Williams Basic Nutrition and Diet Therapy 16th Edition by Nix William

TEST BANK FOR WILLIAMS’ BASIC N UTRITION AND DIET THERAPY 16TH EDITION BY NIX Chapter 01: Food, Nutrition, and Health Nix: Williams’ Basic Nutrition and Diet Therapy, 16th Edition MULTIPLE CHOICE 1. Promoting a health care service that improves diabetes management for the elderly in a community would assist in which of the following? a. Supporting the national health goals Healthy People 2020 b. Reducing hunger in a subset of the United States population c. Improving Medicare reimbursement claims d. Providing access to primary health care services ANS: A Healthy People 2020 has a wide influence and is the focus of the nation’s main objective to promote health and prevent disease. DIF: Cognitive Level: Application REF: p. 2 TOP: Nursing Process: Implementation MSC: NCLEX: Health Promotion and Maintenance 2. A patient requires a nutrition assessment. The most appropriate professional to perform the assessment is a a. physician. b. nurse. c. public health nutritionist. d. registered dietitian. ANS: D The registered dietitian is the nutrition expert registered with the Commission of Dietetic Registration (CDR), the certifying agency of Academy of Nutrition and Dietetics. Registered dietitians are the only professionals who have met strict educational and professional prerequisites and passed a national registration examination that properly prepares them to conduct a nutrition assessment. DIF: Cognitive Level: Application REF: p. 1 TOP: Nursing Process: Assessment MSC: NCLEX: Safe and Effective Care Environment: Management of Care 3. The sum of all body processes inside living cells that sustain life and health is a. science. b. digestion. c. metabolism. d. nutrition. ANS: C Metabolism is the sum of all chemical changes that take place in the body. Metabolism provides energy, builds tissue, and regulates metabolic processes in the body. DIF: Cognitive Level: Knowledge REF: p. 3 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 4. The nutrients that provide the body with its primary source of fuel for energy are a. vitamins. b. minerals. c. fiber. d. carbohydrates. ANS: D Carbohydrates (e.g., starches and sugars) are the body’s primary fuel to carry out necessary processes; fat is the secondary source of energy. DIF: Cognitive Level: Knowledge REF: p. 4 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 5. Which of the following is the most accurate statement regarding the functions of protein? a. Proteins can be a primary fuel source even if there is adequate carbohydrate intake. b. Proteins are a necessary nutrient to provide energy for the body in times of stress. c. Proteins can be used as coenzyme factors during cell metabolism. d. Proteins are essential to building and repairing tissues within the body. ANS: D The primary function of proteins is to provide amino acids, which are the building units necessary to building and repairing tissues within the body. This is a constant process that ensures adequate growth and maintenance of tissues for a strong body. DIF: Cognitive Level: Comprehension REF: p. 4 TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity: Physiological Adaptation 6. A 65-year-old man requires 20N00UkRcSalI/dNayGTwBith.oCutOaMny specific fat or carbohydrate requirements. The approximate number of kilocalories per day from fat that his diet should provide is kcal/day. a. 400 to 700 b. 100 to 300 c. 500 to 800 d. 900 to 1200 ANS: A Fat should provide no more than 20% to 35% of the total kilocalories per day, so for a 2000-kcal diet, 400 to 700 kcal should be provided. DIF: Cognitive Level: Application REF: p. 4 TOP: Nursing Process: Planning MSC: NCLEX: Health Promotion and Maintenance 7. The body’s main storage form of carbohydrate is a. glycogen. b. glycerol. c. glucagon. d. glucose. ANS: A Glycogen is a polysaccharide that is the main storage form of carbohydrate in the human body. It is mainly stored in the liver and to a lesser extent in muscle tissue. DIF: Cognitive Level: Knowledge REF: p. 4 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 8. The number of kilocalories provided by one slice of bread that contains 30 g carbohydrate, 3 g protein, and 1 g fat is kcal. a. 34 b. 136 c. 141 d. 306 ANS: C Calculate as follows: Carbohydrate provides 4 kcal/g, protein provides 4 kcal/g, and fat provides 9 kcal/g. Therefore: 30 g carbohydrate 4 kcal/g = 120 kcal 3 g protein 4 kcal/g = 12 kcal 1 g fat 9 kcal/g = 9 kcal = 141 total kcal (120 kcal + 12 kcal + 9 kcal) DIF: Cognitive Level: Application REF: p. 4 TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity: Physiological Adaptation 9. aT.he8n8umber of kilocalories from fat in a sandwich that contains 22 g fat is kcal. b. 132 c. 154 d. 198 ANS: D Fat provides 9 kcal/g. Thus, 22 g fat 9 kcal/g = 198 kcal. DIF: Cognitive Level: Application REF: p. 4 TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity: Physiological Adaptation 10. The number of kilocalories from protein in a sandwich that contains 15 g protein is kcal. a. 45 b. 60 c. 75 d. 135 ANS: B Protein provides 4 kcal/g. Thus, 15 g protein 4 kcal/g = 60 kcal. DIF: Cognitive Level: Application REF: p. 4 TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity: Physiological Adaptation 11. The basic building units of protein are called acids. a. fatty b. amino c. nucleic d. carboxyl ANS: B The basic building units of protein are amino acids, which are necessary for building, repairing, and maintaining body tissues. DIF: Cognitive Level: Knowledge REF: p. 4 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 12. The main nutrients involved in metabolic regulation and control are a. water and vitamins. b. vitamins and minerals. c. vitamins and fatty acids. d. minerals and carbohydrates. ANS: B Vitamins and minerals are the key nutrients in regulating and controlling the many chemical processes in the body. Vitamins and minerals function as coenzyme factors, which are components of cell enzymes that govern cell chemical reactions in cell metabolism. DIF: Cognitive Level: Knowledge REF: p. 5 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 13. The dietary regimen that would provide optimal nutrition for a person who is recovering from an extended illness is a diet a. low in protein, fat, and carbNoUhyRdSraIteNs;GhTigBh.iCn OmMinerals and vitamins; and very low in fiber. b. providing adequate amounts of carbohydrates, protein, fat, minerals, and vitamins along with adequate water and fiber. c. high in protein, fiber, and fluid; low in carbohydrates; and adequate in vitamins and minerals. d. with essential amounts of vitamins and minerals; high in protein; and low in fat, carbohydrates, and fiber. ANS: B Optimal nutrition incorporates a varied diet supplying adequate amounts of all nutrients, including carbohydrates, protein, fat, vitamins, minerals, fiber, and fluid. DIF: Cognitive Level: Application REF: p. 5 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 14. A young woman is 5 months pregnant. She currently lives in a condition of poverty and often runs out of money to buy food. She is most at risk for a. liver damage. b. osteopenia. c. undernutrition. d. overnutrition. ANS: C A person with undernutrition, or an intake less than the desired amounts of nutrients a person needs to sustain and maintain health, carries a greater risk for physical illness than a person receiving adequate nutrition. In this case, a young, pregnant woman living in poverty who cannot obtain the necessary nutrition for herself and her baby is in a state of undernutrition, placing