Nutrition And Diet Therapy- 6th Edition by Carroll A. Lutz and Erin E. Mazur – Test Bank

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Nutrition And Diet Therapy- 6th Edition by Carroll A. Lutz and Erin E. Mazur – Test Bank

Chapter 2: Carbohydrates

 

 

 

  1. When we say “blood sugar,” we are talking about:
  2. Fructose
  3. Glucose
  4. Galactose
  5. Lactose

 

Ans: 2

  Feedback
1. Fructose is found in fruits and honey.
2. Glucose is the major form of sugar in the blood commonly called blood sugar.
3. Galactose comes mainly from the breakdown of the milk sugar lactose.
4. Lactose occurs only naturally in milk.

KEY: Integrated Process: Nursing Process | Client Need: Physiological Integrity: Basic Care and Comfort | Cognitive Level: Comprehension

 

 

 

  1. Which of the following factors makes carbohydrate important in world nutrition?
  2. They are expensive.
  3. They can be grown in limited areas.
  4. They provide complete nutrition.
  5. They can be stored more simply and cheaply than other foods.

 

Ans: 5

  Feedback
1. Carbohydrates are low in cost.
2. Carbohydrates are easily grown in most climates.
3. Carbohydrates are not considered complete nutrition
4. Carbohydrates are easily stored, do not require refrigeration or electricity, and their shelf life is long.

KEY: Integrated Process: Nursing Process | Client Need: Physiological Integrity: Basic Care and Comfort | Cognitive Level: Comprehension

 

 

 

  1. Dietary fiber that stimulates peristalsis and prevents constipation is called _______ fiber.
  2. Plant
  3. Polyunsaturated
  4. Soluble
  5. Insoluble

 

Ans: 4

  Feedback
1. Dietary fiber refers to foods mostly from plants.
2. Polyunsaturated is a term that is used with fats.
3. Soluble fiber dissolves in water and thickens to form gels.
4. Insoluble fiber aids in the regularity of bowel movements and reduces the risk for some forms of cancer.

KEY: Integrated Process: Nursing Process | Client Need: Physiological Integrity: Basic Care and Comfort | Cognitive Level: Comprehension

 

 

 

  1. Which of the following exchanges contains less than 6 grams of carbohydrate?
  2. Fruit
  3. Milk
  4. Starch/bread
  5. Vegetable

 

Ans: 4

  Feedback
1. One fruit exchange contains approximately 15 grams of carbohydrates.
2. One milk exchange contains approximately 12 grams of carbohydrates.
3. One starch/bread exchange contains approximately 15 grams of carbohydrates.
4. One vegetable exchange contains approximately 5 grams of carbohydrates.

KEY: Integrated Process: Nursing Process | Client Need: Physiological Integrity: Basic Care and Comfort | Cognitive Level: Comprehension

 

 

 

  1. Experts recommend that a healthy male adult consume how many grams of fiber per day?
  2. 25
  3. 32
  4. 38
  5. 45

 

Ans: 3

  Feedback
1. A healthy female adult is recommended to consume 25 grams of fiber per day.
2. A healthy male adult is recommended to consume 38 grams of fiber per day.
3. A healthy male adult is recommended to consume 38 grams of fiber per day.
4. A healthy male adult is recommended to consume 38 grams of fiber per day.

KEY: Integrated Process: Nursing Process | Client Need: Physiological Integrity: Basic Care and Comfort | Cognitive Level: Knowledge

 

 

 

  1. Most items in which of the following exchanges contain 2 to 3 grams of fiber?
  2. Free foods
  3. Meat
  4. Milk
  5. Vegetable

 

Ans: 4

  Feedback
1. Free foods are just that, free and are not accounted for in the exchange.
2. Meat does not contain carbohydrates.
3. One milk exchange contains approximately 12 grams of carbohydrates.
4. One vegetable exchange contains approximately 5 grams of carbohydrates.

KEY: Integrated Process: Nursing Process | Client Need: Physiological Integrity: Basic Care and Comfort | Cognitive Level: Comprehension

 

 

 

  1. One function of fiber in the diet is to aid:
  2. Elimination of intestinal waste
  3. Energy balance
  4. Secretion of hydrochloric acid
  5. Water balance

 

Ans: 1

  Feedback
1. Fiber adds almost no fuel or energy value to the diet, but it does add volume, filling the stomach and providing satiety. It also aids in the elimination of intestinal waste.
2. Fiber adds almost no fuel or energy value.
3. Fiber fills the stomach but does not play a role in the secretion of hydrochloric acid.
4. Fiber does not play a role in water balance.

KEY: Integrated Process: Nursing Process | Client Need: Physiological Integrity: Basic Care and Comfort | Cognitive Level: Knowledge

 

 

 

  1. Dextrose is another name for:
  2. Fructose
  3. Glucose
  4. Galactose
  5. Lactose

 

Ans: 4

  Feedback
1. Another name for glucose is dextrose.
2. Another name for glucose is dextrose.
3. Another name for glucose is dextrose.
4. Another name for glucose is dextrose.

KEY: Integrated Process: Nursing Process | Client Need: Physiological Integrity: Basic Care and Comfort | Cognitive Level: Knowledge

 

 

 

  1. An example of a nonnutritive sweetener is:
  2. Isomalt
  3. Aspartame
  4. Sorbitol
  5. Mannitol

 

Ans: 2

  Feedback
1. Isomalt is a sugar alcohol that is used on a one-to-one replacement basis for sugars in recipes.
2. Aspartame is an example of a nonnutritive sweetener.
3. Sorbitol is a sugar alcohol that is used on a one-to-one replacement basis for sugars in recipes.
4. Mannitol is a sugar alcohol that is used on a one-to-one replacement basis for sugars in recipes.

KEY: Integrated Process: Nursing Process | Client Need: Physiological Integrity: Basic Care and Comfort | Cognitive Level: Knowledge

 

 

 

  1. Milk sugar is referred to as:
  2. Fructose
  3. Lactose
  4. Maltose
  5. Sucrose

 

Ans: 2

  Feedback
1. Fructose is a monosaccharide.
2. Lactose, a disaccharide, is milk sugar.
3. Maltose is a double sugar that occurs primarily during starch digestion and is produced when the body breaks starches into simpler units.
4. Sucrose is ordinary white table sugar.

KEY: Integrated Process: Nursing Process | Client Need: Physiological Integrity: Basic Care and Comfort | Cognitive Level: Knowledge

 

 

 

  1. Sixteen grams of sucrose is equal to ______ teaspoons of sugar.
  2. 1
  3. 4
  4. 8
  5. 16

 

Ans: 2

  Feedback
1. Four grams of carbohydrates (sucrose) equals 1 teaspoon.
2. Four grams of carbohydrates (sucrose) equals 1 teaspoon; so 16 grams would equal 4 teaspoons.
3. Four grams of carbohydrates (sucrose) equals 1 teaspoon; so 32 grams would equal 8 teaspoons.
4. Four grams of carbohydrates (sucrose) equals 1 teaspoon; so 64 grams would equal 16 teaspoons.

KEY: Integrated Process: Nursing Process | Client Need: Physiological Integrity: Basic Care and Comfort | Cognitive Level: Analysis

 

 

 

  1. The storage form of carbohydrate in the body is:
  2. Glycogen
  3. Sucrose
  4. Starch
  5. Glucose

 

Ans: 1

  Feedback
1. Glycogen represents the body’s carbohydrate stores.
2. Sucrose is table sugar.
3. Starch is the major source of carbohydrate in the diet.
4. Glucose is the monosaccharide in the body and the major form of sugar in the blood.

