Ch. 30

Question 1

A nurse is caring for a patient with a malabsorption disorder. The nurse understands that which of the following processes is impaired in this patient?

A) The chemical breakdown of food in the stomach.
B) The movement of nutrients from the digestive tract into the bloodstream.
C) The wavelike muscular movement that propels food through the intestines.
D) The body’s use of energy to build complex substances from simple materials.

Answer 1

Answer: B

Rationale: The provided text defines absorption as the “movement of the smaller elements through the walls of the digestive tract and into the blood.” Malabsorption directly relates to an impairment of this process. Option A refers to digestion. Option C describes peristalsis. Option D defines anabolism.

Question 2

A nursing student is reviewing the digestive process. Which of the following statements correctly describes the role of absorption?

A) “It is the process of breaking down food into smaller particles.”
B) “It primarily occurs in the stomach where food is mixed with gastric juices.”
C) “It is the movement of digested nutrients into the bloodstream for use by the body.”
D) “It is the elimination of waste products from the body.”

Answer 2

Answer: C

Rationale: According to the nursing textbook, absorption is the process where smaller elements (nutrients) move through the walls of the digestive tract and into the blood. Option A is the definition of digestion. While some absorption can occur in the stomach, the primary site for nutrient absorption is the small intestine. Option D describes elimination.

Question 3

A nurse is educating a patient about the importance of protein in their diet. The nurse explains that the building blocks of protein are which of the following?

A) Fatty acids
B) Monosaccharides
C) Amino acids
D) Nucleic acids

Answer 3

Answer: C

Rationale: The textbook defines amino acids as the “building blocks” of proteins. Fatty acids are the building blocks of fats (lipids). Monosaccharides are the basic units of carbohydrates. Nucleic acids are the building blocks of DNA and RNA.

Question 4

Anabolism
A nurse is explaining the concept of metabolism to a patient. Which of the following statements by the nurse accurately describes anabolism?

A) “It is the process of breaking down complex substances into simpler ones to release energy.”
B) “It is the use of energy to build complex substances from simpler ones, like when our bodies build muscle.”
C) “It is the minimum amount of energy your body needs to function at rest.”
D) “It is the process of moving nutrients from the intestine into the bloodstream.”

Answer 4

Answer: B

Rationale: The textbook describes anabolism as “the use of energy to change simple materials into complex body substances and tissue.” This is a constructive process, such as building muscle mass. Option A describes catabolism. Option C defines the basal metabolic rate (BMR). Option D is the definition of absorption.

Question 5

Anorexia
A nurse is caring for an older adult patient who has lost interest in food and has a significantly decreased appetite. The nurse documents this finding as which of the following?

A) Anorexia nervosa
B) Bulimia nervosa
C) Cachexia
D) Anorexia

Answer 5

Answer: D

Rationale: The term anorexia refers to a general loss of appetite. While it is a symptom of anorexia nervosa, it is not the eating disorder itself. Bulimia nervosa involves bingeing and purging. Cachexia is physical wasting associated with chronic illness. In this context, the patient’s loss of appetite is best described as anorexia.

Question 6

A nurse is assessing a 19-year-old female who is significantly underweight, expresses an intense fear of gaining weight, and has a distorted body image. The nurse recognizes these as hallmark signs of which eating disorder?

A) Binge-eating disorder
B) Bulimia nervosa
C) Anorexia nervosa
D) Pica

Answer 6

Answer: C

Rationale: The textbook characterizes anorexia nervosa as a serious disorder involving an altered mental state, a distortion of body image, and an intense fear of gaining weight, leading to life-threatening practices. Binge-eating disorder involves consuming large amounts of food without purging. Bulimia nervosa involves a cycle of bingeing and purging. Pica is the craving and consumption of non-food substances.

Question 7

Anthropometry
A nurse in a pediatric clinic is performing a nutritional assessment on an infant. Which of the following measurements is a component of anthropometry?

A) Serum albumin level
B) 24-hour dietary recall
C) Head circumference
D) Auscultation of bowel sounds

Answer 7

Answer: C

Rationale: The textbook defines anthropometry as “the study of measurements of the human body.” For infants, these measurements include height, weight, length, and head circumference. Serum albumin is a lab value, a 24-hour recall is part of a diet history, and auscultating bowel sounds is part of a physical exam, but not specifically anthropometry.

Question 8

A nurse is caring for a patient with dysphagia (difficulty swallowing). The nurse implements precautions to prevent which of the following complications?

A) Aspiration
B) Dehydration
C) Malnutrition
D) Constipation

Answer 8

Answer: A

Rationale: The textbook defines aspiration as the “inhalation of fluid or foreign matter into the lungs and bronchi.” Patients with dysphagia are at a high risk for aspiration, which can lead to serious complications like pneumonia. While dehydration, malnutrition, and constipation can be related to dysphagia, the immediate and most life-threatening risk the nurse’s precautions address is aspiration.

Question 9

A nurse is explaining energy needs to a patient who has been sedentary for several weeks due to an injury. The nurse correctly explains that the body still requires a certain number of calories for critical functions even while at rest. This minimum energy requirement is known as:

A) Anabolism
B) Catabolism
C) Basal metabolic rate (BMR)
D) Kilocalorie expenditure

Answer 9

Answer: C

Rationale: The textbook defines the basal metabolic rate (BMR) as “the minimum amount of energy required to maintain body functions in the resting, awake state.” Anabolism is the process of building complex substances, catabolism is the breakdown of substances, and kilocalorie is a unit of energy, not the rate of expenditure at rest.

Question 10

A nurse is assessing a patient with a suspected eating disorder who reports consuming excessive amounts of food in one sitting, often feeling out of control. The nurse identifies this behavior as which of the following?

A) Purging
B) Anorexia
C) Bingeing
D) Grazing

Answer 10

Answer: C

Rationale: The textbook defines bingeing in the context of bulimia nervosa as “the intake of excessive amounts of food.” Purging is the act of self-induced vomiting or misuse of laxatives that often follows a binge. Anorexia is a loss of appetite. Grazing involves eating small amounts of food continuously throughout the day.

Question 11

A nurse calculates that a 45-year-old male patient has a body mass index (BMI) of 32.5 kg/m². Based on this finding, the nurse would classify the patient as:

A) Underweight
B) Normal weight
C) Overweight
D) Obese

Answer 11

Answer: D

Rationale: According to the textbook, obesity in adults is defined as a body mass index (BMI) of 30 or higher. A BMI less than 18.5 is underweight, 18.5 to 24.9 is normal weight, and 25.0 to 29.9 is overweight.

