Deck 18: Nutrition and Lower Gastrointestinal Disorders

Question 1

Billy consumed the following foods at lunch: A hamburger with lettuce, tomato, and catsup on a bun; potato salad; and a diet carbonated beverage.Later that afternoon Billy began to experience gas.Which of the following foods was most likely to be responsible for production of the gas?

A)hamburger meat
B)tomato
C)potato salad
D)diet carbonated beverage

Answer 1

D

Question 2

A colostomy involves removal of the entire colon.

Answer 2

False

Question 3

MCT oil does not require bile for digestion and absorption.

Answer 3

True

Question 4

Foods useful in increasing dietary fiber are:

A)bran, milk, and mashed potatoes.
B)peanut butter, oranges, and strawberry jam.
C)saltine crackers, watermelon, and eggs.
D)whole-grain bread, dried beans, and nuts.

Question 5

Daily exercise has been proven to cure constipation by stimulating peristalsis.

Question 6

The development of diverticulosis is influenced by the type of dietary protein one consumes.

Question 7

Acute pancreatitis can result from high blood triglycerides.

Question 8

Which of the following bulk-forming agents may cause an allergic reaction?

A)methylcellulose
B)psyllium
C)polycarbophil
D)malt soup extract

Question 9

Use of stimulant laxatives can lead to:

A)fluid and electrolyte imbalances.
B)anemia.
C)increased appetite.
D)hyperglycemia.

Question 10

Many lactose-intolerant individuals can tolerate up to 2 cups of milk a day when intake is divided throughout the day and taken with food.

Question 11

Celiac disease is characterized by an abnormal immune response to certain amino acids.

Question 12

Irritable bowel syndrome occurs more frequently in men than women and episodes of acute symptoms often increase with age.

Question 13

Of the following beverages, which is least likely to increase intestinal gas?

A)orange juice
B)milk
C)diet cola
D)tea

Question 14

Psyllium may be helpful in the treatment of diarrhea because it reduces the liquidity of the stool.

Question 15

A side effect of consuming a high-fiber diet is:

A)flatulence.
B)ostomy.
C)bacterial overgrowth.
D)diverticulosis.

Question 16

Dietary suggestions for treating constipation are aimed at:

A)decreasing dietary fiber and fluids.
B)increasing dietary fiber and fluids.
C)increasing dietary protein.
D)increasing carbohydrate intake.
E)decreasing protein intake.

Question 17

Constipation may be caused by all of the following except:

A)a low-fiber diet.
B)physical inactivity.
C)medications.
D)a viral infection.

Question 18

The client with a colostomy or ileostomy should have a diet that is restricted in fluids.

Question 19

Charlie is trying to change his eating behaviors and start following a high-fiber diet.The best advice you can give Charlie is to:

A)purchase a bulk-forming agent.
B)gradually add high-fiber foods to his diet.
C)avoid milk products that contain residue.
D)limit his fluid intake.

Question 20

A high-fiber diet increases stool weight and fecal water content.

Question 21

Two minerals commonly malabsorbed as a consequence of fat malabsorption are:

A)iron and selenium.
B)zinc and manganese.
C)calcium and magnesium.
D)phosphorous and calcium.

Question 22

People with lactose intolerance who can't tolerate whole milk may better tolerate any of the following except:

A)chocolate milk.
B)nonfat milk.
C)aged cheese.
D)yogurt with active bacterial cultures.

Question 23

Malabsorption of fat results in:

A)steatorrhea.
B)loss of amino acids.
C)loss of water-soluble vitamins.
D)weight gain.

Question 24

The nutrition therapy for steatorrhea is a:

A)fat-restricted diet.
B)high-fiber diet.
C)low-sodium diet.
D)high-protein diet.

Question 25

Which of the following are not allowed on a fat-restricted diet?

A)angel food cake, fat-free milk, and pears
B)cherry pie, chocolate milk, and spareribs
C)marshmallows, fat-free yogurt, and green beans
D)oranges, jelly beans, and noodles

Question 26

Lactose intolerance is prevalent among all of the following ethnic groups except:

A)Native Americans.
B)Asians.
C)Latinos.
D)Caucasians.

Question 27

Fat malabsorption may be accompanied by a deficiency of:

A)fat- and water-soluble vitamins, potassium, sodium, and iron.
B)fat- and water-soluble vitamins, magnesium, and iron.
C)fat-soluble vitamins, calcium, magnesium, and essential fatty acids.
D)calcium, potassium, sodium, and essential fatty acids.

Question 28

Which of the following statements about MCT oil is false?

A)It is inexpensive.
B)It should not be used to fry food.
C)It should be added to the diet gradually.
D)It may have an unpleasant taste.

Question 29

The primary goal of initial therapy for the client with acute pancreatitis is:

A)to reduce stimulation of the pancreas.
B)to increase insulin production.
C)stimulation of the pancreas.
D)to reduce hydrochloric acid in stomach.

Question 30

Someone with malabsorption problems who is experiencing flatulence and diarrhea may benefit from avoiding:

A)decaffeinated beverages.
B)lightly seasoned foods.
C)lactose-containing foods.
D)low-fat foods.

Question 31

Malabsorption of certain minerals is common in persons with fat malabsorption.This can ultimately result in:

A)fluid and electrolyte imbalances.
B)increased risk of bone loss.
C)loss of taste acuity.
D)insulin resistance.

Question 32

Fat malabsorption is associated with all of the following except:

A)weight loss.
B)essential fatty acid deficiency.
C)loss of sodium and potassium.
D)increased risk of kidney stones.

Question 33

Acute diarrhea that occurs abruptly in a healthy person frequently results from:

A)viral or bacterial infection.
B)lactose intolerance.
C)irritable bowel syndrome.
D)swallowed air.

Question 34

For patients with fat malabsorption problems, fat is better tolerated if it is:

A)provided in small portions.
B)monounsaturated.
C)limited to one meal per day.
D)consumed as fried food.

Question 35

Bacterial food poisoning causes:

A)osmotic diarrhea.
B)steatorrhea.
C)secretory diarrhea.
D)chronic diarrhea.

Question 36

Commercial sports drinks are not recommended for the treatment of severe diarrhea because they are too:

A)expensive.
B)high in sodium.
C)low in sodium.
D)low in potassium.

Question 37

The initial diet order for the client with acute pancreatitis should be:

A)clear liquids.
B)a fat-controlled diet.
C)nothing by mouth.
D)a regular diet.

Question 38

Bacterial overgrowth in the stomach and small intestine can result in:

A)a deficiency of fat-soluble vitamins.
B)weight gain.
C)vitamin B₆ deficiency.
D)abnormal glucose tolerance.

Question 39

Which of the following would be the first step in the treatment of someone with diarrhea?

A)correct the underlying medical condition
B)place the patient on NPO
C)start parenteral nutrition
D)start an oral rehydration solution

Question 40

The most common causes of acute pancreatitis are:

A)gallstones and high VLDL levels.
B)exposure to toxins and smoking.
C)gallstones and alcohol abuse.
D)alcohol abuse and smoking.

Question 41

Patients with celiac disease often cannot tolerate:

A)sucrose.
B)lactose.
C)fat.
D)glucose.

Question 42

Which of the following would be recommended for an infant with cystic fibrosis?

A)a hydrolyzed infant formula
B)breastfeeding with enzyme replacement
C)a fat-restricted infant formula
D)MCT oil

Question 43

The dietary adjustments frequently recommended for the person with irritable bowel syndrome include all of the following except:

A)avoiding fried and fatty foods.
B)avoiding alcohol.
C)consuming small, frequent meals.
D)consuming a high-protein diet.

Question 44

An excessive colonic response to meals, GI hormones, and stress is characteristic of:

A)celiac disease.
B)ulcerative colitis.
C)Crohn's disease.
D)irritable bowel syndrome.

Question 45

Which of the following would you recommend for a client with cystic fibrosis who experiences persistent steatorrhea, gas, and abdominal distention?

A)an increase in pancreatic enzyme replacements
B)a severely fat-restricted diet
C)a hydrolyzed formula
D)liberal use of table salt

Question 46

After intestinal resection, the absorptive efficiency of the intestine is improved through:

A)intestinal adaptation.
B)enzyme replacement therapy.
C)following a high-fiber diet.
D)further surgery.

Question 47

After the acute stage of inflammatory bowel disease, the client should be placed:

A)on a diet that is individualized for the patient.
B)on a high-potassium diet.
C)on a low-protein diet.
D)on a parenteral feeding.

Question 48

Patients with celiac disease must avoid foods that contain:

A)iron.
B)protein.
C)gluten.
D)sugar.

Question 49

Weight loss and malnutrition may occur with chronic pancreatitis due to:

A)malabsorption and food avoidance..
B)malabsorption of fat-soluble vitamins.
C)malabsorption of protein and pain.
D)malabsorption of carbohydrate.

Question 50

Evidence that a child with cystic fibrosis needs an increase in enzyme dosages might include any of the following except:

A)poor growth.
B)steatorrhea.
C)abdominal pain.
D)dysphagia.

Question 51

Aggressive dietary management of Crohn's disease is required in children because this disorder can lead to all of the following except:

A)growth failure.
B)nutrient deficiencies.
C)protein-energy malnutrition.
D)impaired glucose tolerance.