KEY: Integrated Process: Nursing Process | Client Need: Physiological Integrity: Basic Care and Comfort | Cognitive Level: Knowledge

 

 

 

  1. Energy for the body cells is provided by:
  2. Fructose
  3. Glucose
  4. Galactose
  5. Sucrose

 

Ans: 2

  Feedback
1. The body converts fructose into glucose for energy.
2. Glucose is the primary source of energy for the body cells.
3. The body converts galactose into glucose for energy.
4. Sucrose is table sugar.

KEY: Integrated Process: Nursing Process | Client Need: Physiological Integrity: Basic Care and Comfort | Cognitive Level: Knowledge

 

 

  1. A client’s laboratory value of ______ mg/dL for a fasting serum glucose level would be reported to the physician immediately.
  2. 50
  3. 70
  4. 90

4.100

 

Ans: 1

  Feedback
1. Normal fasting blood sugar is 70 to 100 mg/dL70; a value of 50 mg/dL would be of concern.
2. A fasting blood glucose level of 70 mg/dL would be within the normal range of 70 to 100 mg/dL
3. A fasting blood glucose level of 90 mg/dL would be within the normal range of 70 to 100 mg/dL.
4. A fasting blood glucose level of 100 mg/dL would be within the normal range of 70 to 100 mg/dL.

KEY: Integrated Process: Nursing Process | Client Need: Physiological Integrity: Reduction of Risk Potential | Cognitive Level: Application

 

 

 

  1. Which of the following foods would provide the least amount of carbohydrate to a client?
  2. 8 ounces of whole milk
  3. 1 tablespoon of pickled herring
  4. 1 enriched hamburger bun
  5. 1/2 cup unsweetened applesauce

 

Ans: 2

  Feedback
1. A cup of milk, 8 ounces, would provide approximately 12 grams of carbohydrates.
2. Herring is a fish and as such would not contain carbohydrates.
3. A hamburger bun would provide approximately 15 grams of carbohydrates.
4. A 1/2 cup of applesauce would provide approximately 15 grams of carbohydrates.

KEY: Integrated Process: Nursing Process | Client Need: Physiological Integrity: Basic Care and Comfort | Cognitive Level: Application

 

 

 

  1. A client is seeking to increase his intake of complex carbohydrate. Which of the following foods would be appropriate?
  2. Kidney beans
  3. Natural honey
  4. Low-fat cottage cheese
  5. Apple

 

Ans: 1

  Feedback
1. Kidney beans are legumes and a source of complex carbohydrates.
2. Honey contains fructose, a simple carbohydrate.
3. Cottage cheese would most likely contain lactose or milk sugar.
4. Apple, a fruit, would most likely contain fructose.

KEY: Integrated Process: Nursing Process | Client Need: Physiological Integrity: Basic Care and Comfort | Cognitive Level: Application

 

 

 

  1. Which of the following statements about dietary fiber is correct?
  2. Soluble fiber dissolves in oil but not in water.
  3. Insoluble fiber increases intestinal excretion of cholesterol.
  4. Soluble fiber attaches to other waste products in the intestine to stimulate peristalsis.
  5. Fiber is the portion of plants the human body cannot digest.

 

Ans: 4

  Feedback
1. Soluble fiber dissolves in water and thickens to form gels.
2. Soluble fiber has been shown to reduce cholesterol levels.
3. Insoluble fiber stimulates peristalsis.
4. Fiber refers to foods, mostly plants, that the human body cannot break down to digest and that are eliminated in intestinal waste.

KEY: Integrated Process: Nursing Process | Client Need: Physiological Integrity: Basic Care and Comfort | Cognitive Level: Comprehension

 

 

 

  1. Which of the following would be a good source of insoluble fiber?
  2. Apple skin
  3. Oat bran
  4. Broccoli
  5. Oranges

 

Ans: 1

  Feedback
1. Fruit and vegetable skins are good sources of insoluble fiber.
2. Oat brain is a good source of soluble fiber.
3. Broccoli is a good source of soluble fiber.
4. Oranges and other citrus fruits are good sources of fiber.

KEY: Integrated Process: Nursing Process | Client Need: Physiological Integrity: Basic Care and Comfort | Cognitive Level: Application

 

 

 

  1. Which of the following statements would be incorrect?
  2. Ketosis can occur when a person avoids carbohydrate intake.
  3. Acetone and diacetic acid are ketone bodies that can be measured in the urine.
  4. Approximately 130 grams of carbohydrate is needed each day to prevent ketosis.
  5. A person can identify impending ketosis by its symptom of fainting.

 

Ans: 4

  Feedback
1. Ketosis can occur when the body has to break down stored fat and internal protein to meet fuel requirements because carbohydrate intake is low.
2. Ketone bodies, acetone and diacetic acid, can be measured in the urine.
3. An intake of 130 grams of carbohydrates each day is usually enough to prevent ketosis.
4. Fatigue, nausea, and lack of appetite indicate ketosis.{Chris/Ed: but fainting does not?}

KEY: Integrated Process: Nursing Process | Client Need: Physiological Integrity: Reduction of Risk Potential | Cognitive Level: Comprehension

 

 

 

  1. A patient has read about the health benefits of fiber. She asks the nurse about the advisability of taking fiber concentrates. Which of the following statements would be the best response by the nurse?
  2. “Fiber is best obtained from foods because they also contain other nutrients.”
  3. “It is safe to consume any amount of fiber because there are no known interactions with other nutrients.”
  4. “Fiber concentrates are best taken immediately before or with meals.”
  5. “Fiber supplements are recommended for people “on the go” who do not eat much.”

 

Ans: 1

  Feedback
1. Healthy people should achieve a desirable fiber intake by consuming fiber-rich fruits, vegetables, legumes, and whole-grain cereals, which also provide minerals, vitamins, and phytochemicals, instead of adding fiber concentrates (such as psyllium) to their diet.
2. Eating too much fiber can lead to problems such as interference with mineral absorption.
3. Fiber concentrates should be avoided if possible.
4. Individuals should consume an adequate amount of fiber regardless of their activity level. Fiber concentrates do not supply adequate nutrition.

KEY: Integrated Process: Teaching/Learning | Client Need: Physiological Integrity: Basic Care and Comfort | Cognitive Level: Application

 

 

 

  1. Oatmeal, barley, broccoli, and citrus fruits are foods that contain much:
  2. Lactose
  3. Maltose
  4. Soluble fiber
  5. Insoluble fiber

 

Ans: 3

  Feedback
1. Lactose is found in milk.
2. Maltose is found in malt, malt products, beer, some infant formulas, and sprouting seeds.
3. Oatmeal, barley, broccoli, and citrus fruits contain soluble fiber.
4. Sources of insoluble fiber include the woody or structural parts of plants such as fruit and vegetable skins and the outer coating (bran) of wheat kernels.

KEY: Integrated Process: Nursing Process | Client Need: Physiological Integrity: Basic Care and Comfort | Cognitive Level: Knowledge

 

 

 

  1. Which statement is true about nonnutritive sweeteners?
  2. They add bulk to recipes like sugar.
  3. They can replace sugar in a recipe, one for one.
  4. They are slowly and incompletely used by the body.
  5. They add intense sweetness to any recipe.

 

Ans: 4

 

 

Feedback
1. Nonnutritive sweeteners do not add bulk or volume to foods.
2. They are about 150 to 500 times sweeter than sugar.
3. Nonnutritive sweeteners are not slowly and completely used by the body.
4. They are sugar substitutes providing intense sweetness.

KEY: Integrated Process: Nursing Process | Client Need: Physiological Integrity: Basic Care and Comfort | Cognitive Level: Comprehension

 

 

 

  1. Which of the following is a disaccharide?
  2. Glucose
  3. Lactose
  4. Fructose
  5. Galactose

 

Ans: 2

  Feedback
1. Glucose is a monosaccharide.
2. Lactose is a disaccharide.
3. Fructose is a monosaccharide.
4. Galactose is a monosaccharide.

