Deck 18: Nutrition and Lower Gastrointestinal Disorders
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Deck 18: Nutrition and Lower Gastrointestinal Disorders
1
What food would be best tolerated by a patient suffering from diarrhea?
A) green beans
B) i ce cream
C) c offee
D) c hicken
E) a rtichokes
A) green beans
B) i ce cream
C) c offee
D) c hicken
E) a rtichokes
D
2
MCT oil does not require bile for digestion and absorption.
True
3
What beverage would most likely produce intestinal gas?
A) a sports drink
B) t ea
C) diet soda
D) c offee
E) w ater
A) a sports drink
B) t ea
C) diet soda
D) c offee
E) w ater
C
4
Many lactose-intolerant individuals can tolerate up to 2 cups of milk a day when intake is divided throughout the day and taken with food.
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5
What situation best describes a potential cause of constipation?
A) a high-fiber diet
B) l actase deficiency
C) i nadequate fluid intake
D) a viral infection
E) f oodborne illness
A) a high-fiber diet
B) l actase deficiency
C) i nadequate fluid intake
D) a viral infection
E) f oodborne illness
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6
What negative effects have been shown to be associated with stimulant laxatives?
A) f luid and electrolyte imbalances
B) a nemia
C) i ncreased appetite
D) h yperglycemia
E) r ectal bleeding
A) f luid and electrolyte imbalances
B) a nemia
C) i ncreased appetite
D) h yperglycemia
E) r ectal bleeding
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7
Irritable bowel syndrome occurs more frequently in men than in women, and episodes of acute symptoms often increase with age.
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8
Acute pancreatitis can result from high blood triglycerides.
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9
Commercial sports drinks are not recommended for the treatment of severe diarrhea because they are too:
A) expensive .
B) high in sodium.
C) low in potassium.
D) high in sugar.
E) low in sodium.
A) expensive .
B) high in sodium.
C) low in potassium.
D) high in sugar.
E) low in sodium.
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10
Billy consumed the following foods at lunch: A hamburger with lettuce, tomato, and catsup on a bun; cabbage salad, potato chips, and a glass of iced tea. Later that afternoon Billy began to experience intestinal gas. Which food was most likely responsible for the gas production?
A) hamburger meat
B) tomato
C) cabbage salad
D) iced tea
E) potato chips
A) hamburger meat
B) tomato
C) cabbage salad
D) iced tea
E) potato chips
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11
Foods useful for increasing dietary fiber include:
A) bran, milk, and mashed potatoes.
B) peanut butter, oranges, and strawberry jam.
C) saltine crackers, watermelon, and eggs.
D) whole-grain bread, dried beans, and nuts.
E) ground beef, sweet potatoes, and ice cream.
A) bran, milk, and mashed potatoes.
B) peanut butter, oranges, and strawberry jam.
C) saltine crackers, watermelon, and eggs.
D) whole-grain bread, dried beans, and nuts.
E) ground beef, sweet potatoes, and ice cream.
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12
Psyllium may be helpful in the treatment of diarrhea because it reduces the liquidity of the stool.
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13
Daily exercise has been proven to cure constipation by stimulating peristalsis.
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14
What describes a potential cause of osmotic diarrhea?
A) f oodborne illness
B) i ntestinal inflammation
C) i rritating chemicals
D) h igh fructose intake
E) a ccelerated colonic transit
A) f oodborne illness
B) i ntestinal inflammation
C) i rritating chemicals
D) h igh fructose intake
E) a ccelerated colonic transit
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15
A side effect of consuming a high-fiber diet is:
A) flatulence.
B) watery stools.
C) bacterial overgrowth.
D) constipation.
E) hemorrhoids.
A) flatulence.
B) watery stools.
C) bacterial overgrowth.
D) constipation.
E) hemorrhoids.
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16
A high-fiber diet increases stool weight and fecal water content.
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17
Celiac disease is characterized by an abnormal immune response to certain amino acids.
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18
The client with a colostomy or ileostomy should have a diet that is restricted in fluids.
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19
A colostomy involves removal of the entire colon.
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20
What bulk-forming agent may actually cause an allergic reaction?
A) m ethylcellulose
B) psyllium
C) p olycarbophil
D) m alt soup extract
E) m agnesium citrate
A) m ethylcellulose
B) psyllium
C) p olycarbophil
D) m alt soup extract
E) m agnesium citrate
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21
What foods would have the least detrimental effects when consumed by a patient with steatorrhea?
A) bacon and eggs
B) v itamin D milk and ice cream
C) p ancakes and granola
D) g round beef and au gratin potatoes
E) g raham crackers and diet soda
A) bacon and eggs
B) v itamin D milk and ice cream
C) p ancakes and granola
D) g round beef and au gratin potatoes
E) g raham crackers and diet soda
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22
Bacterial overgrowth in the stomach and small intestine can result in:
A) a deficiency of fat-soluble vitamins.
B) weight gain.
C) vitamin B6 deficiency.
D) abnormal glucose tolerance.
E) loss of bone density.
A) a deficiency of fat-soluble vitamins.
B) weight gain.
C) vitamin B6 deficiency.
D) abnormal glucose tolerance.
E) loss of bone density.
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23
Patients with celiac disease must avoid foods that contain:
A) iron.
B) protein.
C) gluten.
D) sugar.
E) trans fats.
A) iron.
B) protein.
C) gluten.
D) sugar.
E) trans fats.
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24
In which ethnic group is lactose intolerance most prevalent?
