Diet & Geria

DIET ( 20 items) The following diet will stimulate the pancreatic secretions and produce attacks of pancreatitis EXCEPT: a. 2 glasses of Green tea and 1 piece spicy taco b. 2 bars of chocolate c. 2 pieces of bagels and 1 slice of watermelon d. 2 cups cream of mushroom soup RATIONALE: C. Foods that should be avoided in clients with pancreatitis are tea, alcohol, coffee, spicy foods, and heavy meals which stimulate the pancreatic secretions and produce attacks of pancreatitis. The client is instructed to eat high protein, low fat, and moderate to high carbohydrate foods. (Saunders Comprehensive © 2006, p 531) 1. The patient with acute pancreatitis is not permitted food or oral fluid intake. As the acute symptoms subside the nurse can gradually reintroduce oral feedings. Between acute attacks the following food should be given: a. High carbohydrates , light meals, low in fats and proteins b. High carbohydrates, light meals, low in fats and high in protein c. High carbohydrates , light meals and low in fiber d. High carbohydrates and calcium , light meals, low in fats and proteins RATIONALE: D. page 1362 / 1359 of Brunner and Suddarth’s (improving nutritional status) 2. Foods such as spinach, canned goods, anchovies and broccoli are given to the following patients, EXCEPT: a. Multiple myeloma b. Cushings disease c. Acute Pancreatitis d. Hypoparathyroidism Rationale: Hypercalcemia is the result of bone destruction due to osteoclast activating factor and interleukin -6 which causes extensive loss of ionized calcium. Page 1083 Brunner 11th edition and Saunders 2008 page 643-644 3. All of the following should be given with high caloric and high carbohydrate diet EXCEPT: 1. High Fever and metabolism such as Kawasaki and measles 2. COPD 3. ADHD and Manic patients 4. Hepatitis A 5. Myxedema 6. Cystic fibrosis a. #2 and# 5 b. # 5 c. # 1and #5 d. #2 ANSWER. LETTER A. COPD increases CO2 and Myxedema has decrease metabolism due to decrease T3 and T4 page 696 of Saunders 2008 blue edition strawberry jams Sherbets Lemonade Diluted fruit juices Kiwi shake A. A child with PKU should avoid foods such A. 6. #2. 4. Pre-eclampsia c. 5. 2. 5. 6. 2. Regular tea. Puffed rice C. Foods allowed in a full-liquid diet are the following EXCEPT: 1. 8 ANSWER: LETTER H (soft diet) all are correct page 137-139 of saunders 2008 Code name: LESBIAN 6. 7.4.#6 B. EXCEPT? a. ESRD and Hepatic encephalopathy b. PKU diet include restrictions in high protein foods (meat and dairy products) and aspartame because they contain large amount of phenylalanine. 8. # 6 and #3 C. A low CHON diet is best for all of the following. Cheese omelet D. # 3 and #2 ANSWER: LETTER B page 139 of saunders 2008 7. PKU . post and malnourish person Absorbed easily No dairy products and pulp fruit juices Used for patients who have difficulty swallowing B. 5 D. Wheat bread Rationale: C. #6. 4 C.#3 D. 8. hard candy Broth . 7 A. The following best describes a clear liquid diet: EXCEPT 1. Liquids that are transparent and are liquid at body temperature and low in calories Easily digested Short term used or transitional diet Bowel preparation for surgery and diagnostic tests Initial feeding after complete bowel rest. 4. Lettuce B. 3. 3. Increase sodium intake to prevent dehydration RATIONALE: A. The following are foods high in cholesterol EXCEPT: a. Chron’s disease. Long-term corticosteroid therapy can result in osteoporosis and pathological fractures. Mechanically altered diet ANSWER: B. and yogurt. Low residue diet c. Liver and organ meats b. Soft diet b. Clients would need to restrict sodium intake. Increase carbohydrate intake to maintain ideal weight d. Potassium loss occurs in this client so a need to increase potassium intake is necessary.ESRD. ice cream. (Saunders Comprehensive © 2006. not high-carbohydrate diet to counteract muscle wasting caused by steroid therapy.d. PKU. DASH diet d. Egg yolk c. Increase calcium and vitamin D supplements to reduce osteoporosis b. AGN with azotemia ANSWER: B LOW CHON DIET: Hepatic encephalopathy . Dietary instructions for a client on long-term corticosteroid therapy include: a. Brocolli RATIONALE: B. Yogurt c. Reduce potassium to avoid cardiac complications c. a. 11. A client which is hypocalcemia should be encouraged to eat which of the following foods? a. green beans. ulcerative colitis because it supplies foods that are LEAST likely to cause an obstruction when the GI tract is inflamed or prone to scarring. The nurse suggests which of the following foods to minimize the risk of digitalis toxicity to a client