Nutrition Practice A
A nurse is performing a cultural nursing assessment for a client whose religious practices include fasting 1 day each week. Which of the following questions should the nurse ask the client? (Select all that apply.) 1. "Are you exempt from fasting during illness?" 2. "Does fasting mean refraining from drinking liquids?" 3. "Does your fasting occur during certain hours of the day?" 4. "Is vegetarianism a form of fasting?" 5. "Does fasting mean eating only a certain type of food?"
1. "Are you exempt from fasting during illness?" 2. "Does fasting mean refraining from drinking liquids?" 3. "Does your fasting occur during certain hours of the day?" 5. "Does fasting mean eating only a certain type of food?"
A nurse is administering a continuous tube feeding at 60 mL/hr with 50mL of water every 4 hours. What should the nurse document as total mL of enteral fluid administered during the 8 hour shift?
580mL 60mL X 4 = 480mL 50mL X 2 = 100mL 480mL + 100mL = 580 mL
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 day." B. "I will keep a daily diet and activity log." C. "I will avoid eating 1 hour before bedtime." D. "I will drink a full glass of water with each meal."
A. "I will take a long walk every day." Benefits of exercise are reduction of tension, promotion of relaxation, and improved sense of well-being.
A nurse is teaching a client who has chronic kidney disease about limiting dietary calcium intake. Which of the following food choices should the nurse include in the teaching as having the highest amount of calcium? A. 1 cup low-fat yogurt B. 1 oz cheddar cheese C. 1 egg D. 1/2 cup spinach
A. 1 cup low-fat yogurt 314 mg of calcium per cup
A nurse is assessing a client who has type 2 diabetes mellitus. The nurse should recognize which of the following as a manifestation of hypoglycemia? A. Confusion B. Polydipsia C. Vomiting D. Ketonuria
A. Confusion
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. Consume 20 mcg of vitamin D daily
A nurse is providing teaching to a client who has dumping syndrome and 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 carbohydrates. C. Decrease foods high in fat content. D. Eat meals low in protein.
A. Consume liquids between meals. Slows movement of food from the stomach
A nurse is assessing a client who has diabetes mellitus. Which of the following findings should the nurse identify as a manifestation of hypoglycemia? A. Diaphoresis B. Bradycardia C. Abdominal cramps D. Acetone breath
A. Diaphoresis Diaphoresis, irritability, and tremors are manifestations of hypoglycemia.
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
A nurse is caring for a client 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 Provides protein and other nutrients in their simplest form, requiring little or no digestion and decreasing stimulation of the bowel
A nurse is providing dietary instructions for a client who has a prescription for warfarin. Which of the following foods should the nurse recommend the client eat in moderation while taking this medication? A. Leafy green vegetables B. Whole grains C. Fruits with skin D. Nuts and seeds
A. Leafy green vegetables
A nurse is caring for an adolescent who has type 1 diabetes mellitus. 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 test after 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. Fasting hyperglycemia that occurs in the morning in response to hypoglycemia during the nighttime.
A nurse is caring for a client who is receiving continuous enteral tube feedings. Which of the following actions should the nurse take to prevent aspiration? A. Monitor gastric residuals every 4 hr. B. Maintain elevation of the head of the client's bed at 15 degrees. C. Confirm proper tube placement by radiograph every 24 hr. D. Flush tubing with 30mL of water before and after medications.
A. Monitor gastric residuals every 4 hr.
A nurse is caring for a client who adheres to a kosher diet. Which of the following food choices would be appropriate for this client? A. Vegetable salad with cheese B. Lean cuts of pork C. Turkey and cheese on rye bread D. Shrimp salad and crackers
A. Vegetable salad with cheese
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 B12 D. Phosphorus
A. Vitamin A Allows eyes to adapt to dim lighting more rapidly at night, which improves night vision.
A nurse is discussing dietary factors to assist in blood pressure management for a client who has hypertension. Which of the following client statements indicates 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. "I should choose whole grain pastas when selecting my foods." Contains ingredients that lower the risk of cardiovascular disease and improve blood pressure.
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 beef that is at least 70% lean." B. "Restrict your daily meat intake to 5 ounces." C. "Select cheeses that contain no more than 6 grams of fat per serving." D. "Choose margarine that contains no more than 4 grams of saturated fat per tablespoon."
B. "Restrict your daily meat intake to 5 ounces." Meats should be the size of a deck of cards.
A nurse is providing discharge reaching to a postpartum client about breast milk use and 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 milk back in the freezer." C. "You can store expressed breast milk in the freezer for up to 18 months." D. "Defrost frozen breast milk on the lowest defrost setting in the microwave."
B. "You cannot place thawed breast milk back in the freezer." Bacteria can grow which destroys the antibodies in the milk.
A nurse is caring fora. 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 nutrition can be stopped." B. "You should consume at least 60 percent of your calorie 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 need to be regular before the therapy can be discontinued.
B. "You should consume at least 60 percent of your calorie orally before the parenteral nutrition can be discontinued." Oral intake must exceed 60% to be discontinued.
