Test Bank Nutritional Foundations Clinical Applications Nursing Approach 6th Edition, Michele
Chapter 01: Wellness Nutrition
1. Examples of informal education include
a. attending a workshop on coronary artery disease sponsored by the American Heart Association.
b. watching a television show about diabetes.
c. learning about food safety techniques in a high school economics course.
d. joining a support group to help overcome an eating disorder.
2. A college student exercises regularly and generally eats a healthy variety of foods, is taking a course in general nutrition, buys locally produced food whenever possible, is an active member of an on-campus faith-based organization, and keeps a journal to help process her emotions. What else could be important for her to include in her life in order to develop her overall wellness?
a. Growing some of her own food
b. Keeping a food record to help evaluate what she eats
c. Eating meals with friends throughout the week
d. Meeting with a registered dietitian to review her food choices
3. For a client who is missing meals because of poor planning or is too busy to eat, emotional health can be affected by _____, which can cause confusion or anxiety.
a. low blood sugar levels
b. high blood sugar levels
c. high blood pressure
d. extremely low blood pressure
4. The best example of the type of concern that is likely to be addressed by the U.S. Department of Health and Human Services when target goals for Healthy People 2030 are updated is
a. preference for vegetarian eating patterns among white women.
b. low intake of fruits and vegetables by African American children.
c. widespread use of bottled water in higher socioeconomic groups.
d. common use of protein and vitamin supplements in athletes.
5. An example of community support for health promotion is
a. teaching a young mother skills in safe food preparation.
b. watching a television documentary about industry errors in food processing.
c. labeling fresh poultry packages with information about proper food storage.
d. being aware that Salmonella can be transmitted because of inadequate food preparation.
6. An example of a technique for health promotion is
a. exercising five times a week.
b. local supermarkets’ expanding the availability of fresh fruits and vegetables.
c. teaching a teenager how to choose healthier foods at fast-food restaurants.
d. information about the relationship of dietary intake and diet-related disorders.
7. For the efficient functioning and maintenance of the body, a person needs to consume sufficient amounts of
8. A nurse has just been assigned to a community health program for older adults. She should check the document Healthy People 2020 to become familiar with
a. nutrition priorities and goals for older American adults.
b. dietary standards for Americans older than 50 years.
c. dietary guidelines recommended for older adults.
d. MyPlate recommendations for older adults.
9. A healthy female middle-aged client asks what she can do to prevent the development of type 2 diabetes. Weight control and nutrition strategies discussed are considered
a. primary treatment.
b. primary prevention.
c. secondary prevention.
d. tertiary prevention.
10. As a home health care nurse, you are visiting a 70-year-old client who has just returned home from the hospital after being treated for coronary artery disease. The medical nutrition therapy developed for him by the hospital dietitian is considered
a. palliative care.
b. primary prevention.
c. secondary prevention.
d. tertiary prevention.
Chapter 02: Personal and Community Nutrition
1. A client tells you that he cannot eat most green vegetables because they taste too bitter. What is the most likely explanation?
a. He has certain genetic taste markers that make him a “super taster.”
b. He associates eating green vegetables with unpleasant childhood memories.
c. He needs to train himself to enjoy the acquired taste of bitter vegetables.
d. He is making an excuse to avoid making healthful changes in his eating habits.
2. A teenaged client is hungry and goes to the refrigerator for a snack. A holiday has just been celebrated at her home, and many of her favorite foods are available. She selects some slices of roast turkey and a cup of her aunt’s special fruit salad. This is an example of
c. food choice.
d. food preference.
3. A mother tells you that she does not allow her young children to eat while they watch television, even though her husband often eats high-fat, sugary foods while they watch television as a family. The most important thing to discuss with her is the
a. genetic factor of preference for sweet and salty tastes.
b. influence of ethnicity on preference for sour tastes.
c. children’s weights when they were born and their weights now.
d. environmental effects of parental food choices and television watching.
4. If a middle-aged couple with two teenage children has insufficient income to purchase food, the most helpful program for them would be the
a. MyPlate food guidance system.
b. National School Lunch and School Breakfast Programs.
c. federal government’s Supplemental Nutrition Assistance Program (SNAP).
d. Special Supplemental Nutrition Program for Women, Infants, and Children (WIC).
5. For most Americans, the most significant nutrition concerns are
a. lack of interest in making healthy food choices.
b. poor availability of fruits and vegetables in many areas.
c. excessive intake of saturated fats, cholesterol, sodium, and sugars.
d. inadequate intake of key vitamins, minerals, and phytochemicals.
6. Excessive intake of high-sodium, high-fat foods can lead to diet-related illnesses such as
a. genetic disorders, hypertension, and diabetes.
b. hypertension and sickle cell anemia.
c. viral infections that necessitate antibiotics.
d. coronary artery disease and hypertension.
7. Of the following, the most important overall dietary modification to help reduce the risk of chronic disease is
a. eating fewer foods that contain preservatives.
b. buying mostly locally grown foods.
c. eating more plant-based foods.
d. eating more animal-based foods.
8. One way to help clients follow the Dietary Guidelines for Americans is to encourage them to use
a. Healthy People 2020.
b. the MyPlate food guidance system.
c. the Supplemental Nutrition Assistance Program (SNAP).
d. the Exchange Lists for Meal Planning.
9. For a client who follows a vegan diet, the most helpful meal planning tool would be
a. the Healthy Eating Plate, produced by the Harvard School of Public Health.
b. the Mediterranean Diet Pyramid, from Oldways Preservation and Exchange Trust.
c. the Power Plate, created by the Physicians Committee for Responsible Medicine.
d. Exchange Lists for Meal Planning, from the American Diabetes Association and the American Dietetic Association
10. An indirect benefit of the “Fruits & Veggies—More Matters” program is
a. better understanding of fruit and vegetable preparation techniques.
b. increased availability of fruits and vegetables in “food deserts.”
c. eating more fresh produce in season.
d. decreasing dietary fat intake.
