Deck 17: Nutrition Care and Assessment
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Deck 17: Nutrition Care and Assessment
1
Specific instructions regarding dietary management for a patient are known as "____."
A) clinical pathways
B) nutrition care plans
C) diet orders
D) nutrition screenings
A) clinical pathways
B) nutrition care plans
C) diet orders
D) nutrition screenings
C
2
Clinical judgments about actual or potential health problems that provide the basis for selecting appropriate nursing interventions are called "____."
A) potential diagnoses
B) nursing diagnoses
C) treatment objectives
D) nursing goals
A) potential diagnoses
B) nursing diagnoses
C) treatment objectives
D) nursing goals
B
3
Nutrition assessment and diagnosis followed by provision of nutrition care by a registered dietitian is termed "____."
A) medical nutrition therapy
B) the nutrition care process
C) a nutrition screening
D) a medical history
A) medical nutrition therapy
B) the nutrition care process
C) a nutrition screening
D) a medical history
A
4
Which statement is true regarding malnutrition among hospitalized patients?
A) Although common among chronic care patients, malnutrition is rare among acute care patients.
B) Malnutrition among hospitalized patients is extremely rare and an indication of seriously flawed care.
C) Only patients who are terminally ill and expected to die within months are at risk of malnutrition.
D) Even acutely ill patients who are not malnourished during admission may become malnourished subsequently.
A) Although common among chronic care patients, malnutrition is rare among acute care patients.
B) Malnutrition among hospitalized patients is extremely rare and an indication of seriously flawed care.
C) Only patients who are terminally ill and expected to die within months are at risk of malnutrition.
D) Even acutely ill patients who are not malnourished during admission may become malnourished subsequently.
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5
The physician asks the staff to administer tube feedings. Who is most often responsible for doing this?
A) the nurse
B) the dietitian
C) the dietetic technician
D) the social worker
A) the nurse
B) the dietitian
C) the dietetic technician
D) the social worker
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6
General weakness and impaired mobility in a patient represents which type of data in the nutrition screening process?
A) admission data
B) anthropometric data
C) functional assessment data
D) laboratory test results
A) admission data
B) anthropometric data
C) functional assessment data
D) laboratory test results
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7
Which health care professional is expected to have extensive knowledge about foods, nutrition, and health?
A) physician
B) registered dietitian
C) nurse
D) social worker
A) physician
B) registered dietitian
C) nurse
D) social worker
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8
Changes in hydration, as well as diarrhea due to illness, affect nutrition status primarily by ____.
A) reducing nutrient and food intake
B) altering metabolism and excretion
C) impairing digestion and absorption
D) impairing cognition
A) reducing nutrient and food intake
B) altering metabolism and excretion
C) impairing digestion and absorption
D) impairing cognition
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9
What is the screening tool that is used in clinical facilities to detect the risk of malnutrition in adults over the age of 65?
A) Subjective Global Assessment
B) Patient Education Materials Assessment Tool
C) Continuity Assessment and Record Evaluation
D) Mini Nutritional Assessment
A) Subjective Global Assessment
B) Patient Education Materials Assessment Tool
C) Continuity Assessment and Record Evaluation
D) Mini Nutritional Assessment
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10
An assessment procedure for identifying clients who are malnourished or at risk for malnutrition is referred to as a "____."
A) health questionnaire
B) health history
C) diet order
D) nutrition screening
A) health questionnaire
B) health history
C) diet order
D) nutrition screening
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11
Which statement most accurately describes nutrition screening?
A) Screenings should be conducted within 24 hours of patient's admission.
B) Screening questions are the same from facility to facility.
C) Assessments must be conducted by physicians.
D) Laboratory tests are not included as part of the screening process.
A) Screenings should be conducted within 24 hours of patient's admission.
B) Screening questions are the same from facility to facility.
C) Assessments must be conducted by physicians.
D) Laboratory tests are not included as part of the screening process.
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12
A nutrition care plan is ____.
