Test Bank For Nutritional Foundations And Clinical Applications: A Nursing Approach, 6th Edition

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01: Wellness NutritionChapter 01: Wellness NutritionGrodner and Escott-Stump: Nutritional Foundations and Clinical Application: A NursingApproach, 6th EditionMULTIPLE CHOICE1. Examples of informal education includea.attending a workshop on coronaryartery disease sponsored by the American Heart Association.b.watching a television show about diabetes.c.learning about food safety techniques in a high school economics course.d.joining a support group to help overcome an eating disorder.ANS: BWatching a television show about diabetes is an example of informal education because it is anexperience that occurs through a daily activity. Attending a workshop or joining a support groupwould be considered nonformal education; a high school course would be considered formaleducation.DIF:Cognitive Level: ApplyingREFage 6TOP: Nursing Process: Implementation MSC: Client Needs: Health promotion and maintenance2. A college student exercises regularly and generally eats a healthy variety of foods, is taking acourse in general nutrition, buys locally produced food whenever possible, is an active member of anon-campus faith-based organization, and keeps a journal to help process her emotions. What elsecould be important for her to include in her life in order to develop her overall wellness?a.Growing some of her own foodb.Keeping a food record to help evaluate what she eatsc.Eating meals with friends throughout the week

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d.Meeting with a registered dietitian to review her food choicesANS: CWellness enhances a person’s level of health through development of each of the six dimensions ofhealth: physical health, intellectual health, emotional health, social health, spiritual health, andenvironmental health. Exercise and eating a health variety of foods help develop physical health;taking a course in general nutrition helps develop intellectual health; buying locally produced foodhelps develop environmental health; being part of a faith-based organization helps develop spiritualhealth; and keeping a journal helps develop emotional health. The missing dimension in this exampleis development of social health; eating meals with friends throughout the week would add thisdimension. Growing her own food would be another example of environmental health; keeping afood record would be another contributor to physical health; and meeting with a registered dietitianmay contribute to physical, intellectual, and emotional health.DIF:Cognitive Level: AnalyzingREFages 1-3TOP: Nursing Process: Assessment MSC: Client Needs: Health promotion and maintenance3. For a client who is missing meals because of poor planning or is too busy to eat, emotional healthcan be affected by _____, which can cause confusion or anxiety.a.low blood sugar levelsb.highblood sugar levelsc.high blood pressured.extremely low blood pressureANS: DPoor eating habits affect emotional health. Missing meals may cause blood sugar levels to decrease,which can cause anxiety or confusion or make it difficult to control emotions. Late night binges onsnack food are likely to result in excessive energy intake but would have a less direct effect onemotional health. Eating small meals throughout the day is likely to maintain more constant blood

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sugar levels, which would actually have a positive effect on emotional health. Excessive caffeineconsumption may contribute to anxiety, but 2 cups of caffeinated coffee is not considered excessive.DIF:Cognitive Level: AnalyzingREFage 2TOP: Nursing Process: Assessment MSC: Client Needs: Psychosocial integrity4. The best example of the type of concern that is likely to be addressed by the U.S. Department ofHealth and Human Services when target goals forHealthy People 2030are updated isa.preference for vegetarian eating patterns among white women.b.low intake of fruits and vegetables by African American children.c.widespread use of bottled water in higher socioeconomic groups.d.common use of protein and vitamin supplements in athletes.ANS: BHealthy Peopleis used to set targets for health promotion to improve the health of all individuals. Itaddresses environmental and social issues that affect health outcomes. Low intake of fruits andvegetables by African American children is likely to have an adverse effect on their health and somay be addressed when target goals are set. Vegetarian eating patterns, use of bottled water, and useof protein and vitamin supplements do not necessarily have an adverse effect on nutritional healthand so are less likely to be addressed.DIF: Cognitive Level: Applying REF: Pages 4-6 TOP: Nursing Process: PlanningMSC: Client Needs: Health promotion and maintenance5. An example of community support for health promotion isa.teaching a young mother skills in safe food preparation.b.watching a television documentary about industry errors in food processing.

