Deck 44: Nutrition

Question 1

Which of the following should the nurse do first when introducing a feeding to a client with an indwelling gavage tube?
1) Irrigate the tube with normal saline solution.
2) Check to see that the tube is properly placed.
3) Place the client in a supine position.
4) Introduce some water before giving the liquid nourishment.

Answer 1

2
Before introducing a feeding through an indwelling gavage tube for enteral nutrition,it is essential that the nurse check to see that the tube is properly placed.It is not necessary to irrigate the tube with normal saline.The client's head should be elevated 30 to 45 degrees to help prevent the chance of aspiration.The tube may be flushed with 30 mL of water before initiating the feeding.However,the nurse should first verify correct tube placement.

Question 2

A client is seen in the outpatient clinic for follow-up of a nutritional deficiency.In planning for the client's dietary intake,the nurse includes a complete protein,such as:
1) Eggs
2) Oats
3) Lentils
4) Peanuts

Answer 2

1
A complete protein contains all essential amino acids in sufficient quantity to support growth and maintain nitrogen balance.Eggs and meats are examples of complete proteins.Incomplete proteins lack one or more of the nine essential amino acids and include oats (cereals)and legumes (lentils and peanuts).

Question 3

Which of the following is accurate nutritional information that the nurse should share with the parents of an adolescent child?
1) Girls require less protein.
2) Boys require additional iron.
3) Vitamin B needs are decreased.
4) Energy and caloric needs are decreased.

Answer 3

2
Adolescent boys require additional iron for muscle development.Daily requirements of protein increase for both adolescent boys and adolescent girls.B complex vitamins are needed to support heightened metabolic activity.Energy and caloric needs are increased to meet greater metabolic demands of growth during the adolescent period.

Question 4

According to the food guide pyramid,vegetables should be included in the average adult's diet as:
1) 1 to 3 servings per day
2) 2 to 4 servings per day
3) 3 to 5 servings per day
4) 6 to 11 servings per day

Question 5

A client is pregnant for the third time.In regard to her nutritional status,she should:
1) Limit her weight gain to a maximum of about 25 pounds
2) Approximately double her protein intake
3) Increase her vitamin A and milk product consumption
4) Increase her intake of folic acid

Question 6

Before inserting a small-bore nasogastric tube for enteral nutrition,the nurse correctly tells the client:
1) "The tube will feel uncomfortable and may make you gag at times when I am inserting it"
2) "We will mark this tube from the end of your nose to your umbilicus to obtain the right length for insertion"
3) "Please hold your breath when I insert this small tube through your nose down into your stomach"
4) "Please tilt your head back after the tube passes the nasopharynx."

Question 7

The client is assessed by the nurse as having a high risk for aspiration.The nursing diagnosis identified for the client is feeding self-care deficit related to unilateral weakness.An appropriate technique for the nurse to use when assisting the client with feeding is to:
1) Place food in the unaffected side of the mouth
2) Place the client in semi-Fowler's position
3) Have the client use a straw
4) Use thinner liquids

Question 8

The nurse is discussing dietary intake with a client who is human immunodeficiency virus (HIV)positive.The nurse informs the client that the diet will include a:
1) Restriction of potassium,phosphate,and sodium
2) Reduction in carbohydrate intake
3) Decreased protein and increased folic acid intake
4) Reduction in fat with smaller,more frequent meals

Question 9

When providing nutritional guidance,the nurse shares with the mother of an 8-year-old client that children of this age need to:
1) Increase their intake of B vitamins
2) Significantly increase iron intake
3) Maintain a sufficient intake of protein and vitamins A and C
4) Increase carbohydrates to meet increased energy needs

Question 10

During an enteral tube feeding,the client complains of abdominal cramping and nausea.The nurse should:
1) Cool the formula
2) Remove the tube
3) Use a more concentrated formula
4) Decrease the administration rate

Question 11

The client is diagnosed with malabsorption syndrome (celiac disease).In teaching about the gluten-free diet,the nurse informs the client to avoid:
1) Citrus fruits
2) Vegetables
3) Red meats
4) Wheat products

Question 12

When assisting the client who practices Islam or Judaism with meal planning,the nurse knows that both religions share an avoidance of:
1) Alcohol
2) Shellfish
3) Caffeine
4) Pork products

