Chapter_16 Respiratory Q & A.docx

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BIO104_CH 16 (Nutrition in Metabolic and Respiratory Stress) 1. The increase in metabolic rate as a part of the stress response can be attributed to: a. catecholamines. b. cortisol. c. eicosanoids. d. cytokines. e. hepcidin. 2. Protein synthesis is inhibited by: a. cortisol. b. eicosanoids . c. mast cells. d. phagocytes. e. aldosterone. 3. During the inflammatory response, mast cells release _____, which causes vasodilation and capillary permeability. a. erythropoietin b. cortisol c. anti-diuretic hormone d. cytokine e. histamine 4 What compound is produced by white blood cells and participates in the inflammatory process? a. glucagon b. catecholamine s c. cytokines d. cortisol e. aldosterone 5. What complication is most closely associated with severe cases of SIRS or sepsis? a. hypertension b. fluid retention c. hypertriglyceridemia d. poor glucose control e. intestinal bleeding
*A serious condition in which there is inflammation throughout the whole body. It may be caused by a severe bacterial infection (sepsis), trauma, or pancreatitis. It is marked by fast heart rate, low blood pressure, low or high body temperature, and low or high white blood cell count. 6. When caring for a patient who is suffering from acute illness and metabolic stress, how would clinicians best estimate protein and energy needs? a. Adjust nutrient intakes according to patient responses. b. Underfeed the patient to minimize tissue loss. c. Maintain the patient at NPO status to promote bowel rest. d. Overfeed the patient to prevent hypoglycemia. e. Increase carbohydrate intake to promote weight gain and appropriate energy use. 7. What describes the immediate care concerns of the clinician during a patient’s time of severe stress? a. educating the patient about nutrient needs b. providing psychological counseling c. determining the level of the patient’s understanding about his condition d. providing nutrition therapy e. restoring fluids and electrolytes 8. In critically ill patients, _____ is used to measure the resting metabolic rate (RMR). a. skinfold measurement b. BMI c. the stress factor equation d. indirect calorimetry e. a clinical body weight growth chart 9. Which amino acid has been shown to have beneficial effects on critically ill patients? a. leucine b. glutamine c. valine d. isoleucine e. phenylalanin e 10. Which amino acid may have beneficial effects on surgical healing of postoperative patients? a. tryptophan b. tyrosine c. arginine d. phenylalanin e e. leucine
11. In critically ill patients, a high intake of _____ may suppress immune function and increase the risk of developing infections. a. fat b. dextrose c. protein d. zinc e. vitamin A 12. What micronutrient plays a role in immunity and wound healing? a. zinc b. choline c. selenium d. vitamin K e. iron 13. Once patients can tolerate oral feedings, what type of diet is often prescribed? a. high fiber b. low sodium c. high-kcalorie, high-protein d. low fat e. low carbohydrate 14. Nutrition therapy for management of COPD involves: a. promoting weight gain. b. supporting wound healing. c. improving food intake. d. relieving chronic cough. e. decreasing supplemental oxygen needs. 15. Emphysema associated with COPD is most often diagnosed by: a. serial chest x-rays. b. clinical signs and lung function tests. c. oxygen saturation readings. d. 24-hour holter monitoring. e. culture and sensitivity of mucus samples. 16. A COPD patient who complains of abdominal discomfort and dyspnea may benefit from: a. small, frequent meals. b. a low-fat diet. c. a high-fiber diet.
