Deck 20: Nutrition Therapy for Liver and Gallbladder Diseases

Question 1

Most often, gallstones cause symptoms and require medical intervention.

Answer 1

False

Question 2

Which of the following is true regarding fatty liver?

A)It is a clinical finding common to many conditions.
B)It usually results in liver failure.
C)It cannot be reversed.
D)It does not result in elevated liver enzymes.

Answer 2

A

Question 3

triglycerides accumulate in the liver, the liver:

A)becomes smaller.
B)turns into scar tissue.
C)becomes inflamed.
D)enlarges.

Answer 3

D

Question 4

Hepatic encephalopathy may be caused by an increased ratio of aromatic amino acids to branched-chain amino acids in brain tissue.

Question 5

Fatty liver can develop from all of the following except:

A)alcoholic liver disease.
B)celiac disease.
C)diseases of malnutrition.
D)obesity.

Question 6

Case Study
Gestational Diabetes: Maria Hinojosa is a 24-year-old Hispanic woman who is in the 26th week of her second pregnancy.She is 5'5" tall and weighs 182 pounds.Maria's first baby weighed 9 lb.10 oz.Her family history reveals that her father has type 2 diabetes.After a routine screening for gestational diabetes, Maria was diagnosed with the disease and referred to a registered dietitian for nutrition counseling.
Hepatomegaly refers to a surgical puncture of a body cavity with an aspirator to draw out excess fluid.

Question 7

A strict sodium restriction is part of the treatment for ascites.

Question 8

Case Study
Gestational Diabetes: Maria Hinojosa is a 24-year-old Hispanic woman who is in the 26th week of her second pregnancy.She is 5'5" tall and weighs 182 pounds.Maria's first baby weighed 9 lb.10 oz.Her family history reveals that her father has type 2 diabetes.After a routine screening for gestational diabetes, Maria was diagnosed with the disease and referred to a registered dietitian for nutrition counseling.
People with malnutrition may experience fatty liver.

Question 9

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

Question 10

Case Study
Gestational Diabetes: Maria Hinojosa is a 24-year-old Hispanic woman who is in the 26th week of her second pregnancy.She is 5'5" tall and weighs 182 pounds.Maria's first baby weighed 9 lb.10 oz.Her family history reveals that her father has type 2 diabetes.After a routine screening for gestational diabetes, Maria was diagnosed with the disease and referred to a registered dietitian for nutrition counseling.
Rapid weight loss aids in the recovery from liver disease.

Question 11

A patient with cirrhosis may present with no symptoms.

Question 12

Nutrients are carried from the digestive tract to the liver via small blood vessels called collaterals.

Question 13

Fat should be restricted in the diet of all patients with cirrhosis.

Question 14

Diuretics are often prescribed to control ascites.

Question 15

An energy-dense, moderate-protein, low-electrolyte nutrient formula is recommended for tube-fed patients with ascites and fluid restrictions.

Question 16

The three most important risk factors for gallstones are body weight, gender, and whether the person smokes cigarettes.
Nutrition in Practice - Alcohol in Health and Disease

Question 17

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

Question 18

Laboratory findings associated with fatty liver include all of the following except:

A)elevated HDL.
B)elevated ALT and AST.
C)elevated glucose.
D)elevated triglycerides.

Question 19

Moderate use of alcohol has been shown to reduce deaths from coronary heart disease in middle-aged and older adults.

Question 20

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

Question 21

Ascites is:

A)yellowing of the sclera of the eyes, skin, and mucous membranes.
B)fluid accumulation in the abdomen.
C)inflammation of the liver.
D)elevated blood ammonia levels.

Question 22

of the following laboratory test results are elevated in liver disease except:

A)bilirubin.
B)albumin.
C)ammonia.
D)AST.

Question 23

Albumin is not always a good indicator of nutrition status in patients with liver disease because:

A)it is often low due to the disease.
B)it is affected by elevated liver enzymes.
C)liver disease causes elevated levels of albumin.
D)ammonia levels affect albumin levels.

Question 24

Blood flow is impeded in a cirrhotic liver, causing:

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

Question 25

Which of the following results when bilirubin accumulates in the bloodstream?

A)jaundice
B)ascites
C)hepatic coma
D)mental disturbances

Question 26

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

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

Question 27

Ascites is exacerbated by:

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

Question 28

patient in the late stage of hepatic encephalopathy may exhibit all of the following symptoms except:

A)confusion.
B)cheerfulness.
C)anger.
D)muscular rigidity.

Question 29

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

A)exposure to infected blood.
B)jaundice.
C)fecal-oral contamination.
D)sexual contact.

Question 30

most appropriate dietary intervention for a malnourished person with hepatitis is:

A)a low-protein diet
B)adequate energy and protein.
C)a tube feeding.
D)fluid and electrolyte replacement.

Question 31

Collaterals are:

A)small blood vessels in the intestines.
B)blood vessels that enlarge in order to allow an alternate path for blood flow.
C)induced by fatty liver disease.
D)hemorrhages in the esophagus.

Question 32

Hepatitis patients should avoid:

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

Question 33

Factors involved in the development of ascites include all of the following except:

A)portal hypertension.
B)reduced albumin synthesis.
C)sodium and water retention by the kidneys.
D)obesity.

Question 34

Furosemide is a drug often used to treat the symptoms of cirrhosis.It is a(n):

A)appetite stimulant.
B)diuretic.
C)laxative.
D)antiviral.

Question 35

most common cause of chronic liver disease in the U.S.is:

A)vitamin B₁₂ deficiency.
B)alcoholism.
C)hepatitis C infection.
D)protein deficiency.

Question 36

Among patients with liver disease, _____ may be a factor if malnutrition develops.

A)low-sodium diets
B)jaundice
C)lactulose
D)impaired memory

Question 37

help reduce ammonia production in the colon, patients with cirrhosis may be given a(n):

A)antibiotic.
B)appetite stimulant.
C)enema.
D)diuretic.

Question 38

Prothrombin time in liver disease patients will be:

A)irrelevant.
B)decreased.
C)prolonged.
D)normal.

Question 39

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

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

Question 40

Consequences of cirrhosis include all of the following except:

A)esophageal varices.
B)portal hypertension.
C)ascites.
D)disorientation.

Question 41

a patient with ascites experiences a sodium level below 128 milliequivalents per liter, a fluid restriction of _____ per day may be necessary.

A)1000-1200 mL
B)1200-1500 mL
C)1500-1800 mL
D)1800-2000 mL

Question 42

Gallstones may consist of any of the following except:

A)calcium salts.
B)cholesterol.
C)bilirubin.
D)lipase.

Question 43

untreated for years, a blocked bile duct may lead to:

A)liver damage.
B)kidney failure.
C)neuropathy.
D)gastritis.

Question 44

If the patient with cirrhosis develops fat malabsorption and requires extra kcalories, these should be provided by:

A)carbohydrates.
B)sugars.
C)MCT oil.
D)fruits and vegetables.

Question 45

therapy for the treatment of cirrhosis includes all of the following except:

A)antibiotics.
B)appetite stimulants.
C)immunosuppressants.
D)diuretics.

Question 46

of the following are possible treatment options for symptomatic gallstones except:

A)cholecystectomy.
B)urosodiol.
C)a sodium-controlled diet.
D)shock-wave lithotripsy.

Question 47

Cholelithiasis affects about _____ percent of the population.

A)1
B)12
C)25
D)38

Question 48

Performing a nutrition assessment on a patient who is a candidate for liver transplant is complicated by all of the following except:

A)liver dysfunction and malnutrition have similar metabolic effects.
B)fluid retention can mask weight loss.
C)fluid retention can alter lab values.
D)supplements may mask underlying nutrient deficiencies.