KEY: Integrated Process: Nursing Process | Client Need: Physiological Integrity: Basic Care and Comfort | Cognitive Level: Knowledge

 

 

 

  1. The nurse is reviewing the patient’s nutritional history. The patient reports that she uses 1 teaspoon of sugar in her coffee. The nurse identifies this sugar as which of the following?
  2. Sucrose
  3. Lactose
  4. Glucose
  5. Fructose

 

Ans: 1

  Feedback
1. Table sugar is sucrose.
2. Lactose is the sugar in milk.
3. Glucose is the sugar used by the body cells.
4. Fructose is the sugar found in fruits and honey.

KEY: Integrated Process: Nursing Process | Client Need: Physiological Integrity: Basic Care and Comfort | Cognitive Level: Application

 

 

 

  1. According to the Food and Nutrition Board of the National Academy of Sciences:
  2. An individual should have at least 10% of total calories eaten containing sugar.
  3. Both adults and children should ingest 100 grams or less of carbohydrates each day.
  4. Forty-five to sixty-five percent of kcalories should come from carbohydrate to minimize disease risk.
  5. People with diets high in added sugar have higher intakes of essential nutrients.

 

Ans: 3

  Feedback
1. According to dietary guidelines, no more than 6% of total calories eaten should comprise added sugars.
2. Adults and children should consume 130 grams of carbohydrates each day.
3. Forty-five to sixty-five percent of calories should come from carbohydrates.
4. People with diets high in sugar tend to have lower intakes of essential nutrients.

KEY: Integrated Process: Nursing Process | Client Need: Physiological Integrity: Basic Care and Comfort | Cognitive Level: Comprehension

 

 

 

Chapter 12: Life Cycle Nutrition: The Mature Adult

 

 

 

  1. When teaching an older adult about how many kilocalories the client should consume, the nurse understands that for each decade past 40 years, a decrease in what percentage of kilocalories is needed?
  2. 2
  3. 3
  4. 4
  5. 5

 

Ans: 4

  Feedback
1. Older adults need about 5% fewer calories per decade after age 40 years.
2. Older adults need about 5% fewer calories per decade after age 40 years.
3. Older adults need about 5% fewer calories per decade after age 40 years.
4. Older adults need about 5% fewer calories per decade after age 40 years.

KEY: Integrated Process: Teaching/Learning | Client Need: Health Promotion and Maintenance | Cognitive Level: Comprehension

 

 

 

  1. The major cause of tooth loss in the elderly population is:
  2. Dental caries
  3. Periodontal disease
  4. Scurvy
  5. Vitamin A deficiency

 

Ans: 2

  Feedback
1. The major cause of tooth loss in the elderly population is periodontal disease, not dental caries.
2. The major cause of tooth loss in the elderly population is periodontal disease.
3. The major cause of tooth loss in the elderly population is periodontal disease, not scurvy.
4. The major cause of tooth loss in the elderly population is periodontal disease, not vitamin A deficiency.

KEY: Integrated Process: Nursing Process | Client Need: Health Promotion and Maintenance | Cognitive Level: Knowledge

 

 

 

  1. The sense of taste diminishes with age and is often the result of the loss of:
  2. Teeth
  3. Hearing
  4. Smell
  5. Vision

 

Ans: 3

  Feedback
1. For the sense of taste to function well, the sense of smell must be intact. After age 65, many people begin to lose some sense of smell. Loss of teeth may affect the older adult’s ability to consume adequate nutrients.
2. For the sense of taste to function well, the sense of smell must be intact. After age 65, many people begin to lose some sense of smell. Hearing is unrelated to the sense of taste.
3. For the sense of taste to function well, the sense of smell must be intact. After age 65, many people begin to lose some sense of smell.
4. Vision aids in stimulating appetite. However, for the sense of taste to function well, the sense of smell must be intact. Vision is unrelated to the sense of taste.

KEY: Integrated Process: Nursing Process | Client Need: Health Promotion and Maintenance | Cognitive Level: Knowledge

 

 

 

  1. Which of the following changes contributes to the danger of dehydration in the elderly client?
  2. Constipation and atherosclerosis of the brain
  3. Decreased basal metabolic rate and decreased skeletal muscle mass
  4. Diminished gastrointestinal mucus and slowed peristalsis
  5. Less-active thirst mechanism and atrophied kidneys

 

Ans: 4

  Feedback
1. Although blood flow to the brain decreases because of narrowing of the arteries and constipation can occur in the elderly, it is the less-active thirst mechanism that increases the risk for dehydration in this age group.
2. Although skeletal muscle mass metabolic rate decline in the elderly, it is the less active thirst mechanism that increases the risk for dehydration in this age group.
3. Although gastrointestinal function slows with aging, it is the less active thirst mechanism that increases the risk for dehydration in this age group.
4. Thirst sensation becomes less operative, increasing the risk for uncompensated dehydration.

KEY: Integrated Process: Nursing Process | Client Need: Physiological Integrity: Reduction of Risk Potential | Cognitive Level: Application

 

 

 

  1. Which of the following interventions is appropriate for an elderly client who complains that he cannot taste his food?
  2. Providing oral hygiene before meals
  3. Increasing fluid intake
  4. Giving him a salt shaker of his own
  5. Converting food service to buffet style

 

Ans: A

  Feedback
1. Providing oral hygiene, including brushing the tongue before meals is helpful in refreshing and moistening the mouth. A dry mouth leads to indistinct taste sensations.
2. Although increasing fluid intake may help moisten the mouth, increasing fluid intake ad lib could lead to fluid overload.
3. Allowing an older adult to have a salt shaker of his own could lead to the overuse of salt, which can affect the older adults’ fluid balance status.
4. Converting food service to buffet style would have little effect on taste.

KEY: Integrated Process: Nursing Process | Client Need: Physiological Integrity: Basic Care and Comfort | Cognitive Level: Application

 

 

 

  1. Older adults require less energy than younger ones because they:
  2. Exercise less than when they were younger
  3. Eat more sweets, which are rapidly converted to fat
  4. Lose height due to osteoporosis
  5. Increase their fat deposits at the expense of muscle tissue

 

Ans: 4

  Feedback
1. Although the older adult may exercise less, this is not the reason for requiring less energy.
2. Older adults may or may not eat more sweets.
3. Although some older adults may lose height due to osteoporosis, this is not true for all older adults. Additionally, loss of height has no impact on energy requirements.
4. The average older person is slowing down. Resting energy expenditure (REE) decreases, especially in the brain, skeletal muscle, and heart. The older adult’s REE may be 10% to 12% less than that of a younger person’s. Lost muscle mass is replaced, if at all, by adipose tissue that is less active metabolically than muscle.

KEY: Integrated Process: Nursing Process | Client Need: Health Promotion and Maintenance | Cognitive Level: Comprehension

 

 

 

  1. A person who is recently widowed may have anorexia. Which of the following suggestions addresses the psychosocial cause of this lack of appetite?
  2. Attending group activities and meals at a senior citizens’ center
  3. Ordering meals-on-wheels
  4. Encouraging the person to make a “company” meal for herself or himself
  5. Engaging in vigorous exercise before meals

 

Ans: 1

  Feedback
1. Anorexia may be due to depression, which may occur with the loss of a spouse. Researchers have found that older persons eat more in social situation than when eating alone.
2. Although meals-on-wheels may help with nutrition, it would be important for the person delivering the meals to sit with the person to provide socialization.
3. A recently widowed individual may be experiencing depression secondary to the loss. Cooking a meal would be too demanding for the person at this time.
4. A recently widowed individual may be experiencing depression secondary to the loss. The individual probably would not have the energy to engage in vigorous exercise.

