1300 ATI RN Nutrition Online Practice 2019 PDF

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ATI RN Nutrition Online Practice 2019 A 1. A nurse in an acute care facility is planning care for a client who has chosen to follow Islamic dietary laws during Ramadan. Which of the following actions should the nurse plan to take? a. Provide a snack for the client after sunset i. Rationale: during Ramadan, pt following Islamic dietary laws eat meals before dawn and after sunset. 2. A nurse is creating a plan of care for a client who has mucositis following a head and neck radiation therapy to treat cancer. Which of the following interventions should the nurse include in the plan? a. Increase fluid intake to 2 L per day i. Rationale: promotes hydration and peristalsis 3. A nurse is providing discharge teaching to a postpartum client about breast milk use and storage. Which of the following statements should the nurse make? a. “You cannot place thawed breast milk back in the freezer” i. Rationale: The nurse should instruct the client that completely thawed breast milk can be stored in the refrigerator but must be used within 24 hr. Breast milk that has been previously frozen should not be refrozen once it has thawed completely. Thawing creates a possibility for bacterial growth and causes a decrease in antibacterial activity, which destroys antibodies in the milk. 4. A nurse is caring for a client who adheres to a kosher diet. Which of the following food choices would be appropriate for this client? a. Vegetable salad with cheese i. Rationale: Clients who adhere to a kosher diet can eat dairy products combined with non-meat products at the same meal. 5. A community health nurse is planning to teach a class about weight management for cardiovascular health. Which of the following statements should the nurse plan to include? a. “Plan to lose weight gradually at ½ to 1 pound per week” i. Rationale: The nurse should inform the participants that losing 0.23 to 0.45 kg (0.5 to 1 lb) per week is a healthy and attainable weight-loss goal. Setting realistic goals for weight loss is an important element of success. Trying to lose weight too quickly places clients at risk for nutritional deficiencies and inadequate energy, which can lead to frustration and defeat 6. A client is experiencing anorexia related to cancer treatment. Which of the following interventions should the nurse implement to increase the client's nutritional intake? a. Add extra calories & protein to every meal i. Rationale: Adding extra calories and protein to every meal will increase the client's nutritional intake. 7. A nurse is teaching about nutritional requirements for a client who is starting a vegetarian diet. Which of the following information should the nurse include in the teaching? a. Include two servings per day of nuts when on a vegetarian diet i. Rationale: The nurse should instruct the client to eat two servings of nuts or flaxseed per day to receive the daily requirement of omega-3 fatty acids. 8. A nurse is teaching a female client about a healthy diet to control hypertension. Which of the following client statements indicates an understanding of the teaching? a. “I will eat four servings of unsalted nuts per week” i. Rationale: Female clients should consume four to five servings of unsalted nuts, seeds, or legumes per week for a heart-healthy diet.

9. A nurse is caring for a client who is dehydrated and is receiving intermittent enteral feeding. Which of the following actions should the nurse plan to take? a. Provide the formula as a continuous infusion i. Rationale: A client who is experiencing dehydration should receive a continuous infusion to prevent receiving a high carbohydrate load with each feeding. 10. A nurse is providing teaching to a client who has dumping syndrome and is experiencing weight loss. Which of the following instructions should the nurse include in the teaching? a. Consume liquids between meals i. Rationale: The nurse should teach the client to drink liquids between meals to slow movement of food from the stomach. 11. A nurse is providing dietary instructions for a client who has a prescription for warfarin. Which of the following foods should the nurse recommend the client eat in moderation while taking this medication? a. Leafy green vegetables i. Rationale: The nurse should recommend the client eat in moderation and maintain consistent intake of leafy green vegetables, which contain a natural form of vitamin K that can negate the anticoagulation effects of warfarin. 12. A nurse is teaching a client who has hypertension about decreasing sodium intake. Which of the following information should the nurse include in the teaching? a. Season foods with herbs and spices i. Rationale: The nurse should instruct the client to replace salt with herbs and spices when seasoning foods. 13. A nurse is teaching a prenatal education class about breastfeeding. Which of the following instructions should the nurse include in the teaching? a. Plan 5-min feedings on each breast on the first day after birth i. Rationale: The nurse should instruct the clients to let the newborn nurse for 5 min on each breast on the first day to promote milk production. 14. A nurse is assessing a client who has type 2 diabetes mellitus. The nurse should recognize which of the following as a manifestation of hypoglycemia? a. Confusion i. Rationale: The nurse should recognize confusion as a manifestation of hypoglycemia. 15. A nurse is teaching a client who is newly diagnosed with type 1 diabetes mellitus how to count carbohydrates. Which of the following statements made by the client indicates an understanding of the teaching? a. “I know the serving size can affect the number of carbohydrates I eat.” i. Rationale: The nurse should instruct the client that the portion size affects the number of carbohydrates 16. A nurse is assessing a client who is suspected of having lactose intolerance. Which of the following is an expected finding? a. Flatulence i. Rationale: Flatulence, bloating, and cramping, and diarrhea are expected findings associated with lactose intolerance. 17. A nurse is performing a cultural nursing assessment for a client whose religious practices include fasting 1 day each week. Which of the following questions should the nurse ask the client? (Select all that apply.) a. “Are you exempt from fasting during illness?” b. “Does fasting mean refraining from drinking liquids?”

