Chapter 36, Nutrition
A dietitian is providing an in-service for the nurses on a medical-surgical unit. During the in-
service, she informs the group that there are six classes of nutrients, and three supply the body
with energy. What are the three sources of energy?
A) Carbohydrates, protein, and lipids
B) Vitamins, minerals, and water
C) Carbohydrates, protein, and water
D) Lipids, vitamins, and minerals
Ans: A
Feedback:
Of the six classes of nutrients, three supply energy (carbohydrates, protein, and lipids), and
three are needed to regulate body processes (vitamins, minerals, and water).
In planning to meet the nutritional needs of a critically ill client in the intensive care unit, which
factor will increase the client’s basal metabolic rate?
A) Infection
B) Advanced age
C) Prolonged fasting
D) Long periods of sleep
Ans: A
Feedback:
Factors that increase a person’s basal metabolic rate (BMR) include growth, infections, fever,
emotional tension, extreme environmental temperatures, and elevated levels of certain
hormones (epinephrine and thyroid hormones). Aging, prolonged fasting, and sleep all decrease
BMR.
A client is interested in losing 15 pounds, and she informs the nurse she is counting her calorie
intake each day. The client has a goal of losing one pound a week until she reaches her goal. The
client asks the nurse how many calories she 3. should decrease daily to lose a pound a week.
What is the nurse’s best response?
A) 500 calories/day
B) 200 calories/day
C) 300 calories/day
D) 400 calories/day
Ans: A
Feedback:
To lose 1 pound (0.45 kg) in a week, daily calorie intake should be decreased by 500 calories a
day. One pound of body fat equals about 3,500 calories; 3,500 calories divided by 7 days = 500
calories/day.
The nurse caring for a client for several days has assessed that he has been eating poorly during
his hospitalization. Which nursing measure should the nurse implement to assist the client in
improving his nutritional intake?
A) Encourage his daughter to prepare food at home and bring it to the client.
, B) Serve large meals and encourage the client to eat as much as possible.
C) Provide distractions while the client is fed so that he will eat more.
D) Provide bland meals.
Ans: A
Feedback:
The nurse should solicit food preferences and encourage favorite foods from home, when
possible. Be sure the foods look attractive and the eating area is free of odors, clutter, and
distractions during mealtime. Provide small, frequent meals to avoid overwhelming the client
with large amounts of food.
Which of the following nutritional guidelines should a nurse provide to a client who is entering
the second trimester of 5. her pregnancy?
A) “You’ll need to eat more calories and to make sure you eat a balanced diet high in nutrients.”
B) “Try to eat your normal number of calories, but aim to eat a diet that’s higher in fruits and
vegetables.”
C) “The more food energy you consume, the greater the chances that you will have a healthy
pregnancy.”
D) “Maintain your regular calorie intake, but take some supplements and emphasize organic
foods.”
Ans: A
Feedback:
Nutrient needs during pregnancy increase to support growth and maintain maternal
homeostasis, particularly during the second and third trimesters. During the last two trimesters,
women of normal weight need approximately 300 extra calories per day. Key nutrient needs
include protein, calories, iron, folic acid, calcium, and iodine. It would be inaccurate to encourage
the client to maximize calorie intake.
The nurse is testing the blood glucose levels of a client with a history of diabetes. The nurse has
performed hand hygiene, checked the order, informed the client and turned on the monitor. After
removing a test strip from the vial, the
nurse should do which of the following?
A) Confirm that the strip and the meter share the same code.
B) Massage the client’s finger toward the selected puncture site.
C) Cleanse the client’s finger with alcohol.
D) Pierce the client’s skin with the lancet.
Ans: A
Feedback:
It is important to confirm that the code on the strip and the meter match. This should precede
massaging and cleansing the client’s finger or piercing his/her skin.
A client is discussing weight loss with a nurse. The patient says, “I will not eat for two weeks, then
I will lose at least 10 pounds.” What should the nurse tell the client?