ATI Practice Test A Nutrition Remediation
Basic care and Comfort
Gastrointestinal Disorders: Recommendations to prevent dumping syndrome
o Consume foods high in pectin to increase the bulk of the stool and to lengthen
transition time in the colon
o Limit caffeine, hot or cold drinks, and fatty foods
o Avoid foods that can exacerbate diarrhea (foods high in roughage)
Cultural, ethnic, and religious influences: Dietary considerations for a client who is
following Islamic Dietary Laws during Ramadan
o Dietary rituals
Clients often avoid alcohol and pork
Clients can fast during Ramadan
Clients get a snack in the evening
o Fasting for religious holidays
Islam calls for fasting during Ramadan
Roman Catholicism calls for refraining from meat consumption on Ash
Wednesday and Fridays during Lent, and to avoid food or beverage intake for
1 hr before communion.
Seventh Day Adventism recommends a 5-6 hr interval between meals.
Judaism calls for a 24-hr fast during Yom Kippur.
Medications Affecting Coagulation: Dietary Instructions for Warfarin
o Foods high in Vitamin K
Dark green vegetables
Eggs
Carrots (these foods can decrease the anticoagulant effects of warfarin)
o In the case of warfarin toxicity
discontinue administration of warfarin, and administer vitamin K
monitor vital signs
obtain baseline prothrombin time (PT), and monitor levels of PT
and international normalized ratio (INR) periodically
Cultural, Ethnic, and Religious influences: Performing a Cultural Assessment about fasting
practices
o Dietary rituals
Clients often avoid alcohol and pork
Clients can fast during Ramadan
Clients get a snack in the evening
o Fasting for religious holidays
Islam calls for fasting during Ramadan
Roman Catholicism calls for refraining from meat consumption on Ash
Wednesday and Fridays during Lent, and to avoid food or beverage intake for
1 hour before communion
, Seventh Day Adventism recommends a 5-6-hour interval between meals.
Judaism calls for a 24 hour fast during Yom Kippur.
Enteral Nutrition: Preventing Aspiration
o Some facilities require gastric residual volume checks, typically every 4 to 6 hr.
Check facility protocol for specific actions to take for the amount of residual
o Monitor intake and output, and include 24-hr totals
o Follow the manufacturer’s recommendations for formula hang time. Refrigerate
unused formula, and discard after 24 hr.
Aspirate for residual volume
o Note the appearance of the aspirate
o Return aspirated contents, or follow the facility’s protocol
Flush tubing with at least 30 mL water
Check gastric contents for pH. A good indication of appropriate
placement is obtaining gastric contents with a pH between 0 and
4.
o Many facilities require measuring every 4 to 6 hr. Other
facilities are moving away from this practice, as there is
insufficient evidence to support it
o Feeding tubes should be flushed with 20 to 50 mL of
warm water every 4 hr to maintain tube patency and
provide hydration
o Check facility policy regarding withholding feedings for high
gastric residual volume (GRV). Typically, the amount is more
than 250 mL on two consecutive measurements for an adult
or more than one-fourth the prescribed volume for children
Health Promotion and Maintenance
Nutrition across the Lifespan: Providing teaching about breastfeeding
o The newborn is offered the breast immediately after birth and frequently thereafter.
There should be eight to 12 feedings in a 24-hour period
o Instruct the client to demand-feed the infant and to assess for hunger cues. These
include rooting, suckling on hands, and fingers, and rapid eye movement. Crying is a
late indicator of hunger.
o The newborn should nurse up to 15 min per breast. Findings that indicate the newborn
has completed the feeding include the slowing of newborn suckling, a softened breast,
or sleeping. Eventually, the infant will empty a breast within 5 to 10 min but might
need to continue to suck to meet comfort needs.