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c. “Does your fasting occur during certain hours of the day?” d. “Does fasting mean eating only a certain type of food?” A nurse is planning dietary teaching for a client who has dumping syndrome following a gastrectomy. Which of the following interventions should the nurse include in the client's plan of care? a. Select grains with less than 2 g fiber per serving i. Rationale: Clients at risk for dumping syndrome better tolerate low-fiber grains that contain less than 2 g fiber per serving to slow gastric emptying. A nurse is assessing a client's risk for pressure injuries using the Braden scale. The client eats more than half of most meals but occasionally refuses a meal. Which of the following information should the nurse document on the nutrition category of the Braden scale? a. 3 (adequate) i. Rationale: A client who eats more than half of most meals, occasionally refuses a meal, and has four servings of protein each day scores a 3 (Adequate) in the nutrition category of the Braden scale. ii. 1 (Very Poor) – A client who scores a 1 (Very Poor) in the nutrition category of the Braden scale never finishes a complete meal, drinks little fluid, and does not drink any dietary supplements. iii. 2 (Probably Inadequate) – A client who scores a 2 (Probably Inadequate) in the nutrition category of the Braden scale only eats about half of meals or snacks and only occasionally takes dietary supplements. iv. 4 (Excellent) – A client who scores a 4 (Excellent) in the nutrition category of the Braden scale eats most of every meal, eats plenty of protein, and occasionally eats between meals. A nurse is providing teaching about lowering solid fat intake to an adolescent client who usually consumes about 2,000 calories per day. Which of the following instructions should the nurse include? a. “Restrict your daily meat intake to 5 ounces.” i. Rationale: The nurse should instruct the client to limit meat intake to about 5 oz per day. A meat portion should be no larger than the size of a deck of cards A home health nurse is reviewing the medical record of a client who had an open reduction internal fixation of the tibia. Which of the following findings should the nurse identify as a risk factor for impaired would healing? a. The client consumes 1,000 kcal daily i. Rationale: Adults who have had surgery require at least 1,500 kcal daily to meet energy needs and build protein for tissue healing. The nurse should recognize that a 1,000 kcal/day intake is below the client's needs. A nurse is providing teaching to a client who has dumping syndrome. Which of the following information should the nurse include? a. Apply pectin to foods i. Rationale: The client should apply pectin, a dietary fiber that helps to delay gastric emptying, to foods. A nurse in a long-term care facility is monitoring a client during mealtime who has Parkinson's disease. Which of the following findings should the nurse identify as the priority? a. The client drools while eating i. Rationale: Drooling while eating can indicate that this client is at greatest risk for aspiration of food from dysphagia, which can lead to pulmonary complications; therefore, the nurse should identify this as the priority finding.

