ATI Nutrition Practice A

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 a total ML of enteral fluid administered during the 8 hr shift? (Round the number to the nearest whole number. Do not use a trailing zero.)

580

A nurse is reviewing the lab findings of a client who has acute pancreatitis. Which of the following is an expected finding? A. increases calcium B. decreased bilirubin C. increased glucose D. decreased alkaline phosphate

C. increased glucose (The nurse should expect an increased glucose level in a client who has acute pancreatitis due to decreased insulin production by the pancreas.) -the rest are the opposite (decreased should be increased, etc.)

A nurse is performing a cultural nursing assessment for a client whose religious practice include fasting 1 day each week. which of the following questions should the nurse ask the client? (SATA)

-"Are you exempt from fasting during illness?" is correct. The nurse should ask the client if fasting is exempt during illness to determine an acceptable plan of care for the client. -"Does fasting mean refraining from drinking liquids?" is correct. The nurse should ask if fasting means refraining from drinking liquids to determine an acceptable plan of care for the client. -"Does your fasting occur during certain hours of the day?" is correct. The nurse should ask if there are certain hours of the day when fasting occurs to determine an acceptable plan of care for the client. -"Is vegetarianism a form of fasting?" is incorrect. Vegetarianism is not a form of fasting. This is not an acceptable question for the nurse to ask the client. -"Does fasting mean eating only a certain type of food?" is correct. The nurse should ask if fasting means eating only a certain type of food to determine an acceptable plan of care for the client.

A nurse is assessing a client who has diabetes mellitus. Which of the following findings should the nurse identify as a manifestations of hypoglycemia? A. Diaphoresis B. Bradycardia C, Abdominal cramps D. Acetone breath

A. The nurse should identify that diaphoresis, irritability, and tremors are manifestations of hypoglycemia. -The nurse should identify that tachycardia as well as hunger are manifestations of hypoglycemia. -The nurse should identify that abdominal cramps as well as nausea and vomiting are manifestations of hyperglycemia. -The nurse should identify that breath with a fruity odor, also known as acetone breath, as well as rapid shallow breathing are manifestations of hyperglycemia.

A nurse is teaching a client who has chronic kidney disease about lmiting dietary calcium intake. Which of the follwoing food choices should the nurse include in the teaching as having a the highest amount of calcium? A. 1 cup of low-fat yogurt B. i oz of cheddar cheese C. 1 egg D. 1/2 cup spinach

A. 1 cup of low-fat yogurt (The nurse should determine that low-fat yogurt contains 314 mg of calcium per cup, which is the highest amount of calcium; therefore, the client should limit low-fat yogurt in the diet.) The nurse should recommend -a different food item to limit because there is another choice that contains more calcium. Cheddar cheese contains 214 mg of calcium per ounce. -a different food item to limit because there is another choice that contains more calcium. One egg contains 25 mg of calcium. -a different food item to limit because there is another choice that contains more calcium. Spinach contains 122 mg of calcium per half cup.

A nurse is providing teaching to a client who has dumping syndrome & 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 carbs C. decreases food high in fat content D. eat meals low in protein

A. Consume liquids between meals (to slow movement of food from the stomach.) The nurse should teach the client that -complex carbohydrates are better tolerated than simple carbohydrates. -high-fat foods are not a cause of dumping syndrome. -a high-protein diet is not a cause of dumping syndrome and can improve anemia.

A nurse is teaching a client about stress management. Which of the following statements by the client indicates an understanding of the teaching? A. I will take a long walk every evening. B. I will keep a daily diet activity log. C. I will avoid eating 1 hour before bedtime. D. I will drink a full glass of water with each meal.

A. Exercise has many benefits, including reduction of tension, promotion of relaxation, and improved sense of well-being. All of these will assist the client in stress management. -Keeping a daily diet and activity log increases awareness of eating patterns and will assist the client to identify needed changes, but it will not reduce the client's stress. -The client should avoid eating 2 to 3 hr before bedtime to promote sleep and reduce stress. -Drinking a full glass of water with each meal will promote a feeling of fullness but will not reduce stress.

A nurse is teaching a client about measures to reduce the risk of osteomalacia. Which of the following instructions should the nurse include in the teaching? A. Consume 20 mcg of vitamin D daily B. Avoid foods with copious amounts of antioxidants C. Increase intake of foods high in purine. D. Take 150 mg of vitamin E daily

A. The nurse should instruct the client to consume 20 mcg of vitamin D daily. Osteomalacia is characterized by a lack of vitamin D, which leads to insufficient bone mineralization. This disorder coincides with osteoporosis, thereby increasing the risk of falls leading to fractures in older adult clients. Vitamin D supplements are recommended for clients age 65 and older to decrease bone loss and maintain bone mineralization, thereby reducing the risk of a softening of the bones. -The nurse should instruct the client to eat foods rich in antioxidants. Antioxidants protect cells from being destroyed by free radicals. Antioxidants include vitamins C, E, and beta-carotene. However, eating foods with copious amounts of antioxidants have not been shown to reduce the risk of osteomalacia. Osteomalacia is characterized by a lack of vitamin D which leads to insufficient bone mineralization. This disorder coincides with osteoporosis, thereby increasing the risk of falls leading to fractures in older adult clients. -The nurse should instruct a client who has gout to decrease intake of foods that contain purine, such as organ meats and certain types of seafood. These foods increase uric acid levels, which exacerbate the possibility of an acute attack. Osteomalacia is characterized by a lack of vitamin D which leads to insufficient bone mineralization. This disorder coincides with osteoporosis, thereby increasing the risk of falls leading to fractures in older adult clients. -The recommended dose of vitamin E is 15 mg per day. Vitamin E is an antioxidant that protects the lungs and RBCs but does not reduce the risk of developing osteomalacia. In large amounts, it can decrease platelet aggregation, which can interfere with blood clotting in older adult clients. Osteomalacia is characterized by a lack of vitamin D which leads to ins

