Nutrition

7) Which of the following are indications for using parenteral nutrition? Select all that apply. a. Paralytic ileus b. Intractable vomiting c. Dysphagia d. Coma

A, B a. Paralytic ileus b. Intractable vomiting

1) The patient asks if coffee is bad for his peptic ulcer. Which of the following would be the nurse's best response? a. "Coffee does not cause ulcers, and drinking it probably does not interfere with ulcer healing. You may try eliminating it from your diet to see what impact it has on your symptoms and then decide whether or not to avoid it." b. "Both caffeinated and decaffeinated coffee can cause ulcers and interfere with ulcer healing. You should eliminate both from your diet." c. "You need to eliminate caffeinated coffee from your diet, but it is safe to drink decaffeinated coffee." d. "You can drink all the coffee you want; it does not affect ulcers."

a. "Coffee does not cause ulcers, and drinking it probably does not interfere with ulcer healing. You may try eliminating it from your diet to see what impact it has on your symptoms and then decide whether or not to avoid it."

3) The client asks if meal replacements, such as Jenny Craig products, are a good idea to help with weight loss. Which of the following would be the nurse's best response? a. "They are a great way to control portions and can help you adhere to your diet when used as suggested." b. "They are gimmicks that fail to teach you how to control your own intake. They are not recommended." c. "Most people gain weight while using them. You should stay away from them." d. "They are not nutritionally balanced so you actually have to overeat in order to meet your nutritional requirements if you use them."

a. "They are a great way to control portions and can help you adhere to your diet when used as suggested."

4) The nurse knows that instructions for a healthy diet have been effective when the client expresses a need to eat more a. Oily fish and nuts b. Lean red and deli meats c. Diet soda and diet desserts d. Italian bread and cornflakes

a. Oily fish and nuts

5) How do the protein recommendations for those with chronic kidney disease without diabetes differ from those who have diabetes? a. Protein is more restricted for people who do not have diabetes. b. Protein is more restricted for people who have diabetes. c. The protein recommendations do not differ for people with diabetes or without diabetes. d. There are no specific protein recommendations for people with diabetes because carbohydrates and fat are the priority concerns.

a. Protein is more restricted for people who do not have diabetes.

1) When developing a teaching plan for a patient who has chronic diarrhea, which of the following foods would the nurse suggest as an appropriate source of potassium? a. Tomato juice b. Pinto beans c. Milk d. Broccoli

a. Tomato juice

3) The client asks if yogurt with probiotics will relieve her symptoms of irritable bowel syndrome. Which of the following would be the nurse's best response? a. "Unfortunately, there isn't anything that will help relieve irritable bowel syndrome." b. "Although it is not guaranteed to help, probiotics may help and do not pose a health risk in healthy people." c. "Because little is known about the effects of probiotics on health, you should avoid consuming them." d. "Probiotics are the only dietary intervention known to help irritable bowel syndrome."

b. "Although it is not guaranteed to help, probiotics may help and do not pose a health risk in healthy people."

1) Which statement indicates the patient understands the instruction about a DASH-style diet? a. "The most important thing about a DASH diet is to eat less cholesterol. No egg yolks for me." b. "I need to eat more fruits, vegetables, and whole grains." c. "As long as I don't add salt to my food while cooking or at the table, I will be able to achieve a low-sodium diet." d. "I had given up sugar-sweetened soft drinks but now I am going to go back to drinking them because they are allowed on my diet."

b. "I need to eat more fruits, vegetables, and whole grains."

1) The client asks if it is okay for her to follow a low-carbohydrate, Atkins-type diet in the short term to get her started on her weight loss efforts. Which of the following would be the nurse's best response? a. "No, low-carbohydrate diets are not healthy and would only sabotage your weight loss efforts." b. "Initially, a low-carbohydrate diet can help you lose weight more quickly than other types of diets, but over time, what is most important is the amount of calories you eat, not the macronutrient distribution. You can try it, but discontinue it if you experience any side effects." c. "A low-carbohydrate diet is better than any other type of diet and is a good choice for you to use." d. "A low-fat diet is easier. Try that instead."

b. "Initially, a low-carbohydrate diet can help you lose weight more quickly than other types of diets, but over time, what is most important is the amount of calories you eat, not the macronutrient distribution. You can try it, but discontinue it if you experience any side effects."

