A 5' 3" (1.6 meter) 113-pound (51.3 kg) client has a lipid profile of total cholesterol 267 mg/dL (6.92 mmol/L), LDL 167 mg/dL (4.33 mmol/L), HDL 85 mg/dL (2.2 mmol/L), triglycerides 79 mg/dL (0.89 mmol/L), and VLDL 16 mg/dL (0.41 mmol/L). Based on these findings, it is most important for the nurse to teach the client to make every effort to completely avoid which foods?

Reference Range

Total Cholesterol [Reference Range: less than 200 mg/dL]

Low Density Lipoproteins (LDL) [Reference Range: less than 130 mg/dL]

High Density Lipoproteins (HDL) [Reference Range: Male: greater than 45 mg/dL or greater than 0.75 mmol/L] Very Low-Density Lipoprotein Cholesterol (VLDL) [Reference Range: 12 to 30 mg/dL or 0.31 to 0.78 mmol/L]

Nuts.

Shellfish.

Eggs.

Cheese.

Answer and Explanation

The Correct Answer is D

Choice A

Nuts is incorrect. Nuts are a good source of healthy fats, including monounsaturated and polyunsaturated fats, which can actually have a positive impact on heart health. They have been associated with improving HDL cholesterol levels and can be a part of a heart-healthy diet. While nuts are calorie-dense, small portions can be included as part of the client's diet to replace less healthy snacks. Therefore, nuts might not need to be completely avoided.

Choice B

Shellfish Is incorrect. Shellfish, including shrimp, crab, and lobster, are relatively low in saturated fat and cholesterol. While they do contain cholesterol, dietary cholesterol has less impact on blood cholesterol levels compared to saturated and trans fats. The client's main concern is elevated LDL cholesterol, which is influenced more by saturated fat intake. Therefore, avoiding shellfish might not be as crucial as focusing on saturated fat sources.

Choice C

Eggs is incorrect. Eggs are a source of dietary cholesterol, but they also provide essential nutrients. Recent research suggests that dietary cholesterol from foods like eggs has less impact on blood cholesterol levels for most people than was previously thought. For the client, the more significant concern is the elevated LDL cholesterol level. If the client enjoys eggs, they might not need to completely avoid them, but they should consume them in moderation and consider other dietary changes to reduce saturated fat intake.

Choice D

Cheese is correct. Cheese is often high in saturated fats, which can contribute to elevated LDL cholesterol levels. Therefore, it would be important for the client to limit their intake of high-fat cheeses.

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Correct Answer is C

Explanation

Choice A

Providing pamphlets about heart-healthy diet selections should not be implemented. Providing information is important, but it might not be as effective if the client is strongly resistant. Engaging in a conversation first can help tailor the information to the client's needs.

Choice B

Referring the client to a dietitian for nutrition education should not be implemented. A dietitian can provide valuable education, but it might be more beneficial to address the client's concerns and resistance before making the referral.

Choice C

Discussing client's concerns about the change in diet should be implemented. When a client is resistant or unwilling to make changes to their diet and lifestyle, it's important for the nurse to engage in open and empathetic communication. Option C, discussing the client's concerns about the change in diet, is the most appropriate initial response.

By engaging in a conversation with the client, the nurse can better understand the client's perspective, reasons for resistance, and potential barriers to making dietary changes. This approach allows the nurse to address the client's concerns, provide information, and work collaboratively to find solutions that might be more acceptable to the client.

Choice D

Suggesting exercise as an alternative to increase HDL levels should not be implemented. Exercise is important for heart health, but it's important to address the client's resistance to dietary changes first. Additionally, dietary changes and exercise can work together to improve overall heart health.

A. 24-hour food recall, food preferences, and allergies. B. Body mass index (BMI) and serum albumin level. C. Triceps skin fold and mid-arm circumference. D. Weight loss history and body surface area (BSA).

Correct Answer is B

Explanation

Choice A

24-hour food recall, food preferences, and allergies is incorrect. While these factors are important for understanding the client's dietary habits and possible dietary restrictions, they do not directly provide information about the client's current nutritional status or overall nutritional health.

Choice B

Body mass index (BMI) and serum albumin level is correct. Body mass index (BMI) and serum albumin level are commonly used parameters to assess a client's nutritional status. These measures provide valuable information about the client's weight, muscle mass, and protein status. Let's break down the options:

Choice C

Triceps skin fold and mid-arm circumference is incorrect. These measurements can provide information about the client's body composition and muscle mass. However, they are not as commonly used as BMI and serum albumin level for assessing nutritional status.

Choice D

Weight loss history and body surface area (BSA) is incorrect. Weight loss history is relevant for understanding changes in the client's weight over time, which can indicate potential malnutrition. However, it's not as comprehensive as BMI, which considers both weight and height. Body surface area (BSA) is not typically used to assess nutritional status.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is C

Explanation

The nurse is admitting an older client with possible malnutrition. Which parameters are most indicative of the client's nutritional status?

Correct Answer is B

Explanation

A female client with haemorrhoids tells the nurse that she understands the need to avoid eating nuts and seeds to prevent inflammation. How should the nurse respond?

A client with glomerulonephritis is preparing for discharge and asks the nurse which kind of diet to follow upon returning home. Which dietary teaching should the nurse include in the discharge instructions?

A client who is training for a first marathon arrives at the clinic reporting an increase in the frequency of leg cramps. Which recommendation should the nurse provide to help decrease the frequency of leg cramps?

When conducting diet teaching for a client diagnosed with hypokalaemia, which foods should the nurse encourage the client to eat?

A client is receiving a continuous gastric tube feeding at 80 mL/hour. The nurse records the client's gastric residual volume as 325 mL during each of two consecutive hourly measurements. What assessment should the nurse complete before contacting the healthcare provider?

While caring for a client receiving total parenteral nutrition (TPN), it is most important for the nurse to monitor which of the client's lab values?