Nutrition Exam 3 Test Bank (Chapter 9, 11, 12, 15)

A good example of living in an obesogenic environment is

A. working for an employer who gives employees free membership at a health club

B. being a former high school athlete who now works in a sedentary job

C. living in an apartment complex where it is unsafe for children to play outside unsupervised

D. a physicians recommendation not to exercise during recovery from surgery

C

The total amount of energy in a bowl of soup that contains 5g of protein, 2g of fat, and 20g of carbohydrate is _____ kcal

A. 27

B. 108

C. 118

D. 133

C

The fuel for all body processes that traps energy released from food is

A. electrons.

B. acetyl coenzyme A

C. glucose-6-phosphate.

D. adenosine triphosphate.

D

If a person hears a friend calling for help and goes running to find out what the friend needs, the person would be getting his or her energy from

A. fatty acids via adrenaline release

B. glucose and amino acids via aerobic pathways

C. glycogen via anaerobic glycolysis

D. fatty acids and glycerol vis oxidative phosphorylation

C

If someone goes on a long hike, after 4 hours most of his or her energy will be obtained from

A. glucose

B. glycogen

C. fatty acids

D. amino acids

C

Athletes who exercise regularly are able to exercise for longer, partly because their body is able to use more energy from

A. fat

B. protein

C. amino acids

D. carbohydrates

A

Of the following, the person who would be expected to have the highest energy expenditure is a

A. man who cycles to work every day and plays on sports teams on the weekend

B. man who works 60 hours a week at night at a high-stress job

C. woman who works as a personal trainer at a health club

D. woman who works as a nurse in a clinic

A

The most effective way to increase energy expenditure is to

A. eat foods that require more energy for digestion, absorption, metabolism, and storage

B. use thyroid hormones to increase basal metabolic rate

C. increase the duration and intensity of daily activities

D. lift weights to increase lean body mass and thereby increase basal metabolism

C

The behavior change that would do most to help preserve lean body mass is

A. avoiding weight loss

B. exercising regularly

C. decreasing dietary fat intake

D. ensuring adequate protein intake

B

The duration of physical activity needed to maintain physical fitness depends on the

A. time of day

B. ambient temperature

C. intensity of the activity

D. flexibility of the individual

C

The most accurate way to measure body fat levels is to use

A. body mass index (BMI)

B. triceps skinfold thickness

C. underwater weighing (densitometry)

D. biometric impedance analysis (BIA)

C

For a man, a total body fat level of 18% is considered

a. too low

b. healthy

c. too high

d. obese

B

If a health practitioner wants to assess whether an underweight woman's body fat is too low, he or she may ask her whether

A. she has lost weight recently.

B. other family members are underweight.

C. she has a normal appetite.

D. she menstruates regularly.

D

If a woman's waist measurement is 34 inches and her hip measurement is 40 inches, her waist-to-hip ratio would be considered to be _____ risk for chronic disease

A. associated with a high

B. unrelated to

C. associated with a low

D. associated with a moderate

A

Frank and Gina are trying to lose weight. They walk 2 miles every evening after dinner, are eating smaller portions, and have stopped eating snacks between meals. Frank has lost twice as much weight as Gina. What is the most likely explanation?

A. Gina is not following the food plan as carefully as Frank is

B. Gina has a gynoid shape, and Frank has an android shape

C. Frank is exercising more than Gina at other times during the day

D. Frank had a higher level of fitness than Gina before they started to make changes

B

It would be especially beneficial for someone to avoid becoming obese if they have a family history of

A. osteoporosis and sarcopenia (muscle wasting)

B. alcoholism and liver cancer

C. sleep apnea and osteoarthritis

D. multiple sclerosis and celiac disease

C

To lose a pound of body fat in a week, daily energy expenditure would have to increase by approximately _____ kcal

A. 350

B. 500

C. 700

D. 3500

B

If someone goes to a seafood buffet and eats large portions of shrimp, crab, and bakes fish, being careful to avoid fried seafood and high-fat sauces, the extra protein consumed will be stored as

