ATI Nutrition Practice Questions

A nurse is administering a continuous tube feeding at 60 mL/hr with 50 mL of water every 4 hr. What should the nurse document as the total mL of enteral fluid administered during the 8 hr shift? (Round the answer to the nearest whole number. Do not use a trailing zero.)

580 mL

A nurse is calculating the daily protein allowance of a client who weighs 176 lb. The client's daily protein allowance is 0.8 g/kg. How many grams of protein should the client consume per day? (round your answer to the dearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

64 g

A nurse is performing a cultural nursing assessment for a client whose religious practices include fasting 1 day each week. Which of the questions should the nurse ask the client? (Select all that apply.) A. "Are you exempt from fasting during illness?" B. "Does fasting mean refraining from drinking liquids?" C. "Does your fasting occur during certain hours of the day?" D. "Is vegetarianism a form of fasting?" E. "Does fasting mean eating only a certain type of food?"

A. "Are you exempt from fasting during illness?" B. "Does fasting mean refraining from drinking liquids?" C. "Does your fasting occur during certain hours of the day?" E. "Does fasting mean eating only a certain type of food?"

A nurse is providing information regarding breastfeeding to the parents of a newborn. Which of the following statements should the nurse make? A. "Breast milk is nutritionally complete for an infant up to 6 months of age." B. "Iron-fortified infant formulas are nutritionally inferior to breast milk." C. "Supplemental water is needed to provide an adequate fluid intake." D. "Use whole cow's milk if you discontinue breastfeeding in the first year."

A. "Breast milk is nutritionally complete for an infant up to 6 months of age." Explanation: A. Breast milk is nutritionally complete to support growth and development of newborns and infants. B. Iron-fortified infant formula is an acceptable substitute for or supplement to breastfeeding. C. Both breast milk and formula provide an adequate water-to-calorie ratio to meet the needs of newborns and infants. D. The introduction of cow's milk should be delayed until after the age of 1 year.

A nurse is caring for a client who has cirrhosis and ascites. Which of the following dietary instructions should the nurse provide for this client? A. "Decrease your sodium intake to 1 to 2 grams per day." B. "Increase your daily fluid intake to 3 liters per day." C. "Consume 0.5 grams per kilogram of protein per day." D. "Eliminate foods that contain vitamin K."

A. "Decrease your sodium intake to 1 to 2 grams per day." Explanation: A. To decrease fluid retention, a client who has cirrhosis should limit their daily sodium intake to 2,000 mg. B. To decrease fluid retention, a client who has cirrhosis should limit fluid intake to 1.5 L per day, depending on sodium levels. C. To prevent malnutrition, a client who has cirrhosis should consume 0.8 to 1.2 g/kg of protein daily. D. Vitamin K is an essential factor in blood coagulation. Clients who have cirrhosis have a decreased production of prothrombin, which increases their risk for bleeding. Because an adequate vitamin K supply depends on dietary intake, a client who has cirrhosis should consume foods that contain vitamin K.

A nurse is teaching a client who has a prescription for ferrous sulfate about food interactions. Which of the following statements indicates that the client understands the teaching? A. "I can take this medication with juice." B. "I can take this medication with my eggs at breakfast." C. "I will drink low-fat milk when taking this medication." D. "I will take this medication with my coffee."

A. "I can take this medication with juice." Explanation: A. The nurse should instruct the client to take this medication between meals with juice. The client can take this medication with meals if gastric upset occurs. B. The nurse should instruct the client that eggs can interfere with the absorption of this medication. C. The nurse should instruct the client that milk decreases absorption of this medication. D. The nurse should instruct the client that caffeine decreases absorption of this medication.

A nurse in an antepartum clinic is teaching a client about nutritional recommendations during pregnancy. Which of the following client statements indicates an understanding of the teaching? A. "I should take a daily iron supplement during my pregnancy." B. "I should decrease protein intake during my pregnancy." C. "I should plan to gain at least 50 pounds during my pregnancy." D. "I should increase my fat intake during the first trimester of my pregnancy."

A. "I should take a daily iron supplement during my pregnancy." Explanation: A. Clients who are pregnant should take 30 mg of iron supplementation daily to reduce the risk for iron-deficiency anemia. B. The client should increase protein intake during pregnancy. C. Recommendations for weight gain during pregnancy are based on pre-pregnancy BMI. Clients who are underweight prior to pregnancy should gain a maximum of 40 lb during pregnancy, and these recommendations decrease for clients who are of normal weight, overweight, or obese. D. The client should reduce fat intake during their entire pragnancy.

A nurse is providing teaching about cancer prevention to a group of clients. Which of the following client statements indicates an understanding of the teaching? A. "I will eat five servings of fruits and vegetables each day." B. "I should limit my alcohol intake to a maximum of three drinks daily." C. "I should eat more refined wheat and oat products." D. "I will eat processed meats to achieve my required protein intake."

A. "I will eat five servings of fruits and vegetables each day." Explanation: A. The nurse should instruct the clients to consume four to five servings, or about 2.5 cups, of fruits and vegetables daily. Eating various fruits and vegetables assists in decreasing blood pressure and weight. B. The nurse should instruct the clients to limit their daily intake of alcohol to one to two drinks per day. Alcohol can cause excessive weight gain, as well as increase the risk for certain types of cancer, such as esophageal, liver, pancreatic, and breast cancer. C. The nurse should instruct the clients to choose whole grain foods over refined foods to prevent gastrointestinal cancers and to help maintain a healthy weight. Whole grain foods that are unrefined contain fiber that increases the feeling of fullness and contributes to a lower total cholesterol level. D. The nurse should instruct the clients to limit their consumption of processed meats because they contain increased amounts of sodium and are high in saturated and trans fats. The nurse should instruct the clients to choose lean cuts of poultry and meats without the skin, such as chicken breasts and fish prepared without hydrogenated oil.

A nurse is teaching a client about stress management. Which of the following statements by the client indicates an understanding of the teaching? A. "I will take a long walk every evening." B. "I will keep a daily diet and activity log." C. "I will avoid eating 1 hour before bedtime." D. "I will drink a full glass of water with each meal."

A. "I will take a long walk every evening." Explanation: A. Exercise has many benefits, including reduction of tension, promotion of relaxation, and improved sense of well-being. All of these will assist the client in stress management. B. Keeping a daily diet and activity log increases awareness of eating patterns and will assist the client to identify needed changes, but it will not reduce the client's stress. C. The client should avoid eating 2 to 3 hr before bedtime to promote sleep and reduce stress. D. Drinking a full glass of water with each meal will promote a feeling of fullness but will not reduce stress.

A nurse is providing dietary instructions for a client who has a prescription for warfarin. Which of the following foods should the nurse recommend the client eat in moderation while taking this medication? A. Leafy green vegetables B. Whole grains C. Fruits with skin D. Nuts and seeds

A. Leafy green vegetables Explanation: A.

A nurse is teaching a client who has chronic kidney disease about limiting dietary calcium intake. Which of the following food choices should the nurse include in the teaching as having the highest amount of calcium? A. 1 cup low-fat yogurt B. 1 oz cheddar cheese C. 1 egg D. ½ cup spinach

A. 1 cup low-fat yogurt Explanation: A. The nurse should determine that low-fat yogurt contains 314 mg of calcium per cup, which is the highest amount of calcium; therefore, the client should limit low-fat yogurt in the diet. B. The nurse should recommend a different food item to limit because there is another choice that contains more calcium. Cheddar cheese contains 214 mg of calcium per ounce. C. The nurse should recommend a different food item to limit because there is another choice that contains more calcium. One egg contains 25 mg of calcium. D. The nurse should recommend a different food item to limit because there is another choice that contains more calcium. Spinach contains 122 mg of calcium per half cup.

A nurse is assessing a client who has type 2 diabetes mellitus. The nurse should recognize which of the following as a manifestation of hypoglycemia? A. Confusion B. Polydipsia C. Vomiting D. Ketonuria

A. Confusion Explanation: A. The nurse should recognize confusion as a manifestation of hypoglycemia. B. The nurse should recognize polydipsia as a manifestation of hyperglycemia. C. The nurse should recognize vomiting as a manifestation of hyperglycemia. D. The nurse should recognize ketonuria as a manifestation of hyperglycemia.

A nurse is teaching a client about measures to reduce the risk of osteomalacia. Which of the following instructions should the nurse include in the teaching? A. Consume 20 mcg of vitamin D daily. B. Avoid foods with copious amounts of antioxidants. C. Increase intake of foods high in purine. D. Take 150 mg vitamin E daily.

A. Consume 20 mcg of vitamin D daily. Explanation: A. The nurse should instruct the client to consume 20 mcg of vitamin D daily. Osteomalacia is characterized by a lack of vitamin D, which leads to insufficient bone mineralization. This disorder coincides with osteoporosis, thereby increasing the risk of falls leading to fractures in older adult clients. Vitamin D supplements are recommended for clients age 65 and older to decrease bone loss and maintain bone mineralization, thereby reducing the risk of a softening of the bones. B. The nurse should instruct the client to eat foods rich in antioxidants. Antioxidants protect cells from being destroyed by free radicals. Antioxidants include vitamins C, E, and beta-carotene. However, eating foods with copious amounts of antioxidants have not been shown to reduce the risk of osteomalacia. Osteomalacia is characterized by a lack of vitamin D which leads to insufficient bone mineralization. This disorder coincides with osteoporosis, thereby increasing the risk of falls leading to fractures in older adult clients. C. The nurse should instruct a client who has gout to decrease intake of foods that contain purine, such as organ meats and certain types of seafood. These foods increase uric acid levels, which exacerbate the possibility of an acute attack. Osteomalacia is characterized by a lack of vitamin D which leads to insufficient bone mineralization. This disorder coincides with osteoporosis, thereby increasing the risk of falls leading to fractures in older adult clients. D. The recommended dose of vitamin E is 15 mg per day. Vitamin E is an antioxidant that protects the lungs and RBCs but does not reduce the risk of developing osteomalacia. In large amounts, it can decrease platelet aggregation, which can interfere with blood clotting in older adult clients. Osteomalacia is characterized by a lack of vitamin D which leads to insufficient bone mineralization. This disorder coincides with osteoporosis, thereby increasing the risk of falls leading to fractures in older adult clients.

A nurse is providing teaching to a client who has dumping syndrome and is experiencing weight loss. Which of the following instructions should the nurse include in the teaching? A. Consume liquids between meals. B. Increase intake of simple carbohydrates. C. Decrease foods high in fat content. D. Eat meals low in protein.

A. Consume liquids between meals. Explanation: A. The nurse should teach the client to drink liquids between meals to slow movement of food from the stomach. B. The nurse should teach the client that complex carbohydrates are better tolerated than simple carbohydrates. C. The nurse should teach the client that high-fat foods are not a cause of dumping syndrome. D. The nurse should teach the client that a high-protein diet is not a cause of dumping syndrome and can improve anemia.

A nurse is caring for a client who is receiving total parenteral nutrition (TPN). The current bag of TPN is empty and a new bag is not available on the unit. Which of the following solutions should the nurse infuse until a new bag of TPN is available? A. Dextrose 10% in water B. 0.45% sodium chloride C. Dextrose 5% in lactated Ringer's D. 0.9% sodium chloride

A. Dextrose 10% in water Explanation: A. The nurse should administer dextrose 10% in water at the same rate as the TPN to prevent hypoglycemia. B. Infusing 0.45% sodium chloride when TPN is not available will not prevent adverse effects associated with abruptly stopping the TPN infusion. C. Infusing dextrose 5% in lactated Ringer's when TPN is not available will not prevent adverse effects associated with abruptly stopping the TPN infusion. D. Infusing 0.9% sodium chloride when TPN is not available will not prevent adverse effects associated with abruptly stopping the TPN infusion.

A nurse is assessing a client who has diabetes mellitus. Which of the following findings should the nurse identify as a manifestation of hypoglycemia? A. Diaphoresis B. Bradycardia C. Abdominal cramps D. Acetone breath

A. Diaphoresis Explanation: A. The nurse should identify that diaphoresis, irritability, and tremors are manifestations of hypoglycemia. B. The nurse should identify that tachycardia as well as hunger are manifestations of hypoglycemia. C. The nurse should identify that abdominal cramps as well as nausea and vomiting are manifestations of hyperglycemia. D. The nurse should identify that breath with a fruity odor, also known as acetone breath, as well as rapid shallow breathing are manifestations of hyperglycemia.

