Chapter 14: Nutrition and Fluid Balance

Multiple Choice. Choose the correct answer.

1. Which of the following is one of the nutritional problems of the elderly?

(A) Increased appetite makes it hard to stay slender.
(B) Reduced physical activity affects appetite.
(C) Special diets increase food choices, so there are too many items to choose from.
(D) Nutritional problems are no different for the elderly than for anybody else.
2. Problems affecting nutritional intake among the elderly and chronically ill include:
(A) Fatigue and pain that occur with certain illnesses increase appetite
(B) Older people produce more saliva
(C) Increase in physical activity and mobility causes an increased appetite
(D) Ability to smell and taste food and drink decreases as people age
3. The most essential nutrient for life is ______
(A) Protein
(B) Fat
(C) Carbohydrates
(D) Water
4. _____ help(s) the body grow new tissue and enable(s) tissue repair.
(A) Proteins
(B) Fats
(C) Carbohydrates
(D) Water
5. According to the USDA’s MyPlate icon, which food groups should make up at least half of a person’s
plate?
(A) Grains and proteins
(B) Vegetables and fruits
(C) Dairy and proteins
(D) Grains and fruits
6. Which of the following is an example of a plant-based protein?
(A) Salmon
(B) Tofu
(C) Steak
(D) Bacon
7. According to MyPlate, what percentage of milk fat should be in a person’s dairy choices?
(A) 1%
(B) 2%
(C) 3%
(D) 4%
8. According to MyPlate, what should half of the grains a person consumes be?
(A) White
(B) Refined
(C) Whole
(D) Flour
9. What information is found on a diet card?
(A) Infection prevention procedures
(B) Food allergies and likes and dislikes
(C) Care team members’ names
(D) Advance directives
10. When a nursing assistant is serving meals to residents, she must always:
(A) Prepare a diet card for each resident
(B) Identify the resident and check the diet card to make sure each resident receives the correct meal
(C) Prepare the meal for each resident
(D) Prepare a diet plan for each resident
11. A ________ diet restricts or eliminates foods that are hard to chew and swallow.
(A) High-residue or high-fiber
(B) Clear liquid or full liquid
(C) Soft or mechanical soft
(D) Bland
12. A resident who is taking diuretics or blood pressure medication may be on a ______ diet.
(A) High-potassium
(B) Modified calorie
(C) Low-protein
(D) Fluid-restricted
13. Which type of vegetarian diet eliminates all poultry, meats, fish, eggs and dairy products, along with
foods that contain these products?
(A) Lacto-ovo vegetarian diet
(B) Lacto-vegetarian diet
(C) Ovo-vegetarian diet
(D) Vegan diet
14. Residents with the abbreviation _____ on their diet cards cannot have anything to eat or drink by
mouth.
(A) NPO
(B) NCS
(C) LCS
(D) ADA
15. Residents who have difficulty ______ may require thickened liquids.
(A) Walking
(B) Swallowing
(C) Digesting food
(D) Gaining weight
16. Which of the following are signs of unintended weight loss that should be reported to the nurse?
(A) Eating lean cuts of meat
(B) Eating dessert before dinner
(C) Avoiding fried foods and sweets
(D) Coughing or choking while eating
17. Which of the following can be an effective way to prevent unintended weight loss?
(A) Promoting independence by insisting residents feed themselves without help
(B) Serving favorite foods
(C) Telling the resident when a meal looks unappetizing
(D) Insisting that residents eat everything on their trays no matter what
18. One way to make dining enjoyable for residents is to:
(A) Vary mealtimes to make dining more interesting
(B) Discourage residents from dressing up for dinner
(C) Assist residents with toileting before meals
(D) Place residents in a reclined position for eating
19. Guidelines for serving meal trays include:
(A) Serve the residents who need the most help with eating first
(B) Do as much as possible for residents to make mealtimes more efficient
(C) Discourage conversation during meals
(D) Say positive things about the food being served
20. Which of the following statements about mealtime is true?
(A) Social interaction is an important part of mealtime.
(B) Nursing assistants should do everything for residents during mealtime so residents will not be
anxious.
(C) Mealtime is a good time for nursing assistants to chat with colleagues since the residents are busy
eating.
(D) Nursing assistants should let residents know when their meal does not look appetizing.

