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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 won’t be hungry
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
ANS: C
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
d. Radiation; tooth decay and tooth loss
and tooth decay
ANS: D
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
client’s 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 client’s 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
can be harmful, but there is no such
thing as excessive intake of vitamins
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
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
bacon; cancers of the lungs and
bladder
b. high-fat foods; cancers of the mouth
and esophagus
c. high-fiber foods; protection against
cancers of the stomach and esophagus
d. high volumes of calories; cancers of
the gall bladder
ANS: D
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
REF: Relationships of Food and Cancer
MULTIPLE RESPONSE
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
aversion to fruits and vegetables since
they exist naturally
b. Fruits and vegetables are very high-
calorie foods and are necessary for
energy
c. Fruits and vegetables contain
phytochemicals, which are thought to
be anticarcinogenic agents
d. Some fruits and vegetables are rich in
vitamin-C, which may protect against
cancers of the stomach and esophagus
e. Some vegetables and fruits are rich in
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
REF: Relationships of Food and Cancer
NUMERIC RESPONSE
1. A client who has cancer has not been eating the appropriate quantities of calories or nutrients
for awhile because of an aversion to food that came with chemotherapy treatments. Over
time, the client has become malnourished, and the client’s 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