TB-Chapter 12 Nutrition Assessment PDF

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PHYSICAL EXAMINATION AND HEALTH ASSESSMENT 8TH EDITION JARVIS TEST BANK

TestBank-PhysicalExaminationandHealthAssessment8e(byJarvis)

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Chapter12:NutritionAssessment MULTIPLECHOICE 1.Thenurserecognizeswhichofthesepersonsisatgreatestriskforundernutrition? a.

5-month-oldinfant

b.

50-year-oldwoman

c.

20-year-oldcollegestudent

d.

30-year-oldhospitaladministrator

ANS:A Vulnerablegroupsforundernutritionareinfants,children,pregnantwomen,recentimmigrants,personswith lowincomes,hospitalizedpeople,andagingadults. DIF:CognitiveLevel:Remembering(Knowledge) MSC:ClientNeeds:HealthPromotionandMaintenance 2.Whenassessingapatientsnutritionalstatus,thenurserecallsthatthebestdefinitionofoptimalnutritional statusissufficientnutrientsthat: NURSINGTB.COM

a.

Areinexcessofdailybodyrequirements.

b.

Providefortheminimumbodyneeds.

c.

Providefordailybodyrequirementsbutdonotsupportincreasedmetabolicdemands.

d.

Providefordailybodyrequirementsandsupportincreasedmetabolicdemands.

ANS:D Optimalnutritionalstatusisachievedwhensufficientnutrientsareconsumedtosupportday-to-daybodyneed andanyincreasedmetabolicdemandsresultingfromgrowth,pregnancy,orillness. DIF:CognitiveLevel:Remembering(Knowledge) MSC:ClientNeeds:HealthPromotionandMaintenance 3.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.

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c.

Thebabysgrowthisminimalatthisage;therefore,caloricrequirementsaredecreased.

d.

Thebabyshouldbeplacedonskimmilktodecreasetheriskofcoronaryarterydiseasewhenheor shegrowsolder.

ANS:A Becauseofrapidgrowth,especiallyofthebrain,bothinfantsandchildrenyoungerthan2yearsofageshould notdrinkskimorlow-fatmilkorbeplacedonlow-fatdiets.Fats(caloriesandessentialfattyacids)are requiredforpropergrowthandcentralnervoussystemdevelopment. DIF:CognitiveLevel:Applying(Application) MSC:ClientNeeds:HealthPromotionandMaintenance 4.Apregnantwomanisinterestedinbreastfeedingherbabyandasksseveralquestionsaboutthetopic.Which informationisappropriateforthenursetosharewithher? a.

Breastfeedingisbestwhenalsosupplemented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,aswellasnaturalimmunity. NURSINGTB.COM

ANS:D Breastfeedingisrecommendedforfull-terminfantsforthefirstyearoflifebecausebreastmilkisideally formulatedtopromotenormalinfantgrowthanddevelopment,aswellasnaturalimmunity.Theother statementsarenotcorrect. DIF:CognitiveLevel:Applying(Application) MSC:ClientNeeds:HealthPromotionandMaintenance 5.Amotherandher13-year-olddaughterexpresstheirconcernrelatedtothedaughtersrecentweightgainand herincreaseinappetite.Whichofthesestatementsrepresentsinformationthenurseshoulddiscusswiththem? a.

Dietingandexercising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.

ANS:B Afteraperiodofslowgrowthinlatechildhood,adolescenceischaracterizedbyrapidphysicalgrowthand

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PHYSICAL EXAMINATION AND HEALTH ASSESSMENT 8TH EDITION JARVIS TEST BANK TestBank-PhysicalExaminationandHealthAssessment8e(byJarvis)

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endocrineandhormonalchanges.Caloricandproteinrequirementsincreasetomeetthisdemand.Becauseof bonegrowthandincreasingmusclemass(and,ingirls,theonsetofmenarche),calciumandironrequirements alsoincrease. DIF:CognitiveLevel:Applying(Application) MSC:ClientNeeds:HealthPromotionandMaintenance 6.Thenurseisassessinga30-year-oldunemployedimmigrantfromanunderdevelopedcountrywhohasbeen intheUnitedStatesfor1month.Whichoftheseproblemsrelatedtohisnutritionalstatusmightthenurse expecttofind? a.

Obesity

b.

Hypotension

c.

Osteomalacia(softeningofthebones)

d.

Coronaryarterydisease

ANS:C Generalundernutrition,hypertension,diarrhea,lactoseintolerance,osteomalacia,scurvy,anddentalcariesare amongthemorecommonnutrition-relatedproblemsofnewimmigrantsfromdevelopingcountries. DIF:CognitiveLevel:Applying(Application)

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MSC:ClientNeeds:HealthPromotionandMaintenance 7.Forthefirsttime,thenurseisseeingapatientwhohasnohistoryofnutrition-relatedproblems.Theinitial nutritionalscreeningshouldincludewhichactivity? a.

Caloriecountofnutrients

b.

Anthropometricmeasures

c.

Completephysicalexamination

d.

