Ch 19 Basic Nutrition and Nutrition Therapy
DRIs for protein are
10-35% of daily calories
what is the DRI for protein?
10-35% of daily calories
For diabetic pts, hypertension, renal disease and generally african americans sodium intake should be less than _____?
1500mg
DRI of B3 niacin
16mg/day for men 14mg/day for women
DRI for B12 is
2.4mcg/day
What is the DRI for lipids (fat)?
25-35% of kcals/day
DRI for fiber intake is
25-38 g/day
what is the lab range for potassium?
3.5-5 mEq/L
DRI for folic acid B9
400mcg/day
What is the DRI for carbohydrates?
45-65% of daily calories
saturated fats should be what % of total calories in a day?
5-6%
DRI for saturated fatty acids are
5-6% of daily calories
for every 1g nitrogen excreted how much protein should be consumed?
6.25g protein
DRI for vitamin D
70 and younger 15mcg/day 70 and older 20 mcg/day
DRI for vitamin A
700mcg/day for women 900mcg/day for men
DRI for vitamin K
90 mcg/day for women 120 mcg/day for men
DRI for vit c ascorbic acid
90mg/day for men 75mg/day for women
DRI of water for women, men and pregnancy
9cups for women 13 cups for men 3 L/day for pregnant women
which vitamins are considered antioxidant vitamins
A, C and E
39. The body mass index (BMI) of a man 6 feet tall weighing _____
ANS: 33.9 The BMI is calculated by dividing the pounds expressed as kilograms by the height in meters squared. 6 feet = 72 inches ÷ 39.37 = 1.83 meters 250 pounds ÷ 2.2 = 113.6 kg 113.6 ÷ (1.83 1.83) = 33.9 REF: Page 632 TOP: Calculating body mass index (BMI)
38. To simplify food values, the measurement of energy obtained by food is defined as the _____ .
ANS: kilocalorie The kilocalorie is the energy value by which foods are measured for their energy- producing potential. REF: Page 608 TOP: Kilocalorie Step: Intervention
21. A patient who has hypertension is complaining about the lack of taste with the low-salt diet that has been ordered. The nurse emphasizes that sodium may: a. contribute to hypertension. b. interfere with blood clotting. c. produce stomach ulcers. d. decrease calcium in the bones.
ANS: A Sodium may contribute to hypertension. REF: Page 643 TOP: Sodium-induced hypertension
26. The nurse has assessed a patient's body mass index (BMI) to be 19.6. This assessment of weight versus height indicates that this patient's weight category is in which category? a. Low health risk b. Overweight c. Obese d. Morbidly obese
ANS: A A BMI between 18.5 and 24.9 is associated with the lowest health risk. Those with BMIs between 25 and 29.9 are considered overweight, and those with BMIs of 30 or greater are considered obese. A BMI of less than 18.5 is considered underweight and is also associated with health risks. REF: Page 632 TOP: Body mass index (BMI)
13. The body uses 22 common amino acids, but 9 of them must be obtained from protein in the diet and are considered: a. essential. b. basic. c. fundamental. d. primary.
ANS: A Essential amino acids must be consumed in the diet, because the body cannot make them. REF: Pages 611-612 TOP: Essential amino acids
28. The nurse counseling a patient about the difference between type 1 and type 2 diabetes stresses that patients with type 2 diabetes are required on a daily basis to receive: a. regular carbohydrate-controlled meals. b. oral hyperglycemic agents. c. insulin injections. d. stringent low-calorie diets.
ANS: A People with type 2 diabetes must take daily regulated meals with controlled carbohydrate content. Type 1 diabetics must have insulin injections. REF: Page 656 TOP: Nutrition in type 2 diabetes
32. A patient diagnosed with renal failure is unable to excrete protein waste products and develops a condition that requires a protein-restricted diet. The nurse instructs the patient that azotemia can be diminished by substituting other food groups for protein, such as: a. potatoes. b. beans. c. cheese. d. soy products.
