Nutrition for Nursing
A nurse is caring for a client who is receiving total parenteral nutrition and is prescribed an oral diet. The client asks the nurse why the TPN is being continued since he is now eating. Which of the following is an appropriate response by the nurse? A) "Your blood glucose levels need to be within normal range before the parenteral nutrition can be stopped "B) "You should consume at least 60 percent of your calories orally before the parenteral nutrition can be discontinued" C) "You should have a weight gain of at least 1 kilogram per day before the therapy is stopped" D) "Your bowel movements need to be regular before the therapy can be discontinued"
"B) "You should consume at least 60 percent of your calories orally before the parenteral nutrition can be discontinued"
A nurse is assisting a client who has dysphagia with an oral feeding. Which of the following actions should the nurse take? (Select all that apply) 1. gently palpate the clients throat during swallowing 2. Position the client in a semi-Fowler's position at 45 degrees 3. Inspect for food pockets in the mouth before feeding 4. Allow the client to rest for 30 minutes before meals 5. Hyperextend the client's neck during swallowing
1, 3, 4
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.)
580 ml
A nurse is teaching a client who is overweight about nutritional recommendations during pregnancy. The nurse should identify that which of the following statements by the client indicates an understanding of teaching? A) "I should take an iron supplement during pregnancy" B) "I should reduce my protein intake during pregnancy" C) "I should gain about 30 pounds during pregnancy" D "I should increase my fat intake during pregnancy"
A) "I should take an iron supplement during pregnancy" Iron deficiency = menstruating, older infants, toddlers, and pregnant.
A nurse is providing teaching regarding diet modifications to a client who is at high risk for cardiovascular disease. The client is accustomed to traditional Mexican foods and wants to continue to include them in her diet. Which if the following recommendations should the nurse give the client? A) Use canola oil instead of lard for frying B) Use soy milk instead of using cow's milk C) Use vegetables in salads rather than soups D) Limit ground beef intake to 8 oz per day
A) Use canola oil instead of lard for frying
A nurse is caring for a client who practices Orthodox Judaism and adheres to a kosher diet. Which of the following food choices would be appropriate for this client? A) Vegetable salad with cheese B) Lean cuts of pork C) Turkey and cheese on rye bread D) Shrimp salad and crackers
A) Vegetable salad with cheese
nurse is teaching a client who has a prescription for ferrous sulfate about food interactions. Which of the following statements indicates that the client understands the teaching?A. "I can take this medication with juice." B. "I can take this medication with my eggs at breakfast." C. "I will drink low-fat milk when taking this medication." D. "I will take this medication with my coffee."
A. "I can take this medication with juice."
A nurse is reviewing laboratory findings of a client who has acute pancreatitis. Which of the following is an expected finding? A) Increased serum calcium B) Decreased serum bilirubin C) Increased serum glucose D) Decreased serum alkaline phosphatase
Answer: Increased serum glucose Due to decreased insulin production from pancreas, the glucose levels will rise.. The nurse should anticipate the rest of the answers with this diagnosis
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?A. Consume liquids between meals B. Increase intake of simple carbohydrates C. Decrease foods high in fat content D. Eat meals low in protein
A. Consume liquids between meals *a group of symptoms, including weakness, abdominal discomfort, and sometimes abnormally rapid bowel evacuation, occurring after meals in some patients who have undergone gastric surgery.
A nurse is assessing a client who is suspected of having lactose intolerance. Which of the following is an expected finding? A) Flatulence B) Bloody stools C) Hyperemesis D) Steatorrhea
A. Flatulence (passing gas) NOT CORRECT: Hyperemesis = A severe type of nausea and vomiting during pregnancy. Steatorrhea = Oily, smelly stools, which often float.
