HESI nutrition
A 17-year-old client is found to have anorexia nervosa. The psychiatrist, in conjunction with the
client and the parents, decides to institute a behavior modification program. What does the
nurse recall is a major component of behavior modification? - ANS-rewarding positive behavior
In behavior modification [1] [2] [3], positive behavior is reinforced, and negative behavior is not
reinforced or punished. Reducing the number or complexity of necessary restrictions,
deconditioning the fear of weight gain, and reducing the number of anxiety-producing situations
may all be part of the program, but none is a major component.
A client describes abdominal discomfort following ingestion of milk. Which enzyme, as a result
of a genetic deficiency, should the nurse consider to be the cause of the client's discomfort? -
ANS-lactase
Milk and milk products are not tolerated well because they contain lactose, a sugar that is
converted to galactose by lactase. Sucrase assists in the digestion of sucrose, which is not a
milk sugar. Maltase assists in the digestion of maltose, which is not a milk sugar. Amylase
assists in the digestion of starch, which is not a milk sugar
A client has been experiencing extreme fatigue lately. The nurse suspects anemia and
examines the client to identify additional clinical manifestations to support this inference. Which
locations on the client's body should the nurse assess? Select all that apply. - ANS-eyelids
(conjunctiva), nail beds, palms
Nail beds lose their pink coloration because of reduced hemoglobin. A reduced amount of
hemoglobin decreases pink color of the lining of the eyelids (conjunctiva). Palms of the hands
will become pale because of the decreased hemoglobin. Sclera is observed for signs of
jaundice, not anemia, when they become pale yellow to orange. Bony prominences are not
assessed when a client has anemia. Bony prominences are examined for redness caused by
pressure that, if prolonged, can lead to a break in the skin and development of pressure ulcers.
A client is admitted to the hospital for a laparoscopic cholecystectomy. What should the nurse
encourage the client to add to the diet to help normalize bowel function after surgery? -
ANS-whole bran
Whole bran provides bulk that promotes intestinal motility and a regular bowel movement.
Vitamins are not related to normalizing bowel function. Cod liver oil is not related to regulating
bowel function. Amino acids are not related to regulating bowel function.
A client is admitted to the hospital with a diagnosis of Crohn disease. What is most important for
the nurse to include in the teaching plan for this client? - ANS-meeting nutritional needs
to avoid gastrointestinal pain and diarrhea, these clients often refuse to eat and become
malnourished. The consumption of a high-calorie, high-protein diet is advised. Diarrhea, not
constipation, is a problem with Crohn disease. Preventing an increase in weakness is a
secondary concern that results from malnutrition; correcting the malnutrition will increase
strength. Anticipating a sexual alteration generally is not a problem with Crohn disease.
, A client is experiencing an exacerbation of ulcerative colitis. A low-residue, high-protein diet and
IV fluids with vitamins have been prescribed. When implementing these prescriptions, which
goal is the nurse trying to achieve? - ANS-reduce colonic irritation
A low-residue diet is designed to reduce colonic irritation, motility, and spasticity. Reduction of
gastric acidity is the aim of bland diets used in the treatment of gastric ulcers. Reducing colonic
irritation, motility, and spasticity hopefully will increase, not reduce, intestinal absorption. This
diet is to allow the bowel to rest, not to reduce infection rates.
A client is to receive total parenteral nutrition (TPN) via a central venous access device/catheter.
What information about this treatment would the nurse recognize as accurate? - ANS-can be
intermitten
Although the central venous catheter remains in situ, total parenteral nutrition does not have to
infuse continuously. Continuous versus intermittent administration depends on the health care
provider's prescription. Placement of the tube after the procedure is verified by x-ray, not
fluoroscopy. The subclavian veins are used most often; the jugular vein is too close to
hair-growing areas, which increases the possibility of sepsis, and neck movements may
interfere with maintaining placement of the catheter. Although a feeling of pressure may be
experienced, it is not a painful procedure.
