Question 1

M.L. is a 34-year-old male computer programmer with a BMI of 26 who is seeking dietary counseling. His dose of Prilosec was recently increased, and although he now suffers less often from heartburn symptoms, he is also leery of medical side effects and would like any and all suggestions to manage his GERD "naturally." Having had GERD for the past eight years and been on some form of antacid or antisecretory medication continuously during that time, M.L. knows what foods or factors cause symptoms, and is able to generally avoid them; hence, he has not had reflux esophagitis in over a year. A 24-hour diet history reveals M.L. ate these foods yesterday: Breakfast: Skipped
Snack: Fresh pear; instant oatmeal made with water, eaten with brown sugar and two non-dairy creamers; skim milk
Lunch: Lean turkey lunch meat on whole-grain bread with lettuce, tomato, and mustard; 100% grape juice diluted with water; snack pack of carrots, no dressing
Snack: Sugar cookies; skim milk
Dinner: Tempura (deep-fried, breaded) salmon; buttered rice; salad with lettuce and tomato; vinegar and oil dressing; water
Snack, at bedtime: Ginger ale and ginger snap cookies
The practitioner gives M.L. a checklist of lifestyle changes that can help minimize GERD symptoms. Based on the diet recall above, M.L. would benefit from education about which topic?

Accepted Answer

The answer of M.L. is a 34-year-old male computer programmer...

Question 2

Current research suggests that periodontal disease may increase the risk of developing:

Accepted Answer

Current research shows a link between periodontal disease and an increased risk for heart disease. The bacteria from periodontal disease can enter the bloodstream and lead to inflammation and plaque buildup in arteries, increasing the risk of heart attack or stroke.

Question 3

Jennie Wilson is a 42-year-old administrative assistant who recently underwent sleeve gastrectomy surgery to treat her obesity and weight-related problems: diabetes and hypertension. Ms. Wilson will need nutrition education before being discharged from the hospital.
On the day following surgery, Ms. Wilson will be allowed to consume what food or fluids?

Accepted Answer

On the day following surgery, Ms. Wilson will need to consume clear liquids only, such as water, broth, or unsweetened tea. Chicken broth is a good choice because it is low in calories and provides some protein. Saltine crackers, tomato soup, skim milk, and fruit smoothies are all too high in sugar or carbohydrates and may not be well-tolerated by Ms. Wilson's body in the early stages of recovery.

Question 4

To avoid dehydration, the patient who has undergone bariatric surgery should:

Accepted Answer

Sipping water and other non-caloric beverages throughout the day is the best way to avoid dehydration after bariatric surgery. Drinking plenty of fluids with meals is not recommended because it can fill the stomach and prevent adequate intake of nutrients. Increasing intake of foods with high water content is beneficial, but liquids are still necessary. Sports drinks are not necessary and can contain large amounts of sugar. Continuing with a clear liquid diet instead of advancing to regular foods is not sustainable and can lead to inadequate nutrition.

Question 5

Which risk factor is most closely associated with development of periodontal disease?

Accepted Answer

Pregnancy is a well-known risk factor for the development of periodontal disease, likely due to hormonal changes during pregnancy that can lead to inflammation in the gums.

Question 6

M.L. is a 34-year-old male computer programmer with a BMI of 26 who is seeking dietary counseling. His dose of Prilosec was recently increased, and although he now suffers less often from heartburn symptoms, he is also leery of medical side effects and would like any and all suggestions to manage his GERD "naturally." Having had GERD for the past eight years and been on some form of antacid or antisecretory medication continuously during that time, M.L. knows what foods or factors cause symptoms, and is able to generally avoid them; hence, he has not had reflux esophagitis in over a year. A 24-hour diet history reveals M.L. ate these foods yesterday: Breakfast: Skipped
Snack: Fresh pear; instant oatmeal made with water, eaten with brown sugar and two non-dairy creamers; skim milk
Lunch: Lean turkey lunch meat on whole-grain bread with lettuce, tomato, and mustard; 100% grape juice diluted with water; snack pack of carrots, no dressing
Snack: Sugar cookies; skim milk
Dinner: Tempura (deep-fried, breaded) salmon; buttered rice; salad with lettuce and tomato; vinegar and oil dressing; water
Snack, at bedtime: Ginger ale and ginger snap cookies
What outcome is M.L. at highest risk for because of his GERD?

