Deck 6: Nutritional Alterations

Question 1

A person with a BMI of 28 would be considered

A) obese.
B) overweight or pre-obese.
C) of normal weight.
D) underweight.

Answer 1

overweight or pre-obese.

Question 2

A primary nutritional intervention for hypertension is

A) decreasing carbohydrates.
B) limiting salt.
C) increasing protein.
D) increasing fluids.

Answer 2

limiting salt.

Question 3

Most of the energy produced from carbohydrate metabolism is used to form what substance?

A) Galactose
B) Glycogen
C) Adenosine triphosphate
D) Antibodies

Answer 3

Adenosine triphosphate

Question 4

Patients with coronary artery disease should be taught about cholesterol.Which situation is most desirable?

A) Low levels of HDL cholesterol
B) Low levels of LDL cholesterol
C) Hypocholesterolemia
D) Low levels of both HDL and LDL cholesterol

Question 5

A patient with poorly controlled diabetes mellitus is to be started on enteral tube feeding.What type of formula would be most appropriate?

A) Whole proteins and glucose polymers
B) Concentrated in calories
C) Low sodium
D) High fat, low carbohydrate

Question 6

Diet therapy for a person with hypertension 1 day after a myocardial infarction would include

A) three meals a day with two snacks.
B) a low-protein diet.
C) a low-salt, low-cholesterol diet.
D) a high-carbohydrate diet.

Question 7

Proteins serve the function of

A) maintaining osmotic pressure.
B) providing minerals in the body.
C) maintaining blood glucose.
D) providing a stored source of energy.

Question 8

Prevention of pulmonary aspiration is best accomplished by

A) administering intermittent feedings.
B) adding thickening agents to the tube feeding solution.
C) suctioning the patient hourly.
D) elevating the head of the bed 30 to 45 degrees.

Question 9

The patient is receiving corticosteroid treatment for neurologic alterations.The nurse should assess the patient for episodes of

A) hyponatremia.
B) hyperalbuminemia.
C) hyperkalemia.
D) hyperglycemia.

Question 10

An effect of malnutrition on respiratory function is

A) decreased surfactant.
B) increased vital capacity.
C) decreased PaCO?.
D) tachypnea.

Question 11

A patient has a new order for intermittent nasogastric feedings every 4 hours.The nasogastric tube is placed by the nurse.The best method for confirming the placement of the tube before feeding would be to

A) obtain radiography of the abdomen.
B) check the pH of fluid aspirated from the tube.
C) auscultate the left upper quadrant of the abdomen while injecting air into the tube.
D) auscultate the right upper quadrant of the abdomen while injecting air into the tube.

Question 12

Which of the following nutritional interventions is a priority for the patient with renal disease who is receiving dialysis?

A) Increase fluids to replace losses.
B) Encourage potassium-rich foods to replace losses.
C) Ensure an adequate amount of protein to prevent catabolism.
D) Limit all nutrients to account for altered renal excretion.

Question 13

Two types of protein-caloric malnutrition are kwashiorkor and marasmus.Kwashiorkor results in

A) weight loss and muscle wasting.
B) low levels of serum proteins, low lymphocyte count, and hair loss.
C) elevated serum albumin and increased creatinine excretion in the urine.
D) hyperpigmentation and a hard, easily palpated liver margin.

Question 14

The patient history plays an important role in assessing the patient's nutritional status.Significant laboratory and clinical findings in the patient with cardiovascular disease include

A) low levels of high-density lipoprotein (HDL) cholesterol and transferrin.
B) elevated low-density lipoprotein (LDL) cholesterol and decreased subcutaneous fat.
C) elevated sodium levels and a soft, fatty liver on palpation.
D) normal triglyceride levels and the presence of S3 on auscultation.

Question 15

A patient is admitted to the critical care unit with severe malnutrition as a result of hepatic failure.A triple-lumen central venous catheter is placed in the right subclavian vein, and TPN is started.For which of the following complications should the patient be evaluated immediately after insertion of the catheter?

A) Pneumothorax
B) Hypoglycemia
C) Central venous thrombosis
D) Pulmonary aspiration

Question 16

What is the rationale for careful intake and output for patients with pulmonary alterations?

