EXAM 1

What are the recommended daily requirements of EPA and DHA to reduce the risk of heart disease? A) 500 mg/day B) 600 mg/day C) 800 mg/day D) 1000 mg/day

A) 500 mg/day

The fruit food group of the MyPyramid is virtually fat free. What is the exception to the rule in this food group? A) Avocado B) Banana C) Cherries D) Pineapple

A) Avocado

Linoleic acid and alpha-linoleic acid are two fatty acids considered to be n-3 fatty acids. Another name for these fatty acids is omega-3 fatty acids. What are the best sources of omega-3 fatty acids? A) Cold-water fish, such as mackerel, salmon, sardines, and lake trout B) Meats, such as beef, veal, lamb, and pork C) Foods made with hydrogenated oils, such as cookies, crackers, stick margarine, and shortening D) Milk and milk products

A) Cold-water fish, such as mackerel, salmon, sardines, and lake trout

What is "good" cholesterol? A) High-density lipoproteins B) Low-density lipoproteins C) Very-low-density lipoproteins D) Chylomicrons

A) High-density lipoproteins

When does the body break down fatty acids incompletely creating an increase in ketone formation? A) Starvation and uncontrolled diabetes B) Periods of a high-fat intake C) Coronary heart disease D) Fat malabsorption syndromes

A) Starvation and uncontrolled diabetes

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.

Ans: D Feedback: 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.

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

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

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

Ans: D Feedback: 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.

What concept was developed from the amount of carbohydrate contained in a food and the glycemic index of the food? A) Glycemic response B) Glycemic indication C) Glycemic level D) Glycemic load

Ans: D Feedback: Because the amount of carbohydrate contained in a typical portion of food also influences glycemic response, the concept of glycemic load was created to more accurately define a food's impact on blood glucose levels. It takes into account both the glycemic index of a food and the amount of carbohydrate in a serving of food. Glycemic indication and glycemic level do not exist. The glycemic response is a physiologic reaction impacted by the glycemic load.

The serving size of a piece of meat is approximately the size of a deck of cards. What is its approximate weight? A) 2 ounces B) 3 ounces C) 6 ounces D) 8 ounces

B) 3 ounces

What do experts recommend limiting to cut saturated fat intake in the diet? A) Butter B) Beef C) Cakes and cookies D) French fries

B) Beef

Cholesterol, a waxy substance found in all cell membranes, is found only in what foods? A) Saturated fats B) Hydrogenated fats C) Foods made from plants D) Animal products

D) Animal products

The nurse is teaching a nutrition class, and the subject for today is the basal metabolic rate (BMR). What percentage range would the nurse tell the students the BMR accounts for in the total energy requirements for most people? A) 10% B) 25% C) 60% D) 75%

Ans: C Feedback: For most people, the BMR accounts for approximately 60% to 70% of the total calories expended.

You are teaching a nutrition class in a bariatric clinic. One of your students asks, "If fat isn't good for you, why not go on a fat-free diet?" You explain that fat does have several functions in food. What is one of those functions? A) It absorbs flavors and aromas of ingredients to improve overall taste. B) It makes meat more rare when you cook it. C) It makes cheese have a rubbery feel. D) It increases rancidity in foods.

A) It absorbs flavors and aromas of ingredients to improve overall taste.

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

Ans: C Feedback: 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 is aware that magnesium deficiency is a potential nutritional problem in the United States. What is the cause of this potential problem? A) Low intake of milk and dairy products B) Not eating enough citrus fruits in our diet C) Not drinking enough enriched orange juice D) The use of refined grains over whole grains

Ans: D Feedback: A low magnesium intake is related to the intake of refined grains over whole-grain breads and cereals because magnesium is lost during the refining process and not replaced.

Which fat is not digested by the body? A) Monounsaturated fat B) Cholesterol C) Phospholipid D) Trans fat

B) Cholesterol

You are eating 1 tablespoon of a salad dressing that contains 14 g of fat and no protein or carbohydrate. How many calories will you consume in the salad dressing? A) 76 cal. B) 98 cal. C) 126 cal. D) 140 cal.

C) 126 cal.

The recommendation for fat intake in the American diet is what? A) 10% of total calories B) 20% of total calories C) 30% of total calories D) 40% of total calories

C) 30% of total calories

What process in the body impairs the digestion of fat? A) Diabetes B) Stomach ulcer C) Inflammation of the pancreas D) Constipation

C) Inflammation of the pancreas

It has been found that fats that are hydrogenated are what? A) Found in cold-water fish B) More likely to oxidize and become rancid than vegetable oils C) More saturated than the original oil from which they were derived D) Less saturated than the original oil from which they were derived

C) More saturated than the original oil from which they were derived

What dietary component raises serum cholesterol more than any other? A) Cholesterol B) Polyunsaturated fat C) Saturated fat D) Monounsaturated fat

C) Saturated fat

Fatty acids are either essential or non-essential. What makes some fatty acids essential? A) They are only found in fish. B) They are saturated fatty acids. C) They cannot be synthesized by the body. D) They are found only in animal products.

C) They cannot be synthesized by the body.

Nutritional recommendations include lowering the intake of total fat in our diets. What is one strategy we can use to lower total fat intake in our diets? A) Substitute regular margarine for butter. B) Use artificially sweetened soft drinks in place of sweetened drinks. C) Use herbs and spices in place of butter. D) Use olive oil in place of corn oil.

C) Use herbs and spices in place of butter.

Which of the following is true of cholesterol? A) Cholesterol provides 9 cal/g. B) Cholesterol is an essential nutrient because it cannot be synthesized by the body. C) Cholesterol in food comes from plants (the "good" cholesterol) and from animal products (the "bad" cholesterol). D) Cholesterol is used by the body to synthesize bile acids and vitamin D.

D) Cholesterol is used by the body to synthesize bile acids and vitamin D.

Phospholipids are unique in that they can act as what in the body? A) Absorbents B) Stabilizers C) Solutes D) Emulsifiers

D) Emulsifiers

The body is very efficient at converting what, when it is in excess, into adipose tissue? A) Sugars B) Starches C) Protein D) Fat

D) Fat

Trans fats are considered "bad" fats. What do they do in the body? (Mark all that apply.) A) Lower HDL-cholesterol B) Increase insulin resistance C) Lower biomarkers of inflammation D) Raise biomarkers of inflammation E) Decrease the risk of colon cancer

A) Lower HDL-cholesterol B) Increase insulin resistance D) Raise biomarkers of inflammation

In the past few years much has been made of trans-fatty acids. The American public has been warned to attempt to eliminate "trans fats" from their diets. Why has this been encouraged? A) Trans-fatty acids raise the level of "bad" cholesterol in the blood. B) Trans-fatty acids lower the level of "bad" cholesterol in the blood. C) Trans-fatty acids are found in coconut, palm, and palm kernel oils. D) Trans-fatty acids account for most fat calories in the average American's diet.

A) Trans-fatty acids raise the level of "bad" cholesterol in the blood.

An 18-month-old victim of a car accident is being admitted to the pediatric ICU. In reviewing the orders for this client, the nurse expects to see diet orders that provide what kind of nutritional therapy? A) Aggressive B) Slow and sure C) Protein restrictive D) Protein delayed

Ans: A Feedback: Aggressive nutritional support is used to restore metabolic balance as quickly as possible. Kwashiorkor results mainly from acute critical illnesses such as trauma, sepsis, and other illnesses seen in intensive care units. The nutritional support used in marasmus is slow. Nutritional support that is protein restrictive or protein delayed is not associated with the treatment of Kwashiorkor.

The nurse is teaching a nutrition class at the local high school. The subject for today is calcium. What is a good source of dietary calcium to teach the class? A) Fortified orange juice B) Organ meats C) Egg yolks D) Potatoes

Ans: A Feedback: Besides dairy products, calcium is also found in bok choy, broccoli, Chinese/Napa cabbage, collards, kale, okra, turnip greens, fortified breakfast cereal, fortified orange juice, legumes, fortified soy milk, and almonds.

The health class asks the nurse what mineral is the most abundant in the body. What would the correct response be? A) Calcium B) Phosphorus C) Magnesium D) Iron

Ans: A Feedback: Calcium is the most plentiful mineral in the body, making up about half of the body's total mineral content. Almost all of the body's calcium is found in the bones and teeth.

In evaluating the new client's needs, the nurse realizes the client will need additional protein due to which of the following situations? A) Peritoneal dialysis B) Hypometabolic condition C) Menopause D) Diabetes mellitus

Ans: A Feedback: Clients receiving peritoneal dialysis lose protein in the dialysis fluid and need higher protein intake to compensate.

The nurse is conducting nutrition counseling for a 21-year-old woman in the clinic area. The nurse is discussing empty calories and explaining empty calories can be used for which of the following? A) Extras to the meal plan B) The fat and sugar in your plan C) To eat an extra slice of toast without counting its calories D) To add servings in any major food group

Ans: A Feedback: Empty calories allow consumers to incorporate small amounts into their eating plan and still meet nutrient needs without exceeding total calorie restraints.

BMI is now being used to determine obesity; however, its use is not without controversy. Research has shown that ethnic differences exist in the relationship between BMI and health risks. Which ethnic group has been shown that the health risks of obesity can occur at a BMI lower than 30? A) Asian Americans B) Black Americans C) Hispanic Americans D) Native Americans

Ans: A Feedback: Ethnic differences exist in the relationship between BMI and health risks. For instance, because of genetic differences in body composition, the health risks of obesity occur at a BMI lower than 30 for Asian Americans and higher than 30 for Black Americans.

It is well recognized that most Americans have become more sedentary than in the past. Many sit at desks working at computers all day. This sedentary lifestyle has increased the risk for various diseases and complications. What have experimental studies shown that prolonged sitting can do? A) Suppress insulin activity in the muscles B) Decreases the risk of osteoporosis C) Increases the use of stored fat for energy D) Increases the effect of menopause

Ans: A Feedback: Experimental studies show that prolonged sitting suppresses lipase and insulin activity in muscles, leading to metabolic abnormalities.

A nurse has attended a seminar covering the objectives of Healthy People 2020. Upon returning to the clinic, the nurse is asked what the clinic could do differently to meet the objectives. Which of the following would be an appropriate answer? A) Regularly measure BMI at each visit. B) Provide nutritional counseling with each visit. C) Determine food insecurity with each visit. D) Provide clients with food journals to return for evaluation.

Ans: A Feedback: Healthy People 2020 is a set of goals to promote health and reduce chronic disease. One of these goals is to increase the proportion of primary care physicians who regularly measure the body mass index of their clients. The other options are not actual goals to complete at each visit.

The nurse is admitting a client to the hospital unit with a diagnosis of marasmus. This diagnosis is most likely secondary to what? A) A chronic disease B) A recent trauma C) The influence of affluence D) The quality of the protein in the diet

Ans: A Feedback: In the United States, marasmus occurs secondary to chronic diseases such as cancer, AIDS, and chronic pulmonary disease. Kwashiorkor occurs secondary to an acute incidence like a trauma. Affluence and protein quality are not associated with marasmus.

