Study Guide

Question 1

Started at QUESTION 14!

Answer 1

Free Point

Question 2

14. The nurse is teaching a patient who has heart failure to read nutrition labels on food prod-ucts. Which nutritional fact is the most important for this patient to pay attention to?

a. The total number of kilocalories of fat per serving
b. The % daily value of fiber provided in a serving
c. The number of milligrams of sodium per serving
d. The number of grams of protein per serving

Answer 2

c. The number of milligrams of sodium per serving

Question 3

15. The patient has risk for osteoporosis. Which foods is the nurse most likely to suggest?

a. Eggs, raw fruits and vegetables
b. Whole-grain breads and pasta, and poultry
c. Green leafy vegetables and citrus fruits
d. Sardines, tofu, cheese, and broccoli

Answer 3

d. Sardines, tofu, cheese, and broccoli

Question 4

16. Which laboratory result is the nurse most likely to examine to determine if the treatment for iron deficiency anemia is effective?

a. Hemoglobin level
b. Electrolyte values
c. Blood clotting factors
d. Albumin level

Answer 4

a. Hemoglobin level

Question 5

17. Which patient is most likely to benefit from an increase in dietary fiber?

a. Has chronic obstructive pulmonary disease
b. Has a high risk for metabolic syndrome
c. Has a high risk for osteoporosis
d. Has a recent diagnosis of hepatitis

Answer 5

b. Has a high risk for metabolic syndrome

Question 6

18. A parent tells the nurse, “The school nutritionist advised parents to send packed lunches that include complete proteins, but I’m not exactly sure what that means.” Which is the best response?

a. “What would you normally send in a packed lunch?”
b. “Just pack a variety of foods that you know your child will eat.”
c. “Complete proteins are generally of animal origin, like eggs or meat, but a complete protein can also be made of a combination of plant-based foods.”
d. “Does your child have any dietary restrictions or food allergies?”

Answer 6

c. “Complete proteins are generally of animal origin, like eggs or meat, but a complete protein can also be made of a combination of plant-based foods.”

Question 7

19. A patient is interested in adding antioxidants to the diet. What is the best advice?

a. Take vitamin supplements, especially A, C, and E.
b. Eat a wide variety of fruits and vegetables.
c. Eat dairy products such as cheese, yogurt, and milk.
d. Take a multi-vitamin and mineral supplement.

Answer 7

b. Eat a wide variety of fruits and vegetables.

Question 8

20. According to the National Institute of Health’s Office of Dietary Supplements, which patient would be advised to have an additional 35 mg/day of vitamin C beyond the usual recommended adult dose?

a. A patient who was recently diagnosed with cancer,
b. A patient who has recent onset of cold symptoms.
c. A patient who drinks alcohol daily.
d. A patient who smokes cigarettes every day.

Answer 8

d. A patient who smokes cigarettes every day.

Question 9

21. The patient is interested in lowering his cholesterol levels and reducing the risk of cardiovascular disease. Which breakfast tray offers the most water-soluble fiber to help the patient meet his goals?

a. Half a grapefruit with hard-boiled egg
b. Hash-browned potatoes with sausage patty
c. Yogurt with honey, granola, and fresh strawberries
d. Oatmeal topped with cinnamon and raw apple slices

Answer 9

d. Oatmeal topped with cinnamon and raw apple slices

Question 10

22. Which patients have conditions that would prompt the nurse to monitor serum sodium levels? Select all that apply.

a. The patient is having a prolonged high fever.
b. The patient has severe diarrhea and vomiting.
c. The patient has iron deficiency anemia.
d. The patient has chronic kidney disease.
e. The patient has cystic fibrosis.

Answer 10

a. The patient is having a prolonged high fever.
b. The patient has severe diarrhea and vomiting.
d. The patient has chronic kidney disease.
e. The patient has cystic fibrosis.

Question 11

23. The home health nurse sees that the patient’s potassium level is 3.6 mmol/ L. There is nothing in the patient’s medication or health history that should affect the potassium levels. What will the nurse do?

a. Tell the patient to make an appointment to see the HCP as soon as possible.
b. Suggest that the patient eat sweet potatoes, fruits, vegetables, fresh meat, legumes, and milk.
c. Take vital signs and assess the patient for signs / symptoms of hyperkalemia.
d. Instruct the patient to have a potassium test repeated every 12-18 months.

