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Foundations and Adult Health Nursing
Chapter 19 - Nutritional Concepts and
Related Therapies
A healthy 35-year old patient wishes to lose weight because her BMI is 27. Which suggestion would be most appropriate for her? A) This BMI is too low for good health; the patient needs to supplement the diet to increase weight. B) This is an acceptable BMI, and it is best to maintain weight at this level for continued good health. C) Appropriate weight loss is possible with a healthy, reduced calorie diet and incorporating at least 30 minutes of physical activity each day. D) This BMI is elevated to the point that treatments, such as surgery are necessary. - ANSWER>>>>>>>C) Appropriate weight loss is possible with a healthy, reduced calorie diet and incorporating at least 30 minutes of physical activity each day. A patient takes medication for hypertension and asks whether there is anything else he can do to help reduce his blood pressure. What is the best nursing response? A) "A low fat, low cholesterol diet with only a limited amount of simple sugars will have the greatest effect on your blood pressure." B) "A salt free diet will have the greatest effect on your blood pressure. Do not add salt in your cooking or at the table." C) "Adequate calcium and potassium intake, as well as lower sodium intake, offers some possibility of helping your blood pressure. Eat plenty of fruits, vegetables, and low fat milk products." D) "Discontinue the use of processed foods, and buy only natural foods. That way, you will have less sodium in your diet." - ANSWER>>>>>>>C) "Adequate calcium and potassium intake, as well as lower sodium intake, offers some possibility of helping your blood pressure. Eat plenty of fruits, vegetables, and low fat milk products." A patient with cancer has anorexia and weight loss. Which suggestion is most likely to help him increase intake and prevent weight loss? A) encourage the patient to eat double portions at each meal.
B) suggest that the patient's snack often on high calorie foods. C) encourage the patient to eat the low-calorie foods first. D) suggest to the patient that he decrease his amount of exercise. - ANSWER>>>>>>>B) suggest that the patient's snack often on high calorie foods. Which dietary recommendations should the nurse include in the discharge instructions of a client in whom coronary artery disease is diagnosed? A) limit intake of whole grains. B) limit intake of tuna. C) limit intake off soybean products. D) limit intake of egg yolks. - ANSWER>>>>>>>D) limit intake of egg yolks. The nurse is reviewing a patient's dietary intake. Which patient behavior reflects compliance with a 2-g sodium restricted diet? A) using only the two packets of salt found on the meal tray. B) Limiting milk to one cup per day. C) avoiding use of salt in cooking. D) using salt free butter with meals. - ANSWER>>>>>>>C) avoiding use of salt in cooking. A patient with iron deficiency anemia started taking iron supplements. What recommendation can the nurse give the patient to increase iron absorption? A) drink milk or take calcium supplements at the same time as eating iron rich foods. B) take iron supplements with coffee, tea, or red wine. C) consumed vitamin C rich foods at the same meal with iron containing foods. D) take iron supplements with a high-fiber bran cereal. - ANSWER>>>>>>>C) consume pvitamin C rich foods at the same meal with iron containing foods. The nurse determines that a hypertensive patient understands the DASH diet when the patient chooses which items from a sample menu used in dietary teaching?
C) locate the healthcare providers diet order in the medical chart, and then obtain a pre- printed diet sheet showing the exchange list for meal planning and a menu pattern based on that prescribed calorie level. D) declined to comment on the diet because the nurse is not a trained professional in the area of nutrition, refer all questions to a registered dietitian - ANSWER>>>>>>>B) discuss the rationale for and the general principles of the diabetic diet with the patient, and then communicate the patient's concerns to the registered dietitian and healthcare provider. A 40-year-old patient recently received a diagnosis of type two diabetes. He is in the hospital for test and is receiving a diabetic diet. His wife expresses concern because she notices cookies on his lunch tray. Which response best describes current recommendations for the use of concentrated sweets in the diabetic diet? A) "sugars and suites are permitted in moderation in the diabetic diet. The important thing is that the total carbohydrate content of the meal is controlled and balance with your husband's medication and nutrient needs." B) "I can understand your concern. Sugars are more rapidly absorbed and have the capacity to raise blood glucose levels more quickly than other carbohydrates. I will check with the kitchen and see if your husband received the wrong tray." C) "I am sure that if the cookies were on the mail tray, they must be allowed in the diet. They are probably very low in sugar. There is likel - ANSWER>>>>>>>A) "sugars and suites are permitted in moderation in the diabetic diet. The important thing is that the total carbohydrate content of the meal is controlled and balance with your husband's medication and nutrient needs." The healthcare provider has recommended that a patient increase the amount of fiber in her diet to help control her blood cholesterol levels. Which guidelines are most appropriate for increasing water soluble fiber in the diet? A) choose a daily fiber supplement that contains no artificial additives and preservatives, follow the instructions on the container, and be sure to drink plenty of water. B) choose foods that are closer to their home state rather than refined or processed, including more fruits, oats, and legumes to increase soluble fiber, and drink plenty of water. C) choose more vegetables, vegetable juices, oh wait, and whole wheat products to increase soluble fiber, and drink plenty of water.
