Williams’ Basic Nutrition & Diet Therapy, 14e (LPN Threads) 14th Edition by Staci Nix – Test Bank

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Williams’ Basic Nutrition & Diet Therapy, 14e (LPN Threads) 14th Edition by Staci Nix – Test Bank

Chapter 2: Carbohydrates

Test Bank

 

MULTIPLE CHOICE

 

  1. Carbohydrates are nutrients that are composed of the elements carbon, hydrogen, and
a. oxygen.
b. nitrogen.
c. water.
d. glucose.

 

 

ANS:  A

The chemical nature of carbohydrates is carbon, hydrogen, and oxygen.

 

DIF:    Cognitive Level: Knowledge          REF:   14                  TOP:   Nursing Process: Planning

MSC:  NCLEX: Physiological Integrity: Physiological Adaptation

 

  1. Carbohydrates play a major role in nutrition because they
a. provide a long-term energy store.
b. are digested in the stomach.
c. help regulate body functions.
d. provide the body’s major source of energy.

 

 

ANS:  D

Rationale: Carbohydrates are the major source of energy for the body, comprising approximately 50% of total caloric intake.

 

DIF:    Cognitive Level: Application          REF:   13                  TOP:   Nursing Process: Planning

MSC:  NCLEX: Physiological Integrity: Physiological Adaptation

 

  1. Carbohydrates are stored as glycogen in the
a. central nervous system and muscles.
b. heart and liver.
c. small intestine.
d. liver and muscles.

 

 

ANS:  D

Rationale: Carbohydrates are stored as glycogen in the liver and muscles.

 

DIF:    Cognitive Level: Knowledge          REF:   17                  TOP:   Nursing Process: Planning

MSC:  NCLEX: Physiological Integrity: Physiological Adaptation

 

  1. An example of a food that contains a fructose sugar is
a. milk.
b. honey.
c. molasses.
d. corn.

 

 

ANS:  B

Fructose is a monosaccharide and is the sweetest of the simple sugars. It is primarily found in fruits and honey.

 

DIF:    Cognitive Level: Knowledge          REF:   14

TOP:   Nursing Process: Implementation

MSC:  NCLEX: Physiological Integrity: Physiological Adaptation

 

  1. Examples of the simple carbohydrates include
a. glucose and galactose.
b. sucrose and starch.
c. lactose and lignin.
d. fructose and glycogen.

 

 

ANS:  A

Monosaccharides are the simple sugar units used to build more-complex carbohydrates. The monosaccharides are glucose, galactose, and fructose.

 

DIF:    Cognitive Level: Application          REF:   15-16

TOP:   Nursing Process: Implementation

MSC:  NCLEX: Physiological Integrity: Physiological Adaptation

 

  1. The sugar to which all other sugars are converted and the one that circulates in the blood to provide major fuel for the body’s cells is
a. sucrose.
b. fructose.
c. glucose.
d. maltose.

 

 

ANS:  C

Glucose is a monosaccharide considered the basic single sugar in the body’s metabolism. Glucose is the form of sugar circulating in the blood and is the primary fuel for the cells.

 

DIF:    Cognitive Level: Knowledge          REF:   14                  TOP:   Nursing Process: Planning

MSC:  NCLEX: Physiological Integrity: Physiological Adaptation

 

  1. Carbohydrates are called “quick energy” foods because
a. they do not take long to prepare and are readily available.
b. the human body can rapidly break them down to yield energy.
c. they are abundant in fast foods and can be readily absorbed.
d. they can yield more energy than other nutrients.

 

 

ANS:  B

Carbohydrates are considered “quick energy” foods because they can readily be metabolized in the body to yield glucose, the main fuel source for the body.

 

DIF:    Cognitive Level: Comprehension   REF:   14                  TOP:   Nursing Process: Planning

MSC:  NCLEX: Physiological Integrity: Physiological Adaptation

 

  1. The carbohydrate form in which glucose is stored in the body is
a. starch.
b. polysaccharide.
c. glycogen.
d. fructose.

 

 

ANS:  C

Glucose is stored in the body as glycogen.

 

DIF:    Cognitive Level: Knowledge          REF:   17                  TOP:   Nursing Process: Planning

MSC:  NCLEX: Physiological Integrity: Physiological Adaptation

 

  1. Of the following, the best food choices for dietary fiber include
a. fruit and fruit juice.
b. rice and crackers.
c. iceberg lettuce and tomato juice.
d. lentils and corn.

 

 

ANS:  D

Dietary fiber is found in unrefined and whole plant foods. Of the choices listed, lentils and corn provide the highest amount of dietary fiber.

 

DIF:    Cognitive Level: Application          REF:   17                  TOP:   Nursing Process: Planning

MSC:  NCLEX: Physiological Integrity: Physiological Adaptation

 

  1. Types of dietary fiber include
a. lactose, galactose, and maltose.
b. polysaccharides and polyols.
c. starch, ptyalin and glucose
d. cellulose, lignin, and noncellulose.

 

 

ANS:  D

Dietary fiber is found in plant foods. Plants contain several types of dietary fiber, including cellulose, lignin, and noncellulose polysaccharides.

 

DIF:    Cognitive Level: Knowledge          REF:   17-19             TOP:   Nursing Process: Planning

MSC:  NCLEX: Physiological Integrity: Physiological Adaptation

 

  1. The recommended daily intake of dietary fiber for an adult woman is _____ g/day.
a. 15
b. 21
c. 25
d. 30

 

 

ANS:  C

The recommended intake of fiber for men and women aged 50 years and younger is 38 g/day and 25 g/day, respectively.

 

DIF:    Cognitive Level: Knowledge          REF:   19                  TOP:   Nursing Process: Planning

MSC:  NCLEX: Physiological Integrity: Physiological Adaptation

 

  1. The health professional is determining the caloric intake for a patient. Her caloric intake from fiber would be
a. 3.4 kcal/g.
b. 0 kcal/g.
c. 4 kcal/g.
d. 9 kcal/g.

 

 

ANS:  B

Human beings lack the necessary enzymes to digest dietary fiber and so, unlike other carbohydrates, dietary fiber does not provide energy.