A) the client's diet prescription ordered by the nurse
B) the dietitian's strategies for meeting an individual's nutritional needs
C) the nurse's documentation of how well the client is eating
D) nutritional formulas showing minimum daily requirements
A) the client's diet prescription ordered by the nurse
B) the dietitian's strategies for meeting an individual's nutritional needs
C) the nurse's documentation of how well the client is eating
D) nutritional formulas showing minimum daily requirements
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13
In a health care facility, who holds the ultimate responsibility for ensuring that all the patient's nutritional needs are met?
A) clinical dietitians
B) physicians
C) nurses
D) pharmacists
A) clinical dietitians
B) physicians
C) nurses
D) pharmacists
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14
A new patient is admitted to the rehabilitation unit. Who is most likely to visit the patient to compile a list of his or her food preferences?
A) nurse
B) physician
C) dietitian
D) dietetic technician
A) nurse
B) physician
C) dietitian
D) dietetic technician
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15
Maisie Green is a frail, elderly widow who lives in a nursing home and has been confined to her bed for 4 months. What is most likely to increase her metabolic stress and her energy and protein needs?
A) weakened immunity
B) medications causing GI discomfort
C) poor emotional health
D) pressure sores
A) weakened immunity
B) medications causing GI discomfort
C) poor emotional health
D) pressure sores
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16
A patient who has had surgery for colostomy placement has been put on bowel rest and has only intravenous fluids for nutrition. In what way would these treatments affect this patient's nutrition status?
A) reduce food intake
B) impair digestion
C) alter nutrient excretion
D) Impair absorption
A) reduce food intake
B) impair digestion
C) alter nutrient excretion
D) Impair absorption
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17
Coordinated programs of treatment that merge the care plans of different health practitioners are called "____."
A) critical pathways
B) clinical integrative plans
C) diagnosis-related groups
D) treatment plans
A) critical pathways
B) clinical integrative plans
C) diagnosis-related groups
D) treatment plans
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18
Impaired nutrient digestion and absorption that affects nutritional status would most likely be caused by ____.
A) insufficient excretion of digestive enzymes
B) anorexia due to illness
C) prolonged immobilization
D) use of diuretics
A) insufficient excretion of digestive enzymes
B) anorexia due to illness
C) prolonged immobilization
D) use of diuretics
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19
Depending on the patient population, estimates indicate that approximately ____ percent of hospitalized patients are malnourished.
A) 20 to 50
B) 35 to 70
C) 45 to 80
D) 50 to 90
A) 20 to 50
B) 35 to 70
C) 45 to 80
D) 50 to 90
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20
A patient's height, weight, and body mass index represent which type of data in the nutrition screening process?
A) admission data
B) anthropometric data
C) functional assessment data
D) laboratory test results
A) admission data
B) anthropometric data
C) functional assessment data
D) laboratory test results
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21
An extensive and accurate log of foods eaten over a period of several consecutive days or weeks is called "____."
A) a food-frequency checklist
B) a food record
C) direct observation
D) 24-hour recall
A) a food-frequency checklist
B) a food record
C) direct observation
D) 24-hour recall
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22
Danny is undergoing a health assessment. What should the clinician do that would most likely result in an accurate assessment of Danny's weight?
A) Ask Danny how much he weighs.
B) Use a scale that is calibrated and checked for accuracy.
C) Measure Danny's weight three times and take an average of the measurements.
D) Use a bathroom scale to weigh Danny.
A) Ask Danny how much he weighs.
B) Use a scale that is calibrated and checked for accuracy.
C) Measure Danny's weight three times and take an average of the measurements.
D) Use a bathroom scale to weigh Danny.
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23
What is a limitation when food intake information is collected using the 24-hour dietary recall method?
A) The process is time consuming.
B) Clients often keep poor records.
C) The method excludes recording of beverages.
D) A 24-hour recall relies on an individual's memory.
A) The process is time consuming.
B) Clients often keep poor records.
C) The method excludes recording of beverages.
D) A 24-hour recall relies on an individual's memory.
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24
A nutritional assessment involves ____.
A) collecting and analyzing health-related data to identify nutrition problems
B) implementing a nutrition care plan
C) identifying existing and potential psychological problems
D) obtaining approval from insurance providers
A) collecting and analyzing health-related data to identify nutrition problems
B) implementing a nutrition care plan
C) identifying existing and potential psychological problems
D) obtaining approval from insurance providers
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25
What is a social factor that can affect food intake and therefore nutrition status?
