consider before confronting the problem of obesity with individual children? a. enjoyment of specific foods is inherited b. childhood obesity is not usually a predictor of adult obesity c. children with obese parents and siblings are destined for obesity d. familial and cultural influences are deciding factors in eating habits

d. familial and cultural influences are deciding factors in eating habits Studies have shown that culture and family eating habits have an effect on a child's eating habits. Inheritance is not known to influence eating habits, although it is believed that hereditary factors may be associated with obesity. Childhood obesity is a known predictor of adult obesity. Although there is a trend toward asserting that children with obese parents and siblings are destined for obesity, with intervention this can be prevented.

Which nutrients would the nurse teach the parents of a child with celiac disease to avoid? a. saturated oils and fats b. milk and hard cheeses c. corn and rice products d. wheat and oat products

d. wheat and oat products Wheat, oats, rye, and barley are major dietary sources of gluten; the gliadin fraction of these grains is not tolerated by individuals with celiac disease. There is no gluten in oils and fats. There is no gluten in cheeses and milk. Corn and rice are used as substitute grains because they do not contain gluten.