Deck 17: Nutrition and Upper Gastrointestinal Disorders

Question 1

To improve a client's acceptance of pureed foods you would:

A)make them watery and thin.
B)serve brightly colored foods.
C)avoid the use of spices and seasonings.
D)avoid pureeing a patient's favorite foods.

Answer 1

B

Question 2

All of the following foods may be indicated for individuals with dysphagia except:

A)cream of wheat.
B)scrambled eggs.
C)brownies with nuts.
D)pureed chicken.

Answer 2

C

Question 3

Which of the following foods would not be appropriate on a Level 1 diet for dysphagia?

A)pudding
B)yogurt with fruit
C)baby cereal
D)pureed sweet potatoes

Answer 3

B

Question 4

GERD often develops as a consequence of:

A)aging.
B)underweight.
C)H.pylori infection.
D)pregnancy.

Question 5

Clinical studies indicate that the gastric banding procedure is more effective and has fewer long-term complications than gastric bypass surgery.

Question 6

All people experience the diarrhea of dumping syndrome following gastric surgery.

Question 7

A condition in which a portion of the stomach protrudes above the diaphragm is:

A)hiatal hernia.
B)Barrett's esophagus.
C)gastritis.
D)gastric ulcer.

Question 8

Bariatric surgery is currently considered the most effective treatment for someone who needs to lose more than 20 pounds.

Question 9

Clients with reflux esophagitis should be instructed to:

A)eat small, frequent meals.
B)drink liquids with meals.
C)lie down after eating.
D)consume caffeine-containing foods and beverages.

Question 10

In the dietary treatment of gastritis, it is important to eliminate irritating foods and beverages.

Question 11

People with _____ often complain of food "sticking" in the esophagus.

A)esophageal dysphagia
B)oropharyngeal dysphagia
C)dyspepsia
D)gastritis

Question 12

Repeated bouts of pneumonia may be associated with:

A)dysphagia.
B)irritable bowel syndrome.
C)peptic ulcers.
D)diverticular disease.

Question 13

Xerostomia is a side effect of many medications and can make chewing and swallowing more difficult.

Question 14

Oropharyngeal dysphagia may be characterized by all of the following except:

A)inability to initiate swallowing.
B)aspiration.
C)impaired peristalsis.
D)hoarse voice.

Question 15

Oropharyngeal dysphagia is common in elderly persons and frequently follows a stroke.

Question 16

The most effective medications for suppressing gastric acid secretion are:

A)H2 blockers.
B)proton-pump inhibitors.
C)antacids.
D)NSAIDs.

Question 17

Dysphagia can be caused by all of the following except:

A)Parkinson's disease.
B)diabetes.
C)esophageal cancer.
D)stroke.

Question 18

All of the following are appropriate for a patient suffering from mouth dryness except:

A)sauces.
B)potato chips.
C)gravies.
D)sugarless gum.

Question 19

Dry mouth can result in all of the following except:

A)bad breath.
B)reduced food intake.
C)dental disease.
D)achalasia.

Question 20

An effective dietary strategy for the treatment of GERD is to:

A)avoid alcohol.
B)avoid gas-forming foods.
C)eat large food portions.
D)suck on a peppermint after a meal.

Question 21

One of the most common causes of acute gastritis is:

A)food allergies.
B)viral infections.
C)repeated use of NSAIDS.
D)radiation therapy.

Question 22

Which of the following plays the primary role in treatment of ulcers?

A)surgery
B)relaxation therapy
C)drug therapy
D)diet

Question 23

General discomfort in the upper abdominal area with complaints of stomach pain, gnawing sensations, fullness, nausea, and bloating is descriptive of:

A)peptic ulcer disease.
B)dyspepsia.
C)hiatal hernia.
D)Sjögren's syndrome.

Question 24

A major factor in the development of both gastritis and peptic ulcer disease is:

A)infection with H.pylori.
B)stress.
C)overeating.
D)cigarette smoking.

Question 25

The symptoms of dumping syndrome include all of the following except:

A)diarrhea.
B)lightheadedness.
C)difficulty breathing.
D)rapid heartbeat.

Question 26

The protein recommendation for bariatric surgery patients is:

A)0.8-1 g/kg body weight per day.
B)2.0-3.0 g/kg ideal body weight per day.
C)1.0-1.2 g/kg body weight per day.
D)1.0-1.5 g/kg ideal body weight per day.