A) methamphetamine use
B) religious beliefs
C) mental illness
D) prescription medications
A) methamphetamine use
B) religious beliefs
C) mental illness
D) prescription medications
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26
The neuropsychological problems assessed in the Mini Nutritional Assessment screening tool include ____.
A) dementia
B) distorted body image perception
C) anxiety
D) schizophrenia
A) dementia
B) distorted body image perception
C) anxiety
D) schizophrenia
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27
An individual with a body mass index of ____ would receive one point for BMI in the Mini Nutritional Assessment screening tool.
A) less than 19
B) 19 to less than 21
C) 21 to less than 23
D) 23 or greater
A) less than 19
B) 19 to less than 21
C) 21 to less than 23
D) 23 or greater
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28
If a client is asked to recount everything eaten in a typical day, the assessor is using ____ to collect food intake data.
A) a food record
B) a calorie count
C) a 24-hour recall
D) direct observation
A) a food record
B) a calorie count
C) a 24-hour recall
D) direct observation
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29
Why might food frequency questionnaires be less accurate than 24-hour recalls for obtaining food intake data?
A) The process examines long-term food intake
B) Dietary supplements can't be included.
C) They typically list only common foods.
D) It may be difficult to estimate average portion sizes of foods eaten less frequently.
A) The process examines long-term food intake
B) Dietary supplements can't be included.
C) They typically list only common foods.
D) It may be difficult to estimate average portion sizes of foods eaten less frequently.
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30
Head circumference is used to ____.
A) monitor brain growth
B) help detect overnutrition
C) evaluate muscle size
D) calculate infant body mass index
A) monitor brain growth
B) help detect overnutrition
C) evaluate muscle size
D) calculate infant body mass index
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31
A registered dietitian performs a Subjective Global Assessment on a newly admitted hospital patient. The dietitian gives several "C" ratings for the assessment variables related to the patient's medical history and physical examination. This most likely means that the patient is ____.
A) obese and needs to lose weight
B) well nourished
C) at risk of malnutrition
D) severely malnourished
A) obese and needs to lose weight
B) well nourished
C) at risk of malnutrition
D) severely malnourished
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32
What is an example of food and nutrition history information that would be included as part of the nutrition assessment?
A) dietary supplements usage
B) high educational level
C) recent weight changes
D) low socioeconomic status
A) dietary supplements usage
B) high educational level
C) recent weight changes
D) low socioeconomic status
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33
Growth charts with BMI-for-age percentiles can be used to assess risk of underweight using the ____ percentile as the cutoff to identify children who may be malnourished.
A) 5th
B) 10th
C) 15th
D) 20th
A) 5th
B) 10th
C) 15th
D) 20th
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34
Lee is a 78-year-old woman with mild loss of muscle mass, loss of about 7% of body weight over the past 6 months, and decreased food intake due to anorexia. Using the Subjective Global Assessment screening tool, she is most likely to be classified in which category?
A) well nourished
B) mild malnutrition
C) moderate malnutrition
D) severe malnutrition
A) well nourished
B) mild malnutrition
C) moderate malnutrition
D) severe malnutrition
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35
A 24-hour recall is used to collect food intake data for one day. The client states that she didn't eat breakfast. She had a soft drink and an apple for lunch, and for dinner she had a slice of pizza. What is the best question the health care professional could ask next regarding this finding?
A) "Is this typically a day's food intake?"
B) "What was on the slice of pizza?"
C) "What kinds of foods do you like to eat?"
D) "Are you on a busy schedule?"
A) "Is this typically a day's food intake?"
B) "What was on the slice of pizza?"
C) "What kinds of foods do you like to eat?"
D) "Are you on a busy schedule?"
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36
Which calculation is more effective in evaluating weight loss in an overweight person?
A) usual body weight
B) ideal body weight
C) %Usual Body Weight
D) %Ideal Body Weight
A) usual body weight
B) ideal body weight
C) %Usual Body Weight
D) %Ideal Body Weight
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37
An example of a behavioral-environmental diagnosis given following a nutrition assessment might be ____.