KEY: Integrated Process: Nursing Process | Client Need: Psychosocial Integrity | Cognitive Level: Application

 

 

 

  1. The nurse documents on a client’s chart that he is edentulous based on which of the following findings?
  2. Multiple carious teeth
  3. Edema of the tissues supporting the teeth
  4. Decreased saliva production
  5. Toothless

 

Ans: 4

  Feedback
1. Dental caries would be used to identify multiple carious teeth.
2. Periodontal disease ranges from simple gum inflammation to serious damage to the soft tissue and bone supporting the teeth.
3. Xerostomia refers to a decrease in the production of saliva.
4. Edentulous refers to the loss of all permanent teeth.

KEY: Integrated Process: Communication and Documentation | Client Need: Physiological Integrity: Physiological Adaptation | Cognitive Level: Application

 

 

 

  1. A client is noted to have xerostomia. The nurse interprets this to mean which of the following?
  2. Dry mouth
  3. Excessive salivation
  4. Lack of gastric juice
  5. Vitamin A deficiency

 

Ans: 1

  Feedback
1. Xerostomia refers to a decrease in the production of saliva.
2. Xerostomia refers to a decrease in, not excess of saliva.
3. Achlorhydria refers to a lack of hydrochloric acid.
4. Xerophthalmia refers to a vitamin A deficiency.

KEY: Integrated Process: Nursing Process | Client Need: Physiological Integrity: Physiological Adaptation | Cognitive Level: Application

 

 

 

  1. The developmental task of middle adulthood, generativity, could be fostered by:
  2. Volunteering to chair a senior center luncheon
  3. Overseeing a political action task force on Social Security
  4. Visiting with other lonesome adults on the Internet
  5. Assisting a preschool teacher with a Thanksgiving project

 

Ans: 4

  Feedback
1. Generativity involves serving as a mentor to the next generation. Volunteering to chair a senior center would not be an example.
2. Generativity involves serving as a mentor to the next generation. Overseeing a political action task force on Social Security would not be an example.
3. Generativity involves serving as a mentor to the next generation. Visiting with other lonesome adults on the Internet would not be an example.
4. Generativity involves serving as a mentor to the next generation. By assisting a preschool teacher with a project, the adult is participating with a younger generation.

KEY: Integrated Process: Nursing Process | Client Need: Psychosocial Integrity | Cognitive Level: Application

 

 

 

  1. The developmental task of young adulthood, intimacy, could be fostered by:
  2. Avoiding gatherings of older people
  3. Participating in a small group discussion on childhood nutrition
  4. Sharing one’s ambition to publish a cookbook with another person
  5. Volunteering to bake cookies for a school bake sale

 

Ans: 3

  Feedback
1. Intimacy involves sharing with another; it would not be evidenced by avoiding gatherings.
2. Intimacy involves sharing with another; it would not be evidenced by participating in small group discussions.
3. Intimacy involves in sharing with another, such as one’s ambition to publish a cookbook.
4. Intimacy involves sharing with another; it would not be evidenced by volunteering to back cookies for a bake sale.

KEY: Integrated Process: Nursing Process | Client Need: Psychosocial Integrity | Cognitive Level: Application

 

 

 

  1. Before beginning a high-protein nutritional supplement for an elderly client, function of which of the following should be assessed?
  2. Stomach
  3. Intestinal
  4. Kidney
  5. Liver

 

Ans: 3

  Feedback
1. With aging comes a decrease in renal function, which could lead to problems if increased protein is consumed.
2. With aging comes a decrease in renal function, which could lead to problems if increased protein is consumed.
3. With aging comes a decrease in renal function, which could lead to problems if increased protein is consumed.
4. With aging comes a decrease in renal function, which could lead to problems if increased protein is consumed.

KEY: Integrated Process: Nursing Process | Client Need: Physiological Integrity: Reduction of Risk Potential | Cognitive Level: Application

 

 

 

  1. Recommendations for nutritional interventions for the elderly client should be based on which of the following?
  2. How the person feels
  3. Recommended dietary allowances and adequate intakes for individuals over 51 years of age
  4. Individualized assessment
  5. Known needs of the elderly population

 

Ans: 3

  Feedback
1. Although how a person feels is important for recommendations, the recommendations must be individualized to the client for maximum effectiveness.
2. Although each age group has recommended allowances and adequate intakes, the recommendations must be individualized to the client for maximum effectiveness.
3. Each person is different. Thus, recommendations must be individualized to the client for maximum effectiveness.
4. Although knowing the needs of the elderly population is important for planning, each person is different and the recommendations must be individualized to the client for maximum effectiveness.

KEY: Integrated Process: Nursing Process | Client Need: Health Promotion and Maintenance | Cognitive Level: Comprehension

 

 

 

  1. Which of the following would be most important to master first for a client who is learning to eat with dentures?
  2. Chewing soft foods
  3. Drinking liquids
  4. Eating mashed foods
  5. Biting regular foods

 

Ans: 2

  Feedback
1. Practicing chewing soft foods would be the second step after practicing swallowing liquids.
2. Swallowing liquids is practiced first when a client is learning to eat with dentures.
3. Eating mashed foods, which are soft, would occur after the client masters swallowing liquids.
4. Biting regular foods would be the last step in learning to eat with dentures.

KEY: Integrated Process: Nursing Process | Client Need: Physiological Integrity: Reduction of Risk Potential | Cognitive Level: Analysis

 

 

 

  1. Which of the following would the nurse least likely identify as a consequence of strength training?
  2. Decreased loss of muscle mass
  3. Slowing of functional decline
  4. Fewer fall-related injuries
  5. Weight loss

 

Ans: 4

  Feedback
1. Strength training decreases muscle mass loss, functional decline, and fall-related injuries.
2. Strength training decreases muscle mass loss, functional decline, and fall-related injuries.
3. Strength training decreases muscle mass loss, functional decline, and fall-related injuries.
4. Strength training decreases muscle mass loss, functional decline, and fall-related injuries. It does not result in weight loss.

KEY: Integrated Process: Nursing Process | Client Need: Health Promotion and Maintenance | Cognitive Level: Comprehension

 

 

 

  1. To maximize intake at meals for an elderly client, how much time should elapse between supplemental feedings and meals to allow hunger to develop?
  2. 30 minutes
  3. 45 minutes
  4. 60 minutes
  5. 90 minutes

 

Ans: 3

  Feedback
1. To maximize intake, 60 minutes should elapse between supplemental feedings and meals to allow hunger to develop.
2. To maximize intake, 60 minutes should elapse between supplemental feedings and meals to allow hunger to develop.
3. To maximize intake, 60 minutes should elapse between supplemental feedings and meals to allow hunger to develop.
4. To maximize intake, 60 minutes should elapse between supplemental feedings and meals to allow hunger to develop.

KEY: Integrated Process: Nursing Process | Client Need: Health Promotion and Maintenance | Cognitive Level: Comprehension

 

 

 

  1. Which of the following protects against age-related bone loss?
  2. Vitamin C
  3. Vitamin D
  4. Folic acid
  5. Vitamin K

 

Ans: 4

  Feedback
1. Vitamin K contributes to bone metabolism and is protective against age-related bone loss. Vitamin K deficiency has been shown to contribute to the occurrence of hip and vertebral fractures in elderly women.
2. Vitamin K contributes to bone metabolism and is protective against age-related bone loss. Vitamin K deficiency has been shown to contribute to the occurrence of hip and vertebral fractures in elderly women.
3. Vitamin K contributes to bone metabolism and is protective against age-related bone loss. Vitamin K deficiency has been shown to contribute to the occurrence of hip and vertebral fractures in elderly women.
4. Vitamin K contributes to bone metabolism and is protective against age-related bone loss. Vitamin K deficiency has been shown to contribute to the occurrence of hip and vertebral fractures in elderly women.