Question 27

Postgastrectomy diets are limited in:

A)fat.
B)simple sugars.
C)protein.
D)complex carbohydrates.

Question 28

Hypochlorhydria may result from:

A)gastritis.
B)peptic ulcer disease.
C)dyspepsia.
D)bariatric surgery.

Question 29

Following bariatric surgery, the gastric pouch may eventually stretch to hold about _____ of food.

A)¹/₃ cup
B)¹/₂ cup
C)1 cup
D)1 ¹/₂ cups

Question 30

To alleviate nausea you would tell a client to:

A)limit highly spiced foods.
B)drink liquids with meals.
C)consume hot meals.
D)eat as quickly as possible.

Question 31

Liquids are restricted during meals following a gastrectomy because they:

A)can speed up the emptying rate of the stomach.
B)slow down the emptying rate of the stomach.
C)add unwanted kcalories.
D)are likely to cause aspiration.

Question 32

Appropriate foods for a postgastrectomy diet include:

A)lean, tender meats.
B)fruit punch.
C)milk shakes.
D)frosted flakes.

Question 33

Nutrition interventions to ease the symptoms of nausea include:

A)eating dry, starchy foods.
B)drinking warm beverages.
C)adding fat to foods.
D)eating raw vegetables.

Question 34

To help delay stomach emptying and reduce diarrhea following a gastrectomy, foods high in _____ may be useful.

A)fat
B)insoluble fiber
C)protein
D)soluble fiber

Question 35

Frequent complications of gastric surgery include all of the following except:

A)bone disease.
B)weight loss.
C)protein malabsorption.
D)iron-deficiency anemia.

Question 36

_____ occurs in up to 15% of cases of peptic ulcer disease.

A)Pain
B)Dysphagia
C)Gastrointestinal bleeding
D)Reflux esophagitis

Question 37

Dietary adjustments after a gastrectomy are influenced by:

A)the size of the remaining stomach.
B)the resulting slower gastric emptying.
C)the type of surgical procedure performed.
D)the patient's food preferences.

Question 38

Nutrition intervention for peptic ulcer disease includes advising the patient to do all of the following except:

A)avoid foods that increase acid secretion.
B)avoid large meals.
C)avoid eating right before bedtime.
D)avoid gas-forming foods.

Question 39

Foods often associated with dyspepsia include all of the following except:

A)raw foods.
B)coffee.
C)spicy foods.
D)high-fat foods.

Question 40

To prevent dumping syndrome, you would tell a client to:

A)limit the amount of fluid consumed with a meal.
B)drink a cold beverage with each meal.
C)avoid fiber-rich foods.
D)avoid lying down after eating.

Question 41

To avoid dehydration, the patient who has undergone bariatric surgery should:

A)sip water and other noncaloric beverages throughout the day.
B)drink plenty of fluids with meals.
C)increase intake of foods with high water content.
D)drink sports drinks.
Use the following case study to answer questions 40-45.
Jennie Wilson is a 42-year-old administrative assistant who recently underwent gastric bypass surgery to treat her obesity and weight-related problems: diabetes and hypertension.Ms.Wilson will need nutrition education before being discharged from the hospital.

Question 42

Which of the following factors is not involved in tooth decay?

A)the type of carbohydrate consumed
B)the frequency of carbohydrate intake
C)the stickiness of foods consumed
D)the fat content of foods consumed

Question 43

M.L.should be made aware that absorption of some nutrients can be adversely affected by antacid and antisecretory medication use.These include:

A)iron.
B)vitamin B₁₂.
C)folate.
D)calcium.
E)all of the above

Question 44

Due to reduced food intake and nutrient malabsorption, Ms.Wilson will likely require supplements of:

A)vitamin B₁₂, iron, and calcium.
B)zinc, magnesium, and iron.
C)vitamin B₆, folate, and niacin.
D)calcium, iron, and vitamin C.
Use the following case study to answer questions 46-50.
M)L.is a 34-year-old male computer programmer with a BMI of 26 who is seeking dietary counseling.His dose of Prilosec was recently increased, and although he now suffers less often from heartburn symptoms, he is also leery of medical side effects and would like any and all suggestions to manage his GERD "naturally." Having had GERD for the past eight years and been on some form of antacid or antisecretory medication continuously during that time, M.L.knows what foods or factors cause symptoms, and is able to generally avoid them; hence, he has not had reflux esophagitis in over a year.A 24-hour diet history reveals M.L.ate these foods yesterday:
Breakfast: Skipped
Snack: Fresh pear; instant oatmeal made with water, eaten with brown sugar and two non-dairy creamers; skim milk
Lunch: Lean turkey lunch meat on whole-grain bread with lettuce, tomato, and mustard; 100% grape juice diluted with water; snack pack of carrots, no dressing
Snack: Sugar cookies; skim milk
Dinner: Tempura (deep-fried, breaded) salmon; buttered rice; salad with lettuce and tomato; vinegar and oil dressing; water
Snack, at bedtime: Ginger ale and ginger snap cookies

