Question 1

A student nurse is completing a community health rotation.One of the clients is a pregnant teen.The student nurse has been teaching the client about infant nutrition.Which statement indicates to the student nurse that the client needs additional teaching?

A) "Breast milk is all my baby will need for the first 4 to 6 months."
B) "Breast milk should be the major source of nutrition for the first year."
C) "My baby won't need as many calories per kilogram as I will."
D) "Breastfeeding my baby will decrease the chances for food allergies."

"My baby won't need as many calories per kilogram as I will."

Accepted Answer

The baby needs more calories than the mother,so this misinformation needs to be clarified.The woman who is lactating needs 500 kcal/day above the usual allowance because the production of milk increases energy requirements.Infants need an energy intake of approximately 108 kcal/kg of body weight in the first half of infancy and 98 kcal/kg in the second half.Infants need about 100 to 120 mL/kg/day of fluid because a large portion of total body weight is water.The American Academy of Pediatrics recommends breast milk or formula as the major source of food for up to 1 year in age.Breast milk or formula provides sufficient nutrition for the first 4 to 6 months of life.The benefits of breastfeeding include reduced food allergies and intolerances,fewer infant infections,and easier digestion.In addition,breast milk is convenient,fresh,always the correct temperature,and economical,because it is less expensive than formula.Infants should not have regular cow's milk during the first year of life.Infants receiving cow's milk have been found to have lower intakes of iron,linoleic acid,and vitamin E; and excessive amounts of sodium,potassium,and protein.

Question 2

A patient with head trauma is scheduled for a gastrostomy tube to be inserted.The spouse asks the nurse why an intravenous (IV)cannot be used.What is the nurse's best response?&#10;A) &#34;The gastrostomy tube will allow us to give medications as well as feedings.&#34;&#10;B) &#34;Research has shown that a gastrostomy tube is safer for patients and maintains function of the gut.&#34;&#10;C) &#34;It will be more expensive in the long run to use a gastrostomy tube than an IV.&#34;&#10;D) &#34;The gastrostomy placement is noninvasive, and the patient will be more content being fed through the stomach.&#34;

Accepted Answer

Research has demonstrated a beneficial effect of enteral nutrition over parenteral routes in patients with a functional GI tract.Therefore enteral feeding is preferred over parenteral nutrition (intravenous nutrition)because it improves use of nutrients,is generally safer for patients,maintains structure and function of the gut,decreases the risk for infection and sepsis,and is less expensive,not more expensive.Medications can also be given through an IV,so this does not answer the spouse's question.The gastrostomy placement is invasive as the tube is inserted directly into the stomach.

Question 3

A patient is receiving parenteral nutrition (PN).While caring for the patient receiving PN what is the nurse's best action?&#10;A) Begin the infusion at 150 mL/hour.&#10;B) Maintain a consistent infusion rate.&#10;C) Touch the insertion site itself with a clean-gloved hand.&#10;D) Monitor the laboratory values on a weekly basis.

Accepted Answer

The solution is provided at a specified rate using an infusion pump over the course of the day to meet the patient's nutritional needs.Parenteral nutrition is usually started at a lower rate,for example,40 to 60 mL/hour,and then advanced to meet the patient's goal rate as tolerance is demonstrated.If the site itself must be touched,wear a sterile glove,not a clean glove.Frequent laboratory measurements for metabolic or electrolyte abnormalities as well as assessment of fluid balance,weight trend,and the ability to heal should occur during administration.Laboratory monitoring includes frequent blood glucose testing because the high dextrose (glucose)content of the solution can easily lead to hyperglycemia and require supplemental insulin as needed.Monitoring laboratory values on a weekly basis is too long and could lead to complications.

Question 4

Which information from the patient indicates teaching by the nurse was successful about the vitamin that is synthesized in the intestine?&#10;A) It is vitamin A.&#10;B) It is vitamin B6.&#10;C) It is vitamin K.&#10;D) It is vitamin D.

Accepted Answer

The body is unable to synthesize vitamins in the required amounts and depends on dietary intake.The exception to this is vitamin K,which the body synthesizes by bacteria in the intestine.In addition,the body produces vitamin D as a response to sunlight exposure.Vitamin A and B? must be obtained from the diet.

