Deck 13: Nutrition Care and Assessment
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Deck 13: Nutrition Care and Assessment
1
A coordinated program of treatment that merges the care plans of different health practitioners is a:
A)critical pathway.
B)care map.
C)clinical pathway.
D)care plan.
A)critical pathway.
B)care map.
C)clinical pathway.
D)care plan.
A
2
Malnutrition :
A)occurs in 10-12% of hospital patients.
B)is always a top priority in patient care.
C)often increases overall patient care costs.
D)frequently shortens hospital stays.
A)occurs in 10-12% of hospital patients.
B)is always a top priority in patient care.
C)often increases overall patient care costs.
D)frequently shortens hospital stays.
C
3
Which of the following is not a criterion for identifying malnutrition risk?
A)depression
B)recent changes in appetite
C)medical diagnosis
D)gender
A)depression
B)recent changes in appetite
C)medical diagnosis
D)gender
D
4
A patient's diet order is prescribed by the:
A)registered dietitian.
B)physician.
C)registered nurse.
D)registered dietetic technician.
A)registered dietitian.
B)physician.
C)registered nurse.
D)registered dietetic technician.
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5
Which of the following medical problems is not generally associated with malnutrition?
A)celiac disease
B)dementia
C)pressure sores
D)incontinence
A)celiac disease
B)dementia
C)pressure sores
D)incontinence
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6
"What is the first thing you ate or drank yesterday morning?" is often the first question asked in a:
A)food frequency questionnaire.
B)kcalorie count.
C)food diary.
D)24-hour recall.
A)food frequency questionnaire.
B)kcalorie count.
C)food diary.
D)24-hour recall.
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7
The medical history provides information about:
A)genetic susceptibility to diseases.
B)living situation.
C)recent food intake.
D)financial concerns that may restrict access to food.
A)genetic susceptibility to diseases.
B)living situation.
C)recent food intake.
D)financial concerns that may restrict access to food.
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8
Medical nutrition therapy includes all of the following except:
A)performing nutrition assessments.
B)diagnosing nutrition problems.
C)developing nutrition care plans.
D)writing a patient's diet order.
A)performing nutrition assessments.
B)diagnosing nutrition problems.
C)developing nutrition care plans.
D)writing a patient's diet order.
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9
Which of the following nursing diagnoses has nutritional implications?
A)hyperthermia
B)self-esteem disturbance
C)impaired dentition
D)sleep pattern disturbance
A)hyperthermia
B)self-esteem disturbance
C)impaired dentition
D)sleep pattern disturbance
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10
A written account of foods and beverages consumed by a client over several days is called a nutrition diagnosis.
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11
Which of the following is not a characteristic of nutrition screening?
A)accurate enough to identify nutrition risk
B)varies according to the health care facility
C)may lead to a referral for nutrition care
D)the first step in the nutrition care process
A)accurate enough to identify nutrition risk
B)varies according to the health care facility
C)may lead to a referral for nutrition care
D)the first step in the nutrition care process
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12
Which of the following is not one of the nurse's roles in nutrition care of a patient?
A)nutrition screening
B)encouraging patients to eat
C)answering questions about special diets
D)developing, implementing, and evaluating nutrition care plans
A)nutrition screening
B)encouraging patients to eat
C)answering questions about special diets
D)developing, implementing, and evaluating nutrition care plans
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13
Which of the following evaluates a person's risk of malnutrition by ranking key variables from the medical history and physical examination?
A)subjective global assessment
B)integrated assessment
C)functional assessment
D)nutrition care plan
A)subjective global assessment
B)integrated assessment
C)functional assessment
D)nutrition care plan
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14
The 24-hour recall provides accurate and complete data for assessing an individual's diet.
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15
To ensure that a planned intervention is realistic, the dietitian takes into account the client's food habits, lifestyle, and other personal factors.
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16
Obtaining an accurate account of a person's usual food intake is dependent upon all of the following but:
A)the person's memory.
B)the person's honesty.