Measurementofweightandweighthistory

ANS:D Parametersusedfornutritionscreeningtypicallyincludeweightandweighthistory,conditionsassociatedwith increasednutritionalrisk,dietinformation,androutinelaboratorydata.Theotherresponsesreflectamoreindepthassessmentratherthanascreening. DIF:CognitiveLevel:Applying(Application) MSC:ClientNeeds:HealthPromotionandMaintenance 8.Apatientisaskedtoindicateonaformhowmanytimesheeatsaspecificfood.Thismethoddescribes whichofthesetoolsforobtainingdietaryinformation?

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PHYSICAL EXAMINATION AND HEALTH ASSESSMENT 8TH EDITION JARVIS TEST BANK TestBank-PhysicalExaminationandHealthAssessment8e(byJarvis)

a.

Fooddiary

b.

Caloriecount

c.

24-hourrecall

d.

Food-frequencyquestionnaire

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ANS:D Withthistool,informationiscollectedonhowmanytimesperday,week,ormonththeindividualeats particularfoods,whichprovidesanestimateofusualintake. DIF:CognitiveLevel:Remembering(Knowledge) MSC:ClientNeeds:HealthPromotionandMaintenance 9.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.

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ANS:A Gastrointestinalsymptomssuchasvomiting,diarrhea,orconstipationmayinterferewithnutrientintakeor absorption.Theotherresponsesarenotcorrect. DIF:CognitiveLevel:Applying(Application) MSC:ClientNeeds:HealthPromotionandMaintenance 10.Duringa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intherecordforthephysiciansreview.

d.

Medicationscanaffectonesmemoryandabilitytoidentifyfoodeateninthelast24hours.

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145

ANS:A Analgesics,antacids,anticonvulsants,antibiotics,diuretics,laxatives,antineoplasticdrugs,steroids,andoral contraceptivesaredrugsthatcaninteractwithnutrients,impairingtheirdigestion,absorption,metabolism,or use.Theotherresponsesarenotcorrect. DIF:CognitiveLevel:Understanding(Comprehension) MSC:ClientNeeds:HealthPromotionandMaintenance 11.Apatienttellsthenursethathisfoodsimplydoesnothaveanytasteanymore.Thenursesbestresponse wouldbe: a.

Thatmustbereallyfrustrating.

b.

Whendidyoufirstnoticethischange?

c.

Myfooddoesntalwayshavealotoftasteeither.

d.

Sometimesthathappens,butyourtastewillcomeback.

ANS:B Withchangesinappetite,taste,smell,orchewingorswallowing,theexaminershouldaskaboutthetypeof changeandwhenthechangeoccurred.Theseproblemsinterferewithadequatenutrientintake.Theother responsesarenotcorrect. NURSINGTB.COM

DIF:CognitiveLevel:Understanding(Comprehension) MSC:ClientNeeds:HealthPromotionandMaintenance 12.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5feet4inchesandweighs110pounds.Thenursesappropriateresponsewould be: a.

Howmuchdoyouthinkyoushouldweigh?

b.

Dontworryaboutit;youre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.

ANS:A Adolescentsincreasedbodyawarenessandself-consciousnessmaycauseeatingdisorderssuchasanorexia nervosaorbulimia,conditionsinwhichtherealorperceivedbodyimagedoesnotfavorablycomparewithan idealimage.Thenurseshouldnotbelittletheadolescentsfeelings,provideunsolicitedadvice,oragreewith her. DIF:CognitiveLevel:Applying(Application)

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PHYSICAL EXAMINATION AND HEALTH ASSESSMENT 8TH EDITION JARVIS TEST BANK TestBank-PhysicalExaminationandHealthAssessment8e(byJarvis)

146

MSC:ClientNeeds:HealthPromotionandMaintenance 13.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

ANS:D Smallportions,fingerfoods,simplemeals,andnutritioussnackshelpimprovethedietaryintakeofyoung children.Foodslikelytobeaspiratedshouldbeavoided(e.g.,hotdogs,nuts,grapes,roundcandies,popcorn). DIF:CognitiveLevel:Applying(Application) MSC:ClientNeeds:HealthPromotionandMaintenance 14.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

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ANS:B Socioeconomicconditionsfrequentlyaffectthenutritionalstatusoftheagingadult;thesefactorsshouldbe closelyevaluated.Physicallimitations,income,andsocialisolationarefrequentproblemsthatinterferewith theacquisitionofabalanceddiet.Adecreaseintasteandsmellanddecreasedgastrointestinalmotilityand absorptionoccurwithaging.Cardiovascularstatusisnotafactorthataffectsanolderadultsnutritionalstatus. DIF:CognitiveLevel:Understanding(Comprehension) MSC:ClientNeeds:HealthPromotionandMaintenance 15.Whenconsideringanutritionalassessment,thenurseisawarethatthemostcommonanthropometric measurementsinclude: a.

Heightandweight.

b.

Legcircumference.

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PHYSICAL EXAMINATION AND HEALTH ASSESSMENT 8TH EDITION JARVIS TEST BANK TestBank-PhysicalExaminationandHealthAssessment8e(byJarvis)

c.

Skinfoldthicknessofthebiceps.

d.

Hipandwaistmeasurements.

