ATI RN Nutrition Online Practice 2023 B

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

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." Rationale: The nurse should instruct the client to limit meat intake to about 5 oz per day. A meat portion should be no larger than the size of a deck of cards.

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." Rationale: Canned pinto beans contain less fat than refried beans.

A nurse is teaching a client who has a prescription for ferrous sulfate about food interactions. Which of the following statements indicates that the client understands the teaching?

"I can take this medication with juice." Rationale: The nurse should instruct the client to take this medication between meals with juice. The client can take this medication with meals if gastric upset occurs.

A nurse is providing teaching to a client who has diabetes mellitus and an HbA1c of 8.7% (less than 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." Rationale: 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 teaching an older adult client about nutritional recommendations. Which of the following statements should the nurse make?

"You should increase your daily protein intake." Rationale: The nurse should instruct the client to increase the daily intake of protein to increase strength and to enhance immune function and wound healing. The nurse should recommend a protein intake of 1 to 1.2 g/kg/day of protein for a healthy older adult client. If the older adult client has acute or chronic medical diagnoses, the nurse should recommend 1.2 to 1.5 g/kg/day of protein.

A nurse in a pediatrician's office is caring for a newborn. The nurse is providing teaching to the parent about infant nutrition at the follow-up visit. Select the 3 statements the nurse should include.

"Your baby is gaining weight at the expected rate." "Your baby's length should be around 27 inches long by one year of age." "Your baby should weigh about twenty pounds by one year of age." Rationale: When taking action and providing teaching, the nurse should inform the parent that their newborn should triple their birth weight and increase in length by 50% by one year of age. The nurse should also inform the parent that their newborn is gaining weight at the expected rate, which is to return to birth weight around 2 weeks of age.

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

A nurse is conducting a screening assessment for the protein status of a client. Which of the following laboratory values should the nurse review?

Albumin Rationale: Albumin levels reflect the overall body protein status and are used to determine the nutritional status, disease severity, and surgical risk and mortality.

A nurse is assessing a client who experienced a 5% weight loss in the past 30 days. Which of the following findings should the nurse identify as an indication of malnutrition?

Ankle edema Rationale: The nurse should identify that lower extremity edema is a manifestation of malnutrition and is indicative of a protein deficiency in the client.

A home health nurse is reviewing the medical record of a male 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 Rationale: 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 is caring for a client who has anemia and a new prescription from an iron supplement. The nurse should recommend the client consume the supplement with which of the following beverages to increase absorption?

Tomato juice Rationale: The nurse should recommend the client consume the supplement with beverages containing vitamin C, such as tomato juice or orange juice, because this will enhance the absorption of the iron supplement.

A nurse is conducting dietary teaching for a group for clients who are trying to become pregnant. Which of the following food items should the nurse include as containing the highest amount of folate?

3.5 oz chicken liver Rationale: The nurse should recommend this food because 3.5 oz of chicken liver contains the highest amount of folate, 770 mcg.

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." Rationale: 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." Rationale: 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 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." Rationale: Clients should consume four to five servings of unsalted nuts, seeds, or legumes per week for a heart-healthy diet.

A nurse is providing teaching to a client who is currently experiencing an exacerbation of Crohn's disease. Which of the following statements by the client indicates an understanding of dietary practices during acute episodes?

"I will follow a high protein diet." Rationale: Clients who have Crohn's disease should follow a high-calorie, high-protein diet to prevent malnutrition and attain the required calories to promote healing.

A nurse is providing nutritional teaching to a client who reports wanting to lose weight. The nurse should identify that which of the following client statements indicates an understanding of the teaching?

"I will make a list before I go grocery shopping." Rationale: Developing a shopping list allows the client to adhere to meal planning, prevent impulse buying, and purchase only the quantity of food needed.

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 their cup for them to drink." Rationale: 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.

A nurse is providing dietary teaching about reducing the risk of infection to a client who has cancer and is receiving chemotherapy. Which of the following client statements indicates an understanding of the teaching?

"I will use leftovers within 24 hours." Rationale: The client should use leftovers within 24 hr to reduce the risk of infection from a foodborne pathogen.

A nurse is caring for a client who has age-related macular degeneration (AMD) and asks the nurse if there are any nutritional changes to consider. Which of the following responses should the nurse make?

"Increase dietary intake of lutein" Rationale: Lutein, a carotenoid found in vitamin A, slows the progression of AMD and is found in kale, spinach, collards, and mustard greens.

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 to 1/2 to 1 pound per week." Rationale: The nurse should inform the participants that losing 0.23 to 0.45 kg (0.5 to 1 lb) per week 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 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?

1/2 cup roasted almonds Rationale: 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 calculating the daily protein allowance of a client who weights 176 lb. The client's daily protein allowance is 0.8 g/kg. How many grams of protein should the client consume per day?

