nutrition final Quiz questions

True or false? Clients with Cystic Fibrosis are at risk for malnutrition due to decreased mucus production.

F The buildup of mucus in the pancreas can stop the absorption of food and key nutrients, resulting in malnutrition and poor growth.

T/F Ulcerative colitis tends to affect both the small and large intestines.

F UC is an inflammatory process confined to the mucosa of any or all the large intestine/colon. You can remember the location of ulcerative colitis since colitis contains the root of the word "colon".

True or false? Nutrition therapy for an obese client should eliminate carbohydrates to promote faster weight loss.

False Response Feedback: It is best to recommend a dietary approach in which calorie restriction includes all food groups. Carbohydrates should not be eliminated to promote faster weight loss.

t/f clients diagnosed with HIV usually have a life expectancy of five years after diagnosis.

False Response Feedback: The use of combination antiretroviral therapy (ART) has dramatically decreased the morbidity and mortality from HIV. Most people with HIV now die from noninfectious causes such as CVD, non-AIDS-related cancers, and kidney disease. People with HIV can live for decades in the clinical latency stage of HIV.

Select all the non-modifiable risk factors for hypertension (HTN). a. Ethnicity b. Age c. Physical inactivity d. Gender e. Sodium intake f. Genetics

a, d, f, b Genetics, gender, age, and ethnicity cannot be modified to decrease risk factors for HTN. Sodium intake can be lowered and physical activity can be increased.

True or false? Priority nutrition concerns for a client with Parkinson's Disease include malnutrition and constipation.

T Diet is of major importance with PD because malnutrition and constipation can be serious consequences of inadequate nutrition. The diet should contain adequate fiber and water to avoid constipation. As swallowing becomes more difficult, dysphagia may result. The patient may have a decreased or absent gag reflex. Nutrition may be impaired due to the inability to ingest food.

t/f Dumping is a common complication after gastric surgery.

True Dumping is a common complication after gastric surgery. The stomach controls the rate of gastric emptying of nutrients into the small intestine, and after surgery, this control is lacking. The stomach empties according to signals from the stomach and duodenum.

What is the single most effective means to lowering blood pressure? a. Weight loss b. Eating more fish c. Medications d. Increasing calcium intake

a

For which of the following situations is a pureed diet most appropriate? a. For clients who have their jaw wired shut b. For clients who need a low-fiber diet c. As a transition between a full liquid diet and a regular diet d. As an initial oral diet after surgery to establish tolerance

a A pureed diet is most appropriate for a client with the jaw wired shut since this client would not be able to chew. A pureed diet is not a transition diet. A clear liquid diet would be appropriate initially after surgery. A client in need of a low-fiber diet would not need their foods pureed.

Which macronutrient produces the greatest amount of carbon dioxide during metabolism and therefore should be consumed in moderation in a client with COPD? a. Carbohydrates b. Vitamins c. Proteins d. Fats

a Carbohydrate metabolism produces the greatest amount of CO2 and has the highest RQ. Fat has the least RQ. It's important to provide adequate nutrition without overfeeding the COPD patient. Patients with COPD have high energy demands due to the work required for them to simply breathe. These patients have a high risk of malnutrition.

Which of the following is NOT a microvascular complication of Diabetes resulting from consistently elevated blood glucose levels? a. Coronary artery disease b. Neuropathy c. Retinopathy d. Nephropathy

a Consistently elevated BG levels damage the tiny vessels (microvessels) in the eyes, kidneys, and extremities. Retinopathy is the leading cause of blindness in the US. Nephrophathy can lead to irreversible kidney damage. Neuropathy affects peripheral circulation and causes decreased sensation in extremities. It is a major contributor to foot and leg amputations. DM2 increases a person's risk of coronary artery disease, but these vessels are larger and called macrovascular vessels.

Which suggestion by the nurse would be appropriate for the client experiencing lactose intolerance? a. Try eating dairy products with other foods to decrease symptoms b. You shouldn't be at risk for nutrient deficiencies c. Milk has the lowest amount of lactose d. You will never be able to drink milk again

a Consuming lactose with other foods may help avoid symptoms. Avoiding milk products can lead to calcium, riboflavin, and Vit D deficiencies. A lactose-free diet is given initially and may be gradually advanced to a low-lactose diet as tolerated by the patient. Most people can tolerate a small amount of lactose at a given time and not experience symptoms. Dairy products all contain lactose, but processing reduces the lactose in some products.

Clients must meet certain criteria before they can be approved for bariatric surgery. Select the client who would NOT be a candidate for this surgery. a. Newly pregnant, BMI of 38 b. BMI of 37 with hypertension c. BMI of 41 d. Failure to lose weight after multiple attempts

a Criteria that would exclude a patient from having bariatric surgery includes endocrine or other disorders that would resolve obesity if treated, current alcohol or drug use, uncontrolled, severe psychiatric illness, and pregnancy. All other clients in question are candidates for bariatric surgery.

