Chapter 6: Energy Balance Nursing School Test Banks

Chapter 6: Energy Balance
Test Bank

MULTIPLE CHOICE

1. A nutrient that does not provide energy for the body is
a. carbohydrate.
b. protein.
c. vitamin.
d. fat.
ANS: C
The energy nutrients are carbohydrate, fat, and protein.

DIF: Cognitive Level: Knowledge REF: 81 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

2. Energy is lost from the body as
a. heat.
b. urine.
c. sweat.
d. fat.
ANS: A
Energy is lost from the body as heat when the internal energy cycle changes stored energy into body fuels, which the body uses for various functions. As the cycle continues water is excreted, carbon dioxide is exhaled, and heat is radiated, returning the end products to the external environment.

DIF: Cognitive Level: Knowledge REF: 82 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

3. The unit of measurement used to refer to the amount of energy in food is the
a. watt.
b. kilogram.
c. milligram.
d. kilocalorie.
ANS: D
The kilocalorie is the unit of measure used to measure the amount of energy in food and is the amount of heat necessary to raise 1 kg of water 1 C.

DIF: Cognitive Level: Knowledge REF: 81-82 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

4. The total number of kilocalories in a snack that contains 10 g carbohydrate, 2 g protein, and 5 g fat is _____ kcal.
a. 17
b. 68
c. 93
d. 153
ANS: C
10 g carbohydrate 4 kcal/g = 40 kcal.
2 g protein 4 kcal/g = 8 kcal.
5 g fat 9 kcal/g = 45 kcal.
Total calories = 40 kcal + 8 kcal + 45 kcal = 93 kcal.

DIF: Cognitive Level: Application REF: 82 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

5. Which of the following represents an external energy cycle?
a. the moon
b. growing plants
c. crystals
d. metabolism
ANS: B
The external energy cycle includes plants, which transform energy from the sun into stored chemical energy.

DIF: Cognitive Level: Application REF: 82 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

6. After foods are eaten, they are converted into which of the following body fuels?
a. amino acids and fatty acids
b. fatty acids and glucose
c. glucose and triglycerides
d. glycogen and glucose
ANS: B
After foods are eaten, they are converted into fatty acids and glucose, both of which are used as fuel for the body.

DIF: Cognitive Level: Application REF: 82 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

7. Metabolic rate would increase with a body temperature of
a. 97.4 F.
b. 98.4 F.
c. 98.6 F.
d. 101.2 F.
ANS: D
Fever increases basal metabolic rate by approximately 7% for each 1 F rise in temperature. Normal body temperature is 98.4 F or 98.6 F; 101.2 F would be high enough to cause a significant increase in metabolic rate.

DIF: Cognitive Level: Application REF: 86 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

8. The amount of energy the body needs to maintain life while at digestive, physical, and emotional rest is called the
a. basal metabolic rate.
b. indirect calorimetry.
c. respiratory quotient.
d. nitrogen balance.
ANS: A
Basal metabolic rate is measured when an individual is at complete digestive, physical, and emotional rest.

DIF: Cognitive Level: Knowledge REF: 83 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

9. Metabolically active tissues in the body include
a. the heart, muscles, and intestine.
b. the brain, nerves, and hair.
c. the liver, kidney, and fingernails and toenails.
d. all body tissues.
ANS: A
The majority of energy is used by small but highly active tissues, including the liver, brain, heart, kidney, and gastrointestinal tract. These organs account for less than 5% of the total body weight but 60% to 75% of basal metabolic needs.

DIF: Cognitive Level: Knowledge REF: 83 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

10. Indirect calorimetry is used to measure which of the following?
a. basal or resting energy expenditure
b. weight
c. physical activity
d. body mass index
ANS: A
Indirect calorimetry measures the amount of energy a person uses while at rest. A portable metabolic cart allows the person to breathe into an attached mouthpiece or ventilated hood system while lying in bed and the normal exchange of oxygen and carbon dioxide is measured. The metabolic rate can be determined from the rate of oxygen utilization.

DIF: Cognitive Level: Knowledge REF: 83-84 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

11. The term for the effect of food intake on metabolic rate is
a. thermic effect of food.
b. resting metabolic rate.
c. total energy requirement.
d. indirect calorimetry.
ANS: A
Once food is eaten, it stimulates metabolism and requires extra energy for digestion, absorption, and transport of the nutrients to the cells. This stimulation is referred to as the thermic effect of food.

