front 1 Compared with renal failure clients who are not on dialysis, clients on continuous ambulatory peritoneal dialysis require: the same amount of dietary protein less dietary protein more dietary protein a different kind of protein | back 1 c |
front 2 Which of the following is a good snack for a client with acute renal failure who is not on dialysis and does not have diabetes? hard candy cheese milk oranges | back 2 a |
front 3 Most renal clients need to avoid salt substitutes because they often contain: phosphorus potassium protein calcium | back 3 b |
front 4 Which of the following are high in potassium? grapes apple and cranberry juices baked potatoes canned pears | back 4 c |
front 5 Mr. S is being treated for renal calculi. The first priority for teaching self-care to this client is to: increase fluid intake limit calcium and phosphorus intake restrict all protein from meat, fish, and poultry sources restrict high-purine foods, such as anchovies and liver | back 5 a |
front 6 When caring for a client with acute glomerulonephritis, the nurse should expect to: increase his or her calcium and phosphorus intake restrain his or her energy intake to avoid weight gain restrict his protein to 20 g/day meticulously monitor his or her intake and output | back 6 d |
front 7 A 56-year-old woman is being treated for acute renal failure. The physician has ordered a 60-g protein diet. When the client's family inquires about the purpose of the diet, the appropriate response is that it is intended to help control the level of ______ in the client's blood. potassium sodium blood urea nitrogen (BUN) water | back 7 c |
front 8 A potassium intake usually is necessary in clients displaying: periorbital edema peripheral edema oliguria polyuria | back 8 c |
front 9 Clients with diabetes and end-stage renal disease must recognize that the need to adjust protein and electrolytes outweighs the need to restrict ______. complex carbohydrates simple carbohydrates saturated fats vegetable proteins | back 9 b |
front 10 Dialysis clients may receive supplemental ______ because of the inability of the diseased kidney to activate this vitamin. vitamin B12 folic acid vitamin D vitamin K | back 10 c |
front 11 Clients with kidney stones are usually advised to: avoid organ meats drink 3 L of fluid per day take 8 oz of cranberry juice daily eliminate calcium-containing foods from their diet | back 11 b |
front 12 Ms. M has had four urinary tract infections during the past year. Common appropriate advice is to have her ______. abstain from sexual intercourse drink at least 8 cups of fluid daily avoid milk and meat in excess of the Food Pyramid parameters drink cranberry juice daily | back 12 d |
front 13 Ms. M has had four urinary tract infections during the past year that were treated in a health clinic. Despite compliance with the medication and nutritional program, she has taken longer than average to recover each time and now has a recurrence. Which of the following interventions would help determine the underlying problem? Test the client's urine for glucose and acetone. Refer the client to a dietitian for a thorough nutritional assessment. Recommend that the physician order a white blood cell count and a serum albumin analysis. Suggest that the client be seen in the sexually transmitted diseases clinic as soon as possible. | back 13 a |
front 14 Mr. J is found to have an elevated serum phosphorus level after 6 months on hemodialysis. Mr. J needs help filling out his menu. Which lunch would best meet his needs? roast beef, noodles, a sliced fresh orange, and milk baked chicken, rice, fresh grapes, and cranberry juice macaroni and cheese, a bran muffin, cooked spinach, apricot halves, and lemonade hamburger on a whole-grain bun, potato chips, a dill pickle, and a cola | back 14 b |
front 15 Which of the following interventions is not appropriate for a client with renal disease and anemia? an iron-rich diet liberal amounts of foods high in vitamin C diagnostic studies to identify hidden bleeding supplementation with water-soluble vitamin K | back 15 d |
front 16 Epoetin alfa, a pharmaceutical form of erythropoietin, may be prescribed for clients with renal disease. This drug: stimulates the liver to liberate stored iron for hemoglobin binds with ferritin to make it more usable by the bone marrow replaces a hormone released by the kidney that stimulates red blood cell production is a special preparation of bioavailable iron | back 16 c |