KEY: Integrated Process: Nursing Process | Client Need: Health Promotion and Maintenance | Cognitive Level: Knowledge

 

 

 

  1. Iron and vitamin B12 absorption is likely impaired in the elderly client because of a decrease in which of the following?
  2. Salivary secretions
  3. Gastric secretions
  4. Bile
  5. Intestinal secretions

 

Ans: 2

  Feedback
1. A decrease in gastric secretions, such as hydrochloric acid, interferes with Vitamin B12 absorption and nonheme iron. Vitamin B12 may remain locked to the food protein, and less nonheme iron will be absorbed in the more alkaline environment.
2. A decrease in gastric secretions, such as hydrochloric acid, interferes with Vitamin B12 absorption and nonheme iron. Vitamin B12 may remain locked to the food protein, and less nonheme iron will be absorbed in the more alkaline environment.
3. A decrease in gastric secretions, such as hydrochloric acid, interferes with Vitamin B12 absorption and nonheme iron. Vitamin B12 may remain locked to the food protein, and less nonheme iron will be absorbed in the more alkaline environment.
4. A decrease in gastric secretions, such as hydrochloric acid, interferes with Vitamin B12 absorption and nonheme iron. Vitamin B12 may remain locked to the food protein, and less nonheme iron will be absorbed in the more alkaline environment.

KEY: Integrated Process: Nursing Process | Client Need: Physiological Integrity: Physiological Adaptation | Cognitive Level: Comprehension

 

 

 

  1. An early sign of dehydration in the elderly client is:
  2. Confusion
  3. Diarrhea
  4. Urinary frequency
  5. Weight loss

 

Ans: 1

  Feedback
1. One of the early signs of dehydration in the elderly is confusion, which may be difficult to ascertain in clients with dementia or altered consciousness.
2. Diarrhea may be a cause of dehydration but not a sign.
3. Reduced urine output, not urinary frequency, may be a sign of dehydration, which may be a late sign.
4. Weight loss is not a reliable indicator for dehydration. If due to dehydration, this would occur much later in the process.

KEY: Integrated Process: Nursing Process | Client Need: Physiological Integrity: Physiological Adaptation | Cognitive Level: Application

 

 

 

  1. An important means of preventing osteoarthritis is:
  2. Weight control
  3. High calcium intake
  4. Generous daily water intake
  5. Vitamin D supplementation

 

Ans: 1

  Feedback
1. Because the force exerted on the knees when walking may be up to six times the body weight, overweight people have a significantly increased risk of osteoarthritis of the knees. Thus, weight control has an important role in the prevention and treatment of osteoarthritis.
2. Calcium plays a role in preventing osteoporosis.
3. Water intake is important for fluid balance but not preventing osteoarthritis.
4. Vitamin D would be important in preventing hip fractures

KEY: Integrated Process: Nursing Process | Client Need: Health Promotion and Maintenance | Cognitive Level: Comprehension

 

 

 

  1. Supplements of which of the following have been recommended as measures to prevent hip fractures in individuals older than 80?
  2. Calcium and vitamin D
  3. Phosphorus and selenium
  4. Iron and Vitamin K
  5. Vitamin B12 and potassium

 

Ans: 1

  Feedback
1. Studies have recommended an intake of calcium and vitamin D as measures to reduce the risk of hip fractures.
2. Studies have recommended an intake of calcium and vitamin D as measures to reduce the risk of hip fractures.
3. Studies have recommended an intake of calcium and vitamin D as measures to reduce the risk of hip fractures.
4. Studies have recommended an intake of calcium and vitamin D as measures to reduce the risk of hip fractures.

KEY: Integrated Process: Nursing Process | Client Need: Physiological Integrity: Reduction of Risk Potential | Cognitive Level: Comprehension

 

 

 

  1. Which of the following would be least effective to implement when feeding clients with dementia?
  2. Reminding the client to swallow
  3. Guiding the client’s hand to start scooping up the food
  4. Isolating the client for meals
  5. Playing quiet music in the dining room

 

Ans: 3

  Feedback
1. Clients with dementia need to be reminded of the steps involved with self-feeding, including swallowing.
2. Clients with dementia need to be assisted with the steps involved with self-feeding, such as by guiding the client’s hand to start scooping up the food.
3. Eating provides time for socialization. The client’s environment needs to be managed to promote this social time.
4. Research has shown that music with a slow tempo tends to dampen environmental noises that might startle clients. The environment should be quiet, and adequately lit.

KEY: Integrated Process: Nursing Process | Client Need: Physiological Integrity: Basic Care and Comfort | Cognitive Level: Application

 

 

 

  1. The group of adults with the largest percentage of individuals reporting no leisure time physical activity and who are thus at increased health risk includes those in which age group?
  2. 25 to 35 years
  3. 36 to 44 years
  4. 45 to 64 years
  5. 65 years and older

 

Ans: 4

  Feedback
1. Of individuals between the ages of 25 to 35 years of age, 22% reported no leisure-time physical activity, accounting for the smallest amount among the age groups.
2. Of individuals between the ages of 36 to 44 years, 24% reported no leisure-time physical activity, accounting for the second lowest amount among the age groups.
3. Of individuals between the ages of 45 to 64 years, 27% reported no leisure-time physical activity, accounting for the second highest amount among the age groups.
4. Of individuals 65 years and older, 32% reported no leisure-time physical activity, the highest for all age groups.

KEY: Integrated Process: Nursing Process | Client Need: Health Promotion and Maintenance | Cognitive Level: Comprehension

 

 

 

  1. The best-retained senses of taste in the older adult are:
  2. Bitter and sour
  3. Sweet and sour
  4. Bitter and salty
  5. Sweet and salty

 

Ans: 1

  Feedback
1. Unlike sensitivity for bitter and sour that remains intact in older clients, the perceptivity for sweet and salt declines with age.
2. Unlike sensitivity for bitter and sour that remains intact in older clients, the perceptivity for sweet and salt declines with age.
3. Unlike sensitivity for bitter and sour that remains intact in older clients, the perceptivity for sweet and salt declines with age.
4. Unlike sensitivity for bitter and sour that remains intact in older clients, the perceptivity for sweet and salt declines with age.

KEY: Integrated Process: Nursing Process | Client Need: Health Promotion and Maintenance | Cognitive Level: Knowledge

 

 

 

  1. Mr. B, a 73-year-old widower, visits his nurse practitioner for follow-up on his hypertension, which is unchanged. Mr. B expresses surprise, saying, “Since my wife died, I haven’t been eating very well.” Which of the following statements by the nurse would be most effective in eliciting pertinent data?
  2. “Are you following a special diet?”
  3. “In what areas do you think you need help?”
  4. “Can you describe your meals on a typical day?”
  5. “It must be very lonesome for you.”

 

Ans: 3

  Feedback
1. Although asking about a special diet would be appropriate, the nurse first needs to determine what the client is eating to determine if there is a problem. Asking about a special diet is also a closed-ended question that would allow for only a yes or no answer, which would limit the amount of information the nurse would be able to collect.
2. Asking about areas needing help, although an open-ended question, should be asked once the nurse gathers information about the client’s typical meals.
3. Asking the client to describe his typical meals is an open-ended question that provides the nurse with valuable information from which additional questions can be formulated.
4. Telling the client that he must be very lonesome, although empathetic, does not address the client’s concern about eating well.

