Question 1

A patient is admitted with poor wound healing and malnutrition.To best address issues of wound healing,the nurse designs interventions to support intake of which nutrient?
A)Protein
B)Minerals
C)Carbohydrates
D)Lipids

Accepted Answer

Protein is essential for wound healing as it is necessary for the production of collagen, which plays a crucial role in the healing process. Adequate intake of protein is important for tissue repair and growth, and can help to prevent malnutrition. Minerals, carbohydrates, and lipids also play important roles in overall health, but protein is most directly related to wound healing.

Question 2

The nurse is reviewing laboratory results and the dietician's analysis of a hospitalized patient's normal home diet.The nurse would plan to support additional amounts of nutrients based on which percentages? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Select all that apply.
A)Carbohydrates 35%
B)Fat 7%
C)Protein 45%
D)Thiamine 18 ng/mL
E)Magnesium 2.2 mEq/L

Accepted Answer

A,B

Question 3

A patient who is being mechanically ventilated is demonstrating respiratory acidosis.The nurse suspects that which metabolic process is malfunctioning?
A)Anaerobic metabolism
B)Catabolism
C)Aerobic metabolism
D)Anabolism

Accepted Answer

Respiratory acidosis occurs when there is an accumulation of carbon dioxide (CO2) in the body due to inadequate ventilation. Aerobic metabolism, which requires oxygen, is responsible for the production of CO2 as a byproduct. If the body cannot adequately remove CO2 through ventilation, it indicates a malfunction in the process of aerobic metabolism, leading to respiratory acidosis.

Question 4

A patient,diagnosed with malnutrition and who has known exposure to Candida,was given an intradermal Candida test dose 3 days ago.The site is currently showing no signs of induration.How would the nurse evaluate this finding?
A)There is lack of anergy.
B)There is no current infection with Candida.
C)The immune system has been impaired,possibly by malnutrition.
D)The test should be repeated in 48 hours.

Accepted Answer

The absence of induration (swelling) at the site of an intradermal Candida test after 3 days suggests an impaired immune response, which could be due to malnutrition. This condition, known as anergy, indicates a lack of reaction to antigens that would normally provoke a response in healthy individuals.

Question 5

A patient in the intensive care unit is at risk for developing malnutrition.Indirect calorimetry is planned to estimate the patient's caloric needs.Which information would the nurse provide to this patient? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Select all that apply.
A)"You will be taken to a special chamber where you can be isolated."
B)"You will be required to exercise on a treadmill for this testing."
C)"You can expect this test to take about 15 to 20 minutes."
D)"In order for results to be accurate,I will need to measure your height."
E)"We will not be able to do this test until you are off the mechanical ventilator."

Accepted Answer

Indirect calorimetry is a non-invasive method to measure the metabolic rate by analyzing the oxygen consumed and carbon dioxide produced. It typically takes 15 to 20 minutes (C) and requires accurate patient data, including height (D), for precise calculations. It does not involve exercise (B) or isolation in a special chamber (A), and it can be performed on patients who are on mechanical ventilators (E), contrary to the statement provided.

Question 6

It is necessary to measure a patient's height,but the patient's legs are suspended in traction.Which nursing action is indicated?
A)Measure from the patient's head to the iliac crest and use a standard table to estimate height.
B)Remove the traction weights long enough to quickly measure length of one leg.
C)Measure the patient's arm span.
D)Estimate the patient's height from his stated weight.

Accepted Answer

Measuring the patient's arm span is a recognized alternative method for estimating height, especially in situations where traditional methods are not feasible, such as when a patient's legs are in traction.

Question 7

It has been calculated that a patient in the intensive care unit needs 1800 calories each day to sustain normal metabolic functioning.The nurse calculates that which number of calories is needed to sustain central nervous system (CNS)functioning?
A)1440 calories
B)360 calories
C)900 calories
D)720 calories

Accepted Answer

The central nervous system (CNS) requires approximately 20% of the total daily caloric intake to function properly. In this case, 20% of 1800 calories is 360 calories (1800 x 0.20 = 360).

Question 8

The nurse is going to calculate a patient's metabolic needs by using the Harris-Benedict equation.Which information should the nurse collect for this calculation? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Select all that apply.
A)Height in centimeters
B)Weight in kilograms
C)Age in months
D)Body mass index (BMI)
E)Body temperature

Accepted Answer

The Harris-Benedict equation requires a person's height (in centimeters), weight (in kilograms), and age (in years, but knowing the age in months can help calculate the exact age in years if necessary) to estimate their basal metabolic rate (BMR). Body mass index (BMI) and body temperature are not used in this calculation.

