Grodner: Nutritional Foundations and Clinical Applications, 5th Edition

Chapter 01: Wellness Nutrition

Test Bank

MULTIPLE CHOICE

1.	Informal education includes education experiences that occur through daily activities, such as
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.	completing a first aid course at the local Red Cross facility.	

ANS:	B
Watching a television show about diabetes is an example of informal education. Attending a workshop would be considered nonformal education; a high school course or a Red Cross first aid course would be considered formal education.

DIF:	Cognitive Level: Application	REF:	Page 1	
TOP:	Nursing Process: Implementation	
MSC:	Client Needs: Health promotion and maintenance

2.	Health is the merging and balancing of five physical and psychologic dimensions of health that include
a.	psychologic, physical, anthropometric, social, and spiritual dimensions.	
b.	financial, emotional, ethnic, spiritual, and mental dimensions.	
c.	physical, intellectual, emotional, social, and spiritual dimensions.	
d.	physical, economic, ethnic, emotional, and anthropometric dimensions.	

ANS:	C
The five physical and psychologic dimensions of health are physical health, intellectual health, emotional health, social health, and spiritual health.

DIF:	Cognitive Level: Knowledge	REF:	Page 2	
TOP:	Nursing Process: Assessment	
MSC:	Client Needs: Health promotion and maintenance

3.	An example of poor eating habits that may affect emotional health is
a.	eating late at night at the pizza parlor.	
b.	eating six small meals throughout the day.	
c.	eating three meals a day plus two snacks.	
d.	missing meals because of poor planning or being too busy to eat.	

ANS:	D
Missing meals may cause low blood sugar which can cause anxiety or confusion or make it difficult to control emotions.

DIF:	Cognitive Level: Comprehension	REF:	Page 3	
TOP:	Nursing Process: Assessment	MSC:	Client Needs: Psychosocial integrity

4.	A group of strategies used to increase the level of health of individuals, families, groups, and communities is known as
a.	wellness.	
b.	health promotion.	
c.	tertiary prevention.	
d.	nutritional assessment.	

ANS:	B
Strategies used to increase the level of health of individuals, families, groups, and communities are known as health promotion. Wellness refers to a lifestyle that enhances our health. Tertiary prevention is limited to interventions with people who have already developed a disorder. Nutritional assessment is the process of determining nutritional status.

DIF:	Cognitive Level: Knowledge	REF:	Pages 3, 5-6, 11	
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 safe food preparation skills.	
b.	watching a television show exposé about industry errors in food processing.	
c.	labeling fresh poultry packages with information about proper food storage.	
d.	being aware that Salmonella can be spread because of inadequate food preparation skills.	

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: Application	REF:	Page 3	
TOP:	Nursing Process: Implementation	
MSC:	Client Needs: Health promotion and maintenance

6.	An example of a technique for health promotion is
a.	a client who exercises five times a week.	
b.	local supermarkets expanding the availability of fresh fruits and vegetables.	
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 to bring about a change in health, such as teaching a teenager how to choose healthier fast foods. Exercising regularly contributes to wellness, but is not bringing about a change in health unless this is a change in behavior. A wider availability of fresh produce does not promote health, unless the supermarket uses specific strategies to encourage their consumption. Information about the relationship between nutrients and disease is simply information unless it is used to promote behavior change.

DIF:	Cognitive Level: Application	REF:	Page 3	
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. Fiber and minerals are both needed, but each only represents one type of nutrient. Supplements are not always necessary because sufficient nutrients can often be obtained from food.

DIF:	Cognitive Level: Comprehension	REF:	Pages 7, 9	
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 more than 50 years old.	
c.	dietary guidelines recommended for older adults.	
d.	MyPyramid 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 Guidelines for Americans and MyPyramid are separate documents from Healthy People 2020.

DIF:	Cognitive Level: Comprehension	REF:	Pages 4-5, 10		
TOP:	Nursing Process: Planning	
MSC:	Client Needs: Health promotion and maintenance

9.	A healthy female client asks what she can do to prevent the development of type 2 diabetes. The strategies you discuss with her are considered
a.	primary treatment.	
b.	primary prevention.	
c.	secondary prevention.	
d.	tertiary prevention.	

