Final nutrition

A 79-year-old client has been admitted to a long-term care facility that follows a liberal diet approach. The family is concerned that this will hurt the client due to a long history of high cholesterol and desire a low-cholesterol diet. How might the nurse respond? A) Malnutrition is a greater threat than hypercholesterolemia. B) The client is too old to worry about it now. C) The facility does not offer specialized, individual diet options. D) If the cholesterol hasn't gone down yet, it never will.

A

A client is admitted with persistent diarrhea and a weight loss of 10 pounds. What would the nurse recognize as the significance of the weight loss if the client stated that he had lost the weight over the past 3 months? A) Signifies a chronic versus acute condition B) Signifies that it was an intentional weight loss C) Signifies there is no nutritional deficit D) Signifies an ongoing acute condition

A

A client is trying to understand where cheese fits into the MyPlate for Older Adults. The nurse explains that according to this plan, cheese is in which section? A) Protein B) Milk C) Dairy D) Fat

A

A client suffering from anorexia due to anxiety and fear has the same goal of nutritional therapy as the client who is anorexic due to medical treatments. What is that goal? A) Stimulate the appetite to maintain adequate nutritional intake. B) Stimulate the appetite to get the client to eat at least 75% of each meal. C) Stimulate the appetite to get the client to eat at least 50% of each meal. D) Stimulate the appetite to maintain three meals a day of oral intake.

A

A mother is concerned her 15-year-old daughter is not very active. The mother wants to know how many calories a day should she feed her to keep her from gaining weight. A) 1800 calories B) 900 calories C) 1200 calories D) 1500 calories

A

Refeeding syndrome is a potentially fatal complication of overfeeding. Why is refeeding syndrome so dangerous? A) It may result in dangerous shifts in serum phosphorus and other electrolytes. B) It results in a decrease in insulin. C) It occurs as a result of a low-calorie diet. D) It may lead to hypovolemic shock.

A

Refeeding syndrome is a potentially fatal complication of overfeeding. Why is refeeding syndrome so dangerous? A) There is an abrupt change from a catabolic state to an anabolic state. B) It results in a decrease in insulin. C) It occurs as a result of a low-calorie diet. D) It improves the client's chance of survival after multiple organ failures.

A

The client has come to the office with an exacerbation of his celiac disease. He says he has been reading the labels and making sure he avoids wheat, barley, and rye. After reviewing the labels with the client, the nurse recognizes which listed ingredient as a suspected culprit? A) Malt flavoring B) Sorghum C) Millet D) Carrageenan

A

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? A) Daily electrolyte levels B) Blood pressure C) Daily weight D) Intake and output

A

The physician has recommended a low-fat diet for the client with chronic pancreatitis. The client is frustrated because he likes to eat dairy products. Which of the following should the nurse suggest this client follow? A) Choose dairy products that provide less than 1 g fat per serving. B) Switch to soy dairy products. C) Eliminate all milk products from his diet. D) Choose cheese with 5 g or less of fat.

A

There is a difference between peripheral parenteral nutrition (PPN) and central vein total parenteral nutrition. What is that difference? A) Dextrose B) Lipid emulsion C) Vitamins D) Electrolytes

A

Which of the following is not a simple carbohydrate? A) Starches B) Table sugar C) Disaccharides D) Monosaccharides

A) Starches

Fibers belong to the class of nutrients known as A) carbohydrate. B) protein. C) lipids. D) minerals.

A) carbohydrate.

The nurse is helping the client adjust to a lactose-free diet. The client is learning to read labels to identify which products contain lactose. Which of the following are safe for the client to consume? Select all that apply. A) Lactate B) Lactic acid C) Lactalbumin D) Casein

A, B, C, D

The nurse is admitting a 42-year-old female with colon cancer to the unit. She is scheduled to have a resection with ileostomy. What do ileostomies cause a decrease in? Select all that apply. A) Fat B) Carbohydrates C) Bile acid D) Insoluble fiber E) Vitamin B12 absorption

A, C, E

Psychological (external) influences that encourage us to find and eat food

Appetite

Celiac disease is a genetic autoimmune disorder that results in a permanent intolerance to certain proteins. What should clients with celiac disease avoid? A) Puffed rice B) Cream of wheat C) Cream of rice D) Corn flakes

B

In the diabetic class on exercise, the nurse stresses that insulin users should test their blood glucose level before exercising. At what blood glucose level would the diabetic need to eat a carbohydrate snack before exercising? A) 70 mg/dL B) 100 mg/dL C) 110 mg/dL D) 130 mg/dL

B

The client at the HIV clinic has come in complaining of unintended weight loss with diarrhea lasting over the last month. How is the wasting syndrome in clients with AIDS defined? A) Loss of 4% of usual weight B) Loss of 10% of usual weight C) Loss of 15% of usual weight D) Loss of 20% of usual weight

B

The nurse emphasizes that nutrition therapy is the basis of treatment for all diabetics in the nutrition class. Which of the following nutrition recommendations for diabetics is true? A) Together, total carbohydrate and monounsaturated fat should provide less than 50% of total calories. B) Glycemic control is dependent on matching carbohydrate intake with the action of insulin or other medication. C) Natural sources of fructose (fruits, vegetables) should be restricted. D) Gram for gram, sucrose cannot replace starch without causing a deleterious effect on glucose levels.

B

The nurse is admitting to the unit a client who is a 42-year-old female with a diagnosis of pancreatic cyst. Her orders include enteral nutrition. What kind of enteral formula would you expect to be ordered by the physician? A) Standard B) Hydrolyzed C) Standard high protein D) Hydrolyzed high fiber

B

The nurse is teaching a nutrition class with a group of student nurses. One of the students asks why the meat and meat exchange list is divided into four subgroups. Which of the following is the most appropriate answer? A) It is divided due to protein content. B) It is divided due to fat content. C) It is divided due to cholesterol content. D) It is divided due to minerals content.

B

The recommended diet for someone with dumping syndrome is low fiber. A person with dumping syndrome asks what foods are good for them to eat. What would be the best response? A) Kidney beans B) Cream of wheat C) Apples D) Shredded wheat

B

Unintentional weight loss can be an indicator of malnutrition; however, apparent weight gain may be an unreliable indicator of improvement due to which of the following? A) Carcinoma B) Anasarca C) Cholecystitis D) Pancreatitis

B

When are infants developmentally ready for the introduction of solid foods? A) 2 to 3 months of age B) 4 to 6 months of age C) 6 to 9 months of age D) 9 to 12 months of age

B

When safely introducing new foods into an infant's diet, the parents should introduce one food at a time in a simple form. What period of time should they wait between introducing new foods so that allergic reactions can be easily identified? A) 2 to 3 days B) 5 to 7 days C) 7 to 14 days D) 3 weeks

B

When teaching a client about diet changes, the nurse knows it is better to emphasize which of the following? A) Good versus bad B) More healthy versus less healthy C) Low carbs and fats versus high carbs and fats D) Calorie counting

B

The nurse suspects that the patient receiving parenteral nutrition (PN) through a central venous catheter (CVC) has an air embolus. What action does the nurse need to take first? A) Raise head of bed to 90 degrees B) Turn patient to left lateral decubitus position C) Notify health care provider immediately D) Have patient perform the Valsalva maneuver

B An air embolus possibly occurs during insertion of the catheter or when changing the tubing or cap. Have the patient assume a left lateral decubitus position first. Then have the patient perform a Valsalva maneuver (holding the breath and "bearing down"). The increased venous pressure created by the maneuver prevents air from entering the bloodstream during catheter insertion. Maintaining integrity of the closed intravenous system also helps prevent air embolus.

The nurse sees the nursing assistive personnel (NAP) perform the following for a patient receiving continuous enteral feedings. What intervention does the nurse need to address immediately with the NAP? The NAP: A) Fastens the tube to the gown with tape. B) Places the patient supine while giving a bath. C) Performs oral care for the patient. D) Elevates the head of the bed 45 degrees.

B Patients receiving enteral feedings should have the head of the bed elevated a minimum of 30 degrees, preferably 45 degrees, unless medically contraindicated. Laying the patient supine increases the risk of aspiration of the feeding and should be avoided. This needs to be addressed to maintain patient safety.

The Food and Nutrition Board (FNB) of the National Academy of Sciences advocates that 10% to 35% of calories come from protein and ________________ from carbohydrate. A) 20% to 35% B) 45% to 65% C) 50% to 70% D) 55% to 75%

B) 45% to 65%

A large hamburger (e.g., Whopper) sandwich contains 628 kcalories and 36 grams of fat. Approximately what percentage of the total energy is contributed by fat? A) 23% B) 52% C) 19% D) 41%

B) 52%

Which of the following is true about the North American diet? A) Most of our protein comes from plant sources. B) Approximately half of our carbohydrates come from simple sugars. C) Most of our fats come from plant sources. D) Most of our carbohydrates come from starches

B) Approximately half of our carbohydrates come from simple sugars

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. A) For 3 to 4 days preoperatively for clients expected to undergo major reconstructive surgery B) On the 8th hospital day in a well-nourished client who has received nutrition C) As soon as possible in malnourished clients D) PN should be initiated only if the anticipated length of therapy is 4 days or more.

B, C

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 suggestions will be important to include in the discussion? (Select all that apply.) A) Liquids should be thin to allow ease of swallowing. B) Use broth, cheese, milk, or tomato sauce instead of water for blenderizing the food. C) All foods should be smooth and not chunky. D) All foods are allowed if liquefied.

B, C, D

The nurse is teaching a nutrition class for nursing students. The discussion for today is about the nutrition therapy for dumping syndrome. What is the nutrition therapy for dumping syndrome that alleviates or controls its symptoms? Select all that apply. A) Clear liquids are the first feeding. B) Small, frequent feedings are the first feedings. C) Only one or two items are eaten at each meal. D) Fat is eliminated from the diet. E) Complex carbohydrates are a part of the diet.

B, C, E

The client is complaining about his diet. He isn't hungry, nothing tastes good, and he can't have what he wants, are just a few of his complaints. The nurse realizes this client needs encouragement and some suggestions to improve his nutritional status. Which of the following are some suggestions the nurse can make? Select all that apply. A) Limit dairy foods to 1 cup each day. B) Try highly seasoned or strongly flavored foods. C) Add salt at the table, not during cooking. D) Spread protein allowance over the day.

B, D

The client is losing weight even though she is following the prescribed diet. The nurse suggests several different strategies to her to increase her calorie intake. Which of the following are some of those suggestions? Select all that apply. A) Coat meat with milk and bread crumbs before baking. B) Mix cream cheese with butter and put on toast. C) Use peanut butter on apple slices. D) Snack frequently on nuts. E) Choose desserts made with eggs and/or milk.

B, D

Contributing factors of gastroesophageal reflux disease (GERD) are increased intra-abdominal pressure and decreased esophageal motility. What are the symptoms of GERD? Select all that apply. A) Pain that increases when you stand up B) Heartburn C) Pain that decreases when you bend over D) Indigestion E) Regurgitation

B, D, E

The client has recently been diagnosed with prehypertensive syndrome. The nurse discusses with the client various lifestyle changes that can help lower the blood pressure. Which of the following are some of those lifestyle changes? Select all that apply. A) Bariatric surgery B) Exercise 150 minutes/week C) Start drug therapy D) Lose weight E) Decrease sodium intake to 2300 g/day

B, D, E

The nurse has given the nutrition class the assignment of creating a list of strategies for enhancing food intake in long-term care residents. What strategies would you expect to find on this list? Select all that apply. A) Let residents eat in their rooms. B) Honor food preferences. C) Make sure the diet is heart healthy. D) Involve the family in mealtime. E) Encourage independence in eating.

B, D, E

The nurse is helping a client prepare menus to reflect dietary changes the physician has ordered due to the recent diagnosis of CHD. The nurse recognizes whole grains are essential in this diet change. Which of the following components of whole grains have been implicated in providing benefits for clients with CHD? Select all that apply. A) Vitamin K B) B vitamins C) Vitamin C D) Fiber E) Phytochemicals

B, D, E

The nurse is teaching a class on nutrition with a group of clients who need to cut sodium from the diet. Today's topic is learning how to correctly read nutritional labels and recognize sodium. Which of the following are ingredients that might be hiding sodium in various foods that the clients need to be aware of? Select all that apply. A) Casein B) MSG C) Gelatin D) Baking soda E) Food coloring F) Baking powder

B, D, F

It is important to meet the protein needs of all the clients. As the nurse caring for a client with fractures, how many grams of protein per kilogram of body weight should his diet provide? A) 0.8 to 1.2 g B) 1.0 to 1.5 g C) 1.2 to 2.0 g D) 2.0 to 2.2 g

C

Osteoarthritis (OA) is a disease that predominantly plagues the elderly. What can weight loss do for older people with OA? A) It has no effect on arthritis symptoms. B) It aggravates arthritis symptoms. C) It relieves symptoms in the weight-bearing joints. D) It relieves symptoms throughout the body.

C

The nurse is caring for a 65-year-old Mr. Y who was admitted 1 week ago after his family found him confused and unable to ambulate in his home. Upon admission, he weighed 150 lb; today, he weighs 140 lb. The nurse knows that determining his percent weight change can help to determine his current nutritional status. What is his percent weight change? A) 3% B) 5% C) 7% D) 9%

C

The nurse is caring for a client in a long-term care facility who is 77 years of age and overweight. The nurse is considering putting this client on a low-calorie diet. Some experts recommend that strict therapeutic diets be used in older adults only when a significant improvement in health can be expected. Which elderly clients would a restrictive diet be recommended for? A) Those with high cholesterol levels B) Those with high potassium levels C) Those with ascites D) Those with mild hypertension

C

The nurse is caring for a client who was admitted for intractable nausea and vomiting that has now been controlled. The physician has ordered the diet to be advanced as tolerated. Of the following foods, what is the best choice for this client? A) Ice cream B) Cream soup C) Dry toast D) Peanut butter and crackers

C

To ensure all inpatients receive adequate care, The Joint Commission specifies that nutrition screening be conducted at what time during hospital admission? A) Immediately upon admission B) Within 12 hours after admission C) Within 24 hours after admission D) Within 36 hours after admission

C

A serving of bleu cheese dressing containing 23 grams of fat would yield _____ kcalories. A) 161 B) 92 C) 207 D) 255

C) 207

Which of the following are substances in plant foods that are not digested in the stomach or small intestine? A) Dextrose B) Disaccharides C) Dietary fiber D) Simple sugars

C) Dietary fiber

Which of the following hormones is made by the fat cells and influences long-term regulation of total fat stores? A) Endorphins B) Cortisol C) Leptin D) Neuropeptide Y

C) Leptin

Which of the following nutrition-related diseases is not one of the three leading causes of death in the United States? A) Cardiovascular disease B) Cancer C) Stroke D) Diabetes

D) Diabetes

Gram for gram, which provides the most energy? A) Carbohydrates B) Proteins C) Alcohol D) Fats

D) Fats

Calcium deficiency is a nutrition risk for adolescents. What is a contributing factor to the risk for calcium deficiency in adolescents? A) An increased intake of fast foods B) Iron deficiency C) The adolescent growth spurt D) The substitution of soft drinks for milk

D

The clinic nurse is caring for a diabetic client who has frequent episodes of hypoglycemia. What would be the best intervention for this client? A) Encourage the client to gain weight. B) Encourage the client to eat three large meals per day. C) Counsel the client to limit total carbohydrate intake to less than 100 g/day. D) Counsel the client to encourage better compliance.

D

The nurse is doing client teaching with a client going home to finish recovering from a small bowel resection and ileostomy. The client is concerned about what the best diet is for him. What would be the best response? A) A regular diet with no restrictions B) Large meals to produce large amounts of stool C) Increase fat intake for added calories D) Eating small, frequent meals

D

The nurse is doing client teaching with a client going home to finish recovering from an exacerbation of peptic ulcer disease. What statement by the client lets the nurse know that the client understands the teaching? A) "I should eat what I like when I like." B) "I should season my food well with the spices I like best." C) "Drinking caffeine throughout the day is recommended." D) "I should not eat for two hours before going to bed."

D

When a client is in acute renal injury (ARI), the nurse should closely monitor which of the following laboratory test values? A) Serum sodium B) Blood urea nitrogen C) Complete blood count D) Serum potassium

D

The building block for proteins containing carbon, hydrogen, oxygen, and nitrogen

Amino acid

Compound that speeds the rate of a chemical process but is not altered by the process

Enzyme

Chemical substances in food that contribute to health.

Nutrients

You eat a snack that contains 15 grams of carbohydrate, 8 grams of fat, and 8 grams of protein. This snack supplies _______________ kcalories.

164

A weight reduction regimen calls for a daily intake of 1,400 kcalories and 30 grams of fat. Approximately what percentage of the total energy is contributed by fat? (Round to the nearest whole number)

19

For student athletes, water is an adequate fluid replacement for events lasting less than _______________ minutes.

60; sixty

What is the caloric value of a meal supplying 110 g of carbohydrate, 25 g of protein, 20 g of fat, 5 g of alcohol, 600 g water, and 3 g of iron?

