Deck 16: Nutrition in Metabolic and Respiratory Stress

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Question
Protein synthesis is inhibited by _____.​

A) ​cortisol
B) ​eicosanoids
C) ​mast cells
D) ​phagocytes
E) ​aldosterone
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Question
If stress continues for a long period, growth retardation and illness can occur.​
Question
What compound is produced by white blood cells and participates in the inflammatory process?​

A) ​glucagon
B) ​catecholamines
C) ​cytokines
D) ​cortisol
E) ​aldosterone
Question
The major precursor to eicosanoids in the inflammatory process is _____.​

A) ​cortisol
B) ​arachidonic acid
C) ​epinephrine
D) ​glucagon
E) ​norepinephrine
Question
Weight loss and wasting are common in the advanced stages of COPD and may result from hypermetabolism, poor food intake, and the actions of various inflammatory proteins.​
Question
Overfeeding an acutely stressed patient improves nitrogen balance and decreases lean tissue losses.​
Question
Excessive energy intake in patients with ARDS can worsen respiratory function.​
Question
An excessive response to metabolic stress can worsen illness and lead to death.​
Question
The high nutrient requirements of acutely stressed patients often require a patient to be fed via the enteral or parenteral route to meet his or her nutritional needs.​
Question
If the reduction in blood flow from inflammation is severe enough to deprive the body's tissues of oxygen and nutrients, SIRS can result.​
Question
Recovery from an injury or illness can be hastened by hypermetabolism and positive nitrogen balance.​
Question
The inflammatory process can alter immune cell function in the body.​
Question
To maintain lean tissue, the protein intakes recommended during acute stress are higher than DRI values.​
Question
Nutrition care for patients in acute respiratory failure is aimed at providing a low-fat, high-carbohydrate diet.​
Question
The symptoms associated with the initial inflammatory response are collectively called the systemic inflammatory response syndrome.​
Question
​The increase in basal metabolic rate as a part of the stress response can be attributed to _____.

A) ​catecholamines
B) ​cortisol
C) ​eicosanoids
D) ​cytokines
E) ​hepcidin
Question
During the inflammatory response, mast cells release _____, which causes vasodilation and capillary permeability.​

A) ​erythropoietin
B) ​cortisol
C) ​anti-diuretic hormone
D) ​cytokine
E) ​histamine
Question
A patient with lung disease would most likely prevent or reverse loss of muscle mass by decreasing activity levels and incorporating more rest.​
Question
Smoking is the primary risk factor in most cases of COPD.​
Question
Patients under 55 years old are several times more likely to develop MODS than are older patients.​
Question
Laura is a critically ill patient. She is 5'4" tall and weighs 150 pounds. What are Laura's protein needs?​

A) ​34-40 g
B) ​54-68 g
C) ​82-136 g
D) ​136-158 g
E) ​160-184 g
Question
The protein needs of a non-obese critically ill patient would be _____.​

A) ​0.8-1.0 g/kg body weight per day
B) ​1.0-1.2 g/kg body weight per day
C) ​1.2-2.0 g/kg body weight per day
D) ​2.0-2.5 g/kg body weight per day
E) ​2.5-3.0 g/kg body weight per day
Question
A COPD patient who complains of abdominal discomfort and dyspnea may benefit from _____.​

A) ​small, frequent meals
B) ​a low-fat diet
C) ​a high-fiber diet
D) ​consuming more liquids
E) ​increased energy consumption
Question
What describes the immediate care concerns of the clinician during a patient's time of severe stress?​

A) ​Educating the patient about nutrient needs
B) ​Providing psychological counseling
C) ​Determining the level of the patient's understanding about his condition
D) ​Providing nutrition therapy
E) ​Restoring fluids and electrolytes
Question
Nutrition therapy for management of COPD involves _____.​

A) ​promoting weight gain
B) ​supporting wound healing
C) ​improving food intake
D) ​relieving chronic cough
E) ​decreasing supplemental oxygen needs
Question
Which amino acid may have beneficial effects on surgical healing of postoperative patients?​

A) ​tryptophan
B) ​tyrosine
C) ​arginine
D) ​phenylalanine
E) ​leucine
Question
When caring for a patient who is suffering from acute illness and metabolic stress, how would clinicians best estimate protein and energy needs?​

A) ​Adjust nutrient intakes according to patient responses
B) ​Underfeed the patient to minimize tissue loss
C) ​Maintain the patient at NPO status to promote bowel rest
D) ​Overfeed the patient to prevent hypoglycemia
E) ​Increase carbohydrate intake to promote weight gain and appropriate energy use
Question
What complication is most closely associated with severe cases of SIRS or sepsis?​

A) ​hypertension
B) ​fluid retention
C) ​hypertriglyceridemia
D) ​poor glucose control
E) ​intestinal bleeding
Question
Excessive kcalorie intake in COPD patients may _____.​

A) ​interfere with catabolic processes
B) ​alter taste perception
C) ​interfere with drug therapy
D) ​increase gas formation
E) ​increase respiratory distress
Question
In critically ill patients, a high intake of _____ may suppress immune function and increase the risk of developing infections.​

A) ​fat
B) ​dextrose
C) ​protein
D) ​zinc
E) ​vitamin A
Question
Emphysema associated with COPD is most often diagnosed by _____.​

A) ​serial chest x-rays
B) ​clinical signs and lung function tests
C) ​oxygen saturation readings
D) ​24-hour halter monitoring
E) ​culture and sensitivity of mucus samples
Question
A 25-year-old woman is critically ill after surviving a motor vehicle accident. The patient is 5'4" and weighs 120 pounds. This patient's energy needs would require how many kcalories for energy?​

A) ​15-20 kcal/kg body weight per day
B) ​22-25 kcal/kg body weight per day
C) ​25-30 kcal/kg body weight per day
D) ​30-35 kcal/kg body weight per day
E) ​38-40 kcal/kg body weight per day
Question
Adequate fluid intake will help the person with COPD by _____.​

A) decreasing carbon dioxide output​
B) ​preventing the secretion of overly thick mucus
C) ​aiding in weight loss
D) ​improving oxygen consumption
E) ​reducing abdominal distention
Question
In critically ill patients, _____ is used to measure the resting metabolic rate (RMR).​

A) ​skinfold measurement
B) ​BMI
C) ​the stress factor equation
D) ​indirect calorimetry
E) ​a clinical body weight growth chart
Question
The most common risk factor associated with development of COPD is _____.​

A) ​alpha-1 anti-trypsin deficiency
B) ​environmental exposure to pollutants
C) ​lung cancer
D) ​cigarette smoking
E) ​cystic fibrosis
Question
Which amino acid has been shown to have beneficial effects on critically ill patients?​

A) ​leucine
B) ​glutamine
C) ​valine
D) ​isoleucine
E) ​phenylalanine
Question
What micronutrient plays a role in immunity and wound healing?​

A) ​Zinc
B) ​Choline
C) ​Selenium
D) ​Vitamin K
E) ​Iron
Question
A parenteral feeding should supply no more than _____ milligrams of dextrose per kilogram of body weight per minute to prevent hyperglycemia.​

A) ​1
B) ​2
C) ​3
D) ​4
E) ​5
Question
What method was developed for estimating energy needs in a patient with traumatic injuries?​

A) ​Parkland formula
B) ​Jackson/Pollock method
C) ​Harris-Benedict equation
D) ​Lund-Browder formula
E) ​Ireton-Jones energy equation
Question
Once patients can tolerate oral feedings, what type of diet is often prescribed?​

A) ​high fiber
B) ​low sodium
C) ​high-kcalorie, high-protein
D) ​low fat
E) ​low carbohydrate
Question
A patient who is on a tube feeding gains nine pounds in three days. The nurse realizes that this may most likely indicate _____.​

A) ​inadequate nutritional intake
B) ​excess protein intake
C) ​a fluid imbalance
D) ​low levels of vitamin D
E) ​refeeding syndrome
Question
​The first organ to fail in MODS is often the _____.

A) ​lungs
B) ​liver
C) ​kidneys
D) ​heart
E) ​brain
Question
While caring for a patient who has been injured, the nurse recognizes which sign of inflammation that accompanies altered blood flow?​

A) ​Hyperglycemia
B) ​Swelling
C) ​Pale skin
D) ​Hypotension
E) ​Confusion
Question
A nurse is treating a patient who is experiencing fluctuations in hormone levels as a result of stress. Based on her understanding of the metabolic effects associated with certain hormones, the nurse knows that aldosterone is responsible for _____.​

A) ​increasing the patient's metabolic rate
B) ​producing glucose from amino acids
C) ​reabsorbing sodium in the kidneys
D) ​releasing fatty acids from adipose tissue
E) ​reabsorbing water in the kidneys
Question
Kati is a 19-year-old female who suffered a head injury and multiple broken bones in a motorcycle accident. She is currently in a coma, on a mechanical ventilator, and receiving enteral nutrition. Kati is 5'2" tall and weighs 115 pounds.