both at nutritional risk. DIF: Cognitive Level: Application REF: p. 5 TOP: Nursing Process: Diagnosis MSC: NCLEX: Safe and Effective Care Environment: Management of Care 15. Which factors place a person at the greatest risk for malnutrition? a. Poor appetite, insufficient nutrient intake, poor hygiene, and depleted nutrition reserves b. Poor hygiene, insufficient exercise, and excess carbohydrate intake c. Depleted carbohydrate intake, poor hygiene, and excess calorie intake d. Poor appetite, insufficient nutrient intake, depleted nutrition reserves, and a form of metabolic stress ANS: D Malnutrition appears when nutritional reserves are depleted and nutrient and energy intake is not sufficient to meet day-to-day needs or added metabolic stress. DIF: Cognitive Level: Knowledge REF: p. 5 TOP: Nursing Process: Diagnosis MSC: NCLEX: Physiological Integrity: Physiological Adaptation 16. Mr. Katz, who is 48 years old, is admitted to the hospital with a fracture to his left hip. He weighs 248 lb (54 lb above his desired weight). He is considered to be in a state of overnutrition. The statement most true regarding his state of overnutrition is that a. desired nutrients are consumNeUdRiSn IexNcGesTs Bam.oCuOnMts without the risk of malnutrition. b. because excess body fat is evident and excess calories are consumed, there is no risk of nutrient deficiency leading to malnutrition. c. even though excess body fat and excess nutrient intake are evident, there still may be a risk for some type of nutrient deficiency leading to malnutrition. d. excess body weight may or may not be present along with excess consumption of carbohydrates and fat, which results in inadequate vitamin and mineral intake. ANS: C Overnutrition results from excess nutrient and energy intake over time, resulting in excess weight and a state of obesity. Malnutrition can result from excess body weight and the lack of vitamin- and mineral-rich food consumption (e.g., consumption of fatty and carbohydrate-rich foods only). DIF: Cognitive Level: Application REF: p. 5 TOP: Nursing Process: Diagnosis MSC: NCLEX: Physiological Integrity: Physiological Adaptation 17. Which is least likely to be a primary cause of malnutrition? a. Conditions of poverty b. Prolonged hospitalization c. Homelessness d. Exercise ANS: D Malnutrition appears when nutritional reserves are depleted and nutrient and energy intake is not sufficient to meet day-to-day needs or the additional requirements necessary during periods of stress, thus exercise is not a factor. DIF: Cognitive Level: Application REF: p. 5 TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity: Physiological Adaptation 18. Overnutrition is characterized by a. overeating at a meal. b. excess nutrient and energy intake over time. c. eating a diet with too much variety. d. using dietary supplements. ANS: B Overnutrition results from excess nutrient and energy intake over time or occurs when excessive amounts of nutrient supplements are consumed, resulting in tissue-damaging effects. DIF: Cognitive Level: Comprehension REF: p. 5 TOP: Nursing Process: Diagnosis MSC: NCLEX: Physiological Integrity: Physiological Adaptation 19. The Dietary Reference Intakes (DRIs) address the nutrient needs of a. all adults. b. most healthy population groups. c. minority ethnic groups. d. pregnant women, infants, and children. ANS: B The DRIs refer to a system of reference values that can be used for assessing and planning diets for healthy population groups and other purposes. DIF: Cognitive Level: Knowledge REF: p. 6 TOP: Nursing Process: Implementation MSC: NCLEX: Health Promotion and Maintenance 20. The Dietary Reference Intakes (DRIs) are developed by the a. U.S. Public Health Service. b. U.S. Food and Drug Administration (FDA). c. Food and Nutrition Board of the Institute of Medicine d. National Institutes of Health (NIH). ANS: C DRIs are developed by the Food and Nutrition Board of the Institute of Medicine. DIF: Cognitive Level: Knowledge REF: p. 6 TOP: Nursing Process: Implementation MSC: NCLEX: Health Promotion and Maintenance 21. When not enough scientific evidence is available to establish a Recommended Dietary Allowance (RDA), the value used to guide intake is called the a. Dietary Reference Intake (DRI). b. tolerable upper intake level (UL). c. estimated average requirement (EAR). d. adequate intake (AI). ANS: D AI is used as a guide when not enough scientific data are available to establish the RDA figure. DIF: Cognitive Level: Knowledge REF: p. 7 TOP: Nursing Process: Implementation MSC: NCLEX: Health Promotion and Maintenance 22. You are asked to help plan meals for a local monthly community dinner meeting for the elderly. The tool that would be most helpful for planning healthy meals is the a. Dietary Reference Intakes. b. Dietary Guidelines for Americans. c. MyPlate food guidance system. d. basic four food groups. ANS: C MyPlate, provided by the U.S. Department of Agriculture, provides a valuable tool for meal planning, providing serving sizes for each food group and the ability to create a balanced meal from each group listed. DIF: Cognitive Level: Knowledge REF: p. 7 TOP: Nursing Process: Implementation MSC: NCLEX: Health Promotion and Maintenance 23. You are asked to explain the Dietary Guidelines for Americans to an adult community education class at the local college. The most appropriate areas to cover in teaching this topic include a. appropriate amounts of sodNiuUmR, SsaItuNraGteTdBC, cOhMolesterol, trans-fatty acids, whole grains, and alcohol. b. adequate calories and protein for weight maintenance, smoking cessation, herbal supplements, and food fads. c. the importance of low-carbohydrate diets, smoking cessation, herbal supplements, appropriate food groups, and sodium and potassium. d. food security, weight maintenance, glucose monitoring, and blood pressure monitoring technique. ANS: A The Dietary Guidelines outlines key recommendations to balance calories and maintain weight along with foods and food components to reduce including sodium, saturated fatty acids, cholesterol, trans-fatty acids, added fats and sugars, refined grains, along with recommendations for limiting alcohol. DIF: Cognitive Level: Application REF: p. 7 TOP: Nursing Process: Implementation MSC: NCLEX: Health Promotion and Maintenance 24. A patient asks you what he should eat to maintain an optimal diet. An appropriate response would be to a. eat a variety of foods and eat in moderation. b. avoid all fast food and processed foods. c. eat only natural, organic foods. d. use vitamin and mineral supplements to ensure adequate nutrients. ANS: A An optimal diet contains a variety of foods and in appropriate quantities to maintain proper weight and health. All foods can fit into a healthy diet in moderation. DIF: Cognitive Level: Application REF: p. 5 TOP: Nursing Process: Implementation MSC: NCLEX: Health Promotion and Maintenance 25. The goal of the MyPlate food guide is to promote a. variety, proportion moderation, gradual improvements, and physical activity. b. physical activity, portion control, daily blood pressure monitoring, and gradual improvements in health. c. portion control, daily physical activity, daily glucose monitoring, moderation, and variety. d. variety, moderation, weighing food portions, daily blood pressure monitoring, and glucose monitoring. ANS: A The goal of MyPlate is to promote variety, proportion moderation, gradual improvements, and physical activity. DIF: Cognitive Level: Knowledge REF: p. 7 TOP: Nursing Process: Implementation MSC: NCLEX: Health Promotion and Maintenance 