Basic Geriatric Nursing, 5th Edition Chapter 06: Maintaining Fluid Balance and Meeting Nutrition Needs Test Bank

Basic Geriatric Nursing, 5th Edition Chapter 06: Maintaining Fluid Balance and Meeting Nutrition Needs Test Bank Chapter 06: Maintaining Fluid Balance and Meeting Nutrition Needs My Nursing Test Banks Wold: Basic Geriatric Nursing, 5th Edition Chapter 06: Maintaining Fluid Balance and Meeting Nutrition Needs Test Bank MULTIPLE CHOICE 1. The nurse explains that the lowest recommended daily caloric intake to meet nutritional needs of the older adult safely is calories. a. 1000 b. 1200 c. 1400 d. ANS: B 1800 The minimal caloric intake for the older adult that will meet nutritional needs of the older adult is 1200 calories. 2. The 65-year-old woman brags that by using the MyPyramid guidelines for nutrition, she has lost 15 lb. The nurse reminds her that in order to maintain the weight loss, she must be physically active for minutes a day. a. 15 to 20 b. 20 to 30 c. 30 to 40 d. 40 to 60 ANS: D According to the guidelines of MyPyramid, an activity period of 40 to 60 minutes a day is necessary to maintain weight loss. 3. The nurse recommends that the older man eat chicken and fish because these are complete proteins, which have: a. some molecules of carbohydrate. b. all the essential amino acids. c. high fat content. d. soluble fiber. ANS: B Fish and lean chicken have all the essential amino acids and very little fat content, unlike red meat. 4. The nurse explains that high-density lipoproteins (HDLs), the so-called healthy fats, are made up of: a. mainly proteins. b. mostly triglycerides. c. mainly cholesterol. d. a variety of minerals. ANS: A HDLs are made up primarily of proteins, as opposed to lipids such as triglycerides, which are found in very-low-density lipoproteins (VLDLs) and cholesterol, which is found in low-density lipoproteins (LDLs). 5. The nurse points out that the nonhealing pressure ulcers and decreasing visual acuity in a patient on a fat-restricted diet may be related to the patients impaired ability to metabolize vitamin: a. A. b. B6. c. B12. d. C. ANS: A Vitamin A is a fat-soluble vitamin and helps with wound healing and night vision acuity. Persons on low-fat diets may not be able to metabolize vitamin A from food sources because of the decreased fat in their diet. 6. The home health nurse does an ongoing assessment of the patient who has had a subtotal gastrectomy for evidence of a deficiency in vitamin: a. A. b. B6. c. B12. d. C. ANS: C Vitamin B12 is generated from the digestion of protein in the stomach. If part of the stomach is gone (gastrectomy), there is less digestive potential for vitamin B12. 7. The nurse giving an iron preparation in capsule form will improve its absorption by giving the patient extra: a. orange juice. b. milk products. c. water. d. caffeine drinks. ANS: A Vitamin C improves the absorption of iron. 8. The nurse caring for the older adult patient who is taking a diuretic for control of hypertension should monitor the patient closely for signs of: a. hypokalemia. b. hypocalcemia. c. hyponatremia. d. hyperkalemia. ANS: A Diuretics deplete the body of potassium, a necessary mineral. 9. The older adult patient in an extended-care facility has a pressure ulcer. The nurse would encourage wound healing by increasing the patients intake of zinc from food sources such as: a. meat. b. citrus fruit. c. green leafy vegetables. d. complex carbohydrates. ANS: A Meat, nuts, and shellfish are dietary sources of zinc. 10. The nurse is aware that older adults need a minimum daily fluid intake of mL. a. 1000 b. 2000 c. 3000 d. ANS: B 4000 The minimum daily fluid requirement is 2000 mL/day. 11. Older adults who consume excessive amounts of alcohol put themselves at risk for nutritional deficits because alcohol: a. decreases blood glucose levels. b. alters the function of some minerals. c. interferes with the absorption of nutrients. d. increases the metabolism. ANS: C Excessive intake of alcohol interferes with the absorption of nutrients because of changes in the stomach lining. 12. The nurse in a retirement center who is selecting a main dish from the residents menu for an Orthodox Jewish man would select: a. crab cakes with white sauce. b. lamb chops with mint jelly. c. ham steak with red gravy. d. pork chops with cranberries. ANS: B Shellfish and pork are not permitted in the diet of Orthodox Jewish persons. 13. The nurse takes into consideration that the patient who would need higher caloric intake would be the patient with a condition such as: a. bacterial pneumonia. b. osteoporosis. c. arthritis. d. stroke. ANS: A Persons with infections require a higher caloric intake. 14. The nurse explains that most older adults need only about 50 g of protein daily, which is equivalent to approximately lb. a.1 b. c. d. ANS: D There are approximately 450 g in a pound, so 50 g is roughly equivalent to lb, essentially the weight of one thin hamburger patty. 