Fundamentals of Nursing: Fundamentals of Nursing: Nutrition Practice Questions
Test yourself on Fundamentals of Nursing: Nutrition with 13 original NCLEX-RN practice questions. Pick an answer to see instant feedback and a full explanation.
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1. A client with a new prescription for warfarin asks the nurse about diet. Which statement by the client indicates a need for further teaching?
Explanation. Vitamin K antagonizes warfarin, reducing its anticoagulant effect. Clients should not increase vitamin K intake to 'help clotting'; consistency is the key teaching point. Suddenly increasing vitamin K-rich foods (spinach, kale, broccoli) decreases warfarin's effectiveness and risks clot formation.
2. The nurse is caring for a client receiving continuous enteral tube feedings. Which action is the priority to prevent aspiration?
Explanation. Aspiration is the most serious risk of enteral feedings. Keeping the head of bed elevated 30 to 45 degrees reduces reflux and aspiration. Flushing prevents clogging and weighing monitors nutrition, but these do not directly prevent aspiration.
3. A client with chronic kidney disease (not on dialysis) requires diet teaching. Which foods should the nurse instruct the client to limit?
Explanation. In CKD, impaired excretion leads to retention of potassium and phosphorus, causing hyperkalemia and bone disease. These are restricted. Vitamin C, fiber, and iron are not specifically restricted (some clients may need iron supplements for anemia).
4. A client is prescribed a clear liquid diet after surgery. Which item is appropriate for the nurse to provide?
Explanation. Clear liquids are fluids you can see through and leave little residue: apple juice, clear broth, gelatin, tea. Cream soup and ice cream are full liquids; orange juice with pulp is not clear.
5. The nurse is evaluating a client at risk for refeeding syndrome. Which electrolyte abnormality is the hallmark of this condition?
Explanation. Refeeding syndrome occurs when nutrition is reintroduced to a malnourished client; insulin surge drives phosphate, potassium, and magnesium into cells. Hypophosphatemia is the hallmark and can cause cardiac and respiratory failure. Levels drop, not rise.
6. A client with celiac disease needs dietary teaching. Which food choice indicates the client understands the gluten-free diet?
Explanation. Celiac disease requires avoiding gluten found in wheat, barley, and rye. Rice and corn are naturally gluten-free and appropriate. Wheat toast, barley, and rye all contain gluten.
7. A client with a low-sodium diet asks for guidance on food choices. Which selection best demonstrates understanding?
Explanation. Fresh fruits and unsalted vegetables are naturally low in sodium. Canned soups, deli/processed meats, pickles, smoked sausage, cheese, and cured ham are all high in sodium and should be avoided on a low-sodium diet.
8. A nurse is assessing a client for protein-calorie malnutrition. Which laboratory value is the best indicator of long-term protein status?
Explanation. Albumin has a long half-life (about 21 days) and reflects long-term protein status. Prealbumin has a short half-life (about 2 days) and reflects acute/recent changes. Hemoglobin and sodium are not specific protein status indicators.
9. The nurse is feeding a client who has dysphagia following a stroke. Which intervention is most appropriate?
Explanation. A chin-tuck maneuver protects the airway by narrowing the airway entrance and directing food into the esophagus, reducing aspiration. Thickened (not thin) liquids are safer; the client should sit upright with small bites.
10. A pregnant client asks about preventing neural tube defects. The nurse emphasizes adequate intake of which nutrient?
Explanation. Folic acid (folate) is essential in early pregnancy to prevent neural tube defects such as spina bifida. The recommended intake is at least 400 to 600 mcg daily, ideally beginning before conception.
11. A client is receiving total parenteral nutrition (TPN) through a central line. Which finding requires immediate nursing intervention?
Explanation. TPN is high in dextrose, so hyperglycemia is a common complication. A glucose of 280 mg/dL requires intervention (assessment, possible insulin, notifying provider). A glucose of 110 is normal; slight weight gain and constipation are not emergencies.
12. A nurse is teaching a client with iron-deficiency anemia about diet. To enhance iron absorption, the nurse should advise taking iron supplements with which beverage?
Explanation. Vitamin C (ascorbic acid) in orange juice enhances absorption of non-heme iron. Milk (calcium), tea, and coffee (tannins/polyphenols) inhibit iron absorption and should be avoided around the time of supplementation.
13. Before administering an intermittent enteral feeding, the nurse aspirates and checks gastric residual volume. The volume is high per facility protocol. What is the nurse's best initial action?
Explanation. A high gastric residual indicates delayed gastric emptying and increased aspiration risk. The nurse should hold the feeding and reassess according to protocol; the aspirate is usually returned (not discarded) to prevent electrolyte loss. Increasing the rate or removing the tube is inappropriate.
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FAQ
What therapeutic diets show up most on the NCLEX?
Focus on clear vs. full liquid, low-sodium (heart failure/HTN), renal (limit potassium, phosphorus, protein), low-residue, gluten-free (celiac), and consistency-of-vitamin-K diet for warfarin. Know which specific foods belong to each and why.
How should I approach enteral and parenteral nutrition questions?
Remember safety priorities: keep HOB elevated 30 to 45 degrees to prevent aspiration with tube feeds, monitor gastric residuals, and watch for hyperglycemia and infection with TPN. TPN requires a central line and gradual weaning to prevent rebound hypoglycemia.
Which lab values matter for nutrition questions?
Albumin reflects long-term protein status (half-life ~21 days), while prealbumin reflects acute/recent changes (~2 days). Also know electrolyte shifts in refeeding syndrome (low phosphate, potassium, magnesium) and potassium/phosphorus restrictions in CKD.