Deck 14: Nutrition for Disorders of the Liver, Gallbladder, and Pancreas

Question 1

For patients with hepatitis,an important way to minimize loss of muscle mass is to

A) participate in daily aerobic exercise.
B) participate in daily strength exercise.
C) maintain an adequate protein intake.
D) maintain an adequate micronutrient intake.

Answer 1

C
Adequate protein intake does not prevent loss of muscle mass but does help minimize it.Patients with hepatitis need to rest to promote recovery and healing;their bodies cannot handle the stress of exercise.Maintaining adequate intake of micronutrients is important but does not specifically help maintain muscle mass.

Question 2

An example of an individual who may be at high risk for gallstones is a(n)

A) underweight woman who runs 3 miles four times a week.
B) overweight man who smokes and has a sedentary job.
C) overweight man who has recently begun an exercise program.
D) mother with four children who has lost 25 pounds in the past 3 months.

Answer 2

D
Rapid weight loss increases risk for gallstones,and so a mother who has lost 25 pounds in the past 3 months could easily develop gallstones.Underweight,regular exercise,smoking,and eating eggs do not increase risk for gallstones.Overweight increases risk for gallstones,but less than rapid weight loss.

Question 3

A patient with end-stage liver disease may lose fat stores and muscle mass,but this may not be evident from measurements of body weight because of

A) dehydration.
B) fat redistribution.
C) ascites and edema.
D) electrolyte imbalances.

Answer 3

C
Many patients with end-stage liver disease accumulate fluid,manifested as ascites and edema.This increases body weight,which may mask fat and muscle losses.Patients with end-stage liver disease are not usually dehydrated and do not usually have electrolyte imbalances.Fat infiltrates the liver but is not otherwise redistributed in the body.

Question 4

If a patient with cirrhosis of the liver has a "soft" diet order,he or she probably has

A) lethargy.
B) cholelithiasis.
C) esophageal varices.
D) hepatic encephalopathy.

Question 5

If a patient with cirrhosis of the liver becomes confused and apathetic,he or she may be developing

A) fatty liver disease.
B) hepatitis D.
C) secondary depression.
D) hepatic encephalopathy.

Question 6

If an obese postmenopausal woman who does not drink alcohol develops fatty liver disease and wants to avoid progression to cirrhosis or liver cancer,the best recommendation is to

A) decrease intake of saturated fats.
B) decrease intake of carbohydrate.
C) lose 3 to 4 lb per week.
D) lose 1 to 2 lb per week.

Question 7

A symptom that is common to all types of hepatitis is

A) jaundice.
B) headache.
C) dehydration.
D) muscle aches.

Question 8

An individual may be at risk for HEV infection if they travel to India and eat

A) curried shrimp.
B) fresh fruit salad.
C) Tandoori chicken.
D) cooked foods from street vendors.

Question 9

After liver transplantation,long-term nutrition recommendations most closely resemble those for patients with

A) hepatitis.
B) gallstones.
C) peptic ulcer disease.
D) metabolic syndrome.

Question 10

If a patient with end-stage liver disease gains 5 lb in 1 week,the most likely explanation is

A) development of ascites.
B) restoration of muscle mass.
C) high energy intake.
D) edema in the extremities.

Question 11

A good meal for a patient with ascites would be

A) canned minestrone soup with saltine crackers.
B) baked chicken with a roll and steamed green beans.
C) bacon,sausage,eggs,and toast.
D) tortilla chips with nacho cheese and salsa.

Question 12

If a malnourished patient with cirrhosis of the liver seems to be vulnerable to development of hepatic encephalopathy,the best food to give them would be

A) scrambled eggs.
B) roast beef with gravy.
C) a hamburger.
D) a bean burrito.

Question 13

In treating patients with hepatitis,it is important for nurses to help patients cope with the challenge of

A) difficulty sleeping.
B) risk of bleeding.
C) sodium restriction.
D) fluid restrictions.

Question 14

If a patient with cirrhosis of the liver is treated with lactulose and neomycin,he or she probably has

A) a secondary infection.
B) ascites.
C) esophageal varices.
D) hepatic encephalopathy.