Question 49

Patients with ascites generally must restrict their intake of:

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

Question 50

Protein needs for the patient with cirrhosis who does not show signs of impending coma are calculated based on:

A)0.5-1.0 grams/kg.
B)0.8-1.2 grams/kg.
C)1.5-2.0 grams/kg.
D)2.0-2.5 grams/kg.

Question 51

diet of a patient with cirrhosis who has severe steatorrhea may need to be supplemented with all of the following except:

A)B vitamins.
B)calcium.
C)magnesium.
D)zinc.

Question 52

calculating RMR for patients with ascites, the patient's _____ must be considered.

A)appetite
B)activity level
C)dry weight
D)current weight

Question 53

Which of the following individuals is at highest risk of gallstones?

A)a female athlete with sports anemia
B)a woman who uses estrogen replacement therapy
C)an overweight African-American male
D)a male patient on long-term tube feeding

Question 54

of the following are risk factors for the formation of gallstones except:

A)long-term parenteral nutrition.
B)head injuries.
C)clofibrate use.
D)rapid weight loss.

Question 55

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

A)salt substitutes.
B)herbs and spices.
C)soft drinks.
D)dairy foods.

Question 56

add energy but not protein to the diet, you would add:

A)butter.
B)milkshakes.
C)vegetables.
D)hard-boiled eggs.

Question 57

important consideration in tube feeding a patient with esophageal varices is:

A)the location of the feeding tube.
B)the size of the feeding tube.
C)the possibility of aspiration.
D)the rate of the tube feeding.

Question 58

Patients with cirrhosis require _____ in order to prevent wasting.

A)adequate fluid
B)adequate kcalories
C)high-fat diets
D)six large meals per day

Question 59

of the following are important factors in medical nutrition therapy following liver transplant except:

A)enteral supplements.
B)a high-kcalorie, low-protein diet.
C)food safety education.
D)vitamin and mineral supplements.

Question 60

Cirrhosis patients frequently develop insulin resistance and consequently must follow a diet that is:

A)consistent in carbohydrate content.
B)low in fiber.
C)consistent in vitamin K intake.
D)low in sodium.

Question 61

patient is admitted to the hospital with decreased albumin, elevated alkaline phosphatase, and elevated bilirubin.The nurse recognizes these clinical findings as evidence of:

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

Question 62

nurse notices abnormal electrolyte levels in a patient with cirrhosis and understands that it is likely a side effect of:

A)poor nutrition.
B)nitroglycerin.
C)lactulose.
D)appetite stimulants.

Question 63

Kelly is a 27-year-old well-nourished female who has been diagnosed with hepatitis A.Which of the following nutrition interventions is needed?

A)high-kcalorie, high-protein diet
B)high-protein, low-fat diet
C)low-sodium, fluid-restricted diet
D)no dietary change is needed

Question 64

drink is equivalent to _____ ounces of beer.

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

Question 65

nurse is working with a hepatitis patient who is malnourished.Which of the following would be the most appropriate type of nutrition support for this patient?

A)a regular, balanced diet
B)frequent, small meals
C)enteral formula supplements
D)high-kcalorie, high-protein diet

Question 66

nurse recognizes the fact that patients with cirrhosis are likely to develop PEM.The nurse should plan to monitor the _____ of a patient with cirrhosis.

A)weight
B)meal intake
C)diet-drug interactions
D)lab values

Question 67

People with diabetes who abuse alcohol are at risk of developing:

A)hypoglycemia.
B)hyperglycemia.
C)hyponatremia.
D)hyponatremia.

Question 68

Case Study Questions
Use the following case study to answer questions
Andrew Jamison is a 47-year-old construction worker with a long history of alcohol abuse.Recently he has been experiencing fatigue, weakness, loss of appetite, and weight loss.A visit to his physician and laboratory testing confirmed a diagnosis of cirrhosis.He is 5'10" tall and currently weighs 145 pounds.
Jamison begins experiencing hyperglycemia as his disease progresses.The appropriate diet for him is:

A)low protein.
B)carbohydrate controlled.
C)low sodium
D)fat controlled.

