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Test Bank For Nutritional Foundations And Clinical Applications: A Nursing Approach, 6th Edition

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    01: Wellness Nutrition Chapter 01: Wellness Nutrition Grodner and Escott-Stump: Nutritional Foundations and Clinical Application: A Nursing Approach, 6th Edition MULTIPLE CHOICE 1. Examples of informal education include a. attending a workshop on coronary artery disease sponsored by the American Heart Association. b. watching a television show about diabetes. c. learning about food safety techniques in a high school economics course. d. joining a support group to help overcome an eating disorder. ANS: B Watching a television show about diabetes is an example of informal education because it is an experience that occurs through a daily activity. Attending a workshop or joining a support group would be considered nonformal education; a high school course would be considered formal education. DIF:Cognitive Level: ApplyingREF age 6 TOP: Nursing Process: Implementation MSC: Client Needs: Health promotion and maintenance 2. A college student exercises regularly and generally eats a healthy variety of foods, is taking a course in general nutrition, buys locally produced food whenever possible, is an active member of an on-campus faith-based organization, and keeps a journal to help process her emotions. What else could be important for her to include in her life in order to develop her overall wellness? a. Growing some of her own food b. Keeping a food record to help evaluate what she eats c. Eating meals with friends throughout the week

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    d. Meeting with a registered dietitian to review her food choices ANS: C Wellness enhances a person’s level of health through development of each of the six dimensions of health: physical health, intellectual health, emotional health, social health, spiritual health, and environmental health. Exercise and eating a health variety of foods help develop physical health; taking a course in general nutrition helps develop intellectual health; buying locally produced food helps develop environmental health; being part of a faith-based organization helps develop spiritual health; and keeping a journal helps develop emotional health. The missing dimension in this example is development of social health; eating meals with friends throughout the week would add this dimension. Growing her own food would be another example of environmental health; keeping a food record would be another contributor to physical health; and meeting with a registered dietitian may contribute to physical, intellectual, and emotional health. DIF:Cognitive Level: AnalyzingREF ages 1-3 TOP: Nursing Process: Assessment MSC: Client Needs: Health promotion and maintenance 3. For a client who is missing meals because of poor planning or is too busy to eat, emotional health can be affected by _____, which can cause confusion or anxiety. a. low blood sugar levels b. high blood sugar levels c. high blood pressure d. extremely low blood pressure ANS: D Poor eating habits affect emotional health. Missing meals may cause blood sugar levels to decrease, which can cause anxiety or confusion or make it difficult to control emotions. Late night binges on snack food are likely to result in excessive energy intake but would have a less direct effect on emotional health. Eating small meals throughout the day is likely to maintain more constant blood

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    sugar levels, which would actually have a positive effect on emotional health. Excessive caffeine consumption may contribute to anxiety, but 2 cups of caffeinated coffee is not considered excessive. DIF:Cognitive Level: AnalyzingREF age 2 TOP: Nursing Process: Assessment MSC: Client Needs: Psychosocial integrity 4. The best example of the type of concern that is likely to be addressed by the U.S. Department of Health and Human Services when target goals for Healthy People 2030 are updated is a. preference for vegetarian eating patterns among white women. b. low intake of fruits and vegetables by African American childre n. c. widespread use of bottled water in higher socioeconomic groups. d. common use of protein and vitamin supplements in athletes. ANS: B Healthy People is used to set targets for health promotion to improve the health of all individuals. It addresses environmental and social issues that affect health outcomes. Low intake of fruits and vegetables by African American children is likely to have an adverse effect on their health and so may be addressed when target goals are set. Vegetarian eating patterns, use of bottled water, and use of protein and vitamin supplements do not necessarily have an adverse effect on nutritional health and so are less likely to be addressed. DIF: Cognitive Level: Applying REF: Pages 4-6 TOP: Nursing Process: Planning MSC: Client Needs: Health promotion and maintenance 5. An example of community support for health promotion is a. teaching a young mother skills in safe food preparation. b. watching a television documentary about industry errors in food processing.

