1 .

The nurse determines that the nutrient intake of the 19-year-old

female is inadequate according to the U.S. Department of Agriculture
MyPlate food group recommendations. Which finding of the female’s
intake prompted this conclusion?
A. 6 ounces of whole grain bread, cereal, or pasta eaten daily.
B. 3 cups of a variety of fruits, juices, and vegetables eaten daily.
C. 5 ½ oz of protein daily with seafood eaten four of the seven days
D. 1 cup of yogurt, ½ cups skim milk, and ½ ounce cheddar cheese daily.

ANSWER: B

A. Eating 6 ounces of whole grains daily exceeds the recommendation for grains. The
recommendation is 5 ounces, with 3 of these ounces being whole grains.
B. According to the MyPlate recommendation, the 19-year-old should consume 2 cups of fruits or
juices and 2 ½ cups of vegetables every day. Vegetables and fruits are two separate food groups.
C. Eating 5 ½ oz of protein daily meets the MyPlate recommendation. It exceeds the
recommendation for seafood, which is at least 8 ounces per week.
D. The intake of dairy products exceeds the MyPlate recommendation by ½ cup.

2. The client with a BMI of30 is attending a health promotion program at

a clinic. Which outcome is best for the nurse to document in the client’s
plan of care?
A. Client will lose 2 lb per week for the next 4 weeks.
B. Client will gain 2 lb per week for the next 4 weeks.
C. Teach client to increase intake of fruits and vegetables.
D. Inform client to call clinic weekly with weight results.

ANSWER: A

A. A BMI of 30 indicates the client is overweight. Losing 2 lb per week is the client-centered,
realistic, and measurable outcome.
B. Weight gain is an inappropriate outcome. A BMI of 30 indicates the client is overweight, not
underweight.
C. Teaching is an intervention, not an outcome.
D. Informing the client is an intervention, not an outcome.
3. The nurse is planning a nutrition session during a health fair. Which
food choices should the nurse include when teaching about omega-3
fatty acids?
A. Fatty fish at least twice weekly
B. Leafy green vegetables daily
C. Low-fat mozzarella cheese weekly
D. Cholesterol-free margarine once daily

ANSWER: A

A. Fatty fishes, such as mackerel, salmon, bluefish, mullet, sablefish, menhaden, anchovy, herring,
lake trout, sardines, and tuna, are high in omega-3 fatty acids. All except tuna provide at least 1 g
of omega—3 fatty acids in 100 g or 3.5 ounces of fish.
B. Leafy green vegetables do not include omega-3 fatty acids.
C. Low-fat mozzarella cheese does not include omega-3 fatty acids.
D. Cholesterol-free margarine does not include omega-3 fatty acids.

4. The client is told to consume high-protein foods for wound healing. Of

the food choices, which should the nurse recommend?
A. 1 hard-boiled egg
B. 1 cup of cooked broccoli
C. ½ cup ½ cottage cheese
D. 1 ounce cheddar cheese

ANSWER: C

A. There are 6 g of protein in one egg.

B. There are 4 g of protein in 1 cup of cooked broccoli.
C. A half cup of cottage cheese supplies 16 g of protein.
D. There are 7 g of protein in 1 ounce of cheddar cheese.

5. The nurse is ensuring that an adolescent diagnosed with type 1 DM

knows about foods that are high in carbohydrates and those that contain
little or no carbohydrates. Which foods should the adolescent identify as
those that contain approximately 15 g of carbohydrate per serving?
Select all that apply.
A. Pancake
B. Green beans
C. Corn
D. Taco shells
 E. Carrots
F. Cottage cheese

ANSWER: A, C, D

A. A serving is one 4-inch pancake. Each serving has 15 g of carbohydrates or is equivalent

to 1 carbohydrate choice.
B. Green beans contain little carbohydrates and are considered “free” foods.
C. One-half cup of corn. Each serving has 15 g of carbohydrates or is equivalent to 1
carbohydrate choice.
D. Two taco shells. Each serving has 15 g of carbohydrates or is equivalent to 1
carbohydrate choice.
E. Carrots contain little carbohydrates and are considered “free” foods.
F. Cottage cheese has zero grams of carbohydrate.

