In-depth nutrition interventions are provided by
a. nurses.
b. physicians.
c. nutrition therapists.
d. registered dietitians.
An example of a common cause of iatrogenic malnutrition is
a. scheduling of daily tests that prevents the patient from eating meals.
b. family members and friends bringing patients food from home.
c. small portion sizes of hospital food and absence of snacks.
d. errors in ordering and delivery of meals for hospital patients.
Noninvasive measurements of height, weight, circumferences, and skinfold thickness are known as _____ measurements.
a. objective
b. mechanical
c. biochemical
d. anthropometric
For adults who are unable to stand, height may be estimated by measuring
a. knee height.
b. stated height.
c. head circumference.
d. wrist circumference.
If a male patient weighs 140 pounds when he is admitted to a long-term care facility and weighs 147 pounds 2 months later, his percent weight change during his hospital stay is
a. 3.5%.
b. 5%.
c. 7%.
d. 14%.
If a patient weighed 150 lbs one month ago and now weights 140 lbs, their weight loss would be considered to be
a. insignificant.
b. mild.
c. moderate.
d. severe.
Rapid weight gain (>1 pound in a day) is probably caused by accumulation of
a. fluid.
b. feces.
c. body fat.
d. lean body mass.
A client with a BMI of 18 would be considered to be
a. underweight.
b. normal weight.
c. overweight.
d. severely overweight.
All hospitalized patients must be screened to determine whether they are at nutritional risk
a. if they report recent weight loss.
b. if their diagnosis is nutrition-related.
c. within 48 hours of hospital admission.
d. within 2 weeks of hospital admission.
Measurements of serum albumin level are used to determine
a. immune function.
b. visceral protein status.
c. somatic protein status.
d. adequacy of protein intake.
An enlarged thyroid gland may indicate a deficiency of
a. iron.
b. iodine.
c. folate.
d. vitamin B12.
If staff are concerned about whether a patient in an acute-care or long-term care facility is eating enough, they may conduct a
a. diet history.
b. kcalorie count.
c. 24-hour diet recall.
d. menu analysis.
A patient may be at high nutritional risk if he or she
a. is receiving a soft diet.
b. has a serum albumin level of 2.5 g/dL.
c. has been receiving a tube feeding for 1 week.
d. has gained 5 pounds during the previous month.
Clear liquid diets are appropriate for patients
a. who are unable to chew.
b. who are experiencing nausea.
c. who have difficulty swallowing.
d. during the first 24 hours after major surgery.
One advantage of a full liquid diet is that it
a. is low in saturated fat and high in fiber.
b. is suitable for patients with lactose intolerance.
c. is likely to be tolerated by patients with dysphagia.
d. provides more protein and kcals than a clear liquid diet.
Enteral feeding is preferred over parenteral nutrition whenever possible because enteral feeding
a. is more satisfying for the client.
b. allows the client to be ambulatory.
c. reduces the risk of foodborne illness.
d. maintains gut function and integrity.
Commercial enteral formula products are preferred over home-blended formulas because commercial products
a. have a better flavor and are more appealing to patients.
b. are synthetic and therefore do not require refrigeration.
c. are cheaper and are more likely to be covered by medical insurance programs.
d. have a more consistent composition and are less likely to be contaminated with bacteria.
A patient who has had a stroke and needs enteral feedings because they cannot chew or swallow but who has no other medical problems can be fed using a(n) _____ formula.
a. isotonic
b. modular
c. elemental
d. polymeric
Elemental formulas contain
a. partially or fully hydrolyzed nutrients.
b. the basic intact nutrients of an adequate diet.
c. elemental minerals in a readily bioavailable form.
d. single macronutrients such as glucose polymers, protein, or lipids.
Feeding tubes should be placed into the small intestine rather than the stomach if
a. the patient is comatose.
b. a regular polymeric formula is being used.
c. the patient prefers not to have a tube passing through his or her nose.
d. the patient is expected to resume oral feedings within 1 to 2 weeks.
A PEG tube is a
a. personal enteric gastrostomy tube.
b. permanent enteral gastric feeding tube.
c. percutaneous endoscopic placement of a gastrostomy.
d. polymeric enteral formula gastrointestinal delivery system.
Rapid infusion of hypertonic enteral formulas may cause
a. aspiration.
b. osmotic diarrhea.
c. weight gain.
d. high blood pressure.
Bolus enteral feedings are appropriate only when the feeding tube administers the formula into the
a. esophagus.
b. stomach.
c. duodenum.
d. jejunum.
To determine the nutritional adequacy of a tube feeding
a. the patient’s actual formula intake and body weight should be recorded daily.
b. intake and output records should be completed during each nursing shift.
c. urine glucose levels, gastric residuals, and bowel movements should be recorded.
d. anthropometric, biochemical, and clinical indexes should be assessed weekly.
To reduce the risk of aspiration, patients who are receiving enteral tube feedings should be positioned
a. sitting upright.
b. lying on their side.
c. with the head of the bed elevated 30 to 45 degrees.
d. with the head of the bed elevated 45 to 60 degrees.
The appropriate type of parenteral feeding for a patient who will need intravenous nutrition for several months or years is _____ nutrition.
a. central parenteral
b. peripheral venous
c. peripheral parenteral
d. intravenous parenteral
The form of carbohydrate used in parenteral nutrition is
a. glucose polymers.
b. dextrose polymers.
c. glucose monohydrate.
d. dextrose monohydrate.
Intravenous lipid emulsions are used as part of parenteral nutrition to prevent fatty acid deficiency and
a. increase patient satiety.
b. provide a source of fat-soluble vitamins.
c. add kcals without increasing osmolality.
d. add kcals with minimal expense.
In patients receiving parenteral nutrition, high blood glucose levels may be caused by
a. inadequate infusions of potassium.
b. rapid infusions of high levels of dextrose.
c. use of peripheral rather than central parenteral nutrition.
d. infusion of too much amino acid that is deaminated and converted to glucose.
During transitions from parenteral or enteral tube feedings to oral feedings, patients should be monitored to make sure that
a. they do not develop hypoglycemia.
b. total nutritional intake is adequate.
c. their weight does not increase rapidly.
d. they do not experience nausea and vomiting.
The adverse effects of malnutrition on the gastrointestinal tract result in
a. decreased absorption of fluids and electrolytes from food.
b. increased bacterial activity inside the gastrointestinal tract.
c. decreased transit time for food passing through the GI tract.
d. increased risk of spread of bacteria from the GI tract into the rest of the body.
The adverse effects of malnutrition on the skin may result in
a. excessive sweating.
b. slow wound healing.
c. increased hair growth.
d. reddening and soreness.
One of the most stressful physical traumas is
a. a fracture in a long bone.
b. a low-grade fever (<100° F). c. minor surgery requiring a general anesthetic. d. a burn that covers >40% of body surface area.
Glycogen stores are usually depleted after an individual fasts for _____ hours.
a. 2 to 4
b. 4 to 8
c. 8 to 12
d. 12 to 18
During the first few days of starvation, the brain obtains glucose that is produced from
a. glycogen via glycolysis.
b. fatty acids via lipogenesis.
c. amino acids via gluconeogenesis.
d. branched-chain amino acids via deamination.