A) Arab Americans
B) Asians
C) Australians
D) Caucasians
E) Pacific Islanders
A) Arab Americans
B) Asians
C) Australians
D) Caucasians
E) Pacific Islanders
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25
In cases of mild-to-moderate pancreatitis, the patient should receive what diet order until he is pain free and experiences no nausea or vomiting?
A) clear liquids
B) a fat-controlled diet
C) nothing by mouth
D) a regular diet
E) a low-sodium diet
A) clear liquids
B) a fat-controlled diet
C) nothing by mouth
D) a regular diet
E) a low-sodium diet
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26
Aggressive dietary management of Crohn's disease is required in children because this disorder can lead to:
A) growth failure.
B) a shortened lifespan.
C) behavioral problems.
D) impaired glucose tolerance.
E) learning disabilities.
A) growth failure.
B) a shortened lifespan.
C) behavioral problems.
D) impaired glucose tolerance.
E) learning disabilities.
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27
The initial treatment for acute pancreatitis includes:
A) providing vitamin D supplementation.
B) increasing insulin production.
C) stimulating the pancreas.
D) reducing hydrochloric acid in stomach.
E) administering intravenous hydration.
A) providing vitamin D supplementation.
B) increasing insulin production.
C) stimulating the pancreas.
D) reducing hydrochloric acid in stomach.
E) administering intravenous hydration.
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28
One of the most common causes of acute pancreatitis is:
A) high LDL levels.
B) exposure to toxins.
C) alcohol abuse.
D) diabetes.
E) smoking.
A) high LDL levels.
B) exposure to toxins.
C) alcohol abuse.
D) diabetes.
E) smoking.
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29
Most cases of Crohn's disease affect which part of the gastrointestinal tract?
A) t he esophagus
B) t he lower esophageal sphincter
C) t he stomach
D) t he duodenum
E) t he ileum
A) t he esophagus
B) t he lower esophageal sphincter
C) t he stomach
D) t he duodenum
E) t he ileum
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30
Malabsorption of some minerals, including _____ often occurs because the minerals form soaps with the unabsorbed fatty acids.
A) iron and selenium
B) chloride and manganese
C) calcium and magnesium
D) phosphorous and vitamin B6
E) vitamins A and K
A) iron and selenium
B) chloride and manganese
C) calcium and magnesium
D) phosphorous and vitamin B6
E) vitamins A and K
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31
A patient with bacterial overgrowth in the gastrointestinal tract would most likely be treated with which type of medication?
A) p roton pump inhibitors
B) antibiotics
C) antidiarrheals
D) H2 receptor antagonists
E) antacids
A) p roton pump inhibitors
B) antibiotics
C) antidiarrheals
D) H2 receptor antagonists
E) antacids
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32
Celiac disease affects intestinal tissue and results in:
A) reduction in mucosal surface area.
B) ulceration, irritation, and bleeding.
C) cessation of the production of digestive enzymes.
D) bacterial overgrowth.
E) acid reflux from the stomach to the esophagus.
A) reduction in mucosal surface area.
B) ulceration, irritation, and bleeding.
C) cessation of the production of digestive enzymes.
D) bacterial overgrowth.
E) acid reflux from the stomach to the esophagus.
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33
Generally, up to _____% of the small intestine can be resected without serious nutritional consequences.
A) 25
B) 30
C) 45
D) 50
E) 75
A) 25
B) 30
C) 45
D) 50
E) 75
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34
What food component could be included in a gluten-free diet?
A) wheat
B) rice
C) barley
D) rye
E) triticale
A) wheat
B) rice
C) barley
D) rye
E) triticale
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35
Mr. Taylor seeks medical treatment for frequent, urgent bowel movements streaked with mucus and blood, and tests reveal a large, continuous area of inflammation affecting the first two layers of tissue in his rectum. What is Mr. Taylor's likely diagnosis?
A) Crohn's disease
B) ulcerative colitis
C) celiac disease
D) irritable bowel syndrome
E) short bowel syndrome
A) Crohn's disease
B) ulcerative colitis
C) celiac disease
D) irritable bowel syndrome
E) short bowel syndrome
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36
With early detection and advances in medical treatment of cystic fibrosis, the median life span for patients with this condition has reached nearly _____ years of age.
A) 20
B) 35
C) 40
D) 45
E) 55
A) 20
B) 35
C) 40
D) 45
E) 55
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37
Beyond complications associated with lung tissue, the pancreas, and sweat glands in the patient with cystic fibrosis, which complication has also been associated with cystic fibrosis?
A) gallbladder and liver disease
B) c ardiac arrhythmias
C) e levated blood glucose levels
D) p oor wound healing
E) v ision loss
A) gallbladder and liver disease
B) c ardiac arrhythmias
C) e levated blood glucose levels
D) p oor wound healing
E) v ision loss
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38
Which condition is most likely associated with fat malabsorption in the gastrointestinal tract?
A) acute pancreatitis
B) celiac disease
C) gall stones
D) c onstipation
E) p eptic ulcer disease
A) acute pancreatitis
B) celiac disease
C) gall stones
D) c onstipation
E) p eptic ulcer disease
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39
A patient who takes pancreatic enzyme replacements is at risk of what type of gastrointestinal side effects?
A) a bdominal bloating
B) rectal bleeding
C) f latulence
D) c onstipation
E) heartburn
A) a bdominal bloating
B) rectal bleeding
C) f latulence
D) c onstipation
E) heartburn
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40
What best describes the protein needs of a patient with chronic pancreatitis?