Chapter 03: Digestion, Absorption, and Metabolism
1. Peristalsis is necessary to make it possible for people to _____ food.
d. smell and taste
2. Examples of mechanical digestion include
a. activity of salivary amylase in the mouth.
b. churning and mixing of food in the stomach.
c. action of bile breaking fats into smaller droplets.
d. effects of secretin in stimulating the pancreas to release bicarbonate.
3. An example of a problem caused by a sphincter muscle not operating properly is
b. gallbladder disease.
d. peptic ulcer.
4. The best description of an enzyme is a(n)
a. chemical messenger.
b. acid and alkali buffer.
d. organic catalyst.
5. Chemicals that act as messengers are called
d. nerve impulses.
6. The action of salivary amylase in the mouth is an example of
a. chemical digestion.
c. mechanical digestion.
d. peristalsis and segmentation.
7. Most mechanical breakdown of food occurs in the
a. large intestine.
b. liver and pancreas.
c. mouth and stomach.
d. esophagus and mouth.
8. The body process over which people have most conscious control is
9. When someone walks by a bakery and smells the fresh bread, his or her mouth starts to water. As the person thinks about eating the fresh bread, another digestive function that starts to occur is
a. peristalsis in the small intestine.
b. stimulation of pancreatic secretions.
c. increased blood flow to the gut and liver.
d. release of the hormone gastrin in the stomach.
10. The most important functions of the small intestine are
a. digestion and denaturation.
b. segmentation and excretion.
c. digestion and absorption.
d. peristalsis and mechanical digestion.
Chapter 04: Carbohydrates
1. The primary function of carbohydrates in the body is to provide
d. dietary fiber.
2. Fructose, galactose, and glucose are examples of
d. complex carbohydrates.
3. The sweetness in a banana comes mostly from
a. fructose and sucrose.
b. fructose and glucose.
c. glucose and maltose.
d. maltose and sucrose.
4. A blood glucose level of 60 mg/dL is considered to be
b. representative of hypoglycemia.
c. representative of normoglycemia.
d. representative of hyperglycemia.
5. In comparison with table sugar (sucrose), honey tastes _____ because it contains _____.
a. sweeter; fructose
b. sweeter; maltose
c. less sweet; fructose
d. less sweet; maltose
6. Someone who follows a strict vegetarian (vegan) diet and eats very few refined foods is likely to have _____ intake of _____ carbohydrates and dietary fiber.
a. low; complex
b. high; complex
c. low; simple
d. high; simple
7. A person would be most likely to produce excessive ketones if his or her food intake that day consisted only of
a. green salad with oil and vinegar dressing.
b. refried pinto beans and rice.
c. cheeseburgers and French fries.
d. fried eggs with bacon and hash brown potatoes.
8. Since the 1970s, consumption of refined white sugar has decreased, mostly because
a. health-conscious consumers are using less of it.
b. use of high-fructose corn syrup has increased.
c. use of artificial sweeteners has increased.
d. use of honey and other natural sweeteners has increased.
9. The person who is most likely to develop dental caries is one who
a. eats dessert after each meal.
b. drinks two or three regular soft drinks every day.
c. snacks on candy bars between meals.
d. chews gum throughout the day.
10. The most significant effect of bacteria in the mouth is fermentation of
a. dietary fiber, which promotes formation of beneficial short-chain fatty acids.
b. dietary fiber, which increases intestinal gas production.
c. simple carbohydrates, which promotes production of sugar alcohols and causes halitosis.
d. simple carbohydrates, which promotes formation of plaque and tooth decay.
Chapter 05: Fats
1. Of the following, the food that would provide the most energy per ounce is
d. hard candy.
2. The most beneficial function of cholesterol in the body is
a. formation of sex hormones, bile, and vitamin D.
b. depositing plaques in arteries.
c. being part of cell membrane structure.
d. solubility in both water and fat.
3. If a patient receiving parenteral nutrition develops eczema, the patient probably has
a. vitamin C deficiency.
b. essential fatty acid deficiency.
c. protein-energy malnutrition.
d. phospholipid and sterol deficiency.
4. If a food that is usually made with hydrogenated oil is made with vegetable oil instead, one potential concern is that the
a. flavor will be significantly different.
b. food will feel oily to the touch.
c. food will contribute more to cardiovascular risk.
d. food will have a shorter shelf life.
5. A triglyceride is a compound composed of
a. glycerol with two fatty acids attached.
b. glycerol with three amino acids attached.
c. glycerol with three fatty acids attached.
d. organic molecules formed in triangular chains.
6. To decrease intake of saturated fatty acids and increase intake of polyunsaturated fatty acid, one dietary change would be from using _____ to using _____ oil.
a. shortening; coconut
b. margarine; olive
c. soybean oil; canola
d. butter; sunflower
7. If a client wants to lose 1 lb of body fat each week, he or she would need to make sure that the daily calorie intake was lower than the daily energy needs by _____ kcal/day.
8. Of the following fats, the one that is most likely to be liquid is
a. milk fat.
b. beef drippings.
c. coconut oil.
d. peanut oil.
9. The number of double bonds present in the fatty acid chain determines the
a. number of fatty acids attached to the glycerol molecule.
b. number of glycerol molecules attached to a fatty acid.
c. degree of saturation or unsaturation of a fatty acid.
d. degree of saturation or unsaturation of the glycerol molecule.
10. A client who wishes to avoid blood clots may benefit from regular intake of
a. fish oil capsules.
d. olives and olive oil.
