(Test Bank) Nutritional Foundations and Clinical Applications A Nursing Approach

Gridner,Escott-Stump, 6

Medicine

Test Bank

6th Edition

• $10.00 $35.00

---

Description

Test Bank for Nutritional Foundations and Clinical Applications A Nursing Approach, The downloadable file consists of 187 pages, and the total size of the file is 0.81 MB. Purchase now only for highly discounted price.

Author(s): Gridner, Escott-Stump

---

---

Study Note Preview

Test bank Application: A Nursing Approach, 6th Edition Chapter 01: W ellness Nutrition My Nursing T est Banks Chapter 02: Personal and Community Nutrition My Nursing T est Banks Chapter 03: Digestion, Absorption, and Metabolism My Nursing T est Banks Chapter 04: Carbohydrates My Nursing T est Banks Chapter 05: Fats My Nursing T est Banks Chapter 06: Pr otein My Nursing T est Banks Chapter 07: V itamins My Nursing T est Banks Chapter 08: W ater and Minerals My Nursing T est Banks Chapter 09: Energy , Weight, and Fitness My Nursing T est Banks Chapter 10: Nutrition Acr oss The Life Span My Nursing T est Banks Chapter 1 1: Nutrition Assessment and Patient Car e My Nursing T est Banks Chapter 12: Food-Related Issues My Nursing T est Banks Chapter 13: Nutrition for Disorders of the Gastr ointestinal T ract My Nursing T est Banks Chapter 14: Nutrition for Disorders of the Liver , Gallbladder , and Pancr eas My Nursing T est Banks Chapter 15: Nutrition for Diabetes Mellitus My Nursing T est Banks Chapter 16: Nutrition in Metabolic Str ess: Burns, T rauma and Surgery My Nursing T est Banks Chapter 17: Nutrition for Cardiopulmonary Diseases My Nursing T est Banks Chapter 18: Nutrition for Diseases of the Kidneys My Nursing T est Banks Chapter 19: Nutrition for Neur o-Psychiatric Disorders My Nursing T est Banks Chapter 20: Nutrition in Cancer and HIV/AIDS My Nursing T est BanksChapter 01: W ellness Nutrition My Nursing T est Banks Chapter 01: W ellness Nutrition Grodner and Escott-Stump: Nutritional Foundations and Clinical Application: A Nursing Appr oach, 6th Edition MUL TIPLE CHOICE 1. Examples of informal education include a.attending a workshop on coronary artery 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: B Watching a television show about diabetes is an example of informal education because it is an experience that occurs through a daily activity . Attending a workshop or joining a support group would be considered nonformal education; a high school course would be considered formal education. DIF:Cognitive Level: ApplyingREFage 6 TOP: Nursing Process: Implementation MSC: Client Needs: Health promotion and maintenance 2. A college student exercises regularly and generally eats a healthy variety of foods, is taking a course in general nutrition, buys locally produced food whenever possible, is an active member of an on-campus faith-based or ganization, and keeps a journal to help process her emotions. What else could be important for her to include in her life in order to develop her overall wellness? a. Growing some of her own food b. Keeping a food record to help evaluate what she eats c. Eating meals with friends throughout the week d. Meeting with a registered dietitian to review her food choices ANS: C Wellness enhances a persons level of health through development of each of the six dimensions of health: physical health, intellectual health, emotional health, social health, spiritual health, and environmental 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 food helps develop environmental health; being part of a faith-based or ganization helps develop spiritual health; and keeping a journal helps develop emotional health. The missing dimension in this example is development of social health; eating meals with friends throughout the week would add this dimension. Growing her own food would be another example of environmental health; keeping a food record would be another contributor to physical health; and meeting with a registered dietitian may contribute to physical, intellectual, and emotional health. DIF:Cognitive Level: AnalyzingREFages 1-3 TOP: Nursing Process: Assessment MSC: Client Needs: Health promotion and maintenance 3. For a client who is missing meals because of poor planning or is too busy to eat, emotional health can be af fected by _____, which can cause confusion or anxiety . a. low blood sugar levels b. high blood sugar levels c. high blood pressured. extremely low blood pressure ANS: D Poor eating habits af fect emotional health. Missing meals may cause blood sugar levels to decrease, which can cause anxiety or confusion or make it dif ficult to control emotions. Late night binges on snack food are likely to result in excessive ener gy intake but would have a less direct ef fect on emotional health. Eating small meals throughout the day is likely to maintain more constant blood sugar levels, which would actually have a positive ef fect on emotional health. Excessive caf feine consumption may contribute to anxiety , but 2 cups of caf feinated cof fee is not considered excessive. DIF:Cognitive Level: AnalyzingREFage 2 TOP: Nursing Process: Assessment MSC: Client Needs: Psychosocial integrity 4. The best example of the type of concern that is likely to be addressed by the U.S. Department of Health and Human Services when tar get goals for Healthy People 2030 are updated is a. 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: B Healthy People is used to set tar gets for health promotion to improve the health of all individuals. It addresses environmental and social issues that af fect health outcomes. Low intake of fruits and vegetables by African American children is likely to have an adverse ef fect on their health and so may be addressed when tar get goals are set. V egetarian eating patterns, use of bottled water , and use of protein and vitamin supplements do not necessarily have an adverse ef fect on nutritional health and so are less likely to be addressed. DIF: Cognitive Level: Applying REF: Pages 4-6 T OP: Nursing Process: Planning MSC: Client Needs: Health promotion and maintenance 5. An example of community support for health promotion is a. teaching a young mother skills in safe food preparation. b. watching a television documentary about industry errors in food processing. c. labeling fresh poultry packages with information about proper food storage. d. being aware that Salmonella can be transmitted because of inadequate food preparation. ANS: C Food labeling information is an example of community support because it is a regulatory measure that supports new health-promoting behaviors within a social context. T eaching, watching television and awareness may increase knowledge, but they do not alter the social context by regulation or environmental change. DIF:Cognitive Level: ApplyingREFage 4 TOP: Nursing Process: Implementation MSC: Client Needs: Health promotion and maintenance 6. An example of a technique for health promotion is a. 