Deck 19: Carbohydrate - and Fat Modified Diets for Malabsorption Disorders

Question 1

The hydrogen breath test is often used to diagnose lactose intolerance, but it can diagnose malabsorption of other types of carbohydrate, as well.​

Answer 1

True

Question 2

Medium-chain triglyceride (MCT) oil does not require bile for digestion and absorption.​

Answer 2

True

Question 3

Malabsorption of _____ often occurs as a consequence of fat malabsorption.​

A) ​iron and selenium
B) ​zinc and manganese
C) ​calcium and magnesium
D) ​phosphorous and calcium
E) ​sodium and potassium

Answer 3

C

Question 4

About 70 to 80 percent of acute cases of pancreatitis are caused by autoimmune diseases.​

Question 5

Motility disorders that accelerate gastric emptying or intestinal transit can cause fat malabsorption because they prevent the normal mixing of dietary fat with lipase and bile.​

Question 6

Ordinarily, the GI tract is protected from bacterial overgrowth by alkaline secretions which prevent bacterial reproduction.​

Question 7

Malabsorption of calcium is common in persons with fat malabsorption. This can ultimately result in _____.​

A) ​fluid and electrolyte imbalances
B) ​increased risk of bone loss
C) ​loss of taste acuity
D) ​insulin resistance
E) ​muscle loss

Question 8

Many lactose-intolerant individuals can tolerate up to 2 cups of milk per day, especially when intake is divided throughout the day and taken with food.​

Question 9

Approximately 75 percent of people worldwide have some degree of lactose intolerance.​

Question 10

Chemical compounds formed from fatty acids and positively charged minerals are called _____.​

A) ​oxalate
B) ​kidney stones
C) ​steatorrhea
D) ​MCTs
E) ​soaps

Question 11

Fat malabsorption is associated with all of these conditions except _____.​

A) ​weight loss
B) ​essential fatty acid deficiency
C) ​loss of sodium and potassium
D) ​increased risk of kidney stones
E) ​deficiency of fat soluble vitamins

Question 12

The xylose test is used to diagnose _____.​

A) ​impaired fat digestion
B) ​excess vitamin B₁₂absorption
C) ​lactose intolerance
D) ​problems with stomach emptying
E) ​nutrient malabsorption

Question 13

Severe liver disease can lead to fat malabsorption because _____.​

A) ​bile availability is reduced
B) ​the production of pancreatic lipase is reduced
C) ​it results in damage to the intestinal wall
D) ​intestinal transit is increased
E) ​duodenal surface area is reduced

Question 14

Which malabsorption disorder is caused by an intestinal infection?​

A) ​celiac disease
B) ​Crohn's disease
C) ​radiation enteritis
D) ​cystic fibrosis
E) giardiasis​

Question 15

Individuals with celiac disease should consume a gluten-free diet until symptoms improve, then switch back to their normal diet.​

Question 16

Acute pancreatitis is most often caused by high blood triglycerides.​

Question 17

Celiac disease is characterized by an abnormal immune response to certain amino acids.​

Question 18

Which laboratory test can diagnosis lactose intolerance?​

A) ​stool fat test
B) ​biopsy
C) ​hydrogen breath test
D) ​xylose absorption
E) endoscopy​

Question 19

Vitamin B₁₂ is absorbed through the _____.​

A) ​duodenum
B) ​stomach
C) ​ileum
D) ​colon
E) ​mouth mucosa

Question 20

Malabsorption of fat results in _____.​

A) ​steatorrhea
B) ​loss of amino acids
C) ​loss of water-soluble vitamins
D) ​weight gain
E) ​loss of intestinal bacteria

Question 21

Bacterial overgrowth in the stomach and small intestine can result in _____.​

A) ​deficiencies of fat-soluble vitamins
B) ​weight gain
C) ​vitamin B₆ deficiency
D) ​abnormal glucose tolerance
E) ​aplastic anemia

Question 22

Anemia caused by an illness rather than a nutrient deficiency is known as _____.​

