CH. 44: NUTRITION PROBLEMS TEST
BANK QUESTIONS AND ANSWERS
WITH SOLUTIONS 2024
1. Which finding for a young adult who follows a vegan diet may indicate the need for cobalamin
supplementation?
a. Glossitis
b. Ecchymoses
c. Dry, scaly skin
d. Gingival swelling - ANSWER ANS: A
Cobalamin (vitamin B12) cannot be obtained from foods of plant origin, so the patient will be most at
risk for signs of cobalamin deficiency, such as glossitis, anorexia, sore mouth and tongue, pallor,
neurologic problems (e.g., depression, dizziness), weight loss, nausea, constipation, and anemia. The
other symptoms listed are associated with other nutritional deficiencies but would not be associated
with a vegan diet.
2. A 76-yr-old woman with a body mass index (BMI) of 17 kg/m2 and a low serum albumin level is being
admitted. Which assessment finding would the nurse expect?
a. Restlessness
b. Hypertension
c. Pitting edema
d. Food allergies - ANSWER ANS: C
Edema occurs when serum albumin levels and plasma oncotic pressure decrease. The blood pressure
and level of consciousness are not directly affected by malnutrition. Food allergies are not an indicator of
nutritional status.
3. Which menu choice best indicates that the patient is implementing the nurse's suggestion to choose
high-calorie, high-protein foods?
a. Baked fish with applesauce
b. Beef noodle soup and canned corn
c. Fresh fruit salad with yogurt topping
d. Fried chicken with potatoes and gravy - ANSWER ANS: D
, Foods that are high in calories include fried foods and those covered with sauces. High-protein foods
include meat and dairy products. The other choices are lower in calories and protein.
4. A patient has a body mass index (BMI) of 31 kg/m2, a normal C-reactive protein level, and low serum
transferrin and albumin levels. What should the nurse encourage the patient to increase in the diet?
a. Iron
b. Protein
c. Calories
d. Carbohydrate - ANSWER ANS: B
The patient's C-reactive protein and transferrin levels indicate low protein stores. The BMI is in the obese
range, so increasing caloric intake is not indicated. The data do not indicate a need for increased
carbohydrate or iron intake.
5. A patient who has just been started on enteral nutrition of full-strength formula at 100 mL/hr has 6
liquid stools the first day. Which action would the nurse plan to take?
a. Slow the infusion rate of the feeding.
b. Check gastric residual volumes more often.
c. Change the enteral feeding system and formula every 8 hours. d. Discontinue administration of water
through the feeding tube. - ANSWER ANS: A
Loose stools indicate poor absorption of nutrients and indicate a need to slow the feeding rate or
decrease the concentration of the feeding. Water should be given when patients receive enteral feedings
to prevent dehydration. When a closed enteral feeding system is used, the tubing and formula are
changed every 24 hours. High residual volumes do not contribute to diarrhea.
6. A young adult with extensive facial injuries from a motor vehicle crash is receiving continuous enteral
nutrition through a percutaneous endoscopic gastrostomy (PEG). Which action will the nurse include in
the plan of care?
a. Keep the patient positioned lying on the left side.
b. Flush the tube with 30 mL of water every 4 hours.
c. Crush and mix medications in with the feeding formula.
d. Obtain a daily abdominal radiograph to verify tube placement. - ANSWER ANS: B
The tube is flushed every 4 hours during continuous feedings to avoid tube obstruction. The patient
should be positioned with the head of the bed elevated. Crushed medications mixed in with the formula
BANK QUESTIONS AND ANSWERS
WITH SOLUTIONS 2024
1. Which finding for a young adult who follows a vegan diet may indicate the need for cobalamin
supplementation?
a. Glossitis
b. Ecchymoses
c. Dry, scaly skin
d. Gingival swelling - ANSWER ANS: A
Cobalamin (vitamin B12) cannot be obtained from foods of plant origin, so the patient will be most at
risk for signs of cobalamin deficiency, such as glossitis, anorexia, sore mouth and tongue, pallor,
neurologic problems (e.g., depression, dizziness), weight loss, nausea, constipation, and anemia. The
other symptoms listed are associated with other nutritional deficiencies but would not be associated
with a vegan diet.
2. A 76-yr-old woman with a body mass index (BMI) of 17 kg/m2 and a low serum albumin level is being
admitted. Which assessment finding would the nurse expect?
a. Restlessness
b. Hypertension
c. Pitting edema
d. Food allergies - ANSWER ANS: C
Edema occurs when serum albumin levels and plasma oncotic pressure decrease. The blood pressure
and level of consciousness are not directly affected by malnutrition. Food allergies are not an indicator of
nutritional status.
3. Which menu choice best indicates that the patient is implementing the nurse's suggestion to choose
high-calorie, high-protein foods?
a. Baked fish with applesauce
b. Beef noodle soup and canned corn
c. Fresh fruit salad with yogurt topping
d. Fried chicken with potatoes and gravy - ANSWER ANS: D
, Foods that are high in calories include fried foods and those covered with sauces. High-protein foods
include meat and dairy products. The other choices are lower in calories and protein.
4. A patient has a body mass index (BMI) of 31 kg/m2, a normal C-reactive protein level, and low serum
transferrin and albumin levels. What should the nurse encourage the patient to increase in the diet?
a. Iron
b. Protein
c. Calories
d. Carbohydrate - ANSWER ANS: B
The patient's C-reactive protein and transferrin levels indicate low protein stores. The BMI is in the obese
range, so increasing caloric intake is not indicated. The data do not indicate a need for increased
carbohydrate or iron intake.
5. A patient who has just been started on enteral nutrition of full-strength formula at 100 mL/hr has 6
liquid stools the first day. Which action would the nurse plan to take?
a. Slow the infusion rate of the feeding.
b. Check gastric residual volumes more often.
c. Change the enteral feeding system and formula every 8 hours. d. Discontinue administration of water
through the feeding tube. - ANSWER ANS: A
Loose stools indicate poor absorption of nutrients and indicate a need to slow the feeding rate or
decrease the concentration of the feeding. Water should be given when patients receive enteral feedings
to prevent dehydration. When a closed enteral feeding system is used, the tubing and formula are
changed every 24 hours. High residual volumes do not contribute to diarrhea.
6. A young adult with extensive facial injuries from a motor vehicle crash is receiving continuous enteral
nutrition through a percutaneous endoscopic gastrostomy (PEG). Which action will the nurse include in
the plan of care?
a. Keep the patient positioned lying on the left side.
b. Flush the tube with 30 mL of water every 4 hours.
c. Crush and mix medications in with the feeding formula.
d. Obtain a daily abdominal radiograph to verify tube placement. - ANSWER ANS: B
The tube is flushed every 4 hours during continuous feedings to avoid tube obstruction. The patient
should be positioned with the head of the bed elevated. Crushed medications mixed in with the formula
