Culture and Nutrition NCLEX

The nurse is planning the menu for a Chinese American client. Which foods should the nurse plan to include in the dietary plan? Select all that apply.

Broccoli Green beans The Chinese American diet is generally vegetarian, although meat is often served. Native Chinese generally do not drink milk or eat milk products because of a genetic tendency for lactose intolerance. Most Chinese Americans do not eat desserts high in sugar; their desserts are usually fruits.

A kosher meal is delivered to a Jewish American client. Which action by the nurse is most appropriate in assisting the client with the meal?

Ask the client to prepare the meal for eating Kosher meals arrive on paper plates and with plastic utensils sealed. Health care providers should not unwrap the utensils or place the food on another serving dish. Although the nurse may want to be helpful in assisting the client with the meal, the only appropriate option for this client is option 1.

A client has been given a prescription for gemfibrozil. The nurse should instruct the client to limit which food while taking this medication?

Beef Gemfibrozil is a lipid-lowering agent. It is given as part of a therapeutic regimen that also includes dietary counseling—specifically, the limitation of saturated and other fats in the diet. Beef contains fat, and its consumption should be limited

An Asian American client is experiencing a fever. The nurse plans care so that the client can self-treat the disorder using which method?

Foods considered to be yin In the Asian American culture, health is believed to be a state of physical and spiritual harmony with nature and a balance between positive and negative energy forces (yin and yang). Yin foods are cold and yang foods are hot. Cold foods are eaten when one has a hot illness (fever), and hot foods are eaten when one has a cold illness. Options 1 and 2 are not health practices specifically associated with the Asian American culture or the yin and yang

The nurse is caring for a slightly intoxicated newly admitted Native American client with gallbladder disease. Based on the client's diagnosis, what dietary issue could be causing this client's problem?

Fried bread and mutton prepared in lard Native American diets include fried bread and mutton prepared in lard, and these dietary issues have contributed to the increased risk of gallbladder disease in this population. Alcohol abuse, vitamin D deficiency, and corn in one's diet do not cause gallbladder disease.

Which clients have a high risk of obesity and diabetes mellitus? Select all that apply.

Latino American man Native American man Hispanic American man African American woman Because of their health and dietary practices, Latino Americans, Native Americans, Hispanic Americans, and African Americans have a high risk of obesity and diabetes mellitus. Owing to dietary practices, Asian Americans have a lower risk for obesity and diabetes mellitus.

A client is admitted to a long-term care facility with the diagnosis of weight loss secondary to anorexia. The health care provider prescribes an enteral tube feeding of a standard formula to run at 40 mL/hour. A nursing student is assigned to care for the client, and the nursing instructor asks the student to describe the nursing considerations related to a tube feeding. Which statement, if made by the student, indicates an understanding of this dietary treatment?

"Enteral feedings require the normal digestive capabilities of the gastrointestinal tract." Enteral nutrition includes offering nutrients by mouth, nasogastric tube, gastrostomy tubes, or percutaneous endoscopic gastrostomy. The common element with these methods of delivery is the fact that the client must have normal gastrointestinal (GI) digestive capabilities. If the client does not have a normal GI tract, other methods of nutrient delivery must be sought, such as parenteral nutrition. Enteral tube feedings may cause aspiration pneumonia from regurgitation of formula into the lungs; however, they generally are not associated with sepsis. Enteral tube feedings should be given at room temperature to avoid problems with diarrhea. The caloric value of most standard enteral feeding formulas is 1 to 2 calories/mL.

A client who was receiving enteral feedings in the hospital has been started on a regular diet and is almost ready for discharge. The client will be self-administering supplemental tube feedings between meals for a short time after discharge. The client expresses concern about performing this procedure at home. What is the nurse's best response?

"Tell me more about your concerns about going home." This client has a specific fear about not being able to handle tube feedings at home. An open communication statement such as "Tell me more about . . ." often leads to valuable information about the client and his or her concerns. Options 1 and 4 are nontherapeutic responses because they place the client's issues on hold. Option 3 is beyond the scope of practice for the nurse to implement and may not be necessary.

