Nutrition chapter 20 test bank PDF

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Nutritional Foundations and Clinical Applications 7th Edition Grodner Test Bank

Grodner et al.: Nutritional Foundations and Clinical Applications: A Nursing Approach, 7th Edition MULTIPLE CHOICE 1. When someone smokes cigarettes and drinks three alcoholic beverages a day, he or she is

contributing to his or her cancer risk via a. initiation. b. metastasis. c. d. progression. ANS: C

is the stage in which the DNA in a normal cell is mutated. is the stage in which the abnormal cells spread outside their original location. is the spread of cancer to secondary sites. The DNA of the cell undergoes mutation in the of carcinogenesis. , in which abnormal cell growth occurs. , in which cancer cells spread beyond their original location. in secondary sites. DIF: Cognitive Level: Applying REF: Page 415 | Page 416 TOP: Nursing Process: Assessment MSC: Client Needs: Physiological Integrity | Client Needs: Health Promotion and Maintenance 2. Someone who uses sunscreen and wears UV protective clothing and hats to prevent

development of skin cancer may need to a. use light therapy to prevent seasonal affective disorder. b. consume extra vitamins C and E and other dietary antioxidants. c. d. consume additional fluids to replace sweat losses caused by additional clothing. ANS: C

Electrolytes, amino acids, and monounsaturated fatty acids are all important in maintaining good nutritional status but do not help protect against carcinogenesis. DIF: Cognitive Level: Applying REF: Page 415 | Page 423 TOP: Nursing Process: Assessment | Nursing Process: Planning MSC: Client Needs: Health Promotion and Maintenance 3. Fruits and vegetables help prevent cancer because they have high amounts of a. phytosterols. b. vitamins. c. antineoplastics. d. ANS: D

Nutritional Foundations and Clinical Applications 7th Edition Grodner Test Bank

. Antioxidants have antineoplastic qualities, but this is not what they are called. Fruits and vegetables contain vitamins, but not all vitamins help prevent cancer. are found in plant oils and help lower blood cholesterol level. DIF: Cognitive Level: Remembering REF: Page 415 | Page 416 TOP: Nursing Process: Assessment | Nursing Process: Planning MSC: Client Needs: Health Promotion and Maintenance 4. A dietary change that would help prevent cancer, according to the National Cancer Institute

recommendations, is a. eating vegetarian meals two or more times a week. b. choosing organic, pesticide-free fruits and vegetables. c. . d. consuming three or more daily servings of low-fat dairy products. ANS: C

. DIF: Cognitive Level: Understanding REF: Page 415 MSC: Client Needs: Health Promotion and Maintenance

TOP: Nursing Process: Planning

5. Factors that contribute to loss of lean body mass in many patients with cancer that are outside

the patient’s control include a. . b. inadequate protein intake. c. inadequate energy intake. d. drug noncompliance. ANS: A

. It may be difficult to maintain adequate intakes of protein and energy and to comply with drug regimens, but these factors are within the patient’s control. DIF: Cognitive Level: Applying TOP: Nursing Process: Assessment

REF: Page 416 | Page 423 MSC: Client Needs: Physiological Integrity

6. A patient in whom cancer has been newly diagnosed is about to begin intense chemotherapy.

She tells you that the only good thing about this diagnosis is that she will now be able to lose weight without even trying. The most appropriate nursing response would be to a. encourage the patient to celebrate the positive aspects of the disease. b. c. reinforce the need to achieve and maintain ideal body weight. d. emphasize eating the right types of foods rather than an amount of food. ANS: B

Nutritional Foundations and Clinical Applications 7th Edition Grodner Test Bank

Even though weight loss may seem like a positive side effect, it could have a negative effect if nutrient stores are depleted. Minimizing loss of lean body mass and maximizing nutrient stores are more important than attaining ideal body weight in patients with cancer. Making good food choices is important, but eating enough food to maintain lean body mass stores is more important. DIF: Cognitive Level: Analyzing TOP: Nursing Process: Planning

REF: Pages 416-418 | Page 423 MSC: Client Needs: Health Promotion and Maintenance

7. If a patient is going to have surgery to remove cancer of the esophagus, it is important to a. prevent poor food intake as a result of depression by warning the patient that the

surgery may be disfiguring. b. emphasize complete abstinence from cigarette smoking and use of alcoholic

beverages. c. d. encourage the patient to enjoy favorite foods to maximize intake. ANS: C

. Warning a patient about being disfigured may not prevent depression. Abstinence from cigarette smoking and alcoholic beverages is wise, but is not necessarily the first priority. Enjoying favorite foods may be helpful to attain adequate intakes of energy, but good sources of protein and micronutrients should also be emphasized. DIF: Cognitive Level: Analyzing TOP: Nursing Process: Planning

REF: Page 416 | Page 417 MSC: Client Needs: Physiological Integrity

8. If a patient has dumping syndrome after surgery to remove a tumor, he or she has probably

had a a. vagotomy. b. c. pancreatectomy. d. small bowel resection. ANS: B

.

DIF: Cognitive Level: Applying TOP: Nursing Process: Assessment

REF: Page 417 MSC: Client Needs: Physiological Integrity

9. Bone marrow cells and cells lining the gastrointestinal tract are more susceptible than other

cells to damage caused by chemotherapy because they a. are target cells for drugs. b. c. are exposed to higher doses of the drugs.

Nutritional Foundations and Clinical Applications 7th Edition Grodner Test Bank d. absorb more of the drugs than they excrete. ANS: B

The drugs do not target these cells specifically, nor are the cells exposed to higher doses of the drugs. The effect of chemotherapy drugs on these cells is not related to absorption and excretion. DIF: Cognitive Level: Understanding TOP: Nursing Process: Assessment

REF: Page 417 MSC: Client Needs: Physiological Integrity

10. If a patient with cancer is receiving a combination of chemotherapeutic agents that is known

to interfere with bone marrow, special attention should be given to prevention of a. dehydration. b. c. nausea and vomiting. d. loss of bone mass. ANS: B

. Certain types of chemotherapy may cause nausea, vomiting, or diarrhea (which may cause dehydration) or may interfere with calcium metabolism, causing loss of bone mass, but these side effects are not caused by the drugs’ effects on bone marrow. DIF: Cognitive Level: Applying TOP: Nursing Process: Assessment

REF: Page 417 | Page 418 MSC: Client Needs: Physiological Integrity

11. If a patient has cancer and is being treated with chemotherapy, the greatest food safety

concern is a. avoiding pesticide residues. b. potential food-drug interactions. c. choosing natural food products. d. . ANS: D

Concerns about pesticide residues are no greater for patients with cancer than for the rest of the population. Food-drug interactions may be a concern for specific individuals but are not related to food safety. Choosing natural food products is not necessarily beneficial and is not a particular concern for patients receiving chemotherapy. DIF: Cognitive Level: Applying REF: Pages 418-420 TOP: Nursing Process: Planning | Nursing Process: Implementation MSC: Client Needs: Safe and Effective Care Environment 12. If a patient is receiving radiation therapy to the head and neck, he or she may need a. . b. dry foods because of taste changes. c. extra fluids and electrolytes because of diarrhea. d. extra dietary fiber and fluids to prevent constipation.

Nutritional Foundations and Clinical Applications 7th Edition Grodner Test Bank ANS: A

. The patient may experience taste changes, but dry foods do not help with this problem. Diarrhea and constipation are more common with radiation to the abdomen and pelvis. DIF: Cognitive Level: Applying REF: Page 417 MSC: Client Needs: Physiological Integrity

TOP: Nursing Process: Planning

13. Patients who have just received bone marrow transplants should not eat a. canned tuna. b. c. mayonnaise. d. steamed vegetables. ANS: B

Canned tuna, commercial mayonnaise, and steamed vegetables carry a lower risk for causing foodborne illness. DIF: Cognitive Level: Applying TOP: Nursing Process: Implementation

REF: Pages 417-419 MSC: Client Needs: Physiological Integrity

14. Patients who receive bone marrow transplants often require parenteral nutrition. Some oral

intake is important to help a. achieve adequate nutrient intake. b. provide nutrients that cannot be infused. c. d. maintain a sense of normality for the patient. ANS: C

It is possible to achieve adequate intake through parenteral nutrition; all nutrients can be infused if parenteral nutrition is carefully planned. Oral intake does help maintain some normality for the patient, but this is not the main reason for using it. DIF: Cognitive Level: Understanding REF: Page 417 MSC: Client Needs: Physiological Integrity

TOP: Nursing Process: Planning

15. If a patient with immunosuppression needs to follow a low-bacterial diet, a meal that he or she

should avoid is a. b. breakfast cereal with milk. c. homemade bread with butter. d. chicken breast sandwich with mayonnaise. ANS: A

Nutritional Foundations and Clinical Applications 7th Edition Grodner Test Bank

Commercial dressings are safe, and the other salad ingredients would be safe as long as they are washed.