front 17 Dialysis dementia is sometimes seen in clients who have been dialyzed for a number of years. Which of the following interventions is designed to minimize this complication? control of dietary protein daily doses of cod liver oil oral fluid restriction restriction of dietary phosphate | back 17 d |
front 18 Gout is: a hereditary metabolic disease caused by an error in fat metabolism a form of osteodystrophy caused by kidney failure untreatable except by diet | back 18 a |
front 19 Which of the following foods may have precipitated an attack of gout and consequently may need to be avoided by the client? A) gravy, liver, and oil-packed sardines B) Roquefort cheese, buttermilk, and vegetable soup C) chocolate ice cream, chicken-fried steak, and Caesar salad D) eggs, pecan rolls, and coffee | back 19 a |
front 20 The substances restricted in dietary treatment of gout are: fatty acids purines calcium-rich foods oxalates | back 20 b |
front 21 The toxic condition characterized by retention of nitrogenous substances in the blood is called: dialysis dementia oliguria renal insufficiency uremia | back 21 d |
front 22 When blood is removed from the body and forced over a semipermeable to clean wastes and then replaced back into the body over a 3- to 5-hour period three or more times a week, this is called: continuous ambulatory peritoneal dialysis glomerular dialysis hemodialysis intermittent peritoneal dialysis | back 22 c |
front 23 Ms. T has chronic renal failure. Client teaching should be based on which of the following rationales? Perhaps the dietary instructions were not well presented or Ms. T was not ready to accept the diet prescription in the past. Protein should always be restricted in clients with chronic renal failure. Different nutritional interventions are appropriate at different stages of the disease. If Ms. T is not more compliant, she will have to undergo dialysis or kidney transplant. | back 23 c |
front 24 Mr. F has a chronic kidney disease and has been losing weight. All the following groups of foods except one will probably be given in large amounts to increase his energy intake. Identify the inappropriate foods. margarine, table sugar, and oil milk, any kind of nuts, and orange juice olives, jelly beans, and Popsicles eggs, suckers, and nondairy creamers | back 24 b |
front 25 Mr. F has a chronic kidney disease and has been losing weight. Sufficient energy intake is necessary to: prevent catabolizing his tissues for fuel maintain his activities of daily living provide at least 80% of his resting energy expenditure utilize all the vitamins he is receiving | back 25 a |
front 26 Renal clients may have to control dietary intake of total kilocalories, protein, potassium, sodium, and fluid. The exact diet prescription may change over time because: of decreased intake as the disease progresses of increased intake early in the disease of the client's clinical condition and the treatment approach types of intake hinge on the client's tolerance and appetite | back 26 c |
front 27 Clients with potassium restrictions may be instructed to do all the following procedures except one. Identify the exception. Cook vegetables in large amounts of water, which is afterward discarded. Use salt substitutes only after cooking. Drink carbonated beverages, cranberry juice, or lemonade. Use any of the permitted foods only in the form specified. | back 27 b |
front 28 Clients with potassium restrictions may be instructed to do all the following procedures except one. Identify the exception. Cook vegetables in large amounts of water, which is afterward discarded. Use salt substitutes only after cooking. Drink carbonated beverages, cranberry juice, or lemonade. Use any of the permitted foods only in the form specified. | back 28 a |
front 29 A measurable goal for a client with renal calculi is to drink sufficient water to produce a urinary output of ______ mL/day. 500 1,000 2,000 3,000 | back 29 c |
front 30 Which of the following interventions for kidney stones has been shown to be ineffective? a low-oxalate diet forcing fluids a low-purine diet a low-calcium diet | back 30 d |
front 31 Sodium is lowest in the following foods: milk and meat fat and fruit starch and milk fresh fruits and vegetables | back 31 d |
