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D
A clear liquid diet would be most appropriate for
a.
someone who has had several teeth removed and is unable to chew.
b.
a pregnant woman with persistent nausea.
c.
someone who has had a stroke and has difficulty swallowing.
d.
a patient who has had major surgery within the past 18 hours.
D
One advantage of a full liquid diet is that it
a.
has low levels of saturated fat and high levels of fiber.
b.
is suitable for patients with lactose intolerance.
c.
is likely to be tolerated by patients with dysphagia.
d.
can provide an adequate diet if very carefully planned.
B
If a patient is receiving radiation to the mouth and neck area and has a sore mouth, the most appropriate type of diet while he or she is in hospital would be a _____ diet.
a.
regular
b.
mechanical soft
c.
full liquid
d.
clear liquid
D
If a patient drools, takes a long time to eat, and often gags during meals, he or she may have
a.
dementia.
b.
esophageal cancer.
c.
regurgitation.
d.
dysphagia.
D
. If a physician orders a diet as tolerated for a patient, the nurse should
a.
make food selections for the patient in accordance with the patients symptoms.
b.
determine the appropriate type of diet for the patient in accordance with the patients condition.
c.
consult the registered dietitian to determine when the diet should be advanced.
d.
encourage the patient to normalize the diet as his or her appetite and symptoms allow.
D
If an individual has back pain and seeks treatment with 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
C
If a patient starts vomiting immediately after eating seafood and states that the one other time he or she ate seafood, he or she had a similar reaction, the patient probably has
a.
food poisoning.
b.
celiac disease.
c.
an allergy to seafood
d.
a viral infection.
B
A one-a-day multivitamin or multimineral supplement at 100% or less of the Dietary Reference Intake (DRI) is probably most beneficial for a(n)
a.
young adult who lifts weights before work every morning.
b.
older adult living at home alone.
c.
business executive with a high-stress job.
d.
newly retired, socially active woman.
A
According to the Dietary Supplement Health and Education Act (DSHEA) of 1994, dietary supplements are considered
a.
foods.
b.
drugs.
c.
nutrients.
d.
food additives.
B
Using a margarine fortified with plant sterol and stanol esters to help decrease blood cholesterol levels is an example of using a
a.
probiotic.
b.
functional food.
c.
dietary supplement.
d.
complementary food.
D
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.
D
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.
C
The most important thing a nurse can do to prevent the spread of foodborne illness among hospitalized patients is to
a.
discard any food that is uneaten within 30 minutes of being served.
b.
wear a mask when serving food or helping feed patients.
c.
wash hands thoroughly before serving food and after using the bathroom.
d.
discourage friends and family members from bringing in food for the patient.
B
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 after organ transplantation.
c.
oral contraceptives or hormone replacement therapy.
d.
oral hypoglycemic agents for treatment of diabetes.
C
If a patient with depression takes a selective serotonin reuptake inhibitor (SSRI), the nurse may want to ask about use of herbal products because of potential interactions if the patient is using
a.
ginseng.
b.
ginkgo biloba.
c.
St. Johns wort.
d.
evening primrose oil.
A
. Nurses should ask patients about their use of over-the-counter medications because
a.
those medications 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.
A
A patient who is an orthodox Jew would not eat
a.
chicken in cream sauce.
b.
a hamburger and fries.
c.
a grilled cheese and tomato sandwich.
d.
scrambled eggs and hash browns.
B
A food restriction shared by both Muslims and Jews is
a.
not combining meat and dairy at the same meal.
b.
not eating pork or any food products from pigs.
c.
avoiding coffee, tea, and alcohol.
d.
eating fish with fins and scales but not shellfish.
D
During a home visit to a patient receiving home enteral nutrition, the greatest source of concern would be if the
a.
patient were receiving enteral feedings only during the night.
b.
patient has gained 1 pound during the past month.
c.
family complains that they miss being able to eat meals together.
d.
family is blending family meals to make their own formula.
