Question 1

What is nitrogen balance useful in determining?&#10;A)The adequacy of protein intake&#10;B)The adequacy of carbohydrate intake&#10;C)The need for vitamin supplementation&#10;D)Fluid and electrolyte balance

Accepted Answer

Nitrogen values often are referred to in discussion of protein requirements because nitrogen is found only in the amino acids that make up proteins. Measuring nitrogen, which is a simple laboratory measure, is the easiest way to measure protein intake or excretion.

Question 2

How does the cachectic patient appear physically?&#10;A)Central obesity only&#10;B)Very thin and malnourished&#10;C)Edematous around the face&#10;D)Very short of breath

Accepted Answer

One should note the effects of body mass on breathing efficiency. Cachectic (nutritionally depleted) patients have readily outlined bony structures with depression of the intercostal spaces. Accessory muscles of respiration often are visible in these patients.

Question 3

Which of the following may be more difficult with a high-carbohydrate diet?&#10;A)Oxygenation&#10;B)Cellular gas exchange&#10;C)Oxygen transport&#10;D)Weaning from mechanical ventilation

Accepted Answer

The major problem that has arisen with carbohydrate intake in patients with respiratory disorders occurs when glucose has been given in excess. The increased 11ea4b05_ea5a_0851_ab93_2d8fa8bb8340_TB4069_11 CO₂ (a result of both the high RQ of glucose metabolism and its conversion to fat) has induced respiratory difficulty in patients who are being weaned from mechanical ventilators. This has been observed primarily when glucose has been administered by the parenteral (IV) route.

Question 4

What gas is required for optimum production of adenosine triphosphate (ATP)?&#10;A)Argon&#10;B)Carbon dioxide&#10;C)Nitrous oxide&#10;D)Oxygen

Accepted Answer

The use of food for energy at the cellular level requires oxygen to support a controlled combustion process that produces energy molecules of ATP, which are used in all body processes for energy (see Figure 18-2).

Question 5

What is the RQ value of a patient eating a pure carbohydrate diet?&#10;A)0.60&#10;B)0.70&#10;C)0.85&#10;D)1.00

Accepted Answer

Pure fat metabolism has an RQ of 0.7 (more oxygen is used than the carbon dioxide produced), protein has a value of 0.85, and carbohydrate has a value of 1 (an even ratio, where one carbon dioxide (CO₂) molecule is produced for each molecule of oxygen (O₂) used).

Question 6

Which of the following might hinder attempts at nutritional repletion in patients with respiratory disease?
1)The use of bronchodilators
2)Simple oxygen therapy
3)Intubation
4)Deep breathing and cough exercises

A)1, 2, 3
B)1, 3
C)2, 4
D)1, 2, 3, 4

Accepted Answer

Nutritional repletion in respiratory patients often is hindered by necessary therapeutic actions. Bronchodilators may produce nausea; oxygen by nasal cannula disturbs the sense of smell and, therefore, taste because 70% of the taste of food is contributed by the sense of smell. Medications that patients are taking may interact with nutrients and render them less available for absorption or even may inhibit specific metabolic enzymes. An intubated patient really complicates the process of eating.

Question 7

Which of the following is associated with a low-protein diet?&#10;A)Increased work of breathing&#10;B)Increased fixed acid load&#10;C)Immune compromise&#10;D)Increased stress on the kidneys

Accepted Answer

Too little protein compromises the immune system, promotes edema and ascites, produces generalized wasting of muscle tissue, and retards growth and proper development in children.

Question 8

Which of the following is an indicator of the energy requirements of the patient?&#10;A)PaO&#8322; to PaO&#8322; ratio&#10;B)Minute ventilation&#10;C)Oxygen uptake per minute&#10;D)Vital capacity

Accepted Answer

The metabolic rates of tissues dictate the amount of oxygen that must be picked up within the lungs. Oxygen uptake ( 11ea4b05_ea59_931b_ab93_f3341479299c_TB4069_11 O₂) is a respiratory factor that can be measured in the laboratory or at the bedside. Nutritionally speaking, it is this measure that indicates the patient's energy requirement. If 11ea4b05_ea59_931c_ab93_3fd29b5ddf5c_TB4069_11 O₂ is measured while a person is in a resting, nonstressed state, the basal metabolic rate (BMR) or basal energy expenditure (BEE) can be calculated.

