Practice Question ch 19 Flashcards
A healthy 35-year-old patient wishes to lose weight because her BMI is 27. Which suggestion would be most appropriate for her?
- This BMI is too low for good health; the patient needs to supplement the diet to increase weight.
- This is an acceptable BMI, and it is best to maintain weight at this level for continued good health.
- Appropriate weight loss is possible with a healthy, reduced-calorie diet and incorporating at least 30 minutes of physical activity into each day.
- This BMI is elevated to the point that treatments, such as surgery, are necessary
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18.5 to 24.9
A patient takes medication for hypertension and asks whether there is anything else he can do to help to reduce his blood pressure. What is the best nursing response?
- “A low-fat, low-cholesterol diet with only a limited amount of simple sugars will have the greatest effect on your blood pressure.”
- “A salt-free diet will have the greatest effect on your blood pressure. Do not add salt in your cooking or at the table.”
- “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.”
- “Discontinue the use of processed foods, and buy only natural foods. That way, you will have less sodium in your diet.”
3
A patient with cancer has anorexia and weight loss. Which suggestion is most likely to help him increase intake and prevent weight loss?
- Encourage the patient to eat double portions at each meal.
- Suggest that the patient snack often on high-calorie foods.
- Encourage the patient to eat the low-calorie foods first.
- Suggest to the patient that he decrease his amount of exercise
2
Which dietary recommendation should the nurse include in the discharge instructions for a client who has been diagnosed with coronary artery disease?
- Limit intake of whole grains.
- Limit intake of tuna.
- Limit intake of soybean products.
- Limit intake of egg yolks
4
The nurse is reviewing a patient’s dietary intake. Which patient behavior reflects compliance with a 2-g sodium-restricted diet?
- Using only the two packets of salt found on the meal tray
- Limiting milk to 1 cup per day
- Avoiding use of salt in cooking
- Using salt-free butter with meals
3
A patient with iron-deficiency anemia started taking iron supplements. What recommendation can the nurse give the patient to increase iron absorption?
- Drink milk or take calcium supplements at the same time as eating iron-rich foods.
- Take iron supplements with coffee, tea, or red wine.
- Consume vitamin C-rich foods at the same meal with iron-containing foods.
- Take iron supplements with a high-fiber bran cereal.
3
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?
- Caesar salad, bread sticks, and frozen yogurt
- Grilled chicken sandwich, strawberries, and lettuce salad
- Grilled cheese sandwich, canned pineapple, and brownie
- Chicken and vegetable stir fry, rice, and egg roll
2
A patient planning for pregnancy has heard that some experts recommend folic acid supplements for women of childbearing age. The patient understands the need for this recommendation by making which statement?
- “Folic acid may help prevent neural tube defects in my baby.”
- “Folic acid provides me with extra calories to make new cells.
“3. “It is impossible for me to receive adequate amounts of folic acid in my diet.
“4. “Folic acid will help me to increase iron absorption in my diet.
1
While the nurse is completing discharge teaching for a patient with elevated cholesterol levels, the patient asks how to distinguish between an unsaturated fat and a saturated fat. Which statement is most accurate?
- Saturated fats are generally from plant sources and are solid at room temperature.
- In unsaturated fats the hydrogen bonds are full.
- Saturated fats are missing hydrogen at points of unsaturation.
- Unsaturated fats are generally from plant sources and are liquid at room temperature
1
A nurse is caring for a patient recently diagnosed with type 2 diabetes. The patient asks the nurse to tell her about the dietary changes she will need to make. Which actions are appropriate and within the scope of practice for a nurse?
- Review the patient’s chart, and recommend a calorie and carbohydrate intake that is based on blood glucose and lipid values.
- 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 health care provider.
- Locate the health care provider’s diet order in the medical chart, and then obtain a preprinted diet sheet showing the exchange lists for meal planning and a menu pattern based on the prescribed calorie level.
- Decline 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.
2
A 40-year-old patient recently received a diagnosis of type 2 diabetes. He is in the hospital for tests 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?
- “Sugars and sweets are permitted in moderation in the diabetic diet. The important thing is that the total carbohydrate content of the meal is controlled and balanced with your husband’s medication and nutrient needs.”
- “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.
“3. “I am sure that if the cookies were on the meal tray, they must be allowed in the diet. They are probably low in sugar. There is likely no need for concern.”
- “Sugar is used to treat hypoglycemia or low blood sugar. Perhaps your husband had a low blood sugar reading before breakfast, and the dietitian sent up the cookies to give him some extra sugar on his lunch meal tray.”
1
The health care 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?
- 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.
- Choose foods that are closer to their whole state rather than refined or processed, including more fruits, oats, and legumes to increase soluble fiber; and drink plenty of water.
- Choose more vegetables, vegetable juices, whole wheat, and whole wheat products to increase soluble fiber; and drink plenty of water.
- Choose more fruit juices to provide fluid and fiber, and include iron-fortified breakfast cereals to enhance the absorption of fiber from the fruit juice
2
A patient is controlling his blood cholesterol through diet. He is familiar with food sources of saturated fat and cholesterol but is confused about trans fatty acids. The nurse should explain that which group of foods contributes the most trans fatty acids
- Butter, cream, fats in meats, and tropical oils such as palm and coconut oils
- Fish oils, nuts and seeds, and vegetable oils such as olive oil and canola oil
- Stick margarines, shortening, deep-fried restaurant foods, and commercially prepared baked goods
- Liquid margarines, vegetable oil spreads, and vegetable oils such as corn, soybean, and cottonseed
3
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 reduced calcium balance? (Select all that apply.)
- Taking small doses of calcium throughout the day rather than one large dose
- Choosing plenty of milk products, and avoiding excess caffeine intake
- Consuming a high-protein diet
- Consuming a diet that has moderate levels of sodium
- Increasing potassium intake
2,3
Which patient comment indicates to the nurse that more teaching is needed for the patient experiencing dumping syndrome after gastric surgery?
- “I should eat six small meals per day.”
- “I should not drink fluids with my meals.”
- “I should use honey or jelly instead of butter.
- “I should lie down for 30 to 60 minutes after eating
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