15. The nurse instructing the older man in the use of MyPyramid points out that he should eat cup(s) of fruit a day. a. b. 1 c. d. 2 ANS: D The MyPyramid guidelines recommend eating 2 cups of fruit daily. 16. While instructing the patient who is to take oral iron supplements, the nurse indicates that: a. supplements should be taken between meals on an empty stomach. b. medication should be drunk from a nonmetal glass. c. the color of the stool will change to dark green or black. d. constipation is likely to occur. ANS: C Iron supplements can color the stool a dark green or black. Iron should be taken with a meal to reduce gastrointestinal irritation. The preparation should be taken through a straw. The supplement might cause diarrhea. 17. When the nurse weighs an edematous patient with congestive heart failure, the weight increase from yesterday is 2.2 lb. The nurse assesses that this patient has retained of fluid. a. 500 mL b. 1 L c. 1500 mL d. 2 L ANS: B The weight gain of 2.2 lb (1 kg) is equal to 1 L of fluid retention. 18. The nurse encourages a group of extended care residents to sit out on the sunny patio for an hour a day during the afternoon in order to help them with the synthesis of vitamin: a. A. b. B12. c. D. d. K. ANS: C Exposure to the sun allows the skin to synthesize vitamin D, which is required for calcium absorption. 19. What is the caloric value (in calories per gram [cal/g]) of protein? a. 9 cal/g b. 4 cal/g c. 0 cal/g d. 7 cal/g ANS: B Proteins yield 4 cal/g. 20. What is the caloric value of alcohol? a. 9 cal/g b. 4 cal/g c. 0 cal/g d. 7 cal/g ANS: D Alcohol yields 7 cal/g. 21. What is the caloric value of vitamins? a. 9 cal/g b. 4 cal/g c. 0 cal/g d. 7 cal/g ANS: C Vitamins yield no calories. 22. What is the caloric value of fat? a. 9 cal/g b. 4 cal/g c. 0 cal/g d. 7 cal/g ANS: A Fats, which can come from either plant sources or animal sources, yield 9 cal/g. MULTIPLE RESPONSE 1. The nurse takes into consideration the factors that influence nutritional needs, which include . (Select all that apply.) a. bone density b. gender c. climate d. presence of illness e. body temperature ANS: B, C, D, E Bone density is not a factor, but all other options are factors that have a significant effect on nutritional needs. 2. The nurse uses a chart to show the vital nutrients required by all persons, which are . (Select all that apply.) a. carbohydrates b. proteins c. vitamins and minerals d. fats e. electrolytes ANS: A, B, C, D Electrolytes are not nutrients, but all other listed options are considered essential nutrients. 3. The nurse encourages older adults to include complex carbohydrates such as vegetables and fruits in their diet because complex carbohydrates contain . (Select all that apply.) a. minerals b. fats c. vitamins d. soluble fiber e. polysaccharides ANS: A, C, D, E No fat is contained in complex carbohydrates. 4. The nurse is aware that older adults who do not take in adequate fluids are at risk for . (Select all that apply.) a. altered absorption of drugs b. digestive disorders c. constipation d. bleeding disorders e. reduced appetite ANS: A, B, C, E Bleeding disorders are not associated with inadequate intake. All other options are problems associated with a fluid deficit. 5. Older adults plagued with chronic health problems may become undernourished because they . (Select all that apply.) a. are too fatigued to prepare meals b. become frustrated when attempting to open packaging c. may be unable to carry groceries any distance d. have no interest in eating out due to health issues e. lack stamina to shop for groceries ANS: A, B, C, E Having no interest in eating out is not going to cause the older adult to be malnourished. Lack of interest in eating or socialization due to a chronic health problem can cause the older adult to be malnourished. All the other options listed can result in the older adult being malnourished. 6. The home health nurse is painfully aware that older adults living independently have many barriers to providing themselves with adequate nutrition, which include . (Select all that apply.) a. difficulty chewing b. lack of transportation to shop c. use of quick frozen meals d. lack of motivation to cook e. sensory changes ANS: A, B, D, E The availability of quick frozen foods, which are easy to prepare, offer a source of better nutrition to the older adult. 7. An older adult who is a resident in an extended-care facility is at risk for nutritional deficits related to . (Select all that apply.) a. repetitive nature of meals b. lack of culturally significant food c. environmental odors d. reaction to being fed by others e. non-nutritious food choices ANS: A, B, C, D Although the food is nutritious, the repetitive nature of the menu, the lack of culturally significant food, and environmental concerns alter the motivation to have adequate intake. 8. The nurse suggests to the older adult that sources of protein that are less expensive than meat include . (Select all that apply.) a. corn b. beans c. whole-grain foods d. cheese e. nuts ANS: B, C, D, E Corn is not a source of protein. 