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29 Cards in this Set

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The nurse is teaching a client about healthy nutrition. The nurse recognizes that the client understands the teaching when the client makes which of the following statements?

A."I need to stop eating red meat."
B."I will increase the servings of fruit juice to four a day."
C."I will make sure that I eat a balanced diet and exercise regularly."
D."I will not eat so many dark green vegetables and eat more yellow vegetables."
C."I will make sure that I eat a balanced diet and exercise regularly."

The client should adopt a balanced eating pattern that includes a variety of nutrient-dense foods and beverages among the basic food groups. The nurse should encourage the client to consume fruits, vegetables, whole-grain products, and fat-free or low-fat milk while staying within energy needs. Total fat intake should be kept between 20% and 35% of total calories with most fats coming from polyunsaturated or monounsaturated fatty acids. The client should choose and prepare foods and beverages with little added sugars or sweeteners and foods with little salt while at the same time eating potassium-rich foods.
The nurse teaches a client who has had surgery to increase intake of which nutrient to help with tissue repair?

A.Fat
B.Protein
C.Vitamins
D.Carbohydrate
B.Protein

Proteins provide a source of energy and are essential for synthesis (building) of body tissue in growth, maintenance, and repair. Proteins are also required for blood clotting, fluid regulation, and acid-base balance. Fats are important for metabolic processes. Vitamins are chemicals used as catalysts in biochemical reactions. They are essential to normal metabolism and are present in small amounts in foods. Carbohydrates are used for energy.
Which action should the nurse take initially to verify correct positioning of a newly placed small-bore feeding tube?

A.Place an order for a radiograph to check position.
B.Confirm the distal mark on the feeding tube after taping.
C.Test the pH of the gastric contents and observe the color.
D.Auscultate over the gastric area as air is injected into the tube.
A.Place an order for a radiograph to check position.
Based on knowledge of peptic ulcer disease (PUD), the nurse anticipates the presence of which bacteria when reviewing the laboratory data for a client suspected of having PUD?

A.Micrococcus
B.Staphylococcus
C.Corynebacteria
D.Helicobacter pylori
D.Helicobacter pylori

H. pylori is a bacterium that causes peptic ulcers, and its presence can be confirmed by laboratory tests. It is treated with antibiotics that control the bacterial infection. The other bacteria listed are not associated with PUD.
The nurse is assessing a client receiving enteral feedings via a small-bore nasointestinal tube. Which assessment finding needs further intervention?

A.Gastric pH of 3.0 during placement check
B.Weight gain of 1 lb over the course of a week
C.Active bowel sounds in the four abdominal quadrants
D.Gastric residual aspirate of 300 mL for the second consecutive time
D.Gastric residual aspirate of 300 mL for the second consecutive time
The nurse evaluates laboratory findings for a client hospitalized because of chronic obstructive pulmonary disease. Which finding is consistent with poor nutrition?

A.Nitrogen balance of 3 g
B.Transferrin level of 370 mg/dl
C.Hemoglobin level of 13.8 g/dl
D.Serum albumin level of 2.5 g/dl
D.Serum albumin level of 2.5 g/dl
The home health nurse is seeing the following clients. Which client is at greatest risk for experiencing inadequate nutrition?

A.A 55-year-old obese man recently diagnosed with diabetes mellitus
B.A recently widowed 76-year-old woman recovering from a mild stroke
C.A 22-year-old mother with a 3-year-old toddler who underwent tonsillectomy
D.A 46-year-old man recovering at home following coronary artery bypass surgery
B.A recently widowed 76-year-old woman recovering from a mild stroke
The nurse is measuring the pH of fluid from a jejunostomy tube and suspects that the tube has migrated into the stomach when the pH reading is:

A.3.0
B.4.0
C.5.0
D.6.0
A.3.0
The nurse wants to begin feeding a client through a small-bore feeding tube that was recently placed. Before initiating feedings through this tube, the nurse confirms tube placement by:

A.Aspirating fluid contents from the stomach
B.Requesting confirmation of placement via radiographic examination
C.Measuring the pH of the fluid aspirated through the small-bore tube
D.Injecting air through the feeding tube while auscultating for air in the stomach
B.Requesting confirmation of placement via radiographic examination
Which of the following statements about water-soluble vitamins is true? (Select all that apply.)

A.They cannot be stored.
B.They often cause toxicity.
C.They must be consumed daily.
D.Supplements must be taken to reach the recommended daily allowance of these vitamins.
A.They cannot be stored.

C.They must be consumed daily
During assessment of the patient with protein calorie malnutrition, the nurse would expect to find:

a. flat or concave abdomen
b. increased sensitivity to cold
c. increased pulse and RR
d. increased reflexes
b. increased sensitivity to cold
The nurse detrmines that the patient with the highest risk for diagnosis of imbalanced nutrition: less than body requirements related to de reased ingestion is the pateint with:

a. TB
b. malabsorption syndrome
c. draining ulcers
d. severe anorexia secondary to radiation
d. severe anorexia secondary to radiation
The nurse monitors the lab results of patient with protein calore malnutrition during treatment. An indication of improvement in patient's condition is:

a. decreased lymphocytees
b. increased serum potassium
c. increased serum transferrin
d. decreased serum prealbumin
c. increased serum transferrin
Nurse is concerned about the skeletal protein reserves of patient who has been hospitalized during cancer chemo, the assessment of patient should include:

a. body mass index
b. height and weight
c. ideal body weight and frame size
d. mid-upper arm circumference and triceps skinfold
d. mid-upper arm circumference and triceps skinfold
When teaching older adult about utritional needs during aging, the nurse emphasies:

a. the need for all nutrients is decreased as one ages
b. fewer calories, but the same amt of protein are required as one ages
c. fats, cars, protein should be decreased but vit and mineral intake increased
d. high calorie oral supplements should be taken between meals
b. fewer calories, but the same amt of protein are required as one ages
When planning nutritional interventions for a healthy 83 year old man, the nurse recognizes that thte factor that is most likely to affect his nutritional status is:

a. living alone on a fixed income

b. changes in cardio function

c. snacking between meals

d. increase in gastrointestinal motility and absorption
a. living alone on a fixed income
When considering tube feedings for a patient with sever protein calorie malnutrition the nurse knows that an advantage of a gastrostomy tube over a nasogastric tube is that:

a. less irritation to the nasal and esophageal mucosa.

b. the patient experiences the sight and smells associated wit heating

c. aspiration resulting from reflux of formulas into the esophagus is less common

d. routine checking for placement is not required
a. less irritation to the nasal and esophageal mucosa.
Nursing interventions for tube feeding safety:

a. prevent aspiration
b. prevent diarrhea
c. maintenance of tube patency
d. maintenance of tube placement
e. prevention of infection
a. prevent aspiration:
elevate 30º-45º

b. prevent diarrhea
small amounts instilled slowly

c. maintenance of tube patency
flush before/after med administration and also flush with water q 4 hours

d. maintenance of tube placement
verify position before each feeding by checking pH. if continuous feeding - check pH q 8 hours

e. prevention of infection
Don't let food bag be out longer than 8 hours, change tubing q 24 hours and rinse bags out between feedings.
Before adminstering a bolus of intermittent tube feeding to a patient with a percutaneous endoscopic gastrostomy (PEG), the nurse aspirates 220 mL of gastric contents. The nurse should:

a. return the aspirate to the stomach and recheck the vol of aspirate in an hour

b. return aspirate to stomach and continue with tube feeding

c. discard teh aspirate

d. notify MD
a. return the aspirate to the stomach and recheck the vol of aspirate in an hour
An indication for TPN that is not appropriate for enteral tube feedings is:

a. head and neck cancer
b. hypermatabolic sstates
c. malabsorption syndrome
d. protein- calorei malnutrition
c. malabsorption syndrome
Nurse is caring for a pateint receiving 1000 mL of TPN sol over 24 hrs. When it is time to change the sol. there is 150 ml remaining in the bottle. the most appropriate action is:

a. hang the new sol. and discard the remaining solution
b. notify MD for instructions
c. open the IV line and infuse remaining
d. wait to change the solution until remaining has infused
a. hang the new sol. and discard the remaining solution
MD inserts a central catheter for TPN and orders sol to start when xray confirms proper position. The xray says the catheter tip is in the superior vena cava: The most appropriate action is:

a. start the solution as ordered
b. notify MD
c. continue to infuse isotonic solution
d. gently push cather in 2 more inches
a. start the solution as ordered
A patient receiving a fat emulsion solution develops N&V, and fever. These symptoms may indicate:

a. a fat embolism
b. a fatty acid deficiency
c. a too rapid infusion rate
d. an allergic reaction to the solution
c. a too rapid infusion rate
When meds are used in treatment of obesity, it is important for the nurse to teach the patient that

a. over the counter diet aids are safe
b. diet and exercise are the most important in weight control since rugs do not help change eating behaviors
c. all drugs used fro weight control are capable of altering CNS fucntion
d. primary effects of meds is psychological
a. over the counter diet aids are safe
b. diet and exercise are the most important in weight control since rugs do not help change eating behaviors
Roux-en-Y bypass complications include:
Dumping syndrome
Lifelong cobalamin supplementation
Hypoglycemic post prandial
The nurse plans care for the morbidly obese patient recognizing that complications of obesity necessitate the cautious use of:

a. IV solutions
b. hypoglycemic agents
c. antyhypertensive drugs
d. sedative and hypnotics
d. sedative and hypnotics
during care of the morbidly obese patient, it is important that the nurse:

a. avoid reference to patient's weight
b. emphasize to patient how important it is to lose weight
c. plan for necessary modifications in equipment and nursing techniques before initiatiing care
d. full assessment of body may not be possible because of skin folds
c. plan for necessary modifications in equipment and nursing techniques before initiatiing care
A postoperative nursing intervention for the obese patient who has undergone a verticle banded gastroplasty is:

a. irrigating and repositioning the nasogastric tube as needed
b. delaying ambulation
c. keeping patient positioned on side
d. using extra long or spinal needle to admin IM shots
d. using extra long or spinal needle to admin IM shots
Dietary teaching for patient following a Roux-en-Y gastric bypass includes info regarding the need to:

a. gradually increase amount of food
b. maintain a long term liquid diet
c. avoid high carb foods and limit fluids to prevent dumping syndrome
d. consume foods high in carb protien and fiber
c. avoid high carb foods and limit fluids to prevent dumping syndrome