DIF: Cognitive Level: Applying REF: Pages 418-420 TOP: Nursing Process: Planning | Nursing Process: Implementation MSC: Client Needs: Health Promotion and Maintenance | Client Needs: Safe and Effective Care Environment 16. The Patient-Generated Subjective Global Assessment tool a. should not be used as a basis for interventions because the data are subjective. b. provides a method for assessing the psychosocial effects of cancer on the patient. c. d. allows patients to evaluate their own nutritional status without the input of a

registered dietitian. ANS: C

The form does not evaluate psychosocial status. DIF: Cognitive Level: Understanding TOP: Nursing Process: Assessment

REF: Page 418 | Page 421 | Page 422 MSC: Client Needs: Physiological Integrity

17. Patients who are experiencing nausea or vomiting may find it easiest to tolerate foods such as a. chicken noodle soup. b. c. chicken curry with rice. d. taco salad with jalapenos. ANS: B

Chicken noodle soup is usually served hot and is mostly fluid. Chicken curry is served hot, is highly seasoned, and has a strong aroma. Taco salad with jalapenos would be very spicy. DIF: Cognitive Level: Applying REF: Page 423 TOP: Nursing Process: Planning | Nursing Process: Implementation MSC: Client Needs: Physiological Integrity | Client Needs: Health Promotion and Maintenance 18. For patients infected with the human immunodeficiency virus (HIV), complex highly active

antiretroviral therapy (HAART) regimens require a. avoidance of alcohol and nonprescription medications. b. self-monitoring of blood glucose levels.

Nutritional Foundations and Clinical Applications 7th Edition Grodner Test Bank c. following a neutropenic diet protocol. d.

.

ANS: D

Use of alcohol and prescription medications should be checked with the pharmacist, but complete avoidance is not necessarily mandatory. A neutropenic diet may be helpful for prevention of foodborne illness but is not necessary to support drug therapy. HAART may have an adverse effect on blood glucose levels, but self-monitoring of blood glucose is not needed for everyone using HAART. DIF: Cognitive Level: Applying TOP: Nursing Process: Planning

REF: Page 427 | Page 428 MSC: Client Needs: Physiological Integrity

19. If a patient develops HIV-associated lipodystrophy syndrome (HALS), the best dietary

recommendation is to a. maintain adequate protein and energy intake so as to reduce muscle loss. b. use medium-chain triglycerides and avoid lactose. c. avoid raw, undercooked, or unpasteurized foods. d. ANS: D

. Maintaining adequate protein and energy intake to reduce muscle loss is important for overall nutritional health; medium-chain triglycerides and avoiding lactose may help patients with diarrhea; and avoiding raw and undercooked foods will help prevent foodborne illness, but these are not related to HALS. DIF: Cognitive Level: Analyzing TOP: Nursing Process: Assessment

REF: Page 426 MSC: Client Needs: Physiological Integrity

20. If a patient with HIV/AIDs is experiencing diarrhea, a good way to increase energy and

protein intakes would be to a. add skim milk powder to shakes and soups. b. add butter to hot cereals, vegetables, rice, and noodles. c. eat three main meals daily, each with a serving of meat or fish. d. ANS: D

. Adding skim milk powder would add protein and energy, but it also contains lactose, which may exacerbate diarrhea. Adding butter provides additional energy but not protein. Intake is usually better when eating is spread between several small meals and snacks rather than three main meals. DIF: Cognitive Level: Applying REF: Page 425 | Page 426 TOP: Nursing Process: Planning | Nursing Process: Implementation MSC: Client Needs: Physiological Integrity 21. If a patient with HIV/AIDS has been feeling very weak and whose weight has dropped from

180 lb to 160 lb in 4 weeks, he or she would be considered to have a. opportunistic infections.

Nutritional Foundations and Clinical Applications 7th Edition Grodner Test Bank b. lipodystrophy or HALS. c. d. AIDS-related depression. ANS: C

. Lipodystrophy is characterized by body composition changes and metabolic alterations. Opportunistic infections and depression may or may not be associated with weight loss. DIF: Cognitive Level: Applying TOP: Nursing Process: Assessment

REF: Pages 424-426 MSC: Client Needs: Physiological Integrity

22. Strategies that may help maximize food intake in patients with HIV/AIDS include a. . b. drinking 1 to 2 glasses of water with each meal. c. not eating unless really hungry, to avoid nausea. d. taking a daily multivitamin and mineral supplement. ANS: A