D
If a patient has had a stroke and needs enteral feedings because he or she cannot chew or swallow but has no other medical problems, he or she can be fed with a(n) _____ formula.
a.
isotonic
b.
modular
c.
elemental
d.
polymeric
A
If a patient with cystic fibrosis and pancreatic insufficiency requires enteral feedings, he or she should be fed a(n)
a.
elemental formula.
b.
modular formula.
c.
formula specially formulated for critically ill patients.
d.
lactose-free formula.
A
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.
C
If a patient is to receive enteral feedings for several weeks because of esophageal surgery but is otherwise generally healthy, he or she may be fed through a _____ tube.
a.
nasogastric
b.
nasoduodenal
c.
percutaneous endoscopic gastrostomy (PEG)
d.
jejunostomy
B
If a patient starts to experience diarrhea 12 hours after starting enteral feedings, the first course of action the medical staff would try is
a.
switching to a lactose-free formula.
b.
decreasing the rate of the formula feeding.
c.
switching to an elemental formula.
d.
stopping the feeding until the diarrhea resolves.
B
Bolus enteral feedings would be appropriate for a patient who
a.
has had a gastrectomy.
b.
has a PEG tube.
c.
is being fed via a nasoduodenal tube.
d.
has a history of aspiration-related pneumonia.
D
To determine the nutritional adequacy of a tube feeding,
a.
the patients 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.
C
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.
A
A patient has undergone several gut resections because of cancer and is unlikely to resume adequate oral intake of nutrients. The best way to feed this patient would be via
a.
central parenteral nutrition.
b.
peripheral parenteral nutrition.
c.
a PEG tube.
d.
jejunal enteral feedings.
C
Intravenous lipid emulsions are used as part of parenteral nutrition to prevent fatty acid deficiency and to
a.
increase patient satiety.
b.
provide a source of fat-soluble vitamins.
c.
add kilocalories without increasing osmolality.
d.
add kilocalories with minimal expense.
B
If a patient receiving parenteral nutrition has a fluid restriction, he or she would need to be fed via _____ parenteral nutrition.
a.
peripheral
b.
central
c.
peritoneal
d.
cyclical
B
During transitions from parenteral or enteral tube feedings to oral feedings, patients should be monitored to ensure 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.
D
The best way to maintain the integrity and function of the gut in someone who is receiving parenteral nutrition is to
a.
supplement parenteral nutrition with probiotics.
b.
encourage patients to smell foods to stimulate gastric juices.
c.
use enemas to keep fluids in the gut without using the oral route.
d.
give the patient small sips of diluted fruit juice if possible.
D
If a patient with multiple sclerosis starts coughing frequently during meals and starts to eat significantly less food than normal, the patient may have
a.
pneumonia.
b.
gastroesophageal reflux disease.
c.
peptic ulcer.
d.
dysphagia.
D
For a patient with dysphagia, the food that would be most difficult to swallow is
a.
applesauce.
b.
mashed potatoes.
c.
chocolate pudding.
d.
chicken noodle soup.
B
If a patient has difficulty swallowing, the best position for eating is
a.
propped up in bed with a caregiver by the bedside.
b.
sitting upright opposite a caregiver.
c.
sitting at a dining table with social dining companions.
d.
lying on the left side, with a caregiver by the side.
B
The most acute risk for patients with dysphagia is
a.
constipation.
b.
dehydration.
c.
dry mouth.
d.
panic attacks.
A
The most helpful recommendation for a client who often experiences heartburn at night would be to
a.
avoid eating within 4 hours of going to bed.
b.
increase the fiber content of the diet.
c.
decrease the fiber content of the diet.
d.
take antacid medications before going to bed.
C
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 and salsa.
D
. Peptic ulcer disease (PUD) would be most like to occur in someone who uses medication to treat
a.
gastroesophageal reflux disease.
b.
constipation.
c.
celiac disease.
d.
joint pain or arthritis.
C
Nutrition therapy for peptic ulcers should be individualized, depending on
a.
type of drug treatment.
b.
location of the ulcer.
c.
patient tolerance.
d.
the cause of the ulcer.
D
If a patient who has undergone gastric bypass surgery for treatment of extreme obesity experiences sudden sweating, nausea, and stomach cramps after meals, the patient may have
a.
gastroesophageal reflux.
b.
pancreatitis.
c.
peptic ulcer disease.
d.
dumping syndrome.
