Nutrition Exam 3 Practice Questions

A client with Diabetes Mellitus states, "I cannot eat big meals; I prefer to snack throughout the day." The nurse should carefully explain that: A. Regulated food intake is basic to controlling blood glucose levels. B. Salt and sugar restriction is the main concern. C. Small, frequent meals are better for digestion. D. Large meals can contribute to a weight problem.

A

The nurse is assisting a patient with newly diagnosed type 2 diabetes to learn dietary planning as part of the initial management of diabetes. The nurse would encourage the patient to limit intake of which foods to help reduce the percent of fat in the diet? a. Cheese b. Broccoli c. Chicken d. Oranges

A (Cheese is a product derived from animal sources and is higher in fat and calories than vegetables, fruit, and poultry. Excess fat in the diet is limited to help avoid macrovascular changes.)

Which vitamin aids in iron absorption? a. vitamin B b. vitamin C c. vitamin E d. vitamin D

B. Vitamin C

Which food provides the only animal source of carbohydrate? A. Beef B. Eggs C. Milk D. Chicken

C (The only animal source of carbohydrate is lactose, the sugar contained in milk. Beef, eggs, and chicken do not provide a source of carbohydrate.)

XX

XX

A nurse is caring for a patient with refractory epilepsy. To enhance medical management, a ketogenic diet has been prescribed. In educating the patient about dietary energy sources, all of the following statements are true, except: A. Proteins consist of polymers of nucleic acids. B. Fat provides more kilocalories per gram than protein. C. A high-fat diet may cause increased serum cholesterol levels. D. Starch is an example of a carbohydrate.

A

Previous administrations of chemotherapy agents to a cancer patient have resulted in diarrhea. Which of the following dietary modifications should the nurse recommend? A. A bland, low-fiber diet B. A high-protein, high-calorie diet C. A diet high in fresh fruits and vegetables D. A diet emphasizing whole and organic foods

A

The home care nurse has taught a client with a problem of inadequate cardiac output about helpful lifestyle adaptations to promote health. Which statement by the client best demonstrates an understanding of the information provided? A. "I will eat enough daily fiber to prevent straining at stool." B. "I will try to exercise vigorously to strengthen my heart muscle." C."I will drink 3000 to 3500 mL of fluid daily to promote good kidney function." D. "Drinking 2 to 3 oz of liquor each night will promote blood flow by enlarging blood vessels."

A

Those with depression should consume adequate amounts of? A. tryptophan and vitamin D B. protein and vitamin K C. beta carotene and vitamin E D. calcium and vitamin B12

A

A nurse is teaching a community program on nutritional guidelines for cancer prevention. Which of the following instructions should the nurse include? (Select all that apply.) A. Eat foods high in vitamin A. B. Add cruciferous vegetables. C. Increase intake of red meats D. Use saturated cooking oil. E. Consume refined grains.

A, B

A nurse is teaching a client about high-fiber foods that can assist in lowering LDL. Which of the following foods should the nurse include in the teaching? (Select All that Apply) A. Beans B. Cheese C. Whole Grains D. Broccoli E. Yogurt

A, C, D

A nurse is caring for a client who has diabetes mellitus and resorts feeling shaky and weak. The clients blood glucose is 53 mg/dL. Which of the following actions should the nurse take? A. Provide subcutaneous insulin for the client B. Offer the client 120 mL (4oz) fruit juice C. Give the client IV potassium D. Administer IV sodium bicarbonate

B

A patient is diagnosed with Congestive Heart Failure and must follow a specific diet. Which spices are okay for the patient to use daily? A. Onion Salt & Garlic Powder B. Ginger & Bay Leaves C. Sea Salt & Pepper D. Garlic Sodium & Nutmeg

B

A patient who has been hospitalized after experiencing a heart attack will most likely receive a diet consisting of: A. Low fat, low sodium, and low carbohydrates B. Low fat, low sodium, and high carbohydrates C. Low fat, high protein, and high carbohydrates D. Liquids for several days, progressing to a soft and then a regular diet

B

The client has been told to consume more omega-3 fatty acids. What food could the nurse say is a good source of omega-3 fatty acids? a. avocado b. fatty fish c. oatmeal d. whole wheat bread

B

During an admission assessment, the patient reports that he takes vitamin E supplements twice a day. The nurse should explain that taking vitamin E supplements twice a day A. ensures healthy vision. B. can lead to toxicity. C. strengthens the immune system. D. helps maintain body tissues.

B (Vitamins are critical in building and maintaining body tissues, supporting the immune system to fight infection, and ensuring healthy vision. However when fat-soluble vitamins, such as vitamins A, D, E, and K, are supplemented in large doses, toxicity may occur.)

When caring for a patient with chronic obstructive pulmonary disease (COPD), the nurse identifies a nursing diagnosis of imbalanced nutrition: less than body requirements after noting a weight loss of 30 lb. Which intervention should the nurse add to the plan of care for this patient? A. Order fruits and fruit juices to be offered between meals. B. Order a high-calorie, high-protein diet with six small meals a day. C. Teach the patient to use frozen meals at home that can be microwaved. D. Provide a high-calorie, high-carbohydrate, nonirritating, frequent feeding diet.

B Because the patient with COPD needs to use greater energy to breathe, there is often decreased oral intake because of dyspnea. A full stomach also impairs the ability of the diaphragm to descend during inspiration, thus interfering with the work of breathing

A client has experienced an episode of pulmonary edema. The nurse determines that the client's respiratory status is improving after this episode if which breath sounds are noted? A. Rhonchi B. Wheezes C. Crackles in the bases D. Crackles throughout the lung fields

C

A community health nurse is assessing a client who reports numbness of the hands and feet for the past 2 weeks. This finding is associated with which of the following nutritional deficiencies? A. Folic Acid B. Potassium C. Vitamin B12 D. Iron

C

A nurse is collecting data from a client who has suspected HIV‑associated muscle wasting. Which of the following findings supports this diagnosis? A. BMI 26 B. Fecal impaction C. Report of fever for 30 days D. Report of high alcohol consumption

C

The nurse monitors the client for a hypoglycemic reaction, knowing that NPH insulin peaks in approximately how many hours following administration? A. 1 hour B. 2 to 3 hours C. 8 to 12 hours D. 16 to 24 hours

C. (other options give either times that are too long or too short)

A client, who is not responding to anti-seizure medications, is prescribed to start a ketogenic diet. This diet will include: A. High carbohydrates and high fat B. Low fat, high salt, and high carbohydrates C. High fat and low carbohydrates D. High glucose, high fat, and low carbohydrates

C. This is a type of diet used with epilepsy clients whose seizures cannot be controlled by medication. It is a high fat and very low carb diet. Often guidelines include eating less than 50 grams of carbs a day to put the body into ketoacidosis.

