Learning System RN Nutrition

A nurse is caring for a client who has diverticulitis and a new prescription for a low-fiber diet. Which of the following food items should the nurse remove from the client's meal tray? Coleslaw- 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. 1. A nurse is reviewing the laboratory reports of a client who is receiving enteral feedings. Which of the following values indicates a complication of enteral feeding that the nurse should report to the provider? BUN 25 mg/Dl A BUN level of 25 mg/dL is above the expected reference range of 10 to 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 2. A nurse is providing teaching about food choices to a client who has diabetes mellitus. Which of the following statements by the client indicates an understanding of the teaching? "I should replace white bread with whole-grain bread." 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. 3. A nurse is caring for an infant who has gastroenteritis and is dehydrated. Which of the following characteristics places the infant at a higher risk of electrolyte imbalances compared to an adult client? Longer intestinal tract—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. A nurse is providing teaching to a client who has gout and urolithiasis. The client asks how to prevent future uric acid stones. Which of the following suggestions should the nurse provide? (Select all that apply.) Correct Answers: C. Take allopurinol as prescribed D. Exercise several times a week E. Limit intake of foods high in purine The nurse should inform the client that allopurinol 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: F. Maintaining an adequate fluid intake of 2 to 3 L per day reduces the risk of stone formation. G. Citrus juices alkalinize the urine, which helps prevent uric acid stone formation. 4. 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 of the following food groups? GRAINS This client only consumed 1 serving of grains on the day of the 24-hour dietary recall. USDA dietary guidelines recommend 3 or more ounce-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 developing 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. 5. A nurse is planning an in-service training session about various dietary practices. Which of the following pieces of information should the nurse include in the teaching? Correct Answer: B. Kosher diets have restrictions regarding how the food must be prepared. Kosher diets are guided by a set of laws regarding the processing, preparation, and eating of food. Incorrect Answers: A. Ovo-vegetarian diets are primarily vegetable-based diets that exclude meat and dairy except for eggs. C. Macrobiotic diets are primarily plant-based but do include fish and seafood. D. Flexitarian diets are primarily plant-based with the occasional consumption of meat, fish, and dairy products. 6. A nurse is creating a plan of care for a client who adheres to Kosher dietary laws. Which of the following food selections should the nurse recommend? Grilled Salmon 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.