Nutrition Final

At the beginning of an acute episode of pancreatitis, the nutrition priority is to provide a. a clear liquid diet. b. jejunal enteral feedings. c. parenteral nutrition. d. intravenous fluids

intravenous fluids At the beginning of an acute episode of pancreatitis, the main priority is to keep patients hydrated. Depending on the length of the episode, patients may need enteral jejunal feedings. Patients may be able to progress to a clear liquid diet, but this would not be the first step. Parenteral feedings are not generally used because of impaired immune responses and bowel atrophy

Someone who may benefit from avoiding sugar-free chewing gum is a patient with a. peptic ulcer disease. b. gastroesophageal reflux disease. c. irritable bowel syndrome. d. celiac disease.

irritable bowel syndrome. Sugar-free chewing gum is usually sweetened with sorbitol or mannitol, which may exacerbate irritable bowel syndrome. PUD, GERD, and celiac disease are not generally affected by chewing gum or intake of sugar alcohols

If a patient has difficulty swallowing, the best position for eating is a. propped up in bed with a caregiver by the bedside. b. sitting upright opposite a caregiver. c. sitting at a dining table with social dining companions. d. lying on the left side, with a caregiver by the side

sitting upright opposite a caregiver. The safest eating position for someone who has trouble swallowing is sitting upright; the caregiver should sit opposite to help provide cues and reminders while the patient is eating. It is usually best for patients with dysphagia not to interact socially during mealtimes because talking may make swallowing more difficult. Sitting propped up in bed and leaning back would make it easier for food to enter the airway. Lying on one's side while eating is very likely to cause aspiration

If a patient has had a large portion of their small intestine removed because of cancer and is unable to maintain a stable weight, a feeding regimen that would be most appropriate is a. enteral feedings into the stomach. b. enteral feedings into the jejunum. c. parenteral nutrition only. d. supplemental parenteral nutrition

supplemental parenteral nutrition Patients who have undergone removal of large portions of the small intestine and are unable to maintain their weight should receive supplemental parenteral nutrition. Enteral feedings would not be more effective than oral feedings because these patients have a limited amount of gut to absorb the nutrients. Parenteral nutrition should not be used alone because some oral feeding helps stimulate recovery of gut function and maintain gut integrity.

Patients with inflammatory bowel disease may benefit from a high-fiber diet during a. acute episodes. b. times of remission. c. recovery from surgery. d. preparation for surgery

times of remission A high-fiber diet may help stimulate peristalsis during times of remission in patients with inflammatory bowel disease. During acute episodes, the diet should be low in fiber and should promote bowel rest. In general, the diet should be high calorie, high protein, and nutrient dense to compensate for malabsorption.

A bottle of beer that contains 13 g of carbohydrates and 16 g of alcohol provides _____ kcal. a. 116 b.155 c. 164 d. 203

164 Carbohydrate provides 4 kcal/g; alcohol provides 7 kcal/g. Therefore, this bottle of beer would provide 164 kcal ([13 x 4] + [16 x 7] = 52 + 112)

Calories per gram of ethanol

7 cal/gram

Calories per kilogram of fat

7700 calories

If a patient is infected with HCV, he or she may a. have consumed contaminated food or water. b. be co-infected with hepatitis B virus (HBV). c. have had sexual contact with an infected person. d. have recently gotten a tattoo.

HCV is associated with sharing contaminated needles or tattooing or piercing equipment. Hepatitis D virus (HDV) is the type of hepatitis that only occurs as a co-infection with HBV. Hepatitis A virus (HAV) and hepatitis E virus (HEV) are spread via contaminated food and water. HAV, HBV, and HDV are transmitted via sexual contact

Someone who drinks one glass of wine every night with dinner plus an occasional beer when watching a football game would be considered to be a. alcoholic. b. an alcohol addict. c. a moderate drinker. d. a heavy drinker

Someone who drinks one to two drinks per day is considered a moderate drinker. A heavy drinker consumes three or more drinks daily. Alcoholism (which is the condition of being an alcohol addict) is a disabling addictive dependence on alcohol, usually characterized by intake of significantly more than one to two drinks daily.

