Test Bank for Williams’ Basic Nutrition and Diet Therapy 15th Edition by Nix

Test Bank for Williams’ Basic Nutrition and Diet Therapy 15th Edition Nix Chapter 01: Food, Nutrition, and Health Nix: Williams' Basic Nutrition and Diet Therapy, 15th Edition MULTIPLE CHOICE 1. Promoting a health care service that improves diabetes management for the elderly in a

community would assist in which of the following? a. Supporting the national health goals Healthy People 2020 b. Reducing hunger in a subset of the United States population c. Improving Medicare reimbursement claims d. Providing access to primary health care services ANS: A

Healthy People 2020 has a wide influence and is the focus of the nation’s main objective to promote health and prevent disease.

DIF: Cognitive Level: Application TOP: Nursing Process: Implementation

REF: p. 2 MSC: NCLEX: Health Promotion and Maintenance

2. A patient requires a nutrition assessment. The most appropriate professional to perform the

assessment is a a. physician. b. nurse. c. public health nutritionist. d. registered dietitian.

ANS: D

The registered dietitian is the nutrition expert registered with the Commission of Dietetic Registration (CDR), the certifying agency of Academy of Nutrition and Dietetics. Registered dietitians are the only professionals who have met strict educational and professional prerequisites and passed a national registration examination that properly prepares them to conduct a nutrition assessment.

DIF: Cognitive Level: Application REF: p. 1 TOP: Nursing Process: Assessment MSC: NCLEX: Safe and Effective Care Environment: Management of Care 3. The sum of all body processes inside living cells that sustain life and health is a. science. b. digestion. c. metabolism. d. nutrition.

ANS: C

Metabolism is the sum of all chemical changes that take place in the body. Metabolism provides energy, builds tissue, and regulates metabolic processes in the body.

DIF: Cognitive Level: Knowledge REF: p. 3 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 4. The nutrients that provide the body with its primary source of fuel for energy are

a. b. c. d.

vitamins. minerals. fiber. carbohydrates.

ANS: D

Carbohydrates (e.g., starches and sugars) are the body’s primary fuel to carry out necessary processes; fat is the secondary source of energy.

DIF: Cognitive Level: Knowledge REF: p. 4 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 5. Which of the following is the most accurate statement regarding the functions of protein? a. Proteins can be a primary fuel source even if there is adequate carbohydrate intake. b. Proteins are a necessary nutrient to provide energy for the body in times of stress. c. Proteins can be used as coenzyme factors during cell metabolism. d. Proteins are essential to building and repairing tissues within the body.

ANS: D

The primary function of proteins is to provide amino acids, which are the building units necessary to building and repairing tissues within the body. This is a constant process that ensures adequate growth and maintenance of tissues for a strong body.

DIF: Cognitive Level: Comprehension REF: p. 4 TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity: Physiological Adaptation 6. A 65-year-old man requires 20N 00UkRcS alI /dNayGT wB ith.oC utOaMny specific fat or carbohydrate

requirements. The approximate number of kilocalories per day from fat that his diet should provide is kcal/day. a. 400 to 700 b. 100 to 300 c. 500 to 800 d. 900 to 1200 ANS: A

Fat should provide no more than 20% to 35% of the total kilocalories per day, so for a 2000-kcal diet, 400 to 700 kcal should be provided.

DIF: Cognitive Level: Application REF: p. 4 MSC: NCLEX: Health Promotion and Maintenance

TOP: Nursing Process: Planning

7. The body’s main storage form of carbohydrate is a. glycogen. b. glycerol. c. glucagon. d. glucose.

ANS: A

Glycogen is a polysaccharide that is the main storage form of carbohydrate in the human body. It is mainly stored in the liver and to a lesser extent in muscle tissue.

DIF: Cognitive Level: Knowledge REF: p. 4 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 8. The number of kilocalories provided by one slice of bread that contains 30 g carbohydrate, 3 g

protein, and 1 g fat is a. 34 b. 136 c. 141 d. 306

kcal.

ANS: C

Calculate as follows: Carbohydrate provides 4 kcal/g, protein provides 4 kcal/g, and fat provides 9 kcal/g. Therefore: 30 g carbohydrate  4 kcal/g = 120 kcal 3 g protein  4 kcal/g = 12 kcal 1 g fat  9 kcal/g = 9 kcal = 141 total kcal (120 kcal + 12 kcal + 9 kcal) DIF: Cognitive Level: Application REF: p. 4 TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity: Physiological Adaptation 9. The number of kilocalories from fat in a sandwich that contains 22 g fat is a. 88 b. 132 c. 154 d. 198

kcal.

ANS: D

Fat provides 9 kcal/g. Thus, 22 g fat  9 kcal/g = 198 kcal.

DIF: Cognitive Level: Application REF: p. 4 TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity: Physiological Adaptation 10. The number of kilocalories from protein in a sandwich that contains 15 g protein is

kcal. a. 45 b. 60 c. 75 d. 135 ANS: B

Protein provides 4 kcal/g. Thus, 15 g protein  4 kcal/g = 60 kcal.

DIF: Cognitive Level: Application REF: p. 4 TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity: Physiological Adaptation 11. The basic building units of protein are called a. fatty

acids.

b. amino c. nucleic d. carboxyl ANS: B

The basic building units of protein are amino acids, which are necessary for building, repairing, and maintaining body tissues.

DIF: Cognitive Level: Knowledge REF: p. 4 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 12. The main nutrients involved in metabolic regulation and control are a. water and vitamins. b. vitamins and minerals. c. vitamins and fatty acids. d. minerals and carbohydrates.

ANS: B

Vitamins and minerals are the key nutrients in regulating and controlling the many chemical processes in the body. Vitamins and minerals function as coenzyme factors, which are components of cell enzymes that govern cell chemical reactions in cell metabolism.

DIF: Cognitive Level: Knowledge REF: p. 5 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 13. The dietary regimen that would provide optimal nutrition for a person who is recovering from

an extended illness is a diet a. low in protein, fat, and carbNoU hyRdS raIteNs;GhTigBh.iC nO mM inerals and vitamins; and very low in fiber. b. providing adequate amounts of carbohydrates, protein, fat, minerals, and vitamins along with adequate water and fiber. c. high in protein, fiber, and fluid; low in carbohydrates; and adequate in vitamins and minerals. d. with essential amounts of vitamins and minerals; high in protein; and low in fat, carbohydrates, and fiber.

ANS: B

Optimal nutrition incorporates a varied diet supplying adequate amounts of all nutrients, including carbohydrates, protein, fat, vitamins, minerals, fiber, and fluid.

DIF: Cognitive Level: Application REF: p. 5 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 14. A young woman is 5 months pregnant. She currently lives in a condition of poverty and often

runs out of money to buy food. She is most at risk for a. liver damage. b. osteopenia. c. undernutrition. d. overnutrition.

A person with undernutrition, or an intake less than the desired amounts of nutrients a person needs to sustain and maintain health, carries a greater risk for physical illness than a person receiving adequate nutrition. In this case, a young, pregnant woman living in poverty who cannot obtain the necessary nutrition for herself and her baby is in a state of undernutrition, placing both at nutritional risk.

DIF: Cognitive Level: Application REF: p. 5 TOP: Nursing Process: Diagnosis MSC: NCLEX: Safe and Effective Care Environment: Management of Care 15. Which factors place a person at the greatest risk for malnutrition? a. Poor appetite, insufficient nutrient intake, poor hygiene, and depleted nutrition

reserves b. Poor hygiene, insufficient exercise, and excess carbohydrate intake c. Depleted carbohydrate intake, poor hygiene, and excess calorie intake d. Poor appetite, insufficient nutrient intake, depleted nutrition reserves, and a form

of metabolic stress ANS: D

Malnutrition appears when nutritional reserves are depleted and nutrient and energy intake is not sufficient to meet day-to-day needs or added metabolic stress.

DIF: Cognitive Level: Knowledge REF: p. 5 TOP: Nursing Process: Diagnosis MSC: NCLEX: Physiological Integrity: Physiological Adaptation 16. Mr. Katz, who is 48 years old, is admitted to the hospital with a fracture to his left hip. He

weighs 248 lb (54 lb above his desired weight). He is considered to be in a state of overnutrition. The statement most true regarding his state of overnutrition is that NU .oCuOnM a. desired nutrients are consum edRiS nI exNcG esT sB am ts without the risk of malnutrition. b. because excess body fat is evident and excess calories are consumed, there is no risk of nutrient deficiency leading to malnutrition. c. even though excess body fat and excess nutrient intake are evident, there still may be a risk for some type of nutrient deficiency leading to malnutrition. d. excess body weight may or may not be present along with excess consumption of carbohydrates and fat, which results in inadequate vitamin and mineral intake.

ANS: C

Overnutrition results from excess nutrient and energy intake over time, resulting in excess weight and a state of obesity. Malnutrition can result from excess body weight and the lack of vitamin- and mineral-rich food consumption (e.g., consumption of fatty and carbohydrate-rich foods only).

DIF: Cognitive Level: Application REF: p. 5 TOP: Nursing Process: Diagnosis MSC: NCLEX: Physiological Integrity: Physiological Adaptation 17. Which is least likely to be a primary cause of malnutrition? a. Conditions of poverty b. Prolonged hospitalization c. Homelessness d. Exercise ANS: D

Malnutrition appears when nutritional reserves are depleted and nutrient and energy intake is not sufficient to meet day-to-day needs or the additional requirements necessary during periods of stress, thus exercise is not a factor.

DIF: Cognitive Level: Application REF: p. 5 TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity: Physiological Adaptation 18. Overnutrition is characterized by a. overeating at a meal. b. excess nutrient and energy intake over time. c. eating a diet with too much variety. d. using dietary supplements.

ANS: B

Overnutrition results from excess nutrient and energy intake over time or occurs when excessive amounts of nutrient supplements are consumed, resulting in tissue-damaging effects.

DIF: Cognitive Level: Comprehension REF: p. 5 TOP: Nursing Process: Diagnosis MSC: NCLEX: Physiological Integrity: Physiological Adaptation 19. The Dietary Reference Intakes (DRIs) address the nutrient needs of a. all adults. b. most healthy population groups. c. minority ethnic groups. d. pregnant women, infants, and children.

ANS: B

The DRIs refer to a system of reference values that can be used for assessing and planning diets for healthy population groups and other purposes.

DIF: Cognitive Level: Knowledge TOP: Nursing Process: Implementation

REF: p. 6 MSC: NCLEX: Health Promotion and Maintenance

20. The Dietary Reference Intakes (DRIs) are developed by the a. U.S. Public Health Service. b. U.S. Food and Drug Administration (FDA). c. Food and Nutrition Board of the Institute of Medicine d. National Institutes of Health (NIH).

ANS: C

DRIs are developed by the Food and Nutrition Board of the Institute of Medicine.

DIF: Cognitive Level: Knowledge TOP: Nursing Process: Implementation

REF: p. 6 MSC: NCLEX: Health Promotion and Maintenance

21. When not enough scientific evidence is available to establish a Recommended Dietary

Allowance (RDA), the value used to guide intake is called the a. Dietary Reference Intake (DRI). b. tolerable upper intake level (UL). c. estimated average requirement (EAR).

d. adequate intake (AI).

ANS: D

AI is used as a guide when not enough scientific data are available to establish the RDA figure.

DIF: Cognitive Level: Knowledge TOP: Nursing Process: Implementation

REF: p. 7 MSC: NCLEX: Health Promotion and Maintenance

22. You are asked to help plan meals for a local monthly community dinner meeting for the

elderly. The tool that would be most helpful for planning healthy meals is the a. Dietary Reference Intakes. b. Dietary Guidelines for Americans. c. MyPlate food guidance system. d. basic four food groups.

ANS: C

MyPlate, provided by the U.S. Department of Agriculture, provides a valuable tool for meal planning, providing serving sizes for each food group and the ability to create a balanced meal from each group listed.

DIF: Cognitive Level: Knowledge TOP: Nursing Process: Implementation

REF: p. 7 MSC: NCLEX: Health Promotion and Maintenance

23. You are asked to explain the Dietary Guidelines for Americans to an adult community

education class at the local college. The most appropriate areas to cover in teaching this topic include a. appropriate amounts of sodN iuU mR, S saI tuNraGteTdBf. atC , cOhM olesterol, trans-fatty acids, whole grains, and alcohol. b. adequate calories and protein for weight maintenance, smoking cessation, herbal supplements, and food fads. c. the importance of low-carbohydrate diets, smoking cessation, herbal supplements, appropriate food groups, and sodium and potassium. d. food security, weight maintenance, glucose monitoring, and blood pressure monitoring technique.

ANS: A

The Dietary Guidelines outlines key recommendations to balance calories and maintain weight along with foods and food components to reduce including sodium, saturated fatty acids, cholesterol, trans-fatty acids, added fats and sugars, refined grains, along with recommendations for limiting alcohol.

DIF: Cognitive Level: Application TOP: Nursing Process: Implementation

REF: p. 7 MSC: NCLEX: Health Promotion and Maintenance

24. A patient asks you what he should eat to maintain an optimal diet. An appropriate response

would be to a. eat a variety of foods and eat in moderation. b. avoid all fast food and processed foods. c. eat only natural, organic foods. d. use vitamin and mineral supplements to ensure adequate nutrients.

ANS: A

An optimal diet contains a variety of foods and in appropriate quantities to maintain proper weight and health. All foods can fit into a healthy diet in moderation.

DIF: Cognitive Level: Application TOP: Nursing Process: Implementation

REF: p. 5 MSC: NCLEX: Health Promotion and Maintenance

25. The goal of the MyPlate food guide is to promote a. variety, proportion moderation, gradual improvements, and physical activity. b. physical activity, portion control, daily blood pressure monitoring, and gradual

improvements in health. c. portion control, daily physical activity, daily glucose monitoring, moderation, and

variety. d. variety, moderation, weighing food portions, daily blood pressure monitoring, and

glucose monitoring.

ANS: A

The goal of MyPlate is to promote variety, proportion moderation, gradual improvements, and physical activity.

DIF: Cognitive Level: Knowledge TOP: Nursing Process: Implementation

REF: p. 7 MSC: NCLEX: Health Promotion and Maintenance

26. A patient is to receive 2400 kcal/day while recovering from a motor vehicle accident. He is to

receive 50% of calories from carbohydrates, 25% of calories from fat, and 25% of calories from protein. Which of the following represents the appropriate calories for each substrate? a. 1500 kcal from carbohydrates, 500 kcal from fat, and 400 kcal from protein b. 1400 kcal from carbohydraN teU s,R6S 00IkNcG alTfB ro. mCfO atM , and 400 kcal from protein c. 1200 kcal from carbohydrates, 600 kcal from fat, and 600 kcal from protein d. 1600 kcal from carbohydrates, 400 kcal from fat, and 400 kcal from protein ANS: C

2400 kcal  0.50 = 1200 kcal from carbohydrates; 2400 kcal  0.25 = 600 kcal from fat; and 2400 kcal  0.25 = 600 kcal from protein.

DIF: Cognitive Level: Application REF: pp. 3-4 TOP: Nursing Process: Implementation MSC: NCLEX: Health Promotion and Maintenance | NCLEX: Physiological Integrity: Physiological Adaptation 27. A patient is placed on a 2300-kcal diet. The health care provider is asked to calculate the

grams of carbohydrates the patient is receiving on the diet. The number of grams of carbohydrates is a. 50 g. b. 35 g. c. 250 g. d. impossible to calculate from this data.

ANS: D

The percentage of carbohydrates in the diet typically ranges from 45% to 65% of the total calories depending on individual needs, tastes, habits, living situations, and energy demands.

However, the health care provider would need to know the specific foods the patient is eating to calculate carbohydrate intake.

DIF: Cognitive Level: Application REF: pp. 3-4 TOP: Nursing Process: Assessment MSC: NCLEX: Health Promotion and Maintenance | NCLEX: Physiological Integrity: Physiological Adaptation 28. A 52-year-old single woman comes to the health professional for advice on maintaining

optimal nutritional health. Her food intake records indicate that she likes to eat at fast food restaurants at least twice a week and relies on processed foods for the majority of her dietary intake. She maintains an active lifestyle and works part time at the local bank. The next step to assist this woman would be to a. assess meal plan options along with the ability to prepare nutritious foods. b. obtain laboratory values to further assess her nutrition status and recommend supplementing her diet with vitamins and minerals. c. find ways to decrease eating at fast food restaurants and incorporate physical exercise into her daily routine. d. recommend that she use the MyPlate food guide to change her eating style and attend cooking classes at the local community center.

ANS: A

The American food environment has been constantly changing over the past several years, with more people eating out and consuming more processed foods. Educating people to follow the MyPlate food guide and the Dietary Guidelines for Americans is important to maintain a healthy lifestyle. NURSINGTB.COM DIF: Cognitive Level: Analysis REF: p. 7 TOP: Nursing Process: Planning MSC: NCLEX: Health Promotion and Maintenance | NCLEX: Physiological Integrity: Physiological Adaptation 29. The person most at risk for malnutrition would be a(n) a. active young adult who eats three to five servings of fruits and vegetables along

with lean meats and fish and complex carbohydrates and exercises three times a week. b. young child who refuses to eat peas, green beans, and broccoli but loves fruits and other vegetables. c. middle-aged man undergoing chemotherapy for leukemia and who is having difficulty eating solid food. d. young weight lifter who has recently undergone surgery for a compound fracture of his left femur.

ANS: C

Malnutrition appears when nutrition reserves are depleted or nutrient and energy intake is not sufficient to meet the day-to-day needs along with the added metabolic stress. In this case, cancer and chemotherapy place an increased metabolic stress on the body and the patient is unable to consume enough food to meet his nutrient requirements, placing him at risk for malnutrition.

DIF: Cognitive Level: Application REF: p. 5 TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity: Physiological Adaptation 30. C.G. is a 45-year-old man who has a history of diabetes, and the dietary history reveals that he

enjoys a good breakfast with whole grain cereal and fruit. For lunch, he usually eats soup or an entrée consisting of a salad and meat along with 2% milk and a sugary soda. He usually has an afternoon snack of chips and sugary soda, and dinner is eaten at a restaurant most days of the week where he chooses steaks, hamburgers, and fries or onion rings along with a salad and a beer or other high-calorie beverage. One of the most important recommendations for C.G. would be a. to not eat at restaurants on a regular basis unless he chooses salads only along with water. b. to continue with whole grains, lean proteins, and vegetables, and replace sugary sodas with sugar-free beverages. c. to drink skim milk and eliminate soups, replacing them with fatty fish five meals a week. d. to enjoy his diet as is but encourage adequate amounts of exercise throughout the week.

ANS: B

The Choose MyPlate approach encourages making food choices for a healthy lifestyle including balancing calories; enjoying food but in a portion-controlled approach; encouraging whole grains, fruits, vegetables, and low-fat dairy; decreasing high-fat and sugary foods; and monitoring sodium. In this case, where diabetes is a concern as well, a meal plan emphasizing portion control, whole grains, vegetables, and drinks without sugar would be appropriate.

NURSINGTB.COM

DIF: Cognitive Level: Analysis REF: p. 7 TOP: Nursing Process: Planning MSC: NCLEX: Health Promotion and Maintenance | NCLEX: Physiological Integrity: Physiological Adaptation

Chapter 02: Carbohydrates Nix: Williams' Basic Nutrition and Diet Therapy, 15th Edition MULTIPLE CHOICE 1. Carbohydrates are nutrients that are composed of the elements carbon, hydrogen, and a. oxygen. b. nitrogen. c. water. d. glucose.

ANS: A

The chemical nature of carbohydrates is carbon, hydrogen, and oxygen.

DIF: Cognitive Level: Knowledge REF: p. 21 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 2. Carbohydrates play a major role in nutrition because they a. provide a long-term energy store. b. are digested in the stomach. c. help regulate body functions. d. provide the body’s major source of energy.

ANS: D

Carbohydrates are the major source of energy for the body, comprising approximately 50% of total caloric intake.

DIF: Cognitive Level: Application REF: p. 20 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 3. Carbohydrates are stored as glycogen in the a. central nervous system and muscles. b. heart and liver. c. small intestine. d. liver and muscles.

ANS: D

Carbohydrates are stored as glycogen in the liver and muscles.

DIF: Cognitive Level: Knowledge REF: p. 23 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 4. An example of a food that contains a fructose sugar is a. milk. b. honey. c. molasses. d. corn.

ANS: B

Fructose is a monosaccharide and is the sweetest of the simple sugars. It is primarily found in fruits and honey.

DIF: Cognitive Level: Knowledge REF: p. 21 TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity: Physiological Adaptation 5. Examples of the simple carbohydrates include a. glucose and galactose. b. sucrose and starch. c. lactose and lignin. d. fructose and glycogen.

ANS: A

Monosaccharides and disaccharides are the simple sugar units used to build complex carbohydrates. The monosaccharides are glucose, galactose, and fructose.

DIF: Cognitive Level: Application REF: pp. 22-23 TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity: Physiological Adaptation 6. The sugar to which all other sugars are converted and the one that circulates in the blood to

provide major fuel for the body’s cells is a. sucrose. b. fructose. c. glucose. d. maltose.

ANS: C

Glucose is a monosaccharide that is the basic, single sugar in the body’s metabolism. Glucose NURSINGTB.COM is the form of sugar circulating in the blood and is the primary fuel for the cells.

DIF: Cognitive Level: Knowledge REF: p. 21 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 7. Carbohydrates are quick energy foods because a. they do not take long to prepare and are readily available. b. the human body can rapidly break them down to yield energy. c. they are abundant in fast foods and can be readily absorbed. d. they can yield more energy than other nutrients.

ANS: B

Carbohydrates are considered quick energy foods because they can readily be metabolized in the body to yield glucose, the main fuel source for the body.

DIF: Cognitive Level: Comprehension REF: p. 21 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 8. The carbohydrate form in which glucose is stored in the body is a. starch. b. polysaccharide. c. glycogen. d. fructose.

ANS: C

Glucose is stored in the body as glycogen.

DIF: Cognitive Level: Knowledge REF: p. 23 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 9. Of the following, the best sources of dietary fiber are a. fruit and fruit juice. b. rice and crackers. c. iceberg lettuce and tomato juice. d. lentils and corn.

ANS: D

Dietary fiber is found in unrefined and whole plant foods. Of the choices listed, lentils and corn provide the highest amount of dietary fiber.

DIF: Cognitive Level: Application REF: p. 23 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 10. Types of dietary fiber include a. lactose, galactose, and maltose. b. polysaccharides and polyols. c. starch, ptyalin, and glucose d. cellulose, lignin, and noncellulose.

ANS: D

Dietary fiber is found in plant foods. Plants contain several types of dietary fiber, including cellulose, lignin, and noncellulose polysaccharides.

NURSINGTB.COM DIF: Cognitive Level: Knowledge REF: pp. 23-24 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 11. The recommended daily intake of dietary fiber for an adult woman is a. 15 b. 21 c. 25 d. 30

g/day.

ANS: C

The recommended intake of fiber for men and women age 50 years and younger is 38 g/day and 25 g/day, respectively.

DIF: Cognitive Level: Knowledge REF: p. 16 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 12. A health professional is determining the caloric intake for a patient. Her caloric intake from

fiber would be a. 3.4 kcal/g. b. 0 kcal/g. c. 4 kcal/g. d. 9 kcal/g.

ANS: B

Human beings lack the necessary enzymes to digest dietary fiber, and so, unlike other carbohydrates, dietary fiber does not provide energy.

DIF: Cognitive Level: Application REF: p. 23 TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity: Physiological Adaptation 13. Wavelike contractions of the muscle fibers of the stomach and intestinal walls are called a. segmentation. b. peristalsis. c. metabolism. d. digestion.

ANS: B

The mechanical digestive process in the stomach entailing wavelike contractions of the muscle fibers of the stomach wall that mix food particles with gastric secretions is called peristalsis.

DIF: Cognitive Level: Knowledge REF: p. 16 (Table 2-2) TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 14. A basket of fruit contains ripe grapes, apples, and oranges as well as pears and peaches that

are not quite ripe. The fruits with the highest amount of simple sugar include the a. pears and apples. b. peaches and oranges. c. grapes and apples. d. peaches and pears.

ANS: C

Fructose is a simple sugar; ripe fruit contains more fructose than less-ripe fruit.

DIF: Cognitive Level: Application REF: p. 21 TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity: Physiological Adaptation 15. An apple contains a type of soluble dietary fiber called a. lignin. b. starch. c. cellulose. d. pectin.

ANS: D

Pectin is a water-soluble fiber found in many fruits. Cellulose and lignin are insoluble fibers.

Starch is another polysaccharide found in grains, legumes, and other vegetables and in small amounts in fruit. Starch does not necessarily contain dietary fiber.

DIF: Cognitive Level: Application REF: pp. 23-24 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 16. Of the following, the food with the lowest carbohydrate content (as a percentage of weight)

would be

a. b. c. d.

orange juice. raisins. whole milk. dried beans.

ANS: C

Milk contains the least carbohydrate content (as a percentage of weight); it contains lactose, but the amount is diluted by all the liquid in the milk. Carbohydrates are more concentrated in dried fruits, juices, and starchy vegetables.

DIF: Cognitive Level: Analysis REF: p. 22 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 17. Digestion of the starch component of a peanut butter sandwich begins in the a. mouth. b. stomach. c. small intestine. d. liver.

ANS: A

The digestion of carbohydrate-rich foods such as starches and sugars begins in the mouth, where the enzyme ptyalin begins to break the starch down into smaller particles.

DIF: Cognitive Level: Knowledge REF: p. 16 (Table 2-2) TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 18. A negative effect of sugar alcoh sI thN atGthTeB y.COM NoUlsRiS a. contain more kilocalories than sugar. b. can cause intoxication. c. promote bacterial disease in the colon. d. may cause diarrhea.

ANS: D

Excessive amounts of sugar alcohols in food products can cause diarrhea because of the slow digestion of the product.

DIF: Cognitive Level: Comprehension REF: p. 20 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 19. Once monosaccharides are absorbed into the intestinal bloodstream, they are transported to

the a. b. c. d.

cells. liver. heart. brain.

ANS: B

The monosaccharides glucose, galactose, and fructose are absorbed directly into the portal blood circulation, which carries them directly to the liver.

DIF: Cognitive Level: Knowledge

REF: pp. 18-19 (Table 2-3)

TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 20. A client has a goal of increasing fiber intake to 30 grams per day. Current intake reveals the

following information: Breakfast intake is 3/4 cup sugary corn popped cereal, 1 cup skim milk, 1 slice white toast, and 1/2 cup orange juice. Lunch includes 2 ounces sliced turkey, 1 slice wheat bread, 1 tablespoon mayonnaise, 2 chocolate chip cookies, and 1 cup water.

Dinner includes 4 ounces beef, 1/2 cup green beans, 3/4 cup instant mashed potatoes with butter, 1 biscuit, and 1 cup skim milk. As the nutrition expert counseling this patient, one appropriate recommendation might be to a. encourage whole-grain breads and cereals in place of white breads and cereals. b. double the amount of proteins such as turkey and beef and eliminate sugar intake. c. add 2 tablespoons of omega-3 fatty-acid enriched margarine to breads and potatoes. d. make no changes because adequate fiber intake is present.

ANS: A

The recommended daily fiber intake is 38 grams per day for men. This intake requires consistent use of whole grains, legumes, vegetables, and fruits, along with seeds and nuts.

Meats and fats such as butter and margarine do not contain fiber.

DIF: Cognitive Level: Analysis REF: pp. 18-19 (Table 2-3) TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 21. An example of a food low in carbohydrates is a. low-fat yogurt. b. steak. c. beans. d. potatoes.

ANS: B

Meats such as beef, poultry, and fish do not contain carbohydrates. Yogurt contains some carbohydrates from the milk and is often sweetened. Starchy vegetables such as beans and potatoes are high in carbohydrates.

DIF: Cognitive Level: Application REF: pp. 22-24 TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 22. The major site or organ in the body for metabolic processing of carbohydrates is the a. intestine. b. heart. c. brain. d. liver.

ANS: D

The liver is the major site for metabolic processing of carbohydrates.

DIF: Cognitive Level: Knowledge

REF: p. 21 | pp. 23-24

TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 23. The digestion of milk yields the monosaccharides a. fructose and glucose. b. galactose and glucose. c. galactose and sucrose. d. glucose and maltose.

ANS: B

The digestion of milk yields the monosaccharides galactose and glucose from the disaccharide lactose.

DIF: Cognitive Level: Knowledge REF: p. 22 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 24. A food that contains maltose is a. milk. b. fruit. c. molasses. d. table sugar.

ANS: C

Maltose is found in molasses.

DIF: Cognitive Level: Application REF: p. 22 TOP: Nursing Process: Implementation MSC: NCLEX: Physiological IntN egUriR tyS :P icC alOAM daptation IhNysGioTloBg. 25. A molecule of glycogen is composed of hundreds of units of a. galactose. b. glucose. c. glucose, fructose, and galactose. d. disaccharide.

ANS: B

Glycogen is composed of glucose units.

DIF: Cognitive Level: Knowledge REF: p. 23 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 26. Sufficient dietary carbohydrates prevent excess formation of a. ketones. b. ammonia. c. amino acids. d. water.

ANS: A

Ketones result from the rapid breakdown of fat. The breakdown of fat occurs when carbohydrate intake is inadequate. Sufficient carbohydrate intake prevents ketosis from occurring.

DIF: Cognitive Level: Knowledge

REF: p. 21

TOP: Nursing Process: Evaluation

MSC: NCLEX: Physiological Integrity: Physiological Adaptation 27. A part of the body that depends on a constant supply of carbohydrate to function properly is

the a. b. c. d.

cardiopulmonary system. urinogenital system. central nervous system. gastrointestinal system.

ANS: C

The central nervous system requires a constant supply of glucose in the bloodstream to function properly.

DIF: Cognitive Level: Knowledge REF: p. 21 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 28. The number of kilocalories from carbohydrates in a baked potato that contains 40 g

carbohydrate is a. 40 b. 80 c. 160 d. 360

kcal.

ANS: C

Carbohydrate contains 4 kcal/g. So a potato that contains 40 g carbohydrate would provide 40  4 = 160 kcal.

DIF: Cognitive Level: ApplicatiN onURSINRGETFB : .pC . 1O5M TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity: Physiological Adaptation 29. A food that is a good source of fiber is a. oatmeal. b. prune juice. c. salmon. d. cornstarch.

ANS: A

Plant foods contain the best sources of fiber. Oatmeal is a whole-grain cereal and is therefore high in fiber.

DIF: Cognitive Level: Application REF: pp. 18-19 (Table 2-3) TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity: Physiological Adaptation 30. Which of the following carbohydrates provides the fastest source of energy? a. ground beef b. cranberry juice c. whole-grain cereal d. milk ANS: B

Cranberry juice contains fructose, a single carbohydrate or monosaccharide, which requires no digestion and so is more quickly absorbed than more complex carbohydrates found in whole grains or the disaccharide lactose in milk.

DIF: Cognitive Level: Application REF: p. 22 TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity: Physiological Adaptation

Chapter 03: Fats Nix: Williams' Basic Nutrition and Diet Therapy, 15th Edition MULTIPLE CHOICE 1. The functions of fat in the body include a. enzyme production, insulation of long bones, and bone structure. b. formation of bone structure and energy for daily activities. c. flavoring low-fat foods, supplying fatty acids, and lubrication for vital organs. d. insulation of vital organs, temperature regulation, and cell membrane structure.

ANS: D

In the body, fat around vital organs and under the skin provides insulation and helps regulate body temperature; fat is also a component of cell membrane structure.

DIF: Cognitive Level: Knowledge REF: p. 32 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 2. The number of kilocalories from fat in a meal that contains 35 g fat is a. 35. b. 140. c. 315. d. 350.

ANS: C

Fat contains 9 kcal/g, so 35 g  9 kcal/g = 315 kcal.

NURSINGTB.COM DIF: Cognitive Level: Application REF: p. 39 TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity: Physiological Adaptation 3. The recommended total calories provided by fat in an 1800-calorie diet should not exceed a. 180 calories. b. 270 calories. c. 630 calories. d. 720 calories.

ANS: C

It is recommended that no more than 35% of total calories come from fat. In an 1800-calorie diet: 1800  0.35 = 630 calories.

DIF: Cognitive Level: Application REF: p. 39 TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity: Physiological Adaptation 4. An element not found in triglycerides is a. carbon. b. hydrogen. c. nitrogen. d. oxygen.

ANS: C

Carbon, hydrogen, and oxygen make up fat, whereas nitrogen is found as part of the protein molecule.

DIF: Cognitive Level: Knowledge REF: p. 27 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 5.

Triglycerides are composed of a. glycerol and amino acids. b. trans-fatty acids. c. hydrogenated fatty acids. d. glycerol and fatty acids.

ANS: D

A triglyceride is composed of three fatty acids attached to a glycerol base.

DIF: Cognitive Level: Knowledge REF: pp. 27-28 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 6. The chemical feature that distinguishes a saturated fatty acid from an unsaturated fatty acid is

the a. b. c. d.

amount of water it contains. amount of cholesterol it contains. source. amount of hydrogen it contains.

ANS: D

Fatty acids are saturated or unsN atU urRaS teI dN deGpT enBd. inCgOoM n whether they are filled with hydrogen. A fatty acid that is not completely filled with all the hydrogen it can hold is unsaturated; the structure of a saturated fatty acid is completely filled with all the hydrogen bonds it can hold.

DIF: Cognitive Level: Knowledge REF: pp. 27-28 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 7. An example of a food that contains a high level of saturated fatty acids is a. beefsteak. b. olive oil. c. green tomatoes. d. whole-grain bread.

ANS: A

Saturated fats are commonly found in animal products. Unsaturated and monounsaturated fats are mostly derived from plant sources. However, tropical oils such as coconut and palm oils, as well as hydrogenated oils, are saturated.

DIF: Cognitive Level: Application REF: p. 28 TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity: Physiological Adaptation 8. Of the following fats, the one that is least saturated is a. safflower oil. b. coconut oil.

c. olive oil. d. butter oil.

ANS: A

Plant fats are generally less saturated than animal fats. However, coconut oil is high in saturated fat. Olive oil contains mostly monounsaturated fatty acids. Safflower oil contains mostly polyunsaturated fatty acids.

DIF: Cognitive Level: Application REF: p. 33 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 9. Most fatty acids in plant foods are a. monounsaturated. b. polyunsaturated. c. unsaturated. d. saturated.

ANS: C

Plant foods are mostly composed of unsaturated fats. However, tropical oils such as palm, palm kernel, and coconut as well as hydrogenated oils are composed of saturated fats.

DIF: Cognitive Level: Comprehension REF: p. 33 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 10. A patient is concerned with her weight. Her energy intake is calculated to be 1600 calories.

Intake records reveal that her fat intake for the past month has been 120 calories or less per day. The most appropriate intervention would be to a. assess for essential fatty aciNdUdR efS icIieNnG cyT. B.COM b. continue to monitor for changes. c. continue current meal plan. d. draw lab work immediately.

ANS: A

An essential fatty acid is one that is essential to the body; its absence will create a specific deficiency. The body cannot manufacture essential fatty acids and must obtain them from the diet.

DIF: Cognitive Level: Analysis REF: p. 29 TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 11. The body needs linoleic acid for a. digestion of food. b. protein metabolism. c. fluid balance. d. blood clotting.

ANS: D

The body needs linoleic acid for functions related to tissue strength, cholesterol metabolism, muscle tone, blood clotting, and heart action.

DIF: Cognitive Level: Knowledge REF: p. 29 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 12. The best food choice to provide alpha-linolenic acid is a. strawberries. b. canola oil. c. raisin toast. d. lard.

ANS: B

Alpha-linolenic acid is primarily found in soybean, canola, and flaxseed oil.

DIF: Cognitive Level: Application REF: p. 29 TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity: Physiological Adaptation 13. The primary reason lecithin is able to help transport fatty material in the bloodstream is

because it is a. a phytosterol. b. a buffer. c. found in hemoglobin. d. amphiphilic.

ANS: D

Lecithin is a phospholipid and is therefore amphiphilic, which means it is partially hydrophobic (able to bind fats and oils) and partly hydrophilic (soluble in an aqueous environment such as blood).

NURSINGTB.COM DIF: Cognitive Level: Application REF: p. 31 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 14. The process of adding hydrogen to fatty acids is called a. hydrolysis. b. hydrogenation. c. emulsification. d. hydration.

ANS: B

Hydrogenation is the process of introducing hydrogen into the fat molecule; this makes the fat more saturated.