A) 0.4-0.8 g/kg of body weight per day
B) 0.8-1.0 g/kg of body weight per day
C) 1.0-1.5 g/kg of body weight per day
D) 1.5-1.8 g/kg of body weight per day
E) 1.8-2.0 g/kg of body weight per day
A) 0.4-0.8 g/kg of body weight per day
B) 0.8-1.0 g/kg of body weight per day
C) 1.0-1.5 g/kg of body weight per day
D) 1.5-1.8 g/kg of body weight per day
E) 1.8-2.0 g/kg of body weight per day
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41
A patient with an ostomy is concerned about excessive odor from his stoma. He should be advised to avoid what food?
A) yogurt
B) brussels sprouts
C) cranberry juice
D) applesauce
E) buttermilk
A) yogurt
B) brussels sprouts
C) cranberry juice
D) applesauce
E) buttermilk
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42
Non-digestible substances in foods that stimulate the growth of nonpathogenic bacteria within the large intestine are called:
A) prebiotics.
B) probiotics.
C) intestinal flora.
D) pathogenic bacteria.
E) subdominant bacteria.
A) prebiotics.
B) probiotics.
C) intestinal flora.
D) pathogenic bacteria.
E) subdominant bacteria.
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43
Kelly is a 27-year-old Caucasian who works as a bank teller. She is 5'3" tall and weighs 102 pounds. She began experiencing recurrent gastrointestinal disturbances such as diarrhea, steatorrhea, and flatulence several months ago. She made an appointment with her physician after noticing that she was losing weight. Laboratory tests confirmed a diagnosis of celiac disease.
Kelly should be instructed to avoid _____ until her intestine has recovered.
A) sodium
B) fat
C) lactose
D) fructose
E) protein
Kelly should be instructed to avoid _____ until her intestine has recovered.
A) sodium
B) fat
C) lactose
D) fructose
E) protein
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44
Diverticulitis is thought to occur in up to _____ percent of individuals with diverticulosis.
A) 10-15
B) 18-23
C) 10-25
D) 25-35
E) 48
A) 10-15
B) 18-23
C) 10-25
D) 25-35
E) 48
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45
The absorption of vitamins and minerals begins in the:
A) stomach.
B) duodenum.
C) jejunum.
D) ileum.
E) colon.
A) stomach.
B) duodenum.
C) jejunum.
D) ileum.
E) colon.
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46
Medical History: A.R. is a healthy 51-year old premenopausal Caucasian woman with pallor who is employed full-time in an office job. She had a pancreatic cyst removed six years ago. She was asymptomatic until one year ago when she developed acute pancreatitis flare-ups after consuming fatty foods. The condition was attributed to scarring at the pancreatic duct, which secretes pancreatic lipase, and was accompanied by severe abdominal pain radiating to her back, vomiting, and steatorrhea. She was placed on oral pancreatic lipase enzyme tablets (Pancrease™) that digest fat and was prescribed to follow a "low-fat diet." The medication and diet help to reduce her symptoms, and she notes that flare-ups generally only occur when she eats too much fat. Anthropometric: Ht: 5'2. Wt: 156 lbs. Wt 1 yr ago: 199 lbs. Frame size: Medium.
Clinical/Labs: A.R.'s serum vitamin D was low (20 ng/mL; normal is 25-80 ng/mL), but all other labs were within normal limits when she last visited her internal medicine physician several months ago. She was placed on a 5,000-IU vitamin D supplement, to be reduced to a 2,000-IU vitamin D supplement thereafter; she takes no other vitamins or minerals. Other medications include Synthroid and Aygestin.
Current Chief Complaints: A.R.'s current problems include constipation and dry skin.
Diet: "My usual grocery list consists of boneless chicken breasts, turkey, pork chops (infrequently), strip steak (infrequently), 90/10 ground beef, pasta (half whole-wheat, half regular), tomatoes and sauce to make pasta sauce, 90 percent fat-free lunch meat ham or turkey, brown rice, steamable microwave vegetables, red and green lettuce, tomatoes, onions, cereal, blueberries if on sale, apples, tangerines, red licorice, bread, crackers, and canned soup. I am concerned about not having enough protein or iron because I am afraid to eat very much red meat. The foods I miss the most include iced tea, which I skip because of caffeine-I am getting bored with water. I like to bake and I miss baked goods, and I also miss cheese-I am afraid it is too high in fat. I have a hard time figuring out what to pack for lunch. The restaurants I go to if I do go out are Chick-Fil-A, Panera, Viva, a local diner, and an Italian restaurant. I like Italian and Mexican food. Usually if I do eat out it is for lunch but it is sometimes hard to figure out something safe to eat..." Dairy foods: Twice a day, drinks 2 8-oz glasses of 1% milk. Fruits: 1 cup per day.
To follow a fat-restricted diet, A.R. should:
A) choose vegetable oils instead of solid fats .
B) use only medium-chain triglyceride oil to fry foods.
C) consume no more than a 6-ounce portion of meat at one sitting.
D) limit fats and oils to 8 teaspoons per day.
E) choose foods that have less than 5 grams of fat per serving.
Clinical/Labs: A.R.'s serum vitamin D was low (20 ng/mL; normal is 25-80 ng/mL), but all other labs were within normal limits when she last visited her internal medicine physician several months ago. She was placed on a 5,000-IU vitamin D supplement, to be reduced to a 2,000-IU vitamin D supplement thereafter; she takes no other vitamins or minerals. Other medications include Synthroid and Aygestin.
Current Chief Complaints: A.R.'s current problems include constipation and dry skin.
