1. A nurse is providing dietary instructions to a client with diabetes. What is most
important for the nurse to include in teaching for prevention of
... [Show More] hypoglycemia?
a. Increase protein intake in the morning.
b. Reduce carbohydrate intake when drinking alcohol.
c. Drink orange juice if lightheadedness occurs.
d. Avoid delaying or skipping meals.
- d. Avoid delaying or skipping meals
Hypoglycemia is an important complication in the treatment of diabetes. The risk
of hypoglycemia increases as nutritional intake decreases, so it is most important
to teach the client to avoid delaying or skipping meals. Carbohydrate intake has
the greatest influence on blood glucose levels, so increasing protein in the
morning will not prevent hypoglycemic episodes. Drinking alcohol inhibits the
release of glucose from the liver; therefore it would be important to increase
carbohydrate intake when drinking alcohol. Lightheadedness is a manifestation
of hypoglycemia, and drinking orange juice would be the means to treat the
hypoglycemia, not prevent it.
2. The healthcare provider has prescribed a diet that limits purine-rich foods. Which
foods should this client avoid?
a. bananas, wine, and cheese
b. anchovies, sardines, and kidneys
c. milk, ice cream, vegetables, and yogurt
d. chicken, fish, and dried fruits
- b. anchovies, sardines, and kidneys
Anchovies, sardines, kidneys, sweetbreads, and lentils are very high in purines.
Bananas and dried fruits are high in potassium. Milk, ice cream, and yogurt are
rich in calcium. Wine, cheese, preserved fruits, meats, and vegetables contain
tyramines.
3. A physician orders a bland, full-liquid diet for a client. Which response, if made by
the client, would indicate to the nurse that the client has understood the nurse's
dietary teaching?
a. "I will have orange juice, pudding, and coffee."
b. "Today I can have apple juice, chicken broth, and vanilla ice cream."
c. "For breakfast I will choose pineapple juice, a bran muffin, and milk."
d. "I can have oatmeal, custard, and tea."
- b "Today I can have apple juice, chicken broth, and vanilla ice cream."A bland, full-liquid diet may include some fruit juices and foods from all of the
food groups. On this diet, the client should avoid gastric irritants, such as orange
juice, coffee, tea, colas, cocoa, breads, bran (fiber), and highly seasoned foods.
4. A nurse working in a community clinic is discussing lifestyle modifications with a
client. The client has been advised to lose weight because of a BMI greater than
25. Which statement by the nurse would be most therapeutic in helping the
client?
a. "Losing weight is a challenge that I can help you with."
b. "It will be important for you to stop having between-meal snacks."
c. "I can offer you some information outlining a variety of ways to lose
weight."
d. "There are herbal preparations for weight loss that are very effective."
- c. I can offer you some information outlining a variety of ways to lose
weight."
The therapeutic response would put the client in a position to make an individual
choice. The nurse would offer options to allow for choice. Telling the client that
losing weight is a challenge the nurse can help with puts the focus on the nurse
and does not offer options. Many weight loss plans include meals plus snacks as
well as limiting options. Offering herbal preparation also limits the options given
to the client.
5. A client has been receiving total parenteral nutrition (TPN) for the last 5 days.
Before discontinuing the infusion, the infusion rate is slowed. What complication
of TPN infusion should the nurse assess the client for as the infusion is
discontinued?
a. dehydration
b. essential fatty acid deficiency
c. rebound hypoglycemia
d. malnutrition
- c. rebound hypoglycemia
When dextrose is abruptly discontinued, rebound hypoglycemia can occur. The
nurse should assess the client for symptoms of hypoglycemia. Essential fatty
acid deficiency is very unlikely to occur because some of these fatty acids are
stored. Preventing dehydration or malnutrition is not the reason for tapering the
infusion rate; the client's hydration and nutritional status and ability to maintain
adequate intake must be established before TPN is discontinued. [Show Less]