Chapter 36 Nutrition

Which nursing student statement regarding vegetarian diets requires further teaching from the nursing instructor?

"According to research, vegetarians have a higher incidence of obesity than others."

The nurse is teaching the caregiver of a toddler about the importance of calcium to help a child's teeth and bones develop properly. Which client statement reflects that nursing teaching has been effective?

"I will be sure to provide milk at meals."

A client with diabetes mellitus must monitor carbohydrate intake. Which client statement requires nursing intervention?

"My favorite drink is coffee with sugar."

A client is discussing vitamin and mineral intake with the nurse. Which client statement requires further nursing teaching?

"My husband and I are ordering a product that has megadoses of vitamins."

A nursing student is teaching healthy nutrition to a client who is vegetarian. Which statement by the nursing student requires the nursing instructor to intervene?

"Obesity is closely linked with vegetarianism."

A client is discussing vitamin and mineral intake with the nurse. Which client statement requires nursing intervention?

"Taking megadoses of vitamins will help me increase muscle mass quickly."

A nurse is estimating caloric requirements for a female client whose healthy weight is 120 lb (54.4 kg) and whose activity level is moderate. What will the client's recommended total daily calories be?

1,680

A nurse is establishing an ideal body weight for a 5'9" (175 cm) healthy female. Based on the rule-of-thumb method, what would be this client's ideal weight?

145 lb/ 65.7 kg

What is the body mass index (BMI) of a client who is 1.68 meters tall and weighs 70 kg?

24.8

A nurse is caring for an adult client who ate a chicken breast and drank a glass of water. There are 60 grams of protein in the chicken breast. Calculate the energy intake, in kilocalories, for this food. Record your answer using a whole number.

240

A nurse is discussing vitamin supplementation. Which groups are more prone to mild vitamin deficiencies? Select all that apply.

Adolescents Pregnant or lactating women Strict vegetarians

At what period of life do nutrient needs stabilize?

Adulthood

A nurse documents a client's hemoglobin as 80 g/L. What nutritional condition does this biochemical data signify?

Anemia

The nurse is attempting to insert an NG tube and, as the tube is passing through the pharynx, the client begins to retch and gag. What nursing interventions are appropriate in this situation? Select all that apply.

Ask the client if he needs to pause before continuing insertion. Continue to advance tube when the client relates that he is ready. Have the emesis basin nearby in case client begins to vomit.

A nurse enters a client's room to perform a tube feeding. Which nursing action should be performed first?

Aspirate stomach contents and check pH.

The nurse has obtained a client's capillary blood glucose sample and the results are significantly lower than reference range. What is the nurse's priority action?

Assess the client for signs and symptoms of hypoglycemia.

Prior to allowing a client to eat, which action is most important for the nurse to take?

Assess the client's level of consciousness.

The nurse is caring for a client who refuses most foods on the dietary tray. Which nursing intervention is appropriate?

Assess when client generally eats meals.

The American Association of Critical-Care Nurses (AACN) has provided a directive regarding best practice for verification of feeding tube placement. Which practice should the nurse adopt?

Bedside techniques, including measuring the pH and observing the appearance of fluid withdrawn from the tube, should be used to assess tube location at regular intervals.

A nurse is teaching a client about diabetes and glucose monitoring. What should the nurse include in the teaching?

Blood from the fingertips shows changes in glucose more quickly than other testing sites.

Which nursing action associated with successful tube feedings follows recommended guidelines?

Check the residual before each feeding or every 4 to 8 hours during a continuous feeding.

A nurse is caring for a client who reports frequent nausea. Which food should the nurse recommend to the client when the nausea is relieved?

Clear fruit juices

The nurse is preparing to administer an intermittent feeding to a client who has a feeding tube. The nurse is unable to aspirate gastric contents and realizes that the tube is clogged. Which action is correct?

Connect a syringe filled with warm water to the feeding tube and flush it out using gentle pressure.

A nurse is working with a 46-year-old woman who is working to lose weight. Based on recommendations from the USDA regarding diet modification, which is not appropriate advice for this client?

