Chapter 25 Nutrition and Diet Therapy

Chapter 25 Nutrition and Diet Therapy

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

MULTIPLE CHOICE. Choose the one alternative that best completes the statement or answers the question.1)A client had a cholecystectomy yesterday and will be discharged in 3 days if there are nocomplications. As part of the nursing care plan for discharge teaching, the client’s assigned nurse isreviewing the dietary recommendations following this kind of surgery. What are appropriatesuggestions for the nurse to plan to include in the client teaching? (Select all that apply.)1)A)Select foods that provide satiety without being high in saturated fat content.B)Resume the dietary habits that were practiced before the surgery.C)Avoid eating foods that contain fat.D)Purchase an herbal digestive product at the local pharmacy.E)Gradually introduce small amounts of foods that previously caused discomfort and eliminatethose that continue to cause undesirable effects.F)Follow a low-fat diet for several weeks after surgery.Answer:A, E, FExplanation:A)The liver continues to produce bile after removal of the gallbladder, and the bile isstill available in the duodenum for emulsification of fat. The bile is just notconcentrated and stored. When a client resumes a regular diet after surgery,continuing on a low-fat diet for several weeks is recommended as the surgicalarea continues to heal. The client will continue to need the recommended dailyamount of dietary fat and is encouraged to follow national guidelines for reducingrisk for cardiac and other diseases. The client should be encouraged to try foodsthat are liked and previously caused discomfort. The client is the best determinantfor what can be tolerated. Some clients take an herbal digestive aid. The nurseshould not recommend this at this time.PlanningHealth Promotion and MaintenanceAnalysisB)The liver continues to produce bile after removal of the gallbladder, and the bile isstill available in the duodenum for emulsification of fat. The bile is just notconcentrated and stored. When a client resumes a regular diet after surgery,continuing on a low-fat diet for several weeks is recommended as the surgicalarea continues to heal. The client will continue to need the recommended dailyamount of dietary fat and is encouraged to follow national guidelines for reducingrisk for cardiac and other diseases. The client should be encouraged to try foodsthat are liked and previously caused discomfort. The client is the best determinantfor what can be tolerated. Some clients take an herbal digestive aid. The nurseshould not recommend this at this time.PlanningHealth Promotion and MaintenanceAnalysis1
C)The liver continues to produce bile after removal of the gallbladder, and the bile isstill available in the duodenum for emulsification of fat. The bile is just notconcentrated and stored. When a client resumes a regular diet after surgery,continuing on a low-fat diet for several weeks is recommended as the surgicalarea continues to heal. The client will continue to need the recommended dailyamount of dietary fat and is encouraged to follow national guidelines for reducingrisk for cardiac and other diseases. The client should be encouraged to try foodsthat are liked and previously caused discomfort. The client is the best determinantfor what can be tolerated. Some clients take an herbal digestive aid. The nurseshould not recommend this at this time.PlanningHealth Promotion and MaintenanceAnalysisD)The liver continues to produce bile after removal of the gallbladder, and the bile isstill available in the duodenum for emulsification of fat. The bile is just notconcentrated and stored. When a client resumes a regular diet after surgery,continuing on a low-fat diet for several weeks is recommended as the surgicalarea continues to heal. The client will continue to need the recommended dailyamount of dietary fat and is encouraged to follow national guidelines for reducingrisk for cardiac and other diseases. The client should be encouraged to try foodsthat are liked and previously caused discomfort. The client is the best determinantfor what can be tolerated. Some clients take an herbal digestive aid. The nurseshould not recommend this at this time.PlanningHealth Promotion and MaintenanceAnalysisE)The liver continues to produce bile after removal of the gallbladder, and the bile isstill available in the duodenum for emulsification of fat. The bile is just notconcentrated and stored. When a client resumes a regular diet after surgery,continuing on a low-fat diet for several weeks is recommended as the surgicalarea continues to heal. The client will continue to need the recommended dailyamount