Question 1

A nurse is caring for a client following a tonsillectomy. Which of the following actions should the nurse take?

Accepted Answer

Answer reason: Post-tonsillectomy care prioritizes hydration while protecting the surgical site from trauma and bleeding. Offering oral fluids when swallowing is safe supports recovery and reduces dehydration risk, and dilution makes the drink less irritating to the throat. Using a straw can increase oropharyngeal suction/pressure and may disrupt the clot, increasing bleeding risk. Saltwater gargles can mechanically irritate the operative area, and codeine is avoided in children after tonsillectomy due to risk of serious respiratory depression from variable metabolism.

Question 2

Which of the following is most important when teaching the parents of a child diagnosed with celiac disease?

Accepted Answer

Answer reason: Celiac disease is an immune-mediated intolerance to gluten that causes intestinal mucosal injury, malabsorption, and poor growth unless gluten is eliminated. The most important parent teaching is strict, lifelong management of diet—avoiding wheat, barley, and rye and preventing cross-contamination—because this is the definitive treatment and prevents complications. Symptom monitoring (e.g., distention) is supportive but does not address the underlying trigger. Adding gluten would worsen inflammation and symptoms, and “ulcer care” is not a priority teaching point for typical celiac management.

Question 3

Which type of formula should not be diluted before being administered to an infant?

Accepted Answer

Answer reason: Infant formula must be prepared exactly as labeled to maintain the intended calorie density, electrolyte load, and osmolality. Ready-to-use formula is already at the correct concentration and is designed to be fed as is; diluting it reduces caloric intake and can contribute to poor weight gain and electrolyte disturbances. In contrast, powdered and liquid concentrated formulas require reconstitution with the correct amount of water before feeding. A common safety issue is over- or under-dilution of concentrates, so following preparation instructions is essential.

Question 4

The nurse is planning a menu for a client with end-stage renal disease. Which food would be appropriate for the nurse to recommend to the client?

Accepted Answer

Answer reason: Clients with end-stage renal disease commonly require restriction of potassium (and often phosphorus) to reduce risk of life-threatening dysrhythmias and other complications from impaired excretion. This choice is relatively low in potassium compared with many fresh fruits and vegetables, making it a safer menu item. In contrast, cantaloupe and tomatoes are higher-potassium foods that are typically limited on a renal diet. Many veggie burger patties are also problematic because they can be high in potassium/phosphorus additives and sodium, increasing electrolyte and fluid-balance risk.

Question 5

A nurse is teaching a client who has chronic pancreatitis. Which of the following statements should the nurse include in the teaching?

Accepted Answer

Answer reason: " Chronic pancreatitis commonly causes exocrine pancreatic insufficiency with malabsorption, especially of fat, leading to steatorrhea and weight loss. Pancreatic enzyme replacement should be taken with meals/snacks so enzymes mix with food in the duodenum to improve digestion and nutrient absorption. Teaching to avoid snacking is incorrect because small, frequent meals are often better tolerated than three large meals. Increasing dietary fat typically worsens steatorrhea and abdominal symptoms, so it is not recommended.

Question 6

A nurse is providing post-op instructions to a client who underwent a cholecystectomy. The client asks about dietary restrictions. Which of the following response should the nurse give?

Accepted Answer

Answer reason: " After cholecystectomy, bile is no longer stored and released in a bolus, so fat digestion can be less efficient initially and high-fat meals can trigger cramping, nausea, and diarrhea. Advising a temporary reduction in fatty/greasy foods supports tolerance while the gastrointestinal tract adapts and the patient advances diet as tolerated. Telling the patient to resume a normal diet immediately ignores common short-term intolerance to fats. A week-long clear-liquid-only plan is unnecessarily restrictive and not typical once bowel function returns post-op.

Question 7

The nurse is discussing with a group of teenagers with cancer the side effects associated with prescribed chemotherapy. Which topic should the nurse consider prioritizing?

Accepted Answer

Answer reason: Chemotherapy teaching should prioritize effects that most threaten hydration, electrolyte balance, and ability to maintain adequate nutrition. These symptoms are common, can become rapidly severe, and can lead to dehydration, weight loss, and treatment nonadherence if not anticipated and managed early with antiemetics and dietary strategies. In contrast, mouth ulcers and alopecia are important but typically progress more gradually and are less immediately destabilizing to fluid status. Activity intolerance can occur but is often multifactorial and generally does not pose the same immediate risk as uncontrolled gastrointestinal losses.

