Nutrition Essentials for Nursing Practice 6th Edition by Susan G. Dudek – Test Bank




Nutrition Essentials for Nursing Practice 6th Edition by Susan G. Dudek – Test Bank

Chapter 2, Carbohydrates


1. Monosaccharides are also known by other names. What is dextrose also known as?
  A) Levulose
  B) Fructose
  C) Glucose
  D) Maltose



2. Much has been learned in the field of nutrition about nutritional intake and how to work toward making our diets optimal nutritionally. When it comes to carbohydrate intake, the latest findings indicate that Americans should:
  A) Decrease their intake of fiber and increase their intake of complex carbohydrates
  B) Increase their intake of fiber and limit consumption of added sugars
  C) Eat total carbohydrates consisting of 50% fiber and 50% simple sugars
  D) Eat a diet based on plenty of fruits and vegetables and limit carbohydrates



3. Lactose is composed of glucose and galactose and is a naturally occurring carbohydrate. Unfortunately, many people cannot tolerate lactose (lactose intolerance) and develop gastrointestinal symptoms after ingesting lactose. These people would do best eating what dairy food?
  A) Milk
  B) Cheese
  C) Yogurt
  D) Butter



4. Sugar alcohols are one of the alternatives to naturally occurring sugar that are used widely in the American diet. Some of the sugar alternatives can cause unpleasant side effects in some people if eaten in large amounts. What can large amounts of sugar alcohols cause in some people?
  A) Diarrhea
  B) Constipation
  C) Elevated serum glucose levels
  D) Nausea



5. You are the clinic nurse teaching newly diagnosed type II diabetics about diet and weight control. One of the subjects you will cover is how to figure out the caloric content of commonly eaten foods. An exercise you give your class is to figure out the calories in a tablespoon of jelly that contains 13 g of carbohydrates, no protein, and no fat. What is the correct number of calories in the jelly?
  A) 26 cal.
  B) 39 cal.
  C) 52 cal.
  D) 65 cal.



6. The digestion of carbohydrates by the body is complex. Where is the primary site of carbohydrate digestion?
  A) Mouth
  B) Stomach
  C) Small intestine
  D) Large intestine



7. An upper level for added sugar has not yet been established but recommendations have been made. What is the Food Guide Pyramid recommended limit of added sugar?
  A) 6% to 10% of the total calorie intake
  B) 10 teaspoons daily in a 1,600-calorie meal plan
  C) 2% to 5% of the total calorie intake
  D) 18 teaspoons for a 2,200-calorie meal plan



8. Fiber is classified as “dietary fiber” or “functional fiber.” The type of fiber that helps lower serum cholesterol and glucose levels is most abundant in what grain?
  A) Wheat bran
  B) Corn
  C) Brown rice
  D) Oats



9. Foods have physiologic effects on the body outside of their nutritional value. Of the following, what food may help prevent constipation?
  A) Shredded wheat
  B) Puffed rice
  C) Oranges
  D) Lettuce



10. Sugar alternatives come in two categories, sugar alcohols and nonnutritive sweeteners. Nonnutritive sweeteners:
  A) Promote dental caries
  B) Are much less sweet than sugar
  C) Provide few or no calories
  D) Cause blood sugar levels to rise rapidly



11. You are making recommendations to a client with a diagnosis of chronic constipation on ways to increase the fiber intake in his diet. What is one recommendation you can make?
  A) Drink orange juice instead of orange drink.
  B) Eat legumes two to three times per week.
  C) Eat cream of wheat instead of white toast.
  D) Eat pretzels instead of potato chips.



12. You are admitting a patient with a diagnosis of morbid obesity for gastric bypass surgery. While you are performing the nutritional screening, the client states, “I eat a lot of sweets and I am a little nervous that I won’t be able to eat them anymore.”  This statement tells you that this patient is at risk for what?
  A) Iron deficiency
  B) Excessive calcium intake
  C) Vitamin A toxicity
  D) Vitamin E toxicity



13. For decades sugar has been blamed as the cause of various disease states. What has research shown sugar to be implicated in the development of?
  A) Obesity
  B) Dental caries
  C) Heart disease
  D) Diabetes mellitus



14. You have been selected to teach a nutrition class for clients who are morbidly obese. You have planned to provide a selection of foods for your clients and have them create nutritional menu plans for a three-day period. Some of the criteria for the nutritional menu are to meet the RDA for carbohydrates and to include a whole-grain food at least 2 times a day. What is an example of a whole-grain food?
  A) Cheerios
  B) Cornflakes
  C) Puffed wheat
  D) Rice Krispies



15. One of the clients in your nutrition class is concerned about constipation and not having enough fiber in his diet. What would be your best response to this client to increase fiber intake?
  A) Eat legumes in place of meat.
  B) Eat cooked vegetables instead of raw vegetables.
  C) Bake foods instead of frying them.
  D) Eat small frequent meals.



