Chapter 08: Water and Minerals My Nursing Test Banks

Chapter 08: Water and Minerals

Grodner and Escott-Stump: Nutritional Foundations and Clinical Application: A Nursing Approach, 6th Edition

MULTIPLE CHOICE

1. If a woman who drinks a cup of decaffeinated coffee in the morning, a cup of fruit juice with lunch, 6 cups of water throughout the day and a cup of tea at bedtime, her fluid intake would be considered

a.

dangerously low.

b.

below optimal.

c.

optimal.

d.

too high.

ANS: C

This womans total fluid intake for the day is 9 cups, the recommended amount for women. Minimum fluid intake for health is around 4 cups; intake below this would be considered dangerously low. Fluid intake can be too high, but the specific amount that causes water intoxication is unknown.

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2. Having only softened tap water at home would be of most concern to a(n)

a.

pregnant woman.

b.

full-time student who also works part-time.

c.

elderly woman with osteoporosis.

d.

retired man with hypertension.

ANS: D

Softened water has relatively high levels of sodium, which exacerbates hypertension in salt-sensitive individuals. It is not ideal for anyone to drink softened water on a regular basis, but it is of special concern for someone with hypertension. Someone who is retired is more likely to drink beverages made with tap water at home. An elderly woman with osteoporosis would benefit from the calcium in hard water, but this is less of a concern. A student who is gone at work or school most of the day would not consume much of the softened tap water. Sodium intake is not a specific concern in pregnancy.

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3. Interstitial fluid is the body fluid

a.

within the cells.

b.

outside the cells.

c.

between the cells.

d.

in the bloodstream.

ANS: C

Interstitial fluid is the body fluid between the cells. The fluid within the cells is intracellular fluid; the fluid outside the cells is extracellular fluid; the fluid in the bloodstream is blood plasma.

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4. Dehydration is most likely to have a negative effect on

a.

digestion of food.

b.

storage of excess energy.

c.

nerve impulse conduction.

d.

body temperature regulation.

ANS: D

Within the body, water helps to regulate body temperature by absorbing and distributing heat throughout the body and through perspiration. Digestion of food requires secretion of digestive fluids, but this is less immediately affected by dehydration. Water is not needed to store excess energy in adipose tissue. Water is not important for this conduction of nerve impulses.

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5. It would be most difficult for the body to maintain homeostasis if over several days someone had an inadequate intake of

a.

calcium.

b.

sodium.

c.

iron.

d.

fluoride.

ANS: B

Homeostasis is maintenance of physiologic equilibrium within the body. All of these minerals help maintain homeostasis, but inadequate intake of sodium over just a few days would have the most effect. Sodium is an electrolyte and is important for maintaining fluid balance in the body. If calcium intake is inadequate, the body can draw on reserves in bone; if iron intake is inadequate, the body has some reserves in the spleen, and so body homeostasis would not be affected unless the deficiency continued long term. Fluoride deficiency may cause dental caries and may affect bone density, but this is also a long-term effect and would not affect the body over a few days.

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6. If an athlete ran a marathon, sweated profusely, and drank only water with some sugar to replace fluids and carbohydrate, his or her body would increase secretion of

a.

adrenaline.

b.

aldosterone.

c.

alanine.

d.

antidiuretic hormone (ADH).

ANS: B

The body would respond to loss of sodium in sweat by releasing the hormone aldosterone; this would prompt the kidney to decrease sodium excretion. During a marathon, the body may produce adrenaline in response to stress, but this would not address the problem of fluid and energy replacement without sodium replacement. Alanine is an amino acid and has no effect on sodium balance. ADH causes the kidneys to decrease water excretion but does not affect sodium excretion.

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7. If a patient complained of muscle weakness, confusion, decreased appetite, and irregular heartbeat, it would be important to check blood levels of

a.

sodium.

b.

calcium.

c.

potassium.

d.

magnesium.

ANS: C

These symptoms are typical of a possible blood potassium level that is either too low or too high; both conditions can be very dangerous. Low sodium levels cause headache, muscle cramps, weakness, reduced ability to concentrate, and loss of memory and appetite; high sodium levels may cause edema and hypertension. High calcium levels cause weakness, lack of energy, poor appetite, nausea and vomiting, constipation, or bone pain; low blood calcium levels cause muscle cramps, spasms, and twitching and tingling in the fingers and around the mouth. Symptoms of magnesium deficiency include twitching of muscles, muscle weakness, and convulsions; symptoms of magnesium overload are long-term diarrhea and dehydration.

