Deck 24: Lower Gastrointestinal Disorders

Question 1

All of the following are included in medical nutrition therapy for constipation except

A)prunes.
B)a low-fiber diet.
C)plenty of fluids.
D)regular physical activity.

Answer 1

B

Question 2

Consequences of severe diarrhea include

A)weight gain.
B)dehydration.
C)hemorrhoids.
D)all of the above

Answer 2

B

Question 3

If severe dehydration accompanies diarrhea, then _____ is typically used to replenish fluids and electrolytes.

A)an IV solution
B)a clear-liquid diet
C)No fluids are permitted during this time.
D)none of the above

Answer 3

A

Question 4

Who would be at high risk for developing constipation?

A)Sarah, who is 30 years old and on a high-fiber diet
B)William, who is an 80-year-old man and lives in a nursing home
C)Joe, a CEO of a major company who exercises regularly
D)All of the above

Question 5

How do laxatives help with the treatment of constipation?

A)Increase stool weight
B)Increase the water content of stool
C)Stimulate peristaltic contractions
D)All of the above

Question 6

The digestion and absorption of nutrients occur primarily in the:

A)stomach.
B)pancreas.
C)small intestine.
D)large intestine.

Question 7

A physician tells a client experiencing constipation about foods that are high in insoluble fiber, like

A)cheddar cheese.
B)chicken.
C)wheat bran.
D)all of the above

Question 8

Which of the following is not known to cause chronic diarrhea?

A)inflammatory disorders
B)infectious diseases
C)malabsorptive disorders
D)probiotic disorders

Question 9

Mrs.Johnson is a 36-year-old female who enters the emergency room complaining of severe diarrhea of a four-hour duration.Physical assessment findings reveal warm, dry skin; decreased turgor; dry mucous membranes; and vital signs of T-99.6, Pulse-104.The nurse caring for Mrs.Johnson should

A)recommend over-the-counter antidiarrheal agents.
B)instruct Mrs.Johnson to remain NPO until the diarrhea subsides.
C)encourage a diet high in protein.
D)evaluate for possible fluid and electrolyte replacement.

Question 10

Mrs.Thomas has been suffering from a mild case of diarrhea for the past 4 days.Which of the following should Mrs.Thomas be given to replace fluid and electrolytes?

A)Apple juice
B)Low-fat milk
C)Caffeine-free carbonated beverage
D)All of the above

Question 11

A food that may produce gas is

A)bananas.
B)dried beans and peas.
C)brown rice.
D)all of the above

Question 12

Bertha suffers from diabetes and has had symptoms of abdominal pain and diarrhea after taking her sugar-free cough medicine.What is the most likely cause?

A)Food allergy
B)Lactose tolerance
C)Flatulence
D)Sugar alcohol

Question 13

All of the following are dietary substances that may increase intestinal gas production except:

A)apples.
B)peaches.
C)beer.
D)cabbage.

Question 14

Which of the following is not a cause of constipation?

A)Excessive physical activity
B)Hypothyroidism
C)Depression medications
D)Calcium supplements

Question 15

Mary has been diagnosed with lactose intolerance after complaining of chronic diarrhea.Which type of diarrhea is she most likely experiencing?

A)Intractable diarrhea
B)Motility disorder-related diarrhea
C)Osmotic diarrhea
D)Secretory diarrhea

Question 16

_____ are medications used as treatment for diarrhea.

A)Laxatives
B)Antidiarrheal agents
C)Antacids
D)a and b

Question 17

Antidiarrheal agents are used for the treatment of diarrhea because

A)they slow GI motility or reduce intestinal secretions.
B)they increase GI motility or increase intestinal secretions.
C)they slow GI motility and may help fight infectious agents.
D)they increase GI motility and reduce intestinal secretions.

Question 18

Mrs.Thomas has been suffering from a mild case of diarrhea for the past 4 days.Once the diarrhea stops, Mrs.Thomas should be given all of the following instructions except

A)gradually introduce a regular diet.
B)avoid milk or milk products for a few days.
C)foods with sorbitol are acceptable.
D)avoid dried beans and onions for a few days.

Question 19

Which of the following statements is true?

A)Constipation is a condition of having difficult bowel movements.
B)Constipation may result in excessive straining during defecation.
C)Constipation can be defined as defecation frequency of less than three bowel movements per week.
D)All of the above

Question 20

Steatorrhea occurs in which of the following conditions?

A)Pancreatitis
B)Cystic fibrosis
C)Crohn's disease
D)Celiac disease
E)All of the above

Question 21

Anna has been diagnosed with steatorrhea.The physician should be concerned about malabsorption of which nutrients?