Answer 11

b. Suggest that the patient eat sweet potatoes, fruits, vegetables, fresh meat, legumes, and milk.

Question 12

24. The nurse is assessing an older resident at a long-term care center. The resident appears flushed, skin turgor is poor, mucous membranes are dry, and resident seems unusually irritable. What would the nurse do first?

a. Test for gag reflex; then offer oral fluids.
b. Obtain an order for electrolyte values.
c. Take vital signs and check urine specific gravity.
d. Check blood sugar and offer a popsicle.

Answer 12

c. Take vital signs and check urine specific gravity.

Question 13

25. A woman is in the first trimester of pregnancy. She reports several episodes of nausea and vomiting, a headache, and irritability. The nurse observes shallow breathing and perspiration, and the woman appears shaky and nervous. What would the nurse do first?

a. Check blood glucose level.
b. Take the temperature.
c. Check pulse oximeter reading.
d. Attach electrocardiogram monitor.

Answer 13

a. Check blood glucose level.

Question 14

26. The patient is going to be discharged with a prescription for an anticoagulant medication. Which question would the nurse ask?

a. “How many servings of leafy green vegetables would you normally eat in a week?”
b. “Do you drink at least 8 glasses of fluid every day?”
c. “What would you typically eat for breakfast every morning?”
d. “Are you having any problems with constipation or adequate fiber intake?”

Answer 14

a. “How many servings of leafy green vegetables would you normally eat in a week?”

Question 15

27. The patient reports noticing that his gums bleed very easily. If the bleeding is caused by a nutritional deficiency, which types of food will correct the problem?

a. Milk, egg yolks, and liver
b. Broccoli, peppers, and tomatoes
c. Cereals, legumes, and nuts
d. Poultry, fish, and brown rice

Answer 15

b. Broccoli, peppers, and tomatoes

Question 16

28. Which patient is at risk for pernicious anemia and is most likely to be prescribed a vitamin B, supplement?

a. Frequently tries different weight-loss plans
b. Eats small amounts of a variety of foods
c. Prefers meat and potatoes, with very few vegetables
d. Adheres to a strict vegan diet

Answer 16

d. Adheres to a strict vegan diet

Question 17

29. The nurse is working with a patient who requires an increase in complete proteins in the diet. Which foods will the nurse recommend? Select all that apply.
    a. Soy
    b. Eggs
    c. Peanuts
    d. Beans
    e. Fish
    f. Yogurt

Answer 17

a. Soy
b. Eggs
e. Fish
f. Yogurt

Question 18

30. A patient reports routinely taking high doses of vitamin supplements. Which vitamin has the greatest potential for toxic effects related to high dosage?

a. A
b. B1 (thiamine)
c. B (riboflavin)
d. C2

Answer 18

a. A

Question 19

31. A patient with ascites has fluid restrictions of 1000 mL /24 hours. The nurse observes that the patient frequently asks visitors and staff to give him extra fluids. What would the nurse do first to improve the patient’s compliance?

a. Assess the patient’s understanding of the fluid restrictions.
b. Offer suggestions to decrease sensation of thirst (e.g., chew gum).
c. Post a sign over the bed that indicates fluid limits.
d. Instruct family, friends, and staff that fluids are limited and measured.

Answer 19

a. Assess the patient’s understanding of the fluid restrictions.

Question 20

32. Which item is allowed on a clear liquid diet?

a. Orange juice
b. Gelatin
c. Sherbet
d. Cream soup

Answer 20

b. Gelatin

Question 21

33. Which patient is most likely to be prescribed a carbohydrate-modified diet?

a. Has heart failure
b. Has hypertension
c. Has cirrhosis of the liver
d. Has diabetes mellitus

Answer 21

d. Has diabetes mellitus

Question 22

34. An Asian American patient reports experiencing nausea, a bloated feeling, and flatulence after eating. Which question is the most relevant?

a. “Do you have any food allergies?”
b. “Are you following the MyPlate guidelines?”
c. “What did you eat just before the onset of the symptoms?”
d. “Is anyone who ate the same food having the same symptoms?”

