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Nutrition Essentials for Nursing Practice 7th Edition Dudek Test Bank

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Nutrition Essentials for Nursing Practice 7th Edition Dudek Test Bank

ISBN-13: 978-1451186123

ISBN-10: 1451186126

Includes powerpoint presentations and answers to case studies, included with the test bank, for free.

 

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Nutrition Essentials for Nursing Practice 7th Edition Dudek Test Bank

ISBN-13: 978-1451186123

ISBN-10: 1451186126

 

 

 

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Free Nursing Test Questions:

  Origin:  Chapter 16- Nutrition for Patients with Metabolic, 1

Chapter:  16

Client Needs:  D3

Cognitive Level:  Comprehension

Difficulty:  Moderate

1. The nurse is discussing metabolic stress and how it creates protein catabolism with the nutrition class. The nurse is asked how you know protein catabolism is occurring. What would be the best answer?

 

  A) The body goes into a negative nitrogen balance.
  B) The body is full of free radicals.
  C) The body goes into a positive nitrogen balance.
  D) The body is full of free fatty acids.
  Ans: A
  Feedback:
  A negative nitrogen balance occurs as muscle proteins are catabolized to provide amino acids for protein synthesis, immune system proteins, and glucose synthesis.

 

 

  Origin:  Chapter 16- Nutrition for Patients with Metabolic, 2

Chapter:  16

Client Needs:  D1

Cognitive Level:  Comprehension

Difficulty:  Moderate

2. Many clients have nutritional needs that are high but whose appetites are poor, such as in clients with advanced COPD. What would be the best nursing action to take to promote maximum intake?

 

  A) Providing pain medications with meals to facilitate digestion
  B) Scheduling treatments during mealtimes to encourage between meal snacking
  C) Eating small frequent meals of soft food
  D) Encouraging the intake of empty-calorie foods and beverages to promote intake
  Ans: C
  Feedback:
  There are various strategies that can be used to promote maximum intake: encouraging small frequent meals; soft diet; drinking high-protein, high-calorie nutrition formulas; and using bronchodilators before eating are just a few.

 

 

  Origin:  Chapter 16- Nutrition for Patients with Metabolic, 3

Chapter:  16

Client Needs:  D1

Cognitive Level:  Comprehension

Difficulty:  Moderate

3. Refeeding syndrome is a potentially fatal complication of overfeeding. Why is refeeding syndrome so dangerous?

 

  A) It may result in dangerous shifts in serum phosphorus and other electrolytes.
  B) It results in a decrease in insulin.
  C) It occurs as a result of a low-calorie diet.
  D) It may lead to hypovolemic shock.
  Ans: A
  Feedback:
  Refeeding syndrome is the result of an abrupt change from a catabolic to an anabolic state. Hypophosphatemia, hypokalemia, hypomagnesemia can occur as cells rapidly remove these minerals from the bloodstream.

 

 

  Origin:  Chapter 16- Nutrition for Patients with Metabolic, 4

Chapter:  16

Client Needs:  D1

Cognitive Level:  Knowledge

Difficulty:  Moderate

4. During the stress response, hormonal changes cause metabolic changes in the body. What is an indication that stress hormone levels are declining?

 

  A) An increase in urinary nitrogen excretion
  B) A decline in serum glucose levels
  C) An increase in serum glucose levels
  D) Fluid retention
  Ans: B
  Feedback:
  Glucose is necessary for the various hormones to function. Resolution of the stress leads to a recovery phase and less need for glucose.

 

 

  Origin:  Chapter 16- Nutrition for Patients with Metabolic, 5

Chapter:  16

Client Needs:  D1

Cognitive Level:  Application

Difficulty:  Moderate

5. The nurse is admitting a critical client to the ICU. During the nutrition assessment, the nurse uses a simple method for estimating the client’s total calorie needs based on his weight of 60 kg and the fact that he is not obese. Approximately how many calories would this client require?

