CNS review: Lifecycle QUIZ

Infant should consume ___________calories per kg body weight during 1st 6 month of life. - -

108 studyforxyz FUNDAMENTALS PRINCIPLES OF NUTRITION

b K 590 -

11. The first trimester includes the: a. entire embryonic period only. b. entire embryonic period and part of the fetal period. c. entire embryonic period and fetal period. d. entire fetal period.

c A 590 -

12. A baby was born at 38 weeks of gestation, weighing 4250 grams (>95th percentile). The baby was: a. preterm. b. premature. c. full term. d overdue.

a K 590 -

13. The length of the pregnancy is called: a. gestation. b. periconceptual period. c. critical period. d. None of the above

a A 591 -

14. A baby was born at 38 weeks of gestation, weighing 3 lbs 8 oz. The baby was: a. considered low birth weight. b. born prematurely. c. normal for gestational age. d. large for gestational age.

If your client was overweight at the start of pregnancy, how much healthy weight should she gain throughout her entire pregnancy? Choose from: -10 lb. -35 to 45 lb. -25 to 35 lb. -15 to 25 lb. - -

15 to 25 lb. Studyforxyz FUNDAMENTALS PRINCIPLES OF NUTRITION

Protein synthesis increases by _________ to __________% in the 1st and 2nd trimester - -

15-25 Studyforxyz FUNDAMENTALS PRINCIPLES OF NUTRITION

Protein synthesis increases by ___________ in 1st-2nd trimester of pregnancy - -

15-25% Studyforxyz FUNDAMENTALS PRINCIPLES OF NUTRITION

Pregnancy weight gain: Overweight women __________lbs, normal weight women _____________ lbs - -

15-25lbs, 25-35lbs Studyforxyz FUNDAMENTALS PRINCIPLES OF NUTRITION

d K 591 -

17. How likely are low-birth weight (LBW) babies to die before 1 year of age as compared to normal infants? a. 5x b. 10x c. 20x d. 40x

How many grams of carbs is recommended during pregnancy based on DRI for pregnant women? - -

175g, which is 45-65% of DV studyforxyz FUNDAMENTALS PRINCIPLES OF NUTRITION

c K 594 -

18. How much weight should women of normal weight gain during pregnancy? a. 15-25 pounds b. 20-35 pounds c. 25-35 pounds d. 28-40 pounds

a K 594 -

19. How much weight should overweight women gain during pregnancy? a. 15-25 pounds b. 20-35 pounds c. 25-35 pounds d. 28-40 pounds

d A 596 -

28. Shelly realizes that she was eating far too much protein prior to becoming pregnant because she was following a low-carbohydrate diet, and would like to balance her diet better. The prenatal dietitian helped her calculate that she was consuming 150 grams of protein per day. How many grams of protein per day can Shelly take out of her diet while still meeting her needs? a. 20 b. 40 c. 60 d. 80

c A 596 -

29. Which food choices would be the equivalent to the amount of protein that Shelly can remove from her diet and still meet her needs? a. 3-4 oz meat, fish, or poultry b. 6-7 oz meat, fish, or poultry c. 9-10 oz meat, fish, or poultry d. 12-13 oz meat, fish, or poultry

c A 596 -

30. Shelly is consuming ~2400 kcalories per day to meet her energy needs now that she is pregnant. How many grams of fat should she consume to meet her recommended intake? a. 33-73 b. 43-83 c. 53-93 d. 63-103

Calcium requirements do not increase during pregnancy, but an additional_____________ mg may be needed in 3rd trimester. This can be obtained by increased absorption and release of Ca from bone. - -

300 Studyforxyz FUNDAMENTALS PRINCIPLES OF NUTRITION

c K 596 -

31. How many grams of protein per day should a pregnant woman add to her diet? a. 15 grams b. 20 grams c. 25 grams d. 30 grams

c K 596 -

34. Which of the following oils is a significant source of omega-3 fatty acids? a. Olive oil b. Corn oil c. Canola oil d. Peanut oil

21. Young children should be offered a. large portions so they can decide how much to eat. b. small portions so they can ask for more if hungry. c. larger portions of food as they grow older. d. the same amount of food each day.

ANS: B In feeding young children, a variety of foods should be offered and served in small portions. Children can ask for a second helping of food if they are still hungry. DIF: Cognitive Level: Application REF: p. 178 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance

5. When should the addition of iron to the diet of both formula-fed and breast-fed infants begin? a. 6 weeks b. 4 to 6 months c. 6 to 9 months d. 1 year

ANS: B The iron stores in infants are adequate enough to provide for growth up to double their birth weight, which, in most cases, comes around 4 to 6 months. Although the iron in breastmilk is highly bioavailable, continuing to only breastfeed an infant past 4 to 6 months of age will lead to depletion of the infant's iron stores by 6 to 9 months. To prevent this depletion, additional sources of iron are needed in the infant's diet. REF: p. 303

2. Foods for infants should be prepared without added a. sugar and salt. b. salt and herbs. c. wheat and sugar. d. milk and wheat.

ANS: A Foods for infants are prepared without added sugar and salt. Foods should not be overseasoned to let tastes develop gradually. DIF: Cognitive Level: Knowledge REF: p. 176 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance

16. An older adult is most likely to have an inadequate nutrient intake if he or she lives a. in a retirement community. b. with a spouse. c. alone. d. with family.

ANS: C Inadequate nutrient intake is more apparent in elderly people who live alone compared with those who have a companion to eat with and enjoy the food. DIF: Cognitive Level: Knowledge REF: p. 197 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance

5. Increased protein is necessary in pregnancy for a. preventing gestational diabetes. b. sparing carbohydrates for energy needs. c. growing maternal tissues. d. preventing pregnancy-induced hypertension.

ANS: C Increased protein is necessary in pregnancy for rapid growth of the fetus, development of the placenta, growth of maternal tissues, increased maternal blood volume, and amniotic fluid. DIF: Cognitive Level: Knowledge REF: p. 148 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance

a K 585 -

4. What are the most common measures used to assess growth? a. Height and weight b. Height and head circumference c. Height and body mass index d. Recumbent length and weight

7. Which children are at risk for having a zinc intake lower than the recommended level? a. Those who do not eat meat or seafood. b. Those who do not receive zinc supplementation. c. Those who drink too much milk. d. Those who do not like many vegetables.

ANS: A Primary sources of zinc in the diet are foods of animal origin. Because of the costs of meat and seafood, children from families with low incomes are more at risk for developing zinc deficiency. Milk and vegetables are not primary sources of zinc. REF: p. 317

a A 611 -

66. Which of the following foods has a high allergic potential? a. Peanut butter and jelly sandwich b. Baked chicken c. Vegetable rice pilaf d. Fruit cup

d K 615 -

73. One-third of the children in the U.S. watch _____ of television per day. a. 1 hour b. 1-2 hours c. 2-3 hours d. 3 or more hours

a K 615 -

74. What percentage of schools in the U.S. meet the Centers for Disease Control and Prevention's recommendation that children participate in 30 minutes of physical education class daily? a. 6-8 b. 10-12 c. 14-16 d. 18-20

d K 617 -

75. By what year of age are the AMDR's for toddlers and young children close to those of adults? a. 1 b. 2 c. 3 d. 4

9. Compared with adults, infants and young children have more body fluid a. outside the cells. b. inside the cells. c. in the bloodstream. d. in intestinal secretions.

ANS: A A larger proportion of an infant's and child's total body water is outside the cells and easily lost, potentially resulting in dehydration. DIF: Cognitive Level: Knowledge REF: p. 171 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance

_____________is a congenital iodine deficiency syndrome that stunts physical and mental growth caused by hypothyroidism - -

Cretinism Studyforxyz FUNDAMENTALS PRINCIPLES OF NUTRITION

_____________ is a congenital iodine deficiency syndrome that stunts physical and mental growth caused by hypothyroidism - -

Cretinism Studyforxyz NUTRITION AND HUMAN HEALTH

28. The IOM recommends supplementaftion or food fortification with which nutrient for the elderly? a. Calcium b. Iron c. Biotin d. B12 -

D Primer

30. The most serious consequence of feeding "double-strength" formula to an infant is likely to be: a. sleepiness. b. colic. c. mental impairment. d. dehydration. -

D Primer

29. Megaloblastic anemia of pregnancy usually results from a deficiency of: a. iron. b. oxytocin. c. antipernicious anemia factor. d. folacin. -

D Primer

Vitamin _________ and __________ supplementation can be considered for babies - -

D and K Studyforxyz FUNDAMENTALS PRINCIPLES OF NUTRITION

What herb reduces milk flow? - -

Jasmine flower Studyforxyz FUNDAMENTALS PRINCIPLES OF NUTRITION

Which of the following considered the main carbohydrate in breast milk? Choose from: -galactose -lactose -fructose -glucose - -

Lactose Studyforxyz FUNDAMENTALS PRINCIPLES OF NUTRITION

What herbs can increase milk flow? - -

Lemon grass, raspberry, hibiscus flower Studyforxyz FUNDAMENTALS PRINCIPLES OF NUTRITION

Pregnancy nutrient requirements that increase include Se, Mn, Vit C but NOT vit E - -

Se, Mn, Vit C but NOT vit E Studyforxyz FUNDAMENTALS PRINCIPLES OF NUTRITION

T 585 -

T/F 1. The U.S. National Center for Health Statistics (NCHS) has compiled reference standards into growth charts, which indicate expected growth for well-nourished infants, children, and adolescents.

F 603-604 -

T/F 10. Prolactin is the first secretion from the breasts after birth that provides nourishment and immunological protection to newborns.

F 609 -

T/F 11. All breastfed infants need fluoride supplements at 6 months of age.

T 611 -

T/F 12. Nonmilk complementary foods should be introduced to an infant between 4 and 6 months of age.

Non-breastfed babies-microbiome is low bifido and high enterococci, coliforms and clostridia - -

True Studyforxyz FUNDAMENTALS PRINCIPLES OF NUTRITION

True or False Breast Milk is low in vitamin D. - -

True Studyforxyz FUNDAMENTALS PRINCIPLES OF NUTRITION

True or False Many babies with milk allergies aren't allergic to lactose in breastmilk, bur rather whey or casein. - -

True Studyforxyz FUNDAMENTALS PRINCIPLES OF NUTRITION

True or False Measuring head circumference is to measure brain growth indirectly. - -

True Studyforxyz NUTRTION ASSESSMENT

Daily intake requirements increase during pregnancy for all of the following nutrients except: Choose one iron Vitamin D Vitamin A Copper - -

Vitamin D Studyforxyz FUNDAMENTALS PRINCIPLES OF NUTRITION

11. Compared with later stages of the life cycle, which of the following describes the infant's protein requirement? a. It is lower on a per-kilogram basis than that of the older child. b. It is lower on a per-kilogram basis than that of an adult. c. It is higher on a per-kilogram basis than that of an adult. d. It is the same on a per-kilogram basis as that of an adult.

ANS: C Infancy is a period of rapid growth, with the infant doubling in weight around 4 to 6 months. At no other time postpartum does a human gain in weight and size this quickly. To allow for this growth, the protein needs on a weight basis are greater than those at any other point in the life cycle. REF: p. 301

22. The most common cause of anemia during pregnancy is a. folic acid deficiency. b. lack of intrinsic factor. c. iron deficiency. d. vitamin C deficiency.

ANS: C Iron-deficiency anemia is most common during pregnancy. DIF: Cognitive Level: Knowledge REF: p. 157 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation

6. Endogenous toxins include a. pollutants in water. b. drugs. c. end products of metabolism of hormones. d. curcuminoids.

ANS: C Pollutants in water and drugs are exogenous toxins. The end products of hormone metabolism are endogenous toxins. Curcuminoids are antioxidants found in some foods such as turmeric and curry. REF: p. 360

7. Presbycusis is a. inability to swallow. b. loss of sense of taste. c. hearing loss. d. lack of dentition.

ANS: C Presbycusis is the most common type of hearing loss. It is usually greater in the high-pitched tonal range. Dysphagia is the inability to swallow. Dysgeusia is the loss of sense of taste or an altered sense of taste. REF: p. 370

15. Which of the following is NOT true of The Dining Practice Standards? a. Are guidelines for long-term care dining b. Recommend against canned nutrition supplements c. They encourage strict dietary control for diabetes and heart disease d. They are endorsed by the Centers for Medicare and Medicaid

ANS: C The Dining Practice Standards were developed by a multidisciplinary group who wanted to improve the dining experience and nutritional care for elders living in long-term care. They were endorsed by the Centers for Medicare and Medicaid. The standards promote person-centered care, liberalized diets, and food first with less reliance on canned supplements. REF: p. 378

20. A type of feeding not recommended for infants during the early months is a. breast milk. b. amino acid-based formula. c. soy-based formula. d. cow's milk.

ANS: D Cow's milk is not recommended for infants during the first year of life because its concentration may cause gastrointestinal bleeding and it provides too heavy a load of solutes for the infant's renal system. DIF: Cognitive Level: Application REF: pp. 175-176 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance

23. Food intake may decrease after the first year of life, and caloric need is not as great because a. the child is using baby fat stores. b. muscle development is occurring. c. the child is still relatively inactive. d. the growth rate slows down.

ANS: D During the first year of life, growth is rapid, especially during the first 6 months. After the first year, the growth rate tends to slow down, and food intake decreases. DIF: Cognitive Level: Knowledge REF: p. 178 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance

7. Energy requirements decrease as adult's age because a. older adults have less stress than younger adults. b. younger adults are still growing; older adults are not. c. the height of adults decreases with age. d. the number of functioning body cells decreases with age.

ANS: D Energy requirements decrease during the aging process because of the decrease in the number of functioning body cells and reduced physical activity. DIF: Cognitive Level: Knowledge REF: p. 188 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance

15. The most suitable first solid food for an infant 6 months of age would be a. yogurt. b. puréed meat. c. crackers. d. infant rice cereal.

ANS: D Iron-fortified infant cereal made from rice, barley, or oats (these are offered one at a time) or puréed fruits and vegetables are usually the most suitable first solid foods for infants. DIF: Cognitive Level: Application REF: pp. 176-177 TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance

6. Prescription and over-the-counter drugs can affect nutritional status because they a. may contain toxins. b. often result in addiction. c. usually contain nutrients. d. may affect appetite or absorption of nutrients.

ANS: D Medication use can affect overall nutritional status because many drugs affect appetite or the absorption of nutrients. DIF: Cognitive Level: Application REF: p. 197 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation

4. What is menarche? a. A low hemoglobin level b. A diet high in fat c. Vitamin A deficiency d. The onset of menstruation

ANS: D Menarche is the onset of menstruation in adolescent young women, associated with Tanner stage 4. Menarche actually occurs in late puberty. REF: p. 332

2. Why do the Dietary Reference Intakes specify recommended nutrient and energy intakes for each life stage group? -

Answer (key points): Age-related physical changes seen within each stage of the life cycle affect body size and composition, which in turn impact nutrient and energy requirements. The Dietary Reference Intakes (DRIs) recommend specific nutrient and energy intakes for each life stage group in addition to additional needs seen in pregnancy and lactation so that nutrient and energy requirements can be met throughout life. (p. 586)

10. Why is fat, particularly essential fatty acids, such as an important part of the diet during pregnancy? -

Answer (key points): All essential fatty acids play important roles in the growth and development of a healthy baby as well as making other fatty acids needed by the body. In addition, DHA is important for brain development and retina formation in the fetus. During pregnancy the AI is 13 g/day for linoleic acid and 1.4 g/day for linolenic acid. (p. 596)

15. When is it appropriate to introduce complementary foods, and how should these foods be introduced into the diet? -

Answer (key points): The AAP recommends introducing non-milk complementary foods between 4 and 6 months of age. Start with iron-rich fortified single-grain cereals such as rice cereal. Mix with human milk or formula to achieve a smooth consistency. Once spoon feeding is established, pureed vegetables can be added, then fruits. Add one food at a time, and wait three to four days to be sure the food is tolerated and there is no adverse reaction. (p. 611)

In breastfed infants, over 90% of intestinal bacteria consist of: Choose from -enterococci -clostridia -lactobacillus -bifidobacterium - -

bifidobacterium Studyforxyz FUNDAMENTALS PRINCIPLES OF NUTRITION

Pregnancy caloric intake: _________ during 1st trimester, _________ extra calories during second trimester, _____________ extra during 3rd trimester - -

no change, 350, 450 Studyforxyz FUNDAMENTALS PRINCIPLES OF NUTRITION

Your 3-year old client was weighed at his pediatricians office today and they determine he was in the 95th percentile for weight. Which of the following describes your client? Choose from overweight obese normal underweight - -

obese Studyforxyz FUNDAMENTALS PRINCIPLES OF NUTRITION

Breastfeeding is recommended for infants because it contains a number of key nutrients. What's the best way to determine if a mother is producing an adequate supply of milk? -monitor the mother's water intake -count the number of bottles she is fills daily -document the number of times the baby feeds -use a growth and development chart to assess baby's progress - -

use a growth and development chart to assess baby's progress Studyforxyz FUNDAMENTALS PRINCIPLES OF NUTRITION

The ____ content in colostrum is roughly double the amount in mature human breast milk. Choose from: -vitamin E -vitamin D -vitamin K -vitamin A - -

vitamin A Studyforxyz FUNDAMENTALS PRINCIPLES OF NUTRITION

Colostrum is high in ____________ and __________, and lower in _______________and milk is produced after a milk supply is established. - -

vitamin A, protein, lactose Studyforxyz FUNDAMENTALS PRINCIPLES OF NUTRITION

Breast Milk contains mostly _______ protein. - -

whey Studyforxyz FUNDAMENTALS PRINCIPLES OF NUTRITION

Before your client got pregnant, she was following the ketogenic diet. She's unsure of how many grams of carbohydrates she should have during pregnancy. Approximately, which of the following is the recommended amount during pregnancy? Choose from: -200 grams -80 grams -175 grams -120 grams - -

-175 grams Studyforxyz FUNDAMENTALS PRINCIPLES OF NUTRITION

Which of the following hormones stimulates ovulation and develops the corpus luteum? Choose from: -thyroid -FSH -PTH -LH - -

-LH Studyforxyz FUNDAMENTALS PRINCIPLES OF NUTRITION

Which of the following is the primary purpose of edema during pregnancy? Choose one -increased blood flow and nutrient transfer to the placenta and fetus -dilute the high concentration of nutrients in pregnant women -to provide room for the baby's and mother's organs to provide the mother and baby with plenty of fluids - -

-increased blood flow and nutrient transfer to the placenta and fetus Studyforxyz FUNDAMENTALS PRINCIPLES OF NUTRITION

Which of the following hormones stimulates milk production during breast feeding? Choose from: -prolactin -insulin -glucagon -oxytocin - -

-prolactin Studyforxyz FUNDAMENTALS PRINCIPLES OF NUTRITION

Determinants of nutrition status in the elderly do not include: Choose from: -loss of spouse -medications -religion -retirement - -

-religion Studyforxyz FUNDAMENTALS PRINCIPLES OF NUTRITION

Which of the following supplements should be considered for breastfed babies? Choose one -vitamins A and vitamin D -iron and vitamin D -vitamin D and Vitamin K -iron and vitamin K - -

-vitamin D and Vitamin K Studyforxyz FUNDAMENTALS PRINCIPLES OF NUTRITION

Daily intake requirements increase during pregnancy for all of the following nutrients except: Choose from: -selenium -manganese -vitamin E -vitamin C - -

-vitamin E Studyforxyz FUNDAMENTALS PRINCIPLES OF NUTRITION

Which of the following is the recommended amount of protein for adolescents? Choose from: -1.1 g/kg -1.0 g/kg -.95 g/kg -1.6 g/kg - -

.95 g/kg Studyforxyz FUNDAMENTALS PRINCIPLES OF NUTRITION

b K 596 -

27. What is the RDA for carbohydrate during pregnancy so as to provide adequate amounts of glucose for both the mother and the fetus? a. 100 g/day b. 175 g/day c. 250 g/day d. 325 g/day

d A 605 -

57. Shelly, a breastfeeding mom, is obtaining the equivalent of 8 cups of water per day from foods and beverages and feels that she is drinking enough water. How many more cups of fluid should Shelly really be consuming per day? a. 2 b. 3 c. 4 d. 5

d K 606 -

58. Within a few days after birth, infants lose what percentage of their body weight? a. 1-2 b. 2-3 c. 4-5 d. 5-6

b K -

585 1. What process occurs when body size increases as a result of an increase in the number and/or size of cells? a. Development b. Growth c. Maturation d. Aging

a K -

585 2. An increase in the number of cells is called: a. hyperplasia. b. hypoplasia. c. hypertrophy. d. hypotrophy.