Question 12

A college health nurse is screening students for eating disorders. Which of the following descriptions from a student would be most indicative of bulimia nervosa?

A) “I am terrified of gaining weight, so I severely restrict my calories and exercise for hours every day.”
B) “I get these uncontrollable urges to eat huge amounts of food, like a whole pizza and a gallon of ice cream, and then I make myself throw up.”
C) “I’ve lost my appetite completely since my mom got sick and have lost 15 pounds without trying.”
D) “I constantly crave and eat non-food items like clay and ice chips.”

Answer 12

Answer: B

Rationale: The textbook characterizes bulimia nervosa as an eating disorder involving an obsession with bingeing (intake of excessive amounts of food) followed by purging (vomiting). Option A describes behaviors associated with anorexia nervosa. Option C describes anorexia (loss of appetite). Option D describes pica.

Question 13

A hospice nurse is caring for a patient with terminal cancer. The nurse observes significant weight loss and loss of muscle mass, giving the patient a “wasting” appearance. The nurse documents this condition as:

A) Anorexia nervosa
B) Marasmus
C) Cachexia
D) Obesity

Answer 13

Answer: C

Rationale: The textbook defines cachexia as “physical wasting.” It is often seen in patients with terminal illnesses who are unable to consume adequate food, resulting in weight loss and the loss of muscle mass. Anorexia nervosa is a psychological eating disorder. Marasmus is a severe malnutrition from a deficiency of both calories and protein. Obesity is an excess of body fat.

Question 14

A nurse is providing dietary education to an athlete. The nurse should emphasize that the primary source of energy for the body’s cells, tissues, and organs comes from which macronutrient?

A) Proteins
B) Lipids
C) Vitamins
D) Carbohydrates

Answer 14

Answer: D

Rationale: The textbook states that carbohydrates are major suppliers of energy for the body. While fats (lipids) and proteins can also be used for energy, carbohydrates are the body’s preferred and most efficient source. Vitamins do not produce energy.

Question 15

When explaining metabolism to a nursing student, the instructor describes the process of breaking down complex substances into simpler ones, which results in a release of energy. Which term best describes this process?

A) Anabolism
B) Catabolism
C) Digestion
D) Absorption

Answer 15

Answer: B

Rationale: The textbook defines catabolism as “the breaking down of substances from complex to simple, resulting in a release of energy.” This is considered a destructive metabolic process. Anabolism is the constructive process of building complex substances. Digestion is the mechanical and chemical breakdown of food, and absorption is the movement of nutrients into the blood.

Question 16

A nurse is providing dietary teaching to a patient with hyperlipidemia. The nurse explains that which waxy, fat-like substance is found in all body cells and is a major contributor to plaque buildup in arteries when levels are too high?

A) Triglyceride
B) Amino acid
C) Cholesterol
D) Glycogen

Answer 16

Answer: C

Rationale: The textbook defines cholesterol as “a waxy, fatlike substance that is found in all cells of the body.” High levels of cholesterol are known to contribute to atherosclerosis (plaque buildup). Triglycerides are the most abundant lipids in food. Amino acids are the building blocks of protein. Glycogen is the stored form of glucose.

Question 17

A nursing student is describing the process of digestion. The student correctly identifies the semiliquid mass of partially digested food that travels from the stomach through the intestines as:

A) Bolus
B) Chyme
C) Peristalsis
D) Pepsin

Answer 17

Answer: B

Rationale: The textbook defines chyme as the “semiliquid mass” of food as it travels through the intestines during digestion. A bolus is the mass of chewed food that is swallowed. Peristalsis is the wavelike muscular movement that propels food. Pepsin is a digestive enzyme in the stomach.

Question 18

A nurse is explaining to a patient how nutrients from food become available for the body to use. Which term should the nurse use to describe the process of breaking down food into smaller, absorbable particles?

A) Metabolism
B) Absorption
C) Ingestion
D) Digestion

Answer 18

Answer: D

Rationale: The textbook defines digestion as “the breaking down of food into smaller particles of nutrients.” Metabolism is the chemical process of using nutrients for energy or storage. Absorption is the movement of those smaller particles into the blood. Ingestion is the act of consuming food.

Question 19

A nurse is caring for an 80-year-old patient who recently had a stroke. The patient coughs and chokes while trying to drink water. The nurse recognizes this as a sign of which condition?

A) Aspiration
B) Anorexia
C) Dysphagia
D) Malabsorption

Answer 19

Answer: C

Rationale: The textbook defines dysphagia as “difficulty in swallowing.” This condition is common after a stroke and puts the patient at high risk for aspiration (the inhalation of fluid into the lungs). Anorexia is a loss of appetite. Malabsorption is the inadequate absorption of nutrients.

Question 20

A nurse is preparing to administer nutrition to a patient who has a functional gastrointestinal tract but is unable to swallow. The nurse anticipates using which method of nutritional support?

A) Total parenteral nutrition (TPN)
B) Intravenous fluids with dextrose
C) A clear liquid diet
D) Enteral feeding

Answer 20

Answer: D

Rationale: The textbook describes enteral feeding, or tube feeding, as a method of nutritional support for patients with a working GI tract who cannot take food orally. Total parenteral nutrition is administered intravenously and is used when the GI tract is nonfunctional. IV fluids with dextrose provide minimal calories. A clear liquid diet would not be appropriate for a patient who cannot swallow safely.

Question 21

A patient asks the nurse why certain foods need to be cooked to be digestible. The nurse’s best response is that cooking helps to activate which substances that are responsible for breaking down food?

A) Amino acids
B) Hormones
C) Enzymes
D) Ketones

Answer 21

Answer: C

Rationale: The textbook defines enzymes as “proteins responsible for catalyzing most chemical reactions in the body, such as digesting food.” Chewing and the action of enzymes are the first steps in digestion. Amino acids are the building blocks of protein. Hormones are chemical messengers. Ketones are produced when fat is broken down for energy.

Question 22

A nurse is teaching a community health class about nutrition. Which of the following statements indicates that a participant understands the concept of fat-soluble vitamins?

