ATI Nutrition Test Bank +330 Q & A 1. A nurse is caring for a client who is receiving TPN. Which of the following lab findings indicates that the TPN
... [Show More] therapy is effective? A. Calcium 8 mg/mL B. He mog lobin 9 g/dL C. Prealbumin 30 mg/dL D. Cholesterol 140 mg/dL 2. A patient who is Islam has a surgery during Ramadan. The nurse suspects the patient may follow what rule? Fasting during daylight hours while at the hospital 3. Basic food choices for kosher, orthodox Judaism diets: - Prealbumin is indicative to nutritional status - Meat - no mixing meat and dairy (cheeseburger) - no pork or shellfish - fish must have scales & fins to be kosher 4. A nurse is providing instructions to a client who has a new diagnosis of celiac disease. Which of the following food choices by the client indicates a need for further teaching? A. Potatoes B. Graham crackers C. Wild rice D. Canned pears 5. A client has anorexia nervosa. What interventions should the nurse implement? Observe client during meals. Reward client based on meals eaten. Watch client after meals for potential purging. 6. A nurse is caring for a client who develops diarrhea while receiving a continuous enteral tube feeding. Which of the following actions should the nurse take? A. Provide a low-protein formula B. Elevate the HOB to 30 deg. C. Switch to intermittent feedings D. Warm the formula to room temp 7. A client has a headache. What deficiency may they have? Vitamin A - Graham crackers are made from wheat flour All others are gluten-free - A client can develop diarrhea if the formula is too cold. 8. A nurse is caring for a client who has age-related macular degeneration (AMD) & asks the nurse if there are any nutritional changes to consider. Which of the following responses should the nurse make? A. Use soy products as much as possible B. Add niacin-rich foods to the diet C. Increase dietary intake of lutein D. Consume foods w/a high glycemic index 9. A mom tells the nurse their child has GERD. what might the nurse tell the mom to do to prevent aspiration? Place in side lying position if the baby is vomiting 10. A nurse is caring for a client who is on a full liquid diet due to dysphagia. Which of the following nursing actions is the highest priority? A. Add thickener to liquids. B. Educate the client about acceptable liquids. C. Perform a calorie count of consumed liquids. D. Offer high-protein liquid supplements. - (Found in vitamin A) - this is highest priority to reduce the risk of aspiration 11. A nurse is caring for a client who is at 8 weeks of gestation & has a BMI of 34. The client asks about weight goals during her pregnancy. The nurse should advise the client to do which of the following? A. Maintain her current BMI. B. Gain approximately 6.8 kg (15 lb). C. Lower her BMI to 30. D. Gain 12.7 to 15.8 kg (28-35 lb). 12. A nurse is providing discharge teaching to a client who has a new ileostomy. Which of the following dietary guidelines should the nurse include in the teaching? A. Plan to reduce dietary salt intake. B. Cook foods w/limited amounts of pasta products. C. Prepare meals on a schedule. D. Reduce dietary B12. 13. A nurse is providing to a client who has dumping syndrome & is experiencing weight loss. Which of the following instructions should the nurse include in the teaching? A. Consume liquids between meals B. Increase intake of simple carbohydrates C. Decrease foods high in fat content D. Eat meals low in protein 14. A nurse is gathering assessment date from a client. what is an accurate way to do this? 24 HR RECALL. Food diary 15. A nurse is providing teaching to a client who has DM & an HbA1c of 8.7%. Which of the following statements by the client indicates understanding of this lab value? A. "I should have gone to my exercise class yesterday." B. "This shows that my result is finally within normal range." C. "This shows that I have not been following my diet." D. "I should have my blood work done 1st thing in the morning." 16. A client who eats 75% of their meal daily asks when they can be weaned off of TPN. How might the nurse respond? You can be weaned off TPN when 60% of calories are coming from the diet. As of right now, I see you are eating majority fo meals. I will let the provider know about your decision to want to be weaned off of TPN 17. A client has iodine deficiency. what should the nurse recommend? Iodized salt 18. A new mom is beginning breast feeding/ bottle feeding. What should the nurse suggest? Feeding baby based on cues, every 3 to 4 hrs. Switch breasts after 5- 10 mins. Use 1-way valves. 