Deck 40: Medical Nutrition Therapy for Neurologic Disorders

Question 1

Which of the following can result from thiamin deficiency?

A) Pernicious anemia
B) Wernicke-Korsakoff syndrome
C) Pellagra
D) Adrenomyeloleukodystrophy

Answer 1

B
Explanation: Thiamin deficiency is the primary cause of Wernicke-Korsakoff syndrome. This is a potential side effect of alcoholism, and the syndrome manifests with encephalopathy, involuntary movement of the eyeballs, and impaired gait. Pernicious anemia is associated with vitamin B₁₂ deficiency and manifests with general weakness and tingling in the hands and feet. Pellagra results from niacin deficiency and is associated with dementia. Adrenomyeloleukodystrophy is a congenital enzyme deficiency that results in the accumulation of very-long-chain fatty acids. This disorder manifests with dementia, aphasia, apraxia, dysarthria, and blindness.

Question 2

For which condition might a ketogenic diet be used in treatment?

A) Myasthenia gravis
B) Migraine headache
C) Epilepsy
D) Guillain-Barré syndrome (GBS)

Answer 2

C
Explanation: The ketogenic diet, which is set up to create and maintain a state of ketosis, has been used to effectively control seizure activity in children with epilepsy. The diet focuses on providing a fat-to-protein and carbohydrate ratio of 4:1 calories. For myasthenia gravis, nutrition therapy is focused on ensuring intake despite chewing and swallowing difficulties. For migraine headaches, nutrition therapy eliminates foods that seem to trigger migraines while maintaining adequate fluid for rehydration. For patients who develop GBS, high calorie and protein intakes are necessary to counter the hypercatabolism associated with the condition.

Question 3

Sensory deficits of limbs on the opposite of the body that result from an occlusion of the middle cerebral artery on one side of the brain are known as

A) hemiparesis.
B) hemiplegia.
C) hemianopsia.
D) hemi-inattention.

Answer 3

A
Explanation: Hemiparesis is a weakness or deficit of sensation on one side of the body that is associated with damage or impairment of the brain on the opposite side. Hemiplegia is a condition of paralysis associated with half of the body. Hemianopsia is blindness in one eye that causes a person to only see half of the visual field. Hemi-inattention is the neglect of one side of the body because the patient is not able to sense that side of the body.

Question 4

Which of the following is NOT true of head-injured patients?

A) They have profound urinary nitrogen loss.
B) Their energy needs are related to the Glasgow Coma Scale.
C) They are hypermetabolic.
D) They have decreased energy needs.

Question 5

How may phenobarbital, used for anticonvulsant therapy, interfere with the intestinal absorption of calcium?

A) It increases metabolism of vitamin D in the liver.
B) It prevents absorption of vitamin D in the intestinal mucosa.
C) It induces diarrhea and loss of electrolytes.
D) It damages the mucosal cells lining the intestinal wall.

Question 6

Which of the following can occur with impaired swallowing?

A) Aspiration pneumonia
B) Hemiparesis
C) Dysgeusia
D) Comminution

Question 7

Pyrazole curcumin is being actively researched for treatment for

A) stroke.
B) traumatic brain injury.
C) ALS.
D) seizures.

Question 8

The Frazier free water protocol is used for patients with

A) Wernicke-Korsakoff syndrome.
B) brain trauma.
C) multiple sclerosis.
D) dysphagia.

Question 9

The guideline for use of a percutaneous endoscopic gastrostomy (PEG) in patients with neurologic disease or disorders is to use

A) whenever there is a risk of aspiration pneumonia.
B) with patients whose swallowing function will not ensure adequate nutritional intake.
C) with patients who refuse a central line for total parenteral nutrition.
D) with patients who are expected to resume oral alimentation within 7 days.

Question 10

Which of the following foods is easiest to swallow for patients experiencing difficulty swallowing?

A) Thin liquids
B) Room temperature cream soups
C) Lukewarm cooked cereals diluted with milk
D) Cool, soft textured foods with sauce or gravy

Question 11

What is the guideline for accepted weight adjusted for quadriplegia?

A) Ideal body weight (IBW) as determined by the Hamwi formula
B) 10 to 15 lb less than IBW as determined by the Hamwi formula
C) 10 to 15 lb less than ideal body mass index (BMI)
D) 15 to 20 lb less than ideal BMI

Question 12

Which of the following is the inability to perform purposeful, complex movements, although no sensory or motor impairment is evident?

A) Apraxia
B) Aphasia
C) Anosmia
D) Agnosia

Question 13

On the Dysphagia Outcome and Severity Scale, at what level is total assistance for the patient necessary?

A) Level 7
B) Level 5
C) Level 3
D) Level 1

Question 14

Which of the following requires the greatest coordination and control in order to swallow?

A) Solid foods
B) Liquids of thin consistency
C) Soft foods with high water content
D) Thick, viscous liquids

Question 15

Damage to which of the following cranial nerves will likely affect the ability to eat food?

A) Olfactory (I) nerve
B) Abducens (VI) nerve
C) Glossopharyngeal (IX) nerve
D) Vagus (X) nerve

Question 16

During which phase of swallowing does bolus formation occur?

A) Oral phase
B) Early pharyngeal phase
C) Middle pharyngeal phase
D) Esophageal phase

Question 17

Which of the following is characterized by a cholesterol plaque within an artery that ruptures and promotes platelet aggregation to clog an already narrowed artery?

A) Intracranial hemorrhage
B) Embolic stroke
C) Thrombotic stroke
D) Transient ischemic attack

Question 18

Because of potential drug-nutrient interactions, it would be more beneficial to provide the majority of their dietary protein to patients with Parkinson disease

A) during breakfast.
B) at the noon meal.
C) evenly throughout the day.
D) with the evening meal.

Question 19

A patient with amyotrophic lateral sclerosis (ALS) has a rating of 3 or 4 on the swallowing severity scale. Which of the following interventions would be recommended in the medical nutrition therapy plan?

A) A regular diet with small, frequent feedings
B) Modification of dietary consistency and texture
C) Supplemental tube feedings
D) Nothing by mouth (NPO)

Question 20

What is dysphagia?

A) Inhalation of a foreign object into the lungs
B) Impaired taste
C) Difficulty swallowing
D) Impairment of the tongue or other muscles essential to speech