HESI RN EVOLVE NUTRITION PRACTICE EXAM

HESI RN EVOLVE NUTRITION PRACTICE EXAM HESI RN EVOLVE Nutrition Practice Exam The registered nurse (RN) is caring for a client who was recently diagnosed with type 2 diabetes mellitus (DM). What information is most important for the RN to teach the client about life-style changes? A. Daily fingerstick glucose monitoring. B. Regular exercise program. C. Portion-controlled, heart healthy diet selections. D. Compliance with oral hypoglycemic medications. C. Portion-controlled, heart healthy diet selections. -The priority action of self-management is reinforcing dietary life-style changes, such as portioncontrolled, heart healthy diet selections (C), to achieve tight blood glucose control and to prevent complications with DM. (A, B, and D) are important in the management of DM but do not have the priority of (C). The registered nurse (RN) suspects that a female client is altering her own diabetic journals to please her healthcare provider. Which laboratory test should the RN review to assess the client's compliance with self management for type 1 diabetes mellitus (DM)? A. Oral glucose tolerance test (GTT). B. 24-hour urine analysis. C. Hemoglobin A1c. D. Fasting cholesterol. C. Hemoglobin A1c. -The A1c (C) measures the average blood glucose level over the past 3 months, including the past 24- hour period, and should be used to compare with the client's diabetic journal. GTT (A) is used to screen for DM. (B and D) do not evaluate the client's blood glucose levels. The registered nurse (RN) is assessing a client regarding the need to increase vitamin B12 after undergoing a subtotal gastrectomy. Which foods should the RN instruct the client to include in the diet? A. Cheese, eggs, and fish. B. Lentils, dried fruits, and soybeans. C. Potatoes, mushrooms, and yogurt. D. Nuts, brown rice, and sunflower seeds. A. Cheese, eggs, and fish. -After a subtotal gastrectomy, there is less secretion of gastric intrinsic factor, which is needed to absorb nutritional vitamin B12. Recommending foods rich in B12, such as cheese, eggs, fish (A), increase the available B12 and should be recommended. (B) are good protein sources rich in iron, and (C and D) provide other vital elements but do not supplement the availability of dietary B12 . The home health registered nurse (RN) is caring for a client with a stage III pressure ulcer. The RN recognizes which food groupthat contains zinc should be added to the client's dietto aid in wound healing? A. Cheese and eggs. B. Green apples and berries. C. Meats and shellfish. D. Complex carbohydrates. C. Meats and shellfish. -(C) is enriched with zinc and promotes wound healing. (A, B, and D) are not enriched with zinc. The registered nurse (RN) receives four new admissions in an assisted living community. After reviewing the clients' medical histories, which client should the RN assess for a higher caloric diet? A. A client with osteoporosis. B. A client with type 2 diabetes mellitus. C. A client with rheumatoid arthritis. D. A client with bacterial pneumonia. D. A client with bacterial pneumonia. -A client with an active infection requires an increase in caloric intake to combat the infection (D). (A, B, and C) do not require an increase of calories to alleviate signs and symptoms related to these chronic illnesses. The registered nurse (RN) in an assisted living community is assisting an Orthodox Jewish client make weekly dinner choices. Which main course selections should the RN suggest that are suitable for a kosher diet? A. Lamb chops with mint jelly. B. Crab cakes with cocktail sauce. C. Pork chops with cranberry relish. D. Steak with cream sauce. A. Lamb chops with mint jelly. -Kashrut is the body of Jewish religious law dealing with foods that can and cannot be eaten and how those foods must be prepared and eaten, which Orthodox Jews follow to "keep the diet kosher." Lamb (A) is a food selection within the guidelines of Jewish religious law. Shellfish is restricted and not within kosher guidelines (B). (C) is the byproduct of an animal that is considered unclean and not allowed to be consumed. Meat and dairy cannot be mixed together on a plate or during a meal, so (D) should not be a recommended choice. The registered nurse (RN) is caring for a client with continuous feeding through a nasogastric (NG) tube at a continuous care rehabiltation community. Which position should the RN place the client to prevent aspiration? A. Trendelenburg. B. Semi-Fowler's. C. Sims. D. Supine. B. Semi-Fowler's. -Elevating the head of the bead to an angle of 30 to 45 degrees (B) is recommended for a