Therapeutic Nutrition Exam 1 Review

The total amount of energy in a bowl of soup that contains 5 g of protein, 2 g of fat, and 20 g of carbohydrate is _____ kcal.

118 Protein provides 4 kcal/g; fat provides 9 kcal/g; carbohydrate provides 4 kcal/g. Therefore, the soup contains 118 kcal ([5 × 4] + [2 × 9] + [20 × 4] = 20 + 18 + 80).

The nurse is recording a client's breakfast intake. Which entry is correct?

25% oatmeal, 50% eggs, 100mL juice A food recording must be accurate using measurable amounts (cups, mL) or in percentage of amount eaten (50% eggs, 25% oatmeal). Do not use "are well" or "two bites" etc.

A high intake of which mineral below is associated with a decrease in blood pressure, stroke, and CVD?

A high potassium intake is associated with a decrease in BP, stroke, and CVD risk.

Which of the following statements regarding nutrition screening is false?

A nutrition screening is completed only when a client is suspected of having a nutritional problem The Joint Commission requires ALL patients (not just those with a suspected nutritional problem) admitted to the hospital be screened for nutritional concerns within 24 hours of admission.

Which is NOT a function of fat?

Aids in digestion of carbohydrates Fats serve as a source of energy, make food smell and taste good, help prevent hunger between meals, cushions and protects body organs, and serves as insulation to regulate body temperature. Fats serve no role in carbohydrate digestion.

What are the nutritional characteristics of a traditional Jewish diet? Select all that apply.

All blood must be drained from animals, Meat and dairy products must not be eaten together, All foods must be Kosher All food must be Kosher even though any food can be considered Kosher if prepared in accordance to Jewish law. There is a set of laws called Kashrut laws that define a Kosher diet. These laws describe how the animal should be hung and how the meat should be cut so that the least amount of blood is released from the animal. Blood is considered to be the soul of the animal, so Jews do not eat rare meat. It must be cooked all the way through. Foods that are unfit for Jews are crustaceans, scavenger birds, birds of prey, mammals and pigs, because although pigs have hooves, they eat pretty much anything so they are seen as dirty. Jews refrain from mixing dairy with meat at any time.

Iodine major function

Assists thyroid with metabolism

What are the two most widely used assessments for interpreting body fatness?

BMI & waist circumference BMI and waist circumference are the most widely used assessments for measuring body fatness. Wait circumference is cost-effective and reliable. Densitometry is under water weighing and is expensive. Skinfold thickness indicates subcutaneous fat stores.

Select the lab result most likely to result in a diagnosis of Diabetes Type 2.

Diagnosis of DM2 happens with an elevated fasting blood glucose value >126, if found on at least two occasions, or hyperglycemia; hemoglobin A1C (HgbA1C) of 6.5 or above; or oral glucose tolerance test >200.

Mouth function

Begins digestion of carbohydrates

Sodium major function

Blood pressure & fluid regulation

Iron major function

Carries oxygen to cells

Which of the following is NOT a microvascular complication of Diabetes resulting from consistently elevated blood glucose levels?

Coronary artery disease Consistently elevated BG levels damage the tiny vessels (microvessels) in the eyes, kidneys, and extremities. Retinopathy is the leading cause of blindness in the US. Nephrophathy can lead to irreversible kidney damage. Neuropathy affects peripheral circulation and causes decreased sensation in extremities. It is a major contributor to foot and leg amputations. DM2 increases a person's risk of coronary artery disease, but these vessels are larger and called macrovascular vessels.

Three?

Daily servings of low fat dairy

Select all the approaches used in the DASH diet eating plan.

Eat less red meat, Use spices without salt, Eat more fruits and vegetables, low-fat dairy

Which suggestion by the nurse would help a client who is experiencing altered taste following chemotherapy treatment?

Eating foods that are tart or spicy may enhance intake when taste is altered. Clients should use seasonings to help with flavors.

Select all the signs and/or symptoms of protein deficiency.

Edema, Impaired nutrient digestion and absorption, Infections, Anemia, Delayed wound healing

What are some actions the nurse can take to increase client nutrition while in the hospital? Select all that apply.

