Intro-nutrition
A client with myasthenia gravis experiences dysphagia. What is the priority risk associated with dysphagia that must be considered when planning nursing care? 1. Aspiration 2. Dehydration 3. Nutritional imbalance 4. Impaired communication
1. Aspiration
Which hormone does the nurse state is formed from cholesterol? 1. Insulin 2. Cortisol 3. Prolactin 4. Growth hormone
2. Cortisol
When providing care for a client who is receiving enteral feedings via a nasogastric (NG) tube, the nurse should take measures to prevent what serious complication? 1. Skin breakdown 2. Aspiration pneumonia 3. Retention ileus 4. Profuse diarrhea
2. Aspiration pneumonia
Which function must be addressed in the plan of care when a client has dysphagia? 1. Writing 2. Focusing 3. Swallowing 4. Understanding
3. Swallowing
During a routine checkup a client reports concerns over weight gain despite trying juice cleanses and other trend diets. The nurse records the client's weight and BMI at a healthy range, but the client states, "I wish I were as thin as my co-workers." The client is at risk for what culturally-bound condition? 1. Neurasthenia 2. Anorexia nervosa 3. Shenjing shuairuo 4. Ataque de nervios
2. Anorexia nervosa
To begin the administration of total parenteral nutrition (TPN), a client has a right subclavian central venous access device inserted. Immediately after insertion of the catheter, what is the priority nursing action? 1. Obtain a chest x-ray to determine placement. 2. Auscultate the lungs to evaluate breath sounds. 3. Draw a blood sample to assess blood glucose level. 4. Assess the right upper extremity for neurologic deficits.
2. Auscultate the lungs to evaluate breath sounds.
The nurse is preparing to administer a nasogastric tube feeding to a client via infusion pump. What is the most important assessment the nurse needs to perform before beginning the pump? 1. Checking for the last bowel movement 2. Checking for residual stomach contents 3. Checking to determine time of last medication for nausea 4. Checking to make sure the head of bed is elevated at least 15 degrees
2. Checking for residual stomach contents
A client has a low hemoglobin level that is attributed to an iron deficiency. Which foods should the nurse recommend that the client increase in the diet? Select all that apply. 1. Grapes 2. Spinach 3. Oranges 4. Beef liver 5. Cantaloupe
2. Grapes 4. beef liver
The school nurse conducts a class in nutrition planning for parents. What is the goal of school health nursing programs? 1. Health promotion 2. Disease management 3. Chronic care management 4. Environmental surveillance
2. Health promotion
A nurse teaches a pregnant woman about the need to increase her intake of complete proteins. Which foods identified by the client indicate that the teaching is effective? Select all that apply. 1. Nuts 2. Milk 3. Eggs 4. Bread 5. Beans 6. Cheese
2. Milk 3. Eggs 6. Cheese
A nurse enters the room of a client with myasthenia gravis and identifies that the client is experiencing increased dysphagia. What should the nurse do first? 1. Administer oxygen 2. Raise the head of the bed 3. Perform tracheal suctioning 4. Call the healthcare provider
2. Raise the head of the bed (do this FIRST, then alert the healthcare provider once patient is safe; use suction only if raising HOB does not work)
A nurse provides dietary instruction to a client who has iron deficiency anemia. Which food choices by the client does the nurse consider most desirable? Select all that apply. 1. Raw carrots 2. Boiled spinach 3. Dried apricots 4. Brussels sprouts 5. Asparagus spears
2. boiled spinach 3. dried apricots
Which iron-rich foods should the nurse recommend for a toddler-age client who is diagnosed with iron deficiency anemia? Select all that apply. 1. Carrots 2. Raisins 3. Oatmeal 4. Lean steak 5. Whole milk
2. raisins 3. oatmeal 4. lean steak
A nurse is teaching a client about a diet that permits 200 g of carbohydrates, 90 g of fat, and 110 g of protein. How many calories per day should the client eat? Record your answer using a whole number. ____ calories per day
2050 (Each gram of fat contains 9 calories, and each gram of carbohydrate and protein contains 4 calories. 800 + 810 + 440 = 2050)
Which represents appropriate nursing management of the client's nasogastric (NG) tube in the immediate postoperative period following gastroduodenostomy? 1. Advancing the tube to the original insertion depth if the tube becomes dislodged. 2. Obtaining a prescription to vigorously irrigate the nasogastric tube if clogging is noted. 3. Carefully monitoring the nasogastric tube to ensure that the tube is patent and the suction is working. 4. Reporting the presence of bright red gastric aspirant in the suction canister during the immediate postoperative period.
3. Carefully monitoring the nasogastric tube to ensure that the tube is patent and the suction is working.
A client with a history of Crohn disease develops an intestinal obstruction. A nasogastric tube is inserted and connected to low continuous suction. The nurse monitors the client for fluid volume deficit. What clinical finding does the nurse expect if the client becomes dehydrated? 1. Restlessness 2. Constipation 3. Inelastic skin turgor 4. Increased blood pressure
3. Inelastic skin turgor
During the administration of total parenteral nutrition (TPN), an assessment of the client reveals a bounding pulse, distended jugular veins, dyspnea, and cough. What is the priority nursing intervention? 1. Restart the client's infusion at another site. 2. Slow the rate of the client's infusion of the TPN. 3. Interrupt the client's infusion and notify the healthcare provider. 4. Obtain the vital signs and continue monitoring the client's status.
3. Interrupt the client's infusion and notify the healthcare provider
The diet prescribed for a client with diverticulosis includes 30 grams of fiber a day. Which breakfast items should the nurse encourage the client to select? 1. Cream of wheat, milk, and cranberry juice 2. Unstrained orange juice, pancakes, and bacon 3. Oatmeal, sliced bananas, whole wheat toast, and milk 4. Poached eggs on whole wheat toast, tomato juice, and tea
3. Oatmeal, sliced bananas, whole wheat toast, and milk
A nurse in the surgical intensive care unit is caring for a client with a large surgical incision. The nurse reviews a list of vitamins and expects that which medication may be prescribed because of its major role in wound healing? 1. Vitamin A (retinol) 2. Vitamin K (phytonadione) 3. Vitamin C (ascorbic acid) 4. Vitamin B12 (cyanocobalamin)
3. Vitamin C (ascorbic acid)
While counseling the parents of an adolescent with anemia related to an inadequate diet, a nurse explains that several different nutrients, including protein, iron, and vitamin B12, are involved. What other nutrient should the nurse include in the teaching? 1. Calcium 2. Thiamine 3. Folic acid 4. Riboflavin
3. folic acid
A nurse is assessing several clients. Which client will require parenteral nutrition? 1. A client with brain neoplasm 2. A client with anorexia nervosa 3. A client with inflammatory bowel disease 4. A client with severe malabsorption disorder
4. A client with severe malabsorption disorder (all the others will require eternal nutrition)
A client is placed on a heart-healthy diet to control the intake of saturated fats and cholesterol. Which information should the nurse include in a teaching plan to explain best the dietary nature of this diet? 1. Polyunsaturated fats come from animal foods such as meat. 2. Plant sources of cholesterol must be limited in the daily diet. 3. Saturated fats come from plant foods, such as seeds and grains. 4. Cholesterol is a necessary body constituent and cannot be eliminated.
4. Cholesterol is a necessary body constituent and cannot be eliminated.
A nurse who has agreed to serve as camp nurse for a week has an influx of children with abdominal pain late in the week. The nurse encourages the camp cook to increase the amounts of fruits and vegetables, whole grains, and other high-fiber foods in the meals. The nurse knows that this will help decrease the incidence of abdominal pain caused by which symptom? 1. Hunger 2. Vomiting 3. Appendicitis 4. Constipation
4. Constipation
The nurse is caring for a client with iron deficiency anemia that has decreased hemoglobin and hematocrit levels. The nurse expects to identify what other abnormal laboratory level? 1. Macrocytic red blood cells (RBCs) 2. Thrombocytopenia 3. Decreased folate levels 4. Increased total iron-binding capacity (TIBC)
4. Increased total iron-binding capacity (TIBC)
A nurse administers several vitamins as part of a client's medical regimen. Which prescribed vitamin is essential for the synthesis of prothrombin by the liver? 1. B12 2. C 3. D 4. K
4. K
The nurse teaches a group of clients that nutritional support of natural defense mechanisms indicates the need for a diet high in what nutrient or nutrients? 1. Essential fatty acids 2. Dietary cellulose and fiber 3. Tryptophan, an amino acid 4. Vitamins A, C, E, and selenium
4. Vitamins A, C, E, and selenium
Discharge teaching for a client with hypercholesterolemia includes nutritional instructions for a diet low in saturated fat. Which items included by the client on a list of foods to avoid support the nurse's conclusion that teaching is effective? 1. High-fiber foods 2. Canned vegetables 3. Citrus fruits and juices 4. Whole milk and hard cheeses
4. Whole milk and hard cheeses
What is the reason for calculating a body mass index (BMI)-for-age during a health maintenance assessment for school-age clients? 1. Assessing for bulimia nervosa 2. Monitoring for failure to thrive 3. Monitoring for anorexia nervosa 4. Assessing for obesity or overweight
4. assessing for obesity or overweight
A client is started on a clear liquid diet after surgery. Which items should the nurse offer the client? Select all that apply. 1. Gelatin 2. Broth 3. Yogurt 4. Ice milk 5. Ginger ale
1. Gelatin 2. Broth 5. Ginger ale
Which glands secrete hormones that regulate metabolism of carbohydrates, proteins, and fats? Select all that apply. 1. Pancreas 2. Thyroid gland 3. Adrenal cortex 4. Adrenal medulla 5. Parathyroid gland
1. pancreas 2. thyroid gland 3. adrenal cortex
A client eats a meal that contains 13 g of fat, 31 g of carbohydrates, and 5 g of protein. What is this client's total caloric intake for this meal? Record your answer using a whole number. ___ calories
261 (Fat contains 9 kilocalories per gram; carbohydrates and proteins contain 4 kilocalories per gram; therefore, 117 + 124 + 20 = 261 kilocalories.)