KEY: Integrated Process: Nursing Process | Client Need: Physiological Integrity: Reduction of Risk Potential | Cognitive Level: Application

 

 

 

  1. A client has dementia and has trouble manipulating forks and spoons. Which of the following items would be most appropriate for her breakfast?
  2. Oatmeal with butter rather than milk
  3. Ham and egg sandwich on a croissant
  4. Waffles with blueberry syrup
  5. Cheese soufflé with cornmeal muffin

 

Ans: 2

  Feedback
1. The client has problems with manual dexterity. Having oatmeal would require the client to use a spoon, which would be difficult. Using butter or milk would not be an issue.
2. The client has problems with manual dexterity. A ham and egg sandwich would be best because no utensils would be needed for self-feeding.
3. The client has problems with manual dexterity. Having waffles would require the use of a fork and knife, which would be difficult. The blueberry syrup would not be an issue.
4. The client has problems with manual dexterity. Having a cheese soufflé would require the use of a spoon, which would be difficult. The corn muffin however would not be a problem.

KEY: Integrated Process: Nursing Process | Client Need: Physiological Integrity: Basic Care and Comfort | Cognitive Level: Application

 

 

 

Chapter 24: Nutritional Care of the Terminally Ill

 

 

 

  1. Which of the following roles is most important in the care of a terminally ill client?
  2. Care provider
  3. Client advocate
  4. Counselor
  5. Teacher

 

Ans: 2

  Feedback
1. Although the nurse may function as a care provider, health-care professionals need to address patients’ values, goals of care, and preferences with regard to treatment to truly become patient advocates.
2. Health-care professionals need to address patients’ values, goals of care, and preferences with regard to treatment to truly become patient advocates.
3. Although the nurse may function as a counselor, health-care professionals need to address patients’ values, goals of care, and preferences with regard to treatment to truly become patient advocates.
4. Although the nurse may function as a teacher, health-care professionals need to address patients’ values, goals of care, and preferences with regard to treatment to truly become patient advocates.

KEY: Integrated Process: Caring | Client Need: Safe and Effective Care Environment: Management of Care | Cognitive Level: Comprehension

 

 

 

  1. Which of the following would be least indicative of approaching death?
  2. Cessation of eating
  3. Cyanosis and dyspnea
  4. Muscle weakness
  5. Polyuria and incontinence

 

Ans: 4

  Feedback
1. Cessation of eating and drinking is a major sign of approaching death.
2. Cyanosis and difficulty breathing are major signs of approaching death.
3. Muscle weakness is a major sign of approaching death.
4. Oliguria and incontinence are major signs of approaching death.{ED/AU: should this be NOT major signs? This doesn’t seem to make sense.}

KEY: Integrated Process: Nursing Process | Client Need: Psychosocial Integrity | Cognitive Level: Application

 

 

 

  1. Ms. L is actively dying and has refused oral intake. Her caregiver is concerned. Which of the following responses would be the most helpful to the caregiver?
  2. “Offer her fluids every hour, but respect her right to refuse.”
  3. “Let’s see if we can obtain an order for an antipyretic suppository.”
  4. “Dehydration is not painful and eases the passage from life. Offer sips of fluid upon request.”
  5. “Put some fluid into her mouth every half hour and see if she will swallow it.”

 

Ans: 3

  Feedback
1. Rather than fluids every hour, a better suggestion would be to offer ice chips or lubricating the lips with a moistened gauze or water-soluble product.
2. There is no need for an antipyretic. Dehydration is believed to have a euphoric effect.
3. Health-care workers need to counsel family members that dehydration at this time is believed to have a euphoric effect and is not painful
4. Life will soon cease when a client’s eating and drinking diminishes critically. It is uncompassionate to force fluids to a client who is actively dying. Additionally, there is the risk of aspiration.

KEY: Integrated Process: Caring | Client Need: Psychosocial Integrity | Cognitive Level: Application

 

 

 

  1. The goal of palliative nutritional care for the terminally ill client is to do which of the following?
  2. Alleviate discomfort and relieve symptoms
  3. Maximize intake of a balanced diet
  4. Compensate for malabsorption problems
  5. Substitute a liquid complete nutritional supplement for solid food

 

Ans: 1

  Feedback
1. The goal of palliative care is the relief of symptoms to alleviate or ease pain and discomfort. Emphasis in palliative care is placed on addressing pain and symptom control, spiritual and psychological support, and improving quality of life.
2. Palliative nutritional care is not aimed at maximizing the intake of a balanced diet. The goal of palliative care is the relief of symptoms to alleviate or ease pain and discomfort. Emphasis in palliative care is placed on addressing pain and symptom control, spiritual and psychological support, and improving quality of life.
3. Palliative nutritional care is not performed to compensate for malabsorption problems. The goal of palliative care is the relief of symptoms to alleviate or ease pain and discomfort. Emphasis in palliative care is placed on addressing pain and symptom control, spiritual and psychological support, and improving quality of life.
4. Palliative nutritional care does not focus on substituting a liquid complete nutritional supplement for solid food. The goal of palliative care is the relief of symptoms to alleviate or ease pain and discomfort. Emphasis in palliative care is placed on addressing pain and symptom control, spiritual and psychological support, and improving quality of life.

KEY: Integrated Process: Nursing Process | Client Need: Psychosocial Integrity | Cognitive Level: Comprehension

 

 

 

  1. An assessment question about fat in the diet of a terminally ill client is appropriate if the client has complained about:
  2. Constipation
  3. Dyspnea
  4. Ravenous hunger
  5. Steatorrhea

 

Ans: 4

  Feedback
1. Constipation does not reflect fat absorption.
2. Dyspnea is unrelated to fat intake.
3. Ravenous hunger is not related to fat intake.
4. Steatorrhea would reflect fat in the stool and provide the basis for assessing fat intake.

KEY: Integrated Process: Nursing Process | Client Need: Physiological Integrity: Physiological Adaptation | Cognitive Level: Application

 

 

 

  1. Which of the following statements is true?
  2. Nutrition support is medically optional except for comatose clients.
  3. Hydration is medically mandatory as long as a client can swallow.
  4. State laws vary as to the obligation to provide hydration and nutrition.
  5. Federal statutes require both nutrition and hydration be provided as long as life persists.

 

Ans: 3

  Feedback
1. Nutrition support is not mandatory for clients who are comatose.
2. Swallowing is not the determinant for hydration.
3. State laws differ as to whether nutrition and hydration are medically obligatory or medically optional.
4. State laws, not federal statutes, define the parameters for nutrition and hydration.

KEY: Integrated Process: Nursing Process | Client Need: Psychosocial Integrity | Cognitive Level: Comprehension

 

 

 

  1. In some states, a charge of ______ can be brought if a client is fed artificially against his or her wishes.
  2. Assault
  3. Battery
  4. Malpractice
  5. Negligence

 

Ans: 2

  Feedback
1. A charge of assault could be brought if a person threatened to feed a client artificially against his or her wishes.
2. In some states, a charge of battery can be made if a client is fed artificially against his or her wishes.
3. In some states, a charge of negligence or malpractice can be made is clients are allowed to intentionally starve themselves to death.
4. In some states, a charge of negligence or malpractice can be made if clients are allowed to intentionally starve themselves to death.

KEY: Integrated Process: Nursing Process | Client Need: Safe and Effective Care Environment: Management of Care | Cognitive Level: Application

 

 

 

  1. Dryness of the mouth caused by an abnormal reduction in salivary secretion is:
  2. Dysgeusia
  3. Parotitis
  4. Stomatitis
  5. Xerostomia

 

Ans: 4

  Feedback
1. Dysgeusia refers to an abnormal taste sensation.
2. Parotitis refers to an inflammation of the salivary glands.
3. Stomatitis refers to an inflammation of oral mucosa.
4. Xerostomia refers to dry mouth.

