Chapter 22. Nutrition in Critical Care
MULTIPLE CHOICE
1. Counter-regulatory hormones include which of the following?
1. Glucagon
2. Insulin
3. Aldosterone
4. Dopamine
ANS: 1
Chapter: Chapter 22, Nutrition in Critical Care
Objective: 1. List four hypermetabolic conditions that increase resting energy expenditure and
hence kilocaloric requirements.
Page: 390
Heading: Hormonal Response
Integrated Processes: Nursing Process
Client Need: Management of Care
Cognitive Level: Comprehension
Concept: Metabolism
Difficulty: Moderate
Feedback
1 This is correct. The catecholamines, glucagon and cortisol, oppose insulin and
are typically referred to as counter-regulatory hormones.
2 This is incorrect. Insulin is not a counter-regulatory hormone.
3 This is incorrect. Aldosterone is not a counter-regulatory hormone.
4 This is incorrect. Dopamine is not a counter-regulatory hormone.
PTS: 1 CON: Metabolism
2. Which of the following chemicals respond to stress by triggering the body to retain water and
sodium?
1. Ketones
2. Glucose
3. Antidiuretic hormone
4. Insulin
ANS: 3
Chapter: Chapter 22, Nutrition in Critical Care
Objective: 1. List four hypermetabolic conditions that increase resting energy expenditure and
hence kilocaloric requirements.
Page: 390
Heading: Hormonal Response
Integrated Processes: Nursing Process
Client Need: Management of Care
Cognitive Level: Comprehension
Concept: Metabolism
Difficulty: Moderate
, Feedback
1 This is incorrect. Ketones do not respond to stress by retaining water and
sodium.
2 This is incorrect. Glucose does not respond to stress by retaining water and
sodium.
3 This is correct. Two hormones, aldosterone and antidiuretic hormone, respond to
stress, and the result is the retention of both water and sodium.
4 This is incorrect. Insulin does not respond to stress by retaining water and
sodium.
PTS: 1 CON: Metabolism
3. A client with which of the following conditions requires the greatest increase in kilocaloric
demand?
1.Surgery for carpal tunnel syndrome
2.Abdominal surgery for a perforated bowel
3.Anterior cruciate ligament surgical repair
4.Burns over abdomen and right leg
ANS: 4
Chapter: Chapter 22, Nutrition in Critical Care
Objective: 2. Describe how metabolism differs in starvation and hypermetabolism.
Page: 392
Heading: Burns
Integrated Processes: Nursing Process
Client Need: Management of Care
Cognitive Level: Application
Concept: Nutrition
Difficulty: Difficult
Feedback
1 This is incorrect. Uncomplicated minor surgery increases the surgical client’s
kilocaloric requirement by only 5%.
2 This is incorrect. Surgery needed to repair soft tissue trauma requires a 14% to
37% increase in kilocalories.
3 This is incorrect. Surgery needed to repair soft tissue trauma requires a 14% to
37% increase in kilocalories, which is not the greatest increase noted.
4 This is correct. Major burns are the most extreme state of stress a client can
sustain and produce a hypermetabolic state that raises kilocaloric needs higher
than those of most other stresses. Kilocaloric requirements may be as high as
8,000 calories per day.
PTS: 1 CON: Nutrition
4. A client is in the critical care unit following abdominal surgery. A nurse is assessing bowel
sounds to determine whether the client is able to begin taking in food and liquids by mouth.
Which of the following is the nurse assessing for?
1. Peristalsis
2. Hypermetabolism
MULTIPLE CHOICE
1. Counter-regulatory hormones include which of the following?
1. Glucagon
2. Insulin
3. Aldosterone
4. Dopamine
ANS: 1
Chapter: Chapter 22, Nutrition in Critical Care
Objective: 1. List four hypermetabolic conditions that increase resting energy expenditure and
hence kilocaloric requirements.
Page: 390
Heading: Hormonal Response
Integrated Processes: Nursing Process
Client Need: Management of Care
Cognitive Level: Comprehension
Concept: Metabolism
Difficulty: Moderate
Feedback
1 This is correct. The catecholamines, glucagon and cortisol, oppose insulin and
are typically referred to as counter-regulatory hormones.
2 This is incorrect. Insulin is not a counter-regulatory hormone.
3 This is incorrect. Aldosterone is not a counter-regulatory hormone.
4 This is incorrect. Dopamine is not a counter-regulatory hormone.
PTS: 1 CON: Metabolism
2. Which of the following chemicals respond to stress by triggering the body to retain water and
sodium?
1. Ketones
2. Glucose
3. Antidiuretic hormone
4. Insulin
ANS: 3
Chapter: Chapter 22, Nutrition in Critical Care
Objective: 1. List four hypermetabolic conditions that increase resting energy expenditure and
hence kilocaloric requirements.
Page: 390
Heading: Hormonal Response
Integrated Processes: Nursing Process
Client Need: Management of Care
Cognitive Level: Comprehension
Concept: Metabolism
Difficulty: Moderate
, Feedback
1 This is incorrect. Ketones do not respond to stress by retaining water and
sodium.
2 This is incorrect. Glucose does not respond to stress by retaining water and
sodium.
3 This is correct. Two hormones, aldosterone and antidiuretic hormone, respond to
stress, and the result is the retention of both water and sodium.
4 This is incorrect. Insulin does not respond to stress by retaining water and
sodium.
PTS: 1 CON: Metabolism
3. A client with which of the following conditions requires the greatest increase in kilocaloric
demand?
1.Surgery for carpal tunnel syndrome
2.Abdominal surgery for a perforated bowel
3.Anterior cruciate ligament surgical repair
4.Burns over abdomen and right leg
ANS: 4
Chapter: Chapter 22, Nutrition in Critical Care
Objective: 2. Describe how metabolism differs in starvation and hypermetabolism.
Page: 392
Heading: Burns
Integrated Processes: Nursing Process
Client Need: Management of Care
Cognitive Level: Application
Concept: Nutrition
Difficulty: Difficult
Feedback
1 This is incorrect. Uncomplicated minor surgery increases the surgical client’s
kilocaloric requirement by only 5%.
2 This is incorrect. Surgery needed to repair soft tissue trauma requires a 14% to
37% increase in kilocalories.
3 This is incorrect. Surgery needed to repair soft tissue trauma requires a 14% to
37% increase in kilocalories, which is not the greatest increase noted.
4 This is correct. Major burns are the most extreme state of stress a client can
sustain and produce a hypermetabolic state that raises kilocaloric needs higher
than those of most other stresses. Kilocaloric requirements may be as high as
8,000 calories per day.
PTS: 1 CON: Nutrition
4. A client is in the critical care unit following abdominal surgery. A nurse is assessing bowel
sounds to determine whether the client is able to begin taking in food and liquids by mouth.
Which of the following is the nurse assessing for?
1. Peristalsis
2. Hypermetabolism
