RN Nutrition Online Practice 2019 A

A nurse is providing education to an adolescent about making nutrient-dense food choices. Which of the following statements by the client indicates an understanding of the teaching?

"Canned pinto beans are a better choice than refried beans." less fat

A nurse is teaching a client who is newly diagnosed with type 1 diabetes mellitus how to count carbohydrates. Which of the following statements made by the client indicates an understanding of the teaching?

"I know the serving size can affect the number of carbohydrates I eat." The nurse should instruct the client that generally three to five carbohydrate choices, or 45 g, are allowed per meal, plus one to two carbohydrate choices for each snack.

A nurse is teaching an adolescent who has a new diagnosis of celiac disease. Which of the following statements by the client indicates an understanding of the teaching?

"I need to eliminate rye from my diet." Eating sources of gluten, such as barley or rye, increases the manifestations of celiac disease.

A nurse is discussing dietary factors to assist in blood pressure management for a client who has hypertension. Which of the following client statements indicates an understanding of the teaching?

"I should choose whole grain pastas when selecting my foods." Whole grains are a healthy choice of carbohydrate because they contain ingredients that lower the risk of cardiovascular disease and improve blood pressure.

A nurse is teaching a female client about a healthy diet to control hypertension. Which of the following client statements indicates an understanding of the teaching?

"I will eat four servings of unsalted nuts per week." Female clients should consume four to five servings of unsalted nuts, seeds, or legumes per week for a heart-healthy diet.

A nurse is reviewing the introduction of solid foods with the guardian of a 4-month-old infant. Which of the following statements by the guardian indicates an understanding of the teaching?

"I will introduce a new solid food every 5 days." to mx for food allergies 1 to 2 teaspoons when trying solid food majority calories come from formula milk fruit juice at 6 months, limit to 4 oz a day

A home health nurse is providing dietary teaching to the guardians of a 3-year-old child. Which of the following statements by the guardians should the nurse identify as understanding of the teaching?

"I will put low-fat milk in her cup for her to drink." Whole milk provides necessary fat for neurological development for children up to 2 years of age, after which the child should consume low-fat or skim milk. Therefore, the nurse should identify this statement as indicating an understanding of the teaching. Choking hazard to avoid - peanut, pop corn, hard pretzels

A community health nurse is planning to teach a class about weight management for cardiovascular health. Which of the following statements should the nurse plan to include?

"Plan to lose weight gradually at ½ to 1 pound per week." It is a healthy and attainable weight-loss goal. Setting realistic goals for weight loss is an important element of success. Trying to lose weight too quickly places clients at risk for nutritional deficiencies and inadequate energy, which can lead to frustration and defeat.

A nurse is providing teaching about lowering solid fat intake to an adolescent client who usually consumes about 2,000 calories per day. Which of the following instructions should the nurse include?

"Restrict your daily meat intake to 5 ounces." a size of card deck

A nurse is providing teaching to a client who has diabetes mellitus and an HbA1c of 8.7%. Which of the following statements by the client indicates an understanding of this laboratory value?

"This shows that I have not been following my diet." An HbA1c level of 8.7% is not within the expected reference range. The HbA1c goal level for a client who has diabetes is between 6.5% and 7%.

A nurse is providing discharge teaching to a postpartum client about breast milk use and storage. Which of the following statements should the nurse make?

"You cannot place thawed breast milk back in the freezer." The nurse should instruct the client that completely thawed breast milk can be stored in the refrigerator but must be used within 24 hr. Breast milk that has been previously frozen should not be refrozen once it has thawed completely. Thawing creates a possibility for bacterial growth and causes a decrease in antibacterial activity, which destroys antibodies in the milk.

A nurse is caring for a client who is receiving total parenteral nutrition (TPN) and is prescribed an oral diet. The client asks the nurse why the TPN is being continued since he is now eating. Which of the following responses should the nurse make?

"You should consume at least 60 percent of your calories orally before the parenteral nutrition can be discontinued."

A client is experiencing anorexia related to cancer treatment. Which of the following interventions should the nurse implement to increase the client's nutritional intake?

Add extra calories and protein to every meal. Adding extra calories and protein to every meal will increase the client's nutritional intake.

A nurse is providing teaching to a client who has dumping syndrome. Which of the following information should the nurse include?

Apply pectin to foods. The client should apply pectin, a dietary fiber that helps to delay gastric emptying, to foods.

A nurse is caring for a client who has undergone a radical head and neck resection to treat cancer and is receiving radiation therapy. The nurse should monitor for which of the following potential adverse effects?

Changes in the production of saliva

A nurse is assessing a client who has an elevated blood pressure, headache, and is sweating. The client recently started taking an MAOI. The nurse should question the client regarding the consumption of which of the following foods?

Cheddar cheese Clients who take MAOIs should avoid the consumption of most types of cheese and other foods that contain high levels of tyramine, which can lead to hypertensive crisis.

A nurse is assessing a client who has type 2 diabetes mellitus. The nurse should recognize which of the following as a manifestation of hypoglycemia?

Confusion

A nurse is teaching a client about measures to reduce the risk of osteomalacia. Which of the following instructions should the nurse include in the teaching?

Consume 20 mcg of vitamin D daily. The nurse should instruct the client to consume 20 mcg of vitamin D daily. Osteomalacia is characterized by a lack of vitamin D, which leads to insufficient bone mineralization. This disorder coincides with osteoporosis, thereby increasing the risk of falls leading to fractures in older adult clients. Vitamin D supplements are recommended for clients age 65 and older to decrease bone loss and maintain bone mineralization, thereby reducing the risk of a softening of the bones.

A nurse is assessing a client who is suspected of having lactose intolerance. Which of the following is an expected finding?

Flatulence Flatulence, bloating, and cramping, and diarrhea are expected findings associated with lactose intolerance.

A nurse is caring for an adolescent who has type 1 diabetes mellitus. Which of the following actions should the nurse take to assess for Somogyi phenomenon?

Monitor blood glucose levels during the night. Somogyi phenomenon is fasting hyperglycemia that occurs in the morning in response to hypoglycemia during the nighttime. The nurse should assess for this phenomenon by monitoring blood glucose levels during the night.

A nurse is caring for a client who is receiving continuous enteral tube feedings. Which of the following actions should the nurse take to prevent aspiration?

Monitor gastric residuals every 4 hr. The nurse can identify delayed gastric emptying by monitoring gastric residuals regularly. Delayed gastric emptying places the client at risk for aspiration and can necessitate a decrease in the feeding rate.

A nurse is caring for a client who expresses a desire to lose weight. Which of the following actions should the nurse take first?

Obtain a 24-hr dietary recall. The first action the nurse should take using the nursing process is to obtain a diet history, such as a 24-hr dietary recall. Having the client write down everything consumed over a 24-hr period is a crucial component of the assessment process to identify eating behaviors and therefore be able to recommend dietary modifications based on the data received.

A nurse is providing teaching to a client who is a vegetarian and requires an increase in zinc intake. Which of the following foods should the nurse include in the teaching as the best source of zinc?

Pinto beans - highest amt of zinc per serving

A nurse in an acute care facility is planning care for a client who has chosen to follow Islamic dietary laws during Ramadan. Which of the following actions should the nurse plan to take?

Provide a snack for the client after sunset. During Ramadan, clients who follow Islamic dietary laws consume meals before dawn and after sunset. The nurse should offer the client a snack or light meal after sunset.

A nurse is caring for a client who is dehydrated and is receiving intermittent enteral feeding. Which of the following actions should the nurse plan to take?

Provide the formula as a continuous infusion. A client who is experiencing dehydration should receive a continuous infusion to prevent receiving a high carbohydrate load with each feeding.

A nurse is teaching a client who has hypertension about decreasing sodium intake. Which of the following information should the nurse include in the teaching?

Season foods with herbs and spices.

A nurse is planning dietary teaching for a client who has dumping syndrome following a gastrectomy. Which of the following interventions should the nurse include in the client's plan of care?

Select grains with less than 2 g fiber per serving. Clients at risk for dumping syndrome better tolerate low-fiber grains that contain less than 2 g fiber per serving to slow gastric emptying. Avoid simple sugar, sugar alcohol, not sit up right (but preferably lie down after eating). No large meals but frequent small meals

A nurse is providing dietary teaching for a client who has osteoporosis. The nurse should instruct the client that which of the following foods has the highest amount of calcium?

½ cup roasted almonds The nurse should determine that ½ cup roasted almonds is the best food source to recommend because ½ cup of almonds contains 185 mg of calcium. Calcium helps to prevent bone loss in clients who have osteoporosis.

A nurse is administering a continuous tube feeding at 60 mL/hr with 50 mL of water every 4 hr. What should the nurse document as the total mL of enteral fluid administered during the 8 hr shift?

580 mL

A nurse is teaching a client about stress management. Which of the following statements by the client indicates an understanding of the teaching?

"I will take a long walk every evening." Exercise has many benefits, including reduction of tension, promotion of relaxation, and improved sense of well-being. All of these will assist the client in stress management.

A nurse is performing a cultural nursing assessment for a client whose religious practices include fasting 1 day each week. Which of the following questions should the nurse ask the client? (Select all that apply.)

-"Are you exempt from fasting during illness?" -"Does fasting mean refraining from drinking liquids?" -"Does your fasting occur during certain hours of the day?" -"Does fasting mean eating only a certain type of food?"

