Chapter 26: Concepts of Basic Nutrition and Cultural Considerations My Nursing Test Banks

Chapter 26: Concepts of Basic Nutrition and Cultural Considerations

Test Bank

MULTIPLE CHOICE

1. The nurse reminds the patient that the salivary glands excrete saliva, which initiates the digestion of:

a.

proteins.

b.

starches.

c.

fats.

d.

fiber.

ANS: B

Saliva initiates the digestion of starches.

DIF: Cognitive Level: Knowledge REF: p. 453 OBJ: Theory #1

TOP: Functions of the Gastrointestinal System

KEY: Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity: physiological adaptation

2. The nurse is aware that vitamin B12 is absorbed in the:

a.

stomach.

b.

large intestine.

c.

liver.

d.

gallbladder.

ANS: A

Vitamin B12, an aid in hemoglobin syntheses, is absorbed in the stomach through the action of the intrinsic factor, which is secreted from the stomach wall.

DIF: Cognitive Level: Knowledge REF: p. 453 OBJ: Theory #1

TOP: Absorption of Vitamins KEY: Nursing Process Step: Planning

MSC: NCLEX: Physiological Integrity: physiological adaptation

3. The nurse emphasizes the dietary recommendations made by the American Heart Association is to limit cholesterol intake to _____ mg/day.

a.

300

b.

400

c.

425

d.

500

ANS: A

The American Heart Association recommends an intake of cholesterol to 300 mg/day or less.

DIF: Cognitive Level: Knowledge REF: p. 455, Box 26-1

OBJ: Theory #4 TOP: Dietary Recommendations

KEY: Nursing Process Step: Planning

MSC: NCLEX: Health Promotion and Maintenance: prevention and early detection of disease

4. A patient refuses to eat all types of meat, which has led to a protein deficiency. The nurse recognizes that the only plant source that contains all nine essential amino acids is:

a.

bean sprouts.

b.

lima beans.

c.

kidney beans.

d.

soybeans.

ANS: D

Soybeans are the only plant source that provides all nine essential amino acids.

DIF: Cognitive Level: Knowledge REF: p. 455 OBJ: Clinical Practice #1

TOP: Sources of Protein KEY: Nursing Process Step: Planning

MSC: NCLEX: Health Promotion and Maintenance: detection and early prevention of disease

5. A patient weighing 132 pounds has been recommended to increase daily protein intake. The nurse assists the patient to make dietary selections of protein after calculating that the daily protein requirement for this patient is _____ g.

a.

24

b.

36

c.

48

d.

60

ANS: C

The protein requirement for the day is equal to the number of kilograms of weight (convert lb to kg) multiplied by 0.8 (i.e., 132/2.2 = 48).

DIF: Cognitive Level: Analysis REF: p. 456 OBJ: Clinical Practice #3

TOP: Dietary Protein Recommendation KEY: Nursing Process Step: Planning

MSC: NCLEX: Health Promotion and Maintenance: prevention and early detection of disease

6. The nurse consults with a patient who is a vegan and stresses that this diet puts the patient at risk for:

a.

diabetes.

b.

iron deficiency.

c.

osteoporosis

d.

scurvy.

ANS: B

In the vegan diet, all animal food sources are excluded, placing a patient who eats this diet most at risk for deficient intake of protein leading to an iron deficiency.

DIF: Cognitive Level: Comprehension REF: p. 456 OBJ: Clinical Practice #1

TOP: Vegan Diets KEY: Nursing Process Step: Assessment

MSC: NCLEX: Health Promotion and Maintenance: prevention and early detection of disease

7. The nurse in a long-term care facility understands that the 86-year-old residents frequent complaints about heartburn are most likely due to the age-related decreased:

a.

peristalsis.

b.

gag reflex.

c.

appetite.

d.

sphincter tone.

ANS: D

The age-related loss of muscle tone in the sphincters increases the incidence of heartburn and esophageal reflux.

