study questions

a client who has eaten too many dietetic candies sweetened with sorbitol may experience which of the following? 1. diarrhea 2. heartburn 3. vomiting 4. low blood glucose

1

a client with hyperlipidemia is prescribed niacin. the client asks if he can just include more niacin rich foods in his diet and forgo the need for niacin in pill form. Which of the following would be the nurses best response? 1. the dose of niacin needed to treat hyperlipidemia is far more than. an be consumed through eating niacin rich diet 2. you cant get the therapeutic form of niacin through food 3. niacin from food is not well absorbed as niacin from pills 4. if you are able to consistently choose niacin fortified foods in your diet, you doctor may allow you to forgo the pills and rely on dietary resources of niacin

1

nurses are in an ideal position to 1. screen patients for risk of malnutrition 2. order therapeutic diets 3. conduct nutrition assessments 4.calculate a patients calorie and protein needs

1

when developing a teaching plan for a client who is lactose intolerant, which of the following foods would the nurse suggest as sources of calcium the client could tolerate? 1. cheddar cheese, bok choy, broccoli 2. spinach, beet greens, skim milk 3. poultry, meat, eggs 4. whole grains, nuts and cocoa

1

when developing a teaching plan for a client who is lactose intolerant, which of the following foods would the nurse suggest as sources of calcium the client could tolerate? 1. cheddar cheese, bok choy, broccoli 2. spinach, beet greens, skim milk 3. pultry, meat, eggs 4. whole grains, nuts and cocoa

1

which of the following recommendations would be most effective at helping a client maximize iron absorption? 1. drink orange juice when you eat iron fortified breakfast cereal 2. avoid drinkin coffee when you eat red meat 3. drink milk w all meals 4. eat dried peas and beans in place of red meat

1

which of the following recommendations would be most effective at helping a client maximize iron absorption? 1. drink orange juice when you eat iron fortified breakfast cereal 2.avoid drinking coffee when you eat red meat 3. drink milk w/ all meals 4. eat dried peas and beans in place of red meats

1

which of the following recommendations would be most effective for someone wanting to eat more fiber? 1. eat legumes more often 2. eat raw veggies in place of cooked ones 3. use potatoes in place of white rice 4. eat fruit for dessert in place of ice cream

1

which of the following statements regarding nutrition screening is false? 1. a nutrition screening is completed only when a patient is suspected of having a nutritional problem 2. a nutrition screen must be completed within 24 hours after admission to the hospital or other health care facility 3. the purpose of nutrition screening is to detect actual or potential malnutrition 4. health-care facilities are free to choose their own screening and to determine how quickly a patient must be rescreened

1

a client asks why sugar should be limited in the diet. which of the following is the nurse's best response? 1. a high sugar intake increases risk of heart disease 2. foods high in sugar generally provide few nutrients other than calories and may make it hard to consume a diet that has enough of all essential nutrients 3. there is a direct correlation b/t sugar intake and risk of obesity 4. sugar provides more calories per gram than starch, protein or fat

2

a healthy young adult client asks how much water he should drink daily. which of the following would be the nurse's best response? 1. the old adage is true: drink 8 oz glasses of water daily 2. drink to satisfy thirst and you will consume adequate fluid 3. you cant overconsume water, so drink as much as you can spread out over the course of the day 4. it is actually not necessary to drink water at all. it is equally healthy to meet your fluid requirement with sugar free soft drinks

2

a healthy young adult client asks how much water he should drink daily. which of the following would be the nurse's best response? 1. the old adage is true: drink eight 8oz glasses of water daily 2. drink to satisfy thirst and you will consume adequate fluid 3. you can't overcome water, so drink as much as you can spread out over the course of the day 4. it is actually not necessary to drink water at all.

2

the client asks if taking supplements of beta-carotene will help reduce the risk of cancer. which of the following would be the nurse's best response? 1supplements of beta-carotene may help reduce the risk of heart disease but not cancer 2. supplements of beta-carotene have not been shown to lower the risk of cancer and may even promote cancer in certain people 3. although evidence is preliminary, taking supplements of beta-carotene is safe and may prove to be effective against cancer in the future 4. natural supplements of beta-carotene are generally harmless; synthetic supplements of beta-carotene may increase cancer risk and should be avoided

2

when developing a teaching plan for a client who is on warfarin (coumadin), which of the following foods would the nurse suggest the client consume a consistent intake of b/c of their vitamin K content? 1. liver, milk, eggs 2. brussel sprouts, cauliflower and spinach 3. fortigies cereals, whole grains, nuts 4. dried peas and beans, wheat germ, seeds

2

which of the following criteria would most likely be on a nutrition screen in the hospital? 1. prealbumin value 2. weight change 3. serum potassium value 4. cultural food preferences

2

your patient has a question about the cardiac diet the dietician reviewed wit him yesterday.what is the nurses nest response? 1. ask your doctor when you go for follow up 2. what is the question? if i can't answer it, i will get the dietician to come back 3. just do your best. the handout she gave you is simply a list of guidelines 4. if i see the dietician around, i will tell her you need her

2

The client wants to eat fewer calories and lose weight by substituting regularly sweetened foods with those that are sweetened with sugar alternatives. Which of the following would be the most effective substitution? 1. sugar free cookies for regular cookies 2. sugar free chocolate candy for reg chocolate candy 3.sugar free soft drinks for reg soft drinks 4. sugar free ice cream for reg ice cream

