Roth 10e NCLEX
Chapter 18
MULTIPLE CHOICE
1. After becoming aware that the client has hyperlipidemia, the nurse educates the client on
medical nutrition therapy designed to improve the condition. The nurse explains to the client
that this treatment involves a restriction of fats in the diet, and that foods such as ______
should be included, while foods such as ______ should be avoided.
a. bacon and salad dressings; sherbet and c. pita bread and peanut oils; blue cheese
plain bagels
b. coconut and cereals; sausage and
processed cheese
and cream soups
d. whole-grain breads and buttermilk;
bakery products and butter
ANS: C
See Table 18_1. Pita bread and peanut oils are in “foods to include” list and blue cheese and
cream soups are in “foods to avoid” list.
PTS: 1
REF: Medical Nutrition Therapy for Hyperlipidemia: Table 18-1
2. After explaining to the client that a fat-controlled diet is necessary to help alleviate the client’s
high cholesterol levels, the client asks the nurse to provide an example of a breakfast that
would satisfy all with the fat restriction. Which of the following would be an appropriate
example of a breakfast for the nurse to give the client?
a.
c.
cereal, two slices of wholewheat toast with one
tablespoon of butter on each,
two slices of bacon, and orange
juice
b. egg and cheese sandwich on a
d.
croissant with a glass of 2% milk and
hash browns
egg-white omelet with
broccoli, a plain bagel with a
tablespoon of honey, two slices
of cantaloupe, and a cup of
coffee with fat-free milk
sausage gravy on two biscuits,
an orange, and a glass of 100%
cranberry juice
ANS: C
Egg whites, fruits and vegetables, plain bagels, honey, and fat-free milk are all foods
to include in fat-restricted diets. Each of the other responses has at least one food to
avoid in fat-restricted diets, so they would not be considered good examples of fatcontrolled breakfasts.
PTS: 1
REF: Medical Nutrition Therapy for Hyperlipidemia: Table 18-1
3. The physician notified the nurse that the client is suffering from congestive heart failure, and
is presenting with edema. The nurse is then notified that diuretics will be prescribed to aid in
the excretion of water and sodium, in order to alleviate the client’s edema. The nurse must
advise the client that a potential side effect of diuretics is _______, and this can be addressed
by the client by consuming ______.
a. again in sodium; supplementary
c. a loss of potassium; saltines
potassium
b. a loss of potassium; fruits and
vegetables
d. swelling of the abdomen; a fat-
restricted diet
ANS: B
Diuretics can cause an excessive loss of potassium. Fruits, especially oranges, bananas, and
prunes, can be useful in such a situation because they are excellent sources of potassium and
contain only negligible amounts of sodium.
PTS: 1
REF: Congestive heart failure
4. The client asks the nurse to identify some examples of products that often have sodium added
to them and to describe the purpose of adding sodium, so the client can increase awareness of
foods to avoid in a sodium-restricted diet. One accurate example that can be provided by the
nurse is:
a. Baking powder, which is used to
c. Brine, which is used in many chocolate
leaven quick breads and cakes
milks and ice creams for smooth
texture
b. Baking soda, which is present in some d. Sodium Chloride, which is used in
quick-cooking cereals and processed
pasteurized cheeses and in some
cheeses
breads and cakes to inhibit growth of
mold
ANS: A
Baking powder—used to leaven quick breads and cakes, baking soda—used to leaven breads
and cakes; sometimes added to vegetables in cooking or used as an “alkalizer” for indigestion,
brine—used in processing foods to inhibit growth of bacteria; in cleaning or blanching
vegetables and fruits; in freezing and canning certain foods’ and for flavor, as in corned beef,
pickles, and sauerkraut, sodium chloride—used in cooking or at the table and in canning and
processing
PTS: 1
REF: Sodium-restricted diets
5. The nurse is aware that the client has been prescribed a 2 gram sodium-restricted diet, and it is
necessary to provide the client with an example of a dinner that would satisfy the diet
requirements. Which of the following examples of a dinner would be appropriate for the
nurse to give to a client on a sodium-restricted diet? Please select the best answer.
a. a large salad with almonds, canned
c. glass of fat-free milk, fresh salad with
chicken, cheddar cheese, dried
oil, vinegar and unsalted nuts, fresh
cranberries, and low-fat ranch dressing
fish with lemon juice, and rice.
with a cup of tea
b.
d. pork and sauerkraut, applesauce, and
glass of cranberry juice
cocktail, ham, frozen
tomato soup with a glass of red wine
vegetables, and a baked potato
ANS: C
Based on Table 18-5, each of the food items in answer C is present in the permitted foods
column, while one or more of the food items in each of the other answers are listed in the
table as a food to limit or avoid.
