Nutrition

The nurse is caring for a patient with dysphagia and is feeding her a pureed chicken diet when she begins to choke. What is the priority nursing intervention? A. Suction her mouth and throat B. Turn her on their side C. Put on oxygen at 2-L nasal cannula D. Stop feeding her and place on NPO

D. Stop feeding her and place on NPO Stop feeding and place patient on NPO. If choking persists, suction airway. Notify health care provider.

BMI above 30 is considered what?

Obese

The nurse is inserting a small-bore nasoenteric tube before starting enteral feedings. What is the correct order of steps to perform this procedure?1. Place patient in high-Fowler's position.2. Have patient flex head toward chest.3. Assess patient's gag reflex.4. Determine length of the tube to be inserted.5. Obtain radiological confirmation of tube placement.6. Check pH of gastric aspirate for verifying placement.7. Identify patient with two identifiers. A. 7, 1, 3, 4, 2, 5, 6 B. 1, 3, 4, 7, 2, 6, 5 C. 7, 1, 3, 2, 4, 6, 5 D. 1, 7, 3, 2, 4, 5, 6

A. 7, 1, 3, 4, 2, 5, 6

Fats are composed of triglycerides and fatty acids. Triglycerides A. Are made up of three fatty acids. B. Can be saturated. C. Can be monounsaturated. D. Can be polyunsaturated.

A. Are made up of three fatty acids. Triglycerides circulate in the blood and are made up of three fatty acids attached to a glycerol.

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. Avoid grapefruit and grapefruit juice, which impair drug absorption. C. Take a multivitamin that includes vitamin D for bone health. D. Cheese and eggs are good sources of protein. Cheese, eggs, and peanut butter are also useful high-protein alternatives. Vitamin D supplements are important for improving strength and balance, strengthening bone health, and preventing bone fractures and falls. Grapefruit and grapefruit juice can interfere with warfarin (Coumadin) (anticoagulant), preventing its breakdown. This would lead to an increased risk of bleeding.

Dietary reference intakes (DRIs) present evidence-based criteria for an acceptable range of amounts of vitamins and nutrients for each gender and age group. Components of DRIs include which of the following? (Select all that apply.) A. Estimated average requirement (EAR) B. Recommended dietary allowance (RDA) C. The Food Guide Pyramid D. Adequate intake (AI) E. The tolerable upper intake level (UL)

A. Estimated average requirement (EAR) B. Recommended dietary allowance (RDA) D. Adequate intake (AI) E. The tolerable upper intake level (UL) Dietary reference intakes (DRIs) present evidence-based criteria for an acceptable range of amounts of vitamins and nutrients for each gender and age group. DRIs have four components. The estimated average requirement (EAR) is the recommended amount of a nutrient that appears sufficient to maintain a specific body function for 50% of the population based on age and gender. The recommended dietary allowance (RDA) indicates the average needs of 98% of the population, not the exact needs of the individual. Adequate intake (AI) is the suggested intake for individuals based on observed or experimentally determined estimates of nutrient intakes and is used when evidence is insufficient to allow the RDA to be set. The tolerable upper intake level (UL) is the highest level that likely poses no risk of adverse health events. It is not a recommended level of intake. The food guide pyramid is not a component of the DRIs.

The patient is asking the nurse about the best way to stay healthy. The nurse explains to the patient that from a nutritional point of view, the patient should (Select all that apply.) A. Maintain body weight in a healthy range. B. Increase physical activity. C. Increase intake of meat and other high-protein foods. D. Keep total fat intake to 10% or less. E. Choose and prepare foods with little salt.

A. Maintain body weight in a healthy range. B. Increase physical activity. E. Choose and prepare foods with little salt. According to the 2005 Dietary Guidelines for Americans, key recommendations include maintaining body weight in a healthy range; increasing physical activity and decreasing sedentary activities; increasing intake of fruits, vegetables, whole grain products, and fat-free or low-fat milk with less red meat; keeping fat intake between 30% and 35% of total calories, with most fats coming from polyunsaturated or monounsaturated fatty acids (most meats contain saturated fatty acids); and choosing prepared foods with little salt while at the same time eating potassium-rich foods.

A nurse in a senior center is counseling a group of older adults about their nutritional needs and considerations. Which of the following information should the nurse include? (Select all that apply) A. Older adults are more prone to dehydration than younger adults are. B. Older adults need the same amount of most vitamins and minerals as younger adults do. C. Many older men and women need calcium supplementation. D. Older adults need more calories than they did when they were younger. E. Older adults should consume a diet low in carbohydrates?