755

A 6-year-old boy has just come in from school and wants a snack. The mother is trying to maintain a heart-healthy diet for him by following the Dietary Guidelines for Americans. What would be the best snack the mother could give him? A) Peanut butter on crackers B) Low-salt potato chips C) Ice cream D) Cheese-flavored popcorn

A

A 77-year-old client who lives alone is admitted to the hospital after his children found him in a confused state at home. It is uncertain whether or not he has been eating correctly. As the nurse is preparing the nursing care plan, which of the following nursing diagnoses would indicate nutrition intervention is appropriate? A) Self-care deficit: feeding B) Risk for impaired skin integrity: colostomy C) Risk for impaired swallowing: resolved D) Risk for activity intolerance

A

A family member is concerned that an elderly family member is not eating correctly. Which of the following is a risk factor for undernutrition among the elderly population? A) Eating alone B) Daily Meals on Wheels delivery C) Traveling to a local center for a hot meal D) Having home health assistance three times a week to fix meals

A

A newly diagnosed diabetic tells the nurse she is using the Exchange Lists for Meal Planning but is having difficulty remembering when a food or beverage is considered to be free. What would be the best response? A) A good guide is the "free food list." B) When the portion size is less than 1 oz C) When it is a nonfat product D) When the client has consumed the recommended number of daily servings from each exchange list

A

A soft diet is considered a modified consistency diet or a mechanically altered diet. What is a mechanically altered diet? A) A diet that contains foods that are altered from their natural consistency so it is easier to chew and swallow them B) A diet that is run through a blender before being served to the client C) A diet that contains foods like ice cream and spaghetti D) A diet that contains foods that are easy to swallow like apple slices and grapes

A

It is widely recognized and accepted that our diets can result in various disorders and diseases. Food is also responsible for many benefits. Some components are specifically known for their cardiometabolic benefits. Which of the following has linked fruits to possible cardiometabolic benefits? A) Antioxidant benefits B) Unsaturated fatty acids C) Sodium D) Omega-3 fatty acids

A

Monitoring and evaluation of nursing goals and outcomes are integral parts of the nursing process. A nurse working on a very busy unit feels she does not have adequate time to monitor clients' nutritional intakes or to ensure they are meeting their established outcomes. What is a simple nursing intervention that can assist the nurse in evaluating clients' intended outcomes? A) Have the client weighted daily and record the weight. B) Make sure the unit aides record how much food is on each tray. C) Have the client's family record the amount of food served at each meal. D) Encourage the client to document what is ordered at each meal.

A

Nutrient deficiencies in young children are generally not a health risk. However, young children who drink too much milk are at risk for what? A) Milk anemia B) Hypercalcemia C) Hypervitaminosis A D) Protein deficiency

A

Nutrition therapy in the elderly has different goals than at other times across the lifespan. What is a primary goal of diet intervention for the elderly? A) Maintain quality of life B) Prolong life C) Prevent the development of complications D) Treat chronic disease

A

One of the clients on the unit has dumping syndrome. Which food is most likely to be restricted for this individual? A) Milk B) Mashed potatoes C) Lean meat D) Margarine

A

Over the age of 50 years, the body needs a higher intake of vitamin D. What is a good source of the vitamin D needed by older adults? A) Fortified milk B) Green leafy vegetables C) Lean red meats D) Nuts

A

Parental support for a healthier lifestyle is vital to children. Parents also recognize that setting a good example for their children is important. Why do some parents who are overweight feel they cannot set a good example in diet and nutrition for their children? A) They do not practice what they preach. B) They feel their children are not motivated. C) They feel their children eat fast food too often. D) They feel their children do not listen to them.

A

Parenteral nutrition (PN) can be infused into either a central or peripheral vein. What type of parenteral solution is infused into a central vein? A) Hypertonic B) Hypotonic C) Isotonic D) 40% isotonic, 50% hypotonic

A

Partially hydrolyzed formulas are made for people with impaired digestion or absorption. What does this mean? A) Partially hydrolyzed formulas do not contain whole proteins. B) Partially hydrolyzed formulas do not contain amino acids. C) Partially hydrolyzed formulas contain only dipeptides. D) Partially hydrolyzed formulas contain only tripeptides.

A

Research done on increasing the effectiveness of client teaching has found that the type of nutritional counseling that is most effective is that done by whom? A) Nurses and dietitians B) Physicians C) Dietitians alone D) The client's family

A

The 74-year-old client in the nursing home has developed a pressure ulcer on her sacrum. What could be a cause of the development of this ulcer? A) Inadequate food and fluid intake B) Turning freely in bed C) Overhydration D) Lack of vitamins B and C

A

The children of a sedentary 90-year-old ask how to combat malnutrition in their parent. What would be the best response to this question? A) Make meal time as enjoyable as possible. B) Feed the parent only heart-healthy food. C) Give the parent a liquid dietary supplement twice a day. D) Feed the parent before the rest of the family.

A

The client has arrived for a scheduled dose of chemotherapy, complaining of nausea. The nurse suggests several strategies to the client. Which of the following is one of those suggestions? A) Eat foods served cold. B) Avoid eating 3 to 4 hours before chemotherapy. C) Eat low carbohydrates. D) Eat three meals a day.

A

The latest studies suggest that in HIV-associated wasting, men tend to lose which of the following? A) More lean body mass than fat tissue B) More fat than lean body mass C) Peripheral fat and retain core fat D) Core fat and retain peripheral fat

A

The nurse has been caring for a client on the unit for the past week. The client had a ruptured appendix and developed peritonitis. The client had a PEG tube inserted for enteral nutrition (EN); however, the client is not recovering well and the health care team has been discussing switching to parenteral nutrition (PN). Which of the following would be the best indicator to switch from EN to PN? A) Paralytic ileus due to peritonitis B) Decreased costs for formula C) Easier to give medications via PN tube D) Decreased risk of further infection

A

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? A) "Parenteral nutrition is an emergency procedure." B) "Parenteral nutrition should be discounted as soon as feasible." C) "Parenteral nutrition formula is compounded by the pharmacy." D) "A central line is the best method for delivery."

A

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? A) 1100 to 1400 calories C) 2000 to 2400 calories B) 1500 to 1900 calories D) 2500 to 2900 calories

A

The nurse is assessing a client who presents with symptoms that are suspicious for type 2 diabetes. During the discussion of the past medical history, which past diagnosis should the nurse recognize as a potential risk factor? A) Gestational diabetes 7 years ago B) Hypertension C) Yo-yo dieting with weight fluctuations D) A great-grandparent with diabetes

A

The nurse is assessing a new client who is being admitted to the ICU after a motor vehicle accident. The client is in critical condition and on assessment the nurse notes there has been no urine output in the past 2 hours, but he does have active bowel sounds. Which form of nutrition does the nurse expect the client to receive? A) Standard EN formula B) AKI PN formula C) AKI EN formula D) Standard PN formula

A

The nurse is conducting discharge teaching with a client who is going home with an ileostomy. What will the nurse teach the client to consume more of? A) Salt B) Fiber C) Fat D) Vitamin B12

A

The nurse is counseling a clinic client who has short bowel syndrome on how to change his diet from regular to low fat. What would be the best food to include in the menu plan? A) Sherbet B) Avocado C) Biscuits D) Coconut

A

The nurse is counseling a clinic client with dumping syndrome who asks if there is anything he can do to help control the symptoms. What would be the best response? A) Eat small, frequent meals. B) Choose high-fiber cereals. C) Drink fluids with meals. D) Limit fat intake.

A

The nurse is counseling a group of clients who have recently been diagnosed with celiac disease. One of the members in the group wants to know what is safe to use as a thickening agent in cooking. Which of the following would be a safe substitute? A) Arrowroot starch B) Cracked germ C) Durum flour D) Farina

A

The nurse is discussing anorexia with the nutrition class. What is the best strategy for combating anorexia? A) Serve food attractively and season according to individual taste. B) Control pain, nausea, or depression with medications. C) Withhold beverages for 30 minutes before and after meals. D) Offer liquid supplements between meals.

A

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? A) 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. B) Start feeding at 10 to 25 mL/hour and advance by 5 to 15 mL/hour every 4 to 8 hours until the maximum rate of 125 mL/hour is reached. C) Start feeding at 50 to 75 mL/hour and advance by 10 to 25 mL/hour every 4 to 8 hours until the maximum rate of 150 mL/hour is reached. D) Start feeding at 50 to 75 mL/hour and advance by 5 to 15 mL/hour every 12 to 24 hours until the maximum rate of 175 mL/hour is reached.

A

The nurse is discussing vitamin and minerals and their action in diabetes with the nutrition class. What essential mineral has been studied for its possible role in the prevention and treatment of diabetes? A) Chromium B) Manganese C) Zinc D) Potassium

A

The nurse is doing client education for a 21-year-old pregnant woman in the clinic. She asked why breastfeeding is so highly recommended. What would be the best response? A) Breast milk is specifically designed to support optimal growth and development in the newborn, and its composition makes it uniquely superior for infant feeding. B) The American Academy of Pediatrics recommends exclusive breastfeeding for the first 9 months of life. C) Research in developed and developing countries shows that breastfeeding decreases the incidence and/or severity of infectious diseases. D) You will get down to your prepregnancy weight much faster if you breastfeed your baby.

A

The nurse is doing client education with a man and his wife before he is released from the hospital. He is poststroke and dysphagic. He is going home on liquids that fall into the honeylike consistency of the National Dysphagia Diet. The wife asks what the definition is for "honeylike" liquids. What is the best response? A) Liquids that can be eaten with a spoon but do not hold their shape. B) All unthickened beverages and supplements C) Liquids thickened to pudding consistency that need to be eaten with a spoon. D) Liquids thicker than water but thin enough to sip through a straw.

A

The nurse is doing client education with a man and his wife before he leaves the hospital. The physician has ordered a high-calorie, high-protein diet for this client who is recovering from a major trauma. The wife asks for an example of a high-protein snack. What is the best response? A) Yogurt B) Cream cheese on toast C) Italian ice D) Granola

A

The nurse is doing nutritional screening on older adults at a health fair. What would be an important question to ask while screening an older person for nutritional risk? A) About the use of three or more prescribed or over-the-counter daily medications B) If the person is over 62 years old C) If they had an unintentional weight loss of 3% or more in 60 days D) If they are living in a household with more than one older adult member

A

The nurse is helping the client prepare for discharge after a severe case of food poisoning. The client has been tolerating his feedings and the physician would like for him to advance to a soft diet for the next week until his next office visit. Which of the following would be a possible reason for this? A) Minimize intestinal activity for healing purposes B) Slowly replace intestinal flora C) Ensure adequate hydration D) To prevent rebound constipation

A

The nurse is preparing a meal plan for a client who will be assisted by a home health aide. The nurse recognizes the overall goal of nutrition therapy for this older adult is which of the following? A) Maintain or restore maximal independent functioning B) Reduce chronic disease deterioration C) Prevent chronic disease D) Decrease the use of medication

A

The nurse is providing nutrition education to a group of new diabetics. Today's topic is learning how to read nutrition labels. The nurse recognizes that more discussion is necessary when one of the participants say which of the following? A) "One cup of any canned food equals one carbohydrate exchange." B) "Some products may count in more than one group." C) "If sugar is the first ingredient, there may be too much sugar in this product." D) "It's important to note the serving size."

A

The nurse is talking with a group of nursing students about clients with gastroesophageal reflux disease (GERD). The students ask what advice could be given to a client with GERD to aid in controlling symptoms. What advice would the nurse give? A) Eat small meals. B) Lie down 30 minutes after eating. C) Drink fruit juices with meals. D) Eat 2 to 3 hours before bedtime.

A

The nurse is talking with the nutrition class about dysphagia and the National Dysphagia Diet. The nurse asks the students to name foods the client could eat on level 2 of the diet. Which of the following foods are on level 2 of the National Dysphagia Diet? A) Well-moistened pancakes with syrup B) Enriched bread C) Fried eggs D) Whole-grain cereals

A

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? A) The intensity of the stress response depends on the cause and the severity of the initial injury. B) The intensity of the stress response depends on the age and gender of the client. C) The intensity of the stress response depends on the gender and previous physical health of the client. D) The intensity of the stress response depends on the age and previous nutritional health of the client.

A

The nurse is teaching a client with chronic pancreatitis how to plan meals that decrease pancreatic stimulation. What would be the best dessert for someone with chronic pancreatitis? A) Angel food cake C) Chocolate pudding B) Ice cream D) Apple pie

A

The nurse is working with a client who has chronic constipation. After evaluating the clients' food intake, it is determined that the client needs to ingest more fiber. What is the recommended daily intake of fiber for this 55-year-old female? A) 21 g/day B) 25 g/day C) 30 g/day D) 38 g/day

A

The nurse is working with a client with lactose intolerance. What can this nurse suggest to this client to increase tolerance to small amounts of milk? A) Consume milk with food. B) Choose skim milk instead of whole milk. C) Drink milk warmed. D) Drink milk over ice.

A

The nurse needs to clarify information on the nutrition recommendations for managing diabetes when she hears one of the students state which of the following? A) A diabetic needs to keep the amount of carbohydrate at each meal in a given day equal. B) A diabetic needs to keep total calories to weight maintenance levels to prevent weight gain. C) A diabetic needs to adjust per-meal doses of insulin based on amount of carbohydrate to be consumed to control postprandial hyperglycemia. D) A diabetic needs to make sure their carbohydrate intake is consistent with the activities of the day and the amount of insulin taken.

A

The parents of a 9-month-old infant ask how to prevent obesity in their child. What would be the best age-appropriate response to their question? A) Infants should be allowed to self-regulate the amount of food they eat. B) Infants should be fed 8 oz of formula per month of age. C) Infants should be fed according to the recommendations of the MyPlate food plan. D) Infants should be fed according to what your family tells you. Ans: A

A

The risk of nutritional and health problems is present in all age groups. What is a nutritional risk of adolescence? A) Vitamin A deficiency B) Sodium deficiency C) Vitamin D deficiency D) Protein deficiency

A

The trauma client is being released home to complete his 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? A) Chicken salad sandwich on a croissant, milk, ice cream with chocolate sauce, and whipped cream B) New England clam chowder, black coffee, and pears in 100% pear juice C) Prime rib, baked potato with sour cream, a glass of white wine, and a piece of low fat cheesecake D) A smoothie made with yogurt, instant breakfast, skim milk and strawberries, and a cookie

A

To assist in nutrition screening in the community, the local senior center has developed a screen to help them identify individuals at high risk for malnutrition. Which of the following risk factors might be included? A) Eats alone most of the time B) Acute weight loss C) BMI D) Appetite

A

Transnasal, or nasogastric (NG), feeding would be most appropriate for which client? A) A middle-aged man with a functional gastrointestinal (GI) tract, poor appetite, and thermal injuries B) An elderly comatose woman who has had a stroke C) An elderly woman with Alzheimer disease who is confused and agitated D) An alcoholic with severe acute pancreatitis

A

What can rapid changes in the infusion rate of total parenteral nutrition cause? A) Glucose level changes B) Protein level changes C) Triglyceride level changes D) Sodium level changes

A

When a person is under acute stress, his or her metabolic and physiologic needs are highly individualized. Based on blood pressure, heart rate, and body temperature, decisions are made about which of the following? A) Fluid status B) Calorie intake C) Risk of refeeding syndrome D) Glucose load

A

Which of the following nutrients can directly supply energy for human use? A) Lipids and oils B) Water C) Vitamins D) Minerals

A) Lipids and oils

What substances, present in fruits and vegetables, provide significant health benefits such as reducing the risk of cancer? A) Phytochemicals B) Beta blockers C) Deoxidizers D) Free radicals

A) Phytochemicals

Which of the following is not true about water? A) Provides energy B) Provides a way to transport nutrients and waste C) By-product of cell chemical reactions D) Dietary need of approximately 9-13 cups per day

A) Provides energy

Which of the following should be limited in the diet because of their effect on blood cholesterol? A) Saturated fats B) Unsaturated fats C) Essential fats D) Amino acids

A) Saturated fats

Healthy People 2010 is designed to A) promote healthful lifestyles and reduce preventable death and disability in all Americans. B) disclose dietary practices that best support health. C) prevent chronic disease. D) eliminate dietary inadequacies and excesses, and to encourage healthful practices.

A) promote healthful lifestyles and reduce preventable death and disability in all Americans

A warning sign or symptom of alcohol poisoning is A) semiconsciousness or unconsciousness. B) rapid breathing. C) skin that is hot to the touch. D) insomnia.

A) semiconsciousness or unconsciousness.

Many diabetics plan their meals from the exchange lists for meal planning. According to the exchange list, a serving of milk may be exchanged for which of the following? Select all that apply. A) Fruit B) Starch C) Other carbohydrates D) Vegetables E) Meat

A, B

The nurse obtains a height and weight at each well-child visit to determine the risk for obesity. All young clients who are not in a healthy weight range should be evaluated for which of the following? Select all that apply. A) Medical risks B) Behavior risks C) Family dynamics D) Child neglect

A, B

When evaluating the history of a client who has gastrointestinal (GI) upset, the nurse is sure to assess the client for routine ingestion of which of the following? (Select all that apply.) A. Beer B. Aspirin C. Acetaminophen D. High-fiber foods

A, B Alcohol and aspirin are two substances directly absorbed through the lining of the stomach. This can contribute to GI upset. High-fiber foods should reduce GI symptoms because they stimulate peristalsis. Acetaminophen does not commonly cause GI symptoms. It is more likely to cause problems with the liver.