6) A client asks if it is okay to drink nutrition formulas in place of eating solid food because it seems to be the only thing she tolerates. Which of the following is the nurse's best response? a. "Nutrition formulas are okay to use as a supplement in your diet, but they do not provide enough nutrition to use them in place of a meal." b. "Nutrition formulas are rich in nutrients and can be used in place of meals if they are what you are able to tolerate best." c. "It is fine to rely on nutritional supplements but vary the brand to ensure you are getting adequate nutrition." d. "Nutrition formulas generally are too high in calories and protein to use in place of meals."

b. "Nutrition formulas are rich in nutrients and can be used in place of meals if they are what you are able to tolerate best."

1) Which statement indicates the patient understands nutrition recommendations regarding carbohydrate intake? a. "People with diabetes should avoid sugars and foods that contain sugars." b. "It is important to consume the proper balance of starch, sugar, and fiber at each meal." c. "It is important to consume the correct amount of carbohydrate at each meal and snack." d. "Carbohydrates must be balanced in relation to the amount of protein and fat consumed."

c. "It is important to consume the correct amount of carbohydrate at each meal and snack."

8) The number of 31⁄2 oz servings of oily fish recommended is a. 2/month b. 1/week c. 2/week d. 3 to 4/week

c. 2/week

3) Which of the following snacks would be best for a patient who wants to eat who has nausea? a. Cheese b. Peanuts c. Banana d. A milkshake

c. Banana

4) The nurse knows her instructions about preventing future calcium oxalate stones have been effective when the client verbalizes he should a. Avoid milk, cheese, and other sources of calcium. b. Take megadoses of vitamin C. c. Consume a normal amount of dietary calcium spread out over the course of the day. d. Eat a high-protein diet.

c. Consume a normal amount of dietary calcium spread out over the course of the day.

3) When developing a teaching plan for a client who is taking insulin, which of the following foods would the nurse suggest the client carry with him to treat mild hypoglycemia? a. Crackers b. Peanuts c. Chocolate drops d. Life Savers

d. Life Savers

1) The nurse knows her instructions about healthy eating to reduce the risk of cancer have been understood when the client states a. "If I follow those healthy eating guidelines, I will not get cancer." b. "To reduce the risk of cancer, I have to eat a vegetarian diet." c. "There is not enough known about diet and cancer to make informed choices about what to eat to reduce the risk of cancer." d. "A mostly plant-based diet may reduce the risk of cancer."

d. "A mostly plant-based diet may reduce the risk of cancer."

7) Which statement indicates the client with HIV needs further instruction about healthy eating? a. "Eating fat increases my chances of getting fat around my middle, so I am trying to choose all nonfat or low-fat food." b. "Eating carbs makes insulin resistance worse, so I am eating a very-low- carbohydrate diet." c. "Protein is the most important nutrient, so I am eating extra red meat at every meal." d. "Monounsaturated fats in olive oil, canola oil, nuts, and avocado are healthiest. I am eating more of them and less of other types of fats."

d. "Monounsaturated fats in olive oil, canola oil, nuts, and avocado are healthiest. I am eating more of them and less of other types of fats."

