Chapter 33: Nutrition My Nursing Test Banks

Chapter 33: Nutrition

Potter: Essentials for Nursing Practice, 8th Edition

MULTIPLE CHOICE

1.A patient who has high cholesterol asks the nurse if there is a need to limit all fat in the diet to lower cholesterol. What is the nurses best response?

a.

You should limit the amount of monounsaturated fats.

b.

You should limit the amount of unsaturated fatty acids.

c.

You should limit the amount of saturated fats.

d.

You should not limit the amount of any kind of fat.

ANS: C

Ingestion of saturated fatty acids appears to increase blood cholesterol levels. Monounsaturated fatty acids appear to lower blood cholesterol levels. Ingestion of unsaturated fatty acids has a minimal effect on blood cholesterol. Saturated fats should be limited to lower cholesterol.

PTS:1DIF:Cognitive Level: Applying (Application)

REF:906

OBJ:Explain the significance of saturated, unsaturated, and polyunsaturated lipids in nutrition.TOP:Nursing Process: Implementation

MSC: Client Needs: Health Promotion and Maintenance

2.The nurse who works on the oncology unit understands the importance of nutrition and the disease process. Which patient should the nurse be most concerned about from a nutritional standpoint?

a.

A patient with cervical cancer

b.

A patient with liver cancer

c.

A patient with prostate cancer

d.

A patient with colon cancer

ANS: B

Absorbed nutrients are carried to the liver, where major metabolic processes occur. The liver also regulates energy through its control of glucose metabolism. Glucose is the primary fuel for the body. The liver and muscles store glucose in the form of glycogen via a process called glycogenesis. The prostate does not contribute to the digestion system. Cervical cancer does not contribute to digestion but does affect the reproductive system. The colon is used to eliminate solid waste material from the body.

PTS:1DIF:Cognitive Level: Analyzing (Analysis)

REF:907

OBJ: Identify nutritional problems and describe a patient at risk for these problems.

TOP: Nursing Process: Planning MSC: Client Needs: Physiological Integrity

3.A 14-year old patient with cancer is concerned about diet, and questions the need for vitamins to supplement the diet. The patient states, I dont think my diet alone is providing the upper intake levels (ULs) of vitamins that I need. What is the best response from the nurse?

a.

You should try to get your vitamins from food, rather than a supplement.

b.

You should be trying to achieve the recommended dietary allowances (RDA).

c.

You should compare your diet to the UL for children, not the UL for adults.

d.

You shouldnt worry about vitamins as long as you are getting enough calories.

ANS: B

The tolerable UL is the highest level that likely poses no risk for adverse health events. It is not a recommended level of intake. There are four components to the DRIs: estimated average requirement (EAR), recommended dietary allowances (RDAs), adequate intakes (AIs), and tolerable upper intake levels (ULs). The EAR is the recommended amount of a nutrient that appears sufficient to maintain a specific body function for 50% of the population based on age and gender. The RDA is the average needs of 98% of the population, not the exact needs of an individual. The AI is the suggested intake for individuals based on observed or experimentally determined estimates of nutrient intakes by groups and is provided when there is insufficient evidence to set an RDA. You shouldnt worry is false reassurance and should not be used. The patient needs to be educated on not using the ULs as a measure of intake, not that vitamins from food are better than supplements.

PTS:1DIF:Cognitive Level: Analyzing (Analysis)

REF:90BJ:Explain dietary guidelines.

TOP:Nursing Process: Implementation

MSC: Client Needs: Health Promotion and Maintenance

4.A student nurse is completing a community health rotation. One of the clients is a pregnant teen. The student nurse has been teaching the client about infant nutrition. Which statement indicates to the student nurse that the client needs additional teaching?

a.

Breast milk is all my baby will need for the first 4 to 6 months.

b.

Breast milk should be the major source of nutrition for the first year.

c.

My baby wont need as many calories per kilogram as I will.

d.

Breastfeeding my baby will decrease the chances for food allergies.

