Diet therapy

Correct answer: C. To reduce fluid retention and cardiac workload

Explanation: In some patients with heart failure, reduced cardiac pumping can cause sodium and water retention, swelling, breathlessness, and increased circulatory workload. Limiting sodium and, when clinically prescribed, fluids can help reduce this retention and support symptom control. The exact restriction must depend on medical assessment, kidney function, medications, and disease severity. Thus, option C is correct.

Correct answer: D. To make swallowing safer and reduce aspiration risk

Explanation: Dysphagia can impair the timing and control of swallowing, allowing thin liquids to enter the airway. Thickened liquids move more slowly and may give some patients better control during swallowing, reducing aspiration risk when prescribed after proper assessment. They are not suitable for everyone and must be selected according to a swallowing evaluation, hydration needs, and professional guidance. Therefore, option D is correct.

Correct answer: A. Checking labels for hidden gluten sources

Explanation: Coeliac disease requires strict avoidance of gluten because wheat, barley, rye, and contaminated products can trigger intestinal injury and symptoms. Gluten may be present in sauces, processed foods, flavourings, or shared equipment, so label reading and prevention of cross-contact are essential. Naturally gluten-free foods still require careful preparation. Hence, checking labels for hidden gluten is the best answer, option A.

Correct answer: B. Calcium and alternative tolerated sources

Explanation: Removing milk can lower calcium intake and may also reduce vitamin D intake, depending on the rest of the diet. A dietitian should assess tolerance because some people can consume yoghurt, hard cheese, or small portions of lactose-containing foods, while others may need fortified lactose-free milk or suitable alternatives. The plan must preserve nutritional adequacy, so option B is correct.

Correct answer: A. Because without energy, protein may be used for energy

Explanation: Burn injury can produce a strong stress response, increasing energy and protein needs for wound healing, immune function, and maintenance of lean tissue. If sufficient energy is not supplied, the body may break down protein for fuel instead of using it to repair damaged tissue. Providing adequate energy therefore has a protein-sparing effect, while the exact prescription requires clinical assessment. Option A is correct.

Correct answer: B. To reduce risk according to digestive tolerance

Explanation: After surgery, gastrointestinal function, motility, and tolerance may recover gradually. Advancing from clear liquids to fuller liquids, soft foods, and a regular diet when appropriate allows the healthcare team to observe nausea, vomiting, bloating, pain, bowel function, and aspiration risk. The progression is individualized rather than automatic, so option B correctly explains its purpose.

Correct answer: C. To reduce vomiting and aspiration risk

Explanation: Positioning the patient appropriately before and during tube feeding supports safer delivery of enteral nutrition. An elevated upper body can help reduce reflux, regurgitation, vomiting, and aspiration of feed into the airway, although the exact position and procedure depend on the tube, patient condition, and institutional protocol. Positioning is only one safety step alongside tube verification and hygienic administration. Therefore, option C is correct.

Correct answer: A. Symptom-triggering foods are not the same for every patient

Explanation: Dietary tolerance varies among people with peptic ulcer symptoms. Spicy, acidic, fatty, caffeinated, or otherwise irritating foods may worsen symptoms for some patients but not for everyone, so unnecessary universal restrictions should be avoided. A dietitian considers the patient’s symptoms, medication, nutritional adequacy, meal pattern, and response to foods. Therefore, individual tolerance makes option A correct.

Correct answer: A. A large portion of a low-index food can still increase total carbohydrate

Explanation: Glycaemic index describes how quickly a carbohydrate-containing food may raise blood glucose compared with a reference food, but it does not show how much carbohydrate is eaten. A large portion of a low-GI food can still provide a substantial carbohydrate load. Diabetes management therefore considers food quality, portion size, total carbohydrate, meal timing, medication, and activity. Hence, option A is correct.

Correct answer: A. To avoid cross-contamination

Explanation: In food allergy, even a small amount of an allergen may trigger symptoms, ranging from itching and hives to breathing difficulty or anaphylaxis. Cross-contact can occur through shared knives, cutting boards, pans, serving spoons, storage containers, or preparation surfaces. Separate utensils, careful cleaning, label reading, and clear communication help reduce this risk. Therefore, option A is correct.

Correct answer: B. Advising the diet according to the stone type and clinical investigations

Explanation: A low-oxalate diet is mainly considered for people who form calcium oxalate stones, and it should not be prescribed blindly for every stone type. Uric-acid, cystine, and infection-related stones may require different dietary measures. Adequate fluids are usually important, so the advice must follow stone analysis, investigations, and professional guidance.

Correct answer: A. One shows body status and the other shows actual intake

Explanation: Laboratory reports provide objective information about body function and nutrient or disease markers, while a dietary history shows what, how much, when, and why the person actually eats. Comparing both helps identify deficiencies, excesses, food-drug issues, adherence problems, and priorities for intervention. Neither source alone gives a complete assessment, so they must be interpreted with clinical findings.