A nurse is teaching about increasing dietary intake of micronutrients to a client who has difficulty seeing at night. Which of the following micronutrients should the nurse include in the teaching? A. Vitamin A B. Calcium C. Vitamin B6 D. Phosphorus

A. Vitamin A enables the eyes to adapt to dim lighting more rapidly at night, which improves night vision. -Calcium facilitates nerve transmission and cell membrane permeability, but it is not a micronutrient that improves night vision. -Vitamin B6 assists in the formation of heme in hemoglobin and the synthesis of neurotransmitters, but it is not a micronutrient that improves night vision. -Phosphorus assists in the formation of bones and teeth and the regulation of hormone activity, but it is not a micronutrient that improves night vision.

A nurse is assessing a client who has type 2 DM. The nurse should recognize which of the following manifestations of hypoglycemia? A. confusion B. polydipsia C. vomiting D. ketonuria

A. confusion the rest are hyperglycemia

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 (Flatulence, bloating, and cramping, and diarrhea are expected findings associated with lactose intolerance.) -bloody stools & hyperemesis is not associated with lactose intolerance. -Steatorrhea, the excretion of large quantities of fat in the stool, is not a finding associated with lactose intolerance.

A nurse is caring for a clinet who has acute inflammatory bowel disease. Which of the following nutritional supplements should the nurse anticipate providing to this client? A. hydrolyzed formula B. polymeric formula C. milk-based supplement formula D. modular product supplement formula

A. hydrolyzed formula (Hydrolyzed or elemental formula provides protein and other nutrients in their simplest form, requiring little or no digestion and decreasing stimulation of the bowel. This type of formula is beneficial for clients who have impaired digestion due to conditions such as inflammatory bowel disease.) - Polymeric formula contains complex nutrient molecules and is not indicated for clients who have impaired digestion. -Milk-based supplemental formulas contain lactose and are poorly tolerated by clients who have inflammatory bowel disease. -Modular formulas are intended to increase the intake of a specific nutrient without increasing volume; they are not intended for clients who have impaired digestion.

A nurse is providing dietary instructions for a client who has a prescription for warfarin. Which of the following food should the nurse recommend the client eat in moderation while taking this medication? A. leafy geen vegetables B. whole grains C. fruits with skin D. nuts & seeds

A. leafy geen vegetables (contain a natural form of vitamin K that can negate the anticoagulation effects of warfarin.) Whole grains, fruits, nuts & seeds do not affect the action of warfarin

A nurse is caring for an adolescent who has type 1 DM. 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 after testing administering a dose of insulin D. compare current glycosylated hemoglobin level with the level at time of diagnosis

A. monitor blood glucose levels during the night (Somogyi phenomenon is fasting hyperglycemia that occurs in the morning in response to hypoglycemia during the nighttime. The nurse should assess for this phenomenon by monitoring blood glucose levels during the night.) -The nurse's assessment of urinary ketones at the same time each day for 1 week is not an effective method of assessing for Somogyi phenomenon. Testing for urinary ketones occurs when a client is experiencing diabetic ketoacidosis. -The nurse's administration of an oral glucose tolerance test after administering a dose of insulin is not an effective method of assessing for Somogyi phenomenon. -The nurse's comparison of the current glycosylated hemoglobin level with the level at time of diagnosis is not an effective method of assessing for Somogyi phenomenon. Glycosylated hemoglobin levels are tested to diagnose diabetes and measure compliance and therapeutic effect of a client's diabetic regimen.

A nurse is caring for a client who is receiving continuous enteral tube feedings. Which fo the following actions should the nurse take to prevent aspiration? A. monitor gastric residual every 4 hr B. maintain elevation of the head of the client bed at 150* C. confirm proper tube placement by radiograph every 24 hr D. flush tubing with 30 mL of water before & after medication

A. monitor gastric residual every 4 hr (The nurse can identify delayed gastric emptying by monitoring gastric residuals regularly. Delayed gastric emptying places the client at risk for aspiration and can necessitate a decrease in the feeding rate.) - The head of the client's bed should be elevated to between 30º and 45° during the feeding and for at least 1 hr afterward. -Confirmation of proper tube placement by radiograph should take place before initiating enteral tube feedings. It is not necessary to confirm placement again unless there is an indication that the tube has become displaced. -Flushing the tube with 30 to 50 mL of water before and after medication administration helps maintain tube patency but does not help prevent aspiration.

A nurse is caring for a client who adheres to a kosher diet. Which fo the following food choices would be appropriate for this client? A. vegetable salad w/ cheese B. lean cuts of pork C. turkey & cheese on rye bread D. shrimp salad & crackers

A. vegetable salad w/ cheese (Clients who adhere to a kosher diet can eat dairy products combined with non-meat products at the same meal.) Clients who adhere to a kosher diet -do not eat pork. -do not combine dairy products with meat products at the same meal. -do not eat shellfish.

A nurse is providing teaching about lowering solid fat intake to an adolescent client who usually consumes about 2,000 calories per day. Which of the following instructions should the nurse include? A. "choose ground beed that is at least 70% lean." B. "restrict your daily meat intake to 5 ounces." C. "select cheeses that contain no more than 6g of fat per serving." D."choose margarine that contains no more than 4g of saturated fat per tablespoon."

