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Nutrition Final
Obesity, Metabloic disorders, GI disorders, Diabetes Mellitus, etc.
| Question | Answer |
|---|---|
| BMI > or = 25? | Overweight |
| BMI > or = 30? | Obese |
| More than how many genes are linked to obesity? | 300 |
| About 30% - 40% of the variance in BMI is attributed to what? | Genetics |
| About 60% -70% of the variance in BMI is attributed to what? | Environment |
| True or False: Respiratory dysfunction is one of the most common complications of obesity. | True |
| A modest weight loss of _% to _% of initial body weight is associated with significant improvements in BP, cholesterol, and plasma lipid levels, and blood glucose levels. | 5 10 |
| A lifestyle approach is the basis of treatment for all people whose BMI is > or = ? | 30 |
| _ and surgery may be used in conjunction with lifestyle interventions, based on the individual's BMI and the presence of comorbidities. | Pharmacotherapy |
| Favorably impacts metabolic rate? | Physical activity |
| Dietary guidelines recommend adults engage in approximately _ minutes of moderate to vigorous-intensity activity on most days of the week to prevent weight gain. | 60 |
| 2 drugs approved by the FDA for long-term use have been shown effective in helping promote and maintain weight loss? | Alli Phentermine |
| Pharmacotherapy drugs are _ stimulants? | CNS |
| Which of the following is an aspect of behavior modification? a. Stimulus recognition b. Professional monitoring c. Cognitive restructuring d. Problem identification | Cognitive restructuring |
| Most effective treatment for severe obesity? | Surgery |
| Inflatable band encircles the uppermost stomach and is buckled? | LAGB |
| Combines gastric restriction to limit food intake with the construction of bypasses of the duodenum and the first portion of the jejunum. | RYBG |
| True or False: Diets that lead to weight loss are not necessary effective for maintaining weight. | True |
| _ drugs effectively reduce the frequency of problematic eating behaviors. | Antidepressant |
| What is a risk factor for eating disorders? a. GI problems b. Adolescent eating problems c. Binge eating d. Depression | GI problems |
| Put these in the correct order of Nutrition Therapy: a. To gradually increase weight b. To prevent further weight loss c. To maintain agreed-upon weight goal d. To gradually reestablish normal eating behaviors | bdac |
| Involving the client in formulating individualized goals and plans promotes what? | Compliance |
| Adequate fat is provided to help delay gastric emptying and contribute satiety for which eating disorder? | BN |
| Approximately _% of American adults are obese. | 31 |
| True or False: Eating in the evening causes weight gain. | False |
| True or False: Skipping meals is an effective strategy for cutting calories? | False |
| True or False: It is easier to lose weight than to maintain a lower weight after weight loss. | True |
| True or False: Milk promotes weight loss. | False |
| True or False: Obesity related health problems improve only after BMI is lowered to normal. | False |
| True or False: If a person will try only one strategy, lowering calories is more effective at promoting short term weight loss than increasing activity is. | True |
| True or False: Even if weight loss does not occur, increasing activity helps lower blood pressure and improves glucose tolerance. | True |
| True or False: People who eat fewer than 1200 calories may need a multivitamin and mineral supplement. | True |
| True or False: For weight loss, it is better to cut carbohydrates than to cut fat grams. | False |
| True or False: Bulimia poses fewer nutritional problems than anorexia does. | True |
| _% of hospitalized patients are malnourished. | 40 |
| Easiest and most preferred method of providing nutrition? | Oral diet |
| _diets are used to achieve or maintain optimal nutritional status. Adjusted to meet age specific needs throughout life cycle. | Regular |
| _ diets contain foods that are chopped, ground, pureed or soft. Prepared in a blender provide food in liquid form. | Modified consistency |
| _diets used for the purpose of preventing or treating disease or illness. | Therapeutic |
| Some patients are unable or unwilling to eat enough food to meet their requirements, so they need? | Nutritional supplements |
| What type of diet is a dysphagia diet? a. Prepared in a blender b. Liquid c. Modified consistency d. Mechanically ground | Modified consistency |
| _allow the patient to taste test several options available, given on rotation schedule. | Liquid supplements |
| _ less frequently used option for maximizing a patient's oral intake. Generally composed of a single nutrient. | Modular products |
| A way of providing nutrition for patients who are unable to consume an adequate oral intake but have at least a partially functional GI tract that is accessible and safe to use? | Enteral nutrition |
| Enteral nutrition is a way of providing nutrition for people who have an inadequate oral intake. What is the other criteria for enteral nutrition? a. Partially functioning GI tract b. Nonfunctioning GI tract c. Obstructed GI tract | Partially functioning GI tract |
