Nutrition Final- 1st half of quizzes

A patient with protein calorie malnutrition can experience altered drug effects (potential for drug toxicity) as a result of their poor protein status. Explain why.

Some drugs bind with protein for transport in the blood. A poor protein status leads to diminished blood proteins, such as albumin and globulin, to bind with these drugs. The result could be an increase in unbound (or free) drug that may lead to toxic drug effects.

Using the protein swap system, calculate how many grams of protein are in this meal. 5 oz turkey burger with 1 oz cheese melted on top one hamburger bun 2 TBSP catsup 1-1/2 cups of French fries 1 cup milk one orange

49 grams

One function of carbohydrate is to 'spare protein'. Explain what this term means in your own words. How would you explain it to a patient?

Spare protein means that carbohydrate keeps protein from being sacrificed as a fuel source. Carbohydrate provides 4 calories/ gm and a source of glucose, which many cells in the body require for fuel. If there is insufficient carbohydrate intake, protein from the diet (and eventually the body if there is not enough in the diet) gets broken down to make glucose, getting sacrificed as fuel instead of used as the building block that it should be in the body. Think about what might happen to a patient with a large wound that needs lots of protein to heal if their protein is getting sacrificed as fuel...would the wound heal as it should? Imagine how you would explain the importance of adequate carbohydrate to a patient in this situation.

Sarcopenia, or loss of muscle associated with aging, is a concern with the older adult. Which of the following statements is true regarding the older adult and sarcopenia.

Spreading protein servings over the day in ~20 gram increments can trigger muscle protein synthesis

An expectant mom, who is planning on breastfeeding her baby, has been avoiding fish because of mercury concerns. She read online that a special fat in fish called DHA helps with brain development in babies and now is confused about what to do. What advice can you offer to her?

Assure her that she can enjoy up to two to three servings of low mercury fish a week

Sweat rate calculation helps in making a plan to maintain fluid balance in the athlete. Which answer describes how sweat rate is calculated?

Athlete is weighed in dry clothing after voiding both before and after exercise

The Recommended Dietary Allowance (RDA) for iron during pregnancy is 27 mg/ day, an increase from 18 mg/ day for women of childbearing age. Which reason is the best explanation a nurse should give to a woman who wonders why she needs to consume more iron than usual?

Poor iron status in the mother can contribute to risk of delivering a low birth weight baby

In addition to educating school-age children about healthy eating, list one more action the school nurse can take to help prevent the development of eating disorders.

Be a role model by not exhibiting weight bias Be a role model by not discussing dieting or weight around children Discuss how the 'thin ideal' (meaning thinking the thinner the better) is not conducive with health Educated students on media literacy topics so they learn to critically evaluate the images they view

All of the following are good sources of protein except one choice. Which food is not a good source of protein?

Brown rice

Which explanation below correctly describes why symptoms of poor protein nutrition include ascites and pedal edema?

Poor protein status alters oncotic pressure

It is not always convenient or quick to measure a patient's height when conducting a nutrition assessment. And, sometimes a patient is not able to stand to have height measured. Which of the following techniques is an acceptable and valid method to use in adults for gathering information under these circumstances?

Recumbent length can be measured

Fetal alcohol syndrome can occur in a child due to alcohol consumption by the mother during pregnancy. What is the daily number of 'standard drinks' that is felt to be safe during pregnancy to avoid this condition?

None

If an athlete complains to you about muscle cramping following intense exercise during a hot, humid day, which mineral should you first suspect as the cause of this symptom?

sodium

Choose which scenario is an appropriate application of the Recommended Dietary Allowance recommendation. This example is for vitamin B-12

the new vegan who no longer consumes animal foods

A breastfeeding mom who is living in a homeless shelter is concerned that her infant is not consuming adequate breastmilk. What can the nurse advise the mother easily track each day to best assess whether or not the baby's daily intake has diminished? Fill in the blank: The mother can track _______________ each day.

number of wet diapers

Some minerals can cause altered heart rhythm if blood levels of the mineral are low. Name two.

potassium Calcium magnesium

Someone's basal metabolic rate (BMR) is influenced by many factors. What factor influences BMR more than any other factor?

body size muscle lean body mass LBM leanness muscle mass body weight

A nurse is discussing alcohol intake and heart health with a female patient who has a low HDL-cholesterol and is trying to manage both her weight and elevated blood triglycerides. Which statement by the nurse fits current recommendations for alcohol for this specific patient?

