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Nutrition for Health and Healthcare 5^th Edition DeBruyne Pinna Test Bank

ISBN-13: 978-1133599111

ISBN-10: 1133599117

 

 

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Chapter 17 – Nutrition and Upper Gastrointestinal Disorders

 

An. Dif. Page(s)

 

True/False

 

a      K     489                 1.     Xerostomia is a side effect of many medications and can make chewing and swallowing more difficult.

1. true
2. false

 

a      K     489                 2.     Oropharyngeal dysphagia is common in elderly persons and frequently follows a stroke.

1. true
2. false

 

a      K     497                 3.     In the dietary treatment of gastritis, it is important to eliminate irritating foods and beverages.

1. true
2. false

 

b      K     501                 4.     All people experience the diarrhea of dumping syndrome following gastric surgery.

1. true
2. false

 

b      K     503                 5.     Bariatric surgery is currently considered the most effective treatment for someone who needs to lose more than 20 pounds.

1. true
2. false

 

b      K     504                 6.     Clinical studies indicate that the gastric banding procedure is more effective and has fewer long-term complications than gastric bypass surgery .

1. true
2. false

 

Multiple Choice

 

d     K     489                 1.     Dry mouth can result in all of the following except:

1. bad breath.
2. reduced food intake.
3. dental disease.
4. achalasia.

 

c      A     489                 2.     Oropharyngeal dysphagia may be characterized all of the following except:

1. inability to initiate swallowing.
2. aspiration.
3. impaired peristalsis.
4. hoarse voice.

 

a      K     489-490         3.     People with _____ often complain of food “sticking” in the esophagus.

1. esophageal dysphagia
2. oropharyngeal dysphagia
3. dyspepsia
4. gastritis

 

b      K     490                 4.     All of the following are appropriate for a patient suffering from mouth dryness except:

1. sauces.
2. potato chips.
3. gravies.
4. sugarless gum.

 

b      K     490                 5.     Dysphagia can be caused all of the following except:

1. Parkinson’s disease.
2. diabetes.
3. esophageal cancer.
4. stroke.

 

a      K     490                 6.     Repeated bouts of pneumonia may be associated with:

1. dysphagia.
2. irritable bowel syndrome.
3. peptic ulcers.
4. diverticular disease.

 

c      A     491                 7.     All of the following foods may be indicated for individuals with dysphagia except:

1. cream of wheat.
2. scrambled eggs.
3. brownie with nuts.
4. pureed chicken.

 

b      A     491                 8.     To improve a client’s acceptance of pureed foods you would:

1. make them watery and thin.
2. consider the color of the foods.
3. avoid the use of spices and seasonings.
4. avoid pureeing a patient’s favorite foods.

 

b      A     492                 9.     Which of the following foods would not be appropriate on a Level 1 diet for dysphagia?

1. pudding
2. yogurt with fruit
3. bacereal
4. pureed sweet potatoes

 

a      K     493                 10.  A condition in which a portion of the stomach protrudes above the diaphragm is:

1. hiatal hernia.
2. Barrett’s esophagus.
3. gastritis.
4. gastric ulcer.

 

d     K     493                 11.  Most often, GERD develops as a consequence of:

1. aging.
2. drugs.
3. feeding tubes.
4. pregnancy.

 

b      K     494                 12.  The most effective medications for suppressing gastric acid secretion are:

1. antibiotics.
2. proton-pump inhibitors.
3. antacids.
4. NSAIDs.

 

a      A     495                 13.  Dietary advice that may help treat GERD includes:

1. avoiding alcohol.
2. avoiding gas-forming foods.
3. eating large servings.
4. sucking on a peppermint after a meal.

 

a      K     495                 14.  Clients with reflux esophagitis should be instructed to:

1. eat small, frequent meals.
2. drink liquids with meals.
3. lie down after eating.
4. consume caffeine-containing foods and beverages.

 

b      K     496                 15.  General discomfort in the upper abdominal area with complaints of stomach pain, heartburn, fullness, nausea, and bloating is descriptive of:

1. peptic ulcer disease.
2. dyspepsia.
3. hiatal hernia.
4. Sjögren’s syndrome.

 

a      K     496                 16.  Foods often associated with dyspepsia include all of the following except:

1. raw foods.
2. coffee.
3. spicy foods.
4. high-fat foods.

 

a      K     497                 17.  Nutrition interventions to ease the symptoms of nausea include:

1. eating dry, starchy foods.
2. drinking warm beverages.
3. adding fat to foods.
4. eating raw vegetables.

 

a      A     497                 18.  To alleviate nausea you would tell a client to:

1. limit highly spiced foods.
2. drink liquids with meals.
3. consume hot meals.
4. eat as quickly as possible.