The nurse is working with a group of senior citizens in helping them develop weight loss goals. The seniors are surprised to learn that traditional height-weight calculations to determine "ideal" body weight have now been replaced by what? A) Body mass index B) Basal metabolic rate C) Desirable weight chart D) Kilogram/meter calculations

Ans: A Feedback: In the clinical setting, BMI has replaced traditional height-weight calculations of "ideal" or "desirable" body weight.

The nurse is working with a 23-year-old client to develop a menu plan for a 2000-calorie food plan. After presenting MyPlate options, the client decides on a menu for the day. Which of the following is the best option for this client? A) 1 cup steamed spinach, 3 oz poached salmon with dill, 1 small apple, 1 cup hot tea sweetened with 1 tsp sugar B) 2 slices white bread, 1 tbsp mayo, 2 slices bologna, 1 slice American cheese, 1 tsp mustard C) 1 cup yogurt with fruit, 1 cup spilt pea and ham soup, 1 cup coffee with creamer and sugar D) 2 cups spaghetti with meatball sauce, 2 cups salad with lettuce, carrots, celery, radishes, green peppers, green onions, and 3 tbsp ranch dressing

Ans: A Feedback: MyPlate guidelines encourage a variety of fruit and vegetables without added solid fats and sugars. Refined grains, whole-fat dairy products, and empty calories are not recommended. The meal option of spinach, salmon, apple, and tea best follows the guidelines in variety and portion sizes.

There is a phenomenon in America that involves its popular fast food addiction. What is the term used to describe the American love affair with "super-sized" portions? A) Portion distortion B) Portion identity C) Increased appetite D) Increased hunger

Ans: A Feedback: Over time, the effects of larger portion sizes distort peoples' perception of how much food is "normal" or necessary to create a feeling of fullness and alter their ability to monitor how much food they have consumed.

What, besides diet, do the American Institute for Cancer Research nutrition and lifestyle guidelines recommend to reduce the risk of cancer? A) Manage weight. B) Eat less than 6 g of salt per day. C) Balance the number of calories consumed with the number of calories used daily. D) Choose 100% juice when drinking fruit or vegetable juices.

Ans: A Feedback: The American Institute for Cancer Research recommends for individuals to be as lean as possible without becoming underweight.

The nurse is aware that the Dietary Guidelines for Americans are published every 5 years and are intended for whom? A) Individuals aged 2 years and older B) Children aged 2 to 12 years C) Infants and senior citizens D) Adults aged 18 years and older

Ans: A Feedback: The DGA are designed for Americans aged 2 years and older. The 2010 version is intended not just for healthy individuals but also for people at increased risk of chronic disease.

During the nutrition class, the nurse asks one of the students to describe the Estimated Average Requirement (EAR). What should the student answer? A) EAR is the amount of a nutrient that is estimated to meet the requirement of half of healthy people in a lifestyle or gender group. B) EAR is the amount of a nutrient that meets the needs of 98% of all people. C) EAR is the amount of a nutrient that meets the needs of all healthy people in a specific population. D) EAR is the amount of a nutrient that is recommended to prevent chronic illness.

Ans: A Feedback: The EAR is the amount of a nutrient that is estimated to meet the requirement of half of healthy people in a lifestyle or gender group.

The school nurse is teaching nutrition to a group of kindergarten students. After presenting MyPlate to the students and discussing their food options, she is glad they understand when she hears which of the following comments? A) Half our plate should be fruits and vegetables. B) We should drink whole milk. C) We should eat twice the grains as protein. D) We should eat a sweet roll instead of candy.

Ans: A Feedback: The MyPlate graphic devotes ½ the plate to fruit and vegetables. Low-fat milk is a better choice as it reduces the amount of fat in the diet.

The nurse is teaching a high school health class on diet and exercise. Which of the following statements can she truthfully make? A) As the intensity of activity increases, the proportion of energy used increases. B) As the duration of activity increases, the proportion of fat used decreases. C) Physically fit people use more energy and store more fat. D) During the first 1 to 2 minutes of exercise, stored fat is the primary fuel.

Ans: A Feedback: The actual amount of energy expended on physical activity depends on the intensity and duration of the activity and the weight of the person performing the activity. The more intense and longer the activity, the greater is the amount of calories burned.

The nurse is helping the client develop a meal plan based on 2000-calorie MyPlate plan. Which of the following menus shows the client understands the plan? A) 1 cup plain yogurt with fresh strawberry slices, 1 hardboiled egg, 1 cup herbal tea, 1 slice 8-grain toast B) 2 cups Rice Krispies with 1 cup low-fat milk, 1 cup sliced strawberries with 1 tsp sugar, 1 slice whole wheat toast with 1 tsp butter and grape jelly, 1 cup coffee black C) 1 cup raspberry flavored yogurt with 1 tsp flax seeds, 2 sliced toasted sourdough bread with 1 tsp canola margarine, 1 cup coffee with creamer D) 2 cups oatmeal with 2 tbsp brown sugar, ½ cup raisins and 1 cup whole milk, 1 cup hot tea with 1 tsp honey

Ans: A Feedback: The breakfast consisting of plain yogurt with strawberries, egg, toast, and tea best follows the guidelines of MyPlate 2000-calorie diet. The other choices contain a variety of hidden fats, sugars, and refined grains.

The nurse has been emphasizing the importance of reading labels to know the content of foods the client is eating. The client recognizes which of the following as a "safe" fat? A) Sunflower oil B) Palm oil C) Partially hydrogenated oil D) Milk fat

Ans: A Feedback: The decreased consumption of saturated or solid fats is recommended to decrease the risk of chronic disease. Palm oil, partially hydrogenated oil, and milk fat are considered solid fats.

The nurse is discussing the various effects of calories on the body. The caloric cost of digesting, absorbing, and metabolizing food is called what? A) The thermic effect B) The metabolic effect C) The basal metabolic rate D) The resting metabolic rate

Ans: A Feedback: The thermic effect of food is an estimation of the amount of energy required to digest, absorb, transport, metabolize, and store nutrients.

The client is meeting with the nurse to discuss starting a weight loss program. It is important that the client is aware where calories come from and how many are consumed. Calories come from the foods we eat and the liquids we drink. How many calories per gram are there in carbohydrates? A) 4 cal/g B) 7 cal/g C) 9 cal/g D) 12 cal/g

Ans: A Feedback: There are 4 cal/g in carbohydrate and protein, 9 cal/g in fat, and 7 cal/g in alcohol.

When properly preparing food, the client must be cognizant that vitamins and minerals differ in that minerals are what? A) Not destroyed by heat and light B) Are destroyed by heat and light C) Released from foods only by cooking D) Need to be supplemented in the diet because they are destroyed by cooking

Ans: A Feedback: Unlike vitamins, minerals are not destroyed by light, air, heat, or acids during food preparation. Minerals are lost only when foods are soaked in water.

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

Ans: A Feedback: "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.

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

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

Children sometimes get mottled tooth enamel because they ingest more fluoride than is recommended while their teeth are forming. What causes this? A) Fluoridated toothpaste B) Fluoride supplements C) Drinking water D) Fluoride in foods

Ans: A Feedback: Children under the age of 8 years are susceptible to mottled teeth enamel if excessive amounts of fluoride are ingested. The swallowing of fluoridated toothpaste has been blamed.

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

Ans: A Feedback: 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

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

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

Ans: A Feedback: 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

Ans: A Feedback: 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.

The nurse is admitting a client onto the unit with a diagnosis of manganese toxicity. What symptoms would be expected in this client? A) Tremors B) Flexibility C) Unaltered gait D) Tetany

Ans: A Feedback: Manganese toxicity is an occupational hazard for miners who inhale manganese dust, leading to central nervous system abnormalities with symptoms similar to parkinsonism.

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

Ans: A Feedback: 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

Ans: A Feedback: 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.

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"

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

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

Ans: A Feedback: 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.

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

Ans: A Feedback: 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.

Ans: A Feedback: 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

Ans: A Feedback: 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.

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

Ans: A Feedback: 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.

The nurse is aware that sugar alternatives come in two categories: polyols and nonnutritive sweeteners. When helping a client develop a menu plan, which of the following is true about nonnutritive sweeteners that the nurse should share with the client? A) They promote dental caries. B) They are much less sweet than sugar. C) They provide few or no calories. D) They cause blood sugar levels to rise rapidly.

Ans: A Feedback: Alternatives to sugar arise from Americans' desire to "have their cake and eat it, too." People want the taste of sweetness without feeling guilty about the calories. The food industry has responded to this demand by developing numerous low-calorie and calorie-free nonnutritive sweeteners. Nonnutritive sweeteners are hundreds of times sweeter than sugar. They do not cause dental caries and do not raise blood sugar levels.

The local community center is offering a class for citizens who are morbidly obese. They plan to provide a selection of foods to create nutritional menu plans for a 3-day period. Some of the criteria for the nutritional menu are to meet the RDA for carbohydrates and to include a whole-grain food at least two times a day. Which of the following is an example of a whole-grain food? A) Cheerios B) Corn flakes C) Puffed wheat D) Rice Krispies

Ans: A Feedback: An example of a whole grain is Cheerios. The other cereals are made from refined grains.

Phenylketonuria (PKU) is a genetic disorder that is characterized by an inability of the body to use the essential amino acid phenylalanine. People with PKU should avoid which nonnutritive sweetener? A) Aspartame B) Saccharin C) Acesulfame K D) Sucralose

Ans: A Feedback: Aspartame is made from the amino acids aspartic acid and phenylalanine. People with phenylketonuria must avoid aspartame. Saccharin, acesulfame K, and sucralose do not have phenylalanine as an ingredient.

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 B) Increased mucus production C) Rule out aphasia D) COPD

Ans: A Feedback: 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.

A nurse is conducting a weight management class at a local clinic for clients who have lost weight and are now trying to maintain a healthy BMI. Which of the following statements indicate the class understands the guidelines? A) We should eat approximately three servings of whole grains every day. B) We should eat approximately three servings of whole grains every week. C) We should eat whole-grain products at least once a day. D) We can eat both whole-grain and enriched refined-grain products in moderation.

Ans: A Feedback: Cross-sectional and prospective epidemiologic studies show that whole-grain intake is associated with lower risk of obesity and weight gain. Fourteen cross-sectional studies show that a daily intake of approximately three servings of whole grains is associated with lower BMI in adults. Studies have also shown that those who consumed more whole grains consistently weigh less.

A nutrition class is learning about the relationship between protein and nitrogen. The assignment given to the class is to calculate how many grams of nitrogen are provided by 80 g of protein. What is the correct answer expressed in whole grams? A) 13 g B) 20 g C) 27 g D) 34 g

Ans: A Feedback: Eighty grams of protein provides approximately 13 g of nitrogen. The total amount of protein consumed (in grams) is divided by 6.25 because protein is 16% nitrogen by weight (80 g ÷ 6.25 = 13 g).