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: C Health 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 a change in behavior . Stocking a wider availability of fresh produce does not promote health, unless the supermarket uses specific strategies to encourage consumption. Information about the relationship between nutrients and disease is simply information unless it is used to promote behavior change. DIF:Cognitive Level: ApplyingREFage 4 TOP: Nursing Process: Implementation MSC: Client Needs: Health promotion and maintenance 7. For the ef ficient functioning and maintenance of the body , a person needs to consume suf ficient amounts of a. fiber. b. nutrients. c. minerals. d. supplements. ANS: B The body needs suf ficient amounts of all nutrients for ef ficient functioning and maintenance. Both fiber and minerals are needed, but each represents only one type of nutrient. Supplements are not always necessary because suf ficient nutrients can often be obtained from food. DIF:Cognitive Level: UnderstandingREFages 8-10 TOP: Nursing Process: Assessment MSC: Client Needs: Physiological integrity 8. A nurse has just been assigned to a community health program for older adults. She should check the document Healthy People 2020 to become familiar with a. nutrition priorities and goals for older American adults. b. dietary standards for Americans older than 50 years. c. dietary guidelines recommended for older adults. d. MyPlate recommendations for older adults. ANS: A Healthy People 2020 focuses on tar gets and goals for improving the health of the nation. The nurse would check the Dietary Reference Intakes for information about dietary standards. The Dietary Guidelines for Americans and MyPlate are separate documents from Healthy People 2020 and focus on specific advice and guidelines for healthy eating. DIF:Cognitive Level: ApplyingREFages 4-5 | Page 10 TOP: Nursing Process: Planning MSC: Client Needs: Health promotion and maintenance 9. A healthy female middle-aged client asks what she can do to prevent the development of type 2 diabetes. W eight control and nutrition strategies discussed are considered a. primary treatment. b. primary prevention. c. secondary prevention. d. tertiary prevention. ANS: B Action to prevent the development of type 2 diabetes is considered primary prevention. Secondary prevention involves early detection to halt and minimize the ef fects of the disease, and tertiary prevention 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 T OP: Nursing Process: Planning MSC: Client Needs: Health promotion and maintenance10. As a home health care nurse, you are visiting a 70-year -old client who has just returned home from the hospital after being treated for coronary artery disease. The medical nutrition therapy developed for him by the hospital dietitian is considered a. palliative care. b. primary prevention. c. secondary prevention. d. tertiary prevention. ANS: D This is an example of tertiary prevention, which entails minimizing complications and helping restore health after heart disease has developed. Primary prevention would occur before the disease developed, and secondary prevention would involve early detection to minimize the ef fects of the disease. Palliative care is intended only to minimize symptoms. DIF: Cognitive Level: Applying REF: Pages 5-6 T OP: Nursing Process: Planning MSC: Client Needs: Health promotion and maintenance 11. A nutrient that can be made by the body is called a. essential. b. complete. c. incomplete. d. nonessential. ANS: D Nonessential nutrients can be made by the body . Essential nutrients cannot be made by the body and must be consumed. The terms complete and incomplete refer to proteins. Complete proteins contain all the essential amino acids; incomplete proteins are lacking one or more essential amino acids. DIF:Cognitive Level: RememberingREFages 8-9 TOP: Nursing Process: Assessment MSC: Client Needs: Physiological integrity 12. A client exercises regularly and wants to make sure he has suf ficient ener gy for his workouts. The type of nutrient that will be most helpful in providing the ener gy he needs is a. carbohydrates. b. water . c. minerals. d. protein. ANS: A Carbohydrates are the best source of fuel to provide ener gy for the body . Protein can also provide fuel for ener gy, but its primary purpose is important structural and functional roles. W ater and minerals are important for health but do not provide fuel for ener gy. DIF: Cognitive Level: Applying REF: Pages 8-10 T OP: Nursing Process: Planning MSC:Client Needs: Physiological integrity 13. A 45-year -old man tells you that he drinks 3 oz of Scotch whiskey most evenings. His alcohol intake is considered a. 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 as whiskey , is 1.5 ounces. Therefore, 3 oz of whiskey per day is considered moderate alcohol intake. DIF:Cognitive Level: AnalyzingREFage 9 TOP: Nursing Process: Assessment MSC: Client Needs: Health promotion and maintenance 14. A dessert contains 4 g of protein, 30 g of carbohydrate, 15 g of fat, and 5 g of alcohol. The nutrient that provides the most kilocalories in the dessert is a. protein. b. carbohydrate. c. fat. d. alcohol. ANS: C Fat provides the highest number of kilocalories: At 9 kcal per gram, 15 g of fat provides 135 kcal. At 4 kcal per gram, 4 g of protein provides 16 kcals. At 4 kcal per gram, 30 g of carbohydrate provides 120 kcal. At 7 kcal per gram, 5 g of alcohol provides 35 kcal. DIF:Cognitive Level: ApplyingREFage 9 TOP: Nursing Process: Assessment MSC: Client Needs: Health promotion and maintenance 15. A cup of frozen yogurt contains 24 g of carbohydrate, 2 g of fat, and 4 g of protein. The total number of kilocalories in the frozen yogurt is a. 110. b. 130. c. 140. d. 162. ANS: B At 4 kcal per gram, 24 g of carbohydrate provides 96 kcal. At 9 kcal per gram, 2 g of fat provides 18 kcal. At 4 kcal per gram, 4 g of protein provides 16 kcal. Therefore, the total kilocalories in the frozen yogurt is 130 kcal (96 + 18 + 16). DIF:Cognitive Level: ApplyingREFages 8-9 TOP: Nursing Process: Assessment MSC: Client Needs: Health promotion and maintenance 16. Combinations of amino acids link together to form a. protein. b. carbohydrates. c. dietary fiber . d. lipids. ANS: A Proteins are made up of various combinations of amino acids, linked together . Carbohydrates are made up of one or more units of simple sugars. Dietary fiber consists mostly of carbohydrate that cannot be digested. Lipids are made up of glycerol and triglycerides or sterols. DIF:Cognitive Level: RememberingREFages 8-9 TOP: Nursing Process: Assessment MSC: Client Needs: Physiological integrity 17. 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 to form a. strong bones and joints. b. body fat stores. c. healthy brain tissue.d. increased muscle mass. ANS: B Excess protein is broken down to amino acids and then used for ener gy or stored as body fat. This mans body will use some of this protein to increase muscle mass, but increasing protein intake beyond the amount needed does not increase muscle formation. Excess protein intake does not improve bone, joint, or brain health. DIF:Cognitive Level: ApplyingREFage 9 TOP: Nursing Process: Assessment MSC: Client Needs: Physiological integrity 18. When clients have a strong family history of both heart disease and cancer , the nurse should encourage them to reduce their intake of a. dietary fiber . b. protein. c. monounsaturated fat. d. saturated fat. ANS: D Saturated fat intake is related to risk of heart disease and certain types of cancer . Monounsaturated fat intake has less ef fect on risk of these diseases. Dietary fiber intake should be increased to help reduce risk of cardiovascular disease and cancer . The ef fects of protein intake on risk of these diseases are much less significant. DIF: Cognitive Level: Applying REF: Page 9 T OP: Nursing Process: Planning MSC:Client Needs: Physiological integrity 19. The National Health and Nutrition Examination Survey (NHANES) is able to assess the overall nutritional and health status of Americans because a. the populations surveyed are representative of the total population. b. it focuses on ethnic and socioeconomic groups at greatest risk. c. it collects lar ge volumes of survey data from all over the nation. d. survey methods and standards are consistent from year to year . ANS: A Data from NHANES represent America overall because the survey populations are carefully selected to represent the total population. Their data therefore provide a better indication of the nations overall health than do lar ge amounts of data from all over the country . It does not focus specifically on populations at high risk for disease. Standardization over time provides useful data on trends and changes but does not reveal the overall health of the nation. DIF:Cognitive Level: ApplyingREFages 4-5 TOP: Nursing Process: Assessment MSC: Client Needs: Health promotion and maintenance 20. In working with a ethnic minority population, a helpful way to increase health literacy could be to a. 