 

DIF:    Cognitive Level: Application          REF:   17

TOP:   Nursing Process: Assessment

MSC:  NCLEX: Physiological Integrity: Physiological Adaptation

 

  1. Wavelike contractions of the muscle fibers of the stomach and intestinal walls are called
a. segmentation.
b. peristalsis.
c. metabolism.
d. digestion.

 

 

ANS:  B

The mechanical digestive process in the stomach entailing wavelike contractions of the muscle fibers of the stomach wall that mix food particles with gastric secretions is called peristalsis.

 

DIF:    Cognitive Level: Knowledge          REF:   24-25             TOP:   Nursing Process: Planning

MSC:  NCLEX: Physiological Integrity: Physiological Adaptation

 

  1. A basket of fruit contains ripe grapes, apples, and oranges as well as pears and peaches that are not quite ripe. The fruits with the highest amount of simple sugar are the
a. pears and apples.
b. peaches and oranges.
c. grapes and apples.
d. peaches and pears.

 

 

ANS:  C

Fructose is a simple sugar; ripe fruit contains more fructose than less-ripe fruit.

 

DIF:    Cognitive Level: Application          REF:   14

TOP:   Nursing Process: Assessment

MSC:  NCLEX: Physiological Integrity: Physiological Adaptation

 

  1. An apple contains a type of soluble dietary fiber called
a. lignin.
b. starch.
c. cellulose.
d. pectin.

 

 

ANS:  D

Pectin is a water-soluble fiber found in many fruits. Cellulose and lignin are insoluble fibers. Starch is another polysaccharide found in grains, legumes, and other vegetables and in small amounts in fruit. Starch does not necessarily contain dietary fiber.

 

DIF:    Cognitive Level: Application          REF:   17-18             TOP:   Nursing Process: Planning

MSC:  NCLEX: Physiological Integrity: Physiological Adaptation

 

  1. Of the following, the food with the lowest carbohydrate content (as a percentage of weight) would be
a. orange juice.
b. raisins.
c. whole milk.
d. dried beans.

 

 

ANS:  C

Milk contains the least carbohydrate content (as a percentage of weight); it contains lactose, but the amount is diluted by all the liquid in the milk. Carbohydrates are more concentrated in dried fruits, juices, and starchy vegetables.

 

DIF:    Cognitive Level: Analysis               REF:   15-16             TOP:   Nursing Process: Planning

MSC:  NCLEX: Physiological Integrity: Physiological Adaptation

 

  1. Digestion of the starch component of a peanut butter sandwich begins in the
a. mouth.
b. stomach.
c. small intestine.
d. liver.

 

 

ANS:  A

The digestion of carbohydrate-rich foods such as starches and sugars begins in the mouth, where the enzyme ptyalin begins to break the starch down into smaller particles.

 

DIF:    Cognitive Level: Knowledge          REF:   24                  TOP:   Nursing Process: Planning

MSC:  NCLEX: Physiological Integrity: Physiological Adaptation

 

  1. A negative effect of sugar alcohols is that they
a. contain more kilocalories than sugar.
b. can cause intoxication.
c. promote bacterial disease in the colon.
d. may cause diarrhea.

 

 

ANS:  D

Excessive amounts of sugar alcohols in food products can cause diarrhea because of the slow digestion of the product.

 

DIF:    Cognitive Level: Comprehension   REF:   20                  TOP:   Nursing Process: Planning

MSC:  NCLEX: Physiological Integrity: Physiological Adaptation

 

  1. Once monosaccharides are absorbed into the intestinal bloodstream, they are transported to the
a. cells.
b. liver.
c. heart.
d. brain.

 

 

ANS:  B

The monosaccharides glucose, galactose, and fructose are absorbed directly into the portal blood circulation.

 

DIF:    Cognitive Level: Knowledge          REF:   26-27             TOP:   Nursing Process: Planning

MSC:  NCLEX: Physiological Integrity: Physiological Adaptation

 

  1. A client has a goal of increasing fiber intake to 30 grams per day. Current intake reveals the following information: Breakfast intake- 3/4 cup sugary corn popped cereal, 1 cup skim milk, 1 slice white toast, and 1/2 cup orange juice. Lunch- 2 ounces sliced turkey, 1 slice wheat bread, 1 tablespoon mayonnaise, 2 chocolate chip cookies, and 1 cup water. Dinner- 4 ounces beef, 1/2 cup green beans, 3/4 cup instant mashed potatoes with butter, 1 biscuit, and 1 cup skim milk. As the nutrition expert counseling this patient, one appropriate recommendation might be:
a. Encourage whole grain breads and cereals in place of white breads and cereals.
b. Double the amount of proteins such as turkey and beef and eliminate sugar intake.
c. Add 2 tablespoons of omega-3 fatty acid enriched margarine to breads and potatoes.
d. No changes are required since adequate fiber intake is present.

 

 

ANS:  A

Rationale: The recommended daily fiber intake is 38 grams per day for men. This intake requires consistent use of whole grains, legumes, vegetables and fruits, along with seeds and nuts. Meats and fats such as butter and margarine do not contain fiber.

 

DIF:    Cognitive Level: Analysis               REF:   19|27-28        TOP:   Nursing Process: Planning

MSC:  NCLEX: Physiological Integrity: Physiological Adaptation, Health Promotion and Maintenance

 

  1. An example of a food low in carbohydrates is
a. low-fat yogurt.
b. steak.
c. beans.
d. potatoes.

 

 

ANS:  B

Meats such as beef, poultry, and fish do not contain carbohydrates. Yogurt contains some carbohydrates from the milk and is often sweetened. Starchy vegetables such as beans and potatoes are high in carbohydrates.

 

DIF:    Cognitive Level: Application          REF:   22-24

TOP:   Nursing Process: Implementation

MSC:  NCLEX: Physiological Integrity: Physiological Adaptation, Health Promotion and Maintenance

 

  1. The major site or organ in the body for metabolic processing of carbohydrates is the
a. intestine.
b. heart.
c. brain.
d. liver.

 

 

ANS:  D

The liver is the major site for metabolic processing of carbohydrates.

 

DIF:    Cognitive Level: Knowledge          REF:   22|26-27        TOP:   Nursing Process: Planning

MSC:  NCLEX: Physiological Integrity: Physiological Adaptation

 

  1. The digestion of milk yields the monosaccharides
a. fructose and glucose.
b. galactose and glucose.
c. galactose and sucrose.
d. glucose and maltose.