A client is complaining of occasional constipation. The nurse recognizes that some foods have a physiologic effect on the body outside of their nutritional value. Of the following, what food would the nurse recommend to the client that may help prevent constipation? A) Shredded wheat B) Puffed rice C) Oranges D) Lettuce

Ans: A Feedback: Fibers in whole grains, dried peas and beans, and bran increase stool weight to help prevent constipation. Puffed rice is made from white (refined) rice which is low in fiber. The fiber in fruits is in the skin, and we do not eat the skin of an orange. Lettuce is not a high-fiber food.

In 2009, the American Heart Association (AHA) recommended limits of added sugar intake for adults to help prevent disease. What were those recommendations? A) 6 teaspoonfuls for women; 10 teaspoonfuls for men B) 8 teaspoonfuls for men; 6 teaspoonfuls for women C) 6 teaspoonfuls for men; 10 teaspoonfuls for women D) 4 teaspoonfuls for women; 6 teaspoonfuls for men

Ans: A Feedback: In 2009, the AHA recommended that most American women limit added sugar intake to a maximum of 100 calories per day (25 g or 6 tsp) and that most American men limit their added sugar intake to 150 calories or less per day (38 g or 10 tsp)

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.

Ans: A Feedback: 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.

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 B) Physicians C) Dietitians alone D) The client's family

Ans: A Feedback: 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.

Polyols or sugar alcohols are one of the alternatives to naturally occurring sugar that are used widely in the American diet. Some of the sugar alternatives can cause unpleasant side effects in some people if eaten in large amounts. What can large amounts of polyols cause in some people? A) Diarrhea B) Constipation C) Elevated serum glucose levels D) Nausea

Ans: A Feedback: Polyols (e.g., sorbitol, mannitol, and xylitol) are natural sweeteners derived from monosaccharides. Some people experience a laxative effect (abdominal gas, discomfort, or osmotic diarrhea) after consuming polyols. Nausea and constipation are not caused by large intakes of sugar alcohols. Sugar alternatives do not increase serum glucose levels.

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

Ans: A Feedback: 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 B) Acute weight loss C) BMI D) Appetite

Ans: A Feedback: 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.

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

Ans: A Feedback: 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.

A client in a nutrition class is concerned about constipation and not having enough fiber in his diet. What would be the best response to this client to increase fiber intake? A) Eat legumes in place of meat. B) Eat cooked vegetables instead of raw vegetables. C) Bake foods instead of frying them. D) Eat small, frequent meals.

Ans: A Feedback: To increase the intake of fiber, encourage clients to eat dried peas and beans two to three times per week. Nuts, dried peas, and beans provide significant starch and fiber, but they are generally consumed less often than other carbohydrate-free selections. The other foods do not increase the fiber content of the diet.

The nurse is conducting a class for a group of clients with newly diagnosed type 2 diabetes mellitus. Which of the following are suggestions to help the clients make better decisions? Select all that apply. A) Eat out less often. B) Bring healthy snacks from home. C) Stock up on "fat-free" and "sugar-free" nutrition bars. D) Switch to whole milk.

Ans: A, B Feedback: Strategies that may make healthy eating easier include eating out less often and bringing healthy snacks from home instead of relying on the vending machine options. Avoid commercially prepared "junk" foods that have been modified to be "fat free" or "sugar free." Fat-free milk is a good choice because milk is a fundamentally healthy food made healthier by the elimination of fat.

The school nurse is teaching nutrition to a second grade class. In helping the students make better choices, which of the following should be emphasized? Select all that apply. A) Fresh fruit B) Whole-grain toast C) Low-fat milk D) Granola E) Macaroni and cheese F) Regular hot dogs

Ans: A, B, C Feedback: Choosing foods without solid fats, additional sugar, and refined flours are better choices. Granola, macaroni and cheese, and regular hot dogs are high in solid fats and sugars.

A day care center has contacted the clinic requesting assistance in providing better choices for snacks for their clients. Which of the following are the best choices for these preschool children? Select all that apply. A) Fresh apple slices B) Strawberries C) Oranges D) Saltine crackers E) Whole-grain cookies

Ans: A, B, C Feedback: Providing fresh fruit versus crackers and cookies is better option. Crackers and cookies can contain solid fats and extra sugar that are not needed by the children. The fresh fruit will also provide more essential nutrients.

The nurse is teaching a client about making better food choices to help her lose weight. Which of the following should the nurse encourage the client to choose? Select all that apply. A) Apple slices B) Plain yogurt with fruit slices C) Baked chicken without skin D) Enriched bread with butter E) Low-sugar candy F) Bologna and whole wheat bread sandwich

Ans: A, B, C Feedback: Some foods are calorie dense, such as regular soft drinks, most desserts, fried foods, full-fat dairy products, high-fat meat, and processed foods. They are considered calorie dense due to their solid fats and added sugars content. Clients should be encouraged to choose nutrient-dense foods instead. These include items prepared without added fat and sugar.

The nurse is helping a 76-year-old woman develop an exercise program. Which of the following are important to consider? Select all that apply. A) Include exercises to improve balance. B) Match her activities to her abilities. C) Determine her level of effort. D) Work up to 150 minutes of moderate-intensity aerobic activity per week. E) Work out longer but slower to improve her activity level.

Ans: A, B, C Feedback: When working with older adults, it is important to keep in mind their activity level, their current abilities, and their limitations as far as movement, endurance, balance, and chronic conditions.

There is more to the glycemic response to a food than the caloric value of the food. The glycemic response is influenced by many different variables. What variables influence the glycemic response of the body to a food? Select all that apply. A) Amount of acid in the food B) The degree the food has been processed C) What other foods are eaten at the same time D) What the glycemic indication of the food is E) How well masticated the food is

Ans: A, B, C Feedback: A food's glycemic response is actually influenced by many variables including the amounts of fat, fiber, and acid in the food; the degree of processing; the method of preparation; the amount eaten; the degree of ripeness (for fruits and vegetables); and whether other foods are eaten at the same time. There is no glycemic indication of food. The absorption of food is more important to glycemic response than how well masticated a food is.

The school nurse is discussing nutrition with a group of preteen students. After discussing the various options in the food groups, they discuss the way solid fats and added sugars can be hidden in food and the importance of reading labels. Which of the following are examples of food with hidden solid fats and/or sugar? A) Sweet rolls B) Banana chips C) Salt D) Microwave popcorn E) Plain beef jerky

Ans: A, B, C, D Feedback: Solid fats and sugar are in many foods. The diligent consumer who reads labels and recognizes the various names that are used will be more aware and can make conscious decisions. Banana chips are often coated with sugar and many brands of salt, including major name brands, now have dextrose added to it. Sweet rolls and microwave popcorn have added solid fats.

The nurse is teaching the high school health class the benefit of drinking milk because it is known that a chronically low intake of calcium can do what? A) Cause low blood calcium levels B) Compromise bone integrity C) Cause tetany D) Impair protein synthesis

Ans: B Feedback: A chronically low calcium intake compromises bone integrity without affecting blood calcium levels.

The nurse is caring for a client status one day after colon resection with anastomosis. The client has a nasogastric tube in place, putting him on NPO status. The nurse is aware this places the client in what state? A) Protein-energy malnutrition B) Negative nitrogen balance C) Marasmus D) Neutral nitrogen balance

Ans: B Feedback: A negative nitrogen balance indicates that protein catabolism is occurring at a faster rate than protein synthesis, which occurs during starvation or the catabolic phase after injury. Protein-energy malnutrition does not occur one day after a major surgery. Marasmus does not follow an acute event such as surgery. A neutral nitrogen balance is the state where protein intake equals protein catabolism.

The nurse is discussing calories and the effect they can have on the body. The nurse explains that a person who takes in too many calories on a consistent basis is in what? A) A negative caloric balance B) A positive energy balance C) A negative energy balance D) A positive caloric balance

Ans: B Feedback: A positive energy balance occurs when calorie intake exceeds calorie output, whether the imbalance is caused by overeating, low activity, or both.

Nitrogen balance in specific groups of people can be a concern. What is the state of nitrogen balance in infants, children, adolescents, and pregnant and lactating women? A) Neutral nitrogen balance B) Positive nitrogen balance C) Negative nitrogen balance D) Metabolic turnover

Ans: B Feedback: A positive nitrogen balance exists during growth, pregnancy, or recovery from injury. Therefore, infants, children, adolescents, and pregnant and lactating women are in a state of positive nitrogen balance. This indicates that protein synthesis exceeds protein breakdown.

The nurse is counseling a young female adult who needs approximately 2000 cal/day to maintain her weight. She would like to lose a few pounds and asks what she would need to limit her intake to if she wanted to lose a pound a week. How should the nurse respond? A) 1000 cal/day B) 1500 cal/day C) 1600 cal/day D) 1800 cal/day

Ans: B Feedback: A pound of body fat is equivalent to 3500 calories. An "extra" 500 cal/day for a week can result in a 1-pound weight gain. By reversing this, 500 cal/day decrease should result in a weight loss of 1 pound per week.

Most people eat less-than-healthful foods from time to time. What is one of the key strategies to fitting less-than-healthful foods into a healthier lifestyle? A) Eating them at certain times of the day B) Eating them by conscious decision C) Eating them frequently D) Eating them in large amounts

Ans: B Feedback: An allowance for empty calories allows consumers to incorporate small amounts of empty calories into their eating plans and still meet nutrient needs without exceeding total calorie constraints.

Normally about 60% of natural phosphorus from food sources is absorbed, but absorption of phosphorus from food preservatives (e.g., phosphoric acid) is almost 100%. Phosphorus deficiency is not a problem in the United States because of what? A) Phosphorus is added to foods because there are few good natural sources. B) Phosphorus is pervasive in the food supply. C) Phosphorus is found only in animal products. D) Phosphorus is found only in plant products.

Ans: B Feedback: Animal proteins, dairy products, legumes are rich natural sources of phosphorus. Soft drinks contain phosphoric acid. Phosphate additives—which are often added to commercially prepared foods to extend shelf life, improve taste, improve texture, or retain moisture—can be significant sources of phosphorus.

The nurse is conducting a nutrition class when one of the clients questions the accuracy of using BMI to determine obesity. The client is surprised to see his BMI is high but he does not feel he is overweight. What is a drawback of using body mass index to determine obesity? A) It is nonthreatening. B) It does not take body composition into account. C) It requires special equipment to measure. D) It does not take diet into account.

Ans: B Feedback: BMI does not take body composition into account; an athlete may have a high BMI even though he or she has well-developed muscle mass and little fat tissue. An elderly person may have a healthy BMI but actually have increased fat tissue compared to muscle mass.

The client is being evaluated for dehydration. The nurse is aware that several conditions increase the loss of fluid from the body. What is one of the conditions that might increase the fluid loss? A) Thirst B) Strenuous exercise C) Congestive heart failure D) Controlled diabetes

Ans: B Feedback: Extreme environmental temperatures (very hot or very cold), high altitude, low humidity, and strenuous exercise increase insensible water losses from respirations and the skin.

The nurse is teaching a nutrition class on how to estimate the total number of calories expended by a person per day according to the rule-of-thumb formula. What is the estimated total calorie expenditure for a 160-pound man who does little activity? A) 1920 B) 2112 C) 2288 D) 3220

Ans: B Feedback: First, calculate the BMR: For men, multiply the weight by 11 (160 × 11 = 1760); next, calculate the estimated total calories based on the activity level (sedentary activity level is indicated at 20%) (1760 × 0.20 = 352). Add the BMR calories and PA calories to determine the total calories for the day: 1760 + 352 = 2112 calories.