who is on digoxin? a. including milk. and cherry pie . Animal products d. page 139 saunders 2008 12. not dehydration. The client needs a high protein. The therapy causes sodium retention. Fish. cheese. Products that are naturally high in calcium are dairy products. p. 521) 10. The best diet for patients with acute phases of gastroenteritis. AGN (HEPA: code name) 9. Apples d. Walnuts ANSWER: D 13. Cooked pasta b. c.b.animal products have the highest content of thiamine. Laboratory analysis of a client indicates a positive calcium oxalate stones. Bread. Other food sources include strawberries. The following are gluten rich foods and should be avoided by celiac disease EXCEPT: a. Patients with pernicious anemia . Increasing intake of plums and cranberries B. and roast beef c. macaroni. animal products. rhubarb. These foods are high in potassium. wheat bran. and oats Peas and peanuts Fruitcakes and donuts ANSWER: B (prevent peripheral neuritis. Which of the following will the nurse include in the diet instructions? A. cakes and cookies b. nuts. FOODS ALLOWED ARE THE FF: MACE (milk . corn. Celiac disease or gluten enteropathy or celiac sprue is the accumulation of amino acid glutamine which is toxic to intestinal mucosal cells. B6. and apricots d. CODE: T CABS ( Tea. 14. Whole grain cereal. chocolate. cooked broccoli. which of the following is the most abundant in B1 a. green beans. Dried beans . and Italian bread RATIONALE: C. Avoiding citrus fruits and juices D. Cottage cheese. Avoiding green leafy vegetables such as spinach C. d. Increasing intake of dairy products Rationale: B. 17. Beans. Puddings and macaroni c. Macaroni and spaghetti d. Fruit salad CODE: BC P MS (bread cakes cookies puddings. Patients in Oncovin (Vincristine) b. Spinach) 15.liver. Almonds. b. wheat and nuts Pork . and B12 are significant vitamin B complex for the following patients EXCEPT: a. Intestinal villi atrophy occurs affecting absorption of nutrients. Chocolate/cocoa/cashews. orange juice. eggs) 16. Vitamin B1. Thiamine rich foods recommended for chronic alcoholic individuals. Calcium oxalate is found in dark green foods such as spinach. and tea. spaghetti) Gluten the protein component of BROW (barley oats and wheat). Turkey. A patient under Bumex and Lasix b. Type 1 diabetes and alcoholics e. Patients taking anti-TB ANSWER: C Alzheimer patients are dementic patients which are irreversible.Bread (white). Chronic renal failure and Addisons disease ANSWER: letter C (the patient is hyperkalemic) 20. . Aldactone and Diabetic ketoacidosis c. Cereals (cooked). An increase in the gastric acid production C. A decrease in the lung elasticity B. The following are low residue diet. The bladder capacity diminishes in size with normal aging. All of the following should be given a low potassium diet EXCEPT? a. therefore the glomerular filtration rate decreases. Patient under cardiac glycosides ANSWER: LETTER C ( patients with adrenal insufficiency are prone for hyperkalemia) GERIATRIC NURSING (20 items) 1. There is a decrease in hydrochloric acid production with aging. EXCEPT: a. All of the following should be given a high potassium diet EXCEPT? a. 18. Patient with bilateral adrenalectomy d. Cooked cereals c. resulting in a decline in the forced expiratory volume and vital capacity. Glucocorticoid excess d. Alzheimer patients d. whole grains they may cause obstruction and scarring page 139 Saunders 2008. CODE: BC P. White bread b. Pasta (whole) 19. 1 year use of Solu cortef c.c. A decrease in the kidney size D. A nurse is assessing an 80-year-old man in the outpatient clinic. Lung elasticity decreases with age. There is decline in the number of functioning nephrons. Refined Pasta d. The kidneys do not change in size. Whole grains LETTER D. An increase in the bladder size Rationale: A. Which of the following will the nurse consider as age-related changes in a geriatric patient? A. ACE 1 inhibitor drugs b. There should be no interference with swallowing in older individuals. Difficulty hearing low-pitched sounds Rationale: C. A nurse taking care of an elderly client with a hearing loss due to aging would expect the client to have: A. 5. quantity. Heightened response to stimuli D. if included). and characteristics of urine (specific gravity) would be the best choice. (Mosby’s Comprehensive Review © 2003. Skin turgor b. When formulating nursing care plan for elderly client’s. and pasta RATIONALE: C. With a change in taste sensations. There is a decreased response to stimuli in the older individual.. The best indication old dehydration in a client who is 85 years old would be changes in: a. Hemoglobin (Hgb) levels RATIONALE: B. Older individuals tend to feel the cold and rarely complain of heat. Generally. Decrease intake of fluids c.716) 4. Blood pressure d. client who are elderly increases the amount of food seasonings. 