A nurse is providing dietary teaching to a client who has a new diagnosis of gastroesophageal reflux disease. Which of the following foods or beverages should the nurse recommend to minimize heartburn?

Correct Answer: D

Rationale: The correct answer is D: Potatoes. Potatoes are bland and less likely to relax the lower esophageal sphincter, making them a good choice for minimizing heartburn in clients with GERD. Choices A, B, and C are incorrect. Orange juice and peppermint can exacerbate GERD symptoms due to their acidic or relaxing effects on the esophageal sphincter. Decaffeinated coffee, although lower in caffeine, is still acidic and can trigger heartburn in individuals with GERD.

Correct Answer: D

Rationale: The correct answer is D. A weight loss of 2.7 kg in four weeks indicates effective adherence to a nutritional plan aimed at reducing body mass index (BMI), moving towards a healthier weight. Choices A, B, and C are incorrect because a decrease in weight is expected for a client with a BMI of 30 undergoing nutritional counseling for weight management, rather than an increase in weight or BMI.

Correct Answer: B

Rationale: In the context of caring for a client who follows the dietary laws of Orthodox Judaism, the nurse should request spaghetti with tomato sauce as the meal choice. This is because Orthodox Judaism prohibits the consumption of pork and pork products (as in option C), and bacon is a pork product (option D). Additionally, mixing meat and dairy products is also prohibited, making the turkey and cheese sandwich (option A) inappropriate. Educationally, understanding cultural and religious dietary practices is crucial for healthcare providers to deliver culturally competent care. By respecting and adhering to a client's dietary restrictions based on their beliefs, healthcare professionals can promote trust, respect, and overall well-being in the patient-provider relationship. This scenario highlights the importance of considering and honoring diverse dietary needs and preferences to provide holistic and patient-centered care.

Correct Answer: D

Rationale: In this scenario, option D, "Offer finger foods at mealtime," is the most appropriate intervention to promote increased food intake for an older adult client in a long-term care facility. Finger foods are easy to eat and can help enhance the client's appetite by providing a variety of textures and flavors. This approach is especially beneficial for individuals who may have difficulty with utensils or decreased oral motor skills. Option A, "Offer sugar substitutes to increase the client's appetite," is incorrect because sugar substitutes do not directly impact appetite or food intake. In fact, some sugar substitutes may have a negative impact on overall health, especially for older adults with specific dietary needs. Option B, "Provide opportunities to eat three large meals per day," is not ideal for older adults who may have reduced appetites or difficulty consuming large meals. Smaller, more frequent meals or snacks throughout the day are often more manageable and can help maintain adequate nutrient intake. Option C, "Provide entertainment while the client is eating," is not the most effective intervention for promoting increased food intake. While a pleasant dining environment can enhance the dining experience, it may not directly address the client's specific needs related to food intake. In an educational context, it is crucial for nurses working with older adult clients to understand the importance of individualized care when developing strategies to promote nutrition. Considering factors such as physical limitations, cognitive abilities, and personal preferences can help tailor interventions to best support each client's nutritional needs and overall well-being.

Correct Answer: D

Rationale: In this scenario, the correct answer is D) A client who has colon cancer and will undergo a hemicolectomy. Total parenteral nutrition (TPN) is indicated for clients who are unable to meet their nutritional needs orally or enterally. After a hemicolectomy, the client may have difficulty tolerating oral intake initially due to bowel rest or complications, making TPN necessary to provide essential nutrients. Option A is incorrect because a client post laminectomy with IV PCA typically does not require TPN unless there are significant complications affecting their ability to take nutrition orally or enterally. Option B is incorrect as dysphagia alone does not warrant TPN; alternative feeding methods like modified diets or enteral feedings are usually attempted first. Option C is also incorrect as COPD and home oxygen therapy do not directly indicate the need for TPN unless there are other complications preventing adequate oral intake. Educationally, this question highlights the importance of understanding when TPN is appropriate and the necessity to assess each client's individual nutritional needs based on their condition and treatment plan. It reinforces the nurse's role in providing optimal nutrition support to promote recovery and well-being in patients undergoing surgical procedures.