Chapter 3: Carbohydrates PrepU

When teaching clients nutritional interventions for preventing long-term health problems, the nurse should emphasize limiting the intake of sugar for which of the following reasons?

Diets high in added sugar likely provide inadequate amounts of essential nutrients.

The nurse recognizes that whole-grain products must consist of the certain components of the grain. What of the following is one of those components?

bran -Whole-grain products must contain the entire kernel, which consists of the bran, endosperm, and germ layers.

The nurse is educating a newly diagnosed diabetic about glycemic response. Which statement from the client indicates an understanding of the effect food has on blood glucose concentration?

"A food's glycemic response can be influenced by many variables."

The nurse is teaching the client about healthy consumption of carbohydrates. The nurse is sure that teaching has been effective when the client makes what statement?

"I should plan my intake to increase fiber and limit added sugars."

Substituting whole grains in place of refined grains is one way to make healthier choices. Which statement(s) indicates an understanding of refined grains? Select all that apply.

- Consist of only the endosperm of the grain - Considered rich in starch - Can have added sugar

The nurse is helping a client calculate how many calories the client is eating through carbohydrates. If the client consumes 30 grams of carbohydrate a day, how many calories is she consuming with those carbohydrates? Enter the correct number ONLY.

120

When providing nutritional information to a client seeking to make eating pattern changes, the nurse correctly states the Recommended Daily Allowance (RDA) for total carbohydrate intake for adults is how much?

130 g/day.

The nurse is reviewing a client's food log and calculating how many calories the client has consumed. The nurse knows that there are how many calories in a gram of carbohydrates? Enter the correct answer ONLY.

4 -Carbohydrates provide 4 calories per gram.

The nurse prepares dietary teaching for a client. What percentage of calories should the nurse identify as being from carbohydrate sources?

45-65% -According to the Acceptable Macronutrient Distribution Ranges (AMDRs) carbohydrates should be 45-65% of all calories consumed. Five to 10% of calories should include linoleic acid. Ten to 35% of calories should be protein. Twenty to 35% of calories should be fat.

The nurse is seeing a client who is newly diagnosed with type 2 diabetes. The client tells the nurse she does not want to consume chemical based nonnutritive sweeteners. Which of the following sugar alternatives should the nurse recommend?

stevia

The nurse recognizes that disaccharides are composed of two sugar molecules. The combination of glucose and fructose creates:

sucrose -Sucrose is composed of glucose and fructose. Maltose is composed of two glucose molecules. Lactose is composed of glucose and galactose. Galactose is a monosaccharide.

A nurse has been trying to teach a client newly diagnosed with diabetes how to interpret food labels and recognize sugars. The client is very upset. He understood about "glucose" but considered "fructose" to be safe to eat without monitoring the amount of intake. Which of the following would be an appropriate response from the nurse?

"Fructose is changed to glucose by the liver." -It is important to remain nonjudgmental and validate the client's concerns. It is also important to continue teaching and reteaching without becoming impatient or angry with the client. Teaching the basic facts would be an important step. If the client continues not to understand, the nurse should evaluate the way in which the teaching is occurring and perhaps find a different way to share the information. Dextrose and glucose are interchangeable terms, both refer to the same type of monosaccharide. Glycogen is the animal (including human) version of starch; it is stored carbohydrate available for energy as needed. It cannot be consumed directly from food.

A non-diabetic client presents to the emergency room with a month-long history of nausea, fatigue, and increased urination. During the nurse's intake assessment, which client statement would the nurse investigate further?

"I recently changed my diet to that one everyone swears by."

The client is upset that despite incorporating low-sugar and sugar-free foods into her eating pattern, she is not losing weight and her blood sugar is still difficult to control. The nurse notes which of the following reasons the client is having this problem?

"Sugar-free" does not mean calorie-free.

The nurse is seeing a client who has been reading about the different nonnutritive sweeteners that are listed on his menu plan as acceptable alternatives to sugar. The client is questioning saccharin because he read that it is a potential carcinogen. How should the nurse respond?

"The FDA has officially withdrawn the proposed ban because evidence is weak."

A client is distressed because a weight loss diet that focused on glycemic load has not resulted in an appreciable reduction in weight. What should the nurse respond to this client?

"Unfortunately, claims that a low glycemic index diet promotes weight loss aren't proven."

The United States Food and Drug Administration (FDA) has approved several nonnutritive sweeteners for use in the United States. Many of these can be used as a sugar substitute in baked goods. Which nonnutritive sweetener(s) should the nurse recommend for use in baking? Select all that apply.

- Neotame - Newtame

The nurse recognizes that carbohydrates are a class of energy-yielding nutrients that contain which of the following elements? Select all that apply.

- carbon - hydrogen - oxygen

The nurse is helping a client plan dietary changes to help the client lose weight. After the discussion the client understands that which of the following are polysaccharides? Select all that apply.

- fiber - starch - glycogen

The nurse is teaching a group of client who are newly diagnosed type 2 diabetes about carbohydrates. The nurse explains that a 1-ounce serving size of cooked rice is approximately how much?

1/2 cup. -A 1-ounce serving of cooked rice, cereal, and pasta is approximately 1/2 cup.

The American Heart Association (AHA) has shared recommendations for maximum caloric intake for adults related to added sugars. Which of the following is this recommendation?

100 cal/day for women; 150 cal/day for men -In 2009, the AHA recommended that most women limit added sugar intake to a maximum of 100 cal/day (25 grams or 6 teaspoonfuls) and men at 150 cal/d (38 grams or 10 teaspoonfuls).

A client has brought in a food log with the grams of carbohydrates noted. The log shows: breakfast - 1 cup plain yogurt, 1 cup whole-oat cereal, 1 cup black coffee, 3/4 cup grapefruit juice; lunch - 2 slices whole-wheat bread, 3 oz cold chicken breast, 2 slices leaf lettuce, 1 slice Swiss cheese, 1 med apple, 1 cup skim milk; and dinner - 3 oz poached salmon with dill, 1/2 cup baked potato, 1/2 cup steamed asparagus, 1 cup green salad with oil and vinegar dressing, and 1 cup sliced strawberries. Approximately how many grams of carbohydrates did this client consume on this day? (Round to the nearest whole number.)

150 -According to MyPlate guidelines, this client consumed the following: breakfast - 1 cup plain yogurt (12 g), 1 cup whole-oat cereal (15 g), 1 cup black coffee (0 g), 3/4 cup grapefruit juice (15 g); lunch - 2 slices whole-wheat bread (30 g), 3 oz cold chicken breast (0 carb g), 2 slices leaf lettuce (5 g), 1 slice Swiss cheese (0 carb g), 1 med apple (15 g), 1 cup skim milk (12 g); and dinner - 3 oz poached salmon with dill (0 carb g), 1/2 cup baked potato (15 g), 1/2 cup steamed asparagus (5 g), 1 cup green salad with oil and vinegar dressing (10 g), and 1 cup sliced strawberries (15 g). When added together, this client consumed 149 g of carbohydrates on this day.

A client who is on a low-carbohydrate diet is having difficulties making suitable food choices during meal times. Which of the following food choices is the BEST for a low-carbohydrate intake eating pattern?

2 cups green beans -The choices contain the following amounts of carbohydrate: 2 cups green beans (20 g), 1 cup lentil soup with ham (30 g), 2 slices whole-wheat bread (30 g), and 1 cup unsweetened canned fruit (30 g). The green beans are lower in carbohydrates than the other choices.

The nurse is teaching a nutrition class to a group of adults. The nurse indicates that the Adequate Intake (AI) for total fiber is set at which of the following amounts?

25 g/day for women; 38 g/day for men

The nurse is helping a client incorporate vegetables into a carbohydrate reduced meal plan. The nurse explains that half a cup of "watery" vegetables contains approximately how many grams of carbohydrates?

5 -A half cup of "watery" vegetables contains approximately 5 grams of carbohydrates. Starchy vegetables contain approximately 15 grams of carbohydrates per serving.

The nurse recognizes that the most common monosaccharides contain how many carbon atoms?

6

The nurse is providing a follow up nutritional session with a client. The client is surprised to learn that carbohydrates have fewer calories than fat does. The client has calculated that she consumed 200 grams of carbohydrates for the day. The nurse knows the client consumed a daily total of how many calories?

800 calories -There are 4 calories in each gram of carbohydrates. This client consumed 200 grams, so 200 x 4 = 800 calories.

When providing nutrition recommendations to clients, the nurse should explain that the best guide to determine appropriate carbohydrate intake is for individuals is which of the following?

Acceptable Macronutrient Distribution Range (AMDR).

The nurse cares for a client with liver cirrhosis. In which way will the nurse expect this health problem to impact the client's nutritional status?

Altered amount of stored glycogen

A young mother is concerned about her children developing dental caries and is asking for appropriate suggestions to help prevent them. Which of the following is an appropriate suggestion for the nurse to offer?

Avoid sugary items that stay in the mouth for a long time.

The body depends on carbohydrates to provide energy. Which organ is totally dependent on glucose for energy?

Brain -Although muscles use a mixture of fat and glucose for energy, the brain is the only organ dependent on glucose for energy. Neither the colon nor the pancreas requires glucose for energy. All digestible carbohydrates are fermented in the colon. The pancreas releases glucagon when a drop in blood glucose occurs.

The nurse is providing discharge instructions to a client suffering from chronic constipation. Which food will have the least impact on the client's chronic constipation?