The stress of Kati's condition places her at risk of hypermetabolism. What kind of complication is most closely associated with hypermetabolism as a result of stress?​

A) ​wasting
B) ​fractures
C) ​kidney failure
D) ​bone pain
E) ​pulmonary edema
Question
Because the immediate stress response can cause a variety of systemic effects, the nurse should closely monitor her patient's _____.​

A) ​heart rate, respiratory rate, and blood pressure
B) ​appetite, temperature, and weight
C) ​pain rating, level of consciousness, and posture
D) ​abdominal girth, reflexes, and edema
E) ​hearing, vision, and sense of smell
Question
John has been hospitalized with a severe infection in his foot. The nurse recognizes that increasing his intake of _____ may help to suppress the inflammation.​

A) ​protein
B) ​omega-3 fatty acids
C) ​carbohydrate
D) ​omega 6-fatty acids
E) ​vitamin D
Question
Mr. Morgan is a critically ill patient in the ICU who is on TPN. The nurse understands that monitoring his _____ can help to determine if he is being overfed.​

A) ​glucose levels
B) ​cholesterol levels
C) ​iron levels
D) ​albumin levels
E) ​calcium levels
Question
Kati is a 19-year-old female who suffered a head injury and multiple broken bones in a motorcycle accident. She is currently in a coma, on a mechanical ventilator, and receiving enteral nutrition. Kati is 5'2" tall and weighs 115 pounds.

Kati's protein needs are estimated at 1.2 to 2 g/kg of body weight based on her condition. Based on this estimation, her daily protein intake would then be _____ g per day.​

A) ​36 to 58 g
B) ​62 to 104 g
C) ​116 to 138 g
D) ​154 to 168 g
E) ​180 to 200 g
Question
One factor that increases the risk of a patient developing MODS is _____.​

A) ​age over 40 years
B) ​an increased length of hospital stay
C) ​uncontrolled blood glucose
D) ​obesity
E) ​the severity of SIRS infection
Question
In what way does nutrition support play a role in treatment of MODS?​

A) ​Supporting gas exchange
B) ​Preventing excessive wasting
C) ​Promoting excretion of waste products
D) ​Maintaining blood pressure
E) ​Increasing cardiac output
Question
Kati is a 19-year-old female who suffered a head injury and multiple broken bones in a motorcycle accident. She is currently in a coma, on a mechanical ventilator, and receiving enteral nutrition. Kati is 5'2" tall and weighs 115 pounds.

If Kati's enteral feeding is not providing adequate energy and protein to meet her nutritional needs, she will experience _____.​

A) ​a loss of lean tissue
B) ​hyperglycemia
C) ​pulmonary edema
D) ​sepsis
E) ​organ failure
Question
​Mr. Jones, a critically ill patient, is 5'9" tall and weighs 176 pounds. The nurse recommends that he receive a minimum of _____ grams of protein daily.

A) ​64
B) ​80
C) ​96
D) ​136
E) ​240
Question
Kati is a 19-year-old female who suffered a head injury and multiple broken bones in a motorcycle accident. She is currently in a coma, on a mechanical ventilator, and receiving enteral nutrition. Kati is 5'2" tall and weighs 115 pounds.

Estimate Kati's energy needs using the Ireton-Jones equation: 1925 + [5 ´ wt (kg)] - [10 ´ age (yr)] + (281 ´ sex) + (292 ´ trauma) + (851 ´ burn).​

A) ​2288
B) ​2681
C) ​2828
D) ​3420
E) ​3240
Question
The principal infection most often associated with MODS is _____.​

A) ​pneumonia
B) ​urinary tract infection
C) ​herpes simplex virus infection
D) ​meningitis
E) ​hepatitis B infection
Question
Kati is a 19-year-old female who suffered a head injury and multiple broken bones in a motorcycle accident. She is currently in a coma, on a mechanical ventilator, and receiving enteral nutrition. Kati is 5'2" tall and weighs 115 pounds.

As a result of the acute-phase inflammatory response, Kati's plasma concentrations of _____ would be expected to decrease.

A) ​glucose and cholesterol
B) ​sodium and potassium
C) ​iron and glucose
D) ​albumin and iron
E) ​magnesium and chloride
Question
A patient who has developed MODS would most likely demonstrate what signs or symptoms associated with liver failure?​

A) ​Abnormal bleeding
B) ​Sepsis
C) ​Altered metabolic processes
D) ​Impaired gas exchange
E) ​Low blood pressure
Question
Kati is a 19-year-old female who suffered a head injury and multiple broken bones in a motorcycle accident. She is currently in a coma, on a mechanical ventilator, and receiving enteral nutrition. Kati is 5'2" tall and weighs 115 pounds.

To decrease the risk of infection, it will be important to keep Kati's _____ under control while she is recovering.​

A) ​serum albumin
B) ​blood glucose
C) ​blood pressure
D) ​serum prealbumin
E) ​nitrogen
Question
Mrs. White is in the ICU for complications following surgery. She has been diagnosed with sepsis and is on a ventilator. In order to most accurately estimate her energy needs, the nurse recognizes that the preferred method to use is _____.​

A) ​the Harris-Benedict equation
B) ​the Penn State equation
C) ​direct calorimetry
D) ​the Mifflin-St. Jeor equation
E) ​the permissive protein balance method
Question
Severe hypercapnia associated with respiratory failure can cause _____, which interferes with normal functioning of the central nervous system.​

A) ​sepsis
B) ​SIRS
C) ​cardiac failure
D) ​COPD
E) ​acidosis
Question
Matching​
a. ​the breakdown of muscle tissue that results from disease or malnutrition
b. ​an acute-phase protein involved in the regulation of iron metabolism
c. ​the main airways of the lungs
d. ​cells within connective tissue that produce and release histamine
e. ​the volume of air a person inhales or exhales each minute
f. ​the surgical removal of dead, damaged, or contaminated tissue resulting from burns or wounds
g. ​respiratory failure triggered by severe lung injury
h. ​the chemical and physical changes that occur within the body during stress
i. ​progressive lung disease characterized by the breakdown of the lungs' elastic structure and destruction of the walls of the respiratory bronchioles and alveoli
j. ​a group of metabolic abnormalities that may result from aggressive refeeding in severely malnourished persons
k. ​a method of estimating resting energy expenditure by measuring a person's oxygen consumption and carbon dioxide production
l. ​insufficient oxygen in the blood
m. ​a group of plasma proteins that assist the activities of antibodies
n. ​insufficient oxygen in body tissues
o. ​a severe reduction in blood flow that deprives the body's tissues of oxygen and nutrients
p. ​a lung disorder characterized by persistent inflammation and excessive secretions of mucus in the main airways of the lungs
q. ​shortness of breath
r. ​a whole-body inflammatory response caused by infection
s. ​a bluish cast in the skin due to the color of deoxygenated hemoglobin
t. ​accumulations of pus
​stress response
Question
Matching​
a. ​the breakdown of muscle tissue that results from disease or malnutrition
b. ​an acute-phase protein involved in the regulation of iron metabolism
c. ​the main airways of the lungs
d. ​cells within connective tissue that produce and release histamine
e. ​the volume of air a person inhales or exhales each minute
f. ​the surgical removal of dead, damaged, or contaminated tissue resulting from burns or wounds
g. ​respiratory failure triggered by severe lung injury
h. ​the chemical and physical changes that occur within the body during stress
i. ​progressive lung disease characterized by the breakdown of the lungs' elastic structure and destruction of the walls of the respiratory bronchioles and alveoli
j. ​a group of metabolic abnormalities that may result from aggressive refeeding in severely malnourished persons
k. ​a method of estimating resting energy expenditure by measuring a person's oxygen consumption and carbon dioxide production
l. ​insufficient oxygen in the blood
m. ​a group of plasma proteins that assist the activities of antibodies
n. ​insufficient oxygen in body tissues
o. ​a severe reduction in blood flow that deprives the body's tissues of oxygen and nutrients
p. ​a lung disorder characterized by persistent inflammation and excessive secretions of mucus in the main airways of the lungs
q. ​shortness of breath
r. ​a whole-body inflammatory response caused by infection
s. ​a bluish cast in the skin due to the color of deoxygenated hemoglobin
t. ​accumulations of pus
​shock
Question
Matching​
a. ​the breakdown of muscle tissue that results from disease or malnutrition
b. ​an acute-phase protein involved in the regulation of iron metabolism
c. ​the main airways of the lungs
d. ​cells within connective tissue that produce and release histamine
e. ​the volume of air a person inhales or exhales each minute
f. ​the surgical removal of dead, damaged, or contaminated tissue resulting from burns or wounds
g. ​respiratory failure triggered by severe lung injury
h. ​the chemical and physical changes that occur within the body during stress
i. ​progressive lung disease characterized by the breakdown of the lungs' elastic structure and destruction of the walls of the respiratory bronchioles and alveoli
j. ​a group of metabolic abnormalities that may result from aggressive refeeding in severely malnourished persons
k. ​a method of estimating resting energy expenditure by measuring a person's oxygen consumption and carbon dioxide production
l. ​insufficient oxygen in the blood
m. ​a group of plasma proteins that assist the activities of antibodies
n. ​insufficient oxygen in body tissues
o. ​a severe reduction in blood flow that deprives the body's tissues of oxygen and nutrients
p. ​a lung disorder characterized by persistent inflammation and excessive secretions of mucus in the main airways of the lungs
q. ​shortness of breath
r. ​a whole-body inflammatory response caused by infection
s. ​a bluish cast in the skin due to the color of deoxygenated hemoglobin
t. ​accumulations of pus
​chronic bronchitis
Question
Matching​
a. ​the breakdown of muscle tissue that results from disease or malnutrition
b. ​an acute-phase protein involved in the regulation of iron metabolism
c. ​the main airways of the lungs
d. ​cells within connective tissue that produce and release histamine
e. ​the volume of air a person inhales or exhales each minute
f. ​the surgical removal of dead, damaged, or contaminated tissue resulting from burns or wounds
g. ​respiratory failure triggered by severe lung injury
h. ​the chemical and physical changes that occur within the body during stress
i. ​progressive lung disease characterized by the breakdown of the lungs' elastic structure and destruction of the walls of the respiratory bronchioles and alveoli
j. ​a group of metabolic abnormalities that may result from aggressive refeeding in severely malnourished persons
k. ​a method of estimating resting energy expenditure by measuring a person's oxygen consumption and carbon dioxide production
l. ​insufficient oxygen in the blood
m. ​a group of plasma proteins that assist the activities of antibodies
n. ​insufficient oxygen in body tissues
o. ​a severe reduction in blood flow that deprives the body's tissues of oxygen and nutrients
p. ​a lung disorder characterized by persistent inflammation and excessive secretions of mucus in the main airways of the lungs
q. ​shortness of breath
r. ​a whole-body inflammatory response caused by infection
s. ​a bluish cast in the skin due to the color of deoxygenated hemoglobin
t. ​accumulations of pus
​refeeding syndrome
Question
A critically ill patient with ARDS is on a tube feeding and requires a fluid restriction. The nurse understands that an appropriate enteral formula would be a _____ formula.​