 

 

ANS:  B

The digestion of milk yields the monosaccharides galactose and glucose from the disaccharide lactose.

 

DIF:    Cognitive Level: Knowledge          REF:   15-16             TOP:   Nursing Process: Planning

MSC:  NCLEX: Physiological Integrity: Physiological Adaptation

 

  1. A food that contains maltose would be
a. milk.
b. fruit.
c. molasses.
d. table sugar.

 

 

ANS:  C

Maltose is found in molasses.

 

DIF:    Cognitive Level: Application          REF:   15-16

TOP:   Nursing Process: Implementation

MSC:  NCLEX: Physiological Integrity: Physiological Adaptation

 

  1. A molecule of glycogen is composed of hundreds of units of
a. galactose.
b. glucose.
c. glucose, fructose, and galactose.
d. disaccharide.

 

 

ANS:  B

Glycogen is composed of glucose units.

 

DIF:    Cognitive Level: Knowledge          REF:   17                  TOP:   Nursing Process: Planning

MSC:  NCLEX: Physiological Integrity: Physiological Adaptation

 

  1. Sufficient dietary carbohydrates prevent excess formation of
a. ketones.
b. ammonia.
c. amino acids.
d. water.

 

 

ANS:  A

Ketones result from the rapid breakdown of fat. The breakdown of fat occurs when carbohydrate intake is inadequate. Sufficient carbohydrate intake prevents ketosis from occurring.

 

DIF:    Cognitive Level: Knowledge          REF:   22                  TOP:   Nursing Process: Evaluation

MSC:  NCLEX: Physiological Integrity: Physiological Adaptation

 

  1. The preferred source of energy for the heart muscle is
a. glucose.
b. glycogen.
c. fatty acids.
d. amino acids.

 

 

ANS:  C

Glycogen is the emergency fuel for the heart, whereas fatty acids are the preferred fuel.

 

DIF:    Cognitive Level: Knowledge          REF:   24                  TOP:   Nursing Process: Planning

MSC:  NCLEX: Physiological Integrity: Physiological Adaptation

 

  1. The number of kilocalories from carbohydrates in a baked potato that contains 40 g carbohydrate is _____ kcal.
a. 40
b. 80
c. 160
d. 360

 

 

ANS:  C

Carbohydrate contains 4 kcal/g, so 40 g ´ 4 kcal/g = 160 kcal.

 

DIF:    Cognitive Level: Application          REF:   21

TOP:   Nursing Process: Assessment

MSC:  NCLEX: Physiological Integrity: Physiological Adaptation

 

  1. A food that is a good source of fiber is
a. oatmeal.
b. prune juice.
c. salmon.
d. cornstarch.

 

 

ANS:  A

Plant foods contain the best sources of fiber. Oatmeal is a whole grain cereal and is therefore high in fiber.

 

DIF:    Cognitive Level: Application          REF:   18-19|21

TOP:   Nursing Process: Implementation

MSC:  NCLEX: Physiological Integrity: Physiological Adaptation

 

  1. Which of the following carbohydrates provides the fastest source of energy?
a. ground beef
b. cranberry juice
c. whole grain cereal
d. milk

 

 

ANS:  B

Cranberry juice contains fructose, a single carbohydrate or monosaccharide, which requires no digestion and so is more quickly absorbed than more complex carbohydrates found in whole grains.

 

DIF:    Cognitive Level: Application          REF:   15

TOP:   Nursing Process: Implementation

MSC:  NCLEX: Physiological Integrity: Physiological Adaptation

 

Chapter 12: Nutrition for Adults: The Early, Middle, and Later Years

Test Bank

 

MULTIPLE CHOICE

 

  1. John is a 34-year-old who is active in his community coaching football. He was also recently promoted to a director level position at this job. John is in _____ adulthood.
a. young
b. young and middle
c. middle
d. older

 

 

ANS:  A

Young adulthood is between the ages of 20 and 44 years. Physical maturity and independence are apparent with the ability to form new relationships, adopt new roles, and make many more choices regarding lifestyle.

 

DIF:    Cognitive Level: Application          REF:   220                TOP:   Nursing Process: Planning

MSC:  NCLEX: Physiological Integrity: Physiological Adaptation, Health Promotion and Maintenance

 

  1. A 42-year-old who makes independent decisions regarding who to marry and what type of family is desired is considered to be making what type of choices?
a. independent
b. dependent
c. wealthy
d. introspective

 

 

ANS:  A

Young adults between the ages of 20 and 44 years are independent in making choices regarding relationships, careers, jobs, marriage, and family.

 

DIF:    Cognitive Level: Application          REF:   220                TOP:   Nursing Process: Planning

MSC:  NCLEX: Physiological Integrity: Physiological Adaptation, Health Promotion and Maintenance

 

  1. Making a choice to lose weight and manage one’s cholesterol level is most characteristic of which of the following age groups?
a. young adult
b. middle adult
c. school-age child
d. adolescence

 

 

ANS:  B

Wellness, health promotion, and reduction of disease risks are becoming the focus of health care for the middle adult years.

 

DIF:    Cognitive Level: Application          REF:   220

TOP:   Nursing Process: Assessment|Nursing Process: Planning

MSC:  NCLEX: Physiological Integrity: Physiological Adaptation, Health Promotion and Maintenance

 

  1. Diabetes is an example of a chronic disease most often appearing during
a. childhood.
b. early adulthood.
c. middle adulthood.
d. older adulthood.

 

 

ANS:  C

Early evidence of chronic disease appears in some middle-aged adults.

 

DIF:    Cognitive Level: Application          REF:   220                TOP:   Nursing Process: Diagnosis

MSC:  NCLEX: Physiological Integrity: Physiological Adaptation

 

  1. Biologic processes associated with aging may cause
a. an increased metabolic rate.
b. increased anxiety.
c. an increased ratio of adipose-to-muscle tissue.
d. increased kidney function.

 

 

ANS:  C

Physical findings associated with aging include an increased ratio of adipose-to- muscle tissue. As the aging process occurs, skeletal muscle mass is reduced, causing a loss of approximately 40% by age 70 years. Skeletal muscle loss is not mandatory; it can be lessened with exercise.

