Nutrition exam 2

A pediatric nurse is often asked by parents what they can do to reduce the risk of cavities in their children's teeth. Which of the following would be the best response?

"A good way is to limit between-meal snacking on carbohydrates, including soft drinks."

A client has asked the nurse to explain the glycemic index. Which of the following is the nurse's best response?

"It is a comparison between the blood glucose response caused by 50 g of pure glucose and 50 g of regular food."

The nurse has been discussing parenteral nutrition (PN) with a group of student nurses. After the discussion, the nurse realizes more discussion is necessary when she hears one say which of the following?

"Parenteral nutrition is an emergency procedure."

The nurse is conducting teaching with a client who has recently been diagnosed with bulimia nervosa. The client asks the nurse what the underlying issue is for the behavior associated with this eating disorder. What would be the best response?

"The cause is unique for each person; there are lots of factors involved."

The nurse is caring for a 21-year-old female with burns that cover more than 20% of her total body surface area (TBSA). The client's parents ask why the client is being fed by a nasogastric tube (NG). Which of the following is the nurse's best response?

"We need to get a lot of calories and nutrients into your daughter to help her heal, and this is the best way to do that."

The client is being discharged home on a high-protein diet. The client asks the nurse what would be the best dessert to help increase intake of protein. Which of the following is the nurse's best response?

pudding

A nurse is trying to help a client understand the difference between glucose and glycogen. The client shows he understands when he indicates that glycogen is the human version of which of the following?

starch

The nurse has been teaching a client with type 2 diabetes in menu planning using the carbohydrate counting method based on a 2000-calorie diet. The nurse asked the client to plan several dinner menus. Which of the following menus demonstrates the client's understanding of carbohydrate counting?

1 taco shell, 3 oz of taco meat; 1 1/2 cups combined chopped lettuce, tomato, onion; 1/3 cup of rice; and 1 cup of papaya

When providing education to a client who weighs 260 pounds, the nurse should tell the client weight loss at which of the following rates should be expected for the first 6 months?

1 to 2 pounds a week

The client is a 32-year-old, well-developed, well-nourished female who was struck by a car while jogging. She has been admitted to the ICU. The nurse has determined she weighs 115 pounds. What will be her recommended calorie intake using the simple equation?

1300 to 1500 calories

The nurse is admitting a critical client to the ICU. During the nutrition assessment, the nurse uses a simple method for estimating the client's total calorie needs based on his weight of 60 kg and the fact that he is not obese. Approximately how many calories would this client require?

1500 to 1800 calories

The nurse is caring for a 25-year-old male who has sustained burns over 30% of his body. If the client weighs 68 kg, approximately how many calories per day should this client consume?

1700 calories

The client is learning how to plan his meal using the food list for diabetes to maintain a 2000-calorie diet. Which of the following are correct guidelines for his carbohydrate choices per meal in the 2000-calorie plan? Select all that apply.

1 serving from the bread, cereal, rice, and pasta group 1 serving of fruit 3 servings of nonstarchy foods

As the nurse caring for a client with an 18% burns over the total body surface area (TBSA), how many grams of protein per kilogram of body weight should his diet provide?

1.5 to 2.0 g

A client has requested ideas for menus on a low-fat diet. The nurse suggests which of the following menus?

1/2 cup of black beans with 1/3 cup of rice and tomatoes, 1 cup of salad with 1 tbsp of Italian dressing, 1/2 cup of steamed broccoli, 3/4 cup of mandarin oranges, and 1 cup of skim milk

For a client who is overweight and following a low-carbohydrate/high-fat diet, what would be an appropriate breakfast on this diet?

1/2 cup of orange juice, 2 scrambled eggs cooked in 2 tsp of butter, and 1 oz of pork sausage

The nurse is admitting a critical client to the surgical ICU. During the nutrition assessment, the nurse uses a simple method for estimating the client's total calorie needs based on his weight of 100 kg and the fact that he is obese. Approximately how many calories would this client require?

1100 to 1400 calories

The nurse has assessed a 28-year-old female client as being at risk for having an unrealistic weight loss goal. The nurse should correctly inform the client that a realistic caloric intake for her is which of the following?