A) “I need to eat foods with these vitamins every single day because my body excretes them in urine.”
B) “Vitamins A, D, E, and K are fat-soluble and can be stored in my body’s fat tissue.”
C) “Fat-soluble vitamins, like Vitamin C and B-complex, dissolve in water.”
D) “My body can make all the fat-soluble vitamins it needs, so I don’t need them in my diet.”

Answer 22

Answer: B

Rationale: The textbook identifies vitamins A, D, E, and K as fat-soluble vitamins. It explains that excess amounts are stored in the liver and fat tissue. Because they are stored, they do not need to be consumed daily, and excessive intake can lead to toxicity. Water-soluble vitamins (like C and B-complex) are excreted in the urine and need to be replenished more frequently.

Question 23

A nurse is providing dietary education to a patient with constipation. To improve bowel regularity, the nurse should recommend increasing the intake of which complex carbohydrate?

A) Simple sugars
B) Saturated fats
C) Fiber
D) Complete proteins

Answer 23

Answer: C

Rationale: The textbook explains that a lack of fiber can lead to bowel-related conditions, including constipation. Fiber, a complex carbohydrate, allows for the formation of bulk and accelerates the passage of food through the intestines. Simple sugars and saturated fats would not help with constipation, and while protein is important, it is not the primary nutrient for promoting regularity.

Question 24

A nurse is explaining the benefits of antioxidants to a patient. The nurse describes that antioxidants help protect the body’s cells from damage caused by which of the following?

A) Pathogens
B) Free radicals
C) Ketones
D) Enzymes

Answer 24

Answer: B

Rationale: The textbook defines free radicals as by-products that result when the body transforms food into energy and can cause cellular damage over time. Antioxidants, such as vitamin E, protect cells from injury from these molecules. Pathogens are disease-causing organisms. Ketones are energy by-products from fat metabolism. Enzymes are catalysts for chemical reactions.

Question 25

A nurse is reviewing the lab results of a patient and notes an elevated level of plasma cholesterol and triglycerides. The nurse recognizes this condition as: A) Hypertension B) Hyperlipidemia C) Hyperglycemia D) Hyperkalemia

Answer 25

Answer: B Rationale: The textbook defines hyperlipidemia as an "elevation of plasma cholesterol, triglycerides, or both." This condition is a risk factor for the development of atherosclerosis. Hypertension is high blood pressure, hyperglycemia is high blood sugar, and hyperkalemia is high potassium.

Question 26

A patient with uncontrolled diabetes mellitus is in a state of starvation for carbohydrates. The nurse understands that the rapid, incomplete breakdown of fat for energy will result in the production of: A) Glucose B) Glycogen C) Amino acids D) Ketones

Answer 26

Answer: D Rationale: The textbook states that if carbohydrate levels are deficient, an excessive amount of fat is rapidly metabolized for energy, resulting in the production of ketones from incomplete fat oxidation. Glucose is the end product of carbohydrate digestion. Glycogen is the stored form of glucose. Amino acids are the building blocks of proteins.

Question 27

A nursing student is learning about the energy content of macronutrients. The student correctly identifies which of the following as the unit of heat energy used to measure the energy in food? A) Gram B) Kilocalorie C) Milligram D) Body Mass Index

Answer 27

Answer: B Rationale: The textbook defines a kilocalorie (kcal) as "the amount of heat energy it takes to raise the temperature of 1000 grams of water 1 degree Celsius." It is the standard unit for measuring the energy provided by food. Gram and milligram are units of weight. Body Mass Index is a calculation of body fat based on height and weight.

Question 28

A nurse working in a developing country assesses a child with a severely swollen abdomen and edema. The nurse recognizes these signs are characteristic of which protein-deficiency disease? A) Marasmus B) Scurvy C) Kwashiorkor D) Anorexia nervosa

Answer 28

Answer: C Rationale: The textbook describes kwashiorkor as a "lack of protein accompanied by fluid retention," which leads to the characteristic swollen abdomen (ascites) and edema. Marasmus results from a deficiency of both protein and calories and is characterized by severe wasting without edema. Scurvy is a vitamin C deficiency. Anorexia nervosa is a psychological eating disorder.

Question 29

A patient with a family history of heart disease is receiving dietary counseling. The nurse correctly identifies which of the following as the term for any fat found within the body, including true fats and oils? A) Triglycerides B) Lipids C) Amino acids D) Carbohydrates

Answer 29

Answer: B Rationale: The textbook defines lipids as "any fat found within the body, including true fats and oils." Triglycerides are the most abundant type of lipid in food. Amino acids are the building blocks of protein. Carbohydrates are the body's primary source of energy.

Question 30

A nurse is explaining the basic components of a healthy diet to a patient. Which of the following should the nurse classify as macronutrients needed in large amounts by the body? A) Vitamins and minerals B) Carbohydrates, fats, and proteins C) Water and fiber D) Electrolytes and enzymes

Answer 30

Answer: B Rationale: The textbook defines macronutrients as nutrients that are needed in large amounts. These include carbohydrates, fats, and proteins, which are the primary sources of energy for the body. Vitamins and minerals are micronutrients. While water is a macronutrient, fiber is a type of carbohydrate. Electrolytes and enzymes are essential but are not classified as macronutrients.

Question 31

A nurse is assessing a patient who reports significant weight loss, fatigue, and chronic diarrhea. The nurse suspects an issue with the intestinal tract's ability to absorb nutrients. This condition is best described as: A) Malnutrition B) Dysphagia C) Malabsorption D) Anorexia

Answer 31

Answer: C Rationale: The textbook defines malabsorption as "inadequate absorption of nutrients in the intestinal tract." This condition directly leads to symptoms like weight loss and fatigue due to the body's inability to utilize ingested nutrients. Malnutrition is a broader term for an imbalance of nutrients. Dysphagia is difficulty swallowing. Anorexia is a loss of appetite.

Question 32

A nurse is admitting a patient from a long-term care facility who appears underweight and has poor skin turgor. The nurse recognizes that this patient is at risk for an imbalance between nutrient intake and the body's needs. This condition is known as: A) Cachexia B) Malnutrition C) Marasmus D) Anorexia nervosa

Answer 32

Answer: B Rationale: The textbook defines malnutrition as "an imbalance in the amount of nutrient intake and the body’s needs." This can include both undernutrition and overnutrition. Cachexia is physical wasting associated with chronic illness. Marasmus is a severe deficiency of all macronutrients. Anorexia nervosa is a psychological eating disorder.