6. The nurse taught the client who has type 2 DM about carbohydrate
counting and the fact that 15 g of carbohydrate equals one carbohydrate
choice. When consuming the following meal, the client should calculate
that the meal contains how many carbohydrate choices?
1 small banana

2 slices bread with 1 slice turkey breast

1 cup milk

2 tomato slices

_________ Carbohydrate choices (Record your answer as a whole number.)

ANSWER: 4

One small banana, two breads, and milk each contain about 15 g of carbohydrates. This equals 4
carbohydrate food choices. Turkey breast is a non-carbohydrate-containing food, and diced raw tomato is
a nonstarchy vegetable. Nonstarchy vegetables can be disregarded in carbohydrate counting if less than
three servings are eaten.

7. The nurse is caring for the client with a history of chronic alcoholism.
Which observation should prompt the nurse to assess for a magnesium
deficiency?
A. Flickerlike movements under the skin
B. Absent reaction when kneecap is tapped
C. Falling from having flaccid muscles
 D. Rumbling bowel sounds after eating

ANSWER: A

A. A neuromuscular sign of hypomagnesemia includes fasciculation, or flickerlike

movements under the skin from spontaneous contractions of muscle fibers. Other signs
include tetany, twitches, hyperreflexia, and seizures.
B. Hyperretlexia, not an absent reaction to a kneecap tap, occurs with hypomagnesemia.
C. Hyperreflexia, not muscle flaccidity, occurs with a magnesium deficiency.
D. GI effects of hypomagnesemia include decreased bowel motility; rumbling sounds
indicates increased motility.

8. The nurse is caring for the client experiencing CRF. Which

low-potassium foods (less than 400 mg of potassium per serving) should
the nurse plan to include on a list of acceptable foods for the client?
A. Cranberry juice, grapes, flesh string beans, fortified puffed rice cereal
B. Prune juice, dried fruit, tomatoes, and all-bran cereal
C. Milk, cantaloupe, peas, and granola cereal
D. Orange juice, raisins, spinach, and dried beans

ANSWER: A

A. Cranberry juice, grapes, fresh string beans, and fortified puffed rice cereal are all
low-potassium foods.
B. Prune juice, dried fruit, tomatoes, and all-bran cereal are high-potassium, not
low-potassium, foods.
C. Milk, cantaloupe, and peas are high—potassium, not low-potassium, foods.
D. Orange juice, raisins, spinach, and dried beans are high-potassium, not low-potassium,
foods-

9. 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?
A. Hemoglobin
B. Folate
C. Ferritin
D. Vitamin B12

ANSWER: C
 A. In iron deficiency, the body cannot synthesize Hgb, but Hgb levels drop fairly late in the
development of iron-deficiency anemia. Other nutrient deficiencies and medical
conditions can affect Hgb levels.
B. Serum folate is specific to folate-deficiency, and not iron-deficiency, anemia.
C. Ferritin levels reflect the available iron stores in the body and are specific to
iron-deficiency anemia. A level less than 10 ng/mL is diagnostic of iron-deficiency
anemia. As the condition improves, ferritin levels rise.
D. Vitamin B12 deficiency is one cause of anemia and may be associated with iron
deficiency, but a rise in vitamin BI2 levels does not indicate that the iron-deficiency
anemia is resolved.

10. The nurse teaches the client with iron-deficiency anemia to eat foods
high in iron and foods that contain vitamin C at the same meal to
increase iron absorption. The nurse evaluates that teaching is effective
when the client selects the meal that includes which foods?
A. Yogurt and oranges
B. Shrimp and potatoes
C. Lean beefsteak and broccoli
D. Chicken and leafy green vegetables

ANSWER: C

A. Yogurt contains less iron than lean beefsteak.

B. Shrimp contains less iron than lean beefsteak.
C. Good sources of iron include lean beefsteak; dark green vegetables such as broccoli have
significant sources of vitamin C.
D. Chicken contains less iron than does lean beefsteak.

11 . The nurse educates the client about foods that are high in calcium.
The nurse evaluates that teaching has been effective when the client
selects which foods?
A. 1 cup whole milk, 1 cup spinach, and 3 ounces sardines
B. 1 cup low-fat yogurt, 1 cup broccoli, and 3 ounces sardines
C. ½ cup 2 ½ cottage cheese, 1 cup spinach, and 3 ounces frozen tofu
D. 1 medium baked potato with 1 tbsp fat—free sour cream, 1 cup spinach, and 3 ounces
tofu

ANSWER: B
 A. One cup of whole milk has 300 mg of calcium, 1 cup of spinach has 30 mg of calcium,
and 3 ounces of sardines has 324 mg, for a total of 654 mg.
B. One cup of low-fat plain yogurt has 448 mg of calcium, 1 cup of broccoli has 60 mg, and
3 ounces of sardines has 324 mg, for a total of 832 mg of calcium.
C. A half cup of 2 ½ cottage cheese has 78 mg of calcium, 1 cup of spinach has 30 mg, and
3 ounces of tofu has 310 mg, for a total of 418 mg.
D. A medium baked potato has 38 mg of calcium, 1 tbsp of low-fat sour cream has 20 mg, 1
cup of spinach has 30 mg, and 3 ounces of tofu has 310 mg, for a total of398 mg of
calcium.