A. amino acids in the liver

B. protein in muscles

C. glycogen in muscles

D. triglycerides in adipocytes

D

According to set point theory, if weight or fatness falls below the level perceived to be appropriate by the body, the individual will

A. experience a greater desire for high-fat foods

B. develop a new, lower set point for body weight

C. experience an overall increase in hunger drive

D. decrease his or her physical activity level until weight is regained

C

The most important factor in setting behavioral goals is

A. the clients willingness to exercise

B. individual habits and preferences

C. the amount of weight loss desired

D. the skill of the health care practitioner

B

If a client wants to relearn to pay attention to hunger and satiety cues, he or she may find it helpful to

A. keep a journal of perceived emotions

B. establish a regular pattern of meals

C. eat all food at home

D. avoid eating until he or she is very hungry

A

An athletes kilocalorie intake is most likely to be appropriate if he or she

A. maintains a low percentage of body fat

B. consumes at least 1800 kcal per day

C. maintains a competitive and healthy weight

D. does not experience hinger between workouts

C

If an athlete weighs 158 lbs at the beginning of an athletic event and weighed 146 lbs at the end of the event because of water lost in sweat, their athletic performance toward the end of the event would be

A. improved

B. unaffected

C. impaired

D. unpredictable

C

The best way for someone to measure fluid loss during a workout is

A. the amount needed to satisfy thirst

B. volume of urine production

C. change in body temperature

D. loss of body weight

D

Sports drinks may be more beneficial than water for an athlete who

A. is exercising in cold weather

B. runs for at least 2 hours, 4 days a week

C. experiences hunger during workouts

D. takes 1 hour aerobics class 5 days a week

B

An example of a good food for replacing glycogen stores is

A. raw carrots

B. string cheese

C. breakfast cereal

D. scrambled eggs

C

The person who is most likely to need to be concerned about the adequacy of his or her protein intake is a

A. male bodybuilder

B. woman who walks 30 minutes per day

C. man who plays basketball twice a week

D. female vegetarian runner with a low kcal intake

D

The factor that is most effective in increasing muscle mass is

A. exercise

B. low fat intake

C. high protein intake

D. amino acid supplements

A

An example of an athlete who is most likely to benefit from a multivitamin or mineral supplement that provides 100% of the DRI is a

A. gymnast

B. swimmer

C. bodybuilder

D. football player

A

An example of a beverage that may have a demonstrated ergogenic effect is

A. milk

B. beer

C. coffee

D. ginseng tea

C

1. A person is diagnosed as having diabetes mellitus if his or her fasting blood glucose level on two occasions is greater than _____ mg/dL.

a. 90

b. 120

c. 126

d. 156

C

2. Long-term complications of diabetes mellitus include

a. arthritis, rheumatism, and osteoporosis.

b. retinopathy, nephropathy, and neuropathy.

c. impaired immunity and opportunistic infections.

d. dermatitis, nephrotic syndrome, and detached retina.

B

3. The type of diabetes therapy that seems to be most effective in decreasing and delaying the complications of diabetes is

a. psychotherapy.

b. intensive therapy.

c. combined therapy.

d. conventional therapy.

B

4. The three main symptoms of untreated type 1 diabetes mellitus are

a. polyphagia, polyuria, and polydipsia.

b. neuropathy, nephropathy, and retinopathy.

c. confusion, loss of coordination, and headaches.

d. fatigue, loss of appetite, and frequent infections.

A

5. The cause of type 1 diabetes mellitus is

a. excessive intake of simple sugars.

b. destruction of pancreatic beta cells.

c. inability of cells to respond to insulin in the bloodstream.

d. inability of the pancreas to keep up with the body's demands for insulin.

B

6. The two strongest risk factors for type 2 diabetes are

a. obesity and family history.

b. recurrent viral infections and stress.

c. male gender and upper body obesity.

d. preference for sweet foods and sedentary lifestyle.