ANS:	B
Prevention of the development of type 2 diabetes before the disorder develops 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: Application	REF:	Page 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 or diet therapy developed for him by the hospital dietitian is
a.	primary treatment.	
b.	primary prevention.	
c.	secondary prevention.	
d.	tertiary prevention.	

ANS:	D
This is an example of tertiary prevention to minimize complications and help 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. Primary treatment is not a recognized term.

DIF:	Cognitive Level: Planning	REF:	Page 6	
TOP:	Nursing Process: Implementation	
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: Knowledge	REF:	Pages 7-8	
TOP:	Nursing Process: Assessment	MSC:	Client Needs: Physiological integrity

12.	Nutrients that do not yield energy include
a.	minerals, vitamins, and water.	
b.	protein, water, and vitamins.	
c.	water, vitamins, and carbohydrates.	
d.	minerals, vitamins, and protein.	

ANS:	A
Minerals, vitamins, and water are all nutrients that do not yield energy. Protein and carbohydrates both yield energy; each provides 4 kcals per gram.

DIF:	Cognitive Level: Comprehension	REF:	Pages 7-9	
TOP:	Nursing Process: Assessment	MSC:	Client Needs: Physiological integrity

13.	Glucose is the
a.	sweetest of all sugars.	
b.	most efficient form of energy for the brain.	
c.	only carbohydrate found in fruits and sugars.	
d.	carbohydrate to avoid to prevent diabetes.	

ANS:	B
Glucose provides the most efficient form of energy for the brain (and muscles too). Fructose and sucrose are both sweeter than glucose so it is not the sweetest sugar. Various other carbohydrates are found in fruits and sugars. Avoiding glucose does not prevent diabetes.

DIF:	Cognitive Level: Knowledge	REF:	Page 8	
TOP:	Nursing Process: Assessment	MSC:	Client Needs: Physiological integrity

14.	The nutrient that provides the highest number of kcals per gram is
a.	protein.	
b.	alcohol.	
c.	fat.	
d.	carbohydrate.	

ANS:	C
Fat provides the highest number of kcals: 9 per gram. Protein and carbohydrate each provide 4 kcals per gram. Alcohol provides 7 kcals per gram

DIF:	Cognitive Level: Comprehension	REF:	Page 8	
TOP:	Nursing Process: Assessment	
MSC:	Client Needs: Health promotion and maintenance

15.	A cup of frozen yogurt contains 24 g carbohydrate, 2 g fat, and 4 g protein. The total number of kcals in the frozen yogurt is
a.	110.	
b.	130.	
c.	140.	
d.	162.	

ANS:	B
24 g carbohydrate provides 24 ´ 4 = 96 kcals. 2 g fat provides 2 ´ 9 = 18 kcals. 4 g protein provides 4 ´ 4 = 16 kcals. Therefore the total kcals in the frozen yogurt is 96 + 18 + 16 = 130 kcals.

DIF:	Cognitive Level: Application	REF:	Page 8	
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: Knowledge	REF:	Pages 8-9	
TOP:	Nursing Process: Assessment	MSC:	Client Needs: Physiological integrity

17.	Amino acids that must be consumed from plant and animal foods are called _____ amino acids.
a.	nonessential 	
b.	essential	
c.	formative	
d.	biologic 	

ANS:	B
Amino acids that must be consumed from plant and animal foods are called essential amino acids. Nonessential amino acids can be formed by the body from other nutrients. Formative amino acids and biologic amino acids are not recognized terms.

DIF:	Cognitive Level: Knowledge	REF:	Page 8	
TOP:	Nursing Process: Assessment	MSC:	Client Needs: Physiological integrity

18.	Lipids provide the best source of
a.	essential amino acids.	
b.	body-building materials.	
c.	glucose for the brain.	
d.	dense energy for the body.	

ANS:	D
Because lipids provide more energy per gram than any other nutrient (lipids provide 9 kcals per gram; protein and carbohydrate provide 4 kcals per gram and alcohol provides 7 kcals per gram), they are the best source of dense energy for the body. They do provide some body-building materials: phospholipids are an important part of the structure of cell membranes. However proteins and minerals probably contribute more than lipids to building body structure. Lipids cannot be converted to glucose in the body.