3

a client asks if it is better to consume folic acid from fortified foods or from a vitamin pill. which of the following is the nurses best response? 1. it is better to consume folic acid through fortified foods b/c it'll be absorbed better than through a pill form 2. it is better to consume folic acid through vitamin pills b/c it'll be better absorbed than through fortified foods 3. fortified foods and pills have the same form of folic acid, so it does not matter which source you use 4. it is better to consume naturally rich sources of folic acid b/c the form is better absorbed than the folic acid in either fortified foods or pills

3

a client asks why eating less sodium is important for healthy people. the nurse's best response is 1. low sodium diets tend to be low in fat, therefore may reduce risk of heart disease 2. low sodium diets are only effective at preventing high BP, not lowering existing high BP, so the time to implement a low sodium diet is when you are healthy 3. there is a pos relationship b/t higher sodium intake and the risk of high BP; lowering sodium intake may help prevent or delay high BP 4. Low sodium diets are inherently low in calories and help people lose weight which can help a variety of chronic diseases

3

a client is diagnosed with pernicious anemia. what vitamin is he not absorbing? 1. folic acid 2. vitamin B6 3. vitamin B12 4. niacin

3

a client with osteoporosis was advised to drink 3 glasses of milk daily to increase her calcium intake. she wants to know why she cant just take calcium supplements. the nurses best response is: 1. calcium supplements are a better idea than drinking more milk b/c milk provides calories. just be sure to take the doses spread out over 3 meals 2. calcium supplements should be avoided 3. calcium is best obtained from food, not pills, and fat free milk is one of the best options 4. it is hard to consume enough calcium through pill form

3

a client with osteoporosis was advised to drink 3 glasses of milk daily to increase her calcium intake. she wants to know why she just cant take calcium supplements. the nurse's best response is 1. calcium supplements are a better idea than drinking more milk bc milk provides calories. just be sure to take the doses spread out over 3 meals 2. calcium supplements should be avoided because they raise blood levels of calcium to an unhealthy level 3. calcium is best obtained from foods, not pills and fat free milk is on of the best options 4. it is hard to consume enough calcium through pill form only

3

the nurse knows her explanation of glycemic index was effective when the client says which of the following? 1. choosing foods that have a low glycemic index is an effective way to eat healthier 2. low glycemic index foods promote weight loss b/c they do not stim release of insulin 3. glycemic index may help me choose the best foods to eat before, during and after training 4. glycemic index is a term referred to the amount of refine sugar in a food

3

the nurse knows her instructions about choosing products that are lactose free have been effective when the client verbalizes she may tolerate: 1. whole milk 2. fat free milk 3. cheddar cheese 4. pudding

3

what should you tell the client about taking mineral supplements? 1. most americans are deficient in minerals, so it is wise to take a multimineral supplement 2. like water soluble vitamins if you consume more minerals than your body needs, you will excrete them in urine, so dont worry 3. if you do not have a mineral deficiency, taking supplements can lead to potentially excessive intake that can cause adverse health effects 4. mineral deficiencies do not exist in the US, so you do not need to waste you money on them

3

which of the following statements is accurate regarding characteristics of a healthy eating pattern? 1. the only healthy eating pattern is a vegetarian one 2. healthy eating patterns eliminate foods that are high in sat fat, added calories and sodium 3. healthy eating patterns may reduce the risk of severe chronic diseases, including cardiovascular disease, type 1 DM and certain cancers 4. most young and middle aged adults consume a healthy eating pattern

3

which population is at risk for combines deficiencies of thiamin, riboflavin and niacin? 1. pregnant women 2. vegetarians 3. alcoholics 4. athletes

3

which vitamin is given in large doses to facilitate wound and bone healing? 1. vitamin a 2. vitamin d 3. vitamin c 4. niacin

3

a client says he never adds salt to any foods that his wife serves, so he believes he is consuming a low sodium diet. which of the following is the nurse's best response? 1. if you dont add salt to any foods then you are fine, continue with that 2. even though you arent adding any salt your wife probably cooks with salt. she should stop that 3. lots of foods are naturally high in sodium, such as milk and meat; in addition to a not using a salt shakers, you must also limit foods naturally high in salt 4. the major sources of sodium are processed and convenience foods. limiting their intake makes the biggest impact on overall sodium intake

4

compared to refined sugar whole grains have more: 1. folic acid 2. vitamin A 3. vitamin C 4. phytonutrients

4

which of the following recommendations would be most effective at increasing potassium intake? 1. choose enriched grains in place of whole grains 2. eat more fruits and veggies 3. eat more seafood and poultry in place of red meat 4. b/c there are few goodd dietary sources of potassium it is best obtained by taking potassium supplements

4

which statement indicates tht the client understands the instruction about using a vitamin supplement? 1. USP on the label guarantees safety and effectiveness 2. natural vitamins are always betters for you than synthesized vitamins 3. vitamins re best absorbed on an empty stomach 4. taking a multivitamin cannot fully make up for poor food choices

4

The physician has recommended that a client take a vitamin supplement. What would the client look for when choosing a vitamin supplement? A)The "Supplement Facts" label B)Look for the nutrient's Recommended Dietary Allowance (RDA) C)Choose the highest price supplement D)Choose a supplement that is "natural"

A The FDA requires a standardized "Supplemental Facts" label on all supplements. This label is intended to provide consumers with better information.