A client is having problems with blood clotting. Which food item should the nurse encourage the client to eat? A. legumes B. citrus fruits C. vegetable oils D. green, leafy vegetables

D

Which of the following criteria must be met for a diagnosis of metabolic syndrome (select all that apply)? a. Hypertension b. Elevated triglycerides c. Elevated plasma glucose d. Increased waist circumference e. Decreased low-density lipoproteins

a, b, c, d (Three of the following five criteria must be met for a diagnosis of metabolic syndrome: 1. Waist circumference of 40 inches or more in men and 35 inches or more in women 2. Triglyceride levels higher than 150 mg/dL, or need for drug treatment for elevated triglyceride levels 3. High-density lipoprotein (HDL) cholesterol levels lower than 40 mg/dL in men and lower than 50 mg/dL in women, or need for drug treatment for reduced HDL cholesterol levels 4. Blood pressure: 130 mm Hg or higher systolic or 85 mm Hg or higher diastolic, or need for drug treatment for hypertension 5. Fasting blood glucose level of 110 mg/dL or higher, or need for drug treatment for elevated glucose levels

You are taking care of a patient with severe COPD. What type of diet would best suit this patient's needs? A. Cut apples, fresh broccoli, and grilled chicken B. Pureed sweet potatoes, ground turkey & gravy with mash potatoes C. Green beans, boiled carrots, and steamed fish D. Fried chicken, French fries, and pudding

B

What is the antidote for Warfarin (Coumadin)? A. Flumazenil B. Narcan C. Protamine Sulfate D. Vitamin K

D

Which assessment data should the nurse assess in the client diagnosed with Guillain-Barré syndrome? A. An exaggerated startle reflex and memory changes. B. Cogwheel rigidity and inability to initiate voluntary movement. C. Sudden severe unilateral facial pain and inability to chew. D. Progressive ascending paralysis of the lower extremities and numbness.

D

Which item would be most beneficial when providing oral care to a patient with metastatic cancer who is at risk for oral tissue injury secondary to chemotherapy? a. Firm-bristle toothbrush b. Hydrogen peroxide rinse c. Alcohol-based mouthwash d. 1 tsp salt in 1 L water mouth rinse

D

Which priority client problem should be included in the care plan for the client diagnosed with Guillain-Barré syndrome? A. High risk for injury. B. Fear and anxiety. C. Altered nutrition. D. Ineffective breathing pattern.

D

A nurse is reinforcing dietary teaching to a client who has type 2 diabetes mellitus. Which of the following instructions should the nurse include? (Select all that apply) A. "Carbohydrates should comprise 55% of daily caloric intake." B. "Use hydrogenated oils for cooking." C. "You can add table sugar to cereals." D. "Eat something if you choose to drink alcohol." E. "Use the same portion sizes to exchange carbohydrates."

A, C, D, E

The nurse is evaluating a 45-year-old patient diagnosed with type 2 diabetes mellitus. Which symptom reported by the patient is considered one of the classic clinical manifestations of diabetes? a. Excessive thirst b. Gradual weight gain c. Overwhelming fatigue d. Recurrent blurred vision

A (The classic symptoms of diabetes are polydipsia (excessive thirst), polyuria, (excessive urine output), and polyphagia (increased hunger). Weight gain, fatigue, and blurred vision may all occur with type 2 diabetes, but are not classic manifestations.)

A nurse is teaching a client who has cancer about ways to increase protein and calories in foods. Which of the following actions should the nurse include? (Select all that apply.) A. Use peanut butter as a spread on crackers. B. Add water in place of milk in soups. C. Top fruit with yogurt. D. Dip chicken in eggs before cooking. E. Sprinkle cheese on a baked potato.

A, C, D, E

The nurse has been teaching a patient with diabetes mellitus how to perform self-monitoring of blood glucose (SMBG). During evaluation of the patient's technique, the nurse identifies a need for additional teaching when the patient does what? a. Chooses a puncture site in the center of the finger pad. b. Washes hands with soap and water to cleanse the site to be used. c. Warms the finger before puncturing the finger to obtain a drop of blood. d. Tells the nurse that the result of 110 mg/dL indicates good control of diabetes.

A (The patient should select a site on the sides of the fingertips, not on the center of the finger pad as this area contains many nerve endings and would be unnecessarily painful. )

A client suffered a myocardial infarction 24 hours ago, but is now able to consume a low-cholesterol-low-sodium diet. Which of the following dietary modifications could the nurse suggest that would increase the client's comfort after a myocardial infarction? Select all that apply. a. avoid foods that are hard to digest b. avoid foods that are too hot c. avoid roughage d. consume foods that are difficult to chew e. consume high-fiber foods f. consume very cold foods

A, B, C

When providing dietary instruction to a patient with hypertension, the nurse would advise the patient to restrict intake of which meat? A. Broiled fish B. Roasted duck C. Roasted turkey D. Baked chicken breast

B

A patient who has recovered from ARDS in the ICU is now malnourished and has lost a significant amount of weight. The physician orders TPN to add nutrition for the patient, who subsequently develops re-feeding syndrome. Which of the following signs or symptoms would the nurse expect to see with re-feeding syndrome? Select all that apply. a. Impaired mental status b. Insulin resistance c. Seizures d. Persistent weight loss e.Constipation

A, B, C

A firefighter who was involved in extinguishing a house fire is being treated for smoke inhalation. He develops severe hypoxia 48 hours after the incident, requiring intubation and mechanical ventilation. Which of the following conditions has he most likely developed? A. Acute respiratory distress syndrome (ARDS). B. Atelectasis. C. Bronchitis. D. Pneumonia

A

The nurse administered 28 units of Humulin N, an intermediate-acting insulin, to a client diagnosed with Type 1 diabetes at 1600. Which action should the nurse implement? A. Ensure the client eats the bedtime snack. B. Determine how much food the client ate at lunch. C. Perform a glucometer reading at 0700. D. Offer the client protein after administering insulin.