Pregnancy requirements aged 14 and older is _________ g/kg body weight - -

1.1 Studyforxyz FUNDAMENTALS PRINCIPLES OF NUTRITION

Which of the following is the daily protein requirement for the first year of life? Choose from 1.0 g/kg 1.6 g/kg 0.8 g/kg 1.1 g/kg - -

1.6 g/kg Studyforxyz FUNDAMENTALS PRINCIPLES OF NUTRITION

c K -

585 3. An increase in cell size is called: a. hyperplasia. b. hypoplasia. c. hypertrophy. d. hypotrophy.

a K 595 -

22. What is the best consumer-oriented tool to recommend that specifically provides nutrition guidance during pregnancy? a. MyPlate b. Dietary Reference Intakes c. Healthy People 2010 d. Diet Analysis +

c K 595 -

23. Which of the following does not occur during pregnancy? a. Appetite increases b. Thirst increases c. Gastrointestinal motility increases d. Gastroesophageal reflux becomes more common

c A 596 -

24. Shelly was following a low-carbohydrate (25 grams CHO/day) diet for weight loss prior to conceiving, and now that she is pregnant she knows that she has to eat more. How many more grams of carbohydrate should Shelly plan to eat per day? a. 100 b. 125 c. 150 d. 175

Recommended protein intake for pregnancy is _________ grams per meal or ___________g per day, - -

25, 71 Studyforxyz FUNDAMENTALS PRINCIPLES OF NUTRITION

c K 596 -

25. How many kcalories should pregnant women consume over and above their regular diet during the second trimester? a. ~150 b. ~250 c. ~350 d. ~450

Recommended protein intake for pregnancy is _____________ grams per meal or 71g per day, as __________gram/kg body weight aged 14 and older - -

25g, 1.1 g/kg Studyforxyz NUTRTION ASSESSMENT

d K 596 -

26. How many kcalories should pregnant women consume over and above their regular diet during the third trimester? a. ~150 b. ~250 c. ~350 d. ~450

Iron requirements in pregnancy is___________mg a day, the highest requirement per life cycle. RDA for men and older women is ____________ mg/day - -

27, 8 Studyforxyz NUTRITION AND HUMAN HEALTH

Iron requirements in pregnancy__________mg/day, the highest requirement per life cycle. RDA for men and older women is _____________mg/day - -

27,8 Studyforxyz FUNDAMENTALS PRINCIPLES OF NUTRITION

The need for iron increases during pregnancy because of the increased blood volume. In addition, the fetus increases its hemoglobin level to ________________grams per 100 ml of blood. - -

20-22 Exam Edge

d K 594 -

20. How much weight should underweight women gain during pregnancy? a. 15-25 pounds b. 20-35 pounds c. 25-35 pounds d. 28-40 pounds

Nursing mothers require a higher caloric intake to keep up with milk production. The number of calories required depends on the individual. The range is between __________ and ___________ extra calories each day. - -

200 and 500 Exam Edge Test 2

b K 606 -

59. How much does an infant's weight change between birth and 4 to 6 months? a. Weight doesn't change significantly b. Weight doubles c. Weight triples d. Weight quadruples

d K 604 -

49. What percentage of the kcalories in human milk come from lipids? a. < 30% b. 30%-40% c. 40%-50% d. > 50%

a K 585 -

5. What term refers to "attainment or progression of a skill or capacity to function" such as the ability to walk during late infancy? a. Development b. Growth c. Maturation d. Senescence

a K 604 -

50. Why is cow's milk unsuitable for infants? a. Protein content is too high b. Protein content is too low c. Fat content is too high d. Fat content is too low

For proper infant development, pregnant women should consume ______DHA a day - -

500-700mg Studyforxyz FUNDAMENTALS PRINCIPLES OF NUTRITION

c K 604 -

51. Which fatty acid plays an important role in brain and eye development during infancy? a. EPA b. SFA c. DHA d. EFA

b K 604 -

52. What are the primary carbohydrates in human milk? a. Sucrose and lactose b. Lactose and oligosaccharides c. Glucose and oligosaccharides d. Fructose and lactose

a K 604 -

53. The protein content of human milk is _____ compared to cow's milk. a. lower b. the same c. higher

c K 605 -

54. When a baby is one month old, his/her mom needs about _____ kcal/day to produce milk. a. 300 b. 400 c. 500 d. 600

b A 605 -

55. Shelly has delivered a healthy baby and is breastfeeding. She was consuming 2400 kcalories per day prior to pregnancy. How many total kcalories will she now need to consume? a. 2660 b. 2730 c. 2800 d. 2900

c A 605 -

56. Shelly has been breastfeeding for almost 9 months. How many kcalories does she currently need to consume each day, if her energy needs were 2400 kcal/day prior to pregnancy? a. 2660 b. 2730 c. 2800 d. 2900

e K 585-586 -

6. Growth and development affect: a. body size. b. body composition. c. nutrient and energy requirements. d. a and c e. All of the above

Most women have a daily protein requirement of at least _________ grams. The American Pregnancy Association recommends ______________grams for pregnant women. - -

60 grams, 75-100 Exam Edge Test 2

c K 598 -

40. Why is maternal cigarette smoking harmful to a pregnant woman's developing fetus? a. It causes dilation of the blood vessels b. It deposits tar in the fetus's lungs c. It reduces blood flow to the fetus d. It delays detachment of the placenta

a K 598 -

41. Smoking during pregnancy increases the risk of which of the following? a. Delivery of a preterm and/or LBW baby b. Gestational diabetes c. Increased weight gain d. C-sections

d K 599 -

42. What percentage of woman diagnosed with gestational diabetes develop type 2 diabetes later in life? a. 15 b. 25 c. 35 d. 50

b K 599 -

43. How many pregnant women are affected by pre-eclampsia or toxemia of pregnancy? a. 1% b. 3% c. 7% d. 11%

a K 599 -

44. Some researchers believe that the desire to consume nonfood items may be related to a deficiency of: a. iron. b. folate. c. B12. d. magnesium.

30. For residents in long-term care facilities, the type of diet model recommended is a. most therapeutic. b. least restrictive. c. no sugar. d. low protein.

ANS: B The least restrictive diet model is recommended since it is the most beneficial to the older adult.

15. What may be a consequence of a child experiencing an early adiposity rebound? a. An increased ratio of lean mass to fat mass as an adolescent. b. An increased ratio of lean mass to fat mass as an adult. c. An increased ratio of fat mass to lean mass as an adult. d. An increased height-to-weight ratio as an adult.

ANS: C Adiposity rebound is associated with the gain of body fat starting between 4 and 6 years of age, and the earlier this occurs, the more likely it is that the person will be heavier as an adult. This will be reflected in a greater BMI (or weight-to-height ratio) as an adult and an increase in fat mass in proportion to overall body weight. The degree of fatness during adolescence is also a contributing factor to the development of adult obesity. REF: pp. 324-325

1. A _______________ is an environmental agent that can alter normal cell growth and development, causing a birth defect. -

Answer: teratogen (p. 588)

16. What is the prevalence of overweight among children and adolescents in the U.S., and what are the contributing factors? What are the resulting health and social consequences? -

Answer (key points): The CDC estimates approximately 17% of children 6 to 11 years of age are at or above the 95th percentile for BMI. This is 54% higher than 20 years ago. The percentage of overweight children is on the rise in the U.S. The behaviors most strongly linked to weight gain in children are unhealthy eating patterns (consumption of energy-dense foods, fast food, pre-packaged food) and physical inactivity (increased television viewing has replaced physical activity and there has been a decrease in physical education requirements in schools). Health conditions once only common in adults are now becoming more common in children—e.g., type 2 diabetes, high blood pressure, and elevated blood lipids. Excess weight in childhood is likely to continue into adolescence and into adulthood. An unhealthy overweight child will very likely become an even more overweight, unhealthy adult. (pp. 613, 615)

1. How is growth assessed for infants, children, and adolescents? -

Answer (key points): The U.S. National Center for Health Statistics (NCHS), part of the Centers for Disease Control and Prevention (CDC), has compiled reference standards into growth charts. The charts indicate expected growth for well-nourished infants, children, and adolescents utilizing percentile curves that represent growth patterns from birth through 20 years of age. Adequacy of growth (i.e., weight) can be plotted in reference to age and sex. Growth is then monitored over time and used as a general indicator of health. (pp. 585-586)

What food is a galactagogue and can increase milk supply? - -

Beer (hops) Studyforxyz FUNDAMENTALS PRINCIPLES OF NUTRITION

Daily intake requirements increase increase during pregnancy for all of the following nutrients except: Choose one Vitamin B5 Vitamin B12 Choline Biotin - -

Biotin Studyforxyz FUNDAMENTALS PRINCIPLES OF NUTRITION

31. Except for when women are pregnant and lactating, the total quantity of nutrients and calories needed during ____ are greater than at any other stage of the life cycle. a. infancy b. childhood c. adolescence d. aging -

C Primer

______________ is the breast milk produced in the first 2-3 days after the baby is born - -

Colostrum Studyforxyz FUNDAMENTALS PRINCIPLES OF NUTRITION

Which of the following is not true about breastfeeding? Choose from: -casein is the most prevalent form of protein found in breastmilk -approximately 23 additional grams of protein a day is recommended -in the first six months of lactation, approximately 330 kcal a day greater than pregnancy is recommended -mothers are advised to wait until breastfeeding is well established before trying to lose weight - - -

casein is the most prevalent form of protein found in breastmilk Studyforxyz FUNDAMENTALS PRINCIPLES OF NUTRITION

Cretinism - -

condition of congenital hypothyroidism in children that results in a lack of mental development and dwarfed physical stature; the thyroid gland is either congenitally absent or imperfectly developed

Which of the following nutrients is important during preconception to reduce the risk of spina bifida and anencephaly? Choose from_ -folate -iron -magnesium -methylcobalamin - -

folate Studyforxyz FUNDAMENTALS PRINCIPLES OF NUTRITION

What is the preferred fuel source for the fetus? Choose one -amino acids -vitamins and minerals -lipids glucose - -

glucose Studyforxyz FUNDAMENTALS PRINCIPLES OF NUTRITION

b K 618 -

77. Signs of iron-deficiency anemia in children include all of the following except: a. irritability. b. increased appetite. c. inattentiveness. d. decreased appetite.

During pregnancy, vit A requirement is _____________mcg/day, and lactation it is __________mcg/day - -

770, 1300 Studyforxyz FUNDAMENTALS PRINCIPLES OF NUTRITION

During pregnancy, vit A requirement is __________mcg/day, and lactation it is __________mcg/day - -

770, 1300 Studyforxyz PUBLIC HEALTH

What are the primary proteins in breastmilk? - -

Secretory IgA and lactoferrin Studyforxyz FUNDAMENTALS PRINCIPLES OF NUTRITION

a K 619 -

79. How does body composition change for males during adolescence? a. Lean body mass increases b. Lean body mass decreases c. Fat body mass increases d. Bone mass stabilizes

Iron requirement for adolescent ________mg ___________mg after onset of menses - -

8-10mg, 15mg Studyforxyz FUNDAMENTALS PRINCIPLES OF NUTRITION

b K 588 -

8. What percentage of birth defects have no known cause? a. 50 b. 60 c. 70 d. 80

d K 620 -

80. What is the protein requirement per kilogram of body weight per day for young adolescents? a. 0.8 g b. 0.85 g c. 0.9 g d. 0.95 g

Do not introduce cow's milk to an baby until after _____________ year old. - -

1 years of age Explanation dairy can induce iron deficiency anemia due to early introduction of whole cow's milk. Several of the minerals, Ca, Mg, Fe and Zn in human milk makes them bioavailable- and protein in cow milk is hard for baby to breakdown and can overload immature kidneys Studyforxyz FUNDAMENTALS PRINCIPLES OF NUTRITION

c K 615,618 -

78. Based on the Physical Activity Guidelines for Americans, parents are encouraged to make sure that their children are involved in how many minutes of physical activity daily or most days of the week? a. 30 b. 45 c. 60 d. 90

a K 591 -

15. What are the two most important predictors of infant health listed here? a. Gestational age and birth weight b. Head circumference and birth weight c. Gestational age and mother's health d. Gestational age and presence of the sucking reflex

d K 591 -

16. How many pounds do babies weigh when they are classified as low-birth weight (LBW) infants? a. < 4.0 b. < 4.5 c. < 5.0 d. < 5.5

a A 594 -

21. Shelly just found out she is pregnant and is 5'4" and weighs 185 lbs. How many pounds should Shelly weigh at most when she delivers if she gains the recommended amount of weight based on her starting weight? a. 205 lbs. b. 215 lbs. c. 225 lbs. d. 230 lbs.

b K 596 -

32. Based on Acceptable Macronutrient Distribution Ranges (AMDRs), protein should provide _____ to _____% of total kcalories during pregnancy. a. 5, 20 b. 10, 35 c. 15, 40 d. 20, 45

b K 596 -

33. How often should foods rich in essential fatty acids be consumed during pregnancy? a. Once per week b. Several times per week c. Several times per month d. Once per month

c K 597 -

35. If a woman consumed a well-planned diet prior to conception, then during pregnancy she would need to increase her daily iron intake by _____ milligrams. a. 5-7 b. 7-9 c. 9-12 d. 12-15 e. 15-18

c K 598 -

36. Inadequacy of which vitamin at the time of conception increases the risk of having a baby with a neural tube defect? a. Thiamin b. Niacin c. Folate d. Riboflavin

a A 597 -

37. Shelly is consuming ~ 15 mg of iron daily. She needs several mg more to meet her needs. Which of the following food choices would provide the highest bioavailability of iron and help her meet her needs? a. Lean beef b. Spinach c. Legumes d. Fortified cereal e. a and d f. All of the above

c K 598 -

38. When does the formation of the neural tube occur in pregnancy? a. Within the first 72 hours b. Within the first week c. Within the first 21 days d. Within the second trimester

b K 598 -

39. How many micrograms of folate should a woman of child-bearing age consume as a supplement or in fortified foods in addition to consuming folate naturally in her diet? a. 200 b. 400 c. 600 d. 800

c K 602 -

45. What hormone stimulates the secretory cells in the mammary gland to synthesize milk? a. Estrogen b. Progesterone c. Prolactin d. Oxytocin

e K 602 -

46. Milk production is regulated by: a. insulin. b. prolactin. c. oxytocin. d. a and b e. b and c

b K 603-604 -

47. What is the special substance produced in the mother's breasts after she gives birth? a. Progesterone b. Colostrum c. Estrogen d. Oxytocin

b K 604 -

48. Which substance in human milk enhances the absorption of iron and protects the infant from certain infectious diseases? a. Vitamin C b. Lactoferrin c. Transferrin d. Hemosiderin

c K 608

60. According to breastfeeding trends reported by the CDC, 75% of women initiate breastfeeding but by six months only _____% are still breastfeeding. a. 17 b. 25 c. 43 d. 50

a K 608

61. What are the most common reasons why women discontinue breastfeeding? a. "Perception" that milk production is inadequate or difficulties related to returning to work b. Tired of inconvenience or desire to sleep through the night c. Colicky baby or feeling that as baby gets older formula is better d. Breastfeeding becomes more uncomfortable or too difficult to fit into hectic schedule

d K 608 -

62. When purchasing an infant formula today, parents should purchase formulas that have which of the following nutrients added? a. Iron b. DHA c. AA d. All of the above

b K 609,610 -

63. How much supplemental vitamin D is recommended for breastfed infants and formula-fed infants consuming less than 16 oz./day of infant formula to prevent rickets? a. 200 IU/day b. 400 IU/day c. 600 IU/day d. 800 IU/day

a K 609,610 -

64. What is the recommended daily dosage of fluoride supplementation for children between 6 months and 3 years of age who live in areas where the local water supply contains no fluoride? a. 0.25 mg b. 0.50 mg c. 0.75 mg d. 1.0 mg

d K 610 -

65. How much iron reserves does a full-term infant have when she or he is born? a. 3-month supply b. 4-month supply c. 5-month supply d. 6-month supply

a K 611 -

67. What is the maximum amount of juice recommended per day for older infants? a. 4-6 ounces per day b. 4-8 ounces per day c. 6-8 ounces per day d. 6-10 ounces per day

b K 612 -

68. Popcorn, peanuts, hot dogs, and hard candy should be avoided during the 1st year of life because: a. they are high in fat and/or sugar. b. they pose a risk for choking. c. those pose a risk for food allergy. d. they pose a foodborne illness risk.

b K 613 -

69. What measurement is most commonly used to assess weight in children over 2 years of age? a. Balance beam scale b. Body mass index c. Weight percentiles d. Bioelectrical impedance analysis

d K 587 -

7. The united ovum and sperm are called a(n): a. blastocyst. b. embryo. c. fetus. d. zygote.

d K 613 -

70. What percentage of children (6 to 11 years of age) are at or above the 95th percentile for BMI? a. 10 b. 12 c. 15 d. 17

d K 613 -

71. Which statement is true? a. BMI is routinely used to assess weight status and health risk in adults but not children. b. Children with BMIs between the 85th and 95th percentiles are classified as obese. c. Children with BMIs between the 85th and 95th percentiles are classified as at risk for overweight. d. Classification of BMI in children is age dependent.

a K 613 -

72. Children below the _____ percentile for BMI are considered underweight. a. 5th b. 7th c. 10th d. 12th

a K 617 -

76. Which one of the following dairy products would be equivalent to 1 cup of milk based on calcium content? a. 1 cup of yogurt b. 1 ounce of hard cheese c. 1 ounce of processed cheese d. ½ cup ice-cream

d K 620 -

81. The Estimated Energy Requirement (EER) during adolescence takes into account all of the following except: a. energy needed to maintain health. b. energy needed to promote optimal growth. c. energy needed to support physical activity. d. stress factors.

d K 620-621 -

82. As a result of rapid growth and development associated with adolescence, the RDA for calcium during late adolescence has been set at: a. 1000 mg/day. b. 1100 mg/day. c. 1200 mg/day. d. 1300 mg/day.

b K 621 -

83. What percentage of teenagers in the U.S. have impaired iron status? a. 5% b. 8% c. 12% d. 20%

a K 622 -

84. The average number of years that a person can expect to live is referred to as: a. life expectancy. b. longevity. c. mortality. d. life span.

a K 622 -

85. The branch of science and medicine dedicated to the social, behavioral, psychological, and health issues of aging is called: a. gerontology. b. seniorology. c. senescencology. d. geritology.

c K 624 -

86. Older adults are at _____ risk for developing nutrition-related problems. a. decreased b. the same c. increased d. no

c K 624 -

87. Age-related loss of lean body mass causes: a. total energy requirements to increase. b. total energy expenditure to remain the same. c. basal metabolism to decrease. d. basic energy metabolism to increase.

d K 624 -

88. Physiological changes that accompany aging include all of the following except: a. an increase in body fat. b. a decrease in bone mass. c. a decrease in lean muscle mass. d. an increase in resting metabolic rate.

b K 624 -

89. After the age of 19, total energy expenditure decreases _____ kcal per year for women. a. 5 b. 7 c. 12 d. 15

c K 588 -

9. What are substances that disrupt the normal course of cell growth and development called? a. Anatogens b. Caratogens c. Teratogens d. Seratogens

b K 624 -

90. After the age of 19, total energy expenditure decreases _____ kcal per year for men. a. 5 b. 10 c. 15 d. 20

Whey : casein ratio is _________ in early lactation, __________ on average and then __________ as baby gets older - -

90:10, 80:20, 60:40 Studyforxyz FUNDAMENTALS PRINCIPLES OF NUTRITION

c K 621 -

91. Bone mass continues to increase slightly for both males and females until approximately age: a. 20. b. 25. c. 30. d. 35.

b K 625 -

92. Bone mass is reduced in the elderly, and this is one of the reasons that their RDA for calcium has been increased from 1,000 mg to _____ mg/day. a. 1100 b. 1200 c. 1300 d. 1400

a K 625 -

93. The perimenopausal stage of life _____ bone loss. a. increases b. decreases c. does not affect d. reverses

c A 625 -

94. As an alternative to hormone replacement therapy, some women find that consuming foods made from or with _____ is helpful. a. omega-3 fatty acids b. olive oil c. soybeans d. tomatoes

d K 626 -

95. Which phytochemical is structurally similar to estrogen? a. Lycopene b. Lutein c. Catechins d. Isoflavones

c K 627 -

96. Which one of the following gastrointestinal changes occurs as part of the aging process? a. Secretion of gastric juice is increased b. Peristalsis increases c. Vitamin B12 absorption is reduced d. Secretion of saliva and mucus is increased

f K 624,627 -

97. During aging: a. secretion of saliva and mucus is reduced. b. difficulty swallowing sets in. c. peristalsis decreases. d. a and b e. a and c f. All of the above

c K 627 -

98. The symptoms of dehydration include all of the following except: a. headache. b. dizziness. c. visual acuity. d. confusion.

a K 628 -

99. What score on the DETERMINE checklist indicates no nutritional risk? a. 4 b. 6 c. 8 d. 10

F 611,612 -

T/F 13. Soft pieces of fruits and vegetables should be fed to infants at 4-6 months of age.

