A client with celiac disease selects a bowl of oatmeal with fresh fruit and skim milk, grapefruit juice, and coffee from the breakfast menu. Which action is most important for the nurse to implement?
Advise the client that too much fruit can irritate the colon.
Inform the client that oatmeal contains gluten.
Commend the client for selecting fat free milk.
Encourage the client to choose decaffeinated coffee.
The Correct Answer is B
Choice A
Advising the client that too much fruit can irritate the colon is not the right choice. While it's true that excessive consumption of certain fruits can cause gastrointestinal discomfort, this information is not directly related to celiac disease or the selected meal.
Choice B
Informing the client that oatmeal contains gluten is the right choice. Celiac disease is an autoimmune disorder in which consuming gluten, a protein found in wheat, rye, and barley, triggers an immune response that damages the small intestine. Oatmeal itself is naturally gluten-free, but it is often processed in facilities that also process gluten-containing grains, which can lead to cross-contamination. Therefore, it's important for individuals with celiac disease to choose certified gluten-free oats to avoid adverse reactions.
Choice C
Commending the client for selecting fat-free milk is not the best choice. While choosing a healthier milk option is beneficial for overall health, it is not the most important action in this situation, considering the client's celiac disease.
Choice D reason;
Encouraging the client to choose decaffeinated coffee is not the right choice. The choice of caffeinated or decaffeinated coffee is a matter of preference and is not directly related to celiac disease or the potential for gluten exposure from the oatmeal.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A
Urinary ketones are not most important. Monitoring urinary ketones can provide information about the utilization of glucose and fat as energy sources. However, it is not the primary lab value to monitor in TPN administration.
Choice B
Serum protein is not most important. Monitoring serum protein levels is important to assess nutritional status, but it might not be as immediate a concern as serum osmolarity.
Choice C
Serum osmolarity is the most important. When caring for a client receiving total parenteral nutrition (TPN), monitoring serum osmolarity is most important. TPN is a highly concentrated solution containing various nutrients, and it is infused directly into the bloodstream. Serum osmolarity reflects the concentration of particles (such as electrolytes, glucose, and other solutes) in the blood. Monitoring serum osmolarity is crucial to prevent complications related to fluid and electrolyte imbalances that can arise from the administration of TPN.
Choice D
Capillary glucose is not the most important. Monitoring capillary glucose levels is important, especially in clients receiving TPN with added glucose. Hyperglycaemia is a potential complication of TPN. While glucose monitoring is important, it is secondary to monitoring serum osmolarity, which encompasses a broader range of solute concentrations.

Correct Answer is ["B","D","E"]
Explanation
Choice A
Pickles, blackberries, seeds are not appropriate. None of these foods are particularly high in calcium. Pickles and blackberries are not significant sources of calcium, and while some seeds contain calcium, they are not among the best sources.
Choice B
Buttermilk, spinach, milk: These foods are good sources of dietary calcium is appropriate. Milk and buttermilk are commonly consumed dairy products that contain calcium. Spinach, while not as high in calcium as dairy products, still contributes to calcium intake.
Choice C
Pickled olives, spam, nuts are not appropriate. These foods are not known for being high in calcium. Additionally, some foods like pickled olives and spam may have high sodium content, which can affect calcium balance.
Choice D
Fresh meats, fresh turkey, fresh chicken is appropriate. Fresh meats, such as turkey and chicken, provide some calcium, although not as much as dairy products. They also contribute to overall nutritional intake.
Choice E
Cheese spread, processed cheese, cheese is appropriate. Dairy products like cheese, especially processed cheese and cheese spread, are good sources of calcium. They can be effective in increasing calcium intake to address hypocalcaemia.

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