B. "restrict your daily meat intake to 5 ounces." (The nurse should instruct the client to limit meat intake to about 5 oz per day. A meat portion should be no larger than the size of a deck of cards.) The nurse should instruct the client -to select ground beef that is at least 90% lean. -to select cheeses that contain no more than 3 g of fat per serving. -to choose margarine that contains no more than 2 g of saturated fat per tablespoon.

The nurse is providing discharge teaching to a postpartum client about breast milk use & storage. Which of the following statements should the nurse make? A. "refrigerate unused breast milk immediately after bottle feeding." B. "you cannot place thawed breast mil back in the freezer." C. "you can store expressed breast milk in the freezer for up to 18 months." D."defrost frozen breast mile on the lowest defrost setting in the microwave."

B. "you cannot place thawed breast mil back in the freezer." (The nurse should instruct the client that completely thawed breast milk can be stored in the refrigerator but must be used within 24 hr. Breast milk that has been previously frozen should not be refrozen once it has thawed completely. Thawing creates a possibility for bacterial growth and causes a decrease in antibacterial activity, which destroys antibodies in the milk.) The nurse should instruct the client -that any milk left in a bottle from a feeding should be immediately discarded. -that the recommended duration of time for safely storing expressed breast milk is 6 months. However, it is acceptable for expressed breast milk to be stored for a maximum of 12 months. -to place the container of breast milk in the refrigerator to slowly thaw. If the breast milk is needed sooner, the nurse should instruct the client to place the container of breast milk under warm, running water. Breast milk should not be thawed or warmed in a microwave. This practice can cause burns to the infant's mouth, throat, or upper gastrointestinal tract due to uneven heating, which might not be recognized when the client spot checks the milk's temperature.

A nurse is caring for a client who expresses a desire 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 plan for dietary moderation

B. Obtain a 24-hr dietary recall (The first action the nurse should take using the nursing process is to obtain a diet history, such as a 24-hr dietary recall. Having the client write down everything consumed over a 24-hr period is a crucial component of the assessment process to identify eating behaviors and therefore be able to recommend dietary modifications based on the data received.) -The nurse should recommend the client weigh themselves regularly to monitor weight loss or gain; however, there is another action the nurse should take first. -The nurse should assist the client with the creation of a personalized exercise plan to increase strength and promote weight loss; however, there is another action the nurse should take first. -The nurse should initiate a personalized diet modification plan with the client based on the client's assessment data to promote weight loss; however, there is another action the nurse should take first.

A nurse in a providers office is assessing a clinet who has HIV. The nurse should idenitfy which of the follwoing findings as an indication to increase the client's nutritional intake? A. T-helper (CD4+) cells 700/mm^3 B. Presence of herpes simplex virus infection C. HIV viral load below detectable levels D. increased lean body mass

B. Presence of herpes simplex virus infection (Secondary infection triggers inflammatory responses that increase the client's metabolic rate. Therefore, the nurse should identify the presence of herpes simplex virus infection as an indication to increase the client's nutritional intake.) -This finding is within the expected reference range. The nurse should recognize that a decreased CD4+ cell count is associated with a need for increased nutritional intake, and a count below 200/mm3 indicates progression to AIDS. -The nurse should recognize that an increased HIV viral load indicates progression of the disease, which increases nutritional needs. -The nurse should identify a decrease in lean body mass or fat as indicating possible HIV-associated wasting syndrome and a need for increased nutritional intake.

A nurse is caring for a client who is receiving total parenteral nutrition (TPN) 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 responses should the nurse make? a. Your blood glucose levels need to be within a normal range before the parenteral nurtrition 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 needs to be regular before the therapy can be discontinued.

B. TPN can be discontinued when oral intake exceeds at least 60% of the client's estimated daily caloric requirements. -Blood glucose levels are monitored when a client is receiving TPN; however, this is not a criterion for discontinuation of the therapy. -A weight gain of 1 kg/day is indicative of fluid overload, an adverse effect of TPN. -Bowel function is monitored when a client is receiving TPN; however, it is not a criterion for discontinuation of the therapy.

A nurse is providing dietary teaching to a client who is postoperative following a gastric bypass procedure. Which of the following instructions should the nurse include? A. Eat six small meals per day B. Begin each meal with a protein. C. Finish each meal even if feeling full D. Plan to eat each meal over 15 min

B. The nurse should instruct the client to begin each meal by eating a protein. The client should consume 60 to 120 g of protein each day. -The nurse should instruct the client to eat three meals and two snacks of a limited portion size each day. -The nurse should instruct the client to eat slowly and to stop eating after beginning to feel full. -The nurse should instruct the client to eat slowly, take time to chew food well, and plan for meals to last between 30 and 60 min.

A nurse is discussing dietary factors to assist in blood pressure management for a client who has hypertension. Which of the following client statements indicate an understanding of the teaching? A. I can drink up to three glasses of wine each day. B. I should choose whole grain pastas when selecting my foods. C. I should decrease my consumption of foods high in potassium. D. I can use low-sodium salt substitutes when I cook my food.

B. Whole grains are a healthy choice of carbohydrate because they contain ingredients that lower the risk of cardiovascular disease and improve blood pressure. -The client can consume alcohol in moderation, if at all. Moderate daily alcohol intake is one drink for women and two drinks for men. -Increased potassium levels decrease blood pressure levels. The client should increase their consumption of foods containing potassium. -The nurse should instruct the client that low-sodium salt substitutes are not sodium-free and can contain nearly half as much sodium as table salt.

A nurse is providing teaching to a client who has dumping syndrome. Which of the following information should the nurse include? A. drink liquids with meals B. apply pectin to foods C. remain active after eating a meal D. replace sugars w/ honey

B. apply pectin to foods (The client should apply pectin, a dietary fiber that helps to delay gastric emptying, to foods.) -The client should avoid drinking liquids with meals to decrease manifestations of dumping syndrome. The client should wait 30 min before and after a meal to drink liquids. -The client should lie down and rest for at least 15 min after eating a meal to decrease manifestations of dumping syndrome. -The client should avoid simple sugars because they can increase manifestations of dumping syndrome. Simple sugars include honey, sugar, and syrup.

A nurse is preparing a health promotion seminary for a group of clients about cancer prevention. Which of the following info should the nurse include? A. consume high-calories foods & beverages at meal time B. eat at least 2.5 cups of fruits & vegetables each day C. plan to perform moderate-intensity excise for 90 min/wk D. limit alcohol consumption to no more than 3 drinks/day

B. eat at least 2.5 cups of fruits & vegetables each day (The nurse should include in the teaching that clients should eat at least 2.5 cups of fruits and vegetables daily to help maintain body weight and reduce the risk for cancer of the lung and gastrointestinal system.) The nurse should include in the teaching -that clients should avoid consuming high-calorie foods and beverages to decrease the risk for cancer. Being overweight or obese can increase hormones that promote cancer cell development and growth. -that clients should eat at least 2.5 cups of fruits and vegetables daily to help maintain body weight and reduce the risk for cancer of the lung and gastrointestinal system. -that clients should limit alcohol consumption to one to two drinks per day, because excessive alcohol intake can increase the risk of certain types of cancer.

A nurse is caring for a client who is at 8 weeks of gestation & has a BMI of 34. The client asks about weight goals during pregnancy. The nurse should advise the client to do which of the following? A. maintain her current BMI B. gain approximately 6.8 kg (15lbs) C. lower her BMI to 30 D. gain 12.7 - 15.8 kg (28-35 lbs)

B. gain approximately 6.8 kg (15lbs) (The nurse should advise the client that based on her BMI, she should gain 4.9 to 9.1 kg (11 to 20 lb) during her pregnancy.) The nurse should advise the client -to gain some weight during pregnancy, but less weight than clients whose BMI is within the expected reference range or lower. -that she should not attempt to lose weight during pregnancy. Losing too much weight during pregnancy could potentially have negative effects on the fetus, such as low birth weight and vitamin deficiencies. -that a weight gain of 12.7 to 15.8 kg (28 to 35 lb) during pregnancy is too high for a client who has a BMI of 34.

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. off the client hot tea w/ daytime meals D. allow the client fo eat privately with their family each day at 1300

B. provide a snack for the client after sunset (During Ramadan, clients who follow Islamic dietary laws consume meals before dawn and after sunset. The nurse should offer the client a snack or light meal after sunset.) During Ramadan: -clients who follow Islamic dietary laws can eat during nighttime hours. - clients who follow Islamic dietary laws fast during daytime hours. When not fasting, Islamic dietary law specifies that caffeine is prohibited and beverages are consumed after, rather than with, meals. -clients who follow Islamic dietary laws consume meals before dawn and after sunset.

A nurse is teaching a client who has HTN about decreasing sodium intake. Which fo the following info should the nurse include in the teaching? A. use soy sauce as marinade for meats B. season food w/ herbs & spices C. select processed cheese products when available D. choose a frozen dinner for a quick meal option

B. season food w/ herbs & spices (replace salt with herbs and spices when seasoning foods.) The nurse should instruct the client -to avoid products that are high in sodium, such as soy sauce, mayonnaise, and ketchup. -that processed cheeses are high in sodium and should be avoided. -to avoid processed foods such as frozen dinners, which can be high in sodium.

A nurse in a long-term care facility is monitoring a client during mealtime who has PD. Which of the following findings should the nurse identify as the priority? A. the client eats all of their cake & a few bites of bread B. the client drools while eating C. the client's had trembles when they holds their spoon D. the client chooses to sit alone during the meal

B. the client drools while eating (can indicate that this client is at greatest risk for aspiration of food from dysphagia, which can lead to pulmonary complications; therefore, the nurse should identify this as the priority finding.) -Eating small portions of non-nutritious foods instead of high-protein, high-calorie foods indicates that the client might be at risk for malnutrition; however, the nurse should identify another finding as the priority. -The nurse should offer the client assistance with feeding to promote adequate food and fluid intake; however, the nurse should identify another finding as the priority. -The nurse should identify that the client is at risk for social isolation due to the disease process, which can lead to depression; however, the nurse should identify another finding as the priority.

A nurse is teaching a client who is newly diagnosed with type 1 DM how to count carbs. Which of the following statements made by the client indicates on understanding of the teaching? A. "i am including vegetables as starch items in my carb count." B. "I am limiting the # of carbs to 4 carb choices or 60 grams per day." C. " i know the serving size can affect the # of carbs i eat." D. "i know the carb count is dependent on the calories in the food item."

C. " i know the serving size can affect the # of carbs i eat." (portion size affects the number of carbohydrates.) The nurse should instruct the client -about the difference between starchy and nonstarchy vegetables to accurately calculate the carbohydrate count. -that generally three to five carbohydrate choices, or 45 g, are allowed per meal, plus one to two carbohydrate choices for each snack. -that the carbohydrate count is not dependent on the calorie count of a food item. Fats and proteins can provide calories as well.

A nurse is teaching a female client about a healthy diet to control HTN. Which of the following statements indicated an understanding of the teaching? A. "I will drink 2 glasses of whole milk daily." B. "I will decrease the potassium in my diet." C. "I will eat 4 serving of unsalted nuts per week." "I will limit alcohol consumption to 3 drinks per day."