DIF: Cognitive Level: Knowledge REF: p. 30 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 15. A change brought about as the result of hydrogenation is that a. liquid fats become solids. b. fats become less saturated. c. monoglycerides become diglycerides. d. vitamins are destroyed.

ANS: A

Hydrogenation is the process of introducing hydrogen into the fat molecule; liquid fats such as vegetable oil are made into solids such as margarine and shortening in this manner.

DIF: Cognitive Level: Application REF: p. 30 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 16. An example of a food that does not contain cholesterol is a. liver. b. sausage. c. cheese. d. coconut.

ANS: D

Cholesterol is a substance that naturally occurs in all animal foods but not in plant foods.

DIF: Cognitive Level: Application REF: p. 31 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 17. Cholesterol is synthesized by the body mainly in the a. intestine. b. liver. c. adipose tissue. d. skin.

ANS: B

Endogenous cholesterol is synthesized in many body tissues, particularly the liver. Small amounts are synthesized in the adrenal cortex, skin, intestines, testes, and ovaries.

NURSINGTB.COM

DIF: Planning Adaptation

dCgoegnitive LReE veFl: Kpn.o3w 1le TOP: Nursing Process: MSC: NCLEX: Physiological Integrity: Physiological

18. After a dietary assessment is completed, it reveals that a client consumes 50% of his or her

daily calories from fat. This amount of fat places the client at risk for a. obesity, arthritis, and elevated blood pressure. b. obesity, elevated blood fats, and diabetes. c. elevated blood pressure, diabetes, and allergies. d. diabetes, dementia, and stroke.

ANS: B

According to the Dietary Reference Intakes, no more than 35% of total calories should come from fat. Excess fat intake places a person at risk for health problems, including obesity, elevated blood fats, and diabetes.

DIF: Cognitive Level: Application REF: p. 39 TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity: Reduction of Risk Potential 19. Factors that increase the risk of heart disease include a. a family history of cancer. b. increased stress and obesity. c. anemia and low thyroid levels. d. gallbladder disease.

ANS: B

Heart disease is a leading cause of death in developed countries. Various risk factors are associated with heart disease including excess dietary fat, especially saturated fat and cholesterol, along with obesity, diabetes, elevated blood fats, and elevated blood pressure.

Additional lifestyle factors include smoking, stress, and lack of exercise.

DIF: Cognitive Level: Knowledge REF: p. 38 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Reduction of Risk Potential 20. The substances that serve as the major vehicles for fat transport in the bloodstream are a. micelles. b. glycolipids. c. chylomicrons. d. bile salts.

ANS: C

After absorption, monoglycerides and fatty acids are reformed into triglycerides, which are then packaged into lipoproteins called chylomicrons. Chylomicrons are made of triglycerides, cholesterol, phospholipids, and proteins, and allow fatty substances to enter the circulation.

DIF: Cognitive Level: Knowledge REF: p. 36 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 21. After eating a dinner of fried chicken, gravy, and mashed potatoes, chemical digestion of the

fat component primarily takes place in the a. mouth. b. stomach.

NURSINGTB.COM c. small intestine. d. large intestine.

ANS: C

The largest part of chemical digestion occurs in the small intestine with bile salts from the gallbladder (which serve as an emulsifier) and several enzymes, including gastric lipase (tributyrinase) and pancreatic lipase that break down triglycerides to diglycerides and monoglycerides.

DIF: Cognitive Level: Application REF: p. 34 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 22. The hormone responsible for stimulating the gallbladder to contract and release bile into the

small intestine is a. gastric lipase. b. cholecystokinin. c. enteric lipase. d. enterokinin.

ANS: B

Cholecystokinin release is stimulated when fat enters the duodenum. Cholecystokinin then causes the gallbladder to contract.

DIF: Cognitive Level: Knowledge

REF: p. 34

TOP: Nursing Process: Planning

MSC: NCLEX: Physiological Integrity: Physiological Adaptation 23. End products of fat digestion do not include a. fatty acids. b. glycerol. c. diglycerides. d. monosaccharides.

ANS: D

The end products of fat digestion include fatty acids, glycerol, and diglycerides.

Monosaccharides are a type of carbohydrate.

DIF: Cognitive Level: Knowledge REF: pp. 35-36 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 24. An important function of bile is to a. digest triglycerides. b. activate the intestinal lipases. c. break fat into smaller particles. d. split fatty acids into two-carbon molecules.

ANS: C

Bile functions as an emulsifier rather than an enzyme. Bile assists in the preparation of fat for chemical digestion by its specific enzymes. This preparation accomplishes two tasks: (1) it breaks down fat into small particles, and (2) it lowers the surface tension of the dispersed and suspended fat particles.

DIF: Cognitive Level: KnowledN geURSINR TOP: Nursing Process: Planning GETFB: .pCp.O3M4-35 MSC: NCLEX: Physiological Integrity: Physiological Adaptation 25. A type of fat that may be associated with a high risk of atherosclerosis if consumed on a

regular basis is a. olive oil. b. safflower oil. c. fish oil. d. butter.

ANS: D

Butter is a highly saturated fat. Excess intake of saturated fat is associated with atherosclerosis.

DIF: Cognitive Level: Application REF: p. 33 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 26. Fat substitutes are used in food products to a. reduce the cost of popular foods. b. reduce the trans-fatty acid content of the food. c. prolong the shelf life of the food. d. improve the flavor and physical texture of low-fat foods.

ANS: D

Fat substitutes such as Simplesse and Olestra provide improved flavor and physical texture to low-fat foods and can help reduce total dietary fat.

DIF: Cognitive Level: Knowledge REF: p. 32 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 27. The greatest number of kilocalories is provided by a. 40 g carbohydrates. b. 30 g fat. c. 60 g carbohydrates. d. 50 g protein.

ANS: B

The 30 g of fat provides the most kilocalories. Fat provides 9 kcal/g; both carbohydrates and proteins provide 4 kcal/g.

Calculations: 30 g fat  9 kcal/g = 270 kcal 40 g carbohydrate  4 kcal/g = 160 kcal 60 g carbohydrate  4 kcal/g = 240 kcal 50 g protein  4 kcal/g = 200 kcal DIF: Cognitive Level: Application REF: p. 38 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 28. A food relatively high in saturated fat is a. corn oil. b. peanut oil.

NURSINGTB.COM c. avocado oil. d. margarine.

ANS: D

Margarine is higher in saturated fat than corn oil, peanut oil, and avocado oil. Margarine is made from oil by hydrogenation. This makes the oil more solid and more saturated.

DIF: Cognitive Level: Application REF: p. 33 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 29. In a diet that contains 50 g fat and a total of 1500 kcal, the proportion of total kilocalories

from fat is a. 3%. b. 13%. c. 30%. d. 33%.

ANS: C

Fat contains 9 kcal/g; 50 g  9 kcal/g = 450 kcal; 450 kcal/1500 total kcal = 0.30, or 30%.

DIF: Cognitive Level: Application REF: p. 33 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 30. A good source of monounsaturated fat is a. fish.

b. margarine. c. avocado. d. tofu.

ANS: C

Good sources of monounsaturated fat include olives and olive oil, peanuts and peanut oil, canola oil, almonds, pecans, and avocados.

DIF: Cognitive Level: Application REF: p. 28 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation

Chapter 04: Proteins Nix: Williams' Basic Nutrition and Diet Therapy, 15th Edition MULTIPLE CHOICE 1. Proteins are built from simpler organic compounds called a. indispensable amino acids. b. amino acids. c. fatty acids. d. monosaccharides.

ANS: B

All proteins are made of building block units called amino acids. Proteins are made from both dispensable and indispensable amino acids.

DIF: Cognitive Level: Knowledge REF: p. 41 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 2. The element that is contained in proteins but not in carbohydrates or lipids is a. carbon. b. hydrogen. c. nitrogen. d. oxygen.

ANS: C

Nitrogen is present in proteins but not in carbohydrates or lipids. Amino acids, the building blocks of protein, are named foNr U thR eiS rI chNeG mT icB al.sC trO ucMture; amino refers to compounds containing nitrogen.

DIF: Cognitive Level: Knowledge REF: p. 42 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 3. Two types of protein in the body are a. complete, incomplete b. animal, vegetable c. dispensable, indispensable d. tissue, plasma

protein and

protein.

ANS: D

Two types of protein in the body are tissue protein and plasma protein. Amino acids are classified as indispensable, dispensable, or conditionally indispensable in the diet according to whether the body can make them.

DIF: Cognitive Level: Comprehension REF: p. 43 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 4. The number of amino acids that are indispensable for human beings is a. 6. b. 9. c. 11. d. 14.

ANS: B

Nine amino acids are classified as indispensable amino acids because the body cannot manufacture them in sufficient quantity or at all.

DIF: Cognitive Level: Knowledge REF: p. 42 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 5. What is the food that is the best source of indispensable amino acids? a. Black beans b. Peanuts c. Safflower oil d. Turkey ANS: D

Indispensable amino acids are provided mostly by high-protein animal products.

DIF: Cognitive Level: Application REF: p. 42 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 6. A protein that contains all indispensable amino acids in the correct proportion and ratio is a. a simple protein. b. an incomplete protein. c. a complete protein. d. an indispensable protein.

ANS: C

A complete protein contains all nine indispensable amino acids in the correct proportion and NURSINGTB.COM ratio needed by the body.

DIF: Cognitive Level: Knowledge REF: p. 42 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 7. The number of kilocalories from protein in a sandwich that contains 24 g protein is

kcal. a. 6 b. 96 c. 120 d. 216 ANS: B

Each gram of protein has 4 kcal, so 24 g  4 kcal = 96 kcal.

DIF: Cognitive Level: Application REF: p. 53 TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity: Physiological Adaptation 8. An animal protein that has relatively little value as a dietary protein source when eaten alone

is a. an egg. b. gelatin. c. milk.

d. fish.

ANS: B

Gelatin is a protein food of animal origin, but it lacks three essential amino acids and has only small amounts of leucine.

DIF: Cognitive Level: Knowledge REF: p. 45 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 9. Proteins from plant sources that are classified as incomplete include a. wheat, peanuts, and corn. b. milk, nuts, and cheese. c. oats, gelatin, and soybeans. d. corn, chicken, and milk.

ANS: A

Grains, peanuts, and corn are examples of plant proteins that are considered incomplete proteins because the food is deficient in one or more of the nine indispensable amino acids.

Soy is the only plant source of complete protein.

DIF: Cognitive Level: Application REF: p. 45 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 10. The primary function of protein in the diet is to supply a. energy for growth and development. b. insulation for vital organs. c. material for growth and maintenance. d. all 20 amino acids for heartNm UaRinSteInNanGcTe.B.COM ANS: C

The primary function of protein is to supply material in the body for growth, maintenance, and repair.

DIF: Cognitive Level: Knowledge REF: p. 44 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 11. Protein plays an important role in the body a. as the first source of energy fuel. b. in the conversion of glucose to glycogen for storage. c. as a coenzyme needed for energy utilization. d. in defense against disease and infection.

ANS: D

Protein assists in the body’s defense against disease and infection by helping build special white blood cells called lymphocytes.

DIF: Cognitive Level: Knowledge REF: p. 44 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 12. After a piece of grilled chicken is partially digested in the stomach, it eventually reaches the

small intestine, where it is digested by which of the following enzymes secreted by the pancreas?

a. b. c. d.

Chymotrypsin, trypsin, and carboxypeptidase Chymotrypsin, pepsin, and trypsin Sucrase, pepsin, and carboxypeptidase Lactase, chymotrypsin, and carboxypeptidase

ANS: A

Chymotrypsin, trypsin, and carboxypeptidase are three enzymes produced by the pancreas to continue breaking down proteins into simpler peptides and amino acids.

DIF: Cognitive Level: Knowledge REF: p. 49 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 13. Proteins are mostly absorbed as a. fatty acids. b. disaccharides. c. amino acids. d. polypeptides.

ANS: C

Proteins are broken down into individual amino acids to be absorbed; polypeptides require further enzymatic breakdown before they can be absorbed.

DIF: Cognitive Level: Knowledge REF: p. 41 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 14. Pepsinogen secreted by the gastric cells is converted into pepsin by a. food in the stomach. b. hydrochloric acid.

NURSINGTB.COM c. gastric lipase. d. pancreatic lipase.

ANS: B

Hydrochloric acid secreted by the stomach converts pepsinogen, an inactive enzyme, into pepsin. Pepsin is the active form of the enzyme that begins protein digestion.

DIF: Cognitive Level: Knowledge REF: p. 48 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 15. Protein catabolism is increased in conditions such as a. pregnancy. b. childhood. c. puberty. d. illness.

ANS: D

Protein catabolism, or the breakdown of protein, is increased during illness or disease and increases the body’s need for protein and kilocalories to rebuild tissue and meet the demands of an increased metabolic rate.

DIF: Cognitive Level: Knowledge REF: pp. 42-43 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation

16. The phase of metabolism that makes growth and repair possible is a. digestion. b. catabolism. c. anabolism. d. homeostasis.

ANS: C

Anabolism is the metabolic process that makes growth and repair possible in the body. It is especially necessary after an illness or disease process. Anabolism also is found during periods of rapid fetal growth during pregnancy, the first year of life, lactation during breastfeeding, and adolescent growth and development into adulthood.

DIF: Cognitive Level: Knowledge REF: pp. 42-43 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 17. A gastric enzyme that coagulates the protein in milk and is produced by infants but not by

adults is a. hydrochloric acid. b. pepsinogen. c. trypsin. d. rennin.

ANS: D

Rennin is the gastric enzyme found in the gastric juices of human infants and some young animals such as calves. Rennin is important to the infant for the digestion of milk.

DIF: Cognitive Level: Knowledge REF: p. 55 TOP: Nursing Process: Planning MSC: NCLEX: Physiological IntN egUriR tyS : PIhN ysGioTloBg. icC alO AM daptation 18. A protein-digesting enzyme found in the stomach rather than in pancreatic secretions is a. trypsin. b. pepsin. c. chymotrypsin. d. carboxypeptidase.

ANS: B

Pepsin is the main gastric enzyme that digests proteins.

DIF: Cognitive Level: Knowledge REF: p. 48 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 19. The enzyme trypsin is activated by the enzyme a. zymogen. b. bile. c. gastrin. d. enterokinase.

ANS: D

Trypsin is activated by the enzyme enterokinase. Enterokinase is secreted from the intestinal cells when food enters the duodenum.

DIF: Cognitive Level: Knowledge

REF: p. 49

TOP: Nursing Process: Planning

MSC: NCLEX: Physiological Integrity: Physiological Adaptation 20. The enzymes aminopeptidase and dipeptidase are secreted by the a. mouth. b. stomach. c. small intestine. d. pancreas.

ANS: C

Aminopeptidase and dipeptidase are enzymes secreted by glands in the wall of the small intestine.

DIF: Cognitive Level: Knowledge REF: p. 49 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 21. Complementary proteins a. provide higher quality protein when eaten together. b. enhance each other’s metabolic actions. c. are more easily absorbed. d. taste good together.

ANS: A

Combining complementary proteins helps to supply adequate amounts of all nine indispensable amino acids in the diet. Because plant proteins are incomplete, a mixture can provide adequate amounts of amino acids. A normal eating pattern throughout the day along with the body’s reserve supply of protein ensures a complementary balance of high-quality protein. Those who follow a vegetarian diet must combine proteins to meet needs.

NURSINGTB.COM DIF: Cognitive Level: Knowledge REF: pp. 45-46 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 22. In the mouth, protein foods are a. broken down to amino acids. b. broken up mechanically by chewing. c. broken down to peptides. d. coagulated by rennin.

ANS: B

Protein digestion begins in the mouth, where food is mechanically processed by chewing.

DIF: Cognitive Level: Knowledge REF: p. 47 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 23. The meal with the highest quality protein is a. an omelet with cheese, whole wheat toast, and orange juice. b. a stir fry with chicken, green beans, and carrots. c. a stuffed turkey breast, peas, and a baked potato. d. a bean burrito, corn on the cob, and a tomato salad.

ANS: A

Eggs are the highest quality protein food and carry a chemical score of 100. Other foods are compared to it according to their amino acid ratios.

DIF: Cognitive Level: Application REF: p. 45 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 24. Which of the following conditions might result in the greatest catabolism? a. Growth b. Multiple trauma with extensive organ damage c. Rehabilitation after routine gallbladder surgery d. Healing a broken bone in the arm ANS: B

Protein catabolism, or the breakdown of protein, is increased during illness or disease and increases the body’s need for protein and kilocalories to rebuild tissue and meet the demands of an increased metabolic rate. In this case, multiple trauma with extensive organ damage requires a greater catabolic rate compared with the other choices and would create the greatest increase in the metabolic rate and need for tissue repair.

DIF: Cognitive Level: Application REF: pp. 42-43 TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity: Physiological Adaptation 25. If the excretion of nitrogen exceeds the nitrogen intake, the condition is called a. total nitrogen balance. b. positive nitrogen balance. c. negative nitrogen balance. d. anabolism.

ANS: C

NURSINGTB.COM

If the body takes in less nitrogen than it excretes, a negative balance occurs. This means that the body has an inadequate protein intake and is losing nitrogen by breaking down more tissue than it is building up.

DIF: Cognitive Level: Comprehension REF: pp. 43-44 TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity: Physiological Adaptation 26. The grams of high-quality protein required daily for an individual who weighs 170 lb and is

close to ideal body weight would be a. 45.2 b. 55.3 c. 61.8 d. 94.0

g.

ANS: C

The Recommended Dietary Allowance for both men and women is set at 0.8 g of high-quality protein per kilogram of desirable body weight per day. In this case, 170 lb/2.2 lb/kg = 77.3 kg, so 77.3 kg  0.8 g/kg = 61.8 g/day of protein.

DIF: Cognitive Level: Application REF: p. 52 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance

27. In planning a vegetarian meal, an appropriate combination of complementary proteins would

be a. b. c. d.

cornmeal tamales and beans. lentils and beans. bean sprouts and cabbage. whole wheat and rice.

ANS: A

In planning complementary food combinations, different families of foods (e.g., grains, legumes, nuts, and dairy) are mixed. Grains usually are low in threonine and high in methionine, whereas legumes are high in threonine and low in methionine. Therefore grains and legumes help balance the amount of indispensable amino acids required by the body.

Acceptable combinations include (1) grains and peas, beans, or lentils; (2) legumes and seeds; and (3) grains and dairy. In the choices given, cornmeal tamales and beans combine foods limited in different amino acids.

DIF: Cognitive Level: Application REF: pp. 45-46 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 28. A client weighs 130 lbs. She is close to her desirable body weight and consumes a total of 40

g of protein/day. The most appropriate nutritional counseling would be to a. increase her protein intake. b. maintain her current protein intake. c. decrease her protein intake. d. increase her use of complementary proteins.

ANS: A

NURSINGTB.COM

The Recommended Dietary Allowance for protein for both men and women is set at 0.8 g of high-quality protein per kilogram of desirable body weight per day.

Based on 0.8 g protein/kg body weight/day: 130 lbs ÷ 2.2 lbs/kg = 59 kg body weight 59 kg  0.8 g protein/kg = 47 g protein/day Thus this client’s protein intake is lower than her estimated needs. It would be appropriate to recommend an increase in protein intake.

DIF: Cognitive Level: Analysis REF: pp. 50-51 TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 29. Very high intakes of animal protein may lead to a. increased body weight and blood lipid levels. b. increased muscle mass and strength. c. decreased body weight and blood lipid levels. d. muscle atrophy and weakness.

ANS: A

Muscle mass and strength only increase with resistance exercise; normal protein intakes are adequate to support the increase. High intakes of animal protein are associated with high intakes of energy, saturated fat, and cholesterol, which may lead to weight gain and hypercholesterolemia.

DIF: Cognitive Level: Comprehension REF: p. 52 TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance

Chapter 05: Digestion, Absorption, and Metabolism Nix: Williams' Basic Nutrition and Diet Therapy, 15th Edition MULTIPLE CHOICE 1. The process of digestion involves a. thermal and chemical actions. b. chemical and metabolic actions. c. mechanical and chemical actions. d. mechanical and thermal actions.

ANS: C

For nutrients to be delivered to the cells, food goes through a series of mechanical and chemical changes.

DIF: Cognitive Level: Knowledge REF: p. 56 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 2. The rhythmic contractions of the stomach and intestine that propel food along are called a. segmentation. b. peristalsis. c. cardiospasm. d. pendular movements.

ANS: B

Peristalsis is the alternating muscular contractions and relaxations that force the contents CoOoMth muscles of the gastrointestinal wall forward through the gastrointesNtiU naRl StrI acNt.GTThB e. sm provide these two movements to ensure continuous passage of the food mass along its journey.

DIF: Cognitive Level: Knowledge REF: p. 57 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 3. An example of a gastric secretion is a. intestinal lipase. b. pancreatic amylase. c. bile. d. hydrochloric acid.

ANS: D

Gastric secretions include enzymes, hydrochloric acid, buffer ions, mucus, water and electrolytes.

DIF: Cognitive Level: Application REF: p. 57 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 4. A pizza slice is being consumed by a hungry teen. The first actions of biting, chewing, and

breaking up the slice into smaller particles are called a. peristalsis. b. segmentation. c. pendular movements.

d. mastication.

ANS: D

Mastication begins the mechanical digestion in the mouth. Mastication is the biting and chewing that begins to break food into smaller particles.

DIF: Cognitive Level: Knowledge REF: p. 58 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 5. A food that begins chemical digestion in the mouth is a. chicken. b. yogurt. c. candy. d. bread.

ANS: D

In the mouth, salivary glands secrete salivary amylase, which is the general name for any starch-splitting enzyme. Thus, a food with starch content, such as bread, could begin its chemical digestion in the mouth.

DIF: Cognitive Level: Application REF: p. 58 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 6. After ingested food is mixed and churned with gastric secretions, the semifluid mass is called a. chyle. b. chyme. c. renin. d. bolus.

ANS: B

By the time the food mass reaches the lower portion of the stomach, it is a semiliquid,acid– food mix called chyme.

DIF: Cognitive Level: Knowledge REF: p. 58 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 7. One type of movement in the small intestine is a. mastication. b. segmentation. c. kinetic propulsion. d. expulsion.

ANS: B

The intestinal muscles produce several types of movement that aid digestion, including peristalsis, pendular movements, segmentation, longitudinal rotation, and surface villi motions.

DIF: Cognitive Level: Knowledge REF: p. 59 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 8. Compared with the pH in the stomach, the pH in the small intestine is a. lower.

b. higher. c. the same. d. neutral.

ANS: B

The pH of the stomach is acidic (lower) and the pH of the small intestine is alkaline (higher).

DIF: Cognitive Level: Application REF: p. 59 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 9. The enzyme that would be most important for digesting a skinless chicken breast would be a. sucrase. b. lipase. c. peptidase. d. bile.

ANS: C

A skinless chicken breast contains more protein than any other nutrient. The protein is partially digested to peptides by peptidase.

DIF: Cognitive Level: Application REF: p. 60 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 10. A food that is high in a macronutrient broken down by trypsin is a. bread. b. fruit. c. margarine. d. fish.

NURSINGTB.COM ANS: D

Trypsin breaks down protein to dipeptides. In this case, fish is the high-protein food.

DIF: Cognitive Level: Application REF: p. 60 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 11. The lining of the stomach and intestine is protected from strong acid by a. pepsinogen. b. bile. c. mucus. d. the presence of food.

ANS: C

Because the stomach contains hydrochloric acid, mucus is available to protect its lining from the erosive effects of the acid. Large quantities of mucus are secreted by the intestinal glands to protect the mucosal lining from irritation and erosion caused by the highly acidic gastric contents entering the duodenum.

DIF: Cognitive Level: Knowledge REF: p. 60 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 12. The hormone that stimulates the pancreas to release its secretions is a. gastrin.

b. enterogastrone. c. cholecystokinin. d. secretin.

ANS: D

The hormone secretin, which is produced by the mucosal glands in the first part of the intestine, controls the secretion of enzymes and other substances from the pancreas.

DIF: Cognitive Level: Knowledge REF: p. 60 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 13. A meal consisting of country-fried steak, carrots, and a baked potato with butter and sour

cream would stimulate the hormone cholecystokinin because of the a. presence of food in the duodenum. b. presence of fat in the duodenum. c. entry of the acidic chyme into the duodenum. d. entry of bile into the duodenum.

ANS: B

The stimulus for the release of cholecystokinin is the presence of fat in the duodenum. Once stimulated, cholecystokinin stimulates the gallbladder to release bile to emulsify fat.

DIF: Cognitive Level: Application REF: p. 60 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 14. After eating fried chicken, the resulting products from the digestion of fat include a. glycerol and fatty acids. b. glucose and fatty acids.

NURSINGTB.COM c. amino acids and dipeptides. d. cholesterol and glycerol.

ANS: A

The resulting products of the digestion of fats are glycerol and fatty acids. Intestinal lipase splits fat into glycerides and fatty acids.

DIF: Cognitive Level: Knowledge REF: p. 60 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 15. A means of absorption that occurs in the small intestine is a. exchange. b. pinocytosis. c. filtration. d. electrochemical transport.

ANS: B

Simple diffusion, facilitated diffusion, active diffusion, and pinocytosis are the processes by which nutrients cross the inner intestinal wall and into the body’s circulation. Pinocytosis is the penetration of larger materials that attach to the thicker cell membrane and are then engulfed by the cell.

DIF: Cognitive Level: Knowledge REF: p. 65 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation

16. After absorption, the end products of carbohydrate and protein digestion enter the a. lacteal. b. bile duct. c. blood system. d. bowel.

ANS: C

Once carbohydrates and protein are digested and absorbed, they cross the inner intestinal wall and enter the bloodstream.

DIF: Cognitive Level: Knowledge REF: p. 65 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 17. The primary nutritional function of the large intestine is the a. absorption of fats. b. absorption of water. c. excretion of waste products. d. completion of the digestive process.

ANS: B

The primary function of the large intestine is to absorb water from the chyme. The water is absorbed in the first half of the colon.

DIF: Cognitive Level: Knowledge REF: p. 65 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 18. A child with phenylketonuria sN hoUuR ldSaIvN oiG dT drBin.kC inOgM a. diet beverages sweetened with aspartame. b. beverages sweetened with high-fructose corn syrup. c. coffee and other caffeinated beverages. d. fluoridated drinking water.

ANS: A

Phenylketonuria is a genetic disease that causes an inability to digest the amino acid phenylalanine. Sources of phenylalanine in the diet, including aspartame, must be limited to prevent mental retardation and central nervous system damage.

DIF: Cognitive Level: Application REF: p. 68 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 19. Gas formation in the colon is the result of the a. ingestion of certain foods. b. ingestion of too much water. c. inadequate ingestion of fiber. d. bacterial action on undigested items.

ANS: D

Bacterial action on indigestible food items in the large intestine can contribute to the formation of gas.

DIF: Cognitive Level: Knowledge

REF: pp. 66-67

TOP: Nursing Process: Planning

MSC: NCLEX: Physiological Integrity: Physiological Adaptation 20. After digestion, fatty materials are absorbed into the a. bloodstream. b. outer skin. c. colon. d. lacteals.

ANS: D

Because fatty materials are not water soluble, these molecules pass into the lymph vessels in the villi (the lacteals), then into the larger lymph vessels of the body, and eventually into the bloodstream.

DIF: Cognitive Level: Knowledge REF: pp. 66-67 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 21. Dietary fiber is beneficial because it a. is high in nutrients. b. is readily digested. c. adds bulk to feces. d. absorbs excess nutrients.

ANS: C

Food fiber is not digested because human beings lack the specific enzymes required for digestion, but it adds bulk to the diet.

DIF: Cognitive Level: Application REF: p. 65 TOP: Nursing Process: Planning MSC: NCLEX: Physiological IntN egUriR tyS : PIhN ysGioTloBg. icC alOAM daptation 22. The sum of all the chemical changes that an organism performs to maintain its life and

produce energy is called a. metabolism. b. digestion. c. absorption. d. respiration.

ANS: A

Metabolism is the sum of all chemical changes that take place in the body by which the organism maintains itself and produces energy for all its functions.

DIF: Cognitive Level: Knowledge REF: pp. 66-67 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 23. Bile contains a. hormones. b. enzymes. c. plasma. d. emulsifiers.

ANS: D

Bile is an emulsifying agent that aids in fat digestion and absorption.

DIF: Cognitive Level: Knowledge REF: p. 58 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 24. Two organs that work with the small intestine in digestion are the a. liver and kidneys. b. stomach and large intestine. c. pancreas and liver. d. large intestine and colon.

ANS: C

The pancreas aids in digestion by secreting enzymes to aid in protein, carbohydrate, and fat digestion. The presence of fat in the small intestine triggers the release of bile from the gallbladder; bile is made in the liver, and the gallbladder is located in the liver.

DIF: Cognitive Level: Comprehension REF: p. 59 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 25. Conversion of amino acids to glucose is called a. metabolism. b. glycogenosis. c. gluconeogenesis. d. catabolism.

ANS: C

Gluconeogenesis is the conversion of amino acids to glucose.

DIF: Cognitive Level: Knowledge REF: p. 68 TOP: Nursing Process: Planning MSC: NCLEX: Physiological IntN egUriR tyS : PIhN ysGioTloBg. icC alO AM daptation 26. The surface of the intestinal wall has mucosal folds, villi, and microvilli to a. aid in peristalsis. b. increase the surface area for absorption. c. decrease the surface area for absorption. d. increase the number of enzyme-secreting cells.

ANS: B

Mucosal folds, villi, and microvilli combine to make the inner surface some 600 times greater than the area of the outer surface of the intestine. This increases the surface area available for absorption.

DIF: Cognitive Level: Knowledge REF: p. 64 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 27. Ways to minimize formation of stomach gas include a. avoiding caffeine. b. chewing with your mouth open. c. drinking liquids through a straw. d. not gulping.

ANS: D

Stomach gas can be minimized by avoiding carbonated beverages, chewing with the mouth closed, not gulping food, not drinking from a can or through a straw, and not eating when nervous.

DIF: Cognitive Level: Application REF: p. 66 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 28. A beverage that may cause intestinal gas in adults is a. milk. b. coffee. c. apple juice. d. cola.

ANS: A

Many adults lack the enzyme lactase to digest milk. For adults who do not produce this enzyme, undigested lactose from milk is fermented by bacteria in the colon, causing intestinal gas.

DIF: Cognitive Level: Application REF: p. 69 TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity: Physiological Adaptation 29. Ms. J. complains of gas and bloating along with abdominal pain, especially after drinking

milk or eating ice cream or cheese. She may have a. lactose intolerance. b. phenylalanine intolerance. c. a calcium deficiency.

NURSINGTB.COM d. a vitamin D deficiency.

ANS: A

Lactose intolerance is characterized by a wide range of gastrointestinal problems such as gas, bloating, and abdominal pain after eating milk and other dairy products. Patients with lactose intolerance do not produce lactase. Undigested lactose from dairy products is fermented by bacteria in the colon, causing gas and other symptoms.

DIF: Cognitive Level: Analysis REF: p. 74 TOP: Nursing Process: Diagnosis MSC: NCLEX: Physiological Integrity: Physiological Adaptation 30. Which of the following foods would require peptidases to assist in its chemical digestion? a. Chicken b. A banana c. Orange juice d. Margarine ANS: A

Proteins require aminopeptidase to assist in removing end amino acids from polypeptides.

Chicken is a food high in protein.

DIF: Cognitive Level: Application REF: pp. 57-58 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation

Chapter 06: Energy Balance Nix: Williams' Basic Nutrition and Diet Therapy, 15th Edition MULTIPLE CHOICE 1. What is a nutrient that does not provide energy for the body? a. A carbohydrate b. A protein c. A vitamin d. Fat ANS: C

The energy nutrients are carbohydrate, fat, and protein.

DIF: Cognitive Level: Knowledge REF: p. 72 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 2. Energy is lost from the body as a. heat. b. urine. c. sweat. d. fat.

ANS: A

Energy is lost from the body as heat when the internal energy cycle changes stored energy into body fuels, which the body uses for various functions. As the cycle continues, water is excreted, carbon dioxide is exhN alU edR,SaI ndNhGeT atBis.rC adOiM ated, returning the end products to the external environment.

DIF: Cognitive Level: Knowledge REF: pp. 72-73 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 3. The unit of measurement used to refer to the amount of energy in food is the a. watt. b. kilogram. c. milligram. d. kilocalorie.

ANS: D

The kilocalorie is the unit of measure used to measure the amount of energy in food and is the amount of heat necessary to raise 1 kg of water 1° C. DIF: Cognitive Level: Knowledge REF: p. 72 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 4. The total number of kilocalories in a snack that contains 10 g carbohydrate, 2 g protein, and 5

g fat is a. 17 b. 68 c. 93 d. 153

kcal.

ANS: C

The calculations are as follows: 10 g carbohydrate  4 kcal/g = 40 kcal 2 g protein  4 kcal/g = 8 kcal 5 g fat  9 kcal/g = 45 kcal Total calories = 40 kcal + 8 kcal + 45 kcal = 93 kcal DIF: Cognitive Level: Application REF: p. 72 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 5. Which of the following represents an external energy cycle? a. The moon b. Growing plants c. Crystals d. Metabolism ANS: B

The external energy cycle includes plants, which transform energy from the sun into stored chemical energy.

DIF: Cognitive Level: Application REF: p. 72 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 6. After foods are eaten, they are converted into which of the following body fuels? a. Amino acids and fatty acids b. Fatty acids and glucose c. Glucose and triglycerides d. Glycogen and glucose ANS: B

After foods are eaten, they are converted into fatty acids and glucose, both of which are used as fuel for the body.

DIF: Cognitive Level: Application REF: p. 72 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 7. The metabolic rate would increase significantly with a body temperature of a. 97.4 F. b. 98.4 F. c. 98.6 F. d. 101.2 F. ANS: D

Fever increases the basal metabolic rate by approximately 7% for each 1° F rise in temperature. Normal body temperature is 98.4° F or 98.6° F; 101.2° F would be high enough to cause a significant increase in the metabolic rate.

DIF: Cognitive Level: Application REF: p. 73 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation

8. The amount of energy the body needs to maintain life while at digestive, physical, and

emotional rest is called a. the basal metabolic rate. b. indirect calorimetry. c. the respiratory quotient. d. total energy expenditure.

ANS: A

The basal metabolic rate is measured and determined when an individual is at complete digestive, physical, and emotional rest.

DIF: Cognitive Level: Knowledge REF: p. 73 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 9. Metabolically active tissues in the body include a. the heart, kidneys, and liver. b. the brain, nerves, and hair. c. the liver, kidney, fingernails, and toenails. d. all body tissues.

ANS: A

The majority of energy is used by small but highly active tissues, including the liver, brain, heart, and kidneys. These organs account for less than 5% of the total body weight but 60% to 75% of basal metabolic needs.

DIF: Cognitive Level: Knowledge REF: p. 73 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation

NURSINGTB.COM 10. Indirect calorimetry is used to measure a. basal or resting energy expenditure. b. the thermic effect of food. c. energy expended in physical activity. d. body mass index ANS: A

Indirect calorimetry measures the amount of energy a person uses while at rest. A portable metabolic cart allows the person to breathe into an attached mouthpiece or ventilated hood system while lying in bed, and the normal exchange of oxygen and carbon dioxide is measured. The metabolic rate can be determined from the rate of oxygen utilization.

DIF: Cognitive Level: Knowledge REF: pp. 73-74 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 11. The term for the effect of food intake on the metabolic rate is a. the thermic effect of food. b. the resting metabolic rate. c. the total energy requirement. d. indirect calorimetry.

ANS: A

Once food is eaten, it stimulates metabolism and requires extra energy for digestion, absorption, and transport of the nutrients to the cells. This stimulation is referred to as the thermic effect of food.

DIF: Cognitive Level: Knowledge REF: p. 73 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 12. The sum of basal metabolism, energy expended in physical activity, and the thermic effect of

food is known as a. the metabolic rate. b. energy intake. c. basal energy needs. d. the total energy requirement.

ANS: D

Together, basal metabolism, physical activities, and the thermic effect of food make up the total energy requirement.

DIF: Cognitive Level: Knowledge REF: p. 77 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 13. When energy intake exceeds energy expenditure, the result can be a. anorexia. b. malnutrition. c. weight gain. d. hyperactivity.

ANS: C

NURSINGTB.COM

When energy intake exceeds energy expenditure, weight gain may result. Excess intake without expenditure results in excess storage of energy as body fat.