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 with honey
B. Apply pectin to foods Pectin is a dietary fiber that helps to delay gastric emptying.
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 if feeling full. D. Plan to eat each meal over 15 min.
B. Begin each meal with a protein. Should eat 60g-120g of protein each day.
A nurse is preparing a health promotion seminar for a group of clients about cancer prevention. Which of the following information should the nurse include? A. Consume high-calorie foods and beverages at meal time. B. Eat at least 2.5 cups of fruits and vegetables each day. C. Plan to perform moderate-intensity exercise for 90 min/week. D. Limit alcohol consumption to no more than three drinks per day.
B. Eat at least 2.5 cups of fruits and vegetables each day.
A nurse is caring for a client who is at 8 weeks of gestation and has a BMI of 34. The client asks about weight goals during her pregnancy. The nurse should advise the client to do which of the following? A. Maintain her current BMI B. Gain approximately 6.8kg (11 to 20 lb) during her pregnancy C. Lower her BMI to 30 D. Gain 12.7 to 15.8 kg (28 to 35 lb)
B. Gain approximately 6.8kg (11 to 20 lb) during her pregnancy
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 diet modification.
B. Obtain a 24-hr dietary recall. Identify eating behaviors and then be able to recommend dietary modifications based on the data received.
A nurse in a provider's office is assessing a client who has HIV. The nurse should identify which of the following findings as an indication to increase the client's nutritional intake? A. T-helper (CD4+) cells 700/mm3 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 Inflammatory response, should increase client's nutritional intake.
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. Offer the client hot tea with daytime meals. D. Allow the client to eat privately with their family each day at 1300.
B. Provide a snack for the client after sunset.
A nurse is teaching a client who has hypertension about decreasing sodium intake. Which of the following information should the nurse include in the teaching? A. Use soy sauce as a marinade for meats. B. Season food with herbs and spices. C. Select processed cheese products when available. D. Choose a frozen dinner for a quick meal option.
B. Season food with herbs and spices.
A nurse in a long-term care facility is monitoring a client during mealtime who has Parkinson's disease. Which of the following findings should the nurse identify as the priority? A. The client eats all of their cake and a few bites of bread. B. The client drools while eating. C. The client's hand trembles when they hold their spoon. D. The client chooses to sit alone during their meal.
B. The client drools while eating. At risk for aspiration of food from dysphagia.
A nurse is providing education to an adolescent about making nutrient-dense food choices. Which of the following statements by the client indicates an understanding of teaching? A. "Pasta with white sauce is a better choice than pasta with red sauce." B. "Sweetened fruit yogurt is a health 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 are a better choice than refried beans." Pinto beans contain less fat.
A nurse is teaching a client who is newly diagnosed with type 1 diabetes mellitus how to count carbohydrates. Which of the following statements made by the client indicates an understanding of the teaching? A. "I am including vegetables as starch items in my carbohydrate count." B. "I am limiting the number of carbohydrates to four carbohydrate choices or 60 grams per day." C. "I know the serving size can affect the number of carbohydrates I eat." D. "I know the carbohydrate count is dependent on the calories in the food item."
C. "I know the serving size can affect the number of carbohydrates I eat."
A nurse is teaching an adolescent who has a new diagnosis of celiac disease. Which of the following statements by the client indicates an understanding of the teaching? A. "I need to decrease the amount of oil I use in cooking." B. "I need to eat fewer acidic foods, such as tomatoes and oranges." C. "I need to eliminate rye from my diet." D. "I need to eliminated milk products from my diet."
C. "I need to eliminate rye from my diet." Increases manifestations of celiac disease.
A nurse is teaching a female client about a healthy diet to control hypertension. Which of the following client statements indicates an understanding of the teaching? A. "I will drink two glasses of whole milk daily." B. "I will decrease the potassium in my diet." C. "I will eat four servings of unsalted nuts per week." D. "I will limit alcohol consumption to three drinks per day."
C. "I will eat four servings of unsalted nuts per week."
A nurse is providing teaching to a client who has diabetes mellitus and an HbA1c of 8.7%. Which of the following statements 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 a 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. "This shows that I have not been following my diet." Normal range is 6.5% and 7%.
A nurse is assessing a client's risk for pressure injuries using the Braden scale. The clients eats more than half of most meals but occasionally refuses a meal. Which of the following information 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 nurse is reviewing the laboratory 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 of 150 mEq/L D. A client who has a BUN of 18 mg/dL
C. A client who has a sodium level of 150 mEq/L Expected range is 136-145 and indicates hypernatremia.
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. Baked potato 85-90 glycemic index so it's the highest
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. Increased hematocrit C. Crackles in the lungs D. Weight loss from baseline
C. Crackles in the lungs
A nurse is evaluating a client who is receiving a continuous enteral feeding and has diarrhea. Which of the following actions should the nurse take to reduce the client's diarrhea? A. Flush the client's feeding tube. B. Administer promethazine to the client. C. Decrease the rate of the feeding. D. Check the client's gastric residual.
C. Decrease the rate of the feeding. Allows for better absorption.
A nurse is 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 medicine? A. Orange juice B. Coffee C. Grapefruit juice D. Milk
C. Grapefruit juice
A nurse is creating a plan of care for a client who has mucositis following head and neck radiation therapy to treat cancer. Which of the following intervention techniques should the nurse include in the plan. A. Encourage three servings of citrus foods daily. B. Provide lemon-glycerin swabs for oral hygiene after meals. C. Increase fluid intake to 2 L per day. D. Heat oral hygiene mouth rinses before use.
C. Increase fluid intake to 2 L per day. Promotes hydration and peristalsis
A nurse is reviewing the laboratory findings of a client who has acute pancreatitis. Which of the following is an expected finding? A. Increased calcium B. Decreased bilirubin C. Increased glucose D. Decreased alkaline phosphatase
C. Increased glucose
A nurse is caring for a client who is receiving total parenteral nutrition (TPN) through a peripherally inserted central catheter. The pharmacist informs the nurse that there will be a delay in delivering the next bad 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. Infuse dextrose 10% in water when the current infusion ends. TPN contains high concentrations of dextrose and proteins. To avoid hypoglycemia, the nurse should infuse 10% or 20% in water until the next bag of TPN solution arrives.
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. Leave the skin on when eating fruit.
A nurse is caring for a client who is dehydrated and 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 administration C. Provide the formula as a continuous infusion D. Dilute the formula before administration
C. Provide the formula as a continuous infusion Should receive a high carbohydrate load with each feeding.
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 findings should the nurse identify as a risk factor for impaired wound healing? A. A client's hemoglobin is 15g/dL B. The client's 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 need at least 1,500 kcal daily to meet energy needs and build protein for tissue healing.
A nurse is reviewing the introduction of solid foods with the guardian of a 4-month old infant. Which of the following statements by the guardian indicates an understanding of the teaching? A. "My baby should consume 2 tablespoons of solid food at each feeding." B. "The majority of my baby's calories should come from solid food." C. "I will give my baby one 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." Gives time to watch for an allergic reaction.
A home health nurse is providing dietary teaching to the guardians 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 grains." D. "I will put low-fat milk in her cup for her to drink."
D. "I will put low-fat milk in her cup for her to drink." Necessary fat for neurological development for children up to 2 years of age.
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 milligrams per day." B. "Reduce your daily intake of food that contain protein." C. "Taking a daily multivitamin will prevent cardiovascular disease." D. "Plan to lose weight gradually at 1/2 to 1 pound per week."
D. "Plan to lose weight gradually at 1/2 to 1 pound per week."
A nurse is providing dietary teaching for a client who has osteoporosis. The nurse should instruct the client that 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. 1/2 cup roasted almonds Has 185mg of calcium
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 foods rather than cold foods. C. Instruct the client to eat three meals per day. D. Add extra calories and protein to every meal.
D. Add extra calories and protein to every meal. Increases the clients nutritional intake.
A nurse is caring for a client who has undergone a radical head and neck resection to treat cancer and is receiving radiation therapy. The nurse should monitor for which of the following potential adverse effects? A. Bone marrow suppression B. Radiation enteritis C. Malabsorption of nutrients D. Changes in the production of saliva
D. Changes in production of saliva
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. Cheddar Cheese Cheese has tyramine, which can lead to a hypertensive crisis.
A nurse is caring for a client who has a new prescription for parenteral nutrition (PN) containing a mixture of dextrose, amino acids, and lipids. Prior to 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. Eggs Eggs phospholipid is an emulsifier and can cause an allergic reaction.
A nurse is teaching about nutritional requirements for a client who is starting a vegetarian diet. Which of the following information 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 vitamin B12. C. Fewer calories are required when on a vegetarian diet. D. Include two servings per day of nuts when on a vegetarian diet.
D. Include two servings per day of nuts when on a vegetarian diet. Achieves the daily requirement of omega-3 fatty acids.
A nurse is providing teaching to a client who is a vegetarian and requires an increase in zinc intake. Which of the following foods should the nurse include in the teaching as the best source of zinc? A. Pineapple B. Green grapes C. Cauliflower D. Pinto beans
D. Pinto beans
A nurse is teaching a prenatal education class about breastfeeding. Which of the following instructions should the nurse include in the teaching? A. Offer supplemental formula until the milk supply is established. B. Offer the newborn 30mL (1 oz) of glucose water after the first breastfeeding session. C. Plan to breastfeed the newborn every 4 hr. 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. Promotes milk production.
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 three large meals per day. D. Select grains with less than 2 g fiber per serving.
D. Select grains with less than 2 g fiber per serving. Low-fiber grains 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. Burp the infant once at the end of the feeding. B. Use a bottle that has a two-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. Cleft lip make it difficult to achieve an adequate 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 bowel sounds after eating. C. The client has an increased interest in eating. D. The client's voice changes after eating.
D. The client's voice changes after eating. Partially swallowed food can affect a persons voice.
A nurse in a clinic is reviewing the laboratory findings of a client who recently began a Dietary Approaches to Stop Hypertension (DASH) diet. Which of the following laboratory findings indicates the client has reached one 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 Goal is to be under 200 mg/dL