C)the interviewer's skill.
D)the interviewer's personality.
A)the person's memory.
B)the person's honesty.
C)the interviewer's skill.
D)the interviewer's personality.
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17
Serum protein values can be affected by fluid imbalances, pregnancy, infections, and some medications.
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18
The registered dietitian performs all of the following services except:
A)conducting nutrition assessments.
B)planning and approving menus.
C)diagnosing nutrition problems.
D)changing a patient's diet order.
A)conducting nutrition assessments.
B)planning and approving menus.
C)diagnosing nutrition problems.
D)changing a patient's diet order.
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19
Which of the following health professionals does not assume a primary role for developing and implementing nutrition care plans?
A)dietetic technician
B)dietitian
C)nurse
D)pharmacist
A)dietetic technician
B)dietitian
C)nurse
D)pharmacist
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20
Limitations of a 24-hour recall include all of the following except:
A)the previous day's intake may not be typical.
B)they are difficult to obtain.
C)the person may not be able to accurately report portion sizes.
D)they provide data for one day only.
A)the previous day's intake may not be typical.
B)they are difficult to obtain.
C)the person may not be able to accurately report portion sizes.
D)they provide data for one day only.
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21
A child's height is measured in the standing position once she or he reaches the age of:
A)12 months.
B)18 months.
C)2 years.
D)3 years.
A)12 months.
B)18 months.
C)2 years.
D)3 years.
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22
Which of the following methods of collecting a dietary history is the most time-consuming and requires a high degree of motivation to complete?
A)24-hour recall
B)food frequency questionnaire
C)food record
D)direct observation
A)24-hour recall
B)food frequency questionnaire
C)food record
D)direct observation
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23
Tools for obtaining food intake data include all of the following except:
A)24-hour recall.
B)food frequency questionnaires.
C)food records.
D)diet manuals.
A)24-hour recall.
B)food frequency questionnaires.
C)food records.
D)diet manuals.
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24
Which of the following is not an anthropometric measurement commonly used to evaluate overnutrition and undernutrition?
A)height
B)arm length
C)waist circumference
D)head circumference
A)height
B)arm length
C)waist circumference
D)head circumference
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25
A disadvantage of using a food record is:
A)the time involved in keeping one.
B)it increases awareness of one's food choices.
C)the process does not rely on a person's memory.
D)it may provide more information than is needed.
A)the time involved in keeping one.
B)it increases awareness of one's food choices.
C)the process does not rely on a person's memory.
D)it may provide more information than is needed.
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26
Which of the following can be used to record behaviors associated with eating, physical activity, medications, and symptoms associated with eating?
A)24-hour recall
B)kcalorie count
C)food frequency questionnaire
D)food record
A)24-hour recall
B)kcalorie count
C)food frequency questionnaire
D)food record
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27
In people who are ill, significant weight loss may be masked by:
A)fluid retention.
B)dehydration.
C)a large tumor.
D)drug therapy.
A)fluid retention.
B)dehydration.
C)a large tumor.
D)drug therapy.
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28
Which of the following is used in infancy to assess brain development?
A)measure of abdominal girth
B)fatfold measurement
C)head circumference
D)height and weight
A)measure of abdominal girth
B)fatfold measurement
C)head circumference
D)height and weight
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29
Which of the following laboratory tests would aid in the diagnosis of anemia?
A)red blood cell count
B)total protein
C)C-reactive protein
D)blood urea nitrogen
A)red blood cell count
B)total protein
C)C-reactive protein
D)blood urea nitrogen
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30
What is the ideal body weight of a 42-year-old female who is 5'5" tall and of medium frame?
A)108 pounds
B)113 pounds
C)132 pounds
D)149 pounds
A)108 pounds
B)113 pounds
C)132 pounds
D)149 pounds
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31
A disadvantage to using a food frequency questionnaire is:
A)it does not take into account fluctuations in food intake.
B)its inability to determine recent changes in food intake.
C)the results are not affected by seasonal changes in diet.
