ATI Nutrition Proctored Exam

Foods high in potassium: Answer- apricots bananas potatoes tomatoes avocado fish spinach beans A nrse is reinforcing diet teaching to a patient who has type 2 DM. Which of the following should the nrse include in the teaching? Select all that apply. A. Carbs should comprise 55% of daily caloric intake B. Use hydrogenated oils for cooking C. Table sugar may be added to cereals D. Drink an alcoholic beverage w/meals E. Protein foods can be substituted for carb foods Answer- A, C, D Not B-hydrogenated oils contain trans fatty acids & cause hyperlipidemia Not E-carbs can be exchanged but not w/proteins A nrse is reviewing dietary guidelines to include in the plan of care for a patient who has type 2 DM. Which of the following guidelines should the nrse include? Select all that apply. A. Weight management B. Lipid profile C. Cultural needs D. Sleep patterns E. Personal preferences Answer- A, B, C, E To avoid hypoglycemia, the patient should consume alcohol... Answer- with a meal or immediately after a meal _______________can be included in a diabetic diet as long as adequate insulin or other agents are provided to cover the sugar intake. Answer- Sucrose (table sugar) The nrse should instruct the diabetic patient that their intake of carbohydrates should be ___to___% of total daily caloric intake. Answer- 45-60% The lacto-ovo vegetarian diet includes: Answer- dairy products and eggs A nrse is teaching a patient measures for healthy bones. Which of the following statements by the patient requires additional teaching? A. "I will eat foods high in calcium." B. "I will increase my fluid intake." C. "I should participate in weight bearing exercises." D. "I should get my vitamin D from the sunlight." Answer- B. increasing fluid does not promote healthy bones A nrse is conducting a nutritional class to a group of newly licensed nrses. Which of the following should be included in the teaching? A. Limit saturated fat to 10% of total caloric intake. B. Good bowel function requires 35 g/day of fiber for women. C. Limit cholesterol consumption to 400 mg/day D. Normal functioning cardiac systems depends on B-complex vitamins Answer- A A nrse is discussing essential nutrients for normal functioning of the nervous system. Which of the following should be included in the teaching? Select all that apply. A. Calcium B. Thiamin C. Vitamin B6 D. Sodium E. Phosphorus Answer- A, B, C, D A school nrse is teaching a group of students how to read food labels. Which of the following should be included in the teaching? Select all that apply. A. Total carbohydrates B. Total fat C. Calories D. Magnesium E. Dietary fiber Answer- A, B, C, E Normal functioning of the nervous system depends on adequate levels of the B-complex vitamins, especially: and also adequate levels of ____and _____for regulators of nerve responses. Answer- thiamin, niacin, vitamin B6 and B12 calcium and sodium normal BMI: Answer- 18.5-24.9 obesity BMI is classified as: Answer- BMI greater than or equal to 30 Basic food choices for kosher, orthodox Judaism diets: Answer- -meat -no mixing meat and diary (cheeseburger) -no pork or shellfish -fish must have scales & fins to be kosher A patient who follows seventh-day Adventist dietary laws will eat a strict: They also avoid: Answer- vegetarian diet, some are lacto-ovo, some are vegan. they avoid alcohol, coffee, tea and caffeinated beverages. A nrse is teaching a patient who has cancer about appropriate food choices. The nrse determines that the patient understands the information when she chooses which of the following snacks? Select all that apply. A. Peanut butter sandwich on whole wheat bread w/2% milk B. Popcorn w/soda C. Yogurt topped w/granola & a banana D. Meat lasagna w/buttered garlic bread E. Plain baked potato Answer- A, C, D Three complications of TPN: Answer- Diarrhea Polyuria Hypocalciumia What has more calcium yogurt or cheese? Answer- yogurt Niacin is found in sources such as: Answer- Beef liver nuts legumes whole-grain enriched breads and cereals Two medications may be added to PN solutions however administering any IV medication through a PN IV line or port is contraindicated. What are the two medications? Answer- Heparin and insulin Expected reference range for pre-albumin: Answer- 23-43 Which of the following food choices is appropriate for a pt. with GERD? Select all that apply. A. Baked salmon B. Skim milk C. Orange juice D. Decaffeinated tea E. Eggs and salsa Answer- A, B, D For which disease/condition would the nrse teach the patient about a gluten-free diet? A. A 54 year old man with pancreatitis. B. A 32 year old woman with celiac disease. C. A 22 year old man with diverticulitis. D. A 76 year old woman with breast cancer. Answer- B. Celiac disease is also known as gluten-sensitive enteropathy (GSE), celiac sprue, and gluten intolerance. It is chronic & hereditary and the patient should be instructed to avoid gluten. Foods/beverages that are gluten-free include: (select all that apply) A. Milk, cheese, dairy products B. Beer C. Fried Eggs D. Baked potatoes E. Fruits and vegetables F. Whole wheat bread Answer- A, C, D, E A patient who has celiac disease should increase intake of what? Answer- simple carbohydrates (fruits, veggies, milk, etc.) A nrse is providing instructions to a patient who has a new diagnosis of celiac disease. Which of the following food choices by the patient indicates a need for further teaching? A. Potatoes B. Graham crackers C. Wild rice D. Canned pears Answer- B. Graham crackers are made from wheat flour All others are gluten-free A patient with what disease will be instructed to avoid foods with seeds or husks (corn, popcorn, berries, tomatoes)? Answer- diverticular A nrse is providing instructions to a patient who reports constipation & has a prescription for a high-fiber, low-fat diet. Which of the following food choices by the patient indicates understanding of the teaching? A. Peanut butter B. Peeled apples C. Hardboiled egg D. Brown rice Answer- D A nrse is caring for a patient post appy. The nrse verifies the postop prescription, which reads "discontinue NPO status; advance diet as tolerated." Which of the following are appropriate for the nrse to offer the patient? Select all that apply. A. Applesauce B. Chicken broth C. Sherbet D. Wheat toast E. Cranberry juice Answer- B, E A patient postop will be on a clear liquid diet following surgery to transition as tolerated back to normal diet. Cranberry juice and chicken broth are clear liquid selections. A nrse is caring for a patient 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 patient about acceptable liquids. C. Perform a calorie count of consumed liquids. D. Offer high-protein liquid supplements. Answer- A this is highest priority to reduce the risk of aspiration A nrse is performing dietary needs assessments for a group of patients. A blenderized liquid diet is appropriate for which of the following patients? Select all that apply. A. A patient who has a wired jaw due to an MVA B. A patient who is 24 hr postop following temporomandibular joint repair C. A patient who has difficulty chewing due to a traumatic brain injury D. A patient who has hypercholesterolemia due to CAD E. A patient who is scheduled for a colonoscopy the next morning Answer- A, B, C A nrse is assessing a patient who is postop following a colon resection. Which of the following findings indicates that the patient is ready to transition from NPO to oral intake? A. Patient report of hunger B. Urinary output exceeding 30 mL/hr C. Decrease in incisional pain D. Passage of flatus Answer- D A nrse is assisting a patient who has a prescription for a mechanical soft diet w/food selections. Which of the following are appropriate selections by the patient? Select all that apply. A. Dried prunes B. Ground turkey C. Mashed carrots D. Fresh strawberries E. Cottage cheese Answer- B, C, E A nrse is teaching a patient who is undergoing cancer treatment about interventions to manage stomatitis. Which of the following statements by the patient indicates an understanding of the teaching? A. "I will try chewing larger pieces of food." B. "I will avoid toasting my bread." C. "I will consume more food in the morning." D. "I will add more citrus foods to my diet." Answer- B. Dry, coarse foods can increase the incidence/risk of stomatitis Which of the following food choices by a patient undergoing chemotherapy with presence of stomatitis indicates a need for further teaching? A. Small pieces of bananas B. Cut up fresh orange & pineapple slices C. Yogurt with granola D. Meat lasagna Answer- B A nrse is caring for a patient who has hypoglycemia. Which of the following is an appropriate action by the nrse? A. Offer crackers & cheese B. Encourage sucking on 8 hard candies C. Provide 8 oz of regular soda D. Give juice w/table sugar Answer- B Which of the following are appropriate dietary choices for a patient with cholecystitis? Select all that apply. A. Baked lightly-seasoned tilapia B. Buttered steamed broccoli C. Skim or 1% low fat milk D. Whole wheat toast E. Pasta with cream sauce and onions Answer- A, C Patients with gallstones, also known as cholecystitis, should avoid what in their diet? Answer- FAT A nrse is planning for an older adult patient who is receiving treatment for malnutrition. The patient is scheduled for discharge to his home where he lives alone. Which of the following actions are appropriate to include in the plan of care? (Select all that apply.) A. Consult social services to arrange home meal delivery B. Encourage the patient to purchase nonperishable boxed meals C. Advise the patient to purchase frozen fruits/veggies D. Recommend drinking a supplement between meals E. Educate the patient on how to read nutrition labels Answer- A, C, D, E Older adult patients will need more _____and vitamin ___to help maintain bone health. The may also be instructed to increase ____in their diet. Answer- calcium and vitamin D increase fiber Older adults have decreased absorption of what three nutrients? Answer- 1. Vitamin B12 2. Folic acid 3. Calcium The soft diet is also known as the bland, low fiber diet and contains foods such as: Answer- Whole foods that are low in fiber, lightly seasoned and easily digested. Is it safe to take antibiotics while breastfeeding? Answer- Yes, PO antibiotics are safe. Notify provider and finish entire course to reduce risk of reoccurence. There is a slight transfer between breast milk though. Food interactions with MAOIs include: Answer- tyramine-rich foods caffiene foods/beverages A nrse is providing follow-up dietary teaching for a patient who recently was prescribed phenelzine (Nardil). When reviewing the patient's dietary log, which of the following foods requires a need for further teaching? A. Cottage cheese B. Banana bread C. Apple pie D. Grilled steak Answer- B Intermittent tube feeding formula set rate: Answer- administered every 4-6 hr in equal portions of 200-300 mL over a 30-60 min time frame, usually by gravity drip Which type of tube feeding is often used in noncritical patients, home tube feedings, and patients in rehabilitation? Answer- intermittent tube feeding What should the head of the bed be elevated at for tube feedings and for how long? Answer- HOB at least 30 degrees and for during and after for 30-60 min to prevent aspiration risk How often should you obtain gastric residuals for a patient receiving tube feedings? Answer- every 4-6 hrs When beginning a new prescription for enteral nutrition by intermittent tube feeding how should you first initiate this feeding? Answer- Increase the formula over the first 4 to 6 feedings until the prescribed volume is achieved A nrse is preparing to administer intermittent enteral feeding to a patient who has neuromuscular disorder. Which of the following are appropriate nursing interventions? Select all that apply. A. Fill the feeding bag w/24 hr worth of formula B. Discard irrigation equipment after 24 hr C. Leave unused portions of formula at the bedside D. Label the unused portion of the formula E. Replace administration tubing & feeding bag every 48 hr Answer- B, D, E Teach parents that they may switch their child to skim or 1% low fat milk after... Answer- 2 years of age A nrse is teaching a patient who has pre-stage chronic kidney disease about dietary management. Which of the following information should the nrse include in the instructions? A. Restrict protein intake B. Maintain a high-phosphorus diet C. Increase intake of foods high in potassium D. Limit dairy products to 1 cup per day Answer- A Major sources of dietary potassium (K): Answer- oranges dried fruits tomatoes avocados dried peas meats broccoli bananas Major sources of dietary chloride (Cl): Answer- table salt Major sources of dietary calcium (Ca): Answer- dairy broccoli kale grains egg yolks Major sources of dietary magnesium (Mg): Answer- green leafy vegetables nuts grains meat milk Major sources of dietary phosphorus (P): Answer- dairy peas soft drinks meat eggs some grains Major sources of dietary sulfur (S): Answer- dried fruits meats red and white wines Major diet sources of vitamin A: Answer- orange/yellow colored foods liver dairy Major diet sources of vitamin D Answer- fish fortified dairy products sunlight Major diet sources of vitamin E Answer- vegetable oils grains nuts dark green vegetables Major diet sources of vitamin K Answer- green leafy vegetables eggs liver Major sources of vitamin C Answer- citrus fruits and juices vegetables Major sources of Thiamin (B1) Answer- meats grains legumes Major sources of riboflavin (B2) Answer- milk meats green leafy vegetables Major sources of niacin (B3) Answer- liver nuts legumes Major sources of pantothenic acid (B5) Answer- organ meats egg yolk avocados broccoli Major sources of pyridoxine (B6) Answer- organ meats grains Major sources of folate Answer- liver green leafy vegetables grains legumes Major sources of cobalamin (B12) Answer- organ meats clams oysters grains Examples of high fiber foods: Answer- lentils lima beans black beans artichokes brussel sprouts broccoli raspberries & blackberries avocados pears bran whole wheat pasta oatmeal split peas LDL expected range: Answer- less than 130 HDL expected range Answer- 35-80 females 35-65 males A patient with fluid volume excess will have what expected lab values? Answer- increased Hct increased or decreased serum electrolytes increased protein decreased aldosterone increased excretion of sodium increased natriuretic peptides decreased BUN & creatinine decreased PaCO2 increased pH Manifestations of hypoglycemia: Answer- mild shakiness mental confusion sweating palpitations headache lack of coordination blurred vision seizures coma A nrse is assessing a patient who has hypoglycemia. Which of the following findings should the nrse expect? A. Fruity breath odor