A

The nurse is teaching a wellness class to a group of women at their workplace. Which findings represent the highest risk for developing cancer? a. Body mass index of 35 kg/m2 and smoking cigarettes for 20 years b. Family history of colorectal cancer and consumes a high-fiber diet c. Limits fat consumption and has regular mammography and Pap screenings d. Exercises five times every week and does not consume alcoholic beverages

A

The nurse teaches a patient with hypertension that uncontrolled hypertension may damage organs in the body primarily by which mechanism? A. Hypertension promotes atherosclerosis and damage to the walls of the arteries. B. Hypertension causes direct pressure on organs, resulting in necrosis and replacement of cells with scar tissue. C. Hypertension causes thickening of the capillary membranes, leading to hypoxia of organ systems. D. Hypertension increases blood viscosity, which contributes to intravascular coagulation and tissue necrosis distal to occlusions.

A

When teaching a patient with myasthenia gravis (MG) about management of the disease, the nurse advises the patient to a. perform physically demanding activities in the morning. b. anticipate the need for weekly plasmapheresis treatments. c. do frequent weight-bearing exercise to prevent muscle atrophy. d. protect the extremities from injury due to poor sensory perception.

A

a low-sodium diet has been prescribed for a client with hypertension.Which food selected from the menu by the client indicates an understanding of this diet? A. baked turkey B. tomato soup C. boiled shrimp D. chicken gumbo

A

Previous administrations of chemotherapy agents to a cancer patient have resulted in diarrhea. Which dietary modification should the nurse recommend? a. A bland, low-fiber diet b. A high-protein, high-calorie diet c. A diet high in fresh fruits and vegetables d. A diet emphasizing whole and organic foods

A Patients experiencing diarrhea secondary to chemotherapy or radiation therapy often benefit from a diet low in seasonings and roughage before the treatment. Foods should be easy to digest and low in fat.

The home care nurse visits a client diagnosed with type 1 diabetes mellitus who takes NPH insulin every morning and checks the client's blood glucose level 4 times per day. The client tells the nurse that, yesterday, the late afternoon blood glucose was 60 mg/dL (3.42 mmol/L) and that she "felt funny." Which statement by the client indicates an understanding of this occurrence? A. "I forgot to take my usual afternoon snack yesterday." B. "My blood glucoses are running low because I'm tired." C. "I took less insulin this morning, so I won't feel funny today." D. "I think I 'felt funny' because my insulin was close to expiring."

A (Hypoglycemia is a blood glucose level of 60 mg/dL (3.42 mmol/L) or less. The causes are multiple, but in this case, omitting the afternoon snack is the cause. Fatigue and self-adjustment of dose are incorrect options. The medication had not yet expired and so was safe to administer.)

Laboratory results have been obtained for a 50-year-old patient with a 15-year history of type 2 diabetes. Which result reflects the expected pattern accompanying macrovascular disease as a complication of diabetes? a. Increased triglyceride levels b. Increased high-density lipoproteins (HDL) c. Decreased low-density lipoproteins (LDL) d. Decreased very-low-density lipoproteins (VLDL)

A (Macrovascular complications of diabetes include changes to large- and medium-sized blood vessels. They include cerebrovascular, cardiovascular, and peripheral vascular disease)

A client diagnosed with diabetes mellitus receives 8 units of regular insulin subcutaneously at 7:30 am. The nurse should be most alert to signs of hypoglycemia at what time during the day? A. 9:30 am to 11:30 am B. 11:30 am to 1:30 pm C. 1:30 pm to 3:30 pm D. 3:30 pm to 5:30 pm

A (Regular insulin is a short-acting insulin. Its onset of action occurs in a half hour and peaks in 2 to 4 hours. Its duration of action is 4 to 6 hours. A hypoglycemic reaction will most likely occur at peak time, which in this situation is between 9:30 am and 11:30 am.)

The nurse is educating the client about limiting consumption of fat in the diet. The client states that is impossible to limit his/her fat intake further because the client is already trimming all visible fats from the foods he/she consumes. What statements could the nurse make about fats in food? (Select all that apply.) a. Avoid pastries because they are usually high in fat. b. Plant foods do not contain fats. c. Foods contain both fats that are visible and fats that are invisible. d. Invisible fats are found in meats, cream, whole milk, cheese, egg yolk, and nuts. e. It is often invisible fats that make it difficult to regulate fat intake. f. The client is correct, no further limitation of fats is necessary.

A, C, D, E

The nurse is leading a support group for clients and families with chronic obstructive pulmonary disease​ (COPD). Which item should be discussed as a method to prevent COPD​ exacerbations? (Select all that​ apply.) A. Restricting smoking in home environment B. Use of cough suppressants C. Use of cool mist humidifier D. Yearly flu vaccine E. Pneumococcal vaccine

A, C, D, E

The nurse is caring for a patient experiencing dysphagia. Which interventions help decrease the risk of aspiration during feeding? (Select all that apply.) A. Sit the patient upright in a chair. B. Give liquids at the end of the meal. C. Place food on the strong side of the mouth. D. Provide thin foods to make it easier to swallow. E. Feed the patient slowly, allowing time to chew and swallow. F. Encourage the patient to lie down to rest for 30 minutes after eating.

A, C, E

A nurse is providing teaching to a client who has vitamin B12 deficiency. Which of the following foods should the nurse instruct the client to consume? (Select All that Apply) A. Meat B. Flaxseed C. Beans D. Eggs E. Milk

A, D, E

You are caring for a patient with newly diagnosed type 1 diabetes. What information is essential to include in your patient teaching before discharge from the hospital? (select all that apply) a. insulin administration b. elimination of sugar from diet c. need to reduce physical activity d. use of portable blood glucose monitor e. hypoglycemia prevention, symptoms, and treatment

A, D, E

When teaching a patient about dietary management of stage 1 hypertension, which instruction is most appropriate? A. Restrict all caffeine. B. Restrict sodium intake. C. Increase protein intake. D. Use calcium supplements.