A client has recently found she is lactose intolerant. She is concerned about getting enough calcium in her diet but doesn't want to take supplements. The nurse recommends the client include which of the following foods in her diet? A) Turnip greens B) Broccoli C) Almonds D) Carrots E) Potatoes F) Tomatoes

A, B, C

A client is being prepared to go home following a stroke. He is being advanced to level 3 dysphagia diet to assess his tolerance before going home. Which of the following choices might he choose for his dinner? Select all that apply. A) Mashed potatoes B) Meatloaf C) Steamed green beans D) Pasta salad with raw vegetables E) Pineapple upside down cake

A, B, C

A family is meeting with the nurse to discuss their concern about their 78-year-old family member who is having difficulty chewing food. The client is refusing a pureed diet. Which of the following are examples of food the family can offer? Select all that apply. A) Ripe bananas B) Soft melon C) Cooked carrots D) Fried potatoes E) Roasted chicken

A, B, C

A liberal diet approach is a holistic approach toward meeting client's nutritional needs. This approach takes into consideration which of the following? Select all that apply. A) Individual personal goals B) Risk/benefit ratio C) Overall prognosis D) Quantity of life E) Family requests

A, B, C

A young mother is concerned her 2-year-old daughter is gaining too much weight. Which of the following should the nurse recommend the mother give daily when following a 1000 cal/day diet? Select all that apply. A) 1 cup vegetables B) 2 cups dairy C) 2 oz protein D) 4 oz grain E) 1/2 cup fruit F) 3 cups dairy

A, B, C

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 which of the following? Select all that apply. A) Lessen disease severity B) Modulate inflammatory responses C) Maintain the integrity of the gastrointestinal mucosa D) Prevent an ileus E) Prevent weight loss

A, B, C

The client is learning to make adjustments in his diet due to his progression of CKD. He understands he needs to limit his potassium intake. He is learning he needs to eat certain vegetables. Which of the following vegetables are safe for him to eat? Select all that apply. A) Cabbage B) Lettuce C) Raw onions D) Cooked spinach E) Yams F) Cooked mushrooms

A, B, C

The relaxation of the lower esophageal sphincter allows an abnormal reflux of gastric contents back into the esophagus. It is possible that the symptoms will improve if various foods are eliminated from the diet. Which of the following foods are recommended to be eliminated? Select all that apply. A) Chocolate ice cream B) Cola C) Peppermint candy D) Orange juice E) Mashed potatoes

A, B, C

Potential complications of parenteral nutrition (PN) include which of the following? (Select all that apply.) A) Electrolyte disturbance B) Rebound hypoglycemia C) Hyperglycemia D) Infectious E) Trace element toxicity

A, B, C, D

Diarrhea can be a complication of tube feeding. What may contribute to the complication of diarrhea in a tube-fed client? (Select all that apply.) A) Bacterial contamination B) Rapid feeding rate C) Low fat content of the formula D) Infusion of a cold formula E) Slow feeding rate

A, B, D

Sometimes children do not want to eat when the parents want them to. What strategies could be used to get a child to eat? Select all that apply. A) Eating with the child B) Limiting snacks C) Offering one food group at a time D) Spacing meal time further apart E) Giving them only what they like

A, B, D

The diabetic class is discussing metabolic syndrome. This can occur with individuals with type 2 diabetes. Which of the following abnormalities make up metabolic syndrome? Select all that apply. A) Hypertension B) Central obesity C) Low triglycerides D) Low high-density lipoprotein (HDL) E) Low low-density lipoprotein (LDL)

A, B, D

The nurse is caring for a client who has been on parenteral nutrition (PN) for 5 days. The nurse is constantly monitoring the client's status to ensure he is doing well. Which of the following are possible side effects of PN that will require immediate attention? (Select all that apply.) A) Shortness of breath B) Elevated temperature C) Drop in blood glucose levels D) Tightness of chest E) Jaundice

A, B, D, E

The nurse is helping a group of diabetics learn how to use the exchange lists. She asks them to name a food item that represents one carbohydrate choice. Which of the following correctly demonstrates one carbohydrate choice? Select all that apply. A) 1/2 cup of potatoes B) 2 tablespoons of dried apricots C) 1 cup of oatmeal D) 3/4 cup of strawberries E) 1 slice of whole wheat bread F) 1/2 cup of peas

A, B, F

Which of the following statements about water-soluble vitamins is true? (Select all that apply.) A. They cannot be stored. B. They often cause toxicity. C. They must be consumed daily. D. Supplements must be taken to reach the recommended daily allowance of these vitamins.

A, C Water-soluble vitamins are eliminated daily; they are not stored. Thus they must be consumed daily. Although toxicity may occur with megavitamin intake, the possibility of toxicity is low. A healthy diet should provide the necessary amount of water-soluble vitamins without the need for supplementation.

Clients with COPD are in respiratory stress. Malnutrition can occur because of this stress. What factors may contribute to malnutrition in the client with COPD? Select all that apply. A) Abdominal bloating B) Diarrhea C) Anorexia D) Dyspnea E) Renal insufficiency

A, C, D

The nurse is doing client education with a newly diagnosed diabetic. One thing the nurse teaches is appropriate initial treatment for a diabetic experiencing hypoglycemia. Which of the following are appropriate initial treatments for hypoglycemia? Select all that apply. A) A regular carbonated beverage B) A chocolate bar C) Life Savers D) Gum drops E) Chocolate cookies

A, C, D

The nurse is teaching a program on healthy nutrition at the senior community center. Which points should be included in the program for older adults? (Select all that apply.) A) Avoid grapefruit and grapefruit juice, which impair drug absorption. B) Increase the amount of carbohydrates for energy. C) Take a multivitamin that includes vitamin D for bone health. D) Cheese and eggs are good sources of protein. E) Limit fluids to decrease the risk of edema.

A, C, D Caution older adults to avoid grapefruit and grapefruit juice because these impair absorption of many drugs. Thirst sensation diminishes, leading to inadequate fluid intake or dehydration; thus older adults should be encouraged to ingest adequate fluids. Some older adults avoid meats because of cost or because they are difficult to chew. Cream soups and meat-based vegetable soups are nutrient-dense sources of protein. Cheese, eggs, and peanut butter are also useful high-protein alternatives. Milk continues to be an important food for older women and men who need adequate calcium to protect against osteoporosis (a decrease of bone mass density). Screening and treatment are necessary for both older men and women. Vitamin D supplements are important for improving strength and balance, strengthening bone health, and preventing bone fractures.

Most children do not follow the "ideal" of eating breakfast, dinner, and a snack at home along with a healthy brown-bag lunch at school. How do many children eat today? Select all that apply. A) Obtain a significant portion of their calories from sweetened beverages B) Eat less protein than meets their needs C) Get one third of their calories from snacks D) Eat at least two heart-healthy meals per day E) Skip breakfast

A, C, E

The nurse is caring for a poststroke client whose dysphagia has improved. The speech therapist has recommended changing this client's diet from level 1 of the National Dysphagia Diet to level 2. What foods would now be included in this client's diet? Select all that apply. A) Well-moistened pancakes with syrup B) Peanut parfait C) Soft canned or cooked fruit D) Coconut E) Poached eggs

A, C, E

The nurse is preparing a client for discharge who was admitted for COPD exacerbation. During the admission, the nurse taught the client some strategies to increase his calorie intake in spite of his early satiety. Which of the following are some of those suggestions? Select all that apply. A) Avoid "gassy" foods. B) Rest before eating. C) Limit "empty" liquids with meals. D) Eat a soft diet. E) Try high-calorie, high-protein nutrition formulas. F) Use bronchodilator before eating.

A, C, E

The nurse is caring for a client experiencing dysphagia. Which interventions will help decrease the risk of aspiration during feeding? (Select all that apply.) A. Have the client sit upright in a chair. B. Give liquids at the end of the meal. C. Place food in the strong side of the mouth. D. Provide thin foods to make it easier to swallow. E. Feed the client slowly, allowing time for the client to chew and swallow. F. Encourage the client to lie down to rest for 30 minutes after eating.

A, C, E The nurse should have the client sit upright or in high-Fowler's position and then feed the client slowly, allowing the client time to chew and swallow. Thin foods should be thickened to the consistency of mashed potatoes to make swallowing easier, and the food should be placed in the strong side of the mouth. Liquids should be thickened, but the client should be allowed to have them as desired. The client should sit upright for 30 minutes after eating to ensure digestion and prevent reflux of the food.

The nurse is caring for a patient experiencing dysphagia. Which interventions help decrease the risk of aspiration during feeding? (Select all that apply.) A) Sit the patient upright in a chair. B) Give liquids at the end of the meal. C) Place food in the strong side of the mouth. D) Provide thin foods to make it easier to swallow. E) Feed the patient slowly, allowing time to chew and swallow. F) Encourage patient to lie down to rest for 30 minutes after eating.

A, C, E Patients with dysphagia are at risk for aspiration and need more assistance with feeding and swallowing. Feed the patient with dysphagia slowly, providing smaller-size bites, and allow the patient to chew thoroughly and swallow the bite before taking another. Position the patient in an upright, seated position in a chair or raise the head of the bed to 90 degrees. If the patient has unilateral weakness, teach him or her and caregiver to place food in the stronger side of the mouth. Additional interventions include providing a 30-minute rest period before eating. Have the patient slightly flex the head to a chin-down position to help prevent aspiration. Determine the viscosity of foods that the patient tolerates best through the use of trials of different consistencies of foods and fluids. Thicker fluids are generally easier to swallow. More frequent chewing and swallowing assessments throughout the meal are necessary. Allow the patient time to empty the mouth after each spoonful, matching the speed of feeding to the patient's readiness. If the patient begins to cough or choke, remove the food immediately.

The nurse is meeting with the wife of a client who has Alzheimer disease (AD). She is concerned about her husbands' nutritional status. What can the nurse tell her to watch for that would indicate a possible nutritional problem? Select all that apply. A) Forgetting he had eaten and eating again B) Forgetting which are green vegetables C) Forgetting what food category bread is in D) Forgetting what time to eat E) Forgetting how to shop for food

A, E

The nurse is measuring the pH of fluid from a jejunostomy tube and suspects that the tube has migrated into the stomach when the pH reading is: A. 3.0 B. 4.0 C. 5.0 D. 6.0

A. 3.0 The pH of gastric contents is low and acidic (3 or less), whereas the pH of the small intestine is higher because of the bicarbonate released.

Which action should the nurse take initially to verify correct positioning of a newly placed small-bore feeding tube? A. Place an order for a radiograph to check position. B. Confirm the distal mark on the feeding tube after taping. C. Test the pH of the gastric contents and observe the color. D. Auscultate over the gastric area as air is injected into the tube.

A. Place an order for a radiograph to check position. Radiography will confirm placement more reliably than other methods of checking placement.

A "Mediterranean" type diet is higher in fat than is recommended, yet it is felt to be a heart healthy diet by the American Heart Association (AHA) because the major oil in this diet is olive oil. What is the major fat in olive oil, canola oil, and peanut oil? A) Trans fat B) Monounsaturated fat C) Polyunsaturated fat D) Omega-3 fat

B

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. The nurse provides him with information and makes several suggestions he can do. Which of the following is one of those suggestions? A) Eliminate fats from his diet B) Consume low-saturated fats C) Exercise an average of 250 minutes/week D) Weight loss of at least 15% within the next 6 months

B

A nursing student is taking a course in geriatric nursing, and the subject for today is altered nutritional status. The instructor lectures about older adults not eating in a healthy manner due to factors such as limited income, inability to prepare cooked meals, or inability to shop due to lack of transportation. What factor in the physical assessment would indicate to the nurse that the older adult client might be malnourished? A) Inability to talk normally B) Poor wound healing C) Enlarged liver with nonpalpable spleen D) Edematous hands and forearms

B

Arthritis is a leading cause of functional limitation among older adults. Osteoarthritis (OA) is the most common form of arthritis. What is the greatest known modifiable risk factor of OA of the knee? A) Nutritional deficiency of folic acid B) Overweight C) Moderately inactive lifestyle D) Inadequate intakes of calcium

B

Clients who receive radiation to the lower neck or midchest are at risk for several complications. What complication is common? A) Mouth blindness B) Esophagitis with dysphagia C) Dumping syndrome D) Chronic blood loss

B

Food allergies in children can be both frightening and dangerous. Which food is most likely to cause an allergy in children? A) Rice B) Soy C) Corn oil D) Tomatoes

B

Physiologically and developmentally, an infant will indicate when it is ready and able to have solid foods added to his or her diet. What indication in an infant would tell you that he or she is ready to progress to solid foods? A) When the infant can sit with support B) The eruption of teeth C) The ability to self-feed D) When the infant can turn his or her head

B

Primary and secondary prevention of diabetes is consistent with the recommendations for the primary and secondary prevention of coronary heart disease. Which of the following are people with diabetes urged to limit their intake of? A) Fiber B) Saturated fat C) Sucrose D) Nonnutritive sweeteners

B

Quality-of-life issues are a priority in the elderly, especially in residents of long-term care facilities. What are the key components in meeting quality-of-life standards among older adults who are residents of long-term care facilities? A) Prevention of depression and diabetes B) Prevention of unintentional weight loss and pressure ulcers C) Prevention of weight gain and hyperlipidemia D) Prevention of low albumin and anorexia

B

Sarcopenia is the loss of muscle mass and strength. It is related to a sedentary lifestyle and less than optimal diet. It is a process that begins in the fourth and fifth decades of life. This loss of muscle mass can be halted or reversed with which of the following? A) Aerobic exercise B) Strength-training exercises C) A high-protein diet D) A high-protein diet, high-calorie diet

B

Steatorrhea is a possible nutritional complication of dumping syndrome. What possible treatment might be prescribed for steatorrhea? A) High-fiber diet B) Fat-soluble vitamin supplements C) Vitamin B12 injections D) High-dose vitamin C

B

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? A) 1200 to 1400 calories B) 1300 to 1500 calories C) 1400 to 1600 calories D) 1500 to 1700 calories

B

The client is going home on a high-protein diet. What would be the best dessert for someone who needs to increase his or her intake of protein? A) Gelatin B) Pudding C) Cherry pie D) Sherbet

B

The client is receiving a hypertonic enteral formula. What side effect might the client have from this enteral formula? A) Vomiting B) Diarrhea C) Lactose intolerance D) Hyperglycemia

B

The client with dysphagia has improved. The speech therapist has recommended moving the client to nectarlike liquids on the National Dysphagia Diet. Which liquids would this include? A) Ice cream B) Thin milkshakes C) Clear juices D) Watermelon

B

The elderly population has a mean intake below the dietary reference intake (DRI) for several nutrients. Which of the following falls into that classification? A) Sodium B) Potassium C) Chloride D) Manganese

B

The infant is 6 months old. What feeding skills would be expected for the infant to have developed? A) Swallows liquid but pushes most solid out B) Begins to eat mashed foods C) Experiments with spoon but prefers to eat with hands D) Begins self-spoon feeding

B

The intake of adequate nutrients is a recommendation to reduce the risk of nutrition-related concerns across the lifespan. Obesity impacts quality of life in the elderly. Along with weight reduction, what vitamins are recommended to help with bone health? A) Vitamin B12 B) Vitamin C C) Vitamin B6 D) Vitamin E

B

The nurse has been working with a client who has CKD. Recent laboratory tests indicate the client's condition is deteriorating and dietary changes need to be implemented. The nurse is preparing to teach the client how to limit his potassium intake. The nurse knows this is based on which of the following serum potassium values? A) Greater than 4 mEq/L B) Greater than 5 mEq/L C) Greater than 6 mEq/L D) Greater than 7 mEq/L

B

The nurse is admitting to the unit a client who is a 42-year-old female with a COPD exacerbation. While doing the admission assessment, the nurse finds out that this client is being treated for depression and has had little or no appetite for over a month. What type of diet would be planned for this client? A) High-calorie, high-protein meals three times a day B) Small frequent meals spread out over the day C) Regular diet with vitamin and mineral supplements with the meals D) High-fiber diet with enteral supplements between the three meals

B

The nurse is assessing the pregnant client for the risk of developing gestational diabetes. When should women who are at high risk for gestational diabetes be screened for the disease? A) Between 24 and 28 weeks' gestation B) Before or shortly after conception C) At 36 weeks' gestation D) At about 40 weeks' gestation

B

The nurse is assisting a client with celiac disease to plan a daily menu. What food would be appropriate for this client? A) White bread B) Tapioca pudding C) Wild rice D) Instant cocoa

B

The nurse is assisting a dysphagic client who is on honeylike liquids with planning a daily menu. What liquid would be appropriate for this client? A) Cream soup B) Yogurt C) Popsicle D) Instant cocoa

B

The nurse is caring for a 21-year-old female with intractable nausea and vomiting. She asks the nurse what can cause nausea and vomiting like she is experiencing. The nurse explains that there can be many causes for intractable nausea and vomiting, including which of the following? A) Intestinal polyps B) Gallbladder disease C) Consumption of spicy foods D) An increase in digestive enzyme production

B

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 (based on Curreri equation)? A) 1500 calories B) 1700 calories C) 1900 calories D) 2100 calories

B

The nurse is caring for a 33-year-old female who was in a motor vehicle accident. She is in the stress response phase. Which amino acid is depleted rapidly during stress? A) Alanine B) Glutamine C) Glycine D) Tyrosine

B

The nurse is conducting an assessment on a new client who is being admitted to the long-term care facility. The client is a 69-year-old gentleman who is moderately active. What is the recommended calorie per day intake? A) 2000 cal/day B) 2200 cal/day C) 2400 cal/day D) 2600 cal/day

B

The nurse is counseling a client who has a diagnosis of depression. In talking with this client, the nurse finds out the client has not been eating. What should the nurse suggest to this client that might help improve her intake? A) Make sure the client eats alone. B) Withhold beverages for 30 minutes before and after eating. C) Combine meals so the client does not have to face eating as often. D) Serve only foods the individual likes.

