Proctored Nutrition Exam Review

A provider tells a client at 12 weeks gestation who practices Hinduism that she needs more protein in her diet and suggest eating more meat. After the provider leaves the examination room, the client tells the nurse that eating animal products will cause her to miscarry. Which of the following responses should the nurse make? A. "Let's discuss other foods." B. "Eating meat during pregnancy provides necessary protein and does not cause miscarriage." C. "Why do you think that eating animal products will cause you to have a miscarriage?" D. "Your doctor is recommending what is best for you and your baby."

A. "Let's discuss other foods that are also high in protein that you could substitute for meat." Many cultures have beliefs about food that the nurse should respect. Discussing non-animal protein sources can help the client identify foods that do not conflict with her religious and cultural beliefs. Asking a "why" question is nontherapeutic and the client might not know the answer and could become defensive.

A nurse is providing nutritional counseling for a client who is pregnant. Which of the following nutrients should the nurse instruct the client to increase in her daily diet? A. Iron B. Calcium C. Vitamin E D. Vitamin K

A. Iron: iron supplements are recommended during pregnancy to promote adequate transfer of iron to the fetus and to support the expansion of the maternal RBC mass.

A nurse in a pediatric clinic is talking with the parent of a toddler who states that her child will not sit at the table to eat with the family. She asks the nurse for recommendations for "finger foods" for her child. Which of the following foods should the nurse suggest? A. Slices of ripe banana B. Popcorn C. Slices of hot dogs D. Raw carrots

A. Slices of ripe banana Toddlers should have about 1 cup of fruit per day. Bananas are nutritious and, as long as they are soft, do not present a choking hazard for young children. Popcorn, hot dogs, and raw carrots are all choking hazards for young children.

A nurse is providing teaching to a client who has COPD about maintaining proper nutrition. Which of the following statements by the client indicates an understanding of the teaching? A. "I will increase my fluid intake when I eat a meal." B. "I will eat more cold foods at meals rather than hot foods." C. "I will avoid high-fat foods like butter and gravies." D. "I will cook my meals instead of eating convenience foods."

B. "I will eat more cold foods at meals rather than hot foods." The client should prepare more cold foods to eat because they provide a decreased feeling of fullness compared to hot foods. The client should avoid drinking fluids with meals because it could contribute to early satiety (the client should consume as much food as possible prior to feeling full or tired). The nurse should encourage butter, sauces, and gravy added to foods to increase caloric intake.

A nurse is reviewing the laboratory reports of a client who is receiving enteral feedings. Which of the following values indicates a complication of enteral feeding that the nurse should report to the provider? A. Sodium 143 mEq/L B. Potassium 4.2 mEq/L C. BUN 25 mg/dL D. Glucose 185 mg/dL

BUN 25 mg/dL This BUN level is above the expected reference range of 10 to 20 mg/dL and indicates dehydration, which is a complication of enteral feedings. The nurse should report this laboratory value to the provider. A glucose level of 185 mg/dL is within the expected reference range of <200mg/dL and does not indicate a complication.

A nurse is caring for a client who has a BMI of 29 and expresses a desire to lose weight. Which of the following actions should the nurse take first? A. Refer the client to a nutritionist B. Discuss eating strategies with the client C. Determine the client's intention to change current eating habits D. Instruct the client to perform 30 min of vigorous exercise daily

C. Determine the client's intention to change current eating habits. When using the nursing process, the nurse should first assess the client's readiness to commit to a change in behavior.

A nurse is reviewing the dietary choices of a client who has chronic pancreatitis. Which of the following food items should the nurse suggest removing from the client's menu for the following day? A. White rice B. Broiled cod C. Ice cream D. Canned peaches

C. Ice cream Clients with chronic pancreatitis should limit fat intake to no more than 30-40% of total calories. Ice cream is high in fat. The client should choose healthier fat-containing options to support a balanced diet, such as avocados and nuts.

A nurse is caring for an infant who has gastroenteritis and is dehydrated. Which of the following characteristics places the infant at a higher risk of electrolyte imbalances compared to an adult client? A. Less extracellular fluid B. Reduced body surface area C. Longer intestinal tract D. Decreased rate of metabolism

C. Longer intestinal tract Compared to adults or older children, infants have a longer intestinal tract. This results in greater fluid losses, especially through diarrhea. Compared to adults/older children, infantas have a larger amount of extracellular fluid that results in a larger fluid volume and more rapid water loss in this age group.

A nurse is caring for a client who is receiving intermittent enteral feedings through an NG tube. the specific gravity of the cleint's urine is 1.035. Which of the following actions should the nurse take? A. Deliver the formula at a slower rate B. Request a lower-fat formula C. Provide more water with feedings D. Instill a lactose-free formula

C. Provide more water with feedings. The elevation(normal is 1.005-1.030) in the client's specific gravity indicates dehydration. The nurse should provide more fluids either by adding free water to feedings or by instilling water between feedings. Another strategy is to request a formula that contains less protein.

A nurse is providing postoperative teaching about the management of dumping syndrome to a client who had a partial gastrectomy. Which of the following instructions should the nurse include in the teaching? A. "Consume at least 4 oz of fluid with meals." B. "Take a short walk after each meal." C. "Use honey to flavor foods such as cereal." D. "Eat protein with each meal."

D. "Eat protein with each meal." The nurse should instruct the client to eat meals that are high in protein and fat with low to moderate carbohydrate content. Protein should be included in every meal because it delays digestion, which helps reduce the manifestations of dumping syndrome. The client should avoid fluids at mealtimes to decrease gastric stimulation and lie down when experiencing early manifestations of dumping syndrome (tachycardia, syncope, sweating) to slow the progress of food through the GI tract. The client should avoid simple carbohydrates like honey, sugar, and syrup because they aggravate the stomach and worsen manifestations of dumping syndrome.

A nurse is planning care for a client who has anorexia and nausea due to cancer treatment. Which of the following interventions should the nurse include? A. Serve foods at warm or hot temperatures B. Offer the client low-density foods C. Make sure the client lies supine after meals D. Limit drinking liquids with food

D. Limit drinking liquids with food. Drinking beverages with food leads to early satiety and bloating, which results in the client consuming fewer calories. The client should receive col or room-temperature foods. The client should have caloric/nutrient-dense foods. To reduce nausea, the client should sit upright for 1 hour after meals.

A nurse is providing dietary teaching to a client who has dumping syndrome following gastric bypass surgery 4 days ago. Which of the following recommendations should the nurse include in the teaching? A. Avoid foods containing protein B. Drink liquids during each meal C. Eat foods that contain simple sugars D. Maintain a supine position after meals

D. Maintain a supine position after meals. The nurse should instruct the client to lie supine to help slow the rapid emptying of food into the small intestine. Dumping syndrome clients should decrease amount of food eaten at once, eat small meals more frequently, and eliminate fluids at mealtime. Fluid shifts occur in the upper gastrointestinal tract when food contents and simple sugars exit the stomach too rapidly, attracting fluid into the upper intestine and decreasing blood volume, which causes nausea/vomiting, sweating, syncope, palpitations, increased heart rate, and hypotension.