26. A patient is to receive 2400 kcal/day while recovering from a motor vehicle accident. He is to receive 50% of calories from carbohydrates, 25% of calories from fat, and 25% of calories from protein. Which of the following represents the appropriate calories for each substrate? a. 1500 kcal from carbohydrates, 500 kcal from fat, and 400 kcal from protein b. 1400 kcal from carbohydraNteUs,R6S00IkNcGalTfBro.mCfOatM, and 400 kcal from protein c. 1200 kcal from carbohydrates, 600 kcal from fat, and 600 kcal from protein d. 1600 kcal from carbohydrates, 400 kcal from fat, and 400 kcal from protein ANS: C 2400 kcal 0.50 = 1200 kcal from carbohydrates; 2400 kcal 0.25 = 600 kcal from fat; and 2400 kcal 0.25 = 600 kcal from protein. DIF: Cognitive Level: Application REF: pp. 3-4 TOP: Nursing Process: Implementation MSC: NCLEX: Health Promotion and Maintenance | NCLEX: Physiological Integrity: Physiological Adaptation 27. A patient is placed on a 2300-kcal diet. The health care provider is asked to calculate the grams of carbohydrates the patient is receiving on the diet. The number of grams of carbohydrates is a. 50 g. b. 35 g. c. 250 g. d. impossible to calculate from this data. ANS: D The percentage of carbohydrates in the diet typically ranges from 45% to 65% of the total calories depending on individual needs, tastes, habits, living situations, and energy demands. However, the health care provider would need to know the specific foods the patient is eating to calculate carbohydrate intake. DIF: Cognitive Level: Application REF: pp. 3-4 TOP: Nursing Process: Assessment MSC: NCLEX: Health Promotion and Maintenance | NCLEX: Physiological Integrity: Physiological Adaptation 28. A 52-year-old single woman comes to the health professional for advice on maintaining optimal nutritional health. Her food intake records indicate that she likes to eat at fast food restaurants at least twice a week and relies on processed foods for the majority of her dietary intake. She maintains an active lifestyle and works part time at the local bank. The next step to assist this woman would be to a. assess meal plan options along with the ability to prepare nutritious foods. b. obtain laboratory values to further assess her nutrition status and recommend supplementing her diet with vitamins and minerals. c. find ways to decrease eating at fast food restaurants and incorporate physical exercise into her daily routine. d. recommend that she use the MyPlate food guide to change her eating style and attend cooking classes at the local community center. ANS: A The American food environment has been constantly changing over the past several years, with more people eating out and consuming more processed foods. Educating people to follow the MyPlate food guide and the Dietary Guidelines for Americans is important to maintain a healthy lifestyle. DIF: Cognitive Level: Analysis REF: p. 7 TOP: Nursing Process: Planning MSC: NCLEX: Health Promotion and Maintenance | NCLEX: Physiological Integrity: Physiological Adaptation 29. The person most at risk for malnutrition would be a(n) a. active young adult who eats three to five servings of fruits and vegetables along with lean meats and fish and complex carbohydrates and exercises three times a week. b. young child who refuses to eat peas, green beans, and broccoli but loves fruits and other vegetables. c. middle-aged man undergoing chemotherapy for leukemia and who is having difficulty eating solid food. d. young weight lifter who has recently undergone surgery for a compound fracture of his left femur. ANS: C Malnutrition appears when nutrition reserves are depleted or nutrient and energy intake is not sufficient to meet the day-to-day needs along with the added metabolic stress. In this case, cancer and chemotherapy place an increased metabolic stress on the body and the patient is unable to consume enough food to meet his nutrient requirements, placing him at risk for malnutrition. DIF: Cognitive Level: Application REF: p. 5 TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity: Physiological Adaptation 30. C.G. is a 45-year-old man who has a history of diabetes, and the dietary history reveals that he enjoys a good breakfast with whole grain cereal and fruit. For lunch, he usually eats soup or an entrée consisting of a salad and meat along with 2% milk and a sugary soda. He usually has an afternoon snack of chips and sugary soda, and dinner is eaten at a restaurant most days of the week where he chooses steaks, hamburgers, and fries or onion rings along with a salad and a beer or other high-calorie beverage. One of the most important recommendations for C.G. would be a. to not eat at restaurants on a regular basis unless he chooses salads only along with water. b. to continue with whole grains, lean proteins, and vegetables, and replace sugary sodas with sugar-free beverages. c. to drink skim milk and eliminate soups, replacing them with fatty fish five meals a week. d. to enjoy his diet as is but encourage adequate amounts of exercise throughout the week. ANS: B The Choose MyPlate approach encourages making food choices for a healthy lifestyle including balancing calories; enjoying food but in a portion-controlled approach; encouraging whole grains, fruits, vegetables, and low-fat dairy; decreasing high-fat and sugary foods; and monitoring sodium. In this case, where diabetes is a concern as well, a meal plan emphasizing portion control, whole grains, vegetables, and drinks without sugar would be appropriate. DIF: Cognitive Level: AnalysisNURSINRGETFB: .pC. 7OM TOP: Nursing Process: Planning MSC: NCLEX: Health Promotion and Maintenance | NCLEX: Physiological Integrity: Physiological Adaptation Chapter 02: Carbohydrates Nix: Williams’ Basic Nutrition and Diet Therapy, 16th Edition MULTIPLE CHOICE 1. Carbohydrates are nutrients that are composed of the elements carbon, hydrogen, and a. oxygen. b. nitrogen. c. water. d. glucose. ANS: A The chemical nature of carbohydrates is carbon, hydrogen, and oxygen. DIF: Cognitive Level: Knowledge REF: p. 21 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 2. Carbohydrates play a major role in nutrition because they a. provide a long-term energy store. b. are digested in the stomach. c. help regulate body functions. d. provide the body’s major source of energy. ANS: D Carbohydrates are the major source of energy for the body, comprising approximately 50% of total caloric intake. DIF: Cognitive Level: Application REF: p. 20 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 3. Carbohydrates are stored as glycogen in the a. central nervous system and muscles. b. heart and liver. c. small intestine. d. liver and muscles. ANS: D Carbohydrates are stored as glycogen in the liver and muscles. DIF: Cognitive Level: Knowledge REF: p. 23 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 4. An example of a food that contains a fructose sugar is a. milk. b. honey. c. molasses. d. corn. ANS: B Fructose is a monosaccharide and is the sweetest of the simple sugars. It is primarily found in fruits and honey. DIF: Cognitive Level: Knowledge REF: p. 21 TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity: Physiological Adaptation 5. Examples of the simple carbohydrates include a. glucose and galactose. b. sucrose and starch. c. lactose and lignin. d. fructose and glycogen. ANS: A Monosaccharides and disaccharides are the simple sugar units used to build complex carbohydrates. The monosaccharides are glucose, galactose, and fructose. DIF: Cognitive Level: Application REF: pp. 22-23 TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity: Physiological Adaptation 6. The sugar to which all other sugars are converted and the one that circulates in the blood to provide major fuel for the body’s cells is a. sucrose. b. fructose. c. glucose. d. maltose. ANS: C Glucose is a monosaccharide that is the basic, single sugar in the body’s metabolism. Glucose is the form of sugar circulating in the blood and is the primary fuel for the cells. DIF: Cognitive Level: Knowledge REF: p. 21 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 7. Carbohydrates are quick energy foods because a. they do not take long to prepare and are readily available. b. the human body can rapidly break them down to yield energy. c. they are abundant in fast foods and can be readily absorbed. d. they can yield more energy than other nutrients. ANS: B Carbohydrates are considered quick energy foods because they can readily be metabolized in the body to yield glucose, the main fuel source for the body. DIF: Cognitive Level: Comprehension REF: p. 21 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 8. The carbohydrate form in which glucose is stored in the body is a. starch. b. polysaccharide. c. glycogen. d. fructose. ANS: C Glucose is stored in the body as glycogen. DIF: Cognitive Level: Knowledge REF: p. 23 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 9. Of the following, the best sources of dietary fiber are a. fruit and fruit juice. b. rice and crackers. c. iceberg lettuce and tomato juice. d. lentils and corn. ANS: D Dietary fiber is found in unrefined and whole plant foods. Of the choices listed, lentils and corn provide the highest amount of dietary fiber. DIF: Cognitive Level: Application REF: p. 23 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 10. Types of dietary fiber include a. lactose, galactose, and maltose. b. polysaccharides and polyols. c. starch, ptyalin, and glucose d. cellulose, lignin, and noncellulose. ANS: D Dietary fiber is found in plant foods. Plants contain several types of dietary fiber, including cellulose, lignin, and noncellulose polysaccharides. DIF: Cognitive Level: Knowledge REF: pp. 23-24 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 11. The recommended daily intake of dietary fiber for an adult woman is g/day. a. 15 b. 21 c. 25 d. 30 ANS: C The recommended intake of fiber for men and women age 50 years and younger is 38 g/day and 25 g/day, respectively. DIF: Cognitive Level: Knowledge REF: p. 16 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 12. A health professional is determining the caloric intake for a patient. Her caloric intake from fiber would be a. 3.4 kcal/g. b. 0 kcal/g. c. 4 kcal/g. d. 9 kcal/g. ANS: B Human beings lack the necessary enzymes to digest dietary fiber, and so, unlike other carbohydrates, dietary fiber does not provide energy. DIF: Cognitive Level: Application REF: p. 23 TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity: Physiological Adaptation 13. Wavelike contractions of the muscle fibers of the stomach and intestinal walls are called a. segmentation. b. peristalsis. c. metabolism. d. digestion. ANS: B The mechanical digestive process in the stomach entailing wavelike contractions of the muscle fibers of the stomach wall that mix food particles with gastric secretions is called peristalsis. DIF: Cognitive Level: Knowledge REF: p. 16 (Table 2-2) TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 14. A basket of fruit contains ripe grapes, apples, and oranges as well as pears and peaches that are not quite ripe. The fruits with the highest amount of simple sugar include the a. pears and apples. b. peaches and oranges. c. grapes and apples. d. peaches and pears. ANS: C Fructose is a simple sugar; ripe fruit contains more fructose than less-ripe fruit. DIF: Cognitive Level: Application REF: p. 21 TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity: Physiological Adaptation 15. An apple contains a type of soluble dietary fiber called a. lignin. b. starch. c. cellulose. d. pectin. ANS: D Pectin is a water-soluble fiber found in many fruits. Cellulose and lignin are insoluble fibers. Starch is another polysaccharide found in grains, legumes, and other vegetables and in small amounts in fruit. Starch does not necessarily contain dietary fiber. DIF: Cognitive Level: Application REF: pp. 23-24 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 16. Of the following, the food with the lowest carbohydrate content (as a percentage of weight) would be a. orange juice. b. raisins. c. whole milk. d. dried beans. ANS: C Milk contains the least carbohydrate content (as a percentage of weight); it contains lactose, but the amount is diluted by all the liquid in the milk. Carbohydrates are more concentrated in dried fruits, juices, and starchy vegetables. DIF: Cognitive Level: Analysis REF: p. 22 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 17. Digestion of the starch component of a peanut butter sandwich begins in the a. mouth. b. stomach. c. small intestine. d. liver. ANS: A The digestion of carbohydrate-rich foods such as starches and sugars begins in the mouth, where the enzyme ptyalin begins to break the starch down into smaller particles. DIF: Cognitive Level: Knowledge REF: p. 16 (Table 2-2) TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 18. A negative effect of sugar alcohNoUlsRiSs IthNatGthTeBy a. contain more kilocalories than sugar. b. can cause intoxication. c. promote bacterial disease in the colon. d. may cause diarrhea. ANS: D Excessive amounts of sugar alcohols in food products can cause diarrhea because of the slow digestion of the product. DIF: Cognitive Level: Comprehension REF: p. 20 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 19. Once monosaccharides are absorbed into the intestinal bloodstream, they are transported to the a. cells. b. liver. c. heart. d. brain. ANS: B The monosaccharides glucose, galactose, and fructose are absorbed directly into the portal blood circulation, which carries them directly to the liver. DIF: Cognitive Level: Knowledge REF: pp. 18-19 (Table 2-3) 20. A client has a goal of increasing fiber intake to 30 grams per day. Current intake reveals the following information: Breakfast intake is 3/4 cup sugary corn popped cereal, 1 cup skim milk, 1 slice white toast, and 1/2 cup orange juice. Lunch includes 2 ounces sliced turkey, 1 slice wheat bread, 1 tablespoon mayonnaise, 2 chocolate chip cookies, and 1 cup water. Dinner includes 4 ounces beef, 1/2 cup green beans, 3/4 cup instant mashed potatoes with butter, 1 biscuit, and 1 cup skim milk. As the nutrition expert counseling this patient, one appropriate recommendation might be to a. encourage whole-grain breads and cereals in place of white breads and cereals. b. double the amount of proteins such as turkey and beef and eliminate sugar intake. c. add 2 tablespoons of omega-3 fatty-acid enriched margarine to breads and potatoes. d. make no changes because adequate fiber intake is present. ANS: A The recommended daily fiber intake is 38 grams per day for men. This intake requires consistent use of whole grains, legumes, vegetables, and fruits, along with seeds and nuts. Meats and fats such as butter and margarine do not contain fiber. DIF: Cognitive Level: Analysis REF: pp. 18-19 (Table 2-3) TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 21. An example of a food low in carbohydrates is a. low-fat yogurt. b. steak. c. beans. d. potatoes. ANS: B Meats such as beef, poultry, and fish do not contain carbohydrates. Yogurt contains some carbohydrates from the milk and is often sweetened. Starchy vegetables