D)it may not be reflective of a typical day's intake.
A)it does not take into account fluctuations in food intake.
B)its inability to determine recent changes in food intake.
C)the results are not affected by seasonal changes in diet.
D)it may not be reflective of a typical day's intake.
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32
For an adult's height to be accurately measured, the person should:
A)stand erect without shoes.
B)stand erect with shoes.
C)stand with feet slightly apart.
D)stand 2" away from the wall.
A)stand erect without shoes.
B)stand erect with shoes.
C)stand with feet slightly apart.
D)stand 2" away from the wall.
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33
Joe, a 69-year-old widower, has lost 27 pounds since his wife's death a year ago.He is 5'11" and his usual body weight is 173 pounds.What is his %UBW?
A)15%
B)69%
C)84%
D)101%
A)15%
B)69%
C)84%
D)101%
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34
Jim is 5'10" tall, is of medium frame, and weighs 135 pounds.Based on his IBW, what is his level of nutritional risk?
A)no risk of malnutrition
B)risk of mild malnutrition
C)risk of moderate malnutrition
D)risk of severe malnutrition
A)no risk of malnutrition
B)risk of mild malnutrition
C)risk of moderate malnutrition
D)risk of severe malnutrition
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35
Which of the following is most often used to monitor a client's response to and compliance with medical nutrition therapy?
A)food record
B)food frequency checklist
C)24-hour recall
D)usual intake record
A)food record
B)food frequency checklist
C)24-hour recall
D)usual intake record
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36
What is the %IBW of a 35-year-old female whose IBW is 120 pounds and whose actual weight is 108 pounds?
A)90
B)110
C)120
D)132
A)90
B)110
C)120
D)132
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37
All of the following standardized conditions should be used when making repeated weight measures on adults except:
A)weight should be taken at the same time of day.
B)weight must be estimated for bedridden patients.
C)the same scale should be used.
D)weight should be taken after the person has voided.
A)weight should be taken at the same time of day.
B)weight must be estimated for bedridden patients.
C)the same scale should be used.
D)weight should be taken after the person has voided.
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38
When direct observations are used to generate an estimate of a client's current food intake, the procedure is called a:
A)kcalorie count.
B)food diary.
C)24-hour recall.
D)food record.
A)kcalorie count.
B)food diary.
C)24-hour recall.
D)food record.
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39
Which of the following is most valuable for evaluating the degree of nutrition risk associated with acute illness?
A)ideal body weight
B)height-weight tables
C)percent ideal body weight
D)percent usual body weight
A)ideal body weight
B)height-weight tables
C)percent ideal body weight
D)percent usual body weight
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40
The height of a person who is unable to stand is estimated from equations that use:
A)elbow breadth or wrist circumference.
B)knee height or full arm span.
C)head circumference or wrist circumference.
D)knee height or elbow breadth.
A)elbow breadth or wrist circumference.
B)knee height or full arm span.
C)head circumference or wrist circumference.
D)knee height or elbow breadth.
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41
Mr.Wilson's low hemoglobin and hematocrit may be indicative of a deficiency of dietary:
A)potassium.
B)calcium.
C)sodium.
D)iron.
A)potassium.
B)calcium.
C)sodium.
D)iron.
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42
Transthyretin is also known as:
A)prealbumin.
B)retinol-binding protein.
C)transferrin.
D)albumin.
A)prealbumin.
B)retinol-binding protein.
C)transferrin.
D)albumin.
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43
The most likely cause of Mr.Wilson's weight loss is:
A)depression due to loss of his spouse.
B)inadequate income to purchase food.
C)lack of knowledge about nutrition.
D)a high level of physical activity.
A)depression due to loss of his spouse.
B)inadequate income to purchase food.
C)lack of knowledge about nutrition.
D)a high level of physical activity.
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44
Among the following, the least expensive lab test for evaluating protein status is:
A)prealbumin.
B)albumin.
C)transthyretin.
D)retinol-binding protein.
A)prealbumin.
