Chapter 18- Digestion and Nutrition, 1


Miller book quiz bank
Lesly Ramos
Flashcards by Lesly Ramos, updated more than 1 year ago
Lesly Ramos
Created by Lesly Ramos about 3 years ago

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1. A nurse teaches an older adult about changes to nutritional requirements. Which of the following meal choices would give evidence that the older adult understands the teaching? A) Baked chicken, carrots, and angel food cake B) Green salad, mashed potatoes, and an oatmeal cookie C) Vegetable beef soup, crackers, and Jell-O D) Baked pork chop, green beans, and sherbet Ans: A Feedback: Older adults need increased intake of foods with a high nutritional value and a concomitant decrease in the intake of foods containing little or no nutrients.
2. A nurse teaches older adults about nutrition. Which of the following statements shows the nurse that the older adult requires further teaching? A) "Alcohol intake will interfere with absorption of B-complex vitamins and vitamin C." B) "Certain 'fluid' pills can decrease the potassium level in my blood." C) "Anticholinergic medications can cause my intestines to work slower." D) "My over-the-counter beta-carotene pill is appropriate for long-term use." Ans: D Feedback: Long-term beta-carotene use can cause vitamin E deficiency. Paralytic ileus can occur with anticholinergic medication. Nutritional supplements and herbal preparations can affect nutrients. Alcohol interferes with the absorption of B-complex vitamins and vitamin C.
3. A 70-year-old client with urosepsis is admitted to a nursing unit. The labs include elevated sodium, blood urea nitrogen, hematocrit, and albumin. Which of the following nursing diagnoses is priority for this client? A) Constipation B) Fluid volume deficit C) Imbalanced nutrition: less than body requirements D) Impaired tissue perfusion Ans: B Feedback: The appropriate nursing diagnosis is fluid volume deficit. Blood values that may be altered in dehydration include elevations in sodium, hematocrit, creatinine, osmolality, and blood urea nitrogen. While the client may develop constipation, it is not the priority at this time. Albumin will be decreased with poor nutrition but increased with dehydration. An elevation in these labs does not implicate impaired tissue perfusion.
4. A nurse plans the diet for an older adult with congestive heart failure. Which of these nursing interventions would be most successful to encourage optimal nutrition? A) Encourage calorie supplements. B) Provide 55% of calories from complex carbohydrates. C) Teach older adults to sit upright for 2 hours after a meal. D) Use moderate to large amounts of flavor enhancers. Ans: B Feedback: Dietary guidelines for older adults recommend a daily intake of five to nine servings of fruits and vegetables; 55% of calories need to come from complex carbohydrates. Older adults need fewer calories with increased quality of nutrients in their nutritional requirements. Older adults with presbyesophagus must sit upright for 30 minutes to 1 hour after eating. Flavor enhancers (except lemon) contain sodium and need to be used in small amounts for older adults who have a diminished sense of taste.
5. A nurse teaches a health education class for older adults about constipation. Which of the following points should the nurse stress? A) Older adults who do not have a daily bowel movement should use a laxative. B) Older adults should limit their intake of high-fiber foods because of a risk of lactose intolerance. C) If older adults need a medication to promote bowel regularity, a laxative or enema should be given. D) If older adults need a medication to promote bowel regularity, a bulk-forming agent is needed daily. Ans: D Feedback: A bulk-forming agent is least likely to have detrimental effects; providing fluid intake is adequate, if a medication is needed to promote regular bowel elimination. If at all possible, older adults should avoid laxatives. Older adults should include several portions of high-fiber foods in their daily diet.
6. A nurse assesses an older adult in the assisted living facility who has presbyphagia. Which of the following systems should the nurse auscultate? A) Abdomen for bruit B) Bowel sounds C) Heart tones D) Lung sounds Ans: D Feedback: Swallowing difficulties create a risk of aspiration. Presbyphagia is unlikely to result in assessment changes to the abdomen or heart.
7. A nurse counsels an older adult regarding nutritional requirements. Which of the following teaching points is priority when discussing age-related changes in nutritional requirements? A) "If possible, try to eliminate animal fats from your diet." B) "You should try to eat less meat and proteins than you did when you were younger." C) "Overall, you don't need to take in as many calories as you used to." D) "As an older adult, you don't need to eat as many starches and complex carbohydrates." Ans: C Feedback: Caloric requirements for older adults are significantly less than those for younger adults. It is unnecessary to wholly eliminate animal fats from the diet, and protein intake should remain same as for younger adults. Complex carbohydrates should constitute the majority of caloric intake.
