Jarvis 3rd Ed Chapter 12 Flashcards
The nurse is working with some of the city’s homeless population. When assessing the 2 day old surgical wound of one of the patients, the nurse is most concerned about:
a. Undernutrition leading to delayed wound healing.
b. Excess weight gain from overconsumption of nutrients.
c. Adequate nutritional intake for athletic performance.
d. Lowered resistance to infection resulting from overnutrition.
a. Undernutrition leading to delayed wound healing.
When providing education on nutrition the nurse explains optimal nutritional status as:
a. consuming food in excess of daily requirements.
b. consuming energy-dense foods to meet the minimum body needs.
c. food intake to meet daily body requirement but not to support increased metabolic demands.
d. consuming nutrients to meet daily body requirements and support increased metabolic demands.
d. consuming nutrients to meet daily body requirements and support increased metabolic demands.
The nurse is providing nutrition information to the mother of a 1-year-old child. Which of these statements represents accurate information for this age group?
a. maintaining adequate fat and caloric intake is important for a child in this age group.
b. the recommended dietary allowances for an infant are the same as for an adolescent.
c. the baby’s growth is minimal at this age; therefore, caloric requirements are decreased.
d. the baby should be placed on skim milk to decrease the risk for coronary artery disease at a later age.
a. maintaining adequate fat and caloric intake is important for a child in this age group.
A pregnant woman is interested in breastfeeding her baby and asks several questions about it. Which information is appropriate for the nurse to share with her?
a. breastfeeding is best when also supplemental with bottle feedings.
b. babies who are breastfed often require supplemental vitamins.
c. breastfeeding is recommended for infants for the first 2 years of life.
d. breast milk provides the nutrients necessary for growth and natural immunity.
d. breast milk provides the nutrients necessary for growth and natural immunity.
A mother and her 13-year-old daughter express concern related to the daughter’s recent weight gain and her increase in appetite. Which of these statements represents information the nurse should discuss with them?
a. dieting and exercise are necessary at this age.
b. snacks should be high in protein, iron, and calcium.
c. Teenagers who have a weight problem should not be allowed to snack.
d. a low-calorie diet is important to prevent the accumulation of fat.
b. snacks should be high in protein, iron, and calcium.
The nurse is assessing a 30-year-old immigrant from Nigeria who has been in Canada for 1 month and is unemployed. Which of these potential problems might the nurse expect to find as related to nutritional status?
a. obesity
b. hypotension
c. osteomalacia (softening of the bones)
d. coronary artery disease
c. osteomalacia (softening of the bones)
Rationale: general undernutrition, hypertension, diarrhea, lactose-intolerance, osteomalacia, scurvy, and dental caries are among the more common nutrition-related problems for new immigrants from developing countries.
The nurse is meeting a patient who has no history of nutrition-related problems for the first clinic visit. The initial nutritional screening should include which activity?
a. calorie count of nutrients
b. anthropometric measures
c. complete physical examination
c. Measurement of weight and weight history
d. measurement of weight and weight history
A patient is asked to indicate on a form how many times he eats a specific food. Which method is the nurse using to assess nutritional intake?
a. food diary
b. calorie count
c. 24 hour recall
d. food frequency questionnaire
d. food frequency questionnaire
The nurse is providing care for a 68-year-old woman who is complaining of constipation. What concern exists regarding her nutritional status.
a. absorption of nutrients may be impaired.
b. constipation may represent a food allergy
c. the patient may need emergency surgery to correct the problem.
d. gastrointestinal problems will increase her caloric demand.
a. absorption of nutrients may be impaired.
During a nutritional assessment, why is it important for the nurse to ask a patient what medication he or she is taking?
a. certain medication can affect the metabolism of nutrients.
b. the nurse needs to assess the patient for allergic reactions.
c. medications need to be documented in the record for the physicians review.
d. Medications can affect memory and ability to identify food eaten in the last 24 hours.
a. certain medication can affect the metabolism of nutrients.
A patient tells the nurse that he simply does not find any food tasty anymore. The best response by the nurse 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 taste either.”
d. “sometimes that happens, but your taste will come back.”
b. “When did you first notice this change.”