Chapter 06: Protein
1. If a person were to eat a diet that provided carbohydrate, fat, and micronutrients, but very little protein, for example if he or she ate only whole-wheat pita bread with olive oil,
a. the body would manufacture amino acids to make essential proteins from fatty acids and glycogen.
b. body metabolism would decrease to conserve amino acids until protein intake was resumed.
c. the liver would recirculate amino acids instead of breaking them down and excreting urea.
d. the body would break down muscle tissue to provide amino acids to make essential proteins.
2. If a man weighs 190 lb and eats 150 g protein per day, his protein intake is _____ of the Recommended Dietary Allowance (RDA).
a. less than 100%
b. between 100% and 150%
c. between 150% and 200%
d. greater than 200%
3. Some proteins contain an alpha helix, which is part of their _____ structure.
4. The most accurate statement about amino acids is that
a. most amino acids contain sulfur.
b. they are stored in the liver for use when needed.
c. essential amino acids cannot be manufactured by body cells.
d. nonessential amino acids cannot be manufactured body cells.
5. Nonessential amino acids can be made by the liver from
a. glucose and urea.
b. other amino acids.
c. fatty acids and glycerol.
d. enzymes and hormones.
6. If a person usually ate 2 ounces of lean meat at lunchtime and decided to substitute cooked lentils instead, how much of the lentils would the person need to eat?
a. 2 tablespoons
d. 1 cup
7. Body proteins may become denatured in the presence of a
a. drug overdose.
b. very high fever.
c. vitamin deficiency.
d. high stress level.
8. The most important function of hydrochloric acid in the stomach is to
a. convert pepsinogen to its active enzyme form, pepsin.
b. denature dietary proteins to allow digestion.
c. kill bacteria in food and prevent foodborne illness.
d. stop the action of salivary amylase.
9. A patient fell off a bicycle and broke one arm and one leg. Immediately after the accident, the patient’s body will be in a state of
10. Without vitamin B6, the body would be unable to
a. absorb amino acids.
b. digest proteins.
c. convert ammonia to urea.
d. regulate acid-base balance.
Chapter 07: Vitamins
1. A patient is admitted to the hospital with confusion, memory loss, and ataxia. What other information would lead you to suspect that his symptoms may be caused by secondary thiamin deficiency?
a. The patient has very limited funds and has been eating mainly rice and beans.
b. The patient admits that he struggles with alcoholism.
c. The patient is recovering from a minor stroke.
d. The patient has a family history of Alzheimer’s disease.
2. An example of someone who has a relatively high risk for vitamin deficiencies is a(n)
a. 45-year-old half marathon runner.
b. 85-year-old man living independently.
c. college-age woman living with roommates.
d. breastfed newborn.
3. Deficiencies are likely to develop most rapidly with low intake of vitamin
4. The best way to ensure intake of a variety of phytochemicals is to
a. take a daily multivitamin supplement that includes phytochemicals.
b. increase intake of soy-based foods, such as soy milk, tofu, and soy flour.
c. choose whole grains and include at least five servings of fruits and vegetables daily.
d. include at least three servings of dairy products daily and use a variety of herbs and spices.
5. The person who would have the highest need for thiamin is
a. someone who lifts weights to maintain health.
b. a pregnant woman.
c. a professional cyclist.
d. an older adult who walks 2 miles daily.
6. A homeless man is brought into the emergency room with muscle weakness, loss of coordination, and tachycardia. He has alcohol on his breath. He may be suffering from a deficiency of
7. If whole milk is stored in a clear bottle in a refrigerator with a glass front,
a. the milk fat may separate and rise to the top of the bottle.
b. some of the protein in the milk may become denatured.
c. the ultraviolet light exposure may destroy the vitamin D.
d. the ultraviolet light exposure may destroy the riboflavin.
8. A good way to increase intake of riboflavin would be to
a. eat cereal with skim milk for breakfast instead of toast and juice.
b. replace romaine lettuce salad with spinach salad.
c. drink orange juice instead of apple juice.
d. make sandwiches with whole grain bread instead of white bread.
9. In a very poor country where the subsistence crop is corn and intake of animal protein is very limited, the population has a high risk for developing
c. spina bifida.
d. pernicious anemia.
10. Niacin can be manufactured by the body from the amino acid
Chapter 08: Water and Minerals
1. If a woman who drinks a cup of decaffeinated coffee in the morning, a cup of fruit juice with lunch, 6 cups of water throughout the day and a cup of tea at bedtime, her fluid intake would be considered
a. dangerously low.
b. below optimal.
d. too high.
2. Having only softened tap water at home would be of most concern to a(n)
a. pregnant woman.
b. full-time student who also works part-time.
c. elderly woman with osteoporosis.
d. retired man with hypertension.
3. Interstitial fluid is the body fluid
a. within the cells.
b. outside the cells.
c. between the cells.
d. in the bloodstream.
4. Dehydration is most likely to have a negative effect on
a. digestion of food.
b. storage of excess energy.
c. nerve impulse conduction.
d. body temperature regulation.
5. It would be most difficult for the body to maintain homeostasis if over several days someone had an inadequate intake of
6. If an athlete ran a marathon, sweated profusely, and drank only water with some sugar to replace fluids and carbohydrate, his or her body would increase secretion of
d. antidiuretic hormone (ADH).
7. If a patient complained of muscle weakness, confusion, decreased appetite, and irregular heartbeat, it would be important to check blood levels of
8. In an older adult who is usually very alert, disorientation may be a sign of
a. iron deficiency.
9. If an elderly client who lives alone and has a limited income has edema, it would be important to evaluate his or her dietary intake of sodium and
10. The term bioavailability means the
a. total amount of a mineral in a food.
b. ratio of free mineral to bound mineral in a food.
c. amount of a mineral that is excreted by the body.
d. amount of a mineral that can be absorbed by the body from a food.
