Nutrition

50 A nurse is calculating the protein needs of a young adult client who weighs 132 lbs. The RDA for protein for an adult who has no medical conditions is 0.8 g/kg. How many grams of protein per day should the nurse recommend for this client?

48 g 132/2.2 = 60 kg 60 kg x 0.8 g = 48g

2 A nurse is presenting an in-service training session about nutrition. How many of the amino acids must be obtained from dietary intake?

9 amino acids Rationale: Proteins are made up of chains of amino acids, which are composed of carbon, hydrogen, oxygen, and nitrogen. Nine amino acids are considered essential for the human body and must be obtained from diet. These include histidine, isoleucine, leucine, lysine, methionine, phenylalanine, threonine, tryptophan, and valine.

35 A nurse is teaching a client with heart disease about a low-cholesterol diet. Which client statement indicates the teaching was effective? A. "I should remove the skin from poultry before eating it" B. "I will eat seafood once per week" C. "I should use margarine when preparing meals D. "I can use whole milk in my oatmeal"

A. "I should remove the skin from poultry before eating it" Rationale: The nurse should identify the client understands the teaching when he states he will remove the skin from poultry before eating, as the skin contains the greatest amount of fat. Incorrect Answers: - B. A client who has heart disease and is on a low-cholesterol diet should eat seafood at least twice per week because it is high in omega-3 fatty acids. - C. A client who has heart disease and is on a low-cholesterol diet should use liquid oils such as canola oil instead of margarine, which is a solid fat. - D. A client who has heart disease and is on a low-cholesterol diet should use nonfat or low-fat milk instead of whole milk in oatmeal or cereal.

29 A nurse is providing teaching for a client who has a prescription for a low-sodium diet to manage hypertension. Which of the following statements by the client indicates an understanding of the teaching? A. "i can snack on fresh fruit" B. "i can continue to eat lunchmeat sandwiches" C. "i can have cottage cheese with my meals" D. "canned soup is a good lunch option"

A. "i can snack on fresh fruit" Rationale: The nurse should identify that fresh fruits contain little to no sodium and are a good snack for a client who has hypertension. Incorrect Answers: - B. Lunchmeats are usually high in sodium and should be avoided. The nurse should recommend choosing lower-sodium options, such as fresh fish or poultry. - C. Cottage cheese contains 390 mg per 113 g (1/2 c) of sodium. The nurse should recommend choosing low-fat yogurt as a low-sodium snack. - D. Canned soups contain high amounts of sodium. The nurse should instruct the client to avoid convenience and fast foods such as canned or dry-packaged soups.

31 A provider tells a client at 12 weeks gestation who practices Hinduism that she needs more protein in her diet and suggests eating more meat. After the provider leaves the examination room, the client tells the nurse that eating animal products will cause her to miscarry. Which response should the nurse make? A. "let's discuss other foods that are also high in protein that you could substitute for meat" B. "eating meat during pregnancy provides necessary protein and does not cause miscarriage" C. "why do you think that eating animal products will cause you to have a miscarriage?" D. "your doctor is recommending what is best for you and your baby"

A. "let's discuss other foods that are also high in protein that you could substitute for meat" Rationale: Many cultures have beliefs about food that the nurse should respect. Discussing non-animal protein sources can help the client identify foods that do not conflict with her religious and cultural beliefs. Incorrect Answers: - B. This is a nontherapeutic response that contradicts the client's beliefs. - C. Asking a "why" question is nontherapeutic. The client might not know the answer and could become defensive. - D. This is a nontherapeutic response that dismisses the client's concerns.

79 A nurse is providing dietary teaching for a client with AIDS who has stomatitis of the mouth. Which of the following instructions should the nurse include in the teaching? A. "you can suck on popsicles to numb your mouth" B. "season food with spices instead of salt" C. "avoid the use of a straw to drink liquids" D. "eat foods at hot temps"

A. "you can suck on popsicles to numb your mouth" Rationale: Popsicles or ice chips can numb the mouth Incorrect Answers: - B. The client should avoid spices, acidic foods, and salt, which can irritate and burn the mouth. - C. The client should instruct the client that using a straw can decrease the comfort when drinking liquids. - D. The client should consume foods that are cold or at room temperature. Hot foods can be irritating or possibly burn the mouth.

48 A nurse is caring for a group of clients on a med-surg unit. Which of the following disorders should the nurse identify as increasing the client's metabolic needs? SATA A. COPD B. hypothyroidism C. cancer D. parkinson's disease E. major burns

A. COPD C. cancer D. parkinson's disease E. major burns Rationale: Clients who have COPD develop hypermetabolism as a result of the increased amount of energy used to breathe. Cancer can cause a number of metabolic changes, including hypermetabolism as a result of tumor growth. Clients who have Parkinson's disease develop hypermetabolism because they burn calories due to muscular rigidity. Clients who have major burns develop severe metabolic stress, which includes hypermetabolism and hypercatabolism. Incorrect Answers: - B. insufficient thyroid hormone results in decreased metabolism

1 A nurse is caring for a client who has protein malnutrition. which of the following foods should the nurse identify as a source of complete protein? A. eggs B. cereal C. peanut butter D. pasta

A. Eggs Rationale: complete proteins contain all of the essential amino acids to support growth and homeostasis. Examples: eggs, meat, poultry, seafood, milk, yogurt, cheese, soybeans, soybean products

34 A nurse is reviewing the laboratory results of a client who has end-stage renal disease and reports fatigue. The client's hemoglobin level is 8 g/dL. The nurse should expect a prescription for which medication? A. Erythropoietin B. Erythromycin C. Filgrastim D. Calcitriol

A. Erythropoietin Rationale: Erythropoietin stimulates the production of RBCs and is used to treat anemia associated with chronic renal failure. Incorrect Answers: - B. Erythromycin is used to treat infections. There is no indication that this client is experiencing an infection. - C. Filgrastim is used to stimulate the production of neutrophils. There is no indication that this client is experiencing neutropenia. - D. Calcitriol is used to prevent hypocalcemia in clients who have chronic kidney disease. There is no indication that this client is experiencing hypocalcemia.

3 A nurse is providing nutritional counseling for a client who is pregnant. Which of the following nutrients should the nurse instruct the client to increase in her daily diet? A. iron B. Calcium C. Vitamin E D. Vitamin K

A. Iron Rationale: Iron supplements are recommended during pregnancy to promote adequate transfer of iron to the fetus and to support the expansion of the maternal RBC mass

49 A nurse is teaching about a low-cholesterol diet to a client who had a myocardial infarction. Which meal selection by the client indicates an understanding of the teaching? A. chicken breast and corn on the cob B. shrimp and rice C. cheese omelet and turkey bacon D. liver and onions

A. chicken breast and corn on the cob Rationale: Chicken breast is low in cholesterol, and all vegetables, including corn, are cholesterol-free. Incorrect Answers: - B. Shrimp are high in cholesterol and should be eaten in moderation; therefore, this food selection does not indicate an understanding of a low-cholesterol diet. - C. Eggs and cheese are high in cholesterol; therefore, this food selection does not indicate an understanding of a low-cholesterol diet. - D. Liver and other organ meats are high in cholesterol; therefore, this food selection does not indicate an understanding of a low-cholesterol diet.

