Chapter 47: Nutrition My Nursing Test Banks

Chapter 47: Nutrition

Test Bank

MULTIPLE CHOICE

1. Which meal contains the best sources of dietary fiber?

a.

Eggs, bacon, orange juice

b.

Salad, whole wheat toast, sliced peach

c.

Roast beef, mashed potatoes with gravy, corn, milk

d.

Grilled hamburger on a bun, fresh carrot sticks, potato chips

ANS: B

Good dietary sources of fiber include fresh fruits, vegetables, and whole grain foods. There is little fiber in eggs, bacon, and orange juice and much fat and sugar. Although there is fiber in the menu of roast beef, mashed potatoes, corn, and milk as well as a hamburger on a bun, carrot sticks, and potato chips, these are not the best sources of dietary fiber.

DIF: Cognitive Level: Application REF: pp. 791-792 | p. 796

OBJ: 1 TOP: Nursing Process Step: Evaluation

MSC: NCLEX Client Needs Category: Physiological Integrity

2. A patient who is 8 weeks postpartum would like to begin a moderate intensity exercise program to lose the remaining 20 lb she gained during her pregnancy. Which exercise regimen will the nurse recommend to accomplish this goal best?

a.

Walking 2 miles daily in 1 hour, four times weekly

b.

Jogging 4 miles in 20 minutes, three times weekly

c.

Walking 4 miles in 1 hour daily

d.

Jogging 2 miles in 20 minutes, twice weekly

ANS: C

According to the National Academy of Sciences, a moderate intensity physical activity would include walking at a rate of 4 to 5 miles/hour four to seven times weekly. Walking 2 miles daily in 1 hour four times weekly is below a moderate level of activity. Jogging 4 miles in 20 minutes three times weekly and jogging 2 miles in 20 minutes twice weekly is beyond a moderate level of activity.

DIF: Cognitive Level: Application REF: p. 800 OBJ: 2

TOP: Nursing Process Step: Implementation

MSC: NCLEX Client Needs Category: Physiological Integrity

3. Which food is a good source of vitamin A?

a.

Sweet potatoes

b.

Apples

c.

Bananas

d.

Whole grain bread

ANS: A

Vegetables and fruits that are orange (sweet potatoes, cantaloupe, carrots) are concentrated with carotene and are a good source of vitamin A. Apples are a good source of soluble and insoluble fiber. Bananas are a good source of fiber, potassium, and vitamin C. Whole grain bread is a good source of vitamin E and fiber.

DIF: Cognitive Level: Comprehension REF: p. 797 OBJ: 3

TOP: Nursing Process Step: Assessment

MSC: NCLEX Client Needs Category: Physiological Integrity

4. Which dietary fats are cardioprotective?

a.

Monounsaturated

b.

Polyunsaturated

c.

Saturated

d.

Trans

ANS: A

Monounsaturated fats decrease low density lipoprotein (LDL) and increase high density lipoprotein (HDL) and are considered to be cardioprotective. Polyunsaturated fats also lower LDL and raise HDL, but are not considered to be cardioprotective. Saturated fats raise both LDL and HDL and are thought to increase atherosclerotic plaque formation in the arteries. Trans fats may induce more heart disease than saturated fats because in addition to raising LDL cholesterol, trans fats decrease HDL cholesterol and increase triglycerides, as well as another undesirable blood fat, lipoprotein.

DIF: Cognitive Level: Knowledge REF: p. 797 OBJ: 1

TOP: Nursing Process Step: Evaluation

MSC: NCLEX Client Needs Category: Health Promotion and Maintenance

5. A patient is receiving continuous tube feedings at 100 mL/hr. At 1400, the nurse determines that there is 175 mL of residual volume. Which action will the nurse take?

a.

Continue the feedings as ordered.

b.

Reduce the feeding by 50%.

c.

Stop the feeding and notify the health care provider.

d.

Aspirate and dispose of the residual and restart the feeding.

ANS: C

When the residual volume of a tube feeding exceeds 100 mL (or the limit set by the health care provider), the tube feeding is stopped and the residual volume is rechecked within 1 hour. When the residual volume has returned to the limits set by the health care provider, it is restarted. Because the residual amount already exceeds the recommended amount, the feeding should not continue. Infusion rate should not be changed without an order from the health care provider.

