Download TESTBANK Chapter Title: The History and Interviewing Process

TESTBANK Chapter Title: Nutritional Alterations and Management
Chapter #: 7
1. A patient with acute pancreatitis is to be started on enteral tube feeding. What type of formula would be most appropriate?
1. Low protein
2. Low sodium
3. Low carbohydrate
4. Low fat
2. When administering a medication as an elixir via a nasogastric tube, it is best to:
1. flush the tube with water both before and after administering the medication.
2. flush the tube with water after administering the medication.
3. mix the medication with the tube feeding formula.
4. check to see if the medication is available in another oral formulation.
3. A patient is receiving intermittent nasogastric feedings every 4 hours. The best method for confirming the placement of the tube
before each feeding would be to:
1. obtain an x-ray of the abdomen.
2. check the pH of fluid aspirated from the tube.
3. auscultate the left upper quadrant of the abdomen while injecting air into the tube.
4. auscultate the right upper quadrant of the abdomen while injecting air into the tube.
4. A person with a body mass index of 28 would be considered:
1. obese.
2. overweight.
3. of normal weight.
4. underweight.
5. Diet therapy for a hypertensive person 1 day after a myocardial infarction would include all of the following except:
1. small frequent meals.
2. low-cholesterol diet.
3. low-salt diet.
4. fluid-restricted diet.
6. A patient would demonstrate that he understood the principles of a low-fat diet if he selected which of the following meals?
1. Scrambled eggs, biscuits with jelly, skim milk, and orange juice
2. Oatmeal with brown sugar, skim milk, and cantaloupe
3. Pancakes with syrup, bacon, skim milk, and grapefruit
4. Waffles with fruit topping, sausage, and skim milk
7. A ventilator-dependent patient receiving a nasoduodenal feeding experiences an increase in oxygen requirement and volume of
endotracheal secretions. The nurse’s first action in regard to the change in the patient’s condition would be to:
1. stop the tube feeding.
2. listen to the patient’s chest sounds.
3. check the placement of the feeding tube.
4. obtain a chest x-ray.
8. Proteins serve the function of:
1. maintaining osmotic pressure.
2. providing minerals in the body.
3. maintaining blood glucose.
4. providing cellular energy.
Copyright © 2003, Elsevier Science (USA). All rights reserved.
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9. Which of the following serves as the main source of energy for patients who are starved and injured?
1. Fats
2. Carbohydrates
3. Proteins
4. Lipids
10. Obtaining height and weight measurements for the critically ill patient:
1. should be deferred until the medical condition stabilizes.
2. should be measured rather than obtained through the patient or family report.
3. requires actual height, but weight can be deferred.
4. requires weight, but height can be deferred.
11. Which of the following nutrients is of special concern for the patient with a history of alcoholism?
1. Thiamin
2. Iron
3. Vitamin A
4. Zinc
12. The primary nutritional intervention for hypertension is:
1. decreasing carbohydrates.
2. limiting salt.
3. increasing protein.
4. increasing fluids.
13. The patient with coronary artery disease should be taught about cholesterol. Which situation is most desirable?
1. Low levels of HDL-cholesterol
2. Low levels of LDL-cholesterol
3. Hypocholesterolemia
4. Low levels of both HDL- and LDL- cholesterol
14. An effect of malnutrition on respiratory function is:
1. decreased surfactant.
2. increased vital capacity.
3. decreased Paco2.
4. tachypnea.
15. What is the rationale for careful intake and output for the patient with pulmonary alterations?
1. Fluid retention occurs with tachypnea.
2. Hemodilution may cause deleterious hypernatremia.
3. Right-sided heart failure may worsen the status of the patient with respiratory compromise.
4. Excessive fluid losses may lead to dehydration and hypovolemic shock.
16. The patient who has sustained a head injury has increased nutritional needs related to the:
1. decrease in metabolism as a result of coma.
2. decrease in blood sugar from a lack of dietary supplementation.
3. anabolism and wound healing.
4. hypermetabolism and catabolism associated with the injury.
Copyright © 2003, Elsevier Science (USA). All rights reserved.
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17. Patients receiving corticosteroids are at risk for:
1. hyponatremia.
2. hyperalbuminemia.
3. hyperkalemia.
4. hyperglycemia.
18. Which of the following nutritional interventions is a priority for the patient with renal disease?
1. Increase fluids to replace losses.
2. Encourage potassium-rich foods to replace losses.
3. Ensure an adequate number of calories to prevent catabolism.
4. Limit all nutrients to account for altered renal excretion.
19. Prevention of pulmonary aspiration is best accomplished by:
1. administering intermittent feedings.
2. adding thickening agents to the tube feeding solution.
3. suctioning the patient hourly.
4. elevating the head of the bed 30 degrees.
Questions 20-23 relate to the following situation.
Mr. D. is admitted to the critical care unit with severe malnutrition as a result of hepatic failure. A triple lumen central venous
catheter is placed in the right subclavian vein and total parenteral nutrition (TPN) is started.
20. Which of the following complications should Mr. D. be evaluated for immediately following insertion of the catheter?
1. Pneumothorax
2. Arterial cannulation
3. Central venous thrombosis
4. Pulmonary aspiration
21. On the third day of infusion, Mr. D. has symptoms of fever and chills. Which of the following complications should be
suspected?
1. Air embolism
2. Pneumothorax
3. Central venous thrombosis
4. Catheter-related sepsis
22. Which of the following medical interventions may be initiated with the onset of hyperglycemia?
1. Discontinuing the infusion
2. Adding insulin to the TPN
3. Weaning the TPN off over 6 hours
4. Starting an infusion of 0.9% normal saline
23. Which of the following dietary restrictions should be maintained for Mr. D.?
1. Fat and magnesium
2. Protein and sodium
3. Carbohydrate and potassium
4. Protein and calcium
Copyright © 2003, Elsevier Science (USA). All rights reserved.