Nutrition
A nurse is providing teaching to a client who has a new prescription for digoxin (Lanoxin). Which of the following foods choices should be limited while taking this medication? (Select all that apply) a. bananas b. celery c. baked potatoes d. tuna e. apples
A & C. Bananas and baked potatoes are high in potatssium. Digoxin lowers serum potation levels, and foods containing potassium should be encouraged
A school nurse is conducting a nutritional course to a group of teens. Which of the following should be included as healthy snack choices? (Select all that apply) a. carrot sticks with low-fat dip b. cheese and crackers c. unbuttered popcorn d. frozen low-fat yogurt e. hot dog
A, B, C, D. All are healthy except hot dogs as they are high in sodium and fat
A nurse is teaching a nutritional class for a group of pregnant clients. Which of the following should be included in the teaching regarding iron-rich foods? (Select all that apply) a. Beans b. Fish c. Dairy products d. lean red meats e. apples
A, B, C, D. Apples are not rich in iron, the others are
A nurse is caring for a client who is immobilized because of bilateral femur and tibia fractures. Which of the following are clinical signs of negative nitrogen balance? (Select all that apply) a. decreased muscle tissue b. impaired organ function c. increased susceptibility to infection d. Increased metabolism e. decreased protein catabolism
A, B, C, D. Decreased muscle tissue, impaired organ function, increased susceptibility to infection, and increased metabolism are all signs of negative nitrogen balance
A school nurse is teaching a group of students how to read food labels. Which of the following should be included in the teaching? (select all that apply) a. total carbohydrates b. total fat c. calories d. magnesium e. dietary fiber
A, B, C, E. Total carbohydrates, total fat, calories, dietary fiber are included on food labels
A nurse is performing dietary needs assessment for a group of clients. A blenderized liquid diet is appropriate for which of the following clients? (Select all that apply) a. A client who has a wired jaw due to a motor vehicle crash b. A client who is 24 hr postop following a temporomandicular joint repari c. A client who has difficulty chewing due to a traumatic brain injury d. A client who has hypercholesterolemia due to coronary artery disease e. A client who is scheduled for a colonoscopy the next morning
A, B, C. A blenderized liquid diet is appropriate for clients with wired jaw, following oral surgery, and who have difficulty swallowing (Colonoscopy patients should receive clear liquids)
A charge nurse is conducting a nutritional class for a group of newly licensed nurses regarding basal metabolic rate (BMR). The charge nurse should inform the class that which of the following increases BMR? (Select all that apply) a. lactation b. prolonged stress c. malnutrition d. puberty e. exposure to extreme cold
A, B, D, E. Lactation, prolonged stress, puberty, and exposure to extreme cold (by using more energy to regulate body temp) increases BMR
A nurse is performing a nutritional assessment on a client. Which of the following clinical findings are suggestive of malnutrition? (Select all that apply) a. poor wound healing b. dry hair c. blood pressure 130/80 mmHg d. weak hand grips e. impaired coordination
A, B, D, E. Poor wound healing, dry hair, weak hand grips, and impaired coordination describe changes reflective to malnutrition
A nurse is assessing a 6-month-old infant who has a lactose intolerance. Which of the following clinical findings are associated with this diagnosis? (select all that apply) a. Abdominal distention b. Flatus c. Hypoactive bowel sounds d. occasional diarrhea e. Visible peristalsis
A, B, D. Abdominal distention, flatus, and occasional diarrhea are findings of lactose intolerance
A nurse is teaching the parents of a toddler about appropriate snack foods. Which of the following should be included in the teaching? (Select all that apply) a. graham crackers b. apple slices c. peeled raisins d. jelly beans e. cheese cubes
A, B, E. Graham crackers, Apple slices, and cheese cubs are appropriate snacks for toddlers (raisins are difficult to chew and pose a choking hazard; jelly beans are difficult to swallow, pose a choking risk and are high in sugar content)
A nurse is planning care for an older adult client who is receiving treatments for malnutrition. The client is scheduled for discharge to his home where he lives alone. Which of the following actions are appropriate to include in the plan of care? (select all that apply) a. Consult social services to arrange home meal delivery b. Encourage the client to purchase nonperishable boxed meals c. Advise the client to purchase frozen fruits and vegetables d. Recommend drinking a supplement between meals e. Educate the client on how to read nutrition labels
A, C, D, E. These are all appropriate actions to promote adequate nutrition (Boxes foods are usually high in calories and salt, and therefore not appropriate)