C. "I will eat 4 serving of unsalted nuts per week." (Female clients should consume four to five servings of unsalted nuts, seeds, or legumes per week for a heart-healthy diet.) Female clients should -eat a diet rich in nonfat or low-fat dairy products to control hypertension and therefore should avoid whole milk. -eat a diet rich in potassium to control hypertension. -drink alcohol in moderation, such as one to two drinks per day, to control hypertension.

A nurse is teaching an adolescent who has a new diagnosis of celiac disease. Which of the following statement by the client indicated an understanding of the teaching? A. "i need to decreased the amount of oil I use in cooking." B. "i need to eat fewer acidic foods, such as tomatoes & oranges." C. "i need to eliminate rye from my diet." D. "i need to eliminate mild products form my diet."

C. "i need to eliminate rye from my diet." (Eating sources of gluten, such as barley or rye, increases the manifestations of celiac disease.) -Oil content of food might need to be decreased in a client who is on a low-fat diet, but oil does not affect the manifestations of celiac disease. -Acidic foods do not affect the manifestations of celiac disease. -Clients who cannot tolerate lactose should avoid milk products.

A nurse is assessing a clients risk for pressure injuries using the Braden scale. The client eats more then half of most meals but occasionally refuses a meal. Which of the following info should the nurse document on the nutrition category of the Braden scale? A. 1 (very poor) B. 2 (probably inadequate) C. 3 (adequate) D. 4 (excellent)

C. 3 (adequate) (A client who eats more than half of most meals, occasionally refuses a meal, and has four servings of protein each day scores a 3 (Adequate) in the nutrition category of the Braden scale.) -A client who scores a 1 (Very Poor) in the nutrition category of the Braden scale never finishes a complete meal, drinks little fluid, and does not drink any dietary supplements. -A client who scores a 2 (Probably Inadequate) in the nutrition category of the Braden scale only eats about half of meals or snacks and only occasionally takes dietary supplements. -A client who scores a 4 (Excellent) in the nutrition category of the Braden scale eats most of every meal, eats plenty of protein, and occasionally eats between meals.

A nurse is reviewing the lab values of a group of clients. Which of the following clients should the nurse identify as experiencing dehydration? A. a client who has a potassium level of 4.4 mEq/L B. A client who has a hematocrit of 45% C. A client who has a sodium level os 150 mEq/L D. A client who has a BUN of 18mg/cL

C. A client who has a sodium level os 150 mEq/L (The nurse should identify that a sodium level of 150 mEq/L is above the expected reference range of 136 to 145 mEq/L and indicates hypernatremia. Hypernatremia, often called water deficit, is a decrease of sodium concentration in the blood caused by an excess of water. Manifestations of hypernatremia include confusion, headache, nausea, and fatigue.) -The nurse should identify that a potassium level of 4.4 mEq/L is within the expected reference range of 3.5 to 5 mEq/L. Hypokalemia can occur with gastrointestinal losses, leading to dehydration. Hyperkalemia can occur with a fluid volume deficit. -The nurse should identify that a hematocrit of 45% is within the expected reference range of 42% to 52% for a male and 37% to 47% for a female. A client who is experiencing dehydration will have an elevated hematocrit. -The nurse should identify that a BUN of 18 mg/dL is within the expected reference range of 10 to 20 mg/dL. A client who is experiencing dehydration will have an increased BUN due to decreased urine output.

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. According to evidence-based practice, the nurse should identify that a baked potato has the highest glycemic index of these foods. The glycemic index of a baked potato is 85 to 90. Glycemic index is a tool used to rank foods according to the degree in which the food raises serum glucose levels. -The nurse should identify a different food because there is another choice that has a higher glycemic index. The glycemic index of sweet corn is 60. -The nurse should identify a different food because there is another choice that has a higher glycemic index. The glycemic index of macaroni is 45. -The nurse should identify a different food because there is another choice that has a higher glycemic index. The glycemic index of peanuts is 14.

A nurse is providing teaching to a client who has diabetes mellitus and a HbA1c of 8.7%. Which of the following statements made by the client indicates an understanding of this laboratory value? A. I should have gone to my exercise class yesterday. B. This shows that my result is finally within normal range. C. This shows that I have not been following my diet. D. I should have my blood work done first thing in the morning.

C. An HbA1c level of 8.7% is not within the expected reference range. The HbA1c goal level for a client who has diabetes is between 6.5% and 7%. -Short-term factors, such as exercise, do not affect the client's HbA1c level. -The HbA1c goal level for a client who has diabetes is between 6.5% and 7%. An HbA1c level of 8.7% indicates less than optimal diabetic control. -The client can give a blood sample at any time of the day because the HbA1c level indicates the average blood glucose levels for the previous 100- to 120-day period. Fasting is not required.

A nurse if providing education to an adolescent about making nutrient-dense food choices. Which of the following statements by the client indicate 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 contain less fat than refried beans. -Pasta with red sauce is a better choice, because it contains less fat than pasta with white sauce. -Sweetened fruit yogurt is higher in fat and added sugars; therefore, plain, fat-free yogurt with fresh fruit is a better choice. -Canadian bacon or another low-fat meat is a better option for protein than sausage.

A nurse is caring for a client who is receiving total parenteral nurtrition (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. TPN contains high concentrations of dextrose and proteins. To avoid hypoglycemia, the nurse should infuse dextrose 10% or 20% in water until the next bag of TPN solution arrives. -The TPN flow rate must remain consistent. Slowing it and then later resuming the prescribed rate increases the risk of inadequate nutrition and metabolic complications. -TPN contains high concentrations of specific nutrients. Infusing 0.9% sodium chloride can cause rapid shifts in serum levels of some substances. -Abruptly stopping a TPN infusion can lead to multiple metabolic complications.