39 A nurse is caring for a client during her first prenatal visit and notes that she is lactose-intolerant. Which food should the nurse include on a list of calcium sources for this client? A. collard greens B. cottage cheese C. orange juice D. broccoli

A. collard greens Rationale: Collard greens are a good source of lactose-free calcium. Collard greens also contain folic acid, which is a nutrient women should consume during pregnancy to prevent birth defects Incorrect Answers: - B. Cottage cheese is a good source of calcium but contains lactose, which the client cannot tolerate. - C. Orange juice is high in vitamin C, but unless the orange juice is calcium-fortified, it is not a rich source of calcium. - D. Broccoli is high in folic acid, but it is not a rich source of calcium

65 A nurse is teaching the parent of a school-age child who has celiac disease. Which food selected by the parents indicates an understanding of the teaching? A. corn tortilla with black beans B. pizza C. canned soup D. hot dogs

A. corn tortilla with black beans Rationale: Children who have celiac disease are placed on a gluten-free diet. Gluten is found in wheat, rye, and barley. Selecting products made from corn indicates an understanding of the teaching as corn and beans are gluten-free foods. Incorrect Answers: - B. Pizza often contains gluten. Gluten is found in wheat, rye, and barley and should be avoided by a child who has celiac disease. - C. Prepared soups often contain gluten. - D. Hot dogs and hot dog buns often contain gluten.

23 A nurse is reviewing laboratory findings of a client who has protein-calorie malnutrition. Which finding should the nurse expect? A. decreased albumin B. elevated hemoglobin C. elevated lymphocytes D. decreased cortisol

A. decreased albumin Rationale: A decrease in the albumin level can be an indication of long-term protein depletion. Other potential conditions that result in decreased albumin levels include burns, wound drainage, and impaired hepatic function. Incorrect Answers: - B. Protein-calorie malnutrition can negatively impact the production of RBCs, resulting in a decrease in hemoglobin. - C. Nutritional deficiencies such as protein-calorie malnutrition can result in low lymphocyte levels, which increases the client's risk of infection. - D. Cortisol is a glucocorticoid that plays a role in the metabolism of proteins, fats, and carbohydrates. Low levels are associated with Addison's disease. However, cortisol is not reflective of protein-calorie malnutrition.

10 A nurse is teaching a group of clients about the functions of liver and gallbladder. What should the nurse include in the teaching as the purpose of bile? A. digesting fats B. producing chyme C. Stimulating gastric acid secretion D. Providing energy

A. digesting fats Rationale: Bile is a product of the liver and aids in the digestion of fats Incorrect Answers: - B. Chyme is a semi-solid mixture of food and gastric secretions that is formed in the stomach. - C. Gastrin is a hormone produced by the stomach mucosa that stimulates the release of gastric secretions during the process of digestion. - D. Glycogen is stored in the liver and is released in the form of glucose to meet the body's energy needs.

74 A nurse is panning an in-service training session about nutrition. Which piece of information should the nurse include? A. fats provide energy B. carbohydrates repair body tissue C. fats regulate fluid balance D. carbohydrates prevent interstitial edema

A. fats provide energy Rationale: Fat serves as a stored energy source for the body, providing 9 cal/g of energy. Incorrect Answers: - B. Proteins play a role in tissue repair. - C. Protein is primarily responsible for regulating fluid balance. - D. The presence of protein prevents interstitial edema. An appropriate amount of albumin in blood keeps interstitial edema from occurring.

71 A nurse is caring for a client who has osteoporosis and a new prescription for calcium supplements. Which food should the nurse recommend to promote calcium absorption? A. fortified milk B. ripe bananas C. steamed broccoli D. green leafy vegetables

A. fortified milk Rationale: Fortified milk provides 2.45 mcg of vitamin D, which promotes calcium absorption from the gastrointestinal tract. Adults up to age 70 need 600 international units of vitamin D per day and 800 international units thereafter. Therefore, fortified milk is a good source of vitamin D. Incorrect Answers: - B. Bananas are a good source of potassium and can reduce bone loss. However, bananas do not promote calcium absorption. - C. Broccoli is a good source of vitamin C, which is important for bone matrix formation. However, steamed broccoli does not promote calcium absorption. - D. Green leafy vegetables are a good source of vitamin K. However, green leafy vegetables contain oxalic acid, which decreases calcium absorption.

22 A nurse is teaching dietary-modification strategies to a client who has been newly diagnosed with cirrhosis. Which food should the nurse recommend? A, grilled chicken B. potato soup C. Fish sticks D. Baked ham

A. grilled chicken Rationale: The nurse should identify that a client who has cirrhosis requires protein to compensate for disease-related weight loss. Increasing protein intake from animal or plant sources will also provide the client with more energy. Incorrect Answers: - B. A client who has cirrhosis should avoid foods that are high in sodium content, especially if ascites is present; therefore, the nurse should recommend another food choice. - C. A client who has cirrhosis should avoid foods that are high in fat, especially if the client is experiencing steatorrhea; therefore, the nurse should recommend another food choice. - D. A client who has cirrhosis should avoid foods that are high in sodium, especially if ascites is present; therefore, the nurse should recommend another food choice

37 A nurse is teaching a group of parents of toddlers about measures to reduce the risk of choking. Which of the following foods increase the risk of choking in toddlers? SATA A. hot dogs B. grapes C. bagels D. marshmallows E. graham crackers

A. hot dogs B. grapes C. bagels D. marshmallows Rationale: Foods that are shaped like a tube, such as hot dogs and grapes, place toddlers at risk for choking because they can completely block the throat when swallowed whole due to their shape and solidity. Foods that are hard to chew, such as bagels and marshmallows, place toddlers at risk for choking; if swallowed before they are adequately chewed, they can block the airway. Incorrect Answer: - E. All foods and fluids can potentially cause choking. However, graham crackers become soft quickly when mixed with saliva. Their consistency when wet is more like cooked cereal or soft cookies soaked in milk. Therefore, graham crackers do not pose an increased choking hazard for toddlers.

24 A nurse is presenting an in-service training session about nutrition. Which simple sugar should the nurse identify as the carbohydrate found in milk? A. lactose B. sucrose C. maltose D. fructose

A. lactose Rationale: Lactose is a form of sugar found in milk Incorrect Answers: - B. Sucrose is table sugar and is also found in fruits and vegetables. - C. Maltose is found in germinating cereals, such as barley. - D. Fructose is found in honey and fruit.

33 A nurse is planning care for a client who is receiving chemotherapy and has a protein deficiency. Which interventions should the nurse include in the plan of care? SATA A. mix powdered skim milk into liquid milk B. add a raw egg to fruit smoothies C. add a slice of cheese to hot veggies D. add honey to hot tea E. mix yogurt into fresh fruit

A. mix powdered skim milk into liquid milk C. add a slice of cheese to hot veggies E. mix yogurt into fresh fruit Rationale: Dairy products are good sources of protein. Mixing powdered skim milk into liquid milk can provide the client with additional protein. Adding cheese to a vegetable can increase the client's protein intake. Adding yogurt to fresh fruit will increase the client's protein intake. Incorrect Answers: - B. Clients who are immunocompromised should avoid foods that contain raw eggs because they are a potential source of infection. - D. Adding honey to hot tea can increase the client's caloric intake, but this will not increase the client's protein intake.

66 A nurse is providing teaching to a female client who has a new prescription for pravastatin to treat hyperlipidemia. Which piece of information should the nurse include in the teaching? A. pravastatin can be taken with grapefruit juice B. pravastatin can be continued during pregnancy C. pravastatin should be taken with the morning meal D. laboratory testing to monitor the client's WBC count is required

A. pravastatin can be taken with grapefruit juice Rationale: Pravastatin, unlike other statins, such as lovastatin, simvastatin, and atorvastatin, is not affected by CYP3A4 inhibitors. It is safe for the client to consume grapefruit juice if desired. Incorrect Answers: - B. Pravastatin can cause fetal anomalies if taken during pregnancy. The nurse should instruct the client to notify her provider if pregnancy is planned or if she becomes pregnant. - C. Taking pravastatin in the evening is recommended as the synthesis of cholesterol increases during the night, thereby increasing the efficacy of the medication. The nurse should instruct the client to take the medication at bedtime. - D. Clients who are taking statin medications should have laboratory testing to evaluate liver function prior to starting the medication and should undergo cholesterol and triglyceride testing periodically during treatment. Pravastatin does not affect the WBC count.

72 A nurse is teaching a client with chronic kidney disease about predialysis dietary recommendations. The nurse should recommend restricting the intake of which of the following nutrients? A. protein B. carbohydrates C. calcium D. mono-unsaturated fats

A. protein Rationale: Dietary restrictions for clients who have chronic kidney disease vary based on the degree of kidney function; however, most clients need protein limitations. Predialysis protein restriction can help preserve some kidney function. Incorrect Answers: - B. Clients who have chronic kidney disease require enough calories to avoid the use of muscle protein for energy. Carbohydrates are a good source of calories for these clients. - C. Many clients who have chronic kidney disease require calcium, vitamin D, and iron supplements. - D. Clients who have chronic kidney disease require enough calories to avoid the use of muscle protein for energy. Foods like canola oil and olive oil are monounsaturated fats that can supply additional calories in the client's meals.

77 A nurse is caring for an older adult client who has dementia, gets up frequently to pace during meals, and eats sparingly. Which actions should the nurse take? A. provide finger foods for the client B. offer food at fewer times each day to promote hunger C. administer a benzodiazepine medication to the client before mealas D. assist the client to sit still during meals using soft restraints

A. provide finger foods for the client Rationale: finger foods will provide nutrition and accommodate the client's behavior Incorrect Answers: - B. Offering food at fewer times each day is likely to decrease the client's intake and is inappropriate. Instead, the nurse should provide snacks between meals and in the evenings if the client is at risk of under nutrition. - C. Administration of a benzodiazepine medication before meals is a form of restraint and should be used only for the safety of the client or others. In addition, the medication can make the client drowsy. - D. Use of physical restraints should be reserved only for the safety of the client or others. In addition, restraining the client is likely to promote agitation.

32 A nurse in a pediatric clinic is talking with the parent of a toddler who states that her child will not sit at the table to eat with the family. She asks the nurse for recommendations for "finger food" for her child. Which food should the nurse suggest? A. slices of ripe banana B. popcorn C. slices of hot dogs D. raw carrots

A. slices of ripe banana Rationale: Toddlers should have about 8 oz (1 cup) of fruit per day. Bananas are nutritious and, as long as they are soft, do not present a choking hazard for young children. Incorrect Answers: - B. Popcorn, chunks of cheese, and raisins present choking hazards for young children. - C. Hot dogs, sausages, and tough meat present choking hazards for young children. - D. Raw carrots, nuts, and seeds present choking hazards for young children.

13 A nurse is caring for a client who has peripheral edema. The nurse should identify that which nutrient regulates extracellular fluid volume? A. sodium B. calcium C. Potassium D. Magnesium

A. sodium Rationale: Sodium regulates extracellular fluid balance, nerve impulse transmission, acid-base balance, and various other cellular activities. Incorrect Answers: - B. Calcium supports bone and tooth formation and facilitates nerve impulse transmission. However, it does not affect extracellular fluid volume. - C. Potassium affects storage of glycogen, nerve impulse transmission, cardiac conduction, and smooth muscle contraction. However, it does not affect extracellular fluid volume. - D. Magnesium affects enzyme and neurochemical activities and the excitability of cardiac and skeletal muscles. However, it does not affect extracellular fluid volume.

68 A nurse is providing teaching to a client who has gout and urolithiasis. The client asks how to prevent uric acid stones. Which suggestions should the nurse provide? A. take allopurinol as prescribed B. exercise several times a week C. limit intake of foods high in purine D. decrease daily fluid intake E. avoid citrus juices

A. take allopurinol as prescribed B. exercise several times a week C. limit intake of foods high in purine Rationale: The nurse should inform the client that allopurinal is an antigout medication that reduces uric acid, which helps prevent uric acid stone formation. Immobility is a risk factor for stone formation; therefore, the client should maintain a healthy lifestyle, including regular exercise. Purine increases the risk of uric acid stone formation; organ meats, poultry, fish, red wine, and gravy are high in purine. Incorrect Answers: - D. Maintaining an adequate fluid intake of 2 to 3 L per day reduces the risk of stone formation. - E. Citrus juices alkalinize the urine, which helps prevent uric acid stone formation.

67 A nurse is caring for a client who has a deficiency of vitamin D. Which food should the nurse recommend the client include in his diet? A. whole milk B. chicken C. oranges D. dried peas

A. whole milk Rationale: The fat-soluble vitamins (A, D, E, K) require fatty substances or tissues to be dissolved and also require the presence of bile in the small intestine for absorption. Whole milk contains vitamins A and K and is often fortified with vitamin D. Incorrect Answers: - B. The water-soluble vitamins (B complex and C) readily dissolve in water and are absorbed into the bloodstream from the small intestine. Chicken contains many of the B complex vitamins, including B2, B3, B6, B12, and pantothenic acid. - C. The water-soluble vitamins (B complex and C) readily dissolve in water and are absorbed into the bloodstream from the small intestine. Oranges are a good source of vitamin C. - D. The water-soluble vitamins (B complex and C) readily dissolve in water and are absorbed into the bloodstream from the small intestine. Dried peas are a good source of many of the B complex vitamins, including B1, folate, and pantothenic acid.

9 A nurse is providing teaching to a client who has COPD about maintaining proper nutrition. Which of the following statements by the client indicates an understanding of the teaching? A. "I will increase my fluid intake when i eat a meal" B. "I will eat more cold foods at meals rather than hot foods" C. "I will avoid high fat foods like butter and gravies" D. "I will cook my meals instead of eating convenience foods"

B. "I will eat more cold foods at meals rather than hot foods" Rationale: The client should prepare more cold foods to eat because they provide a decreased feeling of fullness compared to hot foods. Incorrect Answers: - A. Drinking fluids with meals will contribute to early satiety. The client should consume as much food as possible prior to feeling full or tired. - C. The nurse should encourage the client to add items such as butter, sauces, and gravy to foods to increase caloric intake. - D. The nurse should recommend the client eat convenience foods, easy-to-prepare meals, and ready-prepared meals because they take less energy to cook.

70 A nurse is completing dietary teaching with a client who has heart failure and is prescribed a 2 g sodium diet. Which statement by the client indicates an understanding of the teaching? A. "i should use salt sparingly while cooking" B. "i can have yogurt as a dessert" C. "i should use baking soda when i bake" D. "i should use canned vegetables instead of frozen"

B. "i can have yogurt as a dessert" Rationale: Yogurt is low in fat and sodium and is a good source of calcium and protein. Incorrect Answers: - A. The client requires further teaching when he states he will use salt sparingly while cooking. Salt should be eliminated from the client's diet. Spices or vinegar, which are low in sodium, can be used to season the client's food. - C. The client requires further teaching when he states he will use baking soda when baking. Baking soda is high in sodium and should be eliminated from the client's diet. - D. The client requires further teaching when he states he should select canned vegetables instead of frozen. Canned vegetables are high in sodium and should be eliminated from the client's diet. Frozen or fresh vegetables, which are low in sodium, should be included.

38 A nurse is teaching a client who is beginning a vegan diet and is concerned about maintaining adequate protein intake. Which food serving should the nurse recommend due to the high amount of protein? A. 1/2 cup tomato soup B. 1/2 cup hummus C. 2 tbsp peanut butter D. 1 cup penne pasta

B. 1/2 cup hummus Rationale: Hummus is the best food source to recommend of those provided because it contains 9.7 g of protein per 1/2 cup serving. Incorrect Answers: - A. Tomato soup contains 1.08 g of protein per 1/2 cup. - C. Peanut butter contains 7.11 g of protein per 2 tablespoons. - D. Penne pasta contains 5.81 g of protein per cup.

16 A nurse in a provider's office is reviewing the medical records of a group of clients. Which client is at risk for iron deficiency? SATA A. a client who is postmenopausal B. A client who is vegetarian C. a middle adult male client D. a client who is pregnant E. a toddler who is overweight

B. A client who is vegetarian D. a client who is pregnant E. a toddler who is overweight Rationale: A client who is a vegetarian might require additional iron because the availability of iron in vegetable food sources is limited. During pregnancy, maternal blood volume increases, and the fetus requires additional iron. Therefore, the RDA of iron for clients who are pregnant is increased to 27 mg per day. Toddlers who are overweight may get most of their calories from milk and foods that are not considered healthy, which increases their risk for iron-deficiency anemia. Incorrect Answers: - A. Iron requirements are increased for women who have excessive blood loss due to menstruation. Generally, postmenopausal women do not require additional iron. - C. Most adult males consume adequate iron in their diet and do not require supplementation.

8 A nurse is providing teaching to a young adult client who has a history of calcium oxalate renal calculi. Which of the following instructions should the nurse include? A. Drink fruit punch or juice with every meal B. Consume 1000 mg of dietary calcium daily C. Take 1 g of a vitamin C supplement daily D. increase your daily brain intake

B. Consume 1000 mg of dietary calcium daily Rationale: Clients who are prone to the development of calcium oxalate stones should consume the recommended daily allowance for calcium for their age. The RDA for calcium for adults ages 19 to 50 is 1,000 mg daily. Calcium should be obtained from dietary sources rather than supplements that can promote the development of renal calculi. Incorrect Answers: - A. Clients who are prone to renal calculi should limit beverages with a high sugar content such as fruit punch or juice because these beverages can promote the development of renal calculi. - C. Clients who are prone to the development of calcium oxalate stones should avoid taking nutritional supplements, such as vitamin C. Taking 1 g of vitamin C daily can result in toxicity and promote the development of renal calculi. - D. Clients who are prone to renal calculi should exclude bran from their diet because bran is high in oxalates, which can precipitate the formation of renal calculi.

36 A nurse is planning an in-service training session regarding nutrition. Which mineral should the nurse identify as involved in oxygen transportation? A. Zinc B. Iron C. Phosphorus D. Magnesium

B. Iron Rationale: Iron transports oxygen by means of hemoglobin and myoglobin. It is also a component of enzyme systems. Incorrect Answers: - A. Zinc plays a role in tissue growth and wound healing and supports immune function, but it does not affect oxygen transport. - C. Phosphorus plays a role in bone and teeth formation and energy metabolism, but it does not affect oxygen transport. - D. Magnesium affects enzyme and neurochemical activities and the excitability of cardiac and skeletal muscles, but it does not affect oxygen transport.

55 A nurse is providing nutritional teaching to a group of clients. Which definition for the recommended dietary allowance (RDA) should the nurse include in the teaching? A. The RDA is a comprehensive term that includes various dietary standards and scales B. The RDA defines the level of nutrient intake that meets the needs of healthy people in various groups C. the RDA defines the levels of nutrients that should not be exceeded to prevent adverse health effects D. the RDA is the daily percentage of energy intake values for fat, carbohydrate, and protein

B. The RDA defines the level of nutrient intake that meets the needs of healthy people in various groups Rationale: various groups.The RDA represents daily requirements considered adequate for healthy people. RDAs are based on estimated amounts for each nutrient, including additional amounts for individuals such as women and infants.

17 A nurse is planning dietary teaching for a client who has diabetes mellitus. Which action should the nurse plan to take first? A. Obtain sample menus from the dietitian to give to client B. ask the client to identify the types of foods she prefers C. identify the recommended range of the client's blood glucose level D. Discuss long-term complications that can result from non-adherence to the dietary plan

B. ask the client to identify the types of foods she prefers Rationale: The nurse should apply the nursing process priority-setting framework to plan client care and prioritize nursing actions. Incorrect Answers: - A. The nurse should work with a registered dietitian to provide the client with appropriate materials to use during the dietary teaching. Sample menus can give the client ideas of new foods or exchanges; however, there is another action that the nurse should take first. - C. The nurse should identify the recommended blood glucose range that the client should maintain through diet, medication, and lifestyle changes; however, there is another action that the nurse should take first. - D. The nurse should identify long-term complications so the client understands the importance of adherence to the dietary plan; however, there is another action that the nurse should take first.

76 A nurse is caring for a client who is receiving total par-enteral nutrition (TPN). Which of the following actions should the nurse take? A. Administer 0.9% sodium chloride until TPN is available from the pharmacy B. check the client's capillary blood glucose level every 4 hours C. obtain the client's weight each week D. change the IV tubing every 3 days

B. check the client's capillary blood glucose level every 4 hours Rationale: The nurse should check the client's capillary blood glucose level every 4 hours or according to facility policy due to the client's risk of hyperglycemia while receiving TPN. The dextrose concentration in TPN increases the risk of this complication. Incorrect Answers: - A. The nurse should administer 10% dextrose in water or 20% dextrose in water if TPN is temporarily unavailable from the pharmacy. - C. A client who is receiving TPN is at risk for fluid imbalance due to the fluid administration and hyperosmolarity of the TPN; therefore, the nurse should monitor the client's weight daily. - D. The nurse should change the IV tubing used for TPN every 24 hours to decrease the client's risk of infection.

69 A nurse is teaching an assistive personnel about dietary restrictions for a client who is taking phenelzine to treat depression. The AP's selection of which food for the client's lunch indicates an understanding of the teaching? A. bologna on wheat bread B. chicken salad C. cheddar cheese and crackers D. pizza with pepperoni

B. chicken salad Rationale: Phenelzine is an MAOI. Clients taking MAOIs must avoid foods that contain tyramine due to the potential for a dangerous food-drug interaction. Foods high in tyramine include those that are processed and aged, such as luncheon meats and cheeses. This menu selection does not contain food high in tyramine and indicates an understanding of the teaching. Incorrect Answers: - A. This menu selection includes a highly processed meat that contains tyramine; therefore, it is not an appropriate choice. - C. This menu selection includes an aged cheese that contains tyramine; therefore, it is not an appropriate choice. - D. This menu selection includes pizza, which typically includes aged cheese (such as parmesan) and processed meat, both of which contain tyramine; therefore, it is not an appropriate choice.

40 A nurse is conducting dietary teaching with a client who has a history of renal calculi. Which instruction should the nurse include in the teaching? A. Consume foods containing Vitamin C B. drink 3.8 L of water throughout the day C. Suggest almonds as a snack D. Limit sodium intake to 3 g per day

B. drink 3.8 L of water throughout the day Rationale: The nurse should instruct the client to drink 3.8 L of water per day to keep urine diluted and decrease the risk of kidney stone formation. Incorrect Answers: - A. The nurse should instruct the client to avoid large amounts of vitamin C, which can increase the risk of kidney stone formation. - C. The nurse should instruct the client to avoid high-oxalate foods like almonds or other types of nuts because they increase the risk of kidney stone formation. - D. The nurse should instruct the client to limit sodium intake to 2 g per day. A high-sodium diet increases the risk of kidney stone formation.

