Final Exam Study Guide

The student nurse is working with a PT in a long-term care facility. When discussing the nutrient status of the 75-year-old PT, which statement made by the student requires clarification?

"As people age, synthesis of Vitamin D decreases, but it's alright since less is needed."

During a teaching session for adults at a worksite, a participant asks the occupational health RN if metabolic changes related to aging vary by gender. Which response by the occupational health RN provides the MOST accurate response to this question?

"BMR declines for both genders with a more rapid decline beginning earlier for men than for women."

The RN is teaching a middle-aged, obese, pre-diabetic PT about the need for physical exercise in excess of the recommended 150 minutes of moderate-intensity physical activity. The PT asks the RN which changes related to aging support this recommendation. Which response best explains the relationship between changes related to aging and this exercise recommendation?

"Changes in the metabolic rate led to lean muscles mass loss; increased physical activity can help maintain muscle mass and maintain the metabolic rate."

Teaching on Type 1 Diabetes has been effective when the PT makes which statement?

"I will always need to take Insulin."

What can the RN tell the PT about the recommended daily dose of Vitamin A?

"Recommended doses are not necessary but desirable."

The RN is reviewing a low-carb diet with a PT newly diagnosed with Diabetes at the DRs office. Which statement provides the MOST accurate information about a form of carb that can be used to replace sugar in products for use by Diabetics?

"Sugar alcohols can be used as artificial sweeteners and do not require Insulin for metabolism, making them an ideal form for Diabetics to use."

The nursing instructor is teaching students about the need for nutritional screening for all PT's admitted to a hospital. Which statement made by the student indicates understanding of nutrition screening?

"The RN must complete nutrition screening within 48 hours of any PT being admitted to the hospital."

Which statement made by the RN is the MOST appropriate when providing education for a PT taking high-dose Niacin (Vitamin B3) supplements to improve blood Lipid profiles?

"Your Liver enzymes must be monitored."

Which of the following health conditions can cause Vitamin deficiency? SATA.

- AIDS - Kidney Disease - Liver Disease

What does the RN know to be the daily recommended intake of Calcium for a 30-year-old male?

1000 mg

Which PT requires 10% to 35% of his or her Energy to come from Protein?

A 25-year-old who takes daily walks

How does Protein help maintain pH balance?

Acts as a buffering agent

What is recommended diet for a PT with Fatty Liver Disease?

Balanced diet and no alcohol

Which nutrition-related physical assessment finding does the RN expect in a PT with Anorexia Nervosa?

Bone Pain

Which Mineral is essential to blood clotting?

Calcium

Which is a complication of untreated Fatty Liver Disease?

Cirrhosis

What is often the first manifestation of Type 1 Diabetes?

Diabetic Ketoacidosis

What is the final enzyme in the Protein-splitting system, and where is it produced?

Dipeptidase produced in the small intestine

Which Protein acts as a Catalyst to enable chemical reactions to occur within the body?

Enzyme

Which type of body fat serves vital functions, such as membrane integrity?

Essential fat

A RN is preparing a PT for surgery. The PT records note that the PT has been taking Warfarin at home. Which herb reported by the PT as also being taken at home would be of concern to the RN?

Ginseng

Physiological changes to which brain structure that occur with aging put older adults at a higher risk for dehydration?

Hypothalamus

Where are Plasma Proteins found in the human body?

Inside blood vessels

Which substance does the Pancreas produce?

Lipase

To which site is Galactose transported once it enters the Villi?

Liver

Which Organ produces Bile?

Liver

Which element distinguishes Protein from other nutrients?

Nitrogen

Which of the following systems is MOST affected by a Vitamin A deficiency?

Ocular

By which process is water absorbed throughout the GI tract?

Osmosis

What effect can long-term stress have on the GI tract?

PUD

Where are Amino Acids absorbed?

Portal Circulation

How does the Pancreas affect Metabolism?

Regulates blood Glucose levels

Which is a benefit of initiating Parenteral nutrition over Enteral nutrition?

Shorter-term treatment

The RN is creating a pamphlet for college level students on Nutrition. The RN includes which statement that best reflects the impact of physiological changes for individuals in this stage of early adulthood?