Accepted Answer

Because M.L. has had GERD for eight years and has been on medication continuously during that time, he is at highest risk for developing Barrett's esophagus, a condition in which the lining of the esophagus changes and can increase the risk for esophageal cancer.

Question 7

Jennie Wilson is a 42-year-old administrative assistant who recently underwent sleeve gastrectomy surgery to treat her obesity and weight-related problems: diabetes and hypertension. Ms. Wilson will need nutrition education before being discharged from the hospital.
Due to reduced food intake and nutrient malabsorption, Ms. Wilson will likely require supplements of:

Accepted Answer

Sleeve gastrectomy surgery results in a significant reduction in food intake and malabsorption of nutrients. Vitamin B₁₂ is necessary for the proper functioning of nerve cells and maintaining healthy red blood cells. Iron is important for the formation of red blood cells, and calcium is necessary for maintaining bone health. Therefore, A is the correct choice as it includes these three essential vitamins and minerals that Ms. Wilson may require as supplements after her surgery. Zinc, magnesium, niacin, folate, vitamin C, vitamin E, and vitamin A can also be important, but they are not the best choice for Ms. Wilson in this case.

Question 8

Nursing Exam Review A nurse is working with a patient who is suffering from dysphagia. The most appropriate foods the nurse can suggest might be:

Accepted Answer

Dysphagia is difficulty swallowing, and therefore soft foods are the most appropriate choice as they are easier to swallow and digest. Dry foods like crackers, sticky foods like peanut butter, mixed texture foods like casseroles, and thin liquids like fruit juice can all pose a choking hazard or be difficult to swallow for someone with dysphagia.

Question 9

Dental caries are caused by:

Accepted Answer

Dental caries, commonly known as cavities, are caused by bacteria in the mouth producing acids that attack tooth enamel. These bacteria feed on sugars and carbohydrates left on the teeth after eating, and produce acidic waste products that erode the enamel and eventually cause decay.

Question 10

Nursing Exam Review The nurse is reviewing a patient's chart and notices that the patient has a history of Sjögren's syndrome. The nurse recognizes that the patient may have nutritional problems due to:

Accepted Answer

The answer of Nursing Exam Review The nurse is reviewing...

Question 11

Jennie Wilson is a 42-year-old administrative assistant who recently underwent sleeve gastrectomy surgery to treat her obesity and weight-related problems: diabetes and hypertension. Ms. Wilson will need nutrition education before being discharged from the hospital.
What best describes Ms. Wilson's procedure?

Accepted Answer

Sleeve gastrectomy involves the removal of a large portion of the stomach, leaving a narrow tube-shaped stomach or sleeve. This restricts the amount of food that can be consumed and promotes weight loss.

Question 12

What food would most likely stimulate saliva flow and neutralize acids in the mouth?

Accepted Answer

Cheese is known to stimulate saliva flow and neutralize acids in the mouth, making it the best choice among the given options. The calcium and phosphorus found in cheese also help to remineralize tooth enamel. Hamburger, legumes, orange juice, and pickles may have varying effects on saliva production and acidity levels in the mouth.

Question 13

M.L. is a 34-year-old male computer programmer with a BMI of 26 who is seeking dietary counseling. His dose of Prilosec was recently increased, and although he now suffers less often from heartburn symptoms, he is also leery of medical side effects and would like any and all suggestions to manage his GERD "naturally." Having had GERD for the past eight years and been on some form of antacid or antisecretory medication continuously during that time, M.L. knows what foods or factors cause symptoms, and is able to generally avoid them; hence, he has not had reflux esophagitis in over a year. A 24-hour diet history reveals M.L. ate these foods yesterday: Breakfast: Skipped
Snack: Fresh pear; instant oatmeal made with water, eaten with brown sugar and two non-dairy creamers; skim milk
Lunch: Lean turkey lunch meat on whole-grain bread with lettuce, tomato, and mustard; 100% grape juice diluted with water; snack pack of carrots, no dressing
Snack: Sugar cookies; skim milk
Dinner: Tempura (deep-fried, breaded) salmon; buttered rice; salad with lettuce and tomato; vinegar and oil dressing; water
Snack, at bedtime: Ginger ale and ginger snap cookies
The medication M.L. takes is a proton-pump inhibitor medication that works by:

Accepted Answer

Proton-pump inhibitors work by decreasing gastric acid production.

Question 14

Nursing Exam Review The nurse is working with a client who recently suffered from a stroke. The client complains of painful swallowing, nasal regurgitation during swallowing, and coughing during meals. The nurse recognizes these as symptoms of:

Accepted Answer

The symptoms of painful swallowing, nasal regurgitation during swallowing, and coughing during meals are all indicative of dysphagia, which is difficulty swallowing. GERD, reflux esophagitis, hiatal hernia, and peptic ulcer disease would not present with all of these specific symptoms.

Question 15

Jennie Wilson is a 42-year-old administrative assistant who recently underwent sleeve gastrectomy surgery to treat her obesity and weight-related problems: diabetes and hypertension. Ms. Wilson will need nutrition education before being discharged from the hospital.
What foods should Ms. Wilson be advised to avoid to prevent possible obstruction of the gastric outlet?

Accepted Answer

After sleeve gastrectomy surgery, patients are advised to avoid fibrous foods like celery because they can cause obstruction of the gastric outlet.

Question 16

M.L. is a 34-year-old male computer programmer with a BMI of 26 who is seeking dietary counseling. His dose of Prilosec was recently increased, and although he now suffers less often from heartburn symptoms, he is also leery of medical side effects and would like any and all suggestions to manage his GERD "naturally." Having had GERD for the past eight years and been on some form of antacid or antisecretory medication continuously during that time, M.L. knows what foods or factors cause symptoms, and is able to generally avoid them; hence, he has not had reflux esophagitis in over a year. A 24-hour diet history reveals M.L. ate these foods yesterday: Breakfast: Skipped
Snack: Fresh pear; instant oatmeal made with water, eaten with brown sugar and two non-dairy creamers; skim milk
Lunch: Lean turkey lunch meat on whole-grain bread with lettuce, tomato, and mustard; 100% grape juice diluted with water; snack pack of carrots, no dressing
Snack: Sugar cookies; skim milk
Dinner: Tempura (deep-fried, breaded) salmon; buttered rice; salad with lettuce and tomato; vinegar and oil dressing; water
Snack, at bedtime: Ginger ale and ginger snap cookies
M.L. should be made aware that use of antacids and antisecretory medication:

Accepted Answer

The passage states that M.L. has been on some form of antacid or antisecretory medication continuously for the past eight years and has not had reflux esophagitis in over a year. This suggests that while the medication may have short term effects in reducing symptoms, it does not cure GERD and may not be effective in healing esophagitis in the long term. The answer options about vitamin deficiencies are not mentioned in the passage and are therefore incorrect.

Question 17

What food would be most likely to contribute to dental caries?

Accepted Answer

Dried fruit has a high sugar content and sticks to teeth, providing a breeding ground for bacteria that cause dental cavities. The other options either have low sugar content or actually help to prevent dental cavities.

Question 18

What suggestion for achieving and maintaining weight loss following bariatric surgery is most appropriate?

Accepted Answer

Eating slowly and chewing food thoroughly can help with feeling full and satisfied after a meal, reducing the likelihood of overeating or snacking between meals. Option A may not be the most appropriate choice as meals should be tailored to an individual's calorie and nutrient needs post-surgery. Option B may encourage grazing behavior which can lead to overconsumption of calories. Option C may not be effective in suppressing appetite long-term and may add empty calories. Option E is not recommended as physical activity is necessary for successful weight loss and overall health.

Question 19

Jennie Wilson is a 42-year-old administrative assistant who recently underwent sleeve gastrectomy surgery to treat her obesity and weight-related problems: diabetes and hypertension. Ms. Wilson will need nutrition education before being discharged from the hospital.
Once she is able to tolerate regular foods, what type of foods should Ms. Wilson be encouraged to eat before consuming other foods in a meal?

Accepted Answer

After sleeve gastrectomy surgery, patients are encouraged to eat high-protein foods first before consuming other foods in a meal. This is because protein takes longer to digest and can help patients feel fuller for longer periods of time. Additionally, it can help preserve lean body mass during weight loss. Complex carbohydrates, low-fat foods, low-sodium foods, and high-fat foods are not specifically recommended to be consumed first after surgery.

Question 20

Nursing Exam Review The nurse understands that a patient with GERD will benefit from education on managing the disease. What suggestion should be included in the nurse's teaching?

Accepted Answer

Patients with GERD should avoid eating at bedtime to prevent acid reflux, as lying down with a full stomach can exacerbate symptoms.

Quiz 17: Nutrition and Upper Gastrointestinal Disorders