Ch 19 Basic Nutrition and Nutrition Therapy

DRIs for protein are

10-35% of daily calories

what is the DRI for protein?

10-35% of daily calories

For diabetic pts, hypertension, renal disease and generally african americans sodium intake should be less than _____?

1500mg

DRI of B3 niacin

16mg/day for men 14mg/day for women

DRI for B12 is

2.4mcg/day

What is the DRI for lipids (fat)?

25-35% of kcals/day

DRI for fiber intake is

25-38 g/day

what is the lab range for potassium?

3.5-5 mEq/L

DRI for folic acid B9

400mcg/day

What is the DRI for carbohydrates?

45-65% of daily calories

saturated fats should be what % of total calories in a day?

5-6%

DRI for saturated fatty acids are

5-6% of daily calories

for every 1g nitrogen excreted how much protein should be consumed?

6.25g protein

DRI for vitamin D

70 and younger 15mcg/day 70 and older 20 mcg/day

DRI for vitamin A

700mcg/day for women 900mcg/day for men

DRI for vitamin K

90 mcg/day for women 120 mcg/day for men

DRI for vit c ascorbic acid

90mg/day for men 75mg/day for women

DRI of water for women, men and pregnancy

9cups for women 13 cups for men 3 L/day for pregnant women

which vitamins are considered antioxidant vitamins

A, C and E

39. The body mass index (BMI) of a man 6 feet tall weighing _____

ANS: 33.9 The BMI is calculated by dividing the pounds expressed as kilograms by the height in meters squared. 6 feet = 72 inches ÷ 39.37 = 1.83 meters 250 pounds ÷ 2.2 = 113.6 kg 113.6 ÷ (1.83 1.83) = 33.9 REF: Page 632 TOP: Calculating body mass index (BMI)

38. To simplify food values, the measurement of energy obtained by food is defined as the _____ .

ANS: kilocalorie The kilocalorie is the energy value by which foods are measured for their energy- producing potential. REF: Page 608 TOP: Kilocalorie Step: Intervention

21. A patient who has hypertension is complaining about the lack of taste with the low-salt diet that has been ordered. The nurse emphasizes that sodium may: a. contribute to hypertension. b. interfere with blood clotting. c. produce stomach ulcers. d. decrease calcium in the bones.

ANS: A Sodium may contribute to hypertension. REF: Page 643 TOP: Sodium-induced hypertension

26. The nurse has assessed a patient's body mass index (BMI) to be 19.6. This assessment of weight versus height indicates that this patient's weight category is in which category? a. Low health risk b. Overweight c. Obese d. Morbidly obese

ANS: A A BMI between 18.5 and 24.9 is associated with the lowest health risk. Those with BMIs between 25 and 29.9 are considered overweight, and those with BMIs of 30 or greater are considered obese. A BMI of less than 18.5 is considered underweight and is also associated with health risks. REF: Page 632 TOP: Body mass index (BMI)

13. The body uses 22 common amino acids, but 9 of them must be obtained from protein in the diet and are considered: a. essential. b. basic. c. fundamental. d. primary.

ANS: A Essential amino acids must be consumed in the diet, because the body cannot make them. REF: Pages 611-612 TOP: Essential amino acids

28. The nurse counseling a patient about the difference between type 1 and type 2 diabetes stresses that patients with type 2 diabetes are required on a daily basis to receive: a. regular carbohydrate-controlled meals. b. oral hyperglycemic agents. c. insulin injections. d. stringent low-calorie diets.

ANS: A People with type 2 diabetes must take daily regulated meals with controlled carbohydrate content. Type 1 diabetics must have insulin injections. REF: Page 656 TOP: Nutrition in type 2 diabetes

32. A patient diagnosed with renal failure is unable to excrete protein waste products and develops a condition that requires a protein-restricted diet. The nurse instructs the patient that azotemia can be diminished by substituting other food groups for protein, such as: a. potatoes. b. beans. c. cheese. d. soy products.

