A nurse is providing dietary teaching for a client who is at 28 weeks of gestation and has phenylketonuria (PKU). Which of the following foods should the client avoid?

Apples

Milk

Carrots

Coffee

Answer and Explanation

The Correct Answer is B

A. Apples: Apples are naturally low in phenylalanine, the amino acid that clients with phenylketonuria (PKU) cannot properly metabolize. Fruits like apples are generally safe and are encouraged in a low-phenylalanine diet because they help meet nutritional needs without contributing excess protein or phenylalanine.
B. Milk: Milk is high in protein and contains significant amounts of phenylalanine, making it unsuitable for individuals with PKU. Consuming milk can lead to elevated phenylalanine levels, which are harmful to the developing fetus and can cause cognitive impairments and developmental delays. Pregnant women with PKU must strictly avoid high-protein foods such as milk.
C. Carrots: Carrots are low in protein and phenylalanine, making them a safe and beneficial food choice for clients with PKU. They provide important nutrients like beta-carotene and fiber without compromising phenylalanine restrictions. Including vegetables like carrots supports balanced nutrition during pregnancy.
D. Coffee: Coffee itself contains minimal or no phenylalanine unless additives such as milk or cream are used. While caffeine intake should be moderated during pregnancy, plain coffee does not significantly impact phenylalanine levels and is not a food that must be avoided specifically because of PKU.

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Correct Answer is B

Explanation

A. Instruct the client to lie down after a meal: Lying down after meals increases the risk of aspiration in clients with difficulty swallowing. It impairs gravity-assisted esophageal emptying and allows food or liquids to reflux, increasing the chance of choking or aspiration pneumonia.
B. Encourage the client to rest prior to mealtimes: Resting before meals conserves the client's energy, allowing them to focus on eating slowly and carefully, which promotes safer swallowing. Fatigue increases the risk of aspiration because muscle coordination during swallowing becomes impaired.
C. Turn on the client's television during meals: Turning on the television is a distraction that can reduce the client’s attention during chewing and swallowing. This lack of focus increases the risk of aspiration or choking, especially in clients with dysphagia.
D. Place the client into a semi-reclined position for meals: A semi-reclined position may hinder proper swallowing mechanics and promote aspiration. Clients with swallowing difficulty should ideally be in an upright 90-degree sitting position to reduce aspiration risk during meals.

A. Muscle weakness B. Hyperreflexia C. Chvostek's sign D. Seizures

Correct Answer is A

Explanation

A. Muscle weakness: Potassium is essential for normal neuromuscular function, and a low serum potassium level disrupts muscle cell excitability and contractility. As a result, clients may present with generalized weakness, particularly in the lower extremities, and may have difficulty with mobility or respiration if the weakness progresses.
B. Hyperreflexia: Hyperreflexia is more commonly associated with elevated calcium or magnesium imbalances rather than decreased potassium. Hypokalemia typically causes reduced neuromuscular excitability, which would result in diminished or absent reflexes rather than increased reflex activity. Therefore, hyperreflexia is not an expected finding in a client with low potassium.
C. Chvostek's sign: Chvostek’s sign is associated with hypocalcemia, not hypokalemia. It is elicited by tapping the facial nerve, resulting in twitching of the facial muscles. This sign indicates increased neuromuscular excitability due to low calcium levels, which is unrelated to potassium regulation. It is not expected in cases of decreased potassium.
D. Seizures: Seizures are more commonly linked with abnormalities in sodium or calcium levels, particularly hyponatremia or severe hypocalcemia. While severe hypokalemia can lead to cardiac arrhythmias and muscle paralysis, it is not typically associated with seizures. Therefore, seizures are not a standard finding in clients with hypokalemia.

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A nurse is providing dietary teaching for a client who is at 28 weeks of gestation and has phenylketonuria (PKU). Which of the following foods should the client avoid?

Nursing Test Bank

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