| Generally used for tube feedings for a short duration? | Nasogastric tube |
| _feedings are preferred for permanent or long-term feedings? | Ostomy |
| What tubes are placed with the aid of an endoscope? | PEG |
| Enteral formulas are classified by the type of _ they contain? | Protein |
| _ protein formulas are intended for patients with impaired digestion or absorption. | Hydrolyzed |
| Adults generally need _ to _ mL/dg/day | 30 40 |
| _ formulas are available for patients with respiratory disease. | High fat |
| _ formulas are designed for patients with malabsorption. | Modified fat |
| _ formulas are for renal disease. | Electrolyte modified |
| What stimulates peristalsis, increases stool bulk, and is degraded by gastrointestinal bacteria? | Fiber |
| _ formulas are essentially residue free. | Hydrolyzed |
| Determined by the concentration of sugars, amino acids, and electrolytes. | Osmolality |
| Isotonic formulas have approximately the same osmolality as _? | Blood |
| Some patients develop _ when a hypertonic formula is used. | Diarrhea |
| True or False: Routine formulas provide 1.5 to 2 cal/mL. | False |
| _ formulas have a high viscosity and require a large bore tube to prevent clogging. | High fiber |
| _ formulas have very low viscosity. | Hydrolyzed |
| Feedings generally used for noncritical patients, home-tube feedings, and patients in rehabilitation. | Intermittent |
| Feedings that often cause "dumping sydrome" | Bolus |
| Feedings given at a constant rate over a 16 - 24 hour period. Recommended for critically ill patients. Continuous feedings interrupted every 4 hours. | Continuous drip method |
| Before initiating a feeding, tube placement is verified ideally by _, and bowel sounds are confirmed to be present. | Radiography |
| Commonly recommended maximum flow rate for gastric feedings is _ mL/hr. | 125 |
| What is the most serious potential complication resulting tube feeding? | Aspiration |
| Life saving therapy in patients who have a nonfunctional GI tract. Also used for other conditions such as critical illness, acute pancreatitis, liver transplantation, Aids, Cancer. | Parenteral nutrition |
| Provided as a solution of crystalline essential and nonessential amino acids. | Protein |
| Amino acid formulations are available with and without what? | Electrolytes |
| Providing adequate protein is a primary concern when formulating what? | PN |
| _ balance study can be used to determine adequacy of protein intake. | Nitrogen |
| _ is associated with immune function impairments and increased risk of infectious complications. | Hyperglycemia |
| _ is necessary to correct or prevent fatty acid deficiency. Isotonic. | Fat |
| _should not be added to PN solutions because of the potential incompatibilities of the medication and nutrients in the solution. | Medications |
| _ PN allows serum glucose and insulin levels to drop during the periods when PN is not infused. | Cyclic |
| During the last hour of infusion, the rate may be reduce by one half to prevent rebound_ ? | Hypoglycemia |
| When the patient is able to begin consuming food orally, the amount of PN is gradually reduced to prevent? | Metabolic complications |
| True or False: Hospitalized patients are at risk for malnutrition? | True |
| True or False: Patient tolerance is improved when oral intake progresses slowly after surgery from a clear liquid diet to regular food? | False |
| True or False: Modular products provide a single nutrient and are used to increase the calorie or protein density of food or tube feedings? | True |
| True or False: Osmolality is a primary consideration in selecting an appropriate enteral formula? | False |
| True or False: The terms fiber and residue are synonymous. | False |
| True or False: The patients ability to digest nutrients is a primary consideration when deciding the type of enteral formula to use? | True |
| True or False: A continuous drip delivered by a pump is recommended for administering tube feedings to patients who are critically ill. | True |
| True or False: Parenteral nutrition can be infused through a peripheral or central vein? | True |
| True or False: Hyperglycemia is a normal and harmless consequence of parenteral nutrition. | False |
| True or False: Coloring tube-feeding formulas with food dye helps to prevent aspiration? | False |
| The bodies attempt to promote healing and resolve inflammation when homeostasis is disrupted? | Stress response |
| Phase which happens immediate post-injury. Typically last 12 to 24 hours. Characterized by shock, decreased body temp, urinary output, glucagon and catecholamine levels rise? | Ebb |
| Treatment for which phase: restore blood flow to organs, maintain adequate oxygenation to all tissues, and stop bleeding. | Ebb |
| Which phase is a metabolic response to stress. State of hypercatabolism and hypermetabolism. | Flow |
| Which phase is an inflammatory response. Body's attempt to destroy infectious agents and prevent further tissue damage. Characterized by a change of at least 25% in the plasma concentration of certain proteins. | Acute |