A) ​low residue
B) ​high protein
C) ​nutrient dense
D) ​hydrolyzed
E) ​low fat
Question
Matching​
a. ​the breakdown of muscle tissue that results from disease or malnutrition
b. ​an acute-phase protein involved in the regulation of iron metabolism
c. ​the main airways of the lungs
d. ​cells within connective tissue that produce and release histamine
e. ​the volume of air a person inhales or exhales each minute
f. ​the surgical removal of dead, damaged, or contaminated tissue resulting from burns or wounds
g. ​respiratory failure triggered by severe lung injury
h. ​the chemical and physical changes that occur within the body during stress
i. ​progressive lung disease characterized by the breakdown of the lungs' elastic structure and destruction of the walls of the respiratory bronchioles and alveoli
j. ​a group of metabolic abnormalities that may result from aggressive refeeding in severely malnourished persons
k. ​a method of estimating resting energy expenditure by measuring a person's oxygen consumption and carbon dioxide production
l. ​insufficient oxygen in the blood
m. ​a group of plasma proteins that assist the activities of antibodies
n. ​insufficient oxygen in body tissues
o. ​a severe reduction in blood flow that deprives the body's tissues of oxygen and nutrients
p. ​a lung disorder characterized by persistent inflammation and excessive secretions of mucus in the main airways of the lungs
q. ​shortness of breath
r. ​a whole-body inflammatory response caused by infection
s. ​a bluish cast in the skin due to the color of deoxygenated hemoglobin
t. ​accumulations of pus
​wasting
Question
Matching​
a. ​the breakdown of muscle tissue that results from disease or malnutrition
b. ​an acute-phase protein involved in the regulation of iron metabolism
c. ​the main airways of the lungs
d. ​cells within connective tissue that produce and release histamine
e. ​the volume of air a person inhales or exhales each minute
f. ​the surgical removal of dead, damaged, or contaminated tissue resulting from burns or wounds
g. ​respiratory failure triggered by severe lung injury
h. ​the chemical and physical changes that occur within the body during stress
i. ​progressive lung disease characterized by the breakdown of the lungs' elastic structure and destruction of the walls of the respiratory bronchioles and alveoli
j. ​a group of metabolic abnormalities that may result from aggressive refeeding in severely malnourished persons
k. ​a method of estimating resting energy expenditure by measuring a person's oxygen consumption and carbon dioxide production
l. ​insufficient oxygen in the blood
m. ​a group of plasma proteins that assist the activities of antibodies
n. ​insufficient oxygen in body tissues
o. ​a severe reduction in blood flow that deprives the body's tissues of oxygen and nutrients
p. ​a lung disorder characterized by persistent inflammation and excessive secretions of mucus in the main airways of the lungs
q. ​shortness of breath
r. ​a whole-body inflammatory response caused by infection
s. ​a bluish cast in the skin due to the color of deoxygenated hemoglobin
t. ​accumulations of pus
​mast cells
Question
Matching​
a. ​the breakdown of muscle tissue that results from disease or malnutrition
b. ​an acute-phase protein involved in the regulation of iron metabolism
c. ​the main airways of the lungs
d. ​cells within connective tissue that produce and release histamine
e. ​the volume of air a person inhales or exhales each minute
f. ​the surgical removal of dead, damaged, or contaminated tissue resulting from burns or wounds
g. ​respiratory failure triggered by severe lung injury
h. ​the chemical and physical changes that occur within the body during stress
i. ​progressive lung disease characterized by the breakdown of the lungs' elastic structure and destruction of the walls of the respiratory bronchioles and alveoli
j. ​a group of metabolic abnormalities that may result from aggressive refeeding in severely malnourished persons
k. ​a method of estimating resting energy expenditure by measuring a person's oxygen consumption and carbon dioxide production
l. ​insufficient oxygen in the blood
m. ​a group of plasma proteins that assist the activities of antibodies
n. ​insufficient oxygen in body tissues
o. ​a severe reduction in blood flow that deprives the body's tissues of oxygen and nutrients
p. ​a lung disorder characterized by persistent inflammation and excessive secretions of mucus in the main airways of the lungs
q. ​shortness of breath
r. ​a whole-body inflammatory response caused by infection
s. ​a bluish cast in the skin due to the color of deoxygenated hemoglobin
t. ​accumulations of pus
​emphysema
Question
Mary is a 59-year-old patient who suffered multiple broken bones in a motor vehicle accident. She weighs 138 pounds. The nurse chooses a protein factor of 1.5 g/kg to estimate her protein needs and calculates that Mary's protein requirements are approximately _____ grams per day.​

A) ​94
B) ​103
C) ​121
D) ​180
E) ​208
Question
Matching​
a. ​the breakdown of muscle tissue that results from disease or malnutrition
b. ​an acute-phase protein involved in the regulation of iron metabolism
c. ​the main airways of the lungs
d. ​cells within connective tissue that produce and release histamine
e. ​the volume of air a person inhales or exhales each minute
f. ​the surgical removal of dead, damaged, or contaminated tissue resulting from burns or wounds
g. ​respiratory failure triggered by severe lung injury
h. ​the chemical and physical changes that occur within the body during stress
i. ​progressive lung disease characterized by the breakdown of the lungs' elastic structure and destruction of the walls of the respiratory bronchioles and alveoli
j. ​a group of metabolic abnormalities that may result from aggressive refeeding in severely malnourished persons
k. ​a method of estimating resting energy expenditure by measuring a person's oxygen consumption and carbon dioxide production
l. ​insufficient oxygen in the blood
m. ​a group of plasma proteins that assist the activities of antibodies
n. ​insufficient oxygen in body tissues
o. ​a severe reduction in blood flow that deprives the body's tissues of oxygen and nutrients
p. ​a lung disorder characterized by persistent inflammation and excessive secretions of mucus in the main airways of the lungs
q. ​shortness of breath
r. ​a whole-body inflammatory response caused by infection
s. ​a bluish cast in the skin due to the color of deoxygenated hemoglobin
t. ​accumulations of pus
​minute ventilation
Question
A patient with ARDS requires mechanical ventilation. The nurse recognizes that fluid accumulation is a potential problem that may make it difficult to assess his _____.​