After several days of starvation, the body tissues obtain more of their energy from
a. glucose.
b. glycogen.
c. amino acids.
d. ketone bodies.
During starvation, the body conserves energy by
a. decreasing metabolic rate.
b. shivering to create warmth.
c. sleeping for shorter periods of time.
d. sweating to reduce body temperature.
A major difference between starvation and stress is that metabolic rate _____ during starvation and _____ during stress.
a. increases; decreases
b. decreases; increases
c. is unaffected; increases
d. decreases; is unaffected
Major hallmarks of the ebb phase of stress are
a. hypothermia and lethargy.
b. nausea, vomiting, and diarrhea.
c. increased catabolism of macronutrients.
d. hyperthermia and increased nitrogen excretion.
Seventy-two hours after a major accident involving multiple broken bones, the patient would be expected to be in the _____ phase.
a. Critical
b. Stress
c. Ebb
d. Flow
Patients with poor nutritional status before surgery are at high risk for pneumonia or wound infections after surgery because
a. they are likely to lose more blood and body fluids during surgery.
b. they are likely to already have pneumonia or infections before surgery.
c. they have an increased prevalence of nausea and vomiting after surgery.
d. their nutrient stores may be inadequate to meet increased needs during recovery.
During severe stress, such as major burns over large areas of the body, protein needs may increase to as high as _____ g/kg body weight.
a. 1.2
b. 1.5
c. 2.0
d. 2.5
As patients age, their body composition changes, and their fluid needs during recovery
a. increase.
b. decrease.
c. do not change.
d. vary with the type of metabolic stress.
The amino acid that plays an important role in the gastrointestinal tract during stress is
a. arginine.
b. glutamine.
c. methionine.
d. phenylalanine.
During stress, giving patients extra insulin does not always decrease their high blood glucose levels because
a. the ratio of glucagon to insulin is increased.
b. the extra insulin stimulates glucose production.
c. the number of insulin receptors on cells decreases.
d. high blood glucose levels help protect the body against infection.
During stress and recovery, it is especially important that patients achieve adequate intakes of
a. iron, folate, and vitamin B12.
b. vitamin C, vitamin A, and zinc.
c. potassium, thiamine, and niacin.
d. vitamin K, vitamin D, and calcium.
The best way to determine energy needs of stressed patients is to use
a. indirect calorimetry.
b. the Ireton-Jones formula.
c. the Dietary Reference Intakes.
d. patient hunger and appetite cues.
The activity factor used to estimate energy requirements for patients prescribed bed rest is
a. 1.1.
b. 1.2.
c. 1.3.
d. 1.5.
If someone has a limited food budget and becomes malnourished because they only eat one small meal a day, they would have
a. primary malnutrition.
b. secondary malnutrition.
c. anorexia nervosa.
d. iatrogenic malnutrition.
If a patient has very low levels of serum visceral proteins and poor wound healing but does not look overtly malnourished, they are likely to have
a. hyperglycemia.
b. refeeding syndrome.
c. kwashiorkor.
d. marasmus.
For individuals with marasmus, overly aggressive repletion of nutrients may cause
a. dumping syndrome.
b. refeeding syndrome.
c. nausea and vomiting.
d. rapid increases in body fat.
During refeeding of a patient with protein-energy malnutrition, it is important to provide adequate amounts of
a. iron, folate, and vitamin B12.
b. vitamin C, vitamin A, and zinc.
c. calcium, vitamin D, and vitamin K.
d. phosphorus, potassium, and magnesium.
When refeeding patients with protein-energy malnutrition, it is important to limit intake of
a. fluid.
b. sodium.
c. potassium.
d. phosphorus.
Multiple organ dysfunction syndrome (MODS) usually results in
a. a hypermetabolic state.
b. a hypometabolic state.
c. marasmus.
d. kwashiorkor.
Patients with multiple organ dysfunction syndrome (MODS) benefit most from _____ feedings.
a. Oral
b. enteral
c. central parenteral
d. peripheral parenteral
After surgery, patients may resume oral intake when
a. they have bowel sounds.
b. their appetite returns.
c. they are able to sit upright.
d. their blood glucose level is normal.
Optimal recovery from surgery is promoted by
a. use of enteral tube feedings to supplement oral intake.
b. initiation of parenteral nutrition support immediately after surgery.
c. use of a clear liquid diet for at least 24 to 48 hours to reduce intestinal stress.
d. progression of the diet from liquids to solid foods as quickly as is reasonable.
A burn that destroys the entire epidermis, dermis, and underlying subcutaneous tissue is classified as a _____ burn.
a. first-degree
b. second-degree
c. third-degree
d. nonthermal
During the first 24 to 48 hours after a major burn, the focus of nutrition care is
a. provision of adequate protein.
b. prevention of nausea and vomiting.
c. replacement of fluids and electrolytes.
d. education concerning nutrient needs.
energy needs of burned patients are influenced by the
a. patient’s activity level.
b. patient’s emotional stress level.
c. percentage of total body surface area (TBSA) burned.
d. type of burn: thermal, chemical, electrical, or radioactive.
If an individual has a back problem and seeks treatment using acupuncture as well as a physician at a traditional spine clinic, this would be an example of using _____ medicine.
a. traditional
b. integrative
c. alternative
d. complementary
The merging of conventional therapies with established complementary and alternative medicine is known as _____ medicine.
a. alternative
b. integrative
c. naturopathic
d. homeopathic
Traditional Chinese medicine is based on balance and restoration of
a. natural immunity.
b. yin and yang forces.
c. natural healing forces.
d. body, mind, and spirit.
A macrobiotic diet may help support recovery of individuals with cancer when used along with conventional cancer treatments because it
a. is high in protein, minerals, and vitamins.
b. restricts intake of carcinogens and mutagens.
c. is low in fat and high in fiber and plant foods.
d. starves cancer cells while nourishing healthy cells.
To provide a nutritional “safety net,” patients may be encouraged to take a multivitamin/multimineral supplement that contains
a. specific nutrients which cannot be obtained from the food supply in adequate amounts.
b. 100% or less of the Dietary Reference Intakes (DRIs) for most micronutrients.
c. at least 100% of the DRIs for most micronutrients.
d. specific nutrients that are found to be lacking in their diet using dietary analysis.
The Dietary Supplement Health and Education Act (DSHEA) of 1994 considers dietary supplements to be
a. foods.
b. drugs.
c. nutrients.
d. food additives.
Dietary supplements are regulated by the
a. Centers for Disease Control and Prevention (CDC).
b. Environmental Protection Agency (EPA).
c. U.S. Food and Drug Administration (FDA).
d. U.S. Department of Agriculture (USDA).
Before a manufacturer can distribute a product that contains a new dietary ingredient, it must provide data that demonstrate
a. the safety and efficacy of the product.
b. that the product is distinct from other available products.
c. that the quality of the product can be maintained consistently.
d. that the product has been safely used by study subjects for at least 2 years.
Foods that contain physiologically active food components are called
a. probiotics.
b. functional foods.
c. dietary supplements.
d. complementary foods.