A) ​a peripheral blood smear
B) ​anemia of chronic disease
C) ​iron-deficiency anemia
D) ​leukemia
E) ​malabsorption

Question 23

Lactose intolerance is especially prevalent among _____.​

A) ​Scandinavians
B) ​South Americans
C) ​Europeans
D) ​Caucasians
E) ​African Americans

Question 24

Nutrient deficiencies may occur with chronic pancreatitis due to _____.​

A) ​malabsorption and alcohol abuse
B) ​malabsorption of water-soluble vitamins
C) ​malabsorption of protein and abdominal pain
D) ​malabsorption of carbohydrate
E) ​overproduction of insulin

Question 25

Thirty to fifty percent of patients with long-term chronic pancreatitis will develop _____.​

A) ​diabetes
B) ​thickened pancreatic secretions
C) ​celiac disease
D) ​fluid and electrolyte imbalances
E) ​kidney failure

Question 26

Initial therapy for patients with acute pancreatitis includes _____.​

A) ​withholding oral foods and fluids until pain, nausea, and vomiting disappear
B) ​administration of insulin
C) ​stimulation of the pancreas to release protective enzymes
D) ​reduction of hydrochloric acid in the stomach
E) ​promotion of pancreatic cell growth

Question 27

What would you recommend for a patient with cystic fibrosis who experiences persistent steatorrhea, gas, and abdominal distention?​

A) ​an increase in pancreatic enzyme replacements
B) ​a severely fat-restricted diet
C) ​a hydrolyzed formula
D) ​liberal use of table salt
E) ​calcium supplements

Question 28

Which condition is not a potential cause of bacterial overgrowth?​

A) ​atrophic gastritis
B) ​use of acid-suppressing medications
C) ​lactose intolerance
D) ​certain gastrectomy procedures
E) ​impaired intestinal motility

Question 29

For patients with fat malabsorption problems, dietary fat is better tolerated if it is _____.​

A) ​provided in small portions
B) monounsaturated​
C) ​limited to one meal per day
D) ​consumed as fried food
E) ​provided in liquid form

Question 30

Fat malabsorption is associated with deficiencies of _____.​

A) ​water-soluble vitamins, potassium, sodium, and iron
B) ​fat- and water-soluble vitamins, magnesium, and iron
C) ​fat-soluble vitamins, calcium, magnesium, and essential fatty acids
D) ​calcium, potassium, sodium, and essential fatty acids
E) ​water-soluble vitamins, potassium, magnesium, and iron

Question 31

What advice should not be given to individuals who are interested in incorporating MCT oil into their diet?​

A) ​It is inexpensive.
B) ​It should not be used to fry food.
C) ​It should be added to the diet gradually.
D) ​It may have an unpleasant taste.
E) ​It can be absorbed in absence of lipase or bile.

Question 32

The initial diet order for the patient with acute pancreatitis should be _____.​

A) ​clear liquids
B) ​a fat-controlled diet
C) ​nothing by mouth
D) ​a regular diet
E) ​high-kcalorie diet

Question 33

Nutritional therapy for cystic fibrosis includes all of these recommendations except _____.​

A) ​liberal use of table salt
B) ​multivitamin supplements
C) ​pancreatic enzyme replacement therapy
D) ​a low-protein diet
E) ​calcium, iron and zinc supplements

Question 34

Patients with celiac disease must avoid foods that contain _____.​

A) ​iron
B) ​protein
C) ​gluten
D) ​sugar
E) ​fats

Question 35

Celiac disease affects intestinal tissue and results in _____.​

A) ​a significant reduction in mucosal surface area
B) ​ulceration, irritation, and bleeding
C) ​cessation of the production of digestive enzymes
D) ​bacterial overgrowth
E) ​cobblestone appearance of the intestinal mucosa

Question 36

An individual who is experiencing flatulence and diarrhea due to malabsorption problems may benefit from avoiding _____.​

A) ​decaffeinated beverages
B) ​lightly seasoned foods
C) ​lactose-containing foods
D) ​low-fat foods
E) ​protein-rich foods

Question 37

Which symptom does not indicate that a child with cystic fibrosis needs an increase in pancreatic enzyme replacement dosage?​

