ATI Nutrition Practice Exam

Correct Answer C: Tuna fish

Explanation of the correct answer:

Tuna fish is a soft, easy-to-chew food that is well-suited for older adults who have difficulty chewing due to ill-fitting dentures. It can be prepared in a variety of ways, such as in a salad or mixed with a soft dressing, making it easier to consume without putting stress on the teeth or gums. Additionally, tuna fish provides a good source of protein and healthy fats, which are important for maintaining overall health.

Why the other options are incorrect:

A) Dried fruit:

Dried fruit is hard and chewy, which can be difficult to consume for someone with ill-fitting dentures. The texture can cause discomfort and may even damage dentures or irritate the gums, making it less suitable for the client.

B) Roast beef:

Roast beef is a tough, fibrous meat that requires a significant amount of chewing, which would be difficult for someone with dentures that do not fit properly. This could cause discomfort and may be difficult to eat.

D) Apple slices:

Apple slices are crunchy and hard, which could cause difficulty for the client in chewing. The texture may also pose a risk of damaging dentures or causing irritation to the gums.

Summary:

For an older adult with difficulty chewing due to ill-fitting dentures, tuna fish is a suitable recommendation because it is soft and easy to chew, making it easier to eat and digest. Foods like dried fruit, roast beef, and apple slices are more difficult to chew and may not be ideal for the client in this situation.

Correct Answer B: Client's mucous membranes are pink.

Explanation of the correct answer:

When a client is receiving parenteral nutrition (PN), the effectiveness of the therapy can be assessed through several indicators of overall health and nutrition. Pink mucous membranes indicate adequate hydration and good oxygenation, which are signs that the body is receiving the necessary nutrients to maintain vital functions. Good mucous membrane color reflects the overall nutritional status, including the appropriate balance of fluid and electrolytes, which is a key goal of PN therapy.

Why the other options are incorrect:

A) Client has soft, formed bowel movements:

While regular bowel movements can be a sign of a healthy digestive system, parenteral nutrition bypasses the digestive system, meaning it doesn't typically affect bowel movements directly. The absence of bowel movements is not necessarily an indicator that PN therapy is not working, as it is common for clients receiving PN to have limited bowel function.

C) Client reports ability to complete ADLs:

While activities of daily living (ADLs) are important in evaluating the client’s overall well-being, they are not a direct measure of the effectiveness of parenteral nutrition. PN primarily aims to improve nutritional status, which would be better reflected by physical signs like mucous membrane color, weight gain, and lab values rather than just the ability to perform ADLs.

D) Client's blood glucose level is within the expected reference range:

Blood glucose levels are important to monitor during PN therapy, as the glucose concentration in PN solutions can affect blood sugar. However, normal blood glucose levels alone do not necessarily indicate that the PN therapy is effective in meeting the client's nutritional needs. Other indicators, such as weight gain, improvement in lab results (e.g., albumin), and hydration status (e.g., pink mucous membranes), provide more comprehensive information.

Summary:

The most direct and accurate indicator that parenteral nutrition is effective is the observation of pink mucous membranes, which suggests that the client is receiving sufficient hydration and nutrition.

Correct Answer B: Flush the tubing with 10 mL water every 6 hr

Explanation of the correct answer:

The best method to prevent a small-bore jejunostomy tube from clogging—especially when administering a high-viscosity formula—is to flush the tubing regularly with water. Flushing with at least 10 mL of water every 4 to 6 hours during continuous feedings helps keep the lumen clear of formula buildup. This action is essential in maintaining tube patency and preventing interruptions in nutritional delivery.

Why the other options are incorrect:

A) Replace the bag and tubing every 24 hr:

This is a standard infection-control measure to reduce bacterial contamination of enteral feeding systems, but it does not prevent clogging. Clogging is more closely associated with residue inside the tube rather than how long the tubing is used.

C) Admin the feeding by gravity drip:

Gravity drip lacks precision and consistency in flow rate, which can increase the risk of either underfeeding or overfeeding, and it does not help prevent clogging. In fact, inconsistent flow might increase clogging risk with high-viscosity formulas.

D) Heat the formula prior to infusion:

Heating the formula is not necessary unless specifically ordered, and doing so could alter the formula's composition or increase bacterial growth if not handled properly. It does not aid in preventing clogs.

Summary:

To prevent clogging in a small-bore jejunostomy tube delivering a high-viscosity formula, the nurse should flush the tube with 10 mL of water every 6 hours. This regular flushing helps maintain tube patency and ensures consistent feeding delivery.

Correct Answer A: 1 small baked sweet potato

Explanation of the correct answer:

A. 1 small baked sweet potato:

Sweet potatoes are an excellent source of vitamin A, particularly in the form of beta-carotene, which the body converts into vitamin A. A small baked sweet potato provides a high amount of vitamin A, making it the best choice for a client with vitamin A deficiency.

Why the other options are incorrect:

B. 1 cup avocado:

While avocados are nutritious and provide healthy fats, they are not a significant source of vitamin A. They contain vitamin E and other nutrients but do not provide the high levels of vitamin A found in other foods like sweet potatoes.

C. 1 cup green beans:

Green beans are a healthy vegetable, but they do not provide a substantial amount of vitamin A. They do contain some nutrients, but they are not a primary source of this vitamin.

D. 1 large apple:

Apples are rich in fiber and vitamin C, but they are not a significant source of vitamin A. Vitamin A is primarily found in foods like sweet potatoes, carrots, and dark leafy greens.

Summary:

For a client with vitamin A deficiency, the best source of vitamin A from the options provided is 1 small baked sweet potato (option A), as it is rich in beta-carotene, which the body can convert into vitamin A.

Correct Answers

B. Headache

C. Weakness

E. Sweating

Explanation of Correct Answers

B. Headache – Hypoglycemia causes neuroglycopenic symptoms due to decreased glucose availability to the brain, leading to headache, confusion, irritability, or difficulty concentrating.

C. Weakness – Low blood sugar results in insufficient energy supply to muscles, producing generalized weakness, shakiness, and fatigue.

E. Sweating – Sweating is an adrenergic symptom of hypoglycemia caused by the release of epinephrine as the body attempts to raise blood glucose levels. It is a classic early warning sign.

Why the Other Options Are Wrong

A. Urinary frequency – This is a manifestation of hyperglycemia, caused by osmotic diuresis due to excess glucose in the urine, not hypoglycemia.

D. Increased thirst – Polydipsia (excessive thirst) also indicates hyperglycemia, not hypoglycemia. It occurs as a result of fluid loss from osmotic diuresis.

Correct Answer D. Keep total fat intake at 25% of calories per day.

Explanation of Correct Answer

D. Keep total fat intake at 25% of calories per day

The Dietary Guidelines for Americans recommend that 20% to 35% of total daily calories come from fat, with an emphasis on unsaturated fats. Keeping fat intake around 25% of calories per day is appropriate and supports cardiovascular health while ensuring essential fatty acids are included in the diet. This makes it the correct recommendation for healthy eating.

Why the Other Options Are Wrong

A. Consume 50% of daily food intake from protein

This is far too high. The recommended protein intake is 10% to 35% of daily calories. Consuming 50% from protein could displace essential carbohydrates and fats and is not consistent with balanced nutrition.

B. Limit cholesterol intake to 500 mg per day

This is too high. Current recommendations advise limiting cholesterol intake to less than 300 mg per day (and ideally under 200 mg for those at risk of heart disease).

C. Restrict sodium intake to 3,000 mg per day

This exceeds the recommended amount. Adults should limit sodium intake to less than 2,300 mg per day, with some populations advised to stay closer to 1,500 mg to reduce hypertension and cardiovascular risk.

Correct Answer B: Calcium

Explanation of the correct answer:

B. Calcium:

Calcium is essential for the transmission of nerve impulses. It plays a key role in the functioning of muscle contractions and the release of neurotransmitters. Calcium ions facilitate the electrical signals necessary for nerve impulse transmission and are involved in synaptic function (the communication between nerve cells). Calcium is also critical for bone health, but its role in nerve function is vital for maintaining proper neurological health.

