ASSESS
A patient on warfarin reports eating large amounts of spinach and kale. What should the nurse do?
A. Tell the patient to stop eating leafy greens
B. Advise the patient to reduce potassium intake
C. Educate that vitamin K decreases warfarin effectiveness
D. Increase iron-rich foods
Answer: C
Rationale: Leafy greens contain vitamin K, which antagonizes warfarin and lowers its effectiveness.
Which finding is MOST concerning in a patient with bulimia nervosa?
A. Enamel erosion
B. Calluses on knuckles
C. Swollen parotid glands
D. Potassium level 2.9 mEq/L
Answer: D
Rationale: Hypokalemia is life-threatening and can cause cardiac dysrhythmias.
A patient with pernicious anemia asks why injections are needed. The nurse responds:
A. “Your diet is too low in B12.”
B. “Your body lacks intrinsic factor needed to absorb B12.”
C. “B12 supplements work slowly.”
D. “The injections prevent iron loss.”
Answer: B
Rationale: Pernicious anemia = loss of intrinsic factor → cannot absorb B12; lifelong injections needed.
The nurse is teaching a diabetic about diet. Which statement shows understanding?
A. “My A1c should be below 7.5%.”
B. “My A1c shows my average blood sugar for 3–4 months.”
C. “Carbohydrates are unsafe for diabetics.”
D. “I should avoid all fats.”
Answer: B
Rationale: HbA1c reflects 3–4 month average glucose.
Which patient is at greatest risk for vitamin D deficiency?
A. Patient with a tibia fracture
B. Patient who works outdoors
C. Patient with chronic kidney disease
D. Patient taking niacin
Answer: C
Rationale: Kidneys activate vitamin D; CKD → impaired conversion → deficiency.
. The nurse is assessing an older adult and notes decreased appetite, weight loss, and brittle hair. Which assessment should the nurse perform FIRST?
A. Ask about religious food restrictions
B. Review 24-hour dietary intake
C. Check bowel movement pattern
D. Inspect oral cavity and dentition
Answer: D
Rationale: Poor dentition is a common cause of malnutrition in older adults. Identifying mechanical barriers to chewing/swallowing is the highest priority.
A patient is advancing diet after abdominal surgery. Which order is correct?
A. Full liquid → clear liquid → regular
B. NPO → regular
C. Clear liquid → full liquid → soft → regular
D. Regular → soft → liquid → NPO
Answer: C
Rationale: Diets are advanced as tolerated from easiest to most difficult to digest.
The nurse prepares to check a patient's finger-stick glucose. Which action is correct?
A. Use the center of the finger
B. Milk the finger for blood
C. Warm the hands prior to puncture
D. Wipe away the second drop of blood
Answer: C
Rationale: Warming hands increases circulation and accuracy. The first drop is wiped away, not the second.
A client taking steroids is at risk for which nutritional problem?
A. Weight loss
B. Fluid deficit
C. Weight gain and increased appetite
D. Low sodium levels
Answer: C
Rationale: Corticosteroids → increased appetite, fluid retention, weight gain.
Which vitamin is water-soluble and NOT stored in the body?
A. Vitamin A
B. Vitamin D
C. Vitamin K
D. Vitamin B1
Answer: D
Rationale: Vitamin B-complex and C are water-soluble → not stored → daily intake needed.
A patient with a BMI of 17 is admitted. What is the priority?
A. Educate about sodium intake
B. Screen for malnutrition
C. Recommend exercise
D. Assess interest in weight loss
Answer: B
Rationale: BMI <18.5 = malnourished → requires full nutrition screening.
A client has lactose intolerance. Which symptom does the nurse expect?
A. Constipation
B. Jaundice
C. Osmotic diarrhea
D. Dark tarry stool
Answer: C
Rationale: Lactose intolerance = lactase deficiency → undigested lactose pulls water → osmotic diarrhea.
SATA: Which patients have increased caloric needs?
(Select all that apply.)
A. Infant
B. Toddler
C. Older adult
D. Post-surgical client
E. Patient on bed rest
Answer: A, B, D
Rationale: Infants/toddlers = growth; post-surgery = wound healing = ↑ calories & protein.
16. The nurse is teaching about MyPlate. Which statement indicates understanding?
A. “Half my plate should be protein.”
B. “Half my plate should be fruits and vegetables.”
C. “Dairy should be eliminated.”
D. “Grains should be the smallest portion.”
Answer: B
Rationale: MyPlate recommends ½ fruits + vegetables.
Which lab finding is expected in folate deficiency anemia?
A. Neurological symptoms
B. Elevated potassium
C. Normal neurological function
D. Cyanosis
Answer: C
Rationale: Folate deficiency = NO neurological symptoms (unlike B12 deficiency).
A patient recovering from bariatric surgery reports dizziness, sweating, and diarrhea after meals. What is occurring?
A. Hypoglycemia
B. Dumping syndrome
C. Lactose intolerance
D. Vitamin B1 deficiency
Answer: B
Rationale: Dumping syndrome occurs after gastric bypass due to rapid emptying of stomach contents.
Which meal is BEST for a client with iron-deficiency anemia?
A. Grilled chicken, white rice, apple slices
B. Spinach salad, beans, fortified cereal
C. Yogurt, banana, crackers
D. Baked fish and mashed potatoes
Answer: B
Rationale: Iron-rich foods: spinach, beans, fortified cereals.
A postoperative client has slow wound healing. What nutrient should the nurse increase?
A. Fat
B. Protein
C. Carbohydrates
D. Sodium
Answer: B
Rationale: Protein is essential for tissue repair and collagen formation.
A patient reports dark, tarry stools after starting oral iron supplements. Which action is correct?
A. Stop the medication
B. Assess for GI bleeding
C. Reassure this is a normal side effect
D. Call provider immediately
Answer: C
Rationale: Iron commonly causes dark stools; expected, not harmful.
Which patient is MOST at risk for iron-deficiency anemia?
A. Patient with colon resection
B. Patient with duodenal resection
C. Patient who avoids red meat
D. Patient taking calcium supplements
Answer: B
Rationale: Iron is absorbed in the duodenum; GI surgery removing it causes iron-deficiency anemia.
A nurse suspects zinc deficiency when a patient shows:
A. Increased appetite
B. Dermatitis and poor wound healing
C. Numbness in extremities
D. Weight gain
Answer: B
Rationale: Zinc deficiency → dermatitis, poor taste, poor growth, impaired wound healing.
A patient with dysphagia is at risk for aspiration. Which order is MOST appropriate?
A. Thin liquids
B. Regular diet
C. Pureed foods and thickened liquids
D. Encourage use of a straw
Answer: C
Rationale: Dysphagia requires modified textures to reduce aspiration risk.
The nurse explains that water is an essential nutrient because it:
A. Provides the most calories
B. Enables all cellular metabolism
C. Prevents vitamin toxicity
D. Decreases sodium needs
Answer: B
Rationale: Water is required for cell metabolism, transport, temperature regulation, and biochemical reactions.
During a nutrition assessment, the nurse uses therapeutic communication by asking:
A. “Why don’t you eat healthier foods?”
B. “You should drink more water.”
C. “Tell me about the foods you enjoy and when you usually eat.”
D. “Are you following your diet correctly?”
Answer: C
Rationale: Open-ended, nonjudgmental questions encourage accurate nutrition assessment.
Which electrolyte imbalance is associated with dangerous heart rhythm disturbances?
(Select all that apply)
A. Hypokalemia
B. Hyperkalemia
C. Hypomagnesemia
D. Hypernatremia
E. Zinc deficiency
Answer: A, B, C
Rationale: