Deck 24: Nutritional Care and Support

Question 1

A nursing instructor evaluates a student nurse's application of theory regarding continuous tube feedings. The nursing instructor recognizes that further teaching is warranted when the student nurse

A) Instructs the patient to maintain a supine position.
B) Ensures that the head of the patient's bed is continually raised 30 degrees or more.
C) Interrupts the feeding every 4 hours to check placement.
D) Interrupts the feeding every 4 hours to check residual volume.

Answer 1

Instructs the patient to maintain a supine position.

Question 2

It would be considered inappropriate for a nurse to

A) Set a meal tray down on a patient's over-the-bed table and then immediately leave the room.
B) Remove any item from a patient's over-the-bed table before the delivery of meal trays.
C) Assist a patient with dentures before mealtime.
D) Inquire whether the patient needs to go to the bathroom before eating.

Answer 2

Set a meal tray down on a patient's over-the-bed table and then immediately leave the room.

Question 3

While educating a patient with diabetes about simple carbohydrates, a nurse teaches that simple carbohydrates are quickly converted to glucose and can be used to quickly increase blood glucose. The nurse identifies an example of a simple carbohydrate as

A) Legumes.
B) Vegetables.
C) Fruit juices.
D) Whole grains.

Answer 3

Fruit juices.

Question 4

A physician writes an order to discontinue a nasogastric (NG) tube. When discontinuing the NG tube, the nurse should

A) Slowly withdraw the tube from the patient's nose.
B) Show the removed tube to the patient and his or her spouse.
C) Instill 10 to 20 mL of air into the NG tube's main lumen.
D) Instruct the patient to breathe deeply while removing the tube.

Question 5

A student nurse is discussing ways to assist with meals and improve a patient's eating experience in the hospital. A nurse intervenes when the student says:

A) "I should wipe off the over-the-bed table with disinfectant if a urinal or any other contaminated item has been on it."
B) "To avoid contamination, I should never open any container-milk cartons, juice containers, or cellophane packaging for plastic utensils-on the tray."
C) "I should make rounds to my patients' rooms during mealtimes and ask if they have any needs."
D) "I should ensure that each meal tray is assessed for the correct diet and appropriate temperature of food."

Question 6

A physician writes an order for a nurse to insert a nasogastric (NG) tube for gastric decompression. When inserting the NG tube, the nurse should

A) Force the tube toward the nasopharynx.
B) Instruct the patient to avoid swallowing while inserting the tube.
C) Push the tip of the tube upward against the top side of the nasal passage.
D) Instruct the patient to hyperextend his or her head slightly and then gently insert the tube into the intended naris.

Question 7

When a nurse inserts a nasogastric (NG) tube, the patient becomes cyanotic, coughs incessantly, and is unable to speak. The nurse should

A) Tape the tube to the patient's naris.
B) Continue to insert the tube quickly.
C) Immediately remove the tube completely.
D) Use a flashlight and tongue blade to view the posterior pharynx.

Question 8

While providing diabetic teaching to a patient with newly diagnosed diabetes, a nurse teaches that the best indicator of long-term glycemic control is obtained through measuring

A) Creatinine level.
B) Urine glucose level.
C) Blood glucose level.
D) Glycosylated hemoglobin.

Question 9

A patient has been prescribed the medication lithium as a mood-stabilizing agent. While administering lithium to the patient, a nurse should closely monitor

A) Sodium levels.
B) Calcium levels.
C) Potassium levels.
D) Phosphorus levels.

Question 10

When caring for a patient with diabetes, a nurse checks the morning laboratory values. The nurse notes that the patient's blood glucose level is 60 mg/dL. The nurse recognizes this reading is consistent with

A) Hypoglycemia.
B) Hyperglycemia.
C) A normal value.
D) Diabetic ketoacidosis.

Question 11

While educating a patient with diabetes about the HbA1c test, a nurse teaches that the HbA1c gives a better overall picture of glycemic control by measuring the amount of glucose present over a period of

A) 1 to 2 months.
B) 4 to 5 months.
C) 2 to 3 months.
D) 3 to 4 months.

Question 12

As a nurse inserts a nasogastric (NG) tube, a patient gags and coughs continually and does not appear able to stop. The nurse should

A) Tape the tube to the patient's naris.
B) Continue to insert the tube quickly.
C) Immediately remove the tube completely.
D) Use a flashlight and tongue blade to view the posterior pharynx.

Question 13

While educating a patient with diabetes about complex carbohydrates, a nurse teaches that complex carbohydrates require the body to work harder to break them down to use for energy, helping to maintain a more consistent blood glucose level. The nurse identifies an example of a complex carbohydrate as

A) Bananas.
B) Legumes.
C) Fruit juices.
D) Processed baked goods.

Question 14

A nurse is caring for a patient with diabetes who requires blood glucose monitoring before meals and at bedtime. When checking the patient's blood glucose before lunch, the nurse documents the reading as 130 mg/dL. What should the nurse do next?

A) Continue to monitor.
B) Notify the patient's physician.
C) Give the patient an injection of insulin.
D) Administer a syringe of 50% dextrose.

Question 15

When performing an initial admission assessment on a patient with diabetes, a nurse checks the patient's blood glucose level. The nurse notes that the patient's blood glucose level is 280 mg/dL. The nurse recognizes this reading is consistent with

A) Hypoglycemia.
B) Diabetic coma.
C) Hyperglycemia.
D) A normal value.

Question 16

An emergency department nurse admits an adult patient for a drug overdose. The physician writes an order for the nurse to instill charcoal through a nasogastric (NG) tube. When selecting the NG tube, the nurse should choose a size

A) 4 French.
B) 8 French.
C) 12 French.
D) 16 French.

Question 17

A patient has been prescribed isoniazid (INH), a medication that treats tuberculosis. When administering INH to the patient, a nurse also anticipates administering the nutritional supplement

A) Vitamin K.
B) Vitamin C.
C) Vitamin B₆.
D) Vitamin B_12.

Question 18

When educating a patient about cooking methods, a nurse recognizes that additional teaching is warranted when the patient states that a way to reduce fat intake is by

A) Frying.
B) Baking.
C) Grilling.
D) Broiling.

Question 19

A nurse is caring for a patient who is receiving formula through intermittent tube feedings. When caring for this patient, the nurse should

A) Keep the patient in a supine position.
B) Warm the formula in the microwave oven.
C) Maintain the formula at room temperature.
D) Administer the formula directly from the refrigerator.

Question 20

A nurse teaches a patient with diabetes that the goal of diabetes treatment is to maintain an HbA1c less than

A) 7%.
B) 8%.
C) 9%.
D) 10%.

Question 21

A patient is admitted to a hospital unit with a diagnosis of anorexia nervosa. When caring for this patient, a nurse recognizes that anorexia nervosa is characterized by which of the following?

A) Evidence of emaciation
B) An excessive leanness or wasting of the body
C) An accurate self-perception about body weight
D) Obsessive thoughts about body shape and weight
E) Attempts to reduce one's body weight below normal

Question 22

A patient is in the acute phase of an intestinal disorder and has been scheduled for surgery. A nurse identifies that this patient's diet should be

A) Calorie-restricted.
B) Fiber-restricted.
C) Sodium-restricted.
D) Protein-restricted.

Question 23

A nurse is discussing daily meals with a patient on a regular diet. The nurse explains that the patient can make choices from a balanced meal plan based on approximately

A) 1000 calories per day.
B) 1200 calories per day.
C) 2000 calories per day.
D) 3000 calories per day.

Question 24

A nurse is caring for an elderly patient who is unable to eat more than a few bites at a time. The nurse should modify the patient's diet to

A) A high-calorie, high-protein diet.
B) Five to six small, frequent feedings.
C) A sodium-restricted diet.
D) An antigen-avoidance diet.

Question 25

An instructor explains that some medications, such as nonsteroidal anti-inflammatory drugs, antineoplastics (cancer drugs), and certain antibiotics, can damage the intestinal mucosa. A student identifies that these types of medications can cause

A) Malabsorption.
B) Unintentional weight gain.
C) Increased metabolism.
D) Rapid or increased excretion.

Question 26

A patient with malabsorption syndrome is able to meet some nutritional needs orally but requires partial parenteral nutrition for a limited period because of illness. A nurse identifies that the patient will require

A) A central venous catheter.
B) A peripherally inserted central catheter.
C) A jejunostomy tube.
D) A percutaneous endoscopic gastrostomy tube.
Multiple Response
Identify one or more choices that best complete the statement or answer the question.

Question 27

A nurse educates a class of adolescents about eating disorders. The nurse teaches that which of the following statements about eating disorders are true?

A) Eating disorders are more prevalent in males than in females.
B) Eating disorders can cause a patient's health to be severely affected.
C) Eating disorders generally occur during adolescence or early adulthood.
D) Eating disorders are evidenced by extreme disturbances in eating habits.
E) Eating disorders may result from either physical or psychological causes.

Question 28

A nurse intervenes when a nursing student says that an enteral tube should be used for

A) Postoperative decompression of the stomach.
B) Nutritional support.
C) Breathing assistance.
D) Medication administration.