A) ​weight
B) ​temperature
C) ​kcalorie intake
D) ​fluid intake
E) ​heart rate
Question
Matching​
a. ​the breakdown of muscle tissue that results from disease or malnutrition
b. ​an acute-phase protein involved in the regulation of iron metabolism
c. ​the main airways of the lungs
d. ​cells within connective tissue that produce and release histamine
e. ​the volume of air a person inhales or exhales each minute
f. ​the surgical removal of dead, damaged, or contaminated tissue resulting from burns or wounds
g. ​respiratory failure triggered by severe lung injury
h. ​the chemical and physical changes that occur within the body during stress
i. ​progressive lung disease characterized by the breakdown of the lungs' elastic structure and destruction of the walls of the respiratory bronchioles and alveoli
j. ​a group of metabolic abnormalities that may result from aggressive refeeding in severely malnourished persons
k. ​a method of estimating resting energy expenditure by measuring a person's oxygen consumption and carbon dioxide production
l. ​insufficient oxygen in the blood
m. ​a group of plasma proteins that assist the activities of antibodies
n. ​insufficient oxygen in body tissues
o. ​a severe reduction in blood flow that deprives the body's tissues of oxygen and nutrients
p. ​a lung disorder characterized by persistent inflammation and excessive secretions of mucus in the main airways of the lungs
q. ​shortness of breath
r. ​a whole-body inflammatory response caused by infection
s. ​a bluish cast in the skin due to the color of deoxygenated hemoglobin
t. ​accumulations of pus
​hepcidin
Question
Matching​
a. ​the breakdown of muscle tissue that results from disease or malnutrition
b. ​an acute-phase protein involved in the regulation of iron metabolism
c. ​the main airways of the lungs
d. ​cells within connective tissue that produce and release histamine
e. ​the volume of air a person inhales or exhales each minute
f. ​the surgical removal of dead, damaged, or contaminated tissue resulting from burns or wounds
g. ​respiratory failure triggered by severe lung injury
h. ​the chemical and physical changes that occur within the body during stress
i. ​progressive lung disease characterized by the breakdown of the lungs' elastic structure and destruction of the walls of the respiratory bronchioles and alveoli
j. ​a group of metabolic abnormalities that may result from aggressive refeeding in severely malnourished persons
k. ​a method of estimating resting energy expenditure by measuring a person's oxygen consumption and carbon dioxide production
l. ​insufficient oxygen in the blood
m. ​a group of plasma proteins that assist the activities of antibodies
n. ​insufficient oxygen in body tissues
o. ​a severe reduction in blood flow that deprives the body's tissues of oxygen and nutrients
p. ​a lung disorder characterized by persistent inflammation and excessive secretions of mucus in the main airways of the lungs
q. ​shortness of breath
r. ​a whole-body inflammatory response caused by infection
s. ​a bluish cast in the skin due to the color of deoxygenated hemoglobin
t. ​accumulations of pus
​abscesses
Question
Matching​
a. ​the breakdown of muscle tissue that results from disease or malnutrition
b. ​an acute-phase protein involved in the regulation of iron metabolism
c. ​the main airways of the lungs
d. ​cells within connective tissue that produce and release histamine
e. ​the volume of air a person inhales or exhales each minute
f. ​the surgical removal of dead, damaged, or contaminated tissue resulting from burns or wounds
g. ​respiratory failure triggered by severe lung injury
h. ​the chemical and physical changes that occur within the body during stress
i. ​progressive lung disease characterized by the breakdown of the lungs' elastic structure and destruction of the walls of the respiratory bronchioles and alveoli
j. ​a group of metabolic abnormalities that may result from aggressive refeeding in severely malnourished persons
k. ​a method of estimating resting energy expenditure by measuring a person's oxygen consumption and carbon dioxide production
l. ​insufficient oxygen in the blood
m. ​a group of plasma proteins that assist the activities of antibodies
n. ​insufficient oxygen in body tissues
o. ​a severe reduction in blood flow that deprives the body's tissues of oxygen and nutrients
p. ​a lung disorder characterized by persistent inflammation and excessive secretions of mucus in the main airways of the lungs
q. ​shortness of breath
r. ​a whole-body inflammatory response caused by infection
s. ​a bluish cast in the skin due to the color of deoxygenated hemoglobin
t. ​accumulations of pus
​sepsis
Question
Matching​
a. ​the breakdown of muscle tissue that results from disease or malnutrition
b. ​an acute-phase protein involved in the regulation of iron metabolism
c. ​the main airways of the lungs
d. ​cells within connective tissue that produce and release histamine
e. ​the volume of air a person inhales or exhales each minute
f. ​the surgical removal of dead, damaged, or contaminated tissue resulting from burns or wounds
g. ​respiratory failure triggered by severe lung injury
h. ​the chemical and physical changes that occur within the body during stress
i. ​progressive lung disease characterized by the breakdown of the lungs' elastic structure and destruction of the walls of the respiratory bronchioles and alveoli
j. ​a group of metabolic abnormalities that may result from aggressive refeeding in severely malnourished persons
k. ​a method of estimating resting energy expenditure by measuring a person's oxygen consumption and carbon dioxide production
l. ​insufficient oxygen in the blood
m. ​a group of plasma proteins that assist the activities of antibodies
n. ​insufficient oxygen in body tissues
o. ​a severe reduction in blood flow that deprives the body's tissues of oxygen and nutrients
p. ​a lung disorder characterized by persistent inflammation and excessive secretions of mucus in the main airways of the lungs
q. ​shortness of breath
r. ​a whole-body inflammatory response caused by infection
s. ​a bluish cast in the skin due to the color of deoxygenated hemoglobin
t. ​accumulations of pus
​indirect calorimetry
Question
Matching​
a. ​the breakdown of muscle tissue that results from disease or malnutrition
b. ​an acute-phase protein involved in the regulation of iron metabolism
c. ​the main airways of the lungs
d. ​cells within connective tissue that produce and release histamine
e. ​the volume of air a person inhales or exhales each minute
f. ​the surgical removal of dead, damaged, or contaminated tissue resulting from burns or wounds
g. ​respiratory failure triggered by severe lung injury
h. ​the chemical and physical changes that occur within the body during stress
i. ​progressive lung disease characterized by the breakdown of the lungs' elastic structure and destruction of the walls of the respiratory bronchioles and alveoli
j. ​a group of metabolic abnormalities that may result from aggressive refeeding in severely malnourished persons
k. ​a method of estimating resting energy expenditure by measuring a person's oxygen consumption and carbon dioxide production
l. ​insufficient oxygen in the blood
m. ​a group of plasma proteins that assist the activities of antibodies
n. ​insufficient oxygen in body tissues
o. ​a severe reduction in blood flow that deprives the body's tissues of oxygen and nutrients
p. ​a lung disorder characterized by persistent inflammation and excessive secretions of mucus in the main airways of the lungs
q. ​shortness of breath
r. ​a whole-body inflammatory response caused by infection
s. ​a bluish cast in the skin due to the color of deoxygenated hemoglobin
t. ​accumulations of pus
​bronchioles
Question
Mark is a 23-year-old firefighter who experienced severe burns while fighting a house fire. The nurse recognizes the fact that he may benefit from supplements of _____ to reduce the risk of infection.​

A) ​zinc, vitamin C, and vitamin A
B) ​iron, magnesium, and calcium
C) ​sodium, potassium, and chloride
D) ​phosphorus, thiamin, and riboflavin
E) ​calcium, vitamin D, and vitamin K
Question
Matching​
a. ​the breakdown of muscle tissue that results from disease or malnutrition
b. ​an acute-phase protein involved in the regulation of iron metabolism
c. ​the main airways of the lungs
d. ​cells within connective tissue that produce and release histamine
e. ​the volume of air a person inhales or exhales each minute
f. ​the surgical removal of dead, damaged, or contaminated tissue resulting from burns or wounds
g. ​respiratory failure triggered by severe lung injury
h. ​the chemical and physical changes that occur within the body during stress
i. ​progressive lung disease characterized by the breakdown of the lungs' elastic structure and destruction of the walls of the respiratory bronchioles and alveoli
j. ​a group of metabolic abnormalities that may result from aggressive refeeding in severely malnourished persons
k. ​a method of estimating resting energy expenditure by measuring a person's oxygen consumption and carbon dioxide production
l. ​insufficient oxygen in the blood
m. ​a group of plasma proteins that assist the activities of antibodies
n. ​insufficient oxygen in body tissues
o. ​a severe reduction in blood flow that deprives the body's tissues of oxygen and nutrients
p. ​a lung disorder characterized by persistent inflammation and excessive secretions of mucus in the main airways of the lungs
q. ​shortness of breath
r. ​a whole-body inflammatory response caused by infection
s. ​a bluish cast in the skin due to the color of deoxygenated hemoglobin
t. ​accumulations of pus
​debridement
Question
Mr. Winslett is a COPD patient who is complaining of poor appetite, abdominal discomfort, and bloating. Which suggestion from the nurse is most appropriate for improving his food intake?​

A) ​"Consume larger meals."
B) ​"Substitute beans for meat."
C) ​"Drink a supplement before eating."
D) ​"Eat smaller, more frequent meals."
E) ​"Increase fluid intake throughout the day."
Question
Matching​
a. ​the breakdown of muscle tissue that results from disease or malnutrition
b. ​an acute-phase protein involved in the regulation of iron metabolism
c. ​the main airways of the lungs
d. ​cells within connective tissue that produce and release histamine
e. ​the volume of air a person inhales or exhales each minute
f. ​the surgical removal of dead, damaged, or contaminated tissue resulting from burns or wounds
g. ​respiratory failure triggered by severe lung injury
h. ​the chemical and physical changes that occur within the body during stress
i. ​progressive lung disease characterized by the breakdown of the lungs' elastic structure and destruction of the walls of the respiratory bronchioles and alveoli
j. ​a group of metabolic abnormalities that may result from aggressive refeeding in severely malnourished persons
k. ​a method of estimating resting energy expenditure by measuring a person's oxygen consumption and carbon dioxide production
l. ​insufficient oxygen in the blood
m. ​a group of plasma proteins that assist the activities of antibodies
n. ​insufficient oxygen in body tissues
o. ​a severe reduction in blood flow that deprives the body's tissues of oxygen and nutrients
p. ​a lung disorder characterized by persistent inflammation and excessive secretions of mucus in the main airways of the lungs
q. ​shortness of breath
r. ​a whole-body inflammatory response caused by infection
s. ​a bluish cast in the skin due to the color of deoxygenated hemoglobin
t. ​accumulations of pus
​complement
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Deck 16: Nutrition in Metabolic and Respiratory Stress
1
Protein synthesis is inhibited by _____.​