Diet: "My usual grocery list consists of boneless chicken breasts, turkey, pork chops (infrequently), strip steak (infrequently), 90/10 ground beef, pasta (half whole-wheat, half regular), tomatoes and sauce to make pasta sauce, 90 percent fat-free lunch meat ham or turkey, brown rice, steamable microwave vegetables, red and green lettuce, tomatoes, onions, cereal, blueberries if on sale, apples, tangerines, red licorice, bread, crackers, and canned soup. I am concerned about not having enough protein or iron because I am afraid to eat very much red meat. The foods I miss the most include iced tea, which I skip because of caffeine-I am getting bored with water. I like to bake and I miss baked goods, and I also miss cheese-I am afraid it is too high in fat. I have a hard time figuring out what to pack for lunch. The restaurants I go to if I do go out are Chick-Fil-A, Panera, Viva, a local diner, and an Italian restaurant. I like Italian and Mexican food. Usually if I do eat out it is for lunch but it is sometimes hard to figure out something safe to eat..." Dairy foods: Twice a day, drinks 2 8-oz glasses of 1% milk. Fruits: 1 cup per day.
To follow a fat-restricted diet, A.R. should:
A) choose vegetable oils instead of solid fats .
B) use only medium-chain triglyceride oil to fry foods.
C) consume no more than a 6-ounce portion of meat at one sitting.
D) limit fats and oils to 8 teaspoons per day.
E) choose foods that have less than 5 grams of fat per serving.
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47
A person with _____ typically experiences an excessive colonic response to meals, gastrointestinal hormones, and stress.
A) celiac disease
B) short bowel syndrome
C) Crohn's disease
D) irritable bowel syndrome
E) ulcerative colitis
A) celiac disease
B) short bowel syndrome
C) Crohn's disease
D) irritable bowel syndrome
E) ulcerative colitis
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48
Medical History: A.R. is a healthy 51-year old premenopausal Caucasian woman with pallor who is employed full-time in an office job. She had a pancreatic cyst removed six years ago. She was asymptomatic until one year ago when she developed acute pancreatitis flare-ups after consuming fatty foods. The condition was attributed to scarring at the pancreatic duct, which secretes pancreatic lipase, and was accompanied by severe abdominal pain radiating to her back, vomiting, and steatorrhea. She was placed on oral pancreatic lipase enzyme tablets (Pancrease™) that digest fat and was prescribed to follow a "low-fat diet." The medication and diet help to reduce her symptoms, and she notes that flare-ups generally only occur when she eats too much fat. Anthropometric: Ht: 5'2. Wt: 156 lbs. Wt 1 yr ago: 199 lbs. Frame size: Medium.
Clinical/Labs: A.R.'s serum vitamin D was low (20 ng/mL; normal is 25-80 ng/mL), but all other labs were within normal limits when she last visited her internal medicine physician several months ago. She was placed on a 5,000-IU vitamin D supplement, to be reduced to a 2,000-IU vitamin D supplement thereafter; she takes no other vitamins or minerals. Other medications include Synthroid and Aygestin.
Current Chief Complaints: A.R.'s current problems include constipation and dry skin.
Diet: "My usual grocery list consists of boneless chicken breasts, turkey, pork chops (infrequently), strip steak (infrequently), 90/10 ground beef, pasta (half whole-wheat, half regular), tomatoes and sauce to make pasta sauce, 90 percent fat-free lunch meat ham or turkey, brown rice, steamable microwave vegetables, red and green lettuce, tomatoes, onions, cereal, blueberries if on sale, apples, tangerines, red licorice, bread, crackers, and canned soup. I am concerned about not having enough protein or iron because I am afraid to eat very much red meat. The foods I miss the most include iced tea, which I skip because of caffeine-I am getting bored with water. I like to bake and I miss baked goods, and I also miss cheese-I am afraid it is too high in fat. I have a hard time figuring out what to pack for lunch. The restaurants I go to if I do go out are Chick-Fil-A, Panera, Viva, a local diner, and an Italian restaurant. I like Italian and Mexican food. Usually if I do eat out it is for lunch but it is sometimes hard to figure out something safe to eat..." Dairy foods: Twice a day, drinks 2 8-oz glasses of 1% milk. Fruits: 1 cup per day.
A.R.'s steatorrhea can be evaluated by placing her on a high-fat diet, performing a 48- to 72-hour stool collection, and:
A) checking her cholesterol levels.
B) measuring the stool's fat content.
C) evaluating the pH of a urine sample.
D) measuring the protein content of the stool sample.
E) measuring her body weight.
Clinical/Labs: A.R.'s serum vitamin D was low (20 ng/mL; normal is 25-80 ng/mL), but all other labs were within normal limits when she last visited her internal medicine physician several months ago. She was placed on a 5,000-IU vitamin D supplement, to be reduced to a 2,000-IU vitamin D supplement thereafter; she takes no other vitamins or minerals. Other medications include Synthroid and Aygestin.
Current Chief Complaints: A.R.'s current problems include constipation and dry skin.
Diet: "My usual grocery list consists of boneless chicken breasts, turkey, pork chops (infrequently), strip steak (infrequently), 90/10 ground beef, pasta (half whole-wheat, half regular), tomatoes and sauce to make pasta sauce, 90 percent fat-free lunch meat ham or turkey, brown rice, steamable microwave vegetables, red and green lettuce, tomatoes, onions, cereal, blueberries if on sale, apples, tangerines, red licorice, bread, crackers, and canned soup. I am concerned about not having enough protein or iron because I am afraid to eat very much red meat. The foods I miss the most include iced tea, which I skip because of caffeine-I am getting bored with water. I like to bake and I miss baked goods, and I also miss cheese-I am afraid it is too high in fat. I have a hard time figuring out what to pack for lunch. The restaurants I go to if I do go out are Chick-Fil-A, Panera, Viva, a local diner, and an Italian restaurant. I like Italian and Mexican food. Usually if I do eat out it is for lunch but it is sometimes hard to figure out something safe to eat..." Dairy foods: Twice a day, drinks 2 8-oz glasses of 1% milk. Fruits: 1 cup per day.