Educate on the proper foods for the prescribed diet, Let the client choose meals, Turn on the lights and sit the client up in bed The nurse should NOT criticize food choices or feed the client as much as possible. The nurse should be aggressive about diet progression to meet nutritional requirements and increase client satisfaction. All other answers are appropriate.

The Wellness Approach includes which of the following?

Establishing realistic goals, Minimizing emotional eating, Modifying behavior, Normalizing eating, Being physically active The Wellness Approach does not include making drastic changes or rewarding with food.

True or false? Clients on a regular diet do not need nutritional counseling.

False Education is a top priority, and nursing should explain the rationale of the diet. Clients may need counseling on healthy choices.

True or false? The best measure of long-term blood glucose control is capillary blood glucose prior to meals.

False HgbA1C measures the amount of glycosated hemoglobin in the bloodstream for the past 120 days. It is NOT affected by short-term factors and is therefore a good indicator of long-term blood glucose control.

True or false? Nutrition therapy for an obese client should eliminate carbohydrates to promote faster weight loss.

False It is best to recommend a dietary approach in which calorie restriction includes all food groups. Carbohydrates should not be eliminated to promote faster weight loss.

True or false? It takes about 10 days for fat stores to be depleted during starvation.

False; It takes 4-6 weeks for fat stores to be depleted during starvation.

What are the two strongest risk factors for developing Diabetes Type 2?

Family history and obesity are the two strongest risk factors for developing Diabetes. The other factors play a role but not to the effect of family history and obesity.

For which of the following situations is a pureed diet most appropriate?

For clients who have their jaw wired shut A pureed diet is most appropriate for a client with the jaw wired shut since this client would not be able to chew. A pureed diet is not a transition diet. A clear liquid diet would be appropriate initially after surgery. A client in need of a low-fiber diet would not need their foods pureed.

Select all the non-modifiable risk factors for hypertension (HTN).

Genetics, gender, age, and ethnicity cannot be modified to decrease risk factors for HTN. Sodium intake can be lowered and physical activity can be increased.

What are the nutritional characteristics of a traditional soul food diet? Select all that apply.

High in fat, cholesterol, and sodium; low in calcium The popular term for African-American cooking is "soul food." Many of these foods are rich in nutrients, as found in collard greens and other leafy green and yellow vegetables, legumes, beans, rice and potatoes. Traditional diets are high in fat, cholesterol, and sodium and low in protective nutrients such as fiber, calcium and potassium, and high in fat.

Large intestine function

Houses bacteria that produces several vitamins

Complications of gestational diabetes include which of the following? Select all that apply.

Hypoglycemia for the infant, Increased infant insulin levels, Respiratory difficulties for the infant, Increased risk of DM2 for the mom The infant born to a woman with gestational diabetes is at risk for increased levels of insulin. This happens since the mother's insulin does not cross the placenta, but her glucose does. This can cause the fetus to produce too much insulin which results in hypoglycemia. Gestational diabetes also places an infant at risk for being abnormally large (macrosomia), respiratory difficulties, hypocalcemia, hypokalemia, and jaundice. The mom is also at risk for developing DM2 after pregnancy.

Muslims are prohibited from consuming

Intoxicants are forbidden, including pure vanilla containing alcohol. No coffee, tea, or alcohol.

Potassium major function

Intracellular fluid regulation

The nursing assessment of an obese client should include all of the following except:

Judgments about why the client is obese The nursing assessment of an obese client should be sensitive and nonjudgmental in asking specific and leading questions about weight, diet, and exercise.

Diabetes management in the elderly population can be especially challenging for many reasons. Select the answer that does NOT contribute to this issue.

Living in a retirement home can increase social activity for an older person which can help with depression but does not contribute to problems with diabetes management.

Two?

Max hours of screen time daily

One?

Minimum hour of physical activity daily

Which does NOT play a role in the regulation of body fat?

Muscle mass When energy intake exceeds expenditure, we gain fat; when it is less than expenditure, we lose fat. Genes may influence how calories are stored and energy released. Set points keep our weights pretty constant and the body defends against weight loss in certain situations.

Which statement is NOT true of vitamins?

Vitamins cannot be stored If we consume more than the daily requirement of at fat-soluble vitamin, our bodies store the excess rather than excrete it. True about vitamins: Most vitamins cannot be made by the body Vitamins do not provide energy Most vitamins cannot be made by the body Vitamins can be fat or water soluble

Which suggestion by the nurse would NOT be appropriate for a client experiencing anorexia related to chemotherapy?

