Chapter 05 My Nursing Test Banks

Tabloski Gerontological Nursing, 3/e
Chapter 05

Question 1

Type: MCMA

The nurse is discussing proper nutrition with older community members at a senior citizen center. What should the nurse teach as general guidelines for healthy older individuals?

Standard Text: Select all that apply.

1. Calcium intake should be 1,000 mg for those over the age of 51 years.

2. Older individuals need to take supplements of vitamins A, C, E, and K.

3. Vitamin D intake should be 600 IU up to age 70 and 800 IU if older than 70.

4. Ingest at least 0.8 grams of protein for each kilogram of body weight each day

5. Fluid intake each day should be at least 13 cups for men and 9 cups for women.

Correct Answer: 3,4,5

Rationale 1: Calcium intake should be 1,200 mg for those over the age of 51 years.
Reference: Page 102

Rationale 2: Older individuals need supplements of vitamins D and B12 and calcium, not vitamins A, C, E, and K.
Reference: Page 102

Rationale 3: Vitamin D intake should be 600 IU up to age 70 and 800 IU if older than 70.
Reference: Page 102

Rationale 4: Protein intake for older individuals should be 0.8 grams per kilogram of body weight.
Reference: Page 102

Rationale 5: Fluid intake each day should be at least 13 cups for men and 9 cups for women.
Reference: Page 102

Global Rationale:

Cognitive Level: Applying

Client Need: Health Promotion and Maintenance

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 3. Identify normal nutritional requirements of the older person.

Question 2

Type: MCMA

A patient prescribed medications for gastroesophageal reflux disease (GERD) is at risk for altered absorption of which nutrients?

Standard Text: Select all that apply.

1. Iron

2. Calcium

3. Folic acid

4. Vitamin D

5. Vitamin B12

Correct Answer: 1,2,5

Rationale 1: Medications that alter gastric pH may also alter iron absorption because of the alkalinizing effects of these medications.
Reference: Page 98

Rationale 2: Medications that alter gastric pH may also alter calcium absorption because of the alkalinizing effects of these medications.
Reference: Page 98

Rationale 3: Folic acid absorption is not affected by medications that alter gastric pH.
Reference: Page 98

Rationale 4: Vitamin D absorption is not affected by medications that alter gastric pH.
Reference: Page 98

Rationale 5: Medications that alter gastric pH may also alter vitamin B12 absorption because of the alkalinizing effects of these medications.
Reference: Page 98

Global Rationale:

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub: Reduction of Risk Potential

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 1. Classify the normal changes of aging in body composition and digestion, absorption, and metabolism of nutrients.

Question 3

Type: MCSA

An older patient without any major health problems is experiencing decreased strength and endurance while performing some activities. What should the nurse explain as the reason for the change in strength and endurance?

1. Depression

2. Decrease in lean muscle mass

3. Lowered absorption of vitamin D

4. Increase in cholecystokinin production

Correct Answer: 2

Rationale 1: Depression is not a normal part of the aging process.
Reference: Page 97

Rationale 2: Lean muscle mass diminishes with aging. This can lead to a loss of type II muscle fibers that affect strength and endurance.
Reference: Page 97

Rationale 3: Diminished vitamin D absorption leads to bone loss.
Reference: Page 97

Rationale 4: Cholecystokinin production increases with age and can cause early satiety and low hunger.
Reference: Page 97

Global Rationale:

Cognitive Level: Applying

Client Need: Health Promotion and Maintenance

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 1. Classify the normal changes of aging in body composition and digestion, absorption, and metabolism of nutrients.

Question 4

Type: MCSA

The nurse instructed an older patient on the importance of maintaining adequate hydration. Which statement by the patient indicates that additional teaching is needed?

1. Ill drink water and unsweetened beverages whenever I feel thirsty.

2. I can add an extra cup of decaffeinated coffee with breakfast and dinner.

3. I will set up a schedule to drink a glass of water every 2 hours throughout the day.

4. If I drink a lot of fluids, Ill have to go to the bathroom more often, but Ill get more exercise.

Correct Answer: 1

Rationale 1: The patient needs additional instructions regarding adequate fluid intake. Because the thirst mechanism becomes blunted with age, the patient cannot rely on feeling thirsty as a signal to meet hydration requirements.
Reference: Page 105

Rationale 2: Decaffeinated fluids are allowed and will not lead to diuresis.
Reference: Page 105

Rationale 3: Use of a schedule to maintain adequate fluid intake is preferred because it provides the patient with a continuous stimulus to take fluids.
Reference: Page 105

Rationale 4: The patient can expect to urinate more often with the increased fluid intake.
Reference: Page 105

Global Rationale:

Cognitive Level: Analyzing

Client Need: Health Promotion and Maintenance

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 1. Classify the normal changes of aging in body composition and digestion, absorption, and metabolism of nutrients.

