1. Case Study: Managing Protein Intake in Kidney Disease
Scenario: A nurse is discussing dietary changes with a patient diagnosed with chronic kidney
disease (CKD). The nurse asks the patient about their protein intake.
Question: The nurse advises the patient with CKD to limit their protein intake. What is the
rationale behind this recommendation?
A) Protein can exacerbate fluid retention
B) Protein metabolism produces nitrogen waste that the kidneys must filter
C) Protein intake leads to increased blood sugar
D) Protein increases the risk of developing kidney stones
Answer: B) Protein metabolism produces nitrogen waste that the kidneys must filter
Rationale: In CKD, the kidneys lose their ability to efficiently excrete waste products, such as
nitrogen from protein metabolism. Reducing protein intake helps decrease the workload on the
kidneys.
2. Case Study: Managing Diabetes with Diet
Scenario: A nurse is educating a newly diagnosed diabetic patient on how food choices affect
their blood sugar levels.
Question: The nurse explains that a diet rich in fiber can help manage blood glucose levels.
What is the mechanism behind this recommendation?
A) Fiber slows the absorption of glucose into the bloodstream
B) Fiber directly lowers blood glucose levels
C) Fiber increases insulin production
D) Fiber decreases insulin resistance
Answer: A) Fiber slows the absorption of glucose into the bloodstream
Rationale: Fiber, especially soluble fiber, slows the absorption of glucose, helping to prevent
rapid spikes in blood sugar.
3. Case Study: Nutrition for Pregnancy
Scenario: A pregnant patient is concerned about how much iron they need during pregnancy.
The nurse is discussing their dietary requirements.
,Question: The nurse tells the patient that iron is particularly important during pregnancy. What
is the reason for this?
A) Iron supports the development of the fetus’s nervous system
B) Iron enhances the absorption of calcium
C) Iron helps prevent maternal anemia
D) Iron is required for the development of fetal bones
Answer: C) Iron helps prevent maternal anemia
Rationale: Iron is essential for increasing hemoglobin levels and preventing anemia in the
mother, which can affect oxygen delivery to both the mother and fetus.
4. Case Study: Managing Heart Disease
Scenario: A nurse is counseling a patient with coronary artery disease (CAD) about dietary fat
intake.
Question: Which type of fat should the nurse encourage the patient to increase in their diet to
help reduce the risk of heart disease?
A) Saturated fat
B) Monounsaturated fat
C) Trans fat
D) Polyunsaturated fat
Answer: B) Monounsaturated fat
Rationale: Monounsaturated fats (found in olive oil, avocados, etc.) can help reduce LDL (bad)
cholesterol levels, which lowers the risk of heart disease.
5. Case Study: Managing Hypertension
Scenario: A nurse is educating a patient with hypertension on dietary modifications.
Question: The nurse recommends the DASH diet to the patient with hypertension. What is the
primary purpose of the DASH diet?
A) To reduce sodium intake
B) To increase protein intake
C) To increase carbohydrates for energy
D) To reduce fiber intake
, Answer: A) To reduce sodium intake
Rationale: The DASH (Dietary Approaches to Stop Hypertension) diet focuses on reducing
sodium intake while increasing potassium, calcium, and magnesium to help manage blood
pressure.
6. Case Study: Diet in Celiac Disease
Scenario: A nurse is teaching a patient with celiac disease about dietary changes.
Question: Which food item should the nurse instruct the patient with celiac disease to avoid?
A) Oats
B) Rice
C) Barley
D) Sweet potatoes
Answer: C) Barley
Rationale: Barley contains gluten, which triggers the immune response in individuals with
celiac disease. The patient must avoid gluten-containing foods like barley, wheat, and rye.
7. Case Study: Managing Malnutrition in Elderly
Scenario: A nurse is working with an elderly patient who is underweight and malnourished.
Question: What is the priority nutritional intervention for this elderly patient?
A) Increase fluid intake
B) Provide high-calorie, high-protein meals
C) Recommend low-fat foods
D) Encourage a low-carbohydrate diet
Answer: B) Provide high-calorie, high-protein meals
Rationale: Malnourished elderly patients need high-calorie, high-protein meals to support
muscle mass maintenance and improve overall nutritional status.
