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Nutrition and Hydration
Define the following terms:
Nutrition
how the body uses food to maintain health.
Nutrient
something found in food that provides energy, promotes
growth and health, and helps regulate metabolism.
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Nutrition and Hydration
1. Identify the six basic nutrients and explain MyPyramid
REMEMBER:
• Bodies rely on proper nutrition to function well.
• A well-balanced diet will help residents maintain muscles and
skin tissues and prevent pressure sores.
8 Nutrition and Hydration
Transparency 8-1: Six Basic Nutrients
1. Protein
2. Carbohydrates
3. Fats
4. Vitamins
5. Minerals
6. Water
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Nutrition and Hydration
1. Identify the six basic nutrients and explain MyPyramid
Remember this information about the six basic nutrients:
Protein
• Essential for tissue growth and repair
• Provides a supply of energy
• Includes fish, seafood, poultry, meat, eggs, milk, cheese,
nuts, peas, dried beans/legumes
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Nutrition and Hydration
1. Identify the six basic nutrients and explain MyPyramid
Six basic nutrients (cont’d.):
Carbohydrates
• Provide fuel for energy
• Provide fiber
• Complex carbohydrates include bread, cereal, potatoes, rice,
pasta, vegetables, and fruits
• Simple carbohydrates include sugars, sweets, syrups, and
jellies
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Nutrition and Hydration
1. Identify the six basic nutrients and explain MyPyramid
Six basic nutrients (cont’d.):
Fats
• Help the body store energy
• Provide insulation
• Protect the organs
• Fats include butter, margarine, salad dressings, oils, and fats
in meat
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Nutrition and Hydration
1. Identify the six basic nutrients and explain MyPyramid
Six basic nutrients (cont’d.):
Vitamins
• Vitamins are essential to body functions.
• Fat-soluble vitamins are A, D, E, and K.
• Water-soluble vitamins are B and C.
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Nutrition and Hydration
1. Identify the six basic nutrients and explain MyPyramid
Six basic nutrients (cont’d.):
Minerals
• Maintain body functions
• Minerals include zinc, iron, sodium, potassium, calcium,
magnesium, and phosphorus.
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Nutrition and Hydration
1. Identify the six basic nutrients and explain MyPyramid
Six basic nutrients (cont’d.):
Water
• We need about eight glasses, or 64 ounces, per day.
• Water is the most essential nutrient for life.
• Water aids in digestion, absorption of food, elimination of
wastes, and maintaining normal body temperature.
8 Nutrition and Hydration
Transparency 8-2: MyPyramid
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Nutrition and Hydration
1. Identify the six basic nutrients and explain MyPyramid
Here are some examples of the six food groups:
Grains
• Found in cereal, bread, rice, and pasta
• Two subgroups of grains: whole grains and refined grains
• At least half of all grains consumed should be whole grains
such as whole wheat breads, bran cereals, brown rice, and
whole wheat pastas.
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Nutrition and Hydration
1. Identify the six basic nutrients and explain MyPyramid
Examples of the six food groups (cont’d.):
Vegetables
• Provide fiber and vitamins
• Subgroups are dark green vegetables, orange vegetables dry
beans and peas, starchy vegetables and other vegetables.
• Examples include spinach, carrots, peas, corn and potatoes.
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Nutrition and Hydration
1. Identify the six basic nutrients and explain MyPyramid
Examples of the six food groups (cont’d.):
Fruits
• Provide complex carbohydrates, vitamins and fiber
• Examples include oranges, grapefruit, strawberries, mango,
papayas, and cantaloupe.
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Nutrition and Hydration
1. Identify the six basic nutrients and explain MyPyramid
Examples of the six food groups (cont’d.):
Milk
• Provides nutrients necessary for bones and teeth
• Provides protein, vitamins, and minerals
• Examples include cheese, yogurt, milk, buttermilk, cottage
cheese, and evaporated milk.
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Nutrition and Hydration
1. Identify the six basic nutrients and explain MyPyramid
Examples of the six food groups (cont’d.):
Meat and beans
• Provide protein, vitamins, and minerals
• Examples include fish, chicken, turkey, lean meats, and dry
beans.