D) choose more fruit juices to provide both fluid and five are, and include iron fortified breakfast cereals to enhance the absorption of fiber from the fruit juice. - ANSWER>>>>>>>B) choose foods that are closer to their home state rather than refined or processed, including more fruits, oats, and legumes to increase soluble fiber, and drink plenty of water. A patient is controlling his blood cholesterol through diet. He is familiar with four sources of saturated fat and cholesterol but is confused about transfatty acids. The nurse should explain that which group of foods contributes the most transfatty acids? A) butter, cream, fats in meats, and tropical oil such as palm and coconut oils. B) Fish oil's, nuts and seeds, and vegetable oils such as olive oil and canola oil. C) stick margarine, shortening, deep-fried restaurant food, and commercially prepared baked goods. D) liquid margarine, vegetable oil spreads, and vegetable oil such as corn, soy bean, and cottonseed. - ANSWER>>>>>>>C) stick margarine, shortening, deep-fried restaurant food, and commercially prepared baked goods. A patient with a family history of osteoporosis is taking calcium supplements to help reduce her risk of developing osteoporosis. What recommendations can be made to prevent the development of reduce calcium balance? (Select all that apply) A) taking small doses of calcium throughout the day rather than one large dose. B) choosing plenty of milk products, and avoiding excessive caffeine intake. C) consuming a high-protein diet. D) increasing potassium intake. E) consuming a diet that has moderate levels of sodium. - ANSWER>>>>>>>A) taking small doses of calcium throughout the day rather than one large dose. B) choosing plenty of milk products, and avoiding excessive caffeine intake. D) increasing potassium intake. E) consuming a diet that has moderate levels of sodium. Which patient comment indicates to the nurse that more teaching is needed for the patient experiencing dumping syndrome after gastric surgery? A) "I should eat six small meals per day."
A newly diagnosed patient type 1 diabetic is being educated about the disease and self care at discharge. Which statement, if made by the patient, indicates teaching has been effective? A) "The disease should run its course in 2 days." B) "As long as i take my insulin, i can eat whatever i want." C) "When i begin to sweat, feel nervous, or dizzy, i will eat." D) "I do not have to have insulin shots until i start to feel sick." - ANSWER>>>>>>>C) "When i begin to sweat, feel nervous, or dizzy, i will eat." A family member is sitting at the best side of a patient on clear liquid diet. When the nurse Springsteen the lunch tray, the family member asked the nurse how to tell if an item is on a liquid diet. How should the nurse respond? A) "all soft foods are considered clear." B) "any food can qualify as clear liquid." C) "any liquid that you can see through is considered clear." D) "as long as you can't chew the liquid it qualifies as clear." - ANSWER>>>>>>>C) "any liquid that you can see through is considered clear." Foods on a clear liquid diet include any liquid that one can see through. Included or apple juice, white grape juice, fat-free broth or bouillon, plain gelatin, tea, or black coffee. When patients are on a clear liquid diet, they are usually given meals more frequently - every 2 to 3 hours. Not all foods are considered here liquids. Soft foods and foods that cannot be chewed do not qualify as liquid. A teenage patient recovering from a sports injury asks the nurse, "I want to be a competitive athlete. How many grams of protein should I take?" What is an appropriate response by the nurse? A) A healthy protein intake is about 46 g 56 g of protein a day B) 10 g a day should be enough C) you should take 150 g a day for best results D) carbohydrates are more important for building muscle mass - ANSWER>>>>>>>A) A healthy protein intake is about 46 g 56 g of protein a day
