Nutrition: Week 5
A nurse is caring for several clients in an extended care facility. Which of the following clients is the highest priority to observe during meals? A. A client with decreased vision B. A client who has Parkinson's disease C. A client who has poor dentition D. A patient who has anorexia
B.
A nurse is caring for several clients in an extended care facility. Which of the following clients is the highest priority to observe during meals? A. A client who has decreased vision. B. A client who has Parkinson's disease. C. A client who has poor dentition. D. A client who has anorexia.
B.
Which of the following facts regarding nutritious foods is true? A. Nutritious foods are hard to find. B. Nutritious foods are usually more expensive. C. Nutritious foods are obtainable by all. D. Nutritious foods are usually cheaper than other foods.
B.
A person who BURNS MORE calories than he/she CONSUMES should: A. Become obese B. Gain weight C. Maintain their weight D. Lose weight
D.
A teen with a positive body image: A. Is likely to develop an eating disorder B. Wishes his/her body could be changed in many ways C. Feels that his/her body is inadequate D. Is happy with most aspects of his or her appearance
D.
An RN receives the change-of-shift report about these clients. Which client does the nurse assess first? a. 30-year-old admitted 2 hours ago with malnutrition that is associated with malabsorption syndrome b. 45-year-old who had gastric bypass surgery and is reporting severe incisional pain c. 50-year-old receiving total parenteral nutrition (TP) with a blood glucose (BG) level of 300 mg/dL d. 75-year-old with dementia who is receiving nasogastric feedings and has a respiratory rate of 38 breaths/min
D.
The five major food groups are: A. Grains, Vegetables, Milk, Meat, and Beans B. Grains, Vegetables, Fruits, Milk, and Beans C. Grains, Green Vegetables, Orange Vegetables, Fruits, and Milk D. Grains, Vegetables, Fruits, Milk, and Meats and Beans
D.
What is an appropriate position for a client after or during receiving EN? A. Supine B. Prone C. Sim's D. Semi- Fowlers
D.
What must be recorded in a food record? A.) Foods and snacks B.) Foods, snacks, and beverages C.) Foods only D.) Foods, snacks, beverages, supplements
D.
Which screening/assessment tool was developed specifically for people with liver disease/cancer? A.) NRS-2002 B.) MNA C.) MST D. SGA
D.
True or False: Supplements must be recorded on a food record A.) True B.) False
A.
Which of the following herbal supplements may cause liver damage? A.) Kava Kava B.) Garlic C.) Valerian D. Chamomile
A.
The nurse is caring for a client with stomach cancer. The client is at risk of malnutrition. The nursing care plan should include which of the following? A. Providing oral care prior to meals. B. Encourage the use of alcohol-based mouthwashes. C. Provide liquid supplements between meals to increase nutrient intake. D. Encourage the client to keep a food journal
C.
The nurse is caring for a client with stomach cancer. The client is at risk of malnutrition. The nursing care plan should include which of the following? A. Providing oral care prior to meals. B. Encourage the use of alcohol-based mouthwashes. C. Provide liquid supplements between meals to increase nutrient intake. D. Encourage the client to keep a food journal.
C.
What enzyme do MAOIs inhibit? A.) Helicase B. DNA Polymerase C.) Monoamine Tyramine D.) Maltase
C.
Which type of nutrient is NOT a source of energy? A. Proteins B. Carbohydrates C. Water D. Fats
C.
"Mindless eating" is most likely to cause you to: A. Gain weight B. Feel hungry C. Forget to eat D. Need food
A.
A good source of complex carbohydrates is: A. Fruit B. Honey C. Eggs D. Beans
D.
How often should gastric residuals be obtained with EN? A. Every 4 to 6 hr. B. Every hour C. Every 12 hr. D. Every 2 hr.
A.
Patients receiving EN should have weight and I&O monitored how often? A. Daily B. Weekly C. Monthly D. Every Shift Change
A.