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Nutrition and Hydration
1. Identify the six basic nutrients and explain MyPyramid
Examples of the six food groups (cont’d.):
Oils
• Fats and oils are needed in small amounts.
• Foods like nuts, olives, some fish, and avocados are naturally
high in oils.
• Most of the fats consumed should be polyunsaturated (PUFA)
or monounsaturated (MUFA) fats.
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Nutrition and Hydration
1. Identify the six basic nutrients and explain MyPyramid
Remember these points about elderly residents and MyPyramid:
• Elderly residents may need a modified MyPyramid that
emphasizes nutrient-dense foods, fiber, and water.
• Calories may be reduced, but need for vitamins and minerals
does not decrease.
• Dietary supplements may be appropriate.
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Nutrition and Hydration
2. Describe factors that influence food preferences
Remember these points about food preferences:
• Know and follow residents’ food preferences.
• Ask questions.
• Pay attention when residents express preferences, verbally
or non-verbally.
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Nutrition and Hydration
2. Describe factors that influence food preferences
Think about this question:
What are your regional, cultural, or religious food preferences?
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Nutrition and Hydration
2. Describe factors that influence food preferences
REMEMBER:
Residents have a legal right to make choices about their food and
to refuse food, and NAs must honor residents’ beliefs and
preferences.
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Nutrition and Hydration
Define the following terms:
Therapeutic diet
a diet for people who have certain illnesses; also called
special or modified diet.
Diet cards
cards that list the resident’s name and information about
special diets, allergies, likes and dislikes, and other
instructions.
Puree
to chop, blend, or grind food into a thick paste of baby food
consistency.
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Nutrition and Hydration
3. Explain special diets
The following are common special diets:
• Low-Sodium Diet
• Fluid-Restricted Diet
• Low-Protein Diet
• Low-Fat/Low-Cholesterol Diet
• Modified Calorie Diet for Weight Management
• Dietary Management of Diabetes
• Liquid Diet
• Soft Diet
• Pureed Diet
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Nutrition and Hydration
3. Explain special diets
Think about this question:
Do you now or have you ever followed a special diet?
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Nutrition and Hydration
Define the following terms:
Force fluids
a medical order for a person to drink more fluids.
Restrict fluids
a medical order for a person to limit fluids.
Dehydration
a condition that results from inadequate fluid in the body.
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Nutrition and Hydration
Describe how to assist residents in maintaining fluid balance
Fluid intake is important for several reasons:
• Helps prevent constipation and incontinence
• Dilutes wastes and flushes out urininary system
• May help prevent confusion
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Nutrition and Hydration
Describe how to assist residents in maintaining fluid balance
Watch for these signs and symptoms of dehydration:
• Drinking less than six 8 oz glasses of liquid per day
• Drinking little or no fluids at meals
• Needing help drinking from cup
• Having trouble swallowing liquids
• Having frequent vomiting, diarrhea, or fever
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Nutrition and Hydration
Describe how to assist residents in maintaining fluid balance
Signs and symptoms of dehydration (cont’d.):
• Being easily confused or tired
• Resident has any of the following:
• Dry mouth
• Cracked lips
• Sunken eyes
• Dark urine
• Strong-smelling urine
• Weight loss
• Complaints of abdominal pain
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Nutrition and Hydration
Describe how to assist residents in maintaining fluid balance
Remember these guidelines for preventing dehydration:
• Report warning signs immediately.
• Encourage residents to drink every time you see them.
• Offer fresh water and fluids often.
• Record fluid I&O.
• Offer other forms of liquids if permitted (e.g. ice chips, frozen
flavored ice sticks, gelatin).
• Offer sips of liquids between bites of food.
• Make sure pitcher and cup are close by and are light enough
for resident to lift.
• Offer assistance.
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Nutrition and Hydration
Describe how to assist residents in maintaining fluid balance
REMEMBER:
• Approach residents positively with, “Would you like water or
juice?” rather than, “Do you want anything to drink?”
• Make an effort to find out what residents’ favorite beverages
are and offer at least three times a day, in addition to meals.
• Prevention of dehydration is ongoing – you must constantly
help residents to stay hydrated.
Serving fresh water
Equipment: water pitcher, ice
scoop, glass, straw, gloves
1. Wash hands. Provides for
infection control.
