NURSING 2362 MODDULE 7 EXAM |2022 REVISED

NURSING 2362 MODDULE 7 EXAM 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: Patient- centered 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 Reference: Black, J., & Hawks, J. (2009). Medical-surgical nursing: Clinical management for positive outcomes (8th ed., pp. 712, 713). St. Louis: Saunders. Awarded 1.0 points out of 1.0 possible points. 6. ID: 2A nurse is teaching a client with heart disease about a low-fat diet. Which foods should the nurse tell the client to avoid? Select all that apply. Avocados Correct Baked tuna Green olives Correct Baked potato Fresh cherries Cream cheese Correct Rationale: Fruits and vegetables tend to be lower in fat because they do not come from animal sources, although olives, though technically a fruit, are high in fat (as are avocados), and fish is also naturally lower in fat. Meats and dairy products (e.g., cream cheese) are higher in fat, although modifications can be made to these foods to reduce their fat content. Test-Taking Strategy: Focus on the subject, high-fat foods to be avoided. Recalling that dairy products are high in fat will direct you to cream cheese. Remembering that some fruits and vegetables are high in fat will help you select green olives and avocados. Review foods high in fat if you had difficulty with this question. Level of Cognitive Ability: Applying Client Needs: Physiological Integrity Integrated Process: Teaching and Learning Content Area: Nutrition References: Ignatavicius, D., & Workman, M. (2010). Medical-surgical nursing: Patient-centered collaborative care (6th ed., pp. 795, 796). St. Louis: Saunders. Nix, S. (2009). Williams’ basic nutrition and diet therapy (13th ed., p. 38). St. Louis: Mosby. Awarded 3.0 points out of 3.0 possible points. 7. ID: 6A client with atrial fibrillation has been placed on warfarin sodium (Coumadin). As part of the instructions for the medication, which of the following foods does the nurse tell the client to avoid? Select all that apply. Lettuce Correct Cherries Broccoli Correct Cabbage Correct Potatoes Spaghetti Rationale: Anticoagulant medications work by antagonizing the action of vitamin K, which is needed for clotting. When a client is taking an anticoagulant, foods high in vitamin K are often omitted from the diet. Vitamin K is found in large amounts in green leafy vegetables such as lettuce, broccoli, spinach, Brussels sprouts, cabbage, and turnip greens. The other options are foods that are low in vitamin K. Test-Taking Strategy: Note the strategic word “avoid” in the query of the question. Recall that when a client is taking an anticoagulant, foods high in vitamin K are often omitted from the diet. Knowledge regarding these food items will direct you to the correct options. Review foods high in vitamin K if you had difficulty with this question. Level of Cognitive Ability: Applying Client Needs: Physiological Integrity Integrated Process: Teaching and Learning Content Area: Nutrition References: Ignatavicius, D., & Workman, M. (2010). Medical-surgical nursing: Patient-centered collaborative care (6th ed., p. 783). St. Louis: Saunders. Peckenpaugh, N. (2010). Nutrition essentials and diet therapy (11th ed., pp. 89, 96). St. Louis: Saunders. Awarded 3.0 points out of 3.0 possible points. 8. ID: 0A regular diet has been prescribed for a client with a leg fracture who has been placed in skeletal traction. Which foods that will promote wound healing does the nurse encourage the client to select from the hospital menu? Spare ribs, rice, gelatin, tea Pasta, garlic bread, ginger ale Chicken breast, broccoli, strawberries, milk Correct Peanut butter and jelly sandwich, chocolate cake, tea Rationale: Protein and vitamin C are necessary for wound healing. Poultry and milk are good sources of protein. Broccoli and strawberries are good sources of vitamin C. Peanut butter is a source of niacin. Gelatin, jelly, tea, and ginger ale have no nutritional value. Pasta, rice, and bread deliver complex carbohydrates. Spare ribs may contain some protein but are high in fat. Test-Taking Strategy: Focus on the subject, food items that promote wound healing. Eliminate pasta, garlic bread, and ginger ale first because it contains no fruits or vegetables. Review the food item presented in each option and recall that protein and vitamin C are necessary for wound healing. Review foods high in protein and vitamin C 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: Black, J., & Hawks, J. (2009). Medical-surgical nursing: Clinical management for positive outcomes (8th ed., pp. 532, 533). St. Louis: Saunders. Nix, S. (2009). Williams’ basic nutrition and diet therapy (13th ed., pp. 105, 437). St. Louis: Mosby. Awarded 1.0 points out of 1.0 possible points. 