Question 1

An emergency department nurse admits an adult client for a drug overdose.The physician writes an order for the nurse to instill charcoal through a nasogastric (NG)tube.Which size tube will the nurse select?
A)4 French
B)8 French
C)12 French
D)16 French

Accepted Answer

For administering charcoal through a nasogastric (NG) tube, a larger bore tube is preferred to prevent clogging. A 16 French tube is appropriate for this purpose, as it allows for the smooth passage of the charcoal suspension.

Question 2

A client is prescribed isoniazid (INH), a medication that treats tuberculosis (TB).Which condition will prompt the nurse to remind the physician that the client will need a specific vitamin during the therapy? A)Vitamin K is not absorbed when a client has TB. B)Vitamin C will increase lung healing with TB. C)Vitamin B₆ excretion will increase with INH. D)Vitamin B₁₂prevents nerve damage from INH.

Accepted Answer

Isoniazid (INH) can lead to increased excretion of Vitamin B6 (pyridoxine), which can cause peripheral neuropathy. Supplementation with Vitamin B6 is often recommended to prevent this side effect.

Question 3

A client is prescribed the medication lithium as a mood-stabilizing agent.Which laboratory report indicates the client may be retaining higher than prescribed levels of lithium?
A)Low sodium levels
B)High sodium levels
C)Low potassium levels
D)High potassium levels

Accepted Answer

Low sodium levels can lead to increased retention of lithium in the body because lithium is reabsorbed in the kidneys in a similar manner to sodium. When sodium levels are low, the body tries to retain more sodium, and as a result, more lithium is reabsorbed, potentially leading to higher than prescribed levels of lithium in the bloodstream.

Question 4

A client tells the nurse of experiencing minor gastrointestinal pain, flatulence, and diarrhea several times after meals.Which possible cause should the nurse identify?
A)Anaphylaxis
B)Food intolerance
C)A food allergy
D)Food poisoning

Accepted Answer

Food intolerance often leads to gastrointestinal symptoms such as pain, flatulence, and diarrhea after consuming certain foods, unlike food allergies which involve the immune system and can cause more severe reactions.

Question 5

The nurse prepares a presentation for parents of adolescents with eating disorders.The parents have expressed an interest in understanding the causes and effects of the disorders.Which information will the nurse include? Select all that apply.
A)It is more prevalent in males than in females.
B)It can cause a client's health to be severely affected.
C)It generally occurs during adolescence or early adulthood.
D)It is evidenced by extreme disturbances in eating habits.
E)It may result from either physical or psychological causes.

Accepted Answer

Eating disorders can severely affect health, often occur during adolescence or early adulthood, are characterized by extreme disturbances in eating habits, and may result from physical or psychological causes.

Question 6

A client has been vomiting without relief from medications.The physician orders the client on NPO status.Which action by the nurse violates the physician's order?
A)Maintains previously ordered IV fluids
B)Gives ice chips when the client indicates mouth dryness
C)Provides mouth swabs and lip balm for client comfort
D)Offers mouth care on a regular basis

Accepted Answer

NPO status means "nothing by mouth," so giving ice chips violates this order as it involves ingesting something orally.

Question 7

The nurse is admitting a client for a diagnosis unrelated to nutrition; however, the client states, "I don't eat gluten, but I don't have celiac disease." Which meal will the nurse expect the client to order?
A)Bean soup, cornbread with butter, and tapioca pudding
B)Ham and cheese sandwich on whole wheat bread, and fruit
C)Spaghetti with meat sauce, salad, and cake with butter frosting
D)Baked chicken breast, mashed potatoes with butter, and ice cream

Accepted Answer

The client follows a gluten-free diet, which excludes foods containing gluten, such as wheat, barley, and rye. Choice D (Baked chicken breast, mashed potatoes with butter, and ice cream) is gluten-free, as it does not include any gluten-containing grains or products derived from them. Choices A, B, and C all contain gluten (cornbread, whole wheat bread, and spaghetti/cake, respectively).

Question 8

The nurse is providing care for a client after joint replacement surgery.The nurse delivers a lunch tray with a cheeseburger, French fries, slaw, and fresh fruit.After the meal, the nurse picks up an empty tray.Which comment is more important for the nurse to make if the client states, "My husband ate part of my lunch because I'm just not that hungry"?
A)"That's fine.Most of our clients do not eat all their meals."
B)"I will need to know which foods you actually ate."
C)"The trays are overfilled so clients have plenty to eat."
D)"Let's discuss what foods you would like for the next meal."

Accepted Answer

It's important for the nurse to know exactly what the client ate to accurately assess their nutritional intake and recovery needs after surgery.

