Deck 20: Nutrition in Cancer and HIV/AIDS

Question 1

If a patient is going to have surgery to remove cancer of the esophagus,it is important to

A) prevent poor food intake as a result of depression by warning the patient that the surgery may be disfiguring.
B) emphasize complete abstinence from cigarette smoking and use of alcoholic beverages.
C) provide nutrition support to reverse malnutrition caused by difficulty eating during the disease progression.
D) encourage the patient to enjoy favorite foods to maximize intake.

Answer 1

C
Many patients with head and neck cancer enter surgery with protein-energy malnutrition because the disease may have prevented adequate intake;nutrition support to reverse malnutrition can greatly improve outcomes.Warning a patient about being disfigured may not prevent depression.Abstinence from cigarette smoking and alcoholic beverages is wise,but is not necessarily the first priority.Enjoying favorite foods may be helpful to attain adequate intakes of energy,but good sources of protein and micronutrients should also be emphasized.

Question 2

The Patient-Generated Subjective Global Assessment tool

A) should not be used as a basis for interventions because the data are subjective.
B) provides a method for assessing the psychosocial effects of cancer on the patient.
C) allows for early identification of patients who have potential or actual nutritional deficits.
D) allows patients to evaluate their own nutritional status without the input of a registered dietitian.

Answer 2

C
The Patient-Generated Subjective Global Assessment tool allows for early identification of patients who have potential or actual nutritional deficits.Some parts of the form are completed by the patient,but others are completed by the registered dietitian,and the results are scored and evaluated by a registered dietitian.The data are subjective but vital for recognizing early signs of malnutrition and initiating early intervention.The form does not evaluate psychosocial status.

Question 3

If a patient has cancer and is being treated with chemotherapy,the greatest food safety concern is

A) avoiding pesticide residues.
B) potential food-drug interactions.
C) choosing natural food products.
D) preventing foodborne illness.

Answer 3

D
Individuals undergoing chemotherapy have weakened immune systems and therefore need to be especially careful to prevent foodborne illness.Concerns about pesticide residues are no greater for patients with cancer than for the rest of the population.Food-drug interactions may be a concern for specific individuals but are not related to food safety.Choosing natural food products is not necessarily beneficial and is not a particular concern for patients receiving chemotherapy.

Question 4

If a patient develops HIV-associated lipodystrophy syndrome (HALS),the best dietary recommendation is to

A) maintain adequate protein and energy intake so as to reduce muscle loss.
B) use medium-chain triglycerides and avoid lactose.
C) avoid raw,undercooked,or unpasteurized foods.
D) follow a Mediterranean diet and take omega-3 fatty acid supplements

Question 5

If a patient with cancer is receiving a combination of chemotherapeutic agents that is known to interfere with bone marrow,they should give special attention to prevention of

A) dehydration.
B) foodborne illness.
C) nausea and vomiting.
D) loss of bone mass.

Question 6

If a patient with immunosuppression needs to follow a low-bacterial diet,a meal that he or she should avoid is

A) Caesar salad dressing with alfalfa sprouts.
B) breakfast cereal with milk.
C) homemade bread with butter.
D) chicken breast sandwich with mayonnaise.

Question 7

Patients who have just received bone marrow transplants should not eat

A) canned tuna.
B) soft cheeses.
C) mayonnaise.
D) steamed vegetables.

Question 8

Factors that contribute to loss of lean body mass in many patients with cancer that are outside the patient's control include

A) hypermetabolism.
B) inadequate protein intake.
C) inadequate energy intake.
D) drug noncompliance.

Question 9

Bone marrow cells and cells lining the gastrointestinal tract are more susceptible than other cells to damage caused by chemotherapy because they

A) are target cells for drugs.
B) have a rapid turnover rate.
C) are exposed to higher doses of the drugs.
D) absorb more of the drugs than they excrete.

Question 10

A dietary change that would help prevent cancer,according to the National Cancer Institute recommendations,is

A) eating vegetarian meals two or more times a week.
B) choosing organic,pesticide-free fruits and vegetables.
C) eating five or more daily servings of fruits and vegetables.
D) consuming three or more daily servings of low-fat dairy products.

Question 11

When someone smokes cigarettes and drinks three alcoholic beverages a day,he or she is contributing to his or her cancer risk via

A) initiation.
B) metastasis.
C) promotion.
D) progression.

Question 12

If a patient with HIV/AIDs is experiencing diarrhea,a good way to increase energy and protein intakes would be to

A) add skim milk powder to shakes and soups.
B) add butter to hot cereals,vegetables,rice,and noodles.
C) eat three main meals daily,each with a serving of meat or fish.
D) use peanut butter on toast or as a dip for fruits and vegetables.