A nurse is teaching a client who has chronic kidney disease about limiting dietary calcium intake. Which of the following food choices should the nurse include in the teaching as having the highest amount of calcium?

1 cup low-fat yogurt The nurse should determine that low-fat yogurt contains 314 mg of calcium per cup, which is the highest amount of calcium; therefore, the client should limit low-fat yogurt in the diet.

A nurse is assessing a client's risk for pressure injuries using the Braden scale. The client eats more than half of most meals but occasionally refuses a meal. Which of the following information should the nurse document on the nutrition category of the Braden scale?

3 (Adequate) A client who eats more than half of most meals, occasionally refuses a meal, and has four servings of protein each day scores a 3 (Adequate) in the nutrition category of the Braden scale.

A nurse is reviewing the laboratory values of a group of clients. Which of the following clients should the nurse identify as experiencing dehydration?

A client who has a sodium level of 150 mEq/L The nurse should identify that a sodium level of 150 mEq/L is above the expected reference range of 136 to 145 mEq/L and indicates hypernatremia. Hypernatremia, often called water deficit, is an increase of sodium concentration in the blood caused by a deficit of water. Manifestations of hypernatremia include confusion, headache, nausea, and fatigue.

A nurse is developing an educational program about the glycemic index of foods for clients who have diabetes mellitus. Which of the following foods should the nurse identify as having the highest glycemic index?

Baked potato

A nurse is providing dietary teaching to a client who is postoperative following a gastric bypass procedure. Which of the following instructions should the nurse include?

Begin each meal with a protein. The nurse should instruct the client to begin each meal by eating a protein. The client should consume 60 to 120 g of protein each day. Eat slowly, chew well, last 30 to 60 mins, 3 meals and 2 snacks per day

A nurse is providing teaching to a client who has dumping syndrome and is experiencing weight loss. Which of the following instructions should the nurse include in the teaching?

Consume liquids between meals. The nurse should teach the client to drink liquids between meals to slow movement of food from the stomach.

A nurse is assessing a client who has fluid volume excess. Which of the following manifestations should the nurse expect?

Crackles in the lungs The nurse should identify that a client who has fluid volume excess can develop crackles in the lungs, shortness of breath, and dyspnea.

A nurse is evaluating a client who is receiving a continuous enteral feeding and has diarrhea. Which of the following actions should the nurse take to reduce the client's diarrhea?

Decrease the rate of the feeding. Somogyi phenomenon is fasting hyperglycemia that occurs in the morning in response to hypoglycemia during the nighttime. The nurse should assess for this phenomenon by monitoring blood glucose levels during the night.

A nurse is assessing a client who has diabetes mellitus. Which of the following findings should the nurse identify as a manifestation of hypoglycemia?

Diaphoresis diaphoresis, irritability, and tremors are manifestations of hypoglycemia. Others are tachy, hunger Hyperglycemia signs are abd cramps, N, V, fruity odor, rapid shallow breathing

A nurse is preparing a health promotion seminar for a group of clients about cancer prevention. Which of the following information should the nurse include?

Eat at least 2.5 cups of fruits and vegetables each day. The nurse should include in the teaching that clients should eat at least 2.5 cups of fruits and vegetables daily to help maintain body weight and reduce the risk for cancer of the lung and gastrointestinal system.

A nurse is caring for a client who has a new prescription for parenteral nutrition (PN) containing a mixture of dextrose, amino acids, and lipids. Prior to administration of the PN, the nurse should report which of the following food allergies to the provider?

Eggs Lipid emulsions are isotonic and are composed of soybean or safflower plus soybean oil, with egg phospholipid used as an emulsifier. Clients who are allergic to eggs can have a reaction to the emulsifier. Therefore, the nurse should report this finding to the provider.

A nurse is caring for a client who is at 8 weeks of gestation and has a BMI of 34. The client asks about weight goals during her pregnancy. The nurse should advise the client to do which of the following?

Gain approximately 6.8 kg (15 lb). The nurse should advise the client that based on her BMI, she should gain 4.9 to 9.1 kg (11 to 20 lb) during her pregnancy.

A nurse is providing information to a client who has a new prescription for atorvastatin. Which of the following beverages should the nurse include in the information as contraindicated while taking this medication?

Grapefruit juice The nurse should teach the client to avoid taking atorvastatin with grapefruit juice because it can increase serum levels of the medication, which can increase the risk for rhabdomyolysis and toxicity.

A nurse is caring for a client who has acute inflammatory bowel disease. Which of the following nutritional supplements should the nurse anticipate providing to this client?

Hydrolyzed formula Hydrolyzed or elemental formula provides protein and other nutrients in their simplest form, requiring little or no digestion and decreasing stimulation of the bowel. This type of formula is beneficial for clients who have impaired digestion due to conditions such as inflammatory bowel disease.