8) The best dessert for a patient with GERD is a. Chocolate cake b. Peppermint ice cream c. Cheesecake d. Applesauce

d. Applesauce

4) The best approach for monitoring carbohydrate intake is to use a. The exchange system b. Carbohydrate counting c. Sample menus d. The approach that best helps the individual control blood glucose levels

d. The approach that best helps the individual control blood glucose levels

8) Which food groups provide carbohydrates? (Select all that apply.) a. Vegetables b. Fruit c. Milk d. Meat

A, B, C a. Vegetables b. Fruit c. Milk

6) Nausea in a tube-fed patient may be caused by which of the following? Select all that apply. a. Malplacement of the feeding tube b. A feeding rate that is too rapid c. Providing an excessive volume of formula d. Feeding too soon after intubation e. Anxiety f. Using a formula that is low in residue

A, B, C, D, E a. Malplacement of the feeding tube b. A feeding rate that is too rapid c. Providing an excessive volume of formula d. Feeding too soon after intubation e. Anxiety

4) Which of the following strategies promotes adherence to exercise? Select all that apply. a. Promote structure by encouraging the client to exercise at on-site or supervised exercise sessions. b. Encourage the client to exercise in multiple short bouts (10 minutes each), instead of one long session. c. Encourage a more active lifestyle, such as parking far away from the door when going to the mall or work. d. Encourage the client to exercise at home.

B, C, D b. Encourage the client to exercise in multiple short bouts (10 minutes each), instead of one long session. c. Encourage a more active lifestyle, such as parking far away from the door when going to the mall or work. d. Encourage the client to exercise at home.

1) Which of the following strategies may help promote an adequate oral intake in hospitalized patients? Select all that apply. a. Tell the patient that you wouldn't want to eat the food either but that it is important for the patient's recovery. b. Encourage the patient to select his or her own menu. c. Offer standby alternatives when the patient cannot find anything on the menu he or she wants to eat. d. Advance the diet as quickly as possible, as appropriate.

B,C, D b. Encourage the patient to select his or her own menu. c. Offer standby alternatives when the patient cannot find anything on the menu he or she wants to eat. d. Advance the diet as quickly as possible, as appropriate.

6) Which of the following may help to promote adherence to a hypocaloric diet? a. A meal plan and recipes b. A list of forbidden foods c. A calorie counter d. A fat gram counter

a. A meal plan and recipes

2) Which statement indicates the patient with an ileostomy needs further instruction about what to eat? a. "Drinking lots of water increases the output from my ileostomy." b. "It is best to eat a small evening meal." c. "Oatmeal and bananas may help control diarrhea." d. "A regular eating schedule will help regulate my bowel pattern."

a. "Drinking lots of water increases the output from my ileostomy."

1) Which statement indicates the patient needs further instruction about diet for nephrotic syndrome? a. "I know I need to eat a high-protein diet to replace the protein lost in urine." b. "I need to limit my intake of saturated fat and cholesterol." c. "I should not use salt in cooking or at the table and avoid foods high in sodium such as processed foods, fast foods, convenience foods, condiments, and canned meat and vegetables." d. "I am going to try substituting soy protein for animal sources of protein because it may be better for me."

a. "I know I need to eat a high-protein diet to replace the protein lost in urine."

2) Which statement indicates the patient needs further instruction about GERD? a. "I know a bland diet will help prevent the heartburn I get after eating." b. "Lying down after eating can make GERD symptoms worse." c. "High-fat meals can make GERD symptoms worse." d. "Losing excess weight can help prevent symptoms of GERD."

a. "I know a bland diet will help prevent the heartburn I get after eating."

6) A client on hemodialysis asks if she can use popsicles to help relieve her thirst. Which of the following is the nurses' best response? a. "That's a great idea as long as you deduct the equivalent amount of fluid from your total daily fluid allowance." b. "Popsicles are empty calories. You are better off drinking just plain water." c. "Popsicles are great at relieving thirst, and because they are solid, they do not count as fluid, so you can eat them as desired." d. "Hot things are better at relieving thirst than cold things. Try small amounts of hot tea or coffee to relieve your thirst."

a. "That's a great idea as long as you deduct the equivalent amount of fluid from your total daily fluid allowance."