such as beans and potatoes are high in carbohydrates. DIF: Cognitive Level: Application REF: pp. 22-24 TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 22. The major site or organ in the body for metabolic processing of carbohydrates is the a. intestine. b. heart. c. brain. d. liver. ANS: D The liver is the major site for metabolic processing of carbohydrates. DIF: Cognitive Level: Knowledge REF: p. 21 | pp. 23-24 23. The digestion of milk yields the monosaccharides a. fructose and glucose. b. galactose and glucose. c. galactose and sucrose. d. glucose and maltose. ANS: B The digestion of milk yields the monosaccharides galactose and glucose from the disaccharide lactose. DIF: Cognitive Level: Knowledge REF: p. 22 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 24. A food that contains maltose is a. milk. b. fruit. c. molasses. d. table sugar. ANS: C Maltose is found in molasses. DIF: Cognitive Level: Application REF: p. 22 TOP: Nursing Process: Implementation MSC: NCLEX: Physiological IntNegUriRtyS: PIhNysGioTloBCalOAMdaptation 25. A molecule of glycogen is composed of hundreds of units of a. galactose. b. glucose. c. glucose, fructose, and galactose. d. disaccharide. ANS: B Glycogen is composed of glucose units. DIF: Cognitive Level: Knowledge REF: p. 23 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 26. Sufficient dietary carbohydrates prevent excess formation of a. ketones. b. ammonia. c. amino acids. d. water. ANS: A Ketones result from the rapid breakdown of fat. The breakdown of fat occurs when carbohydrate intake is inadequate. Sufficient carbohydrate intake prevents ketosis from occurring. DIF: Cognitive Level: Knowledge REF: p. 21 TOP: Nursing Process: Evaluation MSC: NCLEX: Physiological Integrity: Physiological Adaptation 27. A part of the body that depends on a constant supply of carbohydrate to function properly is the a. cardiopulmonary system. b. urinogenital system. c. central nervous system. d. gastrointestinal system. ANS: C The central nervous system requires a constant supply of glucose in the bloodstream to function properly. DIF: Cognitive Level: Knowledge REF: p. 21 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 28. The number of kilocalories from carbohydrates in a baked potato that contains 40 g carbohydrate is kcal. a. 40 b. 80 c. 160 d. 360 ANS: C Carbohydrate contains 4 kcal/g. So a potato that contains 40 g carbohydrate would provide 40 4 = 160 kcal. DIF: Cognitive Level: ApplicatiNonURSINRGETFB: .pC. 1O5M TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity: Physiological Adaptation 29. A food that is a good source of fiber is a. oatmeal. b. prune juice. c. salmon. d. cornstarch. ANS: A Plant foods contain the best sources of fiber. Oatmeal is a whole-grain cereal and is therefore high in fiber. DIF: Cognitive Level: Application REF: pp. 18-19 (Table 2-3) TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity: Physiological Adaptation 30. Which of the following carbohydrates provides the fastest source of energy? a. ground beef b. cranberry juice c. whole-grain cereal d. milk ANS: B Cranberry juice contains fructose, a single carbohydrate or monosaccharide, which requires no digestion and so is more quickly absorbed than more complex carbohydrates found in whole grains or the disaccharide lactose in milk. DIF: Cognitive Level: Application REF: p. 22 TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity: Physiological Adaptation Chapter 03: Fats Nix: Williams’ Basic Nutrition and Diet Therapy, 16th Edition MULTIPLE CHOICE 1. The functions of fat in the body include a. enzyme production, insulation of long bones, and bone structure. b. formation of bone structure and energy for daily activities. c. flavoring low-fat foods, supplying fatty acids, and lubrication for vital organs. d. insulation of vital organs, temperature regulation, and cell membrane structure. ANS: D In the body, fat around vital organs and under the skin provides insulation and helps regulate body temperature; fat is also a component of cell membrane structure. DIF: Cognitive Level: Knowledge REF: p. 32 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 2. The number of kilocalories from fat in a meal that contains 35 g fat is a. 35. b. 140. c. 315. d. 350. ANS: C Fat contains 9 kcal/g, so 35 g 9 kcal/g = 315 kcal. DIF: Cognitive Level: Application REF: p. 39 TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity: Physiological Adaptation 3. The recommended total calories provided by fat in an 1800-calorie diet should not exceed a. 180 calories. b. 270 calories. c. 630 calories. d. 720 calories. ANS: C It is recommended that no more than 35% of total calories come from fat. In an 1800-calorie diet: 1800 0.35 = 630 calories. DIF: Cognitive Level: Application REF: p. 39 TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity: Physiological Adaptation 4. An element not found in triglycerides is a. carbon. b. hydrogen. c. nitrogen. d. oxygen. ANS: C Carbon, hydrogen, and oxygen make up fat, whereas nitrogen is found as part of the protein molecule. DIF: Cognitive Level: Knowledge REF: p. 27 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 5. Triglycerides are composed of a. glycerol and amino acids. b. trans-fatty acids. c. hydrogenated fatty acids. d. glycerol and fatty acids. ANS: D A triglyceride is composed of three fatty acids attached to a glycerol base. DIF: Cognitive Level: Knowledge REF: pp. 27-28 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 6. The chemical feature that distinguishes a saturated fatty acid from an unsaturated fatty acid is the a. amount of water it contains. b. amount of cholesterol it contains. c. source. d. amount of hydrogen it contains. ANS: D Fatty acids are saturated or unsNatUurRaSteId NdeGpTenBCgOoMn whether they are filled with hydrogen. A fatty acid that is not completely filled with all the hydrogen it can hold is unsaturated; the structure of a saturated fatty acid is completely filled with all the hydrogen bonds it can hold. DIF: Cognitive Level: Knowledge REF: pp. 27-28 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 7. An example of a food that contains a high level of saturated fatty acids is a. beefsteak. b. olive oil. c. green tomatoes. d. whole-grain bread. ANS: A Saturated fats are commonly found in animal products. Unsaturated and monounsaturated fats are mostly derived from plant sources. However, tropical oils such as coconut and palm oils, as well as hydrogenated oils, are saturated. DIF: Cognitive Level: Application REF: p. 28 TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity: Physiological Adaptation 8. Of the following fats, the one that is least saturated is a. safflower oil. b. coconut oil. c. olive oil. d. butter oil. ANS: A Plant fats are generally less saturated than animal fats. However, coconut oil is high in saturated fat. Olive oil contains mostly monounsaturated fatty acids. Safflower oil contains mostly polyunsaturated fatty acids. DIF: Cognitive Level: Application REF: p. 33 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 9. Most fatty acids in plant foods are a. monounsaturated. b. polyunsaturated. c. unsaturated. d. saturated. ANS: C Plant foods are mostly composed of unsaturated fats. However, tropical oils such as palm, palm kernel, and coconut as well as hydrogenated oils are composed of saturated fats. DIF: Cognitive Level: Comprehension REF: p. 33 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 10. A patient is concerned with her weight. Her energy intake is calculated to be 1600 calories. Intake records reveal that her