Ch.1 - Nutrition in Health

A client is shocked to discover the American diet is considered "poor" and expresses concern over some of the facts they heard. Which client statement does the nurse confirm is true? "Over half of all Americans do not get enough of the recommended total grain and total protein foods." "The push to increase protein in our diets has led to problems with adult and childhood obesity." "80% of Americans have eating patterns that are low in vegetables, fruits, and dairy." "Although most Americans do a good job controlling sodium intake, their sugar intake is still too high."

"80% of Americans have eating patterns that are low in vegetables, fruits, and dairy."

A group of students are reviewing nutrient standards and ask the nurse why none of the nutrients has both a Recommended Dietary Allowance (RDA) and an Adequate Intake (AI). Which statement represents the nurse's best response? "AI reflects the bioavailability of the nutrient, while RDA does not." "AI is set only when there is not enough data for an RDA." "RDA and AI can be used interchangeably." "AI values are used to determine the RDA."

"AI is set only when there is not enough data for an RDA."

The nurse is discussing nutrition reference values in class. Which of the following is a CORRECT statement made by the nurse? "EAR is the nutrient intake estimated to meet the requirement of half of the healthy individuals in a particular life stage and gender group." "UL is an intake level known to meet the nutrient requirements of all individuals." "AI is the highest average daily intake level of a nutrient likely to pose no danger to individuals." "RDA is a set of four nutrient-based reference values used to plan and evaluate diets for individuals with chronic illnesses"

"EAR is the nutrient intake estimated to meet the requirement of half of the healthy individuals in a particular life stage and gender group."

*The nurse is teaching the caregiver of an older adult client about the diet the health care provider has recommended. The goal is to increase caloric intake while improving the client's overall nutritional status. The nurse recognizes that the training has been successful when the caregiver says: "I need to push his supplemental drinks four times a day." "I need to increase his empty calorie intake." "He can still have his favorite food, ice cream." "He can eat whatever he wants with no limits."

"He can still have his favorite food, ice cream." (Generalizations do not apply to all individuals all the time. Comfort foods, such as ice cream, are valuable for their emotional benefits.)

The student asks the nurse to explain the role of nutrient reference values when planning eating patterns. Which of the following is the best response by the nurse? "The Recommended Dietary Allowances (RDAs) were originally developed to recommend nutrients set at a level to protect people from overeating." "All nutrients have a Recommended Dietary Allowance (RDA), Adequate Intake (AI), and/or Estimated Energy Requirement (EER)." "The Dietary Reference Intakes (DRIs) are a set of five nutrient-based reference values used to plan and evaluate diets." "Each reference value is viewed as an average over a period of 30 days."

"The Dietary Reference Intakes (DRIs) are a set of five nutrient-based reference values used to plan and evaluate diets."

A client asks the nurse about the history of nutrition and how it has changed. Which statement will the nurse include when responding? "Today, nutritional deficiencies are extinct thanks to fortified foods in the diet." "Years ago, nutrition was mostly about preventing diseases caused by deficiencies." "The current focus of nutrition is to reduce the risk of acute diseases with diet." "Current health problems related to nutrition insufficiency include heart disease and cancer."

"Years ago, nutrition was mostly about preventing diseases caused by deficiencies." (Nutritional deficiencies are not extinct. Current focus is on chronic diseases, not acute)

The nurse is approached by a client who states, "Are they going to expect me to eat the same thing every day in order to meet my nutrient Recommended Dietary Allowances (RDAs)? I'll be so bored!" Which response should the nurse use? "You do not need to worry about RDAs at your age. Only older adults need to be concerned with RDAs." "You do not have to eat the same foods every day, because RDAs are set high enough to account for a certain amount of daily variation." "If you do not eat the right foods, you will probably consume less than the RDAs and be at risk for inadequate nutrition." "Dietitians cannot create individualized meal plans, so if you want to meet all the RDAs, it is important to eat whatever foods are given to you."

"You do not have to eat the same foods every day, because RDAs are set high enough to account for a certain amount of daily variation."

A client newly diagnosed with diabetes inquires of the nurse, "I do not believe in all these Western medicines and treatments. I want to get better, but is there a way to so that doesn't involve taking medication?" Which response will the nurse give? "Unfortunately, your blood sugar is so high that it will not come down without insulin." "You might be interested in lifestyle medicine, which focuses on lifestyle changes." "Based on your lab results, your body is not able to help itself without medications." "I am not familiar with any other treatment options, but I can refer you to a dietitian."

"You might be interested in lifestyle medicine, which focuses on lifestyle changes."

The nurse has calculated an unintentional percent weight change in the client to be 5 percent. This is concerning if it occurs over: 1 week. 1 month. 3 months. 6 months.

1 month.

The nurse is assessing a client who is being readmitted for continued GI complaints. The nurse notes the client has dropped from 155 pounds to 130 pounds over the past month. What is this client's percent weight change? (Round to the nearest whole number.) Enter the correct number ONLY.

16 (155-130)/155*100 = 16

The nurse is reviewing a client's food diary for the past week. Keeping in mind the healthy and detrimental eating patterns identified in the 2020-2025 Dietary Guidelines for Americans, which meal is most associated with detrimental health outcomes? Meatless chili beans with cheese and onions, with a lemonade Spinach salad with chicken, strawberries, and walnuts, with a diet cola Tuna, asparagus, and white rice, with a flavored seltzer A hamburger with a white bun and pickle spears, with a soda

A hamburger with a white bun and pickle spears, with a soda

Dietary Reference Intakes (DRIs) are a collection of dietary reference standards. Which nutrition-based standard will be excluded from a list of the four original DRIs? Tolerable Upper Intake Level (UL) Adequate Intake (AI) Recommended Dietary Allowances (RDAs) Estimated Average Requirement (EAR) Chronic Disease Risk Reduction Intakes (CDRR)

Chronic Disease Risk Reduction Intakes (CDRR)

*The health of the American population has changed over the past years. The nurse is aware that the increase in chronic disease can be attributed to lifestyle changes. Which lifestyle change(s) has had a negative impact on chronic disease? Select all that apply. Health promotion Technological advances Sedentary lifestyle Exercise promotion Cost of food

Cost of food Sedentary lifestyle *Technological advances (more screen time)

*The nurse understands nutrigenomics has the potential to prevent chronic disease. Which potential benefit may result from nutrigenomic guidance? Increased cost of health care and nutritional intake to support improved quality Reduction of health disparities as the ability to manipulate the human genome advances Development of "genetic food" that provides certain genes with specific intake Dietary advice and guidance that are based on an individual's genetic makeup

Dietary advice and guidance that are based on an individual's genetic makeup

*Plant-based diets have received a lot of attention in recent years. Which meal option aligns with a plant-based eating plan? Breakfast: scrambled eggs, bacon, and hashbrowns Lunch: tuna salad sandwhich and cucumber slices Dinner: pasta with fresh vegetables and a breadstick Snack: salami and cheese on whole wheat crackers

Dinner: pasta with fresh vegetables and a breadstick (Plant-based diets include few or no animal products. Every meal option except dinner includes animal products of some kind: bacon (braekfast), tuna (lunch), salami and cheese (snack))

*To obtain an adequate history and ascertain nutritional risk, which of the following would be an appropriate question for the nurse to ask? Are you allergic to any foods? How is your appetite? Do you avoid any particular foods? Are you on a diet?

Do you avoid any particular foods? (Very specific and can help to indicate whether the client is following a particular plan and possibly avoiding certain foods or additives. Others are too general.)

The nurse recognizes that some clients are very sensitive to certain terms such as "dieting." Which of the following is the most appropriate phrase to use when encouraging a client regarding nutritional changes? Unhealthy options Eating style Poor quality eating pattern Foods to avoid

Eating style

The nurse is seeing a client and becomes concerned that the client is not obtaining enough dietary calcium. Which of the following recommendations should the nurse make to improve the client's calcium intake? Encourage and monitor intake of supplements Insist that the client drink at least one milk-based beverage daily. Refuse to assist the client unless the client drinks milk. Instruct the family to sneak milk into the client's meals.

Encourage and monitor intake of supplements

When teaching a client about diet changes, the nurse knows it is better to emphasize which of the following? Emphasize avoiding bad foods Encourage calorie counting daily Encourage healthy options often Emphasize low fats and carbohydrates

Encourage healthy options often

It has been said that the Western diet includes a high proportion of calorie-dense foods. Which food is an example of a calorie-dense food? Low-fat yogurt Baked chicken Fried fish Hard-boiled egg

Fried fish

Obesity has been the subject of a great deal of research in recent years. Which statement best reflects the application of nutrigenomics to obesity? Having the gene associated with fat mass variation and obesity makes an individual susceptible to obesity. Almost a thousand links among genes, health, and diet have already been identified by researchers. Research suggests that low-protein diets have the greatest impact on obesity. Additional research is needed to identify the gene related to obesity.

Having the gene associated with fat mass variation and obesity makes an individual susceptible to obesity.

