RN nutrition online practice 2023 A

a nurse is teaching a client who has a BMI of 22 about dietary recommendations during pregnancy. which of the following statements by the client indicates an understanding of the teaching?

" I should plan to gain a total of 25 to 35 pounds." WHY: The nurse should teach a client whose weight is within the expected reference range to gain 11.3 to 15.9 kg (25 to 35 lb) during pregnancy.

A nurse is reviewing the introduction of solid foods with the guardian of a 6-month-old infant. Which of the following statements by the guardian indicates an understanding of the teaching?

" I will introduce a new solid food at least every 3 days." WHY: The client understands that new solid food items can be introduced every 3 to 5 days to monitor for indications of food allergies.

A nurse is providing discharge teaching to a postpartum client about breast milk use and storage. Which of the following statements should the nurse make?

"You cannot place thawed breast milk back in the freezer." WHY: The nurse should instruct the client that completely thawed breast milk can be stored in the refrigerator but must be used within 24 hr. Breast milk that has been previously frozen should not be refrozen once it has thawed completely. Thawing creates a possibility for bacterial growth and causes a decrease in antibacterial activity, which destroys antibodies in the milk.

A nurse is assessing a client's risk for pressure injuries using a skin risk assessment tool. The client eats more than half of most meals but occasionally refuses a meal. Which of the following information should the nurse document on the nutrition category of the skin risk assessment tool?

3 (adequate) WHY: A client who eats more than half of most meals, occasionally refuses a meal, and has four servings of protein each day scores a 3 (Adequate) in the nutrition category of the skin risk assessment tool. *A client who scores a 1 (Very Poor) in the nutrition category of the skin risk assessment tool never finishes a complete meal, drinks little fluid, and does not drink any dietary supplements. *A client who scores a 2 (Probably Inadequate) in the nutrition category of the skin risk assessment tool only eats about half of meals or snacks and only occasionally takes dietary supplements. *A client who scores a 4 (Excellent) in the nutrition category of the skin risk assessment tool eats most of every meal, eats plenty of protein, and occasionally eats between meals.

A nurse is providing dietary teaching about increased zinc intake for a client who has chronic skin ulcers of the lower extremities. Which of the following foods should the nurse recommend as containing the highest amount of zinc?

4 oz ground beef patty WHY: The nurse should determine that a ground beef patty is the best food source to recommend because a 4 oz ground beef patty contains 5.49 mg of zinc.

A nurse is assessing a client who has an elevated blood pressure, headache, and is sweating. The client recently started taking an MAOI. The nurse should question the client regarding the consumption of which of the following foods?

Cheddar cheese WHY: Clients who take MAOIs should avoid the consumption of most types of cheese and other foods that contain high levels of tyramine, which can lead to hypertensive crisis. *Grapefruit juice, whole milk, whole grain bread contains little or no tyramine; therefore, consumption is not restricted for clients who are taking MAOIs.

A nurse is creating a plan of care for a client who has mucositis following head and neck radiation therapy to treat cancer. Which of the following interventions should the nurse include in the plan?

Increase fluid intake to 2 L per day. WHY: A client who has mucositis should increase fluid intake to promote hydration and peristalsis.

A nurse is admitting a client who has diabetic ketoacidosis. Which of the following findings should the nurse expect?

Increased urination WHY: The nurse should identify that increased urination is a manifestation of diabetic ketoacidosis. Other manifestations can include fruity breath, Kussmaul respirations, excessive thirst, and orthostatic hypotension.

A nurse is caring for a client who expresses a desire to lose weight. Which of the following actions should the nurse take first?

Obtain a 24-hr dietary recall. WHY: The first action the nurse should take using the nursing process is to obtain a diet history, such as a 24-hr dietary recall. Having the client write down everything consumed over a 24-hr period is a crucial component of the assessment process to identify eating behaviors and, therefore, be able to recommend dietary modifications based on the data received.

A nurse is administering a continuous tube feeding at 60 mL/hr with 50 mL of water every 4 hr. What should the nurse document as the total mL of enteral fluid administered during the 8 hr shift? (Round the answer to the nearest whole number. Do not use a trailing zero.)