60 Which assessment findings identify an indication of protein-calorie malnourishment? A. gingivitis B. dry, brittle hair C. edema D. spoon shaped nails E. poor wound healing

B. dry, brittle hair C. edema E. poor wound healing Rationale: Dry, brittle hair that falls out easily suggests inadequate protein intake and malnutrition. Edema can occur when albumin levels are lower than the expected reference range and indicates protein-calorie malnutrition. Adequate wound healing depends on the ingestion of sufficient protein, calories, water, vitamins (C and A), iron, and zinc. Incorrect Answers: - A. Gingivitis is a manifestation of vitamin C deficiency. - D. Spoon-shaped nails are a manifestation of iron deficiency.

57 A nurse is planning care for a client who is postoperative following a gastrectomy. Which strategy should the nurse include to help prevent dumping syndrome? A. have the client drink plenty of water with meals B. eliminate simple sugars and sugar alcohols from the client's diet C. limit the client's intake to 2 meals per day D. offer the client meals that are low in protein or protein free

B. eliminate simple sugars and sugar alcohols from the client's diet Rationale: Sugar, honey, and sugar alcohols (sorbitol and xylitol) increase hypertonicity and propel food through the intestines faster than food without sweeteners. Incorrect Answers: - A. The client should drink beverages between meals only, about 1 hour after eating solid foods. Mixing food and fluids propels the mixture through the gastrointestinal tract faster than solid food alone. - C. The client should have several smaller meals that include only 1 or 2 foods throughout the day. - D. The client should ingest protein at every meal to slow gastric emptying.

56 A nurse is providing dietary teaching to a client who has chronic renal failure. Which food choice by the client indicates an understanding of the teaching? A. canned soup B. grilled fish C. pastrami D. peanut butter

B. grilled fish Rationale: Protein choices, such as fresh fish or poultry, can minimize the risk of worsening chronic renal failure. Incorrect Answers: - A. Foods that are high in sodium, such as canned soup, should be avoided by clients who have chronic renal failure. - C. Foods that are high in sodium, such as pastrami, should be avoided by clients who have chronic renal failure. - D. Foods that are high in sodium, such as peanut butter, should be avoided by clients who have chronic renal failure.

46 A nurse in a provider's office is assessing a client. The nurse determines the client's BMI is 21.2. This finding is classified as...? A. underweight B. healthy weight C. overweight D. obese

B. healthy weight Rationale: A BMI 18.5 - 24.9 is in the healthy range. Therefore, this client is considered healthy. Incorrect Answers: - A. A BMI below 18.5 is considered underweight and a health risk. - C. A BMI from 25 to 29.9 is in the overweight range. - D. A BMI greater than or equal to 30 is in the obese range.

78 A nurse is planning an in-service training session about nutrition. Which of the following pieces of information should the nurse include? A. fat breaks down into amino acids B. protein serves as an energy source when other sources are inadequate C. glucose breaks down into ammonia D. carbohydrates provide 9 cal/g of energy

B. protein serves as an energy source when other sources are inadequate Rationale: Protein is used as an energy source for the body when carbohydrates and fat stores are unavailable or depleted. Incorrect Answers: - A. Protein breaks down into amino acids. - C. Protein breaks down into ammonia. Glucose does not produce any products of metabolism. - D. Carbohydrates provide 4 cal/g of energy. Fat provides 9 cal/g of energy.

82 A nurse is teaching a client who has lactose intolerance about dietary modifications. Which of the following foods should the nurse recommend? A. bread B. soy cheese C. luncheon meats D. instant mashed potatoes

B. soy cheese Rationale: The nurse should recommend lactose-free food items like soy cheese, soy yogurt, almond milk, and lactose-free milk. Incorrect Answers: - A. Foods that might contain lactose include bread and breakfast cereals. - C. Foods that might contain lactose include luncheon meats, margarine, and salad dressings. - D. Foods that might contain lactose include instant mashed potatoes and instant soups.

19 A nurse is conducting dietary teaching for a client who has AIDS. Which instruction should the nurse include in the teaching? A. discard leftovers after 8 hours B. use a separate cutting board for poultry C. thaw frozen foods at room temp D. store cold foods at 10 degrees C (50 F) or less

B. use a separate cutting board for poultry Rationale: The nurse should instruct the client to use a separate cutting board for raw poultry. Raw poultry can contain bacteria such as salmonella, which may contaminate other foods or work surfaces. Using a separate cutting board prevents cross-contamination of work surfaces when preparing food. Incorrect Answers: - A. Leftover foods should be discarded after 24 hr to prevent the growth of bacteria that can cause a foodborne illness. - C. The client should thaw frozen foods in the refrigerator to prevent the growth of bacteria that can cause a foodborne illness. - D. The client should store cold foods at 4.4°C (40°F) or less. This prevents the growth of bacteria that can cause a foodborne illness.

59 A nurse is providing teaching to a client who has type 2 diabetes. The client states, "I eat pasta every day. I can't imagine giving it up." Which response should the nurse provide? A. "let's discuss this with your doctor; giving up daily pasta may not be necessary" B. "is there another favorite dish you can substitute?" C. "you don't have to give up pasta; just adjust the amount you eat" D. "you can use no added salt tomato products on your pasta"

C. "you don't have to give up pasta; just adjust the amount you eat" Rationale: The American Diabetes Association recommends individualizing carbohydrate restriction for each client. A careful assessment of the client's usual dietary practices and modifications is an important part of teaching clients to manage this disorder.

21 A nurse is providing teaching about calcium intake to a client who is breastfeeding. What is the recommended daily calcium intake for a client who is breastfeeding? A. 800 mg B. 400 mg C. 1000 mg D. 2000 mg

C. 1000 mg Rationale: The nurse should instruct the client that 1,000 mg of calcium is recommended for women age 19 and older, as well as those who are lactating. This amount of calcium is sufficient to meet the needs of the client and the infant because additional calcium is absorbed from the intestines during this time

15 A nurse is reviewing laboratory reports of a client who is receiving enteral feedings. Which value indicates a complication of enteral feeding that the nurse should report to the provider? A. sodium 143 mEq/L B. potassium 4.2 mEq/L C. BUN 25 mg/dL D. glucose 185 mg/dL

C. BUN 25 mg/dL Rationale: A BUN level of 25 mg/dL is above the expected reference range of 10 - 20 mg/dL and indicates dehydration, which is a complication of enteral feedings. The nurse should report this laboratory value to the provider. Incorrect Answers: - A) A sodium level of 143 mEq/L is within the expected reference range of 136 to 145 mEq/L and does not indicate a complication of enteral feeding. - B) A potassium level of 4.2 mEq/L is within the expected reference range of 3.5 to 5.0 mEq/L and does not indicate a complication of enteral feeding. - D) A glucose level of 185 mg/dL is within the expected reference range of <200 mg/dL for casual blood glucose and does not indicate a complication of enteral feeding.

5 A nurse is providing teaching about nutrients to a client. Which of the following statements should the nurse include? A. Carbohydrates transport nutrients throughout the body B. Fats prevent ketosis C. Protein builds and repairs body tissue D. Carbohydrates help regulate body temperature

C. Protein builds and repairs body tissue Rationale: The primary function of protein involves building and repairing body tissues (e.g. muscles, tendons, and collagen). The skin, hair, and nails are also made of protein structures. A diet that is low in protein can impair wound healing. Incorrect Answers: - A. Proteins transport nutrients such as fats and fat-soluble vitamins throughout the body. Protein in the form of hemoglobin transports oxygen; in the form of albumin, it transports many medications. - B. Ketosis develops when the body relies only on fats to meet energy needs. Carbohydrates prevent ketosis by allowing the body to use fat effectively as an energy source without the production of ketones. - D. Fats help regulate body temperature by providing a protective layer when the environmental temperature drops.

7 A nurse is caring for a client who has xerostomia with a lack of saliva. Which of the following nutrients will be affected by the lack of salivary amylase? A. Fat B. Protein C. Starch D. Fiber

C. Starch Salivary amylase begins the process of digestion in the mouth with the initial breakdown of starches. The majority of starch breakdown occurs in the small intestine with pancreatic amylase. Incorrect Answers: - A. Lipase breaks down fats. - B. Pepsin breaks down proteins. - D. Fiber is not digestible, but fermentation occurs in the large intestine by intestinal microbes, which results in the release of methane, hydrogen, water, and fatty acids.

64 A nurse is caring for a client who has scurvy. Which vitamin deficiency should the nurse identify as the cause of the disease? A. Vitamin A B. Vitamin B3 C. Vitamin C D. Vitamin D

C. Vitamin C Rationale: Vitamin C deficiency produces symptoms of scurvy such as delayed wound healing and capillary fragility. Incorrect Answers: - A. A deficiency in vitamin A produces manifestations of night blindness and immunodeficiency. It is not associated with scurvy. - B. A deficiency in vitamin B3 produces manifestations of pellagra, which include a scaly rash on sun-exposed skin, confusion, paranoia, and diarrhea. - D. A deficiency in vitamin D produces manifestations of rickets and osteomalacia, which include bowed legs, fractures, and malformed teeth.

28 A nurse is assisting a client who has dysphagia with eating meals. Which action should the nurse take? A. add water to soups for a thinner consistency B. encourage using water to clear the client's mouth C. ask the client to think of a food that produces salivation D. remind client to rest after meals

C. ask the client to think of a food that produces salivation Rationale: To prevent dryness in the mouth during meals, which can be a risk factor for choking, the nurse should ask the client to think of a food that promotes salivation (e.g. lemon slices or dill pickles). Incorrect Answers: - A. Thick liquids are easier for clients who have dysphagia to manage when swallowing. - B. Clients who have dysphagia should only drink fluids after clearing the mouth of food. They should use coughing and dry swallowing to remove food particles from the mouth. - D. Clients who have dysphagia should rest before meals to avoid fatigue when focusing on swallowing safely.

20 A nurse in a provider's office is teaching a client about foods that are high in fiber. Which food choices made by the client indicate an understanding of the teaching? SATA A. canned peaches B. white rice C. black beans D. whole grain bread E. tomato juice

C. black beans D. whole grain bread Rationale: Dried peas and beans, including black beans, are high in fiber. Whole grains consist of the entire kernel and are also high in fiber. Incorrect Answers: - A. Canned fruits, including peaches, are recommended for clients on a low-fiber diet. Fresh fruits contain more fiber. - B. White rice is recommended for clients on a low-fiber diet. Brown rice is higher in fiber. - E. Canned juices, with the exception of prune juice, are recommended for clients on a low-fiber diet.

44 A nurse is caring for a client from the Middle East who has celiac disease. Which action should the nurse perform regarding the client's diet? A. provide foods prepared according to kosher dietary law B. ask the kitchen to prepare grits to meet the client's need for grains C. determine the client's dietary preferences D. prepare a diet tray that includes vegetables and barley soup

C. determine the client's dietary preferences Rationale: the nurse should assess the client's dietary habits before planning to meet dietary needs. Incorrect Answers: - B. Although clients who have celiac disease are unable to consume grains such as wheat, rye, and barley, it is not culturally sensitive to request the preparation of certain foods without consulting the client. - D. Clients who have celiac disease are unable to process certain grains, including wheat, rye, and barley. If consumed, these grains can result in diarrhea, abdominal pain, and weight loss.

42 A nurse is caring for a client who has a BMI of 29 and expresses a desire to lose weight. Which action should the nurse take first? A. refer the client to a nutritionist B. discuss eating strategies with the client C. determine the client's intention to change current eating habits D. instruct the client to perform 30 min of vigorous exercise daily

C. determine the client's intention to change current eating habits Rationale: When using the nursing process, the nurse should first assess the client's readiness to commit to a change in behavior.

26 A nurse is providing teaching to a client who has constipation. Which instruction should the nurse include? A. use bismuth subsalicylate regularly B. consume low fiber diet C. eat yogurt with live cultures D. use bisacodyl suppositories regularly

C. eat yogurt with live cultures Rationale: Yogurt with live bacterial cultures provides dietary probiotics that help maintain and promote bowel function. Incorrect Answers: - A. Bismuth subsalicylate is an antidiarrheal agent and will increase constipation. - B. Increasing fiber gradually can prevent constipation. A low-fiber diet is recommended for clients who have diarrhea. - D. The regular use of stimulant laxatives can result in decreased defecation reflexes, causing a reliance on stimulant laxatives for bowel movements. This may eventually cause electrolyte imbalances and colitis.

11 A nurse is reviewing the dietary choices of a client who has chronic pancreatitis. Which food item should the nurse suggest removing from the client's menu for the following day? A. white rice B. broiled cod C. ice cream D. canned peaches

C. ice cream Rationale: Clients who have chronic pancreatitis should limit their fat intake to no more than 30% - 40% of total calories. Ice cream is high in fat, with 48 g of fat in a 1-cup serving of vanilla ice cream. The client should choose healthier fat-containing options to support a balanced diet, such as avocados and nuts. Incorrect Answers: - A. Foods high in fiber can reduce lipase activity, making a low-fiber diet helpful for clients who have chronic pancreatitis. White rice is low in fiber, with only 1 g of fiber in a 1-cup serving. - B. Clients who have chronic pancreatitis need an adequate amount of protein, about 1.5 g/kg/day. Fish is a good source of protein, with 26 g of protein in a 170 g portion of cod. - D. Foods high in fiber can reduce lipase activity, making a-low fiber diet helpful for clients who have chronic pancreatitis. Canned peaches are low in fiber, with only 3 g of fiber in a 1-cup serving.

30 A nurse is providing teaching about nutritious diets to a group of adult women. Which statement should the nurse include? A. "include at least 3 g of sodium to daily diet" B. "limit wine consumption to 230 mL daily C. include 2.5 cups of veggies in daily diet" D. "limit water intake to 1.5 L each day"

C. include 2.5 cups of veggies in daily diet" Rationale: The nurse should instruct the women to include 2.5 cups of vegetables and 2 cups of fruit in their daily diets. Fruits and vegetables should be a variety of colors to provide an assortment of nutrients.

43 A nurse is talking with the parent of a preschool-aged child who tells the nurse, "My child has suddenly become disinterested in certain foods." Which of the following statements should the nurse make? A. during this phase, feed your child anything that she will eat B. increase the amount of calories and water your child consumes C. keep a diary of the foods your child eats each day D. provide a large variety of fruit juices for your child to choose from

C. keep a diary of the foods your child eats each day Rationale: The nurse should encourage the parent to keep a diary of the foods the child eats throughout the day for 1 week. This can help the parent realize that the child may be eating better than expected. Evidence suggests that children can self-regulate their caloric intake. When they eat less at a meal, they can compensate by eating more at another meal or by having a snack.

14 A nurse is providing teaching to a client regarding protein intake. Which foods should the nurse include as an example of an incomplete protein? A. eggs B. soybeans C. lentils D. yogurt

C. lentils Rationale: Incomplete proteins are missing 1 or more of the essential amino acids necessary for the synthesis of protein in the body. Examples: lentils, vegetables, grains, nuts, and seeds. Incorrect Answers: - A. B. D. Complete proteins such as eggs, soybeans, and yogurt contain all of the essential amino acids necessary for the synthesis of protein in the body.