 

DIF:    Cognitive Level: Application          REF:   221                TOP:   Nursing Process: Planning

MSC:  NCLEX: Physiological Integrity: Physiological Adaptation, Health Promotion and Maintenance

 

  1. Prescription and over-the-counter drugs can affect nutritional status because they
a. may contain toxins.
b. often result in addiction.
c. usually contain nutrients.
d. may affect appetite or absorption of nutrients.

 

 

ANS:  D

Medication use can affect overall nutritional status because many drugs affect appetite or the absorption of nutrients.

 

DIF:    Cognitive Level: Application          REF:   228-230         TOP:   Nursing Process: Planning

MSC:  NCLEX: Physiological Integrity: Physiological Adaptation

 

  1. Energy requirements decrease as adults age because
a. older adults have less stress than younger adults.
b. younger adults are still growing; older adults are not.
c. the height of adults decreases with age.
d. the number of functioning body cells decreases with age.

 

 

ANS:  D

Energy requirements decrease with the aging process because of the decrease in the number of functioning body cells and reduced physical activity.

 

DIF:    Cognitive Level: Knowledge          REF:   222                TOP:   Nursing Process: Planning

MSC:  NCLEX: Physiological Integrity: Physiological Adaptation, Health Promotion and Maintenance

 

  1. Each decade, basal energy needs decrease
a. 0.5% to 1%.
b. 1% to 2%.
c. 2% to 4%.
d. 5% to 8%.

 

 

ANS:  B

Basal metabolic rate declines an average of 1% to 2% per decade of life.

 

DIF:    Cognitive Level: Knowledge          REF:   222                TOP:   Nursing Process: Planning

MSC:  NCLEX: Physiological Integrity: Physiological Adaptation, Health Promotion and Maintenance

 

  1. If an older adult is losing weight, his or her caloric intake is
a. less than energy needs.
b. approximately the same as energy needs.
c. greater than energy needs.
d. poorly distributed throughout the day.

 

 

ANS:  A

Weight loss is associated with a caloric intake that is less than what is required for energy needs at the time.

 

DIF:    Cognitive Level: Application          REF:   226-227

TOP:   Nursing Process: Assessment

MSC:  NCLEX: Physiological Integrity: Physiological Adaptation

 

  1. A 65-year-old patient’s ideal body weight is 115 lbs and on the yearly physical for the past 2 years reveals a recorded weight of 121 lbs. The assessment for this patient would be which of the following?
a. slightly underweight
b. close to ideal body weight
c. slightly overweight
d. maintained constant weight

 

 

ANS:  B

The assessment is close to ideal body weight. Ongoing review of body mass index indicates that weight ranges in the older adult associated with longer life are not necessarily the “desirable” weights given, but weights 10% to 25% greater. Thus thin older adults, rather than those of moderate weight, have a reduced life expectancy.

 

DIF:    Cognitive Level: Application          REF:   226-227

TOP:   Nursing Process: Assessment

MSC:  NCLEX: Physiological Integrity: Physiological Adaptation, Health Promotion and Maintenance

 

  1. The number of calories per day supplied as carbohydrate for older adults who require 2000 kcal per day would be
a. 450 to 650.
b. 750 to 1250.
c. 900 to 1300.
d. 1100 to 1450.

 

 

ANS:  C

For the older adult, 45% to 65% of total energy intake should be supplied as carbohydrate, with the majority being mostly complex carbohydrates.

2000 kcal divided by 45% to 65 % = 900 to 1300 calories per day.

 

DIF:    Cognitive Level: Application          REF:   222

TOP:   Nursing Process: Assessment|Nursing Process: Planning

MSC:  NCLEX: Physiological Integrity: Physiological Adaptation, Health Promotion and Maintenance

 

  1. The older adult’s diet should include adequate carbohydrates to
a. provide a substrate for vitamins and minerals.
b. support normal brain function.
c. provide building material for muscle mass.
d. maintain blood glucose level.

 

 

ANS:  B

The National Academy of Sciences has determined that an absolute minimum of 130 g/day of carbohydrates is necessary to maintain normal brain function for children and adults.

 

DIF:    Cognitive Level: Knowledge          REF:   222

TOP:   Nursing Process: Assessment|Nursing Process: Planning

MSC:  NCLEX: Physiological Integrity: Physiological Adaptation, Health Promotion and Maintenance

 

  1. It may be advisable for an older adult to take a vitamin or mineral supplement
a. daily.
b. weekly.
c. if he or she has been ill.
d. if he or she is under stress.

 

 

ANS:  C

Supplements often are recommended for persons in debilitated states or who have malabsorption.

 

DIF:    Cognitive Level: Application          REF:   223                TOP:   Nursing Process: Planning

MSC:  NCLEX: Physiological Integrity: Physiological Adaptation, Health Promotion and Maintenance

 

  1. Contributing factors for osteoporosis include
a. inadequate calcium and vitamin D intake.
b. increased estrogen after menopause.
c. excess weight.
d. excess iron intake.

 

 

ANS:  A

Contributing factors for osteoporosis include inadequate intakes of calcium and vitamin D, physical inactivity, smoking and alcohol use, thin build, certain medical conditions and medications.

 

DIF:    Cognitive Level: Knowledge          REF:   223                TOP:   Nursing Process: Planning

MSC:  NCLEX: Physiological Integrity: Physiological Adaptation, Health Promotion and Maintenance

 

  1. Physiologic problems of older adults include
a. diarrhea.
b. increased salivary secretions.
c. decreased thirst and taste sensations.
d. increased muscle tone.

 

 

ANS:  C

As a person ages, a decrease in the thirst mechanism occurs that can lead to inadequate fluid intake and resultant dehydration. The older adult also experiences a decrease in taste, smell, and vision, which affects food intake.

 

DIF:    Cognitive Level: Knowledge          REF:   222|226

TOP:   Nursing Process: Assessment

MSC:  NCLEX: Physiological Integrity: Physiological Adaptation

 

  1. An older adult is most likely to have inadequate nutrient intake if he or she lives
a. in a retirement community.
b. with a spouse.
c. alone.
d. with family.

 

 

ANS:  C

Inadequate nutrient intake is more apparent in elderly people who live alone compared with those who have a companion to eat with and enjoy the food.

