Nutrition & Therapeutic Diets NCLEX PN

The nurse reviews a client's serum sodium level and notes that the level is 150 mEq/L (150 mmol/L). The primary health care provider prescribes dietary instructions for the client based on the sodium level. Which food items would the nurse instruct the client to avoid? SATA

Bacon, Salami, Processed Oat Cereal (The normal serum sodium level is 135 to 145 mEq/L (135 to 145 mmol/L). A serum sodium level of 150 mEq/L (150 mmol/L) is indicative of hypernatremia. Based on this finding, the nurse should instruct the client to avoid foods high in sodium, such as processed foods including cereals and meats (bacon and salami). Summer squash and tomatoes are low in sodium. Focus on the subject, foods high in sodium. Recall the normal serum sodium level. After determining that the client has hypernatremia, determine the foods to avoid. Identify that the foods high in sodium are all preserved and utilize the strategy of comparable or alike options.)

The nurse reinforces instructions regarding diet for a client at risk for hypokalemia. The nurse determines there is a need for further teaching when the client selects which foods as sources high in potassium? SATA

Bread and butter, carrots and peas, & Peppers and onions (Bread and butter, carrots and peas, and peppers and onions are relatively low sources of potassium. Meats and certain fruits and vegetables are high in potassium and include beef and potato salad and avocados and mushrooms. Focus on the subject, foods high in potassium. Note the strategic words, need for further teaching, and identify the question as a negative event query, and the answers are foods that are low in potassium. Recalling the potassium content of the foods identified will direct you to the correct option.)

A postoperative client has been placed on a clear liquid diet. Which items is the client allowed to consume? SATA

Broth, Coffee,Gelatin. (A clear liquid diet consists of foods that are relatively transparent to light and are clear and liquid at room and body temperature. These foods include water, bouillon, clear broth, carbonated beverages, gelatin, lemonade, Popsicles, and regular or decaffeinated coffee or tea. Focus on the subject, a clear liquid diet. Recalling that a clear liquid diet consists of foods that are relatively transparent to light and are clear will assist in answering the question.)

An abdominal postoperative client has been tolerating a full liquid diet, and the nurse plans to advance the diet to solid food as prescribed. The nurse collects data regarding which important item before advancing the diet to solids?

Dentition and ability to chew (It may be necessary to modify a client's diet to a soft or mechanical chopped diet if the client has difficulty chewing. Food and cultural preferences should have been determined on admission. Bowel sounds should be present before introducing any diet to a postoperative client)

A client states that he has removed all dairy foods from his diet because he is lactose intolerant. The nurse plans care for the client knowing which information?

Calcium and protein are valuable nutrients and need to be supplemented in some form. (Calcium and protein need to be supplemented in some form in the diet of the client with lactose intolerance. Focus on the subject, lactose intolerance. Note the closed-ended words in options 1 (all), 2 (only), and 3 (must).)

A primary health care provider prescribes a parenteral nutrition solution to start at 50 mL/hr by infusion pump via an established subclavian central line. After 2 hours of initiating the parenteral nutrition infusion, the client suddenly complains of difficulty in breathing and chest pain. Which action would the nurse prepare to do first?

Clamp the parenteral nutrition infusion.

The nurse is reinforcing dietary instructions to a client with tuberculosis who has lost weight. The nurse reinforces instructions for the client to increase intake of protein and vitamin C. The nurse determines that teaching has been effective when the client selects which food items in the daily diet?

Hamburgers and oranges (The client with tuberculosis often is malnourished and needs dietary support to recover while receiving treatment. Food sources that are rich in protein include meats and legumes. Foods rich in vitamin C include citrus fruits, berries, melons, pineapple, broccoli, cabbage, green peppers, tomatoes, potatoes, chard, kale, asparagus, and turnip greens. Note the strategic word, effective. Focus on the subject, dietary instructions for tuberculosis. Recalling that the diet for the client with tuberculosis should be high in protein, and vitamin C will assist you in answering this question. It is also necessary to know which types of foods contain protein and vitamin C.)