Chapter 09: Energy, Weight, and Fitness
1. A good example of living in an obesogenic environment is
a. working for an employer who gives employees free membership at a health club.
b. being a former high school athlete who now works in a sedentary job.
c. living in an apartment complex where it is unsafe for children to play outside unsupervised.
d. a physician’s recommendation not to exercise during recovery from surgery.
2. The total amount of energy in a bowl of soup that contains 5 g of protein, 2 g of fat, and 20 g of carbohydrate is _____ kcal.
3. The fuel for all body processes that traps energy released from food is
b. acetyl coenzyme A.
d. adenosine triphosphate.
4. If a person hears a friend calling for help and goes running to find out what the friend needs, the person would be getting his or her energy from
a. fatty acids via adrenaline release.
b. glucose and amino acids via aerobic pathways.
c. glycogen via anaerobic glycolysis.
d. fatty acids and glycerol via oxidative phosphorylation.
5. If someone goes on a long hike, after 4 hours most of his or her energy will be obtained from
c. fatty acids.
d. amino acids.
6. Athletes who exercise regularly are able to exercise for longer, partly because their body is able to use more energy from
c. Amino acids.
7. Of the following, the person who would be expected to have the highest energy expenditure is a
a. man who cycles to work every day and plays on sports teams on the weekend.
b. man who works 60 hours a week at a high-stress job.
c. woman who works as a personal trainer at a health club.
d. woman who works as a nurse in a clinic.
8. The most effective way to increase energy expenditure is to
a. eat foods that require more energy for digestion, absorption, metabolism, and storage.
b. use thyroid hormones to increase basal metabolic rate.
c. increase the duration and intensity of daily activities.
d. lift weights to increase lean body mass and thereby increase basal metabolism.
9. The behavior change that would do most to help preserve lean body mass is
a. avoiding weight loss.
b. exercising regularly.
c. decreasing dietary fat intake.
d. ensuring adequate protein intake.
10. The duration of physical activity needed to maintain physical fitness depends on the
a. time of day.
b. ambient temperature.
c. intensity of the activity.
d. flexibility of the individual.
Chapter 10: Nutrition Across The Life Span
1. A pregnant client complains of constipation during pregnancy. This is probably caused by
a. inadequate intakes of dietary fiber and fluids.
b. reduced activity levels as body size increases.
c. increased levels of the hormone estrogen.
d. increased levels of the hormone progesterone.
2. If a woman has had preeclampsia and hypertension in a previous pregnancy, then during this pregnancy she should
a. restrict her sodium intake.
b. continue her regular sodium intake.
c. restrict her protein intake.
d. take iron and calcium supplements.
3. For a woman with a healthy prepregnancy weight, gaining a total of 31 pounds throughout pregnancy would be considered
a. too low for a healthy pregnancy.
b. too high for a healthy pregnancy.
c. within the current recommended range for weight gain.
d. within the current recommended range for weight gain for a woman experiencing gestational diabetes.
4. If an obese woman is 6 months pregnant and has gained about 8 lbs so far, her health care provider should recommend that she
a. try to maintain her current weight throughout the rest of her pregnancy.
b. continue to gain weight at about the same rate throughout the pregnancy.
c. increase her weight gain to achieve weight gain in the recommended range.
d. plan food choices carefully and gradually lose weight during pregnancy.
5. The nutrient that pregnant women are most likely to need to take in the form of a supplement is
d. vitamin C.
6. The health care provider would be most concerned if a pregnant woman told him or her that she
a. has to taste wines to pair with foods for catering events.
b. has cravings for salty snacks throughout the day.
c. follows a vegan pattern of eating.
d. lost 40 lb during the year before she became pregnant.
7. If a woman in her last trimester of pregnancy has marked edema, what else should be evaluated?
a. Body temperature and hematocrit
b. Blood and urinary glucose levels
c. Blood pressure and urine protein levels
d. Sodium intake and urinary sodium excretion
8. Recommendations for treatment of gestational diabetes include
a. weight loss.
b. dietary control.
c. avoidance of sugar.
d. oral diabetes medication.
9. The best way for a nursing mother to increase her milk supply is to
a. nurse her infant more often and for longer periods of time.
b. provide supplemental formula to allow milk reserves to build.
c. drink lactogenic herbal teas that stimulate milk production.
d. drink extra milk and add extra servings of dairy products.
10. The most potentially harmful situation for an infant is
a. breastfeeding during the day and bottle-feeding at night.
b. running out of infant formula and using whole milk for a few days instead.
c. breastfeeding by a mother who is being treated with antibiotics.
d. breastfeeding by a mother who gained less weight than is recommended during pregnancy.
Chapter 11: Nutrition Assessment and Patient Care
1. The situation in which it would be most important for the nurse to contact the registered dietitian (RD) is if a
a. patient complains of constipation during his or her hospital stay.
b. patient’s family complains about the quality of the food in the hospital.
c. patient reports losing 10 lb in the past year without trying.
d. patient has been receiving intravenous glucose and saline but no oral intake for 36 hours.
2. An example of a common cause of iatrogenic malnutrition is
a. scheduling of frequent daily tests that prevents the patient from eating meals.
b. food from home brought in by family members and friends of a patient.
c. small portion sizes of hospital food and absence of snacks.
d. errors in ordering and delivery of meals for hospitalized patients.
3. If a patient is 6 feet tall and his or her waist measures 42 inches, the patient would be considered to have _____ fat levels consistent with _____ risk for chronic disease.
a. essential; low
b. essential; high
c. abdominal; low
d. abdominal; high
4. The best way to estimate height for a patient with both legs amputated below the knee is to use
a. demi-span (distance from the sternal notch to the middle finger).
b. knee height (with the use of calipers to measure heel-to-thigh distance).
c. recumbent bed height measured while the patient is lying down.
d. the patient’s stated pre-amputation height.