DIF: Cognitive Level: Comprehension REF: p. 454 OBJ: Theory #63

TOP: Planning KEY: Nursing Process Step: Evaluation

MSC: NCLEX: Health Promotion and Maintenance: prevention and early detection of disease

8. The patient states that he uses a large amount of table sugar (sucrose) in his foods because it gives him quick energy. The nurse explains that sucrose will:

a.

quickly raise the blood sugar, and the level drops slowly.

b.

not raise the blood sugar as quickly as a protein source will.

c.

cause a hunger and energy lag because of the rapid fall of the blood sugar.

d.

also act as a good support to the digestion of fiber.

ANS: C

Table sugar is high in sucrose, which is quickly absorbed into the bloodstream and can cause rapid rises and falls in blood glucose, which leads to hunger and an energy lag.

DIF: Cognitive Level: Comprehension REF: p. 457 OBJ: Theory #2

TOP: Simple Carbohydrates KEY: Nursing Process Step: Implementation

MSC: NCLEX: Health Promotion and Maintenance: prevention and early detection of disease

9. The nurse evaluates the patients understanding of the fiber content of grains and cereals when the patient selects:

a.

white bread toast with an orange.

b.

wheat bread toast with a peeled apple.

c.

shredded wheat and a banana.

d.

a biscuit and a grapefruit.

ANS: C

Shredded wheat and a banana contain a total of 6 g of fiber per serving, whereas wheat toast with an apple contain a total of 4 g, white bread with a banana contain a total of 3 g, and a biscuit with a grapefruit contain a total of 4 g.

DIF: Cognitive Level: Comprehension REF: p. 458, Table 26-1

OBJ: Theory #3 TOP: Fiber KEY: Nursing Process Step: Evaluation

MSC: NCLEX: Health Promotion and Maintenance: prevention and early detection of disease

10. A patient has been placed on a reduced-cholesterol diet to help control heart disease. The serving that would be most appropriate for the patient to select for supper is:

a.

3 ounces of tuna canned in water.

b.

1 frankfurter.

c.

1 3-ounce pork chop.

d.

chicken breast with skin.

ANS: A

The tuna canned in water contains only 2 g of fat, whereas the highest fat grams are found in the pork chop (19 g) followed by the chicken breast with skin (18 g).

DIF: Cognitive Level: Application REF: p. 459, Table 26-2

OBJ: Theory #9 TOP: Cholesterol KEY: Nursing Process Step: Implementation

MSC: NCLEX: Health Promotion and Maintenance: prevention and early detection of disease

11. The nurse points out to the newly diagnosed type 2 diabetic patient that complex carbohydrates:

a.

do not affect the blood sugar level.

b.

keep the blood sugar at an unsatisfactory high level.

c.

lack adequate nutritional potential.

d.

maintain a more consistent blood sugar level.

ANS: D

Complex carbohydrates (pasta, cereal, rice) provide a more consistent blood sugar level that simple sugars.

DIF: Cognitive Level: Application REF: p. 457 OBJ: Clinical Practice #4

TOP: Vitamins KEY: Nursing Process Step: Implementation

MSC: NCLEX: Health Promotion and Maintenance: prevention and early detection of disease

12. When a patient asks how is a good way to increase fiber in the diet, the nurses best response would be:

a.

eating unpeeled apples.

b.

increase intake of dark leafy greens.

c.

eating broiled salmon.

d.

taking daily concentrated fiber supplements.

ANS: A

Eating the skins of fruits is a good source of fiber. Fiber concentrates do not contain needed vitamins and minerals.

DIF: Cognitive Level: Application REF: p. 457 OBJ: Clinical Practice #4

TOP: Fiber KEY: Nursing Process Step: Planning

MSC: NCLEX: Health Promotion and Maintenance: prevention and early detection of disease

13. The LPN/LVN filling out the Jewish patients dietary menu for lunch would avoid ordering:

a.

meat and fish.

b.

milk and vegetables.

c.

meat and milk.

d.

vegetables and fruit.

ANS: C

Common food practices in Judaism include not eating meat and milk at the same meal.