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    c. labeling fresh poultry packages with information about proper food storage. d. being aware that Salmonella can be transmitted because of inadequate food preparation. ANS: C Food labeling information is an example of community support because it is a regulatory measure that supports new health-promoting behaviors within a social context. Teaching, watching television and awareness may increase knowledge, but they do not alter the social context by regulation or environmental change. DIF:Cognitive Level: ApplyingREF age 4 TOP: Nursing Process: Implementation MSC: Client Needs: Health promotion and maintenance 6. An example of a technique for health promotion is a. exercising five times a week. b. local supermarkets’ expanding the availability of fresh fruits and v egetables. c. teaching a teenager how to choose healthier foods at fast - food restaurants. d. information about the relationship of dietary intake and diet - related disorders. ANS: C Health promotion consists of strategies that are designed improve the health of individuals, families, groups, and communities, such as teaching a teenager how to choose healthier fast foods. Exercising regularly contributes to wellness, but it is not bringing about a change in health unless this is a change in behavior. Stocking a wider availability of fresh produce does not promote health, unless the supermarket uses specific strategies to encourage consumption. Information about the relationship between nutrients and disease is simply information unless it is used to promote behavior change. DIF:Cognitive Level: ApplyingREF age 4

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    TOP: Nursing Process: Implementation MSC: Client Needs: Health promotion and maintenance 7. For the efficient functioning and maintenance of the body, a person needs to consume sufficient amounts of a. fiber. b. nutrients. c. minerals. d. supplements. ANS: B The body needs sufficient amounts of all nutrients for efficient functioning and maintenance. Both fiber and minerals are needed, but each represents only one type of nutrient. Supplements are not always necessary because sufficient nutrients can often be obtained from food. DIF:Cognitive Level: UnderstandingREF ages 8-10 TOP: Nursing Process: Assessment MSC: Client Needs: Physiological integrity 8. A nurse has just been assigned to a community health program for older adults. She should check the document Healthy People 2020 to become familiar with a. nutrition priorities and goals for older American adults. b. dietary standards for Americans older than 50 years. c. dietary guidelines recommended for older adults. d. MyPlate recommendations for older adults. ANS: A Healthy People 2020 focuses on targets and goals for improving the health of the nation. The nurse would check the Dietary Reference Intakes for information about dietary standards. The Dietary

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    Guidelines for Americans and MyPlate are separate documents from Healthy People 2020 and focus on specific advice and guidelines for healthy eating. DIF:Cognitive Level: ApplyingREF ages 4-5 | Page 10 TOP: Nursing Process: Planning MSC: Client Needs: Health promotion and maintenance 9. A healthy female middle-aged client asks what she can do to prevent the development of type 2 diabetes. Weight control and nutrition strategies discussed are considered a. primary treatment. b. primary prevention. c. secondary prevention. d. tertiary prevention. ANS: B Action to prevent the development of type 2 diabetes is considered primary prevention. Secondary prevention involves early detection to halt and minimize the effects of the disease, and tertiary prevention minimizes complications and helps restore health after the disorder has developed. “Primary treatment” is not a recognized term. DIF: Cognitive Level: Applying REF: Pages 5-6 TOP: Nursing Process: Planning MSC: Client Needs: Health promotion and maintenance 10. As a home health care nurse, you are visiting a 70-year-old client who has just returned home from the hospital after being treated for coronary artery disease. The medical nutrition therapy developed for him by the hospital dietitian is considered a. palliative care. b. primary prevention.

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    c. secondary prevention. d. tertiary prevention. ANS: D This is an example of tertiary prevention, which entails minimizing complications and helping restore health after heart disease has developed. Primary prevention would occur before the disease developed, and secondary prevention would involve early detection to minimize the effects of the disease. Palliative care is intended only to minimize symptoms. DIF: Cognitive Level: Applying REF: Pages 5-6 TOP: Nursing Process: Planning MSC: Client Needs: Health promotion and maintenance 11. A nutrient that can be made by the body is called a. essential. b. complete. c. incomplete. d. nonessential. ANS: D Nonessential nutrients can be made by the body. Essential nutrients cannot be made by the body and must be consumed. The terms complete and incomplete refer to proteins. Complete proteins contain all the essential amino acids; incomplete proteins are lacking one or more essential amino acids. DIF:Cognitive Level: RememberingREF ages 8-9 TOP: Nursing Process: Assessment MSC: Client Needs: Physiological integrity 12. A client exercises regularly and wants to make sure he has sufficient energy for his workouts. The type of nutrient that will be most helpful in providing the energy he needs is

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    a. carbohydrates. b. water. c. minerals. d. protein. ANS: A Carbohydrates are the best source of fuel to provide energy for the body. Protein can also provide fuel for energy, but its primary purpose is important structural and functional roles. Water and minerals are important for health but do not provide fuel for energy. DIF: Cognitive Level: Applying REF: Pages 8-10 TOP: Nursing Process: Planning MSC:Client Needs: Physiological integrity 13. A 45-year-old man tells you that he drinks 3 oz of Scotch whiskey most evenings. His alcohol intake is considered a. insignificant. b. moderate. c. higher than is recommended. d. dangerously high. ANS: B Moderate alcohol intake is two servings or fewer per day for men. One serving of spirits, such as whiskey, is 1.5 ounces. Therefore, 3 oz of whiskey per day is considered moderate alcohol intake. DIF:Cognitive Level: AnalyzingREF age 9 TOP: Nursing Process: Assessment MSC: Client Needs: Health promotion and maintenance

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    14. A dessert contains 4 g of protein, 30 g of carbohydrate, 15 g of fat, and 5 g of alcohol. The nutrient that provides the most kilocalories in the dessert is a. protein. b. carbohydrate. c. fat. d. alcohol. ANS: C Fat provides the highest number of kilocalories: At 9 kcal per gram, 15 g of fat provides 135 kcal. At 4 kcal per gram, 4 g of protein provides 16 kcals. At 4 kcal per gram, 30 g of carbohydrate provides 120 kcal. At 7 kcal per gram, 5 g of alcohol provides 35 kcal. DIF:Cognitive Level: ApplyingREF age 9 TOP: Nursing Process: Assessment MSC: Client Needs: Health promotion and maintenance 15. A cup of frozen yogurt contains 24 g of carbohydrate, 2 g of fat, and 4 g of protein. The total number of kilocalories in the frozen yogurt is a. 110. b. 130. c. 140. d. 162. ANS: B At 4 kcal per gram, 24 g of carbohydrate provides 96 kcal. At 9 kcal per gram, 2 g of fat provides 18 kcal. At 4 kcal per gram, 4 g of protein provides 16 kcal. Therefore, the total kilocalories in the frozen yogurt is 130 kcal (96 + 18 + 16).

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    DIF:Cognitive Level: ApplyingREF ages 8-9 TOP: Nursing Process: Assessment MSC: Client Needs: Health promotion and maintenance 16. Combinations of amino acids link together to form a. protein. b. carbohydrates. c. dietary fiber. d. lipids. ANS: A Proteins are made up of various combinations of amino acids, linked together. Carbohydrates are made up of one or more units of simple sugars. Dietary fiber consists mostly of carbohydrate that cannot be digested. Lipids are made up of glycerol and triglycerides or sterols. DIF:Cognitive Level: RememberingREF ages 8-9 TOP: Nursing Process: Assessment MSC: Client Needs: Physiological integrity 17. A bodybuilder tells you that all of his meals and snacks include high-protein foods such as eggs, canned tuna, chicken, milk, and cheese. Most of the extra protein is probably used by his body to form a. strong bones and joints. b. body fat stores. c. healthy brain tissue. d. increased muscle mass. ANS: B

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    Excess protein is broken down to amino acids and then used for energy or stored as body fat. This man’s body will use some of this protein to increase muscle mass, but increasing protein intake beyond the amount needed does not increase muscle formation. Excess protein intake does not improve bone, joint, or brain health. DIF:Cognitive Level: ApplyingREF age 9 TOP: Nursing Process: Assessment MSC: Client Needs: Physiological integrity 18. When clients have a strong family history of both heart disease and cancer, the nurse should encourage them to reduce their intake of a. dietary fiber. b. protein. c. monounsaturated fat. d. saturated fat. ANS: D Saturated fat intake is related to risk of heart disease and certain types of cancer. Monounsaturated fat intake has less effect on risk of these diseases. Dietary fiber intake should be increased to help reduce risk of cardiovascular disease and cancer. The effects of protein intake on risk of these diseases are much less significant. DIF: Cognitive Level: Applying REF: Page 9 TOP: Nursing Process: Planning MSC:Client Needs: Physiological integrity 19. The National Health and Nutrition Examination Survey (NHANES) is able to assess the overall nutritional and health status of Americans because a. the populations surveyed are representative of the total population. b. it focuses on ethnic and socioeconomic groups at greatest risk.

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    c. it collects large volumes of survey data from all over the nation. d. survey methods and stan dards are consistent from year to year. ANS: A Data from NHANES represent America overall because the survey populations are carefully selected to represent the total population. Their data therefore provide a better indication of the nation’s overall health than do large amounts of data from all over the country. It does not focus specifically on populations at high risk for disease. Standardization over time provides useful data on trends and changes but does not reveal the overall health of the nation. DIF:Cognitive Level: ApplyingREF ages 4-5 TOP: Nursing Process: Assessment MSC: Client Needs: Health promotion and maintenance 20. In working with a ethnic minority population, a helpful way to increase health literacy could be to a. invite members of t he community to help identify needs and teaching strategies. b. encourage acculturation and adoption of healthful American eating patterns. c. set up a feeding program to provide healthy food for members of the community. d. use visual aids rather than written materials during health education encounters. ANS: A Members of an ethnic minority population can be very helpful in identifying needs and effective teaching strategies for people in their community and in encouraging people in the community to accept advice from nurses or other health professionals. They do not necessarily need to adopt American eating patterns; often these are less healthful than their traditional eating patterns. Setting up feeding programs does not promote positive self-efficacy. Visual aids may be helpful, but their use is not necessarily the best educational strategy. DIF: Cognitive Level: Applying REF: Pages 6-7 TOP: Nursing Process: Planning