A nurse is developing an educational program about the glycemic index of foods for clients who have diabetes mellitus. Which of the following foods should the nurse identify as having the highest glycemic index? A) Sweet corn B) Macaroni C) Baked potato D) Peanuts
C) Baked potato
A nurse is caring for a client who is being treated for cancer using chemotherapy. Which of the following interventions should the nurse suggest to aid in management of treatment-related changes in taste? A. Use plastic utensils B. Limit fluids with meals C. Serve meals while they are hot D. Eat bland, unseasoned foods
A. Use plastic utensils *Chemotherapy changes the taste buds so that using metal silverware suddenly causes a bitter metallic aftertaste
A nurse is providing dietary teaching about reducing the risk of infection to a client who has cancer and is recieveing chemotherapy. Which of the following statements made by the client indicates an understanding of the teaching? A) "I will thaw my food at room temperature" B) "I will discard my leftovers after three days" C) "I should use home canned goods within 2 years of canning" D) "I should heat my food to at least 120 degrees Fahrenheit"
Answer: "I will discard my leftovers after three days" Foods should be thawed in the fridge, leftovers should be thrown out after 3-4 days, canned goods should be eaten within a year, and food should be heated to at least 140 degrees
nurse is teaching a client about stress management. Which of the following statements by a client should indicate to the nurse that the client understands the teaching? A) "I will take a long walk every evening" B) "I will keep a daily diet and activity log" C) "I will avoid eating one hour before bedtime" D) "I will drink one full glass of water with each meal"
Answer: "I will take a long walk every evening" Exercise can create relaxation and reduces stress. Keeping a daily activity log can cause awareness of how the person eats and weighs causing stress. A person should avoid eating 2-3 hours before bed. Drinking a full glass of water will promote fullness not reduce stress.
A nurse is providing dietary teaching 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? A) I cup apple slices B) 4 oz low-fat cottage cheese C) 4 oz ground beef patty D) 1 cup raw spinach
Answer: 4 oz ground beef patty Ground beef patty contains 5.49 mg of zinc, making it the best choice **Oysters contain more zinc per serving than any other food, but red meat and poultry provide the majority of zinc in the American diet. Other good food sources include beans, nuts, certain types of seafood (such as crab and lobster), whole grains, fortified breakfast cereals, and dairy products
A nurse is providing information regarding breastfeeding to the parents of a newborn. Which of the following statements should the nurse make?' A) "Breast milk is nutritionally complete for an infant up to six months of age B) "Iron-fortified infant formulas are nutritionally inferior to breast milk C) Supplement water is need to provide adequate fluid intake D) Use whole cow's milk if you discontinue breastfeeding in the first year
Answer: Breast milk is nutritionally complete for an infant up to six months of age
A nurse is providing dietary teaching for a client who has COPD. Which of the following instructions should the nurse include in the teaching? A) Eat at least three well-proportioned, large meals a day B) Drink low-protein, low-calorie nutrition formulas between meals C) Avoid adding gravies and sauces to foods D) Consume foods that are soft in texture and easy to chew
Answer: Consume foods that are soft in texture and easy to chew Client's who have COPD do not have the energy to eat three large meals and should eat six small meals throughout the day, they should drink high protein and high calorie formulas, they should add gravy to help prevent dry mouth, and foods that are hard to chew will cause SOB
A nurse is planning to provide dietary teaching to a client who has chronic kidney disease and is prescribed hemodyalysis. Which of the following actions should the nurse plan to take first? A) Create a schedule for the client to limit fluid intake B) Provide the client with a list of foods that are high in sodium C) Determine whether the client has culture-related food preferences D) Explain the purpose of protein restriction in the diet
Answer: Determine whether the client has culture-related food preferences
A nurse is assessing a client who has diabetes mellitus. Which of the following findings should the nurse identify as manifestation of hypoglycemia. A) Diaphoresis B) Bradycardia C) Abdominal cramps D) Acetone breath
