A nurse is conducting dietary teaching with a client who has a history of renal calculi. Which of the following instructions should the nurse include in the teaching?

• A. Consume foods containing vitamin C
• B. Drink 3.8 L (4 qt) of water throughout the day
• C. Suggest almonds as a snack
• D. Limit sodium intake to 3 g per day

Correct Answer: B. Drink 3.8 L (4 qt) of water throughout the day

The nurse should instruct the client to drink 3.8 L of water per day to keep urine diluted and decrease the risk of kidney stone formation.

Incorrect Answers:
A. The nurse should instruct the client to avoid large amounts of vitamin C, which can increase the risk of kidney stone formation.

C. The nurse should instruct the client to avoid high-oxalate foods like almonds or other types of nuts because they increase the risk of kidney stone formation.

D. The nurse should instruct the client to limit sodium intake to 2 g per day. A high-sodium diet increases the risk of kidney stone formation.

A nurse is providing dietary teaching for a client with AIDS who has stomatitis of the mouth. Which of the following instructions should the nurse include in the teaching?

• A. "You can suck on popsicles to numb your mouth."
• B. "Season food with spices instead of salt."
• C. "Avoid the use of a straw to drink liquids."
• D. "Eat foods at hot temperatures."
• Correct Answer: A. "You can suck on popsicles to numb your mouth."
• The nurse should instruct the client to suck on popsicles or ice chips, which can numb the mouth.
• Incorrect Answers:
  B. The client should avoid spices, acidic foods, and salt, which can irritate and burn the mouth.
• C. The client should instruct the client that using a straw can decrease the comfort when drinking liquids.
• D. The client should consume foods that are cold or at room temperature. Hot foods can be irritating or possibly burn the mouth.

A nurse is talking with the parent of a preschool-aged child who tells the nurse, "My child has suddenly become disinterested in certain foods." Which of the following statements should the nurse make?

• A. "During this phase, feed your child anything that she will eat."
• B. "Increase the amount of calories and water your child consumes."
• ✔
• Correct answer C
• C. "Keep a diary of the foods your child eats each day."
• D. "Provide a large variety of fruit juices for your child to choose from."
• Correct Answer: C. "Keep a diary of the foods your child eats each day."
• The nurse should encourage the parent to keep a diary of the foods the child eats throughout the day for 1 week. This can help the parent realize that the child may be eating better than expected. Evidence suggests that children can self-regulate their caloric intake. When they eat less at a meal, they can compensate by eating more at another meal or by having a snack.
• Incorrect Answers:
  A. The nurse should inform the parent that children's dietary habits can change from day to day. It is important to feed the child healthy foods and focus on the quality of food rather than the quantity of food during this time.
• B. The nurse should inform the client that calorie and fluid requirements decrease slightly in a preschool-aged child. The nurse should not promote an increase of calories and water in the child’s diet.
• D. The nurse should inform the parent that excessive consumption of sweetened beverages, including fruit juices, can be associated with adverse health effects such as dental caries, obesity, and metabolic syndrome.

A provider tells a client at 12 weeks gestation who practices Hinduism that she needs more protein in her diet and suggests eating more meat. After the provider leaves the examination room, the client tells the nurse that eating animal products will cause her to miscarry. Which of the following responses should the nurse make?

• ✔
• Correct answer A
• A. "Let’s discuss other foods that are also high in protein that you could substitute for meat."
• B. "Eating meat during pregnancy provides necessary protein and does not cause miscarriage."
• C. "Why do you think that eating animal products will cause you to have a miscarriage?"
• D. "Your doctor is recommending what is best for you and your baby."

Correct Answer: A. "Let’s discuss other foods that are also high in protein that you could substitute for meat."

Many cultures have beliefs about food that the nurse should respect. Discussing non-animal protein sources can help the client identify foods that do not conflict with her religious and cultural beliefs.

Incorrect Answers:
B. This is a nontherapeutic response that contradicts the client's beliefs.

C. Asking a "why" question is nontherapeutic. The client might not know the answer and could become defensive.

D. This is a nontherapeutic response that dismisses the client's concerns.

A nurse is caring for an older adult client who has dementia, gets up frequently to pace during meals, and eats sparingly. Which of the following actions should the nurse take?

• A. Provide finger foods for the client
• B. Offer food at fewer times each day to promote hunger
• C. Administer a benzodiazepine medication to the client before meals
• D. Assist the client to sit still during meals using soft restraints

Correct Answer: A. Provide finger foods for the client

Finger foods will provide nutrition and accommodate the client's behavior.

Incorrect Answers:
B. Offering food at fewer times each day is likely to decrease the client's intake and is inappropriate. Instead, the nurse should provide snacks between meals and in the evenings if the client is at risk of under nutrition.

C. Administration of a benzodiazepine medication before meals is a form of restraint and should be used only for the safety of the client or others. In addition, the medication can make the client drowsy.

D. Use of physical restraints should be reserved only for the safety of the client or others. In addition, restraining the client is likely to promote agitation.

A nurse is assessing a client. Which of the following findings should the nurse identify as an indication of protein-calorie malnourishment? (Select all that apply.)

• A. Gingivitis
• B. Dry, brittle hair
• C. Edema
• D. Spoon-shaped nails
• E. Poor wound healing

Correct Answers:

B. Dry, brittle hair

C. Edema

E. Poor wound healing

Dry, brittle hair that falls out easily suggests inadequate protein intake and malnutrition. Edema can occur when albumin levels are lower than the expected reference range and indicates protein-calorie malnutrition. Adequate wound healing depends on the ingestion of sufficient protein, calories, water, vitamins (especially C and A), iron, and zinc.

Incorrect Answers:
A. Gingivitis is a manifestation of vitamin C deficiency.

D. Spoon-shaped nails are a manifestation of iron deficiency.

A nurse is planning an in-service training session about nutrition. Which of the following statements should the nurse include in the teaching?

• ✔
• Correct answer A
• A. "Fats provide energy."
• B. "Carbohydrates repair body tissue."
• C. "Fats regulate fluid balance."
• D. "Carbohydrates prevent interstitial edema."

Correct Answer: A. "Fats provide energy."

Fat serves as a stored energy source for the body, providing 9 cal/g of energy.

Incorrect Answers:
B. Proteins play a role in tissue repair.

C. Protein is primarily responsible for regulating fluid balance.

D. The presence of protein prevents interstitial edema. An appropriate amount of albumin in blood keeps interstitial edema from occurring.

A nurse is conducting dietary teaching for a client who has AIDS. Which of the following instructions should the nurse include in the teaching?

• A. Discard leftovers after 8 hr
• B. Use a separate cutting board for poultry
• C. Thaw frozen foods at room temperature
• D. Store cold foods at 10°C (50°F) or less

Correct Answer: B. Use a separate cutting board for poultry

The nurse should instruct the client to use a separate cutting board for raw poultry. Raw poultry can contain bacteria such as salmonella, which may contaminate other foods or work surfaces. Using a separate cutting board prevents cross-contamination of work surfaces when preparing food.

Incorrect Answers:
A. Leftover foods should be discarded after 24 hr to prevent the growth of bacteria that can cause a foodborne illness.

C. The client should thaw frozen foods in the refrigerator to prevent the growth of bacteria that can cause a foodborne illness.

D. The client should store cold foods at 4.4°C (40°F) or less. This prevents the growth of bacteria that can cause a foodborne illness.

A nurse is calculating the protein needs of a young adult client who weighs 132 lb. The RDA for protein for an adult who has no medical conditions is 0.8 g/kg. How many grams of protein per day should the nurse recommend for this client? (Fill in the blank with the numeric value only.)

48g

Correct Answer: 48

132/2.2 = 60 kg

60 kg x 0.8 g = 48 g

A nurse is caring for a client who is receiving intermittent enteral feedings through an NG tube. The specific gravity of the client's urine is 1.035. Which of the following actions should the nurse take?

• A. Deliver the formula at a slower rate
• B. Request a lower-fat formula
• ✔
• Correct answer C
• C. Provide more water with feedings
• D. Instill a lactose-free formula

Correct Answer: C. Provide more water with feedings

The elevation in the client's specific gravity indicates dehydration. The nurse should provide more fluids either by adding free water to feedings or by instilling water between feedings. Another strategy is to request a formula that contains less protein.

Incorrect Answers:
A. Slowing the delivery rate is an intervention for diarrhea.

B. Instilling a lower-fat formula is an intervention for abdominal distention and bloating.

D. Instilling a lactose-free formula is an intervention for nausea and vomiting.

A nurse is caring for a client who has protein malnutrition. Which of the following foods should the nurse identify as a source of complete protein?

• ✔
• Correct answer A
• A. Eggs
• B. Cereal
• C. Peanut butter
• D. Pasta

Correct Answer: A. Eggs

Complete proteins contain all of the essential amino acids to support growth and homeostasis. Examples of complete proteins include eggs, meat, poultry, seafood, milk, yogurt, cheese, soybeans, and soybean products.

Incorrect Answers:
B. Incomplete proteins are missing one or more of the essential amino acids necessary to support growth and maintain homeostasis. Cereal is an example of an incomplete protein. However, it can be combined with skim milk to make a complete protein.

C. Peanut butter is an example of an incomplete protein. However, it can be combined with whole-wheat bread to make a complete protein.

D. Pasta is an example of an incomplete protein. However, it can be combined with cheese to make a complete protein

A nurse is planning care for a client who is receiving chemotherapy and has a protein deficiency. Which of the following interventions should the nurse include in the plan of care? (Select all that apply.)

