HESI Nutrition Practice Exam, HESI Nutrition, Nutrition Proctored, Nutrition Hesi Prep, Nutrition Practice Exam

The RN is caring for a client who was recently diagnosed iwth type 2 DM. What information is most important for the RN to teach the client about life-style changes? Correct answer- Portion-controlled, heart healthy diet selections 2. The RN suspects that a female client is altering her own diabetic journals. Which lab test should the RN review? Correct answer- Hemoglobin A1C 3. The RN is assessing the client regarding the need to increase vitamin B12. Which foods should the RN instruct the client to include? Correct answer- Cheese, eggs, fish 4. The home health RN is caring for a client with a stage III pressure ulcer. The RN recognizes which food group that contains zinc should be added to the client's diet Correct answer- Meats and shellfish 5. The RN receives four new admissions in an assisted living community. Which client should the RN assess for a higher caloric diet? Correct answer- A client with bacterial pneumonia 6. Orthodox Jewish client can have what? Correct answer- lamb chops with mint jelly 7. Client's knowledge of low-sodium menu selections Correct answer- White rice/steamed veggies and cottage cheese/sliced tomatoes 8. Lactose intolerant client needs foods enriched with calcium and vit d Correct answer- Fortified soy products 9. Stress incontinence dietary change Correct answer- avoid alcohol and caffeine 10. Instructions for client experiencing dumping syndrome Correct answer- Fluids should be limited to eight oz with meals 11. Recommended food for postoperative colectomy and colostomy Correct answer- chicken noodle soup 12. reduce odor in colostomy Correct answer- eat foods with yogurt drunk buttermilk eat parsley 13. vitamin deficiency increases the susceptibility of bleeding Correct answer- Vit K 14. continuous feeding through a NG tube - position to prevent aspiration? Correct answer- Semi-Fowler's 15. What should the RN include in chinese woman's diet Correct answer- vegetables 16. Foods for client who isn't eating because of mouth ulcers Correct answer- poached or scrambled eggs 17. Meal of pt with RUQ pain should be assessed for Correct answer- saturated fat content 18. How do you take medicine if youre NPO Correct answer- take with water that is not flavored 19. acute cholectisis dietary recommedations Correct answer- baked fish and tomatoes with lettuce 20. what instructions should the nurse include for psylium Correct answer- take with 240mL and follow with a second glass 21. Pt receiving TPN should be monitored for what metabolic chance Correct answer- hyperglycemia 22. seconday cirrhosis instruction do include in dietary teaching plan Correct answer- restricted sodium intake 23. instructions for diet info with simple goiter - what to eliminate? Correct answer- turnips 24. Vit k Deficiency nurse intervention Correct answer- monitor for signs of hematuria, melena, ecchymosis 25. What should the RN teach about recommending client replace saturated fats and healthier fats Correct answer- lowers the amount of low density lipoprotein in the blood 26. value of a protein supplement after surgery Correct answer- add'l protein promotes tissue healing post-0p 27. Pernicious anmia assoc with what vitamin deficiency? Correct answer- B12 28. What illness from bad can of beans Correct answer- clostridium botulinum 29. Likelihood of aging and creating a byproduct that is not health Correct answer- jar of peanut butter 30. What statement indicates new mom needs more instruction for breastfeeding Correct answer- drink a glass of wine while breastfeeding to help milk let down 31. PKU should eliminate Correct answer- chicken and fish 32. low residue diet client should avoid Correct answer- hard salami 33. stool guaiac test - what do you not eat 3 days before Correct answer- raw broccoli 34. Mild hypertension diet recommendation? Correct answer- decrease intake of canned foods 35. Foods to prevent osteoporosis Correct answer- canned tuna 36. Client should limit what with cirrhosis Correct answer- peanut butter 37. client choice that shows they understand low-fat, high fiber Correct answer- vegetable soup, carrots, legumes, celery, toasted oat bread, and an apple 38. foods to instruct chemo patient to eat Correct answer- broccoli/cauliflower/boiled eggs baked potatoes pastas 39. What do you not feed a baby before 12 mo for fear of botulism Correct answer- honey 40. what factor is most likely contributing to older client's malnutrition Correct answer- loss of teeth or poorly fitting dentures 41. which client will have the best response to a high protein diet? Correct answer- client recovering from illness/surgery 42. what outcome of diet therapy would the RN consider good response for HF client Correct answer- control fluid balance 43. nifedipine - what beverage to avoid Correct answer- grapefruit juice 44. How any g/day should RN instruct pregnant woman to add to her diet? Correct answer- pre-pregnant weight divided by 2 = protein needs 45. most common problem in accuracy of client reporting daily food intake Correct