Roth 10e NCLEX Chapter 10

MULTIPLE CHOICE 1. The nurse is assessing a client who is suffering from diarrhea, fever, headache, abdominal pain, and nausea. The client reports having eaten home-canned tomatoes. What foodborne illness should the nurse suspect? a. Campylobacter jejuni c. Cyclospora cayetanensis b. Clostridium botulinum d. Listeria monocytogenes ANS: B Clostridium botulinum is transmitted in home-canned and, rarely, improperly prepared commercially canned food. Campylobacter jejuni is transmitted in unpasteurized milk, contaminated water, raw and undercooked meat and shellfish. Cyclospora cayetanensis is transmitted in food or water contaminated with feces. Listeria monocytogenes is transmitted in unpasteurized milk, raw and cooked poultry and meat, and raw leafy vegetables. PTS: 1 REF: Bacteria That Cause Foodborne Illness

2. The nurse is assessing a client whose medical history includes a bout of foodborne illness caused by mycotoxin found in spoiled peanut butter. The nurse knows that a serious illness can develop as a result of this foodborne illness? What illness is the nurse concerned with in this client? a. Cancer c. heart disease b. blindness d. kidney failure ANS: A Some molds produce a dangerous mycotoxin called aflatoxin that can cause cancer. It can develop in spoiled peanuts and peanut butter, soybeans, grains, nuts, and spices. PTS: 1 REF: Other Substances That Cause Food Poisoning

3. The nurse is teaching a class to a group of clients who suffer from food allergies. What is one possible goal of this teaching? a. for the client to demonstrate an c. for the client to demonstrate understanding of the need to take understanding of the reasons to never eat megadoses of vitamins and minerals in a restaurant. because of their food allergy b. for the client to demonstrate d. for the client to demonstrate understanding of how to identify allergens understanding of the reasons to never eat on a food label at a friends house ANS: B Clients with food allergies will require careful training to avoid their specific allergens. They must be taught to read food labels carefully and to ask for the ingredients of foods in restaurants and at friends homes. PTS: 1 MULTIPLE RESPONSE 1. A client tells the nurse he has diarrhea that he thinks is due to a foodborne illness. Which of the following bacteria should the nurse suspect as causes of the patients diarrhea? Select all that apply. REF: Considerations for the Healthcare Professional

a. Clostridium botulinum b. Clostridium perfringens c. Listeria monocytogenes

d. Salmonella e. Shigella f. Staphyloccoccus aureus

ANS: B, C, D, E, F Clostridium botulinum, one of the deadliest causes of foodborne illness, does not present with diarrhea. Diarrhea would be an expected symptom of foodborne illness resulting from Clostridium perfringens, Salmonella, Shigella, Listeria monocytogenes, and Staphyloccoccus aureus. PTS: 1 2. A client presents with what appears to be a foodborne illness. The client reports consuming raw milk. What bacteria will the nurse suspect as the possible causes of foodborne illness in this patient? Select all that apply. a. Campylobacter jejuni b. Clostridium perfringens c. Escherichia coli (0157:H7) d. Listeria Monocytogenes e. Salmonella f. Shigella

ANS: A, C, D, E Raw milk is one possible source of Campylobacter jejui, Eschericia coli (0157:H7), Listeria monocytogenes, and Salmonella. Clostridiun perfringens, and Shigella are not transported in raw milk. PTS: 1 REF: Bacteria That Cause Foodborne Illness (Table 10-1)

3. The nurse is assessing a client who appears to have a foodborne illness. The clients food recall indicates that undercooked pork was eaten 24 hours before onset of symptoms. With what disease(s) will the nurse say the client may be infected? Select all that apply. a. botulism b. dysentary c. hemolytic uremic syndrome d. Shigellosis e. Trichinosis f. typhoid fever