client on continuous tube feeding. (B) is the recommended position for clients at high risk for aspiration. (A, C, and D) increase risk for client to aspirate during tube feeding. A female Chinese client who moves into an assisted living communityis concerned that the community will not be able to meet her dietary preferences. What should the registered nurse (RN) include in the diet for this client based on her cultural group? A. Dairy products. B. Vegetables. C. Pork and beef. D. Cakes and pies. B. Vegetables. -A Chinese diet includes generous amounts of rice and vegetables which are often included in every meal (B). Native Chinese eat soy products and have a tendency to be lactose intolerant, so diary products are not usually in the diet (A). Fish is more likely to be served with meals, so (C) is not the main focus of a meal. Chinese cultural desserts consist of sliced fruits or sweetened bean or bean curd, not desserts infused with high sugar content, such as cakes and pies (D). A client in an assisted living community is refusing to eat during meal time. The registered nurse (RN) discovers that the client has several mouth ulcers. What types of food should the RN recommend to promote adequate dietary and healing of the ulcers? A. Poached or scrambled eggs. B. Hot soups and broths. C. Peanut butter crackers. D. Ice cream or milk shakes. A. Poached or scrambled eggs. -Bland or soft foods with a significant protein content, such as eggs (A), are the best choice for a client with mouth irritation and will aide in healing oral and buccal ulcers (A). Soups and broths are usually high in sodium and be irritating and cause pain (B). Although peanut butter crackers include a protein and caloric source, crackers and salt in the peanut butter can be painful for the client to eat (C). Extreme temperatures of foods, such as hot (B) or cold products (D) may cause discomfort for the client. A client is admitted with right upper quadrant (RUQ) pain after eating. What should the registered nurse (RN) assess about the meal's content that precipitated the pain? A. Protein source. B. Refined carbohydrates. C. Saturated fat content. D. Fresh, raw vegetables. C. Saturated fat content. -These symptoms are often precipitated in a client with gallbladder dysfunction or obstruction of the common bile duct. Foods high in fat (C) trigger the release of cholecystokinin that stimulates the gallbladder to contract, which spasms and causes biliary colic if the gallbladder is not functioning properly in an effort to eject bile to emulsify fats. (A, B and D) do not elicit the same reaction in the digestive tract as ingested fats have on gallbladder function. The healthcare provider prescribes an oral glucose tolerance test (GTT) for a female client with polyuria and polydypsia. The registered nurse (RN) instructs the client to be NPO after midnight. What should the client be instructed to drink with her morning medications? A. Any clear liquids. B. Tea without sugar. C. Coffee without milk. D. Water without flavorings. D. Water without flavorings. -Water is the only beverage that can be consumed with medications after midnight to obtain accurate results from the GTT (D). (A, B, and C) can alter the test results and should be avoided until after the test has been completed. The registered nurse (RN) is instructing a client with acute cholecystitis about dietary recommendations. Which food selection demonstrates to the RN that the client understands dietary teaching? A. Chicken pot pie and buttered rolls. B. Sauted ground beef with mashed potaoes. C. Fried round steak and macroni with cheese. D. Baked fish and tomatoes with lettuce. D. Baked fish and tomatoes with lettuce. -A client with acute cholecystitis should decrease dietary fat in foods, so baked foods are the best choice (D). (A, B, and C) are foods that are high in fat and could cause biliary colic. Upgrade to remove ads Only $3.99/month The registered nurse (RN) is assessing the client's knowledge of low-sodium menu selections. Which food items listed by the client confirm appropriate choices? (Select all that apply.) A. White rice with steamed vegetables. B. Cottage cheese with sliced tomatoes. C. Canned vegetable soup with crackers. D. Turkey bacon with scrambled eggs. E. Chicken with soy sauce and brown rice. A. White rice with steamed vegetables. B. Cottage cheese with sliced tomatoes. -(A and B) are correct selections that are low in sodium and indicate the client's knowledge about the prescribed diet. (C, D, and E) are low in fat but high in sodium. A client who is lactose intolerant asks the registered nurse (RN) for information about different food sources that are enriched in calcium and vitamin D. Which foods should the RN suggest? A. Fortified soy products. B. Whole wheat breads. C. Prune or cranberry juice. D. Red berries and pears. A. Fortified soy products. -Fortified soy products are options that are enriched with vitamin D and calcium (A). (B, C, and D) are healthy food choices for a well balanced diet but do not help the client reach optimal levels of vitamin D or calcium. The registered nurse (RN) is teaching a female client guidelines to manage stress incontinence. Which dietary change should the RN emphasize that will benefit the client? A. Omit smoked and salted foods. B. Limit fluids to less than 2 liters a day. C. Reduce intake of processed foods. D. Avoid alcohol and caffeine. D. Avoid alcohol and caffeine. -Alcohol and caffeine (D) are both considered diuretics and irritants, which aggravate the bladder and worsen the client's incontinence, so these liquids should be avoided. (A and C) have a higher concentration of sodium and can cause fluid retention but will not directly affect the bladder. Decreasing fluid intake to less than 2 liters a day (B) can lead to constipation which can make the client's symptoms more evident. The registered nurse (RN) is teaching dietary instructions to a client who had a partial gastrectomy and experienced dumping syndrome. Which statement by the client indicates that the instructions were understood? A. Fluids should be limited to eight ounces with meals. B. Rice should be avoided from the client's diet. C. Sugar-free gelatin should be used with caution. D. Meat should consist of no more than 4 ounces or 120 mL/day. A. Fluids should be limited to eight ounces with meals. -To minimizes symptoms of dumping syndrome, the client should limit fluid consumption during meals (A). Complex carbohydrates, such as rice (B), are appropriate choices for a client with dumping syndrome as long as the food is consumed in small frequent meals throughout the day. Simple sugars should be avoided in this diet, so sugar-free gelatin (C) can be eaten. Clients with dumping syndrome should increase protein in the diet, not (D). The registered nurse (RN) is providing a list of recommended foods to the family of a client who recently had a total colectomy and colostomy. Which food item should the RN recommend including in the client's postoperative diet? A. Carbonated beverages. B. Chicken noodle soup. C. Boiled cabbage. D. Bean burritos. B. Chicken noodle soup. -Chicken noodle soup (B) is the best selection for the client because there is no residual gas production after eating and digesting. (A, C, and D) create a large amount of gas after digestion, which can be embarrassing and uncomfortable for the client. The registered nurse (RN) assesses a client who had a total colectomy 2 weeks ago. The client appears to be confident in the management of the new colostomy, but is having problems managing the odor. What instructions should the RN provide the client to help decrease odor in the colostomy bag? (Select all that apply.) A. Eat foods containing yogurt. B. Chew mint flavored gum. C. Drink a glass of buttermilk. D. Eat sprigs of parsley. E. Consume raw vegetables. A. Eat foods containing yogurt. C. Drink a glass of buttermilk. D. Eat sprigs of parsley. -(A, C and D) are correct and are easily digested foods and help to neutralize or reduce odor in the colostomy bag. (B and E) increase gas production and do not help with reducing odor in the colostomy bag. The registered nurse (RN) is educating a client who is newly diagnosed with cirrhosis. The RN should notify the client that which vitamin deficiency, due to liver disease, increases the susceptibility of bleeding? A. Vitamin K. B. Vitamin C. C. Vitamin E. D. Vitamin B. A. Vitamin K. -Clients with cirrhosis have a decrease in bile production, which is necessary for fat emulsification and absorption of fat-soluble vitamin K. A deficit in vitamin K (A) places the client at risk for bleeding due to a decrease in hepatic synthesis of clotting factors, such as prothrombin. (B, C, and D) do not directly affect clotting. A client receives a prescription for psylium for constipation. What instruction should the registered nurse (RN) provide the client about taking this supplement? A. Take medication in the evening before bedtime to reduce fullness. B. Take supplement with 240 ml of liquid and follow with a second glass. C. Take supplement with hot beverages to help dissolve the powder completely. D. Mix supplement with pudding or applesauce to help hide the taste and