NURS135 Practice HESI

Vitamin K 0.5 mg is prescribed for a newborn. The vial on hand is labeled "1 mL = 2 mg." How many milliliters should the nurse administer? Include a leading zero if applicable and record your answer using two decimal places. _____ mL

0.5 mL

When assessing the characteristics of an adolescent with anorexia nervosa, how does the nurse expect to describe the adolescent? A. Manic B. Rebellious C. Hypoactive D. Perfectionistic

D. Perfectionistic Perfectionistic standards and extremes of self-discipline are an attempt to maintain control and meet the client's own and others' expectations. People with anorexia nervosa are often anxious and depressed, not manic. People with anorexia nervosa are frequently compliant in an attempt to meet the expectations of others. People with anorexia nervosa usually use excessive exercise routines as a means of losing weight. Also, many are trying to become the thin, fit ideal woman depicted in the media.

A nurse is teaching the parents of a school-aged child with celiac disease about the nutrients that must be avoided in a gluten-free diet. What nutrients should the nurse teach the parents to avoid? A. Saturated oils and fats B. Milk and hard cheeses C. Corn and rice products D. Wheat and oat products

D. Wheat and oat products. Wheat, oats, rye, and barley are major dietary sources of gluten; the gliadin fraction of these grains is not tolerated by individuals with celiac disease. There is no gluten in oils and fats. There is no gluten in cheeses and milk. Corn and rice are used as substitute grains because they do not contain gluten.

A client with hepatic cirrhosis begins to develop slurred speech, confusion, drowsiness, and a flapping tremor. Which diet can the nurse expect will be prescribed for this client based upon the assessment? A. No protein B. Moderate protein C. High protein D. Strict protein restriction

B. Moderate protein Because the liver is unable to detoxify ammonia to urea and the client is experiencing impending hepatic encephalopathy coma, protein intake should be moderately restricted. Strict protein and no protein restrictions are not required because clients need protein for healing. High protein is contraindicated in hepatic encephalopathy.

A nurse is counseling a pregnant client with iron-deficiency anemia about when and how to take supplemental iron. With what drink is iron absorption most efficient? A. Water B. A strawberry milkshake C. Skim milk D. Orange juice

D. Orange juice Iron should be taken before breakfast, on an empty stomach, to permit maximal absorption; the ascorbic acid in orange juice enhances the absorption of iron. Water does not provide the ascorbic acid necessary for absorption of iron. Iron should not be taken with milk or other dairy products, which may interfere with its absorption.

The school nurse conducts a class in nutrition planning for parents. What is the goal of school health nursing programs? A. Health promotion B. Disease management C. Chronic care management D. Environmental surveillance

A. Health Promotion The goal of school health nursing programs is health promotion through a school curriculum. A class on nutritional planning for parents contributes to health promotion. Disease management is one of the many programs of community health centers. These centers provide primary care to a specific client population within a community. Nurse-managed clinics provide nursing care with a focus on acute and chronic care management. The occupational health nurse may conduct an environmental surveillance for health promotion and accident prevention in the work setting.

A nurse is counseling a pregnant client who maintains a vegetarian diet. What should the nurse plan to do to ensure optimal nutrition during the pregnancy? A. Refer the client to a dietitian to help plan her daily menu. B. Encourage the client to join a group that teaches nutrition. C. Explain that she needs to include meat in her diet at least once a day. D. Advise the client that it is unhealthy to continue a vegetarian diet during pregnancy.

A. Refer the client to a dietitian to help plan her daily menu. The dietitian can give the client specific information that would help her plan nutritious meals. Specific foods, such as nuts and soy products, may be substituted for meat or animal-related products. The client may know healthy nutrition; she needs help to adapt the vegetarian diet to meet pregnancy needs. Explaining that she needs to include meat in her diet at least once a day or advising the client that it is unhealthy to continue a vegetarian diet during pregnancy ignores the client's beliefs and lifestyle; a nutritious vegetarian diet is available during pregnancy.