ANS: C

The baby needs more calories than the mother, so this misinformation needs to be clarified. The woman who is lactating needs 500 kcal/day above the usual allowance because the production of milk increases energy requirements. Infants need an energy intake of approximately 108 kcal/kg of body weight in the first half of infancy and 98 kcal/kg in the second half. Infants need about 100 to 120 mL/kg/day of fluid because a large portion of total body weight is water. The American Academy of Pediatrics recommends breast milk or formula as the major source of food for up to 1 year in age. Breast milk or formula provides sufficient nutrition for the first 4 to 6 months of life. The benefits of breastfeeding include reduced food allergies and intolerances, fewer infant infections, and easier digestion. In addition, breast milk is convenient, fresh, always the correct temperature, and economical, because it is less expensive than formula. Infants should not have regular cows milk during the first year of life. Infants receiving cows milk have been found to have lower intakes of iron, linoleic acid, and vitamin E; and excessive amounts of sodium, potassium, and protein.

PTS:1DIF:Cognitive Level: Analyzing (Analysis)

REF:910

OBJ:Establish a plan of care to meet the nutritional needs of a patient.

TOP:Nursing Process: Evaluation

MSC: Client Needs: Health Promotion and Maintenance

5.A nurse is asked how many kilocalories per gram (kcal/g) carbohydrates and protein can provide. How should the nurse reply?

a.

2 kcal/g

b.

4 kcal/g

c.

9 kcal/g

d.

12 kcal/g

ANS: B

Carbohydrates and protein are sources of energy, each providing 4 kilocalories per gram (kcal/g). Lipids are a source of energy, providing 9 kcal/g. Two kcal/g is too small; 12 kcal/g is too high.

PTS: 1 DIF: Cognitive Level: Remembering (Knowledge)

REF:905

OBJ: List the end products of carbohydrate, protein, and lipid metabolism.

TOP:Nursing Process: Implementation

MSC: Client Needs: Health Promotion and Maintenance

6.Which information from the patient indicates teaching by the nurse was successful about the vitamin that is synthesized in the intestine?

a.

It is vitamin A.

b.

It is vitamin B6.

c.

It is vitamin K.

d.

It is vitamin D.

ANS: C

The body is unable to synthesize vitamins in the required amounts and depends on dietary intake. The exception to this is vitamin K, which the body synthesizes by bacteria in the intestine. In addition, the body produces vitamin D as a response to sunlight exposure. Vitamin A and B6 must be obtained from the diet.

PTS:1DIF:Cognitive Level: Applying (Application)

REF:906OBJ:Explain dietary guidelines.

TOP:Nursing Process: Evaluation

MSC: Client Needs: Health Promotion and Maintenance

7.The patient has been admitted to the cardiac unit with a diagnosis of heart failure. The patient is currently receiving furosemide (Lasix) and is on a low-sodium diet. Which of the following is the best way for the nurse to determine if the patient is retaining fluid?

a.

Figuring the patients body mass index

b.

Calculating the patients ideal body weight

c.

Recording daily weights during hospitalization

d.

Measuring all fluid intake

ANS: C

Serial measures of weight over time provide more useful information than one measurement. When collecting serial measurements of weight, weigh the patient about the same time each day, on the same scale, and with the same amount of clothing. In some patients, a weight change of 2 pounds in 24 hours is significant because 1 pound is roughly equivalent to 500 mL of fluid. Ideal body weight is a standard for height-weight relationships, not fluid. Body mass index is a standard for weight and body fat, not fluid. Measuring all fluid intake does not include the whole picture because this must be related to the output to determine if the patient is retaining fluid.

PTS:1DIF:Cognitive Level: Analyzing (Analysis)

REF:915

OBJ:Establish a plan of care to meet the nutritional needs of a patient.

TOP: Nursing Process: Implementation MSC: Client Needs: Physiological Integrity

8.The patient was admitted with the diagnosis of a stroke. The patient experiences dysphagia and right side paralysis and needs assistance with activities of daily living (ADLs). The nurse caring for the patient has assigned the task of feeding the patient to the new nursing assistant personnel (NAP), and is concerned about aspiration. The nurse knows additional teaching is necessary when NAP states which of the following?

a.

