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Worksheetshmmph
Total questions: 99
Worksheet time: 50mins
Which of the following foods is a source of protein?
Beans
White bread
Potatoes
Candy
What is the recommended daily amount of protein?
1 to 2 ounces
2 to 4 ounces
2 to 6½ ounces
10 ounces
Carbohydrates can make up what percentage of total daily calories?
10% to 20%
25% to 35%
45% to 65%
70% to 90%
Foods with a high glycemic index include which of the following?
Legumes
White bread
Vegetables
Whole grains
A BMI of less than 18.5 is considered _________.
underweight
overweight
normal weight
obese
A BMI of 18.5 to 24.9 is considered _________
normal (or healthy)
underweight
overweight
obese
A BMI of 25 to 29.9 is _________
overweight
underweight
obese
normal weight
A BMI of 30 or greater is categorized as _________.
obese
underweight
normal weight
overweight
Which of the following is a symptom of low body weight?
High blood pressure
Brittle hair
Increased fat stores
Strong muscles
Overnutrition increases the risk of which of the following diseases?
Diabetes
Scurvy
Anemia
Asthma
Low vitamin C can cause ________ in the gums.
irritation
swelling
bleeding
numbness
Which of the following foods is good for brain health?
Flax seed
White bread
Potatoes
Candy
Which of the following is a reason for prescribing a soft diet?
For clients recovering from surgeries on the jaw, mouth, or abdomen
For clients with diabetes
For clients with high blood pressure
For clients with allergies
Which foods are included in a soft diet?
Well-cooked vegetables, low-fiber cereals, easy-to-chew proteins
Raw vegetables, whole nuts, tough meats
Spicy foods, fried foods, hard candies
Carbonated drinks, chips, popcorn
Puree Diet consists of foods that do not require _________
chewing
boiling
freezing
baking
Which of the following is prescribed for difficulty chewing or swallowing, recent oral surgery, or numbness in the mouth?
Puree Diet
Full Liquid Diet
Soft Diet
Clear Liquid Diet
Which foods are included in a full liquid diet?
Foods that are considered liquids and foods that turn into liquids at room temperature
Only solid foods
Only raw vegetables
Only dairy products
Clear liquid diet should only be prescribed for a ________ time.
limited
long
unlimited
extended
Which of the following is NOT a food included in a clear liquid diet?
Broth
Gelatin
Fruit juices without pulp
Bread
Heart Healthy Diet focuses on all of the following EXCEPT:
A) Consuming more fruits and vegetables
B) Increasing whole grains
C) Limiting unhealthy fats
D) Increasing sodium intake
A healthy adult should consume no more than ______ mg of sodium per day.
2,300
1,000
3,500
4,500
Adults should consume _______ L of water a day.
2-3
4-5
0.5-1
6-7
Which of the following is a way to limit sodium intake?
Avoiding table salt
Adding salt to foods while cooking
Eating processed meats
Not reading food labels
Which of the following foods is high in potassium?
Dried beans
White rice
Apples
Chicken
Which juice is listed as high in potassium?
Apple juice
Prune juice
Grape juice
Lemon juice
Name one vegetable that is high in potassium according to the list provided.
Greens such as spinach, collards, kale, and Swiss chard
Iceberg lettuce
Cucumber
Radish
St. John’s wort can decrease the effectiveness of which types of medications?
Birth control, cardiac medications, and antidepressants
Antibiotics, painkillers, and antihistamines
Vitamins, minerals, and herbal supplements
Vaccines, insulin, and antacids
Vitamin K reduces the effectiveness of which medication, increasing the risk of blood clots?
Warfarin
Aspirin
Metformin
Atorvastatin
Antioxidant supplements like vitamin C and E reduce the effectiveness of chemotherapy.
True
False
What are the indications for enteral nutrition?
Disorders that prevent oral nutrition like dysphagia, coma, upper GI obstruction, severe anorexia or malnutrition.
Conditions requiring total parenteral nutrition only.
Situations where oral feeding is fully adequate and possible.
Cases of mild dehydration managed with oral rehydration alone.
List one contraindication for enteral nutrition.
Gastrointestinal bleeding, small or large bowel obstruction, or bowel ischemia.