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c.labelingfresh poultry packages with information about proper food storage.d.being aware thatSalmonellacan be transmitted because of inadequate food preparation.ANS: CFood labeling information is an example of community support because it is a regulatory measurethat supports new health-promoting behaviors within a social context. Teaching, watching televisionand awareness may increase knowledge, but they do not alter the social context by regulation orenvironmental change.DIF:Cognitive Level: ApplyingREFage 4TOP: Nursing Process: Implementation MSC: Client Needs: Health promotion and maintenance6. An example of a technique for health promotion isa.exercising five times a week.b.local supermarkets’ expanding the availability of fresh fruits and vegetables.c.teaching a teenager how to choose healthier foods at fast-food restaurants.d.information about the relationship of dietary intake and diet-related disorders.ANS: CHealth promotion consists of strategies that are designed improve the health of individuals, families,groups, and communities, such as teaching a teenager how to choose healthier fast foods. Exercisingregularly contributes to wellness, but it is not bringing about a change in health unless this is achange in behavior. Stocking a wider availability of fresh produce does not promote health, unlessthe supermarket uses specific strategies to encourage consumption. Information about therelationship between nutrients and disease is simply information unless it is used to promote behaviorchange.DIF:Cognitive Level: ApplyingREFage 4

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TOP: Nursing Process: Implementation MSC: Client Needs: Health promotion and maintenance7. For the efficient functioning and maintenance of the body, a person needs to consume sufficientamounts ofa.fiber.b.nutrients.c.minerals.d.supplements.ANS: BThe body needs sufficient amounts of all nutrients for efficient functioning and maintenance. Bothfiber and minerals are needed, but each represents only one type of nutrient. Supplements are notalways necessary because sufficient nutrients can often be obtained from food.DIF:Cognitive Level: UnderstandingREFages 8-10TOP: Nursing Process: Assessment MSC: Client Needs: Physiological integrity8. A nurse has just been assigned to a community health program for older adults. She should checkthe documentHealthy People 2020to become familiar witha.nutrition priorities and goals for older American adults.b.dietary standards for Americans older than 50 years.c.dietaryguidelines recommended for older adults.d.MyPlaterecommendations for older adults.ANS: AHealthy People 2020focuses on targets and goals for improving the health of the nation. The nursewould check the Dietary Reference Intakes for information about dietary standards. TheDietary

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Guidelines for AmericansandMyPlateare separate documents fromHealthy People 2020and focuson specific advice and guidelines for healthy eating.DIF:Cognitive Level: ApplyingREFages 4-5 | Page 10TOP: Nursing Process: Planning MSC: Client Needs: Health promotion and maintenance9. A healthy female middle-aged client asks what she can do to prevent the development of type 2diabetes. Weight control and nutrition strategies discussed are considereda.primarytreatment.b.primary prevention.c.secondary prevention.d.tertiary prevention.ANS: BAction to prevent the development of type 2 diabetes is considered primary prevention. Secondaryprevention involves early detection to halt and minimize the effects of the disease, and tertiaryprevention minimizes complications and helps restore health after the disorder has developed.“Primary treatment” is not a recognized term.DIF: Cognitive Level: Applying REF: Pages 5-6 TOP: Nursing Process: PlanningMSC: Client Needs: Health promotion and maintenance10. As a home health care nurse, you are visiting a 70-year-old client who has just returned homefrom the hospital after being treated for coronary artery disease. The medical nutrition therapydeveloped for him by the hospital dietitian is considereda.palliative care.b.primary prevention.

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c.secondary prevention.d.tertiary prevention.ANS: DThis is an example of tertiary prevention, which entails minimizing complications and helpingrestore health after heart disease has developed. Primary prevention would occur before the diseasedeveloped, and secondary prevention would involve early detection to minimize the effects of thedisease. Palliative care is intended only to minimize symptoms.DIF: Cognitive Level: Applying REF: Pages 5-6 TOP: Nursing Process: PlanningMSC: Client Needs: Health promotion and maintenance11. A nutrient that can be made by the body is calleda.essential.b.complete.c.incomplete.d.nonessential.ANS: DNonessential nutrients can be made by the body. Essential nutrients cannot be made by the body andmust be consumed. The termscompleteandincompleterefer to proteins. Complete proteins containall the essential amino acids; incomplete proteins are lacking one or more essential amino acids.DIF:Cognitive Level: RememberingREFages 8-9TOP: Nursing Process: Assessment MSC: Client Needs: Physiological integrity12. A client exercises regularly and wants to make sure he has sufficient energy for his workouts.The type of nutrient that will be most helpful in providing the energy he needs is

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a.carbohydrates.b.water.c.minerals.d.protein.ANS: ACarbohydrates are the best source of fuel to provide energy for the body. Protein can also providefuel for energy, but its primary purpose is important structural and functional roles. Water andminerals are important for health but do not provide fuel for energy.DIF: Cognitive Level: Applying REF: Pages 8-10 TOP: Nursing Process: PlanningMSC:Client Needs: Physiological integrity13. A 45-year-old man tells you that he drinks 3 oz of Scotch whiskey most evenings. His alcoholintake is considereda.insignificant.b.moderate.c.higher than is recommended.d.dangerously high.ANS: BModerate alcohol intake is two servings or fewer per day for men. One serving of spirits, such aswhiskey, is 1.5 ounces. Therefore, 3 oz of whiskey per day is considered moderate alcohol intake.DIF:Cognitive Level: AnalyzingREFage 9TOP: Nursing Process: Assessment MSC: Client Needs: Health promotion and maintenance