5. If a male patient weighs 140 pounds when he is admitted to a long-term care facility and weighs 147 pounds 2 months later, his percent weight change during his hospital stay is
6. If a patient weighed 150 lb 1 month ago and now weighs 140 lb, the weight loss would be considered
7. An elderly patient who has been living alone and has gradually been losing weight has had a stroke and is transferred to a long-term care facility. It is unlikely that he will be able to achieve adequate oral intake during recovery, and so a percutaneous endoscopic gastrostomy (PEG) tube is inserted to begin tube feedings into his stomach. If the patient gains 8 lb in the first week of tube feeding, it is likely that
a. he is retaining fluid weight.
b. the tube feeding is well tolerated.
c. he is constipated.
d. the feedings are replenishing muscle and fat stores.
8. Body mass index (BMI) would be most useful for evaluating the weight status of a(n)
a. middle-aged, moderately active woman.
b. elderly, mostly sedentary man.
c. high-school football player.
d. young woman undergoing chemotherapy.
9. An example of a patient considered to be at high nutrition risk is a(n)
a. 72-year-old man who has been vomiting for 12 hours.
b. 38-year-old overweight man who has had a heart attack.
c. 18-month-old child with weight in the third percentile for height.
d. woman with a broken leg and a serum albumin level of 3.8 g/dL.
10. Measurement of serum albumin level would be most useful for predicting visceral protein status in a(n)
a. patient with congestive heart failure who has very little appetite.
b. elderly patient who has been living alone and is scheduled for nonemergency surgery.
c. patient with liver failure related to chronic alcohol abuse.
d. patient who was in a serious car accident and is recovering from multiple fractures.
Chapter 12: Food-Related Issues
1. A clear liquid diet would be most appropriate for
a. someone who has had several teeth removed and is unable to chew.
b. a pregnant woman with persistent nausea.
c. someone who has had a stroke and has difficulty swallowing.
d. a patient who has had major surgery within the past 18 hours.
2. One advantage of a full liquid diet is that it
a. has low levels of saturated fat and high levels of fiber.
b. is suitable for patients with lactose intolerance.
c. is likely to be tolerated by patients with dysphagia.
d. can provide an adequate diet if very carefully planned.
3. If a patient is receiving radiation to the mouth and neck area and has a sore mouth, the most appropriate type of diet while he or she is in hospital would be a _____ diet.
b. mechanical soft
c. full liquid
d. clear liquid
4. If a patient drools, takes a long time to eat, and often gags during meals, he or she may have
b. esophageal cancer.
5. If a physician orders a “diet as tolerated” for a patient, the nurse should
a. make food selections for the patient in accordance with the patient’s symptoms.
b. determine the appropriate type of diet for the patient in accordance with the patient’s condition.
c. consult the registered dietitian to determine when the diet should be advanced.
d. encourage the patient to normalize the diet as his or her appetite and symptoms allow.
6. If an individual has back pain and seeks treatment with acupuncture, as well as a physician at a traditional spine clinic, this would be an example of using _____ medicine.
7. If a patient starts vomiting immediately after eating seafood and states that the one other time he or she ate seafood, he or she had a similar reaction, the patient probably has
a. food poisoning.
b. celiac disease.
c. an allergy to seafood
d. a viral infection.
8. A one-a-day multivitamin or multimineral supplement at 100% or less of the Dietary Reference Intake (DRI) is probably most beneficial for a(n)
a. young adult who lifts weights before work every morning.
b. older adult living at home alone.
c. business executive with a high-stress job.
d. newly retired, socially active woman.
9. According to the Dietary Supplement Health and Education Act (DSHEA) of 1994, dietary supplements are considered
d. food additives.
10. Using a margarine fortified with plant sterol and stanol esters to help decrease blood cholesterol levels is an example of using a
b. functional food.
c. dietary supplement.
d. complementary food.
Chapter 13: Nutrition for Disorders of the Gastrointestinal Tract
1. If a patient with multiple sclerosis starts coughing frequently during meals and starts to eat significantly less food than normal, the patient may have
b. gastroesophageal reflux disease.
c. peptic ulcer.
2. For a patient with dysphagia, the food that would be most difficult to swallow is
b. mashed potatoes.
c. chocolate pudding.
d. chicken noodle soup.
3. If a patient has difficulty swallowing, the best position for eating is
a. propped up in bed with a caregiver by the bedside.
b. sitting upright opposite a caregiver.
c. sitting at a dining table with social dining companions.
d. lying on the left side, with a caregiver by the side.
4. The most acute risk for patients with dysphagia is
c. dry mouth.
d. panic attacks.
5. The most helpful recommendation for a client who often experiences heartburn at night would be to
a. avoid eating within 4 hours of going to bed.
b. increase the fiber content of the diet.
c. decrease the fiber content of the diet.
d. take antacid medications before going to bed.
6. An example of a meal that is likely to relax the lower esophageal sphincter and allow gastroesophageal reflux is
a. pasta with marinara sauce and sourdough bread.
b. ham with rice pilaf.
c. fried chicken and pasta salad.
d. chicken and spinach tortilla wrap and salsa.
7. Peptic ulcer disease (PUD) would be most like to occur in someone who uses medication to treat
a. gastroesophageal reflux disease.
c. celiac disease.
d. joint pain or arthritis.
8. Nutrition therapy for peptic ulcers should be individualized, depending on
a. type of drug treatment.
b. location of the ulcer.
c. patient tolerance.
d. the cause of the ulcer.
