Chapter 12: Nutrition for Adults: The Early, Middle, and Later Years Nursing School Test Banks

Chapter 12: Nutrition for Adults: The Early, Middle, and Later Years
Test Bank

MULTIPLE CHOICE

1. John is a 34-year-old who is active in his community coaching football. He was also recently promoted to a director level position at this job. John is in _____ adulthood.
a. young
b. young and middle
c. middle
d. older
ANS: A
Young adulthood is between the ages of 20 and 44 years. Physical maturity and independence are apparent with the ability to form new relationships, adopt new roles, and make many more choices regarding lifestyle.

DIF: Cognitive Level: Application REF: 220 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation, Health Promotion and Maintenance

2. A 42-year-old who makes independent decisions regarding who to marry and what type of family is desired is considered to be making what type of choices?
a. independent
b. dependent
c. wealthy
d. introspective
ANS: A
Young adults between the ages of 20 and 44 years are independent in making choices regarding relationships, careers, jobs, marriage, and family.

DIF: Cognitive Level: Application REF: 220 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation, Health Promotion and Maintenance

3. Making a choice to lose weight and manage ones cholesterol level is most characteristic of which of the following age groups?
a. young adult
b. middle adult
c. school-age child
d. adolescence
ANS: B
Wellness, health promotion, and reduction of disease risks are becoming the focus of health care for the middle adult years.

DIF: Cognitive Level: Application REF: 220
TOP: Nursing Process: Assessment|Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation, Health Promotion and Maintenance

4. Diabetes is an example of a chronic disease most often appearing during
a. childhood.
b. early adulthood.
c. middle adulthood.
d. older adulthood.
ANS: C
Early evidence of chronic disease appears in some middle-aged adults.

DIF: Cognitive Level: Application REF: 220 TOP: Nursing Process: Diagnosis
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

5. Biologic processes associated with aging may cause
a. an increased metabolic rate.
b. increased anxiety.
c. an increased ratio of adipose-to-muscle tissue.
d. increased kidney function.
ANS: C
Physical findings associated with aging include an increased ratio of adipose-to- muscle tissue. As the aging process occurs, skeletal muscle mass is reduced, causing a loss of approximately 40% by age 70 years. Skeletal muscle loss is not mandatory; it can be lessened with exercise.

DIF: Cognitive Level: Application REF: 221 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation, Health Promotion and Maintenance

6. Prescription and over-the-counter drugs can affect nutritional status because they
a. may contain toxins.
b. often result in addiction.
c. usually contain nutrients.
d. may affect appetite or absorption of nutrients.
ANS: D
Medication use can affect overall nutritional status because many drugs affect appetite or the absorption of nutrients.

DIF: Cognitive Level: Application REF: 228-230 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

7. Energy requirements decrease as adults age because
a. older adults have less stress than younger adults.
b. younger adults are still growing; older adults are not.
c. the height of adults decreases with age.
d. the number of functioning body cells decreases with age.
ANS: D
Energy requirements decrease with the aging process because of the decrease in the number of functioning body cells and reduced physical activity.

DIF: Cognitive Level: Knowledge REF: 222 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation, Health Promotion and Maintenance

8. Each decade, basal energy needs decrease
a. 0.5% to 1%.
b. 1% to 2%.
c. 2% to 4%.
d. 5% to 8%.
ANS: B
Basal metabolic rate declines an average of 1% to 2% per decade of life.

DIF: Cognitive Level: Knowledge REF: 222 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation, Health Promotion and Maintenance

9. If an older adult is losing weight, his or her caloric intake is
a. less than energy needs.
b. approximately the same as energy needs.
c. greater than energy needs.
d. poorly distributed throughout the day.
ANS: A
Weight loss is associated with a caloric intake that is less than what is required for energy needs at the time.

DIF: Cognitive Level: Application REF: 226-227
TOP: Nursing Process: Assessment
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

10. A 65-year-old patients ideal body weight is 115 lbs and on the yearly physical for the past 2 years reveals a recorded weight of 121 lbs. The assessment for this patient would be which of the following?
a. slightly underweight
b. close to ideal body weight
c. slightly overweight
d. maintained constant weight
ANS: B
The assessment is close to ideal body weight. Ongoing review of body mass index indicates that weight ranges in the older adult associated with longer life are not necessarily the desirable weights given, but weights 10% to 25% greater. Thus thin older adults, rather than those of moderate weight, have a reduced life expectancy.