Question 13

A client is diagnosed with a peptic ulcer and has come to the primary health care provider for a follow-up visit.The client asks the nurse what foods are safe to add to his diet.An appropriate response by the nurse is to inform the client that which of the following may be added to the diet?
1) Citrus juices
2) Green vegetables
3) Frequent glasses of milk
4) Unlimited decaffeinated coffee

Question 14

The school nurse suspects that a junior high student may have anorexia nervosa.This eating disorder is characterized by:
1) A lack of control over eating patterns
2) Self-imposed starvation
3) Binge-purge cycles
4) Excessive exercise

Question 15

Which of the following would the nurse expect to see offered on a full liquid diet?
1) Custard
2) Pureed meats
3) Soft fresh fruit
4) Canned soup

Question 16

A client is suspected of having a fat-soluble vitamin deficiency.To assist the client with this deficiency,the nurse informs the client that:
1) "More exposure to sunlight and drinking milk could solve your nutritional problem"
2) "Eating more pork,fish,eggs,and poultry will increase your vitamin B complex intake"
3) "Increasing your protein intake will increase your negative nitrogen imbalance"
4) "Decreasing your triglyceride levels by eating less saturated fats would be a good health intervention for you"

Question 17

The nurse is caring for a client who is receiving parenteral nutrition (PN).Which of the following is an appropriate nursing intervention when administering parenteral nutrition to a client?
1) Begin the infusion rates at 100 to 150 mL/hour.
2) Maintain a consistent infusion rate.
3) Change the infusion tubing once a week.
4) Monitor protein levels daily.

Question 18

While doing a nutritional assessment of a low-income family,the community health nurse determines the family's diet is inadequate in protein content.The nurse suggests which of the following foods to increase protein content with little increase in the food budget?
1) Oranges and potatoes
2) Potatoes and rice
3) Rice and macaroni
4) Peas and beans

Question 19

When teaching the parents of a toddler about safe finger foods,the nurse suggests trying which of the following?
1) Nuts
2) Popcorn
3) Cheerios
4) Hot dogs

Question 20

The nurse should offer a client who has had throat surgery which of the following?
1) Chicken noodle soup
2) Ginger ale
3) Oatmeal
4) Hot tea with lemon

Question 21

A 41-year-old female client has been dieting to lose weight.Which of the following statements indicates that the client needs additional teaching regarding a healthy weight-loss plan?
1) "I have based my diet on the food pyramid."
2) "I am planning to lose between 1 and 2 pounds per week."
3) "I need to eliminate all fat from my diet."
4) "I plan to begin an exercise program as soon as I see my health care provider."

Question 22

The nurse is aware that there are medications that are taken that alter the client's taste and may influence the dietary intake.In reviewing the medications taken by the clients on the unit,the nurse will consult with the nutritionist to develop a palatable meal plan for the client taking:
1) Ampicillin
2) Morphine
3) Furosemide
4) Acetaminophen

Question 23

Which of the following statements reflects the best understanding of the benefits of breast-feeding related to the infant's health and wellness?
1) "My husband and I both have food allergies,but she won't be allergic to my breast milk."
2) "The antibodies she gets will help keep her immunized from many illnesses for up to her first birthday."
3) "I can spend so much more time with her because I have to devote my attention to her while I nurse."
4) "It's so convenient,no formula preparation,no bottles to wash and fill,no packing for outings;its great."

Question 24

Which of the following statements by an older adult shows the most need for follow-up regarding the risk for dehydration in this age-group?
1) "I have a glass of water with each meal and whenever I'm thirsty."
2) "As long as I drink whenever I'm thirsty,I think I'll be well hydrated."
3) "I try not to drink much after dinner so I don't have to get up to urinate at night."
4) "I limit my coffee and tea drinking because I don't think they are particularly good for you."

Question 25

The nurse is caring for a 5-kg 8-month-old infant admitted to the hospital by the health care provider,who was concerned about the infant's low weight.The infant's birth weight was 3.5 kg.The nurse knows that on average an infant doubles his or her birth weight at what age?
1) 2 to 3 months
2) 4 to 5 months
3) 6 to 7 months
4) 8 to 9 months

Question 26

Food safety is a concern of a group of adults attending the community health clinic.The participants identify to the nurse that they have seen a lot of reports on television about Escherichia coli and how dangerous it can be.When asked where the bacteria comes from,the nurse responds that a potential source of E.coli is:
1) Sausage
2) Soft cheeses
3) Milk products
4) Ground beef

Question 27

The nurse and the mother of an infant are discussing the introduction of solid foods into her child's diet.Which of the following statements made by the mother reflects the best understanding of the most appropriate manner to introduce new foods?
1) "Both my husband and I have allergies,so I am very cautious about introducing anything new into her diet."
2) "I'm a fussy eater,and so are my other children;but I will offer her a variety of foods so she will have a good appetite."
3) "I'll start with nonwheat cereal and then vegetables;one new food a week so I can see if something doesn't agree with her."
4) "My other children just loved solids and really were a joy to feed;I expect she will be as receptive to new foods as they were."

