Nutrition Med Surg

A nurse caring for adults with obesity recognizes that obesity is classified based on BMI. Which BMI does the nurse recognize as Class II obesity? 35 kg/m2 29 kg/m2 34 kg/m2 40 kg/m2

35 kg/m2 Explanation: Class I obesity is defined as 30-34.9 kg/m2. Class II obesity is defined as a BMI of 35-39.9 kg/m2. A BMI of 40 kg/m2 or greater defines Class III obesity.

A client reporting shortness of breath is admitted with a diagnosis of cirrhosis. A nursing assessment reveals an enlarged abdomen with striae, an umbilical hernia, and 4+ pitting edema of the feet and legs. What is the most important data for the nurse to monitor? Temperature Albumin Hemoglobin Bilirubin

Albumin Explanation: With the movement of albumin from the serum to the peritoneal cavity, the osmotic pressure of the serum decreases. This, combined with increased portal pressure, results in movement of fluid into the peritoneal cavity. The low oncotic pressure caused by hypoalbuminemia is a major pathophysiologic factor in the development of ascites and edema.

A nurse prepares nutrition education for a client who will undergo bariatric surgery. What nutrition suggestion best indicates a beneficial effect on the number and quality of bowel movements the client may have after surgery? Increase fluid intake Avoid high-fat foods Eat a wide variety of foods Increase protein intake

Avoid high fat foods Explanation Reducing the amount of fat will have a direct beneficial effect on the number and quality of bowel movements a client may have. Increasing fluid intake will help, but it is not the most beneficial. The client should not be encouraged to eat a wide variety of foods; rather, instruction on foods that will be best tolerated will be encouraged. Protein intake does not have a direct correlation to the client's quality of bowel movements post-bariatric surgery.

A newly admitted client has gained weight steadily over the past 2 years and the nurse recognizes the need for a nutritional assessment. What assessment parameters should the nurse include? Select all that apply. Coping strategies BMI Clinical examination findings Wrist circumference Dietary data

BMI Clinical examination findings Dietary data

The nurse cares for a client with obesity and discusses the increased risk of certain cancers related to obesity. Which cancers will the nurse include in the teaching? Select all that apply. Breast Colorectal Cervical Skin Brain

Breast Colorectal Cervical

A patient with IBD would be encouraged to increase fluids, use vitamins and iron supplements, and follow a diet designed to reduce inflammation. Select the meal choice that would be recommended for a low-residue diet. A peanut butter sandwich and fruit cup Broiled chicken with low-fiber pasta Salami on whole grain bread and V-8 juice A fruit salad with yogurt

Broiled chicken with low-fiber pasta Explanation: A low-residue, high-protein, and high-calorie diet is recommended to reduce the size and number of stools. Foods to avoid include yogurt, fruit, salami, and peanut butter.

The nurse is caring for a client receiving enteral nutrition with a standard polymeric formula. For which reason will the nurse question using this formula for the client? History of diverticulitis Treatment for internal hemorrhoids Polyps removed during a colonoscopy Diagnosed with malabsorption syndrome

Diagnosed with malabsorption syndrome Explanation: Various tube feeding formulas are available commercially. Polymeric formulas are the most common and are composed of protein (10% to 15%), carbohydrates (50% to 60%), and fats (30% to 35%). Standard polymeric formulas are undigested and require that the client has relatively normal digestive function and absorptive capacity. This type of formula should be questioned because the client is diagnosed with malabsorption syndrome. There is no reason to question the client for a history of diverticulitis, treatment for internal hemorrhoids, or removal of polyps.

A client has received a diagnosis of gastric cancer and is awaiting a surgical date. During the preoperative period, the client should adopt what dietary guidelines? Eat small, frequent meals with high calorie and vitamin content. Eat frequent meals with an equal balance of fat, carbohydrates, and protein. Eat frequent, low-fat meals with high protein content. Try to maintain the pre-diagnosis pattern of eating.

Eat small, frequent meals with high calorie and vitamin content. Explanation: The nurse encourages the client to eat small, frequent portions of nonirritating foods to decrease gastric irritation. Food supplements should be high in calories, as well as vitamins A and C and iron, to enhance tissue repair.

Which of the following is a cause of a calcium renal stone? Excessive intake of vitamin D Gout Neurogenic bladder Foreign bodies

Excessive intake of vitamin D Explanation Potential causes of calcium renal stones include excessive intake of vitamin D, hypercalcemia, hyperparathyroidism, excessive intake of milk and alkali, and renal tubular acidosis. Gout is associated with uric acid. Struvite stones are associated with neurogenic bladder and foreign bodies.

