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What independent nursing intervention can be implemented to stimulate appetite? Administer prescribed medications. Recommend dietary supplements. Encourage or provide oral care. Assess manifestations of malnutrition. (Ans- Encourage or provide oral care. Explanation: There are many methods of stimulating appetite in a client to prevent malnutrition. One independent nursing intervention that is useful is to encourage or provide oral care. Administering medications and recommending dietary supplements are useful but are not independent nursing actions. The health care provider would need to prescribe the medications. Assessing manifestations of malnutrition occurs after malnutrition is recognized. A nurse is caring for a client with a history of cardiac and vascular disease. Which fats should the nurse allow in the client's diet for his condition? unsaturated fats trans fats saturated fats
NUR 209 Exam 3: Questions & Answers
(Nutritional) 2025/
hydrogenated fats (Ans- unsaturated fats Explanation: Unsaturated fat is a healthier form of fat than saturated fat, because it contains less hydrogen, and therefore can be included in the client's diet. Saturated fats are lipids that contain as much hydrogen as their molecular structure can hold and are generally solid. Most saturated fats are found in animal sources, such as the marbled fat in meat. Saturated fats are responsible for cardiac and vascular diseases. Trans fats are unsaturated fats that have been hydrogenated, a process in which hydrogen is added to the fat. Consumption of trans fats, saturated fats, and hydrogenated fats increases the risk of coronary heart disease. A nurse is assessing the volume of liquid nutrition that has been tube-fed to a client. What will happen if the volume of feeding exceeds the client's physiologic capacity? diarrhea pallor obesity gastric reflux (Ans- gastric reflux Explanation: Overfilling the client's stomach can cause gastric reflux, regurgitation, vomiting, aspiration, and pneumonia. Exceeding the volume of feeding beyond a client's physiologic capacity does not lead to diarrhea, pallor, or obesity. As a rule of thumb, the gastric residual should be no more than 100 mL or no more than 20% of the previous hour's tube-feeding volume. A nurse has just received a client's laboratory results and is reviewing them. Which finding should the nurse recognize as an indication of malnutrition or malabsorption?
This client has a BMI of 26, which falls in the category of overweight: 25. to 29.9. The other BMI values are: underweight, <18.5; normal, 18.5 to 24.9; obesity class I, 30.0 to 34.9; obesity class II, 35.0 to 39.9; and extreme obesity, 40.0+. A nurse is caring for a client who has a vitamin B12 deficiency. Which food would the nurse recommend to help with this deficiency? Liver Pork Cantaloupe Broccoli (Ans- Liver Explanation: The best foods from which to obtain B12 include organ meats and seafood. Pork provides thiamin. Cantaloupe provides vitamin B6; broccoli provides vitamin C. The community nurse is educating client groups about nutrition. Which group does the nurse identify that will benefit most from nutritional counseling and intervention? married, pregnant women over 30 years of age double income, married individuals older adults living on a fixed income people who live in farming communities (Ans- older adults living on a fixed income Explanation:
Older adults who are socially isolated or living on fixed incomes will benefit most from nutritional counseling and intervention. Other individuals are not at the same level of risk. A nurse is feeding a client. Which action will the nurse take? Explain that a bib will be used in case the meal gets messy. Inform the client that the experience will be quick, approximately 10 minutes. Feed the client the meal starting with the protein, explaining it is the most important. Offer options of foods and for the order to be eaten. (Ans- Offer options of foods and for the order to be eaten. Explanation: The loss of independence that comes with the inability to self-feed can be a severe blow to a person's self-esteem. Asking the client's preference regarding the order of items eaten can help maintain dignity while being fed. The nurse should be prepared to spend as much time with the client to assist with the entire meal to support self-worth for the client. Telling a client what the nurse will do does not promote self-esteem but identifies the nurse wanting to control the feeding. The nurse is preparing to insert an ordered nasogastric tube in a 28-year- old client. Which action should the nurse prioritize after the client mentions a history of a fractured nose as a teenager? assess for deviated septum verify with the health care provider to continue with the insertion document history and insert tube
frequent, not less frequent and larger. Supplements may be nutritionally necessary, but these do not act to increase the client's appetite. A nurse is caring for a client with a history of cardiac and vascular disease. Which fats should the nurse allow in the client's diet for his condition? unsaturated fats trans fats saturated fats hydrogenated fats (Ans- unsaturated fats Explanation: Unsaturated fat is a healthier form of fat than saturated fat, because it contains less hydrogen, and therefore can be included in the client's diet. Saturated fats are lipids that contain as much hydrogen as their molecular structure can hold and are generally solid. Most saturated fats are found in animal sources, such as the marbled fat in meat. Saturated fats are responsible for cardiac and vascular diseases. Trans fats are unsaturated fats that have been hydrogenated, a process in which hydrogen is added to the fat. Consumption of trans fats, saturated fats, and hydrogenated fats increases the risk of coronary heart disease. A nurse is providing liquid nourishment 4 to 6 times a day in feedings of less than 30 - minutes duration to a client who is being tube fed. To which of the following tube-feeding schedules is the nurse adhering? cyclic variable continuous bolus (Ans- bolus Explanation:
A bolus or intermittent feeding is the instillation of liquid nourishment 4 to 6 times a day in less than 30 minutes, usually 250 to 400 mL of formula per administration. Cyclic feeding (over a period of 8 to 12 hours) is followed by a 16- to 12-hour pause. Continuous feeding is administered at a steady rate of approximately 1.5 mL/minute. Feeding schedules are not characterized as being variable. Which nursing action is performed according to guidelines for aspirating fluid from a small-bore feeding tube? Use a small syringe and insert 10 mL of air. If fluid is obtained when aspirating, measure its volume and pH and flush the tube with water. Continue to instill air until fluid is aspirated. Place the client in the Trendelenburg position to facilitate the fluid aspiration process. (Ans- If fluid is obtained when aspirating, measure its volume and pH and flush the tube with water. Explanation: The nurse would measure the volume and pH of the aspirated fluid, then flush the tube with water. The nurse would not place the client in Trendelenburg position as this could lead to reflux of the feeding from the stomach and possibly cause aspiration of the solution into the lungs. The nurse would not use a small syringe or continue to instill air until fluid is aspirated. A 45 - year-old client on the inpatient unit has just resumed eating a normal diet. The nurse checks a blood sugar with the morning labs and the result is 99.10 mg/dL (5.5 mmol/L). How would the nurse interpret this blood glucose?
Scrambled eggs with cheese Cereal and milk Toasted bran muffin and jelly (Ans- Scrambled eggs with cheese Explanation: Scrambled eggs with cheese is a food choice high in protein content. Egg and cheese are both proteins. Pasta is a carbohydrate, but the Alfredo sauce is made with milk or a milk base, which is protein. Cereal is a complex carbohydrate with a variety of fortified nutrients, and the milk is a protein/carbohydrate source. Bran muffin and jelly are both carbohydrate sources. The nurse is conducting a client health history interview and notes the client is taking atorvastatin. This observation should prompt the nurse to ask the client which question first? "When did you last have your cholesterol levels checked?" "Is your diet made up primarily of carbohydrate-based foods?" "Do you take a daily multivitamin supplement?" "Do you only consume vegetarian foods?" (Ans- "When did you last have your cholesterol levels checked?" Explanation: Atorvastatin is a commonly prescribed HMO-COA reductase inhibitor. This classification of medication is taken to reduced blood cholesterol levels. It would be relevant to this observation for the nurse to follow with a question about the last time the client had serum triglyceride levels assessed to determine efficacy of the medication. Carbohydrates are not known to have
a direct effect on increasing serum cholesterol levels. While it is important for the nurse to understand the client's nutritional intake and habits, this question would not be prioritized after noting that the client has this medication listed in the drug profile. Multivitamins provide supplementation for vitamin deficiencies but do not have a direct impact on a client's serum cholesterol levels. Overall, vegetarians have a lower incidence of colorectal cancer and fewer problems with obesity and diseases associated with a high-fat diet. Although the nurse can certainly inquire about what type of diet the client habitually consumes, this question does not directly relate to the observation that an ant triglyceride medication is being taken by the client. Which of the following intervention should the nurse use at meal times for a patient who has visual deficits? Identify the food location as though the plate were a clock. Direct the order in which food items are consumed. Have the patient tilt her head forward while eating. Avoid talking to the patient during mealtime. (Ans- Identify the food location as though the plate were a clock. Explanation: Telling the patient, for example, that the chicken is at 9 o'clock and the broccoli is at 12 o'clock helps orient her to the items on the plate and thus facilitates independence in eating. A nurse is caring for a patient who has sustained a head injury and whose level of consciousness fluctuates. The provider prescribes a full liquid diet progressing to pureed diet as tolerated. Before initiating feedings, it is essential that this patient undergo which of the following?
When teaching the parents of a toddler about feeding and eating, the nurse should include which of the following safety measures?
- Give the child 8 to 12 oz of fruit juice daily
- Do not offer the child raw vegetables
- Do not give the child peanut butter
- Have the child drink 28 to 32 oz of milk daily (Ans- Do not offer the child raw vegetables. Raw vegetables, as well as hot dogs, grapes, nuts, popcorn, and candy, have been implicated in choking deaths and should be avoided at least until the child is 3 years old. Which of the following dietary modifications should an adolescent in sports implement?