The nurse provides a list of appropriate food choices to a client with newly diagnosed diabetes. The client reviews the list and says, "I do not like and refuse to eat asparagus, broccoli, and mushrooms." In response, the nurse teaches the client about the food exchange list. The nurse evaluates that teaching was effective when the client states, "Instead of asparagus, broccoli, and mushrooms, I will eat which foods?" A. String beans, beets, or carrots." B. Corn, lima beans, or dried peas." C. Baked beans, potatoes, or parsnips." D. Corn muffins, corn chips, or pretzels."

A. String beans, beets, or carrots. String beans, beets, and carrots are in the vegetable exchange, as are asparagus, broccoli, and mushrooms. Corn, lima beans, dried peas, baked beans, potatoes, or parsnips are starchy vegetables and are listed as bread exchanges. Corn muffins, corn chips, or pretzels are from the bread exchange list.

As the nurse is teaching a child's parents about celiac disease, the mother sighs and says, "My neighbor told me that I'll only need to monitor the diet until our child is 8 years old. I'm so relieved. You know how kids are about eating!" On what fact should the nurse's response be based? A. The basic defect of celiac disease is lifelong. B. Susceptibility to celiac crisis lessens with age. C. The diet is relatively easy to follow for a growing child. D. The child will be able to tolerate small amounts of gluten by school age.

A. The basic defect of celiac disease is lifelong. The diet must continue to be followed because the child will always have an absence of peptidase; some variations in the diet may be allowed, but this should not be promised. Each phase of child development may have problems related to dietary management; follow-up care is needed to prevent crises. A restricted diet is never easy to follow, especially for a growing child. Gluten must be avoided for a prolonged period and perhaps indefinitely.

A client has a hiatal hernia. The client is 5 feet 3 inches tall (163 cm) and weighs 160 pounds (72.6 kg). Which information should the nurse include when discussing prevention of esophageal reflux? A. Increase your intake of fat with each meal. B. Lie down after eating to help your digestion. C. Reduce your caloric intake to foster weight reduction. D. Drink several glasses of fluid during each of your meals.

C. Reduce your caloric intake to foster weight reduction Weight reduction decreases intraabdominal pressure, thereby decreasing the tendency to reflux into the esophagus. Fats decrease emptying of the stomach, extending the period that reflux can occur; fats should be decreased. Lying down after eating increases the pressure against the diaphragmatic hernia, increasing symptoms. Drinking several glasses of fluid during each meal will increase pressure; fluid should be discouraged with meals.

The nurse understands that research demonstrates that malnutrition occurs in as many as 50% of hospitalized clients. The nurse should assess a postoperative client with anorexia for what sign of malnutrition? A. Dependent edema B. Spoon-shaped nails C. Loose, decayed teeth D. Delayed wound healing

D. Delayed wound healing Delayed wound healing often is caused by a lack of nutrients, such as protein and vitamin C, in the diet. Dependent edema usually occurs with severe protein deficiency and heart failure. Spoon-shaped nails usually occur with iron deficiency anemia. Loose, decayed teeth usually indicate prolonged malnutrition.

During a health symposium a nurse teaches the group how to prevent food poisoning. Which statement by one of the participants indicates the teaching is understood? A. "Meats and cream-based foods need to be refrigerated." B. "Once most food is cooked, it does not need to be refrigerated." C. "Poultry should be stuffed and then refrigerated before cooking." D. "Cooked food should be cooled before being put into the refrigerator."

A. Meats and cream-based foods need to be refrigerated. A cold environment limits growth of microorganisms. All food should be refrigerated before and after it is cooked to limit the growth of microorganisms. Stuffing and then refrigerating poultry promotes the growth of microorganisms because the stuffing will still be warm for a period before the refrigerator's cold environment cools the center of the bird. It is advocated that poultry not be stuffed. If it is stuffed, it should be done immediately before cooking. Cooling foods before refrigeration promotes the growth of microorganisms because microorganisms thrive in warm, moist environments.

The nurse is providing care to an infant who is diagnosed with cystic fibrosis (CF). Which parental statement indicates the need for further education related to the potential for poor growth? A. "My child's diagnosis causes delayed bone growth." B. "My child will have a poor appetite, which will lead to poor growth." C. "My child will have increased oxygen demands, which will lead to poor growth." D. "My child will have a decreased ability to absorb nutrients, which will cause poor growth."

