Question 1

The nurse prepares educational material for a high school class that explains how the components of food are metabolized to create energy. Which type of energy should the nurse explain is created by the metabolism of food?

Accepted Answer

The body derives energy in the form of adenosine triphosphate (ATP) from the metabolism of carbohydrates, fats, protein, and alcohol contained in foods and beverages. Energy is needed in the human body to power our body and to produce heat to maintain body temperature. We obtain this energy from stored chemical energy in foods we eat. Lactic acid, calcium carbonate, and potassium biphosphate do not produce energy for the body.

Question 2

An adolescent client with anorexia nervosa asks why eating small amounts of food is a problem. Which response should the nurse make to this client?

Accepted Answer

Food contains stored chemical energy that provides energy to power the body and produce heat to maintain body temperature. The number of calories needed to meet daily energy expenditures depends on many factors including age, body size activity level, and metabolic rate. To lose a pound of body fat the energy balance must be altered by approximately 3,500 kilocalories/day. The quality and balance of the diet is more important than the amount of food eaten to ensure that the body has adequate nutrients for proper functioning.

Question 3

The nurse prepares educational material on nutrition for a community group. Which food item should the nurse explain has the most amount of calories per gram?

Accepted Answer

Foods contain different numbers of calories per gram. Fats contain 9 kcal/gram. Carbohydrates and proteins contain 4 kcal/gram, and alcohol contains 7 kcal/gm.

Question 4

The nurse is calculating the amount of calories a client should consume daily to meet energy needs. What should the nurse consider when making this calculation? (Select all that apply.)

Accepted Answer

Total energy expenditure is the sum of all energy requiring processes in the body as well as any physical activity. The basal metabolic rate and the thermic effect of food are included in this equation. The food source and client's appetite determine the number of calories consumed. The patient's current body weight is not considered.
Total energy expenditure is the sum of all energy requiring processes in the body as well as any physical activity. The basal metabolic rate and the thermic effect of food are included in this equation. The food source and client's appetite determine the number of calories consumed. The patient's current body weight is not considered.

Question 5

A client is concerned about losing weight after joining a gym. Which response should the nurse make to this client?

Accepted Answer

Exercise increases the energy demands and calories utilized by the body. If additional calories are not consumed to compensate for the increased use the result will be a weight deficit. Although a person may lose weight when exercising regularly, weight is also determined by the number of calories consumed. One of the benefits of exercise in overweight people is weight loss. Although dense in calories, candy quickly metabolized in the body and is not a long-lasting energy source.

Question 6

A critically ill client has a fever. By which percent should the nurse adjust the energy expenditure calculation for every degree F for this client?

Accepted Answer

Fever causes elevated energy expenditure as the body responds with increased heart rate and respirations. The clinical nutrition practice is to increase the energy expenditure calculation by 7% for each 1-degree F that the temperature is elevated to compensate for this increase. This has been shown to be especially helpful for an already critically ill patient with altered metabolic needs because of illness.

Question 7

The nurse is planning care for a critically ill client with a fever. For which reasons should the nurse adjust the energy expenditure calculation for this client? (Select all that apply.)

Accepted Answer

Both increased temperature and shivering increase the energy expenditure for the critically ill client. Anorexia should also be considered since a decrease in calories can result in a net weight loss. Weight can be used to monitor the balance of energy expenditure and caloric intake. Appetite determines the amount of food consumed, not the needs of the body for energy.
Both increased temperature and shivering increase the energy expenditure for the critically ill client. Anorexia should also be considered since a decrease in calories can result in a net weight loss. Weight can be used to monitor the balance of energy expenditure and caloric intake. Appetite determines the amount of food consumed, not the needs of the body for energy.
Both increased temperature and shivering increase the energy expenditure for the critically ill client. Anorexia should also be considered since a decrease in calories can result in a net weight loss. Weight can be used to monitor the balance of energy expenditure and caloric intake. Appetite determines the amount of food consumed, not the needs of the body for energy.

Question 8

A female client with a BMI of 35 believes the weight gain is caused by menopause. Which response should the nurse make to this client?

Accepted Answer

Aging can result in decreased physical exercise leading to a positive energy balance and weight gain. With a BMI of 35, the client is obese and at risk for other medical problems such as diabetes and cardiac disease. There is no proven relationship between menopause and weight gain. Dieting alone has not been shown to be as effective as weight loss and exercise. Waiting to act increases the risk for development of other medical problems.

Question 9

An adolescent with a BMI of 28 asks the school nurse for help in losing weight. Which approach should the nurse recommend for the client to reach a negative energy balance and weight loss?

Accepted Answer

Creating negative energy expenditure by decreasing the number of calories consumed daily and increasing physical activity has been shown to be the most effective way to achieve long-term success with weight loss. Radial decreases in food intake produces a negative energy expenditure, but at the cost of adequate nutrition. Reducing food portions by one-half may be an extreme cut unless previous portions are massive. The best diet is one balanced to provide all the nutritional requirements of the body.

Question 10

During regular parent-teacher conferences, the school nurse learns that many overweight students spend time at home working at the computer and watching television. Which action should the nurse take to help the students with the weight issue?

Accepted Answer

Volunteering to supervise outside games on the playground after school would be a way to promote supervised physical exercise in a way that may attract the students. Planning nutrition classes for parents, including information on obesity in health class, or having a speaker would not actively involves the students in exercise.

Question 11

An older client recovering from a serious illness would like to gain back the weight lost while hospitalized. Which action should the nurse recommend to help this client achieve positive energy expenditure? (Select all that apply.)

Accepted Answer

To create a positive energy expenditure, the number of calories consumed need to be increased and energy expended through physical activity should be minimized. Calories can be increased by increasing the amount of food consumed daily and enhancing caloric intake with high protein nutritional supplements. Alcohol consumption increases the number of calories consumed, but does not produce energy. Energy expenditure can also be decreased by avoiding unnecessary strenuous activity. Decreasing nutrient-rich foods could create a negative energy balance.
To create a positive energy expenditure, the number of calories consumed need to be increased and energy expended through physical activity should be minimized. Calories can be increased by increasing the amount of food consumed daily and enhancing caloric intake with high protein nutritional supplements. Alcohol consumption increases the number of calories consumed, but does not produce energy. Energy expenditure can also be decreased by avoiding unnecessary strenuous activity. Decreasing nutrient-rich foods could create a negative energy balance.
To create a positive energy expenditure, the number of calories consumed need to be increased and energy expended through physical activity should be minimized. Calories can be increased by increasing the amount of food consumed daily and enhancing caloric intake with high protein nutritional supplements. Alcohol consumption increases the number of calories consumed, but does not produce energy. Energy expenditure can also be decreased by avoiding unnecessary strenuous activity. Decreasing nutrient-rich foods could create a negative energy balance.
To create a positive energy expenditure, the number of calories consumed need to be increased and energy expended through physical activity should be minimized. Calories can be increased by increasing the amount of food consumed daily and enhancing caloric intake with high protein nutritional supplements. Alcohol consumption increases the number of calories consumed, but does not produce energy. Energy expenditure can also be decreased by avoiding unnecessary strenuous activity. Decreasing nutrient-rich foods could create a negative energy balance.

Question 12

A middle-aged female client is upset about not losing weight despite being active with household chores throughout the day. Which response should the nurse make to this client?

Accepted Answer

The best way to lose weight is to create negative energy expenditure by reducing calories consumed and increasing physical activity. Housework uses about one-third of the calories/min as swimming uses. Moderate to vigorous activity is needed to promote weight loss. Weight gain in older adults is usually related to a decrease in physical activity.

Quiz 9: Energy Balance