Deck 11: Nutritional Assessment

Question 1

Which of the following factors is most likely to affect the nutritional status of an 82-year-old person?
1)Increase in taste and smell
2)Living alone on a fixed income
3)Change in cardiovascular status
4)Increase in gastrointestinal motility and absorption

Answer 1

2
Socioeconomic conditions frequently have the greatest effect on the nutritional status of the aging adult;these factors should be closely evaluated.Physical limitations,income,and social isolation are frequent problems and can obviously interfere with the acquisition of a balanced diet.

Question 2

When the mid upper arm circumference and triceps skinfold of an 82-year-old man are evaluated,it is important to remember that:
1)these measurements are no longer necessary for the elderly.
2)derived weight measures may be difficult to interpret because of wide ranges of normal.
3)these measurements may not be accurate because of changes in skin and fat distribution.
4)measurements may be difficult to obtain if the patient is unable to flex his elbow to at least 90 degrees.

Answer 2

3
Remember that accurate mid upper arm circumerence and triceps skinfold measurements are difficult to obtain and interpret in older adults because of sagging skin,changes in fat distribution,and declining muscle mass.

Question 3

In teaching a patient how to determine total body fat at home,the nurse includes instructions to obtain measurements of:
1)height and weight.
2)frame size and weight.
3)waist and hip circumferences.
4)mid upper arm circumference and arm span.

Answer 3

1
Body mass index,calculated by using height and weight measurements,is a practical marker of optimal weight for height and an indicator of obesity.

Question 4

The nurse recognizes that which of the following persons is at greatest risk for undernutrition?
1)A 5-month-old infant
2)A 50-year-old woman
3)A 20-year-old college student
4)A 30-year-old hospital administrator

Question 5

The nurse is evaluating patients for obesity-related diseases.Which one of the following would be at increased risk?
1)A 29-year-old woman whose percent ideal body weight is 125%,waist is 33 inches,and hips 36 inches
2)A 32-year-old man whose percent ideal body weight is 115%,waist is 34 inches,and hips 36 inches
3)A 38-year-old man whose percent ideal body weight is 120%,waist is 35 inches,and hips 38 inches
4)A 46-year old woman whose percent ideal body weight is 130%,waist is 30 inches,and hips 38 inches

Question 6

A pregnant woman is interested in breast-feeding her baby,and asks several questions about the topic.Which information is appropriate for the nurse to share with her?
1)Breast-feeding is best when also supplemented with bottle feedings.
2)Babies who are breast-fed often require supplemental vitamins.
3)Breast-feeding is recommended for infants for the first 2 years of life.
4)Breast milk provides the nutrients necessary for growth as well as natural immunity.

Question 7

When considering a nutritional assessment,the nurse is aware that the most common anthropometric measurements include:
1)height and weight.
2)leg circumference.
3)biceps skinfold thickness.
4)hip and waist measurement.

Question 8

When assessing a patient's nutritional status,the nurse recalls that the best definition of optimal nutritional status is:
1)nutrients in excess of daily body requirements.
2)sufficient nutrients to provide for the minimum body needs.
3)sufficient nutrients for daily body requirements but not for increased metabolic demands.
4)sufficient nutrients to provide for daily body requirements and for increased metabolic demands.

Question 9

The nurse is assessing a 30-year-old unemployed immigrant from an underdeveloped country who has been in the United States for 1 month.Which of the following problems related to his nutritional status might the nurse expect to find?
1)Obesity
2)Hypotension
3)Osteomalacia
4)Coronary artery disease

Question 10

If a 29-year-old woman weighs 146 pounds and the nurse determines her ideal body weight to be 120 pounds,how would the nurse classify the woman's weight?
1)Obese
2)Mildly overweight
3)Suffering from malnutrition
4)Within appropriate range of ideal weight

Question 11

A mother and her 13-year-old daughter express their concern related to the daughter's recent weight gain and increase in appetite.Which of the following represents information the nurse should discuss with them?
1)The necessity of exercise and dieting at this age
2)Suggestions for snacks high in protein,iron,and calcium
3)Teenagers who have a weight problem should not be allowed to snack
4)The importance of a low-calorie diet to prevent the accumulation of fat

Question 12

A patient tells the nurse that his food just doesn't have any taste anymore.The nurse's best response would be:
1)"That must be really frustrating."
2)"When did you first notice this change?"
3)"My food doesn't always have a lot of taste either."
4)"Sometimes that happens but your taste will come back."

Question 13

Which of the following best describes the technique for measuring frame size?
1)With the patient standing,measure the distance from the top of the head to the back of the heel.
2)With the patient in a sitting position,measure the distance from the condyle of the humerus to the clavicle.
3)With the patient's right arm extended forward and the elbow extended,measure the distance from fingertips to the condyle of the humerus.
4)With the right arm extended forward and the elbow bent,use the calipers to measure the distance between the condyles of the humerus.

Question 14

The nurse is performing a nutritional assessment on a 15-year-old girl,who tells the nurse that she is "so fat." Assessment reveals that she is 5 feet 4 inches and weighs 110 pounds.The nurse's appropriate response would be:
1)"How much do you think you should weigh?"
2)"Don't worry about it,you're not that overweight."
3)"The best thing for you would be to go on a diet."
4)"I used to always think I was fat when I was your age."

