Prepu Questions: Nutrition
A dietary modification for a patient with Ménière's disease would be:
A decrease in sodium intake to 2,000 mg daily. explanation: Patients with Ménière's disease can be successfully treated by adhering to a low-sodium (2000 mg/day) diet, with no caffeine and alcohol.
Which nursing student statement regarding vegetarian diets requires further teaching from the nursing instructor?
"According to research, vegetarians have a higher incidence of obesity than others." explanation: Vegetarians have a lower incidence of colorectal cancer and fewer problems with obesity and diseases associated with a high-fat diet. Protein complementation helps a client get amino acids needed. Vegans rely solely on plant sources for protein; semi-vegetarians exclude only red meat from their diet.
The nurse is providing education about nutrition and feeding to the parent of a toddler. Which statement by the child's parent indicates understanding of the education?
"Boiled eggs and pieces of cheese are good snacks for my child." explanation: Toddlers are often independent and insist on feeding themselves. Appropriate "finger foods" include meatballs, hard-boiled eggs, cooked carrots, fruit slices (without skins), cheese pieces, dry cereal, and crackers. Avoid whole grapes, hot dogs, hard candy, and other foods that could cause choking.
A client tells the nurse, "As long as I only eat 2,400 calories per day, it does not matter which foods I eat." Which response by the nurse is best?
"Can you share an example of what you ate yesterday?" explanation: Healthy adult client on average require 1,800 to 2,400 cal/day. Unless the caloric intake includes an appropriate mix of proteins, carbohydrates, and fats, the person may be marginally nourished or malnourished. In other words, consuming 2,400 calories of chocolate, exclusive of any other food, is not adequate to sustain a healthy state. By asking the client for an example of the foods eaten, the nurse can help the client plan effectively. It is important to teach clients about healthy nutrition, so this response is most appropriate. The other responses from the nurse are not correct.
A nurse is providing care for a pregnant 16-year-old client. The client says that she is concerned she may gain too much weight and wants to start dieting. What information will the nurse provide the client as most accurate about nutrition and pregnancy?
"Good nutrition supports the changes in your body and fetal growth and development." explanation: It is important that a pregnant woman gains weight in a gradual and steady manner throughout the pregnancy. The amount of weight the woman gains is not as important as what she eats. A woman can lose the extra weight after pregnancy, but she can never make up for the effects of poor nutrition on her body and the developing fetus. The recommendation for weight gain based on a normal weight woman is 25-35 pounds. Calories do not have to be increased to increase fetal weight. The client needs adequate intake of protein, vegetables, carbohydrates, and dairy. Prenatal vitamins are a supplement to this. Dieting does not induce premature labor, but if the fetus is premature and the mother has not had good nutrition, the fetus is at greater risk. The nurse also needs to take into account with this adolescent the amount of fast food intake with high sodium content.
The nurse is caring for a 13-year-old girl. The child has been identified as overweight with no underlying psychological or secondary causes. The nurse is reviewing the child's weight-loss progress and nutrition at a follow-up visit. What finding indicates a need for further discussion and teaching?
"Her goal is to be a size smaller by our vacation in two weeks." explanation: The mother must be reminded that a successful weight loss program emphasizes long-term permanent changes, not rapid weight loss or short-term diets to meet a short-term goal.
A nurse has just inserted a nasogastric tube in a client. Which method is most reliable for verifying the correct placement of the tube?
Radiographic confirmation of position explanation: Radiographic (x-ray) examination is the only absolutely reliable method to determine accurate tube placement. In the absence of an x-ray, pH testing is predicative of correct placement. Although visualization of aspirated contents can help confirm correct placement of the tube, this method is not as reliable as an x-ray.
A nurse is caring for a client who has a malabsorption disease. The nurse should understand that which structure in the gastrointestinal system absorbs the majority of digested food and minerals?
Small intestine explanation: Most absorption of digested food and minerals occurs in the small intestines. The stomach is responsible for storing food, secreting digestive enzymes, and digestion. The large intestine forms feces and absorbs water to regulate the consistency of stool. The digestive function of the liver is the production of bile.
The nurse is caring for a client who refuses most foods on the dietary tray. Which nursing intervention is appropriate?
Assess when client generally eats meals. explanation: There are many reasons a client may refuse food that is served. The nurse should assess for food preferences, when the client generally eats, whether the client has digestive concerns, and cultural beliefs about foods. Leaving the client alone to eat, or simply delegating feeding, does not encourage intake. The client does not need an appetite stimulant until a full assessment has been conducted and other interventions have been implemented.
A client aged 83 years who has suffered a cerebrovascular accident and is unable to swallow refuses the insertion of a feeding tube. The nurse communicates the client's wish to the family and health care team. This is an example of what ethical principle?
