Deck 21: Nutrition and Disorders of the Heart and Blood Vessels

Question 1

Adaptive utensils and adequate training enable some people with feeding disabilities to be independent.

Answer 1

True

Question 2

Of the dietary lipids, cholesterol has the strongest effect on blood cholesterol levels.

Answer 2

False

Question 3

Cottage cheese, American cheese, and parmesan cheese should be avoided by a person who needs to restrict her sodium intake.

Answer 3

True

Question 4

Researchers have determined that chronic inflammation promotes the development of atherosclerosis.

Question 5

Diseases of the heart and blood vessels are collectively referred to as:

A)coronary artery disease.
B)cardiovascular disease.
C)coronary heart disease.
D)ischemic heart disease.

Question 6

Cardiovascular diseases are the leading cause of death in both Europe and the United States.

Question 7

Which of the following statements about atherosclerosis is true?

A)It can affect almost any organ in the body.
B)It results in malabsorption.
C)It can interfere with the secretion of digestive enzymes.
D)It is rare in women.

Question 8

Patients who have had a stroke may develop nutritional problems due to their inability to communicate their food preferences.

Question 9

The number of deaths from CVD is greater among men than women.

Question 10

Ischemia refers to a deficiency of blood and oxygen delivery to the tissues.

Question 11

The DASH diet is useful for treating hypertension and also reduces the risk of CHD.

Question 12

Clinical studies suggest that an overweight hypertensive individual can reduce blood pressure by losing weight.

Question 13

People with metabolic syndrome and type 2 diabetes often have small, dense LDL, elevated VLDL levels, and low HDL levels.

Question 14

Atherosclerosis is dangerous to arterial function because:

A)it causes decreased blood pressure on artery walls.
B)it increases arterial elasticity.
C)it narrows the arterial lumen so a clot can easily block it.
D)it changes the heart rate.

Question 15

The formation of plaque is:

A)unrelated to high blood pressure.
B)an inflammatory response.
C)an autoimmune disorder.
D)limited to smaller blood vessels.

Question 16

Plaque consists of all of the following except:

A)fatty deposits.
B)smooth muscle cells.
C)fibrous connective tissue.
D)red blood cells.

Question 17

The most common cause of an aneurysm is high blood pressure.

Question 18

The primary dietary recommendation for heart failure is a protein restriction.

Question 19

Deprivation of oxygen and nutrients to the heart can cause a myocardial infarction.

Question 20

Several of the major risk factors for CHD can be modified by diet and activity.

Question 21

The primary blood cholesterol linked to CHD risk is:

A)HDL.
B)LDL.
C)triglycerides.
D)VLDL.

Question 22

If the TLC diet is adhered to closely, substantial lowering of cholesterol may be seen after:

A)two weeks.
B)three weeks.
C)six weeks.
D)twelve weeks.

Question 23

Which of the following statements about trans fats is false?

A)They raise LDL levels.
B)They are found in foods made with partially hydrogenated oils.
C)Their intake should be kept as low as possible.
D)They raise HDL levels.

Question 24

A person needing to lower his intake of saturated fat should avoid:

A)nuts.
B)baked goods.
C)fish.
D)legumes.

Question 25

The benefits of eating fish for those who have previously suffered a heart attack include all of the following except:

A)reducing blood clotting.
B)stabilizing heart rhythm.
C)lowering triglyceride levels.
D)lowering LDL levels.

Question 26

Clinical trials have shown that a daily intake of _____ grams of fish oil supplements (EPA and DHA combined) taken under the supervision of a physician can lower triglyceride levels.

A)1 to 2
B)2 to 4
C)4 to 6
D)5 to 10

Question 27

Weight loss is associated with all of the following except:

A)a decline in blood pressure.
B)a decrease in LDL cholesterol.
C)an increase in triglycerides.
D)a decrease in insulin resistance.

Question 28

Which of the following dietary factors raises triglyceride levels?

A)high refined carbohydrate intake
B)low soluble fiber intake
C)high protein intake
D)low fat intake

Question 29

All of the following have been proven to be protective against CHD except:

A)antioxidant nutrient supplements.
B)eating 2 fish meals per week.
C)dietary fiber.
D)moderate consumption of alcohol.