Question 5

Type: MCSA

Which assessment data indicates to the nurse that an older patient is experiencing undernutrition?

1. Body mass index (BMI) of 20

2. Unintentional 3% weight loss over a month

3. Denial of taking a multiple vitamin supplement

4. Serum albumin slightly below normal, prealbumin and transferrin within normal limits

Correct Answer: 1

Rationale 1: A body mass index (BMI) less than 22 in the older person is predictive of undernutrition.
Reference: Page 102

Rationale 2: A 3% unintentional weight loss over a month does not indicate undernutrition.
Reference: Page 102

Rationale 3: Taking a multiple vitamin supplement is not directly connected to a diagnosis of undernutrition.
Reference: Page 102

Rationale 4: Albumin, prealbumin, and transferrin are plasma proteins. A lower serum albumin is less specific to malnutrition because it is affected by other conditions, such as liver disease, kidney conditions, and hydration status. Prealbumin and transferrin are more specific to current nutritional status.
Reference: Page 102

Global Rationale:

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub: Reduction of Risk Potential

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 4. Analyze the causes and consequences of undernutrition in the older person.

Question 6

Type: MCSA

Which older patient is at greatest risk for vitamin D deficiency?

1. The patient with macrocytic anemia

2. The patient who does not drink milk

3. The patient who works outdoors daily and does not wear sunscreen

4. The patient who is taking isoniazid (INH) after a positive tuberculin skin test

Correct Answer: 2

Rationale 1: Macrocytic anemia is associated with vitamin B12 deficiency and is not associated with vitamin D deficiency risk.
Reference: Page 102

Rationale 2: Older adults at risk for poor vitamin D status include those who do not consume milk.
Reference: Page 102

Rationale 3: Vitamin D is produced endogenously by the action of sunlight on the skin.
Reference: Page 102

Rationale 4: Patients on isoniazid therapy are routinely prescribed vitamin B6 (pyridoxine) to prevent a deficiency.
Reference: Page 102

Global Rationale:

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub: Reduction of Risk Potential

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 4. Analyze the causes and consequences of undernutrition in the older person.

Question 7

Type: MCSA

A resident in the nursing home is diagnosed with undernutrition and is unable to take in adequate food despite efforts by the multidisciplinary team and family members. Prior to insertion of a permanent feeding tube, which issue needs to be considered?

1. Equipment, care, and time needed to administer the feedings

2. The extent of the surgical intervention, cost and insurance coverage

3. The patients nutritional needs and tolerance of the formula feedings

4. The patients advanced directive and evaluation of risks, benefits, and ethical considerations

Correct Answer: 4

Rationale 1: The actual placement of a feeding tube is a common, relatively simple procedure that can be performed as an outpatient. Staff time may be reduced with the tube feeding than with actually feeding the patient.
Reference: Page 116

Rationale 2: Costs of the equipment and formula are reimbursed by Medicare, Medicaid, or most insurance companies.
Reference: Page 116

Rationale 3: There are a variety of different formulas available for different patient needs.
Reference: Page 116

Rationale 4: Prior to placement of a permanent feeding tube, it is important to evaluate the individual patients wishes and review the advanced directive. The patient and family need accurate information regarding risks, benefits, and ethical considerations associated with placement of the feeding tube.
Reference: Page 116

Global Rationale:

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub: Basic Care and Comfort

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 6. Develop appropriate nursing interventions and treatment for nutrition-related problems of the older person.

Question 8

Type: MCSA

Which observation made by the nurse suggests that a patient is having difficulty swallowing?

1. Drooling

2. Cheilosis

3. Long furrowed tongue

4. Unintentional weight loss

Correct Answer: 1

Rationale 1: Drooling suggests difficulty swallowing because the patient is unable to swallow the saliva produced in the mouth.
Reference: Page 124

Rationale 2: Cheilosis is a condition where painful sores occur at the corners of the mouth, sometimes associated with vitamin B12 deficiency.
Reference: Page 124

Rationale 3: Long furrows in the tongue are indicative of dehydration.
Reference: Page 124

Rationale 4: Unintentional weight loss occurs with difficulty swallowing but is not a specific cause.
Reference: Page 124

Global Rationale:

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub: Reduction of Risk Potential

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 4. Analyze the causes and consequences of undernutrition in the older person.

