105-3

1. An instructor explains to a group of student nurses that the breaking down phase of metabolism that reduces complex substances down to simpler substances and sometimes releases energy as a result is known as ____________________.

catabolism Rationale: The breaking down phase of metabolism called catabolism reduces complex substances down to the simpler substances and sometimes releases energy as a result.

1. A nurse explains to a student that a patient's stomach contents will be removed by inserting a double-lumen nasogastric (NG) tube through the nose into the stomach, then connecting the drainage lumen to a suction source. The student correctly identifies this procedure as ____________________.

gastric decompression Rationale: Gastric decompression is the process of reducing the pressure within the stomach by emptying it of its contents, including ingested food and liquids, gastric juices, and gas. The stomach contents are removed by inserting a double-lumen NG tube through the nose into the stomach, then connecting the drainage lumen to a suction source.

16. A nurse has just completed the insertion of a nasogastric (NG) tube. The nurse should verify placement by aspirating for gastric contents and checking the pH of the aspirate. The nurse recognizes that the pH of gastric contents should be between 1. 1 and 4. 2. 2 and 5. 3. 3 and 6. 4. 4 and 7.

1. 1 and 4. The nurse should check the pH of the aspirated contents with litmus paper strips to verify that it is between 1 and 4.

6. A nurse teaches a patient with diabetes that the goal of diabetes treatment is to maintain an HbA1c less than 1. 7%. 2. 8%. 3. 9%. 4. 10%.

1. 7%. The goal of diabetes treatment is to maintain an HbA1c less than 7%.

Select all that apply: 5. A dietician explains to nursing students that a healthy diet must include a certain amount of dietary fats or lipids because they are which of the following? Select all that apply. 1. An essential concentrated source of fatty acids and energy 2. Necessary for healthy skin 3. Essential for maintaining acid-base balance 4. Necessary for new tissue production 5. Required to help the body absorb fat-soluble vitamins

1. An essential concentrated source of fatty acids and energy This is correct. Fats provide 9 kcal per gram consumed and are an essential concentrated source of fatty acids and energy. 2. Necessary for healthy skin This is correct. Fats are necessary for healthy skin. 5. Required to help the body absorb fat-soluble vitamins This is correct. Fats are required to help the body absorb fat-soluble vitamins.

select all that apply 3. A nurse is caring for a severely underweight patient who has an admitting diagnosis of anorexia nervosa. When assessing this patient, the nurse anticipates which of the following? Select all that apply. 1. Anemia 2. Oily hair 3. Brittle nails 4. Severe diarrhea 5. Muscle weakness

1. Anemia This is correct. Physical symptoms commonly seen in the underweight anorexic patient are amenorrhea, severe constipation, lethargy or fatigue, below normal vital signs, muscle weakness, muscle wasting, anemia, brittle nails, and dull, dry, brittle hair. 3. Brittle nails This is correct. Physical symptoms commonly seen in the underweight anorexic patient are amenorrhea, severe constipation, lethargy or fatigue, below normal vital signs, muscle weakness, muscle wasting, anemia, brittle nails, and dull, dry, brittle hair. 5. Muscle weakness This is correct. Physical symptoms commonly seen in the underweight anorexic patient are amenorrhea, severe constipation, lethargy or fatigue, below normal vital signs, muscle weakness, muscle wasting, anemia, brittle nails, and dull, dry, brittle hair.

1. A nurse is caring for a patient with diabetes who requires blood glucose monitoring before meals and at bedtime. When checking the patient's blood glucose before lunch, the nurse documents the reading as 130 mg/dL. What should the nurse do next? 1. Continue to monitor. 2. Notify the patient's physician. 3. Give the patient an injection of insulin. 4. Administer a syringe of 50% dextrose.

1. Continue to monitor. The 2013 American Diabetic Association guidelines state a range of 70 to 130 mg/dL before meals is acceptable for patients with existing diabetes. Therefore, because the findings are normal, the nurse should continue to monitor.

6. A nurse recognizes that the process in which food is broken down in the gastrointestinal (GI) tract, releasing nutrients for the body to use, is called 1. Digestion. 2. Peristalsis. 3. Indigestion. 4. Absorption.

1. Digestion. Digestion is the process by which food is broken down in the GI tract, releasing nutrients for the body to use.

35. A nurse is caring for a patient with an increased risk for aspiration due to severe gastroesophageal reflux disease (GERD). The nurse identifies that the correct type of nasointestinal (NI) tube for this patient would be a 1. Dobbhoff tube. 2. French tube. 3. Salem sump tube. 4. Levin tube.

1. Dobbhoff tube. One commonly used NI tube is the Dobbhoff, which is mostly used for enteral feedings in patients who are at increased risk for aspiration, such as those with absent or diminished gag reflex or severe GERD.

select all that apply 4. A nurse is caring for a patient who has an admitting diagnosis of bulimia nervosa. When assessing this patient, the nurse anticipates which of the following? Select all that apply. 1. Evidence of dental decay 2. Complaints of indigestion 3. Complaints of constipation 4. Complaints of a sore throat 5. Symptoms of gastric reflux

1. Evidence of dental decay This is correct. Physical symptoms that may be observed in a patient with bulimia nervosa include increasing dental decay from exposure to gastric acid when vomiting. 2. Complaints of indigestion This is correct. Physical symptoms that may be observed in a patient with bulimia nervosa include indigestion. 4. Complaints of a sore throat This is correct. Physical symptoms that may be observed in a patient with bulimia nervosa include chronic inflammation or soreness of throat because of retching and exposure to gastric acid during vomiting. 5. Symptoms of gastric reflux This is correct. Physical symptoms that may be observed in a patient with bulimia nervosa include regurgitation of gastric fluids into the esophagus, known as gastric reflux.

select all that apply 2. A patient is admitted to a hospital unit with a diagnosis of anorexia nervosa. When caring for this patient, a nurse recognizes that anorexia nervosa is characterized by which of the following? Select all that apply. 1. Evidence of emaciation 2. An excessive leanness or wasting of the body 3. An accurate self-perception about body weight 4. Obsessive thoughts about body shape and weight 5. Attempts to reduce one's body weight below normal

1. Evidence of emaciation This is correct. Anorexia nervosa is characterized by an excessive leanness or wasting of the body, known as emaciation. 2. An excessive leanness or wasting of the body This is correct. Anorexia nervosa is characterized by an excessive leanness or wasting of the body, known as emaciation. 4. Obsessive thoughts about body shape and weight This is correct. Individuals with anorexia nervosa exhibit obsessive thoughts related to their body shape and weight, and display an intense fear of obesity. 5. Attempts to reduce one's body weight below normal This is correct. Individuals with anorexia exhibit relentless self-starvation in an effort to reduce the body weight below normal.

Select all that apply: 1. A nurse recognizes that macronutrients include which of the following? Select all that apply. 1. Fats 2. Protein 3. Vitamins 4. Carbohydrates 5. Water

1. Fats This is correct. Macronutrients are required by the body on a daily basis in large amounts (grams) and include protein, carbohydrates, fats, water, and some minerals. 2. Protein This is correct. Macronutrients are required by the body on a daily basis in large amounts (grams) and include protein, carbohydrates, fats, water, and some minerals. 4. Carbohydrates This is correct. Macronutrients are required by the body on a daily basis in large amounts (grams) and include protein, carbohydrates, fats, water, and some minerals. 5. Water This is correct. Macronutrients are required by the body on a daily basis in large amounts (grams) and include protein, carbohydrates, fats, water, and some minerals.

9. When educating a patient about cooking methods, a nurse recognizes that additional teaching is warranted when the patient states that a way to reduce fat intake is by 1. Frying. 2. Baking. 3. Grilling. 4. Broiling.

1. Frying. The patient should reduce his or her fat intake by baking, broiling, or grilling foods.

Select all that apply: 2. A dietitian teaches a class of student nurses that various laws ensure that nutrition facts food labels are found on all processed food products. A student correctly identifies that each food label must include which of the following? Select all that apply. 1. Health claims 2. Bacterial content 3. Macronutrient content 4. Daily Reference Value 5. Vitamin and mineral content

1. Health claims This is correct. Various laws ensure that nutrition facts food labels are found on all processed food products. Each label includes an ingredient list, nutritional descriptions, and health claims. 3. Macronutrient content This is correct. Various laws ensure that nutrition facts food labels are found on all processed food products. Each label includes an ingredient list, nutritional descriptions, and macronutrient content. 4. Daily Reference Value This is correct. Various laws ensure that nutrition facts food labels are found on all processed food products. Each label includes an ingredient list, nutritional descriptions, and a Daily Reference Value. 5. Vitamin and mineral content This is correct. Various laws ensure that nutrition facts food labels are found on all processed food products. Each label includes an ingredient list, nutritional descriptions, and vitamin and mineral content.

28. A dietician teaches that minerals are inorganic compounds used by all body tissues for numerous functions except 1. Helping the body absorb fat-soluble vitamins. 2. Forming the structure of the hard parts of the body. 3. Muscle contraction. 4. Assisting in water metabolism.

1. Helping the body absorb fat-soluble vitamins. Dietary fats or lipids are required to help the body absorb fat-soluble vitamins.

select all that apply 6. A physician has ordered, "Clear liquids, advance as tolerated." A nurse identifies that which of the following factors indicate that the patient is not yet ready to advance his or her diet? Select all that apply. 1. Hypoactive bowel sounds 2. Nausea 3. Complaints of indigestion 4. Hunger 5. Excessive thirst

1. Hypoactive bowel sounds This is correct. Factors indicating that the patient is not yet ready to advance the diet may include hypoactive bowel sounds. 2. Nausea This is correct. Factors indicating that the patient is not yet ready to advance the diet may include nausea. 3. Complaints of indigestion This is correct. Factors indicating that the patient is not yet ready to advance the diet may include complaints of indigestion.

2. When caring for a patient with diabetes, a nurse checks the morning laboratory values. The nurse notes that the patient's blood glucose level is 60 mg/dL. The nurse recognizes this reading is consistent with 1. Hypoglycemia. 2. Hyperglycemia. 3. A normal value. 4. Diabetic ketoacidosis.

1. Hypoglycemia. The 2013 American Diabetic Association guidelines state a range of 70 to 130 mg/dL before meals is acceptable for patients with existing diabetes. A blood glucose level of 60 mg/dL is consistent with hypoglycemia.

19. A nursing instructor evaluates a student nurse's application of theory regarding continuous tube feedings. The nursing instructor recognizes that further teaching is warranted when the student nurse 1. Instructs the patient to maintain a supine position. 2. Ensures that the head of the patient's bed is continually raised 30 degrees or more. 3. Interrupts the feeding every 4 hours to check placement. 4. Interrupts the feeding every 4 hours to check residual volume.

1. Instructs the patient to maintain a supine position. The supine position increases the risk for regurgitation and aspiration. The patient should have the head of the bed raised at least 30 degrees continually to reduce the risk for aspiration.