B

A client with advanced ALS is admitted to the hospital. Because of manifestations that are common in clients with ALS, the nurse should: a. attempt to institute bowel-training activities. b. provide the client with small, frequent feedings. c. obtain an order for intermittent catheterization. d. orient the client to his or her surroundings frequently.

B

A nurse in an oncology clinic is caring for a client who is undergoing treatment for cancer and reports difficulty eating due to inability to taste food. Which of the following interventions should the nurse recommend? A. Avoid citrus juices. B. Use plastic utensils to eat. C. Eat foods that are warm. D. Increase foods high in pectin.

B

A nurse is assessing a client who has hypoglycemia. Which of the following findings should the nurse expect? A. Fruity breath odor B. Diaphoresis C. Ketones in urine D. Polyuria

B

A nurse is caring for a client who has diabetes mellitus and reports feeling shaky and weak. The client's blood glucose is 53 mg/dL. Which of the following actions should the nurse take? A. Provide subcutaneous insulin for the client. B. Offer the client 120 mL (4 oz) fruit juice. C. Give the client IV potassium. D. Administer IV sodium bicarbonate.

B

Acute Respiratory Distress Syndrome (ARDS) can be defined as: A. Sudden life-threatening deterioration of gas exchange in the lungs B. Non-cardiac pulmonary edema with increasing hypoxemia despite treatment with O2 C. Sudden life-threatening pulmonary edema that causes a deterioration of gas exchange despite treatment with O2

B

Polydipsia and polyuria related to diabetes mellitus are primarily due to: a. the release of ketones from cells during fat metabolism b. fluid shifts resulting from the osmotic effect of hyperglycemia c. damage to the kidneys from exposure to high levels of glucose. d. changes in RBCs resulting from attachment of excessive glucose to hemoglobin.

B

The client brings the results of recent cholesterol screening with him to see the nurse. The client is confused about what the results mean and asks what the total cholesterol number should be. Which of the following statements could the nurse make about interpreting the results of the cholesterol screening test? a. Total blood cholesterol should not exceed 150 mg/dl b. Total cholesterol should not exceed 200 mg/dl c. Total cholesterol should not exceed 150 mg/ml d. Total cholesterol should not exceed 200 mg/ml

B

The client has been told to replace saturated fats in the diet with monounsaturated fats and wants to know why. What statement could the nurse make to the client about monounsaturated fats? a. Monounsaturated fats lower the amount of high-density lipoprotein in the blood when they replace saturated fats in the diet. b. Monounsaturated fats lower the amount of low-density lipoprotein in the blood when they replace saturated fats in the diet. c. Monounsaturated fats raise the amount of high-density lipoprotein in the blood when they replace saturated fats in the diet. d. Monounsaturated fats raise the amount of low-density lipoprotein in the blood when they replace saturated fats in the diet.

B

The guidelines for Carbohydrate Counting as medical nutrition therapy for diabetes mellitus includes all of the following EXCEPT: a. Flexibility in types and amounts of foods consumed b. Unlimited intake of total fat, saturated fat and cholesterol c. Including adequate servings of fruits, vegetables and the dairy group d. Applicable to with either Type 1 or Type 2 diabetes mellitus.

B

The nurse in the long-term care facility cares for a 70-year-old man with severe (late-stage) dementia who is undernourished and has problems chewing and swallowing. What should the nurse include in the plan of care for this patient? A. Turn on the television to provide a distraction during meals. B. Provide thickened fluids and moist foods in bite-size pieces. C. Limit fluid intake during scheduled meals to prevent aspiration. D. Allow the patient to select favorite foods from the menu choices.

B

The nurse instructs a 22-year-old female patient with diabetes mellitus about a healthy eating plan. Which statement made by the patient indicates that teaching was successful? a. "I plan to lose 25 pounds this year by following a high-protein diet." b. "I may have a hypoglycemic reaction if I drink alcohol on an empty stomach." c. "I should include more fiber in my diet than a person who does not have diabetes." d. "If I use an insulin pump, I will not need to limit the amount of saturated fat in my diet."

B

The nurse teaches a patient who has had surgery to increase which nutrient to help with tissue repair? A. Fat B. Protein C. Vitamin D. Carbohydrate

B

The physician notified the nurse that the client is suffering from congestive heart failure, and is presenting with edema. The nurse is then notified that diuretics will be prescribed to aid in the excretion of water and sodium, in order to alleviate the client's edema. The nurse must advise the client that a potential side effect of diuretics is _______, and this can be addressed by the client by consuming ______. a. again in sodium; supplementary potassium b. a loss of potassium; fruits and vegetables c. a loss of potassium; saltines d. swelling of the abdomen; a fat-restricted diet

B

Which statement by the nurse most facilitates patient cancer prevention during the promotion stage of cancer development? a. "Exercise every day for 30 minutes." b. "Follow smoking cessation recommendations." c. "Following a vitamin regime is highly recommended." d. "I recommend excision of the cancer as soon as possible."

B The promotion stage of cancer is characterized by the reversible proliferation of the altered cells. Changing the lifestyle to avoid promoting factors (dietary fat, obesity, cigarette smoking, and alcohol consumption) can reduce the chance of cancer development. Cigarette smoking is a promoting factor and a carcinogen. Daily exercise and vitamins alone will not prevent cancer. Surgery at this stage may not be possible without a critical mass of cells, and this advice would not be consistent with the nurse's role.

Your patient's blood glucose level is 215 mg/dL. The patient is about to eat lunch. Per sliding scale, you administer 4 units of Insulin Lispro (Humalog) subcutaneously at 1130. As the nurse, you know the patient is most at risk for hypoglycemia at what time? A. 1145 B. 1230 C. 1430 D. 1630

B ( If you gave the Lispro at 1130, the patient is at most risk for hypoglycemia 1 hour after administration, which is 1230.)