texture. B. Take supplement with 240 ml of liquid and follow with a second glass. -Psylium is a bulk laxative and should be taken with a full glass of fluids followed by another glass of fluids to be effective and decrease chances of impaction (B). (A, C and D) increase risk for further constipation and possible impaction of the client. The registered nurse (RN) is caring for a client who is receiving total parenteral nutrition (TPN). Which metabolic change in the client should the RN assess during administration of TPN? A. Hypercalcemia. B. Hypernatremia. C. Hyperkalemia. D. Hyperglycemia. D. Hyperglycemia. -Hyperglycemia (D) commonly occurs during the administration of TPN and blood glucose checks and laboratory results should be closely monitored. Serum electrolyte deficiencies are more common than an elevation of electrolyte levels (A, B, and C) during administration of TPN. The registered nurse (RN) prepares the dietary treatment plan for a client who has ascites secondary to cirrhosis of the liver. Which instruction should the RN include when teaching the dietary plan? A. Restricted sodium intake. B. Increased protein intake. C. Restrict fluid intake. D. Increase potassium intake. A. Restricted sodium intake. -Sodium restrict (A) should be reinforced due to the relationship of sodium intake and fluid retention which exacerbates ascites. Protein (B) should be limited because protein metabolism increases the ammonia levels in the blood. Fluid intake should be given in limited volumes throughout the day (C), but restricting sodium has a higher priority. (D) does not have a direct affect on the accumulation of ascites. The registered nurse (RN) is preparing dietary information for a client with a simple goiter. Which foods should the RN instruct the client to eliminate from the diet? A. Turnips. B. Oranges. C. Milk. D. Fish. A. Turnips. -Turnips are considered a exogenous goitrogen, which are thyroid-inhibiting substances and should be avoided if the client has a goiter. (B, C, and D) do not need to be avoided and are not considered exogenous goitrogen. A client develps a vitamin K deficiency due to intestinal malabsorption. What intervention should the registered nurse (RN) implement in the plan of care? A. Monitor for signs of hematuria, melena, ecchymosis. B. Increase intake of leafy green vegetables. C. Drink orange juice with a prescribed daily iron supplement. D. Monitor for cardiac irregularities. A. Monitor for signs of hematuria, melena, ecchymosis. -A deficiency of vitamin K increases the client risk for bleeding due to inadequate hepatic synthesis of prothrombin. Close monitoring for hematuria, blood in stool, bruising or ecchymosis (A) is indicated. Although foods rich in vitamin K (B), iron and ascorbic acid (C) are indicated for anemia associated with malabsorption, the risk for bleeding may persist if intestinal malabsorption persists. Vitamin K deficiency is not directly related to cardiac irregularities (D) unless the client experiences severe blood loss. During a nutrition consultation for elevated cholesterol, the dietician recommends that the client replace saturated fats with monounsaturated or polyunsaturated fats. What information should the registered nurse (RN) teach the client about this change in fat in the diet? A. Lowers the amount of low density lipoprotein (LDL) in the blood. B. Lowers the amount of high density lipoprotein (HDL) in the blood. C. Contributes to raising cholesterol levels in the blood. D. Contributes to raising triglycerides levels in the blood. A. Lowers the amount of low density lipoprotein (LDL) in the blood. -When saturated fats are replaced with monounsaturated or polyunsaturated fats, there is a reduced risk of coronary artery disease. This change in diet helps to reduce serum lipids that contribute to fatty plaque formation by lowering LDL levels in the blood (A), as long as there is a limited intake of saturated fats. The change in diet does not have a direct affect on HDL (B). Monounsaturated or polyunsaturated fats can also aide in ridding the body of newly formed cholesterol (C) and triglycerides (D). The registered nurse (RN) is teaching a client how to prepare for a stool guaiac test. Which food should the RN instruct the client to avoid 3 days prior to collecting the specimen for this test? A. Shellfish. B. Pasta. C. Raw broccoli. D. Peanut butter. C. Raw broccoli. -Foods that are high in iron, like raw broccoli (C), and over-the-counter preparations, such as vitamin C, can affect the results causing a "false positive" stool guaiac test and should be avoided at least 3 days prior to