Chapter 17: Nutrition Care

A complete nutrition assessment should include gathering information about a. use of over-the-counter supplements. b. the number of relatives living. c. medications taken 5 years ago. d. clothing and shoe size.

ANS: A A complete nutrition assessment involves a complete diet history, including information about over-the-counter supplements (vitamins and herbs), along with food intake, fluids, and drugs.

An example of a diet with modified texture is a a. liquid diet. b. low-energy diet. c. high-protein diet. d. vegetarian diet.

ANS: A A liquid diet is an example of a diet with a modified texture.

A statement such as "evidence of iron-deficiency anemia" is part of the a. nutrition diagnosis statement. b. clinical flow sheet. c. diet order. d. medical order.

ANS: A A term such as "evidence of iron-deficiency anemia" could be part of the nutrition diagnosis statement, which helps identify nutrition problems, including nutrient deficiencies.

Enteral feeding is administered through a. the gastrointestinal tract. b. the bowel. c. an intravenous drip. d. a syringe.

ANS: A Enteral feeding is a formula-based feeding delivered into various parts of the gastrointestinal tract.

Hypogeusia may suggest a. a nutrient imbalance. b. a lack of physical exercise. c. excessive oral hygiene. d. a life-threatening emergency.

ANS: A Hypogeusia may suggest a nutrient imbalance, specifically; it may be associated with zinc deficiency.

An example of an oral diet that has been modified is a. a low-residue diet. b. a regular diet. c. a high-protein tube feeding. d. parenteral nutrition.

ANS: A Nutrition components of the oral diet can be modified via: (1) texture changes such as low residue or liquid; (2) an increase or decrease in energy value; and (3) nutrients such as fat, protein, carbohydrate, vitamins, or minerals.

A clinical sign of poor nutritional status is a. pale eye conjunctiva. b. firm muscle tone. c. good attention span. d. appropriate body weight.

ANS: A Pale eye conjunctiva may be a sign of iron deficiency.

A plasma protein used to assess nutritional status is a. serum albumin. b. alkaline phosphatase. c. total iron binding capacity. d. blood urea nitrogen

ANS: A Serum albumin and prealbumin are plasma proteins used to assist in the evaluation of nutritional status.

The identification and labeling of an actual nutrition occurrence, risk of an occurrence, or potential for developing a nutrition problem is referred to as the nutrition a. diagnosis. b. assessment. c. plan. d. intervention.

ANS: A The nutrition diagnosis involves the identification and labeling of an actual nutrition occurrence, risk of an occurrence, or potential for developing a nutrition problem.

The statement, "limited oral intake related to fatigue and nausea as evidenced by average daily intake of calories less than 500 kcal and 8-lb weight loss during past 2 months" is an example of what phase of the nutrition care process? a. Diagnosis b. Intervention c. Assessment d. Monitoring

ANS: A The nutrition diagnosis phase of the care process involves the identification and labeling of an actual occurrence, risk of an occurrence, or potential for developing a nutrition problem. In this case, "limited oral intake" is the problem, "related to fatigue and nausea" is the etiology, and "as evidenced by average daily intake of calories less than 500 kcal and 8-lb weight loss during past 2 months" are the signs.

An alternative measure for height for a nonambulatory patient is a. total arm span. b. skin calipers. c. waist circumference. d. creatinine height index.

ANS: A Total arm span measurement can be used as an alternative to estimate height for those who cannot stand.

A food that contains furanocoumarin that can interact with certain medications is a. red apple slices. b. grapefruit juice. c. mashed potatoes. d. chicken noodle soup.

ANS: B Grapefruit juice contains furanocoumarin and can interact with certain medications.

A patient who currently weighs 150 lb should receive further assessment if the medical record shows that his or her usual weight is a. 160 lb. b. 170 lb. c. 180 lb. d. 190 lb.

ANS: B Loss of 10% or more of body weight requires a thorough evaluation. A loss of 20 lb (170 20 = 150) is loss of more than 11% of body weight in this patient.

Methods used for nutrition assessment of patients include a. computed tomographic scans. b. laboratory tests. c. physical therapy. d. fitness testing.

ANS: B Methods used for nutrition assessment of patients include laboratory tests, anthropometrics, observations, and diet history.

