Nutrition final

3300

A burn patient has a total body surface burn area of 50%. If his pre-burn resting energy needs were 2200 calories, what is his post burn calorie need?

Lactose free

A client has received radiation treatments to the abdomen and now suffers from diarrhea. Which of the following diet modifications is likely to help the client?

Chocolate milk

A client with cancer has painful lesions in his or her mouth. Which of the following snack items is most likely to be well tolerated?

inhale

A client with cancer is experiencing difficulty swallowing. When teaching the client to make the process a conscious action, which of the following would the nurse instruct the client to do first?

Offering six small meals

A client with cancer suffers from early satiety. Which of the following interventions is recommended to increase his or her food intake?

diabetes

A frequent cause of gastroparesis is

bananas

A good source of prebiotics is

steatorrhea

A late-appearing symptom of chronic pancreatitis is

true

A lower BMI in cases of cystic fibrosis is associated with increased mortality.

c-resctive protein

A marker of the acute phase of the inflammatory response is

84, 140

A patient in the ICU weighs 70 kg. Based on the protein needs of critically ill patients presented in the text, his dietary protein needs range from _____ grams to ______ grams per day. (Type in whole number as numerals with a comma and space between the two answers- do not spell out or include hyphens or decimal points. Example 10, 12).

provided a jejunostomy tube feeding with a semi-elemental formula high in protein

A patient with acute pancreatitis who is unable to eat by mouth after 48 hours should be

true

A semi-vegetarian diet may reduce symptoms for people with Crohn disease.

false

After diverticulitis has been successfully treated, patients should follow a low fiber diet to prevent recurrence.

breast

Alcohol intake has been convincingly linked to which of the following sites of cancer occurrence?

immobility

All of the following are associated with wound dehiscence except a. obesity b. malnutrition c. abdominal distention d. infection e. immobility f. abdominal pressure

hypoglycemia

All of the following are characteristic of hypermetabolism seen in critically ill patients EXCEPT a. hypoglycemia b. insulin resistance c. increased oxygen consumption d. loss of lean body tissue

fluid restriction

All of the following are characteristic of the diet for burn patients except a. high protein b. high calorie c. six meals per day d. fluid restriction e. supplements

salt/sodium restriction

All of the following are characteristic treatments for clients with cystic fibrosis except a. high calorie diet b. salt/sodium restriction c. water soluble vitamin supplementation d. pancreatic enzyme ingestion before meals and snacks

avoiding snacks

All of the following are characteristics of the diet to treat stable cirrhosis of the liver except a. high protein b. high calories c. low sodium d. avoiding snacks

dumping syndrome

All of the following are potential causes of chronic constipation except a. selected medications b. early onset neurological diseases c. colonic malignancy d. dumping syndrome

gastroparesis

All of the following are risk factors for GERD in adults except a. smoking b. obesity c. selected medications d. gastroparesis

hyperglycemia

All of the following are signs/symptoms of dumping syndrome except

One liter of a 5% glucose IV solution given over 24 hours will provide enough calories to prevent ketosis for 1-3 days post op.

All of the following are true regarding post operative nutrition in patients previously well-nourished except a. Patients should never be fed until bowel sounds are auscultated. b. Adequate nourishment should be given within three days. c. One liter of a 5% glucose IV solution given over 24 hours will provide enough calories to prevent ketosis for 1-3 days post op. d. Calorie needs can be met initially with 25 kcal/kg body weight after the NPO period.

asthma

All of the following conditions can increase risk of refeeding syndrome except a. chronic diuretic therapy b. alcholism c. chronic weight loss d. asthma

high fiber foods

All of the following increase the risk of diverticulosis except a. alcohol consumption b. a diet high in red meat c. high fiber foods d. obesity

vitamin A

All of the following micronutrient supplements are proven to promote pressure wound healing except a. vitamin C b. zinc c. vitamin A d. arginine

More food should be offered in the evening hours when the patient is alert and more likely to eat.

All of the following statements regarding dietary interventions for patiens with hepatitis are correct except a. More food should be offered in the evening hours when the patient is alert and more likely to eat. b. High protein is needed to help heal the liver. c. Patients generally need three or more liters of fluid per day. d. Oral liquid supplements between meals may be needed to assure adequate calorie intake.

albumin

Although multiple indices should be used to assess nutrition status, ________________ is the single best indicator of postooperative complications and mortality after major surgery.

a. cranberry juice c. baked chicken j. steamed white rice k. tender cooked pasta l. scrambled egg m. boiled carrots p. steamed cauliflower q. peaches s. green beans t. banana