Which of the following should a client avoid when on a low-residue diet? (Select all that apply). A. Fatty meats B. High-fiber foods C. Vegetables D. Whole grains E. Poached eggs.

A. Fatty meats B. High-fiber foods D. Whole grains Explanation: A low-residue diet limits the amount of stool traveling through the intestinal tract. The client should avoid whole grains, fatty meats, and high-fiber foods.

A nurse is assessing a client who is suspected of having lactose intolerance. Which of the following is an expected finding? A. Flatulence B. Bloody stools C. Hyperemesis D. Steatorrhea

A. Flatulence Explanation: A. Flatulence, bloating, and cramping, and diarrhea are expected findings associated with lactose intolerance. B. Bloody stools is not a finding associated with lactose intolerance. C. Hyperemesis is not a finding associated with lactose intolerance. D. Steatorrhea, the excretion of large quantities of fat in the stool, is not a finding associated with lactose intolerance.

A nurse is reviewing the laboratory results of a client who is receiving continuous total parenteral nutrition. Which of the following results should the nurse report to the provider? A. Glucose 238 mg/dL B. Potassium 4.7 mEq/L C. Calcium 9.8 mg/dL D. Sodium 140 mEq/L

A. Glucose 238 mg/dL Explanation: A. This laboratory finding is above the expected reference range for casual glucose and requires reporting to the provider. B. A potassium level of 4.7 mEq/L is within the expected reference range of 3.5 to 5.0 mEq/L and does not require reporting to the provider. C. A calcium level of 9.8 mg/dL is within the expected reference range of 9.0 to 10.5 mg/dL and does not require reporting to the provider. D. A sodium level of 140 mEq/L is within the expected reference range of 136 to 145 mEq/L and does not require reporting to the provider.

A nurse is caring for a client who has acute inflammatory bowel disease. Which of the following nutritional supplements should the nurse anticipate providing to this client? A. Hydrolyzed formula B. Polymeric formula C. Milk-based supplement formula D. Modular product supplement formula

A. Hydrolyzed formula Explanations: A. Hydrolyzed or elemental formula provides protein and other nutrients in their simplest form, requiring little or no digestion and decreasing stimulation of the bowel. This type of formula is beneficial for clients who have impaired digestion due to conditions such as inflammatory bowel disease. B. Polymeric formula contains complex nutrient molecules and is not indicated for clients who have impaired digestion. C. Milk-based supplemental formulas contain lactose and are poorly tolerated by clients who have inflammatory bowel disease. D. Modular formulas are intended to increase the intake of a specific nutrient without increasing volume; they are not intended for clients who have impaired digestion.

A nurse is caring for an adolescent who has type 1 diabetes mellitus. Which of the following actions should the nurse take to assess for Somogyi phenomenon? A. Monitor blood glucose levels during the night. B. Check for urinary ketones at the same time each day for 1 week. C. Perform an oral glucose tolerance test after administering a dose of insulin. D. Compare current glycosylated hemoglobin level with the level at time of diagnosis.

A. Monitor blood glucose levels during the night. Explanation: A. Somogyi phenomenon is fasting hyperglycemia that occurs in the morning in response to hypoglycemia during the nighttime. The nurse should assess for this phenomenon by monitoring blood glucose levels during the night. B. The nurse's assessment of urinary ketones at the same time each day for 1 week is not an effective method of assessing for Somogyi phenomenon. Testing for urinary ketones occurs when a client is experiencing diabetic ketoacidosis. C. The nurse's administration of an oral glucose tolerance test after administering a dose of insulin is not an effective method of assessing for Somogyi phenomenon. D. The nurse's comparison of the current glycosylated hemoglobin level with the level at time of diagnosis is not an effective method of assessing for Somogyi phenomenon. Glycosylated hemoglobin levels are tested to diagnose diabetes and measure compliance and therapeutic effect of a client's diabetic regimen.

A nurse is caring for a client who is receiving continuous enteral tube feedings. Which of the following actions should the nurse take to prevent aspiration? A. Monitor gastric residuals every 4 hr. B. Maintain elevation of the head of the client's bed at 15°. C. Confirm proper tube placement by radiograph every 24 hr. D. Flush tubing with 30 mL of water before and after medications.

A. Monitor gastric residuals every 4 hr. Explanation: A. The nurse can identify delayed gastric emptying by monitoring gastric residuals regularly. Delayed gastric emptying places the client at risk for aspiration and can necessitate a decrease in the feeding rate. B. The head of the client's bed should be elevated to between 30º and 45° during the feeding and for at least 1 hr afterward. C. Confirmation of proper tube placement by radiograph should take place before initiating enteral tube feedings. It is not necessary to confirm placement again unless there is an indication that the tube has become displaced. D. Flushing the tube with 30 to 50 mL of water before and after medication administration helps maintain tube patency but does not help prevent aspiration.

A nurse is caring for a group of clients. A client who has which of the following conditions has an increased protein requirement? A. Pressure injury B. Early-stage renal disease C. Coronary artery disease D. Peptic ulcer

A. Pressure injury Explanation: A. A client who has a pressure injury needs additional protein to promote healing. B. Clients who have early-stage renal disease are often advised to reduce the amount of protein in their diet due to impaired kidney function. C. Clients who have coronary artery disease do not have a need for increased protein in their diet. D. Clients who have peptic ulcer disease do not have a need for increased protein in their diet.

A nurse is planning dietary interventions for a client who is prescribed external radiation for laryngeal cancer. The client reports manifestations of stomatitis. Which of the following interventions should the nurse include? A. Provide meals at room temperature. B. Offer the client additional seasonings for food. C. Instruct the client to eat citrus fruits at the beginning of the meal. D. Encourage the client to drink warm tomato juice in place of high-protein supplements.

A. Provide meals at room temperature. Explanation: A. The nurse should plan to offer the client's foods at room temperature or colder. Foods at these temperatures are less irritating to the mucosa. B. The nurse should tell the client to avoid spices and salty foods because they can irritate the oral mucosa. C. The nurse should instruct the client to avoid citrus and other acidic foods because they irritate the oral mucosa. Citrus fruits are an appropriate food recommendation for a client who has dry mouth. D. The nurse should encourage the client to drink high-calorie, high-protein drinks as meal substitutes. This intervention provides adequate nutrient intake with minimal irritation to the oral mucosa. The client should avoid tomato juice because it is acidic and salty, which can irritate the oral mucosa.

A nurse in an emergency department is reviewing the laboratory report for a client who is confused and reports nausea and abdominal cramping. The nurse should expect the client's laboratory results to indicate a dietary deficiency of which of the following minerals? A. Sodium B. Phosphorus C. Potassium D. Chloride

A. Sodium Explanation: A. The nurse should expect the client's laboratory report to indicate a sodium deficit. The manifestations of sodium deficit include confusion, headache, nausea, dizziness, and abdominal cramps. The manifestations of sodium toxicity include confusion, thirst, and weakness. B. The manifestations of phosphorus toxicity reflect those of hypocalcemia, which includes numbness and tingling around the mouth and extremities and tetany. Deficiencies of phosphorus rarely occur because of the extensive amount in the food supply. C. The manifestations of a potassium deficiency are an irregular heart rate, muscle weakness, leg cramps, and anorexia. The manifestations of potassium toxicity are vomiting, diarrhea, cardiac dysrhythmias, and muscle weakness. D. The manifestations of chloride deficiency are lack of emotion, anorexia, and muscle cramps. Vomiting is a manifestation of chloride toxicity.

A nurse is providing teaching regarding diet modifications to a client who is at a high risk for cardiovascular disease. The client is accustomed to traditional Mexican foods and wants to continue to include them in her diet. Which of the following recommendations should the nurse give the client? A. Use canola oil instead of lard for frying. B. Use soy milk instead of cow's milk. C. Use vegetables in salads rather than in soups. D. Limit ground beef intake to 8 oz per day.

A. Use canola oil instead of lard for frying. Explanation: A. The nurse should teach the client to use monounsaturated fats, such as canola oil, instead of saturated fats, such as lard, to reduce the risk for cardiovascular disease. B. The nurse should recognize that soy milk is not part of a traditional Mexican diet and should recommend fat-free or low-fat cow's milk. C. The nurse should teach the client to increase intake of raw and cooked vegetables. D. The nurse should teach the client to limit her intake of lean meat, poultry, and fish to 2.5 to 3 oz per meal.

A nurse is caring for a client who is being treated for cancer using chemotherapy. Which of the following interventions should the nurse suggest to aid in management of treatment-related changes in taste? A. Use plastic utensils. B. Limit fluids with meals. C. Serve meals while they are hot. D. Eat bland, unseasoned foods.

A. Use plastic utensils. Explanation: A. Plastic utensils minimize a metallic taste often accompanied by chemotherapy treatment. B. Fluid intake should be increased to improve taste. C. Foods should be served at room temp or cold to improve taste. D. Tart foods and seasonings could improve taste.

A nurse is caring for a client who adheres to a kosher diet. Which of the following food choices would be appropriate for this client? A. Vegetable salad with cheese B. Lean cuts of pork C. Turkey and cheese on rye bread D. Shrimp salad and crackers

A. Vegetable salad with cheese Explanation: A. Clients who adhere to a kosher diet can eat dairy products combined with non-meat products at the same meal. B. Clients who adhere to a kosher diet do not eat pork. C. Clients who adhere to a kosher diet do not combine dairy products with meat products at the same meal. D. Clients who adhere to a kosher diet do not eat shellfish.

A nurse is teaching about increasing dietary intake of micronutrients to a client who has a difficulty seeing at night. Which of the following micronutrients should the nurse include in the teaching? A. Vitamin A B. Calcium C. Vitamin B6 D. Phosphorus

A. Vitamin A Explanation: A. Vitamin A enables the eyes to adapt to dim lighting more rapidly at night, which improves night vision. B. Calcium facilitates nerve transmission and cell membrane permeability, but it is not a micronutrient that improves night vision. C. Vitamin B6 assists in the formation of heme in hemoglobin and the synthesis of neurotransmitters, but it is not a micronutrient that improves night vision. D. Phosphorus assists in the formation of bones and teeth and the regulation of hormone activity, but it is not a micronutrient that improves night vision.

A nurse is providing dietary teaching to a client who has celiac disease. Which of the following statements by the client indicates an understanding of the teaching? A. "I can return to my normal diet after I follow this diet for 1 month." B. "I can have tapioca pudding for dessert." C. "I will choose canned soups that do not contain meat products." D. "I will eat my sandwiches on whole wheat bread."

B. "I can have tapioca pudding for dessert." Explanation: A. A client who has celiac disease must follow the dietary restrictions throughout their lifetime. B. A client who has celiac disease can consume tapioca because this starch does not contain gluten. C. A client who has celiac disease should avoid processed foods, including canned soups, because they can contain gluten. D. A client who has celiac disease should not eat foods that contain gluten, such as whole wheat bread.

A nurse is discussing dietary factors to assist in blood pressure management for a client who has hypertension. Which of the following client statements indicates an understanding of the teaching? A. "I can drink up to three glasses of wine each day." B. "I should choose whole grain pastas when selecting my foods." C. "I should decrease my consumption of foods high in potassium." D. "I can use low-sodium salt substitutes when I cook my food."

B. "I should choose whole grain pastas when selecting my foods." Explanation: A. The client can consume alcohol in moderation, if at all. Moderate daily alcohol intake is one drink for women and two drinks for men. B. Whole grains are a healthy choice of carbohydrate because they contain ingredients that lower the risk of cardiovascular disease and improve blood pressure. C. Increased potassium levels decrease blood pressure levels. The client should increase their consumption of foods containing potassium. D. The nurse should instruct the client that low-sodium salt substitutes are not sodium-free and can contain nearly half as much sodium as table salt.

A nurse is providing teaching to a client who reports nausea during pregnancy. Which of the following statements by the client indicates an understanding of the teaching? A. "I should drink liquids with meals." B. "I will eat dry cereal before I get out of bed." C. "I will increase the fat content in my diet." D. "I should drink a cup of hot tea between meals."

B. "I will eat dry cereal before I get out of bed." Explanation: A. Drinking liquids with meals leads to abdominal distention, which can exacerbate nausea. B. Carbohydrates, such as dry cereal, are absorbed quickly and readily raise blood sugar levels, which should reduce nausea. C. High-fat foods delay gastric emptying time, which increases nausea. D. The client should avoid caffeinated drinks such as coffee and tea because they can contribute to heartburn.

A nurse is providing dietary teaching about reducing the risk of infection to a client who has cancer and is receiving chemotherapy. Which of the following client statements indicates an understanding of the teaching? A. The nurse should identify that sweating, tremors, confusion, irritability, and heart palpitations are manifestations of hypoglycemia. B. "I will use leftovers within 24 hours." C. "I should use home-canned goods within 2 years of canning." D. "I should heat my food to at least 120 degrees Fahrenheit."

B. "I will use leftovers within 24 hours." Explanation: A. The client should thaw food in the refrigerator to reduce the risk of infection from a foodborne pathogen. B. The client should use leftovers within 24 hr to reduce the risk of infection from a foodborne pathogen. C. The client should use home-canned goods within 1 year of canning and cook for 10 min prior to eating to reduce the risk of infection from a foodborne pathogen. D. The client should keep hot, cooked food at a temperature greater than 60º C (140º F) to reduce the risk of infection from a foodborne pathogen.

A nurse is providing teaching about lowering solid fat intake to an adolescent client who usually consumes about 2,000 calories per day. Which of the following instructions should the nurse include? A. "Choose ground beef that is at least 70% lean." B. "Restrict your daily meat intake to 5 ounces." C. "Select cheeses that contain no more than 6 grams of fat per serving." D. "Choose margarine that contains no more than 4 grams of saturated fat per tablespoon."

B. "Restrict your daily meat intake to 5 ounces." Explanation: A. The nurse should instruct the client to select ground beef that is at least 90% lean. B. The nurse should instruct the client to limit meat intake to about 5 oz per day. A meat portion should be no larger than the size of a deck of cards. C. The nurse should instruct the client to select cheeses that contain no more than 3 g of fat per serving. D. The nurse should instruct the client to choose margarine that contains no more than 2 g of saturated fat per tablespoon.

A nurse is providing discharge teaching to a postpartum client about breast milk use and storage. Which of the following statements should the nurse make? A. "Refrigerate unused breast milk immediately after bottle feeding." B. "You cannot place thawed breast milk back in the freezer." C. "You can store expressed breast milk in the freezer for up to 18 months." D. "Defrost frozen breast milk on the lowest defrost setting in the microwave."

B. "You cannot place thawed breast milk back in the freezer." Explanation: A. The nurse should instruct the client that any milk left in a bottle from a feeding should be immediately discarded. B. The nurse should instruct the client that completely thawed breast milk can be stored in the refrigerator but must be used within 24 hr. Breast milk that has been previously frozen should not be refrozen once it has thawed completely. Thawing creates a possibility for bacterial growth and causes a decrease in antibacterial activity, which destroys antibodies in the milk. C. The nurse should instruct the client that the recommended duration of time for safely storing expressed breast milk is 6 months. However, it is acceptable for expressed breast milk to be stored for a maximum of 12 months. D. The nurse should instruct the client to place the container of breast milk in the refrigerator to slowly thaw. If the breast milk is needed sooner, the nurse should instruct the client to place the container of breast milk under warm, running water. Breast milk should not be thawed or warmed in a microwave. This practice can cause burns to the infant's mouth, throat, or upper gastrointestinal tract due to uneven heating, which might not be recognized when the client spot checks the milk's temperature.

A nurse is caring for a client who is receiving total parenteral nutrition (TPN) and is prescribed an oral diet. The client asks the nurse why the TPN is being continued since he is now eating. Which of the following responses should the nurse make? A. "Your blood glucose levels need to be within a normal range before the parenteral nutrition can be stopped." B. "You should consume at least 60 percent of your calories orally before the parenteral nutrition can be discontinued." C. "You should have a weight gain of at least 1 kilogram per day before the therapy is stopped." D. "Your bowel movements need to be regular before the therapy can be discontinued."

B. "You should consume at least 60 percent of your calories orally before the parenteral nutrition can be discontinued." Explanation: A. Blood glucose levels are monitored when a client is receiving TPN; however, this is not a criterion for discontinuation of the therapy. B. TPN can be discontinued when oral intake exceeds at least 60% of the client's estimated daily caloric requirements. C. A weight gain of 1 kg/day is indicative of fluid overload, an adverse effect of TPN. D. Bowel function is monitored when a client is receiving TPN; however, it is not a criterion for discontinuation of the therapy.

A nurse is teaching an older adult client about nutritional recommendations. Which of the following statements should the nurse make? A. "You should increase your daily calorie intake." B. "You should increase your daily protein intake." C. "You receive an adequate amount of calcium from your diet, so a supplement is not recommended." D. "You receive an adequate amount of vitamin D from sun exposure, so it is not necessary to take a supplement."

B. "You should increase your daily protein intake." Explanation: A. Older adult clients require fewer daily calories due to a decreased metabolism. B. The nurse should instruct the client to increase the daily intake of protein to increase strength and to enhance immune function and wound healing. The nurse should recommend a protein intake of 1 to 1.2 g/kg/day of protein for a healthy older adult client. If the older adult client has acute or chronic medical diagnoses, the nurse should recommend 1.2 to 1.5 g/kg/day of protein. C. The nurse should instruct the client to begin taking a daily calcium supplement to maintain healthy bones and aid in the prevention of osteoporosis. Calcium carbonate is the most economical supplement for the nurse to recommend and should be taken with meals to improve absorption. D. The nurse should instruct the client to begin taking a daily vitamin D supplement of 1,000 to 2,000 IU/day to promote calcium absorption. Older adult clients have a decreased ability to synthesize the vitamin D they receive from sun exposure.

A nurse is providing nutritional teaching to the guardians of a 2-year-old toddler. Which of the following snack foods should the nurse recommend including in the toddler's diet? A. 1 cup of fruit gel bites B. 1 cup of yogurt C. ½ of a hot dog D. ½ of a peanut butter and jelly sandwich

B. 1 cup of yogurt Explanation: A. Fruit gel bites vary in size and are high in complex sugar content. They are difficult to chew and swallow for a 2-year-old toddler because of their sticky consistency, and they also are highly cariogenic, contributing to tooth decay. Because their chewing skills are not yet mature, children are at an extremely high risk for choking until they reach 4 years of age. Therefore, the nurse should not recommend fruit gel bites because they place the child at an increased risk for choking. B. The nurse should recommend yogurt as a snack food for a 2-year-old toddler. The consistency of yogurt poses no choking hazard, and because of their increased activity level, toddlers require 13 to 16 g of protein each day to meet the demands for muscle growth. At 8 g/cup, yogurt is a high-quality source of protein. The nurse can also teach the guardians to make yogurt smoothies by combining yogurt and the child's favorite fruit in a blender. C. A hot dog is round in shape and too large for a 2-year-old toddler to chew and swallow. Because their chewing skills are not yet mature, children are at an extremely high risk for choking until they reach 4 years of age. Therefore, the nurse should not recommend a hot dog because it places the child at an increased risk for choking. D. Peanut butter has a thick consistency, jelly is high in complex sugar, and bread is a complex carbohydrate. These foods are difficult to chew and swallow for a 2-year-old toddler, and they also are highly cariogenic, contributing to tooth decay. Because their chewing skills are not yet mature, children are at an extremely high risk for choking until they reach 4 years of age. Therefore, the nurse should not recommend a peanut butter and jelly sandwich because it places the child at an increased risk for choking.

A nurse is conducting dietary teaching for a group for clients who are trying to become pregnant. Which of the following food items should the nurse include as containing the highest amount of folate? A. ½ cup chickpeas B. 3.5 oz chicken liver C. 1 medium orange D. 1 slice white bread

B. 3.5 oz chicken liver Explanation: A. ½ cup of chickpeas contains 141 mcg of folate. B. 3.5 oz of chicken liver contains the highest amount of folate, 770 mcg. C. A medium orange contains 47 mcg of folate. D. A slice of white bread contains 38 mcg of folate.

A nurse is reviewing the laboratory results of a client who has a pressure injury. Which of the following findings should indicate to the nurse that the client is at risk for impaired wound healing? A. Hgb 15 g/dL B. Albumin 3.0 g/dL C. Prothrombin time 11.5 seconds D. WBC 6,000/mm3

B. Albumin 3.0 g/dL Explanation: A. The nurse should identify that this Hgb level is within than the expected reference range of 14 to 18 g/dL in men and 12 to 16 g/dL in women. An Hgb level below the expected reference range can impair wound healing due to reduced oxygen delivery to tissues. B. The nurse should identify that this albumin level is less than the expected reference range of 3.5 to 5 g/dL. A decreased albumin level is a manifestation of malnutrition and can increase the risk for poor wound healing and infection. C. The nurse should identify that this prothrombin time is within the expected reference range of 11.0 to 12.5 seconds. Altered coagulation can cause reduced blood supply to the wound and impair wound healing. D. The nurse should identify that this WBC count is within the expected reference range of 5,000 to 10,000/mm3. A reduced WBC can impair healing and increase the risk for infection.

A nurse is assessing a client who experienced a 5% weight loss in the past 30 days. Which of the following findings should the nurse identify as an indication of malnutrition? A. Moist skin B. Ankle edema C. Hyperreflexia D. Dilated pupils

B. Ankle edema Explanation: A. Dry skin is a manifestation of malnutrition. B. Lower extremity edema is indicative of a protein deficiency. C. Paresthesia and weak hand grasps are manifestations of malnutrition. D. Dry conjunctiva and corneal vascularization are manifestations of malnutrition.

A nurse is providing teaching to a client who has dumping syndrome. Which of the following information should the nurse include? A. Drink liquids with meals. B. Apply pectin to foods. C. Remain active after eating a meal. D. Replace sugars with honey.

B. Apply pectin to foods. Explanation: A. The client should avoid drinking liquids with meals to decrease manifestations of dumping syndrome. The client should wait 30 min before and after a meal to drink liquids. B. The client should apply pectin, a dietary fiber that helps to delay gastric emptying, to foods. C. The client should lie down and rest for at least 15 min after eating a meal to decrease manifestations of dumping syndrome. D. The client should avoid simple sugars because they can increase manifestations of dumping syndrome. Simple sugars include honey, sugar, and syrup.

A nurse is providing dietary teaching to a client who is postoperative following a gastric bypass procedure. Which of the following instructions should the nurse include? A. Eat six small meals per day. B. Begin each meal with a protein. C. Finish each meal even if feeling full. D. Plan to eat each meal over 15 min.

B. Begin each meal with a protein. Explanation: A. The nurse should instruct the client to eat three meals and two snacks of a limited portion size each day. B. The nurse should instruct the client to begin each meal by eating a protein. The client should consume 60 to 120 g of protein each day. C. The nurse should instruct the client to eat slowly and to stop eating after beginning to feel full. D. The nurse should instruct the client to eat slowly, take time to chew food well, and plan for meals to last between 30 and 60 min.

A nurse is caring for a client who is prescribed captopril. The nurse should recognize that which of the following foods could cause a potential medication interaction? A. Watermelon B. Cantaloupe C. Lettuce D. Carrots

B. Cantaloupe Explanation: A. Watermelon does not create a potential food and medication interaction for the client because it is not high in potassium. One cup of watermelon contains 170 mg potassium. B. ACE inhibitors, such as captopril, retain potassium and can lead to hyperkalemia. The nurse should recognize that cantaloupe is a food source high in potassium as one cup contains 473 mg. The client should avoid cantaloupe as well as other foods that are high in potassium while taking an ACE inhibitor. C. Lettuce does not create a potential food and medication interaction for the client because it is not high in potassium. One cup of shredded green leaf lettuce contains 70 mg of potassium. D. Carrots are high in beta-carotene and do not create a potential food and medication interaction for the client. One cup of carrot slices contains 390 mg of potassium.

A nurse is providing teaching to a client who is lactating about increasing protein intake. Which of the following foods should the nurse recommend as the best source of protein? A. Legumes B. Cottage cheese C. Peanut butter D. Whole grain cereal

B. Cottage cheese Explanation: A. Legumes are not a complete protein. B. Cottage cheese is a complete protein. Complete proteins contain all nine essential amino acids and provide the best support for human growth and nourishment. C. Peanut butter is an incomplete protein. D. Whole grain cereals are an incomplete protein.

A nurse is caring for a client who is receiving continuous tube feedings via a gastrostomy tube. The client has had three loose stools in the last 4 hr. Which of the following prescriptions should the nurse anticipate? A. Reposition the tube and verify placement. B. Decrease the rate of the feeding. C. Administer a prokinetic medication. D. Irrigate the tubing with 30 mL of water.