A) ​cortisol
B) ​eicosanoids
C) ​mast cells
D) ​phagocytes
E) ​aldosterone
A
2
If stress continues for a long period, growth retardation and illness can occur.​
True
3
What compound is produced by white blood cells and participates in the inflammatory process?​

A) ​glucagon
B) ​catecholamines
C) ​cytokines
D) ​cortisol
E) ​aldosterone
C
4
The major precursor to eicosanoids in the inflammatory process is _____.​

A) ​cortisol
B) ​arachidonic acid
C) ​epinephrine
D) ​glucagon
E) ​norepinephrine
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5
Weight loss and wasting are common in the advanced stages of COPD and may result from hypermetabolism, poor food intake, and the actions of various inflammatory proteins.​
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6
Overfeeding an acutely stressed patient improves nitrogen balance and decreases lean tissue losses.​
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7
Excessive energy intake in patients with ARDS can worsen respiratory function.​
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8
An excessive response to metabolic stress can worsen illness and lead to death.​
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9
The high nutrient requirements of acutely stressed patients often require a patient to be fed via the enteral or parenteral route to meet his or her nutritional needs.​
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10
If the reduction in blood flow from inflammation is severe enough to deprive the body's tissues of oxygen and nutrients, SIRS can result.​
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11
Recovery from an injury or illness can be hastened by hypermetabolism and positive nitrogen balance.​
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12
The inflammatory process can alter immune cell function in the body.​
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13
To maintain lean tissue, the protein intakes recommended during acute stress are higher than DRI values.​
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14
Nutrition care for patients in acute respiratory failure is aimed at providing a low-fat, high-carbohydrate diet.​
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15
The symptoms associated with the initial inflammatory response are collectively called the systemic inflammatory response syndrome.​
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16
​The increase in basal metabolic rate as a part of the stress response can be attributed to _____.

A) ​catecholamines
B) ​cortisol
C) ​eicosanoids
D) ​cytokines
E) ​hepcidin
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17
During the inflammatory response, mast cells release _____, which causes vasodilation and capillary permeability.​

A) ​erythropoietin
B) ​cortisol
C) ​anti-diuretic hormone
D) ​cytokine
E) ​histamine
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18
A patient with lung disease would most likely prevent or reverse loss of muscle mass by decreasing activity levels and incorporating more rest.​
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19
Smoking is the primary risk factor in most cases of COPD.​
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20
Patients under 55 years old are several times more likely to develop MODS than are older patients.​
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21
Laura is a critically ill patient. She is 5'4" tall and weighs 150 pounds. What are Laura's protein needs?​

A) ​34-40 g
B) ​54-68 g
C) ​82-136 g
D) ​136-158 g
E) ​160-184 g
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22
The protein needs of a non-obese critically ill patient would be _____.​

A) ​0.8-1.0 g/kg body weight per day
B) ​1.0-1.2 g/kg body weight per day
C) ​1.2-2.0 g/kg body weight per day
D) ​2.0-2.5 g/kg body weight per day
E) ​2.5-3.0 g/kg body weight per day
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23
A COPD patient who complains of abdominal discomfort and dyspnea may benefit from _____.​

A) ​small, frequent meals
B) ​a low-fat diet
C) ​a high-fiber diet
D) ​consuming more liquids
E) ​increased energy consumption
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24
What describes the immediate care concerns of the clinician during a patient's time of severe stress?​

A) ​Educating the patient about nutrient needs
B) ​Providing psychological counseling
C) ​Determining the level of the patient's understanding about his condition
D) ​Providing nutrition therapy
E) ​Restoring fluids and electrolytes
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25
Nutrition therapy for management of COPD involves _____.​

A) ​promoting weight gain
B) ​supporting wound healing
C) ​improving food intake
D) ​relieving chronic cough
E) ​decreasing supplemental oxygen needs
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26
Which amino acid may have beneficial effects on surgical healing of postoperative patients?​

A) ​tryptophan
B) ​tyrosine
C) ​arginine
D) ​phenylalanine
E) ​leucine
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27
When caring for a patient who is suffering from acute illness and metabolic stress, how would clinicians best estimate protein and energy needs?​

A) ​Adjust nutrient intakes according to patient responses
B) ​Underfeed the patient to minimize tissue loss
C) ​Maintain the patient at NPO status to promote bowel rest
D) ​Overfeed the patient to prevent hypoglycemia
E) ​Increase carbohydrate intake to promote weight gain and appropriate energy use
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28
What complication is most closely associated with severe cases of SIRS or sepsis?​

A) ​hypertension
B) ​fluid retention
C) ​hypertriglyceridemia
D) ​poor glucose control
E) ​intestinal bleeding
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29
Excessive kcalorie intake in COPD patients may _____.​

A) ​interfere with catabolic processes
B) ​alter taste perception
C) ​interfere with drug therapy
D) ​increase gas formation
E) ​increase respiratory distress
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30
In critically ill patients, a high intake of _____ may suppress immune function and increase the risk of developing infections.​

A) ​fat
B) ​dextrose
C) ​protein
D) ​zinc
E) ​vitamin A
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31
Emphysema associated with COPD is most often diagnosed by _____.​

A) ​serial chest x-rays
B) ​clinical signs and lung function tests
C) ​oxygen saturation readings
D) ​24-hour halter monitoring
E) ​culture and sensitivity of mucus samples
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32
A 25-year-old woman is critically ill after surviving a motor vehicle accident. The patient is 5'4" and weighs 120 pounds. This patient's energy needs would require how many kcalories for energy?​

A) ​15-20 kcal/kg body weight per day
B) ​22-25 kcal/kg body weight per day
C) ​25-30 kcal/kg body weight per day
D) ​30-35 kcal/kg body weight per day
E) ​38-40 kcal/kg body weight per day
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33
Adequate fluid intake will help the person with COPD by _____.​

A) decreasing carbon dioxide output​
B) ​preventing the secretion of overly thick mucus
C) ​aiding in weight loss
D) ​improving oxygen consumption
E) ​reducing abdominal distention
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34
In critically ill patients, _____ is used to measure the resting metabolic rate (RMR).​

A) ​skinfold measurement
B) ​BMI
C) ​the stress factor equation
D) ​indirect calorimetry
E) ​a clinical body weight growth chart
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35
The most common risk factor associated with development of COPD is _____.​

A) ​alpha-1 anti-trypsin deficiency
B) ​environmental exposure to pollutants
C) ​lung cancer
D) ​cigarette smoking
E) ​cystic fibrosis
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36
Which amino acid has been shown to have beneficial effects on critically ill patients?​

A) ​leucine
B) ​glutamine
C) ​valine
D) ​isoleucine
E) ​phenylalanine
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37
What micronutrient plays a role in immunity and wound healing?​

A) ​Zinc
B) ​Choline
C) ​Selenium
D) ​Vitamin K
E) ​Iron
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38
A parenteral feeding should supply no more than _____ milligrams of dextrose per kilogram of body weight per minute to prevent hyperglycemia.​

A) ​1
B) ​2
C) ​3
D) ​4
E) ​5
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39
What method was developed for estimating energy needs in a patient with traumatic injuries?​

A) ​Parkland formula
B) ​Jackson/Pollock method
C) ​Harris-Benedict equation
D) ​Lund-Browder formula
E) ​Ireton-Jones energy equation
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40
Once patients can tolerate oral feedings, what type of diet is often prescribed?​

A) ​high fiber
B) ​low sodium
C) ​high-kcalorie, high-protein
D) ​low fat
E) ​low carbohydrate
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41
A patient who is on a tube feeding gains nine pounds in three days. The nurse realizes that this may most likely indicate _____.​

A) ​inadequate nutritional intake
B) ​excess protein intake
C) ​a fluid imbalance
D) ​low levels of vitamin D
E) ​refeeding syndrome
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42
​The first organ to fail in MODS is often the _____.

A) ​lungs
B) ​liver
C) ​kidneys
D) ​heart
E) ​brain
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43
While caring for a patient who has been injured, the nurse recognizes which sign of inflammation that accompanies altered blood flow?​

A) ​Hyperglycemia
B) ​Swelling
C) ​Pale skin
D) ​Hypotension
E) ​Confusion
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44
A nurse is treating a patient who is experiencing fluctuations in hormone levels as a result of stress. Based on her understanding of the metabolic effects associated with certain hormones, the nurse knows that aldosterone is responsible for _____.​

A) ​increasing the patient's metabolic rate
B) ​producing glucose from amino acids
C) ​reabsorbing sodium in the kidneys
D) ​releasing fatty acids from adipose tissue
E) ​reabsorbing water in the kidneys
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45
Kati is a 19-year-old female who suffered a head injury and multiple broken bones in a motorcycle accident. She is currently in a coma, on a mechanical ventilator, and receiving enteral nutrition. Kati is 5'2" tall and weighs 115 pounds.

