Deck 19: Nutrition and Liver Diseases

Question 1

Because alcohol consumption can reduce the risk of developing some types of chronic disease, medical personnel should recommend that non-drinkers begin drinking alcohol occasionally to reduce their health risks.

Answer 1

False

Question 2

A primary cause of non-alcoholic fatty liver is:

A) increased levels of VLDLs.
B) exposure to toxins.
C) drug abuse.
D) insulin resistance.
E) pancreatitis.

Answer 2

D

Question 3

In many individuals, fatty liver may be associated with steatohepatitis and:

A) decreased liver enzymes.
B) hypoglycemia.
C) hepatomegaly.
D) hepatitis A infection.
E) autoimmune disease.

Answer 3

C

Question 4

Diuretics are often prescribed to control ascites.

Question 5

A patient with cirrhosis may present with no symptoms.

Question 6

The blood vessels that carry nutrients from the digestive tract to the liver are called collaterals.

Question 7

The most common cause of infection with acute hepatitis A virus is:

A) exposure to infected blood.
B) jaundice.
C) fecal-oral contamination.
D) sexual contact .
E) shared needles with drug abuse.

Question 8

Hepatitis is most often treated with:

A) antiviral medication.
B) rest and a supportive diet.
C) elimination of dietary vitamin K.
D) surgical resection of the liver.
E) supplemental injections of gylcogen.

Question 9

Eating well and taking supplements of protein, vitamins, and minerals protect the body from harmful effects of alcohol.

Question 10

Dietary sodium restriction is a significant part of the treatment for ascites.

Question 11

People with malnutrition may experience fatty liver.

Question 12

Nutritional support for hepatitis includes counseling patients to avoid:

A) fried foods.
B) high-protein foods.
C) excessive intakes of sodium.
D) alcohol.
E) excess sun exposure.

Question 13

The chief causes of hepatic encephalopathy in the United States are alcoholic liver disease and chronic hepatitis C infection.

Question 14

All patients with cirrhosis should be placed on fat-restricted diets to reduce further liver damage.

Question 15

High-fat foods may be restricted in patients with cirrhosis who are experiencing steatorrhea.

Question 16

Evaluating nutrition status in liver transplant candidates is relatively easy because liver dysfunction and malnutrition often have similar metabolic effects.

Question 17

Many patients with cirrhosis require medication or insulin to control hyperglycemia.

Question 18

Protein and energy requirements are increased after transplantation due to the stress of surgery.

Question 19

Rapid weight loss aids in the recovery from liver disease.

Question 20

Hepatomegaly refers to a surgical puncture of a body cavity with an aspirator to draw out excess fluid.

Question 21

Ascites is exacerbated by:

A) low plasma albumin levels.
B) abdominal pressure.
C) hyperglycemia.
D) amino acid imbalances.
E) decreased neurotransmitter levels.

Question 22

Patients with ascites generally must restrict their intake of:

A) fat.
B) carbohydrates.
C) sodium.
D) iron.
E) potassium.

Question 23

A client with cirrhosis who develops changes in personality and motor function may be exhibiting early symptoms of:

A) fatigue.
B) hepatic regression.
C) hepatitis.
D) malnutrition.
E) hepatic encephalopathy.

Question 24

An important consideration in the diet of a patient with esophageal varices is to provide a:

A) soft diet.
B) clear liquid diet.
C) low-protein diet.
D) high-fat diet .
E) high kcalorie, high-protein diet.

Question 25

What signs or symptoms best describe ascites?

A) y ellowing of the sclera of the eyes, skin, and mucous membranes
B) f luid accumulation in the abdomen
C) i nflammation of the liver
D) e levated blood ammonia levels
E) i ncreased amounts of fat in the stool

Question 26

Due to the stress of surgery, liver transplant patients require extra _____ in their postoperative diets.

A) fat
B) protein
C) vitamin C
D) glucose
E) calcium

Question 27

Persons using potassium-sparing diuretics should be cautioned about consuming:

A) eggs.
B) soy sauce.
C) soft drinks.
D) dairy foods.
E) salt substitutes.