For patients who are taking prescription or over-the-counter drugs, herbal preparations
a. should all be avoided.
b. can be considered safe.
c. should be taken separately from drugs.
d. may cause dangerous herb-drug interactions.
Registered dietitians may encourage patients to use specific herbal supplements
a. that are less expensive than conventional medications.
b. that they have used themselves and found to be helpful.
c. that are approved by the U.S. Department of Agriculture (USDA).
d. for which efficacy and safety have been scientifically studied and documented.
Drug-drug or nutrient-drug interactions are likely to occur if the number of medications and/or supplements used by a patient is _____ or more.
a. 3
b. 5
c. 8
d. 10
Unintended effects of drugs are called
a. risks.
b. side effects.
c. secondary benefits.
d. complementary effects.
A patient should be discouraged from using Echinacea to help reduce the duration of colds if he or she is using
a. anticoagulant drugs to prevent formation of blood clots.
b. immunosuppressant drugs following an organ transplant.
c. oral contraceptives or hormone replacement therapy.
d. oral hypoglycemic agents for treatment of diabetes.
If a patient with depression takes a selective serotonin reuptake inhibitor (SSRI), the nurse may want to ask them about use of herbal products because of potential interactions if they are using
a. ginseng.
b. ginkgo biloba.
c. St. John’s wort.
d. evening primrose oil.
If a patient with arthritis develops iron-deficiency anemia, he or she should be asked about use of
a. alcoholic beverages.
b. stool softeners and laxatives.
c. caffeinated foods and beverages.
d. nonsteroidal antiinflammatory drugs.
Nurses should ask patients about their use of over-the-counter medications because
a. they may cause drug-drug or nutrient-drug interactions.
b. the medical staff has a legal responsibility to know what patients are using.
c. they may be able to advise patients about cheaper generic forms of drugs.
d. patients should not take prescription and over-the-counter drugs at the same time.
Most drug absorption occurs in the
a. esophagus.
b. stomach.
c. small intestine.
d. large intestine.
Compared with when a drug is taken on an empty stomach, if it is taken with food it will be
a. excreted more slowly.
b. excreted more quickly.
c. absorbed more slowly.
d. absorbed more quickly.
Drugs used to lower serum cholesterol levels may decrease absorption of
a. minerals.
b. amino acids.
c. fat-soluble vitamins.
d. water-soluble vitamins.
Older adults may be at risk for potassium depletion if they use both
a. certain diuretics and laxatives.
b. decongestants and antihistamines.
c. beta blockers and cholesterol-lowering drugs.
d. antacids and nonsteroidal antiinflammatory drugs.
If a patient is taking a drug that causes nausea, he or she may be advised to
a. drink liquids only.
b. eat only starchy and bland foods.
c. eat spicy foods to stimulate the appetite.
d. drink liquids between rather than with meals.
If a patient is taking a drug that causes dry mouth, he or she may be advised to
a. choose soft, moist foods.
b. use mouthwash between meals.
c. drink liquids only until the problem resolves.
d. choose dry foods to stimulate saliva production.
A meal that should not be eaten by a patient who takes a monoamine oxidase inhibitor (MAOI) is
a. vegetable omelet with grapefruit juice.
b. salami and parmesan cheese sandwich.
c. split pea and ham soup with crackers.
d. beef and vegetable stir fry with rice.
If a patient uses a monoamine oxidase inhibitor (MAOI) and they develop a headache, heart palpitations, and high blood pressure, they may have eaten food containing
a. caffeine.
b. licorice.
c. alcohol.
d. tyramine.
A fruit juice that may increase the bioavailability of certain drugs and may have serious consequences is _____ juice.
a. orange
b. cranberry
c. pineapple
d. grapefruit
Individuals who are taking the anticoagulant warfarin to prevent formation of blood clots should limit their intake of foods high in vitamin
a. A.
b. K.
c. B12.
d. D.
When administering medications to patients receiving tube feedings, to ensure that the correct form of the medication is used and that it is compatible with the enteral formula, the best person to consult is the
a. physician.
b. pharmacist.
c. registered nurse.
d. registered dietitian.
When administering medications to tube-fed patients, crushed medications should be mixed with
a. water.
b. fruit juice.
c. diluted enteral formula.
d. full-strength enteral formula.
Health care providers need to ask specific questions to find out about patients’ use of herbal products because
a. many individuals do not consider these to be drugs or supplements.
b. patients may not be aware of the ingredients in supplements that they take.
c. patients may be spending unnecessary money on products that have no efficacy.
d. patients generally do not want medical staff to know that they use herbal products.
The purpose of diet therapy for patients with dysphagia is to avoid
a. sepsis.
b. reflux.
c. vomiting.
d. aspiration.
The three stages of swallowing are the _____ phases.
a. early, middle, and late
b. oral, laryngeal, and epiglottal
c. bolus, pharyngeal, and posterior
d. oral, pharyngeal, and esophageal
If a patient has difficulty swallowing, the best position for meals is
a. lying flat.
b. sitting upright.
c. lying on one side.
d. leaning backward slightly.
A nurse may suspect that a patient has difficulty swallowing if he or she
a. requests frequent snacks between meals.
b. coughs frequently before and after swallowing.
c. prefers to drink using a straw rather than from an open cup.
d. tends to gulp beverages and eat foods without adequate chewing.
If it is left untreated, gastroesophageal reflux disease (GERD) may lead to
a. esophagitis.
b. hiatal hernia.
c. peptic ulcer disease.
d. dumping syndrome.
An example of a meal that is likely to relax the lower esophageal sphincter and allow gastroesophageal reflux is
a. pasta with marinara sauce and sourdough bread.
b. ham with rice pilaf.
c. fried chicken and pasta salad.
d. chicken and spinach tortilla wrap with spicy salsa.
A patient has a higher risk of peptic ulcer disease (PUD) if they are a chronic user of
a. certain antibiotics.
b. laxatives and stool softeners.
c. magnesium-aluminum antacids.
d. nonsteroidal antiinflammatory drugs.
Nutrition therapy for peptic ulcers should be individualized, but most patients should
a. eat a diet high in fiber.
b. eat a diet low in fat.
c. avoid sources of caffeine.
d. drink several glasses of milk daily.
Patients who have undergone total or partial gastrectomy may experience
a. esophagitis.
b. lactose intolerance.
c. peptic ulcer disease.
d. dumping syndrome.
Nutrition therapy for dumping syndrome includes
a. drinking thickened liquids and increasing protein intake.
b. avoiding caffeinated beverages and decreasing fat intake.
c. avoiding snacks between meals and increasing intake of high-calcium foods.
d. drinking liquids between meals and limiting intake of simple carbohydrates.
Patients with celiac disease should avoid foods that contain
a. rice, soy, and peanuts.
b. maize, corn, and flax.
c. wheat, rye, and barley.
d. rice, quinoa, and millet.
An example of a meal that may contain gluten is
a. baked chicken breast with rice.
b. pork chop with sweet potatoes.
c. grilled steak with baked potato.
d. meatloaf with mashed potatoes.
Individuals with lactose intolerance may tolerate foods that contain small amounts of lactose if they are
a. consumed with other foods.
b. well cooked rather than raw.
c. consumed with foods that contain vitamin D.
d. derived from goat’s milk rather than cow’s milk.