B. "My child will have a poor appetite, which will lead to poor growth." Pediatric clients who are diagnosed with CF experience poor growth despite a healthy appetite and diet; therefore, the parental statement indicates that the infant's poor appetite will lead to poor growth indicates the need for further education. Pediatric clients diagnosed with CF experience poor growth due to delayed bone growth, increased oxygen demands, and a decreased ability to absorb nutrients.

A 17-year-old adolescent was recently found to have type 2 diabetes mellitus. What information will the nurse include when providing education to the family? A. "Your teen will need insulin injections for the rest of her life." B. "The most important interventions are good nutrition and portion control." C. "This is a condition where the body produces antibodies against its own cells." D. "This condition causes weight loss and increased appetite, thirst, and urination."

B. "The most important interventions are good nutrition and portion control." Most children with type 2 diabetes are overweight or at risk for becoming overweight. With nutritional intervention to promote proper weight, the condition may often be managed with diet and exercise alone. A lifelong insulin regimen; the production of antibodies against the child's own cells; and weight loss with increased appetite, thirst, and urination are all typical of type 1 diabetes.

What is the recommended protein intake for preschoolers? A. 1 g/day B. 13 g/day C. 300 mg/day D. 700 mg/day

B. 13 g/day The recommended protein intake for preschoolers is 13 to 19 g/day. The recommended protein intake for preschoolers is not 1 g/day. The recommended cholesterol consumption for children over the age of 2 years should be less than 300 mg/day, while the recommended daily allowance for calcium for children 1 to 3 years old is 700 mg.

The mother of a 4-month-old infant weighing 11 lb (5 kg) asks the nurse how much formula is required per day now that her baby has been weaned from the breast. The recommended caloric intake is 108 kcal/kg, and the formula contains 20 kcal/oz (20 kcal/30 mL). How much formula should the nurse tell the mother to give to her infant each day? A. 21 oz (630 mL) B. 27 oz (810 mL) C. 33 oz (990 mL) D. 39 oz (1170 mL)

B. 27 oz (810 mL) The infant's daily intake should be approximately 27 oz (810 mL). The infant weighs 11 lb (11/2.2 = 5 kg). An infant's daily caloric need is 108 kcal/kg body weight. 108 kcal × 5 kg = 540 kcal/day; because there are 20 kcal/oz, 540 ÷ 20 = 27 oz (20 kcal/30 mL, 540 ÷ 20 X 30 mL = 810 mL) . Twenty-one ounces (630 mL) is inadequate; 33 (990 mL) oz or 39 (1170 mL) oz is excessive.

The nurse is helping an adolescent with iron-deficiency anemia make breakfast meal choices. Which foods should the nurse suggest? A. Apple fruit cup B. Bowl of raisin bran C. Cup of blueberry yogurt D. Slice of wheat bread toast with butter

B. Bowl of raisin bran The iron content in the options is as follows: ¾ cup raisin bran, 13.5 mg; one slice of wheat bread, 0.9 mg; 1 cup of blueberry fruit yogurt, 0.2 mg; and apple fruit cup, 0.2 mg. The best choice is the bowl of raisin bran cereal, which has the highest iron content of all the choices.

Thick mucous gland secretions, elevated sweat electrolytes, meconium ileus, and difficulty maintaining and gaining weight are associated with which autosomal recessive disorder? A. Cerebral palsy B. Cystic fibrosis C. Muscular dystrophy D. Multiple sclerosis

B. Cystic Fibrosis The early symptom of cystic fibrosis is meconium ileus, which is impacted stool in the newborn. Thick mucous secretions, salty sweat, and difficulty gaining weight because of high caloric demands are characteristics of the condition. Cerebral palsy is a motor disorder caused by damage to the brain. Muscular dystrophy is a muscular disorder. Multiple sclerosis is a condition with progressive disintegration of the myelin sheath.

A client asks the nurse what advantage breast-feeding holds over formula feeding. What major group of substances in human milk are of special importance to the newborn and cannot be reproduced in a bottle formula? A. Amino acids B. Gamma globulins C. Essential electrolytes D. Complex carbohydrates

B. Gamma Globulins The antibodies in human milk provide the infant with immunity against all or most of the pathogens that the mother has encountered. Amino acids and essential electrolytes are present in commercial formulas. Complex carbohydrates are not required by the infant.

