Prep U Chapter: 35 Nutrition

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

Fluid and electrolyte levels

The nurse is caring for a patient who has dysphagia and is unable to eat independently. While assisting the patient in eating, which of the following actions is most appropriate for the nurse?

Speak to the patient, but reduce the number of distractions while patient is eating.

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

The nurse is caring for a client on a telemetry unit following a myocardial infarction. The client has undergone numerous medication changes since the event. Which food should be avoided when a client is taking warfarin sodium following a myocardial infarction?

Spinach Spinach is an essential source of vitamin K. Since vitamin K is essential for clotting, it should be consumed sparingly with anticoagulant therapy.

The nurse is providing education to a client concerning calcium intake. During the discussion the nurse addresses a potential health concern related to inadequate calcium intake. Which condition is most impacted by inadequate calcium intake?

Osteoporosis

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

A nurse is caring for a client receiving total parenteral nutrition (TPN). Which should the nurse educate the client about regarding TPN therapy? Select all that apply.

• TPN has three primary components: proteins, carbohydrates, and fats. • TPN has a high glucose concentration. • TPN requires a PICC line or central venous access.

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

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

The nurse is helping a client who wishes to increase Omega-3 fatty acids order breakfast. Which food will the nurse recommend?

salmon

The nurse is providing teaching for a postoperative client complaining of nausea. Which food would be the most appropriate to recommend?

saltine crackers

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

A client has a nursing diagnosis of Imbalanced Nutrition, Less Than Body Requirements. The client's expected outcome is:

to consume 80% of diet tray for each meal.

A nurse teaches a student nurse about the role fats play in the human body. What is the major storage form of fat?

triglycerides

Which clients would the nurse expect to have an increase in basal metabolic rate (BMR)? Select all that apply.

• a toddler who is having a growth spurt • an adolescent who has a fever • an adult who is going through an emotional time due to divorce

A client with headaches has been told by the healthcare provider to increase intake of dietary magnesium. Which food will the nurse teach the client to consume?

whole grains

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.

Which nursing actions follow guidelines for preventing complications with enteral feedings? Select all that apply.

• Elevate the head of the bed at least 30 degrees during the feeding and for at least 1 hour afterward. • Flush the tube before and after feeding. • Clean and moisten the nares every 4 to 8 hours.

The nurse is teaching an older adult client about different types of proteins that can be eaten. Which food will the nurse identify that contain dietary protein? (Select all that apply.)

• beans • nuts • poultry • fish

The nurse is caring for a client who wishes to include more antioxidant and anti-inflammatory foods in the diet. Which food will the nurse recommend? (Select all that apply.)

• cocoa • blueberries

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

The nurse is caring for a client who is vegetarian. Which foods rich in calcium will the nurse recommend? (Select all that apply.)

• fortified soy yogurt • bok choy • kale • turnip greens

The nurse is educating a client with anemia about increasing iron in the diet. Which foods will the nurse teach the client that are high in iron? (Select all that apply.)

• liver • egg yolks • tofu • spinach

When a client provides a return demonstration of appropriate food selections for carbohydrates, which food does the nurse acknowledge as rich in carbohydrates? (Select all that apply.)

• milk • oatmeal • bread

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

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

After a teaching session regarding dietary choices of carbohydrates, which client responses indicate correct understanding of the foods to limit in the diet? Select all that apply.

• rice • wheat germ • corn on the cob • apple

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."

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

"Taking megadoses of vitamins will help me increase muscle mass quickly."

A nurse is caring for a client with a nasogastric tube. The nurse enters the room to flush the nasogastric tube and check gastric residual. Which action should the nurse perform first?

Elevate the head of the bed

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."

The nurse is providing education about nutrition and feeding to the parent of a toddler. Which statement by the child's parent indicates understanding of the education?

"Boiled eggs and pieces of cheese are good snacks for my child."

A nurse is caring for a client who has been admitted on the medical surgical unit. Which statement by the nurse about obtaining an initial weight is correct?

"I need to get your weight at this time with our scales."

A client resides in a long-term care facility. Which nursing intervention would promote increased dietary intake?

Encourage the client to eat in the dining room

A 40-year-old man has consumed a breakfast consisting of cereal, milk, orange juice, and coffee. His blood sugar in 2 hours is likely to be in what range?

140-180 mg/dL

A nurse is establishing an ideal body weight for a 5'9" (175 cm) healthy female. Based on the rule-of-thumb method, what would be this client's ideal weight?

145 lb/ 65.7 kg

The nurse is caring for four clients. The nurse recognizes that which client's lifestyle choice contributes most highly to risk for development of cardiometabolic syndrome?

28-year old who eats fast food daily

The nurse is caring for four older adult clients. Which does the nurse identify at highest risk for cardiometabolic syndrome?

59-year old with bust, abdomen, and hips of similar proportion

The nurse is caring for four older adult clients. Which does the nurse identify as highest risk for cardiometabolic syndrome?

70-year old with a body mass index (BMI) of 34.8

A nurse is teaching a client how to use the information on food labels to facilitate a healthy diet. The nurse has shown the client the label on a can of condensed soup, which states that a serving of the soup contains 46% of the daily value of sodium. What conclusion should the client draw from this information?