The average dietary reference intakes is 46 g to 56 g of protein Per day for the healthy adult. 10 g of protein a day is too low and carries a risk of protein deficiency. 150 g of protein is quite excessive and may have undesirable effects. Proteins have a greater role in building muscle mass and carbohydrates. A patient has been advised to increase fiber intake. Which food with the patient choose to boost fiber consumption? A) biscuits B) White bread C) Brown rice D) water - ANSWER>>>>>>>C) Brown rice Brown rice is rich in fiber and will add to the patients fiber intake. White bread contains far less fiber and nutrients than wheat bread. Hey biscuit ask Marley 1 g of fiber to the diet, and may contain transference. Water is a fluid and does not contribute to fiber intake. A nurse is completing a health history and physical assessment on a patient. Vital signs reveal a slightly elevated blood pressure. The patient admits to having a family history of arthritis, breast cancer, and hypertension. Based on the patient's history and blood pressure, which dietary restriction can the nurse anticipate the primary healthcare provider will implement for this patient? A) sodium B) fluoride C) selenium D) phosphorus - ANSWER>>>>>>>A) sodium Sodium, which is found in stock and processed food, is responsible for fluid and acid- base balance. And excessive amounts sodium leads to hypertension and susceptible individuals. Because of a slightly elevated blood pressure and a family history of hypertension, the patient is at risk for developing hypertension. Fluoride is related to tooth decay, selenium may be associated with cardiomyopathy, and phosphorus is an essential component of bone. A nurse is preparing to administer tube feeding to a patient. The placement of the tube is confirmed when the nurse aspirates 20 mL of gastric contents. The patient asked the nurse why the fluid is being replaced back into the tube. What should the nurse tell the patient?
Therefore the patient may have lower cholesterol and does a reduced risk of heart disease and type two diabetes. Vegetarians midnight have reduce carbohydrate levels as they consume all vegetarian food including cereals. A patient asks a nurse to explain what a kilo calorie it is. What is the nurses best response to these patients question? A) A kilo calorie is the small calorie. B) a kilo calorie is a nutrient in foods. C) A kilocalorie is the source of minerals. D) A kilo calorie is a measurement of energy. - ANSWER>>>>>>>D) A kilo calorie is a measurement of energy. A kilo calorie is a measurement of energy. The more kilo calories a food contains, the more energy and provides. A kilo calorie is not a small calorie, and nutrient in food, or a source of minerals. An obese patient arrives for a clinic appointment. The patient asked the nurse, "I am so fat, do you think that I can lose the weight?" What is the best response the nurse can give to the patient? A) with diet, exercise, and other therapies you may lose weight. B) no, when you reach a certain weight there is nothing you can do. C) yes, the way to success is to stop eating carbohydrates completely. D) ask your doctor; he or she can predict if and how much you can lose. - ANSWER>>>>>>>A) with diet, exercise, and other therapies you may lose weight. Will be Siri is the complex disorder; individualized treatment is necessary, and treatment involves a healthy diet combine with physical activity and psychological counseling. The patient may be able to lose weight with proper treatment. It is on safe for the patient to stop eating carbohydrates completely. No one can predict if and how much weight a person can lose. Telling the patient that nothing can be done is not a true statement. A hospitalized diabetic patient receives a dose of insulin for an elevated blood sugar level. Two hours after that ministration of the drug, the patient begins to complain of weakness, dizziness, vision disturbances, and headaches. The nurse also notices some disorientation, sweating, and a shallow breathing pattern. The nurse recognizes that the patient is experiencing which condition? A) hypoglycemia
B) Hepatomegaly C) hyperglycemia D) hyperlipidemia - ANSWER>>>>>>>A) hypoglycemia Weakness, dizziness, headaches, sweating, shallow breathing pattern, nervousness, vertigo, visual disturbances, and sometimes unconsciousness or symptoms of hypoglycemia or a low blood sugar level. Hepatomegaly is an enlarged liver. Hyperglycemia is an elevated blood sugar level and manifest with polyuria, polydipsia, polyphagia, fatigue, weight loss, if Rudy order on the breath, coma, and death. Hyperlipidemia is an elevation in cholesterol levels A medical - surgical nurse is caring for a patient with a diagnosis of renal calculi. What is essential intervention should be added to the patient care plan? A) increase daily fluid intake B) use frequent position changes C) start coughing and deep breathing D) keep the head of the bed elevated - ANSWER>>>>>>>A) increase daily fluid intake The increasing of fluids is a common dietary treatment for renal calculi or kidney stones. Additional fluid helps dilute that you were an increase his urinary output. The goal is to flush the stones out