A client presents to the emergency department with weakness and dizziness. The blood
pressure is 90/60 mm Hg, pulse is 92 and weak, and body weight reflects a 3-pound (1.4
kilogram) loss in two days. The weather has been hot. Which condition should the nurse
conclude is the priority for this client? - ANS-deficient fluid volume
The low blood pressure indicates hypovolemia, the increased pulse is an attempt to maintain
adequate oxygenation of tissues, and the rapid weight loss reflects loss of body fluid. Although
impaired skin integrity is a concern with dehydration, it is not the priority. The rapid weight loss
reflects a loss of fluid, not a loss of body tissue. Although the client may need assistance with
activities, an inadequate intake of fluid has caused the client's dehydration, which is a serious
medical problem that needs to be treated immediately.
A client who has a history of seizures is scheduled for an arteriogram at 10:00 AM and is to
have nothing by mouth before the test. The client is scheduled to receive an anticonvulsant
medication at 9:00 AM. What should the nurse do? - ANS-Ask the healthcare provider to
prescribe an alternate route of administration.
To achieve the anticonvulsant effect, therapeutic blood levels must be maintained. If the client is
not able to take the prescribed oral preparation, the healthcare provider should be questioned
about alternate routes of administration. Omission will result in lowered blood levels, possibly to
less than the necessary therapeutic level to prevent a seizure. The route of administration
cannot be altered without healthcare provider approval. The client is being kept nothing by
mouth.
A client will be taking cholestyramine, a bile acid sequestrant, as treatment for type II
hyperlipoproteinemia. What vitamin does the nurse anticipate may become deficient because of
this drug therapy? - ANS-vitamin D
Bile acid sequestrants (also known as bile acid-binding resins) bind with bile acids to form an
insoluble compound that is then excreted in the bowel movements. These drugs decrease the
absorption of fat-soluble vitamins (A, D, E, K). Vitamins B3, C, and B12 are water-soluble
vitamins and therefore are not affected by the administration of this drug.
A 17-year-old client is found to have anorexia nervosa. The psychiatrist, in conjunction with the
client and the parents, decides to institute a behavior modification program. What does the
nurse recall is a major component of behavior modification? - ANS-rewarding positive behavior
In behavior modification [1] [2] [3], positive behavior is reinforced, and negative behavior is not
reinforced or punished. Reducing the number or complexity of necessary restrictions,
deconditioning the fear of weight gain, and reducing the number of anxiety-producing situations
may all be part of the program, but none is a major component.
A client describes abdominal discomfort following ingestion of milk. Which enzyme, as a result
of a genetic deficiency, should the nurse consider to be the cause of the client's discomfort? -
ANS-lactase
Milk and milk products are not tolerated well because they contain lactose, a sugar that is
converted to galactose by lactase. Sucrase assists in the digestion of sucrose, which is not a
milk sugar. Maltase assists in the digestion of maltose, which is not a milk sugar. Amylase
assists in the digestion of starch, which is not a milk sugar
A client has been experiencing extreme fatigue lately. The nurse suspects anemia and
examines the client to identify additional clinical manifestations to support this inference. Which
locations on the client's body should the nurse assess? Select all that apply. - ANS-eyelids
(conjunctiva), nail beds, palms
Nail beds lose their pink coloration because of reduced hemoglobin. A reduced amount of
hemoglobin decreases pink color of the lining of the eyelids (conjunctiva). Palms of the hands
will become pale because of the decreased hemoglobin. Sclera is observed for signs of
jaundice, not anemia, when they become pale yellow to orange. Bony prominences are not
assessed when a client has anemia. Bony prominences are examined for redness caused by
pressure that, if prolonged, can lead to a break in the skin and development of pressure ulcers.
A client is admitted to the hospital for a laparoscopic cholecystectomy. What should the nurse
encourage the client to add to the diet to help normalize bowel function after surgery? -
ANS-whole bran
Whole bran provides bulk that promotes intestinal motility and a regular bowel movement.