The nurse is educating a patient with iron deficiency anemia about food sources high in iron and how to enhance the absorption of iron when eating these foods. What can the nurse inform the client would enhance the absorption? Eating calf's liver with a glass of orange juice Eating leafy green vegetables with a glass of water Eating apple slices with carrots Eating a steak with mushrooms

Eating calf's liver with a glass of orange juice Explanation: Food sources high in iron include organ meats (e.g., beef or calf's liver, chicken liver), other meats, beans (e.g., black, pinto, and garbanzo), leafy green vegetables, raisins, and molasses. Taking iron-rich foods with a source of vitamin C (e.g., orange juice) enhances the absorption of iron.

A client has undergone a lumbar puncture as part of a neurological assessment. The client is put under the care of a nurse after the procedure. Which important postprocedure nursing intervention should be performed to ensure the client's maximum comfort? Administer antihistamines according to the physician's prescription Keep the room brightly lit and play soothing music in the background Help the client take a brisk walk around the testing area Encourage the client to drink liberal amounts of fluids

Encourage the client to drink liberal amounts of fluids Explanation The nurse should encourage the client to take liberal fluids and should inspect the injection site for swelling or hematoma. These measures help restore the volume of cerebrospinal fluid extracted. The client is administered antihistamines before a test only if he or she is allergic to contrast dye and contrast dye will be used. The room of the client who has undergone a lumbar puncture should be kept dark and quiet. The client should be encouraged to rest, because sensory stimulation tends to magnify discomfort.

A client has undergone a lumbar puncture as part of a neurological assessment. The client is put under the care of a nurse after the procedure. Which important postprocedure nursing intervention should be performed to ensure the client's maximum comfort? Administer antihistamines according to the physician's prescription Keep the room brightly lit and play soothing music in the background Help the client take a brisk walk around the testing area Encourage the client to drink liberal amounts of fluids

Encourage the client to drink liberal amounts of fluids Explanation: The nurse should encourage the client to take liberal fluids and should inspect the injection site for swelling or hematoma. These measures help restore the volume of cerebrospinal fluid extracted. The client is administered antihistamines before a test only if he or she is allergic to contrast dye and contrast dye will be used. The room of the client who has undergone a lumbar puncture should be kept dark and quiet. The client should be encouraged to rest, because sensory stimulation tends to magnify discomfort.

A patient diagnosed with IBS is advised to eat a diet that is: Sodium-restricted. High in fiber. Low in residue. Restricted to 1,200 calories/day.

High in fiber

A diagnostic test has determined that the appropriate diet for the client with a left cerebrovascular accident (CVA) should include thickened liquids. Which of the following is the priority nursing diagnosis for this client? Decreased Fluid Volume Risk Aspiration Risk Impaired Swallowing Malnutrition Risk

Impaired Swallowing Explanation: Impaired Swallowing was evident on the video fluoroscopy. Aspiration, Malnutrition, and Decreased Fluid Volume Risk can occur but are not the primary diagnosis at this point in time.

What food should the nurse recommend for a client diagnosed with vitamin B12 deficiency? Whole-grain bread Citrus fruit Green vegetables Lean meat

Lean meat Explanation: Vitamin B12 is only found in foods of animal origin

The nurse cares for a client who receives continuous enteral tube feedings and who is at low risk for aspiration. The nurse assesses the gastric residual volume to be 350 mL. The nurse determines which action is correct? Monitoring the feeding closely. Increasing the feeding rate. Lowering the head of the bed. Flushing the feeding tube.

Monitor the feeding closely Explanation High residual volumes (>200 mL) should alert the nurse to monitor the client more closely. Increasing the feeding rate will increase the residual volume. Lowering the head of the bed increases the client's risk for aspiration.

Peptic ulcer disease occurs more frequently in people with which blood type? A B AB O

O

A client with obesity reports pain in the joints. Which musculoskeletal condition related to obesity does the nurse suspect the client has? Osteoarthritis Rheumatoid arthritis Inflammatory arthritis Necrotizing arthritis

Osteoarthritis Explanation Osteoarthritis is an obesity-related musculoskeletal condition. Rheumatoid arthritis, inflammatory arthritis, and necrotizing arthritis are not obesity-related conditions.

The nurse is caring for a client with chronic gastritis. Which interventions will the nurse add to this client's plan of care? Select all that apply. Remind to avoid alcohol intake. Review actions to reduce stress. Provide omeprazole as prescribed. Instruct to avoid foods that aggravate the condition. Suggest using over the counter ibuprofen for pain control.

Remind to avoid alcohol intake. Review actions to reduce stress. Provide omeprazole as prescribed. Instruct to avoid foods that aggravate the condition.

Which statement correctly identifies a difference between duodenal and gastric ulcers? Malignancy is associated with duodenal ulcer. Weight gain may occur with a gastric ulcer. A gastric ulcer is caused by hypersecretion of stomach acid. Vomiting is uncommon in clients with duodenal ulcers.

Vomiting is uncommon in clients with duodenal ulcers.