• A. Mix powdered skim milk into liquid milk
• B. Add a raw egg to fruit smoothies
• C. Add a slice of cheese to hot vegetables
• D. Add honey to hot tea
• E. Mix yogurt into fresh fruit

A. Mix powdered skim milk into liquid milk

C. Add a slice of cheese to hot vegetables

E. Mix yogurt into fresh fruit

Dairy products are good sources of protein. Mixing powdered skim milk into liquid milk can provide the client with additional protein. Adding cheese to a vegetable can increase the client's protein intake. Adding yogurt to fresh fruit will increase the client's protein intake.

Incorrect Answers:
B. Clients who are immunocompromised should avoid foods that contain raw eggs because they are a potential source of infection.

D. Adding honey to hot tea can increase the client's caloric intake, but this will not increase the client’s protein intake.

A nurse is providing teaching to a client who has type 2 diabetes mellitus. The client states, "I eat pasta every day. I can't imagine giving it up." Which of the following responses should the nurse provide?

• A. "Let’s discuss this with your doctor; giving up daily pasta may not be necessary."
• B. "Is there another favorite dish you can substitute?"
• ✔
• Correct answer C
• C. "You don’t have to give up pasta; just adjust the amount you eat."
• D. "You can use no-added-salt tomato products on your pasta."

Correct Answer: C. "You don’t have to give up pasta; just adjust the amount you eat."

The American Diabetes Association recommends individualizing carbohydrate restriction for each client. A careful assessment of the client’s usual dietary practices and modifications is an important part of teaching clients to manage this disorder.

Incorrect Answers:
A. The nurse is capable of counseling clients and providing resources about appropriate dietary choices without consulting the provider.

B. Although this idea has some merit, the client is expressing dismay about giving up pasta. Often, there is no substitute for what the client really enjoys.

D. While reduced sodium intake is recommended for most clients, especially those who have hypertension, this is not a solution for this client’s concern about pasta. Additionally, it does not relate to glycemic control, which is a critical issue for this client.

A nurse is providing teaching to a client who has COPD about maintaining proper nutrition. Which of the following statements by the client indicates an understanding of the teaching?

• A. "I will increase my fluid intake when I eat a meal."
• ✔
• Correct answer B
• B. "I will eat more cold foods at meals rather than hot foods."
• C. "I will avoid high-fat foods like butter and gravies."
• D. "I will cook my meals instead of eating convenience foods."

Correct Answer: B. "I will eat more cold foods at meals rather than hot foods."

The client should prepare more cold foods to eat because they provide a decreased feeling of fullness compared to hot foods.

Incorrect Answers:
A. Drinking fluids with meals will contribute to early satiety. The client should consume as much food as possible prior to feeling full or tired.

C. The nurse should encourage the client to add items such as butter, sauces, and gravy to foods to increase caloric intake.

D. The nurse should recommend the client eat convenience foods, easy-to-prepare meals, and ready-prepared meals because they take less energy to cook.

A nurse is providing teaching about nutrition to an older adult client. The client asks, "Don't I need the same amount of nutrients that I did when I was younger?" Which of the following responses should the nurse make?

• A. "Older adults need less protein."
• B. "Older adults need an increased amount of carbohydrates."
• C. "Older adults need an increased amount of iron."
• ✔
• Correct answer D
• D. "Older adults need an increased amoCorrect Answer: D. "Older adults need an increased amount of calcium."
• Older adults require increased amounts of calcium as well as vitamins D, B12, and A.
• Incorrect Answers:
  A. Many older adults require increased amounts of protein because total body protein can decrease as the body ages.
• B. Older adults do not require an increased amount of carbohydrates, although some older adults might require increased amounts of fiber.
• C. Older adults do not require increased amounts of iron. However, their intake of iron is often inadequate.
• unt of calcium.
• "A nurse is caring for an infant who has gastroenteritis and is dehydrated. Which of the following characteristics places the infant at a higher risk of electrolyte imbalances compared to an adult client?
• A. Less extracellular fluid
• B. Reduced body surface area
• ✔
• Correct answer C
• C. Longer intestinal tract
• D. Decreased rate of metabolism
• Correct Answer: C. Longer intestinal tract
• Compared to adults or older children, infants have a longer intestinal tract. This results in greater fluid losses, especially through diarrhea.
• Incorrect Answers:
  A. Compared to adults or older children, infants have a larger amount of extracellular fluid. This results in a larger fluid volume and more rapid water loss in this age group.
• B. Compared to adults or older children, infants have a larger body surface area. This results in greater fluid losses through insensible means.
• D. Compared to adults or older children, infants have an increased rate of metabolism. This results in the production of more metabolic waste, which must be excreted by the kidneys

A nurse is caring for a client who has diverticulitis and a new prescription for a low-fiber diet. Which of the following food items should the nurse remove from the client's meal tray?

• A. Canned fruit
• B. White bread
• C. Broiled hamburger
• ✔
• Correct answer D
• D. Coleslaw

Correct Answer: D. Coleslaw

Coleslaw contains raw cabbage, which is high in fiber. Clients who are following a low-fiber diet should avoid most raw vegetables.

Incorrect Answers:
A. Canned fruit is an appropriate low-fiber food for a client who is following a low-fiber diet. Fresh fruit contains more fiber.

B. White bread is an appropriate low-fiber food for a client who is following a low-fiber diet. Wholegrain bread contains more fiber.

C. Broiled hamburger is an appropriate low-fiber food for a client who is following a low-fiber diet. Fish and poultry are also low in fiber.

A nurse is caring for a client who has a BMI of 29 and expresses a desire to lose weight. Which of the following actions should the nurse take first?

• A. Refer the client to a nutritionist
• B. Discuss eating strategies with the client
• ✔
• Correct answer C
• C. Determine the client's intention to change current eating habits
• D. Instruct the client to perform 30 min of vigorous exercise daily

Correct Answer: C. Determine the client's intention to change current eating habits

When using the nursing process, the nurse should first assess the client's readiness to commit to a change in behavior.

Incorrect Answers:
A. Effective weight management involves establishing and following healthy eating habits. The nurse should refer the client to a nutritionist for an evaluation of the client's dietary needs and dietary recommendations to promote weight loss. However, this is not the first action the nurse should take.

B. The nurse should discuss various eating strategies, such as portion control and the reduction or elimination of sugar-sweetened beverages, as a means of reducing weight. However, this is not the first action the nurse should take.

D. Although the nurse should recommend increasing physical activity to promote overall health and weight loss, this is not the first action the nurse should take.

A nurse is caring for a client who has a deficiency of vitamin D. Which of the following foods should the nurse recommend the client include in his diet?

• ✔
• Correct answer A
• A. Whole milk
• B. Chicken
• C. Oranges
• D. Dried peas

A nurse is caring for a client who has a deficiency of vitamin D. Which of the following foods should the nurse recommend the client include in his diet?

• ✔
• Correct answer A
• A. Whole milk
• B. Chicken
• C. Oranges
• D. Dried peas

Correct Answer: A. Whole milk

The fat-soluble vitamins (A, D, E, and K) require fatty substances or tissues to be dissolved and also require the presence of bile in the small intestine for absorption. Whole milk contains vitamins A and K and is often fortified with vitamin D.

Incorrect Answers:
B. The water-soluble vitamins (B complex and C) readily dissolve in water and are absorbed into the bloodstream from the small intestine. Chicken contains many of the B complex vitamins, including B2, B3, B6, B12, and pantothenic acid.

C. The water-soluble vitamins (B complex and C) readily dissolve in water and are absorbed into the bloodstream from the small intestine. Oranges are a good source of vitamin C.

D. The water-soluble vitamins (B complex and C) readily dissolve in water and are absorbed into the bloodstream from the small intestine. Dried peas are a good source of many of the B complex vitamins, including B1, folate, and pantothenic acid.

A nurse is providing teaching to a female client who has a new prescription for pravastatin to treat hyperlipidemia. Which of the following pieces of information should the nurse include in the teaching?

• ✔
• Correct answer A
• A. Pravastatin can be taken with grapefruit juice.
• B. Pravastatin can be continued during pregnancy.
• C. Pravastatin should be taken with the morning meal.
• D. Laboratory testing to monitor the client’s WBC count is required.

Correct Answer: A. Pravastatin can be taken with grapefruit juice.

Pravastatin, unlike other statins, such as lovastatin, simvastatin, and atorvastatin, is not affected by CYP3A4 inhibitors. It is safe for the client to consume grapefruit juice if desired.

Incorrect Answers:
B. Pravastatin can cause fetal anomalies if taken during pregnancy. The nurse should instruct the client to notify her provider if pregnancy is planned or if she becomes pregnant.

C. Taking pravastatin in the evening is recommended as the synthesis of cholesterol increases during the night, thereby increasing the efficacy of the medication. The nurse should instruct the client to take the medication at bedtime.

D. Clients who are taking statin medications should have laboratory testing to evaluate liver function prior to starting the medication and should undergo cholesterol and triglyceride testing periodically during treatment. Pravastatin does not affect the WBC count

A nurse is planning dietary teaching for a client who has diabetes mellitus. Which of the following actions should the nurse plan to take first?

