Chapter 13 - Nutrition for Older Adults 1
A 79-year-old client has been admitted to a long-term care facility that follows a liberal diet approach. The family is concerned that this will hurt the client due to a long history of high cholesterol and desire a low-cholesterol diet. How might the nurse respond? A) Malnutrition is a greater threat than hypercholesterolemia. B) The client is too old to worry about it now. C) The facility does not offer specialized, individual diet options. D) If the cholesterol hasn't gone down yet, it never will.
A
A client is trying to understand where cheese fits into the MyPlate for Older Adults. The nurse explains that according to this plan, cheese is in which section? A) Protein B) Milk C) Dairy D) Fat
A
A family member is concerned that an elderly family member is not eating correctly. Which of the following is a risk factor for undernutrition among the elderly population? A) Eating alone B) Daily Meals on Wheels delivery C) Traveling to a local center for a hot meal D) Having home health assistance three times a week to fix meals
A
Nutrition therapy in the elderly has different goals than at other times across the lifespan. What is a primary goal of diet intervention for the elderly? A) Maintain quality of life B) Prolong life C) Prevent the development of complications D) Treat chronic disease
A
Over the age of 50 years, the body needs a higher intake of vitamin D. What is a good source of the vitamin D needed by older adults? A) Fortified milk B) Green leafy vegetables C) Lean red meats D) Nuts
A
The 74-year-old client in the nursing home has developed a pressure ulcer on her sacrum. What could be a cause of the development of this ulcer? A) Inadequate food and fluid intake B) Turning freely in bed C) Overhydration D) Lack of vitamins B and C
A
The children of a sedentary 90-year-old ask how to combat malnutrition in their parent. What would be the best response to this question? A) Make meal time as enjoyable as possible. B) Feed the parent only heart-healthy food. C) Give the parent a liquid dietary supplement twice a day. D) Feed the parent before the rest of the family.
A
The nurse is doing nutritional screening on older adults at a health fair. What would be an important question to ask while screening an older person for nutritional risk? A) About the use of three or more prescribed or over-the-counter daily medications B) If the person is over 62 years old C) If they had an unintentional weight loss of 3% or more in 60 days D) If they are living in a household with more than one older adult member
A
The nurse is preparing a meal plan for a client who will be assisted by a home health aide. The nurse recognizes the overall goal of nutrition therapy for this older adult is which of the following? A) Maintain or restore maximal independent functioning B) Reduce chronic disease deterioration C) Prevent chronic disease D) Decrease the use of medication
A
The nurse is working with a client who has chronic constipation. After evaluating the clients' food intake, it is determined that the client needs to ingest more fiber. What is the recommended daily intake of fiber for this 55-year-old female? A) 21 g/day B) 25 g/day C) 30 g/day D) 38 g/day
A
A family is meeting with the nurse to discuss their concern about their 78-year-old family member who is having difficulty chewing food. The client is refusing a pureed diet. Which of the following are examples of food the family can offer? Select all that apply. A) Ripe bananas B) Soft melon C) Cooked carrots D) Fried potatoes E) Roasted chicken
A, B, C
A liberal diet approach is a holistic approach toward meeting client's nutritional needs. This approach takes into consideration which of the following? Select all that apply. A) Individual personal goals B) Risk/benefit ratio C) Overall prognosis D) Quantity of life E) Family requests
A, B, C
The client has not been eating well since he was admitted to the long-term care facility. When the advanced practice nurse (APN) comes to the facility to see her clients, the nurse mentions her concerns about the nutritional status of this client. The APN notes that one of the client's orders is for a can of liquid dietary supplement to be given between meals three times a day. What may the client be experiencing as a result of taking this supplement? Select all that apply. A) Loss of appetite B) Increased sugar and fat C) Decreased calcium D) Taste fatigue E) Increased hunger
A, D
The nurse is meeting with the wife of a client who has Alzheimer disease (AD). She is concerned about her husbands' nutritional status. What can the nurse tell her to watch for that would indicate a possible nutritional problem? Select all that apply. A) Forgetting he had eaten and eating again B) Forgetting which are green vegetables C) Forgetting what food category bread is in D) Forgetting what time to eat E) Forgetting how to shop for food
A, E
Arthritis is a leading cause of functional limitation among older adults. Osteoarthritis (OA) is the most common form of arthritis. What is the greatest known modifiable risk factor of OA of the knee? A) Nutritional deficiency of folic acid B) Overweight C) Moderately inactive lifestyle D) Inadequate intakes of calcium
B
Quality-of-life issues are a priority in the elderly, especially in residents of long-term care facilities. What are the key components in meeting quality-of-life standards among older adults who are residents of long-term care facilities? A) Prevention of depression and diabetes B) Prevention of unintentional weight loss and pressure ulcers C) Prevention of weight gain and hyperlipidemia D) Prevention of low albumin and anorexia
B
Sarcopenia is the loss of muscle mass and strength. It is related to a sedentary lifestyle and less than optimal diet. It is a process that begins in the fourth and fifth decades of life. This loss of muscle mass can be halted or reversed with which of the following? A) Aerobic exercise B) Strength-training exercises C) A high-protein diet D) A high-protein diet, high-calorie diet
B
The elderly population has a mean intake below the dietary reference intake (DRI) for several nutrients. Which of the following falls into that classification? A) Sodium B) Potassium C) Chloride D) Manganese
B
The intake of adequate nutrients is a recommendation to reduce the risk of nutrition-related concerns across the lifespan. Obesity impacts quality of life in the elderly. Along with weight reduction, what vitamins are recommended to help with bone health? A) Vitamin B12 B) Vitamin C C) Vitamin B6 D) Vitamin E
B
The nurse is conducting an assessment on a new client who is being admitted to the long-term care facility. The client is a 69-year-old gentleman who is moderately active. What is the recommended calorie per day intake? A) 2000 cal/day B) 2200 cal/day C) 2400 cal/day D) 2600 cal/day
B
The nurse is doing client education for a 71-year-old woman who is a resident of a long-term care facility. The assessment indicates that she is at a high risk for malnutrition. What is one reason she could give you for this risk of malnutrition? A) "I eat most of my meals with friends." B) "I just don't have an appetite." C) "I take two different medicines every day." D) "I chew quite well with my dentures."