ANS: A The foods that a patient with renal disease can substitute for energy are in the carbohydrate group. Potatoes are the only carbohydrate listed. REF: Page 643 TOP: Azotemia

30. The patient who had a gastrectomy complains to the nurse about frequent episodes of dumping syndrome. The nurse suggests the patient modify his intake by: a. eating small, frequent meals. b. including more fiber in meals. c. increasing seasoning on food. d. limiting intake to semi-liquids.

ANS: A The symptoms of dumping syndrome can be reduced by consuming small frequent meals of mildly seasoned food; extra fiber is not essential. REF: Page 640 TOP: Dumping syndrome

37. Which are the energy-providing food groups? (Select all that apply.) a. Carbohydrates b. Fats c. Proteins d. Vitamins e. Minerals

ANS: A, B, C The food groups that provide energy are carbohydrates, fats, and proteins. REF: Page 608 TOP: Energy-producing food groups Step: Evaluation

36. What are the four key concepts of the USDA's MyPyramid plan? (Select all that apply.) a. Variety b. Activity c. Proportionality d. Satisfaction e. Moderation

ANS: A, B, C, E The key concepts of MyPyramid are variety, activity, proportionality, and moderation. REF: Page 605 TOP: MyPyramid

Select all that apply: What are the roles of the nurse regarding nutrition? a. pt teaching of the importance of diet b. assist with eating process c. take/ record pt weight d. record pt intake e. observe for clinical signs of poor nutrition f. serve as a communication link g. judge the persons diet based on looks

ANS: A,B,C,D,E,F

27. The eating disorder characterized by body image distortion, excessive exercise, and vicarious enjoyment of food is called: a. self-fasting. b. anorexia nervosa. c. bulimia nervosa. d. binge eating.

ANS: B Anorexia nervosa is an eating disorder characterized by self-imposed starvation, excessive exercise, and body image distortion. REF: Page 635 TOP: Anorexia nervosa

23. At approximately 4 to 6 months of age, solid food is introduced to a baby. Foods with high iron content are recommended by the nurse and include: a. pureed fruit. b. fortified cereals. c. fruit juice. d. rice.

ANS: B At approximately 4 to 6 months, iron-rich foods, such as fortified cereal and pureed meat, are introduced to a baby. REF: Page 623 TOP: Iron-rich foods

14. The nurse reminds a vegan that unless he supplements his diet, he will be deficient in vitamin: a. B6. b. B12. c. K. d. D.

ANS: B B12 is almost exclusively found in animal products but can be supplemented with fortified cereals or vitamins. REF: Page 615 TOP: B12 deficit

20. If the patient taking a diuretic has an erratic pulse and muscle weakness, the nurse should suspect a decrease in: a. sodium. b. potassium. c. chloride. d. iron.

ANS: B Diuretics can deplete potassium through urine excretion and lead to muscle weakness and cardiac arrhythmias. REF: Pages 618, 628, Table 21-13 TOP: Potassium depletion

10. Stored fat that insulates the body and serves as a cushion to protect organs is called: a. subcutaneous tissue. b. adipose tissue. c. cohesive tissue. d. lipid tissue.

ANS: B Fat is stored in the body as adipose tissue. REF: Page 609 TOP: Adipose tissue

35. The nurse teaches a patient who has a nonfunctioning or dysfunctional GI tract that total parenteral nutrition (TPN) will be infused through the: a. carotid artery. b. superior vena cava. c. femoral vein. d. inferior vena cava.

ANS: B TPN solution is usually infused through the superior vena cava. REF: Page 652 TOP: Total parenteral nutrition Step: Implementation

15. A fit, young woman was at zero nitrogen balance, but when she became pregnant the nurse cautioned her that she might develop: a. embolism. b. anabolism. c. catabolism. d. metabolism.