fat intake for the past month has been 120 calories or less per day. The most appropriate intervention would be to a. assess for essential fatty aciNdUdRefSicIieNnGcyT. B b. continue to monitor for changes. c. continue current meal plan. d. draw lab work immediately. ANS: A An essential fatty acid is one that is essential to the body; its absence will create a specific deficiency. The body cannot manufacture essential fatty acids and must obtain them from the diet. DIF: Cognitive Level: Analysis REF: p. 29 TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 11. The body needs linoleic acid for a. digestion of food. b. protein metabolism. c. fluid balance. d. blood clotting. ANS: D The body needs linoleic acid for functions related to tissue strength, cholesterol metabolism, muscle tone, blood clotting, and heart action. DIF: Cognitive Level: Knowledge REF: p. 29 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 12. The best food choice to provide alpha-linolenic acid is a. strawberries. b. canola oil. c. raisin toast. d. lard. ANS: B Alpha-linolenic acid is primarily found in soybean, canola, and flaxseed oil. DIF: Cognitive Level: Application REF: p. 29 TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity: Physiological Adaptation 13. The primary reason lecithin is able to help transport fatty material in the bloodstream is because it is a. a phytosterol. b. a buffer. c. found in hemoglobin. d. amphiphilic. ANS: D Lecithin is a phospholipid and is therefore amphiphilic, which means it is partially hydrophobic (able to bind fats and oils) and partly hydrophilic (soluble in an aqueous environment such as blood). DIF: Cognitive Level: Application REF: p. 31 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 14. The process of adding hydrogen to fatty acids is called a. hydrolysis. b. hydrogenation. c. emulsification. d. hydration. ANS: B Hydrogenation is the process of introducing hydrogen into the fat molecule; this makes the fat more saturated. DIF: Cognitive Level: Knowledge REF: p. 30 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 15. A change brought about as the result of hydrogenation is that a. liquid fats become solids. b. fats become less saturated. c. monoglycerides become diglycerides. d. vitamins are destroyed. ANS: A Hydrogenation is the process of introducing hydrogen into the fat molecule; liquid fats such as vegetable oil are made into solids such as margarine and shortening in this manner. DIF: Cognitive Level: Application REF: p. 30 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 16. An example of a food that does not contain cholesterol is a. liver. b. sausage. c. cheese. d. coconut. ANS: D Cholesterol is a substance that naturally occurs in all animal foods but not in plant foods. DIF: Cognitive Level: Application REF: p. 31 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 17. Cholesterol is synthesized by the body mainly in the a. intestine. b. liver. c. adipose tissue. d. skin. ANS: B Endogenous cholesterol is synthesized in many body tissues, particularly the liver. Small amounts are synthesized in the adrenal cortex, skin, intestines, testes, and ovaries. DIF: Cognitive Level: Knowledge REF: p. 31 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 18. After a dietary assessment is completed, it reveals that a client consumes 50% of his or her daily calories from fat. This amount of fat places the client at risk for a. obesity, arthritis, and elevated blood pressure. b. obesity, elevated blood fats, and diabetes. c. elevated blood pressure, diabetes, and allergies. d. diabetes, dementia, and stroke. ANS: B According to the Dietary Reference Intakes, no more than 35% of total calories should come from fat. Excess fat intake places a person at risk for health problems, including obesity, elevated blood fats, and diabetes. DIF: Cognitive Level: Application REF: p. 39 TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity: Reduction of Risk Potential 19. Factors that increase the risk of heart disease include a. a family history of cancer. b. increased stress and obesity. c. anemia and low thyroid levels. d. gallbladder disease. ANS: B Heart disease is a leading cause of death in developed countries. Various risk factors are associated with heart disease including excess dietary fat, especially saturated fat and cholesterol, along with obesity, diabetes, elevated blood fats, and elevated blood pressure. Additional lifestyle factors include smoking, stress, and lack of exercise. DIF: Cognitive Level: Knowledge REF: p. 38 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Reduction of Risk Potential 20. The substances that serve as the major vehicles for fat transport in the bloodstream are a. micelles. b. glycolipids. c. chylomicrons. d. bile salts. ANS: C After absorption, monoglycerides and fatty acids are reformed into triglycerides, which are then packaged into lipoproteins called chylomicrons. Chylomicrons are made of triglycerides, cholesterol, phospholipids, and proteins, and allow fatty substances to enter the circulation. DIF: Cognitive Level: Knowledge REF: p. 36 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 21. After eating a dinner of fried chicken, gravy, and mashed potatoes, chemical digestion of the fat component primarily takes place in the a. mouth. b. stomach. c. small intestine. d. large intestine. ANS: C The largest part of chemical digestion occurs in the small intestine with bile salts from the gallbladder (which serve as an emulsifier) and several enzymes, including gastric lipase (tributyrinase) and pancreatic lipase that break down triglycerides to diglycerides and monoglycerides. DIF: Cognitive Level: Application REF: p. 34 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 22. The hormone responsible for stimulating the gallbladder to contract and release bile into the small intestine is a. gastric lipase. b. cholecystokinin. c. enteric lipase. d. enterokinin. ANS: B Cholecystokinin release is stimulated when fat enters the duodenum. Cholecystokinin then causes the gallbladder to contract. DIF: Cognitive Level: Knowledge REF: p. 34 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 23. End products of fat digestion do not include a. fatty acids. b. glycerol. c. diglycerides. d. monosaccharides. ANS: D The end products of fat digestion include fatty acids, glycerol, and diglycerides. Monosaccharides are a type of carbohydrate. DIF: Cognitive Level: Knowledge REF: pp. 35-36 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 24. An important function of bile is to a. digest triglycerides. b. activate the intestinal lipases. c. break fat into smaller particles. d. split fatty acids into two-carbon molecules. ANS: C Bile functions as an emulsifier rather than an enzyme. Bile assists in the preparation of fat for chemical digestion by its specific enzymes. This preparation accomplishes two tasks: (1) it breaks down fat into small particles, and (2) it lowers the surface tension of the dispersed and suspended fat particles. DIF: Cognitive Level: KnowledNgeURSINRGETFB: .pCp.O3M4-35 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 25. A type of fat that may be associated with a high risk of atherosclerosis if consumed on a regular basis is a. olive oil. b. safflower oil. c. fish oil. d. butter. ANS: D Butter is a highly saturated fat. Excess intake of saturated fat is associated with atherosclerosis. DIF: Cognitive Level: Application REF: p. 33 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 26. Fat substitutes are used in food products to a. reduce the cost of popular