Skeletal growth is almost complete, so less Calcium and Phosphorus are necessary

What is the best dietary recommendation for a PT diagnosed with HIV?

Standard dietary recommendations

What determines the function of Proteins?

Structure of the Protein

The ADA endorses which type of diet for Type 1 Diabetes management?

The ADA does not endorse any specific diet

Water flows out of the cell when which condition is met?

The cell is surrounded by Hypertonic Solution

Which dietary change is important for the RN to discuss with individuals as they age to help address a declining Metabolic rate?

The intake of "empty calorie" foods should decrease.

The RD is explaining the nutrition care process to a group of nursing students. Which statement by the RD about the nutrition diagnosis is correct?

"It falls into one of THREE categories: intake, clinical, or behavioral-environment."

The RN is teaching a group of nursing students about components of the nutrition diagnostic statement. Which statement by the student indicates that teaching was effective?

"The nutrition diagnostic statement should have THREE main elements: Problem, Etiology and S/S."

A nursing student is caring for an older adult being given Vitamin B12 injections. The instructor asks the student why the PT is receiving the injections. Which response by the student best reflects the physical changes which may lead to a need for Vitamin B12 injections for this PT?

"Vitamin B12 may not be absorbed adequately due to decreased production and secretion of Gastric Hydrochloric Acid."

A nurse is educating a non-diabetic patient about the risk of gestational diabetes and its pathophysiology during pregnancy. Which statement made by the nurse MOST accurately describes gestational diabetes?

"You are at the highest risk after the first 20 weeks of gestation, because insulin sensitivity is decreased by placental and ovarian hormones, and the pancreas cannot compensate."

A high-risk PT asks the RN, "What puts me at risk for Type 2 Diabetes?" What is the RN's response?

"You have a history of Gestational Diabetes."

A student RN is assigned to teach a PT about the tissue functions of Carbohydrates in preparation for a class on a low-carb diet. Which should the student include in the teaching session concerning possible outcomes if dietary Carbohydrate intake is not sufficient? SATA

- "Fat is broken down to use for energy, resulting in production of Ketones." - "The required minute-to-minute supply of Glucose for the Brain may not be available." - "Protein is sacrificed to supply energy, which effects - tissue growth and maintenance."

The RN is providing care for a PT with Type 2 Diabetes Mellitus. The RN knows that unlike Type 1 Diabetes, Type 2 is associated with which of the following? SATA.

- A sedentary lifestyle - A history of PCOS - A BMI of 25 or more - A history of cardiovascular disease

What is an advantage of consuming a diet of Complementary Proteins? SATA.

- Contains less fat - Plant foods cost less - Prevents some chronic diseases - Equivalent to complete Protein diet

A PT has been admitted to the unit after suffering second degree burns over 20% of the body surface area. Which events may occur, resulting in increased mortality for this PT? SATA

- Increased Nitrogen loss - Increased Amino Acid catabolism - Accelerated Protein degradation

Which objectives are appropriate for a patient with Pre-Diabetes? SATA

- Maintaining optimal nutrition - Preventing Hyperglycemia - Preventing complications

Which aspects of health play a role in Pre-Diabetes management? SATA.

- Physical Health - Intellectual Health - Emotional Health - Social Health - Environmental Health

Which type of Protein must be available to meet the body's Metabolic needs? SATA

- Plasma - Complete - Hormone - Tissue

Which gradual onset symptoms occur with Type 2 Diabetes? SATA

- Polyuria - Fatigue - Frequent Infection

Vitamin deficiency can occur in PT's in which conditions? SATA.

- Pregnancy - Poverty - Caffeine Abuse - Drug or Alcohol Abuse

Which are accurate statements concerning aging and the Metabolic rate? SATA

- The change reflects lean muscle mass loss - The change reflects loss of high metabolically active Organ tissues

Which S/S do PT's with Type 1 Diabetes often experience? SATA

- Weight loss - Polyphagia - Polyuria

A female athlete is concerned about safely consuming enough Protein for an upcoming marathon. How much Protein per Kilogram of body weight should the RN recommend?