The nurse is providing discharge instructions to a Chinese American client regarding prescribed dietary modifications. During the teaching session, the client continuously turns away from the nurse. The nurse should implement which best action?

Continue with the instructions, verifying client understanding.

A breast-feeding mother of an infant with lactose intolerance asks the nurse about dietary measures. What foods should the nurse tell the mother are acceptable to consume while breast-feeding? Select all that apply.

Egg yolk Dried beans Green leafy vegetables Breast-feeding mothers with lactose-intolerant infants need to be encouraged to limit dairy products. Milk and cheese are dairy products. Alternative calcium sources that can be consumed by the mother include egg yolk, dried beans, green leafy vegetables, cauliflower, and molasses.

The nurse is caring for a non-English-speaking client and is attempting to integrate the client's cultural practices into Western medicine. What are some other aspects of culturally competent care the nurse can employ? Select all that apply.

Increasing client safety Using spiritual practices Reducing health disparities Increasing client satisfaction Preventing misunderstandings between the nurse and the client Besides integrating cultural practices into Western medicine, other aspects of culturally competent care include the following: increasing client safety, reducing health disparities, increasing client satisfaction, and preventing misunderstandings between the nurse and the client. Incorporating spiritual practices as appropriate to the client's culture are also important. Maintaining eye contact when having a conversation with a client is not always part of culturally competent practices.

The nurse is caring for a client with cirrhosis of the liver. To minimize the effects of the disorder, the nurse teaches the client about foods that are high in thiamine. The nurse determines that the client has the best understanding of the dietary measures to follow if the client states an intention to increase the intake of which food?

Legumes The client with cirrhosis needs to consume foods high in thiamine. Thiamine is present in a variety of foods of plant and animal origin. Legumes are especially rich in this vitamin. Other good food sources include nuts, whole-grain cereals, and pork. Milk contains vitamins A, D, and B2. Poultry contains niacin. Broccoli contains vitamins C, E, and K and folic acid.

An older client is seen in the clinic for a physical examination. Laboratory studies reveal that the hemoglobin and hematocrit levels are low, indicating the need for further diagnostic studies and a blood transfusion. The client is a Jehovah's Witness and refuses to have a blood transfusion. The nurse should take which most appropriate action?

Support the client's decision not to receive a blood transfusion.

When counseling a female Amish client regarding gallbladder disease, what action should the nurse take?

Tell the client that at some point the gallbladder may need to be removed Complex scientific or medical terminology should be avoided when counseling an Amish client (or any client). When counseling a female Amish client, most often the husband and wife will want to discuss health care options together. Overenunciation is inappropriate and not needed

The home care nurse is assigned to visit a Mexican American client to perform an admission assessment. On initially meeting the client, which actions would be considered culturally appropriate? Select all that apply.

Touch the client. Greet the client with a handshake. Smile during the admission assessment. Use affirmative nods during conversations. To demonstrate respect, compassion, and understanding, health care providers (HCP) should greet Mexican American clients with a handshake. On establishing rapport, HCPs may further demonstrate approval and respect through touch, smiling, and affirmative nods of the head. Given the diversity of dialects and the nuances of language, culturally congruent use of humor is difficult to accomplish and therefore should be avoided.

The nurse is explaining the process of bariatric surgery to a severely obese client who has attended a medically supervised weight loss program for approximately 6 months. The client is considering this procedure. What are some conditions that may interfere with a client's commitment to lifelong behavioral changes and that may lead to poor surgical outcomes? Select all that apply.

Untreated depression Binge eating disorders Drug and alcohol abuse Inability to comply with nutritional recommendations Conditions that can lead to poor bariatric surgical outcomes include untreated depression, binge eating disorders, drug and alcohol abuse, and an inability to comply with nutritional recommendations. Lack of family resources and anxiety do not affect bariatric surgical outcomes.