Nutrition ch 2
The nurse is helping a community outreach program to promote healthier eating habits. The 2015-2020 Dietary Guidelines for Americans recommend how many servings of whole grains per day?
2
The nurse recognizes that whole-grain products must consist of the certain components of the grain. What of the following is one of those components?
bran Explanation: Whole-grain products must contain the entire kernel, which consists of the bran, endosperm, and germ layers.
The nurse is helping a client learn how to count carbohydrates for a low-carbohydrate diet. The nurse explains that a 1 ounce-serving of grain is estimated to provide how many grams of carbohydrates?
15 Whether whole or refined, a 1-ounce serving of grain is estimated to provide 15 grams of carbohydrates.
The nurse is teaching a nutrition class with a group of clients who are overweight. The nurse indicates that the adequate intake (AI) for total fiber is set at which of the following amounts?
25 g/day for women; 38 g/day for men. Explanation: The AI for total fiber is set at 14 g/1000 calories or 25 g/day for women and 38 g/day for men.
The nurse is reviewing a client's food log and calculating how many calories the client has consumed. The nurse knows that there are how many calories in a gram of carbohydrates? Enter the correct answer ONLY.
4 Explanation: Carbohydrates provide 4 calories per gram.
The nurse is seeing a client who is newly diagnosed with type 2 diabetes. The client tells the nurse she does not want to consume chemical based nonnutritive sweeteners. Which of the following sugar alternatives should the nurse recommend?
stevia Explanation: Stevia is produced from the stevia plant, an herb. The other choices are produced by mixing various chemicals.
The nurse recognizes that disaccharides are composed of two sugar molecules. The combination of glucose and fructose creates:
sucrose. Explanation: Sucrose is composed of glucose and fructose. Maltose is composed of two glucose molecules. Lactose is composed of glucose and galactose. Galactose is a monosaccharide.
A nurse has been trying to teach a client newly diagnosed with diabetes how to interpret food labels and recognize sugars. The client is very upset. He understood about "glucose" but considered "fructose" to be safe to eat without monitoring the amount of intake. Which of the following would be an appropriate response from the nurse?
"Fructose is changed to glucose by the liver." Explanation: It is important to remain nonjudgmental and validate the client's concerns. It is also important to continue teaching and reteaching without becoming impatient or angry with the client. Teaching the basic facts would be an important step. If the client continues not to understand, the nurse should evaluate the way in which the teaching is occurring and perhaps find a different way to share the information. Dextrose and glucose are interchangeable terms, both refer to the same type of monosaccharide. Glycogen is the animal (including human) version of starch; it is stored carbohydrate available for energy as needed. It cannot be consumed directly from food.
The client is upset that despite incorporating low-sugar and sugar-free foods into her eating pattern, she is not losing weight and her blood sugar is still difficult to control. The nurse notes which of the following reasons the client is having this problem?
"Sugar-free" does not mean calorie-free. Explanation: The use of sugar alternatives does not guarantee lower calorie intake. The term "sugar-free" does not mean calorie-free. The client still needs to check the label for calories and count them as well.
The nurse is seeing a client who has been reading about the different nonnutritive sweeteners that are listed on his menu plan as acceptable alternatives to sugar. The client is questioning saccharin because he read that it is a potential carcinogen. How should the nurse respond?
"The FDA has officially withdrawn the proposed ban because evidence is weak." Explanation: Saccharin may be a potential weak carcinogen; however, the FDA has officially withdrawn its proposed ban because of research findings.
The health care provider has instructed a client to increase his fiber intake. The nurse explains that one serving of fruit or vegetables may contain approximately how many grams of fiber?
1 to 3 grams
A client has been working with the nurse to improve his diet and lose weight. The nurse congratulates the client for choosing skim milk over whole milk. Skim milk is a better choice because of its lower fat content. How many carbohydrates per cup does skim milk contain?
12 grams Explanation: One cup of milk, regardless of the fat content, provides 12 grams of carbohydrates in the form of lactose.
A client who is on a low-carbohydrate diet is having difficulties making suitable food choices during meal times. Which of the following food choices is the BEST for a low-carbohydrate intake eating pattern?