I will remind the patient to tilt the head backward when drinking fluids.

b.

Thin fluids like water and fruit juice will need to be thickened.

c.

I need to watch for pocketing food as I feed the patient.

d.

It will take much longer to feed the patient than it did before the stroke.

ANS: A

Remind the patient to not tilt head backward when eating or while drinking because this may cause food and liquid to be misdirected into the airway. Thin liquids such as water and fruit juice are difficult to control in the mouth and pharynx and are more easily aspirated so these need to be thickened. It will take much longer to feed and pocketing food are both correct.

PTS:1DIF:Cognitive Level: Analyzing (Analysis)

REF:933 | 934

OBJ: Discuss methods for feeding patients who require assistance with oral intake.

TOP:Nursing Process: Evaluation

MSC: Client Needs: Safe and Effective Care Environment

9.A 34-year-old mother delivered her third child 1 year ago. She tells the nurse that her New Years resolution is to lose the 15 pounds that she gained with this pregnancy over the next month. Which of the following is the best statement that the nurse can make to help the patient achieve her weight loss goal?

a.

I dont think you need to lose the weight; you look fine as you are.

b.

The weight will come off by itself because you are breastfeeding.

c.

Lets talk about giving yourself a realistic timeframe to lose it.

d.

That is a realistic, healthy goal for you to have.

ANS: C

Helping the patient set a realistic time frame will be most therapeutic. Patients often have unrealistic expectations about nutritional needs or dieting in reference to weight gain or loss. Help patients understand this concept by asking them to reflect on their rate of weight gain or loss. Changes in weight usually occur over months or years unless an acute illness has occurred. I dont think you need to lose the weight is the nurses opinion and is not therapeutic. The child is 1 year old, breastfeeding probably is not occurring, and it is not an accurate statement. It is not healthy or realistic to lose weight fast; recommended weight loss is  to 1 lb per week.

PTS:1DIF:Cognitive Level: Analyzing (Analysis)

REF:921

OBJ:Establish a plan of care to meet the nutritional needs of a patient.

TOP:Nursing Process: Implementation

MSC: Client Needs: Health Promotion and Maintenance

10.A patient wants to lose 17 pounds. The nurse is aware that the most successful long-term weight loss programs are which of the following?

a.

Programs that get the weight off quickly

b.

Programs that include awareness of portion sizes

c.

Programs that focus on reducing bad carbohydrates

d.

Programs that use purchased premeasured food

ANS: B

A successful weight-loss plan involves sustainable lifestyle modifications that include physical activity, self-monitoring, portion control, and knowledge of energy content of food. Getting the weight off quickly is not healthy. The Dietary Approaches to Stop Hypertension has shown to reduce blood pressure and focuses on reducing the bad cholesterol, not the bad carbohydrates. There is a lack of good evidence evaluating the effectiveness of commercial weight-loss programs.

PTS:1DIF:Cognitive Level: Applying (Application)

REF:907 | 908 | 921

OBJ: Explain the importance of a balance between energy intake and output.

TOP:Nursing Process: Planning

MSC: Client Needs: Health Promotion and Maintenance

11.A patient with head trauma is scheduled for a gastrostomy tube to be inserted. The spouse asks the nurse why an intravenous (IV) cannot be used. What is the nurses best response?

a.

The gastrostomy tube will allow us to give medications as well as feedings.

b.

Research has shown that a gastrostomy tube is safer for patients and maintains function of the gut.

c.

It will be more expensive in the long run to use a gastrostomy tube than an IV.

d.

The gastrostomy placement is noninvasive, and the patient will be more content being fed through the stomach.

ANS: B

Research has demonstrated a beneficial effect of enteral nutrition over parenteral routes in patients with a functional GI tract. Therefore enteral feeding is preferred over parenteral nutrition (intravenous nutrition) because it improves use of nutrients, is generally safer for patients, maintains structure and function of the gut, decreases the risk for infection and sepsis, and is less expensive, not more expensive. Medications can also be given through an IV, so this does not answer the spouses question. The gastrostomy placement is invasive as the tube is inserted directly into the stomach.

