Question 1

A practical nurse is caring for a patient with stage 4 chronic kidney disease who requires a renal diet. The patient asks for help choosing a meal from the hospital menu. Which of the following meal options should the nurse recommend?

Accepted Answer

Answer reason: This meal is relatively lower in potassium (white rice, green beans, apples) and avoids obvious high-potassium items like sweet potato, spinach, orange juice, and banana. It also avoids highly processed/high-sodium foods and phosphorus-heavy dairy commonly found in fast-food style meals. Compared with the other choices, it best aligns with typical renal diet restrictions while still offering a balanced, hospital-appropriate plate.

Question 2

A nurse is caring for a client who is at high risk for aspiration. Which action should the nurse take when feeding the client?

Accepted Answer

Answer reason: Aspiration risk is reduced by maximizing airway protection and promoting esophageal transit using upright positioning during feeding. Fowler’s position (upright, typically 45–90°) uses gravity to keep food and fluids moving away from the airway and decreases reflux-related aspiration. Thin liquids are more easily aspirated than thickened liquids in dysphagia, so offering them would increase risk. Lifting the chin during swallowing can open the airway; the safer compensatory strategy is usually chin-tuck (chin down) when indicated by a swallow evaluation. Lying down after meals increases gastroesophageal reflux and aspiration risk, so the client should remain upright for a period after eating.

Question 3

The nurse judges that the mother understands the diet restrictions for her child with chronic renal failure who is receiving peritoneal dialysis when she reports providing a diet involving which of the following?

Accepted Answer

Answer reason: Peritoneal dialysis increases protein losses across the peritoneal membrane, so children typically need a higher protein intake to maintain growth and prevent hypoalbuminemia. Adequate calories—often from carbohydrates—help spare protein for tissue building rather than energy use, which is especially important in pediatrics. Diet plans in chronic renal failure generally avoid excess potassium and phosphorus due to impaired renal excretion, making a “high potassium” choice unsafe. While sodium and fluid limits may be used depending on volume status and urine output, the hallmark diet adjustment specific to peritoneal dialysis is higher protein with sufficient calories.

Question 4

A client with stage 3 left-sided heart failure is prescribed furosemide. What meal choice by the client does the nurse identify as the best evidence of successful dietary teaching?

Accepted Answer

Answer reason: This meal avoids obvious high-sodium processed items (e.g., cured meats, canned soup, cheese) while including potassium-rich choices like apricots and a baked potato. The other options contain common high-sodium foods such as canned soup, bacon, ham, and cheese, which can worsen volume overload and symptoms. Selecting a low-sodium, potassium-supportive meal best reflects that teaching was understood and applied.

Question 5

An infant who eats very rapidly may experience problems with swallowing excessive air. What should the mother be instructed to do?

Accepted Answer

Answer reason: Rapid, frantic sucking increases aerophagia because the infant swallows more air along with milk/formula, leading to gas and discomfort. Feeding before the infant becomes overly hungry helps the baby stay calmer, pace the suck-swallow-breathe pattern more effectively, and take in less air. Placing an infant prone after feeding increases aspiration/SIDS risk and is not an appropriate strategy. Changing nipple flow can help some infants, but the core issue in “too rapid” feeding is often hunger-driven disorganized feeding behavior, best prevented by earlier feeding cues.

Question 6

You have a patient who is admitted for having a stroke. He is on aspiration precautions and requires a special dietary tray. When lunch is delivered and you are assisting him to eat, you notice an error on his tray. What part of his lunch should be removed from the dietary tray?

Accepted Answer

Answer reason: Aspiration-precaution trays typically restrict thin liquids and require thickened fluids to slow bolus flow and improve airway protection. The other items listed are soft/pureed and/or thickened textures that generally align with common dysphagia diets. Leaving thin liquid on the tray increases risk for coughing, choking, and aspiration pneumonia during feeding.

Question 7

A nurse caring for a patient receiving enteral nutrition knows to flush the patient’s tube with how much water prior to and following feedings?