It is recommended that people older than the age of 50 years take vitamin supplements, but it is important they take the proper type of supplement—namely, "50+" or "mature" multivitamin supplement formulas—because they usually contain what? A) Less iron B) More zinc C) Less vitamin B12 D) More calcium

A "Mature" or "50+" formulas usually have less iron and vitamin K. While seniors do need less iron, the need for vitamin K does not decrease with aging.

A client is admitted with persistent diarrhea and a weight loss of 10 pounds. What would the nurse recognize as the significance of the weight loss if the client stated that he had lost the weight over the past 3 months? A)Signifies a chronic versus acute condition B)Signifies that it was an intentional weight loss C)Signifies there is no nutritional deficit D)Signifies an ongoing acute condition

A A weight loss that occurs relatively rapidly is due to an acute condition versus weight loss that occurs over time. The latter could be caused by a deliberate change in eating habits, or it could have a physiologic cause such as cancer. Anything that occurs over time is considered chronic rather than acute.

There are many enzymes in our body that cannot function without a coenzyme. Which vitamins act as coenzymes? A) B vitamins B) Vitamin C C) Vitamin D D) Vitamin K

A All B vitamins work as coenzymes to facilitate thousands of chemical conversions.

An 80-year-old female was admitted with aspiration pneumonia. During her assessment, she mentions she has recently had difficulty eating because "everything keeps going down the wrong pipe." When the nurse is developing a care plan, which of the following is an appropriate nursing diagnosis to include? A)High risk of aspiration C)Rule out aphasia B)Increased mucus production D)COPD

A Aspiration pneumonia can be the result of liquids getting into the lungs. This is common with vomiting or aphagia. Increased mucus production could be the result of the body trying to remove whatever was in the respiratory tract. Aphasia is difficulty speaking. COPD could be a chronic condition that accompanies aspiration pneumonia but is seldom the cause.

B vitamins are known to be coenzymes and assist with various bodily reactions and functions. Not all coenzymes, however, are considered B vitamins. What substance is a coenzyme and is considered a non-B vitamin? A) Choline B) Isoniazid C) Beta-carotene D) Niacin

A Choline plays important roles in the metabolism and functioning of cells. Although its essentiality is currently uncertain, it may eventually be classified as a B vitamin.

Smoking interferes with the body's use of a specific vitamin, so the RDA for this vitamin has been raised for smokers. Which vitamin is it? A) Vitamin C B) Folate C) Beta-carotene D) Vitamin E

A Cigarette smokers are advised to increase their intake by 35 mg/day because smoking increases oxidative stress and metabolic turnover of vitamin C.

Monitoring and evaluation of nursing goals and outcomes are integral parts of the nursing process. A nurse working on a very busy unit feels she does not have adequate time to monitor clients' nutritional intakes or to ensure they are meeting their established outcomes. What is a simple nursing intervention that can assist the nurse in evaluating clients' intended outcomes? A)Have the client weighted daily and record the weight. B)Make sure the unit aides record how much food is on each tray. C)Have the client's family record the amount of food served at each meal. D)Encourage the client to document what is ordered at each meal.

A In reality, monitoring precedes evaluation as a way to stay on top of progress or difficulties the client is experiencing. Monitoring suggestions include monitoring weight, requesting a nutritional consult, and observing intake whenever possible to judge the adequacy.

It is recognized that many individuals in the United States do not eat properly; however, it is not always necessary for people to take a vitamin supplement. Who of the following individuals is least likely to need a vitamin supplement? A)A moderately active adult B)A pregnant teenager C)An elderly woman living alone D)A housewife on a low-calorie diet

A It is recommended that certain populations take supplements to ensure they are getting adequate nutrition to prevent deficiencies. These include women who are pregnant, dieters who consume fewer than 1200 calories, vegans, finicky eaters, and a large portion of adults age 51 years and older.

The nurse is conducting an assessment of a new client who has been using megadoses of nutritional supplements for several years. The nurse is aware that consistently high doses of many vitamins have no adverse effects; however, long-term exposure to synthetic folic acid may do which of the following? A)Mask a deficiency of vitamin B12 B)Can cause a temporary sensory neuropathy C)May increase the risk of heart disease D)Increase the need for other B vitamins

A Long-term exposure to synthetic folic acid may mask vitamin B12 deficiency, which can cause permanent neurologic damage if left untreated. Other potential risks include an increased risk of cognitive decline in older people with a low vitamin B12 status, increased tumorigenesis in clients with pre-existing lesions, and increased risk of cancer in general.

Research done on increasing the effectiveness of client teaching has found that the type of nutritional counseling that is most effective is that done by whom? A)Nurses and dietitians C)Dietitians alone B)Physicians D)The client's family

A Nutritional counseling by nurses and dietitians is more effective and efficient than that done by dietitians alone. Physicians do not normally provide nutritional counseling, and dietitians alone cannot reinforce what is taught because they are limited in the amount of times they are in contact with the client. Teaching can include the client's family; nutritional counseling should include the client.