Step 1: What is the unit of measurement the nurse should calculate? mL Step 2: Should the nurse convert the units of measurement? No Step 3: Calculate the total amount of enteral tube feeding administered during the 8-hr shift. The nurse should administer the continuous tube feeding at 60 mL/hr for the 8-hr shift.60 mL x 8 = 480 mL Step 4: Calculate the total amount of water administered via the enteral route during the 8-hr shift. If the nurse should administer 50 mL every 4 hr then the client should receive this amount 2 times during the 8-hr shift.50 mL x 2 = 100 mL Step 5: Add the amount of tube feeding administered with the amount of water administered.480 mL + 100 mL = 580 mL Step 6: Round if necessary. Step 7: Reassess to determine whether the total amount makes sense. If the client is to receive 60 mL/hr for 8 hr, as well as 50 mL of water every 4 hr during an 8-hr shift, it makes sense that the client's total fluid intake is 580 mL. The nurse should document 580 mL of enteral fluid administered during the 8-hr shift.

A nurse in a long-term care facility is monitoring a client during mealtime who has Parkinson's disease. Which of the following findings should the nurse identify as the priority?

The client drools while eating. WHY: Drooling while eating can indicate that this client is at greatest risk for aspiration of food from dysphagia, which can lead to pulmonary complications; therefore, the nurse should identify this as the priority finding.

The nurse is preparing a dietary teaching plan for the toddler's parent. For each food, click to specify if the food is recommended or not recommended for the toddler.

When generating solutions, the nurse should recommend foods that do not have gluten as the toddler's manifestations of diarrhea, fatigue, abdominal distention, and weight gain below the expected standards, accompanied by an elevated tissue transglutaminase IgA result indicate that the toddler has celiac disease. The nurse should recommend foods such as eggs, cheese, vegetables, fruits, corn, potatoes, and rice as these do not contain gluten. Foods that contain gluten include those made from wheat, rye, barley, and oats, and should be avoided.

A nurse is reviewing the laboratory data of four clients. The nurse should identify that which of the following clients is experiencing fluid overload?

a client who has a sodium level of 130 mEq/L (136 to 145 mEq/L) WHY: The nurse should identify that this client's sodium level is lower than the expected reference range and indicates hyponatremia. Hyponatremia, often called water deficit, is a decrease of sodium concentration in the blood caused by an excess of water. Manifestations of hyponatremia include confusion, headache, nausea, and fatigue.

hyperactive hypoactive bowel sounds are

abnormal

a client reports constipation during a rou

calcium WHY: calcium can lead to constipation by decreasing peristalsis *excessive magnesium = diarrhea and cramping *excessive potassium = vomiting *excessive phosphorus= no constipation

A nurse is caring for a client who is receiving total parenteral nurition (TPN) therapy. which of the following findings indicates the clients if experiencing a complication of the therapy?

cardiac dysrhythmias WHY: Cardiac dysrhythmias can occur as a complication of TPN therapy due to refeeding syndrome. TPN therapy can increase the client's blood glucose and insulin levels causing electrolytes like potassium to quickly move out of the bloodstream. Hypokalemia can lead to cardiac dysrhythmias.

a nurse is teaching about nutritional requirements for a client who is starting a vegetarian diet. which of the following information should the nurse include in the teaching?

include two serving per day of nuts when on a vegetarian diet. WHY: the nurse should instruct the client to eat two serving of nuts or flaxseed per day to receive the daily requirement of omega-3 fatty acids.

a nurse is reviewing the laboratory findings of a client who has acute pancreatitis. which of the following is an expected finding?

increased glucose WHY: the nurse should expect an increase glucose level in a client who has acute pancreatitis due to decreased insulin production by the pancreas.

a nurse is providing teaching regarding diet modifications to a client who is at a high risk for cardiovascular disease. the client is accustomed to cultural mexican food and wants to continue to include them in their diet. which of the following recommendations should the nurse give the client?

use canola oil instead of lard for frying WHY: the nurse should teach the client to use monounsaturated fats, such as canola oil, instead of saturated fats, such as lard, to reduce the risk for cardiovascular disease.

a nurse is caring for a client who develops diarrhea while receiving a continuous enteral tube feeding. which of the following actions should the nurse take?

warm the formula to room temperature WHY: a client can develop diarrhea if the formula being infused is to cold. therefore, the nurse should warm the formula to temp prior to administration.

A nurse is assessing the meal pattern of a client who has diverticular disease and a prescription for a high-fiber diet. Which of the following food choices by the client contains the most fiber?

