Chapter 36: Nutrition
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." Explanation: Vegetarians have a lower incidence of colorectal cancer and fewer problems with obesity and diseases associated with a high-fat diet. Protein complementation helps a client get amino acids needed. Vegans rely solely on plant sources for protein; semi-vegetarians exclude only red meat from their diet.
After a visit with the health care provider, the nurse calculates the client's body mass index (BMI). Which statement by the nurse best informs the client of the purpose of BMI?
"BMI is used to screen for weight categories that can lead to health problems." Explanation: BMI is a person's weight in kilograms divided by the square of height in meters. A high BMI can be an indicator of high body fatness. BMI can be used to screen for weight categories that may lead to health problems, but it is not diagnostic of the body fatness or health of an individual. Insurance companies have weight charts and do not use BMI for screening. The BMI does not refer to the weight that makes a person feel more comfortable.
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." Explanation: A weight should be obtained in the facility as soon as possible upon admission so that subsequent weights can be compared to the initial one. Clients who are asked to give their current weight often use a very old weight or do not give an accurate weight.
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." Explanation: Consuming megadoses (amounts exceeding those considered adequate for health) of vitamins and minerals can be dangerous. This statement requires further nursing teaching. The other statements do not require further teaching.
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." Explanation: Vegetarians have a lower incidence of colorectal cancer and fewer problems with obesity and diseases associated with a high-fat diet. Protein complementation involves eating a variety of incomplete plant proteins over the course of the day to provide adequate amounts and proportions of all the essential amino acids present in animal protein sources. Vegans rely solely on plant sources for protein; semi-vegetarians exclude only red meat from their diet. Obesity is not linked with vegetarianism.
The nurse is educating a client taking furosemide for heart failure about eating foods that are rich in potassium. Which statement made by the client indicates that education was effective?
"When I take my medication, I will eat a banana or take it with a glass of orange juice." Explanation: The client demonstrates that the teaching was effective by identifying bananas and orange juice as foods rich in potassium. The desired effect of the medication is to excrete sodium to avoid the accumulation of fluid in the lungs. To increase the amount of salt in the diet would be counterproductive. Dairy products such as milk and cheese are not potassium-rich foods. Eating small frequent meals versus three meals per day is irrelevant in increasing potassium level.
A client is 6 weeks' pregnant and is in a clinic for her first prenatal exam. The client asks the nurse how her nutritional needs have changed now that she is pregnant. Which is the nurse's best response?
"You will need an increase in calories, protein, calcium, folic acid, and iron." Explanation: The pregnant woman's diet should include a substantial increase in calories, protein, calcium, folic acid, and iron. Usually, a prenatal multivitamin and mineral supplement is prescribed. The pregnant woman should gain weight throughout her pregnancy, as prescribed and monitored by the health care professional. Pregnant women at risk for nutritional deficiencies are adolescents, underweight women, obese women, women with chronic nutritional problems, women who smoke or ingest alcohol or drugs, low-income women, and women with chronic illnesses such as diabetes or anemia.
What is the body mass index (BMI) of a client who is 1.68 meters tall and weighs 70 kg?
24.8 Explanation: A BMI of 24.8 is correct. The BMI is the ratio of height to weight that more accurately reflects total body fat stores in the general population. To calculate the BMI: divide the weight in kilograms (kg) by the height in meters (m) then divide the answer by the height again to get the BMI.
At what period of life do nutrient needs stabilize?
Adulthood Explanation: Nutrient needs change across the life span in relation to growth, development, activity, and age. Periods of intense growth and development (such as during infancy, adolescence, pregnancy and lactation) increase nutrient needs. Nutrient needs stabilize during adulthood.
A nurse documents a client's hemoglobin as 8 g/dL (80 g/L). What nutritional condition does this biochemical data signify?
Anemia Explanation: If hemoglobin (normal = 12 to 18 g/dL; 120 to 180 g/L) is decreased, anemia is present. A increased hematocrit signifies dehydration. Malnutrition is related to serum albumin, blood urea nitrogen, and creatinine. Decreased serum albumin also signifies malabsorption.
The nurse is concerned that a client is not eating the meals provided. Which interventions should the nurse implement to encourage eating?
