Deck 10: Nutritional Assessment

Question 1

The nurse is using a dietary recall tool to obtain a nutritional history from a client. Which should the nurse recognize is the greatest limitation of the tool?

A) Clients do not remember liquid intake from day to day.
B) The tool does not reflect food preferences of the client.
C) Clients do not provide reliable nutritional information.
D) The tool does not reflect occasional food habits.

Answer 1

The tool does not reflect occasional food habits.

Question 2

A Bioelectrical Impedance Analysis (BIA)is being performed on a client. Which interventions will the nurse implement for this client? Select all that apply.

A) Instruct the client to be NPO for 6 to 8 hours prior to the assessment.
B) Instruct the client to discontinue all vitamin and mineral supplementation for 24 hours prior to the assessment.
C) Instruct the client to lie in a supine position during the assessment.
D) Place electrodes on the dorsal surface of the client's foot.
E) Place electrodes on the dorsal surface of the client's hand.

Answer 2

Instruct the client to lie in a supine position during the assessment.
Place electrodes on the dorsal surface of the client's foot.
Place electrodes on the dorsal surface of the client's hand.

Question 3

The nurse is obtaining nutritional history data from a client. Which question should the nurse ask that specifically assesses the beliefs and practices of the client?

A) "What type of diet do you prefer?"
B) "Can you describe the portion size of the cereal you eat for breakfast?"
C) "Do you take any vitamin supplements?"
D) "Can you describe your activity level?"

Answer 3

"What type of diet do you prefer?"

Question 4

The nurse is preparing to assess a client experiencing obesity paradox. Which information should the nurse recognize contributes to this condition?

A) The client has a binge eating disorder.
B) The client does not have access to nutritious food.
C) The client gains and loses large amounts of weight.
D) The client has a metabolic disorder.

Question 5

The nurse is preparing to assess the nutritional status of several clients. Which client should the nurse expect is most likely to underreport their nutritional intake?

A) Client with depression.
B) Client that smokes.
C) Client that is an older adult.
D) Client that has diabetes.

Question 6

The nurse is reviewing the procedure for taking a skinfold measurement with the educator. Which statement made by the nurse should the educator recognize requires further education?

A) Two measurements should be taken at each site and then compared.
B) Skinfold measurements should be taken on the left and right side of the body.
C) Plastic calipers should be used for the comfort of the client.
D) Both the skinfold layer and muscle are pinched and held gently.

Question 7

The nurse is reviewing the BMI (body mass index)of an adult client. Which should the nurse recognize a BMI of 23 indicates?

A) Mild malnutrition.
B) Normal.
C) Overweight.
D) Obese class 1.

Question 8

The nurse is obtaining tricep skinfold measurement on a client. Which anatomical locations should the nurse use to obtain the measurement?

A) Midpoint of the arm between the scapula and the elbow.
B) Two inches and centered below the scapula.
C) One inch around the umbilicus.
D) Lateral aspect of thigh.

Question 9

The nurse is preparing to assess an infant with a riboflavin deficiency. Which assessment finding should the nurse anticipate?

A) Mottled tooth enamel.
B) Dull, sparse, and brittle hair.
C) Lips cracked at the corners.
D) Muscle wasting.

Question 10

The nurse is calculating the body mass index (BMI)to assess a client's weight. Which should the nurse recognize is a limitation of the calculation?

A) There is lack of correlation of the values in the BMI table with those in height-weight tables.
B) Assumption that all individuals have equal body composition at each given weight.
C) BMI is difficult to accurately calculate.
D) The BMI's use to determine the risk for obesity is reduced in individuals who are on reduced calorie diets.

Question 11

The nurse is reviewing the food record of a client. Which factor should the nurse consider when reviewing the record?

A) The client changes their eating patterns.
B) The client does not measure the food correctly.
C) The client changes the type of foods they eat.
D) The client omits any alcohol that was consumed.

Question 12

A client asks the nurse how anthropometric measurement is obtained. Which information should the nurse provide to the client?

A) The assessment is obtained by subtracting the height in centimeters from the weight in pounds and multiplying by two.
B) The assessment includes any scientific measurement of the body for nutritional analysis.
C) The measurements include the use of growth chart evaluations using height and weight.
D) The measurement estimates skinfold thicknesses.

Question 13

A client tells the nurse they are frustrated because their BMI places them in an overweight category. Which response should the nurse provide the client?

A) "The BMI is a reflection of your nutritional intake."
B) "The BMI used alone does not indicate that you are overweight."
C) "The BMI should be used with a height and weight-table to establish your category of weight.
D) "The BMI can help you set new goals to modify your nutritional intake."

Question 14

The nurse is using waist circumference to assess overnutrition in an adult female. Which is the correct placement for the measurement tape?

A) At the umbilicus.
B) Below the umbilicus.
C) Upper lateral border of the ilium midaxillary line
D) Lower lateral border of the ilium midaxillary line

Question 15

The nurse is assessing a client with overnutrition. Which question should the nurse ask the client?

A) "Do you have access to adequate amounts of food?"
B) "Do you take multiple medications?"
C) "Are you taking dietary supplements?"
D) "Are you allergic to any foods?"