6. (Daily weight would be a better choice. What patterns reflects the age-related change in taste perception experienced by clients who are elderly? a. easily digested food b. 2nd ed. Increased consumptions of salts and sweets d. the nurse should include special measures to accommodate for age-related sensory losses such as: A. p. thermal extremes. Difficulty swallowing C. or excessive pressure. female voices have a higher pitch than male voices and the elderly with presbycusis (hearing loss caused by the aging process) have more difficulty hearing these higherpitched sounds. these products are also readily accessible. Which of the following symptoms of hyperthyroidism would the nurse expect to find in an elderly client? . rice. p. The epithelium of the lining of the ear becomes thinner and drier. Urine output c. Ingestion of more bread. especially sweets and salt.716) 3. Tears in the tympanic membrane B. Difficulty hearing women’s voice D. The health implications must be closely monitored. Increased sensitivity to heat B. to compensate for this loss. p. Use of bland. The normal frequency. Overgrowth of the epithelial auditory lining C. There is no greater incidence of tympanic membrane tears caused by the aging process. 60) 2. A decrease in pain sensation may make an older individual unaware of a serious illness.(A Comprehensive Review for the Certification and Recertification Examinations for Physical Assistants. (Mosby’s Comprehensive Review © 2003. Diminished sensation to pain Rationale: D. 6) 8. Diminished gag reflex b. Reminiscing contributes to successful adaptation by maintaining self-esteem. which may reduce the person’s appetite and increased his consumption of sweet. Palpitations and shortness of breath b. Increased BUN and creatinine b. The cardiac effect of excessive T4 on the client who is elderly is frequent atrial fibrillation and shortness of breath. 7) 9. Moist skin and fine tremors d. Increased protein d. (Better Elderly Care. and spicy foods. Increased residual urine and nocturia d. except a. Which of the following activities will be most effective in meeting the growth and development needs for persons in this age group? a) Aerobic exercise classes b) Transportation for shopping trips c) Reminiscence groups d) Regularly scheduled social activities RATIONALE: C. and working through loss. Anorexia and constipation RATIONALE: A. A drop in hemoglobin c. p. The manifestations of hyperthyroidism in a client who is elderly are different from the average adult client. Elderly has a decreased salivary outflow causing dry mouth and diminished sense of taste. angry. Decrease platelet-release factors RATIONALE: D. reaffirming identity. Nervousness and insomnia c. p. According to Erikson’s theory. A nurse conducting a physiologic assessment in an elderly would expect to find the following considered as a normal observation. The nurse is caring for residents in a long term care setting for the elderly. 10. or they may become depressed. Which of the following are considered age-related changes in the laboratory findings of an elderly client. Increased salivation and diminished sense of taste RATIONALE: D. except a. (Better Elderly Care. a) Increasing sound of radio b) Drooping of eyelids . older adults need to find and accept the meaningfulness of their lives. Senile deafness c. An elderly may show a decrease granular constituents and increase plateletrelease factors possibly due to diminished bone marrow and increased fibrinogen levels. Select all that apply in aging.a. salty . and fear death. 7. such as blues. green. a problem commonly compounded during driving at night. 403) . particularly the lower lid due to poorer muscle tone. (Fundamentals of Nursing by Kozier 7th ed. slowed blink reflex. Other changes result in loss of visual acuity. Visual changes in elderly includes obvious changes around the eye. less power to adaptation to darkness and dim light. distinct voices. and the looseness of eyelids. They have a slow reaction to time to decrease in light and illumination. p.c) Difficulty to distinguish colors d) Presence of halo light e) Increasing illumination f) Difficulty to see the light at night RATIONALE: BCF. loss of peripheral vision. 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