PTS:1DIF:Cognitive Level: Analyzing (Analysis)

REF:926

OBJ: Discuss methods for feeding patients who require assistance with oral intake.

TOP: Nursing Process: Implementation MSC: Client Needs: Physiological Integrity

12.A patient is receiving intermittent enteral tube feedings. When introducing a feeding to this patient, what is the first thing the nurse needs to do?

a.

Place the patient in a supine position.

b.

Irrigate the tube with normal saline.

c.

Check to see that the tube is in the proper position.

d.

Introduce a small amount of fluid into the tube before the tube feeding.

ANS: C

The first step is verify tube placement; feedings instilled into a misplaced tube can cause serious injury or death. You will place the patient in Fowlers or high-Fowlers position, not supine, before starting the feeding. After checking for residual, flush the feeding tube with 30 mL of water, not normal saline. Fluid is not inserted until placement is verified.

PTS:1DIF:Cognitive Level: Applying (Application)

REF:924 | 942

OBJ: Describe the procedure for initiating and maintaining enteral tube feedings.

TOP: Nursing Process: Implementation MSC: Client Needs: Physiological Integrity

13.A new mother is breastfeeding her infant. The nurse asks the mother if she is getting the correct amounts of dietary reference intakes. Which statement from the mother indicates a correct understanding of dietary guidelines?

a.

I am not concerned about dietary guidelines or a strict diet.

b.

I am taking the vitamin doses according to the television advertisements.

c.

I am only taking one multiple vitamin a day and eating whatever I want.

d.

I am eating the correct amount of food according to the recommended dietary allowances and adequate intakes.

ANS: D

When the mother said recommended dietary allowance, it indicated that she knew about the RDAs and the adequate intakes indicates she knew about the AI. In 1997 the Food and Nutrition Board of the National Institute of Medicine/National Academy of Sciences, in partnership with Health Canada, initiated dietary reference intakes (DRIs) in response to the increased public use of nutritional supplements. There are four components to the DRIs: estimated average requirement (EAR), recommended dietary allowances (RDAs), adequate intakes (AIs), and tolerable upper intake levels (ULs). Saying, I am not concerned about dietary guidelines or taking vitamin according to the television advertisements and eating whatever I want does not indicate a correct understanding of the DRIs.

PTS:1DIF:Cognitive Level: Analyzing (Analysis)

REF:90BJ:Explain dietary guidelines.

TOP:Nursing Process: Evaluation

MSC: Client Needs: Health Promotion and Maintenance

14.A patient presents to an ambulatory care clinic reporting a lack of energy and tiredness. One of several assessments the nurse wants to make is a diet history. To perform a home diet history the nurse instructs the patient to keep a journal of which of the following?

a.

All food for the last 5 days

b.

Only solid food for 3 days

c.

All food for 3 days, including one weekend day

d.

Only solid food for 3 days, including one weekend day

ANS: C

The home diet history is conducted over a 3-day period of time, including one weekend day. All food ingested is measured. Three-day food records require the use of measuring cups and scales.

PTS:1DIF:Cognitive Level: Applying (Application)

REF: 912 OBJ: Discuss the major areas of nutritional assessment.

TOP: Nursing Process: Implementation MSC: Client Needs: Physiological Integrity

15.A nurse is caring for a patient who is receiving intermittent gravity feedings through a gastrostomy tube. The patient experiences abdominal discomfort. Which action is best for the nurse to take?

a.

Cool the formula.

b.

Readjust the tube.

c.

Decrease the administration rate.

d.

Increase the concentration of the formula.

ANS: C

Gradual emptying of tube feeding by gravity reduces risk for abdominal discomfort, vomiting, or diarrhea induced by bolus or too-rapid infusion of tube feedings. It is the patients meal and should be delivered in the amount of the time a well-tolerated meal is eaten. Feedings should be at room temperature. Cold formula causes gastric cramping and discomfort. Always determine tube placement, not readjustment, before beginning tube feedings. Always administer feedings as prescribed to ensure that the patient is receiving the ordered nutrients. Increasing the concentration of the formula will cause the patient to receive an inappropriate amount.

PTS:1DIF:Cognitive Level: Analyzing (Analysis)

REF:942 | 944

OBJ: Describe the procedure for initiating and maintaining enteral tube feedings.

TOP: Nursing Process: Implementation MSC: Client Needs: Physiological Integrity

16.A patient needs nutritional counseling after a myocardial infarction to assist in reducing cholesterol level. The nurse would recommend that the patient should eat foods that are high in which type of fat?

a.

Animal fat

b.

Trans fat

c.

Triglyceride fat

d.

Vegetable fat

ANS: D

Most vegetable fats have higher amounts of unsaturated and polyunsaturated fatty acids, which have a minimal effect on blood cholesterol. Animal fats are high in saturated fatty acids, which increase blood cholesterol. Approximately 98% of all lipids in food and 90% of all lipids in the human body are in the form of triglycerides, which have been linked to cardiovascular disease. Trans fatty acids are created when vegetable oils are hydrogenated in food processing; they raise bad cholesterol while lowering good cholesterol.

PTS:1DIF:Cognitive Level: Applying (Application)

REF:906

OBJ:Explain the significance of saturated, unsaturated, and polyunsaturated lipids in nutrition.TOP:Nursing Process: Implementation

MSC: Client Needs: Health Promotion and Maintenance

17.During a nutritional assessment the nurse finds that a patients energy needs exceed nutritional intake. What other assessment finding will the nurse observe?

a.

Weight gain

b.

Weight loss

c.

Anabolism

d.

Excessive adipose tissue

ANS: B

When patients energy needs exceed nutritional intake, weight loss will occur. Energy balance occurs when energy requirements equal energy intake. In general, when a person exceeds his or her energy needs or his or her needs are insufficient, the person either gains or loses weight, respectively. Weight is gained when nutritional intake is more than the body needs. Anabolism is the production of more complex chemical substances by synthesis of nutrients needed to build or repair body tissue; this patient will experience catabolism. Excessive adipose tissue will occur when intake exceeds energy needs; this patient would have insufficient or a lack of adipose tissue. When the body has unused energy, it is stored principally in fat/adipose tissue.

PTS:1DIF:Cognitive Level: Analyzing (Analysis)

REF:907

OBJ: Explain the importance of a balance between energy intake and output.

TOP: Nursing Process: Assessment MSC: Client Needs: Physiological Integrity

18.A patient is receiving parenteral nutrition (PN). While caring for the patient receiving PN what is the nurses best action?

a.

Begin the infusion at 150 mL/hour.

b.

Maintain a consistent infusion rate.

c.

Touch the insertion site itself with a clean-gloved hand.

d.

Monitor the laboratory values on a weekly basis.

ANS: B

The solution is provided at a specified rate using an infusion pump over the course of the day to meet the patients nutritional needs. Parenteral nutrition is usually started at a lower rate, for example, 40 to 60 mL/hour, and then advanced to meet the patients goal rate as tolerance is demonstrated. If the site itself must be touched, wear a sterile glove, not a clean glove. Frequent laboratory measurements for metabolic or electrolyte abnormalities as well as assessment of fluid balance, weight trend, and the ability to heal should occur during administration. Laboratory monitoring includes frequent blood glucose testing because the high dextrose (glucose) content of the solution can easily lead to hyperglycemia and require supplemental insulin as needed. Monitoring laboratory values on a weekly basis is too long and could lead to complications.

PTS:1DIF:Cognitive Level: Applying (Application)

REF:929

OBJ: Describe the procedure for initiating and maintaining parenteral nutrition.

TOP: Nursing Process: Implementation MSC: Client Needs: Physiological Integrity

19.A college student visits the student health center. The student has become a vegan. The nurse assesses that the student is deficient in protein intake. Which food should the nurse suggest as a source of protein?

a.