answer- under reporting of food intake 46. Recommendation to obese adolescent Correct answer- limit juices and soda drinks 47. which info should the RN use to assess a client's nutritional status before the procedure Correct answer- subjective global assessment 48. why is increasing magnesium important Correct answer- enhances the synthesis of proteins, nucleic acids, and fats 49. Primipara from mexico should include what in her diet Correct answer- red meats leafy greens fresh fruits 50. riboflavin rich foods Correct answer- enriched cereals 51. The PN is reinforcing dietary instructions to the parents of a 6 month old baby boy diagnosed with PKU phenylketonuria. What should the PN direct the patients to eliminate from his diet? Correct answer- Chicken and fish 52. The PN obtains the assistance of an interpreter when caing for a primiparous client from mexico who speaks very little English and delivered a full term neonate yesterday. When informing the postpartum dietary plan of care for the client, what should the PN tell the interpreter to encourage her to include in her diet? select all that apply. Correct answer- Red meats, leafy greens, fresh fruits 53. The practical nurse is caring for a client who was recently diagnosed with cirrhosis of the liver. Which foods should be limited in the client's diet? Correct answer- Peanut butter 54. The PN is preparing a client for surgery. Which criteria should the PN use to determine a client's nutritional status before the procedure? Correct answer- Subjective global assessment 55. the PN is caring for a patient who was recently dx with DM II. What information is most important with the client about life-style changes? Correct answer- Portion controlled healthy diet selections 56. The PN is reenforcing diet teaching for a client with a simple goiter. Which foods should the PN recommend that the client eliminate from the diet? Correct answer- Turnips 57. The PN is preparing a client about to hace a stool guiac test. Which food should the PN tell the clinet to aoid 3 days propr to collecting the specimen for this test? Correct answer- Raw broccoli 58. The PN is caring for a client with HF. What outcome of diet therapy should the PN evaluate as a therapeutic response for this client? Correct answer- control fluid balance 59. PN stresses to a female client the importance of osteoporosis prevention. Which foods should the PN recommend the client add to her diet? Correct answer- Canned Tuna 60. the home health PN is caring for a client with a stage 3 pressure ulcer. Which food group that contains zinc should be added to he clients diet to aide in wound healing? Correct answer- meats and fish` 61. The PN is review with the parents of a 6 month baby about the dangers of botulism in food. Which food should the PN reinforce not feeding to their infant before the age of 12 months? Correct answer- honey 62. What is the function of carbohydrates? Correct answer- 1. Provide energy for cellular work. 2. Regulate protein and fat metabolism 63. What percentage of calories/day should be carbohydrates? Correct answer- 45-65% 64. What are the functions of proteins? Correct answer- 1. tissue building 2. backup energy 3. nitrogen balance 4. support immune system 65. What percentage of daily calories should be protein? Correct answer- 10% 66. What perentage of daily should be fat? Correct answer- No more than 20-25% 67. The major actions of what vitamin is normal vision and tissue growth? Correct answer- Vitamin A 68. This vitamin helps maintain serum calcium and phosphorous, and aids in bone development Correct answer- Vitamin D 69. Which vitamin protects cells from oxidation? Correct answer- Vitamin E 70. Which vitamin is responible for normal blood clotting? Correct answer- Vitamin K 71. What are some major sources of Vit A Correct answer- Orange/yellow colored foods liver dairy 72. Major sources of Vit D? Correct answer- Fish foritfied dairy sunlight 73. Major sources of Vit E? Correct answer- Veggie oils grains nuts dark green veggies 74. Major sources of Vit K Correct answer- Green leafy veggies eggs liver 75. What is the recommended daily intake of fluids for men? Correct answer- 3-4 L 76. What is the recommended daily intake of fluids for women Correct answer- 2-3 L 77. How do you measure BMI? Correct answer- weight (kg) / height (m2) 78. What is the normal albumin level? Correct answer- 3.5 - 5.0 79. What is the normal prealbumin level? Correct answer- 23 - 43 80. How long should you store fresh meat? Correct answer- 1-2 days at 40 degrees or cooler 81. How long should you store Milk Correct answer- In the fridge for 5 days 82. How long should you store cheese? Correct answer- 3 - 4 weeks in the fridge 83. How long should you store eggs? Correct answer- In the fridge, 3 weeks in the shell. 