A) altered blood potassium levels
B) inadequate energy intake
C) unintended weight gain
D) disordered eating pattern
A) altered blood potassium levels
B) inadequate energy intake
C) unintended weight gain
D) disordered eating pattern
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38
What technique is most effective when using the 24-hour recall method to obtain food intake data?
A) multiple-pass method
B) direct observation
C) use of a checklist
D) free recall
A) multiple-pass method
B) direct observation
C) use of a checklist
D) free recall
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39
What best describes a food record?
A) a written survey of food consumed in the past year
B) a written account of food consumed during several consecutive days
C) direct observation of how much a person eats
D) an interview discussing food intake in the last day
A) a written survey of food consumed in the past year
B) a written account of food consumed during several consecutive days
C) direct observation of how much a person eats
D) an interview discussing food intake in the last day
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40
In children, a sharp drop in a previously steady growth pattern suggests ____.
A) malnutrition
B) obesity
C) a growth spurt
D) a medical error
A) malnutrition
B) obesity
C) a growth spurt
D) a medical error
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41
Elevated levels of ____ may indicate liver disease.
A) albumin
B) creatine kinase
C) mean corpuscular volume
D) alanine aminotransferase
A) albumin
B) creatine kinase
C) mean corpuscular volume
D) alanine aminotransferase
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42
Mrs. Falwell is 5 ft 4 in. and weighs 110 lb. During the interview, she mentions she has lost "a lot of weight" over the past 5 months. She usually weighs 135 lbs. What is her %UBW?
A) 25
B) 81
C) 120
D) 123
A) 25
B) 81
C) 120
D) 123
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43
Which protein is the most abundant serum protein?
A) transferrin
B) albumin
C) transthyretin
D) retinol-binding protein
A) transferrin
B) albumin
C) transthyretin
D) retinol-binding protein
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44
What %Ideal Body Weight indicates a risk of moderate malnutrition?
A) 90 to 100
B) 85 to 90
C) 80 to 85
D) 70 to 79
A) 90 to 100
B) 85 to 90
C) 80 to 85
D) 70 to 79
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45
Fluid retention typically results in ____.
A) deceptively low lab values
B) deceptively high lab values
C) unintentional weight loss
D) unintentional muscle loss
A) deceptively low lab values
B) deceptively high lab values
C) unintentional weight loss
D) unintentional muscle loss
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46
A BMI-for-age above the ____ percentile indicates that the child may be overweight.
A) 25th
B) 50th
C) 75th
D) 85th
A) 25th
B) 50th
C) 75th
D) 85th
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47
Where do clinical signs of malnutrition appear most rapidly?
A) hair
B) eyes
C) urinary tract
D) cardiovascular system
A) hair
B) eyes
C) urinary tract
D) cardiovascular system
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48
Which nutrition assessment marker is routinely monitored in hospital patients, but is not a sensitive indicator of nutrition status?
A) serum albumin
B) body mass index
C) mean corpuscular volume
D) plasma creatinine
A) serum albumin
B) body mass index
C) mean corpuscular volume
D) plasma creatinine
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49
Which serum protein rises rapidly in response to inflammation or infection associated with critical illness?
A) transferrin
B) prealbumin
C) albumin
D) C-reactive protein
A) transferrin
B) prealbumin
C) albumin
D) C-reactive protein
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50
White blood cells that have the ability to engulf and destroy pathogens are known as "____."
A) phagocytes
B) immunoglobulins
C) lymphocytes
D) lysozymes
A) phagocytes
B) immunoglobulins
C) lymphocytes
D) lysozymes
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51
After blood is centrifuged to remove cells, the fluid that remains is called "____."
A) plasma
B) serum
C) electrolytes
D) platelets
A) plasma
B) serum
C) electrolytes
D) platelets
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52
The half-life of albumin is approximately ____.
A) 12 hours
B) 2 to 3 days
C) 8 to 10 days
D) 14 to 20 days
A) 12 hours
B) 2 to 3 days
C) 8 to 10 days
D) 14 to 20 days
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53
Which of the following biochemical tests has different ranges of normal values for males and females?