A nurse is teaching a client who reports constipation about ways to increase dietary intake of fiber. Which of the following information should the nurse include? A. Replace legumes with broiled meats. B. Consume 1/2 cup of bran daily C. Leave the skin on when eating fruit D. Decrease fluid intake while increasing fiber

C. The nurse should instruct the client that consuming the skin on fruits and vegetables adds fiber to the diet. -The nurse should instruct the client to replace meat-based meals with meals that feature dried peas or beans to add fiber to the diet. -The nurse should instruct the client to add a small amount of bran to the daily diet, working up to 3 tablespoons daily, which is less than ¼ cup. Adding fiber gradually should prevent abdominal distention and excessive flatus. -The nurse should instruct the client to increase fluid intake as fiber intake increases to prevent constipation, abdominal distention, and excessive flatus. The client should consume at least eight 240-mL (8-oz) glasses of water daily.

A nurse if providing information to a client who has a new prescription for atorvastatin. Which of the following beverages should the nurse include in the information as contraindicated while taking this medication? A. Orange juice B. Coffee C. Grapefruit juice D. Milk

C. The nurse should teach the client to avoid taking atorvastatin with grapefruit juice because it can increase serum levels of the medication, which can increase the risk for rhabdomyolysis and toxicity. -The nurse should teach the client that it is safe to take atorvastatin with orange juice. -The nurse should teach the client that it is safe to take atorvastatin with coffee. -The nurse should teach the client that it is safe to take atorvastatin with milk.

A nurse is assessing a client who has fluid volume excess. Which of the following manifestations should the nurse expect? A. weak peripheral pulses B. increases hematocrit C. crackles in the lungs D. weight loss from baseline

C. crackles in the lungs (The nurse should identify that a client who has fluid volume excess can develop crackles in the lungs, shortness of breath, and dyspnea.) The nurse should identify that a client -who has fluid volume excess can have bounding pulses. A client who has fluid volume deficit can have a weak and thready pulse. -who has fluid volume excess can have a decreased hematocrit. A client who has a fluid volume deficit can have an increased hematocrit. -who has fluid volume excess can experience a weight gain. A client who has fluid volume deficit can experience weight loss.

A nurse is evaluating a client who is receiving a continuous enteral feeding & has diarrhea. Which of the following action actions the nurse take to reduce the clients diarrhea? A. flush the clients feeding tube B. administer promethazine to the client C. decrease the rate of the feeding D. check the clients gastric residual .

C. decrease the rate of the feeding (To prevent diarrhea, the nurse should decrease the rate of the tube feeding, which allows for better absorption of the enteral formula.) -The nurse should flush the client's feeding tube before and after giving medications or if the tube is clogged. However, flushing the tube will not reduce the client's diarrhea. -Promethazine is administered for the treatment and prevention of nausea and vomiting, rather than diarrhea. -The nurse should check the client's gastric residual routinely to reduce the risk for aspiration and monitor the absorption of the feeding. However, this action will not reduce the client's diarrhea.

A nurse is creating a plan of care for a client who has mucositis following head & neck radiation therapy to treat cancer. Which of the following interventions should the nurse include in the plan? A. Encourage 3 serving of citrus food daily B. provide lemon-glycerin swabs for oral hygiene after meals C. increased fluid intake to 2 L per day D. heat oral hygiene mouth rinses before use

C. increased fluid intake to 2 L per day (A client who has mucositis should increase fluid intake to promote hydration and peristalsis. A client who has mucositis should -avoid acidic foods to prevent further irritation. -avoid glycerin-based swabs because they cause dryness and irritation. -be provided with room temperature or cooled liquids to reduce irritation.

A nurse is caring for a client who is dehydrated & is receiving intermittent enteral feeding. Which of the following actions should the nurse plan to take? A. use a low-fat formula for administration B. chill the formula prior to admin C. provide the formulas as a continuous infusion D. dilute the formula before admin

C. provide the formulas as a continuous infusion (to prevent receiving a high carbohydrate load with each feeding.) -A client who is experiencing distention and bloating should receive a low-fat formula. A client experiencing dehydration should receive a low-protein formula. -A chilled formula can cause abdominal distention and cramping. The nurse should warm the formula to room temperature prior to administration. The temperature of the formula does not affect the client's dehydration status. -A client who is experiencing dehydration should receive additional water, but diluting the formula will also reduce the amount of nutrients the client receives.

A home health nurse is reviewing the medical record of a client who had an open reduction internal fixation of the tibia. Which of the following finding should the nurse identify as a risk factor for impaired wound healing? A. the clients hemoglobin is 15 g/dL B. the clients peripheral pulses are +3 distal to the affected extremity C. the client consumes 1,000 kcal daily D. The client takes zinc supplements

C. the client consumes 1,000 kcal daily (Adults who have had surgery require at least 1,500 kcal daily to meet energy needs and build protein for tissue healing. The nurse should recognize that a 1,000 kcal/day intake is below the client's needs.) -A hemoglobin level of 15 g/dL is within the expected reference range of 14 to 18 g/dL in men and 12 to 16 g/dL in women. A hemoglobin level below the expected reference range is a risk factor for impaired wound healing. -Pulses +3 strength are an expected finding. The nurse should identify decreased tissue perfusion as a risk factor for impaired wound healing. -The body uses zinc to build proteins and aid the immune response. The nurse should identify this finding as a factor that will promote wound healing.

A nurse is providing teaching to a client who is a vegetarian & requires an increase in zinc intake. Which of the following foods should the nurse include in the teaching as the best sources of zinc? A. pineapple B. green grapes C. cauliflower D. pinto beans

D. pinto beans (The nurse should determine that pinto beans are the best food source to recommend because they contain the highest amount of zinc per serving.)

