nutritional care and support

24. A client's stomach contents will be removed by inserting a double-lumen nasogastric (NG) tube through the nose into the stomach and then connecting the tube to a suction. The nurse identifies this procedure as ____________________.

gastric decompression

_ 22. The nurse is caring for a client admitted with a diagnosis of bulimia nervosa. Which assessment finding will the nurse expect? Select all that apply. 1.Evidence of dental caries 2.Verbal reports of indigestion 3.Statements about constipation 4.Frequent bouts of sore throat 5.Poor skin turgor and sunken eyes

1.Evidence of dental caries 2.Verbal reports of indigestion 4.Frequent bouts of sore throat 5.Poor skin turgor and sunken eyes

23. A physician has ordered "Clear liquids, advance as tolerated." Which factors indicate to the nurse the advancement of the client's diet should be delayed? Select all that apply. 1.Hypoactive bowel sounds 2.Nausea and vomiting 3.Reports of indigestion 4.Expression of hunger 5.Verbalizing thirst

1.Hypoactive bowel sounds 2.Nausea and vomiting 3.Reports of indigestion

11. A client is prescribed the medication lithium as a mood-stabilizing agent. Which laboratory report indicates the client may be retaining higher than prescribed levels of lithium? 1.Low sodium levels 2.High sodium levels 3.Low potassium levels 4.High potassium levels

1.Low sodium levels

5. The LPN/LVN is assigned to feed a client who was admitted with the diagnosis of a cerebral vascular accident (CVA). The client's ability to swallow is intact, but chewing remains difficult. Which type of food will most likely cause the LPN/LVN to consult with the RN? 1.Mechanical soft 2.Pureed 3.Full liquid 4.Thickened liquid

1.Mechanical soft

2. The LPN/LVN is caring for a client with diabetes mellitus and obtains a morning blood glucose level of 60 mg/dL. The LPN/LVN reports the finding to the RN. Which intervention does the LPN/LVN expect? 1.Provide the client with one-half cup of orange juice. 2.Cover the client with insulin using a sliding scale. 3.Chart the finding in the client's medical record. 4.Wait for fifteen minutes and repeat the assessment.

1.Provide the client with one-half cup of orange juice.

1. The nurse assesses a client just admitted from the emergency department with pain in the lower right quadrant of the abdomen. The physician's order reads, "Diet as tolerated." Which conclusion will impact the nurse's decision regarding the client's diet? 1.The client will be NPO due to the probability of surgery. 2.A clear liquid diet is appropriate to avoid possible nausea. 3.The client can have a regular diet until symptoms worsen. 4.A diet high in protein and vitamin C will promote healing.

1.The client will be NPO due to the probability of surgery.

9. The nurse is providing care for a client after joint replacement surgery. The nurse delivers a lunch tray with a cheeseburger, French fries, slaw, and fresh fruit. After the meal, the nurse picks up an empty tray. Which comment is more important for the nurse to make if the client states, "My husband ate part of my lunch because I'm just not that hungry"? 1."That's fine. Most of our clients do not eat all their meals." 2."I will need to know which foods you actually ate." 3."The trays are overfilled so clients have plenty to eat." 4."Let's discuss what foods you would like for the next meal."

2."I will need to know which foods you actually ate."

17. A client tells the nurse of experiencing minor gastrointestinal pain, flatulence, and diarrhea several times after meals. Which possible cause should the nurse identify? 1.Anaphylaxis 2.Food intolerance 3.A food allergy 4.Food poisoning

2.Food intolerance

18. A client has been vomiting without relief from medications. The physician orders the client on NPO status. Which action by the nurse violates the physician's order? 1.Maintains previously ordered IV fluids 2.Gives ice chips when the client indicates mouth dryness 3.Provides mouth swabs and lip balm for client comfort 4.Offers mouth care on a regular basis

2.Gives ice chips when the client indicates mouth dryness

21. The nurse prepares a presentation for parents of adolescents with eating disorders. The parents have expressed an interest in understanding the causes and effects of the disorders. Which information will the nurse include? Select all that apply. 1.It is more prevalent in males than in females. 2.It can cause a client's health to be severely affected. 3.It generally occurs during adolescence or early adulthood. 4.It is evidenced by extreme disturbances in eating habits. 5.It may result from either physical or psychological causes.

2.It can cause a client's health to be severely affected. 3.It generally occurs during adolescence or early adulthood. 4.It is evidenced by extreme disturbances in eating habits. 5.It may result from either physical or psychological causes.

4. The RN provides teaching to a client with newly diagnosed diabetes mellitus. Which method will the LPN/LVN reinforce as the best indicator of long-term glycemic control? 1.Creatinine level 2.Urine glucose level 3.Blood glucose level 4.Glycosylated hemoglobin

4.Glycosylated hemoglobin

7. The nurse is teaching a client newly diagnosed with diabetes mellitus about the eating and nutrition parameters required with the client's diagnosis. Which comment by the client indicates that teaching is understood? 1."I will need to eat 3 meals and 2 snacks daily." 2."I can plan for a special dinner if I skip my lunch." 3."I will find a new method for cooking besides frying." 4."Once a week I can splurge and eat whatever I want."

