Roth 10e NCLEX Chapter 1

MULTIPLE RESPONSE

1. The nurse is counseling a client about the characteristics of good nutrition. One aspect of good nutrition is recognizing the difference between hunger and appetite. Which of the following statements would it be appropriate for the nurse to make about hunger? Select all that apply.

a. / Hunger and appetite mean the same thing / d. / Hunger occurs when there is a decrease in blood glucose that supplies the body with energy.
b. / Hunger is a psychological desire for food. / e. / Ignoring hunger is a good strategy for weight management
c. / Hunger is the physiological need for food. / f. / There is no physiological basis for hunger

ANS: C, D

Reference: Characteristics of Good Nutrition

Rationale: Hunger is the physiological need for food. Appetite is the psychological desire for food based on pleasant memories. When the body signals hunger, that is the indication that there is a decrease in blood glucose. If the hunger signal is ignored until hunger becomes intense, it may lead one to make poor food choices.

2. In an initial assessment of a client, the nurse is looking for physical indicators of good nutrition in the client. What are the physical characteristics that reflect good nutrition? Select all that apply.

a. / alert expression / d. / greasy, blemished complexion with poor color.
b. / clear skin / e. / shiny hair
c. / firm flesh / f. / well developed bone structures

ANS: A, B, C, E, F

Reference: Characteristics of good Nutrition (Table1-2)

Rationale: Shiny hair, clear skin, firm flesh, well developed bone structures, and an alert expression are some of the characteristics of good nutritional status. Greasy, blemished complexion with poor color is one characteristic of poor nutritional status.

3. The nurse is educating a client about eating a balanced diet. Which of these nutrients should the nurse say is the primary energy providing nutrient? Select all that apply.

a. / calcium / d. / protein
b. / carbohydrate / e. / vitamin A
c. / fat / f. / vitamin B12

ANS: B

Reference: Nutrients and Their Functions

Rationale: Carbohydrate is the primary energy providing nutrient. Fats and Proteins also provide energy. Vitamins and minerals do not provide energy.

4. The nurse is asked to explain to a client with a secondary nutrient deficiency what that means. Which of the following statements are correct about secondary nutrient deficiencies? Select all that apply.

a. / A secondary nutrient deficiency cannot result in malnutrition. / d. / A secondary nutrient deficiency is caused by inadequate dietary intake.
b. / A secondary nutrient deficiency can occur as a result of a disease condition that causes malabsorption. / e. / A secondary nutrient deficiency is caused by something other than diet.
c. / A secondary nutrient deficiency can result in malnutrition. / f. / A secondary nutrient deficiency is not a concern because secondary nutrient deficiencies are deficiencies of non-essential nutrients.

ANS: B, C, E

Reference: Nutrient Deficiency

Rationale: Nutrient deficiencies are classified as primary or secondary. Primary deficiencies are caused by inadequate dietary intake. Secondary deficiencies are caused by something other than diet, such as a disease or condition that may cause malabsorption, accelerated excretion, or destruction of the nutrients. Nutrient deficiencies can result in malnutrition.

5. The nurse is educating a client who has a teenage child about why teenagers are at risk of poor nutritional intake. What issues might the nurse discuss with the client? Select all that apply.

a. / Peer pressure will have no effect on the child’s food choices. / d. / The teenager may eat an apple after school.
b. / Teenagers don’t always eat right, but they are not at risk of malnutrition. / e. / The teenager may favor fast-food because their friends like these foods.
c. / The teenager may adopt a crash diet as a result of peer pressure. / f. / The teenager may miss regularly scheduled meals, become hungry and satisfy their hunger with foods that have low nutrient density.

ANS: C, E, F

Reference: Individuals at Risk from Poor Nutritional Intake

Rationale: Teenagers may eat often, but at unusual hours. They may miss regularly scheduled meals become hungry and satisfy their hunger with foods that have low nutrient density. Teenagers are subject to peer pressure; that is they are easily influenced by the opinions of their friends. If friends favor foods with low nutrient density, it is difficult for a teenager to differ with them. Crash diets sometimes result in a form of malnutrition.

6. The 24-hour recall is used to assess dietary–social history. What information should the nurse expect to find on the 24-hour recall? Select all that apply.

a. / a list of the client’s favorite foods / d. / only the foods that were eaten at breakfast, lunch, and dinner.
b. / amounts of food eaten in the last 24 hours / e. / the number of calories consumed in the last 24-hours
c. / methods used to prepare foods eaten in the last 24 hours / f. / types of foods eaten in the last 24 hours

ANS: B, C, F

7. The nurse is explaining to a female patient why her iron status is being checked. Which of the following statements are correct? Select all that apply.

a. / Iron deficiency causes a disease called rickets. / d. / Iron is a necessary component of blood and is lost during each menstrual period.
b. / Iron deficiency is common in children and women. / e. / Men are never iron deficient.
c. / Iron deficiency is the most common nutrient deficiency in the United States. / f. / The need for iron does not change increase with pregnancy.

ANS: B, C, D

Reference: Deficiency Diseases

Rational: The most common form of nutrient deficiency disease in the United States is iron deficiency, which is caused by a lack of the mineral iron and can cause iron deficiency anemia.

Iron deficiency anemia is particularly common among children and women but men can also be iron deficient. Iron is a necessary component of the blood and is lost during each menstrual period. The amount of iron needed is increased in pregnancy to provide for growth of the fetus.

8. The nurse is explaining to a client why serum albumin is being assessed as part of the nutrition assessment. What will the nurse say is the reason for this biochemical test? Select all that apply

a. / Serum albumin level is used to determine if iron stores are adequate. / d. / Serum albumin level is used to estimate body muscle mass.
b. / Serum albumin level is used to determine if there is blockage of the urinary tract. / e. / Serum albumin level may indicate renal failure.
c. / Serum albumin level is used to determine protein status. / f. / Serum albumin level tells us nothing about nutritional status

ANS: C

Reference: Deficiency Diseases

Rational: Serum albumin is used to determine protein status. Serum transferrin is used to determine the amount of iron carrying protein in the blood. Blood urea nitrogen may indicate renal failure, insufficient renal blood supply, or blockage of the urinary tract. Creatinine excretion can be used to estimate body muscle mass.

9. During the nutrition assessment the nurse takes a dietary-social history from the client. What important questions will this history answer? Select all that apply.

a. / Does the client have a refrigerator in which to store perishable foods? / d. / Does the client like regular American food?
b. / Does the client have enough money to buy food? / e. / Does the client have transportation to get to the grocery store to buy food?
c. / Does the client have the ability to prepare food at home? / f. / Is the client at risk for food-drug interactions that can lead to malnutrition?

ANS: A, B, C, E, F

10. The nurse is educating a client about the need for adequate protein intake. What reason will the nurse give the client for the importance of this nutrient? Select all that apply.

a. / Protein helps regulate circulation / d. / Protein is a good source of fiber.
b. / Protein helps regulate digestion, and elimination. / e. / Protein is necessary to build and repair body tissues.
f. Protein is the body’s primary source of energy.
c. / Protein helps regulate respiration

ANS: E

Reference: Nutrients and Their Functions

Rational: Protein is necessary to build and repair body tissues. Carbohydrate is the body’s primary source of energy. Protein does not contain fiber. Vitamins, minerals, and water help regulate respiration, circulation, and digestion and elimination.