Milk may be made suitable for patients with lactose intolerance by treating it with tablets that contain
a. yogurt.
b. lactase enzyme.
c. vitamin D and calcium.
d. Lactobacillus acidophilus.
Major symptoms of inflammatory bowel disease include
a. nausea and vomiting.
b. constipation and flatulence.
c. diarrhea and abdominal pain.
d. weight gain and excessive thirst.
The basic meal plan for patients with inflammatory bowel disease should be
a. high protein, low fat.
b. low kcal, high fat.
c. high kcal, low protein.
d. high kcal, high protein.
Patients with inflammatory bowel disease may benefit from a high-fiber diet during
a. acute episodes.
b. times of remission.
c. recovery from surgery.
d. preparation for surgery.
Fluid loss is most likely to be a problem for a patient with
a. a colostomy.c
b. a hiatal hernia.
c. an ileostomy.
d. Crohn’s disease.
When the entire colon and rectum have been removed, the patient would have
a. a colostomy.
b. constipation.
c. an ileostomy.
d. dumping syndrome.
As effluent progresses through the colon, it becomes more
a. solid.
b. liquid.
c. acidic.
d. alkaline.
Short-bowel syndrome occurs in patients who have undergone removal of large portions of the
a. colon.
b. stomach.
c. large intestine.
d. small intestine.
Patients with short bowel syndrome sometimes require parenteral nutrition support to achieve adequate intakes of nutrients and kcals. It is important for them to return to enteral feedings as soon as possible to prevent
a. loss of sense of taste.
b. loss of lean body mass.
c. atrophy of the intestinal tract.
d. essential fatty acid deficiency.
Infection and inflammation of pouchlike protrusions from the muscular layer of the colon is known as
a. diverticulitis.
b. diverticulosis.
c. Crohn’s disease.
d. inflammatory bowel disease.
For patients with diverticulosis who are not experiencing active inflammation and infection, the recommended diet is
a. pureed.
b. low in fiber.
c. high in fiber.
d. high in protein.
When consuming a high-fiber diet, it is important to also consume adequate amounts of
a. fluid.
b. calcium and iron.
c. fat-soluble vitamins.
d. complex carbohydrates.
Gas in the colon may often be caused by
a. consumption of carbonated beverages.
b. swallowing air while eating or drinking.
c. fermentation of foods by intestinal bacteria.
d. passage of gas into the colon through the colon wall.
A common dietary cause of constipation is
a. megacolon or Hirschsprung’s disease.
b. inadequate intakes of dietary fiber and fluids.
c. chronic intake of excessive amounts of caffeine.
d. inadequate intakes of fruit and vegetable juices.
An example of a high-fiber breakfast is
a. bagel and cream cheese with juice.
b. cornflakes with milk and sliced banana.
c. scrambled eggs with biscuits and honey.
d. oatmeal and whole-wheat toast with jam.
Chronic diarrhea is usually caused by
a. foodborne pathogens.
b. inadequate protein intake.
c. intestinal irritation or malabsorption.
d. excessive intake of dietary fiber.
Treatment of diarrhea generally begins with
a. a high-fiber, low-fat diet.
b. removal of the cause of diarrhea.
c. adequate fluids to hydrate the patient.
d. a low-fat, low-fiber, or low-lactose diet.
A common disorder in patients who abuse alcohol is
a. diarrhea.
b. fatty liver.
c. cholecystitis.
d. viral hepatitis.
It is possible to reverse fatty infiltration of the liver by
a. losing weight.
b. reducing fat intake.
c. increasing protein intake.
d. removing the underlying cause.
A type of hepatitis that is transmitted via the fecal-oral route is hepatitis
a. A.
b. B.
c. C.
d. D.
A symptom that is common to all types of hepatitis is
a. jaundice.
b. headache.
c. dehydration.
d. muscle aches.
The recommended diet for patients with hepatitis is a well-balanced diet with
a. low protein content.
b. supplemental electrolytes.
c. no alcoholic beverages.
d. limited amounts of alcohol.
An individual may be at risk for hepatitis E if they travel to India and eat
a. curried shrimp.
b. fresh fruit salad.
c. Tandoori chicken.
d. cooked foods from street vendors.
For patients with hepatitis, a significant barrier to maintaining an adequate intake of kcals is
a. malabsorption.
b. fat intolerance.
c. loss of appetite.
d. increased metabolic rate.
In cirrhosis of the liver, liver cells
a. decrease in number and increase in size.
b. are displaced by growth of tumors.
c. become disconnected because of breakdown of connective tissue.
d. are replaced by accumulations of fibrous connective tissue and fat.
A low-fiber, soft diet is recommended for patients with
a. hepatitis A.
b. cholelithiasis.
c. esophageal varices.
d. hepatic encephalopathy.
Patients with ascites should restrict their intake of
a. protein.
b. sodium.
c. dietary fiber.
d. saturated fat.
If a patient with cirrhosis of the liver becomes confused and apathetic, he or she may be developing
a. fatty liver.
b. hepatitis D.
c. secondary depression.
d. hepatic encephalopathy.
Drugs that are used to treat hepatic encephalopathy include
a. antidepressants.
b. diuretics and steroids.
c. neomycin and lactulose.
d. laxatives and stool softeners.
Someone who drinks one glass of wine every night with dinner plus an occasional beer when watching a football game would be considered to be a(n)
a. alcoholic.
b. light drinker.
c. moderate drinker.
d. heavy drinker.
Moderate daily alcohol intake may help reduce risk of
a. cancer.
b. stroke.
c. hypertension.
d. heart disease.
If a patient with cirrhosis of the liver seems to be vulnerable to development of hepatic encephalopathy, his or her diet may be supplemented with a formula that contains _____ acids.
a. essential fatty
b. essential amino
c. aromatic amino
d. branched-chain amino
An adequate kcal intake is especially important for patients with cirrhosis of the liver to prevent
a. muscle catabolism.
b. development of ascites.
c. essential fatty acid deficiency.
d. loss of appetite and taste acuity.
A patient with end-stage liver disease may lose fat stores and muscle mass, but this may not be evident from measurements of body weight because of
a. dehydration.
b. fat redistribution.
c. ascites and edema.
d. electrolyte imbalances.
After liver transplantation, long-term nutrition management may need to be tailored to help prevent
a. weight loss, anorexia, and nausea.
b. ascites, edema, and electrolyte imbalances.
c. cirrhosis, hepatic encephalopathy, and hepatic coma.
d. excessive weight gain, hypertension, and hyperlipidemia.
An example of an individual who may be at high risk for gallstones is a(n)
a. underweight woman who runs 3 miles four times a week.
b. man who smokes and eats eggs for breakfast every day.
c. overweight man who has recently begun an exercise program.
d. mother with four children who has lost 25 pounds in the past 3 months.
Cholecystitis is caused by
a. blockage of the bile duct by gallstones, bacterial infection, or ischemia.
b. concentration of bile in the gallbladder that favors formation of gallstones.
c. failure of the gallbladder to contract and release bile into the small intestine.
d. intake of excessive amounts of cholesterol and fat combined with bacterial infection.