Mild dehydration
Stable vital signs
Normal electrolyte levels
How can the risk of aspiration be reduced during enteral feeding?
By checking gastric residuals, verifying tube placement, assessing for peristalsis, and elevating the head of the bed to 30 degrees or more during feedings and at least one hour after.
By placing the patient in a supine position during and after feeding.
By increasing the feeding rate to reduce feeding time.
By avoiding checking tube placement before each feeding.
What should a provider do if a patient develops diarrhea during enteral feeding?
Deliver the formula at a slower rate, dilute the formula, change the formula, or add fiber.
Increase the feeding rate and add more water to the formula.
Stop the feeding immediately and give only clear fluids for 24 hours.
Ignore the symptoms and continue the feeding as planned.
How can skin breakdown be prevented at the tube insertion site?
Routinely inspect tube insertion site, apply skin adhesive or tincture at the tip of client’s nose or tube.
Apply lotion to the tube insertion site every hour.
Cover the tube insertion site with a plastic wrap at all times.
Avoid cleaning the tube insertion site to prevent irritation.
What is the first step when inserting a nasogastric tube?
Lubricate the tube
Elevate the head of the bed
Open the NG tube
Confirm placement with an x-ray
Which items should you gather before inserting a nasogastric tube?
Tape, lubricant, nasogastric tube, pH strips, a container, and a piston syringe
Scissors, gloves, and a mask
Only a nasogastric tube
Only a piston syringe
Estimate the length of tube you'll need by measuring from the tip of the nose to the ______ and then to the xiphoid process (tip of the sternum).
earlobe
shoulder
chin
forehead
What should you do if you meet extreme resistance while inserting the nasogastric tube?
Push harder
Withdraw and try the other nare
Ignore and continue
Call for help immediately
How do you confirm the initial placement of an NG tube?
With an x-ray
By auscultating the abdomen
By checking for bubbling in water
By asking the patient if they can taste saline
Before every feeding, how much gastric secretion should you withdraw using a piston syringe to check pH?
1-2ML
5-10ML
20ML
50ML
The pH of gastric secretions should be under ____ to confirm correct placement of the NG tube.
5 to 5.5
6.5 to 7
7.5 to 8
8.5 to 9
What is the first step in removing a nasogastric tube?
Flush with water
Turn off the suction
Ask the patient to swallow
Remove the tape
What is the main use of gastric decompression?
To relieve the stomach and intestines of pressure caused by air and fluid.
To increase the absorption of nutrients in the stomach.
To stimulate the production of gastric acid.
To prevent the formation of stomach ulcers.
Gastric lavage is indicated for:
Medication toxicity or poisoning
Hyperthermia/hypothermia
GI bleeds when endoscopy is not available
All of the above
What is a double-lumen NG tube used for?
Administering feeds
Gastric decompression
Oxygen therapy
Blood transfusion
Which of the following is an example of a single-lumen tube?
Salem Sump
Dobhoff or Levin
Orogastric tube
PICC line
Fill in the blank: In a double-lumen NG tube, one lumen is for suction, and the other lumen acts as a _____
sump
drain
filter
valve
What is a contraindication for nasogastric tube insertion?
Severe midface trauma, recent nasal surgery, and esophageal surgery.
Gastric ulcer
Mild sore throat
Chronic constipation
Parenteral nutrition is administered via which of the following?
Oral route
PICC line or Central Venous Line
Nasogastric tube
Subcutaneous injection
The bag for parenteral nutrition must be at room temperature before administration.
True
False
List two complications that may occur with parenteral nutrition.
Abnormalities in blood glucose levels (BGL).
Improved wound healing.
Increased appetite and weight gain.
Enhanced absorption of oral medications.
What should you do if the client has chills, fever, or an elevated heart rate during parenteral nutrition?
Check the catheter insertion site for signs of redness, pain, or drainage, and notify the provider.
Increase the rate of parenteral nutrition infusion.
Ignore the symptoms and continue monitoring as usual.
Administer an antipyretic and continue the infusion without notifying anyone.
Which of the following is NOT a step in administering parenteral nutrition?
A) Clamp tube prior to attaching inline filter
B) Scrub the hub of IV catheter
C) Administer oral medication
D) Set rate of infusion on the pump
What are common symptoms of diabetes?
Polydipsia, polyuria, polyphagia, unexplained weight loss, and a random BGL of 200+
Fever, cough, headache
Rash, joint pain, sore throat
Nausea, vomiting, diarrhea
Which type of diabetes is caused by destruction of beta cells leading to an inability to produce insulin?
Type 1
Type 2
Gestational diabetes
Type 3
Type 2 diabetes is managed by diet and exercise, medications, and ________.
insulin
antibiotics
radiation therapy
chemotherapy
Gestational diabetes manifests during ________.
pregnancy
childhood
old age
adolescence
Which of the following is a sign of hypoglycemia (BGL less than 70)?
Severe dehydration
Pallor, tremor, weakness, sweating, and confusion
Acetone breath
Kussmaul respirations
What is the intervention for hypoglycemia?
15g glucose, like a 4oz glass of orange juice or an 8oz glass of milk
Insulin injection
Antibiotics
Surgery
DKA is characterized by a BGL of ______ or higher.
300
180
120
400
Which complication of diabetes is associated with severe dehydration, little to no ketosis, and severe hyperglycemia?
Hypoglycemia
DKA
Hyperglycemic hyperosmolar state
Retinopathy
Oral medications are only for which type of diabetes?
Type 1
Type 2
Gestational
All types
Which oral medication reduces glucose production in the liver?
Sulfonylureas
Glipizide
Biguanides
Meglitinides
The onset of rapid-acting insulin is ______ minutes.
15
5
30
60
The duration of rapid-acting insulin is between ______ and ______ hours.
3 and 6
1 and 2
6 and 10
8 and 12
What is the onset time of short-acting (regular) insulin?
1-4 hours
30-60 minutes
70 minutes to 4 hours
12-24 hours
The peak time of short-acting insulin occurs between _____
1-5 hours
6-8 hours
10-12 hours
13-15 hours
What is the duration of short-acting insulin?
3-6 hours
10 hours
12-24 hours
18-24 hours
NPH insulin has an onset time of _____
1 to 4 hours
5 to 10 minutes
12 to 24 hours
30 to 60 minutes
The peak time of NPH insulin is between _____
4 and 12 hours
1 and 3 hours
12 and 18 hours
18 and 24 hours
Long-acting insulins have an onset between _____
70 minutes and 4 hours
10 minutes and 30 minutes
1 hour and 2 hours
5 hours and 8 hours
Long-acting insulins do not have a peak to control blood sugar all day.
True
False
What is the correct order for drawing up insulin when mixing short-acting and long-acting insulins?
Cloudy before clear
Clear before cloudy
When administering insulin, at what angle should the needle be inserted for clients who are emaciated or have little subcutaneous tissue?
90°
45°
30°
60°
What is included in the health history during the preoperative phase?
Client's medical and surgical history, allergies, current medications, cultural/spiritual beliefs, and social history
Only the client's surgical history
Only the client's allergies
Only the client's current medications
Use of tobacco in surgical clients increases the risk of which of the following?
Blood clots
Myocardial infarction
Death
All of the above
Regular use of alcohol in surgical clients leads to a higher risk for bleeding, infections, heart problems, and a longer hospital stay.
True
False
Assessing the client for a history of cardiovascular and pulmonary diseases is important because conditions like COPD, obstructive sleep apnea (OSA), asthma, CAD, and CHF may lead to ________ complications.
intraoperative
nutritional
dermatological
musculoskeletal
Clients should be asked if they or any members of their family have a history of malignant hyperthermia or reactions to ________.
anesthesia
antibiotics
analgesics
antidepressants
Which of the following vital signs should be obtained during the preoperative physical assessment?
Blood pressure
Pulse
Respirations
All of the above
Informed consent requires that the client or representative has signed the consent in the presence of a legal age witness and is competent.
True
False
Postoperative delirium is a temporary confusion and disorientation that may come and go days to weeks after surgery.
True
False
Obesity increases the risk for which of the following postoperative complications?