1200 to 1500 cal/day

The nurse is counseling a male client with a BMI of 31.8 about decreasing his caloric intake. What would be the best level of caloric intake for this client?

1200 to 1600 cal/day

When providing nutrition therapy for a client who has a diagnosis of bulimia nervosa, which lunch would be best for an 18-year-old client who is being treated for bulimia?

3 oz of grilled swordfish, 1/2 cup of steamed broccoli, 1/2 cup of rice pilaf, and 4 oz of hot tea

When assisting a client prepare a meal plan that includes liquid supplementation, a nurse knows the supplement will provide how much protein content on average?

45 g/L

The nurse is suggesting a 1400 cal/day plan for a client who wants to lose weight. In choosing the balanced diet, which of the following foods can the client intake daily? Select all that apply.

5 oz grilled chicken breast, 2 bunches of leafy greens, 5 tsp olive oil

The clinic nurse is teaching clients with newly diagnosed type 2 diabetes about diet and weight control. To assess if teaching has been effective, the nurse gives the client an exercise in which he must calculate the number of calories in a tablespoon of jelly that contains 13 g of carbohydrates, no protein, and no fat. What is the correct number of calories in the jelly?

52 calories

The American Heart Association (AHA) recommended which of the following limits of added sugar intake for adults to help prevent disease?

6 teaspoonfuls for women; 9 teaspoonfuls for men

The nurse works on a burn unit and is admitting a 16-year-old female who weighs 50 kg. She has severe burns covering 65% of total body surface area. A high-protein diet is ordered. The dietitian figures the client's calorie and protein needs and orders approximately how many grams of protein per day?

75 to 100 g

Partially hydrolyzed formulas are made for people with impaired digestion or absorption. A client with which of the following deficiencies would be a suitable candidate for this type of formula?

A client who cannot breakdown whole proteins

Which of the following changes in metabolic processes should indicate to the nurse that a client's hormone levels are declining?

A decline in serum glucose levels

Transnasal, or nasogastric (NG), feeding would be most appropriate for which client?

A middle-aged man with a functional gastrointestinal (GI) tract, poor appetite, and thermal injuries

The wife of a 69-year-old gentleman recovering from sepsis is frustrated her husband won't eat enough. She has been trying to feed him frequent small meals but he says he isn't hungry. Which of the following suggestions can the nurse make to increase his protein intake? Select all that apply.

Add skim milk to milk. Add chopped eggs to casseroles. Melt cheese on sandwiches, hot vegetables, and potatoes.

The nurse is aware malnutrition can occur because of the physiologic stress caused by respiratory distress. What factors may contribute to malnutrition that is cause by this problem? Select all that apply.

Abdominal bloating, anorexia, dyspnea

The client is a 50-year-old male with cancer, who has been losing weight. The nurse suggests the client eat which of the following to increase his calorie intake?

Add butter to his hot foods.

The nurse is caring for a client with an acute lung injury from trauma who is transitioned to an oral diet. The client reports dry mouth, constipation, and fatigue. Which of the following suggestions can the nurse make to help improve this client's status? Select all that apply.

Add gravies and sauces to food. Rest before eating. Increase fiber intake.

The nurse is providing education to families about identifying signs of an eating disorder. The nurse should include which of the following physical symptoms when discussing anorexia? Select all that apply.

Amenorrhea, Anemia, Hypotension

People with phenylketonuria (PKU) should avoid which nonnutritive sweetener?

Aspartame

The nurse has been caring for a client in ICU who is receiving enteral nutrition (EN) via continuous drip method into the intestine. The nurse knows this enteral feeding method has been ordered because this client is at risk for which of the following problems?

Aspiration

The nurse is preparing a client for discharge who was admitted for pneumonia. The nurse is providing the client with strategies to increase his calorie intake at home. Which of the following suggestions should the nurse include? Select all that apply.

Avoid "gassy" foods. Limit "empty" liquids with meals. Try high-calorie, high-protein nutrition formulas.

The nurse is seeing a client who has a BMI of 36 along with type 2 diabetes and hypertension. The client has tried restrictive dieting unsuccessfully several times. The nurse knows the client should be considered for which of the following interventions?

