CH. 44: NUTRITION PROBLEMS TEST
BANK QUESTIONS COMPLETE
ANSWERS
The nurse is preparing to teach a frail 79-yr-old Hispanic man who lives with an adult
daughter about ways to improve nutrition. Which action would the nurse take first?
a. Ask the daughter about the patient's food preferences.
b. Determine who shops for groceries and prepares the meals.
c. Question the patient about how many meals per day are eaten.
d. Assure the patient that culturally preferred foods will be included. - Answer-ANS: B
The family member who shops for groceries and cooks will be in control of the
patient's diet, so the nurse will need to ensure that this family member is involved in
any teaching or discussion about the patient's nutritional needs. The other
information will also be assessed and used but will not be useful in meeting the
patient's nutritional needs unless nutritionally appropriate foods are purchased and
prepared.
After change-of-shift report, which patient will the nurse assess first?
a. A 40-yr-old woman whose parenteral nutrition infusion bag has 30 minutes of
solution left
b. A 40-yr-old man with continuous enteral feedings who has developed pulmonary
crackles
c. A 30-yr-old man with 4+ generalized pitting edema and severe protein-calorie
malnutrition
d. A 30-yr-old woman whose gastrostomy tube is plugged after crushed medications
were administered - Answer-ANS: B
The patient data suggest aspiration may have occurred, and rapid assessment and
intervention are needed. The other patients should also be assessed soon, but the
data about them do not suggest any immediately life-threatening complications.
A patient hospitalized with chronic heart failure eats only about 50% of each meal
and reports "feeling too tired to eat." Which action would the nurse take first?
a. Teach the patient about the importance of good nutrition.
b. Serve multiple small feedings of high-calorie, high-protein foods.
c. Consult with the health care provider about parenteral nutrition (PN).
d. Obtain an order for enteral feedings of liquid nutritional supplements. - Answer-
ANS: B
Eating small amounts of food frequently throughout the day is less fatiguing and will
improve the patient's ability to take in more nutrients. Teaching the patient may be
appropriate but will not address the patient's inability to eat more because of fatigue.
Enteral nutrition or PN may be needed if the patient is unable to take in enough
nutrients orally but increasing the oral intake should be attempted first.
A patient's peripheral parenteral nutrition (PN) bag is nearly empty, and a new PN
bag has not arrived yet from the pharmacy. Which action would the nurse take?
a. Monitor the patient's capillary blood glucose every 6 hours.
, b. Infuse 5% dextrose in water until a new PN bag is delivered.
c. Decrease the PN infusion rate to 10 mL/hr until a new bag arrives.
d. Flush the peripheral line with saline until a new PN bag is available. - Answer-
ANS: B
To prevent hypoglycemia, the nurse should infuse a 5% dextrose solution until the
next peripheral PN bag can be started. Decreasing the rate of the ordered PN
infusion is beyond the nurse's scope of practice. Flushing the line and then waiting
for the next bag may lead to hypoglycemia. Monitoring the capillary blood glucose
every 6 hours would not identify hypoglycemia while awaiting the new PN bag.
A 19-yr-old woman admitted with anorexia nervosa is 5 ft, 6 in (163 cm) tall and
weighs 88 lb (41 kg). Laboratory tests reveal hypokalemia and iron-deficiency
anemia. Which patient problem has the highest priority?
a. Difficulty coping
b. Negative self-image
c. Electrolyte imbalance
d. Nutritionally compromised - Answer-ANS: C
The patient's hypokalemia may lead to life-threatening cardiac dysrhythmias. The
other diagnoses may also be appropriate for this patient but are not associated with
immediate risk for fatal complications.
The nurse is planning care for a patient who is chronically malnourished. Which
action would the nurse to delegate to assistive personnel (AP)?
a. Assist the patient to choose high-nutrition items from the menu.
b. Monitor the patient for skin breakdown over the bony prominences.
c. Offer the patient the prescribed nutritional supplement between meals.
d. Assess the patient's strength while ambulating the patient in the room. - Answer-
ANS: C
Feeding the patient and assisting with oral intake are included in AP education and
scope of practice. Assessing the patient and assisting the patient in choosing high-
nutrition foods require licensed practical/vocational nurse (LPN/VN)—or registered
nurse (RN)—level education and scope of practice.
A 60-yr-old man who is hospitalized with an abdominal wound infection has been
eating very little and states, "Nothing on the menu sounds good." Which action by
the nurse will be most effective in improving the patient's oral intake?
a. Order six small meals daily.
b. Make a referral to the dietitian.
c. Teach the patient about high-calorie foods.
d. Ask family members to bring favorite foods. - Answer-ANS: D
The patient's statement that the hospital foods are unappealing indicates that favorite
home-cooked foods might improve intake. The other interventions may also help
improve the patient's intake, but the most effective action will be to offer the patient
more appealing foods.
What action would the nurse take when caring for a patient with a soft, silicone
nasogastric tube in place for enteral nutrition?
a. Avoid giving medications through the feeding tube.
b. Keep head of bed elevated to 30- to 45-degree angle.
c. Replace the tube every 3 days to avoid mucosal damage.