21. At which angle should residents be positioned for eating?

 (A) 180 degrees
(B) 120 degrees
(C) 100 degrees
(D) 90 degrees
22. One way to promote independence for a resident with special needs is to:
(A) Use physical and verbal cues
(B) Make verbal cues lengthy and detailed
(C) Put food into the weaker side of residents’ mouths
(D) For visually-impaired residents, put the plate to one side of the resident
23. Which of the following is a symptom of dysphagia (difficulty swallowing)?
(A) Eating everything on the tray at every meal
(B) Sweating profusely during meals
(C) Having a fever during meals
(D) Watering eyes during meals
24. One way to prevent aspiration is to:
(A) Place residents on their sides for eating
(B) Offer several bites of food before offering a liquid
(C) Make sure food is swallowed before offering another bite
(D) Have resident lie down right after eating
25. Fluid balance occurs when:
(A) A person consumes and eliminates equal amounts of fluid
(B) A person consumes more fluid than he eliminates
(C) A person eliminates more fluid than he consumes
(D) A person consumes fluid but does not eliminate it
26. To convert ounces to milliliters multiply by
(A) 30
(B) 20
(C) 60
(D) 15
27. If a resident drinks four ounces of water with a meal, how many milliliters (mL) has he consumed?
(A) 16
(B) 30
(C) 64
(D) 120
28. Warning signs of dehydration include:
(A) Resident drinks more than six 8-ounce glasses of liquids per day
(B) Resident has trouble swallowing liquids
(C) Resident drinks a lot of fluids at meals
(D) Resident has increased urinary output
29. Which of the following is an effective way for a nursing assistant to help prevent dehydration?
 (A) Encourage a resident to drink every time she sees him.
(B) Insist that the resident drink juice.
(C) Withhold fluids if a resident is incontinent.
(D) Leave a carton of milk with the resident each time she leaves the room.
30. Symptoms of fluid overload include:
(A) Skin that appears tight, smooth, and shiny
(B) Weight loss
(C) Increased urine output
(D) Decreased heart rate

31. A resident who has a restrict fluids order:

(A) May not have any fluids at all
(B) Can have water but no other fluids
(C) Can only have fluids with meals
(D) Must limit the daily amount of fluids consumed to a level set by the doctor

32. List five common nutritional problems that elderly people may experience?
1. Older people produce less saliva/effects eating and swallowing. 2. Medications have side
effects. 3. Decrease in physical/mobility cause lack of appetite/constipation. 4. Ability to
smell/taste food/drink 5. Depression/lack of social interaction.

33. List 11 signs and symptoms of dysphagia.

1.Eating slowly 2. avoidance of eating 3.spitting up pieces of food 4.difficulty chewing food
5.difficulty swallowing small bites of food or pills 6. swallowing several times when eating a
single bite 8.bribbling saliva food or fluid from the mouth 9.keeping food inside the mouth or
cheeks during and after meals 10.vomiting while eating or drinking 11.frequent throat clearing
coughing during or after meals.

34. List eight guidelines for preventing aspiration.

1.Feed resident slowly 2. avoid distractions while eating 3. offer small pieces of food or small
spoonfuls of pureed food 4. offer a bite of food then a liquid repeat this 5. play food on the non
paralyzed, or unaffected side of mouth, if one is paralyzed 6. make sure food is actually
swallowed after each bite before offering more food or fluids. However do not put your fingers
inside a resident's mouth 7. Chief president sitting upright for at least 30 minutes after eating and
drinking 8. provide quality mouth care after eating.

35. List four warning signs of dehydration that should be reported.

1.resident drinks little or no fluid that meals 2. residents need help drinking from a cup or glass 3.
presidents have trouble swallowing liquids 4. resident is easily confused or tired

36. List seven symptoms of fluid overload.

 1. weight gain 2. fatigue 3. difficulty breathing or shortness of breath, especially if lying down 4.
swelling of ankles, feet, fingers, or hands 5. coughing 6. decreased urine output 7. increase heart rate