A) ​poor growth
B) ​steatorrhea
C) ​abdominal pain
D) ​coughing
E) ​intestinal gas

Question 38

Acute pancreatitis can be caused by all of these conditions except _____.​

A) ​gallstones
B) ​exposure to toxins
C) ​stress
D) ​alcohol abuse
E) ​elevated blood triglycerides

Question 39

Patients with celiac disease often cannot tolerate _____.​

A) ​vitamin B₆
B) ​lactose
C) ​fat
D) ​glucose
E) ​sucrose

Question 40

Which foods should be avoided by individuals on a fat-restricted diet?​

A) ​angel food cake, fat-free milk, and pears
B) ​cherry pie, chocolate milk, and spareribs
C) ​marshmallows, fat-free yogurt, and green beans
D) ​oranges, jelly beans, and noodles
E) ​pasta, bread and coffee

Question 41

Kati is at greatest risk of _____ malabsorption.​

A) ​macronutrient
B) ​water-soluble vitamin
C) ​B vitamin
D) ​sodium, potassium, and chloride
E) ​amino acid

Question 42

Elevated levels of _____ are indicative of iron deficiency.​

A) ​serum iron
B) ​serum ferritin
C) ​serum transferrin
D) ​bone marrow iron
E) ​RBC count

Question 43

Which food is included in a gluten-restricted diet?​

A) ​wheat
B) ​rice
C) ​barley
D) ​rye
E) ​malted milk

Question 44

In addition to consuming a gluten-free diet, Kati should be instructed to avoid _____ until her intestines have recovered.

A) ​sodium
B) ​fat
C) ​lactose
D) ​fructose
E) ​sucrose

Question 45

Generally, up to _____% of the small intestine can be resected without serious nutrition consequences.​

A) ​25
B) ​30
C) ​45
D) ​50
E) ​60

Question 46

Which food will be included in the diet plan for a patient with celiac disease?

A) ​oatmeal
B) ​scrambled eggs
C) ​whole-wheat toast
D) ​pasta
E) ​mixed oats

Question 47

What does Kati need to understand about the role of oats in her diet?​

A) ​She should purchase only uncontaminated oats and consume limited quantities.
B) ​She should not consume oats in any form.
C) ​She should limit her consumption of oats to 1 cup of dry rolled oats per day.
D) ​She will need to learn how to prepare oats correctly for consumption.
E) ​She will need to always mix oats with proteins.

Question 48

The initial treatment for a patient with acute pancreatitis includes _____.​

A) ​pain control and intravenous hydration
B) ​restricting fluids
C) ​tube feeding with an elemental formula
D) ​immediate administration of total parenteral nutrition
E) ​normal food intake with insulin injections

Question 49

Which condition does not lead to the development of anemia?

A) ​inadequate production of erythrocytes
B) ​rapid destruction of red blood cells
C) ​loss of erythrocytes due to bleeding
D) ​deficiency of oxygen in the tissues
E) ​iron deficiency

Question 50

In celiac disease, which portion of the digestive tract is typically affected?​

A) ​mouth
B) ​esophagus
C) ​stomach
D) ​colon
E) ​small intestines

Question 51

After intestinal resection, the absorptive efficiency of the intestine is improved through _____.​

A) ​intestinal adaptation
B) ​enzyme replacement therapy
C) ​following a high-fiber diet
D) ​further surgery
E) ​hormonal stimulation

Question 52

The type of anemia associated with vitamin B₁₂ and folate deficiency is called _____.​

A) ​hemolytic anemia
B) ​macrocytic anemia
C) ​macrocytic anemia
D) ​anemia of chronic disease
E) ​pernicious anemia

Question 53

The absorption of vitamins and minerals begins in the _____.​

A) ​duodenum/jejunum
B) ​jejunum/ileum
C) ​ileum
D) ​colon
E) ​stomach

Question 54

The gastrointestinal symptoms Kati is experiencing are due to _____.​

A) ​severe damage to the intestinal mucosa and subsequent malabsorption
B) ​a lack of pancreatic enzymes and resulting malabsorption
C) ​gastrointestinal obstructions caused by the secretion of thick mucus
D) ​bacterial overgrowth causing a disruption in fat digestion and absorption
E) ​loss of insulin production and function

Question 55

If Kati does not eliminate gluten from her diet, she could likely experience all of these conditions except _____.​

A) ​anemia
B) ​infertility
C) ​bone disorders
D) ​hypertension
E) ​muscle wasting

Question 56

Which type of diet would most benefit a patient with cystic fibrosis?