Drink juice for majority of fluid intake.

A nurse is caring for a client with a nasogastric tube. The nurse enters the room to flush the nasogastric tube and check gastric residual. Which action should the nurse perform first?

Ensure the head of the bed is elevated.

A nurse is managing a client's continuous tube feeding via an NG tube. How often should the nurse check for residual?

Every 4 to 6 hours

Which task may be safely delegated to unlicensed assistive personnel (UAP)?

Feeding a client who is at risk for aspiration

A client has had a stroke and will require long-term tube feeding. Which type of feeding tubes would be most appropriate for this client's needs?

Gastrostomy tube

The nurse is caring for a client receiving continuous tube feeding. The client has a gastric residual of 550 mL. The previous residual was 200 mL. What action should the nurse take?

Hold the enteral nutrition and notify the primary care provider.

A nurse is preparing to obtain a client's capillary blood sample for glucose testing. The nurse should perform which action?

Hold the lancet perpendicular to the skin and prick the site.

Which nursing action is performed according to guidelines for aspirating fluid from a small-bore feeding tube?

If fluid is obtained when aspirating, measure its volume and pH and flush the tube with water.

A nurse is caring for a client with a gastrostomy tube in place. Which is an accurate guideline for care of the insertion site?

If the gastric tube insertion site has healed and the sutures are removed, use soap and water to clean the site.

What is an appropriate intervention when unexpected situations occur during the administration of a tube feeding?

If the tube becomes clogged when aspirating contents, use warm water and gentle pressure to remove the clog.

The nurse is reviewing a client's most recent laboratory results, which reveal increases in hematocrit, creatinine, and blood urea nitrogen (BUN). After collaborating with the interdisciplinary team, what intervention is most appropriate?

Increase the client's fluid intake.

The nurse is caring for a client with an enlarged thyroid gland. Which nutritional deficiency will the nurse suspect is linked to the client's condition?

Iodine

A female client has developed an abscess following abdominal surgery, and her food intake has been decreasing over the past 2 weeks. Which laboratory finding may suggest the need for nutritional support?

Low serum albumin levels

During a visit to the pediatrician's office, a mother inquires about adding solid foods to the diet of her 6-month-old infant. What does the nurse inform the mother?

New foods should be introduced one at a time for a period of 5 to 7 days.

An athlete wants to increase the intake of complex carbohydrates and asks the nurse about potential sources. Which food is considered a complex carbohydrate?

Pasta

The nurse is providing care for a client who is ordered nothing by mouth (n.p.o.). What is an important nursing intervention?

Provide frequent mouth care.

The nurse is performing a nutritional assessment of an obese client who visits a weight control clinic. What information should the nurse take into consideration when planning a weight reduction plan for this client?

Psychological reasons for overeating should be explored, such as eating as a release for boredom.

The average dietary nutrient intake level that meets the nutritional requirement of almost all healthy people in a selected age and gender group is the:

RDA level

A nurse has just inserted a nasogastric tube in a client. Which method is most reliable for verifying the correct placement of the tube?

Radiographic confirmation of position

The nurse is using a large syringe to administer an intermittent feeding to a client who has a nasogastric feeding tube. Which method should the nurse use to increase the flow rate of the formula?

Raise the height of the syringe.

Which laboratory test is the best indicator of a client in need of TPN?

Serum albumin

The nurse is caring for a client who has dysphagia and is unable to eat independently. The nurse is preparing to assist the client in eating a meal. Which action is appropriate?

Speak to the client but limit the need for the client to respond verbally while chewing and swallowing.

The charge nurse is observing a new nurse care for a client who is receiving a continuous feeding through a nasogastric feeding tube. Which action by the new nurse would require intervention by the charge nurse?

The new nurse places the client in the left lateral recumbent position.

A nurse is checking a client's capillary blood glucose level. Which nursing action is most appropriate?

Touch the test strip directly to a drop of blood.

An older adult client informs the nurse that foods don't taste or smell the same and eating is a chore. What suggestion can the nurse provide to the client to address this age-related change?