If a patient experiences chronic symptoms of cholelithiasis and cholecystitis, the recommended nutrition therapy is
a. a low-fat diet.
b. gradual weight loss.
c. increased fluid intake.
d. a low-cholesterol diet.
After surgical removal of the gallbladder (cholecystectomy), long-term dietary recommendations are
a. a low-fat, low-cholesterol diet.
b. high protein and fluid intakes.
c. a well-balanced diet with no other restrictions.
d. small, frequent meals to ensure adequate intake.
Pancreatitis results in
a. excessive production of digestive enzymes and bicarbonate, causing duodenal ulcers.
b. decreased production of digestive enzymes and bicarbonate, causing malabsorption of fats and proteins.
c. increased production of pancreatic hormones, causing a decrease in blood glucose levels.
d. decreased production of pancreatic hormones, causing an increase in blood glucose levels.
During acute episodes of pancreatitis, patients often require
a. a clear liquid diet.
b. a high-protein diet.
c. a high-fat, high-kcal diet.
d. enteral or parenteral nutrition.
When patients with pancreatitis are able to tolerate enteral feedings, the recommended formula is usually a _____ formula infused into the _____.
a. low-fat elemental; jejunum.
b. low-fat elemental; duodenum.
c. high-kcal, high-protein; jejunum.
d. high-kcal, high-protein; duodenum.
Cystic fibrosis is caused by
a. a genetic defect.
b. cigarette smoking.
c. bacterial infection.
d. inadequate folate intake.
Most patients with cystic fibrosis require a
a. low-fat, low-energy diet and hormone replacement therapy.
b. high-fiber diet, supplements of water-soluble vitamins, and diuretics.
c. high-protein diet, sodium restriction, and supplements of fat-soluble vitamins.
d. high-kcal diet, multivitamin supplements, and enzyme replacement therapy.
One of the most important tools for coping with the reality of a serious chronic disease such as cystic fibrosis is
a. having a sense of humor.
b. avoiding talking about it.
c. making friends only with others who have the same disease.
d. making friends only with others who do not have the same disease.
Infants with cystic fibrosis
a. should be fed specially designed infant formulas.
b. should receive vitamin and mineral supplements.
c. may be breastfed with use of enzyme replacement therapy.
d. should delay introduction of weaning foods if they are underweight.
A bottle of beer that contains 13 g of carbohydrates and 16 g of alcohol provides _____ kcals.
a. 116
b. 155
c. 164
d. 203
A person is diagnosed as having diabetes mellitus if his or her fasting blood glucose level on two occasions is greater than _____ mg/dL.
a. 90
b. 120
c. 126
d. 156
Long-term complications of diabetes mellitus include
a. arthritis, rheumatism, and osteoporosis.
b. retinopathy, nephropathy, and neuropathy.
c. impaired immunity and opportunistic infections.
d. dermatitis, nephrotic syndrome, and detached retina.
. The type of diabetes therapy that seems to be most effective in decreasing and delaying the complications of diabetes is
a. psychotherapy.
b. intensive therapy.
c. combined therapy.
d. conventional therapy.
The three main symptoms of untreated type 1 diabetes mellitus are
a. polyphagia, polyuria, and polydipsia.
b. neuropathy, nephropathy, and retinopathy.
c. confusion, loss of coordination, and headaches.
d. fatigue, loss of appetite, and frequent infections.
The cause of type 1 diabetes mellitus is
a. excessive intake of simple sugars.
b. destruction of pancreatic beta cells.
c. inability of cells to respond to insulin in the bloodstream.
d. inability of the pancreas to keep up with the body’s demands for insulin.
The two strongest risk factors for type 2 diabetes are
a. obesity and family history.
b. recurrent viral infections and stress.
c. male gender and upper body obesity.
d. preference for sweet foods and sedentary lifestyle.
In individuals with type 2 diabetes, insulin production is generally
a. absent.
b. normal.
c. decreased.
d. increased.
Type 2 diabetes is becoming more prevalent in children, largely because of
a. increased intakes of refined sugar.
b. increased awareness and diagnosis.
c. the increasing prevalence of overweight children.
d. inheritance of a dominant gene that causes the disease.
For individuals with diabetes mellitus, glycosylated hemoglobin (HgbA1c) levels should be less than
a. 6%.
b. 7%.
c. 8%.
d. 10%.
The ethnic group that has the lowest prevalence of type 2 diabetes mellitus is
a. Native Americans.
b. African Americans.
c. Hispanic Americans.
d. non-Hispanic whites.
Exogenous insulin is a required part of treatment for all individuals with
a. type 1 diabetes mellitus.
b. type 2 diabetes mellitus.
c. gestational diabetes.
d. impaired glucose tolerance.
The main difference between the different types of exogenous insulin is
a. their shelf life.
b. the concentration of the preparation.
c. the type of solvent used to carry the insulin.
d. the length of time they take to act in the body.
Sulfonylureas and meglitinides decrease blood glucose levels by
a. stimulating insulin secretion.
b. slowing the rate of absorption of glucose.
c. providing an exogenous source of insulin.
d. improving insulin sensitivity.
Patients with diabetes mellitus should exercise at times when their blood glucose level is _____ mg/dL.
a. between 90 and 110
b. between 100 and 160
c. between 100 and 200
d. less than 250
To prevent hypoglycemia after exercise, patients with type 1 diabetes should
a. decrease their insulin dose.
b. omit a scheduled insulin dose.
c. increase their intake of protein-based foods.
d. increase their intake of carbohydrate-based foods.
Patients with type 2 diabetes are most likely to maintain good metabolic control if they
a. avoid all sources of simple carbohydrates.
b. avoid eating during the evening or at night.
c. space their meals evenly throughout the day.
d. eat one large meal and two small meals each day.
Glycosylated hemoglobin level is used to indicate
a. the effect of meals on blood glucose level.
b. day-to-day variations in blood glucose level.
c. iron deficiency anemia in patients with diabetes.
d. overall blood glucose control over several weeks.
A young man with type 1 diabetes runs 3 miles, falls asleep on the sofa, and forgets to eat his next meal. He is likely to experience
a. nephropathy.
b. hypoglycemia.
c. hyperglycemia.
d. diabetic ketoacidosis.
A risk factor for cardiovascular disease that may be modified by dietary or other lifestyle changes includes
a. male gender.
b. family history.
c. race and heredity.
d. physical inactivity.
Atherosclerosis refers to
a. chest pain that often radiates down the left arm.
b. development of lesions in the endothelium of arteries.
c. high levels of low-density lipoprotein (LDL) cholesterol in the blood.
d. complete blockage of a coronary artery, also known as a heart attack.
If a patient has a thrombosis in a cerebral artery, he or she would experience
a. a stroke.
b. a migraine headache.
c. a heart attack.
d. angina pectoris.
Peripheral vascular disease occurs when atherosclerosis causes blockages in the
a. cerebral, vertebral, and carotid arteries.
b. hepatic and renal arteries.
c. pulmonary and myocardial arteries.
d. abdominal aorta, iliac arteries, and femoral arteries.
Cholesterol travels in the bloodstream in
a. bile.
b. plaques.
c. lipoproteins.
d. blood cells.