• A. Obtain sample menus from the dietitian to give to the client
• ✔
• Correct answer B
• B. Ask the client to identify the types of foods she prefers
• C. Identify the recommended range of the client’s blood glucose level
• D. Discuss long-term complications that can result from non-adherence to the dietary plan

Correct Answer: B. Ask the client to identify the types of foods she prefers

The nurse should apply the nursing process priority-setting framework to plan client care and prioritize nursing actions. Each step of the nursing process builds on the previous step, beginning with an assessment or data collection. Before the nurse can formulate a plan of action, implement a nursing intervention, or notify the provider of a change in the client's status, the nurse must first collect adequate data from the client. Assessing or collecting additional data will provide the nurse with the knowledge to make an appropriate decision. Therefore, the nurse should first ask the client about individual food preferences to provide an opportunity for the nurse to include these foods in her diet. Involving the client in the planning will promote her adherence to the dietary plan.

Incorrect Answers:
A. The nurse should work with a registered dietitian to provide the client with appropriate materials to use during the dietary teaching. Sample menus can give the client ideas of new foods or exchanges; however, there is another action that the nurse should take first.

C. The nurse should identify the recommended blood glucose range that the client should maintain through diet, medication, and lifestyle changes; however, there is another action that the nurse should take first.

D. The nurse should identify long-term complications so the client understands the importance of adherence to the dietary plan; however, there is another action that the nurse should take first.

A nurse is planning care for a client who is postoperative following a gastrectomy. Which of the following strategies should the nurse include to help prevent dumping syndrome?

• A. Have the client drink plenty of water with meals
• ✔
• Correct answer B
• B. Eliminate simple sugars and sugar alcohols from the client's diet
• C. Limit the client’s intake to 2 meals per day
• D. Offer the client meals that are low in protein or protein-free

Correct Answer: B. Eliminate simple sugars and sugar alcohols from the client's diet

Sugar, honey, and sugar alcohols (e.g. sorbitol and xylitol) increase hypertonicity and propel food through the intestines faster than food without sweeteners.

Incorrect Answers:
A. The client should drink beverages between meals only, about 1 hour after eating solid foods. Mixing food and fluids propels the mixture through the gastrointestinal tract faster than solid food alone.

C. The client should have several smaller meals that include only 1 or 2 foods throughout the day.

D. The client should ingest protein at every meal to slow gastric emptying.

A nurse is caring for a group of clients on a medical-surgical unit. Which of the following disorders should the nurse identify as increasing the client’s metabolic needs? (Select all that apply.)

• A. COPD
• B. Hypothyroidism
• C. Cancer
• D. Parkinson's disease
• E. Major burns

Correct Answers:

A. COPD

C. Cancer

D. Parkinson's disease

E. Major burns

Clients who have COPD develop hypermetabolism as a result of the increased amount of energy used to breathe. Cancer can cause a number of metabolic changes, including hypermetabolism as a result of the tumor growth. Clients who have Parkinson's disease develop hypermetabolism because they burn calories due to muscular rigidity. Finally, clients who have major burns develop severe metabolic stress, which includes hypermetabolism and hypercatabolism.

Incorrect Answer:
(B) Insufficient thyroid hormone results in decreased metabolism.

A nurse is updating the plan of care for a client who has dumping syndrome. Which of the following instructions should the nurse include?

• A. Consume beverages with meals
• B. Eat 3 large meals per day
• C. Include high-fiber foods in the diet
• ✔
• Correct answer D
• D. Eat a source of protein with each meal

Correct Answer: D. Eat a source of protein with each meal

The nurse should include in the client's plan of care the instruction to eat a source of protein with each meal because protein delays gastric emptying.

Incorrect Answers:
A. The nurse should recommend consuming beverages between meals, which delays gastric emptying.

B. The nurse should recommend consuming small, frequent meals each day to delay gastric emptying and assist with digestion.

C. The nurse should recommend including low-fiber foods in the diet to delay gastric emptying.

A nurse is providing teaching to the guardian of a child who has celiac disease. Which of the following foods should the nurse instruct the guardian to omit from the child's diet?

• A. Cornflakes
• B. Reduced-fat milk
• C. Canned fruits
• D. Wheat bread

Correct Answer: D. Wheat bread

Clients who have celiac disease should eliminate as much gluten as possible from their diets. Wheat, rye, and barley contain gluten and should be eliminated from the diet of a child who has celiac disease.

Incorrect Answers:
A. Cornflakes do not contain gluten and do not have to be omitted from the diet of a child who has celiac disease.

B. Milk is gluten-free and does not have to be eliminated from the diet of a child who has celiac disease.

C. Canned fruits without additives are gluten-free and do not have to be eliminated from the diet of a child who has celiac disease.

A nurse is creating a plan of care for a client who adheres to Kosher dietary laws. Which of the following food selections should the nurse recommend?

• A. Baked pork chop
• B. Cheeseburger
• C. Ham and cheese omelet
• ✔
• Correct answer D
• D. Grilled salmon
• Correct Answer: D. Grilled salmon
• The nurse should recommend grilled salmon for a client who observes Kosher dietary laws. Grilled salmon is a fish with fins and scales, which can be consumed. Seafood with shells, such as lobster or crab, is prohibited.
• Incorrect Answers:
  A. A baked pork chop is a source of pork, which is prohibited by Kosher dietary laws.
• B. A cheeseburger contains both meat and dairy products, which may not be eaten at the same time and is prohibited by Kosher dietary laws.
• C. A ham and cheese omelet contains pork, which is prohibited by Kosher dietary laws.

A nurse is caring for a client who has a new diagnosis of pernicious anemia. The nurse should expect the client's provider to prescribe which of the following medications for this client?

• A. Ferrous sulfate
• B. Epoetin alfa
• C. Vitamin B12
• D. Folic acid

Correct Answer: C. Vitamin B12

The nurse should expect the client's provider to prescribe vitamin B12 for pernicious anemia.

Incorrect Answers:
A. The nurse should expect a prescription for ferrous sulfate for a client who has iron-deficiency anemia.

B. The nurse should expect a prescription for epoetin alfa for a client who has anemia secondary to chemotherapy.

D. The nurse should expect a prescription for folic acid for a client who has anemia due to a folic acid deficiency.

A nurse is presenting an in-service training session about nutrition. How many of the amino acids must be obtained from dietary intake?

• A. 6
• B. 9
• C. 11
• D. 15

Correct Answer: B. 9

Proteins are made up of chains of amino acids, which are composed of carbon, hydrogen, oxygen, and nitrogen. Nine amino acids are considered essential for the human body and must be obtained from diet. These include histidine, isoleucine, leucine, lysine, methionine, phenylalanine, threonine, tryptophan, and valine.

Incorrect Answers:
A. C. D. Of the 20 amino acids identified, the body is able to manufacture 11. These are defined as nonessential amino acids.

A nurse is caring for a client who is receiving total parenteral nutrition (TPN). Which of the following actions should the nurse take?

• A. Administer 0.9% sodium chloride until TPN is available from the pharmacy
• B. Check the client’s capillary blood glucose level every 4 hr
• C. Obtain the client’s weight each week
• D. Change the IV tubing every 3 days

Correct Answer: B. Check the client’s capillary blood glucose level every 4 hr

The nurse should check the client’s capillary blood glucose level every 4 hours or according to facility policy due to the client’s risk of hyperglycemia while receiving TPN. The dextrose concentration in TPN increases the risk of this complication.

Incorrect Answers:
A. The nurse should administer 10% dextrose in water or 20% dextrose in water if TPN is temporarily unavailable from the pharmacy.

C. A client who is receiving TPN is at risk for fluid imbalance due to the fluid administration and hyperosmolarity of the TPN; therefore, the nurse should monitor the client’s weight daily.

D. The nurse should change the IV tubing used for TPN every 24 hours to decrease the client’s risk of infection.

A nurse is caring for a client during her first prenatal visit and notes that she is lactose-intolerant. Which of the following foods should the nurse include on a list of calcium sources for this client?

• ✔
• Correct answer A
• A. Collard greens
• B. Cottage cheese
• C. Orange juice
• D. Broccoli

Correct Answer: A. Collard greens

Collard greens are a good source of lactose-free calcium. One cup of collard greens provides approximately the same amount of calcium as the equivalent volume of 240 mL (8 oz) of milk. Collard greens also contain folic acid, which is a nutrient women should consume during pregnancy to prevent birth defects.

Incorrect Answers:
B. Cottage cheese is a good source of calcium but contains lactose, which the client cannot tolerate.

C. Orange juice is high in vitamin C, but unless the orange juice is calcium-fortified, it is not a rich source of calcium.

D. Broccoli is high in folic acid, but it is not a rich source of calcium.

A nurse is caring for a client who is receiving radiation therapy for breast cancer and reports a metallic taste in the mouth. Which of the following dietary recommendations should the nurse share with the client?

• A. Eat with metal utensils
• B. Limit coffee
• C. Avoid citrus foods
• D. Offer mints

Correct Answer: D. Offer mints

The nurse should encourage the client to suck on mints, which can overcome the metallic taste the client is experiencing as a result of the radiation therapy.

Incorrect Answers:
B. The nurse should encourage the client to add coffee to sweet beverages or milk, as the coffee overcomes the sweetness of the beverage.

C. The nurse should encourage the client to consume foods that contain citrus or that have a tart flavor. This overcomes the metallic taste.

A nurse is caring for a client who has peripheral edema. The nurse should identify that which of the following nutrients regulates extracellular fluid volume?

• A. Sodium
• B. Calcium
• C. Potassium
• D. Magnesium

Correct Answer: A. Sodium

Sodium regulates extracellular fluid balance, nerve impulse transmission, acid-base balance, and various other cellular activities.