2. Identify yourself by name.
Identify the resident by
name. Resident has right
to know identity of his or
her caregiver. Addressing
resident by name shows
respect and establishes
correct identification.
3. Put on gloves. Promotes
infection control.
Serving fresh water (cont’d.)
4. Scoop ice into water
pitcher. Add fresh water.
5. Use and store ice scoop
properly. Do not allow ice to
touch hand and fall back
into container. Place scoop
in proper receptacle after
each use. Avoids
contamination of ice.
6. Take pitcher to resident.
7. Pour glass of water for
resident. Leave pitcher and
glass at the bedside.
Encourages resident to
maintain hydration.
Serving fresh water (cont’d.)
8. Make sure that pitcher and
glass are light enough for
resident to lift. Leave a
straw if the resident
desires. Demonstrates
understanding of resident’s
abilities and/or limitations.
Prevents dehydration.
9. Before leaving resident,
place call light within
resident’s reach. Allows
resident to communicate
with staff as necessary.
10. Remove and discard gloves.
11. Wash your hands. Provides
for infection control.
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Nutrition and Hydration
Define the following terms:
Fluid overload
a condition that occurs when the body is unable to handle the
amount of fluid consumed.
Edema
swelling caused by excess fluid in body tissues.
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Nutrition and Hydration
Describe how to assist residents in maintaining fluid balance
Watch for these signs and symptoms of fluid overload:
• Swelling of extremities
• Weight gain
• Decreased urine
• Shortness of breath
• Increased heart rate
• Tight, smooth, or shiny skin
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Nutrition and Hydration
5. List ways to identify and prevent unintended weight loss
REMEMBER:
Unintended weight loss is a serious problem for the elderly and
NAs must report any weight loss, no matter how small.
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Nutrition and Hydration
5. List ways to identify and prevent unintended weight loss
Watch for these signs and symptoms of unintended weight loss:
• Needing help eating or drinking
• Eating less than 70% of meals/snacks
• Having mouth pain
• Having dentures that do not fit properly
• Having difficulty chewing or swallowing
• Coughing or choking while eating
• Being sad or withdrawing from others
• Being confused, wandering, or pacing
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Nutrition and Hydration
5. List ways to identify and prevent unintended weight loss
Remember these guidelines for preventing unintended weight
loss:
• Report observations warning signs to the nurse immediately.
• Encourage residents to eat; talk positively about food.
• Honor food likes and dislikes.
• Offer different kinds of foods and beverages.
• Help residents who have trouble feeding themselves.
• Food should look, taste, and smell good. Resident may have
poor sense of taste and smell.
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Nutrition and Hydration
5. List ways to identify and prevent unintended weight loss
Guidelines for preventing unintended weight loss (cont’d.):
• Season food to residents’ preferences.
• Allow plenty of time to finish eating.
• Tell nurse if resident cannot use utensils.
• Record meal/snack intake.
• Give oral care before and after meals.
• Position residents sitting upright for feeding.
• Ask about loss of appetite or sadness if you observe them.
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Nutrition and Hydration
6. Identify ways to promote appetites at mealtime
REMEMBER:
• Residents often view mealtime as the highlight of their days.
• Meals are not only a time for getting nourishment but a time
for socialization as well.
• NAs play an important role in assisting residents to get proper
nutrition.
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Nutrition and Hydration
6. Identify ways to promote appetites at mealtime
Remember these guidelines for promoting appetites:
• Check the environment. Address odors. Make sure room is a
comfortable temperature. Turn off TVs. Do not shout or bang
plates or cups.
• Assist with grooming/hygiene tasks before dining, as needed.
• Assist with handwashing.
• Give oral care before eating.
• Offer a trip to the bathroom before eating.
• Encourage use of dentures, glasses, and hearing aids.
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Nutrition and Hydration
6. Identify ways to promote appetites at mealtime
Guidelines for promoting appetites (cont’d.):
• Properly position residents for eating, which is normally in the
upright position.
• Seat residents next to friends.
• Serve food at correct temperature.
• Plates should look appetizing.
• Provide proper eating tools, including adaptive utensils if
needed.
• Be cheerful, positive, and helpful.
• Give additional food when requested.
