Question 1

Nursing Exam Review Multiple Choice The nurse notes that a patient with liver disease has had nausea and vomiting. This is most likely a side effect of:

Accepted Answer

Nausea and vomiting are common side effects of lactulose, a medication used to treat liver disease by reducing ammonia levels in the blood. The other medications listed do not commonly cause these symptoms in relation to liver disease.

Question 2

Brian is a 21-year-old Caucasian student who is in his last year of college. Though he is a good student, it has been Brian's practice since freshman year to binge drink on weekends, typically consuming more than a six-pack of beer on Friday and Saturday nights. Brian is 5'11" tall; has weighed about the same, 195 lbs., for the past few years; and is fairly muscular and athletic in his build. He eats most meals in the cafeteria, but despite access to homemade foods, he eats few vegetables, fruits, and whole grains, and his diet is high in fat and salt. The only snacks he consumes are from the vending machine, and he usually washes down a bag of corn chips with a soda or grabs a burger, fries, and beer when out on weekends. He doesn't take any medications and has no significant medical history. A recent physical examination in preparation for basketball season revealed no remarkable physical findings except muscle aches since restarting weight lifting and new-onset stomach pain, which the doctor assesses to be gastritis. A lipid profile found his triglycerides and VLDL cholesterol to be elevated. His blood pressure is slightly elevated. He has a family history of hypertension, stroke, and alcohol abuse.
Many nutrients are adversely affected by heavy drinking. The doctor cautions Brian to take a multivitamin-mineral supplement and to be aware that heavy drinking can reduce absorption of:

Accepted Answer

Heavy drinking can reduce the absorption of thiamin (vitamin B1), which is crucial for energy metabolism and neurological function. Chronic alcohol consumption can lead to thiamin deficiency, potentially resulting in conditions like Wernicke-Korsakoff syndrome.

Question 3

The beneficial effects of moderate alcohol intake are mainly seen in:

Accepted Answer

Research has shown that moderate alcohol intake (one drink per day for women and up to two drinks per day for men) can have beneficial effects on heart health, especially in older adults with risk factors for heart disease. The other options do not have significant research supporting the beneficial effects of moderate alcohol intake.

Question 4

Brian is a 21-year-old Caucasian student who is in his last year of college. Though he is a good student, it has been Brian's practice since freshman year to binge drink on weekends, typically consuming more than a six-pack of beer on Friday and Saturday nights. Brian is 5'11" tall; has weighed about the same, 195 lbs., for the past few years; and is fairly muscular and athletic in his build. He eats most meals in the cafeteria, but despite access to homemade foods, he eats few vegetables, fruits, and whole grains, and his diet is high in fat and salt. The only snacks he consumes are from the vending machine, and he usually washes down a bag of corn chips with a soda or grabs a burger, fries, and beer when out on weekends. He doesn't take any medications and has no significant medical history. A recent physical examination in preparation for basketball season revealed no remarkable physical findings except muscle aches since restarting weight lifting and new-onset stomach pain, which the doctor assesses to be gastritis. A lipid profile found his triglycerides and VLDL cholesterol to be elevated. His blood pressure is slightly elevated. He has a family history of hypertension, stroke, and alcohol abuse.
Most alcohol metabolism takes place in the:

Accepted Answer

Most alcohol metabolism takes place in the liver, where the enzyme alcohol dehydrogenase converts alcohol into acetaldehyde, which is further metabolized by another enzyme called acetaldehyde dehydrogenase. The liver is also responsible for detoxifying other harmful substances in the body.

Question 5

One alcoholic drink that contains about half an ounce of pure alcohol is equivalent to _____ ounces of beer.

Accepted Answer

One standard drink, containing about half an ounce of pure alcohol, is equivalent to approximately 12 ounces of beer. This is based on the general alcohol content of regular beer.

Question 6

Brian is a 21-year-old Caucasian student who is in his last year of college. Though he is a good student, it has been Brian's practice since freshman year to binge drink on weekends, typically consuming more than a six-pack of beer on Friday and Saturday nights. Brian is 5'11" tall; has weighed about the same, 195 lbs., for the past few years; and is fairly muscular and athletic in his build. He eats most meals in the cafeteria, but despite access to homemade foods, he eats few vegetables, fruits, and whole grains, and his diet is high in fat and salt. The only snacks he consumes are from the vending machine, and he usually washes down a bag of corn chips with a soda or grabs a burger, fries, and beer when out on weekends. He doesn't take any medications and has no significant medical history. A recent physical examination in preparation for basketball season revealed no remarkable physical findings except muscle aches since restarting weight lifting and new-onset stomach pain, which the doctor assesses to be gastritis. A lipid profile found his triglycerides and VLDL cholesterol to be elevated. His blood pressure is slightly elevated. He has a family history of hypertension, stroke, and alcohol abuse.
The Dietary Guidelines for Americans recommend that a healthy limit of alcohol intake for Brian would be:

Accepted Answer

The Dietary Guidelines for Americans recommend that men should limit their alcohol intake to no more than two drinks per day.

