Nutrition Practice Exam

A nurse is teaching a female client about preventing osteoporosis. Which teaching point is correct? A. The recommended daily allowance of calcium may be found in a wide variety of foods. B. Obtaining an x-ray for the bones every 3 years is recommended to detect bone loss C. To prevent factures, the client should avoid strenuous exercise. D. Obtaining the recommended daily allowance of calcium requires taking a calcium supplement.

A. The recommended daily allowance of calcium may be found in a wide variety of foods. Rationale: Perimenopausal women require 1000 mg of calcium per day. Postmenopausal women require 1500 mg per day. Clients usually can get the recommended daily requirement of calcium by eating a varied diet. Osteoporosis does not show up on an ordinary x-ray until 40% of bone has been lost. Bone densitometry, however, can detect bone loss of 3% or less. This test is sometimes recommended routinely for women older than 35 who are at risk for osteoporosis. Strenuous exercise won't cause factures. Although supplement are available, they aren't always necessary.

A nurse is educating a client who is at risk for coronary artery disease (CAD). The nurse knows that the teaching has been successful when the client states that the risk factors that can be controlled or modified include: A. obesity, inactivity, diet and smoking. B. stress, family history and obesity C. gender, family history and older age D. inactivity, stress, gender and smoking.

A. obesity, inactivity, diet and smoking. Rationale: The risk factors for coronary artery disease (CAD) that can be controlled or modified include obesity, inactivity, diet, stress and smoking. Gender, family history, and older age are risk factors that cannot be controlled.

A nurse is providing dietary instructions to a client with diabetes. What is most important for the nurse to include in teaching for prevention of hypoglycemia? A. Reduce carbohydrate intake when drinking alcohol. B. Avoid delaying or skipping meals. C. Increase protein intake in the morning. D. Drink orange juice if lightheadedness occurs.

B. Avoid delaying or skipping meals. Rationale: Hypoglycemia is an important complication in the treatment of diabetes. The risk of hypoglycemia increases as nutritional intake decreases, so it is important to teach the client to avoid delaying or skipping meals. Carbohydrate intake has the greatest influence on blood glucose levels, so increasing protein in the morning will not prevent hypoglycemic episodes. Drinking alcohol inhibits the release of glucose from the liver; therefore it would be important to increase carbohydrate intake when drinking alcohol. Lightheadedness is a manifestation of hypoglycemia, and drinking orange juice would be the means to treat the hypoglycemia, not prevent it.

A postoperative client has been placed on a clear liquid diet. The nurse should provide the client with which item? A. Pureed vegetables B. Chicken broth C. Ice cream D. Oatmeal

B. Chicken broth Rationale: Clear liquid diet consists of liquids that are see-through and are liquid at room temperature.

When measuring gastric residual volume in a client receiving continuous tube feeding through a gastrostomy tube, the nurse attaches a large syringe to the tube and withdraws all fluid remaining in the stomach. After noting the amount of fluid, what should the nurse do? A. Discard the aspirated fluid into a biohazard container B. Re-administer the aspirated fluid through the feeding tube. C. Discard the aspirated fluid down the toilet D. Add the aspirated fluid to the bag of formula.

B. Re-administer the aspirated fluid through the feeding tube. Rationale: The aspirated fluid should be re-administer to the client through the feeding tube when measuring gastric residual volumes. This prevents the loss of fluids, electrolytes, nutrients and medications that are in the gastric fluid. Discarding the aspirated fluid either into a biohazard container or down the toilet, results in the loss of important fluids, electrolytes, nutrients and possibly medications, putting the client at risk for a wide variety of complications. Adding the aspirated fluid to the bag of formula would contaminate the entire bag of formula making it spoil quicker than normal, and could also put the client at risk for infection or complications from spoiled formula.

A physician orders a bland, full-liquid diet for a client. Which response, if made by the client, would indicate to the nurse that the client had understood the nurse's dietary teaching. A. For breakfast, I will choose pineapple juice, a brand muffin and milk B. Today I can have apple juice, chicken broth and vanilla ice cream C. I will have orange juice, pudding and coffee D. I can have oatmeal, custard and tea.

B. Today I can have apple juice, chicken broth and vanilla ice cream. Rationale: A bland, full liquid diet may include some fruit juices and foods from all of the food groups. On this diet, the client should avoid gastric irritants, such as orange juice, coffee, tea, colas, cocoa, breads, bran (fiber) and highly seasoned foods.

The patient with type I diabetes mellitus stays, If I could just avoid what you call carbohydrates in my diet, I guess I would be okay." What is the best response by the nurse? A. It is correct that you do not need to count carbohydrates from fruits and vegetables. B. Eliminating carbohydrates from your diet is a good first step towards getting off of insulin. C. A person with diabetes should monitor their eating of proteins, fats and carbohydrates. D. All we ask you to do is have your blood sugar in range.

C. A person with diabetes should monitor their eating of proteins, fats and carbohydrates. Rationale: Diabetes mellitus is a multifactional, systemic disease associated with problems in the metabolism of all food types. The client's diet should contain appropriate amounts of all three nutrients, plus adequate minerals and vitamins. Limiting carbohydrates intake is just part of a comprehensive diabetic diet plan. A client with type 1 diabetes will need lifelong insulin therapy. Carbohydrates from fruit and vegetables sources will still need to be factored into carbohydrate intake. Telling a client all we ask you to do is a value judgment and is not therapeutic communication.