Vitamins are not related to normalizing bowel function. Cod liver oil is not related to regulating
bowel function. Amino acids are not related to regulating bowel function.
A client is admitted to the hospital with a diagnosis of Crohn disease. What is most important for
the nurse to include in the teaching plan for this client? - ANS-meeting nutritional needs
to avoid gastrointestinal pain and diarrhea, these clients often refuse to eat and become
malnourished. The consumption of a high-calorie, high-protein diet is advised. Diarrhea, not
constipation, is a problem with Crohn disease. Preventing an increase in weakness is a
secondary concern that results from malnutrition; correcting the malnutrition will increase
strength. Anticipating a sexual alteration generally is not a problem with Crohn disease.
, A client is experiencing an exacerbation of ulcerative colitis. A low-residue, high-protein diet and
IV fluids with vitamins have been prescribed. When implementing these prescriptions, which
goal is the nurse trying to achieve? - ANS-reduce colonic irritation
A low-residue diet is designed to reduce colonic irritation, motility, and spasticity. Reduction of
gastric acidity is the aim of bland diets used in the treatment of gastric ulcers. Reducing colonic
irritation, motility, and spasticity hopefully will increase, not reduce, intestinal absorption. This
diet is to allow the bowel to rest, not to reduce infection rates.
A client is to receive total parenteral nutrition (TPN) via a central venous access device/catheter.
What information about this treatment would the nurse recognize as accurate? - ANS-can be
intermitten
Although the central venous catheter remains in situ, total parenteral nutrition does not have to
infuse continuously. Continuous versus intermittent administration depends on the health care
provider's prescription. Placement of the tube after the procedure is verified by x-ray, not
fluoroscopy. The subclavian veins are used most often; the jugular vein is too close to
hair-growing areas, which increases the possibility of sepsis, and neck movements may
interfere with maintaining placement of the catheter. Although a feeling of pressure may be
experienced, it is not a painful procedure.
A client presents to the emergency department with weakness and dizziness. The blood
pressure is 90/60 mm Hg, pulse is 92 and weak, and body weight reflects a 3-pound (1.4
kilogram) loss in two days. The weather has been hot. Which condition should the nurse
conclude is the priority for this client? - ANS-deficient fluid volume
The low blood pressure indicates hypovolemia, the increased pulse is an attempt to maintain
adequate oxygenation of tissues, and the rapid weight loss reflects loss of body fluid. Although
impaired skin integrity is a concern with dehydration, it is not the priority. The rapid weight loss
reflects a loss of fluid, not a loss of body tissue. Although the client may need assistance with
activities, an inadequate intake of fluid has caused the client's dehydration, which is a serious
medical problem that needs to be treated immediately.
A client who has a history of seizures is scheduled for an arteriogram at 10:00 AM and is to
have nothing by mouth before the test. The client is scheduled to receive an anticonvulsant
medication at 9:00 AM. What should the nurse do? - ANS-Ask the healthcare provider to
prescribe an alternate route of administration.
To achieve the anticonvulsant effect, therapeutic blood levels must be maintained. If the client is
not able to take the prescribed oral preparation, the healthcare provider should be questioned
about alternate routes of administration. Omission will result in lowered blood levels, possibly to
less than the necessary therapeutic level to prevent a seizure. The route of administration
cannot be altered without healthcare provider approval. The client is being kept nothing by
mouth.
A client will be taking cholestyramine, a bile acid sequestrant, as treatment for type II
hyperlipoproteinemia. What vitamin does the nurse anticipate may become deficient because of
this drug therapy? - ANS-vitamin D
Bile acid sequestrants (also known as bile acid-binding resins) bind with bile acids to form an
insoluble compound that is then excreted in the bowel movements. These drugs decrease the
absorption of fat-soluble vitamins (A, D, E, K). Vitamins B3, C, and B12 are water-soluble
vitamins and therefore are not affected by the administration of this drug.
