Question 1

Which menu option is least likely to cause wide variations in the diabetic's blood sugar?&#10;A) Ham sandwich on whole wheat bread&#10;B) Sesame bagel with vegetable cream cheese&#10;C) Spaghetti with meat sauce and parmesan cheese&#10;D) Peanut butter and jelly sandwich on white bread

Accepted Answer

Foods with complex carbohydrates such as whole wheat bread have less impact on blood sugar than simple carbohydrates such as bagels,spaghetti,and wheat bread.The ham sandwich on whole wheat bread will have the least impact on the patient's blood sugar levels.

Question 2

Which intervention is most appropriate for the patient with the nursing diagnosis imbalanced nutrition: more than body requirements related to overeating?&#10;A) Use of dishware that limits portion sizes&#10;B) Menu consisting of purchased premeasured food&#10;C) Ketogenic diet that restricts carbohydrate intake&#10;D) Crash diet based on lemon juice and cabbage soup

Accepted Answer

A successful weight-loss plan involves sustainable lifestyle modifications that include physical activity,self-monitoring,portion control,and knowledge of energy content of food.Getting the weight off quickly using a crash diet is not healthy.Ketogenic diets can be harmful for some patients.Premeasured food is expensive and it is difficult to keep the weight off afterward.

Question 3

Which is the best menu option for a patient with celiac disease?&#10;A) Baked chicken breast with roll and butter&#10;B) Spaghetti with meat sauce and tossed salad&#10;C) Oatmeal with raisins,brown sugar,and milk&#10;D) Pizza with tomato sauce,cheese,and mushrooms

Accepted Answer

Oatmeal is gluten-free so it will not worsen symptoms of celiac disease.Pizza crust,roll,and pasta all contain gluten and should be avoided by patients with celiac disease.

Question 4

Which is the highest priority nursing diagnosis for a patient with dysphagia following a stroke?&#10;A) Risk for aspiration related to inability to ingest food and fluids safely&#10;B) Feeding self-care deficit related to neuromuscular impairment and weakness&#10;C) Risk for constipation related to intake of low-fiber foods and thickened liquids&#10;D) Imbalanced nutrition: less than body requirements related to swallowing difficulty

Accepted Answer

Risk of aspiration is the highest priority diagnosis as aspiration can lead to pneumonia and respiratory failure.Imbalanced nutrition would be the next highest priority.Feeding self-care deficit is less important because the patient can be assisted at mealtimes.Risk for constipation is less important than aspiration risk and can be minimized with high-fiber soft foods and liquids.

Question 5

Which action of the patient will facilitate aspiration of food and fluids into the airway?&#10;A) The patient avoids talking when eating or swallowing.&#10;B) The patient tilts the head backward when swallowing.&#10;C) The patient thickens liquids to the consistency of honey.&#10;D) The patient clears the throat after every few bites of food.

Accepted Answer

The nurse should 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.Clearing the throat after every few bites of food helps to maintain a clear airway.The patient should avoid talking when eating or swallowing in order to concentrate on aspiration prevention.

Question 6

Which is the first action of the nurse when administering intermittent enteral tube feedings to the patient?&#10;A) Irrigate the tube with sterile saline.&#10;B) Place the patient in a supine position.&#10;C) Make sure that the feeding solution is chilled.&#10;D) Check to see that the tube is in the proper position.

Accepted Answer

The first step is to verify tube placement; feedings instilled into a misplaced tube can cause serious injury or death.The nurse 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 rather than sterile saline.The feeding solution should be warmed or at room temperature as chilled feeding solution can cause abdominal cramping.

Question 7

Which intervention is most effective for measuring the patient's fluid balance over time?&#10;A) Measure daily intake and output.&#10;B) Figure the patient's body mass index.&#10;C) Record daily weights before breakfast.&#10;D) Calculate the patient's ideal body weight.

Accepted Answer

Daily weights before breakfast provide information about fluid retention and diuresis.Daily intake and output are not as effective for assessing fluid balance over time.Calculation of ideal body weight and BMI do not accurately measure the patient's fluid balance over time.