Select the lab result most likely to result in a diagnosis of Diabetes Type 2. a. HgbA1C of 7.0 b. Capillary blood glucose of 125 c. Oral glucose tolerance test of 175 d. Fasting blood glucose of 65

a Diagnosis of DM2 happens with an elevated fasting blood glucose value >126, if found on at least two occasions, or hyperglycemia; hemoglobin A1C (HgbA1C) of 6.5 or above; or oral glucose tolerance test >200.

Which suggestion by the nurse would help a client who is experiencing altered taste following chemotherapy treatment? a. Tart or spicy foods may enhance your intake b. Avoid highly seasoned foods c. Cook foods thoroughly for food safety d. Eat crackers before getting out of bed in the morning

a Eating foods that are tart or spicy may enhance intake when taste is altered. Clients should use seasonings to help with flavors.

What is the preferred oral feeding position for a client who has trouble swallowing? a. High Fowler's b. Supine c. Trendelenberg d. Semi-Fowler's

a For trouble swallowing, position the client in high Fowler's, preferably in a chair (or head of bed as high as possible) with the head flexed forward, for the feeding and for 30 minutes afterward to help prevent aspiration.

Which of the following is NOT a priority during mealtime for a client with dysphagia? a. Including dessert b. Supervision c. Sitting upright d. Amount and consistency of liquids

a Meals must be supervised to prevent swallowing problems. The patient should sit upright, or head of the bed should be raised to provide support. Tuck chin and tilt head forward. The upright position allows gravity to assist with the passage of food along the esophagus and helps prevent choking and aspiration.The amount and consistency of liquids is individualized for the patient based on his/her level of swallowing difficulty. Including dessert is not a priority concern for a client with dysphagia.

Surgery is often a treatment for cancer. Extra protein is needed after surgery to promote a. Wound healing b. Respiratory health c. GI function d. Musculoskeletal function

a Nutritional requirements increase for calories and protein postop to replenish losses and promote healing. Vit C, B vitamins, and iron are needed as well.

The nurse knows that patient teaching was effective when the client with GERD states which of the following phrases? a. "I may experience symptoms of GERD 1-4 hours after I eat." b. "GERD can't cause any long term health problems." c. "Since obesity doesn't contribute to my GERD, it's not important for me to lose weight." d. "My diet must have caused my GERD."

a Reflux from GERD usually happens 1-4 hours after a meal. Diet does not cause GERD, but food can aggravate symptoms. Losing weight may help decrease symptoms of GERD. Chronic, untreated GERD may cause esophagitis, esophageal ulcers with bleeding, esophageal stricture, dysphagia, pulmonary disease, Barrett's esophagus (precancerous lesion), and esophageal cancer.

Diabetes management in the elderly population can be especially challenging for many reasons. Select the answer that does NOT contribute to this issue. a. Living in a retirement home may increase social activity b. Physical ailments may prevent activity c. Poor dentition may place the elderly at risk nutritionally d. Depression may decrease their willingness to be involved in their care

a Response Feedback: Living in a retirement home can increase social activity for an older person which can help with depression but does not contribute to problems with diabetes management.

What is the most priority concern for a client experiencing dysphagia after a stroke? a. Risk for aspiration pneumonia b. Liquids may need to be thickened c. Meals may be unappealing d. Meals will need to be supervised

a Risk for aspiration pneumonia is high after stroke because of impaired consciousness or dysphagia. Dysphagia after stroke is common. The other answers are concerns, but not priority. Airway obstruction can occur because of problems with chewing and swallowing, food pocketing, and the tongue falling back.

clients who have undergone a traumatic injury have nutrition needs that are a. Higher than normal b. Lower than normal c. The same as before the injury

a The more severe the trauma or injury, the greater the release of catecholamines (norepinephrine and epinephrine) and cortisol, and the greater the hypermetabolic response. Therefore, nutrition needs are higher than normal.

he nursing assessment of an obese client should include all of the following except: a. Judgments about why the client is obese b. Physical exam c. Assessment of comorbidities d. Laboratory tests

a The nursing assessment of an obese client should be sensitive and nonjudgmental in asking specific and leading questions about weight, diet, and exercise.

Which of the following should be monitored by the nurse at least daily while a client is receiving parenteral nutrition (PN)? a. Blood glucose b. Weight c. Intake & output d. Hemoglobin A1C e. Potassium level

a, b, c, e Vital signs and temperature should be performed every 8 hours. Weights, intake and output, and lab work (including potassium and blood glucose) should be done daily. A HgbA1C measures BG control over three months, and would not be part of daily PN monitoring.