Nutrition counseling is most effective when a. the counselor educates the patient about ideal energy and nutrient intake for his or her condition. b. the counselor and patient work together to set goals and individualized action plans. c. the counselor and patient become close and develop a personal friendship. d. the patient identifies his or her own needs and the counselor helps find solutions to those needs.

ANS: B Nutrition counseling is most effective when the patient and counselor collaborate to set priorities and goals and to create individualized action plans that encourage self-care and promote health.

A nutrition diagnosis is based on a. medical diagnoses. b. a nutrition assessment. c. patient goals. d. insurance coverage.

ANS: B The nutrition diagnosis is based on careful study of all the information gathered during nutrition assessment.

A dietary analysis that requires the patient to keep accurate records of what he or she eats and drinks is a a. diet history. b. food intake recall. c. food record. d. calorie count.

ANS: C A food record is a list kept by the patient of foods the patient has consumed over a certain number of days. A calorie count records foods and beverages eaten by the patient. Diet histories and food intake recalls require patients to try to remember what they have eaten over the past few days.

Hospitalized patients should be weighed a. naked. b. every day. c. at the same time each day. d. before they go to the bathroom.

ANS: C Hospitalized patients should be weighed at consistent times each day to obtain consistent measurements and observe trends.

A laboratory test that indicates immune function is the a. serum albumin. b. serum transferrin. c. hematocrit. d. lymphocyte count.

ANS: D One measure of immune status that can be measured is the lymphocyte count.

Patients often underestimate the importance of reporting intake or use of a. coffee. b. tobacco products c. vitamin and mineral supplements. d. prescription medications.

ANS: C Patients often consider vitamin and mineral supplements to be natural and harmless and so do not report them to health care providers.

The nutrition care process step of recommending additional glucose testing would be considered part of a. the assessment. b. the intervention. c. monitoring and evaluation. d. the nutrition diagnosis.

ANS: C Recommending a glucose test would be considered during the nutrition monitoring and evaluation phase to assist in measuring progress toward the patient's goals.

A tool that would be useful to assess changes in subcutaneous fat over a 12-month period would be a. a tape measure. b. a scale. c. calipers. d. a clamp.

ANS: C Skin calipers are a useful tool to measure skinfold thickness. Calipers measure the relative amount of subcutaneous fat at various body sites.

The person most responsible for nutrition care in a clinical setting is the a. physician. b. nurse. c. clinical dietitian. d. patient.

ANS: C The clinical dietitian is the person responsible for nutrition care in the clinical setting. The nurse, physician, and patient all work with the dietitian to create a successful plan of care.

A method of determining a person's basic eating habits is a a. 24-hour food record. b. urinalysis. c. diet history. d. calorie count.

ANS: C The diet history provides knowledge of the patient's basic eating habits.

The member of the health care team who is in closest, continual contact with patients and their families is the a. physician. b. clinical dietitian. c. licensed nurse. d. physical therapist.

ANS: C The nurse provides 24-hour care to the patient and is in closest contact with the patient and family.

The laboratory test used to determine nitrogen balance is a. serum albumin. b. hemoglobin. c. urinary urea nitrogen. d. serum transferrin.

ANS: C Urinary urea nitrogen is a 24-hour urine test that measures the products of protein metabolism. This can be compared to protein intake to estimate nitrogen balance.

An oral diet can be modified by a. energy value, temperature, or cooking method. b. nutrient content, temperature, or spice content. c. energy value, energy density, or texture. d. nutrient content, energy value, or texture.

ANS: D Oral diet modification can consist of changes in nutrient content, energy value, or texture.

Nutrition care must be centered on the a. team. b. family. c. disease. d. person.

ANS: D Nutrition care must be based on individual needs and must be centered on the patient.

An anthropometric measure that gives an estimate of subcutaneous fat is a. weight. b. height. c. mid-upper arm circumference. d. skinfold thickness.

ANS: D Subcutaneous fat can be estimated by skinfold thickness recorded with calipers.

The nurse must have a good understanding of nutrition principles because he or she a. decides whether the food tray is appropriate for the patient. b. knows the patient's likes and dislikes. c. must feed some patients. d. interprets and supports the nutrition care plan.

ANS: D The nurse requires an adequate understanding of nutrition principles because he or she interprets and supports the plan of nutrition care for the patient. The nurse works more closely with the patient than any other practitioner.