12. The nurse educates the client recovering from acute diverticulitis
about the need to increase the amount of dietary fiber in the diet. The
nurse evaluates that teaching has been effective when the client makes
which menu selection for lunch?
A. A chicken sandwich on whole Wheat bread with raw carrots and celery sticks
B. Baked chicken, mashed potatoes, and herbal tea
C. Chicken noodle soup with soda crackers and chocolate pudding
D. Cooked acorn squash, flied chicken, and pasta

ANSWER: A

A. Whole wheat bread and raw fruits and vegetables are foods that are high in fiber
content.
B. There is very little fiber in baked chicken, mashed potatoes, and herbal tea.
C. There is very little fiber in chicken noodle soup with soda crackers and chocolate
pudding.
D. There is less fiber in cooked acorn squash, fried chicken, and pasta than in option 1.

13. 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?
A. 5 to 20 g
B. 20 to 35 g
C. 35 to 50 g
D. 50 to 75 g

ANSWER: B
 A. A daily intake of 5 to 20 g of fiber is less than the minimum daily requirement.
B. The American Dietetic Association recommends an intake of 20 to 35 g of fiber per day
as the minimum daily requirement.
C. A daily intake of 35 to 50 g of fiber is more than the minimum daily requirement.
D. A daily intake of 50 to 75 g of fiber is more than the minimum daily requirement.

14. 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?
A. 1 . Vitamin A
B. 2. Vitamin C
C. 3. Vitamin K
D. 4. Vitamin B12

ANSWER: D

A. Fruits and vegetables that are eaten by vegans contain Vitamin A.

B. Fruits and vegetables that are eaten by vegans contain vitamin C.
C. Fruits and vegetables that are eaten by vegans contain vitamin K.
D. Vegans abstain from eating animal products, which provide vitamin B12.

15. The client prescribed a high—protein, high-calorie diet is not

meeting protein or caloric intake goals. The client states, “I feel full
quickly after eating three meals daily.” Which interventions should the
nurse recommend? Select all that apply.
A. Include more fresh fruits and vegetables in the diet
B. Eat six smaller meals instead of three meals daily
C. Include protein bars and whole milk yogurt as snacks
D. Drink regular instead of diet carbonated beverages
E. Add protein supplements to cooked cereals

ANSWER: B, C , E

A. Although flesh fruits and vegetables contain needed vitamins, these foods are not good
sources of needed calories or protein.
B. The client is likely to increase caloric intake by eating more frequently.
C. Eating protein bars and whole milk yogurt as snacks will increase both protein and
calorie intake.
D. Regular carbonated beverages supply calories as simple sugars, are not a source of
protein, and lack other nutrients.
 E. Protein supplements add calories and protein to the diet.

16. The nurse evaluates that the client placed on a DASH diet can
correctly identify the salt content per serving on a food label. Place an X
on the food label illustrated where the client should have identified the
salt content per serving.
The salt content of one serving is sodium 300 mg.

17. The client is placed on a DASH diet. Which statement made by the
client indicates that the client needs additional teaching about the DASH
diet?
A. “I can have 4 to 5 servings a week of almonds when on this diet.”
B. “I should be eating no more than 3 servings of meat or poultry daily.”
C. “I should be using canola, olive, or peanut oils when cooking foods.”
D. “My 4 to 5 daily fruit servings can include juice, or fresh or dried fruit.”

ANSWER: B

A. On the DASH diet ahnonds are included in the 4 to 5 servings per week of nuts, seeds,
and legumes.
B. On a DASH diet, the client should eat 2 or fewer daily servings of meats, poultry, and
fish. This statement indicates the client needs additional teaching.
C. On the DASH diet, the allowable fats and oils include canola, olive, or peanut oils.
D. On the DASH diet, 4 to 5 servings of fruits should be eaten daily. The servings can include
6 oz juice, a medium fruit, ¼ cup dried fruit, or ½ cup fresh, frozen, or canned fruit.