Autonomy explanation: Autonomy is the ethical principle of respecting the right of clients to make their own decisions about their health care. Nonmaleficence refers to preventing or not causing harm to clients. Veracity refers to telling the truth. Justice refers to fairness and treating clients with equal dignity.
A client is placed on a low-sodium (500 mg/day) diet. Which client statement indicates that the nurse's nutrition teaching plan has been effective?
"I chose broiled chicken with a baked potato for dinner." explanation: The client's choice of a baked potato with broiled chicken indicates effective nutrition teaching because potatoes and chicken are relatively low in sodium. Ham, sardines, and bouillon are extremely high in sodium and shouldn't be included in a low-sodium diet.
The nurse collaborates with the physician and dietician to determine the best type of tube feeding for a client at risk for diarrhea due to hypertonic feeding solutions. Which type of feedings should the nurse suggest?
continuous feedings explanation: Continuous feedings should be administered to a client who is at risk of diarrhea due to hypertonic feeding solutions. Bolus or intermittent feedings cause sudden distention of the small intestine, and cyclic feedings are not advised.
A client is discussing weight loss with a nurse. The client says, "I will diet 5 days a week and eat whatever I want on the weekends." Which teaching should the nurse provide the client based on this statement?
"To lose weight, your caloric intake must be less than the number of calories burned through exercise on a daily basis." explanation: Most nutritionists agree that fasting or following a very low-calorie diet defeats a weight loss plan because the body interprets this eating pattern as starvation and compensates by slowing down the basal metabolic rate, making it even more difficult to lose weight. The nurse should have thorough knowledge of this and make statements that reflect the correct information. Most people do not find that fasting or following a very low-calorie diet is successful. To lose weight, the client's caloric intake must be less than the number of calories burned through exercise each day.
The nurse is teaching the caregiver of a toddler about the importance of calcium to help the toddler's teeth and bones develop properly. Which client statement reflects that nursing teaching has been effective?
"Vitamin D helps calcium absorption." explanation: Adequate amounts of vitamin D, parathyroid hormone, ascorbic acid, lactose, several other amino acids, and physical activity assist in calcium absorption. Inadequate amounts of vitamin D, insufficient exposure to sunlight, decreased amounts of ascorbic acid, decreased physical activity, and emotional stress may decrease calcium absorption.
A nurse is admitting a client to the unit. Which cultural question is most appropriate?
"What are your dietary needs and preferences?" explanation: By asking about dietary needs and preferences, the nurse can gain insight into religious and cultural dietary practices. Asking about "normal" foods assumes that a cultural dietary request is abnormal. The other options will produce limited insight and imply that a cultural dietary need is a restriction or hindrance.
What type of feedings should be administered to a client who is at risk of diarrhea due to hypertonic feeding solutions?
continuous feedings explanation: Continuous feedings should be administered to a client who is at risk of diarrhea due to hypertonic feeding solutions. Bolus or intermittent feedings cause sudden distention of the small intestine, and cyclic feedings are not advised.
Which of the following is a fat-soluble vitamin?
vitamin E explanation: Vitamins A, D, E, and K
The nurse is teaching the pregnant woman about nutrition for herself and her baby. Which statement by the woman indicates that the teaching was effective?
"I will need to take iron supplementation throughout my pregnancy even if I am not anemic." explanation: Iron is recommended for all pregnant women because it is almost impossible for the pregnant woman to get what is required from diet alone, especially after 20 weeks' gestation when the requirements of the fetus increase. Pregnant women can get many nutrients from seafood including phosphorus, but there are specific recommendations about types of fish to avoid because of the risk of mercury poisoning. Milk production actually requires higher levels of zinc, which can be obtained from a healthy diet. Calcium requirements do not increase above prepregnancy levels during pregnancy because calcium absorption is enhanced during pregnancy. It can be unsafe for the pregnant woman to eat anything she wants and gain too much weight. A woman who gains too much weight during pregnancy is at risk for delivering a macrosomic baby.
The nursing educator has completed an educational program for new nurses on eating disorders in teenagers. Which statement by a participant would indicate a need for further education?
"If they refuse to eat, we need to sit with them and not let them leave the table until they do eat something." explanation: Withdraw attention if the child refuses to eat: secondary gain is minimized if refusal to eat is ignored rather than with continuous attention. Mutually establish a contract related to treatment to promote the child's sense of control. Provide mealtime structure, as clear limits let the child know what the expectations are. Provide continuous supervision during the meal and for 30 minutes following it so that the child cannot conceal or dispose of food or induce vomiting.
A nurse is planning a high-energy diet for a client. Which statement by the nurse best describes the types of foods the client should include in the diet?