Question 9

A patient who is hemodynamically stable has been receiving protein replacement therapy for several days.The nurse realizes that which laboratory test would be the best to determine the patient's current nutritional status?
A)Total lymphocyte count
B)Albumin
C)Transferrin
D)Vitamin assay

Accepted Answer

Transferrin is a protein that binds and transports iron in the blood and is a more sensitive indicator of protein status and nutritional status than albumin, especially in the short term.

Question 10

A patient in the intensive care unit is surprised to learn that he has an elevated blood glucose level since he has not been diagnosed with diabetes.How should the nurse explain this elevation?
A)"Many people are not diagnosed with diabetes until they are admitted to an intensive care unit."
B)"Increasing blood glucose is the body's way of making sure there is enough energy for brain functioning."
C)"Many people have diabetes but are not aware of it."
D)"When stressed,the body releases more glucose into the blood,raising the blood glucose level."

Accepted Answer

Stress can cause the body to release more glucose into the blood, leading to an elevation in blood glucose levels. This is known as stress-induced hyperglycemia and can occur in people without diabetes.

Question 11

A patient has been in the intensive care unit for 10 days after a traumatic injury requiring intubation and multiple blood transfusions.The patient now has assessment findings consistent with protein malnutrition.Which laboratory result would the nurse evaluate as supporting this diagnosis?
A)Prealbumin level 15 mg/dL
B)Transferrin level 325 mcg/dL
C)BUN level 10 mg/dL
D)Albumin level 4 g/dL

Accepted Answer

Prealbumin is a more sensitive marker for protein malnutrition than albumin or transferrin. A level of 15 mg/dL or lower is indicative of protein malnutrition. Transferrin levels would be more indicative of iron deficiency, while BUN levels reflect kidney function and albumin levels are more specific to liver function or chronic protein deficiency.

Question 12

A patient's blood oxygen level is measured to be 78%.The nurse implements interventions to improve this level to avoid development of which situation?
A)Anabolism
B)Catabolism
C)Anaerobic metabolism
D)Aerobic metabolism

Accepted Answer

A blood oxygen level of 78% indicates hypoxemia, which means there is not enough oxygen for aerobic metabolism. When there is not enough oxygen available for cells to produce energy through aerobic metabolism, they will start using anaerobic metabolism, which can lead to the production of lactic acid and metabolic acidosis. Therefore, the nurse would want to implement interventions to improve the patient's oxygen level to avoid the development of anaerobic metabolism.

Question 13

The patient was admitted to the emergency department after being injured in a drive-by shooting.Despite very serious injuries,the patient is awake and alert and cries continuously that "someone tried to kill me." The nurse tries to calm the patient because of which catecholamine effects? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Select all that apply.
A)Increased heart rate
B)Increased blood pressure
C)Constriction of coronary vessels
D)Constriction of blood vessels in skeletal muscles
E)Increase in blood glucose

Accepted Answer

The patient's crying and anxiety suggest an increase in the sympathetic nervous system activity, leading to the release of catecholamines such as epinephrine and norepinephrine. This would result in an increased heart rate, increased blood pressure, and an increase in blood glucose, which are all part of the body's fight-or-flight response. Constriction of coronary vessels and blood vessels in skeletal muscles would not be desirable effects in this situation, as it could lead to a decreased blood supply to vital organs and tissues.

Question 14

A patient with poorly controlled diabetes has elevated lipid levels in spite of her attempts to decrease fat and carbohydrate intake.How should the nurse explain this finding?
A)"You are not eating enough and your proteins are breaking down."
B)"Your body is using your high glucose levels to produce lipids."
C)"You are not eating enough carbohydrates."
D)"Most persons with diabetes are not able to efficiently metabolize fats."

Accepted Answer

Elevated glucose levels in diabetes can lead to an increase in lipid production by the liver through a process called lipogenesis. This can result in elevated lipid levels in the bloodstream, even in patients who are attempting to decrease fat and carbohydrate intake. Option A is incorrect as inadequate protein intake does not lead to elevated lipid levels. Option C is incorrect as reducing carbohydrate intake is often a recommended approach for controlling diabetes and lipid levels. Option D is incorrect as not all persons with diabetes have difficulty efficiently metabolizing fats.