Question 15

If a person has no history of liver disease but does have a strong family history of cardiovascular disease,the person may help decrease the overall risk for chronic disease by

A) following a lacto-ovovegetarian diet.
B) avoiding use of NSAIDs.
C) abstaining from drinking any alcoholic beverages.
D) drinking one or two servings of alcoholic beverages daily.

Question 16

If an otherwise healthy patient with normal body weight develops fatty liver disease,it would be especially important to evaluate their

A) blood glucose level.
B) alcohol intake.
C) total fat intake.
D) use of nonsteroidal anti-inflammatory drugs (NSAIDs).

Question 17

Someone who drinks one glass of wine every night with dinner plus an occasional beer when watching a football game would be considered to be

A) alcoholic.
B) an alcohol addict.
C) a moderate drinker.
D) a heavy drinker.

Question 18

Cholecystitis is caused by

A) blockage of the bile duct by gallstones,bacterial infection,or ischemia.
B) concentration of bile in the gallbladder that favors formation of gallstones.
C) failure of the gallbladder to contract and release bile into the small intestine.
D) intake of excessive amounts of cholesterol and fat,in combination with bacterial infection.

Question 19

The person at greatest risk for developing cirrhosis or liver cancer is a(n)

A) young woman who drinks a glass of wine every day.
B) young man who travels extensively to tropical countries.
C) middle-aged overweight man with gallstones.
D) older adult infected with hepatitis C virus (HCV).

Question 20

If a client will be visiting an area where hepatitis E virus (HEV)is endemic,the best way to prevent becoming infected is to

A) eat only cooked fruits and vegetables and drink only commercially bottled water.
B) eat only at internationally recognized establishments.
C) obtain a vaccination before entering that area.
D) avoid and raw or unpasteurized dairy products.

Question 21

If a nurse is beginning an enteral feedings for a patient with pancreatitis,the only appropriate type of formula is

A) modular.
B) hydrolyzed.
C) intact.
D) hypercaloric.

Question 22

The most beneficial dietary change for a patient with cholelithiasis and cholecystitis would be to

A) avoid fried foods and creamy sauces.
B) abstain from drinking alcohol.
C) refrain from eating 4 hours before bedtime.
D) avoid eggs,shrimp,and high-cholesterol foods.

Question 23

A bottle of beer that contains 13 g of carbohydrates and 16 g of alcohol provides _____ kcal.

A) 116
B) 155
C) 164
D) 203

Question 24

At the beginning of an acute episode of pancreatitis,the nutrition priority is to provide

A) a clear liquid diet.
B) jejunal enteral feedings.
C) parenteral nutrition.
D) intravenous fluids.

Question 25

If a patient is infected with HCV,he or she may

A) have consumed contaminated food or water.
B) be co-infected with hepatitis B virus (HBV).
C) have had sexual contact with an infected person.
D) have recently gotten a tattoo.

Question 26

The only appropriate diet order for a patient with pancreatitis is to begin feedings via

A) nasogastric tube.
B) percutaneous endoscopic gastrostomy (PEG)tube.
C) nasoduodenal tube.
D) percutaneous endoscopic gastrojejunostomy.

Question 27

For patients who are infected with hepatitis and have a poor appetite,the best way to increase protein and energy intake would be

A) adding peanut butter to toast,soups,or smoothies.
B) tossing salads and pasta with olive oil.
C) mixing powdered milk into mashed potatoes and soups.
D) adding sugar to coffee and tea.

Question 28

As a patient who has undergone liver transplantation heals,a necessary transition is

A) increasing protein intake to replace pretransplantation losses.
B) restricting fluid and sodium intakes to prevent ascites.
C) generally eating less to avoid weight gain and chronic disease.
D) generally eating more to maintain body weight and muscle mass.

Question 29

For patients with any kind of liver disease,the most important dietary modification is

A) abstaining from alcohol.
B) decreasing fat intake.
C) increasing protein intake.
D) avoiding dietary fructose.

Question 30

After surgical removal of the gallbladder (cholecystectomy),the nurse should counsel patients to

A) follow a low-fat,low-cholesterol diet.
B) ensure high intake of protein and fluid.
C) eat a well-balanced diet as tolerated.
D) avoid snacking between meals.