Question 52

The dietary management for ulcerative colitis includes all of the following principles except:

A)restoration of fluid and electrolyte balance.
B)repletion of protein stores.
C)a high-fiber diet to manage diarrhea.
D)a low-fiber diet to reduce irritation in the colon.

Question 53

The absorption of vitamins and minerals begins in the _____.

A)duodenum
B)jejunum
C)ileum
D)colon

Question 54

Nutrition therapy for cystic fibrosis involves all of the following except:

A)liberal use of table salt.
B)multivitamin supplements.
C)pancreatic enzyme replacement therapy.
D)a low-protein diet.

Question 55

Generally, up to _____% of the small intestine can be resected without serious nutritional consequences.

A)25
B)30
C)45
D)50

Question 56

The treatment for irritable bowel syndrome includes all of the following except:

A)surgery.
B)dietary adjustments.
C)stress management.
D)behavioral therapy.

Question 57

Celiac disease affects intestinal tissue and results in:

A)a significant reduction in mucosal surface area.
B)ulceration, irritation, and bleeding.
C)cessation of the production of digestive enzymes.
D)bacterial overgrowth.

Question 58

Mr.Taylor seeks medical treatment for frequent, urgent bowel movements streaked with mucus and blood, and tests reveal a large, continuous area of inflammation affecting the first two layers of tissue in his rectum.What is Mr.Taylor's likely diagnosis?

A)Crohn's disease
B)ulcerative colitis
C)celiac disease
D)irritable bowel syndrome

Question 59

Which of the following is included in a gluten-free diet?

A)wheat
B)rice
C)barley
D)rye

Question 60

Discrete areas of inflamed tissue in the ileum and cecum that affect all layers of the intestine are characteristic of _____.

A)Crohn's disease
B)ulcerative colitis
C)celiac disease
D)irritable bowel syndrome

Question 61

To help control diarrhea, people with ostomies should consume:

A)applesauce.
B)caffeine.
C)sugar-free candy.
D)grapes.

Question 62

Kati will require nutrition education aimed at eliminating gluten from her diet.The dietitian will teach Kati to:

A)avoid all cereal and grain products.
B)substitute whole-wheat flour for enriched wheat flour when cooking.
C)check ingredient lists on food labels carefully.
D)avoid all milk and milk products.

Question 63

If Kati does not eliminate gluten from her diet, she could likely experience all of the following except:

A)anemia.
B)infertility.
C)bone disorders.
D)hypertension.

Question 64

The gastrointestinal symptoms Kati is experiencing are due to:

A)severe damage to the intestinal mucosa and subsequent malabsorption.
B)a lack of pancreatic enzymes and resulting malabsorption.
C)gastrointestinal obstructions caused by the secretion of thick mucus.
D)bacterial overgrowth causing a disruption in fat digestion and absorption.

Question 65

The client with a colostomy or ileostomy is usually concerned about foods that cause:

A)gas and odor.
B)weight gain.
C)fluid retention.
D)anemia.

Question 66

A.R.'s doctor recommends that she take a multivitamin-mineral supplement because:

A)pancreatic enzyme replacements can decrease the absorption of iron.
B)steatorrhea can promote the loss of vitamins and minerals.
C)pancreatic enzyme replacements can decrease the absorption of folate.
D)all of the above

Question 67

To follow a fat-restricted diet, A.R.should:

A)choose vegetable oils instead of solid fats.
B)use only medium-chain triglyceride oil to fry foods.
C)consume no more than a 6-ounce portion of meat at one sitting.
D)limit fats and oils to 8 teaspoons per day.

Question 68

What conclusions can be drawn from A.R.'s usual dietary intake?

A)A.R.'s usual dietary intake may be lacking in fruit.
B)A.R.'s usual dietary intake may be lacking in milk.
C)A.R.should be permitted to drink iced tea in moderation.
D)all of the above

Question 69

Which type of laxatives act as local irritants to the colonic tissue?

A)stimulant
B)osmotic
C)stool surfactant agents
D)bulk-forming agents
Use the following case study to answer questions 56-61.
Kati is a 27-year-old Caucasian who works as a bank teller.She is 5'3" tall and weighs 102 pounds.She began experiencing recurrent gastrointestinal disturbances such as diarrhea, steatorrhea, and flatulence several months ago.She made an appointment with her physician after noticing that she was losing weight.Laboratory tests confirmed a diagnosis of celiac disease.

Question 70

A.R.'s steatorrhea will promote the loss of:

A)vitamin A.
B)vitamin D.
C)vitamin E.
D)vitamin K.
E)all of the above

Question 71

A.R.can benefit from using medium-chain triglycerides for all of the following except:

A)a source of essential fatty acids.
B)a primary source of energy.
C)an oil for use in recipes.
D)A.R.can use MCT for all of these.