of dietary fat and is encouraged to follow national guidelines for reducingrisk for cardiac and other diseases. The client should be encouraged to try foodsthat are liked and previously caused discomfort. The client is the best determinantfor what can be tolerated. Some clients take an herbal digestive aid. The nurseshould not recommend this at this time.PlanningHealth Promotion and MaintenanceAnalysisF)The liver continues to produce bile after removal of the gallbladder, and the bile isstill available in the duodenum for emulsification of fat. The bile is just notconcentrated and stored. When a client resumes a regular diet after surgery,continuing on a low-fat diet for several weeks is recommended as the surgicalarea continues to heal. The client will continue to need the recommended dailyamount of dietary fat and is encouraged to follow national guidelines for reducingrisk for cardiac and other diseases. The client should be encouraged to try foodsthat are liked and previously caused discomfort. The client is the best determinantfor what can be tolerated. Some clients take an herbal digestive aid. The nurseshould not recommend this at this time.PlanningHealth Promotion and MaintenanceAnalysis2
2)A resident is newly admitted to a long-term care facility. The resident is able to take soft foods andliquids orally and can feed herself. The resident has a nasogastric tube in place for supplementalfeedings because she has recently become anorexic and has been losing weight. The resident will begoing to the facility dining room for meals and the staff nurses are deciding where and with whomshe should sit. If all of the following suggestions are made, which suggestion is most likely toprovide the desired nutritional outcomes for this resident?2)A)Seat the new resident at a table with other residents who talk with each other during the meal.B)Arrange to have the new resident seated at a table with other residents who need assistancewith feeding.C)Introduce the new resident to the others at the beginning of the meal and ask who would liketo have the new resident at their table.D)Encourage the new resident to not be self-conscious about the nasogastric tube.Answer:AExplanation:A)There are several things for the nurses to consider in making the decision,including the need for improved intake because of loss of appetite, the nasogastrictube, and the new environment for the client. Start with placing the client in anenvironment conducive to enjoying a meal and with residents who can feedthemselves and are able to eat soft solid foods. The assistance that the newlyadmitted resident will need is with supplemental tube feedings, not with eating.Introducing the new resident to others is likely to increase the client’s discomfort inthe new environment and is unlikely to be successful for many reasons. Althoughit will be important for the nurses to assess the client’s level of self-consciousnessabout the nasogastric tube and its effect on others at the table where the resident isseated, encouraging the resident to not be self-conscious does not present the bestsuggestion.AssessmentPsychosocial IntegrityAnalysisB)There are several things for the nurses to consider in making the decision,including the need for improved intake because of loss of appetite, the nasogastrictube, and the new environment for the client. Start with placing the client in anenvironment conducive to enjoying a meal and with residents who can feedthemselves and are able to eat soft solid foods. The assistance that the newlyadmitted resident will need is with supplemental tube feedings, not with eating.Introducing the new resident to others is likely to increase the client’s discomfort inthe new environment and is unlikely to be successful for many reasons. Althoughit will be important for the nurses to assess the client’s level of self-consciousnessabout the nasogastric tube and its effect on others at the table where the resident isseated, encouraging the resident to not be self-conscious does not present the bestsuggestion.AssessmentPsychosocial IntegrityAnalysis3