Question 15

The nurse is explaining the mechanics of collecting a 24-hour urine urea nitrogen test to the patient.The nurse would also explain which purpose of this test?
A)Fluid status
B)Kidney function
C)Blood volume
D)Nitrogen balance

Accepted Answer

The 24-hour urine urea nitrogen test is primarily used to assess nitrogen balance in the body, which helps in evaluating the body's protein metabolism and how well the kidneys are functioning in terms of processing waste products. However, its direct purpose is to assess nitrogen balance, not kidney function, fluid status, or blood volume directly.

Question 16

A male patient is 6 feet 2 inches tall with a body weight of 145 lbs.The nurse would calculate this patient's body mass index (BMI)to be in which category?
A)Underweight
B)Normal
C)Overweight
D)Obese

Accepted Answer

The answer of A male patient is 6 feet 2...

Question 17

The nurse is monitoring a patient's metabolic status with a thermodilution catheter to determine oxygen saturation of venous blood.How would the nurse report the findings of this test?
A)As oxygen extraction
B)Using the Fick equation
C)As indirect calorimetry
D)As direct calorimetry

Accepted Answer

The answer of The nurse is monitoring a patient's metabolic...

Question 18

A patient has a pituitary adenoma that has increased secretion of thyroid-stimulating hormone.Which nutritional effect,if any,will the nurse note in this patient?
A)Metabolism will be increased.
B)The patient's appetite will be suppressed.
C)No changes will be noted.
D)The patient will crave salt.

Accepted Answer

Pituitary adenoma is a type of brain tumor that can cause overproduction of certain hormones, including thyroid-stimulating hormone (TSH). Increased secretion of TSH can lead to hyperthyroidism, which results in an increase in metabolism. Therefore, the nurse may note an increase in metabolic rate in this patient.

Question 19

The nurse notices that a patient in the intensive care unit has lost muscle mass and tone in her arms and legs.The nurse would attribute this loss to changes in which process?
A)Energy
B)Catabolism
C)Adenosine triphosphate
D)Anabolism

Accepted Answer

Catabolism refers to the breakdown of molecules, including muscle tissue, for energy production. This breakdown can result in the loss of muscle mass and tone.

Quiz 31: Determinants and Assessment of Nutrition and Metabolic Function

A patient is admitted with poor wound healing and malnutrition.To best address issues of wound healing,the nurse designs interventions to support intake of which nutrient?

A patient who is being mechanically ventilated is demonstrating respiratory acidosis.The nurse suspects that which metabolic process is malfunctioning?

A patient,diagnosed with malnutrition and who has known exposure to Candida,was given an intradermal Candida test dose 3 days ago.The site is currently showing no signs of induration.How would the nurse evaluate this finding?

It is necessary to measure a patient's height,but the patient's legs are suspended in traction.Which nursing action is indicated?

It has been calculated that a patient in the intensive care unit needs 1800 calories each day to sustain normal metabolic functioning.The nurse calculates that which number of calories is needed to sustain central nervous system (CNS) functioning?

The nurse is going to calculate a patient's metabolic needs by using the Harris-Benedict equation.Which information should the nurse collect for this calculation? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A patient who is hemodynamically stable has been receiving protein replacement therapy for several days.The nurse realizes that which laboratory test would be the best to determine the patient's current nutritional status?

A patient in the intensive care unit is surprised to learn that he has an elevated blood glucose level since he has not been diagnosed with diabetes.How should the nurse explain this elevation?

A patient has been in the intensive care unit for 10 days after a traumatic injury requiring intubation and multiple blood transfusions.The patient now has assessment findings consistent with protein malnutrition.Which laboratory result would the nurse evaluate as supporting this diagnosis?

A patient's blood oxygen level is measured to be 78%.The nurse implements interventions to improve this level to avoid development of which situation?

A patient with poorly controlled diabetes has elevated lipid levels in spite of her attempts to decrease fat and carbohydrate intake.How should the nurse explain this finding?

The nurse is explaining the mechanics of collecting a 24-hour urine urea nitrogen test to the patient.The nurse would also explain which purpose of this test?

A male patient is 6 feet 2 inches tall with a body weight of 145 lbs.The nurse would calculate this patient's body mass index (BMI) to be in which category?

The nurse is monitoring a patient's metabolic status with a thermodilution catheter to determine oxygen saturation of venous blood.How would the nurse report the findings of this test?

A patient has a pituitary adenoma that has increased secretion of thyroid-stimulating hormone.Which nutritional effect,if any,will the nurse note in this patient?

The nurse notices that a patient in the intensive care unit has lost muscle mass and tone in her arms and legs.The nurse would attribute this loss to changes in which process?