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Terms in this set (2)

1. The nutrient that provides the densest energy source is

a. fat.
b. protein.
c. alcohol.
d. carbohydrate.

ANS: A
Fat provides the densest energy source. Fat provides 9 kcal/g; protein and carbohydrate each provide 4 kcal/g; alcohol provides 7 kcal/g.

DIF: Cognitive Level: Application REF: Pages 83-84
TOP: Nursing Process: Assessment MSC: Client Needs: Physiological integrity

2. Sex hormones, bile, and vitamin D are formed in the body from

a. sterols.
b. triglycerides.
c. phospholipids.
d. chylomicrons.

ANS: A
The body uses sterols to make sex hormones, bile, and vitamin D. Triglycerides are used for energy and stored fat. Phospholipids are important in cell membranes. Chylomicrons are the first lipoproteins formed after absorption of lipids from the blood.

DIF: Cognitive Level: Knowledge REF: Pages 85, 89-90
TOP: Nursing Process: Assessment MSC: Client Needs: Physiological integrity

3. If a patient receiving fat-free parenteral nutrition develops eczema, the patient may have

a. vitamin C deficiency.
b. essential fatty acid deficiency.
c. protein-energy malnutrition.
d. phospholipid and sterol deficiency.

ANS: B
In a patient receiving fat-free parenteral nutrition, eczema may be a sign of essential fatty acid deficiency. Vitamin C deficiency is not affected by fat intake; symptoms include bleeding gums and breakdown of scar tissue. Eczema is not a sign of protein-energy malnutrition. The body makes phospholipids and sterol and so deficiency does not occur.
DIF: Cognitive Level: Application REF: Page 84
TOP: Nursing Process: Diagnosis MSC: Client Needs: Physiological integrity

4. Hydrogenation of vegetable oils _____ their shelf life and makes them _____ harmful to health.

a. decreases; less
b. increases; less
c. decreases; more
d. increases; more

ANS: D
Hydrogenation of vegetable oils increases their shelf life because the double bonds are removed so the fatty acids are less vulnerable to oxidation. It also makes them more harmful to health because it forms trans fatty acids.

DIF: Cognitive Level: Application REF: Pages 86, 91, 94
TOP: Nursing Process: Assessment
MSC: Client Needs: Health promotion and maintenance | Client Needs: Safe and effective care environment

5. A triglyceride is a compound composed of

a. glycerol with two fatty acids attached.
b. glycerol with three amino acids attached.
c. glycerol with three fatty acids attached.
d. organic molecules formed in triangular chains.

ANS: C
Triglycerides are compounds made up of glycerol and three fatty acids. Glycerol plus two fatty acids is a diglyceride. Glycerol does not combine with amino acids. Triglycerides do not form in triangular chains.

DIF: Cognitive Level: Knowledge REF: Page 85
TOP: Nursing Process: Assessment MSC: Client Needs: Physiological integrity

6. A polyunsaturated fatty acid is a fatty acid with _____ bond(s) on the carbon chain.

a. one double
b. no double
c. oxidized
d. two or more double

ANS: D
Polyunsaturated fatty acids have two or more double bonds on the carbon chain. Fatty acids with one double bond on the carbon chain are monounsaturated; those with no double bonds are saturated. Polyunsaturated fatty acids are vulnerable to oxidation, but this is not part of their structure.

DIF: Cognitive Level: Knowledge REF: Pages 86-87
TOP: Nursing Process: Assessment
MSC: Client Needs: Health promotion and maintenance

7. If a client wants to lose 1 lb of body fat each week, they would need to make sure that their daily calorie intake was lower than their daily energy needs by _____ kcals/day.

a. 350
b. 500
c. 900
d. 3500

ANS: B
One pound of body fat contains 3500 kcals. To create a weekly deficit of 3500 kcals, daily energy intake would need to be less than daily energy expenditure by 3500 ÷ 7 = 500 kcals.

DIF: Cognitive Level: Application REF: Page 84
TOP: Nursing Process: Planning
MSC: Client Needs: Physiological integrity | Client Needs: Health promotion and maintenance

8. In their natural form, most oils come from _____ products and most solid fats come from _____ products.

a. natural; processed
b. organic; refined
c. animal; plant
d. plant; animal

ANS: D
In their natural form, most oils come from plant products and most solid fats come from animal products. A few plant fats, such as coconut and palm oil, are naturally solid and a few animal fats, such as fish oil, are naturally liquid. Food processing may make fats more solid (by hydrogenation), but not necessarily. Some natural fats, such as butter and lard, are solid rather than liquid. Organic fats are not necessarily more liquid. Refining refers to processing grains to remove the bran and germ and does not affect the consistency of the oil.

DIF: Cognitive Level: Comprehension REF: Page 91
TOP: Nursing Process: Planning
MSC: Client Needs: Health promotion and maintenance

9. The number of double bonds present in the fatty acid chain determines the

a. number of fatty acids attached to the glycerol molecule.
b. number of glycerol molecules attached to the fatty acid.
c. degree of saturation or unsaturation of a fatty acid.
d. degree of saturation or unsaturation of the glycerol molecule.

ANS: C
The number of double bonds in a fatty acid chain determines the degree of saturation or unsaturation of a fatty acid. The number of fatty acids attached to the glycerol molecule determines whether it is a monoglyceride (one fatty acid), diglyceride (two fatty acids), or triglyceride (three fatty acids). There is never more than one glycerol molecule attached to a fatty acid and glycerol molecules do not vary in their degree of saturation or unsaturation.

DIF: Cognitive Level: Comprehension REF: Pages 86-87
TOP: Nursing Process: Assessment
MSC: Client Needs: Health promotion and maintenance

10. By interfering with blood clotting, omega-3 fatty acids appear to lower the

a. risk of hypertension.
b. risk of heart disease.
c. levels of serum triglyceride.
d. levels of serum cholesterol.

ANS: B
Omega-3 fatty acids help decrease risk of heart disease by preventing formation of clots that may block arteries that are narrowed by atherosclerotic plaques. Omega-3 fatty acids do not decrease blood pressure or serum levels of triglyceride and cholesterol.

DIF: Cognitive Level: Comprehension REF: Page 87
TOP: Nursing Process: Planning
MSC: Client Needs: Health promotion and maintenance | Client Needs: Physiological integrity

11. Overall energy intake can be greatly affected by relatively small changes in intake of

a. protein.
b. carbohydrate.
c. fat.
d. alcohol.

ANS: C
Fat contains more energy per gram than any other nutrient (9 kcal/g versus 4 kcal/g for protein and carbohydrate and 9 kcal/g for alcohol). Therefore, relative small increases or decreases in fat intake can result in significant increases or decreases in energy intake.

DIF: Cognitive Level: Application REF: Pages 83-84
TOP: Nursing Process: Planning
MSC: Client Needs: Health promotion and maintenance | Client Needs: Physiological integrity

12. The number of kcals provided by 23 g of fat is

a. 92.
b. 161.
c. 207.
d. 230.

ANS: C
Fat contains 9 kcal/g. Therefore 23 g fat contain 23 ´ 9 = 207 kcals.

DIF: Cognitive Level: Application REF: Page 84
TOP: Nursing Process: Assessment
MSC: Client Needs: Health promotion and maintenance

13. If dietary analysis shows that fat provides 31% of an individual's energy intake, their fat intake would be considered to be

a. below the recommended range.
b. within the recommended range.
c. above the recommended range.
d. generally recognized as safe.

ANS: B
The Acceptable Macronutrient Distribution Range for fat is 20% to 35% of kcals; therefore 31% is within the recommended range. "Generally recognized as safe" is a term used for food additives.

DIF: Cognitive Level: Application REF: Page 90
TOP: Nursing Process: Assessment
MSC: Client Needs: Health promotion and maintenance

14. Meat, dairy products, and nuts are major sources of _____ in the diet.

a. fat
b. fiber
c. vitamins
d. carbohydrate

ANS: A
Meat, dairy products, and nuts are major sources of dietary fat (even though some meats and dairy products can be very low in fat; overall these food groups contribute significant dietary fat). Nuts provide dietary fiber, but meat and dairy products do not. These foods contain some vitamins but are not considered major sources. Dairy products and nuts contain a little carbohydrate but meat is almost carbohydrate free.

DIF: Cognitive Level: Application REF: Pages 90-92
TOP: Nursing Process: Implementation
MSC: Client Needs: Health promotion and maintenance

15. Hydrogenation is the process by which a liquid oil is made _____ solid and _____ stable.

a. less; more
b. more; more
c. less; less
d. more; less

ANS: B
Hydrogenation makes a liquid oil more solid and more stable by saturating the unsaturated fatty acids, making it more saturated.

DIF: Cognitive Level: Comprehension REF: Page 94
TOP: Nursing Process: Assessment
MSC: Client Needs: Health promotion and maintenance
16. A client with coronary artery disease tells you that they always look for foods that are labeled "cholesterol free." Foods with this label may still promote heart disease if they are high in

a. monounsaturated fat and cis fat.
b. polyunsaturated fat and trans fat.
c. saturated fat and trans fat.
d. medium chain triglycerides and cis fat.

