Chapter 48Nutrition, Malnutrition, and Obesity: Nursing Management My Nursing Test Banks

Chapter 48Nutrition, Malnutrition, and Obesity: Nursing Management

MULTIPLE CHOICE

1.The nurse is instructing a client on the types of carbohydrates to include in the diet. The nurse should include that the main groups of carbohydrates are:

1.

glucose and fructose.

2.

monosaccharides and disaccharides.

3.

fats and proteins.

4.

sucrose and cellulose.

ANS: 2

Carbohydrates should make up 45% to 65% of our calories. Carbohydrates are consumed in the form of monosaccharides and polysaccharides. This is what the nurse should include in the instructions to the client. Glucose, fructose, and sucrose are monosaccharides. Fats and proteins are not carbohydrates. Cellulose is a nondigestible form of a carbohydrate.

PTS:1DIF:ApplyREF:Carbohydrates

2.The nurse is instructing a client on the purpose of eating indigestible carbohydrates such as fiber. These undigestible carbohydrates are used to:

1.

make fat.

2.

thin the blood.

3.

provide bulk to the stool.

4.

help with digestion of meals.

ANS: 3

These indigestible compounds provide bulk to the stool and assist in the process of elimination. Indigestible carbohydrates do not make fat, thin the blood, or help with the digestion of meals.

PTS:1DIF:ApplyREF:Carbohydrates

3.A client is diagnosed with a disorder that affects his ability to digest fat. The nurse realizes that the digestion of fat or lipids requires an enzyme called gastric lipase and:

1.

bile and insulin.

2.

bile and pancreatic lipase.

3.

pancreatic lipase and cholesterol.

4.

bile and amino acids.

ANS: 2

Most fat digestion takes place in the small intestines through the actions of pancreatic lipase and bile. Insulin does not digest fat. Cholesterol is a type of lipid. Amino acids are elements of protein.

PTS: 1 DIF: Analyze REF: Lipids (Fats)

4.A client is diagnosed with a protein deficiency. The nurse realizes this client may have a disorder that is affecting which of the following?

1.

Pancreas

2.

Gallbladder

3.

Small intestines

4.

Colon

ANS: 3

Protein digestion begins in the stomach. Further digestion of this nutrient takes place in the small intestine. The pancreas, gallbladder, and colon do not digest protein.

PTS: 1 DIF: Analyze REF: Proteins

5.The nurse, instructing a client on the best way to maintain a healthy diet and proper nutrition, would encourage the client to:

1.

eat foods in appropriate portion size and from all the food groups.

2.

eat twice as much meats as grains.

3.

eat mostly fruits.

4.

skip milk products.

ANS: 1

According to the American Dietetic Association, all foods can fit in a healthy diet if the portion sizes are appropriate, foods are consumed in moderation, and regular physical activity is included. Eating twice as much meat as grains does not contribute to a healthy diet. Eating mostly fruits and skipping milk products does not contribute to a healthy diet.

PTS: 1 DIF: Apply REF: Components of a Nutritionally Adequate Diet

6.The nurse is discussing an elderly clients diet and nutritional status with the hospital dietitian because this client is at risk for:

1.

obesity.

2.

malnutrition.

3.

sodium imbalance.

4.

a blood disorder.

ANS: 2

Causes of malnutrition during a hospital stay include disease state or inadequate food intake because of pain, nausea, and the different types of foods available in the hospital. An elderly client in the hospital is not at risk for obesity. A sodium imbalance can occur both prior to or during a hospital stay. The nurse would not be discussing a clients nutritional status with a dietitian because a client is a risk for a blood disorder.

PTS: 1 DIF: Apply REF: Malnutrition: Etiology

7.The nurse, instructing a group of community members regarding diet and exercise, should instruct healthy adults and children to exercise for:

1.

120 minutes a week.

2.

240 minutes a week.

3.

80 minutes a week.

4.

150 minutes a week.

ANS: 4

Exercise and nutrition go hand-in-hand to prevent chronic disease. Most Americans can enhance their health by moderate aerobic exercise for at least 150 minutes each week. The other choices are either too little exercise or too much exercise to enhance health.

PTS: 1 DIF: Apply REF: Components of a Nutritionally Adequate Diet

8.While instructing a client on the bodys nutritional needs, the nurse would include that the majority of calories consumed daily should be supplied from:

1.

vitamins.

2.

fats.

3.

carbohydrates.

4.

proteins.

ANS: 3

To meet the bodys nutritional needs, 45% to 65% of calories should come from carbohydrates. Fat intake should be limited to 20% to 35% of daily calories. Protein intake should be limited to 10% to 35% of total calories. There is no percentage of caloric intake each day for vitamins.

PTS: 1 DIF: Apply REF: Components of a Nutritionally Adequate Diet

9.A client is instructed to avoid specific foods while prescribed a specific medication because of the potential for cytochrome P450 3A to be blocked, which will affect metabolism. Which of the following foods should the client be instructed to avoid?

1.

Apple juice

2.

Prune juice

3.

Grape juice

4.

Grapefruit juice

ANS: 4

Grapefruit juice can block P-glycoprotein, and it inactivates cytochrome P450 3A for up to 24 hours. Other foods that can also block these enzymes include red wine, cyclosporine, St. Johns wort, and herbal teas. Apple, prune, and grape juice do not block these enzymes.

PTS:1DIF:ApplyREF:Cytochrome P450

10.A client who has completely eliminated fats from the diet should be assessed for a deficiency of:

1.

bile.

2.

minerals.

3.

salt.

