RN HESI NUTRITION EXAM/ HESI RN NUTRITION P
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RACTICE EXAM ALL QUESTIONS AND CORRECT A b b b b b b
NSWERS WITH RATIONALES | MOST RECENT AND b b b b b b b
COMPLETE VERSION ALRADY GRADED A+| BRAN b b b b b
D NEW!!! b
A nurse is providing dietary teaching for a client with celiac disease. Which foods sh
b b b b b b b b b b b b b b
ould the nurse teach the client to avoid when following a gluten-
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free diet? Select all that apply. - ANSWER: rye, oats, and wheat
b b b b b b b b b b b
When caring for a client who is receiving enteral feedings, the nurse should take w
b b b b b b b b b b b b b b
hich measure to prevent aspiration - ANSWER: elevate HOB
b b b b b b b b
To prevent aspiration, the nurse should keep the head of the bed elevated between 3
b b b b b b b b b b b b b b
0 and 45 degrees. Elevating the head any higher causes increased sacral pressure an
b b b b b b b b b b b b b
d increases the risk of skin breakdown. Decreasing flow rate, checking residual, and
b b b b b b b b b b b b b
irrigating regularly will not prevent aspiration.
b b b b b
The nurse is teaching a client about the prescribed diet after a Whipple procedure for
b b b b b b b b b b b b b b b
cancer of the pancreas. Which statement should the nurse include in the dietary teachi
b b b b b b b b b b b b b
ng? - ANSWER: Low-
b b b
fat meals should be eaten to prevent interference with your fat digestion mechanism."
b b b b b b b b b b b b
Whipple procedure leads to malabsorption because of impaired delivery of bile to the
b b b b b b b b b b b b
bintestine and interruption of glucose metabolism; interference with fat digestion occu
b b b b b b b b b b
rs. Clients require small, frequent low-fat, high-protein, moderate-
b b b b b b b
bcarbohydrate meals and supplemental feedings. The response "There are no dietary r
b b b b b b b b b b b
estrictions because the tumor has been removed" is false reassurance. High-
b b b b b b b b b b
calorie meals are needed to provide energy and to promote the use of protein for tissu
b b b b b b b b b b b b b b b
e repair. High protein is required for tissue building; there is no problem with the liver
b b b b b b b b b b b b b b b
bin clients with cancer of the pancreas unless metastasis occurs by direct extension.
b b b b b b b b b b b b
celiac disease - ANSWER: intolerance of gluten
b b b b b b
,Celiac disease is an immunological small intestine enteropathy characterized by the
b b b b b b b b b b b
inability to metabolize the gliadin component of gluten found in grains such as wheat
b b b b b b b b b b b b b
, barley, rye, and oats; this results in excessive glutamine that is toxic to the mucosal
b b b b b b b b b b b b b b b b
cells. The stools are fatty and yellow. The intestinal villi are present but will atrophy
b b b b b b b b b b b b b b b
if exposed to foods containing gluten. Fluid balance is not the basic problem with ce
b b b b b b b b b b b b b b
liac disease; however, dehydration may occur in celiac crisi
b b b b b b b b
Tests reveal that a client has phosphatic renal calculi. The nurse teaches the client that
b b b b b b b b b b b b b b b
the diet may include which food item - ANSWER: apples
b b b b b b b b b
Apples are low in phosphate; fresh fruit is low in phosphorus. Chocolate contains mor
b b b b b b b b b b b b b
e phosphate than apples. Rye bread contains more phosphate than apples.