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ANS:A Themostcommonlyusedanthropometricmeasuresareheight,weight,tricepsskinfoldthickness,elbow breadth,andarmandheadcircumferences. DIF:CognitiveLevel:Remembering(Knowledge) MSC:ClientNeeds:HealthPromotionandMaintenance 16.Ifa29-year-oldwomanweighs156pounds,andthenursedeterminesheridealbodyweighttobe120 pounds,thenhowwouldthenurseclassifythewomansweight? a.

Obese

b.

Mildlyoverweight

c.

Sufferingfrommalnutrition

d.

Withinappropriaterangeofidealweight

ANS:A

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Obesity,asaresultofcaloricexcess,referstoweightmorethan20%aboveidealbodyweight.Forthispatient 20%ofheridealbodyweightwouldbe24pounds,andgreaterthan20%ofherbodyweightwouldbeover 144pounds.Therefore,havingaweightof156poundswouldbeconsideredobese. DIF:CognitiveLevel:Applying(Application) MSC:ClientNeeds:HealthPromotionandMaintenance 17.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.

ANS:C Whileholdingtheskinfold,theleverofthecalipersisreleased.Thenursewaits3secondsandthentakesa

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PHYSICAL EXAMINATION AND HEALTH ASSESSMENT 8TH EDITION JARVIS TEST BANK TestBank-PhysicalExaminationandHealthAssessment8e(byJarvis)

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reading.Thisprocedureshouldberepeatedthreetimes,andanaverageofthethreeskinfoldmeasurementsis thenrecorded. DIF:CognitiveLevel:Understanding(Comprehension) MSC:ClientNeeds:HealthPromotionandMaintenance 18.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.

ANS:A Bodymassindex,calculatedbyusingheightandweightmeasurements,isapracticalmarkerofoptimalweight forheightandanindicatorofobesity.Theotheroptionsarenotcorrect. DIF:CognitiveLevel:Understanding(Comprehension) MSC:ClientNeeds:HealthPromotionandMaintenance NURSINGTB.COM

19.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.

29-year-oldwomanwhosewaistmeasures33inchesandhipsmeasure36inches

b.

32-year-oldmanwhosewaistmeasures34inchesandhipsmeasure36inches

c.

38-year-oldmanwhosewaistmeasures35inchesandhipsmeasure38inches

d.

46-year-oldwomanwhosewaistmeasures30inchesandhipsmeasure38inches

ANS:A Thewaist-to-hipratioassessesbodyfatdistributionasanindicatorofhealthrisk.Awaist-to-hipratioof1.0or greaterinmenor0.8orgreaterinwomenisindicativeofandroid(upperbodyobesity)andincreasingriskfor obesity-relateddiseaseandearlydeath.The29-year-oldwomanhasawaist-to-hipratioof0.92,whichis greaterthan0.8.The32-year-oldmanhasawaist-to-hipratioof0.94;the38-year-oldmanhasawaist-to-hip ratioof0.92;the46-year-oldwomanhasawaist-to-hipratioof0.78. DIF:CognitiveLevel:Analyzing(Analysis) MSC:ClientNeeds:HealthPromotionandMaintenance 20.A50-year-oldwomanwithelevatedtotalcholesterolandtriglyceridelevelsisvisitingtheclinictofindout aboutherlaboratoryresults.Whatwouldbeimportantforthenursetoincludeinpatientteachinginrelationto

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PHYSICAL EXAMINATION AND HEALTH ASSESSMENT 8TH EDITION JARVIS TEST BANK TestBank-PhysicalExaminationandHealthAssessment8e(byJarvis)

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thesetests? a.

Therisksofundernutritionshouldbeincluded.

b.

Offermethodstoreducethestressinherlife.

c.

Provideinformationregardingadietlowinsaturatedfat.

d.

Thisconditionishereditary;shecandonothingtochangethelevels.

ANS:C Thepatientwithelevatedcholesterolandtriglyceridelevelsshouldbetaughtabouteatingahealthydietthat limitstheintakeoffoodshighinsaturatedfatsortransfats.Reducingdietaryfatsispartofthetreatmentfor thiscondition.Theotherresponsesarenotpertinenttohercondition. DIF:CognitiveLevel:Applying(Application) MSC:ClientNeeds:HealthPromotionandMaintenance 21.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

NURSINGTB.COM

ANS:B Dysphagia,orimpairedswallowing,interfereswithadequatenutrientintake. DIF:CognitiveLevel:Applying(Application) MSC:ClientNeeds:HealthPromotionandMaintenance 22.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

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PHYSICAL EXAMINATION AND HEALTH ASSESSMENT 8TH EDITION JARVIS TEST BANK TestBank-PhysicalExaminationandHealthAssessment8e(byJarvis)

150

ANS:B Kwashiorkor(proteinmalnutrition)isduetodietsthatmaybehighincaloriesbutcontainlittleornoprotein (e.g.,low-proteinliquiddiets,faddiets,andlong-termuseofdextrose-containingintravenousfluids).The serumalbuminwouldbelessthan3.5g/dL. DIF:CognitiveLevel:A...