Question 28

In liver disease, blood ammonia levels rise because the liver cannot convert the ammonia to:

A) nitrogen.
B) amino acids.
C) urea.
D) sodium.
E) pyruvate

Question 29

In patients with fat malabsorption, fat intake may be restricted to less than _____ percent of total kcalories or as necessary to control steatorrhea.

A) 5
B) 15
C) 25
D) 30
E) 45

Question 30

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.
What laboratory test would most likely be elevated in Mr. Jamison?

A) a lbumin
B) t ransferrin
C) bilirubin
D) HDL
E) CRP

Question 31

What best describes a clinical effect of liver cirrhosis?

A) hand tremor
B) urinary incontinence
C) stiff neck
D) intestinal lesions
E) heart palpitations

Question 32

When blood flow is impeded in a cirrhotic liver, it causes:

A) insulin resistance.
B) elevated cholesterol levels.
C) jaundice.
D) fatty liver.
E) portal hypertension.

Question 33

The most common conditions that precede liver transplantation are chronic hepatitis C infection and:

A) chronic hepatitis B infection.
B) hyperlipidemia.
C) exposure the environmental toxins.
D) malnutrition.
E) alcoholic liver disease.

Question 34

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.
If Mr. Jamison develops advanced cirrhosis, what potential complication may he develop?

A) a ortic aneurysm
B) a nemia
C) a trial fibrillation
D) k idney cancer
E) t ype 2 diabetes

Question 35

Furosemide is what type of drug that may be used to treat the symptoms of cirrhosis?

A) appetite stimulant
B) diuretic
C) laxative
D) antiviral
E) immunosuppressant

Question 36

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.
To improve Mr. Jamison's appetite, his physician may prescribe:

A) megestrol acetate.
B) spironolactone.
C) rifaximin.
D) propranolol.
E) lamivudine.

Question 37

What food would most likely be suggested for a patient who is experiencing wasting and malnutrition ?

A) lean cuts of beef
B) low-fat milk and cheese
C) starchy vegetables, such as corn or potatoes
D) fruit canned in heavy syrup
E) steamed or fresh vegetables

Question 38

Patients with cirrhosis require _____ in order to prevent wasting.

A) extra fluid
B) elevated dietary protein
C) high-fat diets
D) increased iron intake
E) extra kcalories

Question 39

If a patient with ascites does not respond to sodium restriction and diuretic therapy, excess fluid may be removed from the abdomen by:

A) a portosystemic shunt.
B) immunosuppressant therapy.
C) collateral vessels.
D) insulin replacement.
E) paracentesis.

Question 40

The drug _____ is an alternative treatment for elevated ammonia associated with cirrhosis that works by altering bacterial populations.

A) rifaximin
B) megestrol acetate
C) furosemide
D) dronabinol
E) lactulose

Question 41

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:

A) furosemide .
B) interferon alfa.
C) lactulose.
D) spironolactone.
E) hydrochlorothiazide.

Question 42

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:

A) calcium.
B) vitamin C.
C) vitamin E.
D) magnesium.
E) thiamin.

Question 43

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

A) women who have type 2 diabetes.
B) people with risk factors for liver disease.
C) older people with risk factors for heart disease.
D) men who work in the petrochemical industry.
E) people who are overweight.

Question 44

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:

A) stomach.
B) duodenum.
C) jejunum.
D) ileum.
E) liver.

Question 45

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

A) 4
B) 6
C) 10
D) 12
E) 16

Question 46

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:

A) no alcohol intake.
B) no more than one drink per day.
C) no more than two drinks per day.
D) no more than three drinks per day.
E) no more than four drinks per day.

Question 47

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?

A) Decrease sodium intake.
B) Take in adequate kcalories and increase protein intake.
C) Increase fat intake.
D) Decrease carbohydrate intake.
E) Begin strength training.

Question 48

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:

A) 0.3-1.2 g/dL.
B)  3.4-4.8 g/dL.
C) 11-15 g/dL.
D) 10-30 g/dL .
E) 15-45 g/dL.

