Exam (elaborations) NURSING 2362 module 7

Questions ) 1.ID: 4The nurse is instructing a client with hypertension about foods that are low in sodium. Which menu selections by the client indicate to the nurse that the client understands what has been taught? Select all that apply. Spaghetti with fresh tomatoes Correct Boiled lobster with baked potato Grilled chicken with turnip greens Correct Instant hot cereal with bacon Tomato soup with a ham sandwich ) Rationale: Foods that are lower in sodium include fruits and vegetables, which do not contain physiologic saline. Fresh poultry and pastas are also low in sodium. Highly processed and refined foods and luncheon meats are high in sodium unless they are specifically labeled “low sodium.” Saltwater fish and shellfish are higher in sodium. ) ) Test-Taking Strategy: Use the process of elimination and focus on the subject, selecting low-sodium foods. Begin to answer this question by eliminating boiled lobster with baked potato, because saltwater fish and shellfish are high in sodium. Next eliminate the options that contain processed foods and luncheon meats. Review foods that are high and low in sodium if this question was difficult. ) ) Level of Cognitive Ability: Evaluating ) ) Client Needs: Physiological Integrity ) ) Integrated Process: Nursing Process/Evaluation ) ) Content Area: Nutrition ) ) References: Black, J., & Hawks, J. (2009). Medical-surgical nursing: Clinical management for positive outcomes (8th ed., pp. 138, 1439). St. Louis: Saunders. ) Ignatavicius, D., & Workman, M. (2010). Medical-surgical nursing: Patientcentered collaborative care (6th ed., p. 184). St. Louis: Saunders. Awarded 2.0 points out of 2.0 possible points. ) 2.ID: 6A nurse has provided dietary instructions to a client with a new diagnosis of gout. Which menu suggestions by the client indicate to the nurse that the client needs additional instruction? Select all that apply. Carrots Tapioca Scallops Correct Broccoli Chicken liver Correct ) Rationale: Organ meats such as liver, as well as certain sea foods, including scallops, sardines, and herring, should be omitted from the diet of the client who with gout because of the high purine content. The foods identified in the other options contain negligible amounts of purines and may be consumed freely by the client with gout. ) ) Test-Taking Strategy: Note the strategic words “needs additional instruction,” which indicate a negative event query and the need to select foods that are unacceptable for this client. Recalling foods that are high in purines will direct you to the correct options. Review these foods if you had difficulty with this question. ) ) Level of Cognitive Ability: Evaluating ) ) Client Needs: Physiological Integrity ) ) Integrated Process: Teaching and Learning ) ) Content Area: Nutrition ) ) Reference: Ignatavicius, D., & Workman, M. (2010). Medical-surgical nursing: Patient-centered collaborative care (6th ed., p. 354). St. Louis: Saunders. Awarded 2.0 points out of 2.0 possible points. ) 3.ID: 0A clear liquid diet has been prescribed for client who has just undergone surgery. Which foods should the nurse offer to the client? Select all that apply. Custard Apple juice Correct Orange juice Chicken broth Correct Orange gelatin Correct Vanilla ice cream ) Rationale: A clear liquid diet consists of foods, such as apple juice, chicken broth, and gelatin, which are relatively transparent. Custard, orange juice, and vanilla ice cream are components of a full liquid diet. ) ) Test-Taking Strategy: Remembering that a clear liquid diet consists of foods that are relatively transparent will direct you to the correct options. Review the foods allowed on clear liquid and full liquid diets if you had difficulty with this question. ) ) Level of Cognitive Ability: Applying ) ) Client Needs: Physiological Integrity ) ) Integrated Process: Nursing Process/Implementation ) ) Content Area: Nutrition ) ) References: Nix, S. (2009). Williams’ basic nutrition and diet therapy (13th ed., p. 330). St. Louis: Mosby. ) Perry, A., & Potter, P. (2010). Clinical nursing skills & techniques (7th ed., p. 809). St. Louis: Mosby. Awarded 3.0 points out of 3.0 possible points. ) 4.ID: 4Triamterene (Dyrenium) has been prescribed for a client with a history of hypertension. Which fruits should the nurse tell the client to avoid while taking this medication? Select all that apply. Prunes Correct Apples Incorrect Peaches Avocados Correct Nectarines Correct Cranberries ) Rationale: Triamterene is a potassium-sparing diuretic, so the client should avoid foods high in potassium. Fruits that are naturally high in potassium include dried prunes, avocado, bananas, fresh oranges and mangoes, nectarines, and papayas. ) ) Test-Taking Strategy: Note the strategic word “avoid” in the query of the question. To answer this question correctly, you need to recall that triamterene is a potassium-sparing diuretic, then identify the high-potassium foods. This will direct you to the correct options. If you had difficulty with this question, review this medication and food items high in potassium. ) ) Level of Cognitive Ability: Applying ) ) Client Needs: Physiological Integrity ) ) Integrated Process: Teaching and Learning ) ) Content Area: Nutrition ) ) References: Hodgson, B., & Kizior, R. (2010). Saunders nursing drug handbook 2010 (p. 1151). St. Louis: Saunders. ) Nix, S. (2009). Williams’ basic nutrition and diet therapy (13th ed., p. 480). St. Louis: Mosby. Awarded 1.0 points out of 3.0 possible points. ) 5.ID: 5Diverticulitis has been diagnosed in a client who has been experiencing episodes of gastrointestinal cramping. The nurse should tell the client to maintain, during the asymptomatic period, a soft diet that is: Low in fat High in fiber Correct Low in residue High in carbohydrates ) Rationale: When a client’s diverticulitis is asymptomatic, a soft high-fiber diet containing fruits, vegetables, and whole grains is recommended. The client is also instructed to consume a small amount of bran daily and to take bulk-forming laxatives, if prescribed, to increase stool mass and softness. Increasing fluid intake to 2500 to 3000 mL daily (unless contraindicated) is also important. A low-fat diet may be healthy but is not specific to this disorder. A high-carbohydrate diet is not helpful for the client with this condition. ) ) Test-Taking Strategy: Note the strategic word “asymptomatic.” Recalling the pathophysiology of this disorder and the effects of the diets identified in the options will assist you in answering correctly. Review dietary treatment for diverticulitis if you had difficulty with this question. ) ) Level of Cognitive Ability: Applying ) ) Client Needs: Physiological Integrity ) ) Integrated Process: Teaching and Learning ) ) Content Area: Nutrition