The nurse is aware that vitamins have been found to have other functions than to just nourish the body. Vitamins are often used as food additives for specific purposes. Which vitamin is added to frozen fish to help prevent rancidity? A) Vitamin C B) Vitamin E C) Vitamin A D) Vitamin B12

A Some vitamins are used as food additives in certain foods to boost their nutritional content, such as vitamin C and vitamin D. Other foods have certain vitamins added to help preserve quality, such as vitamin C added to frozen fish to help prevent rancidity and to luncheon meats to stabilize the red color. Vitamin E helps retard rancidity to vegetable oils, and beta-carotene adds color to margarine.

It has been proven that folate, when consumed in an adequate amount, may help prevent neural tube defects. When is it necessary to consume the folate to have this effect? A) Before conception and early in pregnancy B) During the second trimester of pregnancy C) During the third trimester of pregnancy D) Throughout pregnancy

A Studies show that an adequate intake of folate before conception and during the first trimester of pregnancy reduces the risk of neural tube defects in infants.

A 77-year-old client who lives alone is admitted to the hospital after his children found him in a confused state at home. It is uncertain whether or not he has been eating correctly. As the nurse is preparing the nursing care plan, which of the following nursing diagnoses would indicate nutrition intervention is appropriate? A)Self-care deficit: feeding B)Risk for impaired skin integrity: colostomy C)Risk for impaired swallowing: resolved D)Risk for activity intolerance

A The diagnosis of self-care deficit: feeding is the most appropriate answer and would indicate that intervention is appropriate to ensure the client is getting adequate nutrition. A colostomy that is functioning correctly would be similar to adequate bowel function in others. A resolved swallowing disorder and decreased physical activity do not necessarily require nutrition intervention.

To assist in nutrition screening in the community, the local senior center has developed a screen to help them identify individuals at high risk for malnutrition. Which of the following risk factors might be included? A)Eats alone most of the time C)BMI B)Acute weight loss D)Appetite

A The local senior center is better equipped to assess lifestyles by communicating with the community that comes for meals. They can recognize clients who may only come sporadically and alone. They can then suggest alternative programs such as Meals-on-Wheels to that individual to ensure they are eating adequately.

A client is concerned she is not getting enough vitamin D in her diet. The nurse explains how we obtain vitamin D and explains that synthesis can be impaired by all of the following, except for? A) Low calcium intake B) Sunscreens C) Aging D) Dense clouds

A The primary function of vitamin D is to maintain normal blood concentrations of calcium and phosphorus. The body has the potential to produce all the vitamin D it needs if exposure to sunlight is optimal and liver and kidney functions are normal.

Nursing care plans include nursing diagnoses that have nutritional significance when the nurse assesses it as being necessary. If the nurse is writing a nursing care plan for a client with an obvious nutritional deficiency, which nursing diagnosis would be most appropriate to include? A)Imbalanced nutrition: less than body requirements B)Deficient fluid volume: less than body requirements C)Constipation D)Impaired oral mucous membrane

A The readiness for enhanced nutrition diagnosis relates directly to nutrition when altered nutrition is the problem, or indirectly when a change in intake will help to manage a nonnutritional problem. A deficient fluid volume, constipation, or impaired oral mucous membranes can be related to nutrition, but they are not considered an obvious nutritional deficiency.

The nurse is teaching a nutrition class to a group of pregnant women in the community. What should the nurse recommend to the students as a good source of vitamin B12? A) Milk B) Green leafy vegetables C) Vegetable oils D) Peanut butter

A Vitamin B12 holds the distinction of being the only water-soluble vitamin that does not occur naturally in plants. It is found in animal products.

The nurse is aware that particular populations are prone to vitamin deficiencies for various reasons. Why are older adults prone to vitamin D deficiency? A) Aging reduces the kidneys' ability to activate vitamin D. B) They are more likely to take prescription medicines that interfere with vitamin D absorption. C) Their fixed incomes limit buying enough foods rich in vitamin D. D) They excrete more vitamin D than younger adults do

A Vitamin D is unique in that the body has the potential to make all it needs if exposure to sunlight is optimal and liver and kidney functions are normal. Elderly persons are particularly at risk for vitamin D deficiency if they have impaired activation by the liver and kidneys.

The class is discussing the various elements that are essential for life. Water is a vital element for the human body. What is one of its functions? A) Serves as a solvent for vitamins and glucose B) Prepares nutrients for transportation to cells C) Makes cell walls without shape and structure D) Provides energy

A Water occupies essentially every space within and between body cells and is involved in virtually every body function, to include serves as a solvent for vitamins, minerals, glucose, and amino acids; provides shape and structure to cells; regulates body temperature; aids in digestion and absorption of nutrients; and transports nutrients and oxygen to cells.

The nurse is caring for a client for whom serum albumin screening has been used to assess protein status. The nurse understands that there are disadvantages to using albumin to indicate the nutritional status of protein in the body. What is one of those disadvantages? A)It is degraded very quickly. B)It is not specific for nutritional status. C)It is a test that requires 12 hours of fasting. D)It must be assessed in relation to the client's blood urea nitrogen.

