Fund. Ch. 33 Nutrition

The nurse is caring for a client who refuses most foods on the dietary tray. Which nursing intervention is appropriate? -Allow the client privacy during mealtime. -Delegate feeding assistance to the unlicensed assistive personnel. -Assess when client generally eats meals. -Contact the healthcare provider to prescribe an appetite stimulant.

Assess when client generally eats meals.

An older adult client who has a BMI of 28.1 and gastroesophageal reflux disease (GERD) reports heartburn frequently. The nurse plans to teach the client how to manage and prevent heartburn. What information will the nurse include in the teaching for this client? Select all that apply. -Do not use products that contain nicotine, such as tobacco and vaping devices. -As long as you sleep with two pillows, you may eat prior to bedtime. -Maintain a diet that is low in fat. -Plan a nutritious diet that will allow you to lose weight. -One ounce of alcohol with the evening meal is allowed.

Do not use products that contain nicotine, such as tobacco and vaping devices. Maintain a diet that is low in fat. Plan a nutritious diet that will allow you to lose weight.

A nurse is obtaining a blood glucose level on an infant. The nurse would use which site to obtain the specimen? -Heel -Ear lobe -Thumb -Index finger

Heel

Which nursing action is performed according to guidelines for aspirating fluid from a small-bore feeding tube? -Use a small syringe and insert 10 mL of air. -If fluid is obtained when aspirating, measure its volume and pH and flush the tube with water. -Continue to instill air until fluid is aspirated. -Place the client in the Trendelenburg position to facilitate the fluid aspiration process.

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. What is an accurate guideline for care of the insertion site? -If the gastrostomy tube is new, dip a cotton-tipped applicator into saline solution and apply pressure to clean the site. -If the gastrostomy tube is new and has crusts or drainage, do not disturb the site by cleaning it. -Adjust or lift the external disk for the first few days after placement to keep crusts from forming. -If the gastric tube insertion site has healed and the sutures are removed, use soap and water to clean the site.

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

What is the route of administration for TPN? -Oral -Subcutaneous -Intramuscular -Intravenous

Intravenous

A client visits a health care facility reporting loss of appetite following a prolonged illness. How should the nurse document the client's condition? -emaciation -cachexia -anorexia -nausea

anorexia

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? -underweight -healthy weight -overweight -obese

overweight

A nurse is working with a 45-year-old construction worker. The nurse obtains his height and weight and calculates that his BMI is 28. How would the nurse best classify James? -underweight -ideal body weight (IBW) -overweight -obese

overweight

The nurse is helping a client, who wishes to increase Omega-3 fatty acids, to order breakfast. Which food will the nurse recommend? -egg whites -wheat toast -salmon -coffee

salmon

A nurse is caring for a client with a history of cardiac and vascular disease. Which fats should the nurse allow in the client's diet for his condition? -unsaturated fats -trans fats -saturated fats -hydrogenated fats

unsaturated fats

A nurse is planning a high-energy diet for a client. Which statement by the nurse best describes the types of foods the client should include in the diet? -"Include plenty of grains, fruits, and vegetables in your diet." -"Include plenty of foods high in vitamin C in your diet." -"Include plenty of foods high in iron in your diet." -"Increase the amount of water you drink on a daily basis."

"Include plenty of grains, fruits, and vegetables in your diet."

A client with diabetes mellitus must monitor carbohydrate intake. Which client statement requires nursing intervention? -"I like to eat eggs for breakfast." -"I'll monitor my intake of fruit juice." -"My favorite drink is coffee with sugar." -"At every meal, I eat a small portion of lean meat."

"My favorite drink is coffee with sugar."

A student is following current recommendations for assessing tube placement. A staff nurse says, "Oh, just insert air and listen for a 'whoosh' sound." How would the student respond? -"Thank you. That would be much easier for me to do." -"That procedure has been found to be unreliable." -"My instructor told me to do it this way, so I will." -"I appreciate your advice. Let me ask the client."

"That procedure has been found to be unreliable."

Which measures are used by the nurse to confirm the correct placement of a nasogastric feeding tube? Select all that apply. -measuring the pH level of aspirated contents -monitoring carbon dioxide levels -obtain a chest x-ray after placement as ordered -measuring tube length -instilling fluid into the tube

-measuring the pH level of aspirated contents -monitoring carbon dioxide levels -obtain a chest x-ray after placement as ordered -measuring tube length

At what period of life do nutrient needs stabilize? -Infancy -Adolescence -Pregnancy -Adulthood

Adulthood

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? -Eat a variety of enjoyable foods, but less quantity. -Drink nonfat or 1% milk. -Drink juice for majority of fluid intake. -Make fruits and vegetables at least half of total food intake.

Drink juice for majority of fluid intake.

The nurse caring for a client for several days has assessed that he has been eating poorly during his hospitalization. Which nursing measure should the nurse implement to assist the client in improving his nutritional intake? -Encourage his daughter to prepare food at home and bring it to the client. -Serve large meals and encourage the client to eat as much as possible. -Provide distractions while the client is fed so that he will eat more. -Provide bland meals.

Encourage his daughter to prepare food at home and bring it to the client.

A client resides in a long-term care facility. Which nursing intervention would promote increased dietary intake? -Encourage the client to eat in the dining room. -Feed the client their meal while in bed. -Allow the client to eat when they want to. -Discourage family from visiting during meals.

Encourage the client to eat in the dining room.