Question 9

The LPN/LVN is assigned to feed a client who was admitted with the diagnosis of a cerebral vascular accident (CVA).The client's ability to swallow is intact, but chewing remains difficult.Which type of food will most likely cause the LPN/LVN to consult with the RN?
A)Mechanical soft
B)Pureed
C)Full liquid
D)Thickened liquid

Accepted Answer

Mechanical soft foods may require more chewing effort, which could be difficult for a client with impaired chewing ability. The LPN/LVN should consult with the RN to ensure the client's safety and appropriate dietary modifications.

Question 10

The nurse is caring for a client in the hospital.On assessment, the nurse discovers the client's hands and feet are swollen.A review of the client's past medical history reveals a history of cardiac problems.Which diet does the nurse expect the physician to order for this client?
A)A fat-restricted diet
B)A carbohydrate-restricted diet
C)A calorie-restricted diet
D)A sodium-restricted diet

Accepted Answer

Swelling of the hands and feet (edema) in a patient with a history of cardiac problems suggests fluid retention, which can be exacerbated by high sodium intake. A sodium-restricted diet is commonly recommended to help manage fluid balance in patients with heart conditions.

Question 11

The nurse is caring for a client admitted with a diagnosis of bulimia nervosa.Which assessment finding will the nurse expect? Select all that apply.
A)Evidence of dental caries
B)Verbal reports of indigestion
C)Statements about constipation
D)Frequent bouts of sore throat
E)Poor skin turgor and sunken eyes

Accepted Answer

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

Question 12

The nurse is teaching a client newly diagnosed with diabetes mellitus about the eating and nutrition parameters required with the client's diagnosis.Which comment by the client indicates that teaching is understood?
A)"I will need to eat 3 meals and 2 snacks daily."
B)"I can plan for a special dinner if I skip my lunch."
C)"I will find a new method for cooking besides frying."
D)"Once a week I can splurge and eat whatever I want."

Accepted Answer

The client understands that frying is not a healthy cooking method for someone with diabetes.

Question 13

The nurse brings a dinner tray to a client on a regular diet.The nurse notes that the client has been blind since birth.Which intervention by the nurse is most helpful in assisting this client to eat?
A)Ask the client how they would like their dinner tray arranged.
B)List and describe the foods that are present on the client's tray.
C)Compare the location of the food on a plate with the face of a clock.
D)Inquire if the client wants anything added or removed from the tray.

Accepted Answer

Using the clock face method to describe the location of food on the plate is a common technique to help visually impaired individuals orient themselves to the food's position, making it easier for them to eat independently.

Question 14

The LPN/LVN is caring for a client with diabetes mellitus and obtains a morning blood glucose level of 60 mg/dL.The LPN/LVN reports the finding to the RN.Which intervention does the LPN/LVN expect?
A)Provide the client with one-half cup of orange juice.
B)Cover the client with insulin using a sliding scale.
C)Chart the finding in the client's medical record.
D)Wait for fifteen minutes and repeat the assessment.

Accepted Answer

A blood glucose level of 60 mg/dL indicates hypoglycemia. The immediate intervention is to increase the client's blood glucose level, which can be achieved by providing a quick source of sugar, such as one-half cup of orange juice.

Question 15

The LPN/LVN is obtaining a blood glucose level on a client with diabetes mellitus, and notes that the blood glucose level is 280 mg/dL.Knowledge of which condition prompts the LPN/LVN to report the finding to the RN?
A)Hypoglycemia
B)Diabetic coma
C)Hyperglycemia
D)A normal value

Accepted Answer

The blood glucose level of 280 mg/dL indicates hyperglycemia, which is a condition of elevated blood glucose levels and requires intervention, especially in a client with diabetes mellitus.

Question 16

When the nurse inserts a nasogastric (NG)tube, the client becomes cyanotic, coughs incessantly, and is unable to speak.Which action should the nurse take immediately?
A)Encourage swallowing.
B)Continue to insert the tube.
C)Remove the tube completely.
D)View the posterior pharynx.

Accepted Answer

When a client becomes cyanotic, coughs incessantly, and is unable to speak during the insertion of a nasogastric (NG) tube, it suggests that the tube may have entered the respiratory tract instead of the esophagus. The immediate action should be to remove the tube completely to prevent respiratory distress or aspiration.

Question 17

The RN provides teaching to a client with newly diagnosed diabetes mellitus.Which method will the LPN/LVN reinforce as the best indicator of long-term glycemic control?
A)Creatinine level
B)Urine glucose level
C)Blood glucose level
D)Glycosylated hemoglobin

Accepted Answer

Glycosylated hemoglobin (HbA1c) is the best indicator of long-term glycemic control as it reflects the average blood glucose levels over the past 2 to 3 months.