B Albumin is often used to assess protein status, even though albumin values are more likely to be altered during critical illness from factors other than protein malnutrition, such as from injury, infection, dehydration, liver disease, renal disease, and congestive heart failure. Albumin is degraded slowly, so serum levels may be maintained until malnutrition is in a chronic stage. It is not specific for nutritional status. Albumin levels do not require fasting prior to being drawn nor is it assessed in relation to blood urea nitrogen.

A client is being admitted to the hospital unit with vague complaints. During the assessment, the nurse discovers that the client has been taking supplements in manner in which the vitamins could result in acting more as drugs. When do vitamins act as drugs in the body? A) When they are prescribed by a physician B) When they are taken in megadoses C) When they are taken in combination with other vitamins D) When they are taken in minidoses

B In megadoses (amounts at least 10 times greater than RDA), vitamins function like drugs, not nutrients.

The nurse is doing admission assessments on four new clients. Mrs. S is a postoperative client. Mrs. X is an 84-year-old who lives alone and tries to eat a heart-healthy diet. Mr. Y was admitted from a long-term care facility because of muscle wasting and swollen neck glands. Mr. Z is a 35-year-old who is a postoperative hernia client. Which client would be referred to the dietitian because of suspected protein-energy malnutrition? A) All of the clients B) The moderate- to high-risk clients with suspected or confirmed protein-energy malnutrition C) The postoperative critical care clients D) The clients who are very young or very old with nutritional deficiencies

B In the clinical setting, nutritional assessments focus on moderate- to high-risk clients with suspected or confirmed protein-energy malnutrition. The other answers are incorrect because not all clients are referred for nutritional assessments by the dietitian, no postoperative critical care clients were admitted, and none of the clients were identified as having nutritional deficiencies.

When teaching a client about diet changes, the nurse knows it is better to emphasize which of the following? A)Good versus bad B)More healthy versus less healthy C)Low carbs and fats versus high carbs and fats D)Calorie counting

B It is better to emphasize "more healthy" versus "less healthy" when teaching about diet changes. To use terms such as good or bad, or carbs and fats, or calorie counting can result in most clients becoming uncooperative because they view diets as short-term punishment. The goal should be to encourage lifestyle changes to help the client improve their health.

A nursing student is taking a course in geriatric nursing, and the subject for today is altered nutritional status. The instructor lectures about older adults not eating in a healthy manner due to factors such as limited income, inability to prepare cooked meals, or inability to shop due to lack of transportation. What factor in the physical assessment would indicate to the nurse that the older adult client might be malnourished? A)Inability to talk normally B)Poor wound healing C)Enlarged liver with nonpalpable spleen D)Edematous hands and forearms

B Physical symptoms may suggest malnutrition; however, they cannot be considered diagnostic. Edema of the lower extremities is a better indicator versus the hands and forearms, both liver and spleen enlargement is suggestive, and speech is usually not affected. Poor wound healing is the better indicator because it shows a lack of proper nutrition to allow for proper healing.

Riboflavin is said to be unique among the water-soluble vitamins. What makes riboflavin unique? A) Meats and beans contribute the most riboflavin to the diet. B) Milk and dairy products contribute the most riboflavin to the diet. C) Meats and beans contribute the least riboflavin to the diet. D) Milk and dairy products contribute the least riboflavin to the diet.

B Riboflavin is unique among water-soluble vitamins in that milk and dairy products contribute the most riboflavin to the diet.

Unintentional weight loss can be an indicator of malnutrition; however, apparent weight gain may be an unreliable indicator of improvement due to which of the following? A) Carcinoma B) Anasarca C) Cholecystitis D) Pancreatitis

B The client's weight can be an unreliable or invalid indicator of malnutrition due to hydration status. Edema, anasarca, fluid resuscitation, heart failure, and chronic liver or renal disease can falsely inflate weight.

Clients who need to be on antibiotics for a prolonged period of time may be at an increased risk of vitamin K deficiency. Why is this? A) Antibiotics impair vitamin K absorption from foods. B) Antibiotics kill intestinal bacteria that produce vitamin K. C) Antibiotics cause loss of appetite, which lowers vitamin K intake. D) Antibiotics inactivate vitamin K in the liver.

B Vitamin K occurs naturally in two forms: One is found in plants, and the other is synthesized in the intestinal tract by bacteria. These intestinal tract bacteria can be killed by the antibiotics, resulting in a shortage or deficiency of vitamin K.

Vitamins can be either fat soluble or water soluble. Their solubility determines many of their characteristics. What is one characteristic that is determined by a vitamin's solubility? A) Availability B) Storage C) Strength D) Function

B Vitamins are classified according to their solubility. Fat-soluble vitamins are vitamins A, D, E, and K. Water-soluble vitamins are vitamin C and the B vitamins. Solubility determines vitamin absorption, transportation, storage, and excretion.

The nurse is admitting a 35-year-old client with alcoholism to the hospital. In planning nursing care, what long-term nutritional goals might the nurse set? A)To alleviate symptoms of disease B)To alleviate side effects of treatments C)To improve eating habits to reduce the risk of chronic disease D)To replenish fluid losses

C After short-term goals are met, attention can center on promoting healthy eating to reduce the risk of chronic diet-related diseases such as obesity, diabetes, hypertension, and atherosclerosis. The other goals are all short term.