"Alcohol can boost your blood triglyceride level, just like sugars do"

A five-year-old patient and their parent are meeting with the nurse following the child's diagnosis one month ago with multiple food allergies. Allergies to milk, seafood, soy, and peanuts were discovered. The parent reports considerable worry because the child seems to be eating less than usual since milk, yogurt, cheese, and peanut butter were consumed daily in their diet and it has been hard to find safe foods to replace them. The nurse weighs the child and finds a weight loss of three pounds in one month. Which response by the nurse is the most appropriate reply to the parent and addresses the concerns presented here?

"I can tell you are worried. Let's brainstorm some ideas today and also consider a referral to our dietitian"

A patient tells the nurse that they are taking red yeast rice to help with their elevated cholesterol after they had some side effects from the traditional statin drugs used to treat hypercholesterolemia. What would be an appropriate response by the nurse?

"Red yeast rice has the same side effects as statin drugs"

Using the carbohydrate counting system, calculate the number of grams of carbohydrate in this entire meal. A pasta salad with 2 cups pasta 1 cup cooked broccoli 1/2 cup cooked peppers 4 oz of cubed cheese 2 TBSP of oil and vinegar dressing A small pear 8 oz of 100% fruit juice

120 gm

How many "carbohydrate choices" are in this meal? Grilled cheese sandwich made with two pieces of sliced whole wheat bread, 1 cup plain yogurt with 1 cup of raspberries stirred in. Vitamin Water 16 oz. poured from large bottle < label says it has 15 gm carbohydrate in 8 oz.>?

7

How to avoid making a patient uncomfortable when discussing weight?

A way to avoid making a patient feel uncomfortable about their weight is to not tell them they are over weight, but instead ask how they feel about their weight and current state of health. Once you have a established an idea of their motivators and opinions regarding their weight/weight loss you can ask if they would like information regarding health problems associated with their weight. Goals should be specific to the patient and their view of their health because if they do not care to lose weight they won't follow a schedule or plan. Equipment should work for all body types and should not imply a size is better than another.

Which volume represents the total daily recommended intake of fluid for the average female adult?

Almost three liters/ day

Match the terms anabolism and catabolism with scenarios where you would expect to find a patient in that metabolic state

Anabolism: adolescent growth spurt, pregnancy, body building Catabolism: experiencing a burn injury, undergoing surgery, trauma

New parents or caregivers might ask the nurse for advice about introducing solid food into an infant's diet. Which of the following statements is evidence-informed advice that the nurse can offer?

Babies can be offered a rotation of cereals made from different grains as their initial solid food

A blood albumin level is a common laboratory test in the clinical setting. Which statement about using this lab test in a nutrition assessment is FALSE?

Blood albumin is an excellent way to assess a patient's current protein nutrition status

Mixing energy drinks and alcohol is a health risk. Which answer explains the reason this practice of mixing the two together is not recommended?

Caffeine gives the drinker a false sense of unimpaired motor skill ability

A thorough nutrition assessment is crucial at the pregnant female's first prenatal visit, with follow up assessments done over the course of the pregnancy. When caring for a 15-year-old pregnant female, which of the following statements is NOT accurate information to consider when doing the nutrition/ nursing assessment?

Calcium needs in the pregnant teen are not increased compared with those of a 25 year old pregnant female

A patient tells you that 'carbohydrates are bad' and they are trying to consume no carbohydrate in their diet. In your own words, explain the importance of carbohydrate to the patient

Carbohydrates are essential to proper functioning in humans because they are a source of energy for the brain and the rest of the body. Carbohydrates also play an important role in the creation of DNA and RNA as well as many components of our body's everyday functions including keratin production and blood clotting. Even insoluble carbohydrates called fiber are needed because it prevents constipation and helps control blood cholesterol and glucose levels. There are many bodily functions that rely on carbohydrates, and completely cutting them out of a diet would cause negative impacts on the body as a whole. And protein sparing!

You are providing a patient with nutrition education and explaining the importance of consuming whole grains. The patient asks you how to know if a food is considered a whole grain. Which suggestion would be an accurate response?