5) How many carbohydrate choices are provided in a serving of food that supplies 19 grams of carbohydrate? a. 1 b. 2 c. 3 d. 4

a. 1

4) Which type of formula may normalize either constipation or diarrhea in tube-fed patients? a. A fiber-enriched formula b. An isotonic formula c. A hydrolyzed formula d. A standard, intact formula

a. A fiber-enriched formula

6) Which of the following may be an appropriate source of calcium for a client who is lactose intolerant? a. Aged cheddar cheese b. Pudding c. Lean meats d. Refined breads and cereals

a. Aged cheddar cheese

4) Which of the following meals would be most appropriate for a patient whose only cancer treatment symptom that impacts intake is neutropenia? a. Baked macaroni and cheese with cooked green beans b. Cottage cheese and fresh fruit plate c. Soft cooked eggs with toast d. Caesar salad with Caesar salad dressing

a. Baked macaroni and cheese with cooked green beans

3) When developing a teaching plan for a client who is on dialysis, which of the following protein sources would the nurse suggest for a client who must also limit her intake of phosphorus? a. Beef b. Cheese c. Tofu d. Kidney beans

a. Beef

8) When should nutrition become part of the care plan for a client with HIV? a. Before the onset of symptoms b. When the client begins to lose weight c. After an acute episode of illness d. When weight loss is more than 5% of initial weight

a. Before the onset of symptoms

5) The client asks what foods she can eat for protein because meat tastes "rotten" to her. Which of the following would be the nurse's best response? a. Cheese omelet, cold chicken sandwich, shrimp salad b. Vegetable soup, pulled-pork sandwich, meatloaf with gravy c. Spaghetti with meatballs, tacos, peanut butter and jelly sandwich d. Hot dogs, hamburgers, vegetable pizza

a. Cheese omelet, cold chicken sandwich, shrimp salad

7) A client with fat malabsorption is at risk for which of the following? a. Oxalate kidney stones b. Constipation c. Deficiencies of essential amino acids d. Type 2 diabetes

a. Oxalate kidney stones

3) When developing a teaching plan for a client on a low-sodium diet, which of the following foods would the nurse advise the client to limit? a. Processed cheese b. Canned fruit c. Eggs d. Milk

a. Processed cheese

6) Which of the following is an appropriate breakfast for a patient on a level 1 dysphagia diet? a. Poached egg b. Cream of wheat c. Granola with milk d. Toast cut into small pieces

b. Cream of wheat

5) A patient with dumping syndrome asks why it is so important to avoid sugars and sweets. Which of the following is the nurse's best response? a. "Sugars and sweets provide empty calories, so they should be limited in everyone's diet." b. "Sugars draw water into the intestines and cause cramping and diarrhea." c. "Sugar makes blood glucose levels increase; hyperglycemia is a complication of dumping syndrome." d. "Avoiding sugars and sweets helps ensure that they will not displace the intake of protein, which you need for healing."

b. "Sugars draw water into the intestines and cause cramping and diarrhea."

5) Which of the following calorie level ranges is considered appropriate for weight loss diets for most women? a. 800-900 cal/day b. 1000-1200 cal/day c. 1400-1600 cal/day d. 1800-2000 cal/day

b. 1000-1200 cal/day

2) A major reason why it becomes increasing difficult to keep losing weight on a weight loss diet is that a. The loss of fat tissue lowers metabolic rate. b. A lighter body expends fewer calories than a heavier body when doing activity. c. Fluid retention becomes an issue over time. d. A decrease in food intake means that fewer calories are used to metabolize food.

b. A lighter body expends fewer calories than a heavier body when doing activity.

6) The nurse knows her instructions about label reading have been effective when the client verbalizes that to determine the amount of carbohydrate choices, you must a. Add the grams of total carbohydrate and grams of sugars together to determine total carbohydrates provided. b. Adjust total carbohydrates for foods that provide more than 5 g of fiber or more than 5 g of sugar alcohols per serving. c. Add grams of total carbohydrate, fiber, and sugars to determine total carbohydrate grams. d. Use only the grams of total carbohydrate to determine carbohydrate choices.

b. Adjust total carbohydrates for foods that provide more than 5 g of fiber or morethan 5 g of sugar alcohols per serving.

