Nutrition
What does high gastric residual indicate?
Delayed gastric emptying (too much left over in the stomach)
Before administering insulin, which nursing action has highest priority?
A. Assess potassium level
B. Confirm diet order and patient’s oral intake
C. Shake insulin vigorously
D. Administer insulin before checking glucose
B. Confirm diet order and patient’s oral intake
🧠 Rationale: Always assess blood sugar and oral intake before insulin to prevent hypoglycemia.
What is the only reliable tool to detect a VTE?
ultrasound
What age do we first test for Hyperlipidemia, and after that how often do we test?
Age 20, every 4-6 years
Which assessment finding best indicates malnutrition?
A. Albumin 4.0 g/dL
B. Prealbumin 8 mg/dL
C. BMI 23 kg/m²
D. Hemoglobin 14 g/dL
B. Prealbumin 8 mg/dL
< 15 mg/dL = acute protein deficiency
Before starting a tube feeding, the nurse’s priority action is to:
A. Check blood glucose
B. Verify tube placement
C. Warm the formula
D. Elevate HOB after feeding
B. Verify tube placement
Confirm placement to prevent aspiration and ensure correct GI location.
What are the symptoms of Hypoglycemia?
Sweating, blurry vision, dizzy, anxiety, hunger, irritability, shaky, tachycardia, headache, fatigue
What are the 5 signs of intolerance for tube feeding?
High gastric residuals, nausea, vomiting, cramping, diarrhea
What three factors directly affect cardiac output?
Heart rate, stroke volume, and myocardial contractility
What is considered hypoglycemic and what is considered hyperglycemic?
Hypo: bs less than 70
Hyper: bs above 250-300
A nurse is caring for a patient recovering from jaw surgery who has difficulty chewing solid foods but can tolerate foods that are smooth and blended to a pudding-like consistency. The nurse is preparing to serve scrambled eggs, mashed potatoes with gravy, and pureed peaches. What type of modified texture diet is this?
Pureed diet
A diabetic patient using an insulin pump presents with confusion and fruity breath odor. What complication should the nurse suspect?
A. Hypoglycemia
B. DKA from pump malfunction
C. HHNS from over-hydration
D. Insulin allergy reaction
B. DKA from pump malfunction
🧠 Rationale: Pump failure → lack of insulin → ketone buildup → DKA.
What chronic vascular damage is caused by long-term hyperglycemia?
Angiopathy (micro and macrovascular damage)
A nurse is assessing a patient with an ejection fraction (EF) of 35%. Which interpretation by the nurse is correct?
A. The patient has a normal EF and adequate perfusion.
B. The patient is experiencing decreased contractility and possible heart failure.
C. The EF value indicates the heart is pumping too forcefully.
D. The patient’s stroke volume is likely higher than normal.
B. The patient is experiencing decreased contractility and possible heart failure.
Which lab values define optimal lipid levels?
Cholesterol < 200 mg/dL
LDL < 130 mg/dL
HDL > 45 (M) / > 55 (F)
Which diet is ordered for a diabetic patient to maintain steady blood glucose?
Consistent carbohydrate diet
List and define the two types of angiopathy
Macrovascular: damage to big blood vessels (coronary arteries, peripheral vascular, cerebral vascular)
Microvascular: damage to tiny blood vessels (retinopathies, nephropathies, neuropathies)
A nurse is caring for a postoperative patient diagnosed with a venous thromboembolism (VTE). Which of the following physician orders should the nurse expect to see for treatment?
A. Start continuous IV heparin infusion as prescribed.
B. Begin a high-protein diet to improve clot resolution.
C. Encourage the patient to ambulate without delay.
D. Discontinue anticoagulants once pain subsides.
A. Start continuous IV heparin infusion as prescribed.
Heparin (an anticoagulant) prevents the clot from getting larger and reduces the risk of a pulmonary embolism (PE).
Define Preload and Afterload
Preload: volume of blood returning to the heart at the end of diastolic stretch
Afterload: resistance the left ventricle must overcome to eject blood
What are the HbA1C normal, pre, and diabetic lab values?
normal: 5%
pre: 5.7-6.4%
Diabetic: greater than 6.5%
When checking gastric residual, when do you hold a tube feed and when do you hold+contact the HCP?
Hold: greater than 250 ml
Hold AND Contact HCP: greater than 500 ml
A nurse administers regular insulin (Humulin R) at 0730 before the patient eats breakfast.
At what time should the nurse be most alert for signs of hypoglycemia?
A. 0745–0830
B. 0900–1130
C. 1200–1400
D. 1800–2000
B. 0900–1130
Since it was given at 0730, the peak (greatest effect) — and therefore highest hypoglycemia risk — will be between 0930 and 1130.
What are the non surgical placements of tube feeding?
Nasogastric or nasointestinal
The nurse is caring for a patient who reports dizziness and blurred vision. Vital signs show BP 84/58 mmHg and HR 118 bpm. Which intervention should be done first?
A. Encourage the patient to ambulate.
B. Increase IV fluids per order to restore volume.
C. Administer antihypertensive medications.
D. Apply compression stockings.
B. Increase IV fluids per order to restore volume.
🧠 Rationale: Low BP + tachycardia indicates hypovolemia → restore perfusion first.
What are the fasting glucose lab ranges for normal, pre, and diabetic?
Normal: less than 99mg/dL
Pre: 100-125 mg/dL
Diabetic: 126 mg/dL or greater