Nausea is a side effect of many cancer treatments. Which suggestions below are appropriate for a client experiencing nausea and/or vomiting after chemotherapy? Select all that apply. a. Try bananas and applesauce to calm your stomach b. Sip on fluids throughout the day c. Fat will help you feel less nauseated d. Eat small, frequent meals e. Add spices to your food to help it taste better

a, b, d to relieve nausea and/or vomiting, eat small, frequent meals. Increase fluids but slowly sip throughout the day, not at mealtime. Avoid fatty foods, strong odors and spicy foods. Try the BRAT diet: bananas, rice, applesauce, and toast.

The client with dumping syndrome is at risk for which complications? Select all that apply. a. Fatty stools b. Iron deficiency anemia c. Weight gain d. Cancer e. Bone disease

a, b, e The client with dumping is at risk for bone disease since calcium is normally absorbed in the duodenum and malabsorption can occur if it is bypassed or the transit time is too rapid. Fat malabsorption causes calcium and Vit D to be malabsorbed. Iron deficiency anemia can result due to decreased food intake. Steatorrhea (excess fat in the stools) can happen due to fat not being exposed to digestive enzymes. Cancer is not a risk factor of dumping syndrome, and clients usually lose weight instead of gaining it.

The chronic nature of HIV presents long-term nutrition challenges. Which problems below are often experienced by a client with HIV? Select all that apply. a. Muscle wasting b. Excess fluid (edema) c. Malnutrition d. Oral infections

a, c, d Any infection challenges nutritional status, and the chronic nature of HIV infection intensifies the challenge. Malnutrition and wasting create a vicious cycle that can be fatal. Oral infections may result in impaired intake and can cause pain, dysphagia, or altered taste. Excess fluid is not usually a concern with HIV since dehydration may result from diarrhea or malabsorption.

he nurse is giving discharge instructions to a client with a new colostomy. Which statements by the nurse are appropriate? Select all that apply. a. You'll want to avoid carbonated drinks and straws b. A high fat diet will help reduce diarrhea c. You can reduce odor from your colostomy by eating yogurt d. Rice may help thicken your stool e. A food schedule is not important. Eat whenever you are hungry.

a, c, d Foods that can thicken stool include applesauce, bananas, cheese, pasta, potatoes, rice, yogurt, and white bread. Avoid foods that cause diarrhea such as acidic, spicy, high fat and greasy, high sugar foods. Avoid practices that may contribute to swallowed air and gas formation such as chewing gum, using a straw, carbonated drinks, smoking, chewing tobacco, and eating quickly. Eat meals on a schedule to promote a regular bowel pattern. Foods than can decrease odor include buttermilk, parsley, yogurt, kefir, and cranberry juice.

The nurse is giving discharge instructions to a client diagnosed with GERD. Which suggestions should he/she include? Select all that apply. a. It is best not to lie down for three hours after eating b. High fat meals will help with excess stomach acid c. Losing weight may help control your symptoms d. You may no longer tolerate spicy foods e. Eating three large meals a day will help with symptoms

a, c, d Small, frequent meals help prevent overdistention of the stomach. Do not overeat. Clients should not lie down for at least three hours after eating. Advise clients to keep a food diary and then avoid foods that provoke symptoms such as spicy foods, carbonated beverages, red wine, and milk. Counsel to lose weight if overweight. GERD is an obesity-related comorbidity.

What are some actions the nurse can take to increase client nutrition while in the hospital? Select all that apply. a. Let the client choose meals b. Feed the client as much as possible c. Educate on the proper foods for the prescribed diet d. Turn on the lights and sit the client up in bed e. Criticize the client's food choices

a, c, d The nurse should NOT criticize food choices or feed the client as much as possible. The nurse should be aggressive about diet progression to meet nutritional requirements and increase client satisfaction. All other answers are appropriate.

Aspiration is the most serious complication of enteral nutrition (EN). Select all the actions below that can help reduce the risk of aspiration. a. Check gastric residual before initiating a feeding b. Lay the client flat so the esophagus is straight during insertion c. Elevate the head of the bed to 45 degrees d. Obtain x-ray confirmation after the feeding tube is inserted e. Begin the tube feeding rate slowly at first to establish tolerance

a, c, d, e Proper patient positioning decreases the risk of aspiration. Elevate the head of the bed to a minimum of 30 degrees, but preferably 45 degrees. You must ensure that the tube is in the proper position before starting tube feedings. Tube placement is ideally verified radiogically (x-ray), and the tube is marked at the exit site with ink or tape. Check gastric residual volumes every 4 hours during the first 48 hours for gastrically fed patients to prevent aspiration. Tube feeding formulas are initiated at full strength but infused at a lower rate than goal to establish tolerance.