C)There are several things for the nurses to consider in making the decision,including the need for improved intake because of loss of appetite, the nasogastrictube, and the new environment for the client. Start with placing the client in anenvironment conducive to enjoying a meal and with residents who can feedthemselves and are able to eat soft solid foods. The assistance that the newlyadmitted resident will need is with supplemental tube feedings, not with eating.Introducing the new resident to others is likely to increase the client’s discomfort inthe new environment and is unlikely to be successful for many reasons. Althoughit will be important for the nurses to assess the client’s level of self-consciousnessabout the nasogastric tube and its effect on others at the table where the resident isseated, encouraging the resident to not be self-conscious does not present the bestsuggestion.AssessmentPsychosocial IntegrityAnalysisD)There are several things for the nurses to consider in making the decision,including the need for improved intake because of loss of appetite, the nasogastrictube, and the new environment for the client. Start with placing the client in anenvironment conducive to enjoying a meal and with residents who can feedthemselves and are able to eat soft solid foods. The assistance that the newlyadmitted resident will need is with supplemental tube feedings, not with eating.Introducing the new resident to others is likely to increase the client’s discomfort inthe new environment and is unlikely to be successful for many reasons. Althoughit will be important for the nurses to assess the client’s level of self-consciousnessabout the nasogastric tube and its effect on others at the table where the resident isseated, encouraging the resident to not be self-conscious does not present the bestsuggestion.AssessmentPsychosocial IntegrityAnalysis3)A client in a skilled-nursing facility has a percutaneous endoscopic gastrostomy (PEG) tube. Theclient receives intermittent feedings throughout the day. About 5:00 a.m. the night nurse discoversthe PEG tube lying on the floor near the client’s bed. What should be the nurse’s priority inplanning and implementing appropriate actions for the client?3)A)Call the physician for an order for soft wrist restraints for the client.B)Insert a clean or sterile indwelling catheter into the gastrostomy opening, inflate the balloon,and clamp the catheter.C)Reinsert the PEG tube.D)Notify the physician that the PEG tube has been dislodged and needs reinserting.Answer:BExplanation:A)Inserting a catheter into the gastrostomy opening will maintain the patency of theopening. The gastrointestinal tract is not sterile, so the catheter does not have to besterile. Inflating the balloon will help secure the placement. Clamping the catheterwill prevent drainage of gastric contents. Percutaneous endoscopic gastrostomytubes should be reinserted by someone who is knowledgeable about the procedure,which is either a physician or a specially trained nurse. Soft wrist restraints may bedesirable to keep the client from pulling out the “stop-gap” catheter. It should notbe the nurse’s first concern or action.PlanningSafe, Effective Care Environment-Safety and Infection ControlAnalysis4
B)Inserting a catheter into the gastrostomy opening will maintain the patency of theopening. The gastrointestinal tract is not sterile, so the catheter does not have to besterile. Inflating the balloon will help secure the placement. Clamping the catheterwill prevent drainage of gastric contents. Percutaneous endoscopic gastrostomytubes should be reinserted by someone who is knowledgeable about the procedure,which is either a physician or a specially trained nurse. Soft wrist restraints may bedesirable to keep the client from pulling out the “stop-gap” catheter. It should notbe the nurse’s first concern or action.PlanningSafe, Effective Care Environment-Safety and Infection ControlAnalysisC)Inserting a catheter into the gastrostomy opening will maintain the patency of theopening. The gastrointestinal tract is not sterile, so the catheter does not have to besterile. Inflating the balloon will help secure the placement. Clamping the catheterwill prevent drainage of gastric contents. Percutaneous endoscopic gastrostomytubes should be reinserted by someone who is knowledgeable about the procedure,which is either a physician or a specially trained nurse. Soft wrist restraints may bedesirable to keep the client from pulling out the “stop-gap” catheter. It should notbe the nurse’s first concern or action.PlanningSafe, Effective Care Environment-Safety and Infection ControlAnalysisD)Inserting a catheter into the gastrostomy opening will maintain the patency of theopening. The gastrointestinal tract is not sterile, so the catheter does not have to besterile. Inflating the balloon will help secure the placement. Clamping the catheterwill prevent drainage of gastric contents. Percutaneous endoscopic gastrostomytubes should be reinserted by someone who is knowledgeable about the procedure,which is either a physician or a specially trained nurse. Soft wrist restraints may bedesirable to keep the client from pulling out the “stop-gap” catheter. It should notbe the nurse’s first concern or action.PlanningSafe, Effective Care Environment-Safety and Infection ControlAnalysis