Roth 10e NCLEX Chapter 15

MULTIPLE CHOICE 1. The nurse is caring for a client in long term care who has been prescribed tetracycline. What, if any, dietary issues related to the tetracycline must the nurse be concerned with? a. Dairy products should not be consumed c. There are no food-drug interactions within 2 hours of taking tetracycline. associated with tetracycline. b. The tetracycline should be taken with milk d. This patient cannot have any dairy 2 hours before eating. products until the course of antibiotic treatment is complete. ANS: A Dairy products should not be consumed within 2 hours of taking tetracycline, or it will not be absorbed. PTS: 1 REF: Sidestepping Potential Problems

2. An healthy elderly client tells the nurse that the doctor said the clients diet should be based on MyPyramid. Which of the following responses is appropriate? a. MyPyramid cant cover all your needs, so c. Once a person is over age 65 MyPyramid you must take a multivitamin-mineral is no longer appropriate for them. supplement every day. b. MyPyramid is appropriate for elderly d. There are special dietary guidelines for clients who have no underlying medical elderly people. problems. ANS: B An elderly clients diet plan should be based on MyPyramid and the nutrients should be checked against the AIs and DRIs. Each person should be examined by a physician, as this client was, to determine their specific nutrient requirements. All elderly clients need not take a multivitamin-mineral supplement each day unless they are taking in fewer than 1500 calories a day. PTS: 1 REF: Food Habits

3. An elderly client who has been hospitalized for 2 weeks keeps refusing her meal trays because she says the hospital food is awful. What type of malnutrition should the nurse be concerned about in a client who is not eating? a. energy malnutrition c. protein energy malnutrition b. malnutrition is not a concern in d. protein malnutrition hospitalized clients ANS: C Elderly people who have long hospital stays can develop protein energy malnutrition in the hospital. They may dislike the food, drugs may dull the appetite, and they may be lonely and depressed. PTS: 1 REF: Food Habits

4. The visiting nurse arranges for an elderly home-bound client to go the local senior center for lunch 2 days a week. The client insists eating out isnt in the budget. How can the nurse overcome this clients objection? a. As an act of charity, offer to pay for the c. Offer to help the client sign up for food

clients meals. stamps. b. Explain that the federal government funds d. Tell the client there is an option of the lunches, so there is no cost to the volunteering 5 hours a week to pay for the client. meal. ANS: B The federal government provides the states with funds to serve hot meals at noon in senior centers across the country. These senior centers become social clubs and are extremely beneficial to the elderly. The federal government also provides transportation for those who are otherwise unable to reach the senior center for the meal. Food stamps are not necessary to pay for meals at the senior center since the meals are free. However, food stamps can sometimes be used for Meals-on-Wheels home delivered meals. PTS: 1 5. The nurse is completing the initial assessment of a hospitalized client who has arthritis. The client uses aspirin daily for pain relief. The nurse makes a note to look at the patients labs when they come in to see if the patient may need supplementation of what nutrient? a. calcium c. magnesium b. iron d. vitamin E ANS: B The regular use of aspirin by clients who have arthritis may cause slight bleeding in the stomach lining, so their diets may require additional iron. PTS: 1 MULTIPLE RESPONSE 1. An elderly client asks the nurse if there are any nutrition related things that might be good for someone with arthritis The nurse makes some suggestions of things the client might want to consider. Which of the following are appropriate statements for the nurse to make? Select all that apply. a. Consume sugar in moderation. d. Eat fatty fish, such as salmon, every day. b. Consume salt in moderation. e. Pomegranate reduces the all of the symptoms associated with arthritis. c. Eat a healthy diet that includes 5 servings f. There is no direct connection between any of fruits and vegetables. specific kind of food and a specific symptom of arthritis. ANS: A, B, C, F There appears to be no direct connection between a specific kind of food and a specific symptom of arthritis. Thus, salmon and pomegranate are not correct answers. Neither is there a special diet that is consistently better for arthritis suffers. The best advice is to eat a healthy diet that includes the 5 a day fruits and vegetables, along with grain products, and sugar and salt in moderation. PTS: 1 REF: Physiological Changes REF: Arthritis

2. The visiting nurse is assessing an elderly client at the clients home. What things that may be related to the clients nutrition should the nurse cover in the assessment? Select all that apply. a. Does the client appear to be depressed? d. How often does the client go out and socialize? b. Does the client have regular visitors? e. Is the client suffering from constipation? c. Has the client undergone any recent f. What medications is the patient taking? economic changes?

ANS: A, B, C, D, E, F Physiological, psychosocial, and economic changes associated with aging may affect the clients nutrition status. Depression and loneliness can affect whether or not someone wants to eat. Economic changes can make it difficult to buy the foods that contribute to a healthy diet and leave less money for social activities. With aging the tone of the intestines is reduced, affecting the persons overall feeling of well being and desire to eat. Drug-drug and food-drug interactions can contribute to decreased nutritional status. PTS: 1 NUMERIC RESPONSE 1. The visiting nurse is calculating the protein requirement for an otherwise healthy 60 year old man who is 56 tall and weighs 180 pounds. How many grams of protein per day should the nurse recommend for this client? ANS: 65 Rationale: The protein requirement for people over age 51 but less than 65 is 0.8 grams per kilogram of body weight. 180 pounds/2.2 = 81.8 kilograms 81.8 * 0.8 = 65 grams of protein per day PTS: 1 REF: Nutritional Requirements REF: The Effects of Aging