1. When counseling a group of overweight individuals, the nurse should stress that during parties, the oxidation of alcohol provides how many kilocalorie/gram to one's diet?
A) 4 kcal/g
B) 5 kcal/g
C) 7 kcal/g
D) 9 kcal/g

2. A dietitian is working with a morbidly obese client in an effort to facilitate weight loss. Which of the dietitian's following teaching points about the nature of adipose tissue should be included in the client education?
A) "Our ultimate goal is going to be eventually rid your body of adipose tissue or fat."
B) "Your fat cells can be considered to be one large energy storage organ that also has a role in hormone production."
C) "We ideally would like to maximize your levels of brown fat and minimize those of white fat."
D) "Obesity is normally the result of the number of 'pre-fat' cells an individual is born with."

3. Which of the following statements most accurately captures an aspect of the basal metabolic rate (BMR)?
A) The resting BMR constitutes a small fraction of the total body energy needs.
B) Females tend to have a lower BMR than males due to a smaller skeletal muscle mass.
C) Variations in muscle mass account for much of the differences in the BMR that exist between individuals.
D) The BMR remains consistent throughout the life span.

4. Which of the following clients would be most reasonably expected to have the highest basal metabolic rate (BMR), assuming none is obese or malnourished?
A) A 22-year-old man, 69 inches tall, who has a sedentary lifestyle
B) A 47-year-old woman, 65 inches tall, who swims 1 mile four times a week
C) A 29-year-old woman, 61 inches tall, who is pregnant and on bed rest
D) A 60-year-old man, 72 inches tall, who is recovering from heart surgery

5. When examining the types of energy expenditure, which of the following statements is accurate?
A) People who are more active and who fidget may have less fat gain than those with decreased nonexercise activity thermogenesis.
B) Parasympathetic stimulation will cause brown fat to generate more heat than other stimulations.
C) Recent research indicates that obese patients with persistent excess caloric intake have decreased sympathetic activity.
D) Carbohydrate intake increases the normal metabolic rate more significantly than other nutrients.

6. When explaining the role of protein and the nine essential amino acids' needs of the body to a group of students, the nurse should emphasis that which of the following foods are complete proteins (foods that provide the essential amino acids in adequate amounts)? Select all that apply.
A) Milk
B) Fish
C) Poultry
D) Nuts
E) Grains

7. A 17-year-old female has announced to her family physician a desire to wholly eliminate fats from her diet. Which of the following aspects of the role of fats would underlie the physician's response to the client?
A) Apart from providing energy, fats are necessary as carriers of certain vitamins and are precursors to prostaglandins.
B) An extreme low-fat diet is associated with an increase in undesirable HDL cholesterol.
C) Fats are a key source of dietary nitrogen, and their elimination from the diet is associated with a negative nitrogen balance.
D) The total elimination of fat from the diet is associated with the development of ketosis.

8. The physician has asked a newly diagnosed cardiac patient to begin taking omega-3 fatty acids to help prevent inflammation and blood clotting. The patient asks the nurse what types of food sources are high in omega-3 fatty acids. The nurse should educate the patient to increase his intake of which of the following items? Select all that apply.
A) Salmon
B) Walnuts
C) Seeds
D) Avocados

9. A 20-year-old male college student has recently finished a Thanksgiving dinner of heroic proportions while home for the holiday weekend. Which of the following phenomena would most likely have produced his sensation of satiety?
A) Stretch receptors in the stomach and small intestine signal the feeding center in the medulla.
B) Increased levels of leptin stimulate a decrease in appetite by way of the vagus nerve.
C) The breakdown of products of lipids such as ketoacids produces a decrease in appetite.
D) Cholecystokinin and glucagon-like peptide-1 suppress the hunger impulse.

10. A 43-year-old male who is 5′10″ tall and weighs 216 lb has been informed by his nurse practitioner that his body mass index (BMI) is 31. Which of the following clinical conclusions based on these data would his nurse be most justified in rejecting?
A) Further investigation of his nutritional status is needed to supplement the BMI value.
B) The client faces an increased risk of type 2 diabetes and hyperlipidemia.
C) He is classified as being obese, likely as the result of the interplay of genetic and lifestyle factors.
D) The client is borderline obese but is not yet at the point of significantly increased risks to health.

11. Which of the following statements about types of obesity is most accurate?
A) Upper body obesity is often referred to as being shaped like a "pear."
B) A waist-hip ratio greater than 1.0 in men can be interpreted to mean upper body obesity.
C) Waist circumference is a measurement of subcutaneous abdominal adipose tissue but not intra-abdominal adipose tissue.
D) A waist circumference of 40 inches or less in women is considered normal and therefore not associated with increased health risk.

