Test Bank Chapter 7 Assessment of the Hospitalized Patient

Chapter 07

Multiple Choice

1. Which one of the following statements regarding resting energy expenditure (REE) prediction equations is true?

A. They are more accurate at predicting a group’s mean REE than an individual's REE

B. They are more accurate at predicting an individual's REE than a group’s mean REE

C. They are able to predict a group’s mean REE and an individual's REE with equal accuracy

D. None of the choices are correct.

2. Which one of the following statements regarding the Harris-Benedict equations is false?

A. They were developed using a technique known as regression analysis

B. They do not include age as a variable

C. Body weight is measured in kilograms

D. They tend to underestimate REE in malnourished, ill patients

3. Which one of the following conditions tends to increase nitrogen excretion and REE the most?

A. Total starvation

B. Partial starvation

C. Major burn

D. Peritonitis/severe sepsis

4. Which one of the following is the preferred approach for determining energy expenditure in free-living research subjects?

A. The Harris-Benedict equations

B. Closed circuit calorimetry

C. Using a computerized metabolic cart

D. Doubly labeled water

5. Which of the following is the most variable component of 24-hour energy expenditure?

A. Resting energy expenditure

B. Thermic effect of food

C. Thermic effect of exercise

D. Sleep energy expenditure

6. Which one of the following factors poses the greatest problem in calculating nitrogen balance?

A. A high protein intake

B. Nutrient needs being met solely by enteral or parenteral nutrition

C. A large amount of wound drainage or blood loss

D. A high urine urea nitrogen value

7. A patient is admitted to a hospital ward with a current body weight of 53 kg. The patient reports that his usual weight is 65 kg. What is the patient's percent weight change?

A. 9%

B. 13%

C. 18%

D. 21%

8. A computerized metabolic monitor or cart is an example of ________.

A. closed circuit calorimetry

B. open circuit calorimetry

C. Douglas bag method

D. direct calorimetry

9. How much would a person with a desirable body weight or reference body weight of 160 lbs. have to weigh in order to be at 175% of desirable body weight?

A. 205 lbs.

B. 235 lbs.

C. 250 lbs.

D. 280 lbs.

10. A recently admitted patient undergoing nutritional screening has an admission weight of 130 lbs. and states that her usual weight is 145 lbs. Based on the information provided, what is the patient’s percent of usual weight?

A. 75%

B. 90%

C. 110%

D. 125%

11. Which of the following is the largest component of 24-hour energy expenditure for most healthy, sedentary adults?

A. Resting energy expenditure

B. Thermic effect of food

C. Thermic effect of exercise

D. Sleep energy expenditure

12. The major route of nitrogen excretion from the body for most individuals is _______.

A. loss of blood

B. feces

C. loss of hair, clipped finger nails, and sloughed-off skin cells

D. urine

13. Arm muscle area can be used as an index of _______.

A. total body energy reserves

B. adipose tissue reserves in the upper arm

C. the amount of lean tissue or muscle in the body

D. None of the choices are correct.

14. Which of the following is not a variable in the World Health Organization REE prediction equations?

A. Age

B. Height or stature

C. Body weight

D. None of the choices are correct.

15. Malnutrition and undernutrition are experienced when there is a deficiency of energy (kilocalories), protein, or other nutrients, causing measurable and adverse effects on body composition, function, and health. An unintentional weight loss of more than a threshold of __________ in the past six months is often used for diagnosis.

A. 20%

B. 15%

C. 10%

D. 5%

16. Malnutrition is associated with many adverse health, social, mental, and financial outcomes. Which one of the following is NOT on this list?

A. Increased incidence rates for cardiovascular disease

B. Anemia

C. Sarcopenia

D. Bone fractures

17. The identification of two or more of the six characteristics is recommended for diagnosing malnutrition (assessed on admission and at frequent intervals). Which one of the following listed is NOT on this list?

A. Insufficient energy intake

B. Weight loss

C. Loss of muscle mass

D. Increase in visceral body fat

18. Early detection of malnutrition is important, and it is an important component of comprehensive geriatric assessment (CGA). There are at least four components in CGA. Which one of the following is NOT on this list?

A. Physical health

B. Chronic disease risk factors

C. Mental health

D. Functional status

19. The half arm-span is the distance from the midline at the _______ to the tip of the middle finger while the non-dominant arm is stretched out in a horizontal position.

A. bottom tip of the sternum

B. chin

C. sternal notch

D. nose

20. In the MNA-SF, if BMI is not available, use the _______ circumference.

A. head

B. abdominal

C. arm

D. calf

21. In the MUST, BMI can be estimated from the _______.

A. MUAC

B. CAM

C. height

D. waist circumference

22. In the MUST, the length of the _______ can be used to estimate height using gender-specific formulas.

A. femur

B. tibia

C. ulna

D. spine

23. ADLs have five basic categories of involvement. Which one of the following is NOT on this list?

A. Personal hygiene

B. Walking outside to accomplish tasks

C. Dressing

D. Toileting and continence

24. IADLs require a _______ level of cognition and judgment than ADLs.

A. similar

B. higher

C. lower

D. deeper

25. Low muscle mass and weakness are potentially disabling in older adults, and the Foundation for the National Institutes of Health Sarcopenia Project recommends the use of _______ to determine weakness.

A. exercise history

B. leg squats

C. sit-ups

D. hand-grip strength testing

26. Mid-upper arm muscle circumference (MAMC) is calculated from MUAC and the _______ and can be used to evaluate fat-free mass.

A. triceps skinfold

B. subscapular skinfold

C. waist circumference

D. BMI

27. The mid-upper arm muscle area (MAMA) can be used to evaluate _______.

A. BMI

B. strength

C. fat-free mass

D. fat mass

True/False

28. Arm muscle area can be a useful index of total body muscle in children and adults.

29. A drawback of the doubly labeled water approach for measuring energy expenditure is that it is unsuitable for use in infants and in women who are pregnant or lactating.

30. In clinical settings such as hospitals, the energy requirements of patients are generally estimated using one of several available prediction equations.

31. Equations for estimating resting energy expenditure (REE) are as good at predicting the mean REE of a group as they are at predicting REE for any individual member of that group.

32. As the score on the Malnutrition Universal Screening Tool increases, risk of malnutrition increases.

33. The Mini Nutritional Assessment is an instrument designed to assess the nutritional status of elderly adults once they have undergone nutritional screening and have been shown to be at nutritional risk.

34. Nutritional assessment typically precedes nutritional screening.

35. A computerized metabolic monitor or cart is an example of indirect calorimetry.

36. A 12 percent weight loss over a period of six months is less significant than a 12 percent weight loss over a period of 12 months.

37. A change in body weight of more than 0.5 kg in one day indicates an accumulation or loss of body water rather than a gain or loss of lean or fat tissue.

Fill-in-the-Blank

38. The Dietary Reference Intake value, which is defined as the average dietary energy intake predicted to maintain energy balance in a healthy person of a defined age, gender, weight, height, and level of physical activity consistent with good health is the __________.

39. Determining energy expenditure by measuring the body’s oxygen consumption and carbon dioxide production is known as __________.

40. A nutrition screening instrument developed by the Malnutrition Advisory Group of the British Association for Parenteral and Enteral Nutrition is known as the __________.

41. When the amount of nitrogen excreted from the body is equal to nitrogen intake, a condition known as __________ is said to exist.

42. The increase in energy expenditure following the consumption of food is known as the __________.

43. A patient who cannot walk or who is bed-ridden is said to be __________.