in the urine. Elevating the head of bed and coughing and deep breathing will not assist with washing the calculus or stones from the body. A patient with gastrointestinal illness is having 6 to 8 watery stools a day. Which intervention should the nurse refrain from implementing, if listed on the patient's nursing care plan by mistake? A) provide three dairy snacks daily B) provide oral fluids containing glucose C) demonstrate meticulous hand hygiene D) administer antidiarrheal medication as prescribed - ANSWER>>>>>>>A) provide three dairy snacks daily The problem is diarrhea, the nurse should administer antidiarrheal medication and provide oral fluids that contain glucose. Therefore dairy products should be avoided. The nurse or teach the patient to use careful handwashing.
B) potassium chloride (KCI) C) parathyroid hormone (parathormone) D) sodium Polystyrene sulfonate (Kayexalate) - ANSWER>>>>>>>D) sodium Polystyrene sulfonate (Kayexalate) Treatment for strict in potassium intake giving intravenous calcium gluconate to decrease than six of high potassium on the heart, giving sodium bicarbonate or insulin in a glucose solution to shift the potassium to the cell, or giving polystyrene sulfonate (kayexalate) orally or rectally. Kayexalate binds with potassium to remove it via the gastrointestinal tract or feces. Digoxin is usually given to patients with cardiac malfunction's; potassium chloride is not an indicator because it will increase the potassium level more; and parathormone is given to patients with the parathyroid dysfunction or patients with a low calcium level Patient is admitted with a diagnosis of dehydration. Which type of intravenous fluid month the nurse expect the primary healthcare provider to prescribe to expand the bodies fluid volume grapes patient is admitted with a diagnosis of dehydration. Which type of intravenous fluid might the nurse expect the primary healthcare provider to prescribe to expand the bodies fluid volume? A) isotonic solution B) Pretonic solution C) hypotonic solution D) hypertonic solution - ANSWER>>>>>>>A) isotonic solution Isotonic solution is a solution of the same osmotic pressure that expands the bodies fluid volume without costing a fluid shifts from one compartment to another. Hypertonic solution is a solution of higher osmotic pressure the pools fluid from the cells. Hypotonic solution is a solution of lower osmotic pressure that moves fluid into the cells, causing them to enlarge. Pretonic solution is not a type of solution used to expand fluid volume. The body has systems that work to keep the pH in the narrow range of normal. What body systems work to keep the pH in the narrow range of normal? (Select all that apply). A) The kidneys B) The blood buffers C) The nervous system
D) The respiratory system E) The gastrointestinal tract - ANSWER>>>>>>>A) The kidneys B) The blood buffers D) The respiratory system The blood buffers, respiratory systems, and kidneys are the bodies three lines of the fans are constantly working to maintain a normal pH. The G.I. and nervous systems are not a part of this process. A nurse is teaching a group of students about active and passive transport. The nurse gives an example of raisins kept in water overnight. The raisins absorbs water and are large in size the next day. What kind of movement to the students identify in that example? A) Active transport B) filtration C) diffusion D) osmosis - ANSWER>>>>>>>D) osmosis In osmosis, water moves through a semi - permeable membrane from the area of last salute concentration to the area of greater concentration. This happens until the solutions are of equal concentration. This causes the raisins to get larger. Active transport is the movement of substances against a concentration gradient. Filtration is the movement of water and suspend their substances outward through a semi- permeable membrane. In diffusion, the solutes move back-and-forth across the membrane until they are even distributed throughout the available space. The primary healthcare provider has requested that a patient be tested for Trousseau sign. Which action indicates the test is being performed correctly? A) The nurse asks The patient to dorsiflex the feet and notes any calf pain. B) The nurse assesses the patient's ability to balance self with eyes closed. C) The nurse tabs the side of the patients cheek and monitors for a facial twitch. D) The nurse applies and inflates a blood pressure cuff and observes for carpal spasms. - ANSWER>>>>>>>D) The nurse applies and inflates a blood pressure cuff and observes for carpal spasms.
