Chapter 11

14. The nurse is performing a nutritional assessment on a 15-year-old girl, who tells the nurse that she is "so fat." Assessment reveals that she is 5 feet 4 inches and weighs 110 pounds. The nurse's appropriate response would be:

A) "How much do you think you should weigh?"

25. The nurse is evaluating patients for obesity-related diseases by calculating the waist-to-hip ratios. Which one of these patients would be at increased risk?

A) 29-year-old woman whose waist is 33 inches and whose hips are 36 inches

1. The nurse recognizes that which of these persons is at greatest risk for undernutrition?

A) 5-month-old infant

12. During a nutritional assessment, why is it important for the nurse to ask a patient what medications he or she is taking?

A) Certain drugs can affect the metabolism of nutrients.

3. The nurse is providing nutrition information to the mother of a 1-year-old child. Which of these statements represents accurate information for this age group?

A) It is important to maintain adequate fat and caloric intake.

18. If a 29-year-old woman weighs 156 pounds and the nurse determines her ideal body weight to be 120 pounds, how would the nurse classify the woman's weight?

A) Obese

11. The nurse is providing care for a 68-year-old woman who is complaining of constipation. What concern exists regarding her nutritional status?

A) The absorption of nutrients may be impaired.

17. When considering a nutritional assessment, the nurse is aware that the most common anthropometric measurements include:

A) height and weight.

24. In teaching a patient how to determine total body fat at home, the nurse includes instructions to obtain measurements of:

A) height and weight.

28. After completing a diet assessment on a 30-year-old woman, the nurse suspects that she may be deficient in iron. Laboratory studies to obtain to verify this condition would be:

A) hemoglobin and hematocrit.

32. The nurse is performing a nutritional assessment on an 80-year-old patient. The nurse knows that physiological changes that directly affect the nutritional status of the elderly include:

A) slowed gastrointestinal motility.

1. A patient has been unable to eat solid food for 2 weeks, and is in the clinic today complaining of weakness, tiredness, and hair loss. The patient states that her usual weight is 175 pounds, but today she weighs 161 pounds. What is her recent weight change percentage? To calculate recent weight change percentage, use this formula:

ANS: 8%

13. A patient tells the nurse that his food just doesn't have any taste anymore. The nurse's best response would be:

B) "When did you first notice this change?"

31. A 21-year-old woman has been on a low-protein liquid diet for the past 2 months. She has had adequate calories and appears well nourished. In further assessing her, what would the nurse expect to find?

B) Decreased serum albumin

1. The nurse is assessing an obese patient for signs of metabolic syndrome. This condition is diagnosed when three or more certain risk factors are present. Which of these assessment findings are risk factors for metabolic syndrome? Select all that apply.

B) Fasting plasma glucose level greater than or equal to 110 mg/dL C) Blood pressure reading of 140/90 mm Hg

27. The nurse needs to perform anthropometric measures of an 80-year-old man who is confined to a wheelchair. Which of the following is true in this situation?

B) Height measurements may not be accurate because of changes in bone.

30. In performing an assessment on a 49-year-old woman who has imbalanced nutrition as a result of dysphagia, which data would the nurse expect to find?

B) Inadequate nutrient food intake

8. The nurse is reviewing a patient's nutritional assessment. Which statement is true concerning the nutritional assessment?

B) It identifies patients who are at risk of malnutrition.

16. The nurse is reviewing the nutritional assessment of an 82-year-old patient. Which of these factors ismost likely to affect the nutritional status of an elderly person?

B) Living alone on a fixed income

44. The nurse is assessing the body weight as a percentage of ideal body weight on an adolescent patient who was admitted for suspected anorexia nervosa. The patient's usual weight was 125 pounds, but today she weighs 98 pounds. The nurse calculates the patient's ideal body weight, and reaches which conclusion?

B) She is experiencing moderate malnutrition.

5. A mother and her 13-year-old daughter express their concern related to the daughter's recent weight gain and increase in appetite. Which of these statements represents information the nurse should discuss with them?

B) Snacks should be high in protein, iron, and calcium.

7. During a nutritional assessment of a 22-year-old male refugee, the nurse must remember to:

B) clarify what is meant by the term "food."

41. During an assessment of a patient who has been homeless for several years, the nurse notices that his tongue is magenta in color. This is an indication of _____ deficiency.

B) riboflavin

19. How should the nurse perform a triceps skinfold assessment?

C) After applying the calipers, wait 3 seconds before taking a reading. Repeat the procedure three times.