Ask the client why he or she is not eating. Explanation: It is important for the nurse to ask the client why he or she is not eating. This will help the nurse to understand the problem, rather than assume the client does not like the food. It is beneficial to discuss the client's culture and food choices and incorporate them within the diet that is prescribed. Offering extra desserts would not allow the client to get the recommended daily allowances as needed to maintain weight. Bringing in food from the home is not a solution and may not be allowed by the facility. Feeding the client each meal removes the client's independence and may increase the lack of food intake.
The nurse has obtained a client's capillary blood glucose sample and the results are significantly lower than reference range. What is the nurse's priority action?
Assess the client for signs and symptoms of hypoglycemia. Explanation: Low blood sugars should prompt the nurse to assess for signs and symptoms of hypoglycemia. There may or may not be a need to contact the primary care provider depending on whether a protocol is in place and the client's clinical presentation. There is not normally a need to obtain a sample from the opposite hand.
Prior to allowing a client to eat, which action is most important for the nurse to take?
Assess the client's level of consciousness. Explanation: The most important thing the nurse can do is to ensure the client is alert enough to safely eat without aspirating. Next, ensuring the client is physically able to self-feed and safely swallow is necessary. The client's cultural needs and eyesight are least important.
A nurse is caring for a client who has a nursing diagnosis of Risk for Aspiration. When preparing to assist this client with eating, how can the nurse best reduce this risk?
Assess the client's level of consciousness. Explanation: Decreased level of consciousness greatly increases a client's risk of aspirating; it is imperative that the nurse assess this prior to the client eating. It is appropriate for the nurse to assess the client's mouth and abdomen and assess for nausea, but none of these actions directly address the client's risk of aspiration.
The nurse is caring for a client who refuses most foods on the dietary tray. Which nursing intervention is appropriate?
Assess when client generally eats meals. Explanation: There are many reasons a client may refuse food that is served. The nurse should assess for food preferences, when the client generally eats, whether the client has digestive concerns, and cultural beliefs about foods. Leaving the client alone to eat, or simply delegating feeding, does not encourage intake. The client does not need an appetite stimulant until a full assessment has been conducted and other interventions have been implemented.
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. Explanation: With glucose monitoring, blood from the fingertips shows changes in blood glucose more quickly than other testing sites. With signs and symptoms of hypoglycemia, a fingertip site should be used. Calibrate the glucose monitors at least every month. Glucose levels increase with illness and stress to the body.
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 Explanation: Milk contains vitamin D, which helps with the absorption of calcium and phosphorous. The other choices do not.
Which nursing action associated with successful tube feedings follows recommended guidelines?
Check the residual before each feeding or every 4 to 6 hours during a continuous feeding. Explanation: The nurse should check the residual before each feeding or every 4 to 6 hours during a continuous feeding. High gastric residual volumes (200 to 250 mL or greater) can be associated with high risk for aspiration and aspiration-related pneumonia. A closed system is the best way to prevent contamination during enteral feedings. The bowel sounds do not have to be assessed as often as 4 times per shift. Once a shift is sufficient. Food dye should not be added as a means to assess tube placement or potential aspiration of fluid.
The nurse is preparing to administer an intermittent feeding to a client who has a feeding tube. The nurse is unable to aspirate gastric contents and realizes that the tube is clogged. Which action is correct?
Connect a syringe filled with warm water to the feeding tube and flush it out using gentle pressure. Explanation: Most obstructions are caused by coagulation of formula. The nurse should try using warm water and gentle pressure to remove the clog. Carbonated sodas, such as Coca-Cola, and meat tenderizers have not been shown effective in removing clogs in feeding tubes. Never use a stylet to unclog tubes. Advancing the tube is not needed, as this will not address the clog.
A nurse is caring for a client who is receiving total parenteral nutrition (TPN). Which action should the nurse perform with TPN?
Discard unused TPN every 24 hours. Explanation: With TPN, any unused portion should be discarded every 24 hours. Vital signs with TPN should be checked every 4 hours. Blood glucose should be checked every 6 hours. If the client has a transparent dressing on the central venous access, it can be changed weekly.
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. Explanation: The nurse found that during pregnancy and lactation, nutrient requirements increase. The nurse would also note that nutritional needs per unit of body weight are greater in infancy than at any other time in life. The nurse would find that men and women differ in their nutrient requirements. Trauma, surgery, and burns increase nutrient requirements. The BMR decreases with each decade in adulthood. The caloric needs of the older adult decrease, not increase.
After teaching the client about a low-fat diet, which items selected by the client would indicate to the nurse that the client comprehends the nutritional teaching?
Egg white omelet with vegetables Explanation: The nurse should recognize the client has understood when the client chooses an egg white omelet. Peanut butter is high in protein but also fat. Frozen hash browns include oil for ease of preparation. Non-dairy creamers often include fat, unless otherwise noted.
A client has had a stroke and will require long-term tube feeding. Which type of feeding tubes would be most appropriate for this client's needs?
Gastrostomy tube Explanation: When enteral feeding is required for a long-term period, an enterostomal tube may be placed through an opening created into the stomach (gastrostomy) or into the jejunum (jejunostomy). NG, NI, and Salem Sump tubes will not meet a client's long-term nutritional needs.
A nurse is caring for a client with a gastrostomy tube in place. Which is an accurate guideline for care of the insertion site?
If the gastric tube insertion site has healed and the sutures are removed, use soap and water to clean the site. Explanation: If the gastric tube insertion site has healed and the sutures are removed, wet a washcloth and apply a small amount of soap onto it. Gently cleanse around the insertion site, removing any crust or drainage. If the gastrostomy tube is new and still has sutures holding it in place, dip a cotton-tipped applicator into sterile saline solution and gently clean around the insertion site, removing any crust or drainage. Avoid adjusting or lifting the external disk for the first few days after placement, except to clean the area.
What is an appropriate intervention when unexpected situations occur during the administration of a tube feeding?
If the tube becomes clogged when aspirating contents, use warm water and gentle pressure to remove the clog. Explanation: Warm water and gentle pressure should be used to unclog a tube. If a large amount of residue is accidentally aspirated, the health care provider should be notified. If the client is nauseated, the head of the bed should remain elevated and an antiemetic administered as prescribed. The tube should be in the stomach, not the esophagus.
The nurse examines the client's lab results: transferrin 220 mg/dL, hematocrit 33%, serum creatinine 1 mg/dL, BUN 17 mg/dL. The nurse should provide which action?
Increase foods rich in iron. Explanation: The nurse should interpret the labs, noting anemia by the hematocrit level and the low iron level or transferrin level. The client needs foods rich in iron to help build more red blood cells and resolve the anemia. The BUN and creatinine levels are normal and there is no indication for a fluid restriction. The serum albumin level is normal and there is no indication of prolonged protein deficiency, or indication to decrease proteins in the diet.
The nurse is reviewing a client's most recent laboratory results, which reveal increases in hematocrit, creatinine, and blood urea nitrogen (BUN). After collaborating with the interdisciplinary team, what intervention is most appropriate?
Increase the client's fluid intake. Explanation: Dehydration can cause increases in hematocrit, BUN, and creatinine. Calorie restriction, increased protein intake, and TPN are not indicated by these laboratory data.
A client who is recovering from a stroke has begun tube feedings. Which principle should the nurse follow when administering the tube feeding?
Intermittent feedings use gravity for instillation or a feeding pump to administer the formula over a set period of time. Explanation: Intermittent feedings are delivered at regular intervals, using gravity for instillation or a feeding pump to administer the formula over a set period of time. The steps for administering feedings are similar regardless of the tube used. Intermittent feedings are the preferred method of introducing the formula over a set period of time via gravity or pump. Feeding intolerance is less likely to occur with smaller volumes. Feeds are not warmed prior to instillation.
The nurse is caring for a client with an enlarged thyroid gland. Which nutritional deficiency will the nurse suspect is linked to the client's condition?
Iodine Explanation: A chronic deficiency of iodine can lead to goiter, which manifests as an enlargement of the thyroid gland.
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 Explanation: The RDA level is the average dietary intake level that meets the nutritional requirement of almost all healthy people in a selected age and gender group.
A nurse has just inserted a nasogastric tube in a client. Which method is most reliable for verifying the correct placement of the tube?
Radiographic confirmation of position Explanation: Radiographic (x-ray) examination is the only absolutely reliable method to determine accurate tube placement. In the absence of an x-ray, pH testing is predicative of correct placement. Although visualization of aspirated contents can help confirm correct placement of the tube, this method is not as reliable as an x-ray.