19. A client has been in a traumatic accident. What might the nurse suspect with his BMR? It may be increased 20. A client has COPD. What are some important considerations regarding their diet? Need high protein high carb diet. More fluids to help thin secretions 21. A client presents to the nurse with ascites. What might the nurse do to his diet to reduce the ascites present? Limit sodium to 2000mg or less daily 22. A client wants to lose weight. What might the nurse recommend to not lose weight too quickly? Loose a lb a week. 23. A client who is pregnant asks about what folic acid pills will help with. the nurse’s appropriate response is: folic acid should be increased during pregnancy to reduce fetal rural tube defects 24. A client on tube feeds is experiencing diarrhea. What can the nurse to to prevent this? Slow the feed rate 25. A patient has stomatitis of the mouth and has been told by the provider to rinse their mouth out every 2 hours. What types of mouthwashes should the nurse recommend? Normal saline, Lidocaine No alcohol based, hydrogen peroxide and CHG because they can be irritating 26. A patient with stomatitis reports having a metallic taste from chemo drugs. What should the nurse recommend? Eat with plastic utensils 27. A patient with stomatitis reports they have lost weight due to the chemo drugs. What interventions should the nurse recommend? Eat cool or room temperature foods Use a straw May use sauces or gravies to help add flavor to food Chew slowly Have a high protein, low carb diet Avoid citrus, salty foods and spicy food Rinse mouth out with gentle mouthwash Eat foods that are not filling 4-6 smaller meals a day 28. A patient receives TPN. What are important interventions the nurse should take? Obtain daily weights Check blood glucose levels every 4 hrs. Have 10% dextrose solution ready if the bag runs out Check patient for egg allergy Change tubing every 24 hrs. Give via port or Central Line If fat floating, return bag to pharmacy 29. A patient has dumping syndrome as a result of gastric bypass surgery. What nutritional teaching should the nurse do with the patient? Limit liquids with meals Avoid exercise after meals Eat slowly and chew thoroughly Avoid sugars Begin the meal with a protein Lie down after meals 30. Dumping syndrome S/S Fullness, faintness, diaphoresis, tachycardia, palpitations, hypotension, nausea, abdominal distinction, cramping, diarrhea, weakness, and syncope. 31. If a client has a BMI between 25-29, they should be referred to a what? Weight loss group 32. If a patient has a BMI less than 18.5, what are they at risk for? Malnutrition 33. s/s of malnutrition dry, thin hair, dry mucous membranes, cool extremities, low BP, high HR with weak and thready pulse muscle wasting present confusion 34. Patients with a BMI of greater than 30 are at risk for: diabetes, CVD, stroke 35. A patient reports following Kosher laws. What dietary practices might they follow? No pork. They will eat meat with dairy only. Must have separate prep boards for meats. 36. Order of how the body gets energy from macronutrients in the body: carbs, fats, proteins 37. A patient asks the nurse what is the meaning of his HbA1C. How might the nurse respond? The HbA1C is a measurement of how well you have been maintaining your sugars within 3 months. A reading of 4-6% is considered normal. For diabetics, they should aim to have readings between 6.5% and 7% to be considered healthy. 38. A patient has burns amongst 15% of his body. What are likely some nutrition interventions the nurse will perform? Give patient high calorie, high protein diet, use enteral feedings to increase food consumption 39. Amounts of nutrients providing energy to the body: Carbs and Protein: 4 g Fats: 9g 40. A patient has coronary artery disease. What is a food the nurse might recommend? Baked salmon 41. Triglycerides range <150 mg/dL 42. LDL range less than 130 43. HDL range 40-60 44. If a patient has PKU. What might the nurse suggest to do? Get serum bilirubin checks 2 times a month during pregnancy 45. A mom is interested in knowing when her infants’ weight will double and triple. What might the nurse tell her? The birthweight may double between 5-6 months and triple by 1 year. 46. A client presents with hyperactive reflexes, Trousseaus sign and Chvostek’s sign. What might the patient be experiencing? Calcium deficiency as calcium is needed for nerve transmission 47. Foods’s high in vitamin A Liver, egg yolks, fortified margarine and butter; dark green and deep orange fruits and vegetables (apricots, broccoli, cantaloupe, carrots, pumpkin, winter squash, sweet potatoes, and spinach) 48. Foods’s high in vitamin D Fortified and full fat dairy products; fish oil; synthesized in skin when exposed to sunlight 49. Foods’s high in vitamin E Vegetable oils and their products such as salad oils, margarine, nuts, seeds, avocado, and mango 50. Foods’s high in vitamin K Green leafy vegetables such as lettuce, cabbage, spinach, peas, asparagus, meat, milk, and soybean oil 51. Foods’s high in vitamin C Citrus fruits, Cantaloupes, Strawberries, Tomatoes, Potatoes, Broccoli, Green peppers, and Spinach 52. Foods’s high in sodium Bacon Butter Canned food Cheese/Cottage cheese Frankfurters Ketchup Lunch meat Milk Mustard Processed food Snack food Soy sauce Table salt White & Whole wheat bread 53. Food’s high in potassium potatoes, raisins, bananas, spinach, avocado’s, carrots 54. Vitamin C deficiency Scurvy impaired wound healing decreased iron absorption 55. Vitamin B deficiency Beriberi 56. botulism comes from canned