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14. A dessert contains 4 g of protein, 30 g of carbohydrate, 15 g of fat, and 5 g of alcohol. Thenutrient that provides the most kilocalories in the dessert isa.protein.b.carbohydrate.c.fat.d.alcohol.ANS: CFat provides the highest number of kilocalories: At 9 kcal per gram, 15 g of fat provides 135 kcal. At4 kcal per gram, 4 g of protein provides 16 kcals. At 4 kcal per gram, 30 g of carbohydrate provides120 kcal. At 7 kcal per gram, 5 g of alcohol provides 35 kcal.DIF:Cognitive Level: ApplyingREFage 9TOP: Nursing Process: Assessment MSC: Client Needs: Health promotion and maintenance15. A cup of frozen yogurt contains 24 g of carbohydrate, 2 g of fat, and 4 g of protein. The totalnumber of kilocalories in the frozen yogurt isa.110.b.130.c.140.d.162.ANS: BAt 4 kcal per gram, 24 g of carbohydrate provides 96 kcal. At 9 kcal per gram, 2 g of fat provides 18kcal. At 4 kcal per gram, 4 g of protein provides 16 kcal. Therefore, the total kilocalories in thefrozen yogurt is 130 kcal (96 + 18 + 16).

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DIF:Cognitive Level: ApplyingREFages 8-9TOP: Nursing Process: Assessment MSC: Client Needs: Health promotion and maintenance16. Combinations of amino acids link together to forma.protein.b.carbohydrates.c.dietary fiber.d.lipids.ANS: AProteins are made up of various combinations of amino acids, linked together. Carbohydrates aremade up of one or more units of simple sugars. Dietary fiber consists mostly of carbohydrate thatcannot be digested. Lipids are made up of glycerol and triglycerides or sterols.DIF:Cognitive Level: RememberingREFages 8-9TOP: Nursing Process: Assessment MSC: Client Needs: Physiological integrity17. A bodybuilder tells you that all of his meals and snacks include high-protein foods such as eggs,canned tuna, chicken, milk, and cheese. Most of the extra protein is probably used by his body toforma.strong bones and joints.b.body fat stores.c.healthy brain tissue.d.increased muscle mass.ANS: B

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Excess protein is broken down to amino acids and then used for energy or stored as body fat. Thisman’s body will use some of this protein to increase muscle mass, but increasing protein intakebeyond the amount needed does not increase muscle formation. Excess protein intake does notimprove bone, joint, or brain health.DIF:Cognitive Level: ApplyingREFage 9TOP: Nursing Process: Assessment MSC: Client Needs: Physiological integrity18. When clients have a strong family history of both heart disease and cancer, the nurse shouldencourage them to reduce their intake ofa.dietary fiber.b.protein.c.monounsaturated fat.d.saturated fat.ANS: DSaturated fat intake is related to risk of heart disease and certain types of cancer. Monounsaturated fatintake has less effect on risk of these diseases. Dietary fiber intake should be increased to help reducerisk of cardiovascular disease and cancer. The effects of protein intake on risk of these diseases aremuch less significant.DIF: Cognitive Level: Applying REF: Page 9 TOP: Nursing Process: PlanningMSC:Client Needs: Physiological integrity19. The National Health and Nutrition Examination Survey (NHANES) is able to assess the overallnutritional and health status of Americans becausea.the populations surveyed are representative of the total population.b.it focuses on ethnic and socioeconomic groups at greatest risk.

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c.it collects large volumes of survey data from all over the nation.d.survey methods and standards are consistent from year to year.ANS: AData from NHANES represent America overall because the survey populations are carefully selectedto represent the total population. Their data therefore provide a better indication of the nation’soverall health than do large amounts of data from all over the country. It does not focus specificallyon populations at high risk for disease. Standardization over time provides useful data on trends andchanges but does not reveal the overall health of the nation.DIF:Cognitive Level: ApplyingREFages 4-5TOP: Nursing Process: Assessment MSC: Client Needs: Health promotion and maintenance20. In working with a ethnic minority population, a helpful way to increase health literacy could be toa.invite members of the community to help identify needs and teaching strategies.b.encourage acculturation and adoption of healthful American eating patterns.c.set up a feeding program to provide healthy food for members of the community.d.use visual aids rather thanwritten materials during health education encounters.ANS: AMembers of an ethnic minority population can be very helpful in identifying needs and effectiveteaching strategies for people in their community and in encouraging people in the community toaccept advice from nurses or other health professionals. They do not necessarily need to adoptAmerican eating patterns; often these are less healthful than their traditional eating patterns. Settingup feeding programs does not promote positive self-efficacy. Visual aids may be helpful, but theiruse is not necessarily the best educational strategy.DIF: Cognitive Level: Applying REF: Pages 6-7 TOP: Nursing Process: Planning

