Test Bank For Krause’s Food & the Nutrition Care Process,13th Edition by L. Kathleen Mahan , Janice L Raymond, Sylvia Escott-Stump

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Krause’s Food & the Nutrition Care Process,13th Edition by L. Kathleen Mahan ,
Janice L Raymond, Sylvia Escott-Stump TEST BANK
Mahan: Krause’s Food and the Nutrition Care Process, 13th EditionMahan: Krause’s
Food and the Nutrition Care Process, 13th Edition
Test Bank
Chapter 6: Clinical: Inflammation, Physical and Functional Assessment
MULTIPLE CHOICE
1. Height assessment on children younger than 2 to 3 years of age should be
performeda. with the child recumbent.b. using the arm span.c. using a stationary
meter.d. using the sitting height.
ANS: AFor infants and children under 3 years of age, recumbent length should be
determined by using a length board to measure the child from the crown of the head to
the heels of the feet. Arm span is an indirect measure of height that may be used in
adults who cannot stand or lie flat. For older children and adults capable of standing, a
stationary meter or statiometer should be used. Sitting height may be used for children
who are not capable of standing.
REF: p. 165
2. Mid-upper arm circumference (MAC) combined with triceps skinfold thickness (TSF)
measurements provide information abouta. risk of obesity-related diseases.b. measure
of adiposity.c. BMI.d. arm muscle and arm fat area.
ANS: DAlthough not commonly used in the acute care setting, measures of the MAC
and TSF in long-term care can provide information about a person’s arm muscle area
and arm fat area. These can be compared with percentile charts to determine the
person’s relative risk for undernutrition or can be tracked over time for changes in the
person’s nutritional status. One-time measures of these are not appropriate for
identifying body composition related to overall adiposity. Body mass index by itself
identifies the relative risk of obesity-related diseases.
REF: p. 167
3. During the assessment of nutritional status, which of the following is the most
objective measure?a. Obtaining a dietary historyb. Evaluating biochemical testsc.
Observing meal consumptiond. Evaluating height and weight based on reference
standards
ANS: BBiochemical tests are considered to be the most objective and sensitive
measures of nutritional status. Subjective information is based on an individual’s
responses, observations, or interpretations. An iron deficiency may be suspected by
reviewing a patient’s diet history that seems to show little intake of iron-rich foods or
observing the eating of a foods that do not contain iron, but measurement of iron-related
blood parameters provides clear evidence that is not subject to debate. Reference
standards for height and weight are established based on cultural interpretations of
what levels are appropriate.
REF: p. 172
4. The skinfold sites most useful for measurement of body fat area. at the biceps and
triceps.b. below the scapula and above the biceps.c. at the triceps and below the
scapula.d. at the iliac crest and the upper thigh.
ANS: CMeasurements of the triceps and subscapular skinfolds are the most useful for
evaluating body fatness because the most complete standards and methods of
evaluation are available for these two sites. Skinfolds at the biceps, iliac crest, and
upper thigh have also been used but have not been as thoroughly investigated as the
triceps and scapula.
REF: p. 168
5. Arm muscle area is determined by usinga. weight and height measurements.b.
triceps skinfold and weight measurements.c. triceps skinfold and mid-upper arm
circumference measurements.d. mid-upper arm circumference and weight
measurements.
ANS: CArm muscle area is determined based on the assumption that a cross-section of
the upper arm reflects two circles with the same center point, one within the other. The
outer circle is considered to be a layer of subcutaneous fat, and the inner circle is
considered to be the muscle. With knowledge of the overall MAC, the inner circle, the
AMA, can be estimated by subtracting the area between the two circles. This area is
related to the triceps skinfold.
REF: pp. 168, 169
6. Measurement of head circumference is useful as an indicator ofa. malnutrition in
children younger than 3 years of age.b. non-nutritional abnormalities in children younger
than 3 years of age.c. nutritional deficiencies in children older than 3 years of age.d.
non-nutritional abnormalities in adults.
ANS: BUp to the age of 3 years, head circumference is a measure of child growth and
brain growth. Any abnormalities or changes in the growth of head circumference can be
monitored. However, these abnormalities are not necessarily specific to nutritional
status. Undernutrition must be very severe to affect this growth.
REF: p. 169
7. ________ reorient(s) hepatic synthesis of plasma proteins and increase the
breakdown of musclea. Hormonesb. Prealbuminc. Cytokinesd. Oxidants
ANS: CCytokines (interleukin-1, interleukin-6, tumor necrosis factor, and eicosanoids)
influence whole-body metabolism, body composition, and nutritional status. Cytokines
reorient hepatic synthesis of plasma proteins and increase the breakdown of muscle
protein to meet the demand for protein and energy during the inflammatory response.
REF: p. 164
8. The Functional Nutritional Assessment includes assessment of tissue reserves of key
nutrients.a. Trueb. False
ANS: AThe functional nutritional assessment focuses on early diagnosis and treatment
of nutritional problems associated with chronic disease including long-latency nutritional
insufficiencies. Assessment of nutrient tissue reserves is advocated with this approach.
REF: p. 172
9. Which of the following can be used for assessing bone mineral density as well as
measuring fat and boneless lean tissue?a. Bioelectrical impedance analysisb. Magnetic
resonance imagingc. Computed tomographyd. Dual-energy x-ray absorptiometry
ANS: DDual-energy x-ray absorptiometry relies on passing an energy beam through
various tissue types, and based on the amount of energy lost, the amount or density of
the tissue can be measured. Bioelectrical impedance analysis conducts an electrical
charge through the body to measure the water content and thus lean tissue of the body.
Magnetic resonance imaging can be used to image the size of body organs, the
skeleton, and the amount and distribution of body fat. Computed tomography images
cross sections of the body, and from these, subcutaneous and intraabdominal fat can
be identified.
REF: pp. 170–171
10. What physical examination technique is being used when a doctor listens for bowel
sounds?a. Auscultationb. Inspectionc. Palpationd. Percussion
ANS: AAuscultation involves the listening for various body sounds. Inspection refers to
an observation of a patient by using vision, smell, and hearing. Palpation involves
feeling the patient, such as when a pulse is determined. Percussion is the use of sound
to determine body organ borders, shape, or position. For example, to determine the size
of the liver, the physician will palpate around the right abdomen to estimate the borders.
REF: p. 172
11. A patient who currently weighs 145 pounds weighed 180 pounds 3 months ago.
How would his current weight be assessed?a. The patient is underweight.b. The patient
has significant weight loss.c. The patient has severe malnutrition.d. The patient has
severe weight loss.
ANS: DThis patient has lost 35 pounds (180 – 145), which is about 19% of his original
weight in 3 months. Because this is greater than 7.5% weight loss, this is interpreted as
severe weight loss. Significant weight loss would be reflected by losing exactly 7.5% of
body weight in this same period of time. No information is given in regard to the
patient’s height or whether 180 pounds is his usual weight. Therefore, determination of
underweight cannot be made. If 180 pounds had been his usual weight, 145/180 
100% = 80% of UBW, which would be assessed as moderate malnutrition.
REF: p. 166
12. An adult weighs 90 kg and is 1.83 m tall. This person’s BMI would be classified asa.
underweight.b. healthy weight.c. overweight.d. obese.
ANS: CThis person’s BMI would be calculated as 90/1.832 = 26.9 kg/m2. This value
falls into the overweight category, 25 to 29.9.
REF: p. 166
13. _______ is used to assess body composition using by measuring body density.a.
Total body potassium measurementb. Air displacement plethysmogramc. Bioelectrical
impedance analysisd. Neutron activation analysis
ANS: BAir displacement plethysmography relies on measurement of body density to
estimate body fat and fat-free mass. A “bod-pod” is a piece of equipment used for this
measurement.
REF: p. 169–170
14. In patients with fluid retention, what happens to biochemical indicators of nutritional
status, such as serum proteins and electrolytes?a. They are increased because of
increased urinary output.b. They are decreased because of poor nutritional status.c.
They are increased because of hemoconcentration.d. They are decreased because of
hemodilution.
ANS: DWhen a patient experiences fluid excess, such as may be associated with renal
failure or congestive heart failure, the excess fluid in the body will affect blood measures
by causing them to be lower. This is simply a reflection of the concentration of the
specific blood parameters in relation to the increased water in the body. If a patient were
dehydrated, the effect would be the reverse—the blood values would increase because
of relative concentration in less water in the body.
REF: p. 174
15. Which of the following is NOT a physical sign of overhydration?a. Weight gain over
2 to 3 daysb. Peripheral edemac. Decreased skin turgord. Ascites
ANS: CShort-term weight gain, peripheral edema, and ascites are all signs of
overhydration. Decreased skin turgor is associated with dehydration.
REF: p. 174
16. It can be argued that a functional nutrition assessment will better identify why a
patient is losing weight because:a. it uses more advanced body composition
techniques.b. it includes assessment of gastrointestinal function.c. tumor necrosis factor
is used as a marker of weight loss.d. it uses prealbumin rather than albumin for
analysis.
ANS: BAssessment of the capacity for digestion, absorption, and transport as well as
hormonal status provides critical background information as to why a patient may be
malnourished. Malabsorption syndrome, in which several nutrients are abnormally
absorbed, is the most dramatic. Constipation, diarrhea, excessive vomiting, and
flatulence also warrant further analysis. Mucosal changes in the gastrointestinal (GI)
tract are indicated by problems such as diarrhea and anorexia. Tests may be done on a
stool sample and can reveal excessive amounts of fat, an indication of malabsorption,
the status of the GI flora, and the amounts and types of bacteria present in the gut.
REF: p. 173
17. A general estimate of desirable body weight for a woman who is 5’5” tall is.a. 140
poundsb. 125 poundsc. 110 poundsd. 115 pounds
ANS: BDesirable body weight can be calculated using the Hamwi method of 100
pounds for the first 5 feet of height and 5 pounds for each inch above 5 feet for women.
For men the calculation is 106 pounds for the first 5 feet of height and 6 pounds for
every inch above 5 feet.
REF: p. 166
18. A 19-year-old man weighs 75 kg and is 1.78 m tall. His BMI would be interpreted
asa. underweight.b. normal, healthy weight.c. overweight.d. one that needs to be plotted
on a growth chart for interpretation.
ANS: DThe BMI calculation would be 75/1.782 = 23.7 kg/m2. However, because the
man is 19 years old, this BMI should be plotted on the growth chart comparing BMI with
age for males, 2 to 20 years of age. After being plotted, this man’s BMI would be
evaluated as being between the 50th and 75th percentiles of BMI for age.
REF: p. 166
19. Measurement of waist:hip ratioa. has been implicated in the risk of developing
cardiovascular disease.b. is particularly useful in a hospital setting.c. can be directly
correlated with serum albumin.d. has been implicated in the risk of developing Crohn’s
disease.
ANS: ABecause fat distribution is an indicator of risk, circumferential or girth
measurements may be used. The presence of excess body fat around the abdomen out
of proportion to total body fat is a risk factor for ailments associated with obesity and the
metabolic syndrome.
REF: p. 169
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