3."I will find a new method for cooking besides frying."

16. The nurse is completing the placement of a nasogastric (NG) tube. Which is the most reliable way for the nurse to initially confirm the placement of the tube? 1.Quickly instill 10 mL of air into the tube and listen for a "whoosh" in the epigastric area. 2.Withdraw some of the stomach contents and check for a pH between 1 and 4. 3.After placement of a radiopaque tube confirm the location of the tube by x-ray. 4.Check a line marked on the tube for location at the entrance of the nares.

3.After placement of a radiopaque tube confirm the location of the tube by x-ray.

_6. The nurse brings a dinner tray to a client on a regular diet. The nurse notes that the client has been blind since birth. Which intervention by the nurse is most helpful in assisting this client to eat? 1.Ask the client how they would like their dinner tray arranged. 2.List and describe the foods that are present on the client's tray. 3.Compare the location of the food on a plate with the face of a clock. 4.Inquire if the client wants anything added or removed from the tray

3.Compare the location of the food on a plate with the face of a clock.

3. The LPN/LVN is obtaining a blood glucose level on a client with diabetes mellitus, and notes that the blood glucose level is 280 mg/dL. Knowledge of which condition prompts the LPN/LVN to report the finding to the RN? 1.Hypoglycemia 2.Diabetic coma 3.Hyperglycemia 4.A normal value

3.Hyperglycemia

20. The nurse is preparing teaching for a client ordered on long-term treatment with corticosteroids. As part of the teaching about side effects, the nurse should inform the client that which body function is primarily affected? 1.Absorption 2.Appetite 3.Metabolism 4.Excretion

3.Metabolism

15. When the nurse inserts a nasogastric (NG) tube, the client becomes cyanotic, coughs incessantly, and is unable to speak. Which action should the nurse take immediately? 1.Encourage swallowing. 2.Continue to insert the tube. 3.Remove the tube completely. 4.View the posterior pharynx.

3.Remove the tube completely.

10. A client is prescribed isoniazid (INH), a medication that treats tuberculosis (TB). Which condition will prompt the nurse to remind the physician that the client will need a specific vitamin during the therapy? 1.Vitamin K is not absorbed when a client has TB. 2.Vitamin C will increase lung healing with TB. 3.Vitamin B6 excretion will increase with INH. 4.Vitamin B12 prevents nerve damage from INH.

3.Vitamin B6 excretion will increase with INH.

12. An emergency department nurse admits an adult client for a drug overdose. The physician writes an order for the nurse to instill charcoal through a nasogastric (NG) tube. Which size tube will the nurse select? 1. 4 French 2. 8 French 3. 12 French 4. 16 French

4. 16 French

13. The nurse assesses a client 24 hours after abdominal surgery. The client is experiencing nausea, anorexia, and is vomiting foul-smelling emesis. Physical assessment reveals an extended abdomen and hypoactive bowel sounds. Which order does the nurse expect from the client's physician? 1.A nasogastric tube inserted to provide enteral nutrition 2.A prescription for anti-nausea and anti-emetic medication 3.A schedule for six small liquid meals to be given daily 4.A nasogastric tube inserted for gastric decompression

4. A nasogastric tube inserted for gastric decompression

19. The nurse is caring for a client in the hospital. On assessment, the nurse discovers the client's hands and feet are swollen. A review of the client's past medical history reveals a history of cardiac problems. Which diet does the nurse expect the physician to order for this client? 1.A fat-restricted diet 2.A carbohydrate-restricted diet 3.A calorie-restricted diet 4.A sodium-restricted diet

4.A sodium-restricted diet

8. The nurse is admitting a client for a diagnosis unrelated to nutrition; however, the client states, "I don't eat gluten, but I don't have celiac disease." Which meal will the nurse expect the client to order? 1.Bean soup, cornbread with butter, and tapioca pudding 2.Ham and cheese sandwich on whole wheat bread, and fruit 3.Spaghetti with meat sauce, salad, and cake with butter frosting 4.Baked chicken breast, mashed potatoes with butter, and ice cream

4.Baked chicken breast, mashed potatoes with butter, and ice cream

__ 14. The nurse is inserting a nasogastric (NG) tube. Which conclusion does the nurse make if a client coughs continually? 1.The client is resisting insertion. 2.The client has a strong gag reflex. 3.The client needs to have a break. 4.The client's airway is compromised.

4.The client's airway is compromised.

25. When a client has an intact digestive system but has difficulty with swallowing, digestion, or the absorption of food, the nurse can expect the client to be ordered on ____________________ feedings.

enteral