A. Older adults are more prone to dehydration than younger adults are. Sensations of thirst diminish with age, leaving older adults more prone to dehydration. B. Older adults need the same amount of most vitamins and minerals as younger adults do. These requirements do not change from middle adulthood to older adulthood. However, some older adults need additional vitamin and mineral supplements to treat or prevent specific deficiencies. C. Many older men and women need calcium supplementation. If older adults ingest insufficient calcium in the diet, they need supplements to help prevent bone demineralization.

The nurse is providing home care for a patient diagnosed with AIDS. In preparing meals for this patient, the nurse should A. Provide small, frequent nutrient-dense meals. B. Encourage intake of fatty foods to increase caloric intake. C. Prepare hot meals because they are more easily tolerated. D. Avoid salty foods and limit liquids to preserve electrolytes.

A. Provide small, frequent nutrient-dense meals. Small, frequent, nutrient-dense meals that limit fatty foods and overly sweet foods are easier to tolerate. Patients benefit from eating cold foods and drier or saltier foods with fluid in between.

In determining the nutritional status of a patient and developing a plan of care, it is important to evaluate the patient according to A. Published standards. B. Nursing professional standards. C. Absence of family input. D. Patient input only.

A. Published standards. Referring to professional standards for nutrition is especially important during this step because published standards are based on scientific findings.

The nurse is educating the patient and his family about the parenteral nutrition. Which aspect related to this form of nutrition would be appropriate to include? Select all that apply. A. The purpose of the fat emulsion in parenteral nutrition is to prevent a deficiency in essential fatty acids. B. We can give you parenteral nutrition through your peripheral intravenous line to prevent further infection. C. The fat emulsion will help control hyperglycemia during periods of stress. D. The parenteral nutrition will help your wounds heal. E. Since we just started the parenteral nutrition, we will only infuse it at 50% of your daily needs for the next 6 hours.

A. The purpose of the fat emulsion in parenteral nutrition is to prevent a deficiency in essential fatty acids. C. The fat emulsion will help control hyperglycemia during periods of stress. D. The parenteral nutrition will help your wounds heal. Sometimes adding intravenous fat emulsions to parenteral nutrition supports the patient's need for supplemental kilocalories, prevents essential fatty acid deficiencies, and helps control hyperglycemia during periods of stress. Parenteral nutrition is administered at 50% of the patient's daily needs for the first 24 hours to assess how he or she is tolerating the infusion.

The nurse is concerned about pulmonary aspiration when providing her patient with tube feedings. The nurse should A. Verify tube placement before feeding. B. Lower the head of the bed to a supine position. C. Add blue food coloring to the enteral formula. D. Run the formula over 12 hours to decrease volume.

A. Verify tube placement before feeding. A major cause of pulmonary aspiration is regurgitation of formula. The nurse needs to verify tube placement and elevate the head of the bed 30 to 45 degrees during feedings and for 2 hours afterward.

The patient is to receive multiple medications via the nasogastric tube. The nurse is concerned that the tube may become clogged. To prevent this, the nurse A. Irrigates the tube with 60 mL of water after all medications are given. B. Checks with the pharmacy to find out if liquid forms of the medications are available. C. Instills nonliquid medications without diluting. D. Mixes all medications together to decrease the number of administrations.

B. Checks with the pharmacy to find out if liquid forms of the medications are available. Avoid crushed medication if liquid is available. Irrigate with 30 mL of water before and after each medication per tube. Dilute crushed medications if not liquid. Read pharmacological information on compatibility of drugs and formula before mixing medications.

A patient is receiving total parenteral nutrition (TPN). What is the primary intervention the nurse should follow to prevent a central line infection? A. Institute isolation precautions B. Clean the central line port through which the TPN is infusing with alcohol C. Change the TPN tubing every 24 hours D. Monitor glucose levels to watch and assess for glucose intolerance

B. Clean the central line port through which the TPN is infusing with alcohol. Use either alcohol or an alcoholic solution of chlorhexidine gluconate to clean the injection port or catheter hub 15 seconds before and after each time it is used to reduce the risk of a central line infection.