A) Fluid retention occurs with tachypnea.
B) Hemodilution may cause deleterious hypernatremia.
C) Fluid volume excess can lead to right-sided heart failure.
D) Excessive fluid losses may lead to dehydration and hypovolemic shock.

Question 17

A patient on mechanical ventilation is receiving total parenteral nutrition (TPN).Which of the following is true?

A) Excessive calorie intake can cause an increase in PaCO?.
B) The patient's head should remain elevated at 45 degrees to avoid aspiration.
C) Lipid intake should be maintained at greater than 2 g/kg/day.
D) TPN is preferred over the use of enteral feeding to avoid the complication of aspiration.

Question 18

A patient who has sustained a head injury has increased nutritional needs related to the

A) decrease in metabolism as a result of coma.
B) decrease in blood sugar from a lack of dietary supplementation.
C) anabolism and wound healing.
D) hypermetabolism and catabolism associated with the injury.

Question 19

The loss of exocrine function of pancreatitis results in

A) anorexia.
B) obesity.
C) malabsorption.
D) hyperglycemia.

Question 20

Obtaining height and weight measurements for the critically ill patient

A) should be deferred until the medical condition stabilizes.
B) should be measured rather than obtained through patient or family report.
C) requires consistent weights in pounds.
D) requires weight, but height can be deferred.

Question 21

A tracheostomy patient is experiencing regurgitation of tube feeding formula.The nurse's first priority should be

A) checking to make sure the tracheostomy cuff is inflated during tube feedings.
B) placing the patient in the right lateral decubitus position to promote gastric emptying.
C) discussing the use of metoclopramide to facilitate gastric motility with the physician.
D) placing the patient in prone position to improve draining from mouth.

Question 22

A patient is admitted to the critical care unit with severe malnutrition as a result of hepatic failure.A triple-lumen central venous catheter is placed in the right subclavian vein, and TPN is started.On the third day of infusion, the patient develops symptoms of fever and chills.Which of the following complications should be suspected?

A) Air embolism
B) Pneumothorax
C) Central venous thrombosis
D) Catheter-related sepsis

Question 23

The nutritional alteration most frequently encountered in hospitalized patients is

A) respiratory quotient (RQ).
B) protein-calorie malnutrition.
C) fat-calorie malnutrition.
D) gluconeogenesis.

Question 24

Which of the following medical interventions may be initiated with the onset of hyperglycemia?

A) Discontinuing the infusion
B) Adding insulin to the TPN
C) Weaning from the TPN over a 6-hour period
D) Starting an infusion of 0.9% normal saline

Question 25

Sodium and fluid restrictions ordered for the patient with heart failure are primarily aimed at reducing

A) use of medications.
B) weight.
C) cardiac workload.
D) serum lipids.

Question 26

A patient is admitted to the critical care unit with severe malnutrition as a result of hepatic failure.A triple-lumen central venous catheter is placed in the right subclavian vein, and TPN is started.Which of the following dietary restrictions should be maintained for the patient?

A) Fat and magnesium
B) Protein and sodium
C) Carbohydrate and potassium
D) Protein and calcium

Question 27

A patient is mechanically ventilated and is receiving enteral nutrition via a nasogastric tube.To help ensure feeding tolerance, the nurse checks residual volumes every 4 hours.During a residual check later in the shift, the nurse aspirates a total residual volume of 350 mL.The nurse will

A) stop the tube feeding, wait 1 hour, and recheck the residual.
B) discontinue the feeding tube and tube feeding and call the physician for TPN orders.
C) continue the tube feeding, if no other gastrointestinal symptoms exist, and reassess the patient with the next residual check.
D) continue the tube feeding and place the patient in the left lateral decubitus position to facilitate gastric emptying.

Question 28

The patient's feeding tube is occluded and cannot be flushed.The nurse knows that the best irrigant for feeding tube occlusion is

A) cola.
B) pancreatic enzyme.
C) water.
D) juice.

Question 29

Which of the following signs would alert the nurse to possible nutritional alterations?

A) Impaired wound healing
B) Edema
C) Nail growth
D) Muscle atrophy
E) diaphoresis

Question 30

A patient was admitted with ESRD and on hemodialysis.Which of the following elements should be restricted?

A) Fluid
B) Protein
C) Carbohydrates
D) Fats
E) Phosphorus