The stress of Kati's condition places her at risk of hypermetabolism. What kind of complication is most closely associated with hypermetabolism as a result of stress?​

A) ​wasting
B) ​fractures
C) ​kidney failure
D) ​bone pain
E) ​pulmonary edema
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46
Because the immediate stress response can cause a variety of systemic effects, the nurse should closely monitor her patient's _____.​

A) ​heart rate, respiratory rate, and blood pressure
B) ​appetite, temperature, and weight
C) ​pain rating, level of consciousness, and posture
D) ​abdominal girth, reflexes, and edema
E) ​hearing, vision, and sense of smell
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47
John has been hospitalized with a severe infection in his foot. The nurse recognizes that increasing his intake of _____ may help to suppress the inflammation.​

A) ​protein
B) ​omega-3 fatty acids
C) ​carbohydrate
D) ​omega 6-fatty acids
E) ​vitamin D
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48
Mr. Morgan is a critically ill patient in the ICU who is on TPN. The nurse understands that monitoring his _____ can help to determine if he is being overfed.​

A) ​glucose levels
B) ​cholesterol levels
C) ​iron levels
D) ​albumin levels
E) ​calcium levels
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49
Kati is a 19-year-old female who suffered a head injury and multiple broken bones in a motorcycle accident. She is currently in a coma, on a mechanical ventilator, and receiving enteral nutrition. Kati is 5'2" tall and weighs 115 pounds.

Kati's protein needs are estimated at 1.2 to 2 g/kg of body weight based on her condition. Based on this estimation, her daily protein intake would then be _____ g per day.​

A) ​36 to 58 g
B) ​62 to 104 g
C) ​116 to 138 g
D) ​154 to 168 g
E) ​180 to 200 g
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50
One factor that increases the risk of a patient developing MODS is _____.​

A) ​age over 40 years
B) ​an increased length of hospital stay
C) ​uncontrolled blood glucose
D) ​obesity
E) ​the severity of SIRS infection
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51
In what way does nutrition support play a role in treatment of MODS?​

A) ​Supporting gas exchange
B) ​Preventing excessive wasting
C) ​Promoting excretion of waste products
D) ​Maintaining blood pressure
E) ​Increasing cardiac output
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52
Kati is a 19-year-old female who suffered a head injury and multiple broken bones in a motorcycle accident. She is currently in a coma, on a mechanical ventilator, and receiving enteral nutrition. Kati is 5'2" tall and weighs 115 pounds.

If Kati's enteral feeding is not providing adequate energy and protein to meet her nutritional needs, she will experience _____.​

A) ​a loss of lean tissue
B) ​hyperglycemia
C) ​pulmonary edema
D) ​sepsis
E) ​organ failure
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53
​Mr. Jones, a critically ill patient, is 5'9" tall and weighs 176 pounds. The nurse recommends that he receive a minimum of _____ grams of protein daily.

A) ​64
B) ​80
C) ​96
D) ​136
E) ​240
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54
Kati is a 19-year-old female who suffered a head injury and multiple broken bones in a motorcycle accident. She is currently in a coma, on a mechanical ventilator, and receiving enteral nutrition. Kati is 5'2" tall and weighs 115 pounds.

Estimate Kati's energy needs using the Ireton-Jones equation: 1925 + [5 ´ wt (kg)] - [10 ´ age (yr)] + (281 ´ sex) + (292 ´ trauma) + (851 ´ burn).​

A) ​2288
B) ​2681
C) ​2828
D) ​3420
E) ​3240
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55
The principal infection most often associated with MODS is _____.​

A) ​pneumonia
B) ​urinary tract infection
C) ​herpes simplex virus infection
D) ​meningitis
E) ​hepatitis B infection
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56
Kati is a 19-year-old female who suffered a head injury and multiple broken bones in a motorcycle accident. She is currently in a coma, on a mechanical ventilator, and receiving enteral nutrition. Kati is 5'2" tall and weighs 115 pounds.

As a result of the acute-phase inflammatory response, Kati's plasma concentrations of _____ would be expected to decrease.

A) ​glucose and cholesterol
B) ​sodium and potassium
C) ​iron and glucose
D) ​albumin and iron
E) ​magnesium and chloride
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57
A patient who has developed MODS would most likely demonstrate what signs or symptoms associated with liver failure?​

A) ​Abnormal bleeding
B) ​Sepsis
C) ​Altered metabolic processes
D) ​Impaired gas exchange
E) ​Low blood pressure
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58
Kati is a 19-year-old female who suffered a head injury and multiple broken bones in a motorcycle accident. She is currently in a coma, on a mechanical ventilator, and receiving enteral nutrition. Kati is 5'2" tall and weighs 115 pounds.

To decrease the risk of infection, it will be important to keep Kati's _____ under control while she is recovering.​

A) ​serum albumin
B) ​blood glucose
C) ​blood pressure
D) ​serum prealbumin
E) ​nitrogen
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59
Mrs. White is in the ICU for complications following surgery. She has been diagnosed with sepsis and is on a ventilator. In order to most accurately estimate her energy needs, the nurse recognizes that the preferred method to use is _____.​

A) ​the Harris-Benedict equation
B) ​the Penn State equation
C) ​direct calorimetry
D) ​the Mifflin-St. Jeor equation
E) ​the permissive protein balance method
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60
Severe hypercapnia associated with respiratory failure can cause _____, which interferes with normal functioning of the central nervous system.​

A) ​sepsis
B) ​SIRS
C) ​cardiac failure
D) ​COPD
E) ​acidosis
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61
Matching​
a. ​the breakdown of muscle tissue that results from disease or malnutrition
b. ​an acute-phase protein involved in the regulation of iron metabolism
c. ​the main airways of the lungs
d. ​cells within connective tissue that produce and release histamine
e. ​the volume of air a person inhales or exhales each minute
f. ​the surgical removal of dead, damaged, or contaminated tissue resulting from burns or wounds
g. ​respiratory failure triggered by severe lung injury
h. ​the chemical and physical changes that occur within the body during stress
i. ​progressive lung disease characterized by the breakdown of the lungs' elastic structure and destruction of the walls of the respiratory bronchioles and alveoli
j. ​a group of metabolic abnormalities that may result from aggressive refeeding in severely malnourished persons
k. ​a method of estimating resting energy expenditure by measuring a person's oxygen consumption and carbon dioxide production
l. ​insufficient oxygen in the blood
m. ​a group of plasma proteins that assist the activities of antibodies
n. ​insufficient oxygen in body tissues
o. ​a severe reduction in blood flow that deprives the body's tissues of oxygen and nutrients
p. ​a lung disorder characterized by persistent inflammation and excessive secretions of mucus in the main airways of the lungs
q. ​shortness of breath
r. ​a whole-body inflammatory response caused by infection
s. ​a bluish cast in the skin due to the color of deoxygenated hemoglobin
t. ​accumulations of pus
​stress response
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62
Matching​
a. ​the breakdown of muscle tissue that results from disease or malnutrition
b. ​an acute-phase protein involved in the regulation of iron metabolism
c. ​the main airways of the lungs
d. ​cells within connective tissue that produce and release histamine
e. ​the volume of air a person inhales or exhales each minute
f. ​the surgical removal of dead, damaged, or contaminated tissue resulting from burns or wounds
g. ​respiratory failure triggered by severe lung injury
h. ​the chemical and physical changes that occur within the body during stress
i. ​progressive lung disease characterized by the breakdown of the lungs' elastic structure and destruction of the walls of the respiratory bronchioles and alveoli
j. ​a group of metabolic abnormalities that may result from aggressive refeeding in severely malnourished persons
k. ​a method of estimating resting energy expenditure by measuring a person's oxygen consumption and carbon dioxide production
l. ​insufficient oxygen in the blood
m. ​a group of plasma proteins that assist the activities of antibodies
n. ​insufficient oxygen in body tissues
o. ​a severe reduction in blood flow that deprives the body's tissues of oxygen and nutrients
p. ​a lung disorder characterized by persistent inflammation and excessive secretions of mucus in the main airways of the lungs
q. ​shortness of breath
r. ​a whole-body inflammatory response caused by infection
s. ​a bluish cast in the skin due to the color of deoxygenated hemoglobin
t. ​accumulations of pus
​shock
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63
Matching​
a. ​the breakdown of muscle tissue that results from disease or malnutrition
b. ​an acute-phase protein involved in the regulation of iron metabolism
c. ​the main airways of the lungs
d. ​cells within connective tissue that produce and release histamine
e. ​the volume of air a person inhales or exhales each minute
f. ​the surgical removal of dead, damaged, or contaminated tissue resulting from burns or wounds
g. ​respiratory failure triggered by severe lung injury
h. ​the chemical and physical changes that occur within the body during stress
i. ​progressive lung disease characterized by the breakdown of the lungs' elastic structure and destruction of the walls of the respiratory bronchioles and alveoli
j. ​a group of metabolic abnormalities that may result from aggressive refeeding in severely malnourished persons
k. ​a method of estimating resting energy expenditure by measuring a person's oxygen consumption and carbon dioxide production
l. ​insufficient oxygen in the blood
m. ​a group of plasma proteins that assist the activities of antibodies
n. ​insufficient oxygen in body tissues
o. ​a severe reduction in blood flow that deprives the body's tissues of oxygen and nutrients
p. ​a lung disorder characterized by persistent inflammation and excessive secretions of mucus in the main airways of the lungs
q. ​shortness of breath
r. ​a whole-body inflammatory response caused by infection
s. ​a bluish cast in the skin due to the color of deoxygenated hemoglobin
t. ​accumulations of pus
​chronic bronchitis
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64
Matching​
a. ​the breakdown of muscle tissue that results from disease or malnutrition
b. ​an acute-phase protein involved in the regulation of iron metabolism
c. ​the main airways of the lungs
d. ​cells within connective tissue that produce and release histamine
e. ​the volume of air a person inhales or exhales each minute
f. ​the surgical removal of dead, damaged, or contaminated tissue resulting from burns or wounds
g. ​respiratory failure triggered by severe lung injury
h. ​the chemical and physical changes that occur within the body during stress
i. ​progressive lung disease characterized by the breakdown of the lungs' elastic structure and destruction of the walls of the respiratory bronchioles and alveoli
j. ​a group of metabolic abnormalities that may result from aggressive refeeding in severely malnourished persons
k. ​a method of estimating resting energy expenditure by measuring a person's oxygen consumption and carbon dioxide production
l. ​insufficient oxygen in the blood
m. ​a group of plasma proteins that assist the activities of antibodies
n. ​insufficient oxygen in body tissues
o. ​a severe reduction in blood flow that deprives the body's tissues of oxygen and nutrients
p. ​a lung disorder characterized by persistent inflammation and excessive secretions of mucus in the main airways of the lungs
q. ​shortness of breath
r. ​a whole-body inflammatory response caused by infection
s. ​a bluish cast in the skin due to the color of deoxygenated hemoglobin
t. ​accumulations of pus
​refeeding syndrome
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65
A critically ill patient with ARDS is on a tube feeding and requires a fluid restriction. The nurse understands that an appropriate enteral formula would be a _____ formula.​