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Nutrition and Hydration
7. Demonstrate how to assist with eating
Remember these points about assisting residents with eating:
• Residents will need different levels of help.
• Some residents will only need help with setting up but can
feed themselves.
• Some residents will need to be fed. Be sensitive and give
privacy.
• Encourage residents to do what they can.
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Nutrition and Hydration
7. Demonstrate how to assist with eating
Review the guidelines for assisting a resident with eating:
• Do not treat the resident like a child. Be supportive and
encouraging.
• Sit at resident’s eye level.
• Allow time for prayer if resident wishes.
• Verify that it is the right resident.
• Do not touch food to test its temperature. Use a hand over
the dish instead.
• Cut foods and pour liquids as needed.
• Identify foods and fluids that are in front of resident. Call
pureed food by the correct name.
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Nutrition and Hydration
7. Demonstrate how to assist with eating
Guidelines for assisting a resident with eating(cont’d.):
• Ask resident what he wants to eat first. Allow resident to
make the choice.
• Do not mix foods unless resident prefers it.
• Do not rush the meal.
• Make mealtime social and friendly. Converse if the resident
wishes to do so.
• Give resident full attention.
• Alternate food and drink and cold and hot or bland and
sweets.
• Honor requests for different food.
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Nutrition and Hydration
7. Demonstrate how to assist with eating
REMEMBER:
• Do not insist on using a clothing protector if a resident does
not wish to use one.
• Use the term “clothing protector” rather than “bib.”
Feeding a resident who cannot feed self
Equipment: meal tray,
clothing protector, 2-3
washcloths or wipes
1. Wash hands. Provides for
infection control.
2. Identify yourself by name.
Identify the resident by
name. Resident has right
to know identity of his or
her caregiver. Addressing
resident by name shows
respect and establishes
correct identification.
Feeding a resident who cannot feed self (cont’d.)
3. Explain procedure to
resident. Speak clearly,
slowly, and directly.
Maintain face-to-face
contact whenever
possible. Promotes
understanding and
independence.
4. Pick up diet card. Ask
resident to state his or
her name. Verify that
resident has received the
right tray. Tray should
only contain foods, fluids,
and condiments permitted
on the diet.
Feeding a resident who cannot feed self (cont’d.)
5. Raise the head of the bed.
Make sure resident is in an
upright sitting position (at a
90-degree angle). Promotes
ease of swallowing.
Prevents aspiration of food
and beverage.
6. Adjust bed height to where
you will be to able to sit at
resident’s eye level. Lock
bed wheels.
7. Place meal tray where it can
be easily seen by the
resident, such as on the
overbed table.
Feeding a resident who cannot feed self (cont’d.)
8. Help resident to clean
hands with hand wipes if
resident cannot do it on her
own. Promotes good
hygiene and infection
control.
9. Help resident to put on
clothing protector, if
desired. Protects resident’s
clothing from food and
beverage spills.
10. Sit facing resident at
resident’s eye level. Sit on
the stronger side if resident
has one-sided weakness.
Feeding a resident who cannot feed self (cont’d.)
10. (cont’d.) Promotes good
communication. Lets
resident know that he or
she will not be rushed while
eating.
11. Tell the resident what foods
are on the tray. Ask what
resident would like to eat
first. Resident has legal
right to make decisions.
Feeding a resident who cannot feed self (cont’d.)
12. Offer the food in bite-sized
pieces, telling the resident
the content of each bite of
food offered. Alternate
types of food, allowing for
resident’s preferences. Do
not feed all of one type
before offering another
type. Report any swallowing
problems to the nurse
immediately. Small pieces
are easier to chew and
lessens the risk of choking.
13. Offer sips of beverage to
resident throughout the
meal. Promotes ease of
swallowing.
Feeding a resident who cannot feed self (cont’d.)
14. Make sure the resident’s
mouth is empty before next
bite or sip. Lessens risk of
choking.
15. Talk with the resident
during the meal. Makes
mealtime more enjoyable.
16. Use washcloths or wipes to
wipe food from resident’s
mouth and hands as needed
during the meal. Wipe again
at the end of the meal.
Maintains resident’s dignity.
17. Remove clothing protector if
used. Dispose of in proper
container.
