Deck 5: Nutrition and Aging

Question 1

The nurse is planning interventions to reduce an older client's risk of dehydration. Which intervention would result in the client's dehydration?
1) Provide peanut butter and crackers for snack
2) Keep the room warm according to client's preference
3) Administer the prescribed diuretic with the evening meal
4) Offer to bring coffee to the client a few times per day

Answer 1

3

Question 2

The nurse is instructing an older client on the use of MyPlate to ensure an adequate nutritional intake. Which meal choices require further teaching? Select all that apply.
1) A salad with chicken, walnuts, and an olive-oil-based dressing
2) Cottage cheese with a large bowl of canned peaches
3) Toast with fruit jam and a bowl of oatmeal
4) Sausage and vegetable omelet with raisins in oatmeal
5) Plain cheeseburger with french fries

Answer 2

2, 5

Question 3

The nurse instructed an older client on the importance of maintaining adequate hydration. Which statement by the client most indicates that additional teaching is needed?
1) "I'll drink water, tea, soda, or juice whenever I feel thirsty."
2) "I can add an extra cup of coffee with breakfast and dinner."
3) "I will set up a schedule to drink water every few hours throughout the day."
4) "If I drink a lot of fluids, I'll get more exercise running to the bathroom."

Answer 3

1

Question 4

An older client is receiving feedings through a permanent feeding tube. Which nursing intervention will decrease this client's risk of aspiration?
1) Administer formulas that contain fiber.
2) Keep the head of the bed elevated at a 30 to 45 degree angle.
3) The risk of aspiration no longer exists after a permanent feeding tube has been placed.
4) Flush the tube with water before and after each medication administered through the tube.

Question 5

The nurse is concerned that an older client exhibits lethargy and headache. What other assessments does the nurse perform immediately? Select all that apply.
1) Mental status
2) Orthostatic blood pressure
3) Daily weight
4) Long tongue furrows
5) Forearm tenting of the skin

Question 6

When planning care, which older client does the nurse identify as being most at risk for malnutrition? Select all that apply.
1) Client with a fever of unknown origin for two weeks
2) Client with dysphagia and a soft diet
3) Client with osteoporosis and a hip fracture
4) Client who chooses a vegetarian diet
5) Client with chronic obstructive pulmonary disease

Question 7

An older client is prescribed diet supplementation to combat unintentional weight loss. How should the nurse provide these supplements to the client?
1) Serve at room temperature
2) Provide with the next meal
3) Provide separate from medications
4) Provide more than an hour before the next meal

Question 8

What should the nurse instruct a caregiver to do to assist a cognitively impaired older client to self-feed?
1) Offer the client a variety of favorite foods.
2) Turn on the television to encourage continual snacking.
3) Serve each food with the proper utensil and cue the client.
4) Explain the location of food in relation to the face of a clock.

Question 9

A resident in the nursing home is diagnosed with undernutrition and is unable to take in adequate food despite efforts by the multidisciplinary team and family members. Prior to insertion of a permanent feeding tube, which issue needs to be considered?
1) Equipment, care, and time needed to administer the feedings
2) The extent of the surgical intervention, cost and insurance coverage
3) The client's nutritional needs and tolerance of the formula feedings
4) The client's advanced directive and evaluation of risks, benefits, and ethical considerations

Question 10

The nurse has completed the teaching for an older client with prescribed metformin. Which statement made by the client best indicates that the client understands the teaching?
1) "An appetite decrease will help me lose weight."
2) "I will add vitamin B fortified cereal to my breakfast."
3) "Eating animal products at each meal is needed."
4) "Drinking coffee will offset any tiredness or weakness."

Question 11

What should the nurse instruct an older client to do to support healthy eating habits? Select all that apply.
1) Increase intake of whole fruits.
2) Limit ready-to-eat meals.
3) Choose no-sugar-added desserts.
4) Use nuts or healthy oils on salads.
5) Eat quickly to avoid feeling full.