9. ID: 4A client who experienced a brain attack (stroke) is experiencing residual dysphagia. Which of the following foods would the nurse remove from the client’s meal tray? Peas Correct Scrambled eggs Cheese casserole Mashed potatoes Rationale: In general, flavorful, warm, or well-chilled foods with texture stimulate the swallow reflex. Moist pastas, casseroles, egg dishes, and potatoes are usually well tolerated. Raw vegetables, chunky vegetables such as diced beets, stringy vegetables, and those with skin, such as corn and peas are foods commonly excluded from the diet of a client with dysphagia. Test-Taking Strategy: Note the strategic word “dysphagia.” Use the process of elimination and select the food that would be most difficult to swallow; this is the correct option. If you had difficulty with this question, review dietary measures for a client with dysphagia. Level of Cognitive Ability: Applying Client Needs: Safe and Effective Care Environment Integrated Process: Nursing Process/Implementation Content Area: Adult Health/Neurological References: Nix, S. (2009). Williams’ basic nutrition and diet therapy (13th ed., pp. 340, 341). St. Louis: Mosby. Peckenpaugh, N. (2010). Nutrition essentials and diet therapy (11th ed., pp. 158, 598, 599). St. Louis: Saunders. Awarded 1.0 points out of 1.0 possible points. 10. ID: 1A client recovering from acute renal failure is being discharged home. The nurse knows that the client understands the therapeutic dietary regimen when the client states that he will plan to eat foods that are low in: Fats Vitamins Potassium Correct Carbohydrates Rationale: Most excretion of potassium and control of potassium balance is carried out by the kidneys. In the client with acute renal failure, potassium intake is limited. The primary mechanism of potassium removal during acute renal failure is dialysis. Vitamins, carbohydrates, and fats are not normally restricted in the client with acute renal failure. Test-Taking Strategy: Note the diagnosis. Recalling the normal functions of the kidneys will direct you to the correct option. Review the therapeutic diet for the client with acute renal failure if you had difficulty with this question. Level of Cognitive Ability: Evaluating Client Needs: Physiological Integrity Integrated Process: Nursing Process/Evaluation Content Area: Nutrition Reference: Black, J., & Hawks, J. (2009). Medical-surgical nursing: Clinical management for positive outcomes (8th ed., p. 814). St. Louis: Saunders. Awarded 1.0 points out of 1.0 possible points. 11. ID: 6A client is resuming eating after undergoing partial gastrectomy. What does the nurse tell the client to avoid doing as a means of minimizing the risk of complications? Lying down after eating Eating high-protein foods Drinking liquids with meals Correct Eating six small meals per day Rationale: The client who has undergone partial gastrectomy is at risk for dumping syndrome. This client should be prescribed a diet that is high in protein, moderate in fat, and low in carbohydrates. The client should lie down after meals and avoid drinking liquids with meals. Frequent small meals are encouraged. The client should avoid concentrated sweets. Test-Taking Strategy: Note the strategic word “avoid” in the query. Focus on the client’s diagnosis and recall that this client is at risk for dumping syndrome. This will direct you to the correct option: the action that will contribute to the problems associated with dumping syndrome. Review the dietary measures to prevent dumping syndrome if you had difficulty with this question. Level of Cognitive Ability: Applying Client Needs: Physiological Integrity Integrated Process: Teaching and Learning Content Area: Adult Health/Gastrointestinal Reference: Black, J., & Hawks, J. (2009). Medical-surgical nursing: Clinical management for positive outcomes (8th ed., p. 637). St. Louis: Saunders. Awarded 1.0 points out of 1.0 possible points. 12. ID: 8A client with renal calculi is instructed to follow an alkaline ash diet. Which menu choice by the client indicates to the nurse that the client understands the prescribed regimen? Chicken, potatoes, and cranberries Spinach salad, milk, and a banana Correct Peanut butter sandwich, milk, and prunes Linguini with shrimp, tossed salad, and a plum Rationale: In an alkaline ash diet, all fruits are allowed except cranberries, prunes, and plums. The incorrect options represent components of an acid ash diet. Test-Taking Strategy: Knowledge of foods that are either included or restricted in an alkaline ash diet is necessary to answer this question. Remembering that cranberries, prunes, and plums are not allowed in an alkaline ash diet will direct you to the correct option. Review the foods allowed in this type of diet if you had difficulty with this question. Level of Cognitive Ability: Evaluating Client Needs: Physiological Integrity Integrated Process: Nursing Process/Evaluation Content Area: Nutrition Reference: Black, J., & Hawks, J. (2009). Medical-surgical nursing: Clinical management for positive outcomes (8th ed., p. 753). St. Louis: Saunders. Awarded 1.0 points out of 1.0 possible points. 