Quiz 81: Oral Nutrition
Perry et al.: Clinical Nursing Skills & Techniques, 9th Edition
Instructor Verified Answers Included
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1. The nurse is admitting a person to the unit and is assessing the patient’s nutritional status. In assessing the patient’s nutritional status, the nurse realizes that:
a. body mass index (BMI) is the main indicator of obesity.
b. ideal body is the standard gauge for nutritional status.
c. clinical judgment is required, along with other indicators.
d. the amount of weight change is the main nutritional indicator.
2. The nurse is assessing the patient for nutritional status. Which laboratory value may indicate compromised protein status?
a. Serum albumin level of 4.0 g/dL
b. Prealbumin level of 12 g/dL
c. Total lymphocyte count of 1600 cells/mm3
d. Prealbumin level of 35 g/dL
3. The nurse is caring for a patient diagnosed with severe dehydration. The nurse notes that the patient’s albumin level is 4.0. What might this indicate?
a. The patient is in a compromised protein state.
b. The level may be falsely high.
c. An acute nutritional deficiency
d. A long-term nutritional deficiency
4. The nurse is caring for a patient who requires assistance with eating. The patient repeatedly apologizes to the nurse, saying, “I’m so sorry. I’m like a baby. I’m such a burden since I can’t even feed myself.” What is the most appropriate strategy for the nurse to use?
a. Feed all of the solid foods first, and then offer liquids.
b. Feed the patient quickly so as not to make the patient feel like it is taking a great deal of time out of the nurse’s day.
c. Minimize conversation so that the patient can eat faster.
d. Appear unhurried, sit at the bedside, and encourage the patient to feed himself/herself as much as possible.
5. What must the nurse do before assisting the patient with feeding?
a. Assess the patient’s gag reflex.
b. Make sure that the consistency of the food is thin.
c. Remove the patient’s dentures to prevent gagging.
d. Prepare the patient to be fed by a staff member.
6. The nurse is caring for an infant who is 3 months old and is being bottle-fed human milk. Will the nurse need to provide the infant with any additional sources of nutrition or fluids?
a. The infant will need extra water in between feedings.
b. The infant will need juice in between feedings.
c. No additional fluids will be needed between meals.
d. The child will need to start on infant cereal.
7. What is an appropriate technique for the nurse to use to prevent aspiration when assisting a patient with meals?
a. Keep the patient’s head back and straight.
b. Offer thin-consistency foods.
c. Provide large amounts of fluids.
d. Have the patient sit up for 30 minutes after eating.
8. The patient is admitted with a diagnosis of stroke. The nurse attempts to feed the patient, but the patient coughs and gags when food is placed in his mouth. What should the nurse do to assist this patient?
a. Feed the patient more slowly.
b. Feed the patient more quickly.
c. Contact the speech pathology department.
d. Ignore the cough and try again later.
9. The nurse is caring for a patient who is 6 feet 2 inches tall and weighs 250 pounds. What is the patient’s body mass index (BMI)?
a. 18.5 kg/m2
b. 30.2 kg/m2
c. 32.13 kg/m2
d. 40.11 kg/m2
10. The nurse is caring for a patient who is believed to be suffering from malnutrition. The nurse calculates that the patient’s body mass index (BMI) is 16.4 kg/m2. What does this indicate about the patient’s weight?
a. The patient is underweight.
b. The patient’s weight is normal.
c. The patient is overweight.
d. The patient is obese (class 1).
11. A patient is admitted to the hospital for evaluation for sleep apnea. The nurse calculates his body mass index (BMI) at 42 kg/m2. What does this indicate about the patient’s weight?
a. The patient is overweight.
b. The patient falls into the class 1 range of obesity.
c. The patient falls into the class 2 range of obesity.
d. The patient falls into the class 3 range of extreme obesity.
12. The nurse is caring for a patient 2 days after surgery. The ordered diet is a mechanical soft diet. Which of the following foods may the patient choose to eat?
b. Baked potato without skin
c. Cooked cereal
d. Soft peeled apples
13. The patient is placed on a clear liquid diet after surgery. Which of the following foods may the patient select?
a. Coffee with milk and sugar
b. Gelatin, popsicles, apple juice
c. Water, orange juice, Jell-O
d. Black coffee, popsicles, ice cream
14. Which of the following is a sign of vitamin C deficiency?
a. Cheilosis (redness/swelling of the lips)
c. Spongy, bleeding, abnormal redness of the gingiva
d. Spoon-shaped, brittle, ridged fingernails
15. The patient is on the dysphagia puree stage of the national dysphagia diet. Which of the following foods may the patient select?
a. Mashed potatoes
b. Dry cereals moistened with milk
c. Well-cooked noodles in gravy
d. Well-moistened cereals
16. The nurse is preparing to assess the nutritional status of an 80-year-old patient in a long-term care agency. What screening tool would best suit this purpose?
a. The Malnutrition Universal Screening Tool (MUST)
b. Mini Nutritional Assessment (MNA)
c. Anthropometric measurements
d. A daily nutrition intake log
1. The nurse is admitting a patient to the medical unit. Which of the following are reasons the nurse may perform a nutritional screening on this patient? (Select all that apply.)
a. To assess risk for malnutrition
b. To assist with feeding
c. To identify risk for aspiration
d. To determine body weight
2. The Nutrition Care Process (NCP) provides structure for the provision of nutritional care to all patients and provides a framework for the registered dietitian (RD) to make decisions regarding medical nutrition therapy. The steps involved in this process include which of the following? (Select all that apply.)
a. Nutrition assessment
b. Nutrition diagnosis
c. Nutrition intervention
d. Nutrition evaluation
3. Biochemical indices help the clinician to determine the effects of nutritional factors or of medical conditions on the health status of patients. No single test is available for evaluating short-term response to medical nutritional therapy. Laboratory tests conducted over time will give more accurate information than a single test. Which of the following are the most important biochemical measures? (Select all that apply.)
a. Ideal body weight
b. Visceral protein status
c. Immune function
d. Percent of weight gain
4. A patient has residual dysphagia post stroke. The nurse notes that the ordered diet is the national dysphagia diet. She knows this diet comprises which of the following? (Select all that apply.)
a. Dysphagia puree diet
b. Dysphagia mechanically altered diet
c. Dysphagia advanced diet
d. Regular diet
5. Which of the following are signs of iron (Fe2+) deficiency? (Select all that apply.)
a. Pale eye membranes
b. Cheilosis (redness/swelling) of the lips
c. Spongy, bleeding gingiva
1. A nurse’s role includes performing ___________________ to assess a patient’s risk status for malnutrition, assessing and assisting an adult patient with feeding, and identifying patients at risk for aspiration during oral feeding.
2. Patients who have a cancer diagnosis, infected or draining wounds, burns, or an elevated temperature for more than 2 days are at elevated _______________ risk.
3. The nurse will collaborate with a ___________ to develop a nutritional plan for a patient identified as being at nutritional risk.
4. ______________ are measures of height; weight; head, arm, and muscle circumferences; and skinfold thickness.
5. _______________ is useful for monitoring short-term changes in visceral protein.
6. The nurse recognizes that the patient is exhibiting signs of ______________ when she notices that he has difficulty holding food and fluid in his mouth and experiences difficulty moving it to his esophagus.
1. The nurse is caring for a patient who is 48 hours post bowel resection with creation of a colostomy. This morning, the nurse assessed the return of bowel sounds. In what order would this patient’s diet progress?
a. Full liquid diet
b. Regular diet
c. Clear liquid diet
e. Soft diet