front 32 A low-potassium, low-phosphorus alternative to milk is: monounsaturated liquid nondairy creamer milk treated with Lact-aid soy milk Alterna | back 32 a |
front 33 The general dietary protein recommendation for clients with renal insufficiency is: 1 g/kg of actual body weight 0.6 g/kg of actual body weight 1.2 to 1.5 g/kg of healthy body weight 1.2 to 1.5 g/kg of actual body weight | back 33 a |
front 34 One-half cup of the following is usually considered 60 cc of fluid: A) watermelon B) coffee C) ice chips D) milk | back 34 c |
front 35 Which one of the following is low in potassium? baked beans chocolate spinach gumdrops | back 35 d |
front 36 Many clients with renal disease need to be intermittently concerned about the intake of the following: total kilocalories fluid protein sodium and potassium | back 36 all |
front 37 Causes for renal disease include the following: trauma excessive fluid intake infection medications | back 37 abcd |
front 38 Functions of the kidney include: secretion of ions to maintain acid-base balance production of erythropoietin synthesis of bile production of activated form of vitamin D | back 38 acd |
front 39 The following statement(s) is(are) true: Obesity increases the risk of renal disease. Normalization of blood pressure and blood glucose are goals for diabetes treatment. High lipid levels increase the risk of renal disease. A low-potassium diet minimizes the risk of kidney disease. | back 39 abc |
front 40 Significant hypertriglyceridemia is often present in clients with a history of renal disease. The nutritional care of clients with elevated triglycerides includes: a modified-fat diet modification of CHO intake a low-potassium diet increased intake of monounsaturated fats | back 40 abd |
front 41 Clients with ______ should have serum levels of fat-soluble vitamins and vitamin B12 monitored every 6 months. chronic pancreatitis gastroesophageal reflux disease (GERD) peptic ulcer disease cholelithiasis | back 41 a |
front 42 Surgical clients have an increased need for ______ because it helps build connective tissue. acetic acid acetylsalicylic acid ascorbic acid nicotinic acid | back 42 c |
front 43 The client with dumping syndrome should be taught to: drink plenty of fluids with meals lie down after meals limit protein to 30 g/day eat high-carbohydrate meals | back 43 b |
front 44 A client with acute colitis will probably be given a ______ diet. high-protein low-fat low-residue sodium-restricted | back 44 c |
front 45 aFoods thought to be deodorizing, which may help the ostomy client, include: buttermilk and yogurt celery and corn figs and prunes ham and eggs | back 45 a |
front 46 A client complains of constipation. Which of the following habits is likely to contribute the most to the client's constipation? being a vegetarian eating the largest meal at noon limiting fruits and vegetables to cooked ones using low-calorie foods and beverages for weight control | back 46 c |
front 47 Clients with hepatitis and cirrhosis of the liver are likely to consume their best intake at: breakfast lunch dinner bedtime | back 47 a |
front 48 Which of the following is allowed on a low-fat diet? French fries goose peanut butter sherbet | back 48 d |
front 49 A client with which of the following conditions is likely to be given pancreatic enzymes (pancrelipase) before meals? cholecystitis cystic fibrosis diabetes hiatal hernia | back 49 b |
front 50 An alcoholic client with cirrhosis of the liver is admitted following 2 days of vomiting and diarrhea. The physician orders a hydrating solution of 5% dextrose in water intravenously. If thiamin is not included in that order, the nurse should inquire about it because: thiamin is necessary to predigest the dextrose for immediate absorption intravenous glucose without thiamin in the cirrhosis client can precipitate the Wernicke-Korsakoff syndrome thiamin prevents folic acid stores from being diluted by the hydrating solution deficiency of thiamin causes delirium tremens | back 50 b |
front 51 Polymorphisms in the organism and the client are suspected of contributing to the different presentations of: diverticular disease gastroduodenal disease gastroesophageal reflux disease (GERD) celiac disease | back 51 b |
front 52 Which of the following diseases is suspected of having an autoimmune component? celiac disease Crohn's disease ulcerative colitis all of the above | back 52 d |
front 53 Clients who have had resection of the ______ are vulnerable to vitamin B12 deficiency. duodenum jejunum ileum liver | back 53 c |