Answer 22

c. “What did you eat just before the onset of the symptoms?”

Question 23

35. Patients with nasogastric (NG) tubes may develop otitis media. What will the nurse do to prevent this occurrence?

a. Increase fluid intake.
b. Remove and reinsert the tube every 24 hours.
c. Suction the nose and mouth.
d. Turn the patient side to side every 2 hours.

Answer 23

d. Turn the patient side to side every 2 hours.

Question 24

36. The nurse is evaluating the performance of an unlicensed assistive personnel (UAP) who is feeding a patient. Which action indicates a need for correction?

a. Offering the patient the bedpan before the meal.
b. Placing the patient in a recumbent position.
c. Providing opportunity for hand hygiene before the meal.
d. Talking with the patient during the feeding.

Answer 24

b. Placing the patient in a recumbent position.

Question 25

37. Which admission assessments would be performed for long-term care residents in relation to potential nutritional problems? Select all that apply.

a. Problems with fine motor movements
b. Ability to chew and swallow different textures of foods
c. Typical daily fluid intake
d. Ability to obtain and prepare own food
e. Dietary restrictions related to chronic health problems
f. Food preferences or rituals related to cultural background

Answer 25

a. Problems with fine motor movements
b. Ability to chew and swallow different textures of foods
c. Typical daily fluid intake
e. Dietary restrictions related to chronic health problems
f. Food preferences or rituals related to cultural background

Question 26

38. The nurse sees an order for “clear liquid diet, advance as tolerated to regular diet.” What does the nurse do to get the best food selection for the patient?

a. Contact the HCP for clarification of the order.
b. Ask the patient if he is hungry and what he prefers to eat.
c. Assess the patient’s overall response to the clear liquid diet.
d. Call the nutritionist and ask for an individualized diet plan.

Answer 26

c. Assess the patient’s overall response to the clear liquid diet.

Question 27

39. The mother asks the nurse about giving strained fruits to her infant. When would this food be introduced?

a. 2 months
b. 5 months
c. 8 months
d. 12 months

Answer 27

b. 5 months

Question 28

40. The patient is taking a diuretic medication every day. Which electrolyte value is the most important to monitor?

a. Chloride
b. Sodium
c. Phosphorus
d. Potassium

Answer 28

d. Potassium

Question 29

41. What are nursing responsibilities in promoting nutrition for patients? Select all that apply.

a. Assisting patients to eat or drink
b. Designing diet plans for patients with chronic health problems
c. Recording the patient’s fluid and food intake
d. Observing the patient for signs of poor nutrition
e. Communicating dietary concerns to other members of the health care team
f. Monitoring laboratory values that are related to nutritional intake

Answer 29

a. Assisting patients to eat or drink
c. Recording the patient’s fluid and food intake
d. Observing the patient for signs of poor nutrition
e. Communicating dietary concerns to other members of the health care team
f. Monitoring laboratory values that are related to nutritional intake

Question 30

42. The patient has just ordered lunch at a restaurant. According to the USDA MyPlate recommendations, which food item would the patient plan to divide and take a portion home in a carry-out box?

a. 10 ounces grilled skinless chicken breast
b. 1 cup of steamed vegetables
c. ¾ cup of mixed fruit salad
d. ¾ cup of brown rice pilaf

Answer 30

a. 10 ounces grilled skinless chicken breast

Question 31

43. The patient is trying to understand the difference between dietary reference intakes (DRIs) and recommended dietary allowances (RDAs). Which patient statement best indicates an understanding of DRIs?

a. “DRIs replace the RDAs but are similar, so I could use either one to monitor my cholesterol.”
b. “Using DRIs, I could decrease my risk for diabetes and monitor my sugar consumption.”
c. “RDAs apply to healthy adult Americans; but I should rely on DRIs because 1 am overweight. “
d. “DRIs are based on disease states; so I can use them as a guideline to control my thyroid problem.”

Answer 31

b. “Using DRIs, I could decrease my risk for diabetes and monitor my sugar consumption.”

Question 32

44. Following bariatric surgery, a patient experiences nausea, cramping, diarrhea, sweating, lightheadedness, and palpitations after eating. What is the most important self-care measure for the nurse to reinforce?

a. Immediately report the symptoms to the surgeon; surgical intervention may be necessary.
b. Be patient and live with the symptoms; they are expected and temporary.
c. Avoid concentrated sweets and drink fluids 30-60 minutes before and after meals.
d. When symptoms occur, replace the next meal with extra fluids such as diluted juices.

Answer 32

c. Avoid concentrated sweets and drink fluids 30-60 minutes before and after meals.

Question 33

45. The patient has sustained severe injuries in an accident. Which food sources supply the nutrient that plays the biggest role in helping the patient to build and repair injured tissue?

a. Green vegetables and bright-colored fruits
b. Pasta and breads made from whole grains
c. Beans, legumes, and soy products
d. Lean meats, poultry, and fish

Answer 33

d. Lean meats, poultry, and fish

Question 34

46. The nurse routinely participates in long distance endurance sports, such as running, swimming, and cycling. Which foods would the nurse eat to have energy over a longer period of time?

a. Corn and potatoes
b. Milk and citrus fruits
c. Honey and table sugar
d. Chocolate and electrolyte drinks

Answer 34

a. Corn and potatoes

Question 35

47. The nurse is talking to a patient who has high cholesterol and a family history of cardiovascular disease. Which foods are most likely to counteract the high cholesterol?

a. Wheat bran and celery
b. Orange juice and white rice
c. Lettuce and pears
d. Oats and barley

Answer 35

d. Oats and barley

Question 36

48. The patient reports sensations of bloating, gas, and constipation after adding lots of fruits, vegetables, and whole grains to her diet. So she has decided to go back to her former dietary pattern and exclude these foods. What is the best advice that the nurse can give the patient?

a. “Resume former dietary patterns and contact your HCP.”
b. “Slowly increase intake of fiber foods and drink at least 8 glasses of water each day.”
c. “Start with a fiber supplement instead of fruits, vegetables, and whole grains.”
d. “Excessive fiber intake can lead to osteoporosis and anemia in women.”

Answer 36

b. “Slowly increase intake of fiber foods and drink at least 8 glasses of water each day.”

Question 37

49. The patient expresses a strong preference for beef that is marbled with fat at every meal, because of the flavor and the feeling of fullness and satisfaction. Nurse would advise that this eating habit is likely to increase risk for which health condition?

a. Osteoporosis
b. Cirrhosis of the liver
c. Diabetes mellitus
d. Atherosclerosis

Answer 37

d. Atherosclerosis

Question 38

50. The patient tells the nurse that he has problems with his cholesterol so a friend told him to eat avocadoes. What is the best response?

a. “Avocadoes are very high in fat so the total cholesterol will increase.”
b. “Avocadoes are a source of monounsaturated fats, which are thought to lower bad cholesterol.”
c. “Avocadoes are yellow fruits, and fruits generally do not affect cholesterol levels.”
d. “Avocadoes are a source of trans-fatty acids, which will increase the good cholesterol.”

Answer 38

b. “Avocadoes are a source of monounsaturated fats, which are thought to lower bad cholesterol.”

Question 39

51. The patient was advised by the HCP to “watch intake of cholesterol.” Which question is the most useful in assessing the likelihood of the patient’s adherence to the provider’s advice?

a. “Do you understand what ‘watch your intake of cholesterol’ means?”
b. “How do you plan to manage your intake of cholesterol?”
c. “Would you like a list of foods that contain high amounts of cholesterol?”
d. “What do you normally eat in a 24-hour period?”

Answer 39

b. “How do you plan to manage your intake of cholesterol?”