The nurse is assessing a patient for nutritional status. In doing so, the nurse must A. Choose a single objective tool that fits the patients condition. B. Combine multiple objective measures with subjective measures. C. Forego the assessment in the presence of chronic disease. D. Use the Mini Nutritional Assessment for pediatric patients.

B. Combine multiple objective measures with subjective measures. Using a single objective measure is ineffective in predicting risk of nutritional problems. Combine multiple objective measures with subjective measures related to nutrition to adequately screen for nutritional problems.

When teaching a patient about current dietary guidelines for the general population, the nurse explains referenced daily intakes (RDIs) and daily reference values (DRVs), otherwise known as daily values. In providing this information, the nurse understands that daily values A. Have replaced recommended daily allowances (RDAs). B. Have provided a more understandable format of RDAs for the public. C. Are based on percentages of a diet consisting of 1200 kcal/day. D. Are not usually easy to find computer experience is required.

B. Have provided a more understandable format of RDAs for the public. Daily values did not replace RDAs but provided a separate, more understandable format for the public. Daily values are based on percentages of a diet consisting of 2000 kcal/day; these values constitute the daily values used on food labels, which are easy for anyone to find.

Before giving the patient an intermittent tube feeding, the nurse should A. Make sure that the tube is secured to the gown with a safety pin. B. Have the tube feeding at room temperature. C. Inject air into the stomach via the tube and auscultate. D. Place the patient in a supine position.

B. Have the tube feeding at room temperature. Cold formula causes gastric cramping and discomfort because the mouth and the esophagus do not warm the liquid. Do not use safety pins. Safety pins can become unfastened and may cause harm to the patient. Auscultation is no longer considered a reliable method for verification of tube placement because a tube inadvertently placed in the lungs, pharynx, or esophagus transmits sound similar to that of air entering the stomach. Place the patient in high-Fowlers position, or elevate the head of the bed at least 30 degrees to help prevent aspiration.

A nurse is caring for a client who is at high risk for aspiration. Which of the following actions should the nurse take? A. Give the clients thin liquids. B. Instruct the client to tuck their chin when swallowing. C. Have the client use a straw. D. Encourage the client to lie down and rest after meals.

B. Instruct the client to tuck their chin when swallowing. Tucking the chin when swallowing allows food to pass down the esophagus more easily.

The nurse would delegate which of the following to nursing assistive personnel (NAP)? Select all that apply. A. Repositioning and retaping a patient's nasogastric tube B. Performing glucose monitoring every 6 hours on a patient C. Documenting PO intake on a patient who is on a calorie count for 72 hours D. Administering enteral feeding bolus after tube placement has been verified E. Hanging a new bag of enteral feeding

B. Performing glucose monitoring every 6 hours on a patient C. Documenting PO intake on a patient who is on a calorie count for 72 hours The skills of measuring blood glucose level after skin puncture (capillary puncture) and writing down the amount the patient ate can be delegated to NAP. The nurse needs to administer enteral feeding because of the risk of aspiration. The nasogastric tube should never be repositioned by the NAP for risk of causing injury to the patient.

The nurse sees the nursing assistive personnel (NAP) perform the following intervention for a patient receiving continuous enteral feedings. Which action would require immediate attention? A. Fastening tube to the gown with new tape B. Placing patient supine while giving a bath C. Hanging a new container of enteral feeding D. Ambulating patient with enteral feedings still infusing

B. Placing patient supine while giving a bath. A patient receiving continuous enteral feedings should never be placed supine because it increases the risk for pulmonary aspiration. If the nurse needs to lay the patient in the supine position, the feedings should be stopped and restarted when the head of the bed is at 45 degrees.

Knowing that protein is required for tissue growth, maintenance, and repair, the nurse must understand that for optimal tissue healing to occur, the patient must be in A. Negative nitrogen balance. B. Positive nitrogen balance. C. Total dependence on protein for kcal production. D. Neutral nitrogen balance.

B. Positive nitrogen balance. When intake of nitrogen is greater than output, the body is in positive nitrogen balance. Positive nitrogen balance is required for growth, normal pregnancy, maintenance of lean muscle mass and vital organs, and wound healing.

In providing diabetic teaching for a patient with type 1 diabetes mellitus, the nurse instructs the patient that A. Insulin is the only consideration that must be taken into account. B. Saturated fat should be limited to less than 7% of total calories. C. Cholesterol intake should be greater than 200 mg/day. D. Nonnutritive sweeteners can be used without restriction.