Question 33

A nurse in a refugee camp is assessing a child who is severely underweight, has significant muscle wasting, and shows no signs of edema. The nurse recognizes these clinical findings as characteristic of which condition? A) Kwashiorkor B) Cachexia C) Scurvy D) Marasmus

Answer 33

Answer: D Rationale: The textbook describes marasmus as a condition "resulting from both protein and calorie deficiency." A key clinical sign is severe wasting of body fat and muscle, without the edema and swollen abdomen seen in kwashiorkor. Cachexia is a general term for physical wasting. Scurvy is a vitamin C deficiency.

Question 34

A nurse is monitoring a client recovering from major surgery who requires extensive tissue repair. The nurse knows that for wound healing to occur, the client's body must primarily be in which metabolic state? A. Catabolism B. Anabolism C. Homeostasis D. Basal metabolic rate

Answer 34

Correct Answer: B Rationale: Page 658 defines anabolism as "the use of energy to change simple materials into complex body substances and tissue." This constructive process, which permits cell growth, is essential for wound healing and tissue repair. Catabolism is the destructive process of breaking down substances. Basal metabolic rate (BMR) is the minimum energy required for body functions at rest.

Question 35

A nurse is educating a client about balanced nutrition. Which of the following substances should the nurse classify as micronutrients? (Select all that apply.) A. Carbohydrates B. Vitamins C. Proteins D. Minerals E. Fats

Answer 35

Correct Answers: B, D Rationale: Based on the text on page 659, vitamins and minerals are referred to as micronutrients because they are needed by the body in limited amounts. Carbohydrates, proteins, and fats are macronutrients, which are needed in large amounts.

Question 36

A nurse is reviewing the laboratory results for a client complaining of muscle weakness. The nurse understands that which mineral, as described on page 663, is essential for nerve conduction and muscle contraction? A. Iron B. Potassium C. Selenium D. Lycopene

Answer 36

Correct Answer: B Rationale: The text on page 663 states that potassium, sodium, and chloride "play a critical role in maintaining fluid balance... They are important in nerve conduction and muscle contraction." Selenium and lycopene are listed as antioxidants. Iron is essential for hemoglobin but not primarily cited for muscle contraction in this context.

Question 37

A nurse is providing dietary teaching to a client with hyperlipidemia and encourages the client to increase their intake of monounsaturated fatty acids. Which of the following food items would be the best choice? A. Avocados B. Hard margarine C. Beef D. Corn oil

Answer 37

Correct Answer: A Rationale: Page 660 identifies avocados, canola oil, olive oil, and almonds as sources of monounsaturated fats. Beef and hard margarines are sources of saturated fats. Corn oil is listed as a source of polyunsaturated fat.

Question 38

When teaching a community health class, the nurse describes the primary function of nutrients. Which statement best defines the role of nutrients in the body? A. Nutrients are chemicals found in food that are responsible for preventing all chronic diseases. B. Nutrients primarily provide hydration and transport waste products from the kidneys. C. Nutrients are substances from food used to supply energy, build and maintain body tissues, and regulate body functions. D. Nutrients are inorganic compounds that regulate metabolic processes and are stored in the liver.

Answer 38

Correct Answer: C Rationale: The definition on page 658 states, "Nutrients are the necessary substances obtained from ingested food that supply the body with energy; build and maintain bones, muscles, and skin; and aid in the normal growth and function of each body system." Option C is the most accurate and comprehensive summary of this definition.

Question 39

A nurse is educating a patient about the digestive process. Which term should the nurse use to describe the wavelike muscular movement that propels food and waste products through the digestive tract? A. Digestion B. Absorption C. Peristalsis D. Chyme

Answer 39

Correct Answer: C Rationale: Page 664 defines peristalsis as "a wavelike muscular movement" that propels the contents (chyme and waste products) through the intestines. Digestion (p. 664) is the breaking down of food. Absorption (p. 664) is the movement of nutrients into the blood. Chyme (p. 664) is the semiliquid mass of digested food.

Question 40

A nurse is providing dietary teaching to a client about increasing the intake of essential fatty acids. Which of the following food items is the best source of polyunsaturated fatty acids? A. Olive oil B. Avocados C. Corn oil D. Hard margarine

Answer 40

Correct Answer: C Rationale: Page 660 identifies corn oil, safflower oil, and soybean oil as sources of polyunsaturated fats. Olive oil and avocados are listed as sources of monounsaturated fats. Hard margarine is a source of saturated fat.

Question 41

A nurse is assessing a client for a suspected eating disorder. The nurse understands that the term purging, commonly associated with bulimia nervosa, refers to which behavior? A. A distortion of body image and intense fear of gaining weight. B. The intake of excessive amounts of food in one sitting. C. Self-induced vomiting or misuse of laxatives after eating. D. A loss of appetite due to illness or medication side effects.

Answer 41

Correct Answer: C Rationale: Page 670 defines purging as vomiting that follows bingeing. It also notes that purging behaviors can include the abuse of laxatives or diuretics. Bingeing is the intake of excessive food. A distorted body image is a key feature of anorexia nervosa (p. 669). A loss of appetite is defined as anorexia (p. 669).

Question 42

A nurse is counseling a patient with hyperlipidemia to limit intake of saturated fatty acids. Which of the following food items should the nurse instruct the patient to avoid? (Select all that apply.) A. Beef B. Avocados C. Olive oil D. Ice cream E. Salmon

Answer 42

Correct Answers: A, D Rationale: Page 660 identifies foods from animal sources, such as beef, and other products like ice cream and hard margarines as major sources of saturated fats. Avocados and olive oil are sources of monounsaturated fats. Salmon is a source of polyunsaturated fat (omega-3).

Question 43

A nurse is initiating an infusion of total parenteral nutrition (TPN) for a patient with a non-functioning GI tract. Which nursing action is a priority for safe administration? A. Change the TPN tubing and filter every 72 hours. B. Monitor the patient's blood glucose levels every 6 hours. C. Administer the TPN solution through a peripheral IV line. D. Keep the TPN solution refrigerated until 10 minutes before infusion.

Answer 43

Correct Answer: B Rationale: Page 680 states that for a patient receiving TPN, glucose levels should be checked at least every 6 hours or more frequently until they stabilize, as TPN solutions are high in dextrose. To prevent infection, the tubing should be changed every 24 hours. TPN is a hypertonic solution and must be infused through a central line (CVC or PICC), not a peripheral line. The solution should be removed from refrigeration and allowed to come to room temperature to prevent venous spasm, which typically takes longer than 10 minutes.