A nurse in an assisted living facility is caring for an older adult client. The nurse should recognize that older adults have decreased absorption of which of the following? (Select all that apply.) A. Calcium B. Chloride C. Folic acid D. Magnesium E. Phosphorus
A, C. Older adults have decreased cellular function and reduced body reserves, leading to decreased absorption of B12, folic acid, and calcium
A nurse is caring for a client who is receiving TPN, but the next bag of solution is not avail for administration at this time. Which of the following is an appropriate action by the nurse? a. Administer 20% dextrose in water IV until the next bag is avail b. Slow the infusion rate of the current bag until the solution is avail c. Monitor for hyperglycemia d. Monitor for hyperosmolar diuresis
A. Administering 20% dextrose in water will avoid hypoglycemia (decreased rates of TPN may cause hypoglycemia, clients should be monitored for hyperosmolar diuresis when the TPN solution has infused too fast)
A nurse is reviewing prescribed meds for an older adult client. Which of the following meds could result in sodium and potassium loss? a. Hydrochlorothiazide (HydroDIURIL) b. Captropril (Capoten) c. Guaifenesin (Anti-Tuss) d. Cephalexin (Keflex)
A. Hydrochlorothiazide is a diuretic and can cause sodium and potassium loss (Captropril is an antihypertensive that doesn't cause decrease in Na and K levels, Guaifenesin is an expectorant, Cephalexin is a first-gen cephalosporin)
A nurse is caring for a client who has hypothyroidism. Which of the following clinical findings are associated with this disorder? a. decreased metabolic demand b. weight loss c. increased heart rate d. diarrhea
A. Hypothyroidism causes a decreased metabolic demand (weight gain, bradycardia, and constipation are also associated with hypothyroidism)
A nurse is educating a client who is taking iron supplements about foods which aid in iron absorption. Which of the following food choices indicate an understanding of the teaching? a. baked potato b. orange juice c. milk d. green beans
B. vitamin C aid in the absorption of iron, and orange juice is a good source of iron
A charge nurse is providing info about fat emulsion added to total parenteral nutrition to a group of nurses. Which of the following statements by the nurse are appropriate? (Select all that apply) a. Concentrations of lipid emulsion can be up to 30% b. Adding lipid emulsion gives the solution a milky appearance c. Check for allergies to soybean oil d. Lipid emulsion prevents essential fatty acid deficiency e. Lipids provide calories by increasing the osmolality of the PN solution
A. Lipid emulsions in 10%, 20%, and 30% are avail B & C. Lipid emulsion are formulated from safflower or soybean oils and egg phospholipid, making the solution look milky & necessary to check allergies D. Lipid emulsion is used for additional calories as concentrated energy and to prevent essential fatty acid deficiency (no increased osmolality)
A nurse in an antepartum clinic is discussing with a newly licensed nurse poor nutrition and risk for pregnant adolescent clients. Which of the following statements by the newly licensed nurse requires additional teaching? a. Pregnant adolescents are at risk for having placenta previa b. Pregnant adolescents are at risk for developing gestational diabetes c. Pregnant adolescents are at risk for having a low birth weight baby d. Pregnant adolescents are at risk for developing pregnancy-induced htn
A. Poor nutritional status does not place the adolescent client at risk for having a placenta previa (inconsistent eating and poor food choices place the adolescent at risk for anemia, regnancy-induced htn, gestational diabetes, premature labor, spontaneous abortion, and delivery of a newborn of low birth weight
A nurse is conducting a nutritional class to a group of newly licensed nurses. Which of the following should be included in the teaching? a. Limit saturated fat to 10% of total caloric intake b. Good bowel function requires 35 g/day of fiber for women c. Limit cholesterol consumption to 400 mg/day d. Normal functioning cardiac systems depends on B-complex vitamins
A. Saturated fats should be limited to 10% of total caloric intake (good bowel function requires 25 g/day of fiber, cholesterol consumption should be limited to 300 mg/day, normal functioning of nervous system depends of b-complex vitamins)
A nurse is providing teaching for a client who has a new prescription for warfarin (Coumadin). Which of the following foods should the nurse instruct the client to avoid? a. Spinach b. Grapefruit c. Peanuts d. Milk
A. Spinach is a green leafy vegetable that is high in vitamin K and decreases the anticoagulation effects of warfarin
A nurse is caring for a client who is to receive a full liquid diet due to dysphagia. Which of the following nursing actions is the highest priority? a. Add thickener to liquids b. Educate the client about acceptable liquids c. Perform a calorie count of consumed liquids d. Offer high protein liquid supplements
