NRS 140 Exam#3: Chapter 18

Alternative to bananas for potassium-Food items with potassium

(a) Apricot Nectar (b) Avocado (c) Canned Apricots and peaches (d) Orange Juice (e) Papaya (f) *Potatoes* (g) Tomato Juice (h) Yogurt

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) Arrowroot starch

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) Choose dairy products that provide less than 1 g fat per serving.

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) Consume milk with food.

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 B) Carbohydrates C) Bile acid D) Insoluble fiber E) Vitamin B12 absorption

A) Fat C) Bile acid E) Vitamin B12 absorption

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) Increase the fiber intake gradually.

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) Malt flavoring

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) Salt

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) Apples

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) Cramping

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) Cream of wheat

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) Most fruits, vegetables, and whole wheat breads provide only 1 to 3 g of fiber per serving.

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) Tapioca pudding

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) 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

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) Low-fiber diet

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) Depends on individual needs

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) Eating small, frequent meals

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) Unprocessed wheat bran

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) Wheat, rye, and barley

High-Fiber Diet

Used for constipation, diverticulosis, and irritable bowel syndrome. It may also promote weight loss and helps lower serum cholesterol levels and improve glucose tolerance in diabetes.

Foods that constitute low-fat diet - breakfast

●*Breakfast* (example) ― Orange Juice/ Oatmeal with fat-free milk/ Whole wheat toast with Jelly ●*Nonfat or Low-Fat food* ●*Very lean meats, fish, and skinless poultry*; *egg whites*; and *low-fat egg substitutes*. ●*Bake, broil, or boil foods* ●*Milk and dairy products that provide less than "1g fat" per serving* and use *low-fat cheese with "3g or less of fat" serving*. ●*Fruits and Vegetables that are prepared without added fat* ●*grain products that are prepared without added fat*. (avoid muffins, waffles, biscuits, pastries, other baked goods) ●*Low-Fat Desserts* (Sherbet, Fruit ices, gelatin, angel food cake, vanilla wafers, graham crackers, nonfat ice cream and frozen yogurt, and fruit whips with gelatin) ●*Limit fats to less than eight equivalents per day*.

Celiac Disease

●A genetic autoimmune disorder characterized by *chronic inflammation of the proximal small intestine mucosa*. ●Related to a permanent *intolerance to certain proteins* found in *wheat, barley, and rye*

Measures to alleviate constipation

●Can be treated by treating the underlying cause ●Increasing fiber and fluid intake effectively relieves and prevents constipation ●High-fiber diet ●Adequate intake set for fiber is 25 g/day for women and 38 g/day for men ●Common practice is to recommend fiber intake be gradually increased. ●Fiber intake should be spread throughout the day ●Lifestyle changes to promote bowel regularity include drinking more fluid and increasing exercise.

Celiac Disease Nutritional Therapy

●Completely and permanently eliminate gluten from the diet - *Gluten Free Diet*

Sign/symptom of rapid increase of fiber in a patient's diet

●Constipation

Best eating pattern for a patient after a 'small bowel resection/ileostomy'

●In the early month after the bowel surgery, *PN is the major source of nutrition and hydration.* ●*Consuming intact nutrients* promotes bowel adaptation because they stimulate blood flow to the intestine and the secretion of pancreatic enzymes and bile acids. ●*6-8 small meals per day*

Suggestion to a client who wants to increase milk tolerance

●Powdered meal replacement supplements ●Soy sour cream ●Yogurt ●Chocolate milk is usually better tolerated than plain milk.

Substitute whole grains for refined grains

●Use Whole Wheat Bread ― in place of White Bread ●Use Brown Rice ― in place of White Rice ●Use Whole Wheat Past ― in place of White Pasta ●Use Bran or Whole-grain cereal ― in place of Refined Cereals ●Use Whole Wheat Flour ― in place of White Flour

Foods to avoid by a Celiac disease patient

●Wheat ●Barley ●Rye