Correct answer: A. When the patient's clinical condition, test results, or weight changes

Explanation: A therapeutic diet is based on the patient’s current clinical and nutritional status. Changes in symptoms, diagnosis, laboratory results, appetite, body weight, kidney function, fluid balance, or treatment can alter the required energy, protein, sodium, potassium, or fluid intake. Therefore, review should occur whenever relevant status changes arise, not merely on a fixed annual date.

Correct answer: A. Identify symptoms and foods that are not tolerated

Explanation: Poor tolerance must first be assessed rather than treated with a universal restriction. The dietitian should ask about symptoms, timing, amount eaten, texture, allergies, and possible trigger foods. This information allows an individualized plan in which portions, consistency, meal frequency, or food choices can be changed safely.

Correct answer: A. Nutritional adequacy, safety, disease control, and adherence

Explanation: A therapeutic diet is successful when it provides enough nutrients, is safe for the patient’s condition, supports the desired clinical outcome, and can actually be followed. Taste and appearance may improve acceptance, but they cannot alone demonstrate nutritional adequacy, disease control, or safety.

Correct answer: A. Provide pancreatic rest while maintaining nutrition support

Explanation: Initial nutrition management in acute pancreatitis aims to reduce symptoms and avoid unnecessary stimulation while preventing malnutrition. The exact route and progression depend on severity, gastrointestinal function, and medical advice; nutrition is advanced as tolerated rather than applying the same severe restriction to every patient.

Correct answer: B. Blood-glucose control and renal nutrient control

Explanation: Diabetic kidney disease combines the nutritional priorities of diabetes and impaired renal function. The plan may need controlled carbohydrate distribution, suitable protein, sodium and sometimes potassium or phosphorus adjustments, while still supplying adequate energy. Laboratory values, kidney stage, medicines, and individual needs must guide the final prescription.

Correct answer: C. Blood-glucose control may become disturbed

Explanation: A large late-night meal can supply more carbohydrate and energy than planned at one time, causing a post-meal glucose rise and making medication-meal coordination more difficult. Regular meal timing, appropriate portions, individualized carbohydrate distribution, and monitoring are more useful than simply banning a food without considering the complete diabetes plan.

Correct answer: D. When ascites or oedema is present

Explanation: Cirrhosis can cause portal hypertension and fluid retention. When ascites or oedema is present, reducing excess dietary sodium may help limit further fluid accumulation as part of the medical plan. It does not mean eliminating all food or water, and the degree of restriction must be individualized according to clinical findings and professional advice.

Correct answer: A. To provide more nutrition when appetite is poor

Explanation: Cancer cachexia may involve reduced appetite, inflammation, weight loss, and loss of muscle tissue. Small, frequent, energy- and protein-dense meals can deliver more nourishment without requiring a large volume of food. The plan should also consider symptoms, treatment effects, tolerance, hydration, and the patient’s preferences rather than relying on sweets alone.

Correct answer: B. High-protein support may be needed during tissue breakdown

Explanation: Severe burns create a hypermetabolic and catabolic state in which body proteins may be broken down, producing negative nitrogen balance. Adequate energy and appropriately increased protein can support immune function, wound healing, and lean-tissue preservation. The exact prescription requires medical and dietetic assessment because renal function and wound status also matter.

Correct answer: A. Some salt substitutes can increase potassium

Explanation: Many salt substitutes replace sodium chloride with potassium chloride. In kidney disease, potassium excretion may be impaired, so unsupervised use can raise blood potassium and cause dangerous cardiac effects. A patient with hypertension and renal disease should check the ingredient label and use a substitute only after professional review of kidney function, medicines, and serum potassium.

Correct answer: A. It can increase digestive discomfort and diarrhoea

Explanation: During severe diarrhoea, the immediate priorities are oral or prescribed rehydration, electrolyte replacement, assessment of severity, and food that is tolerated. A heavy fatty meal may be difficult to digest and can worsen nausea, abdominal discomfort, or stool looseness in some patients. Feeding should not be unnecessarily stopped; foods are reintroduced and advanced according to tolerance and clinical advice.

Correct answer: A. An energy-controlled, low-sodium, balanced diet

Explanation: For obesity, a sustainable reduction in excess energy can support gradual weight loss, while lower sodium intake can help blood-pressure management. The pattern should remain balanced, with vegetables, fruits as appropriate, whole grains, suitable protein, and limited highly processed foods. Individual calorie needs, medicines, comorbidities, and cultural food habits must be considered.

Correct answer: A. The risk of hypoglycaemia may increase

Explanation: Insulin lowers blood glucose according to its dose and timing. If a patient takes insulin but delays or skips the meal that supplies carbohydrate, glucose may fall too low, causing sweating, trembling, dizziness, confusion, or more serious effects. Meal timing must be coordinated with the insulin regimen, monitoring plan, activity, and individualized medical advice.