B. Decrease the rate of the feeding. Explanation: A. There is no indication the client's tube is displaced and will need to be repositioned. If the client's tube were displaced, the client would be experiencing aspiration or vomiting. B. The nurse should identify the client is experiencing diarrhea, which might be due to the formula being delivered continuously and the client's body being unable to digest it. The nurse should anticipate a prescription to decrease the rate of the feeding. C. The nurse should identify that prokinetic medications are used to manage delayed gastric emptying. If administered, they can increase the frequency of the client's stools. D. There is no indication the nurse will need to irrigate the client's tubing. The client's tubing should be flushed every 4 hr with 30 to 50 mL of water to prevent the tubing from becoming clogged.

A nurse is preparing a health promotion seminar for a group of clients about cancer prevention. Which of the following information should the nurse include? A. Consume high-calorie foods and beverages at meal time. B. Eat at least 2.5 cups of fruits and vegetables each day. C. Plan to perform moderate-intensity exercise for 90 min/week. D. Limit alcohol consumption to no more than three drinks per day.

B. Eat at least 2.5 cups of fruits and vegetables each day. Explanation: A. The nurse should include in the teaching that clients should avoid consuming high-calorie foods and beverages to decrease the risk for cancer. Being overweight or obese can increase hormones that promote cancer cell development and growth. B. The nurse should include in the teaching that clients should eat at least 2.5 cups of fruits and vegetables daily to help maintain body weight and reduce the risk for cancer of the lung and gastrointestinal system. C. The nurse should include in the teaching that clients should engage in at least 150 min of moderate-intensity exercise each week to decrease the risk of obesity. Being overweight or obese can increase hormones that can promote cancer cell development and growth. D. The nurse should include in the teaching that clients should limit alcohol consumption to one to two drinks per day, because excessive alcohol intake can increase the risk of certain types of cancer.

A nurse is assessing a client who has end-stage kidney disease (ESKD). Which of the following dietary habits increases the client's risk for dysrhythmias? A. Consuming a diet low in fat B. Eating a diet rich in potassium C. Consuming a diet rich in protein D. Eating a diet deficient in iron

B. Eating a diet rich in potassium Explanation: A. The client's risk for dysrhythmias does not increase due to a diet low in fat. A diet that is high in fat can lead to coronary artery disease, which can increase the risk for dysrhythmias. B. A client who has ESKD has impaired kidney function and is unable to eliminate potassium. As urine output declines, hyperkalemia develops, which can cause cardiac dysrhythmias. C. The client's risk for dysrhythmias does not increase due to a diet rich in protein. However, as uremia occurs from the build-up of waste products from the breakdown of protein, a client who has ESKD should not consume a diet rich in protein. D. A diet deficient in iron can lead to anemia, but the client's risk for dysrhythmias does not increase due to low intake of iron.

A nurse is caring for a client who is at 8 weeks of gestation and has a BMI of 34. The client asks about weight goals during her pregnancy. The nurse should advise the client to do which of the following? A. Maintain her current BMI. B. Gain approximately 6.8 kg (15 lb). C. Lower her BMI to 30. D. Gain 12.7 to 15,8 kg (28 to 35 lb).

B. Gain approximately 6.8 kg (15 lb). Explanation: A. The nurse should advise the client to gain some weight during pregnancy, but less weight than clients whose BMI is within the expected reference range or lower. B. The nurse should advise the client that based on her BMI, she should gain 4.9 to 9.1 kg (11 to 20 lb) during her pregnancy. C. The nurse should advise the client that she should not attempt to lose weight during pregnancy. Losing too much weight during pregnancy could potentially have negative effects on the fetus, such as low birth weight and vitamin deficiencies. D. The nurse should advise the client that a weight gain of 12.7 to 15.8 kg (28 to 35 lb) during pregnancy is too high for a client who has a BMI of 34.

A nurse is providing information about cardiovascular risk to a client who has received a lipid panel report. The nurse should include that which of the following findings is within an expected reference range? A. Total cholesterol 210 mg/dL B. HDL 79 mg/dL C. Triglycerides 175 mg/dL D. LDL 137 mg/dL

B. HDL 79 mg/dL Explanation: A. Cholesterol range should be less than 200 mg/dL. B. An HDL level greater than 45 mg/dL for a male and greater than 55 mg/dL for a female is within the expected reference range. An HDL of 79 mg/dL indicates the client is at low risk for cardiovascular disease. C. A triglyceride level of 175 mg/dL is above the expected reference range of 35 to 135 mg/dL for females and 40 to 160 mg/dL for males. D. An LDL level of 137 mg/dL is above the expected reference range of less than 130 mg/dL.

A nurse is admitting a client who has diabetic ketoacidosis. Which of the following findings should the nurse expect? A. Tremors B. Increased urination C. Heart palpitations D. Sweating

B. Increased urination Explanation: A. The nurse should identify that tremors, diaphoresis, confusion, irritability, and heart palpitations are manifestations of hypoglycemia. B. The nurse should identify that increased urination is a manifestation of diabetic ketoacidosis. Other manifestations can include fruity breath, Kussmaul respirations, excessive thirst, and orthostatic hypotension. C. The nurse should identify that heart palpitations, tremors, diaphoresis, confusion, and irritability are manifestations of hypoglycemia. D. The nurse should identify that sweating, tremors, confusion, irritability, and heart palpitations are manifestations of hypoglycemia.

A nurse is caring for a client who expresses a desire to lose weight. Which of the following actions should the nurse take first? A. Recommend checking weight once weekly. B. Obtain a 24-hour dietary recall. C. Assist with creating an exercise plan. D. Initiate a plan for diet modification.

B. Obtain a 24-hour dietary recall. Explanations: A. The nurse should recommend the client weigh themselves regularly to monitor weight loss or gain; however, there is another action the nurse should take first. B. The first action the nurse should take using the nursing process is to obtain a diet history, such as a 24-hr dietary recall. Having the client write down everything consumed over a 24-hr period is a crucial component of the assessment process to identify eating behaviors and therefore be able to recommend dietary modifications based on the data received. C. The nurse should assist the client with the creation of a personalized exercise plan to increase strength and promote weight loss; however, there is another action the nurse should take first. D. The nurse should initiate a personalized diet modification plan with the client based on the client's assessment data to promote weight loss; however, there is another action the nurse should take first.

A nurse is caring for a client who is receiving radiation therapy. The client reports a metallic taste in his mouth while eating. Which of the following actions should the nurse take? (Select all that apply.) A. Provide three large meals daily. B. Offer citrus fruits. C. Suggest pickles as a snack. D. Rinse silverware prior to eating. E. Gargle with mouthwash.

B. Offer citrus fruits. C. Suggest pickles as a snack. E. Gargle with mouthwash. Explanation: A. The nurse should provide small, frequent meals for a client who is experiencing an altered taste. B. Citrus fruits stimulate the production of more saliva, which helps diminish the metallic taste. C. Pickles stimulate the production of more saliva, which helps diminish the metallic taste. D. Plastic utensils should be used to avoid increasing the metallic taste in foods. E. Gargling with mouthwash stimulates the production of more saliva, which helps diminish the metallic taste.

A nurse is admitting a client who has had a fever and diarrhea for the past 3 days. Which of the following findings should indicate to the nurse the client is dehydrated? A. Distended neck veins B. Orthostatic hypotension C. Weight gain D. Peripheral edema

B. Orthostatic hypotension Explanation: A. Distended neck veins shows fluid volume excess. Dehydration would cause flattened neck veins. B. Orthostatic hypotension occurs due to fluid loss, which causes low blood volume, resulting in low blood pressure. C. Weight gain shows excess fluid volume. Fluid loss could cause weight loss. D. Peripheral edema is an example of excess fluid volume. Dry skin or poor skin turgor are manifestations of dehydration.

The nurse is caring for a client who is receiving intermittent enteral feedings every 4 hr via NG tube. Which of the following actions should the nurse take to reduce the risk of aspiration? A. Check placement of the NG tube once per day. B. Place the client in a semi-Fowler's position. C. Flush the tubing with 20 mL of water prior to each feeding. D. Administer the formula chilled.

B. Place the client in a semi-Fowler's position. Explanation: A. The nurse should check the placement of the NG tube prior to each feeding to reduce the risk for aspiration. B. The nurse should maintain the client in a semi-Fowler's position to reduce the risk for aspiration of stomach contents during the feeding and for at least 30 min after the completion of the feeding. C. The nurse should flush the tubing with at least 40 to 50 mL of water following each feeding to maintain tube patency. D. The nurse should allow the formula to warm to room temperature prior to administration to reduce the risk of abdominal cramps.

A nurse in a provider's office is assessing a client who has HIV. The nurse should identify which of the following findings as an indication to increase the client's nutritional intake? A. T-helper (CD4+) cells 700/mm3 B. Presence of herpes simplex virus infection C. HIV viral load below detectable levels D. Increased lean body mass

B. Presence of herpes simplex virus infection Explanation: A. This finding is within the expected reference range. The nurse should recognize that a decreased CD4+ cell count is associated with a need for increased nutritional intake, and a count below 200/mm3 indicates progression to AIDS. B. Secondary infection triggers inflammatory responses that increase the client's metabolic rate. Therefore, the nurse should identify the presence of herpes simplex virus infection as an indication to increase the client's nutritional intake. C. The nurse should recognize that an increased HIV viral load indicates progression of the disease, which increases nutritional needs. D. The nurse should identify a decrease in lean body mass or fat as indicating possible HIV-associated wasting syndrome and a need for increased nutritional intake.

A nurse in an acute care facility is planning care for a client who has chosen to follow Islamic dietary laws during Ramadan. Which of the following actions should the nurse plan to take? A. Place the client on NPO status during nighttime hours. B. Provide a snack for the client after sunset. C. Offer the client hot tea with daytime meals. D. Allow the client to eat privately with their family each day at 1300.

B. Provide a snack for the client after sunset. Explanation: A. During Ramadan, clients who follow Islamic dietary laws can eat during nighttime hours. B. During Ramadan, clients who follow Islamic dietary laws consume meals before dawn and after sunset. The nurse should offer the client a snack or light meal after sunset. C. During Ramadan, clients who follow Islamic dietary laws fast during daytime hours. When not fasting, Islamic dietary law specifies that caffeine is prohibited and beverages are consumed after, rather than with, meals. D. During Ramadan, clients who follow Islamic dietary laws consume meals before dawn and after sunset.

A nurse is teaching a client who has hypertension about decreasing sodium intake. Which of the following information should the nurse include in the teaching? A. Use soy sauce as a marinade for meats. B. Season foods with herbs and spices. C. Select processed cheese products when available. D. Choose a frozen dinner for a quick meal option.

B. Season foods with herbs and spices. Explanation: A. The nurse should instruct the client to avoid products that are high in sodium, such as soy sauce, mayonnaise, and ketchup. B. The nurse should instruct the client to replace salt with herbs and spices when seasoning foods. C. The nurse should instruct the client that processed cheeses are high in sodium and should be avoided. D. The nurse should instruct the client to avoid processed foods such as frozen dinners, which can be high in sodium.

A nurse in a long-term care facility is monitoring a client during mealtime who has Parkinson's disease. Which of the following findings should the nurse identify as the priority? A. The client eats all of their cake and a few bites of bread. B. The client drools while eating. C. The client's hand trembles when they hold their spoon. D. The client chooses to sit alone during the meal.

B. The client drools while eating. Explanation: A. Eating small portions of non-nutritious foods instead of high-protein, high-calorie foods indicates that the client might be at risk for malnutrition; however, the nurse should identify another finding as the priority. B. Drooling while eating can indicate that this client is at greatest risk for aspiration of food from dysphagia, which can lead to pulmonary complications; therefore, the nurse should identify this as the priority finding. C. The nurse should offer the client assistance with feeding to promote adequate food and fluid intake; however, the nurse should identify another finding as the priority. D. The nurse should identify that the client is at risk for social isolation due to the disease process, which can lead to depression; however, the nurse should identify another finding as the priority.

A nurse is providing education to an adolescent about making nutrient-dense food choices. Which of the following statements by the client indicates an understanding of the teaching? A. "Pasta with white sauce is a better choice than pasta with red sauce." B. "Sweetened fruit yogurt is a healthy breakfast choice." C. "Canned pinto beans are a better choice than refried beans." D. "Sausage is a healthy choice of protein."

C. "Canned pinto beans are a better choice than refried beans." Explanation: A. Pasta with red sauce is a better choice, because it contains less fat than pasta with white sauce. B. Sweetened fruit yogurt is higher in fat and added sugars; therefore, plain, fat-free yogurt with fresh fruit is a better choice. C. Canned pinto beans contain less fat than refried beans. D. Canadian bacon or another low-fat meat is a better option for protein than sausage.

