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 client’s diet should be based on
MyPyramid. Which of the following responses is appropriate?
a. MyPyramid can’t 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 client’s 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 isn’t in the budget. How can the nurse overcome this client’s
objection?
a. As an act of charity, offer to pay for the
c. Offer to help the client sign up for food
client’s 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 patient’s 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
REF: Arthritis
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
2. The visiting nurse is assessing an elderly client at the client’s home. What things that may be related to
the client’s 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 client’s
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 person’s overall feeling
of well being and desire to eat. Drug-drug and food-drug interactions can contribute to decreased
nutritional status.
PTS: 1
REF: The Effects of Aging
NUMERIC RESPONSE
1. The visiting nurse is calculating the protein requirement for an otherwise healthy 60 year old man who
is 5’6” 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