ANS: C
High intakes of saturated fat and trans fat increase blood cholesterol levels and contribute to coronary heart disease. Monounsaturated fat and polyunsaturated fat may slightly decrease serum cholesterol levels if eaten in moderation and so do hot promote heart disease. Intakes of medium chain triglycerides and cis fat are not directly related to heart disease.

DIF: Cognitive Level: Application REF: Page 96
TOP: Nursing Process: Planning
MSC: Client Needs: Health promotion and maintenance

17. If a salad dressing is made with olive oil it would contain mostly _____ fatty acids.

a. trans
b. saturated
c. polyunsaturated
d. monounsaturated

ANS: D
Olive oil is rich in monounsaturated fatty acids. Trans fatty acids are found in hydrogenated fats. Polyunsaturated fatty acids are found mostly in other liquid vegetable oils. Saturated fatty acids are found in dairy, meat fats, and coconut and palm oil.

DIF: Cognitive Level: Application REF: Page 86
TOP: Nursing Process: Planning
MSC: Client Needs: Health promotion and maintenance

18. High levels of trans fatty acids are found in

a. vegetable oils.
b. coconut and palm oil.
c. meats and dairy foods.
d. vegetable oil shortening.

ANS: D
Trans fatty acids are found in vegetable oil shortening; they are formed when the liquid oil is hydrogenated to form a hard, stable fat. Vegetable oils, coconut and palm oil, and meats and dairy foods contain fat in the natural cis form.

DIF: Cognitive Level: Application REF: Page 94
TOP: Nursing Process: Assessment
MSC: Client Needs: Health promotion and maintenance

19. Antioxidants can be used to preserve fats without the addition of

a. hydrogen.
b. hydrogen and carbon.
c. hydrogen and oxygen.
d. hydrogen, water, and carbon.

ANS: A
Antioxidants provide a way to preserve unsaturated fats without addition of hydrogen. Hydrogenation is used to stabilize and unsaturated fats. This process only adds hydrogen, not carbon, oxygen, or water.

DIF: Cognitive Level: Application REF: Page 94
TOP: Nursing Process: Assessment
MSC: Client Needs: Health promotion and maintenance

20. A special property of phospholipids that makes them valuable in foods and in the body is that they

a. carry fat-soluble vitamins.
b. are useful as low-energy fat substitutes.
c. are soluble in water and fat at the same time.
d. function as natural antioxidants.

ANS: C
Phospholipids are valuable in foods and in the body because they are soluble in water and fat at the same time. This makes them useful emulsifiers and important components of cell membranes. Phospholipids have no particular role in carrying fat-soluble vitamins. They are not used as fat substitutes. They do not function as antioxidants.

DIF: Cognitive Level: Comprehension REF: Page 88
TOP: Nursing Process: Assessment MSC: Client Needs: Physiological integrity

21. Most fat enters the lymphatic system after

a. absorption.
b. circulation.
c. metabolism.
d. hydrogenation.

ANS: A
Most fat is absorbed into the lymphatic system from the small intestine. It then passes into the circulation. Therefore, circulation and metabolism occur after, not before, fat enters the lymphatic system. Hydrogenation occurs during food production and is not connected to processing of fat in the body.

DIF: Cognitive Level: Application REF: Page 90
TOP: Nursing Process: Assessment MSC: Client Needs: Physiological integrity

22. If a client has a total blood cholesterol of 246 mg/dL and a low-density lipoprotein cholesterol level of 172 mg/dL, their blood cholesterol level would be considered to be

a. low.
b. desirable.
c. borderline high.
d. high.

ANS: D
Total and LDL-cholesterol levels 240 and 150 mg/dL are considered high. Desirable total and LDL-cholesterol levels are 200 and 130 mg/dL, respectively; borderline high levels are 200-239 and 130-159 mg/dL, respectively.

DIF: Cognitive Level: Application REF: Page 95
TOP: Nursing Process: Assessment
MSC: Client Needs: Health promotion and maintenance | Client Needs: Physiological integrity

23. High levels of low-density lipoproteins are associated with an increased risk of

a. diabetes mellitus.
b. high levels of HDL.
c. coronary artery disease.
d. high blood pressure and stroke.

ANS: C
High levels of low-density lipoproteins are associated with increased risk of coronary artery disease. They do not have a direct effect on risk of diabetes mellitus or high blood pressure and stroke. LDL and HDL levels are not necessarily related.

DIF: Cognitive Level: Knowledge REF: Page 95
TOP: Nursing Process: Assessment
MSC: Client Needs: Health promotion and maintenance
24. The best way to decrease blood cholesterol level is to decrease dietary intake of

a. cholesterol.
b. saturated fat.
c. monounsaturated fat.
d. polyunsaturated fat.