20. In working with a ethnic minority population, a helpful way to increase health literacy could be to a.invite members of the community to help identify needs and teaching strategies. b.encourage acculturation and adoption of healthful American eating patterns. c.set up a feeding program to provide healthy food for members of the community. d.use visual aids rather than written materials during health education encounters.

ANS: A Members of an ethnic minority population can be very helpful in identifying needs and effective teaching strategies for people in their community and in encouraging people in the community to accept advice from nurses or other health professionals. They do not necessarily need to adopt American eating patterns; often these are less healthful than their traditional eating patterns. Setting up feeding programs does not promote positive self-efficacy. Visual aids may be helpful, but their use is not necessarily the best educational strategy. DIF: Cognitive Level: Applying REF: Pages 6-7 TOP: Nursing Process: Planning MSC:Client Needs: Physiological integrity

18. A trend in adults in the United States is that they a. are spending more money on food away from home. b. are eating more family meals at home. c. generally meet the dietary recommendations for promoting health. d. use the MyPyramid tool to plan their diets.

ANS: A According to the consumer price index, it is estimated that Americans spend more than 50% of their food dollars away from home. The sit-down family meals at home have given way to eating on the run, take-out meals, and drive-through restaurants. Although 84% of the population is aware of MyPyramid, of those who know about this tool, only 25% report customizing their diets using it. REF: p. 359

11. Which of the following has been demonstrated by research to be TRUE regarding diet and autism spectrum disorder? a. Research has not linked a dietary cause to autism. b. Autism results from a food allergy. c. Gluten in the diet leads to autism. d. Fluoride in the water has been linked to autism.

ANS: A Although a number of dietary factors have been investigated, research has not demonstrated these to be the cause of autism or to be helpful in the treatment of autism. REF: pp. 326-327

2. When does the greatest increase in height during puberty occur? a. Over the 18- to 24-month "growth spurt" period b. Continually over the entire time c. During the first year of puberty d. Primarily toward the end of puberty

ANS: A Although linear growth occurs throughout the 4 to 7 years of puberty, the greatest increase is during the growth spurt. Growth slows down but continues after sexual maturation. REF: p. 333

29. If a college student is eating only one small meal per day in an attempt to lose weight and is taking high doses of vitamin and mineral supplements to try to make up for the lack of food, the student would be described as having a. malnutrition. b. disordered nutrition. c. overnutrition. d.undernutrition.

ANS: A An imbalance of intake of nutrients, energy, or both (in this case, high intake of some nutrients and low intake of energy) is called malnutrition. Overnutrition refers only to excessive intake, excessive nutrients, or excessive energy. Undernutrition refers only to inadequate intakes of nutrients, energy, or both. Disordered nutrition is not a recognized term. DIF:Cognitive Level: ApplyingREFage 12 TOP: Nursing Process: Assessment MSC: Client Needs: Physiological integrity

29. Older adults need more vitamin D than younger adults because they a. are less efficient at making their own. b. are in a state of positive calcium balance. c. excrete large amounts in their urine. d. require more dietary fat to absorb the vitamin efficiently.

ANS: A As a person ages, the body becomes less efficient in making vitamin D and more may have to be provided in the diet through foods that have been fortified, including milk, milk products, breads, and margarines. DIF: Cognitive Level: Knowledge REF: p. 193 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance

5. Which changes are associated with the normal process of aging? a. Loss of lean body mass, decreased metabolic rate, and decreased function b. Loss of lean body mass, increased metabolic rate, and increased physical activity c. Increased lean body mass, increased metabolic rate, and increased physical activity d. Increased muscle strength and function

ANS: A As lean body mass decreases, the loss of muscle mass results in decreased strength, function, and metabolic rate. Sarcopenia occurs more rapidly in people with limited physical activity; therefore, elderly adults who are also obese tend to be less active and retain excessive adipose tissue. REF: pp. 369-370

3. Which of the following will result from the normal physiologic adaptation during pregnancy? a. Decreased serum hemoglobin b. Proteinuria c. Hypoglycemia d. Constipation

ANS: A As the blood volume expands by 50% during pregnancy, this results in a dilution of blood constituents, such as serum hemoglobin, albumin, and other blood proteins. This also promotes an increase in glomerular filtration rate; however, the kidneys do not increase the volume of urine excretion. Proteinuria occurs when damage occurs to the basement membrane of the glomerulus. Some glucosuria may occur because of decreased efficiency in renal tubule reabsorption during pregnancy but not to the level of promoting hypoglycemia. Constipation is more likely to occur when inadequate water is taken in by the pregnant woman. REF: p. 243

14. A condition of severe, prolonged, and persistent vomiting during pregnancy is called a. hyperemesis gravidarum. b. placenta previa. c. gestational diabetes. d. preeclampsia.

ANS: A Hyperemesis gravidarum is morning sickness in early pregnancy that progresses from a mild state to a severe and prolonged state requiring medical treatment. DIF: Cognitive Level: Knowledge REF: p. 153 TOP: Nursing Process: Diagnosis MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance

12. A client exercises regularly and wants to make sure he has sufficient energy for his workouts. The type of nutrient that will be most helpful in providing the energy he needs is a. carbohydrates. b.water. c. minerals. d.protein.

ANS: A Carbohydrates are the best source of fuel to provide energy for the body. Protein can also provide fuel for energy, but its primary purpose is important structural and functional roles. Water and minerals are important for health but do not provide fuel for energy. DIF: Cognitive Level: Applying REF: Pages 8-10 TOP: Nursing Process: Planning MSC:Client Needs: Physiological integrity

1. Which of these statements is NOT true about colostrum? a. It is higher in fat than mature milk. b. It is higher in immunoglobulins than mature milk. c. It is higher in protein than mature milk. d. It is lower in lactose than mature milk.

ANS: A Colostrum is the thin, yellow, milky fluid that is the first milk available after birth. It is higher in protein and lower in fat and carbohydrates than mature milk. It is also lower in lactose and higher in immunoglobulins than mature milk. REF: p. 286

12. What is the recommendation for vitamin supplementation of infants fed commercially prepared formula? a. It is rarely needed. b. Supplement only vitamins. c. Only water-soluble vitamins should be supplemented. d. Only fat-soluble vitamins should be supplemented.

ANS: A Commercially prepared infant formulas are fortified with all necessary vitamins; therefore, infants being fed formulas rarely need supplementation. The Food and Drug Administration regulates the manufacture of infant formulas so that the nutrient levels provided are consistent with the Infant Formula Act of 1985. REF: p. 304

14. Contributing factors for osteoporosis include a. inadequate calcium and vitamin D intake. b. increased estrogen after menopause. c. excess weight. d. excess iron intake.

ANS: A Contributing factors for osteoporosis include inadequate intakes of calcium and vitamin D, physical inactivity, smoking and alcohol use, a thin body frame, certain medical conditions, and medications. DIF: Cognitive Level: Knowledge REF: p. 192 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance

19. The National Health and Nutrition Examination Survey (NHANES) is able to assess the overall nutritional and health status of Americans because a.the populations surveyed are representative of the total population. b.it focuses on ethnic and socioeconomic groups at greatest risk. c.it collects large volumes of survey data from all over the nation. d.survey methods and standards are consistent from year to year.

ANS: A Data from NHANES represent America overall because the survey populations are carefully selected to represent the total population. Their data therefore provide a better indication of the nations overall health than do large amounts of data from all over the country. It does not focus specifically on populations at high risk for disease. Standardization over time provides useful data on trends and changes but does not reveal the overall health of the nation. DIF:Cognitive Level: ApplyingREFages 4-5 TOP: Nursing Process: Assessment MSC: Client Needs: Health promotion and maintenance

25. Feeding older adults with sensitivity includes a. giving sufficient time to chew and swallow. b. serving only puréed foods. c. avoiding liquids with meals. d. serving bland foods.

ANS: A Feeding older adults with sensitivity helps them achieve adequate intake. Allowing sufficient time to chew and swallow is important when feeding adults with sensitivity. DIF: Cognitive Level: Knowledge REF: p. 195 TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance

8. How does the pubertal growth spurt in girls compare with that in boys? a. It begins sooner. b. It begins later. c. It lasts longer. d. It is not different.

ANS: A Female pubertal changes begin about 1 to 2 years before male changes. Menarche can occur as early as 9 years of age. Peak growth occurs between 9.5 and 14.5 years in girls and between 10.5 and 16.5 years in boys. REF: p. 332

8. A nurse has just been assigned to a community health program for older adults. She should check the document Healthy People 2020 to become familiar with a.nutrition priorities and goals for older American adults. b.dietary standards for Americans older than 50 years. c.dietary guidelines recommended for older adults. d.MyPlate recommendations for older adults.

ANS: A Healthy People 2020 focuses on targets and goals for improving the health of the nation. The nurse would check the Dietary Reference Intakes for information about dietary standards. The Dietary Guidelines for Americans and MyPlate are separate documents from Healthy People 2020 and focus on specific advice and guidelines for healthy eating. DIF:Cognitive Level: ApplyingREFages 4-5 | dm 10 TOP: Nursing Process: Planning MSC: Client Needs: Health promotion and maintenance

15. What is a food choice to help alleviate constipation during pregnancy? a. Figs b. Chocolate c. White bread d. Saltines

ANS: A Helpful remedies for constipation include high-fiber foods such as whole grains, vegetables, dried fruits, and other fruits and juices. DIF: Cognitive Level: Application REF: p. 153 TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance

25. High blood pressure and the accumulation of protein in the urine may be signs of a. preeclampsia. b. hyperemesis. c. alcoholism. d. gestational diabetes.

ANS: A High blood pressure can be fatal to the mother and fetus. If symptoms progress with the accumulation of proteinuria, the condition is referred to as preeclampsia. DIF: Cognitive Level: Application REF: p. 157 TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance

27. The ideal first food for infants is a. human milk. b. cow's milk. c. soy-based formula. d. amino acid-based formula.

ANS: A Human milk is the ideal first food for infants and is recommended by physicians and dietitians. Cow's milk is not recommended and should never be fed to an infant during the first year of life. Unmodified cow's milk can cause gastrointestinal bleeding and provides too heavy a load of solutes for the infant's renal system. Appropriate infant formula can be used if the mother chooses not to breast-feed or if some condition prevents breast-feeding. DIF: Cognitive Level: Knowledge REF: p. 174 TOP: Nursing Process: Evaluation MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance

16. Which phytochemicals are thought to promote the detoxification systems of the body? a. Isothiocyanates b. Carotenoids c. Phytic acid d. Phenols

ANS: A Isothiocyanates promote the production of phase II enzymes in the liver biotransformation system. Carotenoids, phytic acid, and phenols all have antioxidant properties that are protective of different tissues and cells throughout the body. REF: p. 361

10. A good source of calcium for the growing child is a. milk. b. a juice drink. c. a dinner roll. d. a hot dog.

ANS: A Milk is a good source of calcium. Calcium is an important nutrient for the growing child to assist with bone and tooth development. DIF: Cognitive Level: Application REF: p. 171 TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance

30. The amount of breast milk that most women produce a. is governed by supply and demand. b. increases as lactation continues. c. is affected by maternal age. d. is related to maternal milk intake.

ANS: A Milk production is stimulated by the infant feeding; therefore, the supply matches the demand. DIF: Cognitive Level: Comprehension REF: pp. 158-159 TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance

1. Nutritional needs during pregnancy are affected by a. the mother's age. b. the sex of the infant. c. the mother's food cravings. d. whether the mother works.

ANS: A Nutritional needs during pregnancy are affected by the mother's age along with height and prepregnancy weight. DIF: Cognitive Level: Application REF: p. 148 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance

18. A pregnancy is considered high risk if the mother a. is 16 years old. b. is vegetarian. c. works full time. d. exercises four or five times per week.

ANS: A Nutritional risk factors at the onset of pregnancy include age 18 years or younger or 35 years or older; frequent pregnancies; poor obstetric history or poor fetal performance; poverty; bizarre or trendy food habits; abuse of nicotine, alcohol, or drugs; chronic disease with therapeutic diet; and weight less than 85% or more than 120% of normal. DIF: Cognitive Level: Application REF: p. 154 TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity: Physiological Adaptation

27. A major factor in weight control is a. physical activity. b. mineral supplementation. c. steroid use. d. adequate protein intake.

ANS: A Physical activity is a major factor in weight management, and it can help prevent debilitating conditions of aging. DIF: Cognitive Level: Knowledge REF: p. 196 TOP: Nursing Process: Assessment | Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance

12. Which of the following theories of aging is a predetermination theory? a. Genetic theory b. Wear and tear theory c. Free radical theory d. Somatic mutation theory

ANS: A Predetermination theories of aging focus on a built-in mechanism that determines when aging and death will occur. The genetic theory explains that life span is determined by heredity, and thus this falls into the predetermination theory category. Another class of theories is the accumulated damage theories. These describe aging as a process in which the body's systems break down over time because of damage. Wear and tear, free radical, and somatic mutation theories identify different ideas behind how this damage occurs. REF: p. 369

14. What are the signs and symptoms of pregnancy-induced hypertension? a. Hypertension, proteinuria, and edema b. Hypotension, hyperalbuminemia, and excessive urine output c. Abdominal cramping and weight loss d. Weight loss, edema, and hypertension

ANS: A Pregnancy-induced hypertension is evident when a pregnant woman has a blood pressure greater than 140/90 mm Hg, protein spilling into the urine, and subsequent edema. The edema results from the increased blood pressure and protein loss. Weight loss is not common; however, impairment of uterine blood flow can result in reduced placental size and fetal intrauterine growth restriction. REF: p. 268

4. Which of the following is the term used to describe microbial foods or supplements that can be used to change or reestablish the intestinal flora and improve the health of the host? a. Probiotics b. Phytoestrogens c. Stanols d. Lignans

ANS: A Probiotics are beneficial bacteria that promote health of the gastrointestinal tract and can be provided through the diet by eating fermented foods such as yogurt or sauerkraut. Phytoestrogens are plant estrogens, such as found in soy, which have beneficial effects in women's health. Stanols are steroidal compounds that occur in plants that may promote cardiovascular health. Lignans are fiber sources that can act as phytoestrogens and promote immune function. REF: p. 361

16. Combinations of amino acids link together to form a. protein. b.carbohydrates. c.dietary fiber. d.lipids.

ANS: A Proteins are made up of various combinations of amino acids, linked together. Carbohydrates are made up of one or more units of simple sugars. Dietary fiber consists mostly of carbohydrate that cannot be digested. Lipids are made up of glycerol and triglycerides or sterols. DIF:Cognitive Level: RememberingREFages 8-9 TOP: Nursing Process: Assessment MSC: Client Needs: Physiological integrity

30. Effective strategies for weight management in children include a. regular physical activity. b. counting the calorie intake. c. eliminating snacks. d. eliminating fried foods.

ANS: A Regular physical activity is a key strategy in maintaining a healthy weight in children along with varied and healthy food choices. DIF: Cognitive Level: Application REF: p. 183 TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance

15. What method of weight control is most used by adolescents? a. Fasting or refraining from food b. Eating fewer calories and less fat c. Use of diet pills, laxatives, or diuretics d. Exercise

ANS: A Seventeen percent of female and 7% of male high school students reported fasting or refraining from food as means of weight control. A total of 7% of females and 4% of males reported using diet pills. A total of 53% of females and 28% of males reported using exercise as a means of weight control. REF: p. 340

23. The best source of folate is a. fruit juices. b. green, leafy vegetables. c. whole grains. d. citrus fruits.

ANS: B Folate is found in food sources such as green, leafy vegetables; legumes; yeast; chicken; beef; and liver. DIF: Cognitive Level: Application REF: p. 150 TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance

16. When are adolescents most likely to visit a fast-food restaurant? a. Right after school b. During dinnertime through the week c. During dinnertime on the weekend d. During lunchtime on the weekend

ANS: A Teens more frequently visit fast-food restaurants on the way home from school. This may have to do with the location of the fast-food restaurants in relation to their schools because many are located within a short walking or driving distance. Weekday dinnertime is the next most frequently reported visit time. On the weekends, adolescents visit fast-food restaurants more during the lunchtime than during the dinnertime hours. REF: pp. 338-339

10. What does the American Academy of Pediatrics recommend in regard to calories from fat in the diet of a young child? a. Limit fat calories to 30% of total caloric intake. b. Limit fat calories to 20% of total caloric intake. c. Fat calories should only be limited in extreme circumstances. d. Fat calories should be limited for every child older than 1 year of age.

ANS: A The AAP recommends that children older than 2 years of age adopt a lower-fat diet so that no more than 30% of calories come from fat by the age of 5 years. This recommendation comes from the knowledge that obesity and cardiovascular disease development begins during childhood. REF: p. 327

3. Increased dietary intake of what is associated with a reduced risk of chronic disease? a. Grains, fruits, and vegetables b. Legumes c. Vegetable oils d. Trans fatty acids

ANS: A The Dietary Guidelines for Americans, which were established to promote decreased risk of chronic disease, emphasize the increased intake of grains, fruits, and vegetables. Legumes are considered to be a subcategory of vegetables. Vegetable oils vary in the fatty acid profile; therefore, consideration should be given to this before selecting ones to use. Trans fatty acids are harmful in regard to the development of cardiovascular disease and should be avoided. REF: pp. 354-355

4. How can the risk of neural tube defects occurring in utero be reduced? a. Increasing folic acid intake throughout the childbearing years b. Ensuring adequate niacin intake during the first 6 weeks of pregnancy c. Providing an adequate protein intake throughout the pregnancy d. Increasing vitamin C during the first trimester

ANS: A The Medical Research Council Vitamin Study in the early 1990s was stopped early because the results overwhelmingly supported the reduction of risk of neural tube defects with folic acid supplementation. Niacin needs during pregnancy coincide with the increased energy needs during pregnancy. Sufficient protein during pregnancy allows for the growth of tissues in both the mother and the fetus. Vitamin C may be beneficial in reducing the chance of developing preeclampsia. REF: p. 249

18. The Older Americans Act provides funds for a. congregate and home-delivered meals. b. meals served at shelters and community centers. c. meals served at care facilities and hospices. d. meals for homeless older adults.

ANS: A The Older Americans Act provides funds for congregate and home-delivered meals with related nutrition education and food-service components. DIF: Cognitive Level: Knowledge REF: pp. 197-198 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance

13. The feeding process is important for development of a. the bonding relationship with the parent. b. self-identity for the infant. c. autonomy for the infant and parent. d. infant self-actualization.