DIF: Cognitive Level: Application REF: 226-227
TOP: Nursing Process: Assessment
MSC: NCLEX: Physiological Integrity: Physiological Adaptation, Health Promotion and Maintenance

11. The number of calories per day supplied as carbohydrate for older adults who require 2000 kcal per day would be
a. 450 to 650.
b. 750 to 1250.
c. 900 to 1300.
d. 1100 to 1450.
ANS: C
For the older adult, 45% to 65% of total energy intake should be supplied as carbohydrate, with the majority being mostly complex carbohydrates.
2000 kcal divided by 45% to 65 % = 900 to 1300 calories per day.

DIF: Cognitive Level: Application REF: 222
TOP: Nursing Process: Assessment|Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation, Health Promotion and Maintenance

12. The older adults diet should include adequate carbohydrates to
a. provide a substrate for vitamins and minerals.
b. support normal brain function.
c. provide building material for muscle mass.
d. maintain blood glucose level.
ANS: B
The National Academy of Sciences has determined that an absolute minimum of 130 g/day of carbohydrates is necessary to maintain normal brain function for children and adults.

DIF: Cognitive Level: Knowledge REF: 222
TOP: Nursing Process: Assessment|Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation, Health Promotion and Maintenance

13. It may be advisable for an older adult to take a vitamin or mineral supplement
a. daily.
b. weekly.
c. if he or she has been ill.
d. if he or she is under stress.
ANS: C
Supplements often are recommended for persons in debilitated states or who have malabsorption.

DIF: Cognitive Level: Application REF: 223 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation, Health Promotion and Maintenance

14. Contributing factors for osteoporosis include
a. inadequate calcium and vitamin D intake.
b. increased estrogen after menopause.
c. excess weight.
d. excess iron intake.
ANS: A
Contributing factors for osteoporosis include inadequate intakes of calcium and vitamin D, physical inactivity, smoking and alcohol use, thin build, certain medical conditions and medications.

DIF: Cognitive Level: Knowledge REF: 223 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation, Health Promotion and Maintenance

15. Physiologic problems of older adults include
a. diarrhea.
b. increased salivary secretions.
c. decreased thirst and taste sensations.
d. increased muscle tone.
ANS: C
As a person ages, a decrease in the thirst mechanism occurs that can lead to inadequate fluid intake and resultant dehydration. The older adult also experiences a decrease in taste, smell, and vision, which affects food intake.

DIF: Cognitive Level: Knowledge REF: 222|226
TOP: Nursing Process: Assessment
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

16. An older adult is most likely to have inadequate nutrient intake if he or she lives
a. in a retirement community.
b. with a spouse.
c. alone.
d. with family.
ANS: C
Inadequate nutrient intake is more apparent in elderly people who live alone compared with those who have a companion to eat with and enjoy the food.

DIF: Cognitive Level: Knowledge REF: 224 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation, Health Promotion and Maintenance

17. The Older Americans Act provides home-delivered meals for those who
a. cannot afford food.
b. prefer not to leave home.
c. are ill or disabled.
d. are malnourished.
ANS: C
The Older Americans Act provides services to the elderly that include congregate and home-delivered meals with related education and food-service components.

DIF: Cognitive Level: Application REF: 229-230 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation, Health Promotion and Maintenance

18. The Older Americans Act provides
a. congregate and home-delivered meals.
b. meals served at shelters and community centers.
c. meals served at care facilities and hospices.
d. meals for homeless older adults.
ANS: A
The Older Americans Act provides congregate and home-delivered meals with related nutrition education and food-service components.

DIF: Cognitive Level: Knowledge REF: 229-230 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation, Health Promotion and Maintenance

19. Congregate meals are most often served at a
a. church.
b. senior center.
c. nursing home.
d. hospital.
ANS: B
Congregate meals are served in senior centers and other public or private community facilities.

DIF: Cognitive Level: Knowledge REF: 229 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation, Health Promotion and Maintenance

20. The congregate meal for seniors is
a. breakfast.
b. the noon meal.
c. the evening meal.
d. decided by the center.
ANS: B
Congregate meals provide the noon meal.