B)albumin.
C)transthyretin.
D)retinol-binding protein.
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45
Edema means:
A)fluid retention.
B)dehydration.
C)PEM.
D)wasting.
A)fluid retention.
B)dehydration.
C)PEM.
D)wasting.
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46
Mr.Wilson's low albumin level may indicate a depletion of:
A)body fat.
B)body proteins.
C)vitamin D.
D)iron.
A)body fat.
B)body proteins.
C)vitamin D.
D)iron.
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47
A drawback to obtaining detailed genetic information about one's disease risk is:
A)the potential for revealing private information.
B)people may take better care of themselves and seek medical care less often.
C)less effective treatments for some diseases.
D)physicians may quit ordering less expensive lab tests.
Nursing Exam Review Multiple Choice
A)the potential for revealing private information.
B)people may take better care of themselves and seek medical care less often.
C)less effective treatments for some diseases.
D)physicians may quit ordering less expensive lab tests.
Nursing Exam Review Multiple Choice
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48
The human body contains _____ chromosomes.
A)23
B)37
C)46
D)52
A)23
B)37
C)46
D)52
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49
Signs of fluid retention include all of the following except:
A)tight-fitting shoes.
B)puffy face.
C)abdominal distension.
D)reduced skin tension.
A)tight-fitting shoes.
B)puffy face.
C)abdominal distension.
D)reduced skin tension.
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50
Signs of malnutrition tend to appear most often in parts of the body where cell replacement occurs at a rapid rate, including all of the following except the:
A)hair.
B)skin.
C)respiratory tract.
D)digestive tract.
A)hair.
B)skin.
C)respiratory tract.
D)digestive tract.
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51
Genomics research may be helpful in all of these areas except:
A)fine-tuning nutrient recommendations for individuals.
B)establishing indicators of nutrient status for some minerals.
C)understanding how nutrient deficiencies may alter gene expression.
D)determining environmental factors that may influence disease risk.
A)fine-tuning nutrient recommendations for individuals.
B)establishing indicators of nutrient status for some minerals.
C)understanding how nutrient deficiencies may alter gene expression.
D)determining environmental factors that may influence disease risk.
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52
What is Mr.Wilson's ideal body weight?
A)125 pounds
B)144 pounds
C)161 pounds
D)170 pounds
A)125 pounds
B)144 pounds
C)161 pounds
D)170 pounds
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53
Albumin has a half-life of:
A)2-4 days.
B)2-3 weeks.
C)3-6 days.
D)3-6 weeks.
A)2-4 days.
B)2-3 weeks.
C)3-6 days.
D)3-6 weeks.
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54
Which of the following statements about albumin is false?
A)It is the most abundant plasma protein.
B)It is slow to reflect changes in nutrition status.
C)It degrades slowly in the body.
D)It is a sensitive indicator of effective nutritional intervention.
A)It is the most abundant plasma protein.
B)It is slow to reflect changes in nutrition status.
C)It degrades slowly in the body.
D)It is a sensitive indicator of effective nutritional intervention.
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55
What lab value responds to both PEM and iron status?
A)albumin
B)prealbumin
C)retinol-binding protein
D)transferrin
A)albumin
B)prealbumin
C)retinol-binding protein
D)transferrin
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56
Segments of a DNA strand that can be translated into proteins are called:
A)chromosomes.
B)noncoding sequences.
C)genomics.
D)genes.
A)chromosomes.
B)noncoding sequences.
C)genomics.
D)genes.
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57
Which of the following nursing diagnoses is most appropriate for Mr.Wilson?
A)impaired physical mobility
B)feeding self-care deficit
C)imbalanced nutrition: less than body requirements
D)impaired dentition
A)impaired physical mobility
B)feeding self-care deficit
C)imbalanced nutrition: less than body requirements
D)impaired dentition
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58
What is Mr.Wilson's percent usual body weight?
A)86.6%
B)88.3%
C)113.2%
D)115.4%
A)86.6%
B)88.3%
C)113.2%
D)115.4%
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59
The study of the effects of diet on gene expression is called:
A)gene expression.