1 week for hard boiled eggs 84. What temperature should roasts and steaks be cooked to? Correct answer- 145 degrees F 85. What temperature should chicken be cooked to? Correct answer- 180 degrees F 86. What temperature should ground beef be cooked to? Correct answer- 160 degrees F 87. How does grapefruit juice interact with many medications? Correct answer- Increases the serum level of the medication by interfereing its metabolism 88. What medication does Vitamin K interfere with and why? Correct answer- Coumadin. Vitamin K decreases the anticoagulant effects 89. Which foods should you teach a pt with Parkinsons to avoid while they are taking levodopa? Correct answer- Foods high in protein, amino acids, and Vitamin B6 90. Because it can increase the metabolism of the drug, resulting in a less duration of the therapeutic effect 91. Which food can cause hyperkalemia? Correct answer- Licorice 92. Teach a pt taking MAO to avoid foods high in _____? Correct answer- Tyramine aged cheese, smoked meats, red wines, and pickled meats 93. What is the daily increase in calories needed during the second trimester of pregnancy? Correct answer- 340 94. What is the daily increase in calories needed during the third trimester of pregnancy? Correct answer- 452 95. What is the recommended weight gain during the first trimester? Correct answer- 2 - 4 lbs 96. How many additional calories does a lactating, breastfeeding women need during the first 6 months postpartum? Correct answer- 330 97. How many additional calories does a lactating, breastfeeding women need during the second 6 months postpartum? Correct answer- 400 98. How long can you refridgerate breastmilk? Correct answer- 3 - 5 days 99. How long can you store frozen breastmilk? Correct answer- 6 months 100. To prevent CHD, what is the recommended daily intake of cholesterol? Correct answer- less than 200 mg 101. What should be increased to prevent CHD Correct answer- Fiber and Carbs 102. What are some food recommended for CHD that is high in fiber? Correct answer- Oats, beans, fruits, veggies, whole grain, barley, and flax 103. What kind of diet is needed for a pt with hypertension? Correct answer- low sodium high potassium high calcium 104. What are some food sources high in sodium? Correct answer- Canned soups and sauces Potato Chips Pretzels Smoked Meat Seasonings Processed foods 105. What are some food sources high in potassium? Correct answer- Apricots Bananas Tomatoes Potatoes 106. How long should a pt be on a liquid diet after a MI? Correct answer- the first 24 hours 107. What are some sources of Iron? Correct answer- Beef liver, Red meat, Fish, Poultry, Tofu, Dried peas and beans, Whole grains, Dried fruit 108. What are some natural sources of Vitamin B12? Correct answer- Fish, Meat, Poultry, Eggs, Milk 109. What are some Folic acid sources? Correct answer- Green leafy veggies, Dried peas and beans, Liver, Seeds, Orange juice 110. What is a common cause of folic acid deficiency anemia? Correct answer- Crohns Disease 111. Marasmus Correct answer- generally a calorie malnutrition in which body fat and protein are wasted. serum proteins are often preserved 112. kwashiorkor Correct answer- lack of protein quantity or quality in the presence of adequate calories 113. marasmic-kwashiorkor Correct answer- combined protein and energy malnutrition. This problem often presents clinically when metabolic stress is imposed on a chronically starved patient. 114. malnutrition Correct answer- Multi-nutrient problem. protein catabolism exceeds protein intake and synthesis, resulting in negative nitrogen balance, weight loss, decreased muscle mass, and weakness 115. respiratory muscle atrophy, decreased cardiac output, malabsorption, hypoproteinemia, decreased activity tolerance, intolerance to cold, edema, dry flaking skin, dermatitis, poor wound healing, infection, particularly postoperative infection and sepsis Correct answer- complications of severe malnutrition 116. poverty, substance abuse, decline in functional ability to eat independently, dental problems, dysphagia, infectious diseases such as tuberculosis and HIV, diarrhea, vomiting, chemotherapy, catabolic processes such as prolonged immobility increase nutrient requirements and metabolic losses Correct answer- causes of malnutrition 117. Acute PEM Correct answer- type of PEM that develops in patients who were adequately nourished before hospitalization but experience starvation while in a catabolic state from infection, stress, or injury 118. Chronic PEM Correct answer- type of PEM that occurs in those who have cancer, end-stage kidney or liver disease, or chronic neurologic disease. 119. a weight loss of 5% or more in 30days, a weight loss of 10% in 6 months, or a weight that is below ideal Correct answer- clinical description of malnutrition 120. Zinc deficiency Correct answer- Alopecia, diarrhea and glossitis are manifestations of which nutrient deficiency? 121. protein deficiency Correct answer- loss of hair, hepatomegaly, edema of the extremities, are manifestations of which nutrient deficiency? 122. vitamin C deficiency Correct answer- "corkscrew hair", swollen bleeding gums, petechiae/ecchymoses are manifestations of which nutrient deficiency? 123. vitamin A deficiency Correct answer- xerosis of conjunctiva, keratomalacia, bitot's spots, magenta tongue, dry and scaling skin, follicular hyperkeratosis are manifestations of which nutrient deficiency? 