A. The client's safety is the highest priority. Therefore, adding thickener to the liquids is a priority nursing action to reduce the risk for aspiration
A nurse is teaching a nutritional class to a group of women. Which of the following should the nurse include as risk factors for developing osteoporosis? (select all that apply) a. inactivity b. familiar history c. obesity d. hyperlipidemia e. cigarette smoking
A. There is an increased risk for osteoporosis due to inactivity. Weight-bearing exercises should be discussed as primary prevention measures B. Osteoporosis runs in families E. Cigarette smoking may increase the incidence of osteoporosis
A nurse educator is teaching a class on culture and food to a group of newly hired nurses. Which of the following statements by the nurse indicates a need for clarification? a. Clients who practice Roman Catholicism do not drink caffeinated beverages b. By working closely with nutrition services, nurses can meet the client's prescribed diet while promoting their religious practices c. Clients who follow the teachings of Islam eat only the protein of animals that are slaughtered under strict guidelines d. Because not all individuals in one country practice the same religion, a nurse should not consider ethnicity alone in planning for client care
A. This is not a practice of Roman Catholics. Caffeinated beverages are not consumed by Mormons and Muslims because caffeine is a stimulant. This statement requires clarification
A nurse is providing teaching for a client who has a new diagnosis of htn and a prescription for a low-sodium diet. Which of the following client statements indicates a need for further teaching? a. I should select organic canned vegetables b. I need to read food labels when grocery shopping c. I will stop eating frozen dinners for lunch at work d. I know that deli meats are usually high in sodium
A. This statement requires further teaching. Canned foods are usually high in sodium and area therefore a poor choice for a client on a sodium-restricted diet (frozen dinners and deli meats are usually high in sodium and should be avoided)
A nurse is planning care for a client who is receiving continuous drip enteral nutrition. Which of the following interventions should be included in the plan of care? (select all that apply) a. Administer with an infusion pump b. Measure residual every 8 hr c. Flush the feeding tube every 4 hr d. Reinstill the residual feedings into the stomach e. Reduce the flow rate if residual exceeds infused volume over the previous 3-hr period
A. a pump ensures the correct volume of the feeding is being infused C. Flushing every 4 hours promotes patency D. Reinstilling the residual feeding into the stomach returns needed fluids, electrolytes, nutrients, and digestive enzymes (measure residual every 4-6 hr, flow rate should only be reduced if the residual volume of formula exceeds the amount administered over the previous 2 hr period)
A nurse is administering bolus enteral feedings to a client who has malnutrition. Which of the following are appropriate nursing interventions? (Select all that apply) a. Verify the presence of bowel sounds b. Flush the feeding tube with warm water c. Evaluate the head of bed 20 degrees d. Administer the feeding at room temp e. Inspect the tube insertion site
A. ensure the bowel is functioning before bolus feeding B. Ensure patency D. room temp is best to prevent abdominal cramping E. Inspect for signs of infection and leaking (head of bed should be at 30 degrees)
A nurse is planning care for a client who has a new prescription for peripheral parenteral nutrition. Which of the following interventions should the nurse include in the plan of care? (select all that apply) a. examine trends in weight loss b. review prealbumin finding c. Administer an IV solution of 20% dextrose d. add a micron filter to IV tubing e. Use an IV infusion pump
A. examining trends in weight loss will help to evaluate the outcome of PPN B. Reviewing the prealbumin finding will determine nutritional deficiency over a short period of time D. A micron filter is always used when infusing the PN solution E. An IV pump is always used to regulate the flow and provide accurate delivery (An IV solution of 20% dextrose is administered only as total parenteral nutrition using a central vein)
A nurse is preparing to administer intermittent enteral feeds to a client who has neuromuscular disorder. Which of the following are appropriate nursing interventions? (Select all that apply) a. Fill the feeding bag with 24 hr worth of formula b. Discard irrigation equipment after 24 hr c. Leave unused portions of formula at the bedside d. Label the unused portion of the formula e. Replace administration tubing and feeding bag every 48 hr
B & E. Irrigation equipment, administration tubing and feeding bags should be discarded very 24 hr to prevent bacterial contamination D. The unused portion of the formula should be labeled with the time and date the formula was opened and the client's name and room number (fill with only 4 hr worth of fomula, unused formula should be refrigerated up to 24 hr)
A nurse is assisting a client who has a prescription for a mechanical soft diet with food selections. Which of the following are appropriate selections by the client? (Select all that apply) a. Dried prunes b. Ground turkey c. Mashed carrots d. Fresh strawberries e. Cottage cheese
B, C, E. Ground meats, mashed carrots, and cottage cheese require minimal chewing before swallowing (Dried fruits and fresh strawberries are excluded due to potential chewing difficulty and seeds)
A nurse is caring for client following an appendectomy. The nurse verifies the postoperative prescription, which reads "discontinue NPO status; advance diet as tolerated." Which of the following are appropriate for the nurse to offer the client? (Select all that apply) a. Applesauce b. Chicken broth c. Sherbet d. Wheat toast e. Cranberry juice
B, E. Chicken broth and cranberry juice are clear liquids, which is appropriate as an initial selection for a client who is postop. (applesauce, sherbet, and wheat toast are appropriate once the client's diet begins to advance, not initially)
A nurse is caring for several clients in an extended care facility. Which of the following clients is the highest priority to observe during meals? a. a client who has decreased vision b. A client who has Parkinson's disease c. A client who has poor dentition d. A client who has anorexia
B. A client who has Parkinson's disease is at risk for aspiration. Due to this safety risk, this client is the highest priority to observe during meals (A client with decreased vision or poor dentition may need assistance or a modified diet but are not the highest priority, anorexic clients should be observed to monitor intake but not the highest priority)
A nurse is caring for a client on an orthopedic unit who sustained trauma in a motor-vehicle crash. Which of the following laboratory values indicates moderate protein deficiency? a. Serum albumin 3.5 g/dL b. Serum prealbumin 5 mg/dL c. Serum albumin 4.5g/dL d. Serum prealbumin 10 mg/dL
B. A serum prealbumin level of 5 mg/dL is indicative of a moderate depletion of protein. The serum prealbumin test, also known as thyroxin-binding protein, is the most sensitive to acute changes in protein nutrition (serum albumin of 3.5-4.5 g/dL is normal range)
A nurse is caring for a client who is prescribed warfarin (Coumadin). Which of the following food choices should the nurse advise the client to limit? a. orange juice b. broccoli c. ice cream d. chicken
B. Broccoli is a green leafy vegetable and is a good source of vitamin K. THe client should avoid excess vitamin K because it has a negative response to warfarin effects
A nurse is providing nutritional education to the parents of a toddler. Which of the following statements by the parents requires additional teaching? a. I should give my child finger foods b. I should limit juice to 8 oz daily c. A child's serving size is about 1 tbsp for each year of age d. My child should gain about 5 pounds this year
B. Juice should be limited to 4 to 6 oz/day. This statement requires teaching
A charge nurse is teaching a group of nurses about med compatibility with TPN. Which of the following statements by the nurse is appropriate? a. Use the Y-port on the TPN IV tubing to administer antibiotics b. Regular insulin may be added to the TPN solution c. Administer heparin through a port on the TPN tubing d. Administer vitamin K IV bolus via a Y-port on the TPN tubing
B. Regular insulin may be added to the TPN solution to decrease hyperglycemia (antibiotics through the Y-port is contraindicated, Heparin can be added to the TPN solution in the cannula but not directly into a port on the TPN tubing, Vitamin K can be added to the TPN solution but it should not be administered IV bolus through the TPN IV line)
A nurse is teaching a client who is starting continuous feedings about the various types of enteral nutrition formulas. Which of the following should the nurse include in the teaching? a. Formula rich in fiber is recommended when starting EN b. Standard formula contains whole protein c. Hydrolyzed formula is recommended for a full-functioning GI tract d. The high-calorie formula has increased water content
B. Standard formula contains whole protein (milk, meat, eggs) and requires a full-functioning GI tract (residual-free formula without fiber is recommended when starting EN to minimize abdominal distention from increased flatus, hydrolyzed formula is recommended for a partially functioning digestive tract or for those who have impaired ability to digest and absorb foods, formula high in calories is low in water content)
A nurse is teaching a client measures fore healthy bones. Which of the following statements by the client requiring additional teaching? a. "I will eat foods high in calcium." b. "I will increase my fluid intake." c. "I should participate in weight bearing exercises." d. "I should get my vitamin D from sunlight."
