ATI Nutrition

A nurse is assessing a client's nutritional status. The nurse determines the client is consuming 500 calories more per day than his energy level requires. If his dietary habits do not change, how long will it take the client to gain 4.5 kg (10 lb)?

10 weeks 1 lb of body fat = 3.500 calories. Consuming 500 extra calories each day for 7 days would lead to a total of 3,500 calories and a 1lb gain per week. (500 calories x 7 days = 3,500 calories per week. The client is eating an extra 1 lb per week. At the rate of 1 lb per week, the client would gain 10 lo in 10 weeks.

A nurse is caring for a group of clients on a medical-surgical unit. Which of the following disorders should the nurse identify as increasing the client's metabolic needs? (Select all that apply.)

- COPD - Cancer - Parkinson's disease - Major burns Clients who have COPD develop hypermetabolism as a result of the increased amount of energy used to breathe. Cancer can cause a number of metabolic changes, including hypermetabolism as a result of the tumor growth. Clients who have Parkinson's disease develop hypermetabolism because they burn calories due to muscular rigidity. Clients who have major burns develop severe metabolic stress, which includes hypermetabolism and hypercatabolism.

A nurse is assessing a client. Which of the following findings should the nurse identify as an indication of protein-calorie malnourishment? (Select all that apply.)

- Dry, brittle hair - Edema - Poor wound healing Dry, brittle hair that falls out easily suggests inadequate protein intake and malnutrition. Edema can occur when albumin levels are lower than the expected reference range and indicates protein-calorie malnutrition. Adequate wound healing depends on the ingestion of sufficient protein, calories, water, vitamins (especially C and A), iron, and zinc.

A nurse is teaching a group of parents of toddlers about measures to reduce the risk of choking. Which of the following foods increase the risk of choking in toddlers? (Select all that apply.)

- Hot dogs - Grapes - Bagels - Marshmallows Foods that are shaped like a tube, such as hot dogs and grapes, place toddlers at risk for choking because they can completely block the throat when swallowed whole due to their shape and solidity. Foods that are hard to chew, such as bagels and marshmallows, place toddlers at risk for choking; if swallowed before they are adequately chewed, they can block the airway.

A nurse is planning care for a client who is receiving chemotherapy and has a protein deficiency. Which of the following interventions should the nurse include in the plan of care? (Select all that apply.)

- Mix powdered skim milk into liquid milk - Add a slice of cheese to hot vegetables - Mix yogurt into fresh fruit Dairy products are good sources of protein. Mixing powdered skim milk into liquid milk can provide the client with additional protein. Adding cheese to a vegetable can increase the client's protein intake. Adding yogurt to fresh fruit will increase the client s protein intake.

A nurse is providing teaching to a client who has gout and urolithiasis. The client asks how to prevent future uric acid stones. Which of the following suggestions should the nurse provide? (Select all that apply.)

- Take allopurinol as prescribed - Exercise several times a week - Limit intake of foods high in purine The nurse should inform the client that allopurinol is an antigout medication that reduces uric acid, which helps prevent uric acid stone formation. Immobility is a risk factor for stone formation; therefore, the client should maintain a healthy lifestyle, including regular exercise. Purine increases the risk of uric acid stone formation; organ meats, poultry, fish, red wine, and gravy are high in purine.

A nurse in a provider's office is reviewing the medical records of a group of clients. Which of the following clients is at risk for iron deficiency? (Select all that apply.)

- client who is a vegetarian - A client who is pregnant - A toddler who is overweight A client who is a vegetarian might require additional iron because the availability of iron in vegetable food sources is limited. During pregnancy, maternal blood volume increases, and the fetus requires additional iron. Therefore, the RDA of iron for clients who are pregnant is increased to 27 mg per day. Toddlers who are overweight may get most of their calories from milk and foods that are not considered healthy, which increases their risk for iron-deficiency anemia.

A nurse is providing teaching to a young adult client who has a history of calcium oxalate renal calculi. Which of the following instructions should the nurse include?

"Consume 1,000 mg of dietary calcium daily." Clients who are prone to the development of calcium oxalate stones should consume the recommended daily allowance for calcium for their age. The RDA for calcium for adults ages 19 to 50 is 1,000 mg daily. Calcium should be obtained from dietary sources rather than supplements that can promote the development of renal calculi.

A nurse is providing teaching about calcium intake to a client who is breastfeeding. Which of the following is the recommended daily calcium intake for a client who is breastfeeding?

1,000 mg The nurse should instruct the client that 1,000 mg of calcium is recommended for women age 19 and older, as well as those who are lactating. This amount of calcium is sufficient to meet the needs of the client and the infant because additional calcium is absorbed from the intestines during this time.

A nurse is providing postoperative teaching about the management of dumping syndrome to a client who had a partial gastrectomy. Which of the following instructions should the nurse include in the teaching?

"Eat protein with each meal." The nurse should instruct the client to eat meals that are high in protein and fat with low to moderate carbohydrate content. Protein should be included in every meal because it delays digestion, which helps reduce the manifestations of dumping syndrome.

A nurse is teaching a client with heart disease about a low-cholesterol diet. Which of the following client statements indicates the teaching was effective?

"I should remove the skin from poultry before eating it." The nurse should identify the client understands the teaching when he states he will remove the skin from poultry before eating, as the skin contains the greatest amount of fat.

A nurse is providing teaching about food choices to a client who has diabetes mellitus. Which of the following statements by the client indicates an understanding of the teaching?

"I should replace white bread with whole-grain bread." Clients with diabetes mellitus have the same fiber requirements as the general population. Fiber content can be increased by substituting white bread, which is made with refined grains, with whole-grain bread, which retains the outer layer of the grain that is higher in fiber.

A nurse is providing teaching to a client who has COPD about maintaining proper nutrition. Which of the following statements by the client indicates an understanding of the teaching?

"I will eat more cold foods at meals rather than hot foods." The client should prepare more cold foods to eat because they provide a decreased feeling of fullness compared to hot foods.

A nurse is providing teaching about nutritious diets to a group of adult women. Which of the following statements should the nurse include?

"Include 2.5 cups of vegetables in your daily diet." Nutritious diets contain a variety of foods to ensure the required daily allowance of nutrients is ingested. The nurse should instruct the women to include 2.5 cups of vegetables and 2 cups of fruit in their daily diets. Fruits and vegetables should be a variety of colors to provide an assortment of nutrients.

A nurse is talking with the parent of a preschool-aged child who tells the nurse, "My child has suddenly become disinterested in certain foods." Which of the following statements should the nurse make?

"Keep a diary of the foods your child eats each day." The nurse should encourage the parent to keep a diary of the foods the child is eating better than expected. Evidence suggests that children can self regulate their caloric intake. When they eat less at a meal, they can compensate by eating more at another meal or by having a snack.

A provider tells a client at 12 weeks gestation who practices Hinduism that she needs more protein in her diet and suggests eating more meat. After the provider leaves the examination room, the client tells the nurse that eating animal products will cause her to miscarry. Which of the following responses should the nurse make?

"Let's discuss other foods that are also high in protein that you could substitute for meat." Many cultures have beliefs about food that the nurse should respect. Discussing non-animal protein sources can help the client identify foods that do not conflict with her religious and cultural beliefs. (Don't be a dick.)

A nurse is providing teaching about nutrition to an older adult client. The client asks, "Don't I need the same amount of nutrients that I did when I was younger?" Which of the following responses should the nurse make?

"Older adults need an increased amount of calcium." Older adults require increased amounts of calcium as well as vitamins D, B12, and A

A nurse is providing teaching about nutrients to a client. Which of the following statements should the nurse include?

"Protein builds and repairs body tissue." The primary function of protein involves building and repairing body tissues (e.g. muscles, tendons, and collagen). The skin, hair, and nails are also made of protein structures. A diet that is low in protein can impair wound healing.

A nurse is providing dietary teaching for a client with AIDS who has stomatitis of the mouth. Which of the following instructions should the nurse include in the teaching?

"You can suck on popsicles to numb your mouth." The nurse should instruct the client to suck on popsicles or ice chips, which can numb the mouth.

A nurse is providing teaching to a client who has type 2 diabetes mellitus. The client states, "I eat pasta every day. I can't imagine giving it up." Which of the following responses should the nurse provide?

"You don't have to give up pasta; just adjust the amount you eat." The American Diabetes Association recommends individualizing carbohydrate restriction for each client. A careful assessment of the client's usual dietary practices and modifications is an important part of teaching clients to manage this disorder.

A nurse is calculating the protein needs of a young adult client who weighs 132 lb. The RDA for protein for an adult who has no medical conditions is 0.8 g/kg. How many grams of protein per day should the nurse recommend for this client? (Fill in the blank with the numeric value only.)