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8. In an older adult who is usually very alert, disorientation may be a sign of

a.

iron deficiency.

b.

malnutrition.

c.

edema.

d.

dehydration.

ANS: D

Disorientation may be a sign of dehydration, which is common in older adults, partly because their thirst mechanism is diminished. Iron deficiency anemia causes fatigue but not disorientation. Severe malnutrition may affect mental acuity but is less likely than dehydration to cause acute disorientation. Edema causes swelling but does not usually affect orientation.

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9. If an elderly client who lives alone and has a limited income has edema, it would be important to evaluate his or her dietary intake of sodium and

a.

protein.

b.

calcium.

c.

chloride.

d.

potassium.

ANS: A

Edema may be caused by high intake of sodium or inadequate intake of protein if protein levels in the body become so low that cellular fluid levels become imbalanced. Edema is not related to dietary intake of calcium, chloride, or potassium.

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10. The term bioavailability means the

a.

total amount of a mineral in a food.

b.

ratio of free mineral to bound mineral in a food.

c.

amount of a mineral that is excreted by the body.

d.

amount of a mineral that can be absorbed by the body from a food.

ANS: D

Bioavailability is the amount of a mineral that can be absorbed by the body from a food. It is generally lower than the total amount of the mineral in a food. It may be related to the ratio of free mineral to bound mineral in a food, but that is only one of many factors affecting bioavailability. It is not related to the amount excreted by the body.

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11. Long-term dietary calcium intake has the greatest effect on

a.

body temperature.

b.

muscular strength.

c.

bone calcium levels.

d.

blood calcium levels.

ANS: C

Long-term dietary calcium intake affects bone calcium levels. Calcium does not affect body temperature. The body maintains steady levels of calcium in the blood and muscles, using calcium from bone if dietary intake is insufficient.

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12. If people want to maximize their absorption of calcium, they should avoid drinking

a.

tea.

b.

milk.

c.

orange juice.

d.

bottled water.

ANS: A

Tea contains oxalic acid and tannins, both of which decrease absorption of calcium. Milk contains lactose and vitamin D, which increase calcium absorption. Orange juice and bottled water do not have a significant positive or negative effect on calcium absorption.

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13. Lifestyle changes that may help prevent development of osteoporosis include

a.

reducing intake of animal protein.

b.

eating a piece of fruit with lunch every day.

c.

taking a daily multivitamin supplement with adequate amounts of calcium and vitamin D.

d.

taking a 30-minute walk most days.

ANS: D

Taking a 30-minute walk most days may help prevent development of osteoporosis because regular exercise stimulates an increase in bone density. Eating vegetable versus animal protein, increasing intake of fruit, and use of multivitamin supplements with adequate amounts of calcium and vitamin D are unlikely to prevent osteoporosis (although they may have other health benefits).

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14. An example of a food with high levels of phosphorus is

a.

rice.

b.

carrots.

c.

cheese.

d.

bananas.

ANS: C

Foods high in phosphorus include dairy foods (such as cheese). Many processed convenience foods and soft drinks also contain phosphorus as additives. Fruits, vegetables, and rice are not good sources of phosphorus.

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15. A good source of calcium for someone who follows a strict vegetarian (i.e., vegan) diet would be

a.

coconut milk.

b.

a bean burrito.

c.

skim milk.

d.

pasta salad.

ANS: B

A good vegan source of calcium is a bean burrito because legumes contain calcium. Coconut milk and pasta salad are not good sources of calcium. Skim milk is not included in a vegan diet.

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16. Secondary magnesium deficiency is most likely to occur in

a.

areas where access to fresh fruits and vegetables is limited.

b.

clients with type 1 diabetes mellitus.

c.

association with excessive vomiting and diarrhea.

d.

association with dehydration attributable to heat exposure.

ANS: C

Secondary magnesium deficiency may occur with excessive vomiting and diarrhea. Primary magnesium deficiency is rare; deficiency is not usually related to poor intake, and fruits and vegetables are not the only good sources of magnesium. Type 1 diabetes and dehydration due to heat exposure do not cause magnesium deficiency.

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17. Of the following, the food choice that contains the least sodium is

a.

cornbread.

b.

corn tortilla.

c.

corn on the cob.

d.

buttered popcorn.

ANS: C

The food choice that contains the least sodium is corn on the cob. Of all these forms of corn, this is the least processed. Food processing usually involves addition of sodium.

