Deck 21: Nutrition Assessment

Question 1

In which of the following patients would indirect calorimetry be indicated?
I)patients who are difficult to wean from mechanical ventilation
II)patients with morbid obesity
III)patients with a high level of stress

A)I only
B)I and II only
C)I and III only
D)I, II, and III

Answer 1

C

Question 2

Which of the following statements is NOT true regarding kwashiorkor?

A)occurs with a long-term loss of protein
B)often causes facial and limb edema
C)child often has a pot belly
D)may occur in combination with marasmus

Answer 2

A

Question 3

What is the classic measure of energy expenditure?

A)basal oxygen consumption
B)basal metabolic rate (BMR)
C)resting caloric uptake
D)resting carbon dioxide production

Answer 3

B

Question 4

When is the basal metabolic rate (BMR) best obtained?

A)after 10 hours of fasting
B)while walking on a treadmill
C)on rising in the morning
D)1 hour after lunch

Question 5

What changes in lung function are associated with malnutrition?

A)reduced VC
B)increased TLC
C)increased RV
D)decreased FRC

Question 6

Which of the following complications is LEAST likely to influence creatinine excretion?

A)sepsis
B)trauma
C)hypoxemia
D)diet

Question 7

What is the primary purpose of nutrition assessment?

A)to identify how much weight the patient needs to lose
B)to identify the patient's ideal body weight
C)to develop a nutrition care plan
D)to identify the proper caloric intake for the patient

Question 8

What is the normal BMI for adults?

A)15.5 to 20.6 kg/m²
B)18.5 to 24.9 kg/m²
C)20.6 to 25.9 kg/m²
D)22.5 to 26.0 kg/m²

Question 9

What procedure is used to overcome the limitations associated with estimating resting energy expenditures?

A)measuring blood glucose before and after exercise
B)monitoring body temperature during heavy exercise
C)indirect calorimetry
D)the Douglas procedure

Question 10

Which of the following is NOT considered part of the anthropometric assessment?

A)body mass index
B)activity level
C)history of weight loss
D)triceps skinfold

Question 11

Your patient is reported to be cachexic. Which of the following physical findings would support this statement?

A)The patient's belly is swollen.
B)The patient has facial edema.
C)The patient's ribs protrude.
D)The patient's hair falls out easily.

Question 12

What is the recommended measurement for nitrogen balance?

A)blood urea nitrogen
B)serum urea nitrogen
C)urinary nitrogen
D)urinary urea nitrogen

Question 13

Which of the following blood tests is most useful for day to day monitoring of long-term trends in the nutrition status of the patient?

A)albumin levels
B)total white blood cell count
C)hematocrit
D)serum potassium levels

Question 14

Your male patient has a creatinine excretion level of 8 mg/kg body weight/day. What does this indicate?

A)It is normal.
B)There is mild muscle wasting.
C)There is moderate muscle wasting.
D)There is severe muscle wasting.

Question 15

What probably represents the most significant problem while performing calorimetry on a patient being mechanically ventilated?

A)compensating for mechanical dead space
B)leaks in the circuit
C)volume compression during inspiration
D)high PEEP levels

Question 16

Obesity is defined as a BMI over what value?

A)20 kg/m²
B)25 kg/m²
C)30 kg/m²
D)35 kg/m²

Question 17

If your patient is 2 m in height and weighs 80 kg, what is his body mass index (BMI)?

A)40
B)30
C)20
D)15

Question 18

Protein-energy malnutrition may be reflected in reduced values for each of the following except:

A)albumin levels
B)lymphocyte count
C)transferrin
D)red blood cell count

Question 19

Which of the following statements is FALSE regarding energy needs?

A)They vary with state of health.
B)They vary with activity level.
C)They are increased with obese patients.
D)They increase with sepsis.

Question 20

Which of the following pieces of equipment is NOT needed to perform indirect calorimetry?

A)oxygen analyzer
B)Tissot spirometer
C)Douglas bag
D)nitrogen analyzer

Question 21

What effect does high carbohydrate intake have on metabolism?

A)increases CO₂ production
B)reduces oxygen consumption
C)increases caloric needs
D)reduces protein catabolism

Question 22

Which of the following is associated with acute cardiac muscle weakness and potential cardiopulmonary failure?

A)hyperkalemia
B)hypophosphatemia
C)hypernatremia
D)low folic acid levels

Question 23

Why raise the head of the bed during tube feedings?

A)It reduces the time needed.
B)It improves absorption.
C)It reduces the risk of aspiration.
D)It is easier for the caregiver.

Question 24

Magnesium deficiencies are associated with all the following except:

A)reduced diaphragm strength
B)neurologic abnormalities
C)cardiac abnormalities
D)liver enlargement

Question 25

Zinc deficiencies are associated with all the following except:

A)poor blood clotting
B)impaired wound healing
C)bronchospasm
D)reduced immunity

Question 26

Which of the following statements is NOT true regarding malnutrition in patients with chronic obstructive pulmonary disease (COPD)?

A)Use of a nasal cannula may contribute to the problem.
B)Depression is common and may reduce appetite.
C)A high work of breathing increases caloric needs.
D)Vitamin deficiencies increased the need for oxygen.

Question 27

What tube feeding method must be used when the food substance is delivered beyond the pylorus?

A)bolus
B)intermittent
C)continuous drip
D)pressurized

Question 28

Which of the following illnesses is NOT associated with acute catabolic disease?

A)trauma
B)sepsis
C)burns
D)pulmonary embolism

Question 29

What percent of the patient's caloric intake should come from fat in most circumstances?

A)10% to 15%
B)20% to 30%
C)30% to 40%
D)40% to 50%

Question 30

Which of the following is NOT a reason to use enteral feeding over parenteral?

A)reduced incidence of stress ulcers
B)enteral route may avoid intestinal atrophy
C)enteral causes less hypoglycemia
D)enteral is safer and cheaper

Question 31

Which of the following metabolism issues is NOT associated with systemic inflammatory response syndrome (SIRS)?

A)hypoglycemia
B)protein catabolism
C)increased macronutrient requirement
D)triglyceride intolerance

Question 32

Which of the following has an RQ of 1.0?

A)fat
B)carbohydrates
C)protein
D)soy

Question 33

Which of the following is associated with primary protein-energy malnutrition (PEM)?

A)poor diet due to living in a Third World country
B)anorexia
C)malabsorption
D)severe infection

Question 34

What does the RQ represent?

A)matching of respiration to perfusion
B)ratio of the moles of CO₂ produced to O₂ consumed
C)ratio of O₂ consumed to kilograms of ideal body weight
D)ratio of calories consumed to CO₂ produced

Question 35

Which of the following situations is NOT an indication for enteral nutritional support?

A)burns over 30% of the body surface area
B)persistent inability to eat orally
C)severe pancreatitis
D)renal failure

Question 36

Which of the following abnormalities in the respiratory system is/are associated with malnutrition?
I)reduced hypoxic drive
II)reduced airway clearance
III)loss of lung surfactant

A)I only
B)I and II only
C)II and III only
D)I, II, and III

Question 37

What are the primary goals of nutritional support during mechanical ventilation?
I)avoid loss of lean body mass
II)avoid lung infection
III)keep muscles of breathing strong enough for weaning

A)I only
B)I and II only
C)I and III only
D)I, II, and III

Question 38

Which of the following diseases is/are associated with protein-energy malnutrition (PEM)?
I)asthma
II)emphysema
III)cancer

A)I only
B)I and II only
C)II and III only
D)I, II, and III

Question 39

Ideally, approximately what percent of a patient's estimated calorie needs should be provided by protein?

A)20%
B)40%
C)50%
D)60%

Question 40

What tube feeding method is associated with an increased risk of aspiration?

A)bolus
B)intermittent
C)continuous drip
D)pressurized

Question 41

Which of the following pulmonary diseases is similar to chronic obstructive pulmonary disease with regard to metabolic abnormalities?

A)asthma
B)cystic fibrosis
C)pulmonary fibrosis
D)acute respiratory distress syndrome

Question 42

Which of the following statements is NOT true with regard to nutritional support of the patient with advanced chronic obstructive pulmonary disease?

A)Provide low-calorie options.
B)Provide high-protein nutrition.
C)Provide small, frequent meals.
D)Provide good patient education.