ANS: B
The dietary factor that has the greatest impact on blood cholesterol levels is saturated fat intake because it causes the body to make more cholesterol. Cholesterol intake has less impact because most cholesterol is manufactured by the body. Blood cholesterol levels may be slightly inversely related to intake of monounsaturated and polyunsaturated fat.

DIF: Cognitive Level: Comprehension REF: Pages 95-96
TOP: Nursing Process: Planning
MSC: Client Needs: Health promotion and maintenance

25. The client most likely to benefit from use of medium chain triglycerides is one who

a. has essential fatty acid deficiency.
b. has malabsorption because of removal of part of their small intestine.
c. needs to gain weight after surgery and chemotherapy to treat bowel cancer.
d. has high serum total cholesterol and low-density lipoprotein cholesterol levels.

ANS: B
Medium chain triglycerides are beneficial for patients with malabsorption because they are relatively easily absorbed. They do not contain essential fatty acids. They contain the same amount of energy as other fatty acids and so would not be especially beneficial for a client who needs to gain weight. They do not influence serum cholesterol levels.

DIF: Cognitive Level: Application REF: Pages 84, 89
TOP: Nursing Process: Planning
MSC: Client Needs: Health promotion and maintenance

26. A good lunch choice for someone who wants to increase their intake of omega-3 fatty acids would be

a. peanut butter and jelly sandwich.
b. lentil soup.
c. salad with olive oil dressing.
d. tuna salad sandwich.

ANS: D
Fatty fish, such as tuna, are an excellent source of omega-3 fatty acids, so the tuna salad sandwich would be the best choice. Peanut butter and olive oil are high in monounsaturated fatty acids. Lentil soup is likely to be low in fat.

DIF: Cognitive Level: Application REF: Pages 87-88
TOP: Nursing Process: Planning
MSC: Client Needs: Health promotion and maintenance

27. Emulsification occurs so that dietary fat can be _____ by enzymes in the digestive tract.

a. dissolved
b. oxidized
c. broken down
d. hydrogenated

ANS: C
Emulsification increases the surface area of fat droplets in the digestive tract so that they are more accessible to be broken down by enzymes.

DIF: Cognitive Level: Comprehension REF: Page 89
TOP: Nursing Process: Assessment MSC: Client Needs: Physiological integrity

28. A substance that increases the solubility of fats to facilitate their digestion and absorption is

a. bile.
b. stomach acid.
c. salivary lipase.
d. glycerol.

ANS: A
Bile increases the solubility of fats to facilitate their digestion and absorption. Stomach acid does not affect solubility of fats. Salivary lipase begins fat digestion but does not affect solubility. Glycerol is part of the structure of triglycerides, but does not increase their solubility.

DIF: Cognitive Level: Comprehension REF: Page 89
TOP: Nursing Process: Assessment MSC: Client Needs: Physiological integrity

29. Overly restricting the fat intake of infants may lead to failure to thrive. Infants depend on dietary fat and cholesterol for formation of

a. energy stores and bones.
b. brain and bones.
c. brain and nerve tissue.
d. energy stores and nerve tissue.

ANS: C
Infants need dietary fat and cholesterol for formation of brain and nerve tissue. Fat makes an important contribution to energy stores, but energy can be obtained from carbohydrate and protein. Bone formation is not dependent on dietary intake of fat and cholesterol.

DIF: Cognitive Level: Knowledge REF: Page 98
TOP: Nursing Process: Assessment
MSC: Client Needs: Health promotion and maintenance | Client Needs: Physiological integrity
30. A client grew up on a farm and learned to prepare foods using butter and lard produced by the farm animals. She is now in her 60s and has just learned that she has coronary artery disease. To best meet her physical as well as psychologic needs, the health practitioner should

a. suggest that she adopt a low-fat vegetarian dietary pattern.
b. ask how she usually prepares foods and suggest ways to reduce the use of animal fat.
c. advise her to eat more fruits and vegetables and to replace some of the animal fat with palm and coconut oil.
d. advise her to avoid adding fat to foods and eat only very lean poultry and fish.

ANS: B
The health practitioner should start with the ways she usually prepares food and suggest ways she can use less animal fat and more heart-healthy unsaturated fats without making dramatic or arbitrary changes. A low-fat vegetarian dietary pattern is not necessary and is unlikely to be acceptable to the client. Eating more fruits and vegetables may be beneficial, but palm and coconut oil are high in saturated fat, which would not be helpful. It is probably not necessary for her to avoid adding any fat to foods and to eat only very lean poultry and fish; such drastic changes are unlikely to be maintained by the client.

DIF: Cognitive Level: Analysis REF: Pages 105-106
TOP: Nursing Process: Implementation
MSC: Client Needs: Health promotion and maintenance