B. Saturated fat should be limited to less than 7% of total calories. The diabetic patient should limit saturated fat to less than 7% of total calories and cholesterol intake to less than 200 mg/day. Type 1 diabetes requires both insulin and dietary restrictions for optimal control. Nonnutritive sweeteners can be eaten as long as the recommended daily intake levels are followed.

In providing diet education for a patient on a low-fat diet, it is important for the nurse to understand that with few exceptions A. Saturated fats are found mostly in vegetable sources. B. Saturated fats are found mostly in animal sources. C. Unsaturated fats are found mostly in animal sources. D. Linoleic acid is a saturated fatty acid.

B. Saturated fats are found mostly in animal sources. Most animal fats have high proportions of saturated fatty acids, whereas vegetable fats have higher amounts of unsaturated and polyunsaturated fatty acids.

The nurse is caring for a patient with pneumonia who has severe malnutrition. The nurse recognizes that, because of the nutritional status, the patient is at increased risk for: Select all that apply. A. Heart disease. B. Sepsis. C. Pleural effusion. D. Cardiac arrhythmias. E. Diarrhea.

B. Sepsis. C. Pleural effusion. D. Cardiac arrhythmias. Patients who are malnourished on admission are at greater risk of life-threatening complications such as arrhythmia, pleural effusions, sepsis, or hemorrhage during hospitalization.

Dysphagia refers to difficulty when swallowing. Of the following causes of dysphagia, which is considered neurogenic? A. Myasthenia gravis B. Stroke C. Candidiasis D. Muscular dystrophy

B. Stroke Stroke is the only cause of dysphagia in this list that is considered neurogenic. Myasthenia gravis and muscular dystrophy are considered myogenic in origin, whereas candidiasis is considered obstructive.

Which patients are at high risk for nutritional deficits? Select all that apply. A. The divorced computer programmer who eats precooked food from the local restaurant B. The middle-age female with celiac disease who does not follow her gluten-free diet C. The 45-year-old patient with type II diabetes who monitors her carbohydrate intake and exercises regularly D. The 25-year-old patient with Crohn's disease who follows a strict diet but does not take vitamins or iron supplements E. The 65-year-old patient with gallbladder disease whose electrolyte, albumin, and protein levels are normal

B. The middle-age female with celiac disease who does not follow her gluten-free diet D. The 25-year-old patient with Crohn's disease who follows a strict diet but does not take vitamins or iron supplements Patients suffering from celiac disease or Crohn's disease need to take vitamin and iron supplements regularly because they have a deficit resulting from malabsorption.

The patient's blood glucose level is 330 mg/dL. What is the priority nursing intervention? A. Recheck by performing another blood glucose test. B. Call the primary health care provider. C. Check the medical record to see if there is a medication order for abnormal glucose levels. D. Monitor and recheck in 2 hours.

C. Check the medical record to see if there is a medication order for abnormal glucose levels. Check the medical record to see if there is a medication order for deviations in glucose level; if not, notify the health care provider. As the nurse you want to get the patient's blood sugar as close to normal as possible.

The patient has been diagnosed with cardiovascular disease and placed on a low-fat diet. The patient asks the nurse, How much fat should I have? I guess the less fat, the better. The nurse needs to explain that A. Fats have no significance in health and the incidence of disease. B. All fats come from external sources so can be easily controlled. C. Deficiencies occur when fat intake falls below 10% of daily nutrition. D. Vegetable fats are the major source of saturated fats and should be avoided.

C. Deficiencies occur when fat intake falls below 10% of daily nutrition. Deficiency occurs when fat intake falls below 10% of daily nutrition. Various types of fatty acids have significance for health and for the incidence of disease and are referred to in dietary guidelines.

The patient is an 80-year-old male who is visiting the clinic today for his routine physical examination. The patients skin turgor is fair, but he has been complaining of fatigue and weakness. The skin is warm and dry, pulse rate is 126 beats per minute, and urinary sodium level is slightly elevated. After assessment, the nurse should recommend that the patient A. Decrease his intake of milk and dairy products to decrease the risk of osteoporosis. B. Drink more grapefruit juice to enhance vitamin C intake and medication absorption. C. Drink more water to prevent further dehydration. D. Eat more meat because meat is the only source of usable protein.

C. Drink more water to prevent further dehydration. Thirst sensation diminishes, leading to inadequate fluid intake or dehydration. Symptoms of dehydration in older adults include confusion, weakness, hot dry skin, furrowed tongue, and high urinary sodium.