ANS: B When more nitrogen is consumed than is excreted, anabolism occurs. This is also called a positive nitrogen balance. REF: Page 612 TOP: Nitrogen balance

24. A school nurse teaching a group of adolescents about adequate nutrition should encourage increased intake of: a. potassium and sodium. b. chloride and magnesium. c. iron and calcium. d. vitamins and minerals.

ANS: C Dietary inadequacies in adolescence include iron and calcium. REF: Page 626 TOP: Adolescent nutrition

25. A nurse caring for a patient who is prescribed a full liquid diet recognizes that this diet lacks some nutrients including: a. fat-soluble vitamins. b. potassium. c. iron and fiber. d. water-soluble vitamins.

ANS: C A full-liquid diet is deficient in iron and fiber. REF: Page 630 TOP: Full-liquid diets Step: Planning

12. When discussing the digestion and metabolism of fat, the nurse tells the patient who has a history of cholecystitis and is on a low-fat diet that fat must be emulsified to be digested. The ingredient necessary for emulsification is: a. sugar. b. cholesterol. c. bile. d. protein.

ANS: C Bile is necessary to emulsify fat. REF: Page 611 TOP: Function of bile Step: Implementation

29. Careful attention to carbohydrate consumption can improve metabolic control of diabetes. The nurse teaches a meal planning approach that focuses on the total amount of carbohydrates eaten at a meal called: a. carbohydrate splitting. b. reduced caloric intake. c. carbohydrate counting. d. carbohydrate balancing.

ANS: C Carbohydrate counting is a meal planning approach that focuses on the total amount of carbohydrates eaten. REF: Page 639 TOP: Carbohydrate counting

3. Elements that are found in food and necessary for good health but that our bodies cannot make are: a. important nutrients. b. life-saving nutrients. c. essential nutrients. d. necessary nutrients.

ANS: C Elements found in food that our bodies cannot make are essential nutrients. REF: Page 608 TOP: Nutrition

31. The nurse reminds the patient with lactose intolerance that he can avoid the unpleasant symptoms of nausea, bloating, flatulence, and diarrhea if he will avoid eating products that include: a. soy beans. b. rice. c. milk. d. high fiber.

ANS: C Lactose intolerance occurs as a result of a lack of lactase that makes it impossible to break down milk sugar. REF: Page 640 TOP: Lactose intolerance

7. The nurse concludes that additional instruction is not necessary after the patient demonstrates understanding that protein, minerals, iron, and fat combine to: a. regulate body processes. b. provide energy. c. build and repair tissue. d. restore body function.

ANS: C Many nutrients are necessary to build and repair tissue, including protein, minerals, iron, and fat. REF: Page 608 TOP: Nutrition Step: Evaluation

2. When explaining the activity recommendations from the USDA's new MyPyramid plan, the nurse states that the minimum amount of daily exercise needed to balance nutritional intake is: a. 15 minutes. b. 20 minutes. c. 30 minutes. d. 60 minutes.

ANS: C MyPyramid recommends a minimum of 30 minutes of daily exercise to balance nutritional intake. To prevent weight gain, 60 minutes of exercise is recommended. For sustaining weight loss, 60 to 90 minutes a day is recommended. REF: Page 606, Figure 21-1

19. Following the removal of a part of the stomach, the patient is assessed closely by the home health nurse for: a. a stomach ulcer. b. digestive problems. c. pernicious anemia. d. malabsorption.

ANS: C Pernicious anemia results when the intrinsic factor is missing due to surgery on the stomach. REF: Page 616 TOP: Pernicious anemia

8. When reviewing a patient's dietary intake, the nurse recommends that sugar consumption be reduced to the recommended daily level, which is less than: a. 20% of total daily kilocalories. b. 15% of total daily kilocalories. c. 10% of total daily kilocalories. d. 5% of total daily kilocalories.