A nurse is discussing the use of a low-profile gastrostomy device with the guardian of a child who is receiving an an enteral feeding. Which of the following is an appropriate statement by the nurse? A. "The device is usually comfortable for children." B. "Checking residual is much easier with this device." C. "This access requires less maintenance than a traditional nasal tube." D. "Mobility of the child is limited with this device."
A.
A nurse is monitoring a client who is receiving an intravenous fat emulsion (IVFE) nutritional supplement. What action does the nurse take if the client develops a fever, increased triglycerides, and clotting problems? a. Discontinues the IVFE infusion b. Documents the findings and continues to monitor c. Slows the rate of flow of the IVFE infusion d. Switches the infusion to total parenteral nutrition (TP) infusion
A.
An RN who usually works on the pediatric unit is floated to the Gl medical-surgical unit. Which client is appropriate for the charge nurse to assign to the float nurse? a. 20-year-old with anorexia nervosa receiving total parenteral nutrition (TPN) through a central venous line b. 35-year-old who had a laparoscopic gastroplasty yesterday and is now taking sips of clear liquids c. 60-year-old with gastric cancer receiving elemental feedings through a jejunostomy tube d. 65-year-old with morbid obesity who requires a preoperative bariatric surgery assessment
A.
Approximately to % of people in acute care facilities are malnourished upon admission or during part of their hospital stay.
30-50
How is appropriate placement of tubes determined after placement? A. X-Ray B. Acid Strip C. Auscultation D. Blowing Air Through the Tube
A.
A nurse caring for a client with limited access to dental tools provides education regarding adequate nutritional intake. Which of the following statements is the most sufficient? A. "It is important to limit consumption of processed carbohydrates, as they can stick to your teeth and increase the risk for dental caries." B. "You should not consume coffee as it will cause tooth discoloration." C. "It is important to consume adequate calcium as it prevents tooth decay." D. "You should never drink soda if you do not want your teeth to rot."
A.
A nurse is administering bolus enteral feedings to a client who has malnutrition. Which of the following are appropriate nursing interventions? (select all that apply) A. Verify the presence of bowel sounds. B. Flush the feeding tube with warm water. C. Elevate the head of the bed 20 degrees. D. Administer the feeding at room temperature. E. Instill the formula over 60 min.
A, B, D
A nurse is planning care for a client who is receiving treatment for malnutrition. The client is scheduled for discharge to their home where they live alone. Which of the following actions should the nurse include in the plan of care? Select ALL that apply A. Consult social services to arrange home meal delivery B. Encourage the client to purchase nonperishable boxed meals C. Advise the client to purchase frozen fruits and vegetables D. Recommend drinking a supplement between meals E. Educate the client on how to read nutrition labels
A, C, D, E
The nurse is caring for a client with a decreased sense of taste. Which type of foods should the nurse recommend the client consume to compensate for the decreased taste? A. Sweet B. Salty C. Spicy D. Bland
C.
A nurse is instructing a client on how to administer cyclic enteral feedings at home. Which of the following information should the nurse include? A. "Give a feeding every 6 hours." B. "Set the feeding up before you go to bed." C. "Weigh yourself daily." D. "Flush the tube with a carbonated beverage to dislodge clogs." E. "Ensure your head is elevated to 15 degrees during administration."
B, C
A nurse is preparing to administer intermittent enteral feeding to a client. Which of the following are appropriate nursing interventions? (select all that apply) A. Fill the feeding bag with 24 hr worth of formula. B. Discard feeding equipment after 24 hr. C. Place any unused formula in open cans in the refrigerator. D. Flush the feeding tube every 4 hr. E. Elevate the head of the client's bed for 15 min after administration.