A nurse is working with a 54-year-old client with a history of constipation. The client asks if there is anything that should be added to the diet to ease defecation. Which teaching should the nurse provide? -Decrease the amount of carbohydrates you eat. -Include plenty of high-fiber foods in your diet, including beans, vegetables and fruits. -Increase the amount of protein you eat, including salmon and chicken. -Drink a glass of red wine each night before dinner.

Include plenty of high-fiber foods in your diet, including beans, vegetables and fruits.

In planning to meet the nutritional needs of a critically ill client in the intensive care unit, which factor will increase the client's basal metabolic rate? -Infection -Advanced age -Prolonged fasting -Long periods of sleep

Infection

A nurse is feeding a client. Which action will the nurse take? -Explain that a bib will be used in case the meal gets messy. -Inform the client that the experience will be quick, approximately 10 minutes. -Feed the client the meal starting with the protein, explaining it is the most important. -Offer options of foods and for the order to be eaten.

Offer options of foods and for the order to be eaten.

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? -To lose 1 pound/week, the daily intake should be decreased by 200 calories. -One pound of body fat equals approximately 5,000 calories. -Psychological reasons for overeating should be explored, such as eating as a release for boredom. -Obesity is very treatable, and 50% of obese people who lose weight maintain the weight loss for 7 years.

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

A nurse is reviewing a client's laboratory values. Which laboratory value would be indicative of a client's level of malnutrition? -Hemoglobin -Serum albumin -Creatinine -Oxygen saturation

Serum albumin

A nurse has just received a client's laboratory results and is reviewing them. Which finding should the nurse recognize as an indication of malnutrition or malabsorption? -Serum albumin 2.8 g/dL (28 g/L) -Hemoglobin (Hgb) 11.3 g/dL (113 g/L) -Creatinine 1.9 mg/dL (168 µmol/L) -Hematocrit (Hct) 56% (0.56)

Serum albumin 2.8 g/dL (28 g/L)

A nurse observes that a client coughs and chokes when eating. What instructions should the nurse prepare for this client? -Instruct the dietary department to prepare a liquid diet. -Tell the client to chew his food very thoroughly. -Instruct the client to avoid drinking beverages with meals. -Restrict milk and other dairy products in the diet.

Tell the client to chew his food very thoroughly.

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. -Reduce the frequency of meals in order to allow the client to develop an appetite. -Offer nutritional supplements and explain the potential benefits of each. -Offer larger meals and encourage the client to eat as much as is comfortable.

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

A nurse is preparing an education plan for a client who is scheduled for a diagnostic procedure that requires a clear liquid diet the day before the procedure. When teaching the client about what he may consume, which foods would the nurse include? Select all that apply. -apple juice -ice cream -gelatin -pureed vegetables -tea

apple juice gelatin tea

The nurse is helping a client who eats a normal diet of 2000 calories daily to read a nutritional label on a box of cereal. Which nutrient does the nurse identify as appropriate for this client? -total fat greater than 65 g -cholesterol less than 300 mg -sodium greater than 2400 mg -saturated fat greater than 30 mg

cholesterol less than 300 mg

The nurse should begin the process of removing a client's nasogastric (NG) tube by: -confirming the physician's order to remove the tube. -confirming the placement of the NG tube. -separating the tube from suction. -flushing the tube with 10 mL of water or normal saline.

confirming the physician's order to remove the tube.

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 -egg yolks -whole wheat pasta -whole milk -bacon

cured ham table salt bacon

A nurse is caring for a client who is reporting nausea. Which is a sign of nausea? -dizziness and perspiration -impaired swallowing -slow pulse rate -emotional distress

dizziness and perspiration

A nurse is assessing the volume of liquid nutrition that has been tube-fed to a client. What will happen if the volume of feeding exceeds the client's physiologic capacity? -diarrhea -pallor -obesity -gastric reflux

gastric reflux

Which type of feeding tube would be most appropriate for a client requiring enteral feeding for a long period of time? -gastrostomy tube -nasogastric tube -nasointestinal tube -Salem Sump tube

gastrostomy tube

A client with nonhealing wounds requires a feeding tube. Which type of formula does the nurse anticipate will be ordered? -high-protein -standard isotonic -fiber-containing -partially hydrolyzed

high-protein

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? -production of hemoglobin to carry oxygen to tissues -regulation of osmotic pressure in the blood -maintenance of normal bowel elimination -promotion of energy storage in adipose tissue

maintenance of normal bowel elimination

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 -mildly elevated -severely elevated -low

normal

A nurse is preparing a presentation for a local community group on healthy nutrition using information from the USDA's website, ChooseMyPlate.gov. Which recommendation would the nurse be least likely to include? -using appropriate portion sizes -switching to whole milk -replacing sugary drinks with water -making fruits and vegetables account for half of your plate

switching to whole milk

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? -new mother who is bottle-feeding a baby -older adult who lives with grown children -teenager who is in the second trimester of pregnancy -middle-age male who works night shift

teenager who is in the second trimester of pregnancy

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 most suspect? -vitamin A -vitamin B -vitamin C -vitamin D

vitamin D

The nurse is preparing to administer a client's tube feeding. How should the nurse position the client prior to beginning the infusion? -with the head of the bed at least 30 to 45 degrees -supine -with the head of the bed raised between 20 and 30 degrees -in a left side-lying position

with the head of the bed at least 30 to 45 degrees