Chapter 11: Nutritional Assessment Flashcards
Which of the following persons does the nurse recognize to be at greatest risk for undernutrition?
a. A 5-month-old infant
b. A 50-year-old woman
c. A 20-year-old community college student
d. A 30-year-old hospital administrator
a.
When assessing a patient’s nutritional status, the nurse recalls that the best definition of optimal nutritional status is the consumption of:
a. nutrients in excess of daily physiological requirements.
b. sufficient nutrients to provide for the minimum physiological needs.
c. sufficient nutrients to meet daily physiological requirements but not increased metabolic demands.
d. sufficient nutrients to meet daily physiological requirements and increased metabolic demands.
d.
The nurse is providing nutrition information to the mother of a 1-year-old child. Which of the following statements represents accurate information for this age group?
a. It is important to maintain adequate fat and caloric intake.
b. The recommended dietary allowances for an infant are the same as those for an adolescent.
c. At this age, the baby’s growth is minimal, so caloric requirements are lower.
d. The baby should be given skim milk to decrease the risk of coronary artery disease later in life.
a.
A pregnant woman is interested in breastfeeding her baby and asks several questions about it. Which of the following would be appropriate information the nurse should provide?
a. Breastfeeding is best when also supplemented with bottle feedings.
b. Babies who are breastfed often require supplemental vitamins.
c. Breastfeeding is recommended for the first 2 years of life.
d. Breast milk provides the nutrients necessary for growth as well as natural immunity.
d.
A mother and her 13-year-old daughter express their concern about the daughter’s recent weight gain and increase in appetite. Which of the following should the nurse discuss with them?
a. The necessity of exercise and dieting at this age
b. Suggestions for snacks high in protein, iron, and calcium
c. Not allowing snacking by teenagers with a weight problem
d. The importance of a low-calorie diet to prevent the accumulation of fat
b.
The nurse is assessing a 30-year-old unemployed immigrant from a developing country who has been in Canada for 1 month. Which of the following problems related to his nutritional status might the nurse expect to find?
a. Obesity
b. Hypotension
c. Osteomalacia
d. Coronary artery disease
c.
During the nutritional assessment of a 22-year-old male refugee, the nurse must remember to:
a. obtain a 24-hour dietary recall.
b. find out what he means by the term “food.”
c. provide him with a handbook on standard diets.
d. assume that his diet is consistent with other refugees from the same country.
b.
Which of the following statements about nutritional assessment is true?
a. It is only useful in patients who are overweight.
b. It identifies patients who are at risk of malnutrition.
c. Nutritional assessment can only be thoroughly done by a dietitian.
d. It provides the nurse with physical findings related to all the systems.
b.
A patient is at the clinic on his first visit and reports no history of nutrition-related problems. Which of the following should the initial nutritional screening include?
a. Calorie count of nutrients
b. Anthropometric measures
c. Complete physical examination
d. Measurement of weight and weight history
d.
A patient is asked to indicate on a form how many times he eats a specific food. Which of the following methods for obtaining dietary information does this reflect?
a. Food diary
b. Calorie count
c. 24-hour recall
d. Food frequency questionnaire
d.
The nurse is providing care to a 68-year-old woman who is complaining of constipation. What concern exists regarding her nutritional status?
a. The absorption of nutrients may be impaired.
b. The constipation may represent a food allergy.
c. She may need emergency surgery for the problem.
d. The gastrointestinal problem will increase her caloric demand.
a.
During nutritional assessment, why is it important for the nurse to ask a patient what medications he or she is taking?
a. Certain drugs can affect the metabolism of nutrients.
b. The nurse needs to assess the patient for allergic reactions.
c. Medications need to be documented on the patient record for the physician’s review.
d. Medications can affect one’s memory and ability to identify foods eaten in the last 24 hours.
a.
A patient tells the nurse that he does not find any food tasty any more. The nurse’s best response would be:
a. “That must be really frustrating.”
b. “When did you first notice this change?”
c. “My food doesn’t always have a lot of taste either.”
d. “Sometimes that happens but your taste will come back.”
b.
The nurse is performing nutritional assessment on a 15-year-old girl, who tells the nurse that she is “so fat.” Assessment reveals that she is 160 cm (5 feet 4 inches) and weighs 50 kg (110 lbs). The nurse’s appropriate response would be:
a. “How much do you think you should weigh?”
b. “Don’t worry about it, you’re not that overweight.”
c. “The best thing for you would be to go on a diet.”
d. “I used to always think I was fat when I was your age.”
a.
The nurse is discussing appropriate foods for a 3-year-old child with the mother. Which of the following foods can be recommended?
a. Foods that the child will eat, no matter what they are
b. Foods that are easy to hold, such as hot dogs, nuts, and grapes
c. Any foods that the rest of the family is eating
d. Finger foods and nutritious snacks that will not cause choking
d.
Which of the following factors is most likely to affect the nutritional status of an 82-year-old person?
a. Enhanced taste and smell
b. Living alone on a fixed income
c. Change in cardiovascular status
d. Poor gastrointestinal motility and absorption
b.
When considering nutritional assessment, the nurse is aware that the most common anthropometric measurements include:
a. height and weight.
b. leg circumference.
c. biceps skinfold thickness.
d. hip and waist measurements.
a.
If a 29-year-old woman weighs 66 kg (146 lb) and the nurse determines her ideal body weight to be 54 kg (120 lb), how would the nurse classify the woman’s weight?
a. Obese
b. Mildly overweight
c. Suffering from malnutrition
d. Within appropriate range of ideal weight
a.
When assessing muscle mass and fat stores in a 40-year-old woman, the nurse would use:
a. triceps skinfold.
b. mid-arm muscle area.
c. percent ideal body weight.
d. mid-upper arm circumference.
d.
When the mid-upper arm circumference and triceps skinfold of an 82-year-old man are measured, it is important to remember that:
a. these measurements are no longer necessary for the older adult.
b. derived weight measures may be difficult to interpret because of wide ranges of normal.
c. these measurements may not be accurate because of changes in skin and fat distribution.
d. measurements may be difficult to obtain if the patient is unable to flex his elbow to at least 90 degrees.
c.
In teaching a patient how to determine total body fat at home, the nurse includes instructions to obtain measurements of:
a. height and weight.
b. frame size and weight.
c. waist and hip circumferences.
d. mid-upper arm circumference and arm span.
a.
The nurse is evaluating patients for obesity-related diseases. Which one of the following would be at increased risk?
a. A 29-year-old woman whose percent ideal body weight is 125%, waist 83.8 cm (33 in), and hips 91.4 cm (36 in)
b. A 32-year-old man whose percent ideal body weight is 115%, waist 86.4 cm (34 in), and hips 91.4 cm (36 in)
c. A 38-year-old man whose percent ideal body weight is 120%, waist 89 cm (35 in), and hips 96.5 cm (38 in)
d. A 46-year old woman whose percent ideal body weight is 130%, waist 76.2 cm (30 in), and hips 96.5 cm (38 in)
a.
The mother of an 8-year-old boy is concerned about her son’s weight gain. To determine whether this is a problem, the nurse will measure:
a. arm span.
b. waist-to-hip ratio.
c. skinfold thickness.
d. Mid-upper arm circumference.
c.
The nurse needs to determine the body mass index of an 80-year-old man who is confined to a wheelchair. Which of the following is true in this situation?
a. Changes in fat distribution will affect the waist-to-hip ratio.
b. Height measurements may not be accurate because of bone changes.
c. Declining muscle mass will affect the triceps skinfold measurement.
d. Mid-arm circumference is difficult to obtain because of loss of skin elasticity.
b.
After completing nutritional assessment on a 30-year-old woman, the nurse suspects that she may have iron deficiency. Laboratory studies that will verify this condition are:
a. hemoglobin and hematocrit.
b. cholesterol and triglycerides.
c. creatinine and serum protein.
d. serum albumin and urinary urea nitrogen.
a.
A 50-year-old woman is visiting the clinic today to find out about her laboratory results, which show elevated serum, total cholesterol, and triglyceride levels. What would be important for the nurse to include in patient education in relation to these results?
a. The risks of undernutrition
b. Methods to reduce stress in her life
c. Information about a low-saturated-fat diet
d. The fact that this is hereditary and there is nothing she can do to change the levels
c.
A 40-year-old man has recently lost 9 kg (20 lb) because of a quick-loss diet and stress. He tells the nurse that he keeps getting “colds and the flu.” In addition to assessing his nutritional status, which laboratory report would the nurse want to obtain?
a. Serum albumin
b. Cholesterol level
c. Serum transferrin
d. Total lymphocyte count
d.
To obtain an accurate nitrogen balance and creatinine-height index, the nurse must ensure that:
a. the patient’s height and weight have been measured.
b. the laboratory draws the blood specimen early in the morning.
c. an accurate 24-hour urine specimen has been collected.
d. the patient has not had anything by mouth for 8 hours before the test.
c.