Question 44

A nurse is explaining the process of metabolism to a client. Which statement correctly describes catabolism? A. The use of energy to build complex body substances. B. The minimum energy required to maintain body functions at rest. C. The breaking down of complex substances, resulting in a release of energy. D. The chemical process of converting nutrients into end products for storage.

Answer 44

Correct Answer: C Rationale: Page 658 defines catabolism as "the breaking down of substances from complex to simple, resulting in a release of energy." Anabolism (A) is the use of energy to build. Basal metabolic rate (B) is the minimum energy for body functions at rest. Metabolism (D) is the overall process.

Question 45

A nurse is teaching a community health class about macronutrients. Which substances should the nurse include in this category? (Select all that apply.) A. Carbohydrates B. Vitamins C. Proteins D. Minerals E. Fats

Answer 45

Correct Answers: A, C, E Rationale: Page 658 identifies carbohydrates, fats, and proteins as macronutrients, which are "needed in large amounts." Vitamins and minerals are classified as micronutrients (p. 659).

Question 46

A nurse is explaining the primary functions of nutrients to a new client. Which statement best defines the role of nutrients? A. Substances obtained from food that primarily regulate body temperature and blood pressure. B. Substances from food used to supply energy, build and maintain body tissues, and regulate body functions. C. Chemicals used by the body to break down fat stores and prevent all chronic diseases. D. Organic compounds that are responsible for reproduction and growth, but not energy.

Answer 46

Correct Answer: B Rationale: The definition of nutrients on page 658 states they are "substances obtained from ingested food that supply the body with energy; build and maintain bones, muscles, and skin; and aid in the normal growth and function of each body system."

Question 47

A client with uncontrolled diabetes mellitus and insufficient carbohydrate intake is at risk for developing ketosis. The nurse understands this is caused by the rapid metabolic breakdown of which nutrient? A. Protein B. Fat C. Minerals D. Vitamins

Answer 47

Correct Answer: B Rationale: Page 659 states that one function of carbohydrates is to "prevent ketosis (when the body burns fat in the absence of adequate carbohydrate intake)." Page 665 further explains that if carbohydrate levels are deficient, "an excessive amount of fat is rapidly metabolized for energy," resulting in ketones.

Question 48

A nurse is caring for a client who is recovering from major surgery. The nurse understands that for cell growth and tissue repair to occur, the client's body must be in a state of: A. Catabolism B. Anabolism C. Homeostasis D. Basal metabolic rate (BMR)

Answer 48

Correct Answer: B Rationale: Page 658 defines anabolism as "the use of energy to change simple materials into complex body substances and tissue." This constructive process "permits cell growth," which is necessary for tissue repair after surgery.

Question 49

A nurse is teaching a client about the benefits of insoluble fiber. Which statement by the client indicates the teaching has been effective? A. "Insoluble fiber will mix with water and form a gel, which slows down my digestion." B. "Insoluble fiber will help lower my cholesterol and blood pressure." C. "Insoluble fiber will not retain water but will add bulk to my stool and help with regularity." D. "Insoluble fiber is the kind that enhances my immune function and decreases inflammation."

Answer 49

Correct Answer: C Rationale: Page 659 states that insoluble fiber "does not retain water but allows formation of bulk," which results in the "accelerated passage" of waste and promotes regularity. Soluble fiber (A, B, D) forms a gel, lowers cholesterol, and may enhance immune function.

Question 50

A client asks the nurse why carbohydrates are so important in a diet. The nurse's best response is that carbohydrates are: A. The major suppliers of energy for the body. B. Necessary for the absorption of all vitamins. C. The primary building blocks for tissue repair. D. Essential for blood clotting and nerve conduction.

Answer 50

Correct Answer: A Rationale: Page 659 states that carbohydrates "are major suppliers of energy and include sugars, starches, and fiber." Fats are needed for fat-soluble vitamin absorption (p. 659). Proteins are the primary building blocks for tissue (p. 660). Minerals are involved in nerve conduction (p. 663).

Question 51

A nurse is reviewing the definition of a kilocalorie with a client. Which statement accurately defines this term? A. The amount of energy it takes to raise the temperature of 1000 grams of water 1 degree Celsius. B. The total amount of fat stored in 1 gram of adipose tissue. C. The energy required to break down 1 gram of protein into amino acids. D. The heat energy produced by the body in a resting, awake state.

Answer 51

Correct Answer: A Rationale: Page 659 defines a kilocalorie as "the amount of heat energy it takes to raise the temperature of 1000 grams of water 1 degree Celsius."

Question 52

A nurse is teaching a client about micronutrients. Which of the following substances should the nurse classify as micronutrients? A. Carbohydrates and fats B. Proteins and water C. Minerals and vitamins D. Amino acids and fiber

Answer 52

Correct Answer: C Rationale: Page 659 refers to minerals and vitamins as micronutrients, which are "needed by the body in limited amounts." Carbohydrates, fats, proteins, and water are macronutrients (p. 658).

Question 53

A client is admitted with malnutrition. The nurse understands this term is best defined as: A. The result of energy intake consistently exceeding energy use. B. A condition where the body fails to metabolize the amino acid phenylalanine. C. A loss of appetite due to illness or medication side effects. D. An imbalance in the amount of nutrient intake and the body's needs.

Answer 53

Correct Answer: D Rationale: Page 658 defines malnutrition as "an imbalance in the amount of nutrient intake and the body’s needs." Obesity (A) is the result of excess energy intake (p. 659). Phenylketonuria (B) is a specific metabolic disorder (p. 668). Anorexia (C) is a loss of appetite (p. 669).

Question 54

A nurse is educating a client about different types of fats. Which food should the nurse recommend as a good source of monounsaturated fatty acids? A. Corn oil B. Hard margarine C. Avocados D. Salmon

Answer 54

Correct Answer: C Rationale: Page 660 identifies sources of monounsaturated fatty acids as "canola, olive, and peanut oils, as well as almonds, sesame seeds, avocados, and cashews." Corn oil and salmon are polyunsaturated. Hard margarine is a saturated fat.