16. Glycogen is stored in the liver in limited amounts. It is released between meals as glucose to maintain serum blood glucose levels. Glycogen is the human version of what?
  A) Fiber
  B) Sugar
  C) Starch
  D) Protein



17. The National Academy of Sciences has put forth a recommendation to replace the terms “insoluble” and “soluble” with terms more descriptive of the physiologic benefits of particular fibers. What term has been suggested for intact and naturally occurring plant fiber?
  A) Functional fiber
  B) Dietary fiber
  C) Total fiber
  D) True fiber



18. Skim milk is a better choice of beverage than whole milk because along with the lower fat content it has what?
  A) A higher carbohydrate content
  B) A lower carbohydrate content
  C) The same carbohydrate content
  D) No carbohydrate content



19. Phenylketonuria (PKU) is a genetic disorder that is characterized by an inability of the body to utilize the essential amino acid phenylalanine. People with PKU should avoid which nonnutritive sweetener?
  A) Aspartame
  B) Saccharin
  C) Acesulfame-K
  D) Sucralose



20. As a pediatric nurse you are often asked by parents what they can do to reduce the risk of cavities in their children’s teeth. What would be your best response?
  A) “Be sure to feed your children small frequent meals.”
  B) “The best thing you can do is eliminate all sugars from their diet.”
  C) “A good way is to limit between-meal snacking on carbohydrates, including soft drinks.”
  D) “You can give them teeth-friendly snacks, such as orange juice and whole-grain crackers.”



21. Since sugars are absorbed rapidly by the body, it was commonly believed that they produced a greater increase in blood glucose than complex carbohydrates did. What is this response called?
  A) Glycemic index
  B) Glycemic indication
  C) Glycemic load
  D) Glycemic response



22. The glycemic index is a listing of foods and what their impact is on blood glucose response. How is a food’s glycemic index determined?
  A) A comparison is made between the blood glucose response caused by 25 g of pure glucose and 25 g of a food sample.
  B) Serial blood glucose levels are drawn after eating 25 g of a food sample and compared to a chart on blood glucose levels after eating 25 g of sucrose.
  C) Serial blood glucose levels are drawn after eating 50 g of pure sucrose and compared to blood glucose levels after eating 50 g of a food sample.
  D) A comparison is made between the blood glucose response caused by 50 g of pure glucose and 50 g of a food sample.



23. When the body is in the postprandial state, a slight fall in blood glucose stimulates the pancreas to release what?
  A) Glucose
  B) Amylase
  C) Bile
  D) Glucagon



24. Fiber is a necessary part of the nutritional intake. It can, however, cause the absorption of some minerals to be incomplete. Fiber impairs the absorption of what minerals? (Mark all that apply.)
  A) Potassium
  B) Zinc
  C) Magnesium
  D) Calcium
  E) Chloride



25. There is more to the glycemic response to a food than the caloric value of the food. The glycemic response is influenced by many different variables. What variables influence the glycemic response of the body to a food? (Mark all that apply.)
  A) Amount of acid in the food
  B) The degree the food has been processed
  C) What other foods are eaten at the same time
  D) What the glycemic indication of the food is
  E) How well masticated the food is



26. What concept was developed from the amount of carbohydrate contained in a food and the glycemic index of the food?
  A) Glycemic response
  B) Glycemic indication
  C) Glycemic level
  D) Glycemic load



27. What sugar, when burned by the body, does not leave an end product to be excreted by the body?
  A) Sucrose
  B) Glucose
  C) Fructose
  D) Maltose



28. When the body does not have enough glucose, fat cannot be completely burned for energy. What happens to fat oxidation without adequate glucose?
  A) Fat oxidation goes to completion because it draws on the body’s store of glucagon.
  B) Fat oxidation stops prematurely and fat is excreted in the body’s waste.
  C) Fat oxidation goes to completion because it forces the body into ketosis.
  D) Fat oxidation stops prematurely at the intermediate step of ketone formation.



29. Excess glucose in the body can be converted into other substances. What is one of these substances?
  A) Essential amino acids
  B) Nonessential amino acids
  C) Muscle
  D) Glucagon



30. The RDA for carbohydrates is based on the minimum amount of glucose used to fuel the brain. This is not an appropriate guideline for determining carbohydrate intake. It is more appropriate to use the Acceptable Macronutrient Distribution Range (AMDR). What is the suggested carbohydrate intake put forth by the AMDR?
  A) Carbohydrates should make up 25% to 50% of total dietary calories.
  B) Carbohydrates should make up 45% to 65% of total dietary calories.
  C) Carbohydrates should make up 50% to 75% of total dietary calories.
  D) Carbohydrates should make up 65% to 85% of total dietary calories.




Answer Key


1. C
2. B
3. B
4. A
5. C
6. C
7. A
8. D
9. A
10. C
11. B
12. A
13. B
14. A
15. A
16. C
17. B
18. C
19. A
20. C
21. D
22. D
23. D
24. B, D
25. A, B, C
26. D
27. B
28. D
29. B
30. B




Chapter 22, Nutrition for Patients With Cancer or HIV-AIDS

1. Cancer cachexia is a progressive wasting syndrome that is:
  A) Estimated to cause 20% to 40% of cancer deaths
  B) Correlated with the size of the tumor: the bigger the tumor, the more severe the cachexia
  C) Directly related to calorie intake: the fewer the calories consumed, the more severe the cachexia
  D) Most commonly seen developing in clients with breast cancer or sarcoma



2. Alterations in body metabolism occur in patients with all types of cancers. What are these metabolic alterations? (Mark all that apply.)
  A) Hyperglycemia
  B) Hyperlipidemia
  C) Lowered basal metabolic rate
  D) Fluid and electrolyte abnormalities
  E) Increased protein sparing



3. Patients who undergo radiation therapy to the head and neck are at risk for several complications. What is the most likely complication of radiation to the head and neck?
  A) Difficulty chewing and swallowing
  B) Nausea and vomiting
  C) Chronic blood loss
  D) Malabsorption



4. Patients who receive radiation to the lower neck or midchest are at risk for several complications. What complication is most common?
  A) Mouth blindness
  B) Esophagitis with dysphagia
  C) Dumping syndrome
  D) Chronic blood loss



5. A 52-year old-male is admitted to your unit with fatigue, weight loss, and malaise. The patient has lost >10% of his body weight over the past six months. The physician notes that the patient has generalized malabsorption and altered insulin secretion. What are these potential complications of?
  A) Cancer of the stomach
  B) Cancer of the gallbladder
  C) Cancer of the small bowel
  D) Cancer of the pancreas



6. Your patient is scheduled for chemotherapy in one hour. Which of the following would best be avoided before and after chemotherapy?
  A) Coffee
  B) Skim milk
  C) Sherbet
  D) Apple juice



7. A patient undergoing radiation therapy has developed anorexia. What interventions may help improve the patient’s appetite? (Mark all that apply.)
  A) Small amounts of alcohol
  B) Small amounts of coffee
  C) Light exercise
  D) Avoiding strong odors
  E) Drink liquids with meals



8. You are doing discharge teaching with a patient who has a diagnosis of colon cancer, stage 4. Your patient asks if there is anything that he can do for the fatigue he feels. What would be your best response?
  A) You should eat a big breakfast.
  B) You should limit physical activity.
  C) You should limit fluids.
  D) You should drink caffeinated beverages.



9. The patient is in the clinic after being diagnosed with HIV. He asks what vitamin and mineral supplements are recommended to improve his nutritional status. What would be your best response?
  A) Multivitamin and mineral supplements are usually recommended at levels of 100% to 200% of the dietary reference intake (DRI).
  B) Supplements of vitamin A, zinc, and iron are especially beneficial for HIV patients.
  C) Vitamin and mineral supplements are not recommended for HIV patients.
  D) Your blood work shows that you are hypokalemic so you do not need potassium.



10. Your patient complains of a metallic taste in her mouth. What would be the best recommendation?
  A) Eat small, frequent meals.
  B) Brush your teeth before eating.
  C) Use plastic utensils.
  D) Experiment with tart foods.