A) ​low residue
B) ​high protein
C) ​nutrient dense
D) ​hydrolyzed
E) ​low fat
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66
Matching​
a. ​the breakdown of muscle tissue that results from disease or malnutrition
b. ​an acute-phase protein involved in the regulation of iron metabolism
c. ​the main airways of the lungs
d. ​cells within connective tissue that produce and release histamine
e. ​the volume of air a person inhales or exhales each minute
f. ​the surgical removal of dead, damaged, or contaminated tissue resulting from burns or wounds
g. ​respiratory failure triggered by severe lung injury
h. ​the chemical and physical changes that occur within the body during stress
i. ​progressive lung disease characterized by the breakdown of the lungs' elastic structure and destruction of the walls of the respiratory bronchioles and alveoli
j. ​a group of metabolic abnormalities that may result from aggressive refeeding in severely malnourished persons
k. ​a method of estimating resting energy expenditure by measuring a person's oxygen consumption and carbon dioxide production
l. ​insufficient oxygen in the blood
m. ​a group of plasma proteins that assist the activities of antibodies
n. ​insufficient oxygen in body tissues
o. ​a severe reduction in blood flow that deprives the body's tissues of oxygen and nutrients
p. ​a lung disorder characterized by persistent inflammation and excessive secretions of mucus in the main airways of the lungs
q. ​shortness of breath
r. ​a whole-body inflammatory response caused by infection
s. ​a bluish cast in the skin due to the color of deoxygenated hemoglobin
t. ​accumulations of pus
​wasting
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67
Matching​
a. ​the breakdown of muscle tissue that results from disease or malnutrition
b. ​an acute-phase protein involved in the regulation of iron metabolism
c. ​the main airways of the lungs
d. ​cells within connective tissue that produce and release histamine
e. ​the volume of air a person inhales or exhales each minute
f. ​the surgical removal of dead, damaged, or contaminated tissue resulting from burns or wounds
g. ​respiratory failure triggered by severe lung injury
h. ​the chemical and physical changes that occur within the body during stress
i. ​progressive lung disease characterized by the breakdown of the lungs' elastic structure and destruction of the walls of the respiratory bronchioles and alveoli
j. ​a group of metabolic abnormalities that may result from aggressive refeeding in severely malnourished persons
k. ​a method of estimating resting energy expenditure by measuring a person's oxygen consumption and carbon dioxide production
l. ​insufficient oxygen in the blood
m. ​a group of plasma proteins that assist the activities of antibodies
n. ​insufficient oxygen in body tissues
o. ​a severe reduction in blood flow that deprives the body's tissues of oxygen and nutrients
p. ​a lung disorder characterized by persistent inflammation and excessive secretions of mucus in the main airways of the lungs
q. ​shortness of breath
r. ​a whole-body inflammatory response caused by infection
s. ​a bluish cast in the skin due to the color of deoxygenated hemoglobin
t. ​accumulations of pus
​mast cells
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68
Matching​
a. ​the breakdown of muscle tissue that results from disease or malnutrition
b. ​an acute-phase protein involved in the regulation of iron metabolism
c. ​the main airways of the lungs
d. ​cells within connective tissue that produce and release histamine
e. ​the volume of air a person inhales or exhales each minute
f. ​the surgical removal of dead, damaged, or contaminated tissue resulting from burns or wounds
g. ​respiratory failure triggered by severe lung injury
h. ​the chemical and physical changes that occur within the body during stress
i. ​progressive lung disease characterized by the breakdown of the lungs' elastic structure and destruction of the walls of the respiratory bronchioles and alveoli
j. ​a group of metabolic abnormalities that may result from aggressive refeeding in severely malnourished persons
k. ​a method of estimating resting energy expenditure by measuring a person's oxygen consumption and carbon dioxide production
l. ​insufficient oxygen in the blood
m. ​a group of plasma proteins that assist the activities of antibodies
n. ​insufficient oxygen in body tissues
o. ​a severe reduction in blood flow that deprives the body's tissues of oxygen and nutrients
p. ​a lung disorder characterized by persistent inflammation and excessive secretions of mucus in the main airways of the lungs
q. ​shortness of breath
r. ​a whole-body inflammatory response caused by infection
s. ​a bluish cast in the skin due to the color of deoxygenated hemoglobin
t. ​accumulations of pus
​emphysema
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69
Mary is a 59-year-old patient who suffered multiple broken bones in a motor vehicle accident. She weighs 138 pounds. The nurse chooses a protein factor of 1.5 g/kg to estimate her protein needs and calculates that Mary's protein requirements are approximately _____ grams per day.​

A) ​94
B) ​103
C) ​121
D) ​180
E) ​208
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70
Matching​
a. ​the breakdown of muscle tissue that results from disease or malnutrition
b. ​an acute-phase protein involved in the regulation of iron metabolism
c. ​the main airways of the lungs
d. ​cells within connective tissue that produce and release histamine
e. ​the volume of air a person inhales or exhales each minute
f. ​the surgical removal of dead, damaged, or contaminated tissue resulting from burns or wounds
g. ​respiratory failure triggered by severe lung injury
h. ​the chemical and physical changes that occur within the body during stress
i. ​progressive lung disease characterized by the breakdown of the lungs' elastic structure and destruction of the walls of the respiratory bronchioles and alveoli
j. ​a group of metabolic abnormalities that may result from aggressive refeeding in severely malnourished persons
k. ​a method of estimating resting energy expenditure by measuring a person's oxygen consumption and carbon dioxide production
l. ​insufficient oxygen in the blood
m. ​a group of plasma proteins that assist the activities of antibodies
n. ​insufficient oxygen in body tissues
o. ​a severe reduction in blood flow that deprives the body's tissues of oxygen and nutrients
p. ​a lung disorder characterized by persistent inflammation and excessive secretions of mucus in the main airways of the lungs
q. ​shortness of breath
r. ​a whole-body inflammatory response caused by infection
s. ​a bluish cast in the skin due to the color of deoxygenated hemoglobin
t. ​accumulations of pus
​minute ventilation
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71
A patient with ARDS requires mechanical ventilation. The nurse recognizes that fluid accumulation is a potential problem that may make it difficult to assess his _____.​