Question 9

Type: MCSA

An older patient is prescribed diet supplementation to combat unintentional weight loss. How should the nurse provide these supplements to the patient?

1. Serve at room temperature.

2. Provide with the next meal.

3. Provide separate from medications.

4. Provide more than an hour before the next meal.

Correct Answer: 4

Rationale 1: Temperature is not a significant issue when providing supplements.
Reference: Page 116

Rationale 2: Supplements should be given more than 1 hour before meals and not with meals.
Reference: Page 116

Rationale 3: Liquid supplements may be given with medications as long as there is no interference with the specific medication.
Reference: Page 116

Rationale 4: Supplements should be given more than 1 hour before meals to minimize satiety and enable the patient to still eat at mealtime. Liquid supplements are digested more quickly than solids, thus decreasing the feeling of fullness.
Reference: Page 116

Global Rationale:

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub: Reduction of Risk Potential

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 6. Develop appropriate nursing interventions and treatment for nutrition-related problems of the older person.

Question 10

Type: MCSA

An older patient is receiving feedings through a permanent feeding tube. Which nursing intervention will decrease this patients risk of aspiration?

1. Administer formulas that contain fiber.

2. Keep the head of the bed elevated at a 30 to 45 degree angle.

3. The risk of aspiration no longer exists after a permanent feeding tube has been placed.

4. Flush the tube with water before and after each medication administered through the tube.

Correct Answer: 2

Rationale 1: Formulas that contain fiber help stimulate normal bowel function.
Reference: Page 119

Rationale 2: The head of the bed of patients receiving tube feedings should be elevated at a 30 to 45 degree angle to decrease the risk of aspiration.
Reference: Page 119

Rationale 3: The patient is receiving a feeding through a permanent feeding tube. The risk of aspiration continues to exist after the placement of the tube.
Reference: Page 119

Rationale 4: Flushing the tube with medication administration is necessary to prevent clogging of the tube.
Reference: Page 119

Global Rationale:

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Reduction of Risk Potential

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 6. Develop appropriate nursing interventions and treatment for nutrition-related problems of the older person.

Question 11

Type: MCSA

Which older patient would the nurse identify as being at the highest risk of dehydration from receiving nutrition through a feeding tube?

1. Receiving bolus feedings

2. Receiving 50 ml free water at 4-hour intervals

3. Receiving feedings through a jejunostomy tube

4. Receiving feedings with a formula that is 1.5 calories per ml

Correct Answer: 4

Rationale 1: Bolus feedings instead of continuous tube feedings may put the patient at risk for aspiration but not for dehydration.
Reference: Page 119

Rationale 2: A client who is receiving 300 ml of free water daily would not be at risk for dehydration.
Reference: Page 119

Rationale 3: The risk of dehydration is not associated with any particular site of a feeding tube.
Reference: Page 119

Rationale 4: Tube feeding formulas that are denser than 1 calorie per milliliter are hypertonic and predispose the patient to dehydration unless the patient also receives free water.
Reference: Page 119

Global Rationale:

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub: Reduction of Risk Potential

Nursing/Integrated Concepts: Nursing Process: Diagnosis

Learning Outcome: 6. Develop appropriate nursing interventions and treatment for nutrition-related problems of the older person.

Question 12

Type: MCMA

When planning care, for which older patients should the nurse identify as being at risk for malnutrition as a result of hypermetabolism?

Standard Text: Select all that apply.

1. Patient with a fever

2. Patient with dysphagia

3. Patient with osteoporosis

4. Patient who is a vegetarian

5. Patient with chronic lung disease

Correct Answer: 1,5

Rationale 1: The patient with a fever is at risk for malnutrition as a result of hypermetabolism.
Reference: Page 113

Rationale 2: The patient with dysphagia is at risk for malnutrition because of the inability to eat adequate amounts of foods and not because of hypermetabolism.
Reference: Page 113

Rationale 3: Patients with osteoporosis do not have higher metabolic rates.
Reference: Page 113

Rationale 4: There is no connection between hypermetabolism and vegetarianism.
Reference: Page 113

Rationale 5: The patient with chronic obstructive pulmonary disease often is malnourished because of the increased caloric need associated with breathing efforts.
Reference: Page 113

Global Rationale:

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub: Reduction of Risk Potential

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 4. Analyze the causes and consequences of undernutrition in the older person.