Select all the nursing actions that are appropriate for a client with burns who is receiving enteral nutrition (EN). a. Record intake and output to determine fluid status b. Keep client flat to decrease pressure c. Rapidly increase feeding rate to increase nutrition status d. Weigh the client daily e. Monitor blood glucose to prevent hyperglycemia

a,d, e Monitor BG levels since hyperglycemia is associated with infection, morbidity, and mortality. Keep BG between 140-180. Begin feedings slowly, check gastric residuals, and assess bowel sounds every 8 hours. Keep HOB elevated at least 45 degrees to prevent aspiration. Weights may be inaccurate due to fluid shifts and the amount of dressings on the patient but are vitally important. Keep strict I & O records. Prevent refeeding by reintroducing nutrients slowly.

Upon admission to the ICU, when should nutrition support be initiated for the critically ill client who is at high nutritional risk? a. Within 24-48 hours b. Within the first week c. Within three days d. Immediately

a. Nutrition support for the critically ill patient is used until the patient can orally consume 65-75% of estimated needs and should begin within the first 24-48 hours.

Which of the following is an appropriate breakfast for a client on a level I dysphagia diet? a. Smooth, cooked cereal b. Hard boiled egg c. Toast cut into small pieces d. Granola with milk

a. Smooth, cooked cereal

The nurse suspects the client has difficulty swallowing. Who should conduct a swallow evaluation to check for potential impairment? a. The speech pathologist b. The nurse c. The physician d. The dietitian

a. The nurse performs the screening for dysphagia as part of the nutrition screen when asking about ability to chew and swallow food. Speech pathology performs swallowing evaluation for those with potential or actual impairments and recommends feeding techniques.

Which of the following is an indication for using parenteral nutrition (PN)? a. Inflamed GI tract b. Heart failure c. Supplement oral nutrition d. Fluid overload

a. PN may be used in patients who have a nonfunctional or inflamed GI tract or in patients who are unable to meet their estimated calorie needs after 7-10 days of EN. PN is contraindicated in patients who need a fluid restriction, such as in patients with renal failure, liver failure, or congestive heart failure. Patients who are able to ingest nutrition orally do not need PN.

Fill in the blank. The client with lactose intolerance does not have enough of the enzyme _____________. a. Lactase b. Lactose c. Lipase d. Amylase

a. lactase Lactase is an intestinal enzyme needed to break down lactose into two simple sugars: glucose and galactose. Lactose is a disaccharide carbohydrate. A deficiency of lactase is called lactose intolerance. Lactose intolerance is not an allergy.

What are the two most widely used assessments for interpreting body fatness? a. BMI & densitometry b. BMI & waist circumference c. Body weight & densitometry d. Skinfold thickness & waist circumference

b BMI and waist circumference are the most widely used assessments for measuring body fatness. Wait circumference is cost-effective and reliable. Densitometry is under water weighing and is expensive. Skinfold thickness indicates subcutaneous fat stores.

You are the nurse caring for a baby with cleft lip and palate. The parents ask you for help with bottle feeding the baby. Which statement by the nurse is NOT appropriate? a Your baby will need to be burped more often than normal. b. You should consider breast feeding. It's better for your baby. c. Hold your baby upright while bottle feeding. d. It is normal for some milk to escape from your baby's nose during a feeding.

b Breast feeding is extremely challenging for babies with cleft palate. Mothers should never be made to feel guilty for not being able to breast feed their baby. Normal suction typically used to keep the breast in place and pull the nipple to the back of the mouth is impossible with cleft palate. Moms may need to pump breast milk and use a special bottle for larger palate clefts because of the inability to develop negative intraoral pressure.

Since vegan clients adhere to strict, plant-only diets, they may be deficient in which of the following nutrients? a. Zinc b. Vitamin B12 c. Iron d. Calcium

b Since sources of vitamin B12 are all animal-related, vegans require supplementation of B12.

Which of the following statements regarding nutrition screening is false? a. Healthcare facilities are free to choose their own nutrition screening criteria b. A nutrition screening is completed only when a client is suspected of having a nutritional problem c. The purpose of nutrition screening is to detect actual or potential malnutrition d. A nutrition screening must be completed within 24 hours after admission to the hospital

b The Joint Commission requires ALL patients (not just those with a suspected nutritional problem) admitted to the hospital be screened for nutritional concerns within 24 hours of admission.

After the first 24 hours of starvation, the body's prime source of energy is from a. Liver glycogen b. Gluconeogenesis c. Glucose d. Carbohydrates

b The body begins to use fat stores for energy. The process of converting fat and protein to glucose is called gluconeogenesis, and it is the prime source of glucose after the first 24 hours of starvation.

Which is NOT a function of fat? a. Protection from temperature extremes b. Aids in digestion of carbohydrates c. Helps us feel full d. Energy stockpile

b fats serve as a source of energy, make food smell and taste good, help prevent hunger between meals, cushions and protects body organs, and serves as insulation to regulate body temperature. Fats serve no role in carbohydrate digestion.

