Nutrition Exam 2

The most easily absorbed form of iron is found in a. a grilled pork chop. b. tomatoes cooked in an iron skillet. c. collard greens cooked with bacon. d. spinach salad with strawberries.

a grilled pork chop. Heme iron is absorbed most easily; it is found in animal foods, such as pork. Cooking an acidic food such as tomatoes in an iron skillet would increase the iron content, but the iron would be nonheme, which is less well absorbed than heme iron. Similarly, the vitamin C in the strawberries would increase the absorption of the iron in the spinach, but it is still the nonheme form that is less well absorbed. Bacon may contribute a very small amount of heme iron to the collard greens, but it would be much less than the pork chop.

If a patient starts vomiting immediately after eating seafood and states that the one other time he or she ate seafood, he or she had a similar reaction, the patient probably has a. food poisoning. b. celiac disease. c. an allergy to seafood d. a viral infection.

an allergy to seafood

If a patient has a torn ligament, then during healing and recovery, the patients body would need to manufacture a. fibrin. b. albumin. c. collagen. d. hemoglobin.

collagen. Collagen is the main structural protein found in ligaments and other connective tissues, bone, and teeth. Fibrin is an important protein in blood clots. Albumin is an important blood plasma protein. Hemoglobin is the main protein that carries oxygen in the blood.

Wilsons disease is an inherited disorder that causes excessive accumulation of a. iron. b. zinc. c. copper. d. chromium.

copper. Wilsons disease causes excessive accumulation of copper. Excessive accumulation of iron is called hemosiderosis. Excessive accumulations of zinc and chromium do not have specific names.

In comparison with the iron needs of younger women, those of older women a. decrease because of slower turnover of red blood cells. b. decrease because of menopause. c. increase because iron absorption becomes less efficient. d. increase because oxygen use is less efficient.

decrease because of menopause.

The nutrient that pregnant women are most likely to need to take in the form of a supplement is a. iron. b. calcium. c. protein. d. vitamin C.

iron.

Rapid weight gain (>1 pound in a day) is probably caused by accumulation of a. fluid. b. feces. c. body fat. d. lean body mass.

fluid.

According to the Dietary Supplement Health and Education Act (DSHEA) of 1994, dietary supplements are considered a. foods. b. drugs. c. nutrients. d. food additives.

foods.

Using a margarine fortified with plant sterol and stanol esters to help decrease blood cholesterol levels is an example of using a a. probiotic. b. functional food. c. dietary supplement. d. complementary food.

functional food.

A patient may be at high nutritional risk if he or she a. is receiving a soft diet. b. has a serum albumin level of 2.5 g/dL. c. has been receiving a tube feeding for 1 week. d. has gained 5 pounds during the previous month.

has a serum albumin level of 2.5 g/dL.

An example of a meal with high levels of vitamin K is a. grilled shrimp with rice and green beans. b. eggs, bacon, and hash browns. c. stir-fried beef with broccoli. d. bacon, lettuce, and tomato sandwich.

stir-fried beef with broccoli. The best source of vitamin K is green leafy vegetables, such as broccoli. Dairy products, meats, cereals, and fruits provide smaller amounts.

The most important thing a nurse can do to prevent the spread of foodborne illness among hospitalized patients is to a. discard any food that is uneaten within 30 minutes of being served. b. wear a mask when serving food or helping feed patients. c. wash hands thoroughly before serving food and after using the bathroom. d. discourage friends and family members from bringing in food for the patient.

wash hands thoroughly before serving food and after using the bathroom.

An example of a patient considered to be at high nutrition risk is a(n) a. 72-year-old man who has been vomiting for 12 hours. b. 38-year-old overweight man who has had a heart attack. c. 18-month-old child with weight in the third percentile for height. d. woman with a broken leg and a serum albumin level of 3.8 g/dL.

18-month-old child with weight in the third percentile for height.

The RDA of protein for a healthy adult who weighs 60 kg is _____ g/day. a. 36 b. 48 c. 60 d. 72

48 The RDA of protein for a healthy adult is 0.8 g/kg per day. Therefore, the RDA for an adult who weighs 60 kg is 48 g/day (0.8 60).

If a male patient weighs 140 pounds when he is admitted to a long-term care facility and weighs 147 pounds 2 months later, his percent weight change during his hospital stay is a. 3.5%. b. 5%. c. 7%. d. 14%.

5%.

An example of someone who has a relatively high risk for vitamin deficiencies is a(n) a. 45-year-old half marathon runner. b. 85-year-old man living independently. c. college-age woman living with roommates. d. breastfed newborn.

85-year-old man living independently. Subgroups of the population at risk for vitamin deficiencies include older adults because of decreased vitamin absorption and limited physical and economic resources to purchase and prepare food. Active middle-aged adults and college students usually consume enough food to ensure adequate vitamin intake. Vitamin deficiencies are rare among breastfed newborns.

An example of someone who is at high risk for malnutrition and weight loss is a(n) a. 21-year-old student who works part time. b. 36-year-old single mother with three children. c. 57-year-old man who is unemployed. d. 88-year-old widow who lives alone.

88-year-old widow who lives alone.

Rickets would be most likely to develop in a(n) a. elderly frail adult who lives alone. b. Asian college student who does not drink milk. c. white toddler who has been weaned from breast milk. d. 9-month-old breastfed African American baby.

9-month-old breastfed African American baby. Rickets is caused by vitamin D deficiency in infants and toddlers; those who are breast-fed and have dark skin are at higher risk because breast milk is low in vitamin D and dark skin is less efficient at forming vitamin D when exposed to sun. In response to low intake of vitamin D and calcium, elderly adults may develop osteoporosis and younger adults may develop osteomalacia.

If a woman in her last trimester of pregnancy has marked edema, what else should be evaluated? a. Body temperature and hematocrit b. Blood and urinary glucose levels c. Blood pressure and urine protein levels d. Sodium intake and urinary sodium excretion

Blood pressure and urine protein levels

Deficiencies are likely to develop most rapidly with low intake of vitamin a.- A. b.- C. c.- D. d.- E.

C. Vitamin C is water soluble; vitamins A, D, and E are fat soluble. Deficiencies of water-soluble vitamins develop more rapidly because they are not stored in the body.

An example of a food that contains complete protein is a. oatmeal. b. lentil soup. c. peanut butter. d. hard-boiled egg.

Eggs and most other animal foods contain complete protein. Grains, legumes, and nuts contain incomplete proteins.

A mother of a toddler tells you that her child drinks several cups of fruit juice each day. How would you respond? a. It is important to decrease juice intake because high potassium intake can be dangerous for young children. b. Even though fruit juice contains some micronutrients, intake should be limited because it also has high levels of natural sugar. c. As long as the juice is 100% real fruit juice, this is a good way to increase intake of fruits and micronutrients. d. Drinking juice is healthful as long as the child has adequate intake of foods from all the food groups.

Even though fruit juice contains some micronutrients, intake should be limited because it also has high levels of natural sugar.

The program that would be most helpful for a lonely 75-year-old widow who has been gradually losing weight since her husbands death is the _____ Program. a. Senior Nutrition b. Emergency Food Assistance c. Supplemental Nutrition Assistance d. Child and Adult Care Food

Senior Nutrition

If a patient with depression takes a selective serotonin reuptake inhibitor (SSRI), the nurse may want to ask about use of herbal products because of potential interactions if the patient is using a. ginseng. b. ginkgo biloba. c. St. Johns wort. d. evening primrose oil.

St. Johns wort.

The sports coaches at a university are designing training diets for their teams. Why do they need to provide more protein for the mens rowing team than for the womens rowing team? a. The mens team is more active than is the womens team. b. The mens team has more lean body mass than does the womens team. c. The mens team has a higher metabolic rate than does the womens team. d. The mens team uses dietary protein less efficiently than does the womens team.

The mens team has more lean body mass than does the womens team. Men generally require more protein than do women because they have more lean body mass than do women; lean body mass requires more protein to maintain. Men are not necessarily more active than women when they compete in the same sport. They do have a higher metabolic rate, but this is because they have more lean body mass; their higher metabolic rate affects their energy needs, not their protein needs. Men do not use protein less efficiently than do women.

A patient is admitted to the hospital with confusion, memory loss, and ataxia. What other information would lead you to suspect that his symptoms may be caused by secondary thiamin deficiency? a. The patient has very limited funds and has been eating mainly rice and beans. b. The patient admits that he struggles with alcoholism. c. The patient is recovering from a minor stroke. d. The patient has a family history of Alzheimers disease.

The patient admits that he struggles with alcoholism. Alcoholism may be associated with a secondary thiamin deficiency because the liver needs increased amounts of thiamin to detoxify alcohol. Limited food intake may cause primary deficiency (although legumes are a good source of thiamin, and so primary deficiency is unlikely). Strokes and Alzheimers disease may cause confusion, memory loss, and ataxia, but not in relation to a secondary vitamin deficiency.

The main reason that the adequate intake (AI) for vitamin D increases in older adults is that a. their ability to absorb dietary vitamin D is diminished. b. conversion of vitamin D to its active forms is less efficient. c. their skin is less efficient in synthesizing vitamin D during sun exposure. d. they require more vitamin D than do younger adults to maintain bone health.

Their skin is less efficient in synthesizing vitamin D during sun exposure. Older adults need more dietary vitamin D because their skin is less efficient in synthesizing vitamin D during sun exposure. Their ability to absorb vitamin D and convert vitamin D to its active form has less effect on vitamin D needs. They do not necessarily require more total vitamin D than do younger adults for bone health; they need more from foods because their skin manufactures less.