Which statement by the COPD patient indicates that the nurse's teaching about nutrition has been effective? a. "I will drink lots of fluids with my meals." b. "I will have ice cream as a snack every day." c. "I should exercise for 15 minutes before meals." d. "I should avoid much meat or dairy products."

B (High-calorie foods like ice cream are an appropriate snack for patients with COPD. Fluid intake of 3 L/day is recommended, but fluids should be taken between meals rather than with meals to improve oral intake of solid foods. The patient should avoid exercise for an hour before meals to prevent fatigue while eating. Meat and dairy products are high in protein and are good choices for the patient with COPD.)

Which patient with type 1 diabetes mellitus would be at the highest risk for developing hypoglycemic unawareness? a. A 58-year-old patient with diabetic retinopathy b. A 73-year-old patient who takes propranolol (Inderal) c. A 19-year-old patient who is on the school track team d. A 24-year-old patient with a hemoglobin A1C of 8.9%

B (Hypoglycemic unawareness is a condition in which a person does not experience the warning signs and symptoms of hypoglycemia until the person becomes incoherent and combative or loses consciousness. Hypoglycemic awareness is related to autonomic neuropathy of diabetes that interferes with the secretion of counterregulatory hormones that produce these symptoms. Older patients and patients who use â-adrenergic blockers (e.g., propranolol) are at risk for hypoglycemic unawareness.)

Regular insulin is prescribed for a child diagnosed with type 1 diabetes mellitus. The nurse is planning a teaching session with the child and mother about the onset, peak, and duration times of the insulin. Which information should the nurse provide about this type of insulin? A. Onset of 1 hour from injection time, peak of 30 to 90 minutes later, and duration time of 5 hours B. Onset of 30 minutes from injection time, peak of 2 to 4 hours later, and duration time of 4 to 8 hours C. Onset of 2 to 6 hours from injection time, peak of 4 to 14 hours later, and duration time of 14 to 20 hours D. Onset of 6 to 14 hours from injection time, peak of 10 to 16 hours later, and duration time of 20 to 24 hours

B (Regular insulin has an onset of action of 30 minutes from injection time, peak action of 2 to 4 hours later, and a duration time of 4 to 8 hours. Therefore, the remaining options are incorrect.)

The nurse has provided dietary instructions to a client with coronary artery disease. Which statement by the client indicates an understanding of the dietary instructions? A. "I'll need to become a strict vegetarian." B. "I should use polyunsaturated oils in my diet." C. "I need to substitute eggs and whole milk for meat." D. "I should eliminate all cholesterol and fat from my diet."

B The client with coronary artery disease should avoid foods high in saturated fat and cholesterol such as eggs, whole milk, and red meat. The use of polyunsaturated oils is recommended to control hypercholesterolemia.

Which of the following could cause an increase in prothrombin time? A. alcohol B. cabbage C. cranberry juice D. grapefruit

B has vitamin K in it

A nurse is teaching a client who is undergoing cancer treatment about interventions to manage stomatitis. Which of the following statements by the client indicates understanding of the teaching? A. "I will try chewing larger pieces of food." B. "I will avoid toasting my bread." C. "I will consume more food in the morning." D. "I will add more citrus foods to my diet."

B Dry, coarse foods such as toast can worsen the manifestations of stomatitis.

When providing community health care teaching regarding the early warning signs of Alzheimer's disease, which signs should the nurse advise family members to report (select all that apply)? A) Misplacing car keys B) Losing sense of time C) Difficulty performing familiar tasks D) Problems with performing basic calculations E) Becoming lost in a usually familiar environment

B, C, D, E

The nurse is conducting a community health education class on diet and cancer risk reduction. What should be included in the discussion? Select all the apply. A. Limit sodium intake. B. Avoid beef and processed meats. C. Increase consumption of whole grains. D. Eat "colorful fruits and vegetables," including greens. E. Avoid gas-producing vegetables such as cabbage.

B, D Eating cruciferous vegetables such as broccoli, cauliflower, brussels sprouts, and cabbage may reduce cancer risk.

Which of the following foods would the RN exclude when teaching about a Mediterranean diet? Select all that apply A. feta cheese B. pork C. fish D. white pasta with margarine E. strawberries

B, D no red meat, no processed foods

A nurse is conducting teaching with a client regarding nutrition therapy for gastroparesis. Does the nurse know the teaching is successful when the client states that the following are ways to increase nutrition? (Select 3 that apply.) a. Lay down for 1 to 2 hours after eating b. Chew foods thoroughly c. Control blood glucose levels for all patients not just those with diabetes d. Consume fats in liquids if fat in solids is not tolerated e. Consume smaller, more frequent meals f. Be sure to eat only 3 large meals a day with no snacks in between

B, D, E

A nurse is talking with a client who has a new diagnosis of diabetes mellitus type 2 and their caregiver. Which of the following sweeteners should the nurse include as a zero calorie sweetener option? (Select all that applies) A. Sucrose B. Aspartame C. Mannitol D. Xylitol E. Sucralose

B, E

A nurse is talking with a client who has a new diagnosis of diabetes mellitus type 2 and their caregiver. Which of the following sweeteners should the nurse include as a zero-calorie sweetener option? (Select all that apply) A. Sucrose B. Aspartame C. Mannitol D. Xylitol E. Sucralose

B, E

The nurse is teaching a client about lifestyle approaches to reduce serum cholesterol. Which of the following statements could the nurse make about diet and cholesterol? (Select all that apply.) a. Decrease intake of soluble fiber. b. Exercise helps reduce total serum cholesterol. c. Increase intake of cholesterol. d. Reduce intake of monounsaturated fats. e. Reduce intake of saturated fats. f. Weight loss has no effect on serum cholesterol levels.

B, E

A nurse is teaching a group of clients who have diabetes about meal planning. Which of the following client statements indicated understanding? A. "I will avoid having snacks." B. "I should not eat anything containing sugar." C. "I will not eat fruit canned in syrup." D. "I will not eat more than 2,800 mg of sodium a day."

C

A nurse is teaching a group of clients who have diabetes about meal planning. Which of the following client statements indicates understanding? A. "I will avoid having snacks." B. "I should not eat anything containing sugar." C. "I will not eat fruit canned in syrup." D. "I will not eat more than 2,800 mg of sodium a day."