Question 12

During an assessment, the nurse determines that an older client takes medication for atrial fibrillation and takes over-the-counter supplements to enhance nutritional status. Which supplements most concern the nurse? Select all that apply.
1) Zinc
2) Garlic
3) Fish oil
4) Ginseng
5) Ginkgo biloba

Question 13

The nurse is discussing proper nutrition with older community members at a senior citizen center. What should the nurse teach as general guidelines for healthy older individuals? Select all that apply.
1) Calcium intake should be 1,000 mg for those over the age of 51 years.
2) Older individuals need to take supplements of vitamins A, C, E, and K.
3) Vitamin D intake should be 600 IU up to age 70 and 800 IU if older than 70.
4) Ingest at least 0.8 grams of protein for each kilogram of body weight each day.
5) Fluid intake each day should be at least 13 cups for men and 9 cups for women.

Question 14

The nurse is caring for an older client who is receiving phenytoin. Which nutrition-related points does the nurse teach the client? Select all that apply.
1) "Notify the provider for difficulty swallowing."
2) "Sometimes you will not have a good appetite."
3) "Make sure to eat food rich in B vitamins."
4) "Your favorite foods may not taste good anymore."
5) "Get a few minutes of sunshine every day."

Question 15

An older client without any major health problems is experiencing decreased strength and endurance while performing some activities. What should the nurse explain as the reason for the change in strength and endurance?
1) Depression
2) Decrease in lean muscle mass
3) Lowered absorption of vitamin D
4) Increase in cholecystokinin production

Question 16

Which older client is at greatest risk for vitamin D deficiency?
1) The client on steroids for pneumonia
2) The client who is lactose intolerant
3) The client who gardens as a hobby
4) The client on phenytoin while hospitalized

Question 17

Which observation made by the nurse most suggests that a client is having difficulty swallowing?
1) Drooling
2) Alternating food with liquid
3) Tongue furrows
4) Coughing after taking a drink

Question 18

Which older client with a feeding tube would the nurse identify as being at the highest risk of dehydration?
1) The client's tube feeding totals 1,500 mL every 24 hours
2) Receiving 60 mL of water every 4 hours
3) Client has infrequent, loose stools
4) Receiving feedings with a formula that is 1.5 calories per mL

Question 19

An older client who is post-cerebral vascular accident is receiving enteral feedings and is experiencing abdominal cramps and liquid stools. Which is the best nursing intervention to reduce the client's cramping and diarrhea?
1) Advocate for reducing the calories in the formula.
2) Ask to change the client's feeding from bolus to continuous drip.
3) Suggest reducing the amount of formula prescribed.
4) Administer additional free water to the client every day.

Question 20

Which assessment data best indicates to the nurse that an older client is experiencing undernutrition?
1) Body mass index (BMI) of 21
2) Unintentional 3% weight loss over a month
3) Client takes no supplements or vitamins
4) Serum albumin is slightly below normal

Question 21

What food items should the nurse teach an older client to ingest to increase the dietary intake of vitamin D?
1) Eat beef liver, eggs, or salmon each week.
2) Add a bowl of whole wheat cereal to breakfast.
3) Eat three servings of yogurt or cheese each day.
4) Eat kale or spinach each week with dinner.

Question 22

The nurse has instructed an older client on the modified MyPlate and caloric intake. Which client response best indicates that instruction has been effective?
1) "I have to drink six cups of milk every day to get enough vitamin D in my diet."
2) "Eating the lowest daily recommended value provides adequate calories each day."
3) "I will get enough B vitamins as long as I eat the recommended amount of vegetables."
4) "Taking daily protein powder supplements is a good alternative to eating meat."

Question 23

The nurse is using the DETERMINE nutrition screening tool to assess the nutritional status of an older client. Which findings indicate the nurse needs to assess further for nutritional deficiencies? Select all that apply.
1) The client is diagnosed with emphysema.
2) The client eats a can of green beans for dinner.
3) The client lives alone and does not have a vehicle.
4) The client has newly fitted permanent oral dentures.
5) The client is being treated for multiple conditions.

Question 24

An older client has an unintentional weight loss of 20 pounds in the last 3 months. What should the nurse teach the client's family to prevent further loss of weight?
1) Provide liquid nutritional supplements with meals.
2) Add nonfat milk powder to scrambled eggs to add more protein.
3) Encourage the client to resume smoking to increase the appetite.
4) There is nothing to change as weight loss is a normal part of aging.

Question 25

Which statement about food insecurity would the nurse include in a presentation regarding nutritional issues in the older client?
1) "Food insecurity is demonstrated when a person hoards food."
2) "The death of a spouse often results in food insecurity."
3) "African American persons are at risk for food insecurity."
4) "Food insecurity is concern about eating harmful foods."