the test. Shellfish (A), pasta (B) and peanut butter (D) are safe foods to consume prior to the stool guaiac test. The registered nurse (RN) is teaching a client who has mild hypertension about nutritional options. Which instruction should the RN recommend the client change in the daily diet? A. Avoid green leafy vegetables. B. Choose foods with simple sugars. C. Limit foods high in fiber. D. Decrease intake of canned foods. D. Decrease intake of canned foods. -Decreasing the intake of canned foods can decrease salt intake (D). Increasing leafy green vegetables (A) and fiber (C) in a client's diet help maintain blood pressure and weight. Foods containing simple sugars (B) should be exchanged for complex carbohydrates to aid in weight control. The registered nurse (RN) is educating a female client of the importance of osteoporosis prevention. Which foods should the RN instruct the client to include in her diet? A. Apples. B. Cheddar cheese. C. Lima beans. D. Canned tuna. D. Canned tuna. -Osteoporosis related to demineralization of the bone can be prevented or minimized with diet and supplemental amounts of calcium and Vitamin D. A 4 ounce can of tuna fish (D) can provide some calcium but contains about150 international units (IU) of vitamin D and is an inexpensive and safe way in increase Vitamin D. Cheddar cheese (B) provides protein and calcium, but lacks vitamin D. Lima beans (C) are a source of potassium. Apples (A) are a good source of fiber. The registered nurse (RN) is caring for a client who was recently diagnosed with cirrhosis of the liver. The RN should instruct the client to limit which foods from the diet? A. Peanut butter. B. Collard greens. C. Eggs. D. Wheat bread. A. Peanut butter. -Clients with cirrhosis have a difficult time breaking down fat due to hepatic damage and synthesis of bile. Foods like peanut butter (A) are high in fat and protein and should be limited or avoided. Collard greens (B), eggs (C), and wheat bread are low in fat, and are better choices for a client with liver disease. The registered nurse (RN) is assisting a client with meal selections after a myocardial infarction (MI). Which client choices indicate to the RN that the client understands a prescribed low-fat, high fiber diet? A. Chef salad with hard boiled eggs, avocado, fat free dressing, low fat chocolate cake. B. Vegetable soup, carrots, legumes, celery, toasted oat bread, and an apple. C. Broiled chicken stuffed with apples and walnuts on toasted white bread. D. Tuna salad sandwich on wheat bread with a fat free cookie and cantaloupe. B. Vegetable soup, carrots, legumes, celery, toasted oat bread, and an apple. -Vegetable soup, carrots, legumes, celery, toasted oat bread, and an apple (B) contain the least amount of fat and the highest amount of fiber. (A, C, and D) are good choices but still contain increased amounts of saturated fats. The healthcare provider prescribes a protein supplement for a client who is recovering after surgery. What information should the registered nurse (RN) teach the family about the value of the supplement? A. An increase of protein supplies fuel for energy in the client. B. Additional protein promotes tissue healing postoperatively. C. Protein supplements stimulate the client's appetite. D. Increased protein satiates cravings for carbohydrates. B. Additional protein promotes tissue healing postoperatively. -Incised tissue needs additional protein to help build and repair cells, so adding a protein supplement to the diet provides additional amino acid building blocks to promote healing of the surgical site (B). (A, C, and D) do not explain the value of increasing protein in the convalescent period after surgery. The registered nurse (RN) is caring for a client who has pernicious anemia. The RN recognizes which vitamin deficiency is associated with this type of anemia? A. Vitamin D. B. Vitamin B6. C. Vitamin B12. D. Vitamin C. C. Vitamin B12. -In pernicious anemia, a deficit of hydrochloric acid secretion by the stomach also results in a deficit of intrinsic factor which is needed for the body to absorb vitamin B12 (C) for utilization by the bone marrow in erythropoiesis. Absorption and uptake of (A, B, and D) are not affected by lack of intrinsic factor. A client arrives at the urgent care clinic reporting diarrhea, fever, abdominal pain, and nausea and telling the registered nurse (RN) that the symptoms began after eating a can of beans. The RN recognizes the client is exhibiting symptoms of which type of foodborne illness? A. Clostridium botulinum. B. Samonella typhi. C. Listeria monocytogenes. D. Campylobacter