31. An instructor explains that some medications, such as nonsteroidal anti-inflammatory drugs, antineoplastics (cancer drugs), and certain antibiotics, can damage the intestinal mucosa. A student identifies that these types of medications can cause 1. Malabsorption. 2. Unintentional weight gain. 3. Increased metabolism. 4. Rapid or increased excretion.

1. Malabsorption. Drugs that damage the intestinal mucosa, such as nonsteroidal anti-inflammatory drugs, antineoplastics (cancer drugs), and certain antibiotics, can cause malabsorption. Binding of drugs to nutrients will impair absorption of the drug and/or the nutrient.

26. A patient with dysphagia is given a meal of scrambled eggs, cottage cheese, and tea. A nurse identifies that this patient is on a 1. Mechanical soft diet. 2. A full liquid diet. 3. Protein-restricted diet. 4. Pureed diet.

1. Mechanical soft diet. This diet includes all of the items from the full liquid diet plus foods such as scrambled eggs and cottage cheese.

7. A nurse is educating a patient about the process of digestion. The nurse teaches that digestion begins in the 1. Mouth. 2. Stomach. 3. Intestines. 4. Esophagus.

1. Mouth. The process of digestion begins in the mouth, where a digestive enzyme called salivary amylase begins breaking down simple carbohydrates and fat.

14. A nurse is caring for a Jewish patient who adheres to Jewish dietary law. The nurse recognizes that the most appropriate kosher dietary choice to offer to this patient is 1. Salmon. 2. Clam chowder. 3. Grilled shrimp. 4. Pulled pork.

1. Salmon. Kosher foods are those that come from animals identified in the Torah as being fit to eat and foods that are prepared in a proper manner as distinguished by kosher laws. These laws specify that meat must come only from fish with fins and scales; cloven-hoofed animals that chew their cud, such as cows, bison, deer, and goats; and a limited number of fowl species.

21. A dietician teaches a group of student nurses about different types of fat. The dietician says the type of fats that primarily come from animal sources, are solid at room temperature, and are implicated in cardiovascular disease because they increase blood cholesterol are known as 1. Saturated fats. 2. Monounsaturated fats. 3. Polyunsaturated fats. 4. Trans fats.

1. Saturated fats. Saturated fats come from animal sources, are solid at room temperature, and are implicated in cardiovascular disease because they increase blood cholesterol. Thus, these fats should be limited in a healthy diet.

21. It would be considered inappropriate for a nurse to 1. Set a meal tray down on a patient's over-the-bed table and then immediately leave the room. 2. Remove any item from a patient's over-the-bed table before the delivery of meal trays. 3. Assist a patient with dentures before mealtime. 4. Inquire whether the patient needs to go to the bathroom before eating.

1. Set a meal tray down on a patient's over-the-bed table and then immediately leave the room. Sometimes "passing the meal trays" is treated as just that: a task to be completed and nothing more. It is important for a nurse to ensure that his or her patients are aware of and eating their meals.

Select all that apply: 3. A nurse educates a patient about digestion. The nurse explains to the patient that digestive enzymes are released from which of the following organs? Select all that apply. 1. Small intestine 2. Liver 3. Pancreas 4. Esophagus 5. Gallbladder

1. Small intestine This is correct. Most digestion occurs in the first several feet of the small intestine. Digestive enzymes are released from the liver, gallbladder, pancreas, and small intestine, resulting in the breakdown of starches and proteins. 2. Liver This is correct. Most digestion occurs in the first several feet of the small intestine. Digestive enzymes are released from the liver, gallbladder, pancreas, and small intestine, resulting in the breakdown of starches and proteins. 3. Pancreas This is correct. Most digestion occurs in the first several feet of the small intestine. Digestive enzymes are released from the liver, gallbladder, pancreas, and small intestine, resulting in the breakdown of starches and proteins. 5. Gallbladder This is correct. Most digestion occurs in the first several feet of the small intestine. Digestive enzymes are released from the liver, gallbladder, pancreas, and small intestine, resulting in the breakdown of starches and proteins.

11. A patient has been prescribed the medication lithium as a mood-stabilizing agent. While administering lithium to the patient, a nurse should closely monitor 1. Sodium levels. 2. Calcium levels. 3. Potassium levels. 4. Phosphorus levels.

1. Sodium levels A person with a high level of sodium will excrete high levels of sodium and also lithium, which can lead to subtherapeutic levels of the medication. Conversely, those with low sodium levels will retain extra lithium, which leads to increased levels.

11. A dietitian teaches a student nurse about complete proteins. The student nurse demonstrates understanding when identifying an example of a complete protein as 1. Soy. 2. Seeds. 3. Wheat. 4. Brown rice.

1. Soy. Soy protein is the only source of complete proteins that is not an animal source.

20. A student nurse is discussing ways to assist with meals and improve a patient's eating experience in the hospital. A nurse intervenes when the student says: 1. "I should wipe off the over-the-bed table with disinfectant if a urinal or any other contaminated item has been on it." 2. "To avoid contamination, I should never open any container—milk cartons, juice containers, or cellophane packaging for plastic utensils—on the tray." 3. "I should make rounds to my patients' rooms during mealtimes and ask if they have any needs." 4. "I should ensure that each meal tray is assessed for the correct diet and appropriate temperature of food."

2. "To avoid contamination, I should never open any container—milk cartons, juice containers, or cellophane packaging for plastic utensils—on the tray." A nurse should open all containers—milk cartons, juice containers, cellophane packaging for plastic utensils, and condiments—on the tray. Many patients who are unable to accomplish these seemingly simple tasks will just not eat, rather than have to ask for assistance.

