Test Bank for Krauses Food and the Nutrition Care Process 14th Edition by Mahan

Test Bank for Krauses Food and the Nutrition Care

Process 14th Edition by Mahan

To download the complete and accurate content document, go to:

https://testbankbell.com/download/test-bank-for-krauses-food-and-the-nutrition-care-p
rocess-14th-edition-by-mahan/

Visit TestBankBell.com to get complete for all chapters

Chapter 07: Clinical: Biochemical, Physical, and Functional Assessment
Mahan: Krause’s Food and the Nutrition Care Process, 14th Edition

MULTIPLE CHOICE

1. Laboratory tests for nutrients

a. are not useful if you have only a single test result.
b. are always best done on whole blood.
c. may indicate deficiency before clinical or anthropometric data does.
d. are currently not well controlled.
ANS: C
Laboratory-based nutrition testing, used to estimate nutrient concentration in biologic fluids
and tissues, is critical for assessment of both clinical and subclinical nutrient deficiencies.
Most of these states can be assessed in the laboratory so that nutritional intervention can occur
before a clinical or anthropometric change or a frank deficiency occurs. Single test results
may be useful for screening or to confirm an assessment based on changing clinical,
anthropometric, and dietary status. The best biologic medium to test depends on the specific
nutrient. Laboratory assessment is stringently controlled. It involves comparing control
samples with predetermined substance or chemical constituent concentrations with every
patient specimen.

REF: p. 99

2. Which of the following is NOT associated with a decrease in prealbumin levels?

a. Malnutrition
b. Inflammation
c. Protein-wasting disease of the gastrointestinal tract
d. Zinc deficiency
ANS: A
Prealbumin levels may appear normal when a patient has uncomplicated or severe
malnutrition. Prealbumin levels decrease in response to inflammation, protein-wasting
diseases of the intestines and kidney, and in malignancy. As zinc is necessary in the synthesis
of prealbumin, zinc deficiency will result in decreased levels.

REF: p. 104

3. Which nutrient-related disorder is likely to result in a stool test being ordered?

a. Diabetes
b. Anemia
c. Night blindness
d. Cheilosis
ANS: B
The fecal occult blood test is routinely ordered for adults older than age 50 years and younger
adults with unexplained anemia. The presence of blood may indicate bleeding in the
gastrointestinal tract that is causing the anemia.

REF: p. 105
4. Which of the following occurs during acute illness or trauma?
a. Negative acute-phase respondents increase.
b. Positive acute-phase respondents decrease.
c. Negative acute-phase respondents decrease.
d. Both positive and negative acute-phase respondents increase.
ANS: C
Negative acute-phase proteins are those that are negatively affected by trauma, meaning that
their levels and production decrease in response to the trauma. These include albumin,
transferrin, prealbumin, and retinol-binding protein. Positive acute-phase respondents are
those that increase in levels and production in response to trauma.

REF: p. 103

5. Which of the following is a positive acute-phase respondent?

a. Interleukin-1
b. Albumin
c. Transthyretin
d. C-reactive protein
ANS: D
Positive acute-phase respondents include C-reactive protein, alpha-1-antichymotrypsin,
alpha-1-antitrypsin, fibrinogen, ferritin, and complement components C3 and C4, just to name
a few. Interleukin-1 is one of the cytokines triggered by trauma that reorients hepatic synthesis
of plasma proteins. Albumin and transthyretin (prealbumin) are both negative acute-phase
proteins.

REF: p. 103

6. During trauma, what happens to negative acute-phase respondent levels?

a. Blood levels decrease because of decreased synthesis.
b. Blood levels increase because of transport into the vascular space.
c. Blood levels are not altered because of the catabolism of proteins.
d. Blood levels are similar to what they would be during simple starvation.
ANS: A
During the acute phase of trauma, the negative acute-phase respondent levels decrease in the
blood. Part of this is because of decreased synthesis resulting from a downregulation of gene
expression and translation. In the case of albumin, other aspects of the reduction include
increased catabolism and transport to extravascular spaces. This is different from what
happens to albumin during starvation because in that case, plasma albumin levels are
maintained by a shift from the extravascular space.