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d. consuming more liquids. e. increased energy consumption. 17. Adequate fluid intake will help the person with COPD by: a. decreasing carbon dioxide output. b. preventing the secretion of overly thick mucus. c. aiding in weight loss. d. improving oxygen consumption. e. reducing abdominal distention. 18. Excessive kcalorie intake in COPD patients may: a. interfere with catabolic processes. b. alter taste perception. c. interfere with drug therapy. d. increase gas formation. e. increase respiratory stress. 19.. The most common risk factor associated with development of COPD is: a. alpha-1 anti-trypsin deficiency. b. environmental exposure to pollutants. c. lung cancer. d. cigarette smoking. e. cystic fibrosis. Kati is a 19-year-old female who suffered a head injury and multiple broken bones in a motorcycle accident. She is currently in a coma, on a mechanical ventilator, and receiving internal nutrition. Kati is 5’2” tall and weighs 115 pounds. 20. The stress of Kati’s condition places her at risk of hypermetabolism. What kind of complication is most closely associated with hypermetabolism as a result of stress? a. wasting b. fractures c. kidney failure d. bone pain e. pulmonary edema
21. As a result of the acute-phase inflammatory response, Kati’s plasma concentrations of _____ would be expected to decrease. a. glucose and cholesterol b. sodium and potassium c. iron and glucose d. albumin and iron e. magnesium and chloride 22. If Kati’s enteral feeding is not providing adequate energy and protein to meet her nutritional needs, she will experience: a. a loss of lean tissue. b. hyperglycemia. c. pulmonary edema. d. sepsis. e. organ failure. 23. The first organ to fail in MODS is often the: a. lungs. b. liver. c. kidneys . d. heart. e. brain. * Multiple Organ Dysfunction Syndrome 24. One factor that increases the risk of a patient developing MODS is: a. age over 40 years. b. an increased length of hospital stay. c. uncontrolled blood glucose. d. obesity. e. the severity of SIRS infection. 25. The principal infection most often associated with MODS is: a. pneumonia. b. urinary tract infection. c. herpes simplex virus infection. d. meningitis. e. hepatitis B infection.
Nursing Exam Review Multiple Choice 26. While caring for a patient who has been injured, the nurse recognizes which sign of inflammation that accompanies altered blood flow? a. hyperglycemia b. swelling c. pale skin d. hypotension e. confusion 27. John has been hospitalized with a severe infection in his foot. The nurse recognizes that increasing his intake of _____ may help to suppress the inflammation. a. omega-3 fatty acids b. protein c. carbohydrate d. omega 6-fatty acids e. vitamin D 28. Because the immediate stress response can cause a variety of systemic effects, the nurse should closely monitor her patient’s: a. heart rate, respiratory rate, and blood pressure. b. appetite, temperature, and weight. c. pain rating, level of consciousness, and posture. d. abdominal girth, reflexes, and edema. e. hearing, vision, and sense of smell. 29.. A nurse is treating a patient who is experiencing fluctuations in hormone levels as a result of stress. Based on her understanding of the metabolic effects associated with certain hormones, the nurse knows that aldosterone is responsible for: a. increasing the patient’s metabolic rate. b. producing glucose from amino acids. c. reabsorbing sodium in the kidneys. d. releasing fatty acids from adipose tissue. e. reabsorbing water in the kidneys. 30. A patient who is on a tube feeding gains nine pounds in three days. The nurse realizes that this may most likely indicate: a. inadequate nutritional intake. b. excess protein intake. c. a fluid imbalance. d. low levels of vitamin D.
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e. refeeding syndrome. 31. Mr. Morgan is a critically ill patient in the ICU who is on TPN. The nurse understands that monitoring his _____ can help to determine if he is being overfed. a. glucose levels b. cholesterol levels c. iron levels d. albumin levels e. calcium levels 32. Mark is a 23-year-old firefighter who experienced severe burns while fighting a house fire. The nurse recognizes the fact that he may benefit from supplements of _____ to reduce the risk of infection and to counter oxidative stress. a. zinc, vitamin C, and vitamin E b. iron, magnesium, and calcium c. sodium, potassium, and chloride d. phosphorus, thiamin, and riboflavin e. calcium, vitamin D, and vitamin K 33. Mr. Winslett is a COPD patient who is complaining of poor appetite, abdominal discomfort, and bloating. Which suggestion from the nurse is most appropriate for improving his food intake? a. “Consume larger meals.” b. “Substitute beans for meat.” c. “Drink a supplement before eating.” d. “Eat smaller, more frequent meals.” e. “Increase fluid intake throughout the day.” 34. A patient with ARDS requires mechanical ventilation. The nurse recognizes that fluid accumulation is a potential problem that may make it difficult to assess his: a. weight. b. temperature. c. kcalorie intake. d. fluid intake. e. heart rate. 35. A critically ill patient with ARDS is on a tube feeding and requires a fluid restriction. The nurse understands that an appropriate enteral formula would be a _____ formula. a. low residue b. high protein c. nutrient dense
d. hydrolyzed e. low fat