Question 30

A fiber that may be taken in supplement form to reduce cholesterol levels is:

A)oat fiber.
B)wheat bran.
C)psyllium seed husks.
D)fruit skins.

Question 31

In the TLC diet for lowering LDL cholesterol levels, saturated fatty acids are restricted to _____% of daily kcalories.

A)7
B)10
C)15
D)22

Question 32

Low HDL levels:

A)are highly predictive of CHD risk.
B)are associated with underweight.
C)are not a good predictor of CHD risk.
D)are more prevalent in females.

Question 33

The four classic risk factors for CHD are:

A)smoking, high LDL, high blood pressure, and diabetes.
B)age, gender, family history, and diet.
C)smoking, high HDL, high blood pressure, and diabetes.
D)age, smoking, diet, and diabetes.

Question 34

The TLC diet advocates a cholesterol intake of less than _____ milligrams per day.

A)100
B)200
C)300
D)400

Question 35

The largest contributor of cholesterol in the American diet is:

A)meat.
B)fish.
C)milk.
D)eggs.

Question 36

Which of the following forms of exercise is not considered aerobic activity?

A)cycling
B)weight training
C)stair-stepping
D)cross-country skiing

Question 37

Plant stanols and sterols help to lower LDL and are often added to food products such as:

A)margarine.
B)bread.
C)milk.
D)cereal.

Question 38

The risk of atherosclerosis increases with all of the following except:

A)smoking.
B)exercise.
C)aging.
D)diabetes.

Question 39

The TLC diet to reduce elevated LDL cholesterol includes a total fat intake of _____ of daily kcalories.

A)20-25%
B)25-35%
C)35-40%
D)10-15%

Question 40

In order to assess a person's risk for CHD, a complete lipoprotein profile should be obtained every five years beginning at age:

A)20.
B)35.
C)45.
D)50.

Question 41

A patient who is following a low-sodium diet should avoid:

A)canned fruit.
B)fresh meat.
C)tomato-based products.
D)milk.

Question 42

Severe malnutrition that develops as a consequence of heart failure is called _____.

A)CHF
B)cardiomegaly
C)cardiac cachexia
D)tachycardia
Use the following case study to answer questions 40-45.
Betsy Winslow is a 62-year-old retired school teacher.She is 5'3" tall and weighs 155 pounds.Mrs.Winslow is a member of a walking group that meets three mornings a week.She walks two miles each morning.After experiencing episodes of chest pain and shortness of breath when walking, she made an appointment to see her physician.Her laboratory results are as follows: total cholesterol: 251 mg/dL; HDL cholesterol: 47 mg/dL; LDL cholesterol: 146 mg/dL; triglycerides: 203 mg/dL.
Mrs)Winslow's 24-hour recall reveals the following intake:
$\bullet$ Breakfast: Scrambled eggs, bacon, toast with butter and jelly, 2% milk
$\bullet$ Lunch: Hamburger pizza, salad with Italian dressing, Coke
$\bullet$ Snack: 3 chocolate cookies, 2% milk
$\bullet$ Dinner: Fried chicken, mashed potatoes and gravy, buttered corn on the cob, sweet tea, coconut cake
$\bullet$ Snack: Ice cream

Question 43

The DASH diet limits the intake of:

A)fiber.
B)potassium.
C)magnesium.
D)saturated fat.

Question 44

To reduce her risk of CHD, Mrs.Winslow's LDL should be:

A)<100 mg/dL
B)<130 mg/dL.
C)>140 mg/dL.
D)>120 mg/dL.

Question 45

Mrs.Winslow's physician has asked her to try a three-month trial of TLC before he prescribes medications to lower her blood lipids.An alternate choice for the butter that Mrs.Winslow uses that could help lower her cholesterol is:

A)strawberry jam.
B)margarine that contains plant sterols or stanols.
C)cream cheese.
D)margarine made from corn oil.

Question 46

You would tell clients who are prescribed the DASH Eating Plan to:

A)choose fruit and unsalted pretzels as snacks.
B)flavor foods with barbecue or soy sauce.
C)avoid nuts and seeds.
D)reduce the amount of fiber consumed.

Question 47

Which of the following increases the effectiveness of the DASH diet?