The nutrition class is discussing how some nutrients are necessary for various chemical substances in the body. What is an essential component of thyroxine (T4) and triiodothyronine (T3)? A) Iron B) Iodine C) Zinc D) Selenium

Ans: B Feedback: Iodine is an essential component of T3 and T4, the thyroid hormones responsible for regulating metabolic rate, body temperature, reproduction, growth, the synthesis of blood cells, and nerve and muscle function.

What is the term used for practicing vegetarians who choose to occasionally eat meat, fish, or poultry products? A) Vegans B) Flexitarians C) Semi-vegetarians D) Lacto-ovo vegetarians

Ans: B Feedback: Flexitarians primarily eat a plant-based diet but occasionally allow themselves meat, fish, poultry, or dairy foods. Vegans eat no flesh or flesh products. Lacto-ovo vegetarians eat plant-based diets augmented with dairy and egg products. "Semi-vegetarians" do not exist.

The nurse is teaching a client about diet changes due to his recent cholecystectomy with emphasis on low-fat choices. Which of the following is an example of a good menu for the client? A) ½ cup sweet potatoes with marshmallows, 1 cup steamed broccoli, 1 cup cornbread dressing, 4 oz ham B) 1 cup sweet potatoes, 1 cup steamed collard greens, 3 oz wild rice, 3 oz ham C) 1 hamburger bun with sesame seeds, 4 oz hamburger patty fried, 1 slice each American cheese, onion, tomato, and lettuce, 1 tbsp ketchup and mayo D) 5 buffalo sauce-coated chicken wings, 1 cup mashed potatoes with 1 tsp butter and sour cream, 2 cups green salad with lettuce, carrots, tomatoes, onions, radishes, bell peppers, and 2 tbsp oil and vinegar dressing

Ans: B Feedback: Following MyPlate suggestions, the meal choice of sweet potatoes, collard greens, wild rice, and ham best fit the recommendations in variety and portion size. The other choices contain added fat, which could lead to gastric upset in this postcholecystectomy client.

A client is at the clinic for a routine checkup. The nurse is asked how much time would have to be devoted to an exercise program to lose some weight. Which of the following is the best response to this client's question? A) Just increase the intensity of the activity the client is already doing. B) Exercise at least 300 minutes/week and adjust diet. C) Increase energy expenditure by 2500 or more calories per week. D) Reduce daily calorie intake by 350 cal/day to lose a pound a week.

Ans: B Feedback: For additional and more extensive health benefits, adults should increase their aerobic physical activity to 300 minutes/week of moderate intensity. Adjusting the diet to eliminate 500 cal/day should result in a loss of a pound per week.

Determining nitrogen balance in the clinical setting can be very valuable. To determine a client's state of nitrogen balance, a 24-hour urinary urea nitrogen collection is done. What do you also need to do? A) Calculate the client's total calorie intake for that same day. B) Add a coefficient of 4 to that number to account for nitrogen lost in feces, hair, nails, and skin. C) Collect a 24-hour stool specimen on that same day to determine fecal nitrogen losses. D) Be sure that client takes nothing by mouth on the day of the urine collection.

Ans: B Feedback: In the clinical setting, nitrogen balance is determined by comparing nitrogen intake with nitrogen excretion over a 24-hour period. To calculate nitrogen intake, protein intake is measure for a 24-hour period. The total amount of protein consumed (in grams) is then divided by 6.25 because protein is 16% nitrogen by weight. The result is the grams of nitrogen consumed per 24 hours. Nitrogen excretion is ascertained by having a 24-hour urine sample analyzed for the amount (grams) of urinary urea nitrogen it contains. A coefficient of 4 is added to this number to account for the estimated daily nitrogen loss in feces, hair, nails, and skin. Finally, the amount of nitrogen consumed is compared with the total amount of nitrogen excreted to reveal a positive, negative, or neutral nitrogen balance. The other answers are not part of determining the nitrogen balance of the body.

Vegetarians do not always have adequate diets. Clinicians need to encourage vegetarians to do what? A) Eat meat. B) Eat adequate calories. C) Take amino acid supplements. D) Eat complementary proteins at every meal.

Ans: B Feedback: It is important to encourage vegetarians to eat enough calories. Adequate calories are necessary to avoid using amino acids for energy, which could lead to a shortage of amino acids for protein synthesis. You do not encourage a vegetarian to eat meat. It is not always necessary for a vegetarian to take amino acid supplements. Many foods included in vegetarian diets are complete proteins so it is not necessary to eat complementary proteins at every meal.

MyPlate recommends Americans limit their intake of solid fats and added sugars to no more than what of their total caloric intake? A) 10% B) 15% C) 20% D) 25%

Ans: B Feedback: MyPlate recommends Americans limit their intake of solid fats and added sugars to no more than 15% of their total caloric intake.

Many people throughout the world are practicing vegetarians. Their diet is rich in fruits and vegetables so it is also likely to be rich in which mineral? A) Sodium B) Potassium C) Iron D) Iodine

Ans: B Feedback: Potassium is naturally present in most foods, such as fruits, vegetables, whole grains, meats, milk, and yogurt.

The ability of the body to digest protein occurs at different levels depending on the source of the protein. What is the approximate protein digestibility for soy and legumes? A) 85% B) 90% C) 95% D) 100%

Ans: B Feedback: Protein digestibility is over 90% for soy and legumes, 90% to 99% for animal proteins, and 70% to 90% for other plant proteins.

Research has shown that the placement of body fat may be a more reliable indicator of what than the degree of total body fatness? A) Obesity B) Disease risk C) Chronic disease process D) Body composition

Ans: B Feedback: Recent evidence indicates that waist circumference may be an acceptable alternative to BMI measurement. In fact, the location of excess body fat may be a more important and reliable indicator of disease risk than the degree of total body fatness.

The client is a healthy 19-year-old college student who is interested in maintaining a healthy weight by following a 2000-calorie diet. How many servings of vegetables should he eat on a daily basis? A) 2 cups B) 2½ cups C) 3 cups D) 3½ cups

Ans: B Feedback: The 2000-calorie diet MyPlate diet guidelines recommends that individuals age 6 years and older should eat 2½ cups of a variety of vegetables daily.

A client is found to have a BMI of 37. This indicates the client is in which category? A) Obesity class 1 B) Obesity class 2 C) Obesity class 3 D) Obesity class 4

Ans: B Feedback: The BMI categories are as follows: 30 to 34.9 is obesity class 1; 35 to 39.9 is obesity class 2; and 40 or greater is obesity class 3. There is no obesity class 4.

The nurse is admitting a new client to the unit. The client is 17 years old and weighs 120 pounds. What is her basal metabolic rate (BMR) using the rule-of-thumb guideline? A) 600 B) 900 C) 1200 D) 1800

Ans: C Feedback: One imprecise, rule-of-thumb guideline for estimating BMR is to multiply healthy weight (in pounds) by 10 for women and 11 for men. Because this client weighs 120 pounds, 120 × 10 = 1200.

Part of the Dietary Reference Intakes is the Tolerable Upper Intake Level (UL). What is it? A) The recommended level of intake for that nutrient B) The highest level of daily nutrient intake that is likely to pose no risk of adverse health effects C) The nutrient intake amount determined to be most beneficial for preventing chronic disease D) The estimated amount of nutrient that will meet the needs of 90% of a given population

Ans: B Feedback: The UL is the highest level of average daily nutrient intake that is likely to pose no risk of adverse health effects to almost all individuals in the general population.

A client has been told to monitor his sodium intake. What is the Upper Limit (UL) set for adults for sodium Adequate Intake (AI)? A) 1700 mg B) 2300 mg C) 2500 mg D) 3000 mg

Ans: B Feedback: The Upper Limit set for adults for sodium intake is 2300 mg.

The client is being admitted for outpatient surgery. During the assessment, the nurse notes the client is 6 ft 3 in tall and weighs 97 kg. What is this client's BMI? A) 24 B) 27 C) 30 D) 33

Ans: B Feedback: The formula to calculate BMI is weight in kilograms divided by height in meters squared or weight in pounds divided by height in inches squared multiplied by 703. First, convert the 97 kg to pounds by multiplying by 2.2 (97 × 2.2 = 213.4); and then 213.4 / 5625 × 703 = 26.67 or rounded up to 27.

The nurse is admitting a gentleman who weighs 75 kg and is 6 ft 6 in tall. What is this client's body mass index? A) 17 B) 19 C) 21 D) 25

Ans: B Feedback: The formula to calculate BMI is weight in kilograms divided by height in meters squared or weight in pounds divided by height in inches squared multiplied by 703. Weight in kilograms is converted to pounds by multiplying the kilograms by 2.2 (75 × 2.2 = 165). For this client, 165 / 6084 × 703 = 19.06.

The nurse is conducting client education with a group of clients newly diagnosed with hypertension. While discussing sodium and its actions in the body, the nurse teaches that a healthy body maintains sodium balance by adjusting the amount of sodium in what manner? A) Absorbed B) Excreted in the urine C) Excreted in the feces D) Deposited on bones

Ans: B Feedback: The only way the body can rid itself of excess sodium is to increase urinary sodium excretion. For most people, the higher the intake of sodium, the greater is the amount of sodium excreted in the urine.

Trace minerals in the body, although small in quantity, play large roles in its functioning. Trace minerals have been hard to study because of what factor? A) Food composition data are not necessary for all trace minerals. B) Bioavailability varies within the context of the total diet. C) The comparability of trace mineral content of foods is high. D) Reliable and valid indicators of trace element status are readily available.

Ans: B Feedback: Various factors complicate the study of trace minerals. They include high variability of trace mineral content, food composition data are not available for all trace minerals, bioavailability varies within the context of the total diet, and reliable and valid indicators of trace elements status are not available.

Each of us has a specific energy need for our body to function optimally. Once this energy need is met, what will our body do with any excess protein consumed? A) Store it unchanged as protein. B) Convert it to fatty acids and store it. C) Excrete it unchanged in the urine. D) Convert it to urea and excrete it in the feces.

Ans: B Feedback: When protein is consumed in excess of need, the liver converts protein to fatty acids that form triglycerides for storage in adipose tissue. The body does not store protein. Protein is not excreted unchanged in the urine. Nitrogenous wastes are converted to urea for excretion by the body, not protein.

While discussing the various chemical properties of nutrients in the body, the class discusses the differences between anions and cations. What mineral is the major anion in the extracellular fluid? A) Calcium B) Chloride C) Chromium D) Choline

Ans: B Feedback: Chloride is the major anion in the extracellular fluid, where it helps to maintain fluid and electrolyte balance in conjunction with sodium.

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

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

The nurse is assessing a new client who is being admitted due to possible mineral toxicities. Mineral toxicities can occur for various reasons. Which of the following is one of those reasons? A) Unbalanced choice of foods B) Excessive use of mineral supplements C) Normal body metabolism D) Home-processed foods

Ans: B Feedback: Mineral toxicity is related to excessive use of mineral supplements, environmental or industrial exposure, human errors in commercial food processing, or alternations in metabolism.