124. Niacin deficiency Correct answer- diarrhea, glossitis, fissured tongue, nasolabial seborrhea, bilateral dermatitis, disorientation are manifestations of which nutrient deficiency? 125. pyridoxine deficiency Correct answer- stomatitis, cheilosis, glossitis, neuropathy, paresthesia are manifestations of which nutrient deficiency? 126. thiamine deficiency Correct answer- confabulation, neuropathy, paresthesia, congestive heart failure, cardiomegaly, tachycardia are manifestations of which nutrient deficiency? 127. Vitamin D deficiency Correct answer- osteomalacia, bone pain, rickets are manifestations of which nutrient deficiency? 128. 13.0-17.0 g/dL Correct answer- normal range for hemoglobin 129. may indicate anemai, recent hemorrhage, hemodilution caused by fluid retention. may also be secondary to conditions such as low serum albumin, infection, catabolism, or chronic disease Correct answer- Low hemoglobin level (13.0 g/dL) 130. may indicate hemoconcentration or dehydration or may be secondary to liver disease Correct answer- high hemoglobin (17.0 g/dL) 131. 38-50% Correct answer- normal range for hematocrit 132. may reflect anemia, hemorrhage, excessive fluid, renal disease, or cirrhosis Correct answer- low hematocrit (38%) 133. may indicate dehydration or hemoconcentration Correct answer- high hematocrit (50%) 134. 3.5-5 g/dL Correct answer- normal serum albumin level 135. fluid excess Correct answer- low serum albumin (3.5 g/dL) 136. dehydration Correct answer- high serum albumin (5 g/dL) 137. Prealbumin (PAB) Correct answer- plasma protein that provides a more sensitive indicator or nutritional deficiency because of its short half-life of 2 days. it can also assess improvement in nutritional status with refeeding; levels can increase by 1mg/dL daily with adequate nutritional support 138. 15-35 mg/dL Correct answer- normal range for prealbumin 139. serum transferrin Correct answer- can be measured directly or calculated as an indirect measurement of total iron-binding capacity. It has a short half-life of 8-10 days and therefore is also a more sensitive indicator of protein status than albumin 140. 160-200 mg/dL Correct answer- normal cholesterol levels 141. malabsorption, liver disease, pernicious anemia, end-stage cancer, sepsis. Correct answer- causes of low cholesterol levels (160 mg/dL) 142. usually decreased to below 1500 Correct answer- total lymphoctye count levels in malnourished patients - be sure patient is toileted and receives mouth care before mealtime - make sure patient has glasses/hearing aids in place during meals 143. -remove bedpans, urinals, emesis basins from sight - give analgesics to control pain and /or antiemetics for nausea at least 1 hour before mealtime 144. -remind UAP to have patient sit in chair, if possible, at mealtime 145. -if needed, open cartons and packages and cut up food 146. -ask patients about food preferences - decrease distractions and make environment relaxing and comfortable 147. -ensure that meals are visually appealing, appetizing, appropriately warm or cold 148. -appropriate time should be allowed so that the patient does not feel rushed through a meal Correct answer- ways to encourage and promote nutritional intake in malnourished ill patients 149. TEN is indicated for: 150. -patients who can eat but cannot maintain adequate nutrition by oral intake of food alone 151. -patients who have permanent neuromuscular impairment and cannot swallow 152. -those who do not have permanent neuromuscular impairment but are critically ill and cannot eat because of their condition Correct answer- Indications for Total Enteral Nutrition 153. TEN is contraindicated for patients in states of significant hemodynamic compromise, such as those with diffuse peritonitis, severe acute or chronic pancreatitis, intestinal obstruction, intractable vomiting or diarrhea, and paralytic ileus Correct answer- Contraindications for Total Enteral Nutrition 154. development of a clogged tube, refeeding syndrome, tube misplacement and dislodgement, abdominal distention, nausea/vomiting, diarrhea, aspiration pneumonia, hyperkalemia, hyponatremia, Correct answer- Complications of TPN 155. Refeeding syndromeq Correct answer- a life-threatening metabolic complication that can occur when nutrition is restarted for a patient who is in a starvation state. The electrolyte shift of potassium and phosphate into plasma can cause cardiovascular, respiratory, and neurologic problems, primarily as a result of hyophosphatemia. 156. shallow respirations, weakness, acute confusion, seizures, increased bleeding tendency. Correct answer- clinical manifestations of refeeding syndrome 157. correct tube placement Correct answer- pH of gastric fluid ranging from 0- 4 158. indicates tube may be in the lungs 159. ** H2 blockers(Zantac, Pepcid) may also affect pH Correct answer- pH of gastric aspirate greater than 6.0 160. indicates tube may have moved into the intestines Correct answer- pH of gastric aspirate between 7.0 and 8.0 161. Capnometry Correct answer- test used to determine if carbon dioxide is emitted from the tube, which would indicate that the tube is placed in the lungs rather than the stomach. 