64 Rationale: 176 lb = 80 kg 80 kg x 0.8 g = 64 g/day

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 Rationale: According to evidence-based practice, the nurse should identify that a baked potato has the highest glycemic index of these foods. The glycemic index of a baked potato is 85 to 90. Glycemic index is a tool used to rank foods according to the degree in which the food raises serum glucose levels.

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 Rationale: 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.

A nurse in a provider's office is caring for a client. The nurse is planning dietary teaching for the client during the follow-up visit. Identify which of the following information the nurse should include. Select all that apply.

Black beans are a safe source of fiber. Corn is an acceptable food to eat. Quinoa is an acceptable grain to consume. It is safe to use potato flour when cooking. Rationale: When generating solutions and planning dietary teaching for a client who has a new diagnosis of celiac disease, the nurse should plan to instruct the client about foods that contain gluten as well as foods that are gluten-free. The nurse should include that potato flour is safe for use as it does not contain gluten. Beans and legumes are naturally gluten free and are a good source of fiber. Corn, quinoa, and plain rice are also naturally gluten free and acceptable for consumption.

A nurse is caring for a client who is prescribed captopril. The nurse should recognize that which of the following foods could cause a potential medication interaction?

Cantaloupe Rationale: ACE inhibitors, such as captopril, retain potassium and can lead to hyperkalemia. The nurse should recognize that cantaloupe is a food source high in potassium as one cup contains 473 mg. The client should avoid cantaloupe as well as other foods that are high in potassium while taking an ACE inhibitor.

A nurse is caring for a client who has diabetes mellitus and reports feeling dizzy, weak, and shaky. Which of the following is the priority action by the nurse?

Check the client's blood glucose level. Rationale: The first action the nurse should take using the nursing process is to assess the client. Therefore, checking the client's blood glucose level is the priority action.

A nurse is observing a client during mealtime who had a stroke and has left-sided weakness. Which of the following findings places the client at risk for aspiration?

Client is positioned at a 30 degree angle when eating Rationale: The nurse should identify positioning the client at a 30° angle while eating increases the client's risk of aspiration; therefore the nurse should position the client in an upright position at 90° to prevent aspiration of food or liquids. This position helps with swallowing to protect the airway. Aspiration can lead to complications including pneumonia.

The nurse is caring for a client on a medical-surgical unit. Which of the following findings indicate that the client is not tolerating enteral feedings? Select all that apply.

Client's reported concern Emesis output Rationale: When evaluating outcomes, the nurse should recognize that the client reported concern about being nauseous and the presence of emesis requires follow up. These are manifestations of tube feeding intolerance and that the client is not progressing as expected.

A nurse is caring for a client who has been receiving total parenteral nutrition (TPN) and has a prescription to discontinue the TPN. Which of the following findings should indicate to the nurse that the client is experiencing a complication from discontinuing the TPN?

Confusion Rationale: The nurse should identify confusion as a manifestation of hypoglycemia. Clients who are receiving total parenteral nutrition are at risk for developing hypoglycemia when TPN is discontinued. The manifestations of hypoglycemia are confusion, cool and clammy skin, erratic behavior, and shakiness.

A nurse is providing teaching to a client who is breastfeeding about increasing protein intake. Which of the following foods should the nurse recommend as the best source of protein?

Cottage cheese Rationale: The nurse should recommend cottage cheese as the best source of protein because it is a complete protein. Complete proteins contain all nine essential amino acids and provide the best support for human growth and nourishment.

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

Crackles in the lungs Rationale: 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 caring for a client who is receiving continuous tube feedings via a gastrostomy tube. The client has had three loose stools in the last 4 hr. Which of the following prescriptions should the nurse anticipate?

Decrease the rate of the feeding Rationale: The nurse should identify the client is experiencing diarrhea, which might be due to the formula being delivered continuously and the client's body being unable to digest it. The nurse should anticipate a prescription to decrease the rate of the feeding.

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. Rationale: To prevent diarrhea, the nurse should decrease the rate of the tube feeding, which allows for better absorption of the enteral formula.

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 changes indicate the client is moving towards achieving goals of the DASH diet?

Decreased total cholesterol Rationale: A feature of the DASH diet is a reduction in total cholesterol. The goal is to achieve a total cholesterol level within the expected reference range of less than 200 mg/dL. A decreased total cholesterol level indicates that the client moving towards achieving one of the goals of the DASH diet.

A nurse is planning dietary teaching to a client who has chronic kidney disease and is prescribed hemodialysis. Which of the following actions should the nurse plan to take first?

Determine whether the client has culture-related food preferences Rationale: The first action the nurse should take using the nursing process as a priority framework is to assess the client. By determining the client's cultural preferences related to food, the nurse can incorporate the client's beliefs into the dietary plan.

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 Rationale: The nurse should identify that diaphoresis, irritability, and tremors are manifestations of hypoglycemia.

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. Rationale: 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 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 Rationale: 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 their pregnancy. The nurse should advise the client to do which of the following?

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

A nurse is initiating an enteral feeding for a client who has chronic bronchitis. Which of the following types of formula should the nurse anticipate administering to the client?

High calorie Rationale: A client who has pulmonary disease requires a formula that is high in calories and protein to maintain energy demands.

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 Rationale: 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 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 Rationale: 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 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. Rationale: The nurse should instruct the client that consuming the skin on fruits and vegetables adds fiber to the diet.

A nurse is caring for a client who is receiving total parenteral nutrition (TPN). The nurse identifies which of the following as a complication of TPN?

Magnesium 1.1 mEq/L (1.3-2.1 mEq/L) Rationale: The nurse should identify the client's magnesium level is below the expected reference range. Clients receiving TPN are at risk for electrolyte imbalance. When a client receives TPN, electrolytes are quickly pulled out of the bloodstream into cells, which can cause low magnesium. Other risks can include hyperglycemia or hypoglycemia, elevated liver enzymes and triglycerides.

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. Rationale: 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 is immobile and has a pressure injury. Which of the following laboratory findings can be an indicator for delayed wound healing?

Prealbumin 10 mg/dL (15 to 36 mg/dL) Rationale: The nurse should identify that adequate protein, vitamins, and minerals are needed for wound healing. A low prealbumin level increases a client's risk for delayed wound healing and is an indicator of malnutrition.

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

Plan 5-minute feedings on each breast on the first day after birth. Rationale: The nurse should instruct the clients to let the newborn nurse for 5 min on each breast on the first day to promote milk production.

A nurse is providing discharge teaching to a client who has a new ileostomy. Which of the following dietary guidelines should the nurse include in the teaching?

Prepare meals on a schedule Rationale: The nurse should teach a client who has an ileostomy to prepare meals on a schedule to promote regular bowel elimination patterns.

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 Rationale: 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 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 Rationale: Clients at risk for dumping syndrome better tolerate low-fiber grains that contain less than 2 g fiber per serving to slow gastric emptying.

A charge nurse is reviewing the electronic medical record (EMR) of a client. Which of the following findings from the client's EMR should the nurse recognize as an indication that the client is experiencing hypervolemia? Select all that apply.

Respiratory assessment Blood pressure Heart rate Pulse assessment Sodium level Edema assessment Rationale: When recognizing cues, the charge nurse should identify that the client's EMR findings of pulse, respiratory, and edema assessments, blood pressure, heart rate, and sodium level could indicate the client is experiencing hypervolemia. The client findings tachycardia, crackles in the lung bases, bounding peripheral pulses, pitting edema, hyponatremia, and hypertension can be an indication of fluid retention.

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 Rationale: 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 nurse is teaching a client about managing irritable bowel syndrome (IBS). Which of the following information should the nurse include in the teaching?

Take peppermint oil during exacerbation of manifestations. Rationale: The nurse should teach the client to take peppermint oil because peppermint relaxes the smooth muscle of the GI tract and decreases the manifestations of IBS.

A nurse on a pediatric unit is planning care for a school-aged child. Complete the following sentence by using the list of options. The nurse should first address the child's ________, followed by the child's ________.

Temperature Stool pattern Rationale: When prioritizing hypotheses and using the urgent vs non-urgent approach to the child's care, the nurse determines to first address the child's temperature followed by the child's stool pattern. The child has a temperature that is above the expected reference range, therefore the nurse should provide an intervention such as administering an antipyretic to decrease the child's temperature. The nurse should address the parents' report of the child having several loose stools which could indicate diarrhea. Diarrhea can cause a reduction in fluid volume and should be addressed to determine the cause.

A nurse is teaching a client who is preparing for bowel surgery about a low-residue diet. Which of the following food choices by the client indicates an understanding of the teaching?

Two poached eggs and a banana Rationale: A low-residue diet limits the amount of stool traveling through the intestinal tract. The nurse should teach the client to avoid foods high in fiber. Poached eggs and bananas are acceptable low-residue menu choices.

A nurse is caring for a client who is being treated for cancer using chemotherapy. Which of the following interventions should the nurse suggest to aid in management of treatment-related changes in taste?

Use plastic utensils Rationale: Use of plastic utensils can help minimize a metallic taste that often accompanies chemotherapy treatment.

A nurse is caring for a client who is at 16 weeks of gestation. Drag words from the choices below to fill in each blank in the following sentence. After initiating the client's prescriptions, the nurse should identify that the client is at risk for developing ________ and _________.

Venous thrombosis Hyperglycemia Rationale: When analyzing cues, the nurse should identify that after initiating TPN therapy, the client is at risk for developing venous thrombosis and hyperglycemia. Venous thrombosis can develop because of placement of PICC. Hyperglycemia is a complication of TPN and requires routine assessment of the blood glucose level. The nurse should monitor the client for these potential complications and report any unexpected findings to the provider.