The client is learning to make healthy choices in the food he eats by using MyPlate. Approximately what portion of the plate should be protein? A) 15% B) 25% C) 35% D) 45%

Ans: B Feedback: MyPlate is the new graphic that was developed to replace MyPyramid. It features a place setting with half of the dinner plate devoted to fruits and vegetables, ¼ to protein, and ¼ to grain, with dairy accompanying the plate.

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.

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

The nurse is caring for a client with a severe protein deficiency. What other deficiency would the nurse expect to find in this client? A) Selenium B) Sulfur C) Chromium D) Molybdenum

Ans: B Feedback: The major source of inorganic sulfate is body protein turnover of methionine and cysteine. The need for sulfur is met when the intake of sulfur amino acids is adequate. A sulfur deficiency is likely only when protein deficiency is severe.

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.

Ans: B Feedback: 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

Ans: B Feedback: 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 school nurse is working with a 16-year-old high school student who is interested in starting a vegetarian diet. The nurse explains the importance of getting enough protein in the diet. The student will need to learn which proteins are complete and incomplete. Which of the following is a source of complete protein? A) Gelatin B) Soy C) Kidney beans D) Peanut butter

Ans: B Feedback: A source of complete protein is soy. Soy protein is the only complete plant protein. Gelatin, kidney beans, and peanut butter are incomplete proteins. Complete proteins provide all nine essential amino acids.

The body uses glucose for energy. After those energy needs are met, the excess glucose is converted into other substances. What is one of those substances? A) Essential amino acids B) Nonessential amino acids C) Muscle D) Glucagon

Ans: B Feedback: After energy needs are met, excess glucose can be converted to glycogen, be used to make nonessential amino acids and specific body compounds, or converted to fat and stored. Essential amino acids need to be a part of a diet but are not manufactured by the body. Glucose cannot be converted into muscle. Glucose can be stored as glycogen, not glucagon.

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.

Ans: B Feedback: 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.

Lactose is composed of glucose and galactose and is a naturally occurring carbohydrate. Unfortunately, many individuals cannot tolerate lactose and develop gastrointestinal symptoms after ingesting it. These individuals would do best eating what dairy food? A) Milk B) Cheese C) Yogurt D) Butter

Ans: B Feedback: Cheese is virtually lactose free because it is converted to lactic acid during production, with the exception of cottage cheese. The other answers are incorrect because lactose is the naturally occurring carbohydrate in milk, yogurt has large amounts of lactose as well as added sugars, and butter is made from milk.

Much has been learned in the field of nutrition about nutritional intake and how to work toward making our diets nutritionally optimal. When it comes to carbohydrate intake, the latest findings indicate that Americans should do what? A) Decrease their intake of fiber and increase their intake of complex carbohydrates. B) Increase their intake of fiber and limit consumption of added sugars. C) Eat total carbohydrates consisting of 50% fiber and 50% simple sugars. D) Eat a diet based on plenty of fruits and vegetables and limit carbohydrates.

Ans: B Feedback: For optimal carbohydrate intake, Americans are urged to increase their intake of fiber and limit consumption of added sugars. Decreasing the intake of fiber is not recommended. Total carbohydrate consumption should not consist of 50% fiber and 50% simple sugars. Fruits and vegetables are sources of carbohydrates.

Sugar comes in several different forms and is handled by the body in different ways. Which one, when burned by the body, does not leave an end-product to be excreted by the body? A) Sucrose B) Glucose C) Fructose D) Maltose

Ans: B Feedback: Glucose is burned more efficiently and more completely than either protein or fat, and it does not leave an end product that the body must excrete. The other sugars all break down, leaving end products that the body must excrete.

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

Ans: B Feedback: 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

Ans: B Feedback: 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.

The nurse is teaching the client with newly diagnosed type 2 diabetes mellitus how to keep track of his caloric intake. Although it is commonly assumed that fiber does not provide any calories, the client is surprised to learn that research indicates that the caloric value of fiber is which of the following? A) Between 1 cal/g and 2 cal/g B) Between 1.5 cal/g and 2.5 cal/g C) Between 2 cal/g and 3 cal/g D) Between 2.5 cal/g and 3.5 cal/g

Ans: B Feedback: It is commonly assumed that fiber does not provide any calories because it is not truly digested by human enzymes. Yet most fibers, particularly soluble fibers, are fermented by bacteria in the colon and produce carbon dioxide, methane, hydrogen, and short-chain fatty acids, which serve as a source of energy for the mucosal lining of the colon. Although the exact energy value is unknown, current data indicate the value is between 1.5 cal/g and 2.5 cal/g.

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

Ans: B Feedback: 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.

The nutrition class is discussing the various elements that are important to be found in the diet to ensure proper nutrition. It is pointed out that protein is different from carbohydrates and fat because it contains what? A) Hydrogen B) Nitrogen C) Oxygen D) Calcium

Ans: B Feedback: Protein differs from carbohydrate and fat in that it contains nitrogen. Amino acids, which are composed of carbon, hydrogen, oxygen, and nitrogen atoms, are the building blocks of protein. All living tissue contains hydrogen and oxygen; calcium is a mineral that is not contained in protein.

For decades, sugar has been blamed as the cause of various disease states. What has research shown sugar to be implicated in the development of? A) Obesity B) Dental caries C) Heart disease D) Diabetes mellitus

Ans: B Feedback: Sugar is implicated in the development of dental caries. Feeding on sugars and starches, bacteria residing in the mouth produce an acid that erodes tooth enamel. Obesity is caused by an intake of too many calories. Sugar itself is not implicated in either heart disease or diabetes mellitus but obesity is.

The National Academy of Sciences has put forth a recommendation to replace the terms "insoluble" and "soluble" with terms more descriptive of the physiologic benefits of particular fibers. What term has been suggested for intact and naturally occurring plant fiber? A) Functional fiber B) Dietary fiber C) Total fiber D) True fiber

Ans: B Feedback: The National Academy of Sciences recommends that the terms "insoluble" and "soluble" be phased out in favor of attributing specific physiologic benefits to a particular fiber. "Dietary fiber" refers to intact and naturally occurring fiber found in plants. "Functional fiber" refers to fiber that has been isolated or extracted from plants that has beneficial physiologic effects in the body. The sum of dietary and functional fiber equals total fiber. Functional fiber is plant fiber that has been isolated or extracted from plants for the beneficial physiologic effects on the body. Total fiber is the sum of dietary and functional fiber. The term "true" fiber has no meaning in this chapter.

The nurse is discussing protein with a client. The nurse describes that protein is formed from essential and nonessential amino acids. The client is having difficulties understanding the difference. The nurse should explain that essential amino acids are what? A) The only amino acids necessary for growth and tissue maintenance B) Amino acids that must be consumed in the diet C) Amino acids that are found only in animal products and soy D) Amino acids that are more important than nonessential amino acids

Ans: B Feedback: The body cannot make essential amino acids so they must be supplied through the diet. All amino acids are necessary for growth and tissue maintenance. Essential amino acids can be found in other than animal products and soy. Essential amino acids are not more important than nonessential amino acids.

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

Ans: B Feedback: 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.

The nurse is making recommendations to a client with a diagnosis of chronic constipation on ways to increase the fiber intake in his diet. Which of the following could be one of those recommendations? A) Drink organ juice instead of orange drink. B) Eat legumes two or three times per week. C) Eat cream of wheat instead of white toast. D) Eat pretzels instead of potato chips.

Ans: B Feedback: To increase the intake of fiber, encourage clients to eat dried peas and beans two or three times per week. Dried peas and beans are excellent sources of both insoluble and soluble fibers and are a fat-free alternative to meat. Orange juice and potato chips are not high sources of fiber, whereas cream of wheat and pretzels are made from refined grains rather than whole grains.

The RDA for carbohydrates is based on the minimum amount of glucose used to fuel the brain. This is not an appropriate guideline for determining carbohydrate intake. It is more appropriate to use the Acceptable Macronutrient Distribution Range (AMDR). What is the suggested carbohydrate intake put forth by the AMDR? A) Carbohydrates should make up 25% to 50% of total dietary calories. B) Carbohydrates should make up 45% to 65% of total dietary calories. C) Carbohydrates should make up 50% to 75% of total dietary calories. D) Carbohydrates should make up 65% to 85% of total dietary calories.

Ans: B Feedback: A more useful guideline for determining appropriate carbohydrate intake is the Acceptable Macronutrient Distribution Range. It suggests carbohydrates provide 45% to 65% of total calories.

The nurse asks a member of the nutrition class to state the basic messages of the Dietary Guidelines for Americans. What would they include in their answer? Select all that apply. A) Always read the food label. B) Manage weight by calorie balancing. C) Prevent obesity with physical activity. D) Reduce intake of saturated fats, sugars, and alcohol. E) Do not worry about empty calories.

Ans: B, C, D Feedback: The Dietary Guidelines for Americans, 2010 have several key recommendations. Several of them include balancing calories to manage weight; reducing obesity through physical activity; and reducing consumption of sodium, empty calories, sugars, saturated fatty acids, and trans fat. Individuals should be aware of empty calories and make conscious decisions when eating them.

Fiber is a necessary part of the nutritional intake. It can, however, cause the absorption of some minerals to be incomplete. Fiber impairs the absorption of what minerals? Select all that apply. A) Potassium B) Zinc C) Magnesium D) Calcium E) Chloride

Ans: B, D Feedback: Fibers may impair the absorption of some minerals—namely, zinc, calcium, and iron—by binding with them in the small intestine.

A mother is concerned for her 4-year-old daughter putting on too much weight. Which of the following are suggestions the nurse can make to help the mother? Select all that apply. A) Switch the child to a 1000-calorie diet. B) Increase her activity level. C) Switch to sugar-free soda. D) Keep healthy snacks on hand. E) Read labels to reduce sugar intake.

Ans: B, D, E Feedback: The Dietary Guidelines for Americans, 2010 recommend decreasing total caloric intake to manage body weight; however, a 1000-calorie diet is not adequate for a 4-year-old who is rapidly growing. A 1200-calorie or 1400-calorie diet would be more appropriate. It is also recommend that physical activity be increased. Keeping healthy snacks on hand instead of junk food will also help encourage proper eating habits. Steps should also be taken to limit empty calories.

It is important for good health that an individual consume enough of all nutrients to meet the needs of the body. If there is insufficient intake for the energy needs of the body, then the body is in what? A) A negative energy balance B) A positive energy balance C) A negative calorie balance D) A positive caloric balance

Ans: C Feedback: A negative calorie balance occurs when calorie output exceeds intake, whether the imbalance is from decreasing calorie intake, increasing physical activity, or preferably both.

Protein must be broken down into smaller substances before the body can fully use it. For the body to absorb protein, it must first be broken down into what? A) Polypeptides B) Proteases C) Amino acids D) Glucose

Ans: C Feedback: Amino acids are the basic building blocks of all proteins and the end products of protein digestion.