As chronic diseases have become more prevalent, health care providers have begun exploring additional treatment and management options. Which single recommendation has had the largest impact in promoting positive outcomes? Limit alcohol use Increase physical activity Healthy lifestyle Decrease added sugars

Healthy lifestyle

*The nurse is reviewing a client's history and identifies that the client has low levels of physical activity. Which conditions will the nurse include when educating the client about illness caused by lack of physical activity? Select all that apply. Heart disease Type I diabetes Stroke Cancer Lung disease

Heart disease Cancer (Low levels of physical activity can contribute to heart disease, cancer, obesity, type II diabetes; lung disease and stroke have tobacco use as a modifiable risk factor.)

After learning about the history of intake guidelines, students know that simply reading a food's nutrition facts label may not be enough to understand the health effects of the food. Which statement reflects the current focus of work in nutrients and food? The health effects of foods can be simply and accurately reduced to the effects of single nutrients. Total amounts of nutrients consumed should be regulated, without regard for the food source of the nutrients. After a study found that beta carotene protected against cancer, large amounts of the nutrient are now recommended to clients at high risk for cancer. Intake guidelines that focus solely on nutrients can can underestimate the complexity of food.

Intake guidelines that focus solely on nutrients can can underestimate the complexity of food.

The nurse realizes the client can take a number of actions to decrease the risk of chronic disease. Which intervention(s) can reduce the risk of chronic disease? Select all that apply. Limit alcohol intake Decrease intake of added sugars Limit physical activity Decrease intake of sodium Quit smoking

Limit alcohol intake Decrease intake of added sugars Decrease intake of sodium Quit smoking

A nurse is reviewing a client's dietary log for one day. The client began the day with a breakfast of yogurt, fresh strawberries, and a glass of milk. For lunch, they ate a tuna sandwich on whole-grain bread, chips, and a soft drink. Dinner consisted of whole-grain pasta with vegetables, a side salad with low-fat dressing, and a glass of wine. Which group consists entirely of foods that fall under the Adequacy group of the Health Eating Index (HEI)?? Yogurt, chips, pasta Milk, tuna sandwich, salad Strawberries, soft drink, pasta Yogurt, tuna sandwich, wine

Milk, tuna sandwich, salad (The chips, soft drink, and wine would be considered foods under the Moderation group.)

The nurse is approached by the client's spouse who says, "He eats so poorly. I know that is what is making him so sick!" The nurse recognizes that diet plays a role in the risk for chronic diseases. Which eating pattern would the nurse recommend that is associated with positive health outcomes? Plant-based eating pattern A diet high in red meat and refined grains Decreased intake of seafood, nuts, and unsaturated vegatable oils Dietary Approaches to Stop Hypercholesterolemia

Plant-based eating pattern (Dietary Approaches to Stop Hypertension (DASH), not hypercholesterolemia)

Nutrition plays a critical role in all aspects of health. Which is a fact that supports this statement? Proper nutrition aids in the treatment of acute and chronic diseases. Overweight and obese individuals rarely rank their health as very good or excellent. Plant-based diets are the only recommended healthy eating pattern. Healthy People 2030 includes a specific diet plan to address nutritional deficiencies.

Proper nutrition aids in the treatment of acute and chronic diseases.

*The nurse is considering the dietary needs of a client with burn related wounds. Which nutrient does the nurse identify as being the most important for wound healing? Riboflavin Fat Carbohydrate Protein

Protein

While teaching the Recommended Dietary Allowances (RDAs), the nurse should include which of the following points in the discussion? RDAs are the same as dietary reference intakes. RDAs are appropriate for healthy individuals in all age groups. RDA recommendations apply to people with chronic diseases. RDAs represent requirements for macronutrients only.

RDAs are appropriate for healthy individuals in all age groups.

The nurse wants to identify the protein intake level that meets the requirements of 97% of healthy individuals by life stage and sex. Which standard would the nurse use? Recommended Dietary Allowance (RDA) Estimated Average Requirement (EAR) Tolerable Upper Intake Level (UL) Adequate Intake (AI)

Recommended Dietary Allowance (RDA)

*A client states, "My wife wants me to try this Mediterranean diet. She says it will help me lose weight and help my heart." Which food(s) will the nurse recommend to align with the Mediterranean diet? Select all that apply. Broccoli cheddar soup Salmon with wild rice Ground beef burger Chicken with asparagus Roasted green beans

Salmon with wild rice Roasted green beans Chicken with asparagus (Salmon = Seafood; chicken = poultry. Limits red meat (ground beef burger) and processed & high-fat foods (broccoli cheddar soup).)

After reviewing a client's diet quality using the Healthy Eating Index (HEI), the nurse realizes the client is eating too many foods from the Moderation group. Which food(s) should the nurse recommend the client limit or decrease? Select all that apply. Saturated fat Added sugar Dairy Fatty acids Whole grains

Saturated fat Added sugar

*A client has recently gained 25 pounds and was diagnosed with prehypertension. The health care provider has recommended the client follow the Dietary Approaches to Stop Hypertension (DASH) diet. Which menu will the nurse recommend? Lunch consisting of spinach salad made with spinach, pear, almonds, and ranch dressing Breakfast consisting of an orange, 1 cup whole milk, and a whole-wheat bagel with peanut butter Dinner consisting of a bacon, lettuce, and tomato sandwich on whole-wheat bread with mayonnaise Snack of 1 cup of fat-free yogurt topped with blueberries and reduced-sodium whole-wheat crackers

Snack of 1 cup of fat-free yogurt topped with blueberries and reduced-sodium whole-wheat crackers (DASH diet features meals with large amounts of vegetables, fruits, and low-fat dairy products. It also incorporates whole grains, fish, poultry, and nuts while limiting the intake of red meat, sodium, and added sugars. Bad options: whole milk (breakfast), ranch dressing (lunch), bacon and mayonnaise (dinner).)

*The client has just been diagnosed with hypothyroidism and is to be started on thyroid replacement therapy. What important instruction must the nurse be sure to give the client that will affect his eating habits? Take the medication with meals. Take the medication on an empty stomach. Take the medication with milk. Take the medication at bedtime with a snack.

Take the medication on an empty stomach. (Thyroid replacement medication must be taken on an empty stomach)

*The nurse knows the following statement(s) to be true regarding the Estimated Average Requirement (EAR) values. Select all that apply. The EAR exceeds the requirements of half of the group and falls below the requirements of the other half. The EAR is one of the four original nutrient-based standards of the Dietary Reference Intakes (DRIs). The EAR is based solely on the prevention of nutrient deficiencies. The EAR does not include consideration for reducing the risk of chronic disease. The EAR does not take into account the bioavailability of a nutrient.

The EAR exceeds the requirements of half of the group and falls below the requirements of the other half. The EAR is one of the four original nutrient-based standards of the Dietary Reference Intakes (DRIs).

*When planning the goals or client outcomes, the nurse recognizes these should be centered on which of the following? The client's culture The client The disease process The family needs.

The client (Outcomes or goals should be based on the individual's needs. Disease, family, and culture may provide some influence but are not the most important.)

*The nurse suspects that social factors are limiting a client's understanding of the diet restrictions he is to follow. Which of the following may be a factor? The client lives in an assisted-living facility. The client is unable to read. The client lives with family. The client receives daily Meals-on-Wheels.

The client is unable to read.

A recently retired client states, "Now that I am retired, I want to focus on my health." The nurse reviews the client's medical history and lifestyle habits. Which finding would the nurse recommend the client focus on to improve their health? The client follows a vegetarian diet. The client consumes an alcoholic beverage twice per week. The client walks 3 miles each day. The client smokes two cigarettes per day.

The client smokes two cigarettes per day.

The nurse knows that smoking can have many negative effects on health. Which important fact about tobacco use does the nurse share with a client to encourage smoking cessation? Cigarette smoking causes more than 1 million deaths annually. Every day, about 25 young people in the United States become daily cigarette smokers. Tobacco use is the leading cause of preventable disease in the United States. For every smoking death, 10 people are living with a serious smoking-related illness.

Tobacco use is the leading cause of preventable disease in the United States.

A student nurse is reviewing dietary standards in preparation for a test. The student recognizes which standard as presenting the highest level of average daily nutrient intake? Adequate Intake (AI) Estimated Average Requirement (EAR) Recommended Dietary Allowances (RDAs) Tolerable Upper Intake Level (UL)

Tolerable Upper Intake Level (UL)

The nurse is educating a group of students about the placement of Dietary Reference Intakes (DRIs) along the continuum of intake. Which nutrient-based standard is closest to the risk-of-toxicity side of the continuum? Tolerable Upper Intake Level (UL) Chronic Disease Risk Reduction Intake (CDRR) Recommended Dietary Allowance (RDA) Estimated Average Requirement (EAR)

Tolerable Upper Intake Level (UL)

Dieticians use nutrient recommendations for specific purposes. Which statement indicates an understanding of the appropriate application of nutrient recommendations? Determine the exact nutrient requirements for an individual Used to analyze the adequacy of an individual's intake Are helpful in planning and evaluating menus for the general public Are suited to teaching people how to make healthy choices

Used to analyze the adequacy of an individual's intake

*The nurse is aware of advances being made in the field of nutrition. Which question is an example(s) of a question that is driving current nutrition research? Select all that apply. What are the biochemical bases for food choices? What vitamins are best to have in a daily supplement? How can we get people to change their eating behaviors? What are the nutritional needs of aging adults? How does food intake influence a person's microbiota?

What are the biochemical bases for food choices? How can we get people to change their eating behaviors? What are the nutritional needs of aging adults? How does food intake influence a person's microbiota?

The United States Department of Agriculture (USDA) and United States Department of Health and Human Services (USDHHS) consistently promote plant-based, Dietary Approaches to Stop Hypertension (DASH), and Mediterranean diets as healthy eating patterns. Which meal choice example would the nurse recommend to a client who would like to try a Mediterranean diet? Salami on whole wheat bread Tempura vegetables Pizza made with white flour Whole wheat pita bread with hummus

Whole wheat pita bread with hummus (The Mediterranean diet recommends avoiding refined grains, added sugars, deli meats, hot dogs, and other processed meats.)

The nurse is counseling a client on the relationship between excess calorie consumption and health problems. What health problems would the nurse identify as being associated with consuming more calories than are expended? Select all that apply. cancer BMI of 30 or greater failure to thrive blood pressure above 139/89 mm Hg increased blood cholesterol levels

blood pressure above 139/89 mm Hg increased blood cholesterol levels BMI of 30 or greater *cancer (Health problems associated with excess calorie intake include heart disease, cancer, stroke, diabetes, obesity, hypertension, and hypercholesterolemia. Failure to thrive is more likely to be associated with a calorie deficit.)

Which of the ten leading causes of death in the United States are associated with dietary excesses? Select all that apply. heart disease cancer stroke chronic lower respiratory disease nephritis, nephrotic syndrome, and nephrosis

heart disease cancer stroke

The nurse recognizes that a client's nutrition requirements may be related to other medical disorders. Which of the following would indicate that nutrition intervention should be a part of the nursing care plan? impaired physical mobility employed at two jobs lack of family support use of daily multivitamin supplement

impaired physical mobility

The nurse is assisting at a nonprofit clinic that offers medical services for at-risk clients. During assessments, the nurse is aware that several factors can negatively influence the clients' nutritional status. Which of the following may be a factor? Select all that apply. maintains a garden inadequate cooking arrangement receives food boxes monthly impaired intake related to culture low income

inadequate cooking arrangement low income impaired intake related to culture

The nurse recognizes that a client's nutrition therapy is based on which of the following factors? culture needs. RDA requirements. individual needs. age group needs.

individual needs.

The Mini Nutritional assessment (MNA) is a recognized tool that is used to assess nutrition. The nurse recognizes a client is at risk for malnutrition if the client has had symptoms of irritable bowels for how long? longer than 5 months longer than 4 months longer than 1 month longer than 3 months

longer than 3 months

The nurse recognizes that malnutrition is a major contributor to which of the following? home health assistance. frequent hospitalizations. prolonged hospital stays. nursing home admissions.

prolonged hospital stays. (malnutrition is a major contributor to morbidity, mortality, impaired quality of life, and prolonged hospital stays.)

The Acceptable Macronutrient Distribution Ranges (AMDRs) are broad ranges for each energy nutrient. Which of the following is the CORRECT percentage of AMDRs for adults? carbohydrate 20-35% protein 10-35% linoleic acid 0.6-1.2% fat 5-10%

protein 10-35%

When determining expected outcomes of the nursing process, the nurse recognizes that the outcomes will be more successful if they are: realistic for the client. easy for the family. as the health care provider ordered. cost effective for the client.

realistic for the client.

*The nurse is assessing a new client to the unit for possible malnutrition. The nurse is aware that the physical findings are: diagnostic. Specific subjective. reliable.

subjective. (Most physical symptoms cannot be considered diagnostic because evaluation of "normal" versus "abnormal" findings is subjective, and the signs of malnutrition may be nonspecific.)

A common clinical method of assessing nutritional status based on findings in a health history and physical examination is: the Mini Nutritional Assessment. the Joint Commission Nutrition Assessment. the American Dietitian's Assessment. the Subjective Nutritional Assessment.

the Mini Nutritional Assessment.