18. An instructor explains to a student the controversy surrounding the minimum volume of water and fluid required for optimal health. The student understands that most tend to follow the recommendation of 1. 12 to 16 eight-ounce glasses of fluid per day. 2. 6 to 8 eight-ounce glasses of fluid per day. 3. 8 to 12 twelve-ounce glasses of fluid per day. 4. 10 to 14 sixteen-ounce glasses of fluid per day.

2. 6 to 8 eight-ounce glasses of fluid per day. Amid the controversy surrounding the minimum volume of water and fluid required for optimal health, most tend to follow the lesser recommendations of 8 eight-ounce glasses per day.

24. A dietician teaches a group of nursing students that a diet that includes adequate levels of fiber has numerous additional health benefits beyond the stabilization of blood glucose levels, except 1. Promotion of weight loss. 2. A decrease in high-density lipoprotein (HDL). 3. Increased absorption of minerals. 4. A lowered colon pH.

2. A decrease in high-density lipoprotein (HDL). Adequate levels of fiber do not decrease HDL. Fiber decreases low-density lipoprotein (LDL) cholesterol, which reduces the risk for coronary artery disease.

38. A patient with malabsorption syndrome is able to meet some nutritional needs orally but requires partial parenteral nutrition for a limited period because of illness. A nurse identifies that the patient will require 1. A central venous catheter. 2. A peripherally inserted central catheter. 3. A jejunostomy tube. 4. A percutaneous endoscopic gastrostomy tube.

2. A peripherally inserted central catheter. Partial parenteral nutrition uses a peripherally inserted central catheter for patients who are able to meet some of their nutritional needs orally but require additional calories or nutrients for a limited period because of their illness.

Select all that apply: 4. A nursing instructor teaches a group of nursing students that the functions of protein include which of the following? Select all that apply. 1. Forming ketones 2. Building new tissue 3. Manufacturing enzymes 4. Manufacturing hormones 5. Producing energy and heat

2. Building new tissue This is correct. Protein is required for building new tissue, manufacturing hormones and enzymes, producing energy and heat, and maintaining acid-base balance. 3. Manufacturing enzymes This is correct. Protein is required for building new tissue, manufacturing hormones and enzymes, producing energy and heat, and maintaining acid-base balance. 4. Manufacturing hormones This is correct. Protein is required for building new tissue, manufacturing hormones and enzymes, producing energy and heat, and maintaining acid-base balance. 5. Producing energy and heat This is correct. Protein is required for building new tissue, manufacturing hormones and enzymes, producing energy and heat, and maintaining acid-base balance.

select all that apply 1. A nurse educates a class of adolescents about eating disorders. The nurse teaches that which of the following statements about eating disorders are true? Select all that apply. 1. Eating disorders are more prevalent in males than in females. 2. Eating disorders can cause a patient's health to be severely affected. 3. Eating disorders generally occur during adolescence or early adulthood. 4. Eating disorders are evidenced by extreme disturbances in eating habits. 5. Eating disorders may result from either physical or psychological causes.

2. Eating disorders can cause a patient's health to be severely affected. This is correct. Eating disorders are evidenced by extreme disturbances in eating habits, to the point that the patient's health can be severely affected or even result in death. 3. Eating disorders generally occur during adolescence or early adulthood. This is correct. Most eating disorders occur during adolescence or early adulthood but are not restricted to these phases of life. 4. Eating disorders are evidenced by extreme disturbances in eating habits. This is correct. Eating disorders are evidenced by extreme disturbances in eating habits, to the point that the patient's health can be severely affected or even result in death. 5. Eating disorders may result from either physical or psychological causes. This is correct. Eating disorders may result from either physical or psychological causes and result in both physical and psychological effects.

30. A patient is in the acute phase of an intestinal disorder and has been scheduled for surgery. A nurse identifies that this patient's diet should be 1. Calorie-restricted. 2. Fiber-restricted. 3. Sodium-restricted. 4. Protein-restricted.

2. Fiber-restricted. A fiber-restricted diet is used during the acute phase of intestinal disorders, when the presence of fiber may exacerbate intestinal pain, produce diarrhea, or cause an intestinal blockage.

28. A nurse is caring for an elderly patient who is unable to eat more than a few bites at a time. The nurse should modify the patient's diet to 1. A high-calorie, high-protein diet. 2. Five to six small, frequent feedings. 3. A sodium-restricted diet. 4. An antigen-avoidance diet.

2. Five to six small, frequent feedings. This feeding schedule is used with those patients who have difficulty tolerating larger meals or simply are unable to eat more than a few bites at a time, as well as those who need to have food gradually reintroduced. Often elderly patients are only able to eat small amounts at a time, thus making it difficult to obtain the needed nutrients in the traditional three meals a day.

24. A patient has complained several times of minor gastrointestinal pain, flatulence, and diarrhea after meals. A nurse identifies that this is most likely caused by 1. Anaphylaxis. 2. Food intolerance. 3. A food allergy. 4. Food poisoning.

2. Food intolerance. Food intolerance usually involves gastrointestinal symptoms, including bloating, flatulence, diarrhea, and nausea.

20. A dietitian explains to a class that cholesterol is a necessary component of good health. The dietitian realizes that additional instruction is required when a student says that cholesterol is required to 1. Convert sunshine to vitamin D. 2. Form antibodies, enzymes, and hormones. 3. Protect nerves. 4. Produce bile and the adrenal and sex hormones.

2. Form antibodies, enzymes, and hormones. The functions of protein include the formation of antibodies, enzymes, and hormones.

25. A doctor has ordered NPO status for a vomiting patient. A nurse violates the order by 1. Providing the patient with intravenous (IV) fluids. 2. Giving the patient ice chips. 3. Removing the patient's water carafe and drinking glass from the bedside. 4. Putting a sign that reads NPO over the patient's bed.

2. Giving the patient ice chips. NPO stands for "nothing per os," or mouth. It means the patient is restricted from oral intake of food or fluid, including water.

select all that apply 5. A nurse is caring for a patient who has a nasogastric (NG) tube to suction. When caring for this patient, the nurse should do which of the following? Select all that apply. 1. Assess the tube once per shift for patency. 2. Irrigate the clogged tube according to facility policy. 3. Position the tube so that it puts pressure on the naris. 4. Provide infrequent mouth care and lip moisturizer. 5. Assess color, amount, and consistency of gastric drainage.

2. Irrigate the clogged tube according to facility policy. This is correct. Nursing responsibilities when caring for an NG tube to suction include irrigating clogged tube according to physician's orders and facility policy when necessary. 4. Provide infrequent mouth care and lip moisturizer. This is correct. Nursing responsibilities when caring for an NG tube to suction include providing mouth care and applying lip moisturizer every 2 hours to prevent drying of mucous membranes. 5. Assess color, amount, and consistency of gastric drainage. This is correct. Nursing responsibilities when caring for an NG tube to suction include assessing the color, amount, and consistency of gastric drainage.

8. While educating a patient with diabetes about complex carbohydrates, a nurse teaches that complex carbohydrates require the body to work harder to break them down to use for energy, helping to maintain a more consistent blood glucose level. The nurse identifies an example of a complex carbohydrate as 1. Bananas. 2. Legumes. 3. Fruit juices. 4. Processed baked goods.

2. Legumes. Complex carbohydrates, which are found in whole grains, vegetables high in fiber, and legumes such as dried peas and beans, require the body to work harder to break them down to use for energy, helping to maintain a more consistent blood glucose level.

8. A nurse recognizes that the process that gently propels the food bolus into the small intestine is called 1. Digestion. 2. Peristalsis. 3. Indigestion. 4. Absorption.

2. Peristalsis. Muscles and nerves work together to perform peristalsis, moving the food from the esophagus to the stomach, into the small intestine, into the large intestine, and finally to the rectum.

36. A nursing supervisor asks a nurse for a double-lumen nasogastric (NG) tube. The nurse should bring the supervisor a 1. Levin tube. 2. Salem sump tube. 3. French tube. 4. Dobbhoff tube.

2. Salem sump tube. One style of NG tube is the Salem sump tube. The Salem sump tube is a double-lumen tube, meaning that it has two separate channels inside. One lumen is an air vent, and the other is for drainage of stomach contents, irrigation, instillation of medications, and obtaining gastric samples.

23. A dietician explains that a rapid increase in the blood glucose level that stimulates the pancreas to produce more insulin, which rapidly decreases blood glucose and increases appetite, is caused by the ingestion of 1. Saturated fats. 2. Simple carbohydrates. 3. Proteins. 4. Complex carbohydrates.

2. Simple carbohydrates. Simple carbohydrates, such as glucose and fructose, cause a rapid increase in the blood glucose level. The high blood glucose level then stimulates the pancreas to produce more insulin, which will rapidly decrease blood glucose and increase appetite, and thus increase eating.

26. A dietician teaches a group of student nurses that water-soluble vitamins cannot be stored in the body. Some are lost in the urine, making it necessary to consume them on a daily basis. The dietician says one example of a water-soluble vitamin is 1. Vitamin A. 2. Vitamin C. 3. Vitamin D. 4. Vitamin E.

2. Vitamin C. Water-soluble vitamins are dissolvable in water and therefore can be absorbed directly into the bloodstream from the gastrointestinal tract. Water-soluble vitamins include vitamin C.

16. An instructor explains that the old MyPyramid food management system has been replaced with a simpler visual symbol called MyPlate. The instructor realizes that additional instruction is required when a student says: 1. "Half of a plate of food should be fruits and vegetables, with veggies making up the greater portion of the two groups." 2. "Grains and protein should make up half of the plate, with the grains portion being the larger of the two groups." 3. "Adults should consume four to six servings a day from the vegetable group." 4. "Depending on the age of the individual, the entire daily intake of dairy should be restricted to a total of 2 to 3 cups of low-fat or nonfat milk."

3. "Adults should consume four to six servings a day from the vegetable group." Talking about food in terms of servings is a part of the MyPyramid food management system.

27. An instructor is explaining the functions, sources, and intake recommendations for vitamins. The instructor realizes additional instruction is required when a student says: 1. "It is vital to consume an adequate amount of most vitamins in our daily diet or through supplements because the body cannot manufacture many of them." 2. "With exposure of the skin to sunlight 15 minutes twice per week, the body can synthesize a significant amount of the needed vitamin D." 3. "Fat-soluble vitamins serve as coenzymes for metabolism throughout the body and help to stimulate appetite, maintain healthy nervous and integumentary systems, and assist with growth." 4. "Because fat-soluble vitamins can be stored, they can become toxic when consumed in excessively large doses over a long period of time."

3. "Fat-soluble vitamins serve as coenzymes for metabolism throughout the body and help to stimulate appetite, maintain healthy nervous and integumentary systems, and assist with growth." Among other functions, the B vitamins serve as coenzymes for metabolism throughout the body and help to stimulate appetite, maintain healthy nervous and integumentary systems, and assist with growth.