If a malnourished patient with cirrhosis of the liver seems to be vulnerable to development of hepatic encephalopathy, the best food to give them would be a. scrambled eggs. b. roast beef with gravy. c. a hamburger. d. a bean burrito.

a bean burrito Vegetable proteins produce less ammonia than do animal proteins, and so the bean burrito would be a good source of protein for a malnourished patient at risk for hepatic encephalopathy. Scrambled eggs, roast beef, and hamburgers all provide animal protein.

For patients with any kind of liver disease, the most important dietary modification is a. abstaining from alcohol. b. decreasing fat intake. c. increasing protein intake. d. avoiding dietary fructose

abstaining from alcohol. During treatment of any kind of liver disease, it is most important for patients to abstain from drinking alcoholic beverages. Increasing dietary protein may help with recovery, and decreasing fat intake may be generally beneficial as long as energy intake is adequate. Avoiding dietary fructose may be helpful to patients with fatty liver disease, but it is not the most important feature of therapy.

For patients who are infected with hepatitis and have a poor appetite, the best way to increase protein and energy intake would be a. adding peanut butter to toast, soups, or smoothies. b. tossing salads and pasta with olive oil. c. mixing powdered milk into mashed potatoes and soups. d. adding sugar to coffee and tea

adding peanut butter to toast, soups, or smoothies. Peanut butter adds both energy and protein without adding a lot of volume. Olive oil and sugar add only energy, and powdered milk adds protein but relatively little energy

Treatment of diarrhea generally begins with a. a high-fiber, low-fat diet. b. removal of the cause of diarrhea. c. adequate fluids to hydrate the patient. d. a low-fat, low-fiber, or low-lactose diet.

adequate fluids to hydrate the patient. The primary concern in treatment of diarrhea is provision of adequate fluids to hydrate the patient. After taking fluids, affected patients may progress to a low-fat, low-fiber, or low-lactose diet and then to a regular diet as tolerated. If possible, the cause of diarrhea may be removed, but this is not always possible and is not the first priority. A high-fiber, low-fat diet may be beneficial once the diarrhea has resolved.

If an otherwise healthy patient with normal body weight develops fatty liver disease, it would be especially important to evaluate their a. blood glucose level. b. alcohol intake. c. total fat intake. d.use of nonsteroidal anti-inflammatory drugs (NSAIDs).

alcohol intake Fatty liver disease can also be associated with diabetes, and so blood glucose level may also be somewhat relevant. A high fat intake may exacerbate but would not cause fatty liver disease. Use of NSAIDs does not cause fatty liver disease

If a patient has esophagitis and also has worn tooth enamel, he or she may have a. a hiatal hernia. b. fluoride deficiency. c. an eating disorder. d. gastroesophageal reflux disease

an eating disorder The eating disorder bulimia nervosa causes esophagitis and eroded tooth enamel because of the effects of stomach acid being vomited back into the esophagus and mouth. A hiatal hernia and GERD may cause esophagitis, but stomach contents would enter only the esophagus, not the mouth, and so the teeth would not be worn. Fluoride deficiency may cause loss of tooth enamel but would not cause esophagitis

Fluid loss is most likely to be a problem for a patient with a. a colostomy. b. a hiatal hernia. c. an ileostomy. d. Crohn's disease.

an ileostomy Fluid loss is most likely to be a problem for a patient with an ileostomy because food exits the intestines before water is absorbed in the colon. A colostomy may cause some fluid loss, depending on where the colostomy is located and how much of the colon the intestinal contents pass through for fluid absorption. A hiatal hernia does not cause fluid loss. Crohn's disease may cause some fluid loss during acute periods of inflammation because of malabsorption.