9. The nurse cautions the older adult against taking excess vitamin supplements because some vitamins can be retained in fatty tissue and cause liver damage, including vitamin(s) . (Select all that apply.) a. A b. B6 c. C d. D e. E ANS: A, D, E Excess fat-soluble vitamins A, D, and E can be retained in fatty tissue and result in hepatic damage. Chapter 39. Fluids, Electrolytes, & Acid-Base Balance My Nursing Test Banks Chapter 39. Fluids, Electrolytes, & Acid-Base Balance Multiple Choice Identify the choice that best completes the statement or answers the question. 1. Which body fluid lies in the spaces between the body cells? 1) Interstitial 2) Intracellular 3) Intravascular 4) Transcellular ANS: 1 Extracellular fluid lies outside the cells. It is composed of three types of fluid: interstitial, intravascular, and transcellular. Interstitial fluid lies in the spaces between the body cells. Intracellular fluid is contained within the cells. Intravascular fluid is the plasma within the blood. Transcellular fluid includes specialized fluids, such as cerebrospinal, pleural, peritoneal, and synovial; and digestive juices. 2. Chloride, bicarbonate, phosphate, and sulfate are examples of what type of charged particles and why? 1) Cations, because they carry a positive charge 3. A patient is brought to the emergency department (ED) by paramedics 2) Cations, because they carry a negative charge 3) Anions, because they carry a positive charge 4) Anions, because they carry a negative charge ANS: 4 Anions are electrolytes that carry a negative charge; they include chloride, bicarbonate, phosphate, and sulfate. Electrolytes that carry a positive charge are called cations. Cations include sodium, potassium, calcium, and magnesium. after a person standing on the sidewalk saw him fall on a crowded street. He has a history of alcoholism and is frequently brought to the ED. The nurse finds the patient to be disoriented; he has periods of being calm mixed with episodes of being disruptive and loud. His vital signs are the following: BP 138/84 mm Hg; pulse 135 beats/min, regular and strong; respiratory rate 22 breaths/min; temperature 37.1C (98.1F). What electrolyte imbalance might the nurse suspect? 1) Hypomagnesemia 2) Hypocalcemia 3) Hyperkalemia 4) Hypernatremia ANS: 1 Hypomagnesemia is a frequent consequence of alcoholism. Signs and symptoms include disorientation, mood changes, and tachycardia. Hypocalcemia, a low calcium level, is associated with muscle spasms and tetany. Hyperkalemia, a high potassium level, manifests as weakness, fatigue, and cardiac dysrhythmias. Hypernatremia, a high sodium level, produces extreme thirst and agitation. PTS:1DIFifficultREF:p. 1392 KEY: Nursing process: Diagnosis | Client need: PHSI | Cognitive level: Analysis 4. The passive process by which molecules of a solute move through a cell membrane from an area of higher concentration to an area of lower concentration is called which of the following? 1) Osmosis 2) Filtration 3) Hydrostatic pressure 4) Diffusion ANS: 4 Diffusion is a passive process by which molecules move from an area of higher concentration to an area of lower concentration. Osmosis is the movement of water across a membrane from an area of a less-concentrated solution to an area of more-concentrated solution. Filtration is the movement of water and smaller particles from an area of high pressure to low pressure. Hydrostatic pressure is the force created by fluid within a closed system. 5. A client is admitted to the emergency department (ED) in respiratory distress. The results of his arterial blood gases are the following: pH = 7.30; PCO2 = 40; HCO3 = 19 mEq/L; PO2 = 80. The nurse interprets the findings as which of the following? 1) Respiratory acidosis with normal oxygen levels 2) Respiratory alkalosis with hypoxia 3) Metabolic acidosis with normal oxygen levels 4) Metabolic alkalosis with hypoxia ANS: 3 The pH is acidotic. The HCO3 of 19 mEq/L is low and has moved in the same direction as the pH, indicating a metabolic disorder. The PCO2 is within normal range with no signs of compensation. The PO2 level is normal. 6. A patient is admitted to the emergency department (ED) in respiratory distress. The results of his first arterial blood gases were: pH = 7.30; PCO2 = 40; HCO3 = 19 mEq/L; PO2 = 80. The nurse evaluates the patients treatment plan by examining repeat arterial blood gases (ABGs). The results are: pH = 7.38; PCO2 = 32; HCO3 = 19 mEq/L. The nurse concludes which of the following? 1) Respiratory acidosis; the treatment plan is ineffective. 2) Metabolic alkalosis; the treatment plan is effective. 3) Partial compensation; the treatment plan is ineffective. 4) Full compensation; the treatment plan is effective. ANS: 4 Full compensation has occurred as the PCO2 has returned the pH to the normal range. This change indicates that the treatment plan is effective. Partial compensation would be indicated by changes in the PCO2, but the pH would still be outside the normal range. The ABG is now complete compensation metabolic acidosis.