NUR 221 Exam 2 questions with complete
solutions
Basal metabolic rate (BMR) - answer-Energy needed at rest to maintain life-sustaining
v v v v v v v v v v v
activities for a specific amount of time. Older adults have a slower BMR
v v v v v v v v v v v v v
Resting energy expenditure (REE) - answer-Amount of energy needed to consume over
v v v v v v v v v v v
24-hour period for the body to maintain internal working activities while at rest
v v v v v v v v v v v v v
Carbohydrates - answer-Main source of energy in the diet. composed of carbon,
v v v v v v v v v v v
hydrogen, and oxygen. produces 4 kcal/g and serves as the main source of fuel
v v v v v v v v v v v v v v
(glucose) for the brain, skeletal muscles during exercise, erythrocyte and leukocyte
v v v v v v v v v v v
production, and cell function of the renal medulla.
v v v v v v v v
Protein - answer-made up of amino acids. Necessary for nitrogen balance. Proteins
v v v v v v v v v v v
provide a source of energy (4 kcal/g), and they are essential for the growth,
v v v v v v v v v v v v v v
maintenance and repair of body tissue. Consist of oxygen, carbon, hydrogen, and
v v v v v v v v v v v v
nitrogen.
v
Fats (lipids) - answer-Fats (lipids) are the most calorie-dense nutrient, providing 9 kcal/g.
v v v v v v v v v v v v
v
Fats are composed of triglycerides and fatty acids.
v v v v v v v
Water - answer-makes up 60-70% of body weight.
v v v v v v v v
Infants have greatest percentage of total body water
v v v v v v v
Vitamins - answer-organic substances present in small amounts in foods that are
v v v v v v v v v v v
essential to normal metabolism. They are chemicals that act as catalysts in biochemical
v v v v v v v v v v v v v
reactions.
v
Minerals - answer-inorganic elements essential to the body as catalysts in biochemical
v v v v v v v v v v v
reactions.
v
normal BMI - answer-18.5-24.9
v v v
overweight BMI - answer-25-29.9 v v v
obese BMI - answer->30
v v v
Mini Nutritional Assessment (MNA) - answer-If a patient scores 11 or less on the
v v v v v v v v v v v v v
screening part, the health care provider completes the assessment part. A total score of
v v v v v v v v v v v v v v
less than 17 indicates protein-energy malnutrition.
v v v v v v
,Calculate nitrogen balance - answer-by dividing 6.25 into the total grams of protein
v v v v v v v v v v v v
ingested in a day
v v v v
Serum Laboratory Values - answer-Albumin
v v v v
Prealbumin
Hemoglobin
Metabolic half-life - answer-Albumin- 21 days (long term)
v v v v v v v
Transferrin- 8 days v v
Prealbumin- 2 days (acute term) v v v v
Albumin - answer-Normal Value (adult): 3.5-5.0 g/dl
v v v v v v
<2.8 associated with edema
v v v
21 days half life (long term)
v v v v v
Synthesized in the liver from amino acids; indicator of prolonged protein depletion
v v v v v v v v v v v
Prealbumin - answer-Normal value 15-36mg/dl v v v v
<10.7 is severe nutritional deficiency
v v v v
acute term 2 days v v v v
Determines protein depletion in acute conditions v v v v v
Hemoglobin - answer-12-16 g/dl in females v v v v v
14-18 g/dl in males v v v
the iron-containing pigment of the Red blood cells; assists with O2 and CO2 transport.
v v v v v v v v v v v v v
Fruitarian - answer-consumes fruit, nuts, honey, and olive oil
v v v v v v v v
vegan - answer-consumes only plant food
v v v v v
Lactovegetarian - answer-drinks milk but avoids eggs v v v v v v
Ovolactovegetarian - answer-avoids meat, fish, and poultry, but eats eggs and milk v v v v v v v v v v v
Dysphagia - answer-Difficulty swallowing, at risk for aspiration. Need a speech and
v v v v v v v v v v v
language consult. Most common dysphagia is silent and occurs without a cough.