The nurse is performing a nutritional assessment on a 15-year-old girl, who tells the nurse that she is “so fat.” Assessment reveals that she is 1.6 m tall and weighs 50 kg. An appropriate response from the nurse 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. “how much do you think you should weigh?”
The nurse is discussing appropriate foods with the mother of a 3-year-old-child. Which of these foods are recommended?
a. Foods that the child will eat, no matter what they are.
b. foods easy to hold such as hot dogs, nuts, and grapes.
c. any foods, as long as the rest of the family is also eating them.
d. finger foods and nutritious snacks that cannot cause choking.
d. finger foods and nutritious snacks that cannot cause choking.
The nurse is reviewing the nutritional assessment of an 82-year-old patient. Which of these factors will most likely affect the nutritional status of an older adult?
a. increase in taste and smell
b. living alone on a fixed income
c. change in cardiovascular status
d. increase in gastrointestinal motility and absorption.
b. living alone on a fixed income
The nurse is obtaining the objective data for the nutritional assessment. Which of the following would the nurse measure as common anthropometric elements?
a. height and weight
b. leg circumference
c. skinfold thickness of the biceps
d. arm length
a. Height and weight.
(the most common anthropometric measurements are height, weight, waist-to-hip ratio, and waist circumference.)
The nurse is assessing a 29-year-old woman and records her weight as 70kg and height as 1.6m. The nruse calculates the body mass index (BMI) and identifies the patient as being:
a. obese
b. overweight
c. sufffering from malnutrition
d. normal weight
b. overweight.
BMI= weight divided by height.
Normal is 18.5-24.9
Overweight is 25-29.9
Obese - 30 +
During assessment, the nurse measures the patient’s waist to be 76cm and hips circumference to be 86cm. Calculating the waist-hip-ratio, the nurse determines the patient to be:
a. underweight
b. at increased risk for early mortality
c. gynoid obese
d. at risk for metabolic diseases.
b. at increased risk for early mortality.
Waist to hip ratio reflects body fat distribution as an indicator of health risk. Obese individuals with greater proportion of fat in the upper body, especially in the abdomen, have android obesity; obese individuals with most of their fat in the hips and thighs have gynoid obesity. Waist to hip ratio is calculated as waist circumference divided by hip circumference.
A waist to hip ratio of 1.0 or more in men, or 0.8 or more in women is indicative of android (upper body obesity) and increasing risk for obesity related diseases and early mortality.
To gather the anthropometric waist measurement of the patient to calculate the wasit-hip ratio, the nurse will:
a. measure below the umbilicus and above the thighs.
b. measure at the level of the rib cage.
measure at the largest circumference of the buttocks.
c. measure at the largest circumference of the buttocks.
d. measure at the smallest circumference below the rib cage and above the umbilicus.
d. measure at the smallest circumference below the rib cage and above the umbilicus.
What is an Anthropometric Measurement?
Anthropometric measurements are physical measurements of a person’s body size, shape, and composition. These measurements help assess nutritional status, growth, obesity, and health risks.
Examples of Anthropometric Measurements
• Height – Used to assess growth in children and BMI in adults.
• Weight – Helps monitor weight changes, obesity, or malnutrition.
• Body Mass Index (BMI) – Weight (kg) / Height (m²); used to classify underweight, normal weight, overweight, and obesity.
• Waist Circumference – Measures abdominal fat, which is linked to metabolic disorders.
• Waist-to-Hip Ratio – Assesses fat distribution and cardiovascular risk.
• Skinfold Thickness (Calipers) – Measures subcutaneous fat to estimate body fat percentage.
• Mid-Upper Arm Circumference (MUAC) – Used in malnutrition screening, especially in children and pregnant women.
Why is it Called “Anthropometric”?
The term comes from Greek:
• Anthropos (ἄνθρωπος) = “human”
• Metron (μέτρον) = “measure”
So, “anthropometry” means “the measurement of humans.” It is widely used in nutrition, medicine, sports science, and ergonomics to study body composition, health, and physical development.
Let me know if you need more details!