A nurse is reviewing the introduction fo solid foods with the guardian of a 4-month old infant. Which of the following statements by the guardian indicated an understanding of the teaching? A. "my baby should consume 2 tablespoons of solid foot at each feeding' B. "the majority of my baby's calories should come from solid food." C. "i will give my baby 1 bottle of fruit juice each day." D. ""i will introduce a new solid food every 5 days."

D. ""i will introduce a new solid food every 5 days." (The client understands that new food items should be introduced every 4 to 7 days to monitor for indications of food allergies.) -Infants should consume 1 to 2 teaspoons of solid food initially at each feeding. -The infant should receive the majority of calories from infant formula or breast milk. -Fruit juices should be introduced at 6 months of age, limited to 120 mL (4 oz), and offered in a cup.

A community health nurse is planning to teach a class about weight management for cardiovascular health. Which of the following statements should the nurse plan to include? A. "limit your sodium intake to 1,800 mg per day." B. "reduce your daily intake or food that contain protein." C. "taking a daily multivitamin will prevent cardiovascular disease." D. "plan to loose weight gradually at 1/2 to 1 pound per week."

D. "plan to loose weight gradually at 1/2 to 1 pound per week." (The nurse should inform the participants that losing 0.23 to 0.45 kg (0.5 to 1 lb) per week is a healthy and attainable weight-loss goal. Setting realistic goals for weight loss is an important element of success. Trying to lose weight too quickly places clients at risk for nutritional deficiencies and inadequate energy, which can lead to frustration and defeat.) According to the American Heart Association, clients should limit their sodium intake to 1,500 mg/day. Evidence-based practice indicates that the most significant decreases in blood pressure are seen in clients who have a daily sodium intake of 1,500 mg or less. The nurse should inform the participants that -plant-based protein assists in lowering cholesterol levels, which ultimately reduces the workload of the heart. Adequate protein is also important for maintaining muscle mass, which aids in weight management. -if a nutritionally-balanced diet is carefully planned and followed, vitamin supplements are not necessary. Evidence-based practice indicates that multivitamin supplements do not decrease or prevent cardiovascular disease.

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. Clients who take MAOIs should avoid the consumption of most types of cheese and other foods that contain high levels of tyramine, which can lead to hypertensive crisis. -Grapefruit juice contains little or no tyramine; therefore, consumption is not restricted for clients who are taking MAOIs. -Whole milk contains little or no tyramine; therefore, consumption is not restricted for clients who are taking MAOIs. -Whole grain bread contains little or no tyramine; therefore, consumption is not restricted for clients who are taking MAOIs.

A nurse if caring for a client who has a new prescription for parenteral nutrition (PN) containing a mixture of dextrose, amino acids, and lipids. Prior to the administration of the PN, the nurse should report which of the following food allergies to the provider? A. Gelatin B. Peanuts C. Shellfish D. Eggs

D. Lipid emulsions are isotonic and are composed of soybean or safflower plus soybean oil, with egg phospholipid used as an emulsifier. Clients who are allergic to eggs can have a reaction to the emulsifier. Therefore, the nurse should report this finding to the provider. -There is no indication that a gelatin allergy has an effect on the administration of PN. Therefore, the nurse should report this allergy to the dietitian, rather than the provider. -There is no indication that a peanut allergy has an effect on the administration of PN. Therefore, the nurse should report this allergy to the dietitian, rather than the provider. -There is no indication that a shellfish allergy has an effect on the administration of PN. Therefore, the nurse should report this allergy to the dietitian, rather than the provider.

A nurse is teaching a prenatal education class about breastfeeding. Which fo 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 1st breastfeeding session C. plan to breastfeed the newborn every 4 hours 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. (let the newborn nurse for 5 min on each breast on the first day to promote milk production.) The nurse should instruct the clients -to avoid using supplemental formula or water with artificial nipples to decrease the risk of nipple confusion. -to avoid offering the newborn fluids other than breast milk to promote milk production. -to breastfeed on demand when the newborn shows indications of hunger, usually 8 to 12 times per day.

A nurse is providing dietary teaching for a client who has osteoporosis. The nurse should instruct the client of 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. The nurse should determine that ½ cup roasted almonds is the best food source to recommend because ½ cup of almonds contains 185 mg of calcium. Calcium helps to prevent bone loss in clients who have osteoporosis. -The nurse should recommend a different food because there is another choice that contains a higher amount of calcium. One cup of avocado contains 18 mg of calcium. -The nurse should recommend a different food because there is another choice that contains a higher amount of calcium. Two tablespoons of peanut butter contain 17 mg of calcium. -The nurse should recommend a different food because there is another choice that contains a higher amount of calcium. One half cup of roasted sunflower seeds contains 45 mg of calcium.

A home health nurse is providing dietary teaching to a guardian of a 3 year old child. Which of the following statements by the guardians 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 she can practice getting them with her fork. C. I can give her popcorn as a snack to provide a serving of whole grain. D. I will put low-fat milk in her cup for her to drink.

D. Whole milk provides necessary fat for neurological development for children up to 2 years of age, after which the child should consume low-fat or skim milk. Therefore, the nurse should identify this statement as indicating an understanding of the teaching. -The nurse should instruct the guardians to avoid giving the 3-year-old child celery or large amounts of peanut butter because both foods present a choking hazard. The guardians should spread peanut butter in a thin layer to decrease the risk of choking. -The nurse should instruct the guardians to cut items into small pieces to reduce the risk of choking. -The nurse should instruct the guardians to avoid foods that are easy to swallow whole, such as popcorn or hard pretzels, until the child is 4 years old, because they present a choking hazard.