Question 28

A client with a family history of cancer is discussing the effects of free radicals on body cells and tissue.Which of the following responses is the most therapeutic answer to the client's question,"What can I do to protect against free radicals?"
1) "Eat foods like blueberries,oranges,almonds,and carrots;they fight free radicals."
2) "I can give you some literature on which foods are highest in free-radical fighters."
3) "Research seems to support the positive role vitamins A,C,and E play in neutralizing free radicals."
4) "Foods that contain vitamins A,C,and E as well as beta-carotene seem to combat the effects of free radicals."

Question 29

The nurse recognizes which of the following clients as being at greatest risk for a negative nitrogen balance?
1) A 10-year-old with an infected laceration on the left thumb
2) A 75-year-old who fell and experienced a mild concussion
3) A 40-year-old who has partial-thickness burns over 15% of his body
4) A 19-year-old who has lost 70 pounds in 7 months as a result of dieting

Question 30

A nurse is discussing high-nutrient-density food selections with a client recovering from extensive partial-thickness burns.Which of the following statements by the client reflects the best understanding of this dietary concept?
1) "I'll snack on things like sugar-free pudding and Jello."
2) "Fried chicken and potato salad are my favorite comfort foods."
3) "My wife has a wonderful recipe for low-calorie vegetable dip."
4) "It's a good thing that I really enjoy salads and whole wheat breads."

Question 31

The nurse is questioning a newly admitted client regarding his dietary history.Which of the following questions asked by the nurse is most likely to secure additional pertinent information regarding the client's statement,"I think I'm allergic to peanuts"?
1) "What happens when you eat peanuts?"
2) "What makes you think you are allergic to peanuts?"
3) "When did you first notice this sensitivity to peanuts?"
4) "A peanut allergy is very serious;how do you manage to avoid them?"

Question 32

The mother of a 25-month-old is discussing her concerns regarding her daughter's eating habits with the nurse.The most therapeutic response to the mother's statement,"She is such a fussy eater;it seems that she will only eat dry cereal and cheese" is:
1) "As long as she is eating a little from all the food groups and getting enough fluids,she will be all right"
2) "Her weight and height are right on target,so she must be getting what she needs to grow and develop"
3) "Don't expect her to start liking a variety of foods for several more months;just keep offering her what she likes"
4) "Its very common for toddlers to be picky eaters;try offering her food frequently,and offer high-nutrient-density snacks such as the cheese she likes"

Question 33

For the client who is receiving parenteral nutrition via a central venous catheter,the nurse recognizes that a priority is to:
1) Use sterile technique during the administration of the feedings
2) Maintain the initial infusion rate at no more than 40 to 60 mL/hr
3) Complete the administration of the feeding within 12 hours
4) Have radiographic confirmation of the placement of the catheter

Question 34

A nasogastric tube is inserted in order for the client to receive intermittent tube feedings.An initial chest x-ray examination is done to confirm placement of the tube in the stomach.After the x-ray confirmation,the most reliable method of checking for tube placement is for the nurse to:
1) Place the end of the tube in water and observing for bubbling
2) Auscultate while introducing air into the tube
3) Measure the pH of the secretions aspirated
4) Ask the client to speak

Question 35

A client has been receiving tube feedings and is tolerating them very well.The health care provider determines that the rate of the intermittent tube feedings may be advanced.The nurse prepares to:
1) Increase the feedings by 50 mL/day
2) Start an isotonic formula at half strength
3) Infuse a bolus feeding over 5 to 10 minutes
4) Begin feedings with 250 to 500 mL at each interval

Question 36

The nurse is counseling a client undergoing chemotherapy.The client has shared with the nurse that the client does not have much of an appetite and is worried about not getting enough nutrients.Which of the following statements by the nurse addresses the client's concerns?
1) "Let me share information regarding how a high-calorie diet can help prevent you from losing weight."
2) "Let me share information about high-nutrient-density foods to help you make choices."
3) "You need to avoid carbohydrates in your diet."
4) "Your body needs a lot of protein right now to prevent muscle loss."

Question 37

The nurse is caring for a 6-kg 4-month-old infant who is hospitalized with a respiratory infection.The nurse knows that an infant this age needs approximately 108 kcal/kg of body weight.The nurse also understands that human breast milk provides approximately 20 kcal/oz.About how much breast milk does the nurse need to feed the infant every 4 hours in order to provide enough to meet the infant's nutritional needs?
1) 4.5 ounces
2) 5.5 ounces
3) 6.5 ounces
4) 7.5 ounces

Question 38

A nurse is discussing high-nutrient-density food selections with a client recovering from extensive partial-thickness burns.Which of the following statements by the nurse reflects the best understanding of this dietary concept?
1) "Do you enjoy fresh fruits and vegetables?"
2) "Would you consider replacing soda with milk?"
3) "Your body requires lots of energy in order to heal itself,and that energy comes from nutrient-packed foods."
4) "You need a great deal of energy,and you'll get that by eating large volumes of food that can be turned into energy."

Question 39

The nurse is discussing vitamin supplements with a client who is an amateur body builder.Which of the following statements by the nurse shows the greatest understanding concerning the risk for hypervitaminosis?
1) "Vitamins are important to proper body building and repair,but be aware that you can overdose and harm yourself."
2) "Fat-soluble vitamins are stored in the body's fat reserves,so be careful not to take too much vitamins A,D,E,and K."
3) "Water-soluble vitamins are not stored in the body like fat-soluble ones,so it's less likely to overdose on vitamin C and the B complex."
4) "I realize vitamin supplements are a factor in your training,but be aware of daily requirements so you don't overdose,especially the fat-soluble vitamins."

Question 40

The nurse is discussing food selection with a client who recently experienced a partial-thickness burn over 20% of her body.The client expresses a reluctance to ingest a large amount of carbohydrates because she successfully lost 50 pounds and does not want to regain the weight.The most therapeutic response to the client's nutritional needs is:
1) "Don't be concerned about regaining the weight until your burns have healed."
2) "You need a huge amount of calories to heal,so there won't be a weight gain."
3) "You will experience a nitrogen imbalance if there aren't enough carbohydrates in your diet."
4) "The extra carbohydrates will be utilized for energy so that your protein can be saved for repair of your skin."

Question 41

The nurse is counseling a 64-year-old client that it is important to eat plenty of fruits and vegetables,but the client should avoid which of the following because it can inhibit the absorption of some drugs?
1) Oranges
2) Grapefruit
3) Pineapple
4) Asparagus

Question 42

One easy way that parents of teenagers can ensure that they are getting enough iodine in their diets to support the increased thyroid activity during adolescence is to:
1) Give the child a multivitamin daily
2) Use iodized table salt
3) Keep fresh fruit and vegetables on hand for snacks
4) Serve red meat at least once a week

Question 43

When menu planning for a newly diagnosed diabetic client who practices Judaism,the nurse should avoid which of the following dishes?
1) Vegetable beef soup
2) Chicken pot pie
3) Beef lasagna
4) Scrambled eggs

Question 44

Which of the following statements by a new mother indicates that the nurse needs to provide additional teaching before the client is discharged home with her infant?
1) "I will be using infant formula,which will provide all the nutrition that my new baby needs."
2) "I can feed my new baby every 3 to 4 hours when I get home."
3) "I will need to sterilize all my baby's bottles and nipples to make sure they don't have any germs."
4) "I can put a few drops of honey in my baby's formula to make it taste better."

Question 45

The nurse caring for a 55-year-old male client knows that due to his religious beliefs he is most likely a vegetarian.Which of the following religions encourage vegetarianism?
1) Church of Jesus Christ of Latter-Day Saints
2) Seventh-Day Adventist
3) Judaism
4) Pentecostal

Question 46

A 68-year-old female client tells the home care nurse that she is worried about her 70-year-old husband because he does not eat as much as he used to when he was younger.Which of the following is the best response from the nurse?
1) "Perhaps your husband needs to have his thyroid level checked."
2) "Your husband is at an age when his metabolism is slowing down and his energy requirements aren't as great as they were when he was younger."
3) "Are you fixing the foods that he likes?"
4) "That should cut down on your grocery bill."