C
An appropriate meal for someone with dumping syndrome would be
a.
a small vanilla milkshake.
b.
cream of mushroom soup.
c.
half a turkey sandwich.
d.
popcorn and sugar-free soda.
C
If a patient has esophagitis and also has worn tooth enamel, he or she may have
a.
a hiatal hernia.
b.
fluoride deficiency.
c.
an eating disorder.
d.
gastroesophageal reflux disease.
D
An example of a meal that may contain gluten is
a.
baked chicken breast with herbed rice.
b.
pork chop with sweet potatoes and butter.
c.
grilled steak with baked potato and sour cream.
d.
roast beef with mashed potatoes and gravy.
A
A patient with lactose intolerance would be most likely to experience symptoms if he or she ate a
a.
cup of pudding.
b.
turkey sandwich with Swiss cheese.
c.
biscuit with butter and honey.
d.
cup of sherbet.
B
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.
C
. For patients with inflammatory bowel disease, nutrition therapy is
a.
the primary mode of treatment.
b.
rarely necessary.
c.
an important adjunct to drugs and surgery.
d.
highly specialized.
D
Because patients with active Crohns disease have intestinal inflammation, they benefit from high intake of
a.
fat.
b.
dietary fiber.
c.
simple sugars.
d.
protein.
B
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.
C
Fluid loss is most likely to be a problem for a patient with
a.
a colostomy.
b.
a hiatal hernia.
c.
an ileostomy.
d.
Crohns disease.
C
The most significant nutritional concern for a patient with an ileostomy is
a.
fat malabsorption and steatorrhea.
b.
dumping syndrome.
c.
loss of fluid and electrolytes.
d.
malabsorption of protein and carbohydrates.
A
For patients with ostomies, a lower amount of output occurs
a.
if the ostomy is closer to the rectum.
b.
if the ostomy is closer to the rectum.
c.
with high fiber intake.
d.
with high fat intake.
D
If a patient has had a large portion of their small intestine removed because of cancer and is unable to maintain a stable weight, a feeding regimen that would be most appropriate is
a.
enteral feedings into the stomach.
b.
enteral feedings into the jejunum.
c.
parenteral nutrition only.
d.
supplemental parenteral nutrition.
C
If a patient receiving chemotherapy is struggling with nausea and vomiting, helpful suggestions may include
a.
drinking acidic fruit juices to stimulate gastric juices.
b.
being active before and after meals to improve appetite.
c.
eating frequent small meals throughout the day.
d.
eating foods with plenty of flavor and aroma.
A
The best way to prevent formation of diverticula in the colon is to
a.
eat plenty of fruits, vegetables, and whole grains.
b.
avoid foods with rough hulls, such as nuts and seeds.
c.
use stool softeners to promote daily bowel movements.
d.
avoid foods that cause gas and increase pressure in the colon.
C
Someone who may benefit from avoiding sugar-free chewing gum is a patient with
a.
peptic ulcer disease.
b.
gastroesophageal reflux disease.
c.
irritable bowel syndrome.
d.
celiac disease.
A
In 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.
C
If a client complains of excessive gas, a good question to ask is whether he or she
a.
drinks coffee and tea.
b.
has problems with constipation.
c.
chews gum.
d.
is under a lot of stress.
B
An example of a daily change that may help decrease constipation is
a.
drinking tomato juice instead of carbonated beverages with lunch.
b.
eating oatmeal and raisins instead of a bagel for breakfast.
c.
snacking on pretzels instead of potato chips.
d.
eating mashed potatoes instead of pasta with dinner.
D
An example of a high-fiber food item to include with lunch is
a.
pasta with tomato sauce and Parmesan cheese.
b.
beef tacos with lettuce and tomatoes.
c.
an omelet with mushrooms and onions.
d.
black bean soup.
C
A possible cause of acute diarrhea is
a.
short bowel syndrome.
b.
lactose intolerance.
c.
emotional stress.
d.
celiac disease.
C
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.