NOT: Drink lots of fluids with meals DO: Eat in the morning when your appetite is best, Eat small frequent meals, Use condiments like butter to increase your kcals The client experiencing loss of appetite related to chemotherapy should eat small, frequent meals and spread fluids throughout the day instead of drinking large amounts with meals. They should also eat in the morning since this is when appetite is likely to be the best and add high kcal condiments like butter to increase energy intake.

Protein is different from carbohydrates and fats in that is contains which of the following?

Nitrogen Nitrogen makes proteins different from carbohydrates and fats. Nitrogen balance reflects the state of balance between protein breakdown (catabolism) and protein synthesis (anabolism).

To promote optimal wound healing following surgery for cancer, which macronutrient will need to be increased?

Protein Energy and protein requirements may need to be increased to promote optimal wound healing post-op. Protein is needed for tissue repair and resistance to infection. Sufficient kcals are needed to spare use of proteins for energy.

Vitamin D deficiency

Rickets & osteoporosis

Clinical assessment of a child who is obese should include all of the following except:

School performance assessment School performance assessment is not part of the clinical assessment of an obese child. Clinical assessment of children includes a health history, emotional health status, and physical activity patterns.

Nurses are in an ideal position to

Screen clients for risk of malnutrition The process of screening and nutrition assessment is an example of the cooperative effort of how nurses and dietitians identify patients with actual or potential malnutrition. Since nurses have close contact with patients and families, they are in an ideal position to identify these patients and make a referral. The RD would conduct the nutrition assessment, order therapeutic diets, and calculate protein and calorie needs.

Vitamin C deficiency

Scurvy

Pancreas function

Secretes hormones to maintain blood glucose levels

True or false? Weight loss and exercise can prevent or delay Diabetes and normalize blood glucose levels.

True

True or false? A mechanical soft diet is different from a pureed diet since foods can be easily cut with a fork.

True A mechanical soft diet includes all foods easily cut with a fork, chopped, or blended. Composition and consistency of foods should be tailored to the patient's needs. Only puree what is needed for the patient to keep food desirable. Foods may just need to be chopped coarsely or finely.

True or false? Children should aim for 60 minutes of physical activity daily to help lower the risk of DM2, control blood pressure, and boost mental health.

True Being physically active lowers the risk for type 2 diabetes because it helps the body use insulin better, decreasing insulin resistance. Physical activity improves health in lots of other ways, too, from controlling blood pressure to boosting mental health. Aim for 60 minutes of activity a day.

True or false? Children who are obese are at risk for developing diseases that used to mainly affect adults.

True Children with obesity are at higher risk of having other chronic health conditions and diseases that influence physical health. These include asthma, sleep apnea, bone and joint problems, type 2 diabetes, and risk factors for heart disease.

True or false? Many people are living with Diabetes Type 2 and do not know it because the symptoms often appear gradually

True DM2 is slowly progressive and may go undiagnosed for years. 7.2 million out of 30 million that have DM2 are not aware that they have Diabetes. Symptoms occur gradually if at all: polyuria polydipsia, fatigue, frequent infections.

True or false? The goal of nutrition therapy for people being treated for cancer is to prevent weight loss and maintain lean body mass.

True Goals for cancer nutrition therapy include maintenance of weight and lean body mass, adequate hydration, adequate energy and protein intakes, and use of appropriate and safe complementary nutrition therapies.

True or false? When eating patterns of immigrants are Americanized, the diet is often linked to increased risk of chronic disease and obesity.

True Length of stay in the US correlates to the Americanization of the diet and increase in health concerns. In the US, acculturation is linked to an increased risk of chronic disease and obesity. Dietary acculturation is the process that occurs as members of a minority group adopt the eating patterns and food choices of the host country.

True or false? Most deficiencies experienced by vegetarian-type diets are the result of poor planning and relying on refined and processed foods.

True Many vegetarians do not take good care to get all their vitamins and minerals. They rely on highly processed foods which are usually grain based.

True or false? Modern nutritional evidence does not support a major effect of saturated fat on cardiovascular disease (CVD)?