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    MSC:Client Needs: Physiological integrity 21. A client has heard that nutrients can be converted to other nutrients in the body. He takes high- dose vitamin C supplements because he believes this will supply his body’s need for other vitamins. What would you tell him? a. He should switch to a multivitamin supplement instead of just vitamin C. b. Each vitamin has a specific function and needs to be supplied through a variety of foods. c. Vitamin C can provide only water - soluble vitamins, and he still needs to consume fat - soluble vitamins. d. Vitamin C supplements should be taken only when he has symptoms of a cold or influenza. ANS: B Vitamins cannot be converted into other vitamins; each has a specific function, and the best way to consume adequate amounts of each vitamin is to eat a variety of foods. Vitamin C is water soluble, but it cannot be converted to other water-soluble vitamins. Vitamin C is needed by the body at all times, not just when someone is ill. A multivitamin supplement would provide a better range of vitamins than just vitamin C, but it is still better to consume vitamins from food, rather than from supplements. DIF:Cognitive Level: ApplyingREF ages 9-10 TOP: Nursing Process: Assessment MSC: Client Needs: Physiological integrity 22. For a mother with two children who works in health care management 60 to 70 hours a week, the biggest barrier to healthy eating is likely to be a. lack of concern for her own or her children’s health. b. inadequate income to purchase healthy foods. c. insufficient time to plan and prepare healthful meals.

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    d. lack of knowledge about healthy eating. ANS: C For busy professionals and families, the biggest barrier to healthy eating is usually hectic schedules and lack of time to plan and prepare healthy meals. Most mothers, especially those who work in a health care field, are concerned about their family’s health. Many professional women have at least some understanding of healthy eating. With a professional job, lack of income is not very likely to be a barrier to healthy eating. DIF: Cognitive Level: Applying REF: Page 7 TOP: Nursing Process: Planning MSC: Client Needs: Health promotion and maintenance 23. A class of nutrients that is important in body structure and influences the function of muscles and the central nervous system is a. proteins. b. minerals. c. vitamins. d. carbohydrates. ANS: B Minerals are important in body structures and influence the function of muscles and the central nervous system. Proteins are structural components and form part of muscles but are less influential in the central nervous system. Vitamins and carbohydrates do not have structural functions. DIF:Cognitive Level: UnderstandingREF age 10 TOP: Nursing Process: Assessment MSC: Client Needs: Physiological integrity 24. If mine workers were trapped in a mine and it took several days for a rescue team to reach them, the nutrient that they would need most in order to survive is

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    a. protein. b. carbohydrates. c. water. d. vitamins. ANS: C The body can survive only a few days without water. The body may not function optimally without other nutrients, but it can survive many days and even weeks without them. DIF:Cognitive Level: ApplyingREF ages 8-10 TOP: Nursing Process: Assessment MSC: Client Needs: Physiological integrity 25. The client who would benefit most from an increase in dietary fiber intake is one with a. fatigue. b. constipation. c. dehydration. d. coronary heart disease. ANS: B Adequate dietary fiber and fluid intake can help alleviate constipation. It has a small but less significant effect in helping reduce risk of coronary heart disease. Dietary fiber intake does not affect fatigue or hydration status. DIF: Cognitive Level: Applying REF: Page 9 TOP: Nursing Process: Planning MSC: Client Needs: Health promotion and maintenance 26. To provide adequate amounts of vitamins and minerals, the best course of action is to

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    a. lose weight to achieve ideal body weight. b. eat a variety of foods from each food group. c. follow the same general food pattern each day. d. consume foods high in fiber and low in saturated fat. ANS: B Including a variety of foods from each food group increases the likelihood of obtaining adequate amounts of vitamins and minerals. Achieving ideal body weight does not guarantee adequate nutrient intake. Following the same general food pattern each day could actually limit vitamin and mineral intake because the assortment of foods is likely to be limited. Choosing foods high in fiber and low in saturated fat diet does not necessarily result in intake of adequate levels of vitamins and minerals. DIF: Cognitive Level: Applying REF: Page 12 TOP: Nursing Process: Planning MSC: Client Needs: Health promotion and maintenance 27. If a nurse wants to evaluate whether a client’s vitamin or mineral supplement contains too much of a specific nutrient, the nurse should a. check the manufa cturer’s recommendations about intake for that nutrient. b. request blood and urine tests to determine the client’s body stores of that nutrient. c. compare the amount in the supplement to the tolerable upper intake level (UL) for that nutrient. d. compare the amount in the supplement to the Recommended Dietary Allowance (RDA) for that nutrient. ANS: C The UL is the maximum intake that should not be exceeded to prevent adverse health risks; this should be compared to the amount in the supplement. The Recommended Dietary Allowance is the amount that meets the needs of most health individuals in a life-stage and gender group, but it is not