jejuni. A. Clostridium botulinum. -Clostridium botulinum (A) most commonly occurs with inappropriate preparation of canning foods. (B) is most common with undercooked meats. (C) is common with unpasteurized dairy or undercooked meats. (D) is found in water sources or unpasteurized dairy as well, and transferred by chickens and birds through feces. The registered nurse (RN) is visiting a client at home who asks if commercially prepared food products can age or spoil. Which foods should the RN explain have the likelihood of aging and creating a byproduct that is not healthy? A. Jar of peaches. B. Jar of peanut butter. C. Canned chicken. D. Canned salmon. B. Jar of peanut butter. -Peanuts or peanut butter (B) can age and develop mold that produces a mycotoxin called aflatoxin which has been identified as carcinogenic to humans. (A, C, and D) are less likely to cause foodborne illnesses. The registered nurse (RN) is discharging a new mother from the postpartum unit. Which statement made by the client during discharge indicates that the new mother needs further teaching of the breastfeeding instructions? A. Increase caloric intake by a minimum of 500 calories to aid with milk production. B. Drink one glass of wine while breast feeding to help with milk "let down." C. Drink fluids liberally between 2 to 3 liters/day to help with milk production. D. Spicy foods should be avoided to reduce the incidence of causing distress for the baby. B. Drink one glass of wine while breast feeding to help with milk "let down." -Drinking alcohol (B) is not recommended during breastfeeding because it crosses into the mother's breast milk. (A, C and D) are measures that the mother can implement to enhance breast milk quantity and quality. The registered nurse (RN) is providing dietary instructions to the parents of a 6-month-old baby diagnosed with phenylketonuria (PKU). Which foods should the RN teach the parents to eliminate in the infant's diet? A. Grapes and berries. B. Green vegetables. C. Cereals and breads. D. Chicken and fish. D. Chicken and fish. -Phenylketonuria (PKU) is a genetic defect that does not metabolize the amino acid, phenylalanine which becomes toxic to brain development in the baby. Foods that contain phenylalanine, such as chicken and fish (D), and cow's milk protein or products with artificial sweeteners, should not be offered when the baby's diet progresses. Grapes and berries (A), green vegetables (B), cereals and breads (C) are safer food that limits phenylalanine when progressing the infant's diet through growth and development. The registered nurse (RN) is preparing a dietary plan for a client who is on a low residue diet. Which foods should the RN instruct the client to avoid? A. Baked potato. B. Hard salami. C. Cottage cheese. D. Scrambled eggs. B. Hard salami. -A low residue diet is low in fiber, soft in texture, and easily digested. Processed foods, like salami (B), are high in sodium, fat, and encased with a tough membrane and should be avoided. A baked potato (A), cottage cheese (C), and scrambled eggs (D) are low in residue. Which foods should the registered nurse (RN) instruct a client who is receiving chemotherapy to eat? (Select all that apply.) A. Cooked broccoli, cauliflower, and boiled eggs. B. Orange juice. C. Baked potatoes. D. Pastries. E. Pastas. F. Fried chicken. A. Cooked broccoli, cauliflower, and boiled eggs. C. Baked potatoes. E. Pastas. -(A, C, and E) are correct. Clients who are receiving chemotherapy often are immunosuppressed and should eat foods that are cooked (A and C) to minimized the exposure opportunity of contaminates or other bacteria from soil. A bland diet that is high in carbohydrate calories (E) is easier for a client to consume while undergoing chemotherapy. Chemotherapy can cause mucosa breakdown so any acidic foods or drinks (B) should be avoided. Client receiving chemotherapy benefit from an increase in calories, but choosing foods that are high fats, such as (D and F), may cause nausea and vomiting. The registered nurse (RN) is teaching the parents of an 6-month-old baby about the dangers of botulism in food. Which food should the RN instruct the parents not to feed to their infant before the age of 12 months? A. Honey. B. Strawberry jelly. C. Cow's milk. D. Peanut butter. A. Honey. -Botulism spores (A) are the most commonly found microorganism in honey which is dangerous to infants under the age of 12 months. Although strawberry jelly (B), cow's milk (C) and peanut butter (D) should not be fed to infants due to the risk of the development of allergies, these do not pose a risk for botulism. The registered nurse (RN) is caring for an older client with malnutrition. The RN recognizes which factor is most likely contributing to this older client's nutritional status? A. Increased need for vitamins and minerals. B. Loss of teeth or poorly fitting dentures. C. A decline in kidney function. D. Snacks eaten all day without a complete meal. B. Loss of teeth or poorly fitting dentures. -Over a third of older adults have untreated dental caries due to socioeconomic issues that result in loss of teeth or dentures which affect eating habits. Weight loss can cause dentures to fit loosely and if not adjusted, eating becomes challenging and food may not be consumed (B) sufficiently. Increased vitamin and mineral requirements (A), a decline in kidney function (C) and eating snacks all day without a complete meal (D) are not contributing factors related to malnutrition. The registered nurse (RN) is caring for a group of clients who are on high protein diets. The RN recognizes which client's condition is most likely to experience the most therapeutic response with this diet? A. Client with cardiovascular disease. B. Client recovering from illness or surgery. C. Client who is experiencing a stressful life event. D. Client who exercises regularly after sporadic activity. B. Client recovering from illness or surgery. -Recovering from illness or surgery (B) requires additional protein to reconstruct body tissue and heal. A diagnosis of cardiovascular disease (A) and the occurrence of a stressful life event (C) do not require an increase of protein. Changes in exercise regime from sporadic to regular (D) requires a balance diet and hydration with regular exercise, not necessarily an increase in protein. The registered nurse (RN) is caring for a client with heart failure (HF). What outcome of diet therapy should the RN evaluate as a therapeutic response for this client? A. Control fluid balance. B. Promote weight loss. C. Decrease cholesterol intake. D. Manage blood pressure. A. Control fluid balance. -In HF, cardiac function is impaired causing intravascular spaces to becomes congested with excess fluids, which then contributes to the heart's workload related to the excess blood volume. Controlling fluid balance (A) and intravascular volume is a critical outcome in managing HF sequela. Promoting weight loss (B), decreasing cholesterol intake (C), and managing blood pressure (D) are other contributing factors for a heart healthy diet for a client with chronic cardiac dysfunction, but fluid balance is the primary focus in preventing cardiac decompensation. The registered nurse (RN) is teaching a client who receives a new prescription, nifedipine, about blood pressure managment. Which dietary beverage should the RN instruct the client to avoid while taking this medication? A. Cranberry juice. B. Tomato juice. C. Soy milk. D. Grapefruit juice. D. Grapefruit juice. -Some citrus fruits and juices should be avoided while taking calcium channel blockers. Nifedipine should not be taken with grapefruit juice (D) which alters the plasma concentrations of the medication. Cranberry juice (A), tomato juice (B), and soy milk (C) are not contraindicated with this medication. The registered nurse (RN) is teaching a pregnant client about her dietary needs. What amount of protein grams/day should the RN instruct the client to add to her daily diet? A. Add 50 grams/day to each meal. B. Divide pregnant weight by 2 equals protein needs. C. Add 15 grams/day to each meal. D. Divide pre-pregnant weight by 2 equals protein needs. D. Divide pre-pregnant weight by 2 equals protein needs. -Each pregnant woman needs different amounts of protein depending on body weight. A woman weighing 150 pounds needs 75 grams of protein every day. To estimate, use the pre-pregnant weight and divide by two (D). (A, B, and C) are not specific to each woman's needs. The registered nurse (RN) is teaching a client who has a goal of losing 25 pounds about diet and weight loss. Which is the most common problem that the RN should recognize about the accuracy of client reporting about daily food intake? A. Over reporting of food intake. B. Under reporting of food intake. C. Unawareness of the amount of food eaten. D. Unwillingness to change eating habits. B. Under reporting of food intake. -A client is more likely to under report what has been eaten (B) due to the embarrassment or inability to comply with the weight loss goal. Over reporting (A) is not common because it documents the client's "bad habits" or noncompliance with the prescribed diet plan. It is unlikely that the client is unaware of the food consumed (C) on a daily basis. An unwillingness to change eating habits (D) is not always evident in the client's report about daily food intake. The registered nurse (RN) is teaching an obese adolescent. Which is an effective strategy for the RN to recommend to the adolescent about weight management? A. Count calories throughout the day. B. Reduce carbohydrate intake. C. Limit juices and soda drinks. D. Eat three regular meals a day. C. Limit juices and soda drinks. -Based on national reports by the Center of Disease Control and Prevention (CDC), an adolescent drinks an average of 22 ounces of full-calorie sodas per day. Changing this habit can render immediate results if the adolescent eliminates or limits drinking juices and commercial soda drinks (C). Counting calories (A) and reducing carbohydrate intake (B) can be be difficult to accomplish with this age group who are influenced by peer eating habits. Instead of 3 meals a day (D), eating 6 small meals provides nutritional balance that regulates glucose levels and hunger. The registered nurse (RN) is preparing a client for surgery. Which information should the RN use to assess a client's nutritionalstatus before the procedure? A. Serum plasma albumin. B. Complete blood count. C. Subjective Global Assessment. D. A two week calorie count. C. Subjective Global Assessment. -A subjective global assessment examines six parameters an includes recent weight change, dietary intake, gastrointestinal symptoms, functional capacity, stress level, and physical signs, such as muscle wasting, edema, and skin rashes. Subjective global assessment (C) is the most complete tool to determine the nutritional status of a client. Serum plasma albumin (A) can help determine nutritional status, but can vary depending on other health issues with the client. A complete blood count (B) does not provide a complete view of nutritional status, but is an important tool prior to surgery. A two week calorie count (D) is not a tool used to determine nutritional status prior to surgery unless prescribed by a healthcare provider. The registered nurse (RN) is teaching a primigravida client the importance of increasing magnesium in the diet. The client asks why this is important. Which education should the RN provide about magnesium needs during pregnancy? A. Enhances the synthesis of proteins, nucleic acids and fats. B. Aids in prevention of demineralization of bone. C. Assists with metabolism of amino acids. D. Facilitates the synthesis of neural pathways in the fetus. A. Enhances the synthesis of proteins, nucleic acids and fats. -Magnesium needs increase during pregnancy to support fetal growth. Magnesium aids in the synthesis of protein, nucleic acids, and fats (A) for normal neuromuscular function and enzyme use in metabolism of protein and energy. Prevention of demineralization of bone (B), metabolism of amino acids (C), and synthesis of neural pathways in the fetus (D) do not require an increased magnesium. The registered nurse (RN) obtains the assistance of an interpreter when caring for aprimiparousclient from Mexico, who speaks very little English and who delivered a full term neonate yesterday. When educating the client on the dietary plan of care, what should the RN tell the interpreter to encourage the client to include in her diet? (Select all that apply.) A. Red meats. B. Leafy green vegetables. C. Corn. D. Potatoes. E. Fresh fruits. A. Red meats. B. Leafy green vegetables. E. Fresh fruits. -(A, B, and E) are correct. The diets of Hispanic Americans from Mexico and Central America often consist of beans, corn products, tomatoes, chili peppers, potatoes, milk, cheeses, and eggs. This common cultural diet may not include adequate intake of amino acids, vitamins, and iron found in red meats (A), green leafy vegetables (B) and fresh fruits (E), which should be the focus of encouragement for the client during involution and her baby. Corn (C) and potatoes (D) do not provide the additional elements needed for puerperal recovery and healing. The registered nurse (RN) is teaching a primigravida client about a meal plan of foods rich in riboflavin. Which foods should the RN instruct the client to eat at least 2 servings daily? A. Fresh fruits. B. Enriched cereals. C. White potatoes. D. White rice. B. Enriched cereals. -Riboflavin (Vitamin B2) plays a key role in energy metabolism, which aides in the metabolism of fats, carbohydrates, and proteins. Riboflavin is found in enriched cereals (B), breads, leafy vegetables, cheese, and legumes. Fresh fruits (A), white potatoes (C), and white rice (D) do not contain riboflavin.