C

A patient experienced a myocardial infarction four weeks ago and is currently participating in the daily cardiac rehabilitation sessions at the local fitness center. In what level of prevention is the patient participating? A. Primary Prevention B. Secondary Prevention C. Tertiary Prevention D. Quaternary Prevention

C

A patient with type 1 diabetes calls the clinic with complaints of nausea, vomiting, and diarrhea. It is most important that the nurse advise the patient to: A. Hold the regular dose of insulin. B. Drink cool fluids with high glucose content. C. Check the blood glucose level every 2 to 4 hours. D. Use a less strenuous form of exercise than usual until the illness resolves.

C

A patient, who is admitted with diabetes mellitus, has a glucose level of 380 mg/dL and a moderate level of ketones in the urine. As the nurse assesses for signs of ketoacidosis, which respiratory pattern would the nurse expect to find? a. Central apnea b. Hypoventilation c. Kussmaul respirations d. Cheyne-Stokes respirations

C

After explaining to the client that a fat-controlled diet is necessary to help alleviate the client's high cholesterol levels, the client asks the nurse to provide an example of a breakfast that would satisfy all with the fat restriction. Which of the following would be an appropriate example of a breakfast for the nurse to give the client? a. cereal, two slices of whole-wheat toast with one tablespoon of butter on each, two slices of bacon, and orange juice b. egg and cheese sandwich on a croissant with a glass of 2% milk and hash browns c. egg-white omelet with broccoli, a plain bagel with a tablespoon of honey, two slices of cantaloupe, and a cup of coffee with fat-free milk d. sausage gravy on two biscuits, an orange, and a glass of 100% cranberry juice

C

Patients diagnosed with lung cancer should avoid? A. selenium and vitamin D B. protein and vitamin K C. beta carotene and vitamin E D. calcium and vitamin B12

C

The newly diagnosed patient with type 2 diabetes has been prescribed metformin (Glucophage). What should the nurse tell the patient to best explain how this medication works? a. Increases insulin production from the pancreas. b. Slows the absorption of carbohydrate in the small intestine. c. Reduces glucose production by the liver and enhances insulin sensitivity. d. Increases insulin release from the pancreas, inhibits glucagon secretion, and decreases gastric emptying.

C

The nursing instructor is teaching her students about the differences between ARF (Acute Respiratory Failure) and ARDS (Acute Respiratory Distress Syndrome). Which statement best describes this difference if made by the student? A. "ARF occurs in patients with chronic conditions while ARDS occurs in patients with trauma injuries" B. "They are almost the same thing except that ARDS is worse than ARF" C. "ARDS tends to occur up to a day or two after the initiating event, and unlike ARF requires mechanical ventilation to maintain oxygen status" D. "ARF is a disorder that mostly affects the breathing pattern while ARDS mostly affects the gas exchange by blocking the alveoli with fluid"

C

A client newly diagnosed with type 1 diabetes mellitus exercises daily. When teaching this client about medication therapy, the nurse tells the client to inject the daily dose of insulin in which location? A. In any site, but after exercise B. Only in the arm before exercise C. In a site that will not be exercised D. Only in the abdomen before exercise

C (Exercise of a body part increases the rate of absorption of the insulin from that site. For this reason, the client should inject insulin into an area that will not be exercised. This will help the client to avoid hypoglycemia from rapid insulin absorption.)

When evaluating a patient's knowledge regarding a low-sodium, low-fat cardiac diet, the nurse recognizes additional teaching is needed when the patient selects which food? A. Baked flounder B. Angel food cake C. Baked potato with margarine D. Canned chicken noodle soup

D Canned soups are very high in sodium content. Patients need to be taught to read food labels for sodium and fat content.

The nurse is teaching the client about insulin glargine. Which client statement indicates that the client has correct understanding of the medication? A. "This medication can be added to my insulin pump." B. "I plan to take this medication 30 minutes before each meal." C. "I will administer this medication once each night before bed." D. "I'll monitor my blood glucose levels at least every other day."

C (Insulin glargine is a modified human insulin with a prolonged duration of action. According to package labeling, the daily injection should be made at bedtime.

The patient received regular insulin 10 units subcutaneously at 8:30 PM for a blood glucose level of 253 mg/dL. The nurse plans to monitor this patient for signs of hypoglycemia at which time related to the insulin's peak action? a. 8:40 PM to 9:00 PM b. 11:30 PM c. 10:30 PM to 1:30 AM d. 12:30 AM to 8:30 AM

C (Regular insulin exerts peak action in 2 to 5 hours, making the patient most at risk for hypoglycemia between 10:30 PM and 1:30 AM)

A 65-year-old patient with type 2 diabetes has a urinary tract infection (UTI). The unlicensed assistive personnel (UAP) reported to the nurse that the patient's blood glucose is 642 mg/dL and the patient is hard to arouse. When the nurse assesses the urine, there are no ketones present. What collaborative care should the nurse expect for this patient? a. Routine insulin therapy and exercise b. Administer a different antibiotic for the UTI. c. Cardiac monitoring to detect potassium changes d. Administer IV fluids rapidly to correct dehydration.

C (This patient has manifestations of hyperosmolar hyperglycemic syndrome (HHS). Cardiac monitoring will be needed because of the changes in the potassium level related to fluid and insulin therapy and the osmotic diuresis from the elevated serum glucose level)

A college student is newly diagnosed with type 1 diabetes. She now has a headache, changes in her vision, and is anxious, but does not have her portable blood glucose monitor with her. Which action should the campus nurse advise her to take? a. Eat a piece of pizza. b. Drink some diet pop. c. Eat 15 g of simple carbohydrates. d. Take an extra dose of rapid-acting insulin.

C (When the patient with type 1 diabetes is unsure about the meaning of the symptoms she is experiencing, she should treat herself for hypoglycemia to prevent seizures and coma from occurring.)

Which precaution is most important for the nurse to teach a client receiving radiation therapy for head and neck cancer? A. Avoid eating red meat during treatment. B. Pace your leisure activities to prevent fatigue. C. See your dentist twice yearly for the rest of your life. D. Avoid using headphones or headsets until your hair grows back.