B. increasing fluid intake does not promote healthy bones. (vitamin D is necessary for calcium absorption, weight bearing decreases risk of osteoporosis)
A nurse is reviewing prescribed meds for a newly admitted client. Which of the following meds decreases the body's rate of metabolism? a. Prednisone (Deltasone) b. Levothyroxine (synthroid) c. Amithriptyline (Elavil) d. Somatropin (genotropin)
C. Amitriptyline is tricyclic antidepressant use for treating depression and decreases the rate of metabolism
A nurse is discussing clinical findings of dehyration in an infant with a newly licensed nurse. Which of the following statements by the newly licensed nurse requires additional teaching? a. The infant may appear listless b. The infant will have decreased urinary output c. The infant will have bulging fontanels d. The infant will have dry mucous membranes
C. Bulging fontanels are a clinical finding associated with increased intracranial pressure. This statement by a newly licensed nurse requires additional teaching (listlessness, decreased urinary output, and decreased tears and dry mucous membranes are findings of dehyrdation)
A nurse is planning care for a client who has mechanical fixation of the jaw. Which of the following actions are appropriate to include in the plan of care? (select all that apply) a. Thicken the client's liquids to honey consistency b. Educate the client about the use of a nasogastric tube c. Assist the client to use a straw to drink liquids d. Ensure that the client receives ground meats e. Encourage the client's intake of fluids between meals
C. Helping the client use a straw is an appropriate action. The nurse should help the client determine where to insert the straw through the space between the jaws E. The nurse should encourage the intake of fluids for a client who has a mechanical fixation of the jaw.
A nurse in a nutritional clinic is calculating body mass index (BMI) for several clients. Which of the following BMI represents an overweight client? A. 24 B. 30 C. 27 D. 32
C. Overweight is defined as an increased body weight in relation to height, indicated by a BMI of 25-29.9 (normal/healthy weight is 18.5-24.9, obesity is greater than 30)
A nurse is providing teaching to a client about increasing calcium in the diet. Which of the following are an ethnocentric approach to selecting food choices on the client's menu to meet this need? a. Asking the client what he likes to eat b. Notifying the dietician to complete the menu c. Recommending one's own favorite foods d. Asking the client's family to fill out the menu
C. Recommending one's own favorite foods is an example of ethnocentrism, which is the belief that one's own cultural practices are the only correct behavior/beliefs
A community nurse is providing education to a group of adult clients regarding exercise, Which of the following statements by the client indicates a need for additional teaching? a. Regular exercise will improve my bone density b. Regular exercise can improve my cardiovascular health c. Regular exercise will regulate my menstrual cycle d. Regular exercise can relieve my depression
