Chapter 36: Nutrition

Which nursing student statement regarding vegetarian diets requires further teaching from the nursing instructor?

"According to research, vegetarians have a higher incidence of obesity than others."

After a visit with the health care provider, the nurse calculates the client's body mass index (BMI). Which statement by the nurse best informs the client of the purpose of BMI?

"BMI is used to screen for weight categories that can lead to health problems."

A client with diabetes must monitor food intake. Which client statement requires further client education by the nurse? Select all that apply.

"I like to eat all my carbohydrates at lunch." "I only drink coffee for breakfast." "I follow my diet during the week and treat myself on the weekend."

A client with diabetes mellitus must monitor carbohydrate intake. Which client statement requires nursing intervention?

"My favorite drink is coffee with sugar."

A client is discussing vitamin and mineral intake with the nurse. Which client statement requires further nursing teaching?

"My husband and I are ordering a product that has megadoses of vitamins."

A nursing student is teaching healthy nutrition to a client who is vegetarian. Which statement by the nursing student requires the nursing instructor to intervene?

"Obesity is closely linked with vegetarianism."

The nurse is teaching the caregiver of a toddler about the importance of calcium to help the toddler's teeth and bones develop properly. Which client statement reflects that nursing teaching has been effective?

"Vitamin D helps calcium absorption."

The nurse prepares to provide gastrostomy insertion site care. The gastrostomy tube was placed this week. The client reports pain at the site. Which action does the nurse take next?

Administer pain medication.

A nurse documents a client's hemoglobin as 8 g/dL (80 g/L). What nutritional condition does this biochemical data signify?

Anemia

The nurse is concerned that a client is not eating the meals provided. Which interventions should the nurse implement to encourage eating?

Ask the client why he or she is not eating.

The nurse has obtained a client's capillary blood glucose sample and the results are significantly lower than reference range. What is the nurse's priority action?

Assess the client for signs and symptoms of hypoglycemia.

A nurse is caring for a client who has a nursing diagnosis of Risk for Aspiration. When preparing to assist this client with eating, how can the nurse best reduce this risk?

Assess the client's level of consciousness.

Prior to allowing a client to eat, which action is most important for the nurse to take?

Assess the client's level of consciousness.

The nurse is caring for a client who refuses most foods on the dietary tray. Which nursing intervention is appropriate?

Assess when client generally eats meals.

Which nursing action associated with successful tube feedings follows recommended guidelines?

Check the residual before each feeding or every 4 to 8 hours during a continuous feeding.

A nurse is caring for a client who is receiving total parenteral nutrition (TPN). Which action should the nurse perform with TPN?

Discard unused TPN every 24 hours.

A nurse is working with a 46-year-old woman who is working to lose weight. Based on recommendations from the USDA regarding diet modification, which is not appropriate advice for this client?

Drink juice for majority of fluid intake.

The nurse researches factors that may alter nutrition. Which statements accurately describe factors that influence nutritional status? Select all that apply.

During pregnancy and lactation, nutrient requirements increase. Nutritional needs per unit of body weight are greater in infancy than at any other time in life. Men and women differ in their nutrient requirements.

After teaching the client about a low-fat diet, which items selected by the client would indicate to the nurse that the client comprehends the nutritional teaching?

Egg white omelet with vegetables

Which intervention should the nurse take for a client who is receiving continuous tube feedings?

Elevate the head of the bed at least 30 to 45 degrees to prevent aspiration.

A nurse is managing a client's continuous tube feeding via an NG tube. How often should the nurse check for residual?

Every 4 to 6 hours

A nurse in a clinic is caring for a female client who is of childbearing age. Which vitamins or minerals should the nurse recommend to prevent neural tube defects during pregnancy?

Folic acid

Which nursing action is performed according to guidelines for aspirating fluid from a small-bore feeding tube?

If fluid is obtained when aspirating, measure its volume and pH and flush the tube with water.

What is an appropriate intervention when unexpected situations occur during the administration of a tube feeding?

If the tube becomes clogged when aspirating contents, use warm water and gentle pressure to remove the clog.

A client has been on a clear liquid diet for 5 days. What is an appropriate nursing diagnosis for this client?

Imbalanced Nutrition, Less Than Body Requirements

The nurse is reviewing a client's most recent laboratory results, which reveal increases in hematocrit, creatinine, and blood urea nitrogen (BUN). After collaborating with the interdisciplinary team, what intervention is most appropriate?

Increase the client's fluid intake.

The nurse is caring for a client with an enlarged thyroid gland. Which nutritional deficiency will the nurse suspect is linked to the client's condition?

Iodine

The nurse is caring for a client with an enlarged thyroid. What nutritional deficiency is linked to an enlarged thyroid?

Iodine

A female client has developed an abscess following abdominal surgery, and her food intake has been decreasing over the past 2 weeks. Which laboratory finding may suggest the need for nutritional support?

Low serum albumin levels

During a visit to the pediatrician's office, a parent inquires about adding solid foods to the diet of a 6-month-old infant. What does the nurse inform the parent?

New foods should be introduced one at a time for a period of 2 to 3 days.

The nurse is performing a nutritional assessment of an obese client who visits a weight control clinic. What information should the nurse take into consideration when planning a weight reduction plan for this client?

Psychological reasons for overeating should be explored, such as eating as a release for boredom.

A nurse is reviewing a client's laboratory values. Which laboratory value would be indicative of a client's level of malnutrition?

Serum albumin

A client has been diagnosed with anorexia nervosa. Which intervention(s) will the nurse employ during care? Select all that apply.

Set a weight goal with the client. Assess for depression. Supervise client during meals and for 1 hour after. Encourage liquid intake over solid fluids. Monitor for signs of food hoarding or disposing of food. Provide small meals and snacks appropriately.

The nurse is caring for a client who has dysphagia and is unable to eat independently. The nurse is preparing to assist the client in eating a meal. Which action is appropriate?

Speak to the client but limit the need for the client to respond verbally while chewing and swallowing.

During a general survey, the nurse documents the waist circumference of an overweight female client as 43 in (109 cm). Which teaching should the nurse include about the risks associated with this waist circumference?

The client is at risk for diabetes.

The charge nurse is observing a new nurse care for a client who is receiving a continuous feeding through a nasogastric feeding tube. Which action by the new nurse would require intervention by the charge nurse?

The new nurse places the client in the left lateral recumbent position.

A nurse is checking a client's capillary blood glucose level. Which nursing action is most appropriate?

Touch the test strip directly to a drop of blood.

A nurse is checking a client's capillary blood glucose level. Which nursing action is mostappropriate?

Touch the test strip directly to a drop of blood.

An older adult client has diminished thirst sensation. What teaching will the nurse give the client to help the client get enough fluid?

Try drinking something savory like broth.

An older adult client informs the nurse that foods don't taste or smell the same and eating is a chore. What suggestion can the nurse provide to the client to address this age-related change?

Try eating foods that are attractive and at the proper temperature.

The nurse has observed that a client's food intake has diminished in recent days. What intervention should the nurse perform in order to stimulate the client's appetite?

Try to ensure that the client's food is attractive and sufficiently warm.

A nurse is conducting client education with a woman who meets the diagnostic criteria for metabolic syndrome. The nurse is teaching the client about the MyPlate tool for promoting healthy food intake. According to MyPlate, the highest proportion of food in each meal should consist of what?

Vegetables

The client reports to the nurse that she feels as if her eyes are persistently dry. This symptom is consistent with a deficiency in which dietary element?

Vitamin A

A nurse is educating a group of adolescent girls on bone and teeth growth. Which fat-soluble vitamin assists to build bone and teeth?

Vitamin D

A client is prescribed warfarin, an anticoagulant. When educating this client about potential diet and drug interactions, the nurse would caution the client about foods containing which nutrient?

Vitamin K

A client who has bleeding tendencies has a deficiency in which vitamin?