When doing a diet screening on a client, the nurse tries to use terms other than "diet" when asking about the foods the client eats. Which term is not an alternative term to the word "diet"? A)Eating pattern C)Counting calories B)Eating style D)The foods you eat

C Alternative terms to "diet" include eating pattern, eating style, food intake, or the foods you eat. Counting calories is not an alternative term.

When conducting an assessment on a new client, the nurse asks if the client uses any supplements. The nurse is aware that taking supplements is a common choice that Americans make. What is the approximate percentage of American adults who take vitamin supplements based on their beliefs about health? A) 30% B) 40% C) 50% D) 60%

C An estimated 54% of American adults use dietary supplements, primarily in the form of multivitamins with or without minerals.

The nurse works with several clients who routinely take nutritional supplements. The nurse is aware that which of the following statements about vitamins is true? A) Most Americans do not consume adequate amounts of thiamin, riboflavin, and niacin. B) Most Americans do not consume adequate amounts of vitamin C. C) Taking large doses of vitamin A is potentially harmful. D) Because of the potential health benefits, beta-carotene supplements are routinely recommended.

C Extremely high doses of vitamin A (at least 30,000 μg/day) consumed over months or years may cause central nervous system changes, bone and skin changes, and liver abnormalities that range from reversible to fatal. In high doses during pregnancy, vitamin A is also teratogenic, so supplementation is not recommended during the first trimester unless there is specific evidence of vitamin A deficiency.

Vitamin deficiency in the United States is not common. However, inadequate gastric acid secretion secondary to gastric resection, use of medications that suppress gastric acid, or gastric infection with Helicobacter pylori is the most common cause of which of the following? A)Thiamine deficiency B)Riboflavin deficiency C)Vitamin B12 deficiency D)Folic acid deficiency

C Factors that increase the risk of vitamin B12 deficiency include gastric resection, use of medications that suppress gastric acid secretion, and gastric infection with H. pylori.

The nurse is aware that the production of pale yellow urine is assumed to be a reliable indicator of adequate fluid intake. However, in some populations the sensation of thirst comes after significant fluid loss. In which population is this a factor? A) Teenagers B) Middle-aged adults C) The elderly D) The obese

C In healthy adults, thirst is usually a reliable indicator of water need, and output of pale yellow urine indicates intake is adequate. For some, the sensation of thirst is blunted and not a reliable indicator of need. For the elderly and children, and during hot weather or strenuous exercise, drinking fluids should not be delayed because fluid loss may be significant.

A 47-year-old, obese female client is admitted for hypertensive crisis. During the assessment, she states she has tried every diet out there and she is not interested in trying another one. She refuses to talk with the dietitian. Which of the following is the best approach for the nurse to use to help this client? A)Provide the client with colorful graphs and charts to note the foods she eats. B)Ask a social worker to intervene. C)Emphasize things "to do" instead of "not to do." D)Report the client to the physician, and note it in her medical record.

C It is best to emphasize things "to do" instead of "not to do" when trying to teach good eating habits. Many individuals view dieting as punishment and will not want to participate in making any changes. A nurse should listen to the client and not be confrontational. Asking a social worker or reporting the client to the physician will not help in the situation and only make the client less willing to cooperate. The use of graphs and charts would possibly be seen by the client as just another diet tactic.

The health-care provider has suggested that the client use a particular vitamin in megadoses to help lower serum cholesterol. Which vitamin is it? A) Thiamin B) Riboflavin C) Niacin D) Folic acid

C Large doses of niacin in the form of nicotinic acid (1-6 g/day) are used therapeutically to lower total cholesterol and LDL cholesterol and raise HDL cholesterol.

The body has several defense systems to protect itself. Which vitamins work together to inactivate bacteria and viruses? A) Water-soluble vitamins B) B vitamins C) Phytochemicals D) Fat-soluble vitamins

C Phytochemicals are a broad class of nonnutritive compounds that plants produce to protect themselves against viruses, bacteria, and fungi. In foods, phytochemicals help deactivate bacteria and viruses.

To ensure all inpatients receive adequate care, The Joint Commission specifies that nutrition screening be conducted at what time during hospital admission? A)Immediately upon admission B)Within 12 hours after admission C)Within 24 hours after admission D)Within 36 hours after admission

C The Joint Commission specifies that nutrition screening be conducted within 24 hours after admission to a hospital or other health-care facility, even on weekends and holidays.

The nurse recognizes that there are differences between fat-soluble and water-soluble vitamins. Which of the following is one of those differences? A)Water-soluble vitamins are more essential to life than fat-soluble vitamins. B)Water-soluble vitamins attach to protein carriers to be transported through the blood. C)Water-soluble vitamins should be consumed daily. D)Water-soluble vitamins are stored primarily in the liver and adipose tissue.

C There are differences between fat-soluble and water-soluble vitamins. Water-soluble vitamins should be consumed daily. The other choices are true about fat-soluble vitamins.

The nurse is caring for a 65-year-old Mr. Y who was admitted 1 week ago after his family found him confused and unable to ambulate in his home. Upon admission, he weighed 150 lb; today, he weighs 140 lb. The nurse knows that determining his percent weight change can help to determine his current nutritional status. What is his percent weight change? A) 3% B) 5% C) 7% D) 9%

C To determine the percent weight change, subtract the current body weight from the usual body weight and multiple by 100, and then divide by the usual body weight. The answer will be the percent weight change. Because Mr. Y's admission weight is 150 lb and his current weight is 140 lb, the equation would be (150 - 140) × 100 / 150 = 6.666666666667 or 7%. This would indicate a significant weight loss.