 

  A) 1260 to 1360 calories C) 1500 to 1800 calories
  B) 1320 to 1440 calories D) 1800 to 2400 calories
  Ans: C
  Feedback:
  A simple formula of 25 to 30 cal/kg can be used for nonobese adults to determine their calorie intake. Therefore, 60 kg × 25 cal/kg = 1500 calories and 60 kg × 30 cal/kg = 1800 calories.

 

 

  Origin:  Chapter 16- Nutrition for Patients with Metabolic, 6

Chapter:  16

Client Needs:  D1

Cognitive Level:  Application

Difficulty:  Moderate

6. It is important to meet the protein needs of all the clients. As the nurse caring for a client with fractures, how many grams of protein per kilogram of body weight should his diet provide?

 

  A)  0.8 to 1.2 g    B)  1.0 to 1.5 g    C)  1.2 to 2.0 g    D)  2.0 to 2.2 g
  Ans: C
  Feedback:
  Recommended amounts range from 1.2 g/kg to more than 2.0 g/kg, or 20% to 25% of total calories, depending on the client’s weight and type of critical illness. There is little evidence to support or refute any of the methods used in determining protein requirements.

 

 

  Origin:  Chapter 16- Nutrition for Patients with Metabolic, 7

Chapter:  16

Client Needs:  D1

Cognitive Level:  Knowledge

Difficulty:  Moderate

7. When a person is under acute stress, his or her metabolic and physiologic needs are highly individualized. Based on blood pressure, heart rate, and body temperature, decisions are made about which of the following?

 

  A) Fluid status C) Risk of refeeding syndrome
  B) Calorie intake D) Glucose load
  Ans: A
  Feedback:
  The physician determines the client’s fluid needs based on intake and output, blood pressure, heart rate, respiratory rate, and body temperature.

 

 

  Origin:  Chapter 16- Nutrition for Patients with Metabolic, 8

Chapter:  16

Client Needs:  D1

Cognitive Level:  Application

Difficulty:  Moderate

8. The nurse is counseling a client recovering from a major trauma. She is about to be released to go home and finish her recovery. The physician has ordered a high-protein diet for her at home, and the nurse is teaching her methods of increasing protein density in her diet. What would be the best method for this client to increase the protein density in her diet?

 

  A) Add butter to hot foods such as potatoes, cooked cereals, and soups.
  B) Use honey on toast, cereal, and in coffee.
  C) Substitute mayonnaise for salad dressing.
  D) Use double-strength milk (liquid milk fortified with skim milk powder).
  Ans: D
  Feedback:
  Various ways to increase protein is to add skim milk powder to milk; add cheese, peanut butter, and nuts to various foods; use yogurt instead of sour cream; and increase the use of eggs. The use of butter, honey, and mayonnaise will increase the calorie content.

 

 

  Origin:  Chapter 16- Nutrition for Patients with Metabolic, 9

Chapter:  16

Client Needs:  D1

Cognitive Level:  Application

Difficulty:  Moderate

9. The nurse works on a burn unit and is admitting a 16-year-old female who weighs 50 kg. She has severe burns covering 65% of total body surface area. A high-protein diet is ordered. The dietitian figures the client’s calorie and protein needs and orders approximately how many grams of protein per day?

 

  A)  50 to 65 g    B)  75 to 80 g    C)  100 to 115 g    D)  150 to 165 g
  Ans: C
  Feedback:
  There are several equations that can be used to determine protein needs. Using the 2.0 to 2.3 g/kg is one of the similar ones. This client will need 100 to 115 g daily (2.0 × 50 = 100) or (2.3 × 50 = 115).

 

 

  Origin:  Chapter 16- Nutrition for Patients with Metabolic, 10

Chapter:  16

Client Needs:  D1

Cognitive Level:  Application

Difficulty:  Moderate

10. The nurse is admitting a critical client to the surgical ICU. During the nutrition assessment, the nurse uses a simple method for estimating the client’s total calorie needs based on his weight of 100 kg and the fact that he is obese. Approximately how many calories would this client require?