B, C, D
A nurse is providing teaching for a client who has a new diagnosis of hypertension and a prescription for a low sodium diet. Which of the following client statements indicate an understanding of the teaching? Select ALL that apply A. "I should select organic canned vegetables." B. "I need to read food labels when grocery shopping." C. "I will stop eating frozen dinners for lunch at work." D. "I know that deli meats are usually high in sodium." E. "I can refer to the AHA website for dietary guidelines."
B, C, D, E
A nurse is teaching a client who is starting continuous feedings about the various types of enteral nutrition (EN) formulas. Which of the following should the nurse include in the teaching? A. Formula rich in fiber is recommended when starting EN. B. Standard formula contains whole protein. C. Hydrolyzed formula is recommended for a full-functioning GI tract. D. The high-calorie-formula has increased water content.
B.
Foods that contain all nine essential amino acids include: A. Grains B. Meats C. Seeds D. Nuts
B.
Good nutrition can affect your lifelong health by... A. Increasing your risk of stroke B. Helping you avoid gaining weight C. Causing cardiovasular disease D. Leading to osteoporosis
B.
The number of calories you can eat each day without gaining weight depends on your: A. Hunger B. Activity level C. Environment D. Appetite
B.
A nurse is planning care for a client who has mechanical fixation of the jaw following a motorcycle crash. Which of the following actions should the nurse include in the plan of care? Select ALL that apply A. Thicken liquids to honey consistency B. Educate the client about the use of a nasogastric tube C. Assist the client to use a straw to drink liquids D. Ensure that the client receives ground meats E. Encourage intake of fluids between meals
C, E
A client receiving total parenteral nutrition (TP) exhibits symptoms of congestive heart failure (CHF) and pulmonary edema. Which complication of TPN is the client most likely experiencing? a. Calcium imbalance b. Fluid volume deficit c. Fluid volume overload d. Potassium imbalance
C.
A nurse is caring for a client who is receiving intermittent enteral feedings through an NG tube. The specific gravity of the client's urine is 1.035. Which of the following actions should the nurse take? A. Deliver the formula at a slower rate B. Request a lower-fat formula C. Provide more water with feedings D. Instill a lactose-free formul
C.
A client is discharged home with an enteral feeding tube. What does the home health nurse do to determine the patency of the client's enteral tube? a. Arranges for the client to have an x-ray performed periodically b. Auscultates the client's abdomen for bowel sounds before each feeding c. Instills air into the tube to check for placement and patency before each feeding d. Tests aspirated tube contents for pH level before each feeding
D.
A nurse obtains assessment data on a client who had bariatric surgery today. Which finding does the nurse report to the surgeon immediately? a. Bowel sounds are not audible in all quadrants. b. Client's skin under the panniculus is excoriated. c. The client reports pain when being repositioned. d. Urine output total is 15 mL for the past 2 hours.
D.
Some drugs decrease the amount of available ________ therefore decreasing __________
Digestive enzymes; nutrient absorption
If a client cannot tolerate large amounts of food at once, what can the nurse do to help?
Offer several small meals or snacks throughout the day instead of 3 larger meals.
Who can the nurse contact regarding the client's access to food?
Social services
True or False The lack of money to purchase healthy foods or foods required for a specific diet can be a barrier to maintaining a proper diet.
True
The nurse is caring for a client who has decreased smell altering their perception of food. Which of the following conditions may result in decreased smell? A. Smoking B. HIV/AIDS C. Dementia D. Parkinson's disease
A.
Which of the following is included in the nursing care for a client who has undergone mechanical fixation of the jaw? A. Encourage fluid intake B. Determine what is appropriate for the client to consume C. Instruct clients on reading nutrition fact labels D. Provide information on appropriate portion sizes
A.
True or False: A food log is the most common form of food record in acute or long term care settings. A.) True B.) False
B.
What is a potentially fatal complication that can occur with EN? A. Dumping Syndrome B. Refeeding Syndrome C. Abdominal Distention D. Constipation
B.
Which age group is a moderate nutrition risk? A.) 45-55 B.) 65-75 C.) 75-85 D.) 55-65
B.