DIF:	Cognitive Level: Comprehension	REF:	Pages 8-9	
TOP:	Nursing Process: Planning	MSC:	Client Needs: Physiological integrity

19.	The category of nutrients that has a role in the production of hormones and helps protect body organs is
a.	lipids.	
b.	fibers.	
c.	protein.	
d.	carbohydrates.	

ANS:	A
Many lipids are used in the body to form hormones and lipids provide a protective layer of padding around body organs. Dietary fiber does not leave the gastrointestinal tract. Protein is an important part of many body structures but does not necessarily protect body organs; proteins may act as carriers for hormones, but are not used to make the hormones themselves. Carbohydrates are a source of energy and have no real role in body structure or hormonal regulation.

DIF:	Cognitive Level: Comprehension	REF:	Page 8	
TOP:	Nursing Process: Analysis	MSC:	Client Needs: Physiological integrity

20.	Triglycerides, phospholipids, and sterols are categories of
a.	lipids.	
b.	vitamins.	
c.	minerals.	
d.	carbohydrates.	

ANS:	A
Lipids are made up of triglycerides, phospholipids, and sterols. Categories of vitamins are fat soluble and water soluble. Minerals are divided into major minerals and trace minerals. Carbohydrates are simple carbohydrate, complex carbohydrates, and dietary fiber.

DIF:	Cognitive Level: Knowledge	REF:	Pages 8-9	
TOP:	Nursing Process: Analysis	MSC:	Client Needs: Physiological integrity

21.	Water soluble and fat soluble describe the two classes of
a.	fiber.	
b.	vitamins.	
c.	minerals.	
d.	carbohydrates.	

ANS:	B
Vitamins are either water soluble or fat soluble. Dietary fiber is indigestible carbohydrate. Minerals are classified as major minerals or trace minerals. Carbohydrates are simple carbohydrate, complex carbohydrates, and dietary fiber.

DIF:	Cognitive Level: Knowledge	REF:	Pages 8-9	
TOP:	Nursing Process: Assessment	MSC:	Client Needs: Physiological integrity

22.	A category of nutrients that assists other nutrients with metabolic functions throughout the body is
a.	water.	
b.	protein.	
c.	vitamins.	
d.	minerals.	

ANS:	C
Vitamins indirectly assist other nutrients through the complete processes of digestion, absorption, metabolism, and excretion. Water provides a fluid medium and a transport system for body processes. Protein makes up many body structures, enzymes, and components of the immune system. Minerals serve structural purposes and are found in body fluids.

DIF:	Cognitive Level: Comprehension	REF:	Pages 8-9	
TOP:	Nursing Process: Assessment	MSC:	Client Needs: Physiological integrity

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: Comprehension	REF:	Pages 8-9	
TOP:	Nursing Process: Assessment	MSC:	Client Needs: Physiological integrity

24.	If a mine worker was 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
a.	protein.	
b.	carbohydrate.	
c.	water.	
d.	vitamins.	

ANS:	C
The body can only survive a few days without water. The body may not function optimally without other nutrients, but can survive many days and even weeks without them.

DIF:	Cognitive Level: Application	REF:	Pages 8-9	
TOP:	Nursing Process: Assessment	MSC:	Client Needs: Physiological integrity

25.	Combining classic concerns of deficiency diseases with interest to reduce the risk of chronic diet-related diseases is the focus of the
a.	Healthy People 2020.	
b.	Dietary Reference Intakes (DRIs).	
c.	Tolerable Upper Intake Level (UL).	
d.	Estimated Energy Requirement (EER).	

ANS:	B
DRIs combine the classic concerns of deficiency diseases that were the original focus of nutrient recommendations with the contemporary interest to reduce the risk of chronic diet-related diseases such as coronary artery disease, cancer, and osteoporosis. UL is the level of nutrient intake that should not be exceeded to prevent adverse health risks. The EER aims to maintain good health by providing energy intake levels to maintain individuals’ body weights within specific age, gender, height, weight, and physical activity categories. Healthy People 2020 seeks to strengthen policy and practice to improve health.