24. A nurse is reviewing the laboratory values of a group of clients. Which of the following clients should the nurse identify as experiencing dehydration? a. A client who has sodium level of 150 mEq/L i. Rationale: The nurse should identify that a sodium level of 150 mEq/L is above the expected reference range of 136 to 145 mEq/L and indicates hypernatremia. Hypernatremia, often called water deficit, is a decrease of sodium concentration in the blood caused by an excess of water. Manifestations of hypernatremia include confusion, headache, nausea, and fatigue. b. A client who has a potassium level of 4.4 mEq/L i. The nurse should identify that a potassium level of 4.4 mEq/L is within the expected reference range of 3.5 to 5 mEq/L. Hypokalemia can occur with gastrointestinal losses, leading to dehydration. Hyperkalemia can occur with a fluid volume deficit. 25. A nurse is assessing a client who has fluid volume excess. Which of the following manifestations should the nurse expect? a. Crackles in the lungs i. Rationale: obvious 26. A nurse is caring for a client who is receiving continuous enteral tube feedings. Which of the following actions should the nurse take to prevent aspiration? a. Monitor gastric residuals every 4 hr i. Rationale: The nurse can identify delayed gastric emptying by monitoring gastric residuals regularly. Delayed gastric emptying places the client at risk for aspiration and can necessitate a decrease in the feeding rate. 27. A nurse is caring for a client who has undergone a radical head and neck resection to treat cancer and is receiving radiation therapy. The nurse should monitor for which of the following potential adverse effects? a. Changes in production of saliva i. Rationale: Changes in salivation are a potential complication of a head and neck resection and radiation therapy. 28. A nurse is preparing a health promotion seminar for a group of clients about cancer prevention. Which of the following information should the nurse include? a. Eat at least 2.5 cups of fruits and vegetables each day i. Rationale: The nurse should include in the teaching that clients should eat at least 2.5 cups of fruits and vegetables daily to help maintain body weight and reduce the risk for cancer of the lung and gastrointestinal system 29. A nurse is caring for a client who is at 8 weeks gestation and has a BMI of 34. The client asks about weight goals during her pregnancy. The nurse should advise the client to do which of the following? a. Gain approximately 6.8 kg (15 lb) i. Rationale: The nurse should advise the client that based on her BMI, she should gain 4.9 to 9.1 kg (11 to 20 lb) during her pregnancy. 30. A nurse is reviewing the laboratory findings of a client who has acute pancreatitis. Which of the following is an expected finding? a. Increased glucose i. Rationale: The nurse should expect an increased glucose level in a client who has acute pancreatitis due to decreased insulin production by the pancreas. 31. A nurse is reviewing the introduction of solid foods with the guardian of a 4-month-old infant. Which of the following statements by the guardian indicates an understanding of the teaching? a. “I will introduce a new solid food every 5 days.”

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i. Rationale: The client understands that new food items should be introduced every 4 to 7 days to monitor for indications of food allergies. b. "My baby should consume 2 tablespoons of solid food at each feeding." i. Rationale: Infants should consume 1 to 2 teaspoons of solid food initially at each feeding. c. "I will give my baby one bottle of fruit juice each day." i. Rationale: Fruit juices should be introduced at 6 months of age, limited to 120 mL (4 oz), and offered in a cup. A nurse is evaluating a client who is receiving a continuous enteral feeding and has diarrhea. Which of the following actions should the nurse take to reduce the client's diarrhea? a. Decrease the rate of the feeding i. Rationale: To prevent diarrhea, the nurse should decrease the rate of the tube feeding, which allows for better absorption of the enteral formula. A nurse is caring for a client who expressed a desire to lose weight. Which of the following actions should the nurse take first? a. Obtain a 24-hr dietary recall i. Rationale: The first action the nurse should take using the nursing process is to obtain a diet history, such as a 24-hr dietary recall. Having the client write down everything consumed over a 24-hr period is a crucial component of the assessment process to identify eating behaviors and therefore be able to recommend dietary modifications based on the data received. A nurse is assessing a client who has diabetes mellitus. Which of the following findings should the nurse identify as a manifestation of hypoglycemia? a. Diaphoresis i. Rationale: The nurse should identify that diaphoresis, irritability, and tremors are manifestations of hypoglycemia. A nurse is caring for a client who is receiving total parenteral nutrition (TPN) and is prescribed an oral diet. The client asks the nurse why the TPN is being continued since he is now eating. Which of the following responses should the nurse make? a. “You should consume at least 60 percent of your calories orally before the parenteral nutrition can be discontinued.” i. Rationale: TPN can be discontinued when oral intake exceeds at least 60% of the client's estimated daily caloric requirements. A nurse is developing an educational program about the glycemic index of foods for clients who have diabetes mellitus. Which of the following foods should the nurse identify as having the highest glycemic index? a. Baked potato i. Rationale: According to evidence-based practice, the nurse should identify that a baked potato has the highest glycemic index of these foods. The glycemic index of a baked potato is 85 to 90. Glycemic index is a tool used to rank foods according to the degree in which the food raises serum glucose levels. A nurse is teaching a client who reports constipation about ways to increase dietary intake of fiber. Which of the following information should the nurse include? a. Leave the skin on when eating fruit i. Rationale: The nurse should instruct the client that consuming the skin on fruits and vegetables adds fiber to the diet. b. Consume ½ cup of bran daily