Question 7

Nursing Exam Review Multiple Choice Mr. Rahman is an alcoholic patient with cirrhosis. He is malnourished and is experiencing protein catabolism. What action is most important to minimize the loss of lean body mass?

Accepted Answer

Taking in adequate calories and increasing protein intake is the most important action to minimize the loss of lean body mass in a malnourished patient with protein catabolism. Decreasing sodium intake, increasing fat intake, and decreasing carbohydrate intake are not directly related to minimizing the loss of lean body mass. While strength training can help improve muscle mass, it is not the most important action in this scenario.

Question 8

Nursing Exam Review Multiple Choice A patient with liver disease is having laboratory testing. The nurse understands that the normal range of albumin would be:

Accepted Answer

The normal range of albumin is 3.4-4.8 g/dL.

Question 9

Brian is a 21-year-old Caucasian student who is in his last year of college. Though he is a good student, it has been Brian's practice since freshman year to binge drink on weekends, typically consuming more than a six-pack of beer on Friday and Saturday nights. Brian is 5'11" tall; has weighed about the same, 195 lbs., for the past few years; and is fairly muscular and athletic in his build. He eats most meals in the cafeteria, but despite access to homemade foods, he eats few vegetables, fruits, and whole grains, and his diet is high in fat and salt. The only snacks he consumes are from the vending machine, and he usually washes down a bag of corn chips with a soda or grabs a burger, fries, and beer when out on weekends. He doesn't take any medications and has no significant medical history. A recent physical examination in preparation for basketball season revealed no remarkable physical findings except muscle aches since restarting weight lifting and new-onset stomach pain, which the doctor assesses to be gastritis. A lipid profile found his triglycerides and VLDL cholesterol to be elevated. His blood pressure is slightly elevated. He has a family history of hypertension, stroke, and alcohol abuse.
Although Brian has not gained weight recently, he remains slightly overweight. How many kcalories per gram does alcohol provide as a source of energy?

Accepted Answer

Alcohol provides 7 kcalories per gram of energy, which is more than carbohydrates and proteins (4 kcalories per gram) but less than fat (9 kcalories per gram).

The best choices for Brian would be:
1. Reduce or eliminate binge drinking on weekends to improve his overall health and reduce the risk of alcohol abuse in the future.
2. Increase his intake of vegetables, fruits, and whole grains to improve the nutritional quality of his diet and reduce the intake of fat and salt.
3. Choose healthier snacks, such as fruits, nuts, or yogurt, instead of the high-fat and high-salt options from vending machines.
4. Incorporate regular physical activity into his routine to manage his weight and improve his overall health, as well as reduce muscle aches caused by weight lifting.
5. Consider medication or lifestyle changes to manage his elevated triglycerides, VLDL cholesterol, and slightly elevated blood pressure, especially given his family history of hypertension and stroke.

Question 10

Nursing Exam Review Multiple Choice The nurse understands that _____ may not be a good indicator of nutritional status in patients with ascites.

Accepted Answer

In patients with ascites, excess fluid accumulation can lead to weight gain and make weight a poor indicator of nutritional status. Other factors such as wasting of muscle mass can also affect weight measurement.

Question 11

Nursing Exam Review Multiple Choice A patient is admitted to the hospital with decreased albumin, elevated alkaline phosphatase, and elevated bilirubin. The nurse recognizes these clinical findings as evidence of:

Accepted Answer

These clinical findings are indicative of liver disease. Decreased albumin levels may indicate impaired liver function, elevated alkaline phosphatase levels may suggest biliary tract obstruction, and elevated bilirubin levels may indicate liver dysfunction. Portal hypertension, esophageal varices, hepatic coma, and hepatic encephalopathy are all potential complications of liver disease, but these specific clinical findings are not indicative of those conditions.

Question 12

Nursing Exam Review Multiple Choice Kim is a 27-year-old well-nourished female who has been diagnosed with hepatitis A. Which nutrition intervention is most appropriate for Kim?

Accepted Answer

The answer of Nursing Exam Review Multiple Choice Kim is...

Question 13

The most common complication of alcohol abuse is:

Accepted Answer

Chronic alcohol abuse is strongly associated with liver disease, such as alcoholic hepatitis and cirrhosis. Other complications may also occur, but liver disease is the most common complication.

Question 14

Andrew Jamison is a 47-year-old construction worker with a long history of alcohol abuse. Recently he has been experiencing fatigue, weakness, loss of appetite, and weight loss. A visit to his physician and laboratory testing confirmed a diagnosis of cirrhosis. He is 5'10" tall and currently weighs 145 pounds.
Due to the risk of foodborne illness, what food should Mr. Jamison avoid if he has a liver transplant ?

Accepted Answer

Mr. Jamison should avoid unwashed produce due to the risk of foodborne illness. Patients who have had liver transplants are more susceptible to infections and should take extra precautions to avoid exposure to bacteria such as E. coli, Salmonella, and Listeria. Washing produce thoroughly before consuming can help reduce the risk of illness.

Question 15

Brian is a 21-year-old Caucasian student who is in his last year of college. Though he is a good student, it has been Brian's practice since freshman year to binge drink on weekends, typically consuming more than a six-pack of beer on Friday and Saturday nights. Brian is 5'11" tall; has weighed about the same, 195 lbs., for the past few years; and is fairly muscular and athletic in his build. He eats most meals in the cafeteria, but despite access to homemade foods, he eats few vegetables, fruits, and whole grains, and his diet is high in fat and salt. The only snacks he consumes are from the vending machine, and he usually washes down a bag of corn chips with a soda or grabs a burger, fries, and beer when out on weekends. He doesn't take any medications and has no significant medical history. A recent physical examination in preparation for basketball season revealed no remarkable physical findings except muscle aches since restarting weight lifting and new-onset stomach pain, which the doctor assesses to be gastritis. A lipid profile found his triglycerides and VLDL cholesterol to be elevated. His blood pressure is slightly elevated. He has a family history of hypertension, stroke, and alcohol abuse.
Because of his heavy drinking, Brian is at highest risk of what condition?

Accepted Answer

Brian's heavy drinking increases his risk of hypoglycemia. Alcohol consumption can interfere with the liver's ability to release glucose into the bloodstream, potentially leading to low blood sugar levels, especially in individuals who binge drink without eating adequate food.

Question 16

Andrew Jamison is a 47-year-old construction worker with a long history of alcohol abuse. Recently he has been experiencing fatigue, weakness, loss of appetite, and weight loss. A visit to his physician and laboratory testing confirmed a diagnosis of cirrhosis. He is 5'10" tall and currently weighs 145 pounds.
The dietitian assesses Mr. Jamison's protein needs based on an appropriate weight for his height and estimates that he requires _____ grams of protein per day.

Accepted Answer

For patients with cirrhosis, especially with a history of alcohol abuse, the recommended protein intake is higher to support liver function and repair. The general recommendation is 1.2 to 1.5 grams of protein per kilogram of body weight per day for individuals with cirrhosis. For a man of Mr. Jamison's stature, an appropriate weight might be around 75 kg (165 pounds, considering a healthy BMI). Therefore, his protein needs would be approximately 90 to 112.5 grams per day (75 kg x 1.2 to 1.5 g/kg/day), which fits best within the range of 66-99 grams per day given the options provided.

Question 17

Nursing Exam Review Multiple Choice Initial symptoms of cirrhosis are usually nonspecific and may include fatigue, malaise, and:

Accepted Answer

Initial symptoms of cirrhosis are nonspecific and may include fatigue, malaise, and weight loss. Confusion, esophageal varices, jaundice, and ascites are later symptoms of cirrhosis.

Question 18

Brian is a 21-year-old Caucasian student who is in his last year of college. Though he is a good student, it has been Brian's practice since freshman year to binge drink on weekends, typically consuming more than a six-pack of beer on Friday and Saturday nights. Brian is 5'11" tall; has weighed about the same, 195 lbs., for the past few years; and is fairly muscular and athletic in his build. He eats most meals in the cafeteria, but despite access to homemade foods, he eats few vegetables, fruits, and whole grains, and his diet is high in fat and salt. The only snacks he consumes are from the vending machine, and he usually washes down a bag of corn chips with a soda or grabs a burger, fries, and beer when out on weekends. He doesn't take any medications and has no significant medical history. A recent physical examination in preparation for basketball season revealed no remarkable physical findings except muscle aches since restarting weight lifting and new-onset stomach pain, which the doctor assesses to be gastritis. A lipid profile found his triglycerides and VLDL cholesterol to be elevated. His blood pressure is slightly elevated. He has a family history of hypertension, stroke, and alcohol abuse.
Brian asks if he can take acetaminophen to relieve his muscle aches. The doctor replies:

Accepted Answer

Acetaminophen can cause liver damage when consumed with alcohol, so it is best to abstain from alcohol when taking it. Doubling the dose is not recommended as it can increase the risk of liver damage. Sedatives are not indicated for muscle aches. Acetaminophen does not worsen gastritis when consumed with alcohol, but alcohol can irritate the stomach lining and exacerbate gastritis symptoms.

Question 19

Nursing Exam Review Multiple Choice The nurse is working with a patient who has liver cirrhosis and who is malnourished. What describes the most appropriate type of nutrition support for this client?

Accepted Answer

The answer of Nursing Exam Review Multiple Choice The nurse...

Question 20

Nursing Exam Review Multiple Choice Mrs. Juarez is diagnosed with cirrhosis and has developed ascites. Her appetite is poor, and she is losing weight. The nurse realizes that she is at risk for malnutrition and encourages Mrs. Juarez to:

Accepted Answer

The answer of Nursing Exam Review Multiple Choice Mrs. Juarez...

Quiz 19: Nutrition and Liver Diseases