9. If a patient who has undergone gastric bypass surgery for treatment of extreme obesity experiences sudden sweating, nausea, and stomach cramps after meals, the patient may have
a. gastroesophageal reflux.
c. peptic ulcer disease.
d. dumping syndrome.
10. An appropriate meal for someone with dumping syndrome would be
a. a small vanilla milkshake.
b. cream of mushroom soup.
c. half a turkey sandwich.
d. popcorn and sugar-free soda.
Chapter 14: Nutrition for Disorders of the Liver, Gallbladder, and Pancreas
1. If an otherwise healthy patient with normal body weight develops fatty liver disease, it would be especially important to evaluate their
a. blood glucose level.
b. alcohol intake.
c. total fat intake.
d. use of nonsteroidal anti-inflammatory drugs (NSAIDs).
2. If an obese postmenopausal woman who does not drink alcohol develops fatty liver disease and wants to avoid progression to cirrhosis or liver cancer, the best recommendation is to
a. decrease intake of saturated fats.
b. decrease intake of carbohydrate.
c. lose 3 to 4 lb per week.
d. lose 1 to 2 lb per week.
3. If a client will be visiting an area where hepatitis E virus (HEV) is endemic, the best way to prevent becoming infected is to
a. eat only cooked fruits and vegetables and drink only commercially bottled water.
b. eat only at internationally recognized establishments.
c. obtain a vaccination before entering that area.
d. avoid and raw or unpasteurized dairy products.
4. A symptom that is common to all types of hepatitis is
d. muscle aches.
5. In treating patients with hepatitis, it is important for nurses to help patients cope with the challenge of
a. difficulty sleeping.
b. risk of bleeding.
c. sodium restriction.
d. fluid restrictions.
6. An individual may be at risk for HEV infection if they travel to India and eat
a. curried shrimp.
b. fresh fruit salad.
c. Tandoori chicken.
d. cooked foods from street vendors.
7. For patients with hepatitis, an important way to minimize loss of muscle mass is to
a. participate in daily aerobic exercise.
b. participate in daily strength exercise.
c. maintain an adequate protein intake.
d. maintain an adequate micronutrient intake.
8. The person at greatest risk for developing cirrhosis or liver cancer is a(n)
a. young woman who drinks a glass of wine every day.
b. young man who travels extensively to tropical countries.
c. middle-aged overweight man with gallstones.
d. older adult infected with hepatitis C virus (HCV).
9. If a patient with cirrhosis of the liver has a “soft” diet order, he or she probably has
c. esophageal varices.
d. hepatic encephalopathy.
10. A good meal for a patient with ascites would be
a. canned minestrone soup with saltine crackers.
b. baked chicken with a roll and steamed green beans.
c. bacon, sausage, eggs, and toast.
d. tortilla chips with nacho cheese and salsa.
Chapter 15: Nutrition for Diabetes Mellitus
1. At a routine physical examination, a 50-year-old man has a fasting blood glucose level of 160 mg/dL. The next step in diagnosis and treatment would be
a. referral to a diabetes clinic.
b. prescribing an oral hypoglycemic agent.
c. rechecking fasting blood glucose level.
d. evaluating cardiovascular risk factors.
2. If a patient with type 2 diabetes shows early signs of kidney disease, the first priority in nutrition management is
a. restricting dietary protein intake.
b. normalizing blood glucose levels.
c. limiting dietary sodium intake.
d. increasing fluid intake.
3. If a patient with type 1 diabetes is unable to maintain good blood glucose control through insulin injections, the physician may recommend
a. an oral hypoglycemic agent.
b. using an insulin pump.
c. more frequent self-monitoring of blood glucose.
d. a daily exercise routine.
4. If a 15-year-old student who runs cross-country and long-distance track events starts to lose weight and is continually thirsty and hungry, he or she may have
a. type 1 diabetes.
b. type 2 diabetes.
c. acquired immunodeficiency syndrome (AIDS).
d. hepatitis virus infection.
5. The cause of type 1 diabetes mellitus is
a. excessive intake of simple sugars.
b. destruction of pancreatic beta cells.
c. inability of cells to respond to insulin in the bloodstream.
d. inability of the pancreas to keep up with the body’s demands for insulin.
6. The two strongest risk factors for type 2 diabetes are
a. obesity and family history.
b. recurrent viral infections and stress.
c. male gender and upper body obesity.
d. preference for sweet foods and sedentary lifestyle.
7. If a patient with type 2 diabetes wants to lose weight, the preferred choice of medication would be
8. If members of an overweight family wants to reduce their risk for type 2 diabetes, the most helpful nutritional change they could make would be to
a. increase their intake of dietary fiber.
b. decrease their intake of refined sugar.
c. decrease their portion sizes at meals and snacks.
d. switch to a vegetarian pattern of eating.
9. In a patient with type 2 diabetes, a glycosylated hemoglobin (HgbA1c) level of 7.9% would be considered
a. too low.
c. indicative of prediabetes.
d. indicative of poor blood glucose control.
10. The person who would be most likely to develop type 2 diabetes mellitus is a(n)
a. sedentary Asian American man.
b. man with alcohol-related cirrhosis of the liver.
c. woman with retinal damage.
d. overweight Native American woman.
Chapter 16: Nutrition in Metabolic Stress: Burns, Trauma and Surgery
1. If a 75-year-old woman needs hip replacement surgery but reports that she has lost 15 lb since her husband died 3 months ago because she has had very little appetite, the best approach would be to
a. provide enteral feedings immediately after surgery.
b. delay surgery until the patient returns to usual body weight.
c. recommend using a multivitamin or multimineral supplement.
d. ensure at least 2 weeks of good nutritional intake before surgery.