Question 45

Rapid weight loss following bariatric surgery increases the risk of developing:

A)gallbladder disease.
B)hypertension.
C)type 2 diabetes.
D)Sjögren's syndrome.

Question 46

All of the following foods can be problematic following bariatric surgery except:

A)pasta.
B)dried fruits.
C)asparagus.
D)crackers.

Question 47

Suggestions for achieving and maintaining weight loss following bariatric surgery include all of the following except:

A)Eat only during designated mealtimes.
B)Engage in regular physical activity.
C)Drink plenty of water and other beverages to suppress appetite.
D)Eat slowly and chew food thoroughly.

Question 48

On the day following surgery, Ms.Wilson will be allowed to consume all of the following except:

A)sugar-free iced tea.
B)low-fat broth.
C)water.
D)skim milk.

Question 49

Which of the following is least relevant to advising M.L.on minimizing GERD symptoms?

A)whether he smokes
B)whether he drinks alcohol
C)whether he uses non-steroidal anti-inflammatory medications
D)whether he is physically active

Question 50

Which of the following foods stimulates saliva flow and neutralizes acids in the mouth?

A)hamburger
B)legumes
C)orange juice
D)cheese

Question 51

What is the diet progression following bariatric surgery?

A)clear liquid, liquid, pureed, regular
B)liquid, mechanical soft, low-fat, regular
C)pureed, chopped, regular
D)pureed, chopped, soft, regular

Question 52

The medication M.L.takes is a proton-pump inhibitor medication that works by:

A)decreasing gastric acid production.
B)neutralizing gastric acid.
C)coating the esophagus.
D)preventing tissue inflammation.

Question 53

Ms.Wilson's stomach capacity immediately following surgery will be:

A)a few teaspoons.
B)a few tablespoons.
C)¹/₂ cup.
D)³/₄ cup.

Question 54

The practitioner gives M.L.a checklist of lifestyle changes that can help minimize GERD symptoms.Based on the diet recall above, M.L.would benefit from education about each of these tips except:

A)Consume only small meals and drink liquids between meals so that the stomach does not become overly distended, which can exert pressure on the lower esophageal sphincter.
B)Limit foods that weaken lower esophageal sphincter pressure or increase gastric acid secretion, such as fried and fatty foods.
C)During periods of esophagitis, avoid foods and beverages that may irritate the esophagus, such as citrus fruits and juices, tomato products, garlic, onions, pepper, spicy foods, carbonated beverages, and very hot or very cold foods.
D)Avoid eating bedtime snacks or lying down after meals.Meals should be consumed at least three hours before bedtime.

Question 55

Which of the following foods would be most likely to contribute to dental caries?

A)raw carrots
B)milk
C)soft drinks
D)cheese

Question 56

In order to achieve and maintain weight loss after surgery, Ms.Wilson should be encouraged to:

A)avoid drinking high-calorie beverages.
B)eat at least one cup of food at each meal.
C)limit her physical activity.
D)snack between meals to avoid feelings of hunger.

Question 57

Based on the 24-hour diet recall provided, M.L.consumes two cups of dairy foods per day.Based on the USDA Food Patterns:

A)he is eating sufficient dairy foods.
B)he should eat 1 more cup of dairy foods.
C)he should eat 2 more cups of dairy foods.
D)he should eat 3 more cups of dairy foods.

Question 58

Which of the following foods should Ms.Wilson be advised to avoid to prevent possible obstruction of the gastric outlet?

A)bananas
B)celery
C)fish
D)mashed potatoes

Question 59

Dental caries are caused by:

A)bacteria that produce acids that attack tooth enamel.
B)excessive fluoride intake that attacks tooth enamel.
C)high-fiber foods that cause carbohydrate to stick to teeth.
D)excessive consumption of sugar that eats into teeth.