DIF: Cognitive Level: Knowledge REF: p. 77 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 14. An activity that results in increased energy expenditure is a. cleaning the house. b. balancing a checkbook. c. experiencing emotional stress. d. playing video games.

ANS: A

Different kilocalorie expenditures occur with different types of activities. In this case, cleaning the house requires muscular work and so uses more energy than the other activities.

Mental exertion has no effect on energy needs.

DIF: Cognitive Level: Application REF: pp. 77-79 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 15. The thermic effect of food refers to the fact that a. all nutrients contain calories. b. certain foods are more stimulating than others to the gastrointestinal tract. c. the presence of food in the stomach starts the process of digestion.

d. the process of digestion, absorption, and metabolism of food requires energy.

ANS: D

Once food is eaten, it stimulates metabolism and requires extra energy for digestion, absorption, and transport of the nutrients to the cells. This stimulation is referred to as the thermic effect of food.

DIF: Cognitive Level: Knowledge REF: p. 77 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 16. The body’s sources of stored energy include a. glucose. b. adipose tissue. c. undigested food. d. bone.

ANS: B

Adipose tissue stores energy until required by the body.

DIF: Cognitive Level: Knowledge REF: p. 73 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 17. The basal metabolic rate is controlled by the hormone a. cortisol. b. growth hormone. c. thyroxine. d. insulin.

ANS: C

NURSINGTB.COM

The hormone thyroxine controls the metabolic rate in the body. The thyroid function test can assess metabolism by measuring the activity of the gland and the blood levels of its hormone, thyroxine.

DIF: Cognitive Level: Knowledge REF: p. 74 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 18. The first source of stored energy to be used during a period of fasting is a. amino acids. b. glycogen. c. adipose tissue. d. glucose.

ANS: B

A 12- to 48-hour reserve of glycogen exists in the liver and muscle and is quickly depleted if not replenished by daily food intake. Adipose tissue is used for energy after glycogen stores are used, followed by the breakdown of muscle mass in extreme cases of fasting or starvation.

DIF: Cognitive Level: Knowledge REF: p. 73 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 19. Which of the following foods has the greatest caloric density? a. A banana

b. Bread c. Nuts d. Milk ANS: C

Nuts have the greatest caloric density of the choices given because they have the highest concentration of energy for the same quantity of food. Nuts are composed of a higher percentage of fat (the highest energy nutrient) compared with bread, milk, or a banana, which are low in fat.

DIF: Cognitive Level: Application REF: p. 72 TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity: Physiological Adaptation 20. Nutrient density means the a. total weight of the nutrients in a food. b. digestibility of the nutrients in a food. c. concentration of energy in a given amount of food. d. concentration of nutrients in a given amount of food.

ANS: D

Nutrient density is the concentration of nutrients in a given amount of food.

DIF: Cognitive Level: Knowledge REF: p. 72 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 21. The liver and muscles store enough glycogen to last a. 4 to 6 hours.

NURSINGTB.COM b. 6 to 24 hours. c. 12 to 48 hours. d. 24 to 72 hours.

ANS: C

A 12- to 48-hour reserve of glycogen exists in the liver and muscles and is quickly depleted if not replenished by daily food intake.

DIF: Cognitive Level: Knowledge REF: p. 73 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 22. In cases of extreme starvation, the energy substrate used as a last resort would be a. glycogen. b. muscle mass. c. adipose tissue. d. bone mass.

ANS: B

Energy stored as protein exists in limited amounts in muscle mass and is only used once glycogen and fat stores have been exhausted.

DIF: Cognitive Level: Knowledge REF: p. 73 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation

23. Fever increases the basal metabolic rate by approximately a. 1% for each 1° F increase. b. 7% for each 1° C increase. c. 1% for each 7° F increase. d. 7% for each 1° F increase ANS: D

Fever increases the basal metabolic rate approximately 7% for each 1° F rise in temperature.

DIF: Cognitive Level: Knowledge REF: p. 76 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 24. Energy expenditure is increased by a. physical exercise. b. mental work. c. stress. d. fatigue.

ANS: A

Physical exercise increases energy expenditure because it involves muscular work.

DIF: Cognitive Level: Comprehension REF: p. 79 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 25. Energy needs per pound of body weight a. increase with age. b. increase throughout childhood. c. decrease with age. d. are greater in women than in men.

ANS: C

Energy needs per pound of body weight generally decrease during the aging process, with a gradual decline in the basal metabolic rate and physical activity that decreases the total energy requirement.

DIF: Cognitive Level: Comprehension REF: p. 80 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 26. A 75-year-old man’s energy intake should focus on meals a. high in calories with nutrient-dense foods. b. low in calories and high in fiber and meat. c. with lower energy density and high nutrient density. d. high in energy, vitamins, and minerals.

ANS: C

As the aging process continues, there is a gradual decline in the basal metabolic rate and physical activity, resulting in a decrease in the total energy requirement. Food choices should reflect a decline in caloric density and a greater emphasis on nutrient density.

DIF: Cognitive Level: Application REF: p. 80 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance

27. Resting energy expenditure is a. the same as basal energy expenditure. b. slightly higher than basal energy expenditure. c. slightly lower than basal energy expenditure. d. more accurate for predicting energy needs than is basal energy expenditure.

ANS: B

Resting energy expenditure is slightly higher than basal energy expenditure. Basal metabolism is measured and determined when an individual is at complete digestive, physical, and emotional rest. It differs from resting energy expenditure, which is slightly higher because of the sum of all internal working activities of the body, some of which may not be at complete rest.

DIF: Cognitive Level: Comprehension REF: pp. 73-74 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 28. Mr. Jones normally has a basal metabolic rate of 1500 kcal. He develops a fever of 100.6° F.

His rate would now be approximately a. 1550 b. 1600 c. 1710 d. 1830

kcal.

ANS: C

Fever increases basal metabolic rate approximately 7% for each 1° F rise in temperature. In this case, Mr. Jones has a temperature above normal by 2° F (normal = 98.6° F). The resultant increase in calories is 1500 kcaN lU R (0S.0I7NG2T) B =.2C 10OaMdditional kcal; 210 kcal + 1500 kcal = 1710 kcal (approximate new rate).

DIF: Cognitive Level: Analysis REF: p. 76 TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Physiological Integrity: Reduction of Risk Potential 29. The person requiring the highest energy needs per unit of body weight is a a. 15-year-old boy. b. 45-year-old man. c. 75-year-old grandmother. d. 7-year-old girl.

ANS: A

During periods of growth, the growth hormone stimulates cell metabolism and raises basal metabolic rate. The growth rate is highest during infancy and adolescence.

DIF: Cognitive Level: Application REF: p. 80 TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Physiological Integrity: Reduction of Risk Potential 30. The estimated daily basal metabolic rate for a man who weighs 150 lb is a. 1500

kcal.

b. 1575 c. 1636 d. 1686 ANS: C

To calculate the basal metabolic rate (BMR), use the following general formula: Men = 1.0 kcal/kg/hour; 1 kg = 2.2 lb.

Convert weight in pounds (lb) to kilograms (kg) using the following formula: 150 lb/2.2 lb/kg = 68 kg.

Multiply this weight in the following formula: BMR (kcal) = 1.0 kcal/kg/hour  68 kg  24 hours in a day = 1636 kcal.

DIF: Cognitive Level: Application REF: pp. 74-75 TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance

Chapter 07: Vitamins Nix: Williams' Basic Nutrition and Diet Therapy, 15th Edition MULTIPLE CHOICE 1. For a compound to be classified as a vitamin, it must a. be synthesized by the body. b. be required in large quantities. c. perform a vital function. d. be water soluble.

ANS: C

For a compound to be defined as a vitamin, it must be a vital, organic, dietary substance that is not a carbohydrate, fat, protein, or mineral and is necessary in only very small amounts to perform a specific metabolic function or prevent an associated deficiency. It also cannot be manufactured by the body in sufficient amounts to sustain life and must be supplemented by the body.

DIF: Cognitive Level: Comprehension REF: p. 85 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 2. A vitamin that behaves more like a hormone than a vitamin is vitamin a. A. b. D. c. E. d. K. ANS: B

Vitamin D is a prohormone made in the skin by sunlight.

DIF: Cognitive Level: Knowledge REF: p. 87 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 3. The provitamin form of vitamin A that is found in plant pigments is a. beta-carotene. b. chlorophyll. c. beta-xanthophyll. d. calciferol.

ANS: A

Beta-carotene is the provitamin form of vitamin A found in plant pigments. The body converts it to vitamin A, making it a primary source of the vitamin.

DIF: Cognitive Level: Knowledge REF: p. 86 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 4. Spinach, carrots, and sweet potatoes are good sources of a. beta-carotene. b. vitamin A. c. vitamin D. d. vitamin E.

ANS: A

Carotene is the group name of three red and yellow pigments (alpha-, beta-, and gamma-carotene) found in dark-green and yellow vegetables and some fruits. The body converts beta-carotene to vitamin A. DIF: Cognitive Level: Application REF: pp. 87-88 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 5.

Liver is a rich source of a. vitamin A (retinol). b. vitamin C. c. vitamin D. d. vitamin E. ANS: A

Liver is a rich source of preformed, natural vitamin A. Other sources include fish liver oils, egg yolk, butter, and cream.

DIF: Cognitive Level: Application REF: pp. 87-88 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 6. An important function of vitamin A is to a. be incorporated into the bile. b. help with blood clotting. c. act as an antioxidant. d. help form rhodopsin in the eye.

ANS: D

NURSINGTB.COM

Vitamin A helps form the visual pigment rhodopsin in the eye. Retinol, the name given to vitamin A, is an essential part of rhodopsin, commonly known as visual purple. This light-sensitive substance enables the eye to adjust to the different amounts of available light.

DIF: Cognitive Level: Knowledge REF: p. 85 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 7. A deficiency of vitamin A may result in a. osteoporosis. b. bile obstruction. c. breakdown of cell membranes. d. night blindness.

ANS: D

Night blindness results from a deficiency of vitamin A. Vitamin A helps form the visual pigment rhodopsin in the eye. Retinol, the name given to vitamin A, is an essential part of rhodopsin, commonly known as visual purple. This light-sensitive substance enables the eye to adjust to the different amounts of available light.

DIF: Cognitive Level: Knowledge REF: p. 85 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 8. Fish liver oils are a good source of

a. b. c. d.

vitamin D. vitamin E. protein. iron.

ANS: A

Fish liver oils are a natural source of vitamin D. Some other foods are fortified with vitamin D. Because milk is a common food and already contains calcium and phosphorus, it is the most practical to fortify with this vitamin.

DIF: Cognitive Level: Application REF: p. 87 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 9. The active hormonal form of vitamin D is a. cholecalciferol. b. calciferol. c. calcitriol. d. calcitonin.

ANS: C

The active form of vitamin D is calcitriol. Vitamin D is made in the body with the help of the sun’s ultraviolet rays. The compound made in the skin by sunlight is a prohormone. This irradiated compound, cholecalciferol (calciferol), is in its inactive form. It is then activated by two successive enzymes, first in the liver and then in the kidney, to become the active form, calcitriol.

DIF: Cognitive Level: Knowledge REF: p. 87 TOP: Nursing Process: Planning MSC: NCLEX: Physiological IntN egUriR tyS : PIhN ysGioTloBg. icC alO AM daptation 10. Two foods that are commonly fortified with vitamin D are a. cereals and pasta products. b. milk and margarine. c. flour and salt. d. vegetable oils and shortenings.

ANS: B

Because milk is a common food and already contains calcium and phosphorus, it is the most practical to fortify with vitamin D. Butter substitutes, such as margarines, are also fortified.

DIF: Cognitive Level: Application REF: p. 87 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 11. Synthesis of the active hormonal form of vitamin D is the result of the combined action of the a. skin, liver, and kidney. b. pancreas, thyroid, and liver. c. skin, skeleton, and liver. d. kidney, skeleton, and liver.

ANS: A

Vitamin D production begins in the skin with the help of the sun’s ultraviolet rays. The compound made in the skin by sunlight is a prohormone. This irradiated compound, cholecalciferol (calciferol), is in its inactive form. It is then activated by two successive enzymes, first in the liver and then in the kidney, to become the active form, calcitriol.

DIF: Cognitive Level: Knowledge REF: p. 88 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 12. The last organ involved in the production of the physiologically active form of vitamin D is

the a. b. c. d.

liver. kidney. intestine. skin.

ANS: B

Cholecalciferol (inactive form found in skin) is activated by two successive enzymes, first in the liver and then in the kidney, to become the active form, calcitriol.

DIF: Cognitive Level: Knowledge REF: pp. 88-89 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 13. The primary function of vitamin D is to regulate the absorption and metabolism of the

minerals a. sodium and potassium. b. iron and phosphorus. c. calcium and phosphorus.

NURSINGTB.COM d. sodium and calcium.

ANS: C

The primary function of vitamin D is the absorption of calcium and phosphorus. The hormone form calcitriol acts with two other hormones: parathyroid hormone and the thyroid hormone calcitonin. In balance with these two hormones, vitamin D hormone stimulates the absorption of calcium and phosphorus in the small intestine.

DIF: Cognitive Level: Knowledge REF: p. 89 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 14. A vitamin D deficiency in growing children that results in the malformation of skeletal tissue,

especially the long bones, is referred to as a. rickets. b. scurvy. c. pellagra. d. osteoporosis.

ANS: A

Rickets is a disease associated with vitamin D deficiency. It is characterized by malformation of skeletal tissue in growing children in which long bones are soft and often bend under the weight of the child.

DIF: Cognitive Level: Knowledge REF: p. 89 TOP: Nursing Process: Diagnosis MSC: NCLEX: Physiological Integrity: Physiological Adaptation

15. Recommended intakes for vitamin D are difficult to establish because a. exposure to sunlight varies. b. it is present in so many foods. c. the body stores such large amounts. d. the amount in food varies with the season.

ANS: A

Recommended intakes for vitamin D are difficult to establish because of its unique hormone-like nature, the difference in exposure to sun (affected by time spent outside and climate), and limited food sources.

DIF: Cognitive Level: Application REF: p. 89 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 16. A toxic level of vitamin D is most likely to result in a. liver damage. b. hyperpigmentation. c. blindness. d. calcification of soft tissues.

ANS: D

A toxic level of vitamin D can result in calcification of soft tissues, such as in the kidneys and lungs, as well as fragile bones.

DIF: Cognitive Level: Knowledge REF: p. 89 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation

NURSINGTB.COM 17. Sunflower oil is a rich source of a. vitamin A. b. vitamin B. c. vitamin D. d. vitamin E. ANS: D

The richest sources of vitamin E are vegetable oils. Other food sources include nuts, fortified cereals, and avocados.

DIF: Cognitive Level: Application REF: p. 91 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 18. The requirement for vitamin E varies by the amount of an individual’s a. sun exposure. b. protein intake. c. animal fat intake. d. polyunsaturated fatty acid intake.

ANS: D

The requirement for vitamin E varies with the amount of polyunsaturated fatty acids in the diet.

DIF: Cognitive Level: Comprehension

REF: pp. 90-91

TOP: Nursing Process: Planning

MSC: NCLEX: Physiological Integrity: Physiological Adaptation 19. Vitamin E protects membranes because it acts as a. a barrier. b. peroxide. c. an antioxidant. d. a clotting factor.

ANS: C

Vitamin E protects membranes by acting as nature’s most potent fat-soluble antioxidant. The polyunsaturated fatty acids in lipid membranes are easy for oxygen to break down, and vitamin E can interrupt this oxidation and protect the fatty acids of the cell membrane from damage.

DIF: Cognitive Level: Knowledge REF: p. 93 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 20. The fat-soluble vitamin responsible for the synthesis of blood-clotting factors by the liver is

vitamin a. A. b. D. c. E. d. K. ANS: D

The basic function of vitamin K is in the blood-clotting process. The most well-known vitamin K-dependent blood factor is prothrombin.

NURSINGTB.COM DIF: Cognitive Level: Knowledge REF: p. 91 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 21. A good food source of vitamin K is a. spinach. b. sunflower oil. c. pork. d. oranges.

ANS: A

Vitamin K is found in green leafy vegetables, which provide 50 to 800 mcg of phylloquinone per 100 g of food. Smaller amounts are found in milk and other dairy, meats, fortified cereals, fruits, and vegetables.

DIF: Cognitive Level: Application REF: pp. 92-93 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 22. In the past, vitamin A content was listed in International Units; it is now listed in a. milligrams. b. micrograms. c. beta-carotene equivalents. d. retinol equivalents.

ANS: D

Vitamin A is listed in retinol equivalents. One International Unit of vitamin A equals 0.3 mcg retinol or 0.6 mcg beta-carotene.

DIF: Cognitive Level: Knowledge REF: p. 86 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 23. The hormones that participate in calcium metabolism are a. estrogen and oxytocin. b. cortisone and epinephrine. c. aldosterone and thyroxine. d. parathyroid and calcitriol.

ANS: D

The hormone form calcitriol acts with two other hormones, parathyroid hormone and the thyroid hormone calcitonin, to stimulate the absorption of calcium in the small intestine.

DIF: Cognitive Level: Knowledge REF: p. 88 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 24. There is a metabolic partnership between vitamin E and a. zinc. b. chromium. c. selenium. d. iron.

ANS: C

Selenium is a trace mineral that works with vitamin E as an antioxidant. A selenium-containing enzyme, gNluUtaRthSioInNeGpT erB ox.iC daOseM, is the second line of defense in preventing oxidative damage to cell membranes. Selenium spares vitamin E by reducing the body’s requirement for vitamin E, and vitamin E spares selenium by reducing the body’s requirement for selenium.

DIF: Cognitive Level: Knowledge REF: p. 90 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 25. An athlete who increases his or her intake of pasta will also increase his or her need for a. folic acid. b. thiamin. c. pyridoxine. d. vitamin C. ANS: B

The starch in the pasta would be digested and absorbed as glucose. Thiamin acts a coenzyme factor related to the production of energy from glucose and the storage of energy as fat, making energy available to support normal growth.

DIF: Cognitive Level: Application REF: p. 95 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 26. An alcoholic is most likely to be deficient in a. biotin. b. folic acid.

c. thiamin. d. pyridoxine.

ANS: C

Alcohol inhibits the absorption of thiamin. Alcohol-induced thiamin deficiency causes Wernicke’s encephalopathy.

DIF: Cognitive Level: Knowledge REF: p. 95 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 27. The three body systems that can be affected by a thiamin deficiency are the a. nervous, respiratory, and urinary systems. b. nervous, cardiovascular, and gastrointestinal systems. c. gastrointestinal, respiratory, and endocrine systems. d. lymphatic, cardiovascular, and endocrine systems.

ANS: B

The nervous, cardiovascular, and gastrointestinal systems can all be affected by thiamin deficiency. The central nervous system depends on glucose for energy; if thiamin is not present in adequate amounts, sufficient energy cannot be made for the nerves to perform their functions. The heart muscle depends on thiamin as well. Without adequate thiamin, the heart muscle weakens and heart failure results. Thiamin also is necessary for the gastrointestinal tract to function properly. The cells of smooth muscle and secretory glands must have energy to perform their work, and thiamin is a necessary agent for producing that energy.

DIF: Cognitive Level: Knowledge REF: pp. 95-96 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation

NURSINGTB.COM 28. The vitamin that is destroyed by light is a. vitamin C. b. niacin. c. riboflavin. d. biotin.

ANS: C

Riboflavin is easily destroyed by light. Milk, a major source of riboflavin, is sold and stored in plastic or cardboard containers to protect it from light exposure.

DIF: Cognitive Level: Knowledge REF: p. 96 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 29. What is the most important source of riboflavin in the United States? a. Milk b. Lean meats c. Enriched grains d. Green, leafy vegetables ANS: A

Milk is the major source of riboflavin.

DIF: Cognitive Level: Knowledge REF: p. 96 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation

30. The function of all B-complex vitamins is to a. regulate fluid balance. b. function as body structures. c. function as coenzymes. d. provide calories for energy.

ANS: C

The B-complex vitamins function as coenzymes that are necessary agents to break down compounds, but they are not consumed in the process.

DIF: Cognitive Level: Knowledge REF: pp. 96-97 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 31. The disease associated with niacin deficiency is a. anemia. b. cheilosis. c. pellagra. d. beriberi.

ANS: C

Pellagra is a disease caused by the lack of niacin. It is characterized by skin lesions along with gastrointestinal, mucosal, neurologic, and mental symptoms. The four Ds associated with pellagra are dermatitis, diarrhea, dementia, and death.

DIF: Cognitive Level: Knowledge REF: p. 97 TOP: Nursing Process: Diagnosis MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Physiological Integrity: Reduction of Risk Potential NURSINGTB.COM 32. The amino acid that can be converted to niacin in the body is a. leucine. b. phenylalanine. c. tryptophan. d. valine.

ANS: C

Some of the niacin the body requires can be made from the essential amino acid tryptophan.

The total requirement in the body for niacin is stated in terms of niacin equivalents to account for both sources.

DIF: Cognitive Level: Knowledge REF: p. 97 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 33. A good food source of niacin is a. a banana. b. a tomato. c. beef. d. oatmeal.

ANS: C

Meat is a major source of niacin. The greatest intake of niacin in the United States comes from mixed dishes high in meat, poultry, or fish.

DIF: Cognitive Level: Application REF: p. 97 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 34. The vitamin most closely associated with protein metabolism is a. thiamin. b. pyridoxine. c. folic acid. d. choline.

ANS: B

Vitamin B6 (pyridoxine) has an essential role in protein metabolism and functions in many cell reactions involving amino acids.

DIF: Cognitive Level: Knowledge REF: p. 98 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 35. Which of the following diets can help ensure adequate and balanced vitamin intake? a. a high-calorie diet composed of mainly fruits and vegetables b. a high-protein diet concentrating on red meat and fish c. a varied diet composed of all food groups eaten in moderate portions d. a varied diet with a higher emphasis on grains and fish ANS: C

Eating a well-balanced, varied diet can help ensure adequate and balanced intake by supplying needed nutrients from all the foNoU dR grSoI upNsGinTtB h. eC prO opMer portion sizes.

DIF: Cognitive Level: Application REF: p. 109 TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 36. The person most at risk for vitamin D deficiency is a a. 12-year-old girl who plays soccer at the local playground twice a week. b. 28-year-old mother who breastfeeds her 5-month-old infant and takes a daily stroll

in the neighborhood. c. 62-year-old woman who lives in a cold climate and rarely goes outdoors. d. 42-year-old man who plays golf once a week.

ANS: C

Vitamin D is synthesized in the skin with exposure to sunlight. People who do not go outdoors may be at higher risk for developing a vitamin D deficiency.

DIF: Cognitive Level: Application REF: p. 89 TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Physiological Integrity: Reduction of Risk Potential 37. The best food source of folic acid is a. grapefruit.

b. chicken. c. cheese. d. broccoli.

ANS: D

Rich sources of folate are found in liver; green, leafy vegetables; yeast; and legumes. Broccoli would be a high source of folate among the choices.

DIF: Cognitive Level: Application REF: pp. 99-100 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 38. A folic acid deficiency induces a form of anemia called a. microcytic anemia. b. megaloblastic anemia. c. pernicious anemia. d. aplastic anemia.

ANS: B

Megaloblastic anemia can be caused by a lack of folate.

DIF: Cognitive Level: Knowledge REF: p. 102 TOP: Nursing Process: Diagnosis MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Physiological Integrity: Reduction of Risk Potential 39. The B vitamin predominantly found in foods of animal origin is a. pantothenic acid. b. niacin. c. thiamin.

NURSINGTB.COM d. cobalamin.

ANS: D

Because cobalamin occurs as a protein complex in foods, its sources are mostly of animal origin.

DIF: Cognitive Level: Knowledge REF: p. 101 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 40. Vitamin C deficiency is associated with a. scurvy. b. beriberi. c. pernicious anemia. d. megaloblastic anemia.

ANS: A

Extreme vitamin C deficiency is associated with scurvy.

DIF: Cognitive Level: Knowledge REF: p. 83 TOP: Nursing Process: Diagnosis MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Physiological Integrity: Reduction of Risk Potential 41. A 62-year-old woman who smokes one pack of cigarettes a day and whose food intake

records reveal a minimal intake of vitamin C foods is most likely to be at risk for a. easy bruising and pinpoint hemorrhages.

b. cracked and bleeding lips. c. fevers and infections. d. neurologic disorders.

ANS: A

Signs of vitamin C deficiency are tissue bleeding, including easy bruising, and pinpoint skin hemorrhages. Smokers deplete their supply of vitamin C more rapidly than nonsmokers do.

Cigarette smoke is a source of environmental free radicals, and vitamin C is needed to break down toxic compounds in cigarette smoke.

DIF: Cognitive Level: Analysis REF: p. 94 TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Physiological Integrity: Reduction of Risk Potential 42. An example of a meal high in vitamin C is a. a bacon, lettuce, and tomato sandwich and strawberries. b. a hamburger, french fries, and salad. c. a pasta salad, whole-grain roll, and apple. d. nachos with refried beans and salsa.

ANS: A

The best sources of vitamin C are citrus fruits; tomatoes; cabbage and other leafy, green vegetables; berries; melons; peppers; broccoli; potatoes; and yellow vegetables.

DIF: Cognitive Level: Application REF: p. 107 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation

NURSINGTB.COM

43. Phytochemicals act as a. vitamins and minerals. b. cofactors and enzymes. c. antioxidants and hormones. d. antibiotics and antifungals.

ANS: C

Phytochemicals have antibacterial effects, act as antioxidants and hormones, and interact with enzymes and DNA replication. The beneficial effects of phytochemicals are believed to result from the synergistic actions of multiple nutrients as opposed to acting as an isolated compound.

DIF: Cognitive Level: Knowledge REF: p. 120 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 44. Foods rich in phytochemicals include a. mushrooms and algae. b. fruits and vegetables. c. yogurt and goat’s milk. d. soy milk and tofu.

ANS: B

Fruits and vegetables are rich sources of phytochemicals. The term phytochemical comes from the Greek word phyton, meaning “plant.”

DIF: Cognitive Level: Application REF: p. 120 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 45. A young woman who is interested in becoming pregnant should be counseled on healthy

eating choices, especially regarding folate-rich foods, which may help prevent a. neural tube defects. b. osteomalacia. c. pernicious anemia. d. aplastic anemia.

ANS: A

Adequate folate intake before and during pregnancy greatly reduces the risk of neural tube defects in infants.

DIF: Cognitive Level: Knowledge REF: p. 121 TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance

Chapter 08: Minerals Nix: Williams' Basic Nutrition and Diet Therapy, 15th Edition MULTIPLE CHOICE 1. The mineral present in the body in the greatest amount is a. sodium. b. calcium. c. iron. d. chloride.

ANS: B

Calcium is present in the greatest amount in the body and functions in bone and teeth formation, blood clotting, muscle and nerve action, and metabolic reactions.

DIF: Cognitive Level: Knowledge REF: p. 110 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 2. The factors most responsible for regulating calcium absorption from food are a. activity and diet. b. dietary intake and vitamin D hormone. c. metabolic rate and cardiovascular function. d. vitamin D hormone, calcitonin, and parathyroid hormone.

ANS: D

The absorption of dietary calcium depends on the interaction of three hormones—vitamin D, parathyroid hormone, and calciN toUnR inS —ItN haGt T diB re.cC tlyOcMontrol absorption along with indirect metabolic stimuli from the estrogen hormones.

DIF: Cognitive Level: Knowledge REF: p. 111 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 3. Binding agents such as oxalic acid and phytic acid inhibit absorption of a. potassium. b. sodium. c. sulfur. d. calcium.

ANS: D

Oxalic acid is a compound found in some plants, such as spinach, rhubarb, Swiss chard, beet greens, and certain other vegetables and nuts, that form insoluble salts with calcium, called oxalates.

DIF: Cognitive Level: Knowledge REF: p. 114 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 4. The person most at risk for developing osteoporosis is a a. 25-year-old woman who plays tennis three times a week. b. 35-year-old woman who has sustained multiple trauma and is bedridden. c. 55-year-old woman who exercises three times a week and consumes adequate milk

and dairy products at least three times a day.

d. 14-year-old girl who runs track and drink four glasses of milk daily.

ANS: B

Osteoporosis is not a primary calcium deficiency disease, but it does result from a combination of factors that create chronic calcium deficiency. These factors include inadequate intake, poor intestinal absorption connected with hormones controlling calcium absorption and metabolism, and lack of exercise that stimulates muscle insertion action on bones and determines the strength, shape, and mass of bone. The 35-year-old woman who is bedridden is at a higher risk for osteoporosis than the others who are active.

DIF: Cognitive Level: Application REF: p. 113 TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Physiological Integrity: Reduction of Risk Potential 5. An example of a food that is a good source of calcium is a. kidney beans. b. whole-grain bread. c. yogurt. d. spinach.

ANS: C

Good sources of calcium include milk and milk products, including cheese, yogurt, and ice cream.

DIF: Cognitive Level: Application REF: pp. 113-114 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance

NURSINGTB.COM

6. An example of a breakfast high in calcium is a. scrambled eggs and toast. b. pancakes and syrup. c. sausage biscuit. d. cereal and milk.

ANS: D

Cereal and milk provide good sources of calcium because calcium-rich foods include milk and milk products.

DIF: Cognitive Level: Application REF: pp. 113-114 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 7. The functions of energy metabolism and acid-base balance are regulated by a. sodium. b. iron. c. potassium. d. phosphorus.

ANS: D

The functions of phosphorus include bone and teeth formation, energy metabolism, and acid-base balance.

DIF: Cognitive Level: Application REF: p. 121 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 8. Two foods that are good sources of nutrients most important in bone formation are a. margarine and apples. b. milk and yogurt. c. bread and red meat. d. cereal and yogurt.

ANS: B

Milk and yogurt are good sources of calcium and phosphorus, which both play a role in bone formation.

DIF: Cognitive Level: Application REF: p. 113 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 9. An important function of sodium is a. energy metabolism. b. water balance. c. tooth formation. d. nerve conduction.

ANS: B

Sodium functions in water balance, acid-base balance, muscle action, and nutrient absorption.

DIF: Cognitive Level: Knowledge REF: p. 116 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation

NURSINGTB.COM

10. Most of the body’s sodium is found in a. plasma. b. water outside the cells. c. water inside the cells. d. cerebrospinal fluid.

ANS: B

Sodium is the major guardian of the body’s water outside the cell (extracellular), which helps prevent dehydration.

DIF: Cognitive Level: Knowledge REF: pp. 116-117 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 11. Processed foods supply a large percent of what mineral? a. Manganese b. Magnesium c. Sodium d. Iron ANS: C

Food manufacturers add significant amounts of salt and other sodium compounds to processed foods.

DIF: Cognitive Level: Application REF: pp. 116-117 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation

12. The major mineral in water inside cells is a. sodium. b. chloride. c. potassium. d. magnesium.

ANS: C

Potassium is the major electrolyte controlling the water inside the cell (intracellular fluid).

DIF: Cognitive Level: Knowledge REF: p. 117 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 13. Of the foods below, the one providing the best source of potassium is a. spinach. b. lemonade. c. processed cheese crackers. d. french fries.

ANS: A

The richest dietary sources of potassium are unprocessed foods, including oranges and bananas; vegetables such as broccoli and leafy, green vegetables; fresh meats; whole grains; and milk products.

DIF: Cognitive Level: Application REF: p. 118 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 14. The two minerals that occur in N thUeRwSaI teN r oGuTtsB id.eCcO elM ls and regulate water balance are a. calcium and potassium. b. sodium and chloride. c. phosphorus and magnesium. d. iron and zinc.

ANS: B

Sodium and chloride are the two minerals found in the water outside cells; both help control the body water balance.

DIF: Cognitive Level: Knowledge REF: p. 118 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 15. Chloride is incorporated into a. pancreatic secretions. b. intestinal secretions. c. gastric secretions. d. skeletal tissue.

ANS: C

Chloride is a key element in the hydrochloric acid secreted in gastric juices.

DIF: Cognitive Level: Knowledge REF: p. 118 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation

16. An important function of sulfur in the body is a. building connective tissue. b. tooth formation. c. fat storage. d. acid-base balance.

ANS: A

Sulfur is necessary for collagen synthesis and is important in building connective tissue.

Sulfur is also involved in the structure of hair, skin, and nails; general metabolic functions; and vitamin structure.

DIF: Cognitive Level: Knowledge REF: pp. 119-120 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 17. A food that enhances nonheme iron absorption is a. orange juice. b. white toast. c. olive oil. d. sausage.

ANS: A

Vitamin C and moderate amounts of lean meat help enhance the absorption and availability of nonheme iron. Orange juice is a good source of vitamin C. DIF: Cognitive Level: Application REF: pp. 123-124 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 18. Which of the following foods w stBim NoUuRldSbIeNmGoT .pCoOrtMant to assist with thyroxine synthesis? a. Iodized table salt b. Fresh, green lettuce c. An apple d. Yogurt ANS: A

Iodized table salt contains iodine, which helps synthesize thyroxine. Thyroxine-stimulating hormone stimulates the thyroid gland to take up more iodine for thyroxine synthesis when the blood level of thyroxine falls below normal.

DIF: Cognitive Level: Application REF: pp. 125-126 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 19. The main dietary source of iodine is a. seafood. b. legumes. c. iodized table salt. d. fortified foods.

ANS: C

Iodized table salt is the major, reliable source of iodine. The amount of iodine in natural food varies depending on the content of the soil. Seafood is another good source of iodine but is less reliable because most people do not eat seafood daily.

DIF: Cognitive Level: Application REF: p. 117 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 20. Copper has a metabolic association with a. silicon. b. chromium. c. iron. d. molybdenum.

ANS: C

Copper is frequently called the “iron twin” because copper and iron are metabolized in much the same way and both are components of cell enzymes.

DIF: Cognitive Level: Knowledge REF: pp. 128-129 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 21. Chromium is a component of the factor that facilitates the action of insulin. This factor is

called a. factor III. b. the antipernicious factor. c. the glucogenic factor. d. the glucose tolerance factor.

ANS: D

Chromium functions as an essential component of the organic complex glucose tolerance factor, which stimulates the action of insulin.

DIF: Cognitive Level: KnowledN geURSINR GETFB: .pCp.O1M29-130 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 22. A significant food source of selenium is a. turkey. b. potato chips. c. canned fruit. d. broccoli.

ANS: A

Significant sources of selenium include pork, chicken, lamb, turkey, and organ meats.

DIF: Cognitive Level: Application REF: pp. 127-128 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 23. The main function of fluoride is to a. provide structural support. b. prevent anemia. c. prevent dental caries. d. slow aging.

ANS: C

The main function of fluoride is to prevent dental caries. Fluoride strengthens the ability of the tooth structure to withstand the erosive effect of bacterial acids.

DIF: Cognitive Level: Knowledge REF: pp. 128-129 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 24. Trace minerals are called trace elements because they are a. not as important as the other minerals. b. found in small quantities in food sources. c. found in small quantities in the body. d. difficult to detect in the body.

ANS: C

Trace elements occur in very small amounts in the body. Trace elements are defined as those having a required intake of less than 100 mg/day.

DIF: Cognitive Level: Knowledge REF: pp. 129-130 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 25. Minerals are a. organic compounds. b. elements. c. made by plants. d. liquid at room temperature.

ANS: B

Minerals are chemical elements.

DIF: Cognitive Level: Knowledge REF: p. 110 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation

NURSINGTB.COM

26. An example of a lunch high in potassium is a a. hamburger on a bun with sliced tomatoes. b. grilled cheese sandwich and pretzels. c. pasta salad and hard roll. d. bagel with cream cheese and a dill pickle.

ANS: A

Rich food sources of potassium include unprocessed foods including fruits such as oranges and bananas, vegetables such as broccoli and leafy greens, fresh meats, whole grains, and milk products.

DIF: Cognitive Level: Application REF: pp. 117-118 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 27. A potassium deficiency may be caused by a. allergies. b. food poisoning. c. psychological stress. d. myocardial infarction.

ANS: B

A potassium deficiency is more likely to develop with prolonged vomiting or diarrhea, use of diuretic drugs, severe malnutrition, or surgery.

DIF: Cognitive Level: Analysis REF: p. 117 TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Physiological Integrity: Reduction of Risk Potential 28. Amino acids that contain sulfur are a. phenylalanine and calcium. b. threonine and tyrosine. c. methionine and cystine. d. leucine and tryptophan.

ANS: C

The amino acids methionine and cystine contain sulfur.

DIF: Cognitive Level: Knowledge REF: pp. 119-120 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 29. The trace element the body needs to produce antibodies, convert carotene to vitamin A, and

form hemoglobin is a. copper. b. iron. c. magnesium. d. zinc.