ANS: C Recommendations have been made to reduce sugar consumption to less than 10% of total daily kilocalories. REF: Page 609 TOP: Nutrition

11. When providing information about high cholesterol levels, the nurse explains that saturated fats usually are animal in origin, solid at room temperature, and should be avoided because they: a. block absorption of nutrients. b. interfere with metabolism. c. increase blood cholesterol. d. must be hydrogenated.

ANS: C Saturated fats tend to increase blood cholesterol. REF: Page 610 TOP: Saturated fats

16. The nurse explains that the decreased sodium diet prescribed for a patient with a heart problem will help reduce or prevent: a. stroke. b. fluid excretion. c. heart attacks. d. obesity.

ANS: C Sodium attracts water and causes fluid retention. Hypervolemia increases the heart's workload, which can lead to a heart attack. REF: Page 615, Table 21-21 TOP: Fluid retention

33. Nursing interventions to decrease the thirst of a patient who is on a fluid restriction include: a. rinsing the mouth with warm water. b. sipping carbonated drinks. c. sucking on ice chips. d. limiting tooth brushing to once per day.

ANS: C Sucking on ice chips is a way to decrease thirst without adding a large amount of fluid. Rinsing the mouth with cool water and frequent tooth brushing are helpful also. Carbonated drinks contain sodium and will enhance fluid retention. REF: Page 644 TOP: Fluid restrictions Step: Planning

5. The USDA's Recommended Dietary Allowance (RDA) has been replaced by the: a. Nutrition Recommended Allowance (NRA). b. National Bionutritional Allowance (NBA). c. Dietary Reference Intake (DRI). d. Dietary Guidelines for Americans (DGA).

ANS: C The Dietary Reference Intake (DRI) has replaced the Recommended Dietary Allowance (RDA). REF: Page 608 TOP: Nutrition

34. The nurse recognizes that when a patient is unable to consume adequate nutrition by mouth, an alternative route such as a feeding ostomy may be used. Feeding a patient by this means is called: a. total parenteral nutrition (TPN). b. nasogastric. c. enteral. d. parenteral.

ANS: C The administration of nutritionally balanced liquid foods through a feeding ostomy is called enteral nutrition. REF: Page 646 TOP: Enteral feedings

17. The patient complains to the nurse that he feels terrible since he has been taking several different kinds of vitamin preparations. The nurse assesses for indications of vitamin toxicity, which include: a. edema. b. hypertension. c. fatigue. d. diarrhea.

ANS: C Toxicity usually occurs from the use of large supplemental doses of vitamins and minerals and presents as fatigue, nausea, vomiting, and headache. REF: Pages 613-617, Table 21-6 TOP: Vitamin toxicity

18. The nurse cautions the patient with a pancreatic disorder that she will not be able to digest fats well and may be subject to a clotting disorder. This problem is the result of the inability to utilize vitamin: a. B. b. C. c. D. d. K.

ANS: D Vitamins A, D, E, and K are fat-soluble. Difficulty with fat metabolism will result in the inability to utilize fat-soluble vitamins. REF: Page 643 TOP: Fat-soluble vitamins

6. Although alcohol is not an essential nutrient, 1 gram of alcohol provides: a. 4 kcal/g. b. 5 kcal/g. c. 6 kcal/g. d. 7 kcal/g.

ANS: D Alcohol provides 7 kcal/g of energy. REF: Page 608 TOP: Alcohol

4. To demonstrate the energy-producing potential of different foods, the nurse explains that 3 grams of lean meat produces 12 kcal/g, whereas 3 grams of fish oil would produce: a. 6 kcal/g. b. 15 kcal/g. c. 21 kcal/g. d. 27 kcal/g.

ANS: D Fat provides 9 kcal/g. REF: Page 608 TOP: Nutrition

9. The body's storage form of carbohydrates, usually found in the liver with some storage in the muscles, is: a. sugar. b. glucose. c. lipids. d. glycogen.

ANS: D Glycogen is not generally consumed in the diet but is the body's storage form of carbohydrate. It is found mainly in the liver, with some storage in the muscles. REF: Page 609 TOP: Glycogen

1. The nurse makes nutrition a focus in the care plan because of the role it plays in: a. weight control. b. sustained appetite. c. building strong bones. d. health maintenance.

ANS: D Nutrition is the total of all processes involved in taking in and using food substances for proper growth, functioning, and maintenance of health. REF: Page 605 TOP: Nutrition Step: Planning

22. The young woman who is breastfeeding will need an increase of calories and protein. The nurse suggests which foods as sources of protein? a. Green, leafy vegetables b. Citrus fruits c. Asparagus d. Nuts

ANS: D Nuts are a safe source of protein for lactating women. REF: Page 620, Table 21-10 TOP: Protein source

Vegans are at risk for which nutritional deficiency?

B12

production of hemoglobin and myelin, synthesis of new cells and maintenace of nerve cells are functions of which vitamin

B12 cyanocobalamin

Niacin is which B vitamin

B3

folic acid is which vitamin

B9

unsaturated fats are liquid at room temp and are thought to lower which type of cholesterol?

LDL (bad fat that causes thickening of arteries leading to blockage)

the sum of all processes involved in taking in nutrients and using them to maintain body tissue and provide energy is known as

Nutrition

DRI is a combination of

RDA, adequate intake, tolerable upper intake level and the estimated average requirement of each nutrient

RDA stands for

Recommended Dietary Allowance

which vitamins are important to treat pressure ulcers?

Vitamin C,D and zinc

Gi upset, muscle weakness and calcium deposits are signs of toxicity of which vitamin

Vitamin D

formation of blood clotting factors is a function of which vitamin

Vitamin K

Which vitamins are water soluble

Vitamins B and C

are whole grains better than refined grains?

Yes

PEM (protein energy malnutrition) is defined as

a lack of energy or protein intake

DRIs of iron are

adolescent girls 15mg/day premenopausal 18mg/day postmenopausal 8mg/day pregnant women 27mg/day

condition referred to as the body building more tissue than it is breaking down due to a positive nitrogen balance

anabolism

formation and maintenance of bones and teeth, blood clotting, nerve conduction and muscle contraction are functions of which mineral?

calcium

of the six essential nutrients which 3 provide energy?

carbohydrates, fats and proteins

condition referred to as insufficient protein intake which causes the body to break down more body tissue than it is building

catabolism

DRIs of calcium are

children/adolescence is 1300mg/day adults 50 or younger 1000mg/day adults 51 or older 1200mg/day adults with osteoporosis need 1500mg/day

meat, poultry, fish, milk, cheese, eggs and soy products are what kind of proteins

complete proteins which contain all nine essential amino acids

polysaccharides are

complex carbohydrates

starch, glycogen and fiber are classified as

complex carbohydrates

common signs of a deficiency in sodium include

cramps, mental confusion, apathy and appetite loss

poor skin turgor, flushed dry skin, dry mouth, cracked dry lips, decreased urine output, irritability, and disorientation are signs of

dehydration

DRI stands for?

dietary reference intake; refers to a set of nutrient based values for evaluating and planning diets

nutrients that the body cannot make in the amounts essential for good health are called

essential nutrients; must be included in diet

iron absorption is diminished with intake of

fiber and caffeine

formation of DNA and cell division as well as nucleic acid synthesis and amino acid metabolism is function of which vitamin

folic acid B9

function of niacin is

general metabolism

grains, legumes, nuts and seeds are what kind of proteins

incomplete proteins which are typically of plant origin

type of fiber that softens stool, speeds transit of foods through digestive tract and reduces pressure in the colon?

insoluble

wheat bran, vegetables, whole grains, and some fibrous fruits are considered what type of fiber

insoluble

Vitamin B12 is not absorbed without

intrinsic factor

which organ remove excess nitrogen from the body?

