chapter 45
The nurse is describing the ChooseMyPlate program to a patient. Which statement from the patient indicates successful learning? a. "I can use this to make healthy lifestyle food choices." b. "I can use this to count specific calories of food." c. "I can use this for my baby girl." d. "I can use this when I am sick."
a. "I can use this to make healthy lifestyle food choices."
When assessing patient with nutritional needs, which patients will require follow-up from the nurse? (Select all that apply.) a. A patient with infection taking tetracycline with milk b. A patient with irritable bowel syndrome increasing fiber c. A patient with diverticulitis following a high-fiber diet daily d. A patient with an enteral feeding and 500 mL of gastric residual e. A patient with dysphagia being referred to a speech-language pathologist
a. A patient with infection taking tetracycline with milk c. A patient with diverticulitis following a high-fiber diet daily d. A patient with an enteral feeding and 500 mL of gastric residual
To honor cultural values of patients from different ethnic/religious groups, which actions demonstrate culturally sensitive care by the nurse? (Select all that apply.) a. Allows fasting on Yom Kippur for a Jewish patient b. Allows caffeine drinks for a Mormon patient c. Serves no ham products to a Muslim patient d. Serves kosher foods to a Christian patient e. Serves no meat or fish to a Hindu patient
a. Allows fasting on Yom Kippur for a Jewish patient c. Serves no ham products to a Muslim patient e. Serves no meat or fish to a Hindu patient
The patient is an 80-year-old male who is visiting the clinic today for a routine physical examination. The patient's skin turgor is fair, but the patient reports fatigue and weakness. The skin is warm and dry, pulse rate is 116 beats/min, and urinary sodium level is slightly elevated. Which instruction should the nurse provide? a. Drink more water to prevent further dehydration. b. Drink more calorie-dense fluids to increase caloric intake. c. Drink more milk and dairy products to decrease the risk of osteoporosis. d. Drink more grapefruit juice to enhance vitamin C intake and medication absorption.
a. Drink more water to prevent further dehydration.
A nurse is teaching a nutrition class about the different daily values. When teaching about the referenced daily intakes (RDIs), which information should the nurse include? a. Have values for protein, vitamins, and minerals b. Are based on percentages of fat, cholesterol, and fiber c. Have replaced recommended daily allowances (RDAs) d. Are used to develop diets for chronic illnesses requiring 1800 cal/day
a. Have values for protein, vitamins, and minerals
The patient is on parenteral nutrition and is lethargic. The patient reports thirst and headache and has had increased urination. Which problem does the nurse prepare to address? a. Hyperglycemia b. Hypoglycemia c. Hypercapnia d. Hypocapnia
a. Hyperglycemia
The patient is asking the nurse about the best way to stay healthy. The nurse explains to the patient which teaching points? (Select all that apply.) a. Increase physical activity. b. Keep total fat intake to 10% or less. c. Maintain body weight in a healthy range. d. Choose and prepare foods with little salt. e. Increase intake of meat and other high-protein foods.
a. Increase physical activity. c. Maintain body weight in a healthy range. d. Choose and prepare foods with little salt.
When planning care for an adolescent who plays sports, which modification should the nurse include in the care plan? a. Increasing carbohydrates to 55% to 60% of total intake b. Providing vitamin and mineral supplements c. Decreasing protein intake to 0.75 g/kg/day d. Limiting water before and after exercise
a. Increasing carbohydrates to 55% to 60% of total intake
A nurse is teaching a health class about the nutritional requirements throughout the life span. Which information should the nurse include in the teaching session? (Select all that apply.) a. Infants triple weight at 1 year. b. Toddlers become picky eaters. c. School-age children need to avoid hot dogs and grapes. d. Breastfeeding women need an additional 750 kcal/day. e. Older adults have altered food flavor from a decrease in taste cells.
a. Infants triple weight at 1 year. b. Toddlers become picky eaters. e. Older adults have altered food flavor from a decrease in taste cells.
The nurse is planning care for a group of patients. Which task will the nurse assign to the nursing assistive personnel? a. Measuring capillary blood glucose level b. Measuring nasoenteric tube for insertion c. Measuring pH in gastrointestinal aspirate d. Measuring the patient's risk for aspiration
a. Measuring capillary blood glucose level
The nurse is providing home care for a patient diagnosed with acquired immunodeficiency syndrome (AIDS). Which dietary intervention will the nurse add to the care plan? a. Provide small, frequent nutrient-dense meals for maximizing kilocalories. b. Prepare hot meals because they are more easily tolerated by the patient. c. Avoid salty foods and limit liquids to preserve electrolytes. d. Encourage intake of fatty foods to increase caloric intake.
a. Provide small, frequent nutrient-dense meals for maximizing kilocalories.
The patient has just started on enteral feedings, and the patient is reporting abdominal cramping. Which action will the nurse take next? a. Slow the rate of tube feeding. b. Instill cold formula to "numb" the stomach. c. Change the tube feeding to a high-fat formula. d. Consult with the health care provider about prokinetic medication.
a. Slow the rate of tube feeding.
A small-bore feeding tube is placed. Which technique will the nurse use to best verify tube placement? a. X-ray b. pH testing c. Auscultation d. Aspiration of contents
a. X-ray
The nurse is preparing to check the gastric aspirate for pH. Which equipment will the nurse obtain? a. 10-mL Luer-Lok syringe b. Asepto syringe c. Sterile gloves d. Double gloves
b. Asepto syringe
A nurse is teaching about the energy needed at rest to maintain life-sustaining activities for a specific period of time. What is the nurse discussing? a. Resting energy expenditure (REE) b. Basal metabolic rate (BMR) c. Nutrient density d. Nutrients
b. Basal metabolic rate (BMR)
A patient has a decreased gag reflex, left-sided weakness, and drooling. Which action will the nurse take when feeding this patient? a. Position in semi-Fowler's. b. Flex head with chin tuck. c. Place food on left side. d. Offer fruit juice.
b. Flex head with chin tuck.
The patient is admitted with facial trauma, including a broken nose, and has a history of esophageal reflux and of aspiration pneumonia. With which tube will the nurse most likely administer the feeding? a. Nasogastric tube b. Jejunostomy tube c. Nasointestinal tube d. Percutaneous endoscopic gastrostomy (PEG) tube
b. Jejunostomy tube
A nurse is caring for a group of patients. Which patient will the nurse see first? a. Patient receiving total parenteral nutrition of 2-in-1 for 50 hours b. Patient receiving total parenteral nutrition infusing with same tubing for 26 hours c. Patient receiving continuous enteral feeding with same feeding bag for 12 hours d. Patient receiving continuous enteral feeding with same tubing for 24 hours
b. Patient receiving total parenteral nutrition infusing with same tubing for 26 hours
In providing diabetic teaching for a patient with type 1 diabetes mellitus, which instructions will the nurse provide to the patient? 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. Nonnutritive sweeteners can be used without restriction. d. Cholesterol intake should be greater than 200 mg/day.
b. Saturated fat should be limited to less than 7% of total calories.
A patient develops a foodborne disease from Escherichia coli. When taking a health history, which food item will the nurse most likely find the patient ingested? a. Improperly home-canned food b. Undercooked ground beef c. Soft cheese d. Custard
b. Undercooked ground beef
The nurse is concerned about pulmonary aspiration when providing the patient with an intermittent tube feeding. Which action is the priority? a. Observe the color of gastric contents. b. Verify tube placement before feeding. c. Add blue food coloring to the enteral formula. d. Run the formula over 12 hours to decrease overload.
b. Verify tube placement before feeding.
.A nurse is preparing to administer an enteral feeding. In which order will the nurse implement the steps, starting with the first one? 1. Elevate head of bed to at least 30 degrees. 2. Check for gastric residual volume. 3. Flush tubing with 30 mL of water. 4. Verify tube placement. 5. Initiate feeding. a. 4, 2, 1, 5, 3 b. 2, 4, 1, 3, 5 c. 1, 4, 2, 3, 5 d. 2, 1, 4, 5, 3
c. 1, 4, 2, 3, 5
The patient has H. pylori. Which action should the nurse take? a. Encourage avoidance of wheat and oats. b. Encourage milkshakes as a nutritious snack. c. Encourage completion of antibiotic therapy. d. Encourage nonsteroidal antiinflammatory drugs.
c. Encourage completion of antibiotic therapy.
In providing prenatal care to a pregnant patient, what does the nurse teach the expectant mother? a. Calcium intake is especially important in the first trimester. b. Protein intake needs to decrease to preserve kidney function. c. Folic acid is needed to help prevent birth defects and anemia. d. Extra vitamins and minerals should be taken as much as possible.
c. Folic acid is needed to help prevent birth defects and anemia.
The patient has just been started on an enteral feeding and has developed diarrhea after being on the feeding for 2 hours. What does the nurse suspect is the most likely cause of the diarrhea? a. Antibiotic therapy b. Clostridium difficile c. Formula intolerance d. Bacterial contamination
c. Formula intolerance
Before giving the patient an intermittent gastric tube feeding, what should the nurse do? a. Make sure that the tube is secured to the gown with a safety pin. b. Inject air into the stomach via the tube and auscultate. c. Have the tube feeding at room temperature. d. Check to make sure pH is at least 5.
c. Have the tube feeding at room temperature.
The nurse is providing nutrition education to a Korean patient using the five food groups. In doing so, what should be the focus of the teaching? a. Discouraging the patient's ethnic food choices b. Changing the patient's diet to a more conventional American diet c. Including racial and ethnic practices with food preferences of the patient d. Comparing the patient's ethnic preferences with American dietary choices
c. Including racial and ethnic practices with food preferences of the patient
The patient with cardiovascular disease is receiving dietary instructions from the nurse. Which information from the patient indicates teaching is successful? a. Maintain a prescribed carbohydrate intake. b. Eat fish at least 5 times per week. c. Limit trans fat to less than 1%. d. Avoid high-fiber foods.
c. Limit trans fat to less than 1%.