ANS: E Trichinosis is caused by the parasitic roundworm Trichinella spiralis and can be transmitted through undercooked pork. Dysentary is caused by protozoa and is introduced by infected individuals or contaminated water. Hemolytic uremic syndrome can result from Esherichia coli (0157:H7) infection which is transmitted in undercooked hamburger, ground poultry, and unpasteurized milk and apple juice. Shigellosis is transmitted by infected food handlers and is primarily transmitted in cold salads such as tuna, chicken, and potato. One species of Salmonella can cause typhoid fever. PTS: 1 REF: Other Substances That Cause Food Poisoning

4. A client appears to be suffering from a foodborne illness, but the nurse does not uncover any likely bacterial causes in the assessment. She realizes that the client could still be suffering from foodborne illness related ingestion of a poisonous plant. What foods will she look for in the food recall? Select all that apply. a. apple butter b. fish from polluted waters c. fruit preserves ANS: B, D, E d. poisonous mushrooms e. rhubarb leaves f. well cooked beef

Fish from polluted waters, poisonous mushrooms, and rhubarb leaves are examples of foods that contain poison. PTS: 1 REF: Miscellaneous Food Poisonings

5. The nurse is explaining to a parent how to implement an elimination diet for a child who was tested for food allergies using skin tests. Which of the following dietary teaching statements would the nurse make? Select all that apply. a. Food labels provide no useful information d. The child will stay in the first phase of the about whether or not the food contains elimination diet for at least 6 months. anything the child is allergic to. b. Knowing the cause of the allergy allows e. The duration of the first phase of the diet the child to lead a healthy, normal life as will be just 1 to 2 weeks. long as eliminating the offending foods does not lead to nutritional deficits. c. Once the allergic symptoms are resolved, f. Vitamin and mineral supplements may be foods that were eliminated will be added needed because the diet may not be back at the rate of one every 4 to 7 days. nutritionally adequate. ANS: B, C, E, F After completion of allergy testing, the client is usually placed on an elimination diet. For 1 to 2 weeks, the client does not eat any of the tested foods that gave a positive reaction on the skin tests. Sometimes these diets are nutritionally inadequate and vitamin and mineral supplements may be prescribed. After the first couple of weeks, if the allergic symptoms are resolved, other foods are gradually added to the diet at a rate of one food every 4 to 7 days. Knowing the cause of the allergy allows the child to lead a healthy, normal life as long as eliminating the offending foods does not lead to nutritional deficits. It is important to read food labels carefully to identify any allergens in the food. PTS: 1 REF: Food Allergies

6. The nurse is teaching the parent of a child who is starting to eat solid foods about which foods are common food allergens. Which foods will the nurse say are common food allergens? Select all that apply. a. apples b. chocolate c. chicken d. Corn e. Beef f. tree nuts

ANS: B, D, F The most common food allergens are: milk, wheat, corn, eggs, citrus fruit, strawberries, tomatoes, legumes, tree nuts, peanuts, chocolate, soybeans, pork, fish, and shellfish. PTS: 1 REF: Food Allergies (Table 10-4)

7. The nurse is teaching a group of consumers about food safety. Of the following statements, which ones would the nurse communicate during the seminar? Select all that apply. a. Any dishes that held uncooked meat must d. Refrigerate leftovers as soon as the meal is be washed properly before cooked foods finished. are placed on them. b. Do not serve undercooked foods. e. Thaw frozen foods at room temperature before cooking. c. Food must always be protected from f. Wash hands after blowing your nose.

animals. ANS: A, B, C, D, F Cleanliness is important in preventing foodborne illness. Any dishes that held uncooked meat must be washed properly before cooked foods are placed on them. Always wash hands after blowing the nose or using the toilet. Cook foods to the proper temperature and do not serve undercooked foods. Cook foods from the frozen state or thaw them in the refrigerator. Leftovers should be refrigerated as soon as the meal is finished. Always protect food from dust, insects and animals. PTS: 1 REF: Prevention of Foodborne Illnesses