A)Water-soluble vitamins
B)Fat-soluble vitamins
C)Essential fatty acids
D)b and c
E)a, b, and c

Question 22

Sara has been diagnosed with bacterial overgrowth.Her physician might advise her to do all of the following except:

A)use prescribed antibiotics.
B)incorporate MCT oil in her diet.
C)begin using an acid-reducing medication.
D)take supplemental calcium and vitamin B₁₂.

Question 23

Which is the best dessert for a client on a fat-controlled diet?

A)Cookies
B)Ice cream
C)Cherry pie
D)Sherbet

Question 24

Serum amylase levels are monitored in clients in order to

A)establish the presence of lactose intolerance.
B)help confirm a diagnosis of acute pancreatitis.
C)improve protein status.
D)evaluate the need for drug therapy.

Question 25

What is the most frequent cause of chronic pancreatitis?

A)Repeated episodes of acute pancreatitis
B)Alcohol consumption
C)Liver disease
D)Cystic fibrosis

Question 26

Which of the following menus best meets the objectives of a fat-controlled diet for a client with steatorrhea?

A)Tuna fish salad, crackers, ice cream, tea
B)Baked chicken, macaroni and cheese, biscuits, milk
C)Pork tenderloin, plain baked potato, applesauce, tea
D)Sirloin steak, potato salad, broccoli au gratin, milk

Question 27

Which of the following nutrients has the greatest stimulating effect on pancreatic secretions?

A)Carbohydrates
B)Fat
C)Protein
D)Vitamins

Question 28

What additional complication of chronic pancreatitis is a concern for physicians?

A)Dehydration
B)Kidney stones
C)Damage to cells of the pancreas that synthesize insulin and glucagon
D)Nausea

Question 29

Steve is finally able to eat solid foods after being hospitalized with acute pancreatitis six days ago.Which kind of diet would be most appropriate at this time?

A)Low protein
B)Low carbohydrate
C)Low fiber
D)Low fat

Question 30

Pancreatitis is defined as

A)production of a thick mucus that affects the pancreas.
B)an inflammatory disorder of the pancreas.
C)ulceration along the pancreas.
D)none of the above

Question 31

Nutritional consequences of fat malabsorption include which of the following?

A)Weight gain and malnutrition
B)Loss of essential amino acids
C)Increased risk of bone loss
D)Decreased risk of oxalate stone formation
E)All of the above

Question 32

MCT oil is commonly used in malabsorption syndromes because

A)it is high in essential fatty acids.
B)the absorption occurs in the large intestine.
C)it does not require bile for absorption.
D)it can be delivered parenterally.

Question 33

A diet for a person with a fat malabsorption syndrome would typically contain how many grams of fat per day?

A)15 to 25 grams
B)25 to 35 grams
C)25 to 50 grams
D)50 to 60 grams

Question 34

Possible consequences of bacterial overgrowth include all of the following except:

A)night-blindness.
B)bruising.
C)periodontal disease.
D)pernicious anemia.

Question 35

Janice is on a 25 gram fat diet.She should limit meats to _____ ounces per day and limit fats and oils to _____ teaspoons per day.

A)6; 8
B)8; 6
C)4; 2
D)2; 4

Question 36

When calcium is unable to bind oxalate, this may lead to

A)enteric hypoxaluria.
B)kidney stones.
C)hypercalcemia.
D)none of the above

Question 37

The diet therapy for acute pancreatitis may include all of the following except

A)elimination of fat.
B)progression from a liquid diet to solid foods.
C)resumption of oral intake after abdominal pain subsides.
D)use of tube feeding.

Question 38

Which of the following is appropriate for a 50-gram fat-controlled diet?

A)Up to 6 oz.of lean meats and poultry (skinless)
B)Up to 7 oz.of lean meats and poultry (skinless)
C)Up to 6 teaspoons of fat daily
D)Up to 7 teaspoons of fat daily

Question 39

Dan, an alcoholic for the past 20 years, has been diagnosed with chronic pancreatitis.Which other systemic illness is he also at risk for developing?

A)Diabetes
B)Kidney disease
C)Heart disease
D)Short bowel syndrome

Question 40

Which of the following should be excluded from a 50-gram fat-controlled diet?

A)Whole milk
B)Tofu
C)Starchy vegetables
D)All of the above

Question 41

Ulcerative colitis involves which section(s) of the gastrointestinal tract?