A nurse is teaching a client who is newly diagnosed with type 1 diabetes mellitus how to count carbohydrates. Which of the following statements made by the client indicates and understanding of the teaching? A. "I am including vegetables as starch items in my carbohydrate count." B. "I am limiting the number of carbohydrates to four carbohydrate choices or 60 grams per day." C. "I know the serving size can affect the number of carbohydrates I eat." D. "I know the carbohydrate count is dependent on the calories in the food item."

C. "I know the serving size can affect the number of carbohydrates I eat." Explanation: A. The nurse should instruct the client about the difference between starchy and nonstarchy vegetables to accurately calculate the carbohydrate count. B. The nurse should instruct the client that generally three to five carbohydrate choices, or 45 g, are allowed per meal, plus one to two carbohydrate choices for each snack. C. The nurse should instruct the client that the portion size affects the number of carbohydrates. D. The nurse should instruct the client that the carbohydrate count is not dependent on the calorie count of a food item. Fats and proteins can provide calories as well.

A nurse is teaching an adolescent who has a new diagnosis of celiac disease. Which of the following statements by the client indicates an understanding of the teaching? A. "I need to decrease the amount of oil I use in cooking." B. "I need to eat fewer acidic foods, such as tomatoes and oranges." C. "I need to eliminate rye from my diet." D. "I need to eliminate milk products from my diet."

C. "I need to eliminate rye from my diet." Explanation: A. Oil content of food might need to be decreased in a client who is on a low-fat diet, but oil does not affect the manifestations of celiac disease. B. Acidic foods do not affect the manifestations of celiac disease. C. Eating sources of gluten, such as barley or rye, increases the manifestations of celiac disease. D. Clients who cannot tolerate lactose should avoid milk products.

A nurse is teaching a female client about a healthy diet to control hypertension. Which of the following client statements indicates an understanding of the teaching? A. "I will drink two glasses of whole milk daily." B. "I will decrease the potassium in my diet." C. "I will eat four servings of unsalted nuts per week." D. "I will limit alcohol consumption to three drinks per day."

C. "I will eat four servings of unsalted nuts per week." Explanation: A. Female clients should eat a diet rich in nonfat or low-fat dairy products to control hypertension and therefore should avoid whole milk. B. Female clients should eat a diet rich in potassium to control hypertension. C. Female clients should consume four to five servings of unsalted nuts, seeds, or legumes per week for a heart-healthy diet. D. Female clients should drink alcohol in moderation, such as one to two drinks per day, to control hypertension.

A nurse is providing teaching to a client who is currently experiencing an exacerbation of Crohn's disease. Which of the following statement by the client indicates an understanding of dietary practices during acute episodes? A. "I will take a fiber supplement daily." B. "I will increase my fat intake." C. "I will follow a high-protein diet." D. "I will consume three large meals throughout the day."

C. "I will follow a high-protein diet." Explanation: A. Clients who are experiencing an acute episode of Crohn's disease should avoid diets high in fiber to minimize bowel stimulation. During periods of remission, a high-fiber diet can improve elimination and bowel tone. B. Clients who have Crohn's disease should reduce fat intake during acute episodes, because fatty foods can increase diarrhea and steatorrhea. C. Clients who have Crohn's disease should follow a high-calorie, high-protein diet to prevent malnutrition and attain the required calories to promote healing. D. The recommendation for clients who have Crohn's disease is to consume small, frequent meals rather than three large meals. This promotes maximum intake of required nutrients throughout the day.

A nurse is providing nutritional teaching to a client who reports wanting to lose weight. The nurse should identify that which of the following client statements indicates an understanding of the teaching? A. "I will taste my foods while I am cooking." B. "I will exclude breads and pastries from my diet." C. "I will make a list before I go grocery shopping." D. "I will skip lunch if I am too busy to have something healthy."

C. "I will make a list before I go grocery shopping." Explanation: A. The client should not taste foods while cooking to avoid overeating. B. The client should control portion size and eat low-calorie foods first, rather than restricting certain foods, to prevent cravings. C. Developing a shopping list allows the client to adhere to meal planning, prevent impulse buying, and purchase only the quantity of food needed. D. The client should eat three to five meals a day to prevent hunger and the tendency to overeat.

A nurse is caring for a client who has age-related macular degeneration (AMD) and asks the nurse if there are any nutritional changes to consider. Which of the following responses should the nurse make? A. "Use soy products as much as possible." B. "Add niacin-rich foods to your diet." C. "Increase dietary intake of lutein." D. "Consume foods with a high glycemic index."

C. "Increase dietary intake of lutein." Explanation: A. Soy products do not contain antioxidants, lutein, or vitamins E and B12, all of which can slow age-related vision loss. Soy products are often used as meat substitutes in vegetarian diets. B. Niacin aids in lowering LDL and triglycerides, but it has no effect on AMD. C. Lutein, a carotenoid found in vitamin A, slows the progression of AMD and is found in kale, spinach, collards, and mustard greens. D. Foods with a low glycemic index can aid clients who have diabetes mellitus in managing postprandial hyperglycemia, but foods that have a high glycemic index have no effect on AMD.

A nurse is planning discharge teaching for a client who is postoperative following placement of a colostomy. Which of the following statements should the nurse plan to include? A. "Resume a regular diet by 4 weeks after surgery." B. "Add high-fiber foods to your diet." C. "Increase your intake of foods containing pectin." D. "Drink 4 to 6 cups of water per day."

C. "Increase your intake of foods containing pectin." Explanation: A. The client should return to a regular diet by 6 weeks following surgery. B. The nurse should instruct the client to eat low-fiber foods because high-fiber foods can lead to stomal blockage. C. The nurse should instruct the client to consume foods that thicken the consistency of feces, such as foods containing pectin. D. The nurse should instruct the client to drink at least 8 to 10 cups of fluid daily.

A nurse is providing teaching to a client who has diabetes mellitus and an HbA1c of 8.7%. Which of the following statements by the client indicates an understanding of this laboratory value? A. "I should have gone to my exercise class yesterday." B. "This shows that my result is finally within a normal range." C. "This shows that I have not been following my diet." D. "I should have my blood work done first thing in the morning."

C. "This shows that I have not been following my diet." Explanation: A. Short-term factors, such as exercise, do not affect the client's HbA1c level. B. The HbA1c goal level for a client who has diabetes is between 6.5% and 7%. An HbA1c level of 8.7% indicates less than optimal diabetic control. C. An HbA1c level of 8.7% is not within the expected reference range. The HbA1c goal level for a client who has diabetes is between 6.5% and 7%. D. The client can give a blood sample at any time of the day because the HbA1c level indicates the average blood glucose levels for the previous 100- to 120-day period. Fasting is not required.

A nurse is assessing a client's risk for pressure injuries using the Braden scale. The client eats more than half of most meals but occasionally refuses a meal. Which of the following information should the nurse document on the nutrition category of the Braden scale? A. 1 (Very Poor) B. 2 (Probably Inadequate) C. 3 (Adequate) D. 4 (Excellent)

C. 3 (Adequate)

A nurse is providing dietary teaching about increased zinc intake for a client who has chronic skin ulcers of the lower extremities. Which of the following foods should the nurse recommend as containing the highest amount of zinc? A. 1 cup apple slices B. 4 oz low-fat cottage cheese C. 4 oz ground beef patty D. 1 cup raw spinach

C. 4 oz ground beef patty Explanation: A. One cup of apple slices contains 0.04 mg of zinc. B. Four ounces of low-fat cottage cheese contains 0.58 mg of zinc. C. 4 oz ground beef patty contains 5.49 mg of zinc. D. One cup of raw spinach contains 0.16 mg of zinc.

A nurse is reviewing the laboratory values of a group of clients. Which of the following clients should the nurse identify as experiencing dehydration? A. A client who has a potassium level of 4.4 mEq/L B. A client who has a hematocrit of 45% C. A client who has a sodium level of 150 mEq/L D. A client who has a BUN of 18 mg/dL

C. A client who has a sodium level of 150 mEq/L Explanation: A. The nurse should identify that a potassium level of 4.4 mEq/L is within the expected reference range of 3.5 to 5 mEq/L. Hypokalemia can occur with gastrointestinal losses, leading to dehydration. Hyperkalemia can occur with a fluid volume deficit. B. The nurse should identify that a hematocrit of 45% is within the expected reference range of 42% to 52% for a male and 37% to 47% for a female. A client who is experiencing dehydration will have an elevated hematocrit. C. The nurse should identify that a sodium level of 150 mEq/L is above the expected reference range of 136 to 145 mEq/L and indicates hypernatremia. Hypernatremia, often called water deficit, is a decrease of sodium concentration in the blood caused by an excess of water. Manifestations of hypernatremia include confusion, headache, nausea, and fatigue. D. The nurse should identify that a BUN of 18 mg/dL is within the expected reference range of 10 to 20 mg/dL. A client who is experiencing dehydration will have an increased BUN due to decreased urine output.

A nurse is developing an educational program about the glycemic index of foods for clients who have diabetes mellitus. Which of the following foods should the nurse identify as having highest glycemic index? A. Sweet corn B. Macaroni C. Baked potato D. Peanuts

C. Baked potato Explanation: A. The nurse should identify a different food because there is another choice that has a higher glycemic index. The glycemic index of sweet corn is 60. B. The nurse should identify a different food because there is another choice that has a higher glycemic index. The glycemic index of macaroni is 45. C. According to evidence-based practice, the nurse should identify that a baked potato has the highest glycemic index of these foods. The glycemic index of a baked potato is 85 to 90. Glycemic index is a tool used to rank foods according to the degree in which the food raises serum glucose levels. D. The nurse should identify a different food because there is another choice that has a higher glycemic index. The glycemic index of peanuts is 14.

A nurse is assessing a client who has fluid volume excess. Which of the following manifestations should the nurse expect? A. Weak peripheral pulses B. Increased hematocrit C. Crackles in the lungs D. Weight loss from baseline

C. Crackles in the lungs Explanation: A. The nurse should identify that a client who has fluid volume excess can have bounding pulses. A client who has fluid volume deficit can have a weak and thready pulse. B. The nurse should identify that a client who has fluid volume excess can have a decreased hematocrit. A client who has a fluid volume deficit can have an increased hematocrit. C. The nurse should identify that a client who has fluid volume excess can develop crackles in the lungs, shortness of breath, and dyspnea. D. The nurse should identify that a client who has fluid volume excess can experience a weight gain. A client who has fluid volume deficit can experience weight loss.

A nurse is evaluating a client who is receiving a continuous enteral feeding and has diarrhea. Which of the following actions should the nurse take to reduce the client's diarrhea? A. Flush the client's feeding tube. B. Administer promethazine to the client. C. Decrease the rate of the feeding. D. Check the client's gastric residual.

C. Decrease the rate of the feeding. Explanation: A. The nurse should flush the client's feeding tube before and after giving medications or if the tube is clogged. However, flushing the tube will not reduce the client's diarrhea. B. Promethazine (Phenergan) is administered for the treatment and prevention of nausea and vomiting, rather than diarrhea. C. To prevent diarrhea, the nurse should decrease the rate of the tube feeding, which allows for better absorption of the enteral formula. D. The nurse should check the client's gastric residual routinely to reduce the risk for aspiration and monitor the absorption of the feeding. However, this action will not reduce the client's diarrhea.

A nurse is updating a plan of care for a client who is receiving intermittent enteral feedings and is experiencing diarrhea. Which of the following interventions should the nurse include in the plan? A. Discard the client's opened cans of formula within 48 hr. B. Administer the client's formula cold. C. Feed the client in small, frequent volumes. D. Consider a low-calorie formula for the client.

C. Feed the client in small, frequent volumes. Explanation: A. The nurse should discard opened cans of formula within 24 hr to decrease bacterial contamination of the formula. B. The nurse should warm the formula to room temperature. Administering a formula that is cold can stimulate motility of the bowel and cause diarrhea. C. The nurse should administer the feedings in small, frequent volumes because a large volume or rapid feeding of the formula can cause diarrhea. D. Administering a large volume of low-calorie formula at one time can cause diarrhea. The nurse should consider switching to a high-calorie formula to treat diarrhea.

A nurse is providing teaching for a client who has a new prescription for nifedipine. Which of the following foods should the nurse instruct the client avoid? A. Milk B. Aged cheese C. Grapefruit juice D. Bananas

C. Grapefruit juice Explanation: A. Milk is not contraindicated for clients who are taking nifedipine. B. Aged cheese is not contraindicated for clients who are taking nifedipine. C. The nurse should instruct the client to avoid grapefruit and grapefruit juice while taking nifedipine. Concurrent use can result in elevated levels of nifedipine and an increased risk for adverse effects. D. Bananas are not contraindicated for clients who are taking nifedipine.

