Roth 10e NCLEX Chapter 14

MULTIPLE CHOICE 1. During the initial assessment, a 42 year old client indicates that weight gain is a problem despite the clients diet not having changed since the client was 25. What reason would it be appropriate for the nurse to give this client? a. Actual caloric intake must be higher than c. Calorie requirements start to diminish the client estimates it is. after the age of 40, so fewer calories are now needed to meet the bodys needs. b. After age 25 calorie needs begin to d. The client is probably not including diminish, so fewer calories are now calories from alcoholic beverage intake in needed to meet the bodys needs. the estimate of calories consumed. ANS: B Calorie requirements begin to diminish after the age of 25, as basal metabolism rates decrease. After 25 years, a person will gain weight if the total calories are not reduced according to actual need, which will be determined by activity, REE, and amount of lean muscle mass. PTS: 1 REF: Calorie Requirements

2. A client tells the nurse when discharged from the hospital that the client is going to do whatever is necessary to lose some weight. What is the most appropriate response for the nurse to make? a. Be sure to contact your physician before c. Ill have the registered dietitian put embarking on a weight reduction plan. together a meal plan for you. b. Good luck with your effort. d. Just follow a MyPyramid plan for 1,000 calories less a day than you think you need. ANS: A When weight reduction is to be undertaken, the client should confirm with a physician that the client is in good enough health to embark on a weight reduction plan. After consulting the physician, a registered dietitian can help the client develop a healthy eating plan. PTS: 1 REF: Weight Control

3. The nurse is caring for an otherwise healthy patient who has been diagnosed with rheumatoid arthritis (RA). What dietary factors will the nurse say have an effect on RA? a. Diet changes have no affect on RA. c. Taking 500 mg of vitamin C will help reduce the joint inflammation. b. Getting vitamin D through sunlight rather d. Taking 2000 mg of calcium a day will than supplements will help reduce the help protect the joints from further symptoms of RA. damage. ANS: A Researchers have determined that dietary changes have no effect on RA. PTS: 1 REF: Introduction

4. A 40 year old client asks the nurse how much more dietary protein is needed in the diet now that the client is entering middle adulthood. a. At age 40 the need for protein actually c. Dont worry about a specific number, just

diminishes to 0.7 grams per kilogram of be sure to have a big steak every week. body weight. b. At age 40 the need for protein increases to d. No additional protein is needed after age 1.0 grams per kilogram of body weight. 40. ANS: D The estimated protein requirement for all healthy adults is 0.8 grams per kilogram of body weight. PTS: 1 MULTIPLE RESPONSE 1. During the initial assessment of a 39 year old premenopausal women, the client proudly states that she eats very little to maintain herself at a small clothing size. This woman does not take any vitamin and mineral supplements. The nurse should discuss what nutrients that may be of concern for this client? Select all that apply. a. calcium d. vitamin B12 b. iron e. vitamin D c. magnesium f. vitamin E ANS: A, B, E It is especially important of maintain good eating habits during young and middle adulthood. Women, who may be concerned about weight, can easily develop nutritional deficiencies. During young to middle adulthood, the beginnings of osteoporosis may be evident. A diet rich in calcium and vitamin D is thought to help prevent osteoporosis. The iron throughout the childbearing years remains higher than that for men. PTS: 1 NUMERIC RESPONSE 1. The nurse is assessing a client who is overweight and whose weight has been steadily increasing over the last year. The nurse estimates this clients total energy needs to be 1800 calories a day. What energy deficit will the nurse say the client must achieve each day to lose 1 pound a week? ANS: 500 calories Rationale: The client must have a weekly energy deficit of 3500 calories to lose 1 pound a week. 3500 calories divided by 7 days is 500 calories per day. PTS: 1 REF: Weight Control REF: Nutritional Requirements REF: Nutritional Requirements