 

  A) 1100 to 1400 calories C) 2000 to 2400 calories
  B) 1500 to 1900 calories D) 2500 to 2900 calories
  Ans: A
  Feedback:
  A simple formula for obese clients with a BMI greater than 30 indicates that calories may be estimated by using 11 to 14 cal/kg/day of actual weight. Therefore, using this formula: 11 × 100 = 1100 and 14 × 100 = 1400Remember, the client would need from 1100 calories to 1400 calories each day.

 

 

  Origin:  Chapter 16- Nutrition for Patients with Metabolic, 11

Chapter:  16

Client Needs:  D1

Cognitive Level:  Application

Difficulty:  Moderate

11. The client is going home on a high-protein diet. What would be the best dessert for someone who needs to increase his or her intake of protein?

 

  A)  Gelatin    B)  Pudding    C)  Cherry pie    D)  Sherbet
  Ans: B
  Feedback:
  The pudding is a milk-based food. The protein can easily be increased by adding skim milk powder to the milk when making. The other options would more likely increase the calorie intake.

 

 

  Origin:  Chapter 16- Nutrition for Patients with Metabolic, 12

Chapter:  16

Client Needs:  D1

Cognitive Level:  Knowledge

Difficulty:  Moderate

12. People with COPD often have difficulty taking in enough calories because of the fatigue they experience from the hypermetabolism of their respiratory stress. What would be an appropriate nutritional intervention for someone with COPD?

 

  A) Limit total fluid intake.
  B) Increase empty-calorie liquids with meals.
  C) Eat small frequent meals.
  D) Limit fiber.
  Ans: C
  Feedback:
  There are various strategies that can be used to help COPD clients increase their nutritional intake: eating small frequent meals, eating nutritionally dense foods, and limiting “empty” liquids with meals.

 

 

  Origin:  Chapter 16- Nutrition for Patients with Metabolic, 13

Chapter:  16

Client Needs:  D1

Cognitive Level:  Knowledge

Difficulty:  Moderate

13. The nurse is doing client education with a man and his wife before he leaves the hospital. The physician has ordered a high-calorie, high-protein diet for this client who is recovering from a major trauma. The wife asks for an example of a high-protein snack. What is the best response?

 

  A)  Yogurt    B)  Cream cheese on toast    C)  Italian ice    D)  Granola
  Ans: A
  Feedback:
  The yogurt is a milk-based food which is higher in protein. Italian ice is an “empty” calorie drink. Cream cheese on toast and granola would contain increased calories.

 

 

  Origin:  Chapter 16- Nutrition for Patients with Metabolic, 14

Chapter:  16

Client Needs:  D3

Cognitive Level:  Comprehension

Difficulty:  Moderate

14. The nurse is caring for a 21-year-old female burn victim. Her parents ask why their daughter has to be fed by a nasogastric tube (NG). What would be the best response?

 

  A) “Your daughter’s intestines are not working normally right now so we have to feed her through a tube.”
  B) “If your daughter were eating normally, she would get sicker because her intestines are not working right.”
  C) “We need to get a lot of calories and nutrients into your daughter to help her heal, and this is the best way to do that.”
  D) “Trying to eat normally would just wear your daughter outRemember, we feed her through a tube to conserve her energy.”
  Ans: C
  Feedback:
  Early enteral feedings may help maintain intestinal mucosa and reduce episodes of infection and the degree of hypermetabolic stress response. The formula can also be designed to meet the specific nutritional needs that might not be obtained by oral feedings.

 

 

  Origin:  Chapter 16- Nutrition for Patients with Metabolic, 15

Chapter:  16

Client Needs:  D1

Cognitive Level:  Application

Difficulty:  Moderate

15. The nurse is admitting to the unit a client who is a 42-year-old female with a COPD exacerbation. While doing the admission assessment, the nurse finds out that this client is being treated for depression and has had little or no appetite for over a month. What type of diet would be planned for this client?