 

DIF:    Cognitive Level: Knowledge          REF:   224                TOP:   Nursing Process: Planning

MSC:  NCLEX: Physiological Integrity: Physiological Adaptation, Health Promotion and Maintenance

 

  1. The Older Americans Act provides home-delivered meals for those who
a. cannot afford food.
b. prefer not to leave home.
c. are ill or disabled.
d. are malnourished.

 

 

ANS:  C

The Older Americans Act provides services to the elderly that include congregate and home-delivered meals with related education and food-service components.

 

DIF:    Cognitive Level: Application          REF:   229-230         TOP:   Nursing Process: Planning

MSC:  NCLEX: Physiological Integrity: Physiological Adaptation, Health Promotion and Maintenance

 

  1. The Older Americans Act provides
a. congregate and home-delivered meals.
b. meals served at shelters and community centers.
c. meals served at care facilities and hospices.
d. meals for homeless older adults.

 

 

ANS:  A

The Older Americans Act provides congregate and home-delivered meals with related nutrition education and food-service components.

 

DIF:    Cognitive Level: Knowledge          REF:   229-230         TOP:   Nursing Process: Planning

MSC:  NCLEX: Physiological Integrity: Physiological Adaptation, Health Promotion and Maintenance

 

  1. Congregate meals are most often served at a
a. church.
b. senior center.
c. nursing home.
d. hospital.

 

 

ANS:  B

Congregate meals are served in senior centers and other public or private community facilities.

 

DIF:    Cognitive Level: Knowledge          REF:   229                TOP:   Nursing Process: Planning

MSC:  NCLEX: Physiological Integrity: Physiological Adaptation, Health Promotion and Maintenance

 

  1. The congregate meal for seniors is
a. breakfast.
b. the noon meal.
c. the evening meal.
d. decided by the center.

 

 

ANS:  B

Congregate meals provide the noon meal.

 

DIF:    Cognitive Level: Knowledge          REF:   229                TOP:   Nursing Process: Planning

MSC:  NCLEX: Physiological Integrity: Physiological Adaptation, Health Promotion and Maintenance

 

  1. Factors that commonly contribute to malnutrition in older adults include
a. type 2 diabetes and heart disease.
b. loss of teeth or poorly fitting dentures.
c. a weight 10% above desirable standards.
d. increased energy and nutrient needs.

 

 

ANS:  B

Many factors contribute to malnutrition in the elderly, including inadequate food and nutrient intake as a result of ill-fitting or loss of dentures.

 

DIF:    Cognitive Level: Knowledge          REF:   224|226

TOP:   Nursing Process: Assessment|Nursing Process: Planning

MSC:  NCLEX: Physiological Integrity: Physiological Adaptation

 

  1. The protein needs of an older adult are influenced by the adequacy of _____ intake.
a. fiber
b. caloric
c. vitamin
d. mineral

 

 

ANS:  B

Adequate calorie intake is essential in the older adult to prevent calories from protein intake being used for energy needs.

 

DIF:    Cognitive Level: Knowledge          REF:   222-223

TOP:   Nursing Process: Assessment|Nursing Process: Planning

MSC:  NCLEX: Physiological Integrity: Physiological Adaptation, Health Promotion and Maintenance

 

  1. Dehydration is more common in older adults than in younger adults because
a. the kidneys excrete too much water.
b. the thirst mechanism diminishes.
c. intracellular versus extracellular water balance is disturbed.
d. more water needs to be ingested to maintain hydration.

 

 

ANS:  B

As a person ages the thirst mechanism diminishes, which may result in inadequate fluid intake and dehydration.

 

DIF:    Cognitive Level: Comprehension   REF:   226                TOP:   Nursing Process: Planning

MSC:  NCLEX: Physiological Integrity: Physiological Adaptation

 

  1. Factors that influence the nutrition needs of young adults include
a. growth.
b. climate.
c. personality type.
d. physical activity.

 

 

ANS:  D

The nutrition needs of young adults are influenced by physical activity as well as any other conditions, such as pregnancy.

 

DIF:    Cognitive Level: Knowledge          REF:   220-221         TOP:   Nursing Process: Planning

MSC:  NCLEX: Physiological Integrity: Physiological Adaptation, Health Promotion and Maintenance

 

  1. Feeding older adults with sensitivity includes
a. giving sufficient time to chew and swallow.
b. serving only pureed foods.
c. avoiding liquids with meals.
d. serving bland foods.

 

 

ANS:  A

Feeding older adults with sensitivity helps them achieve adequate intake. Giving sufficient time to chew and swallow is important while feeding adults with sensitivity.

 

DIF:    Cognitive Level: Knowledge          REF:   226

TOP:   Nursing Process: Implementation

MSC:  NCLEX: Physiological Integrity: Physiological Adaptation, Health Promotion and Maintenance

 

  1. The Mini Nutritional Assessment (MNA) identifies
a. emotional stability.
b. nutritional risk.
c. vitamin deficiency.
d. social isolation.

 

 

ANS:  B

The MNA is designed to identify nutritional risk. It is a reliable tool that is sensitive and can detect the risk of malnutrition.

 

DIF:    Cognitive Level: Knowledge          REF:   224-226

TOP:   Nursing Process: Assessment

MSC:  NCLEX: Physiological Integrity: Physiological Adaptation, Health Promotion and Maintenance

 

  1. A major factor in weight control is
a. physical activity.
b. mineral supplementation.
c. steroid use.
d. vitamin supplementation.

 

 

ANS:  A

Physical activity is a major factor in weight management and it can help prevent debilitating conditions of aging.

 

DIF:    Cognitive Level: Knowledge          REF:   226

TOP:   Nursing Process: Assessment|Nursing Process: Planning

MSC:  NCLEX: Physiological Integrity: Physiological Adaptation, Health Promotion and Maintenance

 

  1. Examples of foods high in nutrients that help prevent osteoporosis are
a. cottage cheese and oranges.
b. yogurt and canned salmon.
c. oatmeal and green leafy vegetables.
d. broccoli and liver.

 

 

ANS:  B

Foods high in calcium can help prevent osteoporosis. Foods such as yogurt and canned salmon are significant sources of calcium.

 

DIF:    Cognitive Level: Application          REF:   223                TOP:   Nursing Process: Planning

MSC:  NCLEX: Physiological Integrity: Physiological Adaptation, Health Promotion and Maintenance

 

  1. Older adults need more vitamin D than younger adults because they
a. are less efficient at making their own.
b. are in a state of positive calcium balance.
c. excrete large amounts in their urine.
d. do not eat enough fat to absorb the vitamin efficiently.