 

c      K     497                 19.  One of the most common causes of acute gastritis is:

1. food allergies.
2. viral infections.
3. repeated use of NSAIDS.
4. radiation therapy.

 

a      K     497                 20.  Hypochlorhydria may result from:

1. gastritis.
2. peptic ulcer disease.
3. dyspepsia.
4. bariatric surgery.

 

a      K     497                 21.  A major factor in the development of both gastritis and peptic ulcer disease is:

1. infection with H. pylori.
2. stress.
3. overeating.
4. cigarette smoking.

 

c      K     498                 22.  _____ occurs in up to 15% of cases of peptic ulcer disease.

1. Pain
2. Dysphagia
3. Gastrointestinal bleeding
4. Reflux esophagitis

 

c      K     498                 23.  Which of the following plays the primary role in treatment of ulcers?

1. surgery
2. relaxation therapy
3. drug therapy
4. diet

 

d     K     498                 24.  Nutrition intervention for peptic ulcer disease includes advising the patient to do all of the following except:

1. avoid foods that increase acid secretion.
2. avoid large meals.
3. avoid eating right before bedtime.
4. avoid gas-forming foods.

 

a      K     500                 25.  Dietary adjustments after a gastrectomy are influenced by:

1. the size of the remaining stomach.
2. the resulting slower gastric emptying.
3. the type of surgical procedure performed.
4. the patient’s food preferences.

 

b      K     500                 26.  Postgastrectomy diets limit the amounts of:

1. fat.
2. simple sugar.
3. protein.
4. complex carbohydrate.

 

d     K     500                 27.  To help delay stomach emptying and reduce diarrhea following a gastrectomy, foods high in _____ may be useful.

1. fat
2. insoluble fiber
3. protein
4. soluble fiber

 

a      K     500                 28.  Liquids are restricted following a gastrectomy because they:

1. can speed up the emptying rate of the stomach.
2. slow down the emptying rate of the stomach.
3. add unwanted kcalories.
4. are likely to cause aspiration.

 

a      A     501                 29.  Appropriate foods for a postgastrectomy diet include:

1. lean, tender meats.
2. fruit punch.
3. milk shakes.
4. frosted flakes.

 

c      K     501                 30.  The symptoms of dumping syndrome include all of the following except:

1. diarrhea.
2. lightheadedness.
3. difficulty breathing.
4. rapid heartbeat.

 

a      K     501                 31.  To prevent dumping syndrome, you would tell a client to:

1. limit the amount of fluid consumed with a meal.
2. drink a cold beverage with each meal.
3. avoid fiber-rich foods.
4. avoid lying down after eating.

 

c      K     501-502         32.  Frequent complications of gastric surgery include all of the following except:

1. bone disease.
2. weight loss.
3. protein malabsorption.
4. iron-deficiency anemia.

 

b      K     504                 33.  Following bariatric surgery, the gastric pouch will eventually stretch to hold about _____ of food.

1. 1/3 cup
2. ½ cup
3. 1 cup
4. 1 ½ cups

 

d     K     504                 34.  The protein recommendation for bariatric surgery patients is:

1. 0.8 g/kg per day.
2. 1.0 g/kg per day.
3. 1.2 g/kg per day.
4. 1.5 g/kg per day.

 

a      K     504                 35.  Rapid weight loss following bariatric surgery increases the risk of developing:

1. gallbladder disease.
2. hypertension.
3. type 2 diabetes.
4. Sjögren’s syndrome.

 

a      K     504                 36.  The diet progression following bariatric surgery is:

1. liquid, pureed, soft, regular.
2. liquid, mechanical soft, low-fat, regular.
3. pureed, chopped, regular.
4. pureed, chopped, soft, regular.

 

d     A     504                 37.  All of the following foods can be problematic following bariatric surgery except:

1. pasta.
2. dried fruits.
3. asparagus.
4. crackers.

 

c      K     505                 38.  Suggestions for achieving and maintaining weight loss following bariatric surgery include all of the following except:

1. Eat only during designated mealtimes.
2. Engage in regular physical activity.
3. Drink plenty of water and other beverages to suppress appetite.
4. Eat slowly and chew food thoroughly.

 

a      K     505                 39.  To avoid dehydration, the patient who has undergone bariatric surgery should:

1. sip water and other noncaloric beverages throughout the day.
2. drink plenty of fluids with meals.
3. increase intake of foods with high water content.
4. drink sports drinks.

 

Case Study Questions

 

Use the following case study to answer questions 40-45.

Jennie Wilson is a 42-year-old administrative assistant who recently underwent gastric bypass surgery to treat her obesity and weight-related problems of diabetes and hypertension.

 

b      K     504                 40.  Ms. Wilson’s stomach capacity immediately following surgery will be:

1. a few teaspoons.
2. a few tablespoons.
3. ½ cup.
4. ¾ cup.