2 cups green beans Explanation: The choices contain the following amounts of carbohydrate: 2 cups green beans (20 g), 1 cup lentil soup with ham (30 g), 2 slices whole-wheat bread (30 g), and 1 cup unsweetened canned fruit (30 g). The green beans are lower in carbohydrates than the other choices.
The nurse is helping a client incorporate vegetables into a carbohydrate reduced meal plan. The nurse explains that half a cup of "watery" vegetables contains approximately how many grams of carbohydrates?
5 Explanation: A half cup of "watery" vegetables contains approximately 5 grams of carbohydrates. Starchy vegetables contain approximately 15 grams of carbohydrates per serving.
The clinic nurse is teaching clients with newly diagnosed type 2 diabetes about diet and weight control. To assess if teaching has been effective, the nurse gives the client an exercise in which he must calculate the number of 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?
52 calories
The nurse is providing a follow up nutritional session with a client. The client is surprised to learn that carbohydrates have fewer calories than fat does. The client has calculated that she consumed 200 grams of carbohydrates for the day. The nurse knows the client consumed a daily total of how many calories?
800 calories Explanation: There are 4 calories in each gram of carbohydrates. This client consumed 200 grams, so 200 x 4 = 800 calories.
People with phenylketonuria (PKU) should avoid which nonnutritive sweetener?
Aspartame Explanation: Aspartame is made from the amino acids aspartic acid and phenylalanine. People with phenylketonuria must avoid aspartame. Saccharin, acesulfame potassium, and sucralose do not have phenylalanine as an ingredient.
A young mother is concerned about her children developing dental caries and is asking for appropriate suggestions to help prevent them. Which of the following is an appropriate suggestion for the nurse to offer?
Avoid sugary items that stay in the mouth for a long time. Explanation: The client should avoid high-sugar items that stay in the mouth for a long time. Individuals should brush their teeth promptly after eating. Gum should be sweetened with polyols and not sucrose, which can be fermented by bacteria in the mouth and promote cavities. Soft drinks should be limited at all times.
When providing teaching to a client recently diagnosed type 2 diabetes mellitus, the nurse can determine that teaching was effective if the client verbalizes that the caloric value of fiber is which of the following?
Between 1.5 cal/g and 2.5 cal/g. Explanation: 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 that the value is between 1.5 cal/g and 2.5 cal/g.
The Recommended daily amount (RDA) for carbohydrates is based on the minimum amount of glucose used to fuel the brain. Compare this with the Acceptable Macronutrient Distribution Range (AMDR). What is the suggested carbohydrate intake put forth by the AMDR?
Carbohydrates should make up 45% to 65% of total dietary calories. Explanation: 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.
Research consistently demonstrates that sugar is implicated in the development of which of the following health complications?
Dental caries Explanation: 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.
For a weight-loss program, the nurse is planning a class on how to read nutritional labels. The nurse plans to include information about the various names that are used to identify monosaccharides, such as glucose. Glucose also known as:
Dextrose Explanation: Glucose is also known as dextrose. 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.
Polyols or sugar alcohols are one of the alternatives to naturally occurring sugar that are used widely in the American diet. Consuming large amounts of polyvols is most likely to cause which of the following symptoms?
Diarrhea Explanation: 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.
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?
Dietary fiber Explanation: 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.
On ways to increase fiber intake, which of the following recommendations should the nurse make to a client with a diagnosis of chronic constipation.
Eat legumes two or three times per week. Explanation: 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 is not a high source of fiber, and cream of wheat and pretzels are made from refined grains rather than whole grains.
When it comes to carbohydrate intake, the latest findings indicate that Americans should do which of the following?
Increase fiber intake and limit consumption of added sugars. Explanation: 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.
A client has come to the clinic with vague complaints of weakness. The nurse notes on assessment that the client is eating a very restricted diet with little to no carbohydrates and is exercising four times a week. The nurse recognizes which of the following is the most likely factor contributing to the client's symptoms?
Low carbohydrate intake Explanation: The primary function of carbohydrates is to provide energy for cells. If the body does not receive enough glucose to adequately fuel the cells, the body will try to process other components; however, other areas of the body will suffer from the lack as well.
A client with diabetes reports reducing the number of cans of soda consumed each day but admits to "cheating" over the weekends. What should the nurse suggest to this client to help reduce the intake of sugar?
Place a few drops of Stevia in water with lemon Explanation: Stevia is generally recognized as safe for consumption and can be used as a tabletop sweetener. Adding a few drops of the sweetener to water with lemon can help reduce the client's intake of sugar. Fruit juice can have as much or more sugar than a can of soda. Four teaspoons of sugar equals 16 grams. Depending upon the number of glasses ice tea consumed, the client could be ingesting more sugar with the tea than through drinking soda. Mixing soda with carbonated water will dilute the beverage however there is still a substantial amount of sugar in the beverage.
A nurse is trying to help a client understand the difference between glucose and glycogen. The client shows he understands when he indicates that glycogen is the human version of which of the following?
Starch Explanation: Glycogen is the animal (including human) version of starch. It is a stored form of carbohydrate that is available for energy as needed. Fiber is a group name for polysaccharides that cannot be digested and absorbed by the human small intestine. Simple sugar is a classification of carbohydrates that includes monosaccharides and disaccharides commonly referred to as sugars. Protein is in its own classification of nutrient and is not a carbohydrate.
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?
Substitute legumes for meat protein sources. Explanation: 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. Legumes are a source of protein and clients should be encouraged to vary their protein routine. The other foods do not increase the fiber content of the diet.
The nurse is conducting a nutrition class of individuals newly diagnosed with diabetes. The nurse explains that shortly after eating, what happens in the body?
The pancreas releases insulin to move the glucose from the blood stream to the individual cells. Explanation: A rise in blood glucose after eating causes the pancreas to secrete insulin, which moves the increased glucose out of the blood into the body's cells, where it is used as energy. Glucagon is a hormone released by the pancreas as the blood glucose levels fall. The liver stores excess glucose as glycogen.
When helping a client develop a menu plan, which of the following information about nonnutritive sweeteners should the nurse share with the client?
They provide few or no calories. Explanation: Alternatives to sugar arise from people wanting 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
During a home visit the nurse notes that a client's stage 2 pressure injury is not healing as quickly as expected. Why should the nurse assess this client's intake of carbohydrates?
They spare protein needed for healing Explanation: As a primary source of energy, carbohydrates spare protein and prevent ketosis. Consuming adequate carbohydrate to meet energy needs spares protein from being used for energy. An adequate carbohydrate intake is especially important whenever protein needs are increased such as for wound healing. Carbohydrate does not build new tissue.
The school health nurse is providing education to a group of children about the differing nutritional values of sugars. When discussing added sugars, the nurse knows teaching has been effective when the children state which of the following?
add sugars provide empty calories. Explanation: Empty carbohydrate calories are calories that come from added sugars and syrups. Only the calories of the added sugar are considered "empty." The other choices, though reflective of the added calories, are not correct terms.
The nurse should caution clients to be aware of increased caloric value of food due to the inclusion of which of the following ingredients?
added sugasr. Explanation: Sometimes 100% of the calories in a food are from added sugar.
When providing education to a group of students, the school health nurse correctly states that around the world, the most commonly found nutrient in the human diet is which of the following?
carbohydrates. Explanation: Globally, carbohydrates provide the majority of calories in almost all human diets.
The nurse is preparing to teach a class on the benefits of eating whole grains. The nurse is aware that eating patterns rich in whole grains are associated with a lower risk of which of the following health problems?
cardiovascular disease. Explanation: Studies show that diets rich in whole grains are associated with a lower risk of cardiovascular disease, certain types of cancer, and type 2 diabetes and may aid in weight management.
When teaching clients nutritional interventions for preventing long term health problems, the nurse should emphasize limiting the intake of sugar for which of the following reasons?
diets high in added sugar likely provide inadequate amounts of essential nutrients. Explanation: Research does not show that added sugar causes ADHD or type 2 diabetes. Diets high in sugar can lead to inadequate essential nutrients because empty calorie foods are likely to displace more nutritious foods.