For patients with inflammatory bowel disease, nutrition therapy is a. the primary mode of treatment. b. rarely necessary. c. an important adjunct to drugs and surgery. d. highly specialized.

an important adjunct to drugs and surgery Nutrition therapy is important to help maintain nutritional status of patients with inflammatory bowel disease, but is used in conjunction with drug and surgical treatments; it is not the primary mode of treatment. Nutrition therapy is often needed to maintain weight and micronutrient status. Awareness of deficiencies that occur in these patients is important, but the RD does not need specialized knowledge to work with patients with IBD.

A patient with end-stage liver disease may lose fat stores and muscle mass, but this may not be evident from measurements of body weight because of a. dehydration. b. fat redistribution. c. ascites and edema. d. electrolyte imbalances.

ascites and edema. Many patients with end-stage liver disease accumulate fluid, manifested as ascites and edema. This increases body weight, which may mask fat and muscle losses. Patients with end-stage liver disease are not usually dehydrated and do not usually have electrolyte imbalances. Fat infiltrates the liver but is not otherwise redistributed in the body.

The most helpful recommendation for a client who often experiences heartburn at night would be to a. avoid eating within 4 hours of going to bed. b. increase the fiber content of the diet. c. decrease the fiber content of the diet. d. take antacid medications before going to bed.

avoid eating within 4 hours of going to bed. Gastroesophageal reflux disease (GERD) usually occurs 1 to 4 hours after eating; therefore, waiting at least 4 hours after eating before going to bed would help prevent heartburn at night. Antacid medications may be helpful but should not be used on a regular basis before other strategies have been tried. Fiber content of the diet does not affect heartburn

The most beneficial dietary change for a patient with cholelithiasis and cholecystitis would be to a. avoid fried foods and creamy sauces. b. abstain from drinking alcohol. c. refrain from eating 4 hours before bedtime. d. avoid eggs, shrimp, and high-cholesterol foods.

avoid fried foods and creamy sauces. A low-fat diet is used to treat painful symptoms associated with cholelithiasis and cholecystitis. Avoiding alcohol and following a low-cholesterol diet do not alleviate symptoms. Avoiding alcohol is indicated for diseases of the liver, not the gallbladder. Even though gallstones contain cholesterol derivatives, most cholesterol is made by the body and is not dietary. Refraining from eating 4 hours before bedtime would help prevent pain caused by heartburn but not that caused by gallstones

A good meal for a patient with ascites would be a. canned minestrone soup with saltine crackers. b. baked chicken with a roll and steamed green beans. c. bacon, sausage, eggs, and toast. d. tortilla chips with nacho cheese and salsa

baked chicken with a roll and steamed green beans. Patients with ascites should restrict their intake of sodium to limit fluid retention. Baked chicken, a roll, and steamed vegetables have low levels of sodium. Canned soups, cured meats, processed cheese, and chips have high levels of sodium

An example of a high-fiber food item to include with lunch is a. pasta with tomato sauce and Parmesan cheese. b. beef tacos with lettuce and tomatoes. c. an omelet with mushrooms and onions. d. black bean soup

black bean soup Beans such as black beans have especially high amounts of fiber. Tomatoes, lettuce, mushrooms, onions, and white pasta have lower amounts of dietary fiber. Cheese, beef, and eggs contain no dietary fiber

Cholecystitis is caused by a. blockage of the bile duct by gallstones, bacterial infection, or ischemia. b. concentration of bile in the gallbladder that favors formation of gallstones. c. failure of the gallbladder to contract and release bile into the small intestine. d. intake of excessive amounts of cholesterol and fat, in combination with bacterial infection.

blockage of the bile duct by gallstones, bacterial infection, or ischemia. Cholecystitis occurs when gallstones block the cystic duct or as the result of stasis, bacterial infection, or ischemia of the gallbladder. Concentration of bile in the gallbladder causes cholelithiasis, or formation of gallstones. Failure of the gallbladder to contract and release bile may lead to gallstone formation; this may be caused by very low fat intake or dieting. Neither intake of excessive amounts of cholesterol and fat nor bacterial infection is associated with gallbladder disease

If a client complains of excessive gas, a good question to ask is whether he or she a. drinks coffee and tea. b. has problems with constipation. c. chews gum. d. is under a lot of stress

chews gum Excessive gas may be caused by swallowing air while chewing gum. Drinking coffee and tea, stress, and constipation do not usually cause excess gas formation.

