A nurse is reinforcing teaching with a client about nutrition.
The client has hypertension and is taking a potassium-wasting diuretic.
Which of the following dietary instructions should the nurse include in the teaching?
Increase consumption of canned tuna and salmon.
Consume oranges and bananas.
Limit intake of dried fruits.
Avoid cow's milk.
The Correct Answer is B
Choice A rationale
Canned tuna and salmon, while sources of protein and omega-3 fatty acids, are not particularly high in potassium. Clients taking potassium-wasting diuretics need foods rich in potassium to replace the electrolytes lost through increased urination.
Choice B rationale
Oranges and bananas are excellent sources of potassium. Potassium is an essential electrolyte that is often depleted by potassium-wasting diuretics like furosemide or hydrochlorothiazide. Consuming these fruits helps maintain adequate potassium levels, which are crucial for cardiac function and muscle contraction. The normal range for serum potassium is typically 3.5-5.0 mEq/L.
Choice C rationale
Dried fruits, such as apricots and raisins, are high in potassium. However, the question asks what the nurse *should* include, and while dried fruits are beneficial, fresh fruits like oranges and bananas are often more readily available and consumed in larger quantities.
Choice D rationale
Cow's milk contains potassium but is not specifically emphasized for clients on potassium-wasting diuretics. Other food sources like fruits and vegetables generally provide a more direct and often higher concentration of potassium without the added phosphorus and calcium found in milk, which may be considerations for some individuals.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale
Checking gastric residual volume is essential before administering enteral feedings and medications to assess for delayed gastric emptying, which could increase the risk of aspiration. A high residual volume (typically >500 mL or >250 mL on two consecutive checks) may indicate intolerance to the feeding.
Choice B rationale
Turning the client on their left side after administering enteral feedings and medications is not the recommended position. The right lateral decubitus position is preferred as it promotes gastric emptying by allowing gravity to assist the flow of the feeding into the small intestine.
Choice C rationale
Elevating the head of the bed to a 30-45 degree angle during and for at least 30-60 minutes after enteral feedings significantly reduces the risk of aspiration pneumonia. This position utilizes gravity to help keep the feeding within the stomach and prevent reflux into the esophagus and airway.
Choice D rationale
Leaving the client in their position of comfort while feeding them is incorrect. Maintaining an elevated head of bed position (30-45 degrees) is crucial during and after feeding to prevent aspiration, regardless of the client's perceived comfort. A flat or semi-recumbent position increases the risk of regurgitation and subsequent aspiration into the lungs.
Correct Answer is A
Explanation
Choice A rationale
After menopause, the ovaries significantly reduce estrogen and progesterone production. These hormones play a crucial role in maintaining the size and elasticity of breast tissue, including the glandular and fat components. With decreased hormonal support, these tissues atrophy, leading to a reduction in breast volume and a loss of skin elasticity, consequently causing the breasts to sag.
Choice B rationale
While adequate protein intake is essential for overall muscle health, including the pectoral muscles that lie beneath the breasts, it does not directly prevent the atrophy of glandular and fat tissue within the breasts that occurs due to hormonal changes after menopause. Therefore, a high-protein diet alone will not counteract breast sagging caused by these physiological changes.
Choice C rationale
The breasts themselves do not contain significant amounts of muscle tissue. The support for the breasts comes primarily from Cooper's ligaments, which are connective tissues, and the skin's elasticity. Sagging is mainly attributed to the weakening of these supportive structures and the atrophy of glandular and fat tissue after menopause, not a decrease in muscle mass within the breast.
Choice D rationale
Breast sagging after menopause is a common physiological change experienced by many women, regardless of their breast size. While larger breasts may appear to sag more noticeably due to their weight, the underlying cause is hormonal changes affecting tissue elasticity and volume, which occurs in women with all breast sizes.
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