B
If an otherwise healthy patient with normal body weight develops fatty liver disease, it would be especially important to evaluate their
a.
blood glucose level.
b.
alcohol intake.
c.
total fat intake.
d.
use of nonsteroidal anti-inflammatory drugs (NSAIDs).
D
If an obese postmenopausal woman who does not drink alcohol develops fatty liver disease and wants to avoid progression to cirrhosis or liver cancer, the best recommendation is to
a.
decrease intake of saturated fats.
b.
decrease intake of carbohydrate.
c.
lose 3 to 4 lb per week.
d.
lose 1 to 2 lb per week.
A
If a client will be visiting an area where hepatitis E virus (HEV) is endemic, the best way to prevent becoming infected is to
a.
eat only cooked fruits and vegetables and drink only commercially bottled water.
b.
eat only at internationally recognized establishments.
c.
obtain a vaccination before entering that area.
d.
avoid and raw or unpasteurized dairy products.
A
A symptom that is common to all types of hepatitis is
a.
jaundice.
b.
headache.
c.
dehydration.
d.
muscle aches.
C
In treating patients with hepatitis, it is important for nurses to help patients cope with the challenge of
a.
difficulty sleeping.
b.
risk of bleeding.
c.
sodium restriction.
d.
fluid restrictions.
B
An individual may be at risk for HEV infection if they travel to India and eat
a.
curried shrimp.
b.
fresh fruit salad.
c.
Tandoori chicken.
d.
cooked foods from street vendors.
C
For patients with hepatitis, an important way to minimize loss of muscle mass is to
a.
participate in daily aerobic exercise.
b.
participate in daily strength exercise.
c.
maintain an adequate protein intake.
d.
maintain an adequate micronutrient intake.
D
The person at greatest risk for developing cirrhosis or liver cancer is a(n)
a.
young woman who drinks a glass of wine every day.
b.
young man who travels extensively to tropical countries.
c.
middle-aged overweight man with gallstones.
d.
older adult infected with hepatitis C virus (HCV).
C
If a patient with cirrhosis of the liver has a soft diet order, he or she probably has
a.
lethargy.
b.
cholelithiasis.
c.
esophageal varices.
d.
hepatic encephalopathy.
B
A good meal for a patient with ascites would be
a.
canned minestrone soup with saltine crackers.
b.
baked chicken with a roll and steamed green beans.
c.
bacon, sausage, eggs, and toast.
d.
tortilla chips with nacho cheese and salsa.
D
If a patient with cirrhosis of the liver becomes confused and apathetic, he or she may be developing
a.
fatty liver disease.
b.
hepatitis D.
c.
secondary depression.
d.
hepatic encephalopathy.
D
If a patient with cirrhosis of the liver is treated with lactulose and neomycin, he or she probably has
a.
a secondary infection.
b.
ascites.
c.
esophageal varices.
d.
hepatic encephalopathy.
C
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.
alcoholic.
b.
an alcohol addict.
c.
a moderate drinker.
d.
a heavy drinker.
D
If a person has no history of liver disease but does have a strong family history of cardiovascular disease, the person may help decrease the overall risk for chronic disease by
a.
following a lacto-ovovegetarian diet.
b.
avoiding use of NSAIDs.
c.
abstaining from drinking any alcoholic beverages.
d.
drinking one or two servings of alcoholic beverages daily.
D
If a malnourished patient with cirrhosis of the liver seems to be vulnerable to development of hepatic encephalopathy, the best food to give them would be
a.
scrambled eggs.
b.
roast beef with gravy.
c.
a hamburger.
d.
a bean burrito.
A
. If a patient with end-stage liver disease gains 5 lb in 1 week, the most likely explanation is
a.
development of ascites.
b.
restoration of muscle mass.
c.
high energy intake.
d.
edema in the extremities.
C
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.
D
After liver transplantation, long-term nutrition recommendations most closely resemble those for patients with
a.
hepatitis.
b.
gallstones.
c.
peptic ulcer disease.
d.
metabolic syndrome.
D
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.
overweight man who smokes and has a sedentary job.
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.
A
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, in combination with bacterial infection.