"Include plenty of grains, fruits, and vegetables in your diet." explanation: Carbohydrates (grains, fruit, and vegetables) provide high energy. Water, vitamins (such as vitamin C), and minerals (such as iron) are all necessary for a healthy diet, but none of the three provides energy.
A nurse is providing dietary instructions to a client with a history of pancreatitis. Which instruction is correct?
"Maintain a high-carbohydrate, low-fat diet." explanation: A client with a history of pancreatitis should avoid foods and beverages that stimulate the pancreas, such as fatty foods, caffeine, and gas-forming foods; should avoid eating large meals; and should eat plenty of carbohydrates, which are easily metabolized. Therefore, the only correct instruction is to maintain a high-carbohydrate, low-fat diet. An increased sodium or fluid intake isn't necessary because chronic pancreatitis isn't associated with hyponatremia or fluid loss.
In discussing the causes of iron-deficiency anemia in children with a group of nurses, the following statements are made. Which of these statements is a misconception related to iron-deficiency anemia?
"Milk is a perfect food, and babies should be able to have all the milk they want." explanation: Babies with an inordinate fondness for milk can take in an astonishing amount and, with their appetites satisfied, may show little interest in solid foods. These babies are prime candidates for iron-deficiency anemia. Many children with iron-deficiency anemia, however, are undernourished because of the family's economic problems. A caregiver's knowledge deficit about nutrition is often present. Because only 10 percent of dietary iron is absorbed, a diet containing 8 to 10 mg of iron is needed for good health. During the first years of life, obtaining this quantity of iron from food is often difficult for a child. If the diet is inadequate, anemia quickly results.
A nursing student is teaching healthy nutrition to a client who is vegetarian. Which statement by the nursing student requires the nursing instructor to intervene?
"Obesity is closely linked with vegetarianism." explanation: Vegetarians have a lower incidence of colorectal cancer and fewer problems with obesity and diseases associated with a high-fat diet. Protein complementation involves eating a variety of incomplete plant proteins over the course of the day to provide adequate amounts and proportions of all the essential amino acids present in animal protein sources. Vegans rely solely on plant sources for protein; semi-vegetarians exclude only red meat from their diet. Obesity is not linked with vegetarianism.
The parents of a client with cystic fibrosis ask the nurse why supplemental pancreatic enzymes are needed. What is the best response by the nurse?
"Pancreatic enzymes promote absorption of nutrients and fat." explanation: Pancreatic enzymes are given to a client with cystic fibrosis to aid digestion of fat and protein. The enzymes do not decrease mucus accumulation or constipation, nor do they help with the movement of waste products.
A client is discussing vitamin and mineral intake with the nurse. Which client statement requires nursing intervention?
"Taking megadoses of vitamins will help me increase muscle mass quickly." explanation: Consuming megadoses of vitamins and minerals can be dangerous, so this statement requires intervention. The nurse should find out the type and dose of vitamins that the client takes. The other statements do not require intervention.
A client returns to the postnatal ward with her 3-week-old infant. Which statement by the client would prompt the nurse to evaluate the infant for inadequate intake?
"The baby does not exhibit a steady weight gain." explanation: Newborns differ in their feeding needs and preferences. Most breastfed babies need to be fed every 2-3 hours, nursing for 10-20 minutes on each breast. Formula-fed babies usually feed every 3-4 hours, finishing a bottle in 30 minutes or less. Weight gain is the best measure of the infant receiving adequate nutrition. If the newborn seems satisfied, wets 6-10 diapers per day, produces several stools a day, sleeps well, and is gaining weight regularly, then the baby is receiving adequate fluid intake and nutrition. Newborns swallow air during feeding, which can cause fussiness and discomfort. They should be burped several times throughout the feeding. The amount of burping does not relate to weight gain.
What is the body mass index (BMI) of a client who is 1.68 meters tall and weighs 70 kg?
24.8 explanation: A BMI of 24.8 is correct. The BMI is the ratio of height to weight that more accurately reflects total body fat stores in the general population. To calculate the BMI: divide the weight in kilograms (kg) by the height in meters (m) then divide the answer by the height again to get the BMI.
A nurse is caring for an adult client who ate a chicken breast and drank a glass of water. There are 60 grams of protein in the chicken breast. Calculate the energy intake, in kilocalories, for this food. Record your answer using a whole number.
240 explanation: To calculate total energy intake for a protein, multiply the total grams of the protein and multiply it times 4 kilocalories.
A nurse has completed tube feeding a client on a long-term care unit. How long should the nurse keep the head of the bed elevated after completion of the tube feeding?
60 minutes explanation: The head of the bed should stay elevated at least 1 hour following tube feeding to prevent back flow and possible aspiration of the formula into the lungs.