A

7. In individuals with type 2 diabetes, insulin production is generally

a. absent.

b. normal.

c. decreased.

d. increased.

D

8. Type 2 diabetes is becoming more prevalent in children, largely because of

a. increased intakes of refined sugar.

b. increased awareness and diagnosis.

c. the increasing prevalence of overweight children.

d. inheritance of a dominant gene that causes the disease.

C

9. For individuals with diabetes mellitus, glycosylated hemoglobin (HgbA1c) levels should be less than

a. 6%.

b. 7%.

c. 8%.

d. 10%.

B

10. The ethnic group that has the lowest prevalence of type 2 diabetes mellitus is

a. Native Americans.

b. African Americans.

c. Hispanic Americans.

d. non-Hispanic whites.

D

11. Exogenous insulin is a required part of treatment for all individuals with

a. type 1 diabetes mellitus.

b. type 2 diabetes mellitus.

c. gestational diabetes.

d. impaired glucose tolerance.

A

12. The main difference between the different types of exogenous insulin is

a. their shelf life.

b. the concentration of the preparation.

c. the type of solvent used to carry the insulin.

d. the length of time they take to act in the body.

D

13. Sulfonylureas and meglitinides decrease blood glucose levels by

a. stimulating insulin secretion.

b. slowing the rate of absorption of glucose.

c. providing an exogenous source of insulin.

d. improving insulin sensitivity.

A

14. Patients with diabetes mellitus should exercise at times when their blood glucose level is _____ mg/dL.

a. between 90 and 110

b. between 100 and 160

c. between 100 and 200

d. less than 250

C

15. To prevent hypoglycemia after exercise, patients with type 1 diabetes should

a. decrease their insulin dose.

b. omit a scheduled insulin dose.

c. increase their intake of protein-based foods.

d. increase their intake of carbohydrate-based foods.

D

16. Patients with type 2 diabetes are most likely to maintain good metabolic control if they

a. avoid all sources of simple carbohydrates.

b. avoid eating during the evening or at night.

c. space their meals evenly throughout the day.

d. eat one large meal and two small meals each day.

C

17. Glycosylated hemoglobin level is used to indicate

a. the effect of meals on blood glucose level.

b. day-to-day variations in blood glucose level.

c. iron deficiency anemia in patients with diabetes.

d. overall blood glucose control over several weeks.

D

18. A young man with type 1 diabetes runs 3 miles, falls asleep on the sofa, and forgets to eat his next meal. He is likely to experience

a. nephropathy.

b. hypoglycemia.

c. hyperglycemia.

d. diabetic ketoacidosis.

B

19. An individual with a blood glucose level of 40 mg/dL would have

a. hypoglycemia.

b. a normal blood glucose level.

c. hyperglycemia.

d. impaired glucose tolerance.

A

20. Diabetic ketoacidosis may occur in a patient with type 1 diabetes who

a. gets caught in traffic and misses a meal.

b. participates in an all-day sporting event.

c. accidentally takes a double dose of insulin.

d. goes away for the weekend and forgets to take his or her insulin.

D

21. Ketones accumulate in the blood during diabetic ketoacidosis because of increased metabolism of _____ and decreased metabolism of _____.

a. fatty acids; glucose

b. glucose; fatty acids

c. amino acids; glucose

d. glucose; amino acids

A

22. If someone with type 1 diabetes has nausea and vomiting, weakness and fatigue, as well as excessive hunger and thirst, but does not have a fruity or acetone odor on their breath, they may have

a. hepatic encephalopathy.

b. diabetic ketoacidosis (DKA).

c. hyperglycemic hyperosmolar nonketotic syndrome (HHNS).

d. hypoglycemia.

C

23. If a young man with type 1 diabetes wants to eat cake for dessert after a meal of roast chicken, mashed potatoes, gravy, green beans, and dinner rolls, he should eat less

a. potatoes and/or rolls.

b. chicken and gravy.

c. green beans.

d. of everything.