A nurse is caring for a client with a diagnosis of renal calculi secondary to hyperparathyroidism. Which type of diet should the nurse explore with the client when providing discharge information? A. Low purine B. Low calcium C. High phosphorus D. High alkaline ash

B. Low calcium A low calcium intake is recommended. Calcium and phosphorus are components of these stones; foods high in calcium and phosphorus should be avoided. Low purine and high alkaline ash diets are indicated for clients with gout.

A nurse teaches the mother of a 2-year-old child who has celiac disease which foods to avoid. Which foods identified by the mother indicate that she understands the teaching? A. Bacon and eggs B. Macaroni and cheese C. Tuna salad and rice cakes D. Chicken leg and corn on the cob

B. Macaroni and cheese Children with celiac disease cannot digest the gliadin component of gluten. Foods containing grains such as wheat, rye, oats, and barley should be avoided; macaroni is contraindicated because it is a wheat product. Bacon and eggs, tuna and rice cakes, and chicken and corn are gluten-free foods.

An infant is born with a cleft lip. What nursing intervention is unique to infants with cleft lip? A. Changing the infant's position often B. Using modified techniques for feeding C. Monitoring the infant's daily intake and output D. Keeping the infant's head elevated during feedings

B. Using modified techniques for feeding. Infants with a cleft in the lip are unable to suck like other newborns because they cannot form a vacuum to draw milk from the nipple. Frequent position changes are common for all infants, not just ones with cleft lip. Monitoring of intake and output is not necessary because hydration is maintained once a feeding method has been established. All infants should be fed with the head elevated to avoid pooling of milk in the mouth, which could result in aspiration.

When teaching an adolescent with type 1 diabetes about dietary management, what instruction should the nurse include? A. Meals should be eaten at home. B. Foods should be weighed on a gram scale. C. A ready source of glucose should be available. D. Specific foods should be cooked for the adolescent

C. A ready source of glucose should be available. An adolescent with type 1 diabetes must carry a source of simple sugar (e.g., glucose tablets, Insta-Glucose, sugar-containing candy such as LifeSavers) to rapidly counteract the effects of hypoglycemia. This should be followed by a complex carbohydrate and a protein. Stating that meals should be eaten at home is an unrealistic and unnatural instruction for an adolescent. Stating that foods should be weighed on a gram scale is an unnecessary and time-consuming procedure. The adolescent should be made to feel a part of the family; the recommended diet is nutritious and no different from that of the rest of the family. Topics

A nurse is reviewing preoperative instructions with a client who is scheduled for orthopedic surgery at 8:00 AM the next day. What advice does the nurse give the client? A. "Have your dinner completed by 6:00 PM tonight and then no food or fluids after that." B. "Drink whatever liquids you want tonight and then only clear liquids tomorrow morning." C. "Consume a light evening meal tonight and then no food or fluids after midnight." D. "Eat lunch today and then do not drink or eat anything until after your surgery."

C. Consume a light evening meal tonight and then no food or fluids after midnight. By eating a light meal and eliminating food and fluids after midnight, complications are limited during and after surgery; these include aspiration, nausea, dehydration, and possible ileus. A large meal the evening before surgery may not clear before peristalsis is slowed by anesthesia, resulting in abdominal distention and discomfort after surgery. Clear liquids in the morning can cause nausea, vomiting, and aspiration. Fluids should not be withheld for more than eight hours to prevent dehydration. Not eating or drinking anything after lunch is an excessive amount of time to restrict food and fluids before surgery the next morning.

What is the cause of milk anemia in toddlers? A. Drinking skim milk B. Drinking whole milk C. Increased milk intake D. Increased intake of fruits

C. Increased milk intake Toddlers who consume more than 24 ounces of milk daily in place of other foods sometimes develop milk anemia because milk is a poor source of iron. Children are usually not offered low-fat or skim milk until age 2 because they need the fat for satisfactory physical and intellectual growth. Toddlers need to drink whole milk until the age of 2 years to make sure that there is adequate intake of fatty acids necessary for brain and neurological development. Other solid food items are necessary for healthy growth and development in toddlers.