Try eating foods that are attractive and at the proper temperature.

The nurse has observed that a client's food intake has diminished in recent days. What intervention should the nurse perform in order to stimulate the client's appetite?

Try to ensure that the client's food is attractive and sufficiently warm.

The client reports to the nurse that she feels as if her eyes are persistently dry. This symptom is consistent with a deficiency in which dietary element?

Vitamin A

A client has a history of long-term alcohol use. Which nutrient would need to be required in increased amounts?

Vitamin B

A client is prescribed warfarin, an anticoagulant. When educating this client about potential diet and drug interactions, the nurse would caution the client about foods containing which nutrient?

Vitamin K

A client who has bleeding tendencies has a deficiency in which vitamin?

Vitamin K

When planning interventions in the immediate hours after birth the nurse recognizes the need to provide an injection of which vitamin (to manage a lack of it), due to lack of bacteria in the intestinal tract?

Vitamin K

The nurse is assessing clients for basal metabolic rate (BMR). Which client would the nurse suspect would have an increased BMR?

a client who has a fever

The nurse is teaching a client about ways in which to reduce sodium in the diet. Which foods will the nurse recommend that the client avoid? Select all that apply.

cured ham table salt bacon

A woman consumes pasta, grains, and other carbohydrates for which purpose?

energy

A client is receiving total parenteral nutrition (TPN). The nurse will assess for complications related to:

fluid and electrolyte levels.

A client with influenza is prescribed a diet that is rich in fiber and carbohydrates. Which would the nurse incorporate into the education plan as a major reason for the high fiber diet?

maintenance of normal bowel elimination

A client with protein deficiency is encouraged to eat a protein-rich snack. The client requests a peanut butter sandwich. What other food can the nurse provide that will provide the client with complete protein?

milk

A postmenopausal client wishes to increase the amount of vitamin D that she consumes to help keep her bones strong. Which food will the nurse recommend?

milk

An older adult client has a decubitus ulcer with drainage, dysphagia, and immobility. She consumes less than 300 calories per day and has a large amount of interstitial fluid. The client is in a state of:

negative nitrogen balance.

A client who is taking supplements reports severe flushing and itching an hour after ingestion. The nurse is aware that the supplement is most likely:

niacin.

A 45-year-old client on the inpatient unit has just resumed eating a normal diet. The nurse checks a blood sugar with the morning labs and the result is 99.10 mg/dL (5.5 mmol/L). How would the nurse interpret this blood glucose?

normal

The community nurse is educating client groups about nutrition. Which group does the nurse identify that will benefit most from nutritional counseling and intervention?

older adults living on a fixed income

A nurse is caring for a client who has a body mass index (BMI) of 26.5. Which category should the nurse understand this client would be placed in?

overweight

Which client(s), at risk for poor nutritional intake, would benefit from nutritional counseling from the nurse? Select all that apply.

people with substance use problems older adults living on fixed incomes pregnant teenagers

The nurse is teaching four clients in a community health center. Which client does the nurse identify as needing more servings per day of milk?

teenager who is in the second trimester of pregnancy

A nurse is caring for a client who has a malabsorption disease. The nurse should understand that which structure in the gastrointestinal system absorbs the majority of digested food and minerals?

the small intestine

A 16-year-old adolescent informs her nurse that she became a vegetarian 1 year ago. Lately she is reporting fatigue and has trouble concentrating. A quick blood test ordered by her licensed provider informs the nurse that she has pernicious anemia. This is a deficiency of what vitamin?

vitamin B12

Which vitamin is found only in animal foods?

vitamin B12

A nurse in a rural health center meets a new client, age 4. The nurse notices as the client enters the clinic that his legs appear to be bowed. When he smiles, the nurse also notes that his dentition is quite malformed for a child his age. What vitamin deficiency would the nurse mostsuspect?

vitamin D

Which of the following is a fat-soluble vitamin?

vitamin E

A client with headaches has been told by the healthcare provider to increase intake of dietary magnesium. Which food will the nurse teach the client to consume?

whole grains