Accepted Answer

Answer reason: Flushing with 30 mL of water before and after intermittent bolus feedings helps clear residual formula and medication particles and reduces occlusion risk. Smaller volumes may be inadequate to clear the lumen, especially with thicker formulas or slow flow. Larger routine volumes are generally unnecessary for most adults and may be inappropriate in patients on fluid restriction, so this volume is the standard default unless otherwise prescribed.

Question 8

The nurse educates a patient that which of the following macronutrients can be lost during hemodialysis?

Accepted Answer

Answer reason: Patients on dialysis often require increased dietary protein to replace ongoing losses and support tissue repair. Carbohydrates and lipids are large/complex and not typically cleared in clinically meaningful amounts by the dialysis membrane under routine conditions. “Nucleic acids” is not a typical dietary macronutrient category emphasized in dialysis nutrition teaching compared with protein, fat, and carbohydrate.

Question 9

When educating a patient about iron supplements, the nurse should tell the patient to drink which of the following when taking the supplement?

Accepted Answer

Answer reason: Taking iron with a vitamin C–containing beverage increases bioavailability and helps correct iron deficiency more effectively. Milk can decrease absorption because calcium and some proteins can bind iron and inhibit uptake. Water is acceptable but does not improve absorption, and cranberry juice is not a standard recommendation for increasing iron absorption.

Question 10

A nurse is caring for a patient with gout. The patient asks the nurse for help ordering their lunch tray. Which is the best food option for this patient?

Accepted Answer

Answer reason: Organ meats and many meats/seafoods are high-purine foods that can increase urate levels and trigger symptoms. A plant-based meal like a salad is typically low in purines and is therefore the safest lunch choice among the options. In contrast, organ meats and shellfish are classic high-purine foods that are commonly recommended to be limited in gout.

Question 11

The nurse is reviewing meal options for a client recovering from acute kidney injury. Which meal should the nurse recommend?

Accepted Answer

Answer reason: This meal is comparatively lower in potassium than choices centered on sweet potato/carrot, spinach, avocado, and beans, which are all potassium-dense foods. Olive oil adds calories without adding potassium or phosphorus, supporting energy needs when protein and electrolytes may be moderated. A common pitfall is assuming “healthy” produce-heavy meals are safest; in AKI, high-potassium items like spinach and avocado can be unsafe depending on labs and restrictions.

Question 12

A child is started on a soft diet after having been on clear liquids following an episode of severe gastroenteritis. When helping the mother choose foods for her child, which of the following foods would be most appropriate?

Accepted Answer

Answer reason: After gastroenteritis, advancing from clear liquids to a soft diet should emphasize bland, low-fat, low-fiber foods that are easy to digest and help firm stools. This choice aligns with the commonly used BRAT-type approach (bananas/rice) that is gentle on an inflamed GI tract and better tolerated when nausea or diarrhea is resolving. Higher-fat foods can worsen gastric emptying and trigger recurrent vomiting/diarrhea, making meat-based items a poor early choice. High-fiber foods can increase intestinal motility and stool volume, which may prolong diarrhea and abdominal cramping. The selected option best supports gradual GI recovery while maintaining caloric intake.

Question 13

Which of the following foods is most likely to be appropriate for a patient who is Kosher-observant?

Accepted Answer

Answer reason: A Kosher-observant client avoids pork products, shellfish, and mixtures of meat with dairy. Cheeseburgers mix meat and dairy, eggs and bacon include pork, and lobster is shellfish. Grilled chicken is the most appropriate choice among the options because it best aligns with Kosher dietary principles.

Question 14

Which client would be an appropriate candidate for oral hydration?

Accepted Answer

Answer reason: Oral hydration requires a client who can safely swallow and tolerate fluids without risk of aspiration or significant gastrointestinal issues. The postoperative knee surgery client is the most stable and likely able to safely take fluids orally. The other clients present with contraindications such as severe nausea/vomiting or impaired swallowing and aspiration risk.

Question 15

A nurse is helping a patient order lunch. Which of the following options would a patient following a kosher diet not eat?