Vitamin K

When planning interventions in the immediate hours after birth the nurse recognizes the need to provide an injection of which vitamin (to manage a lack of it), due to lack of bacteria in the intestinal tract?

Vitamin K

The nurse is assessing clients for basal metabolic rate (BMR). Which client would the nurse suspect would have an increased BMR?

a client who has a fever

At what period of life do nutrient needs stabilize?

adulthood

A nurse is caring for a client who had an appendectomy earlier in the day. The client now has bowel sounds and is passing flatus. Which food is appropriate for the nurse to serve to the client at this time?

apple juice

A 16-year-old adolescent informs her nurse that she became a vegetarian 1 year ago. Lately she is reporting fatigue and has trouble concentrating. A quick blood test ordered by her licensed provider informs the nurse that she has pernicious anemia. This is a deficiency of what vitamin?

b12

A nurse is caring for a client who reports chest pain. Which test levels would indicate whether the client is at risk for cardiac and vascular disease?

cholesterol

The nurse is caring for four clients. Which client does the nurse assess to be at highest risk for cardiac and vascular disease?

client with total cholesterol of 210 mg/dL, HDL 40 mg/dL

The nurse is teaching a client about ways in which to reduce sodium in the diet. Which foods will the nurse recommend that the client avoid? Select all that apply.

cured ham table salt bacon

A woman consumes pasta, grains, and other carbohydrates for which purpose?

energy

Upon assessment, the nurse determines the client has a body mass index (BMI) of 45. This finding indicates the client is:

extremely obese.

A client is receiving total parenteral nutrition (TPN). The nurse will assess for complications related to:

fluid and electrolyte levels.

A client with influenza is prescribed a diet that is rich in fiber and carbohydrates. Which would the nurse incorporate into the education plan as a major reason for the high fiber diet?

maintenance of normal bowel elimination

An older adult client has a decubitus ulcer with drainage, dysphagia, and immobility. She consumes less than 300 calories per day and has a large amount of interstitial fluid. The client is in a state of:

negative nitrogen balance.

A client who is taking supplements reports severe flushing and itching an hour after ingestion. The nurse is aware that the supplement is most likely:

niacin.

A 45-year-old client on the inpatient unit has just resumed eating a normal diet. The nurse checks a blood sugar with the morning labs and the result is 99.10 mg/dL (5.5 mmol/L). How would the nurse interpret this blood glucose?

normal

The community nurse is educating client groups about nutrition. Which group does the nurse identify that will benefit most from nutritional counseling and intervention?

older adults living on a fixed income

A nurse is caring for a client who has a body mass index (BMI) of 26.5. Which category should the nurse understand this client would be placed in?

overweight

A nurse is working with a 45-year-old construction worker. The nurse obtains his height and weight and calculates that his BMI is 28. How would the nurse best classify James?

overweight

Which client(s), at risk for poor nutritional intake, would benefit from nutritional counseling from the nurse? Select all that apply.

pregnant teenagers people with substance use problems older adults living on fixed incomes

A client has just had abdominal surgery, and the nurse is consulting with him about his diet now that he is allowed to eat. Which nutrient is most important for wound healing?

protein

A nurse is caring for a client with chronic anemia. What should be included in the diet of this client?

red meat

A nurse is caring for a client who has a malabsorption disease. The nurse should understand that which structure in the gastrointestinal system absorbs the majority of digested food and minerals?

small intestine

The nurse is teaching four clients in a community health center. Which client does the nurse identify as needing more servings per day of milk?

teenager who is in the second trimester of pregnancy

The nurse is educating a group of adolescent girls on bone and teeth growth. Which fat-soluble vitamin assists to build bone and teeth?

vitamin A

Which vitamin is found only in animal foods?

vitamin B12

A nurse in a rural health center meets a new client, age 4. The nurse notices as the client enters the clinic that his legs appear to be bowed. When he smiles, the nurse also notes that his dentition is quite malformed for a child his age. What vitamin deficiency would the nurse mostsuspect?

vitamin D

Which of the following is a fat-soluble vitamin?

vitamin E