The nurse has obtained a client's capillary blood glucose sample and the results are significantly lower than reference range. What is the nurse's priority action?
Assess the client for signs and symptoms of hypoglycemia explanation: Low blood sugars should prompt the nurse to assess for signs and symptoms of hypoglycemia. There may or may not be a need to contact the primary care provider depending on whether a protocol is in place and the client's clinical presentation. There is not normally a need to obtain a sample from the opposite hand.
A nurse is caring for a client who has a nursing diagnosis of Risk for Aspiration. When preparing to assist this client with eating, how can the nurse best reduce this risk?
Assess the client's level of consciousness. explanation: Decreased level of consciousness greatly increases a client's risk of aspirating; it is imperative that the nurse assess this prior to the client eating. It is appropriate for the nurse to assess the client's mouth and abdomen and assess for nausea, but none of these actions directly address the client's risk of aspiration.
A nurse is teaching a client about diabetes and glucose monitoring. What should the nurse include in the teaching?
Blood from the fingertips shows changes in glucose more quickly than other testing sites. explanation: With glucose monitoring, blood from the fingertips shows changes in blood glucose more quickly than other testing sites. With signs and symptoms of hypoglycemia, a fingertip site should be used. Calibrate the glucose monitors at least every month. Glucose levels increase with illness and stress to the body.
A client has had a stroke and will require long-term tube feeding. Which type of feeding tubes would be most appropriate for this client's needs?
Gastrostomy tube explanation: When enteral feeding is required for a long-term period, an enterostomal tube may be placed through an opening created into the stomach (gastrostomy) or into the jejunum (jejunostomy). NG, NI, and Salem Sump tubes will not meet a client's long-term nutritional needs.
Which nursing action associated with successful tube feedings follows recommended guidelines?
Check the residual before each feeding or every 4 to 6 hours during a continuous feeding. explanation: The nurse should check the residual before each feeding or every 4 to 6 hours during a continuous feeding. High gastric residual volumes (200 to 250 mL or greater) can be associated with high risk for aspiration and aspiration-related pneumonia. A closed system is the best way to prevent contamination during enteral feedings. The bowel sounds do not have to be assessed as often as 4 times per shift. Once a shift is sufficient. Food dye should not be added as a means to assess tube placement or potential aspiration of fluid.
Which is a correct rationale for encouraging a client with otitis externa to eat soft foods?
Chewing may cause discomfort explanation: The nurse encourages a client with otitis externa to eat soft foods or consume nourishing liquids because chewing may cause discomfort. Chewing will not react with the prescribed medications or cause complications such as otitis media and excessive drainage.
A nurse is caring for a client who has been ordered a clear liquid diet. Which liquid can be included in the client's diet?
Cranberry juice explanation: A clear liquid diet is composed only of clear fluids or foods that become fluid at body temperature. This includes clear broth, coffee, tea, clear fruit juices (apple, cranberry, grape), gelatin, popsicles, and commercially prepared clear liquid supplements. A clear liquid diet requires minimal digestion and leaves minimal residue. Low-fat milk, fruit juices or soup, and juices with fruit pulp (orange and grapefruit) are considered full-liquid diet.
A nurse is preparing to obtain a client's capillary blood sample for glucose testing. The nurse should perform which action?
Hold the lancet perpendicular to the skin and prick the site. explanation: Holding the lancet perpendicular to the skin facilitates proper skin penetration. The lancet should be prepared using aseptic technique, and bleeding should be encouraged by lowering the arm and making use of gravity. The drop of blood should be gently touched to the pad without smearing it.
Which is the primary symptom of achalasia?
Difficulty swallowing explanation: The primary symptom of achalasia is difficulty in swallowing both liquids and solids. The client may also report chest pain and heartburn that may or may not be associated with eating. Secondary pulmonary complications may result from aspiration of gastric contents.
An older adult client who has a BMI of 28.1 and gastroesophageal reflux disease (GERD) reports heartburn frequently. The nurse plans to teach the client how to manage and prevent heartburn. What information will the nurse include in the teaching for this client? Select all that apply.
Do not use products that contain nicotine, such as tobacco and vaping devices. Maintain a diet that is low in fat. Plan a nutritious diet that will allow you to lose weight. explanation: When teaching a client who has GERD, the nurse will include the following information: no smoking, a diet low in fat, and lose weight. Nicotine in tobacco and vaping products lower esophageal sphincter pressure, allowing reflux of stomach contents into the esophagus. Fat in the diet delays emptying of the stomach and increases the likelihood of reflux. Being overweight (a BMI greater than 25) increases intra-abdominal pressure, pushing gastric contents into the esophagus. The client is instructed to raise the head of the bed 30 to 40 degrees. This means placing the legs of the head of the bed on blocks. Using two pillows causes a bend in the neck. Pillows do not raise the level of the esophagus. The client is also instructed to avoid eating before bedtime. Again, eating before bedtime allows for reflux. Alcohol relaxes the lower esophageal sphincter pressure and increases the production of gastric acid. Both of these physiologic actions allow for reflux.