Incorrect Answers:
B. Calcium supports bone and tooth formation and facilitates nerve impulse transmission. However, it does not affect extracellular fluid volume.

C. Potassium affects storage of glycogen, nerve impulse transmission, cardiac conduction, and smooth muscle contraction. However, it does not affect extracellular fluid volume.

D. Magnesium affects enzyme and neurochemical activities and the excitability of cardiac and skeletal muscles. However, it does not affect extracellular fluid volume.

A nurse in a provider's office is assessing a client. The nurse determines the client's body mass index is 21.2. This finding is classified as which of the following?

• A. Underweight
• Correct answer B
• B. Healthy weight
• C. Overweight
• D. Obese

Correct Answer: B. Healthy weight

Body mass index (BMI) is a measure of an individual's weight relative to height. A BMI from 18.5 to 24.9 is in the healthy range. Therefore, this client's weight is considered healthy.

Incorrect Answers:
A. A BMI below 18.5 is considered underweight and a health risk.

C. A BMI from 25 to 29.9 is in the overweight range.

D. A BMI greater than or equal to 30 is in the obese range.

A nurse is educating a client who is at 10 weeks gestation and reports frequent nausea and vomiting. Which of the following statements should the nurse include in the teaching?

• A. "You should eat foods served at warm temperatures."
• B. "You should brush your teeth right after you eat."
• C. "You should try to eat sweet foods when you feel nauseated."
• D. "You should eat dry foods that are high in carbohydrates when you wake up."

Correct Answer: D. "You should eat dry foods that are high in carbohydrates when you wake up."

The nurse should instruct the client to eat foods that are high in carbohydrates such as dry toast or crackers upon waking or when nausea occurs.

Incorrect Answers:
A. The nurse should instruct the client to eat foods served at cool temperatures to decrease nausea and vomiting.

B. The nurse should instruct the client to avoid brushing her teeth immediately after eating to decrease vomiting.

C. The nurse should instruct the client to eat salty and tart foods during periods of nausea.

A nurse is providing teaching about calcium intake to a client who is breastfeeding. Which of the following is the recommended daily calcium intake for a client who is breastfeeding?

• A. 800 mg
• B. 400 mg
• C. 1,000 mg
• D. 2,000 mg

Correct Answer: C. 1,000 mg

The nurse should instruct the client that 1,000 mg of calcium is recommended for women age 19 and older, as well as those who are lactating. This amount of calcium is sufficient to meet the needs of the client and the infant because additional calcium is absorbed from the intestines during this time.

Incorrect Answers:
A. Although the calcium requirement for a client who is breastfeeding does not increase, the nurse should instruct the client that 800 mg of calcium is less than the daily recommended intake of 1,000 mg. The nurse should explore additional sources of calcium with the client if she does not consume milk products.

B. Although the calcium requirement for a client who is breastfeeding does not increase, the nurse should instruct the client that 400 mg of calcium is less than the daily recommended intake of 1,000 mg. The nurse should explore additional sources of calcium with the client if she does not consume milk products.

D. The nurse should identify that 2,000 mg of calcium is above the recommended daily intake of 1,000 mg. A high calcium intake can result in the development of kidney stones and decrease the absorption of other nutrients, such as iron and zinc.

A nurse is providing dietary teaching to a client who has dumping syndrome following gastric bypass surgery 4 days ago. Which of the following recommendations should the nurse include in the teaching?

• A. Avoid foods containing protein
• B. Drink liquids during each meal
• C. Eat foods that contain simple sugars
• D. Maintain a supine position after meals

A nurse is providing dietary teaching to a client who has dumping syndrome following gastric bypass surgery 4 days ago. Which of the following recommendations should the nurse include in the teaching?

• A. Avoid foods containing protein
• B. Drink liquids during each meal
• C. Eat foods that contain simple sugars
• D. Maintain a supine position after meals

Correct Answer: D. Maintain a supine position after meals

The nurse should instruct the client to lie supine after eating to help slow the rapid emptying of food into the small intestine. A client who has dumping syndrome should decrease the amount of food eaten at once, eat small meals more frequently, and eliminate fluids at mealtime. Fluid shifts occur in the upper gastrointestinal tract when food contents and simple sugars exit the stomach too rapidly, attracting fluid into the upper intestine and decreasing blood volume, which causes the client to experience nausea and vomiting, sweating, syncope, palpitations, increased heart rate, and hypotension.

Incorrect Answers:
A. The nurse should instruct the client to include foods containing protein at each meal and only to eat 1 or 2 foods from each food group at once. Protein, fats, and complex carbohydrates are better tolerated by a client who recently had gastric bypass surgery.

B. The nurse should instruct the client to avoid drinking liquids during meals and to wait 30 to 60 minutes after eating solid foods to drink liquids. Drinking liquids with meals increases the motility of the gastrointestinal tract.

C. The nurse should instruct the client to avoid eating foods that contain simple sugars. Simple sugars increase the hypertonicity of the gastrointestinal tract, which increases the movement of the food bolus.

A nurse is teaching about a low-cholesterol diet to a client who had a myocardial infarction. Which of the following meal selections by the client indicates an understanding of the teaching?

• A. Chicken breast and corn on the cob
• B. Shrimp and rice
• C. Cheese omelet and turkey bacon
• D. Liver and onions

Correct Answer: A. Chicken breast and corn on the cob

The nurse should identify that chicken breast is low in cholesterol, and all vegetables, including corn, are cholesterol-free; therefore, this food selection by the client indicates an understanding of the teaching.

Incorrect Answers:
B. Shrimp are high in cholesterol and should be eaten in moderation; therefore, this food selection does not indicate an understanding of a low-cholesterol diet.

C. Eggs and cheese are high in cholesterol; therefore, this food selection does not indicate an understanding of a low-cholesterol diet.

D. Liver and other organ meats are high in cholesterol; therefore, this food selection does not indicate an understanding of a low-cholesterol diet.

A nurse is reviewing the laboratory findings of a client who has protein-calorie malnutrition. Which of the following findings should the nurse expect?

• A. Decreased albumin
• B. Elevated hemoglobin
• C. Elevated lymphocytes
• D. Decreased cortisol

Correct Answer: A. Decreased albumin

A decrease in the albumin level can be an indication of long-term protein depletion. Other potential conditions that result in decreased albumin levels include burns, wound drainage, and impaired hepatic function.

Incorrect Answers:
B. Protein-calorie malnutrition can negatively impact the production of RBCs, resulting in a decrease in hemoglobin.

C. Nutritional deficiencies such as protein-calorie malnutrition can result in low lymphocyte levels, which increases the client's risk of infection.

D. Cortisol is a glucocorticoid that plays a role in the metabolism of proteins, fats, and carbohydrates. Low levels are associated with Addison's disease. However, cortisol is not reflective of protein-calorie malnutrition.

A nurse is caring for a client who has xerostomia with a lack of saliva. Which of the following nutrients will be affected by the lack of salivary amylase?

• A. Fat
• B. Protein
• C. Starch
• D. Fiber

Correct Answer: C. Starch

Salivary amylase begins the process of digestion in the mouth with the initial breakdown of starches. The majority of starch breakdown occurs in the small intestine with pancreatic amylase.

Incorrect Answers:
A. Lipase breaks down fats.

B. Pepsin breaks down proteins.

D. Fiber is not digestible, but fermentation occurs in the large intestine by intestinal microbes, which results in the release of methane, hydrogen, water, and fatty acids.

A nurse is planning an in-service training session about nutrition. Which of the following pieces of information should the nurse include?

• A. Fat breaks down into amino acids.
• B. Protein serves as an energy source when other sources are inadequate.
• C. Glucose breaks down into ammonia.
• D. Carbohydrates provide 9 cal/g of energy.

Correct Answer: B. Protein serves as an energy source when other sources are inadequate.

Protein is used as an energy source for the body when carbohydrates and fat stores are unavailable or depleted.

Incorrect Answers:
A. Protein breaks down into amino acids.

C. Protein breaks down into ammonia. Glucose does not produce any products of metabolism.

D. Carbohydrates provide 4 cal/g of energy. Fat provides 9 cal/g of energy.

A nurse is teaching a client with heart disease about a low-cholesterol diet. Which of the following client statements indicates the teaching was effective?

• A. "I should remove the skin from poultry before eating it."
• B. "I will eat seafood once per week."
• C. "I should use margarine when preparing meals."
• D. "I can use whole milk in my oatmeal."

Correct Answer: A. "I should remove the skin from poultry before eating it."

The nurse should identify the client understands the teaching when he states he will remove the skin from poultry before eating, as the skin contains the greatest amount of fat.

Incorrect Answers:
B. A client who has heart disease and is on a low-cholesterol diet should eat seafood at least twice per week because it is high in omega-3 fatty acids.

C. A client who has heart disease and is on a low-cholesterol diet should use liquid oils such as canola oil instead of margarine, which is a solid fat.

D. A client who has heart disease and is on a low-cholesterol diet should use nonfat or low-fat milk instead of whole milk in oatmeal or cereal.

A nurse is planning an in-service training session regarding nutrition. Which of the following minerals should the nurse identify as involved in oxygen transportation?

• A. Zinc
• B. Iron
• C. Phosphorus
• D. Magnesium

Correct Answer: B. Iron

Iron transports oxygen by means of hemoglobin and myoglobin. It is also a component of enzyme systems.