products 57. Vitamin A deficiency night blindness 58. complete proteins proteins that contain all nine of the essential amino acids- eggs, poultry, soy milk and soybeans 59. incomplete proteins proteins that lack one or more of the essential amino acids- plant sources like beans, grains, legumes 60. If a patient reports having lactose intolerances, what can't they have? Anything with lactose in it, like milk or dairy products 61. What can happen if a client who is lactose intolerance eats lactose foods? Abdominal Cramps 62. S/S of hypoglycemia shakiness, diaphoresis, anxiety, nervousness, chills, nausea, headache, weakness, confusion 63. S/S of hyperglycemia bg >250; thirst, frequency in urination, hunger, warm/dry/flushed skin, weakness, malaise, rapid/weak pulse, hypotension, deep rapid respirations 64. Hypoglycemia Rule of 15 If BS lower than 70: treat with 15 grams carbs, check BS after 15 minutes, repeat if not up, after 3 cycles seek medical attention; every 15 gram carbs= 50 BS increase 65. Good sources for quick carbs for hypoglycemics apple juices, soda, candy, crackers 66. DKA s/s dehydration, ketones in urine, poor skin turgor, Kussmaul respirations 67. Somogyi phenomenon A rebound phenomenon that occurs in clients with type 1 diabetes mellitus. Normal or elevated blood glucose levels are present at bedtime; hypoglycemia occurs at about 2 to 3 am. Counterregulatory hormones, produced to prevent further hypoglycemia, result in hyperglycemia (evident in the prebreakfast blood glucose level). Treatment includes decreasing the evening (predinner or bedtime) dose of intermediate acting insulin or increasing the bedtime snack. 68. What should the nurse do when present with Somogyi phenomenon? Monitor BG during the night 69. Dawn phenomenon Early morning glucose elevation produced by the release of growth hormone, which decreases peripheral uptake of glucose resulting in elevated morning glucose levels. Admin of insulin at a later time in day will coordinate insulin peak with the hormone release. 70. Normal blood glucose range 70-110 71. What must diabetics do to manage their carbs? Carb counting, meaning they must have portion control 72. A patient with CVD should cook with what? Canola oil 73. A client is Hindu. What might the nurse exchange on the client’s tray after seeing they were given a hamburger for dinner? The hamburger with a salad as they do not eat beef 74. A mom reports their child does not eat enough variety of foods. What could the mom do to increase food variety in the Childs diet? Offer foods in different textures, shapes, sizes 75. A mom is concerned about the breastmilk not giving enough nutrients to the baby. What could the nurse tell her? Breastmilk is nutritionally complete till 6 months of age. Dry fortified cereal should be introduced at 4 months. 76. A mom with a 6-month-old is ready to introduce new foods into the Childs diet. What might the nurse suggest her to do? Introduce new foods every 4-7 days and watch for allergic reactions 77. A mom wants to feed her baby who is 8 months old cow’s milk. How might the nurse intervene? Do not feed the baby cow’s milk till they are 8 months old. 78. An older adult who has dementia often gets up from the dinner table and walks around the unit. What could the nurse give them to facilitate eating? Finger foods 79. A patient drinks a lot of alcohol during meals. What are they at risk for? Cancer and Liver Diseases 80. A client takes prednisone. What might the nurse suggest for nutrition while using this medication? Increase in protein and have blood sugar checks as it can cause delayed wound healing 81. A patient practices Judaism. What is a meal the patient might have? Spaghetti and tomato sauce 82. A patient is prescribed phenelzine for depression and has questions about the diet they should follow. What must the nurse tell patient to avoid? Foods’s high in tyramine- aged meats and cheeses, smoked meats, figs, avocado, bananas, chocolate, beer, wine 83. A client has diarrhea. What are low fiber foods the nurse can suggest? wheat bread, pasta, casserole 84. Seventh Day Adventists do not drink coffee, are likely vegetarians 85. A client has just been started on an ACE inhibitor for hypertension. What must the nurse teach the client? Avoid foods such as bananas, potatoes, tomatoes, oranges, broccoli, meats as they can add to increased potassium levels in which the drug already does do in the body. 86. A nurse is planning discharge teaching for a client who is postoperative following placement of a colostomy. Which of the following info should the nurse include? A. "Resume a regular diet by 4 weeks after surgery." B. "Add high-fiber foods to your diet." C. "Increase your intake of foods containing pectin." D. "Drink 4-6 cups of water per day." 87. Chronic kidney disease question: creatinine (3.5 might be the level, norm is 0.6-1.2ish) 88. A patient has dysphagia. What are some interventions the nurse should teach the patient? Rest before meals. Tilt chin down to help swallowing. Sit up when eating. Thick of salivating foods