DIF: Cognitive Level: Knowledge REF: 229 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation, Health Promotion and Maintenance

21. Factors that commonly contribute to malnutrition in older adults include
a. type 2 diabetes and heart disease.
b. loss of teeth or poorly fitting dentures.
c. a weight 10% above desirable standards.
d. increased energy and nutrient needs.
ANS: B
Many factors contribute to malnutrition in the elderly, including inadequate food and nutrient intake as a result of ill-fitting or loss of dentures.

DIF: Cognitive Level: Knowledge REF: 224|226
TOP: Nursing Process: Assessment|Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

22. The protein needs of an older adult are influenced by the adequacy of _____ intake.
a. fiber
b. caloric
c. vitamin
d. mineral
ANS: B
Adequate calorie intake is essential in the older adult to prevent calories from protein intake being used for energy needs.

DIF: Cognitive Level: Knowledge REF: 222-223
TOP: Nursing Process: Assessment|Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation, Health Promotion and Maintenance

23. Dehydration is more common in older adults than in younger adults because
a. the kidneys excrete too much water.
b. the thirst mechanism diminishes.
c. intracellular versus extracellular water balance is disturbed.
d. more water needs to be ingested to maintain hydration.
ANS: B
As a person ages the thirst mechanism diminishes, which may result in inadequate fluid intake and dehydration.

DIF: Cognitive Level: Comprehension REF: 226 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

24. Factors that influence the nutrition needs of young adults include
a. growth.
b. climate.
c. personality type.
d. physical activity.
ANS: D
The nutrition needs of young adults are influenced by physical activity as well as any other conditions, such as pregnancy.

DIF: Cognitive Level: Knowledge REF: 220-221 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation, Health Promotion and Maintenance

25. Feeding older adults with sensitivity includes
a. giving sufficient time to chew and swallow.
b. serving only pureed foods.
c. avoiding liquids with meals.
d. serving bland foods.
ANS: A
Feeding older adults with sensitivity helps them achieve adequate intake. Giving sufficient time to chew and swallow is important while feeding adults with sensitivity.

DIF: Cognitive Level: Knowledge REF: 226
TOP: Nursing Process: Implementation
MSC: NCLEX: Physiological Integrity: Physiological Adaptation, Health Promotion and Maintenance

26. The Mini Nutritional Assessment (MNA) identifies
a. emotional stability.
b. nutritional risk.
c. vitamin deficiency.
d. social isolation.
ANS: B
The MNA is designed to identify nutritional risk. It is a reliable tool that is sensitive and can detect the risk of malnutrition.

DIF: Cognitive Level: Knowledge REF: 224-226
TOP: Nursing Process: Assessment
MSC: NCLEX: Physiological Integrity: Physiological Adaptation, Health Promotion and Maintenance

27. A major factor in weight control is
a. physical activity.
b. mineral supplementation.
c. steroid use.
d. vitamin supplementation.
ANS: A
Physical activity is a major factor in weight management and it can help prevent debilitating conditions of aging.

DIF: Cognitive Level: Knowledge REF: 226
TOP: Nursing Process: Assessment|Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation, Health Promotion and Maintenance

28. Examples of foods high in nutrients that help prevent osteoporosis are
a. cottage cheese and oranges.
b. yogurt and canned salmon.
c. oatmeal and green leafy vegetables.
d. broccoli and liver.
ANS: B
Foods high in calcium can help prevent osteoporosis. Foods such as yogurt and canned salmon are significant sources of calcium.

DIF: Cognitive Level: Application REF: 223 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation, Health Promotion and Maintenance

29. Older adults need more vitamin D than younger adults because they
a. are less efficient at making their own.
b. are in a state of positive calcium balance.
c. excrete large amounts in their urine.
d. do not eat enough fat to absorb the vitamin efficiently.
ANS: A
As a person ages, the body becomes less efficient in making vitamin D and more may have to be provided in the diet through foods that have been fortified, including milk and milk products, breads, and margarines.

DIF: Cognitive Level: Knowledge REF: 223 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation, Health Promotion and Maintenance

30. For residents in long-term care facilities the type of diet model recommended is
a. most restrictive.
b. least restrictive.
c. no sugar.
d. low protein.
ANS: B
The least restrictive diet model is recommended since it is the most beneficial in the older population and stage of life.

DIF: Cognitive Level: Knowledge REF: 233 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

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