front 54 The nurse has determined that a client with cirrhosis of the liver has vomited blood. Which of the following diet modifications should the nurse request? iron rich high fiber full liquid to soft low protein | back 54 c |
front 55 Which of the following are least likely to cause the ostomy client problems? eggs, green pepper, and corn applesauce, cheese, and tomato juice beans, fish, and diet soda broccoli, beer, and peanuts | back 55 b |
front 56 Which of the following foods can be valuable in treating constipation? cheese milk prunes strained orange juice | back 56 c |
front 57 In addition to avoiding barley, rye, and wheat, a person with celiac disease (gluten-sensitive enteropathy) has to be very careful about consuming ______ because of frequent contamination of the product with gluten during production. | back 57 oats |
front 58 When diet modification is advisable, the client with cholecystitis will probably be given a ______ diet. low-protein low-fat low-residue low-carbohydrate | back 58 b |
front 59 Nutrients especially needed by surgical clients include protein, vitamins C and K, and zinc. Protein is necessary to build scar tissue and to: control edema in the wound correct anemia make antibodies prevent ketosis | back 59 a |
front 60 Davey is a 5-year-old tonsillectomy client on a clear-liquid diet. Which of the following fluids is best to offer him? apple juice cranberry juice orange juice tea | back 60 a |
front 61 The often-prescribed 2 L/day of D5W (5% dextrose in water) for postoperative clients is used to: administer the Recommended Dietary Allowance for kilocalories challenge the client's renal system provide fluids and prevent ketosis alleviate nausea and prevent vomiting | back 61 c |
front 62 Ascites in the client with cirrhosis of the liver is worsened by sodium retention and: jaundice diuresis diaphoresis hypoalbuminemia | back 62 d |
front 63 The “E” in the CAGE questionnaire stands for: “Have you ever felt guilty about your drinking?” “Have you ever needed to start the day with a drink?” “Have you ever had a need to decrease your drinking?” “Have people irritated you with criticism about your drinking?” | back 63 b |
front 64 The systemic effects of the dumping syndrome are: bradycardia, dyspnea, and polyuria headache, blurred vision, and hypertension nausea, vomiting, and diarrhea weakness, sweating, and hypotension | back 64 d |
front 65 To reduce the risk of gallstones, clients could be advised to: eat breakfast limit fluid intake after supper eliminate fats from their diets add vinegar to cooked vegetables | back 65 a |
front 66 The single most important factor in nutrient deficiencies in the United States is: peptic ulcer disease celiac disease cholelithiasis alcoholism | back 66 d |
front 67 Ms. S has been scheduled for a colonoscopy. To facilitate the preparation of the bowel, she is instructed to consume a low-residue diet 2 days before and a clear-liquid diet the day before the procedure. Which of the following foods are appropriate on a low-residue diet? liquefied carrot juice, fried eggs, and raisin bread lettuce, boiled ham, and buttered noodles chili with beans, whole-wheat crackers, and aged cheddar cheese ripe peach, deep-fried chicken breast, and cornbread | back 67 b |
front 68 Ms. P is a 78-year-old resident of a home for the aged where independence is the norm. She is being taught a diet for hiatal hernia. Selection of which of the following foods indicates that she understands the instructions? chocolate milk, bean soup, and Boston brown bread decaffeinated coffee, tuna salad, and melon balls peppermint tea, coleslaw, and fried egg skim milk, canned carrots, and lean roast pork | back 68 d |
front 69 Which of the following foods is safest to include for breakfast for a client with a history of dumping syndrome and lactose intolerance? orange juice, pecan roll, and coffee grapefruit half, raisin toast, and cinnamon sugar plain doughnut, cranberry juice cocktail, and eggnog bagel, banana, and oatmeal with butter | back 69 d |
front 70 The self-treatment for diarrhea in healthy adults includes which of the following? nothing by mouth for 24 hours when beginning clear liquids, use milk cautiously when taking full-liquid diet, include banana for pectin content avoid very hot, very cold, and caffeine-containing beverages | back 70 d |