B

The nurse is discussing a high-fiber diet with a client and his wife. The nurse stresses the need to gradually increase fiber in the diet. The nurse warns the couple that which of the following can be an indication of increasing fiber too quickly? A) Infection B) Cramping C) Nausea D) Electrolyte imbalance

B

The nurse is doing admission assessments on four new clients. Mrs. S is a postoperative client. Mrs. X is an 84-year-old who lives alone and tries to eat a heart-healthy diet. Mr. Y was admitted from a long-term care facility because of muscle wasting and swollen neck glands. Mr. Z is a 35-year-old who is a postoperative hernia client. Which client would be referred to the dietitian because of suspected protein-energy malnutrition? A) All of the clients B) The moderate- to high-risk clients with suspected or confirmed protein-energy malnutrition C) The postoperative critical care clients D) The clients who are very young or very old with nutritional deficiencies

B

The nurse is doing client education for a 71-year-old woman who is a resident of a long-term care facility. The assessment indicates that she is at a high risk for malnutrition. What is one reason she could give you for this risk of malnutrition? A) "I eat most of my meals with friends." B) "I just don't have an appetite." C) "I take two different medicines every day." D) "I chew quite well with my dentures."

B

The nurse is doing client education for a 71-year-old woman. She is a resident of a long-term care facility, and the assessment indicates that she is at a high risk for malnutrition. It is noted that she is only eating about 25% of her meals. When asked why she does not eat more, she says she cannot chew very well. She has a regular diet ordered. A request is made for the physician to change the diet. What diet would best suit this client? A) Pureed B) Mechanically altered C) High fiber D) Clear liquid

B

The nurse is doing nutritional counseling with a clinic client who complains of constipation. What would the nurse teach this client to increase in his diet? A) MTP oil B) Apples C) White bread D) White rice

B

The nurse is teaching a class of aides at a long-term care facility how to assess and document a client's nutritional intake. What mandates the documentation of nutritional intake for the residents of long-term care facilities? A) Maximum Data Set (MDS) B) Minimum Data Set (MDS) C) Regulatory Data Set (RDS) D) Maximum Regulatory Set (MRS)

B

The nurse is teaching a class on a high-fiber diet. During the discussion, it is mentioned that some clients will need some form of fiber supplement to ensure adequate intake. Which of the following is a reason for that? A) Fiber is bitter and difficult to eat. B) Most fruits, vegetables, and whole wheat breads provide only 1 to 3 g of fiber per serving. C) High-fiber diets are expensive. D) The best sources for high-fiber are only available seasonally.

B

The nurse is teaching a nutrition class of nursing students concerning several different types of diets. What would be another name for a consistent carbohydrate diet? A) Modified diet B) Diabetic diet C) High fiber diet D) Renal diet

B

The nurse is working with a client to try and determine if she has any food tolerances. The client has been keeping a detail food log as well as recording any symptom that happens and when. The nurse is suspecting the client is lactose intolerant. The nurse believes this because the client has a typical symptom how soon after eating dairy products? A) 15 to 30 minutes B) 15 minutes to 2 hours C) 45 minutes to 1 hour D) 2 to 3 hours

B

The nurse is working with a client who has had difficulty maintaining adequate control of his type 2 diabetes. During the course of the conversation, the client mentions that he gets tired of adding up all the calories and forgets to do it sometimes. What suggestion can the nurse make to help this client? A) Download an app to his smartphone from the ADA to help count calories. B) Switch to the exchange list system. C) Concentrate on checking his glucose before each meal. D) Make a daily plan and follow it precisely.

B

The home care nurse is seeing the following patients. Which patient is at greatest risk for experiencing inadequate nutrition? A) A 55-year-old obese man recently diagnosed with diabetes mellitus B) A recently widowed 76-year-old woman recovering from a mild stroke C) A 22-year-old mother with a 3-year-old toddler who had tonsillectomy surgery D) A 46-year-old man recovering at home following coronary artery bypass surgery

B Older adults who are homebound and have a chronic illness have additional nutritional risks. Frequently this group lives alone with few or no social or financial resources to assist in obtaining or preparing nutritionally sound meals. This contributes to a risk for food insecurity caused by low income and poverty. In addition, the mild stroke might cause dysphagia.

The nurse teaches a patient who has had surgery to increase which nutrient to help with tissue repair? A) Fat B) Protein C) Vitamin D) Carbohydrate

B Proteins provide a source of energy (4 kcal/g), and they are essential for synthesis (building) of body tissue in growth, maintenance, and repair. Collagen, hormones, enzymes, immune cells, deoxyribonucleic acid (DNA), and ribonucleic acid (RNA) are all made of protein.

The client is learning how to plan his meal using the exchange list to maintain a 2000-calorie diet. The client knows that he can choose from a variety of foods as long as he uses the correct number of choices with each meal. Which of the following are correct guidelines for his carbohydrate choices per meal in the 2000-calorie plan? Select all that apply. A) 2 servings from milk group B) 1 serving from the bread, cereal, rice, and pasta group C) 1 serving of fruit D) 3 servings of nonstarchy foods

B, C, D

The nurse is helping an HIV client increase his protein intake. Which of the following are suggestions to help this client? Select all that apply. A) Use honey on toast. B) Add finely chopped hard-boiled eggs to sauces. C) Substitute whole milk for water in recipes. D) Use yogurt as a topping for fruit. E) Substitute mayonnaise for salad dressing.

B, C, D

The home health nurse is seeing the following clients. Which client is at greatest risk for experiencing inadequate nutrition? A. A 55-year-old obese man recently diagnosed with diabetes mellitus B. A recently widowed 76-year-old woman recovering from a mild stroke C. A 22-year-old mother with a 3-year-old toddler who underwent tonsillectomy D. A 46-year-old man recovering at home following coronary artery bypass surgery

B. A recently widowed 76-year-old woman recovering from a mild stroke The 76-year-old woman has multiple issues confronting her that put her at a higher risk for inadequate nutrition, including the recent death of her spouse and her recent stroke. The other clients do have some risk of inadequate nutrition, but not as great a risk as the older widow.

A woman is considering becoming pregnant. The nurse practitioner recommends that the client begin to consume which of the following before attempting pregnancy to prevent neural tube defects in the fetus? A. Calcium B. Folic acid C. Vitamin C D. Riboflavin

B. Folic acid The importance of consuming folic acid to prevent neural tube deficits has been proven. The other vitamins and minerals are important but not essential.

The nurse teaches a client who has had surgery to increase intake of which nutrient to help with tissue repair? A. Fat B. Protein C. Vitamins D. Carbohydrate

B. Protein Proteins provide a source of energy and are essential for synthesis (building) of body tissue in growth, maintenance, and repair. Proteins are also required for blood clotting, fluid regulation, and acid-base balance. Fats are important for metabolic processes. Vitamins are chemicals used as catalysts in biochemical reactions. They are essential to normal metabolism and are present in small amounts in foods. Carbohydrates are used for energy.

The nurse wants to begin feeding a client through a small-bore feeding tube that was recently placed. Before initiating feedings through this tube, the nurse confirms tube placement by: A. Aspirating fluid contents from the stomach B. Requesting confirmation of placement via radiographic examination C. Measuring the pH of the fluid aspirated through the small-bore tube D. Injecting air through the feeding tube while auscultating for air in the stomach

B. Requesting confirmation of placement via radiographic examination The most reliable method for verifying the placement of a small-bore feeling tube is radiographic examination. None of the other methods is as reliable.

Alcohol consumption is encouraged to be limited to no more than one per day for women and two per day for men. How may the moderate consumption of alcohol reduce the risk of heart disease? A) Lowering LDL cholesterol B) Lowering blood pressure C) Reducing platelet aggregation D) Providing vitamin E

C

Children and adolescents with diabetes create unique problems when managing their care. What is the best meal plan for children and adolescents with diabetes? A) High glycemic index B) Carbohydrate counting C) Individualized meal plans D) Exchange lists

C

Clear liquid diets do not contain an adequate amount of calories or most nutrients to maintain optimal nutrition in a client. What is the only vitamin clear liquid diets may contain adequate amounts of? A) Vitamin A B) Vitamin E C) Vitamin C D) Vitamin D

C

Commercially prepared liquid supplement formulas are used to increase the calorie intake of clients actively at risk for malnutrition. How many calories do the standard commercially prepared routine liquid supplement formulas generally provide? A) 150 cal/8 oz B) 200 cal/8 oz C) 250 cal/8 oz D) 300 cal/8 oz

C

Dehydration can be a concern in the elderly population. The modified MyPlate for Older Adults recommends eight glasses of water per day. What is the AI for water for a 65-year-old male? A) 1.7 L/day B) 2.7 L/day C) 3.7 L/day D) 4.7 L/day

C

For a long-term care resident, a restrictive diet could decrease quality of life. When should restrictive diets be used in long-term care facilities? A) When a resident has decreased intake and weight loss B) For hospice care C) When a significant improvement in health can be expected D) For one week a month

C

Full liquid diets have been traditionally used between clear liquid diets and soft diets as diet therapy is advanced after surgery. What does the scientific evidence show about this practice? A) There is a lot of scientific evidence to support it. B) Skipping this step in refeeding puts the client at risk for nutritional complications. C) There is little scientific evidence to support it. D) It is a necessary nutritional step in progressive refeeding of the client.

C

H. pylori is the leading cause of peptic ulcers. How does H. pylori act to cause ulcers in susceptible clients? A) Erodes the mucosal layer of the stomach B) Decreases acid secretion so food can erode the lining of the stomach C) Secretes an enzyme that depletes gastric mucus D) Increases acid secretion so stomach acid actually erodes the lining of the stomach

C

Magnesium is one of the nutrients that older adults often do not get enough of. What are the recommended sources of magnesium for the elderly? A) Fruit juices B) Carrots C) Yogurt D) Potatoes

C

Many clients have nutritional needs that are high but whose appetites are poor, such as in clients with advanced COPD. What would be the best nursing action to take to promote maximum intake? A) Providing pain medications with meals to facilitate digestion B) Scheduling treatments during mealtimes to encourage between meal snacking C) Eating small frequent meals of soft food D) Encouraging the intake of empty-calorie foods and beverages to promote intake

C

Parenteral nutrition (PN) use in AIDS clients is reserved for those clients with nonfunctioning GI tracts. It has been suggested that consuming something different may be just as effective, with none of the risk for preventing weight loss in clients with severe malabsorption. Which of the following is that alternative? A) Standard EN formula B) Fiber added EN formula C) Hydrolyzed EN formula D) Protein-added EN formula

C

People with COPD often have difficulty taking in enough calories because of the fatigue they experience from the hypermetabolism of their respiratory stress. What would be an appropriate nutritional intervention for someone with COPD? A) Limit total fluid intake. B) Increase empty-calorie liquids with meals. C) Eat small frequent meals. D) Limit fiber.

C

People with diabetic kidney disease have different protein requirements than someone with nephrotic syndrome. Individuals with nephrotic syndrome are encouraged to eat protein with high biologic value. Which of the following is an example of a protein with high biologic value? A) Peanut butter B) Gelatin C) Eggs D) Kidney beans

C

Recommended daily allowances for diabetics can be different than for the general population. What is the recommended intake of fiber for diabetics? A) Less fiber than currently recommended for the general population B) More fiber than currently recommended for the general population C) The same amount of fiber as currently recommended for the general population D) Most fiber in the form of insoluble fiber

C

Refeeding syndrome is a potentially fatal complication that can occur in critically ill clients. The nurse recognizes the seriousness of this complication as it can affect approximately how many clients? A) 14% B) 24% C) 34% D) 44%

C

School-aged children do not generally make food choices that meet the recommendations of all the food groups. This means that some foods are eaten in inadequate amounts. Which foods are these? A) Meat, vegetables, and fats B) Meat and grains C) Fruits, grains, and dairy D) Vegetables and grains

C

The client has a 6-month-old infant. It is part of the infant's bedtime routine to get a bottle of warm milk when he goes down for the night. What is this infant at risk for? A) Consuming too many calories B) Developing diabetes later in life C) Nursing bottle caries D) Gastric reflux

C

The client has an active 15-year-old boy. To maintain his weight, how many calories may he need per day? A) 2000 calories B) 2400 calories C) 2800 calories D) 3200 calories

C

The client is a 38-year-old male who is critically ill. He has not been eating well although the staff has been encouraging him to eat. He is afraid of gaining too much weight. Which of the following would be an example of a good meal for this client? A) Granola with honey, fresh strawberries and milk, and hot tea with honey B) Smoothie made with yogurt, instant breakfast mix, and skim milk and peaches C) Omelet with ham, cheese, mushroom, and spinach; whole wheat toast with butter and jelly; and milk and coffee with whipped cream D) 2 strips bacon, 2 scrambled eggs fried in butter, 1 slice sourdough bread, and coffee

C

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? A) Use plain yogurt in place of sour cream. B) Spread peanut butter on apple slices. C) Add butter to his hot foods. D) Substitute milk for water in recipes.

C

The nurse has a client in the clinic who is complaining of nausea and vomiting. Which of the following can be a cause of nausea? A) Increase in digestive enzyme activity B) Increase in gastric acid secretion C) Intestinal obstruction D) Rhinovirus

C

The nurse has a client who is receiving her nourishment via a transnasal tube. The client is receiving an intact formula. The nurse is aware that his client is receiving which of the following? A) Disease-specific amino acids B) High-protein, low-calorie formula C) Complex molecules of protein D) Individualized formula for client needs

C

The nurse has been caring for a client in ICU who is receiving enteral nutrition (EN) via continuous drip method. As per the orders, the nurse is assessing gastric residuals. The nurse is aware that the feeding should be withheld and the client tolerance reassessed if the residual measures which of the following? A) Greater than 300 mL B) Greater than 400 mL C) Greater than 500 mL D) Greater than 600 mL

C

The nurse is admitting a 35-year-old client with alcoholism to the hospital. In planning nursing care, what long-term nutritional goals might the nurse set? A) To alleviate symptoms of disease B) To alleviate side effects of treatments C) To improve eating habits to reduce the risk of chronic disease D) To replenish fluid losses

C

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? A) 1260 to 1360 calories B) 1320 to 1440 calories C) 1500 to 1800 calories D) 1800 to 2400 calories

C

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, as the physician tries to stabilize him. When should this client start on nutritional support? A) Immediately B) In 12 to 24 hours C) In 24 to 48 hours D) In 36 to 48 hours

C

The nurse is discussing weight loss and wasting with a local group of cancer clients. After the program, a member of the audience asks to speak with the nurse. He asks what the difference is between weight loss and wasting in cancer and the weight loss and wasting that occurs in AIDS. What would be the best response? A) In cancer wasting, the client can take medication to stimulate the appetite. B) Cancer wasting is almost impossible to reverse. C) Wasting in AIDS includes either fever, diarrhea, or weakness lasting more than 30 days. D) AIDS wasting begins gender specific

C

The nurse is doing client teaching for a new mother who is formula feeding her infant. The client asks about the nutritional value of formula. What would be your best response? A) Formulas made in the United States have lower nutritional values than are contained in breast milk. B) Formulas made in the United States need to be supplemented with iron. C) Formulas made in the United States have minimum nutrient requirements that are more than the nutrient amount provided in breast milk. D) Formulas made in the United States have the same nutrient value as breast milk.

C

The nurse is helping the client order a low-fat meal. Which of the following is the best meal for this client? A) Potato soup, grilled cheese sandwich on whole wheat bread, 2% milk, and fresh peach slices B) 3 oz of grilled hamburger with low-fat cheese slices, tomato, onions, and 2 tablespoons of mayonnaise and whole wheat bun; baked potato chips; and iced tea C) 2 oz of broiled lean chicken, brown rice, steamed vegetables (broccoli, cauliflower, and carrots), tossed salad with raw vegetables and fat-free dressing, and fat-free milk D) 3 oz of tofu burger; mashed potatoes with gravy; tossed salad with avocado slices, tomato, cucumbers, radishes, carrots, olives, onions, and 2 tablespoons of ranch dressing; iced tea with lemon slices, and 1 cup chocolate ice cream

C

The nurse is reviewing the food log with a client. The nurse is concerned because the client's blood pressure is elevated. Which item on the log may be contributing to the elevated blood pressure? A) Watermelon B) Regular salad dressing C) Hot dogs D) Pork and beans

C

The nurse is talking with the client who was admitted for surgery due to duodenal ulcer disease. The client asks what can be done to reduce the risk of getting more ulcer. What would be the best response? A) There is evidence that a diet without caffeine may reduce the risk of duodenal ulcers. B) Leave chocolate out of the diet. C) There is evidence that a diet high in soluble fiber may reduce the risk of duodenal ulcers. D) Limit the intake of alcohol.