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18. A sodium intake of 2100 mg daily by a healthy adult would be considered

a.

below the adequate intake (AI).

b.

within the recommended range.

c.

below the maximum recommended level.

d.

above the maximum recommended level.

ANS: C

A sodium intake of 2100 mg daily is below the maximum level recommended by the National Research Council (2400 mg/day) and the American Heart Association (2300 mg/day). The AI is 1500 mg. There is no recommended range for sodium intake, just the AI and upper limits.

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19. A family with three young children has limited income, relies on public transportation, and has just moved into a very old apartment complex with old plumbing and lead pipes. The best recommendation to minimize lead exposure would be to

a.

use only bottled water.

b.

run the tap water for 2 minutes before using it.

c.

boil the tap water for 2 minutes before using it.

d.

use only hot water for drinking, cooking, and preparing food.

ANS: B

The best recommendation would be to run the tap water for 2 minutes before using it, so that any water sitting in the pipes that may have absorbed lead would not be used. Using bottled water is not practical for a family with limited income who uses public transportation. Boiling the water would not remove the lead and would actually concentrate it. Hot water would dissolve more lead; in fact, only cold water should be used.

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20. If someone took a 6-hour car ride in an air-conditioned vehicle without making any bathroom stops, they weigh less at the end of the trip than at the beginning because

a.

of insensible fluid losses from the skin and lungs.

b.

body fat stores would be metabolized for energy.

c.

muscle mass would be lost.

d.

fluid would be lost through sweating.

ANS: A

Even in an air-conditioned vehicle, the body still loses fluid through the skin and lungs. The person would not lose significant amounts of sweat in an air-conditioned vehicle. A small but fairly insignificant amount of body fat would be metabolized. Muscle mass would be lost only if the driver were inactive or had low protein or carbohydrate intake over several days.

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21. The main reason that young women require more dietary iron than young men is

a.

that they absorb iron less efficiently.

b.

to compensate for their lower muscle mass.

c.

to replace blood losses during menstruation.

d.

that they recycle hemoglobin more rapidly.

ANS: C

Young women require more dietary iron than young men to replace blood losses during menstruation. There is no difference between iron absorption or hemoglobin recycling in young men versus young women. Higher iron intake does not compensate for lower muscle mass in women.

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22. The most easily absorbed form of iron is found in

a.

a grilled pork chop.

b.

tomatoes cooked in an iron skillet.

c.

collard greens cooked with bacon.

d.

spinach salad with strawberries.

ANS: A

Heme iron is absorbed most easily; it is found in animal foods, such as pork. Cooking an acidic food such as tomatoes in an iron skillet would increase the iron content, but the iron would be nonheme, which is less well absorbed than heme iron. Similarly, the vitamin C in the strawberries would increase the absorption of the iron in the spinach, but it is still the nonheme form that is less well absorbed. Bacon may contribute a very small amount of heme iron to the collard greens, but it would be much less than the pork chop.

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23. The first signal that the body needs fluid is

a.

dark, concentrated urine.

b.

the sensation of hunger.

c.

the sensation of thirst.

d.

headache.

ANS: C

The body signals its need for fluid via the sensation of thirst, a dryness in the mouth. Dark, concentrated urine also indicates a need for fluid, and headache may also be caused by dehydration, but these symptoms occur later than thirst, at a time when the bodys need for fluid is much greater. Hunger is a signal that the body needs food, not fluid.

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24. Hemosiderosis, storage of too much iron in the body, is most likely to occur in a(n)

a.

man who drinks five or more alcoholic beverages every night.

b.

adolescent who drinks four or more soft drinks daily.

c.

toddler who prefers drinking milk to eating meals.

d.

pregnant woman who takes iron supplements.

ANS: A

Hemosiderosis is most likely to occur in a man with high alcohol intake. Adolescents who have high intake of soft drinks are likely to have high intake of phosphorus. Toddlers who prefer to drink milk rather than eating meals may develop iron deficiency. Pregnant women who take iron supplements are unlikely to store too much iron because iron needs are very high during pregnancy.

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25. In countries where the staple food source is unleavened bread made from whole grains, zinc deficiency may be prevented by eating

a.

refined grains.

b.

breads with yeast.

c.

fortified grains.

d.

bread in which the grains were soaked before being baked.

