Nutrition Proctor
A nurse is preparing a presentation about glucosamine to a group of clients. Which of the following information should the nurse include in the teaching?
"Glucosamine may help to increase joint functionality." The nurse should include in the teaching that glucosamine may increase joint functionality by decreasing destruction of cartilage.
Hypertension
Hypertension is a manifestation of fluid overload.
Erythema at the insertion site
Erythema at the insertion site is a manifestation of infection and can indicate the need to change infusion site.
Peripheral edema
Peripheral edema is a manifestation of fluid overload.
This is an action the nurse should take for a client who is receiving TPN and develops hyperglycemia.
Prepare to add insulin to the TPN infusion.
A nurse is admitting a client who states he takes ginkgo biloba every day to improve his memory. The nurse should identify a potential interaction with which of the following medications the client is taking?
Warfarin The nurse should identify a potential interaction between gingko biloba and warfarin. Ginkgo might suppress coagulation and should be used with caution with antiplatelet drugs such as aspirin or anticoagulants such as warfarin or heparin.
A nurse in the PACU is admitting a client who is postoperative following a tonsillectomy. Which of the following actions should the nurse plan to take to prevent aspiration.
Withhold fluids until the client demonstrates a gag reflex. Following a tonsillectomy, the client's gag reflex can be suppressed by local anesthetics or edema. To prevent aspiration, the gag reflex must be present before the client is allowed have fluids.
A nurse is providing teaching to a group of older adults about sources of complete and incomplete protein. Which of the following foods should the nurse include as a complete protein?
Yogurt Yogurt is a source of complete protein.
Garlic is
a powerful vasodilator and may help decrease moderate blood pressure by increasing enzymes in the client's blood that produce nitric oxide.
A biophysical profile includes
a review of fetal breathing movements, gross body movement, fetal tone, reactive fetal heart rate, and amniotic fluid volume to provide an assessment of physical and physiological characteristics of the developing fetus.
Fetal lung maturity is evaluated by
an amniocentesis to examine amniotic fluid for the presence of phosphatidylglycerol (PG) and the lecithin/sphingomyelin (L/S) ratio.
Resveratrol is an
antioxidant extracted from grapes and can increase longevity. Resveratrol is found in red wine, purple grape juice, blueberries, cranberries, and peanuts.
Saw palmetto may help
blocks testosterone receptors.
Garlic may help decrease the client's cholesterol levels
by interfering with the cholesterol synthesis in the liver.
Valerian may cause
doziness and offer sedation and anxiety relief to clients who have sleep issues.
Aloe vera may have anti-inflammatory properties
especially with topical application to the client's skin.
A nurse is teaching a client who has chronic kidney failure about planning a low-protein diet. the client states " Why do I have to be concerned about protein?". Which response should the nurse make?
"A low-protein diet reduces the risk for uremia." Urea is a waste product of protein breakdown and can accumulate in clients who have kidney failure, causing uremia.
A nurse is teaching a client about the uses of aloe vera. Which of the following information should the nurse include in the teaching?
"Aloe vera can act as a laxative." Aloe vera has a laxative effect when taken orally.
A nurse is teaching a client about the uses of chamomile. Which of the following information should the nurse include in the teaching>
"Chamomile may act as a calming agent." Chamomile may act as a calming agent for clients who have sleep issues.
A nurse is teaching a client about the uses of cranberry juice. Which of the following information should the nurse include in the teaching?
"Drinking cranberry juice daily can prevent recurrent urinary tract infections." The client can decrease the risk of having recurrent urinary tract infections by consuming cranberry juice daily, because cranberry juice contains proanthocyanins a compound that prevent bacteria from adhering to the urinary tract mucosa.
A nurse is preparing a presentation about echinacea to a group of clients. Which of the following information should the nurse include in the teaching?
"Echinacea boosts the immune system." The nurse should include in the teaching that echinacea may help boost the immune system.
A nurse is providing teaching to a client who has stomatitis. Which of the following statements by the client indicates a need for further teaching?
"I will season foods with dried spices before cooking." The client should avoid spices, acidic foods, and salty foods because they can cause additional irritation to the oral mucosa; therefore, this statement by the client indicates a need for further teaching.
A nurse is caring for a client who has a new prescription for ferrous sulfate tablets twice daily for iron-deficiency anemia. The client asks the nurse why the provider instructed that she take the ferrous sulfate between meals. Which of the following responses should the nurse make?