Bariatric surgery

The nurse recognizes her client who has recently lost a lot of weight is at risk for refeeding syndrome. Which of the following will be important to monitor in this client?

Blood glucose levels

A client who is trying to reduce his blood pressure to prevent further cardiovascular risk is seeing the clinic nurse to plan his weight loss. Which of the following information should the nurse share with the client to keep the client motivated?

Blood pressure can improve with a 5% reduction of body weight.

Of the following, what food would the nurse recommend to a client that may help prevent constipation?

Brown rice

The nurse explains to a client who is considering bariatric surgery why an assessment of body mass index (BMI) is important. Which of the following reasons would be appropriate for the nurse to include in her explanation?

Calculating the BMI helps in determining the risk of health problems.

A client admitted to hospital with motor vehicle accident trauma is being discharged home to complete recovery. The diet that has been ordered is a high-calorie, high-protein diet in small frequent meals throughout the day. What would be the best sample menu for lunch for this client?

Chicken salad sandwich on a croissant, milk, ice cream with chocolate sauce, and whipped cream

Research consistently demonstrates that sugar is implicated in the development of which of the following health complications?

Dental caries

Polyols or sugar alcohols are one of the alternatives to naturally occurring sugar that are used widely in the American diet. Consuming large amounts of polyols is most likely to cause which of the following symptoms?

Diarrhea

The nurse is planning care for a client who is receiving a hypertonic enteral formula. Which of the following side effects from this type of formula should the nurse anticipate?

Diarrhea

Acute episodes of illness can create problems for clients who have insulin-dependent diabetes. During these periods of acute illness, what should clients who have insulin-dependent diabetes do?

Eat about three carbohydrate choices every 4 hours

The nurse is admitting a client with burns over 60% of the body. The nurse should prepare for which of the following nutritional interventions for this client?

Enteral nutrition

The nurse is discussing the role of micronutrients in the regulation of blood glucose in diabetes. Which of the following statements is true?

There is insufficient evidence to support the use of micronutrient supplements.

The nurse knows clear liquid diets are advanced to soft diets as the nutritional approach after surgery. When determining what does the scientific evidence show about this practice, what information will the nurse find?

There is little scientific evidence to support it.

A student in the nutrition class is giving a report on "Promoting Exercise Adherence in Obese Clients." What strategy would be expected to be included in the report?

Find creative ways to work out at home rather than the gym.

The nurse is verifying the contents of a parenteral nutrition formula before beginning a new bag on the client. Which of the following ingredients would be a reason to call the physician and clarify the order?

Galactose

The nurse educator is teaching a class of nursing students about diet adherence in the obese client. The students are given an assignment to break into groups and make a list of strategies that can be used to encourage clients to adhere to their diets. In order to determine that teaching was effective, which strategy should be on every list?

Give the client preprinted menus.

The nurse is aware there is a gradual increase in the infusion rate for parental nutrition because a rapid change may lead to which of the following?

Glucose level changes

The nurse emphasizes that nutrition therapy is the basis of treatment for all clients with diabetes in the nutrition class. Which of the following nutrition recommendations for clients with diabetes is true?

Glycemic control is dependent on matching carbohydrate intake with the action of insulin or other medication.

A nurse is providing teaching to pregnant women with gestational diabetes. The nurse explains that some foods may quickly raise glucose levels, raise glucose levels to various amounts, and return to normal at different rates. The nurse knows this process is called which of the following?

Glycemic response

A nurse is seeing a client in a weight loss clinic who asks what she can add to her diet to help her feel fuller and better able to stick to a low-calorie regimen. Which of the following foods would be best for the nurse to recommend?

Grilled chicken breast

The nurse can anticipate which of the following eating strategies may be effective for clients with bulimia nervosa?

Have a meal plan at the start of each day.

If a client is overweight or obese, setting the goal of reaching the "ideal" weight may be very hard to accomplish. To achieve health benefits from weight loss, how much weight does an individual actually have to lose?

Health benefits can be realized with only a modest weight loss.

The nurse is admitting to the unit a client who is a 42-year-old female with a diagnosis of pancreatic cancer. Her orders include enteral nutrition. What kind of enteral formula would the nurse expect to be ordered by the physician?