Accepted Answer

Answer reason: This item contains beef (meat) and cheese (dairy), which directly violates that rule. The other options could be kosher depending on preparation and ingredients (e.g., a plain hamburger made from kosher beef and cooked on kosher equipment), so they are not inherently disallowed. In patient care, confirming religious dietary restrictions helps prevent distress and supports culturally competent nutrition planning.

Question 16

When caring for a patient who is status-post tonsillectomy, which of the following drinks would be most appropriate for the nurse to provide?

Accepted Answer

Answer reason: Clear, cool liquids promote hydration without heat-related vasodilation that can increase the risk of hemorrhage. Avoiding acidic beverages is important because acid can sting the throat and may worsen discomfort and reduce intake. Compared with fruit juices that are typically more acidic, a non-citrus flavored drink is the safest choice among the options; hot beverages are specifically contraindicated early post-op.

Question 17

A client receiving hydrochlorothiazide is instructed to increase her dietary intake of potassium. The best snack for the client requiring increased potassium is?

Accepted Answer

Answer reason: Among the listed snacks, avocado provides substantially more potassium per serving than common fruits like apples or pears. Choosing the highest-potassium option best supports maintaining normal neuromuscular and cardiac function. Oranges contain potassium but are typically lower than avocado, making them a less optimal choice here.

Question 18

The nurse is reviewing the plan of care for a client admitted to the behavioral health unit with anorexia nervosa. The nurse understands that the priority goal for this client is?

Accepted Answer

Answer reason: The priority in anorexia nervosa is restoring nutritional status and preventing life-threatening complications such as electrolyte imbalance and organ failure. Gradual weight gain is the primary treatment goal. Psychosocial improvements such as self-esteem and therapy participation are important but are addressed after physiological stability is achieved.

Question 19

A nurse is caring for a pregnant patient who has phenylketonuria (PKU). Which of the following foods should this patient choose to eat?

Accepted Answer

Answer reason: High-protein foods are the main sources of phenylalanine because phenylalanine is an amino acid found in protein. A non-starchy vegetable is very low in protein compared with meats and dairy, making it the safest choice among the options. The other options are protein-rich and would substantially increase phenylalanine intake. Therefore the best selection is the vegetable option.

Question 20

When teaching a patient about foods high in magnesium, the nurse would include?

Accepted Answer

Answer reason: Teaching to include leafy green vegetables aligns with common dietary guidance for increasing magnesium intake. Butter is primarily fat with minimal minerals, making it a poor magnesium source. Cheese and tomatoes contain some magnesium but are not as consistently high-yield as green vegetables compared with typical nursing nutrition teaching.

Question 21

The nurse is caring for a patient with chemotherapy-associated stomatitis. Which of the following is the most appropriate food choice for this patient?

Accepted Answer

Answer reason: This option is smooth and easy to swallow, helping maintain calorie/protein intake without mechanically abrading ulcerated mucosa. By contrast, orange juice is acidic and commonly worsens oral burning, and crusty bread can scrape and increase pain/bleeding. While soup can be soft, it is often served hot and may contain salt/seasoning that irritates inflamed mucosa, making it less consistently appropriate than a bland soft food.

Question 22

How should the nurse record a patient’s intake if they had 240 mL of ice chips?

Accepted Answer

Answer reason: Therefore, a measured 240 mL of ice chips is recorded as 120 mL of fluid intake. This convention prevents overestimating hydration status in patients on strict I&O or fluid restrictions. Recording the full 240 mL would inaccurately inflate oral intake and could misguide clinical decisions about fluid balance.

Question 23

How should the nurse educate a patient with dysphagia to swallow their food?

Accepted Answer

Answer reason: The chin-tuck (chin-to-chest) maneuver narrows the airway entrance and helps position the epiglottis to reduce risk of food or liquid entering the trachea. Neck extension tends to open the airway and can increase aspiration risk in patients with impaired swallow reflexes. Encouraging large bites with water increases bolus volume and can overwhelm a weakened swallow, further raising choking/aspiration risk.

Question 24

A nurse is preparing to administer an enteral feeding to a client via a nasogastric tube. Which action is the most important?

