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Chapter 4: Proteins Test Bank MULTIPLE CHOICE 1. Proteins are built from simpler organic compounds called a. indispensable amino acids. b. amino acids. c. fatty acids. d. monosaccharides.

ANS: B

All proteins are made of building block units called amino acids. Proteins are made from both dispensable and indispensable amino acids. DIF: Cognitive Level: Knowledge REF: 47 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 2. The element that is contained in proteins but not in carbohydrates or lipids is a. carbon. b. hydrogen. c. nitrogen. d. oxygen.

ANS: C

Nitrogen is present in proteins but not in carbohydrates or lipids. Amino acids, the building blocks of protein, are named for their chemical structure; amino  refers to compounds containing nitrogen. DIF: Cognitive Level: Knowledge REF: 47 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 3. Two types of protein in the body are _____ protein and _____ protein. a. complete, incomplete b. animal, vegetable c. dispensable, indispensable d. tissue, plasma

ANS: D

Two types of protein in the body are tissue and plasma protein. Amino acids are classified as indispensable, dispensable, or conditionally indispensable in the diet according to whether the body can make them.

DIF: Cognitive Level: Comprehension REF: 49 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 4. The number of amino acids that are indispensable for human beings is a. 6. b. 9. c. 11. d. 14.

ANS: B

Nine amino acids are classified as indispensable amino acids because the body cannot manufacture them in sufficient quantity or at all. DIF: Cognitive Level: Knowledge REF: 48|51 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 5. In the diet, the greatest proportion of indispensable amino acids is provided by a. black beans. b. peanuts. c. safflower oil. d. turkey.

ANS: D

Indispensable amino acids are provided mostly by high-protein animal products. DIF: Cognitive Level: Application REF: 51 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 6. A protein that contains all indispensable amino acids in the correct proportion and ratio is

called a. simple. b. incomplete. c. complete. d. indispensable.

ANS: C

A complete protein contains all nine indispensable amino acids in the correct proportion and ratio needed by the body. DIF: Cognitive Level: Knowledge REF: 51 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 7. The number of kilocalories from protein in a sandwich that contains 24 g protein is _____

kcal.

a. b. c. d.

6 96 120 216

ANS: B

Each gram of protein has 4 kcal, so 24 g ×   4 kcal = 96 kcal. DIF: Cognitive Level: Application REF: 51 TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity: Physiological Adaptation 8. An animal protein that has relatively little value as a dietary protein source when eaten alone

is a. b. c. d.

egg. gelatin. milk. fish.

ANS: B

Gelatin is a protein food of animal origin, but it lacks three essential amino acids and has only small amounts of leucine. DIF: Cognitive Level: Knowledge REF: 51 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 9. Proteins from plant sources that are classified as incomplete include a. wheat, peanuts, and corn. b. milk, nuts, and cheese. c. oats, gelatin, and soybeans. d. corn, chicken, and milk.

ANS: A

Grains, peanuts, and corn are examples of plant proteins that are considered incomplete proteins because the food is deficient in one or more of the nine indispensable amino acids. Examples include grains, nuts, seeds, and legumes. DIF: Cognitive Level: Application REF: 51 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 10. An example of a protein-free body substance is a. collagen. b. hemoglobin. c. insulin.

d. glycogen.

ANS: D

Glycogen is the storage form of carbohydrates and does not contain protein. DIF: Cognitive Level: Application REF: 14|50-51 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 11. The primary function of protein in the diet is to supply a. energy for growth and development. b. insulation for vital organs. c. material for growth and maintenance. d. all 20 amino acids for heart maintenance.

ANS: C

The primary function of protein is to supply material in the body for growth, maintenance, and repair. DIF: Cognitive Level: Knowledge REF: 50 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 12. Protein plays an important role in the body a. as the first source of energy fuel. b. in the conversion of glucose to glycogen for storage. c. as a coenzyme needed for energy utilization. d. in defense against disease and infection.