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 than written materials during health education encounters. ANS: A Members of an ethnic minority population can be very helpful in identifying needs and ef fective teaching strategies for people in their community and in encouraging people in the community to accept 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. Setting up feeding programs does not promote positive self-ef ficacy . Visual aids may be helpful, but their use is not necessarily the best educational strategy . DIF: Cognitive Level: Applying REF: Pages 6-7 T OP: Nursing Process: Planning MSC:Client Needs: Physiological integrity 21. 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 bodys need for other vitamins. What would you tell him? a. He should switch to a multivitamin supplement instead of just vitamin C. 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 when he has symptoms of a cold or influenza. ANS: B Vitamins cannot be converted into other vitamins; each has a specific function, and the best way to consume adequate amounts of each vitamin is to eat a variety of foods. V itamin C is water soluble, but it cannot be converted to other water -soluble vitamins. V itamin C is needed by the body at all times, not just when someone is ill. A multivitamin supplement would provide a better range of vitamins than just vitamin C, but it is still better to consume vitamins from food, rather than from supplements. DIF:Cognitive Level: ApplyingREFages 9-10 TOP: Nursing Process: Assessment MSC: Client Needs: Physiological integrity 22. For a mother with two children who works in health care management 60 to 70 hours a week, the biggest barrier to healthy eating is likely to be a. lack of concern for her own or her childrens health. b. inadequate income to purchase healthy foods. c. insuf ficient time to plan and prepare healthful meals. d. lack of knowledge about healthy eating. ANS: C For busy professionals and families, the biggest barrier to healthy eating is usually hectic schedules and lack of time to plan and prepare healthy meals. Most mothers, especially those who work in a health care field, are concerned about their familys health. Many professional women have at least some understanding of healthy eating. W ith a professional job, lack of income is not very likely to be a barrier to healthy eating. DIF: Cognitive Level: Applying REF: Page 7 T OP: Nursing Process: Planning MSC: Client Needs: Health promotion and maintenance 23. A class of nutrients that is important in body structure and influences the function of muscles and the central nervous system is a. proteins. b. minerals. c. vitamins. d. carbohydrates. ANS: BMinerals are important in body structures and influence the function of muscles and the central nervous system. Proteins are structural components and form part of muscles but are less influential in the central nervous system. V itamins and carbohydrates do not have structural functions. DIF:Cognitive Level: UnderstandingREFage 10 TOP: Nursing Process: Assessment MSC: Client Needs: Physiological integrity 24. 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 a. protein. b. carbohydrates. c. water . d. vitamins. ANS: C The body can survive only a few days without water . The body may not function optimally without other nutrients, but it can survive many days and even weeks without them. DIF:Cognitive Level: ApplyingREFages 8-10 TOP: Nursing Process: Assessment MSC: Client Needs: Physiological integrity 25. The client who would benefit most from an increase in dietary fiber intake is one with a. fatigue. b. constipation. c. dehydration. d. coronary heart disease. ANS: B Adequate dietary fiber and fluid intake can help alleviate constipation. It has a small but less significant ef fect in helping reduce risk of coronary heart disease. Dietary fiber intake does not affect fatigue or hydration status. DIF: Cognitive Level: Applying REF: Page 9 T OP: Nursing Process: Planning MSC: Client Needs: Health promotion and maintenance 26. To provide adequate amounts of vitamins and minerals, the best course of action is to 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: B Including a variety of foods from each food group increases the likelihood of obtaining adequate amounts of vitamins and minerals. Achieving ideal body weight does not guarantee adequate nutrient intake. Following the same general food pattern each day could actually limit vitamin and mineral intake because the assortment of foods is likely to be limited. Choosing foods high in fiber and low in saturated fat diet does not necessarily result in intake of adequate levels of vitamins and minerals. DIF: Cognitive Level: Applying REF: Page 12 T OP: Nursing Process: Planning MSC: Client Needs: Health promotion and maintenance 27. If a nurse wants to evaluate whether a clients vitamin or mineral supplement contains too much of a specific nutrient, the nurse should a. check the manufacturers recommendations about intake for that nutrient. b. request blood and urine tests to determine the clients 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: C The UL is the maximum intake that should not be exceeded to prevent adverse health risks; this should be compared to the amount in the supplement. The Recommended Dietary Allowance is the amount that meets the needs of most health individuals in a life-stage and gender group, but it is not the upper level for safety . Manufacturers do not necessarily provide reliable information about safety of supplements they are marketing. Blood and urine tests may or may not show whether the body is accumulating unsafe levels of a nutrient, depending on the nutrient and how long the supplement has been taken. DIF:Cognitive Level: ApplyingREFage 1 1 TOP:Nursing Process: Assessment| Nursing Process: Evaluation MSC:Client Needs: Physiological integrity 28. Why is it dif ficult 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 levels of protein intake for various age and gender groups. b. 