REF: p. 103

7. Which of the following is TRUE about bioelectric impedance analysis?

a. It measures lean body tissue.
b. It is noninvasive and portable.
c. It is not accurate in a dehydrated individual.
d. All of the above.
 ANS: D
Bioelectrical impedance analysis (BIA) is a body composition analysis technique based on the
principle that, relative to water, lean tissue has a higher electrical conductivity and lower
impedance than fatty tissue because of its electrolyte content. BIA has been found to be a
reliable measurement of body composition (fat-free mass and fat mass). The equipment
needed is portable, and the method has been shown to be safe and noninvasive. For accurate
results the patient should be well hydrated; have not exercised in the previous 4 to 6 hours;
and have not consumed alcohol, caffeine, or diuretics in the previous 24 hours. If the person is
dehydrated, a higher percentage of body fat than really exists is measured.

REF: pp. 115-116

8. Which indicator of protein status has the longest half-life?

a. Albumin
b. Prealbumin
c. Retinol-binding protein
d. Transferrin
ANS: A
Albumin has a half-life of about 3 weeks. Prealbumin has a half-life of 2 days.
Retinol-binding protein has a half-life of about 12 hours. Transferrin has a half-life of 8 days.

REF: p. 104

9. Which of the following is a measure of somatic protein status?

a. C-reactive protein
b. Retinol-binding protein
c. Urinary methylmalonic acid
d. Urinary creatinine
ANS: D
Urinary excretion of creatinine is related to the skeletal muscle or somatic protein; however,
as the value can be affected by the intake of muscle meats, use of this measure is more limited
to research. C-reactive protein is used as an indicator of inflammation. Retinol-binding protein
may be used as an indicator of protein calorie malnutrition. Urinary methylmalonic acid is a
sensitive indicator of vitamin B12 deficiency.

REF: p. 108

10. Which of the following manifestations will occur in iron deficiency anemia?
a. Microcytic anemia
b. Macrocytic anemia
c. High reticulocyte count
d. High MCV
ANS: A
Microcytic anemia is mostly associated with iron deficiency. Macrocytic anemia, which
would be reflected by a high MCV value, is usually caused by either folate or vitamin B12
deficiency. Reticulocytes are large, nucleated, immature red blood cells that are released in
small numbers with mature red blood cells. The presence of these may indicate erythropoiesis
in response to blood loss, hemolysis, or iron, folate, or vitamin B12 therapies.
 REF: p. 105

11. Which of the following is a measure of iron storage?

a. TIBC
b. Serum ferritin
c. Transferrin
d. Hemoglobin
ANS: B
Ferritin is the storage protein that sequesters the iron gathered in the liver, spleen, and
marrow. Total-iron binding capacity is a direct measure of all proteins available to bind iron
dependent on the number of free iron-binding sites on transferrin. Transferrin is the primary
blood transport protein of iron. Hemoglobin is the oxygen-carrying protein in red blood cells
and uses iron as a functional component.

REF: p. 105

12. Which of the following deficiencies could cause macrocytic anemia?

a. Vitamin B12
b. Vitamin B6
c. Homocysteine
d. Iron
ANS: A
Vitamin B12 and folate deficiencies both may promote the development of macrocytic anemia
because they are involved in DNA synthesis, and loss of either results in the impaired
production of red blood cells. Homocysteine is a product of methionine metabolism. Levels of
homocysteine increase when vitamin B12 and folate are deficient because these are necessary
for its conversion back to methionine. Vitamin B6 affects homocysteine by converting it to
cysteine. However, neither of these promote anemia. Iron is associated with microcytic
anemia.