Question 55

A client with coronary artery disease is instructed to increase their intake of omega-3 fatty acids. Which food should the nurse recommend? A. Beef B. Salmon C. Cashews D. Ice cream

Answer 55

Correct Answer: B Rationale: Page 660 identifies fatty fish (such as salmon, tuna, and mackerel) as a key dietary source of omega-3 fatty acids, which "reduce the risk of heart disease."

Question 56

A client is reviewing a food label and asks what "triglycerides" are. The nurse's best response is: A. "They are the most abundant lipids in food, but an excess can contribute to coronary artery disease." B. "They are a waxy, fatlike substance that is only obtained from dietary intake." C. "They are the 'building blocks' of protein necessary for tissue repair." D. "They are a type of essential fatty acid, like omega-3, that your body cannot produce."

Answer 56

Correct Answer: A Rationale: Page 660 defines triglycerides as "the most abundant lipids in food" and notes that "an excess can be unhealthy, contributing to... coronary artery disease." Cholesterol (B) is the waxy substance. Amino acids (C) are the building blocks of protein.

Question 57

A nurse is educating a client about complete and incomplete proteins. The nurse determines the teaching has been effective when the client identifies which food as a source of complete protein? A. Black beans B. Soybeans C. Peanut butter D. Whole wheat bread

Answer 57

Correct Answer: B Rationale: Page 661 states that sources of complete protein are animal-based (milk, eggs, meat). It specifies that "The only plant protein considered to be a complete protein is found in soybeans." The other options are incomplete proteins.

Question 58

A client is diagnosed with high cholesterol. The nurse should explain that cholesterol is: A. A waxy, fatlike substance found in all cells that is essential for producing hormones and bile. B. An essential fatty acid that must be consumed in the diet daily. C. A type of lipid found only in plant-based foods like vegetable oils and nuts. D. The most abundant lipid in food, which is a major source of energy.

Answer 58

Correct Answer: A Rationale: Page 660 defines cholesterol as "a waxy, fatlike substance that is found in all cells of the body" and is "necessary for the production of some hormones... and aids in digestion as a component of bile salts."

Question 59

A nurse is advising a client to limit their intake of saturated fatty acids. Which of the following foods should the nurse instruct the client to avoid? A. Olive oil B. Almonds C. Beef D. Salmon

Answer 59

Correct Answer: C Rationale: Page 660 identifies "Foods from animal sources, especially beef, lamb, and processed meat" as "major sources of total fat, saturated fat, and cholesterol." Olive oil and almonds are monounsaturated; salmon is polyunsaturated.

Question 60

A client asks the nurse to explain the function of protein. The nurse's response should be based on the knowledge that protein: A. Is the body's major supplier of energy and prevents ketosis. B. Is active in the development, maintenance, and repair of the body's tissues. C. Promotes the absorption of fat-soluble vitamins A, D, E, and K. D. Is a micronutrient needed in limited amounts to regulate body processes.

Answer 60

Correct Answer: B Rationale: Page 660 states that proteins "are active participants in the development, maintenance, and repair of the body’s tissues, organs, and cells." Carbohydrates (A) are the major energy supplier. Fats (C) promote fat-soluble vitamin absorption. Vitamins (D) are micronutrients.

Question 61

A nurse is teaching a vegan client about combining foods to create a complete protein. Which of the following combinations should the nurse recommend? A. Rice and beans B. Peanut butter and jelly C. Pasta and olive oil D. Cereal and fruit

Answer 61

Correct Answer: A Rationale: Page 661 explains that "the combination of two or more complementary proteins can form a complete protein." It provides " rice and beans" as an example.

Question 62

A nurse is caring for an older adult client. The nurse knows this client is at a higher risk for dehydration because: A. Older adults have an increased thirst mechanism. B. Water accounts for only about 50% of their body weight, decreasing their fluid reserves. C. Their bodies store excess water-soluble vitamins, which requires more fluid for dilution. D. Their basal metabolic rate (BMR) is higher, leading to greater insensible water loss.

Answer 62

Correct Answer: B Rationale: Page 661 states, "Water accounts for about 50% of the weight of elderly adults, making this age group at risk for dehydration." It also notes that thirst "may not be an accurate indication of need in the elderly."

Question 63

A client is diagnosed with night blindness. The nurse anticipates this condition is caused by a deficiency in which vitamin? A. Vitamin A B. Vitamin D C. Vitamin E D. Vitamin K

Answer 63

Correct Answer: A Rationale: Page 661 states that Vitamin A "promote[s] night vision" and that "Deficiencies in vitamin A may cause night blindness."

Question 64

A client who lives in an area with very little sun exposure is diagnosed with osteomalacia (softening of the bones). The nurse understands this is likely related to a deficiency in which vitamin? A. Vitamin C B. Vitamin K C. Vitamin D D. Vitamin A

Answer 64

Correct Answer: C Rationale: Page 661 identifies Vitamin D as the "sunshine vitamin" and states it is "important for bone and tissue formation." Page 667 links vitamin D deficiency directly to osteomalacia.

Question 65

A client is admitted with excessive bruising and bleeding. A deficiency in which vitamin would be a likely cause? A. Vitamin E B. Vitamin K C. Vitamin D D. Vitamin C

Answer 65

Correct Answer: B Rationale: Page 662 identifies Vitamin K as "essential for... the clotting, or coagulation, of blood." It explicitly states, "Deficiency of this vitamin can result in bruising and bleeding."

Question 66

A client who follows a strict vegan diet is at risk for developing pernicious anemia. The nurse should educate the client about supplementing which vitamin? A. Vitamin B6 (Pyridoxine) B. Vitamin B9 (Folic acid) C. Vitamin B12 (Cyanocobalamin) D. Vitamin C (Ascorbic acid)

Answer 66

Correct Answer: C Rationale: Page 662 states that Vitamin B12 is "found in animal products, including meat, eggs, and dairy products." Page 676 confirms that vegans are at risk for pernicious anemia and "should supplement the diet with vitamin B12."

Question 67

A nurse is teaching a prenatal class about the importance of preventing neural tube defects in the fetus. The nurse should emphasize the need for adequate intake of which nutrient? A. Vitamin B12 B. Folic acid (Vitamin B9) C. Calcium D. Vitamin D

Answer 67

Correct Answer: B Rationale: Page 662 states that "Folic acid supplements taken before and during pregnancy have been a major factor in the decline of neural tube defects in newborns."

