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FUNDAMENTAL CONCEPT OF NURSING
EXAM 3
Nutrition ++
A patient is admitted to the hospital with a history of liver dysfunction associated with
hepatitis. With which metabolic problem does the nurse anticipate that this patient may
have a problem?
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1. Emulsifying fats
2. Digesting carbohydrates
3. Manufacturing red blood cells
4. Reabsorbing water in the intestines
1. Emulsifying fats
Bile is produced and concentrated in the liver and stored in the gallbladder. As fat
enters the duodenum, it precipitates the release of cholecystokinin, which
stimulates the gallbladder to release bile. Bile, an emulsifier, enlarges the surface
area of fat particles so that enzymes can digest the fat.
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2. The liver is not involved with carbohydrate digestion. Ptyalin (secreted by the
parotid glands), amylase (secreted by the pancreas), and sucrase, lactase, and
maltase (secreted by the walls of the small intestine) digest carbohydrates.
3. The liver is not involved with red blood cell production. People who are deficient
in iron and protein have difficulty with red blood cell production.
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,4. The large intestine, not the liver, is involved with reabsorbing water. The majority
of the water in chyme is reabsorbed in the first half of the colon, leaving the
remainder (approximately 100 mL) to form and eliminate feces.
A nurse is assessing a patient who is admitted to the hospital with withdrawal from
alcohol. Which effect of alcohol on the body will influence the patient's plan of care?
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1. Interferes with the absorption of glucose
2. Accelerates the absorption of medications
3. Decreases the absorption of many important nutrients
4. Lengthens passage time of stool through the intestinal tract
3. Decreases the absorption of many important nutrients
Alcohol interferes with vitamin intake, absorption, metabolism, and excretion. It
specifically interferes with the absorption of vitamins A, D, K, thiamine, folic acid,
pyridoxine, and B 12.
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1. Alcohol interferes with the absorption of thiamine, which is essential to oxidize,
not absorb, glucose.
2. The damaging effects of alcohol decrease, not increase, the efficiency of the
process of absorption of medications in the stomach and intestines. However,
alcohol can potentiate the action of drugs, such as central nervous system
depressants.
4. Alcohol increases intestinal motility so that it decreases, not increases, the
length of time it takes intestinal contents to pass through the body.
An obese resident of a nursing home who is receiving a 1,500-calorie weight reduction
diet has not lost weight in the past 2 weeks. Which should the nurse do first ?
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1. Inform the primary health-care provider of the patient's lack of progress.
2. Instruct the patient to limit intake to 1,000 calories per day.
3. Schedule a multidisciplinary team conference.
4. Keep a log of the oral intake for 3 days.
4. Keep a log of the oral intake for 3 days.
When the expected outcome of an intervention is not attained, the situation must
be reassessed to determine the problem and the plan changed appropriately. A
record of a dietary intake provides objective information about the amounts and
types of food consumed. This information provides data about nutrient
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,deficiencies or excesses, eating patterns, behaviors associated with eating, and
potential problems and needs.
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1. Informing the primary health-care provider of the patient’s status is premature.
The nurse is abdicating the responsibility to help the patient.
2. A change in diet requires a primary health-care provider’s order. Generally,
calories should not be restricted below 1,200 cal/day for women or 1,500 cal/day
for men so that they receive adequate amounts of essential nutrients.
3. Conducting a multidisciplinary team conference may eventually be done, but it
is premature at this time.
A patient of Latino heritage is prescribed a low-fat diet. The patient tells the nurse, "I am
going to have a hard time giving up my favorite family recipes." Which food should the
nurse recommend that is low in fat and generally is included in the Latino culture?
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1. Salsa
2. Pasta
3. Steamed fish
4. Refried beans
1. Salsa
Salsa predominantly contains tomatoes, onions, and peppers, all which are low in
fat.
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2. Pasta contains predominantly carbohydrates, not fat. In addition, in the Latino
culture, rice and beans are preferred over pasta. Pasta is associated with the
Italian culture.
3. Although steamed fish is low in fat, foods in the Latino culture generally are
stewed or fried. Vegetables, legumes, and meat usually are preferred over fish.
4. Refried beans are a fried food that should be avoided on a low-fat diet. Frying
involves cooking food with a saturated or unsaturated fat solution, which is
composed mostly of fatty acids. Fatty acids combine with glycerol to form
triglycerides.
A patient is diagnosed with a vitamin A deficiency. Which type of pie should the nurse
encourage the patient to ingest?
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1. Blueberry
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, 2. Pumpkin
3. Cherry
4. Pecan
2. Pumpkin
Pumpkin is an excellent source of vitamin A. One piece (one-sixth of a 9-inch
diameter pie) contains 3,750 mcg RE (retinol equivalents) of vitamin A.
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One piece of blueberry pie contains only 14 mcg RE of vitamin A.
3. One piece of cherry pie contains only 70 mcg RE of vitamin A. 4. One piece of
pecan pie contains only 115 mcg RE of vitamin A
A patient is anorexic because of stomatitis related to chemotherapy. Which should the
nurse be most concerned about when planning care for this patient?
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1. Aspiration
2. Dehydration
3. Malnutrition
4. Constipation
3. Malnutrition
Stomatitis, inflammation of the mucous membranes of the oral cavity, can be
painful. Patients with stomatitis frequently avoid eating to limit discomfort, which
can lead to inadequate nutritional intake and malnutrition
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1. Although in some patients stomatitis may cause difficulty with swallowing
(dysphagia), which may contribute to aspiration, a bland diet soft in consistency
will help to minimize dysphagia. 2. Ingesting adequate amounts of fluid generally is
not a problem as long as acidic fluids are avoided because they irritate the lesions
of the mucous membranes.
4. Although a loss of appetite may contribute to constipation, an increase in fluid
intake and activity can help prevent constipation.
A nurse is counseling a patient with the diagnosis of osteoporosis. In addition to
calcium, which vitamin supplement should the nurse anticipate that the primary
health-care provider will prescribe for this patient?
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1. B
2. K
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