A)low sodium intake
B)high protein intake
C)supplements of the water-soluble vitamins
D)low potassium intake

Question 48

Niacin taken in large doses:

A)lowers blood triglycerides and raises HDL.
B)lowers HDL and increases LDL.
C)lowers blood triglycerides and lowers HDL.
D)has no effect on blood lipid levels.

Question 49

Compared to the typical American diet, the DASH diet provides:

A)more fruits and vegetables.
B)less milk and dairy products.
C)more grains and fat.
D)more meat.

Question 50

Several hours after a MI, the client's diet should consist of:

A)foods restricted in sodium.
B)increased portion sizes.
C)more frequent meals.
D)decreased carbohydrates.

Question 51

The DASH diet for a person who needs 2000 kcal/day includes _____ servings from the fruit group per day.

A)< 2
B)2-3
C)4-5
D)7-8

Question 52

How many diet-related major risk factors for coronary heart disease does Mrs.Winslow have?

A)2
B)3
C)4
D)5

Question 53

Based on her 24-hour recall, which of the following dietary recommendations is appropriate for Mrs.Winslow if she is to lower her blood lipids with diet alone?

A)Eat more whole grains, legumes, fruits, and vegetables.
B)Drink less milk and eat less ice cream.
C)Choose foods high in insoluble fibers.
D)Eat fewer carbohydrates and choose more high-protein foods.
Use the following case study to answer questions 46-50.
Carmen, age 34, has had hypertension since she was a teenager, as do many members of her immediate family.At a visit to the doctor one year ago after her twin brother had suffered an acute episode of hypertension requiring hospitalization, Carmen decided to seriously attempt to reduce her sodium and salt intakes.She has successfully mastered a low-sodium diet by: eliminating the use of a salt shaker; ordering fresh, no-salt-added foods in restaurants; avoiding salty condiments; avoiding ready-to-eat foods; and using herbs and salt-free seasonings.She has recently begun reading labels and following portions of the DASH diet.Her doctor tells her to expect a further reduction in her blood pressure if she can master the DASH diet.

Question 54

A common side effect of diuretic medications is:

A)dry mouth.
B)nausea.
C)increased taste perception.
D)increased appetite.

Question 55

Optimal resting blood pressure for adults is _____.

A)<105 over <55 mm Hg
B)<115 over <60 mm Hg
C)<120 over <80 mm Hg
D)<140 over <90 mm Hg

Question 56

Which of the following is not a risk factor for hypertension?

A)aging
B)salt sensitivity
C)alcohol abuse
D)excessive calcium intake

Question 57

Lifestyle modifications that help in the treatment of hypertension include all of the following except:

A)reducing weight, if overweight.
B)reducing sodium intake.
C)increasing calcium intake.
D)restricting fluid intake.

Question 58

Assuming Mrs.Winslow's 24-hour recall is typical of her eating habits, her high cholesterol is most likely due to a :

A)high intake of saturated fat.
B)high intake of fiber.
C)low intake of polyunsaturated fat.
D)low intake of simple sugars.

Question 59

Mrs.Winslow's HDL level is considered:

A)desirable.
B)borderline risk.
C)high risk.
D)no risk.

Question 60

The diet health authorities recommend for treatment of hypertension is high in:

A)sodium, chloride, and potassium.
B)calcium, phosphorus, and zinc.
C)potassium, calcium, and magnesium.
D)folate, vitamin B₁₂, and calcium.

Question 61

People with only one arm or hand may benefit from using a _____ when eating.

A)utensil holder
B)rocker knife
C)flexible straw
D)two-handed cup
Nursing Exam Review Multiple Choice

Question 62

In working with clients with disabilities, a valuable assessment method for health care professionals is:

A)interviewing the clients.
B)directly observing clients during mealtimes.
C)conducting nutrition histories.
D)talking with the occupational therapist.

Question 63

All of the following health professionals become involved in the care of patients with feeding disabilities except the:

A)nurse.
B)occupational therapist.
C)pharmacist.
D)dietitian.

Question 64

A patient's lab work shows severe hypertriglyceridemia.The nurse understands that the patient's fat intake should be limited to _____% of kcalories per day in order to prevent dangerous complications.

A)5
B)15
C)20
D)35

Question 65

The nurse is instructing a client on a diet for the treatment of his hypertension.The nurse recognizes that the client understands his diet when he says:

A)"I can freely use salt substitutes and low-sodium products."
B)"I can eat any foods I want in moderate amounts."
C)"I need to increase my intake of fresh fruits, vegetables, whole grains, and milk and milk products."
D)"I don't need to be concerned about the amount of alcohol I drink."