A nurse is providing teaching about a heart healthy diet to a group of clients with hypertension. Which of the following statements by one of the clients indicates a need for further teaching? A. I will replace table salt with dried herbs B. fresh fruits make a good snack option C. I may eat 10 ounces of lean protein each day D. I may thicken gravies with cornstarch as I cook.

C. I may eat 10 ounces of lean protein each day Rationale: Diet is simple eat more fruits, vegetables, and low fat dairy foods. Cut back on foods that are high in saturated fat, cholesterol and trans fats, eat more whole grain foods, fish poultry and nuts, limit sodium, sweets, sugary drinks and red meats (protein)

Which statement indicates the client understands the lifestyle modifications required when managing ulcerative colitis? A. I may have coffee with my meals B. I'm allowed to have alcohol as long as I only drink wine C. I'll have to stop smoking D. I can eat popcorn for an evening snack.

C. I'll have to stop smoking Rationale: Tobacco, caffeine, and alcohol are gastrointestinal stimulants and should be avoided by clients which ulcerative colitis. High-fiber foods such as popcorn and nuts are not allowed because of potential gastrointestinal irritation.

Which serum electrolytes findings should the nurse expect to find in an infant with persistent vomiting? A. K+,3.4; Cl-, 120, Na+, 140 B. K+, 3.5; Cl-, 90; Na+, 145 C. K+, 3.2; Cl-, 92; Na+,120 D K+, 5.5; Cl-110, Na+, 130

C. K+, 3.2; Cl-, 92; Na+,120 Rationale: Chloride and sodium function together to maintain fluid and electrolyte balance With vomiting, sodium chloride and water are lost in gastric fluid. As dehydration occurs, potassium moves into the extra cellular fluid. for these reasons, persistent vomiting can lead to hypokalemia, hypochloremia, and hyponatremia. The normal potassium level is 3.5 to 5.5, the normal chloride level is 98 to 106, and the normal sodium level is 145 to 145. The values of 3.2, 92, and 120, respectively are consistent with persistent vomiting. Each of the other options includes at least two serum electrolyte levels that are normal or high. These are not consistent with persistent vomiting.

A nurse is completing an admission assessment on an adolescent client who is a vegetarian. He eats mil products but does not like beans. Which of the following items should the nurse suggest the client order for lunch to provide the nutrients most likely to be lacking in his diet. A. Baked potato topped with sour cream B. Bagel with cream cheese C. peanut butter and jelly sandwich D. fruit salad

C. Peanut Butter and Jelly Sandwich.

A client is admitted with a diagnosis of dehydration. Which rationale is the primary reason the nurse should look into the client's mouth? A. A complete physical exam must be performed B. To assess for oral lesions C. To assess mucous membranes D. To assess for poorly fitting dentures

C. To assess mucous membranes Rationales: Mucous membranes will appear dry and tacky in a client with dehydration.

The client who is in Buck's traction is constipated. A plan of care that incorporates which breakfast would be most helpful in reestablishing a normal bowel routine? A. orange juice, breakfast pastries (doughnut and Danish) and coffee B. corn flakes with sliced banana, milk and English muffing and jelly C. an orange, raisin bran and milk and wheat toast D. eggs and bacon, buttered white toast, orange juice, and coffee

C. an orange, raisin bran and milk and wheat toast Rationale: High fiber foods provide bulk and decreased water absorption in the bowel. whole grains and fruits (not juices, which often are strained) are recommended. Of all the breakfast options listed, the one that includes an orange, raisin bran and wheat toast is highest in fiber and most likely to enhance bowel elimination. Proteins, white brad, processed foods and liquids contain very little fiber.

Which adverse effect occurs when there is too rapid an infusion of TPN solution? A. hypokalemia B. negative nitrogen balance C. circulatory overload D. Hypoglycemia

C. circulatory overload Rationale: Too rapid infusion of a TPN solution can lead to circulatory overload. The client should be assessed carefully for indications of excessive fluid volume. A negative nitrogen balance occurs in nutritionally depleted individuals, not when TPN fluids are administered in excess. When TPN is administered too rapidly, the client is at risk for receiving an excess of dextrose and electrolytes. Therefore the client is at risk for hyperglycemia and hyperkalemia.

Which dietary measure would be useful in preventing esophageal reflux? A. adding a bedtime snack to the dietary plan. B. increasing fluid intake C. eating-small frequent meals D. avoiding air swallowing with meals.

C. eating-small frequent meals Rationale: Esophageal reflux worsens when the stomach is overdistended with food. Therefore, an important measure is to eat small, frequent meals. fluid intake should be decreased during meals to reduce abdominal distension. avoiding air swallowing does not prevent esophageal reflux Food intake in the evening should be strictly limited to reduce the incidence of nighttime reflux so bedtime snacks are not recommended.

A nurse is teaching a client about type 2 diabetes mellitus. What information would reduce a client's risk of developing this disease? A. Follow a high protein diet including meat, dairy, and eggs. B. you should stop cigarette smoking C. maintain weight within normal limits for your body size and muscle mass D. Prevent developing hypertension by reducing stress and limiting salt intake.

C. maintain weight within normal limits for your body size and muscle mass Rationale: The most important factor predisposing to the development of type 2 diabetes mellitus is obesity. Insulin resistance increases with obesity. Cigarette smoking is not a predisposing factor, but it is a risk facto that increases complications of diabetes mellitus A high protein diet does not prevent diabetes mellitus but it may contribute to hyperlipidemia. Hypertension is not a predisposing factor, but it is a risk factor for developing complication of diabetes mellitus.

The expected outcome of withholding food and fluids from a client who will receive general anesthesia is to help prevent: A. constipation during the immediate postoperative period B. pressure on the diaphragm with poor lung expansion during surgery C. vomiting and possible aspiration of vomitus during surgery D. gas pains and distention during the immediate postoperative period.

C. vomiting and possible aspiration of vomitus during surgery Rationale: Oral food and fluids are withheld before surgery when a client receives general anesthesia primarily to help prevent vomiting and possible aspiration of stomach contents. Constipation after surgery is influenced by multiple factors, such as the nature of the surgery, the postoperative diet, and use of opioid analgesics. food and fluids are not withheld prior to surgery to relieve pressure on the diaphragm and increase lung expansion. withholding food and fluids before surgery does not eliminate gas pains or abdominal distention in the postoperative period. General anesthesia and manipulation of abdominal contents can cause peristaltic action to cease temporarily. this leads to abdominal distention and gas pain.

A nurse is providing care for a client who is 2 days postoperative following abdominal surgery and is about to progress from a clear liquid diet to a full liquids diet. Which of the following items should the nurse tell the client he may now request to have on his meal tray. A. Skim Milk B, Cranberry juice C. Chicken broth D. Flavored gelatin

A. Skim Milk

A client with hyperemesis gravidarum is on a clear liquid diet. The nurse should serve this client: A tea and gelatin dessert B. decaffeinated coffee and scrambled eggs C. apple juice and oatmeal D. milk and ice pops.

A tea and gelatin dessert Rationale: A clear liquid diet consists of foods that are clear liquids at room temperature or body temperature, such as ice pops, regular or decaffeinated coffee and tea, gelatin desserts, carbonated beverages and clear juices. milk, pasteurized eggs, egg substitutes and oatmeal are part of full liquid diets.

A nurse is instructing a group of clients about nutrition and eating foods high in iron. The nurse should include that which of the following aids in the absorption of iron? A. Vitamin A B. Vitamin C C. Oxalates D. Fiber

B. Vitamin C

The nurse is assessing the nutritional status of older clients on a unit. Which client should the nurse identify as the greatest risk for poor nutritional intake? A. the client diagnosed with diabetes five years ago. B. clients whose dentures fit poorly C. those that live in an assisted living apartment D. A client who receives food stamps.

B. clients whose dentures fit poorly Rationale: poor dentition is a common reason for malnutrition.

TPN is prescribed for a client with Crohn's disease. What indicates to the nurse that TPN has been effective? The client: A. as met nutritional needs B. is hydrated C. is not metabolic acidosis D. is in a negative nitrogen balance

A. as met nutritional needs Rationale: The goal of TNP is to meet the client's nutritional needs. TPN is not used to treat metabolic acidosis and is administered to provide a positive nitrogen balance.

The client with a major burn injury receives total parenteral nutrition (TPN). What is the expected outcome of TPN? A. Correct water and electrolyte imbalances. B. Ensure adequate caloric and protein intake. C. Provide supplemental vitamins and minerals. D. Allow the gastrointestinal tract to rest.

B. Ensure adequate caloric and protein intake. Rationale: Nutritional support with sufficient calories and protein is extremely important for a client with severe burns because of the loss of plasma protein through injured capillaries and an increased metabolic rate. Gastric dilation and paralytic ileus commonly occur in clients with severe burns, making oral fluids and foods contraindicated. Water and electrolyte imbalances can be corrected by administration of IV fluids with electrolyte additives, although TPN typically includes all necessary electrolytes. Resting the gastrointestinal tract may help prevent paralytic ileus, and TPN provides vitamins and minerals; however, the primary reason for starting TPN is to provide the protein necessary for tissue healing.

A nurse is teaching a client who needs to increase their daily fluid intake. Which of the following foods has the highest percentage of water by weight? A. Honey B. Yogurt C. Milk D. Lettuce

C. Milk

The nurse is providing diet education for a patient on a low fat diet. Which of the following is most accurate? A. Unsaturated fats are found mostly in animal sources. B. Linoleic acid is saturated fat. C. saturated fats are found mostly in vegetable sources. D. Saturated fats are found mostly in animal sources.

D. Saturated fats are found mostly in animal sources. Rationale: Most animal fats have high proportions of saturated fatty acids, whereas vegetable fats have high amounts of unsaturated and polyunsaturated fatty acids. Linoleic acid, an unsaturated fatty acid, is the only essential fatty acid in humans.