What is the role of shark cartilage in the management of human immunodeficiency (HIV) and acquired immunodeficiency syndrome (AIDS)? A. Shark cartilage enhances immunity B. Shark cartilage reduces oral thrush C. Shark cartilage is a complementary therapy D. Shark cartilage is a nutritional supplement

C. Shark cartilage is a complementary therapy. Shark cartilage is considered as an alternative or complementary therapy to prescribed medications for clients with HIV and AIDS. Lymphocyte transfusions and bone marrow transplants are used to improve immunity in clients with HIV and AIDS. Lemon juice and lemongrass may provide relief from oral thrush in some clients with HIV and AIDS. A high-calorie, high-protein diet is advised to clients with HIV and AIDS to improve their nutritional status.

A primary healthcare provider prescribes a low-sodium, high-potassium diet for a client with Cushing syndrome. Which explanation should the nurse provide to the client about the need to follow this diet? A. "The use of salt probably contributed to the disease." B. "Excess weight will be gained if sodium is not limited." C. "The loss of excess sodium and potassium in the urine requires less renal stimulation." D. "Excessive aldosterone and cortisone cause retention of sodium and loss of potassium."

D. "Excessive adlosterone and cortisone cause retention of sodium and loss of potassium." Clients with Cushing syndrome must limit their intake of salt and increase their intake of potassium. The kidneys are retaining sodium and excreting potassium. An excessive secretion of adrenocortical hormones in Cushing syndrome, not increased or high sodium intake, is the problem. Although sodium retention causes fluid retention and weight gain, the need for increased potassium also must be considered. Because of steroid therapy, excess sodium may be retained, although potassium may be excreted.

A client with a history of pulmonary emboli is taking warfarin daily. The nurse teaches the client about foods that are appropriate to consume when taking this medication. The nurse evaluates that the client needs further teaching when the client makes which statement? A. "Eggs provide a good source of iron, which is needed to prevent anemia." B. "Yellow vegetables are high in vitamin A and should be included in the diet." C. "Milk and other high-calcium dairy products are necessary to counteract bone density loss." D. "Dark green leafy vegetables are high in vitamin K so I should eat them more often."

D. Dark green leafy vegetables are high in vitamin K so I should eat them more often. Foods high in vitamin K should be limited to usual amounts eaten by the client when establishing the prothrombin time/international normalized ratio because vitamin K is part of the body's blood-clotting mechanism and will counter the effects of warfarin if eaten in excess. Foods containing protein and iron are permitted because they are unrelated to blood clotting. Foods containing vitamin A are permitted because vitamin A is unrelated to blood clotting. Foods containing calcium are permitted because calcium is unrelated to blood clotting.

The parents of a preschooler inform the nurse that their child often develops diarrhea and ask whether there might be anything wrong with the child's stomach. Upon assessment, the nurse also finds that the child has poor oral care and is at risk for dental caries. What is the most probable cause for the child's health issues? A. The family often consumes fast foods. B. The parents neglect the child's dietary needs. C. The family does not follow hygienic practices. D. The child consumes excessive amounts of fruit juice.

D. The child consumes excessive amounts of fruit juice. If the child consumes excessive fruit juice or sweetened beverages, it increases the risk for dental caries and gastrointestinal conditions, such as chronic diarrhea. Consuming fast foods often result in childhood obesity, because fast foods are high in fats and starches. Neglecting the dietary needs or not following hygienic practices may cause gastrointestinal problems or make the child susceptible to infections.

After surgery for a myelomeningocele, an infant is being fed by means of gavage. When checking placement of the feeding tube, the nurse is unable to hear the air injected because of noisy breath sounds. What should the nurse do next? A. Notify the provider. B. Advance the tube 1 cm. C. Insert 1 mL of formula slowly. D. Try aspirating stomach contents.

D. Try aspirating stomach contents. Gastric returns indicate correct placement of the feeding tube. Further assessment is necessary before the provider is notified. Advancing the tube even 1 cm may cause undue trauma, regardless of where the tube is located. Inserting even a small amount of formula is unsafe until correct placement is verified; formula may enter the lungs if the tube is not in the stomach.