"Taking the medication between meals will help you absorb the medication more efficiently." Ferrous sulfate provides the iron needed by the body to produce red blood cells. Taking iron supplements between meals helps to increase the bioavailability of the iron.
A nurse is preparing a presentation about valerian to a group of clients. Which of the following information should the nurse include in the teaching
"Valerian is used to promote sleep." The nurse should include in the teaching that the herbal supplement valerian can provide sedation and prevent insomnia in clients who have sleep disorders.
A nurse is teaching a client who plans to take st. John's wort to treat her depression. Which of the following information should the nurse include in the teaching?
"You may experience vivid dreams while taking St. John's wort." The nurse should include in the teaching that St. John's Wort can cause the client to have vivid dreams due to the CNS effects.
Parenteral nutrition solutions should be removed from the refrigerator
1 hr before infusion to allow them to reach room temperature.
Parenteral nutrition solutions must be used or discarded within
24 hr.
A client who had a hemi-colectomy and placement of a colostomy
A client had a hemi-colectomy and placement of a colostomy has a potential risk for aspiration, but is at greater risk for stoma ischemia or necrosis, infection, hemorrhage, and intestinal obstruction.
A nurse is caring for four clients. Which of the following clients should the nurse identify as having the highest risk for aspiration?
A client receiving continuous enteral feeding through NG tube A client who is receiving continuous enteral feedings through an NG tube is at greatest risk for aspiration, because if the tube slips into the lungs the feeding can enter the lungs. The nurse should confirm placement of the NG tube after inserting and before initiating enteral feedings. The nurse should confirm initial placement with an x-ray and subsequently, check by aspirating stomach contents and measuring the pH of the fluid. The aspirate should have a pH of 1 to 4, or as high as 6 if receiving medication that controls gastric acid.
A client who Crohn's disease and has an ileostomy
A client who has Crohn's disease has a potential risk for aspiration, but is at greater risk for skin excoriation, stoma ischemia or necrosis, hemorrhage, and intestinal obstruction.
A nurse is caring for a group of clients. Which of the following clients should the nurse identify as having an increased risk of aspiration while eating?
A client who has had a cerebrovascular accident is correct. Clients who have had a cerebrovascular accident are at risk for aspiration due to the impairment of the muscles, nerves, and reflexes that coordinate the swallowing process. A client who is 4 hr postoperative following a leg amputation with general anesthesia is correct. Pain medications, intubation, and general anesthesia increase the risk of aspiration due to the impairment of the muscles, nerves, and reflexes that coordinate the swallowing process A client who has had radiation therapy for head and neck cancer is correct. Radiation to the head and neck to treat cancer increases the risk for aspiration because it can impair the muscles, nerves, and reflexes that coordinate the swallowing process.
Soft residue diet
A soft residue diet would place the client at risk for aspiration due to difficulty swallowing solids; therefore, this nutritional therapy will not likely be prescribed.
A nurse is caring for a client who is well-hydrated and who demonstrates no evidence of anemia. Which of the following laboratory values gives the nurse an assessment of the adequacy of the client's protein uptake and synthesis?
Albumin Albumin levels reflect the overall body protein status and is used to detect metabolic and liver dysfunction.
A nurse is caring for a client who has cancer and is receiving total parenteral nutrition. Which of the following lab values indicates the treatment is effective?
Albumin 4.2 g/dL Clients who have cancer can receive TPN to provide needed proteins and glucose they are otherwise unable to obtain. An albumin level of 4.2 g/dL is within the expected reference range and indicates the client is receiving adequate amounts of protein.
A nurse is caring for an adolescent female who has an eating disorder. The client is 162.6 cm tall and weighs 38.56 kg. Upon assessment, which of the following manifestations should the nurse expect? select all that apply
Amenorrhea is correct. A client who has anorexia nervosa and has had significant weight loss will commonly experience amenorrhea, or cessation of menses. Altered body image is correct. A client who has anorexia nervosa will commonly view her body as overweight no matter how much weight is lost. Hyperactivity is correct. A client who has anorexia nervosa will commonly engage in excessive exercising to prevent weight gain. Bradycardia is correct. A client who has anorexia nervosa can experience cardiac abnormalities, such as bradycardia and hypotension.