Incorrect Answers:
A. Zinc plays a role in tissue growth and wound healing and supports immune function, but it does not affect oxygen transport.

C. Phosphorus plays a role in bone and teeth formation and energy metabolism, but it does not affect oxygen transport.

D. Magnesium affects enzyme and neurochemical activities and the excitability of cardiac and skeletal muscles, but it does not affect oxygen transport.

A nurse is providing teaching about food choices to a client who has diabetes mellitus. Which of the following statements by the client indicates an understanding of the teaching?

• A. "I will need to eliminate sweet desserts from my diet."
• B. "I should avoid using sucralose in my coffee."
• C. "I should consume alcohol between meals in moderation."
• D. "I should replace white bread with whole-grain bread."

Correct Answer: D. "I should replace white bread with whole-grain bread."

Clients with diabetes mellitus have the same fiber requirements as the general population. Fiber content can be increased by substituting white bread, which is made with refined grains, with whole-grain bread, which retains the outer layer of the grain that is higher in fiber.

Incorrect Answers:
A. Sweet desserts are not prohibited for clients who have diabetes mellitus. Instead, they should be consumed in moderation and substituted for other carbohydrates in the client's meal plan.

B. Sucralose is a non-nutritive sweetener that has been approved by the Food and Drug Administration for this use. It is considered safe for clients who have diabetes mellitus.

C. Although clients who have diabetes mellitus can consume alcohol in moderation, the nurse should instruct the client to consume alcohol with food to avoid hypoglycemia.

A nurse is teaching a client who has lactose intolerance about dietary modifications. Which of the following foods should the nurse recommend?

• A. Bread
• B. Soy cheese
• C. Luncheon meats
• D. Instant mashed potatoes

correct Answer: B. Soy cheese

The nurse should recommend lactose-free food items like soy cheese, soy yogurt, almond milk, and lactose-free milk.

Incorrect Answers:
A. Foods that might contain lactose include bread and breakfast cereals.

C. Foods that might contain lactose include luncheon meats, margarine, and salad dressings.

D. Foods that might contain lactose include instant mashed potatoes and instant soups.

A nurse is providing teaching to a client who has constipation. Which of the following instructions should the nurse include?

• A. Use bismuth subsalicylate regularly
• B. Consume a low-fiber diet
• C. Eat yogurt with live cultures
• D. Use bisacodyl suppositories regularly

Correct Answer: C. Eat yogurt with live cultures

Yogurt with live bacterial cultures provides dietary probiotics that help maintain and promote bowel function.

Incorrect Answers:
A. Bismuth subsalicylate is an antidiarrheal agent and will increase constipation.

B. Increasing fiber gradually can prevent constipation. A low-fiber diet is recommended for clients who have diarrhea.

D. The regular use of stimulant laxatives can result in decreased defecation reflexes, causing a reliance on stimulant laxatives for bowel movements. This may eventually cause electrolyte imbalances and colitis.

A nurse in a pediatric clinic is talking with the parent of a toddler who states that her child will not sit at the table to eat with the family. She asks the nurse for recommendations for "finger foods" for her child. Which of the following foods should the nurse suggest?

• A. Slices of ripe banana
• B. Popcorn
• C. Slices of hot dogs
• D. Raw carrots

Correct Answer: A. Slices of ripe banana

Toddlers should have about 8 oz (1 cup) of fruit per day. Bananas are nutritious and, as long as they are soft, do not present a choking hazard for young children.

Incorrect Answers:
B. Popcorn, chunks of cheese, and raisins present choking hazards for young children.

C. Hot dogs, sausages, and tough meat present choking hazards for young children.

D. Raw carrots, nuts, and seeds present choking hazards for young children.

A nurse in a provider's office is teaching a client about foods that are high in fiber. Which of the following food choices made by the client indicate an understanding of the teaching? (Select all that apply.)

• A. Canned peaches
• B. White rice
• C. Black beans
• D. Whole-grain bread
• E. Tomato juice

Correct Answers:

C. Black beans

D. Whole-grain bread

Dried peas and beans, including black beans, are high in fiber. Whole grains consist of the entire kernel and are also high in fiber.

Incorrect Answers:
A. Canned fruits, including peaches, are recommended for clients on a low-fiber diet. Fresh fruits contain more fiber.

B. White rice is recommended for clients on a low-fiber diet. Brown rice is higher in fiber.

E. Canned juices, with the exception of prune juice, are recommended for clients on a low-fiber diet

A nurse is providing postoperative teaching about the management of dumping syndrome to a client who had a partial gastrectomy. Which of the following instructions should the nurse include in the teaching?

• A. "Consume at least 4 oz of fluid with meals."
• B. "Take a short walk after each meal."
• C. "Use honey to flavor foods such as cereal."
• D. "Eat protein with each meal."

Correct Answer: D. "Eat protein with each meal."

The nurse should instruct the client to eat meals that are high in protein and fat with low to moderate carbohydrate content. Protein should be included in every meal because it delays digestion, which helps reduce the manifestations of dumping syndrome.

Incorrect Answers:
A. The client should avoid fluids at mealtimes to decrease gastric stimulation.

B. The client should lie down when experiencing early manifestations of dumping syndrome (e.g. tachycardia, syncope, or sweating) to slow the progress of food through the gastrointestinal tract.

C. The client should avoid simple carbohydrates such as honey, sugar, and syrup because they aggravate the stomach and worsen manifestations of dumping syndrome.

A nurse is caring for a client from the Middle East who has celiac disease. Which of the following actions should the nurse perform regarding the client's diet?

• A. Provide foods prepared according to kosher dietary law
• B. Ask the kitchen to prepare grits to meet the client’s dietary need for grains
• C. Determine the client's dietary preferences
• D. Prepare a diet tray that includes vegetable and barley soup

Correct Answer: C. Determine the client's dietary preferences

While generalizations are often made regarding the traditional eating practices of clients based on their cultural backgrounds, individual food choices can deviate from these generalizations. The nurse should assess the client's dietary habits before planning to meet dietary needs.

Incorrect Answers:
B. Although clients who have celiac disease are unable to consume grains such as wheat, rye, and barley, it is not culturally sensitive to request the preparation of certain foods without consulting the client.

D. Clients who have celiac disease are unable to process certain grains, including wheat, rye, and barley. If consumed, these grains can result in diarrhea, abdominal pain, and weight loss.

A nurse is providing teaching to a client who is beginning a vegan diet and is concerned about maintaining adequate protein intake. Which of the following food servings should the nurse recommend as having the highest amount of protein?

• A. 1/2 cup tomato soup
• B. 1/2 cup of raw broccoli
• C. 2 tablespoons of peanut butter
• D. 1 cup penne pasta

Correct Answer: C. 2 tablespoons of peanut butter

The nurse should determine that peanut butter is the best food source to recommend because it contains 7.11 g of protein per 2 tablespoons.

Incorrect Answers:
A. The nurse should recommend a different food because there is another choice that contains more protein. Tomato soup contains 1.08 g of protein per 1/2 cup.

B. The nurse should recommend a different food because there is another choice that contains more protein. Raw broccoli contains 3.6 g of protein per 1/2 cup.

D. The nurse should recommend a different food because there is another choice that contains more protein. Penne pasta contains 5.81 g of protein per cup.

A nurse is assisting a client who has dysphagia with eating meals. Which of the following actions should the nurse take?

• A. Add water to soups for a thinner consistency
• B. Encourage using water to clear the client's mouth
• C. Ask the client to think of a food that produces salivation
• D. Remind the client to rest after meals

Correct Answer: C. Ask the client to think of a food that produces salivation

To prevent dryness in the mouth during meals, which can be a risk factor for choking, the nurse should ask the client to think of a food that promotes salivation (e.g. lemon slices or dill pickles).

Incorrect Answers:
A. Thick liquids are easier for clients who have dysphagia to manage when swallowing.

B. Clients who have dysphagia should only drink fluids after clearing the mouth of food. They should use coughing and dry swallowing to remove food particles from the mouth.

D. Clients who have dysphagia should rest before meals to avoid fatigue when focusing on swallowing safe

Correct Answer: A. Corn tortilla with black beans

Children who have celiac disease are placed on a gluten-free diet. Gluten is found in wheat, rye, and barley. Selecting products made from corn indicates an understanding of the teaching, as corn and beans are gluten-free foods.

Incorrect Answers:
B. Pizza often contains gluten. Gluten is found in wheat, rye, and barley and should be avoided by a child who has celiac disease.

C. Prepared soups often contain gluten.

D. Hot dogs and hot dog buns often contain gluten.

A nurse is teaching the parent of a school-age child who has celiac disease. Which of the following foods selected by the parent indicates an understanding of the teaching?

• A. Corn tortilla with black beans
• B. Pizza
• C. Canned soup
• D. Hot dogs

Correct Answer: A. Corn tortilla with black beans

Children who have celiac disease are placed on a gluten-free diet. Gluten is found in wheat, rye, and barley. Selecting products made from corn indicates an understanding of the teaching, as corn and beans are gluten-free foods.

Incorrect Answers:
B. Pizza often contains gluten. Gluten is found in wheat, rye, and barley and should be avoided by a child who has celiac disease.

C. Prepared soups often contain gluten.

D. Hot dogs and hot dog buns often contain gluten.

A nurse is providing nutritional teaching to a group of clients. Which of the following definitions for the recommended dietary allowance (RDA) should the nurse include in the teaching?

