An active male patient who weighs 180 lb (81.65 kg) has undergone dietary instruction. The patient reports that his current diet consists of 60 g of fat, 200 mg of cholesterol, and 5 g of sodium per day. What should a nurse advise the patient to do?

1. A

   Increase his cholesterol

2. B

   Increase his sodium

3. C

   Decrease his cholesterol

4. D

   Decrease his sodium

Appeared in: NCL (MP) Nursing Officer - 2019

Explanation

• The patient's reported sodium intake is 5 grams per day, which is equivalent to 5000 mg.
• Health guidelines recommend limiting sodium intake to no more than 2,300 mg per day for most adults, with an ideal limit of 1,500 mg for many.
• The patient's intake is more than double the recommended upper limit, significantly increasing his risk for hypertension and cardiovascular disease.
• In contrast, his cholesterol intake of 200 mg/day is within the recommended limit of less than 300 mg/day, making sodium the clear priority for intervention.

Why Other Options Were Wrong

• Option A: The patient's cholesterol intake of 200 mg/day is within the healthy limit of less than 300 mg/day. Increasing it would be detrimental to cardiovascular health.
• Option B: This is dangerous advice as the patient's sodium intake is already more than double the recommended upper limit of 2,300 mg/day.
• Option C: While a lower cholesterol intake is generally not harmful, the patient's current level of 200 mg/day is acceptable. The immediate and most significant health risk is the excessive sodium intake, making it the priority.

Related Visual

Clinical Relevance

• Nursing practice connection: Knowing Dietary recommendations for sodium and cholesterol intake in adults helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
• Patient education on diet is a core nursing function for the primary prevention of cardiovascular disease.
• Nurses must be able to quickly identify the most critical dietary risk factor from a patient's history to prioritize teaching and interventions.
• A key nursing intervention is teaching patients how to read food labels to identify high-sodium foods (e.g., processed meats, canned soups, frozen dinners) and choose fresh, whole foods instead.

How to Approach the Question

• First, identify the key values provided in the clinical scenario: the patient's cholesterol intake (200 mg) and sodium intake (5 g).
• Convert all units to be consistent for comparison. Note that 1 gram = 1000 milligrams, so 5 g of sodium is 5000 mg.
• Recall the standard recommended daily limits for a healthy adult: Sodium should be less than 2,300 mg/day, and cholesterol should be less than 300 mg/day.
• Compare the patient's intake to the recommended limits. Cholesterol (200 mg) is within the limit. Sodium (5000 mg) is significantly over the limit.
• Based on this comparison, identify the most pressing dietary issue. The excessive sodium intake poses the greatest immediate health risk.
• Evaluate the given options and select the one that addresses this priority issue, which is to decrease sodium intake.

Concept Tested & Keywords

• Concept Tested: Dietary recommendations for sodium and cholesterol intake in adults.
• Stem keywords: active male patient, dietary instruction, 200 mg of cholesterol, 5 g of sodium
• Lead-in keywords: advise
• Clinical cues: Age/sex group narrows the expected diagnosis, intervention, or normal reference range.

Question ID

QuJTpiqrAm8bhjTEub805i

Copy ID

Reference Book

E6 Nutrition Kumud Khanna 2e p. 300-302