Question 1

The nurse is assisting a client with diverticulosis to select appropriate foods. Which food should be avoided?

Accepted Answer

Answer reason: Clients with diverticulosis should avoid foods with small seeds that can lodge in diverticula; cucumber salad contains seeds. Bran and peaches are acceptable, and high fiber like bran is encouraged.

Question 2

The home health nurse is visiting a 15-year-old with sickle cell disease. Which information obtained on the visit would cause the most concern? The client?

Accepted Answer

Answer reason: In sickle cell disease, maintaining adequate hydration is critical to prevent sickling and vaso-occlusive crises. Drinking several carbonated/caffeinated beverages can promote dehydration and replace needed water. Playing baseball is acceptable with precautions; acetaminophen is appropriate for pain; siblings with trait is not a current care concern.

Question 3

Which snack selection by a client with osteoporosis indicates that the client understands the dietary management of the disease?

Accepted Answer

Answer reason: Osteoporosis management emphasizes calcium and vitamin D intake; yogurt is a high-calcium dairy snack. The other options are relatively low in calcium.

Question 4

The nurse is evaluating nutritional outcomes for an elderly client with anorexia nervosa. Which data best indicates that the plan of care is effective?

Accepted Answer

Answer reason: Weight gain is the most direct and objective indicator of improved nutritional status in anorexia nervosa. Menu selection does not ensure intake, hematocrit reflects hydration/hematologic changes, and tissue turgor reflects hydration more than nutrition.

Question 5

The nurse is teaching a mother who will breast feed for the first time. Which of the following is a PRIORITY?

Accepted Answer

Answer reason: Immediate assistance with positioning promotes effective latch and initiation of breastfeeding, which is the priority for a first-time breastfeeding mother.

Question 6

The nasogastric tube of a post-op gastrectomy client has stopped draining greenish liquid. The nurse should?

Accepted Answer

Answer reason: For a post-gastrectomy NG tube that stops draining, patency should be maintained by irrigating with normal saline as ordered. Distilled water can cause fluid shifts, testing for bubbles is unsafe and not a placement check, and manipulating/repositioning the tube can disrupt the surgical site.

Question 7

The nurse is providing diet instruction to the parents of a child with Cystic Fibrosis. The nurse would emphasize that the diet should be?

Accepted Answer

Answer reason: Children with cystic fibrosis have fat and protein malabsorption and increased energy needs. Diet should be high in calories and protein with no fat restriction to support growth; sodium is not restricted.

Question 8

The nurse is caring for a client with Meniere's disease. When teaching the client about the disease, the nurse should explain that the client should avoid foods high in?

Accepted Answer

Answer reason: In Meniere's disease excess endolymphatic fluid accumulates in the inner ear. A low-sodium diet helps reduce fluid retention; therefore the client should avoid high-sodium foods.

Question 9

Before administering a feeding through a gastrostomy tube, what is the PRIORITY nursing assessment?

Accepted Answer

Answer reason: Ensuring the gastrostomy tube is patent is the priority before any feeding to prevent complications such as leakage, aspiration, or tissue injury; other assessments are non-urgent relative to verifying tube function.

Question 10

The nurse is discussing dietary intake with an adolescent who has acne. The MOST appropriate statement for the nurse is?

Accepted Answer

Answer reason: Evidence does not support specific dietary restrictions or additions for acne; the appropriate teaching is to maintain a well-balanced diet suitable for age.

Question 11

The nurse is caring for a client with trigeminal neuralgia (tic douloureux). To assist the client with nutrition needs, the nurse should?

Accepted Answer

Answer reason: Chewing can trigger severe facial pain in trigeminal neuralgia, so soft, high-calorie foods in small, frequent meals meet caloric needs while minimizing jaw movement. Raw fruits/vegetables and meats require more chewing; sitting in a chair does not address pain-limited intake.

Question 12

What is the preferred position to feed a baby with a cleft palate?

Accepted Answer

Answer reason: Feeding in an upright position uses gravity to reduce nasal regurgitation and aspiration risk in infants with cleft palate.

Question 13

A client is diagnosed with gastroesophageal reflux disease (GERD). The nurse's instruction to the client regarding diet should be to?