• A. The RDA is a comprehensive term that includes various dietary standards and scales.
• B. The RDA defines the level of nutrient intake that meets the needs of healthy people in various groups.
• C. The RDA defines the levels of nutrients that should not be exceeded to prevent adverse health effects.
• D. The RDA is the daily percentage of energy intake values for fat, carbohydrate, and protein.

A nurse is teaching a group of clients about the functions of the liver and gallbladder. Which of the following should the nurse include in the teaching as the purpose of bile?

• A. Digesting fats
• B. Producing chyme
• C. Stimulating gastric acid secretion
• D. Providing energy

Correct Answer: A. Digesting fats

Bile is a product of the liver and aids in the digestion of fats.

Incorrect Answers:
B. Chyme is a semi-solid mixture of food and gastric secretions that is formed in the stomach.

C. Gastrin is a hormone produced by the stomach mucosa that stimulates the release of gastric secretions during the process of digestion.

D. Glycogen is stored in the liver and is released in the form of glucose to meet the body's energy needs.

A nurse is teaching an assistive personnel (AP) about dietary restrictions for a client who is taking phenelzine to treat depression. The AP's selection of which of the following foods for the client’s lunch indicates an understanding of the teaching?

• A. Bologna on wheat bread
• B. Chicken salad
• C. Cheddar cheese and crackers
• D. Pizza with pepperoni

Correct Answer: B. Chicken salad

Phenelzine is an MAOI. Clients taking MAOIs must avoid foods that contain tyramine due to the potential for a dangerous food-drug interaction. Foods high in tyramine include those that are processed and aged, such as luncheon meats and cheeses. This menu selection does not contain food high in tyramine and indicates an understanding of the teaching.

Incorrect Answers:
A. This menu selection includes a highly processed meat that contains tyramine; therefore, it is not an appropriate choice.

C. This menu selection includes an aged cheese that contains tyramine; therefore, it is not an appropriate choice.

D. This menu selection includes pizza, which typically includes aged cheese (such as parmesan) and processed meat, both of which contain tyramine; therefore, it is not an appropriate choice.

A nurse is reviewing the laboratory results of a client who has end-stage renal disease and reports fatigue. The client's hemoglobin level is 8 g/dL. The nurse should expect a prescription for which of the following medications?

• A. Erythropoietin
• B. Erythromycin
• C. Filgrastim
• D. Calcitriol

A nurse is reviewing the laboratory results of a client who has end-stage renal disease and reports fatigue. The client's hemoglobin level is 8 g/dL. The nurse should expect a prescription for which of the following medications?

• A. Erythropoietin
• B. Erythromycin
• C. Filgrastim
• D. Calcitriol

Correct Answer: A. Erythropoietin

Erythropoietin stimulates the production of RBCs and is used to treat anemia associated with chronic renal failure.

Incorrect Answers:
B. Erythromycin is used to treat infections. There is no indication that this client is experiencing an infection.

C. Filgrastim is used to stimulate the production of neutrophils. There is no indication that this client is experiencing neutropenia.

D. Calcitriol is used to prevent hypocalcemia in clients who have chronic kidney disease. There is no indication that this client is experiencing hypocalcemia.

A nurse is caring for a client who is receiving radiation therapy for mouth cancer and reports a dry mouth. Which of the following dietary recommendations should the nurse provide?

• A. Offer graham crackers as a snack
• B. Avoid foods containing citrus
• C. Rinse the mouth with an alcohol-based mouthwash before eating
• D. Use gravies or sauces to soften food
• Correct Answer: D. Use gravies or sauces to soften food
• The nurse should instruct the client to use gravies or sauces to soften foods and make them easier to eat.
• Incorrect Answers:
  A. The client should avoid eating dry, coarse foods such as graham crackers. This type of food can make the client's mouth feel more dry and unpleasant.
• B. The client should consume foods containing citrus to stimulate saliva.
• C. The client should rinse the mouth with an alcohol-free mouthwash before eating. Alcohol-based mouthwash can make the client's mouth drier.

A nurse in a provider's office is reviewing the medical records of a group of clients. Which of the following clients is at risk for iron deficiency? (Select all that apply.)

• A. A client who is postmenopausal
• B. A client who is a vegetarian
• C. A middle adult male client
• D. A client who is pregnant
• E. A toddler who is overweight

Correct Answers:

• B. A client who is a vegetarian
• D. A client who is pregnant
• E. A toddler who is overweight

A client who is a vegetarian might require additional iron because the availability of iron in vegetable food sources is limited. During pregnancy, maternal blood volume increases, and the fetus requires additional iron. Therefore, the RDA of iron for clients who are pregnant is increased to 27 mg per day. Toddlers who are overweight may get most of their calories from milk and foods that are not considered healthy, which increases their risk for iron-deficiency anemia.

Incorrect Answers:
A. Iron requirements are increased for women who have excessive blood loss due to menstruation. Generally, postmenopausal women do not require additional iron.

C. Most adult males consume adequate iron in their diet and do not require supplementation.

A nurse is caring for a client who has scurvy. Which of the following vitamin deficiencies should the nurse identify as the cause of this disease?

• A. Vitamin A
• B. Vitamin B3
• C. Vitamin C
• D. Vitamin D

Correct Answer: C. Vitamin C

• Vitamin C deficiency produces symptoms of scurvy such as delayed wound healing and capillary fragility.
• Incorrect Answers:
  A. A deficiency in vitamin A produces manifestations of night blindness and immunodeficiency. It is not associated with scurvy.
• B. A deficiency in vitamin B3 produces manifestations of pellagra, which include a scaly rash on sun-exposed skin, confusion, paranoia, and diarrhea.
• D. A deficiency in vitamin D produces manifestations of rickets and osteomalacia, which include bowed legs, fractures, and malformed teeth.

A nurse is teaching a group of parents of toddlers about measures to reduce the risk of choking. Which of the following foods increase the risk of choking in toddlers? (Select all that apply.)

• A. Hot dogs
• B. Grapes
• C. Bagels
• D. Marshmallows
• E. Graham crackers

Correct Answers:

• A. Hot dogs
• B. Grapes
• C. Bagels
• D. Marshmallows
• Foods that are shaped like a tube, such as hot dogs and grapes, place toddlers at risk for choking because they can completely block the throat when swallowed whole due to their shape and solidity. Foods that are hard to chew, such as bagels and marshmallows, place toddlers at risk for choking; if swallowed before they are adequately chewed, they can block the airway.

Incorrect Answer:
E. All foods and fluids can potentially cause choking. However, graham crackers become soft quickly when mixed with saliva. Their consistency when wet is more like cooked cereal or soft cookies soaked in milk. Therefore, graham crackers do not pose an increased choking hazard for toddlers.

A nurse is reviewing the laboratory reports of a client who is receiving enteral feedings. Which of the following values indicates a complication of enteral feeding that the nurse should report to the provider?

• A. Sodium 143 mEq/L
• B. Potassium 4.2 mEq/L
• C. BUN 25 mg/dL
• D. Glucose 185 mg/dL

Correct Answer: C. BUN 25 mg/dL

• A BUN level of 25 mg/dL is above the expected reference range of 10 to 20 mg/dL and indicates dehydration, which is a complication of enteral feedings. The nurse should report this laboratory value to the provider.

Incorrect Answers:
A. A sodium level of 143 mEq/L is within the expected reference range of 136 to 145 mEq/L and does not indicate a complication of enteral feeding.

• B. A potassium level of 4.2 mEq/L is within the expected reference range of 3.5 to 5.0 mEq/L and does not indicate a complication of enteral feeding.
• D. A glucose level of 185 mg/dL is within the expected reference range of <200 mg/dL for casual blood glucose and does not indicate a complication of enteral feeding.

A nurse is teaching dietary-modification strategies to a client who has been newly diagnosed with cirrhosis. Which of the following foods should the nurse recommend?

• A. Grilled chicken
• B. Potato soup
• C. Fish sticks
• D. Baked ham

Correct Answer: A. Grilled chicken

• The nurse should identify that a client who has cirrhosis requires protein to compensate for disease-related weight loss. Increasing protein intake from animal or plant sources will also provide the client with more energy.

Incorrect Answers:
B. A client who has cirrhosis should avoid foods that are high in sodium content, especially if ascites is present; therefore, the nurse should recommend another food choice.

• C. A client who has cirrhosis should avoid foods that are high in fat, especially if the client is experiencing steatorrhea; therefore, the nurse should recommend another food choice.
• D. A client who has cirrhosis should avoid foods that are high in sodium, especially if ascites is present; therefore, the nurse should recommend another food choice.

A nurse is providing teaching for a client who has a prescription for a low-sodium diet to manage hypertension. Which of the following statements by the client indicates an understanding of the teaching?

• A. "I can snack on fresh fruit."
• B. "I can continue to eat lunchmeat sandwiches."
• C. "I can have cottage cheese with my meals."
• D. "Canned soup is a good lunch option."

Correct Answer: A. "I can snack on fresh fruit."

• The nurse should identify that fresh fruits contain little to no sodium and are a good snack for a client who has hypertension.

Incorrect Answers:
B. Lunchmeats are usually high in sodium and should be avoided. The nurse should recommend choosing lower-sodium options, such as fresh fish or poultry.

• C. Cottage cheese contains 390 mg per 113 g (1/2 c) of sodium. The nurse should recommend choosing low-fat yogurt as a low-sodium snack.
• D. Canned soups contain high amounts of sodium. The nurse should instruct the client to avoid convenience and fast foods such as canned or dry-packaged soups.