| The treatment goals of the ebb phase of the stress response are what? a. Maintain protein catabolism b. Maintain oxygenation to all tissues c. Decrease blood flow to nonvital organs d. Decrease bleeding | b. Maintain oxygenation to all tissues |
| Life threatening condition may occur when severe inflammation last longer than a few days. HR, RR, WBC, and/or body temp elevates. | SIRS (Systemic inflammatory response syndrome) |
| Primary goal of nutrition therapy is to protect_ and prevent or alleviate malnutrition? | lean body mass |
| Harris-Benedict equations is not for the? | Critically ill |
| Multiply the PT's weight in kilograms by a specified calorie level. Adjusted upward or downward based on the PT's response? | BEE (Basal Energy Expenditure) |
| _ and _ , two nonessential amino acids, may become conditionally essential during periods of stress. | Arginine Glutamine |
| _ and _ should provide 50% to 60% of total caloric needs. | Carbohydrates and Fat |
| What may provide up to 40% of total calories? | Fat |
| Decreased _ output is a frequent complication of metabolic stress. | Renal |
| Trauma and burn patients have been documented to have high urinary and tissue losses of the trace elements selenium, zinc, and _? | Copper |
| Which is the preferred method of feeding concerning a critically ill patient who is hemodynamically stable and has a functional GI Tract? | EN (Enteral Nutrition) |
| True or False: Systemic inflammatory response syndrome (SIRS) is a life threatening condition that may occur when severe inflammation lasts longer than 24 hours. | False |
| Extensive _ are the most severe form of metabolic stress. | Burns |
| Fluid and _ replacement to maintain adequate blood volume and blood pressure are the priorities of the initial post-burn period. | Electrolyte |
| When oral intake is less than 75% of estimated need for over 3 days, _ should be used for total or supplemental nutrition. | EN |
| Occurs when gas exchange between the air and blood is impaired, may cause hypermetabolism? | Respiratory stress |
| Patients that are _ have malnutrition, are hypermetabolic, chronic inflammation, and anorexia may occur. | COPD |
| Nutrition treatment for COPD: high _ and high _ ? | Calorie Protein |
| You are admitting a burn patient to your unit. He is a healthy 18 yr old, 6' 2" tall with a weight of 180 lbs. His burns cover over 15% of his body. What would you expect his approximate protein needs to be? a. 150 g to 191 g b. 164 g to 205 g | b. 164 g to 205 g |
| _ produces more carbon dioxide when they are metabolized than do either proteins or fats? Creates a greater burden on _ ? | Carbohydrates lungs |
| True or False: Aggressive nutrition therapy can reverse the metabolic derangements of severe stress. | False |
| True or False: Stress hormones promote the breakdown of stored nutrients and lean body mass. | True |
| True or False: The metabolic response to severe stress lasts 2 to 48 hours after injury. | False |
| True or False: The acute-phase inflammatory response causes albumin levels to fall. | True |
| After acute stress, the lower small intestine is less likely to have motility dysfunction than is the stomach. | True |
| True or False: The Harris-Benedict equations accurately estimate energy requirements during critical illness. | False |
| True or False: In patients with severe stress, overfeeding may be more detrimental than underfeeding. | True |
| True or False: Stressed patients with low serum iron levels should be supplemented with iron to promote healing. | False |
| True or False: Extensive burns are the greatest stress a person can experience. | True |
| True or False: People with COPD generally need fewer calories than healthy people because they are less physically active. | False |
| Which of the following strategies would be most appropriate for a patient with COPD who is experiencing early satiety? a. Limit empty beverages at meals b. Resting before eating c. Using bronchodilators b4 eating d. Limit salt intake | a. Limit empty beverages at meals |
| When teaching a client diagnosed with COPD about nutritional needs, which of the following types of diet should the nurse discuss? a. High calorie, high protein diet b. Low residue diet c. Low fat, low cholesterol diet d. Low sodium diet | a. High calorie, high protein diet |
| In a burned PT w/ a functional GI tract, why is EN preferred over PN? a. EN can provide higher amounts of calories and protein b. EN is less likely to interfere w/ oral intake c. EN is less expensive d. EN has lower risk of infectious complications | d. EN has lower risk of infectious complications |
| Why may underfeeding critically ill PT's be beneficial? a. It provides less work for GI tract b. It provides fewer substrates for the body to make proinflammatory molecules & has a + effect on hyperglycemia c. Stress hormone levels to drop | b. It provides fewer substrates for the body to make proinflammatory molecules and has a _ effect on hyperclycemia |