kidneys

condition characterized by edema in the feet, legs, face and hands and in extreme cases abdominal. occurs as a result of severe protein restriction in the presence of other calories

kwashiorkor

Trans fat should be limited to what % of calories a day?

less than 1%

what is the DRI for cholesterol? including LDL

less than 100mg/day LDL less than 300mg/day for total cholesterol

organic substances of a fatty nature that are insoluble in water and necessary for good health; include fats and cholesterol

lipids

which nutrient provides the most concentrated source of energy

lipids

where is glycogen stored?

liver

protein, carbohydrates, fats, water and minerals are all examples of

macronutrients

calcium, phosphorus, magnesium, sulfur, sodium, potassium and chloride are considered what kind of minerals

major minerals needed in quantity more than 100mg/day

a chronic condition defined by wasting of body tissues and effects people of all ages d/t a deficiency of protein as well as all other energy-providing foods is called

marasmus

combination of all chemical processes that take place in living organisms is called

metabolism

nutrients requires in smaller amounts; such as vitamins and trace minerals are called

micronutrients

balance between amount of nitrogen ingested in the form of protein and level of nitrogen used by the body is called

nitrogen balance

vitamins are organic compounds that are essential for

normal metabolism and for growth and maintenance of the body; they are NOT sources of energy

iron deficiency limits what

oxygen delivery to the cells causing fatigue, headache, pallor, pale skin, poor attention span

pt with gastric bypass surgery is at risk for

pernicious anemia (B12 deficiency)

increased blood pressure, kidney stones, cardiac dysrythmias, muscle weakness and glucose intolerance are signs of deficiency in which mineral?

potassium

carbohydrates are required in adequate amounts to keep which nutrient from being used as an energy source?

protein

what are the 3 major functions of nutrients?

provide energy, building and repairing tissue, and regulating body processes

dietary fiber cannot be broken down and digested and therefore have no nutritional value. What is a benefit of fiber?

provides roughage or bulk for health maintenance; can lower cholesterol and blood glucose levels and assist in weight loss

simple carbohydrates are absorbed ____ d/t the fact that they require no digestion

rapidly

What are macronutrients?

required in large amounts

a feeling of fullness and satisfaction from food is called

satiety

fatty acid that is solid at room temp and increase the blood cholesterol levels this increasing risk for atherosclerosis and heart disease are

saturated fatty acid

sucrose, lactose, fructose and glucose are examples of what kind of carbohydrate?

simple

simple sugars (mono and disaccharides) are

simple carbohydrates

fluid and acid-base balance, nerve conduction and muscle contraction are all functions of which minerals?

sodium and potassium

fiber that binds with bile acids and cholesterol to prevent absorption resulting in lower cholesterol levels and slowing digestion are

soluble fibers

PEM is typically accompanied by multiple nutrient deficiencies and can lead to

stunted growth and impaired cognitive development in children, reduced mental and physical capacity and lowered resistance to infection

protein is essential for

tissue growth, repair and woundhealing

what is the purpose of DRIs?

to help individuals optimized their health, prevent disease, and avoid consuming too much of a nutrient

iron, zinc, iodine, selenium, copper, manganese, fluoride, chromium, molybdenum are what type of minerals

trace minerals

vision, tissue integrity, growth and reproduction, immune function and embryonic development are functions of which vitamin

vitamin A

fat soluble vitamins include

vitamin A, D, E and K

lipids contain essential fatty acids: linoleic acid and linolenic acid. Also carry which vitamins?

vitamin A,D,E and K

maintenance of blood calcium, phosphorus balance and promotion of bone and teeth are functions of which vitamin

vitamin D

wound healing, tissue growth and maintenance, immune function and absorption of iron are functions of which vitamin

vitamin c ascorbic acid

Fruits, oats, barley, legumes are examples of what kind of fiber?

water-soluble

What are the DRIs for sodium including upper limit?

younger than 50 is 1500mg/day 50-70 is 1300mg/day 70 and older is 1200mg/day upper limit is 2300mg/day