B)nutritional genomics.
C)nutritional science.
D)gene therapy.
A)gene expression.
B)nutritional genomics.
C)nutritional science.
D)gene therapy.
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60
Which of the following is an indicator of good nutritional status?
A)shiny hair
B)smooth tongue
C)lack of fat under the skin
D)rough skin
Use the following case study to answer questions 46-51.
John Wilson is a 74-year-old retired schoolteacher.He is 5'8" tall and weighs 136 pounds.His wife died nine months ago.During a routine visit to the doctor, it was noted that his weight had decreased 21 pounds since his visit a year ago.Mr.Wilson does not have any medical problems, though he does report feeling depressed and lonely.The physician ordered a panel of lab tests including hemoglobin, hematocrit, and albumin, which all were low.
A)shiny hair
B)smooth tongue
C)lack of fat under the skin
D)rough skin
Use the following case study to answer questions 46-51.
John Wilson is a 74-year-old retired schoolteacher.He is 5'8" tall and weighs 136 pounds.His wife died nine months ago.During a routine visit to the doctor, it was noted that his weight had decreased 21 pounds since his visit a year ago.Mr.Wilson does not have any medical problems, though he does report feeling depressed and lonely.The physician ordered a panel of lab tests including hemoglobin, hematocrit, and albumin, which all were low.
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61
Interpreting laboratory tests can be challenging because many factors influence test results.The nurse understands that:
A)no one lab value is an indicator of nutritional deficiencies.
B)serum albumin is the only reliable lab value to determine protein status.
C)fluid imbalances have no effect on lab values.
D)serum values of vitamins and minerals are good indicators of nutrient deficiencies.
A)no one lab value is an indicator of nutritional deficiencies.
B)serum albumin is the only reliable lab value to determine protein status.
C)fluid imbalances have no effect on lab values.
D)serum values of vitamins and minerals are good indicators of nutrient deficiencies.
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62
The nurse recognizes that diseases involving the esophagus may have nutritional implications due to difficulty swallowing, and it will be necessary to:
A)have a family member feed the patient.
B)monitor the patient's food intake.
C)be in the room and encourage the patient to eat.
D)provide the patient with assisted feeding devices.
A)have a family member feed the patient.
B)monitor the patient's food intake.
C)be in the room and encourage the patient to eat.
D)provide the patient with assisted feeding devices.
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63
Which of the following nursing diagnoses has a nutritional implication?
A)feeding self-care deficit
B)impaired verbal communication
C)bowel incontinence
D)sleep deprivation
A)feeding self-care deficit
B)impaired verbal communication
C)bowel incontinence
D)sleep deprivation
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64
The nurse understands the importance of evaluating the progress of growth in pregnant women, infants, children, and adolescents, detecting under- and over-nutrition in all age groups, and measuring changes in body composition over time.The nurse should recognize that all of these purposes can be served through:
A)anthropometric measurements.
B)functional tests of nutrition status.
C)biochemical tests of protein status.
D)physical examination for signs of malnutrition.
A)anthropometric measurements.
B)functional tests of nutrition status.
C)biochemical tests of protein status.
D)physical examination for signs of malnutrition.
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65
Describe the types of information collected in a nutrition screening.
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66
The nurse understands that though a dietitian or dietetic technician may perform a patient's nutrition screening, it should occur within _____ hours of admission.
A)12
B)24
C)36
D)48
A)12
B)24
C)36
D)48
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67
List and describe the steps in the nutrition care process.
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68
When a patient is diagnosed with a chronic illness that requires long-term dietary modifications, the most appropriate role for the nurse is to:
A)write the correct diet order.
B)help patients accept and understand the dietary changes.
C)plan and approve the patient's menus while she/he is in the hospital.
D)evaluate the accuracy of the meal trays.
A)write the correct diet order.
B)help patients accept and understand the dietary changes.