Eric follows a vegetarian eating pattern, and he wants to know whether he needs to take any vitamin and mineral supplements. What would be most important to find out? a. Whether he includes complementary vegetable proteins b. Whether he follows a vegan eating pattern or eats some animal foods c. Whether his skin has regular exposure to sunlight d. Whether he relies on mostly natural or mostly processed foods

Whether he follows a vegan eating pattern or eats some animal foods It would be important to find out whether Eric follows a vegan diet; strict vegan diets do not contain any vitamin B12 (found only in animal products) and vitamin D (obtained mostly from fortified milk). Including complementary vegetable proteins would improve the overall quality of his protein intake but would not affect his vitamin and mineral intake. Regular skin exposure to sunlight would help manufacture some vitamin D, but would not help with vitamin B12 status, and so the question of sun exposure is less important. Processed food may contain fewer micronutrients that natural foods, but this is less critical than whether he includes any animal foods in his diet.

A good source of calcium for someone who follows a strict vegetarian (i.e., vegan) diet would be a. coconut milk. b. a bean burrito. c. skim milk. d. pasta salad.

a bean burrito. A good vegan source of calcium is a bean burrito because legumes contain calcium. Coconut milk and pasta salad are not good sources of calcium. Skim milk is not included in a vegan diet.

A person who follows a strict kosher diet would not eat a. macaroni and cheese. b. a cheeseburger and fries. c. a bean-and-cheese burrito. d. roast beef with mashed potatoes.

a cheeseburger and fries. A strict kosher diet would not include a cheeseburger because meat and dairy may not be eaten together. Both macaroni with cheese and a bean-and-cheese burrito contain only dairy. Roast beef with mashed potatoes is acceptable as long as the beef has been slaughtered appropriately.

A clear liquid diet would be most appropriate for a. someone who has had several teeth removed and is unable to chew. b. a pregnant woman with persistent nausea. c. someone who has had a stroke and has difficulty swallowing. d. a patient who has had major surgery within the past 18 hours.

a patient who has had major surgery within the past 18 hours.

The person who would have the highest need for thiamin is a. someone who lifts weights to maintain health. b. a pregnant woman. c. a professional cyclist. d. an older adult who walks 2 miles daily.

a professional cyclist. Thiamine needs are related to metabolic rate (i.e., energy expenditure) because thiamine is a coenzyme in energy metabolism. Therefore, the professional cyclist needs the most thiamin because he or she has the greatest energy needs. Pregnancy, walking, and weightlifting all increase energy needs, but less so than professional athletic training.

A meal rich in nutrients that promote wound healing is a. a bean burrito with salsa and guacamole. b. a roast beef sandwich on whole grain bread with strawberries. c. a grilled cheese sandwich and carrot sticks. d. tuna salad on a bed of lettuce with crackers.

a roast beef sandwich on whole grain bread with strawberries.

If a patient is 6 feet tall and his or her waist measures 42 inches, the patient would be considered to have _____ fat levels consistent with _____ risk for chronic disease. a. essential; low b. essential; high c. abdominal; low d. abdominal; high

abdominal; high

Without vitamin B6, the body would be unable to a. absorb amino acids. b. digest proteins. c. convert ammonia to urea. d. regulate acid-base balance.

absorb amino acids. Vitamin B6 (pyridoxine) is needed as a carrier for absorption of amino acids. It has several roles in protein metabolism, but it is not needed for protein digestion or for conversion of ammonia from protein breakdown to urea in the liver. Pyridoxine is not involved in regulation of acid-base balance.

Intravenous lipid emulsions are used as part of parenteral nutrition to prevent fatty acid deficiency and to a. increase patient satiety. b. provide a source of fat-soluble vitamins. c. add kilocalories without increasing osmolality. d. add kilocalories with minimal expense.

add kilocalories without increasing osmolality.

The person who is most likely to have an inadequate calcium intake is a(n) a. school-age child who receives free school breakfast and lunch. b. toddler who prefers to drink milk rather than eat meals. c. adolescent boy who plays varsity football. d. adolescent girl who is a competitive gymnast.

adolescent girl who is a competitive gymnast.

Alcohol abuse is associated with poor nutritional status because a. alcohol intake increases basal metabolic rate. b. alcoholic beverages displace healthful foods from the diet. c. alcohol increases the desire for foods with high levels of fat and sugar. d. people with alcoholism often eat in bars that serve a limited number of foods.

alcoholic beverages displace healthful foods from the diet.

If an athlete ran a marathon, sweated profusely, and drank only water with some sugar to replace fluids and carbohydrate, his or her body would increase secretion of a. adrenaline. b. aldosterone. c. alanine. d. antidiuretic hormone (ADH).

aldosterone. The body would respond to loss of sodium in sweat by releasing the hormone aldosterone; this would prompt the kidney to decrease sodium excretion. During a marathon, the body may produce adrenaline in response to stress, but this would not address the problem of fluid and energy replacement without sodium replacement. Alanine is an amino acid and has no effect on sodium balance. ADH causes the kidneys to decrease water excretion but does not affect sodium excretion.

The term bioavailability means the a. total amount of a mineral in a food. b. ratio of free mineral to bound mineral in a food. c. amount of a mineral that is excreted by the body. d. amount of a mineral that can be absorbed by the body from a food.

amount of a mineral that can be absorbed by the body from a food. Bioavailability is the amount of a mineral that can be absorbed by the body from a food. It is generally lower than the total amount of the mineral in a food. It may be related to the ratio of free mineral to bound mineral in a food, but that is only one of many factors affecting bioavailability. It is not related to the amount excreted by the body.

To determine the nutritional adequacy of a tube feeding, a. the patients actual formula intake and body weight should be recorded daily. b. intake and output records should be completed during each nursing shift. c. urine glucose levels, gastric residuals, and bowel movements should be recorded. d. anthropometric, biochemical, and clinical indexes should be assessed weekly.

anthropometric, biochemical, and clinical indexes should be assessed weekly.

During acute bacterial infections, patients need extra protein to manufacture a. hormones. b. antibodies. c. antibiotics. d. enzymes.

antibodies. During bouts of infection, the immune system uses protein to produce antibodies. Hormones are chemical messengers in the body that are sometimes proteins but are not directly involved in fighting infection. Antibiotics help recover from bacterial infections but are administered to the patient and are not produced by the body. Enzymes are protein catalysts in the body and are also not involved in fighting infection.

To prevent baby bottle tooth decay in infants who need a bottle at bedtime, the bottle should not contain a. fruit juice. b. beverages sweetened with sugar. c. any liquid other than water. d. iron-fortified infant formula.

any liquid other than water.

If nutrition screening identifies a patient as being at high nutrition risk, the next step in their care would be nutrition a. intervention by a registered dietitian. b. assessment by a registered dietitian. c. diagnosis by the physician. d. monitoring and evaluation by the nurse.

assessment by a registered dietitian.

Secondary magnesium deficiency is most likely to occur in a. areas where access to fresh fruits and vegetables is limited. b. clients with type 1 diabetes mellitus. c. association with excessive vomiting and diarrhea. d. association with dehydration attributable to heat exposure.

association with excessive vomiting and diarrhea. Secondary magnesium deficiency may occur with excessive vomiting and diarrhea. Primary magnesium deficiency is rare; deficiency is not usually related to poor intake, and fruits and vegetables are not the only good sources of magnesium. Type 1 diabetes and dehydration due to heat exposure do not cause magnesium deficiency.

The lifestyle factor that would contribute most to a childs becoming overweight is a. attending after-school daycare. b. trading foods at lunchtime with friends. c. being raised by one or more grandparents. d. being home alone after school every day.

being home alone after school every day.

A situation that may be associated with moderate nutrition risk is a. use of analgesic medications to manage a patients pain. b. being tube fed for several weeks and transitioning to oral intake. c. food brought in by family members for a hospitalized patient. d. following a low-fat, high-fiber, low-sodium diet.

being tube fed for several weeks and transitioning to oral intake.

A sodium intake of 2100 mg daily by a healthy adult would be considered a. below the adequate intake (AI). b. within the recommended range. c. below the maximum recommended level. d. above the maximum recommended level.

below the maximum recommended level. A sodium intake of 2100 mg daily is below the maximum level recommended by the National Research Council (2400 mg/day) and the American Heart Association (2300 mg/day). The AI is 1500 mg. There is no recommended range for sodium intake, just the AI and upper limits.

Interstitial fluid is the body fluid a. within the cells. b. outside the cells. c. between the cells. d. in the bloodstream.

between the cells. Interstitial fluid is the body fluid between the cells. The fluid within the cells is intracellular fluid; the fluid outside the cells is extracellular fluid; the fluid in the bloodstream is blood plasma.

If a patient complains of fatigue and has spoon-shaped nails, a test that may be ordered is _____ measurement. a. total bilirubin b. blood hemoglobin c. plasma glucose d. blood urea nitrogen (BUN)

blood hemoglobin

Dehydration is most likely to have a negative effect on a. digestion of food. b. storage of excess energy. c. nerve impulse conduction. d. body temperature regulation.

body temperature regulation. Within the body, water helps to regulate body temperature by absorbing and distributing heat throughout the body and through perspiration. Digestion of food requires secretion of digestive fluids, but this is less immediately affected by dehydration. Water is not needed to store excess energy in adipose tissue. Water is not important for this conduction of nerve impulses.