A nurse is caring for a client who has anorexia nervosa and overexercises to avoid gaining weight. Which of the following nursing actions should the nurse take?
Ask the client to agree to talk to a nurse whenever she feels the urge to exercise. To promote effectiveness of treatment, the nurse should implement actions which establish trust and partnership with the client. This action should help the client view the nurse as a partner in treatment.
A nurse is teaching a client who reports taking gingko biloba to improve his memory. Which of the following adverse effects should the nurse include?
Bleeding gums, headache, dizziness, and vertigo. Gingko biloba is an herbal medication used by clients to improve age-related memory loss as well as to decrease leg pain in clients with peripheral arterial disease (PAD). Although gingko biloba is generally well-tolerated, it may suppress coagulation. There have been reports of spontaneous bleeding in clients taking this herbal medication. Clients should be instructed to discontinue use and report increased bleeding, such as nosebleeds, bleeding gums, any cuts that do not stop bleeding, to their provider.
A nurse is teaching a client who has stomatitis, which of the following should the nurse include?
Brush teeth with a soft toothbrush. Rationale: The client should use a soft toothbrush and gently brush after each meal to reduce mouth irritation and prevent superinfections.
Decreased effects of antianxiety medications
Caffeine can reduce the effectiveness of antianxiety medications.
A nurse is assessing a client who is receiving total parenteral nutrition therapy via an infusion pump. Which of the following actions should the nurse take?
Change the IV tubing every 24 hr. obtain the client's blood glucose every 4 hr. change the client's IV site dressing every 48 to 72 hr weight the client daily The nurse should change the client's IV tubing every 24 hr, or per facility protocol, to prevent bacteria from developing in the tubing.
A client who has a chest tube following a fall from a ladder
Chest tubes are inserted in the pleural space to drain air, blood or fluid, reestablish negative pressure, restore intrapleural pressure, and promote lung expansion. The client has the potential risk for aspiration, but is at greater risk for tension pneumothorax, air leaks, accidental disconnection, and poor oxygenation.
A nurse is caring for a client who needs to increase his protein intake. The client tells the nurse some of the food he enjoys. Which of the following foods should the nurse recommend as the best source of protein among these suggestions
Chicken One 3 oz portion of roasted chicken breast provides about 25 g of protein. This is the best source of protein among these options
A nurse is assessing an adolescent female client who has anorexia nervosa. Which of the following findings should the nurse expect?
Constipation Constipation is an expected finding of anorexia nervosa due to the effects of starvation.
A nurse is providing teaching to a client who has cancer about foods that prevent protein-energy malnutrition. Which of the following foods should the nurse include in the teaching?
Cottage cheese is correct. Cottage cheese is a protein-rich food that is appropriate to include when teaching about foods that prevent protein-energy malnutrition. Milkshakes is correct. Milkshakes are a protein-rich food and are appropriate to include when teaching about foods that prevent protein-energy malnutrition. Tuna fish is correct. Tuna fish is a protein-rich food that is appropriate to include when teaching about foods that prevent protein-energy malnutrition. The egg and ham omelet is correct. An egg and ham omelet is a protein-rich food that is appropriate to include when teaching about foods that prevent protein-energy malnutrition.
A nurse prepares to replace the nearly empty container of total parenteral nutrition TPN for a client when she finds that there has been a delay in receiving the new container of solution from the pharmacy. Which of the following solutions should the nurse infuse until the next container of TPN solution becomes available?
Dextrose 10% in water Sudden withdrawal from TPN, which is a hypertonic solution that contains dextrose, vitamins, electrolytes and sometimes lipids, can result in a sudden drop in the client's blood glucose levels. Administering an infusion of 10% dextrose will prevent hypoglycemia
"I will drink liquids through a straw."
Drinking liquids through a straw is an appropriate action; therefore, this statement by the client does not indicate a need for further teaching.
"I will eat frozen bananas as a snack."
Eating frozen bananas as a snack will numb the mouth, which is an appropriate action. This statement by the client does not, therefore, indicate a need for further teaching.
A nurse is teaching a client who is to begin medicated treatment of tuberculosis. The nurse should instruct the client that which of the following herbal supplements can interact adversely with the treatment.
Echinacea The nurse should teach the client that echinacea appears to be an immune system booster, thus it can reduce the actions of medications used to treat tuberculosis.
Decreased effects of antirejection medication
Echinacea can reduce the effectiveness of antirejection medication.
A nurse is assessing a client who is receiving a parental lipid infusion. Which of the following findings is a manifestation of fat overload syndrome?
Elevated temperature An elevated temperature is an early manifestation of fat overload syndrome. The client is at risk for coagulopathy and multi-organ system failure due to fat overload syndrome.
A nurse is instructing a client's family members about feeding safety for a client who has dysphagia following a stroke. Which of the following instructions should the nurse include?
Encourage the client to take small bites. The family members should encourage the client to take small bites and chew food thoroughly in order to prevent choking.
A nurse is preparing an in-service for coworkers about various herbal supplements clients might report using. The nurse should include in the presentation which of the following herbal supplements is used to help the client lose weight.
Ephedra The nurse should identify that ephedra is an extremely dangerous weight loss supplement; however, clients may still report using it for weight loss.
A nurse is caring for a client who is at 6 weeks of gestation and has pneumonia. While the nurse is obtaining the client's history, the client tells the nurse that she takes the herb feverfew for migraine headaches. Which of the following actions should the nurse take?
Explain to the client that she should not take this herb while she is pregnant. The nurse should explain that feverfew interferes with platelet action and can therefore cause bleeding. It is unsafe for the client to take during pregnancy.
A nurse is preparing an in-service about the various supplements clients might use. which of the following herbal supplements should the nurse include as potentially increasing anticoagulant effects of aspirin and other anticoagulants?
Feverfew Feverfew can increase the risk of bleeding due to the suppression of platelet aggregation.
A nurse is teaching a client who takes aspirin daily for coronary artery disease about herbal supplements. The nurse should instruct the client what which of the following herbal supplements may interact adversely with aspirin?
Feverfew The nurse should instruct the client to avoid taking feverfew with aspirin because it suppresses platelet aggregation and places the client at risk for bleeding when taken with aspirin.
A nurse is caring for a client who reports having chronic constipation . which of the following herbal supplements should the nurse recommend?
Flaxseed The nurse should recommend the client use flaxseed to treat constipation, which is a high-fiber product.
Green Tea
Green tea can help treat cancers of the stomach, skin, bladder, and breast.
A nurse is caring for a client who has a large lower-leg ulcer. Which of the following foods should the nurse suggest to the client to provide the most protein for wound healing?
Grilled salmon Poultry, fish, eggs, and beef are complete proteins and are optimal sources of protein to support wound healing.
A nurse is caring for a client who has cancer and a new prescription for ondansetron to treat chemotherapy-induced nausea. For which of the following adverse effects should the nurse monitor
Headache Headache is a common adverse effect of ondansetron. Analgesic relief is often required.
A charge nurse is teaching a group of nurses about clients who report using garlic, ginger and ginkgo biloba. The nurse should identify which of the following as an adverse effect of these supplements?
Increased effects of oral anticoagulants The nurse should include that garlic, ginger, and ginkgo biloba can all interfere with the effects of oral anticoagulants and thus increase the risk of bleeding.
0.9% sodium chloride
Infusing this solution would increase the client's risk for hypoglycemia.
3% sodium chloride
Infusing this solution would increase the client's risk for hypoglycemia.
Lactated Ringer's
Infusing this solution would increase the client's risk for hypoglycemia.
A nurse is planning care for a client who has acute dysphagia. Which of the following nursing interventions should be included in the pan of care?
Instructing the client to tilt head forward when swallowing The client should be instructed to tilt the head forward to facilitate swallowing.
A nurse is caring for a client who is scheduled for a maternal serum alpha-fetoprotein test at 15 weeks of gestation. The nurse provides which of the following explanations about this test to the client?
It is a screening test for spinal defects in the fetus. The maternal serum alpha-fetoprotein (MSAFP) screening test is used to identify suspected neural tube defects (NTDs) and abdominal wall defects. These include spina bifida, microcephaly, and anencephaly. This tool is the basis for further testing, such as amniocentesis and specialized ultrasounds.
NPO until dysphagia subsides
Making the client NPO provides no nutritional support and will not likely be prescribed.
Milk thistle
Milk thistle can reduce the effects of oral contraceptives.