A nurse is caring for a client who is recovering at home after inpatient treatment for burn injuries. To increase the protein density of the client's meals, which of the following recommendations should the nurse make to the client's caregiver?

• A. Use sour cream instead of plain yogurt
• B. Add honey to cooked cereals
• C. Use salad dressing in place of mayonnaise
• D. Add chopped hard-boiled eggs to soups and casseroles
• Correct Answer: D. Add chopped hard-boiled eggs to soups and casseroles
• Eggs are a good source of protein. Adding them to combination foods and coating meats with raw eggs before breading and cooking increases the protein density of those foods.
• Incorrect Answers:
  A. To increase protein density, the caregiver should use plain yogurt in place of sour cream.
• B. Adding honey to cereal increases the caloric density, not the protein density.
• C. Mayonnaise contains more protein than most salad dressings.

A nurse is providing nutritional counseling for a client who is pregnant. Which of the following nutrients should the nurse instruct the client to increase in her daily diet?

• A. Iron
• B. Calcium
• C. Vitamin E
• D. Vitamin K

Correct Answer: A. Iron

• Iron supplements are recommended during pregnancy to promote adequate transfer of iron to the fetus and to support the expansion of the maternal RBC mass.

Incorrect Answers:
B. Calcium is essential for fetal bone and tooth development. However, the recommended daily calcium intake for women of childbearing age is sufficient for a client who is pregnant.

• C. Vitamin E is essential for protection against oxidative stress, so it is important for women who are pregnant to have an adequate supply of this nutrient. However, the recommended daily vitamin E intake for women of childbearing age is sufficient for a client who is pregnant.
• D.) Vitamin K can help prevent a rare bleeding disorder in newborns. However, the recommended daily vitamin K intake for women of childbearing age is sufficient for a client who is pregnant.

A nurse is reviewing the dietary choices of a client who has chronic pancreatitis. Which of the following food items should the nurse suggest removing from the client's menu for the following day?

• A. White rice
• B. Broiled cod
• C. Ice cream
• D. Canned peaches
• Correct Answer: C. Ice cream
• Clients who have chronic pancreatitis should limit their fat intake to no more than 30% to 40% of total calories. Ice cream is high in fat, with 48 g of fat in a 1-cup serving of vanilla ice cream. The client should choose healthier fat-containing options to support a balanced diet, such as avocados and nuts.
• Incorrect Answers:
  A. Foods high in fiber can reduce lipase activity, making a low-fiber diet helpful for clients who have chronic pancreatitis. White rice is low in fiber, with only 1 g of fiber in a 1-cup serving.
• B. Clients who have chronic pancreatitis need an adequate amount of protein, about 1.5 g/kg/day. Fish is a good source of protein, with 26 g of protein in a 170 g portion of cod.
• D. Foods high in fiber can reduce lipase activity, making a-low fiber diet helpful for clients who have chronic pancreatitis. Canned peaches are low in fiber, with only 3 g of fiber in a 1-cup serving.

A nurse is reviewing a client's 24 hr dietary recall. The client reports eating a slice of toasted white bread with butter, a banana, a glass of milk, and a cup of coffee for breakfast; grilled chicken, a baked potato, and a glass of milk for lunch; an apple and cheddar cheese for a snack; and 2 servings of chicken, 2 cups of steamed broccoli, and a glass of milk for dinner. This client's diet is deficient in which of the following food groups?

• A. Dairy
• B. Vegetables
• C. Fruits
• D. Grains
• Correct Answer: D. Grains
• This client only consumed 1 serving of grains on the day of the 24-hour dietary recall. USDA dietary guidelines recommend 3 or more ounce-equivalents of whole-grain products per day. Additionally, the choice of white bread is low in fiber, which can lead to constipation and an increased risk of developing hyperlipidemia. The USDA guidelines recommend that at least half of the grains consumed should be whole grain.
• Incorrect Answers:
  A. The client consumed 3 servings of dairy throughout the day, which is the recommended daily amount according to USDA dietary guidelines.
• B. The client consumed 2.5 cups or more of vegetables, which is the recommended daily amount according to USDA dietary guidelines.
• C. The client consumed 2 servings of fruit, which is the recommended daily amount according to USDA dietary guidelines.

A nurse is assessing a client's nutritional status. The nurse determines the client is consuming 500 calories more per day than his energy level requires. If his dietary habits do not change, how long will it take the client to gain 4.5 kg (10 lb)?

• A. 10 months
• B. 5 months
• C. 5 weeks
• D. 10 weeks
• Correct Answer: D. 10 weeks
• Because 1 lb of body fat is equivalent to 3,500 calories, consuming 500 extra calories each day for 7 days would lead to a total of 3,500 calories and a 1 lb gain per week. At the rate of 1 lb per week, the client would gain 10 lb in 10 weeks.
• Incorrect Answers:
  B. At the rate of 1 lb per week, the client would gain 20 to 25 lb in 5 months.
• C. At the rate of 1 lb per week, the client would gain 5 lb in 5 weeks.

A nurse is planning care for a client who has AIDS and has developed stomatitis. Which of the following interventions should the nurse include in the plan of care?

• A. Rinse the mouth with chlorhexidine solution every 2 hr
• B. Limit fluid intake with meals
• C. Provide oral hygiene with a firm-bristled toothbrush after each meal
• D. Avoid salty foods
• Correct Answer: D. Avoid salty foods
• Stomatitis is an inflammation of the mucosa of the mouth, usually with ulcerations. Foods that are spicy, acidic, or salty should be avoided to prevent further irritation and damage to the oral mucosa.
• Incorrect Answers:
  A. Chlorhexidine is an antiseptic that could cause further irritation to the oral mucosa. The nurse should provide the client with 0.9% sodium chloride solution or baking soda to mix with water and use as a rinse aid.
• B. The nurse should plan to provide moist foods and liquids with meals to decrease the client's discomfort and to promote nutritional intake.
• C. The client's oral care should be provided with a soft-bristled toothbrush to avoid further irritation and damage to the oral mucosa.

A nurse is providing teaching to a young adult client who has a history of calcium oxalate renal calculi. Which of the following instructions should the nurse include?

• A. "Drink fruit punch or juice with every meal."
• B. "Consume 1,000 mg of dietary calcium daily."
• C. "Take 1 g of a vitamin C supplement daily."
• D. "Increase your daily bran intake."

Correct Answer: B. "Consume 1,000 mg of dietary calcium daily."

• Clients who are prone to the development of calcium oxalate stones should consume the recommended daily allowance for calcium for their age. The RDA for calcium for adults ages 19 to 50 is 1,000 mg daily. Calcium should be obtained from dietary sources rather than supplements that can promote the development of renal calculi.

Incorrect Answers:
A. Clients who are prone to renal calculi should limit beverages with a high sugar content such as fruit punch or juice because these beverages can promote the development of renal calculi.

• C. Clients who are prone to the development of calcium oxalate stones should avoid taking nutritional supplements, such as vitamin C. Taking 1 g of vitamin C daily can result in toxicity and promote the development of renal calculi.
• D. Clients who are prone to renal calculi should exclude bran from their diet because bran is high in oxalates, which can precipitate the formation of renal calculi.

A nurse is planning an in-service training session about various dietary practices. Which of the following pieces of information should the nurse include in the teaching?

• A. Ovo-vegetarian diets exclude eggs.
• B. Kosher diets have restrictions regarding how the food must be prepared.
• C. Macrobiotic diets are plant-based and exclude all animals and seafood.
• D. Flexitarian diets exclude the consumption of dairy products.
• Correct Answer: B. Kosher diets have restrictions regarding how the food must be prepared.
• Kosher diets are guided by a set of laws regarding the processing, preparation, and eating of food.
• Incorrect Answers:
  A. Ovo-vegetarian diets are primarily vegetable-based diets that exclude meat and dairy except for eggs.
• C. Macrobiotic diets are primarily plant-based but do include fish and seafood.
• D. Flexitarian diets are primarily plant-based with the occasional consumption of meat, fish, and dairy products.

A nurse is teaching a client with chronic kidney disease about predialysis dietary recommendations. The nurse should recommending restricting the intake of which of the following nutrients?

• A. Protein
• B. Carbohydrates
• C. Calcium
• D. Monounsaturated fats
• Correct Answer: A. Protein
• Dietary restrictions for clients who have chronic kidney disease vary based on the degree of kidney function; however, most clients need protein limitations. Predialysis protein restriction can help preserve some kidney function.
• Incorrect Answers:
  B. Clients who have chronic kidney disease require enough calories to avoid the use of muscle protein for energy. Carbohydrates are a good source of calories for these clients.
• C. Many clients who have chronic kidney disease require calcium, vitamin D, and iron supplements.
• D. Clients who have chronic kidney disease require enough calories to avoid the use of muscle protein for energy. Foods like canola oil and olive oil are monounsaturated fats that can supply additional calories in the client’s meals.

A nurse is planning an in-service training session for a group of nurses regarding the role of enzymes in digestion. Which of the following enzymes plays a role in the digestion of protein?

• A. Amylase
• B. Lipase
• C. Steapsin
• D. Pepsin
• Correct Answer: D. Pepsin
• Pepsin is an enzyme secreted by the gastric mucosa that breaks down protein into polypeptides. Other enzymes such as trypsin and aminopeptidase further break down the polypeptides into amino acids, which can be used by the body.
• Incorrect Answers:
  A. Amylase is an enzyme secreted by the pancreas and intestine that breaks down starches into glucose.
• B. Lipase is an enzyme secreted by the pancreas that breaks down triglycerides into monoglycerides.
• C. Steapsin is an enzyme secreted by the gastric mucosa that breaks down triglycerides into monoglycerides

A nurse is planning care for a client who has anorexia and nausea due to cancer treatment. Which of the following interventions should the nurse include?