Answer: Diaphoresis (Sweating from sweat glands, often in response to heat, exercise, or stress.) Sweating, tachycardia, fatigue, hunger, pale skin are all symptoms of hypoglycemia
A nurse is planning nutritional teaching for the parents of a toddler who has failure to thrive. Which of the following instructions should the nurse include in the teaching? (Select all that apply) 1. Eliminate environmental disruptions during meals 2. Stop the meal when the toddler exhibits negative behavior 3. Provide 240 ml of fruit juice in between meals 4. Schedule meals the time same time each day 5. Allow the toddler to determine the length of the meal
Answer: Eliminate environmental disruptions during meals and schedule meal times at the same time each day
A nurse is providing treatment for a client who has a new prescription for nifedipine. Which of the following foods should the nurse instruct the client to avoid? A) Milk B) Aged cheese C) Grapefruit juice D) Bananas
Answer: Grapefruit juice Drinking grapefruit juice while on this medication can result in increased risk for adverse effects
A nursing 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? A) "I should drink liquids with meals" B) "I will eat dry cereal before I get out of bed" C) "I will increase my fat content in my diet" D) "I should drink a hot cup of tea in between meals"
Answer: I will eat dry cereal before I get out of bed Drinking liquids with meals can cause abdominal distension, dry cereal can be absorbed quickly and raise blood sugars reducing nausea, high-fat content in diet can cause delay in gastric emptying time, and the client should avoid caffeinated drinks that can cause heartburn
A nurse in a clinic is providing nutritional counseling to a client who wants to lose weight. The nurse should identify that which of the following statements indicates the client understands the counseling? A) "I will taste my foods while I am cooking"B) "I will exclude breads and pastries from my diet" C) "I will make a list before I go grocery shopping" D) "I will skip lunch if I am too busy to have something healthy"
Answer: I will make a list before I go grocery shopping
A nurse is performing dietary teaching with a client who has a family history of cardiovascular disease. Which of the following statements should the nurse include in the teaching ?A) "Restrict your dietary potassium intake" B) "Increase your dietary fiber intake" C) "Increase your intake of trans fatty acids" D) "Restrict your protein intake"
Answer: Increase your dietary fiber intake Increasing fiber can help reduce cholesterol levels, increase potassium can help prevent hypertension, increased fatty acids can increase risk of heart disease, increased protein can help prevent hypertension
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? A) Monitor blood glucose levels during the night B) Check for urinary ketones at the same time each day for 1 week C) Perform an oral glucose tolerance test after administering a dose of insulin D) Compare current glycosylated hemoglobin level with the level at the time of diagnosis
Answer: Monitor blood glucose levels during the night Somogyi phenomenon is elevated blood sugars in the morning, checking them at night can help prevent
A nurse is planning dietary teaching for a client who has dumping syndrome following a gastrectomy. Which of the following interventions should the nurse include in the client's plan of care? A) Use simple sugars to sweeten food B) Remain upright for one hour following meals C) Limit eating three large meals per day D) Select grains with less than 2 g fiber per serving
Answer: Select grains with less than 2 g fiber serving Selecting grains with low fiber can help slow gastric emptying time allowing food to sit and digest longer in the stomach
A nurse in a clinic is reviewing the laboratory findings of a client who has type 2 diabetes mellitus. Which if the following findings indicates the client's plan of care is effective? A) Serum creatinine 1.5 mg/dl B) BUN 25 mg/dl C) hbA1c 6.5% D) Pre-meal blood glucose 145 mg/d
Answer: hbA1c 6.5% Any test less than 7% is effective
A nurse is preparing a healthy promotion seminar for a group of clients about cancer prevention. Which of the following information should the nurse include in the seminar? A) Consume high-calorie foods and beverages at meal time B) Eat at least 2.5 cups of fruit and vegetables each day C) Plan to perform moderate-intensity exercise for 90 minutes a week D) Limit alcohol consumption to no more than three drinks per week
B) Eat at least 2.5 cups of fruit and vegetables each day
A nurse is caring for a client who is at eight weeks gestation and has a BMI of 34. The client asks about weight goals during her pregnancy. The nurse should advise the client to do which of the following? A) Maintain her current BMI B) Gain approximately 15 pounds C) Lower her BMI 30 D) Gain 12.5 to 15.8 kg
B) Gain approximately 6.8 kg 15 pounds
A nurse is providing information about cardiovascular risk to a client who has received his lipid panel report. Which of the following is within an expected reference range to include this information? A) Total cholesterol 210 mg/dl B) HDL 79 mg/dl C) Triglycerides 175 mg/dl D) LDL 137 mg/dl
B) HDL 79 mg/dl
A nurse is caring for a client who is recieveing continuous enteral feedings via an NG tube. Which of the following actions should the nurse take to reduce the risk for aspiration if the client develops abdominal distension? A) Place the client on bed rest B) Position the client on his right side C) Increase the rate for 30 min then clamp the tube for 30 min D) Switch the client to a higher-fat formula
B) Position the client on his right side This helps move gastric juices through the system, helping the client move can promote peristalsis, increasing the rate will make the distension worse, and a high-fat formula will cause distension and bloating
A nurse in a provider's office is assessing a client who has HIV. The nurse should identify which of the following findings as an indication to increase the client's nutritional intake? A) T-helper (CD4+) cells 700/mm3 B) Presence of herpes simplex virus C) HIV viral load below detectable levels D) Increased lean body mass
B) Presence of herpes simplex virus
A nurse in an acute care facility is planning care for a client who has chosen to follow Islamic dietary laws during Ramadan. Which of the following actions should the nurse plan to take? A) Place the client on NPO status during nighttime hours B) Provide a snack for the client after sunset C) Offer the client hot tea with daytime meals D) Allow the client to eat privately with his family each day at 1300
B) Provide a snack for the client after sunset
A nurse is planning care for a client who is obese and wants to lose weight. Which of the following actions should the nurse take first? A. Recommend checking weight once weekly B. Obtain a 24-hr dietary recall C. Assist with creating an exercise plan D. Initiate a diet modification plan
B. Obtain a 24-hr dietary recall
A nurse is reviewing the laboratory results of a client who has a pressure ulcer. Which if the following findings should indicate to the nurse that the client is at risk for impaired wound healing? A) Hgb 15 g/dl B) Serum Albumin 3.0 g/dl C) Prothrombin time 11.5 seconds D) WBC 6,000/mm3
B. Serum Albumin 3.0 g/dl Serum albumin range is 3.5-5.0, anything less will decrease wound healing
A nurse in a long-term care facility is monitoring a client who has Parkinson's disease during mealtime. Which of the following findings should the nurse identify as the priority? A. The client eats all of his cake and a few bites of bread B. The client drools while eating C. The client's hand trembles when he holds his spoon D. The client chooses to sit alone during the meal
B. The client drools while eating
A nurse is providing education to an adolescent about making nutrition-dense food choices. Which of the following indications of the client indicates an understanding of the teaching? A) "Pasta with white sauce is a better choice than pasta with red sauce" B) "Sweetened fruit yogurt is a healthy breakfast choice" C) Canned pinto beans are a better choice than refried beans D) Sausage is a healthy choice of protein
C) Canned pinto beans are a better choice than refried beans
A nurse is caring for a client who has advanced Parkinson's disease and dysphagia. Which of the following actions should the nurse take? A) Turn the television on to distract the client during meals B) Give the client fluids to clear his mouth of solid foods during meals C) Offer the client a high-calorie diet D) Encourage the client to maintain a low-Fowler's position following meals
C) Offer the client a high-calorie diet
A nurse is providing discharge teaching to a client who has a new ileostomy. Which of the following dietary guidelines should the nurse include in the teaching? A) Plan to reduce dietary salt intake B) Cook foods with limited amounts of pasta products C) Prepare meals on a schedule D) Reduce dietary B12
C) Prepare meals on a schedule
A nurse is teaching a female client about a healthy diet to control hypertension. Which of the following client statements indicates an understanding of the teaching? A. "I will drink two glasses of whole milk daily." B. "I will decrease the potassium in my diet." C. "I will eat four servings of unsalted nuts per week." D. "I will limit alcohol consumption to two drinks per day."