In providing prenatal care to a patient, the nurse teaches the expectant mother that A. Protein intake needs to decrease to preserve kidney function. B. Calcium intake is especially important in the first trimester. C. Folic acid is needed to help prevent birth defects and anemia. D. The mother should take in as many extra vitamins and minerals as possible.

C. Folic acid is needed to help prevent birth defects and anemia. Folic acid intake is particularly important for DNA synthesis and growth of red blood cells. Inadequate intake may lead to fetal neural tube defects, anencephaly, or maternal megaloblastic anemia.

The patient is on PN and is lethargic. He has been complaining of thirst and headache and has had increased urination. Which of the following problems would cause these symptoms? A. Electrolyte imbalance B. Hypoglycemia C. Hyperglycemia D. Hypercapnia

C. Hyperglycemia Signs and symptoms of hyperglycemia are thirst, headache, lethargy, and increased urination. Electrolyte imbalance is marked by changes in Na, Ca, K, Cl, PO4, Mg, and CO2 levels. These have to be monitored closely when patients are on PN. Hypercapnia increases oxygen consumption and increases CO2 levels. Ventilator-dependent patients are at greatest risk for this. Hypoglycemia is characterized by diaphoresis, shakiness, confusion, and loss of consciousness.

To counter obesity in adolescents, increasing physical activity is often more important than curbing intake. Sports and regular, moderate to intense exercise necessitate dietary modifications to meet increased energy needs for adolescents. The nurse understands that these modifications include A. Decreasing carbohydrates to 25% to 30% of total intake. B. Decreasing protein intake to .75 g/kg/day. C. Ingesting water before and after exercise. D. Providing vitamin and mineral supplements.

C. Ingesting water before and after exercise. Adequate hydration is very important for all athletes. They need to ingest water before and after exercise to prevent dehydration, especially in hot, humid environments

In creating a plan of care to meet the nutritional needs of the patient, the nurse needs to explore the patients feelings about weight and food. The nurse must do this to A. Determine which category of plan to use. B. Set realistic goals for the patient. C. Mutually plan goals with patient and team. D. Prevent the need for a dietitian consult.

C. Mutually plan goals with patient and team. Mutually planned goals negotiated by patient, registered dietitian, and nurse ensure success. Individualized planning cannot be overemphasized.

The patient is having at least 75% of his nutritional needs met by enteral feeding, so the physician has ordered the PN to be discontinued. However, the nurse notices that the PN infusion has fallen behind. The nurse should A. Increase the rate to get the volume caught up before discontinuing. B. Stop the infusion and hang a normal saline drip in place. C. Taper the PN infusion gradually. D. Hang 5% dextrose if the PN runs out.

C. Taper the PN infusion gradually. Sudden discontinuation of PN can cause hypoglycemia. PN must be tapered off. Usually, 10% dextrose is infused when PN solution is suddenly discontinued. The same is true if the PN runs out. Too rapid administration of hypertonic dextrose (PN) can result in an osmotic diuresis and dehydration. If an infusion falls behind schedule, the nurse should not increase the rate in an attempt to catch up.

A nurse is caring for a client who requires a low-residue diet. The nurse should expect to see which of the following foods on the client's meal tray? A. Cooked barley. B. Pureed broccoli C. Vanilla custard D. Lentil soup

C. Vanilla custard A low-residue diet consists of foods that are low in fiber and easy to digest. Dairy products and eggs are appropriate for a low-residue diet.

The nurse is caring for a patient who will be receiving PN. To reduce the risk of developing sepsis, the nurse A. Takes down a running bag of TPN after 36 hours. B. Runs lipids for no longer than 24 hours. C. Wears a sterile mask when changing the CVC dressing. D. Wears clean gloves when changing the CVC dressing.

C. Wears a sterile mask when changing the CVC dressing. During CVC dressing changes, always use a sterile mask and gloves, and assess insertion sites for signs and symptoms of infection.

In general, when energy requirements are completely met by kilocalorie (kcal) intake in food A. Weight increases. B. Weight decreases. C. Weight does not change. D. Kilocalories are not a factor.

C. Weight does not change. In general, when energy requirements are completely met by kilocalorie (kcal) intake in food, weight does not change.

At present, the most reliable method for verification of placement of small-bore feeding tubes is A. Auscultation. B. Aspiration of contents. C. X-ray. D. pH testing.