A)Large intestine
B)Small intestine
C)Jejunum and rectum
D)Biliary tract

Question 42

What are the energy needs of children with cystic fibrosis?

A)10 to 15 percent of the DRI
B)50 to 75 percent of the DRI
C)110 to 200 percent of the DRI
D)120 to 150 percent of the DRI

Question 43

An immune disorder that causes a sensitivity to gliadin is called

A)Crohn's disease.
B)celiac disease.
C)cystic fibrosis.
D)pancreatitis.

Question 44

Dietitians recommend that patients with celiac disease, adapt their diets by

A)following a gluten-free diet.
B)following a fat-controlled diet.
C)avoiding rice.
D)avoiding dairy products.

Question 45

Which of the following inflammatory bowel diseases causes nutrient malabsorption?

A)Crohn's disease
B)Ulcerative colitis
C)a and b

Question 46

The protein fraction in wheat gluten that has toxic effects in celiac disease is called:

A)gluten.
B)gliadin.
C)casein.
D)whey.

Question 47

Betsey, a client with celiac disease, asks the dietitian whether she can include oats in her diet.How should the dietitian respond?

A)Limit your intake to about ½ cup dry rolled oats per day, and monitor your tolerance.
B)You must exclude oats from your diet.
C)You can consume oats freely because they don't contain gluten like wheat or barley.
D)You should compare labels and select oats in baked form or mixed with other grains.

Question 48

An appropriate food for a client with celiac disease is

A)a peanut butter and jelly sandwich on wheat bread.
B)oatmeal cookies.
C)applesauce.
D)cheese and rye crackers.

Question 49

Why are patients with cystic fibrosis advised to follow a high-kcal diet?

A)Increased energy requirements
B)Bronchial tissue inflammation
C)Sweat losses of sodium
D)All of the above

Question 50

Which of these statements is false?

A)The mucus secretions of individuals with cystic fibrosis are abnormally thick and viscous.
B)The airways of people with cystic fibrosis secrete greater amounts of mucus than normal.
C)The major complications of cystic fibrosis are manifested in the sweat glands, pancreas, and lungs.
D)Cystic fibrosis is caused by a genetic disorder that affects chloride transport in exocrine glands.

Question 51

Clinical symptoms of celiac disease do not include which of the following?

A)Diarrhea
B)Reduced GI motility
C)Stunted growth in children
D)Severe underweight in children
E)All of the above

Question 52

Inflammation and lesions along the ileum and colon are called

A)irritable bowel syndrome.
B)Crohn's disease.
C)pancreatitis.
D)cystic fibrosis.

Question 53

An indication for supplemental enteral tube feedings for a client with cystic fibrosis is

A)inadequate sodium chloride intake.
B)the need for water-miscible forms of fat-soluble vitamins.
C)inadequate energy intakes.
D)steatorrhea.

Question 54

The most appropriate diet therapy for clients with cystic fibrosis is to

A)reduce fat to less than 35 grams per day.
B)supply missing enzymes.
C)limit kcalories to 1200 per day.
D)restrict sodium.

Question 55

Which organ can be affected by cystic fibrosis?

A)Pancreas
B)Liver
C)Lungs
D)Gallbladder
E)All of the above

Question 56

Where is vitamin B₁₂ absorbed? (Choose the best answer.)

A)Only in the stomach
B)Only in the small intestine
C)Only in the ileum
D)Only in the colon

Question 57

The usual diet recommendation for a client with ulcerative colitis who is not experiencing a disease exacerbation is a

A)high-fiber diet.
B)high-protein diet.
C)high-fat diet.
D)diet without restrictions.

Question 58

The nutrients of greatest concern for malabsorption in patients with cystic fibrosis include all of the following except:

A)fat-soluble vitamins.
B)B vitamins.
C)essential fatty acids.
D)calcium.
Question 24.4 Conditions Affecting the Small Intestine

Question 59

Which of the following conditions results in fat malabsorption but with no need for a dietary fat restriction?

A)Celiac disease
B)Pancreatitis
C)Cystic fibrosis
D)Crohn's disease

Question 60

The hereditary disorder that is caused by a mutation in the gene for a membrane protein that transports chloride ions is:

A)cystic fibrosis.
B)pancreatitis.
C)Crohn's disease.
D)none of the above

Question 61

Immediately after intestinal surgery, the primary nutritional effort should be to

A)increase protein levels.
B)replace fluids and electrolytes.
C)provide kcalories.
D)decrease gas formation.

Question 62

Which of the following patients should be cautious about consuming probiotics?