ANS: A The feeding process is an important part of the bonding relationship between parent and child. The feeding process influences positive growth. DIF: Cognitive Level: Knowledge REF: p. 173 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance

4. What may a child be at risk for if she drinks large amounts of apple or pear juice throughout the day and limited amounts of water or milk? a. Diarrhea b. Hypervitaminosis A c. Overhydration d. Constipation

ANS: A The high osmolality of apple and pear juices can contribute to carbohydrate malabsorption and diarrhea and therefore should not be used in situations in which fluid replacement is needed. Additionally, excessive fruit juice consumption has been associated with growth failure in children. The juice can replace other food sources of energy and protein, contributing to the child's not feeling hungry but not providing the nutrients necessary for adequate growth. Constipation may result from a poor fiber intake. REF: p. 322

12. Which of the following nutrients should men avoid taking as supplements during their adult years? a. Iron b. Anthocyanin c. Lycopene d. Vitamin D

ANS: A Unless men are diagnosed with iron deficiency anemia, they should avoid intake of additional iron. Excessive iron intake is problematic because it is an oxidant in the body. Lycopene is an antioxidant found in tomato products, pink grapefruit, and watermelon, and increased intake of lycopene has been reported as reducing the risk of prostate cancer. Anthocyanin is a flavonoid that has antioxidant properties, particularly in regard to reducing oxidation of LDL. Vitamin D intakes have been found to be deficient in much of the population, and supplementation is not considered to be a risk. REF: pp. 358-359

11. A pregnant vegetarian can help prevent development of iron-deficiency anemia by consuming foods high in a. vitamin C. b. vitamin D. c. folate. d. protein.

ANS: A Vitamin C enhances absorption of nonheme iron and so prevents development of iron deficiency anemia in vegetarian pregnant women who rely on plant (nonheme) sources of iron. DIF: Cognitive Level: Application REF: pp. 176-177 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance

9. If an older adult is losing weight, his or her caloric intake is a. less than energy needs. b. approximately the same as energy needs. c. greater than energy needs. d. poorly distributed throughout the day.

ANS: A Weight loss is associated with a caloric intake that is less than what is required for energy needs. DIF: Cognitive Level: Application REF: p. 191 TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity: Physiological Adaptation

6. To determine if weight is appropriate for height at a given age for a given gender, where should the data plotted on the NCHS growth chart appear? a. Between the 5th and 85th percentiles b. Between the 10th and 50th percentiles c. Between the 75th and 95th percentiles d. Between the 5th and 25th percentiles

ANS: A When BMI (weight-for-height) is plotted, a BMI that falls below the 5th percentile is interpreted as underweight, and a BMI at or above the 85th percentile is interpreted as at risk for overweight. REF: p. 341

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T/F 14. It is appropriate to feed honey to infants and young children under two years of age.

20. Which of the following is NOT an indication of adequate infant growth from breastfeeding? a. Infant feeds from both breasts during a feeding. b. Infant has at least six to eight wet diapers per day. c. Infant has frequent stools. d. Infant continues to gain weight and length steadily.

ANS: A When an infant feeds from both breasts during a feeding, it is an indication of the volume of milk the mother is producing between feedings. Usual signs for adequate infant growth are the weight and length gain and the wet diaper and stool frequency. REF: p. 289

1. John is a 34-year-old who is active in his community coaching football. He was also recently promoted to a director-level position at his job. John is in a. young adulthood. b. young and middle adulthood. c. middle adulthood. d. older adulthood.

ANS: A Young adulthood is between the ages of 20 and 44 years. Physical maturity and independence are apparent and include the ability to form new relationships, adopt new roles, and make many more choices regarding lifestyle. DIF: Cognitive Level: Application REF: p. 189 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance

2. A 42-year-old who makes his or her own decisions regarding whom to marry and what type of family is desired is considered to be making a. independent choices. b. dependent choices. c. wealthy choices. d. introspective choices.

ANS: A Young adults between the ages of 20 and 44 years are independent in making choices regarding relationships, careers, jobs, marriage, and family. DIF: Cognitive Level: Application REF: p. 189 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance

26. To provide adequate amounts of vitamins and minerals, the best course of action is to a.lose weight to achieve ideal body weight. b.eat a variety of foods from each food group. c.follow the same general food pattern each day. d.consume foods high in fiber and low in saturated fat.

ANS: B Including a variety of foods from each food group increases the likelihood of obtaining adequate amounts of vitamins and minerals. Achieving ideal body weight does not guarantee adequate nutrient intake. Following the same general food pattern each day could actually limit vitamin and mineral intake because the assortment of foods is likely to be limited. Choosing foods high in fiber and low in saturated fat diet does not necessarily result in intake of adequate levels of vitamins and minerals. DIF: Cognitive Level: Applying REF: dm 12 TOP: Nursing Process: Planning MSC: Client Needs: Health promotion and maintenance

14. How would a pressure ulcer be classified if it involves a partial-thickness skin loss involving the epidermis and dermis, presenting as an abrasion or shallow crater? a. Stage 1 b. Stage 2 c. Stage 3 d. Stage 4

ANS: B A Stage 2 pressure ulcer involves a partial-thickness skin loss. Stage 1 pressure ulcers involve intact skin, but the skin may appear red, may feel firm or boggy, and may promote an itching or painful sensation. Stages 3 and 4 pressure ulcers are full-thickness wounds. Stage 3 pressure ulcers involve the subcutaneous tissue, and Stage 4 pressure ulcers go through the fascia and may affect muscle or bone. REF: pp. 372-373

14. A child's BMI is plotted on a growth chart at the 90th percentile. How would this child's BMI be interpreted? a. The child has a normal BMI. b. The child is at risk for becoming overweight. c. The child is overweight. d. The child is obese.

ANS: B A child's BMI between the 85th and 95th percentile is defined as being at risk for becoming overweight. An overweight child is one whose BMI is above the 95th percentile. For a child to be considered obese, the BMI has to be significantly above the 95th percentile. REF: p. 324

8. What is the appropriate serving size for foods offered to a small child? a. 1 tsp for each year of age b. 1 Tbsp for each year of age c. 1/2 cup of each food served d. 1 cup total food per meal

ANS: B A general guide for serving infants and young children is 1 Tbsp of each food for each year of age. Foods should be served on plates appropriate to the child's size. The child will indicate hunger if the served amount does not provide satiety. Larger portions and forced feeding may lead to either over- or underfeeding of the child. REF: p. 311

14. A low birth weight infant weighs less than a. 1500 g. b. 2500 g. c. 3000 g. d. 3500 g.

ANS: B A low birth weight infant weighs less than 2500 g while a very low birth weight infant weighs less than 1500 g. DIF: Cognitive Level: Knowledge REF: p. 173 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance

9. A healthy female middle-aged client asks what she can do to prevent the development of type 2 diabetes. Weight control and nutrition strategies discussed are considered a.primary treatment. b.primary prevention. c.secondary prevention. d.tertiary prevention.

ANS: B Action to prevent the development of type 2 diabetes is considered primary prevention. Secondary prevention involves early detection to halt and minimize the effects of the disease, and tertiary prevention minimizes complications and helps restore health after the disorder has developed. Primary treatment is not a recognized term. DIF: Cognitive Level: Applying REF: Pages 5-6 TOP: Nursing Process: Planning MSC: Client Needs: Health promotion and maintenance

22. The protein needs of an older adult are influenced by the adequacy of a. fiber intake. b. caloric intake. c. vitamin intake. d. mineral intake.

ANS: B Adequate calorie intake is essential in the older adult to prevent calories from protein intake being used for energy needs. DIF: Cognitive Level: Knowledge REF: p. 191 TOP: Nursing Process: Assessment | Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance

7. When do perimenopause and menopause begin in women? a. Early 30s b. Late 40s c. Elder years d. Mid 30s

ANS: B Although genetics, general health, and the timing of menarche affect the timing, generally, perimenopause and menopause begin in a woman's late 40s. REF: p. 358

17. A bodybuilder tells you that all of his meals and snacks include high-protein foods such as eggs, canned tuna, chicken, milk, and cheese. Most of the extra protein is probably used by his body to form a.strong bones and joints. b.body fat stores. c.healthy brain tissue. d.increased muscle mass.

ANS: B Excess protein is broken down to amino acids and then used for energy or stored as body fat. This mans body will use some of this protein to increase muscle mass, but increasing protein intake beyond the amount needed does not increase muscle formation. Excess protein intake does not improve bone, joint, or brain health. DIF:Cognitive Level: ApplyingREFage 9 TOP: Nursing Process: Assessment MSC: Client Needs: Physiological integrity

18. When plotting an infant's weight or length on a percentile growth chart, a curve is produced that can be used to follow the infant's growth. What is this curve called? a. Growth velocity b. Growth channel c. Catch-up growth d. Lag-down growth

ANS: B As a growth pattern develops on a growth chart, the curve produced is known as the growth channel and is reported as a percentile based on the chart. Growth velocity is a measure of the rate of growth during a specified period of time and usually starts high in infancy and then decreases as the person gets older. Catch-up growth is when a smaller infant starts to reach his or her genetic growth potential by increasing growth rate during the first year of life, and lag-down growth is when a larger infant's growth rate decreases to its genetic potential. REF: p. 300

23. Dehydration is more common in older adults than in younger adults because a. the kidneys excrete too much water. b. the thirst mechanism diminishes. c. the intracellular versus extracellular water balance is disturbed. d. more water needs to be ingested to maintain hydration.

ANS: B As a person ages the thirst mechanism diminishes, which may result in inadequate fluid intake and dehydration. DIF: Cognitive Level: Comprehension REF: pp. 195-196 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation

15. A cup of frozen yogurt contains 24 g of carbohydrate, 2 g of fat, and 4 g of protein. The total number of kilocalories in the frozen yogurt is a.110. b.130. c. 140. d.162.

ANS: B At 4 kcal per gram, 24 g of carbohydrate provides 96 kcal. At 9 kcal per gram, 2 g of fat provides 18 kcal. At 4 kcal per gram, 4 g of protein provides 16 kcal. Therefore, the total kilocalories in the frozen yogurt is 130 kcal (96 + 18 + 16). DIF:Cognitive Level: ApplyingREFages 8-9 TOP: Nursing Process: Assessment MSC: Client Needs: Health promotion and maintenance

8. Each decade, basal energy needs decrease a. 0.5% to 1%. b. 1% to 2%. c. 2% to 4%. d. 5% to 8%.

ANS: B Basal metabolic rate declines an average of 1% to 2% per decade of life. DIF: Cognitive Level: Knowledge REF: p. 191 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance

20. For how long do both the American Academy of Pediatricians and the Academy of Nutrition and Dietetics recommend exclusive breastfeeding of infants? a. For 3 months b. For 6 months c. For the first year d. Up until the age of 2 years

ANS: B Both the AAP and the AND recommend breastfeeding as the sole source of infant nutrition until the infant is 6 months old. Afterward, they both recommend that breastfeeding continue with weaning foods supplemented until the age of 1 year. REF: p. 307

19. How many kilocalories are provided by 6 fl oz of breastmilk or standard infant formula? a. 60 kcal b. 120 kcal c. 180 kcal d. 300 kcal

ANS: B Breastmilk and standard infant formula provide 20 kcal/fl oz (6 · 20 = 120 kcal). REF: p. 305

19. During which stage of cognitive development can children identify foods that are "good for you" but probably could not give a reason? a. Sensorimotor stage b. Preoperational stage c. Concrete operations stage d. Formal operations stage

ANS: B Classifying foods as "good" or "bad" without explanation is a characteristic of preoperational thinking. Sensorimotor cognitive development occurs in the first 2 years of life as an infant progresses from automatic reflexes to interactions with the environment. Concrete operational cognition involves more cause-and-effect thinking. Formal operational cognition involves hypothetical and abstract thinking. REF: p. 318

19. Congregate meals are most often served at a a. church. b. senior center. c. nursing home. d. hospital.

ANS: B Congregate meals are served in senior centers and other public or private community facilities. DIF: Cognitive Level: Knowledge REF: p. 200 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance

6. The recommendation for fiber in preschool and school age children a. is 5 g/day. b. is 14 g/kcal. c. is 14 g/day. d. is not part of the DRIs.

ANS: B Dietary Recommended Intakes (DRIs) for fiber in children is the same as that for adults—14 g/kcal. Surveys indicate that current intake in the United States is much lower than this recommendation. REF: p. 327

3. The phase that shows the most erratic growth is a. infancy. b. childhood. c. adolescence. d. adulthood.

ANS: B During childhood, physical growth and appetite occur in spurts. The generally slow and irregular growth rate continues in the early school years, and body changes occur gradually. DIF: Cognitive Level: Application REF: p. 166 TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance

15. For the first 6 months of lactation, what is the recommended energy intake? a. 200 kcal less than the amount for pregnant women b. 330 kcal more than the amount for nonpregnant women c. 550 kcal more than the amount for pregnant women d. The same as the amount for pregnant women in the third trimester

ANS: B During the first 6 months of lactation, breastfeeding women need 330 kcal more than nonpregnant women to promote adequate milk production. This is equal to the kilocalorie needs of a pregnant woman during her second trimester. REF: p. 252

9. Which of the following does NOT describe typical eating behavior in adolescents? a. Skipped meals b. Adequate fruit and vegetable intake c. Frequent dependence on fast foods d. Inadequate time for meals

ANS: B Eating snack foods, soft drinks, and fast foods are commonly reported eating behaviors among adolescents; however, only about one-third of adolescents eat meals with their families every day. These adolescents are more likely to eat more fruits and vegetables. Teens identify lack of time as a reason for inadequate nutrition, and this contributes to the skipped meals and their dependence on fast foods. REF: pp. 338-339

18. Which of the following tends to be a positive development in childhood eating habits that can result from peer influences? a. Selection of nutritious versus nonnutritious foods b. Willingness to try new foods c. Table manners d. Adequate time to eat

ANS: B Eating with other children affects food attitudes and choices. This can be both negative and positive. On the negative side can be the development of food refusals and behaviors associated with meal time. On the positive side, children who see other children trying different foods will be more willing to try the new foods as well. Children cannot differentiate foods based on nutritional value, so they cannot self-select nutritious foods over nonnutritious foods. Table manners are generally dictated by an adult influence. REF: p. 323

28. Examples of foods high in nutrients that help prevent osteoporosis are a. cottage cheese and oranges. b. yogurt and canned salmon. c. oatmeal and green leafy vegetables. d. broccoli and liver.

ANS: B Foods high in calcium can help prevent osteoporosis. Foods such as yogurt and canned salmon are significant sources of calcium. DIF: Cognitive Level: Application REF: p. 192 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance

13. What should the caregiver avoid feeding an infant to reduce the risk of choking? a. Cheese and pudding b. Grapes and hot dogs c. Graham crackers and cheese d. Pasta, such as macaroni

ANS: B Foods with skins or rinds, such as grapes and hot dogs, and foods that stick to the roof of the mouth, such as peanut butter, should not be offered to infants and young children. Foods should be well cooked, mashed, or finely chopped to limit the hazard of choking. REF: p. 310

24. The finding of glycosuria during a routine laboratory test may suggest that the woman has a. anemia. b. gestational diabetes. c. phenylketonuria. d. hypertension.

ANS: B Gestational diabetes presents with glycosuria or sugar spilling over into the urine. Other predisposing factors include age 30 years and older, those who are overweight and have a history of previously unexplained stillbirths, delivery of large babies weighing 9 lb or more, habitual spontaneous abortions, births of babies with multiple congenital defects, and a family history of diabetes or ethnicity associated with a high incidence of diabetes. DIF: Cognitive Level: Knowledge REF: p. 158 TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity: Physiological Adaptation

4. The best example of the type of concern that is likely to be addressed by the U.S. Department of Health and Human Services when target goals for Healthy People 2030 are updated is a.preference for vegetarian eating patterns among white women. b.low intake of fruits and vegetables by African American children. c.widespread use of bottled water in higher socioeconomic groups. d.common use of protein and vitamin supplements in athletes.

ANS: B Healthy People is used to set targets for health promotion to improve the health of all individuals. It addresses environmental and social issues that affect health outcomes. Low intake of fruits and vegetables by African American children is likely to have an adverse effect on their health and so may be addressed when target goals are set. Vegetarian eating patterns, use of bottled water, and use of protein and vitamin supplements do not necessarily have an adverse effect on nutritional health and so are less likely to be addressed. DIF: Cognitive Level: Applying REF: Pages 4-6 TOP: Nursing Process: Planning MSC: Client Needs: Health promotion and maintenance

29. Parents who use natural foods should be advised to a. add honey to water if the infant is constipated. b. avoid giving honey to a child younger than 1 year of age. c. add honey to infant foods as a good source of energy. d. use only unprocessed honey.

ANS: B Honey should not be given to an infant younger than 1 year of age because botulism spores have been reported in honey and the immune capacity of the young infant cannot resist this infection. DIF: Cognitive Level: Knowledge REF: p. 177 TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity: Physiological Adaptation

10. Compared with formula-fed infants, why do breast-fed infants experience a reduced incidence of infections? a. Human milk is higher in fat. b. Human milk has anti-infective factors. c. Commercial infant formula is higher in iron. d. Commercial infant formula is higher in fat.

ANS: B Human milk provides secretory immunoglobulin A, lactoferrin, and lysozymes, which all contribute to preventing infection in the infant's gastrointestinal tract. The lactoferrin contributes to improved bioavailability of the iron in breastmilk and makes the iron unavailable to gut flora. Commercial formula has higher iron content because of its reduced bioavailability compared with breastmilk. Human milk is higher in fat content than formula, but the arachidonic acid and docosahexaenoic acid present are more involved in the infant's neurologic development. REF: p. 305

19. Babies should not be put to sleep with a bottle of formula because a. infants should not hold their own bottles. b. this could lead to early tooth decay. c. infants should not suck while asleep. d. susceptibility to diarrhea is increased.

ANS: B In addition to other concerns, babies should not be put to sleep with a bottle of formula because it can lead to early tooth decay as bacteria ferment nutrients in the formula to produce acid, which damages tooth enamel. DIF: Cognitive Level: Knowledge REF: p. 175 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance

6. Home-delivered meals provided for under the Older Americans Act nutrition program are administered by what agency? a. USDA b. USDHHS c. ALF d. CMS

ANS: B In the U.S. Department of Health and Human Services, the Agency on Aging administers a network of local agencies to provide both home-delivered and congregate meals for elderly adults. This is the only food assistance program through USDHHS. All other food assistance programs are provided through the U.S. Department of Agriculture. Assisted-living facilities are residential programs that provide access to supportive health care to older residents. The Centers for Medicare and Medicaid Services provide health care services but no food assistance. REF: p. 377

8. Iron needs increase during pregnancy because of a. maternal constipation. b. an increased maternal blood volume. c. an increased maternal metabolic rate. d. poor iron absorption during pregnancy.

ANS: B Iron needs are increased during pregnancy for increased hemoglobin synthesis required for the greater maternal blood volume as well as for the baby's necessary prenatal storage of iron. DIF: Cognitive Level: Knowledge REF: p. 150 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance

21. Factors that commonly contribute to malnutrition in older adults include a. type 2 diabetes and heart disease. b. the loss of teeth or poorly fitting dentures. c. a weight 10% above desirable standards. d. increased energy and nutrient needs.

ANS: B Many factors contribute to malnutrition in the elderly, including inadequate food and nutrient intake because of ill-fitting or missing dentures. DIF: Cognitive Level: Knowledge REF: pp. 194-195 TOP: Nursing Process: Assessment | Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation

12. What reason would most likely explain why a 1-year-old child is experiencing iron deficiency? a. Excessive fruit juice consumption b. Excessive milk consumption c. Child is feeding herself, particularly finger foods d. Child is eating table foods

ANS: B Milk anemia results from excessive intake of milk to the exclusion of other foods, and this could occur in a 1-year-old child because young children prefer milk to meat. Excessive fruit consumption is more associated with toddler ages, 2 to 3 years. At 1 year of age, a child will participate in feeding herself finger foods, but a caregiver should still assist in the feeding process. By 1 year of age, most children can eat the same foods as adults, and a well-selected diet can provide adequate iron. REF: p. 326

23. A class of nutrients that is important in body structure and influences the function of muscles and the central nervous system is a. proteins. b.minerals. c. vitamins. d.carbohydrates.

ANS: B Minerals are important in body structures and influence the function of muscles and the central nervous system. Proteins are structural components and form part of muscles but are less influential in the central nervous system. Vitamins and carbohydrates do not have structural functions. DIF:Cognitive Level: UnderstandingREFage 10 TOP: Nursing Process: Assessment MSC: Client Needs: Physiological integrity

13. A 45-year-old man tells you that he drinks 3 oz of Scotch whiskey most evenings. His alcohol intake is considered a. insignificant. b.moderate. c.higher than is recommended. d.dangerously high.

ANS: B Moderate alcohol intake is two servings or fewer per day for men. One serving of spirits, such as whiskey, is 1.5 ounces. Therefore, 3 oz of whiskey per day is considered moderate alcohol intake. DIF:Cognitive Level: AnalyzingREFage 9 TOP: Nursing Process: Assessment MSC: Client Needs: Health promotion and maintenance

1. Which of the following are biologically active, naturally occurring substances in plants that act as natural defense systems and show potential for reducing the risk for cancer and cardiovascular disease? a. Prebiotics b. Phytochemicals c. Butyrates d. Xenobiotics

ANS: B Phytochemicals include substances such as flavonoids, anthocyanins, and carotenoids that provide color, aroma, and flavor to foods. Prebiotics are carbohydrates that are used by beneficial gastrointestinal bacteria to promote their growth and inhibit the growth of harmful bacteria. Butyrate is a short-chain fatty acid that is used by colonic mucosal cells as an energy source. A xenobiotic is a compound foreign to the body, usually harmful. REF: p. 362

12. What recommendation about sodium should be given for pregnant women? a. Aggressive restriction is warranted. b. Sodium intake should be above 2 to 3 g/day. c. Sodium intake should not exceed 1 g/day. d. Sodium intake should not exceed 2 g/day.

ANS: B Pregnancy does not place any additional demands in regard to sodium restriction. Excessive sodium restriction runs the risk of promoting water intoxication, renal and adrenal necrosis, and neonatal hyponatremia. REF: p. 262

27. Nutrition counselors should encourage pregnant teenagers to a. avoid fast food. b. eat foods from all the basic food groups. c. drink fat-free (skim) rather than whole milk. d. eat foods high in dietary fiber.

ANS: B Pregnant teens should consume foods from all five basic foods groups to support fetal development as well as their own growth and development needs. DIF: Cognitive Level: Application REF: p. 154 TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance

7. An example of a food that provides building material for tissue growth is a. bread. b. cheese. c. broccoli. d. an orange.

ANS: B Protein is the fundamental tissue-building substance of the body. Cheese is a food high in protein. DIF: Cognitive Level: Application REF: p. 171 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance

10. The patient who would have the highest protein needs is a. a 36-year-old man who plays basketball. b. a 73-year-old man recovering from a broken hip after a fall. c. a 56-year-old woman who is trying to lose weight. d. a 48-year-old woman who is moderately active.

ANS: B Protein needs increase during recovery from injury. Exercise has a much smaller effect on protein needs, and protein needs do not increase with weight loss. DIF: Cognitive Level: Application REF: p. 191 TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance

17. Total weight gain during the first trimester should be approximately _____ lbs. a. 1 to 2 b. 2 to 4 c. 6 to 10 d. 10 to 15

ANS: B Recommended weight gain in the first trimester of pregnancy is approximately 2 lb to 4 lb. DIF: Cognitive Level: Knowledge REF: p. 152 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance

20. A very overweight pregnant woman older than 30 years of age is at high risk for a. anemia. b. gestational diabetes. c. edema. d. phenylketonuria.

ANS: B Risk factors for women who are more than 120% of standard weight or who have a body mass index of more than 26 include gestational diabetes. During pregnancy, there is an increased metabolic workload along with an increased volume of blood and its load of metabolites, including glucose. DIF: Cognitive Level: Knowledge REF: p. 154 TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity: Physiological Adaptation

8. What is dysgeusia? a. Diminished sense of smell b. Loss of sense of taste c. Dry mouth from decreased salivation d. Result of hypochlorhydria

ANS: B Some change in the sense of taste is associated with aging; however, a total loss of taste sensation more often is associated with the use of medications, diseases of the kidney or liver, diabetes, hypertension, head injury, neurologic conditions, and zinc or niacin deficiencies. Hyposmia is a diminished sense of smell and can contribute to a reduced taste sensation. Xerostomia is dry mouth. A reduction in hydrochloric acid production in the stomach can result in nutrient malabsorption. REF: p. 370

25. The final, major growth spurt of childhood occurs a. at the end of the school-age period. b. with the onset of puberty. c. at the end of adolescence. d. during young adulthood.

ANS: B The final growth spurt of childhood occurs with the onset of puberty. This rapid growth is evident in increasing body size and development of sex characteristics in response to hormonal influences. DIF: Cognitive Level: Knowledge REF: p. 183 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance

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T/F 15. During childhood parents should use food to control behavior.

3. What is the American Academy of Pediatrics' recommendation on the use of supplements for children? a. Routine multiple vitamin and mineral supplements should be given. b. No routine supplementation is needed except fluoride in nonfluoridated areas. c. Maximal doses of vitamins and minerals should be given because it is uncertain that children will eat enough of the nutrients in food. d. Supplements should not be restricted because children are growing so rapidly that overdosing is unlikely.

ANS: B The American Academy of Pediatrics (AAP) supports the use of diet as the means for providing adequate intake of vitamins and minerals to healthy children. Fluoride is the only mineral advocated for supplementation in children. However, some children may be at risk for inadequate nutrition, and for these exceptions, the AAP is supportive of supplementation. These include children from deprived families, children with anorexia or those following fad diets, children with chronic disease, and children following diets to treat obesity. REF: p. 318

5. What is the most appropriate recommendation to make when counseling a newly pregnant patient about alcohol consumption? a. Avoid alcohol for the first trimester; then no more than 1 oz of alcohol per day. b. Avoid alcohol completely throughout the entire pregnancy. c. Limit consumption to 1 oz of alcohol per day. d. Limit consumption to 2 oz of alcohol per day.

ANS: B The American College of Obstetricians and Gynecologists and the March of Dimes both recommend no alcohol through the entire pregnancy. Fetal alcohol syndrome results from fetal exposure to alcohol. This could be attributable to alcohol's effects on cell differentiation, dietary deficiencies associated with alcohol use, and alterations in metabolism. REF: p. 272

5. Which is an appropriate nutritional guideline for the adult years? a. Focus primarily on lipid intake. b. Follow a nutrient-dense, phytochemical-rich food plan. c. Follow a high-protein, low-carbohydrate diet. d. Follow a vegan diet.

ANS: B The Dietary Guidelines for Americans focus on eating nutrient-dense foods, but there is the added benefit that the identified foods tend to also be phytochemical rich. Focusing on lipid intake limits awareness of the variety of benefits that arise from the intake of whole grains, fruits, and vegetables. Dietary recommendations for adolescents focus on the promotion of adequate growth and development during adolescence, and in many cases, they exceed the needs of the average adult. A carefully chosen vegan diet supplemented with specific nutrients can be healthy, but vegan diets (and other very restrictive diets) are generally considered a risk factor for inadequate nutrition. REF: p. 359

9. Nutrition screening using the BMI as an indicator a. is the best indicator for those 85 years of age and older. b. may not be accurate because of body composition changes in elderly adults. c. is better than using mid-arm muscle circumference. d. is not part of the Mini Nutritional Assessment (MNA).

ANS: B The MNA includes six questions and the BMI or calf circumference. However, BMI may not yield accurate results because fat mass increases and lean tissue decreases with aging. A measure such as the mid-arm muscle circumference more accurately reflects body composition. REF: p. 375

26. The Mini Nutritional Assessment identifies a. emotional stability. b. nutritional risk. c. vitamin deficiency. d. social isolation.

ANS: B The Mini Nutritional Assessment is designed to identify nutritional risk. It is a reliable tool and can detect the risk of malnutrition. DIF: Cognitive Level: Knowledge REF: p. 194 TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance

12. The older adult's diet should include adequate carbohydrates to a. provide a substrate for vitamins and minerals. b. support normal brain function. c. provide building material for muscle mass. d. maintain blood glucose level.

ANS: B The National Academy of Sciences has determined that an absolute minimum of 130 g/day of carbohydrates is necessary to maintain normal brain function in children and adults. DIF: Cognitive Level: Knowledge REF: p. 191 TOP: Nursing Process: Assessment | Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance

17. In Medicare benefits, for which of the following are MNT services NOT included? a. Preventive services b. Cancer c. Diabetes d. Preend-stage kidney disease

ANS: B The addition of medical nutrition therapy to Medicare benefits began in 2002 with coverage for nutrition services in the treatment of diabetes and kidney disease. In 2005, expansion of Medicare benefits included the provision of MNT in preventive services for new Medicare beneficiaries. In 2006, CMS began working with long-term care improvement programs to address certain chronic conditions in an effort to reduce hospitalizations. Cancer has not been identified as one of the conditions covered. REF: pp. 376-377

7. For the efficient functioning and maintenance of the body, a person needs to consume sufficient amounts of a.fiber. b.nutrients. c. minerals. d.supplements.

ANS: B The body needs sufficient amounts of all nutrients for efficient functioning and maintenance. Both fiber and minerals are needed, but each represents only one type of nutrient. Supplements are not always necessary because sufficient nutrients can often be obtained from food. DIF:Cognitive Level: UnderstandingREFages 8-10 TOP: Nursing Process: Assessment MSC: Client Needs: Physiological integrity

30. An overweight client has been trying to lose weight for years. She tells you that she believes she is genetically designed to be overweight and that the foods available in supermarkets today make weight loss impossible. The clients attitude shows a.positive self-efficacy. b.negative self-efficacy. c.poor environmental health. d.poor emotional health.

ANS: B The clients attitude demonstrates negative self-efficacy. She does not perceive that she has power over her life and behaviors. A belief that she could change her personal behaviors would reflect positive self-efficacy. She is able to express her feelings, and so she does not necessarily have poor emotional health. Her belief about healthy food choices in her environment is not necessarily accurate.

20. The congregate meal for seniors is a. breakfast. b. the noon meal. c. the evening meal. d. decided by the center.

ANS: B The congregate meal is the noon meal. DIF: Cognitive Level: Knowledge REF: p. 200 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance

16. Which of the following is NOT one of the four syndromes known to be predictive of adverse outcomes in older adults? a. Depression b. Diabetes c. Cognitive impairment d. Malnutrition

ANS: B The four syndromes known to be predictive of adverse outcomes in older adults that are prevalent in patients with frailty (known as failure to thrive) include impaired physical functioning, malnutrition, depression, and cognitive impairment. REF: p. 374

9. What is an appropriate food serving size for a 2-year-old child? a. 2 tsp b. 2 Tbsp c. 1/2 cup d. 1 cup

ANS: B The general recommendation for serving sizes for children is two tablespoons of food per year of age. This may be adjusted according to the child's appetite. Milk and juice may be served in 1/2-cup volumes or less. Cooked cereals may be 1/4 to 1/2 cup in volume, and dry cereal may be 1/2 to 1 cup in volume. REF: p. 322

10. How is soy beneficial in promoting cardiovascular health? a. By reducing saturated fat intake b. By replacing animal protein in the diet c. By stimulating HDL production d. By promoting vasodilation and decrease in blood pressure

ANS: B The isoflavones in soy were originally thought to have a direct effect on the lipoprotein profile associated with serum cholesterol; however, recent evidence has not substantiated any effect on HDL cholesterol or triglycerides. The American Heart Association recommends the use of soy as an alternative to animal protein; therefore, the benefit is seen through a reduction in saturated fat intake. Isoflavones do not have antioxidant properties. Although isoflavones are associated with vasomotor symptoms (hot flashes) in menopausal women, effects on blood pressure have not been noted. REF: pp. 362-363

24. During the school-age years, the rate of growth a. increases rapidly. b. is slow and irregular. c. increases slowly. d. is similar to that during the preschool years.

ANS: B The rate of growth during the school-age years is slow and irregular, with body changes occurring gradually. DIF: Cognitive Level: Knowledge REF: pp. 178-179 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance

18. The approximate recommended age for adding solid food to an infant's diet is a. 4 months. b. 6 months. c. 8 months. d. 12 months.

ANS: B The recommended practice is to introduce solid foods at approximately 6 months of age. Younger infants are not ready to swallow and digest solid foods, and they do not yet need other nutrients besides those provided by breast milk or infant formula. DIF: Cognitive Level: Knowledge REF: p. 176 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance

21. A client has heard that nutrients can be converted to other nutrients in the body. He takes high-dose vitamin C supplements because he believes this will supply his bodys need for other vitamins. What would you tell him? a.He should switch to a multivitamin supplement instead of just vitamin C. b.Each vitamin has a specific function and needs to be supplied through a variety of foods. c.Vitamin C can provide only water-soluble vitamins, and he still needs to consume fat-soluble vitamins. d.Vitamin C supplements should be taken only when he has symptoms of a cold or influenza.

ANS: B Vitamins cannot be converted into other vitamins; each has a specific function, and the best way to consume adequate amounts of each vitamin is to eat a variety of foods. Vitamin C is water soluble, but it cannot be converted to other water-soluble vitamins. Vitamin C is needed by the body at all times, not just when someone is ill. A multivitamin supplement would provide a better range of vitamins than just vitamin C, but it is still better to consume vitamins from food, rather than from supplements. DIF:Cognitive Level: ApplyingREFages 9-10 TOP: Nursing Process: Assessment MSC: Client Needs: Physiological integrity

1. Examples of informal education include a.attending a workshop on coronary artery disease sponsored by the American Heart Association. b.watching a television show about diabetes. c.learning about food safety techniques in a high school economics course. d.joining a support group to help overcome an eating disorder.

ANS: B Watching a television show about diabetes is an example of informal education because it is an experience that occurs through a daily activity. Attending a workshop or joining a support group would be considered nonformal education; a high school course would be considered formal education. DIF:Cognitive Level: ApplyingREFage 6 TOP: Nursing Process: Implementation MSC: Client Needs: Health promotion and maintenance

3. Making a choice to lose weight and manage one's cholesterol level is most likely to occur during a. young adulthood. b. middle adulthood. c. school-age childhood. d. adolescence.

ANS: B Wellness, health promotion, and reduction of disease risks are becoming the focus of health care for the middle adult years. DIF: Cognitive Level: Application REF: p. 189 TOP: Nursing Process: Assessment | Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance

1. Which of the following can result from atrophic gastritis associated with aging? a. Decreased calcium and nonheme iron absorption b. Diminished absorption of vitamin B12 c. Decreased absorption of carbohydrates d. Increased intestinal transit time

ANS: B When the gastric mucosa atrophies, there is a reduction in the secretion of intrinsic factor. This is necessary to promote the absorption of vitamin B12 from dietary sources. Reduced acid production also affects the absorption of nonheme iron but not necessarily calcium. The acid is also needed for the denaturation of protein. REF: p. 371

5. Which of the following results from zinc deficiency in a child's diet? a. Increased fat stores b. Short stature c. Chronic diarrhea d. Mental retardation

ANS: B Zinc is necessary for growth, and improving zinc intake has been beneficial in treating stunted growth and underweight in children. Children develop increased fat stores by taking in an excess of calories compared with energy needs. Chronic diarrhea may be associated with excess intake of fruit juices. Mental retardation may result from a number of nutrient deficiencies and from lead toxicity. REF: p. 317

19. A pregnant adolescent is at risk because she a. does not know how to care for herself. b. has not established good eating habits. c. is still in a growth stage of development. d. will not know about the pregnancy until after the fetal organs have formed.

ANS: C A pregnant adolescent is at risk because adolescence itself is a stage of growth. The physiologic demands of the pregnancy can compromise the teenager's needs for her own unfinished growth and development. DIF: Cognitive Level: Knowledge REF: p. 154 TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity: Physiological Adaptation

14. What are the recommended guidelines regarding the use of low-fat and nonfat milk for infants? a. These are appropriate for overweight infants during the first year. b. These are appropriate for any infant during the first year. c. These are inappropriate for infants during the first year. d. These are inappropriate for infants during the first 3 months of life.

ANS: C All forms of cow's milk are not recommended for provision to infants younger than the age of 1 year. Cow's milk may cause gastrointestinal blood loss, may provide an excessive renal solute load, and is an inadequate source of iron and linoleic acid. REF: p. 306

13. Adequate intake of which nutrient is of greatest concern when working with adolescent athletes? a. Carbohydrate b. Protein c. Water d. Iron

ANS: C Although athletic activity increases the need for almost all nutrients, the one that has the most likelihood of inadequate intake is water. Dehydration that occurs from inadequate replenishment of fluids during physical activity and accompanying heat illness is the second most common noncardiac cause of death among adolescent athletes. Athletes need more carbohydrate to meet energy demands and more protein to prevent muscle loss. Iron intake may be a problem when working with female adolescents. REF: p. 348

19. Milk production is most affected by a. calories consumed by the mother. b. mother's hydration status. c. the frequency of suckling. d. protein consumed by the mother.

ANS: C Although the diet of the mother does affect the milk composition, the frequency of suckling has the biggest effect on milk production. REF: p. 285

1. Which of the following represents the growth experienced by a child during adolescence? a. 50% of the adult height and 20% of the adult weight b. 30% of the adult height and 30% of the adult weight c. 20% of the adult height and 50% of the adult weight d. 10% of the adult height and 20% of the adult weight

ANS: C Although there is great variability in timing of growth among adolescents, the average adolescent gains 20% of his or her adult height during puberty and 40% to 50% of adult body weight. The gain in weight accompanies the gain in height; however, weight gain tends to continue after linear growth has stopped. REF: p. 332

10. A woman has a BMI indicating overweight before pregnancy. Which of the following guidelines for weight gain during pregnancy is recommended? a. Weight gain is contraindicated during this pregnancy. b. Guidelines for weight gain for overweight women are not currently established. c. Weight gain should be controlled to 15 to 25 lb. d. It is not necessary to control weight gain during pregnancy.

ANS: C An overweight BMI is defined as 25 to 29.9. Women with BMIs in this range before pregnancy should promote a weight gain of 15 to 25 lb. Overweight and obese women who are attempting to become pregnant should not promote any weight loss during the pregnancy. REF: p. 263

8. An 8-month-old infant who receives approximately 0.4 L of fluid per day is meeting a. 200% of fluid needs per day. b. 100% of fluid needs per day. c. 75% of fluid needs per day. d. 50% of fluid needs per day.

ANS: C Approximate daily fluid needs during growth years for infants 7 to 12 months is 0.8 L/day. DIF: Cognitive Level: Application REF: p. 171 TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance

15. Physiologic problems of older adults include a. diarrhea. b. increased salivary secretions. c. decreased thirst and taste sensations. d. increased muscle tone.

ANS: C As a person ages, a decrease in the thirst mechanism occurs that can lead to inadequate fluid intake and resultant dehydration. The older adult also experiences a decrease in taste, smell, and vision, which affect food intake. DIF: Cognitive Level: Knowledge REF: pp. 193-194 TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity: Physiological Adaptation

7. What would be the correct interpretation of an adolescent who has a BMI above the 85th percentile? a. The adolescent is overweight. b. The adolescent is obese. c. The adolescent is at risk for becoming overweight. d. The adolescent is overfat.

ANS: C As in children, the plotting of an adolescent's BMI above the 85th percentile but below the 95th percentile is interpreted as being at risk for becoming overweight. A BMI above the 95th percentile is interpreted as being overweight. For an interpretation of obesity, the BMI would have to be significantly above the 95th percentile. REF: p. 341

28. Older infants can generally finger-feed themselves with a refined pincer grasp at a. 6 to 8 months. b. 7 to 9 months. c. 10 to 12 months. d. 12 to 18 months.

ANS: C At 10 to 12 months, infants can finger-feed themselves with a refined pincer grasp. DIF: Cognitive Level: Knowledge REF: p. 177 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance

1. At birth, the reflexes an infant has are a. rooting, biting, and swallowing. b. sucking, munching, and swallowing. c. rooting, sucking, and swallowing. d. grasping, sucking, and gagging.

ANS: C At birth the rooting, sucking, and swallowing reflexes are present along with the tonic neck reflex. DIF: Cognitive Level: Knowledge REF: p. 173 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance

2. To meet the fluoride needs of a breast-fed infant, what should parents be instructed to do? a. Begin giving fluoride supplements immediately after birth. b. Supplement the mother's diet with fluoride. c. Begin giving fluoridated water when the baby's teeth erupt. d. When the infant starts eating solid foods, the foods will provide enough fluoride.

ANS: C Because human milk has low fluoride content regardless of the mother's fluoride intake, after 6 months of age, when an infant's teeth begin to appear, the baby should start receiving fluoridated water on a daily basis. Fluoride supplementation is not recommended before 6 months of age, partially to prevent the likelihood of fluorosis. Fluoride provision through food depends on the water supply used in the preparation of the food. Because communities where fluoridation has not been instituted still exist, adequate fluoride provision through foods alone cannot be guaranteed. REF: pp. 302-303

14. A dessert contains 4 g of protein, 30 g of carbohydrate, 15 g of fat, and 5 g of alcohol. The nutrient that provides the most kilocalories in the dessert is a. protein. b.carbohydrate. c. fat. d.alcohol.

ANS: C Fat provides the highest number of kilocalories: At 9 kcal per gram, 15 g of fat provides 135 kcal. At 4 kcal per gram, 4 g of protein provides 16 kcals. At 4 kcal per gram, 30 g of carbohydrate provides 120 kcal. At 7 kcal per gram, 5 g of alcohol provides 35 kcal. DIF:Cognitive Level: ApplyingREFage 9 TOP: Nursing Process: Assessment MSC: Client Needs: Health promotion and maintenance

14. Among adolescents, which type of eating disorder is most likely to be diagnosed? a. Anorexia nervosa b. Bulimia nervosa c. Disordered eating not otherwise specified d. Excessive eating disorder

ANS: C Because of the strict definitions used by the Diagnostic and Statistical Manual-IV (DSM-IV), many adolescents who demonstrate disordered eating may not fit the criteria associated with anorexia nervosa or bulimia nervosa. The definition for "eating disorder not otherwise specified" can accommodate the variations in growth, the presence of menstrual periods, and cognitive development associated with adolescence. Excessive eating disorder is not defined by the DSM-IV. REF: p. 340

17. What would be a behavior demonstrated by a 7- to 9-month-old to indicate that she is sated and finished eating? a. She falls asleep. b. She pays more attention to her surroundings. c. She plays with or throws her utensils. d. She hands her cup or bottle to her mother.

ANS: C By age 7 to 9 months, an infant has the developmental coordination to pick up and handle utensils through a refined pincer grasp. This allows her to be more active in participating in her feeding, as well as in signaling when she is done. Falling asleep when sated is common in infants up to 3 months of age. From 4 to 6 months, fussing, crying, or losing attentiveness toward the food and paying more attention to the surrounding environment are signals of being done eating. A 10- to 12-month-old infant will hand her mother her cup or bottle as a signal of being done. REF: pp. 307-309

3. The RDA for calcium for all adolescents is _________ with an upper level intake of _______. a. 800 mg; 1000 mg b. 3000 mg; 5000 mg c. 1300 mg; 3000 mg d. There is no RDA for calcium for adolescents

ANS: C Calcium intake is likely to be low in adolescents. The RDA for all adolescents is 1300 mg with an upper limit of 3000 mg. Calcium intake declines with age in adolescents, especially in females. Research suggests that the high soft drink consumption at this age contributes to decreased calcium intake by displacing milk intake. REF: p. 336

6. A good source of calcium during pregnancy is a. orange juice drink. b. lean ground beef. c. milk. d. baked beans.

ANS: C Calcium is essential for fetal development of bones and teeth as well as for the mother's own body needs. Milk, milk-substitute products, generous amounts of green vegetables, and enriched or whole grains are good sources of calcium. DIF: Cognitive Level: Application REF: pp. 149-150 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance

1. Which of the following are appropriate general guidelines for measurements to assess the growth of a child? a. Growth measurements should be made at 1, 4, and 10 years. b. After the child's channel on the growth charts has been determined, it is not necessary to reevaluate on a regular basis. c. Growth measurements of height, weight, and weight for height should be determined at regular intervals. d. After the growth pattern is established, it will not change until adolescence.

ANS: C Children change their eating and activity patterns, causing changes in growth. Because these changes are not always predictable, by checking growth measures at regular intervals, potential growth problems can be identified and treated early. Depending on the child's eating and activity, a child for whom a growth channel had been established could stray from that channel. REF: p. 314

17. The first milk secreted by a new mother is called a. lactation. b. colostomy. c. colostrum. d. prolactin.

ANS: C Colostrum is a thin, yellow fluid first secreted by the mammary gland a few days after childbirth, preceding the mature breast milk. DIF: Cognitive Level: Knowledge REF: p. 174 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance

29. During pregnancy, a 132-pound woman should limit her intake of caffeine to a. 0 mg per day. b. 100 mg per day. c. 300 mg per day. d. her individual tolerance.

ANS: C During pregnancy, caffeine intake should be limited. The overall conclusion is that moderate amounts of caffeine (5 mg/kg to 6 mg/kg/day) throughout the day do not have negative effects on reproduction or fetal health. Thus 60 kg (132 lb) 5 = 300 mg of caffeine/day. DIF: Cognitive Level: Application REF: p. 156 TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance

11. According to the RDA, how much additional protein above that of a nonpregnant woman should a pregnant woman consume during the second half of her pregnancy? a. 10 g b. 15 g c. 25 g d. 35 g

ANS: C During the first half of pregnancy, the protein requirement is the same as that of a nonpregnant woman; however, during the second half, the requirement increases from an average of 46 g for nonpregnant women to 71 g for pregnant women. This reflects a change of 25 g more per day to promote the protein deposition necessary for both the mother and the fetus. REF: p. 283

26. Eating disorders are common in many groups of adolescent girls because a. their appetites are low. b. adolescents are busy and may miss meals. c. society and peers value thinness. d. they tend to be overzealous in following low-fat eating patterns.

ANS: C Eating disorders are common is young girls and in boys because of social, family, and personal pressures concerning figure control, which are strong influences on them to fit in and be accepted. DIF: Cognitive Level: Application REF: p. 184 TOP: Nursing Process: Assessment | Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation

13. What should a pregnant woman do to relieve nausea and vomiting during the early months of her pregnancy? a. Drink liquids with meals and have small, frequent feedings. b. Eat high-fat foods and include liquids with meals. c. Eat small, frequent meals low in fat. d. Eat three regular meals per day.

ANS: C Eating small, frequent dry meals of either carbohydrate or protein seems to reduce nausea in pregnant women. Although taking liquids between meals has been historically advised, no research has validated the suggestion. Meals high in fat tend to stay in the stomach longer, more likely promoting nausea and vomiting. The best recommendation is to eat whatever does not promote nausea and avoid odors that trigger nausea in the individual. REF: p. 270

17. Which of the following is an effect of the decreased circulation of estrogen associated with menopause? a. Increase in bone remodeling b. Increase in HDL levels c. Increase in LDL levels d. Increase in energy levels

ANS: C Estrogen has a protective effect in regard to bone and cardiovascular health. When estrogen circulation decreases, an increase is seen in LDL levels. Estrogen plays a role in bone remodeling, and with loss of estrogen, a decrease in bone mass occurs. Decreased estrogen is associated with a decrease in HDL. Symptoms of menopause include a decrease in energy level. REF: p. 358

9. Adequate folate in the periconceptional period helps prevent a. cretinism. b. mental retardation. c. neural tube defects. d. gestational diabetes.

ANS: C Folate builds mature red blood cells throughout pregnancy and is particularly needed during the early periconceptional period to ensure healthy embryonic tissue development and prevent malformation of the neural tube. DIF: Cognitive Level: Knowledge REF: p. 150 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance

19. Which nutrient is important in later adolescence to protect against birth defects in pregnancy? a. Protein b. Iron c. Folic acid d. Calcium

ANS: C Folic acid needs increase in later adolescence to support lean tissue growth and to protect against neural tube defects in pregnancy. Protein needs are based on weight and gender. Iron needs increase at the onset of menarche. Calcium needs increase to support bone and muscle growth. REF: p. 337

5. An example of community support for health promotion is a.teaching a young mother skills in safe food preparation. b.watching a television documentary about industry errors in food processing. c.labeling fresh poultry packages with information about proper food storage. d.being aware that Salmonella can be transmitted because of inadequate food preparation.

ANS: C Food labeling information is an example of community support because it is a regulatory measure that supports new health-promoting behaviors within a social context. Teaching, watching television and awareness may increase knowledge, but they do not alter the social context by regulation or environmental change. DIF:Cognitive Level: ApplyingREFage 4 TOP: Nursing Process: Implementation MSC: Client Needs: Health promotion and maintenance

22. For a mother with two children who works in health care management 60 to 70 hours a week, the biggest barrier to healthy eating is likely to be a.lack of concern for her own or her childrens health. b.inadequate income to purchase healthy foods. c.insufficient time to plan and prepare healthful meals. d.lack of knowledge about healthy eating.

ANS: C For busy professionals and families, the biggest barrier to healthy eating is usually hectic schedules and lack of time to plan and prepare healthy meals. Most mothers, especially those who work in a health care field, are concerned about their familys health. Many professional women have at least some understanding of healthy eating. With a professional job, lack of income is not very likely to be a barrier to healthy eating. DIF: Cognitive Level: Applying REF: dm 7 TOP: Nursing Process: Planning MSC: Client Needs: Health promotion and maintenance

11. The number of calories per day supplied as carbohydrate for older adults who require 2000 kcal per day should be a. 450 to 650. b. 750 to 1250. c. 900 to 1300. d. 1100 to 1450.

ANS: C For the older adult, 45% to 65% of total energy intake should be supplied as carbohydrate, with the majority being mostly complex carbohydrates: 2000 kcal divided by 45% to 65% = 900 to 1300 calories per day. DIF: Cognitive Level: Application REF: p. 191 TOP: Nursing Process: Assessment | Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance

15. Which feeding practice will avoid the development of tooth decay in infants? a. Give the infant a bottle with fruit juice at bedtime. b. Give the infant a bottle with milk at bedtime. c. Put the infant to bed without a bottle. d. Give the infant a bottle at bedtime only when he or she appears fussy.

ANS: C Giving an infant a bottle at bedtime with either milk or fruit juice allows the teeth to be bathed in the simple carbohydrate that promotes dental caries development. To promote dental health, infants should be fed and burped and then put to bed without a bottle. Also, infants and young children should be limited to 4 to 6 fl oz of juice per day. REF: p. 310

6. An example of a technique for health promotion is a.exercising five times a week. b.local supermarkets expanding the availability of fresh fruits and vegetables. c.teaching a teenager how to choose healthier foods at fast-food restaurants. d.information about the relationship of dietary intake and diet-related disorders.

ANS: C Health promotion consists of strategies that are designed improve the health of individuals, families, groups, and communities, such as teaching a teenager how to choose healthier fast foods. Exercising regularly contributes to wellness, but it is not bringing about a change in health unless this is a change in behavior. Stocking a wider availability of fresh produce does not promote health, unless the supermarket uses specific strategies to encourage consumption. Information about the relationship between nutrients and disease is simply information unless it is used to promote behavior change. DIF:Cognitive Level: ApplyingREFage 4 TOP: Nursing Process: Implementation MSC: Client Needs: Health promotion and maintenance

4. The Omnibus Reconciliation Act (OBRA) a. is aimed at assisted living facilities. b. pays for dietitian consults for those older than 65 years of age. c. is reform legislation aimed at improving skilled nursing care. d. is reform legislation aimed at congregate meal sites.

ANS: C In 1987, Congress passed OBRA to improve quality of care in skilled nursing facilities by strengthening standards. It does not apply to assisted living facilities or congregate meal sites. Although the legislation requires that nutritional assessments be done periodically, it does not directly pay for dietitian services. REF: pp. 378-379

1. Which of the following describes the growth expectations for most infants? a. The birth weight is usually regained by the end of the first month. b. Infants triple their birth weight by 6 months of age. c. Infants double their birth weight by 4 to 6 months of age. d. Infants triple their length by 3 years of age.

ANS: C Infants usually double their birth weight by 4 to 6 months of age and triple their weight by 1 year. Infants usually lose about 6% of their birth weight during the first few days postpartum, but this weight is usually regained by 7 to 10 days postpartum. REF: p. 300

7. When should the introduction of semisolid and strained foods to the infant's diet begin? a. 6 to 8 weeks b. 2 to 4 months c. 4 to 6 months d. 6 to 8 months

ANS: C Introduction of semisolid foods depends on both the infant's developmental readiness and his or her nutrient needs. To maintain iron nutriture, additional sources of iron need to be introduced into the diet by 4 to 6 months of age. However, to be able to feed an infant foods other than formula, the infant needs to be able to demonstrate head and neck control, voluntary movements of the tongue, chewing movements, and the ability to sit unsupported. REF: pp. 309-310

12. Drinking three to four cups of milk a day during pregnancy is recommended because milk is a good source of a. folate. b. iron. c. vitamin D. d. vitamin C.

ANS: C Milk is a good source of vitamin D along with calcium, phosphorus, and magnesium for fetal development of bones and teeth as well as for the mother's own bodily needs. DIF: Cognitive Level: Application REF: p. 151 TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance

11. Which of the following statements about elderly adults is FALSE? a. Among the oldest old, there are more women than men. b. More elderly men than women are married. c. Most elderly live in nursing homes. d. The life expectancy of older adults is greater than it was 100 years ago.

ANS: C Most of today's elderly adults (95%) live someplace other than a nursing home. Women tend to outlive men, so there are more women alive than men at ages 85 years and older. Because of this, there are more women available for men to marry. In 1900, the life expectancy was into the 40s. Now life expectancy is 77 years. REF: p. 378

2. Which of the following is a comorbid diagnosis associated with obesity? a. Osteoporosis b. Premenstrual syndrome c. Type 2 diabetes mellitus d. Chronic lung disease

ANS: C Obesity is associated with a number of other medical conditions, including diabetes, cardiovascular disease, and cancer. Osteoporosis is seen more often in smaller women. No evidence links obesity to an increase in the symptoms associated with premenstrual syndrome. Chronic lung disease is more associated with cigarette smoking. REF: p. 357

16. Which hormone promotes letdown? a. Colostrum b. Progesterone c. Oxytocin d. Prolactin

ANS: C Oxytocin stimulates the myoepithelial cells of the mammary gland to contract, causing milk to move toward the nipple for feeding. Progesterone promotes the development of the mammary glands during pregnancy. Prolactin promotes milk production. Colostrum is the first milk that a woman produces around term. REF: p. 286

13. Which group is at risk of not eating the RDI of nutrients and may benefit by the use of multivitamin supplements? a. Athletes b. Premenopausal women c. Those with food allergies d. Men older than age 50 years

ANS: C People with food allergies are at particular risk because they are often forced to eliminate whole food groups from their diet. Several segments of the adult population fall into high-risk groups that are unlikely to meet their nutrient needs because of life stage, alcohol or drug dependency, food insecurity, chronic illness, or choosing a restrictive diet. REF: p. 360

5. Biologic processes associated with aging may cause a. an increased metabolic rate. b. increased anxiety. c. an increased ratio of adipose to muscle tissue. d. increased kidney function.

ANS: C Physical findings associated with aging include an increased ratio of adipose to muscle tissue. As the aging process occurs, skeletal muscle mass is reduced, causing a loss of approximately 40% by age 70 years. Skeletal muscle loss is not unavoidable; it can be lessened with exercise. DIF: Cognitive Level: Application REF: p. 190 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance

17. Which of the following may cause a preschool child to eat less food at a meal? a. Providing the child with a short-handled spoon or fork. b. Providing food at a warm temperature, not too hot or cold. c. Scheduling feeding time right after play or activity. d. Serving foods so they do not touch one another on the plate.

ANS: C Preschoolers tend to not eat well when they are tired, so a short rest or quiet activity should be scheduled before feeding time. Young children eat better with reduced size utensils that are easier for them to hold. Young children avoid foods with temperature extremes, and they tend to not want to eat mixed foods or foods that touch each other on the plate. REF: p. 322

2. Increased intake of which nutrient may be required in a patient who has pressure ulcers? a. Water b. Vitamin B12 c. Protein d. Potassium

ANS: C Pressure ulcers require protein for wound healing. The amount of protein recommended depends on the stage of the pressure ulcer. Protein deficiency contributes to the development of the pressure ulcer. A multivitamin and mineral supplement is recommended, but there are no specific recommendations for increased vitamin B12 or potassium. REF: p. 372

4. The amount of extra protein required by pregnant women compared with nonpregnant women is approximately a. 10 g/day. b. 15 g/day. c. 25 g/day. d. 30 g/day.

ANS: C Protein intake should increase 25 g/day during pregnancy in addition to nonpregnancy needs. This increase is approximately 50% more than the average adult requirement. DIF: Cognitive Level: Knowledge REF: pp. 148-149 TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance

4. Effective strategies to delay the onset of type 2 diabetes include a. following a low-carbohydrate, high protein diet plan. b. taking a daily multivitamin, multimineral supplement. c. brisk walking with friends for 45 minutes most days during a lunch break. d. drinking at least 2 L water daily to maintain hydration.

ANS: C Regular exercise would be the most effective strategy to delay the onset of type 2 diabetes because it increases glucose uptake by cells independent of insulin. DIF: Cognitive Level: Application REF: pp. 196-197 TOP: Nursing Process: Diagnosis MSC: NCLEX: Physiological Integrity: Physiological Adaptation

26. Three important factors that support adequate lactation are a. diet, exercise, and vitamin supplements. b. intake of dairy products, fluids, and rest. c. diet, fluids, rest and relaxation. d. intake of bland foods and adequate fluids.

ANS: C Successful lactation requires an adequate diet, including energy and nutrients for both the process and product; adequate fluid for adequate milk production; and rest and relaxation to enhance the production and letdown reflexes of breast-feeding. DIF: Cognitive Level: Knowledge REF: pp. 158-159 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance

13. It may be advisable for an older adult to take a vitamin or mineral supplement a. daily. b. weekly. c. if he or she has been ill. d. if he or she is under stress.

ANS: C Supplements often are recommended for persons in debilitated states or who have malabsorption. DIF: Cognitive Level: Application REF: p. 192 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance

10. Which of the following is a method for rating sexual maturation? a. Periods of adolescence b. Gynecologic age c. Tanner stages d. Peak gain velocity

ANS: C Tanner stages are used to determine degree of sexual maturation during puberty. "Periods of adolescence" refers to the years in age during which cognitive and emotional development occur. Gynecologic age is a reference to the number of years between menarche and chronologic age. Peak gain velocity refers to linear growth only. REF: pp. 332-333

8. The recommended energy intake in the second and third trimesters is the sum of the energy requirement for a nonpregnant woman and a daily addition of about _____ kcal in the second and _____ kcal in the third trimesters, respectively. a. 100; 160 b. 250; 350 c. 350; 460 d. 400; 550

ANS: C The DRIs for energy needs for pregnancy add 340 to 360 kcal/day during the second trimester and another 112 kcal/day during the third trimester. These increases accommodate not only the growth of both the mother and fetus during the pregnancy but also an increase in the mother's metabolic rate. REF: p. 251

17. The Older Americans Act provides home-delivered meals for those who a. cannot afford food. b. prefer not to leave home. c. are ill or disabled. d. are malnourished.

ANS: C The Older Americans Act provides services to the elderly that include congregate and home-delivered meals with related education and food-service components. DIF: Cognitive Level: Application REF: pp. 197-198 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance

27. If a nurse wants to evaluate whether a clients vitamin or mineral supplement contains too much of a specific nutrient, the nurse should a.check the manufacturers recommendations about intake for that nutrient. b.request blood and urine tests to determine the clients body stores of that nutrient. c.compare the amount in the supplement to the tolerable upper intake level (UL) for that nutrient. d.compare the amount in the supplement to the Recommended Dietary Allowance (RDA) for that nutrient.

ANS: C The UL is the maximum intake that should not be exceeded to prevent adverse health risks; this should be compared to the amount in the supplement. The Recommended Dietary Allowance is the amount that meets the needs of most health individuals in a life-stage and gender group, but it is not the upper level for safety. Manufacturers do not necessarily provide reliable information about safety of supplements they are marketing. Blood and urine tests may or may not show whether the body is accumulating unsafe levels of a nutrient, depending on the nutrient and how long the supplement has been taken. DIF:Cognitive Level: ApplyingREFage 11 TOP:Nursing Process: Assessment| Nursing Process: Evaluation MSC:Client Needs: Physiological integrity

24. If mine workers were trapped in a mine and it took several days for a rescue team to reach them, the nutrient that they would need most in order to survive is a. protein. b.carbohydrates. c.water. d.vitamins.

ANS: C The body can survive only a few days without water. The body may not function optimally without other nutrients, but it can survive many days and even weeks without them. DIF:Cognitive Level: ApplyingREFages 8-10 TOP: Nursing Process: Assessment MSC: Client Needs: Physiological integrity= 25. The client who would benefit most from an increase in dietary fiber intake is one with a. fatigue. b.constipation. c. dehydration. d.coronary heart disease.= ANS: B Adequate dietary fiber and fluid intake can help alleviate constipation. It has a small but less significant effect in helping reduce risk of coronary heart disease. Dietary fiber intake does not affect fatigue or hydration status. DIF: Cognitive Level: Applying REF: dm 9 TOP: Nursing Process: Planning MSC: Client Needs: Health promotion and maintenance

6. Which vitamin is NOT adequately provided by breastmilk? a. Vitamin C b. Niacin c. Vitamin D d. Vitamin A

ANS: C The breastmilk of an adequately fed, lactating woman provides all vitamins except vitamin D. Human milk provides only about 0.5 mcg of vitamin D, which is one-tenth of the amount recommended by the AAP to prevent vitamin D deficiency and rickets. Supplementation with 5 mcg of vitamin D daily is recommended for breast-fed infants. REF: p. 303

16. The ideal first food for newborns is a. infant formula. b. cow's milk. c. breast milk. d. rice cereal.

ANS: C The ideal first food for newborns is breast milk because its nutrients are uniquely adapted to meet the growth needs of the infant in forms that are easily digested, absorbed, and used. DIF: Cognitive Level: Knowledge REF: pp. 176-177 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance

21. During pregnancy, women should be encouraged not to a. exercise. b. have sexual intercourse. c. drink alcoholic beverages. d. drink decaffeinated coffee.

ANS: C The ingestion of alcohol, nicotine, and recreational or other drugs can cause fetal damage and is contraindicated during pregnancy. Extensive, habitual use of alcohol leads to the well-documented fetal alcohol syndrome. DIF: Cognitive Level: Knowledge REF: pp. 154-155 TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance

11. An adequate source of iron for a breast-fed infant at 8 months of age is a. cow's milk. b. goat's milk. c. an enriched rice cereal. d. applesauce.

ANS: C The iron content of breast milk is highly absorbable and fully meets the needs of an infant for the first 6 months of life. At that point, the infant's nutritional needs for iron exceed what is provided exclusively by breast milk and the addition of puréed meats and enriched cereals after approximately 6 months of age helps supply additional iron. DIF: Cognitive Level: Application REF: p. 179 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance

5. A good source of energy for children is a. chicken. b. cereal with added sugar. c. whole-wheat toast. d. a vitamin supplement.

ANS: C The main energy source for children is carbohydrates, preferably complex carbohydrates. Carbohydrates spare protein so that it is available for building tissue during childhood rather than being broken down for energy needs. Whole-wheat toast is a good source of complex carbohydrates. Cereal also provides carbohydrates, but sugary cereals provide less complex carbohydrates. DIF: Cognitive Level: Application REF: p. 171 TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance

3. Daily kilocalorie needs during the second trimester exceed normal requirements by approximately a. 100 kcal. b. 200 kcal. c. 340 kcal. d. 500 kcal.

ANS: C The national standard recommends an increase of 340 kcal/day during the second trimester and 452 kcal/day during the third trimester of pregnancy. DIF: Cognitive Level: Knowledge REF: p. 148 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance

12. Hypervitaminosis of vitamins A or D is most likely to occur because of a. excessive milk intake. b. overexposure to the sun. c. overuse of vitamin supplements. d. inadequate intake of vegetables and fruits.

ANS: C The overuse of vitamin supplements can lead to hypervitaminosis of vitamins A or D. Excess intake may occur over prolonged periods because of ignorance, carelessness, or misunderstanding. DIF: Cognitive Level: Knowledge REF: p. 172 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance

18. A 70-kg man with a Stage 4 pressure ulcer needs ___________ g/day of protein and __________ kcal/day. a. 84; 2100 b. 70; 2800 c. 105; 2450 d. 140; 2100

ANS: C Those with Stage 4 pressure ulcers require 35 to 40 kcal/kg/day and a minimum of 1.5 g of protein per kg. In patients who are obese, these figures must be adjusted. REF: pp. 372-373

14. Endogenous toxins are a. the same as xenobiotics. b. from environmental pollutants. c. end products of metabolism. d. prebiotics.

ANS: C Toxins that are generated internally such as the end products of metabolism are known as endogenous toxins. Exogenous toxins are of external origin such as chemicals and pollutants. Prebiotics are nondigestible food products that stimulate the growth of bacteria already present in the colon. REF: pp. 360-361

4. Why are infants particularly susceptible to developing dehydration? a. Their mass-to-surface ratio is low. b. Their insulation is poor, resulting in increased water loss. c. Their renal concentrating ability is less than that of older children. d. The increased liquidity of their stools results in greater fluid loss.

ANS: C Under normal conditions, breastmilk and formula provide infants with adequate water. However, if formula is boiled, water evaporation can lead to concentration of formula solids. This places stress on the immature kidneys of the infant. This is also why providing commercially prepared adult foods to an infant could be problematic—the higher sodium concentration of these foods could exceed the infant's renal solute load. Infants should be monitored when they live in hot, humid conditions and when they have episodes of diarrhea or vomiting. Watching for the number of wet diapers is one of the ways to do this. REF: p. 301

2. A college student exercises regularly and generally eats a healthy variety of foods, is taking a course in general nutrition, buys locally produced food whenever possible, is an active member of an on-campus faith-based organization, and keeps a journal to help process her emotions. What else could be important for her to include in her life in order to develop her overall wellness? a.Growing some of her own food b.Keeping a food record to help evaluate what she eats c.Eating meals with friends throughout the week d.Meeting with a registered dietitian to review her food choices

ANS: C Wellness enhances a persons level of health through development of each of the six dimensions of health: physical health, intellectual health, emotional health, social health, spiritual health, and environmental health. Exercise and eating a health variety of foods help develop physical health; taking a course in general nutrition helps develop intellectual health; buying locally produced food helps develop environmental health; being part of a faith-based organization helps develop spiritual health; and keeping a journal helps develop emotional health. The missing dimension in this example is development of social health; eating meals with friends throughout the week would add this dimension. Growing her own food would be another example of environmental health; keeping a food record would be another contributor to physical health; and meeting with a registered dietitian may contribute to physical, intellectual, and emotional health. DIF:Cognitive Level: AnalyzingREFages 1-3 TOP: Nursing Process: Assessment MSC: Client Needs: Health promotion and maintenance

2. According to the National Academy of Sciences, women with normal preconception weight should gain how much during pregnancy? a. 10 to 15 lb b. 20 to 25 lb c. 25 to 35 lb d. 35 to 45 lb

ANS: C Women with BMIs between 18.5 and 24.9 before conception are considered to be of normal weight and are advised to gain between 25 and 35 lb during the course of the pregnancy. Underweight women who start their pregnancies with a BMI under 18.5 are advised to gain 28 to 40 lb. Women with a prepregnancy BMI of 25 to 29.9 are advised to gain 15 to 25 lb. No standard is established for women who are obese. Women giving birth to twins should gain from 40 to 45 lb during pregnancy. REF: p. 263

18. When clients have a strong family history of both heart disease and cancer, the nurse should encourage them to reduce their intake of a.dietary fiber. b.protein. c.monounsaturated fat. d.saturated fat.

ANS: D Saturated fat intake is related to risk of heart disease and certain types of cancer. Monounsaturated fat intake has less effect on risk of these diseases. Dietary fiber intake should be increased to help reduce risk of cardiovascular disease and cancer. The effects of protein intake on risk of these diseases are much less significant. DIF: Cognitive Level: Applying REF: dm 9 TOP: Nursing Process: Planning MSC:Client Needs: Physiological integrity

10. A supercentenarian is a. a woman who is currently 65 years of age who is expected to live to be 100 years old. b. someone born today who can expect to live to be 100 years old or older. c. someone who is 100 years old or older with no disease. d. someone older than 110 years.

ANS: D A supercentenarian is a new group of individuals identified to be older than 110 years of age. This population is now big enough to warrant research. REF: p. 369

9. Who may benefit the most from the light to moderate intake of alcohol in reducing the risk of cardiovascular disease? a. Men in their late 30s b. Women in their 20s c. Women in their late 40s d. Men in their late 40s

ANS: D According to the Dietary Guidelines for Americans, men older than 45 years of age and women older than 55 years of age receive the most benefit from limited alcohol intake. Among younger adults, the benefit of reducing risk of cardiovascular disease is offset by the increased risk of accidents resulting from alcohol abuse. REF: p. 352

13. Which of the following theories of aging is an accumulated damage theory? a. Rate of living theory b. Pacemaker theory c. Immune system theory d. Cross-link theory

ANS: D Accumulated damage theories describe aging as a process in which the body's systems break down over time because of damage. The cross-link theory is one of these because it describes aging changes as results of inappropriate cross-links in protein, DNA, and structural molecules that inhibit the normal functions of the body. Predetermination theories of aging focus on a built-in mechanism that determines when aging and death will occur. Rate of living, pacemaker (or biologic clock), and immune system theory all focus on predetermined programming that leads to aging. REF: p. 369

2. A pregnant woman's energy needs must be met in order to a. spare vitamins. b. spare adipose stores. c. prevent fetal deformity. d. spare protein.

ANS: D Adequate energy is necessary to spare protein. If inadequate kilocalories from energy are provided, then protein will be used for energy. Protein increase is approximately 50% more than the average adult requirement. DIF: Cognitive Level: Knowledge REF: p. 147 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance

16. Which of the following is NOT associated with impaired academic performance in children? a. Iron deficiency b. Food insecurity c. Skipping breakfast d. Bringing lunch from home

ANS: D Although lunches brought from home tend to provide fewer nutrients and less variety than those served in school, they do provide school age children with some nutritional value. Children in poverty tend to be more likely to experience iron deficiency, food insecurity, and skipping of meals. These each have been demonstrated to result in poor performance in regard to academic skill development. The School Breakfast Program provides a means to ensure that children from families with lower incomes have the opportunity for a nutritious breakfast before the school day. REF: p. 323

7. How do the dietary recommendations for breastfeeding mothers differ from those for pregnant women? a. Intake of all nutrients is the same as preconception intake for lactating women. b. The intake level during lactation should be severely restricted to promote weight loss. c. Fluids are forced for pregnant women and limited during lactation. d. Intake of almost all nutrients is needed at higher levels during lactation.

ANS: D Although nutrient needs are increased during both pregnancy and lactation above those of women before conception, lactation needs are greater when women must produce breastmilk, the sole source of food for the infant. Women expend 85 kcal for every 100 ml of milk they produce, and the nutritional profile of the milk reflects their nutritional status. Therefore, for the assured health of the infant, breastfeeding mothers have to continue to maintain and replete their nutritional stores. REF: p. 283

8. What is the most accurate means for determining the energy requirements (EER) of a child? a. Based on growth rate b. Based on age and height c. Based on age d. Based on calories per kilogram

ANS: D Although the EER equations for children older than 3 years of age include age, weight, and height as factors, for children between 13 and 35 months of age, the EER equation only includes the weight factor. The growth rate is highly variable throughout childhood, so it should not be used as a base factor for determination of energy needs. Children vary in weight, height, and body size at any age, which is the basis for the development of growth charts. Because of this variation, age should not be used as the sole base factor for determining energy needs. Calorie needs can be determined on a per centimeter of height basis, but this is independent of the child's age. REF: p. 316

6. During childhood, most calories are needed for a. tissue growth. b. physical activities. c. specific dynamic effect. d. basal metabolic needs.

ANS: D Basal metabolism accounts for 50% of total daily caloric intake during childhood. DIF: Cognitive Level: Knowledge REF: p. 171 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance

13. Which factor has NOT been associated with failure to thrive? a. Food restriction caused by parental concerns about obesity b. Inadequate fiber intake c. Excessive fruit juice intake d. Providing small, frequent meals

ANS: D Because of children's small stomach size and variability in hunger sensation, providing small, frequent meals with age-appropriate, nutrient-dense foods promotes a child's intake of foods. Lack of appetite and inappropriate feeding practices contribute to failure to thrive. Parents may inappropriately restrict foods or amounts of food out of fear their children will develop obesity or other chronic diseases. Inadequate fiber intake is associated with constipation development, which can impair a child's appetite. Excessive fruit juice intake replaces calories from other nutrient-dense foods and limits intake of nutrients necessary for growth, such as protein. REF: p. 326

17. What nutrient does the American Academy of Pediatricians (AAP) recommend to be supplemented at 2 months of age for breast-fed infants, although the DRI for the nutrient in lactating women is at the same level as that in nonpregnant women? a. Vitamin A b. Calcium c. Zinc d. Vitamin D

ANS: D Because of reports of clinical rickets, the AAP recommends an additional 5 mcg of vitamin D daily for infants, starting at 2 months of age. The vitamin A status of the breastfeeding mother may affect the infant, but the DRIs have an increased value for vitamin A intake of lactating women. The DRIs for zinc are also increased for lactation. The calcium content of breastmilk is not related to the calcium intake of women, so the DRIs for calcium do not increase during lactation. REF: p. 258

5. An adolescent female of gynecologic age of 3 years becomes pregnant. Her prepregnancy BMI was 19.0. According to the IOM, how much weight should she try to gain during her pregnancy? a. 15 lb b. Up to 25 lb c. Up to 35 lb d. Up to 40 lb

ANS: D Before her pregnancy, this girl's BMI would be interpreted as underweight; therefore, she should attempt to gain from 28 to 40 lb, with a goal toward the upper part of the range. A BMI over 29 would require a weight gain of 15 lb. For a BMI between 26.1 and 29, the goal would be the upper end of the 15- to 25-lb range. For a normal BMI of 19.8 to 26, the goal would be the upper end of the 25- to 35-lb range. REF: p. 348

12. How is hypertension diagnosed in adolescents? a. Blood pressure of 130/85 mm Hg b. Blood pressure of 140/90 mm Hg c. Blood pressure of 160/100 mm Hg d. Average of three blood pressure readings that exceed the 95th percentile

ANS: D Blood pressure levels are different between adults and adolescents; therefore, a different set of standards is used for adolescents. Percentile charts are available that report blood pressures based on age, gender, and height. These standards should be used to determine hypertension in an adolescent as opposed to applying adult standards. REF: p. 346

20. How can an adolescent plan a vegetarian diet that is in line with the DRIs and Dietary Guidelines for Americans? a. By focusing on a vegan diet b. By ensuring adequate legumes, nuts, and whole grains c. By including fish d. By including eggs and dairy foods

ANS: D By including eggs and dairy foods, a vegetarian can be assured that the diet includes adequate vitamin B12, calcium, and vitamin D. Diets that do not include these foods tend to be inadequate in these nutrients as well as zinc and iron. Unless the bones are eaten with the fish, which is not common across all cultures, only adding fish will not provide adequate calcium in the diet. REF: p. 341

3. Why does constipation occur in elderly adults? a. Increased motility in the small intestine b. Decreased motility in the small intestine c. Increased motility in the large intestine d. Decreased motility in the large intestine

ANS: D Constipation involves a reduction of bowel movements, and one potential reason is a decrease in the motility in the large intestine. The longer intestinal contents remain in the colon, the more water is absorbed and the harder the stool is to transit and eliminate. Delayed transit time, medications, and reduced stimulation of the gut through reduced physical activity all contribute to the development of constipation. REF: p. 371

16. Why should whole cow's milk NOT be given to infants younger than 1 year of age? a. It decreases the renal solute load. b. It can lead to obesity in toddlers. c. It lacks the anti-infective quality of formulas. d. It is associated with lower intakes of iron and linoleic acid.

ANS: D Cow's milk is a poor source of both iron and linoleic acid. Protein and other nutrients in cow's milk increase the renal solute load, placing stress on the infant's kidneys. Also, the protein in cow's milk may cause gastrointestinal bleeding in the infant, promoting an increased need for iron. Use of whole milk for feeding young children has not been demonstrated to promote obesity. REF: p. 303

22. Failure to thrive may be caused by a. early sitting and crawling. b. sleeping with a bottle. c. overuse of vitamin supplements. d. overdilution of formula.

ANS: D Diluting formula provides fluid without adequate nutrients. DIF: Cognitive Level: Knowledge REF: p. 181 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation

11. In early adolescence, which of the following is most likely to be a concern to the adolescent? a. Independence b. The future c. Trusting adults d. Body image

ANS: D During the early adolescence period, adolescents are concerned with their body size, shape, and image. Seeking increased independence and trusting in adults decreases during middle adolescence. Future orientation is characteristic of late adolescence. REF: p. 340

4. During a checkup at the clinic, a child's physical growth is evaluated by using a. fitness testing. b. clinical observation. c. food records. d. growth charts.

ANS: D Growth charts are an assessment tool for measuring normal growth patterns in infants, children, and adolescents. These charts are based on large numbers of well-nourished children representing the national population. DIF: Cognitive Level: Knowledge REF: p. 167 TOP: Nursing Process: Assessment | Nursing Process: Evaluation MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance

3. Why should honey NOT be used in home-prepared formulas for infants? a. The added sweetener will cause the infant to crave sweets. b. The sugars present cannot be digested by the infant. c. The honey will settle out in the formula and cause a curdled appearance. d. The infant has no immunity to the botulism spore that may be present.

ANS: D Honey may be a carrier of Clostridium botulinum spores, which can reproduce and make toxins that can cause death. The spores are resistant to heat treatment and are not destroyed by current processing methods. Infants are born with a preferential taste for sweets; therefore, providing sweet foods will not necessarily exert a craving for more. The simple carbohydrates in honey are digestible by infants. Only water, breastmilk, and rice cereal should be mixed with infant formula—nothing else. REF: p. 302

18. Which of the following can promote failure to thrive in a breast-fed infant as a result of poor milk production? a. Poor latching or suck during the feeding episode b. Small for gestational age infant c. Maternal smoking d. Maternal illness

ANS: D Illness in a breastfeeding mother diverts energy stores away from adequate milk production. Smoking is a factor that can interfere with the letdown reflex, impairing milk flow. Failure to thrive because of poor intake is commonly associated with improper breastfeeding technique and poor suck on the part of the infant. An infant who is small for gestational age may develop failure to thrive because of his or her increased energy needs but limited size to handle increased food intake. REF: p. 283

2. Food insecure families in the United States a. contribute to poor outcomes in children. b. are associated with inadequate iron intake in children 3 years and under. c. are served by SNAP, WIC, and school lunch. d. all of the above.

ANS: D In 2013 in the United States, 11% of households experienced food insecurity. Federal food assistance programs provided services to about 60% of them. Food insecurity is associated with poor outcomes in children. It increases the risk of iron deficiency anemia in children 3 years and under. REF: p. 320

15. The leading cause of death and debilitation among adults in the United States is a. accidents. b. cancer. c. diabetes. d. heart disease.

ANS: D In the United States, the leading causes of death and debilitation among adults are (1) heart disease, (2) cancer, (3) cerebrovascular accident, (4) chronic lower respiratory disease, and (5) accidents. REF: p. 357

7. A good source of iron during pregnancy would be a. watermelon. b. orange juice. c. macaroni and cheese. d. lean ground beef.

ANS: D Iron is distributed primarily in meat, eggs, vegetables, and fortified cereals. DIF: Cognitive Level: Knowledge REF: p. 150 TOP: Nursing Process: Application MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance

6. For managing leg cramps in pregnancy, which of the following minerals has the most scientific support for its use? a. Manganese b. Potassium c. Calcium d. Magnesium

ANS: D Magnesium lactate or citrate supplementation is suggested to relieve potential magnesium deficiencies that may occur with pregnancy and lactation. Leg cramps are one sign of this deficiency. Calcium has also been investigated; however, supplementation to treat leg cramps has not been demonstrated. Manganese and potassium have not been investigated in this regard. REF: p. 262

9. For a breast-fed infant, which nutrient(s) should be the earliest to be supplemented? a. Fluoride and vitamin D b. Iron and magnesium c. Vitamin C d. Vitamin K

ANS: D Most states require that infants receive a vitamin K injection soon after birth to prevent hemorrhagic disease of the newborn. This is more common among breast-fed infants than formula-fed infants because the vitamin K content is not adequate during the first week. Fluoride and iron supplementation is recommended after 6 months of age. Vitamin D supplementation is recommended daily but may be accommodated by providing the infant with adequate sun exposure. REF: p. 304

10. Several vitamins are required in greater amounts during pregnancy because a. fetal demands for the vitamins are high. b. more hemoglobin is synthesized. c. the vitamins are excreted in greater quantities. d. metabolic activities increase.

ANS: D Most vitamins are needed in increased amounts because of their vital role as coenzyme factors in energy production and protein metabolism. DIF: Cognitive Level: Comprehension REF: p. 150 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance

11. A nutrient that can be made by the body is called a. essential. b.complete. c. incomplete. d.nonessential.

ANS: D Nonessential nutrients can be made by the body. Essential nutrients cannot be made by the body and must be consumed. The terms complete and incomplete refer to proteins. Complete proteins contain all the essential amino acids; incomplete proteins are lacking one or more essential amino acids. DIF:Cognitive Level: RememberingREFages 8-9 TOP: Nursing Process: Assessment MSC: Client Needs: Physiological integrity

18. Stage 1 of obesity in adolescence should be treated with: a. structured meal plans and a multidisciplinary health team. b. a diet and recording of food intake and activity. c. a vegan diet and exercise. d. general education on diet and exercise.

ANS: D Overweight adolescents start out at Stage 1 and need only general information without a lot of restrictions. Stage 2 adds the component of food monitoring. A very structured meal plan and multidisciplinary medical team is indicated in the severely overweight at Stage 4. Vegan diets can be dangerous because of their very restrictive nature. REF: p. 344

3. For a client who is missing meals because of poor planning or is too busy to eat, emotional health can be affected by _____, which can cause confusion or anxiety. a.low blood sugar levels b.high blood sugar levels c.high blood pressure d.extremely low blood pressure

ANS: D Poor eating habits affect emotional health. Missing meals may cause blood sugar levels to decrease, which can cause anxiety or confusion or make it difficult to control emotions. Late night binges on snack food are likely to result in excessive energy intake but would have a less direct effect on emotional health. Eating small meals throughout the day is likely to maintain more constant blood sugar levels, which would actually have a positive effect on emotional health. Excessive caffeine consumption may contribute to anxiety, but 2 cups of caffeinated coffee is not considered excessive. DIF:Cognitive Level: AnalyzingREFage 2 TOP: Nursing Process: Assessment MSC: Client Needs: Psychosocial integrity

28. Why is it difficult to specify the number of grams of protein that he or she should eat each day? a.More research studies are needed to help determine ideal levels of protein intake for various age and gender groups. b.Health care professionals should not give specific advice to clients, to avoid lawsuits. c.It is unrealistic to expect clients to meet precise levels of protein intake. d.Recommended protein intakes are expressed as a range and are based on a percentage of energy intake, which varies between individuals.

ANS: D Protein intake does not need to be precise and can be within an acceptable range, expressed as a percentage of energy intake. Health care professionals should not give unnecessarily precise advice, but they can give scientifically based advice without concern for lawsuits. A reasonable amount of research has been conducted to be able to give at least general advice about protein intake. The likelihood that clients will achieve a specific protein intake is not related to the difficulty in identifying what their intake level should be. DIF:Cognitive Level: AnalyzingREFages 8-9 | dm 11 TOP: Nursing Process: Assessment MSC: Client Needs: Physiological integrity

13. Appropriate snack choices for a pregnant woman with morning sickness may include a. a meal of hot soup and Gatorade. b. lemonade with added sugar and peppermint sticks. c. a glass of hot, decaffeinated tea. d. whole-wheat toast with a small amount of light butter and a small piece of fruit.

ANS: D Small, frequent meals and snacks that are fairly dry and consist of easily digested energy foods (e.g., carbohydrates), in addition to mainly cold foods and liquids between meals, are recommended for women with morning sickness. DIF: Cognitive Level: Application REF: pp. 152-153 TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance

19. The 2010 health care reform legislation expands Medicare to include a. an annual wellness visit. b. education and counseling. c. expanded coverage for reimbursement for dietitians. d. all of the above.

ANS: D The 2010 health care reform legislation changed Medicare to include an annual wellness visit and a personalized prevention assessment. Prevention services include referrals to education and preventive counseling or community-based interventions to address risk factors. It also expands medical nutrition therapy reimbursement for registered dietitians to cover therapy considered reasonable and necessary for the prevention of illness and disability. REF: p. 377

17. Which nutrient is required in higher amounts by women after menarche? a. Zinc b. Folic acid c. Calcium d. Iron

ANS: D The DRI for iron among females increases from 8 mg/day before the onset of menses to 15 mg/day after the onset of menses. Among adolescent males, recommended intakes increase from 8 to 11 mg/day, with higher levels required during the growth spurt. REF: p. 337

8. The role of nutrition and dietetic professionals in the adult years involves a. addressing the role of nutrition in the leading causes of death and debility. b. incorporating basic education on food access, selection, and preparation. c. setting mutually acceptable, achievable goals for optimal performance and health. d. all of the above.

ANS: D The adult years offer opportunities for prevention as well as intervention. It is critical for the dietetic professional to consider how to assess clients and group needs and be able to address the total picture of optimal health. REF: p. 359

28. Advantages of breast-feeding for the mother include a. less fluid retention. b. rapid weight loss. c. fewer maternal infections. d. convenience and economy.

ANS: D The advantages of breast-feeding include benefits to both mother and baby such as human breast milk's ability to meet the unique needs of the infant and the convenience and economy for the mother. DIF: Cognitive Level: Knowledge REF: pp. 158-159 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance

11. Which of the following is NOT one of the defining characteristics of metabolic syndrome? a. Abdominal obesity b. Hypertension c. Elevated blood lipids d. Physical inactivity

ANS: D The metabolic syndrome is diagnosed through the identification of three of the five following factors: abdominal obesity, high blood pressure, high blood triglycerides, low HDL, and elevated blood glucose. Although physical inactivity can contribute to the development of these factors, it is not one of the defining characteristics of metabolic syndrome. REF: p. 357

24. Factors that influence the nutrition needs of young adults include a. growth. b. climate. c. personality type. d. physical activity.

ANS: D The nutrition needs of young adults are influenced by physical activity as well as other conditions such as pregnancy. DIF: Cognitive Level: Knowledge REF: p. 196 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance

9. What advice should be given to a pregnant woman about eating fish? a. They should eat only vegetable sources of omega-3 fat. b. There is no specific recommendations about fish. c. They should eat two or three servings of fish per week. d. They should eat two or three servings of low-mercury fish per week.

ANS: D There are specific recommendations for DHA intake during pregnancy. The main food source is fatty, cold-water fish, but many of these sources have high levels of mercury. It is recommended that pregnant women eat two or three servings per week of low-mercury fish such as sardines. Vegetable sources of omega-3 fat are not as efficient sources as fish. REF: p. 271 | pp. 274-275

10. As a home health care nurse, you are visiting a 70-year-old client who has just returned home from the hospital after being treated for coronary artery disease. The medical nutrition therapy developed for him by the hospital dietitian is considered a.palliative care. b.primary prevention. c.secondary prevention. d.tertiary prevention.

ANS: D This is an example of tertiary prevention, which entails minimizing complications and helping restore health after heart disease has developed. Primary prevention would occur before the disease developed, and secondary prevention would involve early detection to minimize the effects of the disease. Palliative care is intended only to minimize symptoms. DIF: Cognitive Level: Applying REF: Pages 5-6 TOP: Nursing Process: Planning MSC: Client Needs: Health promotion and maintenance

16. An acceptable ending pregnancy weight for a woman whose prepregnancy weight is 125 lb is a. 130 to 135 lb. b. 135 to 145 lb. c. 145 to 150 lb. d. 150 to 160 lb.

ANS: D Weight gain for a normal-sized woman with a body mass index of 18.5 to 24.9 is 25 to 35 lb. Thus 125 lb + 25 to 35 lb = 150 lb to 160 lb. DIF: Cognitive Level: Application REF: p. 152 TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance

11. How can a new mom be sure that the baby is getting enough if she is breastfeeding only? -

Answer (key points): The best indicators of adequate milk production are infant weight gain and frequency of wet diapers. Parents should expect 4-5 heavy diaper changes per day. Often during the first six months, infants have very small stomachs and can only consume small amounts of milk at each feeding, so moms may be breastfeeding as often as every two to three hours. Infants should be allowed to nurse on demand. It is expected that newborns will nurse at least 8-12 times each day. (pp. 602-603)

4. The placenta develops early in pregnancy but it takes several weeks before it is fully functional. What is its function? -

Answer (key points): The placenta weighs between 1-2 pounds at term. It is a highly vascularized structure and has many important functions. The placenta transfers nutrients, hormones, oxygen, and other substances from mom to baby. In exchange, the placenta removes metabolic wastes from the fetus and allows passage back into the mother's blood for excretion by the mother's lungs and kidneys. The placenta is also a source of several hormones that serve a variety of functions during pregnancy. (p. 589)

T 617 -

T/F 16. It is recommended that children between the ages of 2 and 8 years consume 2 cups of low-fat milk or equivalent milk products each day.

T 619 -

T/F 17. During adolescence, males experience an increase in lean mass and a relative decrease in body fat, whereas females undergo a decrease in lean mass relative to body fat.

19. Outline the physiological changes that occur as part of aging and discuss their impact on nutritional status. -

Answer (key points): As the aging process occurs, lean muscle mass decreases, BMR decreases, and fat mass increases. Older adults need to reduce energy intake or increase activity level, or weight gain will occur. Age-related bone loss can make bones fragile. Older adults need adequate amounts of protein, calcium, vitamin D, phosphorus, and magnesium. GI motility slows and absorption may be an issue due to the decrease in gastric secretions. They may have impaired absorption of iron, calcium, biotin, folate, vitamin B12, and zinc. They also may have issues with constipation due to decreased motility, so they need to increase fiber. Thirst sensation may be blunted, so older adults need to be sure to achieve an adequate intake of fluids—even more so if increasing fiber. Adequacy of food intake can be impacted by changes in taste, smell, and the ability to chew/ swallow or self-feed. Finally, multiple medications can cause nutrient-drug interactions that can impact nutritional status. (pp. 624-628)

6. How does the developmental origins of health and disease hypothesis relate to chronic disease? -

Answer (key points): Evidence suggests that if less than optimum conditions existed in the womb, there may be permanent changes in the structure and/or function of organs/tissues that will predispose individuals to certain chronic diseases later in life. (pp. 591-592, 593)

14. Why is fluoride an important part of an infant's diet, and what are the current recommendations regarding need for supplementation? -

Answer (key points): Fluoride is needed to form teeth and can help prevent dental caries later in life. Parents need to check to see if local water supply is fluoridated. If not, then fluoride supplementation is recommended. The recommended dosage for fluoride is 0.25 mg/day for children between 6 months and 3 years of age. (p. 610)

5. What are two important predictors of infant health? -

Answer (key points): Gestational age and birth weight are important predictors of infant health. Premature births and low birth weights are the leading causes of infant mortality. LBW infants are 40x more likely to die in the first year of life as compared to normal-weight infants. In 2008, 12% of babies born in the U.S. were premature and 8% were LBW. (p. 591)

8. Why is breastfeeding the ideal method for nourishing babies? -

Answer (key points): Human milk is ideal to support optimal growth and development during infancy and early childhood. Evidence shows that early feeding experiences may influence later stages of life. Human milk provides immunologic protection against pathogenic viruses and bacteria. Breastfed babies get less sick than formula-fed babies. (pp. 603-604)

7. Outline the physiological changes that pregnant woman experience and relate how these changes affect nutrient requirements. -

Answer (key points): Increased energy needs to support growth of the fetus, placenta, and maternal tissue: 348 kcal/day during the second trimester and 452 kcal/day during the third trimester. Carbohydrates need to remain the major energy source with a minimum of 175 g of CHO per day (additional 2-3 servings of carbohydrates per day). Protein needs are increased by 25 grams per day for the formation of fetal and maternal tissues. Dietary fat should provide 20 to 35% of kcalories with particular attention to ensuring adequacy of essential fatty acids, DHA (required for brain development and formation of retinas in fetus), and EPA (fetal growth and development). Additional calcium is needed for growth and development, but if it is not provided in the diet, the mother's stores can provide it. Increased iron is needed for forming hemoglobin and promoting growth and development of the fetus and placenta. Increased folate is needed for cell division and critical for development of the nervous system of the fetus. (pp. 595-598)

12. How are energy and nutrient requirements determined during lactation? -

Answer (key points): It depends on whether the mother is exclusively breastfeeding or feeding a combination of human milk and formula. If breastfeeding only, she will need 500 kcal extra per day (minus ~170 kcal available from fat stores = 330 kcal) for the first 6 months and 400 kcal/day for the second 6 months. Recommendations for micronutrients are similar to those during pregnancy, although vitamin A requirements during lactation are greater and folate requirements are a bit reduced. Vitamin C is of interest because large amounts of vitamin C are secreted in milk and thus the RDA increases to 120 mg/day during lactation. Inadequate fluid intake can decrease milk volume; thus, fluid needs for lactating women are 13 cups per day. (pp. 604-605)

17. What role do the parents play in developing healthy eating behaviors in their children? What role does the child play? -

Answer (key points): Most experts agree that parents should provide nutritious, age-appropriate foods and foster a healthy relationship between their child and food. It is the child's responsibility to determine if he or she eats and how much. In order for parents to make mealtimes pleasant and foster a healthy relationship between their child and food, they should: (1) avoid using food to control behavior, (2) model good eating habits, (3) be patient (4) Introduce new foods gradually, (5) Encourage nutritious snacking, and (6) Promote self-regulation. (pp. 613-614, 616)

18. Why are older adults considered "at risk" for developing many nutrition-related health problems? -

Answer (key points): Older adults are "at risk" because food insecurity, social isolation, depression, illness, and multiple medications are all factors that can compromise nutritional status. In addition, the physiological changes associated with aging can affect nutrient use as well. (pp. 623-628)

3. What are teratogens? Provide an example of a common teratogen and the overall affects of exposure. -

Answer (key points): Teratogens are a broad group of environmental agents such as chemicals, drugs, infections, and/or radiation that negatively affect the normal course of cell growth and development in an unborn child. Fetal alcohol syndrome (FAS) or fetal alcohol effect (FAE) are the results of exposure to one of the most familiar teratogens, alcohol during pregnancy. FAS results in a small head circumference, unusual facial characteristics, and other physical deformities. Many infants are developmentally delayed. FAE is characterized by learning and behavior problems that are unfortunately not apparent until later in life. (pp. 588-589)

9. Pregnant women who are vegans are at higher risk for certain vitamin and mineral deficiencies. Identify the vitamins and minerals of concern and provide recommendations for how these vitamins and minerals could be obtained through food. -

Answer (key points): Vegans who become pregnant need to be concerned with getting adequate amounts of vitamin B12, vitamin B6, iron, calcium, and zinc because they've eliminated all foods of animal origin. These nutrients can be "made up" by including additional servings of grains, legumes, nuts, and calcium-fortified foods such as tofu and soy milk. B12 can be added to the diet via fortified cereal or nutritional yeast. (p. 597)

13. Several cases of rickets in breastfed infants have been reported nationwide in recent years. What is the cause, and how can this be prevented from becoming a more widespread problem? -

Answer (key points): Women with low sun exposure due to such factors as skin color, cloud cover, smog, and/or use of sunscreen may have low concentrations of vitamin D in their breast milk. In the U.S., in recent years, several cases of rickets in breastfed infants have been reported. The AAP recommends that breastfed infants and formula-fed infants consuming less than 16 oz. of infant formula daily receive vitamin D supplements (400 IU/day) beginning the first few days of life. (p. 609-610)

T 622 -

T/F 18. The branch of science and medicine dedicated to the social, behavioral, psychological, and health issues of aging is called gerontology.

T 626 -

T/F 19. As an alternative to hormone replacement therapy, some women find that consuming foods made from soybeans is helpful because soybeans contain isoflavones that are structurally similar to estrogen.

F 588 -

T/F 2. A teratogen is an environmental agent that positively embraces normal growth and development.

F 627 -

T/F 20. With age, the sensation of thirst is not affected.

7. _______________ is an inflammation of the mucosal membrane lining the stomach that can reduce the number of cells that produce gastric secretions. -

Answer: Atrophic gastritis (p. 627)

8. At the age of 85, Mrs. Ferdinand began to experience a loss of appetite known as _______________ that led to her weight loss and overall physiological decline. -

Answer: anorexia of aging (p. 627)

6. The first time a female menstruates is referred to as _______________. -

Answer: menarche (p. 618)

5. A desire to consume nonfood substances such as laundry starch, clay, soil, or burnt matches is termed _______________. -

Answer: pica (p. 599)

2. The _______________, an organ made up of fetal and maternal tissue, supplies nutrients and oxygen to the fetus. -

Answer: placenta (p. 589)

3. The pituitary gland produces the hormone _______________, which stimulates the production of milk in alveoli. -

Answer: prolactin (p. 602)

T 591-592 -

T/F 3. The developmental origins hypothesis is a theory suggesting that conditions during gestational development can alter risk for chronic diseases later in life.

T 594 -

T/F 4. Normal-weight women (prepregnancy BMI between 18.5 and 24.9 kg/m2) should gain 25 to 35 pounds during pregnancy.

F 594 -

T/F 5. Overweight women (prepregnancy BMI 25.0 to 29.0 kg/m2) are encouraged to gain between 5 and 15 pounds during pregnancy.

T 596 -

T/F 6. The energy demands of pregnancy are about 60,000 kcal over the course of pregnancy.

T 597 -

T/F 7. The recommended intake for iron increases substantially during pregnancy.

T 598 -

T/F 8. Women with poor folate status in early pregnancy are at increased risk of having a baby with a neural tube defect.

T 598 -

T/F 9. Smoking increases the risk of premature detachment of the placenta.

Measuring __________________ is to measure brain growth indirectly. - -

head circumference Studyforxyz FUNDAMENTALS PRINCIPLES OF NUTRITION

Your client is a 24-year-old female who recently gave birth to a two-week old baby girl. She feels overwhelmed with the baby crying often, she is sleep deprived. How can she best tell her baby is hungry? Choose from: -infants brings hands to mouth, sucks on them, and moves head side to side -infant moves head side to side -infants brings hands to breast -infants brings hands to breast and moves side to side - - -

infants brings hands to mouth, sucks on them, and moves head side to side Studyforxyz FUNDAMENTALS PRINCIPLES OF NUTRITION

Placental function depends on what nutrients? - -

iron, vit C, E, B12, Zn, Se, Cu, omega 3 and folate Studyforxyz FUNDAMENTALS PRINCIPLES OF NUTRITION

Infants born preterm are at risk for death, neurological problems, congenital malformations, and chronic health problems later in life. At what week is it considered preterm? Choose from 39 weeks less than 37 weeks 37 weeks less than 40 weeks - -

less than 37 weeks Studyforxyz FUNDAMENTALS PRINCIPLES OF NUTRITION

Human breastmilk has a high content of ____ and ____ fatty acid content. Choose from -palmitic and linoleic -linoleic and lauric -arachidonic and oleic -palmitic and oleic - -

palmitic and oleic Studyforxyz FUNDAMENTALS PRINCIPLES OF NUTRITION

A pregnant woman read about the benefits of DHA during pregnancy and wants to add more DHA-rich foods into her diet. She doesn't like salmon and is concerned about eating too much fish that will increase risk of mercury toxicity. You recommend that she consume any of the following except: Choose one caviar tilefish mackerel tilapia - -

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