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Chapter 24. Nutritional Care and Support

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Chapter 24. Nutritional Care and Support

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  • November 2, 2024
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  • 2024/2025
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Chapter 24. Nutritional Care and Support

Multiple Choice
Identify the choice that best completes the statement or answers the question.

1. A nurse is caring for a patient with diabetes who requires blood glucose monitoring before meals and at
bedtime. When checking the patient’s blood glucose before lunch, the nurse documents the reading as
130 mg/dL. What should the nurse do next?
1. Continue to monitor.
2. Notify the patient’s physician.
3. Give the patient an injection of insulin.
4. Administer a syringe of 50% dextrose.
2. When caring for a patient with diabetes, a nurse checks the morning laboratory values. The nurse notes that
the patient’s blood glucose level is 60 mg/dL. The nurse recognizes this reading is consistent with
1. Hypoglycemia.
2. Hyperglycemia.
3. A normal value.
4. Diabetic ketoacidosis.
3. When performing an initial admission assessment on a patient with diabetes, a nurse checks the patient’s
blood glucose level. The nurse notes that the patient’s blood glucose level is 280 mg/dL. The nurse
recognizes this reading is consistent with
1. Hypoglycemia.
2. Diabetic coma.
3. Hyperglycemia.
4. A normal value.
4. While providing diabetic teaching to a patient with newly diagnosed diabetes, a nurse teaches that the best
indicator of long-term glycemic control is obtained through measuring
1. Creatinine level.
2. Urine glucose level.
3. Blood glucose level.
4. Glycosylated hemoglobin.
5. While educating a patient with diabetes about the HbA1c test, a nurse teaches that the HbA1c gives a better
overall picture of glycemic control by measuring the amount of glucose present over a period of
1. 1 to 2 months.
2. 4 to 5 months.
3. 2 to 3 months.
4. 3 to 4 months.
6. A nurse teaches a patient with diabetes that the goal of diabetes treatment is to maintain an HbA1c less than
1. 7%.
2. 8%.
3. 9%.
4. 10%.
7. While educating a patient with diabetes about simple carbohydrates, a nurse teaches that simple carbohydrates
are quickly converted to glucose and can be used to quickly increase blood glucose. The nurse identifies an
example of a simple carbohydrate as
1. Legumes.

, 2. Vegetables.
3. Fruit juices.
4. Whole grains.
8. While educating a patient with diabetes about complex carbohydrates, a nurse teaches that complex
carbohydrates require the body to work harder to break them down to use for energy, helping to maintain
a more consistent blood glucose level. The nurse identifies an example of a complex carbohydrate as
1. Bananas.
2. Legumes.
3. Fruit juices.
4. Processed baked goods.
9. When educating a patient about cooking methods, a nurse recognizes that additional teaching is warranted
when the patient states that a way to reduce fat intake is by
1. Frying.
2. Baking.
3. Grilling.
4. Broiling.
10. A patient has been prescribed isoniazid (INH), a medication that treats tuberculosis. When administering INH
to the patient, a nurse also anticipates administering the nutritional supplement
1. Vitamin K.
2. Vitamin C.
3. Vitamin B6.
4. Vitamin B12.
11. A patient has been prescribed the medication lithium as a mood-stabilizing agent. While administering lithium
to the patient, a nurse should closely monitor
1. Sodium levels.
2. Calcium levels.
3. Potassium levels.
4. Phosphorus levels.
12. An emergency department nurse admits an adult patient for a drug overdose. The physician writes an order for
the nurse to instill charcoal through a nasogastric (NG) tube. When selecting the NG tube, the nurse should
choose a size
1. 4 French.
2. 8 French.
3. 12 French.
4. 16 French.
13. A physician writes an order for a nurse to insert a nasogastric (NG) tube for gastric decompression. When
inserting the NG tube, the nurse should
1. Force the tube toward the nasopharynx.
2. Instruct the patient to avoid swallowing while inserting the tube.
3. Push the tip of the tube upward against the top side of the nasal passage.
4. Instruct the patient to hyperextend his or her head slightly and then gently insert the
tube into the intended naris.
14. As a nurse inserts a nasogastric (NG) tube, a patient gags and coughs continually and does not appear able to
stop. The nurse should
1. Tape the tube to the patient’s naris.
2. Continue to insert the tube quickly.

, 3. Immediately remove the tube completely.
4. Use a flashlight and tongue blade to view the posterior pharynx.
15. When a nurse inserts a nasogastric (NG) tube, the patient becomes cyanotic, coughs incessantly, and is unable
to speak. The nurse should
1. Tape the tube to the patient’s naris.
2. Continue to insert the tube quickly.
3. Immediately remove the tube completely.
4. Use a flashlight and tongue blade to view the posterior pharynx.
16. A nurse has just completed the insertion of a nasogastric (NG) tube. The nurse should verify placement by
aspirating for gastric contents and checking the pH of the aspirate. The nurse recognizes that the pH of gastric
contents should be between
1. 1 and 4.
2. 2 and 5.
3. 3 and 6.
4. 4 and 7.
17. A physician writes an order to discontinue a nasogastric (NG) tube. When discontinuing the NG tube, the
nurse should
1. Slowly withdraw the tube from the patient’s nose.
2. Show the removed tube to the patient and his or her spouse.
3. Instill 10 to 20 mL of air into the NG tube’s main lumen.
4. Instruct the patient to breathe deeply while removing the tube.
18. A nurse is caring for a patient who is receiving formula through intermittent tube feedings. When caring for
this patient, the nurse should
1. Keep the patient in a supine position.
2. Warm the formula in the microwave oven.
3. Maintain the formula at room temperature.
4. Administer the formula directly from the refrigerator.
19. A nursing instructor evaluates a student nurse’s application of theory regarding continuous tube feedings. The
nursing instructor recognizes that further teaching is warranted when the student nurse
1. Instructs the patient to maintain a supine position.
2. Ensures that the head of the patient’s bed is continually raised 30 degrees or more.
3. Interrupts the feeding every 4 hours to check placement.
4. Interrupts the feeding every 4 hours to check residual volume.
20. A student nurse is discussing ways to assist with meals and improve a patient’s eating experience in the
hospital. A nurse intervenes when the student says:
1. “I should wipe off the over-the-bed table with disinfectant if a urinal or any
other contaminated item has been on it.”
2. “To avoid contamination, I should never open any container—milk cartons, juice
containers, or cellophane packaging for plastic utensils—on the tray.”
3. “I should make rounds to my patients’ rooms during mealtimes and ask if they have
any needs.”
4. “I should ensure that each meal tray is assessed for the correct diet and appropriate
temperature of food.”
21. It would be considered inappropriate for a nurse to
1. Set a meal tray down on a patient’s over-the-bed table and then immediately leave
the room.

, 2. Remove any item from a patient’s over-the-bed table before the delivery of meal trays.
3. Assist a patient with dentures before mealtime.
4. Inquire whether the patient needs to go to the bathroom before eating.
22. A nurse is monitoring a patient’s intake and output. The patient drinks part of a can of cola. The nurse should
1. Ask the patient to finish the can of cola.
2. Estimate how much of the can was consumed by the patient.
3. Measure the remainder to determine the amount ingested.
4. Not record such a small amount of fluid.
23. When monitoring the fluid intake of an average adult patient over a 24-hour period, a nurse should expect the
patient to consume between
1. 500 and 1200 mL of fluid
2. 1200 and 1500 mL of fluid
3. 1500 and 2500 mL of fluid
4. 2500 and 3500 mL of fluid
24. A patient has complained several times of minor gastrointestinal pain, flatulence, and diarrhea after meals. A
nurse identifies that this is most likely caused by
1. Anaphylaxis.
2. Food intolerance.
3. A food allergy.
4. Food poisoning.
25. A doctor has ordered NPO status for a vomiting patient. A nurse violates the order by
1. Providing the patient with intravenous (IV) fluids.
2. Giving the patient ice chips.
3. Removing the patient’s water carafe and drinking glass from the bedside.
4. Putting a sign that reads NPO over the patient’s bed.
26. A patient with dysphagia is given a meal of scrambled eggs, cottage cheese, and tea. A nurse identifies that
this patient is on a
1. Mechanical soft diet.
2. A full liquid diet.
3. Protein-restricted diet.
4. Pureed diet.
27. A nurse is discussing daily meals with a patient on a regular diet. The nurse explains that the patient can make
choices from a balanced meal plan based on approximately
1. 1000 calories per day.
2. 1200 calories per day.
3. 2000 calories per day.
4. 3000 calories per day.
28. A nurse is caring for an elderly patient who is unable to eat more than a few bites at a time. The nurse should
modify the patient’s diet to
1. A high-calorie, high-protein diet.
2. Five to six small, frequent feedings.
3. A sodium-restricted diet.
4. An antigen-avoidance diet.
29. A patient is complaining of swollen hands and legs and mild fluid retention. The nurse decides to change the
patient’s diet to

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