Roth 10e NCLEX Chapter 2

MULTIPLE CHOICE 1. The nurse is talking with an adult client about following the Dietary Guidelines for Americans (2005). The client states that there are young children in the home, so the Dietary Guidelines for Americans wont help her plan a healthy diet for the entire family. When the nurse responds, for whom should the nurse say the Dietary Guidelines for Americans (2005) are appropriate? a. the general public over 2 years of age b. the general public over 12 years of age c. the general public over 18 years of age d. the general public between the ages of 18 and 64

ANS: A The Dietary Guidelines for Americans, 2005 are targeted to the general public over 2 years of age in the United States. PTS: 1 REF: Dietary Guidelines for Americans, 2005

2. The nurse is teaching the client about the health benefits of consuming at least 3 ounces of whole grains each day. Which of the following foods would the nurse encourage the client to consume? a. enriched pasta b. oatmeal c. plain bagel d. wheat bread

ANS: B The whole grains that are most often consumed in the United States are whole wheat, whole oats (oatmeal), whole-grain corn, popcorn, brown rice, whole rye, whole-grain barley, buckwheat, triticale, bulgur, millet, quinoa, and sorghum. enriched pasta, plain bagels, and wheat bread are not whole grain foods. PTS: 1 REF: Food Groups to Encourage

3. The nurse is educating a black client about how sodium in the diet may affect blood pressure. Which of the following statements could the nurse make to this client? a. Consume less than 1 teaspoon of salt per day. c. Consume no more than 2000 mg of sodium per day.

b. Consume less than 2300 mg of sodium per d. There is no need to restrict sodium intake. day. ANS: C On average, the higher ones salt (sodium chloride) intake is, the higher ones blood pressure will be. Individuals with hypertension, blacks, and middle-aged and older adults should aim to consume no more than 2000 mg of sodium per day. Those not in the specific population groups just noted should consume less than 2300 mg of sodium (approximately 1 teaspoon of salt) per day. PTS: 1 REF: Sodium and Potassium

4. The nurse is teaching a client who recently moved to Chicago from Puerto Rico about planning a balanced diet. What food might the nurse suggest the client consume that is often missing from Puerto Rican cuisine? a. corn c. non-starchy vegetables b. olive oil d. seafood ANS: C The traditional Puerto Rican diet may be lacking in milk and non-starchy vegetables. Corn, olive oil, and seafood are some of the foods found in Puerto Rican cuisine. PTS: 1 REF: Puerto Rican

5. The nurse is completing an initial assessment of a Somali client. For religious reasons, this client may avoid particular foods. Which food might this client avoid due to religious doctrine? a. goat c. pork b. lamb d. sheep ANS: C This client might be Muslim. If this is the case, no pork is eaten due to religious doctrine. Meats that are typically consumed in the Somali diet are lamb, goat, camel, sheep, and some beef. PTS: 1 MULTIPLE RESPONSE 1. A basic premise of the Dietary Guidelines for Americans, 2005 is that we should consume adequate nutrients within calorie needs. In explaining this to a client, what recommendations could the nurse communicate? Select all that apply. a. Consume a variety of nutrient-dense foods d. People over age 50 should consume and beverages within and among the basic vitamin B12 in its crystalline form. food groups while choosing foods that limit the intake of saturated and trans fats, cholesterol, added sugars, salt, and alcohol. b. Meet recommended intakes within energy e. Women of childbearing age who may needs by adopting a balanced eating become pregnant and those in the first pattern such as the USDA Food Guide or trimester of pregnancy should consume the Dietary Approaches to Stop adequate synthetic folic acid daily (from Hypertension (DASH) Eating Plan. fortified food or supplements) in addition to food forms of folate from a varied diet. c. Older adults, people with dark skin, and people exposed to insufficient ultraviolet band-radiation (i.e. sunlight) should consume extra vitamin D-fortified foods and supplements. f. Women of childbearing age who may become pregnant should eat foods high in heme-iron and consume iron-rich plant foods or iron-fortified foods with an enhancer of iron absorption, such as vitamin C rich foods. REF: Somali

ANS: A, B, C, D, E, F

A basic premise of the Dietary Guidelines for Americans, 2005 is that recommended diets will provide all of the nutrients needed for growth and development while not exceeding calorie needs. Answers a, b, c, d, e, and f reflect the key recommendations for consuming adequate nutrients within calorie needs. PTS: 1 REF: Adequate Nutrients within Calorie Needs