Question 16

A nurse is teaching a client how to estimate portion sizes of food. Which technique should the nurse use during the client's teaching?

A) Measuring cups.
B) Food scale.
C) Analogies.
D) Plastic containers.

Question 17

A postoperative client asks the nurse why a registered dietician is evaluating their nutritional intake. Which information should the nurse provide the client? Select all that apply.

A) Meet a regulatory agency requirement.
B) Determine nutritional needs.
C) Asses for cultural dietary considerations.
D) Asses for potential food-drug interactions.
E) Review religious practices

Question 18

A client weighed 156 pounds one month prior currently weighs 140 pounds. Which percent of weight change should the nurse document in the client's record?

A) 5%.
B) 10%.
C) 12%.
D) 14.3%.

Question 19

The nurse is caring for a client with undernutrition. Which should the nurse recognize is a clinical condition associated with undernutrition?

A) Renal failure.
B) Hypertension.
C) Delayed wound healing.
D) Delayed menopause.

Question 20

The nurse is educating a client about the risk factors for poor nutritional health. Which should the nurse include when discussing overnutrition? Select all that apply.

A) Alcohol abuse.
B) Sedentary lifestyle.
C) Excess intake of fat, sugar, calories, or nutrients.
D) Lack of knowledge about food preparation.
E) Lack of knowledge about portion sizes.

Question 21

The nurse is evaluating the nutritional intake of college athletes. Which tool should the nurse use?

A) BMI.
B) Height-weight table.
C) Food record.
D) Skinfold measurements.

Question 22

The nurse is reviewing the records for the obstetrical client's in the clinic. Which client should the nurse recognize is at the greatest risk for insufficient gestational weight gain?

A) 33-year-old African American female.
B) 18-year-old White female.
C) 24-year-old Hispanic female.
D) 28-year-old Asian female.

Question 23

Which laboratory finding should the nurse anticipate for a client experiencing mild malnutrition?

A) Prealbumin of 115 mg/L.
B) Prealbumin of 75 mg/L.
C) Prealbumin of 40 mg/L.
D) Prealbumin of 175 mg/L.

Question 24

The nurse is preparing to conduct a focused interview on a client who reports a recent weight gain. Which inquiry by the nurse is the most appropriate for this client?

A) "Have you increased your carbohydrate intake?"
B) "Are you eating your meals late in the day?"
C) "Please tell me about what foods and beverages you have consumed for the past 24 hours."
D) "Have you noticed your energy level has decreased with your recent weight gain?

Question 25

The nurse is preparing to assess an older client that has experienced undernutrition. Which assessment findings should the nurse anticipate? Select all that apply.

A) Muscle loss.
B) Memory loss.
C) Functional decline.
D) Physical decline.
E) Poor concentration.

Question 26

Which nitrogen laboratory finding should the nurse anticipate for a client experiencing catabolism?

A) Loss of nitrogen exceeds the intake.
B) Intake of protein exceeds the nitrogen loss.
C) Caloric intake exceeds the nitrogen loss.
D) The level of nitrogen in the body is balanced.

Question 27

An older adult asks the nurse why skinfold measurements are not done during the assessment. Which response should the nurse provide?

A) "Skinfold measurements are no longer included in the assessment of a BMI."
B) "As a person ages, the skinfold measurement test is not as accurate."
C) "Calculating the BMI (body mass index)is more efficient."
D) "A detailed dietary history will provide the information that we need."

Question 28

The nurse is collecting nutritional intake information from a client. The nurse does not feel the client is being forthcoming and honest with the intake self-reports. Which factor may be associated with inaccurate reporting of dietary intake?

A) Female gender.
B) Male gender.
C) Higher socioeconomic levels.
D) Lower educational levels.

Question 29

The nurse is preparing to assess a client's tricep skinfold measurement. Which location is appropriate for the nurse to use during this assessment?

A) Olecranon process.
B) Midpoint of the arm.
C) Upper most arm.
D) Acromion process.

Question 30

A client asks the nurse about the use of height and weight tables to determine ideal weight. Which response should the nurse provide the client?

A) "It is important for you to adhere to the recommendations of height and weight tables to avoid weight-related complications."
B) "Height and weight tables are highly subjective."
C) "Using height and weight tables can be problematic because they are often inaccurate."
D) "Height and weight tables have significant limitations for predicting weight status of an individual."

Question 31

The nurse is evaluating a list of clients that may require a detailed nutritional assessment. Which client should the nurse recognize would most benefit from a detailed nutritional assessment?

A) A 21-year-old female who has just begun college and has lost 5 pounds in the first semester.
B) A 2-year-old whose mother stated that he seems to be growing faster than she can buy him clothes.
C) A 50-year-old male who reported that he lost 10 pounds in 6 weeks without even trying.
D) A 35-year-old female who has gained 10 pounds in a year after the birth of her first child.

Question 32

The nurse is preparing a community education program to address obesity. Which subpopulation should the nurse focus upon?

A) Native American males.
B) Hispanic females.
C) African American females.
D) White males.