Chapter 60: Care of Patients with Malnutrition: Undernutrition and Obesity

Chapter 60: Care of Patients with Malnutrition: Undernutrition and Obesity

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

MULTIPLE CHOICE

1. A client is in the family practice clinic. Today the client weighs 186.4 pounds (84.7 kg). Six months ago the client weighed 211.8 pounds (96.2 kg). What action by the nurse is best?
   1. Ask the client if the weight loss was intentional.
   2. Determine if there are food allergies or intolerances.
   3. Perform a comprehensive nutritional assessment.
   4. Perform a rapid bedside blood glucose test.

ANS:   A

This client has had a 12% weight loss. The nurse first determines if the weight loss was intentional. If not, then the nurse proceeds to a comprehensive nutritional assessment. Food intolerances are part of this assessment. Depending on risk factors and other findings, a blood glucose test may be warranted.

DIF:     Applying/Application                         REF: 1236                   KEY: Nutrition| nutritional disorders| nutritional assessment| nursing assessment MSC:            Integrated Process: Nursing Process: Assessment                                       NOT:                          Client Needs Category: Physiological Integrity: Reduction of Risk Potential

2. A nursing student is studying nutritional problems and learns that kwashiorkor is distinguished from marasmus with which finding?
   1. Deficit of calories
   2. Lack of all nutrients
   3. Specific lack of protein
   4. Unknown cause of malnutrition

ANS:   C

Kwashiorkor is a lack of protein when total calories are adequate. Marasmus is a caloric malnutrition.

DIF:     Remembering/Knowledge                 REF: 1236                   KEY: Nutritional disorders| nutritional assessment                                     MSC: Integrated Process: Teaching/Learning                       NOT:                                                 Client Needs Category: Physiological Integrity: Physiological Adaptation

3. A nurse is reviewing laboratory values for several clients. Which value causes the nurse to conduct nutritional assessments as a priority?
   1. Albumin: 3.5 g/dL
   2. Cholesterol: 142 mg/dL
   3. Hemoglobin: 9.8 mg/dL
   4. Prealbumin: 28 mg/dL

ANS:   B

A cholesterol level below 160 mg/dL is a possible indicator of malnutrition, so this client would be at highest priority for a nutritional assessment. The albumin and prealbumin levels are normal. The low hemoglobin could be from several problems, including dietary deficiencies, hemodilution, and bleeding.

DIF:            Remembering/Knowledge                 REF:    1239                 KEY: Nutritional disorders| nutritional assessment| laboratory values  MSC: Integrated Process: Nursing Process: Assessment      NOT:          Client Needs Category: Safe and Effective Care Environment: Management of Care

4. A client is receiving bolus feedings through a Dobhoff tube. What action by the nurse is most important?
   1. Auscultate lung sounds after each feeding.
   2. Check tube placement before each feeding.
   3. Check tube placement every 8 hours.
   4. Weigh the client daily on the same scale.

ANS:           B

For bolus feedings, the nurse checks placement of the tube per institutional policy prior to each feeding, which is more often than every 8 hours during the day. Auscultating lung sounds is also important, but this will indicate a complication that has already occurred. Weighing the client is important to determine if nutritional goals are being met.

DIF:            Applying/Application                         REF:    1243                 KEY: Nutritional disorders| tube feedings| equipment safety                                     MSC: Integrated Process: Nursing Process: Assessment                      NOT:                                                 Client Needs Category: Safe and Effective Care Environment: Safety and Infection Control