A.R.'s steatorrhea can be evaluated by placing her on a high-fat diet, performing a 48- to 72-hour stool collection, and:
A) checking her cholesterol levels.
B) measuring the stool's fat content.
C) evaluating the pH of a urine sample.
D) measuring the protein content of the stool sample.
E) measuring her body weight.
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49
A potential treatment for irritable bowel syndrome that is still under investigation is use of:
A) arachidonic acid.
B) peppermint oil.
C) omega-6-fatty acids.
D) MCT oil.
E) hydrolyzed formula.
A) arachidonic acid.
B) peppermint oil.
C) omega-6-fatty acids.
D) MCT oil.
E) hydrolyzed formula.
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50
Kelly is a 27-year-old Caucasian who works as a bank teller. She is 5'3" tall and weighs 102 pounds. She began experiencing recurrent gastrointestinal disturbances such as diarrhea, steatorrhea, and flatulence several months ago. She made an appointment with her physician after noticing that she was losing weight. Laboratory tests confirmed a diagnosis of celiac disease.
The gastrointestinal symptoms Kelly 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) reduced transit and subsequent food breakdown in the large intestine .
The gastrointestinal symptoms Kelly 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) reduced transit and subsequent food breakdown in the large intestine .
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51
Medical History: A.R. is a healthy 51-year old premenopausal Caucasian woman with pallor who is employed full-time in an office job. She had a pancreatic cyst removed six years ago. She was asymptomatic until one year ago when she developed acute pancreatitis flare-ups after consuming fatty foods. The condition was attributed to scarring at the pancreatic duct, which secretes pancreatic lipase, and was accompanied by severe abdominal pain radiating to her back, vomiting, and steatorrhea. She was placed on oral pancreatic lipase enzyme tablets (Pancrease™) that digest fat and was prescribed to follow a "low-fat diet." The medication and diet help to reduce her symptoms, and she notes that flare-ups generally only occur when she eats too much fat. Anthropometric: Ht: 5'2. Wt: 156 lbs. Wt 1 yr ago: 199 lbs. Frame size: Medium.
Clinical/Labs: A.R.'s serum vitamin D was low (20 ng/mL; normal is 25-80 ng/mL), but all other labs were within normal limits when she last visited her internal medicine physician several months ago. She was placed on a 5,000-IU vitamin D supplement, to be reduced to a 2,000-IU vitamin D supplement thereafter; she takes no other vitamins or minerals. Other medications include Synthroid and Aygestin.
Current Chief Complaints: A.R.'s current problems include constipation and dry skin.
Diet: "My usual grocery list consists of boneless chicken breasts, turkey, pork chops (infrequently), strip steak (infrequently), 90/10 ground beef, pasta (half whole-wheat, half regular), tomatoes and sauce to make pasta sauce, 90 percent fat-free lunch meat ham or turkey, brown rice, steamable microwave vegetables, red and green lettuce, tomatoes, onions, cereal, blueberries if on sale, apples, tangerines, red licorice, bread, crackers, and canned soup. I am concerned about not having enough protein or iron because I am afraid to eat very much red meat. The foods I miss the most include iced tea, which I skip because of caffeine-I am getting bored with water. I like to bake and I miss baked goods, and I also miss cheese-I am afraid it is too high in fat. I have a hard time figuring out what to pack for lunch. The restaurants I go to if I do go out are Chick-Fil-A, Panera, Viva, a local diner, and an Italian restaurant. I like Italian and Mexican food. Usually if I do eat out it is for lunch but it is sometimes hard to figure out something safe to eat..." Dairy foods: Twice a day, drinks 2 8-oz glasses of 1% milk. Fruits: 1 cup per day.
In which way would A.R. benefit from using medium-chain triglycerides?
A) a s a source of essential fatty acids
B) a s a primary source of energy
C) t o add flavor to foods
D) a s a method of weight control
E) t o keep foods palatable and soft
Clinical/Labs: A.R.'s serum vitamin D was low (20 ng/mL; normal is 25-80 ng/mL), but all other labs were within normal limits when she last visited her internal medicine physician several months ago. She was placed on a 5,000-IU vitamin D supplement, to be reduced to a 2,000-IU vitamin D supplement thereafter; she takes no other vitamins or minerals. Other medications include Synthroid and Aygestin.
Current Chief Complaints: A.R.'s current problems include constipation and dry skin.
Diet: "My usual grocery list consists of boneless chicken breasts, turkey, pork chops (infrequently), strip steak (infrequently), 90/10 ground beef, pasta (half whole-wheat, half regular), tomatoes and sauce to make pasta sauce, 90 percent fat-free lunch meat ham or turkey, brown rice, steamable microwave vegetables, red and green lettuce, tomatoes, onions, cereal, blueberries if on sale, apples, tangerines, red licorice, bread, crackers, and canned soup. I am concerned about not having enough protein or iron because I am afraid to eat very much red meat. The foods I miss the most include iced tea, which I skip because of caffeine-I am getting bored with water. I like to bake and I miss baked goods, and I also miss cheese-I am afraid it is too high in fat. I have a hard time figuring out what to pack for lunch. The restaurants I go to if I do go out are Chick-Fil-A, Panera, Viva, a local diner, and an Italian restaurant. I like Italian and Mexican food. Usually if I do eat out it is for lunch but it is sometimes hard to figure out something safe to eat..." Dairy foods: Twice a day, drinks 2 8-oz glasses of 1% milk. Fruits: 1 cup per day.
