Progressive Care Nursing Certification (PCCN) Practice Exam

How should the nurse respond to a student recommending a high-protein diet to a patient with heart failure?

1. This is appropriate due to obesity in heart failure patients

2. Heart failure patients may appear obese but are often malnourished

3. The patient should be advised to decrease protein intake

4. Nutritional counseling should be done by a physician

The correct answer is: Heart failure patients may appear obese but are often malnourished

The response indicating that heart failure patients may appear obese but are often malnourished is correct as it highlights a crucial point about the nutritional status of these patients. In heart failure, particularly in advanced stages, patients can experience a condition known as cachexia, which leads to muscle wasting and, paradoxically, a decrease in overall body protein stores despite an outward appearance that might suggest obesity. This can result from a combination of factors including poor appetite, increased metabolic demands, and fluid retention. Understanding this nuance is essential when considering dietary recommendations. While protein is vital in many diets for maintaining muscle mass and overall health, the needs of heart failure patients can vary significantly. A diet too high in protein may place additional strain on the kidneys and affect fluid status, vital considerations for these patients. In the context of nutrition, a nuanced approach is required for individuals with heart failure. This involves carefully monitoring their overall dietary intake, including not only protein but also sodium and fluid levels, to prevent exacerbation of their condition. Therefore, recognizing the potential for malnutrition in this population is imperative when discussing appropriate dietary strategies.