A) ​weight
B) ​temperature
C) ​kcalorie intake
D) ​fluid intake
E) ​heart rate
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72
Matching​
a. ​the breakdown of muscle tissue that results from disease or malnutrition
b. ​an acute-phase protein involved in the regulation of iron metabolism
c. ​the main airways of the lungs
d. ​cells within connective tissue that produce and release histamine
e. ​the volume of air a person inhales or exhales each minute
f. ​the surgical removal of dead, damaged, or contaminated tissue resulting from burns or wounds
g. ​respiratory failure triggered by severe lung injury
h. ​the chemical and physical changes that occur within the body during stress
i. ​progressive lung disease characterized by the breakdown of the lungs' elastic structure and destruction of the walls of the respiratory bronchioles and alveoli
j. ​a group of metabolic abnormalities that may result from aggressive refeeding in severely malnourished persons
k. ​a method of estimating resting energy expenditure by measuring a person's oxygen consumption and carbon dioxide production
l. ​insufficient oxygen in the blood
m. ​a group of plasma proteins that assist the activities of antibodies
n. ​insufficient oxygen in body tissues
o. ​a severe reduction in blood flow that deprives the body's tissues of oxygen and nutrients
p. ​a lung disorder characterized by persistent inflammation and excessive secretions of mucus in the main airways of the lungs
q. ​shortness of breath
r. ​a whole-body inflammatory response caused by infection
s. ​a bluish cast in the skin due to the color of deoxygenated hemoglobin
t. ​accumulations of pus
​hepcidin
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73
Matching​
a. ​the breakdown of muscle tissue that results from disease or malnutrition
b. ​an acute-phase protein involved in the regulation of iron metabolism
c. ​the main airways of the lungs
d. ​cells within connective tissue that produce and release histamine
e. ​the volume of air a person inhales or exhales each minute
f. ​the surgical removal of dead, damaged, or contaminated tissue resulting from burns or wounds
g. ​respiratory failure triggered by severe lung injury
h. ​the chemical and physical changes that occur within the body during stress
i. ​progressive lung disease characterized by the breakdown of the lungs' elastic structure and destruction of the walls of the respiratory bronchioles and alveoli
j. ​a group of metabolic abnormalities that may result from aggressive refeeding in severely malnourished persons
k. ​a method of estimating resting energy expenditure by measuring a person's oxygen consumption and carbon dioxide production
l. ​insufficient oxygen in the blood
m. ​a group of plasma proteins that assist the activities of antibodies
n. ​insufficient oxygen in body tissues
o. ​a severe reduction in blood flow that deprives the body's tissues of oxygen and nutrients
p. ​a lung disorder characterized by persistent inflammation and excessive secretions of mucus in the main airways of the lungs
q. ​shortness of breath
r. ​a whole-body inflammatory response caused by infection
s. ​a bluish cast in the skin due to the color of deoxygenated hemoglobin
t. ​accumulations of pus
​abscesses
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74
Matching​
a. ​the breakdown of muscle tissue that results from disease or malnutrition
b. ​an acute-phase protein involved in the regulation of iron metabolism
c. ​the main airways of the lungs
d. ​cells within connective tissue that produce and release histamine
e. ​the volume of air a person inhales or exhales each minute
f. ​the surgical removal of dead, damaged, or contaminated tissue resulting from burns or wounds
g. ​respiratory failure triggered by severe lung injury
h. ​the chemical and physical changes that occur within the body during stress
i. ​progressive lung disease characterized by the breakdown of the lungs' elastic structure and destruction of the walls of the respiratory bronchioles and alveoli
j. ​a group of metabolic abnormalities that may result from aggressive refeeding in severely malnourished persons
k. ​a method of estimating resting energy expenditure by measuring a person's oxygen consumption and carbon dioxide production
l. ​insufficient oxygen in the blood
m. ​a group of plasma proteins that assist the activities of antibodies
n. ​insufficient oxygen in body tissues
o. ​a severe reduction in blood flow that deprives the body's tissues of oxygen and nutrients
p. ​a lung disorder characterized by persistent inflammation and excessive secretions of mucus in the main airways of the lungs
q. ​shortness of breath
r. ​a whole-body inflammatory response caused by infection
s. ​a bluish cast in the skin due to the color of deoxygenated hemoglobin
t. ​accumulations of pus
​sepsis
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75
Matching​
a. ​the breakdown of muscle tissue that results from disease or malnutrition
b. ​an acute-phase protein involved in the regulation of iron metabolism
c. ​the main airways of the lungs
d. ​cells within connective tissue that produce and release histamine
e. ​the volume of air a person inhales or exhales each minute
f. ​the surgical removal of dead, damaged, or contaminated tissue resulting from burns or wounds
g. ​respiratory failure triggered by severe lung injury
h. ​the chemical and physical changes that occur within the body during stress
i. ​progressive lung disease characterized by the breakdown of the lungs' elastic structure and destruction of the walls of the respiratory bronchioles and alveoli
j. ​a group of metabolic abnormalities that may result from aggressive refeeding in severely malnourished persons
k. ​a method of estimating resting energy expenditure by measuring a person's oxygen consumption and carbon dioxide production
l. ​insufficient oxygen in the blood
m. ​a group of plasma proteins that assist the activities of antibodies
n. ​insufficient oxygen in body tissues
o. ​a severe reduction in blood flow that deprives the body's tissues of oxygen and nutrients
p. ​a lung disorder characterized by persistent inflammation and excessive secretions of mucus in the main airways of the lungs
q. ​shortness of breath
r. ​a whole-body inflammatory response caused by infection
s. ​a bluish cast in the skin due to the color of deoxygenated hemoglobin
t. ​accumulations of pus
​indirect calorimetry
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76
Matching​
a. ​the breakdown of muscle tissue that results from disease or malnutrition
b. ​an acute-phase protein involved in the regulation of iron metabolism
c. ​the main airways of the lungs
d. ​cells within connective tissue that produce and release histamine
e. ​the volume of air a person inhales or exhales each minute
f. ​the surgical removal of dead, damaged, or contaminated tissue resulting from burns or wounds
g. ​respiratory failure triggered by severe lung injury
h. ​the chemical and physical changes that occur within the body during stress
i. ​progressive lung disease characterized by the breakdown of the lungs' elastic structure and destruction of the walls of the respiratory bronchioles and alveoli
j. ​a group of metabolic abnormalities that may result from aggressive refeeding in severely malnourished persons
k. ​a method of estimating resting energy expenditure by measuring a person's oxygen consumption and carbon dioxide production
l. ​insufficient oxygen in the blood
m. ​a group of plasma proteins that assist the activities of antibodies
n. ​insufficient oxygen in body tissues
o. ​a severe reduction in blood flow that deprives the body's tissues of oxygen and nutrients
p. ​a lung disorder characterized by persistent inflammation and excessive secretions of mucus in the main airways of the lungs
q. ​shortness of breath
r. ​a whole-body inflammatory response caused by infection
s. ​a bluish cast in the skin due to the color of deoxygenated hemoglobin
t. ​accumulations of pus
​bronchioles
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77
Mark is a 23-year-old firefighter who experienced severe burns while fighting a house fire. The nurse recognizes the fact that he may benefit from supplements of _____ to reduce the risk of infection.​

A) ​zinc, vitamin C, and vitamin A
B) ​iron, magnesium, and calcium
C) ​sodium, potassium, and chloride
D) ​phosphorus, thiamin, and riboflavin
E) ​calcium, vitamin D, and vitamin K
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78
Matching​
a. ​the breakdown of muscle tissue that results from disease or malnutrition
b. ​an acute-phase protein involved in the regulation of iron metabolism
c. ​the main airways of the lungs
d. ​cells within connective tissue that produce and release histamine
e. ​the volume of air a person inhales or exhales each minute
f. ​the surgical removal of dead, damaged, or contaminated tissue resulting from burns or wounds
g. ​respiratory failure triggered by severe lung injury
h. ​the chemical and physical changes that occur within the body during stress
i. ​progressive lung disease characterized by the breakdown of the lungs' elastic structure and destruction of the walls of the respiratory bronchioles and alveoli
j. ​a group of metabolic abnormalities that may result from aggressive refeeding in severely malnourished persons
k. ​a method of estimating resting energy expenditure by measuring a person's oxygen consumption and carbon dioxide production
l. ​insufficient oxygen in the blood
m. ​a group of plasma proteins that assist the activities of antibodies
n. ​insufficient oxygen in body tissues
o. ​a severe reduction in blood flow that deprives the body's tissues of oxygen and nutrients
p. ​a lung disorder characterized by persistent inflammation and excessive secretions of mucus in the main airways of the lungs
q. ​shortness of breath
r. ​a whole-body inflammatory response caused by infection
s. ​a bluish cast in the skin due to the color of deoxygenated hemoglobin
t. ​accumulations of pus
​debridement
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79
Mr. Winslett is a COPD patient who is complaining of poor appetite, abdominal discomfort, and bloating. Which suggestion from the nurse is most appropriate for improving his food intake?​

A) ​"Consume larger meals."
B) ​"Substitute beans for meat."
C) ​"Drink a supplement before eating."
D) ​"Eat smaller, more frequent meals."
E) ​"Increase fluid intake throughout the day."
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80
Matching​
a. ​the breakdown of muscle tissue that results from disease or malnutrition
b. ​an acute-phase protein involved in the regulation of iron metabolism
c. ​the main airways of the lungs
d. ​cells within connective tissue that produce and release histamine
e. ​the volume of air a person inhales or exhales each minute
f. ​the surgical removal of dead, damaged, or contaminated tissue resulting from burns or wounds
g. ​respiratory failure triggered by severe lung injury
h. ​the chemical and physical changes that occur within the body during stress
i. ​progressive lung disease characterized by the breakdown of the lungs' elastic structure and destruction of the walls of the respiratory bronchioles and alveoli
j. ​a group of metabolic abnormalities that may result from aggressive refeeding in severely malnourished persons
k. ​a method of estimating resting energy expenditure by measuring a person's oxygen consumption and carbon dioxide production
l. ​insufficient oxygen in the blood
m. ​a group of plasma proteins that assist the activities of antibodies
n. ​insufficient oxygen in body tissues
o. ​a severe reduction in blood flow that deprives the body's tissues of oxygen and nutrients
p. ​a lung disorder characterized by persistent inflammation and excessive secretions of mucus in the main airways of the lungs
q. ​shortness of breath
r. ​a whole-body inflammatory response caused by infection
s. ​a bluish cast in the skin due to the color of deoxygenated hemoglobin
t. ​accumulations of pus
​complement
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Unlock Deck
Unlock for access to all 90 flashcards in this deck.