A nurse is working with a 46-year-old woman who is working to lose weight. Based on recommendations from the USDA regarding diet modification, which is not appropriate advice for this client?
Drink juice for majority of fluid intake . explanation: Water should comprise the majority of fluid intake. The remainder should come from food sources such as fruit or 100% fruit juices.
A nurse is working with a 46-year-old woman who is working to lose weight. Based on recommendations from the USDA regarding diet modification, which is not appropriate advice for this client?
Drink juice for majority of fluid intake. explanation: Water should comprise the majority of fluid intake. The remainder should come from food sources such as fruit or 100% fruit juices.
The average daily nutrient intake value estimated to meet the needs of 50% of healthy people in a selected age and gender group is:
EAR level explanation: The EAR level is the average dietary nutrient intake value estimated to meet the needs of 50% of healthy people in a selected age and gender group.
A nurse is managing a client's continuous tube feeding via an NG tube. How often should the nurse check for residual?
Every 4 to 6 hours explanation: Checking for residual before each feeding or every 4 to 6 hours during a continuous feeding according to institutional policy is implemented to identify delayed gastric emptying. Residuals are not measured immediately after a flush.
Which task may be safely delegated to unlicensed assistive personnel (UAP)?
Feeding a client who is at risk for aspiration explanation: Assisting clients to eat may be delegated to UAP. These care providers are normally educated in the risks posed by aspiration. UAP cannot insert or remove NG tubes and they cannot administer tube feedings.
Which nursing action is performed according to guidelines for aspirating fluid from a small-bore feeding tube?
If fluid is obtained when aspirating, measure its volume and pH and flush the tube with water. explanation: The nurse would measure the volume and pH of the aspirated fluid, then flush the tube with water. The nurse would not place the client in Trendelenburg position as this could lead to reflux of the feeding from the stomach and possibly cause aspiration of the solution into the lungs. The nurse would not use a small syringe or continue to instill air until fluid is aspirated.
A 47-year-old client has been admitted to the hospital after being found unconscious in a park. Upon regaining consciousness, the client admits to heavy alcohol use over many years. Assessment reveals a low body mass index, low electrolyte levels, and impaired skin integrity. Vital signs are within normal ranges. What nursing diagnosis should be prioritized in the care of this client?
Imbalanced nutrition: less than body requirements related to chronic alcohol intake explanation: High alcohol intake is associated with malnutrition, which can result in low electrolyte levels, low body mass index, and impaired skin integrity. This diagnosis is of more immediate concern than the client's coping, knowledge, or future risk for injury.
A 20-year-old man who is addicted to methamphetamines has been admitted to the hospital with a diagnosis of protein-calorie malnutrition after many months of inadequate food intake. Which treatment plan would the care team most likely favor?
Incremental feeding combined with vitamin and mineral supplementation explanation: Slow administration of protein and calories combined with mineral and vitamin supplementation is important in the treatment of protein-calorie malnutrition. Albumin transfusions and total parenteral feeding would likely not be necessary because the client has no noted swallowing or metabolic problems, and rapid administration of fluids and carbohydrates may precipitate congestive heart failure.
A client who is recovering from a stroke has begun tube feedings. Which principle should the nurse follow when administering the tube feeding?
Intermittent feedings use gravity for instillation or a feeding pump to administer the formula over a set period of time. explanation: Intermittent feedings are delivered at regular intervals, using gravity for instillation or a feeding pump to administer the formula over a set period of time. The steps for administering feedings are similar regardless of the tube used. Intermittent feedings are the preferred method of introducing the formula over a set period of time via gravity or pump. Feeding intolerance is less likely to occur with smaller volumes. Feeds are not warmed prior to instillation.
The nurse is caring for a client with an enlarged thyroid. What nutritional deficiency is linked to an enlarged thyroid?
Iodine explanation: A chronic deficiency of iodine can lead to endemic goiter. The major initial symptom is an enlarged thyroid gland.
The nurse is performing an assessment for a client with anemia admitted to the hospital to have blood transfusions administered. Why would the nurse need to include a nutritional assessment for this patient?
It may indicate deficiencies in essential nutrients explanation: A nutritional assessment is important, because it may indicate deficiencies in essential nutrients such as iron, vitamin B12, and folate.