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    the upper level for safety. Manufacturers do not necessarily provide reliable information about safety of supplements they are marketing. Blood and urine tests may or may not show whether the body is accumulating unsafe levels of a nutrient, depending on the nutrient and how long the supplement has been taken. DIF:Cognitive Level: ApplyingREF age 11 TOP:Nursing Process: Assessment| Nursing Process: Evaluation MSC:Client Needs: Physiological integrity 28. Why is it difficult to specify the number of grams of protein that he or she should eat each day? a. More research studies are needed to help determine ideal levels of protein intake for various age and gend b. Health care professionals should not give specific advice to clients, to avoid lawsuits. c. It is unrealistic to expect clients to meet precise levels of protein intake. d. Recommended protein intakes are expressed as a range and are based on a percentage of energy intake, wh individuals. ANS: D Protein intake does not need to be precise and can be within an acceptable range, expressed as a percentage of energy intake. Health care professionals should not give unnecessarily precise advice, but they can give scientifically based advice without concern for lawsuits. A reasonable amount of research has been conducted to be able to give at least general advice about protein intake. The likelihood that clients will achieve a specific protein intake is not related to the difficulty in identifying what their intake level should be. DIF:Cognitive Level: AnalyzingREF ages 8-9 | Page 11 TOP: Nursing Process: Assessment MSC: Client Needs: Physiological integrity 29. If a college student is eating only one small meal per day in an attempt to lose weight and is taking high doses of vitamin and mineral supplements to try to make up for the lack of food, the student would be described as having

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    a. malnutrition. b. disordered nutrition. c. overnutrition. d. undernutrition. ANS: A An imbalance of intake of nutrients, energy, or both (in this case, high intake of some nutrients and low intake of energy) is called malnutrition. Overnutrition refers only to excessive intake, excessive nutrients, or excessive energy. Undernutrition refers only to inadequate intakes of nutrients, energy, or both. “Disordered nutrition” is not a recognized term. DIF:Cognitive Level: ApplyingREF age 12 TOP: Nursing Process: Assessment MSC: Client Needs: Physiological integrity 30. An overweight client has been trying to lose weight for years. She tells you that she believes she is genetically designed to be overweight and that the foods available in supermarkets today make weight loss impossible. The client’s attitude shows a. positive self - efficacy. b. negative self - efficacy. c. poor environmental health. d. poor emotional health. ANS: B The client’s attitude demonstrates negative self -efficacy. She does not perceive that she has power over her life and behaviors. A belief that she could change her personal behaviors would reflect positive self-efficacy. She is able to express her feelings, and so she does not necessarily have poor

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    emotional health. Her belief about healthy food choices in her environment is not necessarily accurate. DIF:Cognitive Level: ApplyingREF ages 1-2 | Page 12 TOP: Nursing Process: Assessment MSC: Client Needs: Psychosocial integrity 02: Personal and Community Nutrition Chapter 02: Personal and Community Nutrition Grodner and Escott-Stump: Nutritional Foundations and Clinical Application: A Nursing Approach, 6th Edition MULTIPLE CHOICE 1. A client tells you that he cannot eat most green vegetables because they taste too bitter. What is the most likely explanation? a. He has certain genetic taste markers that make him a “super taster.” b. He associates eating green vegetables with unpleasant childhood memories. c. He needs to train himself to enjoy the acquired taste of bitter vegeta bles. d. He is making an excuse to avoid making healthful changes in his eating habits. ANS: A Some people have variations in genetic taste markers that make them “super tasters.” These people often experience the taste of certain vegetables as being bitter. Environmental factors such as childhood memories may also influence food choices but are not usually associated with tasting vegetables as bitter. Tastes can be acquired and sometimes people make excuses to avoid making changes, but these are less likely explanations for this particular problem DIF:Cognitive Level: ApplyingREF age 18 TOP: Nursing Process: Assessment MSC: Client Needs: Health promotion and maintenance