162. increasing temperature and pulse, signs of dehydration such as dry mucous membranes and decreased urinary output. diminished breath sounds, patients may become short of breath or report chest discomfort Correct answer- manifestations of aspiration pneumonia 163. -flush tube with 20 to 30mL water at least every 4 hours with continuous tube feeding, before and after each intermittent tube feeding, before and after drug administration, and after checking residual volume 164. -if tube becomes clogged, use 30mL of water for flushing, applying gentle pressure with a 50mL piston syringe 165. -avoid the use of carbonated beverage, except for existing clogs when water is not effective. Do not use cranberry juice. 166. -whenever possible, use liquid medications instead of crushed tablets unless liquid forms cause diarrhea Correct answer- interventions to maintain patent feeding tube with TEN 167. abdominal distention, nausea, and vomiting during tube feedings are often caused by overfeeding. to prevent overfeeding, check gastric residual volumes every 4-6 hours. American Society of Parenteral and Enteral Nutrition (ASPEN) recommends holding a feeding if the gastric residual volumes are more than 200mL on two consecutive assessments Correct answer- interventions to prevent abdominal distention and nausea/vomiting with TEN 168. increased plasma volume results in an increased renal excretion of water (in patients with normal renal function) and leads to osmotic dehydration. If patients do not have normal renal or cardiac function, expansion of the plasma volume can lead to circulatory overload and pulmonary edema, especially in older adults. 169. also excessive diarrhea can develop when hyperosmolar enteral preparations are delivered quickly which can also lead to dehydration Correct answer- Risks of hypertonic enteral feedings 170. hyperkalemia and hyponatremia Correct answer- two most common electrolyte imbalances associated with enteral nutrition therapy 171. used for some patients who can eat but are not able to take in enough nutrients to meet their needs. 172. The patient must have adequate peripheral vein access and be able to tolerate large volumes of fluid to have PPN Correct answer- Indications for Partial Parenteral Nutrition 173. IV fat (lipid) emulsions (IVFEs) and amino acid-dextrose solutions. Correct answer- Two main types of PPN 174. fever, increased triglycerides, clotting problems, and multi-system organ failure. 175. (discontinue the IVFE solution and report to health care provider immediately) Correct answer- For patients receiving IVFEs , monitor for these manifestations of fat overload syndrome, especially in those who are critically ill. 176. TPN is indicated when patient requires intensive nutritional support for an extended time 177. Examples: patients with extensive burns, severe exacerbation of chron's disease, cancer and chemotherapy causing n/v, patients who are septic or acquired immunodeficiency syndrome. Correct answer- Indications for TPN 178. Hyperglycemia, Fluid imbalance including dehydration or hypovolemic shock, if patient has cardiac or renal dysfunction patient may develop fluid overload, congestive heart failure, and pulmonary edema, Correct answer- Complications of TPN 179. -check each bag of TPN solution for accuracy by comparing it with the physicians or pharmacists prescription 180. -monitor IV pump for accuracy in delivering the prescribed hourly rate 181. -if the TPN solution is temporarily unavailable, give 10% dextrose/water or 20% dextrose/water until solution can be obtained. 182. -if the TPN administration is not on time ("behind") do not attempt to "catch up" by increasing the rate 183. -monitor patients weight daily 184. -monitor serum electrolytes and glucose daily or per facility protocol 185. -monitor and carefully record patients intake and output 186. -assess IV site for signs of infection or infiltration 187. -Change IV tubing every 24 hours or per facility protocol 188. -Change dressing around IV site every 48-72 hours or per facility protocol 189. -before administering TPN, have a second nurse check the prescription and solution to prevent patient harm Correct answer- Nursing interventions for TPN 190. -control of protein intake 191. -fluid intake limitation 192. -restriction of potassium, sodium, and phosphorus intake; 193. -taking vitamin and mineral supplements 194. -eating enough calories to meet metabolic needs Correct answer- general dietary changes for patients with CKD 195. Protein=1-1.05 g/kg/day 196. fluid= 500-700 mL/day plus amount of urine output 197. Potassium= 70 mEq/day 198. Sodium= 2.4g/day 199. phosphorus= 700mg/day Correct answer- dietary restrictions for patient with kidney disease with hemodialysis 200. -diet should be high in carbohydrates and calories with moderate amounts of fat and protein (limit fat if steatorrhea is present) 201. -small frequent meals are often preferable to three standard meals 202. -mL/day fluids 203. -vitamins and minerals include multivitamin including B complex (especially thiamine, vitamin B12), vitamin K, Vitamin C, and zinc Correct answer- Hepatitis Nutritional therapy 204. -sodium restriction 1-2g/day 205. -1.2-1.5 g/kg protein recommended 206. -may need to restrict fluids to 1200mL/day 207. -vitamin supplements such as thiamine, folate, and b12 208. -Thiamine is found in pork, nuts, whole grain cereals, and legumes. Correct answer- Cirrhosis nutritional therapy - patient is maintained on NPO in early stages 209. -patients with severe pancreatitis and are unable to eat for 24-48 hours after illness onset may begin jejunal tube feeding unless parlytic ileus is present. 