Question 8

The nurse has taught a client who is experiencing constipation about appropriate food choices. Which of the following statements by the client would require follow-up?

Accepted Answer

Answer reason: " Constipation management relies on increasing dietary fiber (especially from fruits, vegetables, whole grains) along with adequate fluid intake to soften stool and promote regular bowel motility. This meal is largely low-fiber because fish provides no fiber and chips are typically refined/processed with minimal fiber, so it does not reflect the recommended dietary pattern despite including a glass of water. The other options include higher-fiber choices (fruit, popcorn/whole-grain snack, vegetables, sweet potato with skin, and apple slices), which better support stool bulk. A common teaching point is that fluids alone without sufficient fiber often do not adequately relieve constipation.

Question 9

When providing discharge teaching for a client with uric acid calculi, the nurse should include an instruction to avoid which type of food?

Accepted Answer

Answer reason: Foods highest in purines include organ meats (e.g., liver, kidney), certain fish, and some game meats, so avoiding them is a key dietary teaching point. In contrast, spinach and beets are more associated with oxalate content and calcium oxalate stone risk rather than uric acid calculi. Dairy products like cottage cheese are generally low in purines and are not a typical driver of uric acid stone formation.

Question 10

The nurse is caring for the client with diverticulitis. The nurse should plan to instruct the client to avoid which food during an episode of diverticulitis?

Accepted Answer

Answer reason: Raw vegetables are harder to digest and add bulk that can increase mechanical irritation and cramping. This choice is a raw, fibrous food and is therefore the least appropriate during an acute flare. In contrast, refined grains and soft, cooked foods tend to be better tolerated in the short term until inflammation resolves.

Question 11

The nurse is planning meals for the client on hemodialysis and fluid restriction secondary to ARF. Which afternoon snack should the nurse include?

Accepted Answer

Answer reason: This choice provides a snack that is relatively low in potassium and does not add a large fluid volume. A large banana is high in potassium and increases risk for hyperkalemia-related dysrhythmias. A glass of milk adds significant fluid and also contributes potassium and phosphorus, and a ham sandwich is high in sodium, which worsens thirst and fluid retention.

Question 12

Which factor is the priority postoperative care need of the client after gastric resection?

Accepted Answer

Answer reason: Clients are at high risk for poor intake, weight loss, and deficiencies (e.g., iron, vitamin B12) and may experience dumping syndrome, so dietary teaching and monitoring become central to recovery. Nursing priorities include advancing diet as ordered, encouraging small frequent meals, monitoring tolerance (nausea, diarrhea, abdominal cramping), and tracking weight/labs. While body image, skin care, and spiritual needs can be important, they do not address the most immediate physiologic threat to healing and long-term stability in this procedure.

Question 13

A nurse is preparing a dietary teaching plan for a client with rheumatoid arthritis. Select the recommended supplement that will reduce inflammation for the client?

Accepted Answer

Answer reason: This directly supports reduced joint inflammation and may improve pain and stiffness as an adjunct to medical therapy. Vitamin D and calcium carbonate are commonly used to support bone health (especially with steroid use) but are not primary anti-inflammatory supplements. Iron-rich foods address iron deficiency/anemia and do not target inflammation in rheumatoid arthritis.

Question 14

A client with HIV experiences frequent bouts of diarrhea. The nurse determines dietary teaching is effective when the client states the need to avoid?

Accepted Answer

Answer reason: Diarrhea in clients with HIV is often worsened by lactose intolerance and reduced lactase activity, making dairy a common trigger. Avoiding lactose-containing foods helps decrease stool frequency and volume and reduces cramping and gas. In contrast, bland, low-fat, low-fiber foods and clear soups are typically better tolerated during diarrheal episodes. Teaching focuses on hydration and eliminating foods that commonly exacerbate osmotic diarrhea, with dairy being a high-yield culprit.

Question 15

Which diet plan is recommended for an infant with heart failure?