• A. Serve foods at warm or hot temperatures
• B. Offer the client low-density foods
• C. Make sure the client lies supine after meals
• D. Limit drinking liquids with food
• Correct Answer: D. Limit drinking liquids with food
• Drinking beverages with food leads to early satiety and bloating, which results in the client consuming fewer calories.
• Incorrect Answers:
  A. The nurse should make sure the client receives cold or room-temperature foods.
• B. To increase the nutritional value of the food and the client's caloric intake, the nurse should make sure that the client receives high-protein, high-calorie, nutrient-dense foods. The client should also eat nutrient-dense foods first during meals.
• C. To reduce nausea, the client should sit upright for 1 hour after meals. The client should also rest before meals to conserve energy for eating and digesting food.

A nurse is providing teaching about nutritious diets to a group of adult women. Which of the following statements should the nurse include?

• A. "Include at least 3 g of sodium in your daily diet."
• B. "Limit wine consumption to 230 mL daily."
• C. "Include 2.5 cups of vegetables in your daily diet."
• D. "Limit water intake to 1.5 L each day."
• Correct Answer: C. "Include 2.5 cups of vegetables in your daily diet."
• Nutritious diets contain a variety of foods to ensure the required daily allowance of nutrients is ingested. The nurse should instruct the women to include 2.5 cups of vegetables and 2 cups of fruit in their daily diets. Fruits and vegetables should be a variety of colors to provide an assortment of nutrients.
• Incorrect Answers:
  A. The nurse should instruct the women to consume sodium in moderation. The American Heart Association recommends consuming less than 2.5 g of sodium daily, and the adequate intake (AI) is 1.5 g. Excessive intake of sodium can lead to hypertension.
• B. Although certain alcoholic beverages, such as red wine, contain phytochemicals that can reduce the risk of cardiovascular disease and offer anti-inflammatory properties, excessive intake can lead to a deficiency in other nutrients. The recommended amount of alcohol for women is a drink per day, which is equivalent to 350 mL (12 oz) of beer, 148 mL (5 oz) of wine, or 44 mL (1.5 oz) of hard alcohol that is over 80 proof.
• D. Water is an important component of a nutritious diet because it is necessary for the digestion, absorption, and transport of nutrients. The nurse should instruct these women to drink between 2 and 3 L of water daily to maintain homeostasis, based on client comorbidities, the climate, and the client's activity level.

A nurse is providing teaching to a client who has gout and urolithiasis. The client asks how to prevent future uric acid stones. Which of the following suggestions should the nurse provide? (Select all that apply.)

• A. Take allopurinol as prescribed
• B. Exercise several times a week
• C. Limit intake of foods high in purine
• D. Decrease daily fluid intake
• E. Avoid citrus juices

Correct Answers:

A. Take allopurinol as prescribed

B. Exercise several times a week

C. Limit intake of foods high in purine

The nurse should inform the client that allopurinol is an antigout medication that reduces uric acid, which helps prevent uric acid stone formation. Immobility is a risk factor for stone formation; therefore, the client should maintain a healthy lifestyle, including regular exercise. Purine increases the risk of uric acid stone formation; organ meats, poultry, fish, red wine, and gravy are high in purine.

Incorrect Answers:
D. Maintaining an adequate fluid intake of 2 to 3 L per day reduces the risk of stone formation.

E. Citrus juices alkalinize the urine, which helps prevent uric acid stone formation.

A nurse is completing dietary teaching with a client who has heart failure and is prescribed a 2 g sodium diet. Which of the following statements by the client indicates an understanding of the teaching?

• A. "I should use salt sparingly while cooking."
• B. "I can have yogurt as a dessert."
• C. "I should use baking soda when I bake."
• D. "I shoul
• Correct Answer: B. "I can have yogurt as a dessert."
• The client understands the teaching when he selects yogurt as a dessert. Yogurt is low in fat and sodium and is a good source of calcium and protein.
• Incorrect Answers:
  A. The client requires further teaching when he states he will use salt sparingly while cooking. Salt should be eliminated from the client's diet. Spices or vinegar, which are low in sodium, can be used to season the client's food.
• C. The client requires further teaching when he states he will use baking soda when baking. Baking soda is high in sodium and should be eliminated from the client's diet.
• D. The client requires further teaching when he states he should select canned vegetables instead of frozen. Canned vegetables are high in sodium and should be eliminated from the client's diet. Frozen or fresh vegetables, which are low in sodium, should be included.
• d use canned vegetables instead of frozen."

A nurse is providing teaching about nutrients to a client. Which of the following statements should the nurse include?

• A. "Carbohydrates transport nutrients throughout the body."
• B. "Fats prevent ketosis."
• C. "Protein builds and repairs body tissue."
• D. "Carbohydrates help regulate body temperature."

Correct Answer: C. "Protein builds and repairs body tissue."

The primary function of protein involves building and repairing body tissues (e.g. muscles, tendons, and collagen). The skin, hair, and nails are also made of protein structures. A diet that is low in protein can impair wound healing.

Incorrect Answers:
A. Proteins transport nutrients such as fats and fat-soluble vitamins throughout the body. Protein in the form of hemoglobin transports oxygen; in the form of albumin, it transports many medications.

B, Ketosis develops when the body relies only on fats to meet energy needs. Carbohydrates prevent ketosis by allowing the body to use fat effectively as an energy source without the production of ketones.

D. Fats help regulate body temperature by providing a protective layer when the environmental temperature drops.

A nurse is providing dietary teaching to a client who has chronic renal failure. Which of the following food choices by the client indicates an understanding of the teaching?

• A. Canned soup
• B. Grilled fish
• C. Pastrami
• D. Peanut butter

Correct Answer: B. Grilled fish

Protein choices, such as fresh fish or poultry, can minimize the risk of worsening chronic renal failure.

Incorrect Answers:
A. Foods that are high in sodium, such as canned soup, should be avoided by clients who have chronic renal failure.

C. Foods that are high in sodium, such as pastrami, should be avoided by clients who have chronic renal failure.

D. Foods that are high in sodium, such as peanut butter, should be avoided by clients who have chronic renal failure.

A nurse is providing teaching to a client regarding protein intake. Which of the following foods should the nurse include as an example of an incomplete protein?

• A. Eggs
• B. Soybeans
• C. Lentils
• D. Yogurt

Correct Answer: C. Lentils

Incomplete proteins are missing 1 or more of the essential amino acids necessary for the synthesis of protein in the body. Examples of incomplete proteins include lentils, vegetables, grains, nuts, and seeds.

Incorrect Answers:
A. B. D. Complete proteins such as eggs, soybeans, and yogurt contain all of the essential amino acids necessary for the synthesis of protein in the body.

A nurse is presenting an in-service training session about nutrition. Which of the following simple sugars should the nurse identify as the carbohydrate found in milk?

• A. Lactose
• B. Sucrose
• C. Maltose
• D. Fructose

Correct Answer: A. Lactose

The nurse should identify that lactose is a form of sugar that is found in milk.

Incorrect Answers:

B. Sucrose is table sugar and is also found in fruits and vegetables.

C. Maltose is found in germinating cereals, such as barley.

D. Fructose is found in honey and fruit.

A home health nurse is planning care for a client who is receiving chemotherapy and has neutropenia. Which of the following foods should the nurse include in the client's plan of care?

• A. Soft-boiled eggs
• B. Brie cheese made with unpasteurized milk
• C. Cold deli-meat sandwiches
• D. Baked chicken

Correct Answer: D. Baked chicken

Well-cooked meats, including baked chicken, do not pose a threat to clients who have neutropenia and may be included in the client's dietary plan. For optimal safety, poultry should be cooked to an internal temperature of 74°C (165°F).

Incorrect Answers:
B. Soft cheeses like brie, which are made with unpasteurized milk, can contain bacteria and should be avoided by clients who have neutropenia. Hard or processed cheeses or those clearly labeled as made with pasteurized milk are an alternative to brie for a client who has neutropenia.

C. Cold deli meats and lunch meats can contain Listeria monocytogenes. These bacteria remain viable at refrigerated and room temperatures and can make a client who is immunocompromised severely ill. As an alternative, the nurse should recommend heating all deli meats or lunch meats.

A nurse is caring for a client who has osteoporosis and a new prescription for calcium supplements. Which of the following foods should the nurse recommend to promote calcium absorption?

• A. Fortified milk
• B. Ripe bananas
• C. Steamed broccoli
• D. Green leafy vegetables

Correct Answer: A. Fortified milk

Fortified milk provides 2.45 mcg of vitamin D, which promotes calcium absorption from the gastrointestinal tract. Adults up to age 70 need 600 international units of vitamin D per day and 800 international units thereafter. Therefore, fortified milk is a good source of vitamin D.

Incorrect Answers:
B. Bananas are a good source of potassium and can reduce bone loss. However, bananas do not promote calcium absorption.

C. Broccoli is a good source of vitamin C, which is important for bone matrix formation. However, steamed broccoli does not promote calcium absorption.

D. Green leafy vegetables are a good source of vitamin K. However, green leafy vegetables contain oxalic acid, which decreases calcium absorption.