Chapter 11. Normal Childhood Nutrition and Its Disorders
1. If a patient with multiple sclerosis starts coughing
frequently during meals and starts to eat significantly less
food than normal, the patient may have
a.pneumonia.
b.gastroesophageal reflux
disease. c.peptic ulcer.
d.dysphagia.
ANS: D
Patients with multiple sclerosis may develop dysphagia; coughing during meals and eating less
than usual are common symptoms. Dysphagia may cause pneumonia if food enters the lungs
and causes infection. Gastroesophageal reflux disease causes burning and pain but typically not
coughing. Peptic ulcer causes intestinal pain but not coughing.
2. For a patient with dysphagia, the food that would be most difficult to swallow
is a.applesauce.
b.mashed potatoes.
c.chocolate pudding.
d.chicken noodle soup.
ANS: D
Patients with dysphagia often have difficulty swallowing thin liquids, such as chicken
noodle soup. Thicker, pureed foods such as applesauce, mashed potatoes, and chocolate
pudding are usually easier to swallow.
3. If a patient has difficulty swallowing, the best position for eating
is a.propped up in bed with a caregiver by the bedside.
b.sitting upright opposite a caregiver.
c.sitting at a dining table with social dining
companions. d.lying on the left side, with a caregiver by
the side.
ANS: B
The safest eating position for someone who has trouble swallowing is sitting upright; the
caregiver should sit opposite to help provide cues and reminders while the patient is eating. It
is usually best for patients with dysphagia not to interact socially during mealtimes because
talking
, may make swallowing more difficult. Sitting propped up in bed and leaning back would make
it easier for food to enter the airway. Lying on ones side while eating is very likely to cause
aspiration.
4. The most acute risk for patients with dysphagia
is a.constipation.
b.dehydration.
c.dry mouth.
d.panic attacks.
ANS: B
An acute daily concern for patients with dysphagia is dehydration. Patients are not usually
allowed to drink fluids without supervision, and so fluid intake must be monitored
throughout the day. Constipation and dry mouth may occur with poor fluid and food intake
but are less acute. Patients with dysphagia may experience feelings of panic, but this is not
the most acute concern.
5. The most helpful recommendation for a client who often experiences heartburn at night
would be to
a.avoid eating within 4 hours of going to
bed. b.increase the fiber content of the diet.
c.decrease the fiber content of the diet.
d.take antacid medications before going to bed.
ANS: A
Gastroesophageal reflux disease (GERD) usually occurs 1 to 4 hours after eating; therefore,
waiting at least 4 hours after eating before going to bed would help prevent heartburn at
night. Antacid medications may be helpful but should not be used on a regular basis before
other strategies have been tried. Fiber content of the diet does not affect heartburn.
6. An example of a meal that is likely to relax the lower esophageal sphincter and
allow gastroesophageal reflux is
a.pasta with marinara sauce and sourdough
bread. b.ham with rice pilaf.
1. If a patient with multiple sclerosis starts coughing
frequently during meals and starts to eat significantly less
food than normal, the patient may have
a.pneumonia.
b.gastroesophageal reflux
disease. c.peptic ulcer.
d.dysphagia.
ANS: D
Patients with multiple sclerosis may develop dysphagia; coughing during meals and eating less
than usual are common symptoms. Dysphagia may cause pneumonia if food enters the lungs
and causes infection. Gastroesophageal reflux disease causes burning and pain but typically not
coughing. Peptic ulcer causes intestinal pain but not coughing.
2. For a patient with dysphagia, the food that would be most difficult to swallow
is a.applesauce.
b.mashed potatoes.
c.chocolate pudding.
d.chicken noodle soup.
ANS: D
Patients with dysphagia often have difficulty swallowing thin liquids, such as chicken
noodle soup. Thicker, pureed foods such as applesauce, mashed potatoes, and chocolate
pudding are usually easier to swallow.
3. If a patient has difficulty swallowing, the best position for eating
is a.propped up in bed with a caregiver by the bedside.
b.sitting upright opposite a caregiver.
c.sitting at a dining table with social dining
companions. d.lying on the left side, with a caregiver by
the side.
ANS: B
The safest eating position for someone who has trouble swallowing is sitting upright; the
caregiver should sit opposite to help provide cues and reminders while the patient is eating. It
is usually best for patients with dysphagia not to interact socially during mealtimes because
talking
, may make swallowing more difficult. Sitting propped up in bed and leaning back would make
it easier for food to enter the airway. Lying on ones side while eating is very likely to cause
aspiration.
4. The most acute risk for patients with dysphagia
is a.constipation.
b.dehydration.
c.dry mouth.
d.panic attacks.
ANS: B
An acute daily concern for patients with dysphagia is dehydration. Patients are not usually
allowed to drink fluids without supervision, and so fluid intake must be monitored
throughout the day. Constipation and dry mouth may occur with poor fluid and food intake
but are less acute. Patients with dysphagia may experience feelings of panic, but this is not
the most acute concern.
5. The most helpful recommendation for a client who often experiences heartburn at night
would be to
a.avoid eating within 4 hours of going to
bed. b.increase the fiber content of the diet.
c.decrease the fiber content of the diet.
d.take antacid medications before going to bed.
ANS: A
Gastroesophageal reflux disease (GERD) usually occurs 1 to 4 hours after eating; therefore,
waiting at least 4 hours after eating before going to bed would help prevent heartburn at
night. Antacid medications may be helpful but should not be used on a regular basis before
other strategies have been tried. Fiber content of the diet does not affect heartburn.
6. An example of a meal that is likely to relax the lower esophageal sphincter and
allow gastroesophageal reflux is
a.pasta with marinara sauce and sourdough
bread. b.ham with rice pilaf.