In which way would A.R. benefit from using medium-chain triglycerides?
A) a s a source of essential fatty acids
B) a s a primary source of energy
C) t o add flavor to foods
D) a s a method of weight control
E) t o keep foods palatable and soft
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52
A patient with an ileostomy should be counseled to avoid ____ to best prevent an obstruction at the stoma site.
A) coconut
B) dried beans
C) rice
D) eggs
E) corn
A) coconut
B) dried beans
C) rice
D) eggs
E) corn
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53
Medical History: A.R. is a healthy 51-year old premenopausal Caucasian woman with pallor who is employed full-time in an office job. She had a pancreatic cyst removed six years ago. She was asymptomatic until one year ago when she developed acute pancreatitis flare-ups after consuming fatty foods. The condition was attributed to scarring at the pancreatic duct, which secretes pancreatic lipase, and was accompanied by severe abdominal pain radiating to her back, vomiting, and steatorrhea. She was placed on oral pancreatic lipase enzyme tablets (Pancrease™) that digest fat and was prescribed to follow a "low-fat diet." The medication and diet help to reduce her symptoms, and she notes that flare-ups generally only occur when she eats too much fat. Anthropometric: Ht: 5'2. Wt: 156 lbs. Wt 1 yr ago: 199 lbs. Frame size: Medium.
Clinical/Labs: A.R.'s serum vitamin D was low (20 ng/mL; normal is 25-80 ng/mL), but all other labs were within normal limits when she last visited her internal medicine physician several months ago. She was placed on a 5,000-IU vitamin D supplement, to be reduced to a 2,000-IU vitamin D supplement thereafter; she takes no other vitamins or minerals. Other medications include Synthroid and Aygestin.
Current Chief Complaints: A.R.'s current problems include constipation and dry skin.
Diet: "My usual grocery list consists of boneless chicken breasts, turkey, pork chops (infrequently), strip steak (infrequently), 90/10 ground beef, pasta (half whole-wheat, half regular), tomatoes and sauce to make pasta sauce, 90 percent fat-free lunch meat ham or turkey, brown rice, steamable microwave vegetables, red and green lettuce, tomatoes, onions, cereal, blueberries if on sale, apples, tangerines, red licorice, bread, crackers, and canned soup. I am concerned about not having enough protein or iron because I am afraid to eat very much red meat. The foods I miss the most include iced tea, which I skip because of caffeine-I am getting bored with water. I like to bake and I miss baked goods, and I also miss cheese-I am afraid it is too high in fat. I have a hard time figuring out what to pack for lunch. The restaurants I go to if I do go out are Chick-Fil-A, Panera, Viva, a local diner, and an Italian restaurant. I like Italian and Mexican food. Usually if I do eat out it is for lunch but it is sometimes hard to figure out something safe to eat..." Dairy foods: Twice a day, drinks 2 8-oz glasses of 1% milk. Fruits: 1 cup per day.
Steatorrhea is classified as:
A) excessive protein in the stools.
B) excessive fat in the stools.
C) excessive minerals in the stools.
D) decrease of fat in the stool.
E) decrease of protein in the stools.
Clinical/Labs: A.R.'s serum vitamin D was low (20 ng/mL; normal is 25-80 ng/mL), but all other labs were within normal limits when she last visited her internal medicine physician several months ago. She was placed on a 5,000-IU vitamin D supplement, to be reduced to a 2,000-IU vitamin D supplement thereafter; she takes no other vitamins or minerals. Other medications include Synthroid and Aygestin.
Current Chief Complaints: A.R.'s current problems include constipation and dry skin.
Diet: "My usual grocery list consists of boneless chicken breasts, turkey, pork chops (infrequently), strip steak (infrequently), 90/10 ground beef, pasta (half whole-wheat, half regular), tomatoes and sauce to make pasta sauce, 90 percent fat-free lunch meat ham or turkey, brown rice, steamable microwave vegetables, red and green lettuce, tomatoes, onions, cereal, blueberries if on sale, apples, tangerines, red licorice, bread, crackers, and canned soup. I am concerned about not having enough protein or iron because I am afraid to eat very much red meat. The foods I miss the most include iced tea, which I skip because of caffeine-I am getting bored with water. I like to bake and I miss baked goods, and I also miss cheese-I am afraid it is too high in fat. I have a hard time figuring out what to pack for lunch. The restaurants I go to if I do go out are Chick-Fil-A, Panera, Viva, a local diner, and an Italian restaurant. I like Italian and Mexican food. Usually if I do eat out it is for lunch but it is sometimes hard to figure out something safe to eat..." Dairy foods: Twice a day, drinks 2 8-oz glasses of 1% milk. Fruits: 1 cup per day.
Steatorrhea is classified as:
A) excessive protein in the stools.
B) excessive fat in the stools.
C) excessive minerals in the stools.
D) decrease of fat in the stool.
E) decrease of protein in the stools.
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54
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) iron supplementation.
A) intestinal adaptation.
B) enzyme replacement therapy.
C) following a high-fiber diet.
D) further surgery.
E) iron supplementation.
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55
What situation is most commonly associated with development of diverticular disease?