ANS: D

Protein assists in the body’s defense against disease and infection by helping build special white blood cells called lymphocytes. DIF: Cognitive Level: Knowledge REF: 51 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 13. After a piece of grilled chicken is digested by the mouth and stomach, it eventually reaches

the small intestine, where it is digested by the following enzymes secreted by the pancreas: a. chymotrypsin, trypsin, and carboxypeptidase b. chymotrypsin, pepsin, and trypsin c. sucrase, pepsin, and carboxypeptidase d. lactase, chymotrypsin, and carboxypeptidase

ANS: A

Chymotrypsin, trypsin, and carboxypeptidase are three enzymes produced by the pancreas to continue breaking down proteins into simpler peptides and amino acids. DIF: Cognitive Level: Knowledge REF: 56-57 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 14. Proteins are absorbed as a. fatty acids. b. disaccharides. c. amino acids. d. polypeptides.

ANS: C

Proteins are broken down to individual amino acids to be absorbed; polypeptides require further enzymatic breakdown before they can be absorbed. DIF: Cognitive Level: Knowledge REF: 56 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 15. Pepsinogen secreted by the gastric cells is converted into pepsin by a. food in the stomach. b. hydrochloric acid. c. gastric lipase. d. pancreatic lipase.

ANS: B

Hydrochloric acid secreted by the stomach converts pepsinogen, an inactive enzyme, into pepsin. Pepsin is the active form of the enzyme, which begins protein digestion. DIF: Cognitive Level: Knowledge REF: 54-55 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 16. Protein catabolism is increased in conditions such as a. pregnancy. b. childhood. c. puberty. d. illness.

ANS: D

Protein catabolism, or the breakdown of protein, is increased during illness or disease and increases the body’s need for protein and kilocalories to rebuild tissue and meet the demands of an increased metabolic rate. DIF: Cognitive Level: Knowledge

REF: 49-50

TOP: Nursing Process: Planning

MSC: NCLEX: Physiological Integrity: Physiological Adaptation 17. The phase of metabolism that makes growth and repair possible is a. digestion. b. catabolism. c. anabolism. d. homeostasis.

ANS: C

Anabolism is the metabolic process that makes growth and repair possible in the body. It is especially necessary after an illness or disease process. Anabolism also is found during periods of rapid fetal growth during pregnancy, the first year of life, lactation during breast-feeding, and adolescent growth and development into adulthood. DIF: Cognitive Level: Knowledge REF: 49-50 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 18. A gastric enzyme that coagulates the protein in milk and is produced by infants but not by

adults is a. hydrochloric acid. b. pepsinogen. c. trypsin. d. rennin.

ANS: D

Rennin is the gastric enzyme found in the gastric juice of human infants and some young animals such as calves. Rennin is important to the infant in the digestion of milk. DIF: Cognitive Level: Knowledge REF: 55 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 19. A protein-digesting enzyme found in the stomach rather than in pancreatic secretions is a. trypsin. b. pepsin. c. chymotrypsin. d. carboxypeptidase.

ANS: B

Pepsin is the main gastric enzyme that digests proteins. DIF: Cognitive Level: Knowledge REF: 54-55 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 20. The enzyme trypsin is activated by the enzyme

a. b. c. d.

zymogen. bile. gastrin. enterokinase.

ANS: D

Trypsin is activated by the enzyme enterokinase. Enterokinase is secreted from the intestinal cells when food enters the duodenum. DIF: Cognitive Level: Knowledge REF: 55 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 21. The enzymes aminopeptidase and dipeptidase are secreted by the a. mouth. b. stomach. c. small intestine. d. pancreas.

ANS: C

Aminopeptidase and dipeptidase are enzymes secreted by glands in the wall of the small intestine. DIF: Cognitive Level: Knowledge REF: 56 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 22. Complementary proteins a. provide higher quality protein when eaten together. b. enhance each other's metabolic actions. c. are more easily absorbed. d. taste good together.

ANS: A

Combining complementary proteins helps to supply adequate amounts of all nine indispensable amino acids for the diet. Because plant proteins are incomplete, a mixture can provide adequate amounts of amino acids. A normal eating pattern throughout the day along with the body’s reserve supply of protein ensures a complementary balance of high-quality protein. Those who follow a vegetarian eating pattern must combine proteins to meet needs. DIF: Cognitive Level: Knowledge REF: 51-52 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 23. In the mouth, protein foods are a. broken down to amino acids. b. broken up mechanically by chewing.

c. broken down to peptides. d. coagulated by rennin.