DIF:	Cognitive Level: Comprehension	REF:	Pages 4, 10-11	
TOP:	Nursing Process: Assessment	
MSC:	Client Needs: Health promotion and maintenance

26.	The best course of action to provide adequate amounts of vitamins and minerals is to
a.	promote weight loss.	
b.	eat a variety of foods.	
c.	eat at least 3 meals per day.	
d.	consume a high-fiber, low-fat diet.	

ANS:	B
Including a variety of foods increases the likelihood of obtaining adequate amounts of vitamins and minerals. Loss of weight will not contribute to adequate nutrient intake. Eating at least 3 meals per day may help increase nutrient intake to some extent, but they could still be meals that provide a limited assortment of foods. Similarly, a high-fiber, low-fat diet could consist of foods that are relatively low in vitamins and minerals.

DIF:	Cognitive Level: Application	REF:	Page 11	
TOP:	Nursing Process: Planning	
MSC:	Client Needs: Health promotion and maintenance

27.	If a nurse wants to evaluate a client’s dietary intake, he or she may use
a.	anthropometric measurements, 24-hour recall, and/or a food record.	
b.	computer dietary analysis and biochemical laboratory testing.	
c.	diet history, a food record, and/or computer dietary analysis.	
d.	measurements of limbs, analysis of body fluids, and a diet history.	

ANS:	C
Methods to assess dietary intake include use of a diet history, a food record, and/or computer-assisted dietary analysis. Anthropometric measurements (including measurements of limbs) and biochemical laboratory testing (including analysis of body fluids) are used to help assess nutritional status, but not dietary intake.

DIF:	Cognitive Level: Application	REF:	Pages 14-15	
TOP:	Nursing Process: Assessment, Evaluation		
MSC:	Client Needs: Physiological integrity		

28.	If a nurse wants to assess a client’s nutritional status, he or she may use
a.	dietary standards, dietary behaviors, Acceptable Macronutrient Distribution Ranges, and biochemical analysis.	
b.	biochemical analysis, food records, computerized dietary analysis, and Tolerable Upper Intake Level.	
c.	Recommended Dietary Allowances, clinical examination, psychosocial behaviors, and risk assessment.	
d.	dietary evaluation, clinical examination, biochemical analysis, and anthropometric measurements.	

ANS:	D
Nutritional status is assessed using a combination of dietary evaluation, clinical examination, biochemical analysis, and anthropometric measurements. Dietary standards Acceptable Macronutrient Distribution Ranges, Tolerable Upper Intake Level, and Recommended Dietary Allowances may be used to evaluate data obtaining using these methods. Dietary behaviors, psychosocial behaviors, food records, and computerized dietary analysis may be used as part of dietary evaluation.

DIF:	Cognitive Level: Application	REF:	Page 15	
TOP:	Nursing Process: Assessment, Evaluation		
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 they would be described as having
a.	malnutrition.	
b.	nonnutrition.	
c.	overnutrition.	
d.	disordered eating.	

ANS:	A
An imbalance of nutrients and/or energy (in this case, high intake of some nutrients and low intake of energy) is called malnutrition. Overnutrition only refers to excessive intake or nutrients and/or energy. Disordered eating refers to unusual eating habits that may or may not lead to some form of malnutrition. Nonnutrition is not a recognized term.

DIF:	Cognitive Level: Application	REF:	Page 14	
TOP:	Nursing Process: Assessment	MSC:	Client Needs: Physiological integrity

30.	A professional trained in normal and clinical nutrition, food science, and food service management who is credentialed by the Commission on Dietetic Registration of the American Dietetic Association is a
a.	registered nurse (RN).	
b.	registered dietitian (RD).	
c.	clinical nutritionist (CN).	
d.	certified home economist (CHE).	

ANS:	B
Only registered dietitians meet these professional standards. Clinical nutritionists have a masters or doctoral degree in nutrition but do not have the other credentials. A registered nurse does not have in-depth clinical nutrition, food science, and food service training. Certified home economists do not have clinical nutrition training.

DIF:	Cognitive Level: Knowledge	REF:	Page 15	
TOP:	Nursing Process: Planning	
MSC:	Client Needs: Safe and effective care environment