13. ID: 6A client who has sustained multiple fractures of the left leg is in skeletal traction. The nurse has obtained an overhead trapeze to improve the client’s bed mobility. To which of the following high-risk areas must the nurse pay particular attention during assessment for indications of pressure and skin breakdown? Left heel Scapulae Right heel Correct Back of the head Rationale: Certain areas are under pressure and at risk for breakdown in the client who is in skeletal traction. These areas include the elbows (if they are used for repositioning instead of a trapeze) and the heel of the good leg, which is used as a brace when the client pushes up from the bed). Other such pressure points include the ischial tuberosity, popliteal space, and Achilles tendon. Test-Taking Strategy: Use the process of elimination and note the strategic words “high-risk areas” and “pressure and skin breakdown.” Visualize the client in the question. Eliminate the left heel and the back of the head, because the heel is immobilized and the client can lift the head if a trapeze is in use. Eliminate the scapulae next, because the client is also able to lift this area from the mattress with the use of the trapeze as well. Knowing that the unaffected heel is used to push into the mattress will direct you to the correct option. Review care of the client in skeletal traction if you had difficulty with this question. Level of Cognitive Ability: Analyzing Client Needs: Physiological Integrity Integrated Process: Nursing Process/Assessment Content Area: Adult Health/Musculoskeletal References: Black, J., & Hawks, J. (2009). Medical-surgical nursing: Clinical management for positive outcomes (8th ed., pp. 524, 525). St. Louis: Saunders. Perry, A., & Potter, P. (2010). Clinical nursing skills & techniques (7th ed., pp. 286-288). St. Louis: Mosby. Awarded 1.0 points out of 1.0 possible points. 14. ID: 4Which food should the nurse offer to a client who has been prescribed a full liquid diet? Toast Plain bagel Cooked custard Correct Scrambled eggs Rationale: A full liquid diet consists of liquid foods that are clear or opaque liquid foods, including those that are liquid at room temperature. Cooked custard is allowed on a full liquid diet. Toast and a bagel are allowed on a regular diet (a diet with no restrictions). Scrambled eggs are allowed on a soft diet. Test-Taking Strategy: Remembering that a full liquid diet consists of liquid foods that are clear or opaque, including those that are liquid at room temperature will direct you to the correct option. Review the foods allowed on a full liquid diet 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 1.0 points out of 1.0 possible points. 15. ID: 8A client with heart failure and hypertension who has been admitted to the hospital is unable to make her own selections from the menu. Which of the following meals does the nurse select for the client’s supper on the day of admission? Smoked ham, fresh carrots, boiled potato Hot dog in a bun, sauerkraut, baked beans Turkey, baked potato, salad with oil and vinegar Correct Shrimp, baked potato, salad with blue cheese dressing Rationale: Foods that are high in sodium should be limited in the diet of the client with hypertension and heart failure. Foods in the meat group that are higher in sodium include bacon, luncheon meat, chipped or corned beef, ham, hot dogs, kosher meat, smoked or salted meat or fish, and a variety of shellfish. These foods should be avoided or strictly limited for hypertensive clients. Test-Taking Strategy: Use the process of elimination, recalling that the client with hypertension and heart failure needs to limit sodium in the diet. Eliminate the hot dog and smoked ham first because they are highly processed meats. (Sauerkraut is also high in sodium.) Eliminate the menu consisting of shrimp and salad with blue cheese dressing next, because shellfish and commercial dressings are high in sodium. Review foods high in sodium if you had difficulty with this question. Level of Cognitive Ability: Applying Client Needs: Physiological Integrity Integrated Process: Nursing Process/Implementation Content Area: Adult Health/Cardiovascular References: Black, J., & Hawks, J. (2009). Medical-surgical nursing: Clinical management for positive outcomes (8th ed., p. 1298). St. Louis: Saunders. Nix, S. (2009). Williams’ basic nutrition and diet therapy (13th ed., pp. 132, 133, 374, 375). St. Louis: Mosby. Awarded 1.0 points out of 1.0 possible points. 