Question 8

Which nursing diagnosis is the highest priority for a patient who had the large intestine removed?&#10;A) Risk for deficient fluid volume related to excessive fluid loss in stool&#10;B) Risk for compromised human dignity related to stigma from ileostomy&#10;C) Bathing/hygiene self-care deficit related to presence of ileostomy bag&#10;D) Social isolation related to perceived offensive odor from ileostomy bag

Accepted Answer

Risk for deficient fluid volume related to excessive fluid loss in stool as the large intestine functions to absorb water from the stool.Without the large intestine,stools are watery and the patient is at risk for dehydration due to excessive fluid loss.Compromised human dignity,self-care deficit,and social isolation are all lower priority diagnoses.

Question 9

Which outcome is most appropriate for a patient with the nursing diagnosis imbalanced nutrition: more than body requirements related to recent pregnancy and childbirth?&#10;A) The patient will lose 1 pound per week for the next 6 weeks.&#10;B) The patient will use fashion strategies to enhance appearance.&#10;C) The patient will regain normal liver enzymes within 1 month.&#10;D) The patient will demonstrate adaptation to body changes from pregnancy.

Accepted Answer

The patient should aim for slow,steady weight loss such as 1 pound per week for the next 6 weeks.Fashion strategies to enhance appearance and adaptation to body changes from pregnancy are appropriate for the altered body image nursing diagnosis.There is no mention of abnormal liver enzymes so the patient would not have a goal of regaining normal liver enzymes.

Question 10

Which food item contains the most calories?&#10;A) 1 g of cane sugar&#10;B) 1 g of lean meat&#10;C) 1 g of butter&#10;D) 1 g of banana

Accepted Answer

Fats contain 9 kilocalories per gram (kcalorie/g)while carbohydrates and protein provide 4 kcalorie/g.Therefore 1 g of butter would have more calories than 1 g of lean meat,sugar,or banana.

Question 11

Which soup is appropriate for a patient who follows a vegan diet?&#10;A) Cream of broccoli and cheddar cheese soup&#10;B) Moroccan carrot,apple,and cauliflower soup&#10;C) Minestrone soup with lamb,vegetables,and pasta&#10;D) Egg drop soup with chow mein noodles and scallions

Accepted Answer

The answer of Which soup is appropriate for a patient...

Question 12

Which action of the nurse is best to reduce abdominal discomfort when administering intermittent gravity feedings through a gastrostomy tube?&#10;A) Chill the formula.&#10;B) Dilute the formula.&#10;C) Infuse the formula slowly.&#10;D) Lower the head of the bed.

Accepted Answer

The answer of Which action of the nurse is best...

Question 13

Which condiment is the healthiest option for the patient to reduce the chances of having a heart attack?&#10;A) Olive oil&#10;B) Margarine&#10;C) Shortening&#10;D) Cream cheese

Accepted Answer

The answer of Which condiment is the healthiest option for...

Question 14

Which laboratory finding indicates that the patient has not been eating well?&#10;A) Serum albumin level 2.1 g/dL&#10;B) Presence of nitrites in the urine&#10;C) Prothrombin time 11.5 seconds&#10;D) Serum creatinine level 0.8 mg/dL

Accepted Answer

The answer of Which laboratory finding indicates that the patient...

Question 15

Which dish must be removed from the meal tray of an orthodox Jewish patient?&#10;A) Penne pasta with marinara sauce and soft breadsticks&#10;B) Scrambled eggs,bacon,and toast with strawberry jelly&#10;C) Stir-fried chicken with noodles,broccoli,and teriyaki&#10;D) Green salad with red peppers,carrots,beets,and radishes

Accepted Answer

The answer of Which dish must be removed from the...

Question 16

Which is the best reason why a gastrostomy tube is ordered rather than parenteral nutrition for a patient with dysphagia?&#10;A) Parenteral nutrition can only be administered to the patient in the hospital.&#10;B) The gastrostomy tube provides more nutrition and protects intestinal function.&#10;C) Parenteral nutrition is significantly more expensive than gastrostomy feedings.&#10;D) The gastrostomy tube allows for administration of medications as well as nutrition.

Accepted Answer

The answer of Which is the best reason why a...