C

The nurse is teaching a class of newly diagnosed adolescent diabetics. The topic for tonight is hypoglycemia. The nurse asks one young man to name one thing that can cause hypoglycemia in an insulin-dependent diabetic. Which of the following would be an acceptable answer? A) Acute illness B) Stress C) Delaying meal time D) Too much food

C

The nurse is teaching a nutrition class for nursing students. They are given an assignment of planning a one-day menu for someone with gastroesophageal disease (GERD). What would be an acceptable entrÈe for a client who has GERD? A) Enchiladas with red sauce B) Curried rice C) New York strip steak D) Chili casserole

C

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? A) 50 to 65 g B) 75 to 80 g C) 100 to 115 g D) 150 to 165 g

C

There are commercial formulas made specifically for infants born with inborn errors of metabolism. For which of the following is there a special commercial formula? A) Constipation B) Corn syrup urine disease C) Phenylketonuria D) Cystic fibrosis

C

Type 1 diabetics who are well-controlled can consume alcohol without adversely affecting their blood glucose, if they drink in moderation and drink with meals instead of between meals. Why are they advised to drink with meals? A) They are less likely to consume too much alcohol when it is taken with meals. B) It aids in the digestion of food when consumed at the same time. C) It increases the risk of hypoglycemia when consumed between meals. D) Taken with meals, it tends to cause people to eat less.

C

What is an indication for use of parenteral nutrition (PN) in a client? A) Recovering stroke victim B) Drastic weight loss measures C) Inadequate oral intake expected over a 7- to 10-day period D) Preparing for major surgery on the digestive system

C

When doing a diet screening on a client, the nurse tries to use terms other than "diet" when asking about the foods the client eats. Which term is not an alternative term to the word "diet"? A) Eating pattern B) Eating style C) Counting calories D) The foods you eat

C

Whole milk is added to the diet of infants, just like other foods are added to their diet. By what age does whole milk become a major source of nutrients for the child? A) 6 months B) 9 months C) 12 months D) 2 years

C

Which statement made by an adult patient demonstrates understanding of healthy nutrition teaching? A) I need to stop eating red meat. B) I will increase the servings of fruit juice to four a day. C) I will make sure that I eat a balanced diet and exercise regularly. D) I will not eat so many dark green vegetables and eat more yellow vegetables.

C Obesity is an epidemic in the United States. Proposed contributing factors are sedentary lifestyle and poor meal choices. Healthy eating and participation in exercise or other activities of healthy living promote good health.

Which of the following is not a characteristic of protein? A) Major component of body structure B) Supplies 4 kcalories per gram C) Most significant energy source for humans D) Forms enzymes

C) Most significant energy source for humans

Acute episodes of illness can create problems for insulin-dependent diabetics. During these periods of acute illness, what should insulin-dependent diabetics do? A) Insulin-dependent diabetics should not take insulin. B) Insulin-dependent diabetics should not eat. C) Insulin-dependent diabetics should use regular sweetened carbonated beverages, gelatin, ice cream, and popsicles to consume the exact amount of carbohydrate normally allowed. D) Insulin-dependent diabetics should use regular sweetened carbonated beverages, gelatin, ice cream, and popsicles to consume between 45 and 50 g of carbohydrates every 3 to 4 hours.

D

Anorexia can be caused by many medications. One of the ways medication can cause anorexia is to decrease the ability to taste. What is one of the recommendations to improve intake in an anorexic if this is occurring? A) Avoid tart flavors. B) Change the medication so it does not affect the taste. C) Enhance food flavors with sweet seasonings. D) Use strong seasonings on your food.

D

During a nutrition screening, an 84-year-old client tells the nurse he really likes ice cream. He goes on to say that, when he was growing up, his grandfather used to give him ice cream when he hurt himself in any way. He also says that his mother would give him homemade chicken soup when he was sick. One of the admission diagnoses for this client is minor depression with mood swings. In planning his meals, what would be appropriate for the nurse to include? A) Favorite "take-out" food B) Foods your client tolerates well C) Foods high in nutritional value D) Foods that are considered "comfort foods"

D

Hypertension is one of the most common conditions in the United States. It is estimated that just over half the adults in the U.S. have either prehypertension or hypertension making it a serious medical condition. What is the initial treatment for stage 1 hypertension? A) Exercise B) Antihypertensives C) Vitamin supplements D) Diet

D

It has been established that many people over 50 years have low serum levels of vitamin B12. Where is it recommended that older adults get most of their vitamin B12 from? A) Citrus fruits and juices B) Red meats C) Milk and dairy products D) Fortified cereals

D

Most recommended levels of intake for vitamins and minerals do not change with aging. An exception to this is the recommended dietary allowances of vitamin D, which are higher in adults over age 50 years. What causes the body's need for vitamin D to increase over the age of 50 years? A) The ability to absorb calcium, which decreases with age B) The potential risk for coronary heart disease, which uses vitamin D C) The increased consumption of coffee and tea interferes with vitamin D synthesis D) The ability to synthesize vitamin D from sunlight, which decreases with age

D

Most standard enteral formulas are low in residue. What client are they most suited to? A) Someone with constipation B) Someone with diarrhea C) Someone with long-term formula use D) The initial feeding in clients who have been on bowel rest

D

Older adults need adequate protein in their diet. What are the approximate protein needs per day for an older adult weighting 132 pounds (60 kg)? A) 24 g/day B) 36 g/day C) 44 g/day D) 48 g/day

D

Part of the nutrition assessment is calculating the client's BMI. The nurse is aware that a BMI of 18 indicates the client falls in what category? A) Obese B) Overweight C) Healthy weight D) Underweight

D

People who have lactose intolerance suffer from bloating, gas, and diarrhea. What type of diarrhea is caused by lactose intolerance? A) Secretory diarrhea B) Watery C) No diarrhea D) Osmotic diarrhea

D

The cause of the long-term complications of diabetes is poorly understood. What is known are interventions that can significantly lower the incidence of these long term complications. Which of the following is one of these interventions? A) Controlling blood lipid level, carbohydrate intake, and blood glucose level B) Controlling protein intake, blood pressure, and blood lipid level C) Controlling blood glucose levels, triglyceride level, and weight D) Controlling blood glucose levels, blood pressure, and blood lipid level

D

The client has just been put on a gluten-free diet. Which foods should the client avoid? A) Corn, oats, and rice B) Wheat, oats, and rice C) Oats, corn, and barley D) Wheat, rye, and barley

D

The client is a 19-year-old female who appears to be in a prediabetic stage. Anxious to lose weight, she wants to know which diet other diabetics follow to help her lose weight. Which of the following should the nurse recommend? A) 1200-calorie MyPlate plan B) 1400-calorie Exchange Lists plan C) Low-fat, low-carbohydrate diet D) Individualized to each individual

D

The client is a 65-year-old male. Approximately, how much longer can he expect to live? A) 15.8 years B) 16.5 years C) 17.3 years D) 19.2 years

D

The client with dysphagia is filling out his menu for the following day. What would be a good choice for breakfast for this client? A) Peanut butter on toast B) Pecan waffles C) Bananas D) Scrambled eggs

D

The client's diet has just been changed to a protein-dense diet. She asks how she can increase the protein density of her diet. What would be the best response? A) Use honey on toast and cereal. B) Substitute mayonnaise for salad dressing. C) Add whipped cream to coffee and tea. D) Melt cheese on sandwiches and vegetables.

D

The clinic nurse is caring for a client who has dumping syndrome. The nurse is doing client teaching about the disease process. What statement by the client tells the nurse the client understands the process? A) An intermediate dumping reaction can occur one hour after eating. B) An intermediate dumping reaction produces weakness, dizziness, and a rapid heartbeat. C) An intermediate dumping reaction occurs because of a rapid absorption of carbohydrates. D) An intermediate dumping reaction produces gas, abdominal pain, and diarrhea.

D

The nurse has been teaching a client with type 2 diabetes menu planning using the exchange list 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 the exchange diet? A) 1 cup of spaghetti noodles, 4 meatballs, 1/2 cup of spaghetti sauce; coleslaw, 1 slice of buttered garlic bread, and 1 cup of milk B) 4 oz of broiled hamburger patty, 1 cup of mashed potatoes with butter, 1 cup of green beans, and 1 cup of low-fat vanilla ice cream C) 1 1/2 cups of chicken noodle soup (1/2 cup of chicken breast, 1 cup of egg noodles, chopped carrots, onions, celery, and broth), 1 oz of saltine crackers, 1 cup of hot tea with 1 teaspoon of honey D) 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

D

The nurse has given the nutrition class the assignment of creating a list of interventions that will benefit a person with gastroesophageal reflux disease (GERD). What intervention would be expected to be seen on that list? A) The client should use peppermint after every meal to settle the stomach. B) The client should avoid items that increase lower esophageal sphincter pressure. C) The client should include bedtime snacks in the diet. D) The client should lose weight if overweight.

D

The nurse is admitting a client to the unit with a diagnosis of lung cancer. This client is undergoing a partial lobectomy followed by chemotherapy. The client is a 55-year-old male who weighs 125 pounds. What is the approximate protein and calorie intake per day for this client? (Round to the nearest whole number.) A) 110 g/day of protein; 1400 cal/day B) 120 g/day of protein; 1600 cal/day C) 130 g/day of protein; 1800 cal/day D) 140 g/day of protein; 2000 cal/day

D

The nurse is admitting a client who is diagnosed with type 2 diabetes mellitus. While in the hospital, the client has a referral to see a bariatric surgeon for evaluation for gastric surgery. The bariatric surgeon writes an order for a body mass index (BMI) to be calculated. The nurse understands that a BMI is which of the following? A) A calculation of an index of a person's ideal weight B) A calculation of a person's prealbumin level C) A calculation of calorie intake necessary to maintain ideal weight D) A calculation of an index of a person's weight in relation to height

D

The nurse is admitting a client with burns over 60% of the body. What would be the best type of nutrition for this client? A) Oral nutrition B) Oral nutrition with a liquid supplement C) Parenteral nutrition D) Enteral nutrition

D

The nurse is admitting to the unit a client who is a 42-year-old female with dysphagia following a head trauma. What fluid would be the best choice for this client if she were on the nectarlike stage of the National Dysphagia Diet? A) Bottled water B) Fruit juice C) Iced coffee D) Vegetable juices

D

The nurse is assessing a 39-year-old woman's diet who has been complaining of chronic constipation. The nurse recognizes that this individual should increase her fiber intake to how much each day? A) 15 g/day B) 25 g/day C) 35 g/day D) Depends on individual needs

D

The nurse is assessing a new client to the unit who is admitted for kidney stones. When asked about over-the-counter drugs, herbs, and supplement use, the client mentions that she does take several supplements. The nurse recognizes which of the following supplements may be contributing to the kidney stones? A) Coenzyme 10 B) Vitamin D C) B vitamins D) Vitamin C

D

The nurse is caring for a 21-year-old female with type 1 diabetes who is on a 2000-calorie diet. The nurse knows the client understands the diabetic teaching when she states, "I need four carbohydrate choices at breakfast." Which of the following menus indicates her understanding? A) 3/4 cup of low-fat granola, 8 oz of plain yogurt, coffee, and 2 cups of orange juice B) 1 cup of orange juice, 1 waffle topped with 1/2 cup of blueberries, and coffee C) A parfait consisting of 1 1/4 cups of strawberries, 1/2 cup of low-fat granola, 6 oz of plain yogurt, and black coffee D) Black coffee, 1/2 cup of orange juice, 1 low-fat waffle topped with 3/4 cup of blueberries, and 1 teaspoon of light margarine

D

The nurse is caring for a 51-year-old female with breast cancer who is on a regular diet. She is to have a mastectomy the following day and the nurse is doing client teaching. What strategy would the nurse teach this client to increase her protein and calorie intake to promote healing after surgery? A) Consume high-fiber, low-fat nutritional supplements. B) Eat less food. C) Take protein supplements and eat low-fat, low-calorie meals. D) Eat food that has been modified to be more protein- and calorie-dense.

D

The nurse is counseling a client recovering from a major 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? A) Add butter to hot foods such as potatoes, cooked cereals, and soups. B) Use honey on toast, cereal, and in coffee. C) Substitute mayonnaise for salad dressing. D) Use double-strength milk (liquid milk fortified with skim milk powder).

D

The nurse is finishing an admission assessment for Mrs. M who was admitted during a previous shift. While doing the medical psychosocial history, the following facts come to light: Two years ago, she was treated for a major depressive episode; she practices Islam; she lives in the area of town where there are many Muslim people; and she comes from a wealthy family. Her hair is visibly dry and dull, and she mentions that her hand grip has gotten weaker over the last few months. Because of the findings during this assessment, the nurse decides to refer her to the dietitian for a nutrition assessment. What in the medical psychosocial assessment might lead to a nutritional deficiency? A) The culture she lives in B) It is Ramadan, and Mrs. M practices Islam. C) Her hair is dry and dull. D) She has had a major depressive episode.

D

The nurse is helping a client plan menu choices. The client is currently recovering from dehydration from severe diarrhea. The client laboratory results showed hyponatremia and hypokalemia on admission. The client is now eating but refusing to eat bananas. The nurse suggests which of the following as a possible alternative? A) Blueberries B) Pears C) Strawberries D) Cantaloupe

D

The nurse is helping a new client on the unit who was admitted with CKD. The client is also a long time type 2 diabetic. He has recently been experiencing nausea, vomiting, and anorexia. His lab workup reveals he is malnourished. The nurse recognizes his malnourishment is likely related to which of the following? A) Dehydration B) Anuria C) Recurrent UTI's D) Increasing urinary excretion

D

The nurse is reviewing the nutrition orders for a newly admitted client with an exacerbation of COPD. The nurse expects the client calorie needs to be which of the following? A) 110% above RMR B) 120% above RMR C) 130% above RMR D) 140% above RMR

D

The nurse is teaching a nutrition class for nursing students. The discussion for today is about the nutrition therapy for malabsorption disorders. What is the nutrition therapy for malabsorption disorders used to alleviate or control its symptoms? A) Clear liquids with vitamin and mineral supplements B) Small, frequent meals that are low in soluble fiber C) A low-fat, high-fiber diet for all malabsorption disorders D) Individualized therapy according to symptoms and complications

D

The nurse is teaching a nutrition class for nursing students. The topic for today is nutrition therapy for diabetic older adults. What is the most important factor impacting glycemic control in adults? A) People naturally lose weight as they age. B) Older adults eat less sugar than younger adults. C) Older adults metabolize carbohydrates differently than younger adults. D) Serum blood sugar levels rise with age.

D

The nurse is teaching clients who are on protein-restricted diets. What should the nurse teach these clients to do? A) Eat all the protein in one meal. B) Take protein supplements as needed. C) Cook all the protein in the microwave. D) Spread the protein out over the whole day.

D

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? A) Dextrose B) Amino acids C) Vitamins D) Galactose

D

The nurse is working with a client who needs to lower his sodium intake, but he doesn't like to cook so he eats out a lot. He has been trying to order wisely; however, the nurse notes he should change which of the following habits? A) Requesting no added salt B) Choosing grilled versus fried C) Choosing fresh fruit for dessert D) Enjoying soup for an appetizer

D

The nursing class has been given the assignment of making a 2000-calorie menu for diabetics based on the carbohydrate counting method. What would be the best choice for a bedtime snack on this diet plan? A) 1 cup of shredded wheat and 1 cup of whole milk B) 1 cup of cubed papaya and a mocha latte C) 1 cup of chocolate ice cream and 1 cup of nonfat milk D) 3 cups of no-fat-added popcorn and 1 cup of nonfat milk

D

The physician has instructed the client to decrease her sodium intake. The client is upset because she's afraid the food will not taste good if she does. Which of the following should the nurse suggest to this client? A) Use garlic salt, onion salt, or celery salt. B) Use smoked meat. C) Use soy substitutes instead of meat. D) Use herbs and spices to flavor the food.

D

Two clients are on enteral nutrition: one is on a standard formula and the other is on a hydrolyzed formula. What is the difference in the two formulas? A) Standard formulas have only free amino acids as their source of protein, whereas completely hydrolyzed formulas contain whole proteins. B) Hydrolyzed formulas have soybean oil added and standard formulas do not. C) Standard formulas include everything the client needs nutritionally, whereas hydrolyzed formulas are lacking in calcium and potassium. D) Standard formulas have whole proteins, whereas completely hydrolyzed formulas contain only free amino acids as their source of protein.

D

Ulcers in the stomach and duodenum are referred to as peptic ulcers. What is the leading cause of peptic ulcers? A) Alcohol B) Spicy foods C) Nonsteroidal anti-inflammatories D) H. pylori infection

D

When educating the client, the nurse understands that there can be some negativity associated with the term "diet". Many clients may view "diet" as another term for which of the following? A) A health behavior B) A medical treatment C) A positive experience D) A short-term punishment to endure

D

The nurse is assessing a patient receiving enteral feedings via a small-bore nasogastric tube. Which assessment findings need further intervention? A) Gastric pH of 4.0 during placement check B) Weight gain of 1 pound over the course of a week C) Active bowel sounds in the four abdominal quadrants D) Gastric residual aspirate of 350 mL for the second consecutive time

D Delayed gastric emptying is a concern if 250 mL or more remains in the patient's stomach on each of two consecutive assessments. The North American Summit on Aspiration in the Critically Ill Patient made the following recommendations regarding gastric residual volumes (GRVs): (1) stop feedings immediately if aspiration occurs; (2) withhold feedings and reassess patient tolerance to feedings if GRV is over 500 mL for two successive measurements; and (3) routinely evaluate the patient for aspiration and use nursing measures to reduce the risk of aspiration if GRV is between 250 and 500 mL.