B
The nurse is teaching a class of aides at a long-term care facility how to assess and document a client's nutritional intake. What mandates the documentation of nutritional intake for the residents of long-term care facilities? A) Maximum Data Set (MDS) B) Minimum Data Set (MDS) C) Regulatory Data Set (RDS) D) Maximum Regulatory Set (MRS)
B
The nurse has given the nutrition class the assignment of creating a list of strategies for enhancing food intake in long-term care residents. What strategies would you expect to find on this list? Select all that apply. A) Let residents eat in their rooms. B) Honor food preferences. C) Make sure the diet is heart healthy. D) Involve the family in mealtime. E) Encourage independence in eating.
B, D, E
Dehydration can be a concern in the elderly population. The modified MyPlate for Older Adults recommends eight glasses of water per day. What is the AI for water for a 65-year-old male? A) 1.7 L/day B) 2.7 L/day C) 3.7 L/day D) 4.7 L/day
C
For a long-term care resident, a restrictive diet could decrease quality of life. When should restrictive diets be used in long-term care facilities? A) When a resident has decreased intake and weight loss B) For hospice care C) When a significant improvement in health can be expected D) For one week a month
C
Magnesium is one of the nutrients that older adults often do not get enough of. What are the recommended sources of magnesium for the elderly? A) Fruit juices B) Carrots C) Yogurt D) Potatoes
C
Osteoarthritis (OA) is a disease that predominantly plagues the elderly. What can weight loss do for older people with OA? A) It has no effect on arthritis symptoms. B) It aggravates arthritis symptoms. C) It relieves symptoms in the weight-bearing joints. D) It relieves symptoms throughout the body.
C
The nurse is caring for a client in a long-term care facility who is 77 years of age and overweight. The nurse is considering putting this client on a low-calorie diet. Some experts recommend that strict therapeutic diets be used in older adults only when a significant improvement in health can be expected. Which elderly clients would a restrictive diet be recommended for? A) Those with high cholesterol levels B) Those with high potassium levels C) Those with ascites D) Those with mild hypertension
C
The nurse is discussing with the nutrition class which dietary supplements older adults need to take. Which supplement is needed by older adults? A) Vitamin B6 B) Vitamin K C) Vitamin D D) Niacin
C
A 71-year-old female client has functional limitations, in part caused by obesity. The nurse is discussing the need to lose weight with this client but she is not receptive to the idea. What is one reason this woman might have for not agreeing with the suggestion to lose weight? A) The client feels that losing weight can cause a strain on the body. B) The client feels that she would feel worse if she lost weight. C) The client does not feel that her weight impedes her functionality. D) The client does not feel the need to make changes at this point in her life.
D
It has been established that many people over 50 years have low serum levels of vitamin B12. Where is it recommended that older adults get most of their vitamin B12 from? A) Citrus fruits and juices B) Red meats C) Milk and dairy products D) Fortified cereals
D
Most recommended levels of intake for vitamins and minerals do not change with aging. An exception to this is the recommended dietary allowances of vitamin D, which are higher in adults over age 50 years. What causes the body's need for vitamin D to increase over the age of 50 years? A) The ability to absorb calcium, which decreases with age B) The potential risk for coronary heart disease, which uses vitamin D C) The increased consumption of coffee and tea interferes with vitamin D synthesis D) The ability to synthesize vitamin D from sunlight, which decreases with age
D
Older adults need adequate protein in their diet. What are the approximate protein needs per day for an older adult weighting 132 pounds (60 kg)? A) 24 g/day B) 36 g/day C) 44 g/day D) 48 g/day
D
The client is a 65-year-old male. Approximately, how much longer can he expect to live? A) 15.8 years B) 16.5 years C) 17.3 years D) 19.2 years
D
Which lunch is best for a healthy 65-year-old who lives independently? A) 6 oz of chicken noodle soup, 6 saltine crackers with 2 tablespoons of butter, 3/4 cup of ice cream, and 12 oz of diet soda B) 3 oz of hamburger, lettuce leaf, tomato slice, 1 slice of onion, 1 oz of processed cheese, 1 hamburger bun, 6 oz of French fries, and one 8-oz strawberry milkshake C) 6 chicken nuggets, 1/4 cup of ketchup, 4 oz cup of applesauce, and one 4-inch slice pumpkin pie with whipped cream D) 3 oz of tuna on whole wheat bread, 1 medium apple, and 8 oz of 2% milk
D