11. The dietician has recommended that your patient’s diet be changed from regular to nutrient dense. What is the most nutrient-dense snack for someone with a dry mouth?
  A) A peanut butter sandwich
  B) A cherry popsicle
  C) Boost or Ensure
  D) Hard cheese with crackers



12. Your patient’s diet has just been changed to a protein-dense diet. She asks you how she can increase the protein density of her diet. What would be the best response?
  A) Using honey on toast and cereal
  B) Substituting mayonnaise for salad dressing
  C) Adding whipped cream to coffee and tea
  D) Melting cheese on sandwiches and vegetables



13. You are speaking to a group of cancer patients who are undergoing chemotherapy. What would you recommend as a snack for these patients?
  A) Sherbet
  B) Hot cocoa
  C) Potato chips
  D) French fries



14. Taste changes are a common complaint of cancer patients. What is the most common complaint voiced by cancer patients about their food?
  A) Salty
  B) Sweet
  C) Bitter
  D) Sour



15. Your radiation therapy patient has come to the clinic complaining of stomatitis. The patient asks you to make suggestions about the best foods to eat. What would be the best lunch for someone with stomatitis?
  A) Cottage cheese with canned fruit
  B) Vegetable beef soup
  C) Reuben sandwich (ham, cheese, and sauerkraut on pumpernickel bread)
  D) Pizza



16. Your HIV patient has developed lipodystrophy. What may lipodystrophy result in? (Mark all that apply.)
  A) Weight change
  B) Glucose intolerance
  C) Elevated cholesterol
  D) Social stigmatization
  E) Lowered triglycerides



17. Your patient at the HIV clinic has come in complaining of unintended weight loss with diarrhea lasting over the last month. How is the wasting syndrome in patients with acquired immunodeficiency syndrome (AIDS) defined?
  A) 5% of usual weight
  B) 10% of usual weight
  C) 15% of usual weight
  D) 20% of usual weight



18. The latest studies suggest that in HIV-associated wasting men tend to lose what?
  A) More lean body mass than fat tissue
  B) More fat than lean body mass
  C) Peripheral fat and retain core fat
  D) Core fat and retain peripheral fat



19. Parenteral nutrition (PN) use in AIDS patients is reserved for those patients with nonfunctioning GI tracts. It has been suggested that consuming ____________ formulas orally may be just as effective, with none of the risk, for preventing weight loss in patients with severe malnutrition.
  A) Standard
  B) Fiber added
  C) Hydrolyzed
  D) Protein added



20. A patient with HIV disease asks you for some general nutritional guidelines. Which of the following is an appropriate response?
  A) “Avoid high-protein supplements.”
  B) “It is not necessary to increase fat in your diet.”
  C) “Try to eat only three times a day.”
  D) “Be sure to take a multivitamin and mineral tablet with extra iron at least four times a day.”



21. You are teaching nutrition guidelines to a group of newly diagnosed HIV/AIDS patients. What tip would you give them to eat a healthier diet?
  A) Drink sweetened beverages and foods high in added sugar.
  B) Eat at least 2 cups per day of a variety of fruits and vegetables.
  C) Eat a diet rich in whole grains, vegetables, fruits, and legumes with lean sources of protein.
  D) Avoid foods high in monounsaturated fat.



22. You are the clinic nurse doing patient teaching with a 21-year-old female who has a diagnosis of HIV/AIDS. She is asymptomatic at this point and wants to know how much she should raise her caloric intake to maintain her weight. What would be your best response?
  A) “You should increase your caloric intake by 5%.”
  B) “You should increase your caloric intake by 10%.”
  C) “You should increase your caloric intake by 15%.”
  D) “You should increase your caloric intake by 20%.”



23. Saquinavir (Invirase) may be prescribed for the HIV/AIDS patient. What would be important to teach the patient about this drug?
  A) Avoid alcohol.
  B) Do not take it with high-fat meal.
  C) There are fewer side effects if taken with food.
  D) Take it within 2 hours of a high-calorie, high-fat meal.



24. As HIV/AIDS progresses, patients’ quality of life becomes more and more important. How can quality of life be greatly improved for an HIV/AIDS patient?
  A) By healing mouth sores
  B) By improving a poor appetite
  C) By correcting malabsorption
  D) By decreasing episodes of fever



25. You are the clinic nurse teaching a group of HIV/AIDS patients about their disease process. You are discussing nutrition-related problems and how to control them. Which of the following are recommended for people with diarrhea? (Mark all that apply.)
  A) Limiting food intake
  B) Increasing fluid intake
  C) Avoiding lactose
  D) Increasing intake of foods rich in pectin
  E) Drink liquids that are either hot or cold



26. You are the nurse caring for a 51-year old-female with breast cancer who is on a regular diet. She is to have a mastectomy the following day and you are doing patient teaching. What strategy would you teach this patient to increase her protein and calorie intake to promote healing after surgery?
  A) Consume high-fiber, low-fat nutritional supplements.
  B) Eat less food.
  C) Take protein supplements and eat low-fat, low-calorie meals.
  D) Eat food that has been modified to be more protein- and calorie-dense.