A client who has recently been started on enteral feedings begins to complain of abdominal cramping, followed by passage of two liquid stools. The nurse notes that the client has abdominal distention as well. The nurse reviews the nutritional content on the label of the can to see if it contains which ingredient?

Lactose (Several tube feeding formulas contain lactose. A client with an unreported history of lactose intolerance would develop symptoms such as these in response to nutritional therapy with these formulas. If the client is diagnosed as lactose intolerant, a lactose-free formula should be prescribed by the primary health care provider. This will resolve the client's symptoms and promote adequate nutrition for the client. Focus on the subject, client complaint of abdominal cramping and passage of two liquid stools. Associate the symptoms experienced by the client with the symptoms of lactose intolerance.)

The nurse reinforces instructions to a client to increase the amount of riboflavin in the diet. The nurse would tell the client to select which food item that is high in riboflavin?

Milk (Food sources of riboflavin include milk, lean meats, fish, and grains. Tomatoes and citrus fruits are high in vitamin C. Green leafy vegetables are high in folic acid. Focus on the subject, food sources high in riboflavin. Knowledge regarding food items that are high in riboflavin is required to answer this question. Remember that milk is a food source of riboflavin, so this will help you to eliminate the remaining options.)

The nurse is reinforcing instructions to a client on how to decrease the intake of potassium in the diet. The nurse determines the need for further teaching if the client selects which foods to include in the diet? Select all that apply.

Potatoes, Avocado, Sal substitute. (Potatoes and avocados are potassium-containing foods and should be avoided if on a potassium-restricted diet. Salt substitute, often potassium chloride used in place of regular salt (sodium chloride), is a source of potassium. Eggs, bread, and lettuce are all foods low in potassium and are allowed in a potassium-restricted diet. Focus on the subject, food sources allowed in a potassium-restricted diet. Note the strategic words need for further teaching, and that the question is a negative event query asking for the foods to exclude from a potassium-restricted diet. Recalling the foods that are high in potassium will direct you to the correct answers.)

A client has a serum sodium level of 151 mEq/L (151 mmol/L), and the nurse reinforces dietary teaching about the types of foods to avoid. The nurse determines that there is a need for further teaching if the client states that which food choices are good? SATA

Sauerkraut, American Cheese (The nurse should instruct the client to avoid foods high in sodium. Sauerkraut and American cheese are high in sodium content. Focus on the subject, foods to avoid that are high in sodium. Note the strategic words, need for further teaching. These words indicate a negative event query and ask you to select an option that is an incorrect statement.)

The nurse is providing dietary instructions to a client with gout. The nurse would tell the client to avoid which food item?

Scallops (Scallops should be omitted from the diet of a client who has gout because of the high purine content. The food items identified in the remaining options have negligible purine content and may be consumed by the client with gout. Focus on the subject, the food item to avoid. Note the client's diagnosis of gout and think about the pathophysiology associated with this condition. Recalling the food items that are high in purine will direct you to the correct option.

The nurse needs to increase the calcium in the diet of a client who is lactose intolerant. Which food items would the nurse encourage? SATA

Tofu, Broccoli, Sardines, Mustard Greens (Lactose-intolerant clients should not eat dairy products. Therefore, these clients need high-calcium foods from nondairy sources. Tofu, broccoli, mustard greens, and sardines are foods that are high in calcium that do not come from dairy sources. Although milk and cheese are high in calcium, they are dairy products, which lactose-intolerant clients need to avoid. There are two knowledge elements to this question: lactose intolerance and foods that are high in calcium. Because lactose-intolerant clients cannot digest dairy products properly, choose nondairy foods that are high in calcium.)