Long-term dietary calcium intake has the greatest effect on a. body temperature. b. muscular strength. c. bone calcium levels. d. blood calcium levels.

bone calcium levels. Long-term dietary calcium intake affects bone calcium levels. Calcium does not affect body temperature. The body maintains steady levels of calcium in the blood and muscles, using calcium from bone if dietary intake is insufficient.

In countries where the staple food source is unleavened bread made from whole grains, zinc deficiency may be prevented by eating a. refined grains. b. breads with yeast. c. fortified grains. d. bread in which the grains were soaked before being baked.

breads with yeast. Zinc deficiency may be prevented by making breads with yeast; the yeast breaks the bond between the zinc and phytic acid, which prevents zinc from being absorbed. Eating refined grains would result in even lower zinc intake; fortification of grains does not include adding zinc; and soaking grains before making bread does not release the zinc from the phytic acid.

If a hospitalized patient is not recovering well and seems to have a poor appetite, it would be appropriate to request a a. tube feeding. b. calorie count. c. food record. d. menu analysis.

calorie count.

One advantage of a full liquid diet is that it a. has low levels of saturated fat and high levels of fiber. b. is suitable for patients with lactose intolerance. c. is likely to be tolerated by patients with dysphagia. d. can provide an adequate diet if very carefully planned.

can provide an adequate diet if very carefully planned.

A patient fell off a bicycle and broke one arm and one leg. Immediately after the accident, the patients body will be in a state of a. anabolism. b. catabolism. c. deamination. d. hypermetabolism.

catabolism. Immediately after a serious accident, the physical stress, immobility, and need to break down damaged tissues cause loss of tissue through catabolism. Anabolism occurs when new protein is being formed during growth or healing. Deamination is one part of catabolism; it involves removal of the amino group when amino acids are broken down. Hypermetabolism is a term that describes an increased state of metabolism in general.

If a patient receiving parenteral nutrition has a fluid restriction, he or she would need to be fed via _____ parenteral nutrition. a. peripheral b. central c. peritoneal d. cyclical

central

A patient has undergone several gut resections because of cancer and is unlikely to resume adequate oral intake of nutrients. The best way to feed this patient would be via a. central parenteral nutrition. b. peripheral parenteral nutrition. c. a PEG tube. d. jejunal enteral feedings.

central parenteral nutrition.

If a patient is immobilized for several days and cannot get out of bed, the most important thing for the nurse to do is a. compare fluid intake and output and check for edema. b. change the patients position or turn the patient several times a day. c. conduct a calorie count to make sure the patients food intake is adequate. d. change sheets and blankets during each shift.

change the patients position or turn the patient several times a day.

An example of a food with high levels of phosphorus is a. rice. b. carrots. c. cheese. d. bananas.

cheese. Foods high in phosphorus include dairy foods (such as cheese). Many processed convenience foods and soft drinks also contain phosphorus as additives. Fruits, vegetables, and rice are not good sources of phosphorus.

A patient who is an orthodox Jew would not eat a. chicken in cream sauce. b. a hamburger and fries. c. a grilled cheese and tomato sandwich. d. scrambled eggs and hash browns.

chicken in cream sauce.

If a child does not like a food when he or she tries it for the first time, the a. childs preference should be respected, and the child should not be encouraged to try it again. b. child should be offered a reward if he or she eats a reasonable amount of the food. c. child should be encouraged to eat at least five bites to see whether his or her taste buds adjust. d. child should be offered the food at least 8 to 10 times at other meals before he or she decides whether he or she likes it.

child should be offered the food at least 8 to 10 times at other meals before he or she decides whether he or she likes it.

Examples of individuals who may have an increased risk for malnutrition include a. inactive middle-aged men. b. sleep-deprived adolescents. c. children with chronic infections. d. breastfed infants.

children with chronic infections. Chronic infection at any age and especially in childhood increases the risk of malnutrition because nutrient needs may be higher and nutrients may not be so well absorbed. Also, appetite may be lower. Inactivity in middle-aged men is likely to lead to overnutrition, not undernutrition. Sleep-deprivation in adolescents is not associated with malnutrition. Breast-fed infants are usually well nourished and are not at high risk for malnutrition.

The best way to ensure intake of a variety of phytochemicals is to a. take a daily multivitamin supplement that includes phytochemicals. b. increase intake of soy-based foods, such as soy milk, tofu, and soy flour. c. choose whole grains and include at least five servings of fruits and vegetables daily. d. include at least three servings of dairy products daily and use a variety of herbs and spices.

choose whole grains and include at least five servings of fruits and vegetables daily. The best way to ensure intake of a variety of phytochemicals is to eat a variety of plant-based foods, including whole grains, fruits, and vegetables. Multivitamin supplements do not necessarily contain phytochemicals. Soy-based foods contain only a limited selection of phytochemicals. Dairy products do not contain phytochemicals; herbs and spices may provide some but are used in small quantities and so would not provide significant amounts.

If an individual has back pain and seeks treatment with acupuncture, as well as a physician at a traditional spine clinic, this would be an example of using _____ medicine. a. traditional b. integrative c. alternative d. complementary

complementary

If a patient who received four prescription medications is going to begin enteral tube feedings, the best thing for the nurse to do is to a. use liquid medications and flush the tube before and after administration. b. crush each medication and dissolve it in water before administration. c. crush the medications and mix them with the tube feeding. d. contact the pharmacy to determine the best route of administration

contact the pharmacy to determine the best route of administration.

If a woman has had preeclampsia and hypertension in a previous pregnancy, then during this pregnancy she should a. restrict her sodium intake. b. continue her regular sodium intake. c. restrict her protein intake. d. take iron and calcium supplements.

continue her regular sodium intake.

If an obese woman is 6 months pregnant and has gained about 8 lbs so far, her health care provider should recommend that she a. try to maintain her current weight throughout the rest of her pregnancy. b. continue to gain weight at about the same rate throughout the pregnancy. c. increase her weight gain to achieve weight gain in the recommended range. d. plan food choices carefully and gradually lose weight during pregnancy.

continue to gain weight at about the same rate throughout the pregnancy.

The most important function of hydrochloric acid in the stomach is to a. convert pepsinogen to its active enzyme form, pepsin. b. denature dietary proteins to allow digestion. c. kill bacteria in food and prevent foodborne illness. d. stop the action of salivary amylase.

convert pepsinogen to its active enzyme form, pepsin. Hydrochloric acid is essential in the stomach for activating pepsinogen to pepsin in order to begin protein digestion. The acid does denature some proteins, but this is not essential to digestion. Stomach acid may play a role in killing pathogenic bacteria and does stop the action of salivary amylase, but these effects are less important.

Of the following, the food choice that contains the least sodium is a. cornbread. b. corn tortilla. c. corn on the cob. d. buttered popcorn.

corn on the cob. The food choice that contains the least sodium is corn on the cob. Of all these forms of corn, this is the least processed. Food processing usually involves addition of sodium.

If a person usually ate 2 ounces of lean meat at lunchtime and decided to substitute cooked lentils instead, how much of the lentils would the person need to eat? a. 2 tablespoons b. cup c. cup d. 1 cup

cup Each ounce of meat is equivalent to cup cooked dry peas or lentils. Therefore, 2 oz of meat would be equivalent to cup.

If a patient starts to experience diarrhea 12 hours after starting enteral feedings, the first course of action the medical staff would try is a. switching to a lactose-free formula. b. decreasing the rate of the formula feeding. c. switching to an elemental formula. d. stopping the feeding until the diarrhea resolves.

decreasing the rate of the formula feeding.

In an older adult who is usually very alert, disorientation may be a sign of a. iron deficiency. b. malnutrition. c. edema. d. dehydration.

dehydration. Disorientation may be a sign of dehydration, which is common in older adults, partly because their thirst mechanism is diminished. Iron deficiency anemia causes fatigue but not disorientation. Severe malnutrition may affect mental acuity but is less likely than dehydration to cause acute disorientation. Edema causes swelling but does not usually affect orientation.

The best way to estimate height for a patient with both legs amputated below the knee is to use a. demi-span (distance from the sternal notch to the middle finger). b. knee height (with the use of calipers to measure heel-to-thigh distance). c. recumbent bed height measured while the patient is lying down. d. the patients stated pre-amputation height.

demi-span (distance from the sternal notch to the middle finger).

Recommendations for treatment of gestational diabetes include a. weight loss. b. dietary control. c. avoidance of sugar. d. oral diabetes medication.

dietary control.

If a patient drools, takes a long time to eat, and often gags during meals, he or she may have a. dementia. b. esophageal cancer. c. regurgitation. d. dysphagia.

dysphagia.

A good way to increase intake of riboflavin would be to a. eat cereal with skim milk for breakfast instead of toast and juice. b. replace romaine lettuce salad with spinach salad. c. drink orange juice instead of apple juice. d. make sandwiches with whole grain bread instead of white bread.

eat cereal with skim milk for breakfast instead of toast and juice. The most significant source of riboflavin in the United States is milk, and so switching to cereal with milk for breakfast would increase riboflavin intake. Replacing romaine lettuce with spinach would increase intake of folate. Replacing apple juice with orange juice would increase vitamin C intake. Eggs, meats, and whole grains are all good but lesser sources of riboflavin. Using whole grains would increase intake of several vitamins and would increase riboflavin intake slightly, but less than by drinking extra milk.