C)plan and approve the patient's menus while she/he is in the hospital.
D)evaluate the accuracy of the meal trays.
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69
The nurse recognizes that the dietitian has appropriately documented a nutrition diagnosis for a patient who recently lost a significant amount of weight as:
A)recent weight loss of 10 pounds.
B)unintentional weight loss related to poor kcalorie intake as evidenced by 10% weight loss in the past 2 months.
C)unintentional weight loss as evidenced by 10% weight loss.
D)recent weight loss of 10% of usual body weight.
A)recent weight loss of 10 pounds.
B)unintentional weight loss related to poor kcalorie intake as evidenced by 10% weight loss in the past 2 months.
C)unintentional weight loss as evidenced by 10% weight loss.
D)recent weight loss of 10% of usual body weight.
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70
Describe how bed rest and immobility compromise nutrition status.
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71
The nurse recognizes that an illness that interferes with the digestion or absorption of nutrients may ultimately lead to:
A)difficulty swallowing.
B)inappropriate food intake.
C)a shorter hospital stay.
D)slower healing from injury.
A)difficulty swallowing.
B)inappropriate food intake.
C)a shorter hospital stay.
D)slower healing from injury.
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72
An elderly male is admitted to the hospital with a diagnosis of malnutrition three months after his wife died.The nurse recognizes that this is most likely due to which criteria for identifying malnutrition risk?
A)depression or social isolation
B)recent unintentional weight change
C)history of chronic illness
D)age
A)depression or social isolation
B)recent unintentional weight change
C)history of chronic illness
D)age
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73
The nurse recognizes that a patient experiencing a high fever and vomiting is at risk for:
A)malnutrition.
B)wasting.
C)dehydration.
D)fluid retention.
A)malnutrition.
B)wasting.
C)dehydration.
D)fluid retention.
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74
The nurse recognizes that weight gain due to fluid retention in a patient with liver cirrhosis can mask symptoms of:
A)liver failure.
B)PEM.
C)obesity.
D)gallbladder disease.
A)liver failure.
B)PEM.
C)obesity.
D)gallbladder disease.
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75
The nurse is measuring the length of an infant and understands that in order to perform this measurement correctly:
A)the infant must be completely undressed.
B)a measuring board should be used.
C)a flexible tape measure should be used.
D)the measurement should be recorded to the nearest ¼".
A)the infant must be completely undressed.
B)a measuring board should be used.
C)a flexible tape measure should be used.
D)the measurement should be recorded to the nearest ¼".
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76
The nurse realizes that malnutrition is a common problem among people who are hospitalized and that it is associated with:
A)a weakened immune system.
B)lower mortality rates.
C)reduced health care costs.
D)fewer complications.
A)a weakened immune system.
B)lower mortality rates.
C)reduced health care costs.
D)fewer complications.
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77
If the nurse is unable to obtain a patient's weight and the patient states her weight, the nurse understands that:
A)five pounds should be added to the self-reported weight.
B)self-reported weights are valid.
C)the weight should be documented as self-reported.
D)it is impolite to ask a patient's weight.
A)five pounds should be added to the self-reported weight.
B)self-reported weights are valid.
C)the weight should be documented as self-reported.
D)it is impolite to ask a patient's weight.
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78
The dietitian asks the nurse to observe a patient's food intake and record the kinds and quantities of foods the patient receives and leaves on his plate.The nurse realizes that the dietitian is interested in keeping a _____ for this patient.
A)food record
B)24-hour recall
C)kcalorie count
D)usual intake record
A)food record
B)24-hour recall
C)kcalorie count
D)usual intake record
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79
The nurse reviews the dietitian's note that includes a specific nutrition problem, its etiology, and evidence of the problem.The nurse recognizes this as the:
A)nursing diagnosis.
B)physician's diet order.
C)hospital diet manual.
D)nutrition diagnosis.
A)nursing diagnosis.
B)physician's diet order.
C)hospital diet manual.
D)nutrition diagnosis.
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80
Matching


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