Feeding a resident who cannot feed self (cont’d.)
18. Remove food tray. Check
for eyeglasses, dentures, or
any personal items before
removing tray. Place tray in
proper area to be picked
up.
19. Make resident comfortable.
Make sure sheets are free
from wrinkles and the bed
free from crumbs. Wrinkles
and crumbs can cause skin
breakdown.
20. Return bed to lowest
position. Remove privacy
measures. Provides for
safety.
Feeding a resident who cannot feed self (cont’d.)
21. Place call light within
resident’s reach. Allows
resident to communicate
with staff as necessary.
22. Wash your hands. Provides
for infection control.
23. Report any changes in
resident to the nurse.
Provides nurse with
information to assess
resident.
24. Document procedure using
facility guidelines. What you
write is a legal record of
what you did. If you don’t
document it, legally it didn’t
happen.
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Nutrition and Hydration
7. Demonstrate how to assist with eating
REMEMBER:
• It is important to know how much food a resident is eating.
• Tracking methods vary from facility to facility.
• Know your facility’s method.
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Nutrition and Hydration
8. Identify signs and symptoms of swallowing problems
REMEMBER:
• “Dysphagia” means difficulty in swallowing.
• It might be caused by stroke, head/neck cancer, multiple
sclerosis, Parkinson’s or Alzheimer’s disease.
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Nutrition and Hydration
8. Identify signs and symptoms of swallowing problems
Watch for these signs and symptoms of dysphagia:
• Coughing during or after meals
• Choking during meals
• Dribbling saliva, food, or fluid from the mouth
• Food residue inside the mouth or cheeks during and after
meals
• Gurgling sound in voice during or after meals or loss of voice
• Slow eating
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Nutrition and Hydration
8. Identify signs and symptoms of swallowing problems
Signs and symptoms of dysphagia (cont’d.):
• Avoidance of eating
• Spitting out pieces of food
• Several swallows needed per mouthful
• Frequent throat clearing during and after meals
• Watering eyes when eating or drinking
• Food or fluid coming up into the nose
• Visible effort to swallow
• Shorter or more rapid breathing while eating or drinking
• Difficulty chewing food
• Difficulty swallowing medications
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Nutrition and Hydration
8. Identify signs and symptoms of swallowing problems
Remember these points about thickened liquids:
• Thickening improves the ability to control fluid in the mouth
and throat.
• A doctor orders the necessary thickness after evaluation by a
speech therapist.
• Some beverages arrive already thickened.
• NAs cannot offer residents who must have thickened liquids
regular liquids, including water.
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Nutrition and Hydration
8. Identify signs and symptoms of swallowing problems
There are three different thickening consistencies for liquids:
• Nectar thick
• Honey thick
• Pudding thick
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Nutrition and Hydration
8. Identify signs and symptoms of swallowing problems
REMEMBER:
Never offer regular liquids, including water, to residents who
need thickened liquids.
8 Nutrition and Hydration
Transparency 8-3: Preventing Aspiration
•
•
•
•
•
Position in a straight, upright position.
Offer small pieces of food or small spoons of pureed food.
Feed resident slowly.
Place food in the non-paralyzed side of the mouth.
Make sure mouth is empty before next bite of food or sip of
drink.
• Have residents stay in upright position for 30 minutes after
eating or drinking.
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Nutrition and Hydration
Define the following terms:
Total parenteral nutrition (hyperalimentation)
the intravenous infusion of nutrients administered directly
into the bloodstream, bypassing the digestive tract.
Nasogastric tube
a feeding tube that is inserted into the nose and goes into the
stomach.
Percutaneous endoscopic gastrostomy (PEG) tube
a tube placed through the skin directly into the stomach to
assist with eating.
Gastrostomy
surgical opening into the stomach.
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Nutrition and Hydration
8. Identify signs and symptoms of swallowing problems
REMEMBER:
• Your role in tube feelings is to observe for problems and
changes in the resident.
• NAs do not insert or remove tubes, do the feeding, or clean
the tubes.
