NUR 155 Nursing Fundamentals
Exam 2
Exam Structure:
Subject: Nursing / Nutrition, Gastrointestinal, Genitourinary, Mobility, Health
Promotion
Source: NUR 155 Exam 2
Format: Multiple-Choice Questions & Select-All-That-Apply
1. The nurse is providing education to a patient about the difference
between simple and complex carbohydrates. Which statement by the
patient indicates a need for further education?
A. "Simple carbohydrates give me quick energy."
B. "Complex carbohydrates come from fruit."
C. "Complex carbohydrates take longer to break down."
D. "Simple carbohydrates come from milk products."
Correct Answer: B. "Complex carbohydrates come from fruit."
Rationale:
1. Fruits primarily contain simple carbohydrates (fructose, glucose).
2. Complex carbohydrates are found in foods like whole grains, legumes,
and starchy vegetables.
3. The patient's statement confuses the sources of simple vs. complex
carbs, indicating a misunderstanding that requires correction.
2. The nurse teaches the family member to provide the patient with
how much dietary fiber per day?
A. 25 to 35 g
B. 20 to 35 g
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C. 25 to 40 g
D. 20 to 40 g
Correct Answer: B. 20 to 35 g
Rationale:
1. The general recommended daily intake of dietary fiber for adults is
20 to 35 grams.
2. This range is supported by major health organizations to promote
digestive health, regulate blood sugar, and lower cholesterol.
3. The nurse is providing education to an older adult around a healthy
diet to support the challenges related to aging. Which statement
indicates a need for further education?
A. "I should choose foods that are nutrient dense."
B. "High-fiber foods minimize the risk of constipation."
C. "I should eat more calories to avoid malnutrition."
D. "I can add spices to enhance the taste of food."
Correct Answer: C. "I should eat more calories to avoid malnutrition."
Rationale:
1. Older adults typically have lower caloric needs due to decreased
metabolism and activity.
2. The focus should be on nutrient-dense foods (high in
vitamins/minerals per calorie), not simply increasing calorie intake,
which could lead to weight gain without improving nutritional status.
4. When caring for an adolescent patient with anorexia nervosa, the
nurse knows what would be the best treatment option for this
patient?
A. Hospitalization with skilled nursing care
B. Compulsory tube feedings
C. Individually determined by a collaborative team
D. Outpatient treatment
Correct Answer: C. Individually determined by a collaborative team
Rationale:
1. Eating disorder treatment must be highly individualized based on
severity, medical stability, and psychosocial factors.
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2. A collaborative team (physician, therapist, dietitian, nurse) creates a
tailored plan, which may include outpatient care, hospitalization, or
nutritional support, depending on the patient's specific needs.
5. A new UAP is measuring a patient's height. Which step of the
procedure indicates a need for the registered nurse to provide further
education on this skill?
A. The UAP instructs the patient to remove shoes.
B. The UAP measures from the top of the patient's head to the bottom of the
patient's foot arch.
C. The UAP positions the head against the headboard or measuring device.
D. The UAP makes sure the patient is standing erect.
Correct Answer: B. The UAP measures from the top of the patient's head to
the bottom of the patient's foot arch.
Rationale:
1. Correct height measurement is from the top of the head to
the heel (floor), not the arch.
2. Measuring to the arch will result in an inaccurate, shorter
measurement, affecting calculations like BMI and nutritional
assessments.
6. The nurse is performing an oral examination on a patient and
notices a beefy-red tongue. The nurse identifies this as a characteristic
finding for what condition?
A. Anorexia nervosa
B. Malnutrition
C. Bulimia
D. Pernicious anemia
Correct Answer: D. Pernicious anemia
Rationale:
1. A smooth, beefy-red tongue (glossitis) is a classic sign of vitamin B12
deficiency.
2. Pernicious anemia is an autoimmune condition that impairs B12
absorption, leading to this specific oral manifestation along with
neurological symptoms.
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7. The nurse has delegated the feeding of a patient who has recently
had a stroke to the UAP. Which procedure that the UAP performs
would demonstrate a need for further education?
A. Uses thickened liquids
B. Puts the bed at 25 degrees
C. Encourages slow eating
D. Has the patient alternate between food and sips of fluid
Correct Answer: B. Puts the bed at 25 degrees
Rationale:
1. To prevent aspiration during feeding, the head of the bed should be
elevated to at least 30 degrees (ideally 45-90 degrees).
2. A 25-degree angle is insufficient and increases the risk of aspiration
pneumonia in a patient with dysphagia post-stroke.
8. The nurse recognizes which outcome statement to be appropriate
for the nursing diagnosis Impaired Swallowing?
A. Patient will consume 50% of each meal.
B. Patient will gain 2 lb a week.
C. Patient will not show any signs of aspiration during meals.
D. Patient will demonstrate using an assistive device to feed self.
Correct Answer: C. Patient will not show any signs of aspiration during
meals.
Rationale:
1. The primary safety concern with Impaired Swallowing is aspiration,
which can lead to pneumonia.
2. A direct, measurable outcome is the absence of aspiration signs
(coughing, choking, wet voice during/after meals). Weight gain and
intake are secondary to safe swallowing.
9. The nurse is explaining to the UAP that the patient is on a full-liquid
diet. Which statement by the UAP indicates a need for reorientation?
A. "I can give the patient orange juice."
B. "I can give the patient yogurt."
C. "I can give the patient oatmeal."
D. "I can give the patient milk."
Correct Answer: C. "I can give the patient oatmeal."
Rationale: