Chapter 25 Nutrition and Diet Therapy

Chapter 25  Nutrition and Diet Therapy

Complete Chapter Questions And Answers
 

Sample Questions

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 no 1)
complications. As part of the nursing care plan for discharge teaching, the client’s assigned nurse is
reviewing the dietary recommendations following this kind of surgery. What are appropriate
suggestions for the nurse to plan to include in the client teaching? (Select all that apply.)

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 eliminate

those that continue to cause undesirable effects.
F) Follow a low-fat diet for several weeks after surgery.

Answer: A, E, F
Explanation: A) The liver continues to produce bile after removal of the gallbladder, and the bile is

still available in the duodenum for emulsification of fat. The bile is just not
concentrated and stored. When a client resumes a regular diet after surgery,
continuing on a low-fat diet for several weeks is recommended as the surgical
area continues to heal. The client will continue to need the recommended daily
amount of dietary fat and is encouraged to follow national guidelines for reducing
risk for cardiac and other diseases. The client should be encouraged to try foods
that are liked and previously caused discomfort. The client is the best determinant
for what can be tolerated. Some clients take an herbal digestive aid. The nurse
should not recommend this at this time.
Planning
Health Promotion and Maintenance
Analysis

B) The liver continues to produce bile after removal of the gallbladder, and the bile is
still available in the duodenum for emulsification of fat. The bile is just not
concentrated and stored. When a client resumes a regular diet after surgery,
continuing on a low-fat diet for several weeks is recommended as the surgical
area continues to heal. The client will continue to need the recommended daily
amount of dietary fat and is encouraged to follow national guidelines for reducing
risk for cardiac and other diseases. The client should be encouraged to try foods
that are liked and previously caused discomfort. The client is the best determinant
for what can be tolerated. Some clients take an herbal digestive aid. The nurse
should not recommend this at this time.
Planning
Health Promotion and Maintenance
Analysis

1

C) The liver continues to produce bile after removal of the gallbladder, and the bile is
still available in the duodenum for emulsification of fat. The bile is just not
concentrated and stored. When a client resumes a regular diet after surgery,
continuing on a low-fat diet for several weeks is recommended as the surgical
area continues to heal. The client will continue to need the recommended daily
amount of dietary fat and is encouraged to follow national guidelines for reducing
risk for cardiac and other diseases. The client should be encouraged to try foods
that are liked and previously caused discomfort. The client is the best determinant
for what can be tolerated. Some clients take an herbal digestive aid. The nurse
should not recommend this at this time.
Planning
Health Promotion and Maintenance
Analysis

D) The liver continues to produce bile after removal of the gallbladder, and the bile is
still available in the duodenum for emulsification of fat. The bile is just not
concentrated and stored. When a client resumes a regular diet after surgery,
continuing on a low-fat diet for several weeks is recommended as the surgical
area continues to heal. The client will continue to need the recommended daily
amount of dietary fat and is encouraged to follow national guidelines for reducing
risk for cardiac and other diseases. The client should be encouraged to try foods
that are liked and previously caused discomfort. The client is the best determinant
for what can be tolerated. Some clients take an herbal digestive aid. The nurse
should not recommend this at this time.
Planning
Health Promotion and Maintenance
Analysis

E) The liver continues to produce bile after removal of the gallbladder, and the bile is
still available in the duodenum for emulsification of fat. The bile is just not
concentrated and stored. When a client resumes a regular diet after surgery,
continuing on a low-fat diet for several weeks is recommended as the surgical
area continues to heal. The client will continue to need the recommended daily
amount of dietary fat and is encouraged to follow national guidelines for reducing
risk for cardiac and other diseases. The client should be encouraged to try foods
that are liked and previously caused discomfort. The client is the best determinant
for what can be tolerated. Some clients take an herbal digestive aid. The nurse
should not recommend this at this time.
Planning
Health Promotion and Maintenance
Analysis

F) The liver continues to produce bile after removal of the gallbladder, and the bile is
still available in the duodenum for emulsification of fat. The bile is just not
concentrated and stored. When a client resumes a regular diet after surgery,
continuing on a low-fat diet for several weeks is recommended as the surgical
area continues to heal. The client will continue to need the recommended daily
amount of dietary fat and is encouraged to follow national guidelines for reducing
risk for cardiac and other diseases. The client should be encouraged to try foods
that are liked and previously caused discomfort. The client is the best determinant
for what can be tolerated. Some clients take an herbal digestive aid. The nurse
should not recommend this at this time.
Planning
Health Promotion and Maintenance
Analysis

2

2) A resident is newly admitted to a long-term care facility. The resident is able to take soft foods and 2)
liquids orally and can feed herself. The resident has a nasogastric tube in place for supplemental
feedings because she has recently become anorexic and has been losing weight. The resident will be
going to the facility dining room for meals and the staff nurses are deciding where and with whom
she should sit. If all of the following suggestions are made, which suggestion is most likely to
provide the desired nutritional outcomes for this resident?

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 assistance

with feeding.
C) Introduce the new resident to the others at the beginning of the meal and ask who would like

to have the new resident at their table.
D) Encourage the new resident to not be self-conscious about the nasogastric tube.