33. Which of these interventions is most appropriate when the nurse is planning nutritional interventions for a healthy, active 74-year-old woman?

C) Decrease the number of calories she is eating because of the decrease in energy requirements from loss of lean body mass.

35. A 16-year-old girl is being seen at the clinic for gastrointestinal complaints and weight loss. The nurse determines that many of her complaints may be related to erratic eating patterns, eating predominantly fast foods, and high caffeine intake. In this situation, which is most appropriate when collecting current dietary intake information?

C) Have the patient complete a food diary for 3 days, including 2 weekdays and 1 weekend day.

29. A 50-year-old woman with elevated total cholesterol and triglyceride levels is visiting the clinic today to find out about her laboratory results. What would be important for the nurse to include in patient teaching in relation to these tests?

C) Information regarding a diet low in saturated fat

39. Which of these conditions is due to an inadequate intake of both protein and calories?

C) Marasmus

22. The nurse is concerned about the skeletal protein reserves of a patient who has been hospitalized frequently for chronic lung disease. Which of these measurements would be necessary to include in the assessment?

C) Mid-arm muscle area

6. The nurse is assessing a 30-year-old unemployed immigrant from an underdeveloped country who has been in the United States for 1 month. Which of these problems related to his nutritional status might the nurse expect to find?

C) Osteomalacia

21. When the mid-upper arm circumference and triceps skinfold of an 82-year-old man are evaluated, which is important for the nurse to remember?

C) These measurements may not be accurate because of changes in skin and fat distribution.

40. A pregnant woman who is HIV positive is asking the nurse about breastfeeding her infant. Which of these statements is true?

C) Women who are HIV positive should not breastfeed because HIV can be transmitted through breast milk.

38. A 65-year-old man is brought to the emergency department after he was found dazed and incoherent, alone in his apartment. He has an enlarged liver and is moderately dehydrated. When evaluating his serum albumin level, the nurse must keep in mind that:

C) low serum albumin levels may be caused by reasons other than protein-calorie malnutrition.

26. The mother of an 8-year-old boy is concerned about the amount of weight her son has gained. To determine whether this is a problem, the nurse will measure:

C) skinfold thickness.

42. A 50-year-old patient has been brought to the emergency department after a housemate found that he could not get out of bed alone. He has lived in a group home for years, but for several months he has not participated in the activities and has stayed in his room. The nurse assesses for signs of under nutrition, and x-rays reveal that he has osteomalacia, which is a deficiency of:

C) vitamin D and calcium.

4. A pregnant woman is interested in breastfeeding her baby, and asks several questions about the topic. Which information is appropriate for the nurse to share with her?

D) Breast milk provides the nutrients necessary for growth as well as natural immunity.

36. The nurse is preparing to measure fat and lean body mass and bone mineral density. Which tool is appropriate?

D) Dual-energy x-ray absorptiometry

15. The nurse is discussing appropriate foods with the mother of a 3-year-old child. Which of these foods are recommended?

D) Finger foods and nutritious snacks that can't cause choking

10. A patient is asked to indicate on a form how many times he eats a specific food. This would describe which of these methods for obtaining dietary information?

D) Food frequency questionnaire

34. The nurse in a family practice clinic is reviewing the patients scheduled for appointments. Which of these statements is true regarding routine laboratory testing in the following individuals?

D) Laboratory tests for iron and lead levels should be assessed at 9 to 12 months.

9. The nurse is seeing for the first time a patient who has no history of nutrition-related problems. The initial nutritional screening should include which activity?

D) Measurement of weight and weight history

37. The nurse is reviewing laboratory studies on a patient who may have protein malnutrition. Which of these measurements is an early indicator of protein malnutrition?

D) Serum transferrin

43. An elderly patient in a nursing home has been receiving tube feedings for several months. During an oral examination, the nurse notes that patient's gums are swollen, ulcerated, and bleeding in some areas. The nurse suspects that the patient has what condition?

D) Vitamin C deficiency

23. The nurse is measuring a patient's frame size. Which of these statements best describes the correct technique for measuring frame size?

D) With the right arm extended forward and the elbow bent, use the calipers to measure the distance between the condyles of the humerus.

20. To assess the muscle mass and fat stores on a 40-year-old woman, the nurse would use:

D) mid-upper arm circumference.

2. When assessing a patient's nutritional status, the nurse recalls that the best definition of optimal nutritional status is:

D) sufficient nutrients to provide for daily body requirements and for increased metabolic demands.