ATI RN
ATI Nutrition Proctored Exam 2019
1. A nurse is caring for four clients. The nurse should plan to administer total parenteral nutrition for which of the following clients?
- A. A client who is postoperative following a laminectomy and is receiving IV PCA
- B. A client who has dysphagia and does not recognize his family
- C. A client who has COPD and is going home with oxygen
- D. A client who has colon cancer and will undergo a hemicolectomy
Correct answer: D
Rationale: Total parenteral nutrition (TPN) is essential for clients undergoing significant surgical procedures like a hemicolectomy to ensure they receive adequate nutrition when oral intake is not possible. Choices A, B, and C do not typically require TPN. Choice A is managing postoperative pain with IV PCA, choice B is likely to need alternative feeding methods due to dysphagia, and choice C is going home with oxygen for COPD management, which does not directly relate to the need for TPN.
2. A nurse is planning care for a client who has ascites secondary to liver disease. Which of the following interventions should the nurse include in the plan of care?
- A. Reduce complex carbohydrates to 30% of total calories.
- B. Restrict protein intake to less than 0.8 g/kg/day.
- C. Decrease daily caloric intake by 20%.
- D. Limit sodium to 2000 mg or less per day.
Correct answer: D
Rationale: The correct answer is to limit sodium to 2000 mg or less per day. Ascites, which is the abnormal accumulation of fluid in the abdominal cavity, is commonly associated with liver disease. Limiting sodium intake helps manage fluid retention by reducing the fluid accumulation in the abdomen. Choices A, B, and C are incorrect because reducing complex carbohydrates, restricting protein intake, or decreasing caloric intake are not the primary interventions for managing ascites in liver disease.
3. A nurse is caring for a client who is receiving parenteral nutrition. Which of the following findings indicates the therapy is effective?
- A. Client has soft, formed bowel movements.
- B. Client’s mucous membranes are pink.
- C. Client reports ability to complete ADLs.
- D. Client’s blood glucose level is within the expected reference range.
Correct answer: D
Rationale: The correct answer is D because having a blood glucose level within the expected reference range indicates that parenteral nutrition is effectively meeting the client's nutritional needs. Choices A, B, and C are incorrect because soft, formed bowel movements, pink mucous membranes, and the ability to complete activities of daily living do not directly reflect the effectiveness of parenteral nutrition therapy.
4. A client taking antibiotics develops diarrhea. Which of the following foods should the nurse recommend to include in the client’s diet?
- A. Whole wheat bread
- B. Fresh orange sections
- C. Ice cream
- D. Yogurt
Correct answer: D
Rationale: Yogurt is the correct answer because it contains probiotics that can help restore normal gut flora and reduce antibiotic-associated diarrhea. Whole wheat bread (Choice A) may worsen diarrhea due to its high fiber content. Fresh orange sections (Choice B) are acidic and may irritate the digestive system further. Ice cream (Choice C) is high in sugar and fat, which can exacerbate diarrhea.
5. A client has a small-bore jejunostomy and is receiving a continuous tube feeding with a high-viscosity formula. Which of the following actions should the nurse take to prevent the tubing from clogging?
- A. Replace the bag and tubing every 24 hours
- B. Flush the tubing with 10 mL water every 6 hours
- C. Administer the feeding by gravity drip
- D. Heat the formula prior to infusion
Correct answer: B
Rationale: To prevent clogging when using high-viscosity formulas in a small-bore jejunostomy, the nurse should flush the tubing with 10 mL of water every 6 hours. This action helps maintain tube patency and prevent blockages. Replacing the bag and tubing every 24 hours (Choice A) is unnecessary and does not specifically address preventing clogging. Administering the feeding by gravity drip (Choice C) or heating the formula prior to infusion (Choice D) are not effective interventions for preventing tubing clogging.
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