Goals of therapy to reduce risk of cardiovascular disease focus on lowering levels of
a. triglycerides.
b. low-density lipoprotein (LDL) cholesterol.
c. high-density lipoprotein (HDL) cholesterol.
d. very low-density lipoprotein (VLDL) cholesterol.
A desirable serum total cholesterol level is <_____ mg/dL. a. 100 b. 130 c. 160 d. 200
A serum triglyceride level of 175 mg/dL is considered
a. normal.
b. borderline high.
c. high.
d. very high.
Risk of cardiovascular disease is inversely associated with levels of
a. total cholesterol.
b. low-density lipoprotein (LDL) cholesterol.
c. high-density lipoprotein (HDL) cholesterol.
d. very low-density lipoprotein (VLDL) cholesterol.
Therapeutic lifestyle changes (TLCs) recommended to reduce the risk of coronary heart disease include reduced intake of _____ fat(s).
a. total
b. saturated
c. monounsaturated
d. polyunsaturated
Each 1% increase in dietary kcal from saturated fats is associated with an increase in LDL cholesterol level of about
a. 2%.
b. 4%.
c. 5%.
d. 7%.
Most dietary fat should be in the form of
a. fat substitutes.
b. fat-soluble vitamins.
c. polyunsaturated fat.
d. monounsaturated fat.
The type of fiber that is most effective in helping to decrease LDL cholesterol is
a. dietary fiber.
b. soluble fiber.
c. insoluble fiber.
d. resistant starch.
Most people experience reductions in LDL cholesterol if they limit dietary cholesterol intake to less than _____ mg/day.
a. 100
b. 200
c. 300
d. 400
A dietary change that is likely to have a significant effect on reducing the risk of coronary heart disease is
a. snacking on tortilla chips instead of peanuts.
b. drinking decaffeinated coffee instead of regular coffee.
c. switching from cornflakes to oatmeal for breakfast.
d. choosing a fast-food fish sandwich instead of a hamburger.
The first step in therapy to reduce the risk for coronary heart disease is
a. therapeutic lifestyle change.
b. stress reduction.
c. use of LDL-lowering medications.
d. use of anti-thrombotic medications.
Drug therapy should be initiated at the same time as therapeutic lifestyle change (TLC) only in patients who
a. have severe hypercholesterolemia.
b. are not using other prescription medications.
c. have a family history of coronary heart disease.
d. are unwilling to implement therapeutic lifestyle change.
Primary or essential hypertension is caused by
a. unknown factors.
b. sedentary lifestyle.
c. excess sodium intake.
d. being overweight or obese.
If a patient’s blood pressure is 152/94 mm Hg, they have
a. normal blood pressure.
b. prehypertension.
c. stage 1 hypertension.
d. stage 2 hypertension.
Before drug therapy is considered, patients with mild to moderate hypertension should attempt to lower their blood pressure using lifestyle modifications for
a. 3 to 6 weeks.
b. 6 to 8 weeks.
c. 3 to 6 months.
d. 6 to 8 months.
Risk of hypertension may be decreased by increasing intake of foods that are good sources of
a. iron, zinc, and copper.
b. selenium, chromium, and iodine.
c. sodium, chloride, and bicarbonate.
d. potassium, magnesium, and calcium.
If a middle-aged man has high blood pressure, has a sedentary lifestyle, is about 30 pounds overweight, eats mostly processed food, and drinks two alcoholic beverages most days, the most effective way for him to lower his blood pressure is to
a. reduce his sodium intake.
b. achieve and maintain a healthy weight.
c. participate in aerobic exercise every day.
d. abstain from drinking alcoholic beverages.
In America, most dietary sodium comes from
a. salt added at the table.
b. sodium naturally present in foods.
c. salt added to foods during cooking.
d. salt added to foods during processing.
The main purpose of nutrition therapy for patients who have just experienced a myocardial infarction is to decrease
a. blood pressure.
b. the risk of blood clotting.
c. LDL cholesterol levels.
d. the workload of the heart.
One or 2 days after a myocardial infarction, patients are likely to best tolerate
a. a clear liquid diet.
b. mostly cold foods.
c. small, frequent meals.
d. three moderate meals a day.
For patients with congestive heart failure, nutrition therapy focuses on
a. restriction of dietary sodium intake.
b. abstinence from alcoholic beverages.
c. achievement and maintenance of a healthy weight.
d. restriction of dietary saturated fats and cholesterol.
If patients with congestive heart failure experience cardiac cachexia, it is important to make sure that they have adequate intakes of
a. vitamin C and iron.
b. energy and protein.
c. essential amino acids and essential fatty acids.
d. dietary fiber and monounsaturated fats.
The best time to begin to adopt heart-healthy eating habits is during
a. childhood to establish a lifelong healthy lifestyle.
b. adolescence because most teens have poor eating habits.
c. young adulthood once development is complete.
d. middle adulthood when coronary heart disease begins to develop.
Compared with a comparable regular food, a food product that claims to be “light” must contain ____% fewer kcals or _____% less fat.
a. 25; 75
b. 33; 33
c. 33; 50
d. 50; 33
Malnourished patients with chronic obstructive pulmonary disease (COPD) require protein intakes that are
a. relatively low to reduce the metabolic burden.
b. the same as healthy patients.
c. relatively high to increase ventilatory drive.
d. higher than can be met by oral intake.
The respiratory quotient may be decreased by increasing the proportion of energy intake from
a. fat.
b. protein.
c. carbohydrates.
d. fat and carbohydrates.
Most patients with acute respiratory failure require enteral or parenteral nutrition support because they
a. require mechanical ventilation.
b. often have difficulty swallowing.
c. are too tired to consume an adequate diet.
d. are unable to coordinate eating and breathing.
When using parenteral nutrition support for patients with acute respiratory failure, it is important to avoid use of high glucose concentrations because
a. glucose tolerance is often impaired.
b. they may cause hypersecretion of insulin.
c. they result in excess carbon dioxide production.
d. they may lead to development of diabetes mellitus.
The overall function of the kidneys is to
a. detect and eliminate body toxins.
b. maintain thermal homeostasis in the body.
c. maintain chemical homeostasis in the body.
d. control biochemical metabolism in the body.
The individual units that carry out the work of the kidneys are called
a. filters.
b. tubules.
c. nephrons.
d. capillaries.
Nephrotic syndrome causes loss of excessive amounts of
a. fluid.
b. protein.
c. sodium.
d. calcium.
To control hypertension and edema, patients with nephrotic syndrome should restrict their intake of
a. fluids.
b. protein.
c. sodium.
d. energy.
Hidden” sources of sodium include
a. mouthwash.
b. saltine crackers.
c. opaque salt shakers.
d. raw fruits and vegetables.
In a patient with acute renal failure, a sudden gain in weight is usually caused by
a. urea retention.
b. fluid retention.
c. increased fat stores.
d. increased muscle mass.
Retention of excessive amounts of waste products of protein metabolism in the blood is known as
a. oliguria.
b. jaundice.
c. nephritis.
d. uremia.
For patients with renal failure, the best sources of protein are
a. animal proteins.
b. vegetable proteins.
c. high-quality proteins.
d. essential amino acids.
