Chapter 12, 13, 17, 19 Nutrition PDF

Chapter 12: Nutrition for Adults: The Early, Middle, and Later Years Nix: Williams’ Basic Nutrition and Diet Therapy, 16th 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...

Chapter 12: Nutrition for Adults: The Early, Middle, and Later Years Nix: Williams’ Basic Nutrition and Diet Therapy, 16th 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. 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. 107  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 Integrity: Physiological Adaptation | 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. 108  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. 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. 191 109  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 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 110  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 to eat with and enjoy the food. 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. 111  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 The congregate meal is the noon meal. DIF: Cognitive Level: Knowledge REF: p. 200 TOP: Nursing Process: Planning 112  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. c. personality type. 113  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. 114  DIF: Cognitive Level: Knowledge REF: p. 196 TOP: Nursing Process: Assessment | Nursing Process: Planning 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 115  Chapter 13: Community Food Supply and Health Nix: Williams’ Basic Nutrition and Diet Therapy, 16th 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. 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. 116  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 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 117  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 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 118  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 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 119  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. 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. 120  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 Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 20. Nutrition programs established by the government for the elderly include a. the Share a Meal campaign. 121  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 cholesterol must also be low in saturated fat. 122  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. 123  b. an apple. c. milk. d. rice. 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 124  a. crackers. b. fortified cereal. c. ice cream. d. sausage. ANS: B 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 125  Chapter 17: Nutrition Care Nix: Williams’ Basic Nutrition and Diet Therapy, 16th 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 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 155  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. 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. 156  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. 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 157  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 REF: p. 291 TOP: Nursing Process: Assessment 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. 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 158  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 practitioner. DIF: Cognitive Level: Application REF: pp. 298-299 TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 159  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 a. a nutrient imbalance. b. a lack of physical exercise. c. excessive oral hygiene. 160  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 161  Skin calipers are a useful tool to measure skinfold thickness. Calipers measure the relative amount of subcutaneous fat at various body sites. 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. 162  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 furanocoumarin that can interact with certain medications is a. red apple slices. b. grapefruit juice. c. mashed potatoes. d. chicken noodle soup. ANS: B Grapefruit juice contains furanocoumarin and can interact with certain medications. 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 = 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 163  Chapter 19: Coronary Heart Disease and Hypertension Nix: Williams’ Basic Nutrition and Diet Therapy, 16th 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 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 175  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) 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. 176  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 REF: pp. 332-333 TOP: Nursing Process: Implementation 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: Application REF: p. 336 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. 177  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. 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 178  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 17. The cause of essential hypertension is a. coronary heart disease. b. stress. c. hormone imbalance. d. unknown. 179  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 Integrity: Physiological Adaptation 21. Nutrition therapy for those with heart failure restricts sodium to a. 1.0 g per day. 180  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. 181  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 182  28. The sandwich that is likely to have the lowest sodium content is a a. tuna sandwich. 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. canned salmon. b. ketchup. c. ramen soup. d. 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 183