Ann has stage 4 CKD. In addition to protein and fluid restrictions, her diet is managed for 1500 mg sodium, low phosphorus and 80 milliquivalents of potassium. Regarding those three minerals, indicate which foods are allowed if her diet is not individualized based on daily labwork. a. cranberry juice b. orange juice c. baked chicken d. peanut butter e. bacon f. baked potato g. baked beans h. V-8 vegetable juice i. cola beverage j. steamed white rice k. tender cooked pasta l. scrambled egg m. boiled carrots n. cheese o. unsalted nuts p. steamed cauliflower q. peaches r. baked apples s. green beans t. banana

a. boiled egg e. grilled fish f. unsalted peanuts h. thawed frozen strawberries i. navy beans j. lowfat milk

Bill was recently diagnosed with hypertension and placed on the DASH diet. Indicate all of the foods that would be allowed on his new diet prescription. a. boiled egg b. 2 oz ham c. fast food french fries d. milkshake e. grilled fish f. unsalted peanuts g. pizza cooked from frozen state h. thawed frozen strawberries i. navy beans j. lowfat milk

false

Brands of enzymes used to treat cystic fibrosis are quite similar such that dosing need not be changed if a different brand is used.

true

Calorie requirements for a burn patient may be as high as 8000 per day.

red blood cell hemolysis

Cirrhosis of the liver is characterized by all of the following except a. esophageal varices b. hepatic encephalopathy c. portal hypertension d. red blood cell hemolysis

The commercially prepared solutions are less subject to contamination than a homemade feeding.

Commercially prepared enteral solutions are preferred to homemade feeding for cancer patients because:

true

Cystic fibrosis is the most common life-threatening genetic disorder in the United States.

frequent blood glucose monitoring and insulin dosing

Diabetes in cystic fibrosis is primarily managed by-

true

Diagnosis of celiac disease may take up to ten years in some individuals.

fat

Dietary restriction of _________ is suggested for cholecystitis.

phosphorus, magnesium, potassium

Failure to monitor serum levels of ____, ______, and _______ after refeeding a chronically malnourished patient may be fatal for the client.

true

Following a fundoplication, post op patients have strict dietary restrictions for six weeks.

fewer complications

For patients requiring nutrition support after gastrointestinal surgery, enteral nutrition is preferred to parenteral nutrition because research demonstrates enteral nutrition results in

reducing dietary protein

For patients with hepatic encephalopathy, which of the following strategies IS NOT EFFECTIVE?

duodenal

Gastrointestinal pain severe enough to awaken a patient at night is suggestive of a/an ______ ulcer.

fermentable carbohydrates including beans, milk, apples

IBS may be successfull treated with a low FODMOP diet. When hydrogen breath tests are not available to identify the single offending FODMOP food, patients will be told to restrict all of the following except a. gastric stimulants including caffeine and mint b. fermentable carbohydrates including beans, milk, apples c. sugar free gum and candy d. cabbage, onions and high fructose corn syrup

glass utensils

In addition to cooking beef or pork in a microwave oven, using which of the following would be effective in minimizing metallic tastes.

true

In some cases of severe constipation (fecal impaction), patients may experience diarrhea.

Patients suffering a flair up of IBD should rest the bowel and rely on parenteral nutrition until the flare has subsided.

Indicate which statement is false regarding irritable bowel disease (IBD). a. In cases of IBD, white blood cells attack the lining of the gastrointestinal tract. b. IBD includes Crohn's and ulcerative colitis. c. Patients suffering a flair up of IBD should rest the bowel and rely on parenteral nutrition until the flare has subsided. d. Patients with IBD should avoid alcohol, excess dietary fat and high carbohydrate foods during a flare up.

true

Korsakoff psychosis in patients with cirrhosis of the liver is irreversible.

production of glucose from fat and amino acids in muscle and organs

Match the chemical cellular reaction response to uncomplicated starvation. gluconeogenesis

breakdown of stored glucose in liver

Match the chemical cellular reaction response to uncomplicated starvation. glycogenolysis

accumulation of acetone from the incomplete metabolism of fatty acids in late starvation

Match the chemical cellular reaction response to uncomplicated starvation. ketosis

breakdown of fat tissue in an effort to conserve

Match the chemical cellular reaction response to uncomplicated starvation. lipolysis

diarrhea does not respond to treatment within 24 hours

Medical treatment for dehydration is most important in all the following conditions except a. diarrhea induces a fever above 102 degrees F b. diarrhea does not respond to treatment within 24 hours c. diarrhea accompanied by blood in the stool d. diarrhea unresolved for more than 3 days e. diarrhea causes severe abdominal pain

true

Medical treatment for hiatal hernia is the same as therapies for gastroesophageal reflux disease.

appetite stimulant

Megestrol is a drug given to cancer clients because it acts as which of the following?

ursodiol

Obese patients who elect to have a roux en y procedure should be placed on _______ to reduce the chance of developing gallstones.