2. A client tells the nurse that there is no reason to engage in regular physical activity as long as one has a BMI is in the normal range. There are benefits to physical activity not related to body weight that the nurse could discuss with this client. Which of the following statements would be appropriate for the nurse to share with the client? Select all that apply. a. Engaging in regular exercise builds endurance. b. Engaging in regular exercise increases physical fitness. d. Exercise helps control blood pressure. e. Exercise promotes psychological wellbeing and self- esteem. Exercise reduces feelings of depression and anxiety.

c. Engaging in regular exercise will f. guarantee that the client will never have a heart attack.

ANS: A, B, D, E, F There are health benefits to exercise and physical activity that are independent of weight management. Engaging in regular physical activity increases fitness; helps build and maintain healthy bones, muscles, and joints; builds endurance and muscular strength; lowers risk factors for several chronic diseases (but does not eliminate the risk factors); helps control blood pressure; promotes psychological well-being and self esteem; and reduces feelings of depression and anxiety. PTS: 1 REF: Physical Activity

3. A client who is at risk of developing coronary artery disease makes comments indicating a lack of understanding of which fats are unhealthy and why they should be limited in the diet. Which of the following dietary teaching statements would the nurse make to this client? Select all that apply. a. Do not consume nuts because they are high in fat. d. Keep total fat intake between 20 and 35% of calories.

b. High intake of saturated fats, trans fats, and cholesterol increases the risk of coronary heart disease.

e. Select lean, low-fat and fat free meats, poultry, and milk.

c. Intake of all fats should be kept as close to f. zero as possible.

The diet must contain some fat because dietary fats serve as carriers for the absorption of fat-soluble vitamins A, D, E, and K and carotenoids.

ANS: B, D, E, F

Fats and oils are part of a healthy diet, but the type of fat makes a difference to heart health, and the total amount of fat consumed is also important. High intake of saturated fats, trans fats, and cholesterol increases the risk of coronary heart disease. Fats serve as a carrier for the absorption of the fat-soluble vitamins A, D, E, and K and carotenoids. Adults should keep total intake of fat between 20 and 35% of calories, with most fats coming from sources of polyunsaturated and monounsaturated fatty acids, such as fish, nuts, and vegetable oils. When selecting and preparing meat, poultry, dry beans, and milk or milk products, choose lean, low-fat, or fat-free. PTS: 1 REF: Fats

4. The visiting nurse is assessing a homebound client who complains of frequent diarrheal illness that may be food related. The visiting nurse tells the client that it is estimated that every year about 76 million people in the United States become ill from pathogens in food. Which of the following recommendations would the nurse make regarding prevention of foodborne illnesses? Select all that apply. a. Clean hands before preparing food. b. Cook foods to a safe temperature to kill microorganisms. c. Consume organic raw milk. ANS: A, B, E, F The key recommendations for avoiding foodborne illness are: clean hands, food contact surfaces, and fruits, and vegetable; separate raw, cooked, and ready-to-eat foods while shopping, preparing, or storing foods; cook foods to a safe temperature to kill microorganisms; refrigerate perishable food promptly, and defrost foods properly; and avoid raw (unpasteurized) milk or any products made from unpasteurized milk, raw or partially cooked eggs or foods containing raw eggs, raw or undercooked meat and poultry; and unpasteurized juices, and raw sprouts. PTS: 1 REF: Food Safety d. Defrost foods on the kitchen counter. e. Do not eat partially cooked eggs. f. Separate raw foods from ready-to eat foods while shopping.

5. A client at risk for heart disease asks the nurse for some small changes that can be made in the diet to begin adopting an Italian-Mediterranean style diet. Select all that apply. a. begin using olive oil as the primary fat in d. eliminate pasta from the diet the diet b. eat small portions e. have fruit for dessert c. eliminate cheese from the diet f. have the main meal of the day at lunch ANS: A, B, E, F The Italians on the Mediterranean side have a low incidence of heart disease due to their eating habits. The most important aspects of the Italian-Mediterranean diet are the use of olive oil and the eating of small portions. Italians consume a healthy mix of pasta, rice, beans, olives, fruits, vegetables, and seafood. The Italians eat their main meal at lunch and dessert is usually fresh fruit. PTS: 1 REF: Mediterranean Influence