Question 1

A 41-year-old female client has been dieting to lose weight.Which of the following statements indicates that the client needs additional teaching regarding a healthy weight-loss plan?

Accepted Answer

Total fat intake should be between 20% and 35% of total calories with most fats coming from polyunsaturated or monounsaturated fatty acids.The Food Guide Pyramid is a basic guide for buying food and meal preparation.This basic system provides for diets ranging from 1600 to 2800 kcal/day.Losing weight at a slow rate is healthier than taking it off quickly.In general,when energy requirements are completely met by kilocalorie intake in food,weight does not change.When the kilocalories ingested exceed a person's energy demands,the individual gains weight.If the kilocalories ingested fail to meet a person's energy requirements,the individual loses weight.

Question 2

The nurse is aware that there are medications that are taken that alter the client's taste and may influence the dietary intake.In reviewing the medications taken by the clients on the unit,the nurse will consult with the nutritionist to develop a palatable meal plan for the client taking:

Accepted Answer

Ampicillin may cause an alteration in taste.Opiates,such as morphine,cause decreased peristalsis and may result in constipation.Decreased drug absorption may occur when diuretics,such as furosemide,are administered with food.Decreased acetaminophen absorption may occur if administered with food.Overdose of acetaminophen is associated with liver failure.Morphine,furosemide,and acetaminophen do not affect the client's sense of taste.

Question 3

Which of the following statements reflects the best understanding of the benefits of breast-feeding related to the infant's health and wellness?

Accepted Answer

Breast-feeding benefits include the following: reduced food allergies and intolerances;fewer infant infections;easier digestion;convenient;always correct temperature,available,and fresh;economical,because it is less expensive than formula;and increased time for mother and infant interaction.The other options are not incorrect but do not focus on health benefits for the infant as directly as the answer.

Question 4

Which of the following statements by an older adult shows the most need for follow-up regarding the risk for dehydration in this age-group?

Accepted Answer

Thirst sensation diminishes with age,leading to inadequate fluid intake or dehydration.The remaining options deal more with the effects of fluid consumption than with the risk for dehydration.

Question 5

The nurse is caring for a 5-kg 8-month-old infant admitted to the hospital by the health care provider,who was concerned about the infant's low weight.The infant's birth weight was 3.5 kg.The nurse knows that on average an infant doubles his or her birth weight at what age?

Accepted Answer

The infant usually doubles birth weight at 4 to 5 months and triples it at 1 year.

Question 6

Food safety is a concern of a group of adults attending the community health clinic.The participants identify to the nurse that they have seen a lot of reports on television about Escherichia coli and how dangerous it can be.When asked where the bacteria comes from,the nurse responds that a potential source of E.coli is:

Accepted Answer

E.coli may be contracted from undercooked meat,such as ground beef.Sausage is a potential source of botulism.Soft cheeses are a potential source of listeriosis,and milk products are a potential source of shigellosis.

Question 7

The nurse and the mother of an infant are discussing the introduction of solid foods into her child's diet.Which of the following statements made by the mother reflects the best understanding of the most appropriate manner to introduce new foods?

Accepted Answer

Caregivers introduce new foods one at a time,approximately 4 to 7 days apart to identify allergies.The other options are not as directly focused on the possibility of food allergies.

Question 8

A client with a family history of cancer is discussing the effects of free radicals on body cells and tissue.Which of the following responses is the most therapeutic answer to the client's question,"What can I do to protect against free radicals?"

Accepted Answer

Certain vitamins are currently of interest in their role as antioxidants.These vitamins neutralize substances called free radicals,which produce oxidative damage to body cells and tissues.Researchers believe that oxidative damage increases a person's risk for various cancers.These vitamins include beta-carotene and vitamins A,C,and E.The remaining options oversimplify the response or give very unspecific information.

Question 9

The nurse recognizes which of the following clients as being at greatest risk for a negative nitrogen balance?

Accepted Answer

Negative nitrogen balance occurs when the body loses more nitrogen than the body gains,for example,with infection,sepsis,burns,fever,starvation,head injury,and trauma.Although all these clients may be experiencing an increased nitrogen need for body repair,the burn client has the greatest need and so is at greatest risk for a negative nitrogen balance.

Question 10

A nurse is discussing high-nutrient-density food selections with a client recovering from extensive partial-thickness burns.Which of the following statements by the client reflects the best understanding of this dietary concept?

Accepted Answer

High-nutrient-density foods,such as fruits and vegetables,provide a large number of nutrients in relationship to kilocalories.Low-nutrient-density foods,such as alcohol or sugar,are high in kilocalories but are nutrient poor.The remaining options mention low-calorie and comfort food;they are not really discussing high-nutrient-density foods.

Question 11

The nurse is questioning a newly admitted client regarding his dietary history.Which of the following questions asked by the nurse is most likely to secure additional pertinent information regarding the client's statement,"I think I'm allergic to peanuts"?

Accepted Answer

Asking the client to describe the reactions to a particular food allows for a more thorough discussion than does any of the other options.Some options are more directed at the management rather than securing additional information regarding the reaction itself.

Question 12

The mother of a 25-month-old is discussing her concerns regarding her daughter's eating habits with the nurse.The most therapeutic response to the mother's statement,"She is such a fussy eater;it seems that she will only eat dry cereal and cheese" is:

Accepted Answer

Toddlers exhibit strong food preferences and become picky eaters.Small frequent meals consisting of breakfast,lunch,and dinner with three interspersed high-nutrient-density snacks help improve nutritional intake.The answer provides the most comprehensive response to the mother's statement because it provides both an explanation and a suggestion.