C. "I will eat four servings of unsalted nuts per week." *Magnesium can help in lowering high blood pressure. Green leafy vegetables, seeds and nuts (e.g. almonds, cashew nuts, sunflower seeds and pumpkin seeds) are good sources of magnesium.
A nursing is planning discharge teaching for a client who is postoperative following a placement of a colostomy. Which of the following information should the nurse include? A. "resume a regular diet by 4 weeks after surgery" B. "Add high fiber foods to your diet" C. "increase your intake of foods containing pectin" D. "drink 4 to 6 cups of water per day"
C. "increase your intake of foods containing pectin" Pectin is a fiber found in fruits. It is used to make medicine. People use pectin for high cholesterol, high triglycerides, and to prevent colon cancer and prostate cancer. It is also used for diabetes and gastroesophageal reflux disease (GERD).
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 . A) Grapefruit juice B) Whole milk C) Whole grain bread D) Cheddar cheese
D) Cheddar cheese *MAOI= Monoamine oxidase inhibitor
A nurse is caring for a client who is receiving total parenteral nutrition (TPN) through a peripherally inserted central catheter. The pharmacist informs the nurse that there will be a delay in delivering the next bag of TPN solution. Which of the following actions should the nurse take? A. Slow the rate of the current infusion B. Infuse 0.9% sodium chloride when the current infusion ends C. Infuse dextrose 10% in water when the current infusion ends D. Remove the tubing and flush the access device when the current infusion ends
C. Infuse dextrose 10% in water when the current infusion ends
A nurse is caring for a client who is receiving total parenteral nutrition (TPN). Which of the following laboratory findings indicates that the TPN therapy is effective? A. Calcium 8 mg/mL B. Hemoglobin 9 g/dL C. Prealbumin 30 mg/dL D. Cholesterol 140 mg/dL
C. Prealbumin 30 mg/dL
A nurse is teaching a client about managing irritable bowel syndrome. Which of the following information should the nurse include in the teaching? A) Increase intake of fresh fruit high in fructose B) Limit foods that contain probiotics C) Take peppermint oil during exacerbation of manifestations D) Substitute white sugar with honey
C. Take peppermint oil during exacerbation of manifestations Fresh fruit can cause increase of manifestations, probiotics can cause an increase in bacteria, honey is high in fructose and is difficult to absorb, peppermint helps soothe and relax the muscles of the GI tract
A nurse is planning strategies to reduce the intake of solid fats for a client who has hyperlipidemia. Which of the following strategies should the nurse include in the plan? A) Choose cheese with 4 g of fat per serving B) Limit eating four eggs with yolks per week C) Choose eating ground meat that is 75% lean D) Limit meat to 5 oz per day
D) Limit meat to 5 oz per day
A nurse is reviewing the introduction of solid foods with the parent of a 4-month-old infant. Which if the following statements by the parent indicates an understand of the teaching? A) "My baby should consume 2 tablespoons of solid food at each feeding" B) "The majority of my baby's calories should come from solid food" C) "I will give my baby one bottle of fruit juice every day" D) "I will introduce a new solid food every 5 days"
D) "I will introduce a new solid food every 5 days"
A client is experiencing anorexia related to cancer treatment. Which of the following interventions should the nurse implement to increase the client's nutritional intake? A) Recommend cooking aromatic foods to stimulate appetite B) Serve hot foods rather than cold foods C) Instruct the client to eat three meals per day D) Add extra calories and protein to every meal
D) Add extra calories and protein to every meal
A client reports constipation during a routine check up. The client was previously encouraged to increase his intake of mineral supplements. Which of the following minerals should the nurse identify as the cause of constipation? A) Phosphorus B) Potassium C) Magnesium D) Calcium
D) Calcium Calcium decreases peristalsis
A nurse is educating a group of women about vitamin and mineral intake during pregnancy. Which of the following should the nurse instruct the women to avoid taking at the same time as iron supplements? A) Magnesium B) Vitamin b12 C) Vitamin A D) Calcium