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MSC:Client Needs: Physiological integrity21. A client has heard that nutrients can be converted to other nutrients in the body. He takes high-dose vitamin C supplements because he believes this will supply his body’s need for other vitamins.What would you tell him?a.He should switch to a multivitamin supplement instead of just vitaminC.b.Each vitamin has a specific function and needs to be supplied through a variety of foods.c.Vitamin C can provide only water-soluble vitamins, and he still needs to consume fat-soluble vitamins.d.Vitamin C supplements should be taken only whenhe has symptoms of a cold or influenza.ANS: BVitamins cannot be converted into other vitamins; each has a specific function, and the best way toconsume adequate amounts of each vitamin is to eat a variety of foods. Vitamin C is water soluble,but it cannot be converted to other water-soluble vitamins. Vitamin C is needed by the body at alltimes, not just when someone is ill. A multivitamin supplement would provide a better range ofvitamins than just vitamin C, but it is still better to consume vitamins from food, rather than fromsupplements.DIF:Cognitive Level: ApplyingREFages 9-10TOP: Nursing Process: Assessment MSC: Client Needs: Physiological integrity22. For a mother with two children who works in health care management 60 to 70 hours a week, thebiggest barrier to healthy eating is likely to bea.lack of concern for her own or her children’s health.b.inadequate income to purchase healthy foods.c.insufficient time to plan and prepare healthful meals.

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d.lack of knowledge about healthyeating.ANS: CFor busy professionals and families, the biggest barrier to healthy eating is usually hectic schedulesand lack of time to plan and prepare healthy meals. Most mothers, especially those who work in ahealth care field, are concerned abouttheir family’s health. Many professional women have at leastsome understanding of healthy eating. With a professional job, lack of income is not very likely to bea barrier to healthy eating.DIF: Cognitive Level: Applying REF: Page 7 TOP: Nursing Process: PlanningMSC: Client Needs: Health promotion and maintenance23. A class of nutrients that is important in body structure and influences the function of muscles andthe central nervous system isa.proteins.b.minerals.c.vitamins.d.carbohydrates.ANS: BMinerals are important in body structures and influence the function of muscles and the centralnervous system. Proteins are structural components and form part of muscles but are less influentialin the central nervous system. Vitamins and carbohydrates do not have structural functions.DIF:Cognitive Level: UnderstandingREFage 10TOP: Nursing Process: Assessment MSC: Client Needs: Physiological integrity24. If mine workers were trapped in a mine and it took several days for a rescue team to reach them,the nutrient that they would need most in order to survive is

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a.protein.b.carbohydrates.c.water.d.vitamins.ANS: CThe body can survive only a few days without water. The body may not function optimally withoutother nutrients, but it can survive many days and even weeks without them.DIF:Cognitive Level: ApplyingREFages 8-10TOP: Nursing Process: Assessment MSC: Client Needs: Physiological integrity25. The client who would benefit most from an increase in dietary fiber intake is one witha.fatigue.b.constipation.c.dehydration.d.coronary heart disease.ANS: BAdequate dietary fiber and fluid intake can help alleviate constipation. It has a small but lesssignificant effect in helping reduce risk of coronary heart disease. Dietary fiber intake does not affectfatigue or hydration status.DIF: Cognitive Level: Applying REF: Page 9 TOP: Nursing Process: PlanningMSC: Client Needs: Health promotion and maintenance26. To provide adequate amounts of vitamins and minerals, the best course of action is to

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a.lose weight to achieve ideal body weight.b.eat a variety of foods from each food group.c.follow the same general food pattern each day.d.consume foods high in fiber and low in saturated fat.ANS: BIncluding a variety of foods from each food group increases the likelihood of obtaining adequateamounts of vitamins and minerals. Achieving ideal body weight does not guarantee adequate nutrientintake. Following the same general food pattern each day could actually limit vitamin and mineralintake because the assortment of foods is likely to be limited. Choosing foods high in fiber and low insaturated fat diet does not necessarily result in intake of adequate levels of vitamins and minerals.DIF: Cognitive Level: Applying REF: Page 12 TOP: Nursing Process: PlanningMSC: Client Needs: Health promotion and maintenance27.If a nurse wants to evaluate whether a client’s vitamin or mineral supplement contains too muchof a specific nutrient, the nurse shoulda.check the manufacturer’s recommendations about intake for that nutrient.b.request blood and urine tests to determine the client’s body stores of that nutrient.c.compare the amount in the supplement to the tolerable upper intake level (UL) for that nutrient.d.compare the amount in the supplement to the Recommended Dietary Allowance (RDA) for that nutrient.ANS: CThe UL is the maximum intake that should not be exceeded to prevent adverse health risks; thisshould be compared to the amount in the supplement. The Recommended Dietary Allowance is theamount that meets the needs of most health individuals in a life-stage and gender group, but it is not