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 protein intakes are expressed as a range and are based on a percentage of energy intake, which varies between individuals. ANS: D Protein intake does not need to be precise and can be within an acceptable range, expressed as a percentage of ener gy intake. Health care professionals should not give unnecessarily precise advice, but they can give scientifically based advice without concern for lawsuits. A reasonable amount of research has been conducted to be able to give at least general advice about protein intake. The likelihood that clients will achieve a specific protein intake is not related to the dif ficulty in identifying what their intake level should be. DIF:Cognitive Level: AnalyzingREFages 8-9 | Page 1 1 TOP: Nursing Process: Assessment MSC: Client Needs: Physiological integrity 29. If a college student is eating only one small meal per day in an attempt to lose weight and is taking high doses of vitamin and mineral supplements to try to make up for the lack of food, the student would be described as having a. malnutrition. b. disordered nutrition. c. overnutrition. d. undernutrition. ANS: A An imbalance of intake of nutrients, ener gy, or both (in this case, high intake of some nutrients and low intake of ener gy) is called malnutrition. Overnutrition refers only to excessive intake, excessive nutrients, or excessive ener gy. Undernutrition refers only to inadequate intakes of nutrients, ener gy, or both. Disordered nutrition is not a recognized term. DIF:Cognitive Level: ApplyingREFage 12 TOP: 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 she is genetically designed to be overweight and that the foods available in supermarkets today make weight loss impossible. The clients attitude shows a. positive self-ef ficacy . b. negative self-ef ficacy . c. poor environmental health. d. poor emotional health. ANS: B The clients attitude demonstrates negative self-ef ficacy . She does not perceive that she has power over her life and behaviors. A belief that she could change her personal behaviors would reflect positive self-ef ficacy . She is able to express her feelings, and so she does not necessarily have poor emotional health. Her belief about healthy food choices in her environment is not necessarily accurate. DIF:Cognitive Level: ApplyingREFages 1-2 | Page 12 TOP: Nursing Process: Assessment MSC: Client Needs: Psychosocial integrity Chapter 02: Personal and Community Nutrition My Nursing T est Banks Chapter 02: Personal and Community Nutrition Grodner and Escott-Stump: Nutritional Foundations and Clinical Application: A Nursing Appr oach, 6th Edition MUL TIPLE CHOICE 1. A client tells you that he cannot eat most green vegetables because they taste too bitter . What is the most 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: A Some people have variations in genetic taste markers that make them super tasters. These people often experience the taste of certain vegetables as being bitter . Environmental factors such as childhood memories may also influence food choices but are not usually associated with tasting vegetables as bitter . Tastes can be acquired and sometimes people make excuses to avoid making changes, but these are less likely explanations for this particular problem DIF:Cognitive Level: ApplyingREFage 18 TOP: Nursing Process: Assessment MSC: Client Needs: Health promotion and maintenance 2. A teenaged client is hungry and goes to the refrigerator for a snack. A holiday has just been celebrated at her home, and many of her favorite foods are available. She selects some slices of roast turkey and a cup of her aunts special fruit salad. This is an example of a. 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 by convenience, but many of her favorite foods are available, and so her choices are not limited. The food is abundant, and she may choose to binge and overeat, but her selections are made according to her food preference. DIF:Cognitive Level: AnalyzingREFage 18 TOP: Nursing Process: Assessment MSC: Client Needs: Psychosocial integrity 3. 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 the a. genetic factor of preference for sweet and salty tastes. b. influence of ethnicity on preference for sour tastes. c. childrens weights when they were born and their weights now . d. environmental ef fects of parental food choices and television watching. ANS: D Because young children spend so much time with their families, their parents food choices have a major ef fect on their own future food choices. Preventing young children from eating while watching television will have only a short-term ef fect, and they are likely to imitate their father in eating high-fat, high-sugar snacks. The fathers food preferences are probably influenced by genetics and ethnicity , and it may be interesting to find out whether the childrens current weights are healthy for their heights (although their birth weight is probably not relevant), but this information has less immediate ef fect on the nutritional health of this family . DIF:Cognitive Level: ApplyingREFage 18 | Page 35 TOP: Nursing Process: Implementation MSC: Client Needs: Psychosocial integrity 4. If a middle-aged couple with two teenage children has insuf ficient income to purchase food, the most helpful program for them would be the a. MyPlate food guidance system. b. National School Lunch and School Breakfast Programs. c. federal governments Supplemental Nutrition Assistance Program (SNAP). d. Special Supplemental Nutrition Program for W omen, Infants, and Children (WIC). ANS: C SNAP provides financial assistance to buy nutritious foods for individuals and families with incomes below certain levels. WIC provides assistance only to women who are pregnant or breastfeeding and to infants and children up to the age of 5 who are at nutritional risk. School meal programs would benefit the children but not the adults. MyPlate would help the family make healthy food choices but would not help with their financial problems. DIF:Cognitive Level: ApplyingREFages 18-19 | Page 21 TOP: Nursing Process: Planning MSC: Client Needs: Health promotion and maintenance 5. For most Americans, the most significant nutrition concerns are 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: C Most Americans have high intake of saturated fats, cholesterol, sodium, and sugars, which is associated with increased prevalence of chronic disease. Many people have inadequate intake ofmicronutrients, but this has a lesser overall ef fect 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 widespread problem in the country as a whole. Many Americans express at least some concern about making healthy food choices. DIF:Cognitive Level: UnderstandingREFages 18-20 | Page 30 TOP: Nursing Process: Assessment MSC: Client Needs: Health promotion and maintenance 6. Excessive intake of high-sodium, high-fat foods can lead to diet-related illnesses such as a. genetic disorders, hypertension, and diabetes. b. hypertension and sickle cell anemia. c. viral infections that necessitate antibiotics. d. coronary artery disease and hypertension. ANS: D Coronary 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 not affected by dietary fat and sodium intake. DIF:Cognitive Level: ApplyingREFage 19 TOP: Nursing Process: Assessment MSC: Client Needs: Health promotion and maintenance 7. Of the following, the most important overall dietary modification to help reduce the risk of chronic disease is a. 