DIF: Cognitive Level: Application REF: p. 802 OBJ: 6

TOP: Nursing Process Step: Implementation

MSC: NCLEX Client Needs Category: Safe, Effective Care Environment

6. What is the average daily dietary intake level sufficient to meet the nutrient requirements of most healthy individuals in a group?

a.

Dietary Reference Intake (DRI)

b.

Tolerable Upper Intake Level (UL)

c.

Estimated Average Requirements (EAR)

d.

Adequate Intake (AI)

ANS: A

The Recommended Dietary Allowance (RDA) table lists the average daily dietary intake level that is sufficient to meet the nutrient requirements of almost all (97% to 98%) healthy individuals in a group. RDAs are goals in meeting nutritional needs. The UL is the highest level of daily nutrient intake that is likely to pose no risk of adverse health effects to almost all individuals in the general population. The EAR is a nutrient intake value that is estimated to meet the requirement of half of the healthy individuals in a group. The AI is a value based on observed or experimentally determined approximations of nutrient intake by a group of healthy people. The AI is used when the RDA cannot be determined.

DIF: Cognitive Level: Knowledge REF: p. 795 OBJ: 1

TOP: Nursing Process Step: Planning

MSC: NCLEX Client Needs Category: Physiological Integrity

7. Which is a macronutrient that is a separate factor necessary for complete nutrition and wellness?

a.

A phytochemical

b.

A trace mineral

c.

Fiber

d.

A vitamin

ANS: C

Macronutrients are essential chemical elements needed by all life in large quantities for normal function. Dietary fiber is derived from plant sources and consists of indigestible carbohydrates and lignin and digestible macronutrients (carbohydrates, proteins), such as cereal brans, sweet potatoes, and legumes, which contribute to overall nutrition. Another category of fiber is functional fiber, which consists of indigestible carbohydrates that have a beneficial physiologic effect on humans. Phytochemicals, minerals, and vitamins are micronutrients.

DIF: Cognitive Level: Comprehension REF: p. 796 OBJ: 1

TOP: Nursing Process Step: Planning

MSC: NCLEX Client Needs Category: Physiological Integrity

8. A newly admitted patient asks the nurse why the physician has ordered the DASH diet for him. The nurse informs the patient that this diet is ordered to encourage healthy eating specifically for the diagnosis of:

a.

diabetes.

b.

hypertension.

c.

arthritis.

d.

seizure disorder.

ANS: B

DASH stands for Dietary Approaches to Stop Hypertension.

DIF: Cognitive Level: Application REF: p. 791 OBJ: 1

TOP: Nursing Process Step: Implementation

MSC: NCLEX Client Needs Category: Health Promotion and Maintenance

9. A patient presents at the physicians office with reports of frequent nosebleeds and delayed clotting. The physician diagnoses this patient with a vitamin deficiency. To treat this type of deficiency, the nurse will encourage the patient to consume foods high in vitamin:

a.

C.

b.

D.

c.

K.

d.

A.

ANS: C

Symptoms of bleeding and/or delayed clotting implicate a vitamin K deficiency.

DIF: Cognitive Level: Application REF: p. 798 | p. 808

OBJ: 1 | 5 TOP: Nursing Process Step: Planning

MSC: NCLEX Client Needs Category: Health Promotion and Maintenance

MULTIPLE RESPONSE

10. What provide(s) energy sources for body activities and metabolism? (Select all that apply.)

a.

Protein

b.

Fat

c.

Carbohydrate

d.

Minerals

e.

Vitamins

ANS: A, B, C

The macronutrients protein, fat, and carbohydrate are primary energy sources required for balanced metabolism. Minerals and vitamins are not primary sources of energy for the body.

DIF: Cognitive Level: Comprehension REF: p. 796 OBJ: 1

TOP: Nursing Process Step: Assessment

MSC: NCLEX Client Needs Category: Physiological Integrity

11. A patient is receiving total parenteral nutrition. Which action(s) will the nurse perform? (Select all that apply.)

a.

