Roth 10e NCLEX Chapter 21

MULTIPLE CHOICE 1. A cancer client is having trouble eating and has not kept up with the prescribed diet for a

week. The nurse wants to help the client increase quantity and quality of eating. Which strategy would be most beneficial for the nurse to use to help the client improve eating habits? a. Attempt to convince the client to eat c. Offer food to the client directly after later at night, since appetites of cancer treatment as a mood-enhancer clients are typically heightened at night. b. Encourage the client to eat foods they d. Remind the client of their need to eat, enjoy, and attempt to get their family since they may be focused on other and friends to bring some of those things too often foods to them
ANS: B

Sometimes clients will be willing to eat foods that are brought from home. Encourage him or her to eat foods he or she enjoys.
PTS: 1 REF: Considerations for the Health Care Professional; Nutritional Care of the Client 2. A client who was recently diagnosed with cancer is curious as to what to expect in regards to

diet. The client is expecting to be told to reduce caloric intake because of the cancer, but is not sure why. The nurse should respond to this expectation by saying it is _____ because _______________________.
a. Accurate; increasing caloric intake will c. Inaccurate; the client will need an

simply feed the cancer cells, which is not desired

b. Accurate; it would be a waste to

prescribe high caloric intake since the client wont be hungry

ANS: C

increased caloric intake because of a higher metabolic rate and loss of nutrients due to the cancer d. Inaccurate; the client will not be prescribed any change in diet

The nutrient and calorie needs of the cancer client are actually greater than they were before the onset of the disease. The cancer causes an increase in the metabolic rate, tissue must be rebuilt, and the nutrients lost to the cancer must be replaced.
PTS: 1 REF: Nutritional Care of the Cancer Client

3. After undergoing multiple treatments for cancer, the client begins to describe some side

effects to the nurse. Knowing that the treatment underwent by the client was ______, the nurse would most likely expect the side effects described by the client to be _____________________.
a. Chemotherapy; bowel obstruction and c. Radiation; nausea and fluid retention

dry mouth b. Chemotherapy; difficulty swallowing and tooth decay

ANS: D

d. Radiation; tooth decay and tooth loss

Radiation of the head or neck can cause a decrease in salivary secretions, which causes dry mouth and difficulty in swallowing. This reduction in saliva also causes tooth decay and sometimes the loss of teeth.
PTS: 1 REF: The Treatment of Cancer

4. A client who has previously been diagnosed with cancer and who has been undergoing

treatment is now concerned about problems with tasting foods. The client states this problem to the nurse, who subsequently describes to the client that there are many changes in taste that can be associated with cancer. Therefore, the nurse told the client that it was necessary to specify the change in taste in order to determine the potential cause. If the client described the problem as _______, the nurse would likely tell the client that this change was due to __________.
a. Everything tasting the same; the c. Food tasting too sweet; the destruction clients indifference toward food from of taste buds that comes with many experiencing stress cancers b. Experiencing a metallic taste when d. Foods tasting different than normal; eating chicken; chemotherapy nutritional imbalance ANS: B

Cancer clients, after chemotherapy, may experience a metallic taste when eating protein foods.
PTS: 1 REF: The Effects of Cancer

5. After being asked about the relationship between food and cancer, the nurse illustrates the

importance of the notion of moderation to the clients diet in order to help prevent risk of cancer. Which of the following statements would be most appropriate for the nurse to say to the client in regards to moderation in their diet?
a. Excessive intake of carcinogenic foods c. It is necessary to consume vitamins in

moderation, but one should eliminate carcinogenic foods completely from their diets if possible b. It is important to consume all types of d. One should only attend to moderation food in moderation, including in regards to carcinogenic foods potentially carcinogenic as well as vitamin-rich foods
ANS: B

can be harmful, but there is no such thing as excessive intake of vitamins

The most important principle is moderation. An occasional serving of bacon or buttered popcorn or wine is not likely to cause cancer, but the regular, excessive use of carcinogenic foods may contribute to cancer. Vitamins that are thought to prevent cancer should be ingested in foods that naturally contain them. Excessive intake of vitamin supplements can be harmful.
PTS: 1 REF: Relationships of Food and Cancer

6. A client who has recently been screened for cancer is nervous about how their diet might be

associated with cancer risk. The client asks the nurse what in their diet might be associated with cancer, one example the nurse could provide might be _____, which are associated with _______________.
a. cured and smoked foods such as c. high-fiber foods; protection against

bacon; cancers of the lungs and bladder b. high-fat foods; cancers of the mouth and esophagus
ANS: D

cancers of the stomach and esophagus

d. high volumes of calories; cancers of

the gall bladder

Cured and smoked foods such as bacon and ham can be associated with cancers of the stomach and esophagus. High-fat diets have been associated with cancers of the uterus, breast, prostate, and colon. The regular, excessive intake of calories is associated with cancers of the gallbladder and endometrium. It is thought that diets high in fiber help to protect against colorectal cancer.
PTS: 1 MULTIPLE RESPONSE REF: Relationships of Food and Cancer

After being notified about the need for nine or more servings of fruits and vegetables each day, the cancer client asks the nurse why so many fruits and vegetables are needed in the diet. Which of the following reasons would be appropriate for the nurse to give to the client? Select all that apply.

a. Clients are less likely to form an

d. Some fruits and vegetables are rich in

aversion to fruits and vegetables since they exist naturally

b. Fruits and vegetables are very high-

vitamin-C, which may protect against cancers of the stomach and esophagus
e. Some vegetables and fruits are rich in

calorie foods and are necessary for energy

c. Fruits and vegetables contain

phytochemicals, which are thought to be anticarcinogenic agents

vitamin-A, which may protect against cancers of the lung, bladder, and larynx f. The proteins that come from fruit and vegetable seeds are the ideal proteins for cancer clients

ANS: C, D, E

Diets containing sufficient amounts of vitamin C-rich foods may protect against cancers of the stomach and esophagus. Diets containing sufficient carotene and vitamin A-rich foods may protect against cancers of the lung, bladder, and larynx. Phytochemicals, substances that occur naturally in plant foods, are thought to be anticarcinogenic agents. Examples include flavonoids, phenols, and indoles, and fruits and vegetables appear to have an abundance of them.
PTS: 1 NUMERIC RESPONSE 1. A client who has cancer has not been eating the appropriate quantities of calories or nutrients REF: Relationships of Food and Cancer

for awhile because of an aversion to food that came with chemotherapy treatments. Over time, the client has become malnourished, and the clients dietician has come up with a new diet to combat this. If the nurse recently weighed the client as 68 kilograms, how many grams of protein per day maximum should the nurse expect to provide the client in order to provide energy and spare protein for tissue building and the immune system?
ANS: 136 Rationale: Clients with good nutritional status will need from 1.0 to 1.2 grams of protein per

kilogram of body weight a day. Malnourished clients may need from 1.3 to 2.0 grams of protein per kilogram of body weight a day.
PTS: 1 REF: Nutritional Care of the Cancer Client