In teaching a patient how to determine best weight for the patient’s height, the nurse includes instructions to obtain measurements of:
a. height and weight.
b frame size and weight.
c. waist and hip circumference.
d. mid-upper arm circumference and arm span.
a. height and weight.
The nurse is evaluating patients for obesity-related diseases by calculating the waist to hip ratios. which one of these patients would be at increased risk?
a. a 29-year old woman whose waist measures 33 inches (86 cm) and hip measures 36 inches (91cm).
b. a 32 year old man whose waist measures 34 inches (86 cm) and hips measure 36 inches (91 cm).
c. A 38 year old man whose waist measures 35 inches (89 cm) and hips measure 38 inches (96 cm).
d. A 46 year old woman whose waist measures 30 inches (76 cm) and hips measure 38 inches (96 cm).
a. a 29-year old woman whose waist measures 33 inches (86 cm) and hip measures 36 inches (91cm).
The numbers in option D (30 and 38) seem far apart, so you’d think the ratio would be higher. But actually, closer numbers (like 33 and 36 in option A) make the ratio higher, not lower. Here’s a simple way to think about it:
Dumbed-down way to rationalize it:
1. If waist and hip are close in size, the ratio is high = BAD.
• Example: 33/36 = 0.916 (high risk)
• This means there’s almost no difference between the waist and hips → more apple-shaped (which is riskier).
2. If the hip is much bigger than the waist, the ratio is low = GOOD.
• Example: 30/38 = 0.789 (low risk)
• This means the waist is much smaller compared to the hips → more pear-shaped (which is healthier).
The Takeaway:
• High waist-to-hip ratio (WHR) = Apple-shaped = More fat around the belly = Higher health risk.
• Low WHR = Pear-shaped = More fat in hips/thighs = Lower health risk.
So when in doubt, think: “If waist and hip are almost the same, that’s a bad sign.”
The answer is based on the waist-to-hip ratio (WHR), which is used to assess the distribution of body fat and the risk of metabolic and cardiovascular diseases.
How to Calculate Waist-to-Hip Ratio (WHR):

WHR Risk Thresholds (WHO Guidelines)
• For women: WHR >0.85 = increased risk.
• For men: WHR >0.90 = increased risk.
Let’s Calculate WHR for Each Person:
1. Option A (29-year-old woman)
• Waist: 33 in (86 cm)
• Hip: 36 in (91 cm)
• WHR = 33/36 = 0.916 → High Risk (>0.85 for women).
2. Option B (32-year-old man)
• Waist: 34 in (86 cm)
• Hip: 36 in (91 cm)
• WHR = 34/36 = 0.94 → High Risk (>0.90 for men).
3. Option C (38-year-old man)
• Waist: 35 in (89 cm)
• Hip: 38 in (96 cm)
• WHR = 35/38 = 0.921 → High Risk (>0.90 for men).
4. Option D (46-year-old woman)
• Waist: 30 in (76 cm)
• Hip: 38 in (96 cm)
• WHR = 30/38 = 0.789 → Low Risk (≤0.85 for women).
Why is Option A the Correct Answer?
Even though both men in options B and C also have a high WHR, option A is selected because it is the highest risk for a woman. In clinical practice, women with WHR >0.85 have a significantly higher risk of metabolic syndrome, diabetes, and heart disease.
Key Takeaway
WHR is a better predictor of health risks than BMI because it accounts for fat distribution. Abdominal fat (“apple shape”) is more dangerous than hip/thigh fat (“pear shape”).
After completing a diet assessment on a 30-year-old woman, the nurse suspects that she may be deficient in iron. The nurse can verify by using laboratory values of:
a. hemoglobin and hematocrit
b. cholesterol and triglycerides
c. urinalysis
d. serum albumin
a. hemoglobin and hematocrit
A 50-year old woman with elevated total cholesterol and triglyceride levels is visiting the clinic to discuss the laboratory results. The nurse will include patient education on:
a. the risks of undernutrition
b. methods to reduce stress in her life.
c. Information to include a diet low in saturated fat.
d. The condition being hereditary and why nothing she can do can change the levels.
c. Information to include a diet low in saturated fat.
Reducing dietary fats is part of the treatment for this condition.