Accepted Answer

Answer reason: Infants with heart failure fatigue easily during feeds and often have increased metabolic demand, so they may not tolerate large volumes needed to meet calorie requirements. Concentrating formula increases caloric density while keeping total fluid volume lower, improving growth without worsening volume overload. Routine fluid restriction is not a standard “diet plan” for all infants with heart failure and risks inadequate intake unless specifically prescribed and carefully monitored. Low-sodium formulas are not typically required for infants and are less central than ensuring adequate calories for weight gain and recovery.

Question 16

The nurse is planning care for a neonate with cleft lip and palate. Which issue is a priority of care?

Accepted Answer

Answer reason: The cleft interferes with effective latch and creation of negative pressure, leading to poor intake, prolonged feeds, fatigue, and risk of inadequate weight gain and dehydration. It also increases the chance of milk entering the nasal cavity and airway, so safe feeding strategies and appropriate nipples/positioning are urgent care needs. Surgical repair is not immediate in the newborn period, and pain control is not typically a primary issue unless postoperative. Psychosocial support for parents is important, but it follows stabilization of essential physiologic needs.

Question 17

The parents of a child with cystic fibrosis ask the nurse which diet is recommended for their child. What is the best response by the nurse?

Accepted Answer

Answer reason: A high-calorie diet helps prevent poor weight gain and supports growth and immune function. Fat is not routinely restricted; instead, higher fat intake is often needed with pancreatic enzyme replacement to improve absorption. Sodium is typically supplemented rather than restricted because of excessive salt loss in sweat and risk for hyponatremic dehydration.

Question 18

The nurse is caring for the malnourished adolescent consuming a vegan diet. The nurse should assess for signs of which vitamin deficiency in the client?

Accepted Answer

Answer reason: Deficiency impairs DNA synthesis and myelin maintenance, so assessment focuses on megaloblastic anemia symptoms (fatigue, pallor) and neurologic findings (paresthesias, gait changes, cognitive/irritability changes). Water- and fat-soluble vitamins like A, C, and K can generally be obtained from plant sources (fruits/vegetables and leafy greens), so they are less specifically linked to veganism. Early recognition is important because neurologic deficits may become irreversible if prolonged.

Question 19

The hospitalized child has lactose intolerance and is placed on a lactose-restricted diet. Which dietary supplement should the nurse anticipate being added to the child's diet?

Accepted Answer

Answer reason: Reduced calcium intake increases risk for inadequate bone mineralization and impaired growth, so supplementation is often anticipated unless adequate non-dairy sources are ensured. Lactose intolerance affects digestion of lactose, not protein absorption, so routine protein supplementation is not the key concern. Vitamin B12 and beta-carotene deficiencies are not the most predictable consequence of removing lactose-containing dairy from the diet compared with calcium shortfall.

Question 20

The clinic nurse is discussing eye health with an adult. Which nutrients should the nurse encourage the client to consume to protect against cataract development?

Accepted Answer

Answer reason: Dietary antioxidants (notably vitamins C and E and carotenoids such as lutein/zeaxanthin) help neutralize free radicals and may slow lens opacification risk over time. Minerals and amino acids are essential for general health but are not the primary nutrient class associated with cataract risk reduction. Lecithins are phospholipids important in cell membranes, but they are not a standard evidence-based dietary recommendation for cataract prevention.

Question 21

The child is found to be deficient in iron. To increase the child’s absorption of iron, which vitamin should the nurse encourage the parents to supplement?

Accepted Answer

Answer reason: This is a common nursing teaching point for iron deficiency: pair iron-rich foods or iron supplements with a vitamin C source (e.g., citrus juice) to improve uptake. In contrast, vitamins A, D, and E do not directly increase gastrointestinal iron absorption in the same clinically actionable way. This guidance supports safer, more effective nutritional management of pediatric iron deficiency.

Question 22

The nurse is caring for the client experiencing dysphagia. Which food item should the nurse remove from the client's meal tray?

Accepted Answer

Answer reason: Whole kernel foods are difficult to form into a single, manageable bolus and can scatter in the mouth, increasing the chance of choking or aspiration. Soft, smooth items like custard and pureed meat are commonly appropriate for dysphagia diets because they are easier to swallow safely. Moist, well-cooked pasta is often tolerated better than dry or crumbly foods because added moisture helps bolus cohesion and transit.