27. You are teaching a nutrition class for nursing students about palliative nutrition therapy. The goals of palliative nutrition therapy are providing comfort and relieving side effects. How can these goals be met?
  A) Encourage the patient to follow the primary caregiver’s ordered diet.
  B) Provide mouth care when the patient asks for it.
  C) Offer comfort foods if the patient becomes anxious or fearful.
  D) Respect the client’s wishes regarding the level of nutritional support desired.



28. Immunotherapy is used to treat cancer patients by enhancing their immune system. What nutritional imbalances can be caused by immunotherapy?
  A) Hypernatremia
  B) Hypokalemia
  C) Hyperabsorption
  D) Hypoproteinemia



29. You are admitting a 42-year-old male with metastatic lung cancer to your unit. He tells you that food tastes bitter to him. What causes this?
  A) Radiation therapy to the chest
  B) A decreased threshold for urea
  C) Metallic eating utensils
  D) An increased threshold for sucrose



30. You are doing patient teaching with a cancer patient who is going to have colon resection. The patient asks you what the differences in the diet will be after the surgery. What would be the best response for this patient?
  A) You will have to be fed with central parenteral nutrition because your gut is not functioning.
  B) You will have to eat less protein and fewer calories per day after you start eating again.
  C) You will have a clear liquid diet starting the day after surgery.
  D) You will be given a special diet of a high-fiber, low-calorie enteral supplement.



31. You are admitting a patient to your unit with a diagnosis of lung cancer. This patient is undergoing a partial lobectomy followed by chemotherapy The patient is a 55-year-old male who weighs 125 pounds. What is the approximate protein and calorie intake per day for this patient?
  A) 85 g/day of protein; 2,000 cal/day
  B) 70 g/day of protein; 1,800 cal/day
  C) 60 g/day of protein; 1,500 cal/day
  D) 50 g/day of protein; 1,200 cal/day



32. You are doing nutrition teaching with a 63-year-old woman who has just been diagnosed with ovarian cancer. She has been admitted for radiation therapy prior to surgery. She weighs 130 pounds. Approximately how much protein and how many calories a day should this patient have in her diet?
  A) 75 g/protein/day; 2,320 cal/day
  B) 71 g/protein/day; 2,068 cal/day
  C) 66 g/protein/day; 1,855cal/day
  D) 61 g/protein/day; 1,575 cal/day



33. HIV/AIDS patients are already in an immune-compromised state so they have to be especially careful about foodborne illnesses. What strategies can you teach your HIV/AIDS patients to help them avoid contracting a foodborne illness? (Mark all that apply.)
  A) “Refrigerate foods immediately after purchase.”
  B) “Discard leftovers after 5 days.”
  C) “Avoid salad bars and buffets when eating out.”
  D) “Thaw food in the microwave, never at room temperature.”
  E) “Keep hot foods >140º F and cold food <40º F.”



34. You are caring for a patient who has a diagnosis of pancreatic cancer and is considering hospice care. She asks you what to look for, from a nutrition stand point, when making a decision. What advice could you give her?
  A) Look for a hospice program that tells the patient what to do and when.
  B) Look for a hospice program that tells the patient what level of nutritional support they will have.
  C) Look for a hospice program that uses a team approach that includes physician, dietitian, and nurse.
  D) Look for a hospice program that serves soft food only.



35. You are discussing weight loss and wasting with a local group of cancer patients. After the program, a member of the audience asks to speak with you. He asks what the difference is between weight loss and wasting in cancer and the weight loss and wasting that occurs in AIDS. What would be your best response?
  A) In cancer wasting, you can take medications to stimulate your appetite.
  B) Cancer wasting is almost impossible to reverse.
  C) Wasting in AIDS includes either fever, diarrhea, or weakness lasting >30 days.
  D) AIDS wasting begins gender specific.




Answer Key


1. A
2. A, B, D
3. A
4. B
5. D
6. A
7. B, C, D
8. A
9. A
10. C
11. C
12. D
13. A
14. C
15. A
16. B, C, D
17. B
18. A
19. C
20. B
21. C
22. B
23. D
24. C
25. B, C, D
26. D
27. D
28. D
29. B
30. A
31. A
32. B
33. A, C, E
34. C
35. C




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