A

24. Patients with type 1 diabetes should be taught to regulate the _____ meal and snacks.

a. kcal content of

b. total amount of sugars in

c. total amount of dietary fiber in

d. total amount of carbohydrates in

D

25. An example of a good after-workout snack for someone with type 1 diabetes is

a. skim milk.

b. beef jerky.

c. string cheese.

d. peanuts.

A

26. Sugar alcohols appear to be safe for use as sweetening agents, but their use may

a. cause diarrhea.

b. result in weight gain.

c. have adverse effects on plasma lipid levels.

d. displace more nutrient-dense foods in the diet.

A

27. To facilitate compliance, the prescribed meal plan for patients with diabetes mellitus should

a. include some favorite foods each week.

b. be based on the patient's usual eating habits.

c. be tailored to achieve individual weight-loss goals.

d. include meals and snacks eaten at the same time each day.

B

28. If a young woman with type 1 diabetes mellitus is in a car accident and breaks several bones, she is likely to need

a. less insulin than usual.

b. more insulin than usual.

c. a different type of insulin.

d. the same amount of insulin.

B

29. Patients with type 1 diabetes mellitus who are sick and unable to eat regular food should consume

a. parenteral nutrition support.

b. commercial liquid nutrition supplements.

c. liquid, semiliquid, or soft sources of carbohydrates.

d. noncaloric fluids only to minimize the increase in blood glucose level.

C

30. Eating plans for patients with diabetes mellitus and gastroparesis should include

a. six small meals daily.

b. three regular meals daily.

c. high protein intake.

d. increased fluid intake.

A

A clear liquid diet would be most appropriate for

a. someone who has had several teeth removed and is unable to chew

b. a pregnant woman with persistence nausea

c. someone who has had a stroke and had difficulty swallowing

d. a patient who has had major surgery within the past 18 hours

D

One advantage of a full liquid diet is that it

a. has low levels of saturated fat and high levels of fiber

b. is suitable for patients with lactose intolerance

c. is likely to be tolerated by patients with dysphagia

d. can provide an adequate diet if very carefully planned

D

If a patient is receiving radiation to the mouth and neck area and has a sore mouth, the most appropriate type of diet while he or she is in hospital would be a _____ diet.

a. regular

b. mechanical soft

c. full liquid

d. clear liquid

B

If a patient drools, takes a long time to eat, and often gags during meals, he or she may have

a. dementia

b. esophageal cancer

c. regurgitation

d. dysphagia

D

If a physician orders a diet as tolerated for a patient, the nurse should

a. make food selections for the patient in accordance with the patients symptoms.

b. determine the appropriate type of diet for the patient in accordance with the patients condition.

c. consult the registered dietitian to determine when the diet should be advanced.

d. encourage the patient to normalize the diet as his or her appetite and symptoms allow.

D

If an individual has back pain and seeks treatment with acupuncture, as well as a physician at a traditional spine clinic, this would be an example of using _____ medicine.

a. traditional

b. integrative

c. alternative

d. complementary

D

If a patient starts vomiting immediately after eating seafood and states that the one other time he or she ate seafood, he or she had a similar reaction, the patient probably has

a. food poisoning

b. celiac disease

c. an allergy to seafood

d. a viral infection

C

A one-a-day multivitamin or multimineral supplement at 100% or less of the Dietary Reference Intake (DRI) is probably most beneficial for a(n)

a. young adult who lifts weights before work every morning

b. older adult living at home alone

c. business executive with a high-stress job

d. newly retired, socially active woman

B

According to the Dietary Supplement Health and Education Act (DSHEA) of 1994, dietary supplements are considered

a. foods

b. drugs

c. nutrients

d. food additives

A

Using a margarine fortified with plant sterol and stanol esters to help decrease blood cholesterol levels is an example of using a

a. probiotic

b. functional food

c. dietary supplement

d. complementary food

B

For patients who are taking prescription or over-the-counter drugs, herbal preparations