| What does the PT require during the first 24 to 48 hours after a severe burn? a. PN b. Supplements of trace elements c. Fluid and electrolytes d. A low-carbohydrate diet to decrease CO2 production | c. Fluid and electrolytes |
| What does a spike in C-reactive protein indicate in people w/ acute metabolic stress? a. Protein needs are not being met b. Protein intake is adequate c. Inflammatory response is occurring d. Inflammatory response has ended | c. Inflammatory response is occurring |
| How much daily protein may a 70 kilograms person with severe burns require? a. 56 grams b. 70 grams c. 105 grams d. 175 grams | d. 175 grams |
| If underfeeding is used for critically ill patients, when should the calories begin to be advanced toward 100% of need? a. After 3-5 days b. After 5-7 days c. After 7-10 days d. After 10 days | a. After 3-5 days |
| Nutrition therapy has the effect to _ the effectiveness of drug therapy. | maximize |
| Nutrition therapy can alleviate the _ of the disease and its treatments. | side effects |
| _ is the second leading cause of death in the United States. | cancer |
| Nutrient intake, _, or need can be impacted by cancer treatments. | absorption |
| _ nutrition for terminally ill patients with cancer may improve quality of life and enhance well being. | palliative |
| Exclusive breast feeding for up to _ months is recommended. | 6 |
| What is one of the strongest links to cancer risk? a. genetics b. diet c. body weight d. occupation | c. body weight |
| Fat may increase cancer rish by increasing _ that promote cancer cell growth. | hormones |
| Promoting low levels of _ _ can promote cancer cell growth. | chronic inflammation |
| _% of patients with upper GI cancer and _% of patiends with lung cancer have already experienced significant weight loss. | 80 60 |
| _ _ is an indicator of poor prognosis in people with cancer. | weight loss |
| _ can induce changes in metabolism that alter the body's use of fuels and promote loss of lean body mass and weight. | tumors |
| Progressive wasting syndrome? | cachexia |
| Metabolic alterations in the body can occur as effects of tumors. What can these metabolic alterations include? a. decreased energy expediture b. increased muscle protein synthesis c. decelerated fat break down d. insulin resistance | d. insulin resistance |
| _ patients prior to sugery are at higher risk of morbidity and mortality. | malnourished |
| After surgery patients need an increase in protein, calories, vitamins _ and _ , to replenish losses and promote healing. | C B |
| _ injures all rapidly dividing cells; it is most lethal for the poorly differentiated and rapidly proliferating cells of cancer tissue. | radiation |
| _ may be needed for 1 to 2 months after bone marrow transplantation. | TPN |
| Hemopoietic and peripheral blood stem cell transplantation- when oral diet resumes, a liquid diet restricted in _, fiber, and _ is given to minimize malabsorption and improve tolerance. | lactose fat |
| What makes a patient a candidate for PN? a. weight of less than 75% of ideal b. chemoradiation to the head or neck c. minimum improvement in nutritional parameters d. decreased infection rate | b. chemoradiation to the head or neck |
| _ recommends calorie intakes increase by 10% for asymptomatic clients so that body weight can be maintained. | WHO |
| True or False: The weight recommendations from the HIV research of the nutrition infection unit at Tufts University School of medicine are for 45 cal/kg if the client has an opportunistic infection. | True |
| The nurse knows her instructions about healthy eating to reduce the risk of cancer have been understood when the client states? a."if i follow a healthy eating guideline I wont get cancer. b."a mostly plant-based diet may reduce the risk of cancer." | b. "a mostly plant-based diet may reduce the risk of cancer." |
| Which of the following metabolic changes often occur from cancer? a. increased fat synthesis b. increased body protein turnover c. insulin resistance d. increased energy expenditure e. decreased muscle protein synthesis | b c d e |
| Which of the following strategies would the nurse suggest to help the client increase the protein density of his diet? a. top baked potatoes with sour cream b. mix cream cheese with butter with hot bread c. substitute milk for water in recipes | c. substitute milk for water in recipes |
| Which of the following meals would be appropriate for a PT whose only cancer treatment symptom that impacts intake is neutropenia? a. baked mac and cheese w/ cooked green beans b. cottage cheese and fresh fruit plate c. soft cooked eggs with toast | a. baked mac and cheese w/ cooked green beans |
| The PT asks what foods she can eat for protein because meat tastes "rotten"? a. cheese omelat, cold chicken sandwich, shrimp salad b. vegetable soup, pulled pork sandwich, meatloaf with gravy c. spaghetti with meatballs, tacos, peanut butter | a. cheese omelat, cold chicken sandwich, shrimp salad |
| When should nutrition become part of the care plan for a client with HIV? a. before the onset of symptoms b. when the client begins to lose weight c. after an acute episode of illness d. when weight loss is more than 5% of initial weight | a. before the onset of symptoms |