Which types of foods provide carbohydrates? Select all that apply. a. Animal proteins b. Vegetables c. Fruit d. Milk

b, c, d Knowing which foods provide carbohydrates is important since all carbohydrates digest to glucose. Clients should should nutrient-dense carbohydrates which include vegetables, fruits, and dairy in addition to whole grains and legumes. Animal proteins provide fat and protein but not carbohydrates.

Which does NOT play a role in the regulation of body fat? a. Set point b. Intake vs expenditure c. Genetics d. Muscle mass

d When energy intake exceeds expenditure, we gain fat; when it is less than expenditure, we lose fat. Genes may influence how calories are stored and energy released. Set points keep our weights pretty constant and the body defends against weight loss in certain situations.

Complications of gestational diabetes include which of the following? Select all that apply. a. Abnormally small infant b. Increased infant insulin levels c. Respiratory difficulties for the infant d. Increased risk of DM2 for the mom e. Hypoglycemia for the infant

b, c, d, e The infant born to a woman with gestational diabetes is at risk for increased levels of insulin. This happens since the mother's insulin does not cross the placenta, but her glucose does. This can cause the fetus to produce too much insulin which results in hypoglycemia. Gestational diabetes also places an infant at risk for being abnormally large (macrosomia), respiratory difficulties, hypocalcemia, hypokalemia, and jaundice. The mom is also at risk for developing DM2 after pregnancy.

Choose the signs and symptoms that are consistent with dysphagia. Select all that apply. a. Weight gain b. Drooling c. Heartburn d. Pocketing food e. Dry mouth f. Coughing while eating

b, c, d, f Coughing while eating, drooling, heartburn, and pocketing food are all symptoms consistent with dysphagia. Clients with dysphagia typically lose weight because of issues with swallowing food. Dry mouth is not a common symptom, but if a patient reports the issue he/she should think or talk about food prior to eating to stimulate saliva

Postsurgery nutrition is important to long-term success. Which suggestions below are part of post bariatric surgery nutrition therapy? Select all that apply. a. Drink plenty of fluids with meals b. Eat small meals and chew thoroughly c. Eat three scheduled meals a day d. Eat a high carb, low protein diet e. Avoid alcohol

b,c,e The adherence to reduced intake is necessary because of the concern for abdominal distention, cramping abdominal pain, and diarrhea. Patients are advised to take small bites and chew foods thoroughly until they are the consistency of applesauce. Alcohol should be avoided. Protein is needed to minimize the loss of lean body mass. The diet should be high in protein and low in carbohydrates and fat. Eating should be structured with three nutrient dense meals per day. Fluids should not be consumed with meals or for at least 30 minutes after meals to decrease the risk of dumping syndrome.

Malnutrition is a critical illness associated with many undesirable effects. Which problems below are associated with malnutrition in the critically ill client? Select all that apply. a. Decreased ventilator time b. Impaired immune function c. Anasarca d. Weakened respiratory muscles e. Increased infectious complications

b,d,e Malnutrition is associated with impaired immune function, weakened respiratory muscles, prolonged ventilator dependence, and increased infectious complications in critically ill patients.

A high intake of which mineral below is associated with a decrease in blood pressure, stroke, and CVD? a. Sodium b. Potassium c. Iron d. Calcium

b. Response Feedback: A high potassium intake is associated with a decrease in BP, stroke, and CVD risk.

Select the bariatric surgical procedure that is reversible. Selected a. Vertical sleeve gastrectomy b. Gastric banding c. Roux-en-Y gastric bypass

b. Gastric banding

The goal of nutrition support in Multiple Organ Dysfunction Syndrome (MODS) is to a. Maintain fluid balance b. Establish glycemic control c. Preserve organ function d. Decrease fever

c

Select the client with a high-risk nutrition finding. a. Serum albumin 4.0 g/dL b. Intended 12% weight loss in six months c. Choking when swallowing food d. BMI of 21

c All findings are normal except choking when swallowing food. This client would need further assessment and evaluation.

Complications in the first three months after bariatric surgery are common. Which complication below is the result of not drinking enough fluids? a. Diarrhea b. Protein malnutrition c. Dehydration d. Dumping syndrome

c Dehydration can occur because of inadequate fluid intake or excessive losses through vomiting or diarrhea. Dumping can occur because of the rapid emptying of a hyperosmolar load (high sugar and high carb foods) into the jejunum. Protein malnutrition (though uncommon) can occur due to poor oral intake or prolonged vomiting and diarrhea. Diarrhea can occur because of lactose intolerance, drinking fluids with meals, infection, dumping syndrome, or intake of sugar alcohols.

To promote optimal wound healing following surgery for cancer, which macronutrient will need to be increased? a. Fat b. Carbohydrates c. Protein

c Response Feedback: Energy and protein requirements may need to be increased to promote optimal wound healing post-op. Protein is needed for tissue repair and resistance to infection. Sufficient kcals are needed to spare use of proteins for energy.

