Description
Saunders Comprehensive Review for the NCLEX-PN 4th Edition Silvestri Test Bank
ISBN-13: 978-1416047308
ISBN-10: 1416047301
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Silvestri: Saunders Comprehensive Review for the NCLEX-PN®
Examination, 4th Edition
Chapter 12: Nutritional Components of Care
Test Bank
MULTIPLE CHOICE
- A nurse has provided dietary instructions to a client with renal calculi who must learn to eat an alkaline-ash diet. The nurse determines that the client has properly understood the information presented if the client chooses which of the following selections from a diet menu?
| 1. | Chicken, potatoes, and cranberries |
| 2. | Peanut butter sandwich, milk, and prunes |
| 3. | A spinach salad, milk, and a banana |
| 4. | Linguini with shrimp, tossed salad, and a plum |
ANS: 3
Rationale: In an alkaline-ash diet, all fruits are allowed except cranberries, prunes, and plums. Options 1, 2, and 4 represent an acid-ash diet.
Test-Taking Strategy: Knowledge of foods that are either included or restricted in an alkaline-ash diet is required to answer this question. Remember that cranberries, prunes, and plums are not allowed in an alkaline-ash diet. Review the foods allowed in this diet if you had difficulty with this question.
DIF: Level of Cognitive Ability: Comprehension
REF: Linton, A., & Maebius, N. (2007). Introduction to medical-surgical nursing (4th ed.). Philadelphia: Saunders. | Mahan, L., & Escott-Stump, S. (2004). Krause’s food, nutrition and diet therapy (11th ed.). St. Louis: Saunders.
OBJ: Client Needs: Physiological Integrity
TOP: Content Area: Adult Health/Renal
MSC: Integrated Process: Nursing Process/Evaluation
- A client with hypertension has been prescribed a low-sodium diet. The nurse teaching this client about foods that are allowed would include which of the following in a list provided to the client?
| 1. | Tomato soup |
| 2. | Summer squash |
| 3. | Instant oatmeal |
| 4. | Boiled shrimp |
ANS: 2
Rationale: Foods that are lower in sodium are fruits and vegetables (option 2), because they do not contain physiological saline. Highly processed or refined foods (options 1 and 3) are higher in sodium unless they are specifically noted as “low sodium.” Saltwater fish and shellfish are high in sodium.
Test-Taking Strategy: Begin to answer this question by eliminating options 1 and 4 because they are highest in sodium. Next, eliminate option 3 because it is a processed food. Review the foods high in sodium if you had difficulty with this question.
DIF: Level of Cognitive Ability: Application
REF: Linton, A., & Maebius, N. (2007). Introduction to medical-surgical nursing (4th ed.). Philadelphia: Saunders.
OBJ: Client Needs: Health Promotion and Maintenance
TOP: Content Area: Adult Health/Cardiovascular
MSC: Integrated Process: Teaching and Learning
- A client with a history of hypertension has been prescribed triamterene (Dyrenium). The nurse determines that the client understands the effect of this medication on the diet if the client states to avoid which of the following fruits?
| 1. | Apples |
| 2. | Pears |
| 3. | Bananas |
| 4. | Cranberries |
ANS: 3
Rationale: Triamterene is a potassium-sparing diuretic, and the client should avoid foods high in potassium. Fruits that are naturally higher in potassium include avocados, bananas, fresh oranges and mangoes, nectarines, papayas, and dried prunes and other dried fruits.
Test-Taking Strategy: First, recall that triamterene is a potassium-sparing diuretic. Next, identify the foods high in potassium. This will direct you to option 3. Review this medication and foods high in potassium if you had difficulty with this question.
DIF: Level of Cognitive Ability: Comprehension
REF: Hodgson, B., & Kizior, R. (2008). Saunders nursing drug handbook 2008. Philadelphia: Saunders. OBJ: Client Needs: Physiological Integrity
TOP: Content Area: Adult Health/Cardiovascular
MSC: Integrated Process: Nursing Process/Evaluation
- A client with a history of gastrointestinal upset has been diagnosed with acute diverticulitis. The nurse gives the client suggestions for foods to aid in symptom management that are on which of the following diets?
| 1. | A high-carbohydrate diet |
| 2. | A low-fat diet |
| 3. | A high-fat diet |
| 4. | A low-fiber diet |
ANS: 4
Rationale: A low-fiber diet places less strain on the intestines because this type of diet is easier to digest. This diet is used for acute diverticulitis, ulcerative colitis, and irritable bowel syndrome. The diets identified in options 1, 2, and 3 will not aid in symptom management.