Check the ingredient listing for grains with the word 'whole' or a grain closest to its original form

Why is a low-fat diet not recommended for very young children?

Children are still undergoing brain development up to age 2 years and require a full fat diet for both brain and central nervous system components. Children can slowly phase into the recommendations on reduced intake of saturated fat after the age of two years in accordance with the US Dietary Guidelines.

You are educating a patient who has hypertension about sodium and blood pressure. Pretend you only have two minutes to give some general advice that the patient can use to make future dietary decisions. In only one or two sentences, explain to the patient (in a general, overarching way) how they can reduce their sodium intake.

Choosing foods close to their original form, such as plain meats/poultry, fish; fruits and vegetables; whole grains; milk and yogurt; healthy oils can keep sodium intake below 2,300 mg/ day. Check and compare food labels for sodium content when making choices to help minimize intake of sodium from processed foods (convenience/ canned) and pickled foods

The 24-hour recall is often used as part of a nutrition assessment. List one criticism of this tool.

Diet recalls weaknesses: subjective - subject to the patient's ability to recall and to accurate portion-telling subject to social/reporting bias - patient's want us to like them, not judge them and so may give us a perceived 'right' answer vs the real answer to a question. Research tells us that some folks over-report healthful foods like fruits and vegetables and under-report alcohol. a one day snapshot that may not reflect usual intake

Name the three broad risk factors for poor nutrition status the nurse should consider with every nutrition assessment. What three questions do you ask yourself about the patient when determining if a patient is potentially at risk for poor nutrition?

Does the patient have: 1) decreased intake for any reason? 2) altered absorption or excretion of any nutrient for any reason? 3) a condition that causes increased nutrient needs that are not be met?

Many different nutrition screening tools exist. Which statement about these tools is accurate?

Each nutrition screening tool is developed for use with a set population

Prevention or treatment of overweight and obesity in children is important since excess weight can lead to health consequences into adulthood. Which of the following is an appropriate intervention for the nurse to suggest to a concerned parent of an overweight child?

Encourage the parent to follow a healthy eating pattern even though they are at a healthy weight

The gold standard for determining energy expenditure is indirect calorimetry, but that technology is expensive and not always available in every setting. There are multiple equations that are used to determine energy expenditure. Online apps and tools use some of these formula as do clinicians who do not have access to indirect calorimetry. Which of the following is a limitation or drawback to using these equations?

Equations have a high margin of error because they were developed for a set population but are used on the general population

Which of the following is true about mineral status in the body?

Excess intake of some minerals can lead to a deficiency of other minerals because some minerals compete with each other for absorption

An essential amino acid is an amino acid that the body can synthesize using metabolic byproducts found in the body's amino acid pool

False

Dieting during adolescence is linked with improved body image and lowered risk of overweight in adulthood.

False

Fructose in a piece of fruit is a simple sugar and the amount of fruit consumed per day should fall within the recommendation for added sugar intake. true or false

False

Intake of fish should be avoided during pregnancy because of the negative risk of high intake of mercury on fetal brain development.

False

Research has proven that any caffeine intake during pregnancy is associated with an increased risk of delivering a low birth weight baby. For this reason, it is recommended that pregnant women completely avoid caffeine intake during pregnancy

False

The Food and Drug Administration (FDA) requires a warning on dietary supplements that lists possible side effects or safety concerns for pregnant females or children. true or false

False

The Recommended Dietary Allowance (RDA) for carbohydrate is 130 gm/ day for non-pregnant/lactating adults and children because this amount of intake provides sufficient carbohydrate for muscle activity and other body functions that require glucose. True or False

False

The requirement for daily iron intake remains unchanged for males from age five years through adulthood.

False

Why might an older female patient experience a higher blood alcohol level than a younger male who consumed the same amount of alcohol?

Females produce less alcohol dehydrogenase

A patient, who is trying to avoid catching a cold from family members, purchases a bottle of orange juice that states it "supports a healthy immune system" and tells the nurse that this claim is because vitamin C prevents a cold. Which answer is the best response for the nurse to offer to the patient?

Food and supplement labels can make claims about a healthy structure or function in the body. This type of claim does not mean the product can prevent or treat a disease

What is the American Academy of Pediatrics recommendation regarding offering children fruit juice?