b b b b b b b b b b
Cheese is made with milk, which contains phosphate and should be avoided. Dairy pr
b b b b b b b b b b b b b
oducts are high in phosphorus. b b b b
kcal of sugars - ANSWER: for each gram of sugar it is 4 kcal
b b b b b b b b b b b b b
cushings disease - b b
bANSWER: Common symptoms of Cushing disease are weight gain, truncal obesityb b b b b b b b b b
, buffalo hump, and moon face because of deposits of adipose tissue. The condition is
b b b b b b b b b b b b b b b
caused by excess cortisol secretion caused by hypersecretion of adrenocorticotropic
b b b b b b b b b b
hormone (ACTH). Other characteristics are diabetes mellitus, muscle wasting, osteo
b b b b b b b b b
porosis, ecchymosis, and slow healing of wounds. Addison disease is adrenal insuffi
b b b b b b b b b b b
ciency. Symptoms of Addison disease include hypotension, dehydration, hypoglyce
b b b b b b b b
mia, and hyperpigmentation of the skin. Multiple sclerosis is a progressive disease in
b b b b b b b b b b b b
volving destruction of the myelin sheath, leading to nerve damage. Kaposi sarcoma is
b b b b b b b b b b b b
ba cancer associated with acquired immunodeficiency syndrome (AIDS)
b b b b b b b
A slightly overweight client is to be discharged from the hospital after a cholecystect
b b b b b b b b b b b b b
omy. What is most important for the nurse to include in teaching the client about nutrit
b b b b b b b b b b b b b b b
ion? - ANSWER: low fatty foods needed
b b b b b b
Bile, which aids in fat digestion, is not as concentrated as before surgery. Once the bo
b b b b b b b b b b b b b b b
dy adapts to the absence of the gallbladder, the client should be able to tolerate a
b b b b b b b b b b b b b b b
,regular diet that contains fat. Initially the client should avoid fatty foods unless other
b b b b b b b b b b b b b
wise indicated. A low- b b b
protein diet is not necessary. Although teaching the client about a low-
b b b b b b b b b b b
calorie diet to promote weight reduction is important, it is not as important as tempora
b b b b b b b b b b b b b b
ry avoidance of fatty foods with the gradual resumption of a regular diet. While vitam
b b b b b b b b b b b b b b
in C, vitamin A, and zinc are important, they are not the priority
b b b b b b b b b b b b
The nurse provides a list of appropriate food choices to a client with newly diagnosed
b b b b b b b b b b b b b b b
diabetes. The client reviews the list and says, "I do not like and refuse to eat asparagus
b b b b b b b b b b b b b b b b
, broccoli, and mushrooms." In response, the nurse teaches the client about the food e
b b b b b b b b b b b b b b
xchange list. The nurse evaluates that teaching was effective when the client states, "I
b b b b b b b b b b b b b
nstead of asparagus, broccoli, and mushrooms, I will eat which foods? -
b b b b b b b b b b b
bANSWER: String beans, beets, or carrots. b b b b b
String beans, beets, and carrots are in the vegetable exchange, as are asparagus, brocc
b b b b b b b b b b b b b
oli, and mushrooms. Corn, lima beans, dried peas, baked beans, potatoes, or parsnips
b b b b b b b b b b b b b
are starchy vegetables and are listed as bread exchanges. Corn muffins, corn chips, or
b b b b b b b b b b b b b
pretzels are from the bread exchange list.
b b b b b b b
While a nurse is teaching a client with diabetes about food choices, the client states, "
b b b b b b b b b b b b b b b
I do not like broccoli." Which food should the nurse suggest to substitute for broccoli
b b b b b b b b b b b b b b
? - ANSWER: greenbeans
b b b
According to exchange lists for meal planning, green beans and broccoli are equival
b b b b b b b b b b b b
ent vegetable substitutes. Peas are a starch and are not an equivalent vegetable substi
b b b b b b b b b b b b b
tute for broccoli. Corn is a starch and is not an equivalent vegetable substitute for bro
b b b b b b b b b b b b b b b
ccoli. Mashed potato is a starch and is not an equivalent vegetable substitute for broc
b b b b b b b b b b b b b b
coli.
n older adult is returned to the surgical unit after having a subtotal gastrectomy. Whic
b b b b b b b b b b b b b b
h dietary modification should the nurse anticipate that the healthcare provider will mo
b b b b b b b b b b b b
st likely prescrib - ANSWER: small feedings
b b b b b b
Small, frequent feedings are tolerated best after a subtotal gastrectomy. Roughage m
b b b b b b b b b b b
ay be irritating to the gastrointestinal (GI) tract after surgery. As soon as edema subsi
b b b b b b b b b b b b b b
des, the individual generally is given small amounts of fluid, and then the diet
b b b b b b b b b b b b b
, is progressed gradually. Allowing only personal food preferences does not ensure incl
b b b b b b b b b b b
usion of nutrients necessary for recovery.
b b b b b
A client is experiencing an exacerbation of ulcerative colitis. A low-residue, high-
b b b b b b b b b b b
protein diet and IV fluids with vitamins have been prescribed. When implementing th
b b b b b b b b b b b b b
ese prescriptions, which goal is the nurse trying to achieve? -
b b b b b b b b b b
ANSWER: reduce colonic irritation
b b b b
A low-
b
residue diet is designed to reduce colonic irritation, motility, and spasticity. Reducti
b b b b b b b b b b b
on of gastric acidity is the aim of bland diets used in the treatment of gastric ulcers. R
b b b b b b b b b b b b b b b b b
educing colonic irritation, motility, and spasticity hopefully will increase, not reduc
b b b b b b b b b b
e, intestinal absorption. This diet is to allow the bowel to rest, not to reduce infection
b b b b b b b b b b b b b b b
brates.
Which food should be avoided by a client who is prescribed monoamine oxidase inhi
b b b b b b b b b b b b b
bitors (MAOIs)? - ANSWER: bologna
b b b b
Bologna has a high tyramine content; tyramine should not be consumed by clients tak
b b b b b b b b b b b b b
ing monoamine oxidase inhibitors (MAOIs) because the drug interaction may cause s
b b b b b b b b b b b
evere hypertension. Potatoes and citrus fruits do not contain tyramine.
b b b b b b b b b
Grapefruit juice may cause a negative drug interaction in clients taking buspirone.
b b b b b b b b b b b
celiac disease - ANSWER: lifelong
b b b b
The diet must continue to be followed because the child will always have an absence
b b b b b b b b b b b b b b b
of peptidase; some variations in the diet may be allowed, but this should not be promi
b b b b b b b b b b b b b b b
sed. Each phase of child development may have problems related to dietary manage
b b b b b b b b b b b b
ment; follow- b
up care is needed to prevent crises. A restricted diet is never easy to follow, especially
b b b b b b b b b b b b b b b b
for a growing child. Gluten must be avoided for a prolonged period and perhaps indef
b b b b b b b b b b b b b b
initely.
A client with a history of a pulmonary embolus is to receive 3 mg of warfarin daily. T
b b b b b b b b b b b b b b b b b
he client has blood drawn twice weekly to ascertain that the international normalized
b b b b b b b b b b b b b
ratio (INR) stays within a therapeutic range. The nurse provides dietary
b b b b b b b b b b
b b b b b b b
RACTICE EXAM ALL QUESTIONS AND CORRECT A b b b b b b
NSWERS WITH RATIONALES | MOST RECENT AND b b b b b b b
COMPLETE VERSION ALRADY GRADED A+| BRAN b b b b b
D NEW!!! b
A nurse is providing dietary teaching for a client with celiac disease. Which foods sh
b b b b b b b b b b b b b b
ould the nurse teach the client to avoid when following a gluten-
b b b b b b b b b b b
free diet? Select all that apply. - ANSWER: rye, oats, and wheat
b b b b b b b b b b b
When caring for a client who is receiving enteral feedings, the nurse should take w
b b b b b b b b b b b b b b
hich measure to prevent aspiration - ANSWER: elevate HOB
b b b b b b b b
To prevent aspiration, the nurse should keep the head of the bed elevated between 3
b b b b b b b b b b b b b b
0 and 45 degrees. Elevating the head any higher causes increased sacral pressure an
b b b b b b b b b b b b b
d increases the risk of skin breakdown. Decreasing flow rate, checking residual, and
b b b b b b b b b b b b b
irrigating regularly will not prevent aspiration.
b b b b b
The nurse is teaching a client about the prescribed diet after a Whipple procedure for
b b b b b b b b b b b b b b b
cancer of the pancreas. Which statement should the nurse include in the dietary teachi
b b b b b b b b b b b b b
ng? - ANSWER: Low-
b b b
fat meals should be eaten to prevent interference with your fat digestion mechanism."
b b b b b b b b b b b b
Whipple procedure leads to malabsorption because of impaired delivery of bile to the
b b b b b b b b b b b b
bintestine and interruption of glucose metabolism; interference with fat digestion occu
b b b b b b b b b b
rs. Clients require small, frequent low-fat, high-protein, moderate-
b b b b b b b
bcarbohydrate meals and supplemental feedings. The response "There are no dietary r
b b b b b b b b b b b
estrictions because the tumor has been removed" is false reassurance. High-
b b b b b b b b b b
calorie meals are needed to provide energy and to promote the use of protein for tissu
b b b b b b b b b b b b b b b
e repair. High protein is required for tissue building; there is no problem with the liver
b b b b b b b b b b b b b b b
bin clients with cancer of the pancreas unless metastasis occurs by direct extension.