BANK QUESTIONS COMPLETE
ANSWERS
The nurse is preparing to teach a frail 79-yr-old Hispanic man who lives with an adult
daughter about ways to improve nutrition. Which action would the nurse take first?
a. Ask the daughter about the patient's food preferences.
b. Determine who shops for groceries and prepares the meals.
c. Question the patient about how many meals per day are eaten.
d. Assure the patient that culturally preferred foods will be included. - Answer-ANS: B
The family member who shops for groceries and cooks will be in control of the
patient's diet, so the nurse will need to ensure that this family member is involved in
any teaching or discussion about the patient's nutritional needs. The other
information will also be assessed and used but will not be useful in meeting the
patient's nutritional needs unless nutritionally appropriate foods are purchased and
prepared.
After change-of-shift report, which patient will the nurse assess first?
a. A 40-yr-old woman whose parenteral nutrition infusion bag has 30 minutes of
solution left
b. A 40-yr-old man with continuous enteral feedings who has developed pulmonary
crackles
c. A 30-yr-old man with 4+ generalized pitting edema and severe protein-calorie
malnutrition
d. A 30-yr-old woman whose gastrostomy tube is plugged after crushed medications
were administered - Answer-ANS: B
The patient data suggest aspiration may have occurred, and rapid assessment and
intervention are needed. The other patients should also be assessed soon, but the
data about them do not suggest any immediately life-threatening complications.
A patient hospitalized with chronic heart failure eats only about 50% of each meal
and reports "feeling too tired to eat." Which action would the nurse take first?
a. Teach the patient about the importance of good nutrition.
b. Serve multiple small feedings of high-calorie, high-protein foods.
c. Consult with the health care provider about parenteral nutrition (PN).
d. Obtain an order for enteral feedings of liquid nutritional supplements. - Answer-
ANS: B
Eating small amounts of food frequently throughout the day is less fatiguing and will
improve the patient's ability to take in more nutrients. Teaching the patient may be
appropriate but will not address the patient's inability to eat more because of fatigue.
Enteral nutrition or PN may be needed if the patient is unable to take in enough
nutrients orally but increasing the oral intake should be attempted first.
A patient's peripheral parenteral nutrition (PN) bag is nearly empty, and a new PN
bag has not arrived yet from the pharmacy. Which action would the nurse take?
a. Monitor the patient's capillary blood glucose every 6 hours.
, b. Infuse 5% dextrose in water until a new PN bag is delivered.
c. Decrease the PN infusion rate to 10 mL/hr until a new bag arrives.
d. Flush the peripheral line with saline until a new PN bag is available. - Answer-
ANS: B
To prevent hypoglycemia, the nurse should infuse a 5% dextrose solution until the
next peripheral PN bag can be started. Decreasing the rate of the ordered PN
infusion is beyond the nurse's scope of practice. Flushing the line and then waiting
for the next bag may lead to hypoglycemia. Monitoring the capillary blood glucose
every 6 hours would not identify hypoglycemia while awaiting the new PN bag.
A 19-yr-old woman admitted with anorexia nervosa is 5 ft, 6 in (163 cm) tall and
weighs 88 lb (41 kg). Laboratory tests reveal hypokalemia and iron-deficiency
anemia. Which patient problem has the highest priority?
a. Difficulty coping
b. Negative self-image
c. Electrolyte imbalance
d. Nutritionally compromised - Answer-ANS: C
The patient's hypokalemia may lead to life-threatening cardiac dysrhythmias. The
other diagnoses may also be appropriate for this patient but are not associated with
immediate risk for fatal complications.
The nurse is planning care for a patient who is chronically malnourished. Which
action would the nurse to delegate to assistive personnel (AP)?
a. Assist the patient to choose high-nutrition items from the menu.
b. Monitor the patient for skin breakdown over the bony prominences.
c. Offer the patient the prescribed nutritional supplement between meals.
d. Assess the patient's strength while ambulating the patient in the room. - Answer-
ANS: C
Feeding the patient and assisting with oral intake are included in AP education and
scope of practice. Assessing the patient and assisting the patient in choosing high-
nutrition foods require licensed practical/vocational nurse (LPN/VN)—or registered
nurse (RN)—level education and scope of practice.
A 60-yr-old man who is hospitalized with an abdominal wound infection has been
eating very little and states, "Nothing on the menu sounds good." Which action by
the nurse will be most effective in improving the patient's oral intake?
a. Order six small meals daily.
b. Make a referral to the dietitian.
c. Teach the patient about high-calorie foods.
d. Ask family members to bring favorite foods. - Answer-ANS: D
The patient's statement that the hospital foods are unappealing indicates that favorite
home-cooked foods might improve intake. The other interventions may also help
improve the patient's intake, but the most effective action will be to offer the patient
more appealing foods.
What action would the nurse take when caring for a patient with a soft, silicone
nasogastric tube in place for enteral nutrition?
a. Avoid giving medications through the feeding tube.
b. Keep head of bed elevated to 30- to 45-degree angle.
c. Replace the tube every 3 days to avoid mucosal damage.