C C. Radiation therapy that is directed in or around the oral cavity has a variety of actions that increase the risk for dental caries (cavities) and tooth decay. The salivary glands are affected, which changes the composition of the person's saliva and often causes "dry mouth."

Which statement made by the client regarding fish oil requires further teaching? A. "Fish oil can cause bleeding, so I will need to stop taking my supplements at least 5 days before my surgery." B. "I will make sure to monitor my glucose levels since fish oil can raise by blood sugar." C. "Fish oil can increase my levels of Vitamin E." D. "I will take my fish oil twice per week as directed by my doctor."

C fish oil decreases vitamin E levels

The nurse is teaching a women's group about prevention of hypertension. What information should be included in the teaching for all the women (select all that apply)? A. Lose weight. B. Limit nuts and seeds. C. Limit sodium and fat intake. D. Increase fruits and vegetables. E. Exercise 30 minutes most days.

C, D, E Primary prevention of hypertension is to make lifestyle modifications that prevent or delay the increase in blood pressure (BP). Along with exercise for 30 minutes on most days, the dietary approaches to stop hypertension (DASH) eating plan is a healthy way to lower BP by limiting sodium and fat intake, increasing fruits and vegetables, and increasing nutrients that are associated with lowering BP. Weight loss may or may not be necessary for the individual. Nuts and seeds and dried beans are used for protein intake.

The nurse is caring for a patient suffering from anorexia secondary to chemotherapy. Which strategy would be most appropriate to increase the patient's nutritional intake? a. Increase intake of liquids at mealtime to stimulate the appetite. b. Serve three large meals per day plus snacks between each meal. c. Avoid the use of liquid protein supplements to encourage eating at mealtimes. d. Add items such as skim milk powder, cheese, honey, or peanut butter to selected foods.

D The nurse can increase the nutritional density of foods by adding items high in protein and/or calories (e.g., peanut butter, skim milk powder, cheese, honey, brown sugar) to foods the patient will eat. Increasing fluid intake at mealtime fills the stomach with fluid and decreases the desire to eat. Small frequent meals are best tolerated. Supplements can be helpful.

A client diagnosed with widespread lung cancer asks the nurse why he must be careful to avoid crowds and people who are ill. What is the nurse's best response? A. "With lung cancer, you are more likely to develop pneumonia and could pass this on to other people who are already ill." B. "When lung cancer is in the bones, it becomes a bone marrow malignancy, which stops producing immune system cells." C. "The large amount of mucus produced by the cancer cells is a good breeding ground for bacteria and other microorganisms." D. "When lung cancer is in the bones, it can prevent production of immune system cells, making you less resistant to infection."

D

A client is admitted to the visiting nurse service for assessment and follow-up after being discharged from the hospital with new-onset heart failure (HF). The nurse teaches the client about the dietary restrictions required with HF. Which statement by the client indicates that further teaching is needed? A. "I'm not supposed to eat cold cuts." B. "I can have most fresh fruits and vegetables." C. "I'm going to weigh myself daily to be sure I don't gain too much fluid." D. "I'm going to have a ham and cheese sandwich and potato chips for lunch."

D

A client tells the nurse that he is experiencing some leg stiffness when walking and slowness when performing ADLs. Occasionally he has noted slight tremors in his hands at rest. This in-formation leads the nurse to suspect a. amyotrophic lateral sclerosis (ALS). b. Huntington's disease. c. myasthenia gravis (MG). d. Parkinson's disease (PD).

D

A nurse is assessing a female client with multiple trauma who is at risk for developing acute respiratory distress syndrome. The nurse assesses for which earliest sign of acute respiratory distress syndrome? A. Bilateral wheezing B. Inspiratory Crackles C. Intercostal retractions D. Increased respiratory rate

D

A nurse is caring for a client who is prescribed warfarin. The nurse should teach the client that which of the following vitamins can interfere with this medication? A. Vitamin A B. Vitamin D C. Vitamin E D. Vitamin K

D

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. 1 cup steamed long‑grain brown rice B. 6 medium raw strawberries C. ½ cup boiled Brussels sprouts D. 2 large, poached eggs

D

A nurse is educating a prediabetic client about the Mediterranean diet. Which of the following statements indicates that the teaching was successful? A. "On this diet, I can consume wine instead of beer with no limits" B. "I can still eat pizza each day because of the cheese, meat, and vegetables for my toppings" C. "With this diet, a 12 oz steak is still a viable dinner option" D. "This diet will likely minimize my waistline"

D

Selenium is especially important for which of the following conditions? A. Cancer B. Hypertension C. Addison's disease D. COPD

D

Sugar should be limited for especially what disease? A. Guillain-Barré Syndrome B. Multiple Sclerosis C. Myasthenia Gravis D. Huntington's Disease

D

The client is being evaluated to rule out ALS. Which signs/symptoms would the nurse note to confirm the diagnosis? A. Muscle atrophy and flaccidity. B. Fatigue and malnutrition. C. Slurred speech and dysphagia. D. Weakness and paralysis.

D

The nurse caring for a client diagnosed with Parkinson's disease writes a problem of"impaired nutrition." Which nursing intervention would be included in the plan of care? A. Consult the occupational therapist for adaptive appliances for eating. B. Request a low-fat, low-sodium diet from the dietary department. C. Provide three (3) meals per day that include nuts and whole-grain breads. D. Offer six (6) meals per day with a soft consistency.

D

The nurse caring for a patient hospitalized with diabetes mellitus would look for which laboratory test result to obtain information on the patient's past glucose control? a. Prealbumin level b. Urine ketone level c. Fasting glucose level d. Glycosylated hemoglobin level

D

The nurse instructs a 68-yr-old woman with hypercholesterolemia about natural lipid-lowering therapies. The nurse determines further teaching is necessary if the patient makes which statement? A. "Omega-3 fatty acids are helpful in reducing triglyceride levels." B. "I should check with my physician before I start taking any herbal products." C. "Herbal products do not go through as extensive testing as prescription drugs do." D. "I will take garlic instead of my prescription medication to reduce my cholesterol."