18. The client is recovering from an exacerbation of ulcerative colitis.

The nurse evaluates that the client understands the dietary teaching for
disease management when the client selects which foods?
A. Fried Cajun chicken, French fries, steamed pea pods, and a glass of fruit juice
B. Cream of tomato soup, mixed green salad with oil, and a glass of whole milk
C. Baked fish, steamed green beans, buttered mashed potatoes, and herbal tea
D. Chili con came, whole wheat bread with butter, and a half glass of red wine

ANSWER: C

A. Spicy and high-residue foods should be avoided because these stimulate the bowels.
 B. Milk products should be avoided because lactose intolerance is common in those with
ulcerative colitis.
C. A low-residue diet that is high in calories and protein should be gradually introduced as
the client’s tolerance for solid food increases.
D. Alcohol and spicy foods are intestinal stimulants and should be avoided.

19. The client is scheduled for a breath test for hydrogen excretion.
Which statement should the nurse include when the client asks how this
will evaluate for lactose intolerance?
A. Undigested lactose causes water in the colon to form oxygen and hydrogen.
B. Hydrogen is produced by lactose digestion in the small intestine.
C. Undigested lactose produces hydrogen when metabolized by colon bacteria.
D. During the digestive process, lactose is broken down into lactic acid and hydrogen.

ANSWER: C

A. Lactose does not cause the breakdown of water molecules.

B. Lactose-intolerant individuals are unable to digest lactose.
C. After fasting, the client ingests lactose. In lactose intolerance, undigested lactose
produces hydrogen when metabolized by colon bacteria. The hydrogen can be detected
when excreted in a breath.
D. Lactose-intolerant individuals are unable to digest lactose.

20. The client tells the nurse, “My mother has celiac disease, and I might
also have the disease.” The nurse agrees that this may be possible when
the client states having diarrhea after eating which food?
A. 1.Eggs
B. 2. Peanut butter
C. 3. Whole wheat bread
D. 4. Dark leafy green vegetables

ANSWER: C

A. Eggs do not contain gluten.

B. Peanut butter does not contain gluten.
C. Celiac disease is an autoimmune disease that results in chronic intestinal inflammation
after ingesting gluten. Having a first-degree relative with celiac disease increases the
client’s risk of developing the disease.
D. Dark leafy green vegetables do not contain gluten.
21 . The client is hospitalized with emphysema. When reviewing the
prescribed diet, which dietary modifications should the nurse consider
appropriate if the client has no other underlying medical conditions?
Select all that apply.
A. Mechanical soft
B. Low calorie
C. High protein
D. Restricted potassium
E. Increased calcium

ANSWER: A. C

A. Mechanical soft decreases the effort of chewing. Eating, chewing, and digestion increase
oxygen demand. Carbohydrate (CHO) metabolism increases carbon dioxide (C02) levels.
B. A high-calorie, not low-calorie, diet is prescribed because of the increased energy
consumption with eating.
C. A high-protein, low-CHO diet is prescribed to provide calories for energy but prevent
increased C02 levels.
D. Potassium is restricted with renal failure, not emphysema.
E. Calcium is increased with diseases such as tuberculosis or osteoporosis, not emphysema.

22. The clinic nurse is planning to measure the skinfold of an

underweight older adult client to estimate the amount of total body fat.
Prioritize the nurse’s steps when measuring the triceps skinfold on the
client.
A. Mark the midpoint of the client’s arm with a pen
B. Place the calipers at the midpoint mark and read the measurement to nearest milliliter
(mL)
C. Grasp the skin and subcutaneous tissue between thumb and forefinger, pulling away
from the muscle
D. Measure the distance between the acromion and olecranon processes and divide by 2
E. Ask the client to bend his or her arm at the elbow and lay the arm across his or her
stomach
F. Ask the client to hang his or her arm loosely at the side

ANSWER: E, D, A, F, C, B

E. Ask the client to bend his or her arm at the elbow and lay the arm across his or her stomach. This is
performed first so that a correct measurement of the distance between the acromion process and
olecranon can be obtained.
D. Measure the distance between the acromion and olecranon processes and divide by 2. This
measurement is needed to determine the midpoint.

A. Mark the midpoint of the client’s arm with a pen. The midpoint will be the location where the calipers
are applied to obtain the measurement.