7) One of the factors that influence protein allowance during acute kidney injury is the individual's a. Level of activity b. Degree of catabolism c. Blood pressure d. Serum albumin concentration

b. Degree of catabolism

5) Which of the following would be most appropriate in modifying a regular diet to a high-fiber diet? a. Ice cream in place of gelatin b. Apple in place of apple juice c. Rice in place of mashed potatoes d. Cream of wheat in place of cream of rice

b. Apple in place of apple juice

5) Which tube-feeding delivery method is most likely to cause dumping syndrome? a. Intermittent feedings b. Bolus feedings infused into the stomach c. Bolus feedings infused into the small intestine d. Continuous drip feedings

b. Bolus feedings infused into the stomach

4) The nurse knows her instructions have been effective when the patient with dumping syndrome verbalizes she should a. Avoid lying down after eating. b. Drink liquids between, not with, meals. c. Eat simple sugars in place of starches. d. Avoid protein.

b. Drink liquids between, not with, meals.

4) The nurse knows his or her instructions have been effective when the client with celiac disease verbalizes that an appropriate breakfast is a. Eggs and toast b. Grits with berries c. Bran flakes cereal with milk d. Buttermilk pancakes with syrup

b. Grits with berries

8) When instituting nutrition therapy for a client diagnosed with anorexia nervosa, the priority is to a. Teach the client about nutrient and calorie requirements. b. Halt weight loss. c. Normalize eating behaviors. d. Provide sufficient calories for weight gain.

b. Halt weight loss.

8) Which of the following strategies would help a client achieve a low-fat diet? a. Substitute margarine for butter. b. Limit portion sizes of meat. c. Substitute whole wheat bread for white bread. d. Eat more fruit in place of vegetables.

b. Limit portion sizes of meat.

2) The client asks if he can continue using butter on his DASH-style healthy diet. Which of the following would be the nurse's best response? a. "No, butter does not fit into a heart healthy diet." b. "Butter is not limited in a heart healthy diet because most people only use small amounts." c. "You can use small amounts of butter if you are willing to compromise on other foods, such as eating meatless meals occasionally." d. "You can use small amounts of butter if you give up meat entirely."

c. "You can use small amounts of butter if you are willing to compromise on other foods, such as eating meatless meals occasionally."

8) The client asks if she will need to follow a diet after she recovers from her kidney transplant. Which of the following is the nurse's best response? a. "You will always have to limit protein and phosphorus intake to help preserve the health of the new kidney." b. "After recovery, all restrictions are lifted and you can eat anything you want." c. "You may need to modify some aspects of your diet because of side effects from the medications you will be taking, and you should continue to eat a heart-healthy diet to decrease the risks of diabetes, hypertension, heart disease, and obesity." d. "All the restrictions you followed before dialysis will resume after you recover from the transplant."

c. "You may need to modify some aspects of your diet because of side effects from the medications you will be taking, and you should continue to eat a heart-healthy diet to decrease the risks of diabetes, hypertension, heart disease, and obesity."

8) It is recommended that parenteral nutrition not be used when the patient is adequately nourished and expected to resume oral intake within a. 2 to 3 days b. 5 to 7 days c. 7 to 14 days d. 14 to 21 days

c. 7 to 14 days

3) Which type of enteral formula would be most appropriate for a patient experiencing malabsorption related to inflammatory bowel disease? a. A standard intact formula b. A fiber-enriched intact formula c. A hydrolyzed formula for malabsorption d. A patient with malabsorption cannot receive enteral nutrition

c. A hydrolyzed formula for malabsorption

7) What is the priority for preventing diabetes in people who are at high risk? a. Eat a low-carbohydrate diet. b. Consume a consistent amount of carbohydrate at every meal. c. Achieve moderate weight loss through increased activity and lowered calorie and fat intake. d. Eat a low-sugar diet.

c. Achieve moderate weight loss through increased activity and lowered calorie and fat intake.

