Chapter 12 - Nutrition Assessment

Which of the following is the most accurate and easy to implement nutritional assessment method? A. Food diary B. 24-hour recall C. Food frequency questionnaire D. Direct observation

A. Food diary The food diary is most complete and accurate if the nurse teaches the individual to record information immediately after eating. The 24-hour recall is the easiest and most popular method, but contains several sources for error including difficulty with memory recall, atypical intake in previous 24 hours, altered truth telling, and underreporting of snacks, sauces, and condiments. The food frequency questionnaire does not always quantify amount of intake and relies on the individual's memory. Direct observation is the most accurate method; however, it is difficult to implement and usually is only done when the nurse is concerned about parent feeding patterns or eating issues leading to malnutrition for a patient who is hospitalized (i.e., patient with anorexia nervosa).

Which of the following signs and symptoms would indicate malnutrition? (Select all that apply.) A. Lips cracked and pale pink, tongue beefy red. B. Skin color appropriate for race, intact, without evidence of dryness C. Erect posture with symmetric gait and muscle tone appropriate for age D. Hair dull and dry E. Bleeding gums

A. Lips cracked and pale pink, tongue beefy red. D. Hair dull and dry E. Bleeding gums There are several signs and symptoms of malnutrition which are included in Table 12-1. Skin color appropriate for race, intact, without evidence of dryness is a normal expected finding for skin assessment. Erect posture with symmetric gait and muscle tone appropriate for age is a normal expected finding for musculoskeletal assessment.

In order for a weight-loss program to be effective, what fat intake would be considered a low-fat diet? A. Mostly trans-fatty acid or saturated fat B. Between 20% and 25% of the total calorie intake C. Between 10% and 20% of the total calorie intake D. Less than 300 mg per day

B. Between 20% and 25% of the total calorie intake The cardinal features of a successful long-term weight loss plan include eating a low-fat diet which equates to 20% to 25% of total calories. Consumption of cholesterol should be less than 300 mg per day. Fat intake of 10% to 20% of total calorie intake would be too low for an appropriate low-fat diet. Intake of saturated fat should be limited. Trans-fatty acid consumption should be as low as possible.

For optimum health, infants and children up to 2 years of age should receive whole milk. What component of whole milk is essential for neurologic development? A. Fortified vitamin D B. Fat C. Pasteurized protein D. Lactose

B. Fat Infants and children younger than 2 years of age should not drink skim or low-fat milk or be placed on low-fat diets. Fat (calories and essential fatty acids) is required for proper growth and central nervous system development.

Which of the following changes in aging adults affect nutritional status? (Select all that apply.) A. Increased muscle mass B. Poor dentition C. Increased saliva production D. Decreased visual acuity E. Slowed GI motility

B. Poor dentition D. Decreased visual acuity E. Slowed GI motility The normal physiologic changes in aging adults that affect nutritional status include: poor dentition, decreased visual acuity, decreased saliva production, slowed GI motility, decreased GI absorption, and diminished olfactory and taste sensitivity. Aging adults experience decreased saliva production. Aging adults experience loss of lean body mass and increase in fat mass.

Which of the following is the reason for increased caloric and protein requirements during adolescence? A. Decreased dependence on parents. B. Rapid physical growth and increasing muscle mass C. Changes in diet D. Change in cognitive and psychological factors

B. Rapid physical growth and increasing muscle mass Adolescence is a period when the child experiences rapid physical growth and endocrine and hormonal changes. While there is change regarding adolescent cognitive and psychological factors, these do not increase nutritional requirements. Adolescents often eat differently, especially when they are with peers. Their activity level/participation in sports may increase caloric needs, but this does not apply to all adolescents. The process of individuation ("figuring out who they are") and spending more time away from parents does not increase nutritional needs.

Obesity in adults is defined as: A) excess body fat placed predominately within the hips and thighs. B) excessive body fat leading to body weight 5% above ideal. C) a body mass index of 30 or greater. D) overnourished.

C) a body mass index of 30 or greater. Obesity in adults is defined as a body mass index of 30 or greater. Overweight in adults is defined as a body mass index of 25 or greater. Obese people with most of their fat in the hips and thighs have gynoid obesity; android (upper body) obesity places a person at higher risk for obesity-related diseases and early mortality. Obesity is greater than 120% of the ideal body weight. Overnutrition is caused by the consumption of nutrients, especially calories, sodium, and fat, in excess of body needs.

A dietary practice to restrict meat on certain days such as Ash Wednesday and Fridays during Lent is an example of what type of nutritional influence? A. Ethnic B. Economic C. Religious D. Cultural

C. Religious Meat restrictions on certain holy days is a religious influence on dietary practices for many denominations of Catholics.

A comprehensive nutritional assessment always includes A. a direct observation of feeding and eating processes. B. a comprehensive metabolic panel. C. anthropometric measures. D. a work history.

C. anthropometric measures. Anthropometric measures evaluate growth, development, and body composition. Examples include height, weight, waist circumference, derived weight measures (e.g., body mass index, waist-to-hip ratio), and triceps skinfold thickness.

Nutritional status is best determined by: A. triglycerides. B. 24-hour diet recall. C. serum albumin. D. clinical manifestations.

C. serum albumin. Laboratory testing is required to make an accurate diagnosis of malnutrition. Serum albumin is a common measurement of visceral protein status. Low serum albumin levels occur with protein-calorie malnutrition, altered hydration status, and decreased liver function. A serum albumin level of 2.8 to 3.5 g/dL represents moderate visceral protein depletion, and a level less than 2.8 g/dL denotes severe depletion. Clinical signs of nutritional deficiencies can be detected by a physical examination, but clinical manifestations may be a late sign of nutritional deficiencies. These signs may also be non-nutritional in origin. Triglycerides are used to screen for hyperlipidemia and the risk for coronary artery disease. A 24-hour diet recall is the easiest and most popular method for obtaining information about nutritional intake; however, this method has significant sources for error.