Plant-based protein

b.

Poultry-based protein

c.

Egg-based protein

d.

Milk-based protein

ANS: A

Vegans eat only foods of plant origin; therefore only plant-based protein can be eaten. Ovolactovegetarians avoid meat, fish, and poultry but eat eggs and milk. Lactovegetarians drink milk but avoid eggs and other animal-based foods.

PTS:1DIF:Cognitive Level: Applying (Application)

REF:909

OBJ: Identify nutritional problems and describe a patient at risk for these problems.

TOP:Nursing Process: Implementation

MSC: Client Needs: Health Promotion and Maintenance

20.The nurse caring for a patient with dysphagia has assigned the task of feeding the patient to the new nursing assistant personnel (NAP). The nurse asks the NAP how long the patient should be upright after eating. Which answer indicates the NAP has a correct understanding?

a.

2 hours after meal time

b.

30 minutes after meal time

c.

20 minutes after meal time

d.

10 minutes after meal time

ANS: B

The patient should remain sitting upright for at least 30 to 60 minutes after the meal. Remaining upright after meals or snack reduces chance of aspiration by allowing food particles remaining in pharynx to clear. Ten to twenty minutes is not enough time, whereas 2 hours is too long.

PTS:1DIF:Cognitive Level: Analyzing (Analysis)

REF:935

OBJ: Discuss methods for feeding patients who require assistance with oral intake.

TOP: Nursing Process: Evaluation MSC: Client Needs: Physiological Integrity

21.The nurse has to insert a nasogastric tube for the purpose of temporary tube feedings. To determine the length of the tube, the nurse should use which measurement?

a.

Tip of the nose to the xiphoid process of the sternum and add an additional 20 cm

b.

Tip of the chin to the earlobe to xiphoid process of the sternum

c.

Tip of nose to the earlobe to xiphoid process of the sternum

d.

Tip of the earlobe to the nose to the umbilicus

ANS: C

Determine the length of the tube you will insert, and mark location on the tube or mark with tape. Measure the distance from the tip of nose to earlobe to xiphoid process of the sternum. Adding an additional length of half the distance from the xiphoid process to the umbilicus may aid in seating the tube further into the stomach. Add an additional 20 to 30 cm (8 to 12 inches) for a nasointestinal tube. Chin to the earlobe to the xiphoid process and the tip of the earlobe to the nose to the umbilicus will provide an inaccurate length.

PTS:1DIF:Cognitive Level: Applying (Application)

REF:937

OBJ: Describe the procedure for initiating and maintaining enteral tube feedings.

TOP: Nursing Process: Implementation MSC: Client Needs: Physiological Integrity

22.The nurse needs to verify feeding tube placement using the gastrointestinal (GI) pH measurement test. The NG tube placement was confirmed via x-ray 6 hours ago. After several attempts, the nurse is unable to aspirate GI fluid from the tube. The tube is secure and the external marking of the tube are in the original place. The patient appears to be tolerating the tube feedings and is not experiencing any distress. What should the nurse do?

a.

Contact the health care professional to order another x-ray for placement verification.

b.

Instill 60 mL of air to check the placement with a stethoscope.

c.

Increase the amount of water given to the patient to prevent GI distress.

d.

Assume the tube is in the correct place.

ANS: D

If, after repeated attempts, it is not possible to aspirate fluid from a tube that was originally established by x-ray examination to be in desired position, and (a) there are no risk factors for tube dislocation, (b) there is no change in the external marked tube length, and (c) patient is not experiencing difficulty, assume the tube is correctly placed. Another x-ray is not needed. Flushing the tube with 30 ml, not 60, of air is to help obtain the aspirate, not to check placement. Checking for placement with air is an outdated process. Increasing the water will not check placement.

PTS:1DIF:Cognitive Level: Analyzing (Analysis)

REF:928

OBJ: Describe the procedure for initiating and maintaining enteral tube feedings.