A nurse is providing information to a client who has a new prescription for atorvastatin. Which of the following beverages should the nurse include in the information as contraindicated while taking this medication? A. Orange juice B. Coffee C. Grapefruit juice D. Milk

C. Grapefruit juice Explanation: A. The nurse should teach the client that it is safe to take atorvastatin with orange juice. B. The nurse should teach the client that it is safe to take atorvastatin with coffee. C. The nurse should teach the client to avoid taking atorvastatin with grapefruit juice because it can increase serum levels of the medication, which can increase the risk for rhabdomyolysis and toxicity. D. The nurse should teach the client that it is safe to take atorvastatin with milk.

A nurse in a clinic is reviewing the laboratory findings of a client who has type 2 diabetes mellitus. Which of the following findings indicates the client's plan of care is effective? A. Serum creatinine 1.5 mg/dL B. BUN 25 mg/dL C. HbA1c 6.5% D. Pre-meal blood glucose 145 mg/dL

C. HbA1c 6.5% Explanation: A. The nurse should identify that this finding is above the expected reference range of 0.6 to 1.3 mg/dL and does not indicate the plan of care is effective. B. The nurse should identify that this finding is above the expected reference range of 10 to 20 mg/dL and does not indicate the plan of care is effective. C. The nurse should identify that a HbA1c level of less than 7% indicates the plan of care is effective for a client who has type 2 diabetes mellitus. D. The nurse should identify that this finding is above the expected reference range of 70 to 110 mg/dL and does not indicate the plan of care is effective.

A nurse is initiating an enteral feeding for a client who has chronic bronchitis. Which of the following types of formula should the nurse anticipate administering to the client? A. Low protein B. High carbohydrate C. High calorie D. Low fat

C. High calorie Explanation: A. A client who has pulmonary disease requires a high-protein formula to prevent malnutrition and maintain muscle and lung strength. B. As the breakdown of carbohydrates increases the production of carbon dioxide, a client who has pulmonary disease requires a formula with low to moderate amounts of carbohydrates. C. A client who has pulmonary disease requires a formula that is high in calories and protein to maintain energy demands. D. A client who has pulmonary disease requires a formula that is high in fat to maintain caloric needs and energy demands.

A nurse is creating a plan of care for a client who has mucositis following head and neck radiation therapy to treat cancer. Which of the following interventions should the nurse include in the plan? A. Encourage three servings of citrus foods daily. B. Provide lemon-glycerin swabs for oral hygiene after meals. C. Increase fluid intake to 2 L per day. D. Heat oral hygiene mouth rinses before use.

C. Increase fluid intake to 2 L per day. Explanation: A. A client who has mucositis should avoid acidic foods to prevent further irritation. B. A client who has mucositis should avoid glycerin-based swabs because they cause dryness and irritation. C. A client who has mucositis should increase fluid intake to promote hydration and peristalsis. D. A client who has mucositis should be provided with room temperature or cooled liquids to reduce irritation.

A nurse is reviewing the laboratory findings of a client who has acute pancreatitis. Which of the following is an expected finding? A. Increased calcium B. Decreased bilirubin C. Increased glucose D. Decreased alkaline phosphatase

C. Increased glucose Explanation: A. The nurse should anticipate decreased calcium as an expected finding in a client who has acute pancreatitis. B. The nurse should anticipate increased bilirubin as an expected finding in a client who has acute pancreatitis. C. The nurse should expect an increased glucose level in a client who has acute pancreatitis due to decreased insulin production by the pancreas. D. The nurse should anticipate increased alkaline phosphatase as an expected finding in a client who has acute pancreatitis.

A nurse is caring for a client who is receiving total parenteral nutrition (TPN) through a peripherally inserted central catheter. The pharmacist informs the nurse that there will be a delay in delivering the next bag of TPN solution. Which of the following actions should the nurse take? A. Slow the rate of the current infusion. B. Infuse 0.9% sodium chloride when the current infusion ends. C. Infuse dextrose 10% in water when the current infusion ends. D. Remove the tubing and flush the access device when the current infusion ends.

C. Infuse dextrose 10% in water when the current infusion ends. Explanation: A. The TPN flow rate must remain consistent. Slowing it and then later resuming the prescribed rate increases the risk of inadequate nutrition and metabolic complications. B. TPN contains high concentrations of specific nutrients. Infusing 0.9% sodium chloride can cause rapid shifts in serum levels of some substances. C. TPN contains high concentrations of dextrose and proteins. To avoid hypoglycemia, the nurse should infuse dextrose 10% or 20% in water until the next bag of TPN solution arrives. D. Abruptly stopping a TPN infusion can lead to multiple metabolic complications.

A nurse is teaching a client who reports constipation about ways to increase dietary intake of fiber. Which of the following information should the nurse include? A. Replace legumes with broiled meats. B. Consume 1/2 cup of bran daily. C. Leave the skin on when eating fruit. D. Decrease fluid intake while increasing fiber.

C. Leave the skin on when eating fruit. Explanation: A. The nurse should instruct the client to replace meat-based meals with meals that feature dried peas or beans to add fiber to the diet. B. The nurse should instruct the client to add a small amount of bran to the daily diet, working up to 3 tablespoons daily, which is less than ¼ cup. Adding fiber gradually should prevent abdominal distention and excessive flatus. C. The nurse should instruct the client that consuming the skin on fruits and vegetables adds fiber to the diet. D. The nurse should instruct the client to increase fluid intake as fiber intake increases to prevent constipation, abdominal distention, and excessive flatus. The client should consume at least eight 240-mL (8-oz) glasses of water daily.

A nurse is caring for a client who has advanced Parkinson's disease and dysphagia. Which of the following actions should the nurse take? A. Turn the television on to distract the client during meals. B. Give the client fluids to clear the mouth of solid foods during meals. C. Offer the client a high-calorie diet. D. Encourage the client to maintain a low-Fowler's position following meals.

C. Offer the client a high-calorie diet. Explanation: A. The nurse should limit distractions so that the client can concentrate on eating, which reduces the risk of aspiration. B. The nurse should not offer liquids to clear the client's mouth of solid foods because this increases the risk for aspiration. C. The nurse should add high-calorie food to the client's diet because muscular rigidity increases metabolic rate, which increases caloric need. D. The nurse should position a client who has advanced Parkinson's disease in a high-Fowler's position following meals to prevent aspiration.

A nurse is caring for a client who is receiving total parenteral nutrition (TPN). Which of the following laboratory findings indicates that the TPN therapy is effective? A. Calcium 8 mg/mL B. Hemoglobin 9 g/dL C. Prealbumin 30 mg/dL D. Cholesterol 140 mg/dL

C. Prealbumin 30 mg/dL Explanation: A. The nurse should identify that this value is below the expected reference range of 9 to 10.5 mg/dL and does not indicate the TPN is effective. B. The nurse should identify that this value is below the expected reference range of 14 to 18 g/dL for males and 12 to 16 g/dL for females and does not indicate the TPN is effective. C. Prealbumin level is a sensitive indicator of nutritional status. The nurse should identify that a level of 30 mg/dL is within the expected reference range of 15 to 36 mg/dL and indicates the TPN is effective. D. The nurse should identify that this value is within the expected reference range of less than 200 mg/dL; however, it does not indicate the TPN is effective. Decreased levels of cholesterol can be an indication of malnutrition.

A nurse is performing a comprehensive nutritional assessment for a client. After reviewing the client's laboratory results, which of the following findings should the nurse report to the provider? A. WBC count 6,000/mm3 B. Sodium 139 mEq/L C. Prealbumin 8 mg/dL D. Thyroxine (T4) 9.2 mcg/dL

C. Prealbumin 8 mg/dL Explanation: A. An elevated WBC count can indicate an infection and dietary deficiencies in iron or vitamin B12. However, this value is within the expected reference range of 5,000 to 10,000/mm3. B. A low sodium level can indicate malnutrition. However, this sodium level is within the expected reference range of 136 to 145 mEq/L. C. A prealbumin level of 8 mg/dL is a critical value that indicates severe malnutrition and requires reporting to the provider who can prescribe a nutritional intervention. The expected reference range for prealbumin is 15 to 36 mg/dL. D. A T4 level above the expected reference range can indicate hyperthyroidism, which can cause weight loss. A T4 level below the expected reference range can indicate hypothyroidism or protein malnutrition. However, this value is within the expected reference range of 4 to 12 mcg/dL.

A nurse is providing discharge teaching to a client who has a new ileostomy. Which of the following dietary guidelines should the nurse include in the teaching? A. Plan to reduce dietary salt intake. B. Consume limited amounts of pasta products. C. Prepare meals on a schedule. D. Reduce dietary B12.

C. Prepare meals on a schedule. Explanation: A. The nurse should teach a client who has an ileostomy to increase dietary salt intake to replenish fluid loss. B. The nurse should teach a client who has an ileostomy to consume increased amounts of pasta and other foods that can help thicken the stool. C. The nurse should teach a client who has an ileostomy to prepare meals on a schedule to promote regular bowel elimination patterns. D. The nurse should teach a client who has an ileostomy that vitamin B12 is necessary to prevent anemia related to malabsorption.

A nurse is caring for a client who is dehydrated and is receiving intermittent enteral feeding. Which of the following actions should the nurse plan to take? A. Use a low-fat formula for administration. B. Chill the formula prior to administration. C. Provide the formula as a continuous infusion. D. Dilute the formula before administration.

C. Provide the formula as a continuous infusion. Explanation: A. A client who is experiencing distention and bloating should receive a low-fat formula. A client experiencing dehydration should receive a low-protein formula. B. A chilled formula can cause abdominal distention and cramping. The nurse should warm the formula to room temperature prior to administration. The temperature of the formula does not affect the client's dehydration status. C. A client who is experiencing dehydration should receive a continuous infusion to prevent receiving a high carbohydrate load with each feeding. D. A client who is experiencing dehydration should receive additional water, but diluting the formula will also reduce the amount of nutrients the client receives.

A nurse is planning care for a client who is receiving radiation to the neck and has developed stomatitis. Which of the following interventions should the nurse include in the plan? A. Avoid the use of a straw when drinking liquids. B. Drink high-carbohydrate nutritional supplements. C. Relieve mouth pain by consuming frozen foods. D. Rinse the mouth with hydrogen peroxide after eating.

C. Relieve mouth pain by consuming frozen foods. Explanation: A. The use of a straw should be encouraged to minimize contact of liquids with sores in the mouth. B. High-calorie, high-protein drinks should be encouraged to promote healing and replace traditional meal. C. Frozen bananas, ice cream, or popsicles can numb the mouth and help alleviate pain. D. Good oral hygiene should be encouraged by using a soft-bristled toothbrush and frequent rinsing of mouth using 0.9% sodium chloride and water or water and baking soda mixture.

A nurse is teaching a client about managing irritable bowel syndrome (IBS). Which of the following information should the nurse include in the teaching? A. Increase intake of fresh fruit high in fructose. B. Limit foods that contain probiotics. C. Take peppermint oil during exacerbation of manifestations. D. Substitute white sugar with honey.

C. Take peppermint oil during exacerbation of manifestations. Explanation: A. Fruit that is high in fructose, such as fresh pears, can increase a client's manifestations of IBS. B. The client should increase intake of food containing probiotics because probiotics decrease bacteria in the bowel and can decrease the manifestations of IBS. C. The nurse should teach the client to take peppermint oil because peppermint relaxes the smooth muscle of the GI tract and decreases the manifestations of IBS. D. Honey is high in fructose and is difficult to absorb, causing manifestations of IBS. White sugar contains glucose, which is easy to absorb and can help the absorption of fructose.

A home health nurse is reviewing the medical record of a client who had an open reduction internal fixation of the tibia. Which of the following findings should the nurse identify as a risk factor for impaired wound healing? A. The client's hemoglobin is 15 g/dL. B. The client's peripheral pulses are +3 distal to the affected extremity. C. The client consumes 1,000 kcal daily. D. The client takes zinc supplements.