ANS: A The foods that a patient with renal disease can substitute for energy are in the carbohydrate group. Potatoes are the only carbohydrate listed. REF: Page 643 TOP: Azotemia
30. The patient who had a gastrectomy complains to the nurse about frequent episodes of dumping syndrome. The nurse suggests the patient modify his intake by: a. eating small, frequent meals. b. including more fiber in meals. c. increasing seasoning on food. d. limiting intake to semi-liquids.
ANS: A The symptoms of dumping syndrome can be reduced by consuming small frequent meals of mildly seasoned food; extra fiber is not essential. REF: Page 640 TOP: Dumping syndrome
37. Which are the energy-providing food groups? (Select all that apply.) a. Carbohydrates b. Fats c. Proteins d. Vitamins e. Minerals
ANS: A, B, C The food groups that provide energy are carbohydrates, fats, and proteins. REF: Page 608 TOP: Energy-producing food groups Step: Evaluation
36. What are the four key concepts of the USDA's MyPyramid plan? (Select all that apply.) a. Variety b. Activity c. Proportionality d. Satisfaction e. Moderation
ANS: A, B, C, E The key concepts of MyPyramid are variety, activity, proportionality, and moderation. REF: Page 605 TOP: MyPyramid
Select all that apply: What are the roles of the nurse regarding nutrition? a. pt teaching of the importance of diet b. assist with eating process c. take/ record pt weight d. record pt intake e. observe for clinical signs of poor nutrition f. serve as a communication link g. judge the persons diet based on looks
ANS: A,B,C,D,E,F
27. The eating disorder characterized by body image distortion, excessive exercise, and vicarious enjoyment of food is called: a. self-fasting. b. anorexia nervosa. c. bulimia nervosa. d. binge eating.
ANS: B Anorexia nervosa is an eating disorder characterized by self-imposed starvation, excessive exercise, and body image distortion. REF: Page 635 TOP: Anorexia nervosa
23. At approximately 4 to 6 months of age, solid food is introduced to a baby. Foods with high iron content are recommended by the nurse and include: a. pureed fruit. b. fortified cereals. c. fruit juice. d. rice.
ANS: B At approximately 4 to 6 months, iron-rich foods, such as fortified cereal and pureed meat, are introduced to a baby. REF: Page 623 TOP: Iron-rich foods
14. The nurse reminds a vegan that unless he supplements his diet, he will be deficient in vitamin: a. B6. b. B12. c. K. d. D.
ANS: B B12 is almost exclusively found in animal products but can be supplemented with fortified cereals or vitamins. REF: Page 615 TOP: B12 deficit
20. If the patient taking a diuretic has an erratic pulse and muscle weakness, the nurse should suspect a decrease in: a. sodium. b. potassium. c. chloride. d. iron.
ANS: B Diuretics can deplete potassium through urine excretion and lead to muscle weakness and cardiac arrhythmias. REF: Pages 618, 628, Table 21-13 TOP: Potassium depletion
10. Stored fat that insulates the body and serves as a cushion to protect organs is called: a. subcutaneous tissue. b. adipose tissue. c. cohesive tissue. d. lipid tissue.
ANS: B Fat is stored in the body as adipose tissue. REF: Page 609 TOP: Adipose tissue
35. The nurse teaches a patient who has a nonfunctioning or dysfunctional GI tract that total parenteral nutrition (TPN) will be infused through the: a. carotid artery. b. superior vena cava. c. femoral vein. d. inferior vena cava.
ANS: B TPN solution is usually infused through the superior vena cava. REF: Page 652 TOP: Total parenteral nutrition Step: Implementation
15. A fit, young woman was at zero nitrogen balance, but when she became pregnant the nurse cautioned her that she might develop: a. embolism. b. anabolism. c. catabolism. d. metabolism.
ANS: B When more nitrogen is consumed than is excreted, anabolism occurs. This is also called a positive nitrogen balance. REF: Page 612 TOP: Nitrogen balance
24. A school nurse teaching a group of adolescents about adequate nutrition should encourage increased intake of: a. potassium and sodium. b. chloride and magnesium. c. iron and calcium. d. vitamins and minerals.
ANS: C Dietary inadequacies in adolescence include iron and calcium. REF: Page 626 TOP: Adolescent nutrition
25. A nurse caring for a patient who is prescribed a full liquid diet recognizes that this diet lacks some nutrients including: a. fat-soluble vitamins. b. potassium. c. iron and fiber. d. water-soluble vitamins.
ANS: C A full-liquid diet is deficient in iron and fiber. REF: Page 630 TOP: Full-liquid diets Step: Planning
12. When discussing the digestion and metabolism of fat, the nurse tells the patient who has a history of cholecystitis and is on a low-fat diet that fat must be emulsified to be digested. The ingredient necessary for emulsification is: a. sugar. b. cholesterol. c. bile. d. protein.
ANS: C Bile is necessary to emulsify fat. REF: Page 611 TOP: Function of bile Step: Implementation
29. Careful attention to carbohydrate consumption can improve metabolic control of diabetes. The nurse teaches a meal planning approach that focuses on the total amount of carbohydrates eaten at a meal called: a. carbohydrate splitting. b. reduced caloric intake. c. carbohydrate counting. d. carbohydrate balancing.
ANS: C Carbohydrate counting is a meal planning approach that focuses on the total amount of carbohydrates eaten. REF: Page 639 TOP: Carbohydrate counting
3. Elements that are found in food and necessary for good health but that our bodies cannot make are: a. important nutrients. b. life-saving nutrients. c. essential nutrients. d. necessary nutrients.
ANS: C Elements found in food that our bodies cannot make are essential nutrients. REF: Page 608 TOP: Nutrition
31. The nurse reminds the patient with lactose intolerance that he can avoid the unpleasant symptoms of nausea, bloating, flatulence, and diarrhea if he will avoid eating products that include: a. soy beans. b. rice. c. milk. d. high fiber.
ANS: C Lactose intolerance occurs as a result of a lack of lactase that makes it impossible to break down milk sugar. REF: Page 640 TOP: Lactose intolerance
7. The nurse concludes that additional instruction is not necessary after the patient demonstrates understanding that protein, minerals, iron, and fat combine to: a. regulate body processes. b. provide energy. c. build and repair tissue. d. restore body function.
ANS: C Many nutrients are necessary to build and repair tissue, including protein, minerals, iron, and fat. REF: Page 608 TOP: Nutrition Step: Evaluation
2. When explaining the activity recommendations from the USDA's new MyPyramid plan, the nurse states that the minimum amount of daily exercise needed to balance nutritional intake is: a. 15 minutes. b. 20 minutes. c. 30 minutes. d. 60 minutes.
ANS: C MyPyramid recommends a minimum of 30 minutes of daily exercise to balance nutritional intake. To prevent weight gain, 60 minutes of exercise is recommended. For sustaining weight loss, 60 to 90 minutes a day is recommended. REF: Page 606, Figure 21-1
19. Following the removal of a part of the stomach, the patient is assessed closely by the home health nurse for: a. a stomach ulcer. b. digestive problems. c. pernicious anemia. d. malabsorption.
ANS: C Pernicious anemia results when the intrinsic factor is missing due to surgery on the stomach. REF: Page 616 TOP: Pernicious anemia
8. When reviewing a patient's dietary intake, the nurse recommends that sugar consumption be reduced to the recommended daily level, which is less than: a. 20% of total daily kilocalories. b. 15% of total daily kilocalories. c. 10% of total daily kilocalories. d. 5% of total daily kilocalories.
ANS: C Recommendations have been made to reduce sugar consumption to less than 10% of total daily kilocalories. REF: Page 609 TOP: Nutrition
11. When providing information about high cholesterol levels, the nurse explains that saturated fats usually are animal in origin, solid at room temperature, and should be avoided because they: a. block absorption of nutrients. b. interfere with metabolism. c. increase blood cholesterol. d. must be hydrogenated.
ANS: C Saturated fats tend to increase blood cholesterol. REF: Page 610 TOP: Saturated fats
16. The nurse explains that the decreased sodium diet prescribed for a patient with a heart problem will help reduce or prevent: a. stroke. b. fluid excretion. c. heart attacks. d. obesity.
ANS: C Sodium attracts water and causes fluid retention. Hypervolemia increases the heart's workload, which can lead to a heart attack. REF: Page 615, Table 21-21 TOP: Fluid retention
33. Nursing interventions to decrease the thirst of a patient who is on a fluid restriction include: a. rinsing the mouth with warm water. b. sipping carbonated drinks. c. sucking on ice chips. d. limiting tooth brushing to once per day.
ANS: C Sucking on ice chips is a way to decrease thirst without adding a large amount of fluid. Rinsing the mouth with cool water and frequent tooth brushing are helpful also. Carbonated drinks contain sodium and will enhance fluid retention. REF: Page 644 TOP: Fluid restrictions Step: Planning
5. The USDA's Recommended Dietary Allowance (RDA) has been replaced by the: a. Nutrition Recommended Allowance (NRA). b. National Bionutritional Allowance (NBA). c. Dietary Reference Intake (DRI). d. Dietary Guidelines for Americans (DGA).
ANS: C The Dietary Reference Intake (DRI) has replaced the Recommended Dietary Allowance (RDA). REF: Page 608 TOP: Nutrition
34. The nurse recognizes that when a patient is unable to consume adequate nutrition by mouth, an alternative route such as a feeding ostomy may be used. Feeding a patient by this means is called: a. total parenteral nutrition (TPN). b. nasogastric. c. enteral. d. parenteral.
ANS: C The administration of nutritionally balanced liquid foods through a feeding ostomy is called enteral nutrition. REF: Page 646 TOP: Enteral feedings
17. The patient complains to the nurse that he feels terrible since he has been taking several different kinds of vitamin preparations. The nurse assesses for indications of vitamin toxicity, which include: a. edema. b. hypertension. c. fatigue. d. diarrhea.
ANS: C Toxicity usually occurs from the use of large supplemental doses of vitamins and minerals and presents as fatigue, nausea, vomiting, and headache. REF: Pages 613-617, Table 21-6 TOP: Vitamin toxicity
18. The nurse cautions the patient with a pancreatic disorder that she will not be able to digest fats well and may be subject to a clotting disorder. This problem is the result of the inability to utilize vitamin: a. B. b. C. c. D. d. K.
ANS: D Vitamins A, D, E, and K are fat-soluble. Difficulty with fat metabolism will result in the inability to utilize fat-soluble vitamins. REF: Page 643 TOP: Fat-soluble vitamins
6. Although alcohol is not an essential nutrient, 1 gram of alcohol provides: a. 4 kcal/g. b. 5 kcal/g. c. 6 kcal/g. d. 7 kcal/g.
ANS: D Alcohol provides 7 kcal/g of energy. REF: Page 608 TOP: Alcohol
4. To demonstrate the energy-producing potential of different foods, the nurse explains that 3 grams of lean meat produces 12 kcal/g, whereas 3 grams of fish oil would produce: a. 6 kcal/g. b. 15 kcal/g. c. 21 kcal/g. d. 27 kcal/g.
ANS: D Fat provides 9 kcal/g. REF: Page 608 TOP: Nutrition
9. The body's storage form of carbohydrates, usually found in the liver with some storage in the muscles, is: a. sugar. b. glucose. c. lipids. d. glycogen.
ANS: D Glycogen is not generally consumed in the diet but is the body's storage form of carbohydrate. It is found mainly in the liver, with some storage in the muscles. REF: Page 609 TOP: Glycogen
1. The nurse makes nutrition a focus in the care plan because of the role it plays in: a. weight control. b. sustained appetite. c. building strong bones. d. health maintenance.
ANS: D Nutrition is the total of all processes involved in taking in and using food substances for proper growth, functioning, and maintenance of health. REF: Page 605 TOP: Nutrition Step: Planning
22. The young woman who is breastfeeding will need an increase of calories and protein. The nurse suggests which foods as sources of protein? a. Green, leafy vegetables b. Citrus fruits c. Asparagus d. Nuts
ANS: D Nuts are a safe source of protein for lactating women. REF: Page 620, Table 21-10 TOP: Protein source
Vegans are at risk for which nutritional deficiency?
B12
production of hemoglobin and myelin, synthesis of new cells and maintenace of nerve cells are functions of which vitamin
B12 cyanocobalamin
Niacin is which B vitamin
B3
folic acid is which vitamin
B9
unsaturated fats are liquid at room temp and are thought to lower which type of cholesterol?
LDL (bad fat that causes thickening of arteries leading to blockage)
the sum of all processes involved in taking in nutrients and using them to maintain body tissue and provide energy is known as
Nutrition
DRI is a combination of
RDA, adequate intake, tolerable upper intake level and the estimated average requirement of each nutrient
RDA stands for
Recommended Dietary Allowance
which vitamins are important to treat pressure ulcers?
Vitamin C,D and zinc
Gi upset, muscle weakness and calcium deposits are signs of toxicity of which vitamin
Vitamin D
formation of blood clotting factors is a function of which vitamin
Vitamin K
Which vitamins are water soluble
Vitamins B and C
are whole grains better than refined grains?
Yes
PEM (protein energy malnutrition) is defined as
a lack of energy or protein intake
DRIs of iron are
adolescent girls 15mg/day premenopausal 18mg/day postmenopausal 8mg/day pregnant women 27mg/day
condition referred to as the body building more tissue than it is breaking down due to a positive nitrogen balance
anabolism
formation and maintenance of bones and teeth, blood clotting, nerve conduction and muscle contraction are functions of which mineral?
calcium
of the six essential nutrients which 3 provide energy?
carbohydrates, fats and proteins
condition referred to as insufficient protein intake which causes the body to break down more body tissue than it is building
catabolism
DRIs of calcium are
children/adolescence is 1300mg/day adults 50 or younger 1000mg/day adults 51 or older 1200mg/day adults with osteoporosis need 1500mg/day
meat, poultry, fish, milk, cheese, eggs and soy products are what kind of proteins
complete proteins which contain all nine essential amino acids
polysaccharides are
complex carbohydrates
starch, glycogen and fiber are classified as
complex carbohydrates
common signs of a deficiency in sodium include
cramps, mental confusion, apathy and appetite loss
poor skin turgor, flushed dry skin, dry mouth, cracked dry lips, decreased urine output, irritability, and disorientation are signs of
dehydration
DRI stands for?
dietary reference intake; refers to a set of nutrient based values for evaluating and planning diets
nutrients that the body cannot make in the amounts essential for good health are called
essential nutrients; must be included in diet
iron absorption is diminished with intake of
fiber and caffeine
formation of DNA and cell division as well as nucleic acid synthesis and amino acid metabolism is function of which vitamin
folic acid B9
function of niacin is
general metabolism
grains, legumes, nuts and seeds are what kind of proteins
incomplete proteins which are typically of plant origin
type of fiber that softens stool, speeds transit of foods through digestive tract and reduces pressure in the colon?
insoluble
wheat bran, vegetables, whole grains, and some fibrous fruits are considered what type of fiber
insoluble
Vitamin B12 is not absorbed without
intrinsic factor
which organ remove excess nitrogen from the body?
kidneys
condition characterized by edema in the feet, legs, face and hands and in extreme cases abdominal. occurs as a result of severe protein restriction in the presence of other calories
kwashiorkor
Trans fat should be limited to what % of calories a day?
less than 1%
what is the DRI for cholesterol? including LDL
less than 100mg/day LDL less than 300mg/day for total cholesterol
organic substances of a fatty nature that are insoluble in water and necessary for good health; include fats and cholesterol
lipids
which nutrient provides the most concentrated source of energy
lipids
where is glycogen stored?
liver
protein, carbohydrates, fats, water and minerals are all examples of
macronutrients
calcium, phosphorus, magnesium, sulfur, sodium, potassium and chloride are considered what kind of minerals
major minerals needed in quantity more than 100mg/day
a chronic condition defined by wasting of body tissues and effects people of all ages d/t a deficiency of protein as well as all other energy-providing foods is called
marasmus
combination of all chemical processes that take place in living organisms is called
metabolism
nutrients requires in smaller amounts; such as vitamins and trace minerals are called
micronutrients
balance between amount of nitrogen ingested in the form of protein and level of nitrogen used by the body is called
nitrogen balance
vitamins are organic compounds that are essential for
normal metabolism and for growth and maintenance of the body; they are NOT sources of energy
iron deficiency limits what
oxygen delivery to the cells causing fatigue, headache, pallor, pale skin, poor attention span
pt with gastric bypass surgery is at risk for
pernicious anemia (B12 deficiency)
increased blood pressure, kidney stones, cardiac dysrythmias, muscle weakness and glucose intolerance are signs of deficiency in which mineral?
potassium
carbohydrates are required in adequate amounts to keep which nutrient from being used as an energy source?
protein
what are the 3 major functions of nutrients?
provide energy, building and repairing tissue, and regulating body processes
dietary fiber cannot be broken down and digested and therefore have no nutritional value. What is a benefit of fiber?
provides roughage or bulk for health maintenance; can lower cholesterol and blood glucose levels and assist in weight loss
simple carbohydrates are absorbed ____ d/t the fact that they require no digestion
rapidly
What are macronutrients?
required in large amounts
a feeling of fullness and satisfaction from food is called
satiety
fatty acid that is solid at room temp and increase the blood cholesterol levels this increasing risk for atherosclerosis and heart disease are
saturated fatty acid
sucrose, lactose, fructose and glucose are examples of what kind of carbohydrate?
simple
simple sugars (mono and disaccharides) are
simple carbohydrates
fluid and acid-base balance, nerve conduction and muscle contraction are all functions of which minerals?
sodium and potassium
fiber that binds with bile acids and cholesterol to prevent absorption resulting in lower cholesterol levels and slowing digestion are
soluble fibers
PEM is typically accompanied by multiple nutrient deficiencies and can lead to
stunted growth and impaired cognitive development in children, reduced mental and physical capacity and lowered resistance to infection
protein is essential for
tissue growth, repair and woundhealing
what is the purpose of DRIs?
to help individuals optimized their health, prevent disease, and avoid consuming too much of a nutrient
iron, zinc, iodine, selenium, copper, manganese, fluoride, chromium, molybdenum are what type of minerals
trace minerals
vision, tissue integrity, growth and reproduction, immune function and embryonic development are functions of which vitamin
vitamin A
fat soluble vitamins include
vitamin A, D, E and K
lipids contain essential fatty acids: linoleic acid and linolenic acid. Also carry which vitamins?
vitamin A,D,E and K
maintenance of blood calcium, phosphorus balance and promotion of bone and teeth are functions of which vitamin
vitamin D
wound healing, tissue growth and maintenance, immune function and absorption of iron are functions of which vitamin
vitamin c ascorbic acid
Fruits, oats, barley, legumes are examples of what kind of fiber?
water-soluble
What are the DRIs for sodium including upper limit?
younger than 50 is 1500mg/day 50-70 is 1300mg/day 70 and older is 1200mg/day upper limit is 2300mg/day