A) ​high-kcalorie, high-fat
B) ​low-kcalorie, low-protein
C) ​high-protein, low-fat
D) ​high-fiber
E) ​low-kcalorie, low-fat

Question 57

Deficiencies of _____ most frequently cause anemia.​

A) ​iron, folate, and vitamin B₁₂
B) ​carbohydrate, protein, and fat
C) ​iron, folate, and vitamin B₆
D) ​essential fatty acids
E) ​iron and vitamin D

Question 58

Hemolytic anemia is associated with a deficiency of _____.​

A) ​iron
B) ​vitamin C
C) ​folate
D) ​vitamin E
E) ​vitamin B₁₂

Question 59

Mrs. Hernandez, a 59-year-old female, has been experiencing diarrhea and increased intestinal gas after drinking milk. She is diagnosed with lactose intolerance and subsequently worries about her bone health if she cannot drink milk. The nurse reassures her that she may still be able to tolerate some dairy foods and consume adequate calcium by all of these means except _____.​

A) ​adding lactase to milk
B) ​consuming yogurt with live bacterial cultures
C) ​dividing her milk intake into small portions throughout the day
D) ​consuming processed, but not aged, cheeses
E) ​consuming food with her milk

Question 60

Kati will require nutrition education aimed at eliminating gluten from her diet. The dietitian will teach Kati to _____.​

A) ​avoid all cereal and grain products
B) ​substitute whole-wheat flour for enriched wheat flour when cooking
C) ​check ingredient lists on food labels carefully
D) ​avoid all milk and milk products
E) ​avoid fish and poultry

Question 61

Matching
a.failure of stem cells to develop into RBCs
b.stimulates RBC production in bone marrow
c.characterized by large immature red blood cells, as occurs in folate or vitamin B12 deficiency
d.production of RBCs
e.blocks the release of iron from storage and thereby renders iron unavailable for red blood cell production
f.genetic mutation that results in altered hemoglobin structure
g.genetic mutation that reduces hemoglobin synthesis
h.results from iron deficiency
i.immature RBC
j.associated with shortened RBC life span
reticulocytes

Question 62

Which organ senses low oxygen content and releases chemicals that stimulate RBC production?

A) ​lungs
B) ​kidney
C) ​bone marrow
D) ​heart
E) ​liver

Question 63

Matching
a.failure of stem cells to develop into RBCs
b.stimulates RBC production in bone marrow
c.characterized by large immature red blood cells, as occurs in folate or vitamin B12 deficiency
d.production of RBCs
e.blocks the release of iron from storage and thereby renders iron unavailable for red blood cell production
f.genetic mutation that results in altered hemoglobin structure
g.genetic mutation that reduces hemoglobin synthesis
h.results from iron deficiency
i.immature RBC
j.associated with shortened RBC life span
erythropoiesis

Question 64

Which process is impacted by cystic fibrosis?​

A) ​blood clotting
B) ​sweating
C) ​liver function
D) ​neuromuscular function
E) ​blood pressure regulation

Question 65

Which clinical procedure does not evaluate and diagnose malabsorption?​

A) ​endoscopy
B) ​stool fat analysis
C) ​hydrogen breath test
D) ​xylose absorption test
E) ​resection

Question 66

Fat malabsorption can lead to _____.