a. should all be avoided

b. can be considered safe

c. should be taken separately from drugs

d. may cause dangerous herb-drug interactions

D

Registered dietitians may encourage patients to use specific herbal supplements

a. that are less expensive than conventional medications

b. that they have used themselves and found to be helpful

c. that are approved by the U.S. Department of Agriculture (USDA)

d. for which efficacy and safety have been scientifically studied and documented

D

The most important thing a nurse can do to prevent the spread of foodborne illness among hospitalized patients is to

a. discard any food that is uneaten within 30 minutes of being served

b. wear a mask when serving food or helping feed patients

c. wash hands throughly before serving food and after using the bathroom

d. discourage friends and family members from bringing in food for the patient

C

A patient should be discouraged from using echinacea to help reduce the duration of colds if he or she is using

a. anticoagulant drugs to prevent formation of blood clots

b. immunosuppressant drugs after organ transplantation

c. oral contraceptives or hormone replacement therapy

d. oral hypoglycemic agents for treatment of diabetes

B

If a patient with depression takes a selective serotonin reuptake inhibitor (SSRI), the nurse may want to ask about use of herbal products because of potential interactions if the patient is using

a. ginseng

b. ginkgo biloba

c. St. Johns wort

d. evening primrose oil

C

Nurses should ask patients about their use of over-the-counter medications because

a. those medications may cause drug-drug or nutrient-drug interactions

b. the medical staff has a legal responsibility to know what patients are using

c. they may be able to advise patients about cheaper generic forms of drugs

d. patients should not take prescription and over-the-counter drugs at the same time

A

A patient who is an orthodox Jew would not eat

a. chicken in cream sauce

b. a hamberger and fries

c. a grilled cheese and tomato sandwich

d. scrambled eggs and hash browns

A

A food restriction shared by both Muslims and Jews is

a. not combining meat and diary at the same meal

b. not eating pork or any food products from pigs

c. avoiding coffee, tea, and alcohol

d. eating fish with fins and scales but not shellfish

B

During a home visit to a patient receiving home enteral nutrition, the greatest source of concern would be if the

a. patient were receiving enteral feedings only during the night

b. patient has gained 1 pound during the past month

c. family complains that they miss being able to eat meals together

d. family is blending family meals to make their own formula

D

If a patient has had a stroke and needs enteral feedings because he or she cannot chew or swallow but has no other medical problems, he or she can be fed with a(n) _____ formula.

a. isotonic

b. modular

c. elemental

d. polymeric

D

If a patient with cystic fibrosis and pancreatic insufficiency requires enteral feedings, he or she should be fed a(n)

a. elemental formula

b. modular formula

c. formula specially formulated for critically ill patients

d. lactose-free formula

A

Feeding tubes should be placed into the small intestine rather than the stomach if

a. the patient is comatose

b. a regular polymeric formula is being used

c. the patient prefers not to have a tube passing through his or her nose

d. the patient is expected to resume oral feedings within 1 to 2 weeks

A

If a patient is to receive enteral feedings for several weeks because of esophageal surgery but is otherwise generally healthy, he or she may be fed through a _____ tube.

a. nasogastric

b. nasoduodenal

c. percutaneous endoscopic gastrostomy (PEG)

d. jejunostomy

C

If a patient starts to experience diarrhea 12 hours after starting enteral feedings, the first course of action the medical staff would try is

a. switching to lactose-free formula

b. decreasing the rate of the formula feeding

c. switching to an elemental formula

d. stopping the feeding until the diarrhea resolves

B

Bolus enteral feedings would be appropriate for a patient who

a. has had a gastrectomy

b. has a PEG tube

c. is being fed via a nasoduodenal tube

d. has a history of aspiration-relate pneumonia

B

To determine the nutritional adequacy of a tube feeding,

a. the patients actual formula intake and body weight should be recorded daily

b. intake and output records should be completed during each nursing shift

c. urine glucose levels, gastric residuals, and bowel movements should be recorded