Why the other options are incorrect:

A. Phosphorus:

Phosphorus is a vital mineral primarily involved in the formation of bones and teeth, and it helps in energy production within cells. However, it does not play a primary role in the transmission of nerve impulses. Calcium is the mineral specifically needed for that function.

C. Chloride:

Chloride is an essential mineral that helps maintain fluid balance and works in tandem with sodium to regulate blood volume and blood pressure. While chloride does participate in some electrolyte balance functions within the body, it is not directly involved in nerve impulse transmission like calcium.

D. Zinc:

Zinc is important for immune function, wound healing, and cell division. It is also involved in the synthesis of DNA and protein. Although zinc is critical for various bodily functions, it does not play a direct role in the transmission of nerve impulses.

Summary:

Calcium is the mineral necessary for the transmission of nerve impulses, as it is involved in neurotransmitter release and muscle contraction. The other minerals—phosphorus, chloride, and zinc—are important for other physiological functions but do not directly affect nerve impulse transmission.

Correct Answer C. Position the newborn at a 20-degree angle after feeding.

Explanation of Correct Answer

C. Position the newborn at a 20-degree angle after feeding.

Infants with gastroesophageal reflux should be kept in an upright position after feedings to reduce the likelihood of gastric contents flowing back into the esophagus. A 20–30 degree angle is recommended for safe positioning, along with frequent burping and smaller, more frequent feedings. This strategy minimizes reflux and aspiration risk.

Why the Other Options Are Wrong

A. Provide a small feeding just before bedtime.

Feeding right before bedtime increases the risk of reflux when the infant is lying flat. Feedings should be spaced to allow some upright time before sleep.

B. Place the newborn in a side-lying position if vomiting.

Side-lying is not recommended because it increases aspiration risk. The safest sleep position for all infants, including those with reflux, is supine (on the back).

D. Dilute formula with 1 tablespoon of water.

Diluting formula reduces its caloric and nutrient content, leading to inadequate nutrition and electrolyte imbalances. Formula should always be prepared according to manufacturer instructions unless otherwise prescribed.

Correct Answer A: Maintain consistent food textures at mealtimes

Explanation of the correct answer:

A. Maintain consistent food textures at mealtimes:

As people age, their senses of taste and smell often diminish, which can reduce appetite and food enjoyment. Maintaining consistent food textures enhances the overall eating experience by making meals easier to chew and swallow, especially if the client also has subtle or undiagnosed dysphagia, which is common in older adults. Consistency in texture can also help the client focus on flavor and aroma, supporting safer and more pleasurable eating. This strategy addresses both sensory and nutritional concerns.

Why the other options are incorrect:

B. Use kosher salt in place of table salt:

This substitution does not significantly enhance taste perception for individuals with decreased sensory ability. Moreover, older adults are often advised to limit sodium intake due to the risk of hypertension and cardiovascular disease. Encouraging the use of more salt—whether kosher or not—could be harmful to this population.

C. Label and date food in the refrigerator:

While labeling and dating food is a helpful safety practice, it primarily addresses memory or cognitive issues rather than decreased taste and smell. Although sensory decline might reduce a client’s ability to detect spoiled food, this intervention does not directly improve or compensate for sensory deficits during mealtime, which is the focus of the question.

D. Wait 1 hour after eating to consume fluids:

This is not a recognized or evidence-based strategy for managing decreased taste or smell. In fact, delaying fluid intake may lead to dehydration, which can further blunt taste perception. Adequate hydration is actually beneficial for maintaining oral mucosal health and optimizing taste function.

Summary:

Maintaining consistent food textures at mealtimes helps older adults with decreased taste and smell enjoy meals more and promotes safer, more effective chewing and swallowing. It supports both sensory engagement and nutritional intake. The other options do not directly address the sensory deficits or may pose health risks.