Question 40

52. Which laboratory value would the nurse check to evaluate the protein status of a patient who has been receiving medical nutrition therapy?

a. Hemoglobin
b. Albumin
c. White blood cell count
d. Electrolyte values

Answer 40

b. Albumin

Question 41

53. A patient has symptoms of steatorrhea and flatulence. Which diet is the HCP most likely to recommend?

a. Carbohydrate-modified diet
b. Protein-restricted diet
c. Sodium-restricted diet
d. Fat-controlled diet

Answer 41

d. Fat-controlled diet

Question 42

54. The nurse is talking to a 17-year-old female whose parents have reluctantly allowed her to start a vegan diet if she agrees to talk to an HCP before beginning the diet. The HCP is most likely to monitor her for which nutrition-related condition?

a. Anorexia nervosa
b. Rickets
c. Iron deficiency anemia
d. Marasmus

Answer 42

c. Iron deficiency anemia

Question 43

55. Which patient is at the greatest risk for a negative nitrogen balance that will lead to atrophy of muscles?

a. The patient gets nothing by mouth for several days due to intractable nausea and vomiting.
b. The patient is in the first trimester of a normal pregnancy.
c. The patient sustained severe burns to 50% of the body surface.
d. The patient has been fasting for several days for a religious ritual.

Answer 43

c. The patient sustained severe burns to 50% of the body surface.

Question 44

56. During a trip to a developing country, the nurse observes that many of the toddlers appear very fat with enlarged abdomens and swollen extremities. Which nutritional deficiency is associated with these symptoms?

a. Carbohydrates
b. Fats
c. Vitamins
d. Protein

Answer 44

d. Protein

Question 45

57. The patient reports a habit of smoking at least one pack of cigarettes every day. Which foods would the nurse encourage the patient to eat, because of the heavy smoking habit?

a. Fish and poultry
b. Milk products
c. Citrus fruits
d . Whole grains

Answer 45

c. Citrus fruits

Question 46

58. A 69-year-old patient reports frequently taking antacids. Why does this patient have an increased risk for developing pernicious anemia?

a. Low stomach acidity blocks the absorption of vitamin B, from foods.
b. Antacids interfere with the body’s ability to use heme iron.
c. Older people who take antacids are less likely to produce intrinsic factor.
d. Antacids inhibit the digestion of foods that supply vitamin C.

Answer 46

a. Low stomach acidity blocks the absorption of vitamin B, from foods.

Question 47

59. The mother reports that her child took a few extra chewable vitamins, because he thought they were gummy candies. Which question is the most important to assess for potential toxicity?

a. “Does the product contain vitamin C?”
b. “How much does the child weigh?”
c. “Is iron listed as one of the ingredients?”
d. “Did you induce vomiting?”

Answer 47

c. “Is iron listed as one of the ingredients?”

Question 48

60. Which patient would not be offered low-fat?

a.15-year-old female with type 1 diabetes
b. 26-year-old female who is in the third trimester of pregnancy
c. 68-year-old female who has hip fracture related to osteoporosis
to cow’s milk
d. 18-month-old female who is transitioning

Answer 48

d. 18-month-old female who is transitioning

Question 49

61. Which parental action encourages good dietary habits in the child?

a. Allow the child to eat whenever he is hungry and skip meals if he is not hungry.
b. Give the child whatever the rest of the family is eating; do not cater to special requests.
c. Encourage the child to help with food preparation and create a positive environment.
d. Give everyone the same serving size and quietly remove leftover food.

Answer 49

c. Encourage the child to help with food preparation and create a positive environment.

Question 50

62. The nurse is talking to an adolescent girl about nutrition, but the girl seems bored, uninterested, and unlikely to try any of the nurse’s suggestions. What would the nurse do?

a. Delay the discussion until the girl initiates interest.
b. Explain the science of physiology and
nutrition.
c. Assess the girl’s interest in other health topics.
d. Describe how nutrition improves skin and facial appearance.

Answer 50

d. Describe how nutrition improves skin and facial appearance.

Question 51

63. The UAP brings holiday cupcakes to the long-term care center and passes them out to all of the residents before checking with the nurse. What would the nurse do first?

a. Ask the UAP to collect the cupcakes and then determine who is allowed to have one.
b. Praise the UAP for bringing seasonally appropriate good cheer to the residents.
c. Remind the UAP that not all residents should have too much sugar, so next time, ask first.
d. Sit with the residents, enjoy the cupcakes, and make the food into a social occasion.