A) viral infection
B) bacterial infection
C) constipation
D) lactose intolerance
E) pregnancy
A) viral infection
B) bacterial infection
C) constipation
D) lactose intolerance
E) pregnancy
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56
Medical History: A.R. is a healthy 51-year old premenopausal Caucasian woman with pallor who is employed full-time in an office job. She had a pancreatic cyst removed six years ago. She was asymptomatic until one year ago when she developed acute pancreatitis flare-ups after consuming fatty foods. The condition was attributed to scarring at the pancreatic duct, which secretes pancreatic lipase, and was accompanied by severe abdominal pain radiating to her back, vomiting, and steatorrhea. She was placed on oral pancreatic lipase enzyme tablets (Pancrease™) that digest fat and was prescribed to follow a "low-fat diet." The medication and diet help to reduce her symptoms, and she notes that flare-ups generally only occur when she eats too much fat. Anthropometric: Ht: 5'2. Wt: 156 lbs. Wt 1 yr ago: 199 lbs. Frame size: Medium.
Clinical/Labs: A.R.'s serum vitamin D was low (20 ng/mL; normal is 25-80 ng/mL), but all other labs were within normal limits when she last visited her internal medicine physician several months ago. She was placed on a 5,000-IU vitamin D supplement, to be reduced to a 2,000-IU vitamin D supplement thereafter; she takes no other vitamins or minerals. Other medications include Synthroid and Aygestin.
Current Chief Complaints: A.R.'s current problems include constipation and dry skin.
Diet: "My usual grocery list consists of boneless chicken breasts, turkey, pork chops (infrequently), strip steak (infrequently), 90/10 ground beef, pasta (half whole-wheat, half regular), tomatoes and sauce to make pasta sauce, 90 percent fat-free lunch meat ham or turkey, brown rice, steamable microwave vegetables, red and green lettuce, tomatoes, onions, cereal, blueberries if on sale, apples, tangerines, red licorice, bread, crackers, and canned soup. I am concerned about not having enough protein or iron because I am afraid to eat very much red meat. The foods I miss the most include iced tea, which I skip because of caffeine-I am getting bored with water. I like to bake and I miss baked goods, and I also miss cheese-I am afraid it is too high in fat. I have a hard time figuring out what to pack for lunch. The restaurants I go to if I do go out are Chick-Fil-A, Panera, Viva, a local diner, and an Italian restaurant. I like Italian and Mexican food. Usually if I do eat out it is for lunch but it is sometimes hard to figure out something safe to eat..." Dairy foods: Twice a day, drinks 2 8-oz glasses of 1% milk. Fruits: 1 cup per day.
A.R.'s doctor recommends that she take a multivitamin-mineral supplement because:
A) pancreatic enzyme replacements can decrease the absorption of iron .
B) steatorrhea can promote the loss of excess fluid.
C) A.R. is at higher risk of weight gain.
D) she may develop kidney stones.
E) steatorrhea damages the gastrointestinal tract.
Clinical/Labs: A.R.'s serum vitamin D was low (20 ng/mL; normal is 25-80 ng/mL), but all other labs were within normal limits when she last visited her internal medicine physician several months ago. She was placed on a 5,000-IU vitamin D supplement, to be reduced to a 2,000-IU vitamin D supplement thereafter; she takes no other vitamins or minerals. Other medications include Synthroid and Aygestin.
Current Chief Complaints: A.R.'s current problems include constipation and dry skin.
Diet: "My usual grocery list consists of boneless chicken breasts, turkey, pork chops (infrequently), strip steak (infrequently), 90/10 ground beef, pasta (half whole-wheat, half regular), tomatoes and sauce to make pasta sauce, 90 percent fat-free lunch meat ham or turkey, brown rice, steamable microwave vegetables, red and green lettuce, tomatoes, onions, cereal, blueberries if on sale, apples, tangerines, red licorice, bread, crackers, and canned soup. I am concerned about not having enough protein or iron because I am afraid to eat very much red meat. The foods I miss the most include iced tea, which I skip because of caffeine-I am getting bored with water. I like to bake and I miss baked goods, and I also miss cheese-I am afraid it is too high in fat. I have a hard time figuring out what to pack for lunch. The restaurants I go to if I do go out are Chick-Fil-A, Panera, Viva, a local diner, and an Italian restaurant. I like Italian and Mexican food. Usually if I do eat out it is for lunch but it is sometimes hard to figure out something safe to eat..." Dairy foods: Twice a day, drinks 2 8-oz glasses of 1% milk. Fruits: 1 cup per day.
A.R.'s doctor recommends that she take a multivitamin-mineral supplement because:
A) pancreatic enzyme replacements can decrease the absorption of iron .
B) steatorrhea can promote the loss of excess fluid.
C) A.R. is at higher risk of weight gain.
D) she may develop kidney stones.
E) steatorrhea damages the gastrointestinal tract.
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57
Kelly is a 27-year-old Caucasian who works as a bank teller. She is 5'3" tall and weighs 102 pounds. She began experiencing recurrent gastrointestinal disturbances such as diarrhea, steatorrhea, and flatulence several months ago. She made an appointment with her physician after noticing that she was losing weight. Laboratory tests confirmed a diagnosis of celiac disease.
Kelly will require nutrition education aimed at eliminating gluten from her diet. The dietitian will teach Kelly 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) consume only the foods she has prepared herself.
Kelly will require nutrition education aimed at eliminating gluten from her diet. The dietitian will teach Kelly 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) consume only the foods she has prepared herself.
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58
To help control diarrhea, a patient with an ostomy should consume:
A) applesauce.
B) caffeine.
C) sugar-free candy.
D) grapes.
E) milk.
A) applesauce.
B) caffeine.
C) sugar-free candy.
D) grapes.
E) milk.