front 71 Which of the following dietary modifications is suggested for gastroesophageal reflux disease (GERD)? consuming a small glass of wine with meals taking mint lozenges after meals planning small, frequent meals that include protein substituting decaffeinated coffee for regular | back 71 c |
front 72 Which of the following items is associated with tightening the cardiac sphincter? alcohol peppermint chocolate protein | back 72 d |
front 73 Which of the following statements about peptic ulcer treatment is true? Modern medications are almost always effective without a drastic change in diet. Avoidance of alcohol and coffee is required to promote healing. Whole milk is advised to neutralize gastric acid. Surgery for peptic ulcer cures the disease with no long-term nutritional effects. | back 73 a |
front 74 The recommended fiber intake for clients with uncomplicated diverticulosis is ______ grams per day. | back 74 30 |
front 75 Clients with liver disease may be better able to digest fats in ______ than in other foods. liquid and soft margarines milk products and eggs fish and poultry quick breads and pastries | back 75 b |
front 76 To maintain homeostasis for a client who is NPO (nothing by mouth) with a gastric suctioning device in place, freezing ______ to provide ice chips can be helpful. sugar solutions salt solutions carbonated beverages electrolyte solutions | back 76 d |
front 77 Over the long term, clients with cystic fibrosis need to be monitored for: cardiovascular disease diabetes mellitus kidney disease osteoporosis | back 77 b |
front 78 Clients with cystic fibrosis are particularly susceptible to all but one of the following conditions. Identify the exception. growth failure obesity mineral deficiencies vitamin deficiencies | back 78 b |
front 79 The American Society of Anesthesiologists' guidelines suggest which of the following intakes is permissible for healthy individuals undergoing elective procedures? white grape juice until 2 hours before the procedure breast milk until 2 hours before scheduled surgery infant formula 4 hours before an elective procedure begins meal containing roast chicken 6 hours before scheduled surgery | back 79 a |
front 80 Alcohol education for teenagers should always include: information about acute poisoning suggestions to increase vitamin and mineral intake test data on the length of time it takes to metabolize alcohol demonstration of intoxicated behavior | back 80 a |
front 81 Which of the following factors has not been implicated in the etiology of inflammatory bowel disease? autoimmune reaction to bacterial flora in the bowel environmental factors genetic susceptibility reactivation of a viral infection | back 81 d |
front 82 Which of the following is commonly transmitted by the oral–fecal route? hepatitis A hepatitis B hepatitis C peritonitis | back 82 a |
front 83 Which of the following meals would be best for someone with delayed gastric emptying? whole-milk eggnog and vanilla wafers beef stew with dumplings chicken rice soup and skim milk split pea soup and wheat crackers | back 83 c |
front 84 Which of the following practices should be avoided to prevent traveler's diarrhea? drinking sealed carbonated beverages without ice buying foods from street vendors eating cooked foods piping hot selecting dry foods such as bread and cereal | back 84 b |
front 85 When clients experience a flare in Crohn's disease, which of the following foods may increase diarrhea and cramping? A) bananas B) carrots C) milk D) rice | back 85 c |
front 86 Which of the following items have not been associated with relapse from remission in clients with ulcerative colitis? alcohol potatoes red meat sausage | back 86 b |
front 87 Which of the following statements about Crohn's disease and ulcerative colitis is false? Both are local diseases with signs and symptoms confined to the bowel. About 20% of Inflammatory Bowel Disease (IBD) clients have a first-degree relative (parent, sibling, child) with the disease. Dietary restrictions are not included as part of therapy. Common, nonpathogenic microorganisms of intestinal tract are thought to be causally related. | back 87 a |
front 88 All but one of the following measures can be helpful in treating postprandial hypotension. Identify the exception. eating small, frequent meals limiting carbohydrate intake resting in a recliner after eating increasing fiber intake | back 88 d |