KEY: Integrated Process: Nursing Process | Client Need: Physiological Integrity: Physiological Adaptation | Cognitive Level: Knowledge

 

 

 

  1. Impairment or perversion of gustatory sense wherein normal tastes are perceived as unpleasant is:
  2. Dysgeusia
  3. Parotitis
  4. Stomatitis
  5. Xerostomia

 

Ans: 1

  Feedback
1. Dysgeusia refers to an abnormal taste sensation.
2. Parotitis refers to an inflammation of the salivary glands.
3. Stomatitis refers to an inflammation of oral mucosa.
4. Xerostomia refers to dry mouth.

KEY: Integrated Process: Nursing Process | Client Need: Physiological Integrity: Physiological Adaptation | Cognitive Level: Knowledge

 

 

 

  1. A client is complaining of pruritus. The nurse interprets this as which of the following?
  2. Excessive hair growth above the lip
  3. Severe itching
  4. Hives
  5. Inflammation of the skin

 

Ans: 2

  Feedback
1. Hirsutism refers to the growth of coarse, dark hair in typically hair-free areas such as above the lip.
2. Pruritus refers to severe itching.
3. Hives is dermatologic response manifested by raised red macules that are itchy.
4. Dermatitis refers to an inflammation of the skin.

KEY: Integrated Process: Nursing Process | Client Need: Physiological Integrity: Physiological Adaptation | Cognitive Level: Comprehension

 

 

 

  1. Discoloration (blue, gray, or purple) of the skin or mucous membranes due to lack of oxygen in the blood is called ______.
  2. Petechiae
  3. Contusions
  4. Cyanosis
  5. Purpura

 

Ans: 3

  Feedback
1. Petechiae are pinpoint round spots that appear on the skin as a result of bleeding under the skin.
2. Contusions are bruises or ecchymotic areas.
3. Cyanosis refers to the bluish discoloration of the skin and mucous membranes due to a lack of oxygenation.
4. Purpura refers to red or purple discolorations on the skin that do not blanch with pressure. They are larger than petechiae and smaller than contusions.

KEY: Integrated Process: Nursing Process | Client Need: Physiological Integrity: Physiological Adaptation | Cognitive Level: Knowledge

 

 

 

  1. The goal of nutrition screening for the client under hospice care is which of the following?
  2. Recognize areas for improvement in diet.
  3. Identify food-related concerns.
  4. Gather data to correlate long-term nutritional habits with the onset of disease.
  5. Distinguish food-handling practices that are suboptimal.

 

Ans: 2

  Feedback
1. Nutritional screening is done to discuss any food-related concerns, not to recognize any areas of nutrition that need improvement.
2. The goal of palliative nutritional care is to assist the client and caregiver with any food-related concerns. These difficulties may be related to uncomfortable symptoms and attitudes and beliefs held about food. Screening the client with a terminal illness for food-related concerns is the first step.
3. Nutritional screening is done to gather data but not data related to nutritional habits and disease onset.
4. Nutritional screening is not done to identify suboptimal food-handling practices.

KEY: Integrated Process: Nursing Process | Client Need: Psychosocial Integrity | Cognitive Level: Comprehension

 

 

 

  1. A client is terminally ill when he or she has an irreversible lethal disease and death is expected within which time frame?
  2. 2 months
  3. 3 months
  4. 6 months
  5. 1 year

 

Ans: 3

  Feedback
1. An individual is considered terminally ill if he or she has a medical

prognosis of 6 months or less based on the usual disease progression.

2. An individual is considered terminally ill if he or she has a medical

prognosis of 6 months or less based on the usual disease progression.

3. An individual is considered terminally ill if he or she has a medical

prognosis of 6 months or less based on the usual disease progression.

4. An individual is considered terminally ill if he or she has a medical

prognosis of 6 months or less based on the usual disease progression.

KEY: Integrated Process: Nursing Process | Client Need: Physiological Integrity: Physiological Adaptation | Cognitive Level: Knowledge

 

 

 

  1. Mr. W, a hospice client, wishes to treat his anemia so he will not feel so fatigued. Which of the following would be least appropriate to suggest?
  2. Iron-fortified cereals
  3. Citrus fruits with every meal
  4. Chicken breasts every other day
  5. Raisins and prunes for snacks

 

Ans: 2

  Feedback
1. Iron-fortified foods would be appropriate.
2. A vitamin C source should be consumed with red meats and iron-fortified foods, but it does not have to be eaten with every meal.
3. Chicken breast is an appropriate choice.
4. Raisins and prunes are high in iron and a good choice for snacks.

KEY: Integrated Process: Teaching/Learning | Client Need: Physiological Integrity: Physiological Adaptation | Cognitive Level: Application

 

 

 

  1. Ms. D has been under the care of hospice for 4 months. For the past few days she has taken only one-fourth of her usual food. Her caregiver is greatly concerned. What advice would be least appropriate?
  2. “Offer her tasty foods to show you love her.”
  3. “Be firm like a parent and insist that she increase her intake.”
  4. “See if she would take just an ounce of complete supplement every hour.”
  5. “Ask her what she wants from you. It may be just companionship.”

 

Ans: 2

  Feedback
1. It would be appropriate for the nurse to suggest to the caregiver that he or she give the client tasty foods. Such a suggestion helps to make the caregiver feel useful and needed and also gives her some emotional comfort.
2. Telling the caregiver to be firm is inappropriate and nontherapeutic. There is no need for the caregiver to be an authority figure at this time but rather should be a support person to the client.
3. Suggesting small amounts of supplement every hour helps the client feel useful and needed and also gives her some emotional support.
4. Telling the caregiver to ask the client what she wants demonstrates a respect for the client’s needs as well as the caregiver’s needs.

KEY: Integrated Process: Caring | Client Need: Psychosocial Integrity | Cognitive Level: Application

 

 

 

  1. Ms. L has an abdominal cancer that is causing a partial bowel obstruction. She is able to take oral nourishment and has refused a feeding tube. Which of the following would be least appropriate to give?
  2. Liquid supplement
  3. Dietary fiber with every meal and feeding
  4. Clear liquids
  5. Lean, tender chicken or turkey

 

Ans: 2

  Feedback
1. If oral intake is not contraindicated, a liquid supplement may be given.
2. If oral intake is not contraindicated, small meals low in fiber and residue would be appropriate.
3. Clear liquids are appropriate if oral intake is not contraindicated.
4. Lean tender chicken and turkey are mild foods that can be easily chewed and low in fiber.

KEY: Integrated Process: Nursing Process | Client Need: Physiological Integrity: Physiological Adaptation | Cognitive Level: Application

 

 

 

  1. Many foods taste bitter to a client. Which of the following suggestions would be expected to help alleviate this problem?
  2. Adding cocoa to coffee for a mocha flavor
  3. Marinating beef in vinegar sauce before cooking
  4. Sprinkling coarse salt on the fish before baking
  5. Using glass cooking utensils

 

Ans: 4

  Feedback
1. Coffee intake should be decreased.
2. Meat should be marinated in juices or wines, not vinegar.
3. Salt typically is not liked when a client experiences a bitter taste.
4. Cooking food in a glass or porcelain container helps improve taste.

KEY: Integrated Process: Teaching/Learning | Client Need: Physiological Integrity: Physiological Adaptation | Cognitive Level: Application

 

 

 

  1. Which of the following would be most appropriate to suggest to a client with hiccups?
  2. Avoiding peppermint flavorings
  3. Swallowing a teaspoonful of granulated sugar
  4. Increasing the amount of fluid consumed at each meal
  5. Using straws to ingest liquids and semisolids

 

Ans: 2

  Feedback
1. Peppermint has no effect of hiccups.
2. Swallowing a teaspoonful of granulated sugar may be helpful for hiccups.
3. Increasing fluids with meals has no effect on hiccups.
4. Straws should be avoided with hiccups.

