Nutritional Concepts

Every question here, with the answer

1. A nurse is reviewing a patient’s BMI and notes that the value falls in the obese category. The patient is very physically active and has a body type in which fat distribution may differ from generalized standards. What is the best nursing action?

   1. Ignore the BMI result because exercise makes BMI invalid.
   2. Use BMI as one tool and assess additional factors before drawing conclusions about nutritional and related health.
   3. Use the BMI result as the only basis for determining the patient’s nutritional health.
   4. Classify the patient’s caloric intake as excessive based only on BMI.

   Answer: Use BMI as one tool and assess additional factors before drawing conclusions about nutritional and related health.

   BMI is a commonly used tool, but the section cautions that ethnicity, exercise, and other factors can affect interpretation. The nurse should use BMI as part of a broader assessment rather than as the sole determinant.

2. An older adult reports eating less, feeling lonely, and drinking little fluid because of concern about bladder problems. Which nursing considerations are supported by the section? Select all that apply.

   1. Plan nutrient-dense foods because caloric needs may be lower while nutrient needs increase.
   2. Assess hydration and discuss that decreased thirst can contribute to poor fluid intake.
   3. Teach that thirst increases with age and is a reliable guide for fluid intake.
   4. Consider community programs that provide socialization and well-balanced meals.
   5. Assess protein and vitamin B12 intake because they are commonly underconsumed in older adults.

   Answer: Plan nutrient-dense foods because caloric needs may be lower while nutrient needs increase., Assess hydration and discuss that decreased thirst can contribute to poor fluid intake., Consider community programs that provide socialization and well-balanced meals., Assess protein and vitamin B12 intake because they are commonly underconsumed in older adults.

   Older adults may need fewer calories but still require nutrient-dense foods, and protein, vitamin B12, and hydration are specific concerns. Loneliness and poverty can reduce intake, so community meal programs may help; thirst does not increase with age.

3. A patient has had a prolonged period of inadequate caloric intake. The nurse explains how the body meets energy needs during a caloric deficit. Which statement is most accurate?

   1. The body metabolizes glycogen stored in the liver first, then fat cells; with prolonged starvation, proteins may be metabolized.
   2. The body stores excess energy as glycogen before using any stored fuel.
   3. The body metabolizes proteins first, then glycogen, then fat cells.
   4. The body uses cholesterol first because it provides the quickest energy release.

   Answer: The body metabolizes glycogen stored in the liver first, then fat cells; with prolonged starvation, proteins may be metabolized.

   During a caloric deficit, the body first uses carbohydrates stored as glycogen in the liver, then fat stores. If starvation is prolonged, protein metabolism can occur and may lead to life-threatening conditions.

4. A nurse is teaching a patient how to choose carbohydrates to support steadier energy and bowel function. Which statements should the nurse include? Select all that apply.

   1. Insoluble fiber, such as cellulose, acts as a bulking agent for stool.
   2. Complex carbohydrates release energy more slowly than simple sugars.
   3. Honey is preferred when the goal is slower energy release than complex carbohydrates.
   4. Dietary fiber is metabolized by enzymes in the same way as starches.
   5. Fruits, vegetables, whole grains, and legumes provide soluble fiber that can help control blood sugar after meals.

   Answer: Insoluble fiber, such as cellulose, acts as a bulking agent for stool., Complex carbohydrates release energy more slowly than simple sugars., Fruits, vegetables, whole grains, and legumes provide soluble fiber that can help control blood sugar after meals.

   Soluble fiber helps reduce postprandial blood sugar absorption, and insoluble fiber adds stool bulk. Complex carbohydrates release energy more slowly than simple sugars; fiber is broken down by bacteria in the large intestine rather than metabolized by enzymes like starches.

5. A patient with underlying kidney impairment asks whether a very high-protein diet would be a healthy way to improve nutrition. What is the nurse’s best response?

   1. “A very high-protein diet is safest because protein is always the body’s primary energy source.”
   2. “Only animal protein should be used because plant protein cannot supply adequate protein.”
   3. “Excessive protein intake can be harmful with kidney impairment, so protein intake should be balanced for individual needs.”
   4. “Protein should be avoided completely because it is not essential to human life.”

   Answer: “Excessive protein intake can be harmful with kidney impairment, so protein intake should be balanced for individual needs.”

   The section states that excessive dietary protein may be harmful in people with underlying kidney impairment. Protein is essential, but intake should be healthy and balanced for the individual rather than excessive or absent.

6. A patient wants to reduce cardiovascular risk through dietary fat choices. Which teaching points are consistent with the section? Select all that apply.

   1. Choose partially hydrogenated oils because they are a healthier human-made fat.
   2. Eliminate trans fats because they are associated with atherosclerosis and adversely affect cholesterol levels.
   3. Favor fats derived from plants, which typically contain unsaturated fat, over animal fats that contain saturated fat.
   4. Limit saturated fats because they are associated with increased cardiovascular risk.
   5. Increase fried foods, red meat, high-fat dairy products, and processed baked goods.

   Answer: Eliminate trans fats because they are associated with atherosclerosis and adversely affect cholesterol levels., Favor fats derived from plants, which typically contain unsaturated fat, over animal fats that contain saturated fat., Limit saturated fats because they are associated with increased cardiovascular risk.

   The section says saturated fats raise cardiovascular risk and should be limited, and that eliminating trans fats is recommended because they are linked to atherosclerosis and harm cholesterol levels. Animal products contain saturated fat, while plant-derived fat is typically unsaturated. Partially hydrogenated oil is the source of trans fats, and fried foods, red meat, high-fat dairy, and processed baked goods are sources of LDL (“bad cholesterol”).