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the upper level for safety. Manufacturers do not necessarily provide reliable information about safetyof supplements they are marketing. Blood and urine tests may or may not show whether the body isaccumulating unsafe levels of a nutrient, depending on the nutrient and how long the supplement hasbeen taken.DIF:Cognitive Level: ApplyingREFage 11TOP:Nursing Process: Assessment| Nursing Process: EvaluationMSC:Client Needs: Physiological integrity28. Why is it difficult to specify the number of grams of protein that he or she should eat each day?a.More research studies are needed to help determine ideal levelsof protein intake for various age and gendb.Health care professionals should not give specific advice to clients, to avoid lawsuits.c.It is unrealistic to expect clients to meet precise levels of protein intake.d.Recommended proteinintakes are expressed as a range and are based on a percentage of energy intake, whindividuals.ANS: DProtein intake does not need to be precise and can be within an acceptable range, expressed as apercentage of energy intake. Health care professionals should not give unnecessarily precise advice,but they can give scientifically based advice without concern for lawsuits. A reasonable amount ofresearch has been conducted to be able to give at least general advice about protein intake. Thelikelihood that clients will achieve a specific protein intake is not related to the difficulty inidentifying what their intake level should be.DIF:Cognitive Level: AnalyzingREFages 8-9 | Page 11TOP: Nursing Process: Assessment MSC: Client Needs: Physiological integrity29. If a college student is eating only one small meal per day in an attempt to lose weight and istaking high doses of vitamin and mineral supplements to try to make up for the lack of food, thestudent would be described as having

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a.malnutrition.b.disordered nutrition.c.overnutrition.d.undernutrition.ANS: AAn imbalance of intake of nutrients, energy, or both (in this case, high intake of some nutrients andlow intake of energy) is calledmalnutrition. Overnutritionrefers only to excessive intake, excessivenutrients, or excessive energy.Undernutritionrefers only to inadequate intakes of nutrients, energy,or both. “Disordered nutrition” is not a recognized term.DIF:Cognitive Level: ApplyingREFage 12TOP: Nursing Process: Assessment MSC: Client Needs: Physiological integrity30. An overweight client has been trying to lose weight for years. She tells you that she believes sheis genetically designed to be overweight and that the foods available in supermarkets today makeweight loss impossible. The client’s attitude showsa.positive self-efficacy.b.negative self-efficacy.c.poor environmental health.d.poor emotional health.ANS: BThe client’s attitude demonstrates negative self-efficacy. She does not perceive that she has powerover her life and behaviors. A belief that she could change her personal behaviors would reflectpositive self-efficacy. She is able to express her feelings, and so she does not necessarily have poor

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emotional health. Her belief about healthy food choices in her environment is not necessarilyaccurate.DIF:Cognitive Level: ApplyingREFages 1-2 | Page 12TOP: Nursing Process: Assessment MSC: Client Needs: Psychosocial integrity02: Personal and Community NutritionChapter 02: Personal and Community NutritionGrodner and Escott-Stump: Nutritional Foundations and Clinical Application: A NursingApproach, 6th EditionMULTIPLE CHOICE1. A client tells you that he cannot eat most green vegetables because they taste too bitter. What is themost likely explanation?a.He has certain genetic taste markers that make him a “super taster.”b.He associates eating green vegetables with unpleasant childhood memories.c.He needs to train himself to enjoy the acquired taste of bitter vegetables.d.He is making an excuse to avoid making healthful changes in his eating habits.ANS: ASome people have variations in genetic taste markers that make them “super tasters.” These peopleoften experience the taste of certain vegetables as being bitter. Environmental factors such aschildhood memories may also influence food choices but are not usually associated with tastingvegetables as bitter. Tastes can be acquired and sometimes people make excuses to avoid makingchanges, but these are less likely explanations for this particular problemDIF:Cognitive Level: ApplyingREFage 18TOP: Nursing Process: Assessment MSC: Client Needs: Health promotion and maintenance