210. -TEN is preferred over TPN because it causes fewer episodes of glucose elevation 211. -when food is tolerated during the healing phase, small frequent moderate-to-high carbohydrate, high-protein, low-fat meals are prescribed 212. -foods should be bland with little spice 213. -GI stimulants such as caffeine and alcohol should be avoided. - commercial liquid nutritional preparations may be added to boost caloric intake 214. -in chronic pancreatitis Pancreatic-enzyme replacement therapy (PERT) may be needed 215. -chronic patients may also need an increased number of calories (4000- 6000) to maintain weight) Correct answer- Pancreatitis nutritional therapy 216. cool, clammy skin 217. anxious, nervous, irritable 218. mental confusion 219. weakness 220. hunger 221. blurred vision 222. tachycardia, palpitations Correct answer- symptoms of hypoglycemia 223. warm, moist skin 224. rapid, deep, kussmaul type respirations 225. fruity breath 226. fatigue 227. polyuria, polydypsia Correct answer- Symptoms of hyperglycemia 228. 4 kcal Correct answer- Proteins and carbohydrates provide how many kcal of energy per gram ingested? 229. 9 kcal Correct answer- fats provide how many kcal of energy per gram ingested? 230. animal sources of fat are primarily which type of fat? Correct answer- saturated 231. to reduce the risk of cardiovascular disease AHA guidelines recommend limiting saturated fat to less than 7%, trans fat to less than 1%, and cholesterol to less than 300mg/day. Diet therapy includes eating fish at least 2 times per week and eating whole grain high-fiber foods. Correct answer- diet to reduce risk of cardiovascular disease 232. Obesity BMI Correct answer- BMI of 30 or greater 233. Overweight BMI Correct answer- BMI between 25-29.9 234. normal weight BMI Correct answer- BMI between 18.5-24.9 235. Underweight BMI Correct answer- BMI below 18.5 236. additional caloric energy needs for breastfeeding women Correct answer- During the first 6 months after birth, the energy needs for milk production is estimated at an additional 500 calories per day, the amount decreases to 400 calories a day after the first 6 months of lactation 237. complications related to iron deficiency during pregnancy Correct answer- risk of giving birth to a low birth weight infant 238. Complications related to folic acid deficiency during pregnancy Correct answer- risk of giving birth to an infant with spinal bifida or anencephaly 239. instructions for patient with iron deficiency Correct answer- take iron with food source in vitamin C to aid in absorption, avoid drinking coffee or tea within 1 hour of iron intake, heme iron can be found in meat and poultry, nonheme iron can be found in beans and dried fruit 240. folic acid recommendations for women Correct answer- All female clients of childbearing age are recommended to consume 400mcg of folic acid each day. The need increases to 600 mcg per day during pregnancy. Folic acid decreases the risk of neural tube defects in the developing fetus. 241. Ulcerative colitis diet Correct answer- well-balanced, low-residue, low-fat, high-protein, high-calorie, no dairy products. also avoid caffeinated beverages, spicy foods, and alcohol. 242. during severe exacerbations patient may be kept NPO to allow bowel rest. Patient may also be put on TPN. 243. During less severe exacerbations, patient may drink elemental formulas such as vivonex plus 244. Chron's disease diet Correct answer- During severe exacerbations patient may be NPO to promote bowel rest, TPN may be needed. 245. Teach patients to follow a low-residue, high-calorie diet, and avoid foods that cause discomfort such as milk, gluten, and other GI stimulants like caffeine. 246. If patient has fistula: patient needs 3000 calories daily to promote healing of fistula, also increased need for protein. TEN or TPN may be needed. 247. irrritable bowel nutritional therapy Correct answer- when a flare occurs, high-fiber fruits, vegetables, grains, nuts, and seeds should be avoided. also avoid caffeine, alcohol, and beverages with fructose or sorbatol. diarrhea may cause zinc deficiency so it is recommended that zinc be replaced at the rate of 12-15 mg/L of intestinal output. 248. intestinal obstruction nutritional therapy Correct answer- NPO, NGT is inserted to decompress bowel, IV fluid replacement, TPN may be prescribed if patient has had chronic nutritional problem and has been NPO for an extended period 249. gastritis diet Correct answer- -limit intake of any foods and spices that cause distress such caffeine, chocolate, mustard, food with high acid content (tomato products, citrus juices), or those that are heavily seasoned. 