Question 17

Which nursing diagnosis is most appropriate for a newborn who did not receive vitamin K supplementation immediately after birth?&#10;A) Ineffective breastfeeding related to inability to latch on&#10;B) Ineffective protection related to impaired blood clotting&#10;C) Risk for unstable blood glucose related to developmental level&#10;D) Disorganized infant behavior related to altered primitive reflexes

Accepted Answer

The answer of Which nursing diagnosis is most appropriate for...

Question 18

Which intervention is most appropriate for the nursing diagnosis ineffective breastfeeding related to maternal malnutrition?&#10;A) Encourage the mother to eat a diet rich in nutrients and protein.&#10;B) Provide a quiet nursing environment to reduce maternal anxiety.&#10;C) Allow the infant to room with the mother and breastfeed on demand.&#10;D) Avoid supplemental feedings for the infant to promote breastfeeding.

Accepted Answer

The answer of Which intervention is most appropriate for the...

Question 19

The nurse is caring for a pediatric patient with the nursing diagnosis constipation related to side effects of medications.Which menu option will the nurse recommend to the patient?&#10;A) Baked chicken nuggets and canned peaches&#10;B) Pancakes with sausage,butter,and maple syrup&#10;C) Peanut butter and jelly sandwich on white bread&#10;D) Snack mix with dried apricots,raisins,and almonds

Accepted Answer

The answer of The nurse is caring for a pediatric...

Question 20

Which is the most appropriate nursing diagnosis for a patient with a BMI of 46?&#10;A) Risk for imbalanced fluid volume related to rapid intravascular fluid shift&#10;B) Risk for imbalanced body temperature related to impaired thermoregulation&#10;C) Risk for compromised human dignity related to loss of control of body functions&#10;D) Imbalanced nutrition: more than body requirements related to chronic overeating

Accepted Answer

The answer of Which is the most appropriate nursing diagnosis...

Question 21

Which foods are recommended options for a patient with high cholesterol?&#10;A) Pure Irish butter with sea salt added&#10;B) Unsalted cashews,pecans,and pistachios&#10;C) Cottage cheese made with 2% milk&#10;D) Salad dressing made with vinegar and olive oil&#10;E) Guacamole made with fresh avocado and tomato

Accepted Answer

The answer of Which foods are recommended options for a...

Question 22

Which menu item should be removed from the tray of a patient on a full liquid diet?&#10;A) Cup of chicken bouillon&#10;B) Cup of tomato cream soup&#10;C) Cup of orange frozen yogurt&#10;D) Cup of strawberry applesauce

Accepted Answer

The answer of Which menu item should be removed from...

Question 23

Which nursing diagnoses are priorities for a patient receiving parenteral nutrition?&#10;A) Impaired oral mucus membranes related to irritation from nasogastric tube&#10;B) Risk for infection related to invasive peripherally inserted central catheter line&#10;C) Situational low self-esteem related to presence of gastrostomy tube in abdomen&#10;D) Risk for impaired blood glucose levels related to concentrated IV dextrose solution&#10;E) Health-seeking behaviors related to desire to manage parenteral nutrition at home

Accepted Answer

The answer of Which nursing diagnoses are priorities for a...

Question 24

Which nursing diagnoses are priorities for a patient taking prednisone 40 mg PO daily for chronic inflammation?&#10;A) Risk for deficient fluid volume related to excessive hormonal fluid loss through kidneys&#10;B) Risk for unstable blood glucose related to hyperglycemic side effects of corticosteroids&#10;C) Risk for impaired dentition related to loss of minerals for teeth and bone support within the jaw&#10;D) Risk for constipation related to side effects of corticosteroids with loss of urge to defecate&#10;E) Risk for imbalanced nutrition: more than body requirements related to increased appetite

Accepted Answer

The answer of Which nursing diagnoses are priorities for a...

Question 25

Which is the appropriate intervention for a patient with the nursing diagnosis feeding self-care deficit related to neuromuscular hand and arm weakness?&#10;A) Provide meticulous oral hygiene before and after meals.&#10;B) Consult a speech-language pathologist for swallow precautions.&#10;C) Provide the patient with a pleasant,quiet environment for meals.&#10;D) Teach the patient how to use adaptive utensils to facilitate independence.

Accepted Answer

The answer of Which is the appropriate intervention for a...

Deck 35: Nutrition