Answer 51

b. Praise the UAP for bringing seasonally appropriate good cheer to the residents.

Question 52

64. A patient is on fluid restrictions because of renal failure. Which interventions would the nurse use? Select all that apply.

a. Encourage the patient to drink most of the fluid allowance in the morning.
b. Explain the various sources of fluid such as IV fluids, gelatin, and fluids taken with medications.
c. Suggest chewing gum and sucking on breath mints.
d. Explain the rationale for fluid restrictions.
e. Show the volume of fluid that is allowed for the shift.
f. Post a sign in the room so that visitors are aware of fluid restrictions.

Answer 52

b. Explain the various sources of fluid such as IV fluids, gelatin, and fluids taken with medications.
c. Suggest chewing gum and sucking on breath mints.
d. Explain the rationale for fluid restrictions.
e. Show the volume of fluid that is allowed for the shift.
f. Post a sign in the room so that visitors are aware of fluid restrictions.

Question 53

65. The patient is trying to lose weight because he is obese and has been told that he has a high risk for diabetes, coronary heart disease, and stroke. What is the most important point that the nurse would emphasize?

a. Strictly adhere to 1500 kcal/ day, but eat a variety of foods.
b. Take a multivitamin and mineral supplement while dieting.
c. Exercise 60-90 minutes most days of the week.
d. A weight loss of 5% to 15% can reduce health-related risks.

Answer 53

d. A weight loss of 5% to 15% can reduce health-related risks.

Question 54

66. Which patient is most likely to be a candidate for bariatric surgery?

a. Body mass index of 40 or higher
b. Body mass index of 35 or higher
c. Body mass index of 23 with severe cardiovascular disease
d. Body mass index of 17 with diabetes

Answer 54

a. Body mass index of 40 or higher

Question 55

67. The patient is newly diagnosed with type 2 diabetes. In talking to the patient about diet management, what would the nurse suggest?

a. Suggest the patient follow a standardized preprinted menu for each meal.
b. Indicate that two or more servings of fried fish would be beneficial.
c. Closely monitor and control intake of table sugar and desserts.
d. Emphasize consistent mealtimes; approximately every 4-5 hours.

Answer 55

d. Emphasize consistent mealtimes; approximately every 4-5 hours.

Question 56

68. A patient who is a known diabetic presents with weakness, diaphoresis, and disorientation. What would the nurse do first?

a. Encourage the patient to drink a lot of water.
b. Give the patient a glass of milk.
c. Establish intravenous access and give glucose.
d. Have the patient suck on a hard candy.

Answer 56

b. Give the patient a glass of milk.

Question 57

69. What is the best way for the nurse to assess for proper nasogastric tube placement prior to administering a tube feeding?

a. Observe the patient’s comfort while in sitting position.
b. Auscultate for a gurgling sound over the epigastric region after pushing air through the nasogastric tube.
c. Give a test dose of a small amount of water and observe the patient’s reaction.
d. Aspirate gastric fluid and check pH.

Answer 57

d. Aspirate gastric fluid and check pH.

Question 58

70. Which dietary alterations would be recommended to the patient experiencing poor wound healing?

a. Increase protein and vitamin C.
b. Increase fluid intake and avoid fructose.
c. Restrict intake of carbohydrate and concentrated sweets.
d. Increase calories and reduce sodium intake.

Answer 58

a. Increase protein and vitamin C.

Question 59

71. Which instructions would the nurse give to the patient who has been prescribed an iron supplement? Select all that apply.

a. Take the iron with orange juice.
b. Drink a glass of milk after the iron supplement if needed to settle the stomach.
c. Keep the iron supplement in a high cabinet out of reach of children.
d. Take fiber supplement and iron together to avoid constipation.
e. Chew calcium antacid tablet after iron to avoid feelings of reflux.
f. Limit iron in the diet while taking iron supplement.

Answer 59

a. Take the iron with orange juice.
c. Keep the iron supplement in a high cabinet out of reach of children.