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2. A teenaged client is hungry and goes to the refrigerator for a snack. A holiday has just beencelebrated at her home, and many of her favorite foods are available. She selects some slices of roastturkey and a cup of her aunt’s special fruit salad. This is an example ofa.bingeing.b.abundance.c.food choice.d.food preference.ANS: DThis teenager is able to select foods according to her preferences. Food choices are restricted byconvenience, but many of her favorite foods are available, and so her choices are not limited. Thefood is abundant, and she may choose to binge and overeat, but her selections are made according toher food preference.DIF:Cognitive Level: AnalyzingREFage 18TOP: Nursing Process: Assessment MSC: Client Needs: Psychosocial integrity3. A mother tells you that she does not allow her young children to eat while they watch television,even though her husband often eats high-fat, sugary foods while they watch television as a family.The most important thing to discuss with her is thea.genetic factor of preference for sweet and salty tastes.b.influence of ethnicity on preference for sour tastes.c.children’s weights when they were born and their weights now.d.environmental effects of parental food choices and television watching.ANS: D

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Because young children spend so much time with theirfamilies, their parents’ food choices have amajor effect on their own future food choices. Preventing young children from eating while watchingtelevision will have only a short-term effect, and they are likely to imitate their father in eating high-fat, high-sugar snacks. The father’s food preferences are probably influenced by genetics andethnicity, and it may be interesting to find out whether the children’s current weights are healthy fortheir heights (although their birth weight is probably not relevant), but this information has lessimmediate effect on the nutritional health of this family.DIF:Cognitive Level: ApplyingREFage 18 | Page 35TOP: Nursing Process: Implementation MSC: Client Needs: Psychosocial integrity4. If a middle-aged couple with two teenage children has insufficient income to purchase food, themost helpful program for them would be thea.MyPlatefood guidance system.b.National School Lunch and School Breakfast Programs.c.federal government’s Supplemental Nutrition Assistance Program (SNAP).d.Special Supplemental Nutrition Program for Women, Infants, and Children (WIC).ANS: CSNAP provides financial assistance to buy nutritious foods for individuals and families with incomesbelow certain levels. WIC provides assistance only to women who are pregnant or breastfeeding andto infants and children up to the age of 5 who are at nutritional risk. School meal programs wouldbenefit the children but not the adults.MyPlatewould help the family make healthy food choices butwould not help with their financial problems.DIF:Cognitive Level: ApplyingREFages 18-19 | Page 21TOP: Nursing Process: Planning MSC: Client Needs: Health promotion and maintenance5. For most Americans, the most significant nutrition concerns are

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a.lack of interest in making healthy food choices.b.poor availability of fruits and vegetables in many areas.c.excessive intake of saturated fats, cholesterol, sodium, and sugars.d.inadequate intake of key vitamins, minerals, and phytochemicals.ANS: CMost Americans have high intake of saturated fats, cholesterol, sodium, and sugars, which isassociated with increased prevalence of chronic disease. Many people have inadequate intake ofmicronutrients, but this has a lesser overall effect than excessive intakes of fats, sodium, and sugars.Some areas of the country have poor availability of fruits and vegetables, but this is not a widespreadproblem in the country as a whole. Many Americans express at least some concern about makinghealthy food choices.DIF:Cognitive Level: UnderstandingREFages 18-20 | Page 30TOP: Nursing Process: Assessment MSC: Client Needs: Health promotion and maintenance6. Excessive intake of high-sodium, high-fat foods can lead to diet-related illnesses such asa.genetic disorders, hypertension, and diabetes.b.hypertension and sickle cell anemia.c.viral infections that necessitate antibiotics.d.coronary artery disease and hypertension.ANS: DCoronary artery disease and hypertension are more common in individuals who consume high-sodium, high-fat diets. The risk for genetic disorders, sickle cell anemia, and viral infections is notaffected by dietary fat and sodium intake.

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DIF:Cognitive Level: ApplyingREFage 19TOP: Nursing Process: Assessment MSC: Client Needs: Health promotion and maintenance7. Of the following, the most important overall dietary modification to help reduce the risk of chronicdisease isa.eating fewer foods that contain preservatives.b.buying mostly locally grown foods.c.eating more plant-based foods.d.eating more animal-based foods.ANS: CScientific evidence from the nutrition literature shows that shifting to a more plant-based diet is oneof four significant modifications to dietary intake patterns that will improve the overall health ofAmericans. Preservatives per se have not been associated with health status (although foods thatcontain preservatives may be more highly processed and may have higher levels of fat, sugar, andsodium and lower levels of nutrients than do foods without preservatives). Buying locally grownfoods may be a good agricultural and economic practice, but it does not affect health status. Eatingmore animal-based foods would be the opposite of what is recommended.DIF: Cognitive Level: Applying REF: Page 20 TOP: Nursing Process: PlanningMSC: Client Needs: Health promotion and maintenance8. One way to help clients follow theDietary Guidelines for Americansis to encourage them to usea.HealthyPeople2020.b.theMyPlatefood guidancesystem.c.the Supplemental Nutrition Assistance Program (SNAP).

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d.theExchangeListsforMealPlanning.ANS: BMyPlateis designed to help clients implement the recommendations of theDietary Guidelines forAmericans. Healthy People 2020sets national targets for health promotion. SNAP provides funds forindividuals and families with low incomes to buy nutritious foods. TheExchange Lists for MealPlanningis intended primarily for patients with diabetes and those who need to lose weight; thesystem helps patients choose appropriate portion sizes to control their intake of fat, protein,carbohydrate, and energy.DIF: Cognitive Level: Understanding REF: Pages 18-23 | Pages 27-28TOP: Nursing Process: Planning MSC: Client Needs: Health promotion and maintenance9. For a client who follows a vegan diet, the most helpful meal planning tool would bea.the Healthy Eating Plate, produced by the Harvard School of Public Health.b.the Mediterranean Diet Pyramid, from Oldways Preservation and Exchange Trust.c.the Power Plate, created by the Physicians Committee for Responsible Medicine.d.ExchangeListsforMealPlanning,from the American Diabetes Association and theAmerican Dietetic AANS: CThe Power Plate is a vegan food planning guide that eliminates all sources of animal foods. TheHealthy Eating Plate and Mediterranean Diet Pyramid could be adapted for a vegan diet, but theyinclude meat and dairy options. TheExchange Lists for Meal Planningis intended to help designeating patterns for clients who need to monitor their intake of energy and specific macronutrients,such as clients with diabetes.DIF: Cognitive Level: Applying REF: Pages 22-25 | Pages 27-28TOP: Nursing Process: Planning MSC: Client Needs: Health promotion and maintenance10.An indirect benefit of the “Fruits & Veggies—More Matters” program is

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a.better understanding of fruit and vegetable preparation techniques.b.increased availability of fruits and vegetables in “food deserts.”c.eating more fresh produce inseason.d.decreasing dietary fat intake.ANS: D“Fruits & Veggies—More Matters” is designed to increase intake of fruits and vegetables. Fruits andvegetables are naturally low in fat; they would replace higher fat foods in the diet and thus wouldindirectly decrease dietary fat intake. The program does not address fruit and vegetable preparationtechniques, does not target availability of produce in “food desert” areas, and does not address eatingfruits and vegetables in season versus out of season.DIF: Cognitive Level: Applying REF: Page 23 | Page 26 | Page 30TOP: Nursing Process: Implementation MSC: Client Needs: Health promotion and maintenance11. A meal planning guide that would be helpful for a patient who needs to closely monitor theirintake of calories, carbohydrates, protein, and fat is thea.National Fruit and Vegetable Program.b.MyPlatefood guidance system.c.DietaryGuidelinesforAmericans.d.ExchangeListsforMealPlanning.ANS: DIn theExchange Lists for Meal Planning,foods are grouped according to their kilocalorie,carbohydrate, protein, and fat content, and serving sizes that contain specific amounts of each ofthese are listed. Therefore, this guide can help clients monitor their intake. The National Fruit and

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Vegetable Program simply encourages increased intake of fruits and vegetables. TheDietaryGuidelines for Americansgives general advice but does not translate this into specific amounts offoods.MyPlatewould help patients achieve healthy intake of kilocalories, carbohydrate, protein, andfat, but it would not be specific enough for them to monitor their intake closely.DIF: Cognitive Level: Applying REF: Pages 19-23 | Pages 26-28TOP: Nursing Process: Planning MSC: Client Needs: Health promotion and maintenance12. One reason that increasing fruit and vegetable consumption helps decrease dietary fat intake isthat fruits and vegetablesa.are natural appetite suppressants.b.replace high-fat foods in the diet.c.are rich in antioxidants and phytochemicals.d.decrease absorption of fat from foods.ANS: BFruits and vegetables replace high-fat foods in the diet because they are high in fiber and water; theycause satiety so that clients have less desire for high-fat foods. Fruits and vegetables are not, and donot contain, natural appetite suppressants and do not hinder absorption of fat from foods. They arerich in antioxidants and phytochemicals, but increased intake of these substances does not affect fatintake.DIF:Cognitive Level: UnderstandingREFage 23 | Pages 26-27TOP: Nursing Process: Assessment MSC: Client Needs: Health promotion and maintenance13. Why are health professionals concerned about the trend toward eating more food away fromhome?a.Larger portion sizes often contribute to excessive caloric intake.