b b b b b b b b b b b b
celiac disease - ANSWER: intolerance of gluten
b b b b b b
,Celiac disease is an immunological small intestine enteropathy characterized by the
b b b b b b b b b b b
inability to metabolize the gliadin component of gluten found in grains such as wheat
b b b b b b b b b b b b b
, barley, rye, and oats; this results in excessive glutamine that is toxic to the mucosal
b b b b b b b b b b b b b b b b
cells. The stools are fatty and yellow. The intestinal villi are present but will atrophy
b b b b b b b b b b b b b b b
if exposed to foods containing gluten. Fluid balance is not the basic problem with ce
b b b b b b b b b b b b b b
liac disease; however, dehydration may occur in celiac crisi
b b b b b b b b
Tests reveal that a client has phosphatic renal calculi. The nurse teaches the client that
b b b b b b b b b b b b b b b
the diet may include which food item - ANSWER: apples
b b b b b b b b b
Apples are low in phosphate; fresh fruit is low in phosphorus. Chocolate contains mor
b b b b b b b b b b b b b
e phosphate than apples. Rye bread contains more phosphate than apples.
b b b b b b b b b b
Cheese is made with milk, which contains phosphate and should be avoided. Dairy pr
b b b b b b b b b b b b b
oducts are high in phosphorus. b b b b
kcal of sugars - ANSWER: for each gram of sugar it is 4 kcal
b b b b b b b b b b b b b
cushings disease - b b
bANSWER: Common symptoms of Cushing disease are weight gain, truncal obesityb b b b b b b b b b
, buffalo hump, and moon face because of deposits of adipose tissue. The condition is
b b b b b b b b b b b b b b b
caused by excess cortisol secretion caused by hypersecretion of adrenocorticotropic
b b b b b b b b b b
hormone (ACTH). Other characteristics are diabetes mellitus, muscle wasting, osteo
b b b b b b b b b
porosis, ecchymosis, and slow healing of wounds. Addison disease is adrenal insuffi
b b b b b b b b b b b
ciency. Symptoms of Addison disease include hypotension, dehydration, hypoglyce
b b b b b b b b
mia, and hyperpigmentation of the skin. Multiple sclerosis is a progressive disease in
b b b b b b b b b b b b
volving destruction of the myelin sheath, leading to nerve damage. Kaposi sarcoma is
b b b b b b b b b b b b
ba cancer associated with acquired immunodeficiency syndrome (AIDS)
b b b b b b b
A slightly overweight client is to be discharged from the hospital after a cholecystect
b b b b b b b b b b b b b
omy. What is most important for the nurse to include in teaching the client about nutrit
b b b b b b b b b b b b b b b
ion? - ANSWER: low fatty foods needed
b b b b b b
Bile, which aids in fat digestion, is not as concentrated as before surgery. Once the bo
b b b b b b b b b b b b b b b
dy adapts to the absence of the gallbladder, the client should be able to tolerate a
b b b b b b b b b b b b b b b
,regular diet that contains fat. Initially the client should avoid fatty foods unless other
b b b b b b b b b b b b b
wise indicated. A low- b b b
protein diet is not necessary. Although teaching the client about a low-
b b b b b b b b b b b
calorie diet to promote weight reduction is important, it is not as important as tempora
b b b b b b b b b b b b b b
ry avoidance of fatty foods with the gradual resumption of a regular diet. While vitam
b b b b b b b b b b b b b b
in C, vitamin A, and zinc are important, they are not the priority
b b b b b b b b b b b b
The nurse provides a list of appropriate food choices to a client with newly diagnosed
b b b b b b b b b b b b b b b
diabetes. The client reviews the list and says, "I do not like and refuse to eat asparagus
b b b b b b b b b b b b b b b b
, broccoli, and mushrooms." In response, the nurse teaches the client about the food e
b b b b b b b b b b b b b b
xchange list. The nurse evaluates that teaching was effective when the client states, "I
b b b b b b b b b b b b b
nstead of asparagus, broccoli, and mushrooms, I will eat which foods? -
b b b b b b b b b b b
bANSWER: String beans, beets, or carrots. b b b b b
String beans, beets, and carrots are in the vegetable exchange, as are asparagus, brocc
b b b b b b b b b b b b b
oli, and mushrooms. Corn, lima beans, dried peas, baked beans, potatoes, or parsnips
b b b b b b b b b b b b b
are starchy vegetables and are listed as bread exchanges. Corn muffins, corn chips, or
b b b b b b b b b b b b b
pretzels are from the bread exchange list.