 

 

ANS:  A

As a person ages, the body becomes less efficient in making vitamin D and more may have to be provided in the diet through foods that have been fortified, including milk and milk products, breads, and margarines.

 

DIF:    Cognitive Level: Knowledge          REF:   223                TOP:   Nursing Process: Planning

MSC:  NCLEX: Physiological Integrity: Physiological Adaptation, Health Promotion and Maintenance

 

  1. For residents in long-term care facilities the type of diet model recommended is
a. most restrictive.
b. least restrictive.
c. no sugar.
d. low protein.

 

 

ANS:  B

The least restrictive diet model is recommended since it is the most beneficial in the older population and stage of life.

 

DIF:    Cognitive Level: Knowledge          REF:   233                TOP:   Nursing Process: Planning

MSC:  NCLEX: Physiological Integrity: Physiological Adaptation

 

Chapter 22: Surgery and Nutrition Support

Test Bank

 

MULTIPLE CHOICE

 

  1. The most common nutrition deficiency among surgical patients is a deficiency of
a. vitamin C.
b. iron.
c. protein.
d. essential fatty acids.

 

 

ANS:  C

Protein deficiencies among surgical patients are the most common.

 

DIF:    Cognitive Level: Knowledge          REF:   449                TOP:   Nursing Process: Planning

MSC:  NCLEX: Physiological Integrity: Physiological Adaptation, Health Promotion and Maintenance

 

  1. Before general surgery, nothing is given by mouth for at least _____ hours.
a. 4
b. 8
c. 12
d. 24

 

 

ANS:  B

Nothing is given by mouth for at least 8 hours before surgery to avoid serious complications such as aspiration of stomach contents into the lungs.

 

DIF:    Cognitive Level: Knowledge          REF:   449                TOP:   Nursing Process: Planning

MSC:  NCLEX: Physiological Integrity: Physiological Adaptation, Health Promotion and Maintenance

 

  1. Protein is especially needed in the postoperative recovery period for
a. energy.
b. control of edema.
c. control of hypertension.
d. optimal kidney function.

 

 

ANS:  B

Protein assists in the maintenance of osmotic pressure, which is necessary to maintain normal movement of fluid between the capillaries and surrounding tissue. Without maintenance of osmotic pressure, edema develops.

 

DIF:    Cognitive Level: Knowledge          REF:   450                TOP:   Nursing Process: Planning

MSC:  NCLEX: Physiological Integrity: Physiological Adaptation, Health Promotion and Maintenance

 

  1. For a patient who can take an oral diet, a food that would be a good source of energy during the postoperative period could be
a. meat.
b. cereals and other grains.
c. carrots.
d. fried potatoes.

 

 

ANS:  B

During the postoperative period, the primary source of energy for the body should be carbohydrates supplied by cereals and other grains.

 

DIF:    Cognitive Level: Application          REF:   451                TOP:   Nursing Process: Planning

MSC:  NCLEX: Physiological Integrity: Physiological Adaptation, Health Promotion and Maintenance

 

  1. A food choice that provides a good source of energy during the postoperative period is
a. hamburger.
b. potato chips.
c. oatmeal.
d. shrimp.

h

 

 

ANS:  C

Oatmeal is a good source of carbohydrates that provides the necessary energy for the body to meet increased energy needs while also sparing protein for tissue synthesis.

 

DIF:    Cognitive Level: Application          REF:   451                TOP:   Nursing Process: Planning

MSC:  NCLEX: Physiological Integrity: Physiological Adaptation, Health Promotion and Maintenance

 

  1. Blood losses may result in a deficiency of
a. calcium.
b. glucose.
c. iron.
d. vitamin C.

 

 

ANS:  C

Iron-deficiency anemia may result from blood loss or faulty iron absorption.

 

DIF:    Cognitive Level: Knowledge          REF:   451                TOP:   Nursing Process: Planning

MSC:  NCLEX: Physiological Integrity: Physiological Adaptation, Health Promotion and Maintenance

 

  1. Two minerals that are lost during tissue catabolism are
a. sodium and chloride.
b. calcium and magnesium.
c. iron and zinc.
d. potassium and phosphorus.

 

 

ANS:  D

Potassium and phosphorus are lost during tissue catabolism. When tissue is broken down, cell potassium and phosphorus are lost from inside the cells.

 

DIF:    Cognitive Level: Knowledge          REF:   451                TOP:   Nursing Process: Planning

MSC:  NCLEX: Physiological Integrity: Physiological Adaptation, Health Promotion and Maintenance

 

  1. Fluid loss is accompanied by loss of the electrolytes
a. sodium and chloride.
b. calcium and magnesium.
c. iron and zinc.
d. potassium and phosphorus.

 

 

ANS:  A

During the postoperative period, large water losses may occur as a result of vomiting, hemorrhage, fever, or excessive urination. Because sodium is the major electrolyte in extracellular fluid, losses will occur with losses of water. Chloride losses also occur because it is also widely distributed within the extracellular compartment.

 

DIF:    Cognitive Level: Comprehension   REF:   451                TOP:   Nursing Process: Planning

MSC:  NCLEX: Physiological Integrity: Physiological Adaptation, Health Promotion and Maintenance

 

  1. A good source of vitamin C, important during the healing process, is
a. whole wheat crackers.
b. broccoli.
c. vanilla pudding.
d. pretzels.

 

 

ANS:  B

Broccoli is a good source of vitamin C necessary to build and maintain strong tissues, especially connective tissues.

 

DIF:    Cognitive Level: Application          REF:   451                TOP:   Nursing Process: Planning

MSC:  NCLEX: Physiological Integrity: Physiological Adaptation, Health Promotion and Maintenance

 

  1. Commercial enteral feeding formulas are preferred to blenderized food because they
a. have a thinner consistency.
b. carry less risk of bacterial growth and infection.
c. are better tolerated.
d. are less expensive.

 

 

ANS:  B

Commercially prepared enteral feeding formulas provide a sterile, homogenized solution and are less likely to become contaminated with bacteria than blenderized food.