During assessment of a 78-year-old patient taking multiple medications for various chronic conditions, the nruse is concernd that the patient is experiencing:
a. increase in hair growth.
b inadequate nutrient food intake.
c. extreme weight gain.
d. increase in abdominal fat.
b. inadequate nutrient food intake.
Older adults are prescribed multiple medications that may interact with nutrients, vitamin supplements, and other prescription medications.
A 21 - year old woman with extensive weight gain over the past 12 months, has a BMI of 38, indicating obesity. The nurse is concerned that she is at increased risk for:
a. Polypharmacy.
b. diabetes
c. optimal nutrition
d. low mortality
b. diabetes
The nurse is performing a nutritional assessment on an 80-year-old patient. The nurse knows that physiological changes can directly affect the nutritional status of the older adult and include:
a. slowed gastrointestinal motility.
b. hyperstimulation of the salivary glands
c. increased sensitivity to spicy and aromatic foods.
d. decreased gastrointestinal absorption causing esophageal reflux.
a. slowed gastrointestinal motility.
Normal physiological changes in aging adults that affect nutritional status include slowed gastrointestinal motility, decreased gastrointestinal absorption, diminished olfactory and taste sensitivity, decreased saliva production, decreased visual acuity, and poor dentition.
Why isn’t D correct?
• D says: “Decreased gastrointestinal absorption causing esophageal reflux.”
• While gastric absorption does decrease with age, it does not directly cause reflux. Reflux happens due to weakened lower esophageal sphincter (LES), not absorption issues.
Why A is correct?
• Slowed gastrointestinal motility is a normal physiological change in aging. It leads to constipation, delayed digestion, and reduced appetite, which directly affects nutrition.
Key Takeaway:
• Aging causes slowed digestion (A = correct).
• Esophageal reflux happens from a weak sphincter, not absorption issues (D = incorrect).
Which of these interventions is most appropriate when the nurse is planning nutritional interventions for a healthy, active 74-year old woman?
a. decreasing the amount of carbohydrates to prevent lean muscle catabolism.
b. increasing the amount of soy and tofu in her diet to promote bone growth and reverse osteoporosis.
c. decreasing the number of calories she is eating because of the decrease in energy requirements from the loss of lean body mass.
d. increasing the number of calories she is eating because of the increased energy needs of the older adult.
c. decreasing the number of calories she is eating because of the decrease in energy requirements from the loss of lean body mass.
(important nutritional features of the older years are a decrease in energy requirements as a result of loss of lean body mass, the most metabolically active tissue, and an increase in fat mass.)
The nurse in a family practice clinic is reviewing the patients scheduled for appointments. Which of these statements is true regarding routine laboratory testing in the following individuals?
a. In pregnancy, no laboratory testing is needed unless problems with the pregnancy are suspected.
b. in the older adult, laboratory values regarding cholesterol and triglycerides levels are the most important because of the risk for disease.
c. routine laboratory testing is not necessary during adolescence.
d. laboratory tests for infants with suspected undernutrition.
d. laboratory tests for infants with suspected undernutrition.
In infancy and childhood, laboratory tests are performed only when undernutrition is suspected or if the child has an illness. During adolescence, laboratory evaluation of hgb and hematocrit values and urinalysis are performed. Many laboratory values are monitored during pregnancy, and older adults should be monitored for signs of renal insufficiency and over-hydration or under-hydration.
A 16 year old girl is being seen 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 predominantly fast foods, and high caffeine intake. In this situation, which is most appropriate when collecting current dietary intake information?
a. Scheduling a time for direct observation of the adolescent during meals.
b. Asking the patient for a 24-hour diet recall and assuming it to be reflective of a typical day for her.
c. having the patient complete a food diary for 3 days, including 2 weekdays and 1 weekend day.
d. using the food frequency questionnaire to identify the amount of intake of specific foods.
c. having the patient complete a food diary for 3 days, including 2 weekdays and 1 weekend day.
Because of the erratic eating behaviour of this individual, assessing dietary intake over a few days would produce more accurate information regarding eating patterns.