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i. Rationale: The nurse should instruct the client to add a small amount of bran to the daily diet, working up to 3 tablespoons daily, which is less than ¼ cup. Adding fiber gradually should prevent abdominal distention and excessive flatus. A nurse is assessing a client who has an elevated blood pressure, headache, and is sweating. The client recently started taking an MAOI. The nurse should question the client regarding the consumption of which of the following foods? a. Cheddar cheese i. Rationale: Clients who take MAOIs should avoid the consumption of most types of cheese and other foods that contain high levels of tyramine, which can lead to hypertensive crisis. A nurse is providing dietary teaching to a client who is postoperative following a gastric bypass procedure. Which of the following instructions should the nurse include? a. Begin each meal with a protein i. Rationale: The nurse should instruct the client to begin each meal by eating a protein. The client should consume 60 to 120 g of protein each day. A nurse is teaching a client about measures to reduce the risk of osteomalacia. Which of the following instructions should the nurse include in the teaching? a. Consume 20 mcg of vitamin D daily i. Rationale: The nurse should instruct the client to consume 20 mcg of vitamin D daily. Osteomalacia is characterized by a lack of vitamin D, which leads to insufficient bone mineralization. This disorder coincides with osteoporosis, thereby increasing the risk of falls leading to fractures in older adult clients. Vitamin D supplements are recommended for clients age 65 and older to decrease bone loss and maintain bone mineralization, thereby reducing the risk of a softening of the bones. b. Take 150 mg of vitamin E daily. i. Rationale: The recommended dose of vitamin E is 15 mg per day. Vitamin E is an antioxidant that protects the lungs and RBCs but does not reduce the risk of developing osteomalacia. In large amounts, it can decrease platelet aggregation, which can interfere with blood clotting in older adult clients. Osteomalacia is characterized by a lack of vitamin D which leads to insufficient bone mineralization. This disorder coincides with osteoporosis, thereby increasing the risk of falls leading to fractures in older adult clients. A home health nurse is providing dietary teaching to the guardians of a 3-year-old child. Which of the following statements by the guardians should the nurse identify as understanding of the teaching? a. “I will put low-fat milk in her cup for her drink” i. Rationale: Whole milk provides necessary fat for neurological development for children up to 2 years of age, after which the child should consume low-fat or skim milk. Therefore, the nurse should identify this statement as indicating an understanding of the teaching. A nurse is providing education to an adolescent about making nutrient-dense food choices. Which of the following statements by the client indicates an understanding of the teaching? a. “Canned pinto beans are a better choice than refried beans.” i. Rationale: Canned pinto beans contain less fat than refried beans. A nurse is caring for a client who has a new prescription for parenteral nutrition (PN) containing a mixture of dextrose, amino acids, and lipids. Prior to administration of the PN, the nurse should report which of the following food allergies to a provider? a. Eggs

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i. Rationale: Lipid emulsions are isotonic and are composed of soybean or safflower plus soybean oil, with egg phospholipid used as an emulsifier. Clients who are allergic to eggs can have a reaction to the emulsifier. Therefore, the nurse should report this finding to the provider. A nurse is providing dietary teaching for a client who has osteoporosis. The nurse should instruct the client that which of the following foods has the highest amount of calcium? a. ½ cup roasted almonds i. Rationale: The nurse should determine that ½ cup roasted almonds is the best food source to recommend because ½ cup of almonds contains 185 mg of calcium. Calcium helps to prevent bone ...