The nurse has given dietary instructions to a client to minimize the risk of osteoporosis. The nurse determines that the client understands the recommended changes if the client verbalizes the intention to increase intake of which foods? SATA

Yogurt & Cottage cheese (Calcium intake is important to minimize the risk of osteoporosis. The major dietary source of calcium is from dairy foods, including milk, yogurt, and a variety of cheeses. Calcium also may be added to certain products, such as orange juice, which are then advertised as being "fortified" with calcium. Calcium supplements are also recommended to minimize the risk of osteoporosis. Fish, potatoes, chicken, and white bread are foods that are not high in calcium. Focus on the subject, dietary needs for osteoporosis. Defining osteoporosis and knowing that calcium is required will lead you to select options that are foods high in calcium.)

The nurse is reinforcing instructions to a client about complete/high quality protein foods. Which food choices would indicate the client understood the teaching? SATA

_Eggs & Chicken (Complete/high-quality proteins are proteins that contain all essential amino acids and are found in a variety of meats, eggs, and dairy products. Beans are incomplete/lower-quality proteins as are some cereals. Oranges and broccoli contain vitamins and minerals and minimal protein. Focus on the subject, a complete/high-quality protein. Remember that animal sources including eggs are a food source for complete proteins.)

The nurse who is assisting in a weight loss program prepares to monitor a client's weight. The client receives education about caloric intake and weight reduction. In order to lose 2 pounds per week the caloric intake should be decreased by how many calories per day?

1000 calories (To obtain a weight loss of 1 pound per week the client needs a decrease in daily caloric intake of 500 calories. To lose 2 pounds per week the client needs to decrease intake by 1000 calories per day. Focus on the subject, planning a client's weight loss. In order to plan a weight loss, it is necessary to know the formula that 1 pound weight loss per week requires a decrease of 500 calories per day.)

A hospitalized client is a lacto-vegetarian. Which food item would the nurse remove from the meal tray?

Eggs (Lacto-vegetarians eat milk, cheese, and dairy foods but avoid meat, fish, poultry, and eggs. Focus on the subject, lacto-vegetarian. With that in mind, immediately eliminate broccoli. From the remaining three options, note that milk and cheese are dairy products, making them comparable or alike, so they can be eliminated. Eggs are the food items that are not consumed by lacto-vegetarians; however, they are eaten by lacto-ovo vegetarians.)

A client has been on total parenteral nutrition for 8 weeks. The primary health care provider prescribes that the total parenteral nutrition be weaned down by 50 mL/hr/day until discontinued. The client asks the nurse, "Why doesn't the doctor just stop the parenteral nutrition instead of dragging it on for 3 days?" The nursing response would be to explain that the primary health care provider is concerned about which phenomenon?

Rebound hypoglycemia (Clients receiving total parenteral nutrition are receiving high concentrations of glucose. To give the pancreas time to adjust to decreasing glucose loads, the infusion rates are tapered down. Before discontinuing the parenteral nutrition, the body must adjust to the lowered glucose levels. If the total parenteral nutrition were suddenly withdrawn, the client would probably have rebound hypoglycemia. The subject of the question is the complications of total parenteral nutrition when it is discontinued. Recalling that a concern of total parenteral nutrition that needs to be monitored is the effect of the high glucose concentrations and the effect on insulin levels will direct you to option 4.)

The nurse is preparing to administer an intermittent tube feeding to a client. The nurse aspirates 90 mL of residual from the tube. What would the nurse do? Select all that apply.

Document the amount of residual,Reinstill the residual and administer the feeding. ( Unless otherwise instructed or if the residual contents appear abnormal, an amount of less than 100 mL is reinstilled; then a normal amount of prescribed tube feeding is administered. The amount of residual should be documented. It is important to return the contents to the stomach to prevent electrolyte imbalances. The feeding is not held, and the residual is not sent to the laboratory. The tube feeding should continue at the prescribed rate. Note the subject, residual from a nasogastric (NG) tube. Generally the residual is always reinstilled to prevent electrolyte and nutritional imbalance. There is no data in the question that indicates that laboratory analysis is necessary. To prevent dehydration, clients need to get the correct amount of feeding prescribed.)