Question 68

A nurse is educating a client about antioxidants. Which of the following substances should the nurse include in the teaching? (Select all that apply.) A. Vitamin C B. Potassium C. Beta carotene D. Vitamin E E. Calcium

Answer 68

Correct Answers: A, C, D Rationale: Page 664 defines antioxidants as substances that protect cells from free radicals. Table 30.1 (p. 664) and the text list beta carotene, Vitamin C, and Vitamin E as antioxidants. Potassium and calcium are minerals.

Question 69

A client is experiencing muscle weakness and cardiac dysrhythmias. The nurse should review the client's laboratory results for which mineral? A. Iron B. Magnesium C. Potassium D. Phosphorus

Answer 69

Correct Answer: C Rationale: Page 663 states that potassium, sodium, and chloride "are important in nerve conduction and muscle contraction." It specifies that if levels are adequate, "muscle tissue, including that of the heart, can function properly."

Question 70

A nurse is caring for a client diagnosed with scurvy. The nurse understands this condition is caused by a deficiency in which vitamin? A. Vitamin A B. Vitamin B1 C. Vitamin C D. Vitamin D

Answer 70

Correct Answer: C Rationale: Page 667 identifies scurvy as "a deficiency of vitamin C." Page 662 notes that Vitamin C (ascorbic acid) is important for wound healing and tissue repair.

Question 71

A nurse is educating a client about the digestive process. Which term should the nurse use to describe the wavelike muscular movement that propels food through the digestive tract? A. Digestion B. Absorption C. Chyme D. Peristalsis

Answer 71

Correct Answer: D Rationale: Page 664 defines peristalsis as "a wavelike muscular movement" that propels chyme and waste products. Digestion (A) is the breaking down of food. Absorption (B) is the movement of nutrients into the blood. Chyme (C) is the semiliquid mass of digested food.

Question 72

A client's digestion of carbohydrates begins in the mouth with the action of which enzyme? A. Pepsin B. Salivary amylase (ptyalin) C. Lipase D. Trypsin

Answer 72

Correct Answer: B Rationale: Page 664 states, "For example, salivary amylase (ptyalin) breaks down carbohydrates (starch) into maltose" as the "first stage of digestion" in the mouth.

Question 73

A nurse is teaching a client about the MyPlate dietary guide. Which instruction is consistent with this guide? A. "Make half of your plate grains and protein." B. "Make half of your plate fruits and vegetables." C. "Ensure that dairy is the largest portion of your meal." D. "Eliminate all fats and oils from your diet."

Answer 73

Correct Answer: B Rationale: Page 665, describing the MyPlate guide (Fig. 30.3), states: "Serving sizes of fruits and vegetables are to cover half of a plate."

Question 74

A client is admitted with a body mass index (BMI) of 34 kg/m². How should the nurse classify this client? A. Normal weight B. Overweight C. Obese (class 1) D. Extreme obesity (class 3)

Answer 74

Correct Answer: C Rationale: Box 30.8 on page 672 classifies BMI. A BMI of "30.0 kg/m² to 34.9 kg/m²" is classified as Obese (class 1).

Question 75

A nurse in a developing country is assessing a child with a protuberant abdomen and fluid retention, signs of kwashiorkor. The nurse understands this is caused by: A. A deficiency of both protein and calories. B. A lack of protein accompanied by fluid retention. C. A lack of vitamin D, leading to soft bones. D. An inability to metabolize the amino acid phenylalanine.

Answer 75

Correct Answer: B Rationale: Page 668 defines kwashiorkor as "a lack of protein accompanied by fluid retention" (see Fig. 30.4). Marasmus (A) is a deficiency of both protein and calories.

Question 76

A client is admitted with dysphagia. The nurse understands this client is at high risk for which complication? A. Aspiration B. Malabsorption C. Phenylketonuria D. Hyperlipidemia

Answer 76

Correct Answer: A Rationale: Page 667 defines dysphagia as "difficulty in swallowing." Page 673 identifies individuals with difficulty swallowing as being "at risk of aspirating food and fluids into their lungs."

Question 77

A nurse is screening an adolescent client for anorexia nervosa. Which assessment finding is a key feature of this disorder? A. Bingeing on 2000-3000 calories at one time. B. Self-induced vomiting or misuse of laxatives. C. A distortion of body image and intense fear of gaining weight. D. A loss of appetite related to a medication side effect.

Answer 77

Correct Answer: C Rationale: Page 669 states that a primary feature of anorexia nervosa is a "distortion of body image, with an intense fear of gaining weight or being viewed as 'fat,' despite... weight [being] less than healthy or normal." Bingeing (A) and purging (B) are hallmarks of bulimia nervosa (p. 670).

Question 78

A client is admitted with cachexia secondary to a terminal illness. How would the nurse expect this client to present? A. As obese, with a BMI over 30. B. With a distended abdomen and fluid retention. C. With physical wasting, weight loss, and loss of muscle mass. D. With an intense fear of gaining weight and a distorted body image.

Answer 78

Correct Answer: C Rationale: Page 672 defines cachexia as "physical wasting" and notes it is "often seen in patients suffering from terminal illnesses... the effects... are evident in weight loss and the loss of muscle mass."

Question 79

A client is diagnosed with hyperlipidemia. The nurse should plan to teach the client about lowering their: A. Blood glucose and insulin levels. B. Plasma cholesterol, triglycerides, or both. C. Red blood cell folate concentrations. D. Serum potassium and sodium levels.

Answer 79

Correct Answer: B Rationale: Page 669 defines hyperlipidemia as an "elevation of plasma cholesterol, triglycerides, or both."

Question 80

A client presents with behaviors of binging on large amounts of food followed by self-induced vomiting. The nurse recognizes these as the primary behaviors of which eating disorder? A. Anorexia B. Bulimia nervosa C. Anorexia nervosa D. Cachexia

Answer 80

Correct Answer: B Rationale: Page 670 defines bulimia nervosa as "an obsession with bingeing (the intake of excessive amounts of food)... followed by purging (vomiting)."

Question 81

A nurse is assessing a client for malabsorption. Which condition is a common example of a malabsorption syndrome? A. Diabetes mellitus B. Celiac disease C. Hypertension D. Anorexia nervosa

Answer 81

Correct Answer: B Rationale: Page 667 discusses malabsorption (inadequate absorption of nutrients) and gives "celiac disease, or gluten-sensitive enteropathy" as a primary example.

