ATI Nutrition Proctored Exam (Retake 2019)
Part 1: General Notes
Broad overview of nutrition concepts and foundational information.
Part 2: Focused Review Notes
Targeted content from weak areas identified during assessment.
Part 3: ATI Rational with Additional/Supported Information
Official ATI rationales supplemented with evidence-based explanations and
resources.
PART 1: GENERAL NOTES (Important Facts)
• Be wary of questions regarding children drinking too much milk i.e. more than 3-4 cups of
milkeach day. Too much milk intake reduces intake of other essential nutrients, especially iron.
Watch for anemia with milk-aholics.
• Vitamin D’s presence is required by the parathyroid gland, in order for it to function.
• If the patient is taking digoxin or K-supplements, avoid salt substitutes because many are
potassium based
• Potassium Sources: bananas, potatoes, citrus fruits
• No milk (as well as fresh fruit or veggies) on neutropenic precautions.
• Nondairy sources of calcium include RHUBARB, SARDINES, COLLARD GREENS 24
• Nonfat milk reduces reflux by increasing lower esophageal sphincter pressure
• Yogurt has live cultures, so do not give to immunosuppressed patients
• No phenylalanine with a kid positive for PKU (no meat, no dairy, no aspartame).
• Acid Ash diet: cheese, corn, cranberries, plums, prunes, meat, poultry, pastry, bread
• Alk Ash diet: milk, veggies, rhubarb, salmon
PART 2: Focused Review Notes
Manifestations of Vitamin A Toxicity
• Can cause teratogenic effects on fetuses
• Blurred vision
• Bone pain or swelling
• Hypercalcemia
• ICP
• Liver damage
• Skin peeling, itching
• Nausea and vomiting
, • Abnormal softening of the skull bone (children) and bulging fontanels
Planning Care for a Client Who Follows Seventh-Day Adventist Dietary Laws
• Vegetarianism o Do not consume animal products of any type INCLUDING eggs and
milk products.
o Vitamin B12 and Vitamin D supplements may be needed with a pure vegan diet.
• Vegan diets are adequate in protein due to intake of nuts and legumes (dried peas
and cooked beans).
Initiating Continuous Enteral Feeding
• This is recommended for critically ill patients because it is associated with small residual
volumes, and a lower risk of aspiration and diarrhea.
• Residual volumes should be measures q4-6hrs.
• Feeding tubes should be flushed with water q4hr to maintain patency and hydration.
• If patient’s gastric volume exceeds 500ml, the continuous feeding should be HELD and
tolerance reassessed. o In children, residual volumes should be measured and held if
the amount is equal to or greater than ¼ the prescribed feeding amount.
• Residual should be returned and the amount rechecked in 30min to 1hr.
Recommendations for Nutritional Supplement
• Add skim milk to powder milk (double strength milk)
• Use whole milk instead of water recipes
• Add cheese, peanut butter, chopped hard-boiled eggs, yogurt.
• Dip meats in eggs or milk and coat with bread crumbs before cooking.
• Nuts and dried beans are significant sources of protein great alternatives to dairy allergy
or lactose intolerance!
Assessing Caloric Intake
• Toddlers: 1 to 3 years old o Limit 100% juice 4 to 6oz a day o The 1 to
2-year-old requires whole cow’s milk to provide adequate fat.
o Food serving size is 1 tablespoon for each year of age.
• Preschoolers: 3 to 6 years old o Preschoolers need 13 to 19 g/day of
complete protein.
o 1 tablespoon per year of age for size of foods.
o May switch to skin or 1% low-fat milk after 2 years.
• School-Age Children: 6 to 12 years old o Weight loss program is directed
for children 40% overweight.
• Adolescence
o Energy requirements average 2,000 calorie/day for a 12 to 18-year-old
female. o Energy requirements average 2,200 to 2,800 calorie/day for a 12
to 18-yearold male.
Part 1: General Notes
Broad overview of nutrition concepts and foundational information.
Part 2: Focused Review Notes
Targeted content from weak areas identified during assessment.
Part 3: ATI Rational with Additional/Supported Information
Official ATI rationales supplemented with evidence-based explanations and
resources.
PART 1: GENERAL NOTES (Important Facts)
• Be wary of questions regarding children drinking too much milk i.e. more than 3-4 cups of
milkeach day. Too much milk intake reduces intake of other essential nutrients, especially iron.
Watch for anemia with milk-aholics.
• Vitamin D’s presence is required by the parathyroid gland, in order for it to function.
• If the patient is taking digoxin or K-supplements, avoid salt substitutes because many are
potassium based
• Potassium Sources: bananas, potatoes, citrus fruits
• No milk (as well as fresh fruit or veggies) on neutropenic precautions.
• Nondairy sources of calcium include RHUBARB, SARDINES, COLLARD GREENS 24
• Nonfat milk reduces reflux by increasing lower esophageal sphincter pressure
• Yogurt has live cultures, so do not give to immunosuppressed patients
• No phenylalanine with a kid positive for PKU (no meat, no dairy, no aspartame).
• Acid Ash diet: cheese, corn, cranberries, plums, prunes, meat, poultry, pastry, bread
• Alk Ash diet: milk, veggies, rhubarb, salmon
PART 2: Focused Review Notes
Manifestations of Vitamin A Toxicity
• Can cause teratogenic effects on fetuses
• Blurred vision
• Bone pain or swelling
• Hypercalcemia
• ICP
• Liver damage
• Skin peeling, itching
• Nausea and vomiting
, • Abnormal softening of the skull bone (children) and bulging fontanels
Planning Care for a Client Who Follows Seventh-Day Adventist Dietary Laws
• Vegetarianism o Do not consume animal products of any type INCLUDING eggs and
milk products.
o Vitamin B12 and Vitamin D supplements may be needed with a pure vegan diet.
• Vegan diets are adequate in protein due to intake of nuts and legumes (dried peas
and cooked beans).
Initiating Continuous Enteral Feeding
• This is recommended for critically ill patients because it is associated with small residual
volumes, and a lower risk of aspiration and diarrhea.
• Residual volumes should be measures q4-6hrs.
• Feeding tubes should be flushed with water q4hr to maintain patency and hydration.
• If patient’s gastric volume exceeds 500ml, the continuous feeding should be HELD and
tolerance reassessed. o In children, residual volumes should be measured and held if
the amount is equal to or greater than ¼ the prescribed feeding amount.
• Residual should be returned and the amount rechecked in 30min to 1hr.
Recommendations for Nutritional Supplement
• Add skim milk to powder milk (double strength milk)
• Use whole milk instead of water recipes
• Add cheese, peanut butter, chopped hard-boiled eggs, yogurt.
• Dip meats in eggs or milk and coat with bread crumbs before cooking.
• Nuts and dried beans are significant sources of protein great alternatives to dairy allergy
or lactose intolerance!
Assessing Caloric Intake
• Toddlers: 1 to 3 years old o Limit 100% juice 4 to 6oz a day o The 1 to
2-year-old requires whole cow’s milk to provide adequate fat.
o Food serving size is 1 tablespoon for each year of age.
• Preschoolers: 3 to 6 years old o Preschoolers need 13 to 19 g/day of
complete protein.
o 1 tablespoon per year of age for size of foods.
o May switch to skin or 1% low-fat milk after 2 years.
• School-Age Children: 6 to 12 years old o Weight loss program is directed
for children 40% overweight.
• Adolescence
o Energy requirements average 2,000 calorie/day for a 12 to 18-year-old
female. o Energy requirements average 2,200 to 2,800 calorie/day for a 12
to 18-yearold male.