2. If a patient is healing more slowly than expected after surgery, he or she may benefit from
a. enteral feedings.
b. supplemental zinc and vitamins A and C.
c. supplemental iron and vitamins B12 and D.
d. additional branched-chain amino acids.
3. Of the following, the most stressful physical traumas would be
a. a single bone fracture.
b. a low-grade fever
c. minor surgery.
d. a large third-degree burn.
4. If someone has been fasting for 36 hours, his or her body is meeting its glucose needs by breaking down
b. keto acids.
c. amino acids.
d. fatty acids.
5. If a malnourished patient has a poor appetite, the nurse’s first priority should be to recommend
a. enteral feedings.
b. increasing intake of fruits and vegetables.
c. several small meals and snacks each day.
d. limiting between-meal snacks to promote hunger.
6. Once patients have completely recovered from gastric bypass surgery for treatment of obesity, an appropriate meal would be
a. a large green salad with chopped turkey and vinaigrette dressing.
b. a medium vanilla shake.
c. half a small chicken breast and cup of green beans.
d. a cup of bean soup with vegetable sticks.
7. If a student group goes on hunger strike and drinks water but does not eat any food for 4 days, they are likely to
a. feel colder than usual.
b. have increased mental acuity.
c. sleep for shorter periods of time.
d. develop fluid overload.
8. A major difference between starvation and stress is that metabolic rate _____ during starvation and _____ during recovery from injury.
a. increases; decreases
b. decreases; increases
c. is unaffected; increases
d. decreases; is unaffected
9. If a patient who has fallen down a flight of steps has a low body temperature, low blood pressure, and high blood glucose levels, he or she is probably
a. in the initial injury (ebb) phase.
b. in the recovery (flow) phase.
c. developing a serious infection.
d. developing multiple organ dysfunction syndrome (MODS).
10. Four day after a major accident involving multiple broken bones, the patient would be expected to be in the _____ phase.
Chapter 17: Nutrition for Cardiopulmonary Diseases
1. If a patient has a family history of cardiovascular disease and is concerned about his own level of risk, the most useful measurements would be
a. serum sodium and glucose levels.
b. blood oxygen and carbon dioxide levels.
c. serum total and high-density lipoprotein (HDL) cholesterol levels.
d. serum triglyceride and low-density lipoprotein (LDL) cholesterol levels.
2. If gangrene develops in a patient’s foot and the patient is found to have high blood lipid levels, he or she probably has
a. type 2 diabetes mellitus.
b. peripheral artery disease.
c. angina pectoris.
d. fatty liver disease.
3. If a patient has a thrombosis in a cerebral artery, he or she would experience
a. a stroke.
b. a migraine headache.
c. a heart attack.
d. angina pectoris.
4. A patient who would be likely to have elevated serum triglyceride levels is a(n)
a. single mother who works full-time and eats only two meals a day.
b. teenager taking antibiotics during recovery from a streptococcal infection.
c. overweight man who drinks three alcoholic beverages a day.
d. young man infected with hepatitis A virus.
5. The primary goal of therapy to reduce risk of cardiovascular disease is to lower serum levels of _____ cholesterol.
d. very-low-density lipoprotein (VLDL)
6. In a 55-year-old woman, an LDL cholesterol level of 195 mg/dL would be considered
b. borderline high.
d. very high.
7. A serum triglyceride level of 175 mg/dL is considered
b. borderline high.
d. very high.
8. For a person who is implementing therapeutic lifestyle changes (TLCs) to reduce his or her risk of coronary heart disease, the best salad choice would be
b. mixed greens with olive oil vinaigrette and walnuts.
c. sliced tomatoes with basil vinaigrette and feta cheese.
d. fruit salad with yogurt dressing and coconut.
9. Of the following, the most helpful change to decrease blood LDL cholesterol levels would be to
a. eat oatmeal instead of a bagel for breakfast.
b. use fresh rather than canned vegetables.
c. use margarine instead of butter.
d. eat a salad instead of a sandwich for lunch.
10. A patient with high serum LDL cholesterol levels tells you that he usually eats a granola bar and a cup of coffee on the way to work; eats a grilled cheese sandwich and chips for lunch; eats a home-cooked meal for dinner, which is usually a chicken dish with potatoes or pasta and frozen vegetables; and snacks on popcorn and pretzels. The most beneficial change for him to make to lower his LDL cholesterol levels would be to
a. use fresh instead of frozen vegetables.
b. drink decaffeinated instead of regular coffee.
c. eat unsalted pretzels and popcorn.
d. eat a turkey sandwich with 100% whole-grain bread instead of grilled cheese.
Chapter 18: Nutrition for Diseases of the Kidneys
1. Kidney disease affects the body’s ability to maintain
a. body temperature.
b. body weight.
c. bone health.
d. bowel function.
2. If a patient is losing significant amounts of protein in urine, he or she probably has
a. acute renal failure.
b. chronic renal failure
c. nephrotic syndrome.
d. renal calculi.
3. One of the nurse’s important roles in care of patients with nephrotic syndrome is
a. monitoring serum sodium level.
b. monitoring fluid intake and output.
c. ordering a high-protein, low-sodium diet.
d. monitoring serum phosphorus level.
4. The best way to ensure that patients with nephrotic syndrome are able to use their dietary protein to maintain lean body tissue is to
a. provide 1.5 to 2.0 g protein per kilogram of body weight per day.
b. encourage daily exercise.
c. ensure adequate energy intake.
d. provide adequate dietary potassium.
5. An example of a source of “hidden” sodium is
b. saltine crackers.
c. opaque salt shakers.
d. raw fruits and vegetables.
6. If a patient with acute renal failure gains 2 lb in 24 hours, the cause is likely to be
a. urea retention.
b. fluid retention.
c. increased fat stores.
d. increased muscle mass.