C. Regular exercise does not regulate the menstrual cycle.
A nurse is preparing to administer lipid emulsion and notes a layer of fate floating in the IV solution bag. Which of the following is an appropriate action by the nurse? a. Shake the bag to mix the fat b. Turn the bag upside down one time c. Return the bag to the pharmacy d. Administer the bag of solution
C. Returning the solution to the pharmacy is an appropriate action by the nurse because "cracking" of the solution has occurred and it should not be administered
A nurse is discussing the use of a low-profile gastrostomy device with the parents of a child who is receiving an enteral feeding. Which of the following is an appropriate statement by the nurse? a. The device can be uncomfortable for children b. Checking residual is much easier with this device c. Tub baths are allowed with this device d. Mobility of the child is limited with this device
C. The low-profile gastrostomy device is fully immersible in water (more comfortable for children, checking residual is more difficult due to the close proximity of the button on the skin, the mobility of the child is decreased because of the close proximity of the button on the abdomen)
A nurse is caring for an Asian client who has htn. Which of the traditional Asian dietary patterns places the client at risk for this condition? a. Incorporation of plant based foods in the diet b. Consumption of raw fruits c. Preparation of foods using sodium d. A focus on shellfish in the diet
C. The preparation of foods using sodium places the client at risk for htn. Many spices in the Asian diet contain sodium, or it is used as a preservative. Sodium consumption should be in moderation
A nurse is caring for a client who is transitioning to an oral diet following a partial laryngectomy. Which of the following actions by the nurse is appropriate? a. Request to have the client's oral meds provided in liquid form b. Instruct the client to follow each bite of food with a drink of water c. Encourage the client to tuck the chin when swallowing d. Consult the dietician about providing the client with a thin liquid diet
C. Tucking the chin when swallowing helps to close off the trachea and reduces the risk for aspiration (liquid meds still have aspiration risk, drinking thin liquids increases the risk of aspiration, thick fluids might help)
A nurse is discussing foods that are high in vitamin D with a client who is unable to be out in the sunlight. Which of the following should be included in the teaching? a. tacos and rice b. hamburgers and fried potatoes c. ham and brussels sprouts d. eggs and fortified milks
D. Sunlight helps synthesize vitamin D, so clients need egg yolks and fortified milk, which are booth good sources of vitamin D.
A nurse is assessing a client who is post-op following a colon resection. Which of the following findings indicates that the client is ready to transition from NPO to oral intake? a. Client reports hunger b. Urinary output exceeding 30 mL/hr c. decrease in incisional pain d. passage of flatus
D. The passage of flatus is an indicator of intestinal activity, which indicates the client is ready to transition to oral intake (the others do not indicate intestinal activity)
A nurse is caring for a client who has a prescription for levodopa (Sinemet). Which of the following should the client limit in her diet? a. tyramine b. vitamin C c. Magnesium d. vitamin b6
D. Vitamin b6 should be limited while taking levodopa. Vitamin B6 increases the metabolism of levodopa, which decreases the therapeutic effects of this medication (vitamin c should be limited for a client taking a proton pump inhibitor, tyramine should be limited for a client who is taking a monoamine oxidase inhibitor)
A nurse is discussing nutrients for normal functioning of the nervous system. Which of the following should be included in the teaching? (select all that apply) a. Calcium b. Thiamin c. vitamin B6 d. Sodium e. Phosphorus
a. Calcium is an important regulator of nerve responses b & c. Normal functioning of the nervous system depends on adequate levels of the b-complex vitamins, especially thiamin, niacin, and vitamins b6 and b12 d. sodium is an important regulator of nerve responses
A nurse is conducting a nutritional class on minerals and electrolytes. Which of the following food sources should be included when discussing magnesium? a. Nuts b. Tomatoes c. Canned Soup d. Yogurt
a. Nuts are a good source of magnesium and should be included in the teaching (tomatoes - potassium, canned soup - sodium, yogurt - calcium)
A nurse is completing an assessment of a client who is a first generation immigrant to the US. Which of the following questions should the nurse consider asking to understand the client's culture-based nutrition habits? a. What type of afternoon snacks do you consume? b. What type of meal do you prepare for a holiday? c. What time of day do you eat breakfast? d. What cooking utensils are used in food preparation?
b. Traditional meals are often consumed as part of the client's dinner or symbolic events, such as holidays and weddings. This question helps the nurse understand culture-based nutrition habits
A nurse is discussing health problems associated with nutrient deficiencies. Which of the following conditions is associated with a deficiency of Vitamin C? a. Dysrhythmias b. Scurvy c. Pernicious anemia d. Megaloblastic anemia
b. scurvy is associated with a vitamin C deficiency (potassium deficiency causes dysrhythmias, vitamin B12 deficiency causes pernicious anemia, folate deficiency causes megaloblastic anemia)