Drinking water with meals tends to fill the stomach so that the patient will actually consume less food and fewer nutrients. Not eating unless really hungry will also decrease food intake, especially if the patient’s appetite is poor. Taking a daily multivitamin and mineral supplement will not help increase food intake and will not increase energy and protein intake. DIF: Cognitive Level: Applying REF: Page 423 | Page 425 TOP: Nursing Process: Planning MSC: Client Needs: Physiological Integrity | Client Needs: Health Promotion and Maintenance 23. One of the reasons that nutrition therapy is so important for patients with HIV/AIDS is that it

is an area in which a. b. their needs are not affected by the disease process. c. interventions can have curative effects on the disease. d. they do not need the involvement of health care providers. ANS: A

Patients’ nutrient needs are greatly affected by the HIV/AIDS disease process. Nutrition interventions cannot help cure HIV/AIDS. Patients with HIV/AIDS still need the involvement of health care providers to help them achieve optimal nutritional status. DIF: Cognitive Level: Understanding REF: Page 424 MSC: Client Needs: Psychosocial Integrity

TOP: Nursing Process: Planning

24. The factor that contributes most to malnutrition in patients with HIV/AIDS is a. b. fear of weight gain.

Nutritional Foundations and Clinical Applications 7th Edition Grodner Test Bank c. use of antiretroviral therapy. d. increase in physical activity. ANS: A

Patients using antiretroviral therapy may fear weight gain and lipodystrophy, but malnutrition is less common in patients who use these drugs. If patients with HIV/AIDS feel well enough to increase their physical activity level, they are unlikely to suffer from malnutrition. DIF: Cognitive Level: Analyzing TOP: Nursing Process: Assessment

REF: Page 424 MSC: Client Needs: Physiological Integrity

25. Patients infected with HIV who develop hypogonadism are most likely to experience a. loss of body fat. b. weight gain. c. d. dehydration. ANS: C

Loss of body fat may occur but is less pronounced. Weight gain is less common. Dehydration as a result of diarrhea, vomiting, or fever is not directly related to hypogonadism. DIF: Cognitive Level: Analyzing TOP: Nursing Process: Assessment

REF: Page 426 MSC: Client Needs: Physiological Integrity

26. To minimize risk of infection with Cryptosporidium, patients with HIV/AIDS should a. eat yogurt that contains live cultures. b. avoid eating canned fruits and vegetables. c. avoid eating undercooked meat, poultry, fish, or eggs. d. ANS: D

Eating yogurt that contains live cultures may help prevent or minimize diarrhea. Avoiding undercooked meat, poultry, fish, or eggs helps decrease the risk of experiencing other foodborne illnesses. Eating canned fruits and vegetables is generally safe for patients with HIV/AIDS. DIF: Cognitive Level: Applying REF: Page 426 | Page 427 TOP: Nursing Process: Planning | Nursing Process: Implementation MSC: Client Needs: Health Promotion and Maintenance | Client Needs: Safe and Effective Care Environment 27. Patients with cancer who undergo irradiation of the lower abdomen are likely to experience a. nausea. b. vomiting.

Nutritional Foundations and Clinical Applications 7th Edition Grodner Test Bank c. . d. constipation. ANS: C

Patients receiving radiation do not usually experience constipation. DIF: Cognitive Level: Understanding TOP: Nursing Process: Assessment

REF: Page 417 MSC: Client Needs: Physiological Integrity

28. A seasoning that may help stimulate food intake in patients with taste abnormalities is a. b. soy sauce. c. honey. d. garlic. ANS: A

Salty (soy sauce), sweet (honey), and bland (garlic) seasonings are less likely to help overcome taste abnormalities. DIF: Cognitive Level: Applying REF: Page 423 MSC: Client Needs: Physiological Integrity

TOP: Nursing Process: Planning

29. An important nutritional goal for patients with cancer or HIV/AIDS is to a. eat several meals a day. b. avoid use of supplements. c. d. maintain usual eating habits. ANS: C

Eating several meals a day is a strategy to help achieve this goal, but it is not a goal. Patients should try to focus on eating food rather than using supplements, but it is not necessary to avoid supplements completely. Patients may need to modify their usual eating habits to achieve optimal nutritional status and improve their quality of life. DIF: Cognitive Level: Applying REF: Page 424 TOP: Nursing Process: Planning | Nursing Process: Evaluation MSC: Client Needs: Physiological Integrity | Client Needs: Health Promotion and Maintenance 30. Patients experiencing diarrhea should make sure they have a generous intake of a. fat. b. c. protein. d. dietary fiber. ANS: B

Nutritional Foundations and Clinical Applications 7th Edition Grodner Test Bank High intake of fat may exacerbate diarrhea. An adequate intake of protein helps maintain the integrity of gastrointestinal health, which minimizes diarrhea, but protein intake is not the first...