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: C Scientific evidence from the nutrition literature shows that shifting to a more plant-based diet is one of four significant modifications to dietary intake patterns that will improve the overall health of Americans. Preservatives per se have not been associated with health status (although foods that contain preservatives may be more highly processed and may have higher levels of fat, sugar , and sodium and lower levels of nutrients than do foods without preservatives). Buying locally grown foods may be a good agricultural and economic practice, but it does not af fect health status. Eating more animal-based foods would be the opposite of what is recommended. DIF: Cognitive Level: Applying REF: Page 20 T OP: Nursing Process: Planning MSC: Client Needs: Health promotion and maintenance 8. One way to help clients follow the Dietary Guidelines for Americans is to encourage them to use a. Healthy People 2020. b. the MyPlate food guidance system. c. the Supplemental Nutrition Assistance Program (SNAP). d. the Exchange Lists for Meal Planning. ANS: B MyPlate is designed to help clients implement the recommendations of the Dietary Guidelines for Americans. Healthy People 2020 sets national tar gets for health promotion. SNAP provides funds for individuals and families with low incomes to buy nutritious foods. The Exchange Lists for Meal Planning is intended primarily for patients with diabetes and those who need to lose weight; the system helps patients choose appropriate portion sizes to control their intake of fat, protein, carbohydrate, and ener gy.DIF: Cognitive Level: Understanding REF: Pages 18-23 | Pages 27-28 TOP: Nursing Process: Planning MSC: Client Needs: Health promotion and maintenance 9. For a client who follows a vegan diet, the most helpful meal planning tool would be a. the Healthy Eating Plate, produced by the Harvard School of Public Health. b. the Mediterranean Diet Pyramid, from Oldways Preservation and Exchange T rust. c. the Power Plate, created by the Physicians Committee for Responsible Medicine. d.Exchange Lists for Meal Planning, from the American Diabetes Association and the American Dietetic Association ANS: C The Power Plate is a vegan food planning guide that eliminates all sources of animal foods. The Healthy Eating Plate and Mediterranean Diet Pyramid could be adapted for a vegan diet, but they include meat and dairy options. The Exchange Lists for Meal Planning is intended to help design eating patterns for clients who need to monitor their intake of ener gy and specific macronutrients, such as clients with diabetes. DIF: Cognitive Level: Applying REF: Pages 22-25 | Pages 27-28 TOP: Nursing Process: Planning MSC: Client Needs: Health promotion and maintenance 10. An indirect benefit of the Fruits & V eggiesMore Matters program is a. better understanding of fruit and vegetable preparation techniques. b. increased availability of fruits and vegetables in food deserts. c. eating more fresh produce in season. d. decreasing dietary fat intake. ANS: D Fruits & V eggiesMore Matters is designed to increase intake of fruits and vegetables. Fruits and vegetables are naturally low in fat; they would replace higher fat foods in the diet and thus would indirectly decrease dietary fat intake. The program does not address fruit and vegetable preparation techniques, does not tar get availability of produce in food desert areas, and does not address eating fruits and vegetables in season versus out of season. DIF: Cognitive Level: Applying REF: Page 23 | Page 26 | Page 30 TOP: Nursing Process: Implementation MSC: Client Needs: Health promotion and maintenance 11. A meal planning guide that would be helpful for a patient who needs to closely monitor their intake of calories, carbohydrates, protein, and fat is the a. National Fruit and V egetable Program. b. MyPlate food guidance system. c. Dietary Guidelines for Americans. d. Exchange Lists for Meal Planning. ANS: D In the Exchange 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 of these are listed. Therefore, this guide can help clients monitor their intake. The National Fruit and Vegetable Program simply encourages increased intake of fruits and vegetables. The Dietary Guidelines for Americans gives general advice but does not translate this into specific amounts of foods. MyPlate would help patients achieve healthy intake of kilocalories, carbohydrate, protein, and fat, but it would not be specific enough for them to monitor their intake closely . DIF: Cognitive Level: Applying REF: Pages 19-23 | Pages 26-28 TOP: Nursing Process: Planning MSC: Client Needs: Health promotion and maintenance12. One reason that increasing fruit and vegetable consumption helps decrease dietary fat intake is that fruits and vegetables a. 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: B Fruits and vegetables replace high-fat foods in the diet because they are high in fiber and water; they cause satiety so that clients have less desire for high-fat foods. Fruits and vegetables are not, and do not contain, natural appetite suppressants and do not hinder absorption of fat from foods. They are rich in antioxidants and phytochemicals, but increased intake of these substances does not af fect fat intake. DIF:Cognitive Level: UnderstandingREFage 23 | Pages 26-27 TOP: Nursing Process: Assessment MSC: Client Needs: Health promotion and maintenance 13. Why are health professionals concerned about the trend toward eating more food away from home? a. Larger portion sizes often contribute to excessive caloric intake. 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: A Restaurants and fast food outlets often serve lar ge portions that increase caloric intake. Eating away from home does not necessarily decrease social interaction, inasmuch as families or friends may eat away 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 29 TOP: Nursing Process: Planning MSC: Client Needs: Health promotion and maintenance 14. If clients want to use the food label to check the number of kilocalories in a product, they should also check the a. calories from fat. b. servings per container . c. Percent Daily V alue. d. ingredient list. ANS: B The number of calories in a product is stated for a standard serving size of that food. Clients need to multiply the calories per serving by the number of servings in the container to know how many calories are in the container . The calories from fat are not related to the total number of calories in the food. The Percent Daily V alue refers to the nutrient content of the food rather than its caloric value. The ingredient list does not give any information about calories. DIF:Cognitive Level: AnalyzingREFage 32 TOP: Nursing Process: Implementation MSC: Client Needs: Health promotion and maintenance 15. The most useful part of the food label for clients who want to make sure they choose foods high in nutrients is the a. Percent Daily V alue. b. health claims.c. organic seal. d. amount of nutrients per serving. ANS: A The Percent Daily V alue shows how a food fits into the overall daily diet and would therefore show whether it makes a high or low contribution to nutrient intake. Health claims may indicate that a food has high or low amounts of specific nutrient related to that particular health claim, but they would not indicate overall nutrient content of the food. The or ganic seal, if present, indicates the farming methods used to grow the food but does not give any information about nutrient content. The amount of nutrients per serving is listed for only some nutrients; the listing would not give any information about vitamins and minerals in the food because these are listed only as Percent Daily Values. DIF:Cognitive Level: ApplyingREFages 31-35 TOP: Nursing Process: Implementation MSC: Client Needs: Health promotion and maintenance 16. If a client is trying to increase intake of dietary fiber , a useful symbol to look for on the food label would be the a. MyPlate food guidance graphic. b. U.S. Department of Agriculture (USDA) 100% Or ganic seal. c. Fruits & V eggiesMore Matters logo. d. 100% Whole Grain stamp. ANS: D Whole grains are an important source of dietary fiber , and so the 100% Whole Grain stamp would help a client select high-fiber foods. Fruits and vegetables also contain high amounts of dietary fiber, but the Fruits & V eggiesMore Matters logo is not used in labeling individual foods. MyPlate is also not used on food labels. The or ganic status of a food does not reveal any information about its dietary fiber content. DIF: Cognitive Level: Understanding REF: Pages 21-23 | Page 27 | Pages 33-34 TOP: Nursing Process: Implementation MSC: Client Needs: Health promotion and maintenance 17. The Nutrition Facts panel on a food label is useful for a. 