Question 1

Jones experienced a burn and is currently in a state of stress.Mr.Jones is 5'9" tall and weighs 176 pounds.The nurse recommends that he receive a minimum of _____ grams of protein per day.

Accepted Answer

The recommended protein intake for burn patients is 1.5-2.0 grams per kilogram of body weight per day. Mr. Jones weighs 176 pounds, which is approximately 80 kilograms. Therefore, he should receive a minimum of 120 grams of protein per day.

Question 2

Winslett is a COPD patient who is complaining of poor appetite, abdominal discomfort, and bloating.Which of the following is the nurse's appropriate suggestion for improving his food intake?

Accepted Answer

Eating smaller, more frequent meals can help alleviate bloating and abdominal discomfort in patients with COPD. It can also help improve appetite by making meals more manageable and less overwhelming. Consuming larger meals may exacerbate discomfort and bloating, and substituting beans for meat may not be enough to address the underlying issues. Drinking a supplement before eating may not be necessary if smaller, more frequent meals are consumed. The nurse should suggest that Winslett eats smaller, more frequent meals to help improve his food intake. Larger meals may lead to increased abdominal discomfort and bloating, while substituting beans for meat may not be suitable for his individual dietary needs. Drinking a supplement before eating may also not address the underlying issue of poor appetite.

Question 3

is a 23-year-old firefighter who experienced severe burns while fighting a house fire.The nurse recognizes the fact that he may benefit from supplements of minerals such as _____ to reduce the risk of infection.

Accepted Answer

Zinc, copper, and selenium are all important minerals for wound healing and reducing the risk of infection. Zinc plays a crucial role in immune function and wound healing, while copper helps with collagen formation and selenium is an antioxidant that supports immune function. Iron and calcium are important for overall health but are not specifically indicated for reducing infection risk in burn patients. Sodium, potassium, and chloride are electrolytes that may need to be monitored in burn patients, but supplementing these minerals would not necessarily reduce the risk of infection. Thiamin and riboflavin are B vitamins that are important for energy metabolism but are not specifically indicated for burn patients. Zinc, copper, and selenium are important minerals for wound healing and reducing the risk of infection. Zinc helps with immune function and wound healing, while copper and selenium also have antimicrobial properties. Iron, calcium, sodium, potassium, chloride, thiamin, and riboflavin are important minerals for overall health, but they may not specifically target infection prevention in burn patients like zinc, copper, and selenium do.

Question 4

of the following are therapies used to manage MODS except:

Accepted Answer

Physical therapy may be helpful in improving mobility and function after recovery from MODS, but it is not a direct therapy for managing the condition. Mechanical ventilation, fluid resuscitation, and hemofiltration or dialysis are all commonly used interventions for managing MODS. Physical therapy may be used in some cases to improve functional capacity and mobility of patients with MODS, but it is not a therapy used to manage the condition itself. Mechanical ventilation, fluid resuscitation, and hemofiltration or dialysis are all commonly used therapies to manage MODS.

Question 5

critically ill patient with ARDS is on a tube feeding and requires a fluid restriction.The nurse understands that an appropriate enteral formula will be:

Accepted Answer

A critically ill patient with ARDS requires a nutrient-dense enteral formula to meet their caloric and nutritional needs while on a fluid restriction. A nutrient-dense formula contains a higher concentration of calories, carbohydrates, and protein per volume, which is ideal for patients that require a limited volume of intake. A nutrient-dense formula would provide the patient with adequate nutrition while adhering to fluid restriction guidelines. This type of formula typically contains higher levels of protein, vitamins, and minerals, which can support the patient's recovery and healing process. Low residue or hydrolyzed formulas are not necessarily appropriate for this patient population, as they may lack important nutrients or complicate preexisting gastrointestinal issues.

Question 6

Mr.Morgan is an acutely stressed patient in the ICU who is on TPN.The nurse understands that monitoring the patient's _____ can help to determine if the patient is being overfed.

Accepted Answer

Monitoring glucose levels can help to determine if the patient is being overfed because TPN is high in sugar and can cause hyperglycemia. If the patient's glucose levels are consistently high, it may indicate that their TPN infusion rate needs to be adjusted. Cholesterol, iron, and albumin levels are not necessarily indicative of overfeeding. Monitoring the patient's glucose levels can help determine if they are being overfed because TPN is a form of nutrition that is delivered directly into the bloodstream, bypassing the normal digestive process. This can cause a sudden spike in glucose levels, which can be dangerous for the patient. By monitoring the glucose levels, the nurse can adjust the TPN to ensure that the patient is receiving the appropriate amount of nutrition without causing harm. Cholesterol and iron levels are not directly affected by TPN, and while albumin levels may be helpful in assessing overall nutritional status, they may not be as useful in determining if the patient is being overfed.

Question 7

is a 59-year-old patient who suffered multiple broken bones in a motor vehicle accident.She weighs 138 pounds.The nurse chooses a protein factor of 1.5 g/kg to estimate her protein needs and calculates that Mary's protein requirements are approximately _____ grams per day.

Accepted Answer

138 pounds = 62.6 kg62.6 kg x 1.5 g/kg = 93.9 g/day93.9 g/day rounded to the nearest whole number is 94 g/day.

Question 8

Nutrition support plays a role in the therapy for MODS in all of the following ways except:

Accepted Answer

While nutrition support plays a crucial role in providing nutrients and promoting recovery, it does not directly play a role in maintaining blood pressure. Blood pressure management is typically addressed through fluids, medications, and other medical interventions. While nutrition support can help provide nutrients to the body, prevent excessive wasting, and promote recovery, it does not directly maintain blood pressure. Blood pressure is typically managed through other interventions such as fluids and medications.

Question 9

first organ to fail in MODS is normally the:

Accepted Answer

The lungs are the first organ to fail in MODS (Multiple Organ Dysfunction Syndrome), which is a progressive failure of multiple organs in critically ill patients. The failure of the lungs can lead to respiratory failure, which is the most common cause of death in patients with MODS. Eventually, other organs such as the liver, kidneys, and heart may also fail. The lungs are typically the first organ to fail in MODS (multiple organ dysfunction syndrome). This is because they are very sensitive to changes in oxygen levels and are often affected by the initial insult or injury that triggered the development of MODS. As the dysfunction progresses, other organs may also begin to fail, such as the liver, kidneys, and heart.

Question 10

has been hospitalized with a severe infection in his foot.The nurse recognizes that increasing his intake of _____ may help to suppress the inflammation.

Accepted Answer

Omega-3 fatty acids have anti-inflammatory properties and increasing their intake may help suppress inflammation in the foot. Protein is important for wound healing, but it does not directly impact inflammation. Carbohydrates do not have anti-inflammatory properties. Omega-6 fatty acids, while essential, can promote inflammation if consumed in excess. Omega-3 fatty acids have anti-inflammatory properties and can help suppress inflammation, which may be beneficial in treating a severe infection. Protein and carbohydrates are essential nutrients for overall health, but do not specifically target inflammation. Omega-6 fatty acids, on the other hand, can promote inflammation and may not be helpful in this situation.

Question 11

Case Study Questions
Use the following case study to answer questions 
Kati is a 19-year-old female who suffered a head injury and multiple broken bones in a motorcycle accident.She is currently in a coma, on a mechanical ventilator, and receiving enteral nutrition.Kati is 5'2" tall and weighs 115 pounds.
-If Kati's enteral feeding is not providing adequate energy and protein to meet her nutritional needs, she will experience:

Accepted Answer

A lack of adequate energy and protein intake can lead to a loss of lean tissue, or muscle mass. Hyperglycemia refers to high blood sugar levels, which may be a concern in some patients but is not directly related to inadequate enteral nutrition. Pulmonary edema is a buildup of fluid in the lungs that can occur for various reasons but is not directly related to nutrition. Sepsis is a potentially life-threatening condition that can occur as a result of infection but is not directly related to nutrition in this case. If Kati's enteral feeding is not providing adequate energy and protein to meet her nutritional needs, she will experience a loss of lean tissue. This can lead to muscle wasting and weakness, which can prolong her recovery and delay her ability to regain her independence. Hyperglycemia is high blood sugar, which is not directly related to inadequate nutrition. Pulmonary edema is a condition where fluid builds up in the lungs, which is not caused by inadequate nutrition. Sepsis is a potentially life-threatening complication of an infection and is not directly related to inadequate nutrition.

Question 12

patient with ARDS requires mechanical ventilation.The nurse recognizes that fluid accumulation is a potential problem and understands that this may make it difficult to assess his:

Accepted Answer

Fluid accumulation in the patient with ARDS can make it difficult to assess their weight accurately, as it may include both fluid and tissue weight. This can be important for evaluating the effectiveness of treatments or for adjusting medication dosages, so the nurse needs to be aware of potential limitations in weight measurements. Temperature, calorie intake, and fluid intake are not generally affected by fluid accumulation. Patients with ARDS require mechanical ventilation, and fluid accumulation is a potential problem in these patients. The accumulation of fluid may make it difficult to assess the patient's weight accurately. Therefore, A) weight is the best choice. The accumulation of fluid is unlikely to affect the assessment of temperature, calorie intake, or fluid intake.

Question 13

nurse understands that the inflammatory process can cause a variety of systemic effects and monitors her patient's:

Accepted Answer

The inflammatory process can cause a variety of systemic effects, including increased heart rate, respiratory rate, and temperature. Monitoring these vital signs can help the nurse identify and address any potential complications. Blood pressure, appetite, and weight may also be affected, but are not typically the primary focus of monitoring in the context of inflammation. The inflammatory process can lead to systemic effects such as fever, tachycardia, and tachypnea. Therefore, monitoring the patient's heart rate, respiratory rate, and temperature is important in identifying and managing potential complications. Monitoring blood pressure is also important, but appetite and weight are not necessarily affected by the inflammatory process.