7) When instituting nutrition therapy for a client diagnosed with bulimia nervosa, the priority is to a. Teach the client about nutrient and calorie requirements. b. Halt weight loss. c. Normalize eating behaviors. d. Provide sufficient calories for weight gain.

c. Normalize eating behaviors.

3) Which of the following strategies would the nurse suggest to help the client increase the protein density of his diet? a. Top baked potatoes with sour cream. b. Mix cream cheese with butter and spread on hot bread. c. Substitute milk for water in recipes. d. Add whipped cream to coffee.

c. Substitute milk for water in recipes.

7) The client understands that losing weight will help lower blood pressure. What does the client need to know about weight loss diets? a. For overall health and weight, it doesn't matter what kind of diet you choose. b. A very-low-carbohydrate diet is best because it promotes quick weight loss and is nutritionally adequate in all food components known to provide cardiometabolic benefits. c. The appropriate calorie level DASH diet can promote weight loss while providing adequate amounts of food components that have cardiometabolic benefits. d. Low-fat, low-calorie diets are the best for overweight cardiac clients because bene- fits are achieved from reducing all types of fat in the diet.

c. The appropriate calorie level DASH diet can promote weight loss while providing adequate amounts of food components that have cardiometabolic benefits.

2) The nurse knows her instructions on how to reduce the risk of foodborne illness have been understood when the client states a. "It is okay to thaw food at room temperature as long as I cook it immediately after it is defrosted." b. "Leftovers are not safe to eat." c. "Fruits and vegetables do not need to be washed if I peel them or eat them after they are cooked." d. "All meat, fish, and poultry should be cooked to the well-done stage."

d. "All meat, fish, and poultry should be cooked to the well-done stage."

2) The client with type 1 diabetes asks if she can have a glass of wine with dinner on the weekends. Which of the following would be the nurse's best response? a. "It is better to have wine between meals than with meals so that it doesn't interfere with your normal food intake." b. "People with diabetes cannot have alcohol because it raises blood glucose levels very quickly." c. "A mixed drink would be better than wine because the mixer will help slow the absorption of the alcohol." d. "An occasional glass of wine with dinner will not cause any problems. Be sure to limit yourself to one serving."

d. "An occasional glass of wine with dinner will not cause any problems. Be sure to limit yourself to one serving."

6) A client asks how to alter a diet to lower high triglyceride levels. Which of the following is the nurse's best response? a. "Alcohol lowers triglycerides, but don't drink more than 2 drinks daily." b. "Lower your cholesterol intake by eliminating egg yolks and butter." c. "Eat less sodium by avoiding processed foods and don't salt your food at the table." d. "Eat more fish and substitute whole grains for refined grains."

d. "Eat more fish and substitute whole grains for refined grains."

2) A client with predialysis CKD asks if it is okay that she saves all her meat allowance for her evening meal. Which of the following would be the nurse's best response? a. "You cannot have any meat on a predialysis diet." b. "It doesn't matter when you eat your meat allowance, so if you prefer to save it all for dinner, that is fine." c. "If you want to eat your meat allowance all at one time, it would be better to eat it for breakfast so that your body has all day to metabolize it." d. "It is best if you spread your meat allowance out over the whole day."

d. "It is best if you spread your meat allowance out over the whole day."

5) Which of the following recommendations would be most appropriate to limit trans fats? a. Avoid red meats. b. Avoid egg yolks and shellfish. c. Avoid corn oil. d. Avoid commercially made baked goods and stick margarines.

d. Avoid commercially made baked goods and stick margarines.

2) For which of the following situations is a pureed diet most appropriate? a. As an initial oral diet after surgery to establish tolerance b. As a transition between a full liquid diet and a regular diet c. For patients who need a low-fiber diet d. For patients who have had their jaw wired

d. For patients who have had their jaw wired

7) A patient who develops pernicious anemia after gastric surgery needs supplemental a. Protein b. Iron c. Folic acid d. Vitamin B12

d. Vitamin B12