Nutrition Flashcards
NCLEX-type questions regarding nutrition
A postoperative client has been placed on a clear liquid diet. The
nurse should provide the client with which items that are allowed to
be consumed on this diet? Select all that apply.
A. Broth
B. Coffee
C. Gelatin
D. Pudding
E. Vegetable juice
F. Pureed vegetables
A. Broth, B. Coffee, C. Gelatin
Rationale: A clear liquid diet consists of foods that are relatively transparent to light and are clear and liquid at room and body temperature. These foods include items such as water, bouillon, clear broth, carbonated beverages, gelatin, hard candy, lemonade, ice pops, and regular or decaffeinated coffee or tea. The incorrect food items are items that are allowed on a full liquid diet.
A client has just been started on total parenteral nutrition (TPN) for severe malnutrition. The nurse determines that refeeding syndrome has occurred after noting which of the following laboratory test results?
A. Magnesium 2 mg/dL
B. Calcium 9.8 mg/dL
C. Phosphorus 1.2 mg/dL
D. Potassium 4.2 mEq/L
C. Phosphorus 1.2 mg/dL
Rationale: TPN is a concentrated glucose‐and‐protein solution that utilizes phosphorus in metabolism of the nutrients and produces a shift of phosphorus into the cells, thus causing a serum phosphorus deficit. Options A, B, and D are incorrect. These electrolytes also can be decreased in the refeeding syndrome. First, recall the purpose and content of TPN. Recall that electrolytes are utilized for enzyme reactions and metabolism, and recognize that the phosphorus level is low, to choose option C.
Clients suffering from profound malnutrition may experience the refeeding syndrome when first initiating total parenteral nutrition (TPN). To determine if this occurs, the nurse must do which of the following?
A. Monitor potassium, phosphorus, and magnesium levels closely
B. Check blood glucose levels every 6 hours
C. Assess client for hyperactive bowel sounds
D. Assess the client’s level of consciousness every shift
A. Monitor potassium, phosphorus, and magnesium levels closely
Rationale: Magnesium, potassium, and phosphate levels may drop because magnesium (needed for ATP synthesis) and phosphorus (a component of ATP) are utilized rapidly as the TPN solution is metabolized, and potassium is taken up intracellularly in energy metabolism. Blood sugars are checked frequently but are not related to the refeeding syndrome. Bowel sounds and level of consciousness would be part of a routine assessment but do not reflect refeeding syndrome. The question requires specific knowledge of the refeeding syndrome. Eliminate option D because it is unrelated to the other 3 options. Eliminate option C because TPN is often given to rest the bowel. Choose option A over B because it is more specific and blood sugars are specifically connected to hyperglycemia.
A nurse is teaching a pregnant client about nutrition and food sources that are high in folic acid. Which of the following food items does the nurse tell the client contains the highest amount of folic acid?
A. Lettuce
B. Oranges
C. Broccoli
D. Pinto beans
D. Pinto beans
Rationale: Foods high in folic acid include beans (black, kidney, pinto, refried), peanuts, orange juice and oranges, asparagus, peas, broccoli, lettuce, and spinach. Pinto beans contain 294 mcg per 1-cup serving. An orange contains 44 mcg per 1-cup serving, lettuce contains 60 mcg per 1-cup serving, and broccoli contains 78 mcg per 1-cup serving.
A client is receiving parenteral nutrition (PN) with fat emulsion (lipids) piggybacked to the PN solution. For which signs of an adverse reaction to the fat emulsion should the nurse monitor the client? Select all that apply.
A. Chills
B. Pallor
C. Headache
D. Chest and back pain
E. Nausea and vomiting
F. Subnormal temperature
A. Chills, C. Headache, D. Chest and back pain, E. Nausea and vomiting
Rationale: Signs of an adverse reaction to fat emulsion include chest and back pain, chills, fever, dyspnea, cyanosis, diaphoresis, flushing, headache, nausea and vomiting, pressure over the eyes, vertigo, and thrombophlebitis at the infusion site.
Which food should the nurse offer to a client who has been prescribed a full liquid diet?
A. Toast
B. Plain bagel
C. Cooked custard
D. Scrambled eggs
C. Cooked custard
Rationale: A full liquid diet consists of liquid foods that are clear or opaque liquid foods, including those that are liquid at room temperature. Cooked custard is allowed on a full liquid diet. Toast and a bagel are allowed on a regular diet (a diet with no restrictions). Scrambled eggs are allowed on a soft diet.
A clear liquid diet has been prescribed for client who has just undergone surgery. Which foods should the nurse offer to the client? Select all that apply.
A. Custard
B. Apple juice
C. Orange juice
D. Chicken broth
E. Orange gelatin
F. Vanilla ice cream
B. Apple juice, D. Chicken broth, E. Orange gelatin
Rationale: A clear liquid diet consists of foods, such as apple juice, chicken broth, and gelatin, which are relatively transparent. Custard, orange juice, and vanilla ice cream are components of a full liquid diet. Remembering that a clear liquid diet consists of foods that are relatively transparent will direct you to the correct options. Review the foods allowed on clear liquid and full liquid diets if you had difficulty with this question.
A client with a urinary tract infection has been started on nitrofurantoin (Macrodantin), a urinary antiseptic medication, and is taught about the foods that will maintain the urinary pH in the acid range. Which food does the nurse tell the client to avoid while taking this medication?
A. Prunes
B. Oranges
C. Rhubarb
D. Cranberries
C. Rhubarb
Rationale: When a client is taking nitrofurantoin, the urinary pH must be maintained in the acid range, and so the client needs to be instructed to consume an acid ash diet. Rhubarb reduces the acidity of the urine and should be avoided when acidic urine is required. Prunes, oranges, and cranberries are acceptable foods.
A client tells the nurse that during the past 2 weeks her urine output has been greater than usual. The nurse, gathering subjective data from the client, most appropriately asks the client whether she has been:
A. Regularly exercising
B. Experiencing headaches
C. Having heavy menstrual cycles
D. Drinking an excessive amount of coffee
D. Drinking an excessive amount of coffee
Rationale: Ingestion of certain foods directly affects urine production and excretion. Coffee, tea, cocoa, and cola, all of which contain caffeine, promote increased urine formation. The incorrect options are not specifically related to the client’s complaint.
A client with liver cancer who is undergoing chemotherapy tells the nurse that some foods on the meal tray taste bitter. Which of the following foods does the nurse suggest that the client avoid, knowing that it is most likely to taste bitter to the client?
A. Beef
B. Custard
C. Potatoes
D. Cantaloupe
A. Beef
Rationale: Chemotherapy may distort how certain foods taste to the client. Beef and pork are often reported by people undergoing chemotherapy to taste bitter or metallic. The nurse can promote nutrition by helping the client choose alternative sources of protein. The foods set forth in other options are not likely to cause this problem.
A client who has recently been started on enteral feedings complains of abdominal cramping and diarrhea. The nurse reviews the nutritional content on the label of the can of feeding solution. Which of the following ingredients is the nurse looking for?
A. Maltose
B. Lactose
C. Sucrose
D. Fructose
B. Lactose
Rationale: Several tube-feeding formulas contain lactose. A client with a history of lactose intolerance would experience the symptoms identified in the question if one of these formulas were administered. If the client is found to be lactose intolerant, the physician should prescribe a lactose-free formula. This will resolve the client’s symptoms and promote adequate nutrition for the client.