23. When monitoring the fluid intake of an average adult patient over a 24-hour period, a nurse should expect the patient to consume between 1. 500 and 1200 mL of fluid 2. 1200 and 1500 mL of fluid 3. 1500 and 2500 mL of fluid 4. 2500 and 3500 mL of fluid

3. 1500 and 2500 mL of fluid The average adult requires between 1500 and 2500 mL of fluid intake per 24 hours, depending on size and health status.

1. A nurse is caring for a 60-year-old, sedentary female patient. While educating the patient about how many calories are required to maintain her current body weight, the nurse recommends approximately 1. 800 calories a day. 2. 1000 calories a day. 3. 1600 calories a day. 4. 2000 calories a day.

3. 1600 calories a day. A sedentary, older adult woman needs about 1600 calories a day to maintain her body weight.

5. While educating a patient with diabetes about the HbA1c test, a nurse teaches that the HbA1c gives a better overall picture of glycemic control by measuring the amount of glucose present over a period of 1. 1 to 2 months. 2. 4 to 5 months. 3. 2 to 3 months. 4. 3 to 4 months.

3. 2 to 3 months. Health-care providers evaluate a patient's long-term glycemic control by measuring glycosylated hemoglobin, known as HbA13. A red blood cell has an average life span of 120 days, so the HbA1c measures the amount of glucose present over a period of 2 to 3 months, giving a better overall picture of glycemic control.

27. A nurse is discussing daily meals with a patient on a regular diet. The nurse explains that the patient can make choices from a balanced meal plan based on approximately 1. 1000 calories per day. 2. 1200 calories per day. 3. 2000 calories per day. 4. 3000 calories per day.

3. 2000 calories per day. A regular diet is appropriate for those patients without special nutritional needs. This diet provides approximately 2000 calories per day and offers a balanced meal plan.

29. A homeless man is admitted to the hospital with severe emaciation, a swollen abdomen, lethargy, and skin infections. The patient is diagnosed with a disease known as kwashiorkor, a condition caused by 1. A vitamin B deficiency. 2. Eating too many simple carbohydrates. 3. A failure to eat adequate protein. 4. A failure to eat an adequate amount of polyunsaturated fats.

3. A failure to eat adequate protein. Severe protein deficiency results in a disease known as kwashiorkor.

33. A nurse intervenes when a nursing student says that an enteral tube should be used for 1. Postoperative decompression of the stomach. 2. Nutritional support. 3. Breathing assistance. 4. Medication administration.

3. Breathing assistance. An endotracheal tube is used as a breathing tube.

10. A nurse educates a patient about increasing his or her intake of complete proteins. The patient demonstrates understanding when identifying an example of a complete protein as 1. Nuts. 2. Corn. 3. Eggs. 4. Beans.

3. Eggs Proteins that do not contain all nine essential amino acids are called incomplete proteins and come from plant sources. Examples include corn, wheat, seeds, beans, brown rice, and nuts.

7. While educating a patient with diabetes about simple carbohydrates, a nurse teaches that simple carbohydrates are quickly converted to glucose and can be used to quickly increase blood glucose. The nurse identifies an example of a simple carbohydrate as 1. Legumes. 2. Vegetables. 3. Fruit juices. 4. Whole grains.

3. Fruit juices. Simple carbohydrates, which are found primarily in fruits, fruit juices, processed baked goods, and sugar, are quickly converted to glucose and can be used to quickly increase blood glucose.

19. A nurse explains to a patient that there is a good type of cholesterol responsible for taking excess cholesterol back to the liver from the cells. This type of cholesterol is called 1. Trans fat. 2. Low-density lipoprotein (LDL). 3. High-density lipoprotein (HDL). 4. Triglycerides.

3. High-density lipoprotein (HDL). HDL is the transporter responsible for taking excess cholesterol back to the liver from the cells, helping to maintain a proper balance. Thus, it is commonly referred to as the good cholesterol.

3. When performing an initial admission assessment on a patient with diabetes, a nurse checks the patient's blood glucose level. The nurse notes that the patient's blood glucose level is 280 mg/dL. The nurse recognizes this reading is consistent with 1. Hypoglycemia. 2. Diabetic coma. 3. Hyperglycemia. 4. A normal value.

3. Hyperglycemia The 2013 American Diabetic Association guidelines state a range of 70 to 130 mg/dL before meals is acceptable for patients with existing diabetes. A blood glucose level of 280 mg/dL is consistent with hyperglycemia.

15. When a nurse inserts a nasogastric (NG) tube, the patient becomes cyanotic, coughs incessantly, and is unable to speak. The nurse should 1. Tape the tube to the patient's naris. 2. Continue to insert the tube quickly. 3. Immediately remove the tube completely. 4. Use a flashlight and tongue blade to view the posterior pharynx.

3. Immediately remove the tube completely. If the patient cannot speak, becomes cyanotic, or coughs incessantly, the tube is likely to be in the lungs. The nurse should immediately remove the tube.

17. A physician writes an order to discontinue a nasogastric (NG) tube. When discontinuing the NG tube, the nurse should 1. Slowly withdraw the tube from the patient's nose. 2. Show the removed tube to the patient and his or her spouse. 3. Instill 10 to 20 mL of air into the NG tube's main lumen. 4. Instruct the patient to breathe deeply while removing the tube.

3. Instill 10 to 20 mL of air into the NG tube's main lumen. Nursing responsibilities when removing an NG tube include instilling 10 to 20 mL of air into the NG tube's main lumen to empty the tube of any gastric contents.