Clinical assessment of a child who is obese should include all of the following except: a. Physical assessment b. Physical activity assessment c. School performance assessment d. Emotional health assessment

c School performance assessment is not part of the clinical assessment of an obese child. Clinical assessment of children includes a health history, emotional health status, and physical activity patterns.

A client with Parkinson's Disease is filling out his menu form for the next day. What would be a good choice of breakfast for this client? a. Smoothie b. Peanut butter on toast c. Scrambled eggs d. Pecan waffles

c Scrambled eggs are smooth, soft, and easily formed into a bolus. Eggs are a better consistency over a smoothie, which could cause choking. Sticky and course textured foods should be avoided since they could cause choking.

Which suggestion would NOT be appropriate for a client with COPD? a. you should rest at least 30 minutes prior to eating b. Eat five or six small meals a day c. Drink as much fluid as you can with meals so you don't get dehydrated d. Wear your oxygen while you eat to keep your saturation up

c to decrease dyspnea and preserve energy, the patient should rest for at least 30 minutes before eating and use a bronchodilator before meals. If the patient uses supplemental oxygen, it can help to use oxygen by nasal cannula while eating. A diet high in calories and protein, moderate carbohydrate, and moderate to high in fat is recommended and can be divided into five or six small meals a day. Fluid intake should be at least 3L/day unless contraindicated by other medical conditions such as heart or kidney failure. Fluid should be consumed between meals rather than with meals.

What are the two strongest risk factors for developing Diabetes Type 2? a. Physical inactivity b. Obesity c. Smoking d. Family history e. Ethnicity

d, b Family history and obesity are the two strongest risk factors for developing Diabetes. The other factors play a role but not to the effect of family history and obesity

Feeding tubes may be used long-term or short-term and be placed bedside or surgically. Select the tubes below that are for long-term feeding AND require surgical placement. a. Nasogastric b. Nasoduodenal c. Gastrostomy d. Jejunostomy

c, d A Gastrostomy or percutaneous endoscopic gastrostomy (PEG) tube is surgically inserted into the stomach and used for long-term feeding. A Jejunostomy tube is surgically inserted into the small intestine and also used for long-term feeding. Nasogastric (NGT) and nasoduodenal tubes are temporarily inserted through the nose and used for short-term feedings.

here are many reasons a client may be considered for enteral nutrition (EN). Select all the problems below that would indicate the client is a candidate for EN a. Bowel obstruction b. Non-functioning GI tract c. Dysphagia d. Burns e. Poor oral intake

c, d, e EN is less costly than parenteral nutrition (given via a vein), helps maintain gut integrity and helps prevent translocation of bacteria. Indications for EN include dysphagia, poor oral intake, and burns (as long as the GI tract is functioning). Bowel obstruction is a contraindication for EN since the GI tract is compromised. EN should never be used with a non-functioning GI tract.

The nurse knows her instructions have been effective when the client with dumping syndrome verbalizes she should a. Avoid lying down after eating b. Avoid protein c. Drink liquids between meals, not with meals d. Eat simple sugars in place of starches

c. Consume liquids between meals and not with food to slow movement from the stomach into the duodenum. At least 30 minutes after a meal and enough to prevent dehydration. Avoid too hot and too cold liquids.

The Wellness Approach includes which of the following? a. Making drastic changes b. Rewarding with food c. Establishing realistic goals d. Being physically active e. Modifying behavior f. Minimizing emotional eating g. Normalizing eating

c. Establishing realistic goals d. Being physically active e. Modifying behavior f. Minimizing emotional eating g. Normalizing eating

Which suggestion by the nurse would NOT be appropriate for a client experiencing anorexia related to chemotherapy? a. Use condiments like butter to increase your kcals b. Eat in the morning when your appetite is best c. Drink lots of fluids with meals d. Eat small, frequent meal

c. The client experiencing loss of appetite related to chemotherapy should eat small, frequent meals and spread fluids throughout the day instead of drinking large amounts with meals. They should also eat in the morning since this is when appetite is likely to be the best and add high kcal condiments like butter to increase energy intake

Which is the most important nutrient for wound healing, supporting immune functioning, and maintaining lean body mass? a. Fat b. Zinc c. Vitamin A d. Protein

d

The nurse is recording a client's breakfast intake. Which entry is correct? a. He ate much better than yesterday b. Half carton milk, most of his eggs c. Three bites of oatmeal, some of his orange juice d. 25% oatmeal, 50% eggs, 100mL juice

d A food recording must be accurate using measurable amounts (cups, mL) or in percentage of amount eaten (50% eggs, 25% oatmeal). Do not use "are well" or "two bites" etc.

Early enteral feedings in the hypermetabolic client are established to a. Preserve GI function b. Maintain mucus mass c. Promote normal bacterial growth d. All the above

d Early enteral feedings help maintain gut mucus mass and barrier function, increases intestinal blood flow, and promotes normal bacterial growth in the gut. It also promotes optimal conditions for wound healing.