To effectively eliminate waste products from the body, it is necessary for the kidneys to excrete a minimum of 30 mL/hr. Therefore in a 24 - hour period, The patient should have an output of at least 720 mL. There was no indication that a bladder infection is present. If you let volume deficit occurs if there is a large fluid output, and in this case it is below the normal 30 mL/hour. That urinary output falls below the minimum for that period of time. A nursing diagnosis of fluid volume deficit has been added to the nursing care plan of a patient. A prescription has been written for the patient to consume a minimum of 2000 mL of fluid daily. Which is the best approach for the nurse to use in an effort to encourage fluid intake? A) determine the patient's favorite beverage B) encourage the patient to consume the fluid C) Half family members bring soft drinks and juices D) start a peripheral intravenous line and infuse the fluid - ANSWER>>>>>>>B) encourage the patient to consume the fluid The most effective intervention would be to encourage the patient to consume the fluid. The patients resources and preferences should be considered, but most patients can be encouraged to take it in, even if their favorite beverage is not available. If the patient needs to be encouraged to increase oral intake, determine the patient's favorite beverages and incorporate them into the care plan. The family members should not be asked to bring juices and soft drinks. Starting a peripheral intravenous line requires a prescription and is not a nursing function. Hey Hendry patient has been admitted to intensive care unit (ICU) with dyspnea, tachycardia, tremors, lethargy, and disorientation. There was sorts of arterial blood gas testing showed pH 7.28, Paco2 60 mm Hg, and HCO3 22 mEq/L. What condition is suspected? A) metabolic acidosis B) metabolic alkalosis C) respiratory acidosis D) respiratory alkalosis - ANSWER>>>>>>>C) respiratory acidosis With respiratory acidosis, the pH is below 7.35, Paco2 is above 45 mm Hg, and HCO is normal. With respiratory alkalosis, the pH is above 7.45, Paco2 is below 35 mm Hg, and HCO3 is normal. With metabolic acidosis, The pH is below 7.35, Paco2 is normal or
below 35 mm Hg, and HCO3 is below 22mEq/L. With metabolic alkalosis, the pH is above 7.45, Paco2 is normal or above 45 mm Hg, and HCO3 is above 26 mEq/L. A nurse is giving dietary advice to a patient with hypokalemia. The patient is not sure what foods to incorporate in the diet. What foods does the nurse emphasize in the patients diet for recovery? Select all that apply. A) apricots B) Orange juice C) bananas D) Salted snacks E) cantaloupe - ANSWER>>>>>>>A) apricots B) Orange juice C) bananas E) cantaloupe And hypokalemia, potassium is here in levels are dangerously low. The nurse will emphasize the intake of apricots, orange juice, bananas, and cantaloupe. This is because such fools are rich in potassium and will aid in recovery. Salted snacks are high in sodium and are usually recommend it to those with Hyponatremia. In hyponatremia sodium levels in the blood fall to unhealthy levels. Of other electrolyte disorders, which disorder is considered the most dangerous and potentially fatal? A) hyperkalemia B) Hypercalcemia C) hypernatremia D) hypermagnesemia - ANSWER>>>>>>>A) hyperkalemia Hyperkalemia is an elevated level of potassium and is considered the most dangerous. It can lead to serious arrhythmias of cardiac arrest. Hypernatremia causes cellular dehydration and an interruption in cellular processes, but it's not the most dangerous of the disorders listed. Hypercalcemia can depressed neuromuscular activity and need to that development of renal calculi, but it is not the most dangerous of the disorders listed.