Question 5

A 14-year old patient with cancer is concerned about diet,and questions the need for vitamins to supplement the diet.The patient states,"I don't think my diet alone is providing the upper intake levels (ULs)of vitamins that I need." What is the best response from the nurse?

A) "You should try to get your vitamins from food, rather than a supplement."
B) "You should be trying to achieve the recommended dietary allowances (RDA)."
C) "You should compare your diet to the UL for children, not the UL for adults."
D) "You shouldn't worry about vitamins as long as you are getting enough calories."

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Accepted Answer

The tolerable UL is the highest level that likely poses no risk for adverse health events.It is not a recommended level of intake.There are four components to the DRIs: estimated average requirement (EAR),recommended dietary allowances (RDAs),adequate intakes (AIs),and tolerable upper intake levels (ULs).The EAR is the recommended amount of a nutrient that appears sufficient to maintain a specific body function for 50% of the population based on age and gender.The RDA is the average needs of 98% of the population,not the exact needs of an individual.The AI is the suggested intake for individuals based on observed or experimentally determined estimates of nutrient intakes by groups and is provided when there is insufficient evidence to set an RDA."You shouldn't worry" is false reassurance and should not be used.The patient needs to be educated on not using the ULs as a measure of intake,not that vitamins from food are better than supplements.

Question 6

A patient who has high cholesterol asks the nurse if there is a need to limit all fat in the diet to lower cholesterol.What is the nurse's best response?&#10;A) &#34;You should limit the amount of monounsaturated fats.&#34;&#10;B) &#34;You should limit the amount of unsaturated fatty acids.&#34;&#10;C) &#34;You should limit the amount of saturated fats.&#34;&#10;D) &#34;You should not limit the amount of any kind of fat.&#34;

Accepted Answer

Ingestion of saturated fatty acids appears to increase blood cholesterol levels.Monounsaturated fatty acids appear to lower blood cholesterol levels.Ingestion of unsaturated fatty acids has a minimal effect on blood cholesterol.Saturated fats should be limited to lower cholesterol.

Question 7

The patient was admitted with the diagnosis of a stroke.The patient experiences dysphagia and right side paralysis and needs assistance with activities of daily living (ADLs).The nurse caring for the patient has assigned the task of feeding the patient to the new nursing assistant personnel (NAP),and is concerned about aspiration.The nurse knows additional teaching is necessary when NAP states which of the following?

A) "I will remind the patient to tilt the head backward when drinking fluids."
B) "Thin fluids like water and fruit juice will need to be thickened."
C) "I need to watch for pocketing food as I feed the patient."
D) "It will take much longer to feed the patient than it did before the stroke."

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Accepted Answer

Remind the patient to not tilt head backward when eating or while drinking because this may cause food and liquid to be misdirected into the airway.Thin liquids such as water and fruit juice are difficult to control in the mouth and pharynx and are more easily aspirated so these need to be thickened.It will take much longer to feed and pocketing food are both correct.

Question 8

A patient is receiving intermittent enteral tube feedings.When introducing a feeding to this patient,what is the first thing the nurse needs to do?&#10;A) Place the patient in a supine position.&#10;B) Irrigate the tube with normal saline.&#10;C) Check to see that the tube is in the proper position.&#10;D) Introduce a small amount of fluid into the tube before the tube feeding.

Accepted Answer

The first step is verify tube placement; feedings instilled into a misplaced tube can cause serious injury or death.You will place the patient in Fowler's or high-Fowler's position,not supine,before starting the feeding.After checking for residual,flush the feeding tube with 30 mL of water,not normal saline.Fluid is not inserted until placement is verified.

Question 9

A new mother is breastfeeding her infant.The nurse asks the mother if she is getting the correct amounts of dietary reference intakes.Which statement from the mother indicates a correct understanding of dietary guidelines?

A) "I am not concerned about dietary guidelines or a strict diet."
B) "I am taking the vitamin doses according to the television advertisements."
C) "I am only taking one multiple vitamin a day and eating whatever I want."
D) "I am eating the correct amount of food according to the recommended dietary allowances and adequate intakes."

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Accepted Answer

When the mother said "recommended dietary allowance," it indicated that she knew about the RDAs and the adequate intakes indicates she knew about the AI.In 1997 the Food and Nutrition Board of the National Institute of Medicine/National Academy of Sciences,in partnership with Health Canada,initiated dietary reference intakes (DRIs)in response to the increased public use of nutritional supplements.There are four components to the DRIs: estimated average requirement (EAR),recommended dietary allowances (RDAs),adequate intakes (AIs),and tolerable upper intake levels (ULs).Saying,"I am not concerned about dietary guidelines" or "taking vitamin according to the television advertisements" and "eating whatever I want" does not indicate a correct understanding of the DRIs.

Question 10

A college student visits the student health center.The student has become a vegan.The nurse assesses that the student is deficient in protein intake.Which food should the nurse suggest as a source of protein?

A) Plant-based protein
B) Poultry-based protein
C) Egg-based protein
D) Milk-based protein

Accepted Answer

Vegans eat only foods of plant origin; therefore only plant-based protein can be eaten.Ovolactovegetarians avoid meat,fish,and poultry but eat eggs and milk.Lactovegetarians drink milk but avoid eggs and other animal-based foods.

Question 11

A nurse is asked how many kilocalories per gram (kcal/g)carbohydrates and protein can provide.How should the nurse reply?&#10;A) 2 kcal/g&#10;B) 4 kcal/g&#10;C) 9 kcal/g&#10;D) 12 kcal/g

Accepted Answer

The answer of A nurse is asked how many kilocalories...

Question 12

The nurse who works on the oncology unit understands the importance of nutrition and the disease process.Which patient should the nurse be most concerned about from a nutritional standpoint?&#10;A) A patient with cervical cancer&#10;B) A patient with liver cancer&#10;C) A patient with prostate cancer&#10;D) A patient with colon cancer

Accepted Answer

The answer of The nurse who works on the oncology...

Question 13

The patient has been admitted to the cardiac unit with a diagnosis of heart failure.The patient is currently receiving furosemide (Lasix)and is on a low-sodium diet.Which of the following is the best way for the nurse to determine if the patient is retaining fluid?

A) Figuring the patient's body mass index
B) Calculating the patient's ideal body weight
C) Recording daily weights during hospitalization
D) Measuring all fluid intake

Accepted Answer

The answer of The patient has been admitted to the...

Question 14

A nurse is caring for a patient who is receiving intermittent gravity feedings through a gastrostomy tube.The patient experiences abdominal discomfort.Which action is best for the nurse to take?&#10;A) Cool the formula.&#10;B) Readjust the tube.&#10;C) Decrease the administration rate.&#10;D) Increase the concentration of the formula.

Accepted Answer

The answer of A nurse is caring for a patient...

Question 15

A patient wants to lose 17 pounds.The nurse is aware that the most successful long-term weight loss programs are which of the following?&#10;A) Programs that get the weight off quickly&#10;B) Programs that include awareness of portion sizes&#10;C) Programs that focus on reducing bad carbohydrates&#10;D) Programs that use purchased premeasured food

Accepted Answer

The answer of A patient wants to lose 17 pounds.The...

Question 16

A patient needs nutritional counseling after a myocardial infarction to assist in reducing cholesterol level.The nurse would recommend that the patient should eat foods that are high in which type of fat?

A) Animal fat
B) Trans fat
C) Triglyceride fat
D) Vegetable fat

Accepted Answer

The answer of A patient needs nutritional counseling after a...

Question 17

During a nutritional assessment the nurse finds that a patient's energy needs exceed nutritional intake.What other assessment finding will the nurse observe?&#10;A) Weight gain&#10;B) Weight loss&#10;C) Anabolism&#10;D) Excessive adipose tissue

Accepted Answer

The answer of During a nutritional assessment the nurse finds...

Question 18

A patient presents to an ambulatory care clinic reporting a lack of energy and tiredness.One of several assessments the nurse wants to make is a diet history.To perform a home diet history the nurse instructs the patient to keep a journal of which of the following?