| True or False: People who are obese are at increased risk of several types of cancer. | True |
| True or False: Weight loss is an indicator of poor prognosis in people with cancer. | True |
| True or False: Clients who are adequately nourished may be better able to withstand the effects of cancer treatment. | True |
| True or False: Cachexia is directly related to the amount of calories consumed. | False |
| True or False: The appeitite of clients with anorexia tends to improve as the day progresses. | False |
| True or False: Cancer survivors are urged to follow diet recommendations to reduce the risk of cancer in the future. | True |
| True or False: Lipodystrophy can be prevented with a low-fat diet. | False |
| True or False: Clients with HIV who are experiencing malabsorption always have diarrhea. | False |
| True or False: Clients with HIV/AIDS have problems with appetite and intake similar to those of cancer clients. | True |
| True or False: Nutritional counseling of clients with HIV/AIDS should include how to avoid foodborne illnesses. | True |
| The _ help regulate acid-base balance by secreting hydrogen ions to increase PH and excreting bicarbonate to lower PH. | kidneys |
| Kidneys play an important role maintaining normal metabolism of calcium and _. | phosphorus |
| _ may lead to protein calorie malnutrition, anemia, increased risk of infection, vitamin D deficiency, and increased clotting. | hypoalbuminemia |
| For people on hemodialysis, fluid allowance equals the volume of any urine produced plus _ mL. | 1000 |
| Nephrotic syndrome can be caused by what? a. lupus b. proteinuria c. stress d. hyperlipidemia | a. lupus |
| Stage _ requires dialysis or kidney transplant for survival. | 5 |
| _ is the leading cause of Chronic Kidney Disease? | diabetes |
| Clients who are undergoing dialysis may develop a deficiency of _? | zinc |
| What are the calorie recommendations for patients with chronic kidney disease? a. 40 cal/kg for adults under 60 years, 35/40 cal/kg for those who are older b. 35/40 cal/kg for all adults c. 35 cal/kg for adults under 60, 30 cal/kg for 60+ | c. 35 cal/kg for adults under 60, 30 cal/kg for 60+ |
| Post op diet after kidney transplant should be high in _ | protein |
| Acute Renal Failure should strictly limit fluid, _, and protein. | electrolytes |
| True or False: The goal of nutrition therapy for acute renal failure is to provide an adequate amount of calories, protein, and other nutrients to prevent or minimize malnutrition. Easy to achieve with EN, PN, and Oral. | False |
| Which statement indicates the PT needs further instruction about diet for nephrotic syndrome? a. I know I need to eat a high protein diet to replace the protein lost in urine. b. I need to limit my intake of saturated fat and cholesterol. | a. I know I need to eat a high protein deit to replace the protein lost in urine |
| The PT with stage 4 CKD asks if it's okay that she saves all her meat allowance for her evening meal. a. you cannot have any meat on a stage 4 diet. b. it is best if you spread your meat allowance out over the whole day. | b. it is best if you spread your meat allowance out over the whole day |
| When developing a teaching plan for a client who in on dialysis, which of the following protein sources would the nurse suggest for a client who must also limit her intake of phosporus? a. beef b. cheese c. tofu d. kindey beans | a. beef |
| Preventing future calcium stones have been effective when the PT verbalizes he should? a. avoid milk, cheese, and other calcium b. take megadoses of vitamin c c. avoid draft beer, beans, berries, chocolate, and other high oxalate foods d. high protein | c. avoid draft beer, beans, berries, chocolate, and other high oxalate foods |
| How do protein recommendations differ from CKD to Diabetic kidney disease? a. protein is more restricted for CKD than for diabetic kidney disease b. protein is more restricted for diabetic kidney disease than for CKD | a. protein is more restricted for CKD, than diabetic |
| A client on hemodialysis asks if she can use popsicles to help relieve her thirst? a. that's a great idea as long as you deduct the evquivalent amount of fluid from your total daily fluid allowance. b. popsicles are empty calories, u should drink water | a. that's a great idea as long as you deduct the equivalent amount of fluid from your total daily fluid allowance |
| One of the factors that influence protein allowance during acute renal failure is the individual's? a. level of activity b. degree of catabolism c. blood pressure d. serum albumin concentration | b. degree of catabolism |
| True or False: Early in the course of chronic kidney disease, limiting protein may help to preserve kidney function. | True |
| True or False: Foods high in protein tend to be high in phosphorus. | True |
| True or False: Milk is an excellent source of high-biologic value protein for people with chronic kidney disease. | False |
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Demure_Dulcet
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