Test-Taking Strategy: Note that the diagnosis in the question refers to an acute inflammation in the colon. With this in mind, you should select the diet that would be least irritating to intestinal mucosa. This will direct you to option 4. If you had difficulty with this question, review the diet prescribed for diverticulitis.
DIF: Level of Cognitive Ability: Application
REF: Linton, A., & Maebius, N. (2007). Introduction to medical-surgical nursing (4th ed.). Philadelphia: Saunders. OBJ: Client Needs: Physiological Integrity
TOP: Content Area: Adult Health/Gastrointestinal
MSC: Integrated Process: Nursing Process/Implementation
- A client is recovering from abdominal surgery and has a large abdominal wound. The nurse encourages the client to eat which of the following foods that are naturally high in vitamin C to promote wound healing?
| 1. | Chicken |
| 2. | Bananas |
| 3. | Oranges |
| 4. | Milk |
ANS: 3
Rationale: Citrus fruits and juices are especially high in vitamin C. Other sources are potatoes, tomatoes, and other fruits and vegetables. Meats and dairy products are two food groups that are not especially high in vitamin C.
Test-Taking Strategy: Focus on the subject, the food that is naturally high in vitamin C. Remember that citrus fruits and juices are especially high in vitamin C. Review these foods if you had difficulty with this question.
DIF: Level of Cognitive Ability: Application
REF: Lehne, R. (2007). Pharmacology for nursing care (6th ed.). St. Louis: Saunders.
OBJ: Client Needs: Physiological Integrity
TOP: Content Area: Fundamental Skills
MSC: Integrated Process: Nursing Process/Implementation
- A client with a brain attack (stroke) is experiencing residual dysphagia. The nurse would remove which of the following food items that arrived on the client’s meal tray from the dietary department?
| 1. | Mashed potatoes |
| 2. | Peas |
| 3. | Cheese casserole |
| 4. | Scrambled eggs |
ANS: 2
Rationale: In general, flavorful, very warm, or well-chilled foods with texture stimulate the swallowing reflex. Moist pastas, casseroles, egg dishes, and potatoes are usually well tolerated. Raw vegetables, chunky vegetables such as diced beets, and stringy vegetables such as spinach, corn, and peas are commonly excluded from the diet of a client with a poor swallowing reflex.
Test-Taking Strategy: Note the strategic words “dysphagia” and “remove.” Use the process of elimination to select the food that would be most difficult to swallow. This will direct you to option 2. If you had difficulty with this question, review dietary substitutions for a client with an impaired swallowing reflex.
DIF: Level of Cognitive Ability: Application
REF: Schlenker, E., & Long, S. (2007). Williams’ essentials of nutrition & diet therapy (9th ed.). St. Louis: Mosby. OBJ: Client Needs: Physiological Integrity
TOP: Content Area: Adult Health/Neurological
MSC: Integrated Process: Nursing Process/Implementation
- A client is resuming a diet after hemigastrectomy. To minimize complications, the nurse would tell the client to avoid doing which of the following?
| 1. | Eating six small meals per day |
| 2. | Excluding concentrated sweets in the diet |
| 3. | Lying down after eating |
| 4. | Drinking liquids with meals |
ANS: 4
Rationale: The client who has had a hemigastrectomy is at risk for dumping syndrome. This client should be placed on a diet that is high in protein, moderate in fat, and high in calories. The client should avoid drinking liquids with meals. Frequent small meals are encouraged, and the client should avoid concentrated sweets.
Test-Taking Strategy: Note the strategic word “avoid” in the query of the question. Use the process of elimination, selecting option 4 as the item that will contribute to the problems associated with dumping syndrome. If you had difficulty with this question, review the diet pattern changes after hemigastrectomy.