A nurse is teaching about nutritional requirements for a client who is starting a vegetarian diet. Which of the following information should the nurse include in the teaching?

Include two servings per day of nuts when on a vegetarian diet. The nurse should instruct the client to eat two servings of nuts or flaxseed per day to receive the daily requirement of omega-3 fatty acids.

A nurse is creating a plan of care for a client who has mucositis following head and neck radiation therapy to treat cancer. Which of the following interventions should the nurse include in the plan?

Increase fluid intake to 2 L per day. A client who has mucositis should increase fluid intake to promote hydration and peristalsis. Avoid acidic food, glycerin based swabs, hot liquid

A nurse is reviewing the laboratory findings of a client who has acute pancreatitis. Which of the following is an expected finding?

Increased glucose The nurse should expect an increased glucose level in a client who has acute pancreatitis due to decreased insulin production by the pancreas.

A nurse is caring for a client who is receiving total parenteral nutrition (TPN) through a peripherally inserted central catheter. The pharmacist informs the nurse that there will be a delay in delivering the next bag of TPN solution. Which of the following actions should the nurse take?

Infuse dextrose 10% in water when the current infusion ends. TPN contains high concentrations of dextrose and proteins. To avoid hypoglycemia, the nurse should infuse dextrose 10% or 20% in water until the next bag of TPN solution arrives.

A nurse is providing dietary instructions for a client who has a prescription for warfarin. Which of the following foods should the nurse recommend the client eat in moderation while taking this medication?

Leafy green vegetables The nurse should recommend the client eat in moderation and maintain consistent intake of leafy green vegetables, which contain a natural form of vitamin K that can negate the anticoagulation effects of warfarin.

A nurse is teaching a client who reports constipation about ways to increase dietary intake of fiber. Which of the following information should the nurse include?

Leave the skin on when eating fruit. The nurse should instruct the client that consuming the skin on fruits and vegetables adds fiber to the diet.

A nurse is teaching a prenatal education class about breastfeeding. Which of the following instructions should the nurse include in the teaching?

Plan 5-min feedings on each breast on the first day after birth. to promote milk production

A nurse in a provider's office is assessing a client who has HIV. The nurse should identify which of the following findings as an indication to increase the client's nutritional intake?

Presence of herpes simplex virus infection Secondary infection triggers inflammatory responses that increase the client's metabolic rate. Therefore, the nurse should identify the presence of herpes simplex virus infection as an indication to increase the client's nutritional intake.

A nurse is preparing to bottle feed an infant who has a cleft lip. Which of the following actions should the nurse take to reduce the risk of aspiration?

Squeeze the infant's cheeks together while feeding. The nurse should identify that an infant who has a cleft lip will have difficulty in obtaining an adequate seal during feeding. The nurse should gently squeeze the infant's cheeks together to decrease the width of the cleft, allowing the infant to achieve a better seal, which reduces the risk of aspiration.

A home health nurse is reviewing the medical record of a client who had an open reduction internal fixation of the tibia. Which of the following findings should the nurse identify as a risk factor for impaired wound healing?

The client consumes 1,000 kcal daily. Adults who have had surgery require at least 1,500 kcal daily to meet energy needs and build protein for tissue healing. The nurse should recognize that a 1,000 kcal/day intake is below the client's needs.

A nurse in a long-term care facility is monitoring a client during mealtime who has Parkinson's disease. Which of the following findings should the nurse identify as the priority?

The client drools while eating. Drooling while eating can indicate that this client is at greatest risk for aspiration of food from dysphagia, which can lead to pulmonary complications; therefore, the nurse should identify this as the priority finding.

A nurse is assessing a client for dysphagia following a stroke. The nurse should identify which of the following findings as a manifestation of dysphagia?

The client's voice changes after eating. The nurse should identify that hoarseness or a change in voice after eating is a manifestation of dysphagia because partially swallowed food can alter the client's voice.

A nurse in a clinic is reviewing the laboratory findings of a client who recently began a Dietary Approaches to Stop Hypertension (DASH) diet. Which of the following laboratory findings indicates the client has reached one of the goals of the DASH diet?

Total cholesterol 190 mg/dL Goal for DASH total cholesterol less than 200 mg/dL BG 70 - 130 Na 135 - 145

A nurse is caring for a client who adheres to a kosher diet. Which of the following food choices would be appropriate for this client?

Vegetable salad with cheese Clients who adhere to a kosher diet can eat dairy products combined with non-meat products at the same meal. NO meat and shellfish

A nurse is teaching about increasing dietary intake of micronutrients to a client who has difficulty seeing at night. Which of the following micronutrients should the nurse include in the teaching?

Vitamin A Vitamin A enables the eyes to adapt to dim lighting more rapidly at night, which improves night vision.