v v v v v v v v v v v v
patients eat with a chin tuck and food goes on strong side of the mouth
v v v v v v v v v v v v v v v
NPO Diet - answer-nothing by mouth. Rest the GI tract or for patients with swallowing
v v v v v v v v v v v v v v
problems.require enternal if NPO >5 days
v v v v v v
Pureed Diet - answer-clients with dysphagia or wired jaws; foods that have been
v v v v v v v v v v v v
blenderized to smooth consistency
v v v v
Soft/Low-residue diet - answer-reduces volume and frequency of stools includes easily v v v v v v v v v v
digested foods that are easy to chew and swallow
v v v v v v v v v
, Dysphagia diets- 4 levels - answer-Dysphagia puree- pudding like
v v v v v v v v
Dysphagia mechanically altered-soft texture
v v v
Dysphagia advanced- no hard, sticky or crunchy foods
v v v v v v v
Regular
These levels are determined by a swallow test
v v v v v v v
4 levels of liquid for dysphagia patients - answer-Liquid thin (water),
v v v v v v v v v v v
Nectar-like (apricot, prune, tomato), v v v v
Honey-like (smoothies, yogurt), v v v
Spoon-thick (pudding) v
Enteral Nutrition - answer-nutrition may be provided with nasogastric, gastric, or jejunal
v v v v v v v v v v v
tubes. comes in cans or prefilled bags. Diarrhea can be caused by bacteria being in the
v v v v v v v v v v v v v v v v
bag, bag only good for 24 hours. If nausea, cramping or diarrhea occurs slow the tube
v v v v v v v v v v v v v v v v
feeding down
v v
Nasogastric (NG) Tube - answer-inserted through the nose
v v v v v v v
is used short term 4 weeks or less
v v v v v v v
assess sputum before placing into the nose incase the sputum is deviated
v v v v v v v v v v v v
Landmarks for inserting-Nose, ear, xiphoid process for stomach add 8-10 inches for
v v v v v v v v v v v
small intestine
v v
Gastrostomy (G-tube) or jejunostomy (j-tube) - answer-inserted surgically MD; used for
v v v v v v v v v v
long term
v v
jejunostomy tube ( j-tube) - answer-is the only tube that is beyond the stomach and is not
v v v v v v v v v v v v v v v v
vcontraindicated by facial trauma v v v
Tubes places in the stomach - answer-The nasogastric tube and the PEG tube are
v v v v v v v v v v v v v
placed in the stomach, and placement could lead to aspiration
v v v v v v v v v v
PEG tube - answer-long term; MD performs in endoscopy; does not require surgery
v v v v v v v v v v v v
Meds per feeding tube - answer-Insert crushed med one at a time
v v v v v v v v v v v
Make sure meds can be crushed, if unsure contact pharmacy
v v v v v v v v v
Flush in between each med with water
v v v v v v
Nursing Responsibilities v
vfor NG Tubes - answer-X-ray is the only reliable method of placement verification for
v v v v v v v v v v v v v
vinitial feeding. Must check x-ray first.
v v v v v
Verify tube placement
v v v
HOB up at least 30 degrees
v v v v v
If laying flat turn tube feeding off put it on hold
v v v v v v v v v v
Assess bowel sounds v v
solutions
Basal metabolic rate (BMR) - answer-Energy needed at rest to maintain life-sustaining
v v v v v v v v v v v
activities for a specific amount of time. Older adults have a slower BMR
v v v v v v v v v v v v v
Resting energy expenditure (REE) - answer-Amount of energy needed to consume over
v v v v v v v v v v v
24-hour period for the body to maintain internal working activities while at rest
v v v v v v v v v v v v v
Carbohydrates - answer-Main source of energy in the diet. composed of carbon,
v v v v v v v v v v v
hydrogen, and oxygen. produces 4 kcal/g and serves as the main source of fuel
v v v v v v v v v v v v v v
(glucose) for the brain, skeletal muscles during exercise, erythrocyte and leukocyte
v v v v v v v v v v v
production, and cell function of the renal medulla.
v v v v v v v v
Protein - answer-made up of amino acids. Necessary for nitrogen balance. Proteins
v v v v v v v v v v v
provide a source of energy (4 kcal/g), and they are essential for the growth,
v v v v v v v v v v v v v v
maintenance and repair of body tissue. Consist of oxygen, carbon, hydrogen, and
v v v v v v v v v v v v
nitrogen.
v
Fats (lipids) - answer-Fats (lipids) are the most calorie-dense nutrient, providing 9 kcal/g.
v v v v v v v v v v v v
v
Fats are composed of triglycerides and fatty acids.
v v v v v v v
Water - answer-makes up 60-70% of body weight.
v v v v v v v v
Infants have greatest percentage of total body water
v v v v v v v
Vitamins - answer-organic substances present in small amounts in foods that are
v v v v v v v v v v v
essential to normal metabolism. They are chemicals that act as catalysts in biochemical
v v v v v v v v v v v v v
reactions.
v
Minerals - answer-inorganic elements essential to the body as catalysts in biochemical
v v v v v v v v v v v
reactions.
v
normal BMI - answer-18.5-24.9
v v v
overweight BMI - answer-25-29.9 v v v
obese BMI - answer->30
v v v
Mini Nutritional Assessment (MNA) - answer-If a patient scores 11 or less on the
v v v v v v v v v v v v v
screening part, the health care provider completes the assessment part. A total score of
v v v v v v v v v v v v v v
less than 17 indicates protein-energy malnutrition.