A nurse is caring for a client who has Crohn's disease and is receiving parenteral nutrition. Which of the following interventions should the nurse include in the care of this client?
Monitor daily laboratory values and report as needed. Laboratory data, as well as observation of clinical signs, are important to prevent the development of nutrient deficiencies or toxicities.
A nurse is providing dietary teaching for a client who has a burn injury and adheres to a vegan diet. The nurse should recommend which of the following foods as the best source of protein to promote wound healing?
One cup of lentils The nurse should determine that nuts and legumes, such as lentils, are the best foods to recommend for protein intake for this client. One cup of lentils contains 17.86 g of protein. A diet high in protein and calories is required to promote wound healing. Nuts and legumes are good sources of protein to include in a plant based diet such as a vegan diet.
A nurse is completing an admission assessment on an adolescent client who is a vegetarian. He eats milk products but does not like beans. Which of the following items should the nurse suggest the client order for lunch to provide the nutrients most likely to be lacking in his diet?
Peanut butter and jelly sandwich A vegetarian diet may be low in protein, especially if the client does not substitute protein-rich beans for meat protein. Peanut butter is an excellent source of protein. A peanut butter and jelly sandwich, especially if prepared on protein-enriched bread, can provide almost 20 grams of protein.
A nurse on an inpatient eating disorder unit is caring for a client who has anorexia nervosa and has a body mass index of 17.2 . Which of the following actions should the nurse take
Provide the client with small meals frequently is correct. Clients who have anorexia generally will not consume large meals .Monitor the client's weight daily is correct. Daily weighing makes it difficult for the client to hide weight loss. Stay with the client during meals and for 1 hr afterward is correct. The nurse should offer support and encouragement at mealtimes but also monitor the client's behavior to prevent purging following food ingestion. Offer specific privileges for sustained weight gain is correct. Positive reinforcement includes rewards for improvements in eating behaviors and is an appropriate strategy for clients who have eating disorders.
An indirect Coombs test identifies
Rh incompatibility between the mother and fetus.
"I will rinse my mouth with baking soda and water frequently."
Rinsing the mouth with baking soda and water frequently is an appropriate action; therefore, this statement by the client does not indicate a need for further teaching.
A nurse is providing care for a client who has anorexia nervosa. Which of the following nursing interventions should the nurse take?
Schedule regular weigh-in times. Treatment for anorexia nervosa is structured. The client is weighed at regularly scheduled times. The goal is to achieve 90% of ideal body weight.
A nurse is assessing a client and discovers the infusion pump with the client's total parenteral nutrition solution is not infusing. The nurse should monitor the client for which of the following conditions?
Shakiness and diaphoresis When a sudden interruption in the infusion of TPN occurs, the client is at risk for hypoglycemia. Shakiness and diaphoresis are manifestations of hypoglycemia.
A nurse is caring for a client who requires total parenteral nutrition. Which of the following actions should the nurse take when finding that the TPN solution is infusing too rapidly?
Sit the client upright. Fluid overload can cause dyspnea. The nurse should slow the infusion rate and sit the client upright to help prevent or treat dyspnea. The nurse should also administer oxygen if necessary.
A nurse is planning teaching for the parents of a toddler who follows a vegetarian diet. The nurse should plan to include which of the following foods as the best source of dietary protein for the child?
Soy milk Soy products are a source of complete protein and should be included as the best source of dietary protein for the child.
A nurse is caring for a client who is experiencing dysphagia. The nurse should recommend a referral to which of the following members of the health care team?
Speech therapist A speech therapist assesses and makes recommendations for clients experiencing speech, language, and swallowing difficulties.
Increased effects of antidepressant medications
St. John's wort is an example of an herbal product that can increase the effects of antidepressants.
A nurse is teaching a client who has iron deficiency anemia about ferrous sulfate. What should be included in the teaching
The client should take the medication at least 1 hr before bedtime to reduce the risk of stomach irritation. Antacids interfere with the absorption of ferrous sulfate. The client should take the medication between meals for optimal absorption. Dairy products interfere with the absorption of carbonyl iron; therefore, the client should not take the medication with yogurt.
A nurse is preparing to administer total parenteral nutrition 1800 mL to infuse over 24 hours. The nurse should set the IV pup to deliver how many mL per hour?