Question 14

nurse recognizes all of the following as the classic signs of inflammation except:

Accepted Answer

Hyperglycemia is not a classic sign of inflammation. Classic signs of inflammation include swelling, redness, and heat, as well as pain and loss of function in the affected area. Classic signs of inflammation include swelling, redness, heat, and pain. Hyperglycemia is not a classic sign of inflammation but may occur as a secondary response due to the release of stress hormones.

Question 15

principal infection associated with MODS is:

Accepted Answer

Pneumonia is the most common infection associated with MODS, as it often leads to respiratory failure and subsequent organ dysfunction. Fungal, viral, and herpes simplex infections can also contribute to the development of MODS, but they are less commonly implicated than pneumonia. Pneumonia is the most commonly identified infection associated with MODS.

Question 16

patient is admitted to the ER with multiple gunshot wounds.The nurse understands that the initial treatment includes:

Accepted Answer

Administering IV fluids is the initial treatment for a patient with multiple gunshot wounds as it helps to maintain adequate blood volume and perfusion to vital organs. Enteral nutrition and PPN may be considered later in the patient's treatment plan, but they are not the initial priority. Referral to the dietitian is also not a priority in the initial treatment of a patient with multiple gunshot wounds. Administering IV fluids is the priority in the initial treatment of a patient with multiple gunshot wounds. This is to prevent shock and maintain blood pressure. Enteral nutrition and PPN should not be started until the patient is stable and hemodynamically sound. Referral to the dietitian can be made at a later time during the recovery process.

Question 17

patient who is on a tube feeding gains nine pounds in three days.The nurse realizes that this may indicate:

Accepted Answer

A sudden gain of nine pounds in three days indicates fluid imbalance rather than adequate nutrition, excess protein intake, or nutrient imbalance. This may be due to an increase in fluid retention or an increase in tube feeding rate without adequate adjustment of electrolyte balance. The nurse should assess for signs of fluid overload, such as swelling or shortness of breath, and report the findings to the healthcare provider. Rapid weight gain in a patient who is receiving tube feeding is likely due to fluid imbalance, specifically fluid overload. It is important for the nurse to monitor the patient's fluid intake and output, as well as their electrolyte levels, and adjust the tube feeding accordingly to prevent further complications such as edema and heart failure.

Question 18

of the factors that increases the risk of MODS is:

Accepted Answer

Malnutrition is a known risk factor for multiple organ dysfunction syndrome (MODS) as it can weaken the immune system and impair the body's ability to recover from illness or injury.

Question 19

Case Study Questions
Use the following case study to answer questions 
Kati is a 19-year-old female who suffered a head injury and multiple broken bones in a motorcycle accident.She is currently in a coma, on a mechanical ventilator, and receiving enteral nutrition.Kati is 5'2" tall and weighs 115 pounds.
-frequent cause of death among older intensive care patients with multiple or severe injuries is:

Accepted Answer

Multiple organ dysfunction syndrome (MODS) is a common complication in patients with severe injuries requiring intensive care. It occurs when multiple organs fail, often due to inadequate blood flow or oxygenation, leading to death in many cases. Pulmonary edema, heart attacks, and stroke are also potential complications, but MODS is the leading cause of death in these patients. Multiple organ dysfunction syndrome (MODS) is a frequent cause of death among intensive care patients with multiple or severe injuries. It is a syndrome characterized by progressive organ failure, which is often caused by severe sepsis, trauma, burns, or other insults. Pulmonary edema and heart attack can also occur in these patients, but they are not as common as MODS. Stroke is not a frequent cause of death in this population.

Question 20

White is in the ICU for complications following surgery.She has been diagnosed with sepsis and is on a ventilator.In order to most accurately estimate her energy needs, the nurse recognizes that the preferred method to use is:

Accepted Answer

The Ireton-Jones equation is specifically designed for critically ill patients, taking into account their illness severity, body weight, age, and other variables that may affect their energy needs. This would be the most accurate method to use in the case of a patient in the ICU with sepsis and on a ventilator. The preferred method for estimating energy needs in critically ill patients on mechanical ventilation with sepsis and other complications is the Ireton-Jones equation. This equation takes into consideration the patient's weight, age, sex, and clinical condition, and has been shown to be more accurate in this population than the Harris-Benedict or Mifflin-St.Jeor equations. Direct calorimetry is the gold standard for measuring energy expenditure, but it is not typically used in clinical practice due to its cost and complexity.

Quiz 24: Energy- and Protein-Modified Diets for Metabolic and Respiratory Stress