A bowl of this soup contains nearly half of the sodium that the client should consume during a day.

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

Energy

At what period of life do nutrient needs stabilize?

Adulthood

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

Anemia

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

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

Assess when the client generally eats meals.

A nurse is caring for a client who has a decrease in appetite. Which actions by the nurse would be appropriate?

Assist with oral hygiene before serving the meal tray.

A nurse is teaching a client about diabetes and glucose monitoring. What should the nurse include in the teaching?

Blood from the fingertips shows changes in glucose more quickly than other testing sites.

A nurse is caring for an older adult client who is admitted with failure to thrive. Which laboratory value would the nurse expect to find with this diagnosis?

Blood urea nitrogen 15 mg/dL (5.35 mmol/L)

After reviewing the client's chart, the nurse notes that the client has been ordered a clear liquid diet. Which meal tray would the client be allowed to eat?

Bouillon, apple juice, and gelatin

An athlete wants to increase her intake of complex carbohydrates and asks the nurse about potential sources. Which food is considered a complex carbohydrate?

Bread

A nurse is planning a high-energy diet for a client. What nutrient provides energy to the body and should be increased in the diet?

Carbohydrates

A nurse provides discharge education for a client diagnosed with ketosis. Which nutrient would be added to this client's diet?

Carbohydrates

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 teaching an adolescent client about nutrition following a hospital admission. What should the nurse understand about adolescent nutrition?

Childhood nutrition problems may worsen during adolescence.

A nurse is caring for a client who has been ordered a clear liquid diet. Which of the following can be included in the client's diet?

Cranberry juice

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.

A nurse is learning about religious dietary restrictions at a nursing conference. Which of the following religious meal selections should the nurse understand is appropriate?

Hindus: Vegetable plate

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.

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. The nurse would measure the volume and pH of the aspirated fluid, then flush the tube with water. The nurse would not place the client in Trendelenburg position as this could lead to reflux of the feeding from the stomach and possibly cause aspiration of the solution into the lungs. The nurse would not use a small syringe or continue to instill air until fluid is aspirated.

A client is reporting cracking fissures in the corner of her mouth. Which instruction should the nurse include in the information provided to the client?

Increase intake of eggs and milk

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

Iodine

You are the nurse caring for a client with an enlarged thyroid gland. You anticipate which nutritional deficiency is linked to the client's condition?

Iodine

The nurse is caring for a client with malnutrition due to protein deficiency. Which of the following foods should be included in this client's diet?

Meats

The nurse is caring for a client who is pregnant. Which nutrition education will the nurse provide?

More servings of milk daily will be required.

During a visit to the pediatrician's office, a mother inquires about adding solid foods to the diet of her infant age 6 months. What does the nurse inform the mother?

New foods should be introduced one at a time for a period of five to seven days.

A client who is taking supplements complains of 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

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

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.

The average dietary nutrient intake level that meets the nutritional requirement of almost all healthy people in a selected age and gender group is the:

RDA level

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

Serum albumin

Which laboratory test is the best indicator of a client in need of TPN?

Serum albumin

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 charge nurse is observing a new nurse care for a client who is receiving a continuous feeding through a nasogastric feeding tube. Which actions 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 caring for a client who has a nasointestinal tube inserted. The nurse is checking placement using gastric aspirate to check the pH level. Which of the following findings should the nurse expect if the tube is in the duodenum?

The stomach pH is 7.5

A physician orders nutritional therapy administered via a central vein for a patient who cannot take foods orally. What is the term for this type of nutrition?

Total parenteral nutrition (TPN)

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 postmenopausal client wishes to increase the amount of vitamin D that she consumes to help keep her bones strong. Which food will the nurse recommend?

milk

The nurse is providing care for a patient whose abdominal fistula has necessitated the use of total parenteral nutrition (TPN). What action should the nurse implement in the care of this patient?

Use a pump to administer the patient's TPN.

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 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?

Vitamin B12

Which vitamin is found only in animal foods?

Vitamin B12

The nurse is caring for a client who has been experiencing prolonged wound healing from a surgical procedure. A deficiency in which nutrient would be associated with this condition?

Vitamin C

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 most suspect?

Vitamin D

Which of the following is a fat-soluble vitamin?

Vitamin E

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 Approximately half of the body's requirement of vitamin K is synthesized by bacteria in the lower intestinal tract.

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

A 28-year-old woman client is in an outpatient clinic with frequent reports of fatigue. Her physician has prescribed her ferrous sulfate 325 mg to treat iron-deficiency anemia. A nurse is teaching the client about medication administration. What food would be best consumed with her ferrous sulfate?

a glass of orange juice

A client has developed dysphagia secondary to a cerebrovascular accident. The nurse is aware that the client is at risk for:

aspiration

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

A client is deficient in found to be deficient in vitamin K. What complications should the nurse closely assess for related to this deficiency?

bleeding tendencies

The nurse is helping a client who eats a normal diet of 2000 calories daily to read a nutritional label on a box of cereal. Which nutrient does the nurse identify as appropriate for this client?

cholesterol less than 300 mg

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

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

extremely obese