 

  A) High-calorie, high-protein meals three times a day
  B) Small frequent meals spread out over the day
  C) Regular diet with vitamin and mineral supplements with the meals
  D) High-fiber diet with enteral supplements between the three meals
  Ans: B
  Feedback:
  Clients with COPD and anorexia should be encouraged to eat small frequent meals that are high-calorie and high-protein. Supplements of high-protein, high-calorie nutrition formulas can also be offered between meals.

 

 

  Origin:  Chapter 16- Nutrition for Patients with Metabolic, 16

Chapter:  16

Client Needs:  D1

Cognitive Level:  Application

Difficulty:  Moderate

16. The trauma client is being released home to complete his recovery. The diet that has been ordered is a high-calorie, high-protein diet in small frequent meals throughout the day. What would be the best sample menu for lunch for this client?

 

  A) Chicken salad sandwich on a croissant, milk, ice cream with chocolate sauce, and whipped cream
  B) New England clam chowder, black coffee, and pears in 100% pear juice
  C) Prime rib, baked potato with sour cream, a glass of white wine, and a piece of low fat cheesecake
  D) A smoothie made with yogurt, instant breakfast, skim milk and strawberries, and a cookie
  Ans: A
  Feedback:
  The chicken salad sandwich, milk, ice cream with chocolate sauce and whipped cream provides more calories and proteins than the other choices.

 

 

  Origin:  Chapter 16- Nutrition for Patients with Metabolic, 17

Chapter:  16

Client Needs:  D1

Cognitive Level:  Knowledge

Difficulty:  Moderate

17. The nurse is caring for a 33-year-old female who was in a motor vehicle accident. She is in the stress response phase. Which amino acid is depleted rapidly during stress?

 

  A)  Alanine    B)  Glutamine    C)  Glycine    D)  Tyrosine
  Ans: B
  Feedback:
  Glutamine, normally a nonessential amino acid, may become conditionally essential during periods of stress. It appears to be rapidly depleted during stress.

 

 

  Origin:  Chapter 16- Nutrition for Patients with Metabolic, 18

Chapter:  16

Client Needs:  D1

Cognitive Level:  Knowledge

Difficulty:  Moderate

18. The nurse is admitting a client with burns over 60% of the body. What would be the best type of nutrition for this client?

 

  A) Oral nutrition
  B) Oral nutrition with a liquid supplement
  C) Parenteral nutrition
  D) Enteral nutrition
  Ans: D
  Feedback:
  EN is used over PN, unless the EN is contraindicated. PN is used with extreme caution due to the increased risk of infection.

 

 

  Origin:  Chapter 16- Nutrition for Patients with Metabolic, 19

Chapter:  16

Client Needs:  D1

Cognitive Level:  Knowledge

Difficulty:  Moderate

19. The nurse is talking with the nutrition class about how the normal response to severe acute stress impacts metabolism. One of the students asks what the intensity of stress response is based on. What is the best response?

 

  A) The intensity of the stress response depends on the cause and the severity of the initial injury.
  B) The intensity of the stress response depends on the age and gender of the client.
  C) The intensity of the stress response depends on the gender and previous physical health of the client.
  D) The intensity of the stress response depends on the age and previous nutritional health of the client.
  Ans: A
  Feedback:
  The stress response is the body’s attempt to promote healing and resolve inflammation when homeostasis is disrupted. The intensity of the stress response depends to some extent on the cause and/or severity of the initial injury.

 

 

  Origin:  Chapter 16- Nutrition for Patients with Metabolic, 20

Chapter:  16

Client Needs:  D1

Cognitive Level:  Comprehension

Difficulty:  Moderate

20. The nurse is admitting an 18-year-old male to the ICU following a motor vehicle accident. The client is currently receiving IV fluids with no nutrition, as the physician tries to stabilize him. When should this client start on nutritional support?

 

  A) Immediately C) In 24 to 48 hours
  B) In 12 to 24 hours D) In 36 to 48 hours
  Ans: C
  Feedback:
  To be efficacious in reducing the risk of infectious complications, EN should be initiated as soon as fluid resuscitation is complete and the client is hemodynamically stable, preferably within the first 24 to 48 hours.

