Nutritional Principles in Nursing Q&A with
Rationale | Rasmussen University
1. A nurse is caring for a client who is receiving total parenteral nutrition (TPN). Which of the
following actions should the nurse take to prevent a common complication of TPN?
A. Change the TPN tubing every 72 hours.
B. Infuse the TPN at a rapid rate to ensure adequate calorie intake.
C. Monitor blood glucose levels every 4 to 6 hours.
D. Check the gastric residual every 4 hours.
Answer: C
Rationale: TPN contains a high concentration of dextrose, which significantly increases the
risk for hyperglycemia. Monitoring blood glucose levels allows for early identification and
management of blood sugar fluctuations. Frequent monitoring is a standard nursing
intervention for all clients receiving parenteral nutrition to ensure metabolic stability.
2. A nurse is teaching a client about the DASH (Dietary Approaches to Stop Hypertension)
diet. Which of the following instructions should the nurse include?
A. Increase intake of foods rich in potassium, calcium, and magnesium.
B. Limit consumption of whole grains.
C. Decrease intake of low-fat dairy products.
,D. Consume no more than 4,000 mg of sodium per day.
Answer: A
Rationale: The DASH diet emphasizes minerals like potassium and calcium which help
lower blood pressure naturally. It specifically targets reducing sodium and saturated fat
while increasing fiber. Following this diet has been clinically shown to reduce systolic and
diastolic blood pressure levels.
3. A client with chronic kidney disease (CKD) is being educated on a renal diet. The nurse
should explain that protein intake is often limited because:
A. Protein causes fluid retention in the extremities.
B. Breakdown of protein produces nitrogenous waste that the kidneys cannot easily filter.
C. High protein intake leads to excessive potassium loss.
D. Protein interferes with the absorption of iron.
Answer: B
Rationale: In CKD, the kidneys lose their ability to excrete urea and other nitrogenous
wastes produced from protein metabolism. Restricting protein helps decrease the
workload on the kidneys and may delay the progression of the disease. Nurses must
monitor blood urea nitrogen (BUN) levels closely to assess the client’s tolerance to protein.
4. A nurse is providing discharge teaching for a client who has a new prescription for warfarin.
Which food should the nurse instruct the client to consume in consistent amounts?
A. Spinach
, B. Bananas
C. Chicken breast
D. White bread
Answer: A
Rationale: Spinach is high in Vitamin K, which is the direct antagonist to warfarin and can
decrease the drug’s effectiveness. Clients do not need to avoid Vitamin K entirely but must
keep their intake consistent to maintain stable INR levels. Sudden increases or decreases in
leafy green intake can lead to clotting or bleeding complications.
5. Which of the following is the most reliable indicator of a client’s fluid status over a short
period of time?
A. Skin turgor
B. Daily weight
C. Serum sodium levels
D. 24-hour calorie count
Answer: B
Rationale: Daily weight is the most accurate and sensitive measure of fluid gain or loss in
the clinical setting. One liter of fluid is equivalent to 1 kilogram of body weight, making
weight changes very telling of fluid shifts. Nurses should ensure weights are taken at the
same time each day using the same scale and similar clothing.