Immediately after a subtotal gastrectomy, a client is admitted to the postanesthesia care unit (PACU). The nurse irrigates the nasogastric tube and observes small blood clots in the return. Which is the best nursing intervention? 1. Clamp the nasogastric tube 2. Irrigate the tube with iced saline 3. Document this expected response 4. Notify the healthcare provider of this finding
3. Document this expected response
Three days after admission to the hospital for a brain attack (cerebrovascular accident, CVA), a client has a nasogastric tube inserted and is receiving continuous tube feedings. Which action should the nurse take to best evaluate whether the feeding is being absorbed? 1. Aspirate for a residual volume 2. Evaluate the intake in relation to the output 3. Instill air into the client's stomach while auscultating 4. Compare the client's body weight with the baseline data
1. Aspirate for a residual volume
A client with malabsorption syndrome is admitted to the hospital for medical intervention. A subclavian catheter is inserted, and the client is started on total parenteral nutrition (TPN). What should the nurse teach the client in order to prevent the most common complication of TPN? 1. Avoid disturbing the dressing or getting it wet. 2. Keep the head as still as possible whenever moving. 3. Regulate the flow rate on the infusion pump as necessary. 4. Monitor daily weights at the same time while wearing the same clothing.
1. Avoid disturbing the dressing or getting it wet.
A client's serum albumin value is 2.8 g/dL (28 g/L). Which food selected by the client indicates that the nurse's dietary teaching is successful? 1. Beef broth 2. Fruit salad 3. Sliced turkey 4. Spinach salad
3. Sliced turkey
A client who takes daily megadoses of vitamins is hospitalized with joint pain, loss of hair, yellow pigmentation of the skin, and an enlarged liver due to vitamin toxicity. What type of toxicity does the nurse suspect? 1. Retinol (vitamin A) 2. Thiamine (vitamin B1) 3. Pyridoxine (vitamin B6) 4. Ascorbic acid (vitamin C)
1. Retinol (vitamin A)
The nurse is counseling a client with type 1 diabetes about the client's favorite foods that are lowest in carbohydrates (CHO). Which food choice picked by the client determines that teaching was effective? 1. Skim milk 2. Apple juice 3. Nonfat yogurt 4. Fresh orange juice
1. Skim milk
A nurse is teaching a community group about the basics of nutrition. A participant questions why fluoride is added to drinking water. The nurse should respond that it is a necessary element added to drinking water to promote what? 1. Dental health 2. Growth and development 3. Improved hearing 4. Night vision
1. Dental health
After gastric surgery a client has a nasogastric tube in place. What should the nurse do when caring for this client? 1. Monitor for signs of electrolyte imbalance. 2. Change the tube at least once every 48 hours. 3. Connect the nasogastric tube to high continuous suction. 4. Assess placement by injecting 10 mL of water into the tube.
1. Monitor for signs of electrolyte imbalance.
Thiamine (vitamin B1) and niacin (vitamin B3) are prescribed for a client with alcoholism. Which body function maintained by these vitamins should the nurse include in a teaching plan? 1. Neuronal activity 2. Bowel elimination 3. Efficient circulation 4. Prothrombin development
1. Neuronal activity
A nurse is developing a teaching plan for a child who has anemia as a result of inadequate nutrition. In addition to iron, which nutrients should the nurse include that are necessary for red blood cell synthesis? Select all that apply. 1. Protein 2. Calcium 3. Vitamin C 4. Vitamin D 5. Carbohydrates
1. Protein 3. Vitamin C
What should the nurse teach the young mother about the nutritional needs of the newborn? 1. The newborn should be breastfed for the first twelve months. 2. The newborn should be given 2% cow's milk if breast feeding is not possible. 3. The newborn should receive solid food in addition to milk starting from the fourth month. 4. The breastfed newborn should receive iron supplements during the first four months.
1. The newborn should be breastfed for the first twelve months.
A client is admitted to the hospital with gastrointestinal bleeding, and a nasogastric tube is inserted. The healthcare provider prescribes the nasogastric tube to be irrigated with normal saline whenever necessary to maintain patency. What should the nurse do first when it is determined that the nasogastric tube is not patent? 1. Instill normal saline. 2. Assess breath sounds. 3. Auscultate for bowel sounds. 4. Check the tube for placement.
4. Check the tube for placement.