Davis: Nutrition

The nurse taught the client who has type II DM about the carbohydrate counting and the fact that 15 g of carbohydrate equals one carbohydrate choice. When consuming the following meal, the client should calculate that the meal contains how many carbohydrate choices? - 1 small banana - 2 slices bread with one slice turkey breast - 1 cup milk - 2 tomato slices

4 carbohydrate choices One small banana, two breads, and milk each contain about 15 g of carbohydrates. This equals four carbohydrate choices. Turkey breast is a non-carbohydrate containing food, and diced raw tomato is a non-starchy vegetable. Non-starchy vegetables can be disregarded and carbohydrate counting if less than three servings are eaten.

The clinic nurse is planning to measure the skinfold of an underweight older adult client to estimate the amount of total body fat. Prioritize the nurses steps when measuring the triceps skinfold on the client. 1. Mark the midpoint of the clients arm with a pen 2. Place the calipers at the midpoint mark and read the measurement to the nearest milliliter (mL) 3. Grasp the skin and subcutaneous tissue between thumb and forefinger, pulling away from the muscle 4. Measure the distance between the acromion and the olecranon processes and divide by 2 5. Ask the client to bend his or her arm at the elbow and lay the arm across his or her stomach 6. Ask the client to hang his or her arm loosely at the side

5-4-1-6-3-2 5. This is performed first so that a correct measurement of the distance between the acromion process and the olecranon process can be obtained 4. This measurement is needed to determine the midpoint 1. The midpoint will be the location where the calipers are applied to obtain the measurement 6. This position relaxes the arm 3. Only the skin and subcutaneous tissue are used to measure the skinfold thickness 2. This step is performed last

The client with a BMI of 30 is attending a health promotion program at a clinic. Which outcome is best for the nurse to document in the client's plan of care? a. The client will lose 2 pounds per week for the next four weeks. b. The client will gain 2 pounds per week for the next four weeks. c. Teach the client to increase intake of fruits and vegetables. d. Informed the client to call the clinic weekly with weight results.

a A BMI of 30 indicates the client is overweight. Losing 2 pounds per week is the client centered, realistic, and measurable outcome.

The nurse is caring for a client with a history of chronic alcoholism. Which observation should prompt the nurse to assess for a magnesium deficiency? a. Flicker like movements under the skin b. Absent reaction when kneecap is tapped c. Falling from having flaccid muscles d. Rumbling bowel sounds after eating

a A neuromuscular sign of hypomagnesemia includes fasciculation, or flicker like movements under the skin from spontaneous contractions of muscle fibers. Other signs include tetany, twitches, hyperreflexia, and seizures.

The new nurse is caring for the client experiencing CRF. The experienced nurse determines that the new nurse is able to list acceptable foods for the client when the list contains which low potassium foods (less than 400 mg of potassium per serving)? a. Cranberry juice, grapes, fresh string beans, and fortified puffed rice cereal b. Prune juice, dried fruit, tomatoes, and all bran cereal c. Milk, cantaloupe, peas, and granola cereal d. Orange juice, raisins, spinach, and dried beans

a Cranberry juice, grapes, fresh string beans, and 45 puffed rice cereal are all low potassium foods.

The nurse is planning a nutrition session during a health fair. Which food choices should the nurse include when teaching about omega-3 fatty acids? a. Fatty fish at least twice weekly b. Leafy green vegetables daily c. Low fat mozzarella cheese weekly d. Cholesterol free margarine once daily

a Fatty fishes, such as mackerel, salmon, bluefish, mullet, sable fish, menhaden, anchovy, herring, lake trout, sardines, and tuna, are high in omega-3 fatty acids. All except tuna provide at least 1 g of omega-3 fatty acids in 100 g or 3.5 ounces of fish.

The nurse educate the client recovering from acute diverticulitis about the need to increase the amount of dietary fiber in the diet. The nurse evaluates that teaching has been effective when the client makes which menu selection for lunch? a. A chicken sandwich on whole wheat bread with raw carrots and celery sticks b. Baked chicken, mashed potatoes, and herbal tea c. Chicken noodle soup with soda crackers and chocolate pudding d. Cooked acorn squash, fried chicken, and pasta

a Whole wheat bread and raw fruits and vegetables are foods that are high in fiber content.

The nurse is caring for the 2-year-old with iron-deficiency anemia. Which should the nurse recommend? Select all that apply. a. Limit the toddler's milk intake to 24 oz per day b. Limit the toddler's juice intake to 4-6 oz per day c. Offer iron-rich foods such as beef, lentils, broccoli, and raisins d. Even if vegan, avoid feeding the toddler a vegan diet e. Feed the toddler to ensure an adequate intake

a, b, c a. Milk should be limited to 24 oz per day to maintain an appetite for iron-enriched cereals, meats, fruits, and vegetables. b. Juice should be limited to 4-6 oz per day for children ages 1-5 years. c. Beef, lentils, broccoli, and raisins are some of the iron-rich foods.