KEY: Integrated Process: Teaching/Learning | Client Need: Physiological Integrity: Physiological Adaptation | Cognitive Level: Application

 

 

 

  1. Ms. N is a hospice client who has had insulin-dependent diabetes mellitus (type 1 diabetes) for many years. The visiting nurse asks the client and caregiver to relate the client’s history of clinical signs and symptoms of hypoglycemia. The nurse is concerned because of which of the following reasons?
  2. Often no signs and symptoms of impending coma are shown because of epinephrine deficiency.
  3. With approaching death, hyperglycemia needs to be steadfastly avoided.
  4. Ketoacidosis is particularly hazardous for the client with a terminal illness.
  5. A change in type or dose of insulin may be required to counterbalance the client’s hypersensitivity to the drug.

 

Ans: 1

  Feedback
1. Many of these clients have deficiencies in the counterregulatory hormones, especially epinephrine, and may lapse into a coma without any warning signs. Caregivers need to be informed of this potential complication.
2. There is no need to avoid hyperglycemia with approaching death. Suitable range for blood sugars would be 127 to 309 mg/dL.
3. Ketoacidosis is just as dangerous for a terminally ill client as for one who is not terminally ill.
4. The primary guide for determining the level of nutritional intervention is the wish of the client.

KEY: Integrated Process: Nursing Process | Client Need: Physiological Integrity: Physiological Adaptation | Cognitive Level: Comprehension

 

 

 

  1. Ms. N is a hospice client who has had insulin-dependent diabetes mellitus (type 1 diabetes) for many years. The visiting nurse instructs the caregiver to feed Ms. N 30 to 50 g of carbohydrate every 3 hours:
  2. To prevent starvation ketosis
  3. To promote water excretion
  4. To spare fat for weight gain
  5. To show a sign of loving care and concern

 

Ans: 1

  Feedback
1. Carbohydrates every 3 hours are given to prevent starvation ketosis.
2. Carbohydrates are not given to help promote water excretion.
3. Carbohydrates are not given to spare fat for weight gain.
4. Carbohydrates are not given to show love and concern, although that message may come across.

KEY: Integrated Process: Teaching/Learning | Client Need: Physiological Integrity: Reduction of Risk Potential | Cognitive Level: Comprehension

 

 

 

  1. Ms. O is a hospice client suffering from daily nausea and vomiting. Which of the following should be corrected to help alleviate the nausea and vomiting?
  2. Remove the partially filled emesis basin next to her lunch tray.
  3. Post a daily schedule showing exercise periods following breakfast, lunch, and dinner.
  4. Provide a lunch tray containing foods from all the groups.
  5. Restrict liquids to mealtimes.

 

Ans: 1

  Feedback
1. The client should not be exposed to noxious odors, so it would be beneficial to remove any emesis from her nearby lunch tray.
2. The client will most likely not be interested in exercise periods due to the nausea and vomiting.
3. The client’s diet should be determined by what she can tolerate.
4. The client should restrict fluids to 1 hour before or after meals to prevent early satiety.

KEY: Integrated Process: Nursing Process | Client Need: Physiological Integrity: Physiological Adaptation | Cognitive Level: Application

 

 

 

  1. The nurse is working with a client experiencing migraine headaches. When discussing possible triggers, which of the following would the nurse be least likely to include?
  2. Overeating
  3. Food additives
  4. Peanuts
  5. Caffeine

 

Ans: 1

  Feedback
1. Hunger or missed meals can trigger a migraine headache. Migraine headaches can also be triggered by one or many foods. Common food offenders include many common food additives, processed meats, peanuts and peanut products, soybeans, yeast, chocolate, aged cheeses, seasonings, caffeine, some types of alcohol, and flavorings.
2. Hunger or missed meals can trigger a migraine headache. Migraine headaches can also be triggered by one or many foods. Common food offenders include many common food additives, processed meats, peanuts and peanut products, soybeans, yeast, chocolate, aged cheeses, seasonings, caffeine, some types of alcohol, and flavorings.
3. Hunger or missed meals can trigger a migraine headache. Migraine headaches can also be triggered by one or many foods. Common food offenders include many common food additives, processed meats, peanuts and peanut products, soybeans, yeast, chocolate, aged cheeses, seasonings, caffeine, some types of alcohol, and flavorings.
4. Hunger or missed meals can trigger a migraine headache. Migraine headaches can also be triggered by one or many foods. Common food offenders include many common food additives, processed meats, peanuts and peanut products, soybeans, yeast, chocolate, aged cheeses, seasonings, caffeine, some types of alcohol, and flavorings.

KEY: Integrated Process: Teaching/Learning | Client Need: Physiological Integrity: Reduction of Risk Potential | Cognitive Level: Application

 

 

 

  1. A client has dyspnea and has read that caffeine helps break up and expel secretions. The client asks you for a recommendation. An appropriate response would be which of the following?
  2. Caffeine is a bronchodilator, so it is correct.
  3. Consumption of caffeine is never recommended.
  4. Milk will help prevent the mucus.
  5. Fruit juice will work just as well.

 

Ans: 1

  Feedback
1. Coffee, tea, and chocolate are bronchodilators that increase blood pressure, dilate pulmonary vessels, increase glomerular filtration rate, and thus break up and expel pulmonary secretions and fluids.
2. Although too much caffeine is not good, coffee, tea, and chocolate are bronchodilators that increase blood pressure, dilate pulmonary vessels, increase glomerular filtration rate, and thus break up and expel pulmonary secretions and fluids.
3. Milk will not help break up the mucus. Coffee, tea, and chocolate are bronchodilators that increase blood pressure, dilate pulmonary vessels, increase glomerular filtration rate, and thus break up and expel pulmonary secretions and fluids.
4. Fruit juice does not contain caffeine. Coffee, tea, and chocolate are bronchodilators that increase blood pressure, dilate pulmonary vessels, increase glomerular filtration rate, and thus break up and expel pulmonary secretions and fluids.

KEY: Integrated Process: Nursing Process | Client Need: Physiological Integrity: Physiological Adaptation | Cognitive Level: Application

 

 

 

  1. After teaching a group of nurses about the signs of approaching death, the instructor determines that additional teaching is needed when the group identifies which of the following as a sign?
  2. Decrease in body temperature
  3. Decreased verbalization
  4. Increase in pulse rate
  5. Fall in blood pressure

 

Ans: 2

  Feedback
1. Signs of impending death include a decrease in body temperature, a rise then decrease in pulse rate, a rise then decrease in respirations, and a fall in blood pressure.
2. Signs of impending death include a decrease in body temperature, a rise then decrease in pulse rate, a rise then decrease in respirations, and a fall in blood pressure. The client experiences a decrease in mental alertness but verbalization varies.
3. Signs of impending death include a decrease in body temperature, a rise then decrease in pulse rate, a rise then decrease in respirations, and a fall in blood pressure.
4. Signs of impending death include a decrease in body temperature, a rise then decrease in pulse rate, a rise then decrease in respirations, and a fall in blood pressure.

KEY: Integrated Process: Teaching/Learning | Client Need: Psychosocial Integrity | Cognitive Level: Analysis

 

 

 

  1. Which of the following would be considered a suitable range for blood glucose in the hospice population?
  2. 60 to 100 mg/dL
  3. 100 to 120 mg/dL
  4. 127 to 309 mg/dL
  5. 400 mg/dL and above

 

Ans: 3

  Feedback
1. A suitable range for blood sugars would be 127 to 309 mg/dL in the hospice population.
2. A suitable range for blood sugars would be 127 to 309 mg/dL in the hospice population.
3. A suitable range for blood sugars would be 127 to 309 mg/dL in the hospice population.
4. A suitable range for blood sugars would be 127 to 309 mg/dL in the hospice population.

KEY: Integrated Process: Nursing Process | Client Need: Physiological Integrity: Reduction of Risk Potential | Cognitive Level: Application

 

 

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