- Drink water before and after sports activities
- Decrease carbohydrates to 30%-40% of daily calories
- Keep protein intake at the same level
- Increase fats to 30%-40% of caloric intake (Ans- Drink water before and after sports activities. An adolescent should drink water before and after sports activities to prevent dehydration.
A nurse is caring for a patient who has impaired swallowing due to a cerebrovascular accident. Which of the following interventions should the nurse use to assist the patient with feeding? Provide the patient with a straw. Offer the patient thin fluids. Elevate the head of the bed 45 to 90°. Place food in the weaker side of the mouth. (Ans- Elevate the head of the bed 45 to 90°. The patient's head should be sufficiently elevated to prevent aspiration. Which of the following are appropriate choices for a patient prescribed a full liquid diet (select all that apply) Plain yogurt Custard Ice cream Mashed potatoes Pureed meat Gelatin (Ans- A full liquid diet includes smooth-textured dairy products (such as plain yogurt), custards, refined cooked cereals, vegetable and fruit juices, ice cream, and all the elements of a clear liquid diet, such as coffee, carbonated beverages, and gelatin. Mashed potatoes and pureed meat are not permitted until the patient progresses to a pureed diet or beyond.
Albumin is not sensitive to acute changes in nutritional status. Its long half- life (21 days) makes it a better indicator of chronic illness states than of current protein status at a given point in time. To assess a stroke patient for complications secondary to inadequate swallowing, the nurse should do which of the following? Auscultate the patient's lungs. Place the tip of a tongue depressor on the patient's posterior tongue. With a penlight, inspect the patient's uvula and the soft palate. Place fingers on the patient's throat at the level of the larynx and ask him to swallow. (Ans- Auscultate the patient's lungs. "Silent" aspirations are a common complication of swallowing impairment. Which of the following strategies for enhancing the intake of healthful foods is appropriate for an adolescent? Encouraging the adolescent to consume snack foods from the grains food group Permitting the adolescent to skip breakfast to enhance appetite at later meals Making healthful food choices more convenient and available for the adolescent Allowing the adolescent complete autonomy in making food choices (Ans- Making healthful food choices more convenient and available for the adolescent
This helps prompt the adolescent to make healthier food choices. A nurse inserting a nasogastric tube asks the patient to flex her head toward her chest after the tube passes through the nasopharynx. This action facilitates proper insertion of the tube by closing off the glottis. preventing curling of the tube in the mouth. allowing the patient to breathe through her mouth. opening the lower esophageal sphincter. (Ans- closing off the glottis. This action prohibits the tube from entering the trachea. A nurse is providing teaching to a patient who is receiving intermittent nasogastric feedings. Which of the following should the nurse instruct the patient to report immediately? A feeling of fullness Persistent coughing Discomfort in the naris Postfeeding belching (Ans- Persistent coughing This could indicate that the distal end of the nasogastric tube has moved into the respiratory tract. Immediate assessment is needed, because the patient might be at risk for aspiration.
To prevent a common complication of continuous enteral tube feedings, a nurse should limit the time the formula hangs to 4 hr. chill the formula prior to administration. deliver the formula at a brisk rate. allow the feeding bag to empty before refilling it. (Ans- limit the time the formula hangs to 4 hr. Formula that hangs longer than 4 to 8 hr is at risk for bacterial contamination, typically manifested by the patient as diarrhea. The most reliable method for verifying initial placement of a small-bore feeding tube is by measuring the pH of gastric aspirate. auscultating the epigastric area while injecting air. obtaining an abdominal x-ray. placing the open end of the tube in a cup of water. (Ans- obtaining an abdominal x-ray. This is the most reliable method for verifying initial placement of a small- bore feeding tube. An older adult patient in a long-term care facility is receiving intermittent enteral feedings in his room. His affect is flat, and the nurse suspects that
he is feeling isolated. Which of the following interventions is appropriate for this patient? Encourage him to go to the dining room at meal times to talk with other patients. Suggest that he watch television while his feedings are being administered. Remind him that he can have visitors after his feeding administration times. Ask the facility chaplain to speak with the patient. (Ans- Encourage him to go to the dining room at meal times to talk with other patients. By encouraging the resident to maintain a normal schedule and social interactions, the nurse is helping to rebuild his social network and reverse patterns of isolation. A patient with a gastric ileus post-operatively requires nutritional support for approximately 2 weeks. Which of the following types of feeding tubes is appropriate for this patient? Nasogastric tube Nasointestinal tube Percutaneous endoscopic gastrostomy tube Percutaneous endoscopic jejunostomy tube (Ans- Nasointestinal tube A nasointestinal tube allows postpyloric feeding by depositing enteral formula directly into the intestines. This is an appropriate choice for a