REF: p. 105

13. Apolipoprotein B (apoB)

a. is a subparticle of LDL cholesterol.
b. is a subparticle of HDL cholesterol.
c. should be measured as a risk factor for CVD according to ACC/AHA guidelines.
d. is not an independent marker for CVD risk.
ANS: D
The new ACC/AHA guidelines deemphasize use of any markers other than LDL cholesterol
and HDL cholesterol. Emerging risk markers for atherosclerotic cardiovascular disease
(ACVD) that are not recommended in ATP 4 include differentiating subparticles of LDL by
size and grouping by pattern, apolipoprotein B (apoB), and apolipoprotein E (apoE)
phenotype. The Cholesterol Expert Panel determined that these markers are not independent
markers for risk and do not add to prediction equations.

REF: p. 109

14. Which of the following would be included in a complete blood count?

 a. Total cholesterol
b. Mean cell volume
c. Glucose
d. Albumin
ANS: B
A CBC panel focuses on the analysis and descriptions of the red blood cells, including
hemoglobin, hematocrit, and mean cell volume (the size of the red blood cells). Glucose, total
cholesterol, and albumin are values on a common serum chemistry or blood panel.

REF: pp. 101-102

15. Which laboratory value would be added in a comprehensive metabolic panel (compared with
a BMP)?
a. Albumin
b. Glucose
c. Blood urea nitrogen
d. White blood cells
ANS: A
The Centers for Medicare and Medicaid Services established that for the BMP, the following
tests are reimbursable: glucose, calcium, potassium, carbon dioxide, chloride, blood urea
nitrogen, and creatinine. For the CMP, the following are added: albumin, total protein,
alkaline phosphate, alanine aminotransferase, aspartate aminotransferase, and bilirubin. WBC
would appear on a CBC, which may include a differential identifying the levels of the
different types.

REF: pp. 101-102

16. Which of the following is NOT a laboratory measure of hydration status?

a. Serum sodium
b. Blood urea nitrogen
c. Serum glucose
d. Urine specific gravity
ANS: C
Although high serum glucose levels in people with diabetes mellitus have a dehydrating
effect, by itself, it is not a measure of hydration. Glucose, sodium, and blood urea nitrogen
(BUN) are all factors in the calculation of serum osmolality. Serum osmolality, serum sodium,
BUN, and urine specific gravity are all laboratory values that may be used to assess hydration
status.

REF: p. 103

17. Which of the following is a measure of glucose control?

a. Highly sensitive C-reactive protein
b. Hemoglobin A1C
c. Homocysteine
d. Apolipoprotein B
ANS: B
Test Bank for Krauses Food and the Nutrition Care Process 14th Edition by Mahan

The percentage of glycosolated hemoglobin (hemoglobin A1C) in the blood is directly related
to the average blood glucose levels for the preceding 2 to 3 months. Homocysteine and
hs-CRP are two inflammatory markers, higher levels of which are associated with increased
risk of cardiovascular disease. Apolipoprotein B is the part of the protein present in
low-density lipoprotein, and it is also associated with increased risk of atherogenesis, possibly
through its susceptibility to oxidation by ROS and lipid peroxides.

REF: p. 109

18. BMIs of _______ are associated with increased risk of mortality in those 65 and older.
a. less than 23
b. less than 18.5
c. greater than 24.9
d. there is no association between BMI and risk of mortality
ANS: A
Differences in race, sex, and age must be considered when evaluating the BMI. BMI values
tend to increase with age, yet the relationship between BMI and mortality appears to be
U-shaped in adults aged 65 and older. The risk of mortality increased in older adults with a
BMI of less than 23.

REF: p. 113

19. In urinalysis tests, which of the following is expected to appear at some level in normal
people?
a. Glucose
b. Ketones
c. Blood
d. Protein
ANS: D
Small amounts of protein, from 2 to 8 mg/dL, are expected in normal urine. Larger amounts
are associated with damage to the kidneys. Results for glucose, ketones, and blood in the urine
are expected to be negative.

REF: p. 102

Visit TestBankBell.com to get complete for all chapters