ANS: B

Protein digestion begins in the mouth, where food is mechanically processed by chewing. DIF: Cognitive Level: Knowledge REF: 54 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 24. Of the following, the food with the highest quality protein is a. an omelet with cheese, whole wheat toast, and orange juice. b. stir fry with chicken, green beans, and carrots. c. stuffed turkey breast, peas, and baked potato. d. a bean burrito, corn on the cob, and tomato salad.

ANS: A

Eggs are the highest-quality protein food and carry a chemical score of 100. Other foods are compared to it according to their amino acid ratios. DIF: Cognitive Level: Application REF: 56-58 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 25. Which of the following conditions might result in the greatest catabolism? a. growth b. multiple trauma with extensive organ damage c. rehabilitation after routine gallbladder surgery d. healing a broken bone in the arm

ANS: B

Protein catabolism, or the breakdown of protein, is increased during illness or disease and increases the body’s need for protein and kilocalories to rebuild tissue and meet the demands of an increased metabolic rate. In this case, multiple trauma with extensive organ damage requires a greater catabolic rate compared with the other choices and would create the greatest increase in metabolic rate and need for tissue repair. DIF: Cognitive Level: Application REF: 58 TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity: Physiological Adaptation 26. If the excretion of nitrogen exceeds the nitrogen intake, the condition is called a. total nitrogen balance. b. positive nitrogen balance. c. negative nitrogen balance. d. anabolism.

ANS: C

If the body takes in less nitrogen than it excretes, a negative balance occurs. This means that the body has an inadequate protein intake and is losing nitrogen by breaking down more tissue than it is building up. DIF: Cognitive Level: Comprehension REF: 49-50 TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity: Physiological Adaptation 27. The grams of high-quality protein required daily for an individual who weighs 170 lb and is

close to ideal body weight would be _____ g. a. 45.2 b. 55.3 c. 61.8 d. 94.0

ANS: C

The Recommended Daily Allowance for both men and women is set at 0.8 g of high-quality protein per kilogram of desirable body weight per day. In this case, 170 lb/2.2 lb/kg = 77.3 kg. 77.3 kg ×   0.8 g/kg = 61.8 g/day of protein. DIF: Cognitive Level: Application REF: 59 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation, Health Promotion and Wellness 28. In planning a vegetarian meal, an appropriate combination of complementary proteins would

be a. b. c. d.

cornmeal tamales and beans. lentils and beans. bean sprouts and cabbage. whole wheat and rice.

ANS: A

In planning complementary food combinations, different families of foods (e.g., grains, legumes, nuts, and dairy) are mixed. Grains usually are low in threonine and high in methionine, whereas legumes are high in threonine and low in methionine. Therefore, grains and legumes help balance each other in the amount of indispensable amino acids required by the body. Acceptable combinations include (1) grains and peas, beans, or lentils; (2) legumes and seeds; and (3) grains and dairy. In the choices given, cornmeal tamales and beans combine foods limited in different amino acids. DIF: Cognitive Level: Application REF: 51-52 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation, Health Promotion and Wellness

29. A client weighs 130 lbs. She is close to desirable body weight and consumes a total of 40

grams of protein/day. The most appropriate nutritional counseling would be to a. increase protein intake. b. maintain current protein intake. c. decrease protein intake. d. increase use of complementary proteins.

ANS: A

The RDA for protein for both men and women is set at 0.8 grams of high-quality protein per kilogram of desirable body weight per day. Based on 0.8 g protein/kg body weight/day: 130 lbs ÷ 2.2 lbs/kg = 59 kg body weight 59 kg x 0.8 g protein/kg = 47 grams protein/day Thus, this client’s protein intake is lower than her estimated needs. It would be appropriate to recommend an increase in protein intake. DIF: Cognitive Level: Analysis REF: 58|60|62-63 TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity: Physiological Adaptation, Health Promotion and Wellness...