Accepted Answer

Answer reason: Verifying tube placement is the highest priority because incorrect placement can result in feeding entering the lungs, leading to aspiration and potentially life-threatening complications. All other actions are secondary to ensuring patient safety before initiating feeding.

Question 25

A nurse is caring for a patient with acute scleroderma. The patient is experiencing esophageal dysmotility as a manifestation of this condition. Which of the following safety measures are not indicated in the care of this patient?

Accepted Answer

Answer reason: A safer approach is typically texture modification toward thicker liquids/purees as indicated by an objective swallow evaluation, rather than starting with liquids and advancing. Keeping the head of bed elevated during and after meals is indicated to reduce reflux/aspiration risk in scleroderma-related esophageal dysfunction. Collaboration with speech-language pathology is appropriate to assess swallowing safety and guide diet consistency, and communicating dysphagia risk in hand-off supports ongoing aspiration precautions.

Question 26

A patient has been assessed and found to have severe dysphagia and will need long-term nutritional support, which one of the following types of feeding would MOST likely to be beneficial for this patient?

Accepted Answer

Answer reason: A gastrostomy tube is appropriate when swallowing is severely impaired but the gastrointestinal tract can still be used, allowing reliable delivery of nutrition, fluids, and medications. Nasogastric and nasoduodenal tubes are generally intended for short-term feeding and have higher risks of irritation, dislodgement, and patient intolerance over time. Parenteral nutrition is reserved for cases where the gut cannot be used and carries higher risks such as catheter-related infection and metabolic complications.

Question 27

Your patient with peritonitis is NPO and complaining of thirst. What is your priority?

Accepted Answer

Answer reason: When a patient is NPO, oral intake (including ice chips unless specifically ordered) must be avoided to reduce aspiration risk and prevent worsening of GI/peritoneal pathology or interference with potential procedures. Thirst in NPO patients is most safely managed by keeping the oral mucosa moist and clean, which reduces dryness and subjective thirst without violating NPO status. Increasing IV fluids may be necessary for hypovolemia but does not directly address the immediate comfort problem of dry mouth and should be guided by provider orders and assessment findings (vitals, I&O, labs). Diversion can help coping but does not treat the physiologic cause of thirst (xerostomia).

Question 28

A nurse is providing patient teaching to a ten year old patient with celiac disease and their parents. What food can this patient safely consume?

Accepted Answer

Answer reason: Rice is naturally gluten-free, so a rice-based food is generally safe when prepared without gluten-containing additives or cross-contamination. Rye bread is unsafe because rye contains gluten, and whole wheat pasta is unsafe because wheat contains gluten. Oats are often avoided unless specifically labeled gluten-free due to frequent processing cross-contamination, making it a less reliable choice on exams.

Question 29

A client with Cushing’s syndrome should be educated on which type of diet?

Accepted Answer

Answer reason: A sodium-restricted diet helps reduce fluid retention and supports blood pressure control, making it the most appropriate education point among the choices. In contrast, calcium should generally be increased (not restricted) because hypercortisolism accelerates bone loss and fracture risk. Potassium is often depleted (so restriction is inappropriate), and protein is usually increased to help counter cortisol-driven protein catabolism and poor wound healing.

Question 30

A patient, who has recovered from cholecystitis, is being discharged home. What meal options below are best for this patient?

Accepted Answer

Answer reason: This meal uses a lean cooking method (baked) and includes low-fat sides, making it easier to digest and less likely to provoke symptoms. The other options include fried foods and/or high-fat dairy (cheese, gravy) that increase fat load and can worsen post-cholecystitis discomfort. Choosing lower-fat, non-fried foods supports recovery and minimizes recurrence of pain and GI upset.

Question 31

SITUATION: The nurse is doing health teaching for a client with microcytic leukemia who is having trouble choosing food from the hospital menu. Which food should the nurse recommend for the client to have a nutritional need?

Accepted Answer

Answer reason: Microcytosis most commonly reflects impaired hemoglobin synthesis, often related to iron deficiency, so teaching should emphasize iron-rich food choices. Among the options, this choice provides a more meaningful amount of dietary iron and protein to support erythropoiesis compared with the others listed. Tea is a poor recommendation because tannins can reduce non-heme iron absorption, which can worsen microcytic anemia patterns. Squash and brown rice are nutritious but are not as iron-dense for correcting a microcytic picture as the best option provided.