7. If a patient with third-degree burns covering 40% of the body surface area suddenly exhibits high blood pressure and edema and is not producing urine, he or she has probably developed
a. severe malnutrition.
b. nephrotic syndrome.
c. chronic renal failure.
d. acute renal failure.
8. It would be most challenging to design a diet for chronic renal failure for
a. a patient with elevated levels of serum low-density lipoprotein (LDL) cholesterol.
b. a patient with hypertension.
c. someone who follows a vegan eating pattern.
d. someone who adheres to strict kosher food laws.
9. Protein needs of patients with acute renal failure who do not need dialysis are
a. lower than those of patients receiving hemodialysis.
b. the same as those of patients receiving hemodialysis.
c. higher than those of patients receiving hemodialysis.
d. dependent on the volume of urine produced.
10. In order to calculate fluid needs for a patients in the oliguric phase of acute renal failure, it is important to know the patient’s
a. body weight.
b. energy intake.
c. serum sodium level.
d. amount of output.
Chapter 19: Nutrition for Neuro-Psychiatric Disorders
1. The best place for a patient with Alzheimer’s disease to eat would be
a. in front of the television.
b. at a table with a caregiver.
c. at a table with several dining companions.
d. alone in a quiet room.
2. An example of a meal that may be beneficial for cognitive function in patients with Alzheimer’s disease is
a. baked salmon and spinach salad.
b. scrambled eggs and whole-grain toast.
c. cottage cheese and applesauce.
d. calves’ liver and onions.
3. If a patient with amyotrophic lateral sclerosis (ALS) is having difficulty speaking and is losing weight, it would be important to evaluate
a. his or her resting energy expenditure.
b. his or her appetite and interest in food.
c. whether he or she has diarrhea and malabsorption.
d. his or her ability to swallow.
4. Whenever possible, comatose patients should be fed
a. a full liquid diet.
c. through peripheral parenteral nutrition.
d. through central parenteral nutrition.
5. A child who is following a ketogenic diet to help control seizures is most likely to need help in coping with
a. early satiety.
6. If a child is following a ketogenic diet for treatment of epilepsy, the nurse would want to ensure that the child is receiving supplements of
a. essential amino acids.
b. pancreatic enzymes.
c. vitamin D.
d. vitamin C.
7. A helpful strategy to prevent development of Guillain-Barré syndrome would be to
a. avoid sexual contact with affected individuals.
b. drink only pasteurized milk.
c. use gloves to avoid contact with infected blood.
d. avoid eating home-canned food.
8. If a patient suspects that her migraine headaches are triggered by certain foods, the first step would be to
a. keep a headache-food diary.
b. evaluate blood antibody levels.
c. use an elimination diet.
d. avoid eating the offending foods.
9. When you evaluate a patient with multiple sclerosis, your greatest nutrition-related concern would be
a. reliance on a caregiver to prepare and serve food.
b. the patient’s frustration with loss of independence.
c. reliance on preprepared processed foods.
d. food’s being one of the few things the patient still enjoys.
10. As multiple sclerosis progresses, it is most important to monitor the patient’s
a. ability to self-feed.
b. blood glucose levels.
c. the degree of depression.
d. blood lipid levels.
Chapter 20: Nutrition in Cancer and HIV/AIDS
1. When someone smokes cigarettes and drinks three alcoholic beverages a day, he or she is contributing to his or her cancer risk via
2. Someone who uses sunscreen and wears UV protective clothing and hats to prevent development of skin cancer may need to
a. use light therapy to prevent seasonal affective disorder.
b. consume extra vitamins C and E and other dietary antioxidants.
c. ensure adequate intake of vitamin D from fortified foods and supplements.
d. consume additional fluids to replace sweat losses caused by additional clothing.
3. Fruits and vegetables help prevent cancer because they have high amounts of
4. A dietary change that would help prevent cancer, according to the National Cancer Institute recommendations, is
a. eating vegetarian meals two or more times a week.
b. choosing organic, pesticide-free fruits and vegetables.
c. eating five or more daily servings of fruits and vegetables.
d. consuming three or more daily servings of low-fat dairy products.
5. Factors that contribute to loss of lean body mass in many patients with cancer that are outside the patient’s control include
b. inadequate protein intake.
c. inadequate energy intake.
d. drug noncompliance.
6. A patient in whom cancer has been newly diagnosed is about to begin intense chemotherapy. She tells you that the only good thing about this diagnosis is that she will now be able to lose weight without even trying. The most appropriate nursing response would be to
a. encourage the patient to celebrate the positive aspects of the disease.
b. encourage adequate nutrient intake to maximize tolerance of chemotherapy.
c. reinforce the need to achieve and maintain ideal body weight.
d. emphasize eating the right types of foods rather than an amount of food.
7. If a patient is going to have surgery to remove cancer of the esophagus, it is important to
a. prevent poor food intake as a result of depression by warning the patient that the surgery may be disfiguring.
b. emphasize complete abstinence from cigarette smoking and use of alcoholic beverages.
c. provide nutrition support to reverse malnutrition caused by difficulty eating during the disease progression.
d. encourage the patient to enjoy favorite foods to maximize intake.
8. If a patient has dumping syndrome after surgery to remove a tumor, he or she has probably had a
d. small bowel resection.
9. Bone marrow cells and cells lining the gastrointestinal tract are more susceptible than other cells to damage caused by chemotherapy because they
a. are target cells for drugs.
b. have a rapid turnover rate.
c. are exposed to higher doses of the drugs.
d. absorb more of the drugs than they excrete.
10. If a patient with cancer is receiving a combination of chemotherapeutic agents that is known to interfere with bone marrow, they should give special attention to prevention of
b. foodborne illness.
c. nausea and vomiting.
d. loss of bone mass.
AND MUCH MORE