 

 

  Origin:  Chapter 16- Nutrition for Patients with Metabolic, 21

Chapter:  16

Client Needs:  D1

Cognitive Level:  Application

Difficulty:  Moderate

21. The nurse is caring for a 68-year-old male client who is receiving enteral nutrition (EN). The nurse is aware there is an increased risk for refeeding syndrome in this client due to which of the following conditions noted in his past medical history?

 

  A) Chronic alcoholism C) Cholecystectomy
  B) Morbid obesity D) Bariatric surgery
  Ans: A
  Feedback:
  Refeeding syndrome may occur by reintroducing carbohydrates to clients who have adapted to starvation by burning fat. This will increase insulin secretion and the thiamin and minerals involved in carbohydrate metabolism. Alcoholism is one of those conditions.

 

 

  Origin:  Chapter 16- Nutrition for Patients with Metabolic, 22

Chapter:  16

Client Needs:  D1

Cognitive Level:  Application

Difficulty:  Moderate

22. The client is a 50-year-old male with cancer, who has been losing weight. The nurse suggests the client eat which of the following to increase his calorie intake?

 

  A) Use plain yogurt in place of sour cream.
  B) Spread peanut butter on apple slices.
  C) Add butter to his hot foods.
  D) Substitute milk for water in recipes.
  Ans: A
  Feedback:
  Adding butter or margarine to hot foods is one way to add calories to the daily diet. The other choices will add protein to the diet.

 

 

  Origin:  Chapter 16- Nutrition for Patients with Metabolic, 23

Chapter:  16

Client Needs:  D1

Cognitive Level:  Knowledge

Difficulty:  Moderate

23. The nurse is reviewing the nutrition orders for a newly admitted client with an exacerbation of COPD. The nurse expects the client calorie needs to be which of the following?

 

  A) 110% above RMR C) 130% above RMR
  B) 120% above RMR D) 140% above RMR
  Ans: D
  Feedback:
  For clients hospitalized with an exacerbation of COPD, their calorie needs may be 140% above RMR.

 

 

  Origin:  Chapter 16- Nutrition for Patients with Metabolic, 24

Chapter:  16

Client Needs:  D1

Cognitive Level:  Application

Difficulty:  Moderate

24. The client is complaining that she is tired of the commercial high-calorie, high-protein drink and would like to have something different. Which of the following would be a good substitute for a snack?

 

  A) Cup of mixed fruit
  B) Smoothie made with yogurt, instant breakfast mix, whole milk, and strawberries
  C) Milkshake made with blueberries, frozen yogurt, and skim milk
  D) Snack crackers with cheese and grapes
  Ans: B
  Feedback:
  The smoothie contains more calories and protein than the other choices.

 

 

  Origin:  Chapter 16- Nutrition for Patients with Metabolic, 25

Chapter:  16

Client Needs:  D1

Cognitive Level:  Knowledge

Difficulty:  Moderate

25. The nurse recognizes her client who has recently lost a lot of weight is at risk for refeeding syndrome. Which of the following will be important to monitor in this client?

 

  A) Daily electrolyte levels C) Daily weight
  B) Blood pressure D) Intake and output
  Ans: A
  Feedback:
  Clients at high risk for refeeding syndrome should have their electrolytes monitored daily.

 

 

  Origin:  Chapter 16- Nutrition for Patients with Metabolic, 26

Chapter:  16

Client Needs:  D1

Cognitive Level:  Application

Difficulty:  Moderate

26. The nurse is caring for a 25-year-old male who has sustained burns over 30% of his body. If the client weighs 68 kg, approximately how many calories per day should this client consume (based on Curreri equation)?

 

  A)  1500 calories    B)  1700 calories    C)  1900 calories    D)  2100 calories
  Ans: B
  Feedback:
  Using the Curreri equation (25 cal × kg of body weight) + (40 cal × %TBSA) would be (25 × 68) + (40 × .30) = 1712; therefore, the client will need approximately 1700 calories each day.

