NR 228 Nutrition, Health and Wellness Comprehensive Guide (Week 1 To 8) (Fully Covered) Revised 2023/2024 (Chapter 1-17)

Ch. 1 (Wellness Nutrition) Which of the following shows a possible relationship between intellectual and social health? A. A child with iron deficiency and poor attention span in school B. A teenager overeating after a break-up of a relationship and skipping family dinner time because she isn't hungry C. A mother on a tight budget spending twice as much money on fresh produce at a nearby convenience store rather than at a distant grocery store and experiencing repeated headaches at night D. A college student binge drinking on the weekend with friends and earning poor grades as a result of a lack of studying A recently diagnosed patient with diabetes is taught that vegetables are a low-carbohydrate food and all but a few can be eaten without restriction. He is encouraged to buy more vegetables at his nutrition consultation. However, he lives in an apartment complex that is over a mile away from any grocery store, and his only mode of transportation is his electric wheelchair. This living environment is an example of which of the following? A. Nutrient disparity B. Poor socioeconomic status C. Food desert D. Health illiteracy A 65-year-old patient who is diagnosed with type 2 diabetes mellitus walks briskly for 30 minutes each day. This exercise helps control blood glucose levels and decreases the need for medication. This disease prevention would best fit into which one of the following classifications? A. Primary B. Secondary C. Tertiary D. Quaternary Establishing priorities, setting realistic and measurable outcomes, and choosing interventions are all part of which step in the nursing process? A. Assessment B. Diagnosis C. Planning D. Implementation E. Evaluation Both carbohydrates and proteins provide approximately ___4_____ kilocalories per gram. Ch. 2 (Personal & Community Nutrition) During your nursing assessment of a patient who is pregnant, you find she has low folate levels. Upon further inquiry, you also find she has little income and eats few fresh fruits and vegetables because of their cost. To which government-funded program(s) could you refer her? A. Supplemental Nutrition Assistance Program (SNAP) B. Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) C. School Lunch Program D. Medicare E. Both a and b F. Both b and d The Nutrition Facts label is based on a 2000-calorie diet. For which age group is it most appropriate? A. 2 to 12 years of age B. 13 to 18 years of age C. 40 to 60 years of age D. 75 to 90 years of age The U.S. Food and Drug Administration (FDA) regulates food labeling, as well as dietary supplement labeling. However, a difference exists between how the two labels are regulated. What is this difference? A. Dietary supplement labels can contain claims concerning the prevention of a disease, whereas food labels cannot. B. Dietary supplement labels can contain claims concerning the treatment of a disease, whereas food labels cannot. C. Dietary supplements must be proven unsafe before they can be removed from the market. D. Dietary supplements must be proven safe before they can be sold on the market. What is the definition of "light" when found on a food label? A. Contains no more than 3 grams of fat per serving. B. Contains 25% less of a nutrient or calories. C. Contains no more than 10 grams of fat per serving. D. Contains one third fewer calories or one half the fat of the original product. Using the exchange group nutrient values, the following meal would contain approximately ___52_____ grams of carbohydrates: one serving of fat-free milk, two servings of a vegetable, one serving of a lean meat, and two servings of fruit. Ch. 3 (Digestion, Absorption, Metabolism) Once a gallbladder has been removed, what organ is then solely responsible for releasing the bile needed for fat digestion? A. Liver B. Pancreas C. Stomach D. Duodenum A patient tells you that he has intense heartburn on a regular basis. As he is describing what it feels like, you realize he is most likely experiencing gastroesophageal reflux disease (GERD). Which muscle in his digestive tract is most likely weakened and releasing stomach acid into his esophagus? A. Parotid gland B. Hepatic muscularis C. Diaphragm D. Cardiac sphincter What approximate percentage of carbohydrate, protein, and fat does a healthy human gastrointestinal tract absorb during the process of digestion and absorption? A. 65% B. 75% C. 85% D. 95% During the process of metabolism, which nutrients directly enter the lymphatic system from the gastrointestinal tract? A. Carbohydrates and fat-soluble vitamins B. Carbohydrates and small parts of broken-down lipids C. Proteins and fat-soluble vitamins D. Fat-soluble vitamins and large lipids Ch. 9 (Energy, Weight, & Fitness) Adequate stores of muscle glycogen would be most important for which athlete? A. Marathon runner B. 100-meter sprinter C. 400-meter sprinter D. High jumper Given that each individual is in a healthy mental and physical state, who will most likely have the highest basal metabolic rate (BMR)? A. 25-year-old professional male athlete B. 22-year-old female distance runner C. 77-year-old male farmer D. 45-year-old female construction worker A female dancer, 19, enters a clinic with a small bone fracture in her foot. The following preliminary information is collected: body mass index (BMI): 17, 12% body fat. What other symptom is she probably experiencing? A. Muscle hypertrophy B. Amenorrhea C. Hyperlipidemia D. Sleep apnea Ch. 4 (Carbohydrates) A 29-year-old patient with a body mass index (BMI) of 36 (Category II Obese) wants to start a lowcarbohydrate diet. Which recommendation would ensure the patient follows the dietary reference intakes (DRIs) and acceptable macronutrient distribution ranges (AMDRs) for carbohydrate intake? A. Carbohydrate consumption needs to account for at least 35% of the total kilocalorie intake. B. Consuming 80 g of carbohydrates each day will meet metabolic needs. C. Carbohydrate consumption needs to account for at least 45% of the total kilocalorie intake. D. Consuming 130 g of carbohydrates each day will meet metabolic needs. E. Both a and b F. Both c and d A patient asks whether blood sugar is the same type of sugar that he added to his cereal earlier that morning. You respond by telling him that table sugar is actually called which of the following? A. Glucose B. Maltose C. Starch D. Sucrose What are possible outcomes for dietary glucose once it has been absorbed? A. Used directly for energy in cells. B. Converted to protein, and then stored in muscle. C. Converted to fat, and then stored in lipocytes. D. Converted to glycogen, and then stored in the liver. E. a, c, and d F. b, c, and d A mother is concerned her daughter with phenylketonuria (PKU) is consuming phenylalanine, an amino acid that causes serious side effects in patients with PKU. The mother provides a list of the beverages her daughter consumes on a regular basis. Which of the following drinks contains phenylalanine and should be immediately excluded from her daughter's diet? A. Orange juice sweetened with fructose B. Pepsi sweetened with Splenda C. Herbal tea sweetened with Equal D. Sprite sweetened with saccharin Which of the following health problems is directly related to an overconsumption of sugars, specifically table sugar? A. Dental caries B. Obesity C. Type 2 diabetes mellitus D. Attention deficit/hyperactivity disorder (ADHD) Ch. 8 (Water & Minerals) A sprinter on a track-and-field team loses body water through insensible perspiration after a 400-meter race. Through which organ(s) does the majority of this water loss, or output, occur? A. Kidney B. Skin C. Large intestine D. Lungs E. a, c, and d F. b and d If the hypothalamus is not functioning normally and releases too little antidiuretic hormone, the individual is suffering from what? A. Hypothermia B. Dehydration C. Edema D. Homeostasis A person diagnosed with osteoporosis needs adequate amounts of which vitamin for calcium absorption from the small intestine? A. Vitamin D B. Biotin C. Vitamin C D. Vitamin B12 A pregnant patient from a rural part of the state tells you at her first check-up (16 weeks' gestation) that the cornstarch she uses to make gravy looks delicious to her. She has eaten tablespoons of it mixed with small amounts of water several times. She asks you if this is normal. You explain she is actually deficient in which of the following? A. Selenium B. Magnesium C. Iron D. Phosphorous The adequate intake of water for women is ___9______ cups per day. Ch. 5 (Fats) A patient at a long-term care facility has been receiving long-term total parenteral nutrition (TPN) because of gut immobility. He has developed skin lesions on his neck, underarms, and groin. You are asked to review his TPN solution. The label does not list linoleic or linolenic acid; however, all of the other macronutrients are listed in adequate quantities. What is one possible diagnosis for the development of these lesions? A. Diet deficient in essential amino acids B. Diet deficient in carbohydrates C. Diet deficient in essential fatty acids D. Diet deficient in triglycerides A patient wants to decrease the amount of saturated fat in her diet while increasing the amount of omega-6 or linoleic acid. She is currently using butter as her fat of choice. Which oil would you recommend she start using for baking and sautéing? A. Canola oil B. Palm oil C. Olive oil D. Coconut oil Which of the following foods will most likely contribute to increased blood cholesterol levels? A. Eggs B. Shrimp C. Bacon D. Oysters A food label lists "partially hydrogenated fat" in the ingredient list. This wording indicates that the food product contains which one of the following? A. Trans fat B. Saturated fat C. Monounsaturated fat D. Polyunsaturated fat A patient needs 2000 kilocalories per day; 25% of these calories should come from fat. Approximately how many total grams of fat should the patient eat? A. 42 B. 52 