An example of the lifestyle habit of chaining is a. gradually reducing intake of sugar-sweetened beverages. b. eating a piece of fruit with breakfast every day. c. keeping a record of all food and beverages eaten. d. involving all family members in choosing healthy foods.

eating a piece of fruit with breakfast every day. Eating a piece of fruit with breakfast every day is an example of chaining. Chaining involves linking two behaviors; soon the individual will always want to eat a piece of fruit whenever he or she eats breakfast. Gradually reducing intake of sugar-sweetened beverages, keeping a record of all food and beverages eaten, and involving all family members in choosing healthy foods are other good strategies to help improve eating habits.

Foods that are good sources of preformed vitamin A include a. sweet potatoes. b. egg yolk. c. tomatoes. d. carrots.

egg yolk. Preformed vitamin A is found only in the fat of animal foods; egg yolk is a good source. Sweet potatoes, tomatoes, and carrots are all good sources of carotenoids, which can be converted to retinoids (vitamin A) in the body.

Measurement of serum albumin level would be most useful for predicting visceral protein status in a(n) a. patient with congestive heart failure who has very little appetite. b. elderly patient who has been living alone and is scheduled for nonemergency surgery. c. patient with liver failure related to chronic alcohol abuse. d. patient who was in a serious car accident and is recovering from multiple fractures.

elderly patient who has been living alone and is scheduled for nonemergency surgery.

If a patient with cystic fibrosis and pancreatic insufficiency requires enteral feedings, he or she should be fed a(n) a. elemental formula. b. modular formula. c. formula specially formulated for critically ill patients. d. lactose-free formula.

elemental formula

If a physician orders a diet as tolerated for a patient, the nurse should a. make food selections for the patient in accordance with the patients symptoms. b. determine the appropriate type of diet for the patient in accordance with the patients condition. c. consult the registered dietitian to determine when the diet should be advanced. d. encourage the patient to normalize the diet as his or her appetite and symptoms allow.

encourage the patient to normalize the diet as his or her appetite and symptoms allow.

One way a 50-year-old individual can help maintain lean body mass and minimize increases in body fat is to a. engage in regular exercise, including strength training. b. use stress-reduction strategies, such as massage therapy. c. ensure that the diet includes adequate amounts of high-quality protein. d. decrease energy intake to prevent weight gain.

engage in regular exercise, including strength training.

The first step to ensure adequate intake of vitamins is to a. use a daily multivitamin supplement. b. increase fortification of key foods in the food supply. c. target specific supplements for specific subgroups of the population. d. ensure that the diet includes a variety of foods from all of the food groups.

ensure that the diet includes a variety of foods from all of the food groups. The best way to ensure adequate intake of vitamins is to start with a diet that includes a variety of foods from all the food groups. Reliance on supplements and food fortification do not result in an overall optimal diet. Use of supplements by specific subgroups of the population may be a second step in ensuring dietary adequacy, but it would not be the first step.

The most accurate statement about amino acids is that a. most amino acids contain sulfur. b. they are stored in the liver for use when needed. c. essential amino acids cannot be manufactured by body cells. d. nonessential amino acids cannot be manufactured body cells.

essential amino acids cannot be manufactured by body cells. Body cells cannot manufacture essential amino acids. Cells can make nonessential amino acids from essential amino acids. The liver is not able to store significant amounts of amino acids. Some but not most amino acids contain sulfur.

During a home visit to a patient receiving home enteral nutrition, the greatest source of concern would be if the a. patient were receiving enteral feedings only during the night. b. patient has gained 1 pound during the past month. c. family complains that they miss being able to eat meals together. d. family is blending family meals to make their own formula.

family is blending family meals to make their own formula.

A young woman recently married tells you that she is excited to have children. She should be especially careful to consume adequate amounts of a. folic acid. b. vitamin B12. c. pyridoxine. d. vitamin E.

folic acid. Women who may become pregnant need to ensure adequate intake of folic acid to prevent neural tube defects. The neural tube forms before many women know they are pregnant, and so it is important to ensure adequate intake of folic acid before pregnancy. Vitamin B12, pyridoxine, and vitamin E are all important vitamins, but the need for them is not especially associated with pregnancy.

Registered dietitians may encourage patients to use specific herbal supplements a. that are less expensive than conventional medications. b. that they have used themselves and found to be helpful. c. that are approved by the U.S. Department of Agriculture (USDA). d. for which efficacy and safety have been scientifically studied and documented.

for which efficacy and safety have been scientifically studied and documented.

The most reliable source of iodine in the United States is a. seafood. b. dairy products. c. fortified table salt. d. residues of cleaning products.

fortified table salt. The main source of iodine in the United States is fortified table salt. Seafood is a good source, but most Americans do not eat it often enough for it to be their main source of iodine. Dairy products may contain some iodine, depending on the animal that produced them, but they are not reliable sources. Residues of cleaning products may provide some dietary iodine, but the amount is not usually enough to be significant.

The best way to maintain the integrity and function of the gut in someone who is receiving parenteral nutrition is to a. supplement parenteral nutrition with probiotics. b. encourage patients to smell foods to stimulate gastric juices. c. use enemas to keep fluids in the gut without using the oral route. d. give the patient small sips of diluted fruit juice if possible.

give the patient small sips of diluted fruit juice if possible.

If a man weighs 190 lb and eats 150 g protein per day, his protein intake is _____ of the Recommended Dietary Allowance (RDA). a. less than 100% b. between 100% and 150% c. between 150% and 200% d. greater than 200%

greater than 200% The RDA for protein is 0.8 g per kilogram of body weight. This mans weight is 190 lb, or 86 kg; 86 kg 0.8 = 69.1 g protein per day. Thus, an intake of 150 g is more than twice his RDA of 69.1 g of protein per day.

Bolus enteral feedings would be appropriate for a patient who a. has had a gastrectomy. b. has a PEG tube. c. is being fed via a nasoduodenal tube. d. has a history of aspiration-related pneumonia.

had a PEG tube

High levels of glucocorticoid hormones are likely to be produced by someone who a. participates in a weight-training program. b. consumes excessive amounts of protein. c. is pregnant. d. has a large infected wound.

has a large infected wound. Glucocorticoid hormones are produced by the adrenal cortex and have a major role in protein catabolism. For an infected wound, catabolism is necessary to break down damaged tissue. Weight training and pregnancy are anabolic conditions. Consuming excessive amounts of protein places a burden on the kidneys for excretion of nitrogenous waste but does not affect glucocorticoid hormone levels.

The health care provider would be most concerned if a pregnant woman told him or her that she a. has to taste wines to pair with foods for catering events. b. has cravings for salty snacks throughout the day. c. follows a vegan pattern of eating. d. lost 40 lb during the year before she became pregnant.

has to taste wines to pair with foods for catering events.

An elderly patient who has been living alone and has gradually been losing weight has had a stroke and is transferred to a long-term care facility. It is unlikely that he will be able to achieve adequate oral intake during recovery, and so a percutaneous endoscopic gastrostomy (PEG) tube is inserted to begin tube feedings into his stomach. If the patient gains 8 lb in the first week of tube feeding, it is likely that a. he is retaining fluid weight. b. the tube feeding is well tolerated. c. he is constipated. d. the feedings are replenishing muscle and fat stores.

he is retaining fluid weight.

Interventions for obese children should focus on a. gradual weight loss. b. low-fat food choices. c. healthy lifestyle behaviors. d. increased physical activity.

healthy lifestyle behaviors.

High urinary urea excretion may be caused by a. high protein intake. b. phenylketonuria. c. kidney failure. d. administration of growth hormone.

high protein intake. High levels of urinary urea excretion may be caused by protein intake in excess of the bodys need; excess protein is deaminated and used to provide energy; and the ammonia is converted to urea by the liver and excreted by the kidneys. Kidney failure causes high blood levels of urea because the kidneys are unable to excrete it; urinary urea levels would be low. Phenylketonuria is an inability to break down excess phenylalanine and would have very little effect on urea excretion. Administration of growth hormone would cause anabolism, which would result in greater use of amino acids and less urea excretion.

If a patient needs regular injections of vitamin B12, the most likely explanation is that a. he or she follows a vegan eating pattern. b. he or she struggles with alcoholism. c. he or she has a malabsorption syndrome. d. his or her stomach does not produce intrinsic factor.

his or her stomach does not produce intrinsic factor. Vitamin B12 injections are necessary for patients who do not produce intrinsic factor, which is essential for absorption of vitamin B12 from the gut. Patients who follow a vegan eating pattern need vitamin B12 supplements because this vitamin is found only in animal foods. However, they can use oral supplements because they are still able to absorb the vitamin; they do not need injections. Alcoholism does not affect absorption of vitamin B12. Malabsorption syndromes may decrease absorption of vitamin B12, but with adequate dietary intake and supplements, affected patients may still be able to absorb sufficient amounts from the gut.

A patient should be discouraged from using echinacea to help reduce the duration of colds if he or she is using a. anticoagulant drugs to prevent formation of blood clots. b. immunosuppressant drugs after organ transplantation. c. oral contraceptives or hormone replacement therapy. d. oral hypoglycemic agents for treatment of diabetes.

immunosuppressant drugs after organ transplantation.

The best way to encourage children to consume adequate nutrients with less than 30% of kilocalories from fat is to a. avoid fast food and fried foods. b. follow a vegan eating pattern. c. provide low-fat foods and a vitamin or mineral supplement. d. include plenty of fruits, vegetables, and whole grains.

include plenty of fruits, vegetables, and whole grains.