Which nutrient is necessary for healthy bones? A. Fiber B. Calcium C. Thiamin D. Niacin
B.
A client has a primary problem of inadequate nutrition caused by the effects of chemotherapy. The client is receiving continuous enteral feedings through a nasogastric tube (NG) tube. What does the RN ask the LPNLVN to do for this client? a. Assess the nutritional parameters of the client every 3 days. b. Check the residual volume of the NG tube every 4 hours. c. Monitor the client for signs and symptoms of pneumonia. d. Teach the client about the purpose of enteral feedings.
B.
A malnourished client is being discharged on enteral nutrition products. Which suggestion from the registered dietitian does the nurse implement to make the enteral feeding experience more normal for the client? a. Administering the feeding product on a regular schedule Incorrect b. Bringing the enteral product and napkin to the client on a tray c. Emphasizing the need to take iron medications before the feeding d. Once feeding is completed, putting equipment out of view
B.
A nurse is caring for a client who is receiving total parenteral nutrition (TPN). Which of the following actions should the nurse take? A. Administer 0.9% sodium chloride until TPN is available from the pharmacy B. Check the client's capillary blood glucose level every 4 hr C. Obtain the client's weight each week D. Change the IV tubing every 3 days
B.
A nurse is caring for a client who is transitioning to an oral diet following a partial laryngectomy. Which of the following actions should the nurse take to reduce the client's risk for aspiration? A. Request to have the client's oral medications provided in liquid form B. Instruct the client to follow each bite with a drink of water C. Encourage the client to tuck the chin when swallowing D. Consult the dietitian about providing the client with a thin liquid diet
C.
A nurse is caring for a client who is transitioning to an oral diet following a partial laryngectomy. Which of the following actions should the nurse take to reduce the client's risk for aspiration? A. Request to have the client's oral meds provided in liquid form. B. Instruct the client to follow each bite of food with a drink of water. C. Encourage the client to tuck the chin when swallowing. D. Consult the dietician about providing the client with a thin liquid diet.
C.
A nurse is reviewing the laboratory reports of a client who is receiving enteral feedings. Which of the following values indicates a complication of enteral feeding that the nurse should report to the provider? A. Sodium 143 mEg/L B. Potassium 4.2 mEg/L C. BUN 25 mg/dL D. Glucose 185 mg/dL
C.
A nurse manager in a long-term care facility plans nutritional assessments of all residents. Which nutritional assessment activity does the nurse delegate to unlicensed assistive personnel (UP) at the facility? a. Assessing residents' abilities to swallow b. Determining residents' functional status c. Measuring the daily food and fluid intake of residents d. Screening a portion of the residents with the Mini Nutritional Assessment
C.
Oral contraceptives cause deficiency in which two vitamins? A.) E and K B.) A and D C.) B and C D.) D and K
C.
Per the National Dysphagia Diet there are three levels of solid textures. Which of the following is NOT one of the levels? A. Mechanically altered B. Pureed C. Liquid D. Advanced
C.
What time of tube is used for short term use (less than 3-4 wks) A. Nasogastric Tubes B. Nasoduodenal Tubes C. Nasoenteric Tubes D. Nasojejunal Tubes
C.
Where does most drug absorption occur in the body? A.) The stomach B.) The large intestine C.) The small intestine D.) The esophagus
C.
Which nursing care activity for a malnourished client does the nurse safely delegate to unlicensed assistive personnel (UAP)? a. Completing the Mini Nutritional Assessment b. Determining body mass index (BMI) c. Estimating body fat using skin-fold measurements d. Measuring current height and weight
D.
Which of the following medical conditions places a client most at risk for aspiration? A. Dementia B. Cancer C. HIV/AIDS D. Stroke
D.
What can the nurse do to help alleviate some of the confusion when choosing proper foods to eat or purchase?
Educate the client on how to read food labels to be aware of nutritional, caloric and sodium values