 

 

  Origin:  Chapter 16- Nutrition for Patients with Metabolic, 27

Chapter:  16

Client Needs:  D1

Cognitive Level:  Application

Difficulty:  Moderate

27. The client is a 32-year-old, well-developed, well-nourished female who was struck by a car while jogging. She has been admitted to the ICU. The nurse has determined she weighs 115 pounds. What will be her recommended calorie intake using the simple equation?

 

  A) 1200 to 1400 calories C) 1400 to 1600 calories
  B) 1300 to 1500 calories D) 1500 to 1700 calories
  Ans: B
  Feedback:
  The simple equation for determined calorie needs is 25 to 30 cal/kg. To determine the weight, first convert the pounds to kilograms (pounds divided by 2.2 = kilograms) (115/2.2 = 52 kg) then multiply 25 × 52 = 1300 and 30 × 52 = 1560.

 

 

  Origin:  Chapter 16- Nutrition for Patients with Metabolic, 28

Chapter:  16

Client Needs:  D1

Cognitive Level:  Application

Difficulty:  Moderate

28. The client is a 38-year-old male who is critically ill. He has not been eating well although the staff has been encouraging him to eat. He is afraid of gaining too much weight. Which of the following would be an example of a good meal for this client?

 

  A) Granola with honey, fresh strawberries and milk, and hot tea with honey
  B) Smoothie made with yogurt, instant breakfast mix, and skim milk and peaches
  C) Omelet with ham, cheese, mushroom, and spinach; whole wheat toast with butter and jelly; and milk and coffee with whipped cream
  D) 2 strips bacon, 2 scrambled eggs fried in butter, 1 slice sourdough bread, and coffee
  Ans: C
  Feedback:
  The goal of the diet for critically ill clients is high-calorie, high-protein. The meal of an omelet, toast with butter and jelly, milk and coffee with whipped cream provide the most calories and protein of the four choices.

 

 

  Origin:  Chapter 16- Nutrition for Patients with Metabolic, 29

Chapter:  16

Client Needs:  D3

Cognitive Level:  Knowledge

Difficulty:  Moderate

29. Refeeding syndrome is a potentially fatal complication that can occur in critically ill clients. The nurse recognizes the seriousness of this complication as it can affect approximately how many clients?

 

  A)  14%    B)  24%    C)  34%    D)  44%
  Ans: C
  Feedback:
  Refeeding syndrome is a disorder that may affect as many as 34% of critically ill clients, producing symptoms that range from mild to life threatening.

 

 

  Origin:  Chapter 16- Nutrition for Patients with Metabolic, 30

Chapter:  16

Client Needs:  D1

Cognitive Level:  Knowledge

Difficulty:  Moderate

30. Evidence suggests that enteral nutrition (EN) is superior to parenteral nutrition (PN) and will impact client mortality among the critically ill in the ICU. Early EN has been noted to which of the following? Select all that apply.

 

  A) Lessen disease severity
  B) Modulate inflammatory responses
  C) Maintain the integrity of the gastrointestinal mucosa
  D) Prevent an ileus
  E) Prevent weight loss
  Ans: A, B, C
  Feedback:
  Early EN helps maintain the integrity of the gastrointestinal tract, modulate the stress and inflammatory responses, and lessen disease severity. It also allows for more calories and protein to be delivered during the early stages of an ICU admission while will have an impact on client mortality.

 

 

  Origin:  Chapter 16- Nutrition for Patients with Metabolic, 31

Chapter:  16

Client Needs:  D1

Cognitive Level:  Application

Difficulty:  Moderate

31. A client is admitted to the unit with COPD exacerbation; the client has been cooperative in all aspects of his nursing care except eating. His major complaints are dry mouth, constipation, and fatigue. Which of the following suggestions can the nurse make to help improve this client’s status? Select all that apply.

 

  A) Add gravies and sauces to food.
  B) Drink coffee with his meal.
  C) Rest before eating.
  D) Use the bronchodilator after eating.
  E) Increase fiber intake.
  Ans: A, C, E
  Feedback:
  There are various strategies the client can use to improve his nutritional intake: adding gravies and sauces to the food, resting before eating, and increasing his fiber intake will help with his complaints of dry mouth, constipation, and fatigue.