TOP: Nursing Process: Implementation MSC: Client Needs: Physiological Integrity

MULTIPLE RESPONSE

1.A patient is having a problem with wound healing. The nurse assesses the patients tray and finds that only 25% of all meals are eaten. The nurse teaches the patient that protein intake is important for what reasons? (Select all that apply.)

a.

It is essential for body tissue growth.

b.

It is essential for tissue maintenance.

c.

Essential amino acids can only be obtained from dietary sources.

d.

It is essential for repair.

e.

Negative nitrogen balance is needed for wound healing.

ANS: A, B, C, D

Protein provides energy, but because of the essential role of protein in growth, maintenance, and repair, a diet needs to provide adequate kilocalories from nonprotein sources. The body is unable to synthesize some amino acids, such as essential amino acids. The body can only obtain these from daily food sources. The body needs a positive nitrogen balance, not negative, for growth, maintenance of lean muscle mass and vital organs, and wound healing.

PTS:1DIF:Cognitive Level: Applying (Application)

REF:905

OBJ: List the end products of carbohydrate, protein, and lipid metabolism.

TOP: Nursing Process: Implementation MSC: Client Needs: Physiological Integrity

2.A school nurse is presenting a class on nutritional needs to a group of 16-year-old adolescents. When discussing a balanced diet, the objectives for Healthy People 2020, and the goals of the ChooseMyPlate program, the nurse explains to this age group that nutritional goals should include which of the following? (Select all that apply.)

a.

To balance energy expenditure and caloric intake to increase weight gain

b.

To promote food choices for a healthy lifestyle

c.

To decrease the intake of vitamins and minerals

d.

To reduce chronic disease related to diet and weight

e.

To limit fast foods because of increase in salt, fat, and calories

ANS: B, D, E

Healthy People 2020 continues the overall goal to promote health and reduce chronic disease related to diet and weight. Vitamins and mineral should not be decreased in adolescence. Calcium is essential for the rapid bone growth of adolescence. Boys also need adequate iron for muscle development. B-complex vitamins are necessary to support heightened metabolic activity during adolescence. Fast food is common and adds extra salt, fat, and kilocalories. ChooseMyPlate is directed at helping the obese and overweight population choose healthier foods and confront the obesity epidemic by providing a basic, visual guide for making food choices for a healthy lifestyle.

PTS:1DIF:Cognitive Level: Applying (Application)

REF:907 | 908

OBJ: Describe the basic food groups and their value in planning meals for good nutrition.

TOP:Nursing Process: Planning

MSC: Client Needs: Health Promotion and Maintenance

3.Which patients should be assessed for nutritional deficiencies? (Select all that apply.)

a.

Patient who scored a 13 on the mini-nutritional assessment

b.

Elderly patient on bed rest after surgery on the small intestines

c.

Patient receiving an IV of 5% dextrose

d.

School-aged patient with positive nitrogen balance

e.

Middle-age patient with rashes and easily pluckable hair

ANS: B, C, E

These types of patients should be assessed for nutritional deficiencies: congenital anomalies and surgical revisions of the gastrointestinal tract (surgery on the small intestines) interfere with normal function; patients receiving only intravenous infusion of 5% to 10% dextrose are at risk for nutritional deficiencies. The skin and hair are primary areas that reflect nutrient and hydration deficiencies. Be alert for rashes; dry, scaly skin; poor skin turgor; skin lesions; hair loss; easily pluckable hair; hair without luster; and an unhealthy scalp as these could indicate nutritional deficiencies. A person who scores 12 to 14 points on the mini-nutritional assessment has a normal nutritional status. A person in positive nitrogen balance is healthy; the body needs a positive nitrogen balance for growth, maintenance of lean muscle mass and vital organs, and wound healing. Negative nitrogen balance would be a cause to assess for nutritional deficiencies.

PTS:1DIF:Cognitive Level: Analyzing (Analysis)

REF:915

OBJ: Identify nutritional problems and describe a patient at risk for these problems.

TOP: Nursing Process: Assessment MSC: Client Needs: Physiological Integrity

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