A nurse is caring for a patient with a postsurgical wound. When planning care, which goal will be the priority? a. Reduce dependent nitrogen balance. b. Maintain negative nitrogen balance. c. Promote positive nitrogen balance. d. Facilitate neutral nitrogen balance.
c. Promote positive nitrogen balance.
In determining malnourishment in a patient, which assessment finding is consistent with this disorder? a. Moist lips b. Pink conjunctivae c. Spoon-shaped nails d. Not easily plucked hair
c. Spoon-shaped nails
The patient is having at least 75% of nutritional needs met by enteral feeding, so the health care provider has ordered the parenteral nutrition (PN) to be discontinued. However, the nurse notices that the PN infusion has fallen behind. What should the nurse do? a. Increase the rate to get the volume caught up before discontinuing. b. Stop the infusion as ordered. c. Taper infusion gradually. d. Hang 5% dextrose.
c. Taper infusion gradually.
In general, when a patient's energy requirements are completely met by kilocalorie (kcal) intake in food, which assessment finding will the nurse observe? a. Weight increases. b. Weight decreases. c. Weight does not change. d. Weight fluctuates daily.
c. Weight does not change.
.A nurse is asked how many kcal per gram fats provided. How should the nurse answer? a. 3 b. 4 c. 6 d. 9
d. 9
A nurse is caring for patients with dysphagia. Which patient has neurogenic dysphagia? a. A patient with benign peptic stricture b. A patient with muscular dystrophy c. A patient with myasthenia gravis d. A patient with stroke
d. A patient with stroke
The nurse is teaching a health class about the ChooseMyPlate program. Which guidelines will the nurse include in the teaching session? a. Balancing sodium and potassium b. Decreasing water consumption c. Increasing portion size d. Balancing calories
d. Balancing calories
The patient is to receive multiple medications via the nasogastric tube. The nurse is concerned that the tube may become clogged. Which action is best for the nurse to take? a. Instill nonliquid medications without diluting. b. Irrigate the tube with 60 mL of water after all medications are given. c. Mix all medications together to decrease the number of administrations. d. Check with the pharmacy for availability of the liquid forms of medications.
d. Check with the pharmacy for availability of the liquid forms of medications.
The nurse is assessing a patient for nutritional status. Which action will the nurse take? a. Forego the assessment in the presence of chronic disease. b. Use the Mini Nutritional Assessment for pediatric patients. c. Choose a single objective tool that fits the patient's condition. d. Combine multiple objective measures with subjective measures.
d. Combine multiple objective measures with subjective measures.
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." Which information will the nurse include in the teaching session? a. Cholesterol intake needs to be less than 300 mg/day. b. Fats have no significance in health and the incidence of disease. c. All fats come from external sources so this can be easily controlled. d. Deficiencies occur when fat intake falls below 10% of daily nutrition.
d. Deficiencies occur when fat intake falls below 10% of daily nutrition.
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, how should the nurse measure the tube? a. From the tip of the nose to the earlobe b. From the tip of the earlobe to the xiphoid process c. From the tip of the earlobe to the nose to the xiphoid process d. From the tip of the nose to the earlobe to the xiphoid process
d. From the tip of the nose to the earlobe to the xiphoid process
A nurse is teaching a patient about proteins that must be obtained through the diet and cannot be synthesized in the body. Which term used by the patient indicates teaching is successful? a. Amino acids b. Triglycerides c. Dispensable amino acids d. Indispensable amino acids
d. Indispensable amino acids
A patient is on a full liquid diet. Which food item choice by the patient will cause the nurse to intervene? a. Custard b. Frozen yogurt c. Pureed vegetables d. Mashed potatoes and gravy
d. Mashed potatoes and gravy
The patient has a calculated body mass index (BMI) of 34. How will the nurse classify this finding? a. Normal weight b. Underweight c. Overweight d. Obese
d. Obese
In teaching mothers-to-be about infant nutrition, which instruction should the nurse provide? a. Supplement breast milk with corn syrup. b. Give cow's milk during the first year of life. c. Add honey to infant formulas for increased energy. d. Provide breast milk or formula for the first 4 to 6 months.
d. Provide breast milk or formula for the first 4 to 6 months.
In providing diet education for a patient on a low-fat diet, which information is important for the nurse to share? a. Polyunsaturated fats should be less than 7% of the total calories. b. Trans fat should be less than 7% of the total calories. c. Unsaturated fats are found mostly in animal sources. d. Saturated fats are found mostly in animal sources.
d. Saturated fats are found mostly in animal sources.
The nurse is caring for a patient receiving total parenteral nutrition (TPN). Which action will the nurse take? a. Run lipids for no longer than 24 hours. b. Take down a running bag of TPN after 36 hours. c. Clean injection port with alcohol 5 seconds before and after use. d. Wear a sterile mask when changing the central venous catheter dressing.
d. Wear a sterile mask when changing the central venous catheter dressing.