Question 32

Nurse Pippy is reviewing a client’s fluid intake and output record. Fluid intake and urine output should relate in which way?

Accepted Answer

Answer reason: Fluid balance assessment is based on the principle that, in a stable adult, total intake and total output should be roughly balanced over 24 hours. Although urine is the largest measurable output, additional ongoing losses (insensible water loss through skin and lungs, stool, drains) mean intake will not consistently be a fixed multiple or fraction of urine output. A large mismatch between intake and urine output suggests either fluid retention (e.g., renal impairment, heart failure) or excessive losses/dehydration and warrants further assessment of vitals, weight trends, and other outputs. Options implying “double,” “half,” or “inversely proportional” are not physiologic rules used for routine I&O interpretation.

Question 33

To encourage adequate nutritional intake for a female client with Alzheimer’s disease, the nurse should?

Accepted Answer

Answer reason: Clients with Alzheimer’s disease often have impaired attention, initiation, and sequencing, which can reduce oral intake even when food is available. Calm supervision and cueing during meals supports task completion, reduces distraction, and allows the nurse to promptly assist with opening containers, utensil use, and safe swallowing as needed. This approach directly targets the functional barrier to eating and can improve total intake. Privacy during meals more commonly worsens intake in cognitive impairment due to decreased prompting, and focusing only on menu selection does not ensure the client will actually eat.

Question 34

Which of the following interventions will help lessen the effect of GERD (acid reflux)?

Accepted Answer

Answer reason: GERD symptoms worsen when gastric contents reflux into the esophagus, especially in the supine position where gravity no longer helps keep acid in the stomach. Raising the head of the bed decreases nighttime reflux by using gravity to reduce backflow and esophageal acid exposure. Lying down after eating and increasing fluids just before bedtime both increase the likelihood of reflux by increasing gastric volume and promoting supine regurgitation. Wearing a girdle can increase intra-abdominal pressure and can worsen reflux rather than relieve it.

Question 35

Which of the following foods should be avoided by clients who are prone to develop heartburn as a result of gastroesophageal reflux disease (GERD)?

Accepted Answer

Answer reason: This choice is a classic trigger because it can relax the LES (methylxanthines) and may increase reflux episodes, leading to heartburn. In contrast, simple low-acid foods like lettuce are typically not reflux triggers unless they cause problematic gastric distention for a particular patient. Teaching focuses on identifying and avoiding common trigger foods to reduce symptom frequency and mucosal irritation.

Question 36

A client has a percutaneous endoscopic gastrostomy tube inserted for tube feedings. Before starting a continuous feeding, the nurse should place the client in which position?

Accepted Answer

Answer reason: Semi-Fowler’s (about 30–45°) is the standard minimum elevation recommended for continuous PEG feedings and is generally better tolerated for prolonged periods than higher angles. Supine positioning increases risk of regurgitation and aspiration, especially with continuous infusion. Reverse Trendelenburg can help with reflux but is not the routine first-line nursing position for tube feeding compared with head-of-bed elevation in Semi-Fowler’s.

Question 37

Rob is a 46 y.o. admitted to the hospital with a suspected diagnosis of Hepatitis B. He’s jaundiced and reports weakness. Which intervention will you include in his care?

Accepted Answer

Answer reason: Hepatitis causes hepatic inflammation with marked fatigue and decreased tolerance for activity, so conserving energy is a key nursing priority. Small, frequent meals improve caloric intake and reduce nausea/anorexia commonly seen with acute hepatitis, while resting after meals further decreases metabolic demand and supports recovery. A low-protein diet is not routine for uncomplicated hepatitis and is generally reserved for severe hepatic failure with encephalopathy risk. Regular exercise can worsen fatigue and is inappropriate during acute symptomatic illness.

Question 38

The client being seen in the out-patient clinic has been taking olanzapine (Zyprexa) for one month and has experienced a 12-pound weight gain during that time. When the client expresses an interest in preventing further weight gain the first action of the nurse should make which recommendation to the client?