F. Ask the client to hang his or her arm loosely at the side- This position relaxes the arm.

C. Grasp the skin and subcutaneous tissue between thumb and forefinger, pulling away from the muscle.
Only the skin and subcutaneous tissue are used to measure the skinfold thickness.

B. Place the calipers at the midpoint mark and read the measurement to the nearest milliliter (mL). This
step is performed last.

23. The nurse is planning to administer an intermittent enteral feeding

through an NG tube. Which intervention should the nurse implement?
A. Administer the feeding as rapidly as possible.
B. Position the client supine for 1 hour after completing the feeding
C. Confirm tube placement after the feeding has been infused.
D. Elevate the head of the client’s bed to 45 degrees during the feeding.

ANSWER: D

A. Rapid administration of a bolus feeding reduces lower esophageal sphincter pressure

and increases the risk for aspiration.
B. A supine position after a feeding is completed increases the risk for aspiration.
C. Tube placement should be confirmed before the feeding is started.
D. Positioning the head of the bed at 45 degrees elevation promotes gravity flow of the
formula into the stomach and maintains normal functioning of the lower esophageal
sphincter.

24. A mother is concerned about achieving a nutritious intake for her

14-month-old child. Which advice by the nurse would be best?
A. Feed the child before the rest of the family and then let the child play while the family
cats.
B. Because the child’s stomach holds only 'A cup, select food from one food group for each
meal.
C. Offer 1% tablespoons of food from each food group with every meal; offer nutritious
snacks.
D. Avoid retrying foods that the child pushes away because these are foods the child
dislikes.
ANSWER: C

A. To develop healthy eating habits, the child should eat with the rest of the family and, if
not hungry, should remain at the table.
B. The 14-month-old child’s stomach holds a little more than 1 cup.
C. The 14-month-old child’s serving size should be about a tablespoonful for each year of
age. Offering a variety of foods from the food groups will help ensure a nutritious diet
and avoid consuming too much or too little food from any one food group. Offering
three meals and three nutritious snacks a day increases the likelihood that the toddler
will obtain Sufficient nourishment.
D. If foods are pushed away, they should be retried later. It takes 8 to 15 exposures to a
food to effect behavior change.

25. The nurse is caring for the 2-year-old with iron- deficiency anemia.
Which should the nurse recommend? Select all that apply.
A. Limit the toddler’s milk intake to 24 ounces per day.
B. Limit the toddler’s juice intake to 4 to 6 ounces per day.
C. Offer iron-rich foods such as beef, lentils, broccoli, and raisins.
D. Even if vegan, avoid feeding the toddler a vegan diet.
E. Parental feeding of the toddler to ensure an adequate intake.

ANSWER: A, B, C

A. Milk should be limited to 24 ounces per day to maintain an appetite for iron-enriched
cereals, meats, fruits, and vegetables.
B. Juice should be limited to 4 to 6 ounces per day for children ages 1 to 5 years.
C. Beef, lentils, broccoli, and raisins are some of the iron—rich foods.
D. A toddler can consume a vegan diet if the diet is well planned to include iron-rich foods.
E. Toddlers are developing independence and will want to feed themselves. Parental
feeding can delay the child’s mastering of developmental stages and cause the child to
dislike the foods if the parent attempts to force-feed the child.

26. The 6-year—old with chronic constipation is prescribed a

high—fiber diet and increased fluid intake. When teaching the parents,
which foods should the nurse identify as having the highest amount of
fiber per serving?
A. Whole wheat or rye breads
B. Raw or cooked vegetables
C. Fresh, frozen, or dried fruits
D. Baked beans or black-eyed peas
ANSWER: D

A. Whole wheat or rye breads provide 1 g of fiber serving.

B. Raw or cooked vegetables provide 2 to 3 g of fiber per serving.
C. Fresh, frozen, or dried fruits have about 2 g of fiber per serving.
D. Legumes such as baked beans, navy beans, or black-eyed peas provide about 8 g of fiber
per serving.

27. 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?
A. Protein
B. Calcium
C. Vitamin B12
D. Beta-carotene

ANSWER: B

A. The ability to ingest protein is unaffected in persons with lactose intolerance.

B. A deficiency of the enzyme lactase results in an inability to digest lactose, the sugar
found in dairy products. A lactose-restricted diet, which removes milk and other dairy
products from the diet, can result in a calcium, riboflavin, and vitamin D deficiency.
C. The ability to ingest vitamin B12 is unaffected in persons with lactose intolerance.
D. The ability to ingest beta-carotene from foods in the meat and bean, grain, vegetable,
and fruit food groups is unaffected in persons with lactose intolerance.