C. 55 D. 65 Ch. 6 (Protein) Which enzyme found in the stomach of infants aids in milk coagulation, allowing for a longer absorption or transit time? A. Pepsin B. Pepsinogen C. Rennin D. Trypsin A patient recently started following a high-protein, low-carbohydrate diet. The first week he lost 5 pounds, but currently in the fourth week, he has only lost 1 pound. He is confused about why this is happening since he has not changed eating or exercise habits. What is one probable reason as it related to protein metabolism? A. During the first week, he lost the majority of weight from water, attributable to excess urea excretion. B. During the first week, he lost the majority of weight from fat, attributable to protein catabolism. C. During the fourth week, the majority of the weight he lost was from glycogen excretion, attributable to lipid catabolism. D. During the fourth week, the majority of the weight he lost was from fat, attributable to protein anabolism. Which patient would most likely be in positive nitrogen balance? A. A patient 5 months along in her pregnancy B. An adult patient in the psychiatry ward C. A patient visiting the outpatient clinic for weight loss education D. A patient with Type 2 diabetes mellitus Which nutrients would most likely be deficient in a person following a vegan diet, given no supplementation? A. Vitamin D, vitamin C, and iron B. Vitamin E, iron, and vitamin B12 C. Vitamin B12, iron, and calcium D. Vitamin E, calcium, and zinc A 150-pound athlete should eat no more than __116_____ grams of protein per day (rounded to the nearest whole number). Ch. 7 (Vitamins) Which vitamin would be directly absorbed into the lymphatic system? A. Vitamin C B. Vitamin B12 C. Choline D. Vitamin E A patient with leukemia undergoing cancer treatment is most likely to become deficient in which vitamin? A. Folate B. Vitamin K C. Vitamin C D. Iron Which of the following foods would you recommend to a pregnant woman in her first trimester to ensure that she consume adequate amounts of folate? A. Dry breakfast cereal B. Cheddar cheese C. Chili with beans D. Pineapple E. a and c F. b and d Warfarin has been prescribed to a patient recovering from a triple bypass surgery of the heart. A specific dose has been recommended, based on his present food consumption pattern that needs to remain constant to ensure that the warfarin will work as intended. Which of the following foods should he regulate and eat in moderation as a result of this medication? A. Apples B. Oranges C. Spinach D. Sweet potato Ch. 10 (Nutrition Across the Lifespan) A pregnant patient is experiencing constipation and asks if this is normal. Constipation is normal and leads to increased absorption of nutrients, particularly iron and calcium, and is caused by an increased production of what hormone? A. Thyroxine B. Human placental lactogen C. Progesterone D. Estrogen An 18-year old African-American patient enters the clinic. She is 21 weeks pregnant. She has been experiencing dizziness, headaches, severe nausea, and small amounts of blood in her urine. Her hands, face, and feet look puffy. What is a possible diagnosis for these symptoms? A. Diabetes mellitus B. Foodborne illness C. Maternal phenylketonuria D. Preeclampsia The hormones progesterone, estrogen, and human chorionic gonadotropin all signal what to occur during pregnancy? A. Increased glucose circulation and increased immune response B. Increased glucose circulation and decreased immune response C. Decreased glucose circulation and increased immune response D. Decreased glucose circulation and decreased immune response Which of the following foods is/are a choking hazard to a young child? A. Grapes B. Hot dog C. Applesauce D. Peanut butter and jelly sandwich E. b and d F. a and b Ch. 11 (Nutrition Assessment & Patient Care) Which patient would be at high risk for developing malnutrition in a hospitalized setting? A .Patient on intravenous feedings that contain only glucose and saline B. Patient receiving food through a nasogastric tube for longer than 24 hours C. Patient on a clear-liquid diet for longer than 24 hours D. Patient on a soft-food diet for longer than 3 days E. a and c F. b and c Measuring recumbent bed height falls under which key area of patient assessment? A. Anthropometrics B. Biochemical tests C. Clinical observations D. Diet evaluation E. a and c F. b and c Upon admission to the hospital, a patient weighs 145 pounds. His usual weight is 165 pounds; he has lost 20 pounds in the last 3 months. What is this patient's risk category for malnutrition? A. No risk B. Low risk C. Moderate risk D. High risk A female patient fs laboratory report shows a creatinine level of 1.6 mg/dL. This level is indicative of which disease? A. Diabetes mellitus B. Liver failure C. Hypokalemia D. Renal disease A patient has been taking naproxen twice a day to relieve pain associated with arthritis for the past 5 years. To avoid liver toxicity or stomach bleeding, the patient is advised to limit the intake of: A. Dairy