Question 72

Diverticular disease often occurs with:

A)a bacterial infection.
B)aging.
C)constipation.
D)food intolerances.

Question 73

Kati is at greatest risk of malabsorption of:

A)the macronutrients.
B)the water-soluble vitamins.
C)the B vitamins.
D)sodium, potassium, and chloride.

Question 74

Which form of diarrhea is caused by a lactase deficiency?

A)secretory
B)osmotic
C)steatorrhea
D)hydrolytic

Question 75

Kati should be instructed to avoid _____ until her intestine has recovered.

A)sodium
B)fat
C)lactose
D)fructose

Question 76

Which statement is true?

A)Research has proven that low-fiber diets cause diverticulosis.
B)Limiting meat intakes and physical activity prevent diverticulosis.
C)Severe cases of diverticulitis may require temporary NPO status.
D)Diverticulitis is an inflammation of the mucosa throughout the colon.

Question 77

Nonpathogenic bacteria in the intestinal tract perform all of the following functions except:

A)degrade undigested or unabsorbed dietary carbohydrate.
B)produce certain vitamins.
C)prevent invasion of tissues by pathogenic bacteria.
D)stimulate the production of proteins.

Question 78

Steatorrhea is classified as a(n) _____ diarrhea.

A)motility disorder-related
B)osmotic
C)secretory
D)all of the above

Question 79

What does Kati need to understand about the role of oats in her diet?

A)She should purchase only uncontaminated oats and consume limited quantities.
B)She should not consume oats in any form.
C)She should limit her consumption of oats to 1 cup of dry rolled oats per day.
D)She will need to learn how to prepare oats correctly for consumption.
Use the following case study to answer questions 62-68.
Medical History: A.R.is a healthy 51-year old premenopausal Caucasian woman with pallor who is employed full-time in an office job.She had a pancreatic cyst removed six years ago.She was asymptomatic until one year ago when she developed acute pancreatitis flare-ups after consuming fatty foods.The condition was attributed to scarring at the pancreatic duct, which secretes pancreatic lipase, and was accompanied by severe abdominal pain radiating to her back, vomiting, and steatorrhea.She was placed on oral pancreatic lipase enzyme tablets (Pancrease™) that digest fat, and was also prescribed to follow a "low-fat diet." The medication and diet help to reduce her symptoms, and she notes that flare-ups generally only occur when she eats too much fat.
Anthropometric: Ht: 5'2.Wt: 156 lbs.Wt 1 yr ago: 199 lbs.Frame size: Medium.
Clinical/Labs: A.R.'s serum vitamin D was low (20 ng/mL; normal is 25-80 ng/mL), but all other labs were within normal limits when she last visited her internal medicine physician several months ago.She was placed on a 5,000-IU vitamin D supplement, to be reduced to a 2,000-IU vitamin D supplement thereafter; she takes no other vitamins or minerals.Other medications include Synthroid and Aygestin.
Current Chief Complaints: A.R.'s current problems include constipation and dry skin.
Diet: "My usual grocery list consists of boneless chicken breasts, turkey, pork chops (infrequently), strip steak (infrequently), 90/10 ground beef, pasta (half whole-wheat, half regular), tomatoes and sauce to make pasta sauce, 90 percent fat-free lunch meat ham or turkey, brown rice, steamable microwave vegetables, red and green lettuce, tomatoes, onions, cereal, blueberries if on sale, apples, tangerines, red licorice, bread, crackers, and canned soup.I am concerned about not having enough protein or iron because I am afraid to eat very much red meat.The foods I miss the most include iced tea, which I skip because of caffeine-I am getting bored with water.I like to bake and miss baked goods, and I also miss cheese-I am afraid it is too high in fat.I have a hard time figuring out what to pack for lunch.The restaurants I go to if I do go out are Chick-Fil-A, Panera, Viva, a local diner, and an Italian restaurant.I like Italian and Mexican food.Usually if I do eat out it is for lunch but it is sometimes hard to figure out something safe to eat..." Dairy foods: Twice a day, drinks 2 8-oz glasses of 1% milk.Fruits: 1 cup per day.

Question 80

A.R.'s diet prescription is ≤35% of kcalories from fat.A.R.looks at menus online before going out to eat, and appropriately selects:

A)Manhattan clam chowder in a bread bowl (670 kcal, 29 g of fat).
B)barbeque chicken chopped salad with vinaigrette dressing (500 kcal, 25 g of fat).
C)Mediterranean veggie sandwich on basil-tomato bread (590 kcal, 13 g of fat).
D)Black Forest ham on a pretzel roll (325 kcal, 13 g of fat).