A client with stress incontinence asks the nurse what kind of diet to follow at home. The nurse should recommend that the client: A. avoid milk products B. decrease fluid intake C. increase intake of fruit juice D. avoid alcohol and caffeine

D. avoid alcohol and caffeine. Rationale: Clients with stress incontinence should be encouraged to avoid alcohol and caffeine products because both are bladder stimulants. The client should not decrease fluid intake, increasing the intake of fruit juice may be desirable but will not affect the episodes of incontinence.

After a school-age child with insulin-dependent diabetes mellitus attends a teaching session about nutrition, the nurse determines that the teaching has been effective when the child states which of the following? a) "If I'm not hungry for a meal, I can eat the carbohydrates for a snack later." b) "When I don't finish a meal, I must make up the carbohydrates right then." c) "When I don't finish a meal, I just need to take more insulin." d) "If I don't eat all my meal, I can make up the carbohydrates at the next meal."

a) "If I'm not hungry for a meal, I can eat the carbohydrates for a snack later." Rationale: The diabetic diet usually is based on an exchange system that takes into account the fact that some foods have similar fat, carbohydrate, and protein components and therefore can be exchanged one for another. The mal or snack must be eaten in its entirety because it is calculated together with the dose of insulin. If a child does not eat all the meal or snack, then a make up meal should be given.

The nurse is performing a nutritional assessment and is concerned about under nutrition in a client. Which condition should the nurse suspect is related to a nutritional disorder? A. high blood pressure B. Delayed menopause C. Poor wound healing D. Urinary track Infection.

C. Poor wound healing

A nurse is providing nutritional teaching to a client who has dumping syndrome following a hemi-colectomy,. Which of the following foods should the nurse instruct the client to avoid? A. fresh apples B. Rice C. Poached eggs D. White bread

A. fresh apples Rationale: Dumping syndrome is when the stomach empties food into the small bowel at a faster ate than normal this can also be called rapid gastric emptying. Should limit high sugar foods such as soda, juice, ensure, boost cakes, pies, candy doughnuts, cookies fruit cooked or canned with sugar, honey jams or jellies.

The nurse is teaching a client with osteoporosis about optimal dietary choices to reduce the severity of the condition. What instruction should the nurse provide? A. "Decrease your intake of nuts and seeds." B. "Eat more dairy products such as cheese and yogurt." C. "Decrease your intake of red meat." D. "Eat more fresh fruits and vegetables."

B. "Eat more dairy products such as cheese and yogurt." Rationale: Osteoporosis causes a severe, general reduction in skeletal bone mass. To offset this reduction, the client should be advised to increase calcium intake by consuming more dairy products, which provide about 75% of the calcium in the average diet. Changing intake of red meat, nuts, seeds, or fruit would not prevent osteoporosis from worsening.

A nurse is caring for a client who is receiving total parenteral nutrition (TPN). The pharmacy is delayed in supplying the client's next container of TPN. Which of the following fluids should the nurse infuse until the next container arrives? A. Dextrose 5% in water B. Dextrose 10% in water C. 0.9% sodium chloride D. Lactated Ringer's solution

B. Dextrose 10% in water

A nurse is instructing a group of clients about nutrition. The nurse should include that which of the following is a trigger for the formation of Vitamin D in the body. A. Calcium B. Exposure to sunlight C. Vitamin A depletion D. Wight bearing exercise.

B. Exposure to sunlight

A nurse is instructing a group of clients regarding nutrition. which of the following is a good source of omega 3 fatty acids that the nurse should include in the teaching? A. Dietary supplements B. Fish C. Corn Oil D. Leafy green vegetables.

B. Fish

A client who has been vomiting for 2 days has a nasogastric tube inserted. The nurse notes that over the past 10 hours, the tube has drained 2 l of fluid. The nurse should further assess the client for which electrolyte imbalance? A. Hypermagnesemia B. hypokalemia C. hypocalcemia D. Hypernatremia

B. Hypokalemia Rationale: Loss of electrolytes from the gastrointestinal tract through vomiting, diarrhea, or nasogastric suction is a common cause of potassium loss, resulting in hypokalemia. Hypermagnesemia does not result from excessive loss of gastrointestinal fluids. Common causes of hypernatremia are water loss (as in diabetes insipidus or osmotic diuresis) and excessive sodium intake. common causes of hypocalcemia include chronic renal failure, elevated phosphorus concentration, and primary hypoparathyroidism.

A nurse is reviewing the laboratory results for a client who has a history of atherosclerosis and notes elevated cholesterol levels. Which of the following statements by the client indicates the nurse should plan follow-up teaching on low cholesterol diet? A. I flavor my mean with lemon juice. B. I eat two eggs for breakfast each morning. C. I cook my food with canola oil D. I take an omega-2 supplement daily.

B. I eat two eggs for breakfast each morning.

The nurse has been teaching the client about maintaining a high fiber diet. The client's selection of which breakfast menu indicates an understanding of the instructions? A. corn flakes, mil, white toast, and orange juice B. Oatmeal, milk, grapefruit, edges and bran muffin C. Danish pastry, prune juice, coffee and milk D. scrambled eggs, bacon, English muffing and apple juice.

B. Oatmeal, milk, grapefruit, edges and bran muffin Rationale: Oatmeal, grapefruit wedges, and bran muffins are all high fiber foods. Pastries are made from highly processed flour and do not contain much fiber. Purine juice is not high in fiber but has a laxative effect. Processed foods, such as processed cereals and white bread are typically low in fiber. Animal proteins contain little if any fiber.

a nurse is caring for a client following a CVA and observes the client experiencing severe dysphagia The nurse notifies the provide. Which of the following nutritional therapies will likely be prescribed? A. Soft residue diet B. Supplemental via nasogastric tube C. NPO until dysphagia subsides D. Initiation of total parental nutrition.

B. Supplemental via nasogastric tube

A nurse is instructing a group of clients regarding calcium rich foods, which of the following foods should the nurse include in the teaching of the best source of calcium? A. 1/2 cup of ice cream B. 1 ounce swiss cheese C. 1 cup milk D. 1 cup cottage cheese

C. 1 cup milk

Which method would be most appropriate for the nurse to use to determine if a 2-year-old is obese? A. Skinfold thickness measurements B. Weight-for-length charts C. Body mass index (BMI)-for-age D. Abdominal girths.

C. Body mass index (BMI)-for-age Rationale: The BMI-for-age is most appropriate way for the nurse to assess for obesity in children ages 2 to 20 years. Weight-for-length charts are used to measure appropriate growth in children from birth to up to the age of 2 years. Abdominal girths provide little information about appropriate body composition because 2-year-olds typically have rounded abdomens. Measuring skinfold thickness with skinfold calipers is a common method used to assess obesity in adults and is not routinely performed by nurses.

A teenage girl has been diagnosed with a UTI (urinary tract infection). The nurse recognized the need for teaching when the client makes which statement. A. I will not take bubble baths. B. I can drink cranberry juice C. I can drink coffee D. I will drink plenty of water

C. I can drink coffee Rationale: Drinking coffee and other beverages that contain caffeine can irritate the bladder and should be avoided. bubble baths, bath oils and hot tubs can irritate the urethra and perineal area. Drinking plenty of water will keep urine flushed through the bladder. Cranberry juice helps to acidify the urine.

A nurse is providing teaching about the Mediterranean diet to a client newly who has a new diagnosis of hypertension,. Which of the following statements by the client indicates a need for further teaching? A. I can drink wine in moderation B. I can have fish two times a week C. I will limit my intake of red meat to twice weekly D. I can have dairy in moderate portions daily.

C. I will limit my intake of red meat to twice weekly. Rationale: The Mediterranean diet is much like the DASH diet and significantly limits the amount of red meat in the diet.

A school age client with diabetes is placed on an intermediate-acting insulin and regular insulin before breakfast and before dinner. She will receive a snack of milk and cereal at bedtime. What does the nurse tell the client the snack is intended to do? A. Help her stay on her diet B. Provide carbohydrates for immediate use C. Prevent late night hypoglycemia D. Help her regain lost weight

C. Prevent late night hypoglycemia Rationale: Intermediate acting insulins peaks in 6 to 8 hours, which would occur during sleep. A bedtime snack is needed to prevent late night hypoglycemia. The snack is not given to help regain weight. Milk contains fat and protein, which cause delayed absorption into the blood stream and also maintains the blood glucose level at night when the intermediate acting insulin will peak. The snack is not used to provide carbohydrates for immediate use because an intermediate acting insulin, unlike regular insulin, does not peak immediately. The snack has nothing to do with a diet.

The nurse is instructing a client with hypertension on the importance of choosing foods low in sodium. The nurse should teach the client to limit the intake of which food? A. Apples B. Bananas C. Smoked sausage D. Steamed vegetables

C. Smoked sausage Rationale: Smoked sausage is a high fat, high cholesterol food. The other food choices are foods found on a DASH diet.

A nurse is instructing a group of clients about nutrition. The nurse should include that which of the following foods is a good source of high quality protein? A. Legumes B. Grains C. Soybeans D. Green vegetables

C. Soybeans

A client is asking about dietary modifications to counteract the long-term effects of prednisone. What is the most appropriate information for the nurse to give the client? A. increase your intake of polyunsaturated fats? B. increase your intake of complex carbohydrates C. increase your intake of calcium and Vitamin D D. increase our intake of dietary sodium

C. increase your intake of calcium and Vitamin D Rationale: Problems associated with long term corticosteroid therapy include sodium retention, osteoporosis, and hyperglycemia. An increase in calcium and Vitamin D is needed to help prevent bone deterioration Dietary modifications need to reduce sodium maintain high protein levels for tissue repair, and reduce carbohydrates as there is a tendency toward hyperglycemia, increased intake of complex carbohydrates is not indicated because of hyperglycemia. there should be decreased fat intake because there is a tendency for central fat deposition.

A nurse is teaching a client about nutritional requirements necessary to promote wound healing. Which of the following nutrients should the nurse include in the teaching? A. calcium B. Vitamin D C. protein D. Vitamin B1

C. protein

The part of a child with celiac disease asks, "How long must he stay on this diet?" Which response by the nurse is best? A. "Until his stools appear normal." B. "Until the jejunal biopsy is normal." C. "For the next 6 months." D. "For the rest of his life."

D. "For the rest of his life." Rationale: Most children with celiac disease have a lifelong sensitivity to gluten, which requires that they maintain some type of diet restriction for the rest of their lives.