Which laboratory test is the best indicator of a client in need of TPN?
Serum albumin Explanation: Assessment of serum albumin level is the best indicator of a client in need of total parenteral nutrition (TPN). Clients whose levels are 2.5 g/dL (25 g/L) or less are at severe risk for malnutrition. Creatinine is used to assess kidney function. Hemoglobin and hematocrit assess the red blood cells of a client.
The nurse is caring for a client who has dysphagia and is unable to eat independently. The nurse is preparing to assist the client in eating a meal. Which action is appropriate?
Speak to the client but limit the need for the client to respond verbally while chewing and swallowing. Explanation: Talking during eating increases the risk of aspiration for a client who has dysphagia. Arranging food on the plate in a clock face pattern is a strategy appropriate for a client who is visually impaired. Clients who have dysphagia need to eat slowly and be continually observed for signs of aspiration. Allow enough time for the client to adequately chew and swallow the food. The client may need to rest for short periods during eating.
A client having a bowel surgery asks why being NPO after surgery is necessary. Which statement by the nurse best describes the reason?
To rest the gastrointestinal tract and promote healing Explanation: Withholding food may be indicated in the following situations: to rest the gastrointestinal tract to promote healing, clear the gastrointestinal tract of contents before surgery or diagnostic procedures, prevent aspiration during surgery or in high-risk clients, give normal intestinal motility time to return, treat severe vomiting or diarrhea, and to treat medical problems, such as bowel obstruction or acute inflammation of the gastrointestinal tract. Withholding food does not cause gas to accumulate or increase the amount of mucus in the bowel.
A physician orders nutritional therapy administered via a central vein for a client who cannot take foods orally. What is the term for this type of nutrition?
Total parenteral nutrition (TPN) Explanation: TPN is nutritional therapy that bypasses the gastrointestinal tract and is administered through a central vein. PPN is nutritional therapy used for clients who have an inadequate oral intake and require supplementation of nutrients through a peripheral vein. A PEG is a surgically placed gastrostomy tube. A PEJ is a surgically placed jejunostomy tube.
A nurse is checking a client's capillary blood glucose level. Which nursing action is most appropriate?
Touch the test strip directly to a drop of blood. Explanation: The nurse should touch a drop of blood to pad to the test strip without smearing it. Test strips are not cleaned and blood flow is encouraged by warming or stroking the finger, not having the client make a fist. The site should not be wiped with alcohol after testing.
An older adult client informs the nurse that foods don't taste or smell the same and eating is a chore. What suggestion can the nurse provide to the client to address this age-related change?
Try eating foods that are attractive and at the proper temperature. Explanation: The nurse should suggest eating foods that are attractive and at the proper temperature. Other suggestions include eating one food at a time rather than mixing foods and eating foods with different textures and aromas. The nurse should refrain from suggesting spicy foods, which may not be well tolerated by a client or may not be part of the client's flavor profile.
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. Explanation: Food in the health care setting can often be unattractive and cool. Ensuring that it is appealing to the eyes and presented at the correct temperature can stimulate the client's appetite. Meals should be small and more frequent, not less frequent and larger. Supplements may be nutritionally necessary, but these do not act to increase the client's appetite.
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 Explanation: MyPlate recommends the Americans make half of their plate fruits and vegetables. Dairy, proteins, and unsaturated fats are important components of a healthy diet but they should be consumed in smaller quantities than 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 Explanation: Dryness of the eyes (xerophthalmia) is associated with a deficiency of vitamin A.
A nurse is educating a group of adolescent girls on bone and teeth growth. Which fat-soluble vitamin assists to build bone and teeth?
Vitamin D Explanation: Vitamin D stimulates the absorption of calcium, which is an essential component for building strong, healthy bones and teeth. Vitamin A is essential in maintaining visual acuity, cell growth, and the immune system. Vitamin E is an antioxidant and also functions in promoting healing and healthy skin (cell growth). Vitamin K is essential in clotting.
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 Explanation: Specific foods may interact with medications, altering the effectiveness of the drug. Vegetables high in vitamin K decrease the effectiveness of the commonly used anticoagulant warfarin. Calcium, potassium, and Vitamin C do not interact with warfarin.
A client who has bleeding tendencies has a deficiency in which vitamin?