Question 66

The client asks the nurse about the effects of physical activity on CHD risk.The nurse states that:

A)physical activity is not important in a program to reduce CHD risk.
B)weight training can dramatically raise HDL if undertaken regularly.
C)diet, rather than physical activity, should be the primary focus of reducing CHD risk.
D)30 minutes of moderate exercise on most days can reverse many risk factors for CHD.

Question 67

Which of the following team members works with the client to evaluate the need for special feeding devices and then teaches the client how to use the device?

A)speech-language pathologist
B)physical therapist
C)occupational therapist
D)dietitian

Question 68

Carmen's daily sodium intake should not exceed _____ milligrams, as the DASH Eating Plan is even more effective when accompanied by a low sodium intake.

A)1000
B)1500
C)2,828
D)3,400

Question 69

Mrs.Smith is a 59-year-old African-American female who is 5' 2" tall and weighs 180 pounds.She is a smoker who engages in no physical activity, and her diet history shows a high intake of saturated fat and sodium as well as excess kcalories.Her lipid profile shows elevated LDL and decreased levels of HDL.In order to raise her HDL levels, the nurse recommends that Mrs.Smith:

A)quit smoking.
B)eat less saturated fat.
C)consume less sodium.
D)take fish oils.

Question 70

A patient's lipid profile shows elevated total cholesterol and LDL.The nurse recommends which of the following nutrition interventions?

A)eat less fiber
B)consume less saturated fat
C)consume less polyunsaturated fat
D)eat more protein

Question 71

The nurse recognizes that an effective way to lower LDL cholesterol levels is to:

A)use reduced-fat margarine.
B)use margarines made with plant sterols.
C)switch from butter to margarine.
D)use butter instead of margarine.

Question 72

At a restaurant, Carmen scans the menu for foods that fit the DASH plan.These include:

A)fish entrees.
B)lean poultry.
C)nut butter sandwiches.
D)whole-grain side orders.
E)all of the above

Question 73

Carmen discovers that the DASH diet contains more fiber and _____ than the typical American diet.

A)potassium
B)magnesium
C)calcium
D)all of the above
E)a and c only

Question 74

A patient is advised to follow the TLC diet to lower LDL cholesterol.If the patient's daily caloric intake is 2000 calories, fat intake should be restricted to _____ grams per day.

A)44-78
B)56-78
C)44-67
D)56-67

Question 75

People with tremors, spasticity, and uneven or jerky movements may benefit from the use of:

A)a rocker knife.
B)a cutout plastic cup.
C)weighted utensils.
D)a battery-powered feeding machine.

Question 76

The nurse is working with a client who has been placed on the TLC diet to reduce his elevated LDL cholesterol.This client needs 2800 kcalories to maintain his desirable body weight.Which of the following would meet this client's diet prescription?

A)98-123 grams fat; < 50 grams saturated fat; < 75 milligrams cholesterol
B)62-109 grams fat; < 45 grams saturated fat; < 300 milligrams cholesterol
C)78-109 grams fat; < 21 grams saturated fat; < 200 milligrams cholesterol
D)90-112 grams fat; < 24 grams saturated fat; < 200 milligrams cholesterol

Question 77

A common nutritional problem among people with disabilities is:

A)increased micronutrient needs.
B)increased protein needs.
C)inadequate food intake.
D)increased fluid needs.

Question 78

In order to follow the DASH Diet, Carmen should limit:

A)fatty fish.
B)sugar-containing beverages.
C)starchy vegetables.
D)lactose-containing beverages.

Question 79

The nurse is counseling a patient who recently had a heart attack.Which of the following dietary recommendations would be most appropriate?

A)Replace processed meats with fatty fish.
B)Consume more whole grains.
C)Consume fewer fruits and vegetables.
D)Use salt substitutes.

Question 80

Carmen's understanding of the DASH diet is reflected in each of the following statements except:

A)"I need to eat more fruits."
B)"I need to eat more vegetables."
C)"I need to eat more meats."
D)"I need to eat more low-fat dairy products."
E)"I need to eat more whole grains."