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 food rather than cold foods. C. instruct the client to eat 3 meals per day D. add extra calories & protein in every meal

D. add extra calories & protein in every meal (AD. add extra calories & protein in every meal) -Cancer treatments can cause an increased sensitivity to odors, precipitating nausea and increasing anorexia. The nurse should -serve cold foods rather than hot foods. Hot foods emit odors that can further decrease the client's appetite. -advise the client to eat small, frequent meals approximately every 2 hr.

A nurse is caring for a client who had undergone a radial head & neck resection to treat cancer & is receiving radiation therapy. The nurse should monitor for which of the following potential AE? A. bone marrow suppression B. radiation enteritis C. malabsorption of nutrients D. changes in the production of saliva

D. changes in the production of saliva (hanges in salivation are a potential complication of a head and neck resection and radiation therapy.) -Bone marrow suppression is an adverse effect from chemotherapy. -Radiation enteritis occurs following radiation of the pelvis or abdomen, rather than the head and neck. -Malabsorption of nutrients is a potential complication of radiation enteritis, an effect of radiation to the abdomen and pelvis.

A nurse is teaching about nutritional requirements for a client who is starting a vegetarian diet. Which of the following info should the nurse include in the teaching? A. consume high-fat cheese to replace meats when on a vegetarian diet B. a vegetarian diet is high in Vit. B12 C. fewer calories are required when on a vegetarian diet D. include 2 servings per day of nuts when on a vegetarian diet

D. include 2 servings per day of nuts when on a vegetarian diet (to receive the daily requirement of omega-3 fatty acids.) -The nurse should instruct the client to consume low-fat cheese as a protein substitute. High-fat cheese has more saturated fat and calories than meat. -Foods that contain vitamin B12 are animal-related. The best sources of dietary vitamin B12 are meats and other animal products. As vitamin B12 is generally not present in plant-based foods, the nurse should instruct the client to take vitamin B12 supplements or consume foods fortified with B12 to compensate for a potential deficiency. -Clients who are consuming a vegetarian diet require a deceased intake of dietary fat rather than fewer calories. The nurse should instruct the client to increase intake of nutrient-dense foods to avoid the breakdown of the body's protein for energy requirements.

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 foods B remain upright for 1 hr following meals C. limit eating to 3 large meals per day D. select grains w/ less than 2g fiber per serving

D. select grains w/ less than 2g fiber per serving (Clients at risk for dumping syndrome better tolerate low-fiber grains that contain less than 2 g fiber per serving to slow gastric emptying.) The nurse should instruct the client -to avoid simple sugars and sugar alcohols, which make food mass more hypertonic, causing a greater fluid volume shift and triggering dumping syndrome. -to lie down after eating to slow the movement of food through the gastrointestinal system. -to eat small, frequent meals to slow gastric emptying.

A nurse is preparing to bottle feed an infant who has a cleft lip. Which of the following actions should the nurse take to reduce the risk of aspiration? A. burb the infant once at the end of the feeding B. use a bottle that has a 2-way valve C. place a low-flow-rate nipple on the bottle D. squeeze the infant's cheeks together while feeding

D. squeeze the infant's cheeks together while feeding (The nurse should identify that an infant who has a cleft lip will have difficulty in obtaining an adequate seal during feeding. The nurse should gently squeeze the infant's cheeks together to decrease the width of the cleft, allowing the infant to achieve a better seal, which reduces the risk of aspiration.) -The nurse should burp the infant after each ounce of feeding or at least two to three times during the feeding. Infants who have a cleft lip can swallow air while feeding, which can cause vomiting and an increased risk of aspiration. -The nurse should use a bottle with a bottle with a one-way valve to assist the infant in effective feeding, because this allows the liquid to flow into the infant's mouth rather than back into the bottle. Providing an effective flow of formula reduces the risk of aspiration. -The nurse should place a high-flow rate nipple on the bottle because the infant can have difficulty achieving a good seal, which decreases suction and increases the risk of aspiration.

A nurse is assessing a 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 bowl sounds after eating C. the clinet has an increased interest in eating D. the client voice changes after eating

D. the client voice changes after eating (The nurse should identify that hoarseness or a change in voice after eating is a manifestation of dysphagia because partially swallowed food can alter the client's voice.) -The nurse should identify that painful swallowing is a manifestation of dysphagia. -The nurse should identify that peristalsis increases after eating to promote the passage of food through the intestines. This is an expected finding of gastrointestinal functioning, not a manifestation of dysphagia. -The nurse should identify that clients who have dysphagia can become discouraged while eating and consume less food, possibly leading to malnutrition.

A nurse in a clinic is reviewing the lab findings of a client who recently begin a Dietary Approaches to Stop HTN (DASH) diet. Which of the following lab findings indicates the client has reached 1 of the goals of the DASH diet? A. sodium 150 mEq/L B. Chloride 106 mEq/L C. Fasting glucose 130 mg/dL D. total cholesterol 190 mg/dL

D. total cholesterol 190 mg/dL (A feature of the DASH diet is a reduction in total cholesterol. This laboratory finding is within the expected reference range of cholesterol less than 200 mg/dL, and indicates that the client has achieved one of the goals of the DASH diet.) -A feature of the DASH diet is a reduction in sodium intake. This laboratory finding is above the expected reference range of 135 to 145 mEq/L for sodium and indicates that the client has not reached a goal of the DASH diet. -This laboratory finding is within the expected reference range of 98 to 106 mEq/L, but it is not an indication of achieving a goal of a DASH diet. -A feature of the DASH diet is a reduction in serum glucose, as hyperglycemia is an associated risk factor for hypertension and coronary heart disease. This laboratory finding is above the expected reference range of 70 to 130 mg/dL and indicates that the client has not reached a goal of the DASH diet.