True More recent studies are suggesting there is not conclusive evidence to establish a link between saturated fat intake and blood cholesterol levels. Modern nutritional evidence does not support a major effect of saturated fat on CVD risk.

True or false? Cancer related to obesity is preventable.

True Obesity is a behavioral risk factor for cancer that is reversible. Weight loss, along with a healthy diet high in vegetables, can help reduce cancer risk.

True or false? Obesity has become an epidemic among both genders and all ethnicities.

True Obesity prevalence has increased in both men and women, in all age groups, and in all racial and ethnic groups.

True or false? Asian Americans tend to have lower incidences of heart disease.

True Positive health factors related to an Asian diet include low incidence of heart disease, bowel cancer, and breast cancer.

Which types of foods provide carbohydrates? Select all that apply.

Vegetables, milk, fruit Knowing which foods provide carbohydrates is important since all carbohydrates digest to glucose. Clients should should nutrient-dense carbohydrates which include vegetables, fruits, and dairy in addition to whole grains and legumes. Animal proteins provide fat and protein but not carbohydrates.

Populations at greatest risk for malnutrition include

Very young children, Elderly adults, Excessive dieters, Chronic alcoholics All individuals are potentially at risk for malnutrition, but there are certain populations of people at greatest risk for malnutrition. These include very young children, older adults, those with incomplete diets (chronic alcoholics, excessive dieters, eating disorders, poorly planned vegetarian diets), those with dementia, depression, swallowing disorders, decreased mobility, those taking drugs with antinutrient or catabolic properties, clients in hypermetabolic states, and clients with no oral intake and/or receiving standard IV solutions for 10 days (adults) or 5 days (older adults).

Since vegan clients adhere to strict, plant-only diets, they may be deficient in which of the following nutrients?

Vitamin B12 Since sources of vitamin B12 are all animal-related, vegans require supplementation of B12.

Which of the following criteria would most likely be on a nutrition screen in the hospital?

Weight change Nutrition screening identifies characteristics known to be associated with nutrition problems, such as unintended weight loss and decreased appetite. The nutrition screening process facilitates completion of early intervention goals, includes collection and interpretation of relevant data, helps determine the need for a nutrition assessment, is cost effective, and may be completed in any setting. All other answers would be on the nutrition assessment.

What is the single most effective means to lowering blood pressure?

Weight loss is the most effective means to lowering BP.

Vitamin A deficiency

Xeropthalmia

Select the client with a high-risk nutrition finding.

YES: choking when swallowing food NO: BMI of 21, Intended 12% weight loss in six months, Serum albumin 4.0 g/dL

Vitamin B6 (Pyridoxine) deficency

anemia

Vitamin K deficiency

bleeding disorders

Calcium major fucntion

bone and tooth formation

What are the three macronutrients?

carbohydrates, fats, proteins Macronutrients are fat, carbohydrate, and protein. They are energy-yielding nutrients.

Which foods would be appropriate on a full liquid diet?

chicken broth, orange juice, milkshake Full liquids are liquid at room and body temperature. Chicken broth, orange juice, and milkshakes are full liquids. It provides more variety than clear liquids. Apple juice, coffee, and beef broth are clear liquids. Blended peas, carrots, and chicken are not liquids and would be appropriate for a pureed diet. Cooked pasta with tomato sauce would be on a mechanical soft or regular diet.

Five?

daily servings of fruit

Four?

daily servings of water

Small intestine function

digests and absorbs food

Liver function

produces bile

What is the primary function of fat?

provide energy Fat is the densest form of stored energy in food and our bodies providing 9 kcal/g. Fats can produce more than twice the energy than carbohydrates and protein.

One reason that increasing fruit and vegetable consumption helps decrease dietary fat intake is that fruits and vegetables

replace high-fat foods in the diet Fruits and vegetables replace high-fat foods in the diet because they are high in fiber and water; they cause satiety so that clients have less desire for high-fat foods. Fruits and vegetables are not, and do not contain, natural appetite suppressants and do not hinder absorption of fat from foods. They are rich in antioxidants and phytochemicals, but increased intake of these substances does not affect fat intake.

The primary site of carbohydrate digestion is in the

small intestine The small intestine is the major organ of digestion, and and the final stages of the digestive process occur here. The digestive process of carbohydrates begins in the mouth, but the majority of digestion takes place in the small intestine.