Hydrolyzed

Parenteral nutrition (PN) can be infused into either a central or peripheral vein. What type of parenteral solution is infused into a central vein?

Hypertonic

The nurse is caring for a 90-year-old woman who is receiving parenteral nutrition (PN). The nurse will know to assess frequently for which of the possible complications of PN?

Phlebitis

When considering the rationale for an order for a hydrolyzed formula for a client taking enteral feeds, the nurse knows the client requires this formula because the client has which of the following?

Impaired digestion or absorption

The nurse is admitting an 18-year-old male to the ICU following a motor vehicle accident. The client is currently receiving IV fluids with no nutrition until the client is stabilized. When should this client start on nutritional support?

In 24 to 48 hours

The nurse is teaching a basic class about nutrition to clients in a weight loss program. After discussing the process of carbohydrate digestion, the nurse recognizes teaching has been effective when the clients correctly identify which of the following as the primary site of carbohydrate digestion?

In the small intestine

A 19-year-old college student has come to the college health clinic for information on how to decrease his risk for developing diabetes. He is concerned because he is overweight and he just learned his mother has been diagnosed with type 2 diabetes. Which of the following suggestions should the nurse offer this client?

Increase consumption of nuts and berries.

When it comes to carbohydrate intake, the latest findings indicate that Americans should do which of the following?

Increase intake of fiber and limit consumption of added sugars.

The nurse at an eating disorders clinic should work with a client who has been diagnosed with anorexia to focus of nutrition therapy goals on which of the following?

Increasing total number of daily calories

The nurse knows research studies have shown which of the following about enteral nutrition?

It has no impact on the length of hospitalization.

Evidence suggests that enteral nutrition (EN) is superior to parenteral nutrition (PN) and will impact client mortality among the critically ill in the ICU. Early EN has been noted to do which of the following? Select all that apply.

Lessen disease severity Modulate inflammatory responses Maintain the integrity of the gastrointestinal mucosa

When bodily energy needs are met, excess glucose is utilized to make which of the following?

Nonessential amino acids

The client is a 38-year-old male who is critically ill. The client's appetite remains low. He is afraid of gaining too much weight. Which of the following would be an example of an appropriate meal for this client?

Omelet with ham, cheese, mushroom, and spinach; whole wheat toast with butter and jelly; and milk and coffee with whipped cream

The nurse is aware that there will be times when enteral nutrition (EN) will not be feasible to use with a critically ill client. Which of the following are indications to use parenteral nutrition (PN)? Select all that apply.

On the 8th hospital day in a well-nourished client who has received nutrition, As soon as possible in malnourished clients

The nurse is caring for a client with a paralytic ileus who has been on parenteral nutrition for 4 days. The nurse would know to monitor the client for which of the following?

Refeeding

The nurse is teaching a nutrition class of nursing students regarding several different types of diets. Which of the following diets should the nurse discuss for clients who require adjusted sodium and potassium in the diet?

Renal diet

When discussing the complications associated with obesity, the nurse should include which of the following? Select all that apply.

Respiratory dysfunction, Dyslipidemia, Cholecystitis

A client has been instructed by a health-care provider to take liquid supplements. Which of the following suggestions should the nurse make to help the clients tolerate the supplement?

Serve them cold.

The client is complaining that she is tired of the commercial high-calorie, high-protein drink and would like to have something different. Which of the following would be a good substitute for a snack?

Smoothie made with yogurt, instant breakfast mix, whole milk, and strawberries

The nurse is discussing enteral and parenteral nutrition with a class of graduate nurses. They are asked to devise an appropriate feeding schedule for a client on gastric enteral nutrition. Which of the following would be expected to be seen on their feeding schedule?

Start feeding at 10 to 40 mL/hour and advance by 10 to 20 mL/hour every 3 to 12 hours until the maximum rate of 125 mL/hour is reached.

The nurse is providing education to the family members of a client who is receiving a standard enteral formula. The nurse knows this formula is suitable for this client for which of the following reasons?

The client was on bowel rest.

When explaining to the family members of a client who requires parenteral nutrition (PN) why the client requires a central venous catheter, what can the nurse tell the family is the difference between peripheral and central vein (PN)?