C. X-ray. At present, the most reliable method for verification of placement of small-bore feeding tubes is x-ray examination. Aspiration of contents and pH testing are not infallible. The nurse would need a more precise indicator to help differentiate the source of tube feeding aspirate. Auscultation is no longer considered a reliable method for verification of tube placement because a tube inadvertently placed in the lungs, pharynx, or esophagus transmits sound similar to that of air entering the stomach.

In determining kcal expenditure, the nurse knows that carbohydrates and proteins provide 4 kcal of energy per gram ingested. The nurse also knows that fats provide _____ kcal per gram. A. 3 B. 4 C. 6 D. 9

D. 9 Fats (lipids) are the most calorie-dense nutrient, providing 9 kcal per gram.

Patients who are unable to digest or absorb enteral nutrition benefit from parenteral nutrition (PN). However, the goal to move toward use of the GI tract is constant because PN A. Can be given only in the hospital setting. B. Cannot be used in patients in highly stressed situations. C. Can be given only by way of a peripheral IV line. D. Can lead to villous atrophy and cell shrinkage.

D. Can lead to villous atrophy and cell shrinkage. Disuse of the GI tract has been associated with villous atrophy and generalized cell shrinkage.

A nurse is preparing a presentation about basic nutrients for a group of high school athletes. She should explain that which of the following nutrients provides the body with the most energy? A. Fat. B. Protein C. Glycogen D. Carbohydrates

D. Carbohydrates Body's greatest energy spice; providing energy for cells is their primary function.

A patient's gastric residual volume was 250 mL at 0800 and 350 mL at 1200. What is the appropriate nursing action? A. Assess bowel sounds B. Raise the head of the bed to at least 45 degrees C. Position the patient on his or her right side to promote stomach emptying D. Do not reinstall aspirate and hold the feeding until you talk to the primary care provider

D. Do not reinstall aspirate and hold the feeding until you talk to the primary care provider Do not administer feeding when a single gastric residual volume exceeds 500 mL or when two consecutive measurements (taken 1 hour apart) each exceed 250 mL because of the potential for aspiration.

The patient is elderly and has been diagnosed with Imbalanced nutrition: less than body requirements. Her treatment regimen should include having the nurse A. Encourage weight gain as rapidly as possible. B. Encourage large meals three times a day. C. Decrease fluid intake to prevent feeling full. D. Encourage fiber intake.

D. Encourage fiber intake. Increasing fiber intake deters constipation and enhances appetite. Weight gain should be slow and progressive. Frequent small meals should be encouraged to increase dietary intake and to help offset anorexia. Older adults need eight 8-ounce glasses of fluid per day from beverage and food sources.

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. I'm going to alternate formula with whole milk starting next month. Infants should not have regular cow's milk during the first year of life. It is too concentrated for the infant's kidneys to manage. There is also an increased risk for developing milk-product allergies.

Some proteins are manufactured in the body, but others are not. Those that must be obtained through diet are known as A. Amino acids. B. Dispensable amino acids. C. Triglycerides. D. Indispensable amino acids.

D. Indispensable amino acids. The simplest form of protein is the amino acid. The body does not synthesize indispensable amino acids, so these need to be provided in the diet. The body synthesizes dispensable amino acids.

The patient is admitted with facial trauma, including a broken nose, and has a history of esophageal reflux and of aspiration pneumonia. Given this information, which of the following tubes is appropriate for this patient? A. Nasogastric tube B. Percutaneous endoscopic gastrostomy (PEG) tube C. Nasointestinal tube D. Jejunostomy tube

D. Jejunostomy tube Patients with gastroparesis or esophageal reflux or with a history of aspiration pneumonia may require placement of tubes beyond the stomach into the intestine. The jejunostomy tube is the only tube in the list that is beyond the stomach and is not contraindicated by facial trauma.

The nurse evaluates which laboratory values to assess a patient's potential for wound healing? A. Fluid status B. Potassium C. Lipids D. Nitrogen balance

D. Nitrogen balance Nitrogen balance is important to determining serum protein status. A negative nitrogen balance is present when catabolic states exist. When a patient has a decreased protein level, he or she is at risk for delayed wound healing.

In teaching mothers-to-be about infant nutrition, the nurse instructs patients to A. Give cows milk during the first year of life. B. Supplement breast milk with corn syrup. C. Add honey to infant formulas for increased energy. D. Remember that breast milk or formula is sufficient for the first 4 to 6 months.