8. A nurse manager of the long-term care facility develops plans to reduce nutritional deficits. Which of the following interventions is appropriate to include in the plan? A) Encourage residents to eat in their rooms to minimize distractions. B) Offer four to five small meals a day rather than three larger meals. C) Promote oral care for residents multiple times each day. D) Provide incentives for residents to eat all the food on their trays. Ans: C Feedback: Adequate oral care is important in the promotion of adequate food intake, because it enhances chewing, eating, and swallowing. Eating alone is associated with lower caloric intake. Offering incentives may be construed as coercive or patronizing. Frequent, small meals may be necessitated by certain medical conditions, but this is not a recognized strategy for the promotion of nutrition among a larger group of older adults.
9. A nurse evaluates the plan of care for a client who experienced an ischemic stroke. Which of the following assessment findings should signal the nurse to the possibility that the client has developed dysphagia? A) The client complains of being excessively hungry. B) The client drinks large amounts of water with meals. C) The client pockets food in the affected cheek during meals. D) The client prefers to sit in a high Fowler's position after eating. Ans: C Feedback: Pocketed food suggests dysphagia. Sitting upright after meals prevents, rather than indicates, dysphagia and neither hunger nor high fluid intake is indicative of dysphagia.
10. A nurse admits a 90-year-old client to the hospital with a diagnosis of failure to thrive. Which of the following laboratory data should the nurse expect? A) Low albumin and red blood cells B) Elevated white blood cells (WBCs) and low potassium C) Low platelets and low prothrombin time (PT) D) Elevated calcium and magnesium Ans: A Feedback: Anemia and low serum albumin levels are consistent with malnutrition. Elevated WBCs, calcium, and magnesium and low platelets and PT are not characteristic of malnutrition.
11. A nurse assesses older adults at a senior center. One older adult, age 78, has a body mass index (BMI) of 15. Which response by the nurse is appropriate? A) "You are too skinny." B) "Have you been losing weight?" C) "Have you tried to lose this extra weight?" D) "Congratulations your BMI is great." Ans: B Feedback: The nurse uses therapeutic communication to assess the weight loss. Unintentional weight loss is considered a significant indicator of poor nutrition. Healthy adult BMI is between 18 and 25 and may extend to 30 for older adults.
12. A nurse working for human services visits a long-term care facility. Which resident assessment finding indicates poor quality care? A) BMI of 29 B) Indentured mouth C) Serum albumin of 3.5 D) Unintentional weight loss Ans: D Feedback: Healthy adult BMI is between 18 and 25 and may extend to 30 for older adults. Dentures are a common finding in older adults. Normal serum albumin is 3.5 to 5; unintentional weight loss is an indicator of quality of care provided by the facility.
13. A nurse plans care for a client who states that food is no longer appealing. The nurse notes a dry mouth and teeth in poor condition. Which interventions should the nurse include in the plan of care? (Select all that apply.) A) Eight-ounce bottle of water between each meal B) Hard toothbrush C) Ice cold water at bedside D) Meals in the common room E) Oral care before each meal Ans: A Feedback: Social isolation can lead to lack of appetite. Saliva-producing activities before each meal and 60 to 80 ounces of water a day are recommended to treat dry mouth. Iced drinks are less palatable to the older adult with poor oral condition. A soft electric toothbrush is recommended.
14. A nurse at a rehabilitation unit assesses an 86-year-old woman with a BMI of 30 and a history of heart failure, whose oral intake is declining. Which of the following risk factors is related to this older adult's decline in appetite? A) Diuretics B) Exercise C) Female gender D) Obesity Ans: A Feedback: Diuretics decrease saliva, olfactory function, and gustatory functioning. Women have better olfactory and gustatory function than men; exercise increases appetite. Obesity is unrelated.
15. An older adult states, "I just feel so full so fast, I can't eat any more." Which of the following responses is most appropriate? A) "All of us feel that way after a meal." B) "Make an appointment with your health care provider." C) "Slower emptying of your stomach may be the cause." D) "This happens when you have gall stones." Ans: C Feedback: Slight slowing of gastric emptying in older adults after ingestion of large meals leads to early sensations of fullness. Gallstone symptoms include pain, not fullness. An emergent visit to the health care provider is not indicated.
16. An older adult develops diarrhea. Which of the following is the priority intervention for the nurse? A) Assess for pancreatitis. B) Determine the last bowel movement. C) Review meal preparation techniques with the client. D) Review the client's medication list. Ans: D Feedback: A number of medications can cause diarrhea in the older adult (e.g., Cimetidine, laxatives, antibiotics, cardiovascular drugs, and cholinesterase inhibitors). Additionally, Clostridium difficile and its related diarrhea are related to antibiotic usage.
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