12. A 40-year-old female has been categorized as being obese, with a body mass index (BMI) of 33.2. Which of the following health problems place the client at a significantly increased risk for when compared with individuals with a BMI below 25? Select all that apply.
A) Cardiac arrhythmias
B) Osteoarthritis
C) Multiple sclerosis
D) Atelectasis
E) Gallbladder disease
F) Insulin resistance

13. Frustrated with his inability to lose weight despite attempting numerous fad diets, a 42-year-old male who is 5′11″ and 270 lb has visited a clinic to gain tools to achieve long-term weight loss. Which of the following statements by the clinician is most accurate?
A) "Recent findings have determined that obesity is largely genetic and not preventable, but that doesn't mean we can't work together to help you lose weight and keep it off."
B) "A combined approach of behavior therapy, changing your lifestyle habits, and increased physical activity gives the highest chance of long-term success."
C) "By significantly changing the way you live your life, you could set and meet a goal of losing about 5% of your body weight each month."
D) "Combined with regular exercise, a diet of taking in 500 to 1000 kcal/day will be the best approach."

14. The patient who has been consuming a very low-calorie diet (VLCD) of 450 kcal/day should be assessed for which of the following high-risk complications? Select all that apply.
A) Irregular heart rhythms
B) Bone/joint inflammation
C) Abdominal pain related to gallstones
D) Flank pain and spasm associated with kidney sludge
E) Elevated cholesterol levels

15. Which of the following measures would likely be rejected as part of a first-line weight loss plan for a client with a BMI of 30.2, type 2 diabetes, and hypertension?
A) Prescription drug therapy
B) Gastric bypass
C) Calorie reduction by 500 to 1000 kcal/day
D) 30 minutes or more of moderate-intensity activity at least 3 days per week

16. During a humanitarian trip to an underdeveloped country, a medical student is assessing a 6-year-old male who has a protuberant abdomen, dry hair, and wrinkled skin. The child's heart rate is 59 beats/minute, blood pressure 89/50, and temperature 95.2°F (35.1°C). What is the most likely etiology of the child's health problems?
A) A diet lacking in fat-soluble vitamins
B) Fluid and electrolyte imbalances secondary to low -carbohydrate intake
C) A diet that is low or high in carbohydrates but low in fat
D) A diet deficient in both protein and calories

17. A nurse who works on an oncology ward is providing care for a 68-year-old female patient with a diagnosis of lung cancer with bone metastases. The client is experiencing rapid weight loss and is exhibiting the signs and symptoms of malnutrition. The nurse would recognize that which of the following factors is most likely contributing to the client's malnutrition?
A) Autoimmune responses associated with acute illness are inhibiting anabolism.
B) Chronic hypoxia is precluding many of the aerobic processes required in body maintenance and repair.
C) Protein mass is being lost from the liver and other organs, and the liver is synthesizing fewer serum proteins.
D) Intestinal malabsorption is occurring as a result of tumor metastases.

18. A 20-year-old male who is addicted to crystal methamphetamine has been admitted to a hospital with a diagnosis of protein-calorie malnutrition after many months of inadequate food intake. Which of the following treatment plans would the care team most likely favor?
A) Intravenous infusion of albumin coupled with vitamin supplementation
B) Total parenteral nutrition
C) Incrementally feeding combined with vitamin and mineral supplementation
D) Rapid administration of normal saline and carbohydrates

19. A teenage female has been admitted for complications resulting from bulimia nervosa. She has abused laxatives for many years and has been self-inducing vomiting since the age of 9. The nurse's admission assessment should pay close attention to which of the following complications that can arise from this disorder? Select all that apply. Assess for
A) dry, cracked lips and poor skin turgor.
B) missing tooth enamel and increased number of dental cavities.
C) painful swallowing and stomach cramping related to reflux and esophagitis.
D) fruity breath and labored, deep, gasping respirations.
E) jaundice of the skin and eyes.

20. As part of the intake protocol at an eating disorders clinic, an interview precedes a physical examination. Which of the following questions would a clinician be justified in excluding from an intake interview of a 16-year-old female referred by her pediatrician for the treatment of anorexia nervosa?
A) "Do you remember when your last menstrual period was?
B) "Have you noticed any new hair growth on your body in the last several months?"
C) "Have you had any episodes of shortness of breath in the recent past?"
D) "Can you tell me about some of the habits that you have related to food in your daily routine?"