Step 1: What is the unit of measurement the nurse should calculate? (Place the unit of measure being calculated on the left side of the equation.) X mL/hr = Step 2: Determine the ratio that contains the same unit as the unit being calculated. (Place the ratio on the right side of the equation, ensuring that the unit in the numerator matches the unit being calculated.) 1,800 mLX mL/hr = 24 hr Step 3: Place any remaining ratios that are relevant to the item on the right side of the equation along with any needed conversion factors to cancel out unwanted units of measurements. 1,800 mLX mL/hr = 24 hr Step 4: Solve for X. X mL/hr = 75 mL/hr Step 5: Round if necessary. Step 6: Reassess to determine whether the amount to administer makes sense. If the prescription reads TPN 1800 mL to infuse over 24 hr, it makes sense to administer 75 mL/hr. The nurse should set the IV pump to deliver TPN IV at 75 mL/hr.
This is an action the nurse should take for catheter displacement in a client who is receiving TPN.
Stop the TPN infusion.
A nurse is caring for a client following a CVA and observes the client experiencing severe dysphagia. The nurse notifies the provider. Which of the following nutritional therapies will likely be prescribed?
Supplements via nasogastric tube Supplements via nasogastric tube provide enteral nutrition for clients who are at risk for aspiration caused by a diminished gag reflex or difficulty swallowing. This nutritional therapy will likely be prescribed.
A nurse is conducting a nutritional assessment for a client who weighs 75 kg . The nurse should calculate that the clients recommended dietary allowance for protein is how much per day?
The RDA for protein is 0.8 mg/kg To calculate the client's RDA for protein, the nurse would first determine the client's weight in kg, and then multiply by 0.8 mg/kg.165 lb/X kg = 2.2 lb/1 kgX = 75 kg75 kg x 0.8 mg = 60 g
a nurse is completing a medical interview with a client who has elevated cholesterol levels and takes warfarin. The nurse should recognize that which of the following actions by the client can potentiate the effects of warfarin?
The client uses garlic to lower cholesterol levels. The nurse should recognize that garlic can potentiate the action of the warfarin.
A nurse at a provider's office is providing teaching to a client who is taking chemotherapy and losing weight. Which of the following should the nurse recommend to increase calorie and protein intake?
Top fruits with yogurt are correct. Topping fruits with yogurt is an appropriate recommendation to increase the client's protein and calorie intake. Add cream to soups is correct. Adding cream to soups is an appropriate recommendation to increase the client's protein and calorie intake. Using milk instead of water in recipes is correct. Using milk instead of water in recipes is an appropriate recommendation to increase the client's protein and calorie intake Dip meats in eggs and bread crumbs before cooking is correct. Dipping meats in eggs and bread crumbs before cooking is an appropriate recommendation to increase the client's protein and calorie intake.
Initiation of total parenteral nutrition
Total parenteral nutrition is initiated when the GI tract cannot be used for the ingestion, digestion, and absorption of essential nutrients. This nutritional therapy will not likely be prescribed.
This is an action the nurse should take for a client who is receiving TPN and develops an embolism.
Turn the client on his left side.
Soy contains a compound with
estrogenic properties beneficial for women who are postmenopausal.
Garlic can cause
gastrointestinal irritation in client's who have infectious or inflammatory GI disorders
Echinacea may help treat
herpes simplex infection by acting as an antiviral supplement.
Although evidence is inconclusive, ginkgo biloba may
improve age-related memory impairment and senile dementia.
Ingesting large amounts of soy can
increase the client's risk of developing oxalate kidney stones.
Chamomile
increases drowsiness when used with any type of CNS depressant.
Ginger appears to have antiemetic properties and
may help reduce nausea and vomiting.
If the rate of delivery falls behind for TPN
no attempt should be made to "catch up" as this may cause severe hyperglycemia.
Feverfew is used for
prophylaxis of migraine headaches by suppressing serotonin and inhibiting vasoconstriction in the brain.
Capsicum is derived from
red peppers and the ingredient is found in topical preparations that treat arthritis pain. Capsicum may reduce the pain of inflammation by interfering with substance P, which transmits pain impulses.
Garlic can
reduce triglycerides and LDL cholesterol levels and raise HDL cholesterol.
St. John's wort can be beneficial in the
treatment for mild to moderate depression.
incomplete protein sources
vegetable proteins (grains, legumes, nuts, seeds, and vegetables)