Deck 42: Nursing Management: Nutritional Problems

Question 1

What is the daily recommended intake of fibre for a 38-year-old healthy female?

A) 21 g
B) 25 g
C) 30 g
D) 38 g

Answer 1

25 g

Question 2

In evaluating a patient outcome of "identifies high-protein foods," the nurse knows that the outcome has been met when for lunch,the patient selects which of the following foods from the hospital menu?

A) Bacon and tomato sandwich,bean soup,and coffee
B) Peanut butter and jelly sandwich,French fries,and whole milk
C) Chicken noodle soup,grilled cheese sandwich,and apple juice
D) Barbecued chicken breast sandwich,fruit yogurt,and skim milk

Answer 2

Barbecued chicken breast sandwich,fruit yogurt,and skim milk

Question 3

A high-calorie,high-protein diet is provided for a patient with a fractured hip and severe protein-calorie depletion,but the patient is not able to ingest enough food to correct the malnutrition.To meet the patient's nutritional needs,the nurse recognizes that during the patient's recovery,the patient will most likely require which of the following?

A) Arrange for smaller portions to be served on patient trays.
B) Serve multiple small feedings of high-calorie,high-protein foods.
C) Give continuous tube feedings of liquid nutritional supplements.
D) Administer intravenous (IV)feeding with parenteral nutrition (PN)solutions.

Answer 3

Serve multiple small feedings of high-calorie,high-protein foods.

Question 4

A 72-year-old patient is seen at the clinic for symptoms of a urinary tract infection.She is 155 cm tall and weighs 42 kg.The nursing history reveals that she drinks tea and eats toast twice a day for her meals because it is easy to fix and she has no appetite.Laboratory results include hemoglobin 6.5 mmol/L (10.5 g/dL)and albumin 20 g/L (2.0 g/dL).The nurse determines that the patient is near starvation with severe protein depletion when which of the following additional findings is observed?

A) A small,nodular liver
B) Generalized weakness
C) Edema of the face and extremities
D) Increased blood urea nitrogen and serum creatinine levels

Question 5

While caring for an older adult patient hospitalized with dehydration and moderate protein-calorie malnutrition,the nurse identifies a nursing diagnosis of risk for infection based on what knowledge?

A) Lymphocyte activity and phagocytosis are decreased.
B) Anemia of malnutrition contributes to susceptibility to infection.
C) Weakness of muscles leads to impaired ability to clear the lungs.
D) Wound healing is delayed if protein is not available for tissue building.

Question 6

A 66-year-old patient preparing for surgery for cancer of the lung is very thin and has a very low-normal position on the BMI chart.The nurse plans preoperative care for the patient with the knowledge that his nutritional needs include which of the following?

A) An increase in both calories and protein immediately following his surgical recovery
B) An increase in protein and calorie intake several weeks before surgery
C) A normal amount of calories for a man his age but increased protein to prepare for healing during the postoperative period
D) Fewer calories than normal for a man his age and weight because his activity will be decreased during the postoperative period

Question 7

How often would the nurse flush a feeding tube for the patient who is on continuous enteral nutrition (EN)?

A) Every 2 hours
B) Every 4 hours
C) Every 6 hours
D) Every 12 hours

Question 8

A woman weighs 66 kg and asks the nurse how much protein she should include in her diet each day.What should the nurse recommend that the woman's diet should include?

A) 36 g protein
B) 53 g protein
C) 75 g protein
D) 98 g protein

Question 9

The nurse is teaching a community group to evaluate the nutritional content of food.If the label on a jar of peanut butter states that each serving contains 16 g of fat and 190 calories,what is the percentage of fat per serving?

A) 34%
B) 59%
C) 76%
D) 88%

Question 10

What percentage of the patient's caloric needs should be met before the nurse would anticipate discontinuation of the PN?

A) 25%
B) 30%
C) 60%
D) 75%

Question 11

Total parenteral nutrition (TPN)with a peripherally inserted central catheter is initiated for a patient who has tar burns and multiple fractures from a roofing accident.After 6 hours of TPN infusion,the nurse checks the patient's capillary blood glucose level and finds it to be 8.9 mmol/L (160 mg/dL).What is the most appropriate nursing action?

A) Notify the physician of the blood glucose level.
B) Recheck the capillary blood glucose in 4 hours.
C) Check the catheter insertion site for signs of inflammation.
D) Slow the rate of the TPN solution to prevent hyperglycemia.

Question 12

A patient with a central catheter placed in the right subclavian vein for administration of TPN is very anxious about the catheter and is reluctant to move her right arm or turn her head.Initially,what should the nurse do?

A) Ask her why she is reluctant to move with the catheter in place.
B) Describe the placement,retention,and rationale for care of the catheter.
C) Reassure her that the TPN line is temporary so that she can anticipate the end of the treatment.
D) Provide passive range of motion to her right arm and shoulder to demonstrate that movement will not dislodge the catheter.

Question 13

During assessment of a patient who is a vegan,the nurse observes for signs of nutritional deficiency.What is the most common nutritional deficiency related to a strict vegan diet that would be manifested?

A) Muscle wasting
B) Bleeding gums and loose teeth
C) Pallor and changes in sensation of the extremities
D) Dry,scaly skin and cracked mucous membranes

Question 14

When assessing anthropometric measurements on a 28-year-old male,the patient asks what information is obtained from the measurement of his midarm muscle circumference.The nurse's response is based on which following information regarding this measurement?