Protein needs of patients with acute renal failure who do not need dialysis are
a. lower than those of patients receiving hemodialysis.
b. the same as those of patients receiving hemodialysis.
c. higher than those of patients receiving hemodialysis.
d. dependent on the volume of urine produced.
For patients in the oliguric phase of acute renal failure, fluid needs are
a. less than 1 L.
b. 1 mL/kg body weight.
c. double the amount of output.
d. the amount of output plus 500 mL.
A gradual, irreversible loss of kidney function is called
a. acute renal failure.
b. chronic renal failure.
c. nephrotic syndrome.
d. dialysis-dependent renal failure.
Before development of end-stage renal disease, nutrition therapy for patients with chronic renal failure focuses on
a. limiting intakes of sodium and fluid.
b. limiting foods that produce toxic metabolic by-products.
c. providing sufficient protein to prevent secondary complications.
d. providing adequate energy, protein, and nutrients to promote recovery.
The National Renal Diet
a. provides carefully calculated menus for patients with chronic renal failure.
b. provides flexible meal planning tools for patients with chronic renal failure.
c. provides lists of foods that are acceptable for patients with chronic renal failure.
d. allows patients with chronic renal failure to select foods without the help of a registered dietitian.
Of the following, the meal that would be best to include as part of a renal diet plan is
a. cheese omelet with biscuits.
b. baked chicken with rice and green beans.
c. bean burrito with tortilla chips and salsa.
d. peanut butter sandwich on whole wheat bread.
A food that is restricted in patients who are receiving hemodialysis because it is high in phosphorus is
a. banana.
b. potato.
c. egg.
d. milk.
Medications used to reduce serum phosphorus levels should be taken
a. with fluids.
b. with meals.
c. between meals.
d. 1 hour after meals.
Patients with chronic renal failure often need supplements that contain an active form of vitamin
a. A.
b. C.
c. D.
d. K.
. In patients with chronic renal failure, inadequate production of the hormone erythropoietin causes
a. anemia.
b. uremia.
c. hypertension.
d. fluid retention.
Patients treated with hemodialysis often require supplements containing
a. trace elements.
b. essential fatty acids.
c. fat-soluble vitamins.
d. water-soluble vitamins.
In peritoneal dialysis, the peritoneum serves as the
a. nephron.
b. dialysate.
c. homeostatic agent.
d. dialysis membrane.
The type of peritoneal dialysis in which the patient receives four of five exchanges of dialysate every day, each dwelling in the peritoneal cavity for about 4 hours, is known as _____ peritoneal dialysis.
a. intermittent
b. nocturnal
c. continuous cycling
d. continuous ambulatory
Patients treated with peritoneal dialysis have higher dietary protein needs than those treated with hemodialysis because
a. more protein is lost into the peritoneal dialysate.
b. protein is needed for maintenance of the peritoneum.
c. patients treated with peritoneal dialysis tend to be more active.
d. peritoneal dialysis is a more efficient method of removal of nitrogenous waste.
Patients treated with peritoneal dialysis have lower energy needs than those treated with hemodialysis because
a. hemodialysis increases metabolic rate.
b. peritoneal dialysis suppresses metabolic rate.
c. dextrose is absorbed from the peritoneal dialysate.
d. patients treated with peritoneal dialysis are less active.
If blood phosphorus levels are elevated, patients may develop
a. anemia.
b. renal calculi.
c. osteoporosis.
d. osteodystrophy.
Patients with diabetes mellitus and chronic renal failure who are treated using peritoneal dialysis may have difficulty controlling their diabetes because
a. insulin is lost into the dialysate.
b. glucose is absorbed from the dialysate.
c. the combined food restrictions are so complex.
d. peritoneal dialysis causes taste changes and food aversions.
Immediately following renal transplantation, energy needs
a. are lower than normal.
b. are higher than normal.
c. fluctuate from day to day.
d. depend on nutritional status before surgery.
Steroid therapy may result in
a. lactose intolerance.
b. glucose intolerance.
c. hypertriglyceridemia.
d. increased protein needs.
Most renal calculi are composed of
a. cystine.
b. struvite.
c. uric acid.
d. calcium oxalate.
The most important advice for preventing kidney stones is to
a. restrict dietary calcium intake.
b. increase dietary protein intake.
c. drink at least 10 to 12 cups of fluid daily.
d. achieve and maintain a healthy body weight.
An example of a food that may increase urinary oxalate levels is
a. a ginger cookie.
b. a cinnamon roll.
c. a blueberry muffin.
d. strawberry shortcake.
The stage of carcinogenesis in which the deoxyribonucleic acid (DNA) of the cell undergoes mutation is called
a. initiation.
b. metastasis.
c. promotion.
d. progression.
An individual with a blood glucose level of 40 mg/dL would have
a. hypoglycemia.
b. a normal blood glucose level.
c. hyperglycemia.
d. impaired glucose tolerance.
Diabetic ketoacidosis may occur in a patient with type 1 diabetes who
a. gets caught in traffic and misses a meal.
b. participates in an all-day sporting event.
c. accidentally takes a double dose of insulin.
d. goes away for the weekend and forgets to take his or her insulin.
Ketones accumulate in the blood during diabetic ketoacidosis because of increased metabolism of _____ and decreased metabolism of _____.
a. fatty acids; glucose
b. glucose; fatty acids
c. amino acids; glucose
d. glucose; amino acids
If someone with type 1 diabetes has nausea and vomiting, weakness and fatigue, as well as excessive hunger and thirst, but does not have a fruity or acetone odor on their breath, they may have
a. hepatic encephalopathy.
b. diabetic ketoacidosis (DKA).
c. hyperglycemic hyperosmolar nonketotic syndrome (HHNS).
d. hypoglycemia.
If a young man with type 1 diabetes wants to eat cake for dessert after a meal of roast chicken, mashed potatoes, gravy, green beans, and dinner rolls, he should eat less
a. potatoes and/or rolls.
b. chicken and gravy.
c. green beans.
d. of everything.
Patients with type 1 diabetes should be taught to regulate the _____ meal and snacks.
a. kcal content of
b. total amount of sugars in
c. total amount of dietary fiber in
d. total amount of carbohydrates in
An example of a good after-workout snack for someone with type 1 diabetes is
a. skim milk.
b. beef jerky.
c. string cheese.
d. peanuts.
Sugar alcohols appear to be safe for use as sweetening agents, but their use may
a. cause diarrhea.
b. result in weight gain.
c. have adverse effects on plasma lipid levels.
d. displace more nutrient-dense foods in the diet.
To facilitate compliance, the prescribed meal plan for patients with diabetes mellitus should
a. include some favorite foods each week.
b. be based on the patient’s usual eating habits.
c. be tailored to achieve individual weight-loss goals.
d. include meals and snacks eaten at the same time each day.
If a young woman with type 1 diabetes mellitus is in a car accident and breaks several bones, she is likely to need
a. less insulin than usual.
b. more insulin than usual.
c. a different type of insulin.
d. the same amount of insulin.