Question 60

Once she is able to tolerate regular foods, what type of foods should Ms.Wilson be encouraged to eat before consuming other foods in a meal?

A)complex carbohydrates
B)high-protein foods
C)low-fat foods
D)high-fat foods

Question 61

The nurse is reviewing a patient's chart and notices that the patient has a history of Sjögren's syndrome.The nurse recognizes that the patient may have nutritional problems due to:

A)low blood sugar.
B)dry mouth.
C)impaired digestion.
D)malabsorption.

Question 62

The nurse is working with a client who had bariatric surgery four months ago.The nurse should tell this client to:

A)consume only liquids.
B)eat whatever she wants.
C)take megadoses of vitamins and minerals.
D)consume only small amounts of food at a time.

Question 63

Define dysphagia and explain the dietary treatment for this disorder.

Question 64

The nurse understands that the educational needs of a patient following bariatric surgery include:

A)recognizing sensations that occur when the gastric pouch is full.
B)eating often throughout the day.
C)drinking adequate fluids with meals.
D)supplementing meals with milkshakes.

Question 65

The nurse recognizes that a patient with peptic ulcer disease should avoid foods that may irritate the gastrointestinal lining, such as:

A)alcohol, coffee, and spicy foods.
B)eggs, ribs, and cheese.
C)tea, orange juice, and potato chips.
D)apples, broccoli, and sweet potatoes.

Question 66

The nurse explains to a bariatric surgery patient that an appropriate meal size for when he is first discharged home is:

A)only 1 tablespoon.
B)a few spoonfuls.
C)about ²/₃ cup.
D)about 1 cup.

Question 67

The nurse is working with a client who recently suffered from a stroke.The client complains of painful swallowing, nasal regurgitation during swallowing, and coughing during meals.The nurse recognizes these as symptoms of:

A)dysphagia.
B)gastritis.
C)reflux esophagitis.
D)hiatal hernia.

Question 68

Matching

Question 69

Discuss the potential complications of gastritis.

Question 70

The nurse recognizes that finding the best diet for a patient with dysphagia is often challenging, and the most appropriate foods are:

A)dry foods like crackers.
B)sticky foods like peanut butter.
C)foods with mixed textures like casseroles.
D)soft, cohesive foods like mashed potatoes.

Question 71

All of the following are risk factors for developing periodontal disease except:

A)dental plaque.
B)smoking.
C)diabetes.
D)atherosclerosis.

Question 72

The nurse understands that a patient with GERD will benefit from education on managing the disease.All of the following suggestions would be included in the education except:

A)Avoid eating at bedtime.
B)Limit chocolate, high-fat foods, coffee, and tea.
C)Consume liquids with meals.
D)Avoid alcohol.

Question 73

A patient experiences nausea, vomiting, abdominal cramping, diarrhea, and lightheadedness after meals following gastric bypass surgery.The nurse recognizes these as symptoms of:

A)malabsorption.
B)high blood sugar.
C)Sjögren's syndrome.
D)dumping syndrome.

Question 74

What should the nurse include in the care plan to address the nutritional needs of a patient who has undergone a partial gastrectomy?

A)several small meals and snacks
B)low-fiber diet
C)low-fat diet
D)high-kcalorie diet with snacks between meals

Question 75

Following gastric resection, the nurse understands the need to limit _____ in the patient's diet.

A)fiber
B)meat
C)vegetables
D)sugar

Question 76

Current research suggests that periodontal disease may increase the risk of developing:

A)heart disease.
B)renal failure.
C)arthritis.
D)dermatitis.
Nursing Exam Review Multiple Choice

Question 77

Mr.Green uses NSAIDs regularly to control chronic pain and complains of frequent stomach pain.The nurse recognizes this as gastritis and realizes that he may be at risk for deficiencies of:

A)calcium and phosphorous.
B)iron and vitamin B₁₂.
C)sodium and potassium.
D)vitamins C and E.

Question 78

What dietary advice would you give someone who is experiencing GERD?

Question 79

The nurse is reinforcing the dietitian's instructions for a postgastrectomy diet.The nurse realizes the client understands his diet when he states that he should:

A)emphasize grains, fruits, and vegetables in his diet.
B)limit the amount of sweets like colas, honey, and jam.
C)eliminate meats, eggs, and milk.
D)exclude decaffeinated coffee, tea, and artificially sweetened drinks.

Question 80

List the symptoms of dumping syndrome and explain the sequence of events that results in these symptoms.