DIF: Cognitive Level: Application REF: p. 469, Table 26-7

OBJ: Theory #7 TOP: Nutrition and Culture/Religion

KEY: Nursing Process Step: Implementation

MSC: NCLEX: Psychosocial Integrity: coping and adaptation

14. A nurse takes into consideration that the usual diet of Asian Americans has a potential for altering health because the diet is high in:

a.

protein.

b.

starch.

c.

sodium.

d.

vitamin C.

ANS: C

The Asian diet is high in sodium and fat.

DIF: Cognitive Level: Comprehension REF: p. 466 OBJ: Theory #7

TOP: Nutrition and Culture/Religion KEY: Nursing Process Step: Planning

MSC: NCLEX: Health Promotion and Maintenance: prevention and early detection of disease

15. The mother of a 4-month-old infant asks what type of cereal is most appropriate to feed the infant as a first solid food. The best response from the nurse is to suggest:

a.

wheat.

b.

barley.

c.

corn.

d.

rice.

ANS: D

A cereal such as rice is the best initial choice, because it is easily tolerated, provides additional calories and iron, and is least likely to be allergenic.

DIF: Cognitive Level: Comprehension REF: p. 466 OBJ: Theory #8

TOP: Nutritional Needs Across the Life Span

KEY: Nursing Process Step: Implementation

MSC: NCLEX: Health Promotion and Maintenance: growth and development

16. A mother is concerned that her toddler is not eating enough at mealtimes. The most informative suggestion by the nurse would be to:

a.

provide large servings to stimulate appetite.

b.

provide single-item foods that do not touch each other on the plate.

c.

increase the amount of milk at each meal.

d.

use plain white dishes to keep attention focused on food.

ANS: B

Toddlers prefer single-item foods in small quantities that do not touch each other on a colorful plate. Milk intake should decrease during the toddler years as solid food takes the place of milk.

DIF: Cognitive Level: Application REF: p. 467 OBJ: Theory #8

TOP: Nutritional Needs Across the Life Span

KEY: Nursing Process Step: Implementation

MSC: NCLEX: Health Promotion and Maintenance: growth and development

17. On assessment, the nurse finds that the female patient has a BMI of 26, a waist of 37 inches, pale conjunctiva, and a large muscle mass. The indicator of this patient being overweight is:

a.

BMI level.

b.

waist measurement.

c.

conjunctiva.

d.

large muscle mass.

ANS: B

A waist measurement in women of over 35 is an indicator of greater risk for overweight and disease.

DIF: Cognitive Level: Analysis REF: p. 470 OBJ: Clinical Practice #2

TOP: Physical Signs of Obesity KEY: Nursing Process Step: Assessment

MSC: NCLEX: Health Promotion and Maintenance: prevention and early detection of disease

18. The nursing action that is most beneficial toward creating an atmosphere conducive to eating for a hospitalized patient immobilized in bed is:

a.

lower the head of bed as tolerated.

b.

remove the urinal from the over-the-bed table.

c.

invite the patient to wash hands and face before eating.

d.

use a deodorizer to remove any unpleasant odor in the room.

ANS: B

Remove distracting articles such as the urinal and emesis basin.

DIF: Cognitive Level: Application REF: p. 472 OBJ: Theory #6

TOP: Promoting Appetite KEY: Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity: basic care and comfort

19. The nurse is delivering a meal tray to a patient in a skilled nursing facility who is a Muslim. The nurse should confirm the meal is free of:

a.

raw fruits.

b.

eggplant.

c.

pork.

d.

lamb.

ANS: C

People of the Muslim faith are prohibited from eating pork.

DIF: Cognitive Level: Application REF: p. 467, Table 26-7

OBJ: Theory #7 TOP: Culture and Nutrition

KEY: Nursing Process Step: Implementation

MSC: NCLEX: Psychosocial Integrity: coping and adaptation

20. The nurse would be sure the diet of a patient in an extended care facility who has a large pressure ulcer on his sacrum would include foods rich in vitamin:

a.