ANS: B

Zinc deficiency may be prevented by making breads with yeast; the yeast breaks the bond between the zinc and phytic acid, which prevents zinc from being absorbed. Eating refined grains would result in even lower zinc intake; fortification of grains does not include adding zinc; and soaking grains before making bread does not release the zinc from the phytic acid.

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26. The most reliable source of iodine in the United States is

a.

seafood.

b.

dairy products.

c.

fortified table salt.

d.

residues of cleaning products.

ANS: C

The main source of iodine in the United States is fortified table salt. Seafood is a good source, but most Americans do not eat it often enough for it to be their main source of iodine. Dairy products may contain some iodine, depending on the animal that produced them, but they are not reliable sources. Residues of cleaning products may provide some dietary iodine, but the amount is not usually enough to be significant.

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27. A client feels constantly tired even though she is getting 8 hours of sleep each night, and she is gaining about 2 lbs a month even though she has not changed her eating habits. You discover that she eats only organic and natural foods and avoids anything that is fortified. She may have a deficiency of

a.

iron.

b.

zinc.

c.

potassium.

d.

iodine.

ANS: D

Deficiency of iodine causes lethargy and weight gain; the most reliable source of iodine is iodized salt, but if the client avoids fortified foods, she may be avoiding this valuable source. Iron deficiency would cause anemia and tiredness, but not weight gain. Deficiency of zinc impairs growth, reduces appetite, and causes immunologic disorders. Deficiency of potassium causes muscle weakness, confusion, decreased appetite, and, in severe cases, cardiac dysrhythmias. Foods are not usually fortified with iron, zinc, and potassium, and so avoiding fortified foods would not necessarily affect intake of these nutrients.

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28. Dietary fluoride is important for

a.

decreasing staining of teeth.

b.

decreasing sensitivity of teeth.

c.

stimulating production of saliva.

d.

increasing the strength of tooth enamel.

ANS: D

Dietary fluoride is important for the strength of tooth enamel. It does not decrease staining or sensitivity of teeth or stimulate production of saliva.

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29. Measuring the amount of a mineral in a plant food may not necessarily indicate whether it is a valuable dietary source of that mineral because

a.

plant foods contain phytates, oxalates, and binders that reduce bioavailability.

b.

plant foods require cooking or processing to make minerals bioavailable.

c.

plants often contain inactive forms of minerals.

d.

the amount of minerals in plants varies widely, depending on growing conditions.

ANS: A

Plant foods contain phytates, oxalates, and binders that may limit the amount of a mineral that is available to the body, even if it is present in the food. Minerals may become more bioavailable with cooking or processing, but this is not necessarily true. Most minerals do not exist in different forms; they are generally either present or absent. The amount of minerals in plants may vary somewhat depending on the growing conditions, but this is less of a factor than bioavailability.

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30. Wilsons disease is an inherited disorder that causes excessive accumulation of

a.

iron.

b.

zinc.

c.

copper.

d.

chromium.

ANS: C

Wilsons disease causes excessive accumulation of copper. Excessive accumulation of iron is called hemosiderosis. Excessive accumulations of zinc and chromium do not have specific names.

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31. A good dietary source of chromium is

a.

pasta.

b.

grapes.

c.

oatmeal.

d.

cauliflower.

ANS: C

Oatmeal is a good dietary source of chromium because it is a whole grain. Good sources do not include refined grains (such as pasta), fruits, and vegetables.

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32. Apart from lowering dietary sodium intake, a dietary change that is most likely to help decrease high blood pressure levels is

a.

decreasing intake of dairy products.

b.

increasing intake of vegetable protein.

c.

increasing intake of calcium and potassium.

d.

replacing saturated fats with polyunsaturated fats.

ANS: C

Dietary changes that may help decrease high blood pressure include increasing intake of calcium and potassium. This could be accomplished by increasing, rather than decreasing, intake of dairy products. Intake of vegetable versus animal protein and replacing saturated fats with polyunsaturated fats do not decrease blood pressure, although these changes may have other health benefits.

DIF: Cognitive Level: Analyzing REF: Page 138 | Pages 146-147

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33. A wife who blames her high blood pressure on her husbands preference for salty foods is an example of

a.

denial.

b.

chaining.

c.

reframing.

d.

projection.

ANS: D

A wife who blames her high blood pressure on her husbands preference for salty foods is an example of projection. She is projecting her unhealthy behaviors on her husband instead of taking responsibility for her own health. Denial would be ignoring the problem. Chaining would be associating one behavior with another. Reframing would be replacing negative expectations and associations with positive ones.

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