Deck 40: Medical Nutrition Therapy for Neurologic Disorders

Question 1

For which condition might a ketogenic diet be used in treatment?

A)Myasthenia gravis
B)Migraine headache
C)Epilepsy
D)Guillain-Barré syndrome (GBS)

Answer 1

C
The ketogenic diet, which is set up to create and maintain a state of ketosis, has been used to effectively control seizure activity in children with epilepsy.The diet focuses on providing a fat-to-protein and carbohydrate ratio of 4:1 calories.For myasthenia gravis, nutrition therapy is focused on ensuring intake despite chewing and swallowing difficulties.For migraine headaches, nutrition therapy eliminates foods that seem to trigger migraines while maintaining adequate fluid for rehydration.For patients who develop GBS, high calorie and protein intakes are necessary to counter the hypercatabolism associated with the condition.

Question 2

Which of the following is NOT true of head-injured patients?

A)They have profound urinary nitrogen loss.
B)Their energy needs are related to the Glasgow Coma Scale.
C)They are hypermetabolic.
D)They have decreased energy needs.

Answer 2

D
Head injury results in hypermetabolism evidenced by increased energy expenditure and profound urinary nitrogen loss.Correlations between the severity of brain injury as measured by the Glasgow Coma Scale and energy requirements have been shown.

Question 3

Which of the following is the inability to perform purposeful, complex movements, although no sensory or motor impairment is evident?

A)Apraxia
B)Aphasia
C)Anosmia
D)Agnosia

Answer 3

A
Lesions in the central portion of the frontal lobe may present with apraxia, the inability to execute purposeful movements.Aphasia is an impaired or absent comprehension or communication because of a lesion of the dominant cerebral hemisphere.Anosmia is the loss or impairment of smell caused by a lesion near the base of the brain.Agnosia is a loss of comprehension that is associated with Alzheimer disease.

Question 4

Pyrazole curcumin is being actively researched for treatment for

A)stroke.
B)traumatic brain injury.
C)ALS.
D)seizures.

Question 5

The Frazier free water protocol is used for patients with

A)Wernicke-Korsakoff syndrome.
B)brain trauma.
C)multiple sclerosis.
D)dysphagia.

Question 6

On the Dysphagia Outcome and Severity Scale, at what level is total assistance for the patient necessary?

A)Level 7
B)Level 5
C)Level 3
D)Level 1

Question 7

A patient with amyotrophic lateral sclerosis (ALS) has a rating of 3 or 4 on the swallowing severity scale.Which of the following interventions would be recommended in the medical nutrition therapy plan?

A)A regular diet with small, frequent feedings
B)Modification of dietary consistency and texture
C)Supplemental tube feedings
D)Nothing by mouth (NPO)

Question 8

Sensory deficits of limbs on the opposite of the body that result from an occlusion of the middle cerebral artery on one side of the brain are known as

A)hemiparesis.
B)hemiplegia.
C)hemianopsia.
D)hemi-inattention.

Question 9

Which of the following can result from thiamin deficiency?

A)Pernicious anemia
B)Wernicke-Korsakoff syndrome
C)Pellagra
D)Adrenomyeloleukodystrophy

Question 10

The guideline for use of a percutaneous endoscopic gastrostomy (PEG) in patients with neurologic disease or disorders is to use

A)whenever there is a risk of aspiration pneumonia.
B)with patients whose swallowing function will not ensure adequate nutritional intake.
C)with patients who refuse a central line for total parenteral nutrition.
D)with patients who are expected to resume oral alimentation within 7 days.

Question 11

Because of potential drug-nutrient interactions, it would be more beneficial to provide the majority of their dietary protein to patients with Parkinson disease

A)during breakfast.
B)at the noon meal.
C)evenly throughout the day.
D)with the evening meal.

Question 12

What is dysphagia?

A)Inhalation of a foreign object into the lungs
B)Impaired taste
C)Difficulty swallowing
D)Impairment of the tongue or other muscles essential to speech

Question 13

How may phenobarbital, used for anticonvulsant therapy, interfere with the intestinal absorption of calcium?

A)It increases metabolism of vitamin D in the liver.
B)It prevents absorption of vitamin D in the intestinal mucosa.
C)It induces diarrhea and loss of electrolytes.
D)It damages the mucosal cells lining the intestinal wall.

Question 14

Which of the following requires the greatest coordination and control in order to swallow?

A)Solid foods
B)Liquids of thin consistency
C)Soft foods with high water content
D)Thick, viscous liquids

Question 15

Damage to which of the following cranial nerves will likely affect the ability to eat food?

A)Olfactory (I) nerve
B)Abducens (VI) nerve
C)Glossopharyngeal (IX) nerve
D)Vagus (X) nerve

Question 16

During which phase of swallowing does bolus formation occur?

A)Oral phase
B)Early pharyngeal phase
C)Middle pharyngeal phase
D)Esophageal phase

Question 17

What is the guideline for accepted weight adjusted for quadriplegia?

A)Ideal body weight (IBW) as determined by the Hamwi formula
B)10 to 15 lb less than IBW as determined by the Hamwi formula
C)10 to 15 lb less than ideal body mass index (BMI)
D)15 to 20 lb less than ideal BMI

Question 18

Which of the following is characterized by a cholesterol plaque within an artery that ruptures and promotes platelet aggregation to clog an already narrowed artery?

A)Intracranial hemorrhage
B)Embolic stroke
C)Thrombotic stroke
D)Transient ischemic attack

Question 19

Which of the following can occur with impaired swallowing?

A)Aspiration pneumonia
B)Hemiparesis
C)Dysgeusia
D)Comminution

Question 20

Which of the following foods is easiest to swallow for patients experiencing difficulty swallowing?

A)Thin liquids
B)Room temperature cream soups
C)Lukewarm cooked cereals diluted with milk
D)Cool, soft textured foods with sauce or gravy