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    2. A teenaged client is hungry and goes to the refrigerator for a snack. A holiday has just been celebrated at her home, and many of her favorite foods are available. She selects some slices of roast turkey and a cup of her aunt’s special fruit salad. This is an example of a. bingeing. b. abundance. c. food choice. d. food preference. ANS: D This teenager is able to select foods according to her preferences. Food choices are restricted by convenience, but many of her favorite foods are available, and so her choices are not limited. The food is abundant, and she may choose to binge and overeat, but her selections are made according to her food preference. DIF:Cognitive Level: AnalyzingREF age 18 TOP: Nursing Process: Assessment MSC: Client Needs: Psychosocial integrity 3. A mother tells you that she does not allow her young children to eat while they watch television, even though her husband often eats high-fat, sugary foods while they watch television as a family. The most important thing to discuss with her is the a. genetic factor of preference for sweet and salty tastes. b. influence of ethnicity on preference for sour tastes. c. children’s weights when they were born and their weights now. d. environmental effects of parental food choices and television watching. ANS: D

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    Because young children spend so much time with their families, their parents’ food choices have a major effect on their own future food choices. Preventing young children from eating while watching television will have only a short-term effect, and they are likely to imitate their father in eating high- fat, high- sugar snacks. The father’s food preferences are probably influenced by genetics and ethnicity, and it may be interesting to find out whether the children’s current weights are healthy for their heights (although their birth weight is probably not relevant), but this information has less immediate effect on the nutritional health of this family. DIF:Cognitive Level: ApplyingREF age 18 | Page 35 TOP: Nursing Process: Implementation MSC: Client Needs: Psychosocial integrity 4. If a middle-aged couple with two teenage children has insufficient income to purchase food, the most helpful program for them would be the a. MyPlate food guidance system. b. National School Lunch and School Breakfast Programs. c. federal government’s Supplemental Nutrition Ass istance Program (SNAP). d. Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). ANS: C SNAP provides financial assistance to buy nutritious foods for individuals and families with incomes below certain levels. WIC provides assistance only to women who are pregnant or breastfeeding and to infants and children up to the age of 5 who are at nutritional risk. School meal programs would benefit the children but not the adults. MyPlate would help the family make healthy food choices but would not help with their financial problems. DIF:Cognitive Level: ApplyingREF ages 18-19 | Page 21 TOP: Nursing Process: Planning MSC: Client Needs: Health promotion and maintenance 5. For most Americans, the most significant nutrition concerns are

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    a. lack of interest in making healthy food choices. b. poor availability of fruits and vegetables in many areas. c. excessive intake of saturated fats, cholesterol, sodium, and sugars. d. inadequate intake of key vitamins, minerals, and phytochemicals. ANS: C Most Americans have high intake of saturated fats, cholesterol, sodium, and sugars, which is associated with increased prevalence of chronic disease. Many people have inadequate intake of micronutrients, but this has a lesser overall effect than excessive intakes of fats, sodium, and sugars. Some areas of the country have poor availability of fruits and vegetables, but this is not a widespread problem in the country as a whole. Many Americans express at least some concern about making healthy food choices. DIF:Cognitive Level: UnderstandingREF ages 18-20 | Page 30 TOP: Nursing Process: Assessment MSC: Client Needs: Health promotion and maintenance 6. Excessive intake of high-sodium, high-fat foods can lead to diet-related illnesses such as a. genetic disorders, hypertension, and diabetes. b. hypertension and sickle cell anemia. c. viral infections that necessitate antibiotics. d. coronary artery disease and hypertension. ANS: D Coronary artery disease and hypertension are more common in individuals who consume high- sodium, high-fat diets. The risk for genetic disorders, sickle cell anemia, and viral infections is not affected by dietary fat and sodium intake.

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    DIF:Cognitive Level: ApplyingREF age 19 TOP: Nursing Process: Assessment MSC: Client Needs: Health promotion and maintenance 7. Of the following, the most important overall dietary modification to help reduce the risk of chronic disease is a. eating fewer foods that contain preservatives. b. buying mostly locally grown foods. c. eating more plant - based foods. d. eating more animal - based foods. ANS: C Scientific evidence from the nutrition literature shows that shifting to a more plant-based diet is one of four significant modifications to dietary intake patterns that will improve the overall health of Americans. Preservatives per se have not been associated with health status (although foods that contain preservatives may be more highly processed and may have higher levels of fat, sugar, and sodium and lower levels of nutrients than do foods without preservatives). Buying locally grown foods may be a good agricultural and economic practice, but it does not affect health status. Eating more animal-based foods would be the opposite of what is recommended. DIF: Cognitive Level: Applying REF: Page 20 TOP: Nursing Process: Planning MSC: Client Needs: Health promotion and maintenance 8. One way to help clients follow the Dietary Guidelines for Americans is to encourage them to use a. Healthy People 2020. b. the MyPlate food guidance system. c. the Supplemental Nutrition Assistance Program (SNAP).