Question 82

A nurse is performing a nutritional screening on an older adult. Which acronym represents a helpful self-assessment tool for malnutrition in this population? A. CAGE B. PQRST C. DETERMINE D. REEDA

Answer 82

Correct Answer: C Rationale: Page 671 states that "Tools such as... the DETERMINE self-assessment... are helpful in screening for malnutrition in older adults." The acronym stands for disease, eating poorly, tooth loss, economic hardship, etc.

Question 83

A nurse is reviewing a client's laboratory results. Which lab value is the best indicator of a client's recent nutritional status? A. Albumin B. Prealbumin C. Transferrin D. Hematocrit

Answer 83

Correct Answer: B Rationale: Page 673 explains that prealbumin levels are "valuable for determining recent nutritional status" because prealbumin has a short half-life of 2 days (Table 30.2). Albumin (A) has a long half-life (21 days) and reflects longer-term status.

Question 84

A client is admitted with severe protein-calorie malnutrition. Which laboratory finding would the nurse expect? A. Prealbumin 18 mg/dL B. Albumin 4.0 g/dL C. Prealbumin 4 mg/dL D. Albumin 3.0 g/dL

Answer 84

Correct Answer: C Rationale: Table 30.2 on page 673 shows the laboratory values indicating degrees of malnutrition. A prealbumin level of <5 mg/dL is classified as severe malnutrition. An albumin of 3.0 g/dL (D) indicates mild malnutrition. The other values are normal.

Question 85

A nurse is assessing an older adult client with poor dentition. The nurse understands that being edentulous (toothless) places the client at risk for: A. An increased intake of high-nutrient, high-fiber foods. B. A lower BMI due to inability to chew, or a higher BMI from intake of soft, high-calorie foods. C. An increased risk of hyperlipidemia from overconsumption of animal products. D. A higher risk for aspiration pneumonia.

Answer 85

Correct Answer: B Rationale: Page 673 states that "Edentulous (toothless) people may experience lower BMI values related to being unable to chew." It also notes that "an increase in BMI may occur from increased consumption of high-calorie foods with low-level nutrients, such as soft, sweet foods."

Question 86

A nurse is assessing a client for dehydration and pinches the skin on the client's forearm. The skin "takes on the appearance of a tent" and returns to normal slowly. The nurse should interpret this as: A. Normal skin turgor. B. A sign of dehydration. C. A sign of fluid overload. D. An indication of malnutrition.

Answer 86

Correct Answer: B Rationale: Page 673 states, "Skin turgor is an indication of... hydration. In dehydration, when the skin is pinched, the skin takes on the appearance of a tent and returns to its original position very slowly."

Question 87

A nurse is assessing a male client and measures his waist circumference at 41 inches (104 cm). The nurse should use this finding to educate the client about his high risk for which condition? A. Heart disease B. Osteoporosis C. Anorexia nervosa D. Marasmus

Answer 87

Correct Answer: A Rationale: Box 30.7 on page 672 states that an average waist size of "102 cm (40 inches) for men puts them in the high-risk category for heart disease."

Question 88

A nurse is caring for a client at high risk for aspiration. Which nursing intervention is a priority? A. Encourage the client to use a straw for all liquids. B. Keep the head of the bed elevated to 45 degrees during and after eating. C. Offer a clear liquid diet only. D. Instruct the client to tilt their head back when swallowing.

Answer 88

Correct Answer: B Rationale: Box 30.9 on page 674, "Aspiration Precautions," lists "Elevate the head of the bed to 45 degrees or higher during eating and for a minimum of 45 minutes after eating" as a key procedural concern. Tilting the head back (D) or using a straw (A) can increase the risk of aspiration.

Question 89

A client is prescribed a clear liquid diet. Which of the following items is appropriate for the nurse to offer? A. Orange juice B. Vanilla yogurt C. Apple juice D. Cream of chicken soup

Answer 89

Correct Answer: C Rationale: Page 677 defines a clear liquid diet. It includes "Clear juices that do not contain pulp (such as apple or cranberry juice, gelatin, popsicles, and clear broths)." Orange juice (A) has pulp. Yogurt (B) and cream soups (D) are part of a full-liquid diet.

Question 90

: A client with chronic kidney disease is placed on a renal diet. The nurse should plan to restrict which of the following nutrients? (Select all that apply.) A. Potassium B. Protein C. Carbohydrates D. Sodium E. Phosphorus

Answer 90

Correct Answers: A, B, D, E Rationale: Page 677 states that renal diets "restrict potassium, sodium, protein, and phosphorus intake."

Question 91

A nurse is caring for a client with a non-functioning GI tract who is receiving total parenteral nutrition (TPN). Which nursing action is a priority? A. Change the TPN tubing every 72 hours. B. Monitor the client's blood glucose levels every 6 hours. C. Administer the TPN solution through a 22-gauge peripheral IV line. D. Keep the TPN solution refrigerated until the moment of infusion.

Answer 91

Correct Answer: B Rationale: Page 681 states that for a patient receiving TPN, "Glucose levels should be checked at least every 6 hours... until they stabilize," as TPN solutions are high in dextrose. Tubing should be changed every 24 hours (A). TPN (especially >10% dextrose) must be given via a CVC or PICC, not a peripheral line (C).

Question 92

What is the "gold standard" for confirming the placement of a newly inserted nasogastric (NG) tube? A. Auscultation of an air bolus over the stomach. B. Testing the pH of the gastric aspirate. C. Radiographic (x-ray) confirmation. D. Asking the client to speak or hum.

Answer 92

Correct Answer: C Rationale: Box 30.12 on page 679 explicitly states, "Studies support the use of radiographic confirmation as the only reliable method to date of confirming enteral tube placement." It also notes that auscultation (A) "is no longer recognized as a reliable source."

Question 93

A nurse is assisting a client with dysphagia and one-sided muscle weakness with feeding. Which action is appropriate? A. Place food in the affected (weak) side of the mouth. B. Encourage the client to tuck their chin when swallowing. C. Provide all liquids through a straw to speed up intake. D. Have the client lie flat to prevent food from falling out.

Answer 93

Correct Answer: B Rationale: Box 30.11 on page 678, "Assisting an Adult with Feeding," states, "Chin-tucking may help prevent aspiration." It also states to have the patient turn the head to the affected side (not place food there) and to avoid straws. The head of the bed must be elevated 30-45 degrees.