16. ID: 8The nurse teaches a client who has begun taking phenelzine (Nardil), a monoamine oxidase inhibitor (MAOI), about the medication. Which foods are allowed in the diet of the client taking phenelzine? Select all that apply. Peas Correct Broccoli Correct Potatoes Correct Red wine Avocados Cereal with raisins Rationale: Because phenelzine is an MAOI, the client should avoid foods that are high in tyramine, which could trigger a potentially fatal hypertensive crisis. Foods to avoid include aged cheeses, smoked or processed meats, red wines, beer, and certain fruits, including avocados, raisins, and figs. Vegetables, with the exception of broad-bean pods, are generally acceptable. Test-Taking Strategy: Use the process of elimination. Recalling that foods that contain tyramine must be avoided by the client taking an MAOI will help direct you to the correct options. Review client teaching points for MAOIs if you had difficulty with this question. Level of Cognitive Ability: Applying Client Needs: Physiological Integrity Integrated Process: Teaching and Learning Content Area: Pharmacology Reference: Hodgson, B., & Kizior, R. (2010). Saunders nursing drug handbook 2010 (p. 901). St. Louis: Saunders. Awarded 3.0 points out of 3.0 possible points. 17. ID: 0A client with a genitourinary tract infection has been prescribed metronidazole (Flagyl) and fluid therapy. The nurse concludes that the client understands the dietary regimen to be followed while taking the medication when the client states that she must avoid: Alcohol Correct Diet cola Bran flakes Chicken livers Rationale: A disulfiram (Antabuse)-type reaction may result when someone taking metronidazole ingests alcohol. This syndrome includes flushing, palpitations, shortness of breath, severe headache, and nausea. To help prevent this reaction, the nurse must warn the client not to drink alcohol while taking this medication. The items presented in the remaining options are acceptable for consumption by the client while taking this medication. Test-Taking Strategy: Use the process of elimination. Use general medication guidelines to answer correctly and recall that alcohol can affect the action of many medications. This will assist in directing you to the correct option. Review this medication and the associated dietary regimen if you had difficulty with this question. Level of Cognitive Ability: Evaluating Client Needs: Physiological Integrity Integrated Process: Nursing Process/Evaluation Content Area: Pharmacology Reference: Hodgson, B., & Kizior, R. (2010). Saunders nursing drug handbook 2010 (pp. 748, 749). St. Louis: Saunders. Awarded 1.0 points out of 1.0 possible points. 18. ID: 9Calcitriol (Rocaltrol) is prescribed for a client with hypocalcemia. Which foods does the nurse, knowing that they may interfere with calcium absorption, instruct the client to limit in the diet? Select all that apply. Bran Correct Milk Clams Spinach Correct Orange juice Rationale: The client taking a medication to treat hypocalcemia should be instructed to avoid excessive consumption of spinach, rhubarb, bran, and whole-grain cereals, all of which may limit calcium absorption. Good dietary sources of calcium include milk products, dark-green leafy vegetables, clams, oysters, sardines, and orange juice fortified with calcium. Test-Taking Strategy: Focus on the subject, foods that can interfere with calcium absorption. Thinking about each food listed and how it might affect calcium absorption will direct you to the correct options. Review the foods high in calcium if you had difficulty with this question. Level of Cognitive Ability: Applying Client Needs: Physiological Integrity Integrated Process: Teaching and Learning Content Area: Pharmacology Reference: Lehne, R. (2010). Pharmacology for nursing care (7th ed., pp. 884, 885). St. Louis: Saunders. Awarded 2.0 points out of 2.0 possible points. 19. ID: 0The nurse provides instructions to a client who is beginning therapy with theophylline (Theo-24). The nurse recognizes that the client understands the instructions when the client states that he will be sure to limit consumption of: Coffee, cola, and chocolate Correct Oysters, lobster, and shrimp Apples, oranges, and pineapple Cottage cheese, cream cheese, and dairy creamers Rationale: Theophylline is a methylxanthine bronchodilator, and the nurse teaches the client to limit the intake of xanthine-containing foods while taking this medication. These foods include coffee, tea, cola, and chocolate. Test-Taking Strategy: Recall that theophylline is a methylxanthine bronchodilator and that intake of excessive amounts of foods naturally high in xanthines should be avoided. With this in mind, eliminate the incorrect options. Review this medication and the foods naturally high in xanthines if you had difficulty with this question. Level of Cognitive Ability: Evaluating Client Needs: Physiological Integrity Integrated Process: Nursing Process/Evaluation Content Area: Pharmacology Reference: Lehne, R. (2010). Pharmacology for nursing care (7th ed., p. 906). St. Louis: Saunders. Awarded 1.0 points out of 1.0 possible points. 