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    d. the Exchange Lists for Meal Planning. ANS: B MyPlate is designed to help clients implement the recommendations of the Dietary Guidelines for Americans. Healthy People 2020 sets national targets for health promotion. SNAP provides funds for individuals and families with low incomes to buy nutritious foods. The Exchange Lists for Meal Planning is intended primarily for patients with diabetes and those who need to lose weight; the system helps patients choose appropriate portion sizes to control their intake of fat, protein, carbohydrate, and energy. DIF: Cognitive Level: Understanding REF: Pages 18-23 | Pages 27-28 TOP: Nursing Process: Planning MSC: Client Needs: Health promotion and maintenance 9. For a client who follows a vegan diet, the most helpful meal planning tool would be a. the Healthy Eating Plate, produced by the Harvard School of Public Health. b. the Mediterranean Diet Pyramid, from Oldways Preservation and Exchange Trust. c . the Power Plate, created by the Physicians Committee for Responsible Medicine. d. Exchange Lists for Meal Planning, from the American Diabetes Association and the American Dietetic A ANS: C The Power Plate is a vegan food planning guide that eliminates all sources of animal foods. The Healthy Eating Plate and Mediterranean Diet Pyramid could be adapted for a vegan diet, but they include meat and dairy options. The Exchange Lists for Meal Planning is intended to help design eating patterns for clients who need to monitor their intake of energy and specific macronutrients, such as clients with diabetes. DIF: Cognitive Level: Applying REF: Pages 22-25 | Pages 27-28 TOP: Nursing Process: Planning MSC: Client Needs: Health promotion and maintenance 10. An indirect benefit of the “Fruits & Veggies—More Matters” program is

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    a. better understanding of fruit and vegetable preparation techniques. b. increased availability of fruits and vegetables in “food deserts.” c. eating more fresh produce in season. d. decreasing dietary fat intake. ANS: D “Fruits & Veggies—More Matters” is designed to increase intake of fruits and vegetables. Fruits and vegetables are naturally low in fat; they would replace higher fat foods in the diet and thus would indirectly decrease dietary fat intake. The program does not address fruit and vegetable preparation techniques, does not target availability of produce in “food desert” areas, and does not address eating fruits and vegetables in season versus out of season. DIF: Cognitive Level: Applying REF: Page 23 | Page 26 | Page 30 TOP: Nursing Process: Implementation MSC: Client Needs: Health promotion and maintenance 11. A meal planning guide that would be helpful for a patient who needs to closely monitor their intake of calories, carbohydrates, protein, and fat is the a. National Fruit and Vegetable Program. b. MyPlate food guidance system. c. Dietary Guidelines for Americans. d. Exchange Lists for Meal Planning. ANS: D In the Exchange Lists for Meal Planning, foods are grouped according to their kilocalorie, carbohydrate, protein, and fat content, and serving sizes that contain specific amounts of each of these are listed. Therefore, this guide can help clients monitor their intake. The National Fruit and

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    Vegetable Program simply encourages increased intake of fruits and vegetables. The Dietary Guidelines for Americans gives general advice but does not translate this into specific amounts of foods. MyPlate would help patients achieve healthy intake of kilocalories, carbohydrate, protein, and fat, but it would not be specific enough for them to monitor their intake closely. DIF: Cognitive Level: Applying REF: Pages 19-23 | Pages 26-28 TOP: Nursing Process: Planning MSC: Client Needs: Health promotion and maintenance 12. One reason that increasing fruit and vegetable consumption helps decrease dietary fat intake is that fruits and vegetables a. are natural appetite suppressants. b. replace high - fat foods in the diet. c. are rich in antioxidants and phytochemicals. d. decrease absorption of fat from foods. ANS: B Fruits and vegetables replace high-fat foods in the diet because they are high in fiber and water; they cause satiety so that clients have less desire for high-fat foods. Fruits and vegetables are not, and do not contain, natural appetite suppressants and do not hinder absorption of fat from foods. They are rich in antioxidants and phytochemicals, but increased intake of these substances does not affect fat intake. DIF:Cognitive Level: UnderstandingREF age 23 | Pages 26-27 TOP: Nursing Process: Assessment MSC: Client Needs: Health promotion and maintenance 13. Why are health professionals concerned about the trend toward eating more food away from home? a. Larger portion sizes often contribute to excessi ve caloric intake.