4.

vitamins A, D, E, and K.

ANS: 4

Fat is used to transport digested substances and fat-soluble vitamins. The client who has eliminated fats from the diet should be assessed for a deficiency of the fat-soluble vitamins, or vitamins A, D, E, and K.

PTS: 1 DIF: Analyze REF: Metabolism

11.The nurse should instruct a client who is prescribed warfarin to limit or avoid foods that are:

1.

high in proteins.

2.

high in sugars.

3.

high in vitamin K.

4.

low in proteins.

ANS: 3

Significant changes in the intake of foods high in vitamin K can interfere with the anticoagulation properties of warfarin. These foods include bananas; celery; broccoli; green, leafy vegetables; spinach; and liver. The client who is prescribed warfarin does not need to avoid foods that are high in protein or sugar. The client does not need to avoid foods that are low in protein.

PTS: 1 DIF: Apply REF: Warfarin

12.While obtaining the health history, it is important for the nurse to ask the client about the use of herbal products, over-the-counter remedies, and dietary supplements because:

1.

they should be stopped during admission to the hospital.

2.

they should be increased during a time of illness.

3.

these are not important items to talk about and should not be asked about.

4.

these products may have potential interactions with medications that are being prescribed.

ANS: 4

Herbal products, over-the-counter remedies, and dietary supplements may have potential interactions with medications that are being prescribed, and a history of use of these products is necessary to avoid possible drug interactions.

PTS:1DIF:ApplyREF:Natural Products

13.A client is diagnosed as being obese. The nurse realizes that this clients body mass index (BMI) is most likely:

1.

between 15 and 19.

2.

between 20 and 24.

3.

between 25 and 29.

4.

greater than 30.

ANS: 4

A BMI of 25 to 29 is considered overweight. A BMI greater than 30 is considered obese. A BMI less than 18.5 is considered underweight. A BMI between 18.5 and 24.9 is considered normal weight.

PTS: 1 DIF: Analyze REF: Box 48-3 BMI Categories

14.A client with a BMI of 30 has set a goal to lose 10% of her current body weight within 6 months. The nurse realizes that the safest level of weight loss for this client would be:

1.

1 to 2 pounds each week.

2.

3 pounds each week.

3.

4 to 5 pounds each week.

4.

6 pounds each week.

ANS: 1

To reduce body weight by 10% for a person with a BMI of 30 would be to lose 1 to 2 lbs each week. The other amounts of weekly weight loss might lead to nutritional disorders.

PTS: 1 DIF: Analyze REF: Obesity: Planning and Implementation

15.While caring for a client with a gastrostomy (GT) tube, it is important for the nurse to:

1.

clean it weekly.

2.

flush it with water before and after the feeding.

3.

change the GT tube daily.

4.

not give medications through the tube.

ANS: 2

The GT site should be cleaned daily, and it is important that the nurse flush the tube with water before and after the feedings and medication administration to avoid tube obstruction. The site of the tube should be cleaned daily. The GT is not changed daily. The GT is used for medication administration.

PTS: 1 DIF: Apply REF: Gastrostomy Feedings

16.A client, diagnosed with renal failure, is prescribed enteral nutrition. The enteral food product will contain which of the following ?

1.

Lower protein content

2.

Higher fat content

3.

Lower calorie content

4.

Lower carbohydrate content

ANS: 1

Enteral feedings to support a client diagnosed with renal failure will have a lower protein content. Feedings for these clients will not have a higher fat content, lower calorie content, or lower carbohydrate content.

PTS: 1 DIF: Apply REF: Table 48-2 Enteral Nutrition Formulary

MULTIPLE RESPONSE

1.The nurse is instructing a client on the advantages of following a nutritionally adequate diet. Which of the following should be included in these instructions? (Select all that apply.)

1.

Varies during the life cycle

2.

Supports key body systems

3.

Supports a healthy weight

4.

Tastes good

5.

Helps prevent chronic disease

6.

Is low in carbohydrates and proteins

ANS: 1, 2, 3, 5

A nutritionally adequate diet is one that meets the needs of the individual at that stage of his life cycle, supports the body systems, and maintains proper weight. A nutritionally adequate diet will also help prevent the onset of chronic disease. A nutritionally adequate diet is not low in carbohydrates and proteins.

PTS: 1 DIF: Apply REF: Components of a Nutritionally Adequate Diet

2.The nurse is helping a dietitian determine a clients resting energy expenditure (REE). Which of the following will influence this clients REE? (Select all that apply.)

1.

Age

2.

Diet

3.

BMI

4.

Chronic illnesses

5.

Urine output

6.

Appetite

ANS: 1, 2, 3, 4

The resting energy expenditure (REE) is the amount of calories needed to maintain body weight at rest. The REE is influenced by age, diet, BMI, and chronic illness. Urine output and appetite are not known to influence a clients REE.

PTS:1DIF:AnalyzeREF:Metabolic Rate

3.The nurse is concerned that a client with a gastrostomy feeding tube is developing a complication. Which of the following are considered complications associated with this type of feeding tube? (Select all that apply.)

1.

Nausea

2.

Vomiting

3.

Aspiration

4.

Abdominal distention

5.

Leg cramps

6.

Muscle pain

ANS: 1, 2, 3, 4

Complications of a gastrostomy tube include nausea, vomiting, malabsorption, aspiration, abdominal distention, tube obstruction, diarrhea, and constipation. Leg cramps and muscle pain are not complications of a gastrostomy tube.

PTS: 1 DIF: Analyze REF: Gastrostomy Feedings

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