Question 9

Which of the following might indicate poor nutritional status?&#10;A)Low BMI&#10;B)Positive nitrogen balance&#10;C)Positive response to skin antigen testing&#10;D)High serum albumin level

Accepted Answer

BMIs below 19 are associated with malnutrition problems and more prevalent pneumonia infection.

Question 10

Which of the following is true about anaerobic metabolism?
1)It can cause metabolic acidosis.
2)It results in excess lactate production.
3)It results in excess production of carbon dioxide.
4)It is a very inefficient method of producing ATP.

A)1, 2, 3
B)1, 3
C)2, 4
D)1, 2, 3, 4

Accepted Answer

In anaerobic metabolism, pyruvate produces lactate (lactic acid) rather than acetyl coenzyme A (CoA). The greater the energy production without sufficient oxygen, the more lactic acid is produced. This can result in lactic acidosis. If this occurs, the acid must be buffered with bicarbonate ( 11ea4b05_ea59_e140_ab93_933bc52a2849_TB4069_11 ), and carbon dioxide is produced in the process. This requires increased minute ventilation to eliminate the carbon dioxide generated. This is a short-term solution only. In the absence of oxygen, inefficient anaerobic metabolism will rapidly result in death.

Question 11

What mineral plays a very important role in oxygen transport?&#10;A)Calcium&#10;B)Iron&#10;C)Zinc&#10;D)Magnesium

Accepted Answer

The answer of What mineral plays a very important role...

Question 12

What test is most useful for screening a patient for protein malnutrition?&#10;A)Serum albumin level&#10;B)Triceps skinfold&#10;C)Creatinine-height index&#10;D)BMI

Accepted Answer

The answer of What test is most useful for screening...

Question 13

What element must be stored in sufficient quantities to meet the metabolic demands of the diaphragm?&#10;A)Arginine&#10;B)Glycogen&#10;C)2,3-DPG (diphosphoglycerate)&#10;D)Fat

Accepted Answer

The answer of What element must be stored in sufficient...

Question 14

Which of the following is not associated with a high-fat diet?&#10;A)Increased risk of heart disease&#10;B)Decreased tissue oxygenation&#10;C)Decreased DLCO&#10;D)Increased carbon dioxide production

Accepted Answer

The answer of Which of the following is not associated...

Question 15

What method of nutritional delivery is considered the least efficient?&#10;A)By mouth&#10;B)By nasogastric tube&#10;C)By arterial line&#10;D)By IV line

Accepted Answer

The answer of What method of nutritional delivery is considered...

Question 16

Measuring the patient's energy expenditure with the use of oxygen consumption is referred to as _____ calorimetry.&#10;A)direct&#10;B)indirect&#10;C)simple&#10;D)complex

Accepted Answer

The answer of Measuring the patient's energy expenditure with the...

Question 17

What dietary adjustment might be best for patients with more severe chronic obstructive pulmonary disease (COPD)?&#10;A)Increased carbohydrates&#10;B)Increased fats&#10;C)Increased proteins&#10;D)Increased salt intake

Accepted Answer

The answer of What dietary adjustment might be best for...

Question 18

Which of the following are associated with increased metabolism?
1)Severe burns
2)Severe infection
3)Multiple traumas
4)Hyperthyroidism

A)1, 2, 3
B)1, 3
C)2, 4
D)1, 2, 3, 4

Accepted Answer

The answer of Which of the following are associated with...

Question 19

Which of the following is a pulmonary effect of starvation?&#10;A)Increased diffusing capacity of the lung for carbon monoxide (DLCO)&#10;B)Increased forced expiratory volume in 1 second (FEV1)&#10;C)Increased risk of pneumonia&#10;D)Increased functional residual capacity (FRC)

Accepted Answer

The answer of Which of the following is a pulmonary...

Question 20

Of which of the following components should the majority of dietary intake be made up?&#10;A)Fat&#10;B)Carbohydrate&#10;C)Protein&#10;D)None of the above

Accepted Answer

The answer of Of which of the following components should...

Question 21

Which of the following findings during inspection would suggest that the patient is malnourished?&#10;A)Generalized obesity&#10;B)Use of accessory muscles&#10;C)Presence of wheezes&#10;D)Weak cough

Accepted Answer

The answer of Which of the following findings during inspection...

Deck 18: Nutrition Assessment