Assess for electrolyte imbalance.

b.

Check residual volume qid.

c.

Position the patient in a high Fowlers position.

d.

Monitor blood glucose levels.

e.

Discard the solution every 24 hours.

ANS: A, D, E

Electrolytes are monitored during parenteral nutrition. Hyperglycemia may develop and therefore should be monitored. Solutions are discarded every 24 hours. Checking residual volume qid is not an accurate nursing action. Positioning the patient in a high Fowlers position is not necessary for parenteral nutrition.

DIF: Cognitive Level: Application REF: pp. 807-808 OBJ: 6 | 7

TOP: Nursing Process Step: Implementation

MSC: NCLEX Client Needs Category: Physiological Integrity

12. A patient is being discharged on psyllium (Metamucil). Which explanation(s) by the nurse would be accurate regarding fiber intake? (Select all that apply.)

a.

It adds bulk to fecal content.

b.

It enhances gastric emptying.

c.

It decreases blood cholesterol concentration.

d.

It decreases postprandial blood glucose concentration.

e.

It stimulates the appetite.

ANS: A, C, D

Functional fibers such as psyllium add bulk to fecal contents. Fibers can reduce the absorption of dietary fat and cholesterol as well as enterohepatic recirculation of cholesterol and bile acids. This may reduce blood cholesterol concentration. In addition, functional fibers delay gastric emptying, which reduces postprandial blood concentration, potentially preventing excessive insulin secretion and insulin sensitivity. Fibers delay gastric emptying. Functional fibers assist with weight control because they provide a sense of fullness and satiety.

DIF: Cognitive Level: Comprehension REF: p. 796 OBJ: 1

TOP: Nursing Process Step: Implementation

MSC: NCLEX Client Needs Category: Health Promotion and Maintenance

13. What can be directly absorbed from the GI tract into the bloodstream? (Select all that apply.)

a.

Glucose

b.

Sucrose

c.

Fructose

d.

Galactose

e.

Lactose

f.

Maltose

ANS: A, C, D

Monosaccharides, such as glucose (also known as dextrose), fructose, and galactose, are the only sugars that can be absorbed directly from the gastrointestinal tract into the blood. Disaccharides, such as sucrose (common table sugar), lactose, and maltose, are the most common sugars in foods but must be metabolized to monosaccharides before being absorbed into the bloodstream.

DIF: Cognitive Level: Knowledge REF: p. 796 OBJ: 1

TOP: Nursing Process Step: Planning

MSC: NCLEX Client Needs Category: Physiological Integrity

14. How are essential fatty acids used in the body? (Select all that apply.)

a.

Building cell membranes

b.

Energy production

c.

Prostaglandin production

d.

Catalyzing metabolic reactions

e.

Eicosanoid production

f.

Stimulation of growth hormone

ANS: A, C, E

Essential fatty acids are required for cell membrane structure, prostaglandin production, and eicosanoid production. Essential fatty acids are not a source of energy, do not catalyze metabolic reactions, and do not stimulate growth hormone.

DIF: Cognitive Level: Comprehension REF: p. 797 OBJ: 1

TOP: Nursing Process Step: Planning

MSC: NCLEX Client Needs Category: Physiological Integrity

15. A patient is being treated for symptoms of alcohol withdrawal and has been identified to have a thiamine deficiency. When performing physical assessment on this patient specific to thiamine deficiency, the nurse will focus on:(Select all that apply.)

a.

level of consciousness.

b.

cardiac status.

c.

sensitivity to light.

d.

risk for diarrhea.

e.

nutrition status.

ANS: A, B, E

Signs and symptoms of thiamine deficiency include anorexia, constipation, indigestion, confusion, edema, muscle weakness, cardiomegaly, and heart failure. Assessment will focus on level of consciousness, cardiac status, and nutrition status. Photophobia and diarrhea are not symptoms related to thiamine deficiency.

DIF: Cognitive Level: Application REF: p. 801 OBJ: 3

TOP: Nursing Process Step: Assessment

MSC: NCLEX Client Needs Category: Physiological Integrity

Leave a Reply