A)Diabetic
B)Dementia
C)Chemotherapy
D)Influenza

Question 63

Generally, up to _____ percent of the small intestine can be resected without serious nutrition complications.

A)30
B)40
C)50
D)60

Question 64

Symptoms associated with irritable bowel syndrome do not include

A)constipation.
B)diarrhea.
C)flatulence, abdominal pain, and bloating.
D)steatorrhea.

Question 65

Patients with ileostomies are at risk for developing obstructions.A patient can reduce her risk for this complication by:

A)following a high-fiber diet.
B)chewing food thoroughly.
C)taking B₁₂ injections.
D)chewing gum daily.

Question 66

Which of the following foods is least likely to cause an obstruction for a patient with an ostomy if cut into small pieces and chewed carefully?

A)Corn and popcorn
B)Dried fruit
C)Bananas
D)Nuts and seeds

Question 67

A potential side effect of a high-fiber diet would be:

A)diarrhea.
B)diverticulosis.
C)flatulence.
D)ostomy.

Question 68

What is the malabsorption syndrome that results after surgery when the absorptive capacity of the remaining intestine is insufficient for meeting nutritional needs?

A)Celiac disease
B)Short bowel syndrome
C)Irritable bowel syndrome
D)Inflammatory bowel disease

Question 69

Three-year-old Jenny is on antibiotics for 10 days.In order to prevent complications, her mother was advised to add _____ to her diet.

A)fruit punch
B)sugar-free gelatin
C)saltines
D)yogurt

Question 70

Following a colostomy, patients typically experience _____.

A)low urine output
B)constipation
C)acidosis
D)hyperglycemia

Question 71

Miss Bell is ordered a high-fiber diet to maintain normal bowel movement.What could prevent her intake of high-fiber foods (e.g., raw apples, salads)?

A)Low acid production
B)Lack of fiber enzymes
C)Poor dentition
D)Short-term memory problems

Question 72

Which of the following foods might help reduce odors for patients with colostomies?

A)Buttermilk
B)Cranberry juice
C)Beer
D)a and c
E)a and b
Questions for Section 24.6 Probiotics and Intestinal Health

Question 73

A surgical procedure that creates a stoma from the final segment of the colon that remains after a colectomy is:

A)an ileostomy.
B)a colostomy.
C)a stoma.
D)none of the above

Question 74

Mrs.Smith has severe ulcerative colitis and is scheduled for surgery in two days.Her nutrition status has been deteriorating.Which of the following therapies is recommended for nutritional support?

A)High-kcalorie and high-protein diet
B)Enteral feedings
C)Total parenteral nutrition
D)Clear liquid diet

Question 75

Which of the following diagnoses or its treatment could be causing Miss.Bell's constipation?

A)Depression
B)Osteoporosis
C)Memory loss
D)a and b
E)b and c

Question 76

Medications prescribed to patients with irritable bowel syndrome include

A)anticholinergics and antidiarrheals.
B)antidepressants and antimicrobials.
C)antidepressants and laxatives.
D)a and b
E)a and c

Question 77

Alison has had chronic and recurring diarrhea.She also has a past history of depression and anxiety.Which of the following is the most likely diagnosis for Alison?

A)Short bowel syndrome
B)Irritable bowel syndrome
C)Crohn's disease
D)Diverticulosis

Question 78

Which statement is true?

A)There is strong evidence to support the recommendation that patients with diverticulosis should avoid nuts, popcorn, and foods that contain seeds.
B)The nutritional recommendations for diverticulosis are to increase the fiber content of the diet gradually and to emphasize insoluble fiber sources.
C)Diverticulosis is the most common complication of diverticulitis.
D)High-fiber diets, because of the associated stool weight and bulk, require more vigorous muscle contractions within the large intestine than do low-fiber diets.

Question 79

Case Studies
Miss Betty Bell is a new resident to Lake Nursing Home.She has a history of osteoporosis, depression, and memory loss.She tells her admitting nurse that she has not had a bowel movement since 1967.Her nurse questions her further to determine that she has had irregular bowel movements for the past 40 plus years.
All of the following are potential causes for constipation except:

A)dehydration.
B)a low-fiber diet
C)increased food intake.
D)decreased physical activity.

Question 80

Dietary recommendations for patients with short-bowel syndrome include which of the following?

A)Concentrated sweets to provide kcal
B)Fluids between meals only
C)Diet high in complex carbohydrates
D)High-oxalate diet
E)All of the above
Questions for Section 24.5 Conditions Affecting the Large Intestine