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Roth 10e NCLEX
Chapter 22
MULTIPLE CHOICE
1. The nurse is determining how much protein a post-surgical client requires. Which of the
following would be an appropriate amount of protein for the nurse to recommend for the postsurgical client?
a. 50 to 80 grams
b. 60 to 90 grams
c. 80 to 100 grams
d. 100 to 120 grams
ANS: C
Because protein losses following surgery can be significant and because protein is especially
needed then to rebuild tissue, control edema, avoid shock, resist infection, and transport fats, a
high-protein diet of 80 to 100 grams a day may be recommended.
PTS: 1
REF: Postsurgery Nutritional Care
2. The nurse is caring for a client who will receive enteral nutrition through a PEG tube. The
client also has a condition that inhibits digestion and absorption of nutrients. What type of
enteral nutrition formula will the nurse select for this client?
a. elemental
b. modualr
c. polymeric
d. renal
ANS: A
Clients who are able to digest and absorb nutrients can be given polymeric formulas. Clients
who have limited ability to digest or absorb nutrients may be given elemental or hydrolyzed
formulas. Modular formulas can be used as supplements to other formulas or for developing
customized formulas for certain clients. This client was not identified as having renal disease,
so a renal formula would be inappropriate.
PTS: 1
REF: The Client Receiving Enteral Nutrition
3. A nurse is caring for a client who is receiving enteral nutrition via a nasogastric tube at a rate
of 50ml/hour over 24 hours. The nurse notes that the client is also now receiving the drug
phenytoin. The nurse notes that there is a food drug interaction with this drug. How will the
nurse alter the client’s feeding to avoid the food-drug interaction?
a. Administer the medication at midnight c. No change to the tube feeding protocol
and turn off the tube feeding until 6:00
is necessary because the client is not
am.
eating food.
b. Decrease the tube feeding rate by 50% d. Stop the tube feeding for an hour
until the drug is discontinued.
before the drug is administered until an
hour after.
ANS: D
There is a food-drug interaction between the phenytoin and the tube feeding formula, so it is
necessary to separate administration of the tube feeding with administration of the medication.
The tube feeding should be stopped for an hour before the drug is administered until an hour
after.
PTS: 1
4.
REF: The Client Receiving Enteral Nutrition
A client who is been receiving enteral nutrition now has pneumonia. What nutrition related
complication would the nurse say could be related to development of pneumonia in this
client?
a. Aspiration of formula from the feeding c. There are no nutrition complications
tube.
b. Fluid retention associated with high
sodium intake
that could contribute to development
of pneumonia.
d. Tube feeding being delivered at too
low a rate
ANS: A
Aspiration occurs when some of the formula enters the lung and can cause the client to
develop pneumonia.
PTS: 1
REF: Possible Complications with Enteral Nutrition
5. The nurse is caring for a client with serious burns who is unable to eat. What would the nurse
do to ensure the client is getting adequate nutrition? Select the best answer.
c. Wait one week and see if the client’s
begin either tube feeding or parenteral
condition improves enough that they
feeding as appropriate.
client can eat.
b. Immediately begin tube feedings.
d. Wait two days and if the client still
cannot eat, begin parenteral feeding.
a. Assess the client and immediately
ANS: A
If the client is unable to eat, either tube feedings or parenteral feedings, whichever is more
appropriate, should be started immediately.
PTS: 1
REF: The Client With Burns
6. The nurse assesses a client with AIDS and finds the client’s temperature is 2 degrees
Fahrenheit above normal. The nurse knows that this client will need more calories because
fever increases the basal metabolic rate (BMR). The nurse would calculate that this client’s
BMR is increased by what percent over normal?
a. 7%
b. 14%
c. 17%
d. 22%
ANS: B
Fever is a hypermetabolic state in which each degree of fever raises the BMR by 7%. Since this
client’s temperature is 2 degrees Fahrenheit above normal, the BMR is elevated 14%
PTS: 1
REF: The Client with Infection
MULTIPLE RESPONSE
1. A client is scheduled to have surgery in 4 weeks, and it was determined that the nutritional
status of the client needs to be improved. Which of the following nutrients would the nurse
identify as being of particular concern for a client about to have surgery? Select all that apply
a. fat
b. protein
c. vitamin A
d. vitamin C
e. vitamin K
f. zinc
ANS: B, C, D, E, F
Protein is needed for wound healing, tissue building, and blood regeneration. Extra
carbohydrates will be converted to glycogen and stored to help provide energy after surgery,
when needs are high and when clients may be unable to eat normally. The B vitamins are
needed for the increased metabolism, vitamins A and C and zinc for wound healing, vitamin
D for the absorption of calcium, and vitamin K for proper clotting of the blood.
PTS: 1
REF: Presurgery Nutritional Care
2. Twenty minutes after eating a meal, a gastric surgery client begins to experience dizziness,
cramps, and vomiting. The nurse recognizes the symptoms of dumping syndrome and
recommends the client avoid which of the following foods? Select all that apply.
a. candy bars
b. eggs
c. fruit juice
d. large amounts of fluid with meals
e. red meat
f. regular soda
ANS: A, C, D, F
Sometimes following gastric surgery, dumping syndrome occurs within 15 to 30 minutes after
eating. This is characterized by dizziness, weakness, cramps, vomiting, and diarrhea. To
prevent dumping syndrome, the diet should be high in protein and fat, and carbohydrates—
especially concentrated sweets--should be restricted. Candy bars, fruit juice and regular soda
are all high in concentrated sugars. Large amounts of fluids should not be consumed with
meals. Fluids consumed with a meal should be limited to 4 oz.
PTS: 1
REF: Postsurgery Nutritional Care
3. The visiting nurse is caring for a client who has AIDS. At the nurse’s most recent visit, the
nurse notices that the client has lost weight and discerns that the client is experiencing
anorexia. The nurse knows there are several issues that could cause anorexia in a client with
AIDS. Which of the following would the nurse say could be causing the client’s loss of
appetite? Select all that apply.
a. altered taste
b. dementia
c. depression
ANS: A, B, C, D, E, F
d. medications
e. oral infections
f. pain
AIDS clients commonly experience serious protein-energy malnutrition and, thus, body
wasting. There are several causes of reduced food intake in AIDS clients. Some of these are
medications, oral infections, altered taste, fever, pain, depression, dysphagia, and dementia.
PTS: 1
REF: Problems Related to Feeding AIDS Clients; Table 22-3
NUMERIC RESPONSE
1. A client who weighed 80 kilograms was given an intravenous solution that contained 500
calories immediately after surgery. This was the client’s only calorie intake for the following
24-hour period. The nurse estimates the client’s daily energy needs to be 40 calories per kg of
body weight. What will the nurse determine the client’s energy deficit to be for the 24 hours
post surgery?
ANS:
2700 calories
The estimated daily calorie requirement for adults after surgery is 35 to 45 calories per
kilogram of body weight. Calculation: 80 kg x 40 kcal/kg=3200 kcal – 500 kcal=2700
calories
PTS: 1
REF: Postsurgery Nutritional Care