DIF: Cognitive Level: Knowledge REF: 88 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

12. The sum of basal metabolism, energy expended in physical activity, and thermic effect of food is known as
a. metabolic rate.
b. energy intake.
c. basal energy needs.
d. total energy requirement.
ANS: D
Together, basal metabolism, physical activities, and the thermic effect of food make up the total energy requirement.

DIF: Cognitive Level: Knowledge REF: 88 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

13. When energy intake exceeds energy expenditure, the result can be
a. anorexia.
b. malnutrition.
c. weight gain.
d. hyperactivity.
ANS: C
When energy intake exceeds energy expenditure, weight gain may result. Excess intake without expenditure results in excess storage of energy as body fat.

DIF: Cognitive Level: Knowledge REF: 88 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

14. An activity that results in increased energy expenditure is
a. cleaning house.
b. balancing a checkbook.
c. experiencing emotional stress.
d. playing video games.
ANS: A
Different kilocalorie expenditures occur with different types of activities. In this case, cleaning house requires muscular work and so uses more energy than the other activities. Mental exertion has no effect on energy needs.

DIF: Cognitive Level: Application REF: 88-90 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

15. The thermic effect of food refers to the fact that
a. all nutrients contain calories.
b. certain foods are more stimulating than others to the gastrointestinal tract.
c. the presence of food in the stomach starts the process of digestion.
d. the process of digestion, absorption, and metabolism of food requires energy.
ANS: D
Once food is eaten, it stimulates metabolism and requires extra energy for digestion, absorption, and transport of the nutrients to the cells. This stimulation is referred to as the thermic effect of food.

DIF: Cognitive Level: Knowledge REF: 88 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

16. The bodys sources of stored energy include
a. glucose.
b. adipose tissue.
c. undigested food.
d. bone.
ANS: B
Adipose tissue stores energy until required by the body.

DIF: Cognitive Level: Knowledge REF: 83 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

17. Basal metabolic rate is controlled by the hormone
a. cortisol.
b. growth hormone.
c. thyroxine.
d. insulin.
ANS: C
The hormone thyroxine controls the metabolic rate in the body. The thyroid function test can assess metabolism by measuring the activity of the gland and the blood levels of its hormone, thyroxine.

DIF: Cognitive Level: Knowledge REF: 84 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

18. The first source of stored energy to be used during a period of fasting is
a. amino acids.
b. glycogen.
c. adipose tissue.
d. glucose.
ANS: B
A 12- to 48-hour reserve of glycogen exists in the liver and muscle and is quickly depleted if not replenished by daily food intake. Adipose tissue is used for energy after glycogen stores are used, followed by the breakdown of muscle mass in extreme cases of fasting or starvation.

DIF: Cognitive Level: Knowledge REF: 83 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

19. Which of the following foods has the greatest caloric density?
a. banana
b. bread
c. nuts
d. milk
ANS: C
Nuts have the greatest caloric density of choices given because they have the highest concentration of energy for the same quantity of food. Nuts are composed of a higher percentage of fat (the highest-energy nutrient) compared with bread, milk, or a banana, which are low in fat.

DIF: Cognitive Level: Application REF: 82
TOP: Nursing Process: Assessment
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

20. Nutrient density means the
a. total weight of the nutrients in a food.
b. digestibility of the nutrients in a food.
c. concentration of energy in a given amount of food.
d. concentration of nutrients in a given amount of food.
ANS: D
Nutrient density is the concentration of nutrients in a given amount of food.

DIF: Cognitive Level: Knowledge REF: 82 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

21. The liver and muscles store enough glycogen to last _____ hours.
a. 4 to 6
b. 6 to 24
c. 12 to 48
d. 24 to 72
ANS: C
A 12- to 48-hour reserve of glycogen exists in the liver and muscles and is quickly depleted if not replenished by daily food intake.

DIF: Cognitive Level: Knowledge REF: 83 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

22. In cases of extreme starvation, the energy substrate most likely to be used as a last resort would be
a. glycogen.
b. muscle mass.
c. adipose tissue.
d. amino acids.
ANS: B
Energy stored as protein exists in limited amounts in muscle mass and is only used once glycogen and fat stores have been exhausted.