Question 13

Type: MCSA

What should the nurse instruct a caregiver to do to assist a cognitively impaired older patient to self-feed?

1. Offer the patient a variety of favorite foods.

2. Provide diversional stimuli, such as a television show, so the patient can eat without thinking about it.

3. Serve each food separately with the proper utensil and cue the patient to use the utensil to eat that particular food.

4. Place the food types in the same arrangement on the plate and relate the location to the face of a clock to assist the patient in locating the food on the plate.

Correct Answer: 3

Rationale 1: Offering the patient many choices may add to the patients confusion.
Reference: Page 116

Rationale 2: Excess stimulation like watching television may add to the patients confusion.
Reference: Page 116

Rationale 3: Limiting the patient to one task and food, and cueing the patient to use the utensil to eat the specific food can be effective in promoting self-feeding.
Reference: Page 116

Rationale 4: Placing the food on the plate and relating the location to a clock is used to assist patients with limited vision.
Reference: Page 116

Global Rationale:

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Reduction of Risk Potential

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 6. Develop appropriate nursing interventions and treatment for nutrition-related problems of the older person.

Question 14

Type: MCMA

During an assessment, the nurse determines that an older patient is taking several supplements that affect blood clotting. Which supplements did the nurse assess that this patient is taking?

Standard Text: Select all that apply.

1. Zinc

2. Garlic

3. Fish oil

4. Ginseng

5. Vitamin E

Correct Answer: 2,3,4,5

Rationale 1: Zinc does cause antiplatelet effects.
Reference: Page 106

Rationale 2: A supplement with an antiplatelet effect includes garlic.
Reference: Page 106

Rationale 3: A supplement with an antiplatelet effect includes fish oil.
Reference: Page 106

Rationale 4: A supplement with an antiplatelet effect includes ginseng.
Reference: Page 106

Rationale 5: A supplement with an antiplatelet effect includes vitamin E.
Reference: Page 106

Global Rationale:

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub: Pharmacological and Parenteral Therapies

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 5. Evaluate tools and parameters used to assess nutrition status.

Question 15

Type: MCMA

The nurse is concerned that an older patient is experiencing dehydration. What did the nurse assess in this patient?

Standard Text: Select all that apply.

1. Confusion

2. Headache

3. Weight gain

4. Long tongue furrows

5. Forearm tenting of the skin

Correct Answer: 1,2,4

Rationale 1: Confusion is a symptom of dehydration in the older adult.
Reference: Page 98

Rationale 2: Headache is a symptom of dehydration in the older adult.
Reference: Page 98

Rationale 3: Weight gain would not occur in a patient that is dehydrated. Weight gain is an indication of overhydration.
Reference: Page 98

Rationale 4: Long tongue furrows are symptoms of dehydration in the older adult.
Reference: Page 98

Rationale 5: Tenting on the forearm is not an accurate indicator of dehydration because the older patient will often have tenting with a normal hydration status as a result of loss of skin elasticity.
Reference: Page 98

Global Rationale:

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub: Physiological Adaptation

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 5. Evaluate tools and parameters used to assess nutrition status.

Question 16

Type: MCMA

What should the nurse instruct an older patient to do to support healthy eating habits?

Standard Text: Select all that apply.

1. Increase fiber intake.

2. Reduce sodium intake.

3. Look for hidden sugar.

4. Enjoy olive oil and walnuts.

5. Complete a meal in 10 minutes.

Correct Answer: 1,2,3,4

Rationale 1: Increasing fiber intake is a healthy eating tip.

Rationale 2: Reduce sodium intake is a healthy eating tip.

Rationale 3: Looking for hidden sugar is a healthy eating tip.

Rationale 4: Enjoying good fats such as olive oil and walnuts is a healthy eating tip.

Rationale 5: Slowing down at mealtime and not completing a meal in 10 minutes is a healthy eating tip.

Global Rationale:

Cognitive Level: Applying

Client Need: Health Promotion and Maintenance

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 6. Develop appropriate nursing interventions and treatment for nutrition-related problems of the older person.

Question 17

Type: MCMA

The nurse is caring for an older patient who is receiving phenytoin. Which nutritional issues is this patient at risk for developing?

Standard Text: Select all that apply.

