Nutrition Essentials for Nursing Practice 6th Edition by Susan G. Dudek – Test Bank

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Nutrition Essentials for Nursing Practice 6th Edition by Susan G. Dudek – Test Bank

Chapter 2, Carbohydrates

1. Cancer cachexia is a progressive wasting syndrome that is:
  A) Estimated to cause 20% to 40% of cancer deaths
  B) Correlated with the size of the tumor: the bigger the tumor, the more severe the cachexia
  C) Directly related to calorie intake: the fewer the calories consumed, the more severe the cachexia
  D) Most commonly seen developing in clients with breast cancer or sarcoma

 

 

2. Alterations in body metabolism occur in patients with all types of cancers. What are these metabolic alterations? (Mark all that apply.)
  A) Hyperglycemia
  B) Hyperlipidemia
  C) Lowered basal metabolic rate
  D) Fluid and electrolyte abnormalities
  E) Increased protein sparing

 

 

3. Patients who undergo radiation therapy to the head and neck are at risk for several complications. What is the most likely complication of radiation to the head and neck?
  A) Difficulty chewing and swallowing
  B) Nausea and vomiting
  C) Chronic blood loss
  D) Malabsorption

 

 

4. Patients who receive radiation to the lower neck or midchest are at risk for several complications. What complication is most common?
  A) Mouth blindness
  B) Esophagitis with dysphagia
  C) Dumping syndrome
  D) Chronic blood loss

 

 

5. A 52-year old-male is admitted to your unit with fatigue, weight loss, and malaise. The patient has lost >10% of his body weight over the past six months. The physician notes that the patient has generalized malabsorption and altered insulin secretion. What are these potential complications of?
  A) Cancer of the stomach
  B) Cancer of the gallbladder
  C) Cancer of the small bowel
  D) Cancer of the pancreas

 

 

6. Your patient is scheduled for chemotherapy in one hour. Which of the following would best be avoided before and after chemotherapy?
  A) Coffee
  B) Skim milk
  C) Sherbet
  D) Apple juice

 

 

7. A patient undergoing radiation therapy has developed anorexia. What interventions may help improve the patient’s appetite? (Mark all that apply.)
  A) Small amounts of alcohol
  B) Small amounts of coffee
  C) Light exercise
  D) Avoiding strong odors
  E) Drink liquids with meals

 

 

8. You are doing discharge teaching with a patient who has a diagnosis of colon cancer, stage 4. Your patient asks if there is anything that he can do for the fatigue he feels. What would be your best response?
  A) You should eat a big breakfast.
  B) You should limit physical activity.
  C) You should limit fluids.
  D) You should drink caffeinated beverages.

 

 

9. The patient is in the clinic after being diagnosed with HIV. He asks what vitamin and mineral supplements are recommended to improve his nutritional status. What would be your best response?
  A) Multivitamin and mineral supplements are usually recommended at levels of 100% to 200% of the dietary reference intake (DRI).
  B) Supplements of vitamin A, zinc, and iron are especially beneficial for HIV patients.
  C) Vitamin and mineral supplements are not recommended for HIV patients.
  D) Your blood work shows that you are hypokalemic so you do not need potassium.

 

 

10. Your patient complains of a metallic taste in her mouth. What would be the best recommendation?
  A) Eat small, frequent meals.
  B) Brush your teeth before eating.
  C) Use plastic utensils.
  D) Experiment with tart foods.

 

 

11. The dietician has recommended that your patient’s diet be changed from regular to nutrient dense. What is the most nutrient-dense snack for someone with a dry mouth?
  A) A peanut butter sandwich
  B) A cherry popsicle
  C) Boost or Ensure
  D) Hard cheese with crackers

 

 

12. Your patient’s diet has just been changed to a protein-dense diet. She asks you how she can increase the protein density of her diet. What would be the best response?
  A) Using honey on toast and cereal
  B) Substituting mayonnaise for salad dressing
  C) Adding whipped cream to coffee and tea
  D) Melting cheese on sandwiches and vegetables

 

 

13. You are speaking to a group of cancer patients who are undergoing chemotherapy. What would you recommend as a snack for these patients?
  A) Sherbet
  B) Hot cocoa
  C) Potato chips
  D) French fries

 

 

14. Taste changes are a common complaint of cancer patients. What is the most common complaint voiced by cancer patients about their food?
  A) Salty
  B) Sweet
  C) Bitter
  D) Sour

 

 

15. Your radiation therapy patient has come to the clinic complaining of stomatitis. The patient asks you to make suggestions about the best foods to eat. What would be the best lunch for someone with stomatitis?
  A) Cottage cheese with canned fruit
  B) Vegetable beef soup
  C) Reuben sandwich (ham, cheese, and sauerkraut on pumpernickel bread)
  D) Pizza

 

 

16. Your HIV patient has developed lipodystrophy. What may lipodystrophy result in? (Mark all that apply.)
  A) Weight change
  B) Glucose intolerance
  C) Elevated cholesterol
  D) Social stigmatization
  E) Lowered triglycerides

 

 

17. Your patient at the HIV clinic has come in complaining of unintended weight loss with diarrhea lasting over the last month. How is the wasting syndrome in patients with acquired immunodeficiency syndrome (AIDS) defined?
  A) 5% of usual weight
  B) 10% of usual weight
  C) 15% of usual weight
  D) 20% of usual weight

 

 

18. The latest studies suggest that in HIV-associated wasting men tend to lose what?
  A) More lean body mass than fat tissue
  B) More fat than lean body mass
  C) Peripheral fat and retain core fat
  D) Core fat and retain peripheral fat

 

 

19. Parenteral nutrition (PN) use in AIDS patients is reserved for those patients with nonfunctioning GI tracts. It has been suggested that consuming ____________ formulas orally may be just as effective, with none of the risk, for preventing weight loss in patients with severe malnutrition.
  A) Standard
  B) Fiber added
  C) Hydrolyzed
  D) Protein added

 

 

20. A patient with HIV disease asks you for some general nutritional guidelines. Which of the following is an appropriate response?
  A) “Avoid high-protein supplements.”
  B) “It is not necessary to increase fat in your diet.”
  C) “Try to eat only three times a day.”
  D) “Be sure to take a multivitamin and mineral tablet with extra iron at least four times a day.”

 

 

21. You are teaching nutrition guidelines to a group of newly diagnosed HIV/AIDS patients. What tip would you give them to eat a healthier diet?
  A) Drink sweetened beverages and foods high in added sugar.
  B) Eat at least 2 cups per day of a variety of fruits and vegetables.
  C) Eat a diet rich in whole grains, vegetables, fruits, and legumes with lean sources of protein.
  D) Avoid foods high in monounsaturated fat.

 

 

22. You are the clinic nurse doing patient teaching with a 21-year-old female who has a diagnosis of HIV/AIDS. She is asymptomatic at this point and wants to know how much she should raise her caloric intake to maintain her weight. What would be your best response?
  A) “You should increase your caloric intake by 5%.”
  B) “You should increase your caloric intake by 10%.”
  C) “You should increase your caloric intake by 15%.”
  D) “You should increase your caloric intake by 20%.”

 

 

23. Saquinavir (Invirase) may be prescribed for the HIV/AIDS patient. What would be important to teach the patient about this drug?
  A) Avoid alcohol.
  B) Do not take it with high-fat meal.
  C) There are fewer side effects if taken with food.
  D) Take it within 2 hours of a high-calorie, high-fat meal.

 

 

24. As HIV/AIDS progresses, patients’ quality of life becomes more and more important. How can quality of life be greatly improved for an HIV/AIDS patient?
  A) By healing mouth sores
  B) By improving a poor appetite
  C) By correcting malabsorption
  D) By decreasing episodes of fever

 

 

25. You are the clinic nurse teaching a group of HIV/AIDS patients about their disease process. You are discussing nutrition-related problems and how to control them. Which of the following are recommended for people with diarrhea? (Mark all that apply.)
  A) Limiting food intake
  B) Increasing fluid intake
  C) Avoiding lactose
  D) Increasing intake of foods rich in pectin
  E) Drink liquids that are either hot or cold

 

 

26. You are the nurse caring for a 51-year old-female with breast cancer who is on a regular diet. She is to have a mastectomy the following day and you are doing patient teaching. What strategy would you teach this patient to increase her protein and calorie intake to promote healing after surgery?
  A) Consume high-fiber, low-fat nutritional supplements.
  B) Eat less food.
  C) Take protein supplements and eat low-fat, low-calorie meals.
  D) Eat food that has been modified to be more protein- and calorie-dense.

 

 

27. You are teaching a nutrition class for nursing students about palliative nutrition therapy. The goals of palliative nutrition therapy are providing comfort and relieving side effects. How can these goals be met?
  A) Encourage the patient to follow the primary caregiver’s ordered diet.
  B) Provide mouth care when the patient asks for it.
  C) Offer comfort foods if the patient becomes anxious or fearful.
  D) Respect the client’s wishes regarding the level of nutritional support desired.

 

 

28. Immunotherapy is used to treat cancer patients by enhancing their immune system. What nutritional imbalances can be caused by immunotherapy?
  A) Hypernatremia
  B) Hypokalemia
  C) Hyperabsorption
  D) Hypoproteinemia

 

 

29. You are admitting a 42-year-old male with metastatic lung cancer to your unit. He tells you that food tastes bitter to him. What causes this?
  A) Radiation therapy to the chest
  B) A decreased threshold for urea
  C) Metallic eating utensils
  D) An increased threshold for sucrose

 

 

30. You are doing patient teaching with a cancer patient who is going to have colon resection. The patient asks you what the differences in the diet will be after the surgery. What would be the best response for this patient?
  A) You will have to be fed with central parenteral nutrition because your gut is not functioning.
  B) You will have to eat less protein and fewer calories per day after you start eating again.
  C) You will have a clear liquid diet starting the day after surgery.
  D) You will be given a special diet of a high-fiber, low-calorie enteral supplement.

 

 

31. You are admitting a patient to your unit with a diagnosis of lung cancer. This patient is undergoing a partial lobectomy followed by chemotherapy The patient is a 55-year-old male who weighs 125 pounds. What is the approximate protein and calorie intake per day for this patient?
  A) 85 g/day of protein; 2,000 cal/day
  B) 70 g/day of protein; 1,800 cal/day
  C) 60 g/day of protein; 1,500 cal/day
  D) 50 g/day of protein; 1,200 cal/day

 

 

32. You are doing nutrition teaching with a 63-year-old woman who has just been diagnosed with ovarian cancer. She has been admitted for radiation therapy prior to surgery. She weighs 130 pounds. Approximately how much protein and how many calories a day should this patient have in her diet?
  A) 75 g/protein/day; 2,320 cal/day
  B) 71 g/protein/day; 2,068 cal/day
  C) 66 g/protein/day; 1,855cal/day
  D) 61 g/protein/day; 1,575 cal/day

 

 

33. HIV/AIDS patients are already in an immune-compromised state so they have to be especially careful about foodborne illnesses. What strategies can you teach your HIV/AIDS patients to help them avoid contracting a foodborne illness? (Mark all that apply.)
  A) “Refrigerate foods immediately after purchase.”
  B) “Discard leftovers after 5 days.”
  C) “Avoid salad bars and buffets when eating out.”
  D) “Thaw food in the microwave, never at room temperature.”
  E) “Keep hot foods >140º F and cold food <40º F.”

 

 

34. You are caring for a patient who has a diagnosis of pancreatic cancer and is considering hospice care. She asks you what to look for, from a nutrition stand point, when making a decision. What advice could you give her?
  A) Look for a hospice program that tells the patient what to do and when.
  B) Look for a hospice program that tells the patient what level of nutritional support they will have.
  C) Look for a hospice program that uses a team approach that includes physician, dietitian, and nurse.
  D) Look for a hospice program that serves soft food only.

 

 

35. You are discussing weight loss and wasting with a local group of cancer patients. After the program, a member of the audience asks to speak with you. He asks what the difference is between weight loss and wasting in cancer and the weight loss and wasting that occurs in AIDS. What would be your best response?
  A) In cancer wasting, you can take medications to stimulate your appetite.
  B) Cancer wasting is almost impossible to reverse.
  C) Wasting in AIDS includes either fever, diarrhea, or weakness lasting >30 days.
  D) AIDS wasting begins gender specific.

 

 

 

Answer Key

 

1. A
2. A, B, D
3. A
4. B
5. D
6. A
7. B, C, D
8. A
9. A
10. C
11. C
12. D
13. A
14. C
15. A
16. B, C, D
17. B
18. A
19. C
20. B
21. C
22. B
23. D
24. C
25. B, C, D
26. D
27. D
28. D
29. B
30. A
31. A
32. B
33. A, C, E
34. C
35. C

Chapter 12, Nutrition for Infants, Children, and Adolescents

1. At each well-child visit an infant is weighed and measured and the results are plotted on a growth chart. What is this monitoring an indication of?
  A) Being breastfed
  B) Adequacy of intake
  C) Maternal–infant bonding
  D) Good parenting skills

 

 

2. When are infants developmentally ready for the introduction of solid foods?
  A) 2 to 3 months
  B) 4 to 6 months
  C) 6 to 9 months
  D) 9 to 12 months

 

 

3. At what age does The American Academy of Pediatrics recommend that juices be introduced into the diets of infants?
  A) Not before 1 month of age
  B) Not before 3 months of age
  C) Not before 6 months of age
  D) Not before 9 months of age

 

 

4. Nutrient deficiencies in young children are generally not a health risk. However, young children who drink too much milk are at risk for what?
  A) Iron deficiency anemia
  B) Hypercalcemia
  C) Hypervitaminosis A
  D) Protein deficiency

 

 

5. John is a 6-month-old infant. What is the recommendation for the first solid food that should be introduced into his diet?
  A) Infant vegetables
  B) Infant rice cereal
  C) Strained infant fruits
  D) Non-citrus fruit juices

 

 

6. Whole milk is added to the diet of infants, just like other foods are added to their diet. By what age does whole milk become a major source of nutrients for the child?
  A) 6 months
  B) 9 months
  C) 12 months
  D) 2 years

 

 

7. Physiologically and developmentally an infant will indicate when it is ready and able to have solid foods added to his diet. What indication in an infant would tell you that he is ready to progress to solid foods?
  A) When the infant can sit with support
  B) The eruption of teeth
  C) The ability to self-feed
  D) When the infant can turn the head

 

 

8. Infants can be either breastfed or formula fed. What would an infant who is formula fed be at risk for?
  A) Underfeeding
  B) Overfeeding
  C) Dehydration
  D) Iron overload

 

 

9. Infants who are formula fed do not need added dietary supplements. What do breastfed infants, ranging in age from birth to 1 year, need supplemented?
  A) Vitamin D
  B) Vitamin A
  C) Calcium
  D) Vitamin B12

 

 

10. A young child, until the age of 4, is at risk of choking. To decrease this risk, what should young children not be given?
  A) Cubes of cheese
  B) Noodles
  C) Soda crackers
  D) Grapes

 

 

11. The Dietary Guidelines for Americans recommend a heart-healthy diet. What ages are these recommendations for?
  A) 1 year to adult
  B) 2 years to adult
  C) 5 years to adult
  D) 10 years to adult

 

 

12. As children grow, they generally consume more calories, decide if they want to eat, and how much they want to eat. What is the rule-of-thumb guideline to determine an age-appropriate serving size for a 3-year-old?
  A) 3 teaspoons
  B) 2 tablespoons
  C) 3 tablespoons
  D) Equal to that of an adult

 

 

13. Your 6-year-old has just come in from school and wants a snack. You are trying to maintain a heart-healthy diet for him by following the Dietary Guidelines for Americans. What would be the best snack you could give him?
  A) Peanut butter on crackers
  B) Low-salt potato chips
  C) Ice cream
  D) Cheese-flavored popcorn

 

 

14. School-aged children do not generally make food choices that meet the recommendations of all the food groups. This means that some foods are eaten in inadequate amounts. Which foods are these?
  A) Meat, vegetables, and fats
  B) Meat and grains
  C) Fruits, grains, and dairy
  D) Vegetables and grains

 

 

15. Sometimes children do not want to eat when you want them to. What strategies could be used to get a child to eat. (Mark all that apply.)
  A) Eating with the child
  B) Limiting snacks
  C) Offering one food group at a time
  D) Spacing meal times further apart
  E) Giving them only what they like

 

 

16. There are commercial formulas made specifically for infants born with inborn errors of metabolism. For which of the following is there a special commercial formula?
  A) Constipation
  B) Corn syrup urine disease
  C) Phenylketonuria
  D) Cystic fibrosis

 

 

17. The risk of nutritional and health problems is present in all age groups. What is a nutritional risk of adolescence?
  A) Vitamin A deficiency
  B) Sodium deficiency
  C) Vitamin D deficiency
  D) Protein deficiency

 

 

18. Food allergies in children can be both frightening and dangerous. Which food is most likely to cause an allergy in children?
  A) Rice
  B) Soy
  C) Corn oil
  D) Tomatoes

 

 

19. When safely introducing new foods into an infant’s diet, you should introduce one food at a time in a simple form. What period of time should you wait between introducing new foods so that allergic reactions can be easily identified?
  A) 2 to 3 days
  B) 5 to 7 days
  C) 7 to 14 days
  D) 3 weeks

 

 

20. Your client has a 6-month-old infant. It is part of the infant’s bedtime routine to get a bottle of warm milk when he goes down for the night. What is this infant at risk for?
  A) Consuming too many calories
  B) Developing diabetes later in life
  C) Nursing bottle caries
  D) Gastric reflux

 

 

21. You have an active 15-year-old boy at your house. To maintain his weight, how many calories may he need per day?
  A) 2,000 calories
  B) 3,000 calories
  C) 4,000 calories
  D) 5,000 calories

 

 

22. In children, breakfast skipping is an everyday occurrence for 8% to 15% of children ages 6 years to 13 years. What have studies suggested about skipping breakfast?
  A) It adversely affects cognition and learning.
  B) It is correlated with obesity.
  C) It promotes high cholesterol levels.
  D) It tends to stop when the children become adolescents.

 

 

23. Parental support for a more healthful lifestyle is vital to children. Parents also recognize that setting a good example for their children is important. Why do some parents who are overweight feel they cannot set a good example in diet and nutrition for their children?
  A) They do not practice what they preach.
  B) They feel their children are not motivated.
  C) They feel their children eat fast food too often.
  D) They feel that their children do not listen to them.

 

 

24. Calcium deficiency is a nutrition risk for adolescents. What is a contributing factor to the risk for calcium deficiency in adolescents?
  A) An increased intake of fast foods
  B) Iron deficiency
  C) The adolescent growth spurt
  D) The substitution of soft drinks for milk

 

 

25. Your 15-year-old daughter is not very active. You know that she may need fewer than how many calories a day to keep from gaining weight?
  A) 2,000 calories
  B) 900 calories
  C) 1,200 calories
  D) 1,500 calories

 

 

26. You are doing client education for a 21-year-old pregnant woman in the clinic. She asks you why breastfeeding is so highly recommended. What would be your best response?
  A) Breast milk is specifically designed to support optimal growth and development in the newborn and its composition makes it uniquely superior for infant feeding.
  B) The American Academy of Pediatrics recommends exclusive breastfeeding for the first 6 months of life.
  C) Research in developed and developing countries shows that breastfeeding decreases the incidence and/or severity of infectious diseases.
  D) You will get down to your prepregnancy weight much faster if you breastfeed your baby.

 

 

27. You are discussing infant weight gain with a group of first-time moms at the clinic. One of the mothers asks you why her baby gets weighed and measured so often. What would be your best answer?
  A) The caregiver wants to make sure the baby is growing fast enough.
  B) The caregiver uses the weight for height comparison to know if your baby is getting enough to eat.
  C) The caregiver wants to make sure the baby is gaining weight.
  D) The caregiver uses the weight for height comparison to know if your baby is growing proportionately.

 

 

28. Which lunch is best for a 10-year-old who is active?
  A) 6 oz. of chicken noodle soup; 6 saltine crackers with 2 tablespoons of butter;  cup of ice cream; 12 oz. of diet soda
  B) 3 oz. of hamburger; lettuce leaf; tomato slice; 1 slice of onion; 1 oz. of processed cheese; 1 hamburger bun; 6 oz. of French fries; 1 8-oz. strawberry milkshake
  C) 6 chicken nuggets;  cup of ketchup; 4 oz. cup of applesauce; 1 4″ slice of pumpkin pie with whipped cream
  D) 3 oz. of tuna on whole-wheat bread; 1 medium apple; 8 oz. of 2% milk

 

 

29. Your infant is 6 months old. What feeding skills would you expect your infant to have developed?
  A) Pincer-grasp
  B) Ability to grasp
  C) Eats with fingers
  D) Uses spoon

 

 

30. You are discussing nutrition and diet for children with the local Parent-Teacher Organization. One couple asks about the approximate caloric intake for an active 7-year-old. You ascertain that the child is 7 years, 5 months old; weighs 65 pounds; and is 52 inches tall. What would be the best answer regarding caloric intake per day for this child?
  A) Approximately 1500 calories/day
  B) Approximately 1800 calories/day
  C) Approximately 2100 calories/day
  D) Approximately 2500 calories/day

 

 

31. Most children do not follow the “ideal” of eating breakfast, dinner, and a snack at home along with a healthy brown-bag lunch at school. How do many children eat today? (Mark all that apply.)
  A) Obtain a significant portion of their calories from sweetened beverages.
  B) Eat less protein than meets their needs.
  C) Get one third of their calories from snacks
  D) Eat at least 2 heart-healthy meals/day
  E) Skip breakfast

 

 

32. One of the students in your nutrition class is giving a report on “Adolescent Obesity.” One of the topics in the report is health risks increased by obesity. What health risk would you expect to be included in the report?
  A) Hypercalcemia
  B) Type I diabetes
  C) Hypercholesterolemia
  D) Metabolic syndrome

 

 

33. You are lecturing to a class of nursing students about nutrition in children. You give the students an assignment to plan a heart healthy diet for an 8-year-old. Which of the following would be the best breakfast?
  A) 2 fried eggs; 2 pieces of white toast with 3 teaspoons of butter; 2 pieces of bacon; and 8 oz. of orange juice.
  B) 2 pieces of French toast;  cup of maple syrup; and 6 oz. of grape juice.
  C) 1 cup of oatmeal; 8 oz. of 2% milk; and 1 piece of wheat toast with 1 teaspoon of butter.
  D) 1 pkg. of toaster pastries; and 1 glass of apple juice.

 

 

34. You are doing client teaching for a new mother who is formula feeding her infant. The client asks about the nutritional value of formula. What would be your best response?
  A) Formulas made in the United States have lower nutritional values than are contained in breast milk.
  B) Formulas made in the United States need to be supplemented with iron.
  C) Formulas made in the United States have minimum nutrient requirements that are more than the nutrient amount provided in breast milk.
  D) Formulas made in the United States have the same nutrient value as breast milk.

 

 

35. The parents of a 9-month-old infant ask you how to prevent obesity in their child. What would be the best age-appropriate response to their question?
  A) Infants should be allowed to self-regulate the amount of food they eat.
  B) Infants should be fed 8 oz. of formula per month of age.
  C) Infants should be fed according to the recommendations of the MyPyramid food plan.
  D) Infants should be fed according to what your family tells you.

 

 

 

Answer Key

 

1. B
2. B
3. C
4. A
5. B
6. C
7. B
8. B
9. A
10. D
11. B
12. C
13. A
14. C
15. A, B, D
16. C
17. A
18. B
19. B
20. C
21. C
22. A
23. A
24. D
25. A
26. A
27. B
28. D
29. B
30. C
31. A, C, E
32. D
33. C
34. C
35. A

Chapter 22, Nutrition for Patients With Cancer or HIV-AIDS

1. Cancer cachexia is a progressive wasting syndrome that is:
  A) Estimated to cause 20% to 40% of cancer deaths
  B) Correlated with the size of the tumor: the bigger the tumor, the more severe the cachexia
  C) Directly related to calorie intake: the fewer the calories consumed, the more severe the cachexia
  D) Most commonly seen developing in clients with breast cancer or sarcoma

 

 

2. Alterations in body metabolism occur in patients with all types of cancers. What are these metabolic alterations? (Mark all that apply.)
  A) Hyperglycemia
  B) Hyperlipidemia
  C) Lowered basal metabolic rate
  D) Fluid and electrolyte abnormalities
  E) Increased protein sparing

 

 

3. Patients who undergo radiation therapy to the head and neck are at risk for several complications. What is the most likely complication of radiation to the head and neck?
  A) Difficulty chewing and swallowing
  B) Nausea and vomiting
  C) Chronic blood loss
  D) Malabsorption

 

 

4. Patients who receive radiation to the lower neck or midchest are at risk for several complications. What complication is most common?
  A) Mouth blindness
  B) Esophagitis with dysphagia
  C) Dumping syndrome
  D) Chronic blood loss

 

 

5. A 52-year old-male is admitted to your unit with fatigue, weight loss, and malaise. The patient has lost >10% of his body weight over the past six months. The physician notes that the patient has generalized malabsorption and altered insulin secretion. What are these potential complications of?
  A) Cancer of the stomach
  B) Cancer of the gallbladder
  C) Cancer of the small bowel
  D) Cancer of the pancreas

 

 

6. Your patient is scheduled for chemotherapy in one hour. Which of the following would best be avoided before and after chemotherapy?
  A) Coffee
  B) Skim milk
  C) Sherbet
  D) Apple juice

 

 

7. A patient undergoing radiation therapy has developed anorexia. What interventions may help improve the patient’s appetite? (Mark all that apply.)
  A) Small amounts of alcohol
  B) Small amounts of coffee
  C) Light exercise
  D) Avoiding strong odors
  E) Drink liquids with meals

 

 

8. You are doing discharge teaching with a patient who has a diagnosis of colon cancer, stage 4. Your patient asks if there is anything that he can do for the fatigue he feels. What would be your best response?
  A) You should eat a big breakfast.
  B) You should limit physical activity.
  C) You should limit fluids.
  D) You should drink caffeinated beverages.

 

 

9. The patient is in the clinic after being diagnosed with HIV. He asks what vitamin and mineral supplements are recommended to improve his nutritional status. What would be your best response?
  A) Multivitamin and mineral supplements are usually recommended at levels of 100% to 200% of the dietary reference intake (DRI).
  B) Supplements of vitamin A, zinc, and iron are especially beneficial for HIV patients.
  C) Vitamin and mineral supplements are not recommended for HIV patients.
  D) Your blood work shows that you are hypokalemic so you do not need potassium.

 

 

10. Your patient complains of a metallic taste in her mouth. What would be the best recommendation?
  A) Eat small, frequent meals.
  B) Brush your teeth before eating.
  C) Use plastic utensils.
  D) Experiment with tart foods.

 

 

11. The dietician has recommended that your patient’s diet be changed from regular to nutrient dense. What is the most nutrient-dense snack for someone with a dry mouth?
  A) A peanut butter sandwich
  B) A cherry popsicle
  C) Boost or Ensure
  D) Hard cheese with crackers

 

 

12. Your patient’s diet has just been changed to a protein-dense diet. She asks you how she can increase the protein density of her diet. What would be the best response?
  A) Using honey on toast and cereal
  B) Substituting mayonnaise for salad dressing
  C) Adding whipped cream to coffee and tea
  D) Melting cheese on sandwiches and vegetables

 

 

13. You are speaking to a group of cancer patients who are undergoing chemotherapy. What would you recommend as a snack for these patients?
  A) Sherbet
  B) Hot cocoa
  C) Potato chips
  D) French fries

 

 

14. Taste changes are a common complaint of cancer patients. What is the most common complaint voiced by cancer patients about their food?
  A) Salty
  B) Sweet
  C) Bitter
  D) Sour

 

 

15. Your radiation therapy patient has come to the clinic complaining of stomatitis. The patient asks you to make suggestions about the best foods to eat. What would be the best lunch for someone with stomatitis?
  A) Cottage cheese with canned fruit
  B) Vegetable beef soup
  C) Reuben sandwich (ham, cheese, and sauerkraut on pumpernickel bread)
  D) Pizza

 

 

16. Your HIV patient has developed lipodystrophy. What may lipodystrophy result in? (Mark all that apply.)
  A) Weight change
  B) Glucose intolerance
  C) Elevated cholesterol
  D) Social stigmatization
  E) Lowered triglycerides

 

 

17. Your patient at the HIV clinic has come in complaining of unintended weight loss with diarrhea lasting over the last month. How is the wasting syndrome in patients with acquired immunodeficiency syndrome (AIDS) defined?
  A) 5% of usual weight
  B) 10% of usual weight
  C) 15% of usual weight
  D) 20% of usual weight

 

 

18. The latest studies suggest that in HIV-associated wasting men tend to lose what?
  A) More lean body mass than fat tissue
  B) More fat than lean body mass
  C) Peripheral fat and retain core fat
  D) Core fat and retain peripheral fat

 

 

19. Parenteral nutrition (PN) use in AIDS patients is reserved for those patients with nonfunctioning GI tracts. It has been suggested that consuming ____________ formulas orally may be just as effective, with none of the risk, for preventing weight loss in patients with severe malnutrition.
  A) Standard
  B) Fiber added
  C) Hydrolyzed
  D) Protein added

 

 

20. A patient with HIV disease asks you for some general nutritional guidelines. Which of the following is an appropriate response?
  A) “Avoid high-protein supplements.”
  B) “It is not necessary to increase fat in your diet.”
  C) “Try to eat only three times a day.”
  D) “Be sure to take a multivitamin and mineral tablet with extra iron at least four times a day.”

 

 

21. You are teaching nutrition guidelines to a group of newly diagnosed HIV/AIDS patients. What tip would you give them to eat a healthier diet?
  A) Drink sweetened beverages and foods high in added sugar.
  B) Eat at least 2 cups per day of a variety of fruits and vegetables.
  C) Eat a diet rich in whole grains, vegetables, fruits, and legumes with lean sources of protein.
  D) Avoid foods high in monounsaturated fat.

 

 

22. You are the clinic nurse doing patient teaching with a 21-year-old female who has a diagnosis of HIV/AIDS. She is asymptomatic at this point and wants to know how much she should raise her caloric intake to maintain her weight. What would be your best response?
  A) “You should increase your caloric intake by 5%.”
  B) “You should increase your caloric intake by 10%.”
  C) “You should increase your caloric intake by 15%.”
  D) “You should increase your caloric intake by 20%.”

 

 

23. Saquinavir (Invirase) may be prescribed for the HIV/AIDS patient. What would be important to teach the patient about this drug?
  A) Avoid alcohol.
  B) Do not take it with high-fat meal.
  C) There are fewer side effects if taken with food.
  D) Take it within 2 hours of a high-calorie, high-fat meal.

 

 

24. As HIV/AIDS progresses, patients’ quality of life becomes more and more important. How can quality of life be greatly improved for an HIV/AIDS patient?
  A) By healing mouth sores
  B) By improving a poor appetite
  C) By correcting malabsorption
  D) By decreasing episodes of fever

 

 

25. You are the clinic nurse teaching a group of HIV/AIDS patients about their disease process. You are discussing nutrition-related problems and how to control them. Which of the following are recommended for people with diarrhea? (Mark all that apply.)
  A) Limiting food intake
  B) Increasing fluid intake
  C) Avoiding lactose
  D) Increasing intake of foods rich in pectin
  E) Drink liquids that are either hot or cold

 

 

26. You are the nurse caring for a 51-year old-female with breast cancer who is on a regular diet. She is to have a mastectomy the following day and you are doing patient teaching. What strategy would you teach this patient to increase her protein and calorie intake to promote healing after surgery?
  A) Consume high-fiber, low-fat nutritional supplements.
  B) Eat less food.
  C) Take protein supplements and eat low-fat, low-calorie meals.
  D) Eat food that has been modified to be more protein- and calorie-dense.

 

 

27. You are teaching a nutrition class for nursing students about palliative nutrition therapy. The goals of palliative nutrition therapy are providing comfort and relieving side effects. How can these goals be met?
  A) Encourage the patient to follow the primary caregiver’s ordered diet.
  B) Provide mouth care when the patient asks for it.
  C) Offer comfort foods if the patient becomes anxious or fearful.
  D) Respect the client’s wishes regarding the level of nutritional support desired.

 

 

28. Immunotherapy is used to treat cancer patients by enhancing their immune system. What nutritional imbalances can be caused by immunotherapy?
  A) Hypernatremia
  B) Hypokalemia
  C) Hyperabsorption
  D) Hypoproteinemia

 

 

29. You are admitting a 42-year-old male with metastatic lung cancer to your unit. He tells you that food tastes bitter to him. What causes this?
  A) Radiation therapy to the chest
  B) A decreased threshold for urea
  C) Metallic eating utensils
  D) An increased threshold for sucrose

 

 

30. You are doing patient teaching with a cancer patient who is going to have colon resection. The patient asks you what the differences in the diet will be after the surgery. What would be the best response for this patient?
  A) You will have to be fed with central parenteral nutrition because your gut is not functioning.
  B) You will have to eat less protein and fewer calories per day after you start eating again.
  C) You will have a clear liquid diet starting the day after surgery.
  D) You will be given a special diet of a high-fiber, low-calorie enteral supplement.

 

 

31. You are admitting a patient to your unit with a diagnosis of lung cancer. This patient is undergoing a partial lobectomy followed by chemotherapy The patient is a 55-year-old male who weighs 125 pounds. What is the approximate protein and calorie intake per day for this patient?
  A) 85 g/day of protein; 2,000 cal/day
  B) 70 g/day of protein; 1,800 cal/day
  C) 60 g/day of protein; 1,500 cal/day
  D) 50 g/day of protein; 1,200 cal/day

 

 

32. You are doing nutrition teaching with a 63-year-old woman who has just been diagnosed with ovarian cancer. She has been admitted for radiation therapy prior to surgery. She weighs 130 pounds. Approximately how much protein and how many calories a day should this patient have in her diet?
  A) 75 g/protein/day; 2,320 cal/day
  B) 71 g/protein/day; 2,068 cal/day
  C) 66 g/protein/day; 1,855cal/day
  D) 61 g/protein/day; 1,575 cal/day

 

 

33. HIV/AIDS patients are already in an immune-compromised state so they have to be especially careful about foodborne illnesses. What strategies can you teach your HIV/AIDS patients to help them avoid contracting a foodborne illness? (Mark all that apply.)
  A) “Refrigerate foods immediately after purchase.”
  B) “Discard leftovers after 5 days.”
  C) “Avoid salad bars and buffets when eating out.”
  D) “Thaw food in the microwave, never at room temperature.”
  E) “Keep hot foods >140º F and cold food <40º F.”

 

 

34. You are caring for a patient who has a diagnosis of pancreatic cancer and is considering hospice care. She asks you what to look for, from a nutrition stand point, when making a decision. What advice could you give her?
  A) Look for a hospice program that tells the patient what to do and when.
  B) Look for a hospice program that tells the patient what level of nutritional support they will have.
  C) Look for a hospice program that uses a team approach that includes physician, dietitian, and nurse.
  D) Look for a hospice program that serves soft food only.

 

 

35. You are discussing weight loss and wasting with a local group of cancer patients. After the program, a member of the audience asks to speak with you. He asks what the difference is between weight loss and wasting in cancer and the weight loss and wasting that occurs in AIDS. What would be your best response?
  A) In cancer wasting, you can take medications to stimulate your appetite.
  B) Cancer wasting is almost impossible to reverse.
  C) Wasting in AIDS includes either fever, diarrhea, or weakness lasting >30 days.
  D) AIDS wasting begins gender specific.

 

 

 

Answer Key

 

1. A
2. A, B, D
3. A
4. B
5. D
6. A
7. B, C, D
8. A
9. A
10. C
11. C
12. D
13. A
14. C
15. A
16. B, C, D
17. B
18. A
19. C
20. B
21. C
22. B
23. D
24. C
25. B, C, D
26. D
27. D
28. D
29. B
30. A
31. A
32. B
33. A, C, E
34. C
35. C

 

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