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    b. Eating away from home means less social interaction. c. Eating out tends to decrease the variety of foods eaten. d. Restaurant meals are associated with more sedentary lifestyles. ANS: A Restaurants and fast food outlets often serve large portions that increase caloric intake. Eating away from home does not necessarily decrease social interaction, inasmuch as families or friends may eat away from home in groups. Eating out does not necessarily decrease the variety of foods eaten, depending on individual food choices. Eating out has not been related to physical activity levels. DIF:Cognitive Level: UnderstandingREF age 21 | Page 29 TOP: Nursing Process: Planning MSC: Client Needs: Health promotion and maintenance 14. If clients want to use the food label to check the number of kilocalories in a product, they should also check the a. calories from fat. b. servings per container. c. Percent Daily Value. d. ingredient list. ANS: B The number of calories in a product is stated for a standard serving size of that food. Clients need to multiply the calories per serving by the number of servings in the container to know how many calories are in the container. The calories from fat are not related to the total number of calories in the food. The Percent Daily Value refers to the nutrient content of the food rather than its caloric value. The ingredient list does not give any information about calories.

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    DIF:Cognitive Level: AnalyzingREF age 32 TOP: Nursing Process: Implementation MSC: Client Needs: Health promotion and maintenance 15. The most useful part of the food label for clients who want to make sure they choose foods high in nutrients is the a. Percent Daily Value. b. health claims. c. organic seal. d. amount of nutrients per serving. ANS: A The Percent Daily Value shows how a food fits into the overall daily diet and would therefore show whether it makes a high or low contribution to nutrient intake. Health claims may indicate that a food has high or low amounts of specific nutrient related to that particular health claim, but they would not indicate overall nutrient content of the food. The organic seal, if present, indicates the farming methods used to grow the food but does not give any information about nutrient content. The amount of nutrients per serving is listed for only some nutrients; the listing would not give any information about vitamins and minerals in the food because these are listed only as Percent Daily Values. DIF:Cognitive Level: ApplyingREF ages 31-35 TOP: Nursing Process: Implementation MSC: Client Needs: Health promotion and maintenance 16. If a client is trying to increase intake of dietary fiber, a useful symbol to look for on the food label would be the a. MyPlate food guidance graphic. b. U.S. Depar tment of Agriculture (USDA) 100% Organic seal. c. “Fruits & Veggies — More Matters” logo.

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    d. 100% Whole Grain stamp. ANS: D Whole grains are an important source of dietary fiber, and so the 100% Whole Grain stamp would help a client select high-fiber foods. Fruits and vegetables also contain high amounts of dietary fiber, but the “Fruits & Veggies—More Matters” logo is not used in labeling individual foods. MyPlate is also not used on food labels. The organic status of a food does not reveal any information about its dietary fiber content. DIF: Cognitive Level: Understanding REF: Pages 21-23 | Page 27 | Pages 33-34 TOP: Nursing Process: Implementation MSC: Client Needs: Health promotion and maintenance 17. The Nutrition Facts panel on a food label is useful for a. determining the ingredients in a product. b. determining the ease of preparing a product. c. comparing the price value of two or more products. d. comparing the nutritional value of two or more products. ANS: D The Nutrition Facts panel on a food label lists the quantities of specific key nutrients in the food and can therefore be used to compare the nutritional value of two or more products. The ingredients are listed elsewhere on the package, rather than in the Nutrition Facts panel. The Nutrition Facts panel does not indicate how easy the food is to prepare and does not include any information about cost or price. DIF:Cognitive Level: UnderstandingREF ages 32-33 TOP: Nursing Process: Implementation MSC: Client Needs: Health promotion and maintenance 18. A pregnant woman may look for a health claim on food labels that links

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    a. sodium intake and risk of stroke. b. calcium intake and risk of osteoporosis. c. folic acid intake and risk of neural tube defects. d. fruit and vegetable intake and risk of heart disease. ANS: C The U.S. Food and Drug Administration has approved use of a health claim stating the relationship between folic acid intake during pregnancy and decreased risk of neural tube defects in infants. It has also approved use of a health claim stating the relationships between (1) calcium intake and (2) decreased risk of osteoporosis, between (1) a diet rich in fiber-containing grain products, fruits, and vegetables and (2) reduced risk of coronary heart disease, and between (1) a diet low in sodium and (2) reduced risk of high blood pressure (not specifically stroke); however, this information is not directly relevant to a pregnant women. DIF:Cognitive Level: ApplyingREF age 35 TOP: Nursing Process: Implementation MSC: Client Needs: Health promotion and maintenance 19. An eating behavior that is most likely to have a negative long-term effect on health is a. a monthly meal out at an expensive restaurant. b. eating French fries with lunch once a week. c. avoiding a specific fruit or vegetable. d. drinking one can of sugar - sweetened beverage every day. ANS: D Small daily practices have a cumulative effect on nutritional health. Eating a rich meal once a month or even ordering French fries once a week will have less overall effect on health than daily habits. It

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