250. -alcohol and tobacco are avoided 251. -a bland, non-spicy diet and smaller more frequent meals is recommended 252. -vitamin B12 replacement 253. dumping syndrome Correct answer- group of symptoms that occur after eating, when undigested contents move too quickly into our small intestine. can occur after any opperation on the stomach. Gastric bypass is the most common cause 254. nutritional changes to prevent dumping syndrome Correct answer- -eat six small meals 255. -avoid fluids with meals 256. -limit intake of foods and drinks with high sugar content 257. -lactose( sugar found in dairy) may cause dumping symptoms 258. -consume high protein, high fat, low to moderate carbohydrate diet. 259. -increase fiber intake. 260. -including fat with a meal (margarine, oil, mayonnaise) adds calories and may help symptoms 261. -avoid alcohol 262. -stay away from acidic foods such as tomatoes and citrus fruits 263. -vitamins including iron and calcium may be needed. 264. Parkinsons diet Correct answer- -serve a soft diet, which is easy to swallow 265. -provide high protein, high calorie foods or supplements to maintain weight 266. -if pateint is taking MAOI-type B (selegiline, rasagiline) teach patients to avoid tyramine products including cheeses, aged ,smoked, or cured foods. 267. food sources of iron Correct answer- red meat, organ meat, egg yolks, kidney beans, green leafy vegetables, raisins, kale, carrots, apricots, blackstrap molasses 268. symptoms of vitamin b12 deficiency Correct answer- pallor and jaundice, glossitis, fatigue, weight loss, paresthesias (abnormal sensations) in feet and hands and poor balance 269. food sources of folic acid Correct answer- -green leafy vegetables - liver 270. -yeast 271. -dried beans 272. -nuts 273. -enriched breads, breakfast cereals, pastas, flour, cornmeal, white rice 274. -orange juice 275. food sources of dietary calcium Correct answer- milk, yogurt, cheese, fish with edible bones, and green leafy vegetables 276. food sources of magnesium Correct answer- dark leafy vegetables (spinach), whole grains, nuts, beans, lentils, avocados, bannanas, low fat dairy products, 277. dietary instructions for children 1-3 yrs Correct answer- Nutrition requirements: 278. -1300kcal 279. -16 grams of protein 280. Serving size guidelines: 281. -1 tablespoon fruit or vegetable serving for each year of age 282. -1/4 of an adult serving of bread and cereal 283. -2 to 3 cups of milk per day 284. -meat or meat alternative offered twice a day 285. dietary instructions for children 4-6 years Correct answer- Nutritional requirements: 286. -1800kcal 287. -24 grams protein 288. dietary instructions for children 7-12 Correct answer- Nutrition requirements: 289. -2000 to 2200 kcal 290. -28 to 46 grams protein depending on sexual maturity 291. -calcium requirements: adequate intake (AI) begins at 800 mg at age 8 and increases to 1300 throughout adolescence 292. -iron and zinc requirements increase 293. dietary instructions for adolescence 13-19 years Correct answer- 2200 kcal for females, 2500 to 2900 kcal for males 294. protein 45g females, 59g males 295. calcium 1300 mg 296. patient teaching patient experiencing diarrhea Correct answer- avoid extremely hot or cold foods 297. avoid caffeine 298. DASH diet for hypertension Correct answer- Grains: 6-8 servings per day 299. Vegetables: 4-5 servings per day 300. Fruits: 4-5 servings per day 301. Low fat dairy: 2-3 servings per day 302. Lean meat, poultry and fish: 6 or fewer servings per day 303. nuts, seeds, and legumes: 4-5 servings PER WEEK 304. fats and oils: 2-3 servings per day 305. sweets: 5 or fewer PER WEEK 306. alcohol: men should limit alcohol to 2 or fewer a day and women 1 or fewer a day 307. introducing solid foods to infants Correct answer- 4 months: Infant rice cereal should be offered first because of low allergy potential 308. 6-8 months: strained fruits 309. drugs that interact with grapefruit juice Correct answer- Buspirone (Buspar) Carbamazepine (Tegretol) Cyclosporine (Gengraf, Neoral) 310. Nifedipine (Procardia, Aldalat) Simvastatin (Zocor) 311. Sirolimus (Rapamune) Tacrolimus (Prograf), verapamin hydrochoride (Calan) 312. nutrients that aid in wound healing Correct answer- protein, zinc, vitamin c 313. symptoms of hypokalemia Correct answer- -fatigue, weakness, muscle cramps 314. -tingling/numbness 315. -nausea or vomiting 316. -abdominal cramps, bloating 317. -constipation 318. -heart palpitations 319. appropriate weight gain during pregnancy based on pre-pregnancy BMI Correct answer- BMI less than 18.5 = 28-40lbs 320. BMI 18.5 to 24.9= 25-35lbs 321. BMI 25 to 29.9= 15-25lbs 322. BMI 30 or greater= 11-20lbs 323. diabetes mellitus dietary instructions Correct answer- Meal planning with the Glycemic index involves choosing foods that have a low or medium GI. If eating a food with a high GI, you can combine it with low GI foods to help balance the meal 324. -low-glycemic index foods: fruit