48 Convert the pounds (lbs) into kilograms (kg). 132 lbs / 2.2 = 60 kg Plug the kilograms into the equation. 60 kg x 0.8 = 48 grams of protein

A nurse is presenting an in-service training session about nutrition. How many of the amino acids must be obtained from dietary intake?

9 Proteins are made up of chains of amino acids, which are composed of carbon, hydrogen, oxygen, and nitrogen. Nine amino acids are considered essential for the human body and must be obtained from diet. These include histidine, isoleucine, leucine, lysine, methionine, phenylalanine, threonine, tryptophan, and valine.

A nurse is caring for a client who is recovering at home after inpatient treatment for burn injuries. To increase the protein density of the client's meals, which of the following recommendations should the nurse make to the client's caregiver?

Add chopped hard-boiled eggs to soups and casseroles Eggs are a good source of protein. Adding them to combination foods and coating meats with raw eggs before breading and cooking increases the protein density of those foods.

A nurse is planning dietary teaching for a client who has diabetes mellitus. Which of the following actions should the nurse plan to take first?

Ask the client to identify the types of foods she prefers. Always ask your patient about preferences.

A home health nurse is planning care for a client who is receiving chemotherapy and has neutropenia. Which of the following foods should the nurse include in the client's plan of care?

Baked Chicken Well-cooked meats, including baked chicken, do not pose a threat to clients who have neutropenia and may be included in the client's dietary plan. For optimal safety, poultry should be cooked to an internal temperature of 74°C (165°F).

A nurse is caring for a client who is receiving total parenteral nutrition (TPN). Which of the following actions should the nurse take?

Check the client's capillary blood glucose level every 4 hr The nurse should check the client's capillary blood glucose level every 4 hours or according to facility policy due to the client's risk of hyperglycemia while receiving TPN. The dextrose concentration in TPN increases the risk of this complication.

A nurse is teaching an assistive personnel (AP) about dietary restrictions for a client who is taking phenelzine to treat depression. The AP's selection of which of the following foods for the client's lunch indicates an understanding of the teaching?

Chicken Salad Phenelzine is an MAOI. Clients taking MAOIs must avoid foods that contain tyramine due to the potential for a dangerous food-drug interaction. Foods high in tyramine include those that are processed and aged, such as luncheon meats and cheeses. This menu selection does not contain food high in tyramine and indicates an understanding of the teaching.

A nurse is teaching about a low-cholesterol diet to a client who had a myocardial infarction. Which of the following meal selections by the client indicates an understanding of the teaching?

Chicken breast and corn on the cob The nurse should identify that chicken breast is low in cholesterol, and all vegetables, including corn, are cholesterol-free; therefore, this food selection by the client indicates an understanding of the teaching

A nurse is caring for a client who has diverticulitis and a new prescription for a low-fiber diet. Which of the following food items should the nurse remove from the client's meal tray?

Coleslaw Coleslaw contains raw cabbage, which is high in fiber. Clients who are following a low-fiber diet should avoid most raw vegetables.

A nurse is caring for a client during her first prenatal visit and notes that she is lactose-intolerant. Which of the following foods should the nurse include on a list of calcium sources for this client?

Collard greens Collard greens are a good source of lactose-free calcium. One cup of collard greens provides approximately the same amount of calcium as the equivalent volume of 240 mL (8 oz) of milk. Collard greens also contain folic acid, which is a nutrient women should consume during pregnancy to prevent birth defects.

A nurse is teaching the parent of a school-age child who has celiac disease. Which of the following foods selected by the parent indicates an understanding of the teaching?

Corn tortilla with black beans Children who have celiac disease are placed on a gluten-free diet. Gluten is found in wheat, rye, and barley. Selecting products made from corn indicates an understanding of the teaching, as corn and beans are gluten-free foods.

A nurse is reviewing the laboratory findings of a client who has protein-calorie malnutrition. Which of the following findings should the nurse expect?

Decreased Albumin A decrease in the albumin level can be an indication of long-term protein depletion. Other potential conditions that result in decreased albumin levels include burns, wound drainage, and impaired hepatic function.

A nurse is caring for a client from the Middle East who has celiac disease. Which of the following actions should the nurse perform regarding the client's diet?

Determine the client's dietary preferences While generalizations are often made regarding the traditional eating practices of clients based on their cultural backgrounds, individual food choices can deviate from these generalizations. The nurse should asses the client's dietary habits before planning to meet dietary needs.

A nurse is caring for a client who has a BMI of 29 and expresses a desire to lose weight. Which of the following actions should the nurse take first?

Determine the client's intention to change current eating habits When using the nursing process, the nurse should first assess the client's readiness to commit to a change in behavior.

A nurse is updating the plan of care for a client who has dumping syndrome. Which of the following instructions should the nurse include?

Eat a source of protein with each meal The nurse should include in the client's plan of care the instruction to eat a source of protein with each meal because protein delays gastric emptying.

A nurse is providing teaching to a client who has constipation. Which of the following instructions should the nurse Question Feedbac include?

Eat yogurt with live cultures Yogurt with live bacterial cultures provides dietary probiotics that help maintain and promote bowel function.

A nurse is planning care for a client who is postoperative following a gastrectomy. Which of the following strategies should the nurse include to help prevent dumping syndrome?

Eliminate simple sugars and sugar alcohols from the client's diet Sugar, honey, and sugar alcohols (e.g. sorbitol and xylitol) increase hypertonicity and propel food through the intestines faster than food without sweeteners.

A nurse is caring for a client who has osteoporosis and a new prescription for calcium supplements. Which of the following foods should the nurse recommend to promote calcium absorption?

Fortified milk Fortified milk provides 2.45 mcg of vitamin D, which promotes calcium absorption from the gastrointestinal tract. Adults up to age 70 need 600 international units of vitamin D per day and 800 international units thereafter. Therefore, fortified milk is a good source of vitamin D.

A nurse is teaching dietary-modification strategies to a client who has been newly diagnosed with cirrhosis. Which of the following foods should the nurse recommend?

Grilled chicken The nurse should identify that a client who has cirrhosis requires protein to compensate for disease-related weight loss. Increasing protein intake from animal or plant sources will also provide the client with more energy.

A nurse is reviewing the dietary choices of a client who has chronic pancreatitis. Which of the following food items should the nurse suggest removing from the client's menu for the following day?

Ice cream Clients who have chronic pancreatitis should limit their fat intake to no more than 30% to 40% of total calories. Ice cream is high in fat, with 48 g of fat in a 1-cup serving of vanilla ice cream. The client should choose healthier fat-containing options to support a balanced diet, such as avocados and nuts.

A nurse is providing nutritional counseling for a client who is pregnant. Which of the following nutrients should the nurse instruct the client to increase in her daily diet?

Iron Iron supplements are recommended during pregnancy to promote adequate transfer of iron to the fetus and to support the expansion of the maternal RBC mass.

A nurse is planning an in-service training session about various dietary practices. Which of the following pieces of information should the nurse include in the teaching?

Kosher diets have restrictions regarding how the food must be prepared. Kosher diets are guided by a set of laws regarding the processing, preparation, and eating of food.

A nurse is presenting an in-service training session about nutrition. Which of the following simple sugars should the nurse identify as the carbohydrate found in milk?

Lactose The nurse should identify that lactose is a form of sugar that is found in milk.

A nurse is providing teaching to a client regarding protein intake. Which of the following foods should the nurse include as an example of an incomplete protein?

Lentils Incomplete proteins are missing 1 or more of the essential amino acids necessary for the synthesis of protein in the body. Examples of incomplete proteins include lentils, vegetables, grains, nuts, and seeds.

A nurse is planning care for a client who has anorexia and nausea due to cancer treatment. Which of the following interventions should the nurse include?

Limit drinking liquids with food Drinking beverages with food leads to early satiety and bloating, which results in the client consuming fewer calories.

A nurse is caring for an infant who has gastroenteritis and is dehydrated. Which of the following characteristics places the infant at a higher risk of electrolyte imbalances compared to an adult client?

Longer Intestinal Tract Compared to adults or older children, infants have a longer intestinal tract. This results in greater fluid losses, especially through diarrhea.

A nurse is providing dietary teaching to a client who has dumping syndrome following gastric bypass surgery 4 days ago. Which of the following recommendations should the nurse include in the teaching?

Maintain a supine position after meals The nurse should instruct the client to lie supine after eating to help slow the rapid emptying of food into the small intestine. A client who has dumping syndrome should decrease the amount of food eaten at once, eat small meals more frequently, and eliminate fluids at mealtime. Fluid shifts occur in the upper gastrointestinal tract when food contents and simple sugars exit the stomach too rapidly, attracting fluid into the upper intestine and decreasing blood volume, which causes the client to experience nausea and vomiting, sweating, syncope, palpitations, increased heart rate, and hypotension.

A nurse is caring for a client who is receiving radiation therapy for breast cancer and reports a metallic taste in the mouth. Which of the following dietary recommendations should the nurse share with the client?

Offer mints The nurse should encourage the client to suck on mints, which can overcome the metallic taste the client is experiencing as a result of the radiation therapy.

A nurse is planning an in-service training session for a group of nurses regarding the role of enzymes in digestion. Which of the following enzymes plays a role in the digestion of protein?

Pepsin Pepsin is an enzyme secreted by the gastric mucosa that breaks down protein into polypeptides.

A nurse is providing teaching to a female client who has a new prescription for pravastatin to treat hyperlipidemia. Which of the following pieces of information should the nurse include in the teaching?

Pravastatin can be taken with grapefruit juice. Pravastatin, unlike other statins, such as lovastatin, simvastatin, and atorvastatin, is not affected by CYP344 inhibitors. It is safe for the client to consume grapefruit juice if desired.

A nurse is teaching a client with chronic kidney disease about predialysis dietary recommendations. The nurse should recommending restricting the intake of which of the following nutrients?

Protein Dietary restrictions for clients who have chronic kidney disease vary based on the degree of kidney function; however, most clients need protein limitations. Predialysis protein restriction can help preserve some kidney function.

A nurse is planning an in-service training session about nutrition. Which of the following pieces of information should the nurse include?

Protein serves as an energy source when other sources are inadequate Protein is used as an energy source for the body when carbohydrates and fat stores are unavailable or depleted.

A nurse is caring for a client who is receiving intermittent enteral feedings through an NG tube. The specific gravity of the client's urine is 1.035. Which of the following actions should the nurse take?

Provide more water with feedings The elevation in the client's specific gravity indicates dehydration. The nurse should provide more fluids either by adding free water to feedings or by instilling water between feedings. Another strategy is to request a formula that contains less protein.

A nurse is caring for a client who has peripheral edema. The nurse should identify that which of the following nutrients regulates extracellular fluid volume?

Sodium Sodium regulates extracellular fluid balance, nerve impulse transmission, acid-base balance, and various other cellular activities.

A nurse is teaching a client who has lactose intolerance about dietary modifications. Which of the following foods should the nurse recommend?

Soy cheese The nurse should recommend lactose-free food items like soy cheese, soy yogurt, almond milk, and lactose-free milk.

A nurse is caring for a patient who has xerostomia with a lack of saliva. Which of the following nutrients will be affected by the lack of salivary amylase?

Starch Salivary amylase begins the process of digestion in the mouth with the initial breakdown of starches. The majority of starch breakdown occurs in the small intestine with pancreatic amylase.

A nurse is providing nutritional teaching to a group of clients. Which of the following definitions for the recommended dietary allowance (RDA) should the nurse include in the teaching?

The RDA defines the level of nutrient intake that meets the needs of healthy people in various groups. The RDA represents daily requirements considered adequate for healthy people. RDAs are based on estimated amounts for each nutrient, including additional amounts for individuals such as women or infants.

A nurse is caring for a client who is receiving radiation therapy for mouth cancer and reports a dry mouth. Which of the following dietary recommendations should the nurse provide?

Use gravies or sauces to soften food The nurse should instruct the client to use gravies or sauces to soften foods and make them easier to eat.

A nurse is caring for a client who has scurvy. Which of the following vitamin deficiencies should the nurse identify as the cause of this disease?

Vitamin C Vitamin C deficiency produces symptoms of scurvy such as delayed wound healing and capillary fragility.

A nurse is providing teaching to the guardian of a child who has celiac disease. Which of the following foods should the nurse instruct the guardian to omit from the child's diet?

Wheat bread Clients who have celiac disease should eliminate as much gluten as possible from their diets. Wheat, rye, and barley contain gluten and should be eliminated from the diet of a child who has celiac disease.

A nurse is caring for a client who has a deficiency of vitamin D. Which of the following foods should the nurse recommend the client include in his diet?

Whole milk The fat-soluble vitamins (A, D, E, and K) require fatty substances or tissues to be dissolved and also require the presence of bile in the small intestine for absorption. Whole milk contains vitamins A and K and is often fortified with vitamin D