 

DIF:    Cognitive Level: Knowledge          REF:   456-457         TOP:   Nursing Process: Planning

MSC:  NCLEX: Physiological Integrity: Physiological Adaptation, Health Promotion and Maintenance

 

  1. An example of a food item that is usually NOT part of a regular oral diet is
a. steamed broccoli.
b. braised chicken.
c. baked potato.
d. pureed carrots.

 

 

ANS:  D

Pureed carrots are not part of a regular oral diet since the texture has been modified.

 

DIF:    Cognitive Level: Application          REF:   452-453         TOP:   Nursing Process: Planning

MSC:  NCLEX: Physiological Integrity: Physiological Adaptation, Health Promotion and Maintenance

 

  1. Advancing the carbohydrate load in total parenteral nutrition too quickly may result in
a. hyperglycemia.
b. hypoglycemia.
c. fluid overload.
d. anemia.

 

 

ANS:  A

Advancing the carbohydrate load too quickly when administering total parenteral nutrition can result in hyperglycemia.

 

DIF:    Cognitive Level: Application          REF:   452                TOP:   Nursing Process: Planning

MSC:  NCLEX: Physiological Integrity: Physiological Adaptation, Health Promotion and Maintenance

 

  1. Patients who have had radical surgery of the head, neck, or throat may require
a. a clear liquid diet.
b. a full liquid diet.
c. tube feedings.
d. a low-residue diet.

 

 

ANS:  C

When regular oral feedings are not tolerated or the patient is severely debilitated or has undergone radical neck or face surgery, feedings by tube may be necessary.

 

DIF:    Cognitive Level: Application          REF:   462                TOP:   Nursing Process: Planning

MSC:  NCLEX: Physiological Integrity: Physiological Adaptation

 

  1. Immediately following a gastrectomy, postoperative nutrition feedings are met by
a. small frequent oral feedings.
b. jejunostomy feedings.
c. total parenteral nutrition.
d. an oral full liquid diet.

 

 

ANS:  B

Postopertive feedings immediately following a gastrectomy usually are provided though a jejunostomy tube providing elemental feedings.

 

DIF:    Cognitive Level: Knowledge          REF:   462                TOP:   Nursing Process: Planning

MSC:  NCLEX: Physiological Integrity: Physiological Adaptation

 

  1. Once placed on an oral diet following a gastrectomy, an appropriate feeding would consist of
a. water and ice chips only.
b. chocolate pudding and ginger ale.
c. scrambled eggs and toast.
d. steak strips and potato wedges.

 

 

ANS:  C

After a gastrectomy, meals should be small, frequent, and easily digested such as scrambled eggs and toast.

 

DIF:    Cognitive Level: Application          REF:   462                TOP:   Nursing Process: Planning

MSC:  NCLEX: Physiological Integrity: Physiological Adaptation, Health Promotion and Maintenance

 

  1. Ms. Jones has recently had gastric surgery and 45 minutes after eating her regular diet she feels cramping and full with waves of weakness and dizziness. Ms. Jones is most likely experiencing
a. a heart attack.
b. a gallbladder attack.
c. a pulmonary embolus.
d. dumping syndrome.

 

 

ANS:  D

Dumping syndrome is a frequently encountered complication after extensive gastric resection. After the initial recovery from surgery, when the patient begins to feel better and eats a regular diet in greater volume and variety, discomfort may occur 30 to 60 minutes after meals. A cramping and full feeling develops, the pulse becomes rapid, and a wave of weakness, cold sweating, and dizziness may follow.

 

DIF:    Cognitive Level: Application          REF:   462

TOP:   Nursing Process: Assessment

MSC:  NCLEX: Physiological Integrity: Physiological Adaptation

 

  1. Of the following, the food item most likely to lead to dumping syndrome is
a. lean meat.
b. butter.
c. chocolate cookies.
d. whole wheat toast.

 

 

ANS:  C

The complex of symptoms in dumping syndrome constitutes a shock syndrome that results when a meal containing a large portion of readily soluble carbohydrates rapidly enters, or “dumps” into the small intestine.

 

DIF:    Cognitive Level: Application          REF:   462                TOP:   Nursing Process: Planning

MSC:  NCLEX: Physiological Integrity: Physiological Adaptation, Health Promotion and Maintenance

 

  1. Physiologic symptoms of dumping syndrome result from
a. the intestinal contents being absorbed too quickly.
b. the ingested food remaining in the stomach too long.
c. the stomach emptying too quickly into the intestine.
d. water being drawn from the blood into the intestine and decreasing the blood volume.

 

 

ANS:  D

Dumping syndrome results when a meal containing a large portion of readily soluble carbohydrates rapidly enters, or “dumps,” into the small intestine. This rapidly entering food mass is a concentrated solution in relation to the surrounding circulation of blood. To achieve an osmotic balance, water is drawn from the blood into the intestine. This water shift rapidly shrinks the vascular fluid volume. As a result, blood pressure drops and signs of rapid heart action to rebuild the blood volume appear.

 

DIF:    Cognitive Level: Knowledge          REF:   462-463         TOP:   Nursing Process: Planning

MSC:  NCLEX: Physiological Integrity: Physiological Adaptation

 

  1. If a patient requires parenteral nutrition for a prolonged period, the most appropriate type of feeding is
a. elemental enteral formula.
b. intact enteral formula.
c. total parenteral nutrition.
d. peripheral parenteral nutrition.

 

 

ANS:  C

Total parenteral nutrition is indicated if the gastrointestinal tract cannot be used for a long period. Total parenteral nutrition, which supplies all the macronutrients and micronutrients along with fluid to meet daily requirements, is necessary for patients who need intravenous nutrition for an extended period.

 

DIF:    Cognitive Level: Application          REF:   458                TOP:   Nursing Process: Planning

MSC:  NCLEX: Physiological Integrity: Physiological Adaptation

 

  1. After a cholecystectomy, an example of a food item that may need to be decreased is
a. fried chicken.
b. applesauce.
c. whole grain bread.
d. sherbet.

 

 

ANS:  A

Depending on individual tolerance and response, a relatively low-fat diet may be needed. The gallbladder stores bile produced by the liver, which is secreted when fat enters the small intestine. After surgery, control of fat in the diet facilitates wound healing and comfort because the hormonal stimulus for bile secretion still functions in the surgical area, causing pain with intake of fatty foods. The body also needs a period to readjust to the more dilute supply of liver bile available to assist in fat digestion and absorption.