A) ​kidney stones
B) ​diabetes
C) ​muscle loss
D) ​decreased pancreatic function
E) ​hypertension

Question 67

Matching
a.failure of stem cells to develop into RBCs
b.stimulates RBC production in bone marrow
c.characterized by large immature red blood cells, as occurs in folate or vitamin B12 deficiency
d.production of RBCs
e.blocks the release of iron from storage and thereby renders iron unavailable for red blood cell production
f.genetic mutation that results in altered hemoglobin structure
g.genetic mutation that reduces hemoglobin synthesis
h.results from iron deficiency
i.immature RBC
j.associated with shortened RBC life span
hepcidin

Question 68

A patient with celiac disease should avoid _____.

A) ​tofu
B) ​fresh fruit
C) ​egg custards
D) ​vodka
E) ​soy sauce

Question 69

Matching
a.failure of stem cells to develop into RBCs
b.stimulates RBC production in bone marrow
c.characterized by large immature red blood cells, as occurs in folate or vitamin B12 deficiency
d.production of RBCs
e.blocks the release of iron from storage and thereby renders iron unavailable for red blood cell production
f.genetic mutation that results in altered hemoglobin structure
g.genetic mutation that reduces hemoglobin synthesis
h.results from iron deficiency
i.immature RBC
j.associated with shortened RBC life span
thalassemia

Question 70

Matching
a.failure of stem cells to develop into RBCs
b.stimulates RBC production in bone marrow
c.characterized by large immature red blood cells, as occurs in folate or vitamin B12 deficiency
d.production of RBCs
e.blocks the release of iron from storage and thereby renders iron unavailable for red blood cell production
f.genetic mutation that results in altered hemoglobin structure
g.genetic mutation that reduces hemoglobin synthesis
h.results from iron deficiency
i.immature RBC
j.associated with shortened RBC life span
erythropoietin

Question 71

Matching
a. excessive bacterial colonization of the stomach and small intestine
b. excessive fat in the stools resulting from fat malabsorption; characterized by stools that are loose, frothy, and foul smelling due to a high fat content
c. an inherited disease characterized by the production of abnormally viscous exocrine secretions
d. a condition characterized by an abnormal immune reaction to wheat gluten that causes severe intestinal damage and nutrient malabsorption
e. a gluten-sensitive disorder characterized by a severe skin rash
g. a malabsorption syndrome that follows resection of the small intestine due to insufficient absorptive capacity in the remaining intestine
h. chemical compounds formed from fatty acids and positively charged minerals
i. refers to medications or enzyme preparations that are coated to withstand gastric acidity and dissolve only at the higher pH of the small intestine
j. do not require lipase or bile for digestion and absorption, can be used as an alternative source of dietary fat,
k. used to test whether small intestine is able to absorb nutrients
bacterial overgrowth

Question 72

Explain how enzyme replacement preparations avoid digestion by the acid of the stomach.

Question 73

Matching
a. excessive bacterial colonization of the stomach and small intestine
b. excessive fat in the stools resulting from fat malabsorption; characterized by stools that are loose, frothy, and foul smelling due to a high fat content
c. an inherited disease characterized by the production of abnormally viscous exocrine secretions
d. a condition characterized by an abnormal immune reaction to wheat gluten that causes severe intestinal damage and nutrient malabsorption
e. a gluten-sensitive disorder characterized by a severe skin rash
g. a malabsorption syndrome that follows resection of the small intestine due to insufficient absorptive capacity in the remaining intestine
h. chemical compounds formed from fatty acids and positively charged minerals
i. refers to medications or enzyme preparations that are coated to withstand gastric acidity and dissolve only at the higher pH of the small intestine
j. do not require lipase or bile for digestion and absorption, can be used as an alternative source of dietary fat,
k. used to test whether small intestine is able to absorb nutrients
steatorrhea

Question 74

Matching
a.failure of stem cells to develop into RBCs
b.stimulates RBC production in bone marrow
c.characterized by large immature red blood cells, as occurs in folate or vitamin B12 deficiency
d.production of RBCs
e.blocks the release of iron from storage and thereby renders iron unavailable for red blood cell production
f.genetic mutation that results in altered hemoglobin structure
g.genetic mutation that reduces hemoglobin synthesis
h.results from iron deficiency
i.immature RBC
j.associated with shortened RBC life span
hemolytic anemia

