Deck 29: Management of Clients with Malnutrition

Question 1

The nurse can reduce the risk of access site infection in a client receiving TPN by

A) adding antibiotics to the TPN fluid.
B) changing the catheter every 48 hours.
C) changing the transparent dressing every 72 hours.
D) using a semipermeable dressing on the insertion site.

Answer 1

changing the transparent dressing every 72 hours.

Question 2

The nurse explains that in the administration of total parenteral nutrition (TPN), options for infusion do not include which of the following?

A) Central venous access device inserted through the jugular vein
B) Peripheral IV catheter in the back of the hand
C) PICC line inserted peripherally and threaded to the subclavian vein
D) Totally implanted ports or external tunneled central venous catheters

Answer 2

Peripheral IV catheter in the back of the hand

Question 3

A nurse is caring for several clients with small-bore feeding tubes and nasogastric (NG) tubes. Which of the following activities can the nurse delegate to the unlicensed assistive personnel?

A) Assessing placement of the nasoenteric feeding tube
B) Reattaching suction to a nasogastric tube after the client ambulates
C) Refilling the tube-feeding bag for a small-bore gastrostomy tube
D) Performing skin care at the exit site of a jejunostomy tube

Answer 3

Performing skin care at the exit site of a jejunostomy tube

Question 4

A client with anorexia nervosa has a nursing diagnosis of Imbalanced Nutrition: Less than Body Requirements related to inadequate food intake. The client's current weight is 92 pounds. The nurse would evaluate that the client is making safe progress if the weight after 1 week is

A) 107 pounds.
B) 102 pounds.
C) 97 pounds.
D) 94 pounds.

Question 5

The nurse's action that will best prevent clogging of a gastric feeding tube is to

A) adhere to the tube flushing protocol.
B) apply intermittent suction.
C) check tube placement every 4 hours.
D) periodically reposition the tube.

Question 6

In feeding a client with a cognitive impairment, the least helpful nursing action is to

A) create a quiet, unhurried environment.
B) distract the client with conversation.
C) orient the client to the feeding equipment.
D) provide several small meals.

Question 7

To help prevent hyperglycemia in a client receiving TPN, the nurse would

A) administer the solution slowly.
B) keep the infusion at room temperature.
C) protect the solution from light.
D) use an infusion pump.

Question 8

A client who has begun receiving TPN with lipids develops shaking chills, shortness of breath, and chest pain. The priority action by the nurse is to immediately

A) call the physician.
B) obtain a 12-lead ECG.
C) stop the infusion.
D) take a set of vitals.

Question 9

The nurse should assist the malnourished client with oral hygiene by providing the client with

A) a firm-bristled toothbrush.
B) alcohol-containing mouthwashes.
C) glycerin and lemon swabs.
D) warm saltwater rinses.

Question 10

The nurse explains to a client with renal failure who requires an oral nutritional supplement that the most appropriate brand would be

A) Boost Plus.
B) Nepro.
C) Nutra Shake.
D) Probalance.

Question 11

When assisting a dysphagic client to eat, the nurse should

A) have the client slightly flex the neck for swallowing.
B) place the client in Sims position for 15 minutes after meals.
C) position the client in the semi-Fowler position.
D) use the fingers to check the client's mouth for food.

Question 12

In the initial assessment of a client with bulimia, the nurse would inquire about

A) binge-eating episodes.
B) black, tarry stools.
C) flatulence.
D) hyperactivity.

Question 13

The nurse teaching a family member how to position a client who is to receive tube feedings would suggest

A) allowing the client to assume a position of comfort during the feeding.
B) elevating the head of the bed at least 45 degrees before the feeding.
C) encouraging the client to move out of bed into a chair for the feeding.
D) placing the client in a left side-lying position with the head of the bed flat.

Question 14

The nurse providing instructions to a client who will be discharged to home with self-administered bolus enteral feedings would teach the client to infuse the feeding over

A) 2 to 10 minutes.
B) 10 to 15 minutes.
C) 15 to 30 minutes.
D) 30 to 60 minutes.

Question 15

At 8 AM a nurse hangs a bag containing enteral nutrition formula for a client. The nurse will return at

A) 9 AM to change the tubing and bag and add new formula.
B) 10 AM to discard remaining formula and replace it with new.
C) 12 noon to replace formula after rinsing the bag and tubing.
D) 1 PM to flush the bag and tubing and add formula.

Question 16

The client manifestation noted by the nurse as inconsistent with malnutrition is

A) constipation.
B) delayed wound healing.
C) fatigue.
D) postural hypotension.

Question 17

After discussing reasonable weight loss goals with a client, the nurse would see the need for further teaching with the client's statement

A) "I will limit my intake to 500 calories a day."
B) "I will try to eat very slowly."
C) "I'll try to pick foods from all five food groups."
D) "It's important to begin a regular exercise program."

Question 18

A client who is diagnosed with bulimia would be most likely to manifest the psychosocial alteration of

A) denial.
B) depression.
C) self-mutilation.
D) social withdrawal.

Question 19

Before administering enteral feeding, the nurse can ensure proper tube placement by

A) asking the client to swallow.
B) auscultating the stomach as 10 ml of water is injected.
C) extracting stomach contents from the tube.
D) holding the end of the tube under water to check for bubbling.

Question 20

The nurse preparing a postoperative teaching plan for a client who had a gastric stapling would include that

A) dumping syndrome is a common side effect.
B) fluids must be taken in liberal amounts.
C) exercise is prohibited after meals.
D) small, frequent feedings must become a habit.

Question 21

When planning care for the client with obesity who is having a gastric restrictive procedure, the nurse would include interventions designed to (Select all that apply)

A) encourage the client to lose 4-6 pounds a week.
B) ensure client and nurse safety.
C) monitor the client while taking weight loss medication.
D) prevent wound and skin complications.