C. The client consumes 1,000 kcal daily. Explanation: A. A hemoglobin level of 15 g/dL is within the expected reference range of 14 to 18 g/dL in men and 12 to 16 g/dL in women. A hemoglobin level below the expected reference range is a risk factor for impaired wound healing. B. Pulses +3 strength are an expected finding. The nurse should identify decreased tissue perfusion as a risk factor for impaired wound healing. C. Adults who have had surgery require at least 1,500 kcal daily to meet energy needs and build protein for tissue healing. The nurse should recognize that a 1,000 kcal/day intake is below the client's needs. D. The body uses zinc to build proteins and aid the immune response. The nurse should identify this finding as a factor that will promote wound healing.

A nurse is caring for a client who has anemia and a new prescription for an iron supplement. The nurse should recommend the client consume the supplement with which of the following beverages to increase absorption? A. Protein shake B. Skim milk C. Tomato juice D. Green tea

C. Tomato juice Explanation: A. A protein shake contains calcium, which impairs iron absorption when the items are consumed together. B. Milk contains calcium, which impairs iron absorption when the items are consumed together. C. The nurse should recommend the client consume the supplement with beverages containing vitamin C, such as tomato juice or orange juice, because this will enhance the absorption of the iron supplement. D. Green tea contains caffeine, which impairs iron absorption when the items are consumed together.

A nurse is teaching a client who has a BMI of 22 dietary recommendations during pregnancy. Which of the following statements by the client indicates an understanding of the teaching? A. "I should avoid a vegetarian diet." B. "I should decrease my intake of protein." C. "I should increase my daily intake by 600 calories." D. "I should plan to gain a total of 25 to 35 pounds."

D. "I should plan to gain a total of 25 to 35 pounds." Explanation: A. The nurse should teach the client that a well-balanced vegetarian diet provides the nutritional requirements needed during pregnancy. B. The nurse should teach the client to increase protein intake during pregnancy. C. The nurse should teach a client who has a BMI of 22 to increase daily intake by 400 calories. Increasing to 600 calories daily can lead to obesity and gestational diabetes. D. The nurse should teach a client whose weight is within the expected reference range to gain 11.3 to 15.9 kg (25 to 35 lb) during pregnancy.

A nurse is reviewing the introduction of solid foods with the guardian of a 4-month-old infant. Which of the following statements by the guardian indicates an understanding of the teaching? A. "My baby should consume 2 tablespoons of solid food at each feeding." B. "The majority of my baby's calories should come from solid food." C. "I will give my baby one bottle of fruit juice each day." D. "I will introduce a new solid food every 5 days."

D. "I will introduce a new solid food every 5 days." Explanation: A. Infants should consume 1 to 2 teaspoons of solid food initially at each feeding. B. The infant should receive the majority of calories from infant formula or breast milk. C. Fruit juices should be introduced at 6 months of age, limited to 120 mL (4 oz), and offered in a cup. D. The client understands that new food items should be introduced every 4 to 7 days to monitor for indications of food allergies.

A home health nurse is providing dietary teaching to a guardian of a 3-year-old child. Which of the following statements by the guardians should the nurse identify as understanding of the teaching? A. "I will offer my child a cup of peanut butter to dip her celery in." B. "I can leaver her grapes whole, so she can practice getting them with her fork." C. "I can giver her popcorn as a snack to provide a serving of whole grains." D. "I will put low-fat milk in her cup for her to drink."

D. "I will put low-fat milk in her cup for her to drink." Explanation: A. The nurse should instruct the guardians to avoid giving the 3-year-old child celery or large amounts of peanut butter because both foods present a choking hazard. The guardians should spread peanut butter in a thin layer to decrease the risk of choking. B. The nurse should instruct the guardians to cut items into small pieces to reduce the risk of choking. C. The nurse should instruct the guardians to avoid foods that are easy to swallow whole, such as popcorn or hard pretzels, until the child is 4 years old, because they present a choking hazard. D. Whole milk provides necessary fat for neurological development for children up to 2 years of age, after which the child should consume low-fat or skim milk. Therefore, the nurse should identify this statement as indicating an understanding of the teaching.

A community health nurse is planning to teach a class about weight management for cardiovascular health. Which of the following statements should the nurse plan to include? A. "Limit your sodium intake to 1,800 milligrams per day." B. "Reduce your daily intake of foods that contain protein." C. "Taking a daily multivitamin will prevent cardiovascular disease." D. "Plan to lose weight gradually at ½ to 1 pound per week."

D. "Plan to lose weight gradually at ½ to 1 pound per week." Explanation: A. According to the American Heart Association, clients should limit their sodium intake to 1,500 mg/day. Evidence-based practice indicates that the most significant decreases in blood pressure are seen in clients who have a daily sodium intake of 1,500 mg or less. B. The nurse should inform the participants that plant-based protein assists in lowering cholesterol levels, which ultimately reduces the workload of the heart. Adequate protein is also important for maintaining muscle mass, which aids in weight management. C. The nurse should inform the participants that if a nutritionally-balanced diet is carefully planned and followed, vitamin supplements are not necessary. Evidence-based practice indicates that multivitamin supplements do not decrease or prevent cardiovascular disease. D. The nurse should inform the participants that losing 0.23 to 0.45 kg (0.5 to 1 lb) per week is a healthy and attainable weight-loss goal. Setting realistic goals for weight loss is an important element of success. Trying to lose weight too quickly places clients at risk for nutritional deficiencies and inadequate energy, which can lead to frustration and defeat.

A nurse is assessing the meal pattern of a client who has diverticular disease and a prescription for a high-fiber diet. Which of the following food choices by the client contains the most fiber? A. 1 medium banana B. 1/2 cup oatmeal C. 1 medium apple with skin D. 1/2 cup bran cereal

D. 1/2 cup bran cereal Explanation: A. One medium banana contains 3 g of fiber. B. A ½ cup of oatmeal contains 4 g of fiber. C. One medium apple with skin contains 4 g of fiber. D. The nurse should determine that a ½ cup of bran cereal contains the most fiber at 10 g per serving.

A nurse is reviewing the laboratory data of four clients. The nurse should identify that which of the following clients is experiencing fluid overload? A. A client who has an albumin level of 5.5 g/dL B. A client who has a urine specific gravity of 1.035 C. A client who has a Hct of 55% D. A client who has a sodium level of 130 mEq/L

D. A client who has a sodium level of 130 mEq/L Explanation: A. The nurse should identify that this client's albumin level is greater than the expected reference range of 3.5 to 5 g/dL. An elevated serum albumin level is an indication of dehydration, or fluid volume deficit, resulting from hemoconcentration. B. The nurse should identify that this client's urine specific gravity is greater than the expected reference range of 1.005 to 1.030. An elevated urine specific gravity is an indication of concentrated urine resulting from fluid volume deficit. C. The nurse should identify that this client's Hct is greater than the expected reference range of 37% to 47% for women and 42% to 52% for men. An elevated Hct is an indication of hemoconcentration from fluid volume deficit. D. The nurse should identify that this client's sodium level is lower than the expected reference range of 136 to 145 mEq/L and indicates hyponatremia. Hyponatremia, often called water deficit, is a decrease of sodium concentration in the blood caused by an excess of water. Manifestations of hyponatremia include confusion, headache, nausea, and fatigue.

A client is experiencing anorexia related to cancer treatment. Which of the following interventions should the nurse implement to increase the client's nutritional intake? A. Recommend cooking aromatic foods to stimulate appetite. B. Serve hot foods rather than cold foods. C. Instruct the client to eat three meals per day. D. Add extra calories and protein to every meal.

D. Add extra calories and protein to every meal. Explanation: A. Cancer treatments can cause an increased sensitivity to odors, precipitating nausea and increasing anorexia. B. The nurse should serve cold foods rather than hot foods. Hot foods emit odors that can further decrease the client's appetite. C. The nurse should advise the client to eat small, frequent meals approximately every 2 hr. D. Adding extra calories and protein to every meal will increase the client's nutritional intake.

A nurse is creating a plan of care for a client who has anorexia nervosa. Which of the following interventions should the nurse include in the plan? A. Weigh the client once weekly at the same time of the day. B. Stay with the client for 30 min after meals. C. Allow the client to schedule mealtimes. D. Assign privileges based on direct weight gain.

D. Assign privileges based on direct weight gain. Explanation: A. The client should be weighed at the same time each day, not each week. It shows if the client is compliant with treatment. B. The nurse should stay with the client during and for 1 hr after meals. This ensures the client does not discard any food or beverages or engage in self-induced vomiting. C. The nurse is responsible for determining mealtimes. Allowing the client to schedule their own mealtimes does not ensure that they will condume enough calories for increased weight gain. D. The nurse should explain to the client that restrictions and privileges will be dependent on treatment compliance and direct weight gain. This approach involves the client in development of the plan of care and gives them control in achieving desired privileges.

A client reports constipation during a routine checkup. The client was previously encouraged to increase their intake of mineral supplements. Which of the following minerals should the nurse identify as the possible cause of the constipation? A. Phosphorus B. Potassium C. Magnesium D. Calcium

D. Calcium Explanation: A. Excessive phosphorus supplementation does not cause constipation. B. Excessive potassium supplementation can cause vomiting. C. Excessive magnesium supplementation can cause diarrhea and cramping. D. Calcium can lead to constipation by decreasing peristalsis.

A nurse is educating a group of clients about vitamin and mineral intake during pregnancy. Which of the following supplements should the nurse instruct the clients to avoid taking with iron? A. Magnesium B. Vitamin B12 C. Vitamin A D. Calcium

D. Calcium Explanation: A. Magnesium does not interfere with iron absorption. B. Magnesium does not interfere with iron absorption. C. Vitamin A does not interfere with iron absorption. D. The nurse should instruct the client to take calcium and iron supplements at different times, or between meals, because calcium can interfere with iron absorption if taken together with meals.

A nurse is caring for a client who has undergone a radical head and neck resection to treat cancer and is receiving radiation therapy. The nurse should monitor for which of the following potential adverse effects? A. Bone marrow suppression B. Radiation enteritis C. Malabsorption of nutrients D. Changes in the production of saliva

D. Changes in the production of saliva Explanation: A. Bone marrow suppression is an adverse effect from chemotherapy. B. Radiation enteritis occurs following radiation of the pelvis or abdomen, rather than the head and neck. C. Malabsorption of nutrients is a potential complication of radiation enteritis, an effect of radiation to the abdomen and pelvis. D. Changes in salivation are a potential complication of a head and neck resection and radiation therapy.

A nurse is caring for a client who has diabetes mellitus and reports feeling dizzy, weak, and shaky. Which of the following is the priority action by the nurse? A. Offer the client 180 mL (6 oz) of orange juice. B. Document the client's intake from the most recent meal. C. Teach the client manifestations of hypoglycemia. D. Check the client's blood glucose level.

D. Check the client's blood glucose level. Explanation: A. The nurse should offer the client 180 mL of orange juice, but another action is the priority. B. The nurse should document the client's intake, but another action is the priority. C. The nurse should teach the client manifestations of hypoglycemia, but another action is the priority. D. The first action the nurse should take using the nursing process is to assess the client. Therefore, checking the client's blood glucose level is the priority action.

A nurse is assessing a client who has an elevated blood pressure, headache, and is sweating. The client recently started taking MAOI. The nurse should question the client regarding the consumption of which of the following foods? A. Grapefruit juice B. Whole milk C. Whole grain bread D. Cheddar cheese

D. Cheddar cheese Explanation: A. Grapefruit juice contains little or no tyramine; therefore, consumption is not restricted for clients who are taking MAOIs. B. Whole milk contains little or no tyramine; therefore, consumption is not restricted for clients who are taking MAOIs. C. Whole grain bread contains little or no tyramine; therefore, consumption is not restricted for clients who are taking MAOIs. D. Clients who take MAOIs should avoid the consumption of most types of cheese and other foods that contain high levels of tyramine, which can lead to hypertensive crisis.

A nurse is providing dietary teaching for a client who has COPD. Which of the following instructions should the nurse include in the teaching? A. Eat at least three well-proportioned, large meals a day. B. Drink low-protein, low-calorie nutrition formulas between meals. C. Avoid adding gravies and sauces to foods. D. Consume foods that are soft in texture and easy to chew.

D. Consume foods that are soft in texture and easy to chew. Explanation: A. Clients who have COPD usually do not have the energy to eat large meals. The client should eat six small meals per day. B. Clients should drink high-protein, high-calorie formulas between meals. C. Clients who have COPD should add gravy and sauces to foods to prevent dry mouth. D. Eating a soft diet and avoiding foods that are difficult to chew will decrease shortness of breath while eating.