Postmenopausal breast

Obesity is most clearly linked to which of the following cancers?

liver

Patients facing surgery are at a paricular risk if there is damage to the ____________.

true

Patients scheduled for intestinal biopsy to rule out celiac disease must avoid dietary gluten up to six weeks before the biopsy is taken.

false

Patients undergoing major gastrointestinal surgery should not be provided peri-operative nutrition in order to prevent intestinal failure.

false

Patients with peptic ulcers should be encouraged to drink milk to reduce activity of stomach acid.

false

Post op ileostomy patients are at risk for fluid retention and and abdominal distention.

true

Post prandial hypotension is virtually unheard of in younger people.

True

Pre-operative malnutrition has been consistently linked to post-operative complications and poor patient outcomes.

true

Preoperative fasting guidelines are much more liberalized in recent years but there has been an overall lack of implementation of the newer guidelines.

true

Prolonged preoperative fasting may result in sustained postoperative insulin resistance and accelerated tissue catabolism

shock

Protein depletion in pre-operative patients increases the risk of all the following except

oral ulcerations

Providing drinking straws is most appropriate for the client with which of the following problems?

achalasia

Providing small frequent meals with low fiber, avoiding hot and cold foods, additional fluids and sometimes esophageal dilitation are therapies used to treat

colon and prostate

Red and processed meat intake are related to increased risk of which types of cancer?

false

Refeeding syndrome is most often confined to ICU settings.

individuals have genetic differences in enzymes that influence the activation of carcinogens.

Regarding the connection between methods of cooking meat and the risk of cancer, which of the following statements is true? a. Pot-roasting and stewing produces carcinogens known to cause cancer in animals. b. Consumption of rare meat is a recognized risk factor for gastrointestinal cancer. c. Individuals have genetic differences in enzymes that influence the activation of carcinogens. d. Microwaving inactivates carcinogens that form in protein foods during cooking.

true

Resting energy expense of burn patients remains elevated at 130-140% for three years after a burn.

true

Smoking is associated with reduced incidence of ulcerative colitis.

brussels sprouts and broccoli

Some evidence suggests which of the following vegetables are specifically protective against cancer?

parkland

The _____ formula is useful to help calculate fluid needs of adults and children who have burn injury.

1/2 ounce

The average person's liver can metabolize ________ alcohol per hour.

Initiation

The first step in the evolution of a normal cell to a cancer cell in which a gene is altered by some force or agent is which of the following?

indirect calorimetry

The ideal method for assessing the energy needs of critically ill patients is

true

The most common causes of cirrhosis of the liver are alcohol and chronic hepatic viral infections.

acetaminophen poisoning and selected viral infection.

The most common causes of hepatitis are

cystic fibrosis related diabetes

The most common co-morbid condition of CF is -

Helicobacter pylori

The most commons cause of gastritis is

carcinoma

The term for cancer of the epithelial tissue, such as the lining of the gastrointestinal tract, is:

Alteration in the body's metabolism produced by the tumor

The wasting that occurs in some cancer clients is attributed to:

Administer antiemetic and analgesic drugs as needed

To maximize food intake when a cancer client suffers from nausea and vomiting, the nurse should:

phosphorus

Ventilator-dependent patients must have serum ____________ levels monitored closely because an acute drop of this element can cause respiratory failure.

increase bone fractures

Vitamin A supplements are increasingly being replaced with beta carotene because long term vitamin A supplementation is associated with

cachexia

Wasting of the body seen in some chronic diseases such as AIDS, cancer, malaria, and tuberculosis is called:

thiamin

Wernicke encephalopathy may be successfully treated with intravenous administration of _________ within 24 hours of hospital admission.

a. shrimp & lobster c. sweet tea and fruit punch d. baked liver and onions

Which foods would be RESTRICTED for a person who suffers with gout? a. shrimp & lobster b. rice and pasta c. sweet tea and fruit punch d. baked liver and onions

Butter, cheese sauce, and gravy

Which of the following food items act as lubricants for the person with swallowing difficulty?

Pasteurized eggnog

Which of the following foods is likely to be well received by a cancer client with mouth ulcerations?

IRT screen, DNA testing, sweat test

Which of the following is the correct order for identification of cystic fibrosis in newborns?

Dry skim milk

Which of the following items is suggested as an additive for a client with a poor appetite to increase the nutritional value of regular foods?

Vary supplement flavors to prevent taste fatigue.

Which of the following nursing interventions help cancer clients with anorexia maintain nutritional intake?

IBS occurs more frequently in men

Which of the following statements IS NOT characteristic of irritable bowel syndrome? a. IBS occurs more frequently in men b. IBS symptoms include constipation and diarrhea c. Patients with IBS rarely have symptoms while sleeping d. IBS is a benign condition that does no permanent damage to the intestines.

vitamin A

Which vitamin is thought to protect against cancer development because of its role in cell differentiation of epithelial tissue.