NURS 235 Nutrition exam Study Guide

A nurse is calculating the body mass index (BMI) of a 35-year-old male patient who is extremely obese. The patient's height is 5'6" and his current weight is 325 lb. What would the nurse document as his BMI? a. 50.5 b. 52.4 c. 54.5 d. 55.2 - ANSWERSb. BMI= weight/height in inches X height in inches times 70.3 A nurse is evaluating a patient following the administration of an enteral feeding. Which findings are normal and are criteria that indicate patient tolerance to the feeding? Select all that apply. a. Absence of nausea, vomiting b. Weight gain c. Bowel sounds within normal range d. Large amount of gastric residue e. Absence of diarrhea and constipation f. Slight abdominal pain and distention - ANSWERSa, c, e Criteria to consider when evaluating patient feeding tolerance include: absence of nausea, vomiting, minimal or no gastric residue, absence of diarrhea and constipation, absence of abdominal pain and distention, presence of bowel sounds within normal limits. A nurse is feeding an older adult patient who has dementia. Which intervention should the nurse perform to facilitate this process? a. Stroke the underside of the patient's chin to promote swallowing b. Serve meals in different places and at different times c. Offer a whole tray of various foods to choose from d. Avoid between-meal snacks to ensure hunger at mealtime - ANSWERSa. To feed a patient with dementia, the nurse should stroke the underside of the patients chin to promote swallowing, serve meals in the same place and at the same time, provide one food item at a time since a whole tray may be overwhelming, and provide between-meal snacks that are easy to consume using the hands. A patient who has COPD is refusing to eat. Which intervention would be most helpful in stimulating appetite in this patient? a. Administering pain medication after meals b. Encouraging food from home when possible c. Scheduling his respiratory therapy before each meal d. Reinforcing the importance of his eating exactly what is delivered to him - ANSWERSB. Food from home that the patient enjoys may stimulate him to eat. Pain medication should be given before meals, respiratory therapy should be scheduled after meals, and telling the patient what he must eat is no guarantee that he will comply. A nurse is feeding a patient who is experiencing dysphagia. Which nursing intervention would the nurse initiate for this patient? a. Feed the patient solids first and then liquids last b. Place the head of the bed at a 30-degree angle during feeding c. Puree all foods to a liquid consistency d. Provide a 30-minute rest period prior to mealtime - ANSWERSd. When feeding a patient who has dysphagia, the nurse should provide a 30-minute rest period prior to mealtime to promote swallowing; alternate solids and liquids when feeding the patient; sit the patient upright or, if on bedrest, elevate the head of the bed at a 90-degree angle; and initiate a nutrition consult for diet modification and food size and/or consistency. A nurse is evaluating patients to determine their need for parenteral nutrition (PN). Which patients would be the best candidates for this type of nutritional support. Select all that apply. a. A patient with irritable bowl syndrome who has intractable diarrhea b. A patient with celiac disease not absorbing nutrients from the GI tract c. A patient who is underweight and needs short-term nutritional support d. A patient who is comatose and needs long-term nutritional support e. A patient who has anorexia and refuses to take foods via the oral route f. A patient with burns who has not been able to eat adequately for 5 days - ANSWERSa, b, f Assessment criteria used to determine the need for PN include an inability to achieve or maintain enteral access; motility disorders; intractable diarrhea; impaired absorption of nutrients from the GI tract; and when oral intake has been or is expected to be inadequate over a 7-to 14-day period. PN promotes tissue healing and is a good choice for a patient with burns who has an inadequate diet. Oral intake is the best method of feeding; the second best method is via the eternal route. For short term use (less than 4 weeks), a nasogastric or nasointestinal route is usually selected. A gastrostomy (enteral feeding) is the preferred route to deliver enteral nutrition in the patient who is comatose because the gastroesophageal sphincter remains intact, making regurgitation and aspiration less likely than with NG tube feedings. Patients who refuse to take food should not be force fed nutrients against their will. A nurse is feeding a patient who states that she is feeling nauseated and can't eat what is being offered. What would be the most appropriate initial action of the nurse in this situation? a. Remove the tray from the room b. Administer an antiemetic and encourage the patient to take small amounts c. Explore with the patient why she does not want to eat her food d. Offer high-calorie snacks such as pudding and ice cream - ANSWERSa. The first action of the nurse when a patient has nausea is to remove the tray from the room. The nurse may then offer small amounts of foods and liquids such as crackers or ginger ale. The nurse may also administer a prescribed antiemetic and try small amounts of food when it takes effect. A patient has been admitted to the alcoholic referral unit in the local hospital. Based on an understanding of the effects of alcohol on the GI tract, which is a priority concern related to nutrition? a. Vitamin B malnutrition b. Obesity c. Dehydration d. Vitamin C deficiency - ANSWERSa. The need for B vitamins is increased in alcoholics because these nutrients are used to metabolize alcohol, thus depleting their supply. Alcohol abuse specifically affects the B vitamins. Obesity, dehydration, and vitamin C deficiency may be present, but these are not directly related to the effect of alcohol on the GI tract. A nurse is caring for a newly placed gastrostomy tube of a postoperative patient. Which nursing action is performed correctly? a. The nurse dips a cotton-tipped applicator into sterile saline solution and gently cleans around the insertion site b. The nurse wets a washcloth and washes the area around the tube with soap and water c. The nurse adjusts the external disk every 3 hours to avoid crusting around the tube d. The nurse tapes a gauze dressing over the site after cleansing it - ANSWERSa. When caring for a new gastrostomy tube, the nurse would use a cotton-tipped applicator dipped in sterile saline to gently cleanse the area, removing any crust or drainage. The nurse would not use a washcloth with soap and water on a new gastrostomy tube, but may use this method if the site is healed. Also, once the sutures are removed, the nurse should rotate the external bumper 90 degrees once a day. The nurse should leave the site open to air unless there is drainage. If there is drainage, one thickness of precut gauze should be placed under the external bumper and changed as needed to keep the area dry. A nurse is assessing a patient who has been NPO (nothing by mouth) prior to abdominal surgery. The patient is ordered a clear liquid diet for breakfast, to advance to a house diet as tolerated. Which assessments would indicate to the nurse that the patient's diet should not be advanced? a. The patient consumed 75% of the liquids on her breakfast tray b. The patient tells you she is hungry c. The patient's abdomen is soft, nondistended, with bowel sounds d. The patient reports fullness and diarrhea after breakfast - ANSWERSd. Tolerance of diet can be assessed by the following: absence of nausea, vomiting, and diarrhea; absence of feeling fullness; absence of abdominal pain and distention; feelings of hunger; and the ability to consume at least 50% to 75% of the food on the meal tray. A patient who is moved to a hospital bed following throat surgery is ordered to receive continuous tube feedings through a small-bore nasogastric tube. Following placement of the tube, Which nursing action would the nurse initiate to ensure correct placement o