A pregnant client complains of constipation during pregnancy. This is probably caused by a. inadequate intakes of dietary fiber and fluids. b. reduced activity levels as body size increases. c. increased levels of the hormone estrogen. d. increased levels of the hormone progesterone.

increased levels of the hormone progesterone.

Apart from lowering dietary sodium intake, a dietary change that is most likely to help decrease high blood pressure levels is a. decreasing intake of dairy products. b. increasing intake of vegetable protein. c. increasing intake of calcium and potassium. d. replacing saturated fats with polyunsaturated fats.

increasing intake of calcium and potassium. Dietary changes that may help decrease high blood pressure include increasing intake of calcium and potassium. This could be accomplished by increasing, rather than decreasing, intake of dairy products. Intake of vegetable versus animal protein and replacing saturated fats with polyunsaturated fats do not decrease blood pressure, although these changes may have other health benefits.

Dietary fluoride is important for a. decreasing staining of teeth. b. decreasing sensitivity of teeth. c. stimulating production of saliva. d. increasing the strength of tooth enamel.

increasing the strength of tooth enamel. Dietary fluoride is important for the strength of tooth enamel. It does not decrease staining or sensitivity of teeth or stimulate production of saliva.

A client feels constantly tired even though she is getting 8 hours of sleep each night, and she is gaining about 2 lbs a month even though she has not changed her eating habits. You discover that she eats only organic and natural foods and avoids anything that is fortified. She may have a deficiency of a. iron. b. zinc. c. potassium. d. iodine.

iodine. Deficiency of iodine causes lethargy and weight gain; the most reliable source of iodine is iodized salt, but if the client avoids fortified foods, she may be avoiding this valuable source. Iron deficiency would cause anemia and tiredness, but not weight gain. Deficiency of zinc impairs growth, reduces appetite, and causes immunologic disorders. Deficiency of potassium causes muscle weakness, confusion, decreased appetite, and, in severe cases, cardiac dysrhythmias. Foods are not usually fortified with iron, zinc, and potassium, and so avoiding fortified foods would not necessarily affect intake of these nutrients.

Lead poisoning may be diagnosed at the same time as a. food allergies. b. anorexia nervosa. c. iron deficiency anemia. d. vitamin D and calcium deficiencies.

iron deficiency anemia.

The child most likely to develop type 2 diabetes is the one who a. is obese. b. is malnourished. c. has multiple food allergies. d. lives in a low-income household.

is obese.

The primary reason that many Americans use vitamin supplements on a regular basis is that a. supplements taste better than food. b. this practice is necessary for good health. c. it is cheaper than consuming an adequate diet. d. it is easier than making dietary and behavioral modifications.

it is easier than making dietary and behavioral modifications. It is often easier to take vitamin supplements than to make dietary and behavioral modifications to ensure that the diet provides adequate nutrients. Supplements do not necessarily taste good, and supplements are not necessary for good health for most people. Supplements are also not necessarily cheaper than foods containing a variety of nutrients.

A small child has normal weight, but his arms and legs are thin, whereas his belly and face appear swollen. His mother tells you that the only food they have had in the house for the past 3 weeks is noodles and some bread. The child probably has a. malabsorption syndrome. b. acute infection. c. marasmus. d. kwashiorkor.

kwashiorkor. The child probably has kwashiorkor caused by inadequate protein intake with adequate energy intake (noodles and bread provide carbohydrate but little protein). Marasmus is caused by inadequate intakes of both energy and protein and is characterized by extreme wasting in the entire body. Acute infection or malabsorption syndromes may exacerbate malnutrition but are not the primary cause.

Janet eats beans, grains, fruits, and vegetables, and milk. Her diet is considered a. lactovegetarian. b. ovolactovegetarian. c. flexitarian. d. vegan.

lactovegetarian Diets than contain plant foods plus milk are lactovegetarian diets; ovolactovegetarian diets include milk and eggs. Vegan diets contain only plant foods. Diets that contain plant foods plus dairy, eggs, and occasional meat, fowl, or fish are flexitarian.

Protein needs continue to increase until about age 24 years because a. height continues to increase. b. lean body mass continues to increase. c. protein metabolism becomes less efficient. d. higher protein intake prevents conversion of muscle to body fat.

lean body mass continues to increase.

An appropriate way to maintain a healthy body weight includes a. eating only at set mealtimes. b. learning to respond to actual hunger cues. c. counting calories to restrict energy intake. d. avoiding foods that have high levels of fat and added sugar.

learning to respond to actual hunger cues.

If a patient is prescribed long-term treatment with steroids, he or she will need to be advised to a. avoid foods that contain tyramine. b. avoid grapefruit juice. c. try to eat more than they want, to avoid weight loss. d. limit intake of high-calorie foods, to avoid weight gain.

limit intake of high-calorie foods, to avoid weight gain.

For clients with phenylketonuria the most important part of treatment is to a. not eat any foods that contain phenylalanine. b. limit their phenylalanine intake to the amount their bodies need. c. take enzyme supplements to help digest phenylalanine. d. take penicillin to prevent complications.

limit their phenylalanine intake to the amount their bodies need. People with phenylketonuria do need some phenylalanine to make essential proteins, but they should not take in more than they need because they will be unable to break down the excess. Phenylalanine is an amino acid, the smallest product of protein digestion, and so it is not digested by enzymes. Penicillin is used to prevent secondary infections in people with sickle cell anemia but is not used to treat phenylketonuria.

When a nurse is recording food intake for a calorie count, the best way to describe food intake is to a. list the percentage of each food served that was actually eaten. b. describe intake in qualitative terms, such as fair, adequate, and good. c. weigh each food before and after the patient eats and list the weight of food eaten. d. visit the patient each day and obtain a 24-hour diet recall.

list the percentage of each food served that was actually eaten.

The most likely cause of vitamin toxicity is a. high intake of fortified foods. b. increased absorption as a result of medications. c. long-term use of megadose supplements. d. high intake of nutrient-dense foods.

long-term use of megadose supplements. Vitamin toxicity is usually caused by use of high-dose supplements over a long period of time. Levels of vitamins in fortified foods are unlikely to be toxic, and very few foods contain high enough levels to cause toxicity. Medications do not cause significant increases in vitamin absorption.

In adults older than 80, the greatest dietary concern is a. preventing weight gain. b. increasing lean body mass. c. maintaining adequate nutritional status. d. preventing coronary heart disease and cancer.

maintaining adequate nutritional status.

Hemosiderosis, storage of too much iron in the body, is most likely to occur in a(n) a. man who drinks five or more alcoholic beverages every night. b. adolescent who drinks four or more soft drinks daily. c. toddler who prefers drinking milk to eating meals. d. pregnant woman who takes iron supplements.

man who drinks five or more alcoholic beverages every night. Hemosiderosis is most likely to occur in a man with high alcohol intake. Adolescents who have high intake of soft drinks are likely to have high intake of phosphorus. Toddlers who prefer to drink milk rather than eating meals may develop iron deficiency. Pregnant women who take iron supplements are unlikely to store too much iron because iron needs are very high during pregnancy.

For patients who are taking prescription or over-the-counter drugs, herbal preparations a. should all be avoided. b. can be considered safe. c. should be taken separately from drugs. d. may cause dangerous herb-drug interactions.

may cause dangerous herb-drug interactions.

If a patient is receiving radiation to the mouth and neck area and has a sore mouth, the most appropriate type of diet while he or she is in hospital would be a _____ diet. a. regular b. mechanical soft c. full liquid d. clear liquid

mechanical soft

The type of anemia associated with folate deficiency is _____ anemia. a. microcytic b. pernicious c. megaloblastic d. iron deficiency

megaloblastic The type of anemia associated with folate deficiency is megaloblastic anemia. Microcytic anemia is associated with iron deficiency. Pernicious anemia is associated with vitamin B12 deficiency. Iron deficiency anemia is (as its name suggests) associated with deficiency of iron, not of folate.

Some choline can be synthesized by the body from a. glycerol. b. cholesterol. c. tryptophan. d. methionine.

methionine. The body can synthesize some choline from methionine, but not enough to meet the needs of the body. The body cannot synthesize choline from glycerol, cholesterol, or tryptophan.

Body mass index (BMI) would be most useful for evaluating the weight status of a(n) a. middle-aged, moderately active woman. b. elderly, mostly sedentary man. c. high-school football player. d. young woman undergoing chemotherapy.

middle-aged, moderately active woman.

As adults age, they are likely to want to add _____ to their food. a. less salt b. more salt c. fewer salt substitutes d. more salt substitutes

more salt

Most physically active adults in America do not need to eat more protein than inactive adults because a. exercise does not increase protein needs as long as energy needs are met. b. exercise increases the efficiency of recycling amino acids so that extra needs are met endogenously. c. most people have high enough protein intake to provide the extra protein needed for active muscles. d. most Americans are not sufficiently active to cause an increase in protein requirements.

most people have high enough protein intake to provide the extra protein needed for active muscles. Athletes have higher protein needs than nonathletes (1.2 to 1.7 g/kg versus 0.8 g/kg, respectively). However, most Americans consume the amount of protein recommended for athletes, and so most American athletes do not need to increase their protein intake. Exercise does not increase the efficiency of protein turnover.