Which foods would be appropriate on a full liquid diet? a. Cooked pasta with tomato sauce b. Apple juice, coffee, beef broth c. Blended peas, carrots, chicken d. Chicken broth, orange juice, milkshake

d Full liquids are liquid at room and body temperature. Chicken broth, orange juice, and milkshakes are full liquids. It provides more variety than clear liquids. Apple juice, coffee, and beef broth are clear liquids. Blended peas, carrots, and chicken are not liquids and would be appropriate for a pureed diet. Cooked pasta with tomato sauce would be on a mechanical soft or regular diet.

Immunosuppression is common in cancer patients after treatment. Which statement by the client suggests that food safety teaching was effective? a. I will still get to enjoy runny eggs for breakfast b. It's ok for me to eat sushi since it contains vital nutrients c. I don't have to wash my apples if they are organic d. I will use my leftovers within 3 to 4 days of cooking them

d Immunosuppression puts the patient at high risk for infection by bacterial and fungal pathogens. Patient must follow food safety guidelines of avoiding undercooked meat and eggs, wash and/or peel fruits and vegetables, and follow safety guidelines for food prep and storage. Leftovers should be used within 3-4 days. Fish should be cooked and not raw, so no sushi.

Which of the following criteria would most likely be on a nutrition screen in the hospital? a. Cultural food preferences b. Serum potassium value c. Prealbumin value d. Weight change

d Nutrition screening identifies characteristics known to be associated with nutrition problems, such as unintended weight loss and decreased appetite. The nutrition screening process facilitates completion of early intervention goals, includes collection and interpretation of relevant data, helps determine the need for a nutrition assessment, is cost effective, and may be completed in any setting. All other answers would be on the nutrition assessment.

Which food below should the client with Celiac disease avoid eating? a. Corn chips b. Rice c. Quinoa d. Wheat crackers

d Rice, corn, and quinoa are naturally gluten-free. Also gluten-free are potatoes and flax. Clients with Celiac disease must abstain from all varieties of wheat, barley, and rye. They must read all ingredient labels since gluten is added as a stabilizer and preservative in many foods.

Nurses are in an ideal position to a. Calculate a client's protein and calorie needs b. Conduct comprehensive nutrition assessments c. Order therapeutic diets d. Screen clients for risk of malnutrition

d The process of screening and nutrition assessment is an example of the cooperative effort of how nurses and dietitians identify patients with actual or potential malnutrition. Since nurses have close contact with patients and families, they are in an ideal position to identify these patients and make a referral. The RD would conduct the nutrition assessment, order therapeutic diets, and calculate protein and calorie needs.

Clients with inflammatory bowel disease need what kind of diet? a. Vegetarian b. Low fat, high protein c. High fat, high carbohydrate d. High protein, high calorie

d. A high calorie, high protein diet divided into small, frequent meals is recommended for clients with IBD to facilitate healing. A low fiber diet minimizes stimulation to the bowel during flares.

Which of the following is NOT a component of parenteral nutrition (PN)? a. Amino acids b. Sterile water c. Dextrose d. Fiber

d. PN solutions are a complex mix of protein, carbohydrate, fat, electrolytes, vitamins, and trace elements in sterile water. Since the carbohydrates in PN solution are not from whole foods, fiber is not a component.

Malnutrition as the result of Inflammatory Bowel Disease may be caused by a. Poor intake b. Poor digestion c. Malabsorption d. Drug-nutrient reactions e. All the above

e

Populations at greatest risk for malnutrition include a. Very young children b. Elderly adults c. Excessive dieters d. Chronic alcoholics e. All the above

e All individuals are potentially at risk for malnutrition, but there are certain populations of people at greatest risk for malnutrition. These include very young children, older adults, those with incomplete diets (chronic alcoholics, excessive dieters, eating disorders, poorly planned vegetarian diets), those with dementia, depression, swallowing disorders, decreased mobility, those taking drugs with antinutrient or catabolic properties, clients in hypermetabolic states, and clients with no oral intake and/or receiving standard IV solutions for 10 days (adults) or 5 days (older adults).

True or false? All patients with dysphagia do well on the same type of diet.

f

true or false? Parenteral nutrition (PN) is the preferred route for nutrition if the client cannot consume adequate nutrients orally.

f PN may be needed, but it's important to continue to use oral or enteral nutrition to preserve the small intestine. Patients with cancer are at high risk for malnutrition Nutrition therapy should be included in every cancer treatment plan.