Difficulty intubating
Decreased oxygenation
Increased risk for developing a deep vein thrombosis or pulmonary embolism
All of the above
Smoking increases the client's risk for developing infections after surgery.
True
False
What are the manifestations of DVT?
Pain, hot, redness, and swelling of the affected limb.
Fever, cough, and chest pain.
Headache, blurred vision, and dizziness.
Nausea, vomiting, and diarrhea.
What is the prevention method for DVT mentioned in the notes?
Mobilization soon after and frequently after surgery, application of SCDs to the lower extremities while the client is in bed or the chair.
Administering high doses of vitamin C daily.
Restricting all movement for at least 48 hours post-surgery.
Applying heat packs to the lower extremities continuously.
What are the manifestations of pulmonary embolism?
Chest pain, especially while taking a deep breath; difficulty breathing; tachycardia; and hypoxia.
Abdominal pain, jaundice, and dark urine.
Blurred vision, tinnitus, and photophobia.
Joint pain, swelling, and morning stiffness.
Preoperatively, hypovolemia can be caused by:
Excessive fluid intake
Lack of fluid intake due to NPO status
Administration of diuretics
Increased capillary refill
Intraoperatively, hypovolemia can be caused by:
Anesthesia-related medications
Increased fluid intake
Decreased surgical time
Increased myocardial function
List two manifestations of hypovolemia.
Tachycardia, hypotension, confusion, oliguria, decreased central venous pressure (CVP), decreased capillary refill.
Bradycardia, hypertension, polyuria, increased central venous pressure (CVP), flushed skin.
Fever, hyperglycemia, increased appetite, excessive sweating.
Jaundice, cyanosis, productive cough, hematuria.
How can hypovolemia be prevented during the perioperative period?
Close hemodynamic monitoring throughout the perioperative period.
Administering excessive diuretics before surgery.
Restricting all fluid intake during surgery.
Delaying fluid replacement until after surgery.
What is the intervention for hypovolemia?
Treat with fluid replacement with crystalloids, colloids, blood, or blood products.
Administer insulin to lower blood glucose levels.
Provide bronchodilators to open airways.
Apply ice packs to reduce swelling.
What are the causes of hypervolemia?
CHF or renal insufficiency or failure. Client needed fluid resuscitation due to rapid loss of fluids or blood, such as in trauma.
Dehydration due to excessive sweating.
Hypoglycemia from insulin overdose.
Vitamin D deficiency.
What are the manifestations of hypervolemia?
Tachycardia, increased CVP, hypertension, crackles in the lungs, peripheral edema, decreased hemoglobin and hematocrit.
Bradycardia, decreased CVP, hypotension, clear lungs, no edema, increased hemoglobin and hematocrit.
Tachycardia, decreased CVP, hypotension, dry mucous membranes, increased hemoglobin and hematocrit.
Bradycardia, increased CVP, hypertension, crackles in the lungs, peripheral edema, increased hemoglobin and hematocrit.
What is the intervention for hypervolemia?
Administration of diuretics and fluid restriction, monitoring of their hemodynamics, intake and output, and electrolyte levels.
Encouraging increased fluid intake and high-sodium diet.
Administering vasoconstrictors and promoting bed rest only.
Providing high-calorie supplements and limiting physical activity.
What are the signs of bleeding postoperatively?
Decrease in blood pressure, tachypnea, and possibly a decrease in oxygen saturation.
Increase in blood pressure, bradycardia, and increased urine output.
Fever, chills, and productive cough.
Localized swelling and redness at the surgical site.
What is the recommended use of an incentive spirometer postoperatively?
Ten repetitions per hour should be done with the IS, and each breath held for 3 to 5 seconds.
Use the IS only once daily, holding each breath for 10 seconds.
Perform five repetitions per hour, exhaling quickly after each use.
Use the IS continuously for 30 minutes without breaks.
What should a client do after abdominal and chest surgery when coughing and moving?
Hold pillow over abdomen when coughing and moving.
Take deep breaths without support.
Lie flat on the back at all times.
Avoid coughing to prevent pain.
What is maceration? Fill in the blank: Maceration is an irritation of the ________ caused by moisture.
epidermis
dermis
muscle
bone