For a patient with dysphagia, the food that would be most difficult to swallow is a. applesauce. b. mashed potatoes. c. chocolate pudding. d. chicken noodle soup

chicken noodle soup Patients with dysphagia often have difficulty swallowing thin liquids, such as chicken noodle soup. Thicker, pureed foods such as applesauce, mashed potatoes, and chocolate pudding are usually easier to swallow

A patient with lactose intolerance would be most likely to experience symptoms if he or she ate a a. cup of pudding. b. turkey sandwich with Swiss cheese. c. biscuit with butter and honey. d. cup of sherbet.

cup of pudding A cup of pudding would contain a cup of milk; most individuals with lactose intolerance can only tolerate 1/2 to 3/4 cup milk at one time. Sherbet, Swiss cheese, biscuits, and butter all have low levels of lactose

The most acute risk for patients with dysphagia is a. constipation. b. dehydration. c. dry mouth. d. panic attacks.

dehydration An acute daily concern for patients with dysphagia is dehydration. Patients are not usually allowed to drink fluids without supervision, and so fluid intake must be monitored throughout the day. Constipation and dry mouth may occur with poor fluid and food intake but are less acute. Patients with dysphagia may experience feelings of panic, but this is not the most acute concern

If a patient with end-stage liver disease gains 5 lb in 1 week, the most likely explanation is a. development of ascites. b. restoration of muscle mass. c. high energy intake. d. edema in the extremities.

development of ascites. In a patient with end-stage liver disease, sudden weight gain is usually a sign of ascites. Muscle mass would not be restored this quickly, even with plenty of exercise and good nutritional intake. Energy intake high enough to produce this much weight gain is unlikely because patients with liver disease often have poor appetite. Edema in the extremities is more common with congestive heart failure

If a person has no history of liver disease but does have a strong family history of cardiovascular disease, the person may help decrease the overall risk for chronic disease by a. following a lacto-ovo vegetarian diet. b. avoiding use of NSAIDs. c. abstaining from drinking any alcoholic beverages. d. drinking one or two servings of alcoholic beverages daily

drinking one or two servings of alcoholic beverages daily Moderate alcohol intake may help reduce risk of heart disease and is acceptable for people without any history of or risk factors for liver disease. Abstaining from drinking alcohol would not increase cardiovascular risk, but it also would not decrease risk. NSAIDs do not affect cardiovascular risk. Following a lacto-ovo vegetarian diet may increase cardiovascular risk if it includes large quantities of eggs and high-fat dairy products such as cheese.

If a patient who has undergone gastric bypass surgery for treatment of extreme obesity experiences sudden sweating, nausea, and stomach cramps after meals, the patient may have a. gastroesophageal reflux. b. pancreatitis. c. peptic ulcer disease. d. dumping syndrome.

dumping syndrome Patients who have undergone gastric bypass may experience dumping syndrome as a large volume of hyperosmolar food is dumped into the small intestine because the stomach reservoir is missing or too small. GERD and peptic ulcers are not necessarily more common after gastrectomy. Pancreatitis causes extreme pain and vomiting but is not related to gastric bypass

If a patient with multiple sclerosis starts coughing frequently during meals and starts to eat significantly less food than normal, the patient may have a. pneumonia. b. gastroesophageal reflux disease. c. peptic ulcer. d. dysphagia.

dysphagia Patients with multiple sclerosis may develop dysphagia; coughing during meals and eating less than usual are common symptoms. Dysphagia may cause pneumonia if food enters the lungs and causes infection. Gastroesophageal reflux disease causes burning and pain but typically not coughing. Peptic ulcer causes intestinal pain but not coughing

After surgical removal of the gallbladder (cholecystectomy), the nurse should counsel patients to a. follow a low-fat, low-cholesterol diet. b. ensure high intake of protein and fluid. c. eat a well-balanced diet as tolerated. d. avoid snacking between meals.