Question 15

The nurse is seeing a patient for the first time who has no history of nutrition-related problems.The initial nutritional screening should include which of the following?
1)Calorie count of nutrients
2)Anthropometric measures
3)Complete physical examination
4)Measurement of weight and weight history

Question 16

During a nutritional assessment,why is it important for the nurse to ask a patient what medications he or she is taking?
1)Certain drugs can affect the metabolism of nutrients.
2)The nurse needs to assess the patient for allergic reactions.
3)Medications need to be documented on the record for the physician's review.
4)Medications can affect one's memory and ability to identify food eaten in the last 24 hours.

Question 17

After completing a diet assessment on a 30-year-old woman,the nurse suspects that she may be deficient in iron.Laboratory studies to obtain to verify this condition would be:
1)hemoglobin and hematocrit.
2)cholesterol and triglycerides.
3)creatinine and serum protein.
4)serum albumin and urinary urea nitrogen.

Question 18

Which of the following statements is true concerning the nutritional assessment?
1)It is only useful in patients who are overweight.
2)It identifies patients who are at risk of malnutrition.
3)This assessment can only be thoroughly done by a dietician.
4)It provides the nurse with physical findings related to all the systems.

Question 19

The nurse is concerned about the skeletal protein reserves of a patient who has been hospitalized frequently for chronic lung disease.Which of the following measurements would be necessary to include in the assessment?
1)Body mass index
2)Weight and height
3)Mid arm muscle area
4)Ideal body weight and frame size

Question 20

The nurse needs to determine the body mass index of an 80-year-old man who is confined to a wheelchair.Which of the following is true in this situation?
1)Changes in fat distribution will affect the waist-to-hip ratio.
2)Height measurements may not be accurate because of changes in bone.
3)Declining muscle mass will affect the triceps skinfold measure.
4)Mid arm circumference is difficult to obtain because of loss of skin elasticity.

Question 21

The nurse is performing a nutritional assessment on an 80-year-old patient.The nurse knows that physiologic changes that directly affect the nutritional status of the elderly include:
1)slowed gastrointestinal motility.
2)hyperstimulation of the salivary glands.
3)an increased sensitivity to spicy and aromatic foods.
4)decreased gastrointestinal absorption causing esophageal reflux.

Question 22

Which body composition-measuring tool measures fat and lean body mass and bone mineral density?
1)Waist-to-hip ratio
2)Body mass index
3)Bioelectrical impedance analysis
4)Dual-energy x-ray absorptiometry

Question 23

The nurse is assessing an obese patient for signs of metabolic syndrome.This condition is diagnosed when three or more certain risk factors are present.Which of the following are risk factors for metabolic syndrome? Select all that apply.
1)Fasting plasma glucose level less than 110 mg/dl
2)Fasting plasma glucose level greater than or equal to 110 mg/dl
3)Blood pressure reading of 140/90 mm/Hg
4)Blood pressure reading of 110/80 mm/Hg
5)Triglyceride level of 120 mg/dl

Question 24

Which of the following measurements is an early indicator of protein malnutrition?
1)Serum albumin
2)Serum creatinine
3)Nitrogen balance
4)Serum transferrin

Question 25

A 50-year-old woman with elevated serum,total cholesterol,and triglyceride levels is visiting the clinic today to find out about her laboratory results.What would be important for the nurse to include in patient teaching in relation to these tests?
1)The risks of undernutrition
2)Methods to reduce stress in her life
3)Information regarding a low saturated fat diet
4)The fact that this is hereditary and there is nothing she can do to change the levels

Question 26

Which of the following individuals is most likely to have an anergic response when assessing skin test antigens?
1)An 8-year-old child
2)An obese individual
3)A healthy 80-year-old female
4)An individual with malnutrition

Question 27

Which of the following interventions is most appropriate when the nurse is planning nutritional interventions for a healthy,active 74-year-old woman?
1)Decrease the amount of carbohydrates to prevent lean muscle catabolism.
2)Increase the amount of soy and tofu in her diet to promote bone growth and reverse osteoporosis.
3)Decrease the number of calories she is eating because of the decrease in energy requirements from loss of lean body mass.
4)Increase the number of calories she is eating because of the increased energy needs of the elderly.

Question 28

In performing an assessment on a 49-year-old woman who has imbalanced nutrition as a result of dysphagia,which of the following data would the nurse expect to find?
1)An increase in hair growth
2)Inadequate food intake
3)Weight 10% to 20% over ideal
4)Sore,inflamed buccal cavity

Question 29

During an assessment of a patient who has been homeless for several years,the nurse notices that his tongue is magenta in color.This is an indication of:
1)iron deficiency.
2)riboflavin deficiency.
3)vitamin D and calcium deficiency.
4)vitamin C deficiency.

Question 30

A 16-year-old girl is being seen at the clinic for gastrointestinal complaints and weight loss.The nurse determines that many of her complaints may be related to erratic eating patterns,eating predominantly fast foods,and high caffeine intake.In this situation,which of the following is most appropriate when collecting current dietary intake information?
1)Schedule a time for direct observation of the adolescent during meals.
2)Ask the patient for a 24-hour diet recall and assume this is reflective of a typical day for her.
3)Have the patient complete a food diary for 3 days-2 weekdays and 1 weekend day.
4)Use the food frequency questionnaire to identify the amount of intake of specific foods.

Question 31

Which of the following conditions is due to an inadequate intake of both protein and calories?
1)Obesity
2)Bulimia
3)Marasmus
4)Kwashiorkor

Question 32

A 40-year-old man has had a recent weight loss of 20 pounds because of a quick loss diet and stress.He tells the nurse that he keeps getting "colds and the flu." In addition to assessing his nutrition status,the nurse would also want to obtain which laboratory report?
1)Serum albumin
2)Cholesterol level
3)Serum transferrin
4)Total lymphocyte count