The nurse is reviewing the laboratory results for a 52-year-old male patient: fasting plasma glucose 7.2mmol/L; high density lipoprotein cholesterol 0.9 mmol/L; triglycerides 2 mmol/L. During assessment the patient’s BP is read as 145/88. His waist circumference is 110 cm, and the hip circumference is 98 cm. The nurse recognizes that the patient is at risk for:
a. Red man syndrome
b. Sjogren’s syndrome
c. Short bowel syndrome.
d. metabolic syndrome.
d. metabolic syndrome.
Metabolic syndrome is diagnosed when three or more of the risk determinants - BP, fasting blood glucose, high density lipoprotein - show high levels. Highly prevalent, characterized by distinctive collection of abnormalities, including abdominal obesity, hypertension, dyslipidemia, insulin resistance, and dysglycemia.
A 22 year old patient presents with chronic diarrhea, weight loss, fatigue, bloating, and cramps. Her hemoglobin laboratory results indicate anemia. The nurse suspects:
a. obesity
b. cardiovascular disease
c. celiac disease
d. metabolic syndrome
c. celiac disease
Celiac disease is a medical condition in which the absorptive surface of the the small intestine is damaged by gluten. This results in an inability of the body to absorb nutrients: protein, fat, carbs, vitamins, and minerals. 1 in 133 persons in Canada are affected by celiac disease. Common symptoms are anemia, chronic diarrhea, weight loss, fatigue, cramps and bloating, and irritability.
The nurse is working with a number of patients with liver disease from excessive alcohol consumption. The nurse recognizes that these patients are at risk for:
a. weight loss from alcohol consumption replacing caloric food intake.
b. undernutrition from consuming alcohol in place of nutritious foods.
c. obesity from a fatty liver.
d. overnutrition with the increased calories from alcohol consumption.
b. undernutrition from consuming alcohol in place of nutritious foods.
A 70-year old female patient has been brought to the emergency department after a fall in her home. The patient is a widow and has become socially isolated. The nurse assesses the patient for undernutrition and radiography reveals that she has osteoporosis, which is a deficiency of:
a. iron
b. riboflavin
c. vitamin d and calcium
d. vitamin c
c. vitamin d and calcium
Vitamin d and calcium deficiencies are associated with osteoporosis.
The nurse is assessing the body weight as a percentage of ideal body weight in an adolescent patient who was admitted for suspected anorexia nervosa. The patient’s usual weight has been around 125lbs, but today she weighs 98 lbs. The nurse calculates the patient’s ideal body weight and concludes that the patient is:
a. experiencing mild malnutrition.
b. experiencing moderate malnutrition
c. experiencing severe malnutrition
d. still within expected parameters with her current weight.
b. experiencing moderate malnutrition
By dividing her current weight by her usual weight, and then multiplying by 100, a percentage of 78.4% is obtained, which means that the patients current weight is 78.4% of her ideal b ody weight. A current weight of 80% to 90% of ideal weight suggests mild nutrition; a current weight of 70% to 80% of ideal weight suggests moderate malnutrition; a current weight of less than 70% of ideal weight suggests severe malnutrition.
The nurse is reviewing a 42 year old female patient’s laboratory tests as part of a nutritional assessment. Which of the results indicate that the patient might have anemia?
a. Fasting. Blood glucose of 7.0 mmol/L
b. Cholesterol 4.8 mmol/L
c. Hemoglobin 90/ g/L
d. Triglycerides 2 mmol/L
c. Hemoglobin 90/ g/L
The nurse recognizes which of these persons is at greatest risk for undernutrition?
A. A 5 month old infant
B. A 50 year old woman
C. A 20 year old college student
D. 30 year old hospital administrator
A. A 5 month old infant
If a 29 y/o woman weighs 156 lbs, and the nurse determines her IDW to be 120 lbs, then how would the nurse classify the woman’s weight ?