A nurse is instructing a group of adult clients about nutrition. The nurse should include which of the following as the recommended amount of vegetables servings per day? A. 1/2 cup B. 2 cups C. 1 cup D. 2 1/2 cups

D. 2 1/2 cups Rationale: 3 cups for men and 2 1/2 for women

A nurse is teaching a group of adults about nutrition. The nurse should include which of the following amounts as an appropriate daily intake of fiber for adult women? A. 5 to 10 g B. 10 to 15 g C. 40 to 50 g D. 20 to 35 g

D. 20 to 35 g

Obesity can have a harmful effect on the body in a variety of ways. What is the nurse's priority in educating clients to prevent obesity? A. Consume a consistent of carbohydrates every meal B. Eat a low-carbohydrate diet. C. Eat a low sugar diet. D. Achieve moderate weight loss through increased activity and a low calorie, low-fat diet.

D. Achieve moderate weight loss through increased activity and a low calorie, low-fat diet. Rationale: Diet, exercise, and gradual weight loss is key to keeping the weight off.

A nurse is teaching a client about following a low-cholesterol diet after coronary artery bypass grafting. Which of the following client food choices reflects the client's understanding of these dietary instructions? A. Eggs B. Liver C. Milk D. Beans

D. Beans

A client is admitted with fatigue, shortness of breath, pale skin, and dried, cracked lips, tongue and mouth. The hemoglobin is 9 g/dl (90g/l) and red blood cell count is 3.5 million cells/mm3 (3.5 x 1012/l). What should the nurse instruct the client to do? A. limit fluid intake to 1,000 ml per day. B. Eat a serving of fish with high omega 3 content 2 times a week. C. Increase the amount of carbohydrates in the diet. D. Eat foods with good sources of iron.

D. Eat foods with good sources of iron. Rationale: The client is demonstrating signs of anemia and should crease the iron in the diet. Foods such as red meats, beets, cabbage are good source of iron. The client should not limit the fluid intake to 1,000 ml per day, but should maintain an adequate fluid intake of about 3,000 ml per day. Carbohydrates will not provide the necessary dietary intake of iron. While fish is a healthy choice, beef, lamb and iron-rich vegetables are more important in the diet at this time.

A nurse is caring for an antepartum client who has ifon-deficiency anemia. When teaching the client about nutrition, the nurse should emphasize the need for an increased intake of which of the following foods? A. Whole grain breads B,. Milk and cheese C. Fresh fruits D. Red meat and organ meat

D. Red meat and organ meat

A nurse is instructing a group of clients regarding nutrition. The teaching should state that which of the following groups of foods contains the highest level of carbohydrates? A. milk, eggs, and cheese B. chicken, green beans and apples C. Butter, oils and avocados D. Rice, Potatoes, and oranges.

D. Rice, Potatoes, and oranges.

A nurse is teaching a client who has cholecystitis about required dietary modifications. The nurse should include which of the following foods as appropriate for the client's diet. A. Creamed chicken B. Macaroni and cheese C. ice Cream D. Roast turkey

D. Roast Turkey

A school nurse is assessing an obese 10 year old child who wants to lose weight. What question will be most important for the nurse to ask to develop a realistic plan of care? A. do your parents have any medical conditions? B. Do you have friends who can support you while you try to lose weight? C. Ho long have you been worried about your weight? D. What kinds of foods do your parents serve at meal times and for snacks?

D. What kinds of foods do your parents serve at meal times and for snacks? Rationale: The greatest determinant of childhood obesity is environmental facts, which include parental diet choices and influence. Children of obese parents are inclined to obesity based on food served in the family home. The parents'' medical conditions and weight concerns are important, but the nurse needs to work with the current situation. Friends can serve as a support system, but the nurse is trying to college data about the obesity.

Which dietary measure would be useful in preventing esophageal reflux? A. avoiding air swallowing with meals B. increasing fluid intake C. adding a bedtime snack to the dietary plan D. eating small, frequent meals

D. eating small, frequent meals Rationale: Esophageal reflux worsens when the stomach is overdistended with food. Therefore, an important measure is to eat small, frequent meals. Fluid intake should be decreased during meals to reduce abdominal distention. Avoiding air swallowing does not prevent esophageal reflux. Food intake in the evening should be strictly limited to reduce the incidence of nighttime reflux, so bedtime snacks are not recommended.

A client who has been diagnosed with gastroesophageal reflux disease (GERD) reports heartburn. To decrease the heartburn, the nurse should instruct the client to eliminate which item from the diet. A. raw vegetables B. air-popped popcorn C. lean beef D. hot chocolate

D. hot chocolate Rationale: With GERD, eating substances that decrease lower esophageal sphincter pressure causes heartburn. A decrease in the lower esophageal sphincter pressure allows gastric contents to reflux into the lower end of the esophagus. Foods that can cause a decrease in esophageal sphincter pressure include fatty foods, chocolate, caffeinated beverages, peppermint and alcohol. A diet high in protein and low in fact is recommended for clients with GERD. Lean beef, popcorn and raw vegetables would be acceptable.