Question 75

Matching
a. excessive bacterial colonization of the stomach and small intestine
b. excessive fat in the stools resulting from fat malabsorption; characterized by stools that are loose, frothy, and foul smelling due to a high fat content
c. an inherited disease characterized by the production of abnormally viscous exocrine secretions
d. a condition characterized by an abnormal immune reaction to wheat gluten that causes severe intestinal damage and nutrient malabsorption
e. a gluten-sensitive disorder characterized by a severe skin rash
g. a malabsorption syndrome that follows resection of the small intestine due to insufficient absorptive capacity in the remaining intestine
h. chemical compounds formed from fatty acids and positively charged minerals
i. refers to medications or enzyme preparations that are coated to withstand gastric acidity and dissolve only at the higher pH of the small intestine
j. do not require lipase or bile for digestion and absorption, can be used as an alternative source of dietary fat,
k. used to test whether small intestine is able to absorb nutrients
cystic fibrosis

Question 76

Matching
a.failure of stem cells to develop into RBCs
b.stimulates RBC production in bone marrow
c.characterized by large immature red blood cells, as occurs in folate or vitamin B12 deficiency
d.production of RBCs
e.blocks the release of iron from storage and thereby renders iron unavailable for red blood cell production
f.genetic mutation that results in altered hemoglobin structure
g.genetic mutation that reduces hemoglobin synthesis
h.results from iron deficiency
i.immature RBC
j.associated with shortened RBC life span
aplastic anemia

Question 77

Matching
a. excessive bacterial colonization of the stomach and small intestine
b. excessive fat in the stools resulting from fat malabsorption; characterized by stools that are loose, frothy, and foul smelling due to a high fat content
c. an inherited disease characterized by the production of abnormally viscous exocrine secretions
d. a condition characterized by an abnormal immune reaction to wheat gluten that causes severe intestinal damage and nutrient malabsorption
e. a gluten-sensitive disorder characterized by a severe skin rash
g. a malabsorption syndrome that follows resection of the small intestine due to insufficient absorptive capacity in the remaining intestine
h. chemical compounds formed from fatty acids and positively charged minerals
i. refers to medications or enzyme preparations that are coated to withstand gastric acidity and dissolve only at the higher pH of the small intestine
j. do not require lipase or bile for digestion and absorption, can be used as an alternative source of dietary fat,
k. used to test whether small intestine is able to absorb nutrients
xylose absorption

Question 78

Iron is absorbed primarily in the _____.​

A) ​lungs
B) ​duodenum
C) ​stomach
D) ​ileum
E) ​liver

Question 79

Matching
a. excessive bacterial colonization of the stomach and small intestine
b. excessive fat in the stools resulting from fat malabsorption; characterized by stools that are loose, frothy, and foul smelling due to a high fat content
c. an inherited disease characterized by the production of abnormally viscous exocrine secretions
d. a condition characterized by an abnormal immune reaction to wheat gluten that causes severe intestinal damage and nutrient malabsorption
e. a gluten-sensitive disorder characterized by a severe skin rash
g. a malabsorption syndrome that follows resection of the small intestine due to insufficient absorptive capacity in the remaining intestine
h. chemical compounds formed from fatty acids and positively charged minerals
i. refers to medications or enzyme preparations that are coated to withstand gastric acidity and dissolve only at the higher pH of the small intestine
j. do not require lipase or bile for digestion and absorption, can be used as an alternative source of dietary fat,
k. used to test whether small intestine is able to absorb nutrients
soaps​

Question 80

Matching
a.failure of stem cells to develop into RBCs
b.stimulates RBC production in bone marrow
c.characterized by large immature red blood cells, as occurs in folate or vitamin B12 deficiency
d.production of RBCs
e.blocks the release of iron from storage and thereby renders iron unavailable for red blood cell production
f.genetic mutation that results in altered hemoglobin structure
g.genetic mutation that reduces hemoglobin synthesis
h.results from iron deficiency
i.immature RBC
j.associated with shortened RBC life span
megaloblastic anemia