The protein found in muscles whose function is similar to that of hemoglobin in blood is a. collagen. b. oxyglobin. c. myoglobin. d. myosin.

myoglobin. Hemoglobin carries oxygen in blood; the protein that carries oxygen in muscles is myoglobin. Myosin is a contractile protein found in muscles, and collagen is a structural protein found in ligaments and tendons. Oxyglobin does not exist.

A food restriction shared by both Muslims and Jews is a. not combining meat and dairy at the same meal. b. not eating pork or any food products from pigs. c. avoiding coffee, tea, and alcohol. d. eating fish with fins and scales but not shellfish.

not eating pork or any food products from pigs.

The best way for a nursing mother to increase her milk supply is to a. nurse her infant more often and for longer periods of time. b. provide supplemental formula to allow milk reserves to build. c. drink lactogenic herbal teas that stimulate milk production. d. drink extra milk and add extra servings of dairy products.

nurse her infant more often and for longer periods of time.

A good dietary source of chromium is a. pasta. b. grapes. c. oatmeal. d. cauliflower.

oatmeal. Oatmeal is a good dietary source of chromium because it is a whole grain. Good sources do not include refined grains (such as pasta), fruits, and vegetables.

If someone took a 6-hour car ride in an air-conditioned vehicle without making any bathroom stops, they weigh less at the end of the trip than at the beginning because a. of insensible fluid losses from the skin and lungs. b. body fat stores would be metabolized for energy. c. muscle mass would be lost. d. fluid would be lost through sweating.

of insensible fluid losses from the skin and lungs. Even in an air-conditioned vehicle, the body still loses fluid through the skin and lungs. The person would not lose significant amounts of sweat in an air-conditioned vehicle. A small but fairly insignificant amount of body fat would be metabolized. Muscle mass would be lost only if the driver were inactive or had low protein or carbohydrate intake over several days.

A one-a-day multivitamin or multimineral supplement at 100% or less of the Dietary Reference Intake (DRI) is probably most beneficial for a(n) a. young adult who lifts weights before work every morning. b. older adult living at home alone. c. business executive with a high-stress job. d. newly retired, socially active woman.

older adult living at home alone.

If a woman who drinks a cup of decaffeinated coffee in the morning, a cup of fruit juice with lunch, 6 cups of water throughout the day and a cup of tea at bedtime, her fluid intake would be considered a. dangerously low. b. below optimal. c. optimal. d. too high.

optimal. This womans total fluid intake for the day is 9 cups, the recommended amount for women. Minimum fluid intake for health is around 4 cups; intake below this would be considered dangerously low. Fluid intake can be too high, but the specific amount that causes water intoxication is unknown.

Foods rich in antioxidant vitamins include a. oranges and vegetable oils. b. apples and butter. c. carrots and olive oil. d. mushrooms and milk.

oranges and vegetable oils. The two vitamins that function as antioxidants in the body are vitamins C and E. Citrus fruits such as oranges are excellent sources of vitamin C; vegetable oils are excellent sources of vitamin E.

After going through menopause, a woman may need to pay extra attention to her food and activity habits because she is now at increased risk for a. osteoporosis. b. type 2 diabetes. c. bronchial asthma. d. iron deficiency anemia.

osteoporosis.

Nonessential amino acids can be made by the liver from a. glucose and urea. b. other amino acids. c. fatty acids and glycerol. d. enzymes and hormones.

other amino acids. The body can make nonessential amino acids from other amino acids. Once the amino group has been removed from an amino acid and has been formed into urea, the body cannot turn it back into an amino acid. Fatty acids and glycerol cannot be used to make amino acids. Enzymes and hormones may help control the manufacture of nonessential amino acids but are not themselves used to make them.

The situation in which it would be most important for the nurse to contact the registered dietitian (RD) is if a a. patient complains of constipation during his or her hospital stay. b. patients family complains about the quality of the food in the hospital. c. patient reports losing 10 lb in the past year without trying. d. patient has been receiving intravenous glucose and saline but no oral intake for 36 hours.

patient has been receiving intravenous glucose and saline but no oral intake for 36 hours.

A meal that a family should not share with their 10-month-old infant is a. meatloaf and mashed potatoes. b. refried beans and cheese. c. peanut butter and honey sandwich. d. baked fish and butternut squash.

peanut butter and honey sandwich.

An example of a meal with high levels of biotin is a a. cheese-and-tomato sandwich. b. roast beef and mustard sandwich. c. peanut butter and jelly sandwich. d. vegetarian sandwich with avocado and alfalfa sprouts.

peanut butter and jelly sandwich. The richest sources of biotin include liver, kidney, peanut butter, egg yolks, and yeast.

In a very poor country where the subsistence crop is corn and intake of animal protein is very limited, the population has a high risk for developing a. scurvy. b. pellagra. c. spina bifida. d. pernicious anemia.

pellagra. Corn has low levels of niacin, and low intake of animal protein would mean that relatively little tryptophan would be available to be converted to niacin; therefore, the population would be at risk for developing pellagra, the niacin deficiency disorder. Scurvy is caused by deficiency of vitamin C. Lack of folate during early pregnancy can lead to spina bifida. Pernicious anemia is caused by lack of intrinsic factor in the stomach to facilitate absorption of vitamin B12.

If a patient is to receive enteral feedings for several weeks because of esophageal surgery but is otherwise generally healthy, he or she may be fed through a _____ tube. a. nasogastric b. nasoduodenal c. percutaneous endoscopic gastrostomy (PEG) d. jejunostomy

percutaneous endoscopic gastrostomy (PEG)

The best description of blindness caused by vitamin A deficiency in developing countries is that it is a. temporary and treatable. b. infectious and often fatal. c. limited to night blindness. d. permanent but preventable.

permanent but preventable. The blindness caused by vitamin A deficiency is permanent once it occurs, but it can be prevented by administration of periodic supplements. Vitamin deficiencies may be exacerbated by infections that increase nutrient needs, but the deficiencies themselves are not infectious. Blindness may cause early death but is itself not fatal. Vitamin A deficiency may cause both night blindness and complete blindness.

Measuring the amount of a mineral in a plant food may not necessarily indicate whether it is a valuable dietary source of that mineral because a. plant foods contain phytates, oxalates, and binders that reduce bioavailability. b. plant foods require cooking or processing to make minerals bioavailable. c. plants often contain inactive forms of minerals. d. the amount of minerals in plants varies widely, depending on growing conditions.

plant foods contain phytates, oxalates, and binders that reduce bioavailability. Plant foods contain phytates, oxalates, and binders that may limit the amount of a mineral that is available to the body, even if it is present in the food. Minerals may become more bioavailable with cooking or processing, but this is not necessarily true. Most minerals do not exist in different forms; they are generally either present or absent. The amount of minerals in plants may vary somewhat depending on the growing conditions, but this is less of a factor than bioavailability.

If a patient has had a stroke and needs enteral feedings because he or she cannot chew or swallow but has no other medical problems, he or she can be fed with a(n) _____ formula. a. isotonic b. modular c. elemental d. polymeric

polymeric

If a patient complained of muscle weakness, confusion, decreased appetite, and irregular heartbeat, it would be important to check blood levels of a. sodium. b. calcium. c. potassium. d. magnesium.

potassium. These symptoms are typical of a possible blood potassium level that is either too low or too high; both conditions can be very dangerous. Low sodium levels cause headache, muscle cramps, weakness, reduced ability to concentrate, and loss of memory and appetite; high sodium levels may cause edema and hypertension. High calcium levels cause weakness, lack of energy, poor appetite, nausea and vomiting, constipation, or bone pain; low blood calcium levels cause muscle cramps, spasms, and twitching and tingling in the fingers and around the mouth. Symptoms of magnesium deficiency include twitching of muscles, muscle weakness, and convulsions; symptoms of magnesium overload are long-term diarrhea and dehydration.

An example of a situation in which nitrogen balance is positive is a. aging. b. infection. c. starvation. d. pregnancy.

pregnancy. Positive nitrogen balance means that more nitrogen is retained in the body than is excreted. This would be the situation in pregnancy, when new tissue is being formed in the mother and fetus. Aging, infection, and starvation are all times when the nitrogen balance would be negative.

A wife who blames her high blood pressure on her husbands preference for salty foods is an example of a. denial. b. chaining. c. reframing. d. projection.

projection. A wife who blames her high blood pressure on her husbands preference for salty foods is an example of projection. She is projecting her unhealthy behaviors on her husband instead of taking responsibility for her own health. Denial would be ignoring the problem. Chaining would be associating one behavior with another. Reframing would be replacing negative expectations and associations with positive ones.

If an elderly client who lives alone and has a limited income has edema, it would be important to evaluate his or her dietary intake of sodium and a. protein. b. calcium. c. chloride. d. potassium.

protein. Edema may be caused by high intake of sodium or inadequate intake of protein if protein levels in the body become so low that cellular fluid levels become imbalanced. Edema is not related to dietary intake of calcium, chloride, or potassium.

An elderly patient falls at home and lies on the floor for 24 hours without anything to eat or drink for 24 hours before being found and admitted to the hospital. What would be an important thing for the nurse to do before collecting blood to evaluate nutritional status? a. Weigh the patient. b. Assess food and beverage intake before the fall. c. Rehydrate the patient. d. Manage the patients pain.

rehydrate the patient

Scurvy would be most likely to occur in someone who lives in a a. remote village in northern Minnesota. b. farming community in Florida. c. city in central California. d. fishing community on the coast of Maine.

remote village in northern Minnesota. Scurvy is caused by vitamin C deficiency. Both Florida and California produce abundant citrus fruit, other fruits, and vegetables, which are excellent sources of vitamin C. A community on the coast of Maine does not necessarily produce good sources of vitamin C locally, but it is connected to commercial transportation, and so a variety of foods are probably available. A remote village in northern Minnesota may not have good access to fresh fruits and vegetables during the winter months, and so scurvy could potentially develop.