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: D The Nutrition Facts panel on a food label lists the quantities of specific key nutrients in the food and can therefore be used to compare the nutritional value of two or more products. The ingredients are listed elsewhere on the package, rather than in the Nutrition Facts panel. The Nutrition Facts panel does not indicate how easy the food is to prepare and does not include any information about cost or price. DIF:Cognitive Level: UnderstandingREFages 32-33 TOP: Nursing Process: Implementation MSC: Client Needs: Health promotion and maintenance 18. A pregnant woman may look for a health claim on food labels that links 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 intake and risk of heart disease.ANS: C The U.S. Food and Drug Administration has approved use of a health claim stating the relationship between folic acid intake during pregnancy and decreased risk of neural tube defects in infants. It has also 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, and vegetables 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 not directly relevant to a pregnant women. DIF:Cognitive Level: ApplyingREFage 35 TOP: Nursing Process: Implementation MSC: Client Needs: Health promotion and maintenance 19. An eating behavior that is most likely to have a negative long-term ef fect on health is a. a monthly meal out at an expensive restaurant. b. eating French fries with lunch once a week. c. avoiding a specific fruit or vegetable. d. drinking one can of sugar -sweetened beverage every day . ANS: D Small daily practices have a cumulative ef fect on nutritional health. Eating a rich meal once a month or even ordering French fries once a week will have less overall ef fect on health than daily habits. It is possible to avoid a specific fruit or vegetable and still make healthy food choices by including other fruits and vegetables. DIF:Cognitive Level: ApplyingREFage 18 | Page 21 TOP: Nursing Process: Assessment MSC: Client Needs: Health promotion and maintenance 20. The most helpful general recommendation for making healthy food choices would be to a. focus on or ganic and natural foods. b. learn to use the Nutrition Facts Panel on food labels. c. eat more food from plant sources and less food from animal sources. d. replace refined grain products with whole grain foods. ANS: C The most helpful overall recommendation would be a shift to a more plant-based diet, which automatically decreases intake of saturated fat and cholesterol. Replacing refined grains with whole grains is a good choice, but it is only one aspect of healthy eating. Or ganic and natural foods do not necessarily improve nutrient intake. Learning to use the Nutrition Facts Panel is helpful, but not all foods have these labels (fruits, vegetables, and meats do not have to carry these labels). DIF:Cognitive Level: AnalyzingREFage 20 | Pages 32-34 TOP: Nursing Process: Planning MSC: Client Needs: Health promotion and maintenance 21. A client works at a fast food restaurant and usually orders a cheesebur ger and regular soda at lunchtime. What would be the most simple recommendation to make this a healthier choice? a. Eat the meat patty and cheese without the bun, and drink juice. b. Do not add ketchup or mustard, and drink cappuccino. c. Skip this meal and fast until dinner . d. Omit the cheese from the bur ger, and drink skim milk. ANS: D Omitting the cheese from the hambur ger would decrease intake of saturated fat and calories; replacing the soda with skim milk would replace the calcium without added fat and sodium. Removing the bun would decrease calories but would not decrease the fat content; drinking juicewould provide some nutrients but also an amount of sugar similar to that of regular soda. Ketchup and mustard add sodium and a relatively small number of calories, but their impact is less significant than the cheese; fast-food cappuccino is high in sugar and fat. Missing meals does not usually help improve overall dietary intake; regular intake of nutrients throughout the day helps body metabolism function well. DIF: Cognitive Level: Analyzing REF: Pages 19-21 T OP: Nursing Process: Planning MSC: Client Needs: Health promotion and maintenance 22. A male client is 38 years old. He is married with two children, aged 7 and 9 years. Both he and his wife work full time. What other information would be important to know when showing him how to use MyPlate to develop a personalized food plan? a. His wife enjoys cooking home-made meals. b. He is currently training to run a marathon. c. Both his father and mother both have type 2 diabetes. d. He has an aller gy to nuts. ANS: B MyPlate recommendations are based on age, sex, and activity level. Therefore, the most important information would be that he is training for a marathon. MyPlate gives recommendations for numbers of servings from each food group each day; it does not recommend specific foods, and so allergy information not important because other foods within the food group could be selected. His parents health problems may help motivate him to make healthy food choices, but this information is not needed to use MyPlate. The number of foods from each food group is not af fected by whether foods are home cooked or preprepared. DIF:Cognitive Level: ApplyingREFage 21 TOP: Nursing Process: Assessment MSC: Client Needs: Health promotion and maintenance 23. For a busy client who works 50 hours a week, a helpful strategy for making healthy food choices is a. eating several small meals throughout the day . b. planning meals and snacks in advance. c. buying fruits and vegetables in season. d. using the Dietary Guidelines for Americans as a guide. ANS: B Planning ahead for meals and snacks can be very helpful for busy clients so that they do not rely on impulsive food choices. It allows them to make decisions ahead of time instead of waiting until they are tired and hungry . Eating several small meals throughout the day may help maintain ener gy in a long workday but does not help make healthier food choices. Buying fruits and vegetables in season helps to save money on groceries but is not necessarily related to making healthy food choices. The Dietary Guidelines for Americans provides general advice but does not help with specific food choices. DIF:Cognitive Level: ApplyingREFage 31 | Page 35 TOP: Nursing Process: Planning MSC: Client Needs: Health promotion and maintenance 24. A single mother has epilepsy and does not drive. She works full time from home, and her three children take the bus to school. She generally rides her bike or walks wherever she needs to go. What would be your greatest concern related to the familys nutritional well-being? a. It is not safe for someone with epilepsy to prepare food with sharp knives and a hot stove. b. She is unlikely to be able to af ford healthy food for three children as a single mother . c. Because she does not drive, she may not have access to af fordable and high-quality food.d. Working full time would not leave her enough time to prepare nutritious food for her family . ANS: C The greatest concern is that because she does not drive, she may not have access to af fordable and quality food. Depending on her job, she may have suf ficient income to purchase nutritious food, and many women are able to work full time and make time to prepare food for their families. She may need to be careful in the kitchen and perhaps cook only when other family members are home in case she has a seizure, but if her epilepsy is well controlled, there is no reason why she should not cook. DIF:Cognitive Level: AnalyzingREFages 29-31 TOP: Nursing Process: Assessment MSC: Client Needs: Safe and ef fective care environment 25. For someone who is able to shop for food only once a month, the most nutritious fruits and vegetables would be _____ fruits and vegetables. a. fresh seasonal b. frozen c. canned d. dried ANS: B When they have to be stored for longer than a few days, the most nutritious type of fruits and vegetables would be frozen. Many fresh fruits and vegetables lose some vitamins and may start to rot after a few days. Canned and dried fruits and vegetables are better than none at all, but they contain lower levels of vitamins and may contain added salt or sugar . DIF:Cognitive Level: ApplyingREFages 30-31 TOP: Nursing Process: Implementation MSC: Client Needs: Health promotion and maintenance 26. In choosing between two types of canned soup with regard to the best source of calcium, what information would you look for? a. Dairy products in the ingredient list b. The Percent Daily V alue for calcium c. Health claims related to calcium content d. A Good source of calcium description ANS: B The most helpful comparison would be the Percent Daily V alue for calcium in the two products. The presence of dairy products in the ingredient list does not indicate the amount of calcium in the product. Similarly , health claims and Good source of calcium descriptions would not help you compare the two products. DIF:Cognitive Level: ApplyingREFages 32-33 TOP: Nursing Process: Implementation MSC: Client Needs: Health promotion and maintenance 27. In a comparison of food products, the description that means the lowest fat content per serving is a. lean. b. very lean. c. light. d. low fat. ANS: DLow fat means no more than 3 g of fat per serving. Lean means no more than 10 g of fat per serving. Extra lean means no more than 5 g of fat per serving. Light means that the food contains one third fewer calories, or half the fat, of the original, which does not give any specific information about the fat content. DIF:Cognitive Level: AnalyzingREFage 33 TOP: Nursing Process: Implementation MSC: Client Needs: Health promotion and maintenance 28. The main reason for choosing or ganic foods is a. to support the local economy . b. concern for the environment. c. to improve nutrient intake. d. better taste and quality . ANS: B The main reason for choosing or ganic foods is concern for the environment. Many or ganic foods are grown and sold locally , but this is not a primary concern. Or ganic foods are not necessarily better in terms of nutritional value, taste, and quality . DIF: Cognitive Level: Applying REF: Pages 33-34 T OP: Nursing Process: Planning MSC: Client Needs: Safe and ef fective care environment 29. An individual would be described as having an external locus of control if he or she a. writes out a shopping list each week and generally buys only foods on the list. b. tries to eat mostly foods produced through or ganic and sustainable farming practices. c. has decided to eat a turkey sandwich but ends up ordering pizza with friends. d. tries to influence friends and family to help them make healthier food choices. ANS: C Individuals with an external locus of control do not feel they are able to control outside forces that have power over their experiences, so they may be easily influenced to eat pizza instead of a sandwich. Individuals who write and buy foods from a shopping list would be described as having an internal locus of control because they have an inner sense of their ability to guide life events. Use of or ganic foods and a desire to influence other peoples food choices are not related to locus of control. DIF:Cognitive Level: ApplyingREFage 43 TOP: Nursing Process: Assessment MSC: Client Needs: Psychosocial integrity 30. In a research study , subjects in one group decrease their intake of saturated fat and cholesterol, and those in a control group maintain their current level of intake for 2 years, with regular monitoring of risk factors for cardiovascular disease. This type of research study is called a(n) a. case study . b. epidemiologic study . c. monitoring study . d. experimental study . ANS: D In experimental studies, researchers compare health outcomes of subjects who receive treatment or intervention with those of subjects in a control group, who receive no treatment or intervention. In epidemiologic studies, researchers track the occurrence of health or disease processes among populations to determine possible causative factors. In case studies, researchers examine individual cases of disease or health problems. Monitoring studies is not a recognized research term. DIF:Cognitive Level: RememberingREFage 29TOP: Nursing Process: Assessment MSC: Client Needs: Health promotion and maintenance Chapter 03: Digestion, Absorption, and Metabolism My Nursing T est Banks Chapter 03: Digestion, Absorption, and Metabolism Grodner and Escott-Stump: Nutritional Foundations and Clinical Application: A Nursing Appr oach, 6th Edition MUL TIPLE CHOICE 1. Peristalsis is necessary to make it possible for people to _____ food. a. chew b. digest c. swallow d. smell and taste ANS: C Peristalsis makes swallowing possible as involuntary movements of circular and longitudinal muscles move food along the esophagus from the mouth to the stomach. Chewing is accomplished by jaw muscles and is not related to peristalsis. Peristalsis helps move food along the gastrointestinal tract to the places where digestion of each nutrient takes place, but it does not make digestion itself possible. Smell and taste are not related to peristalsis. DIF:Cognitive Level: ApplyingREFage 42 TOP: Nursing Process: Assessment MSC: Client Needs: Physiological integrity 2. Examples of mechanical digestion include a. activity of salivary amylase in the mouth. b. churning and mixing of food in the stomach. c. action of bile breaking fats into smaller droplets. d. effects of secretin in stimulating the pancreas to release bicarbonate. ANS: B Churning and mixing of food in the stomach is an example of mechanical digestion because it causes physical breakdown of the food. Salivary amylase is an enzyme that causes chemical breakdown of food; bile causes emulsification of fats. Secretin is a hormone that stimulates release of bicarbonate from the pancreas; this buf fers stomach acid so that intestinal enzymes can work. DIF:Cognitive Level: UnderstandingREFages 42-43 | Page 47 TOP: Nursing Process: Assessment MSC: Client Needs: Physiological integrity 3. An example of a problem caused by a sphincter muscle not operating properly is a. constipation. b. gallbladder disease. c. heartburn. d. peptic ulcer . ANS: C Heartburn is caused by reflux of acidic stomach contents into the esophagus when the sphincter muscle between these two parts of the digestive tract does not operate properly . Constipation is usually caused by slow peristalsis, often in relation to inadequate intake of dietary fiber and fluid. Gallbladder disease is unrelated to gastrointestinal sphincters. Peptic ulcer is usually caused by Helicobacter pylori infection. DIF: Cognitive Level: Applying REF: Pages 42-43 | Page 46 | Pages 49-50TOP: Nursing Process: Assessment MSC: Client Needs: Physiological integrity 4. The best description of an enzyme is a(n) a. chemical messenger . b. acid and alkali buf fer. c. emulsifier . d. organic catalyst. ANS: D Enzymes are or ganic catalysts that work on specific classes of nutrients to change them from one form to a simpler form. The description chemical messenger applies to hormones. The emulsifier in the intestines is bile. The pancreas secretes alkaline bicarbonate to buf fer stomach acid so that intestinal enzymes can work properly . DIF:Cognitive Level: RememberingREFage 40 | Pages 43-44 TOP: Nursing Process: Assessment MSC: Client Needs: Physiological integrity 5. Chemicals that act as messengers are called a. proteins. b. hormones. c. enzymes. d. nerve impulses. ANS: B Hormones act as messengers between or gans to cause release of needed secretions. Some, but not all, hormones are proteins. Enzymes work locally on specific classes of nutrients to change them from one form to a simpler form. Nerve impulses send messages in the body but via electrical impulses rather than via chemicals. DIF:Cognitive Level: RememberingREFages 43-44 | Page 47 TOP: Nursing Process: Assessment MSC: Client Needs: Physiological integrity 6. The action of salivary amylase in the mouth is an example of a. chemical digestion. b. chewing. c. mechanical digestion. d. peristalsis and segmentation. ANS: A Salivary amylase is an enzyme that chemically digests starch in the mouth. It does not contribute to mechanical digestion. Chewing is an example of mechanical digestion. Peristalsis and segmentation help propel food along the gastrointestinal tract and mix food with intestinal secretions. DIF: Cognitive Level: Understanding REF: Page 40 | Page 42 | Page 47 TOP: Nursing Process: Assessment MSC: Client Needs: Physiological integrity 7. Most mechanical breakdown of food occurs in the a. large intestine. b. liver and pancreas. c. mouth and stomach. d. esophagus and mouth. ANS: C Mechanical breakdown of food occurs in the mouth during chewing and in the stomach as the food is mixed by muscular action. By the time food reaches the lar ge intestine, it is already broken down,and most of the nutrients have been absorbed. The liver and pancreas produce secretions that help with chemical but not mechanical breakdown of food. Food passes through the esophagus lar gely unchanged, and so the esophagus is not involved in breakdown. DIF:Cognitive Level: UnderstandingREFage 40 | Pages 42-44 TOP: Nursing Process: Assessment MSC: Client Needs: Physiological integrity 8. The body process over which people have most conscious control is a. ingestion. b. digestion. c. metabolism. d. excretion. ANS: A People can choose the foods and fluids they ingest. Digestion, metabolism, and excretion are lar gely automatic processes. A persons actions may af fect those processes indirectly (e.g., exercise af fects metabolism, stress may af fect digestion), but people have less control over them than over ingestion. DIF: Cognitive Level: Applying REF: Page 48 T OP: Nursing Process: Planning MSC:Client Needs: Physiological integrity 9. When someone walks by a bakery and smells the fresh bread, his or her mouth starts to water . As the person thinks about eating the fresh bread, another digestive function that starts to occur is a. peristalsis in the small intestine. b. stimulation of pancreatic secretions. c. increased blood flow to the gut and liver . d. release of the hormone gastrin in the stomach. ANS: D Release of the hormone gastrin from the stomach may be caused by the cephalic phase of gastric secretions when someone thinks about eating food. Thinking about food does not stimulate peristalsis, pancreatic secretions, or blood flow to the gut and liver . DIF:Cognitive Level: ApplyingREFage 43 TOP: Nursing Process: Assessment MSC: Client Needs: Physiological integrity 10. The most important functions of the small intestine are a. digestion and denaturation. b. segmentation and excretion. c. digestion and absorption. d. peristalsis and mechanical digestion. ANS: C Most digestion and absorption occurs in the small intestine. Denaturation is not part of the digestive process. Segmentation occurs in the small intestine, but excretion does not. Peristalsis occurs throughout the digestive tract, and mechanical digestion occurs in the mouth and stomach. DIF:Cognitive Level: ApplyingREFages 43-45 TOP: Nursing Process: Assessment MSC: Client Needs: Physiological integrity 11. The most important function of the villi of the small intestine is to a. increase the secretion of enzymes for digestion. b. increase the surface area for absorption of nutrients. c. excrete waste into the intestines. d. secrete hormones in response to nutrients in the gut.ANS: B Villi increase the surface area of the small intestine, which makes it possible for it to absorb more nutrients. Digestion occurs in the small intestine but is not a function of the villi. Excretion does not occur in the small intestine. The villi do not secrete hormones. DIF:Cognitive Level: RememberingREFage 43 TOP: Nursing Process: Assessment MSC: Client Needs: Physiological integrity 12. The layer of the gastrointestinal tract that contributes most to mechanical digestion of food is the a. mucosa. b. submucosa. c. muscularis. d. serosa. ANS: C The muscularis is a layer of muscle tissue that causes churning, peristalsis, and segmentation of food, which contribute to mechanical digestion. The mucosa is the inside layer that releases enzymes and digestive juices. The submucosa is a layer of connective tissue that contains blood vessels and nerves that regulate digestion. The serosa is the outermost layer of the gastrointestinal wall and connects to the peritoneum lining. DIF:Cognitive Level: UnderstandingREFage 42 TOP: Nursing Process: Assessment MSC: Client Needs: Physiological integrity 13. If pancreatic secretions were absent, a. there would be no bicarbonate to buf fer the acid in chyme entering the duodenum. b. mechanical digestion in the stomach would be inhibited. c. the hormone secretin would not be secreted by the small intestine. d. the gallbladder would not contract to release bile into the small intestine. ANS: A Pancreatic secretions contain bicarbonate, which is important in buf fering the acidity of chyme from the stomach. Pancreatic secretions enter the small intestine, below the stomach, and so have no effect on the stomachs mechanical digestion. The hormone secretin causes release of pancreatic secretions; pancreatic secretions do not af fect its release. Bile release is initiated by the hormone cholecystokinin (CCK), not by pancreatic secretions. DIF:Cognitive Level: ApplyingREFages 43-44 TOP: Nursing Process: Assessment MSC: Client Needs: Physiological integrity 14. Release of digestive secretions into the small intestine is caused by _____ that are released when _____. a. enzymes; food enters the stomach b. enzymes; food enters the small intestine c. hormones; food enters the stomach d. hormones; enters the small intestine ANS: D Hormones that are released when chyme enters the small intestine cause the release of digestive secretions into the small intestine. The causative agents are hormones, not enzymes. The digestive secretions contain enzymes; enzymes do not trigger their release. If hormones were released when food entered the stomach, digestive secretions would be released into the small intestine too early and could cause damage. DIF:Cognitive Level: UnderstandingREFages 43-44