Accepted Answer

Answer reason: A short-term, detailed food log identifies caloric sources, snacking patterns, sugary beverages, portion sizes, and timing that can be targeted with specific, realistic changes. Olanzapine is strongly associated with increased appetite and metabolic risk, so early self-monitoring is a practical first step that also improves adherence to later nutrition counseling. Options like daily clinic weights are impractical and do not address intake drivers, while enrolling in a program or seeing a nutritionist is more appropriate after initial data are gathered to individualize the plan.

Question 39

The patient has just been diagnosed with hyperlipidemia. Aside from the prescribed Atorvastatin, she is advised to lose weight and implement some dietary changes. The nurse talks to her about possible nutritional modifications. All of the following are accurate except?

Accepted Answer

Answer reason: Dietary management of hyperlipidemia emphasizes reducing saturated fat and dietary cholesterol while increasing unsaturated fats and fiber to lower LDL and overall cardiovascular risk. Increasing red meat intake typically raises saturated fat intake and can worsen lipid profiles, making it the incorrect recommendation. Choosing fatty fish more often supports intake of omega-3 fatty acids, which can help lower triglycerides and improve cardiometabolic risk. Increasing fruits and vegetables increases soluble fiber and displaces energy-dense, high–saturated fat foods, supporting both lipid control and weight loss.

Question 40

SITUATION: A client is pregnant and asks the nurse what she could do about her hemorrhoids and its pain. Which of the following is the first intervention that the nurse should recommend to a pregnant woman complaining of hemorrhoid pain?

Accepted Answer

Answer reason: Increasing fiber intake, fluids, and using stool-softening strategies decreases hard stools and minimizes Valsalva during defecation, improving symptoms with minimal fetal risk. Topical steroid preparations and oral medications are not typically the initial step because medication exposure should be minimized in pregnancy and many agents are used only if conservative measures fail. Surgery is reserved for severe, refractory cases or complications (e.g., thrombosed hemorrhoid) and is not an initial recommendation.

Question 41

A client has a total gastrectomy. The nurse explains to the client the need for long-term injections of which vitamin?

Accepted Answer

Answer reason: This leads to progressive depletion of body B12 stores and risk of megaloblastic anemia and neurologic deficits if not replaced. Because oral absorption is impaired without intrinsic factor, long-term parenteral replacement is the reliable approach. Folate deficiency can also cause macrocytosis, but folate absorption does not depend on intrinsic factor and typically does not require lifelong injections.

Question 42

The oncology nurse is providing care for a client receiving chemotherapy. What should be the highest-priority nursing intervention to decrease nausea in this client?

Accepted Answer

Answer reason: Dietary modification is a first-line nursing intervention for chemotherapy-associated nausea because high-fat and highly seasoned foods delay gastric emptying and intensify gastric irritation, worsening nausea. Choosing bland, low-fat foods and avoiding strong odors/irritants helps reduce stimulation of the vomiting center and improves tolerance of oral intake. Withholding all oral nutrition for 24 hours risks dehydration and malnutrition and is not a standard recommendation. Antiemetics are most effective when given prophylactically/scheduled around chemotherapy rather than only after vomiting has already occurred.

Question 43

What should the nurse do as a priority when caring for the client with myasthenia gravis to minimize the risk for complications of the disease?

Accepted Answer

Answer reason: Myasthenia gravis causes fluctuating skeletal muscle weakness that commonly involves bulbar muscles, increasing fatigue with chewing and swallowing and raising aspiration risk during meals. Prioritizing safe nutrition support reduces exertion, promotes adequate intake, and helps prevent choking/aspiration-related respiratory complications. Offering to cut food into small pieces is an immediate, practical intervention that supports safer, less fatiguing eating. By contrast, assessing for viral pneumonia is not a primary MG-specific complication-prevention priority compared with proactive aspiration precautions during feeding.

Question 44

A client with renal calculi is advised to restrict calcium in the diet. The nurse determines that the client understands the restriction when the client states to avoid which types of foods?