DIF: Level of Cognitive Ability: Application
REF: Linton, A., & Maebius, N. (2007). Introduction to medical-surgical nursing (4th ed.). Philadelphia: Saunders. OBJ: Client Needs: Physiological Integrity
TOP: Content Area: Adult Health/Gastrointestinal
MSC: Integrated Process: Nursing Process/Implementation
- A client who has developed atrial fibrillation that is not responding to medication therapy has begun taking warfarin (Coumadin). The nurse is doing discharge dietary teaching with the client. The nurse would plan to teach the client to avoid which of the following foods while taking this medication?
| 1. | Cherries |
| 2. | Potatoes |
| 3. | Spaghetti |
| 4. | Broccoli |
ANS: 4
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 broccoli, cabbage, turnip greens, and lettuce. The other options listed are foods that are lower in vitamin K.
Test-Taking Strategy: Knowledge about the relationship between warfarin and vitamin K is needed to answer this question. Note the strategic word “avoid” in the query of the question. This tells you that the correct option is a food that is high in vitamin K. Recalling that green leafy vegetables are high in vitamin K will direct you to this option. If you had difficulty with this question, review foods high in vitamin K.
DIF: Level of Cognitive Ability: Application
REF: Schlenker, E., & Long, S. (2007). Williams’ essentials of nutrition & diet therapy (9th ed.). St. Louis: Mosby. OBJ: Client Needs: Physiological Integrity
TOP: Content Area: Pharmacology
MSC: Integrated Process: Teaching and Learning
- A nurse is instructing a pregnant client in her first trimester about nutrition. The nurse would correct which of the following misunderstandings on the part of the client about nutrition during pregnancy?
| 1. | Calcium intake should be increased for the duration of the pregnancy. |
| 2. | Iron supplements should be taken throughout pregnancy. |
| 3. | The maternal diet significantly influences fetal growth and development. |
| 4. | Pregnancy greatly increases the risk of malnourishment for the mother. |
ANS: 4
Rationale: Although pregnancy poses some nutritional risk for the mother, the client is not at risk of becoming malnourished. Calcium is critical during the third trimester but must be increased from the onset of pregnancy. Intake of dietary iron is usually insufficient for the majority of pregnant women, and iron supplements are routinely encouraged. Good nutrition during pregnancy significantly and positively influences fetal growth and development.
Test-Taking Strategy: Note the strategic word “misunderstandings.” This indicates a negative event query and the need to select an incorrect statement. Noting the words “greatly increases the risk of malnourishment” in option 4 will direct you to this option. Review nutrition guidelines during pregnancy if you had difficulty with this question.
DIF: Level of Cognitive Ability: Application
REF: Schlenker, E., & Long, S. (2007). Williams’ essentials of nutrition & diet therapy (9th ed.). St. Louis: Mosby. OBJ: Client Needs: Physiological Integrity
TOP: Content Area: Maternity/Antepartum
MSC: Integrated Process: Teaching and Learning
- A client with liver cancer who is receiving chemotherapy tells the nurse that some foods on the meal tray taste bitter. The nurse would try to limit which of the following foods that is most likely to have this taste for the client?
| 1. | Beef |
| 2. | Potatoes |
| 3. | Custard |
| 4. | Cantaloupe |
ANS: 1
Rationale: Chemotherapy may cause distortion of taste. Frequently, beef and pork are reported to taste bitter or metallic. The nurse can promote client nutrition by assisting the client to choose alternative sources of protein in the diet. The food items in options 2, 3, and 4 are not likely to cause distortion of taste.
Test-Taking Strategy: Focus on the subject, the food item that would cause an altered taste sensation in the client receiving chemotherapy. Remember that meat items can cause a bitter or metallic taste for the client receiving chemotherapy. If you had difficulty with this question, review interventions related to nutrition in the client receiving chemotherapy.
DIF: Level of Cognitive Ability: Application
REF: Schlenker, E., & Long, S. (2007). Williams’ essentials of nutrition & diet therapy (9th ed.). St. Louis: Mosby. OBJ: Client Needs: Physiological Integrity
TOP: Content Area: Adult Health/Oncology
MSC: Integrated Process: Nursing Process/Implementation