4. A dietitian educates a nurse about Dietary Reference Intakes (DRIs). The dietitian teaches the nurse that DRIs contain recommendations for sex, age, pregnancy, and 1. Race. 2. Weight. 3. Lactation. 4. Educational level.

3. Lactation. The Food and Drug Administration (FDA) first established standards for the minimum amount of nutrients necessary to protect most individuals from disease. These standard guidelines are known as DRIs and contain recommendations for sex, age, pregnancy, and lactation.

18. A nurse is caring for a patient who is receiving formula through intermittent tube feedings. When caring for this patient, the nurse should 1. Keep the patient in a supine position. 2. Warm the formula in the microwave oven. 3. Maintain the formula at room temperature. 4. Administer the formula directly from the refrigerator.

3. Maintain the formula at room temperature. Nursing responsibilities when administering intermittent tube feedings include maintaining the formula at room temperature to decrease the potential for gastric discomfort.

22. A nurse is monitoring a patient's intake and output. The patient drinks part of a can of cola. The nurse should 1. Ask the patient to finish the can of cola. 2. Estimate how much of the can was consumed by the patient. 3. Measure the remainder to determine the amount ingested. 4. Not record such a small amount of fluid.

3. Measure the remainder to determine the amount ingested. If the can of carbonated cola contained 360 mL and the patient drank only part of it, the nurse would measure the remainder and subtract that from the 360 mL to determine the amount ingested.

32. A patient on long-term treatment with corticosteroids is experiencing weight gain and a rounding of the face shape, called moon facies. A nurse identifies that this is due to the corticosteroids' effect on the patient's 1. Absorption. 2. Appetite. 3. Metabolism. 4. Excretion.

3. Metabolism. In the case of long-term treatment with corticosteroids, the patient may experience weight gain, hyperglycemia, bone loss, muscle wasting, and rounding of the face shape, called moon facies.

5. A nurse teaches a patient that the American Heart Association (AHA) recommends 1. Disregarding the number of calories consumed. 2. Eating red meat and dairy products at each meal. 3. That no more than 25% to 35% of one's total daily intake of calories should come from fat. 4. Eliminating all forms of fat from your diet.

3. That no more than 25% to 35% of one's total daily intake of calories should come from fat. Although dietary fat is required to be healthy, the AHA recommends that no more than 25% to 35% of one's total daily intake of calories should come from fat. It is important to note that the majority of one's consumed fat should be the healthier fats rather than saturated fat.

10. A patient has been prescribed isoniazid (INH), a medication that treats tuberculosis. When administering INH to the patient, a nurse also anticipates administering the nutritional supplement 1. Vitamin K. 2. Vitamin C. 3. Vitamin B6. 4. Vitamin B12.

3. Vitamin B6 Patients receiving INH therapy must be treated for more than 6 months, which can lead to vitamin B6 deficiency. Patients are started on vitamin B6 as soon as INH is prescribed to prevent the deficiency.

12. A nurse teaches a patient about eating combinations of incomplete proteins to provide the body with all nine amino acids that are needed for complete protein synthesis. The patient demonstrates understanding by stating: 1. "I will combine eggs and milk." 2. "I will combine bacon and eggs." 3. "I will combine fish and soy products." 4. "I will combine red beans and brown rice."

4. "I will combine red beans and brown rice." It is important to note that eating combinations of incomplete proteins provides the body with all nine amino acids needed for complete protein synthesis. By consuming two or more incomplete protein sources, an individual can still meet his or her protein requirements. Commonly used combinations include red beans and brown rice.

A nurse teaches a patient about the importance of consuming more complex carbohydrates. The patient demonstrates understanding by stating: 1. "I will consume more fruit." 2. "I will consume more milk." 3. "I will consume more syrup." 4. "I will consume more pasta."

4. "I will consume more pasta." Pasta is a source of complex carbohydrates.

12. An emergency department nurse admits an adult patient for a drug overdose. The physician writes an order for the nurse to instill charcoal through a nasogastric (NG) tube. When selecting the NG tube, the nurse should choose a size 1. 4 French. 2. 8 French. 3. 12 French. 4. 16 French.

4. 16 French. Larger-bore NG tubes, such as 16 French or 18 French, are most commonly used for obtaining gastric specimens, instilling charcoal for poisoning or drug overdose, and patients requiring gastric decompression or washing out of the stomach, termed lavage.

2. A nurse is caring for an active, 55-year-old male patient. While educating the patient about how many calories are required to maintain his current body weight, the nurse recommends approximately 1. 1000 calories a day. 2. 1500 calories a day. 3. 2000 calories a day. 4. 2500 calories a day.

4. 2500 calories a day. An active, older adult male needs about 2500 calories a day to maintain his body weight.

3. A nurse is educating a class of active, 21-year-old male college students about how many calories a day they require to maintain their current body weights. The nurse recommends approximately 1. 1200 calories a day. 2. 1800 calories a day. 3. 2400 calories a day. 4. 3000 calories a day.

4. 3000 calories a day. An active, 21-year-old male needs about 3000 calories a day to maintain his body weight.

29. A patient is complaining of swollen hands and legs and mild fluid retention. The nurse decides to change the patient's diet to 1. A fat-restricted diet. 2. An antigen-avoidance diet. 3. A calorie-restricted diet. 4. A sodium-restricted diet.

4. A sodium-restricted diet. A sodium-restricted diet is used for those patients with hypertension, congestive heart failure, or kidney or liver failure, as well as those who require help to prevent or correct fluid retention.

9. A nurse recognizes that the process in which nutrients are taken into the gastrointestinal (GI) tract is called 1. Digestion. 2. Peristalsis. 3. Indigestion. 4. Absorption.