Diet modifications for patient diagnosed with chronic inflammatory bowel disease include which of the following?
Low residue explanation: Oral fluids and a low-residue, high-protein, high-calorie diet with supplemental vitamin therapy and iron replacement are prescribed to meet the nutritional needs, reduce inflammation, and control pain and diarrhea.
Crohn disease not only affects adults but also can occur in children. The nurse assesses for which major manifestation in children with Crohn disease?
Malnutrition explanation: When Crohn disease occurs in children, one of the major manifestations may be retardation of growth and significant malnutrition.
A nurse gives a speech on nutrition to a group of pregnant women. Within the model of the communication process, what is the speech itself known as?
Message explanation: The message is the actual physiologic product of the source. It might be a speech, interview, conversation, chart, gesture, memorandum, or nursing note. This communication process is initiated based on a stimulus. The sender or source of the message is a person or group who initiates or begins the communication process. The channel of communication is the medium the sender has selected to send the message.
Vitamin D, officially classified as a vitamin, functions as a hormone in the body. What other hormone is necessary in the body for vitamin D to work?
Parathyroid hormone explanation: The small, but vital, amount of ECF calcium, phosphate, and magnesium is directly or indirectly regulated by vitamin D and parathyroid hormone.
A nurse is caring for a client with excessive abdominal fat. Which method should the nurse teach as the best strategy to use for healthy eating?
Plan meals using ChooseMyPlate. explanation: The client should eat various foods that are high in nutrient value and low in saturated and trans fats, cholesterol, added sugars, and salt. Several small meals per day can help to offset blood sugar. Planning meals with ChooseMyPlate, a guide to portion size, is an effort to illustrate how to divide healthy food choices in a more easily understood way. Limiting the amount of added sugar or non-caloric sweeteners is advised. A heathy diet should include the recommended daily allowance of vitamins and minerals. These should come from food, not just vitamin supplements. Reducing calories for fast weight loss is not sustainable and can cause rebound weight gain.
A nurse encourages a client with an immunologic disorder to eat a nutritionally balanced diet to promote optimal immunologic function. Which snacks have the greatest probability of stimulating autoimmunity?
Potato chips and chocolate milk shakes explanation: A diet containing excessive fat, such as that found in potato chips and milk shakes, seems to contribute to autoimmunity — overreaction of the body against constituents of its own tissues. Raisins, carrot sticks, fruit, mineral water, applesauce, and saltine crackers are snacks containing adequate amounts of vitamin A, zinc, and carotene, which are beneficial for the body.
The average dietary nutrient intake level that meets the nutritional requirement of almost all healthy people in a selected age and gender group is the:
RDA level explanation: The RDA level is the average dietary intake level that meets the nutritional requirement of almost all healthy people in a selected age and gender group.
The nurse is caring for a client admitted with an upper respiratory infection. The client tells the nurse about following the holistic belief of hot/cold. Which food items should the nurse provide to the client based on this information?
Soup, hot tea, and toast explanation: The client believes in the hot/cold theory of disease, so the client needs to treat cold diseases with hot food and hot diseases with cold food. The most appropriate choice would be the soup, hot tea, and toast. The other options are all cold foods, which the client would not use to treat a cold disease such as an upper respiratory infection.
The nurse is caring for a client on a telemetry unit following a myocardial infarction. The client has undergone numerous medication changes since the event. Which food should be avoided when a client is taking warfarin sodium following a myocardial infarction?
Spinach explanation: Spinach is an essential source of vitamin K. Since vitamin K is essential for clotting, it should be consumed sparingly with anticoagulant therapy.
A client is receiving continuous tube feeding via a nasogastric (NG) tube. What should the nurse use to determine that the NG is in correct placement? Select all that apply.
Stop tube feedings for 1 hour after medication before testing the pH of the gastric fluid. Visually assess aspirate that it differs from the color and consistency of the tube feeding. Measure the exposed length of feeding tube and compare it to the baseline measurement. explanation: The tube feeding and medications can alter the pH, so stop the tube feeding for 1 hour before testing the pH of the aspirate. The aspirate from the stomach should be different from the tube feeding: green with particles of off-white or brown may be present and the aspirate should be clear in consistency. The feeding tube has radiographic markings and the same marking present at the nare should be the same as charted in the baseline when the tube was confirmed initially by chest x-ray. Chest x-rays are not repeated to confirm placement of a feeding tube because they would expose the client to unnecessary radiation. The aspirate in the stomach should have a pH range of 4 to 6, and is usually <5.5.
A nurse is working with a child undergoing behavioral modification therapy for attention deficit hyperactivity disorder (ADHD). The nurse finds that the child is thin. What could be the most likely reason for this observation?
