NUR 1172/NUR1172 Exam 4 V1 |
Nutritional Principles in Nursing Q&A with
Rationale | Rasmussen University
1. A nurse is caring for a patient with Stage 4 Chronic Kidney Disease (CKD). Which of the
following dietary interventions is most important to discuss to prevent secondary
hyperparathyroidism?
A. Restricting phosphorus-rich foods
B. Increasing dietary calcium intake
C. Decreasing total caloric intake
D. Supplementing with Vitamin C
Answer: A
Rationale: In advanced CKD, the kidneys fail to excrete phosphorus effectively, leading to
hyperphosphatemia. High phosphorus levels signal the parathyroid glands to release
hormone, which can pull calcium from bones. The nurse must educate the patient to limit
dairy, nuts, and legumes to maintain bone health.
2. A client is receiving Total Parenteral Nutrition (TPN) through a central line. The nurse notes
the bag is nearly empty but the next bag has not arrived from the pharmacy. Which solution
should the nurse hang to prevent hypoglycemia?
A. 0.9% Sodium Chloride
,B. Lactated Ringer’s
C. 10% Dextrose in Water (D10W)
D. 5% Dextrose in 0.45% Sodium Chloride
Answer: C
Rationale: TPN contains high concentrations of dextrose, causing the pancreas to secrete
high levels of insulin. If the infusion is suddenly stopped, the patient is at high risk for
rebound hypoglycemia. Hanging 10% dextrose provides enough glucose to maintain blood
sugar levels until the new TPN bag is available.
3. A nurse is providing discharge instructions to a patient who has undergone a gastrectomy
and is at risk for dumping syndrome. Which instruction should be included?
A. Drink 8 ounces of water with every meal.
B. Eat three large meals per day to maintain weight.
C. Include a high-protein, low-carbohydrate snack.
D. Lie down for 30 minutes after eating.
Answer: D
Rationale: Lying down after meals slows the transit of food from the stomach into the
small intestine. This helps minimize the rapid osmotic shift that causes the symptoms of
dumping syndrome. The nurse should also advise the patient to consume liquids between
meals rather than during them.
, 4. A patient with Human Immunodeficiency Virus (HIV) is experiencing significant muscle
wasting and weight loss. What is the most appropriate nutritional recommendation?
A. Follow a strict vegan diet to reduce inflammation.
B. Increase intake of calorie-dense, high-protein foods.
C. Restrict fat intake to less than 10% of total calories.
D. Consume mostly raw vegetables to preserve enzymes.
Answer: B
Rationale: HIV-related wasting syndrome requires an aggressive nutritional approach to
preserve lean body mass. High-protein and high-calorie foods help counteract the
metabolic stress and malabsorption associated with the virus. The nurse should encourage
frequent, small meals that are nutrient-dense.
5. Which laboratory value is the most sensitive indicator of nutritional status in a patient with
acute renal failure?
A. Serum Albumin
B. Serum Creatinine
C. Blood Urea Nitrogen (BUN)
D. Prealbumin
Answer: D
Nutritional Principles in Nursing Q&A with
Rationale | Rasmussen University
1. A nurse is caring for a patient with Stage 4 Chronic Kidney Disease (CKD). Which of the
following dietary interventions is most important to discuss to prevent secondary
hyperparathyroidism?
A. Restricting phosphorus-rich foods
B. Increasing dietary calcium intake
C. Decreasing total caloric intake
D. Supplementing with Vitamin C
Answer: A
Rationale: In advanced CKD, the kidneys fail to excrete phosphorus effectively, leading to
hyperphosphatemia. High phosphorus levels signal the parathyroid glands to release
hormone, which can pull calcium from bones. The nurse must educate the patient to limit
dairy, nuts, and legumes to maintain bone health.
2. A client is receiving Total Parenteral Nutrition (TPN) through a central line. The nurse notes
the bag is nearly empty but the next bag has not arrived from the pharmacy. Which solution
should the nurse hang to prevent hypoglycemia?
A. 0.9% Sodium Chloride
,B. Lactated Ringer’s
C. 10% Dextrose in Water (D10W)
D. 5% Dextrose in 0.45% Sodium Chloride
Answer: C
Rationale: TPN contains high concentrations of dextrose, causing the pancreas to secrete
high levels of insulin. If the infusion is suddenly stopped, the patient is at high risk for
rebound hypoglycemia. Hanging 10% dextrose provides enough glucose to maintain blood
sugar levels until the new TPN bag is available.
3. A nurse is providing discharge instructions to a patient who has undergone a gastrectomy
and is at risk for dumping syndrome. Which instruction should be included?
A. Drink 8 ounces of water with every meal.
B. Eat three large meals per day to maintain weight.
C. Include a high-protein, low-carbohydrate snack.
D. Lie down for 30 minutes after eating.
Answer: D
Rationale: Lying down after meals slows the transit of food from the stomach into the
small intestine. This helps minimize the rapid osmotic shift that causes the symptoms of
dumping syndrome. The nurse should also advise the patient to consume liquids between
meals rather than during them.
, 4. A patient with Human Immunodeficiency Virus (HIV) is experiencing significant muscle
wasting and weight loss. What is the most appropriate nutritional recommendation?
A. Follow a strict vegan diet to reduce inflammation.
B. Increase intake of calorie-dense, high-protein foods.
C. Restrict fat intake to less than 10% of total calories.
D. Consume mostly raw vegetables to preserve enzymes.
Answer: B
Rationale: HIV-related wasting syndrome requires an aggressive nutritional approach to
preserve lean body mass. High-protein and high-calorie foods help counteract the
metabolic stress and malabsorption associated with the virus. The nurse should encourage
frequent, small meals that are nutrient-dense.
5. Which laboratory value is the most sensitive indicator of nutritional status in a patient with
acute renal failure?
A. Serum Albumin
B. Serum Creatinine
C. Blood Urea Nitrogen (BUN)
D. Prealbumin
Answer: D