A nurse is teaching a client about preparing low fat meals. The nurse should include that which of the following oils contains saturated fat? A. Olive B. Coconut C. Corn D. Canola

B. Coconut

A nurse is teaching a client about using herbal supplements as part of the client's healthcare regimen. What client statement indicates the nurse's teaching was effective? A. "I need to make sure that the supplement does not interact with other meds I am taking." B. "The supplements are not medications, so there is very little risk of side effects." C. "If the label says that it is all natural, then it should be okay for me to use." D. "I can use the internet to check out what would work best for me."

A. "I need to make sure that the supplement does not interact with other meds I am taking." Rationale: Herbal supplements are classified as a food by the FDA and as such are not regulated for quality and potency as medications are. However, they still can cause side effects and interact with medications, thus the need to assess each client for use of herbal remedies. A label of "all natural" does not automatically ensure that the supplement is okay to use. The client should get information from knowledgeable and reliable sources before using any herbal supplement.

A nurse is teaching a client who has diabetes about which dietary source should provide the greatest percentage of calories. Which of the following statements indicates the client understands the teaching? A. "I should eat more calories from complex carbohydrates than anything else." B. "Protein should be my main source of calories." C. "Simple sugars are needed more than other calorie sources." D. "Most of my calories each day should be from fats."

A. "I should eat more calories from complex carbohydrates than anything else."

Which client is at increased risk for developing a wound infection? A. A client with an albumin level of 2.4 g/dl B. a client with a hemoglobin of 11.4 C. A client that does not ambulate on first post op day D. A client with a body mass index BM of 27

A. A client with an albumin level of 2.4 g/dl Rationale: Nutrition plays an important role in wound healing. Because vitamins and protein are essential for wound healing. A client with an albumin level less than 3.0 g/dl is considered malnourished and is at increased risk for developing a wound infection. Frequent pain medication allows the client to be more comfortable and does not increase risk of infection. A client not ambulating on post op day 1 is at a greater risk of deep vein thrombosis and pneumonia. A client who has a BMI of 27 is considered overweight and isn't at increased risk for developing wound infection.

A nurse is caring for a client who is to receive a mechanically altered diet, which of the following client food choices necessitates intervention by the nurse? A. Piece of wheat toast. B. Scrambled eggs C. Cottage cheese D. Sliced Banana.

A. A piece of wheat Toast Rationale: a mechanically altered diet is "specifically prepared to alter the consistency of food in order to facilitate oral intake. Examples is soft foods, pureed (blended) foods, ground meat, and thickened liquids.

Nutritional diversity is common among cultural or ethnic groups. how would the nurse assure that a Jewish patient had appropriate food delivered to her room? A. Complete a cultural assessment of the patient's health beliefs and practices. B. Tell her that she needs to bring in all of her own food. C. Assume that the patient requires a kosher diet D. Let her have what is delivered, dietary should know what the patient needs.

A. Complete a cultural assessment of the patient's health beliefs and practices. Rationale: A cultural assessment should include questions about a patient's dietary preferences.

The patient has a stage 4 pressure ulcer on the sacral area. What type of foods would the patient benefit from? A. Dried beans, eggs, and meats B. Liver, spinach and corn C. Peanuts, tomatoes, and cabbage D. Oats, fruits, and vegetables

A. Dried beans, eggs, and meats Rationale: Wound healing needs plenty of protein to rebuild tissue.

A nurse working in a community clinic is discussing lifestyle modifications with a client. The client has been advised to lose weight because of a BMI greater than 25. Which statement by the nurse would be most therapeutic in helping the client? A. I can offer you some information outlining a variety of ways to lose weight B. Losing weight is a challenge that i can help you with. C. There are herbal preparations for weight loss that are very effective D. It will be important for you to stop having between meal snacks.

A. I can offer you some information outlining a variety of ways to lose weight. Rationale: The therapeutic response would put the client in a position to make an individual choice. The nurse would offer options to allow for choice. Telling the client that losing weight is a challenge the nurse can help with puts the focus on the nurse and does not offer options. many weight loss plans include meals plus snacks as well as limiting options. Offering herbal preparation also limits the options given to the client.

A nurse is caring for a client who has Crohn's disease and is receiving parental nutrition. Which of the following interventions should the nurse include in the care of this client? A. Monitor daily laboratory values and report as needed. B. remove unused parental nutrition after 12 hour of use. C. Monitor the flow rate of the parental nutrition carefully and increase the rate as needed if it falls behind. D. remove the parental nutrition solution from the refrigerator 2 hour before infusion.

A. Monitor daily laboratory values and report as needed.

A client has been receiving total parental nutrition (TPN) for the last 5 days. Before discontinuing the infusion, the infusion rate is slowed. What complication of TPN infusion should the nurse assess the client for as the infusion is discontinued: A. rebound hypoglycemia B. essential fatty acid deficiency C. Dehydration D. Malnutrition.

A. Rebound hypoglycemia Rationale: When dextrose is abruptly discontinued, rebound hypoglycemia can occur. The nurse should assess the client for symptoms of hypoglycemia. Essentially fatty acid deficiency is very unlikely to occur because of some of these fatty acids are stored. Preventing dehydration or malnutrition is not the reason for tapering the infusion rate, the client's hydration and nutritional status and ability to maintain adequate intake must be established before TPN is discontinued.