Question 23

Which of the following patients would most benefit from parenteral nutrition?

Accepted Answer

Answer reason: Parenteral nutrition is indicated when the gastrointestinal tract cannot be safely used or must be rested to reduce stimulation and complications. Severe pancreatitis often requires bowel rest because enteral feeding may worsen pain, inflammation, and pancreatic enzyme secretion in the acute phase, making IV nutrition a more appropriate bridge when adequate enteral intake is not possible. In contrast, neck cancer, post-CVA dysphagia, and mechanical ventilation commonly still allow enteral tube feeding (NG/PEG), which is preferred when the gut is functional due to lower infection risk and better preservation of gut integrity. Therefore, the patient with severe pancreatitis is the clearest scenario where parenteral nutrition provides the most benefit.

Question 24

A client is experiencing mild diarrhea through his colostomy. What is the most appropriate instruction to give the client?

Accepted Answer

Answer reason: Dietary management of mild diarrhea focuses on adding foods that help firm stools and reduce intestinal motility while maintaining hydration. Bananas are binding and provide pectin and potassium, which can help thicken output and replace electrolyte losses that can occur with increased ostomy drainage. In contrast, prunes and apple juice can have a laxative effect due to sorbitol and can worsen loose stool. Increasing lettuce adds roughage that may increase stool volume and output, which is not ideal during diarrhea.

Question 25

To meet the nutritional needs of a postoperative client who is tolerating clear liquids, the nursing priority is to?

Accepted Answer

Answer reason: Postoperative diet advancement is based on return of GI function and tolerance of the current diet without nausea, vomiting, distention, or worsening pain. If the client is tolerating clear liquids, the next step to better meet caloric and protein needs is to progress to the next ordered diet level while continuing to monitor for intolerance. Assessing bowel sounds can be part of ongoing evaluation, but absence or presence alone is not a reliable gatekeeper for advancing diet compared with actual tolerance of intake. A soft diet is a larger jump than typically indicated immediately after clear liquids, and menu selection does not address the priority of providing adequate nutrition progression.

Question 26

A nurse is assisting a client on a clear liquid diet in selecting his menu. The nurse determines further teaching is necessary when the client selects which of the following?

Accepted Answer

Answer reason: A milkshake contains dairy/fat and is not a clear liquid, so choosing it indicates misunderstanding of diet restrictions. Gelatin, tea, and many popsicles are typically acceptable because they are considered clear liquids when they melt to a transparent liquid (avoiding red/purple if indicated). Selecting a milk-based item could increase GI workload and interfere with the intended purpose of a clear liquid diet.

Question 27

Before feeding a client with Parkinson’s disease, which nursing action is most important?

Accepted Answer

Answer reason: Parkinson’s disease commonly causes dysphagia and impaired protective airway reflexes, increasing aspiration risk during meals. Upright positioning aligns the oropharynx and esophagus and uses gravity to facilitate safe swallowing, making it the key preventive action before initiating feeding. Suction availability is a reactive safety measure and does not prevent aspiration from occurring. Speech therapy evaluation can be important for long-term management, but immediate nursing priority before feeding is safe positioning to reduce aspiration risk.

Question 28

A client complains of excessive flatulence. The nurse teaches the client about foods that may cause flatulence. Which selection of food, if made by the client, would indicate further teaching is needed?

Accepted Answer

Answer reason: g., cruciferous vegetables and lactose-containing dairy). Cauliflower is a classic gas-producing cruciferous vegetable, and ice cream can cause gas in people with lactose intolerance. Potatoes can contribute to gas depending on preparation and individual tolerance, but they are less classically implicated than cruciferous vegetables and lactose. A plain protein like steak is not a typical high-gas food choice, so choosing it suggests the client did not understand which foods are more likely to worsen flatulence.

Question 29

To prevent aspiration in a client with impaired swallowing, the nurse should?

Accepted Answer

Answer reason: Aspiration risk increases when oral intake occurs in a reclined position because gravity allows food and liquids to pool in the pharynx and enter the airway. Upright high-Fowler’s positioning optimizes airway protection and supports safer bolus transit during swallowing. Using a straw can increase the volume and speed of liquid delivery, which may worsen aspiration in dysphagia. Placing food on the paralyzed side reduces oral control and increases pocketing, whereas food is typically placed on the stronger side with careful pacing and consistency adjustments.