Question 49

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? 

A) 4
B) 6
C) 7
D) 8
E) 10

Question 50

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

A) height
B) weight
C) blood cholesterol
D) appetite
E) waist circumference

Question 51

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:

A) portal hypertension.
B) liver disease.
C) esophageal varices.
D) hepatic coma.
E) hepatic encephalopathy.

Question 52

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?

A) high-kcalorie, high-protein diet
B) high-protein, low-fat diet
C) low-sodium, fluid-restricted diet
D) low-fat, high-fiber diet
E) N o dietary change is needed.

Question 53

The most common complication of alcohol abuse is:

A) chronic pancreatitis.
B) liver disease.
C) chronic renal failure.
D) cardiac arrhythmias.
E) type 2 diabetes.

Question 54

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 ?

A) s teak
B) c ooked fruit
C) u nwashed produce
D) c anned vegetables
E) s crambled eggs

Question 55

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?

A) bone marrow suppression
B) goiter
C) hypoglycemia
D) galactosemia
E) hypotension

Question 56

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.

A) 25-51
B) 52-62
C) 66-99
D) 98-108
E) 112-118

Question 57

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

A) confusion.
B) esophageal varices.
C) jaundice.
D) ascites.
E) weight loss.

Question 58

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:

A) "Yes, but you should double the dose if you drink alcohol that day."
B) "No; you should take a sedative."
C) "Yes; that drug doesn't interact with alcohol."
D) "Yes, if you abstain from drinking alcohol that day."
E) "No; the acetaminophen will worsen gastritis if you drink alcohol."

Question 59

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?

A) a  regular, balanced diet
B) f requent, small meals
C) e nteral formula supplements
D) h igh-kcalorie, high-protein diet
E) o ral supplements of fluid and electrolyte replacements

Question 60

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:

A) eat four to six times per day.
B) increase her intake of carbohydrates.
C) consume a liquid nutrition supplement with each meal.
D) drink more fruit juice.
E) include 3500 mg of sodium in her diet.

Question 62

Describe why ascites, portal hypertension, and esophageal varices occur in clients with cirrhosis.

Question 63

Explain the potential needs for enteral or parenteral nutrition among patients with advanced cirrhosis.

Question 64

Describe the possible causes of hepatic encephalopathy.

Question 65

Describe post-transplant concerns related to medication use in a patient who has had a liver transplant.

Question 66

Nursing Exam Review Multiple Choice The immediate concerns that the nurse must recognize when caring for a patient who has had a liver transplant are organ rejection and:

A) hypertension.
B) disorientation.
C) jaundice.
D) infection.
E) hemorrhage.

Question 67

Nursing Exam Review Multiple Choice The hepatic portal vein and the hepatic artery together supply approximately _____ ml of blood each minute to the extensive network of vessels in the liver.

A) 200
B) 500
C) 800
D) 1500
E) 2200

Question 68

Explain how chronic alcohol use can affect brain function.

Question 69

Nursing Exam Review Multiple Choice A nurse is working with a patient whom she suspects is suffering from hepatic encephalopathy. What sign or symptom most likely indicates early stages of the disease?

A) neurological functioning
B) p ronounced tremor
C) d isorientation
D) a bnormal reflexes
E) muscular rigidity

Question 70

Nursing Exam Review Multiple Choice A nurse is caring for a patient who is recovering from a liver transplant. Because the patient is at higher risk of foodborne illness, the nurse should educate the patient by giving him which information?

A) Avoid eating one hour before bedtime.
B) Wash fresh produce before eating.
C) Increase intake of high kcalorie foods.
D) Eat six small meals per day.
E) Drink fluids between meals.

Question 71

Nursing Exam Review Multiple Choice Following a liver transplant, immunosuppressive drugs are given to reduce the immune responses that cause rejection. The nurse recognizes that these drugs can affect nutrition status because of their effects on:

A) kidney function.
B) pancreatic function.
C) the gastrointestinal tract.
D) the absorption of nutrients.
E) the regulation of insulin.