Question 69

Organs affected by alcohol abuse include all of the following except the:

A)lungs.
B)liver.
C)GI tract.
D)heart.

Question 70

Case Study Questions
Use the following case study to answer questions
Andrew Jamison is a 47-year-old construction worker with a long history of alcohol abuse.Recently he has been experiencing fatigue, weakness, loss of appetite, and weight loss.A visit to his physician and laboratory testing confirmed a diagnosis of cirrhosis.He is 5'10" tall and currently weighs 145 pounds.
Complications of cirrhosis that Mr.Jamison may be facing in the future include all of the following except:

A)ascites.
B)portal hypertension.
C)gastroesophageal varices.
D)kidney cancer.

Question 71

risk of diet-drug interactions is high in patients with liver disease.The nurse understands that this is due to the fact that:

A)most drugs are metabolized in the liver.
B)most drugs are absorbed in the liver.
C)most people with liver disease do not eat well.
D)most nutrients are absorbed in the liver.

Question 72

patients with liver dysfunction, the risk of diet-drug interactions is especially high for patients with:

A)heart disease.
B)diabetes.
C)renal failure.
D)anemia.

Question 73

nurse understands the implication of fluid retention in patients with ascites and knows that _____ may not be a good indicator of nutritional status.

A)height
B)weight
C)blood cholesterol
D)appetite

Question 74

Case Study Questions
Use the following case study to answer questions
Andrew Jamison is a 47-year-old construction worker with a long history of alcohol abuse.Recently he has been experiencing fatigue, weakness, loss of appetite, and weight loss.A visit to his physician and laboratory testing confirmed a diagnosis of cirrhosis.He is 5'10" tall and currently weighs 145 pounds.
46.Of the following laboratory tests performed on Mr.Jamison, which one would you expect to see elevated?

A)albumin
B)transferrin
C)ammonia
D)HDL

Question 75

most common complication of alcohol abuse is:

A)chronic pancreatitis.
B)liver disease.
C)chronic renal failure.
D)heart arrhythmias.

Question 76

beneficial effects of moderate alcohol intake are mainly seen in:

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

Question 77

Examples of common nutrient deficiencies seen as a result of alcohol abuse include all of these except:

A)folate.
B)thiamin.
C)vitamin A.
D)sodium.

Question 78

Case Study Questions
Use the following case study to answer questions
Andrew Jamison is a 47-year-old construction worker with a long history of alcohol abuse.Recently he has been experiencing fatigue, weakness, loss of appetite, and weight loss.A visit to his physician and laboratory testing confirmed a diagnosis of cirrhosis.He is 5'10" tall and currently weighs 145 pounds.
Jamison eventually receives a liver transplant.Due to the risk of foodborne illness, Mr.Jamison should avoid all of the following foods except:

A)rare steak.
B)sushi.
C)unpasteurized milk.
D)canned vegetables.

Question 79

Case Study Questions
Use the following case study to answer questions
Andrew Jamison is a 47-year-old construction worker with a long history of alcohol abuse.Recently he has been experiencing fatigue, weakness, loss of appetite, and weight loss.A visit to his physician and laboratory testing confirmed a diagnosis of cirrhosis.He is 5'10" tall and currently weighs 145 pounds.
improve Mr.Jamison's appetite, his physician may prescribe:

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

Question 80

Case Study Questions
Use the following case study to answer questions
Andrew Jamison is a 47-year-old construction worker with a long history of alcohol abuse.Recently he has been experiencing fatigue, weakness, loss of appetite, and weight loss.A visit to his physician and laboratory testing confirmed a diagnosis of cirrhosis.He is 5'10" tall and currently weighs 145 pounds.
dietitian assesses Mr.Jamison's protein needs based on an appropriate weight for his height and estimates that he requires _____ grams of protein per day.

A)25-51
B)52-62
C)56-83
D)98-118