before eating 89. A nurse is teaching a client about managing IBS. Which of the following info should the nurse include in the teaching? A. Increase intake of fresh fruit high in fructose B. Limit foods that contain probiotics C. Take peppermint oil during exacerbation of manifestations D. Substitute white sugar w/honey 90. A nurse is reviewing the lab results of a client who has a pressure ulcer. Which of the following findings should indicate to the nurse that the client is at risk for impaired wound healing? A. Hgb 15 g/dL B. Serum albumin 3.0 g/dL C. Prothrombin time 11.5 sec D. WBC 6000/mm3 91. Antidote for Warfarin= Vitamin K 92. Diet for disequilibrium syndrome/nausea (vertigo) question: low fat, low carb 93. Best source of protein food: cheese 94. Good iron sources for vegetarians: dried beans 95. HDL levels normal is 40-59 (higher for men) 96. LDL levels less than 100 is best 97. Total cholesterol levels normal is less than 200 98. normal Hct 34-50% higher in men than women 99. normal BUN & creatinine BUN=80-140 higher in men than women Creat=0.6-1.2 100. normal prealbumin and albumin prealbumin= 23-43 albumin= 3.5-5.0 101. Pt is obese & wants to lose weight, what is the 1st thing a nurse should do? identify client's motivation 102. Cheese is a ____protein. Complete 103. Gelatin is a ______protein. incomplete 104. Salmon is a ______protein. complete 105. % of total daily protein should be: 12-20% 106. % of total fat in diet should be, sat fats?: 30%, sat fats less than 10% 107. mechanical soft diet clear and full liquids + diced or ground foods 108. pureed diet clear and full liquids + food and fluids that have been pureed to a thick liquid form [e.g., pureed meats, fruits, scrambled eggs] 109. soft diet similar to regular diet, but foods must require little chewing and be easy to digest 110. thin liquids regular-no modification needed. Clear juices, milk, coffee, ice cream 111. nectar thick liquids Easily pourable and are comparable to apricot nectar or thicker cream soups 112. honey thick liquids slightly thicker, less pourable, drizzle from a cup or bowl 113. spoon thick liquids pudding consistency 114. Toddlers should NOT have: hot dogs, marshmallows, grapes, blueberries, nuts, seeds, popcorn, fruit snacks, as they are choking hazards 115. Toddlers should have: pudding, crackers, yogurt, soft cheeses because they are easier to chew and less of a choking hazard 116. fluid volume deficit s/s thirst (early sign), fever, rapid/weak pulse, increased resp, hypotension, weight loss, anxiety, decreased output, HA, increased specific gravity 117. fluid volume excess s/s Hypertension Bounding pulse JVD Peripheral edema ↑ urine output that is dilute Acute, rapid weight gain S3 heart sound in adults Bulging fontanels in infants Crackles on auscultation Dyspnea, cough and increased RR Mental status changes (headache, confusion, lethargy; seizures possible) 118. BUN normal range 10-20 119. specific gravity 1.005-1.030 120. A mom with a toddler should serve the client 8-12 oz of fruit juice? True or false? False: give the m4-6 oz as it can be very sugary 121. Serving food warm can do what? Enhance the flavors of foods 122. DASH diet followers should: increase foods high in calcium 123. S/S of allergic reaction hives, itching, anaphylaxis, hoarseness 124. Clients with a sodium restriction should take which types of dairy products Low fat due to having high sodium amounts 125. Warfarin food interactions Vitamin K rich foods Green vegetables Leafy vegetables Beef and pork liver Many fruits, vegetables, legumes Patients do not need to limit intake Patients need to maintain consistent intake Thiamin rich foods 126. dehydration and BP LOW bp 127. Protein intake in a normal client should be restricted to 5-6 oz daily (DASH diet/TLC- 3 oz or size of fist) 128. Good source of heme iron is ground beef or other meats 129. Water intoxication may indicate hyponatremia 130. Vitamin B12 deficiency pernicious anemia 131. Vitamin B12 food sources Shellfish, Liver, Fish, and Lean meat 132. A client practicing Judaism should replace the bacon on their tray with: chicken breast 133. Toddler should feed themselves to: promote independence 134. Common childhood allergies eggs, nuts, milk, soy 135. A student nurse is helping the nurse with initial assessment data. The student asks the nurse how to calculate BMI. The nurse would reply with : Assess the client’s weight in kg and height in meters. Square the height. Diving kg/m^2 to find the BMI. OR Assess the client’s weight in lbs and height in inches. Squares the height. Divining lbs/in^2 and multiply by 703 136. A mom who has a BMI of 27 asks the nurse how much weight should they gain during pregnancy. What should the nurse respond with? You should gain weight based on your BMI: 18.5 or lower= 28-40 lbs 18.5-24.9= 25-35lbs 25-29.9= 15-25lbs 30=11-20 lbs. With your BMI you should gain 15-25 lbs during pregnancy 137. Prealbumin therapeutic ranges 15-36 138. What does albumin measure? The amount of protein a person is getting. 139. Albumin therapeutic ranges [Show Less]