Question 30

The nurse determines that which diet would be most appropriate for a client with ulcerative colitis?

Accepted Answer

Answer reason: A low-residue pattern limits fiber and other poorly digested components that increase fecal volume and frequency during flares. Higher protein supports tissue repair and helps counter malnutrition and hypoalbuminemia risk from inflammation and poor intake. A high-residue/high-fiber diet can worsen symptoms by increasing peristalsis and stool output, making it an unsafe choice during active disease.

Question 31

Which dietary instructions should the nurse give to a client with toxic hepatitis?

Accepted Answer

Answer reason: Liver inflammation and injury increase metabolic demands while often reducing appetite and oral intake, so nutrition aims to prevent catabolism and support hepatic regeneration. A calorie-dense diet helps maintain energy stores and limits the need to break down body protein for fuel. Low-calorie intake would worsen weight loss, fatigue, and impaired healing. NPO status is not routine unless complications (e.g., severe vomiting, aspiration risk) require temporary restriction, and low-residue diets are not a primary therapy for hepatitis.

Question 32

Which instruction should a nurse give a client with pancreatitis during discharge teaching?

Accepted Answer

Answer reason: Reducing pancreatic irritation and preventing recurrence are key discharge goals in pancreatitis, and alcohol is a major trigger for acute attacks and progression to chronic disease. Teaching should prioritize eliminating or at least strictly restricting alcohol to decrease pancreatic inflammation and risk of future flares. High-fat meals are inappropriate because fat stimulates pancreatic enzyme secretion and can worsen symptoms; instead, patients are typically advised to eat small, low-fat meals. Caffeine avoidance is not a core evidence-based discharge instruction for pancreatitis compared with alcohol cessation and fat restriction.

Question 33

The nurse is providing discharge teaching for a client who was hospitalized with gout. The nurse determines that teaching was effective when the client states the need to reduce the intake of?

Accepted Answer

Answer reason: Gout flares are driven by hyperuricemia, so client teaching emphasizes reducing high-purine foods that raise uric acid levels. Organ meats are among the highest-purine foods and are a classic dietary trigger, making reduction an appropriate discharge goal. Most fruits (including berries) are low in purines and are generally acceptable in a gout diet. While some plant proteins can contain purines, they are typically less strongly associated with gout attacks than organ meats, so they are not the best target compared with organ meat intake.

Question 34

The nurse is providing information on dietary management to a child diagnosed with ulcerative colitis. The nurse should teach the child the importance of which diet?

Accepted Answer

Answer reason: A calorie-dense plan supports energy needs, growth, and tissue repair during flares and recovery. High-residue intake typically worsens stool frequency and cramping during active disease, so it is not the priority teaching point. Protein restriction is inappropriate because healing requires adequate protein, and salt restriction is not a standard dietary goal for ulcerative colitis.

Question 35

The nurse has provided dietary instruction to a client for the prevention of nutritional anemia. The nurse determines that further instruction is not necessary when the client selects which food?

Accepted Answer

Answer reason: Leafy green vegetables are a key dietary source of folate and also provide non-heme iron, making them an appropriate choice when teaching prevention. Citrus fruits mainly contribute vitamin C, which can enhance iron absorption but is not a primary source of iron/folate. Milk products are poor sources of iron and can interfere with iron absorption when consumed in large amounts with iron-rich foods.

Question 36

After a tonsillectomy, the child has impaired swallowing related to inflammation and pain. Which fluids should the nurse plan to administer?

Accepted Answer

Answer reason: They are also less likely to irritate the surgical site compared with acidic beverages. Red or brown liquids can mask signs of bleeding (blood in emesis), delaying recognition of a complication. Dairy-based items like ice cream can increase mucus and throat clearing, which may worsen discomfort and coughing after throat surgery.

Question 37

The client is told to consume high-protein foods for wound healing. Of the food choices, which should the nurse recommend?