8. Case Study: Post-Operative Nutrition
Scenario: A nurse is discussing dietary changes with a patient diagnosed with chronic kidney
disease (CKD). The nurse asks the patient about their protein intake.
Question: The nurse advises the patient with CKD to limit their protein intake. What is the
rationale behind this recommendation?
A) Protein can exacerbate fluid retention
B) Protein metabolism produces nitrogen waste that the kidneys must filter
C) Protein intake leads to increased blood sugar
D) Protein increases the risk of developing kidney stones
Answer: B) Protein metabolism produces nitrogen waste that the kidneys must filter
Rationale: In CKD, the kidneys lose their ability to efficiently excrete waste products, such as
nitrogen from protein metabolism. Reducing protein intake helps decrease the workload on the
kidneys.
2. Case Study: Managing Diabetes with Diet
Scenario: A nurse is educating a newly diagnosed diabetic patient on how food choices affect
their blood sugar levels.
Question: The nurse explains that a diet rich in fiber can help manage blood glucose levels.
What is the mechanism behind this recommendation?
A) Fiber slows the absorption of glucose into the bloodstream
B) Fiber directly lowers blood glucose levels
C) Fiber increases insulin production
D) Fiber decreases insulin resistance
Answer: A) Fiber slows the absorption of glucose into the bloodstream
Rationale: Fiber, especially soluble fiber, slows the absorption of glucose, helping to prevent
rapid spikes in blood sugar.
3. Case Study: Nutrition for Pregnancy
Scenario: A pregnant patient is concerned about how much iron they need during pregnancy.
The nurse is discussing their dietary requirements.
,Question: The nurse tells the patient that iron is particularly important during pregnancy. What
is the reason for this?
A) Iron supports the development of the fetus’s nervous system
B) Iron enhances the absorption of calcium
C) Iron helps prevent maternal anemia
D) Iron is required for the development of fetal bones
Answer: C) Iron helps prevent maternal anemia
Rationale: Iron is essential for increasing hemoglobin levels and preventing anemia in the
mother, which can affect oxygen delivery to both the mother and fetus.
4. Case Study: Managing Heart Disease
Scenario: A nurse is counseling a patient with coronary artery disease (CAD) about dietary fat
intake.
Question: Which type of fat should the nurse encourage the patient to increase in their diet to
help reduce the risk of heart disease?
A) Saturated fat
B) Monounsaturated fat
C) Trans fat
D) Polyunsaturated fat
Answer: B) Monounsaturated fat
Rationale: Monounsaturated fats (found in olive oil, avocados, etc.) can help reduce LDL (bad)
cholesterol levels, which lowers the risk of heart disease.
5. Case Study: Managing Hypertension
Scenario: A nurse is educating a patient with hypertension on dietary modifications.
Question: The nurse recommends the DASH diet to the patient with hypertension. What is the
primary purpose of the DASH diet?
A) To reduce sodium intake
B) To increase protein intake
C) To increase carbohydrates for energy
D) To reduce fiber intake
, Answer: A) To reduce sodium intake
Rationale: The DASH (Dietary Approaches to Stop Hypertension) diet focuses on reducing
sodium intake while increasing potassium, calcium, and magnesium to help manage blood
pressure.
6. Case Study: Diet in Celiac Disease
Scenario: A nurse is teaching a patient with celiac disease about dietary changes.
Question: Which food item should the nurse instruct the patient with celiac disease to avoid?
A) Oats
B) Rice
C) Barley
D) Sweet potatoes
Answer: C) Barley
Rationale: Barley contains gluten, which triggers the immune response in individuals with
celiac disease. The patient must avoid gluten-containing foods like barley, wheat, and rye.
7. Case Study: Managing Malnutrition in Elderly
Scenario: A nurse is working with an elderly patient who is underweight and malnourished.
Question: What is the priority nutritional intervention for this elderly patient?
A) Increase fluid intake
B) Provide high-calorie, high-protein meals
C) Recommend low-fat foods
D) Encourage a low-carbohydrate diet
Answer: B) Provide high-calorie, high-protein meals
Rationale: Malnourished elderly patients need high-calorie, high-protein meals to support
muscle mass maintenance and improve overall nutritional status.
8. Case Study: Post-Operative Nutrition