products B. Grapefruit juice C. Alcohol D. Foods high in vitamin K Ch. 14 (Nutrition for Disorders of the Liver, Gallbladder, & Pancreas) A homeless person living in a crowded outdoor colony with no access to bathrooms is exhibiting diarrhea, vomiting, jaundice, and dark urine. Which type of hepatitis is most likely responsible for these symptoms? A. A B. B or C C. D D. A or E Limiting fruit intake follows appropriate nutrition therapy for a patient with which condition? A. Hepatitis A B. Cirrhosis C. Nonalcoholic steatohepatitis D. Pancreatitis A patient with cirrhosis has a swollen distended abdomen. Which nutrition therapy is most appropriate for this condition? A. Limit fat intake. B. Increase probiotics intake. C. Limit protein intake. D. Restrict sodium to less than 2000 mg per day. Which of the following is a risk factor for the development of gallstones? A. Age 30 years and older B. High-carbohydrate diet C. After a very low-calorie diet D. Male gender Ch. 15 (Nutrition for Diabetes Mellitus) When blood glucose levels are low, the pancreas releases: A. Insulin; fat cells then take in glucose from the blood. B. Insulin; the liver then releases glucose into the blood. C. Glucagon; fat cells then take in glucose from the blood. D. Glucagon; the liver then releases glucose into the blood. A patient's laboratory work shows a hemoglobin A1C level of 5.9%. After an oral glucose tolerance test, his blood glucose is recorded at 178 mg/dL. This patient is diagnosed with which condition? A. Gestational diabetes B. Prediabetes C. Type 1 diabetes (T1DM) D. Type 2 diabetes (T2DM) A high-school student with T1DM boluses before his lunchtime meal with short-acting insulin. How long should he wait before joining his gym class in a 1-mile run? A. Strenuous exercise is not recommended for those with T1DM. B. Waiting for any amount of time is not needed because this student bolused with short-acting insulin. C. This student should wait 30 to 60 minutes before exercising. D. This student should wait 2 or more hours before exercising. A diabetic patient presents with vomiting and abdominal pain. She has also had heartburn for the last two days and feels like she is losing weight. You look at her medical history and find she has taken the drug Reglan in the past. What is a probable diagnosis for this patient? A. Metabolic Syndrome B. Gastroparesis C. Acanthosis nigricans D. Poly cystic ovary syndrome Ch. 16 (Nutrition in Metabolic Stress: Burns, Trauma, & Surgery) Which stress-altering hormone stimulates the use of fat for energy? A. Antidiuretic hormone B. Adrenocorticotropic hormone C. Norepinephrine D. Aldosterone A patient recovering from trauma is a devout member of a faith that practices fasting on a routine basis. The usual fasting time is 24 hours, once a month. If he decides to fast during recovery, where will the majority of his energy come from during the first 24 hours of fasting? A. Liver glycogen stores are the prime source of glucose. B. Fatty stores are the prime source of glucose. C. Protein stores are the prime source of glucose. D. Muscle glycogen stores are the prime source of glucose. A patient with a stage IV pressure ulcer in a nursing home is in need of special nutrition care. Which vitamins and minerals are of particular importance for healing? A. Vitamin B12, zinc, and calcium B. Vitamin C, zinc, and calcium C. Vitamin C, vitamin A, and zinc D. Vitamin A, zinc, and calcium Ch. 17 (Nutrition for Cardiopulmonary Diseases) Lovastatin is used to treat which condition? A. Cardiovascular disease B. Hypertension C. Dyslipidemia D. Chronic obstructive pulmonary disease As part of the Therapeutic Lifestyle Changes (TLC) diet, it is advised that butter be replaced with which of the following fats? A. Olive oil B. Almond butter C. Lard D. Cream E. Both a and b F. Both a and d A woman with a total cholesterol level of __________, an LDL level of __________, and an HDL level of _________ has optimal cholesterol levels. A. 188; 98; 38 B. 219; 122; 45 C. 150; 109; 25 D. 172; 79; 51 Ch. 20 (Nutrition in Cancer & HIV/AIDS) The process of cancer spreading from one organ, such as the colon, to another organ, such as the lungs, is called _______________. A. Metastasis B. Cachexia C. Carcinogenesis D. Mucositis Which cells in the body have a rapid turnover rate, particularly of concern during chemotherapy? A. Muscle cells B. Bone marrow cells C. Cells of the intestinal tract D. Cells of the mouth E. a, c and d F. b, c, and d Which food would best be tolerated by a patient with cancer who is experiencing nausea and vomiting? A. Freezer pop B. Banana C. Potato chips D. White bread Which of the following is a high-risk food for the patient with an immunosuppressed system? A. Store-bought cookie dough B. Peanut butter and jelly sandwich C. Greek salad with feta cheese D. Shrimp scampi A 150-pound person with human immunodeficiency virus (HIV) who involuntarily loses 25 pounds over 6 months has lost __17_____% of usual weight and is at nutritional risk.