A. Obese
B. Mildly overweight
C. Suffering malnutrition
D. Within appropriate range of ideal weight
A. Obese
How should the nurse perform a triceps skinfold assessment?
a. After pinching the skin and fat, the calipers are vertically applied to the fat fold.
b. The skin and fat on the front of the patients arm are gently pinched, and then the calipers are
applied.
c. After applying the calipers, the nurse waits 3 seconds before taking a reading . After repeating the procedure three times, an average is recorded.
d. The patient is instructed to stand with his or her back to the examiner and arms folded across the
chest. The skin on the forearm is pinched.
c. After applying the calipers, the nurse waits 3 seconds before taking a reading. After repeating the
procedure three times, an average is recorded.
In performing an assessment on a 49-year-old woman who has imbalanced nutrition as a result of
dysphagia, which data would the nurse expect to find?
a. Increase in hair growth
b. Inadequate nutrient food intake
c. Weight 10% to 20% over ideal
d. Sore, inflamed buccal cavity
b. Inadequate nutrient food intake
A 21-year-old woman has been on a low-protein liquid diet for the past 2 months. She has had adequate
intake of calories and appears well nourished. After 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. Decreased serum albumin
Why Does a Low-Protein Diet Lead to Decreased Serum Albumin?
Albumin is a protein made by the liver and is essential for:
✔ Maintaining oncotic pressure (keeping fluid in blood vessels).
✔ Transporting hormones, vitamins, and drugs.
✔ Healing and immune function.
What’s Happening in This Patient?
1. She has been on a low-protein liquid diet for 2 months.
• Even though she is eating enough calories, she is not consuming enough protein.
2. Low protein intake = Decreased albumin levels in the blood.
• The liver needs protein to make albumin.
• Without enough protein, albumin production decreases, leading to low serum albumin.
Why Are the Other Options Incorrect?
• (a) Poor skin turgor
❌ This indicates dehydration, but she is not lacking fluids, just protein.
• (c) Increased lymphocyte count
❌ Malnutrition (especially protein deficiency) weakens the immune system, so lymphocytes would likely decrease, not increase.
• (d) Triceps skinfold less than standard
❌ Triceps skinfold measures fat stores, but the patient has adequate calorie intake, so fat stores may still be normal.
Key Takeaways
✔ Albumin is a protein. If you don’t eat enough protein, your albumin levels drop.
✔ Low albumin = Fluid imbalance, swelling (edema), and poor healing.
✔ Calories alone are not enough; you need protein for proper body function.
Would you like a quick chart of signs and symptoms of low albumin?
The nurse is preparing to measure fat and bone mineral density. Which tool is
appropriate?
a. Measuring tape
b. Skinfold calipers
c. Bioelectrical impedance analysis (BIA)
d. Dual-energy x-ray absorptiometry (DEXA)
d. Dual-energy x-ray absorptiometry (DEXA)
Which of these conditions is due to an inadequate intake of both protein and calories?
a. Obesity
b. Bulimia
c. Marasmus
d. Kwashiorkor
C. Marasmus
Marasmus, protein-calorie malnutrition, is due to an inadequate intake of protein and calories or prolonged
starvation. Obesity is due to caloric excess; bulimia is an eating disorder. Kwashiorkor is protein malnutrition.
During an assessment of a patient who has been homeless for several years, the nurse notices that his
tongue is magenta in color, which is an indication of a deficiency in what mineral and/or vitamin?
a. Iron
b. Riboflavin
c. Vitamin D and calcium
d. Vitamin C
b. Riboflavin
Magenta tongue is a sign of riboflavin deficiency. In contrast, a pale tongue is probably attributable to iron deficiency. Vitamin D and calcium deficiencies cause osteomalacia in adults, and a vitamin C deficiency causes scorbutic gums.
An older adult patient in a nursing home has been receiving tube feedings for several months. During an oral examination, the nurse notes that patients gums are swollen, ulcerated, and bleeding in some areas. The nurse suspects that the patient has what condition?
a. Rickets
b. Vitamin A deficiency
c. Linoleic-acid deficiency
d. Vitamin C deficiency
d. Vitamin C deficiency
Vitamin C deficiency causes swollen, ulcerated, and bleeding gums, known as scorbutic gums. Rickets is a condition related to vitamin D and calcium deficiencies in infants and children. Linoleic-acid deficiency causes eczematous skin. Vitamin A deficiency causes Bitot spots and visual problems.