foods. b. reduce the trans-fatty acid content of the food. c. prolong the shelf life of the food. d. improve the flavor and physical texture of low-fat foods. ANS: D Fat substitutes such as Simplesse and Olestra provide improved flavor and physical texture to low-fat foods and can help reduce total dietary fat. DIF: Cognitive Level: Knowledge REF: p. 32 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 27. The greatest number of kilocalories is provided by a. 40 g carbohydrates. b. 30 g fat. c. 60 g carbohydrates. d. 50 g protein. ANS: B The 30 g of fat provides the most kilocalories. Fat provides 9 kcal/g; both carbohydrates and proteins provide 4 kcal/g. Calculations: 30 g fat 9 kcal/g = 270 kcal 40 g carbohydrate 4 kcal/g = 160 kcal 60 g carbohydrate 4 kcal/g = 240 kcal 50 g protein 4 kcal/g = 200 kcal DIF: Cognitive Level: Application REF: p. 38 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 28. A food relatively high in saturated fat is a. corn oil. b. peanut oil. c. avocado oil. d. margarine. ANS: D Margarine is higher in saturated fat than corn oil, peanut oil, and avocado oil. Margarine is made from oil by hydrogenation. This makes the oil more solid and more saturated. DIF: Cognitive Level: Application REF: p. 33 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 29. In a diet that contains 50 g fat and a total of 1500 kcal, the proportion of total kilocalories from fat is a. 3%. b. 13%. c. 30%. d. 33%. ANS: C Fat contains 9 kcal/g; 50 g 9 kcal/g = 450 kcal; 450 kcal/1500 total kcal = 0.30, or 30%. DIF: Cognitive Level: Application REF: p. 33 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 30. A good source of monounsaturated fat is a. fish. b. margarine. c. avocado. d. tofu. ANS: C Good sources of monounsaturated fat include olives and olive oil, peanuts and peanut oil, canola oil, almonds, pecans, and avocados. DIF: Cognitive Level: Application REF: p. 28 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation Chapter 04: Proteins Nix: Williams’ Basic Nutrition and Diet Therapy, 16th Edition MULTIPLE CHOICE 1. Proteins are built from simpler organic compounds called a. indispensable amino acids. b. amino acids. c. fatty acids. d. monosaccharides. ANS: B All proteins are made of building block units called amino acids. Proteins are made from both dispensable and indispensable amino acids. DIF: Cognitive Level: Knowledge REF: p. 41 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 2. The element that is contained in proteins but not in carbohydrates or lipids is a. carbon. b. hydrogen. c. nitrogen. d. oxygen. ANS: C Nitrogen is present in proteins but not in carbohydrates or lipids. Amino acids, the building blocks of protein, are named foNr UthReiSr IchNeGmTicBal.sCtrOucMture; amino refers to compounds containing nitrogen. DIF: Cognitive Level: Knowledge REF: p. 42 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 3. Two types of protein in the body are protein and protein. a. complete, incomplete b. animal, vegetable c. dispensable, indispensable d. tissue, plasma ANS: D Two types of protein in the body are tissue protein and plasma protein. Amino acids are classified as indispensable, dispensable, or conditionally indispensable in the diet according to whether the body can make them. DIF: Cognitive Level: Comprehension REF: p. 43 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 4. The number of amino acids that are indispensable for human beings is a. 6. b. 9. c. 11. d. 14. ANS: B Nine amino acids are classified as indispensable amino acids because the body cannot manufacture them in sufficient quantity or at all. DIF: Cognitive Level: Knowledge REF: p. 42 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 5. What is the food that is the best source of indispensable amino acids? a. Black beans b. Peanuts c. Safflower oil d. Turkey ANS: D Indispensable amino acids are provided mostly by high-protein animal products. DIF: Cognitive Level: Application REF: p. 42 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 6. A protein that contains all indispensable amino acids in the correct proportion and ratio is a. a simple protein. b. an incomplete protein. c. a complete protein. d. an indispensable protein. ANS: C A complete protein contains all nine indispensable amino acids in the correct proportion and ratio needed by the body. DIF: Cognitive Level: Knowledge REF: p. 42 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 7. The number of kilocalories from protein in a sandwich that contains 24 g protein is kcal. a. 6 b. 96 c. 120 d. 216 ANS: B Each gram of protein has 4 kcal, so 24 g 4 kcal = 96 kcal. DIF: Cognitive Level: Application REF: p. 53 TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity: Physiological Adaptation 8. An animal protein that has relatively little value as a dietary protein source when eaten alone is a. an egg. b. gelatin. c. milk. d. fish. ANS: B Gelatin is a protein food of animal origin, but it lacks three essential amino acids and has only small amounts of leucine. DIF: Cognitive Level: Knowledge REF: p. 45 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 9. Proteins from plant sources that are classified as incomplete include a. wheat, peanuts, and corn. b. milk, nuts, and cheese. c. oats, gelatin, and soybeans. d. corn, chicken, and milk. ANS: A Grains, peanuts, and corn are examples of plant proteins that are considered incomplete proteins because the food is deficient in one or more of the nine indispensable amino acids. Soy is the only plant source of complete protein. DIF: Cognitive Level: Application REF: p. 45 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 10. The primary function of protein in the diet is to supply a. energy for growth and development. b. insulation for vital organs. c. material for growth and maintenance. d. all 20 amino acids for heartNmUaRinSteInNanGcTe.B ANS: C The primary function of protein is to supply material in the body for growth, maintenance, and repair. DIF: Cognitive Level: Knowledge REF: p. 44 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 11. Protein plays an important role in the body a. as the first source of energy fuel. b. in the conversion of glucose to glycogen for storage. c. as a coenzyme needed for energy utilization. d. in defense against disease and infection. ANS: D Protein assists in the body’s defense against disease and infection by helping build special white blood cells called lymphocytes. DIF: Cognitive Level: Knowledge REF: p. 44 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 12. After a piece of grilled chicken is partially digested in the stomach, it eventually reaches the small intestine, where it is digested by which of the following enzymes secreted by the pancreas? a. Chymotrypsin, trypsin, and carboxypeptidase b. Chymotrypsin, pepsin, and trypsin c. Sucrase, pepsin, and carboxypeptidase d. Lactase, chymotrypsin, and carboxypeptidase ANS: A Chymotrypsin, trypsin, and carboxypeptidase are three enzymes produced by the pancreas to continue breaking down proteins into simpler peptides and amino acids. DIF: Cognitive Level: Knowledge REF: p. 49 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 13. Proteins are mostly absorbed as a. fatty acids. b. disaccharides. c. amino acids. d. polypeptides. ANS: C Proteins are broken down into individual amino acids to be absorbed; polypeptides require further enzymatic breakdown before they can be absorbed. DIF: Cognitive Level: Knowledge REF: p. 41 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 14. Pepsinogen secreted by the gastric cells is converted into