Cashews

The National Academy of Sciences has put forth a recommendation to replace the terms "insoluble" and "soluble" with terms more descriptive of the physiologic benefits of particular fibers. What term has been suggested for intact and naturally occurring plant fiber?

Dietary fiber

A nurse is providing teaching to a pregnant woman with gestational diabetes. The nurse describes a phenomenon in which a food causes serum glucose to rise to an elevated level before returning to basline. The nurse recognizes that teaching has been effective when the client identifies what term as referring to this phenomenon?

Glycemic response -The glycemic response is the effect a food has on the blood glucose concentration: how quickly the glucose level rises, how high it goes, and how long it takes to return to normal. The glycemic index is a numeric measure of the glycemic response of 50 g of a food sample. The glycemic load is a food's glycemic index multiplied by the amount of carbohydrate it contains to determine impact on blood glucose levels.

A client with diabetes reports reducing the number of cans of soda consumed each day but admits to "cheating" over the weekends. What should the nurse suggest to this client to help reduce the intake of sugar?

Place a few drops of Stevia in water with lemon -Stevia is generally recognized as safe for consumption and can be used as a tabletop sweetener. Adding a few drops of the sweetener to water with lemon can help reduce the client's intake of sugar. Fruit juice can have as much or more sugar than a can of soda. Four teaspoons of sugar equals 16 grams. Depending upon the number of glasses ice tea consumed, the client could be ingesting more sugar with the tea than through drinking soda. Mixing soda with carbonated water will dilute the beverage however there is still a substantial amount of sugar in the beverage.

Carbohydrates are classified as either simple sugars or complex carbohydrates. Which complex carbohydrate is the most common?

Starch

The nurse is conducting a nutrition class of individuals newly diagnosed with diabetes. The nurse explains that shortly after eating, what happens in the body?

The pancreas releases insulin to move the glucose from the blood stream to the individual cells.

During a home visit the nurse notes that a client's stage 2 pressure injury is not healing as quickly as expected. Why should the nurse assess this client's intake of carbohydrates?

They spare protein needed for healing

The school health nurse is providing education to a group of children about the differing nutritional values of sugars. When discussing added sugars, the nurse knows teaching has been effective when the children state which of the following?

add sugars provide empty calories.

The nurse is providing education to a client regarding healthy eating habits. The nurse should caution the client to be cautious of increased caloric value of food due to the inclusion of what ingredient?

added sugars.

The nurse recognizes that nonnutritive sweeteners are produced from a variety of sources. One common sweetener is produced by combining amino acids aspartic acid and phenylalanine. This common nonnutritive sweetener is called which of the following?

aspartame

When providing education to a group of students, the school health nurse correctly states that around the world, the most commonly found nutrient in the human diet is which of the following?

carbohydrates.

The nurse is preparing to teach a class on the benefits of eating whole grains. The nurse is aware that eating patterns rich in whole grains are associated with a lower risk of which of the following health problems?

cardiovascular disease.

The nurse is explaining the different type of sugars to a client. The nurse correctly classifies maltose and lactose in which of the following sugar categories?

disaccharides. -Disaccharides are sucrose, maltose, and lactose. Monosaccharides are glucose, fructose, and galactose. Polysaccharides are starch, fiber, and glycogen. There are no trisaccharides.

The nurse is seeing a client who reports having increased frequency of stools after consuming a food that contains a polyol. Based on the report, the nurse suspects that the food did not include what type of polyol?

erythritol -Polyols, or sugar alcohols, are sweeteners made from hydrogenated sugars and starches. Most polyols—including xylitol, mannitol, and sorbitol—are incompletely absorbed, potentially leading to a laxative effect when they ferment in the large intestine. Erythritol is an exception. It is rapidly absorbed in the small intestine and is thus not likely to produce a laxative effect.

The nurse is discussing enriched grains with a group of young mothers. The nurse informs the women that enriched grains must be fortified with which of the following?

folic acid.

When explaining the nutritional value of adding fruit to an eating pattern, the nurse states that most of the calories in fruit come from which of the following sugars?

fructose. -Generally, almost all calories in fruit come from fructose and glucose.

The nurse is explaining to a group of college students how the body tries to maintain a steady supply of glucose for energy between meals. The nurse explains that the liver breaks down which substance to release glucose?

glycogen -Liver glycogen breaks down and release glucose into the bloodstream between meals to maintain normal blood glucose levels. Glucagon is the hormone released by the pancreas to balance the action of insulin. Galactose and sucrose are types of carbohydrates.

The nurse who is providing education during a nutritional class shares that the individual body cells take only as much glucose as is needed for immediate energy. The nurse knows teaching has been effective when the students states the liver and muscle cells store excess glucose as which of the following?

glycogen -Muscle and liver cells store extra glucose as glycogen. Glucose is used for energy and must be changed to be stored. Glucagon is the hormone secreted by the pancreas in response to lower blood glucose levels to signal the need to convert stored glycogen back into glucose. Galactose is a monosaccharide that is converted to glucose by the liver.

A client has been brought to the unit with general complaints of nausea, fatigue, and anorexia. On assessment, the nurse learns that the client has not been eating well and has been eating mainly a low-carbohydrate, high-protein diet. The nurse is aware that which of the following may be occurring?

ketosis -Without adequate glucose, the body may use protein, and this can lead to ketosis. An increasing production of ketone bodies can cause nausea, fatigue, loss of appetite, and ketoacidosis.

When teaching about the path of glucose in the body, the nurse can explain that after it is absorbed into the intestinal mucosa, glucose travels next to which of the following body organs?

liver

The nurse is teaching a nutrition class. The nurse recognizes that the students understand the lesson when one student makes which of the following statements?

monosaccharides are absorbed in the body without undergoing digestion. -Monosaccharides are absorbed in the body without needing to be broken down or split into smaller components before absorption. Maltose and lactose are disaccharides. Fiber is a complex carbohydrate, also a type of polysaccharide.

The nurse recognizes that glucose, fructose, and galactose are also referred to as which of the following?

monosaccharides. -Glucose, fructose, and galactose each contain a single molecule of sugar and are referred to as monosaccharides. Disaccharides contain two molecules of sugar, and polysaccharides contain long chains of molecules. There are no specific trisaccharides.

The nurse is aware that glycogen is the stored version of glucose available for when the body may need it. The nurse knows that the majority of the glycogen is stored in which part of the body?

muscles -Typically, two thirds of the body's glycogen is stored in the muscle, where it is available only for use in the muscle, and the remaining one third is stored in the liver, where it is available for all body cells.

The nurse recognizes that the bran layer of grains contains many components that are beneficial. When teaching about the nutritional benefits of whole grains, the nurse states that one of the nonnutrient compounds that has been associated with a reduced risk of chronic diseases is which of the following?

phytonutrients -Phytonutrients are bioactive, nonnutrient plant compounds found in bran that is associated with a reduced risk of chronic diseases. Protein and starch are found in the endosperm layer, and vitamin E is located in the germ layer of grain.

When providing education regarding sugar alternatives, the nurse should include that some alternatives occur naturally but are not true sugars. Which of the following originate(s) in starches?

polyols -Polyols or sugar alcohols are produced from the fermentation or hydrogenation of monosaccharides or disaccharides. Most originate in sucrose or glucose and maltose in starches.

If a client is not consuming enough carbohydrates, the nurse realizes that the body will use what to try to meet its energy needs?

protein

The nurse educator is discussing the effects of the digestion process of starch in a nutritional health class. The class should understand that cooked starch begins digestion due to the action of which of the following?

salivary amylase. -Cooked starch begins to undergo digestion in the mouth due to the action of salivary amylase. This action is stopped by stomach acids. Most digestion occurs in the small intestine, where pancreatic amylase reduces the complex carbohydrates into smaller chains and disaccharides.

The nurse is facilitating a weight management class for a group of adolescents. Today's discussion is about recognizing the added sugars in their diets. After the meeting, the students can successfully recognize that which product contains the most added sugar?

soda -Soda, energy drinks, and sport drinks are the largest contributor to empty calories in the American diet.

The school health nurse is preparing an educational session for students in the school. The nurse correctly includes in the presentation that plants use glucose for energy, however, glucose that is not used for immediate energy is stored in the form of which of the following?

starch

The nurse is explaining the difference between whole grains and refined grains to a small group of clients. The nurse explains that refined grains are rich in which of the following nutrients?

starch -Refined grains have most of the bran and germ removed. They are rich in starch but lack the fiber, B vitamins, vitamin E, trace minerals, unsaturated fat, and most of the phytochemicals found in whole grains.

A nurse is conducting nutritional teaching with a client who is experiencing constipation. The nurse recognizes the client had a knowledge deficit when the client was surprised to discover that some fibers can provide a source of energy to which of the following?

the mucosal lining of the colon. - Soluble fibers are fermented by bacteria and broken down into carbon dioxide, methane, hydrogen, and short-chain fatty acids, which can serve as a source of energy to the mucosal lining of the colon.

The nurse is concerned that a client is consuming an excessive amount of carbohydrates. It is important for the nurse to recommend eating pattern changes to the client in order to prevent an increase in which of the following?

triglycerides.

The nurse instructs a client on foods to increase total fiber intake to 25 grams/day. Which breakfast choice indicate that teaching has been effective?

½ cup all bran cereal, ½ cup skim milk, 1 slice whole wheat bread, sliced pear