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59
Kelly is a 27-year-old Caucasian who works as a bank teller. She is 5'3" tall and weighs 102 pounds. She began experiencing recurrent gastrointestinal disturbances such as diarrhea, steatorrhea, and flatulence several months ago. She made an appointment with her physician after noticing that she was losing weight. Laboratory tests confirmed a diagnosis of celiac disease.
If Kelly does not eliminate gluten from her diet, she could likely experience which complication?
A) type 2 diabetes
B) infertility
C) kidney disease
D) hypertension
E) leukemia
If Kelly does not eliminate gluten from her diet, she could likely experience which complication?
A) type 2 diabetes
B) infertility
C) kidney disease
D) hypertension
E) leukemia
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60
Kelly is a 27-year-old Caucasian who works as a bank teller. She is 5'3" tall and weighs 102 pounds. She began experiencing recurrent gastrointestinal disturbances such as diarrhea, steatorrhea, and flatulence several months ago. She made an appointment with her physician after noticing that she was losing weight. Laboratory tests confirmed a diagnosis of celiac disease.
What does Kelly 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 is free to consume oats because they do not contain gluten.
What does Kelly 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 is free to consume oats because they do not contain gluten.
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61
Nursing Exam Review Sarah is a 21-year-old college student who has been diagnosed with Crohn's disease. She is underweight and has a poor appetite. Realizing that Sarah is at nutritional risk, the nurse advises that Sarah:
A) consume an oral nutrition supplement two to three times a day
B) increase the fiber in her diet
C) increase her intake of milk to four cups a day
D) eat more high-fat foods
E) begin tube feedings to supplement her diet
A) consume an oral nutrition supplement two to three times a day
B) increase the fiber in her diet
C) increase her intake of milk to four cups a day
D) eat more high-fat foods
E) begin tube feedings to supplement her diet
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62
Match between columns
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63
Nursing Exam Review The nurse is planning for the nutritional needs of a patient with acute pancreatitis accompanied by pain and nausea. The nurse understands that initially:
A) all oral fluids and food should be withheld.
B) the patient can have liquids only.
C) tube feeding with an elemental formula should begin immediately.
D) TPN should be started immediately.
E) the patient should have a regular, fat-restricted diet .
A) all oral fluids and food should be withheld.
B) the patient can have liquids only.
C) tube feeding with an elemental formula should begin immediately.
D) TPN should be started immediately.
E) the patient should have a regular, fat-restricted diet .
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64
Discuss the characteristic differences between Crohn's disease and ulcerative colitis.
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65
Identify the possible causes of diarrhea and describe its appropriate treatment.
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66
To be considered "probiotic," bacteria must meet what criteria?
A) They must be nonpathogenic when consumed.
B) They must be consumed in small amounts.
C) They must colonize the intestine.
D) They must produce gas as a by-product of their activity.
E) They must be compatible with vitamin D.
A) They must be nonpathogenic when consumed.
B) They must be consumed in small amounts.
C) They must colonize the intestine.
D) They must produce gas as a by-product of their activity.
E) They must be compatible with vitamin D.
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67
Nursing Exam Review Which food would the nurse include in a diet plan for a patient with celiac disease?
A) r ye bread
B) s crambled eggs
C) w hole-wheat toast
D) s calloped potatoes
E) p ancakes
A) r ye bread
B) s crambled eggs
C) w hole-wheat toast
D) s calloped potatoes
E) p ancakes
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68
For which of the following people might heavy probiotics consumption be unsafe?
A) Teresa, who has IBS
B) Bobbie, who is lactose intolerant
C) Tim, who has AIDS
D) Bill, who drinks alcohol daily
E) Katie, who suffers from constipation
A) Teresa, who has IBS
B) Bobbie, who is lactose intolerant
C) Tim, who has AIDS
D) Bill, who drinks alcohol daily
E) Katie, who suffers from constipation
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69
Nursing Exam Review Mrs. Burgess is a 67-year-old female who was recently diagnosed with depression and prescribed a tricyclic antidepressant drug. In addition, she is on medication for high blood pressure and high cholesterol and takes a calcium supplement. She phones her physician's office complaining of problems with constipation. The nurse suspects that the problems may be due to:
A) depression.
B) age.
C) medications.
D) high blood pressure.
E) high cholesterol.
A) depression.
B) age.
C) medications.
D) high blood pressure.
E) high cholesterol.
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70
Describe important components of nutrition management for people with ostomies.
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71
What is Cystic Fibrosis and what are the nutritional requirements for children?
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72
Describe the dietary restrictions for a patient with celiac disease.
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73
Much of the research investigating probiotics and intestinal illness has focused on the prevention and treatment of:
A) irritable bowel syndrome .
B) diverticular disease.
C) infectious diarrhea.
D) Crohn's disease.
E) peptic ulcer disease.
A) irritable bowel syndrome .
B) diverticular disease.
C) infectious diarrhea.
D) Crohn's disease.
E) peptic ulcer disease.
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74
Which food does not contain probiotics?
A) kefir
B) apples
C) pickles
D) yogurt
E) sauerkraut
A) kefir
B) apples
C) pickles
D) yogurt
E) sauerkraut
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75
Nursing Exam Review 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 worried 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 what means?
A) Eating ice cream
B) Consuming yogurt with live bacterial cultures
C) Most people with lactose intolerance can consume 2 cups of milk throughout the day
D) Consuming processed cheeses
E) Drinking 2% milk instead of 1% milk
A) Eating ice cream
B) Consuming yogurt with live bacterial cultures
C) Most people with lactose intolerance can consume 2 cups of milk throughout the day
D) Consuming processed cheeses
E) Drinking 2% milk instead of 1% milk
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