Having only softened tap water at home would be of most concern to a(n) a. pregnant woman. b. full-time student who also works part-time. c. elderly woman with osteoporosis. d. retired man with hypertension.

retired man with hypertension. Softened water has relatively high levels of sodium, which exacerbates hypertension in salt-sensitive individuals. It is not ideal for anyone to drink softened water on a regular basis, but it is of special concern for someone with hypertension. Someone who is retired is more likely to drink beverages made with tap water at home. An elderly woman with osteoporosis would benefit from the calcium in hard water, but this is less of a concern. A student who is gone at work or school most of the day would not consume much of the softened tap water. Sodium intake is not a specific concern in pregnancy.

A family with three young children has limited income, relies on public transportation, and has just moved into a very old apartment complex with old plumbing and lead pipes. The best recommendation to minimize lead exposure would be to

run the tap water for 2 minutes before using it. The best recommendation would be to run the tap water for 2 minutes before using it, so that any water sitting in the pipes that may have absorbed lead would not be used. Using bottled water is not practical for a family with limited income who uses public transportation. Boiling the water would not remove the lead and would actually concentrate it. Hot water would dissolve more lead; in fact, only cold water should be used.

The most potentially harmful situation for an infant is a. breastfeeding during the day and bottle-feeding at night. b. running out of infant formula and using whole milk for a few days instead. c. breastfeeding by a mother who is being treated with antibiotics. d. breastfeeding by a mother who gained less weight than is recommended during pregnancy.

running out of infant formula and using whole milk for a few days instead.

If a patient is taking a monoamine oxidase inhibitor (MAOI) for depression, a meal that may result in unpleasant side effects and dangerous hypertension is a. salad with bacon and blue cheese. b. peanut butter sandwich and grapefruit juice. c. fresh fruit salad with nuts and honey. d. cream of mushroom soup with crackers.

salad with bacon and blue cheese.

An example of a common cause of iatrogenic malnutrition is a. scheduling of frequent daily tests that prevents the patient from eating meals. b. food from home brought in by family members and friends of a patient. c. small portion sizes of hospital food and absence of snacks. d. errors in ordering and delivery of meals for hospitalized patients.

scheduling of frequent daily tests that prevents the patient from eating meals.

Some proteins contain an alpha helix, which is part of their _____ structure. a. primary b. secondary c. tertiary d. quaternary

secondary The alpha helix structure is an example of the secondary structure of proteins. The primary structure is the amino acid sequence. The tertiary structure comprises bonds that form within chains in loops or folds. Quaternary structure is formed by combinations of more than one polypeptide.

If a patient weighed 150 lb 1 month ago and now weighs 140 lb, the weight loss would be considered a. insignificant. b. mild. c. moderate. d. severe.

severe.

The person most likely to be eligible for the Supplemental Nutrition Assistance Program (SNAP) is a a. 55-year-old single man who earns minimum wage. b. college student who works part time. c. single mother with three children who works part time. d. pregnant woman with gestational diabetes.

single mother with three children who works part time.

The best way to reduce the risk of asphyxiation (choking) in toddlers is to make sure that they a. drink plenty of fluids with meals. b. avoid conversation during meals. c. sit down while eating and chew foods well. d. eat with utensils rather than with their fingers.

sit down while eating and chew foods well.

If a registered dietitian is concerned about the adequacy of a clients vitamin C intake, he or she would want to find out whether the client a. drinks milk. b. follows a vegan diet. c. has regular exposure to sunlight. d. smokes cigarettes.

smokes cigarettes. The dietitian would need to know whether the client smokes cigarettes because smokers require more vitamin C than nonsmokers. A vegan diet raises concerns about intake of vitamin B12 (found only in animal foods) but does not necessarily affect vitamin C intake. Regular exposure to sunlight and milk intake affect vitamin D status but not vitamin C status.

It would be most difficult for the body to maintain homeostasis if over several days someone had an inadequate intake of a. calcium. b. sodium. c. iron. d. fluoride.

sodium. Homeostasis is maintenance of physiologic equilibrium within the body. All of these minerals help maintain homeostasis, but inadequate intake of sodium over just a few days would have the most effect. Sodium is an electrolyte and is important for maintaining fluid balance in the body. If calcium intake is inadequate, the body can draw on reserves in bone; if iron intake is inadequate, the body has some reserves in the spleen, and so body homeostasis would not be affected unless the deficiency continued long term. Fluoride deficiency may cause dental caries and may affect bone density, but this is also a long-term effect and would not affect the body over a few days.

If a hospitalized patient is taking warfarin (Coumadin) to reduce risk of blood clots, you would be concerned if a family member brought them lunch consisting of a. a fruit smoothie containing grapefruit juice. b. a peanut butter sandwich and chocolate milk. c. spicy rice and beans with tomatoes. d. spinach salad with chopped egg and nuts.

spinach salad with chopped egg and nuts.

An example of a high-folate meal is a. fish, French fries, and coleslaw. b. spinach salad with orange segments. c. oatmeal with brown sugar and raisins. d. pork chops with applesauce.

spinach salad with orange segments. Good sources of folate include leafy green vegetables (including spinach), legumes, ready-to-eat cereals, and some fruits and juices (including orange). Fish, oatmeal, raisins, pork, and applesauce are not good sources of folate.

An example of a meal that contains complementary proteins is a. pasta and tomato sauce. b. split pea soup with crackers. c. oatmeal and buttered toast. d. fruit yogurt with strawberries.

split pea soup with crackers. Split pea soup with crackers contains complementary proteins: The incomplete legume protein in the split pea soup complements the incomplete grain protein in the crackers. Vegetables such as tomato sauce and fruit such as strawberries do not contain sufficient protein to complement another incomplete protein in a meal. Both oatmeal and toast are grains, and so their incomplete proteins are not complementary. Fruit yogurt contains complete protein and does not need to be combined with an incomplete protein.

Nurses should ask patients about their use of over-the-counter medications because a. those medications may cause drug-drug or nutrient-drug interactions. b. the medical staff has a legal responsibility to know what patients are using. c. they may be able to advise patients about cheaper generic forms of drugs. d. patients should not take prescription and over-the-counter drugs at the same time.

those medications may cause drug-drug or nutrient-drug interactions.

Vegetables are likely to be highest in vitamin C if they are a. boiled. b. canned. c. stir-fried. d. oven roasted.

stir-fried. Vegetables are likely to be highest in vitamin C if they are stir-fried. Heat destroys vitamin C, and so cooking for the minimum amount of time preserves vitamin C. Oven roasting is a slow cooking method, and so more vitamin C is lost. Vitamin C is also water soluble, and so cooking methods that use water, such as boiling and canning, cause loss of vitamin C into the cooking liquid. In stir-frying, vegetables are cooked quickly without water.

The best way for older adults who live in cold climates to meet their increased need for vitamin D is to a. increase their skin exposure to sunlight. b. increase their intake of vitamin Dfortified dairy products. c. take vitamin D supplements. d. increase their intake of fatty fish.

take vitamin D supplements.

If a patient reports feeling lethargic and having a headache, and you notice that his or her hair is thin and the skin is dry, it would be important to ask the patient whether he or she a. has access to and is able to afford enough food. b. follows a vegan eating pattern or restricts intake of animal foods. c. uses any herbal or botanical remedies on a regular basis. d. takes high-dose vitamin supplements that contain vitamin A.

takes high-dose vitamin supplements that contain vitamin A.

Lifestyle changes that may help prevent development of osteoporosis include a. reducing intake of animal protein. b. eating a piece of fruit with lunch every day. c. taking a daily multivitamin supplement with adequate amounts of calcium and vitamin D. d. taking a 30-minute walk most days.

taking a 30-minute walk most days. Taking a 30-minute walk most days may help prevent development of osteoporosis because regular exercise stimulates an increase in bone density. Eating vegetable versus animal protein, increasing intake of fruit, and use of multivitamin supplements with adequate amounts of calcium and vitamin D are unlikely to prevent osteoporosis (although they may have other health benefits).

If people want to maximize their absorption of calcium, they should avoid drinking a. tea. b. milk. c. orange juice. d. bottled water.

tea. Tea contains oxalic acid and tannins, both of which decrease absorption of calcium. Milk contains lactose and vitamin D, which increase calcium absorption. Orange juice and bottled water do not have a significant positive or negative effect on calcium absorption.

An older adults nutritional status may decline if he or she has arthritis because a. arthritis is associated with loss of appetite. b. the ability to prepare food may be impaired. c. taste changes may cause food to be unappetizing. d. arthritis causes an increase in protein and nutrient requirements.

the ability to prepare food may be impaired.