A) hematocrit
B) mean corpuscular volume
C) mean corpuscular hemoglobin concentration
D) white blood cell (WBC) count
A) hematocrit
B) mean corpuscular volume
C) mean corpuscular hemoglobin concentration
D) white blood cell (WBC) count
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54
What clinical effects of protein-energy malnutrition (PEM) would most likely be seen in an individual's hair?
A) hair falling out easily
B) thick hair
C) hair firm in scalp
D) shiny hair
A) hair falling out easily
B) thick hair
C) hair firm in scalp
D) shiny hair
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55
An individual who is at risk of moderate malnutrition has a %Usual Body Weight of ____.
A)
B) 70 to 75
C) 75 to 84
D) 85 to 90
A)
B) 70 to 75
C) 75 to 84
D) 85 to 90
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56
Immunity against a specific antigen is called "____ immunity."
A) adaptive
B) innate
C) systemic
D) complementary
A) adaptive
B) innate
C) systemic
D) complementary
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57
Which test is primarily used for monitoring kidney function?
A) glycated hemoglobin
B) C-reactive protein
C) blood urea nitrogen
D) alanine aminotransferase
A) glycated hemoglobin
B) C-reactive protein
C) blood urea nitrogen
D) alanine aminotransferase
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58
_______ are large globular proteins produced by B cells that function as antibodies.
A) Antigens
B) Immunoglobulins
C) Antibodies
D) Lysozymes
A) Antigens
B) Immunoglobulins
C) Antibodies
D) Lysozymes
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59
An individual who is at risk of mild malnutrition has a %Usual Body Weight of ____.
A)
B) 75 to 84
C) 85 to 95
D) >95
A)
B) 75 to 84
C) 85 to 95
D) >95
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60
Physical signs of fluid retention include ____.
A) dark-colored urine
B) reduced skin tension
C) abdominal distention
D) thirst
A) dark-colored urine
B) reduced skin tension
C) abdominal distention
D) thirst
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61
Match between columns
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62
List two advantages and two disadvantages for each of the four methods used for obtaining food intake data.
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63
Explain why serum proteins are used as part of biochemical assessment measurements and list three examples.
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64
Describe the differences between fluid retention and dehydration.
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65
A nonspecific response to illness or injury is called "____. "
A) an allergy
B) cell-mediated immunity
C) humoral immunity
D) inflammation
A) an allergy
B) cell-mediated immunity
C) humoral immunity
D) inflammation
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66
Describe clinical signs of malnutrition in an individual's eyes, lips, skin, and nails.
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67
Discuss the different types of historical data collected for a nutrition assessment.
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68
Discuss the undesirable impact of immune responses on nutrition status.
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69
Describe the use of anthropometric measurements in infants and children.
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70
Which tissue is a type of lymphoid tissue?
A) spleen
B) lungs
C) appendix
D) brain
A) spleen
B) lungs
C) appendix
D) brain
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71
Discuss the role of nurses on the nutrition care team and list five nutrition-related nursing diagnoses.
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72
Describe how malnutrition impacts the body's immune response.
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73
Describe the effects of illness on nutrition status and list two examples of conditions associated with malnutrition.
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74
An example of an antigen is a(an) ____.
A) monocyte
B) NK cell
C) virus
D) T cell
A) monocyte
B) NK cell
C) virus
D) T cell
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75
A foreign antigen has entered the body and has elicited the immune response. A helper T cell binds to an antigen fragment on an antigen-presenting cell. What happens next?
A) B cells produce more antibodies.
B) A cytotoxic T cell destroys the antigen.
C) Free antibodies attach to the antigens.
D) A macrophage engulfs the target antigen.
A) B cells produce more antibodies.
B) A cytotoxic T cell destroys the antigen.
C) Free antibodies attach to the antigens.
D) A macrophage engulfs the target antigen.
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76
Which type of cell releases proteins that damage parasites?
A) basophils
B) monocytes
C) eosinophils
D) neutrophils
A) basophils
B) monocytes
C) eosinophils
D) neutrophils
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