A.

b.

B1 (thiamine).

c.

C.

d.

E.

ANS: C

Vitamin C helps protect the body against infections and promotes wound healing.

DIF: Cognitive Level: Application REF: p. 462, Table 26-4

OBJ: Theory #2 TOP: Vitamins KEY: Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity: physiological adaptation

21. The nurse is visiting an elderly patient who lives alone. The suggestion made by the nurse that would be most helpful in improving the patients nutrition would be:

a.

keep the environment noise free to concentrate on eating.

b.

decrease intake of fluids to improve appetite.

c.

use salt as needed to spice up the flavor of foods.

d.

cook favorite foods in bulk and freeze in individual serving containers.

ANS: D

Cooking and freezing favorite foods for easy preparation later is helpful in improving the overall nutrition of an elderly patient.

DIF: Cognitive Level: Application REF: p. 469, Patient Teaching

OBJ: Clinical Practice #1 TOP: Nutritional Needs Across the Life Span

KEY: Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity: basic care and comfort

22. When assisting with the nutritional assessment of a newly admitted, confused, emaciated cancer patient, the nurses most beneficial intervention to support the nutritional status of this patient would be to:

a.

obtain the information from the family.

b.

ask simple questions of the patient.

c.

ask for a dietitian consult.

d.

request an order for a full liquid diet.

ANS: C

A dietitian should be consulted if the patient has high nutritional needs.

DIF: Cognitive Level: Application REF: p. 462 OBJ: Theory #9

TOP: Nutritional Assessment KEY: Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity: basic care and comfort

23. The nurse caring for a patient with human immunodeficiency syndrome HIV would encourage the intake of greater amounts of:

a.

vitamin D.

b.

protein.

c.

vitamin C.

d.

raw fruits and vegetables.

ANS: B

Patients with HIV lose muscle mass and need to increase their nutritional intake in the form of extra calories and protein.

DIF: Cognitive Level: Comprehension REF: p. 464 OBJ: Clinical Practice #4

TOP: Nutrition for HIV patient KEY: Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity: basic care and comfort

24. The home health nurse is visiting an elderly patient with a history of malnutrition and memory loss. The nurse addresses the nutritional needs of the patient by:

a.

writing down all the information for the patient.

b.

giving the patient MyPlate for reference.

c.

involving the family.

d.

making out a grocery list for the patient.

ANS: C

The patient may not be able to remember what needs to be done, and involving the family will help in meeting the patients needs.

DIF: Cognitive Level: Application REF: p. 469 OBJ: Clinical Practice #1

TOP: Malnutrition KEY: Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity: reduction of risk

25. A patient of Mexican-American descent has a blood pressure of 160/90 mm Hg and is moderately obese. The nurse can help the patient modify his diet by suggesting:

a.

decreasing spices when cooking.

b.

avoiding fried foods altogether.

c.

limiting corn tortillas to two per day.

d.

substituting the use of lard with canola oil.

ANS: D

Canola oil is an unsaturated fat, whereas lard is saturated, and saturated fats should be limited to 10% of total fat intake.

DIF: Cognitive Level: Application REF: p. 459 OBJ: Clinical Practice #4

TOP: Patient Education KEY: Nursing Process Step: Implementation

MSC: NCLEX: Health Promotion and Maintenance: prevention and early detection of disease

COMPLETION

26. The nurse takes into consideration that the patient with pernicious anemia who lacks the intrinsic factor cannot absorb ________.

ANS:

vitamin B12

The intrinsic factor excreted by the wall of the stomach allows the absorption of vitamin B12

DIF: Cognitive Level: Knowledge REF: p. 462, Table 26-4

OBJ: Theory #5 TOP: Pernicious Anemia

KEY: Nursing Process Step: Planning

MSC: NCLEX: Physiological Integrity: physiological adaptation

27. The nurse uses a chart to show an obese patient who is trying to lose weight by counting calories that each gram of carbohydrate supplies _____ calories.