 

DIF:    Cognitive Level: Application          REF:   463-464         TOP:   Nursing Process: Planning

MSC:  NCLEX: Physiological Integrity: Physiological Adaptation, Health Promotion and Maintenance

 

  1. The surgery in which the colon is attached to an opening in the abdominal wall is known as a(n)
a. cholecystectomy.
b. ileostomy.
c. colostomy.
d. jejunostomy.

 

 

ANS:  C

Intestinal surgery may require the making of an opening in the abdominal wall to the outside from the intestine. If the opening is farther along the colon in the last part of the large intestine, it is called a colostomy.

 

DIF:    Cognitive Level: Knowledge          REF:   464-465         TOP:   Nursing Process: Planning

MSC:  NCLEX: Physiological Integrity: Physiological Adaptation

 

  1. If the intestinal drainage from an ostomy site is still liquid, the patient has a(n)
a. gastrectomy.
b. ileostomy.
c. colostomy.
d. intestinal bypass.

 

 

ANS:  B

An ileostomy is an opening in the abdominal wall to the ileum. The drainage from an ileostomy is liquid because the food mass is still liquid at this point.

 

DIF:    Cognitive Level: Application          REF:   465-466         TOP:   Nursing Process: Planning

MSC:  NCLEX: Physiological Integrity: Physiological Adaptation, Health Promotion and Maintenance

 

  1. Of the following, a food item found on a full liquid diet is
a. pureed chicken.
b. mashed potatoes.
c. chocolate ice cream.
d. scrambled eggs.

 

 

ANS:  C                    DIF:    Cognitive Level: Application          REF:   455

TOP:   Nursing Process: Implementation

MSC:  NCLEX: Physiological Integrity: Physiological Adaptation, Health Promotion and Maintenance

 

  1. A burn that causes cell damage in both the top layer of skin and some of the dermis is a _____ burn.
a. superficial
b. superficial partial-thickness
c. deep partial-thickness
d. full-thickness

 

 

ANS:  B

Superficial partial-thickness burns involve cell damage in both the top layer of the skin (epidermis) and some of the second layer of the skin (dermis). A superficial burn involves cell damage in the top layer of skin, a deep partial-thickness burn results in destruction of the epidermis and dermis, and a full-thickness burn results in loss of the epidermis, dermis, and frequently the underlying fat layer.

 

DIF:    Cognitive Level: Knowledge          REF:   466                TOP:   Nursing Process: Planning

MSC:  NCLEX: Physiological Integrity: Physiological Adaptation, Health Promotion and Maintenance

 

  1. During the initial stage of treatment of a severe burn
a. a dextrose intravenous feeding is started.
b. total parenteral nutrition is initiated.
c. the patient is encouraged to take water orally.
d. an intravenous electrolyte solution is given.

 

 

ANS:  D

During the initial stage of treatment for a severe burn, referred to as the immediate shock period, massive flooding edema occurs at the burn site. Loss of protective skin leads to immediate losses of water, electrolytes, and protein. Cell dehydration follows. Immediate intravenous fluid therapy with a salt solution replaces water and electrolytes to help prevent shock.

 

DIF:    Cognitive Level: Knowledge          REF:   466-467

TOP:   Nursing Process: Implementation

MSC:  NCLEX: Physiological Integrity: Physiological Adaptation

 

  1. An intravenous solution that is immediately given to a burn patient to prevent hypovolemia is
a. lactated Ringer’s solution.
b. 5% dextrose.
c. normal saline.
d. total parenteral nutrition.

 

 

ANS:  A

Immediate intravenous fluid therapy with a salt solution replaces water and electrolytes to help prevent shock. Lactated Ringer’s solution is the intravenous fluid given to prevent hypovolemia. This is a salt solution, 6% hetastarch in solution.

 

DIF:    Cognitive Level: Knowledge          REF:   467

TOP:   Nursing Process: Implementation

MSC:  NCLEX: Physiological Integrity: Physiological Adaptation

 

  1. An appropriate tube feeding route for a patient at high risk for aspiration is
a. nasogastric.
b. nasojejunal.
c. gastrostomy.
d. esophagostomy.

 

 

ANS:  B

If a patient is at high risk for aspiration, then a feeding tube is placed in the small intestine rather than the stomach to lessen the chance of aspiration of food into the lungs.

 

DIF:    Cognitive Level: Comprehension   REF:   455-456

TOP:   Nursing Process: Assessment

MSC:  NCLEX: Physiological Integrity: Physiological Adaptation

 

  1. Total parenteral nutrition formulas provide protein in the form of
a. peptides.
b. protein isolates.
c. amino acids.
d. dextrose.

 

 

ANS:  C

Parenteral nutrition therapy infuses nutrients directly into the bloodstream. Proteins are supplied in the simplest form, amino acids, for direct absorption into the bloodstream.

 

DIF:    Cognitive Level: Knowledge          REF:   458-459         TOP:   Nursing Process: Planning

MSC:  NCLEX: Physiological Integrity: Physiological Adaptation

 

  1. A good snack for a patient with dumping syndrome is
a. cheese and whole grain crackers.
b. applesauce and graham crackers.
c. nonfat milk and pretzels.
d. fig bars and juice.

 

 

ANS:  A

The complex of symptoms in dumping syndrome constitutes a shock syndrome

that results when a meal containing a large portion of readily soluble carbohydrates rapidly enters, or “dumps,” into the small intestine. An appropriate food choice for someone with dumping syndrome would include complex carbohydrate and protein as well as fat—in this case, cheese and whole grain crackers. Nonfat milk and pretzels would not provide any fat, plus liquids should be given between rather than with meals, and milk contains some simple carbohydrates, which may not be tolerated.

 

DIF:    Cognitive Level: Application          REF:   462-463

TOP:   Nursing Process: Implementation

MSC:  NCLEX: Physiological Integrity: Physiological Adaptation

 

  1. Patients who are treated with antibiotics may have decreased synthesis of
a. vitamin K.
b. vitamin C.
c. zinc.
d. iron.

 

 

ANS:  A

Patients who are treated with antibiotic may have decreased gut flora and vitamin K synthesis.

 

DIF:    Cognitive Level: Application          REF:   451                TOP:   Nursing Process: Planning

MSC:  NCLEX: Physiological Integrity: Physiological Adaptation

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