The child cannot sit through meals. explanation: Children with ADHD are not patient enough to sit through meals. This results in reduced dietary intake. This is the most likely reason for children with ADHD to be thin. Children with ADHD do not have impaired taste sensation. These children do not have loss of appetite unless they are on drugs like methylphenidate. It is not known whether children with ADHD are genetically predisposed to being thin.
A male client, aged 42, is diagnosed with diabetes mellitus. He visits the gym regularly and is a vegetarian. Which of the following factors is important when assessing the client?
The client's consumption of carbohydrates explanation: While assessing a client, it is important to note the client's consumption of carbohydrates because he has high blood sugar. Although other factors such as the client's mental and emotional status, history of tests involving iodine, and exercise routine can be part of data collection, they are not as important to information related to the client's to be noted in a client with high blood sugar.
The nurse has observed that a client's food intake has diminished in recent days. What intervention should the nurse perform in order to stimulate the client's appetite?
Try to ensure that the client's food is attractive and sufficiently warm. explanation: Food in the health care setting can often be unattractive and cool. Ensuring that it is appealing to the eyes and presented at the correct temperature can stimulate the client's appetite. Meals should be small and more frequent, not less frequent and larger. Supplements may be nutritionally necessary, but these do not act to increase the client's appetite.
A nurse is conducting client education with a woman who meets the diagnostic criteria for metabolic syndrome. The nurse is teaching the client about the MyPlate tool for promoting healthy food intake. According to MyPlate, the highest proportion of food in each meal should consist of what?
Vegetables explanation: MyPlate recommends the Americans make half of their plate fruits and vegetables. Dairy, proteins, and unsaturated fats are important components of a healthy diet but they should be consumed in smaller quantities than vegetables.
A nurse is educating a group of adolescent girls on bone and teeth growth. Which fat-soluble vitamin assists to build bone and teeth?
Vitamin D explanation: Vitamin D stimulates the absorption of calcium, which is an essential component for building strong, healthy bones and teeth. Vitamin A is essential in maintaining visual acuity, cell growth, and the immune system. Vitamin E is an antioxidant and also functions in promoting healing and healthy skin (cell growth). Vitamin K is essential in clotting.
A client is prescribed warfarin, an anticoagulant. When educating this client about potential diet and drug interactions, the nurse would caution the client about foods containing which nutrient?
Vitamin K explanation: Specific foods may interact with medications, altering the effectiveness of the drug. Vegetables high in vitamin K decrease the effectiveness of the commonly used anticoagulant warfarin. Calcium, potassium, and Vitamin C do not interact with warfarin.
A client is deficient in found to be deficient in vitamin K. What complications should the nurse closely assess for related to this deficiency?
bleeding tendencies explanation: A deficiency in vitamin K will cause bleeding tendencies related to the inability for the blood to clot appropriately. Visual disturbances may indicate a deficiency in vitamin A. Alterations in calcium levels may indicate a deficiency in vitamin D. Cardiac dysrhythmias may be caused by potassium, calcium, magnesium deficiency.
A client tells the nurse "my heart is skipping beats again; I'm having palpitations." After completing a physical assessment, the nurse concludes the client is experiencing occasional premature atrial complexes (PACs). The nurse should instruct the client to
avoid caffeinated beverages. explanation: If premature atrial complexes (PACs) are infrequent, no medical interventions are necessary. Causes of PACs include caffeine, alcohol, nicotine, stretched atrial myocardium (e.g., as in hypervolemia), anxiety, hypokalemia (low potassium level), hypermetabolic states (e.g., with pregnancy), or atrial ischemia, injury, or infarction. The nurse should instruct the client to avoid caffeinated beverages.
The nurse is caring for a client who wishes to include more antioxidant and anti-inflammatory foods in the diet. Which food(s) will the nurse recommend? Select all that apply.
cocoa blueberries explanation: Studies have shown that the daily consumption of dark chocolate, which is rich in flavonoids, plant sources such as cocoa and blueberries, and others with antioxidant and anti-inflammatory properties, has cardiometabolic benefits. Milk chocolate, pork products, and red meat do not have antioxidant or anti-inflammatory effects.
The nurse is providing teaching for a postoperative client complaining of nausea. Which food would be the most appropriate to recommend?
crackers explanation: The dry crackers or soda crackers or saltine crackers are best to help control the nausea. Nausea is an uneasiness of the stomach that often comes before vomiting. The cracker absorbs the gastric acid, which may be causing the nausea. Avoiding protein or fat is best when nauseated. Scrambled eggs are protein and will not absorb the gastric acid. Chicken noodle soup can provide more liquid in the stomach, making a client feel fuller and the client may vomit. Chocolate donuts should be avoided as they have fat and that could worsen the nausea.