Accepted Answer

Answer reason: Cottage cheese is a concentrated dairy protein source and, per typical serving values, provides more protein than a single egg or a 1-ounce portion of cheddar. Broccoli is primarily a vegetable with relatively low protein content despite other micronutrient benefits. Therefore, selecting the highest-protein option best supports wound healing goals.

Question 38

The nurse is planning a seminar on healthy living for college students. The nurse should educate the students about consuming a minimum of how many grams of fiber per day?

Accepted Answer

Answer reason: General adult guidance commonly targets roughly 25–38 g/day (often taught as about 20–35 g/day depending on sex and caloric intake), making this the best minimum range for a healthy college population. Lower ranges are insufficient for most adults and would not meet standard health-promotion recommendations. Much higher ranges are unnecessary for routine counseling and may increase bloating or interfere with tolerance if increased too rapidly without fluids.

Question 39

The nurse is caring for the client with agoraphobia who has an inadequate milk intake. For which vitamin deficiency should the nurse specifically assess when caring for the client?

Accepted Answer

Answer reason: With inadequate milk intake, the client is at increased risk for vitamin D deficiency, which can contribute to osteomalacia in adults and overall impaired bone health. The presence of agoraphobia may also limit outdoor exposure and reduce cutaneous vitamin D synthesis, further increasing risk. Vitamins A, C, and B6 are not primarily dependent on milk intake and are more strongly linked to other food sources and deficiency patterns.

Question 40

The client with early-stage iron-deficiency anemia is on a high-iron diet. An increase in the level of which specific serum laboratory test should indicate to the nurse that the diet has been effective?

Accepted Answer

Answer reason: In early-stage deficiency, hemoglobin may still be near normal and can lag behind restoration of iron reserves, so it is less sensitive for early response to dietary therapy. Folate and vitamin B12 relate to megaloblastic anemia rather than iron-deficiency anemia, so changes in those levels would not validate response to a high-iron diet. Therefore, a rising ferritin level best indicates that iron stores are being replenished.

Question 41

The child recovering from surgery is advanced from a clear liquid to a full liquid diet. The child is requesting something to eat. Which full liquid food item should the nurse offer to the child?

Accepted Answer

Answer reason: Pudding fits this definition because it is a smooth, dairy-based item that is considered a full liquid. Plain gelatin is a clear liquid item and does not meet the “full liquid” advancement goal. Chicken noodle soup contains solid pieces (noodles/chicken) and is not appropriate for a full liquid diet unless strained to remove solids.

Question 42

A client has just delivered a baby and is successfully breast-feeding. How many extra kilocalories per day does the client need to consume to compensate for the increased energy requirements of lactation?

Accepted Answer

Answer reason: Lactation substantially increases maternal energy expenditure because calories are required to synthesize breast milk in addition to meeting the mother’s baseline metabolic needs. Standard postpartum nutrition guidance is to add about 450–500 kcal/day for exclusive breastfeeding to support adequate milk production while maintaining maternal health. This value aligns with typical estimates of the energy cost of producing breast milk after accounting for physiologic adaptations and mobilization of maternal fat stores. Lower amounts (e.g., 300 kcal/day) may be insufficient for exclusive breastfeeding, while much higher amounts (e.g., 800–1000 kcal/day) exceed usual recommendations for most clients.

Question 43

When teaching a diabetic client about nutritional planning, which food selection would be considered one healthy serving of carbohydrate?

Accepted Answer

Answer reason: A small piece of whole fruit such as a small orange is approximately one carbohydrate serving and is a healthier choice because it provides fiber, vitamins, and a slower glycemic rise than refined/sugary foods. Two slices of white bread are usually closer to two carbohydrate servings (about 30 g), exceeding a single serving. Two cups of cooked rice is far more than one serving (multiple exchanges), and ice cream adds significant sugar and saturated fat and is not typically taught as a “healthy” single carb serving.

Question 44

The nurse is counseling a client on how to prevent cholecystitis. What is the most important guideline for the nurse to include?

Accepted Answer

Answer reason: Cholecystitis is commonly triggered by gallstones that obstruct bile flow, and high-fat intake promotes gallbladder contraction against an obstructed duct, worsening biliary colic and inflammation. A diet lower in fat and cholesterol reduces bile cholesterol saturation and decreases postprandial gallbladder stimulation, helping reduce stone-related symptoms and recurrence risk. Weight management is beneficial, but it is a broader long-term risk-factor strategy and is less directly protective than reducing dietary fat that provokes acute attacks. Low-protein intake has no preventive role, and limiting exercise is incorrect because physical activity supports healthy weight and metabolic risk reduction.

Question 45

To reduce occurrences of the dumping syndrome, the nurse should instruct a client to do which of the following?

Accepted Answer

Answer reason: Dumping syndrome is triggered by rapid gastric emptying into the small intestine, causing fluid shifts and vasomotor symptoms after eating. Lying down or resting after meals helps slow gastric emptying and reduces the postprandial drop in circulating volume that drives dizziness, palpitations, and weakness. In contrast, drinking fluids with meals increases volume delivered to the intestine and can worsen symptoms, so fluids are typically separated from meals. Dietary advice also emphasizes small, frequent meals with higher protein and fat and lower simple carbohydrates, making the high-carbohydrate/low-protein option inappropriate.

Question 46

A client with irritable bowel syndrome is being prepared for discharge. Which dietary instructions should be included in the teaching?

Accepted Answer

Answer reason: Increasing soluble fiber helps regulate bowel function and can reduce constipation-predominant symptoms by adding bulk and promoting more predictable elimination. High-fat meals can stimulate intestinal motility and may exacerbate postprandial urgency, bloating, and abdominal pain, so limiting fat supports symptom control. Low-fiber choices are more appropriate for acute inflammation/strictures (e.g., some IBD situations) rather than functional bowel disorders like IBS. Therefore, the most helpful discharge teaching combines increased fiber with lower fat intake.

Question 47

A client with lactose intolerance requires dietary teaching. Which foods should the nurse advise the client to eat to ensure adequate calcium intake?

Accepted Answer

Answer reason: Fermented dairy products like yogurt and many cheeses contain less lactose and are common, practical sources of dietary calcium for patients who cannot tolerate milk. Beef liver is not a meaningful calcium source, and bananas/avocados provide minimal calcium. While leafy greens can contain calcium, spinach is high in oxalates that reduce calcium absorption, making that pair a less reliable teaching choice for ensuring adequate intake.

Question 48

The nurse is preparing to feed an infant with pyloric stenosis prior to surgical repair. What is the most important intervention?

Accepted Answer

Answer reason: Infants with pyloric stenosis have gastric outlet obstruction with a high risk of emesis and aspiration during/after feeds. Frequent burping reduces swallowed air and gastric distention, which helps minimize vomiting and supports safer, better-tolerated oral intake while awaiting surgical correction. Feeding quickly increases gastric volume/pressure and can worsen vomiting. Stopping all feeds after vomiting is not the priority nursing intervention during a feed and can contribute to inadequate intake; instead, focus on techniques that improve tolerance and follow provider orders regarding feeding plans and NPO status.

Question 49

A nurse is caring for a 2-year-old client with asthma. What is the most appropriate nursing intervention for this client?

Accepted Answer

Answer reason: Asthma can involve airway inflammation and increased work of breathing, which often leads to tachypnea and higher insensible fluid losses; maintaining hydration helps keep secretions thinner and easier to clear. Cold fluids can also soothe an irritated throat and may be better tolerated by a young child who is coughing or mildly dyspneic, supporting oral intake. Warm liquids are more commonly emphasized for croup/upper-airway irritation and are not specifically beneficial for asthma. I.V. boluses are not routine for asthma unless there is clear dehydration or shock, and unnecessary boluses can worsen respiratory status in some children.

Question 50

Which nursing diagnosis should have the highest priority in the plan of care for a client with an eating disorder?

Accepted Answer

Answer reason: g., dehydration, electrolyte disturbances, dysrhythmias, and impaired organ function). Eating disorders commonly create an immediate risk for inadequate intake and metabolic instability, so addressing nutritional restoration and hydration is the most urgent nursing focus. Psychosocial problems like disturbed body image, ineffective coping, and family dysfunction are important but are typically addressed after stabilization of vital physiologic status. A common distractor is disturbed body image, which is central to the disorder’s etiology, but it does not supersede the immediate safety threat posed by inadequate nutrition.

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