Accepted Answer

Answer reason: High-fat foods lower LES tone and delay gastric emptying, worsening reflux; reducing fat intake decreases GERD symptoms. Avoiding all raw produce is unnecessary, milk products may aggravate reflux, and small frequent meals are preferred over three average meals.

Question 14

The nurse is caring for clients over the age of 70. The nurse knows that due to age-related changes, the elderly clients tolerate diets that are?

Accepted Answer

Answer reason: Older adults have decreased gastric motility and reduced bile/pancreatic secretions, making fat digestion harder; therefore they better tolerate low-fat diets.

Question 15

The nurse discusses nutrition with a pregnant woman who is iron deficient and follows a vegetarian diet. The selection of which foods indicate the woman has learned sources of iron?

Accepted Answer

Answer reason: Fortified cereals and dried fruits are good vegetarian sources of non‑heme iron. The other pairings either are not rich in iron (whole grains/yellow vegetables; oranges) or are unsuitable/low-iron for a vegetarian diet (fish and dairy).

Question 16

A client diagnosed with gouty arthritis is admitted with severe pain and edema in the right foot. When the nurse develops a plan of care, which of the following should be included?

Accepted Answer

Answer reason: Encourage high fluid intake to dilute urine and prevent urate crystal precipitation and renal calculi. High-protein diets increase purines, salicylates can alter uric acid excretion, and heat may worsen acute inflammation (cold is preferred).

Question 17

When teaching a client with coronary artery disease about nutrition, the nurse should emphasize?

Accepted Answer

Answer reason: Large, heavy meals divert blood to the GI tract and increase cardiac workload, which can precipitate angina in coronary artery disease. The sodium limit given (7 g/day) is excessive; other options are less specific to CAD risk reduction.

Question 18

During an assessment of a client with cardiomyopathy, the nurse finds that the systolic blood pressure has decreased from 145 to 125 mm Hg and the heart rate has risen from 72 to 88 beats per minute and the client complains of periodic dizzy spells. The nurse instructs the client to?

Accepted Answer

Answer reason: Drop in SBP with increased HR and dizziness suggests volume depletion/orthostatic hypotension. Management is to expand intravascular volume with fluids and sodium; salty snacks like potato chips address this. Other options restrict sodium or do not provide adequate sodium replacement.

Question 19

The nurse evaluates the nutritional intake of a 16-year-old girl at a camp for adolescents. The girl eats all of the food provided to her at the camp cafeteria. Each of the day's three meals contains foods from all areas of the food pyramid, and each meal averages about 900 calories and 3 mg of iron. The girl has been menstruating monthly for about two years. Which of the following descriptions, if made by the nurse, BEST describes the girl's intake if her weight is appropriate for her height?

Accepted Answer

Answer reason: Daily intake is ~2700 kcal (900 × 3), which exceeds typical needs for a 16-year-old girl (~2200 kcal), while iron intake totals only ~9 mg/day, below the ~15 mg recommended for menstruating adolescents.

Question 20

The nurse is teaching parents of a 7 month-old about adding table foods. Which of the following is an APPROPRIATE finger food?

Accepted Answer

Answer reason: For a 7‑month‑old, appropriate finger foods are soft, bite-size pieces. Bananas are soft and easy to mash, while hot dogs, whole grapes, and popcorn are choking hazards.

Question 21

A 7 year-old child is hospitalized following a major burn to the lower extremities. A diet high in protein and carbohydrates is recommended. The nurse informs the child and family that the MOST important reason for this diet is to?

Accepted Answer

Answer reason: Severe burns create a hypermetabolic state; providing high carbohydrates and protein spares body proteins from being broken down for energy, preserving them for tissue repair and metabolic needs.

Question 22

In performing a nutritional assessment on a 2 year-old, the nurse must know that, in general?

Accepted Answer

Answer reason: Toddlers’ serving size guideline is about one tablespoon of solid food per year of age; for a 2-year-old this equals two tablespoons. This helps assess adequacy of intake.

Question 23

The nurse would expect the cystic fibrosis client to receive supplemental pancreatic enzymes along with a diet?

Accepted Answer

Answer reason: Cystic fibrosis causes pancreatic insufficiency and malabsorption; management includes pancreatic enzymes with a high-calorie, high-carbohydrate, high-protein diet to meet increased energy needs.