Based on knowledge of peptic ulcer disease (PUD), the nurse anticipates the presence of which bacteria when reviewing the laboratory data for a patient suspected of having PUD? A) Micrococcus B) Staphylococcus C) Corynebacterium D) Helicobacter pylori

D Marshall and Warren first identified Helicobacter pylori in 1984. It is a bacteria that causes up to 85% of peptic ulcers and is confirmed by laboratory tests. It is treated with antibiotics that control the bacterial infection.

Which statement made by a patient of a 2-month-old infant requires further education? A) I'll continue to use formula for the baby until he is a least a year old. B) I'll make sure that I purchase iron-fortified formula. C) I'll start feeding the baby cereal at 4 months. D) I'm going to alternate formula with whole milk starting next month.

D Infants should not have regular cow's milk during the first year of life. It causes gastrointestinal bleeding, is too concentrated for the infant's kidneys to manage, increases the risk of milk product allergies, and is a poor source of iron and vitamins C and E. Breast milk or formula provides sufficient nutrition for the first 4 to 6 months of life. The development of fine-motor skills of the hand and fingers parallels the infant's interest in food and self-feeding. Iron-fortified cereals are typically the first semisolid food to be introduced. For infants 4 to 11 months, cereals are the most important nonmilk source of protein.

A meal consisting of a cheeseburger, large fries, and a chocolate shake provides a total of 1,120 kcalories, of which 48 percent of the energy is from carbohydrate and 13 percent from protein. How many kcalories of fat does the meal contain? A) 137 B) 313 C) 287 D) 437

D) 437

Which of the following contain no calories? A) Alcohol B) Proteins C) Carbohydrates D) Vitamins

D) Vitamins

A client has gained 2 lb of weight in the past day. The nurse calculates this weight gain to be __________ ml of fluid.

The correct response is "1000"

A client calls the clinic complaining of diarrhea that has lasted 36 hours. The nurse recommends what as nutrition therapy for this client? A) Liberal fluid intake B) Clear liquids only to decrease bowel stimulation C) Low-potassium foods D) Liberal intake of apple juice to replace nutrients

A

A client has been instructed to start a high-fiber diet to treat her chronic constipation. Which of the following suggestions will help the client make the transition easier? A) Increase the fiber intake gradually. B) Add lots of nuts and seeds to the diet. C) Add 1 cup of bran a day immediately. D) Always peel any fruit before eating.

A

A client suffering from diarrhea asks what might be the cause. The nurse knows that this client suffers from diarrhea secondary to Crohn disease. What type of diarrhea does this client have? A) Secretory B) Osmotic C) Watery D) Infectious

A

An 80-year-old female was admitted with aspiration pneumonia. During her assessment, she mentions she has recently had difficulty eating because "everything keeps going down the wrong pipe." When the nurse is developing a care plan, which of the following is an appropriate nursing diagnosis to include? A) High risk of aspiration B) Increased mucus production C) Rule out aphasia D) COPD

A

Commercially prepared liquid formulas are often used to supplement other oral diets. What is a characteristic of commercially prepared routine liquid supplements? A) Lactose free B) Fat free C) Not available in grocery stores D) High in residue

A

Dairy products, beef, pork, poultry, and lamb, eaten so liberally in the American diet, provide the majority of which of the following substances? A) Saturated fat B) Polyunsaturated fat C) Monounsaturated fat D) Omega-3 fat

A

During a well-child visit, the nurse determines the BMI and reviews the food records to evaluate for which of the following? A) Adequacy of intake B) Progression toward optimal BMI C) Risks of obesity D) Risks of malnutrition

A

In children, breakfast skipping is an everyday occurrence for 8% to 15% of children ages 6 years to 13 years. What have studies suggested about skipping breakfast? A) It adversely affects cognition and learning. B) It is correlated with obesity. C) It promotes high cholesterol levels. D) It tends to stop when the children become adolescents.

A

Infants who are formula fed do not need added dietary supplements. What do breastfed infants, ranging in age from birth to 1 year, need supplemented? A) Vitamin D B) Vitamin A C) Calcium D) Vitamin B12

A

Intravenous fat or lipids are usually given separately from parenteral nutrition (PN). What allergy would make lipids contraindicated in a client? A) Egg B) Milk C) Peanuts D) Soy

A

Nursing care plans include nursing diagnoses that have nutritional significance when the nurse assesses it as being necessary. If the nurse is writing a nursing care plan for a client with an obvious nutritional deficiency, which nursing diagnosis would be most appropriate to include? A) Imbalanced nutrition: less than body requirements B) Deficient fluid volume: less than body requirements C) Constipation D) Impaired oral mucous membrane

A

The nurse is caring for a 68-year-old male client who is receiving enteral nutrition (EN). The nurse is aware there is an increased risk for refeeding syndrome in this client due to which of the following conditions noted in his past medical history? A) Chronic alcoholism B) Morbid obesity C) Cholecystectomy D) Bariatric surgery

A

The nurse is caring for a 90-year-old woman who is receiving peripheral parenteral nutrition (PPN). The nurse will know to assess frequently for which of the possible complications of PPN? A) Phlebitis B) Refeeding syndrome C) Gingivitis D) Tube feeding syndrome

A

The nurse is caring for a client with a new ostomy. When planning his discharge teaching, what food would be included that would help thicken his stool and control diarrhea? A) Applesauce B) Buttermilk C) Eggs D) Peas

A

The nurse is caring for a client with dumping syndrome. While filling out the menu for the next day, the client asks what the best dessert would be. What is the best response? A) Yogurt B) Ice cream C) Chocolate pudding D) Apple pie

A

The nurse is caring for a client with uremia that has impacted his nutritional status. The nurse is aware that this individual's appetite tends to be the best at what time of the day? A) Breakfast B) Lunch C) Dinner D) Bedtime

A

The nurse is discussing metabolic stress and how it creates protein catabolism with the nutrition class. The nurse is asked how you know protein catabolism is occurring. What would be the best answer? A) The body goes into a negative nitrogen balance. B) The body is full of free radicals. C) The body goes into a positive nitrogen balance. D) The body is full of free fatty acids.

A

The nurse is discussing the differences of the DASH diet and traditional Mediterranean diet with a client. The nurse explains the main difference between the two diets is which of the following? A) Amount of fat B) Amount of sodium C) Amount of fish D) Amount of calories

A

The nurse is discussing the different types of groups in the exchange list plan with a newly diagnosed diabetic. The nurse explains that there are three sublists in the fat exchange list. Which of the following would be the reason for the different sublists? A) Type of fat B) Amount of fat C) Amount of cholesterol D) Amount of calories

A

The nurse is discussing the need of some clients with type 2 diabetes to take exogenous insulin. Which of the following would be the correct reason for these clients needing exogenous insulin? A) Lifestyle interventions are not achieving glycemic control. B) The client is not exercising enough. C) The client is not following the caregiver's care plan. D) The client is not eating enough.

A

The nurse is monitoring a dialysis client whose urine output is 400 mL in 24 hours. The nurse realizes this client is on a fluid restriction. What would the fluid allowance be for this client? A) 1400 mL B) 1900 mL C) 2600 mL D) 4000 mL

A

The nurse is working with a client who was recently diagnosed to be lactose intolerant. The client needs to adapt to a low-lactose diet. Which of the following should the client avoid? A) Powdered meal replacement supplements B) Rice milk C) Soy sour cream D) Yogurt

A

Which action is initially taken by the nurse to verify correct position of a newly placed small-bore feeding tube? A) Placing an order for x-ray film examination to check position B) Confirming the distal mark on the feeding tube after taping C) Testing the pH of the gastric contents and observing the color D) Auscultating over the gastric area as air is injected into the tube

A At present the most reliable method for verification of placement of small-bore feeding tubes is x-ray film examination. The measurement of the pH of gastric secretions withdrawn from the feeding tube helps to determine the location of the tube. Auscultation has repeatedly been shown to be ineffective in detecting tubes accidentally placed in the lung. Further, it is not effective in distinguishing between gastric and intestinal placement for feeding tubes.

The patient receiving total parenteral nutrition (TPN) asks the nurse why his blood glucose is being checked since he does not have diabetes. What is the best response by the nurse? A) TPN can cause hyperglycemia, and it is important to keep your blood glucose level in an acceptable range. B) The high concentration of dextrose in the TPN can give you diabetes; thus you need to be monitored closely. C) Monitoring your blood glucose level helps to determine the dose of insulin that you need to absorb the TPN. D) Checking your blood glucose level regularly helps to determine if the TPN is effective as a nutrition intervention.

A The TPN formula is a combination of crystalline amino acids, hypertonic dextrose, electrolytes, vitamins, and trace elements. Administration of concentrated glucose is accompanied by increases in endogenous insulin production, which causes cations (potassium, magnesium, and phosphorus) to move intracellularly. Blood glucose levels should be monitored every 6 hours to assess for hyperglycemia. Maintaining blood glucose within acceptable limits helps prevent complications from the TPN.

Which of the following terms describes psychological influences that encourage us to find and eat food? A) Appetite B) Hunger C) Satiety D) Obsession

A) Appetite

A client is admitted to the unit with COPD exacerbation; the client has been cooperative in all aspects of his nursing care except eating. His major complaints are 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. A) Add gravies and sauces to food. B) Drink coffee with his meal. C) Rest before eating. D) Use the bronchodilator after eating. E) Increase fiber intake.

A, C, E

The client has not been eating well since he was admitted to the long-term care facility. When the advanced practice nurse (APN) comes to the facility to see her clients, the nurse mentions her concerns about the nutritional status of this client. The APN notes that one of the client's orders is for a can of liquid dietary supplement to be given between meals three times a day. What may the client be experiencing as a result of taking this supplement? Select all that apply. A) Loss of appetite B) Increased sugar and fat C) Decreased calcium D) Taste fatigue E) Increased hunger

A, D

The wife of a 69-year-old gentleman with COPD 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. A) Add skim milk to milk. B) Use mayonnaise in place of salad dressing. C) Add marshmallows to hot chocolate. D) Add chopped eggs to casseroles. E) Melt cheese on sandwiches, hot vegetables, and potatoes. F) Add honey to fruit.

A, D, E

The client is learning the difference of the amounts of potassium in various foods. The nurse suggests several fruit and vegetable choices that are low in potassium to the client. What did the nurse suggest? Select all that apply. A) Eggplant B) Zucchini C) Okra D) Blueberries E) Corn F) Pineapple

A, D, E, F

During the stress response, hormonal changes cause metabolic changes in the body. What is an indication that stress hormone levels are declining? A) An increase in urinary nitrogen excretion B) A decline in serum glucose levels C) An increase in serum glucose levels D) Fluid retention

B

Gastroesophageal reflux disease (GERD) that goes untreated can cause a variety of problems for the client. What can be caused by untreated GERD? A) Esophageal varices B) Adenocarcinoma C) Peptic ulcers D) Gastric banding

B

Hydrolyzed formulas are specially made enteral formulas that have been altered from the commercially prepared standard formulas. What are hydrolyzed formulas intended for? A) Clients with low protein needs B) Clients with impaired digestion or absorption C) Clients with a nonfunctional gastrointestinal tract D) Clients with taste fatigue from routine formulas

B

Infants can be either breastfed or formula fed. What would an infant who is formula fed be at risk for? A) Underfeeding B) Overfeeding C) Dehydration D) Iron overload

B

Liquid supplements are often given to clients to help optimize their nutritional status. What is the best way to make these supplements better accepted by the client? A) Serve them at room temperatures. B) Serve them cold. C) Serve them as dessert. D) Serve them unflavored.

B

Monounsaturated fat is considered a "heart healthy" fat. Which oil is highest in monounsaturated fat? A) Fish oil B) Olive oil C) Corn oil D) Coconut oil

B

Nutrient recommendations for the intake of fat are the same for diabetics as for people with preexisting cardiovascular disease. What is this recommendation? A) Keep trans fat as high as possible. B) Limit saturated fat to less than 7% of total calories. C) Polyunsaturated fat should provide up to 20% of total calories. D) The level of monounsaturated fat should be the total daily calorie intake.

B

The DASH diet emphasizes whole foods versus individual nutrients. The nurse recognizes which of the following is a suggested food for the grains group? A) Enriched grain B) Whole grain C) White rice D) Raw, unprocessed grain

B

The Dietary Guidelines for Americans recommend a heart-healthy diet. What ages are these recommendations for? A) 1 year to adult B) 2 years to adult C) 5 years to adult D) 10 years to adult

B

The client is a 6-month-old infant boy. What is the recommendation for the first solid food that should be introduced into his diet? A) Infant vegetables B) Infant rice cereal C) Strained infant fruits D) Non-citrus fruit juices

B

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? A) Cup of mixed fruit B) Smoothie made with yogurt, instant breakfast mix, whole milk, and strawberries C) Milkshake made with blueberries, frozen yogurt, and skim milk D) Snack crackers with cheese and grapes

B

The client is frustrated that she is not losing weight even though she is following the DASH plan. After reviewing her food log, the nurse recognizes which "food" might be the culprit? A) Black coffee B) Sweet iced tea C) Low-fat milk D) Fruit juice

B

The nurse is caring for a client for whom serum albumin screening has been used to assess protein status. The nurse understands that there are disadvantages to using albumin to indicate the nutritional status of protein in the body. What is one of those disadvantages? A) It is degraded very quickly. B) It is not specific for nutritional status. C) It is a test that requires 12 hours of fasting. D) It must be assessed in relation to the client's blood urea nitrogen.

B

The nurse is caring for a client taking iron and erythropoietin for the anemia of CKD. What type of iron will this client be receiving? A) Oral B) Intravenous C) Enteral D) Intramuscular

B

The nurse is caring for a client who just returned to the unit from following colon surgery. The client has a new colostomy. When the nurse begins client teaching, what should the nurse advise this client to do? A) Limit fluid to help control diarrhea. B) Increase fluid to replenish losses. C) Increase fat intake to slow gastrointestinal motility. D) Increase fiber intake because fiber absorbs water in the gut.

B

The clinic nurse is teaching a group of HIV/AIDS clients about their disease process. They are discussing nutrition-related problems and how to control them. Which of the following are recommended for people with diarrhea? Select all that apply. A) Limiting food intake B) Increasing fluid intake C) Avoiding lactose D) Increasing intake of foods rich in pectin E) Drink liquids that are either hot or cold

B, C, D

The nurse is teaching a group of student nurses the importance of knowing the potassium content of foods when helping their clients who have CKD. The students are instructed to list fruits and vegetables according to their content of low-, medium-, and high-potassium. Which ones will the nurse expect to see listed as medium-potassium foods? Select all that apply. A) Brussel sprouts B) Turnips C) Peaches D) Celery E) Mangoes F) Nectarines

B, C, D, E

The nurse is admitting a new client to the unit who is complaining of diarrhea. The client is dehydrated and will be receiving hydration. Which of the components of the blood will the nurse expect to see below normal limits? Select all that apply. A) Phosphorus B) Sodium C) Calcium D) Potassium

B, D

A 47-year-old, obese female client is admitted for hypertensive crisis. During the assessment, she states she has tried every diet out there and she is not interested in trying another one. She refuses to talk with the dietitian. Which of the following is the best approach for the nurse to use to help this client? A) Provide the client with colorful graphs and charts to note the foods she eats. B) Ask a social worker to intervene. C) Emphasize things "to do" instead of "not to do" D) Report the client to the physician, and note it in her medical record.

C

A client who was widowed 6 weeks ago had had a depressed appetite since his wife died. He admits to not eating very much and says his appetite gets worse as the day goes on. He has unintentionally lost 19 pounds since his wife's death and complains of around-the-clock fatigue. He is admitted to the unit for weight loss due to inadequate nutritional intake. What nursing intervention would be appropriate for the nurse to include in the care plan for this client? A) Make sure the client orders a wide variety of foods he likes so he eats a lot. B) Tell the client that he should not snack between meals. C) Encourage the client to eat a big breakfast. D) Suggest that the client eat alone in his room.

C

A client with malabsorption syndrome is having an exacerbation. What alteration would be recommended to the diet to decrease the stimulation to the bowel? A) High-fiber diet B) High-protein diet C) Low-fiber diet D) Low-protein diet

C

A nurse is lecturing a class of nursing students about nutrition in children. The students are given an assignment to plan a heart-healthy diet for an 8 year old. Which of the following would be the best breakfast? A) 2 fried eggs, 2 pieces of white toast with 3 teaspoons of butter, 2 pieces of bacon, and 8 oz of orange juice B) 2 pieces of French toast, 1/4 cup of maple syrup, and 6 oz of grape juice C) 1 cup of oatmeal, 8 oz of 2% milk, and 1 piece of wheat toast with 1 teaspoon of butter D) 1 package of toaster pastries and 1 glass of apple juice

C

As children grow, they generally consume more calories, decide if they want to eat, and how much they want to eat. What is the rule-of-thumb guideline to determine an age-appropriate serving size for a 3-year-old? A) 3 teaspoons B) 2 tablespoons C) 3 tablespoons D) Equal to that of an adult

C

At what age does the American Academy of Pediatrics (AAP) recommend that juices be introduced into the diets of infants? A) Not before 1 month of age B) Not before 3 months of age C) Not before 6 months of age D) Not before 9 months of age

C

Enteral nutrition (EN) is used to supplement adequate nutrition to a client who cannot take in adequate calories and nutrients orally. Research studies have shown what about enteral nutrition? A) It is better than parenteral nutrition. B) It reduces length of hospital stay. C) It does not reduce length of hospital stay. D) It reduces mortality.