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Nutrition and Hydration
8. Identify signs and symptoms of swallowing problems
Observe and report the following regarding tube feedings:
• Redness/drainage around opening
• Skin sores or bruises
• Cyanotic skin
• Resident complaints of pain or nausea
• Choking
• Tube falls out
• Problems with equipment
• Feeding pump alarm sounds
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Nutrition and Hydration
9. Describe how to assist residents with special needs
REMEMBER:
Residents with certain conditions or diseases, such as stroke,
Parkinson’s disease, Alzheimer’s disease or other dementias,
head trauma, blindness or confusion may need special assistance
when eating.
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Nutrition and Hydration
9. Describe how to assist residents with special needs
Remember these guidelines for assisting residents with special
needs:
• Use physical cues like placing your hand over his.
• Use short, clear verbal cues (e.g. “Pick up your spoon” and
“Put some carrots on your spoon”). Wait until one task is
finished before giving the next cue.
• Use assistive devices as ordered.
• For visually impaired residents, use imaginary clock face to
explain position of food on plate.
• For residents who have had CVA, place food in unaffected or
stronger side of mouth. Make sure food is swallowed.
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Nutrition and Hydration
9. Describe how to assist residents with special needs
Guidelines for assisting residents with special needs (cont’d.):
• If resident has blind spots, place food in field of vision.
• If resident has tremors, use physical cues and place food and
drinks close to resident.
• Place residents with poor balance in dining room chair with
armrests. If resident leans, ask her to keep elbows on the
table.
• If resident has poor neck control, neck brace may be used to
stabilize head. Use assistive devices as needed. If resident is
in a geri-chair, a wedge cushion behind the head and
shoulders may be used.
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Nutrition and Hydration
9. Describe how to assist residents with special needs
Guidelines for assisting residents with special needs (cont’d.):
• If resident bites utensils, ask him to open his mouth. Wait
until jaw relaxes to remove utensil.
• If resident pockets food in cheeks, remind him to chew and
swallow. Touch cheek. Ask him to use his tongue to get the
food.
• If resident holds food in mouth, ask her to chew and swallow.
Gently press down on tongue when removing spoon from the
mouth to help trigger swallowing. Make sure resident has
swallowed before offering more food.
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Nutrition and Hydration
Chapter Exam
Multiple Choice.
1.To help prevent aspiration, residents should be in the ________
position when eating.
(A) Upright
(B) Lying down
(C) Prone
(D) Lateral
2.A nursing assistant’s duties regarding tube feedings include
(A) Inserting tubes
(B) Doing the feedings
(C) Observing the feeding and reporting problems
(D) Cleaning the tubes
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Nutrition and Hydration
Chapter Exam (cont’d.)
3.Which of the following foods supplies a significant amount of calcium?
(A) Cream cheese
(B) Butter
(C) Unfortified rice milk
(D) Yogurt
4.Which statement is true of fats?
(A) Saturated fats should be limited.
(B) Fat provides nothing useful to the body.
(C) Fat is not stored in the body when eaten in excess.
(D) Fats do not add flavor to foods.
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Nutrition and Hydration
Chapter Exam (cont'd.)
5.Grains are found in which of the following foods?
(A) Bananas
(B) Cheese
(C) Pasta
(D) Nuts
6.Which is the most essential nutrient for life?
(A) Vegetables
(B) Water
(C) Grains
(D) Protein
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Nutrition and Hydration
Chapter Exam (cont'd.)
7.Which of the following is a good source of protein?
(A) Corn oil
(B) An orange
(C) Fish
(D) Grape jelly
8.Which of the following is true about food preferences?
(A) Residents are old enough that their preferences will not change.
(B) It is not important to honor residents’ food preferences.
(C) Education is never a factor in determining food preference.
(D) Religion might influence food preference.
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Nutrition and Hydration
Chapter Exam (cont'd.)
9.Which of the following is an effective way for a nursing assistant help
prevent dehydration?
(A) Encourage a resident to drink every time she sees him
(B) Insist that the resident drink juice
(C) Withhold fluids if a resident is incontinent
(D) Leave a carton of milk with the resident each time she leaves
the room
10.Which of the following are signs of unintended weight loss that
should be reported to the nurse?
(A) Eating lean cuts of meat
(B) Eating dessert before dinner
(C) Avoiding fried foods and sweets
(D) Coughing or choking while eating
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Nutrition and Hydration
Chapter Exam (cont'd.)