A
The most beneficial dietary change for a patient with cholelithiasis and cholecystitis would be to
a.
avoid fried foods and creamy sauces.
b.
abstain from drinking alcohol.
c.
refrain from eating 4 hours before bedtime.
d.
avoid eggs, shrimp, and high-cholesterol foods.
C
After surgical removal of the gallbladder (cholecystectomy), the nurse should counsel patients to
a.
follow a low-fat, low-cholesterol diet.
b.
ensure high intake of protein and fluid.
c.
eat a well-balanced diet as tolerated.
d.
avoid snacking between meals.
B
If a nurse is beginning an enteral feedings for a patient with pancreatitis, the only appropriate type of formula is
a.
modular.
b.
hydrolyzed.
c.
intact.
d.
hypercaloric.
D
At the beginning of an acute episode of pancreatitis, the nutrition priority is to provide
a.
a clear liquid diet.
b.
jejunal enteral feedings.
c.
parenteral nutrition.
d.
intravenous fluids.
D
The only appropriate diet order for a patient with pancreatitis is to begin feedings via
a.
nasogastric tube.
b.
percutaneous endoscopic gastrostomy (PEG) tube.
c.
nasoduodenal tube.
d.
percutaneous endoscopic gastrojejunostomy.
A
For patients with any kind of liver disease, the most important dietary modification is
a.
abstaining from alcohol.
b.
decreasing fat intake.
c.
increasing protein intake.
d.
avoiding dietary fructose.
D
If a patient is infected with HCV, he or she may
a.
have consumed contaminated food or water.
b.
be co-infected with hepatitis B virus (HBV).
c.
have had sexual contact with an infected person.
d.
have recently gotten a tattoo.
A
For patients who are infected with hepatitis and have a poor appetite, the best way to increase protein and energy intake would be
a.
adding peanut butter to toast, soups, or smoothies.
b.
tossing salads and pasta with olive oil.
c.
mixing powdered milk into mashed potatoes and soups.
d.
adding sugar to coffee and tea.
C
As a patient who has undergone liver transplantation heals, a necessary transition is
a.
increasing protein intake to replace pretransplantation losses.
b.
restricting fluid and sodium intakes to prevent ascites.
c.
generally eating less to avoid weight gain and chronic disease.
d.
generally eating more to maintain body weight and muscle mass.
C
A bottle of beer that contains 13 g of carbohydrates and 16 g of alcohol provides _____ kcal.
a.
116
b.
155
c.
164
d.
203
C
At a routine physical examination, a 50-year-old man has a fasting blood glucose level of 160 mg/dL. The next step in diagnosis and treatment would be
a.
referral to a diabetes clinic.
b.
prescribing an oral hypoglycemic agent.
c.
rechecking fasting blood glucose level.
d.
evaluating cardiovascular risk factors.
B
If a patient with type 2 diabetes shows early signs of kidney disease, the first priority in nutrition management is
a.
restricting dietary protein intake.
b.
normalizing blood glucose levels.
c.
limiting dietary sodium intake.
d.
increasing fluid intake.
B
If a patient with type 1 diabetes is unable to maintain good blood glucose control through insulin injections, the physician may recommend
a.
an oral hypoglycemic agent.
b.
using an insulin pump.
c.
more frequent self-monitoring of blood glucose.
d.
a daily exercise routine.
A
If a 15-year-old student who runs cross-country and long-distance track events starts to lose weight and is continually thirsty and hungry, he or she may have
a.
type 1 diabetes.
b.
type 2 diabetes.
c.
acquired immunodeficiency syndrome (AIDS).
d.
hepatitis virus infection.
B
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 bodys demands for insulin.
A
. 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.
D
If a patient with type 2 diabetes wants to lose weight, the preferred choice of medication would be
a.
insulin.
b.
sulfonylureas.
c.
thiazolidinediones.
d.
metformin.
C
If members of an overweight family wants to reduce their risk for type 2 diabetes, the most helpful nutritional change they could make would be to
a.
increase their intake of dietary fiber.
b.
decrease their intake of refined sugar.
c.
decrease their portion sizes at meals and snacks.
d.
switch to a vegetarian pattern of eating.
Note 
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