1.5 to 2 g/kg of body weight per day

The RN should expect a PT with Pre-Diabetes to have which value for fasting blood Glucose?

110 mg/dL

The RN is teaching a prenatal class for young adult women in the second trimester of pregnancy. The RN informs the participants that the BMR may increase by how much each term?

15% to 20%.

A RN is collecting objective data from a PT in a DRs office to create a plan of care. The RN records a weight of 154 lbs., and a height of 69 inches. What is the PT's BMI?

23.0

What is the minimum amount of water a day that healthy adults need?

4 cups

The national standard for Nutrition needs for older adults are based upon which estimated percentage decrease in Metabolic activity during the middle and older years?

5%

A RN is assessing PT's for Gestational Diabetes risk. Which PT does the RN identify as having the HIGHEST risk for developing Gestational Diabetes?

A 30-year-old Asian female with a BMI of 27

Which is the Pathophysiological basis for reduced cell Metabolism beginning at approximately 30 years of age?

A gradual loss of functioning cells

What is an example of a nutritional intervention recommended in the Healthy People 2020 national goal for nutrition and weight status?

An improved workplace food menu

The RN is caring for a PT with Liver Disease and low Plasma Protein levels. For what complication should the RN monitor the PT?

Ascites

A PT is admitted to the Oncology unit with Colon Cancer. The PT is suffering from intractable Nausea and Vomiting related to medical therapy. The RN knows that malnutrition causes which process that decreases the PT's immunity?

Atrophy of Organs and Tissues

Type 1 Diabetes is an autoimmune disease resulting in the destruction of which cells?

Beta cells of Pancreas

What does Phosphorus toxicity cause?

Bone reabsorption

What role does Protein play in the immune system?

Builds Lymphocytes

How do Plasma Proteins maintain vascular blood volume?

By exerting Colloidal Osmotic Pressure

What type of Protein keeps the wall of the Arteries intact?

Collagen

Where does intestinal gas form in the GI tract?

Colon

What type of Amino Acid is necessary for PT's experiencing certain illnesses?

Conditionally Indispensable

Which meal program is MOST appropriate for a physically active elderly person who is socioeconomically stable?

Congregate nutrition services

What is an expected assessment finding for a PT with Impaired Glucose Tolerance (IGT)?

Dyslipidemia

Which food is the best source of Phosphorus?

Eggs

The RD is formulating a nutrition care plan for a PT at risk for developing Hypertension. Which nutrition diagnosis is MOST appropriate?

Excessive calorie intake related to regular consumption of large portions of high-fat meals, as evidenced by diet history and BMI of 35

The RN is reviewing medical records of PT's on the unit. Which PT's are displaying indications of Metabolic Syndrome?

Female: BP 138/88, Wait Circumference 37 in, HDL Cholesterol 40 mg/dL.

A PT in an outpatient clinic is having a test done to determine his or her BMR. The RN expects the PT to have an increased BMR due to which finding?

Fever of 101.0 degrees Fahrenheit

Which factor has the greatest effect on the absorption of nutrients in the small and large Intestinal tract?

Fiber

Which is a PRIORITY in providing initial Nutritional counseling to a PT with HIV?

Food-borne illness prevention

which Organ stores Bile?

GallBlader

What is the definition of Pre-Diabetes?

Glucose levels that do not meet the criteria for Diabetes but are still considered high risk for developing Diabetes

A pregnant woman is being screened for Gestational Diabetes during her 28-week gestation visit. The DR uses the one-step method to determine the presence of Gestational Diabetes in this PT. What result indicates that the PT will be diagnosed with Gestational Diabetes and that the RN will need to implement proper dietary education?

Glucose result 155 mg/dL two hours post oral Glucose tolerance test

Stored water becomes available for use in body function when which is used for Energy?

Glycogen

When food is not available, such as during sleep, the body draws from its stored energy. Which stored energy source is responsible for maintaining normal Glucose levels during sleep?

Glycogen

A PT has not eaten for 24 hours in order to lose weight. The RN is assisting the PT in developing a healthy diet and exercise regimen to lose weight. What source of stored energy has this PT's body been using during the period of starvation?