Which of the following statements about evaluating the results of laboratory tests is true?
a. Normal values do not vary according to age.
b. Variations based on biocultural differences may exist.
c. It is not necessary to repeat laboratory tests once malnutrition has been determined.
d. Laboratory tests are more sensitive than other parts of the assessment and should take priority.
b.
When assessing a 49-year-old woman with imbalanced nutrition as a result of dysphagia, which of the following data would the nurse expect to find?
a. An increase in hair growth
b. Inadequate food intake
c. Weight 10 to 20% over ideal
d. Sore, inflamed buccal cavity
b.
A 21-year-old woman has been on a low-protein liquid diet for the past 2 months. She has had adequate calorie intake and appears well nourished. With further assessment, what would the nurse expect to find?
a. Poor skin turgor
b. Decreased serum albumin
c. Increased lymphocyte count
d. Triceps skinfold less than standard
b.
The nurse is performing nutritional assessment on an 80-year-old patient. The nurse knows that physiological changes that directly affect the nutritional status of the older adult include:
a. slowed gastrointestinal motility.
b. hyperstimulation of the salivary glands.
c. an increased sensitivity to spicy and aromatic foods.
d. decreased gastrointestinal absorption causing esophageal reflux.
a.
Which of the following interventions is most appropriate when the nurse is planning nutritional interventions for a healthy, active 74-year-old woman?
a. Decrease the amount of carbohydrates to prevent lean muscle catabolism.
b. Increase the amount of soy and tofu in her diet to promote bone growth and reverse osteoporosis.
c. Decrease calorie intake because of the decrease in energy requirements from loss of lean body mass.
d. Increase calorie intake because of the increased energy needs of the older adult.
c.
Which of the following statements about routine laboratory testing is true in the following individuals?
a. In pregnant women, no laboratory testing is needed unless problems in the pregnancy are suspected.
b. In older adults, laboratory values for cholesterol and triglycerides are most important with regard to risk of disease.
c. In adolescents, unless disease is suspected, laboratory evaluation of hemoglobin and hematocrit levels and urinalysis for glucose and protein are adequate.
d. In infants and children, laboratory tests should be performed at each well-child checkup, whether or not the child is exhibiting signs of illness that affect nutritional status.
c.
A 16-year-old girl is at the clinic for gastrointestinal complaints and weight loss. The nurse determines that many of her complaints may be related to erratic eating patterns, eating mostly fast foods, and high caffeine intake. In this situation, which of the following is most appropriate when collecting current dietary intake information?
a. Arrange for direct observation of the adolescent during meals.
b. Ask the patient for a 24-hour diet recall and assume this is reflective of a typical day for her.
c. Have the patient complete a food diary for 3 days—2 weekdays and 1 day in the weekend.
d. Use the food frequency questionnaire to identify the intake amount of specific foods.
c.
Which of the following individuals is most likely to have an anergic response to skin test antigens when immunity is being assessed?
a. An 8-year-old child
b. An obese individual
c. A healthy 80-year-old female
d. An individual with malnutrition
d.
Which of the following measurements is an early indicator of protein malnutrition?
a. Serum albumin
b. Serum creatinine
c. Nitrogen balance
d. Serum transferrin
d.
A 65-year-old man is brought to the emergency department after he was found dazed and incoherent, alone in his apartment. He has an enlarged liver and is moderately dehydrated. When evaluating his serum albumin level, the nurse must keep in mind that:
a. serum albumin levels will increase as liver function decreases.
b. serum albumin levels are a sensitive measure of early protein malnutrition.
c. low serum albumin levels may be caused by reasons other than protein-calorie malnutrition.
d. the results of the serum albumin measurement along with the patient’s hemoglobin level should be considered.
c.
Which of the following conditions is due to an inadequate intake of both protein and calories?
a. Obesity
b. Bulimia
c. Marasmus
d. Kwashiorkor
c.
A pregnant woman who is human immunodeficiency virus (HIV) positive is asking the nurse about breastfeeding her baby. Which of the following statements is appropriate?
a. There is not enough information to know whether it would be safe for women who are HIV positive to breastfeed.
b. It is safe for women who are HIV positive to breastfeed.
c. Women who are HIV positive should not breastfeed because HIV can be transmitted through breast milk.
d. She can breastfeed as long as she uses pumped breast milk.
c.
During an assessment of a patient who has been homeless for several years, the nurse notices that his tongue is magenta in colour. This is an indication of:
a. iron deficiency.
b. riboflavin deficiency.
c. vitamin D and calcium deficiency.
d. vitamin C deficiency.
b.