1. Altered swallowing

2. Reduced oral intake

3. Affected folate levels

4. Altered taste and smell

5. Affected vitamin D levels

Correct Answer: 2,3,4,5

Rationale 1: Phenytoin does not affect the patients ability to swallow.
Reference: Page 100

Rationale 2: Phenytoin causes patients to experience reduced oral intake.
Reference: Page 100

Rationale 3: Phenytoin affects folate levels in the body.
Reference: Page 100

Rationale 4: Phenytoin alters a patients taste and smell.
Reference: Page 100

Rationale 5: Phenytoin affects vitamin D levels in the body.
Reference: Page 100

Global Rationale:

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Pharmacological and Parenteral Therapies

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 6. Develop appropriate nursing interventions and treatment for nutrition-related problems of the older person.

Question 18

Type: MCSA

An older patient receiving enteral feedings is experiencing abdominal cramps and liquid stools. Which ingredient in the patients tube feeding would cause these manifestations?

1. Maltose

2. Lactose

3. Fructose

4. Sucrose

Correct Answer: 2

Rationale 1: Maltose is a type of sugar and is not implicated in the development of abdominal cramps and liquid stools when receiving an enteral feeding.
Reference: Page 120

Rationale 2: Lactose is implicated in the formation of diarrhea in the patient receiving enteral feedings. A lactose-free supplement should be used for this patient.
Reference: Page 120

Rationale 3: Fructose is a type of sugar and is not implicated in the development of abdominal cramps and liquid stools when receiving an enteral feeding.
Reference: Page 120

Rationale 4: Sucrose is a type of sugar and is not implicated in the development of abdominal cramps and liquid stools when receiving an enteral feeding.
Reference: Page 120

Global Rationale:

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub: Pharmacological and Parenteral Therapies

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 6. Develop appropriate nursing interventions and treatment for nutrition-related problems of the older person.

Question 19

Type: MCSA

The nurse is planning interventions to reduce an older patients risk of dehydration. Which intervention would support the onset of dehydration in the patient?

1. Ensuring fresh water is available to the patient

2. Providing the prescribed diuretic with breakfast

3. Administering the prescribed diuretic with the evening meal

4. Offering a drink of water every time the patients room is entered

Correct Answer: 3

Rationale 1: Ensuring that fresh water is available will help reduce the patients risk of dehydration.
Reference: Page 98

Rationale 2: Providing diuretics in the morning will help reduce the risk of dehydration when patients voluntarily restrict fluids and experience nocturia.
Reference: Page 98

Rationale 3: Administering prescribed diuretics with the evening meal will encourage nocturia and voluntary restriction of fluids by the patient. This will lead to dehydration.
Reference: Page 98

Rationale 4: By offering water to the patient when entering the room, the risk for dehydration can be decreased.
Reference: Page 98

Global Rationale:

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Reduction of Risk Potential

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 6. Develop appropriate nursing interventions and treatment for nutrition-related problems of the older person.

Question 20

Type: MCMA

The nurse is instructing an older patient on the use of My Plate to ensure an adequate nutritional intake. Which food items would the nurse teach the patient to fill on one-half of the plate?

Standard Text: Select all that apply.

1. Oils

2. Fruits

3. Grains

4. Proteins

5. Vegetables

Correct Answer: 2,5

Rationale 1: Oils are to be used sparingly and would only use the small circle in the middle of the plate.
Reference: Page 101

Rationale 2: Fruits should be included for one-half of the plate.
Reference: Page 101

Rationale 3: Grains should be included for one-fourth of the plate.
Reference: Page 101

Rationale 4: Proteins should be included for one-fourth of the plate.
Reference: Page 101

Rationale 5: Vegetables should be included for one-half of the plate.
Reference: Page 101

Global Rationale:

Cognitive Level: Applying

Client Need: Health Promotion and Maintenance

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 3. Identify normal nutrition requirements of the older person.

Question 21

Type: MCSA

The nurse has instructed an older patient on the modified My Plate and caloric intake. Which patent response indicates that instruction has been effective?

1. If I consume the lowest daily recommended value for all of the food groups, it will result in approximately 2,000 calories.

2. If I consume the lowest daily recommended value for all of the food groups, it will result in approximately 1,600 calories.

3. If I consume the lowest daily recommended value for all of the food groups, it will result in approximately 2,200 calories.

4. If I consume the lowest daily recommended value for all of the food groups, it will result in approximately 2,400 calories.