eat a well-balanced diet as tolerated. After cholecystectomy, long-term dietary restrictions are not needed. Some patients need to restrict fat intake for a few weeks during recovery, but not for the long term. High intake of protein and fluid is not needed. Including nutritious snacks may be helpful during recovery

If a client will be visiting an area where hepatitis E virus (HEV) is endemic, the best way to prevent becoming infected is to a. eat only cooked fruits and vegetables and drink only commercially bottled water. b. eat only at internationally recognized establishments. c. obtain a vaccination before entering that area. d. avoid all types of dairy products.

eat only cooked fruits and vegetables and drink only commercially bottled water. HEV is transmitted via the fecal-oral route, so avoiding raw fruits, raw vegetables, and potentially contaminated water helps prevent infection. Even internationally recognized establishments may employ infected food workers. Dairy products are less common sources of HEV. A vaccination for HEV is not available.

The best way to prevent formation of diverticula in the colon is to a. eat plenty of fruits, vegetables, and whole grains. b. avoid foods with rough hulls, such as nuts and seeds. c. use stool softeners to promote daily bowel movements. d. avoid foods that cause gas and increase pressure in the colon.

eat plenty of fruits, vegetables, and whole grains. Diverticula are caused by high pressure in the colon, often in association with straining to have a bowel movement; they can be prevented by intake of high-fiber foods, such as fruits, vegetables, and whole grains. There is no evidence that nuts, seeds, or other foods with hulls increase risk of diverticula. Using stool softeners to promote daily bowel movements may help prevent diverticula, but eating a high-fiber diet is preferable because of other nutritional benefits. Foods that cause gas are not associated with formation of diverticula.

If a patient receiving chemotherapy is struggling with nausea and vomiting, helpful suggestions may include a. drinking acidic fruit juices to stimulate gastric juices. b. being active before and after meals to improve appetite. c. eating frequent small meals throughout the day. d. eating foods with plenty of flavor and aroma

eating frequent small meals throughout the day. Patients receiving chemotherapy who have nausea and vomiting are most likely to maintain adequate nutritional intake if they eat several small meals throughout the day. Rest before and after meals is more likely than activity to help control nausea. Acidic fruit juices may increase feelings of nausea. Bland foods are likely to be better tolerated than flavorful and aromatic foods.

An example of a daily change that may help decrease constipation is a. drinking tomato juice instead of carbonated beverages with lunch. b. eating oatmeal and raisins instead of a bagel for breakfast. c. snacking on pretzels instead of potato chips. d. eating mashed potatoes instead of pasta with dinner.

eating oatmeal and raisins instead of a bagel for breakfast. Increasing intake of dietary fiber helps prevent constipation; oatmeal and raisins have significantly higher levels of fiber than does a bagel. In fruit and vegetable juices, most of the fiber is removed during the juicing process; drinking vegetable juice would add nutrients but not fiber. Pretzels have less fat than potato chips, but both have low amounts of fiber. Mashed potatoes contain only slightly more fiber than does pasta.

A possible cause of acute diarrhea is a. short bowel syndrome. b. lactose intolerance. c. emotional stress. d. celiac disease

emotional stress Acute diarrhea may be caused by enteritis, medications, dietary changes, or emotional stress. Short bowel syndrome, lactose intolerance, and celiac disease may cause chronic diarrhea by causing various types of malabsorption

If a patient with cirrhosis of the liver has a "soft" diet order, he or she probably has a. lethargy. b. cholelithiasis. c. esophageal varices. d. hepatic encephalopathy.

esophageal varices. A low-fiber, soft diet is recommended for patients with esophageal varices because fibrous or abrasive foods could cause potentially life-threatening bleeding. Patients with cholelithiasis should follow a low-fat diet; patients with hepatic encephalopathy should restrict their protein intake. Lethargy associated with liver disorders may make a soft diet easier to eat, but this would not be the reason for the diet order

In consuming a high-fiber diet, it is important to also consume adequate amounts of a. fluid. b. calcium and iron. c. fat-soluble vitamins. d. complex carbohydrate

fluid It is important to consume adequate fluid along with a high-fiber diet to prevent fecal impaction. High-fiber diets generally have high levels of complex carbohydrates. Slightly more calcium and iron may be needed because fiber may decrease the bioavailability of these nutrients. However, diets high in fiber tend to have higher amounts of nutrients in general. Requirements for fat-soluble vitamins are not generally affected by fiber intake.

An individual may be at risk for HEV infection if they travel to India and eat a. curried shrimp. b. fresh fruit salad. c. Tandoori chicken. d.cooked foods from street vendors.

fresh fruit salad

An example of a meal that is likely to relax the lower esophageal sphincter and allow gastroesophageal reflux is a. pasta with marinara sauce and sourdough bread. b. ham with rice pilaf. c. fried chicken and pasta salad. d. chicken and spinach tortilla wrap and salsa

fried chicken and pasta salad High-fat foods and beverages relax the lower esophageal sphincter (allowing stomach contents to back up). Both fried chicken and pasta salad are high in fat and would exacerbate gastroesophageal reflux. The other meals are relatively low in fat and would be much less likely to cause reflux.

For patients with ostomies, a lower amount of output occurs a. if the ostomy is closer to the rectum. b. if the ostomy is further from the rectum. c. with high fiber intake. d. with high fat intake.

if the ostomy is closer to the rectum. As effluent progresses through the colon, water is absorbed, and the effluent becomes more solid; therefore, an ostomy closer to the rectum would have a smaller volume. Fiber intake may increase output slightly, but less so than the site of the ostomy; fat intake does not significantly affect the amount of output

As a patient who has undergone liver transplantation heals, a necessary transition is a. increasing protein intake to replace pretransplantation losses. b. restricting fluid and sodium intakes to prevent ascites. c. generally eating less to avoid weight gain and chronic disease. d. generally eating more to maintain body weight and muscle mass.

generally eating less to avoid weight gain and chronic disease. Patients who have undergone liver transplantation require extra energy and protein during recovery, but in the long term they should generally eat less to avoid excessive weight gain, hypertension, hyperlipidemia, and diabetes. After healing is complete, their protein needs are similar to those of other healthy adults. Sodium intake should be moderate, but fluid restriction is unnecessary; ascites is unlikely to occur as long as the new liver is functioning well

An appropriate meal for someone with dumping syndrome would be a. a small vanilla milkshake. b. cream of mushroom soup. c. half a turkey sandwich. d. popcorn and sugar-free soda.

half a turkey sandwich Individual tolerances vary, but the turkey half-sandwich would probably be tolerated best. Half a sandwich is probably small enough not to cause symptoms. A milkshake is high in sugar and probably too cold. Cream of mushroom soup is probably too hot, and liquids should be taken between rather than with meals. The carbonation in the soda may increase gastrointestinal distention because of gas

f a patient with cirrhosis of the liver is treated with lactulose and neomycin, he or she probably has a. a secondary infection. b. ascites. c. esophageal varices. d. hepatic encephalopathy

hepatic encephalopathy Neomycin is an antibiotic used to sterilize the bowel to decrease the amount of urea that can be converted to ammonia, and lactulose is used to lower stool pH, which traps ammonia in the colon; these two drugs are used to decrease ammonia levels in hepatic encephalopathy. Esophageal varices are not treated with medications. Ascites is treated with sodium restriction. Secondary infections may be treated with neomycin but not with lactulose

If a patient with cirrhosis of the liver becomes confused and apathetic, he or she may be developing a. fatty liver disease. b. hepatitis D. c. secondary depression. d. hepatic encephalopathy.

hepatic encephalopathy. If a patient with cirrhosis of the liver becomes confused and apathetic, he or she may be developing hepatic encephalopathy because the brain is influenced by compounds that have been absorbed from the intestine and have not been metabolized by the liver. Fatty liver disease develops first, before progression to cirrhosis. Any form of hepatitis can lead to cirrhosis, but cirrhosis does not cause hepatitis. Depression may cause apathy, but it does not usually cause confusion

If a nurse is beginning an enteral feedings for a patient with pancreatitis, the only appropriate type of formula is a. modular. b. hydrolyzed. c.intact. d. hypercaloric

hydrolyzed For patients with pancreatitis, formula must be hydrolyzed or elemental so that it does not require digestion and stimulate the pancreas. It is infused after most digestion takes place in the intestines and thus needs to be ready for absorption. Modular, intact, and hypercaloric formulas would stimulate the pancreas to produce digestive enzymes and this would cause great pain in a patient with pancreatitis

A symptom that is common to all types of hepatitis is a. jaundice. b. headache. c. dehydration. d. muscle aches.

jaundice All types of hepatitis cause jaundice. HEV causes flulike aches and pains, including headache. Dehydration may occur if patients have nausea and vomiting

Peptic ulcer disease (PUD) would be most like to occur in someone who uses medication to treat a. gastroesophageal reflux disease. b. constipation. c. celiac disease. d. joint pain or arthritis

joint pain or arthritis Risk of PUD increases with chronic use of nonsteroidal anti-inflammatory drugs (NSAIDs), often used to treat joint pain or arthritis. Use of antacids to treat GERD would decrease risk of PUD. Laxatives and stool softeners used to treat constipation do not affect risk of PUD. Celiac disease is treated by avoiding dietary sources of gluten, not with medications

Milk may be made suitable for patients with lactose intolerance by treating it with tablets that contain a. yogurt. b. lactase enzyme. c. vitamin D and calcium. d. Lactobacillus acidophilus.

lactase enzyme Lactase enzyme tables may be added to milk 24 hours before it is drunk to digest the lactose; this makes the milk suitable for patients with lactose intolerance. Lactobacillus acidophilus and yogurt are not necessarily better tolerated than regular milk. Vitamin D and calcium do not affect lactose intolerance, although patients with lactose intolerance may benefit from supplements of these nutrients if their intake is low because they avoid milk.

If an obese postmenopausal woman who does not drink alcohol develops fatty liver disease and wants to avoid progression to cirrhosis or liver cancer, the best recommendation is to a. decrease intake of saturated fats. b. decrease intake of carbohydrate. c. lose 3 to 4 lb per week. d. lose 1 to 2 lb per week.

lose 1 to 2 pounds per week For an obese woman, gradual weight loss, 1 to 2 lb per week, probably helps reverse fatty liver disease and prevents progression. More rapid weight loss may exacerbate fatty liver disease and would result in loss of muscle tissue, as well as body fat. Decreasing intake of fructose may be helpful, but a general decrease in carbohydrate intake is not necessarily recommended other than to reduce energy intake. A decrease in total fat intake may be helpful and may help decrease energy intake, but a specific decrease in saturated fat intake is not warranted for this condition

The most significant nutritional concern for a patient with an ileostomy is a. fat malabsorption and steatorrhea. b. dumping syndrome. c. loss of fluid and electrolytes. d. malabsorption of protein and carbohydrates.

loss of fluid and electrolytes For a patient with an ileostomy, digestive output exits the body instead of passing through the colon, the major site of absorption of water and electrolytes. Digestion and absorption of protein, carbohydrate, and fat are not usually affected. Dumping syndrome is caused by a partial or total gastrectomy

For patients with hepatitis, an important way to minimize loss of muscle mass is to a. participate in daily aerobic exercise. b. participate in daily strength exercise. c. maintain an adequate protein intake. d. maintain an adequate micronutrient intake

maintain an adequate protein intake. Adequate protein intake does not prevent loss of muscle mass but does help minimize it. Patients with hepatitis need to rest to promote recovery and healing; their bodies cannot handle the stress of exercise. Maintaining adequate intake of micronutrients is important but does not specifically help maintain muscle mass

After liver transplantation, long-term nutrition recommendations most closely resemble those for patients with a. hepatitis. b. gallstones. c. ulcer disease. d. metabolic syndrome

metabolic syndrome Long-term nutrition management after liver transplantation needs to be tailored to help prevent excessive weight gain, hypertension, and hyperlipidemia; recommendations would be most similar to those for patients with metabolic syndrome. Patients with hepatitis usually need to be encouraged to eat more; those with gallstones need to decrease total fat intake, and peptic ulcer disease is mostly managed with drug therapy and stress reduction.

An example of an individual who may be at high risk for gallstones is a(n) a. underweight woman who runs 3 miles four times a week. b. overweight man who smokes and has a sedentary job. c. overweight man who has recently begun an exercise program. d. mother with four children who has lost 25 pounds in the past 3 months

mother with four children who has lost 25 pounds in the past 3 months Rapid weight loss increases risk for gallstones, and so a mother who has lost 25 pounds in the past 3 months could easily develop gallstones. Underweight, regular exercise, smoking, and eating eggs do not increase risk for gallstones. Overweight increases risk for gallstones, but less than rapid weight loss

The person at greatest risk for developing cirrhosis or liver cancer is a(n) a. young woman who drinks a glass of wine every day. b. young man who travels extensively to tropical countries. c. middle-aged overweight man with gallstones. d. older adult infected with hepatitis C virus (HCV)

older adult infected with hepatitis C virus (HCV) Infection with HCV often progresses to cirrhosis or liver cancer; the progression is more rapid in older adults. For a woman, drinking less than 2 drinks a day should not cause liver damage. Traveling to tropical countries does not necessarily increase risk for cirrhosis or liver cancer as long as appropriate precautions are taken to prevent hepatitis infection. Gallstones are not related to liver cancer or cirrhosis.

Nutrition therapy for peptic ulcers should be individualized, depending on a. type of drug treatment. b. location of the ulcer. c. patient tolerance. d. the cause of the ulcer

patient tolerance There are no specific dietary recommendations for treatment of peptic ulcer, and so foods eaten depend on the patient's symptoms and tolerance. The type of drug treatment and location of the ulcer do not significantly affect food tolerance. Factors that contribute to formation of peptic ulcers are mostly nonnutritional (stress, skipping meals, chronic use of use of NSAIDs), and so dietary intake is not a significant factor in treatment

The only appropriate diet order for a patient with pancreatitis is to begin feedings via a. nasogastric tube. b. percutaneous endoscopic gastrostomy (PEG) tube. c. nasoduodenal tube. d. percutaneous endoscopic gastrojejunostomy

percutaneous endoscopic gastrojejunostomy Enteral feedings for patients with pancreatitis should be infused into the jejunum below the ligament of Treitz to decrease pancreatic stimulation. Infusion into the stomach or duodenum would stimulate the pancreas and greatly increase pain

In treating patients with hepatitis, it is important for nurses to help patients cope with the challenge of a. difficulty sleeping. b. poor appetite. c. fat restriction. d. fluid restrictions.

poor appetite For patients with hepatitis, poor appetite makes it difficult to maintain adequate nutritional intake. Fluids are generally encouraged rather than restricted, especially to replace losses from vomiting or diarrhea. Fat intake does not need to be restricted unless not tolerated. Patients are usually very tired and would rather sleep than eat.

Because patients with active Crohn's disease have intestinal inflammation, they benefit from high intake of a. fat. b. dietary fiber. c. simple sugars. d. protein

protein Patients with inflammatory bowel disease benefit from a diet high in protein to compensate for malabsorption. Fat intake should be moderate to provide adequate kilocalories within a healthful diet; high fat intake may cause steatorrhea. Dietary fiber may irritate the inflamed gut. Simple sugars provide a readily digested and absorbed source of energy but no other nutrients

An example of a meal that may contain gluten is a. baked chicken breast with herbed rice. b. pork chop with sweet potatoes and butter. c. grilled steak with baked potato and sour cream. d. roast beef with mashed potatoes and gravy.

roast beef with mashed potatoes and gravy. Gravy is often made with wheat flour, which contains gluten. Rice, potatoes, and sweet potatoes do not contain gluten. Baked chicken, pork chops, and grilled steak do not contain gluten unless they are breaded or coated with wheat flour before being cooked