PTS: 1
REF: Adjustment to Sodium Restriction
MULTIPLE RESPONSE
1. The nurse is evaluating an adult client for metabolic syndrome in order to assess the risk for
cardiovascular disease. The client is concerned about his obese child as well. Which of these
risk factors that the adult client may demonstrate would also be a risk factor for a child?
Select all that apply.
a. Blood pressure of 138/88 mm Hg
b. Blood pressure of 142/85 mm Hg
c. High blood lipids such as high
d. High HDL
e. High LDL
f. Low C-reactive protein
triglycerides
ANS: A, B, E
A blood pressure of 142/85 mm Hg would classify the client as having Stage 1 hypertension,
with high blood pressure being a risk factor associated with metabolic syndrome. High blood
lipids such as high triglycerides, low HDL, and high LDL are risk factors associated with
metabolic syndrome. Elevated highly sensitive C-reactive protein in the blood is also a risk
factor associated with metabolic syndrome. Each of the risk factors listed in the section apply
to children as well as adults.
PTS: 1
REF: Objectives
2. A client suffered a myocardial infarction 24 hours ago, but is now able to consume a low-
cholesterol-low-sodium diet. Which of the following dietary modifications could the nurse
suggest that would increase the client’s comfort after a myocardial infarction? Select all that
apply.
a. avoid foods that are hard to digest
d. consume foods that are difficult to
b. avoid foods that are too hot
c. avoid roughage
e. consume high-fiber foods
f. consume very cold foods
chew
ANS: A, B, C
Foods should not be extremely hot or extremely cold. They should be easy to chew and digest
and contain little roughage so that the work of the heart will be minimal. Both chewing and
the increased activity of the gastrointestinal tract that follow ingestion of high-fiber foods
cause extra work for the heart.
PTS: 1
REF: Myocardial infarction
3. The client tells the nurse that the physician advised the client to restrict the amount of sodium
consumed to help control the client’s hypertension. The client thinks it would be best to
simply consume no sodium or sodium containing foods. What would be the most appropriate
way for the nurse to respond to the client’s statement? Please choose the best answer.
a. Notify the client that no sodium is
needed for survival
c. Notify the client that it is impossible to
have a diet totally free of sodium
b. Notify the client that in order to reduce d. Notify the client what foods would be
the amount of sodium in the diet, the
amount of potassium in the diet must
be increased
appropriate for a sodium-free diet
ANS: C
It is impossible to have a diet totally free of sodium. Meats, fish, poultry, dairy products,
eggs, cereals, vegetables, fruits, and fats all contain certain amounts of sodium naturally.
Water contains varying amounts of sodium.
PTS: 1
REF: Sodium-restricted diets
NUMERIC RESPONSE
1. The client tells the nurse that the doctor has put him on a sodium-restricted diet that would
allow him to consume 2 grams of sodium per day. Assuming the client consumes the average
amount of sodium consumed by U.S. adults, how many grams of sodium must the client
restrict per day in order to satisfy the prescribed sodium-restricted diet?
ANS:
5
Rationale: It is estimated that the average adult consumes 7 grams of sodium a day. In order to
consume 2g of sodium per day, the client would need to restrict 5 grams per day.
PTS: 1
REF: Sodium-restricted diets
2. The client notifies the nurse that the physician prescribed a diet for hyperlipidemia that would
restrict the client’s percentage of calories from fats to the maximum recommended by the
American Heart Association. Assuming the client consumes an average U.S. diet, what
percentage of decrease in calories from fats must the nurse say the client needs to incorporate
into his/her daily diet?
ANS:
5
Rationale: The American Heart Association has developed guidelines that recommend that
adult diets contain less than 200mg of cholesterol per day and that fats provide no more than
20% to 35% of calories. Currently, it is believed that nearly 40% of the calories in the
average U.S. diet come from fats. 40% (average) – 35% (maximum recommended) = 5%
decrease.
PTS: 1
REF: Medical Nutrition Therapy For Hyperlipidemia