C

The nurse asks a student in the nutrition class to give an example of a medium-fat meat and meat substitute group food. Which of the following is the best response? A) 1 oz of cottage cheese B) 1 tablespoon of peanut butter C) 1 egg D) 1 small hot dog

C

The nurse is assessing a new client who is being evaluated for coronary heart disease. After reviewing his dietary habits, the nurse notes which of the following as a possible contributing factor to this client's condition? A) Monounsaturated fatty acids B) Saturated fatty acids C) Trans fatty acids D) Polyunsaturated fatty acids

C

The nurse is assisting a client in making a menu for a low-fiber diet. Which would be the best choice for a breakfast menu? A) Apple juice, coffee, 2 poached eggs, 2 pieces of bacon, and white toast with butter B) Hot cocoa, shredded wheat, and 2% milk C) Coffee with cream and sugar, muffin, and 2 tablespoons of butter D) Hot tea, bagel, and 2 tablespoons of cream cheese

C

The nurse is caring for a 21-year-old female burn victim. Her parents ask why their daughter has to be fed by a nasogastric tube (NG). What would be the best response? A) "Your daughter's intestines are not working normally right now so we have to feed her through a tube." B) "If your daughter were eating normally, she would get sicker because her intestines are not working right." C) "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." D) "Trying to eat normally would just wear your daughter out, so we feed her through a tube to conserve her energy."

C

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? A) Hypervitaminosis D B) Renal failure C) Refeeding D) Bloating syndrome

C

The nurse is caring for a client with chronic, well-controlled diabetes who is post-op for a knee replacement. The client is confused by the menu choices as he has been following the ADA diet. What diet has replaced the traditional standard "ADA diet" for hospitalized clients with diabetes? A) Carbohydrate counting diet B) Exchange lists for meals diet C) Consistent carbohydrate diet D) High glycemic index diet

C

The nurse is discussing with the nutrition class which dietary supplements older adults need to take. Which supplement is needed by older adults? A) Vitamin B6 B) Vitamin K C) Vitamin D D) Niacin

C

The nurse is releasing a client with dysphagia. What is one thing to teach the client to aid in maximizing oral intake as safely as possible? A) Serve food and liquids hot. B) Encourage liquids with meals. C) Discourage consumption of alcohol. D) Encourage the client to rest after meals.

C

While doing admission assessments, the nurse finds that Mrs. S does not drink; Mrs. X enjoys a glass of wine at supper and bedtime; Mr. Y has been drinking at least a six-pack of beer every day for the past 20 years and has been ordered by his doctor; and Mr. Z has a cocktail when he goes out to dinner, which is about once a month. Which clients would be considered at nutritional risk? A) Mrs. X and Mr. Z B) Mrs. S and Mr. Y C) Mrs. X and Mr. Y D) Mrs. S and Mr. Z

C

In chemistry terms, which of the following most accurately describes the term organic? A) Products sold at health food stores B) Substances containing energy-yielding nutrients C) Substances containing carbon D) Products grown without the use of pesticides

C) Substances containing carbon

The "Freshman 15" is the A) typical waist circumference of college students after freshman year. B) typical body fat percentage of college students after freshman year. C) amount of weight (in pounds) typically gained during freshman year of college. D) typical BMI of college students after freshman year

C) amount of weight (in pounds) typically gained during freshman year of college.

In clients with ostomies, specific foods can create odor problems. Which of the following foods are odorproducing foods that clients with ostomies should avoid? Select all that apply. A) Applesauce B) Buttermilk C) Eggs D) Peas E) Asparagus

C, D, E

The nutrition class has been given the assignment of creating a list of interventions that will benefit a person with a colostomy. What interventions would be expected on that list? Select all that apply. A) Limit carbohydrates. B) Avoid foods that thicken stools. C) Limit fiber. D) Chew food thoroughly. E) Avoid odor-causing foods.

C, D, E

The nurse is teaching a client about healthy nutrition. The nurse recognizes that the client understands the teaching when the client makes which of the following statements? A. "I need to stop eating red meat." B. "I will increase the servings of fruit juice to four a day." C. "I will make sure that I eat a balanced diet and exercise regularly." D. "I will not eat so many dark green vegetables and eat more yellow vegetables."

C. "I will make sure that I eat a balanced diet and exercise regularly." The client should adopt a balanced eating pattern that includes a variety of nutrient-dense foods and beverages among the basic food groups. The nurse should encourage the client to consume fruits, vegetables, whole-grain products, and fat-free or low-fat milk while staying within energy needs. Total fat intake should be kept between 20% and 35% of total calories with most fats coming from polyunsaturated or monounsaturated fatty acids. The client should choose and prepare foods and beverages with little added sugars or sweeteners and foods with little salt while at the same time eating potassium-rich foods.

A 71-year-old female client has functional limitations, in part caused by obesity. The nurse is discussing the need to lose weight with this client but she is not receptive to the idea. What is one reason this woman might have for not agreeing with the suggestion to lose weight? A) The client feels that losing weight can cause a strain on the body. B) The client feels that she would feel worse if she lost weight. C) The client does not feel that her weight impedes her functionality. D) The client does not feel the need to make changes at this point in her life.

D

A nurse is attending a conference on "Nutrition and Nursing." One of the subjects being covered is "How to Facilitate Client and Family Nutritional Teaching." The nurse returns to the unit and shares several suggestions on nutritional teaching for clients and families with other members of the staff. Which of the following is an appropriate suggestion for teaching? A) Suggest books to both the client and his or her family to read. B) Make sure the client selects lots of "comfort foods." C) Emphasize to the client's family what the client should not eat. D) Listen to the client's concerns and ideas.

D

A student in a nutrition class is giving a report on "Adolescent Obesity." One of the topics in the report is health risks increased by obesity. What health risk would you expect to be included in the report? A) Hypercalcemia B) Type 1 diabetes mellitus C) Hypercholesterolemia D) Hyperlipidemia

D

A trauma client is being released home to complete his recovery. He is experiencing anorexia related to pain. What would be the most effective intervention for this client's anorexia? A) Schedule procedures and medications when they are least likely to interfere with meals. B) Give small meals of food that decrease the client's pain. C) Withhold beverages for 30 minutes before and after meals. D) Control pain, nausea, or depression with medications.

D

A young child, until the age of 4 years, is at risk of choking. To decrease this risk, what should young children not be given? A) Cubes of cheese B) Noodles C) Soda crackers D) Grapes

D

H. pylori is the main causative factor of peptic ulcers. What can be done to combat H. pylori in susceptible clients? A) Antiemetics B) Antihistamines C) Antacids D) Antibiotics

D

The nurse is preparing a client for discharge home. The client has been treated for an impaction due to chronic constipation. The client is trying to understand the high-fiber diet the physician has ordered. The nurse teaches the client that adding a particular "food" can act as a laxative and is easily added to the daily meals. Which of the following is that "food"? A) All whole wheat products B) Substituting beans for meat C) All dried fruit for snacks D) Unprocessed wheat bran

D

The nurse is teaching a nutrition class and knows the students understand the content of the lecture on nutrition and diabetes when a student is heard to say, "Nutrition therapy is the cornerstone of treatment for" which of the following? A) Pregnant diabetics B) Type 1 diabetics C) Type 2 diabetics D) All diabetics

D

Which lunch is best for a 10-year-old who is active? A) 6 oz of chicken noodle soup, 6 saltine crackers with 2 tablespoons of butter, 3/4 cup of ice cream, and 12 oz of diet soda B) 3 oz of hamburger, lettuce leaf, tomato slice, 1 slice of onion, 1 oz of processed cheese, 1 hamburger bun, 6 oz of French fries, and one 8-oz strawberry milkshake C) 6 chicken nuggets, 1/4 cup of ketchup, 4 oz cup of applesauce, and one 4-inch slice of pumpkin pie with whipped cream D) 3 oz of tuna on whole wheat bread, 1 medium apple, and 8 oz of 2% milk

D

Which lunch is best for a healthy 65-year-old who lives independently? A) 6 oz of chicken noodle soup, 6 saltine crackers with 2 tablespoons of butter, 3/4 cup of ice cream, and 12 oz of diet soda B) 3 oz of hamburger, lettuce leaf, tomato slice, 1 slice of onion, 1 oz of processed cheese, 1 hamburger bun, 6 oz of French fries, and one 8-oz strawberry milkshake C) 6 chicken nuggets, 1/4 cup of ketchup, 4 oz cup of applesauce, and one 4-inch slice pumpkin pie with whipped cream D) 3 oz of tuna on whole wheat bread, 1 medium apple, and 8 oz of 2% milk

D

The essential nutrients A) must be consumed at every meal. B) are required for infants but not adults. C) can be made in the body when they are needed. D) cannot be made by the body and therefore must be consumed to maintain health.

D) cannot be made by the body and therefore must be consumed to maintain health.

The client's CKD has progressed to the point where the physician has ordered her to limit her potassium intake. When discussing this change with the nurse, she wonders what fruit she can now safely eat. The nurse recommends which of the following fruits? Select all that apply. A) Apricots B) Oranges C) Kiwi D) Plums E) Cranberries F) Pineapple

D, E, F

The nurse is assessing a client receiving enteral feedings via a small-bore nasointestinal tube. Which assessment finding needs further intervention? A. Gastric pH of 3.0 during placement check B. Weight gain of 1 lb over the course of a week C. Active bowel sounds in the four abdominal quadrants D. Gastric residual aspirate of 300 mL for the second consecutive time

D. Gastric residual aspirate of 300 mL for the second consecutive time Gastric residual aspirate of 300 mL indicates that the client is not digesting the food. Active bowel sounds in all four quadrants is a positive sign. Weight gain of 1 lb in a week is an appropriate weight variance. A gastric pH of 3.0 is expected.

Based on knowledge of peptic ulcer disease (PUD), the nurse anticipates the presence of which bacteria when reviewing the laboratory data for a client suspected of having PUD? A. Micrococcus B. Staphylococcus C. Corynebacteria D. Helicobacter pylori

D. Helicobacter pylori H. pylori is a bacterium that causes peptic ulcers, and its presence can be confirmed by laboratory tests. It is treated with antibiotics that control the bacterial infection. The other bacteria listed are not associated with PUD.

The nurse evaluates laboratory findings for a client hospitalized because of chronic obstructive pulmonary disease. Which finding is consistent with poor nutrition? A. Nitrogen balance of 3 g B. Transferrin level of 370 mg/dl C. Hemoglobin level of 13.8 g/dl D. Serum albumin level of 2.5 g/dl Factors that affect serum albumin levels include hydration; hemorrhage; renal or hepatic disease; large amounts of drainage from wounds, drains, burns, or the gastrointestinal tract; steroid administration; exogenous albumin infusions; age; and trauma, burns, stress, or surgery. A normal serum albumin level is 4.0 g/dl. The other options are incorrect.

D. Serum albumin level of 2.5 g/dl Factors that affect serum albumin levels include hydration; hemorrhage; renal or hepatic disease; large amounts of drainage from wounds, drains, burns, or the gastrointestinal tract; steroid administration; exogenous albumin infusions; age; and trauma, burns, stress, or surgery. A normal serum albumin level is 4.0 g/dl. The other options are incorrect.

Hereditary material that provides the blueprints for the production of cell proteins

Genes

Compound secreted into the bloodstream that acts to control the function of distant cells

Hormone

Physiological (internal) drive to find and eat food, mostly regulated by innate cues to eating

Hunger

Heat needed to raise 1 liter of water 1 degree Celsius

Kcalorie

State in which there is no longer a desire to eat; a feeling of satisfaction

Satiety

A neurotransmitter synthesized from the amino acid tryptophan that appears to decrease the desire to eat carbohydrates and to induce sleep

Serotonin

The six classes of nutrients include carbohydrates, lipids, proteins, vitamins, minerals, and _______________.

water; h2o

The nurse cares for clients who are receiving dialysis. The nurse is aware that the clients can absorb calories from what? A) The dialysate used in hemodialysis B) The dialysate used in peritoneal dialysis C) Potassium exchange resin drugs D) Epogen

B

A 32-year-old female is preparing for discharge from the unit after being treated for a hypertensive crisis. The physician has ordered a 2000-calorie DASH diet. The nurse is helping the client create menus to follow once she goes home. Which of the following is a good menu option for this client? A) 1/2 cup of whole wheat spaghetti, 1 oz meatballs made with lean ground beef, 1/2 cup fat-free spaghetti sauce; 1/2 cup steamed broccoli; 1/2 cup sliced fresh peaches; and 1 cup black coffee B) 3 breaded fried chicken strips, 1 small baked potato with 1 tablespoon each of butter and sour cream, 1 slice of sourdough bread with 1/2 teaspoon of butter and jelly, 1/2 cup of sweet peas, and 1/2 cup of vanilla ice cream C) 1 cup of spilt green pea soup with ham, 6 saltine crackers with American cheese slices, and hot tea with honey D) 4 oz of poached salmon with lemon juice, 1 cup of au gratin potatoes, 3/4 cup of spinach, 1 cup of tossed salad (lettuce, tomatoes, carrots, radishes, crotons, celery, grated cheese, olives) with 2 tablespoons of fat-free dressing, and 2 cups of diet soda

A

An intervention proven to reduce hypertension and increase weight loss is a "heart healthy" diet. What diet besides the DASH diet is recommended as "heart healthy"? A) Mediterranean diet B) Low-calorie, low-potassium diet C) Los Angeles diet D) Metabolic diet

A

Clients who receive radiation to the lower neck or midchest are at risk for several complications. What complication is common? A) Mouth blindness B) Esophagitis with dysphagia C) Dumping syndrome D) Chronic blood loss

A

Clients who undergo radiation therapy to the head and neck are at risk for several complications. What is the most likely complication of radiation to the head and neck? A) Difficulty chewing and swallowing B) Nausea and vomiting C) Chronic blood loss D) Malabsorption

A

Research has been conducted to determine how various food types affect the body and various conditions. Which of the following food groups has been noted to lower triglyceride levels in human trials? A) Fish oil B) Whole grains C) Nuts D) Vegetable oils

A

The client is a diabetic who has been following the exchange diet plan; however, his renal function appears to be deteriorating. The nurse has suggested he makes a change in exchange group to hopefully improve his proteinuria. Which of the following suggestions did the nurse make? A) Choose more animal source protein over plant source. B) Choose more plant source protein over animal source. C) Eliminate all animal source protein. D) Eliminate all plant source protein.

A

The client is recovering well after a successful kidney transplant. During a follow-up visit, he mentions he is thirsty a lot and wishes he could drink more. When asked how much he is drinking, he answers 1000 mL plus his urine output. The nurse lets him know that since he is doing so well, he can now advance his fluid intake to which of the following? A) As much as he wants B) 2000 mL plus urine output C) 2000 mL D) 3000 mL

A

The nurse is conducting a workshop on cancer prevention and awareness. The nurse emphasizes a heathy nutritious diet has been shown to decrease the risk for various types of cancer. The nurse points out that a high consumption of processed meats has been associated with which type of cancer? A) Colon B) Lung C) Breast D) Stomach

A

The nurse is conducting nutrition teaching with a client who just passed a kidney stone. The client asks what foods he should avoid to decrease his risk for developing more kidney stones. What foods should he be advised to avoid? A) Spinach B) Wine C) Green beans D) Grapefruit juice

A

The nurse is discussing with a group of student nurses the various foods that have the potential to provide cardiometabolic benefits. One student asks what can help lower triglyceride levels. The nurse would respond with which of the following? A) Fish B) Milk C) Whole wheat D) Fruit

A

The nurse is doing client teaching with a cancer client who is going to have a colon resection. The client asks what the differences in the diet will be after the surgery. What would be the best response for this client? A) You will have to be fed with parenteral nutrition (PN) while your gut is not functioning. B) You will have to eat less protein and fewer calories per day after you start eating again. C) You will have a clear liquid diet starting the day after surgery. D) You will be given a special diet of high-fiber, low-calorie enteral supplement.

A

The nurse is teaching a client with CKD about necessary food changes that he must now make due to the progression of his disease. He needs to limit his potassium now and give up eating which of the following? A) Tomatoes B) Bell peppers C) Corn D) Green beans

A

The nurse is teaching a group of student nurses how to develop menu plans based on a 2000-calorie DASH eating plan. Which of the following menus best demonstrates this plan? A) 1/2 cup of brown rice; 6 oz of steamed salmon; 1/2 cup of steamed green beans; 1 cup of tossed salad with lettuce, carrots, tomatoes, celery, radishes, and onions; 1 tablespoon of fat-free salad dressing; and hot tea B) 3 oz of ground beef patty fried; 1 whole wheat hamburger bun with lettuce leaf, tomato slice, 1 slice of American cheese, 2 tablespoons of mayonnaise and mustard; and 2 cups diet soda C) 1 cup of clam chowder in medium-sized bread bowl, 4 saltine crackers, and 2 cups of skim milk D) 1 slice of pizza with cheddar cheese, pepperoni, mushroom slices, bell pepper, olives, and pizza sauce; and 2 cups of milk

A

The nurse is working with a client who has not been eating well. The client is a 59-year-old gentleman and weighs 50 kg. He is also mainly sedentary and refuses to exercise. The nurse calculates this client's calorie and protein needs are which of the following? A) 1500 cal/day; 125 g/day of protein B) 1700 cal/day; 130 g/day of protein C) 1900 cal/day; 135 g/day of protein D) 2100 cal/day; 140 g/day of protein

A

The nurse is working with a client who needs to lose weight to try and lower his hypertension. The client wants to focus on individual nutrients and the nurse is trying to encourage him to look at eating whole "real" foods instead. Which of the following explanations can the nurse share with this client concerning this? A) It is likely several aspects of the diet lower blood pressure. B) It is easier to design menu plans. C) Focusing on individual nutrients is more time consuming. D) It enables more use of prepared foods.