The nurse is aware that vitamins are organic compounds that differ in function and availability. When discussing the difference with a client, which of the following statements would best describe vitamins? A)Vitamins are composed of long chains of molecules linked together. B)Vitamins provide energy. C)Vitamins are susceptible to destruction by factors such as heat, air, and light. D)Vitamins exist in only one active form.

C Vitamins are susceptible to destruction and subsequent loss of function due to vulnerability to heat, light, oxidation, acid, and alkalis. Vitamins are individual molecules. They do not provide energy but are needed for metabolism of energy. They are extremely complex chemical substances that differ widely in structure.

A client who was widowed 6 weeks ago had had a depressed appetite since his wife died. He admits to not eating very much and says his appetite gets worse as the day goes on. He has unintentionally lost 19 pounds since his wife's death and complains of around-the-clock fatigue. He is admitted to the unit for weight loss due to inadequate nutritional intake. What nursing intervention would be appropriate for the nurse to include in the care plan for this client? A)Make sure the client orders a wide variety of foods he likes so he eats a lot. B)Tell the client that he should not snack between meals. C)Encourage the client to eat a big breakfast. D)Suggest that the client eat alone in his room.

C Ways to promote adequate intake include encouraging a big breakfast if appetite deteriorates throughout the day; promoting congregate dining, if appropriate; ordering snacks and nutritional supplements; and encouraging good oral hygiene.

While doing admission assessments, the nurse finds that Mrs. S does not drink; Mrs. X enjoys a glass of wine at supper and bedtime; Mr. Y has been drinking at least a six-pack of beer every day for the past 20 years and has been ordered by his doctor; and Mr. Z has a cocktail when he goes out to dinner, which is about once a month. Which clients would be considered at nutritional risk? A)Mrs. X and Mr. Z B)Mrs. S and Mr. Y C)Mrs. X and Mr. Y D)Mrs. S and Mr. Z

C Risk begins at more than one drink daily for women and more than two drinks daily for men. The other answers are incorrect because Mrs. S and Mr. Z do not fit the criteria for being at nutritional risk due to alcohol consumption.

Part of the nutrition assessment is calculating the client's BMI. The nurse is aware that a BMI of 18 indicates the client falls in what category? A) Obese B) Overweight C) Healthy weight D) Underweight

D A BMI of less than 18.5 is considered underweight; 18.5 to 24.9 is healthy weight; 25 to 29.9 is overweight; 30 to 34.9 is obesity class 1; 35 to 39.9 is obesity class 2; and greater than 40 is obesity class 3.

Some chemical reactions within the body create free radicals. These free radicals destroy cells in our body. Some vitamins act as antioxidants to prevent this destruction of cells by free radicals. Which vitamin is a major antioxidant? A) Vitamin B6 B) Thiamin C) Folate D) Vitamin C

D Vitamins that function as major antioxidants are vitamin C, vitamin E, and beta-carotene. Each has a slightly different role in the body.

The nurse is finishing an admission assessment for Mrs. M who was admitted during a previous shift. While doing the medical psychosocial history, the following facts come to light: Two years ago, she was treated for a major depressive episode; she practices Islam; she lives in the area of town where there are many Muslim people; and she comes from a wealthy family. Her hair is visibly dry and dull, and she mentions that her hand grip has gotten weaker over the last few months. Because of the findings during this assessment, the nurse decides to refer her to the dietitian for a nutrition assessment. What in the medical psychosocial assessment might lead to a nutritional deficiency? A)The culture she lives in B)It is Ramadan, and Mrs. M practices Islam. C)Her hair is dry and dull. D)She has had a major depressive episode.

D A client's medical-psychosocial history may shed light on factors that influence intake, nutritional requirements, or nutrition counseling. Some of these factors include depression, eating disorders, language barriers, and impaired intake related to culture. Even though it is Ramadan and Mrs. M fasts until sunset, living in a Muslim culture does not mean that she is malnourished. The fact that her hair is dry and dull is only one sign or symptom of malnutrition, and it is not part of the medical psychosocial admission assessment nutritional screening.

When educating the client, the nurse understands that there can be some negativity associated with the term "diet." Many clients may view "diet" as another term for which of the following? A)A health behavior B)A medical treatment C)A positive experience D)A short-term punishment to endure

D Among clients, diet is a four-letter word with negative connotations, such as counting calories, deprivation, sacrifice, and misery. A diet is viewed as a short-term punishment to endure until a normal pattern of eating can resume. The other answers do not cause the negative connotations the word "diet" does.

The clinic nurse is conducting an education session for clients who are taking anticoagulants. Which of the following should the nurse stress to the clients? A)They should avoid all sources of vitamin D. B)They should maintain a consistent intake of vitamin D. C)They should avoid all sources of vitamin K. D)They should maintain a consistent intake of vitamin K.

D Anticoagulants interfere with hepatic synthesis of vitamin K-dependent clotting factors. Clients should try to maintain a consistent intake so that the effect on coagulation time is as constant and predictable as possible.