Nutrition across the lifespan: teaching about pregnancy weight goals
o Recommend weight gain during pregnancy
First semester: recommended weight gain is 1.1 to 4.4 lb
Second and third trimesters: recommended weight gain is 2 to 4 lb/month
o Normal weight client (BMI 18.5-24.9): 1 lb/week for a total of 25 to 35 lb
o Underweight client (BMI <18.5): just more than 1 lb/week for a total of 28 to 40 lb
o Overweight client (BMI 25-29.9): 0.66 lb/week for a total of 15 to 25 lb
o Obese client (BMI >30): 0.5 lb/week for a total of 11 to 20 lb
Basic care and Comfort
Gastrointestinal Disorders: Recommendations to prevent dumping syndrome
o Consume foods high in pectin to increase the bulk of the stool and to lengthen
transition time in the colon
o Limit caffeine, hot or cold drinks, and fatty foods
o Avoid foods that can exacerbate diarrhea (foods high in roughage)
Cultural, ethnic, and religious influences: Dietary considerations for a client who is
following Islamic Dietary Laws during Ramadan
o Dietary rituals
Clients often avoid alcohol and pork
Clients can fast during Ramadan
Clients get a snack in the evening
o Fasting for religious holidays
Islam calls for fasting during Ramadan
Roman Catholicism calls for refraining from meat consumption on Ash
Wednesday and Fridays during Lent, and to avoid food or beverage intake for
1 hr before communion.
Seventh Day Adventism recommends a 5-6 hr interval between meals.
Judaism calls for a 24-hr fast during Yom Kippur.
Medications Affecting Coagulation: Dietary Instructions for Warfarin
o Foods high in Vitamin K
Dark green vegetables
Eggs
Carrots (these foods can decrease the anticoagulant effects of warfarin)
o In the case of warfarin toxicity
discontinue administration of warfarin, and administer vitamin K
monitor vital signs
obtain baseline prothrombin time (PT), and monitor levels of PT
and international normalized ratio (INR) periodically
Cultural, Ethnic, and Religious influences: Performing a Cultural Assessment about fasting
practices
o Dietary rituals
Clients often avoid alcohol and pork
Clients can fast during Ramadan
Clients get a snack in the evening
o Fasting for religious holidays
Islam calls for fasting during Ramadan
Roman Catholicism calls for refraining from meat consumption on Ash
Wednesday and Fridays during Lent, and to avoid food or beverage intake for
1 hour before communion
, Seventh Day Adventism recommends a 5-6-hour interval between meals.
Judaism calls for a 24 hour fast during Yom Kippur.
Enteral Nutrition: Preventing Aspiration
o Some facilities require gastric residual volume checks, typically every 4 to 6 hr.
Check facility protocol for specific actions to take for the amount of residual
o Monitor intake and output, and include 24-hr totals
o Follow the manufacturer’s recommendations for formula hang time. Refrigerate
unused formula, and discard after 24 hr.
Aspirate for residual volume
o Note the appearance of the aspirate
o Return aspirated contents, or follow the facility’s protocol
Flush tubing with at least 30 mL water
Check gastric contents for pH. A good indication of appropriate
placement is obtaining gastric contents with a pH between 0 and
4.
o Many facilities require measuring every 4 to 6 hr. Other
facilities are moving away from this practice, as there is
insufficient evidence to support it
o Feeding tubes should be flushed with 20 to 50 mL of
warm water every 4 hr to maintain tube patency and
provide hydration
o Check facility policy regarding withholding feedings for high
gastric residual volume (GRV). Typically, the amount is more
than 250 mL on two consecutive measurements for an adult
or more than one-fourth the prescribed volume for children
Health Promotion and Maintenance
Nutrition across the Lifespan: Providing teaching about breastfeeding
o The newborn is offered the breast immediately after birth and frequently thereafter.
There should be eight to 12 feedings in a 24-hour period
o Instruct the client to demand-feed the infant and to assess for hunger cues. These
include rooting, suckling on hands, and fingers, and rapid eye movement. Crying is a
late indicator of hunger.
o The newborn should nurse up to 15 min per breast. Findings that indicate the newborn
has completed the feeding include the slowing of newborn suckling, a softened breast,
or sleeping. Eventually, the infant will empty a breast within 5 to 10 min but might
need to continue to suck to meet comfort needs.
Nutrition across the lifespan: teaching about pregnancy weight goals
o Recommend weight gain during pregnancy
First semester: recommended weight gain is 1.1 to 4.4 lb
Second and third trimesters: recommended weight gain is 2 to 4 lb/month
o Normal weight client (BMI 18.5-24.9): 1 lb/week for a total of 25 to 35 lb
o Underweight client (BMI <18.5): just more than 1 lb/week for a total of 28 to 40 lb
o Overweight client (BMI 25-29.9): 0.66 lb/week for a total of 15 to 25 lb
o Obese client (BMI >30): 0.5 lb/week for a total of 11 to 20 lb
