Chapter 40 Nursing Management Nutritional Problems

3427 Words Mar 1st, 2015 14 Pages
Chapter 40: Nursing Management: Nutritional Problems
Test Bank
MULTIPLE CHOICE
1. Which finding for a 19-year-old female who is a vegan may indicate the need for cobalamin

supplementation?
a. Paresthesias
b. Ecchymoses
c. Dry, scaly skin
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:
889
TOP: Nursing Process: Assessment
MSC: NCLEX: Physiological Integrity
2

2. A 76-year-old woman with a body
…show more content…
An x-ray is obtained immediately after placement of the PEG tube to check position, but daily x-rays are not needed.
DIF: Cognitive Level: Apply (application)
REF:
898
TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity

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7. A malnourished patient is receiving a parenteral nutrition (PN) infusion containing amino

acids and dextrose from a bag that was hung 24 hours ago. The nurse observes that about 50 mL remain in the PN container. Which action is best for the nurse to take?
a. Ask the health care provider to clarify the written PN order.
b. Add a new container of PN using the current tubing and filter.
c. Hang a new container of PN and change the IV tubing and filter.
d. Infuse the remaining 50 mL and then hang a new container of PN.
ANS: B

All PN solutions are changed at 24 hours. PN solutions containing dextrose and amino acids require a change in tubing and filter every 72 hours rather than daily. Infusion of the additional 50 mL will increase patient risk for infection. Changing the IV tubing and filter more frequently than required will unnecessarily increase costs. The nurse (not the health care provider) is responsible for knowing the indicated times for tubing and filter changes.
DIF: Cognitive Level: Apply (application)
REF:
eTable 40-8
TOP: Nursing Process: Implementation
MSC: NCLEX: Physiological Integrity
8. A patient’s capillary blood glucose level is 120 mg/dL 6 hours after