d. anthropometric, biochemical, and clinical indexes should be assessed weekly

D

To reduce the risk of aspiration, patients who are receiving enteral tube feedings should be positioned

a. sitting upright

b. lying on their side

c. with the head on the bed elevated 30 to 45 degrees

d. with the head of the bed elevated 45 to 60 degrees

C

A patient has undergone several gut resections because of cancer and is unlikely to resume adequate oral intake of nutrients. The best way to feed this patient would be via

a. central parental nutrition

b. peripheral parenteral nutrition

c. a PEG tube

d. jejunal enteral feedings

A

Intravenous lipid emulsions are used as part of parenteral nutrition to prevent fatty acid deficiency and to

a. increase patient satiety

b. provide a source of fat-soluble vitamins

c. add kilocalories without increasing osmolality

d. add kilocalories with minimal expense

C

If a patient receiving parenteral nutrition has a fluid restriction, he or she would need to be fed via _____ parenteral nutrition.

a. peripheral

b. central

c. peritoneal

d. cyclical

B

During transitions from parenteral or enteral tube feedings to oral feedings, patients should be monitored to ensure that

a. they do not develop hypoglycemia

b. total nutritional intake is adequate

c. their weight does not increase rapidly

d. they do not experience nausea and vomiting

B

The best way to maintain the integrity and function of the gut in someone who is receiving parenteral nutrition is to

a. supplement parenteral nutrition with probiotics

b. encourage patients to smell foods to stimulate gastric juices

c. use enemas to keep fluids in the gut without using the oral route

d. give the patient small sips of diluted fruit juice if possible

D

The situation in which it would be most important for the nurse to contact the registered dietitian (RD) is if a

a. patient complains of constipation during his or her hospital stay.

b. patients family complains about the quality of the food in the hospital.

c. patient reports losing 10 lb in the past year without trying.

d. patient has been receiving intravenous glucose and saline but no oral intake for 36 hours.

D

An example of a common cause of iatrogenic malnutrition is

a. scheduling of frequent daily tests that prevents the patient from eating meals.

b. food from home brought in by family members and friends of a patient.

c. small portion sizes of hospital food and absence of snacks.

d. errors in ordering and delivery of meals for hospitalized patients.

A

If a patient is 6 feet tall and his or her waist measures 42 inches, the patient would be considered to have _____ fat levels consistent with _____ risk for chronic disease.

a. essential; low

b. essential; high

c. abdominal; low

d. abdominal; high

D

The best way to estimate height for a patient with both legs amputated below the knee is to use

a. demi-span (distance from the sternal notch to the middle finger).

b. knee height (with the use of calipers to measure heel-to-thigh distance).

c. recumbent bed height measured while the patient is lying down.

d. the patients stated pre-amputation height.

A

If a male patient weighs 140 pounds when he is admitted to a long-term care facility and weighs 147 pounds 2 months later, his percent weight change during his hospital stay is

a. 3.5%.

b. 5%.

c. 7%.

d. 14%.

B

If a patient weighed 150 lb 1 month ago and now weighs 140 lb, the weight loss would be considered

a. insignificant.

b. mild.

c. moderate.

d. severe.

D

An elderly patient who has been living alone and has gradually been losing weight has had a stroke and is transferred to a long-term care facility. It is unlikely that he will be able to achieve adequate oral intake during recovery, and so a percutaneous endoscopic gastrostomy (PEG) tube is inserted to begin tube feedings into his stomach. If the patient gains 8 lb in the first week of tube feeding, it is likely that

a. he is retaining fluid weight.

b. the tube feeding is well tolerated.

c. he is constipated.

d. the feedings are replenishing muscle and fat stores.

A

Body mass index (BMI) would be most useful for evaluating the weight status of a(n)

a. middle-aged, moderately active woman.

b. elderly, mostly sedentary man.

c. high-school football player.

d. young woman undergoing chemotherapy.

A