A nurse is preparing to administer an influenza vaccine to an adult client who reports food allergies. Which of the following food allergies could place the client at risk for a reaction? A. Peanuts B. Milk C. Shellfish D. Eggs

D. Eggs Explanation: A. A peanut allergy is not a contraindication for receiving the influenza vaccine. B. A milk allergy is not a contraindication for receiving the influenza vaccine. C. A shellfish allergy is not a contraindication for receiving the influenza vaccine. D. A hypersensitivity to eggs can place a client at risk for allergic reactions when receiving the influenza vaccine. The vaccine should only be administered by a healthcare provider who can recognize and respond to severe allergic reactions.

A nurse is caring for a client who has a new prescription for parenteral nutrition (PN) containing a mixture of dextrose, amino acids, and lipids. Prior to administration of the PN, the nurse should report which of the following food allergies to the provider? A. Gelatin B. Peanuts C. Shellfish D. Eggs

D. Eggs Explanations: A. There is no indication that a gelatin allergy has an effect on the administration of PN. Therefore, the nurse should report this allergy to the dietitian, rather than the provider. B. There is no indication that a peanut allergy has an effect on the administration of PN. Therefore, the nurse should report this allergy to the dietitian, rather than the provider. C. There is no indication that a shellfish allergy has an effect on the administration of PN. Therefore, the nurse should report this allergy to the dietitian, rather than the provider. D. Lipid emulsions are isotonic and are composed of soybean or safflower plus soybean oil, with egg phospholipid used as an emulsifier. Clients who are allergic to eggs can have a reaction to the emulsifier. Therefore, the nurse should report this finding to the provider.

A nurse is caring for a client who is receiving continuous feedings via an NG tube. The nurse notices that the tube feeding has stopped infusing. Which of the following actions is the nurse's priority? A. Change the formula. B. Change the tube. C. Notify the provider. D. Flush the tube with warm water.

D. Flush the tube with warm water. Explanation: A. The nurse might need to switch to a less calorically dense formula if the tubing clogs frequently, but this is not the first action the nurse should take. B. The nurse might need to change the tube if clumps of formula have formed in the tube, but this is not the first action the nurse should take. C. The nurse might need to notify the provider, but this is not the first action the nurse should take. D. According to evidence-based practice, the first action the nurse should take when a tube feeding stops infusing is to flush the tube with 30 to 50 mL of warm water to re-establish flow. Other interventions might be required if flushing does not remove the clog.

A nurse is teaching about nutritional requirements for a client who is starting a vegetarian diet. Which of the following information should the nurse include in the teaching? A. Consume high-fat cheese to replace meats when on a vegetarian diet. B. A vegetarian diet is high in vitamin B12. C. Fewer calories are required when on a vegetarian diet. D. Include two servings per day of nuts when on a vegetarian diet.

D. Include two servings per day of nuts when on a vegetarian diet. Explanations: A. The nurse should instruct the client to consume low-fat cheese as a protein substitute. High-fat cheese has more saturated fat and calories than meat. B. Foods that contain vitamin B12 are animal-related. The best sources of dietary vitamin B12 are meats and other animal products. As vitamin B12 is generally not present in plant-based foods, the nurse should instruct the client to take vitamin B12 supplements or consume foods fortified with B12 to compensate for a potential deficiency. C. Clients who are consuming a vegetarian diet require a deceased intake of dietary fat rather than fewer calories. The nurse should instruct the client to increase intake of nutrient-dense foods to avoid the breakdown of the body's protein for energy requirements. D. The nurse should instruct the client to eat two servings of nuts or flaxseed per day to receive the daily requirement of omega-3 fatty acids.

A nurse is developing a teaching plan for a client who has dysphagia and is being discharged home with a prescription for a mechanical soft diet. Which of the following foods should the nurse include in the plan? A. Fresh peas B. White rice C. Orange slices D. Mashed potatoes

D. Mashed potatoes Explanation: A. Fresh peas have increased amounts of fiber, which increases the risk for aspiration. B. White rice is considered in an advanced diet because it can cause aspiration for a client who has dysphagia. C. A mechanical soft diet includes cooked fruits and veggies rather than raw, such as oranges. D. A mechanical soft diet is a diet of foods with altered texture. It includes cooked fruits and vegetables, foods that are softened with liquids, and foods that are thickened for consistency.

A nurse is providing discharge teaching to a client who has Parkinson's disease and a prescription for levodopa-carbidopa. Which of the following foods should the nurse instruct the client to consume with the medication? A. 6 oz Greek yogurt B. 1 oz cheddar cheese C. Six peanut butter crackers D. One slice wheat toast

D. One slice wheat toast Explanation: A.Absorption of levodopa-carbidopa decreases when consumed with foods that are high in protein. Six oz of Greek yogurt contains 17 g of protein. The nurse should instruct the client to consume a food that contains less protein. B. Absorption of levodopa-carbidopa decreases when consumed with foods that are high in protein. One oz of cheddar cheese contains 7 g of protein. The nurse should instruct the client to consume a food that contains less protein. C. Absorption of levodopa-carbidopa decreases when consumed with foods that are high in protein. Six peanut butter crackers contain 6 g of protein. The nurse should instruct the client to consume a food that contains less protein. D. Absorption of levodopa-carbidopa decreases when consumed with protein. One slice of wheat toast is the lowest source of protein at 3 g per slice.

A nurse is providing teaching to a client who is a vegetarian and requires an increase in zinc intake. Which of the following foods should the nurse include in the teaching as the best source of zinc? A. Pineapple B. Green grapes C. Cauliflower D. Pinto beans

D. Pinto beans

A nurse is teaching a prenatal education class about breastfeeding. Which of the following instructions should the nurse include in the teaching? A. Offer supplemental formula until the milk supply is established. B. Offer the newborn 30 mL (1 oz) of glucose water after the first breastfeeding session. C. Plan to breastfeed the newborn every 4 hr. D. Plan 5-min feedings on each breast on the first day after birth.

D. Plan 5-min feedings on each breast on the first day after birth. Explanation: A. The nurse should instruct the clients to avoid using supplemental formula or water with artificial nipples to decrease the risk of nipple confusion. B. The nurse should instruct the clients to avoid offering the newborn fluids other than breast milk to promote milk production. C. The nurse should instruct the clients to breastfeed on demand when the newborn shows indications of hunger, usually 8 to 12 times per day. D. The nurse should instruct the clients to let the newborn nurse for 5 min on each breast on the first day to promote milk production.

A nurse is planning dietary teaching for a client who has dumping syndrome following a gastrectomy. Which of the following interventions should the nurse include in the client's plan of care? A. Use simple sugars to sweeten foods. B. Remain upright for 1 hr following meals. C. Limit eating to three large meals per day. D. Select grains with less than 2 g fiber per serving.

D. Select grains with less than 2 g fiber per serving. Explanation: A. The nurse should instruct the client to avoid simple sugars and sugar alcohols, which make food mass more hypertonic, causing a greater fluid volume shift and triggering dumping syndrome. B. The nurse should instruct the client to lie down after eating to slow the movement of food through the gastrointestinal system. C. The nurse should instruct the client to eat small, frequent meals to slow gastric emptying. D. Clients at risk for dumping syndrome better tolerate low-fiber grains that contain less than 2 g fiber per serving to slow gastric emptying.

A nurse is preparing to bottle feed an infant who has a cleft lip. Which of the following actions should the nurse take to reduce the risk of aspiration? A. Burp the infant once at the end of the feeding. B. Use a bottle that has a two-way valve. C. Place a low-flow rate nipple on the bottle. D. Squeeze the infant's cheeks together while feeding.

D. Squeeze the infant's cheeks together while feeding. Explanation: A. The nurse should burp the infant after each ounce of feeding or at least two to three times during the feeding. Infants who have a cleft lip can swallow air while feeding, which can cause vomiting and an increased risk of aspiration. B. The nurse should use a bottle with a bottle with a one-way valve to assist the infant in effective feeding, because this allows the liquid to flow into the infant's mouth rather than back into the bottle. Providing an effective flow of formula reduces the risk of aspiration. C. The nurse should place a high-flow rate nipple on the bottle because the infant can have difficulty achieving a good seal, which decreases suction and increases the risk of aspiration. D. The nurse should identify that an infant who has a cleft lip will have difficulty in obtaining an adequate seal during feeding. The nurse should gently squeeze the infant's cheeks together to decrease the width of the cleft, allowing the infant to achieve a better seal, which reduces the risk of aspiration.

A nurse is assessing a client for dysphagia following a stroke. The nurse should identify which of the following findings as a manifestation of dysphagia? A. The client reports abdominal pain after eating. B. The client has an increase in bowel sounds after eating. C. The client has an increased interest in eating. D. The client's voice changes after eating.

D. The client's voice changes after eating. Explanation: A. The nurse should identify that painful swallowing is a manifestation of dysphagia. B. The nurse should identify that peristalsis increases after eating to promote the passage of food through the intestines. This is an expected finding of gastrointestinal functioning, not a manifestation of dysphagia. C. The nurse should identify that clients who have dysphagia can become discouraged while eating and consume less food, possibly leading to malnutrition. D. The nurse should identify that hoarseness or a change in voice after eating is a manifestation of dysphagia because partially swallowed food can alter the client's voice.

A nurse in a clinic is reviewing the laboratory findings of a client who recently began a Dietary Approaches to Stop Hypertension (DASH) diet. Which of the following laboratory findings indicates the client has reached one of the goals of the DASH diet? A. Sodium 150 mEq/L B. Chloride 106 mEq/L C. Fasting glucose 130 mg/dL D. Total cholesterol 190 mg/dL

D. Total cholesterol 190 mg/dL Explanation: A. A feature of the DASH diet is a reduction in sodium intake. This laboratory finding is above the expected reference range of 135 to 145 mEq/L for sodium and indicates that the client has not reached a goal of the DASH diet. B. This laboratory finding is within the expected reference range of 98 to 106 mEq/L, but it is not an indication of achieving a goal of a DASH diet. C. A feature of the DASH diet is a reduction in serum glucose, as hyperglycemia is an associated risk factor for hypertension and coronary heart disease. This laboratory finding is above the expected reference range of 70 to 130 mg/dL and indicates that the client has not reached a goal of the DASH diet. D. A feature of the DASH diet is a reduction in total cholesterol. This laboratory finding is within the expected reference range of cholesterol less than 200 mg/dL, and indicates that the client has achieved one of the goals of the DASH diet.

A nurse is teaching a client who is preparing for bowel surgery about a low-residue diet. Which of the following food choices by the client indicates an understanding of the teaching? A. Three slices of bacon and oatmeal toast B. Granola with raisins and strawberries C. Whole wheat French toast with blueberries and maple syrup D. Two poached eggs and a banana

D. Two poached eggs and a banana Explanation: A. A low-residue diet limits the amount of stool traveling through the intestinal tract. The client should avoid whole grains, fatty meats, and high-fiber foods. D. A low-residue diet limits the amount of stool traveling through the intestinal tract. The nurse should teach the client to avoid foods high in fiber. Poached eggs and bananas are acceptable low-residue menu choices.

A nurse is caring for a client who develops diarrhea while receiving continuous enteral tube feeding. Which of the following actions should the nurse take? A. Provide a low-protein formula. B. Elevate the head of the bed to 30°. C. Switch to intermittent feedings. D. Warm the formula to room temperature.

D. Warm the formula to room temperature. Explanation: A. The nurse should provide a low-fat formula for a client who has diarrhea. B. Elevating the head of the client's bed to 30° prevents aspiration rather than diarrhea. C. A client who has diarrhea should receive a continuous enteral feeding. D. A client can develop diarrhea if the formula being infused is too cold. Therefore, the nurse should warm the formula to room temperature prior to administration.

A nurse is providing dietary teaching for a client who has osteoporosis. The nurse should instruct the client that which of the following foods has the highest amount of calcium? A. 1 cup avocado B. 2 tablespoons peanut butter C. ½ cup roasted sunflower seeds D. ½ cup roasted almonds

D. ½ cup roasted almonds Explanation: A. The nurse should recommend a different food because there is another choice that contains a higher amount of calcium. One cup of avocado contains 18 mg of calcium. B. The nurse should recommend a different food because there is another choice that contains a higher amount of calcium. Two tablespoons of peanut butter contain 17 mg of calcium. C. The nurse should recommend a different food because there is another choice that contains a higher amount of calcium. One half cup of roasted sunflower seeds contains 45 mg of calcium. D. The nurse should determine that ½ cup roasted almonds is the best food source to recommend because ½ cup of almonds contains 185 mg of calcium. Calcium helps to prevent bone loss in clients who have osteoporosis.