The nurse is speaking to an exercise class when one of the participants asks, "Why should I do strength training?" Which of the following would be a proper response to this question? A) In strength training, warm-up and cool-down periods are not required. B) Strength training gives you a really good body. C) Strength training improves bone density. D) Strength training decreases the metabolic rate.

Ans: C Feedback: Changes in body composition are positive outcomes of muscle-strengthening activities that are not reflected on the scale, as are improved bone density.

The nurse is asked to explain the concept of variety within a major food group. Which would be the best example to give to illustrate the concept of variety within a major food group? A) Orange juice, fresh grapefruit, lemonade B) Hamburger roll, waffle, saltine crackers C) Chicken, black beans, walnuts D) Margarine, butter, mayonnaise

Ans: C Feedback: Chicken, black beans, and walnuts are all found in the protein group. This example shows the greatest variety of choices. Following a variety helps ensure more essential nutrients are consumed.

A client is asking the nurse to explain the Healthy People 2020. What should the nurse say are the overall goals of Healthy People 2020? A) Improve community health B) Increase health disparities among Americans C) Improve quality and years of healthy life D) Increase quantity of health disparities among Americans

Ans: C Feedback: Healthy People 2020 is a program that focuses on improving the health of all Americans and eliminating health disparities.

Numerous health agencies in the United States have issued dietary recommendations so that Americans can choose diets aimed at what? A) Reducing their weight B) Increasing their activity levels C) Reducing their risk of chronic disease D) Reducing the risk of acute heart disease

Ans: C Feedback: Healthy eating and regular exercise are essential for reducing the risk of chronic disease. Many health agencies have published guidelines or recommendations to meet these goals.

One of the major messages conveyed by the Dietary Guidelines for Americans includes the consumption of alcohol. What is the message about alcohol? A) Drink alcohol to ward off heart disease. B) If you drink alcohol, include it in your empty calories. C) If you drink alcohol, drink in moderation. D) Drink alcohol to lessen your risk of colon cancer.

Ans: C Feedback: If alcohol is consumed, it should be consumed in moderation—up to one drink per day for women and two drinks per day for men—and only by adults of legal drinking age.

The nurse is aware that making the decision to lower calorie intake requires a two-pronged approach. What is one of them? A) Increasing activity level B) Eating more carbohydrates C) Eating less sweets D) Eating more grains and breads

Ans: C Feedback: It is important to substitute healthy choices for calorie-dense items such as sweets. This lowers calorie intake while increasing nutrient intake.

There are several types of vegetarian diets including a lacto-vegetarian diet. What do lacto-vegetarians avoid eating? A) Cheese B) Butter C) Eggs D) Nuts

Ans: C Feedback: Lacto-vegetarians do not eat eggs. The diets of lacto-vegetarians include milk and milk products, such as cheese and butter; whereas, nuts are a part of a typical vegetarian (non-animal products) diet.

The nurse is teaching a high school health class, and the subject for today is calcium. What would the nurse teach the students to eat to promote the absorption of calcium? A) Protein B) Fiber C) Lactose D) Fat

Ans: C Feedback: Milk is a "nearly perfect" source because it contains vitamin D and lactose, which promote calcium absorption.

The nurse is admitting a healthy, 25-year-old male to the unit for outpatient knee surgery. During the nutrition assessment, it is determined that he weighs 78.2 kg. Using the rule-of-thumb guideline for calculating BMR, what is the approximate BMR of this client? A) 860 B) 1720 C) 1892 D) 2580

Ans: C Feedback: One imprecise, rule-of-thumb guideline for estimating BMR is to multiply healthy weight (in pounds) by 10 for women and 11 for men. First, convert the weight to pounds by multiplying, 78.2 kg × 2.2 = 172.04; and then 172.04 × 11 = 1892.44.

The nurse is teaching a nutrition class at the local high school. The subject for today is "Dietary Supplements and Caloric Intake." One of the class activities is to answer the following question: "An amino acid supplement that provides 15 g of protein and no other nutrients provides how many calories?" Which of the following is the correct response? A) 0 calories because the amino acids are in pill form B) 30 calories C) 60 calories D) 80 calories

Ans: C Feedback: Protein provides 4 cal/g. An amino acid supplement that provides 15 g of protein and no other nutrients provides 60 calories (4 cal/g × 15 g = 60 calories).

It is necessary to restrict protein intake in clients diagnosed with certain disease processes, such as clients in renal failure who are unable to excrete nitrogenous wastes. What other disease process necessitates a protein-restricted diet? A) Pancreatitis B) Congestive heart failure C) Severe liver disease D) Diabetes mellitus

Ans: C Feedback: Protein restriction is used for people with severe liver disease and those with renal failure who are unable to excrete nitrogenous wastes. There is no physiologic reason to restrict protein intake in the other disease processes.

Many people throughout the world are practicing vegetarians. Those who are pure vegans are at risk for nutritional deficiencies because they do not eat natural food sources of specific nutrients. One problem with a pure vegan diet is that it does not include any natural food sources of what? A) Iron B) Zinc C) Vitamin B12 D) Calcium

Ans: C Feedback: Pure vegans do not eat any natural food sources of vitamin B12. This is of concern for vegans because vitamin B12 does not occur naturally in plants; it is naturally found only in animals. Iron, zinc, and calcium can be found in various quantities in a pure vegan diet.

The client is adhering to the Acceptable Macronutrient Distribution Ranges (AMDRs) in his diet. He knows that adhering to the AMDRs has been associated with which of the following? A) A reduced risk of type 1 diabetes mellitus B) Weight loss C) A modest decrease in chronic disease risk D) A reduced rate of breast cancer

Ans: C Feedback: The AMDRs are broad ranges for each energy nutrient, expressed as a percentage of total calories consumed. These ranges are associated with reduced risk of chronic disease and are such that an adequate intake of all nutrients can be obtained.

The nurse is explaining to the client that at rest, the body uses energy that is included in the basal metabolic rate (BMR). What is the BMR? A) The caloric cost of day-to-day activities B) The caloric cost of mild activity C) The caloric cost of staying alive D) The caloric cost of studying

Ans: C Feedback: The BMR is the amount of calories expended in a 24-hour period to fuel the involuntary activities of the body at rest and after a 12-hour fast.

Bariatric clinics help clients move toward a healthier lifestyle. Which of the following should the nurse encourage each client to do? A) Follow the preplanned daily menus. B) Read the general healthy eating message. C) Obtain nutrients from food, not supplements. D) Change several lifestyle behaviors at the same time.

Ans: C Feedback: The MyPlate graphic and Dietary Guidelines are based on the philosophy that the nutrient needs, to the greatest extent possible, should be met through food and not supplements.

The nutrition class is learning that maintaining homeostasis is a function of the body. Which statement is true regarding homeostasis and minerals? A) For some minerals, the body maintains homeostasis by altering the mineral absorbed. B) For some minerals, the body maintains homeostasis by altering the mineral excreted. C) For some minerals, the body maintains homeostasis by releasing minerals from storage for redistribution. D) For some minerals, the body maintains homeostasis by using one mineral in place of another.

Ans: C Feedback: The body has several mechanisms by which it maintains mineral balance. It may release minerals from storage for redistribution. The body may also alter the rate of absorption or excretion.

The client weighs 130 pounds. Calculate the client's protein RDA to the nearest whole gram. A) 33 g B) 40 g C) 47 g D) 54 g

Ans: C Feedback: The client's weight is divided by 2.2 to determine the weight in kilograms. The kilograms is then multiplied by 0.8 to determine the protein RDA, thus 130 ÷ 2.2 = 59; 59 × 0.8 = 47.2.

The nurse is conducting an assessment of the 38-year-old male who is requesting assistance with weight loss. The nurse determines the client has abdominal obesity based on the waist circumference of which of the following? A) Greater than 30 in B) Greater than 35 in C) Greater than 40 in D) Greater than 45 in

Ans: C Feedback: The current waist circumference recognized as abdominal obesity in the United States is 40 in or more for men and 35 in or more for women.

The client is a 25-year-old female student being seen for a physical examination. If this client is 5 ft 4 in tall and weighs 125 pounds, what is her BMI? A) 17 B) 19 C) 21 D) 23

Ans: C Feedback: The formula for calculating BMI is weight in pounds divided by height in inches squared multiplied by 703. Thus, 125 / 4096 × 703 = 21.45.

When teaching the nutrition class, the nurse explains the old Recommended Dietary Allowances (RDAs) and the new Dietary Reference Intakes (DRIs). What would the nurse tell the class is the reason for changing from the RDAs to the DRIs? A) The DRIs are expanded versions of the RDAs associated with dietary excesses. B) The DRIs are updated versions of the RDAs associated with dietary excesses. C) The DRIs have an expanded focus of reducing chronic diseases associated with dietary excesses. D) The DRIs have a more limited focus of reducing chronic diseases associated with dietary excesses.

Ans: C Feedback: The old RDAs have been replaced with a new set of standards, the DRIs, which incorporate an expanded focus of reducing the risk of chronic diseases associated with dietary excesses.

The Healthy People 2020 is a program focused on improving the health of all Americans. Which of the following is one of the goals of Healthy People 2020? A) Reduce caloric needs. B) Remove saturated fats from the food supply. C) Eat a variety of nutrient dense foods. D) Encourage decreased consumption of all dairy products.

Ans: C Feedback: The overall objectives of Healthy People 2020 is to encourage eating a variety of nutrient-dense foods in all food groups; limit the intake of saturate fat, trans fat, cholesterol, added sugars, sodium, and alcohol; and balance calorie intake with calorie needs. The guidelines recommend changing to low-fat or fat-free dairy products. They do not advocate eliminating saturated fats.

The nurse is assessing the client's BMI during a routine physical examination. The client is a 19-year-old male who stands 6 ft tall and weighs 235 pounds. The nurse determines the client falls into which BMI category? A) Healthy weight B) Overweight C) Obesity class 1 D) Obesity class 2

Ans: C Feedback: To determine the BMI, the weight in pounds is divided by the height in inches squared and multiplied by 703 (235 / 5184 × 703 = 31.8). According to the BMI chart, a BMI score of 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 40 and above is obesity class 3.

The health-care provider has instructed the client to eat foods that will provide more vitamin E. Which of the following should the nurse recommend that the client eat? A) Fortified milk B) Egg yolks C) Vegetable oils D) Red meat

Ans: C Feedback: Vitamin E is found in vegetable oils and products made from oil such as margarine, salad dressing, and other prepared foods.

The nurse is talking to a third-grade class about protein digestion during a nutrition class. The nurse explains that the principal site of protein digestion is where? A) Mouth B) Stomach C) Small intestine D) Large intestine

Ans: C Feedback: Most protein digestion occurs in the small intestine.

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%

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

The client is learning to make healthy choices in the food she serves her family. Based on a 1800 calorie diet, how many servings of dairy products should she plan for her two teenagers, her husband, and herself on a daily basis? A) 2 cups B) 2½ cups C) 3 cups D) 3½ cups

Ans: C Feedback: Based on MyPlate guidelines, individuals 9 years old and older should consume 3 cups of dairy products daily when following a 1800 calorie diet plan.

While discussing nutrition with the group of clients, the nurse explains that some vitamins and minerals work together. What trace element is an essential component of vitamin B12? A) Nickel B) Selenium C) Cobalt D) Molybdenum

Ans: C Feedback: Cobalt is an essential component of vitamin B12.

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.

Ans: C Feedback: 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.

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

Ans: C Feedback: 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.

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

Ans: C Feedback: 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 nutrition class is learning about minerals. What is a characteristic of minerals that the class should know? A) Minerals are easily destroyed by light, air, heat, and acids. B) Minerals are digested primarily in the small intestine. C) Minerals originate from the earth's crust. D) Minerals are broken down and rearranged during metabolism.

Ans: C Feedback: Minerals are inorganic elements that originate from the earth's crust, not from plants or animals. Minerals do not undergo digestion nor are they broken down or rearranged during metabolism. They may combine with other elements or organic compounds, but they will still retain their chemical identities.

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

Ans: C Feedback: 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.

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.

Ans: C Feedback: 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 admitting a healthy 35-year-old woman to the outpatient surgery department for the removal of a plantar wart. She consumes approximately 2000 cal/day. What is her recommended intake of water? A) 1000 mL of fluid per day B) 1500 mL of fluid per day C) 2000 mL of fluid per day D) 2500 mL of fluid per day

Ans: C Feedback: There are three methods to estimate fluid needs. When the amount of calories per day is known, then the method of 1 mL/cal consumed can be used. Because this client consumes 2000 cal/day, 2000 cal/day × 1 mL/cal = 2000 mL/day.

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

Ans: C Feedback: 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.

The clinic nurse is teaching clients with newly diagnosed type 2 diabetes about diet and weight control. One of the subjects covered is how to figure out the caloric content of commonly eaten foods. An exercise given to the client is to figure out the calories in a tablespoon of jelly that contains 13 g of carbohydrates, no protein, and no fat. What is the correct number of calories in the jelly? A) 26 calories B) 39 calories C) 52 calories D) 65 calories

Ans: C Feedback: All digestible carbohydrates provide 4 cal/g consumed. A tablespoon of jelly that contains 13 g of carbohydrates, no protein, and no fat provides 52 calories (4 cal/g × 13 g = 52 cal).

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 B) Eating style C) Counting calories D) The foods you eat

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

A pediatric nurse is often asked by parents what they can do to reduce the risk of cavities in their children's teeth. Which of the following would be the best response? A) "Be sure to feed your children small, frequent meals." B) "The best thing you can do is eliminate all sugars from their diet." C) "A good way is to limit between-meal snacking on carbohydrates, including soft drinks." D) "You can give them teeth-friendly snacks, such as orange juice and whole-grain crackers."

Ans: C Feedback: Clients who want to reduce their risk of cavities should be advised to limit between-meal snacking on carbohydrates, including soft drinks. Eating small frequent meals or feeding children orange juice and whole-grain crackers do not limit the nutrients in food that erode the teeth. It is not possible nor is it advisable to eliminate all sugars from their diet.

The nurse is planning a weight loss class to teach a group of clients how to read nutritional labels to enable them to make informed choices. The nurse plans to include information about the various names that are used to identify monosaccharides, such as dextrose. What is dextrose also known as? A) Levulose B) Fructose C) Glucose D) Maltose

Ans: C Feedback: Dextrose is also known as glucose. Glucose is the sugar of greatest distinction: It circulates through the blood to provide energy for body cells; it is a component of all disaccharides; it is virtually the sole constituent of complex carbohydrates; and it is the sugar to which the body converts all other digestible carbohydrates. Fructose is another monosaccharide, but it is known as "fruit sugar" or levulose. Maltose is a disaccharide and is not naturally found in foods.

A nurse is trying to help a client understand the difference between glucose and glycogen. She explains that glycogen is stored in the liver in limited amounts and it is released between meals as glucose to maintain serum blood glucose levels. The client shows he understands when he indicates that glycogen is the human version of which of the following? A) Fiber B) Sugar C) Starch D) Protein

Ans: C Feedback: Glycogen is the animal (including human) version of starch. It is a stored form of carbohydrate that is available for energy as needed.

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.

Ans: C Feedback: 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 nurse is teaching a basic class of nutrition to clients in a weight loss program. After discussing the complex process of carbohydrate digestion, the nurse recognizes the class understood when he hears a client state that the primary site of carbohydrate digestion occurs where? A) In the mouth B) In the stomach C) In the small intestine D) In the large intestine

Ans: C Feedback: Most carbohydrate digestion occurs in the small intestine, where pancreatic amylase reduces complex carbohydrates into shorter chains and disaccharides. Carbohydrate digestion begins in the mouth, but its effects are halted by the acids in the stomach. Carbohydrates are digested before they reach the large intestine.

A client has been working with the nurse to improve her diet and lose weight. The nurse congratulates the client for choosing skim milk over whole milk. Skim milk is a better choice of beverage than whole milk because, along with the lower fat content, it has what? A) A higher carbohydrate content B) A lower carbohydrate content C) The same carbohydrate content D) No carbohydrate content

Ans: C Feedback: One cup of milk, regardless of the fat content, provides 12 g of carbohydrates in the form of lactose.

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

Ans: C Feedback: 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.

The clinic nurse is teaching newly diagnosed type 2 diabetics about nutritional diets. One of the subjects covered is how to figure out the recommended dietary allowance for protein in a healthy adult. The class is given the following exercise: What is the RDA for an individual weighing 75 kg? Which of the following is the correct RDA for protein for this individual? A) 30 g B) 45 g C) 60 g D) 75 g

Ans: C Feedback: The RDA for protein for a healthy adult is 0.8 g/kg; therefore, a healthy adult who weighs 75 kg has an RDA for protein of 60 g (0.8 g/kg × 75 kg = 60 g).

The nurse is admitting a healthy adult woman to the outpatient department for the removal of a plantar wart. She weighs 70 kg. What is her recommended dietary allowance (RDA) for protein? A) 42 g B) 49 g C) 56 g D) 63 g

Ans: C Feedback: The RDA for protein for a healthy adult is 0.8 g/kg; therefore, a healthy adult woman who weighs 70 kg has an RDA for protein of 56 g (0.8 g/kg × 70 kg = 56 g).

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%

Ans: C Feedback: 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.

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.

Ans: C Feedback: 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.

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

Ans: C Feedback: 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 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.

Ans: C Feedback: 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.

The American Cancer Society (ACS) and American Institute of Cancer Research (AICR) have both made recommendations for eating properly to prevent cancer. Which of the following are true for both guidelines? Select all that apply. A) Do not use supplements to protect against cancer. B) Choose whole grains instead of refined grains. C) Eat a variety of food with emphasis on plant sources. D) Limit the intake of red meats.

Ans: C, D Feedback: Both ACS and AICR recommend to eat a variety of plant source foods and limit the intake of red meats. Only the AICR recommends not using supplements and only the ACS recommends whole-grain consumption.

The nurse has been explaining to a group of clients that proteins have many different functions in the body. What determines a protein's function? A) The quality of the protein B) The amino acids contained in the protein C) The completeness of the protein D) The shape of a protein

Ans: D Feedback: A protein's shape determines its function. The quality of the protein, the amino acid content, and the completeness of the protein do not determine the function of the protein in the body.

Water is vital to the human body and needs to be consumed daily. As vital as water is, most people get most of their fluid intake by ingesting other beverages. What value might the other beverages have? A) They are more beneficial to the body than water. B) They are complete sources of fluids for the body. C) They provide no beneficial caloric intake to the body. D) They may provide phytochemicals to the body.

Ans: D Feedback: Although naturally calorie-free plain water could be used to completely satisfy fluid needs, other beverages have value in that they may provide nutrients, phytochemicals, and interest to the diet.

The body does not truly store protein. It does, however, maintain recycled amino acids from broken-down body proteins. What is this called? A) Metabolic store B) Protein turnover C) Amino acid store D) Metabolic pool

Ans: D Feedback: Although protein is not truly stored in the body as are glucose and fat, a supply of each amino acid exists in a metabolic pool of free amino acids within cells and circulating in blood. This pool consists of recycled amino acids from body proteins that have broken down and also amino acids from food.

The body needs an adequate supply of energy to prevent its protein being burned for energy. To prevent the burning of protein, termed "protein sparing," what does the body need an adequate supply of? A) Glucose B) Fat C) Carbohydrate D) Carbohydrate and fat

Ans: D Feedback: An adequate supply of energy from carbohydrate and fat is needed to spare protein from being burned for calories. The intake of glucose, fat, or carbohydrate alone does not prevent protein sparing.

Complementary proteins are made by combining two protein sources to make a complete protein. What is an example of a complementary protein? A) Black beans and kidney beans B) Strawberry milk shake C) Butterscotch pudding D) Macaroni and cheese

Ans: D Feedback: An example of a complementary protein is macaroni and cheese. Combining two different incomplete proteins or a small amount of any complete protein with an incomplete protein boosts the overall quality to that of a complete protein. Proteins that can be combined to obtain sufficient quantities and proportions of all essential amino acids are called complementary proteins. The components of the other foods do not act together to form a complete protein.

While teaching a nutrition class, the nurse discusses the largest source of sodium in the typical American diet. What is it? A) Salt added during cooking B) Salt added at the table C) Foods naturally high in salt D) Processed foods

Ans: D Feedback: Approximately 75% of sodium consumed in the average American diet is from processed food. Virtually all Americans consume more than the UL for sodium.

Amino acids, the building blocks of proteins, have the ability to act as buffers in the body. This means that proteins can maintain normal blood pH. By maintaining normal blood pH, the body's proteins are protected from being what? A) Neutralized B) Naturalized C) Deneutralized D) Denatured

Ans: D Feedback: Because amino acids contain both an acid (COOH) and a base (NH2), they can act as either acids or bases depending on the pH of the surrounding fluid. The ability to buffer or neutralize excess acids and bases enables proteins to maintain normal blood pH, which protects body proteins from being denatured. Proteins are not neutralized, naturalized, or deneutralized.

The client is beginning an exercise program for the health benefits and to aid in preventing weight gain. How many minutes per week should the client plan on performing moderate-intensity physical activity to meet the recommended number of minutes? A) 60 minutes/week B) 90 minutes/week C) 120 minutes/week D) 150 minutes/week

Ans: D Feedback: For substantial health benefits, adults should do at least 150 minutes (2 hours and 30 minutes) a week of moderate-intensity aerobic physical activity. Aerobic activity should be performed in episodes of at least 10 minutes and spread throughout the week.

The client is interested in starting an exercise program that will provide the most benefit. What type of exercise is known to raise the metabolic rate? A) Intense aerobic exercise B) Low-impact aerobic exercise C) Flexibility exercise D) Resistance exercise

Ans: D Feedback: Muscle-strengthening activities, which include strength training, resistance training, and strength and endurance exercises, build muscles, which helps to raise metabolic rate.

Antioxidants disarm free radicals produced during normal oxygen metabolism. Which mineral is a component of an enzyme that acts as an antioxidant? A) Iron B) Iodine C) Zinc D) Selenium

Ans: D Feedback: Selenium is a component of a group of enzymes, called glutathione peroxidases, that function as antioxidants to disarm free radicals produced during normal oxygen metabolism.