A) All food for the last 5 days
B) Only solid food for 3 days
C) All food for 3 days, including one weekend day
D) Only solid food for 3 days, including one weekend day

Accepted Answer

The answer of A patient presents to an ambulatory care...

Question 19

A 34-year-old mother delivered her third child 1 year ago.She tells the nurse that her New Year's resolution is to lose the 15 pounds that she gained with this pregnancy over the next month.Which of the following is the best statement that the nurse can make to help the patient achieve her weight loss goal?

A) "I don't think you need to lose the weight; you look fine as you are."
B) "The weight will come off by itself because you are breastfeeding."
C) "Let's talk about giving yourself a realistic timeframe to lose it."
D) "That is a realistic, healthy goal for you to have."

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Accepted Answer

The answer of A 34-year-old mother delivered her third child...

Question 20

The nurse caring for a patient with dysphagia has assigned the task of feeding the patient to the new nursing assistant personnel (NAP).The nurse asks the NAP how long the patient should be upright after eating.Which answer indicates the NAP has a correct understanding?

A) 2 hours after meal time
B) 30 minutes after meal time
C) 20 minutes after meal time
D) 10 minutes after meal time

Accepted Answer

The answer of The nurse caring for a patient with...

Question 21

Which patients should be assessed for nutritional deficiencies? (Select all that apply.)&#10;A) Patient who scored a 13 on the mini-nutritional assessment&#10;B) Elderly patient on bed rest after surgery on the small intestines&#10;C) Patient receiving an IV of 5% dextrose&#10;D) School-aged patient with positive nitrogen balance&#10;E) Middle-age patient with rashes and easily pluckable hair

Accepted Answer

The answer of Which patients should be assessed for nutritional...

Question 22

The nurse has to insert a nasogastric tube for the purpose of temporary tube feedings.To determine the length of the tube,the nurse should use which measurement?&#10;A) Tip of the nose to the xiphoid process of the sternum and add an additional 20 cm&#10;B) Tip of the chin to the earlobe to xiphoid process of the sternum&#10;C) Tip of nose to the earlobe to xiphoid process of the sternum&#10;D) Tip of the earlobe to the nose to the umbilicus

Accepted Answer

The answer of The nurse has to insert a nasogastric...

Question 23

A school nurse is presenting a class on nutritional needs to a group of 16-year-old adolescents.When discussing a balanced diet,the objectives for Healthy People 2020,and the goals of the ChooseMyPlate program,the nurse explains to this age group that nutritional goals should include which of the following? (Select all that apply.)

A) To balance energy expenditure and caloric intake to increase weight gain
B) To promote food choices for a healthy lifestyle
C) To decrease the intake of vitamins and minerals
D) To reduce chronic disease related to diet and weight
E) To limit fast foods because of increase in salt, fat, and calories

Accepted Answer

The answer of A school nurse is presenting a class...

Question 24

The nurse needs to verify feeding tube placement using the gastrointestinal (GI)pH measurement test.The NG tube placement was confirmed via x-ray 6 hours ago.After several attempts,the nurse is unable to aspirate GI fluid from the tube.The tube is secure and the external marking of the tube are in the original place.The patient appears to be tolerating the tube feedings and is not experiencing any distress.What should the nurse do?

A) Contact the health care professional to order another x-ray for placement verification.
B) Instill 60 mL of air to check the placement with a stethoscope.
C) Increase the amount of water given to the patient to prevent GI distress.
D) Assume the tube is in the correct place.

Accepted Answer

The answer of The nurse needs to verify feeding tube...

Question 25

A patient is having a problem with wound healing.The nurse assesses the patient's tray and finds that only 25% of all meals are eaten.The nurse teaches the patient that protein intake is important for what reasons? (Select all that apply.)

A) It is essential for body tissue growth.
B) It is essential for tissue maintenance.
C) Essential amino acids can only be obtained from dietary sources.
D) It is essential for repair.
E) Negative nitrogen balance is needed for wound healing.

Accepted Answer

The answer of A patient is having a problem with...

Deck 33: Nutrition