DIF: Cognitive Level: Knowledge REF: 83 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

23. Fever increases basal metabolic rate approximately _____ for each _____ rise.
a. 1%, 1 F
b. 1%, 1 C
c. 1%, 7 F
d. 7%, 1 F
ANS: D
Fever increases basal metabolic rate approximately 7% for each 1 F rise in temperature.

DIF: Cognitive Level: Knowledge REF: 86 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

24. Energy expenditure is increased by
a. physical exercise.
b. mental work.
c. stress.
d. fatigue.
ANS: A
Physical exercise increases energy expenditure because it involves muscular work.

DIF: Cognitive Level: Knowledge REF: 86-87 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

25. Energy needs per pound of body weight
a. increase with age.
b. increase throughout childhood.
c. decrease with age.
d. are greater in women than in men.
ANS: C
Energy needs per pound of body weight generally decrease during the aging process, with a gradual decline in basal metabolic rate and physical activity that decreases the total energy requirement.

DIF: Cognitive Level: Comprehension REF: 90 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

26. A 65-year-old mans energy intake should focus on meals
a. high in calories with nutrient-dense foods.
b. low in calories and high in fiber and meat.
c. with a lower caloric density and increased nutrient density.
d. high calorie level for middle age with lowered nutrient density.
ANS: C
As the aging process continues, there is a gradual decline in basal metabolic rate and physical activity, resulting in a decrease in the total energy requirement. Food choices should reflect a decline in caloric density and a greater emphasis on nutrient density.

DIF: Cognitive Level: Application REF: 90 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation, Health Promotion and Maintenance

27. Resting energy expenditure is
a. the same as basal energy expenditure.
b. slightly higher than basal energy expenditure.
c. slightly lower than basal energy expenditure.
d. more accurate for predicting energy needs than is basal energy expenditure.
ANS: B
Resting energy expenditure is slightly higher than basal energy expenditure. Basal metabolism is measured when an individual is at complete digestive, physical, and emotional rest. It differs from resting energy expenditure, which is slightly higher because of the sum of all internal working activities of the body, some of which may not be at complete rest.

DIF: Cognitive Level: Comprehension REF: 83 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

28. Mr. Jones normally has a basal metabolic rate of 1500 kcal. He develops a fever of 100.6 F. His rate would now be approximately _____ kcal.
a. 1550
b. 1600
c. 1710
d. 1830
ANS: C
Fever increases basal metabolic rate approximately 7% for each 1 F rise in temperature. In this case, Mr. Jones has a temperature above normal of 2 F (normal = 98.6 F). The resultant increase in calories is 1500 kcal (0.07 2) = 210 additional kcal. 210 kcal + 1500 kcal = 1710 kcal (approximate new rate).

DIF: Cognitive Level: Analysis REF: 86
TOP: Nursing Process: Assessment
MSC: NCLEX: Physiological Integrity: Physiological Adaptation, Reduction of Risk Potential

29. The person requiring the highest energy needs per unit of body weight is a
a. 15-year-old boy.
b. 45-year-old man.
c. 75-year-old grandmother.
d. 7-year-old girl.
ANS: A
During periods of growth, the growth hormone stimulates cell metabolism and raises basal metabolic rate. Growth is highest during infancy and adolescence.

DIF: Cognitive Level: Application REF: 90
TOP: Nursing Process: Assessment
MSC: NCLEX: Physiological Integrity: Physiological Adaptation, Reduction of Risk Potential

30. The estimated daily basal metabolic rate for a man who weighs 150 lb is _____ kcal.
a. 1500
b. 1575
c. 1636
d. 1686
ANS: C
To calculate the basal metabolic rate (BMR), use the general formula:
Men = 1.0 kcal/kg/hour; 1 kg = 2.2 lb.
Convert weight (lb) to kg:
150 lb/2.2 lb/kg = 68 kg.
Multiply by formula:
BMR (kcal) = 1.0 kcal/kg/hour 68 kg 24 hours in a day = 1636 kcal.

DIF: Cognitive Level: Application REF: 84-85
TOP: Nursing Process: Assessment
MSC: NCLEX: Physiological Integrity: Physiological Adaptation, Health Promotion and Wellness

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