Question 13

Fruits and vegetables help prevent cancer because they have high amounts of

A) phytosterols.
B) vitamins.
C) antineoplastics.
D) antioxidants.

Question 14

If a patient is receiving radiation therapy to the head and neck,he or she may need

A) moist and semiliquid foods because of loss of saliva.
B) dry foods because of taste changes.
C) extra fluids and electrolytes because of diarrhea.
D) extra dietary fiber and fluids to prevent constipation.

Question 15

Patients who are experiencing nausea or vomiting may find it easiest to tolerate foods such as

A) chicken noodle soup.
B) a turkey sandwich.
C) chicken curry with rice.
D) taco salad with jalapenos.

Question 16

Someone who uses sunscreen and wears UV protective clothing and hats to prevent development of skin cancer may need to

A) use light therapy to prevent seasonal affective disorder.
B) consume extra vitamins C and E and other dietary antioxidants.
C) ensure adequate intake of vitamin D from fortified foods and supplements.
D) consume additional fluids to replace sweat losses caused by additional clothing.

Question 17

If a patient has dumping syndrome after surgery to remove a tumor,he or she has probably had a

A) vagotomy.
B) gastrectomy.
C) pancreatectomy.
D) small bowel resection.

Question 18

A patient in whom cancer has been newly diagnosed is about to begin intense chemotherapy.She tells you that the only good thing about this diagnosis is that she will now be able to lose weight without even trying.The most appropriate nursing response would be to

A) encourage the patient to celebrate the positive aspects of the disease.
B) encourage adequate nutrient intake to maximize tolerance of chemotherapy.
C) reinforce the need to achieve and maintain ideal body weight.
D) emphasize eating the right types of foods rather than an amount of food.

Question 19

Patients who receive bone marrow transplants often require parenteral nutrition.Some oral intake is important to help

A) achieve adequate nutrient intake.
B) provide nutrients that cannot be infused.
C) maintain the integrity of the small intestine.
D) maintain a sense of normality for the patient.

Question 20

For patients infected with the human immunodeficiency virus (HIV),complex highly active antiretroviral therapy (HAART)regimens require

A) avoidance of alcohol and nonprescription medications.
B) self-monitoring of blood glucose levels.
C) following a neutropenic diet protocol.
D) careful timing around meals and snacks to promote absorption.

Question 21

If a patient with HIV/AIDS has been feeling very weak and whose weight has dropped from 180 lb to 160 lb in 4 weeks,he or she would be considered to have

A) opportunistic infections.
B) lipodystrophy or HALS.
C) AIDS-related wasting syndrome.
D) AIDS-related depression.

Question 22

Patients infected with HIV who develop hypogonadism are most likely to experience

A) loss of body fat.
B) weight gain.
C) loss of muscle mass.
D) dehydration.

Question 23

Strategies that may help maximize food intake in patients with HIV/AIDS include

A) eating several small meals and snacks daily.
B) drinking 1 to 2 glasses of water with each meal.
C) not eating unless really hungry,to avoid nausea.
D) taking a daily multivitamin and mineral supplement.

Question 24

The factor that contributes most to malnutrition in patients with HIV/AIDS is

A) opportunistic infections.
B) fear of weight gain.
C) use of antiretroviral therapy.
D) increase in physical activity.

Question 25

Patients experiencing diarrhea should make sure they have a generous intake of

A) fat.
B) fluids.
C) protein.
D) dietary fiber.

Question 26

Patients with cancer who undergo irradiation of the lower abdomen are likely to experience

A) nausea.
B) vomiting.
C) diarrhea.
D) constipation.

Question 27

An important nutritional goal for patients with cancer or HIV/AIDS is to

A) eat several meals a day.
B) avoid use of supplements.
C) improve quality of life.
D) maintain usual eating habits.

Question 28

One of the reasons that nutrition therapy is so important for patients with HIV/AIDS is that it is an area in which

A) patients can have some control of their medical care.
B) their needs are not affected by the disease process.
C) interventions can have curative effects on the disease.
D) they do not need the involvement of health care providers.

Question 29

To minimize risk of infection with Cryptosporidium,patients with HIV/AIDS should

A) eat yogurt that contains live cultures.
B) avoid eating canned fruits and vegetables.
C) avoid eating undercooked meat,poultry,fish,or eggs.
D) drink only filtered water or water than has been boiled for 1 minute.

Question 30

A seasoning that may help stimulate food intake in patients with taste abnormalities is

A) lemon juice.
B) soy sauce.
C) honey.
D) garlic.