A

The nurse is working with the client to help him learn the DASH diet to lower his blood pressure. Which nutrient is very effective in lowering blood pressure when someone follows the DASH diet? A) Potassium B) Sodium C) Glucose D) Phosphorus

A

The nurse recognizes that sometimes cultural factors will influence food choices. While working with a Mexican American client, which of the following should the nurse encourage the client to change to improve his dietary habits? A) Substitute oil for lard. B) Substitute whole wheat for corn. C) Decrease the amount of lard used. D) Increase the use of vegetables.

A

The nursing students are making a list of interventions for people who need to limit their intake of sodium to 2000 mg/day. What would be an acceptable intervention for this population? A) Limit processed cheese use. B) Limit bread to two slices per day. C) Drink and cook with distilled water. D) Use low-sodium milk.

A

The radiation therapy client has come to the clinic complaining of stomatitis. The client asks for suggestions about the best foods to eat. What would be the best lunch for someone with stomatitis? A) Cottage cheese with canned fruit B) Vegetable beef soup C) Reuben sandwich (ham, cheese, and sauerkraut on pumpernickel bread) D) Pizza

A

The nurse is teaching a client how to plan a 2000-calorie DASH menu. The nurse asks the client to list several food options. Which of the following can the client list for the nurse? Select all that apply. A) 1/2 cup of brown rice B) 1/2 cup of orange juice C) 1 egg D) 2 teaspoons of soft margarine E) 1 1/2 cups of yogurt F) 1 cup of steamed vegetables

A, B, C

HIV/AIDS clients are already in an immune-compromised state so they have to be especially careful about foodborne illnesses. What strategies can the nurse teach the HIV/AIDS clients to help them avoid contracting a foodborne illness? Select all that apply. A) Refrigerate foods immediately after purchase. B) Discard leftovers after five days. C) Avoid salad bars and buffets when eating out. D) Thaw food in the microwave, never at room temperature. E) Keep hot foods above 140∞F and cold foods below 40∞F.

A, C, E

A client has a history of type 2 diabetes and hypertension. His renal function has slowly been deteriorating. The nurse, when reviewing his diet with him, notices his sodium intake may be too high. The nurse reminds him to limit his sodium intake to how much daily? A) 1000 mg/day B) 1500 mg/day C) 2000 mg/day D) 2500 mg/day

B

A client is asking the clinic nurse for suggestions to lower her risk for developing cancer. Which of the following is a possible suggestion? A) Exercise at least 175 minutes each week. B) Consume a healthy diet with emphasis on plant food. C) Maintain a BMI of 18. D) Consume a healthy diet with emphasis on animal food.

B

A client with HIV disease asks for some general nutritional guidelines. Which of the following is an appropriate response? A) Avoid high-protein supplements. B) It is not necessary to increase fat in the diet. C) Try to eat only three times a day. D) Be sure to take a multivitamin and mineral tablet daily

B

The clinic nurse is doing client teaching with a 21-year-old female who has a diagnosis of HIV/AIDS. She is asymptomatic at this point and wants to know how much she should raise her calorie intake to maintain her weight. What would be the best response? A) "You should increase your calorie intake by 5%." B) "You should increase your calorie intake by 10%." C) "You should increase your calorie intake by 15%." D) "You should increase your calorie intake by 20%."

B

The nurse is admitting a 42-year-old male with metastatic lung cancer to the unit. He tells the nurse that food tastes bitter to him. The nurse recognizes that the possible cause for this could be which of the following? A) Radiation therapy to the chest B) A decreased threshold for urea C) Metallic eating utensils D) An increased threshold for sucrose

B

The nurse is caring for a renal client on a low-protein diet. The nurse is aware that this client needs to make major adjustments to his diet. What should he be advised regarding eating? A) Eat all the meat allowances early in the day. B) Increase intake of sugar and fat. C) Increase intake of grains and vegetables. D) Eat more vegetable sources of protein.

B

The nurse is caring for an individual with nephrotic syndrome. The client's daily laboratory results have returned from the lab and the nurse finds an elevation in which of the following results concerning? A) Sodium and potassium B) Protein and sodium C) Potassium and cholesterol D) Protein and chloride

B

The nurse is conducting client teaching with a dialysis client who is awaiting kidney transplant. The client asks what the difference in his diet will be after he gets his new kidney. What would be the best response for this client? A) You will have to eat more protein but fewer calories each day after you get your new kidney. B) You will have to eat less protein and fewer calories each day after you get your new kidney. C) You will have to eat less protein but more calories each day after you get your new kidney. D) You will have to eat less protein and the same calories each day after you get your new kidney.

B

The nurse is doing nutrition teaching with a 63-year-old woman who has just been diagnosed with ovarian cancer. She has been admitted for radiation therapy prior to surgery. She weighs 130 pounds. Approximately how much protein and how many calories a day should this client have in her diet? (Round to the nearest whole number.) A) 55 g/day of protein; 1300 cal/day B) 60 g/day of protein; 1500 cal/day C) 65 g/day of protein; 1700 cal/day D) 70 g/day of protein; 1900 cal/day

B

The nurse is helping a 58-year-old gentleman who was recently admitted to the unit with nephrotic syndrome plan his menu. This gentleman's admission vitals were blood pressure 140/90, height 6 ft 3 in, and weight 200 pounds. His labs revealed proteinuria and hyperlipidemia. He also has 2+ pitting edema. The nurse determines his daily protein intake should be which of the following? (Round to the nearest whole number) A) 54 to 63 g B) 64 to 73 g C) 74 to 83 g D) 84 to 93 g

B

The nurse is teaching a client with CKD to understand the necessary diet changes. The nurse knows that the client understands the teaching when she states which of the following? A) "I need to increase my protein intake." B) "I need to restrict my protein intake." C) "I need to restrict my sodium intake." D) "I need to restrict my potassium intake."

B

The nurse is teaching a group of HIV/AIDS clients nutrition therapy and their needs. The nurse explains that their protein intake should be approximately which of the following? A) 80 to 130 g/day for men, 60 to 80 g/day for women B) 100 to 150 g/day for men, 80 to 100 g/day for women C) 120 to 170 g/day for men, 100 to 120 g/day for women D) 140 to 190 g/day for men, 120 to 140 g/day for women

B

The nurse is teaching a group of student nurses about eating correctly to correct and/or prevent hypertension. After the discussion, the students were able to indicate which of the following as effective as drug monotherapy for mild hypertension? A) Low-sodium diet B) Whole foods diet C) Low-calorie diet D) Low-fat diet

B

The client has prepared some menus based on a 2000-calorie DASH diet. Which of the following dishes show the client understands the diet? Select all that apply. A) 1 chicken leg B) 1 medium-sized apple C) 1/2 cup of tomato juice D) 1 cup of vanilla fat-free ice cream E) 3 tablespoons of peanut butter crackers

B, C

The HIV client has developed lipodystrophy. What may lipodystrophy result in? Select all that apply. A) Weight change B) Insulin resistance C) Hypertriglyceridemia D) Social stigmatization E) Lowered triglycerides

B, C, D

A client is discussing changing to a Mediterranean diet from the DASH diet with the nurse. The client has a chronic history of hyperlipidemia, obesity, and hypertension. He has been talking with a friend who has experienced good results with the Mediterranean diet. The nurse recognizes that the Mediterranean diet has been noted in studies to do which of the following? A) Increase the risk of CHD B) Increase the risk of alcoholism C) Shown improvements in MetS components D) Maintain A1C levels

C

As HIV/AIDS progresses, clients' quality of life becomes more and more important. How can quality of life be greatly improved for an HIV/AIDS client? A) By healing mouth sores B) By improving a poor appetite C) By correcting malabsorption D) By decreasing episodes of fever

C

Research has shown that as the intake of sodium increases so does the blood pressure. For the possible prevention of hypertension, it is recommended by the American Heart Association (AHA) that all Americans try to reduce their intake of sodium to which of the following? A) 1800 mg B) 2000 mg C) 2300 mg D) 3000 mg

C

The average sodium intake in the American diet is approximately 3900 mg/day. In the average American diet, where does the greatest amount of sodium come from? A) Salt added during cooking B) Salt added at the table C) Salt added to processed foods D) Natural sources of sodium

C

The client complains of a metallic taste in her mouth. What would be the best recommendation? A) Eat small, frequent meals. B) Brush your teeth before eating. C) Use plastic utensils. D) Experiment with tart foods.

C

The client overhears the dietitian and the physician talking about the client's nutrient requirements. The client asks the nurse why the "experts" are having so much trouble deciding what the best diet should be. What is the best response? A) "You have a disease process that creates unique nutritional problems in your body. We haven't gotten the diet exactly right yet." B) "Even ëexperts' can disagree from time-to-time." C) "Clients in acute renal injury, like you, cannot use protein or calories efficiently. It is difficult to adjust your intake of these nutrients to meet your nutritional goals." D) "You are breaking down parts of your body to use as energy because right now your body isn't able to optimally use the calories and protein you are eating."

C

The dietitian has recommended that the client's diet be changed from regular to nutrient dense. What is the most nutrient-dense snack for someone with a dry mouth? A) A peanut butter sandwich B) A cherry popsicle C) Boost or Ensure drink D) Hard cheese with crackers

C

The nurse has given a group of students the assignment of making a DASH menu based on 2000 heart healthy calories. What would be the best lunch on this diet? A) Cheese sandwich, 1 tablespoon of mayonnaise, 6-inch Italian roll, 1 large leaf of iceberg lettuce, 2 slices of tomato, low-sodium potato salad, and 1 medium apple B) Ham sandwich with 2 oz of low-sodium ham, 1 teaspoon of Dijon mustard, 1 slice of cheddar cheese, 6-inch Italian roll, large leaf of iceberg lettuce, 2 slices of tomato, low-sodium potato salad, and 1 medium peach C) Beef sandwich with 2 oz of low-sodium beef; 1 tablespoon of Dijon mustard; 2 slices of reduced fat cheddar cheese; sesame roll; 1 large leaf of romaine lettuce; 2 slices of tomato; 1 cup of low-fat, low-sodium potato salad; and 1 medium orange D) 1 low-fat grilled cheese sandwich on white bread, 1 large leaf of iceberg lettuce, 2 slices of tomato, 1 tablespoon of original ranch dressing, 1 individual package of corn chips, and 1 medium orange

C

The nurse is caring for a client who has a diagnosis of renal calculi. The client asks what he can do to keep from forming more calculi. What foods would the nurse tell him to avoid for oxalate-based calculi? A) Chocolate, strawberries, and wine B) Rhubarb, green beans, and tomatoes C) Beets, rhubarb, and tea D) Instant coffee, oranges, and potatoes

C

The nurse is conducting a support group with clients who have CKD. Today's topic is concerning the various types of protein and the reasons for consuming one over the other. The nurse discusses the rationale for using high biologic proteins instead of low biologic proteins is related to which of the following reasons? A) Contain less nitrogen and therefore minimize urea production B) Contain more fat and therefore more calories to minimize body protein catabolism C) Promote reuse of circulating nonessential amino acids for protein synthesis and therefore minimize urea production D) Are the only type of protein used for protein synthesis

C

The nurse is helping the client make necessary adjustments to his diet due to his advancing CKD. The client needs to limit his potassium intake but he is having difficulties because he loves to eat fruit. Which of the following does the nurse suggest he avoid? A) Apples B) Watermelon C) Raisins D) Peaches

C

The nurse is meeting with a client who has CKD. The client has been trying to follow the prescribed diet but finds it very restrictive, and she feels punished that she cannot occasionally have some of her favorite foods. As she sits and cries complaining that she never feels good anymore and she just doesn't want to deal with it anymore, the nurse notes she may be more malnourished. Which of the following can the nurse suggest that might prove beneficial? A) Suggest she meets with a family member to talk about her frustrations. B) Give her permission to ignore the diet restrictions one day a week. C) Suggest taking a specially formulated vitamin supplement. D) Readjust her diet to include one of her favorite foods.

C

The nurse is teaching a nutrition class to a group of student nurses. During the discussion, one student asks if there is one factor that has been shown to increase the risk of cancer. Which of the following should the nurse answer? A) Sedentary lifestyle B) Intake of fast foods C) Excess body weight D) Increased protein intake

C

The nurse is teaching nutrition guidelines to a group of newly diagnosed HIV/AIDS clients. What tip should the nurse give the clients to eat a healthier diet? A) Drink sweetened beverages and foods high in added sugar. B) Eat at least 2 cups per day of a variety of fruits and vegetables. C) Eat a diet rich in whole grains, vegetables, fruits, and legumes with lean sources of protein. D) Avoid foods high in monosaturated fat.

C

A nurse is assessing a new client who was just admitted to the unit with cancer cachexia. The nurse is aware that cachexia is related to which of the following? A) Glucose resistance B) Hyperalbuminemia C) Decreased protein requirement D) Poor prognosis

D

Immunotherapy is used to treat cancer clients by enhancing their immune system. What nutritional imbalances can be caused by immunotherapy? A) Hypernatremia B) Hypokalemia C) Hyperabsorption D) Hypoproteinemia

D

One of the strategies for reducing the risk of cardiovascular disease is to increase high-density lipoprotein (HDL) cholesterol. What is the best way of increasing HDL? A) Reducing saturated fat intake B) Reducing cholesterol intake C) Increasing dietary fiber intake D) Losing weight, if overweight

D

Saquinavir (Invirase) may be prescribed for the HIV/AIDS client. What would be important to teach the client about this drug? A) Avoid alcohol. B) Do not take it with high-fat meal. C) There are fewer side effects if taken with food. D) Take it within 2 hours of a high-calorie, high-fat meal.

D

The AHA has recommended limiting sodium intake to 2300 mg/day. Which of the following foods is the best choice for the client on a restricted-sodium diet? A) 2 large graham cracker rectangles B) 1 corn bread muffin C) 2 slices of reduced fat cheese D) 1 teaspoon of soft margarine

D

The client has recently started on hemodialysis after a long history of type 2 diabetes and a gradual deterioration of her renal function. She mentions that she is tired of always feeling thirsty. The nurse makes a few suggestions for her to try. Which of the following is one of those suggestions? A) Eat ice chips when feeling thirsty. B) Rinse her mouth with hot liquids. C) Eat frozen fruit juice. D) Rinse her mouth with ice cold water.

D

The client is status post a recent kidney transplant and is progressing well with healing, kidney function, and diet. During a follow-up visit, the nurse lets him know that he can increase his potassium intake to which of the following? A) 2 to 3 g/day B) 3 to 4 g/day C) 4 to 5 g/day D) Unrestricted

D

The diet recommendations for the treatment and prevention of all renal calculi are not effective when used alone. What is the most effective dietary intervention for renal stones? A) Altering urinary pH through an acid or a basic ash diet B) Restricting the intake of the offending substance C) Losing weight, if overweight D) Increasing fluid intake

D

The nurse is caring for a 71-year-old female with heart failure who is on a 1800 mg/day sodium-restricted diet. The nurse knows the client understands the nutrition teaching when she states, "I need to restrict my intake of sodium so I will choose a breakfast of . . . " which of the following? A) 1/2 cup of low-fat granola, 6 oz of plain yogurt, coffee, and 1 cup of orange juice B) 1 cup of orange juice, 1 waffle topped with 3/4 cup of blueberries, and coffee C) A parfait consisting of 1 1/4 cups of strawberries, 1/2 cup of low-fat granola, 6 oz of plain yogurt, and black coffee D) 2 cups puffed-wheat cereal; 1 slice of whole wheat bread; 1 medium banana; 1 cup of nonfat milk; 1 cup of orange juice; and 1 teaspoon of soft, unsalted margarine

D

The nurse is teaching a nutrition class for nursing students about palliative nutrition therapy. The goals of palliative nutrition therapy are providing comfort and relieving side effects. How can these goals be met? A) Encourage the client to follow the primary caregiver's ordered diet. B) Provide mouth care when the client asks for it. C) Offer comfort foods if the client becomes anxious or fearful. D) Respect the client's wishes regarding the level of nutritional support desired.

D

The nurse is teaching a nutrition class for nursing students. The discussion for today is about nutrition therapy for nephrotic syndrome. The goal of nutrition therapy is to reduce proteinuria and possibly slow the progression of kidney disease. According to recent studies, what is the suggested way to do this? A) Low biologic value protein always works best in clients with kidney disease. B) There is no difference among proteins as long as the client gets enough of them. C) Use biologic value protein in the client's diet. D) Use soy protein in the client's diet.

D