Question 24

A client with emphysema visits the clinic. While teaching about proper nutrition, the nurse should emphasize?

Accepted Answer

Answer reason: COPD/emphysema clients often experience dyspnea and poor intake during meals; supplemental oxygen while eating improves oxygenation and decreases work of breathing, facilitating nutrition. High sodium does not liquefy sputum; exercise after therapy is unrelated to mealtime nutrition; mouth care aids infection prevention, not nutrition.

Question 25

The client who is receiving enteral nutrition through a gastrostomy tube has had four diarrhea stools in the past 24 hours. The nurse should?

Accepted Answer

Answer reason: Medications such as antibiotics or those containing sorbitol commonly cause diarrhea in tube-fed clients. Reviewing medications is the best initial action. Increasing infusion rate or water flush may worsen diarrhea, and attaching a rectal bag addresses symptoms not cause.

Question 26

Which of the following statements by a parent would alert the nurse to assess for iron deficiency anemia in a 14 month-old child?

Accepted Answer

Answer reason: Toddlers who consume excessive cow's milk often displace iron‑rich solid foods, leading to iron‑deficiency anemia ("milk anemia"). The other statements are not specific risk indicators for iron deficiency.

Question 27

The nurse is teaching diet restrictions for a client with Addison's disease. The client would indicate an understanding of the diet by stating?

Accepted Answer

Answer reason: Addison's disease causes mineralocorticoid deficiency leading to renal sodium loss, dehydration, and hyperkalemia. Diet teaching emphasizes increasing sodium and fluids while restricting potassium.

Question 28

A client is admitted to the rehabilitation unit following a CVA and mild dysphagia. The MOST appropriate intervention for this client is?

Accepted Answer

Answer reason: After CVA with dysphagia, upright positioning during meals best promotes safe chewing and swallowing and reduces aspiration risk. Thin clear liquids may increase aspiration risk, tilting head back is contraindicated, and dry finger foods are unsafe for dysphagia.

Question 29

The nurse is planning a meal plan that would provide the most iron for a child with anemia. Which of the following dinner menus would be BEST?

Accepted Answer

Answer reason: This menu provides the highest iron: heme iron from ground beef plus iron-rich legumes (lima beans) and raisins; the other options contain less iron-dense foods.

Question 30

The mother of a 3 month-old infant tells the nurse that she wants to change from formula to whole milk and add cereal and meats to the diet. What should be emphasized as the nurse teaches about infant nutrition?

Accepted Answer

Answer reason: Infants under 12 months should not receive cow’s milk because it is difficult to digest, low in iron, and imposes a high renal solute load. Other options recommend practices not appropriate for a 3‑month‑old (solids and juice are introduced later; no need to dilute milk with fluoridated water).

Question 31

An eight year-old child is hospitalized during the edema phase of minimal change nephrotic syndrome. The nurse is assisting in choosing the lunch menu. Which one of the following is the BEST choice?

Accepted Answer

Answer reason: During edema in minimal change nephrotic syndrome, sodium intake should be minimized. Processed meats and cheese (bologna, frankfurter, grilled cheese) are high in sodium. Chicken with corn and milk is the lowest-sodium option.

Question 32

A three year-old child diagnosed as having celiac disease attends a day care center. Which of the following would be an appropriate snack?

Accepted Answer

Answer reason: Celiac disease requires a gluten-free diet. Potato chips are made from potatoes and are gluten-free, while crackers, bread, and cookies contain wheat gluten.

Question 33

The nurse is teaching parents about diet for a 4 month-old infant with gastroenteritis and mild dehydration. In addition to oral rehydration fluids, the diet should include?

Accepted Answer

Answer reason: For infants with mild gastroenteritis, continue the usual age-appropriate diet. Breast milk or formula provides adequate nutrients and is safe; broths, teas, juices, gelatin, and soda are inappropriate and can worsen electrolyte imbalance.

Question 34

Weaning should be started at the age of ....?

Accepted Answer

Answer reason: Introduction of complementary foods typically begins around 4–6 months when developmental readiness signs appear (loss of tongue-thrust reflex, ability to sit with support, and interest in foods). Starting earlier risks aspiration and GI immaturity, while delaying solids beyond this window can increase risk of iron deficiency and insufficient energy intake. Thus, the recommended window to initiate weaning is 4–6 months.