28. The home health nurse is evaluating the parents’ dietary

management of the child with celiac disease. Which foods, or products
that contain those foods, should the parents eliminate from their child’s
diet? Select all that apply.
A. Rice
B. Barley
C. Wheat
D. Corn
E. Oats

ANSWER: B, C, E

A. Rice does not contain gluten and can be eaten by someone with celiac disease.
B. Barley contains gluten and should be eliminated if celiac disease is present.
C. Wheat contains gluten and should be eliminated if celiac disease is present.
 D. Corn does not contain gluten and can be eaten by someone with celiac disease.
E. Oats contain gluten and should be eliminated if celiac disease is present.

29. The clinic nurse is teaching the mother about childhood nutrition.
Which statements is the clinic nurse likely to include? Select all that
apply.
A. Infants and children need all the vitamins that adults need but in different amounts.
B. Forcing a toddler to eat a distasteful food imprints a permanent avoidance behavior.
C. Calculate the recommended grams of fiber for the child by taking the child’s age in years.
D. Children ages I to 2 years should be drinking whole milk rather than skim milk.
E. Preschoolers are able to meet their nutritional needs by eating three healthy meals a
day.
F. Preschoolers tend to eat more and stay at the table longer when eating with their peers.

ANSWER: A, B, D, F

A. Infants, children, and adults do require the same vitamins, but in different amounts.
B. Permanent avoidance behaviors can be imprinted by forcing distasteful foods onto a
toddler. Foods should be introduced and if refused reintroduced at a later time.
C. The grams of fiber recommended for the child are calculated by taking the child’s age in
years plus 5. Considering only the child’s age in determining the amount of fiber will
result in an insufficient amount of fiber.
D. Whole milk provides adequate fat for the still- growing child’s brain.
E. Preschoolers and toddlers need to eat three meals a day and wholesome snacks
between meals to meet their nutritional needs.
F. Preschoolers are developing socially and mimic behavior, so they will tend to eat more
and stay at the table longer when eating with peers.

30. 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?
A. Vitamin A
B. Vitamin C
C. Vitamin D
D. Vitamin E

ANSWER: B
 A. Vitamin A does not affect iron absorption. It is essential to night vision, the health of
epithelial tissue, normal bone growth, and energy regulation.
B. Vitamin C (ascorbic acid) facilitates iron absorption by acting on hydrochloric acid to
keep iron in the more absorbable ferrous form.
C. Vitamin D does not affect iron absorption. It is essential for absorption and use of
calcium for bone and tooth growth.
D. Vitamin B does not affect iron absorption. It is an antioxidant that stimulates the
immune system.

31 . The nurse is caring for four children. Which child should the nurse
further assess for a vitamin C deficiency (scurvy)?

ANSWER: A
 A. Inflamed, spongy, and bleeding gums are associated with a vitamin C deficiency; this
child should be further assessed for scurvy.
B. The child with the swollen feet is experiencing kwashiorkor due to a severe dietary
protein deficiency.
C. The infant presented in this illustration has swollen, red cracks at the corners of the
mouth, indicative of a vitamin B deficiency.
D. This child is displaying “flag sign” hair, involving alternating light and dark bands of color
along individual hair fibers, and thinning hair, also due to a severe dietary protein
deficiency.

32. 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?
A. Pudding
B. Chicken noodle soup
C. Applesauce
D. Plain gelatin

ANSWER: A

A. Full liquid foods include nontransparent foods that turn liquid at room temperature.
Food items include pudding, custard, ice cream, sherbet, breakfast drinks, milk, and
strained soups or vegetable juices.
B. Unstrained chicken noodle soup is a food item on a regular diet.
C. Applesauce does not turn liquid at room temperature; it would be on a regular diet.
D. Plain gelatin is a clear liquid food item.

33. The older adult client is asking the nurse about nutritional
information. Which response gives good nutrition advice for the older
adult?
A. “Maintain an appropriate weight for your height, and include high-nutrient foods.”
B. “Increase vitamin E intake, and do muscle strengthening exercises 20 minutes daily.”
C. “Avoid high-fiber and gas-forming foods, and take a multivitamin supplement daily.”
D. “A vegan diet and drinking at least 2 quarts of water daily are recommended as we age.”