Fruit juice intake should be limited to no more than 6 oz/ day in children age 1-6 years of age

Adequate folic acid intake during pregnancy is crucial and plays a role in decreasing the risk of neural tube defects. Which of the following statements is accurate information for the nurse to relay to a patient who shares that they hope to become pregnant sometime soon.

Gluten-free products often lack fortification with folic acid

You are a school nurse teaching a high school health class about added sugar. Which of the following statements is NOT true about added sugars?

Honey contains essential B-vitamins and is great to use in baking because it is not considered added sugar

Your post-operative patient is eating poorly, picking at pudding and jello and otherwise drinking the Ensure nutrition drink delivered with their meals. Given what you know about wound healing and nutrition, what is the best advice you could offer to this patient?

I would tell this patient that in order for proper wound healing to occur they need to have increased carbohydrates to provide energy and prevent protein wasting so protein can do its job. They also need increased protein because protein is responsible for tissue construction and repair as well as transporting oxygen to the injured area. I would also tell them to increase their fluid intake so that the nutrients they are consuming are able to get to the scene, and it will also replace any fluid lost during the surgery or from the wound site. Finally I would tell them to make sure they get key micronutrients such as iron and vitamin a and b12 to ensure that there is oxygen arriving to the area and wound healing is promoted. Then I would tell them that ways to do this include eating 3 balanced meals that include a variety of proteins such as eggs, milk, or meat, and carbs such as rice, pasta, vegetables, and fruit.

A patient is scheduled to have an assessment of their energy expenditure using indirect calorimetry. Which of the following statements by the nurse is NOT accurate advice to give the patient as they prepare for this assessment?

If you are going to smoke, have your last cigarette no closer than one hour before the assessment

Picky eating and food jags are common in young children and are developmentally appropriate behaviors. List one idea you could offer a concerned caregiver who is worried about this concern and wants their child's intake to improve.

Involve the child in shopping and meal preparation Give the child a choice between two foods that are both good choices Continue to offer small portions of new foods for the child to try Ignore the food jags as long as the child is growing healthfully Notice whether the picky eating is due to the food texture and offer the food in another form Notice whether the picky eating is due to any physical complaints - but don't ask the child directly about a particular symptom. Instead you can say "tell me how you feel when you eat xyz"

Many nutrients are required for a wound to heal properly. Which of the following is true regarding nutrition and wound healing?

Iron is required to deliver oxygen to the wound site

What is the recommendation by the Dietary Guidelines for Americans and the World Health Organization (WHO) regarding intake of added sugars in the diet?

Limit intake to less than 10% of total calories per day

Waist circumference measurement is a part of the nursing nutrition assessment for metabolic syndrome. How can the nurse obtain this information?

Locate the patient's iliac crests and use them as a guide to measure the waist circumference at those points

The Recommended Dietary Allowance (RDA) for protein is the daily amount of protein recommended for which person?

Middle-aged adult who is very sedentary

You are working in a pediatric practice and are asked to speak with the parents of a toddler newly diagnosed with a milk allergy. The family has an appointment with a dietitian in two weeks and is worried about what to do in the meantime. What advice is the most important for the nurse to give this family at this time?

Milk can be a hidden ingredient in food so every food label must be checked, even flavorings

1) What effect would it have on nitrogen balance calculations if a patient mistakenly did not use the collection jug even once while urinating over 24-hour the collection period? 2) How could the nurse emphasize the importance of adhering to accurate urine collection? (meaning: what would you say to the patient?)

Missing any urine in the 24 hr collection would yield a falsely lower value of protein in the urine. Lower protein in the collection would alter the math equation for nitrogen balance making it falsely look like more protein was retained for anabolism. The mistake would mistakenly make the healthcare team think the patient had a better nutrition status than they actually did The nurse could emphasize to the patient the importance of an accurate collection so that the team would know whether the patient was getting adequate protein to improve their health/ heal a wound/ recover from a trauma or illness/ build muscle (or whatever the nutrition goal is for the patient related to protein intake)

Energy drinks are popular, especially with teens and young adults. Which statement about energy drinks is accurate information that the nurse can share with a patient?

Mixing energy drinks with alcohol is associated with an increased risk of binge drinkin

Malnutrition associated with deficient protein intake can cause a variety of symptoms. Which symptom might cause a nurse to suspect a patient has malnutrition associated with deficient protein intake?