Vitamin K Explanation: Vitamin K deficiencies are manifested in two ways: an increased tendency to hemorrhage and hemorrhagic disease of the newborn, which is common in premature or anoxic newborns.
An athlete wants to increase the intake of complex carbohydrates and asks the nurse about potential sources. Which food is considered a complex carbohydrate?
Whole grain pasta Explanation: Starches such as grains (e.g., pasta, rice, bread, cereals) are considered complex carbohydrates. Honey belongs in the category of sugars, which is considered a simple carbohydrate. Peanuts and eggs belong in the protein category.
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 Explanation: A client who has a fever would have an increased BMR. The energy needs of the body are increased due to the client's fever. The BMR is decreased in an older adult client, a client who is fasting, and a client who is asleep.
The nurse is teaching a community group about reading food labels. When teaching about avoidance of refined sugar, the nurse will teach people to avoid foods containing which ingredient(s)? Select all that apply.
molasses corn syrup corn sweetener brown sugar Explanation: Molasses, corn syrup and corn sweetener, and brown sugar are refined sugars. Honey is a naturally occurring sugar. Therefore, clients do not have to avoid honey.
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. Explanation: A negative nitrogen balance exists when excretion of nitrogen exceeds the intake.
The nurse is planning nutrition education for a group of older adults in the community. Which factor(s) will the nurse consider, because of the effect on nutritional choices in this client population? Select all that apply.
changes in taste accessibility of food resources fixed income costs of health care Explanation: Older adults often consume diets high in carbohydrates. Reasons include changes in taste; changes in the ability to prepare or obtain foods; and limited accessibility or financial limitations related to increased cost of health care and other expenses on a fixed income. Changes in taste accompany normal age related changes. This tends to lead older adults to prefer to eat carbohydrates over other food groups. Carbohydrates require little preparation as they often come ready to consume. Because older adults may have reduced energy or ability to spend a long time standing in the kitchen to prepare their food, foods of convenience may be chosen over more nutrient rich foods. Despite common beliefs about getting older, people tend to have more financial limitations because they are no longer active in the work force, are tied to a fixed income and incur increased health care costs associated with aging. Accessibility to a variety of foods can also be constrained. Older adults may find it difficult to access food stores that carry a variety of foods due to distance or cost.
The nurse is providing education to a client with high triglyceride and cholesterol levels. Which food should the client be cautioned to avoid?
coconut Explanation: Coconut oil, palm oil, and palm kernel oil are highly saturated fats.
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 Explanation: Sodium is found in higher concentrations in table salt, bacon, and processed meats. The other choices do not have a high concentration of sodium.
A woman consumes pasta, grains, and other carbohydrates for which purpose?
energy Explanation: The main function of carbohydrates is to provide energy.
A client is receiving total parenteral nutrition (TPN). The nurse will assess for complications related to:
fluid and electrolyte levels. Explanation: Total parenteral nutrition (TPN) is nutrition administered through a central venous access and is high in nutrients and electrolytes. It is important to assess fluid and electrolyte levels with TPN infusions. Falls are a risk associated with ability to reposition and not TPN. There is no pain associated with TPN infusions as the medication is administered via a central venous access line. Nausea or vomiting are not adverse effects associated with TPN as the medication is administered via a central line and not by a feeding tube in the stomach.
A client who follows a vegetarian diet should include which foods to maintain a healthy diet?
legumes and vegetables Explanation: The vegetarian diet or vegan includes only foods from plants: fruits, vegetables, legumes (dried beans and peas), grains, seeds and nuts. Red meats are not part of a vegetarian diet. Chocolate, wine, and processed white bread would not be considered to be healthy choices for a vegetarian diet.
A client has developed an abscess following abdominal surgery, and the client's food intake has been decreasing over the past 2 weeks. Which laboratory finding may suggest the need for nutritional support?
low prealbumin levels Explanation: Prealbumin levels are a good indicator of a client's short-term nutritional status; decreased levels are suggestive of malnutrition. Protein in the client's urine, low blood sugars, and increased white blood cells are not necessarily indicative of malnutrition. Proteinuria is urine having an abnormal amount of protein. The condition is often a sign of kidney disease. Random blood sugar can be affected by food intake. White blood cells are indicative of infection.