Which activity would be appropriate for the nurse to delegate to an unlicensed assistive personnel (UAP) for a client diagnosed with a myocardial infarction who is stable? A. Record the intake and output. B. Help the client identify risk factors for coronary artery disease. C. Provide teaching on a 2 g sodium diet. D. Evaluate the lung sounds.

A. Record the intake and output. Rationale: UAP are able to measure and record intake and output. The nurse is responsible for client teaching, physical assessments, and evaluating the information collected on the client.

A client has a total serum cholesterol level of 326 mg/dl (8.44 mmol/L.) the nurse explains to the client that this level. A. is high and will require dietary modification. B. is borderline normal and may require dietary modification. C. is normal and requires no further treatment. D. is low and requires no further treatment.

A. is high and will require dietary modification. Rationale: A total serum cholesterol level is 326 md/dl (8.44 mmol/L) is high. A client with this cholesterol level will require dietary modifications and may be placed on lipid-lowering medication. Normal serum cholesterol is from 140 to 200 mg/dl (3.6 to 5.2 mmol/L) A low cholesterol level would be a level under 140 mg/dl (3.6 mmol/L). Borderline normal would be 200 to 210 mg/dl (5.2 to 5.4 mmol/L)

A nurse is teaching a client with constipation about management of the problem. Which statement by the client indicates understanding? A. I'll consume a low residue diet B. I'll avoid heavy lifting C. I'll consume foods high in fiber D. I'll limit water intake to three glasses per day.

C. I'll consume foods high in fiber Rationale: The client understanding that foods high in fiber help with constipation indicates effective teaching. A low residue diet, a sedentary lifestyle, and limited water intake would predispose the client to constipation. There is no need to avoid heavy lifting to prevent constipation.

The healthcare provider has prescribed a diet that limits purine-rich foods. Which foods should this client avoid: A. milk, ice cream, vegetables, and yogurt B. chicken, fish, and dried fruits C. anchovies, sardines, and kidneys D. bananas, wine and cheese.

C. anchovies, sardines, and kidneys Rationale: Anchovies, sardines, kidneys, sweetbreads, and lentils are very high in purines. Bananas and dried fruits are high in potassium. Milk, ice creams, and yogurt are rich in calcium. Wine, cheese, preserved fruits, meats, and vegetables contain tyramines.

A client undergoes a barium swallow fluoroscopy that confirms gastroesophageal reflux disease (GERD). Based on the diagnosis, the client should be instructed to take which action? A. Eat a snack before going to bed B. Limit alcohol to 3 alcoholic beverages per day C. sleep with the head of bed flat D. Avoid caffeine and carbonated beverages.

D. Avoid caffeine and carbonated beverages. Rationale: The nurse should instruct the client with GERD to follow a low fat high fiber diet. Caffeine, carbonated beverages, alcohol and smoking should be avoided because they aggravate GERD. In addition the client should take antacids are prescribed (typically 1 hour and 3 hours after meals and at bedtime. lying down with the head of bed elevated, not flat, reduces intraabdominal pressure thereby reducing the symptoms of GERD.

The nurse teaches the client with type I diabetes about the importance of maintaining a stable blood glucose level. The nurse should suggest the client include which type of food to minimize the risk in blood glucose level after meals? A. meats B. dairy products C. vitamin-fortified foods D. dietary fiber

D. dietary fiber Rationale: Foods high in dietary fiber tend to blunt the rise in blood glucose levels after meals. Dietary fiber is the part of food not broken down and absorbed during digestion. Most fibers come from plants; good sources include whole grains, legumes, vegetables, fruits, and nuts. The other foods do not minimize this rise in blood sugar after meals. Dairy products are poor sources of fiber. Foods fortified with vitamins are satisfactory if they also contain fiber. However, many foods fortified with vitamins contain either no dietary fiber (such as fortified milk) or little fiber (such as products fortified with vitamins but made with refined grains). Meats are poor sources of fiber.

A nurse is caring for a client who is well-hydrated and who demonstrates no evidence of anemia. Which of the following laboratory values gives the nurse an assessment of the adequacy of the client's protein uptake and synthesis? A. Potassium B. Albumin C. Sodium D. Calcium

B. Albumin

The client with type 1 diabetes mellitus says, "If I could just avoid what you call carbohydrates in my diet, I guess I would be okay." What is the best response by the nurse? A. "All we ask you to do is have your blood sugar in range." B. "It is correct that you do not need to count carbohydrates from fruits and vegetables." C. "Eliminating carbohydrates from your diet is a good first step toward getting off of insulin." D. "A person with diabetes should monitor their eating of proteins, fats, and carbohydrates."

D. "A person with diabetes should monitor their eating of proteins, fats, and carbohydrates." Rationale: Diabetes mellitus is a multifactorial, systemic disease associated with problems in the metabolism of all food types. The client's diet should contain appropriate amounts of all three nutrients, plus adequate minerals and vitamins. Limiting carbohydrate intake is just part of a comprehensive diabetic diet plan. A client with type 1 diabetes will need lifelong insulin therapy. Carbohydrates from fruit and vegetable sources will still need to be factored into carbohydrate intake. Telling a client "all we ask you to do" is a value-judgement and is not therapeutic communication.