Ch. 17 Altered Nutrition

Question 1

You have inflammation of the large intestine, a condition called ulcerative colitis. What is the most probable reason that you would develop iron-deficiency anemia?

a. You are experiencing chronic blood loss in your stools.
b. You have inadequate hydrochloric acid for absorption of iron.
c. You have lost usable surface area in the large intestine for absorption of iron.
d. You do not have an adequate iron intake in your diet.

Answer 1

a. You are experiencing chronic blood loss in your stools.

Question 2

You are part of the healthcare team at a clinic for adolescents with anorexia nervosa. Which of the assessments that you perform is focused on recognizing the most common cause for mortality in those with anorexia nervosa?

a. Lung assessment
b. Cardiovascular assessment
c. Skin assessment
d. Neurologic assessment

Answer 2

b. Cardiovascular assessment

Question 3

Which dietary change would be recommended for the individual with celiac disease?

a. Avoid milk or milk products.
b. Avoid wheat, barley, rye, and oats.
c. Avoid rice, soy, and nuts.
d. Avoid long-chain fatty acids.

Answer 3

b. Avoid wheat, barley, rye, and oats.

Question 4

Which of the following affects the sensations of hunger and satiety and, therefore, plays a major role in the development of obesity?

a. The hypothalamus
b. The pituitary gland
c. The thyroid gland
d. The pancreas

Answer 4

a. The hypothalamus

Question 5

Which of the following does not contribute as an energy source in the diet?

a. Carbohydrates
b. Fats
c. Proteins
d. Vitamins

Answer 5

d. Vitamins

Question 6

You are caring for an individual with liver disease. What are you most concerned about in terms of nutrition?

a. The patient may be unable to adequately store nutrients.
b. The patient may be unable to synthesize nutrients.
c. The patient may be unable to metabolize macronutrients.
d. All of these are major concerns.

Answer 6

d. All of these are major concerns.

Question 7

Your patient has gallbladder disease and is unable to store and release adequate bile to the small intestine. What dietary modifications do you suggest?

a. Increase protein intake
b. Decrease fat intake
c. Increase complex carbohydrates
d. No dietary changes are needed

Answer 7

b. Decrease fat intake

Question 8

You are working in the newborn nursery and are an advocate for breast-feeding. It is the winter in northern Minnesota and you are concerned about low sunlight exposure in infants who are breast-feeding as they may develop vitamin D deficiency. What is the major manifestation of vitamin D deficiency?

a. Impaired mineralization in growing bones
b. Impaired retinal development
c. Impaired osteoclast activity
d. Keratinization of mucous membranes

Answer 8

a. Impaired mineralization in growing bones

Question 9

You are planning a nutritional in-service to your clinic’s service area in California. What concept of altered nutrition should you focus your talk to address the largest nutritional problem in your area?

a. Altered metabolism.
b. Undernutrition.
c. Overnutrition.
d. All of these are equally prevalent.

Answer 9

c. Overnutrition.

Question 10

What is known about glucose transport into the small intestine?

a. It requires cotransport with sodium.
b. It occurs through active transport.
c. It must first be reduced as it is rarely consumed in the typical diet.
d. All of these are true about glucose transport.

Answer 10

d. All of these are true about glucose transport.

Question 11

What is the first plan of action for the formula-fed newborn who is just diagnosed with PKU?

a. Switch to a special formula with phenylalanine.
b. Prepare for a blood transfusion.
c. Switch to a phenylalanine-free formula.
d. Require the mother to breast-feed.

Answer 11

c. Switch to a phenylalanine-free formula.

Question 12

Which of the following vitamins is supplemented in pregnancy because of its important role in embryogenesis and the prevention of neural tube defects in the fetus?

a. Vitamin A
b. Citric acid
c. Folate
d. Vitamin B12

Answer 12

c. Folate

Question 13

What are typical manifestations for malabsorption syndromes?

a. Constipation, dry mouth, weakness
b. Diarrhea, bloating, stomach pain
c. Bloody stools, fissures, rectal bleeding
d. Nausea, vomiting, stomach cramping

Answer 13

b. Diarrhea, bloating, stomach pain

Question 14

Your neighbor, as she put it, is a “lactose intolerant health nut” and she is always experimenting with various supplements. Recently, she went into the clinic for evaluation of pain in her leg and was found to have multiple bone fractures. Which of the following supplements, in toxic levels, causes multiple skeletal fractures?

a. Phosphorus
b. Iron
c. Zinc
d. Calcium

Answer 14

a. Phosphorus

Question 15

A nurse is caring for a client following a paracentesis. Which of the following findings indicate the bowel was perforated during the procedure?

A. Client report of upper chest pain
B. Decreased urine output
C. Pallor
D. Temperature elevation

Answer 15

D. CORRECT: Fever is an indication of bowel perforation during a paracentesis.

Question 16

A nurse is planning care for a client who has a new prescription for total parenteral nutrition (TPN). Which of the following interventions should be included in the plan of care? (Select all that apply.)

A. Obtain a capillary blood glucose four times daily.
B. Administer prescribed medications through a secondary port on the TPN IV tubing.
C. Monitor vital signs three times during the 12‑hr shift.
D. Change the TPN IV tubing every 24 hr.
E. Ensure a daily aPTT is obtained.

Answer 16

A. CORRECT: The client is at risk for hyperglycemia during the administration of TPN and can require supplemental insulin.
C. CORRECT: Vital signs are recommended every 4 to 8 hr to assess for fluid volume excess and infection.
D. CORRECT: It is recommended to change the IV tubing that is used to administer TPN every 24 hr.

Question 17

A nurse is providing care to a client who is 1 day postoperative following a paracentesis. The nurse observes clear, pale‑yellow fluid leaking from the operative site. Which of the following is an appropriate nursing intervention?

A. Place a clean towel near the drainage site.
B. Apply a dry, sterile dressing.
C. Apply direct pressure to the site.
D. Place the client in a supine position.

Answer 17

B. CORRECT: Application of a sterile dressing will contain the drainage and allow continuous assessment of color and quantity

Question 18

A nurse is completing discharge teaching with a client who is 3 days postoperative following a transverse colostomy. Which of the following should the nurse include in the teaching?

A. Mucus will be present in stool for
5 to 7 days after surgery.
B. Expect 500 to 1,000 mL of semiliquid stool after 2 weeks.
C. Stoma should be moist and pink.
D. Change the ostomy bag when it is ¾ full.

Answer 18

C. CORRECT: A pink, moist stoma is an expected finding for a colostomy

Question 19

A nurse is caring for a client who is receiving TPN solution. The current bag of solution was hung 24 hr ago, and 400 mL remains to infuse. Which of the following is the appropriate action for the nurse to take?

A. Remove the current bag and hang a new bag.
B. Infuse the remaining solution at the current rate and then hang a new bag.
C. Increase the infusion rate so the remaining solution is administered within the hour and hang a new bag.
D. Remove the current bag and hang
a bag of lactated Ringer’s.

Answer 19

A. CORRECT: The current bag of TPN should not hang more than 24 hr due to the risk of infection

Question 20

What prevents Warfarin from working correctly?

Answer 20

Vitamin K

Question 21

What is the angle of the bed for tube feedings?

Answer 21

30-45 degrees

Question 22

How often should the placement of feeding tubes be checked?

Answer 22

Every 4 hours