ANSWER: A

A. Overall weight control and consumption of foods high in nutrients will promote healthy
aging.
B. Supplements, such as vitamin E, are not substitutes for food.
C. Fiber is needed by the older adult because bowel motility decreases with aging.
 D. A vegan diet does not ensure a nutrient-dense diet.

34. The nurse is counseling the client placed on a DASH diet who has
limited food refrigeration capabilities and prefers using canned
vegetables. Which nutrient excess should the nurse caution the client
about when eating mainly canned, rather than fresh, vegetables?
A. Potassium
B. Vitamin A
C. Vitamin C
D. Sodium

ANSWER: D

A. Potassium is not a concern in the processing of canned vegetables.

B. Vitamin A is not a concern in the processing of canned vegetables.
C. Vitamin C is not a concern in the processing of canned vegetables.
D. Canned vegetables, even those low in sodium, have higher sodium levels than fresh or
frozen.

35. 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?
A. Minerals
B. Lecithins
C. Antioxidants
D. Amino acids

ANSWER: C

A. Minerals generally do not have an antioxidant function.

B. Lecithins are emulsifiers, not antioxidants, and do not protect against vision problems.
C. Oxidative stress plays a role in cataract formation. Antioxidants such as vitamin E and
vitamin C may reduce the likelihood of developing cataracts.
D. Amino acids are building blocks of protein.

36. The nurse is caring for the older adult client who has experienced
unintended weight loss. Which energy- dense protein foods should the
nurse offer to the client when the client requests a snack?
 A. Carrot sticks or apple wedges with dip
B. Peanut butter on celery or a hard-boiled egg
C. Whole wheat toast with grape jelly or a bagel
D. Yogurt or cottage cheese with blueberries

ANSWER: B

A. Fruit and vegetables are not good sources of protein and are generally low in calories
per serving. Dip can be high in fat content.
B. Peanut butter and eggs are good sources of complete proteins and are energy and
nutrient dense.
C. Grain products, such as Whole Wheat toast, are not good sources of protein and are not
energy dense.
D. Yogurt and cottage cheese are good sources of protein but are not energy dense even
with blueberries, which are low in calories.

37. The nurse reads in the HCP’s history and physical note that the
hospitalized child has a pica eating disorder. Which conclusions by the
nurse are correct? Select all that apply.
A. The child consistently eats nonfood substances such as dirt, crayons, and paper.
B. The child regurgitates, chews, and then reswallows previously ingested food.
C. A primary safety concern for the child is the possibility of accidental poisoning.
D. The child’s greatest risk, aspiration, should be monitored for at all times.
E. Complications of the disorder can include malabsorption and fecal impaction.
F. Usually children with a pica disorder are intellectually bright and precocious.

ANSWER: A, C , E

A. Pica is an eating disorder of young children who persistently eat nonfood substances
such as dirt, clay, paint chips, crayons, yarn, or paper.
B. The act of regurgitating, chewing, and then reswallowing previously ingested food is a
rumination disorder.
C. Accidental poisoning can occur from toxic substances in nonfood items that are ingested.
D. Accidental poisoning, not aspiration, is the greatest risk associated with a pica disorder.
Regurgitating can increase the risk for aspiration.
E. Malabsorption, fecal impaction, constipation, and intestinal obstruction are
complications associated with eating nonfood substances.
F. The incidence of a pica disorder increases with children who are cognitively challenged,
possibly because of their inability to distinguish edible from inedible substances as early
as other children can.
38. An experienced nurse is observing a new nurse teaching the client
about TPN. Which statement indicates that the new nurse needs
additional orientation regarding the administration of TPN?
A. “A gastrostomy tube will be inserted through the abdominal wall into your stomach to
administer your TPN.”
B. “Your blood glucose will be monitored frequently because the TPN has a high
concentration of dextrose.”
C. “Although an infusion pump will be used to administer the TPN solution, you can still
ambulate with assistance.”
D. “The TPN provides nutrients of proteins, carbohydrates, fats, electrolytes, vitamins, and
trace minerals.”

ANSWER: A

A. Parenteral nutrition provides nutrients by the IV route, not through a gastrostomy tube.
B. Because TPN solutions are 10% to 50% dextrose in water, blood glucose is monitored
frequently for signs of hyperglycemia.
C. The TPN solution is delivered via a pump at a controlled rate to prevent glucose and
volume overload. The pump is attached to a mobile IV stand for ambulation.
D. The composition of the TPN solution includes proteins, carbohydrates, fats, electrolytes,
vitamins, and trace minerals. It also contains sterile water.