 

 

  Origin:  Chapter 16- Nutrition for Patients with Metabolic, 32

Chapter:  16

Client Needs:  D1

Cognitive Level:  Knowledge

Difficulty:  Moderate

32. The nurse is aware that there will be times when enteral nutrition (EN) will not be feasible to use with a critically ill client. Which of the following are indications to use parenteral nutrition (PN)? Select all that apply.

 

  A) For 3 to 4 days preoperatively for clients expected to undergo major reconstructive surgery
  B) On the 8th hospital day in a well-nourished client who has received nutrition
  C) As soon as possible in malnourished clients
  D) PN should be initiated only if the anticipated length of therapy is 4 days or more.
  Ans: B, C
  Feedback:
  When EN is not feasible or available, PN should be considered: only after 7 days of hospitalization in a previously well-nourished client who has not received any nutrition therapy, as soon as possible after admission in malnourished clients, for 5 to 7 days preoperatively in malnourished clients expected to undergo major upper gastrointestinal surgery, and PN should only be initiated if the anticipated length of PN therapy is 7 days or more.

 

 

  Origin:  Chapter 16- Nutrition for Patients with Metabolic, 33

Chapter:  16

Client Needs:  D1

Cognitive Level:  Knowledge

Difficulty:  Moderate

33. The nurse is preparing a client for discharge who was admitted for COPD exacerbation. During the admission, the nurse taught the client some strategies to increase his calorie intake in spite of his early satiety. Which of the following are some of those suggestions? Select all that apply.

 

  A) Avoid “gassy” foods.
  B) Rest before eating.
  C) Limit “empty” liquids with meals.
  D) Eat a soft diet.
  E) Try high-calorie, high-protein nutrition formulas.
  F) Use bronchodilator before eating.
  Ans: A, C, E
  Feedback:
  There are various strategies that can be used to increase calorie and protein intake in a client with COPD who is reporting difficulty with early satiety. Avoiding “gassy” foods and limiting “empty” liquids will help him to not feel as full. Using a high-calorie, high-protein formula will increase the content but not necessarily the amount. Resting before eating, eating a soft diet, and using his bronchodilator are useful strategies if he is having difficulties with shortness of breath.

 

 

  Origin:  Chapter 16- Nutrition for Patients with Metabolic, 34

Chapter:  16

Client Needs:  D1

Cognitive Level:  Application

Difficulty:  Moderate

34. The wife of a 69-year-old gentleman with COPD is frustrated her husband won’t eat enough. She has been trying to feed him frequent small meals but he says he isn’t hungry. Which of the following suggestions can the nurse make to increase his protein intake? Select all that apply.

 

  A) Add skim milk to milk.
  B) Use mayonnaise in place of salad dressing.
  C) Add marshmallows to hot chocolate.
  D) Add chopped eggs to casseroles.
  E) Melt cheese on sandwiches, hot vegetables, and potatoes.
  F) Add honey to fruit.
  Ans: A, D, E
  Feedback:
  The protein content of prepared foods can be increased by adding skim milk powder, eggs, and cheese. The addition of mayonnaise, marshmallows, and honey will increase the calorie density of foods.

 

 

  Origin:  Chapter 16- Nutrition for Patients with Metabolic, 35

Chapter:  16

Client Needs:  D3

Cognitive Level:  Knowledge

Difficulty:  Moderate

35. Clients with COPD are in respiratory stress. Malnutrition can occur because of this stress. What factors may contribute to malnutrition in the client with COPD? Select all that apply.

 

  A) Abdominal bloating D) Dyspnea
  B) Diarrhea E) Renal insufficiency
  C) Anorexia    
  Ans: A, C, D
  Feedback:
  As many as 30% of clients with COPD have low BMI. This may be due to anorexia, early satiety related to abdominal bloating, and fatigue due to dyspnea.

 

 

 

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