Accepted Answer

Answer reason: Milk and other dairy products are major dietary sources of calcium, so choosing an option that includes milk best demonstrates understanding of calcium restriction. The other options list mainly meats/eggs (protein/purines) or broad plant groups, which are not the core targets of a calcium-restricted diet. Although chocolate may relate more to oxalate content, the inclusion of milk makes this the most directly aligned choice with the stated calcium restriction.

Question 45

The nurse is reinforcing teaching to a client recently diagnosed with a hiatal hernia. Which of the following instructions should the nurse include to promote comfort and reduce symptoms?

Accepted Answer

Answer reason: Smaller, more frequent meals reduce gastric distention and lower the likelihood of reflux, improving post-meal comfort. Lying flat after eating and drinking large volumes with meals both increase reflux risk by promoting gastric fullness and reducing the effect of gravity. Tight abdominal garments further increase intra-abdominal pressure and can exacerbate symptoms rather than relieve them.

Question 46

A client with diabetes mellitus states, “I cannot eat big meals; I prefer to snack throughout the day.” The nurse should carefully explain that?

Accepted Answer

Answer reason: Emphasizing regulated intake helps prevent large postprandial glucose excursions and reduces risk of hypoglycemia when medications are taken without adequate food. “Salt and sugar restriction” oversimplifies diabetes nutrition; the priority is balanced carbohydrate distribution and overall dietary pattern rather than avoiding sugar alone. Statements about digestion or weight may be partially true but do not address the primary diabetes-care principle of coordinating food intake with glucose control.

Question 47

Which of the following should be included in a plan of care for a client who is lactose intolerant?

Accepted Answer

Answer reason: Lactose intolerance is due to reduced lactase, so symptoms correlate with the lactose dose delivered to the gut at one time. Smaller, divided amounts are often better tolerated and can allow the client to still obtain nutrients from dairy while minimizing bloating, cramps, and diarrhea. Advising milk on an empty stomach increases symptom risk because gastric emptying is faster and there is no mixing with other foods to slow lactose delivery. Eliminating all dairy is unnecessary for many clients and can contribute to inadequate calcium/vitamin D intake unless carefully substituted.

Question 48

The nurse is providing dietary teaching for a client with Meniere’s disease. Which statement indicates that the client understands the role of diet in triggering her symptoms?

Accepted Answer

Answer reason: " Meniere’s disease symptoms are worsened by fluctuations in inner-ear (endolymph) fluid volume and pressure. Dietary sodium promotes fluid retention, which can increase endolymphatic pressure and trigger or worsen vertigo, tinnitus, and aural fullness. Therefore, recognizing the need for a low-sodium diet reflects correct understanding of a key nonpharmacologic trigger control strategy. Avoiding breads/cereals, restricting potassium, or blaming dairy are not standard, evidence-based dietary triggers emphasized in Meniere’s management.

Question 49

The nurse is teaching a female client with a leg ulcer about tissue repair and wound healing. Which of the following statements by the client indicates effective teaching?

Accepted Answer

Answer reason: Wound healing depends on adequate nutrition to support collagen synthesis, immune function, and tissue regeneration. Fruits and vegetables supply key micronutrients (especially vitamin C and vitamin A) and antioxidants that support epithelialization and collagen formation. Tightly wrapping a bandage and expecting a cold foot suggest impaired perfusion or excessive compression, which can worsen ischemia and delay healing. Restricting protein is counterproductive because protein is needed for fibroblast activity, angiogenesis, and overall tissue repair.

Question 50

A nurse is assigned to care for a client with anorexia nervosa. Which intervention should the nurse apply following the patient's meals?

Accepted Answer

Answer reason: Limiting bathroom access immediately after meals reduces the opportunity for self-induced vomiting or misuse of laxatives/diuretics, which are common purging behaviors associated with anorexia nervosa (binge-purge type) and can rapidly negate caloric intake. Exercise-focused options increase energy expenditure and can reinforce compulsive activity, undermining weight gain goals and safety. Prolonged forced bed rest is not a standard post-meal intervention and does not directly address the high-risk behavior the nurse can most effectively prevent.

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