½ cup bran cereal WHY: A high-fiber diet is recommended for clients who have diverticular disease because bulky, soft stools are easier for the client to pass and result in decreased pressure within the colon. The nurse should determine that a ½ cup of bran cereal contains the most fiber at 10 g per serving. *FIber foods: -fruits -grains -lentils -almonds -nuts -quinoa -berries -sweet potatoes -avocados -raspberry -oats -artichokes -pears -chickpea -kidney beans -apple

clients who have had a total gastrectomy are at risk for

dumping syndrome due to the rapid emptying of food into the small intestine which stimulates bowel motility. -Dumping syndrome can cause vasomotor responses, such as muscle weakness, flushing, tachycardia, and sweating which are similar to manifestations of hypoglycemia.

a nurse is assessing a client who had end-stage kidney disease (ESKD). which of the following dietary habits increases the client's risk for dysrhythmias?

eating a diet rich in potassium WHY: A client who has ESKD has impaired kidney function and is unable to eliminate potassium. As urine output declines, hyperkalemia develops, which can cause cardiac dysrhythmias.

a nurse is preparing to administer an influenza vaccine to an adult client who reports allergies. which of the following food allergies could place the client at risk for a reaction?

eggs WHY: A hypersensitivity to eggs can place a client at risk for allergic reactions when receiving the influenza vaccine. The vaccine should only be administered by a healthcare provider who can recognize and respond to severe allergic reactions. *milk, shellfish, & peanut are not a contraindication for receiving the influenza vaccine.

a nurse is updating a plan of care for a client who is receiving intermittent enteral feedings and is experiencing diarrhea. which of the following interventions should the nurse include in the plan?

feed the client in small frequent volume WHY: The nurse should administer the feedings in small, frequent volumes because a large volume or rapid feeding of the formula can cause diarrhea.

a nurse is assessing a client who is suspected of having lactose intolerance. which of the following is an expected finding?

flatulence WHY: flatulence, bloating, cramping and diarrhea are expected findings associated with lactose intolerance.

For each assessment finding, click to specify if the finding is consistent with dumping syndrome, hypoglycemia, or refeeding syndrome. Each finding may support more than one condition. refeeding sydnrome

-muscle weakness

For each assessment finding, click to specify if the finding is consistent with dumping syndrome, hypoglycemia, or refeeding syndrome. Each finding may support more than one condition. hypoglycemia:

-muscle weakness -sweating

A nurse is performing a comprehensive nutritional assessment for a client. After reviewing the client's laboratory results, which of the following findings should the nurse report to the provider as an indication of protein deficiency?

prealbumin 8 mg/dL (15 to 36 mg/dL) WHY: Prealbumin is a plasma protein. A prealbumin level of 8 mg/dL is a critical value that indicates severe malnutrition and requires reporting to the provider who can prescribe a nutritional intervention.

a nurse in a providers office is assessing a client who has HIV the nurse should identify which of the following findings as an indication to increase the clients nutritional intake?

presence of herpes simplex virus infection WHY: Secondary infection triggers inflammatory responses that increase the client's metabolic rate. Therefore, the nurse should identify the presence of herpes simplex virus infection as an indication to increase the client's nutritional intake.

A nurse is caring for a group of clients. A client who has which of the following conditions has an increased protein requirement?

pressure injury WHY: A client who has a pressure injury needs additional protein to promote healing.

a nurse is planning care for a client who is receiving radiation to the neck and had developed stomatitis. which of the following interventions should the nurse include in the plan?

relieve mouth pain by consuming frozen foods. WHY: the nurse should encourage the client to consume frozen foods, such as frozen bananas, ice cream, or popsicles, which can numb the mouth and help alleviate

A nurse is teaching a client who has hypertension about decreasing sodium intake. Which of the following information should the nurse include in the teaching?

seasons foods with herbs and spices WHY: The nurse should instruct the client to replace salt with herbs and spices when seasoning foods.

A nurse is providing teaching about cancer prevention to a group of clients. Which of the following client statements indicates an understanding of the teaching?

" i will eat five servings of fruit and vegetables each day." WHY: The nurse should instruct the clients to consume four to five servings, or about 2.5 cups, of fruits and vegetables daily. Eating various fruits and vegetables assists in decreasing blood pressure and weight.

A nurse is providing information regarding breastfeeding to the parents of a newborn. Which of the following statements should the nurse make?

"Breast milk is the source of complete nutrition for an infant up to 6 months of age." WHY: Breast milk is a source of complete nutrition to support the growth and development of newborns and infants. The introduction of solid foods can occur after 6 months of age.

a nurse is providing dietary teaching to a client who had celiac disease. which of the following statements by the client indicates an understanding of the teaching?

"I can have tapioca pudding for dessert." WHY: A client who has celiac disease can consume tapioca because this starch does not contain gluten.

A nurse is teaching a client who is newly diagnosed with type 1 diabetes mellitus how to count carbohydrates. Which of the following statements made by the client indicates an understanding of the teaching?

"I know the serving size can affect the number of carbohydrates I eat." WHY: The nurse should instruct the client that the portion size affects the number of carbohydrates.

A nurse in an antepartum clinic is teaching a client about nutritional recommendations during pregnancy. Which of the following client statements indicates an understanding of the teaching?

"I should take a daily iron supplement during my pregnancy." WHY: Clients who are pregnant should take 30 mg of iron supplementation daily to reduce the risk for iron-deficiency anemia.

A nurse is providing teaching to a client who reports nausea during pregnancy. Which of the following statements by the client indicates an understanding of the teaching?

"I will eat dry cereal before I get out of bed." WHY: Carbohydrates, such as dry cereal, are absorbed quickly and readily raise blood sugar levels, which should reduce nausea.

A nurse is planning discharge teaching for a client who is postoperative following placement of a colostomy. Which of the following statements should the nurse plan to include?

"Increase your intake of foods containing pectin." WHY: The nurse should instruct the client to consume foods that thicken the consistency of feces, such as foods containing pectin. *The nurse should instruct the client to eat low-fiber foods because high-fiber foods can lead to stomal blockage.

A nurse is caring for a client who is receiving total parenteral nutrition (TPN) and is prescribed an oral diet. The client asks the nurse why the TPN is being continued since they are now eating. Which of the following responses should the nurse make?

"You should consume at least 60 percent of your calories orally before the parenteral nutrition can be discontinued." WHY: TPN can be discontinued when oral intake exceeds at least 60% of the client's estimated daily caloric requirements.

a nurse is caring for a client who has cirrhosis and ascites. which of the following dietary instructions should the nurse provide for this client?

"decrease your sodium intake to 1 to 2 grams per day." WHY: To decrease fluid retention, a client who has cirrhosis should limit their daily sodium intake to 2,000 mg.

For each assessment finding, click to specify if the finding is consistent with dumping syndrome, hypoglycemia, or refeeding syndrome. Each finding may support more than one condition. Dumping syndrome

-abdominal cramping -muscle weakness -nausea -diarrhea -sweating

A nurse is teaching a client who has chronic kidney disease about limiting dietary calcium intake. Which of the following food choices should the nurse include in the teaching as having the highest amount of calcium?

1 cup low-fat yogurt WHY: The nurse should determine that low-fat yogurt contains 314 mg of calcium per cup, which is the highest amount of calcium; therefore, the client should limit low-fat yogurt in the diet.

a nurse is providing nutritional teaching to the guardians of 2-year-old toddler. which of the following snack foods should the nurse recommend including in the toddlers diet?

1 cup of yogurt WHY: The nurse should recommend yogurt as a snack food for a 2-year-old toddler. The consistency of yogurt poses no choking hazard, and because of their increased activity level, toddlers require 13 to 16 g of protein each day to meet the demands for muscle growth. At 8 g/cup, yogurt is a high-quality source of protein. The nurse can also teach the guardians to make yogurt smoothies by combining yogurt and the child's favorite fruit in a blender.

A nurse is caring for a client who is receiving total parenteral nutrition (TPN). The current bag of TPN is empty and a new bag is not available on the unit. Which of the following solutions should the nurse infuse until a new bag of TPN is available?

Dextrose 10% in water WHY: The nurse should administer dextrose 10% in water at the same rate as the TPN to prevent hypoglycemia.

A nurse is caring for a client who is receiving intermittent enteral feedings every 4 hr via an NG tube. Which of the following actions should the nurse take to reduce the risk for aspiration?

Place the client in a semi-Fowler's position. WHY: The nurse should maintain the client in a semi-Fowler's position to reduce the risk for aspiration of stomach contents during the feeding and for at least 30 min after the completion of the feeding. *The nurse should flush the tubing with at least 40 to 50 mL of water following each feeding to maintain tube patency.

A nurse is planning dietary interventions for a client who is prescribed external radiation for laryngeal cancer. The client reports manifestations of stomatitis. Which of the following interventions should the nurse include?

Provide meals at room temperature. WHY: The nurse should plan to offer the client's foods at room temperature or colder. Foods at these temperatures are less irritating to the mucosa.