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b.Eating away from home means less social interaction.c.Eating out tends to decrease the variety of foods eaten.d.Restaurant meals are associated with more sedentary lifestyles.ANS: ARestaurants and fast food outlets often serve large portions that increase caloric intake. Eating awayfrom home does not necessarily decrease social interaction, inasmuch as families or friends may eataway from home in groups. Eating out does not necessarily decrease the variety of foods eaten,depending on individual food choices. Eating out has not been related to physical activity levels.DIF:Cognitive Level: UnderstandingREFage 21 | Page 29TOP: Nursing Process: Planning MSC: Client Needs: Health promotion and maintenance14. If clients want to use the food label to check the number of kilocalories in a product, they shouldalso check thea.calories from fat.b.servings per container.c.Percent Daily Value.d.ingredient list.ANS: BThe number of calories in a product is stated for a standard serving size of that food. Clients need tomultiply the calories per serving by the number of servings in the container to know how manycalories are in the container. The calories from fat are not related to the total number of calories inthe food. The Percent Daily Value refers to the nutrient content of the food rather than its caloricvalue. The ingredient list does not give any information about calories.

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DIF:Cognitive Level: AnalyzingREFage 32TOP: Nursing Process: Implementation MSC: Client Needs: Health promotion and maintenance15. The most useful part of the food label for clients who want to make sure they choose foods highin nutrients is thea.Percent Daily Value.b.health claims.c.organic seal.d.amount of nutrients perserving.ANS: AThe Percent Daily Value shows how a food fits into the overall daily diet and would therefore showwhether it makes a high or low contribution to nutrient intake. Health claims may indicate that a foodhas high or low amounts of specific nutrient related to that particular health claim, but they would notindicate overall nutrient content of the food. The organic seal, if present, indicates the farmingmethods used to grow the food but does not give any information about nutrient content. The amountof nutrients per serving is listed for only some nutrients; the listing would not give any informationabout vitamins and minerals in the food because these are listed only as Percent Daily Values.DIF:Cognitive Level: ApplyingREFages 31-35TOP: Nursing Process: Implementation MSC: Client Needs: Health promotion and maintenance16. If a client is trying to increase intake of dietary fiber, a useful symbol to look for on the food labelwould be thea.MyPlatefood guidance graphic.b.U.S. Department of Agriculture (USDA) 100% Organic seal.c.“Fruits & Veggies—More Matters” logo.

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d.100% Whole Grain stamp.ANS: DWhole grains are an important source of dietary fiber, and so the 100% Whole Grain stamp wouldhelp a client select high-fiber foods. Fruits and vegetables also contain high amounts of dietary fiber,but the “Fruits & Veggies—More Matters” logo is not used in labeling individual foods.MyPlateisalso not used on food labels. The organic status of a food does not reveal any information about itsdietary fiber content.DIF: Cognitive Level: Understanding REF: Pages 21-23 | Page 27 | Pages 33-34TOP: Nursing Process: Implementation MSC: Client Needs: Health promotion and maintenance17. The Nutrition Facts panel on a food label is useful fora.determining the ingredients in a product.b.determining the ease of preparing a product.c.comparing the price value of two or more products.d.comparing the nutritional value of two or more products.ANS: DThe Nutrition Facts panel on a food label lists the quantities of specific key nutrients in the food andcan therefore be used to compare the nutritional value of two or more products. The ingredients arelisted elsewhere on the package, rather than in the Nutrition Facts panel. The Nutrition Facts paneldoes not indicate how easy the food is to prepare and does not include any information about cost orprice.DIF:Cognitive Level: UnderstandingREFages 32-33TOP: Nursing Process: Implementation MSC: Client Needs: Health promotion and maintenance18. A pregnant woman may look for a health claim on food labels that links

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a.sodium intake and risk of stroke.b.calcium intake and risk of osteoporosis.c.folic acid intake and risk of neural tube defects.d.fruit and vegetable intakeand risk of heart disease.ANS: CThe U.S. Food and Drug Administration has approved use of a health claim stating the relationshipbetween folic acid intake during pregnancy and decreased risk of neural tube defects in infants. It hasalso approved use of a health claim stating the relationships between (1) calcium intake and (2)decreased risk of osteoporosis, between (1) a diet rich in fiber-containing grain products, fruits, andvegetables and (2) reduced risk of coronary heart disease, and between (1) a diet low in sodium and(2) reduced risk of high blood pressure (not specifically stroke); however, this information is notdirectly relevant to a pregnant women.DIF:Cognitive Level: ApplyingREFage 35TOP: Nursing Process: Implementation MSC: Client Needs: Health promotion and maintenance19. An eating behavior that is most likely to have a negative long-term effect on health isa.a monthly meal out at an expensive restaurant.b.eating French fries with lunch once a week.c.avoiding a specificfruit or vegetable.d.drinking one can of sugar-sweetened beverage every day.ANS: DSmall daily practices have a cumulative effect on nutritional health. Eating a rich meal once a monthor even ordering French fries once a week will have less overall effect on health than daily habits. It

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