Question 13

For the client who is receiving parenteral nutrition via a central venous catheter,the nurse recognizes that a priority is to:

Accepted Answer

After catheter placement,the catheter is flushed with saline or heparin until the position is radiographically confirmed.Aseptic technique,not sterile technique,is used during the administration of feedings.An initial rate of 40 to 60 mL/hr is recommended,and the rate is gradually increased.The rate of administration is not the priority.The nurse must first confirm correct placement of the catheter.A single container of PN should hang no longer than 24 hours;lipids no more than 12 hours.The nurse must first confirm correct placement of the catheter before any infusion is begun.

Question 14

A nasogastric tube is inserted in order for the client to receive intermittent tube feedings.An initial chest x-ray examination is done to confirm placement of the tube in the stomach.After the x-ray confirmation,the most reliable method of checking for tube placement is for the nurse to:

Accepted Answer

After the x-ray confirmation,the next best method involves testing the pH of the feeding tube aspirate and observing the appearance of the aspirate.A properly obtained pH of 0 to 4 is a good indication of gastric placement.Placing the end of the tube in water and observing for bubbling is not an accurate method of checking for tube placement.Auscultation is no longer considered a reliable method for verification of tube placement because a tube inadvertently placed in the lungs,pharynx,or esophagus can transmit a sound similar to that of air entering the stomach.Asking the client to speak as a method of checking for tube placement has a high degree of inaccuracy.There have been cases reported in which clients have been able to speak despite placement of feeding tubes in the lung.

Question 15

A client has been receiving tube feedings and is tolerating them very well.The health care provider determines that the rate of the intermittent tube feedings may be advanced.The nurse prepares to:

Accepted Answer

When a client is tolerating tube feedings well,the nurse should expect the health care provider to order the feedings to be increased by 50 mL/day to achieve needed volume and calories in six to eight feedings.Formula is started at full strength for isotonic formulas.Intermittent feedings are allowed to infuse over at least 20 to 30 minutes.Feedings should be begun with no more than 150 to 250 mL at one time.

Question 16

The nurse is counseling a client undergoing chemotherapy.The client has shared with the nurse that the client does not have much of an appetite and is worried about not getting enough nutrients.Which of the following statements by the nurse addresses the client's concerns?

Accepted Answer

Foods are sometimes described according to their nutrient density,the proportion of essential nutrients to the number of kilocalories.High-nutrient-density foods,such as fruits and vegetables,provide a large number of nutrients in relationship to kilocalories.The client did not express a concern about weight loss but is asking about nutrition.Protein provides energy,but because of protein's essential role in growth,maintenance,and repair,a diet needs to provide adequate kilocalories from nonprotein sources.Each gram of carbohydrate produces 4 kcal and serves as the main source of fuel (glucose)for the brain,skeletal muscles during exercise,erythrocyte and leukocyte production,and cell function of the renal medulla.When there is sufficient carbohydrate in the diet to meet the energy needs of the body,protein is spared as an energy source.

Question 17

The nurse is caring for a 6-kg 4-month-old infant who is hospitalized with a respiratory infection.The nurse knows that an infant this age needs approximately 108 kcal/kg of body weight.The nurse also understands that human breast milk provides approximately 20 kcal/oz.About how much breast milk does the nurse need to feed the infant every 4 hours in order to provide enough to meet the infant's nutritional needs?

Accepted Answer

6 kg x 108 kcal/kg/day = 648 kcal/day;648 kcal/day ÷ 20 kcal/oz = 32.4 oz/day;32.4 oz/day ÷ 24 hr/day = 1.35 oz/hr;1.35 oz/hr x 4 hours = 5.4 ounces every 4 hours.

Question 18

A nurse is discussing high-nutrient-density food selections with a client recovering from extensive partial-thickness burns.Which of the following statements by the nurse reflects the best understanding of this dietary concept?

Accepted Answer

High-nutrient-density foods,such as fruits and vegetables,provide a large number of nutrients in relationship to kilocalories.Low-nutrient-density foods,such as alcohol or sugar,are high in kilocalories but are nutrient poor.The remaining options either provide suggestions for food substitutes or provide a less informative explanation.

Question 19

The nurse is discussing vitamin supplements with a client who is an amateur body builder.Which of the following statements by the nurse shows the greatest understanding concerning the risk for hypervitaminosis?

Accepted Answer

The fat-soluble vitamins (A,D,E,and K)are stored in the fatty compartments of the body.Hypervitaminosis of fat-soluble vitamins results from megadoses (intentional or unintentional)of supplemental vitamins,excessive amounts in fortified food,and large intake of fish oils.The water-soluble vitamins,vitamin C and the B complex (which is eight vitamins),are not stored,so these need to be provided in the daily food intake.Although water-soluble vitamins are not stored,toxicity can still occur.The remaining option is not incorrect but is not as inclusive as the answer.

Question 20

The nurse is discussing food selection with a client who recently experienced a partial-thickness burn over 20% of her body.The client expresses a reluctance to ingest a large amount of carbohydrates because she successfully lost 50 pounds and does not want to regain the weight.The most therapeutic response to the client's nutritional needs is:

Accepted Answer

Negative nitrogen balance occurs when the body loses more nitrogen than the body gains;for example,with infection,sepsis,burns,fever,starvation,head injury,and trauma.Nutrition during this period needs to provide nutrients to put clients into positive nitrogen balance for healing.Carbohydrates are the main source of energy in the diet.The remaining options concentrate more on the weight gain issue than the energy need.

Quiz 44: Nutrition