Moon face

Older adults in general are at a higher risk of dehydration than are younger adults. Which answer best describes the main reason for this risk in the older adult population?

Older adults have lower total body water because of reduced muscle mass

A father is asking the nurse when he can introduce solid foods into the diet of his baby. How should the nurse respond? Briefly explain two things: 1) the timing you would suggest and 2) why this timing is appropriate

One thing I would suggest to this father is that when the baby shows proper developmental signs that they are ready to chew and swallow then new foods can be incorporated to the diet. If a baby is able to pincher grasp then it is likely they can pick up cereals such as cheerios and chew on them as well. Other common signs they are ready to introduce solid foods is that they are able to sit up by themselves, show signs of being able to chew, and do not push food out of their mouth when eating by reflex. Additionally prior to 4-6 months of age a baby does not have the proper enzymes to digest solid foods, so solid food intake should only begin after that. The reason why the baby must have all these signs is because it can be a choking hazard if the baby is unable to properly chew and swallow their food, and because if they start too soon and the enzymes haven't developed they won't be digesting the solid food and it could cause nutritional deficiencies or problems in their GI tract.

The US Dietary Guidelines together with the MyPlate icon outline healthy eating recommendations. All of the following are recommendations contained in these guidelines except one. Which statement is incorrect?

Our plates should be 1/3 vegetables

Despite the fact that fiber is not absorbed by the body, it is essential in the diet for several purposes. Which of the following is a function of fiber in the diet?

Promotes laxation

If someone consumes adequate protein intake, but lacks intake of adequate calories, what metabolic consequence could occur as a result?

Protein from the diet will be sacrificed to be used as an energy source

Which statement about protein digestion and absorption is accurate?

Protein is absorbed in the small intestine after being broken down to peptides and amino acids

Define the term 'sarcopenia'.

Sarcopenia is the loss of muscle mass associated with aging.

A 30-year-old female presents to an obstetric clinic for her first prenatal visit and shares with the nurse that because she had 'issues with high blood sugar' during her last pregnancy. Because of this problem, she decided to go on a very low carbohydrate diet to 'get her blood sugar in line and lose some weight ' starting two months before trying to conceive this baby. The patient is still following the diet four months later and asks for advice about the diet. Given the patient's report, what is the most appropriate information the nurse should share in response to the woman's request for advice?

The need for carbohydrate during pregnancy increases compared with pre-pregnancy because the fetal brain needs glucose

You are a nurse working in an obstetrics practice and during your nursing assessment learn that your patient who is six months pregnant is following a very low carbohydrate diet. You know that the Recommended Dietary Allowance (RDA) for carbohydrate is increased during pregnancy. What information should you share with the patient?

The pregnant female needs increased carbohydrate intake to provide needed glucose for the fetus

Health recommendations about alcohol intake use the terminology of a "standard drink". Why are recommendations given in terms of a "standard drink"?

The total grams of alcohol is the same for each standard drink

A family is visiting the pediatrician for a well-visit for their 2.5 year-old and 6 year-old children. While the nurse is doing an assessment, the family shares that they think the 2.5 year-old child is not eating enough and that meal time is a battle to get the child to eat more. The 6 year-old eats plenty and their intake is not a concern to the family. The adults serve meals portioned out on each person's plate and then brings the plate to the table. The two children are served the same portions as one another. Which response is the most appropriate for the nurse to offer to the family?

The younger child only needs a portion of about two to three tablespoons of each food to be considered a serving

Minerals can chelate several drugs and cause them to not be absorbed. List one drug or class of drug that is an example of this effect

Thyroxine Tetracyclines Fluoroquinolones Tetracycline Levothyroxine

Even with adequate intake by the mother, the vitamin D content of breastmilk is insufficient to meet the needs of the infant.

True

Glucose is the simple sugar that circulates in our blood stream. In the hospital, glucose is given in the intravenous form called dextrose true or false

True

Joking around about weight and making weight comments to a child or adolescent can contribute to later risk of disordered eating and eating disorders in the person.

True

You are a nurse working in a gastroenterology practice. A new patient reports feeling sick after drinking a glass of milk and thinks they better give up on having any dairy foods in the future. What is the best first advice to give this patient who gets diagnosed with lactose intolerance during the office visit?