D) amoxicillin (clavulanic acid) - ANSWER>>>>>>>C) potassium chloride (KCI) Leg cramps, hyperreflexia, diminished deep tendon reflexes, paresthesia, and decreased bowel sounds are signs and symptoms associated with hypokalemia. Calcium gluconate is given for low calcium. Lasix is not given, because a diuretic will further deplete potassium stores. There is no indication that the patient has an infection; therefore amoxicillin is incorrect. The nurse is caring for a patient with hyperkalemia who has been prescribed polystyrene sulfonate (kayexalate). What should the nurse monitor to provide effective care of and treatment to the patient? A) serum magnesium levels B) serum sodium levels C) serum calcium levels D) serum uric acid levels - ANSWER>>>>>>>B) serum sodium levels Administering polystyrene sulfonate (kayexalate) may lead to the increase in serum sodium levels by inhibiting renal excretion. Therefore, the nurse should monitor this your room sodium levels as part of assessment. Polystyrene sulfonate does not alter the levels of cereal magnesium in the patient. Therefore, the nurse need not monitor serum magnesium levels. Serum calcium levels are monitored when the patient is on parathyroid hormone therapy. Uric acid levels are monitored in a patient with kidney deficiency. The 6 classes of essential nutrients are? - ANSWER>>>>>>>carbohydrates, fats, proteins, minerals, water, vitamins Vitamin B12 is found in? - ANSWER>>>>>>>meats as well as fish Which nutrients provides energy? - ANSWER>>>>>>>carbohydrates and proteins: 4 kcal/gram Fats: 9kcal/gram Which nutrients build and repair tissue? - ANSWER>>>>>>>Protein, calcium, phosphorus, iron, and fat There are two types of carbohydrates what are they? Give an example. - ANSWER>>>>>>>Simple carbohydrates:
- monosaccharides (example: fructose ["Fruit sugar"] glucose galactose).
- dissaccharides (example: sucrose lactose). And Complex carbohydrates:
Polysaccharides (example: Dextrin cellulose Pectin glycogen). The term insoluble means? - ANSWER>>>>>>>Incapable of being dissolved The difference between saturated fatty acid's, unsaturated fatty acid's, and trans fatty acids is? - ANSWER>>>>>>>* Saturated fatty acids: most are animal origin and are solid at room temperature. *unsaturated fatty acid's: typically from plants and are liquid at room temperature. possible blood cholesterol lowering effect of moderate levels of intake.
- Transfatty acids: found in foods containing partially hydrogenated vegetable oils. How do saturated fatty acid's increase a persons risk of arthrosclerosis? - ANSWER>>>>>>>In humans, saturated fat intake increases LDL cholesterol in comparison with on nutrients except trans fats. Because saturated fat also increases high density lipoprotein (HDL) cholesterol, the total cholesterol (TC) to HDL cholesterol ratio (A risk marker for CVD) is not altered. Cholesterol is synthesize where? - ANSWER>>>>>>>Cholesterol is synthesized in the liver and is found in foods of animal origin. Cholesterol provides no energy. What happens to access dietary fat in our body? - ANSWER>>>>>>>Excess dietary fat will be stored as adipose tissue in our body. What foods are good to lower cholesterol? - ANSWER>>>>>>>High fiber (oatmeal), fish (omega-3), nuts (walnuts,almonds) The purpose of lipoprotein's is? - ANSWER>>>>>>>To facilitate the transport of lipids in the bloodstream: high density (HDL-Good) and low density (LDL-lousy) lipoprotein's. What type of foods are high in cholesterol level? - ANSWER>>>>>>>Eating too much saturated fat increase his cholesterol levels. This is why it is best to limit them out of foods we eat that are high in saturated fats such as: butter, ghee, hard margarines, lard, fatty meat and meat products such ass sausages, full fat cheese, milk, cream and yogurt, coconut and palm oil's and coconut cream. How do you make a protein complete? - ANSWER>>>>>>>By adding a grain The difference between complete proteins and incomplete proteins are? - ANSWER>>>>>>>* complete proteins: are generally of animal origin.
- incomplete proteins: are generally plant origin; include greens, lgumes, nuts, and seeds