 

d     A     504                 41.  On the day following surgery, Ms. Wilson will be allowed to consume all of the following except:

1. sugar-free iced tea.
2. low-fat broth.
3. water.
4. skim milk.

 

Ms. Wilson will need nutrition education before being discharged from the hospital.

 

b      A     504                 42.  Once she is able to tolerate regular foods, what type of foods should Ms. Wilson be encouraged to eat before consuming other foods in a meal?

1. complex carbohydrates
2. high-protein foods
3. low-fat foods
4. high-fat foods

 

b      A     504                 43.  Which of the following foods should Ms. Wilson be advised to avoid to prevent possible obstruction of the gastric outlet?

1. bananas
2. celery
3. fish
4. mashed potatoes

 

a      A     505                 44.  In order to achieve and maintain weight loss after surgery, Ms. Wilson should be encouraged to:

1. avoid drinking high-calorie beverages.
2. eat at least one cup of food at each meal.
3. limit her physical activity.
4. snack between meals to avoid feelings of hunger.

 

a      A     504                 45.  Due to reduced food intake and nutrient malabsorption, Ms. Wilson will likely require supplements of:

1. vitamin B₁₂, iron, and calcium.
2. zinc, magnesium, and iron.
3. vitamin B₆, folate, and niacin.
4. calcium, iron, and vitamin D.

 

Nutrition in Practice – Nutrition and Oral Health

 

a      K     509                 46.  Dental caries are caused by:

1. bacteria that produce acids that attack tooth enamel.
2. excessive fluoride intake that attacks tooth enamel.
3. high-fiber foods that cause carbohydrate to stick to teeth.
4. excessive consumption of sugar that eats into teeth.

 

d     K     509                 47.  Which of the following factors is not involved in tooth decay?

1. the type of carbohydrate consumed
2. the frequency of carbohydrate intake
3. the stickiness of foods consumed
4. the fat content of foods consumed

 

c      A     509-510         48.  Which of the following foods would be most likely to contribute to dental caries?

1. raw carrots
2. milk
3. soft drinks
4. cheese

 

d     A     510                 49.  Which of the following foods stimulates saliva flow and does not contribute to acid formation in the mouth?

1. hamburger
2. legumes
3. orange juice
4. cheese

 

d     K     511                 50.  All of the following are risk factors for developing periodontal disease except:

1. dental plaque.
2. smoking.
3. diabetes.
4. atherosclerosis.

 

a      K     511                 51.  Current research suggests that periodontal disease may increase the risk of developing:

1. heart disease.
2. renal failure.
3. arthritis.
4. dermatitis.

 

Nursing Exam Review Questions

b      K     489                 52.  The nurse is reviewing a patient’s chart and notices that the patient has a history of Sjögren’s syndrome. The nurse recognizes that the patient may have nutritional problems due to:

1. low blood sugar.
2. dry mouth.
3. impaired digestion.
4. malabsorption.

 

a      A     489                 53.  The nurse is working with a client who recently suffered from a stroke. The client complains of painful swallowing, nasal regurgitation during swallowing, and coughing during meals. The nurse recognizes these as symptoms of:

1. dysphagia.
2. gastritis.
3. reflux esophagitis.
4. hiatal hernia.

 

d     A     491                 54.  The nurse recognizes that finding the best diet for a patient with dysphagia is often challenging, and the most appropriate foods are:

1. dry foods like crackers.
2. sticky foods like peanut butter.
3. foods with mixed textures like casseroles.
4. soft, cohesive foods like mashed potatoes.

 

c      A     495                 55.  The nurse understands that a patient with GERD will benefit from education on managing the disease. All of the following suggestions would be included in the education except:

1. Avoid eating at bedtime.
2. Limit chocolate, high-fat foods, coffee, and tea.
3. Consume liquids with meals.
4. Avoid alcohol.

 

b      A     497                 56.  Mr. Green uses NSAIDs regularly to control chronic pain and complains of frequent stomach pain. The nurse recognizes this as gastritis and realizes that he may be at risk for deficiencies of:

1. calcium and phosphorous.
2. iron and vitamin B₁₂.
3. sodium and potassium.
4. vitamins C and E.

 

a      A     498                 57.  The nurse recognizes that a patient with peptic ulcer disease should avoid foods that may irritate the gastrointestinal lining, such as:

1. alcohol, coffee, and spicy foods.
2. eggs, ribs, and cheese.
3. tea, orange juice, and potato chips.
4. apples, broccoli, and sweet potatoes.

 

a      A     500                 58.  What should the nurse include in the care plan to address the nutritional needs of a patient who has undergone a partial gastrectomy?

