Deck 49: Nutrition

Question 1

At 7:15 a.m., two assistants in nursing are assigned the task of feeding breakfast to four incapacitated clients. What instruction should the nurse include in this delegation?

A) Engage the client in conversation during the meal.
B) Breakfast should be completed by 8:00 a.m. so that baths may begin.
C) Stand to the left of right-handed clients during feeding.
D) Give fluids before and after each bite of solid foods.

Answer 1

Engage the client in conversation during the meal.

Question 2

What criteria does the nurse evaluate to determine if an infant's regurgitation, or spitting up, should be further investigated?

A) If the baby is gaining weight adequately.
B) How much the baby spits up at a time.
C) The consistency of the regurgitated matter.
D) How often the baby spits up.

Answer 2

If the baby is gaining weight adequately.

Question 3

The client who was started on total parenteral nutrition (TPN) yesterday has the following morning lab results. Which result indicates the greatest urgency for the nurse's collaboration with the physician?

A) Potassium of 3.5.
B) Serum glucose of 328.
C) Prealbumin of 15.
D) BUN of 60.

Answer 3

Serum glucose of 328.

Question 4

Nitrogen balance testing is planned for a newly admitted client. What instruction to the staff caring for this client is essential?

A) Accurate measurement of protein intake is very important.
B) Remove the client's oxygen cannula 10 minutes prior to the test.
C) All urine output should be collected for 48 hours.
D) Keep the client NPO beginning at midnight before the test.

Question 5

A client who is undergoing radiotherapy to her neck may experience nutrition difficulties because:

A) she could have diarrhoea as a side effect.
B) her ability to taste will be distorted.
C) her neck is burnt and sore.
D) her absorption of nutrients will be affected.

Question 6

On admission, the client weighs 75 kg. The client reports that this is a weight loss from 82 kg. What is the percent weight loss?

A) 4.5%.
B) 10.0%.
C) 8.5%.
D) 6.25%.

Question 7

The nurse is calculating the body mass index (BMI) of a client admitted to the long-term care facility. The client is 1.75 metres tall and weighs 65 kilograms. What BMI measurement should the nurse document for this client?

Question 8

The client reports that her adolescent daughter has started a vegan diet. Which addition to meals should the nurse recommend to help ensure that this adolescent does not become iron deficient?

A) Tofu
B) Soybean milk
C) Brewer's yeast
D) Orange juice
E) Okra
F) Apples

Question 9

The client who has undergone a gastrointestinal surgery is permitted to have a clear liquid diet on the second postoperative day. Which fluid should the nurse order for this client?

A) Cranberry juice.
B) Tomato juice because it is the client's favourite.
C) Apricot nectar.
D) Chicken broth.

Question 10

A nurse is caring for an Arabic client who has severed a tendon in his right hand. The nurse would:

A) tell the client to eat with his left hand.
B) ensure the client has plenty of meat to help with healing.
C) encourage fluids before meals.
D) assist the client to eat his normal diet.

Question 11

The parents of a 7-month-old child have started offering solid foods to their baby. The baby has enjoyed and tolerated rice cereal, applesauce, and other fruits. Which food should the nurse recommend to be introduced next?

A) Strained chicken.
B) Strained beef.
C) Pumpkin.
D) Green beans.

Question 12

The client's lab studies reveal a normal serum albumin with a prealbumin of 10. How does the nurse interpret the significance of these readings?

A) Carbohydrate malnutrition has occurred over the last six months.
B) The client is now relatively well nourished with malnutrition six to eight months ago.
C) The client has had recent protein malnutrition.
D) The client is at risk for development of malabsorption syndromes.

Question 13

The major dietary source of body energy is:

A) protein.
B) cholesterol and lipids.
C) carbohydrates.
D) vitamins.

Question 14

The nurse has instructed an overweight client to follow a 8,360-kilojoule diet by substituting foods considered low in kilojoules for those higher in kilojoules. How does the client interpret the food label to decide if a food is low in kilojoules?

A) The product label will state "lighter" or "reduced kilojoules".
B) Nutritional labelling on the product will indicate less than 167 kilojoules per serving.
C) The nutrition facts label will have the letter "L" located in the lower right corner.
D) The product will contain no more than 11% fat.

Question 15

What nursing diagnosis is the most important for the nurse to include in the care plan of a client who has just been started on total parenteral nutrition (TPN) therapy?

A) Imbalanced Nutrition: Less than Body Requirements.
B) Fluid Volume Deficit.
C) Activity Intolerance.
D) Risk for Infection.

Question 16

The parent of a newborn infant calls the paediatrician's office to report that the baby wakes up every two hours and only takes about 60 mL of formula before going back to sleep. What instruction should the nurse give this parent?

A) Offer the baby less formula to prevent waste.
B) Continue to feed the baby with this "on demand" schedule.
C) Nutritional labelling on the product will indicate the precise kilojoule value per serving.
D) Make the baby wait at least three hours between feedings.

Question 17

The client is weighed each month while residing in the long-term care facility. This month the client weighs 50 kg. The nurse compares this weight to the last three months' results and discovers the client has lost 10 kg. There has been no attempt to lose this weight. How does the nurse interpret this weight loss?

A) Severe malnutrition.
B) Mild malnutrition.
C) Moderate malnutrition.
D) No malnutrition.

Question 18

The nurse has advised the client to consume alcohol only in moderation because:

A) drinking alcohol leads to weight loss.
B) alcohol increases appetite and fat deposits.
C) alcohol is a stimulant.
D) excessive alcohol decreases absorption of nutrients.

Question 19

The client has a body mass index (BMI) of 18. How does the nurse interpret this finding?

A) The client is overweight.
B) The client is normal.
C) The client is underweight.
D) The client is obese.

Question 20

A nurse is discussing a daily diet plan with an ethnic client. The nurse should:

A) tell the client what good and bad foods are.
B) order a normal western diet.
C) negotiate with client to accommodate differences.
D) refer the client to a dietitian for further education.

Question 21

As the nasogastric tube is passed into the oropharynx, the client begins to gag and cough. What is the correct nursing action?

A) Give the client a few sips of water.
B) Remove the tube and attempt reinsertion.
C) Have the client tilt the head back to open the passage.
D) Use firm pressure to pass the tube through the glottis.

Question 22

What instruction does the nurse give the client as the nasogastric tube is being removed?

Question 23

The nurse notices that the client's continuous open system tube-feeding set is almost empty. What action should the nurse take?

A) Add tube feeding to the set.
B) Flush the set with clear carbonated soda and discontinue.
C) Clamp the set and add a new feeding.
D) Discontinue the feeding and hang a closed system bag.

Question 24

Arrange the steps of nasogastric tube insertion in the proper order.

A) Ask the client to tilt the head forward.
B) Insert the tube with its natural curve toward the client.
C) Ask the client to hyperextend the neck.
D) Have the client swallow a small amount of liquid.
E) Employ a slight twisting motion on the tube.

Question 25

The nurse is inserting a nasogastric tube to administer tube feedings. The nurse must do an initial assessment. What should be assessed prior the insertion of the tube?

A) Presence of gag reflex.
B) Deviated septum.
C) Mental status.
D) History of nasal surgery.
E) All of the above.

Question 26

The nurse notes that the client's feeding tube has become clogged. What is the nurse's action?

A) Place the client in high Fowler's position.
B) Assess the client's lung sounds.
C) Assess the client's bowel sounds.
D) Flush and aspirate the tube with water.