A nurse is teaching about increasing dietary intake of micronutrients to a client who has difficulty seeing at night. Which of the following micronutrients should the nurse include in the teaching?

Vitamin A WHY: Vitamin A enables the eyes to adapt to dim lighting more rapidly at night, which improves night vision.

Which of the following nursing interventions are the priority in the client's care?

When prioritizing hypothesis, and using the urgent versus non-urgent priority framework, the nurse should recognize that administering pain medications as needed, monitoring pancreatic enzyme levels, and administering antibiotics are the priority interventions in the client's plan of care. Controlling a client's pain is a priority intervention to promote client comfort. Monitoring pancreatic enzyme levels determines the effectiveness of treatment and can indicate a worsening of a client's condition. Antibiotic therapy is instituted to reduce infection. Pancreatitis causes inflammation that can injure intestinal mucosa, allowing the normal flora in the gut to multiply, and producing opportunistic infection. While measuring intake and output and obtaining daily weights would be included in the client's plan of care, these are not priority interventions.

a nurse is caring for a client who has undergone a radical head and neck resection to treat cancer and is receiving radiation therapy. the nurse should monitor for which of the following potential adverse effects?

changes in the production of saliva WHY: Changes in salivation are a potential complication of a head and neck resection and radiation therapy.

a nurse is assessing a client who has type 2 diabetes mellitus. the nurse should recognize which of the following as a manifestation of hypoglycemia?

confusion WHY: the nurse should recognize confusion as a manifestation of hypoglycemia

a nurse is teaching a client about measures to reduce the risk of osteomalacia. which of the following instructions should the nurse include in the teaching?

consume 20 mcg of vitamin D daily. WHY: The nurse should instruct the client to consume 20 mcg of vitamin D daily. Osteomalacia is characterized by a lack of vitamin D, which leads to insufficient bone mineralization. This disorder coincides with osteoporosis, thereby increasing the risk of falls leading to fractures in older adult clients. Vitamin D supplements are recommended for clients age 65 and older to decrease bone loss and maintain bone mineralization, thereby reducing the risk of a softening of the bones.

a nurse is providing dietary teaching for a client who has COPD. which of the following instructions should the nurse include in the teaching?

consume foods that are soft in texture and easy to chew WHY: eating a soft diet and avoiding foods that are difficult to chew will decrease shortness of breath while eating.

A nurse is providing teaching to a client who has dumping syndrome and is experiencing weight loss. Which of the following instructions should the nurse include in the teaching?

consume liquids between meals WHY: The nurse should teach the client to drink liquids between meals to slow movement of food from the stomach.

a nurse is providing dietary instructions for a client who has a prescription for warfarin. which of the following foods should the nurse recommend the client eat in moderation while taking this medications.

leafy green vegetables WHY: The nurse should recommend the client eat in moderation and maintain consistent intake of leafy green vegetables, which contain a natural form of vitamin K that can negate the anticoagulation effects of warfarin.

a nurse is caring for an adolescent who has type 1 diabetes mellitus. which of the following actions should the nurse take to assess for somogyi phenomenon?

monitor blood glucose levels during the night. WHY: somogyi phenomenon is fasting hyperglycemia that occurs in the morning in response to hypoglycemia during the nighttime. the nurse should assess for this phenomenon by monitoring blood glucose levels during the nights.

A nurse is caring for a client who has advanced Parkinson's disease and dysphagia. Which of the following actions should the nurse take?

offer the client a high-calorie diet WHY: The nurse should add high-calorie food to the client's diet because muscular rigidity increases metabolic rate, which increases caloric need.

a nurse is providing discharge teaching to a client who had parkinson's disease and a prescription for levodopa-carbidopa. which of the following foods should the nurse instruct the client to consume with the medication?

one slice wheat toast WHY: absorption of levodopa-carbidopa decreases when consumed with protein. one slice of wheat toast is the lowest source of protein at 3 g per slice.

A nurse id admitting a client who has had a fever and diarrhea for the past 3 days. which of the following findings should indicate to the nurse the client is dehydrated?

orthostatic hypotension WHY: The nurse should identify a client who is dehydrated can experience orthostatic hypotension due to the fluid loss from the client's body, which causes low blood volume, resulting in low blood pressure.

a nurse is providing teaching to a client who is a vegetarian and requires an increase in zinc intake. which of the following foods should the nurse include in the teaching as the best source of zinc?

pinto beans WHY: the nurse should determine that pinto beans are the best food source to recommend b/c they contain the highest amount of zinc per serving