with edible skins such as apples, peanuts, and fat-free yogurt, oatmeal (rolled or steal-cut), oat bran, 325. -moderate glycemic index: whole wheat, rye, pita bread, quick oats, brown rice 326. -high Glycemic index: white rice, white bread, popcorn, pretzels, ricecakes, pineapple, melons, bannanas 327. causes of diarrhea in patient receiving enteral feedings Correct answer- feeding on an intermittent schedule, bowel impaction or obstruction, 328. complications of central vein TPN Correct answer- Sepsis, insertion- related pneumothorax and hemothorax 329. Alternate calcium sources for patients with lactose intolerance Correct answer- egg yolk, green leafy vegetables, dried beans, cauliflower, molasses 330. Precautions with TPN delivery Correct answer- -TPN must be delivered through access to central veins, usually through a PICC line or the subclavian or internal jugular veins. 331. Caloric value of most standard enteral feeding formulas Correct answer- 1 to 2 cal/mL 332. Normal total protein levels Correct answer- 6-8g/dL 333. food sources of niacin Correct answer- milk, eggs, meats, and dairy products 334. food sources of vitamin C Correct answer- tomatoes, potatoes, strawberries 335. Tuberculosis Nutritional therapy Correct answer- increase intake of protein, iron, and vitamin c 336. cholecystitis diet Correct answer- decrease intake of dietary fat 337. food sources of potassium Correct answer- spinach, avocado, oranges 338. What information is most important for the RN to teach a client with type 2 diabetes about life-style changes? Correct answer- Portion-controlled, heart healthy diet selections 339. -in order to achieve tight blood glucose control and to prevent complications with DM 340. Which lab test should be run to assess a client's compliance with self management for type 1 diabetes? Correct answer- Hemoglobin A1c 341. -measures average blood glucose level over the past 3 months 342. Which foods contain vitamin B12? Correct answer- cheese, eggs, and fish 343. What food groups contain zinc in order to aid in wound healing? Correct answer- meats and shellfish 344. A client with an active infection (such as bacterial pneumonia) requires what kind of diet? Correct answer- high caloric diet 345. -calories help combat infection 346. What main course selection would be suitable for a kosher diet? Correct answer- lamb chops with mint jelly 347. What are examples of food low in sodium? Correct answer- white rice with steamed vegetables, and cottage cheese with sliced tomatoes 348. Foods enriched in calcium and vitamin D include what? Correct answer- fortified soy products 349. Which dietary change should be avoided in order to manage stress incontinence and urine output? Correct answer- alcohol and caffeine 350. -cause fluid retention and directly affect the bladder 351. For a patient with dumping syndrome, what should they limit in their diet in order to minimize symptoms? Correct answer- fluids should be limited to eight ounces with meals 352. -clients with dumping syndrome should increase protein and avoid simple sugars 353. What food should be recommended to a client who recently had a total colectomy or colostomy? Correct answer- chicken noodle soup 354. -no residual gas production after eating or digest 355. -prevents embarrassment 356. What are some foods that help combat odor in order to manage a total colectomy? Correct answer- yogurt, buttermilk, and parsley 357. -easily digestible and help neutralize and reduce odor 358. What vitamin deficiency increases the susceptibility of bleeding due to liver disease? Correct answer- vitamin K 359. -without this vitamin, clients are at risk for bleeding due to a decrease in hepatic synthesis of clotting factors 360. Which position prevents aspiration for clients with continuous tube feeding? Correct answer- semi-fowler's position 361. -elevate head and angle neck 30-45 degrees 362. What do Chinese diets generally include in them? Correct answer- vegetables 363. What types of foods will aide in healing of oral and buccal ulcers? Correct answer- poaches or scrambled eggs 364. -bland or soft foods with significant protein content 365. What about a food's content can cause the right upper quadrant (RUQ) to be in pain after eating? Correct answer- saturated fat 366. If a client is instructed to be NPO after midnight, what should they be instructed to drink with morning medications? Correct answer- water without flavoring 367. What foods are recommended to a patient with acute cholecystitis? Correct answer- baked fish and tomatoes with lettuce 368. -patients should decrease dietary fat 369. What should be taken with a prescription for psylium for constipation? Correct answer- 2 full glasses of water 370. -decreases chances of impaction 371. What metabolic change should be assessed in clients receiving Total parenteral nutrition (TPN)? Correct answer- hyperglycemia 372. What should patients with ascites secondary to cirrhosis of the liver avoid? Correct answer- restrict sodium intake 373. What foods should be avoided in patients with goiter? Correct answer- turnips 374. -most vegetables