Lewis Chapter 44
Which finding for a young adult who follows a vegan diet may indicate the
need for cobalamin supplementation?
a. Glossitis
b. Ecchymoses
c. Dry, scaly skin
d. Gingival swelling
ANS: A
Cobalamin (vitamin B12) cannot be obtained from foods of plant origin, so the
patient will be most at risk for signs of cobalamin deficiency, such as glossitis,
anorexia, sore mouth and tongue, pallor, neurologic problems (e.g.,
depression, dizziness), weight loss, nausea, constipation, and anemia. The
other symptoms listed are associated with other nutritional deficiencies but
would not be associated with a vegan diet.
A 76-yr-old woman with a body mass index (BMI) of 17 kg/m2 and a low
serum albumin level is being admitted. Which assessment finding would the
nurse expect?
a. Restlessness
b. Hypertension
c. Pitting edema
d. Food allergies
ANS: C
Edema occurs when serum albumin levels and plasma oncotic pressure
decrease. The blood pressure and level of consciousness are not directly
affected by malnutrition. Food allergies are not an indicator of nutritional
status.
Which menu choice best indicates that the patient is implementing the nurse‘s
suggestion to choose high-calorie, high-protein foods?
a. Baked fish with applesauce
b. Beef noodle soup and canned corn
c. Fresh fruit salad with yogurt topping
, d. Fried chicken with potatoes and gravy
ANS: D
Foods that are high in calories include fried foods and those covered with
sauces.
High-protein foods include meat and dairy products. The other choices are
lower in calories and protein.
A patient has a body mass index (BMI) of 31 kg/m2, a normal C-reactive
protein level, and low serum transferrin and albumin levels. What should the
nurse encourage the patient to increase in the diet?
a. Iron
b. Protein
c. Calories
d. Carbohydrate
ANS: B
The patient's C-reactive protein and transferrin levels indicate low protein
stores. The BMI is in the obese range, so increasing caloric intake is not
indicated. The data do not indicate a need for increased carbohydrate or iron
intake.
A patient who has just been started on enteral nutrition of full-strength formula
at 100 mL/hr has 6 liquid stools the first day. Which action would the nurse
plan to take?
a. Slow the infusion rate of the feeding.
b. Check gastric residual volumes more often.
c. Change the enteral feeding system and formula every 8 hours.
d. Discontinue administration of water through the feeding tube.
ANS: A
Loose stools indicate poor absorption of nutrients and indicate a need to slow
the feeding rate or decrease the concentration of the feeding. Water should be
given when patients receive enteral feedings to prevent dehydration. When a
closed enteral feeding system is used, the tubing and formula are changed
every 24 hours. High residual volumes do not contribute to diarrhea.
Which finding for a young adult who follows a vegan diet may indicate the
need for cobalamin supplementation?
a. Glossitis
b. Ecchymoses
c. Dry, scaly skin
d. Gingival swelling
ANS: A
Cobalamin (vitamin B12) cannot be obtained from foods of plant origin, so the
patient will be most at risk for signs of cobalamin deficiency, such as glossitis,
anorexia, sore mouth and tongue, pallor, neurologic problems (e.g.,
depression, dizziness), weight loss, nausea, constipation, and anemia. The
other symptoms listed are associated with other nutritional deficiencies but
would not be associated with a vegan diet.
A 76-yr-old woman with a body mass index (BMI) of 17 kg/m2 and a low
serum albumin level is being admitted. Which assessment finding would the
nurse expect?
a. Restlessness
b. Hypertension
c. Pitting edema
d. Food allergies
ANS: C
Edema occurs when serum albumin levels and plasma oncotic pressure
decrease. The blood pressure and level of consciousness are not directly
affected by malnutrition. Food allergies are not an indicator of nutritional
status.
Which menu choice best indicates that the patient is implementing the nurse‘s
suggestion to choose high-calorie, high-protein foods?
a. Baked fish with applesauce
b. Beef noodle soup and canned corn
c. Fresh fruit salad with yogurt topping
, d. Fried chicken with potatoes and gravy
ANS: D
Foods that are high in calories include fried foods and those covered with
sauces.
High-protein foods include meat and dairy products. The other choices are
lower in calories and protein.
A patient has a body mass index (BMI) of 31 kg/m2, a normal C-reactive
protein level, and low serum transferrin and albumin levels. What should the
nurse encourage the patient to increase in the diet?
a. Iron
b. Protein
c. Calories
d. Carbohydrate
ANS: B
The patient's C-reactive protein and transferrin levels indicate low protein
stores. The BMI is in the obese range, so increasing caloric intake is not
indicated. The data do not indicate a need for increased carbohydrate or iron
intake.
A patient who has just been started on enteral nutrition of full-strength formula
at 100 mL/hr has 6 liquid stools the first day. Which action would the nurse
plan to take?
a. Slow the infusion rate of the feeding.
b. Check gastric residual volumes more often.
c. Change the enteral feeding system and formula every 8 hours.
d. Discontinue administration of water through the feeding tube.
ANS: A
Loose stools indicate poor absorption of nutrients and indicate a need to slow
the feeding rate or decrease the concentration of the feeding. Water should be
given when patients receive enteral feedings to prevent dehydration. When a
closed enteral feeding system is used, the tubing and formula are changed
every 24 hours. High residual volumes do not contribute to diarrhea.
