Chapter 11: Nutrition Assessment and Patient Care

Chapter 11: Nutrition Assessment and Patient Care

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. The situation in which it would be most important for the nurse to contact the registered dietitian (RD) is if a

a.	patient complains of constipation during his or her hospital stay.
b.	patient’s family complains about the quality of the food in the hospital.
c.	patient reports losing 10 lb in the past year without trying.
d.	patient has been receiving intravenous glucose and saline but no oral intake for 36 hours.

 

 

ANS:  D

It would be most important for the nurse to contact the RD to conduct a nutrition assessment if the patient has received only intravenous fluids with no nutrient intake for more than 24 hours. Constipation may warrant a nutrition assessment if it is ongoing, but in the short term, it is probably related to surgery, medical procedures, inactivity, or medications. Loss of 10 lb in a year is not considered severe and would warrant nutrition assessment only if other nutrition risk factors are present. Family complaints should be treated with respect but would warrant nutrition assessment only if the patient’s oral intake is significantly compromised; stressed family members often complain about food because it is unfamiliar and they believe it is the one thing in the hospital that should be familiar.

 

DIF:    Cognitive Level: Applying               REF:   Pages 228-229 | Page 234

TOP:   Nursing Process: Assessment           MSC:  Client Needs: Physiological integrity

 

2. An example of a common cause of iatrogenic malnutrition is

a.	scheduling of frequent daily tests that prevents the patient from eating meals.
b.	food from home brought in by family members and friends of a patient.
c.	small portion sizes of hospital food and absence of snacks.
d.	errors in ordering and delivery of meals for hospitalized patients.

 

 

ANS:  A

A common cause of iatrogenic malnutrition is the scheduling of frequent tests that require patients to fast beforehand, possibly through the next meal time. It is not uncommon for patients to miss breakfast because they need to fast, to miss lunch because they are having a test, and to be too tired to eat very much at dinner. Bringing food from home may help prevent malnutrition. Hospital portion sizes are usually appropriate, and extra food and snacks can be ordered if needed. Errors in ordering and delivering patient meals are rare.

 

DIF:    Cognitive Level: Applying               REF:   Page 228

TOP:   Nursing Process: Assessment           MSC:  Client Needs: Physiological integrity

 

3. If a patient is 6 feet tall and his or her waist measures 42 inches, the patient would be considered to have _____ fat levels consistent with _____ risk for chronic disease.

a.	essential; low
b.	essential; high
c.	abdominal; low
d.	abdominal; high

 

 

ANS:  D

Waist-to-height ratio (WHtR) indicates abdominal fat levels, which can be predictive of risk for diabetes, hypertension, and cardiovascular disease. This patient has a WHtR ratio of 42:72, or 0.58. A WHtR ratio exceeding 0.5 is consistent with high risk for chronic disease.

 

DIF:    Cognitive Level: Applying               REF:   Page 167 | Page 235

TOP:   Nursing Process: Assessment           MSC:  Client Needs: Health promotion and maintenance

 

4. The best way to estimate height for a patient with both legs amputated below the knee is to use

a.	demi-span (distance from the sternal notch to the middle finger).
b.	knee height (with the use of calipers to measure heel-to-thigh distance).
c.	recumbent bed height measured while the patient is lying down.
d.	the patient’s stated pre-amputation height.

 

 

ANS:  A

The most reliable method for a double leg amputee would be to use a formula based on measured demi-span. Knee height and recumbent bed height would not be measurable with lower limbs missing. Stated height is not necessarily accurate.

 

DIF:    Cognitive Level: Applying               REF:   Page 233

TOP:   Nursing Process: Assessment           MSC:  Client Needs: Health promotion and maintenance

 

5. If a male patient weighs 140 pounds when he is admitted to a long-term care facility and weighs 147 pounds 2 months later, his percent weight change during his hospital stay is

a.	3.5%.
b.	5%.
c.	7%.
d.	14%.

 

 

ANS:  B

Percent weight change = [(147 – 140) ÷ 140] ´ 100 = (7 ÷ 140) ´ 100 = 5%.

 

DIF:    Cognitive Level: Applying               REF:   Page 234

TOP:   Nursing Process: Assessment           MSC:  Client Needs: Physiological integrity