D. Remember that breast milk or formula is sufficient for the first 4 to 6 months. Breast milk or formula provides sufficient nutrition for the first 4 to 6 months of life. Infants should not have regular cows milk during the first year of life. Cows milk causes gastrointestinal bleeding, is too concentrated for the infants kidneys to manage, increases the risk of milk product allergies, and is a poor source of iron and vitamins C and E. Honey and corn syrup are potential sources of botulism toxin and should not be used in the infant diet.

The nurse is teaching the patient about dietary guidelines. In discussing the four components of dietary reference intakes (DRIs), it is important to understand that A. The estimated average requirement (EAR) is appropriate for 100% of the population. B. The recommended dietary allowance (RDA) meets the needs of the individual. C. Adequate intake (AI) determines the nutrient requirements of the RDA. D. The tolerable upper intake level (UL) is not a recommended level of intake.

D. The tolerable upper intake level (UL) is not a recommended level of intake. The tolerable upper intake level (UL) is the highest level that likely poses no risk of adverse health events. It is not a recommended level of intake.

The nurse is preparing to insert a nasogastric tube in a patient who is semiconscious. To determine the length of the tube needed to be inserted, the nurse measures from the A. Tip of the nose to the xiphoid process of the sternum. B. Earlobe to the xiphoid process of the sternum. C. Tip of the nose to the earlobe. D. Tip of the nose to the earlobe to the xiphoid process.

D. Tip of the nose to the earlobe to the xiphoid process. Measure distance from the tip of the nose to the earlobe to the xiphoid process of the sternum. This approximates the distance from the nose to the stomach in 98% of patients. For duodenal or jejunal placement, an additional 20 to 30 centimeters is required.

The ChooseMyPlate program was developed to replace MyFoodPyramid as a basic guide for buying food and meal preparations. This system was developed by the A. Food and Drug Administration. B. 1990 Nutrition Labeling and Education Act. C. Referenced daily intakes (RDIs). D. U.S. Department of Agriculture.

D. U.S. Department of Agriculture. The ChooseMyPlate program was developed by the U.S. Department of Agriculture to replace the MyFoodPyramid program. ChooseMyPlate serves as a basic guide for making food choices for a healthy lifestyle.

A patient is receiving both parenteral (PN) and enteral nutrition (EN). When would the nurse collaborate with the health care provider and request discontinuing parenteral nutrition? A. When 25% of the patient's nutritional needs are met by the tube feedings B. When bowel sounds return C. When central line has been in for 10 days D. When 75% of the patient's nutritional needs are met by the tube feedings

D. When 75% of the patient's nutritional needs are met by the tube feedings. When meeting 75% of nutritional needs by enteral feedings or reliable dietary intake, it is usually safe to discontinue PN therapy.

A nurse is caring for a client who weighs 80 kg (176 lb) and is 1.6 m (5 ft 3 in) tall. Calculate the body mass index (BMI) and determine whether this clients BMI indicates a healthy weight, underweight, overweight, or obese.

Step 1: Clients weight and height = 80 kg and 1.6 m Step 2: 1.6 * 1.6 = 2.56 Step 3: 80 / 2.56 = 31.25 A BMI greater than 30 identifies obesity.

The energy needed to maintain life-sustaining activities for a specific period of time at rest is known as A. BMR. B. REE. C. Nutrients. D. Nutrient density.

A. BMR The basal metabolic rate (BMR) is the energy needed to maintain life-sustaining activities for a specific period of time at rest.

A patient who is receiving parenteral nutrition (PN) through a central venous catheter (CVC) has an air embolus. What would the nurse do first? A. Have the patient perform a Valsalva procedure B. Clamp the intravenous (IV) tubing to prevent more air from entering the line C. Have the patient take a deep breath and hold it D. Notify the health care provider immediately

A. Have the patient perform a Valsalva procedure. Turn the patient on his or her left side to prevent air from entering the left side of the heart. Then have the patient perform a Valsalva maneuver (holding the breath and "bearing down").

The ChooseMyPlate program includes guidelines for A. Children younger than 2 years. B. Balancing calories. C. Increasing portion size. D. Decreasing water consumption.

B. Balancing calories. The ChooseMyPlate program includes guidelines for balancing calories; decreasing portion size; increasing healthy foods; increasing water consumption; and decreasing fats, sodium, and sugars.