39. The client’s infusion pump delivering TPN malfunctions, and the
nurse determines that, based on the amount of solution left in the TPN
bag, the client did not receive any TPN for the last 6 hours. The nurse
should monitor the client for which immediate complication?
A. Air embolism
B. Rebound hypoglycemia
C. Rebound hyperglycemia
D. Low serum albumin level

ANSWER: B

A. There is no indication that air has been allowed to enter the infusion line.
B. Because the TPN solution is high in dextrose, rebound hypoglycemia can occur from the
delayed pancreatic reaction to a change in insulin requirements.
C. Dextrose is no longer being given; thus hyperglycemia is unlikely to occur.
D. Although TPN contains protein, not receiving TPN for 6 hours would not affect the serum
albumin level immediately, or at all.
40. 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?
A. Vitamin B6
B. Vitamin A
C. Vitamin D
D. Vitamin C

ANSWER: C

A. Vitamin B6 is primarily found in meat, fish, and poultry, and it is not associated with
sunshine.
B. Vitamin A is not synthesized with exposure to sunlight.
C. Agoraphobia is a fear of the outdoors, crowds, or uncontrolled social conditions. Milk is a
major source of vitamin D, and vitamin D can be synthesized in the body by exposure to
sunlight.
D. Vitamin C is not synthesized with exposure to sunlight.

41 . The nurse is caring for the client experiencing dysphagia. Which

food item should the nurse remove from the client’s meal tray?
A. Corn
B. Custard
C. Pureed meat
D. Moist pasta

ANSWER: A

A. Chunky vegetables, such as corn, should be removed from the meal tray of the client
with dysphagia (swallowing difficulties) due to the risk of choking.
B. Custard that is flavorful or well chilled will stimulate the swallowing reflex.
C. Pureed foods, such as pureed meats, are easier to swallow and prevent choking.
D. Moist pasta will stimulate the swallowing reflex.

42. The client taking lithium for treatment of a bipolar disorder is

concerned that the medication is becoming less effective in controlling
symptoms. It is most important for the nurse to question the client’s
intake of which nutrient?
A. Salt
B. Protein
C. Potassium
 D. Carbohydrates

ANSWER: A

A. A high-salt diet increases urinary excretion of lithium, limiting the drug’s effectiveness.
B. Lithium is unaffected by high protein.
C. Lithium is unaffected by potassium.
D. Lithium is unaffected by carbohydrate diets.

43. The nurse is presenting a nutritional teaching session in a rural

community. Which statement should the nurse exclude?
A. “Iron is needed for energy; fish and poultry are significant sources of iron.”
B. “Fluoride is needed for bone and teeth health; well water is a good source of fluoride.”
C. “Iodine deficiency can cause mental retardation; seafood is a good source of iodine.”
D. “Potassium is essential to heart function; bananas are a good source of potassium.”

ANSWER: B

A. This statement is correct.

B. Well water usually does not contain fluoride. City water is fluoridated.
C. This statement is correct.
D. This statement is correct.

44. A dietary aide shows the nurse the snack options for the client on a
clear liquid diet. Which selection should the nurse eliminate from the
snack choices?
A. Glass of skim milk
B. Small dish of plain gelatin
C. Glass of iced tea
D. Carton of apple juice

ANSWER: A

A. A clear liquid diet contains foods that are clear liquids at room or body temperature.
Milk products are not included on a clear liquid diet.
B. Plain gelatin is considered a clear liquid.
C. Tea is considered a clear liquid.
D. Clear fruit juices such as apple juice are considered clear liquids.
45. The nurse is caring for the newly hospitalized child whose parents
practice the Hindu faith. Which dietary modification should the nurse
anticipate based on their faith beliefs?
A. Abstaining from meat on Fridays
B. Eating only a vegetarian diet
C. Avoiding pork or pork products
D. Serving “hot” foods to treat a “cold” illness

ANSWER: B

A. Some Roman Catholics abstain from meat on certain days such as Fridays during Lent,
Good Friday, and Ash Wednesday.
B. Religious such as Hindu and Seventh-Day Adventist promote eating a vegetarian diet.
C. Orthodox Judaism and Islam prohibit the ingestion of pork or pork products.
D. Traditional Chinese medicine emphasizes hot and cold foods for treating illness. This
refers to the food’s effect upon the body and not the temperature of the food.