Question 35

The first line treatment for diarrhea in children is?

Accepted Answer

Answer reason: Most childhood diarrhea is viral and managed by preventing and correcting dehydration with low-osmolarity oral rehydration solution. WHO/UNICEF recommend adding zinc for 10–14 days, which shortens illness duration and reduces subsequent episodes. IV fluids are reserved for severe dehydration or shock, and antibiotics or antidiarrheals are rarely indicated and can be harmful.

Question 36

ORS is mainly used to replace loss of?

Accepted Answer

Answer reason: Oral rehydration solution is formulated with specific concentrations of sodium, potassium, chloride, citrate, and glucose to correct dehydration. The glucose promotes sodium and water absorption via the sodium-glucose cotransporter in the small intestine. It replaces fluids and electrolytes lost through diarrhea or vomiting, not proteins, vitamins, or fats.

Question 37

ORS is used in?

Accepted Answer

Answer reason: Oral rehydration salts (ORS) contain glucose and electrolytes in the correct ratio to enhance sodium–glucose cotransport in the gut, promoting water absorption. This therapy is recommended to treat dehydration caused by acute diarrhoeal illness, including cholera. It is not indicated for uncomplicated cold, malaria, or fever without diarrhoea.

Question 38

A patient with anemia would benefit from which diet?

Accepted Answer

Answer reason: Anemia management emphasizes iron-rich foods and nutrients that support erythropoiesis. Organ meats provide highly bioavailable heme iron, while legumes offer nonheme iron, and dark green leafy vegetables supply iron and folate needed for red blood cell production. The other options are not as concentrated in iron or folate. Therefore, the first diet best supports correction of anemia.

Question 39

A client who is recovering from a surgery has been ordered a change from a clear liquid diet to a full liquid diet. The nurse would offer which full liquid item to the client?

Accepted Answer

Answer reason: A full liquid diet includes foods that are liquid at room temperature and provide more nutritional value than clear liquids, such as milk, ice cream, custard, and pudding. Clear liquids include water, broth, carbonated beverages, gelatin, and popsicles. Therefore, pudding is appropriate for a full liquid diet, whereas the other options are clear liquids.

Question 40

A nurse is reviewing the principles of good nutrition for a patient with COPD to support his overall health. Which of the following suggestions regarding patient nutrition would most likely support the health of the patient with COPD?

Accepted Answer

Answer reason: In COPD, both undernutrition and obesity worsen outcomes: low weight weakens respiratory muscles, while excess weight increases the work of breathing and oxygen demand. Nutritional counseling focuses on adequate calories and protein to maintain an optimal body weight. Therefore, achieving and maintaining a healthy weight most directly supports respiratory function and overall health. The other choices are general health or environmental advice and are not specific nutritional strategies for COPD.

Question 41

A patient with Alzheimer’s disease has had difficulties eating and is not getting enough nutrients in his diet. The patient’s daughter asks the nurse if there is anything that can be done to improve his nutrition intake. Which recommendation should the nurse give?

Accepted Answer

Answer reason: Patients with Alzheimer’s often need cueing and supervision during meals to initiate eating, maintain attention, and ensure adequate intake. Stand-by assistance allows the caregiver to prompt, reassure, and offer help as needed without taking over, which improves nutritional consumption and safety. The other options do not directly enhance intake and may even decrease it (e.g., limiting calories or reducing palatability).

Question 42

A 38-year-old patient has been diagnosed with amyotrophic lateral sclerosis (ALS) and subsequently has developed breathing difficulties including shortness of breath and an inability to cough. Which best describes a nutritional challenge associated with this?

Accepted Answer

Answer reason: ALS can involve bulbar motor neuron degeneration leading to weakness of the oropharyngeal muscles and impaired swallowing (dysphagia). Respiratory muscle weakness further reduces cough effectiveness, increasing aspiration risk and making oral intake difficult. This results in poor nutritional intake and weight loss, not excess weight gain. Abdominal pain and increased inflammation are not typical nutritional challenges specific to ALS-related breathing difficulties.

Question 43

Which of the following is a physiological need?