4. Absorption. Absorption is the process by which nutrients are taken from the end products of digestion into the villi that contain capillaries. This is the point where the majority of nutrients are absorbed into the bloodstream.

17. It is a primary function of water in the body to 1. Cushion the brain and spinal cord. 2. Lubricate joints. 3. Maintain body temperature. 4. All of the above.

4. All of the above. Depending on age, a person's entire daily intake of dairy should be restricted to a total of 2 to 3 cups of low-fat or nonfat milk or three small servings of other low-fat products.

34. A nursing student is asked to identify the difference between a nasogastric (NG) tube and a nasointestinal (NI) tube. The student correctly identifies that 1. Only an NI tube is inserted through the nose. 2. An NG tube is inserted through the stomach and into the duodenum. 3. An NI tube is shorter than an NG tube. 4. An NI tube is smaller in bore size and more flexible than an NG tube.

4. An NI tube is smaller in bore size and more flexible than an NG tube. An NI tube is usually smaller in bore size and more flexible than an NG tube.

30. A nurse explains to a vegetarian that he or she must be careful to ingest a greater amount of beans, dried fruit, whole grains, and molasses to prevent 1. Kwashiorkor. 2. Crohn disease. 3. Mineral toxicity. 4. An iron deficiency.

4. An iron deficiency. Vegetarians will be at risk for iron deficiency unless they are careful to ingest a greater amount of iron-rich, nonmeat foods such as beans, dried fruit, whole grains, and molasses.

25. A dietician explains that insoluble fiber is not digested, but passes through the intestines, acting like a bulk laxative and drawing water into the intestines, helping to prevent constipation. A good source of insoluble fiber would be 1. Carrots. 2. Strawberries and blueberries. 3. Beans. 4. Dark green leafy vegetables.

4. Dark green leafy vegetables. Dark green leafy vegetables are a good source of insoluble fiber.

4. While providing diabetic teaching to a patient with newly diagnosed diabetes, a nurse teaches that the best indicator of long-term glycemic control is obtained through measuring 1. Creatinine level. 2. Urine glucose level. 3. Blood glucose level. 4. Glycosylated hemoglobin.

4. Glycosylated hemoglobin. Health-care providers evaluate a patient's long-term glycemic control by measuring glycosylated hemoglobin, known as HbA13. A red blood cell has an average life span of 120 days, so the HbA1c measures the amount of glucose present over a period of 2 to 3 months, giving a better overall picture of glycemic control.

13. A physician writes an order for a nurse to insert a nasogastric (NG) tube for gastric decompression. When inserting the NG tube, the nurse should 1. Force the tube toward the nasopharynx. 2. Instruct the patient to avoid swallowing while inserting the tube. 3. Push the tip of the tube upward against the top side of the nasal passage. 4. Instruct the patient to hyperextend his or her head slightly and then gently insert the tube into the intended naris.

4. Instruct the patient to hyperextend his or her head slightly and then gently insert the tube into the intended naris. The nurse should have the patient hyperextend his or her head just slightly. Next, the nurse should gently insert the lubricated tip of the NG into the intended naris.

37. A patient who requires long-term feeding has a surgical endoscopic placement of a feeding tube in the stomach. A nurse correctly identifies this as a 1. Jejunostomy tube (J-tube). 2. Nasogastric (NG) tube. 3. Nasointestinal (NI) tube. 4. Percutaneous endoscopic gastrostomy (PEG) tube.

4. Percutaneous endoscopic gastrostomy (PEG) tube. A PEG tube is placed in the stomach.

22. A dietician teaches a group of student nurses that omega-3 and omega-6 fatty acids are found in walnuts, flaxseed, and several types of fatty fish, and are essential for normal cell development. The dietician says these types of fats are known as 1. Trans fats. 2. Monounsaturated fats. 3. Saturated fats. 4. Polyunsaturated fats.

4. Polyunsaturated fats. Polyunsaturated fats are essential for normal cell development and are found in sources such as corn oil, soybean oil, sesame oil, and safflower oil. Two examples of essential polyunsaturated fats are the omega-3 and omega-6 fatty acids that are found in walnuts, flaxseed, and several types of fatty fish.

14. As a nurse inserts a nasogastric (NG) tube, a patient gags and coughs continually and does not appear able to stop. The nurse should 1. Tape the tube to the patient's naris. 2. Continue to insert the tube quickly. 3. Immediately remove the tube completely. 4. Use a flashlight and tongue blade to view the posterior pharynx.

4. Use a flashlight and tongue blade to view the posterior pharynx. If the patient gags or coughs continually and does not seem able to stop, the tube may be curled up in the back of the throat. The nurse should use a flashlight and tongue blade to view the posterior pharynx to look for the tube.

15. A nurse explains micronutrients to a patient. The patient identifies that micronutrients include 1. Amino acids. 2. Water. 3. Proteins. 4. Vitamins.

4. Vitamins. Micronutrients include vitamins and trace minerals.

2. An instructor explains to a group of student nurses that when the body uses components to build or reconstruct new components or tissue, it is called ____________________.

anabolism Rationale: When the body uses components to build or reconstruct new components or tissue, it is called anabolism

2. An instructor explains that a type of intermittent tube feeding in which a physician-ordered volume of formula is administered using a large irrigating syringe at set intervals throughout the day is called ____________________ feeding.

bolus Rationale: Bolus feeding is a frequently used type of intermittent tube feeding in which a physician-ordered volume of formula is administered at set intervals throughout the day.