D) Calcium High doses of calcium, especially calcium carbonate, the form found in most supplements, can block the absorption of iron
A nurse is assessing an older adult client for dysphagia following a stroke. The nurse should identify which of the following findings as a manifestation of dysphagia? A) The client reports abdominal pain after eating B) The client has an increase in bowel sounds after eating C) The client has a loss of appetite D) The client has a change in his voice after eating
D) The client has a change in his voice after eating
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 the understanding of the teaching? A) "I am including vegetables as starch items in my carbohydrate count B) "I am limiting the number of carbohydrates to four carbohydrates to four carbohydrate choices or 60 grams per day" C) "I know the serving size can affect the number of carbohydrates I eat" D) "I know the carbohydrate count is dependent on the calorie in the food items"
D. "I know the serving size can affect the number of carbohydrates I eat" The nurse should teach the client between starchy and nonstarchy vegetables, 45 grams are usually allowed during a meal (three to five carb choices), carbohydrate count is not dependent on calorie count
A home health nurse is providing dietary teaching to the parents of a 3-year-old child. Which of the following statement by the parents should the nurse identify as understanding of the teaching? A. "I will offer my child a cup of peanut butter to dip her celery in." B. "I can leave her grapes whole so that she can practice getting them with her fork." C. "I can giver her popcorn as a snack to provide a serving of whole grains." D. "I will put low-fat milk in her cup for her to drink."
D. "I will put low-fat milk in her cup for her to drink."
A nurse is providing dietary teaching for a client who has osteoporosis. The nurse should instruct the client that which of the following foods has the highest amount of calcium? A. 1 cup avocado B. 2 tablespoons peanut butter C. 1/2 cup roasted sunflower seeds D. 1/2 cup roasted almonds
D. 1/2 cup roasted almonds
A nurse is planning care for a client who has a new prescription for enteral nutrition by intermittent tube feeding. Which of the following actions should the nurse include in the plan of care?A. Use cooled formula for feeding B. Initiate the feeding at half-strength for the first 24 hr C. Administer the feeding over 10 min D. Increase the volume of formula over the first four to six feedings
D. Increase the volume of formula over the first four to six feedings
A nurse is leading a discussion at a prenatal education class with a group of expectant mothers who plan to breastfeed. Which of the following instructions should the nurse include in the teaching? A. Offer supplemental formula until the milk supply is established B. Offer the newborn 30 mL (1 oz) of glucose water after the first breastfeeding session C. Plan to breastfeed the newborn every 4 hr D. Plan 5 min feedings on each breast on the first day after birth
D. Plan 5 min feedings on each breast on the first day after birth Avoid using supplemental formula because this can confuse the newborn, do not give baby anything other than breast milk, newborns feed about 8-12 times a day
A nurse is preparing to administer intermittent enteral tube feedings to a client. In what order should the nurse perform the following actions before beginning feeding? 1. Flush tubing with 30 ml of water 2. Place the client in Fowler's position 3. Check residual 4. Verify tube placement
Place client in Fowler's position,Verify tube placement, Check residual, Flush tubing with 30 ml of water
what is the normal HDL (high density lipoprotein) range?
greater than 60mg/dl (lower than 40 is too low)
what is the normal LDL (low density lipoprotein) range?
less than 100mg/dl, although levels of 100-129 are acceptable in people with no health issues
what is the normal range for triglycerides?
less than 150mg/dl
what is the normal range for cholesterol levels?
less than 200mg/dl
What does a lipid panel screen for?
screening tool for abnormalities in lipids, such as cholesterol and triglycerides