Question 18

The nurse is preparing teaching for a client ordered on long-term treatment with corticosteroids.As part of the teaching about side effects, the nurse should inform the client that which body function is primarily affected?
A)Absorption
B)Appetite
C)Metabolism
D)Excretion

Accepted Answer

Corticosteroids primarily affect metabolism. They can lead to changes in glucose metabolism (increasing the risk of diabetes), fat metabolism (leading to changes in body fat distribution), and protein metabolism (affecting muscle mass and strength).

Question 19

The nurse assesses a client 24 hours after abdominal surgery.The client is experiencing nausea, anorexia, and is vomiting foul-smelling emesis.Physical assessment reveals an extended abdomen and hypoactive bowel sounds.Which order does the nurse expect from the client's physician?
A)A nasogastric tube inserted to provide enteral nutrition
B)A prescription for anti-nausea and anti-emetic medication
C)A schedule for six small liquid meals to be given daily
D)A nasogastric tube inserted for gastric decompression

Accepted Answer

The symptoms suggest a postoperative ileus or bowel obstruction, where the bowel is not functioning properly to move contents forward. A nasogastric tube for gastric decompression would relieve the symptoms by removing the gastric contents and reducing pressure and distension.

Question 20

The nurse is inserting a nasogastric (NG)tube.Which conclusion does the nurse make if a client coughs continually?
A)The client is resisting insertion.
B)The client has a strong gag reflex.
C)The client needs to have a break.
D)The client's airway is compromised.

Accepted Answer

Continuous coughing during the insertion of a nasogastric (NG) tube suggests that the tube may have entered the respiratory tract instead of the esophagus, indicating the client's airway is compromised. This is a critical safety concern that requires immediate attention.

Quiz 24: Nutritional Care and Support

An emergency department nurse admits an adult client for a drug overdose.The physician writes an order for the nurse to instill charcoal through a nasogastric (NG) tube.Which size tube will the nurse select?

A client is prescribed isoniazid (INH) , a medication that treats tuberculosis (TB) .Which condition will prompt the nurse to remind the physician that the client will need a specific vitamin during the therapy?

A client is prescribed the medication lithium as a mood-stabilizing agent.Which laboratory report indicates the client may be retaining higher than prescribed levels of lithium?

A client tells the nurse of experiencing minor gastrointestinal pain, flatulence, and diarrhea several times after meals.Which possible cause should the nurse identify?

The nurse prepares a presentation for parents of adolescents with eating disorders.The parents have expressed an interest in understanding the causes and effects of the disorders.Which information will the nurse include? Select all that apply.

A client has been vomiting without relief from medications.The physician orders the client on NPO status.Which action by the nurse violates the physician's order?

The nurse is admitting a client for a diagnosis unrelated to nutrition; however, the client states, "I don't eat gluten, but I don't have celiac disease." Which meal will the nurse expect the client to order?

The LPN/LVN is assigned to feed a client who was admitted with the diagnosis of a cerebral vascular accident (CVA) .The client's ability to swallow is intact, but chewing remains difficult.Which type of food will most likely cause the LPN/LVN to consult with the RN?

The nurse is caring for a client in the hospital.On assessment, the nurse discovers the client's hands and feet are swollen.A review of the client's past medical history reveals a history of cardiac problems.Which diet does the nurse expect the physician to order for this client?

The nurse is caring for a client admitted with a diagnosis of bulimia nervosa.Which assessment finding will the nurse expect? Select all that apply.

The nurse is teaching a client newly diagnosed with diabetes mellitus about the eating and nutrition parameters required with the client's diagnosis.Which comment by the client indicates that teaching is understood?

The nurse brings a dinner tray to a client on a regular diet.The nurse notes that the client has been blind since birth.Which intervention by the nurse is most helpful in assisting this client to eat?

The LPN/LVN is caring for a client with diabetes mellitus and obtains a morning blood glucose level of 60 mg/dL.The LPN/LVN reports the finding to the RN.Which intervention does the LPN/LVN expect?

The LPN/LVN is obtaining a blood glucose level on a client with diabetes mellitus, and notes that the blood glucose level is 280 mg/dL.Knowledge of which condition prompts the LPN/LVN to report the finding to the RN?

When the nurse inserts a nasogastric (NG) tube, the client becomes cyanotic, coughs incessantly, and is unable to speak.Which action should the nurse take immediately?

The RN provides teaching to a client with newly diagnosed diabetes mellitus.Which method will the LPN/LVN reinforce as the best indicator of long-term glycemic control?

The nurse is preparing teaching for a client ordered on long-term treatment with corticosteroids.As part of the teaching about side effects, the nurse should inform the client that which body function is primarily affected?

The nurse assesses a client 24 hours after abdominal surgery.The client is experiencing nausea, anorexia, and is vomiting foul-smelling emesis.Physical assessment reveals an extended abdomen and hypoactive bowel sounds.Which order does the nurse expect from the client's physician?

The nurse is inserting a nasogastric (NG) tube.Which conclusion does the nurse make if a client coughs continually?