NR228 ROK for Final Exam Latest Update 2023/2024 (40 Verified Q&A)

NR 228 1. The nurse is caring for a post liver transplant client? What nutritional considerations would there be for the client? -Total parenteral nutrition or tube feeding may be necessary -Nutrition is not a concern because the client is overweight -Fats and carbohydrates are not a concern long term after transplant -A dietary consult would not be necessary for the client 2. The nurse is caring for a client who has been in a 2nd story fall with multiple broken bones and head trauma. The client is on enteral feeding at 50ml/hr and a water bolus of 100ml every 4hrs. What nursing interventions would be appropriate for this client? Select all that apply -Head of bed elevated 45 degrees - turn client on life side -monitor intake and output -give additional water bolus as needed -check gastric residual -blood glucose monitoring 3. The nutritionist asks the new oncology nurse what is the increase in percentage of energy/ nutrients needed when a patient has an infection? -Greater than 20% -15-20% -5-10% -10-15% 4. The GI tract not only is responsible for digestion and absorption of nutrients it also does the following: Select all that apply. -Can go weeks without food - replaces electrolytes to the body -prevents bacterial imbalance -starts shutting down to stress response -protects immunity -Protects the host from harmful bacteria 5. The nurse is discussing fluid restriction with a client with cirrhosis. The nurse realizes that the client needs further teaching when the client states? -Im limited as to what I can drink and eat due to the fluid building in my abdomen -I can only drink 1200ml of fluid a day but I can have all the jello I want - Ice cream, pudding and milk are considerate fluids as well -I should only drink the fluids on my tray and avoid all other fluids 6.The nurse is caring for a client with acute hepatitis B. The nurse knows what oral feeding would be appropriate for this client. -NGT feedings that are high in fiber and calories -Liquid diet then progression ti small, frequent meals high in calories and protein -Parenteral feedings with high dextrose content and low lipid content -Several large meals daily with focus on high quality protein 7.True or false. Deaths from heart disease have declined. -false -true 8. Which statement best describes the change in nutritional advice?-Low fats and high proteins are now being promoted -Low fats and higher carbohydrates are now being promoted -Variations of carbohydrates and trans fats are being promoted -Healthy fats and moderate portions via the mediterrnean diet are being promoted 9. Which disease is considered a considered a chronic lung disease • Chronic Bronchitis • Acute respiratory failure • Respiratory distress syndrome • Emphysema • Asthma 10.Which of the following responses by the nurse best describes cancer cachexia? -It involves polyphagia even though it results in severe weight loss -It is the thinning of cardiac tissue leading to death -It is the increase in cancer lead the causes anemia -It involves anorexia and results in wasting of lean body mass 11.The nurse understands parenteral nutrition is a standard protocol for stem cell transplantation. Why is it important to maintain some oral and enteral nutrition? -It is not important because parenteral nutrition is adequate throughout hospitalization -only oral nutrition is an acceptable form of nutritional supplementation -Parenteral nutrition is needed to maintain intestinal sterility -Oral or enteral nutrition is important to promote small intestine integrity 12. Resections of which portions of the GI tract can alter nutritional intake and nutrition absorption -Resection of the duodenum, jejunum and ileum -Resection of any portion of the GI tract -Resection of the stomach, ileum and colon -Resection of the stomach of the stomach, duodenum and jejunum 13. The oncology nurse is discussing the difference between acute and chronic weight loss. Which statement below is correct? -A decrease in viral load is noted with chronic weight loss -A decrease in vital load is noted which acute weight loss -There are different energy stores, which are depleted in each weight loss -chronic weight loss can be due to stress 14.Which of the following forms of metabolism produces the greatest amount of carbon dioxide -Protein metabolism -Carbohydrate metabolism -Combination metabolism -Fat metabolism 15. The nurse is educating a patient with newly diagnosed hypertension. What should the nurse include in her client's teaching. SATA -Avoid pickled and smoked meats due to high sodium content -Add salt while cooking the food so it evaporates with heat -Use salt free seasoning like MSG to flavor foods -Avoid instant rice and flavored rice due to high salt content -rinse canned vegetables to decrease the salt content 16. Systemic inflammatory response syndrome is an inflammatory response that occursin infection. Which is the correct statement -Clients in SIRS are in a hypometabolic state -Clients in SIRS are in a hypermetabolic state -Clients in SIRS should be watched for hypoglycemia -Clients in SIRS should use parenteral nutrition 17. The nurse is caring for a client with 30% TBSA (total body surface area) burns and is on parietal feedings. What is the target blood glucose range for this client? • Less than 150 • 150-180 • None of the above • 180-250mg/dl 18. A breast cancer patient has had a reoccurrence. The patient asks the nurse if this is bone cancer because it is in her hip. What is the best response of the nurse? -This is a common area of spreading but it will not be considered a metastasis - Yes, breast cancer can metastasize to the bone and it will be considered bone cancer -Breast cancer can only be in the breast, also known as being breast specific -The bones are a common site of metastasis but it will be called breast cancer 19. The nurse is caring for a client with pancreatitis. What nursing considerations shouldthe nurse have concerning the client. SATA -Take blood glucose very 4-6hours -Malabsorption will not be a problem from the client -early enteral feeding improves outcomes -instruct the client to consume at least half the about of alcohol as they previously did - instruct the client to avoid all alcohol -Abdominal pain will subside with PO feedings 20. The nurse is treating a client with cholecystitis. What is the recommended therapy for symptomatic cholecystitis? -the gallstone will usually pass on its own -client should go on a low fat diet -Surgical removal of the gallbladder -surgical removal only if there is a family history 21. Low density lipoproteins constitute this percentage of total serum cholesterol?