11.Which of the following can be an effective way to prevent unintended
weight loss?
(A) Promoting independence by insisting residents feed themselves
without help
(B) Honoring food likes and dislikes
(C) Telling the resident how unappetizing their meals look
(D) Insisting that residents eat everything on their trays no matter wha
12.Which of the following statements about mealtime is true?
(A) Social interaction is an important part of mealtime.
(B) Mealtime is only about getting proper nourishment.
(C) Mealtime is a good time for NAs to chat with co-workers since the
residents are busy eating.
(D) If you think a resident’s meal looks awful you should say so.
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Nutrition and Hydration
Chapter Exam (cont’d.):
13.At which angle should residents be positioned for eating?
(A) 90 degrees
(B)120 degrees
(C)180 degrees
(C) 30 degrees
14.If a resident refuses to wear a clothing protector, the nursing
assistant should
(A) Respect the resident’s refusal
(B) Refuse to serve the resident until she puts it on
(C) Insist that the resident wear it
(D) Point out to the resident that she’s making your work more
difficult
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Nutrition and Hydration
Chapter Exam (cont’d.):
15.Residents who need some assistance with eating may benefit from:
(A) The nursing assistant doing everything for the resident
(B) The nursing assistant insisting the resident eat alone so he can
learn to be independent
(C) The nursing assistant using the hand-over-hand approach
(D) The nursing assistant telling his family they need to come at
mealtimes to help
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Nutrition and Hydration
Chapter Exam (cont’d.):
16.Which of the following statements shows how a nursing assistant can
promote dignity and independence during mealtime?
(A) The nursing assistant should make the choice about which food
the resident should eat first.
(B) The nursing assistant should talk to other staff members while
assisting residents with eating.
(C) If the resident requests a different food from what is being
served, the nursing assistant should honor this request.
(D) The nursing assistant should mix a resident’s foods together
without discussing it with the resident.
8
Nutrition and Hydration
Chapter Exam (cont’d.):
17.Which of the following is a symptom of dysphagia (difficulty
swallowing)?
(A) Eating everything on the tray at every meal
(B) Sweating during meals
(C) Fever during meals
(D)Watering eyes during meals
18.Which of the following is a reason a resident might be placed on a
special diet?
(A) Because the NA thinks the resident is too heavy
(B) Because the dietary department is testing out new recipes
(C) Because the resident doesn’t care for eggs
(D) Because the resident has food allergies
8
Nutrition and Hydration
Chapter Exam (cont’d.):
19.What is the first food to be restricted in a low-sodium diet?
(A) Milk
(B) Salt
(C) Red meat
(D)Foods high in fat
20.Which statement best describes a pureed diet?
(A) This diet is often used for people who have trouble chewing
and/or swallowing more textured foods.
(B) This diet consists of only clear juices, broth, gelatin, and
popsicles.
(C) This diet consists of only clear liquids, cream soups, milk, and
ice cream.
(D) This diet is often used for people who are tired of chewing.
8
Nutrition and Hydration
Chapter Exam (cont’d.):
21.What does the abbreviation “NPO” mean?
(A) Nothing pureed only
(B) Not prepared on-site
(C) Nothing by mouth
(D) Note preferences only
22.Which type of residents may have an order for thickened liquids?
(A) Residents who have swallowing problems
(B) Residents who refuse to drink water
(C) Residents who do not eat meat
(D) Residents who have certain religious beliefs
8
Nutrition and Hydration
Chapter Exam (cont’d.):
23.Why is it important to observe plates and meal trays when residents
have finished eating?
(A) It helps the NA decide what to feed residents first.
(B) Residents who are trying to lose weight will want you to keep a
record of how much they’ve eaten.
(C) It is not important to observe what and how much a resident
eats.
(D) It helps to identify a change in food preferences.
8
Nutrition and Hydration
Chapter Exam (cont’d.):
24.When assisting residents who have had a stroke, the nursing
assistant should
(A) Place food in the stronger side of the resident’s mouth
(B) Place food in the weaker side of the resident’s mouth
(C) Offer another bite of food before the resident has swallowed the
last bite
(D) Encourage the resident to take large bites