The clinic nurse is teaching the mother about childhood nutrition. Which statements is the clinic nurse likely to include? Select all that apply. a. Infants and children need all the vitamins that adults need but in different amounts. b. Forcing a toddler to eat a distasteful food imprints a permanent avoidance behavior. c. Calculate the recommended grams of fiber for the child by taking the child's age in years. d. Children ages 1-2 years should be drinking whole milk rather than skim milk. e. Preschoolers are able to meet their nutritional needs by eating three healthy meals a day. f. Preschoolers tend to eat more and stay at the table longer when eating with their peers.

a, b, d, f a. Infants, children, and adults do require the same vitamins, but in different amounts. b. Permanent avoidance behaviors can be imprinted by forcing distasteful foods onto a toddler. Foods should be introduced and if refused reintroduced at a later time. d. Whole milk provides adequate fat for the sill-growing childs' brain. f. Preschoolers are developing socially and mimic behavior, so they will tend to eat more and stay at the table longer when eating with peers.

The nurse is ensuring that an adolescent diagnosed with type I DM knows about foods that are high in carbohydrates and those that contain little or no carbohydrates. Which foods should the adolescent identify as those that contain approximately 15 g of carbohydrate per serving? Select all that apply. a. Pancake b. Green beans c. Corn d. Taco shells e. Carrots f. Cottage cheese

a, c, d a. A serving is 1 4-inch pancake. Each serving has 15 g of carbohydrates or is equivalent to one carbohydrate choice. c. one half-cup cup of corn. Each serving has 15 g of carbohydrates or is equivalent to one carbohydrate choice. d. Two taco shells. Each serving has 15 g of carbohydrates or is equivalent to one carbohydrate choice.

The nurse reads in the HCP's history and physical note that the hospitalized child has a pica eating disorder. Which conclusions by the nurse are correct? Select all that apply. a. The child consistently eats nonfood substances such as dirt, crayons, and paper. b. The child regurgitates, chews, and then re-swallows previously ingested food. c. A primary safety concern for the child is the possibility of accidental poisoning. d. The child's greatest risk, aspiration, should be monitored for at all times. e. Complications of the disorder can include malabsorption and fecal impaction. f. Usually children with a pica disorder are intellectually bright and precocious.

a, c, e a. Pica is an eating disorder of young children who persistently eat nonfood substances such as dirt, clay, paint chips, crayons, yarn, or paper. c. Accidental poisoning can occur from toxic substances in nonfood items that are ingested. e. Malabsorption, fecal impaction, constipation, and intestinal obstruction are complications associated with eating nonfood substances.

The child is found to be deficient in iron. To increase the child's absorption of iron, which vitamin should the nurse encourage the parents to supplement? a. Vitamin A b. Vitamin C c. Vitamin D d. Vitamin E

b

The hospitalized child has lactose intolerance and is placed on a lactose-restricted diet. Which dietary supplement should the nurse anticipate being added to the child's diet? a. Protein b. Calcium c. Vitamin B 12 d. Beta-carotene

b A deficiency of the enzyme lactase results in an inability to digest lactose, the sugar found in dairy products. A lactose-restricted diet, which removes milk and other dairy products from the diet, can result in a calcium, riboflavin, and vitamin D deficiency.

The nurse determines that the nutrient intake of the 19-year-old female is inadequate according to the U.S. Department of Agriculture MyPlate food group recommendations. Which finding of the client's intake prompted this conclusion? a. Eats 6 ounces of whole grain bread, cereal, or pasta daily b. Eats 3 cups of a variety of fruits, juices, and vegetables daily c. Eats 5 1/2 oz of protein daily with seafood eaten four of the seven days d. Eats 1 cup of yogurt, 1 1/2 cups of skim milk, and 1/2 ounce cheddar cheese daily

b According to the MyPlate recommendation, the 19-year-old should consume 2 cups of fruits or juices and 2 1/2 cups of vegetables every day. Vegetables and fruits are two separate food groups.

The nurse is caring for the older adult client who has experienced unintended weight loss. Which energy-dense protein foods should the nurse offer when the client requests a snack? a. Carrot sticks or apple wedges with dip b. Peanut butter on celery or a hard-boiled egg c. Whole wheat toast with grape jelly or a bagel d. Yogurt or cottage cheese with blueberries

b Peanut butter and eggs are good sources of complete proteins and are energy and nutrient dense.

The home health nurse is evaluating the parents' dietary management of the child with celiac disease. Which foods, or products that contain those foods, should the parents eliminate from their child's diet? Select all that apply. a. Rice b. Barley c. Wheat d. Corn e. Oats

b, c, e Barley, wheat, and oats all contain barley and should be eliminated from the diet.

The client prescribed a high-protein, high caloric diet is not meeting protein or caloric intake goals. The client states, "I feel full quickly after eating three meals daily." Which intervention should the nurse recommend? Select all that apply. a. Include more fresh fruits and vegetables in the diet b. Eat six smaller meals instead of three meals daily c. Include protein bars and whole milk yogurt as snacks d. Add protein supplements to cooked cereals

b, c, e b. The client is likely to increase caloric intake by eating more frequently. c. Eating protein bars and whole milk yogurt as snacks will increase both protein and calorie intake. e. Protein supplements add calories and protein to the diet.

The client is recovering from an exacerbation of ulcerative colitis. The nurse evaluates that the client understands the dietary teaching for disease management when the client selects which foods? a. Fried Cajun chicken, french fries, steamed peapods, and a glass of fruit juice b. Cream of tomato soup, mixed green salad with oil, and a glass of whole milk c. Baked fish, steamed green beans, buttered mashed potatoes, and herbal tea d. Chili con carne, whole wheat bread with butter, and a half a glass of red wine

c A low residue diet that is high in calories and proteins should be gradually introduced as the clients tolerance for solid food increases.

The nurse plans to discuss ways to prevent food poisoning. What information should the nurse plan to address? a. Keep all meet together during the preparation, cooking, and serving processes. b. Drink natural, unpasteurized milk because it contains less harmful chemicals. c. Wash fruits and vegetables thoroughly, especially those that will be eaten raw d. Ensure that ground beef patties are cooked to a temperature of 125°F

c Bacteria from improper handling can remain on raw fruits and vegetables. Therefore, these should all be carefully washed before eating.

The client tells the nurse, "my mother has celiac disease, and I might also have the disease." The nurse agrees that this may be possible when the client states having diarrhea after eating which food? a. Eggs b. Peanut butter c. Whole wheat bread d. Dark leafy green vegetables

c Celiac disease is an auto immune disease that results in chronic intestinal inflammation after ingesting gluten. Whole wheat bread contains gluten.

The client with early stage iron deficiency anemia is on a high iron diet. An increase in the level of which specific serum laboratory test should indicate to the nurse that the diet has been effective? a. Hemoglobin b. Folate c. Ferritin d. Vitamin B 12

c Ferritin levels reflect the available iron stores in the body and are specific to iron deficiency anemia. A level less than 10 ng/mL is diagnostic of iron deficiency anemia. As the condition improves, ferritin levels rise.

The nurse teaches the client with iron deficiency anemia to eat high iron foods and those containing vitamin C at the same meal to increase iron absorption. Which foods included in the meal indicate that teaching has been effective? a. Yogurt and oranges b. Shrimp and potatoes c. Lean beef steak and broccoli d. Chicken and leafy green vegetables

c Good sources of iron include lean beef steak; dark green leafy vegetables such as broccoli have a significant source of vitamin C.

Which nutrients should the nurse encourage the client to consume to protect against cataract development? a. Minerals b. Lecithins c. Antioxidants d. Amino Acids

c Oxidative stress plays a role in cataract formation. Antioxidants such as vitamin E and vitamin C may reduce the likelihood of developing cataracts.

A mother in concerned about achieving a nutritious intake for her 14 month old child. Which advice by the nurse would be best? a. Feed the child before the rest of the family and then let the child play while the family eats. b. Because the child's stomach holds only 1/2 cup, select food from one food group for each meal. c. Offer 1 1/2 tablespoons of food from each food group with every meal; offer nutritious snacks. d. Avoid retrying foods that the child pushed away because these are foods the child dislikes.

c The 14 month-old child's serving size should be about a tablespoon for each year of age. Offering a variety of foods from the food groups will help ensure a nutritious diet and avoid consuming too much or too little food from any one food group. Offering three meals and three nutritious snacks a day increases the likelihood that the toddler will obtain sufficient nourishment.

The 6-year-old with chronic constipation is prescribed a high-fiber diet and increased fluid intake. Which foods should the nurse teach the parents as having the highest amount of fiber per serving? a. Whole wheat or rye breads b. Raw or cooked veggies c. Fresh, frozen, or dried fruits d. Baked beans or black-eyes peas

d Legumes such as baked beans, navy beans, or black-eyes peas provide about 8 g of fiber per serving.

The nurse is caring for the malnourished adolescent consuming a vegan diet. The nurse should assess for signs of which vitamin deficiency in the client? a. Vitamin A b. Vitamin C c. Vitamin K d. Vitamin B 12

d Vegans abstain from eating animal products, which provide vitamin B 12.