The most common symptom of esophageal disease is
dysphagia. explanation: Dysphagia may vary from an uncomfortable feeling that a bolus of food is caught in the upper esophagus to acute pain upon swallowing. Nausea is the most common symptom of gastrointestinal problems in general. Vomiting is a nonspecific symptom that may have a variety of causes. Odynophagia refers specifically to acute pain upon swallowing.
A client is being treated for hyperuricemia. Part of the treatment strategy is for the client to avoid contributing factors whenever possible. Which activities might bring on an acute attack?
eating organ meats and sardines explanation: During an acute attack, high-purine foods are avoided, including organ meats, gravies, meat extracts, anchovies, herring, mackerel, sardines, and scallops. The other listed factors do not worsen attacks.
A woman consumes pasta, grains, and other carbohydrates for which purpose?
energy explanation: The main function of carbohydrates is to provide energy.
A client is receiving total parenteral nutrition (TPN). The nurse will assess for complications related to:
fluid and electrolyte levels. explanation: Total parenteral nutrition (TPN) is nutrition administered through a central venous access and is high in nutrients and electrolytes. It is important to assess fluid and electrolyte levels with TPN infusions. Falls are a risk associated with ability to reposition and not TPN. There is no pain associated with TPN infusions as the medication is administered via a central venous access line. Nausea or vomiting are not adverse effects associated with TPN as the medication is administered via a central line and not by a feeding tube in the stomach.
A client with influenza is prescribed a diet that is rich in fiber and carbohydrates. Which would the nurse incorporate into the education plan as a major reason for the high fiber diet?
maintenance of normal bowel elimination explanation: Dietary fiber is a minimal source of energy but plays an essential role in stimulating peristalsis and maintaining normal bowel elimination. Proteins have specific functions of producing hemoglobin for carrying oxygen to tissues, insulin for blood glucose regulations, and albumin for regulating osmotic pressure in the blood. Fats perform the important functions of energy storage of adipose tissue, vitamin absorption, and transport of fat-soluble vitamins A, D, E, and K.
An older adult client has a decubitus ulcer with drainage, dysphagia, and immobility. She consumes less than 300 calories per day and has a large amount of interstitial fluid. The client is in a state of:
negative nitrogen balance. explanation: A negative nitrogen balance exists when excretion of nitrogen exceeds the intake.
A 45-year-old client on the inpatient unit has just resumed eating a normal diet. The nurse checks a blood sugar with the morning labs and the result is 99.10 mg/dL (5.5 mmol/L). How would the nurse interpret this blood glucose?
normal explanation: Normal blood glucose is 80 to 110 mg/dL (4 to 7 mmol/L).
The community nurse is educating client groups about nutrition. Which group does the nurse identify that will benefit most from nutritional counseling and intervention?
older adults living on a fixed income explanation: Older adults who are socially isolated or living on fixed incomes will benefit most from nutritional counseling and intervention. Other individuals are not at the same level of risk.
A nurse is working with a 45-year-old construction worker. The nurse obtains his height and weight and calculates that his BMI is 28. How would the nurse best classify James?
overweight explanation: A body mass index (BMI) between 25 and 29.9 is considered overweight.
A nurse is caring for a client who has a body mass index (BMI) of 26.5. Which category should the nurse understand this client would be placed in?
overweight explanation: A client with a BMI below 18.5 should be considered underweight. A client with a BMI of 18.5 to 24.9 is considered to be at a healthy weight. A client with a BMI of 25 to 29.9 is considered overweight; a client with a BMI of 30 or greater indicates obesity. A BMI greater than 40 is considered extreme obesity.
Which client(s), at risk for poor nutritional intake, would benefit from nutritional counseling from the nurse? Select all that apply.
pregnant teenagers people with substance use problems older adults living on fixed incomes explanation: Examples of those in the United States at risk for an inadequate nutritional intake include older adults who are socially isolated or living on fixed income, homeless people, children of economically deprived parents, pregnant teenagers, people with substance use problems, and clients with eating disorders. Children of middle-income parents and individuals who prefer to purchase food from local farmers are not necessarily at risk.
The nurse is helping a client, who wishes to increase Omega-3 fatty acids, to order breakfast. Which food will the nurse recommend?
salmon explanation: Omega-3 fatty acids are found in fish such as salmon, halibut, sardines, olive oil, flaxseed, walnuts, and certain types of legumes. The other food choices do not contain Omega-3 fatty acids.
Which vitamin is found only in animal foods?
vitamin B12 explanation: Vitamin B12 functions in the formation of mature red blood cells and in synthesis of DNA and RNA. This vitamin is only found in animal foods (meats, fish, poultry, milk, and eggs).