v v v v v v
,Calculate nitrogen balance - answer-by dividing 6.25 into the total grams of protein
v v v v v v v v v v v v
ingested in a day
v v v v
Serum Laboratory Values - answer-Albumin
v v v v
Prealbumin
Hemoglobin
Metabolic half-life - answer-Albumin- 21 days (long term)
v v v v v v v
Transferrin- 8 days v v
Prealbumin- 2 days (acute term) v v v v
Albumin - answer-Normal Value (adult): 3.5-5.0 g/dl
v v v v v v
<2.8 associated with edema
v v v
21 days half life (long term)
v v v v v
Synthesized in the liver from amino acids; indicator of prolonged protein depletion
v v v v v v v v v v v
Prealbumin - answer-Normal value 15-36mg/dl v v v v
<10.7 is severe nutritional deficiency
v v v v
acute term 2 days v v v v
Determines protein depletion in acute conditions v v v v v
Hemoglobin - answer-12-16 g/dl in females v v v v v
14-18 g/dl in males v v v
the iron-containing pigment of the Red blood cells; assists with O2 and CO2 transport.
v v v v v v v v v v v v v
Fruitarian - answer-consumes fruit, nuts, honey, and olive oil
v v v v v v v v
vegan - answer-consumes only plant food
v v v v v
Lactovegetarian - answer-drinks milk but avoids eggs v v v v v v
Ovolactovegetarian - answer-avoids meat, fish, and poultry, but eats eggs and milk v v v v v v v v v v v
Dysphagia - answer-Difficulty swallowing, at risk for aspiration. Need a speech and
v v v v v v v v v v v
language consult. Most common dysphagia is silent and occurs without a cough.
v v v v v v v v v v v v
patients eat with a chin tuck and food goes on strong side of the mouth
v v v v v v v v v v v v v v v
NPO Diet - answer-nothing by mouth. Rest the GI tract or for patients with swallowing
v v v v v v v v v v v v v v
problems.require enternal if NPO >5 days
v v v v v v
Pureed Diet - answer-clients with dysphagia or wired jaws; foods that have been
v v v v v v v v v v v v
blenderized to smooth consistency
v v v v
Soft/Low-residue diet - answer-reduces volume and frequency of stools includes easily v v v v v v v v v v
digested foods that are easy to chew and swallow
v v v v v v v v v
, Dysphagia diets- 4 levels - answer-Dysphagia puree- pudding like
v v v v v v v v
Dysphagia mechanically altered-soft texture
v v v
Dysphagia advanced- no hard, sticky or crunchy foods
v v v v v v v
Regular
These levels are determined by a swallow test
v v v v v v v
4 levels of liquid for dysphagia patients - answer-Liquid thin (water),
v v v v v v v v v v v
Nectar-like (apricot, prune, tomato), v v v v
Honey-like (smoothies, yogurt), v v v
Spoon-thick (pudding) v
Enteral Nutrition - answer-nutrition may be provided with nasogastric, gastric, or jejunal
v v v v v v v v v v v
tubes. comes in cans or prefilled bags. Diarrhea can be caused by bacteria being in the
v v v v v v v v v v v v v v v v
bag, bag only good for 24 hours. If nausea, cramping or diarrhea occurs slow the tube
v v v v v v v v v v v v v v v v
feeding down
v v
Nasogastric (NG) Tube - answer-inserted through the nose
v v v v v v v
is used short term 4 weeks or less
v v v v v v v
assess sputum before placing into the nose incase the sputum is deviated
v v v v v v v v v v v v
Landmarks for inserting-Nose, ear, xiphoid process for stomach add 8-10 inches for
v v v v v v v v v v v
small intestine
v v
Gastrostomy (G-tube) or jejunostomy (j-tube) - answer-inserted surgically MD; used for
v v v v v v v v v v
long term
v v
jejunostomy tube ( j-tube) - answer-is the only tube that is beyond the stomach and is not
v v v v v v v v v v v v v v v v
vcontraindicated by facial trauma v v v
Tubes places in the stomach - answer-The nasogastric tube and the PEG tube are
v v v v v v v v v v v v v
placed in the stomach, and placement could lead to aspiration
v v v v v v v v v v
PEG tube - answer-long term; MD performs in endoscopy; does not require surgery
v v v v v v v v v v v v
Meds per feeding tube - answer-Insert crushed med one at a time
v v v v v v v v v v v
Make sure meds can be crushed, if unsure contact pharmacy
v v v v v v v v v
Flush in between each med with water
v v v v v v
Nursing Responsibilities v
vfor NG Tubes - answer-X-ray is the only reliable method of placement verification for
v v v v v v v v v v v v v
vinitial feeding. Must check x-ray first.
v v v v v
Verify tube placement
v v v
HOB up at least 30 degrees
v v v v v
If laying flat turn tube feeding off put it on hold
v v v v v v v v v v
Assess bowel sounds v v