47 A nurse is caring for an infant who has gastroenteritis and is dehydrated. Which characteristics place the infant at a higher risk of electrolyte imbalances compared to an adult client? A. less extracellular fluid B. reduced body surface area C. longer intestinal tract D. decreased rate of metabolism

C. longer intestinal tract Rationale: Compared to adults or older children, infants have a longer intestinal tract. This results in greater fluid losses, especially through diarrhea. Incorrect Answers: - A. Compared to adults or older children, infants have a larger amount of extracellular fluid. This results in a larger fluid volume and more rapid water loss in this age group. - B. Compared to adults or older children, infants have a larger body surface area. This results in greater fluid losses through insensible means. - D. Compared to adults or older children, infants have an increased rate of metabolism. This results in the production of more metabolic waste, which must be excreted by the kidneys.

51 A nurse is caring for a client who is receiving intermittent enteral feedings through an NG tube. The specific gravity of the client's urine is 1.035. Which action should the nurse take? A. deliver the formula at a slower rate B. request a lower fat formula C. provide more water with feedings D. instill a lactose-free formula

C. provide more water with feedings Rationale: The elevation in the client's specific gravity indicates dehydration. The nurse should provide more fluids either by adding free water to feedings or by instilling water between feedings. Another strategy is to request a formula that contains less protein. Incorrect Answers: - A. Slowing the delivery rate is an intervention for diarrhea. - B. Instilling a lower-fat formula is an intervention for abdominal distention and bloating. - D. Instilling a lactose-free formula is an intervention for nausea and vomiting.

27 A nurse is caring for a client who has a new diagnosis of pernicious anemia. The nurse should expect the provider to prescribe which medication? A. ferrous sulfate B. epoetin alfa C. vitamin B12 D. folic acid

C. vitamin B12 Rationale: Vitamin B12 is prescribed for pernicious anemia Incorrect Answers: - A. The nurse should expect a prescription for ferrous sulfate for a client who has iron-deficiency anemia. - B. The nurse should expect a prescription for epoetin alfa for a client who has anemia secondary to chemotherapy. - D. The nurse should expect a prescription for folic acid for a client who has anemia due to a folic acid deficiency.

62 A nurse is providing teaching about food choices to a client who has diabetes mellitus. Which statement by the client indicates an understanding of the teaching? A. "i will need to eliminate sweet desserts from my diet" B. "i should avoid using sucralose in my coffee" C. "i should consume alcohol between meals in moderation" D. "i should replace white bread with whole grain bread"

D. "i should replace white bread with whole grain bread" Rationale: Clients with diabetes mellitus have the same fiber requirements as the general population. Fiber content can be increased by substituting white bread, which is made with refined grains, with whole-grain bread, which retains the outer layer of the grain that is higher in fiber. Incorrect Answers: - A. Sweet desserts are not prohibited for clients who have diabetes mellitus. Instead, they should be consumed in moderation and substituted for other carbohydrates in the client's meal plan. - B. Sucralose is a non-nutritive sweetener that has been approved by the Food and Drug Administration for this use. It is considered safe for clients who have diabetes mellitus. - C. Although clients who have diabetes mellitus can consume alcohol in moderation, the nurse should instruct the client to consume alcohol with food to avoid hypoglycemia.

45 A nurse is providing teaching about nutrition to an older adult client. The client asks, "Don't I need the same amount of nutrients that I did when I was younger?" Which of response should the nurse make? A. "older adults need less protein" B. "older adults need an increased amount of carbohydrates" C. "older adults need an increased amount of iron" D. "older adults need an increased amount of calcium"

D. "older adults need an increased amount of calcium" Rationale: Older adults require an increased amounts of calcium as well as vitamins D, B12, and A Incorrect Answers: - A. Many older adults require increased amounts of protein because total body protein can decrease as the body ages. - B. Older adults do not require an increased amount of carbohydrates, although some older adults might require increased amounts of fiber. - C. Older adults do not require increased amounts of iron. However, their intake of iron is often inadequate.

80 A nurse is educating a client who is at 10 weeks gestation and reports frequent nausea and vomiting. Which statement should the nurse include in the teaching? A. "you should eat foods served at warm temps" B. "you should brush your teeth right after you eat" C. "you should try to eat sweet foods when you feel nauseated" D. "you should eat dry foods that are high in carbohydrates when you wake up"

D. "you should eat dry foods that are high in carbohydrates when you wake up" Rationale: The nurse should instruct the client to eat foods that are high in carbohydrates such as dry toast or crackers upon waking or when nausea occurs Incorrect Answers: - A. The nurse should instruct the client to eat foods served at cool temperatures to decrease nausea and vomiting. - B. The nurse should instruct the client to avoid brushing her teeth immediately after eating to decrease vomiting. - C. The nurse should instruct the client to eat salty and tart foods during periods of nausea.

58 A nurse is assessing a client's nutritional status. The nurse determines that the client is consuming 500 calories more per day than his energy level requires. If his dietary habits do not change, how long will it take the client to gain 4.5 kg (10 lb)? A. 10 months B. 5 months C. 5 weeks D. 10 weeks

D. 10 weeks Rationale: Because 1 lb of body fat is equivalent to 3500 calories, consuming 500 extra calories each day for 7 days would lead to a total of 3500 calories and a 1 lb gain per week. At the rate of 1 lb per week, the client would gain 10 lb in 10 weeks

4 A nurse is providing dietary teaching for a client with AIDS who has stomatitis of the mouth. Which of the following instructions should the nurse include in the teaching? A. Rinse the mouth with chlorhexidine solution every 2 hr B. Limit fluid intake with meals C. Provide oral hygiene with a firm-bristled toothbrush after each meal D. Avoid salty foods

D. Avoid salty foods Rationale: Stomatitis is an inflammation of the mucosa of the mouth, usually with ulcerations. Foods that are spicy, acidic, or salty should be avoided to prevent further irritation and damage to the oral mucosa.

6 A nurse is providing teaching to the guardian of a child who has celiac disease. Which of the following foods should the nurse instruct the guardian to omit from the child's diet? A. Cornflakes B. Reduced-fat milk C. Canned fruits D. Wheat bread

D. Wheat bread Rationale: Clients who have celiac disease should eliminate as much gluten as possible from their diets. Wheat, rye, and barley contain gluten and should be eliminated from the diet of a child who has celiac disease.

73 A nurse is caring for a client who is recovering at home after inpatient treatment for burn injuries. To increase the protein density of the client's meals, which of the following recommendations should the nurse make to the client's caregiver? A. use sour cream instead of plain yogurt B. add honey to cooked cereals C. use salad dressing in place of mayonnaise D. add chopped hard boiled eggs to soups and casseroles

D. add chopped hard boiled eggs to soups and casseroles Rationale: Eggs are a good source of protein. Adding them to combination foods and coating meats with raw eggs before breading and cooking increases the protein density of those foods Incorrect Answers: - A. To increase protein density, the caregiver should use plain yogurt in place of sour cream. - B. Adding honey to cereal increases the caloric density, not the protein density. - C. Mayonnaise contains more protein than most salad dressings.

12 A home health nurse is planning care for a client who is receiving chemotherapy and has neutropenia. Which food should the nurse include in the client's plan of care? A. soft boiled eggs B. brie cheese made with unpasteurized milk C. cold deli-meat sandwiches D. baked chicken

D. baked chicken Rationale: Well-cooked meats, including baked chicken, do not pose a threat to clients who have neutropenia Incorrect Answers: - B. Soft cheeses like brie, which are made with unpasteurized milk, can contain bacteria and should be avoided by clients who have neutropenia. Hard or processed cheeses or those clearly labeled as made with pasteurized milk are an alternative to brie for a client who has neutropenia. - C. Cold deli meats and lunch meats can contain Listeria monocytogenes. These bacteria remain viable at refrigerated and room temperatures and can make a client who is immunocompromised severely ill. As an alternative, the nurse should recommend heating all deli meats or lunch meats.