If a person were to eat a diet that provided carbohydrate, fat, and micronutrients, but very little protein, for example if he or she ate only whole-wheat pita bread with olive oil, a. the body would manufacture amino acids to make essential proteins from fatty acids and glycogen. b. body metabolism would decrease to conserve amino acids until protein intake was resumed. c. the liver would recirculate amino acids instead of breaking them down and excreting urea. d. the body would break down muscle tissue to provide amino acids to make essential proteins.

the body would break down muscle tissue to provide amino acids to make essential proteins. The body needs regular dietary protein to provide amino acids. If no protein is eaten in the diet, the body uses muscle tissue to provide amino acids to make essential body proteins. The liver cannot recirculate amino acids; some are always broken down, and the nitrogen portion is excreted as urea. Body metabolism may decrease slightly, but it would not be sufficient to conserve amino acids for any length of time. The body cannot manufacture amino acids from fatty acids and glycogen.

The main reason that young women require more dietary iron than young men is a. that they absorb iron less efficiently. b. to compensate for their lower muscle mass. c. to replace blood losses during menstruation. d. that they recycle hemoglobin more rapidly.

to replace blood losses during menstruation. Young women require more dietary iron than young men to replace blood losses during menstruation. There is no difference between iron absorption or hemoglobin recycling in young men versus young women. Higher iron intake does not compensate for lower muscle mass in women.

The property of protein that is most important to its buffering properties is a. its ability to create osmotic pressure in intravascular, intracellular, and interstitial fluids. b. the fact that amino acids include both an acid carboxyl group and an amine base group. c. its ability to pump nutrients and other vital substances across cell membranes. d. its communication (hormones) and catalytic (enzyme) functions that help regulate body functions.

the fact that amino acids include both an acid carboxyl group and an amine base group. All of these statements are true of proteins, but the condition that allows it to act as a buffer is the composition of amino acids that includes both an acid carboxyl group and an amine base group.

A patient with diabetes is recovering at home after foot surgery. He takes antidepressant and antihypertensive medications, as well as an oral hypoglycemia agent. When the nurse visits at noon to change his dressing, his or her greatest concern would be a. the open bottle of vodka on the table next to his recliner. b. the fact that he has not yet eaten lunch. c. his reliance mainly on canned and prepackaged food in the house. d. his complaints that his family does not come and help him.

the open bottle of vodka on the table next to his recliner.

An appropriate size serving of meat, poultry, or fish is about the size of a. your fist. b. a dollar bill. c. the palm of your hand. d. one fourth of a dinner plate.

the palm of your hand. An appropriate size serving of meat, poultry, or fish is about the size of the palm of your hand. This represents about 3 ounces. A serving the size of a fist or one fourth of most dinner plates would be too large. A dollar bill is flat and therefore does not indicate a three-dimensional serving size.

Feeding tubes should be placed into the small intestine rather than the stomach if a. the patient is comatose. b. a regular polymeric formula is being used. c. the patient prefers not to have a tube passing through his or her nose. d. the patient is expected to resume oral feedings within 1 to 2 weeks.

the patient is comatose.

The first signal that the body needs fluid is a. dark, concentrated urine. b. the sensation of hunger. c. the sensation of thirst. d. headache.

the sensation of thirst. The body signals its need for fluid via the sensation of thirst, a dryness in the mouth. Dark, concentrated urine also indicates a need for fluid, and headache may also be caused by dehydration, but these symptoms occur later than thirst, at a time when the bodys need for fluid is much greater. Hunger is a signal that the body needs food, not fluid.

If whole milk is stored in a clear bottle in a refrigerator with a glass front, a. the milk fat may separate and rise to the top of the bottle. b. some of the protein in the milk may become denatured. c. the ultraviolet light exposure may destroy the vitamin D. d. the ultraviolet light exposure may destroy the riboflavin.

the ultraviolet light exposure may destroy the riboflavin. Riboflavin is destroyed by ultraviolet light, and so storage of milk in a clear bottle and a glass-front refrigerator may cause loss of riboflavin. Vitamin D is not affected by ultraviolet light. Ultraviolet light does not cause milk fat to separate out and does not denature protein.

A homeless man is brought into the emergency room with muscle weakness, loss of coordination, and tachycardia. He has alcohol on his breath. He may be suffering from a deficiency of a. thiamin. b. riboflavin. c. niacin. d. folate.

thiamin. Symptoms of thiamine deficiency include muscle weakness, loss of coordination, and tachycardia. Alcoholism increases the bodys need for thiamin and may contribute to a secondary thiamin deficiency. Symptoms of riboflavin deficiency include cheilosis, glossitis, and dermatitis. Niacin deficiency causes pellagra, characterized by dermatitis, dementia, and diarrhea. Symptoms of folate deficiency include megaloblastic anemia, glossitis, diarrhea, irritability, absent-mindedness, depression, and anxiety.

An example of a breakfast that would meet the School Breakfast Program requirements would be a. scrambled egg, bacon, toast, and orange juice. b. cold breakfast cereal with milk, toast with honey. c. toast with peanut butter, banana, and milk. d. turkey sausage, hash browns, ketchup, and milk.

toast with peanut butter, banana, and milk.

If a 2-year-old is drinking four 8-oz cups of milk daily, he or she is probably drinking a. too little milk to provide sufficient calcium for the growing skeleton. b. approximately the right amount of milk to meet nutrient needs. c. approximately the right amount of milk, if the child is at a healthy weight. d. too much milk, which may displace other important foods from the diet.

too much milk, which may displace other important foods from the diet.

During transitions from parenteral or enteral tube feedings to oral feedings, patients should be monitored to ensure that a. they do not develop hypoglycemia. b. total nutritional intake is adequate. c. their weight does not increase rapidly. d. they do not experience nausea and vomiting.

total nutritional intake is adequate

Niacin can be manufactured by the body from the amino acid a. alanine. b. arginine. c. tryptophan. d. phenylalanine.

tryptophan. Niacin can be manufactured by the body from tryptophan, but not from alanine, arginine, or phenylalanine.

A BMI of 18 would reflect a. underweight. b. normal weight. c. overweight. d. severe overweight.

underweight A BMI less than 18.5 is classified as underweight. A BMI between 18.5 and 24.9 is considered normal weight, 25 to 29.9 is considered overweight, and 30 or greater is considered obese.

Overall, the greatest concern in screening patients for risk of malnutrition is a. edema. b. muscle wasting. c. unintended weight gain. d. unintended weight loss.

unintended weight loss.

Vitamin K deficiency could be a problem in someone who a. does not produce intrinsic factor. b. uses antibiotics for several months. c. struggles with alcoholism. d. has limited skin exposure to sunlight.

uses antibiotics for several months. Antibiotics kill gut bacteria that synthesize vitamin K, and so long-term use of antibiotics may cause vitamin K deficiency. Intrinsic factor is required for absorption of vitamin B12, not vitamin K. Alcoholism is associated with secondary deficiencies of several B vitamins. Skin exposure to sunlight stimulates production of vitamin D.

An example of rationalizing is a. restricting food intake by rationing food. b. coping with stress by using biofeedback techniques. c. identifying emotional triggers for eating. d. using a busy schedule to justify poor food choices.

using a busy schedule to justify poor food choices.

Body proteins may become denatured in the presence of a a. drug overdose. b. very high fever. c. vitamin deficiency. d. high stress level.

very high fever. Very high fever may denature body proteins because the extreme heat changes the shape of the protein. Drug overdoses, vitamin deficiencies, and high stress levels do not cause proteins to become denatured.

If an older adult develops delusions and hallucinations, it is important to check his or her blood levels of a. vitamin B12. b. intrinsic factor. c. folic acid. d. thiamin.

vitamin B12. Delusions and hallucinations may be signs of vitamin B12 deficiency, even before development of anemia. Intrinsic factor is produced by the stomach and is vital for absorption of vitamin B12; it is not found in the blood. Loss of intrinsic factor in older adults contributes to vitamin B12 deficiency. Folic acid deficiency may cause irritability, absent-mindedness, depression, and anxiety, and thiamin deficiency causes memory loss and confusion, but neither of these is associated with delusions and hallucinations.

A patient who is scheduled for knee surgery mentions not having eaten much in the past few weeks because it has been difficult to shop and prepare food. To evaluate the patients immune function, the physician may decide to test the patients serum _____ levels. a. iron b. vitamin D c. prealbumin d. creatinine

vitamin D

If an older adult is confused, he or she may have a deficiency of a. iron. b. zinc. c. water. d. protein.

water.

The best way to evaluate the weight of a hospitalized patient is a. at the same time as assessing the patients vital signs. b. no more than once a week, to avoid measuring fluid shifts rather than true weight. c. by using a bed scale. d. while the patient is wearing a hospital gown, at the same time each day, and after voiding.

while the patient is wearing a hospital gown, at the same time each day, and after voiding.

An example of a child who is at high risk for iron deficiency anemia is the child a. who has allergies to milk and nuts. b. who lives in an African American low-income family. c. whose parents work full time. d. who eats most food away from home.

who lives in an African American low-income family.

To reduce the risk of aspiration, patients who are receiving enteral tube feedings should be positioned a. sitting upright. b. lying on their side. c. with the head of the bed elevated 30 to 45 degrees. d. with the head of the bed elevated 45 to 60 degrees.

with the head of the bed elevated 30 to 45 degrees.

For a woman with a healthy prepregnancy weight, gaining a total of 31 pounds throughout pregnancy would be considered a. too low for a healthy pregnancy. b. too high for a healthy pregnancy. c. within the current recommended range for weight gain. d. within the current recommended range for weight gain for a woman experiencing gestational diabetes.

within the current recommended range for weight gain.

If an older adult has lost several teeth and complains that foods are bitter or tasteless, he or she may have a deficiency of a. zinc. b. iron. c. vitamin C. d. vitamin B12.

zinc.