Glycogen in the Liver

When assessing the diet of a PT who is being treated with the antifungal drug Griseofulvin, the RN would understand that which Pathophysiological process results in increased absorption of Griseofulvin with a high-fat diet?

High-fat diets stimulate the secretion of Bile acids, hence increasing drug absorption

A PT is going to have BMR measured to help develop a diet plan to promote a healthy lifestyle. Which condition can prevent the PT from getting the testing done?

Increase in body temperature

Which type of Amino Acids are found in the Protein of an Egg?

Indispensable

Dietary prescriptions for Diabetes are based on which factors?

Individual nutrition assessment and treatment goals

Which is a characteristic of Type 2 Diabetes?

Insulin produced by the body cannot be used

What is the advantage of using the MNA to assess the nutritional status in elderly individuals in nursing homes?

It evaluates the risk for malnutrition

Which Organs play the greatest role in maintaining pH in the body?

Kidneys and Lungs

Which accessory Organs assist with the digestion and absorption of food?

Liver, Gallbladder, Pancreas

Which best describes the function of Vitamin A?

Maintains skin and mucous membranes

What is a basic goal of nutritional therapy for PT's with Type 1 Diabetes?

Maintenance of lean weight

Which are the three components of nutritional monitoring and evaluation?

Monitor progress, Measure outcomes, Evaluate outcomes

Which statement is MOST accurate regarding Vitamins?

Most Vitamins are provided through dietary intake

Which dietary considerations is necessary for the Type 2 Diabetes PT prior to moderately exercising for one hour?

No modifications are necessary

Why would lacking the Leptin receptor be associated with severe early-onset Obesity?

No negative feedback regarding energy intake

Which entity provides cash and/or commodities to supplement meals offered at congregate and home-delivered nutrition programs?

Nutrition Service Incentive Program

What is the clinical term for a PT who has excess body fat?

Obese

The RN knows that BMR, physical activity, and lean muscle mass are all included in which category of risk factors for Obesity?

Physiological

Which dietary strategy should a RN recommend for a Type 2 Diabetic PT?

Planning regular times for meals and snacks

Which type of Enteral nutritional formula is designed for a PT with a fully functional GI tract?

Polymeric

When assessing the dietary intake of a PT with CKD, what information should the RN obtain?

Previous and current dietary intake

Which statement best explains how primary deficiency of a Vitamin occurs?

Primary deficiency occurs when the Vitamin is not consumed in sufficient amounts

Which best describes the function of Vitamin D?

Promotes Calcium absorption

Which is true regarding the recommended daily dose of Vitamin D?

Recommended daily doses are measured in international units

What is the impact of Yo-Yo dieting?

Reduced Metabolic Rate and Lean Body Mass

A PT is concerned about developing Gestational Diabetes during her pregnancy. When should the RN advise the PT to be tested for Gestational Diabetes?

Second Trimester

Which hormone stimulates the Pancreas to send Alkaline Pancreatic juices into the Duodenum to buffer acidic Chyme?

Secretin

What small intestinal movement results in the progressive chopping of a food mass into soft lumps, mixing it with GI secretions?

Segmentation Rings

Which program is available for low-income older adults to help improve nutrition by increasing their servings of fruits and vegetables?

Senior Farmers' Market Nutrition Program

Which dietary change is important for the RN to discuss with individuals as they age to help address a declining Metabolic Rate?

The intake of "empty calorie" foods should decrease.

Once an individual reaches early adulthood, which best reflects the process of physical growth?

The physical growth process involves the vital growth of new cells to replace old cells

As the RN prepares an educational session for a group of middle-aged adults, which is important to include concerning Metabolism and weight management?

There is a need for fewer Kilocalories due to a declining Metabolic rate

How are Electrolytes measured?

Total number of particles in solution

Genetic predisposition and environmental factors are common with which type of Diabetes?

Type 1 Diabetes

A deficiency of which Mineral can result in Rickets?

Vitamin D

Which of the following is a Fat-Soluble Vitamin?

Vitamin D

A RN is providing dietary counseling to a lacto-vegetarian PT. Which complementary food combination is the best choice for providing the necessary Amino Acids to achieve a complete Protein balance for the PT?

Whole wheat pasta and cheese