A) It is a measurement of subcutaneous fat stores.
B) It is used to calculate the body mass index (BMI).
C) It is an indicator of protein stores.
D) It is an indicator of hydration status.

Question 15

A patient is commencing continuous tube feedings through a percutaneous endoscopic gastrostomy tube.To maintain safe and effective delivery of the tube feeding,what should the nurse do?

A) Flush the tube with 50 mL of water every 8 hours.
B) Obtain a daily X-ray film for verification of tube placement.
C) Check residual volume every 4 hours.
D) Position the patient on the left side with the head of the bed elevated 45 degrees.

Question 16

To determine the underlying factors relating to the undernourishment of an older adult patient,what is the most appropriate question the nurse can ask?

A) "Do you have a history of any malabsorption diseases?"
B) "Do you have a way to get to a grocery store to buy your food?"
C) "Are you taking any medications that alter your taste or tolerance of foods?"
D) "Can you give me an example of what you normally eat throughout the day?"

Question 17

PN containing amino acids and dextrose was ordered and begun 24 hours ago for a malnourished patient.The nurse observes that about 50 mL remain in the PN container.Which action is appropriate at this time?

A) Infuse the remaining 50 mL,and then hang a new container of PN.
B) Hang a new container of PN,and change the IV tubing and filter.
C) Continue to use the same tubing and filter,and hang a new container of PN.
D) Clarify with the physician if the new PN also requires a tubing and filter change.

Question 18

When using a nutrition screening tool,how can the nurse identify a patient at nutritional risk without further assessment?

A) Pressure ulcers
B) A recent hip fracture
C) Vomiting for 3 days
D) A laparoscopic cholecystectomy 1 week ago

Question 19

A feeding tube has been inserted,and the patient is started on continuous EN.As part of the insertion procedure,the tube was externally secured to the patient.How often should the nurses assess the patient to ensure that the tube stays secured to the patient's body and does not move?

A) Every 4 hours
B) Every 8 hours
C) Every 12 hours
D) Every 24 hours

Question 20

A patient with difficulty swallowing is started on continuous tube feedings of a full-strength commercial formula at 100 mL/hour.The patient has six diarrhea stools the first day.What is the action that is most appropriate for the nurse to take first?

A) Slow the feeding flow rate.
B) Discontinue any water intake.
C) Notify the physician for a change in formula.
D) Check the amount of residual feeding in the stomach.

Question 21

Which of the following behaviours in a young woman with bulimia would cause the nurse the most concern?

A) The patient eats only about 20% of breakfast.
B) The patient ambulates continuously in the hallway.
C) The patient goes into the bathroom after each meal.
D) The patient asks for laxatives to treat constipation.

Question 22

When using a soft silicone nasogastric tube for enteral feedings,the nurse will need to do which of the following?

A) Flush the tubing after checking for residual volumes.
B) Administer continuous feedings using an infusion pump.
C) Replace the tube every 3 to 5 days to avoid mucosal damage.
D) Avoid giving medications through the feeding tube.

Question 23

A patient who is receiving a continuous tube feeding through a small-bore silicone feeding tube has a computed tomography (CT)scan ordered and will have to be placed in a flat position for the scan.What will the nurse plan to do?

A) Ask the physician to reschedule the CT scan.
B) Send the patient for a CT scan with oral suction in case of aspiration.
C) Suspend the feeding 30 to 60 minutes before the scan.
D) Connect the feeding tube to continuous suction during the scan.

Question 24

A 22-year-old woman is admitted to the hospital with a diagnosis of anorexia nervosa.She is 163 cm tall and weighs 41 kg.On admission,her laboratory tests reveal hypokalemia,hypercholesterolemia,and iron-deficiency anemia.In planning care for the patient,the nurse places the highest priority on which of the following nursing diagnoses?

A) Risk for activity intolerance related to anemia and weakness
B) Ineffective health maintenance related to obsession with body image
C) Risk for decreased cardiac output related to electrolyte imbalance
D) Imbalanced nutrition: less than body requirements related to refusal to eat

Question 25

The hospital nurse educator is observing a new registered nurse (RN)who is caring for a patient receiving PN through a single-lumen central line inserted in the right subclavian vein.Which action by the new RN indicates that the RN can safely care for the patient?

A) Flushes the line after drawing a blood specimen
B) Reminds the patient to keep the right arm straight
C) Checks capillary blood glucose every 8 hours
D) Infuses the PN solution using an infusion pump

Question 26

The nurse notes that the peripheral PN bag is almost empty,and a new PN bag has not yet arrived from the pharmacy.Which following action is appropriate?

A) Decreasing the rate of the current PN infusion to 10 mL/hour until the new bag arrives
B) Infusing 5% dextrose in water until the new PN bag is delivered from the pharmacy
C) Flushing the peripheral line with saline and waiting until the new PN bag is available
D) Monitoring the patient's capillary blood glucose until a new PN bag is hung

Question 27

A patient who has a wound infection after major surgery has been taking in only about 50% to 75% of the ordered meals and states,"Nothing on the menu really appeals to me." Which nursing action will be most effective in improving the patient's oral intake?

A) Order at least six small meals daily.
B) Have family members bring in favourite foods from home.
C) Teach the patient about high-calorie,high-protein foods.
D) Make a referral to the dietitian.