b b b b b b b
While a nurse is teaching a client with diabetes about food choices, the client states, "
b b b b b b b b b b b b b b b
I do not like broccoli." Which food should the nurse suggest to substitute for broccoli
b b b b b b b b b b b b b b
? - ANSWER: greenbeans
b b b
According to exchange lists for meal planning, green beans and broccoli are equival
b b b b b b b b b b b b
ent vegetable substitutes. Peas are a starch and are not an equivalent vegetable substi
b b b b b b b b b b b b b
tute for broccoli. Corn is a starch and is not an equivalent vegetable substitute for bro
b b b b b b b b b b b b b b b
ccoli. Mashed potato is a starch and is not an equivalent vegetable substitute for broc
b b b b b b b b b b b b b b
coli.
n older adult is returned to the surgical unit after having a subtotal gastrectomy. Whic
b b b b b b b b b b b b b b
h dietary modification should the nurse anticipate that the healthcare provider will mo
b b b b b b b b b b b b
st likely prescrib - ANSWER: small feedings
b b b b b b
Small, frequent feedings are tolerated best after a subtotal gastrectomy. Roughage m
b b b b b b b b b b b
ay be irritating to the gastrointestinal (GI) tract after surgery. As soon as edema subsi
b b b b b b b b b b b b b b
des, the individual generally is given small amounts of fluid, and then the diet
b b b b b b b b b b b b b
, is progressed gradually. Allowing only personal food preferences does not ensure incl
b b b b b b b b b b b
usion of nutrients necessary for recovery.
b b b b b
A client is experiencing an exacerbation of ulcerative colitis. A low-residue, high-
b b b b b b b b b b b
protein diet and IV fluids with vitamins have been prescribed. When implementing th
b b b b b b b b b b b b b
ese prescriptions, which goal is the nurse trying to achieve? -
b b b b b b b b b b
ANSWER: reduce colonic irritation
b b b b
A low-
b
residue diet is designed to reduce colonic irritation, motility, and spasticity. Reducti
b b b b b b b b b b b
on of gastric acidity is the aim of bland diets used in the treatment of gastric ulcers. R
b b b b b b b b b b b b b b b b b
educing colonic irritation, motility, and spasticity hopefully will increase, not reduc
b b b b b b b b b b
e, intestinal absorption. This diet is to allow the bowel to rest, not to reduce infection
b b b b b b b b b b b b b b b
brates.
Which food should be avoided by a client who is prescribed monoamine oxidase inhi
b b b b b b b b b b b b b
bitors (MAOIs)? - ANSWER: bologna
b b b b
Bologna has a high tyramine content; tyramine should not be consumed by clients tak
b b b b b b b b b b b b b
ing monoamine oxidase inhibitors (MAOIs) because the drug interaction may cause s
b b b b b b b b b b b
evere hypertension. Potatoes and citrus fruits do not contain tyramine.
b b b b b b b b b
Grapefruit juice may cause a negative drug interaction in clients taking buspirone.
b b b b b b b b b b b
celiac disease - ANSWER: lifelong
b b b b
The diet must continue to be followed because the child will always have an absence
b b b b b b b b b b b b b b b
of peptidase; some variations in the diet may be allowed, but this should not be promi
b b b b b b b b b b b b b b b
sed. Each phase of child development may have problems related to dietary manage
b b b b b b b b b b b b
ment; follow- b
up care is needed to prevent crises. A restricted diet is never easy to follow, especially
b b b b b b b b b b b b b b b b
for a growing child. Gluten must be avoided for a prolonged period and perhaps indef
b b b b b b b b b b b b b b
initely.
A client with a history of a pulmonary embolus is to receive 3 mg of warfarin daily. T
b b b b b b b b b b b b b b b b b
he client has blood drawn twice weekly to ascertain that the international normalized
b b b b b b b b b b b b b
ratio (INR) stays within a therapeutic range. The nurse provides dietary
b b b b b b b b b b