Correct Answer: 2

Rationale 1: Following the lowest recommended values for all the food groups will result in approximately 1,600 calories of energy.
Reference: Page 102

Rationale 2: Following the lowest recommended values for all the food groups will result in approximately 1,600 calories of energy.
Reference: Page 102

Rationale 3: Following the lowest recommended values for all the food groups will result in approximately 1,600 calories of energy.
Reference: Page 102

Rationale 4: Following the lowest recommended values for all the food groups will result in approximately 1,600 calories of energy.
Reference: Page 102

Global Rationale:

Cognitive Level: Analyzing

Client Need: Health Promotion and Maintenance

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 3. Identify normal nutrition requirements of the older person.

Question 22

Type: MCSA

What food items should the nurse teach an older patient to ingest to increase the dietary intake of vitamin D?

1. Eat liver at least once a week.

2. Plan to eat salmon at least twice a week.

3. Eat three servings of yogurt or cheese each day.

4. Red meat should be consumed every other day.

Correct Answer: 1

Rationale 1: Food sources of vitamin D include liver, fish liver oils, and fortified milk.
Reference: Page 102

Rationale 2: Salmon is not identified as a source for vitamin D.
Reference: Page 102

Rationale 3: Yogurt or cheese are not mandated to be fortified with vitamin D and are not considered good choices.
Reference: Page 102

Rationale 4: Red meat is not identified as being a source for vitamin D.
Reference: Page 102

Global Rationale:

Cognitive Level: Applying

Client Need: Health Promotion and Maintenance

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 3. Identify normal nutrition requirements of the older person.

Question 23

Type: MCSA

Which statement about food insecurity would the nurse include in a presentation regarding nutritional issues in the older patient?

1. Food insecurity is when a person hoards food.

2. White older persons are at a higher risk for food insecurity than African Americans.

3. African American older persons are at a higher risk for food insecurity than Caucasian Americans.

4. Food insecurity is when a person is concerned that he or she is eating foods that might be harmful to his or her health.

Correct Answer: 3

Rationale 1: Food insecurity is when a patient lacks sufficient funds or access to buy food.

Rationale 2: African Americans and Hispanic older persons are at a disproportionate risk of food insecurity compared with other households.

Rationale 3: African Americans and Hispanic older persons are at a disproportionate risk of food insecurity compared with other households.

Rationale 4: Food insecurity is when a patient lacks sufficient funds or access to buy food. It can force an individual to decide between paying bills, buying medications, or buying groceries.

Global Rationale:

Cognitive Level: Applying

Client Need: Health Promotion and Maintenance

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 4. Analyze the causes and consequences of undernutrition in the older person.

Question 24

Type: MCMA

The nurse is using the DETERMINE nutrition screening tool when assessing the nutritional status of an older patient. Which criteria are included in this screening tool?

Standard Text: Select all that apply.

1. Disease

2. Above the age of 80

3. Reduced social contact

4. Eats fruits and vegetables

5. Needs assistance in self-care

Correct Answer: 1,2,3,5

Rationale 1: Disease is a category in the DETERMINE nutrition screening tool.
Reference: Page 111

Rationale 2: Above the age of 80 is a category in the DETERMINE nutrition screening tool.
Reference: Page 111

Rationale 3: Reduced social contact is a category in the DETERMINE nutrition screening tool.
Reference: Page 111

Rationale 4: Eats fruits and vegetables is not a category in the DETERMINE nutrition screening tool.
Reference: Page 111

Rationale 5: Needs assistance in self-care is a category in the DETERMINE nutrition screening tool.
Reference: Page 111

Global Rationale:

Cognitive Level: Applying

Client Need: Health Promotion and Maintenance

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 5. Evaluate tools and parameters used to assess nutrition status.

Question 25

Type: MCSA

An older patient has an unintentional weight loss of 20 pounds in the last 3 months. What should the nurse teach the patients family to prevent further loss of weight?

1. Provide liquid nutritional supplements with meals.

2. Add nonfat milk powder to scrambled eggs to add more protein.

3. Encourage the patient to resume smoking to increase the appetite.

4. There is nothing to change as weight loss is a normal part of aging.

Correct Answer: 2

Rationale 1: Nutritional supplements should be offered at least an hour before or after a meal.
Reference: Page 117

Rationale 2: Interventions for patients with undernutrition issues include adding nonfat milk to soups, puddings, scrambled eggs, and other recipes.
Reference: Page 117

Rationale 3: The patient should stop smoking to improve taste perception.
Reference: Page 117

Rationale 4: Weight loss is not a part of the normal aging process.
Reference: Page 117

Global Rationale:

Cognitive Level: Applying

Client Need: Health Promotion and Maintenance

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 6. Develop appropriate nursing interventions and treatment for nutrition-related problems of the older person.

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