NUR 1172/NUR1172 Exam 3 V3 |
Nutritional Principles in Nursing Q&A with
Rationale | Rasmussen University
1. A nurse is caring for a client who is receiving total parenteral nutrition (TPN). Which of the
following is the most important nursing action to prevent infection?
A. Monitor blood glucose levels every 4 hours.
B. Change the TPN tubing every 72 hours.
C. Check the TPN solution for cloudiness or particles.
D. Use strict aseptic technique when changing the TPN dressing.
Correct Answer: D
Expert Explanation: The high glucose content in TPN solutions provides an ideal
environment for bacterial growth, making infection the most common complication. Strict
aseptic technique during dressing changes and line manipulation is essential to minimize
the risk of catheter-related bloodstream infections. While glucose monitoring and checking
the solution are important, they do not directly prevent the introduction of pathogens at
the site.
2. A client is transitioning from TPN to enteral nutrition. At what point should the nurse
anticipate the TPN will be discontinued?
A. When the client can tolerate 25% of their calorie needs enterally.
,B. As soon as the enteral feeding tube is successfully placed.
C. When the client reports feeling full and no longer hungry.
D. When the client can meet at least 60% to 75% of their calorie needs enterally.
Correct Answer: D
Expert Explanation: TPN should be tapered and eventually discontinued only when the
enteral or oral intake is sufficient to meet the majority of the client’s nutritional
requirements. Usually, a threshold of 60% to 75% of total calorie needs is required to
ensure the client does not suffer from a nutritional deficit during the transition. Stopping
TPN too early can lead to hypoglycemia or malnutrition if the enteral route is not yet fully
functional.
3. A nurse is reviewing the laboratory results of a client with refeeding syndrome. Which of
the following electrolyte imbalances is most characteristic of this condition?
A. Hyperkalemia
B. Hypercalcemia
C. Hypermagnesemia
D. Hypophosphatemia
Correct Answer: D
Expert Explanation: Refeeding syndrome occurs when a severely malnourished patient
begins receiving nutrition, causing a shift from catabolism to anabolism. This process
,triggers insulin release, which drives phosphorus, potassium, and magnesium into the cells,
resulting in dangerously low serum levels. Hypophosphatemia is the hallmark sign and can
lead to respiratory failure and cardiac arrhythmias.
4. A nurse is preparing to administer an intermittent enteral feeding to a client. What is the
priority action before starting the infusion?
A. Warm the formula to body temperature.
B. Check for a gastric residual volume of at least 500 mL.
C. Verify the placement of the feeding tube.
D. Flush the tube with 100 mL of sterile water.
Correct Answer: C
Expert Explanation: Verifying tube placement is the most critical safety step to prevent
the accidental infusion of formula into the lungs, which can cause aspiration pneumonia.
Methods such as checking the pH of aspirate or checking the mark at the nose are used,
though X-ray is the gold standard for initial placement. Feeding a client through a displaced
tube can have life-threatening consequences.
5. A pregnant client asks the nurse how much weight she should expect to gain during her
pregnancy. If her pre-pregnancy BMI was 22 (normal), what is the recommended weight
gain?
A. 25 to 35 pounds
B. 15 to 25 pounds
, C. 11 to 20 pounds
D. 28 to 40 pounds
Correct Answer: A
Expert Explanation: For a woman with a normal pre-pregnancy Body Mass Index (BMI),
the recommended total weight gain is 25 to 35 pounds (11.5 to 16 kg). This gain supports
the growth of the fetus, placenta, and increased maternal blood volume and tissue.
Underweight women require more gain, while overweight and obese women require less
to reduce the risk of complications.
6. Which of the following foods should the nurse recommend to a pregnant client to help
prevent neural tube defects?
A. Spinach and fortified cereals
B. Red meat and poultry
C. Milk and cheese
D. Citrus fruits and tomatoes
Correct Answer: A
Expert Explanation: Folate (folic acid) is essential for DNA synthesis and the proper
closure of the neural tube in the developing fetus. Leafy green vegetables like spinach and
fortified grains are excellent sources of this nutrient. Adequate intake is particularly critical
in the first few weeks of pregnancy, often before a woman knows she is pregnant.
Nutritional Principles in Nursing Q&A with
Rationale | Rasmussen University
1. A nurse is caring for a client who is receiving total parenteral nutrition (TPN). Which of the
following is the most important nursing action to prevent infection?
A. Monitor blood glucose levels every 4 hours.
B. Change the TPN tubing every 72 hours.
C. Check the TPN solution for cloudiness or particles.
D. Use strict aseptic technique when changing the TPN dressing.
Correct Answer: D
Expert Explanation: The high glucose content in TPN solutions provides an ideal
environment for bacterial growth, making infection the most common complication. Strict
aseptic technique during dressing changes and line manipulation is essential to minimize
the risk of catheter-related bloodstream infections. While glucose monitoring and checking
the solution are important, they do not directly prevent the introduction of pathogens at
the site.
2. A client is transitioning from TPN to enteral nutrition. At what point should the nurse
anticipate the TPN will be discontinued?
A. When the client can tolerate 25% of their calorie needs enterally.
,B. As soon as the enteral feeding tube is successfully placed.
C. When the client reports feeling full and no longer hungry.
D. When the client can meet at least 60% to 75% of their calorie needs enterally.
Correct Answer: D
Expert Explanation: TPN should be tapered and eventually discontinued only when the
enteral or oral intake is sufficient to meet the majority of the client’s nutritional
requirements. Usually, a threshold of 60% to 75% of total calorie needs is required to
ensure the client does not suffer from a nutritional deficit during the transition. Stopping
TPN too early can lead to hypoglycemia or malnutrition if the enteral route is not yet fully
functional.
3. A nurse is reviewing the laboratory results of a client with refeeding syndrome. Which of
the following electrolyte imbalances is most characteristic of this condition?
A. Hyperkalemia
B. Hypercalcemia
C. Hypermagnesemia
D. Hypophosphatemia
Correct Answer: D
Expert Explanation: Refeeding syndrome occurs when a severely malnourished patient
begins receiving nutrition, causing a shift from catabolism to anabolism. This process
,triggers insulin release, which drives phosphorus, potassium, and magnesium into the cells,
resulting in dangerously low serum levels. Hypophosphatemia is the hallmark sign and can
lead to respiratory failure and cardiac arrhythmias.
4. A nurse is preparing to administer an intermittent enteral feeding to a client. What is the
priority action before starting the infusion?
A. Warm the formula to body temperature.
B. Check for a gastric residual volume of at least 500 mL.
C. Verify the placement of the feeding tube.
D. Flush the tube with 100 mL of sterile water.
Correct Answer: C
Expert Explanation: Verifying tube placement is the most critical safety step to prevent
the accidental infusion of formula into the lungs, which can cause aspiration pneumonia.
Methods such as checking the pH of aspirate or checking the mark at the nose are used,
though X-ray is the gold standard for initial placement. Feeding a client through a displaced
tube can have life-threatening consequences.
5. A pregnant client asks the nurse how much weight she should expect to gain during her
pregnancy. If her pre-pregnancy BMI was 22 (normal), what is the recommended weight
gain?
A. 25 to 35 pounds
B. 15 to 25 pounds
, C. 11 to 20 pounds
D. 28 to 40 pounds
Correct Answer: A
Expert Explanation: For a woman with a normal pre-pregnancy Body Mass Index (BMI),
the recommended total weight gain is 25 to 35 pounds (11.5 to 16 kg). This gain supports
the growth of the fetus, placenta, and increased maternal blood volume and tissue.
Underweight women require more gain, while overweight and obese women require less
to reduce the risk of complications.
6. Which of the following foods should the nurse recommend to a pregnant client to help
prevent neural tube defects?
A. Spinach and fortified cereals
B. Red meat and poultry
C. Milk and cheese
D. Citrus fruits and tomatoes
Correct Answer: A
Expert Explanation: Folate (folic acid) is essential for DNA synthesis and the proper
closure of the neural tube in the developing fetus. Leafy green vegetables like spinach and
fortified grains are excellent sources of this nutrient. Adequate intake is particularly critical
in the first few weeks of pregnancy, often before a woman knows she is pregnant.
