Chapter 39: Nutritional Problems

Chapter 39: Nutritional Problems

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. Which finding for a young adult who follows a vegan diet may indicate the need for cobalamin supplementation?

a.	Paresthesias	c.	Dry, scaly skin
b.	Ecchymoses	d.	Gingival swelling

 

 

ANS:  A

Cobalamin (vitamin B₁₂) cannot be obtained from foods of plant origin, so the patient will be most at risk for signs of cobalamin deficiency, such as paresthesias, peripheral neuropathy, and anemia. The other symptoms listed are associated with other nutritional deficiencies but would not be associated with a vegan diet.

 

DIF:    Cognitive Level: Apply (application)           REF:               856

TOP:   Nursing Process: Assessment           MSC:  NCLEX: Physiological Integrity

 

2. A 76-yr-old woman with a body mass index (BMI) of 17 kg/m² and a low serum albumin level is being admitted by the nurse. Which assessment finding will the nurse expect to find?

a.	Restlessness	c.	Pitting edema
b.	Hypertension	d.	Food allergies

 

 

ANS:  C

Edema occurs when serum albumin levels and plasma oncotic pressure decrease. The blood pressure and level of consciousness are not directly affected by malnutrition. Food allergies are not an indicator of nutritional status.

 

DIF:    Cognitive Level: Apply (application)           REF:               858

TOP:   Nursing Process: Assessment           MSC:  NCLEX: Physiological Integrity

 

3. Which menu choice best indicates that the patient is implementing the nurse’s suggestion to choose high-calorie, high-protein foods?

a.	Baked fish with applesauce
b.	Beef noodle soup and canned corn
c.	Fresh fruit salad with yogurt topping
d.	Fried chicken with potatoes and gravy

 

 

ANS:  D

Foods that are high in calories include fried foods and those covered with sauces. High-protein foods include meat and dairy products. The other choices are lower in calories and protein.

 

DIF:    Cognitive Level: Analyze (analysis)                                  REF:   863

TOP:   Nursing Process: Evaluation            MSC:  NCLEX: Physiological Integrity

 

4. A patient has a body mass index (BMI) of 31 kg/m², a normal C-reactive protein level, and low serum transferrin and albumin levels. The nurse will plan patient teaching to increase the patient’s intake of foods that are high in

a.	iron.	c.	calories.
b.	protein.	d.	carbohydrate.

 

 

ANS:  B

The patient’s C-reactive protein and transferrin levels indicate low protein stores. The BMI is in the obese range, so increasing caloric intake is not indicated. The data do not indicate a need for increased carbohydrate or iron intake.

 

DIF:    Cognitive Level: Apply (application)           REF:               860

TOP:   Nursing Process: Planning               MSC:  NCLEX: Physiological Integrity

 

5. A patient who has just been started on tube feedings of full-strength formula at 100 mL/hr has 6 diarrhea stools the first day. Which action should the nurse plan to take?

a.	Slow the infusion rate of the tube feeding.
b.	Check gastric residual volumes more frequently.
c.	Change the enteral feeding system and formula every 8 hours.
d.	Discontinue administration of water through the feeding tube.

 

 

ANS:  A

Loose stools indicate poor absorption of nutrients and indicate a need to slow the feeding rate or decrease the concentration of the feeding. Water should be given when patients receive enteral feedings to prevent dehydration. When a closed enteral feeding system is used, the tubing and formula are changed every 24 hours. High residual volumes do not contribute to diarrhea.

 

DIF:    Cognitive Level: Apply (application)           REF:               865

TOP:   Nursing Process: Planning               MSC:  NCLEX: Physiological Integrity