D

The nurse is discussing dietary changes for a client with chronic obstructive pulmonary disease. Which advice should the nurse​ include? A. Follow a​ high-carbohydrate diet. B. Restrict fluids. C. Increase dairy products. D. Follow a​ low-salt diet.

D

The nurse is teaching a patient with type 2 diabetes mellitus about exercise to help control his blood glucose. The nurse knows the patient understands when the patient elicits which exercise plan? a. "I want to go fishing for 30 minutes each day; I will drink fluids and wear sunscreen." b. "I will go running each day when my blood sugar is too high to bring it back to normal." c. "I will plan to keep my job as a teacher because I get a lot of exercise every school day." d. "I will take a brisk 30-minute walk 5 days per week and do resistance training 3 times a week."

D

The client is prescribed insulin lispro 3 times a day with the amount based on blood glucose levels. Which client statement should indicate to the nurse that the client understood discharge teaching regarding insulin lispro? A. "The medication should be administered 1 hour after each meal." B. "I should spread the 3 daily doses evenly throughout the 24-hour day." C. "Lispro should be taken at least 1 hour before each of my 3 daily meals." D. "I will take the lispro 10 to 15 minutes before I eat my daily three meals."

D (Lispro is a rapid-acting insulin analog with an onset of action of 15 minutes. The client should administer the dose 10 to 15 minutes before eating a meal. )

Patients may be deficient in which vitamin during the winter months? A. A B. B C. C D. D

D (The body can synthesize vitamin D from a cholesterol compound in the skin when exposed to adequate sunlight. People at risk for vitamin D deficiency are those who spend little time outdoors; older people; and people who live in an institution (e.g., a nursing home). The deficiency can also occur in the winter)

A client receiving Vitamin K MOST likely has which abnormal clinical finding? A. Diarrhea B. Seizure activity C. Sudden severe confusion D. Altered coagulation studies

D (Vitamin K is an essential nutrient for the synthesis of clotting factors, which takes place in the liver. It is also the antidote for warfarin (Coumadin), an oral anticoagulant. The administration of vitamin K enhances the coagulation process, thus minimizing a patient's risk for excessive bleeding.)

The nurse is caring for a client with a diagnosis of myocardial infarction (MI) and is assisting the client in completing the diet menu. Which beverage should the nurse instruct the client to select from the menu? A. Tea B. Cola C. Coffee D. Raspberry juice

D A client with a diagnosis of MI should not consume caffeinated beverages. Caffeinated products can produce a vasoconstrictive effect, leading to further cardiac ischemia, so Coffee, tea, and cola all contain caffeine and need to be avoided in the client with MI.

A 64-yr-old male patient who is receiving radiation to the head and neck as treatment for an invasive malignant tumor complains of mouth sores and pain. Which intervention should the nurse add to the plan of care? a. Provide ice chips to soothe the irritation. b. Weigh the patient every month to monitor for weight loss. c. Cleanse the mouth every 2 to 4 hours with hydrogen peroxide. d. Provide high-protein and high-calorie, soft foods every 2 hours.

D A patient with stomatitis should have soft, nonirritating foods offered frequently. The diet should be high in protein and high in calories to aid healing

The nurse is caring for a patient suffering from anorexia secondary to chemotherapy. Which of the following strategies would be most appropriate for the nurse to use to increase the patient's nutritional intake? A. Increase intake of liquids at mealtime to stimulate the appetite. B. Serve three large meals per day plus snacks between each meal. C. Avoid the use of liquid protein supplements to encourage eating at mealtime. D. Add items such as skim milk powder, cheese, honey, or peanut butter to selected foods.

D D. The nurse can increase the nutritional density of foods by adding items high in protein and/or calories (such as peanut butter, skim milk powder, cheese, honey, or brown sugar) to foods the patient will eat.

For a male client who has acquired immunodeficiency syndrome with chronic diarrhea, anorexia, a history of oral candidiasis, and weight loss, which dietary instruction would be included in the teaching plan? A. "Follow a low-protein, high-carbohydrate diet." B. "Eat three large meals per day." C. "Include unpasteurized dairy products in the diet." D. "Follow a high-protein, high-calorie diet.

D Dietary instructions should include the need for a high-protein, high-calorie diet. The patient should be taught to eat small, frequent meals and include low-microbial foods, such as pasteurized dairy products, washed and peeled fruits and vegetables, and well-cooked meats.

A nurse is teaching a client about dietary recommendations to lower high blood pressure. Which of the following statements indicates an understanding of the teaching? A. "My daily sodium consumption should be 3,000 milligrams" B. "I should consume foods low in potassium" C. "My limit is three cigarettes a day" D. "I should consume low-fat dairy products"

D low fat dairy products promote calcium intake → lowers BP and cholesterol

A nurse is developing a teaching plan for a client taking insulin? Which of the following foods should the client carry with him as a minor snack to help treat hypoglycemia? A. Crackers B. Almonds C. White Chocolate D. Life Saver candy

D. (Although chocolate does contain sugar, it also provides a substantial amount of fat that can delay the absorption of sugar. The best choices for treating hypoglycemia are absorbable pure sugars including soft drinks, fruit juices, or lifesavers. Almonds and crackers do not contain simple sugars)

The acceptable macronutrient distribution range for carbohydrates is a. 20-30% of cal b. 45-65% of cal c. 10-25% of cal d. 30-45% of cal AMDR (acceptable macronutrient distribution range) for fats is a. 20-30% of cal b. 45-65% of cal c.35-45% of cal d. 20-35% of cal AMDR (acceptable macronutrient distribution range) for protein is a. 10-35% of cal b.20-35% of cal c. 15-25% of cal d. 35-45% of cal

The acceptable macronutrient distribution range for carbohydrates is a. 20-30% of cal b. 45-65% of cal c. 10-25% of cal d. 30-45% of cal AMDR (acceptable macronutrient distribution range) for fats is a. 20-30% of cal b. 45-65% of cal c.35-45% of cal d. 20-35% of cal AMDR (acceptable macronutrient distribution range) for protein is a. 10-35% of cal b. 20-35% of cal c. 15-25% of cal d. 35-45% of cal