Guaranteed Pass Solutions 2025-2026
Updated.
Know the types of therapeutic diets - Answer -clear diet
-full liquid
-pureed
-mechanical/dental soft
-soft/low residue; low fiber
-high fiber
-regular
Clear Liquid Diet - Answer Foods that are clear and liquid at room or body temperature that
leave little residue and are easily absorbed; commonly ordered for short-term use (24 to 48
hours) after surgery, before diagnostic tests, and after episodes of diarrhea and vomiting.
Examples: water, apple/cranberry juice, gelatin, popsicles
Full Liquid Diet - Answer Includes foods on clear-liquid diet plus addition of smooth-textured
dairy products like milk and ice cream, strained soups, custard, refined cooked cereals,
vegetable juice, and pureed vegetables; commonly ordered before or after surgery for patients
who are acutely ill from infection or for patients who cannot chew or tolerate solid foods.
Pureed - Answer Includes foods on clear- and full-liquid diet plus easily swallowed foods that
do not require chewing (scrambled eggs, pureed meats, vegetables and fruits, mashed
potatoes);
ordered for patients with head and neck abnormalities or who have had oral surgery; can be
modified for low sodium, fat, or calorie count.
Mechanical/ Dental Soft - Answer Consists of all previous diets plus addition of lightly
seasoned ground or finely diced meats, flaked fish, cottage cheese, cheese, rice, potatoes,
pancakes, light breads, cooked vegetables, cooked or canned fruits, peanut butter; AVOID tough
meats, nuts, bacon, and fruits with tough skin or membranes
Soft/ low residue; low fiber - Answer Addition of low fiber, easily digested foods such as
pastas, casseroles, moist tender meats, and canned cooked fruits and veggies; includes foods
that are easy to chew and simply cooked. Does NOT permit fatty, rich, and fried foods
,High Fiber - Answer Addition of fresh uncooked fruits, steamed veggies, bran, oatmeal and
dried fruits; includes sufficient amounts of ingestible carbohydrates to relieve constipation,
increase GI motility, and increase stool weight
Regular Diet - Answer NO dietary restrictions
Restricted Fluids - Answer required in severe heart failure or kidney failure
Sodium Restriction - Answer -Allows low levels of sodium and may include a 4g (no added
salt), 2g (moderate), 1g (strict), or 500mg (very strict)
-ordered for pt's with heart failure, renal failure, cirrhosis, hypertension
Fat modified - Answer -low total and saturated fat and low cholesterol intake limited to <
300mg daily, and fat intake 30% to 35%
-eliminates/reduces fatty foods for hypercholesterolemia, malabsorption disorders, diarrhea
Diabetic - Answer allows for patients to select amount of food from basic food groups
What are the risk factors for nutritional problems? - Answer -Clear/Full-liquid diets for more
than 3 days without or with inappropriate/insufficient nutrient supplementation.
-IV feeding (dextrose or saline) or NPO for more than 3 days without supplementation.
-Low intakes of prescribed diet/tube feedings.
-Weight 20% above or 10% below desirable body weight (accounting for edema).
-Pregnancy weight gain deviating from normal patterns.
-Diagnoses that increase nutritional needs, decrease nutrient intake, or both: Cancer,
malabsorption, diarrhea, hyperthyroidism, excessive- inflammation, postoperative status,
hemorrhage, infected/draining wounds, burns, infection, major trauma.
-Chronic use of drugs (especially alcohol).
,-Alterations in chewing, swallowing, appetite, taste, and smell.
-Body temperature consistently above 37° C (98.6° F) for more than 2 days.
-Hemocrit : <43% in men, <37% in women.
-Hemaglobin: <14 g/dL in men, <12 g/dL in women.
-Absolute decrease in lymphocyte count ( <1500 cells/mm3).
-Elevated (>250 mg/dL)/Decreased ( <130 mg/dL ) total plasma cholesterol.
-Serum albumin <3 g/dL in patients without renal or liver disease, generalized dermatitis,
overhydration.
How to assist with feeding patients - Answer 1. Prepare patient's room for mealtime.
a. Perform hand hygiene. Clear over-bed table.
b. Help patient to comfortable sitting position in
chair or place bed in high-Fowler's
position. If patient is unable to sit, turn him or
her on side with head of bed
elevated.
2. Prepare patient for meal.
a. Help patient with pain relief and elimination
needs and help him or her perform hand
hygiene before meals.
b. Help patient put in dentures and put on
eyeglasses or insert contact lenses if used.
3. Ask in which order patient would like to eat his or her meal. Ask about desired seasonings.
Help patient to cut food in bite size pieces if unable to do independently.
4. Use adaptive eating and drinking aids as needed according to your assessment (e.g.,two-
handled cup with lid, plate with plate guard, utensils with splints, utensils with
enlarged handles)
, 5. Identify food placement for disoriented, visually impaired, or easily fatigued patients by
locating on plate as if plate were a clock.
6. Feed patient in manner that facilitates chewing and swallowing.
a. Older adult: Feed small amounts at a time, observing biting, chewing, swallowing, and fatigue
between bites; be sure that patient has swallowed food.
7.Watch patient successfully swallow first few bites of food and drink. If the patient is able to do
so on there on stop here and return back to the room 15-20 minutes later. If patient is at risk to
aspirate then stay at bedside.
What should you do if you are feeding your patient and they begin to aspirate? - Answer
STOP FEEDING IMMEDIATELY and suction their airway
Precautions with aspirations - Answer Almost any condition that produces general muscle
weakness or any condition associated with neurologic impairment of the swallowing
mechanism and altered mental status places patients at risk for dysphagia/aspirations (e.g.,
brain injury, stroke). Be aware that patients without primary neurologic diagnoses such as
myocardial infarction (heart attack), pneumonia, and chronic obstructive pulmonary disease are
also at risk for dysphagia/aspirations.
(read page 832 in skills book)
Can the assessment of a patient's risk to aspirate be delegated to a NAP? - Answer No;
However, NAP may feed patients after receiving instruction on aspiration precautions.
Nasogastric/nasointestinal tube used for suctioning - Answer Suctioning:
-Following major surgery.
- Conditions affecting GI tract altering normal
peristalsis.
-Keeps stomach empty until normal peristalsis
returns.
Nasogastric/nasointestinal tube for feeding - Answer Feeding: