NCLEX Nutrition

Question 1

When teaching a diabetic client about nutrition, the nurse understands that the client should be taught about the amount of consumption of carbohydrates such as pasta, bread, etc. What information should the nurse include in this teaching?

Answer 1

The nurse should teach the client that carbohydrate intake restrictions should be individualized. No one size fits all approach is appropriate. The client may be able to continue eating daily pasta or bread with a reduction in the portions of this food category. Whole grains are recommended for diabetic clients because the fiber recommendations are the same for a client with DM.

Question 2

A nurse is teaching a client with Dumping Syndrome. What priority teaching points should the nurse include?

Answer 2

Dumping syndrome - food moves from stomach into the small bowel rapidly after eating.
* Consume small, frequent meals
* Consume protein and fat with each meal
* Avoid simple sugar
* Avoid lactose
* Avoid drinking liquids during meals.
* Drink liquids 1-hour pre or post-meal.
* The client should** lay down **for 30 to 60 minutes post-meal to delay gastric emptying.
* Monitor iron and vitamin B 12

Question 3

The nurse understands that the recommended intake of grains, dairy, vegetables, fruits, meats, and oils for a healthly adult includes the following servings:

Answer 3

In 24 hours the intake should be as follows:
Grains - 3 or more ounce-equivalents of whole-grain products
Dairy - 3 servings
Vegetables - 2.5 cups or more
Fruits - 2 servings
Meat, poultry, fish, dried beans, eggs - 2 to 3 servings
Oils - sparingly

Question 4

A nurse is caring for a client with constipation. Nutrition education for this client should include:

Answer 4

Constipation - dx in part on report of less then three bowel movements per week.
Teach to:
* Increase fiber (fruits, vegetables, wheat bran, beans, prunes) gradually to 20-25 grams/day.
* Increase water intake
* Psyllium and methylcellulose are fiber supplements that can assist in treatment but do not contain vitamins
* Probiotics can assist in constipation relief due to promotion of health bowel function. Do NOT give to immune-compromised or critically ill clients.
* Do NOT advise regular usage of simulate laxatives

Question 5

The nurse is providing nutrition education for a client dx with chronic renal failure. The nurse should include the following recommendations:

Answer 5

• Limit dietary sodium (canned soup, peanut butter, cold cuts, cured meats, and most savory snack foods)
• Limit dietary potassium (dried fruits, spinach, broccoli, bananas, avocado, beans, and lentils)
• Limit dietary phosphorus 1 serving or less (peanut butter, bran, dried peas/beans, chocolate, beer, and cola)
• Ensure intake of high quality proteins (poultry, fish, eggs, soy, and meat). Meat intake 5-6 oz day for men / 4 oz day for women. Protein intake is typically limited.

Question 6

When calculating the protein requirements for a healthy young adult client the nurse understands that the RDA for protein is _______ g/kg.

Answer 6

The RDA of protein is 0.8 g/kg daily. Remember when calculating the grams of protein required a day you must change the clients weight in pounds to kilograms prior to multiplying the weight by 0.8 to obtain your answer.

Question 7

The nurse is providing nutrition educaiton to a client with COPD. What information should the nurse include in teaching this client?

Answer 7

• Cosume soft textured foods that are chewed easily.
• Add gravy, butter, and sauces
• Drink high-protein, high calorie formulas between meals
• Consume small meals (six) throughout the day
• Consume cold foods to decrease feelings of fullness
• Consume fluids after meals
• Consume convenience foods that are easy-to-cook (less energy required to prepare)

Question 8

The nurse understands that vitamin C deficiency places a client at risk for:

Answer 8

Scurvy which produces symptoms of delayed wound healing, fatigue, and bruising/bleeding.

Question 9

The nurse understands that vitamin A deficiency places a client at risk for:

Answer 9

Immunodeficiency and night time blindness.

Question 10

The nurse understands that vitamin D deficiency places a client at risk for:

Answer 10

Rickets and osteomalacia with symptoms of bowed legs, fractures, and malformed teeth. Vitamin D is required by the parathyroid gland for appropriate functioning.

Question 11

When teaching a group of nursing students about iron the nurse would include the following information:

Answer 11

Iron is necessary for oxygen transportation. Heme sources (iron from animal sources that comprises 95% of functional iron in the human body) include meat, fish, and poultry.

Question 12

The nurse is caring for a client with celiac disease. When discussing nutrition with the client the nurse would include what information?

Answer 12

Celiac disease is an immune disorder characterized by an abnormal immune response to wheat gluten, rye, and barley. Recommendation includes lifelong adherance to gluten-free diet. The client should avoid lactose-containing foods in most cases. Caution with oat intake; oats are not always risk-free. NO malt, modified food starch, soy sauce, most sauces, communion wafers, play dough, pizza, canned soup, and hot dogs. The client can have corn.

Question 13

The nurse understands that incomplete proteins are:

Answer 13

Missing 1 or more essential amino acids (9 needed to be complete) necessary for synthesis of protein in the human body. Incomplete proteins include vegetables, nuts, grains, and lentils.

Question 14

The nurse is caring for a client with neutropenic precautions. The nurse understands that dietary recommendations for this client would include:

Answer 14

Do NOT consume: milk, fresh fruits, fresh vegetables, soft boiled eggs, soft cheeses, and deli meats.

Question 15

The nurse is teaching a group of nursing students about body mass index. The nurse knows that the students understand when they state the anticipated BMI ranges for underweight, healthy weight, overweight, and obese as:

Answer 15

Underweight - below 18.5
Healthy weight - 18.5 to 24.9
Overweight - 25 to 29.9
Obese - greater than or equal to 30

Question 16

The nurse understands that medications that should be avoided with grapefruit juice include:

Answer 16

Calcium channel blockers, Statins (except pravastatin which is not affected by grapefruit juice), organ transplant medications (cyclosporine), buspirone, antiarrhythmics (amiodarone), and corticosteroids (buspirone)

Question 17

The nurse is admitting a new client to the medical-surgical unit. The client reports adhering to a Kosher diet. The nurse understands that a Kosher diet means:

Answer 17

Kosher diets are common for Orthodox Judaism. Food must be prepared a specific way on a Kosher diet (Kosher kitchen with no meat and milk together). Animal slaughter must be “humane.” Pork or shellfish products are not included in this diet.

Question 18

The nurse has admitted a client to the medical-surgical unit who consumes an ovo-vegetarian diet. When the client’s breakfast tray arrives two eggs are present on the tray. The nurse understands that an ovo-vegetarian diet would exclude what food groups?

Answer 18

An ovo-vegetarian diet is predominately vegetable (plant) - based and excludes dairy and meat products. Eggs are allowed on this diet.

Question 19

The nurse understand that a macrobiotic diet excludes which food groups?

Answer 19

A macrobiotic diet excludes meats. The diet is predominately plant-based but includes fish and seafood.

Question 20

The nurse understands that a flexitarian diet consists of what dietary recommendations?

Answer 20

Flexitarians occasionally consume meat, fish, and dairy. The diet is predominately plant-based.

Question 21

The nurse is providing dietary teaching for a mother of a toddler. What information would be important to include?

Answer 21

Toddlers (1 year to 3 years) should limit juice intake to 4 to 6 oz a day. Whole milk is recommended to provide adequate fat intake. Be alert to questions that recommend too much milk intake such as more than 3 cups a day because “milk-aholics” are at risk for nutrient deficiency particularly iron the child may also be overweight. The toddler should eat a variety of food groups with special attention paid to limit choking hazards such as hotdogs, grapes, berries, and foods that become gummy in the mouth.

Question 22

The nurse is providing nutrition counseling to the parents of a preschooler. What information should the nurse include?

Answer 22

The nurse should recommend the preschooler (3 to 6 year old) eats a variety of food groups. The protein intake recommendation is 13 to 19 g/day of complete protein sources for this age group. The parent may transition the child to low-fat or skim (nonfat) milk after the child reaches at least two years of age.

Question 23

The nurse is providing teaching to the parents of a school-aged child. What recommendation should the nurse include?

Answer 23

School-age children (6 to 12 years old) should eat a well balanced diet. Weight loss programs are recommended if the child is 40% overweight.

Question 24

The nurse is teaching an adolescent about nutrition recommendations. What information should the nurse include?

Answer 24

The average diet of an adolescent is deficient in folate, vitamin A, vitamin E, iron, zinc, magnesium, calcium, and fiber. The daily caloric intake for a female age 12-18 year old is 2,000 calories/day. The daily caloric intake for a male age 12-18 years old is 2,200 to 2,800 calories /day.

Question 25

An adult client asks the nurse about what a balanced diet means. The nurse should educate the client that a balanced diet means:

Answer 25

Carb intake is 40 to 65%
Fat intake is 20 to 35%
Protein intake is 10 to 35%
Fluid intake 2 to 3 liters for women
Fluid intake 3 to 4 liters for men

Question 26

The nurse is caring for a client with pancreatitis. What nutritional interventions should the nurse anticipate for this client?

Answer 26

NPO with NG tube insertion
TPN may be prescribed until oral intake resumes
Low fat, high protein, and high carb diet
Supplements of vitamin C and B-complex vitamins.
Monitor for hypomagnesemia and hypocalcemia.
Monitor bowel sounds
Strict I & O
Enzymes are taken pre-meal or snack

Question 27

What would be included for dietary recommendations for clients experiencing dry mouth complications?

Answer 27

Avoid coarse foods
Consume citrus
Use sauces to soften food
Drink recommended fluid intake

Question 28

A client has a clear-liquid diet order. What would the nurse anticipate on the clients food tray?

Answer 28

Water, clear beverages, carbonated beverages, clear juice, coffee, tea, broth, and gelatin.

Question 29

A client has a full-liquid diet order. What would the nurse anticipate on the clients food tray?

Answer 29

Milk products (cream soups, pudding, custards)
Clear liquids
Strained vegetables, cereal, and fruits

Question 30

A client has a soft diet order. What would the nurse anticipate on the clients food tray?

Answer 30

This is a bland diet. Go light on seasonings. The diet is typically low fiber and digests easily. Think mashed potatoes, cream of rice, plain noodles, and other non-gas forming foods.

Question 31

A client has a mechanical soft diet order. What would the nurse anticipate on the clients food tray?

Answer 31

Minimum chewing is required on this diet. Foods such as diced meats, cooked vegs, cheese, and canned fruits.

Question 32

A client has a pureed diet order. What would the nurse anticipate on the clients food tray?

Answer 32

Pureed foods that are a thick liquid consistency.

Question 33

List high fiber foods:

Answer 33

• Beans
• Vegetables
• Oats
• Whole grains
• Cereals
• Nuts, seeds
• Raw or dried fruits
• Barley
• Flaxseed
• Avocado
• Chickpea
• Brown Rice
• Sweet Potato/Regular Potato
• Quinoa