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1. A nurse is providing dietary teaching about prevention of neural tube defects in
the fetus to a client who is pregnant. Which of the following nutrients should the
nurse recommend?
Calcium
Folate
Vitamin B12
Magnesium
Folate
Rationale: Folate is essential for preventing neural tube defects such as spina
bifida and anencephaly. The recommended daily intake for pregnant women is
600 mcg. Women of childbearing age should consume 400 mcg daily.
2. A nurse is caring for a client who had a stroke and has manifestations of
dysphagia. Which of the following interventions should the nurse take?
Tilt the client's head backward to facilitate swallowing
Use liquids to clear food from the client's mouth
Add a thickening agent to liquids
Place the client in a semi-Fowler's position
Add a thickening agent to liquids
,Rationale: Thickened liquids are easier for clients with dysphagia to swallow and
reduce the risk of aspiration. Tilting the head backward increases aspiration
risk. Liquids should be thickened, not used to clear food. Semi-Fowler's is not as
protective as high-Fowler's.
3. A nurse is providing discharge teaching to an older adult client who lives alone.
Which of the following strategies should the nurse include to address the client's
decreased sense of taste and smell?
Maintain consistent food textures at mealtimes
Use kosher salt in place of table salt
Label and date food in the refrigerator
Wait 1 hour after eating to consume fluids
Label and date food in the refrigerator
Rationale: Decreased sense of smell increases the risk of consuming spoiled
food. Labeling and dating food helps ensure food safety. Kosher salt still
contains sodium. Consistent textures do not address taste/smell changes.
4. A nurse is teaching a client who has a goiter appropriate food choices related to
dietary needs. Which of the following client statements indicates an understanding
of the teaching?
"I will eat more tuna"
"I will eat more red meat"
"I will eat bananas for a snack"
"I would eat blueberries every morning"
"I will eat more tuna"
Rationale: Goiter is often caused by iodine deficiency. Tuna is a good source of
iodine. Red meat, bananas, and blueberries are not significant sources of iodine.
,5. A nurse is reviewing the laboratory findings of a client who has Clostridium
difficile. Which of the following findings should indicate to the nurse that the client
is experiencing fluid volume deficit?
Potassium 3.5 mEq/L
HCT 53%
Sodium 145 mEq/L
HbA1c 5%
HCT 53%
Rationale: An elevated hematocrit indicates hemoconcentration due to fluid
volume deficit. Potassium of 3.5 is at the low end of normal. Sodium of 145 is
within normal limits. HbA1c of 5% is normal.
6. A client in the oliguric phase of acute renal failure had a urinary output of 420
ml during the preceding 24-hour period. How much fluid should the nurse plan to
provide the client over the next 24 hr?
2,550 ml
1,530 ml
920 ml
2,040 ml
920 ml
Rationale: During the oliguric phase, fluid intake should be equal to urinary
output plus 500–600 mL for insensible losses. 420 mL + 500 mL = 920 mL.
7. A nurse is teaching a client ways to manage anorexia while receiving radiation
therapy. Which of the following instructions should the nurse include in the
teaching?
"Limit high-kilocalorie supplements to between meals"
"Eat hot food rather than cold foods"
"Avoid overeating during 'good' days"
"Consume nutrition-dense foods first"
, "Consume nutrition-dense foods first"
Rationale: Clients with anorexia should consume nutrient-dense foods first to
maximize intake when appetite is best. Cold foods are often better tolerated.
Small, frequent meals are encouraged.
8. A nurse is caring for four clients. The nurse should plan to administer total
parenteral nutrition for which of the following clients?
A client who is postoperative following a laminectomy and is receiving IV PCA
A client who has dysphagia and does not recognize his family
A client who has COPD and is going home with oxygen
A client who has colon cancer and will undergo a hemicolectomy
A client who has colon cancer and will undergo a hemicolectomy
Rationale: TPN is indicated for clients who cannot absorb nutrients through the
GI tract, such as those requiring bowel rest before major abdominal surgery. The
other clients have functioning GI tracts or less severe nutritional needs.
9. A nurse is providing dietary teaching to a client who has a new diagnosis of
gastroesophageal reflux disease. Which of the following foods or beverages should
the nurse recommend to minimize heartburn?
Orange juice
Decaffeinated coffee
Peppermint
Potatoes
Potatoes
Rationale: Potatoes are low-acid and do not relax the lower esophageal
sphincter. Orange juice is acidic. Coffee and peppermint can relax the LES and
worsen GERD.