Sodium is a necessary nutrient and the major extracellular cation in the body. What is one of its functions? A) Cardiac stability B) Muscular stability C) Immune system functioning D) Nerve impulse transmission

Ans: D Feedback: Sodium is largely responsible for regulating fluid balance. It also regulates cell permeability and the movement of fluid, electrolytes, glucose, insulin, and amino acids. Sodium is pivotal in acid-base balance, nerve transmission, and muscular irritability.

The nurse is working with clients at the clinic develop appropriate weight loss goals. The nurse is aware that people who store a disproportionate amount of body fat in the abdomen are at increased risk for what? A) Cardiopulmonary disease B) Type 1 diabetes mellitus C) Hypolipidemia D) Hypertension

Ans: D Feedback: Storing a disproportionate amount of total body fat in the abdomen increases the risk for type 2 diabetes mellitus and cardiovascular disease.

The nurse is conducting nutrition counseling at the clinic. A client who is at risk for prostate cancer asks what he can do to reduce his risk. Which of the following is an appropriate suggestion? A) Eat a vegan diet. B) Engage in physical activity at least 60 minutes a day. C) Eat at least 2 cups of refined grains a week. D) Eat at least 2½ cups of vegetables and fruits every day.

Ans: D Feedback: The ACS and AICR both recommend that individuals to engage in regular exercise at least 30 minutes each day, to limit the consumption of red meats, to eat whole grains instead of refined grains, and to eat at least 2½ cups of vegetables and fruits every day to decrease the risk of developing cancer.

One of the students in a nutrition class asks the nurse to explain the Acceptable Macronutrient Distribution Ranges (AMDRs). Which of the following is the best answer? A) AMDRs are specific ranges for essential nutrients. B) AMDRs are specific ranges for trace minerals. C) AMDRs are nonspecific broad ranges for major nutrients. D) AMDRs are broad ranges for each energy nutrient.

Ans: D Feedback: The AMDRs are broad ranges for each energy nutrient, expressed as a percentage of total calories consumed.

The range for protein for adults as recommended by the Acceptable Macronutrient Distribution Range for protein is what percentage of total calories? A) 25% to 50% B) 20% to 45% C) 15% to 40% D) 10% to 35%

Ans: D Feedback: The Acceptable Macronutrient Distribution Range for protein for adults is 10% to 35% of total calories.

The diet is influenced by all foods and drinks consumed, which includes alcohol. What is the current recommendation for alcohol consumption according to the various published guidelines? A) One drink each day for men and women B) One drink each day for men, two drinks each day for women C) Two drinks each day for men and women D) Two drinks each day for men, one drink each day for women

Ans: D Feedback: The American Heart Association, the American Cancer Society, and the American Institute for Cancer Research recommended that alcohol consumption be limited to one drink per day for women and two drinks per day for men.

The Dietary Reference Intakes (DRIs) are a set of standards that include reference values that are based on what? A) The concepts of dietary-related chronic diseases B) The concepts of preventing nutritional deficiencies C) The concepts of balance and need D) The concepts of probability and risk

Ans: D Feedback: The DRIs is a group name that includes four separate reference values that are based on the concepts of probability and risk. They include updated RDAs, EAR, AI, and UL.

While teaching about the Recommended Dietary Allowances (RDAs), the nurse has included which of the following points in the discussion? A) RDAs have been established for all essential nutrients. B) RDAs represent requirements of specific nutrients. C) RDAs meet the needs of all healthy people. D) RDAs are not appropriate for people who have acute or chronic illness.

Ans: D Feedback: The RDAs represent the average daily recommended intake to meet the nutrient requirements of 97% to 98% of healthy individuals. Health professionals use the RDAs as a starting point and adjust them according to the individual's needs.

A woman is being admitted to the outpatient surgery department. The nurse discovers she weighs 130 pounds and is 5 ft 5 in tall. What is her body mass index? A) 15 B) 17 C) 19 D) 22

Ans: D Feedback: The formula to calculate BMI is weight in kilograms divided by height in meters squared or weight in pounds divided by height in inches squared multiplied by 703. For this client: 130 / 4225 × 703 = 21.6 or rounded up to 22.

Protein is an important nutrient that helps supply the body with the elements necessary for life. Protein can be used by the body for fuel when what occurs? A) Complete proteins are consistently ingested. B) When there are inadequate stores of iron in the body C) When the RDA for B vitamins are met D) When there is inadequate intake of calories

Ans: D Feedback: The nutrient that athletes most need to increase in their diet is calories. To bulk up, athletes need exercise, enough calories, and adequate protein. Protein is not used for fuel by the body just because it is consistently ingested, there are inadequate stores of iron present, or the RDA for B vitamins has not been met.

The nurse has been asked to speak on diet and nutrition at a local town meeting. During the presentation, the nurse explains to the attendees about "Adequate Intake" and its primary purpose. What should the nurse say on this subject? A) The primary purpose of the Adequate Intake is to provide the highest level of daily nutrient intake. B) The primary purpose of the Adequate Intake is to provide an estimate of the amount of nutrients required by individuals. C) The primary purpose of the Adequate Intake is to provide a value comparable with the RDA. D) The primary purpose of the Adequate Intake is to provide a goal for the nutrient intake of individuals.

Ans: D Feedback: The primary purpose of the adequate intake is as a goal for the nutrient intake of individuals. It is the recommended average daily intake thought to meet or exceed the needs of individuals.

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.

Ans: D Feedback: 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.

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

Ans: D Feedback: 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.

Copper is used by the body in hemoglobin synthesis, collagen formation, wound healing, and maintenance of nerve fibers. What mineral has the potential to cause a deficiency of copper in the body? A) Iron B) Chromium C) Molybdenum D) Zinc

Ans: D Feedback: Excess zinc intake has the potential to induce copper deficiency by impairing its absorption.

Bottled water is high on the list of purchases made by American consumers. The nurse is aware that children who drink bottled water might need what? A) Chlorine supplement B) Magnesium supplement C) Iron supplement D) Fluoride supplement

Ans: D Feedback: Fluoride promotes the mineralization of developing tooth enamel prior to both eruption and the remineralization of surface enamel in erupted teeth. Studies show that water fluoridation reduces tooth decay by approximately 25% over a person's lifetime. Bottled water may not be fluoridated.

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

Ans: D Feedback: 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.

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.

Ans: D Feedback: 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.

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.

Ans: D Feedback: 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

Ans: D Feedback: 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 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

Ans: D Feedback: 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.

When the body does not have enough glucose, fat cannot be completely burned for energy. What happens to fat oxidation without adequate glucose? A) Fat oxidation goes to completion because it draws on the body's store of glucagon. B) Fat oxidation stops prematurely, and fat is excreted in the body's waste. C) Fat oxidation goes to completion because it forces the body into ketosis. D) Fat oxidation stops prematurely at the intermediate step of ketone formation.

Ans: D Feedback: Fat normally supplies about half of the body's energy requirement. Yet glucose fragments are needed to efficiently and completely burn fat for energy. Without adequate glucose, fat oxidation prematurely stops at the intermediate step of ketone body formation. Fat oxidation does not go into completion without adequate glucose. Fat oxidation does not draw on the glucagon stores of the body. Fat oxidation does not stop prematurely and fat is excreted in the body's waste.

The human body uses checks and balances to maintain homeostasis. When the body is in the postprandial state, a slight fall in blood glucose stimulates the pancreas to release what? A) Glucose B) Amylase C) Bile D) Glucagon

Ans: D Feedback: In the postprandial state, as the body uses the energy from the last meal, the blood glucose concentration begins to drop. Even a slight fall in blood glucose stimulates the pancreas to release glucagon, which causes the liver to release glucose from its supply of glycogen. The result is that blood glucose levels increase to normal. The pancreas does not release glucose or bile. The pancreas does release amylase but not in response to a fall in serum glucose levels.

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"

Ans: D Feedback: 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.

Food has a definite effect on the blood glucose concentration. Some foods may quickly raise glucose levels; raise glucose levels to various amounts; and return to normal at different rates. What is this response called? A) Glycemic index B) Glycemic indication C) Glycemic load D) Glycemic response

Ans: D Feedback: The glycemic response is the effect a food has on the blood glucose concentration; how quickly the glucose level rises, how high it goes, and how long it takes to return to normal. The glycemic index is a numeric measure of the glycemic response of 50 g of a food sample. The glycemic load is a food's glycemic index multiplied by the amount of carbohydrate it contains to determine impact on blood glucose levels.

The glycemic index is a listing of foods and what their impact is on blood glucose response. How is a food's glycemic index determined? A) A comparison is made between the blood glucose response caused by 25 g of pure glucose and 25 g of a food sample. B) Serial blood glucose levels are drawn after eating 25 g of a food sample and compared to a chart on blood glucose levels after eating 25 g of sucrose. C) Serial blood glucose levels are drawn after eating 50 g of pure sucrose and compared to blood glucose levels after eating 50 g of a food sample. D) A comparison is made between the blood glucose response caused by 50 g of pure glucose and 50 g of a food sample.

Ans: D Feedback: To more accurately assess a food's impact on blood glucose response, the concept of glycemic index was developed. A food's glycemic index is determined by comparing the impact on blood glucose after 50 g of a food sample is eaten compared to the impact of 50 g of pure glucose or white bread.

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.

Ans: D Feedback: 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.

What are the main reasons to hydrogenate a fat? A) Improve function and increase rancidity B) Improve function and decrease rancidity C) Decrease function and stabilize D) Decreases function and destabilize

B) Improve function and decrease rancidity

High-fat diets are known to be a leading cause of obesity in America. What are high-fat diets also implicated in? A) Pancreatitis B) Insulin resistance C) Cystic fibrosis D) Liver disease

B) Insulin resistance

The stability of fats is influenced by their degree of unsaturation. Which fats are most susceptible to rancidity? A) Saturated fats B) Monounsaturated fats C) Polyunsaturated fats D) Trans fats

B) Monounsaturated fats

Many of our foods are now labeled "heart healthy" to designate their nutritional superiority for our body. Which of the following oils is considered "heart healthy"? A) Corn oil B) Olive oil C) Coconut oil D) Sunflower oil

B) Olive oil

Monounsaturated fats are liquid at room temperature. Where are monounsaturated fats predominantly found? A) Meat B) Olive oil C) Fish D) Corn oil

B) Olive oil

Fat is classified as either "good" fat or "bad" fat, or saturated and unsaturated fatty acids. What is the difference between saturated and unsaturated fatty acids? A) The number of carbon atoms B) Unsaturated fatty acids have at least one double bond between carbon atoms C) The way they are absorbed D) Saturated fats are found only in animal products

B) Unsaturated fatty acids have at least one double bond between carbon atoms

Even at rest the body has energy requirements. How much of the body's caloric needs at rest are provided by fat? A) 30% B) 40% C) 50% D) 60%

D) 60%

What is the recommended dietary allowance of monounsaturated fats? A) 30% B) 35% C) 40% D) There is none

D) There is none