Nutrition, Feeding And Eating ATI Posttest

Which of the following strategies for enhancing the intake of healthful foods is appropriate for an adolescent? A) Encouraging the adolescent to consume snack foods with the grains food group B) Permitting the adolescent to skip breakfast to enhance appetite at later meals C) Making healthful food choices more convenient and available for the adolescent D) Allowing the adolescent complete autonomy in making food choices

A patient has finished a 16-oz container of orange juice. The intake and output sheet documents fluid in milliliters. Which of the following should the nurse document as intake?

Which of the following interventions should a nurse use at mealtimes for a patient who has visual deficits? A) Identify the food locations as though the plate were a clock B) Direct the order in which food items are consumed C) Have the patient tilt her head forward while eating D) Avoid talking to the patient during mealtime Identify the food location as though the plate were a clock. MY ANSWER Telling the patient, for example, that the chicken is at 9 o'clock and the broccoli is at 12 o'clock helps orient her to the items on the plate and thus facilitates independence in eating. Direct the order in which food items are consumed. The patient should direct the order of food as well as the speed at which to eat it. Visual deficits should not affect these personal choices. Have the patient tilt her head forward while eating. This intervention is recommended to facilitate swallowing in patients who have dysphagia, not visual impairment. Avoid talking to the patient during mealtime. Mealtime is a social activity. The nurse should converse with the patient or invite visitors to join the patient for meals.

A nurse is caring for a patient who has sustained a head injury and whose level of consciousness fluctuates. The provider prescribes a full liquid diet progressing to a pureed diet as tolerated. Before initiating feedings, it is essential that this patient undergo which of the following? A) Chest xray B) Swallowing examination C) Nasogastric tube insertion D) Olfactory nerve evaluation Chest x-ray Unless the patient has had any trauma in the chest area, this is not mandatory and is unlikely to provide any data confirming or refuting his ability to ingest food safely by mouth. Swallowing examination MY ANSWER Patients at high risk for aspiration include those with a decreased level of consciousness. This patient has some periods of decreased alertness, thus a swallowing examination is essential to determine his ability to ingest food safely by mouth. Nasogastric tube insertion Unless it has been determined that this patient cannot ingest food safely by mouth, this intervention is unlikely to be prescribed. Olfactory nerve evaluation Testing cranial nerve I, the olfactory nerve, determines the acuity of the patient's sense of smell. Although this sense can be associated with the patient's enjoyment of food, testing of this sense would not provide any data confirming or refuting his ability to ingest food safely by mouth.

Which of the following is the primary purpose for asking a patient to keep a 3- to 7-day food diary? A) To allow the patient to rely on health professionals to identify problem areas B) TO determine any changes in the patient's appetite C) To evaluate any significant changes in body weight D) To assess the pattern of intake and compare with daily reference intakes

Which of the following dietary modifications should an adolescent engaging in sports implement? A) In crease fats to 30% to 40% of daily kilocalories B) Drink water before and after sports activity C) Keep protein intake at the same level D) Decrease carbohydrates to 30% to 40% of daily kilocalories Increase fats to 30% to 40% of daily kilocalories. Fat needs are not increased for adolescents engaging in sports. Drink water before and after sports activities. MY ANSWER An adolescent should drink water before and after sports activities to prevent dehydration. Keep protein intake at the same level. Protein should be increased to 1.0 to 1.5 g/kg/day. Decrease carbohydrates to 30% to 40% of daily kilocalories. The acceptable macronutrient range for carbohydrates is 45% to 65% of total calories.

To assess a stroke patient for complications secondary to inadequate swallowing, the nurse should do which of the following? A) Auscultate the patient's lungs B) Place the tip of a tongue depressor on the patient's posterior tongue C) With a penlight, inspect the patient's uvula and the soft palate D) Place fingers on the patient's throat at the level of the larynx and ask him to swallow

When teaching the parents of a toddler about feeding and eating, the nurse should include which of the following safety measures? A) Do not give the child peanut butter B) Have the child drink 28 to 32 oz of milk daily C) Give the child 8 to 12 oz of fruit juice daily D) Do not offer the child raw vegetables Do not give the child peanut butter. This is a recommendation for infancy, because peanuts and peanut butter carry a high risk of severe allergic reactions. Once it has been determined that the child does not have multiple food allergies, peanut butter is an attractive source of protein for children. Have the child drink 28 to 32 oz of milk daily. More than 24 oz of milk daily in lieu of other foods may result in iron deficiency anemia. Give the child 8 to 12 oz of fruit juice daily. Juice should be limited to 4 to 6 oz per day because it is high in sugar content. Do not offer the child raw vegetables. MY ANSWER Raw vegetables, as well as hot dogs, grapes, nuts, popcorn, and candy, have been implicated in choking deaths and should be avoided at least until the child is 3 years old.

A nurse should recognize that which of the following is correct regarding albumin level as a diagnostic marker for nutritional status? A) Albumin level is a poor short-term indicator of protein status B) Hydration status does not affect a patient's albumin level C) An albumin level of 3.2 g/dL is within the normal reference range D) Albumin level is calculated by keeping a 24-hr record of protein intake

A nurse is caring for a patient who has impaired swallowing due to a cerebrovascular accident. Which of the following interventions should the nurse use to assist the patient with feeding? A) Provide the patient with a straw B) Offer the patient thin fluids C) Elevate the head of the bed 45 to 90 degrees D) Place food in the weaker side of the mouth Provide the patient with a straw. Patients with dysphagia cannot always control the amount of fluid they take in through a straw. Thus, it can increase their risk for aspiration. Offer the patient thin fluids. Thicker fluids are usually easier to swallow than thin fluids. Elevate the head of the bed 45 to 90°. MY ANSWER The patient's head should be sufficiently elevated to prevent aspiration. Place food in the weaker side of the mouth. For patients who have unilateral weakness, it is best to place food in the stronger side of the mouth.

A nurse is performing a nutritional assessment. When obtaining and interpreting anthropometric values, the nurse should recognize which of the following? A) Isolated measurements of height and weight are of greater significance than changes over time B) A weight increase of 4 lbs in a patient with renal failure indicates retention of 1,000 mL of fluid C) The patient should be weighed on the same scale at the same time each day D) The ratio of height-to-weight circumference is the most accurate way to identify obesity Isolated measurements of height and weight are of greater significance than changes over time. Changes in values for an individual over time are of greater significance than isolated measurements because they show trends that provide more information about the patient's health status. A weight increase of 4 lb in a patient with renal failure indicates retention of 1,000 mL of fluid. A 2-lb weight increase reflects retention of 1,000 mL of fluid. The patient should be weighed on the same scale at the same time each day. MY ANSWER Weighing a patient on the same scale at the same time of day provides the most consistent data for gauging trends in the patient's weight, as shifts in fluid intake and output can alter weight significantly. The patient should also be weighed with the same amount of clothing and/or linen each time. The ratio of height-to-wrist circumference is the most accurate way to identify obesity. Obesity is identified by multiple factors, particularly body mass index. Height-to-wrist circumference is an indicator of body-frame size.

Which of the following are appropriate choices for a patient described a full liquid diet? A) Plain yogurt B) Custard C) Pureed vegetables D) Mashed potatoes E) Pureed meat F) Gelatin MY ANSWER A full liquid diet includes smooth-textured dairy products (such as plain yogurt), custards, refined cooked cereals, vegetable and fruit juices, ice cream, and all the elements of a clear liquid diet, such as coffee, carbonated beverages, and gelatin. Mashed potatoes and pureed meat are not permitted until the patient progresses to a pureed diet or beyond.