ANS:

4

four

One gram of carbohydrate supplies 4 calories.

DIF: Cognitive Level: Knowledge REF: p. 457 OBJ: Clinical Practice #4

TOP: Calories KEY: Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity: basic care and comfort

28. The portion of carbohydrates that cannot be broken down by intestinal enzymes and juices is ________.

ANS:

fiber

Fiber is the portion of carbohydrates that cannot be broken down by intestinal flora.

DIF: Cognitive Level: Knowledge REF: p. 457 OBJ: Theory #4

TOP: Theory #2 KEY: Nursing Process Step: N/A MSC: NCLEX: N/A

MULTIPLE RESPONSE

29. The nurse stresses to a patient that proteins, one of the biochemical substances used by the body, can be found in: (Select all that apply.)

a.

eggs.

b.

glucose.

c.

yogurt.

d.

fish.

e.

soybeans.

f.

nuts.

ANS: A, C, D, E, F

Sources of protein are meats, poultry, fish, eggs, dairy products, cereals, grains, legumes, most vegetables, and soybeans.

DIF: Cognitive Level: Comprehension REF: pp. 455-456 OBJ: Theory #3

TOP: Nutrition KEY: Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity: physiological adaptation

30. When a nurse performs a nutritional assessment on a patient with HIV, what is important to include? (Select all that apply.)

a.

Source of illness

b.

Family and social history

c.

Patients education

d.

Income level

e.

Physical assessment

ANS: B, C, D, E

All are factors that can influence the patients nutritional status with the exception of the source of illness.

DIF: Cognitive Level: Application REF: p. 469 OBJ: Clinical Practice #2

TOP: Nutritional Assessment KEY: Nursing Process Step: Assessment

MSC: NCLEX: Physiological Integrity: basic care and comfort

31. The nurse instructs the patient on a vegetarian diet that protein intake can be supported by including complementary proteins in the diet with such foods as: (Select all that apply.)

a.

bean soup with cornbread.

b.

tofu stir-fried with vegetables.

c.

peanut butter on whole wheat bread.

d.

apples and cheese.

e.

lean fish with green beans.

ANS: A, B, C

Complementary proteins are plant source foods combined to achieve a complete protein intake. Beans, tofu, and peanut butter are all examples of complementary proteins.

DIF: Cognitive Level: Application REF: p. 455 OBJ: Theory #3

TOP: Complementary proteins KEY: Nursing Process Step: Implementation

MSC: NCLEX: Health Promotion and Maintenance: prevention and early detection of disease.

32. The nurse reminds the patient that adequate fiber in the diet has many health benefits, which include: (Select all that apply.)

a.

improves elimination.

b.

decreases blood glucose levels in diabetics.

c.

delays the absorption of carbohydrates from the intestine.

d.

enhances absorption of vitamin D.

e.

decreases the absorption of fat.

ANS: A, B, C, E

Dietary fiber adds bulk to the stool for better elimination. Fiber also delays the absorption of fats and carbohydrate, which lowers the blood sugar levels in diabetics.

DIF: Cognitive Level: Analysis REF: p. 457 OBJ: Theory #3

TOP: Function of Fiber KEY: Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity: physiological adaptation

33. The nurse points out that the advantages of breast-feeding include that breast milk: (Select all that apply.)

a.

provides immunity to most childhood diseases for several months.

b.

causes no allergies.

c.

should be supplemented with vitamin D.

d.

encourages growth of normal bacterial flora in the bowel.

e.

contains both fat-soluble and water-soluble vitamins.

ANS: A, B, D, E

Breast milk provides total nutrition, provides immunity to most childhood diseases for the few several months of life, causes no allergies, encourages normal bacterial flora in the bowel, and has both fat and water soluble vitamins.

DIF: Cognitive Level: Application REF: p. 466 OBJ: Theory #8

TOP: Breast Feeding KEY: Nursing Process Step: Implementation

MSC: NCLEX: Health Promotion and Maintenance: growth and development

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