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 Explanation: Dietary fiber is a minimal source of energy but plays an essential role in stimulating peristalsis and maintaining normal bowel elimination. Proteins have specific functions of producing hemoglobin for carrying oxygen to tissues, insulin for blood glucose regulations, and albumin for regulating osmotic pressure in the blood. Fats perform the important functions of energy storage of adipose tissue, vitamin absorption, and transport of fat-soluble vitamins A, D, E, and K.
A client with protein deficiency is encouraged to eat a protein-rich snack. The client requests a peanut butter sandwich. What other food can the nurse provide that will provide the client with complete protein?
milk Explanation: Complete proteins, such as milk, typically come from animal sources. Proteins from plant sources, such as soybeans, are usually incomplete. Carrots and bread are not significant protein sources.
A client who is taking supplements reports severe flushing and itching an hour after ingestion. The nurse is aware that the supplement is most likely:
niacin. Explanation: Niacin, part of the B vitamins, has a known side effect of flushing and itching after ingestion. The other vitamins that make up the B complex vitamin are B1 thiamin, B2 riboflavin, B3 niacin, B5 pantothenic acid, B6 pyridoxine, B7 biotin, B9 folic acid, and B12 cobalamin. Other adverse effects of the B complex vitamins include nausea, vomiting, constipation, abdominal pain, and black stools.
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 Explanation: Normal blood glucose is 80 to 110 mg/dL (4 to 7 mmol/L).
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 Explanation: A body mass index (BMI) between 25 and 29.9 is considered overweight.
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 Explanation: A client with a BMI below 18.5 should be considered underweight. A client with a BMI of 18.5 to 24.9 is considered to be at a healthy weight. A client with a BMI of 25 to 29.9 is considered overweight; a client with a BMI of 30 or greater indicates obesity. A BMI greater than 40 is considered extreme obesity.
Which client(s), at risk for poor nutritional intake, would benefit from nutritional counseling from the nurse? Select all that apply.
pregnant teenagers people with substance use problems older adults living on fixed incomes Explanation: Examples of those in the United States at risk for an inadequate nutritional intake include older adults who are socially isolated or living on fixed income, homeless people, children of economically deprived parents, pregnant teenagers, people with substance use problems, and clients with eating disorders. Children of middle-income parents and individuals who prefer to purchase food from local farmers are not necessarily at risk.
A nurse is caring for a client with chronic anemia. What should be included in the diet of this client?
red meat Explanation: Red meat is a source of iron. It therefore should be included in the diet of a client with chronic anemia. Dairy products, citrus fruits, and yellow vegetables are nutrient-dense foods and not sources of iron. Dairy products are sources of fat, whereas citrus fruits and yellow vegetables are sources of vitamins.
A nurse is learning about religious dietary restrictions at a nursing conference. Which religious meal selection should the nurse understand is appropriate?
vegetable plate for a client who practice Hinduism Explanation: Dietary restrictions associated with religions are extremely important to provide culturally competent nursing care. Clients who practice Hinduism do not consume beef, because cows are considered a sacred creature. They are typically vegetarians; therefore, a vegetable plate is appropriate for this client. Clients who practice Orthodox Judaism eat have kosher foods. Shrimp and pork are prohibited in a kosher diet. Members of The Church of Jesus Christ of Latter-day Saints do not drink coffee, tea, or alcohol and they limit their meat consumption.
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 Explanation: Vitamin B12 deficiency is most commonly found in vegetarians, particularly in strict vegans. Individuals who have such rigid dietary restrictions must take care to supplement this vitamin.
Which vitamin is found only in animal foods?
vitamin B12 Explanation: Vitamin B12 functions in the formation of mature red blood cells and in synthesis of DNA and RNA. This vitamin is only found in animal foods (meats, fish, poultry, milk, and eggs).
A nurse is assessing the nutritional needs of clients. Which criteria indicates that a client most likely needs total parenteral nutrition (TPN)?
wasting syndrome from AIDS Explanation: The client with AIDS that has wasting syndrome is the priority reason that a client would most likely need TPN. Residual of more than 100 mL could be normal for the individual, or could indicate the need to decrease the rate of the tube feeding, or a need to change the formula. The presence of dumping syndrome would not be a reason for a client to most likely need TPN. A serum albumin level of 4.2 g/dL (3.63 mmol/L) is normal. This does not indicate that