True or false? For the client with Celiac disease, the ingestion of gluten causes an allergic response in the body.

false Celiac disease is a chronic autoimmune disorder (not an allergy) in which the mucosa of the small intestine, especially the duodenum and proximal jejunum, is damaged by dietary gluten. The ingestion of storage proteins in wheat, barley, and rye in genetically susceptible individuals triggers a toxic reaction and damages the mucosa.

true or false? The best measure of long-term blood glucose control is capillary blood glucose prior to meals.

false HgbA1C measures the amount of glycosated hemoglobin in the bloodstream for the past 120 days. It is NOT affected by short-term factors and is therefore a good indicator of long-term blood glucose control

True or false? It takes about 10 days for fat stores to be depleted during starvation.

false It takes 4-6 weeks for fat stores to be depleted during starvation.

True or false? Enteral formulas are considered medications and go through strict FDA approval.

false There are currently more than 110 EN formulas available in the US for adult and pediatric patients. Enteral formulas are considered medical foods. Because formulas are food, and not medications, their composition is determined by the manufacturer and does not require FDA approval.

True or false? The first system affected by compromised nutrition status is the circulatory system.

false When metabolic stress develops, hormonal and metabolic changes decrease the immune system's ability to protect the body. If nutrition is not optimal, the immune system is further subdued. Compromised nutritional status makes it difficult for the body to mount both a stress response and an immune response when confronted with a metabolic stressor such as a virus, surgery, or trauma. Malnutrition affects each part of the immune system.

True or false? Parenteral nutrition (PN) must be given via an artery.

false vein

True or false? Obesity has become an epidemic among both genders and all ethnicities.

true

True or false? Oral intake after surgery should be started as soon as bowel function is established.

true

Weight loss and exercise can prevent or delay Diabetes and normalize blood glucose levels.

true

true or false? Psychologic stressors are a possible aggravator of irritable bowel syndrome.

true

t/f A large portion of cancers are preventable since they are the result of tobacco use and unhealthy lifestyles.

true A large portion of cancers could be prevented since many develop because of tobacco use and unhealthy lifestyle behaviors. As many as 42% of newly diagnosed cancers in 2018 could have been prevented.

True or false? Children should aim for 60 minutes of physical activity daily to help lower the risk of DM2, control blood pressure, and boost mental health.

true Being physically active lowers the risk for type 2 diabetes because it helps the body use insulin better, decreasing insulin resistance. Physical activity improves health in lots of other ways, too, from controlling blood pressure to boosting mental health. Aim for 60 minutes of activity a day

Children who are obese are at risk for developing diseases that used to mainly affect adults.

true Children with obesity are at higher risk of having other chronic health conditions and diseases that influence physical health. These include asthma, sleep apnea, bone and joint problems, type 2 diabetes, and risk factors for heart disease.

True or false? Many people are living with Diabetes Type 2 and do not know it because the symptoms often appear gradually.

true DM2 is slowly progressive and may go undiagnosed for years. 7.2 million out of 30 million that have DM2 are not aware that they have Diabetes. Symptoms occur gradually if at all: polyuria polydipsia, fatigue, frequent infections.

True or false? Before considering enteral nutrition (EN), it must be established if the client has a functioning GI tract.

true Enteral nutrition uses the GI tract to provide nourishment. Nutrients "enter" the body via the GI tract, so it must be functioning and accessible.

t/f The goal of nutrition therapy for people being treated for cancer is to prevent weight loss and maintain lean body mass.

true Goals for cancer nutrition therapy include maintenance of weight and lean body mass, adequate hydration, adequate energy and protein intakes, and use of appropriate and safe complementary nutrition therapies

Most deficiencies experienced by vegetarian-type diets are the result of poor planning and relying on refined and processed foods.

true Many vegetarians do not take good care to get all their vitamins and minerals. They rely on highly processed foods which are usually grain based.

Modern nutritional evidence does not support a major effect of saturated fat on cardiovascular disease (CVD)?

true More recent studies are suggesting there is not conclusive evidence to establish a link between saturated fat intake and blood cholesterol levels. Modern nutritional evidence does not support a major effect of saturated fat on CVD risk.

T/F Clients who have bariatric surgery often see a rapid reversal of their obesity-related comorbidities.

true Most people who undergo bariatric surgery successfully improve their overall quality of life. In addition to losing weight, patients often experience the resolution of comorbidities such as Diabetes.

True or false? Cancer related to obesity is preventable.

true Obesity is a behavioral risk factor for cancer that is reversible. Weight loss, along with a healthy diet high in vegetables, can help reduce cancer risk.

True or false? Refeeding is a serious complication of parenteral nutrition (PN) and is brought on by giving nutrition too quickly.

true Refeeding is a potentially fatal complication that occurs from an abrupt change from a catabolic state to an anabolic state and an increase in insulin caused by a dramatic increase in carb intake. It is caused by feeding a client who is in a malnourished state too quickly.

True or false? Nutrition therapy for a client with HIV should be individualized since there is no "one size fits all" diet.

true There is no standard diet for HIV/AIDS. An individualized assessment identifies the patient's needs based on weight, lab values, body composition, and clinical data.