ANS: B

Iron is necessary for hemoglobin synthesis, proper glucose metabolism in the cell, antibody production, drug detoxificationNURSINGTB.COM in the liver, collagen and purine synthesis, and conversion of carotene to vitamin A. DIF: Cognitive Level: Application REF: p. 120 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 30. A significant source of phosphorus would be provided by a. skim milk. b. an apple. c. chocolate. d. lemonade.

ANS: A

The best sources of phosphorus are high-protein foods including milk and milk products, meat, fish, and eggs.

DIF: Cognitive Level: Application REF: pp. 114-115 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance

Chapter 09: Water and Electrolyte Balance Nix: Williams' Basic Nutrition and Diet Therapy, 15th Edition MULTIPLE CHOICE 1. The hormone that conserves body water is a. the vitamin D hormone. b. the antidiuretic hormone. c. aldosterone. d. the parathyroid hormone.

ANS: B

The antidiuretic hormone works on the kidneys’ nephrons to induce reabsorption and conservation of water.

DIF: Cognitive Level: Knowledge REF: p. 143 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 2. The two minerals that occur in the extracellular fluid and regulate water balance are a. calcium and potassium. b. sodium and chloride. c. phosphorus and magnesium. d. potassium and magnesium.

ANS: B

Sodium and chloride are the two minerals that occur in the extracellular fluid and regulate water balance.

NURSINGTB.COM DIF: Cognitive Level: Knowledge REF: pp. 135-136 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 3. A person is most likely to have a high body water content if he or she is a. overweight. b. underweight. c. a bodybuilder. d. sedentary.

ANS: C

An athlete would have a high body water content related to the amount of muscle mass.

Muscle mass contains a relatively large amount of water.

DIF: Cognitive Level: Application REF: pp. 134-135 TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Physiological Integrity: Reduction of Risk Potential 4. The term extracellular fluid includes a. plasma and tissue secretions. b. plasma and fluid inside cells. c. fluid surrounding cells and in beverages. d. fluid surrounding cells and fluid inside cells.

ANS: A

Extracellular fluid is the total body water outside the cells, including plasma and tissue secretions.

DIF: Cognitive Level: Knowledge REF: p. 137 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 5. A basic mechanism for maintaining body hydration is a. thirst. b. electrolyte balance. c. acid-base balance. d. activity level.

ANS: A

Thirst is the basic mechanism for maintaining hydration.

DIF: Cognitive Level: Knowledge REF: p. 136 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 6. The hormone responsible for promoting conservation of sodium in the kidney is a. aldosterone. b. the antidiuretic hormone. c. angiotensin. d. renin.

ANS: A

Aldosterone is produced by the adrenal glands, which trigger the kidneys’ nephrons to NURSINGTB.COM reabsorb sodium.

DIF: Cognitive Level: Knowledge REF: p. 143 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 7. Mr. J. consumes approximately 1500 mL/day from fluid contained in liquids and foods and

from the metabolism of foods. What percent of his fluid requirement does he meet if he requires 2400 mL/day? a. 41% b. 51% c. 62% d. 84% ANS: C

The intake from liquids, liquids in foods, and metabolism is approximately 1500 mL/day, so 1500 mL ÷ 2400 mL = 62%.

DIF: Cognitive Level: Analysis REF: p. 134 TOP: Nursing Process: Evaluation MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Physiological Integrity: Reduction of Risk Potential 8. Water formed from metabolism comes from a. that which is contained in foods. b. moving from compartment to compartment. c. what is absorbed from gastrointestinal secretions.

d. the oxidation of nutrients in the cells.

ANS: D

Metabolic water, or water of oxidation, is the product of cell oxidation when nutrients are burned in the body for energy.

DIF: Cognitive Level: Comprehension REF: p. 138 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 9. The approximate volume of digestive secretions produced by the stomach each day is a. 1000 mL. b. 1500 mL. c. 2000 mL. d. 2500 mL. ANS: D

The approximate total volume of digestive secretions produced by an average-sized adult is 8200 mL per 24 hours. Of this amount, 2500 mL is from gastric secretions.

DIF: Cognitive Level: Knowledge REF: p. 142 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 10. The kidneys must excrete water in the urine because a. the body needs to get rid of the ingested water. b. water provides the vehicle for excretion of waste products. c. they physiologically cannot retain all the water. d. hormones ensure that a maximal amount of water is retained by the body.

ANS: B

NURSINGTB.COM

The largest amount of water exits through the kidneys. A certain amount of water must be excreted as urine to carry the various waste products of metabolism. This is called obligatory water loss because it is compulsory for survival and must occur daily for health.

DIF: Cognitive Level: Knowledge REF: p. 143 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 11. Plasma proteins and electrolytes are examples of solutes a. filtered from the plasma by the kidneys. b. found in body fluids that influence the movement of water. c. released into the plasma by the liver. d. recycled by the mucosa during digestion.

ANS: B

Plasma proteins, mainly in the form of albumin and globulin, are organic compounds of large molecular size responsible for controlling water movement in the body and guarding blood volume by influencing the shift of water in and out of capillaries in balance with the surrounding water. Electrolytes are particles that are free to move throughout a solution to maintain chemical balance.

DIF: Cognitive Level: Application REF: p. 139 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation

12. What is an example of a substance that can pass through a capillary membrane? a. Glucose b. Hemoglobin c. Plasma proteins d. Antibodies ANS: A

Glucose passes through a capillary membrane. The walls of the capillaries are thin and porous; therefore water molecules and small particles can move freely across them.

DIF: Cognitive Level: Application REF: p. 141 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 13. An acid has a pH a. greater than 7.0. b. lower than 7.0. c. greater than 5.0. d. lower than 5.0.

ANS: B

A pH less than 7.0 is considered acidic, whereas anything above 7.0 is considered basic. A pH of 7.0 is neutral.

DIF: Cognitive Level: Knowledge REF: p. 144 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 14. An example of a cation is a. sodium. b. phosphate. c. carbonate. d. sulfate.

ANS: A

Cations are ions carrying positive charges, such as sodium, potassium, calcium, and magnesium.

DIF: Cognitive Level: Knowledge REF: p. 139 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 15. The organic molecule responsible for creating colloidal osmotic pressure is a. glucose. b. an electrolyte. c. protein. d. sodium.

ANS: C

Protein is an organic molecule responsible for creating colloidal osmotic pressure.

DIF: Cognitive Level: Application REF: p. 139 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 16. An example of an electrolyte is

a. b. c. d.

glucose. iron. potassium. carbon dioxide.

ANS: C

Electrolytes are small, inorganic substances that can dissociate or break apart in a solution and carry an electrical charge. Examples include potassium, sodium, chloride, calcium, magnesium, carbonate, phosphate, and sulfate.

DIF: Cognitive Level: Comprehension REF: pp. 138-139 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 17. The ways in which water and solutes move across membranes include a. diffusion and filtration. b. capillary action and circulation. c. peristalsis and contraction. d. conduction and pulsation.

ANS: A

Forces that move water and solutes across membranes include osmosis, diffusion, filtration, active transport, and pinocytosis.

DIF: Cognitive Level: Knowledge REF: pp. 140-141 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 18. Functions of water in the body include a. providing an energy sourceN . URSINGTB.COM b. temperature control. c. nerve impulse transmission. d. transport of vitamins A, D, E, and K. ANS: B

The body water supply acts as a solvent, serves as a means of transport, provides form and structure, regulates temperature control, and provides lubrication for the body.

DIF: Cognitive Level: Knowledge REF: p. 134 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 19. The term used to denote concentration of electrolytes in a given volume is a. valence. b. colloidal osmotic pressure. c. pH. d. milliequivalent.

ANS: D

Milliequivalents are used to express the number of electrolytes per unit of fluid in a solution.

DIF: Cognitive Level: Knowledge REF: p. 139 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation

20. Cations primarily responsible for controlling body water distribution are a. sodium and chloride. b. calcium and phosphorus. c. sodium and potassium. d. sodium and bicarbonate.

ANS: C

Sodium and potassium are cations that control the distribution of water in the body. Sodium is the major extracellular electrolyte and potassium is the major intracellular electrolyte.

DIF: Cognitive Level: Knowledge REF: p. 139 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 21. A patient who is experiencing severe diarrhea and vomiting would have a. increased body water requirements. b. decreased body water requirements. c. no change in body water requirements. d. an immediate need for intravenous fluid.

ANS: A

Diarrhea and vomiting increase the loss of fluid from the body and hence increase body water requirements to replace losses and maintain a state of homeostasis.

DIF: Cognitive Level: Application REF: p. 142 TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Physiological Integrity: Reduction of Risk Potential

NURSINGTB.COM 22.2 The kidneys clean the blood by 2 a. osmosis. . b. filtration. c. active transport. d. diffusion.

ANS: B

The kidneys filter the blood to maintain the appropriate levels of all constituents of blood and remove waste products.

DIF: Cognitive Level: Knowledge REF: p. 143 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 23. Oral rehydration therapy is preferred over intravenous therapy for fluid replacement caused by

diarrhea because it a. is quicker. b. tastes better. c. is more readily available. d. provides electrolytes as well as fluid.

ANS: C

Oral hydration is preferred over intravenous therapy if the fluid can be consumed by the patient because it is just as effective as intravenous therapy, is more readily available, and is less expensive.

DIF: Cognitive Level: Knowledge REF: p. 142 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies | NCLEX: Physiological Integrity: Basic Care and Comfort 24. What is the predominant regulator of circulating blood volume? a. Blood pressure b. Plasma proteins c. Water intake d. Hormones ANS: B

Plasma protein molecules are retained in blood vessels, controlling water movement in the body and guarding blood volume by influencing the shift of water in and out of the capillaries in balance with the surrounding water.

DIF: Cognitive Level: Knowledge REF: pp. 138-139 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 25. Water retention would be the result of which of the following hormones? a. The antidiuretic hormone b. Estrogen c. Progesterone d. Insulin ANS: A

The antidiuretic hormone promotes water conservation; it works on the kidneys’ nephrons to induce reabsorption of water. IN nU anRySsI treNsG sfT ulBs. ituCaOtiM on with a threatened or real loss of body water, this hormone is released to conserve vital body water.

DIF: Cognitive Level: Comprehension REF: p. 143 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Physiological Integrity: Reduction of Risk Potential 26. Thirst tends to be an unreliable index of fluid needs in a. infants. b. pregnant women. c. breast-feeding women. d. older adults.

ANS: D

Thirst is an unreliable index of fluid needs in the elderly because the thirst mechanism usually diminishes with age and dehydration can easily occur.

DIF: Cognitive Level: Knowledge REF: p. 138 TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Physiological Integrity: Reduction of Risk Potential 27. Plasma proteins maintain colloidal osmotic pressure because a. they are large molecules. b. proteins are not found in the cells.

c. proteins are positively charged. d. they contain water as part of their structure.

ANS: A

Plasma proteins maintain colloidal osmotic pressure because they are large molecules, mainly in the form of albumin and globulin. Plasma protein molecules are retained in the blood vessels, controlling water movement in the body and guarding blood volume by influencing the shift of water in and out of capillaries in balance with the surrounding water.

DIF: Cognitive Level: Knowledge REF: p. 139 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 28. Treatment for diarrhea in children is to a. withhold oral intake and immediately begin intravenous fluids until diarrhea stops. b. sponge with an electrolyte solution of sodium, potassium, and sugar. c. give an age-appropriate diet along with oral fluids that contain sodium, potassium,

sugar, and sodium bicarbonate. d. administer the BRAT (bananas, rice, applesauce, and tea) diet.

ANS: C

Administering an age-appropriate diet along with fluids that contain sodium, potassium, glucose, and sodium bicarbonate is beneficial in treating diarrhea and replacing lost fluid and electrolytes to bring the body into a state of homeostasis.

DIF: Cognitive Level: Application REF: p. 142 TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Physiological Integrity: Basic Care and Comfort 29. The electrolyte present in the most abundance in gastric digestive fluids is a. chloride. b. potassium. c. sodium. d. bicarbonate.

ANS: A

The electrolyte that is most abundant in gastric digestive fluids is chloride.

DIF: Cognitive Level: Knowledge REF: pp. 138-139 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 30. For osmosis to occur there must be a. a semipermeable membrane. b. cations and anions. c. membrane channels. d. hormonal control.

ANS: A

Osmosis is the process by which water moves from an area of low concentration to an area of high concentration; this can only happen if the two areas are separated by a semipermeable membrane.

DIF: Cognitive Level: Application REF: p. 140 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation

NURSINGTB.COM

Chapter 10: Nutrition during Pregnancy and Lactation Nix: Williams' Basic Nutrition and Diet Therapy, 15th Edition MULTIPLE CHOICE 1. Nutritional needs during pregnancy are affected by a. the mother’s age. b. the sex of the infant. c. the mother’s food cravings. d. whether the mother works.

ANS: A

Nutritional needs during pregnancy are affected by the mother’s age along with height and prepregnancy weight.

DIF: Cognitive Level: Application REF: p. 148 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 2. A pregnant woman’s energy needs must be met in order to a. spare vitamins. b. spare adipose stores. c. prevent fetal deformity. d. spare protein.

ANS: D

Adequate energy is necessary tN oU spRaS reIpNroGteTinB..IfCiO naMdequate kilocalories from energy are provided, then protein will be used for energy. Protein increase is approximately 50% more than the average adult requirement.

DIF: Cognitive Level: Knowledge REF: p. 147 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 3. Daily kilocalorie needs during the second trimester exceed normal requirements by

approximately a. 100 kcal. b. 200 kcal. c. 340 kcal. d. 500 kcal.

ANS: C

The national standard recommends an increase of 340 kcal/day during the second trimester and 452 kcal/day during the third trimester of pregnancy.

DIF: Cognitive Level: Knowledge REF: p. 148 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 4. The amount of extra protein required by pregnant women compared with nonpregnant women

is approximately

a. b. c. d.

10 g/day.

15 g/day.

25 g/day.

30 g/day.

ANS: C

Protein intake should increase 25 g/day during pregnancy in addition to nonpregnancy needs.

This increase is approximately 50% more than the average adult requirement.

DIF: Cognitive Level: Knowledge REF: pp. 148-149 TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 5. Increased protein is necessary in pregnancy for a. preventing gestational diabetes. b. sparing carbohydrates for energy needs. c. growing maternal tissues. d. preventing pregnancy-induced hypertension.

ANS: C

Increased protein is necessary in pregnancy for rapid growth of the fetus, development of the placenta, growth of maternal tissues, increased maternal blood volume, and amniotic fluid.

DIF: Cognitive Level: Knowledge REF: p. 148 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance

NURSINGTB.COM

6. A good source of calcium during pregnancy is a. orange juice drink. b. lean ground beef. c. milk. d. baked beans.

ANS: C

Calcium is essential for fetal development of bones and teeth as well as for the mother’s own body needs. Milk, milk-substitute products, generous amounts of green vegetables, and enriched or whole grains are good sources of calcium.

DIF: Cognitive Level: Application REF: pp. 149-150 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 7. A good source of iron during pregnancy would be a. watermelon. b. orange juice. c. macaroni and cheese. d. lean ground beef.

ANS: D

Iron is distributed primarily in meat, eggs, vegetables, and fortified cereals.

DIF: Cognitive Level: Knowledge

REF: p. 150

TOP: Nursing Process: Application MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 8. Iron needs increase during pregnancy because of a. maternal constipation. b. an increased maternal blood volume. c. an increased maternal metabolic rate. d. poor iron absorption during pregnancy.

ANS: B

Iron needs are increased during pregnancy for increased hemoglobin synthesis required for the greater maternal blood volume as well as for the baby’s necessary prenatal storage of iron.

DIF: Cognitive Level: Knowledge REF: p. 150 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 9. Adequate folate in the periconceptional period helps prevent a. cretinism. b. mental retardation. c. neural tube defects. d. gestational diabetes.

ANS: C

Folate builds mature red blood cells throughout pregnancy and is particularly needed during the early periconceptional period to ensure healthy embryonic tissue development and prevent malformation of the neural tubeN.URSINGTB.COM DIF: Cognitive Level: Knowledge REF: p. 150 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 10. Several vitamins are required in greater amounts during pregnancy because a. fetal demands for the vitamins are high. b. more hemoglobin is synthesized. c. the vitamins are excreted in greater quantities. d. metabolic activities increase.

ANS: D

Most vitamins are needed in increased amounts because of their vital role as coenzyme factors in energy production and protein metabolism.

DIF: Cognitive Level: Comprehension REF: p. 150 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 11. A pregnant vegetarian can help prevent development of iron-deficiency anemia by consuming

foods high in a. vitamin C. b. vitamin D. c. folate.

d. protein.

ANS: A

Vitamin C enhances absorption of nonheme iron and so prevents development of iron deficiency anemia in vegetarian pregnant women who rely on plant (nonheme) sources of iron.

DIF: Cognitive Level: Application REF: pp. 176-177 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 12. Drinking three to four cups of milk a day during pregnancy is recommended because milk is a

good source of a. folate. b. iron. c. vitamin D. d. vitamin C. ANS: C

Milk is a good source of vitamin D along with calcium, phosphorus, and magnesium for fetal development of bones and teeth as well as for the mother’s own bodily needs.

DIF: Cognitive Level: Application REF: p. 151 TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 13. Appropriate snack choices for a pregnant woman with morning sickness may include NURSINGTB.CO a. a meal of hot soup and Gatorade. b. lemonade with added sugar and peppermint sticks. c. a glass of hot, decaffeinated tea. d. whole-wheat toast with a small amount of light butter and a small piece of fruit.

ANS: D

Small, frequent meals and snacks that are fairly dry and consist of easily digested energy foods (e.g., carbohydrates), in addition to mainly cold foods and liquids between meals, are recommended for women with morning sickness.

DIF: Cognitive Level: Application REF: pp. 152-153 TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 14. A condition of severe, prolonged, and persistent vomiting during pregnancy is called a. hyperemesis gravidarum. b. placenta previa. c. gestational diabetes. d. preeclampsia.

ANS: A

Hyperemesis gravidarum is morning sickness in early pregnancy that progresses from a mild state to a severe and prolonged state requiring medical treatment.

DIF: Cognitive Level: Knowledge REF: p. 153 TOP: Nursing Process: Diagnosis MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 15. What is a food choice to help alleviate constipation during pregnancy? a. Figs b. Chocolate c. White bread d. Saltines ANS: A

Helpful remedies for constipation include high-fiber foods such as whole grains, vegetables, dried fruits, and other fruits and juices.

DIF: Cognitive Level: Application REF: p. 153 TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 16. An acceptable ending pregnancy weight for a woman whose prepregnancy weight is 125 lb is a. 130 to 135 lb. b. 135 to 145 lb. c. 145 to 150 lb. d. 150 to 160 lb.

ANS: D

Weight gain for a normal-sized woman with a body mass index of 18.5 to 24.9 is 25 to 35 lb.

Thus 125 lb + 25 to 35 lb = 150NlUbRtoS1I6N0GlbT. B.COM DIF: Cognitive Level: Application REF: p. 152 TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 17. Total weight gain during the first trimester should be approximately a. 1 to 2 b. 2 to 4 c. 6 to 10 d. 10 to 15

lbs.

ANS: B

Recommended weight gain in the first trimester of pregnancy is approximately 2 lb to 4 lb.

DIF: Cognitive Level: Knowledge REF: p. 152 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 18. A pregnancy is considered high risk if the mother a. is 16 years old. b. is vegetarian. c. works full time. d. exercises four or five times per week.

ANS: A

Nutritional risk factors at the onset of pregnancy include age 18 years or younger or 35 years or older; frequent pregnancies; poor obstetric history or poor fetal performance; poverty; bizarre or trendy food habits; abuse of nicotine, alcohol, or drugs; chronic disease with therapeutic diet; and weight less than 85% or more than 120% of normal.

DIF: Cognitive Level: Application REF: p. 154 TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity: Physiological Adaptation 19. A pregnant adolescent is at risk because she a. does not know how to care for herself. b. has not established good eating habits. c. is still in a growth stage of development. d. will not know about the pregnancy until after the fetal organs have formed.

ANS: C

A pregnant adolescent is at risk because adolescence itself is a stage of growth. The physiologic demands of the pregnancy can compromise the teenager’s needs for her own unfinished growth and development.

DIF: Cognitive Level: Knowledge REF: p. 154 TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity: Physiological Adaptation 20. A very overweight pregnant woman older than 30 years of age is at high risk for a. anemia. b. gestational diabetes.

NURSINGTB.COM c. edema. d. phenylketonuria.

ANS: B

Risk factors for women who are more than 120% of standard weight or who have a body mass index of more than 26 include gestational diabetes. During pregnancy, there is an increased metabolic workload along with an increased volume of blood and its load of metabolites, including glucose.

DIF: Cognitive Level: Knowledge REF: p. 154 TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity: Physiological Adaptation 21. During pregnancy, women should be encouraged not to a. exercise. b. have sexual intercourse. c. drink alcoholic beverages. d. drink decaffeinated coffee.

ANS: C

The ingestion of alcohol, nicotine, and recreational or other drugs can cause fetal damage and is contraindicated during pregnancy. Extensive, habitual use of alcohol leads to the well-documented fetal alcohol syndrome.

DIF: Cognitive Level: Knowledge REF: pp. 154-155 TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 22. The most common cause of anemia during pregnancy is a. folic acid deficiency. b. lack of intrinsic factor. c. iron deficiency. d. vitamin C deficiency.

ANS: C

Iron-deficiency anemia is most common during pregnancy.

DIF: Cognitive Level: Knowledge REF: p. 157 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 23. The best source of folate is a. fruit juices. b. green, leafy vegetables. c. whole grains. d. citrus fruits.

ANS: B

Folate is found in food sources such as green, leafy vegetables; legumes; yeast; chicken; beef; and liver.

DIF: Cognitive Level: Application REF: p. 150 NURSINGTB.CO TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 24. The finding of glycosuria during a routine laboratory test may suggest that the woman has a. anemia. b. gestational diabetes. c. phenylketonuria. d. hypertension.

ANS: B

Gestational diabetes presents with glycosuria or sugar spilling over into the urine. Other predisposing factors include age 30 years and older, those who are overweight and have a history of previously unexplained stillbirths, delivery of large babies weighing 9 lb or more, habitual spontaneous abortions, births of babies with multiple congenital defects, and a family history of diabetes or ethnicity associated with a high incidence of diabetes.

DIF: Cognitive Level: Knowledge REF: p. 158 TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity: Physiological Adaptation 25. High blood pressure and the accumulation of protein in the urine may be signs of a. preeclampsia. b. hyperemesis.

c. alcoholism. d. gestational diabetes.

ANS: A

High blood pressure can be fatal to the mother and fetus. If symptoms progress with the accumulation of proteinuria, the condition is referred to as preeclampsia.

DIF: Cognitive Level: Application REF: p. 157 TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 26. Three important factors that support adequate lactation are a. diet, exercise, and vitamin supplements. b. intake of dairy products, fluids, and rest. c. diet, fluids, rest and relaxation. d. intake of bland foods and adequate fluids.

ANS: C

Successful lactation requires an adequate diet, including energy and nutrients for both the process and product; adequate fluid for adequate milk production; and rest and relaxation to enhance the production and letdown reflexes of breast-feeding.

DIF: Cognitive Level: Knowledge REF: pp. 158-159 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 27. Nutrition counselors should encourage pregnant teenagers to NURSINGTB.COM a. avoid fast food. b. eat foods from all the basic food groups. c. drink fat-free (skim) rather than whole milk. d. eat foods high in dietary fiber.

ANS: B

Pregnant teens should consume foods from all five basic foods groups to support fetal development as well as their own growth and development needs.

DIF: Cognitive Level: Application REF: p. 154 TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 28. Advantages of breast-feeding for the mother include a. less fluid retention. b. rapid weight loss. c. fewer maternal infections. d. convenience and economy.

ANS: D

The advantages of breast-feeding include benefits to both mother and baby such as human breast milk’s ability to meet the unique needs of the infant and the convenience and economy for the mother.

DIF: Cognitive Level: Knowledge REF: pp. 158-159 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 29. During pregnancy, a 132-pound woman should limit her intake of caffeine to a. 0 mg per day. b. 100 mg per day. c. 300 mg per day. d. her individual tolerance.

ANS: C

During pregnancy, caffeine intake should be limited. The overall conclusion is that moderate amounts of caffeine (5 mg/kg to 6 mg/kg/day) throughout the day do not have negative effects on reproduction or fetal health. Thus 60 kg (132 lb)  5 = 300 mg of caffeine/day.

DIF: Cognitive Level: Application REF: p. 156 TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 30. The amount of breast milk that most women produce a. is governed by supply and demand. b. increases as lactation continues. c. is affected by maternal age. d. is related to maternal milk intake.

ANS: A

Milk production is stimulated bNyUthReSiI nfN anGt T feBe. diC ngO;Mtherefore, the supply matches the demand.

DIF: Cognitive Level: Comprehension REF: pp. 158-159 TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance

Chapter 11: Nutrition during Infancy, Childhood, and Adolescence Nix: Williams' Basic Nutrition and Diet Therapy, 15th Edition MULTIPLE CHOICE 1. At birth, the reflexes an infant has are a. rooting, biting, and swallowing. b. sucking, munching, and swallowing. c. rooting, sucking, and swallowing. d. grasping, sucking, and gagging.

ANS: C

At birth the rooting, sucking, and swallowing reflexes are present along with the tonic neck reflex.

DIF: Cognitive Level: Knowledge REF: p. 173 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 2. Foods for infants should be prepared without added a. sugar and salt. b. salt and herbs. c. wheat and sugar. d. milk and wheat.

ANS: A

Foods for infants are prepared N wU ithRoS utIaNdG deTdBs. ugCaO r aMnd salt. Foods should not be overseasoned to let tastes develop gradually.

DIF: Cognitive Level: Knowledge REF: p. 176 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 3. The phase that shows the most erratic growth is a. infancy. b. childhood. c. adolescence. d. adulthood.

ANS: B

During childhood, physical growth and appetite occur in spurts. The generally slow and irregular growth rate continues in the early school years, and body changes occur gradually.

DIF: Cognitive Level: Application REF: p. 166 TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 4. During a checkup at the clinic, a child’s physical growth is evaluated by using a. fitness testing. b. clinical observation.

c. food records. d. growth charts.

ANS: D

Growth charts are an assessment tool for measuring normal growth patterns in infants, children, and adolescents. These charts are based on large numbers of well-nourished children representing the national population.

DIF: Cognitive Level: Knowledge REF: p. 167 TOP: Nursing Process: Assessment | Nursing Process: Evaluation MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 5. A good source of energy for children is a. chicken. b. cereal with added sugar. c. whole-wheat toast. d. a vitamin supplement.

ANS: C

The main energy source for children is carbohydrates, preferably complex carbohydrates.

Carbohydrates spare protein so that it is available for building tissue during childhood rather than being broken down for energy needs. Whole-wheat toast is a good source of complex carbohydrates. Cereal also provides carbohydrates, but sugary cereals provide less complex carbohydrates.

DIF: Cognitive Level: Application REF: p. 171 TOP: Nursing Process: ImplemeN ntU atR ioS n INGTB.COM MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 6. During childhood, most calories are needed for a. tissue growth. b. physical activities. c. specific dynamic effect. d. basal metabolic needs.

ANS: D

Basal metabolism accounts for 50% of total daily caloric intake during childhood.

DIF: Cognitive Level: Knowledge REF: p. 171 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 7. An example of a food that provides building material for tissue growth is a. bread. b. cheese. c. broccoli. d. an orange.

ANS: B

Protein is the fundamental tissue-building substance of the body. Cheese is a food high in protein.

DIF: Cognitive Level: Application REF: p. 171 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 8. An 8-month-old infant who receives approximately 0.4 L of fluid per day is meeting a. 200% of fluid needs per day. b. 100% of fluid needs per day. c. 75% of fluid needs per day. d. 50% of fluid needs per day.

ANS: C

Approximate daily fluid needs during growth years for infants 7 to 12 months is 0.8 L/day.

DIF: Cognitive Level: Application REF: p. 171 TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 9. Compared with adults, infants and young children have more body fluid a. outside the cells. b. inside the cells. c. in the bloodstream. d. in intestinal secretions.

ANS: A

NURSINGTB.COM

A larger proportion of an infant’s and child’s total body water is outside the cells and easily lost, potentially resulting in dehydration.

DIF: Cognitive Level: Knowledge REF: p. 171 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 10. A good source of calcium for the growing child is a. milk. b. a juice drink. c. a dinner roll. d. a hot dog.

ANS: A

Milk is a good source of calcium. Calcium is an important nutrient for the growing child to assist with bone and tooth development.

DIF: Cognitive Level: Application REF: p. 171 TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 11. An adequate source of iron for a breast-fed infant at 8 months of age is a. cow’s milk.

b. goat’s milk. c. an enriched rice cereal. d. applesauce.

ANS: C

The iron content of breast milk is highly absorbable and fully meets the needs of an infant for the first 6 months of life. At that point, the infant’s nutritional needs for iron exceed what is provided exclusively by breast milk and the addition of puréed meats and enriched cereals after approximately 6 months of age helps supply additional iron.

DIF: Cognitive Level: Application REF: p. 179 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 12. Hypervitaminosis of vitamins A or D is most likely to occur because of a. excessive milk intake. b. overexposure to the sun. c. overuse of vitamin supplements. d. inadequate intake of vegetables and fruits.

ANS: C

The overuse of vitamin supplements can lead to hypervitaminosis of vitamins A or D. Excess intake may occur over prolonged periods because of ignorance, carelessness, or misunderstanding.

DIF: Cognitive Level: Knowledge REF: p. 172 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 13. The feeding process is important for development of a. the bonding relationship with the parent. b. self-identity for the infant. c. autonomy for the infant and parent. d. infant self-actualization.

ANS: A

The feeding process is an important part of the bonding relationship between parent and child.

The feeding process influences positive growth.

DIF: Cognitive Level: Knowledge REF: p. 173 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 14. A low birth weight infant weighs less than a. 1500 g. b. 2500 g. c. 3000 g. d. 3500 g.

ANS: B

A low birth weight infant weighs less than 2500 g while a very low birth weight infant weighs less than 1500 g.

DIF: Cognitive Level: Knowledge REF: p. 173 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 15. The most suitable first solid food for an infant 6 months of age would be a. yogurt. b. puréed meat. c. crackers. d. infant rice cereal.

ANS: D

Iron-fortified infant cereal made from rice, barley, or oats (these are offered one at a time) or puréed fruits and vegetables are usually the most suitable first solid foods for infants.

DIF: Cognitive Level: Application REF: pp. 176-177 TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 16. The ideal first food for newborns is a. infant formula. b. cow’s milk. c. breast milk. d. rice cereal.

ANS: C

The ideal first food for newborns is breast milk because its nutrients are uniquely adapted to NURSINGTB.COM meet the growth needs of the infant in forms that are easily digested, absorbed, and used.

DIF: Cognitive Level: Knowledge REF: pp. 176-177 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 17. The first milk secreted by a new mother is called a. lactation. b. colostomy. c. colostrum. d. prolactin.

ANS: C

Colostrum is a thin, yellow fluid first secreted by the mammary gland a few days after childbirth, preceding the mature breast milk.

DIF: Cognitive Level: Knowledge REF: p. 174 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 18. The approximate recommended age for adding solid food to an infant’s diet is a. 4 months. b. 6 months. c. 8 months.

d. 12 months.

ANS: B

The recommended practice is to introduce solid foods at approximately 6 months of age.

Younger infants are not ready to swallow and digest solid foods, and they do not yet need other nutrients besides those provided by breast milk or infant formula.

DIF: Cognitive Level: Knowledge REF: p. 176 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 19. Babies should not be put to sleep with a bottle of formula because a. infants should not hold their own bottles. b. this could lead to early tooth decay. c. infants should not suck while asleep. d. susceptibility to diarrhea is increased.

ANS: B

In addition to other concerns, babies should not be put to sleep with a bottle of formula because it can lead to early tooth decay as bacteria ferment nutrients in the formula to produce acid, which damages tooth enamel.

DIF: Cognitive Level: Knowledge REF: p. 175 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 20. A type of feeding not recommended for infants during the early months is a. breast milk.

NURSINGTB.COM b. amino acid-based formula. c. soy-based formula. d. cow’s milk.

ANS: D

Cow’s milk is not recommended for infants during the first year of life because its concentration may cause gastrointestinal bleeding and it provides too heavy a load of solutes for the infant’s renal system.

DIF: Cognitive Level: Application REF: pp. 175-176 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 21. Young children should be offered a. large portions so they can decide how much to eat. b. small portions so they can ask for more if hungry. c. larger portions of food as they grow older. d. the same amount of food each day.

ANS: B

In feeding young children, a variety of foods should be offered and served in small portions.

Children can ask for a second helping of food if they are still hungry.

DIF: Cognitive Level: Application REF: p. 178 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and

Maintenance 22. Failure to thrive may be caused by a. early sitting and crawling. b. sleeping with a bottle. c. overuse of vitamin supplements. d. overdilution of formula.

ANS: D

Diluting formula provides fluid without adequate nutrients.

DIF: Cognitive Level: Knowledge REF: p. 181 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 23. Food intake may decrease after the first year of life, and caloric need is not as great because a. the child is using baby fat stores. b. muscle development is occurring. c. the child is still relatively inactive. d. the growth rate slows down.

ANS: D

During the first year of life, growth is rapid, especially during the first 6 months. After the first year, the growth rate tends to slow down, and food intake decreases.

DIF: Cognitive Level: Knowledge REF: p. 178 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance

NURSINGTB.COM

24. During the school-age years, the rate of growth a. increases rapidly. b. is slow and irregular. c. increases slowly. d. is similar to that during the preschool years.

ANS: B

The rate of growth during the school-age years is slow and irregular, with body changes occurring gradually.

DIF: Cognitive Level: Knowledge REF: pp. 178-179 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 25. The final, major growth spurt of childhood occurs a. at the end of the school-age period. b. with the onset of puberty. c. at the end of adolescence. d. during young adulthood.

ANS: B

The final growth spurt of childhood occurs with the onset of puberty. This rapid growth is evident in increasing body size and development of sex characteristics in response to hormonal influences.

DIF: Cognitive Level: Knowledge REF: p. 183 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 26. Eating disorders are common in many groups of adolescent girls because a. their appetites are low. b. adolescents are busy and may miss meals. c. society and peers value thinness. d. they tend to be overzealous in following low-fat eating patterns.

ANS: C

Eating disorders are common is young girls and in boys because of social, family, and personal pressures concerning figure control, which are strong influences on them to fit in and be accepted.

DIF: Cognitive Level: Application REF: p. 184 TOP: Nursing Process: Assessment | Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 27. The ideal first food for infants is a. human milk. b. cow’s milk. c. soy-based formula. d. amino acid-based formula.

ANS: A

Human milk is the ideal first food for infants and is recommended by physicians and NURSINGTB.COM dietitians. Cow’s milk is not recommended and should never be fed to an infant during the first year of life. Unmodified cow’s milk can cause gastrointestinal bleeding and provides too heavy a load of solutes for the infant’s renal system. Appropriate infant formula can be used if the mother chooses not to breast-feed or if some condition prevents breast-feeding.

DIF: Cognitive Level: Knowledge REF: p. 174 TOP: Nursing Process: Evaluation MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 28. Older infants can generally finger-feed themselves with a refined pincer grasp at a. 6 to 8 months. b. 7 to 9 months. c. 10 to 12 months. d. 12 to 18 months.

ANS: C

At 10 to 12 months, infants can finger-feed themselves with a refined pincer grasp.

DIF: Cognitive Level: Knowledge REF: p. 177 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 29.

Parents who use natural foods should be advised to a. add honey to water if the infant is constipated.

b. avoid giving honey to a child younger than 1 year of age. c. add honey to infant foods as a good source of energy. d. use only unprocessed honey.

ANS: B

Honey should not be given to an infant younger than 1 year of age because botulism spores have been reported in honey and the immune capacity of the young infant cannot resist this infection.

DIF: Cognitive Level: Knowledge REF: p. 177 TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity: Physiological Adaptation 30. Effective strategies for weight management in children include a. regular physical activity. b. counting the calorie intake. c. eliminating snacks. d. eliminating fried foods.

ANS: A

Regular physical activity is a key strategy in maintaining a healthy weight in children along with varied and healthy food choices.

DIF: Cognitive Level: Application REF: p. 183 TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance

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Chapter 12: Nutrition for Adults: The Early, Middle, and Later Years Nix: Williams' Basic Nutrition and Diet Therapy, 15th Edition MULTIPLE CHOICE 1. John is a 34-year-old who is active in his community coaching football. He was also recently

promoted to a director-level position at his job. John is in a. young adulthood. b. young and middle adulthood. c. middle adulthood. d. older adulthood.

ANS: A

Young adulthood is between the ages of 20 and 44 years. Physical maturity and independence are apparent and include the ability to form new relationships, adopt new roles, and make many more choices regarding lifestyle.

DIF: Cognitive Level: Application REF: p. 189 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 2. A 42-year-old who makes his or her own decisions regarding whom to marry and what type of

family is desired is considered to be making a. independent choices. b. dependent choices. c. wealthy choices.

NURSINGTB.COM d. introspective choices.

ANS: A

Young adults between the ages of 20 and 44 years are independent in making choices regarding relationships, careers, jobs, marriage, and family.

DIF: Cognitive Level: Application REF: p. 189 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 3. Making a choice to lose weight and manage one’s cholesterol level is most likely to occur

during a. young adulthood. b. middle adulthood. c. school-age childhood. d. adolescence.

ANS: B

Wellness, health promotion, and reduction of disease risks are becoming the focus of health care for the middle adult years.

DIF: Cognitive Level: Application REF: p. 189 TOP: Nursing Process: Assessment | Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance

4. Effective strategies to delay the onset of type 2 diabetes include a. following a low-carbohydrate, high protein diet plan. b. taking a daily multivitamin, multimineral supplement. c. brisk walking with friends for 45 minutes most days during a lunch break. d. drinking at least 2 L water daily to maintain hydration.

ANS: C

Regular exercise would be the most effective strategy to delay the onset of type 2 diabetes because it increases glucose uptake by cells independent of insulin.

DIF: Cognitive Level: Application REF: pp. 196-197 TOP: Nursing Process: Diagnosis MSC: NCLEX: Physiological Integrity: Physiological Adaptation 5. Biologic processes associated with aging may cause a. an increased metabolic rate. b. increased anxiety. c. an increased ratio of adipose to muscle tissue. d. increased kidney function.

ANS: C

Physical findings associated with aging include an increased ratio of adipose to muscle tissue.

As the aging process occurs, skeletal muscle mass is reduced, causing a loss of approximately 40% by age 70 years. Skeletal muscle loss is not unavoidable; it can be lessened with exercise.

DIF: Cognitive Level: Application REF: p. 190 TOP: Nursing Process: Planning MSC: NCLEX: Physiological IntN egUriR tyS : PIhN ysGioTloBg. icC alO AM daptation | NCLEX: Health Promotion and Maintenance 6. Prescription and over-the-counter drugs can affect nutritional status because they a. may contain toxins. b. often result in addiction. c. usually contain nutrients. d. may affect appetite or absorption of nutrients.

ANS: D

Medication use can affect overall nutritional status because many drugs affect appetite or the absorption of nutrients.

DIF: Cognitive Level: Application REF: p. 197 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 7.

Energy requirements decrease as adult’s age because a. older adults have less stress than younger adults. b. younger adults are still growing; older adults are not. c. the height of adults decreases with age. d. the number of functioning body cells decreases with age.

ANS: D

Energy requirements decrease during the aging process because of the decrease in the number of functioning body cells and reduced physical activity.

DIF: Cognitive Level: Knowledge REF: p. 188 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 8. Each decade, basal energy needs decrease a. 0.5% to 1%. b. 1% to 2%. c. 2% to 4%. d. 5% to 8%.

ANS: B

Basal metabolic rate declines an average of 1% to 2% per decade of life.

DIF: Cognitive Level: Knowledge REF: p. 191 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 9. If an older adult is losing weight, his or her caloric intake is a. less than energy needs. b. approximately the same as energy needs. c. greater than energy needs. d. poorly distributed throughout the day.

ANS: A

Weight loss is associated with a caloric intake that is less than what is required for energy needs.

NURSINGTB.COM

DIF: Cognitive Level: Application REF: p. 191 TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity: Physiological Adaptation 10. The patient who would have the highest protein needs is a. a 36-year-old man who plays basketball. b. a 73-year-old man recovering from a broken hip after a fall. c. a 56-year-old woman who is trying to lose weight. d. a 48-year-old woman who is moderately active.

ANS: B

Protein needs increase during recovery from injury. Exercise has a much smaller effect on protein needs, and protein needs do not increase with weight loss.

DIF: Cognitive Level: Application REF: p. 191 TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 11. The number of calories per day supplied as carbohydrate for older adults who require 2000

kcal per day should be a. 450 to 650. b. 750 to 1250. c. 900 to 1300.

d. 1100 to 1450.

ANS: C

For the older adult, 45% to 65% of total energy intake should be supplied as carbohydrate, with the majority being mostly complex carbohydrates: 2000 kcal divided by 45% to 65% = 900 to 1300 calories per day.

DIF: Cognitive Level: Application REF: p. 191 TOP: Nursing Process: Assessment | Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 12. The older adult’s diet should include adequate carbohydrates to a. provide a substrate for vitamins and minerals. b. support normal brain function. c. provide building material for muscle mass. d. maintain blood glucose level.

ANS: B

The National Academy of Sciences has determined that an absolute minimum of 130 g/day of carbohydrates is necessary to maintain normal brain function in children and adults.

DIF: Cognitive Level: Knowledge REF: p. 191 TOP: Nursing Process: Assessment | Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance

NURSINGTB.COM

13. It may be advisable for an older adult to take a vitamin or mineral supplement a. daily. b. weekly. c. if he or she has been ill. d. if he or she is under stress.

ANS: C

Supplements often are recommended for persons in debilitated states or who have malabsorption.

DIF: Cognitive Level: Application REF: p. 192 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 14.

Contributing factors for osteoporosis include a. inadequate calcium and vitamin D intake. b. increased estrogen after menopause. c. excess weight. d. excess iron intake.

ANS: A

Contributing factors for osteoporosis include inadequate intakes of calcium and vitamin D, physical inactivity, smoking and alcohol use, a thin body frame, certain medical conditions, and medications.

DIF: Cognitive Level: Knowledge REF: p. 192 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 15. Physiologic problems of older adults include a. diarrhea. b. increased salivary secretions. c. decreased thirst and taste sensations. d. increased muscle tone.

ANS: C

As a person ages, a decrease in the thirst mechanism occurs that can lead to inadequate fluid intake and resultant dehydration. The older adult also experiences a decrease in taste, smell, and vision, which affect food intake.

DIF: Cognitive Level: Knowledge REF: pp. 193-194 TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity: Physiological Adaptation 16. An older adult is most likely to have an inadequate nutrient intake if he or she lives a. in a retirement community. b. with a spouse. c. alone. d. with family.

ANS: C

Inadequate nutrient intake is more apparent in elderly people who live alone compared with those who have a companion toNeUaR tw dB en.joCyOtM he food.

SiIthNaGnT DIF: Cognitive Level: Knowledge REF: p. 197 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 17. The Older Americans Act provides home-delivered meals for those who a. cannot afford food. b. prefer not to leave home. c. are ill or disabled. d. are malnourished.

ANS: C

The Older Americans Act provides services to the elderly that include congregate and home-delivered meals with related education and food-service components.

DIF: Cognitive Level: Application REF: pp. 197-198 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 18. The Older Americans Act provides funds for a. congregate and home-delivered meals. b. meals served at shelters and community centers. c. meals served at care facilities and hospices. d. meals for homeless older adults.

ANS: A

The Older Americans Act provides funds for congregate and home-delivered meals with related nutrition education and food-service components.

DIF: Cognitive Level: Knowledge REF: pp. 197-198 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 19. Congregate meals are most often served at a a. church. b. senior center. c. nursing home. d. hospital.

ANS: B

Congregate meals are served in senior centers and other public or private community facilities.

DIF: Cognitive Level: Knowledge REF: p. 200 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 20. The congregate meal for seniors is a. breakfast. b. the noon meal. c. the evening meal. d. decided by the center.

ANS: B

NURSINGTB.COM

The congregate meal is the noon meal.

DIF: Cognitive Level: Knowledge REF: p. 200 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 21. Factors that commonly contribute to malnutrition in older adults include a. type 2 diabetes and heart disease. b. the loss of teeth or poorly fitting dentures. c. a weight 10% above desirable standards. d. increased energy and nutrient needs.

ANS: B

Many factors contribute to malnutrition in the elderly, including inadequate food and nutrient intake because of ill-fitting or missing dentures.

DIF: Cognitive Level: Knowledge REF: pp. 194-195 TOP: Nursing Process: Assessment | Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 22. The protein needs of an older adult are influenced by the adequacy of a. fiber intake. b. caloric intake.

c. vitamin intake. d. mineral intake.

ANS: B

Adequate calorie intake is essential in the older adult to prevent calories from protein intake being used for energy needs.

DIF: Cognitive Level: Knowledge REF: p. 191 TOP: Nursing Process: Assessment | Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 23. Dehydration is more common in older adults than in younger adults because a. the kidneys excrete too much water. b. the thirst mechanism diminishes. c. the intracellular versus extracellular water balance is disturbed. d. more water needs to be ingested to maintain hydration.

ANS: B

As a person ages the thirst mechanism diminishes, which may result in inadequate fluid intake and dehydration.

DIF: Cognitive Level: Comprehension REF: pp. 195-196 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 24. Factors that influence the nutrition needs of young adults include a. growth. b. climate.

NURSINGTB.COM c. personality type. d. physical activity.

ANS: D

The nutrition needs of young adults are influenced by physical activity as well as other conditions such as pregnancy.

DIF: Cognitive Level: Knowledge REF: p. 196 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 25. Feeding older adults with sensitivity includes a. giving sufficient time to chew and swallow. b. serving only puréed foods. c. avoiding liquids with meals. d. serving bland foods.

ANS: A

Feeding older adults with sensitivity helps them achieve adequate intake. Allowing sufficient time to chew and swallow is important when feeding adults with sensitivity.

DIF: Cognitive Level: Knowledge REF: p. 195 TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance

26. The Mini Nutritional Assessment identifies a. emotional stability. b. nutritional risk. c. vitamin deficiency. d. social isolation.

ANS: B

The Mini Nutritional Assessment is designed to identify nutritional risk. It is a reliable tool and can detect the risk of malnutrition.

DIF: Cognitive Level: Knowledge REF: p. 194 TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 27. A major factor in weight control is a. physical activity. b. mineral supplementation. c. steroid use. d. adequate protein intake.

ANS: A

Physical activity is a major factor in weight management, and it can help prevent debilitating conditions of aging.

DIF: Cognitive Level: Knowledge REF: p. 196 TOP: Nursing Process: Assessment | Nursing Process: Planning NURSINGTB.COM MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 28. Examples of foods high in nutrients that help prevent osteoporosis are a. cottage cheese and oranges. b. yogurt and canned salmon. c. oatmeal and green leafy vegetables. d. broccoli and liver.

ANS: B

Foods high in calcium can help prevent osteoporosis. Foods such as yogurt and canned salmon are significant sources of calcium.

DIF: Cognitive Level: Application REF: p. 192 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 29. Older adults need more vitamin D than younger adults because they a. are less efficient at making their own. b. are in a state of positive calcium balance. c. excrete large amounts in their urine. d. require more dietary fat to absorb the vitamin efficiently.

ANS: A

As a person ages, the body becomes less efficient in making vitamin D and more may have to be provided in the diet through foods that have been fortified, including milk, milk products, breads, and margarines.

DIF: Cognitive Level: Knowledge REF: p. 193 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 30. For residents in long-term care facilities, the type of diet model recommended is a. most therapeutic. b. least restrictive. c. no sugar. d. low protein.

ANS: B

The least restrictive diet model is recommended since it is the most beneficial to the older adult.

DIF: Cognitive Level: Knowledge REF: p. 200 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation

Chapter 13: Community Food Supply and Health Nix: Williams' Basic Nutrition and Diet Therapy, 15th Edition MULTIPLE CHOICE 1. If a health practitioner were to travel around the world, the deficiency he or she is most likely

to encounter in populations overall is a. zinc deficiency. b. biotin deficiency. c. iron deficiency. d. ascorbic acid deficiency.

ANS: C

Iron-deficiency, protein-energy malnutrition, vitamin A deficiency, and iodine deficiency are the most common deficiencies in the world today.

DIF: Cognitive Level: Application REF: p. 223 TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 2. Farmers use pesticides to a. increase the shelf life of foods. b. control plant diseases. c. prevent food-borne disease. d. genetically modify crops.

NURSINGTB.COM

ANS: B

Pesticides are used to control plant diseases. Farmers use certain chemicals to control a wide variety of destructive insects that reduce crop yield.

DIF: Cognitive Level: Application REF: p. 207 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 3. Farming methods that use natural means of pest control without the use of synthetic pesticides

are called a. fossil fuel. b. genetically modified. c. organic. d. irradiated.

ANS: C

Organic farming methods use natural means of pest control and meet the standards set by the U.S. Department of Agriculture National Organic Program. Organic foods are grown without the use of synthetic pesticides or fertilizers, sewage sludge, or ionizing radiation.

DIF: Cognitive Level: Knowledge REF: p. 207 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance

4. Lead absorption is increased in children with a. malnutrition. b. iron deficiency. c. high sugar intakes. d. unsafe drinking water.

ANS: B

An iron deficiency increases lead absorption four- or fivefold, thus increasing the risk of lead toxicity.

DIF: Cognitive Level: Knowledge REF: p. 219 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 5. Children exposed to high levels of lead are most likely to experience a. mental deficits. b. heart problems. c. respiratory problems. d. kidney problems.

ANS: A

Children exposed to high levels of lead sustain permanent neurologic damage that can manifest itself in the form of mental deficits.

DIF: Cognitive Level: Application REF: p. 219 TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance

NURSINGTB.COM

6. Mercury poisoning is most often caused by eating a. raw seafood. b. improperly canned foods. c. fish from contaminated water. d. crops grown with pesticides.

ANS: C

Mercury poisoning is most often caused by eating fish from contaminated water. Methyl mercury is a toxin contaminating large bodies of water and the fish within that water.

DIF: Cognitive Level: Application REF: p. 222 TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 7. The main government agency responsible for food safety is the a. Centers for Disease Control and Prevention (CDC). b. U.S. Food and Drug Administration (FDA). c. U.S. Public Health Service (PHS). d. Federal Trade Commission (FTC).

ANS: B

The U.S. Food and Drug Administration is responsible for ensuring, among other things, that America’s food supply is safe, pure, and wholesome.

DIF: Cognitive Level: Knowledge REF: p. 202 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 8. A health claim approved by the U.S. Food and Drug Administration (FDA) is one that links a. fiber-rich foods and a reduced risk of heart disease. b. a diet low in sodium and the prevention of hypertension. c. zinc and wound healing. d. folate and a reduced risk of diabetes.

ANS: B

A diet low sodium and the prevention of hypertension is a health claim approved by the FDA. The FDA guidelines indicate that any health claim on a label must be supported by substantial scientific evidence.

DIF: Cognitive Level: Knowledge REF: p. 207 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 9. Leftovers placed in the refrigerator should be stored at or below a. 32° F. b. 40° F. c. 42° F. d. 45° F. ANS: B

NURSINGTB.COM

Home refrigerator temperatures should be maintained at 40° F or lower.

DIF: Cognitive Level: Application REF: p. 212 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 10. The overall effect of food additives on the nutritional value of foods is that they a. decrease nutritional value. b. sometimes increase nutritional value. c. have no effect on nutritional value. d. are legal only if they increase nutritional value.

ANS: B

Food additives can sometimes increase the nutritional value of foods along with helping to produce uniform qualities, standardizing many functional factors, preserving foods by preventing oxidation, and controlling acidity or alkalinity.

DIF: Cognitive Level: Application REF: p. 210 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 11. Hazard Analysis and Critical Control Point (HACCP) food safety systems a. include testing to ensure that food will not cause food-borne illness.

b. allow food safety inspectors to critique the food production process without

visiting the site. c. can be used only in restaurants and food-service facilities. d. help prevent food-borne illness by controlling specific aspects of food production.

ANS: D

HACCP is a food safety system that focuses on preventing food-borne illness by identifying critical points and eliminating hazards in the food production process.

DIF: Cognitive Level: Knowledge REF: p. 215 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 12. Bacterial food poisoning is caused by a. ingestion of toxic bacteria. b. toxins produced by bacteria in the intestines. c. toxins produced by bacteria in the bloodstream. d. ingestion of toxins produced by bacteria in the food before it is eaten.

ANS: D

Bacterial food poisoning is caused by the ingestion of bacterial toxins that have developed in the food through the growth of specific kinds of bacteria before the food is eaten.

DIF: Cognitive Level: Knowledge REF: p. 217 TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance

NURSINGTB.COM

13. The U.S. Food and Drug Administration enforces federal regulations pertaining to a. the use of pesticides. b. food prices. c. nutrition labeling. d. food subsidies.

ANS: C

Nutrition labeling regulations are enforced by the U.S. Food and Drug Administration.

DIF: Cognitive Level: Knowledge REF: pp. 203-204 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 14. The bacterial toxin that may contaminate improperly canned green beans is produced by a. Staphylococcus aureus. b. Salmonella typhi. c. Listeria monocytogenes. d. Clostridium botulinum.

ANS: D

Clostridium botulinum is an anaerobic (or nearly so) bacterial toxin. The relatively air-free can and use of inappropriate canning methods provide good conditions for toxin production.

DIF: Cognitive Level: Knowledge REF: p. 218 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and

Maintenance 15. Under the Commodity Supplemental Food Program, foods that are good sources of nutrients

that are often lacking in the diets of low-income populations are a. bought by the government to distribute to the needy. b. sold below market value in areas of poverty. c. sent to Third World countries. d. processed to make nonperishable food items.

ANS: A

Under the Commodity Supplemental Food Program, the U.S. Department of Agriculture purchases food items that are good sources of nutrients often lacking in the diets of target populations and then distributes the food to state agencies and tribal organizations.

DIF: Cognitive Level: Knowledge REF: p. 224 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 16. To prevent ingesting food-borne parasites that might be present in meat, an important strategy

is to a. thoroughly reheat leftovers. b. freeze the meat before cooking. c. cook the meat thoroughly before eating. d. store the meat in air-tight packaging.

ANS: C

Thorough cooking kills parasites in meats.

NURSINGTB.COM DIF: Cognitive Level: Application REF: p. 219 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 17. Under the Supplemental Nutrition Assistance Program (SNAP), food stamps are supposed to

supplement a household’s food needs for a. 1 week. b. 2 weeks. c. 1 month. d. 2 months.

ANS: C

Under the SNAP, the person or “household” is issued a debit card, or food stamps, which are supposed to supplement the household’s food needs for 1 month.

DIF: Cognitive Level: Knowledge REF: p. 224 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 18. Meals provided by the National School Lunch Program must provide a. a variety of foods from each food group throughout the week. b. about one-third of a child’s Recommended Dietary Allowance for key nutrients. c. meals familiar to key ethnic groups in each local school. d. free lunchtime meals for all students regardless of income.

ANS: B

Meals provided by the National School Lunch Program must provide approximately one-third of a child’s Recommended Dietary Allowance for protein, vitamin A, vitamin C, iron, calcium, and calories, and they must meet the recommendations found in the 2015–2020 Dietary Guidelines for Americans.

DIF: Cognitive Level: Knowledge REF: p. 225 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 19. The WIC program provides nutritious foods to a. low-income women with high-risk pregnancies and mothers with infants of birth

weight less than 4 lb. b. children between the ages of 2 and 5 from low-income families who are enrolled in a preschool program. c. all pregnant and postpartum women and their children younger than 5 years of age. d. low-income women who are pregnant and their children who are younger than 5 years of age.

ANS: D

The Women, Infants, and Children (WIC) food program provides nutrition supplementation, education, counseling, and referrals for health care and social services to women who are pregnant or who have recently given birth and to their infants and children younger than 5 years of age.

DIF: Cognitive Level: Knowledge REF: p. 225 TOP: Nursing Process: Planning MSC: NCLEX: Physiological IntN egUriR tyS : PIhN ysGioTloBg. icC alO AM daptation | NCLEX: Health Promotion and Maintenance 20. Nutrition programs established by the government for the elderly include a. the Share a Meal campaign. b. drive-through meals. c. a congregate meals program. d. the Nutrition Supplements Program.

ANS: C

Congregate meals programs are funded through the Nutrition Services Incentive Program.

DIF: Cognitive Level: Knowledge REF: p. 225 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 21. To increase shelf life, an example of a food that may be treated by irradiation is a. an apple. b. yogurt. c. a hotdog. d. milk.

ANS: A

Fresh produce such as apples may be irradiated to increase shelf life. Irradiation can kill bacteria and parasites on food after harvest.

DIF: Cognitive Level: Application REF: pp. 209-210 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 22. Standard information on the Nutrition Facts panel on a food label includes a. the serving size. b. cooking instructions. c. whether the product is kosher. d. total calories per container.

ANS: A

Food labels contain a Nutrition Facts panel that lists the amount of nutrients in a standard serving of food along with the calories from fat, percentage of daily values, number of calories per gram of fat, carbohydrates, and protein.

DIF: Cognitive Level: Application REF: p. 204 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 23. If a food label states the product is low in cholesterol, it must also be low in a. sodium. b. calories. c. saturated fat. d. total fat.

ANS: C

Foods described as low in cholN esU teRroSl I mNuG stTaB lso.C beOlM ow in saturated fat.

DIF: Cognitive Level: Application REF: p. 207 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 24. A microorganism that can live and grow without oxygen is called a. aerobic. b. anaerobic. c. antioxidant. d. antibiotic.

ANS: B

Anaerobic means that a microorganism can live and grow in an oxygen-free environment.

DIF: Cognitive Level: Knowledge REF: p. 219 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 25. Someone who has flu-like symptoms (severe diarrhea, fever, and headache) 2 days after

attending a catered event probably has a. influenza. b. a food-borne infection. c. bacterial food poisoning. d. heavy metal poisoning.

ANS: B

A food-borne infection presents with flu-like symptoms and is caused by the ingestion of food that is heavily contaminated with bacteria. Bacterial food poisoning usually causes symptoms within a few hours rather than 2 days later.

DIF: Cognitive Level: Application REF: p. 215 TOP: Nursing Process: Nursing Diagnosis MSC: NCLEX: Physiological Integrity: Physiological Adaptation 26. Most food-related hazards to consumers are caused by a. food-borne illness. b. overuse of additives. c. contamination of foods with pesticides. d. eating fish from contaminated water.

ANS: A

Most food-related hazards to consumers are caused by food-borne illness, which causes a high incidence of illness and death.

DIF: Cognitive Level: Application REF: p. 215 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 27. A food item that is a particularly effective carrier of staphylococcal food poisoning is a. potato salad. b. an apple. c. milk. d. rice.

NURSINGTB.COM ANS: A

Staphylococcal food poisoning often is caused by food handlers with infected cuts. Therefore foods that require handling during preparation, such as chopping potatoes, are more likely to be contaminated. Foods that are particularly effective carriers for staphylococci and their toxins include custard or cream-filled bakery goods, processed meats, ham, tongue, cheese, ice cream, potato salad, sauces, chicken and ham salads, and dishes in which multiple ingredients are mixed during preparation.

DIF: Cognitive Level: Application REF: p. 217 TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 28. A food item that may contain lecithin is a. baking soda. b. ice cream. c. baked potato. d. whole wheat bread.

ANS: B

Lecithin is a food additive that acts as an emulsifier in dairy products.

DIF: Cognitive Level: Application

REF: p. 212

TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 29. A possible cause of the spread of illness by food contaminated with Escherichia coli could be a. a mother who forgets to wash her hands after changing her infant’s diaper and then

cooks dinner. b. eating leftover restaurant food that has been stored in the refrigerator for 24 hours. c. using home-canned green beans to make a green bean casserole for a family meal. d. keeping a dish containing meat and vegetables warm on a restaurant steam table

for an hour.

ANS: A

Pathogenic Escherichia coli are most often spread through fecal contamination, undercooked meat, and unpasteurized foods.

DIF: Cognitive Level: Application REF: pp. 216-217 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 30. An example of a food covered by a Special Supplemental Nutrition Program for Women,

Infants, and Children (WIC) voucher would be a. crackers. b. fortified cereal. c. ice cream. d. sausage.

ANS: B

NURSINGTB.COM

Foods covered by the WIC vouchers include milk, eggs, cheese, juice, fortified cereals, fruits, and vegetables.

DIF: Cognitive Level: Application REF: p. 225 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance

Chapter 14: Food Habits and Cultural Patterns Nix: Williams' Basic Nutrition and Diet Therapy, 15th Edition MULTIPLE CHOICE 1. Food habits are least affected by a. news reports. b. economics. c. cultural factors. d. social customs.

ANS: A

Food habits are somewhat affected by news reports but to a lesser degree than are economics, cultural factors, and social customs. Food habits, like any other form of human behavior, develop from many personal, cultural, social, economic, and psychological influences.

DIF: Cognitive Level: Application REF: p. 229 MSC: NCLEX: Health Promotion and Maintenance

TOP: Nursing Process: Planning

2. An example of foods for which consumption has increased because of changing lifestyles and

family patterns are a. fast-food french fries. b. fresh apples and carrots. c. fresh mashed potatoes. d. homemade wheat breads.

ANS: A

NURSINGTB.COM

With the fast pace of life today, the convenience of french fries and other items from fast-food establishments have become a part of recent family eating patterns.

DIF: Cognitive Level: Application REF: p. 243 MSC: NCLEX: Health Promotion and Maintenance

TOP: Nursing Process: Planning

3. A new food or new advice about food is more readily accepted if it comes from a. a dietitian. b. a grocery clerk. c. a hairdresser. d. an advertiser.

ANS: C

Food habits are influenced by many factors, including social influences, economics, and psychological factors.

DIF: Cognitive Level: Application REF: p. 228 MSC: NCLEX: Health Promotion and Maintenance 4. In Mediterranean countries, the main cooking fat is a. olive oil. b. lard or shortening. c. peanut oil. d. butter.

TOP: Nursing Process: Planning

ANS: A

Mediterranean cooking includes predominantly olive oil.

DIF: Cognitive Level: Knowledge REF: p. 238 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 5. Of the following, the healthiest snack item would be a. whole-wheat crackers and hummus. b. ice cream topped with strawberries. c. pretzels with cheese dip. d. chicken nuggets with ranch dip.

ANS: A

A snack of whole-wheat crackers and hummus provides whole grain and vegetable protein and is relatively low in fat.

DIF: Cognitive Level: Application REF: p. 229 TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 6. A factor that contributes to the increasing prevalence of obesity is a. the expanding portion sizes at restaurants. b. an increased intake of fruits and vegetables. c. a lower sodium intake in snack foods. d. greater prevention of chronic disease.

NURSINGTB.COM

ANS: A

The expanding portion sizes common in many restaurants is closely linked to the expanding weight and waistlines found in the American population.

DIF: Cognitive Level: Application REF: p. 243 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 7. An example of acculturation for a person emigrating from China to the United States would

be a. b. c. d.

changing the diet staple from rice to bread. continuing to eat steamed rice with meals. giving up fresh fruits with meals. dressing in jeans occasionally.

ANS: A

Switching from rice to bread with meals would be a change in dietary intake to match the new culture. Emigration from one part of the world to another usually is accompanied by changes in dietary intake, lifestyle, and disease risk to match the new culture—a phenomenon known as acculturation.

DIF: Cognitive Level: Application REF: p. 230 TOP: Nursing Process: Implementation MSC: NCLEX: Health Promotion and Maintenance | NCLEX: Psychosocial Integrity

8. An example of a Cajun dish would be a. meatballs. b. jambalaya. c. chow mein. d. a burrito.

ANS: B

Jambalaya is a dish commonly found in the Cajun culture. It consists of red beans and rice, blackened catfish or red snapper, barbecued shrimp, breaded catfish with Creole sauce, and boiled crawfish.

DIF: Cognitive Level: Application REF: pp. 233-234 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity | NCLEX: Health Promotion and Maintenance 9. An eating style that includes a relatively high number of “eating occasions” is referred to as a. grazing. b. meals. c. episodes. d. snacking.

ANS: A

Eating many times throughout the day is a pattern recently termed grazing.

DIF: Cognitive Level: Knowledge REF: p. 243 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance

NURSINGTB.COM 10.1 Improved dietary quality and beneficial developmental assets are associated with 0 a. eating family meals. . b. women in the workplace. c. religious dietary laws. d. fast foods.

ANS: A

Although family meals have been shown to have an inverse relationship with high-risk behaviors among adolescents, improved dietary quality, and beneficial developmental assets, family mealtimes are on the decline.

DIF: Cognitive Level: Knowledge REF: p. 243 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance | NCLEX: Psychosocial Integrity 11. An example of a type of American household that is becoming more common would be a. a couple who are married. b. unrelated roommates living together. c. single-family households. d. traditional, nuclear families.

ANS: B

An increasing proportion of American households consist of unrelated people living together.

DIF: Cognitive Level: Application MSC: NCLEX: Psychosocial Integrity

REF: pp. 241-242

TOP: Nursing Process: Planning

12. An example of an Asian food item that is a good source of protein would be a. rice candy. b. tofu. c. broccoli stir-fry. d. buttermilk curd.

ANS: B

Tofu is a soybean curd used in Asian food patterns. It is a good source of protein in the diet.

DIF: Cognitive Level: Application REF: p. 234 TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 13. A factor that has the greatest influence on food habits is a. food availability. b. nutrition information. c. sedentary lifestyles. d. a decline in functional illiteracy.

ANS: A

Food availability, economics, and personal food meanings and beliefs are the primary factors influencing food habits.

DIF: Cognitive Level: Knowledge REF: p. 230 TOP: Nursing Process: Planning NURSINGTB.CO MSC: NCLEX: Health Promotion and Maintenance | NCLEX: Psychosocial Integrity 14. A factor that has the least effect on food habits is a. food availability. b. economics. c. health and nutrition. d. beliefs regarding food.

ANS: C

Food habits are influenced by such factors as food availability, economics, and beliefs regarding food, but not necessarily by which foods are good for health and nutrition.

DIF: Cognitive Level: Knowledge REF: p. 230 MSC: NCLEX: Health Promotion and Maintenance

TOP: Nursing Process: Planning

15. On special occasions and holidays, an Italian family that has immigrated to the United States

is most likely to serve a. chicken fried rice. b. chicken Parmesan. c. chicken enchiladas. d. chicken and dumplings.

ANS: B

An example of a traditional Italian meal served on special occasions and holidays is chicken Parmesan. Traditional foods are especially important during holidays and special occasions for people who have immigrated to the United States.

DIF: Cognitive Level: Application TOP: Nursing Process: Implementation

REF: p. 236 MSC: NCLEX: Psychosocial Integrity

16. A dish that is not allowed according to Jewish (kosher) food laws is a. bacon-wrapped dates. b. scrambled eggs with toast. c. beef and vegetable stew. d. grilled salmon with lemon.

ANS: A

According to Jewish dietary law, foods containing pork, such as bacon, are not to be eaten.

DIF: Cognitive Level: Application TOP: Nursing Process: Implementation

REF: p. 238 MSC: NCLEX: Psychosocial Integrity

17. When Muslims fast during the month of Ramadan a. only liquids are allowed for the entire month. b. hospitalized patients and pregnant women are exempt. c. nights are often spent in special feasts. d. only special foods are allowed during the day.

ANS: C

During Ramadan, Muslins observe daily fasting, taking no food or drink from dawn to sunset.

However, nights are spent in spNeU ciR alSfeIaN stG sT thB at.bCegOiM n with an appetizer followed by the family’s “evening breakfast.”

DIF: Cognitive Level: Knowledge REF: p. 240 MSC: NCLEX: Health Promotion and Maintenance

TOP: Nursing Process: Planning

18. An example of a vegetable common to a Puerto Rican food pattern is a. a papaya. b. sweet potatoes. c. a watermelon. d. yellow rice.

ANS: B

Sweet potatoes are a starchy vegetable common in the diet of individuals from Puerto Rico.

DIF: Cognitive Level: Application REF: pp. 230-231 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity | NCLEX: Health Promotion and Maintenance | NCLEX: Psychosocial Integrity 19. According to Jewish (kosher) food laws, an example of foods that must not be eaten together

would be a. chicken and noodles. b. cheese and crackers. c. a hamburger with cheese. d. scrambled eggs and milk.

ANS: C

According to Jewish (kosher) food laws, meat and milk products are not to be eaten at the same meal or prepared with the same utensils.

DIF: Cognitive Level: Application REF: p. 238 TOP: Nursing Process: Implementation MSC: NCLEX: Health Promotion and Maintenance | NCLEX: Psychosocial Integrity 20. Alcohol is strictly prohibited a. in the Jewish diet. b. in the Greek diet. c. in the traditional Southern diet. d. in the Muslim diet.

ANS: D

Alcohol is strictly prohibited under Muslim dietary laws.

DIF: Cognitive Level: Knowledge REF: p. 240 TOP: Nursing Process: Planning MSC: NCLEX: Health Promotion and Maintenance | NCLEX: Psychosocial Integrity 21. Cajun cuisine is especially popular in a. the southern United States. b. the western United States. c. Asian countries. d. Puerto Rico.

ANS: A

Cajun cuisine is especially popN ulU arRiS nI thN eG soTuB th.eC rnOUMnited States. The Cajun people, concentrated in the coastal waterways in southern Louisiana, have contributed a unique cuisine and food pattern to the American diet.

DIF: Cognitive Level: Knowledge REF: pp. 233-234 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 22. Current trends in eating habits in the United States include a. more meals and fewer snacks. b. fewer meals and more snacks. c. more home-cooked meals. d. more use of canned foods.

ANS: B

Americans are moving toward a concept of balanced days instead of balanced meals. They are increasing the number of times a day they eat, a pattern of “grazing” that incorporates fewer meals and more snacks.

DIF: Cognitive Level: Knowledge REF: p. 241 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity | NCLEX: Health Promotion and Maintenance | NCLEX: Psychosocial Integrity 23. Snacking is a. generally unhealthy for most people.

b. a way to provide missing nutrients if carefully planned. c. more expensive than eating only three meals per day. d. essential for achieving optimal dietary intake.

ANS: B

Well-planned snacks can help provide missing nutrients.

DIF: Cognitive Level: Application REF: p. 243 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 24. Soy sauce, ginger, almonds, and sesame seeds are basic seasonings for a. German b. Chinese c. Mexican d. Native American

_ food.

ANS: B

Chinese cooking involves various seasonings, including soy sauce, ginger, almonds, and sesame seeds.

DIF: Cognitive Level: Knowledge REF: p. 234 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 25. Food neophobia is fear of eating a. unfamiliar foods. b. foods in new situations.

NURSINGTB.COM c. undercooked meat. d. processed foods.

ANS: A

Food neophobia is the fear of eating unfamiliar foods.

DIF: Cognitive Level: Knowledge REF: pp. 228-229 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 26. According to Jewish dietary laws, a type of seafood that should be avoided is a. salmon. b. shrimp. c. orange roughy. d. trout.

ANS: B

Only fish with fins and scales are allowed according to Jewish dietary laws. Shellfish and crustaceans are not to be eaten.

DIF: Cognitive Level: Application REF: p. 238 TOP: Nursing Process: Implementation MSC: NCLEX: Health Promotion and Maintenance | NCLEX: Psychosocial Integrity

27. A Middle Eastern dish that is a salad made from soaked bulgur combined with chopped

tomatoes, parsley, mint, and green onion, and is mixed with olive oil and lemon juice is a. pita bread. b. kibbeh. c. falafel. d. tabouli.

ANS: D

Tabouli is a salad made from soaked bulgur combined with chopped tomatoes, parsley, mint, and green onion. It is mixed with olive oil and lemon juice. It is a representative food of Middle Eastern and Mediterranean food cultures.

DIF: Cognitive Level: Application REF: p. 240 TOP: Nursing Process: Implementation MSC: NCLEX: Health Promotion and Maintenance | NCLEX: Psychosocial Integrity 28. A staple food found in the Navajo diet is a. collard greens. b. apples. c. corn. d. trout.

ANS: C

The Navajos established corn as one of their staple crops.

DIF: Cognitive Level: Knowledge REF: p. 231 TOP: Nursing Process: Implementation MSC: NCLEX: Psychosocial InteNgU ritR yS |N ICNLGETXB: H .eCalOthMPromotion and Maintenance 29. A common vegetable found in many dishes popular in the Southern United States is a. cactus. b. artichoke. c. collard greens. d. eggplant.

ANS: C

Vegetables such as turnip greens, collard greens, mustard greens, and spinach are frequently used and cooked with bacon or salt pork.

DIF: Cognitive Level: Knowledge REF: p. 233 TOP: Nursing Process: Planning MSC: NCLEX: Health Promotion and Maintenance | NCLEX: Psychosocial Integrity 30. A food pattern for which tea is the main beverage is a. Jewish cuisine. b. Cajun cuisine. c. Middle Eastern cuisine. d. Japanese cuisine.

ANS: D

Tea is the characteristic beverage of Japanese cuisine.

DIF: Cognitive Level: Knowledge

REF: p. 234

TOP: Nursing Process: Planning

MSC: NCLEX: Health Promotion and Maintenance | NCLEX: Psychosocial Integrity

Chapter 15: Weight Management Nix: Williams' Basic Nutrition and Diet Therapy, 15th Edition MULTIPLE CHOICE 1. When energy intake exceeds energy expenditure, the result may be a. anorexia. b. malnutrition. c. obesity. d. hyperactivity.

ANS: C

If there is more energy intake as food rather than energy output as physical activity and basal metabolic needs, obesity may be the result.

DIF: Cognitive Level: Application REF: p. 245 TOP: Nursing Process: Diagnosis MSC: NCLEX: Physiological Integrity: Physiological Adaptation 2. The ideal weight for height for a person is 110 lb. If his or her current weight is 140 lb, then

he or she can be classified as a. slightly overweight. b. underweight. c. obese. d. extremely obese.

ANS: C

Obesity generally means body N wU eiR ghStIeN xcGeT edBs . idCeO alMbody weight for height by 20%. In this case, 140 lb is 27% above ideal weight (140 – 110/110%).

DIF: Cognitive Level: Application REF: p. 245 TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity: Physiological Adaptation 3. The most important factor in determining fatness or leanness is a. weight. b. height. c. body composition. d. diet.

ANS: C

Body composition, instead of absolute weight in pounds, provides a better evaluation of overall health relative to weight.

DIF: Cognitive Level: Knowledge REF: pp. 246-247 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 4. An example of an extreme weight-loss measure is a. setting realistic goals. b. aerobic exercise. c. behavior modification.

d. fasting.

ANS: D

Extreme practices to lose weight include fasting, fad diets, macronutrient restrictions, and clothing and body wraps.

DIF: Cognitive Level: Application REF: p. 256 TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity: Physiological Adaptation 5. The most precise method for determining body composition is a. skinfold calipers. b. body weight. c. underwater weighing. d. fitness testing.

ANS: C

Underwater, or hydrostatic, weighing is the most precise method for determining body composition.

DIF: Cognitive Level: Knowledge REF: pp. 246-247 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 6. It is difficult to define an ideal weight because a. body weight increases with age. b. men tend to weigh more than women do. c. body weight is largely deteN rmUiR neSdIbN yG geTnBet.icCs.OM d. a wide range of weights can be associated with good health.

ANS: D

Defining an ideal body weight is difficult because of the wide range of weights associated with good health.

DIF: Cognitive Level: Application REF: p. 249 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 7. The total body fat content that is associated with the lowest risk of chronic disease for women

is a. b. c. d.

7.0% to 15.8%.

14.5% to 22.0%.

12.0% to 25.8%.

32.2% to 36.9%.

ANS: D

For women, the ideal range of total body fat associated with the lowest risk of chronic disease is 32.2% to 36.9%.

DIF: Cognitive Level: Knowledge REF: p. 248 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance

8. A teenage girl who has a distorted body image and refuses to maintain a minimally acceptable

body weight should be evaluated for a. anorexia nervosa. b. bulimia nervosa. c. fasting. d. compulsive dieting.

ANS: A

The American Psychiatric Association has established criteria for the diagnosis of anorexia nervosa, including a disturbed view of body size or shape, refusal to maintain or gain the minimal body weight for age and height, intense fear of weight gain or becoming fat, and, for females, absence of at least three menstrual cycles.

DIF: Cognitive Level: Application REF: p. 268 TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 9. Health problems related to obesity include a. hypertension and lung disease. b. hypertension and diabetes. c. diabetes and arthritis. d. arthritis and asthma.

ANS: B

American adults who are overweight or obese increase their risk of conditions such as hypertension; type 2 diabetes; heart disease; sleep apnea; gastroesophageal reflux; degenerative joint disease; andNpU roRstS atI e,NbGreTaB st. , aCnO dM colon cancers.

DIF: Cognitive Level: Application REF: p. 250 TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 10. For men, the range of body fat percentage associated with the lowest risk of chronic disease is a. 7.0% to 15.8%. b. 14.5% to 22.0%. c. 21.0% to 25.8%. d. 32.2% to 36.9%.

ANS: C

A body fat content within the range of 21% to 25.8% of total body weight is associated with the lowest risk of chronic disease for men between the ages of 20 and 79 years.

DIF: Cognitive Level: Knowledge REF: p. 248 TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 11. The acceptable amount of total body weight provided by fat for a 120-lb woman is

approximately a. 8.4 to 15.0 lb.

b. 18.6 to 22.1 lb. c. 25.6 to 30.5 lb. d. 38.6 to 44.3 lb.

ANS: D

Total body fat content for women is between 32.2% and 36.9% of total body weight: 120 lb  32.2% = 38.64 lb and 120 lb  36.9% = 44.28 lb.

DIF: Cognitive Level: Application REF: p. 248 TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 12. Mary is a 32-year-old woman who admits to repeated episodes of eating large quantities of

food at one sitting, including two boxes of cookies, a family-size bag of chips, six candy bars, and even more at times. She then vomits to rid her body of the food. This would be an example of a. anorexia nervosa. b. bulimia nervosa. c. fasting. d. compulsive overeating.

ANS: B

Bulimia nervosa is an eating disorder involving repeated episodes of binge eating followed by a compensatory mechanism to rid the body of excess calories.

DIF: Cognitive Level: Application REF: p. 269 TOP: Nursing Process: AssessmN enU t RSINGTB.COM MSC: NCLEX: Physiological Integrity: Physiological Adaptation 13. A 2-lb increase in fat is the kilocalorie equivalent of a. 1000 kcal. b. 3000 kcal. c. 3500 kcal. d. 7000 kcal.

ANS: D

One pound of fat is the kilocalorie equivalent of 3500 kcal, so 2 lb would be equivalent to 7000 kcal.

DIF: Cognitive Level: Application REF: p. 263 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 14. The most significant contributing factor to the increase in obesity in the United States is a. excessive alcohol intake. b. excessive sugar intake. c. lack of exercise. d. lack of concern about weight control.

ANS: C

Lack of exercise is a major contributing factor to the increase in obesity in the United States.

DIF: Cognitive Level: Analysis REF: p. 250 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 15. An effective method for weight reduction includes a. fasting. b. limiting food groups. c. the drug phenylpropylamine. d. behavior modification.

ANS: D

Behavior modification is an effective method of weight reduction designed to help change patterns that contribute to excessive weight gain such as excess food intake and lack of exercise.

DIF: Cognitive Level: Application REF: p. 258 TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 16. Surgical techniques used for weight reduction are a. expensive and not very helpful. b. the only alternative for extreme obesity. c. associated with significant risks. d. not effective.

ANS: C

Significant risks are associatedNURSINGTB.COM with surgical techniques for weight reduction, along with other problems and side effects. The inherent risk of surgery and postsurgery malnutrition are critical issues that should be thoroughly addressed with the patient.

DIF: Cognitive Level: Knowledge REF: pp. 257-258 TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 17. In all probability, the most significant factor in the development of obesity is a. genetics and family food patterns. b. psychologic influences. c. social influences. d. physiologic influences.

ANS: A

Genetics and family food patterns play a significant factor in the development of obesity.

Family food patterns can provide an environment that allows the genetic trait to present itself.

DIF: Cognitive Level: Knowledge REF: p. 252 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 18. If a child has obese parents, the likelihood of the child also being obese is a. no different from that of any other child.

b. very great. c. very low. d. dependent on other environmental factors.

ANS: B

Genetic factors have a major influence on obesity. However, a genetic influence is not the determining factor. The daily life, environment, and habits the person chooses influence the expression of this genetic trait.

DIF: Cognitive Level: Application REF: p. 264 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 19. Expression of genetic factors a. determines an individual’s body weight. b. influences an individual’s chance of becoming overweight. c. cannot be overcome by diet and exercise habits. d. is solely responsible for similarities in body weight within families.

ANS: B

The expression of genetic factors influences an individual’s chance of becoming overweight.

However, a genetic influence is not the determining factor. The daily life, environment, and habits chosen influence the expression of this genetic trait.

DIF: Cognitive Level: Knowledge REF: pp. 250-251 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance

NURSINGTB.COM 20.2 The most important key to a successful weight-loss program is 0 a. personal motivation. . b. exercise. c. dietary restriction. d. a good nutrition counselor.

ANS: A

For a weight-loss program to be successful, personal motivation is a key factor to obtain the desired results.

DIF: Cognitive Level: Knowledge REF: p. 258 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 21. Food behaviors of value in a weight-reduction program include a. eating quickly. b. choosing small portions. c. eating while doing other activities. d. skipping meals.

ANS: B

Choosing small portions is a food behavior of great value in a weight-reduction program.

DIF: Cognitive Level: Application TOP: Nursing Process: Implementation

REF: p. 259

MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance | NCLEX: Psychological Integrity 22. To lose 2 lb over a 2-week period, caloric intake would need to be reduced by a. 150 kcal/day. b. 300 kcal/day. c. 350 kcal/day. d. 500 kcal/day.

ANS: D

Rationale: Loss of 2 lb is equivalent to 7000 kcal. Over 14 days, this would mean a decrease of 500 kcal/day.

DIF: Cognitive Level: Application REF: p. 263 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 23. Clinical or extreme obesity is defined as a body mass index (BMI) of a. >40. b. >35. c. 30 to 39. d. 25 to 34.

ANS: B

A person is considered clinically or extremely obese if they have a BMI >35.

DIF: Cognitive Level: Knowledge REF: p. 247 TOP: Nursing Process: Planning MSC: NCLEX: Physiological IntN egUriR tyS : PIhN ysGioTloBg. icC alO AM daptation | NCLEX: Health Promotion and Maintenance 24. Very fit adults are likely to have a body mass index (BMI) that is a. slightly lower than is associated the lowest risk of chronic disease. b. slightly higher than is associated the lowest risk of chronic disease. c. about the same as is associated the lowest risk of chronic disease. d. much higher than is associated the lowest risk of chronic disease.

ANS: A

Body fat ranges associated with fitness are slightly lower than those associated with a healthy BMI and chronic disease prevention.

DIF: Cognitive Level: Knowledge REF: pp. 246-247 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 25. A hormone that seems to control eating behavior and fat storage is a. insulin. b. thyroxine. c. leptin. d. growth hormone.

ANS: C

Leptin is a hormone that seems to control eating behavior and fat storage. The obesity gene encodes for a hormone-like protein believed to play a role in determining a person’s set point for fat storage.

DIF: Cognitive Level: Knowledge REF: p. 250 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 26. Dangers associated with the use of very low calorie diets include a. dehydration. b. a decreased metabolic rate. c. sleep disorders. d. hyperactivity.

ANS: B

Very low calorie diets can cause semistarvation, which causes acidosis, low blood pressure, electrolyte loss, tissue protein loss, and decreased basal metabolic rate.

DIF: Cognitive Level: Application REF: p. 256 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 27. Body wraps result in a loss of a. muscle tissue. b. cellulite. c. body fat. d. water.

ANS: D

NURSINGTB.COM

Body wraps result in the loss of body water. Special “sauna suits” or body wrapping claim to help weight loss in certain spots of the body or clear up so-called cellulite tissue. (The term cellulite is not a scientific term.) The resulting small weight loss is caused by temporary water loss.

DIF: Cognitive Level: Knowledge REF: p. 256 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 28. The rate of weight loss in moderately overweight adults should average a. 0.5 to 1 lb/week. b. 1.5 to 2 lb/week. c. 2 to 4 lb/week. d. 3 to 6 lb/week.

ANS: A

The safe rate of weight loss for moderately overweight adults is an average of 0.5 to 1 lb/week.

DIF: Cognitive Level: Knowledge REF: p. 258 TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance

29. Problems associated with bulimia nervosa include a. dry skin. b. breathing difficulties. c. abnormal hair growth. d. erosion of dental enamel.

ANS: D

Erosion of dental enamel is a result of stomach acid coating the teeth while vomiting.

Additional oral problems include oral mucosal irritation, decreased salivary secretions, and a dry mouth.

DIF: Cognitive Level: Knowledge REF: p. 269 TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Psychological Integrity 30. A sound food plan for weight loss contains a. very little fat content. b. very little carbohydrates. c. more protein than carbohydrates. d. a balance of macronutrients.

ANS: D

A sound food plan for weight loss contains a balance of macronutrients along with realistic goals, adequate nutrition and kilocalories, and cultural appeal.

DIF: Cognitive Level: Knowledge REF: pp. 258-259 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance NURSINGTB.COM 31. The hormone that tends to have the opposite effect to leptin is a. ghrelin. b. secretin. c. insulin. d. peptidase.

ANS: A

The counterpart to leptin is the enteric peptide ghrelin. Ghrelin is an appetite stimulant secreted from the stomach to activate the appetite-regulating network.

DIF: Cognitive Level: Knowledge REF: p. 250 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation

Chapter 16: Nutrition and Physical Fitness Nix: Williams' Basic Nutrition and Diet Therapy, 15th Edition MULTIPLE CHOICE 1. The body’s carbohydrate energy reserve consists of a. glucose and fructose. b. sugar and starch. c. glucose and glycogen. d. glycogen and fatty acids.

ANS: C

Glucose circulating in the blood and glycogen stores in the muscle cells and liver provide the body’s carbohydrate energy reserve.

DIF: Cognitive Level: Knowledge REF: p. 279 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 2. An athlete who has been using anabolic steroids may be at risk for a. hepatitis. b. diabetes. c. hypertension. d. osteoporosis.

ANS: A

Use of anabolic steroids may cause masculinization, gynecomastia, liver abnormalities including hepatitis, atherosclerN osU isR , aStI roN phGyToBf . thCeOteMsticles and decreased sperm production, mood swings, and depression.

DIF: Cognitive Level: Knowledge REF: p. 287 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 3. If an athlete exercises for a prolonged time, the muscles become a. atrophied. b. fatigued. c. cramped. d. limp.

ANS: B

With prolonged exercise, the muscles become fatigued. The nutrient reserves become depleted during continuous exercise; the body burns its fuel stores to meet increasing energy demands and requires replenishing. With prolonged exercise, nutrient levels fall too low to sustain the body’s continued demands. Fatigue follows, and exhaustion may result.

DIF: Cognitive Level: Application REF: p. 283 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 4. The fuel source for short-term energy needs is a. glycogen. b. fatty acids. c. fructose.

d. amino acids.

ANS: A

The source for short-term energy needs is glycogen stored in muscle cells and the liver.

DIF: Cognitive Level: Knowledge REF: p. 284 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 5. The most appropriate pregame meal for an athlete would be a. pasta with cream sauce and apple juice. b. cheese and fruit. c. cereal with skim milk and orange juice. d. a bagel with cream cheese and water.

ANS: C

A pregame meal consisting of a bowl of cereal with skim milk and a small glass of orange juice would provide high complex carbohydrates, very little fat, moderate protein, moderate fiber, and approximately 300 kcal.

DIF: Cognitive Level: Application REF: p. 284 TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity: Physiological Adaptation 6. Long-term energy needs are provided by a. glucose and fatty acids. b. glycogen and fatty acids. c. ascorbic acid and fatty acids. d. glycogen and amino acids. NURSINGTB.COM ANS: A

Long-term energy needs are provided by glucose and fatty acids. Fatty acids serve as a fuel source from stored fat tissue. Some glucose is always needed as a fuel source.

DIF: Cognitive Level: Knowledge REF: p. 285 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 7. For the body to maintain a high level of steady exercise, a. there must be ample fat stores. b. there must be sufficient oxygen available to the cells. c. a constant supply of dietary carbohydrate is needed. d. the energy expenditure must decrease.

ANS: B

Sufficient oxygen must be available to cells to maintain a high level of steady exercise. The aerobic capacity depends on two basic factors: (1) the fitness of the lungs, heart, and blood vessels and (2) body composition.

DIF: Cognitive Level: Knowledge REF: p. 279 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 8. To prepare for an athletic event of high endurance, the proper glycogen-loading process is a. intensive workouts and very high intake of complex carbohydrates.

b. intensive workouts 2 to 3 times a day and high intake of simple carbohydrates. c. gradually reducing the duration and intensity of workouts and increasing

carbohydrate intake. d. gradually reducing the duration and intensity of workouts and decreasing

carbohydrate intake.

ANS: C

The current practice of glycogen or carbohydrate loading involves a moderate, gradual tapering of exercise while total carbohydrate intake in the diet is increased.

DIF: Cognitive Level: Application REF: p. 284 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 9.

Dehydration is least affected by the surrounding temperature. body fat content. the level of fitness. the pregame or preexercise state of hydration.

a. b. c. d.

ANS: B

Fluid needs depend on the intensity and duration of exercise, surrounding temperature, altitude, humidity, level of fitness, and the pregame state of hydration. It is not affected by body fat content per se.

DIF: Cognitive Level: Knowledge REF: p. 280 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 10. The effect of exercise on bloodNliUpR opSrI otN eiG nT leB ve.lC s iOs M to a. decrease low-density lipoproteins (LDLs) and decrease high-density lipoproteins

(HDLs). b. increase LDLs and increase HDLs. c. increase LDLs and decrease HDLs. d. decrease LDLs and increase HDLs. ANS: D

Exercise raises blood levels of HDLs because HDL carries surplus cholesterol from the tissues to the liver for breakdown and removal from the body. At the same time the surplus is removed, LDL levels decrease.

DIF: Cognitive Level: Knowledge REF: p. 274 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 11. Aerobic capacity is related to a. fitness of the heart and lungs. b. hydration status. c. hormone levels. d. environmental temperature and humidity.

ANS: A

Aerobic capacity depends on the fitness of the lungs, heart, and blood vessels as well as body composition.

DIF: Cognitive Level: Knowledge REF: pp. 273-274 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 12. The maximal attainable heart rate for a 30-year-old is a. 145 beats/min. b. 165 beats/min. c. 180 beats/min. d. 190 beats/min.

ANS: D

Rationale: The maximal attainable heart rate is calculated as 220 – age. In this case 220 – 30 = 190.

DIF: Cognitive Level: Application REF: p. 279 TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity: Physiological Adaptation 13. Aerobic capacity is expressed in terms of the amount of a. water absorbed per kilogram of body weight per minute. b. oxygen consumed per kilogram of body weight per minute. c. oxygen consumed per pound of body weight per minute. d. carbon dioxide produced per kilogram of body weight per minute.

ANS: B

Aerobic capacity is expressed in terms of the amount of oxygen consumed per kilogram of body weight per minute. It depends on the fitness of the lungs, heart, and blood vessels as well as body composition.

NURSINGTB.COM DIF: Cognitive Level: Knowledge REF: p. 279 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 14. A lower proportion of lean body mass to fat is associated with a. a lower fitness level. b. a greater fitness level. c. no effect on fitness level. d. a gradual decline in fitness level.

ANS: A

A lower fitness level is associated with a lower proportion of lean body mass to fat. Body tissues that are metabolically active comprise the lean body mass, which is mainly muscle mass.

DIF: Cognitive Level: Comprehension REF: p. 319 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 15. The calories supplied by fat for an athletic person who requires 2200 kcal/day should be a. 220 to 440 kcal. b. 330 to 660 kcal. c. 440 to 770 kcal. d. 550 to 880 kcal.

ANS: C

The percentage of total daily calories supplied from fat should not be less than 20% or greater than 35%. Thus, 2200 kcal  0.20 = 440 kcal; 2200 kcal  0.35 = 770 kcal.

DIF: Cognitive Level: Application REF: p. 284 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 16. A food that would provide significant support during exercise is a. lean beef. b. ice cream. c. oatmeal. d. spinach.

ANS: C

A major nutrient for energy support during exercise is a carbohydrate, and oatmeal is a good source of carbohydrates.

DIF: Cognitive Level: Application REF: p. 284 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 17. During general training, the carbohydrate needs of an athlete who weighs 70 kg would be

about a. 140 to 280 g/day. b. 210 to 350 g/day. c. 280 to 420 g/day. d. 350 to 490 g/day.

ANS: D

NURSINGTB.COM

During general training, athletes usually need 5 to 7 g of carbohydrates per kilogram body weight per day. Thus, 70 kg  5 = 350 g; 70 kg  7 = 490 g; needs are 350 to 490 g/day.

DIF: Cognitive Level: Application REF: pp. 283-284 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 18. Vitamins and minerals are important in energy production because a. they supply a necessary energy source. b. they speed up energy production. c. more are needed during exercise. d. they are needed as cofactors in enzyme reactions.

ANS: D

Vitamins and minerals are important in energy production as cofactors in enzyme reactions.

Increased exercise does not require increased vitamins and minerals.

DIF: Cognitive Level: Comprehension REF: p. 281 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 19. An example of a meal that could help maximize performance if eaten before athletic

competition is

a. b. c. d.

a cheeseburger with french fries. grilled chicken, french fries, and cola. whole grain pasta with tomatoes and spinach. fried chicken breast, onion rings, and lemonade.

ANS: C

A meal before an athletic competition should be low fat, low protein, and high complex carbohydrate and consist of approximately 300 kcal. The whole grain pasta with tomatoes and spinach would provide this type of meal.

DIF: Cognitive Level: Application REF: p. 284 TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity: Physiological Adaptation 20. The most beneficial rehydration fluid for most types of exercise lasting 1 hour or less is a. water fortified with electrolytes and vitamins. b. water with a small amount each of honey, lemon, and salt. c. a prepared or commercial solution with electrolytes and glucose polymers. d. water with nothing added.

ANS: D

Water is the most beneficial fluid for rehydration for most types of exercise.

DIF: Cognitive Level: Application REF: p. 280 TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity: Physiological Adaptation 21. For older adults, it is importantNth UaRt SINGTB.COM a. they perform 150 minutes of high-intensity exercise every week. b. those between the ages of 65 and 75 be active at least 3 times per week. c. they be as physically active during the week as their condition and abilities allow. d. all of them perform aerobic exercise 60 minutes each day of the week.

ANS: C

Older adult guidelines follow Healthy People 2020 physical activity recommendations unless they cannot perform 150 minutes of moderate-intensity aerobic activity every week. If they cannot exercise at this intensity or for this amount of time, they should be as physically active as their abilities and condition allow.

DIF: Cognitive Level: Knowledge REF: p. 273 TOP: Nursing Process: Intervention MSC: NCLEX: Physiological Integrity: Physiological Adaptation 22. The behavior change that would be the most beneficial for a sedentary adult with diabetes

would be a. playing golf 3 times a week using a golf cart. b. a personalized walking program most days of the week. c. limiting fast food meals to once a week. d. bicycling 50 miles every weekend.

ANS: B

A carefully planned, moderate exercise routine can increase the number of insulin receptor sites on cell membranes and is therefore beneficial for persons with diabetes.

DIF: Cognitive Level: Application REF: p. 278 TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 23. The feeling of well-being after a vigorous workout may be from the production of a. heat. b. muscle. c. endorphins. d. adrenaline.

ANS: C

Exercise stimulates the production of brain opiates, substances called endorphins. These natural chemicals decrease pain and improve mood, which may include an exhilarating kind of “high.”

DIF: Cognitive Level: Knowledge REF: p. 277 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance | NCLEX: Psychosocial Integrity 24. An athlete is planning to eat a light meal of pasta with vegetables, fruit, and yogurt before a

competitive event which begins at 2:00 PM. The athlete should eat the meal between a. 1:00 PM and 1:30 PM. b. noon and 1:00 PM. c. 11:00 AM and noon.

NURSINGTB.COM d. 10:00 AM and 11:00 AM. ANS: D

An athlete should consume a light meal 3 to 4 hours before a competitive event, i.e. between 10:00 AM and 11:00 AM for an event that begins at 2:00 PM. This schedule gives the body time to digest, absorb, and transform the meal and to store glycogen.

DIF: Cognitive Level: Application REF: pp. 282-283 TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Physiological Integrity: Reduction of Risk Potential 25. Some fat in the diet is required to provide a. essential fatty acids. b. sufficient energy for all activities. c. cholesterol for hormone production. d. adequate body fat stores.

ANS: A

Some fat in the diet is needed to provide essential fatty acids for the body to function properly.

DIF: Cognitive Level: Knowledge REF: p. 284 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation

26. An important question for a health provider to ask when evaluating the diet of a female

adolescent athlete is a. if she experiences leg cramps at night. b. if she experiences headaches after workouts. c. whether she has regular menstrual periods. d. whether she cross-trains with different kinds of exercise.

ANS: C

It is important to ask female adolescent athletes whether they have regular menstrual periods.

If not, she may have inadequate energy intake and may be at risk for low bone mineral density and osteoporosis due to inadequate dietary intakes and low estrogen levels.

DIF: Cognitive Level: Application REF: p. 283 TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 27.

Before running three miles, an athlete should a. take a 5-minute shower to prevent fatigue. b. perform 25 push-ups for muscle strength. c. eat a high-protein, high-fat meal for energy. d. warm up slowly with moderate exercise.

ANS: D

Warming up the muscles before exercise is important to prevent stress or injury to the body.

Time to cool down afterward also is necessary.

NURSINGTB.COM DIF: Cognitive Level: Application REF: p. 279 TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Physiological Integrity: Reduction of Risk Potential 28. An appropriate amount of exercise for a 12-year-old would be a. up to 30 minutes of enjoyable activity per day. b. at least 20 minutes of physical activity per day. c. at least 60 minutes of physical activity per day. d. 1 to 2 hours of physical activity at least twice a week.

ANS: C

Children and adolescents should engage in 60 minutes (1 hour) or more of physical activity per day.

DIF: Cognitive Level: Knowledge REF: p. 272 TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 29. Exercise can be an effective nonpharmacologic treatment for a. anorexia nervosa. b. cirrhosis of the liver. c. extreme obesity.

d. stage 1 hypertension.

ANS: D

Exercise is an effective nondrug treatment for hypertension. Exercise often needs to be moderated for individuals with anorexia nervosa who may exercise too much. Exercise does not affect liver function. Individuals with extreme obesity may be unable to safely begin an exercise program without first restricting energy intake for some initial weight loss.

DIF: Cognitive Level: Application REF: p. 275 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Physiological Integrity: Reduction of Risk Potential 30. If a young adult wants to maximize his or her bone density, a type of exercise that may be

helpful is a. swimming. b. cycling. c. running. d. yoga.

ANS: C

Weight bearing exercise, such as running, increases osteoblast activity and helps increase bone density.

DIF: Cognitive Level: Application REF: p. 277 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance

Chapter 17: Nutrition Care Nix: Williams' Basic Nutrition and Diet Therapy, 15th Edition MULTIPLE CHOICE 1. 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.

DIF: Cognitive Level: Knowledge REF: p. 289 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 2. 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

NURSINGTB.COM

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

DIF: Cognitive Level: Knowledge REF: p. 289 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 3. 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.

DIF: Cognitive Level: Knowledge REF: p. 291 TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity: Physiological Adaptation 4. 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.

DIF: Cognitive Level: Knowledge REF: p. 293 TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity: Physiological Adaptation 5. 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.

DIF: Cognitive Level: Knowledge REF: p. 295 TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity: Physiological Adaptation 6. A laboratory test that indicates immune function is the a. serum albumin. b. serum transferrin. c. hematocrit.

NURSINGTB.COM d. lymphocyte count.

ANS: D

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

DIF: Cognitive Level: Knowledge REF: p. 295 TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity: Physiological Adaptation 7. 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.

DIF: Cognitive Level: Knowledge REF: p. 295 TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity: Physiological Adaptation 8. 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.

DIF: Cognitive Level: Knowledge REF: p. 294 TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity: Physiological Adaptation 9. 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.

DIF: Cognitive Level: Knowledge REF: p. 296 TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity: Physiological Adaptation 10. 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.

NURSINGTB.COM

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.

DIF: Cognitive Level: Knowledge REF: p. 291 TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity: Physiological Adaptation 11. 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.

DIF: Cognitive Level: Knowledge TOP: Nursing Process: Assessment

REF: p. 291

MSC: NCLEX: Physiological Integrity: Physiological Adaptation 12. 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.

DIF: Cognitive Level: Knowledge REF: p. 291 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 13. 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.

DIF: Cognitive Level: Knowledge REF: p. 298 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 14. An example of an oral diet that has been modified is a. a low-residue diet.

NURSINGTB.COM 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.

DIF: Cognitive Level: Knowledge REF: p. 298 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 15. 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.

DIF: Cognitive Level: Knowledge REF: pp. 298-299 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation

16. 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.

DIF: Cognitive Level: Application REF: p. 299 TOP: Nursing Process: Assessment | Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 17. 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 N prUaR ctS itiI onNeGr.TB.COM DIF: Cognitive Level: Application REF: pp. 298-299 TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 18. 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.

DIF: Cognitive Level: Knowledge REF: p. 297 TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 19. 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.

DIF: Cognitive Level: Application REF: pp. 300-301 TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 20. 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.

DIF: Cognitive Level: Application REF: p. 301 TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity: Physiological Adaptation 21.

Hypogeusia may suggest NURSINGTB.COM 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.

DIF: Cognitive Level: Knowledge REF: p. 296 TOP: Nursing Process: Diagnosis MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 22. 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.

DIF: Cognitive Level: Application REF: p. 297 TOP: Nursing Process: Nursing Diagnosis

MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 23. 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.

DIF: Cognitive Level: Knowledge REF: p. 294 TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Physiological Integrity: Reduction of Risk Potential 24. 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 vNaU riR ouSsIbN odGyTsB it. esC . OM DIF: Cognitive Level: Application REF: p. 295 TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity: Physiological Adaptation 25. 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.

DIF: Cognitive Level: Knowledge REF: p. 298 TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity: Physiological Adaptation 26. 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.

DIF: Cognitive Level: Application REF: p. 297 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 27. 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.

DIF: Cognitive Level: Knowledge REF: pp. 299-300 TOP: Nursing Process: Planning | Nursing Process: Evaluation MSC: NCLEX: Physiological Integrity: Physiological Adaptation 28. A food that contains furanocouN mUarRinStIhN atGcT anBi. ntC erOacMt 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.

DIF: Cognitive Level: Knowledge REF: p. 301 TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity: Physiological Adaptation 29. 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.

DIF: Cognitive Level: Knowledge REF: p. 297 TOP: Nursing Process: Diagnosis MSC: NCLEX: Physiological Integrity: Physiological Adaptation

30. 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.

DIF: Cognitive Level: Application REF: p. 295 TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity: Physiological Adaptation

NURSINGTB.COM

Chapter 18: Gastrointestinal and Accessory Organ Problems Nix: Williams' Basic Nutrition and Diet Therapy, 15th Edition MULTIPLE CHOICE 1. The lower esophageal sphincter muscle controls entry of food into the a. esophagus. b. stomach. c. small intestine. d. rectum.

ANS: B

The lower esophageal sphincter muscle controls entry of food into the stomach.

DIF: Cognitive Level: Knowledge REF: p. 307 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 2. The term used to describe difficulty in swallowing is a. pyrosis. b. polydipsia. c. dysphagia. d. dyspepsia.

ANS: C

Dysphagia means difficulty swallowing.

DIF: Cognitive Level: KnowledN geURSINR TOP: Nursing Process: Planning GETFB: .pC. 3O0M6 MSC: NCLEX: Physiological Integrity: Physiological Adaptation 3. Many people who have gastroesophageal reflux are a. underweight. b. obese. c. male. d. children.

ANS: B

Gastrointestinal reflux is more common in people who are obese or pregnant or who have pernicious vomiting or nasogastric tubes.

DIF: Cognitive Level: Knowledge REF: pp. 307-308 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 4. If a resident who has Parkinson’s disease and resides in a long-term care facility has recurring

pneumonia and coughs while eating, this may be evidence of a. dysphasia. b. dysphagia. c. achalasia. d. dyspnea.

ANS: B

Dysphagia can cause persons to aspirate food particles, sometimes without evidence of coughing or choking. Aspiration of food contents into the lung causes pneumonia and other serious problems.

DIF: Cognitive Level: Application REF: p. 307 TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity: Physiological Adaptation 5. Small outpouchings in the lower gastrointestinal tract are called a. hernias. b. lesions. c. diverticula. d. epiploic appendages.

ANS: C

The small outpouchings that can develop in the lower intestine are called diverticula.

DIF: Cognitive Level: Knowledge REF: p. 317 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 6. An eroded mucosal area in the central portion of the gastrointestinal tract describes a a. hiatal hernia. b. diverticulum. c. peptic ulcer. d. Crohn’s lesion.

ANS: C

A peptic ulcer is an eroded mucNoUsaRl S arIeN a iGnTthBe.cC enOtrMal portion of the gastrointestinal tract.

DIF: Cognitive Level: Knowledge REF: p. 309 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 7. Most ulcers occur in the a. esophagus. b. stomach. c. duodenal bulb. d. ileum.

ANS: C

Most ulcers occur in the duodenal bulb.

DIF: Cognitive Level: Knowledge REF: p. 309 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 8. A food that should be omitted from the diet of a patient with peptic ulcer disease is a. black pepper. b. apple juice. c. milk. d. popcorn.

ANS: A

Current diet therapy is based on individual response to foods, but a few foods have been shown to affect acid secretion such as black pepper, hot chili peppers, and chili powder. Other food items that stimulate acid secretion are coffee, chocolate, and alcohol.

DIF: Cognitive Level: Knowledge REF: p. 312 TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 9. General nutrition guidelines for a patient with a peptic ulcer center around eating a a. well-balanced diet as tolerated, rich in antioxidants. b. high-protein, low-fiber diet with no seasonings. c. high-protein diet and regularly scheduled meals. d. low-fiber diet with no seasonings and no milk or cream.

ANS: A

A patient with a peptic ulcer should eat a general, well-balanced diet as tolerated, rich in antioxidants to help restore gastrointestinal well-being.

DIF: Cognitive Level: Application REF: pp. 311-312 TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 10. Patients with irritable bowel syndrome may benefit from regular use of a. antioxidant-rich foods. b. iron supplements. c. antibiotics.

NURSINGTB.COM d. probiotics and prebiotics.

ANS: D

Probiotics and prebiotics may help relieve symptoms for patients with irritable bowel syndrome.

DIF: Cognitive Level: Knowledge REF: p. 318 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Physiological Integrity: Reduction of Risk Potential 11. To reduce the incidence of constipation, an appropriate dietary intervention would be to a. encourage daily use of over-the-counter laxatives. b. include at least one serving of yogurt daily. c. include natural laxatives such as dried apricots and prunes. d. decrease fluid intake since this may interfere with bowel regularity.

ANS: C

Fruits such as dried apricots and prunes are natural laxatives and can help reduce the incidence of constipation by helping increasing the fiber content of the diet.

DIF: Cognitive Level: Application REF: p. 318 TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Physiological Integrity: Reduction of Risk Potential

12. A cause of diarrhea is a. drinking too much liquid with a meal. b. lactose intolerance. c. excessive intake of protein. d. swallowing air while eating.

ANS: B

Lactose intolerance occurs in people who lack the digestive enzyme lactase and is a cause of diarrhea. Lactase deficiency causes malabsorption, which results in diarrhea.

DIF: Cognitive Level: Knowledge REF: pp. 316-317 TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity: Physiological Adaptation 13. A patient with a history of diverticulosis who complains of severe, left lower quadrant pain

with diarrhea, nausea, and vomiting should be evaluated for a. diverticulitis. b. obstruction. c. appendicitis. d. celiac disease.

ANS: A

Diverticulitis develops when the small pouches or pockets in the muscular mucosal lining of the small intestine (diverticula) become infected. The infected area is painful and can present with diarrhea, nausea, and vomiting.

DIF: Cognitive Level: ApplicatiN onURSINR GETFB: .pC. 3O1M7 TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity: Physiological Adaptation 14. Treatment for diverticulosis includes a diet that is a. bland. b. low in fiber. c. high in fiber. d. a full liquid diet.

ANS: C

The diet for diverticulosis should be high in fiber, void of foods that may cause gas or intolerance (such as lactose), and low in fat.

DIF: Cognitive Level: Knowledge REF: p. 317 TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity: Physiological Adaptation 15. The characteristic symptoms of celiac disease are a. vomiting and diarrhea. b. diarrhea and steatorrhea. c. abdominal pain and constipation. d. chronic, bloody diarrhea.

ANS: B

Celiac disease is characterized by diarrhea and steatorrhea. Hypersensitivity to the protein gluten in certain grains causes mucosal surface damage to the intestine. The villi are malformed, which reduces the absorbing surface by as much as 95%.

DIF: Cognitive Level: Knowledge REF: pp. 319-320 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 16. Hepatitis is usually the result of a. a viral infection, alcohol abuse, or drug abuse. b. a bacterial or viral infection. c. excessive fat and protein intake. d. chronic malnutrition.

ANS: A

Hepatitis is an inflammatory condition caused by alcohol abuse or certain viruses, drugs, or toxins.

DIF: Cognitive Level: Knowledge REF: p. 321 TOP: Nursing Process: Nursing Diagnosis MSC: NCLEX: Physiological Integrity: Physiological Adaptation 17. Viral hepatitis can be contracted through a. ingestion of contaminated food or water. b. airborne viruses from coughing and sneezing. c. physical contact with an infected person. d. alcohol abuse.

ANS: A

NURSINGTB.COM

Viral hepatitis can be contracted through contaminated food or water.

DIF: Cognitive Level: Knowledge REF: p. 321 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 18. The treatment of hepatitis includes a. rest and optimal nutrition. b. antibiotics and optimal nutrition. c. fluid restriction and rest. d. diuretics and optimal nutrition.

ANS: A

Hepatitis is treated by rest and optimal nutrition with a high-carbohydrate, moderate-fat, high-energy, and high-protein diet.

DIF: Cognitive Level: Knowledge REF: p. 321 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 19. In order to promote health of liver cells and prevent fatty infiltration, patients with liver

disease should consume a. low intakes of refined carbohydrates. b. generous intakes of antioxidants. c. mostly unsaturated sources of fat. d. moderately high protein intakes.

ANS: D

Optimal nutrition for patients with hepatitis should consist of a diet that is moderately high in protein.

DIF: Cognitive Level: Knowledge REF: p. 322 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 20. A major difficulty in treating hepatitis is that a. the person must stay in isolation for a long time. b. the person can have only a clear liquid diet. c. the person usually has a poor appetite. d. typically only one kind of antibiotic will cure it.

ANS: C

Symptoms of hepatitis include anorexia, jaundice, and underlying malnutrition. The person usually has a poor appetite associated with these symptoms.

DIF: Cognitive Level: Application REF: p. 322 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 21. Pathologic changes in the liver caused by cirrhosis include a. fatty infiltration. b. spongy tissue formation. c. gallstone formation. d. edema and swelling.

ANS: A

Pathologic changes in the liverNcU auRseSdIbNyGcT irrBh. osCisOiM nclude fatty infiltration caused by a state of liver disease where the liver is damaged beyond repair.

DIF: Cognitive Level: Knowledge REF: p. 322 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 22. The major nutrition problem related to development of ascites is a. a protein deficiency. b. an excessive fat intake. c. a deficiency of digestive enzymes. d. an excessive sodium intake.

ANS: A

Low plasma protein levels contribute to ascites, or abdominal fluid accumulation.

DIF: Cognitive Level: Knowledge REF: p. 323 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 23. The most appropriate snack for a patient with cirrhosis of the liver would be a. chicken noodle soup. b. pretzels with peanut butter. c. chips and salsa. d. yogurt with raspberries.

ANS: D

Patients with cirrhosis of the liver should focus on foods high in protein, low in sodium, and moderate in fat content. Foods should also be soft.

DIF: Cognitive Level: Application REF: pp. 322-323 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 24. A food item that may be restricted in the patient with cirrhosis is a. apple slices. b. orange sherbet. c. hotdog. d. peas.

ANS: C

Hotdogs are high in sodium. Sodium often is restricted to 500 to 1000 mg/day in a patient with cirrhosis to help reduce fluid retention (ascites).

DIF: Cognitive Level: Application REF: pp. 322-323 TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity: Physiological Adaptation 25. The primary objective of treatment of hepatic encephalopathy is to a. encourage the patient to eat. b. feed the patient parenterally to give the liver a rest. c. remove sources of excess ammonia. d. encourage the patient to exercise and maintain mental functions.

ANS: C

The primary treatment objectivN eU foRr S heIpNatGicTeBn. ceCpO haMlopathy is to remove the excess ammonia.

One of the main functions of the liver is to remove ammonia and therefore nitrogen from the blood by converting it to urea for urinary excretion. When cirrhosis continues and fibrous scar tissue replaces more and more functional liver tissue, the blood can no longer circulate normally through the liver. Therefore other vessels develop around the scar tissue, bypass the liver, and proceed to the brain, producing ammonia intoxication.

DIF: Cognitive Level: Knowledge REF: pp. 322-323 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 26. Bile is produced by the a. gallbladder. b. pancreas. c. liver. d. intestine.

ANS: C

Bile is produced by the liver. The basic function of the gallbladder is to concentrate and store bile, then release the concentrated bile into the small intestine when fat is present.

DIF: Cognitive Level: Knowledge REF: p. 324 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 27. The most important function of the gallbladder is to a. produce bile.

b. synthesize cholesterol. c. release lipase enzymes. d. concentrate and store bile.

ANS: D

The most important function of the gallbladder is to concentrate and store bile, then release the concentrated bile into the small intestine when fat is present.

DIF: Cognitive Level: Knowledge REF: p. 324 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 28. The presence of gallstones in the gallbladder is called a. cholecystitis. b. cholelithiasis. c. cholecystectomy. d. cholecystokinin.

ANS: B

Cholelithiasis refers to the presence of gallstones in the gallbladder. When continued infection alters the solubility of the bile ingredients, cholesterol separates out and forms gallstones.

DIF: Cognitive Level: Knowledge REF: p. 324 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 29. A clinical symptom of gallbladder inflammation or gallstones is a. pain and distention after eating. b. jaundice. c. anorexia.

NURSINGTB.COM d. weakness and apathy.

ANS: A

A clinical symptom of gallbladder inflammation is pain and distention after eating. When infection, stones, or both are present, the normal contraction of the gallbladder, triggered by fat entering the intestine, causes pain.

DIF: Cognitive Level: Knowledge REF: p. 324 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 30. Nutrition therapy for gallbladder disorders includes a. reducing cholesterol intake. b. eliminating gas-forming foods. c. lowering fat intake. d. increasing caloric intake.

ANS: C

A low-fat intake may help avoid pain and discomfort because the presence of fat entering the small intestine stimulates the contraction of the gallbladder.

DIF: Cognitive Level: Application REF: pp. 324-325 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 31. A food choice that would help provide adequate protein for recovery from hepatitis is

a. b. c. d.

grilled chicken. an apple turnover. fruit salad. an English muffin.

ANS: A

Grilled chicken provides a good source of dietary protein that is essential for tissue repair, which is an important part of recovery from hepatitis.

DIF: Cognitive Level: Application REF: pp. 321-322 TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity: Physiological Adaptation 32. Ascites, a localized edema of the peritoneal cavity, is caused by a. low plasma protein levels. b. excessive sodium intake. c. too much fat in the diet. d. excessive fluid intake.

ANS: A

In patients with liver failure, low plasma protein levels may lead to ascites, or abdominal fluid accumulation.

DIF: Cognitive Level: Knowledge REF: p. 323 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 33. Crohn’s disease is a. a disorder of protein metabN olU isR mS . INGTB.COM b. a chronic enzyme deficiency. c. an over-production of insulin. d. an inflammatory bowel disease.

ANS: D

Crohn’s disease and ulcerative colitis are inflammatory bowel diseases.

DIF: Cognitive Level: Knowledge REF: p. 315 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 34. An elemental diet provides a. all necessary vitamins and minerals. b. all nutrients needed in a bland, low-residue form. c. all nutrients needed in their simplest, absorbable form. d. a diet high in mineral elements.

ANS: C

An elemental diet formula provides the necessary nutrients in their simplest, absorbable form.

DIF: Cognitive Level: Knowledge REF: p. 316 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 35. Patients with cystic fibrosis need to take a. enzymes and supplements.

b. large doses of vitamins and minerals. c. antidiarrheal agents. d. hormones and enzymes.

ANS: A

Enzymes and supplements are necessary for treatment of cystic fibrosis. Pancreatic enzymes are ingested orally along with vitamin supplements, especially fat-soluble vitamins.

DIF: Cognitive Level: Knowledge REF: pp. 312-313 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 36. A food that is considered a common food allergen is a. peanut butter. b. rice crackers. c. lemonade. d. chocolate.

ANS: A

Milk, eggs, peanuts, tree nuts, fish, shellfish, wheat, soy, and sesame are the most common food allergens.

DIF: Cognitive Level: Application REF: p. 318 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 37. A food that individuals with celiac disease might need to avoid is a. malted milk. b. buttermilk. c. rice.

NURSINGTB.COM d. prune juice.

ANS: A

Malted milk contains gluten. All products that contain dietary sources of gluten including wheat, barley, and rye products should be avoided in addition to any other products that may be processed in facilities that also process these types of grain products where cross-contamination could result.

DIF: Cognitive Level: Application REF: pp. 319-320 TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Physiological Integrity: Reduction of Risk Potential 38. A food that individuals with celiac disease would need to eliminate is a. cream of wheat. b. homemade applesauce. c. vanilla yogurt. d. buttermilk.

ANS: A

Individuals with celiac disease eliminate any food prepared with wheat, rye, oat, or barley products.

DIF: Cognitive Level: Application

REF: pp. 319-320

TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Physiological Integrity: Reduction of Risk Potential

NURSINGTB.COM

Chapter 19: Coronary Heart Disease and Hypertension Nix: Williams' Basic Nutrition and Diet Therapy, 15th Edition MULTIPLE CHOICE 1. The underlying pathologic process in coronary heart disease appears to be a. atrophy of the heart muscle. b. weakened coronary vessels. c. fibrous plaques in coronary vessels. d. inadequate nutrition to the heart muscle.

ANS: C

The underlying pathologic process in coronary heart disease is atherosclerosis. This process is characterized by the formation of fatty, fibrous plaques that may begin in childhood and develop into fatty streaks, largely composed of cholesterol, on the inside lining of major blood vessels.

DIF: Cognitive Level: Knowledge REF: p. 327 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 2. The underlying pathologic process in coronary heart disease is known as a. angina. b. atherosclerosis. c. hypertension. d. myocardial infarction.

ANS: B

NURSINGTB.COM

The underlying pathologic process in coronary heart disease is known as atherosclerosis, characterized by the formation of fatty, fibrous plaques that may begin in childhood and develop into fatty streaks, largely composed of cholesterol, on the inside lining of major blood vessels.

DIF: Cognitive Level: Knowledge REF: p. 327 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 3. An infarct in a major artery supplying the brain results in a. a myocardial infarction. b. a coma. c. a cerebrovascular accident. d. hypertension.

ANS: C

An infarct in a major artery supplying the brain is called a cerebrovascular accident. Cells die when they are deprived of their normal blood supply, and the local area of dead tissue is called an infarct.

DIF: Cognitive Level: Knowledge REF: p. 328 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 4. A localized area of dying or dead tissue is called a. atheroma.

b. infarct. c. thrombus. d. lesion.

ANS: B

Cells die when deprived of their normal blood supply. The local area of dying or dead tissue is called an infarct.

DIF: Cognitive Level: Knowledge REF: p. 334 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 5. A risk factor for coronary heart disease that cannot be controlled is a. obesity. b. family history. c. lack of exercise. d. smoking.

ANS: B

Risk factors associated with heart disease are sex, age, family history, elevated serum cholesterol, and dietary fat as well as compounding diseases such as diabetes, hypertension, and metabolic syndrome. Family history, age, and sex cannot be controlled.

DIF: Cognitive Level: Knowledge REF: p. 330 TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Physiological Integrity: Reduction of Risk Potential 6. Protection against coronary heart disease is associated with a high-density lipoprotein (HDL) NURSINGTB.COM

value of at least a. 30 mg/dL. b. 40 mg/dL. c. 60 mg/dL. d. 80 mg/dL. ANS: C

The optimal level for HDL is 60 mg/dL or greater.

DIF: Cognitive Level: Knowledge REF: p. 330 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 7. A food choice that may be limited in a meal plan controlling fat and cholesterol is a. pork sausage. b. baked beans. c. broiled fish. d. glazed carrots.

ANS: A

Dietary cholesterol and saturated fat are found in large amounts in foods of animal origin such as meat, dairy, and butter.

DIF: Cognitive Level: Application TOP: Nursing Process: Implementation

REF: pp. 332-333

MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 8.

The function of lipoproteins is to carry a. proteins to the liver for metabolism. b. proteins to the cells for metabolism. c. fat and cholesterol to the cells for energy and metabolism. d. cholesterol to adipose tissue for storage.

ANS: C

Because fat is not soluble in water, it is carried in the bloodstream in small, wrapped packages of protein called lipoproteins. The function of lipoproteins is to carry fat and cholesterol to the cells for energy and metabolism.

DIF: Cognitive Level: Knowledge REF: p. 329 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 9. An appropriate seasoning choice to use for a sodium-restricted diet would be a. celery salt. b. lemon juice. c. soy sauce. d. BBQ sauce.

ANS: B

Lemon juice is very low in sodium. Celery salt, soy sauce, and BBQ sauce all contain sodium as a component.

DIF: Cognitive Level: ApplicatiN onURSINR GETFB: .pC. 3O3M6 TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity: Physiological Adaptation 10. Appropriate snacks for a patient with hypertension would include a. corn chips and salsa. b. pretzel rings and cheese dip. c. orange juice with whole-wheat toast. d. french fries with apple slices.

ANS: C

Orange juice with whole-wheat toast contains the least sodium. Nutrition therapy for hypertension includes managing sodium intake to control fluid accumulation. High potassium foods such as orange juice may also be helpful.

DIF: Cognitive Level: Application REF: p. 343 TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 11. Dietary guidelines from the American Heart Association for foods to limit or consume in

moderation include a. avoiding all foods that contain cholesterol and animal fats. b. cutting back on foods that contain partially hydrogenated vegetable oils. c. aiming to eat less than 100 mg of cholesterol each day.

d. not consuming foods that contain dairy fat.

ANS: B

Foods to limit or consume in moderation include those that contain partially hydrogenated vegetable oils (to reduce trans fats in the diet) and those that are high in dietary cholesterol.

Cholesterol should also be limited to less than 300 mg each day.

DIF: Cognitive Level: Knowledge REF: p. 333 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 12. Dietary modifications during the first 24 to 48 hours after myocardial infarction include a. increasing fiber intake. b. avoiding cholesterol. c. reducing energy intake. d. reducing fluid intake.

ANS: C

All care after a myocardial infarction is aimed at ensuring cardiac rest so that the damaged heart can be restored to normal functioning. Energy restriction reduces metabolism and therefore reduces the workload for the heart.

DIF: Cognitive Level: Application REF: p. 327 TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity: Physiological Adaptation 13. Heart failure results in a. difficulty breathing. b. anemia. c. dehydration. d. myocardial infarction.

NURSINGTB.COM

ANS: A

In heart failure, the progressively weakened heart muscle is unable to maintain an adequate cardiac output to sustain normal blood circulation. The resulting fluid imbalances cause edema, which makes breathing difficult and places more stress on the laboring heart.

DIF: Cognitive Level: Knowledge REF: p. 336 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 14. The Therapeutic Lifestyle Changes (TLC) diet emphasizes intake of foods such as a. corn, tomatoes, low-fat yogurt, and baked chicken breast. b. biscuits, sausage, cheese, and lettuce. c. fried rice, sweet and sour pork, and rice milk. d. steak, blue cheese, French fries, and olives.

ANS: A

The TLC diet emphasizes intake of vegetables, fruits, and whole grains, with low-fat dairy products, poultry, fish, and legumes.

DIF: Cognitive Level: Application REF: p. 333 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance

15. The greatest proportion of dietary fatty acids should be a. saturated. b. polyunsaturated. c. unsaturated. d. fish oil.

ANS: C

The greatest proportion of dietary fatty acids should be unsaturated (a combination of both polyunsaturated and monounsaturated).

DIF: Cognitive Level: Knowledge REF: p. 334 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 16. A food that should be limited by patients with heart failure is a. shredded wheat cereal. b. salted potato chips. c. tofu. d. angel food cake.

ANS: B

Because of sodium’s role in tissue fluid balance, high-sodium foods such as salted potato chips are restricted in the treatment of cardiac edema.

DIF: Cognitive Level: Application REF: p. 333 TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity: Physiological Adaptation

NURSINGTB.COM 17.1 The cause of essential hypertension is 7 a. coronary heart disease. . b. stress. c. hormone imbalance. d. unknown.

ANS: D

The cause of essential hypertension is unknown, although injury to the inner lining of the blood vessel wall appears to be an underlying link.

DIF: Cognitive Level: Knowledge REF: p. 338 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 18. A patient’s blood pressure reading is 150/92 mm Hg. This would be considered a. hypotension. b. stage 1 hypertension. c. normotension. d. stage 2 hypertension.

ANS: B

A blood pressure reading between 140/90 and 159/99 mm Hg indicates the presence of stage 1 hypertension.

DIF: Cognitive Level: Application

REF: p. 339

TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity: Physiological Adaptation 19. The diagnosis of stage 1 and stage 2 hypertension is based on measurements of a. systolic blood pressure. b. diastolic blood pressure. c. systolic and diastolic blood pressure. d. resting blood pressure.

ANS: C

Current hypertension screening and treatment programs identify persons with hypertension according to the severity of the systolic and diastolic blood pressures.

DIF: Cognitive Level: Knowledge REF: pp. 339-340 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 20. The main source of dietary sodium in food is a. processed foods. b. found naturally in foods. c. found in cooking compounds. d. found as a mineral in drinking water.

ANS: A

The main source of dietary sodium comes from processed foods, fast food, and some types of restaurant foods.

DIF: Cognitive Level: Knowledge REF: p. 343 TOP: Nursing Process: Planning MSC: NCLEX: Physiological IntN egUriR tyS : PIhN ysGioTloBg. icC alO AM daptation 21. Nutrition therapy for those with heart failure restricts sodium to a. 1.0 g per day. b. 1.5 g per day. c. 2.0 g per day. d. 2.5 g per day ANS: C

Restricting sodium to 2 g per day is recommended for those with heart failure.

DIF: Cognitive Level: Knowledge REF: p. 343 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 22. An example of a food that is recommended with the Dietary Approaches to Stop Hypertension

(DASH) eating plan is a. lemonade. b. a fresh orange. c. a bread roll. d. bottled water.

ANS: B

A diet rich in fruits (such as oranges), vegetables, and low-fat dairy products with a reduced content of saturated and total fat is recommended with the DASH eating plan.

DIF: Cognitive Level: Application REF: p. 343 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Physiological Integrity: Reduction of Risk Potential 23. Hypertension is common in some ethnic groups, including a. Europeans. b. Asians. c. African Americans. d. Native Americans.

ANS: C

There is a high incidence of hypertension in African Americans, with the highest incidence among older African American women.

DIF: Cognitive Level: Knowledge REF: p. 344 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 24. The best way to control coronary heart disease is a. through early diagnosis. b. to meet regularly with a dietitian. c. to eliminate fat from the diet. d. to develop a heart-healthy lifestyle during childhood.

ANS: D

Developing a heart-healthy lifestyle during childhood may be the best way to control heart disease.

NURSINGTB.COM

DIF: Cognitive Level: Application REF: p. 344 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Physiological Integrity: Reduction of Risk Potential 25. The dish that is most likely to be consistent with the Dietary Approaches to Stop Hypertension

(DASH) recommendations is a. a grilled cheese sandwich. b. pork fried rice. c. beef tacos. d. lentil curry.

ANS: D

The DASH eating pattern recommends generous servings of fruits, vegetables, and low-fat dairy as well as lean meats, nuts, seeds, beans, and high-fiber grains. The lentil curry is most likely to be consistent with this plan.

DIF: Cognitive Level: Application REF: p. 343 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 26. The Dietary Approaches to Stop Hypertension (DASH) diet encourages intake of a. foods high in monounsaturated fats. b. foods high in soluble fiber. c. fruits, vegetables, and low-fat dairy products.

d. breads, cereals, rice, and pasta.

ANS: C

The DASH diet recommends eating four to six servings of fruits, four to six servings of vegetables, and two to three servings of low-fat dairy foods per day.

DIF: Cognitive Level: Knowledge REF: p. 343 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Physiological Integrity: Reduction of Risk Potential| NCLEX: Health Promotion and Maintenance 27. Appropriate food choices for a breakfast while following the DASH diet may include a. a fried egg, a biscuit, and gravy. b. a hash brown casserole and sausage. c. oatmeal with a sliced banana. d. chipped beef and a croissant with butter.

ANS: C

Oatmeal with a sliced banana provides whole grains and fruit. The DASH diet recommends eating four to six servings of fruits, four to six servings of vegetables, and two to three servings of low-fat dairy foods per day in addition to lean meats and high-fiber grains.

DIF: Cognitive Level: Application REF: p. 343 TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 28. The sandwich that is likely to have the lowest sodium content is a a. tuna sandwich.

NURSINGTB.COM b. ham sandwich. c. grilled cheese sandwich. d. plain hamburger.

ANS: D

Processed cheese, canned fish, and cured ham are likely to be higher in sodium than a hamburger made with fresh ground beef.

DIF: Cognitive Level: Application REF: p. 343 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 29. An example of a food that is a good source of calcium is a. olive oil. b. skim milk. c. oatmeal. d. lemonade.

ANS: B

Milk is a good source of calcium.

DIF: Cognitive Level: Application REF: p. 342 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 30. A food that can be used freely on a sodium-restricted diet is

a. b. c. d.

canned salmon. ketchup. ramen soup. a fresh apple.

ANS: D

Fruits contain negligible amounts of sodium in their natural state. Processed foods, including canned, frozen, and other packaged items, contain significant amounts of sodium.

DIF: Cognitive Level: Application REF: p. 342 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Physiological Integrity: Reduction of Risk Potential

Chapter 20: Diabetes Mellitus Nix: Williams' Basic Nutrition and Diet Therapy, 15th Edition MULTIPLE CHOICE 1. The primary organ involved in the disease process of type 1 diabetes mellitus is the a. adrenal gland. b. pancreas. c. kidney. d. liver.

ANS: B

The hormone insulin must be present for glucose to be used by the cells in the body. Insulin is produced by the cells of the pancreas. Thus, the pancreas is the organ involved in the disease process of type 1 diabetes mellitus.

DIF: Cognitive Level: Knowledge REF: p. 347 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 2. The main factors that influence development of type 2 diabetes mellitus are a. weight and heredity. b. liver disease. c. enzyme deficiencies. d. childhood illnesses.

ANS: A

Weight and heredity seem to plNaU yR aS roI leNiG nT thB e. deCvO elM opment of type 2 diabetes mellitus.

DIF: Cognitive Level: Knowledge REF: p. 348 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 3. Type 2 diabetes is most common in a. infants. b. children. c. adolescents. d. older adults.

ANS: D

Type 2 diabetes is most common in adults 40 years or older, although it may be seen at younger ages.

DIF: Cognitive Level: Knowledge REF: p. 348 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 4. An example of a food that would be part of the carbohydrate exchange group would be a. whole-wheat bread. b. vanilla ice cream. c. white tuna. d. skim milk.

ANS: A

The carbohydrate exchange groups include breads, cereals, and grains; starchy vegetables; crackers and snacks; beans, peas, and lentils; and fruits.

DIF: Cognitive Level: Application REF: p. 366 TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity: Physiological Adaptation 5. In reviewing the plan of care for a patient with type 2 diabetes who is overweight and likes to

eat sweets, an initial goal might be to a. start 10 units of regular insulin 30 minutes before each meal. b. replace a snack of five filled chocolate cookies with three graham crackers. c. check blood sugar after eating cookies and initiate sliding scale insulin. d. remove all carbohydrate foods and encourage only high-protein foods.

ANS: B

Replacing chocolate cookies with graham crackers would be an initial step in improving weight loss and implementing a healthy lifestyle of proper nutrition and exercise.

DIF: Cognitive Level: Application REF: p. 366 TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity: Physiological Adaptation 6. A 62-year-old patient with a history of blood sugars slightly above normal and recurrent skin

infections may need to be further assessed for a. type 2 diabetes. b. gestational diabetes. c. chronic kidney disease. d. hepatitis.

NURSINGTB.COM ANS: A

With a history of abnormal blood sugars and recurrent skin infections, an assessment for type 2 diabetes should be completed.

DIF: Cognitive Level: Application REF: p. 348 TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity: Physiological Adaptation 7. Uncontrolled diabetes is related to the abnormal metabolism of a. carbohydrates and proteins. b. proteins and fats. c. carbohydrates, proteins, and fats. d. carbohydrates only.

ANS: C

Uncontrolled diabetes causes alterations in glucose metabolism as well as abnormal metabolism of proteins and fats.

DIF: Cognitive Level: Knowledge REF: p. 355 TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity: Physiological Adaptation 8. A fasting blood glucose level of 85 mg/dL would be considered consistent with

a. b. c. d.

an impaired glucose tolerance. diabetes. normal health. a diabetic coma.

ANS: C

A blood glucose below 100 mg/dL is considered normal.

DIF: Cognitive Level: Application REF: p. 351 TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity: Physiological Adaptation 9. The largest portion of islet cells in the pancreas are the cells that synthesize a. glucagon. b. insulin. c. somatostatin. d. growth hormone.

ANS: B

The largest portion of islet cells are the cells that synthesize insulin, a hormone.

DIF: Cognitive Level: Knowledge REF: p. 368 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 10. The hormone that is synthesized by the  cells of the pancreatic islets is a. glycogen. b. ketone. c. somatostatin.

NURSINGTB.COM d. insulin.

ANS: C

Somatostatin is produced in the  cells of the pancreatic islets.

DIF: Cognitive Level: Knowledge REF: pp. 354-355 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 11. The hormone considered to act in a manner opposite to insulin is a. glucagon. b. somatostatin. c. growth hormone. d. adrenaline.

ANS: A

Glucagon is a hormone that acts in a manner opposite to insulin to balance the overall blood glucose level. It can rapidly break down stored glycogen and, to a lesser extent, fat.

DIF: Cognitive Level: Knowledge REF: p. 354 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 12. Which of the following functions is not associated with the hormone insulin? a. Insulin moves glucose into the cell. b. Insulin inhibits fat breakdown.

c. Insulin converts glucose into glycogen. d. Insulin mobilizes liver glycogen to yield glucose.

ANS: D

Insulin does not mobilize liver glycogen to yield glucose. Insulin circulates glucose into cells by way of specialized insulin receptors, helps change glucose to glycogen and store it in muscles and liver, stimulates the change of glucose to fat for storage as body fat, inhibits the breakdown of tissue fat and protein, promotes uptake of amino acids by skeletal muscle, and influences the burning of glucose for constant energy as needed.

DIF: Cognitive Level: Knowledge REF: p. 353 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 13. The accumulation of glucose in the blood is called a. glycosuria. b. polydipsia. c. hyperglycemia. d. hypoglycemia.

ANS: C

The accumulation of glucose in the blood is called hyperglycemia and the presence of low glucose in the blood is called hypoglycemia.

DIF: Cognitive Level: Knowledge REF: p. 352 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 14. Ketones are a by-product of the metabolism of a. carbohydrates.

NURSINGTB.COM b. proteins. c. fats. d. alcohol.

ANS: C

Ketones form as a by-product of fat metabolism when the supply of glucose is insufficient.

DIF: Cognitive Level: Knowledge REF: p. 355 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 15. An individual attends a community-sponsored, health-screening event and a slightly elevated

blood sugar level is detected. An appropriate intervention would be to a. inform the individual that he or she has diabetes and should go to the emergency room immediately. b. recommend the individual start a high-protein, low-carbohydrate diet and begin exercising. c. recommend the individual follow up with his or her health care practitioner for further evaluation. d. tell the individual not to worry and that there is no need for any additional follow-up.

ANS: C

A recommendation to follow up with the individual’s health care practitioner would be most appropriate. The community screening helps to identify those individuals in the community who may benefit from additional medical follow-up and screening for the risk of diabetes.

DIF: Cognitive Level: Application REF: pp. 361-362 TOP: Nursing Process: Evaluation MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 16. The three common, long-term complications of diabetes affect the cells of the a. pancreas, liver, and spleen. b. kidney, eye, and nerve tissue. c. kidney, liver, and spleen. d. heart, liver, and brain.

ANS: B

Long-term complications of diabetes affect the kidney (nephropathy), eye (retinopathy), and nerve tissue (neuropathy).

DIF: Cognitive Level: Knowledge REF: p. 355 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 17. For a patient receiving a 2000 kcal diet, the recommended range of calories that should come

from carbohydrate is a. 500 to 750 kcal. b. 750 to 900 kcal. c. 900 to 1300 kcal. d. 1350 to 1650 kcal.

ANS: C

NURSINGTB.COM

The amount of calories provided by carbohydrates in a 2000 kcal diet would range from 900 to 1300 kcal; 45% to 65% of calories should come from carbohydrate. Thus, 2000 kcal  45% = 900 kcal and 2000 kcal  65% = 1300 kcal.

DIF: Cognitive Level: Application REF: p. 367 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 18. A good source of fiber-rich food is a. steel cut oats. b. a grilled chicken breast. c. cinnamon applesauce. d. an English muffin.

ANS: A

Steel cut oats are a good source of fiber.

DIF: Cognitive Level: Application REF: pp. 363-364 TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 19. For a patient with diabetes, a good nonnutritive choice to sweeten tea would be a. cane sugar.

b. aspartame. c. honey. d. fructose.

ANS: B

Commonly used nonnutritive sweeteners include aspartame, which has no nutritional value.

Cane sugar, honey, and fructose are all nutritive sweeteners because they do provide energy.

DIF: Cognitive Level: Application REF: p. 363 TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 20. If a patient with type 1 diabetes has a fever and increased blood glucose levels, he or she

should a. drink only water until blood glucose levels drop. b. adjust the insulin dose to normalize blood glucose levels. c. maintain normal insulin doses and food intake. d. seek medical advice immediately.

ANS: B

During illness and fever, blood glucose levels often increase. Patients should increase their insulin dose to maintain blood glucose levels as close to normal as possible. They should maintain normal food intake, taking carbohydrate as liquid or soft foods if appetite is poor.

They should contact a physician if the illness lasts for more than 24 hours, if fever remains high, or if blood glucose remains 250 mg/dL and a urine dip-stick tests shows moderate to large ketones are present.

NURSINGTB.COM

DIF: Cognitive Level: Application REF: pp. 368-369 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 21. A dietary pattern that would be most beneficial for a patient with diabetes is a a. low-sodium diet. b. low-sugar diet. c. high-protein diet. d. Mediterranean diet.

ANS: D

A Mediterranean diet plan is generally appropriate for a patient with diabetes.

DIF: Cognitive Level: Application REF: p. 364 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 22. A menu selection high in saturated fat is a. grilled turkey burgers with onion and peppers. b. baked ziti with sausage and cream sauce. c. baked salmon and herbed potatoes. d. baked macaroni and tomato sauce.

ANS: B

Baked ziti with sausage and cream sauce would contain saturated fats from the sausage and the cream-based sauce.

DIF: Cognitive Level: Application REF: p. 366 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 23. The form of insulin that has its peak action after about 8 hours is a. rapid-acting insulin. b. intermediate-acting insulin. c. long-acting insulin. d. oral hypoglycemic insulin.

ANS: B

Intermediate-acting (NPH) insulin peaks after about 8 hours.

DIF: Cognitive Level: Knowledge REF: p. 359 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 24. Women with a history of gestational diabetes mellitus are at risk for developing a. chronic kidney disease. b. type 2 diabetes. c. type 1 diabetes. d. morbid obesity.

ANS: B

The risk for developing type 2 diabetes is significantly higher in women with a history of gestational diabetes.

DIF: Cognitive Level: Knowledge REF: p. 349 TOP: Nursing Process: Planning MSC: NCLEX: Physiological IntN egUriR tyS :P h ys io lo g ic al A daptation INGTB.COM 25. For individuals with type 2 diabetes, exercise a. decreases insulin efficiency. b. stimulates the release of insulin. c. decreases risk of cardiovascular disease. d. raises blood glucose levels.

ANS: C

Exercise increases the number of insulin receptors on muscle cells. Long-term studies have shown that with type 2 diabetes, exercise helps control blood glucose and reduces the risk of cardiovascular disease, hyperlipidemia, hypertension, and obesity.

DIF: Cognitive Level: Knowledge REF: p. 348 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 26. Type 2 diabetes usually appears after the age of a. 30 years. b. 40 years. c. 50 years. d. 60 years.

ANS: B

Type 2 diabetes usually appears after the age of 40 years but is now also being diagnosed in children.

DIF: Cognitive Level: Knowledge REF: p. 348 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 27. Mr. Jones is 20 lb above his desirable weight and has type 2 diabetes. A recommendation to

Mr. Jones would be to a. increase kilocalorie intake. b. include between-meal snacks. c. take extra food during exercise. d. decrease kilocalorie intake.

ANS: D

Decreasing kilocalorie intake will help Mr. Jones lose weight and control his type 2 diabetes.

DIF: Cognitive Level: Application REF: p. 365 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 28. The number of kilocalories from protein for an adult receiving a 2200 kcal diet should be

between a. 100 and 330 kcal. b. 220 and 770 kcal. c. 250 and 800 kcal d. 350 and 1200 kcal.

ANS: B

NURSINGTB.COM

The protein content for an adult with diabetes is 10% to 35% of total energy intake. On a 2200 kcal diet, 2200  10% = 220 kcal and 2200  35% = 770 kcal.

DIF: Cognitive Level: Application REF: p. 364 TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity: Physiological Adaptation 29. A food that is not in the meat group of the Choose Your Foods: Exchange Lists for Diabetes is a. turkey. b. shrimp. c. egg. d. milk.

ANS: D

Turkey, shrimp, and egg are all part of the meat and meat substitute group. Milk is in a separate group.

DIF: Cognitive Level: Knowledge REF: pp. 366-367 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 30. A patient with type 2 diabetes eats a high-protein, very low-carbohydrate diet to try to lose

weight. The main long-term concern if the patient continues this eating pattern would be a. excessive weight loss. b. the development of hypertension.

c. the development of liver disease d. the development of neuropathy.

ANS: D

Excessive protein intakes may contribute to the development of nephropathy in patients with diabetes because disposal of extra nitrogenous waste puts unnecessary stress on the kidneys.

DIF: Cognitive Level: Application REF: p. 364 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation

NURSINGTB.COM

Chapter 21: Kidney Disease Nix: Williams' Basic Nutrition and Diet Therapy, 15th Edition MULTIPLE CHOICE 1. The microscopic functional units of the kidney are called a. nephrons. b. glomeruli. c. tubules. d. loops of Henle.

ANS: A

The nephron is the functional unit of the kidney. It performs functions such as filtration, reabsorption, secretion, and excretion.

DIF: Cognitive Level: Knowledge REF: p. 371 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 2. The structure responsible for filtering the blood is the a. loop of Henle. b. proximal tubule. c. distal tubule. d. glomerulus.

ANS: D

The glomerulus filters the blood. Only the larger blood proteins and cells remain behind in the circulating blood as it leaves thN eU glRoS mI erN uG luT s.B.COM DIF: Cognitive Level: Knowledge REF: p. 371 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 3. Disease conditions that can interfere with normal kidney function include a. obstruction and infection. b. chronic caffeine intake. c. chronic alcohol abuse. d. anemia.

ANS: A

Obstruction and infection can interfere with normal nephron function.

DIF: Cognitive Level: Knowledge REF: p. 373 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 4. Glomerulonephritis or nephritic syndrome is one of the causes of a. stage 5 chronic kidney disease (CKD) or end-stage renal disease (ESRD). b. stage 1 CKD. c. kidney stones. d. heart failure.

ANS: A

Glomerulonephritis is one of the three most common causes of stage 5 CKD.

DIF: Cognitive Level: Knowledge REF: p. 375 TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity: Physiological Adaptation 5. Clinical symptoms associated with chronic kidney disease do not include a. anemia. b. diabetes mellitus. c. hypertension. d. bone pain.

ANS: B

Complications of chronic kidney disease do not include diabetes mellitus.

DIF: Cognitive Level: Knowledge REF: p. 378 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 6. The presence of protein in the urine is called a. hematuria. b. oliguria. c. proteinuria. d. anuria.

ANS: C

Proteinuria results from an abnormal excess of serum proteins in the urine.

DIF: Cognitive Level: Knowledge REF: p. 375 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation

NURSINGTB.COM

7. Classic symptoms of acute glomerulonephritis include a. azotemia. b. proteinuria. c. ascites. d. anemia.

ANS: B

Classic symptoms of acute glomerulonephritis include hematuria and proteinuria, although edema and hypertension also may occur.

DIF: Cognitive Level: Knowledge REF: p. 375 TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity: Physiological Adaptation 8. Azotemia refers to elevated blood levels of a. glucose. b. cholesterol. c. amines. d. urea.

ANS: D

Elevated blood levels of urea nitrogen and other nitrogenous products are reflected in the characteristic laboratory finding of azotemia.

DIF: Cognitive Level: Knowledge REF: p. 378 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 9. Nephrotic syndrome, or nephrosis, is a disease that a. is caused by chronic hypertension. b. allows large amounts of protein to escape into the tubule. c. causes the buildup of toxic wastes in the blood. d. results in the formation of kidney stones.

ANS: B

Nephrotic syndrome, or nephrosis, results from nephron tissue damage to both the glomerulus and tubule. The primary damage is to the major filtering membrane of the glomerulus, which allows large amounts of protein to pass into the tubule.

DIF: Cognitive Level: Knowledge REF: p. 375 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 10. The massive edema of nephrotic syndrome is caused by a. blockage in the nephron tubules. b. excessive fluid intake. c. large protein losses in the urine. d. a diet too high in sodium.

ANS: C

In nephrotic syndrome, large amounts of protein pass into the tubule. The large protein loss leads to massive edema and ascites as well as proteinuria.

DIF: Cognitive Level: ApplicatiN onURSINRGETFB : .pC . 3O7M 5 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 11. Medical nutrition therapy for nephrotic syndrome includes a. high protein intake. b. moderate protein intake. c. high potassium intake. d. fluid restriction.

ANS: B

Medical nutrition therapy for nephrotic syndrome includes moderate protein intake at 0.8 g/kg/day, which is sufficient to meet nutritional and growth needs without adding to the burden on the kidney to excrete waste products formed from the breakdown of extra protein.

DIF: Cognitive Level: Application REF: p. 375 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 12. The hormone that causes the kidneys to reabsorb water and decrease urine production is a. renin. b. vitamin D. c. erythropoietin. d. antidiuretic hormone.

ANS: D

Antidiuretic hormone (ADH) works on the distal nephron tubule to conserve water by reabsorption.

DIF: Cognitive Level: Application REF: p. 372 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 13. The sudden shutdown of kidney function as the result of traumatic injury is called a. nephrosis. b. glomerulonephritis. c. acute kidney failure. d. chronic kidney failure.

ANS: C

Acute kidney failure results when renal function in healthy kidneys shuts down suddenly after some metabolic insult or traumatic injury, causing a life-threatening situation. This is a medical emergency.

DIF: Cognitive Level: Knowledge REF: p. 376 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 14. A major clinical symptom of acute kidney failure is a. hematuria. b. proteinuria. c. oliguria. d. massive edema.

ANS: C

A major symptom of acute kidnNeU yRfaSilI urNeGisToBli. guCrO iaM , which is caused when the cellular debris from the tissue damage blocks the renal tubules.

DIF: Cognitive Level: Knowledge REF: p. 376 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 15. A progressive increase in serum urea levels occurs in a. acute renal failure. b. glomerulonephritis. c. chronic kidney failure. d. nephrotic syndrome.

ANS: C

A progressive increase in serum urea levels occurs in chronic kidney failure. Increasing loss of nephron function results in elevated amounts of nitrogenous metabolites, such as urea.

DIF: Cognitive Level: Knowledge REF: p. 378 TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity: Physiological Adaptation 16. Ms. Jones comes to the emergency department with a severe drug reaction to penicillin. She

may be at risk for a. diabetes or heart disease. b. high sodium intake. c. protein-energy malnutrition.

d. acute kidney failure.

ANS: D

Acute kidney failure can result from drug reactions in allergic or sensitive persons, such as a reaction to antibiotics (such as penicillin) or antimicrobial agents.

DIF: Cognitive Level: Application REF: p. 376 TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity: Physiological Adaptation 17. Mr. Jones has chronic kidney disease. He is 55 years of age, weighs 165 lbs, and has a

glomerular filtration rate (GFR) of 22 mL/min. His estimated energy needs per day are approximately a. 1125 to 2200 kcal/day. b. 1500 to 2350 kcal/day. c. 1875 to 2625 kcal/day. d. 2250 to 2850 kcal/day.

ANS: C

Carbohydrate and fat must provide enough energy to spare protein and maintain body weight (BW). A GFR of 22 mL/min is consistent with stage 4 chronic kidney disease (CKD).

Recommended energy intake is 25 to 35 kcal/kg of BW/day. In this case, 165 lb = 75 kg; 75 kg  25 kcal/kg/day = 1875 kcal; 75 kg  35 kcal/kg/day = 2625 kcal.

DIF: Cognitive Level: Application REF: p. 379 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance

NURSINGTB.COM 18. The bone disease osteodystrophy is associated with a. glomerulonephritis. b. acute renal failure. c. chronic renal failure. d. nephrotic syndrome.

ANS: C

The disturbed metabolism of calcium and phosphate from lack of vitamin D, a process that occurs in the kidneys, leads to bone pain from osteodystrophy in patients with chronic renal failure.

DIF: Cognitive Level: Knowledge REF: p. 378 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Physiological Integrity: Reduction of Risk Potential 19. The classic symptoms of chronic kidney failure result from a. a diet high in sodium. b. a diet chronically low in fluid intake. c. severe trauma to the body. d. the progressive loss of nephrons.

ANS: D

Chronic kidney failure, or chronic renal insufficiency, is caused by the progressive breakdown of renal tissues, which impairs all renal function. Few functioning nephrons remain, and they gradually deteriorate.

DIF: Cognitive Level: Application REF: p. 378 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 20. The bone disease osteodystrophy develops because of the kidneys’ inability to a. excrete calcium. b. activate vitamin D. c. absorb vitamin D. d. excrete urea.

ANS: B

The disturbed metabolism of calcium and phosphate from lack of vitamin D activation, a process that occurs in the kidneys, leads to bone pain from osteodystrophy.

DIF: Cognitive Level: Knowledge REF: p. 378 TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity: Physiological Adaptation 21. Symptoms of chronic kidney failure include a. nitrogen retention. b. euphoria. c. jaundice. d. the inability to sleep.

ANS: A

NURSINGTB.COM

Symptoms of chronic kidney disease include fluid imbalances, electrolyte imbalances, nitrogen retention, anemia, hypertension, and azotemia.

DIF: Cognitive Level: Knowledge REF: p. 378 TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity: Physiological Adaptation 22. Carbohydrates and fats are important in the diets of patients with kidney disease because they a. prevent fatigue. b. spare protein for tissue synthesis. c. are low in sodium. d. are metabolized before they reach the kidney.

ANS: B

Carbohydrate and fat must supply sufficient nonprotein kilocalories to supply energy and spare protein for tissue synthesis.

DIF: Cognitive Level: Knowledge REF: p. 379 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 23. The “cleaning solution” used in hemodialysis is called the a. filtrate. b. plasma.

c. urine. d. dialysate.

ANS: D

The “cleaning solution” used in hemodialysis is called the dialysate.

DIF: Cognitive Level: Knowledge REF: p. 381 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 24. The method of dialysis that allows patients to be mobile is a. hemodialysis. b. renal dialysis. c. peritoneal dialysis. d. continuous dialysis.

ANS: C

Peritoneal dialysis is an alternative form of treatment for dialysis that allows patients to be mobile. In this process, the patient introduces the dialysate solution directly into the peritoneal cavity 4 or 5 times a day, where it can be exchanged for fluids that contain the metabolic waste products.

DIF: Cognitive Level: Knowledge REF: p. 380 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 25. When patients with chronic kidney disease begin dialysis, they can increase their intake of a. protein. b. phosphorus. c. energy.

NURSINGTB.COM d. fat.

ANS: A

Patients treated using dialysis can increase protein intake from 1.1 to 1.5 g/kg body weight because of a more liberal diet. This helps maintain muscle mass.

DIF: Cognitive Level: Application REF: p. 381 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 26. For patients with uric acid stones, health practitioners may recommend a diet low in a. calcium. b. vegetable protein. c. purines. d. fat.

ANS: C

Excess excretion of uric acid may be caused by some impairment with the metabolism of purine, a nitrogen end product of dietary protein from which uric acid is formed.

DIF: Cognitive Level: Knowledge REF: p. 388 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 27. One of the first recommendations for any type of kidney stone is to a. increase the fiber in the diet.

b. reduce calcium intake. c. increase fluid intake. d. decrease protein intake.

ANS: C

A large fluid intake is the primary therapy that helps produce more dilute urine and prevent accumulation of materials that form stones.

DIF: Cognitive Level: Knowledge REF: p. 388 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 28. The most common type of kidney stone is composed of a. calcium. b. uric acid. c. cystine. d. magnesium.

ANS: A

The most common type of kidney stone (approximately 80%) is composed of calcium oxalate or calcium phosphate.

DIF: Cognitive Level: Knowledge REF: p. 388 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 29. The type of diet recommended for a person with a calcium stone depends on a. body weight. b. the composition of the stone. c. fiber intake.

NURSINGTB.COM d. fluid intake.

ANS: B

Medical nutrition therapy for calcium stones depends on the composition of the stone. If a stone is composed of calcium phosphate, additional sources of phosphorus should be controlled. If a stone is calcium oxalate, foods high in oxalate should be avoided.

DIF: Cognitive Level: Knowledge REF: p. 388 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 30. Patients with chronic renal disease may need to restrict their intake of foods high in

phosphorus, such as a. milk, nuts, and legumes. b. meat, chicken, and fish. c. bread, cereal, rice, and pasta. d. fruit and potatoes.

ANS: A

Phosphorus-containing foods include milk, nuts, and legumes.

DIF: Cognitive Level: Application REF: p. 388 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 31. For patients treated with dialysis, a good source of protein could be

a. b. c. d.

sherbet. green beans. a scrambled egg. apple crisp.

ANS: C

Eggs are a high-biologic value protein for patients on dialysis.

DIF: Cognitive Level: Application REF: p. 382 TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity: Physiological Adaptation

NURSINGTB.COM

Chapter 22: Surgery and Nutrition Support Nix: Williams' Basic Nutrition and Diet Therapy, 15th Edition MULTIPLE CHOICE 1. The most common nutritional deficiency among surgical patients is a deficiency of a. vitamin C. b. iron. c. protein. d. essential fatty acids.

ANS: C

Protein deficiencies among surgical patients are the most common.

DIF: Cognitive Level: Knowledge REF: p. 393 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 2. Before general surgery, nothing is given by mouth for at least a. 4 hours. b. 8 hours. c. 12 hours. d. 24 hours.

ANS: B

Nothing is given by mouth for at least 8 hours before surgery to avoid serious complications such as aspiration of stomach cN onUtR enStsIiN ntG oTthBe.luCnO gsM. DIF: Cognitive Level: Knowledge REF: p. 392 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 3. Protein is especially needed in the postoperative recovery period for a. energy. b. control of edema. c. control of hypertension. d. optimal kidney function.

ANS: B

Protein assists in the maintenance of osmotic pressure, which is necessary to maintain normal movement of fluid between the capillaries and surrounding tissue. Without maintenance of osmotic pressure, edema develops.

DIF: Cognitive Level: Knowledge REF: p. 392 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 4. For a patient who can take an oral diet, a food that would be a good source of energy during

the postoperative period would be a. lean steak. b. breakfast cereal.

c. carrots. d. fried potatoes.

ANS: B

During the postoperative period, the primary source of energy for the body should be carbohydrates supplied by cereals and other grains.

DIF: Cognitive Level: Application REF: p. 409 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 5. Mr. B needs to have his gall bladder removed. His appetite has been poor, and he has lost 20

lb in the past 4 months. Before surgery he should a. focus on fruit, vegetables, and organic foods. b. allow his appetite to dictate his food choices. c. increase his intake of energy, protein, vitamins, and minerals. d. maintain a lower energy intake to reduce stress on his body.

ANS: C

Mr. B’s weight loss indicates that he has decreased his nutrient stores. This could impair his ability to heal after surgery. Prior to surgery, he should try to increase his intake of energy, protein, vitamins, and minerals to boost his nutrient stores. For example, he could eat six small meals each day.

DIF: Cognitive Level: Application REF: p. 405 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance

NURSINGTB.COM 6. Blood losses may result in a deficiency of a. calcium. b. glucose. c. iron. d. vitamin C. ANS: C

Iron-deficiency anemia may result from blood loss or faulty iron absorption.

DIF: Cognitive Level: Knowledge REF: p. 394 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 7. Two minerals that are lost during tissue catabolism are a. sodium and chloride. b. calcium and magnesium. c. iron and zinc. d. potassium and phosphorus.

ANS: D

Potassium and phosphorus are lost during tissue catabolism. When tissue is broken down, cell potassium and phosphorus are lost from inside the cells.

DIF: Cognitive Level: Knowledge REF: p. 394 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and

Maintenance 8. Fluid loss due to vomiting, fever, or excessive urination is accompanied by loss of the

electrolytes a. sodium and chloride. b. calcium and magnesium. c. iron and zinc. d. potassium and phosphorus.

ANS: A

Because sodium is the major electrolyte in extracellular fluid, electrolyte losses will occur with water loss. Chloride losses also occur because it is also widely distributed within the extracellular compartment.

DIF: Cognitive Level: Comprehension REF: p. 394 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 9. A good source of vitamin C, important during the healing process, is a. whole-wheat crackers. b. broccoli. c. vanilla pudding. d. pretzels.

ANS: B

Broccoli is a good source of vitamin C that is necessary to build and maintain strong tissues, especially connective tissues.

NURSINGTB.COM DIF: Cognitive Level: Application REF: p. 394 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 10. Commercial enteral feeding formulas are preferred to blenderized food because they a. have a thinner consistency. b. carry less risk of infection. c. are better tolerated. d. are less expensive.

ANS: B

Commercially prepared enteral feeding formulas provide a sterile, homogenized solution and are less likely to become contaminated with bacteria than blenderized food.

DIF: Cognitive Level: Knowledge REF: p. 399 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 11. An example of a food item that is usually not part of a regular oral diet is a. steamed broccoli. b. braised chicken. c. a baked potato. d. puréed carrots.

Puréed carrots are not part of a regular oral diet because the texture has been modified.

DIF: Cognitive Level: Application REF: p. 399 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 12. Advancing the carbohydrate load too quickly in total parenteral nutrition may result in a. hyperglycemia. b. hypoglycemia. c. fluid overload. d. anemia.

ANS: A

Advancing the carbohydrate load too quickly when administering total parenteral nutrition can result in hyperglycemia.

DIF: Cognitive Level: Application REF: p. 403 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 13. Patients who have had radical surgery of the head, neck, or throat may require a. a clear liquid diet. b. a full liquid diet. c. tube feedings. d. a low-residue diet.

ANS: C

NURSINGTB.COM

If regular oral feedings are not tolerated, the patient is severely debilitated, or has undergone radical neck or face surgery, tube feedings may be necessary.

DIF: Cognitive Level: Application REF: pp. 404-405 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 14. Immediately following a gastrectomy, initial postoperative nutrition feedings are met by a. small, frequent oral feedings. b. jejunostomy feedings. c. total parenteral nutrition. d. an oral full liquid diet.

ANS: B

Immediately following a gastrectomy, postoperative feedings usually are provided through a jejunostomy tube that provides elemental feedings.

DIF: Cognitive Level: Knowledge REF: p. 405 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 15. Once placed on an oral diet following a gastrectomy, an appropriate meal would consist of a. milk and applesauce. b. sweet tea and cookies. c. a scrambled egg and toast. d. a plain hamburger and fries.

ANS: C

After a gastrectomy, meals should be small, frequent, and easily digestible, such as scrambled eggs and toast. Liquids should be provided between meals rather than with meals.

DIF: Cognitive Level: Application REF: p. 405 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 16. Ms. Jones has recently had gastric surgery; 45 minutes after eating her regular diet she feels

cramping and full with waves of weakness and dizziness. Ms. Jones is most likely experiencing a. a heart attack. b. a gallbladder attack. c. a pulmonary embolus. d. dumping syndrome.

ANS: D

Dumping syndrome is a frequently encountered complication after extensive gastric resection.

After the initial recovery from surgery when the patient begins to feel better and eats a regular diet in greater volume and variety, discomfort may occur 30 to 60 minutes after meals. A cramping and full feeling develops, the pulse becomes rapid, and a wave of weakness, cold sweating, and dizziness may follow.

DIF: Cognitive Level: Application REF: p. 405 TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity: Physiological Adaptation

NpGinTgBs.yC 17. The food item most likely to leN adUtR o SdI um ndOroMme is a. lean meat. b. butter. c. chocolate pudding. d. whole-wheat toast.

ANS: C

The complex of symptoms in dumping syndrome constitutes a shock syndrome that results when a meal containing a large portion of readily soluble carbohydrates rapidly enters, or “dumps” into the small intestine.

DIF: Cognitive Level: Application REF: p. 405 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 18. Physiologic symptoms of dumping syndrome result from a. the intestinal contents being absorbed too quickly. b. the ingested food remaining in the stomach too long. c. the stomach emptying too quickly into the intestine. d. water being drawn from the blood into the intestine and decreasing the blood

volume.

ANS: D

Dumping syndrome results when a meal containing a large portion of readily soluble carbohydrates rapidly enters, or “dumps,” into the small intestine. This particular food mass is a concentrated solution in relation to the surrounding circulation of blood. To achieve an osmotic balance, water is drawn from the blood into the intestine. This water shift rapidly shrinks the vascular fluid volume. As a result, blood pressure drops and signs of rapid heart action to rebuild the blood volume appear.

DIF: Cognitive Level: Knowledge REF: p. 405 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 19. If a patient requires parenteral nutrition for a prolonged period, the most appropriate type of

feeding is a. elemental enteral formula. b. intact enteral formula. c. total parenteral nutrition. d. peripheral parenteral nutrition.

ANS: C

Total parenteral nutrition is indicated if the gastrointestinal tract cannot be used for a long period. Total parenteral nutrition, which supplies all the macronutrients and micronutrients along with fluid to meet daily requirements, is necessary for patients who need intravenous nutrition for an extended period.

DIF: Cognitive Level: Application REF: p. 396 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 20. After a cholecystectomy, an example of a food item that may need to be decreased is NURSINGTB.COM a. fried chicken. b. applesauce. c. white bread. d. sherbet.

ANS: A

Depending on individual tolerance and response, a relatively low-fat diet may be needed. The gallbladder stores bile produced by the liver, which is secreted when fat enters the small intestine. After surgery, control of fat in the diet facilitates wound healing and comfort because the hormonal stimulus for bile secretion still functions in the surgical area, causing pain with intake of fatty foods. The body also needs a period to readjust to the more dilute supply of liver bile available to assist in fat digestion and absorption.

DIF: Cognitive Level: Application REF: p. 407 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 21. The surgery in which the colon is attached to an opening in the abdominal wall is known as a. a cholecystectomy. b. an ileostomy. c. a colostomy. d. a jejunostomy.

ANS: C

Intestinal surgery may require the making of an opening in the abdominal wall to the outside of the body from the intestine. If the opening is farther along the colon in the last part of the large intestine, it is called a colostomy.

DIF: Cognitive Level: Knowledge REF: p. 407 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 22. If the intestinal drainage from an ostomy site is still liquid, the patient has a. a gastrectomy. b. an ileostomy. c. a colostomy. d. an intestinal bypass.

ANS: B

An ileostomy is an opening in the abdominal wall to the ileum. The drainage from an ileostomy is liquid because the food mass is still liquid at this point.

DIF: Cognitive Level: Application REF: p. 407 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 23. A food item that would be an appropriate part of a full liquid diet is a. pureed chicken. b. mashed potatoes. c. chocolate ice cream. d. scrambled eggs.

ANS: C

NURSINGTB.COM

Full liquid diets include foods that are liquid at room temperature, such as ice cream.

DIF: Cognitive Level: Application REF: p. 407 TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 24. A burn that causes cell damage in both the top layer of skin and some of the dermis is a

burn. a. superficial b. superficial partial-thickness c. deep partial-thickness d. full-thickness ANS: B

Superficial partial-thickness burns involve cell damage in both the top layer of the skin (epidermis) and some of the second layer of the skin (dermis). A superficial burn involves cell damage in the top layer of skin; a deep partial-thickness burn results in destruction of the epidermis and dermis; and a full-thickness burn results in loss of the epidermis, dermis, and frequently the underlying fat layer.

DIF: Cognitive Level: Knowledge REF: p. 408 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance

25. During the initial stage of treatment of a severe burn a. an intravenous dextrose feeding is started. b. total parenteral nutrition is initiated. c. the patient is encouraged to take water orally. d. an intravenous electrolyte solution is given.

ANS: D

During the initial stage of treatment for a severe burn, referred to as the immediate shock period, massive flooding edema occurs at the burn site. Loss of protective skin leads to immediate losses of water, electrolytes, and protein. Cell dehydration follows. Immediate intravenous fluid therapy with a salt solution replaces water and electrolytes to help prevent shock.

DIF: Cognitive Level: Comprehension REF: pp. 408-409 TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity: Physiological Adaptation 26. An intravenous solution that is immediately given to a burn patient to prevent hypovolemia is a. lactated Ringer’s solution. b. 5% dextrose. c. normal saline. d. total parenteral nutrition.

ANS: A

Immediate intravenous fluid therapy with a salt solution replaces water and electrolytes to help prevent shock. Lactated Ringer’s solution is the intravenous fluid given to prevent hypovolemia. This is a salt soluNtiUoR n,S6I %NhGeT taB st. arC chOiM n solution.

DIF: Cognitive Level: Knowledge REF: pp. 408-409 TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity: Physiological Adaptation 27. An appropriate tube feeding route for a patient at high risk for aspiration is a. nasogastric. b. jejunostomy. c. gastrostomy. d. esophagostomy.

ANS: B

If a patient is at high risk for aspiration, then a feeding tube is placed in the small intestine (the jejunum is a common site) rather than the stomach to lessen the chance of aspiration of food into the lungs.

DIF: Cognitive Level: Comprehension REF: p. 399 TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity: Physiological Adaptation 28. Total parenteral nutrition formulas provide protein in the form of a. peptides. b. protein isolates. c. amino acids.

d. dextrose.

ANS: C

Parenteral nutrition therapy infuses nutrients directly into the bloodstream. Proteins are supplied in the simplest form, amino acids, for direct absorption into the bloodstream.

DIF: Cognitive Level: Knowledge REF: p. 402 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 29. If a patient has increased protein and zinc needs to promote wound healing, a good meal

choice would be a. beef and bean stew. b. squash soup with sour cream. c. stir-fried vegetables and rice. d. citrus fruit salad and yogurt.

ANS: A

Beef and legumes are both high in protein and zinc.

DIF: Cognitive Level: Application REF: p. 409 TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity: Physiological Adaptation 30. Patients who are treated with antibiotics may have decreased synthesis of a. vitamin K. b. vitamin C. c. zinc. d. iron.

NURSINGTB.COM

ANS: A

Patients who are treated with antibiotics may have decreased gut flora and vitamin K synthesis.

DIF: Cognitive Level: Knowledge REF: p. 394 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation

Chapter 23: Nutrition Support in Cancer and HIV Nix: Williams' Basic Nutrition and Diet Therapy, 15th Edition MULTIPLE CHOICE 1. Ordinarily, the cell operates in an orderly fashion under the influence of the a. genetic code. b. outside environment. c. endoplasmic reticulum. d. nutrients taken into the cell.

ANS: A

Cell operation is guided by a cell’s genes and genetic code.

DIF: Cognitive Level: Knowledge REF: p. 411 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 2. The point at which a mutagen causes irreversible damage to DNA is referred to as a. neoplasms. b. promotion. c. initiation. d. progression.

ANS: C

Initiation is the point at which a mutagen causes irreversible damage to the DNA. DIF: Cognitive Level: KnowledN geURSINRGETFB : .pC . 4O1M 1 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 3. Factors associated with the development of cancer include a. foods that are microwaved. b. radiation exposure. c. food-borne disease. d. diabetes mellitus.

ANS: B

Causes of cancer include mutations or changes in a cell’s genes caused by chemical carcinogens such as cigarette smoke; radiation from x-rays, radioactive materials, sunlight, or atomic wastes; viruses; epidemiologic factors; stress factors; and some dietary factors linking deficiencies of specific nutrients with an increased risk of DNA damage and cancer.

DIF: Cognitive Level: Knowledge REF: pp. 413-414 TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity: Physiological Adaptation 4. The immune system’s ability to function is compromised by a. increased metabolism of water-soluble vitamins. b. increased metabolism caused by emotional stress. c. severe malnutrition with atrophy of organs and tissues. d. increased hormonal levels associated with stress.

ANS: C

Severe malnutrition compromises the capacity of the immune system because of the atrophy of the organs and tissues that are involved in immunity.

DIF: Cognitive Level: Knowledge REF: p. 413 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 5. The cellular component of the immune system that is derived from the thymus is the a. T cell. b. B cell. c. phagocyte. d. lymphocyte.

ANS: A

T cells are lymphocytes derived from the thymus cells, and B cells are lymphocytes derived from the bursal intestinal cells.

DIF: Cognitive Level: Knowledge REF: pp. 412-413 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 6. The cells responsible for synthesis and secretion of antibodies are the a. immunoglobulins. b. T cells. c. B cells. d. lymphocytes.

ANS: C

The B cells produce proteins knNoUwRnSaI s aNnGtiT boBd. ieCs,OwMhich also kill antigens.

DIF: Cognitive Level: Knowledge REF: pp. 412-413 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 7. The person who has the highest risk for developing cancer is a. a minimum-wage worker who usually runs out of money to buy food between

paychecks and eats mostly pasta. b. a body builder who supplements his or her food intake with protein shakes and

vitamin and mineral supplements. c. an elderly man who lives alone and eats at the local congregate meal site at noon

each weekday. d. a nurse who has a young family and works full time in the oncology clinic of a

local hospital.

ANS: A

Protein-energy malnutrition, often caused by having inadequate money to buy food, decreases immunity and increases the risk of cancer.

DIF: Cognitive Level: Application REF: p. 415 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 8. Cancer therapy that uses radioactive isotopes is a. surgery. b. radiation therapy.

c. chemotherapy. d. an x-ray.

ANS: B

Radiation therapy involves treatment with high-energy radiography that targets the cancer site to kill or shrink cancerous cells.

DIF: Cognitive Level: Knowledge REF: p. 414 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 9. A disadvantage associated with abdominal radiation is that a. the structure and function of the bowel may be adversely affected. b. the radiation can be dispersed to all the abdominal organs once it passes into the

cavity. c. it is hard to pinpoint the precise area to target the radiation. d. the treatment itself is often very painful for the patient.

ANS: A

Radiation to the bowel affects the intestinal mucosa, causing loss of villi and the absorbing surface; therefore, malabsorption problems may follow. Ulcers or inflammation and obstruction or fistulas also may develop from tissue breakdown.

DIF: Cognitive Level: Application REF: p. 414 TOP: Nursing Process: Intervention MSC: NCLEX: Physiological Integrity: Physiological Adaptation 10. Patients who receive chemotherapeutic drugs often develop a. tremors.

NURSINGTB.COM b. anemia. c. hypertension. d. abnormal heart rhythms.

ANS: B

Chemotherapeutic drugs affect bone marrow and interfere with the production of red blood cells, causing anemia.

DIF: Cognitive Level: Knowledge REF: p. 414 TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity: Physiological Adaptation 11. A major systemic effect of cancer is a. edema. b. hypoglycemia. c. dehydration. d. negative nitrogen balance.

ANS: D

Negative nitrogen balance is a major systemic effect of cancer.

DIF: Cognitive Level: Knowledge REF: pp. 414-415 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 12. An appropriate recommendation for a patient with cancer who has a poor appetite is to

a. b. c. d.

plan several small meals and snacks each day. let hunger dictate the eating pattern to avoid nausea. drink a full glass of water before each meal. eat mostly fruits and vegetables.

ANS: A

Patients with a poor appetite should plan to eat several small meals and snacks each day, regardless of their hunger level, to minimize weight loss and tissue catabolism.

DIF: Cognitive Level: Application REF: p. 430 TOP: Nursing Process: Intervention MSC: NCLEX: Physiological Integrity: Physiological Adaptation 13. Patients who receive chemotherapy drugs often develop anemia because the drugs a. damage the bone marrow. b. prevent iron absorption. c. interfere with folate metabolism. d. destroy hemoglobin.

ANS: A

Chemotherapy affects the bone marrow. Reduced red blood cell production causes anemia.

DIF: Cognitive Level: Knowledge REF: p. 414 TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity: Physiological Adaptation 14. The primary goal in nutrition care of patients with cancer is to a. prevent further growth of thNeUtuRm SoIr.NGTB.COM b. reduce nutrients that the tumor feeds on. c. prevent malnutrition. d. promote weight gain.

ANS: C

The primary goal of nutrition care in cancer patients is to prevent malnutrition. Negative nitrogen balance is a major systemic effect of cancer. Adequate calories are necessary to spare protein for tissue building.

DIF: Cognitive Level: Knowledge REF: p. 418 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 15. To counteract the hypermetabolic state of cancer, it is important to increase the intake of a. protein. b. kilocalories. c. vitamins. d. fats.

ANS: B

It is important to increase the intake of kilocalories to supply adequate energy and spare protein to be used for tissue healing. The hypermetabolic nature of the disease and its healing requirements place great energy demands on a cancer patient.

DIF: Cognitive Level: Application

REF: p. 416

TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Physiological Integrity: Reduction of Risk Potential 16. For patients with cancer, a good source of dietary protein is a. a scrambled egg. b. applesauce. c. orange sherbet. d. mashed potatoes.

ANS: A

Scrambled eggs are a good source of dietary protein, which is necessary for tissue synthesis for healing.

DIF: Cognitive Level: Application REF: pp. 416-417 TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 17. Given a functional gastrointestinal tract, the preferred method of feeding a patient with cancer

is a. b. c. d.

a normal oral intake. a liquid formula diet. tube feeding. total parenteral feeding.

ANS: A

With a functional gastrointestinal tract, the preferred method of feeding is a normal oral diet NURSINGTB.COM supplied with adequate kilocalories and protein sources along with adequate fat, vitamins, and minerals.

DIF: Cognitive Level: Knowledge REF: pp. 415-416 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 18. If salivary secretions are reduced or absent, it may be most helpful to a. serve a clear liquid diet. b. use a tube feeding. c. serve food in semiliquid form. d. serve water with the meal.

ANS: C

Food served in a semiliquid form may be better accepted by patients with decreased salivary secretions.

DIF: Cognitive Level: Application REF: p. 420 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 19. Mr. T has been undergoing treatment for cancer; he has not felt like eating all day and

complains of much discomfort and pain. A possible initial intervention to assist in increasing his appetite is to a. administer appetite-stimulant medication as soon as possible. b. assess for weight loss and speak with the physician regarding tube feeding.

c. assess pain and discomfort and provide pain-relief measures. d. change the diet plan to all liquids to make it easier to ingest food items.

ANS: C

Patients are better able to eat if pain is controlled and if they are as comfortably positioned as possible.

DIF: Cognitive Level: Application REF: p. 422 TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity: Physiological Adaptation 20. An appropriate intervention for a patient with neutropenia would be to a. drink liquids between meals rather than with meals. b. cook food items immediately after thawing. c. eat at least six, small meals each day. d. serve soy-based milk rather than cow’s milk.

ANS: B

For those with neutropenia, foods should be cooked right after thawing to avoid possible microbial contamination.

DIF: Cognitive Level: Application REF: p. 419 TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Physiological Integrity: Reduction of Risk Potential 21. A patient with lipodystrophy may benefit from following a a. Mediterranean diet.

NURSINGTB.COM b. high-protein diet. c. liquid and semiliquid diet. d. vegetarian diet.

ANS: A

Lipodystrophy is often associated with metabolic syndrome, so a heart-healthy, Mediterranean diet may help lessen comorbidities and complications.

DIF: Cognitive Level: Application REF: p. 431 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 22. Mucositis is an inflammation of the a. stomach mucosa. b. intestinal mucosa. c. oral mucosa. d. pancreas.

ANS: C

Mucositis is an inflammation of the tissues around the mouth or other orifices of the body.

DIF: Cognitive Level: Knowledge REF: pp. 419-420 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 23. Symptoms that may occur during the asymptomatic HIV infection stage include a. persistent fatigue, night sweats, thrush, and diarrhea.

b. a flulike syndrome lasting a few days or weeks. c. pneumonia, lymphoma, Kaposi’s sarcoma, and tuberculosis. d. hyperglycemia, heart arrhythmias, and loss of appetite.

ANS: B

Approximately 2 to 4 weeks after initial exposure and infection, a mild flulike episode lasting about 1 week may occur. This brief, mild response reflects the initial development of antibodies to the viral infection.

DIF: Cognitive Level: Application REF: pp. 422-424 TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity: Physiological Adaptation 24. If a patient has a CD4+ ƒ of 350 cells/µL, they have a. stage 0 HIV. b. stage 1 HIV. c. stage 2 HIV. d. stage 3 HIV. ANS: C

Stage 2 CD4+ T-lymphocyte values are defined as 200 to 499 cells/µL. DIF: Cognitive Level: Application REF: p. 424 TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity: Physiological Adaptation 25. Protease inhibitors work by a. inhibiting the enzyme proteN asUeR . SINGTB.COM b. preventing reverse transcriptase. c. binding to HIV. d. enhancing the enzyme lipase.

ANS: A

Protease inhibitors work by inhibiting the basic enzyme protease, which is essential to HIV’s development.

DIF: Cognitive Level: Application REF: p. 426 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 26. Nutrition support is a vital care component throughout the progression of HIV infection and

especially in the advanced stages of the disease because of its role in a. controlling involuntary weight loss and tissue wasting. b. maintaining cardiac function. c. preventing the spread of the HIV virus. d. preventing anemia and constipation.

ANS: A

The role of nutrition support is a vital component of care for the patient with HIV infection to control involuntary weight loss and tissue wasting.

DIF: Cognitive Level: Application REF: p. 430 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance

27. A fundamental effect of untreated HIV infection is a. nausea. b. vomiting. c. major weight loss. d. cirrhosis.

ANS: C

Patients with HIV typically have a decreased appetite and an insufficient energy intake coupled with elevated resting energy expenditure. Major weight loss follows and eventually leads to extreme cachexia, similar to that seen in cancer patients.

DIF: Cognitive Level: Knowledge REF: p. 430 TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity: Physiological Adaptation 28. An HIV-positive patient should be referred to the clinical dietitian on the AIDS team a. at the first contact with a health professional. b. at stage 2 with development of symptoms. c. at stage 3 with AIDS-indicator conditions. d. when the patient has nutrition-related problems.

ANS: A

An HIV-positive patient should be referred to the clinical dietitian at the first contact with a health professional. The initial evaluation is critical in providing guidelines for ongoing care.

DIF: Cognitive Level: Application REF: p. 426 TOP: Nursing Process: AssessmN enU t RSINGTB.COM MSC: NCLEX: Physiological Integrity: Physiological Adaptation 29. The nutrition care plan for AIDS patients is a. the same as for healthy individuals. b. consistent throughout the course of the disease. c. based on the CD4+ T-lymphocyte count. d. individualized and continually adjusted throughout the course of the disease.

ANS: D

The nutrition care plan for patient with AIDS, as any other medical nutrition therapy, is individualized and adjusted throughout the course of the disease.

DIF: Cognitive Level: Application REF: p. 430 TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity: Physiological Adaptation 30. The best strategy for a person with HIV infection is to a. recommend intake of specific combinations of food. b. expect significant changes in lifestyle behaviors. c. promote optimal nutrition while making the fewest food changes. d. act as a catalyst for selecting appropriate lifestyle changes.

ANS: C

Guidelines for counseling a person with HIV infection include promoting optimal nutrition while making the fewest food changes. Changing behavior in any area requires the motivation, desire, and ability to achieve one’s goals, and AIDS is no exception. All information or actions should proceed in manageable steps, as small as necessary.

DIF: Cognitive Level: Application REF: p. 431 TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance

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