Try a small amount of yogurt instead of milk

Which dietary supplements alter platelet aggregation and could have negative consequences when taken in large doses or along with medications that already affect blood clotting?

Vitamin E, fish oil, gingko, garlic

A teenager suspected of having an eating disorder reports that the slight bowing of her legs just occurred in the last week and must be from the vegan diet she started the prior week. When documenting in the medical record, which statement by the nurse is the best assessment of the findings?

Vitamin deficiencies do not manifest symptoms quickly in cells that turn over slowly in the body, such as bone.

Body Mass Index (BMI) is used to screen patients for overweight, obesity, and underweight. What other anthropomorphic tool is useful to use along with a BMI to better assess the patient than BMI alone?

Waist circumference Body composition

Weight gain recommendations during pregnancy differ among women. List one reason that weight gain recommendations might be higher for one woman compared with another woman?

Weight gain recommendations are based on pre-pregnancy weight. Females who are underweight need to gain more weight compared with those at a healthy weight or overweight. Additionally, females at higher risk of delivering a low birth weight baby are recommended to gain more than women of low risk. High risk categories include teens and Black women. Number of babies.

Assessing cultural, including religious, influences on nutrition is an important step in every nutrition assessment. In assessing a patient newly diagnosed with hypertension, which statement best reflects a way to begin this portion of the assessment?

What would you like me to know about your dietary practices?

You are a nurse working in a college health clinic. A 21-year-old student who has type 1 diabetes asks you about what the recommendation is for drinking alcohol with diabetes. Which response is the appropriate answer?

consume alcohol only with food and when blood glucose is controlled

Offer two ideas to a patient who consumes very little fiber on how to improve fiber intake. Be specific (meaning: do not write 'consume more fiber at breakfast' or similar general statement - list specific ideas that a patient could follow and not be left with questions about what you mean)

consume fruit with skin or seeds, like apple or berries choose a whole grain breakfast cereal have half the dinner plate filled with vegetables keep edible skin on any fruits or vegetables (like apple, pear, baked potato, zucchini) snack on whole grain crackers or popcorn choose some bean-based dishes, such as black bean or lentil soup or add chickpeas to a salad try to have five servings total of fruits and vegetables per day

Adequate protein in the diet is essential for muscle-building. Name one other function of protein in the body

energy blood components growth and development enzymes immune function calories healing fluid balance hormones pH balance

A low blood calcium level is an early warning sign of a calcium deficiency

false

Claims on the front of a package such as "rich in vitamins" or "made with less sodium" indicate that the food is a healthy option true or false

false

The body is capable of adjusting mineral absorption rate when someone has a mineral deficiency and this adjustment corrects the deficiency

false

Wearing heavy clothing to increase sweating during exercise is a helpful way to burn more calories and lose fat.

false

If a patient has lowered gastric acid production from medications, aging, or gastric resection, it could cause reduced absorption of two minerals. List the two minerals affected by this situation.

iron and calcium

Over-nutrition and under-nutrition are not mutually exclusive conditions. Both of these conditions can exist together in a patient and we should not assume that just because a patient exhibits signs of over-nutrition that they are not at risk of undernutrition. In two words, list the term used to describe the presence of both over-nutrition in the form of obesity along with nutritional deficiencies or under-nutrition in the same patient?

obesity paradox double burden

When conducting a patient assessment, the nurse should assess for risk factors for poor nutrition. Poor calcium status can occur for many reasons. All of the following statements except one reflect a risk factor for poor calcium status. Choose the statement that is not a risk factor for poor calcium status.

substitution of fortified almond milk in place of cow's milk in the diet

You are teaching a patient how to spot added sugar on a food label. In addition to watching for the word 'sugar' on the ingredient label, list one other ingredient that is considered an added sugar.

sucrose anything ending in ose brown sugar high fructose corn syrup syrup honey

Elevated blood cholesterol can be lowered with dietary management. Which of the following recommendations is NOT part of the recommendations to lower serum cholesterol?

switching to snack foods that contain palm oil instead of corn oil

A patient presents to the emergency department with an elevated blood alcohol concentration (BAC), hypoglycemia, and is suspected of abusing alcohol. Which micronutrient will automatically be prescribed to this patient to avoid precipitating a nutrient deficiency when IV dextrose (glucose) is given? Correct!

thiamin