pepsin by a. food in the stomach. b. hydrochloric acid. c. gastric lipase. d. pancreatic lipase. ANS: B Hydrochloric acid secreted by the stomach converts pepsinogen, an inactive enzyme, into pepsin. Pepsin is the active form of the enzyme that begins protein digestion. DIF: Cognitive Level: Knowledge REF: p. 48 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 15. Protein catabolism is increased in conditions such as a. pregnancy. b. childhood. c. puberty. d. illness. ANS: D Protein catabolism, or the breakdown of protein, is increased during illness or disease and increases the body’s need for protein and kilocalories to rebuild tissue and meet the demands of an increased metabolic rate. DIF: Cognitive Level: Knowledge REF: pp. 42-43 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 16. The phase of metabolism that makes growth and repair possible is a. digestion. b. catabolism. c. anabolism. d. homeostasis. ANS: C Anabolism is the metabolic process that makes growth and repair possible in the body. It is especially necessary after an illness or disease process. Anabolism also is found during periods of rapid fetal growth during pregnancy, the first year of life, lactation during breastfeeding, and adolescent growth and development into adulthood. DIF: Cognitive Level: Knowledge REF: pp. 42-43 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 17. A gastric enzyme that coagulates the protein in milk and is produced by infants but not by adults is a. hydrochloric acid. b. pepsinogen. c. trypsin. d. rennin. ANS: D Rennin is the gastric enzyme found in the gastric juices of human infants and some young animals such as calves. Rennin is important to the infant for the digestion of milk. DIF: Cognitive Level: Knowledge REF: p. 55 TOP: Nursing Process: Planning MSC: NCLEX: Physiological IntNegUriRtyS: PIhNysGioTloBCalOAMdaptation 18. A protein-digesting enzyme found in the stomach rather than in pancreatic secretions is a. trypsin. b. pepsin. c. chymotrypsin. d. carboxypeptidase. ANS: B Pepsin is the main gastric enzyme that digests proteins. DIF: Cognitive Level: Knowledge REF: p. 48 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 19. The enzyme trypsin is activated by the enzyme a. zymogen. b. bile. c. gastrin. d. enterokinase. ANS: D Trypsin is activated by the enzyme enterokinase. Enterokinase is secreted from the intestinal cells when food enters the duodenum. DIF: Cognitive Level: Knowledge REF: p. 49 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 20. The enzymes aminopeptidase and dipeptidase are secreted by the a. mouth. b. stomach. c. small intestine. d. pancreas. ANS: C Aminopeptidase and dipeptidase are enzymes secreted by glands in the wall of the small intestine. DIF: Cognitive Level: Knowledge REF: p. 49 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 21. Complementary proteins a. provide higher quality protein when eaten together. b. enhance each other’s metabolic actions. c. are more easily absorbed. d. taste good together. ANS: A Combining complementary proteins helps to supply adequate amounts of all nine indispensable amino acids in the diet. Because plant proteins are incomplete, a mixture can provide adequate amounts of amino acids. A normal eating pattern throughout the day along with the body’s reserve supply of protein ensures a complementary balance of high-quality protein. Those who follow a vegetarian diet must combine proteins to meet needs. DIF: Cognitive Level: Knowledge REF: pp. 45-46 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 22. In the mouth, protein foods are a. broken down to amino acids. b. broken up mechanically by chewing. c. broken down to peptides. d. coagulated by rennin. ANS: B Protein digestion begins in the mouth, where food is mechanically processed by chewing. DIF: Cognitive Level: Knowledge REF: p. 47 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 23. The meal with the highest quality protein is a. an omelet with cheese, whole wheat toast, and orange juice. b. a stir fry with chicken, green beans, and carrots. c. a stuffed turkey breast, peas, and a baked potato. d. a bean burrito, corn on the cob, and a tomato salad. ANS: A Eggs are the highest quality protein food and carry a chemical score of 100. Other foods are compared to it according to their amino acid ratios. DIF: Cognitive Level: Application REF: p. 45 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 24. Which of the following conditions might result in the greatest catabolism? a. Growth b. Multiple trauma with extensive organ damage c. Rehabilitation after routine gallbladder surgery d. Healing a broken bone in the arm ANS: B Protein catabolism, or the breakdown of protein, is increased during illness or disease and increases the body’s need for protein and kilocalories to rebuild tissue and meet the demands of an increased metabolic rate. In this case, multiple trauma with extensive organ damage requires a greater catabolic rate compared with the other choices and would create the greatest increase in the metabolic rate and need for tissue repair. DIF: Cognitive Level: Application REF: pp. 42-43 TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity: Physiological Adaptation 25. If the excretion of nitrogen exceeds the nitrogen intake, the condition is called a. total nitrogen balance. b. positive nitrogen balance. c. negative nitrogen balance. d. anabolism. ANS: C If the body takes in less nitrogen than it excretes, a negative balance occurs. This means that the body has an inadequate protein intake and is losing nitrogen by breaking down more tissue than it is building up. DIF: Cognitive Level: Comprehension REF: pp. 43-44 TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity: Physiological Adaptation 26. The grams of high-quality protein required daily for an individual who weighs 170 lb and is close to ideal body weight would be g. a. 45.2 b. 55.3 c. 61.8 d. 94.0 ANS: C The Recommended Dietary Allowance for both men and women is set at 0.8 g of high-quality protein per kilogram of desirable body weight per day. In this case, 170 lb/2.2 lb/kg = 77.3 kg, so 77.3 kg 0.8 g/kg = 61.8 g/day of protein. DIF: Cognitive Level: Application REF: p. 52 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 27. In planning a vegetarian meal, an appropriate combination of complementary proteins would be a. cornmeal tamales and beans. b. lentils and beans. c. bean sprouts and cabbage. d. whole wheat and rice. ANS: A In planning complementary food combinations, different families of foods (e.g., grains, legumes, nuts, and dairy) are mixed. Grains usually are low in threonine and high in methionine, whereas legumes are high in threonine and low in methionine. Therefore grains and legumes help balance the amount of indispensable amino acids required by the body. Acceptable combinations include (1) grains and peas, beans, or lentils; (2) legumes and seeds; and (3) grains and dairy. In the choices given, cornmeal tamales and beans combine foods limited in different amino acids. DIF: Cognitive Level: Application REF: pp. 45-46 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation | NCLEX: Health Promotion and Maintenance 28. A client weighs 130 lbs. She is close to her desirable body weight and consumes a total of 40 g of protein/day. The most appropriate nutritional counseling would be to a. increase her protein intake. b. maintain her current protein intake. c. decrease her protein intake. d. increase her use of complementary proteins. ANS: A The Recommended Dietary Allowance for protein for both men and women is set at 0.