Accepted Answer

Answer reason: According to Maslow’s hierarchy, physiological needs are the most basic survival requirements such as oxygen, fluids, food, and sleep. Food is essential for cellular metabolism and energy and therefore is a true physiological need. Shelter is generally categorized under safety needs, and love and respect correspond to love/belonging and esteem needs. Thus, food is the best answer.

Question 44

Home care instructions were provided by the nurse to a client diagnosed with viral hepatitis. The nurse determines that the client understands the given instructions if the client makes which statement?

Accepted Answer

Answer reason: Viral hepatitis impairs liver function, so nutritional strategies that reduce hepatic workload and improve tolerance are appropriate. Small, frequent meals can help with nausea and poor appetite, and limiting fat/protein can decrease metabolic demand on the liver in teaching-focused questions. The other statements include unsafe or incorrect guidance: acetaminophen can be hepatotoxic, prolonged strict bed rest is unnecessary, and alcohol avoidance is important but is not the best single statement demonstrating comprehensive dietary understanding compared with the specific nutrition instruction.

Question 45

A client has depression refuses to eat. What is the nurse's best initial action?

Accepted Answer

Answer reason: The best initial nursing action is to attempt a simple, client-centered intervention to promote oral intake, such as offering a preferred food. This is low risk, can be implemented immediately, and addresses nutrition before escalating to consultations or provider notification. Consulting a dietitian or notifying the provider may be appropriate if poor intake persists or the client is medically compromised, but they are not the first step. Documentation is important, but it is not the best initial action when an intervention can be tried right away.

Question 46

A patient is suffering from a broken jaw. Which food would be appropriate?

Accepted Answer

Answer reason: With a broken jaw, chewing is difficult or contraindicated, so the safest and most appropriate choices are soft or liquid foods that require minimal mastication. Soup, pudding, and ice cream are easy to swallow and help maintain calorie and fluid intake while protecting the injury. The other options include hard, crunchy, or chewy foods (carrots, fried chicken, cereal, peanuts, broccoli, fish) that can increase pain and risk disrupting healing.

Question 47

Best method to prevent dehydration in acute diarrhea is?

Accepted Answer

Answer reason: Oral rehydration solution (ORS) is the best first-line method to prevent dehydration in acute diarrhea because it replaces both water and electrolytes using glucose-sodium co-transport to enhance intestinal absorption. It is effective, safe, and widely recommended for mild to moderate dehydration and for preventing worsening fluid loss. IV fluids are reserved for severe dehydration, shock, or inability to tolerate oral intake. Antibiotics and antiemetics do not directly prevent dehydration and are only indicated in selected cases for specific causes or symptom control.

Question 48

A client with Parkinson's disease is at risk of aspiration. What is the best nursing intervention?

Accepted Answer

Answer reason: Parkinson’s disease commonly causes dysphagia and impaired airway protection, increasing aspiration risk during oral intake. Keeping the client upright during meals and for a period afterward uses gravity to promote safe swallowing and reduce reflux/aspiration. The other options increase aspiration risk: thin liquids are harder to control, large meals increase fatigue and choking risk, and fluids before meals can increase fullness and interfere with safer, controlled swallowing.

Question 49

A nurse is caring for a newborn with a cleft palate. What is the priority nursing intervention during feeding?

Accepted Answer

Answer reason: Newborns with a cleft palate have impaired ability to create suction, increasing feeding difficulty and risk of aspiration. A specialized nipple/feeder helps deliver milk with less need for suction and supports safer, more effective oral intake. Feeding supine increases aspiration risk, and routine bottle nipples may be ineffective. Burping is still important because these infants often swallow more air during feeding.

Question 50

A 2-year-old child with a high fever refuses fluids. What should the nurse do first?

Accepted Answer

Answer reason: A febrile 2-year-old who refuses fluids is at high risk for dehydration, so the priority is to promote safe oral hydration using small, frequent sips that are better tolerated than large volumes. Forcing fluids increases the risk of aspiration, vomiting, and worsening refusal. Notifying the provider is appropriate because persistent refusal with high fever may require further evaluation and possible alternative hydration strategies (e.g., oral rehydration plan or IV fluids). Monitoring urine output alone does not address the immediate need to prevent dehydration.

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