The dextrose content is greater than 10%.

The nurse knows that refeeding syndrome is a potentially life-threatening complication that can result from parenteral nutrition for which of the following reasons?

The drawing out of electrolytes from the bloodstream

The nurse is talking with the nutrition class about how the normal response to severe acute stress impacts metabolism. One of the students asks what the intensity of stress response is based on. What is the best response?

The intensity of the stress response depends on the cause and the severity of the initial injury.

Commercially prepared liquid formulas are often used to supplement other oral diets. When providing client education, the nurse should tell the client that one of the characteristics of commercially prepared routine liquid supplements is which of the following?

They are lactose free.

When helping a client develop a menu plan, which of the following information about nonnutritive sweeteners should the nurse share with the client?

They provide few or no calories.

The nurse is asked to discuss weight loss drugs to a group of bariatric clients. Which of the following information should the nurse include regarding phentermine/topiramate?

Tolerance may develop after only a few weeks.

A client tells the nurse he is having difficulty finding a practical way to ensure he remains within the daily calorie limit that will promote weight loss. Which of the following tips will most likely help the client?

Use a smaller plate for meals.

The nurse is teaching the family members of the client about the pureed diet the client will need to follow while his jaw is wired as he heals from a broken jaw. Which of the following recommendations will be important to include in the discussion? Select all that apply.

Use broth, cheese, milk, or tomato sauce instead of water for blenderizing the food., All foods should be smooth and not chunky.,All foods are allowed if liquefied.

The nurse is counseling a client recovering from a major burn trauma. She is about to be released to go home and finish her recovery. The physician has ordered a high-protein diet for her at home, and the nurse is teaching her methods of increasing protein density in her diet. What would be the best method for this client to increase the protein density in her diet?

Use double-strength milk (liquid milk fortified with skim milk powder).

When planning treatment with a client with obesity, it is important for the nurse to include which of the following behavior modification techniques?

Using a small plate

The nurse is assessing a client who is postoperative. The client is prescribed a clear liquid diet. When asked about nutritional quality of this type of diet, the nurse can tell the client the diet contains a good source of which of the following vitamins?

Vitamin C

The nurse is helping a client try to understand why the family is now putting on weight after a recent move from another country. The nurse suggests which of the following may be contributing to this problem?

Weight gain is dependent on an obesogenic environment.

The nurse is a member of a panel discussing the optimal type of weight loss diet. When the panel members ask the audience what the most important thing to remember about weight loss is, which of the following responses indicates the discussion was effective?

Weight loss is dependent on the amount of the calories consumed.

Drugs are available to aid in weight loss, but they are not for everyone. When is a person a candidate for drug therapy in the treatment of obesity?

When a BMI is 30 or greater

When providing nutritional teaching to a group of clients recently diagnosed with type 2 diabetes mellitus, the nurse should introduce which tool as the most helpful developing an effective meal planning?

glycemic index

A client has been working with the nurse to improve her diet and lose weight. When assisting the client create a meal plan, the client requires a dairy source that is relatively low in carbohydrates in order to include more whole grains. Which of the following foods should be included?

Whole milk, 8 oz

When providing teaching to a client newly diagnosed with type 2 diabetes, what should the nurse tell the client about nutrient recommendations for the intake of fat?

Worry about the type of fat, not so much the amount.

The nurse is conducting client education with a client recovering from major trauma and his wife before he is discharged from the hospital. A high-calorie, high-protein diet is being recommended to optimize the client's recovery. The nurse should suggest which of the following as a high-protein snack?

Yogurt

lactose is composed of glucose and galactose and is a naturally occurring carbohydrate. Unfortunately, many individuals cannot tolerate lactose and develop gastrointestinal symptoms after ingesting it. These individuals would do best eating what dairy food?

cheese

Intravenous fat or lipids are usually given separately from parenteral nutrition (PN). What allergy would make lipids contraindicated in a client?

egg

The nurse is conducting client education with a client newly diagnosed with diabetes. Which of the following are appropriate initial treatments for mild hypoglycemia? Select all that apply.

life savers gum drops soft drink