1. several small meals and snacks
2. low-fiber diet
3. low-fat diet
4. high-kcalorie diet with snacks between meals

 

b      A     500                 59.  The nurse is reinforcing the dietitian’s instructions for a postgastrectomy diet. The nurse realizes the client understands his diet when he states that he should:

1. emphasize grains, fruits, and vegetables in his diet.
2. limit the amount of sweets like colas, honey, and jam.
3. eliminate meats, eggs, and milk.
4. exclude decaffeinated coffee, tea, and artificially sweetened drinks.

 

d     K     500                 60.  Following gastric resection, the nurse understands the need to limit _____ in the patient’s diet.

1. fiber
2. meat
3. vegetables
4. sugar

 

d     A     501                 61.  A patient experiences nausea, vomiting, abdominal cramping, diarrhea, and lightheadedness after meals following gastric bypass surgery. The nurse recognizes this as symptoms of:

1. malabsorption.
2. high blood sugar.
3. Sjögren’s syndrome.
4. dumping syndrome.

 

b      K     504                 62.  Following bariatric surgery, the nurse understands that the capacity of the stomach is:

1. a few teaspoons.
2. a few tablespoons.
3. about 2/3 cup.
4. about 1 cup.

 

d     K     504                 63.  The nurse is working with a client who had bariatric surgery four months ago. The nurse should tell this client to:

1. consume only liquids.
2. eat whatever she wants.
3. take megadoses of vitamins and minerals.
4. consume only small amounts of food at a time.

 

a      A     505                 64.  The nurse understands that the educational needs of a patient following bariatric surgery include:

1. recognizing sensations that occur when the gastric pouch is full.
2. eating often throughout the day.
3. drinking adequate fluids with meals.
4. supplementing meals with milkshakes.

 

Matching

 

f	489	1.     achalasia	a.     dry mouth caused reduced salivary flow. b.     an autoimmune disease characterized the destruction of secretory glands, resulting in dry mouth and dry eyes. c.     an inability to transfer food from the mouth and pharynx to the esophagus; usually caused a neurological or muscular disorder. d.    an inability to move food through the esophagus; usually caused an obstruction or a motility disorder. e.     abnormal narrowing of a passageway due to inflammation, scarring, or other structural changes. f.      an esophageal disorder characterized weakened peristalsis and impaired relaxation of the lower esophageal sphincter. g.     a condition in which the upper portion of the stomach protrudes above the diaphragm. h.    inflammation in the esophagus related to the reflux of acidic stomach contents. i.      a condition in which esophageal cells damaged chronic exposure to stomach acid are replaced cells that resemble those in the stomach or small intestine, sometimes becoming cancerous.
i	494	2.     Barrett’s esophagus
d	489	3.     esophageal dysphagia
g	493	4.     hiatal hernia
c	489	5.     oropharyngeal dysphagia
h	494	6.     reflux esophagitis
b	489	7.     Sjögren’s syndrome
e	489	8.     stricture
a	489	9.     xerostomia

 

e	497	1.     achlorhydria	a.     the surgical removal of part of the stomach (partial) or the entire stomach (total). b.     a feeling of pain, bloating, or discomfort in the upper abdominal area. c.     inflammation of stomach tissue. d.    a class of drugs that inhibit the enzyme that pumps hydrogen ions into the stomach. e.     an absence of gastric acid secretions. f.      symptoms that result from the rapid emptying of an osmotic load from the stomach into the small intestine. g.     surgery that treats severe obesity. h.    a class of drugs that suppress acid secretion inhibiting receptors on acid-producing cells.
g	499	2.     bariatric surgery
f	500	3.     dumping syndrome
b	496	4.     dyspepsia
a	499	5.     gastrectomy
c	497	6.     gastritis
h	494	7.     histamine-2 receptor blockers
d	494	8.     proton-pump inhibitors

 

 

b	509	1.     cariogenic	a.     a film of bacteria and bacterial by-products that accumulates on the tooth surface. b.     conducive to development of dental caries. c.     inflammation of the gums; characterized redness, swelling, and bleeding. d.    mineralized dental plaque, often associated with inflammation and bleeding. e.     inflammation or degeneration of the tissues that support the teeth.
d	509	2.     dental calculus
a	509	3.     dental plaque
c	509	4.     gingivitis
e	509	5.     periodontitis

 

 

Essay

 

489-493         1.     Define dysphagia and explain the dietary treatment for this disorder.

 

495                 2.     What dietary advice would you give someone who is experiencing GERD?

 

497                 3.     Discuss the complications of gastritis.

 

500-501         4.     Describe the typical scenario that accompanies dumping syndrome.

 

502                 5.     Why does fat malabsorption occur in clients who have undergone gastric surgery that bypasses the duodenum?

 

504-505         6.     Describe the nutritional concerns for a patient following bariatric surgery.