20. ID: 8A client with a urinary tract infection has been started on nitrofurantoin (Macrodantin), a urinary antiseptic medication, and is taught about the foods that will maintain the urinary pH in the acid range. Which food does the nurse tell the client to avoid while taking this medication? Prunes Oranges Rhubarb Correct Cranberries Rationale: When a client is taking nitrofurantoin, the urinary pH must be maintained in the acid range, and so the client needs to be instructed to consume an acid ash diet. Rhubarb reduces the acidity of the urine and should be avoided when acidic urine is required. Prunes, oranges, and cranberries are acceptable foods. Test-Taking Strategy: Use the process of elimination and note the strategic word “avoid.” Recalling the items that are acid ash foods will direct you to the correct option. Review this medication and acid ash foods if you had difficulty with this question. Level of Cognitive Ability: Applying Client Needs: Physiological Integrity Integrated Process: Teaching and Learning Content Area: Pharmacology References: Kee, J., Hayes, E., & McCuistion, L. (2009). Pharmacology: A nursing process approach (6th ed., p. 488). St. Louis: Saunders. Nix, S. (2009). Williams’ basic nutrition and diet therapy (13th ed., p. 429). St. Louis: Mosby. Awarded 1.0 points out of 1.0 possible points. 21. ID: 4For which vitamin deficiency should the nurse monitor the client who is on a vegan diet? Vitamin A Vitamin B12 Correct Vitamin C Vitamin E Rationale: The client on a vegan diet does not consume animal products and is therefore at risk for vitamin B12 deficiency. Fruits and vegetables, which are acceptable to the client on a vegan diet, contain vitamins A, C, and E. Test-Taking Strategy: Focus on the subject, a vegan diet. Recalling that vitamin B12 is found in animal products will direct you to the correct option. Review the components of a vegan diet if you had difficulty with this question. Level of Cognitive Ability: Understanding Client Needs: Physiological Integrity Integrated Process: Nursing Process/Assessment Content Area: Nutrition Reference: Nix, S. (2009). Williams’ basic nutrition and diet therapy (13th ed., p. 53). St. Louis: Mosby. Awarded 1.0 points out of 1.0 possible points. 22. ID: 4A client with cirrhosis has an increased ammonia level. Which diet does the nurse anticipate will be of benefit to the client? One low in protein Correct One high in protein One with a moderate amount of fat One high in carbohydrates Rationale: A low-protein diet would be prescribed for the client with cirrhosis who has an increased ammonia level. Protein in the diet is transported to the liver by the portal vein after digestion and absorption. The liver breaks down protein, resulting in the formation of ammonia. Therefore the client would benefit from a low-protein diet. Test-Taking Strategy: Recall the physiology of the liver to answer this question. Note the strategic words “will be of benefit.” This tells you that the correct option is the one that is appropriate for the client’s diet. Also note that “high in protein” and “low in protein” are opposites, suggesting that one of these options is correct. Review diet therapy for the client with cirrhosis if you had difficulty with this question. Level of Cognitive Ability: Understanding Client Needs: Physiological Integrity Integrated Process: Nursing Process/Planning Content Area: Adult Health/Gastrointestinal References: Ignatavicius, D., & Workman, M. (2010). Medical-surgical nursing: Patient-centered collaborative care (6th ed., p. 1355). St. Louis: Saunders. Nix, S. (2009). Williams’ basic nutrition and diet therapy (13th ed., pp. 357-359). St. Louis: Mosby. Awarded 1.0 points out of 1.0 possible points. 23. ID: 8A nurse provides dietary instructions to a client with cholecystitis. Which menu selection by the client indicates to the nurse that the client understands the instructions? Roast turkey with a baked potato Correct Fruit plate with fresh whipped cream Fried chicken with macaroni and cheese Barbecued spare ribs with buttered noodles Rationale: The client with cholecystitis should reduce intake of fat. Foods that should generally be avoided to achieve this end include sauces and gravies, fatty meats, fried foods, products made with cream, and heavy desserts. Therefore the correct answer is roast turkey with a baked potato, which is a meal low in fat. Test-Taking Strategy: Use the process of elimination and focus on the client’s diagnosis. Eliminate barbecued spare ribs with buttered noodles and fried chicken with macaroni and cheese because they are comparable or alike in that they contain fat. Next eliminate the fruit plate with fresh whipped cream, because fresh whipped cream is high in fat. Review the appropriate dietary measures for the client with cholecystitis if you had difficulty with this question. Level of Cognitive Ability: Evaluating Client Needs: Physiological Integrity Integrated Process: Nursing Process/Evaluation Content Area: Adult Health/Gastrointestinal References: Black, J., & Hawks, J. (2009). Medical-surgical nursing: Clinical management for positive outcomes (8th ed., p. 1124). St. Louis: Saunders. Nix, S. (2009). Williams’ basic nutrition and diet therapy (13th ed., p. 360). St. Louis: Mosby. Awarded 1.0 points out of 1.0 possible points. 24.ID: 6