54 A nurse is caring for a client who has diverticulitis and a new prescription for a low-fiber diet. Which food item should the nurse remove from the client's meal tray? A. canned fruit B. white bread C. broiled hamburger D. coleslaw

D. coleslaw Rationale: Coleslaw contains raw cabbage, which is high in fiber. Clients who are following a low fiber diet should avoid most raw vegetables. Incorrect Answers: - A. Canned fruit is an appropriate low-fiber food for a client who is following a low-fiber diet. Fresh fruit contains more fiber. - B. White bread is an appropriate low-fiber food for a client who is following a low-fiber diet. Wholegrain bread contains more fiber. - C. Broiled hamburger is an appropriate low-fiber food for a client who is following a low-fiber diet. Fish and poultry are also low in fiber.

63 A nurse is updating the plan of care for a client who has dumping syndrome. Which instruction should the nurse include? A. consume beverages with meals B. eat 3 large meals per day C. include high fiber foods in the diet D. eat a source of protein with each meal

D. eat a source of protein with each meal Rationale: protein delays gastric emptying Incorrect Answers: - A. The nurse should recommend consuming beverages between meals, which delays gastric emptying. - B. The nurse should recommend consuming small, frequent meals each day to delay gastric emptying and assist with digestion. - C. The nurse should recommend including low-fiber foods in the diet to delay gastric emptying.

52 A nurse is providing postoperative teaching about the management of dumping syndrome to a client who had a partial gastrectomy. Which instruction should the nurse include in the teaching? A. consume at least 4 oz of fluid with meals B. take a short walk after each meal C. use honey to flavor foods such as cereal D. eat protein with each meal

D. eat protein with each meal Rationale: The nurse should instruct the client to eat meals that are high in protein and fat with low to moderate carbohydrate content. Protein should be included in every meal because it delays digestion, which helps reduce manifestations of dumping syndrome Incorrect Answers: - A. The client should avoid fluids at mealtimes to decrease gastric stimulation. - B. The client should lie down when experiencing early manifestations of dumping syndrome (e.g. tachycardia, syncope, or sweating) to slow the progress of food through the gastrointestinal tract. - C. The client should avoid simple carbohydrates such as honey, sugar, and syrup because they aggravate the stomach and worsen manifestations of dumping syndrome.

61 A nurse is reviewing a client's 24 hr dietary recall. The client reports eating a slice of toasted white bread with butter, a banana, a glass of milk, and a cup of coffee for breakfast; grilled chicken, a baked potato, and a glass of milk for lunch; an apple and cheddar cheese for a snack; and 2 servings of chicken, 2 cups of steamed broccoli, and a glass of milk for dinner. This client's diet is deficient in which food group? A. dairy B. vegetables C. fruits D. grains

D. grains Rationale: he client consumed 1 serving of grains on the day of the 24-hr dietary recall. USDA dietary guidelines recommend 3 or more oz-equivalents of whole-grain products per day. Additionally, the choice of white bread is low in fiber, which can lead to constipation and an increased risk of hyperlipidemia. The USDA guidelines recommend that at least half of the grains consumed should be whole grain. Incorrect Answers: - A. The client consumed 3 servings of dairy throughout the day, which is the recommended daily amount according to USDA dietary guidelines. - B. The client consumed 2.5 cups or more of vegetables, which is the recommended daily amount according to USDA dietary guidelines. - C. The client consumed 2 servings of fruit, which is the recommended daily amount according to USDA dietary guidelines.

41 A nurse is creating a plan of care for a client who adhered to Kosher dietary laws. Which food selection should the nurse recommend? A. baked pork chop B. cheeseburger C. ham and cheese omelet D. grilled salmon

D. grilled salmon Rationale: The nurse should recommend grilled salmon for a client who observes Kosher dietary laws. Grilled salmon is a fish with fins and scales, which can be consumed. Seafood with shells, such as lobster or crab, is prohibited. Incorrect Answers: - A. A baked pork chop is a source of pork, which is prohibited by Kosher dietary laws. - B. A cheeseburger contains both meat and dairy products, which may not be eaten at the same time and is prohibited by Kosher dietary laws. - C. A ham and cheese omelet contains pork, which is prohibited by Kosher dietary laws.

25 A nurse is planning care for a client who has anorexia and nausea due to cancer treatment. Which intervention should the nurse include? A. serve foods at warm or hot temps B. offer the client low density foods C. make sure the client lies supine after meals D. limit drinking liquids with food

D. limit drinking liquids with food Rationale: Drinking beverages with food leads to early satiety and bloating, which results in the client consuming fewer calories.

75 A nurse is providing dietary teaching to a client who has dumping syndrome following gastric bypass surgery 4 days ago. Which recommendation should the nurse include in the teaching? A. avoid foods containing protein B. drink liquids during each meal C. eat foods that contain simple sugars D. maintain a supine position after meals

D. maintain a supine position after meals Rationale: Lying in a supine position after eating slows the rapid emptying of food into the small intestine. A client who has dumping syndrome should decrease the amount of food eaten at once, eat small meals more frequently, and eliminate fluids at mealtime. Fluid shifts occur in the upper GI tract when food contents and simple sugars exit the stomach too rapidly, attracting fluid into the upper intestine and decreasing blood volume, which causes the client to experience nausea and vomiting, sweating, syncope, palpitations, increased heart rate, and hypotension.

81 A nurse is caring for a client who is receiving radiation therapy for breast cancer and reports a metallic taste in the mouth. Which of the following dietary recommendations should the nurse share with the client? A. eat with metal utensils B. limit coffee C. avoid citrus fruits D. offer mints

D. offer mints Rationale: The nurse should encourage the client to suck on mints, which can overcome the metallic taste the client is experiencing as a result of the radiation therapy. Incorrect Answers: - B. The nurse should encourage the client to add coffee to sweet beverages or milk, as the coffee overcomes the sweetness of the beverage. - C. The nurse should encourage the client to consume foods that contain citrus or that have a tart flavor. This overcomes the metallic taste.

18 A nurse is planning an in-service training session for a group of nurses regarding the role of enzymes in digestion. Which of the following enzymes plays a role in the digestion of protein? A. amylase B. lipase C. steapsin D. pepsin

D. pepsin Rationale: Pepsin is an enzyme secreted by the gastric mucosa that breaks down protein into polypeptides. Other enzymes such as trypsin and aminopeptidase further break down the polypeptides into amino acids, which can be used by the body. Incorrect Answers: - A. Amylase is an enzyme secreted by the pancreas and intestine that breaks down starches into glucose. - B. Lipase is an enzyme secreted by the pancreas that breaks down triglycerides into monoglycerides. - C. Steapsin is an enzyme secreted by the gastric mucosa that breaks down triglycerides into monoglycerides.

53 A nurse is caring for a client who is receiving radiation therapy for breast cancer and reports a metallic taste in the mouth. Which dietary recommendation should the nurse share with the client? A. offer graham crackers as a snack B. avoid foods containing citrus C. rinse the mouth with an alcohol based mouthwash before eating D. use gravies or sauces to soften food

D. use gravies or sauces to soften food Incorrect Answers: - A. The client should avoid eating dry, coarse foods such as graham crackers. This type of food can make the client's mouth feel more dry and unpleasant. - B. The client should consume foods containing citrus to stimulate saliva. - C. The client should rinse the mouth with an alcohol-free mouthwash before eating. Alcohol-based mouthwash can make the client's mouth drier.