Question 29

A patient who requires long-term feeding has a surgical endoscopic placement of a feeding tube in the stomach. A nurse correctly identifies this as a

A) Jejunostomy tube (J-tube).
B) Nasogastric (NG) tube.
C) Nasointestinal (NI) tube.
D) Percutaneous endoscopic gastrostomy (PEG) tube.

Question 30

A patient is complaining of swollen hands and legs and mild fluid retention. The nurse decides to change the patient's diet to

A) A fat-restricted diet.
B) An antigen-avoidance diet.
C) A calorie-restricted diet.
D) A sodium-restricted diet.

Question 31

A patient has complained several times of minor gastrointestinal pain, flatulence, and diarrhea after meals. A nurse identifies that this is most likely caused by

A) Anaphylaxis.
B) Food intolerance.
C) A food allergy.
D) Food poisoning.

Question 32

A nurse is caring for a severely underweight patient who has an admitting diagnosis of anorexia nervosa. When assessing this patient, the nurse anticipates which of the following?

A) Anemia
B) Oily hair
C) Brittle nails
D) Severe diarrhea
E) Muscle weakness

Question 33

When monitoring the fluid intake of an average adult patient over a 24-hour period, a nurse should expect the patient to consume between

A) 500 and 1200 mL of fluid
B) 1200 and 1500 mL of fluid
C) 1500 and 2500 mL of fluid
D) 2500 and 3500 mL of fluid

Question 34

A nursing student is asked to identify the difference between a nasogastric (NG) tube and a nasointestinal (NI) tube. The student correctly identifies that

A) Only an NI tube is inserted through the nose.
B) An NG tube is inserted through the stomach and into the duodenum.
C) An NI tube is shorter than an NG tube.
D) An NI tube is smaller in bore size and more flexible than an NG tube.

Question 35

A patient on long-term treatment with corticosteroids is experiencing weight gain and a rounding of the face shape, called moon facies. A nurse identifies that this is due to the corticosteroids' effect on the patient's

A) Absorption.
B) Appetite.
C) Metabolism.
D) Excretion.

Question 36

A nurse is monitoring a patient's intake and output. The patient drinks part of a can of cola. The nurse should

A) Ask the patient to finish the can of cola.
B) Estimate how much of the can was consumed by the patient.
C) Measure the remainder to determine the amount ingested.
D) Not record such a small amount of fluid.

Question 37

A nursing supervisor asks a nurse for a double-lumen nasogastric (NG) tube. The nurse should bring the supervisor a

A) Levin tube.
B) Salem sump tube.
C) French tube.
D) Dobbhoff tube.

Question 38

A patient with dysphagia is given a meal of scrambled eggs, cottage cheese, and tea. A nurse identifies that this patient is on a

A) Mechanical soft diet.
B) A full liquid diet.
C) Protein-restricted diet.
D) Pureed diet.

Question 39

A nurse is caring for a patient with an increased risk for aspiration due to severe gastroesophageal reflux disease (GERD). The nurse identifies that the correct type of nasointestinal (NI) tube for this patient would be a

A) Dobbhoff tube.
B) French tube.
C) Salem sump tube.
D) Levin tube.

Question 40

A doctor has ordered NPO status for a vomiting patient. A nurse violates the order by

A) Providing the patient with intravenous (IV) fluids.
B) Giving the patient ice chips.
C) Removing the patient's water carafe and drinking glass from the bedside.
D) Putting a sign that reads NPO over the patient's bed.

Question 41

A physician has ordered, "Clear liquids, advance as tolerated." A nurse identifies that which of the following factors indicate that the patient is not yet ready to advance his or her diet?

A) Hypoactive bowel sounds
B) Nausea
C) Complaints of indigestion
D) Hunger
E) Excessive thirst

Question 42

A nurse is caring for a patient who has an admitting diagnosis of bulimia nervosa. When assessing this patient, the nurse anticipates which of the following?

A) Evidence of dental decay
B) Complaints of indigestion
C) Complaints of constipation
D) Complaints of a sore throat
E) Symptoms of gastric reflux

Question 43

A nurse explains to a student that a patient's stomach contents will be removed by inserting a double-lumen nasogastric (NG) tube through the nose into the stomach, then connecting the drainage lumen to a suction source. The student correctly identifies this procedure as ____________________.

Question 44

A nurse is caring for a patient who has a nasogastric (NG) tube to suction. When caring for this patient, the nurse should do which of the following?

A) Assess the tube once per shift for patency.
B) Irrigate the clogged tube according to facility policy.
C) Position the tube so that it puts pressure on the naris.
D) Provide infrequent mouth care and lip moisturizer.
E) Assess color, amount, and consistency of gastric drainage.

Question 45

An instructor explains that a type of intermittent tube feeding in which a physician-ordered volume of formula is administered using a large irrigating syringe at set intervals throughout the day is called ____________________ feeding.