--55 -10-20 22. During metabolic stress, some nonessential amino acids become conditionally essential. One of these amino acids are mobilized in large quantities from skeletal muscle and lung to be used directly as a fuel source by intestinal cells. What is this amino acid? -Nitrogen -Protease -Glutamine -Dipeptides 23. During severe stress, the body’s metabolic rate becomes: -Hypoglycemic -Hypometabolic -Ebb phase -hypermetabolic 24. The nurse is caring for a client with ascites. What mineral would the nurse expect to restrict? -Calcium -Magnesium -Sodium -Potassium 25. The discharge planning for a patient on newly prescribed warfarin should include which of the following. ASTA --Educate on foods high in vitamin K -educate on foods low calories --Educate on alcohol avoidance -Educate on bruising related to the drug --No education is necessary with warfarin usage 26. The nurse is caring for a patient with multi trauma accident in the ICU and nutrition has not been started. What is the client at risk if nutrient was not optimal prior to the accident? --Energy requirements are not the priority with this client --energy requirements will be met from endogenous sources --energy requirements are lower, so no nutrition is needed --energy requirements will be met from exogenous sources 27. The nurse is analyzing lab values. Which lab value is a cause for concern? --triglycerides=150 and low density lipoproteins (LDL) 129 --triglycerides=457 and low density lipoprotein(LDL) 185 --triglycerides=222 and low density lipoproteins (LDL) 129 --triglycerides=142 and low density lipoproteins (LDL) 100 28. Nutritional goals for a client with over 30% (TBSA) total body surface area burns are as follows: --nutritent need s satisfied, improved feedings tolerance, prevent Curling’s ulcers --vitamin and mineral replacement, increase antibiotic therapy, monitor blood glucose --replace lost protein in urine, and wounds, cut down on carbohydratess --insertion of NGT, consult dietician, consult speech therapy 29. The nurse educator asks the student nurses which of the following illness have been associated with vitamin D deficiency? SATA --cardiovascular --phenyketonuria --dyslipidemia --insulin resistance --gastric ulcers 50. The nurse is caring for a client with 40% TBSA (total body surface area) burns with NGT. what precautions should the nurse take prevent client aspiration? SATA --keep HOB flat during feedings --keep HOB at 45 degrees during feeding --make sure clients is ordered a proton pump inhibitor or H2 receptor blocker --restrain client hands so they can not pull out NGT --evaluate gastric residual volume --keep bed in lowest position 30. A charge nurse is reviewing some nutritional facts with nursing students and ask “which factors contribute to the HIV/AIDS malnutrition? SATA --decrease food intake --altered metabolism --malabsorption --lactose intolerance --patient denial of diagnosis 31. The nurse is caring for a client post cholecystectomy. The nurse knows that bile enters the small intestine continually rather than in response to food in the GI tract. What type of diet should some clients have to follow for several weeks after surgery? --low fiber diet --low fat diet --diet low in sugar --low cholesterol diet 32. The nurse is teaching students about cancer and asks the new nurse “which of the followingstatements are true regarding cancer? SATA --cancer cells can revers reproduction to give rise to new and healthy cells --cancer cells do not need adequate blood supply to prolifrate or any energy sources --cancer cells have uncontrolled cellular reproduction and do not respond to normal growth signals --cancer cells contain abnormal nuclei and cytoplasm, which are seen under microscope --cancer cells have an increase rate of mitosis, which is a type of cellular reproduction 33. The nurse is caring for a client with anorexia nervosa. What happens after a brief period of going food or an interval intake below metabolic need? --the body extract stored carbohydrates, fat and protein from muscles and organs --Blood sugar increases to meet metabolic demands --blood flow to skeletal muscles increase --glycogen stores last for 72 to 120 hours for glucose control and energy 34. The oncology nurse understands that the newly diagnosed HIV/AIDS patient needs further teaching when the patients states which of the following? --”one way to check nutritional risk is to measure my weight on a regular basis so i am not at nutritional risk” --”weight loss greater than 10% in the last 6 months places an HIV/AIDS patient at nutritional risk” --”my body mass index will also need to be monitored for changes on a regular basis” --“Muscle depletion is expected early in the diagnosis of HIV/AIDS, which happens in newly diagnosed HIV clients.” 35. A bariatric nurse is teaching a group of clients about obstructive sleep apnea(OSA). Which one of the following choices should nurses include in the teaching of OSA? SATA --low levels of blood glucose --elevated levels of low density lipoproteins --low levels of high density lipoprotein --low levels of C-Reactive protein --elevated levels of total cholesterol 36. A community health nurse is teaching a group home residents about cardiovascular disease.A cardiac lesion that partially occludes cardiac blood flow is called which of the following choices? --myocardial infarction --angina pectoris --cardiac tamponade --peripheral artery disease 37. The newly hired hematology/oncology nurse recognizes that cell replications occurs in whichproper order? --Initiation, promotion, progression, and malignant conversion --initiation, progression, promotion and malignant conversion --progression, initiation, malignant conversion, and promotion --different cells mutate and replicate in different orders 38. The nurse is caring for client in the emergency department that was in an auto accident and has severe trauma. The nurse knows the client in the immediate post injury or the ( EBB phase) of the injury. What are the clients metabolic responses? SATA --decrease cardiac output --hypothermia --hypotension --decrease catecholamines --decreased insulin --hypoglycemia 39. A life threatening cause of diarrhea is cryptosporidium. The nurses understanding of cryptospridum is it can be described as a waterborne pathogen that is resistant to which of the following? --vitamin --warfarin --chlorination --fluorodation Powered by TCPDF ()