Answer: A
Explanation: 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 nasogastric
tube, and the new environment for the client. Start with placing the client in an
environment conducive to enjoying a meal and with residents who can feed
themselves and are able to eat soft solid foods. The assistance that the newly
admitted 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 in
the new environment and is unlikely to be successful for many reasons. Although
it will be important for the nurses to assess the client’s level of self-consciousness
about the nasogastric tube and its effect on others at the table where the resident is
seated, encouraging the resident to not be self-conscious does not present the best
suggestion.
Assessment
Psychosocial Integrity
Analysis

B) 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 nasogastric
tube, and the new environment for the client. Start with placing the client in an
environment conducive to enjoying a meal and with residents who can feed
themselves and are able to eat soft solid foods. The assistance that the newly
admitted 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 in
the new environment and is unlikely to be successful for many reasons. Although
it will be important for the nurses to assess the client’s level of self-consciousness
about the nasogastric tube and its effect on others at the table where the resident is
seated, encouraging the resident to not be self-conscious does not present the best
suggestion.
Assessment
Psychosocial Integrity
Analysis

3

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 nasogastric
tube, and the new environment for the client. Start with placing the client in an
environment conducive to enjoying a meal and with residents who can feed
themselves and are able to eat soft solid foods. The assistance that the newly
admitted 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 in
the new environment and is unlikely to be successful for many reasons. Although
it will be important for the nurses to assess the client’s level of self-consciousness
about the nasogastric tube and its effect on others at the table where the resident is
seated, encouraging the resident to not be self-conscious does not present the best
suggestion.
Assessment
Psychosocial Integrity
Analysis

D) 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 nasogastric
tube, and the new environment for the client. Start with placing the client in an
environment conducive to enjoying a meal and with residents who can feed
themselves and are able to eat soft solid foods. The assistance that the newly
admitted 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 in
the new environment and is unlikely to be successful for many reasons. Although
it will be important for the nurses to assess the client’s level of self-consciousness
about the nasogastric tube and its effect on others at the table where the resident is
seated, encouraging the resident to not be self-conscious does not present the best
suggestion.
Assessment
Psychosocial Integrity
Analysis

3) A client in a skilled-nursing facility has a percutaneous endoscopic gastrostomy (PEG) tube. The 3)
client receives intermittent feedings throughout the day. About 5:00 a.m. the night nurse discovers
the PEG tube lying on the floor near the client’s bed. What should be the nurse’s priority in
planning and implementing appropriate actions for the client?

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: B
Explanation: A) Inserting a catheter into the gastrostomy opening will maintain the patency of the

opening. The gastrointestinal tract is not sterile, so the catheter does not have to be
sterile. Inflating the balloon will help secure the placement. Clamping the catheter
will prevent drainage of gastric contents. Percutaneous endoscopic gastrostomy
tubes 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 be
desirable to keep the client from pulling out the “stop-gap” catheter. It should not
be the nurse’s first concern or action.
Planning
Safe, Effective Care Environment – Safety and Infection Control
Analysis

4

B) Inserting a catheter into the gastrostomy opening will maintain the patency of the
opening. The gastrointestinal tract is not sterile, so the catheter does not have to be
sterile. Inflating the balloon will help secure the placement. Clamping the catheter
will prevent drainage of gastric contents. Percutaneous endoscopic gastrostomy
tubes 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 be
desirable to keep the client from pulling out the “stop-gap” catheter. It should not
be the nurse’s first concern or action.
Planning
Safe, Effective Care Environment – Safety and Infection Control
Analysis

C) Inserting a catheter into the gastrostomy opening will maintain the patency of the
opening. The gastrointestinal tract is not sterile, so the catheter does not have to be
sterile. Inflating the balloon will help secure the placement. Clamping the catheter
will prevent drainage of gastric contents. Percutaneous endoscopic gastrostomy
tubes 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 be
desirable to keep the client from pulling out the “stop-gap” catheter. It should not
be the nurse’s first concern or action.
Planning
Safe, Effective Care Environment – Safety and Infection Control
Analysis

D) Inserting a catheter into the gastrostomy opening will maintain the patency of the
opening. The gastrointestinal tract is not sterile, so the catheter does not have to be
sterile. Inflating the balloon will help secure the placement. Clamping the catheter
will prevent drainage of gastric contents. Percutaneous endoscopic gastrostomy
tubes 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 be
desirable to keep the client from pulling out the “stop-gap” catheter. It should not
be the nurse’s first concern or action.
Planning
Safe, Effective Care Environment – Safety and Infection Control
Analysis

5

4) A father brings his 1-year-old son to the neighborhood health clinic for a scheduled well-child 4)
visit. The nurse measures the vital signs, height, and weight of the child as part of the initial
assessment information. The child weighs 23 pounds (10.5 kg) and is 36 inches (90 cm) tall. When
the nurse compares these findings with the standardized growth chart for a child of this age, the
nurse determines that the child is:

A) Within expectations in weight and height.
B) Below expectations in weight and above in height.
C) Above expectations in both height and weight.
D) Within expectations in weight and above in height.

Answer: D
Explanation: A) According to data from the National Center for Health Statistics (revised, 2001), a

child is expected to triple the birth weight and increase 50 percent of the birth
length in the first year. Average birth weight is 7 pounds, 8 ounces (3400 g) and
average birth length is 20 inches (50 cm).
Assessment
Health Promotion and Maintenance
Application

B) According to data from the National Center for Health Statistics (revised, 2001), a
child is expected to triple the birth weight and increase 50 percent of the birth
length in the first year. Average birth weight is 7 pounds, 8 ounces (3400 g) and
average birth length is 20 inches (50 cm).
Assessment
Health Promotion and Maintenance
Application

C) According to data from the National Center for Health Statistics (revised, 2001), a
child is expected to triple the birth weight and increase 50 percent of the birth
length in the first year. Average birth weight is 7 pounds, 8 ounces (3400 g) and
average birth length is 20 inches (50 cm).
Assessment
Health Promotion and Maintenance
Application

D) According to data from the National Center for Health Statistics (revised, 2001), a
child is expected to triple the birth weight and increase 50 percent of the birth
length in the first year. Average birth weight is 7 pounds, 8 ounces (3400 g) and
average birth length is 20 inches (50 cm).
Assessment
Health Promotion and Maintenance
Application