The nurse is explaining the different type of sugars to a client. The nurse correctly classifies maltose and lactose in which of the following sugar categories?
disaccharides. Explanation: Disaccharides are sucrose, maltose, and lactose. Monosaccharides are glucose, fructose, and galactose. Polysaccharides are starch, fiber, and glycogen. There are no trisaccharides.
The nurse is helping a client plan dietary changes to help the client lose weight. After the discussion the client understands that which of the following are polysaccharides? Select all that apply.
fiber starch glycogen Explanation: Fiber, starch, and glycogen are polysaccharides or complex carbohydrates. Glucose is a monosaccharide. Sucrose is a disaccharide.
The nurse is discussing enriched grains with a group of young mothers. The nurse informs the women that enriched grains must be fortified with which of the following?
folic acid. Explanation: Enriched grains are required to be fortified with folic acid, a mandate that is designed to reduce the risk of neural tube defects.
When explaining the nutritional value of adding fruit to an eating pattern, the nurse states that most of the calories in fruit come from which of the following sugars?
fructose. Explanation: Generally, almost all calories in fruit come from fructose and glucose.
The nurse is explaining to a group of college students how the body tries to maintain a steady supply of glucose for energy between meals. The nurse explains that the liver breaks down which substance to release glucose?
glycogen Explanation: Liver glycogen breaks down and release glucose into the bloodstream between meals to maintain normal blood glucose levels. Glucagon is the hormone released by the pancreas to balance the action of insulin. Galactose and sucrose are types of carbohydrates.
The nurse who is providing education during a nutritional class shares that the individual body cells take only as much glucose as is needed for immediate energy. The nurse knows teaching has been effective when the students states the liver and muscle cells store excess glucose as which of the following?
glycogen. Explanation: Muscle and liver cells store extra glucose as glycogen. Glucose is used for energy and must be changed to be stored. Glucagon is the hormone secreted by the pancreas in response to lower blood glucose levels to signal the need to convert stored glycogen back into glucose. Galactose is a monosaccharide that is converted to glucose by the liver.
A client has been brought to the unit with general complaints of nausea, fatigue, and anorexia. On assessment, the nurse learns that the client has not been eating well and has been eating mainly a low-carbohydrate, high-protein diet. The nurse is aware that which of the following may be occurring?
ketosis Explanation: Without adequate glucose, the body may use protein, and this can lead to ketosis. An increasing production of ketone bodies can cause nausea, fatigue, loss of appetite, and ketoacidosis.
The nurse recognizes that glucose, fructose, and galactose are also referred to as which of the following?
monosaccharides. Explanation: Glucose, fructose, and galactose each contain a single molecule of sugar and are referred to as monosaccharides. Disaccharides contain two molecules of sugar, and polysaccharides contain long chains of molecules. There are no specific trisaccharides.
The nurse recognizes that carbohydrates are a class of energy-yielding nutrients that contain which of the following elements? Select all that apply.
oxygen hydrogen carbon
If a client is not consuming enough carbohydrates, the nurse realizes that the body will use what to try to meet its energy needs?
protein Explanation: Protein can provide energy; however, it has other specialized functions that it needs to perform, and it cannot do both. Consuming adequate carbohydrates to meet energy needs has the effect of protein sparing.
The nurse is facilitating a weight management class for a group of adolescents. Today's discussion is about recognizing the added sugars in their diets. After the meeting, the students can successfully recognize that which product contains the most added sugar?
soda Explanation: Soda, energy drinks, and sport drinks are the largest contributor to empty calories in the American diet.
The nurse instructs a client on foods to increase total fiber intake to 25 grams/day. Which breakfast choice indicate that teaching has been effective?
½ cup all bran cereal, ½ cup skim milk, 1 slice whole wheat bread, sliced pear Explanation: The breakfast choice of all bran cereal, whole wheat bread, and a pear provides 18 grams of fiber. The breakfast choice of ½ cup strawberries provides 1.5 grams of fiber. The breakfast choice with orange slices provides 4 grams of fiber. The breakfast choice with oatmeal and banana provides 7 grams of fiber.