Patients with type 1 diabetes mellitus who are sick and unable to eat regular food should consume
a. parenteral nutrition support.
b. commercial liquid nutrition supplements.
c. liquid, semiliquid, or soft sources of carbohydrates.
d. noncaloric fluids only to minimize the increase in blood glucose level.
Eating plans for patients with diabetes mellitus and gastroparesis should include
a. six small meals daily.
b. three regular meals daily.
c. high protein intake.
d. increased fluid intake.
Control of maternal blood glucose levels is important during pregnancy to protect the infant from development of
a. obesity.
b. macrosomia.
c. type 1 diabetes mellitus.
d. pancreatic insufficiency.
For women with type 1 diabetes, good metabolic control is especially important at the time of conception and during the first trimester to prevent
a. macrosomia.
b. fetal malformations.
c. nutrient deficiencies.
d. excessive weight gain.
Most children who develop type 2 diabetes are treated using diet, exercise, and
a. family therapy.
b. exogenous insulin.
c. behavior modification.
d. oral hypoglycemic agents.
The stage of carcinogenesis in which the deoxyribonucleic acid (DNA) of the cell undergoes mutation is called
a. initiation.
b. metastasis.
c. promotion.
d. progression.
Dietary factors that may help protect against carcinogenesis include
a. electrolytes.
b. amino acids.
c. antioxidants.
d. monounsaturated fatty acids.
Fruits and vegetables contain some specific chemicals that help prevent cancer, known as
a. phytosterols.
b. vitamins.
c. antineoplastics.
d. phytochemicals.
A dietary change that would help prevent cancer, according to the National Cancer Institute recommendations, is
a. eating vegetarian meals two or more times a week.
b. choosing organic, pesticide-free fruits and vegetables.
c. eating five or more daily servings of fruits and vegetables.
d. consuming three or more daily servings of low-fat dairy products.
The syndrome of loss of lean body mass and body fat stores that occurs in many patients with cancer is called
a. cachexia.
b. anorexia.
c. neoplasia.
d. catabolism.
Benefits of adequate dietary intake in patients with cancer include
a. decreased risk of hypertension.
b. increased tolerance of therapy.
c. prevention of metastasis of the disease.
d. prevention of hair loss during chemotherapy.
A common problem in patients with head and neck cancer, even before they undergo surgery, is
a. dehydration.
b. nausea and vomiting.
c. protein-energy malnutrition.
d. weight gain due to inactivity.
If a patient has dumping syndrome after surgery to remove a tumor, they have probably had a
a. vagotomy.
b. gastrectomy.
c. pancreatectomy.
d. small bowel resection.
Bone marrow cells and cells lining the gastrointestinal tract are more susceptible than other cells to damage caused by chemotherapy because they
a. are target cells for drugs.
b. have a rapid turnover rate.
c. are exposed to higher doses of the drugs.
d. absorb more of the drugs than they excrete.
Effects of chemotherapy on bone marrow result in
a. allergic reactions.
b. immunosuppression.
c. nausea and vomiting.
d. loss of lean body mass.
Side effects of radiation therapy are caused by damage to _____ cells _____ the treatment range.
a. healthy; within
b. healthy; outside
c. cancer; within
d. cancer; outside
An allogeneic bone marrow transplant uses bone marrow
a. obtained from an identical twin.
b. collected from a matched healthy donor.
c. collected using hypoallergenic techniques.
d. harvested from the patient before treatment.
Patients who receive bone marrow transplants often require parenteral nutrition. Some oral intake is important to help
a. achieve adequate nutrient intakes.
b. provide nutrients that cannot be infused.
c. maintain the integrity of the small intestine.
d. maintain a sense of normalcy for the patient.
A meal that a patient with immunosuppression who needs to follow a low-bacterial diet should avoid is
a. Caesar salad dressing with alfalfa sprouts.
b. breakfast cereal with milk.
c. homemade bread with butter.
d. chicken breast sandwich with mayonnaise.
The Patient-Generated Subjective Global Assessment tool
a. should not be used as a basis for interventions because the data are subjective.
b. provides a method for assessing the psychosocial effects of cancer on the patient.
c. allows for early detection of patients who have potential or actual nutritional deficits.
d. allows patients to evaluate their own nutritional status without the input of a registered dietitian.
Patients who are experiencing nausea or vomiting may find it easiest to tolerate foods like
a. chicken noodle soup.
b. a turkey sandwich.
c. chicken curry with rice.
d. taco salad with jalapenos.
Acquired immunodeficiency syndrome (AIDS) is caused by a
a. fungus.
b. parasite.
c. rotavirus.
d. retrovirus.
Infections that cause the morbidity associated with AIDS are called _____ infections.
a. Invasive
b. Neoplastic
c. Metastatic
d. opportunistic
Nutritional problems associated with the use of highly active antiretroviral therapy (HAART) include
a. hypertension and stroke.
b. nausea and food aversions.
c. loss of lean body mass and body fat.
d. hyperlipidemia and diabetes mellitus.
The Centers for Disease Control and Prevention (CDC) have defined AIDS-related wasting syndrome as _____ loss of >10% of body weight in 1 month _____ chronic diarrhea, weakness, or fever.
a. involuntary; without
b. voluntary; without
c. involuntary; with
d. voluntary; with
Strategies that may help maximize food intake in patients with HIV/AIDS include
a. eating several small meals and snacks daily.
b. drinking 1 to 2 glasses of water with each meal.
c. not eating unless really hungry to avoid nausea.
d. taking a daily multivitamin and mineral supplement.
One of the reasons that nutrition therapy is so important for patients with HIV/AIDS is that it is an area where
a. clients can have some control of their medical care.
b. their needs are not affected by the disease process.
c. interventions can have curative effects on the disease.
d. they do not need the involvement of health care providers.
Factors that contribute to malnutrition in patients with HIV/AIDS include
a. opportunistic infections.
b. fear of weight gain.
c. use of antiretroviral therapy.
d. increase in physical activity.
Hypogonadism may contribute to malnutrition and wasting because of
a. increased metabolic rate.
b. dry mouth and stomatitis.
c. fatigue and inability to prepare food.
d. altered taste acuity and food aversions.
Some types of antiretroviral therapy are associated with changes in body composition that are referred to as
a. lipodystrophy.
b. hypogonadism.
c. hyperlipidemia.
d. wasting syndrome.
To minimize risk of infection with Cryptosporidium, patients with HIV/AIDS should
a. eat yogurt that contains live cultures.
b. avoid eating canned fruits and vegetables.
c. avoid eating undercooked meat, poultry, fish, or eggs.
d. drink only filtered water or water than has been boiled for 1 minute.
Patients with cancer who undergo radiation of their lower abdomen are likely to experience
a. nausea.
b. vomiting.
c. diarrhea.
d. constipation.
Foods that may help stimulate food intake in patients with taste abnormalities include those that are
a. tart.
b. salty.
c. sweet.
d. bland.
An important nutritional goal for patients with cancer or HIV/AIDS is to
a. eat several meals a day.
b. avoid use of supplements.
c. improve quality of life.
d. maintain their usual eating habits.
Patients experiencing diarrhea should make sure they have a generous intake of
a. fat.
b. fluids.
c. protein.
d. dietary fiber.

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