The nurse is admitting a client who is diagnosed with type 2 diabetes mellitus. While in the hospital, the client has a referral to see a bariatric surgeon for evaluation for gastric surgery. The bariatric surgeon writes an order for a body mass index (BMI) to be calculated. The nurse understands that a BMI is which of the following? A)A calculation of an index of a person's ideal weight B)A calculation of a person's prealbumin level C)A calculation of calorie intake necessary to maintain ideal weight D)A calculation of an index of a person's weight in relation to height

D BMI, an index of a person's weight in relation to height, stimulates relative risk of health problems related to weight. "Healthy" or "normal" BMI is defined as 18.5 to 24.9. Values above and below this range are associated with increased health risks. Calculation of ideal weight is not an index. Prealbumin levels are given by the laboratory, not calculated by the nurse. A BMI is not a calculation of necessary caloric intake to maintain ideal weight.

Beta-carotene is an important vitamin for vision. To help ensure a client incorporates this in his diet, which of the following foods such the nurse encourage the client to eat? A) Citrus juice B) Egg yolks C) Vegetable oils D) Winter squash

D Beta-carotene is found in "greens" (turnip, dandelion, beets, collard, mustard), spinach, kale, broccoli, carrots, peaches, pumpkin, red peppers, sweet potatoes, winter squash, mango, apricots, and cantaloupes.

During a nutrition class, a group of individuals learn that vitamins can exist in more than one form and have more than one function. Which of the following vitamins exists in more than one form? A) Vitamin B12 B) Thiamin C) Riboflavin D) Vitamin A

D In its preformed state, vitamin A exists as an alcohol (retinol), aldehyde (retinaldehyde), or acid (retinoic acid). The term vitamin A also includes provitamin A carotenoids.

During a nutrition screening, an 84-year-old client tells the nurse he really likes ice cream. He goes on to say that, when he was growing up, his grandfather used to give him ice cream when he hurt himself in any way. He also says that his mother would give him homemade chicken soup when he was sick. One of the admission diagnoses for this client is minor depression with mood swings. In planning his meals, what would be appropriate for the nurse to include? A)Favorite "take-out" food B)Foods your client tolerates well C)Foods high in nutritional value D)Foods that are considered "comfort foods"

D Nutrition theory does not always apply to practice. Honor clients' requests for individual comfort foods whenever possible. Comfort foods (e.g., ice cream, chicken soup, mashed potatoes) are valuable for their emotional benefits, if not their nutritional ones.

A client is having difficulties understanding the difference between fat-soluble and water-soluble vitamins. The nurse explains which of the following is one of those differences? A) Fat-soluble vitamins must be consumed daily. B)Fat-soluble vitamins are absorbed directly into the bloodstream. C)Fat-soluble vitamins are excreted in the urine when consumed in excess of need. D)Fat-soluble vitamins are stored, primarily in the liver and adipose tissue.

D There are multiple differences between fat-soluble and water-soluble vitamins. Fat-soluble vitamins are stored, primarily in the liver and adipose tissue. The remainder choices are true of water-soluble vitamins.

Thiamin acts as a coenzyme when the body metabolizes carbohydrates. It also has another important function. What is that other function? A) Thiamin is important in the metabolism of fats. B) Thiamin is important in the digestive process. C) Thiamin is important in liver functioning. D) Thiamin is important in nervous system functioning.

D Thiamin (vitamin B1) is a coenzyme in the metabolism of carbohydrates and branched-chain amino acids. In addition, thiamin is important in the nervous system functioning.

A nurse is attending a conference on "Nutrition and Nursing." One of the subjects being covered is "How to Facilitate Client and Family Nutritional Teaching." The nurse returns to the unit and shares several suggestions on nutritional teaching for clients and families with other members of the staff. Which of the following is an appropriate suggestion for teaching? A) Suggest books to both the client and his or her family to read. B)Make sure the client selects lots of "comfort foods." C)Emphasize to the client's family what the client should not eat. D)Listen to the client's concerns and ideas.

D Ways to facilitate client and family teaching include keeping the message simple, helping the client to select appropriate foods, and listening to the client's concerns and ideas. Clients are more willing to follow through with suggestions if they have a voice in the process.

A client is on a low-calorie diet that recommends she test her urine for ketones to tell how well she is adhering to the guidelines of the diet. What does the presence of ketones signify about her intake? a) it is too high in protein b) it is too high in fat c) it is too high in carbohydrates d) it is too low in carbohydrates

d

(T/F) "natural" vitamins are superior to "synthetic" ones

false

(T/F) USP on a label of vitamin supplements means that the product is safe

false

(T/F) all vitamins need to be consumed on a daily basis

false

(T/F) daily use of multivitamin reduces the risk of CV disease and cancer

false

(T/F) natural folate foods is better absorbed than synthetic folic acid added to foods

false

(T/F) vitamins provide energy

false

(T/F) with vitamin supplements, the higher the price, the better the quality

false

(T/F) b/c underconsumption is linked to adverse health outcomes americans low intake of vitamin D is a public health concern

true

(T/F) there is no mechanism for iron excretion so the body maintains iron balance by altering the rate of absorption

true

(T/F) under optimal conditions, vitamin D is not an essential nutrient b/c the body can make all it needs from sunlight on the skin

true

(T/F) vitamins are susceptible to destruction

true