Question 1

The registered dietitian is completing her initial assessment for Mr.Delgado.When estimating his energy needs she selects _____ for his stress factor.

Accepted Answer

A) 1.7 
B) 1.8 
C) 1.9 
D) 2.0 
A) 1.7 
B) 1.8 
C) 1.9 
D) 2.0

Question 2

Dave has 2nd degree burns on his back torso, left arm, and left leg.This represents about _____% of his total body surface area (TBSA).

Accepted Answer

A) 27 
B) 36 
C) 45 
D) 72 
A) 27 
B) 36 
C) 45 
D) 72

Question 3

Which of these statements is false?

Accepted Answer

A) High-energy enteral supplements are especially useful for COPD patients because they reduce satiety and enhance appetite. 
B) Clinical studies have not confirmed that low-carbohydrate formulas reduce respiratory stress in patients with COPD. 
C) Some pulmonary enteral formulas have a different macronutrient distribution than standard formulas, with more energy from fat and less from carbohydrate. 
D) The ratio of carbon dioxide production to oxygen consumption in cells is lower when fat is consumed than when carbohydrate is consumed. 
A) High-energy enteral supplements are especially useful for COPD patients because they reduce satiety and enhance appetite. 
B) Clinical studies have not confirmed that low-carbohydrate formulas reduce respiratory stress in patients with COPD. 
C) Some pulmonary enteral formulas have a different macronutrient distribution than standard formulas, with more energy from fat and less from carbohydrate. 
D) The ratio of carbon dioxide production to oxygen consumption in cells is lower when fat is consumed than when carbohydrate is consumed.

Question 4

Which of these statements is true?

Accepted Answer

A) For the vast majority of critically ill patients, nutrient needs are easily met through oral intake of a regular diet. 
B) Current research studies support that in the stressed patient, parenteral nutrition should not be used in combination with enteral nutrition. 
C) A high-kcalorie, high-protein diet is inappropriate for patients recovering from acute stress because of the risk of refeeding syndrome. 
D) Enteral formulas developed specifically for promotion of wound healing have high nutrient density and may contain extra zinc, vitamin A, arginine, or glutamine. 
A) For the vast majority of critically ill patients, nutrient needs are easily met through oral intake of a regular diet. 
B) Current research studies support that in the stressed patient, parenteral nutrition should not be used in combination with enteral nutrition. 
C) A high-kcalorie, high-protein diet is inappropriate for patients recovering from acute stress because of the risk of refeeding syndrome. 
D) Enteral formulas developed specifically for promotion of wound healing have high nutrient density and may contain extra zinc, vitamin A, arginine, or glutamine.

Question 5

Having burns increases Joseph's risk for all of the following except:

Accepted Answer

A) infection. 
B) intestinal ileus or gastrointestinal malfunction. 
C) bronchitis. 
D) dehydration.
Margaret Chen is a 73-year-old widow and mother of 3 adult children.She visits her physician due to decreased appetite, lethargy, weight loss, and a productive cough for the past 2 weeks.Her past medical history includes osteoporosis, sinusitis, respiratory infections, and smoking. 
A) infection. 
B) intestinal ileus or gastrointestinal malfunction. 
C) bronchitis. 
D) dehydration.
Margaret Chen is a 73-year-old widow and mother of 3 adult children.She visits her physician due to decreased appetite, lethargy, weight loss, and a productive cough for the past 2 weeks.Her past medical history includes osteoporosis, sinusitis, respiratory infections, and smoking.

Question 6

Which symptom is associated with systemic inflammatory response syndrome (SIRS)?

Accepted Answer

A) Fever 
B) Reduced heart and respiratory rates 
C) Abnormal red blood cell counts 
D) Impaired inflammatory response 
A) Fever 
B) Reduced heart and respiratory rates 
C) Abnormal red blood cell counts 
D) Impaired inflammatory response

Question 7

The nurse orders a nutrition consult due to Joseph's poor intake.All of the following are likely contributing to his low intake, except for:

Accepted Answer

A) pain. 
B) sedation. 
C) feeding problems. 
D) positive nitrogen balance. 
A) pain. 
B) sedation. 
C) feeding problems. 
D) positive nitrogen balance.

Question 8

Which of the following can raise the energy needs of a critically ill patient?

Accepted Answer

A) Being bedridden 
B) Mechanical ventilation 
C) Wasting 
D) Electrolyte imbalances 
A) Being bedridden 
B) Mechanical ventilation 
C) Wasting 
D) Electrolyte imbalances

Question 9

Randall is a 54-year-old man who has recently been involved in an accident.His injuries include multiple open wounds and two broken ribs.Inflammatory responses at the injury site would include all of the following except

Accepted Answer

A) accumulation of fluid. 
B) dilation of small blood vessels. 
C) decreased capillary permeability. 
D) increased flow of immune factors to the site. 
A) accumulation of fluid. 
B) dilation of small blood vessels. 
C) decreased capillary permeability. 
D) increased flow of immune factors to the site.

Question 10

What are the current findings of research on glutamine supplementation?

Accepted Answer

A) It may increase the number of infections 
B) It may reverse suppressed catecholamine release 
C) It may reduce mortality rates in critically ill patients 
D) All of the above 
A) It may increase the number of infections 
B) It may reverse suppressed catecholamine release 
C) It may reduce mortality rates in critically ill patients 
D) All of the above

Question 11

An estimate of the kcalorie needs of a 70-kg man who has sepsis would be

Accepted Answer

A) 1525-1700 kcalories. 
B) 1750-2100 kcalories. 
C) 2450-2800 kcalories. 
D) 2950-3175 kcalories. 
A) 1525-1700 kcalories. 
B) 1750-2100 kcalories. 
C) 2450-2800 kcalories. 
D) 2950-3175 kcalories.

Question 12

Fish oils are rich in

Accepted Answer

A) omega-3 fatty acids. 
B) omega-6 fatty acids. 
C) linolenic acids. 
D) stearic acid. 
A) omega-3 fatty acids. 
B) omega-6 fatty acids. 
C) linolenic acids. 
D) stearic acid.

Question 13

After a patient sustains trauma from a car accident, his heart rate, respiratory rate, and blood pressure increase.What is happening?

Accepted Answer

A) Respiratory stress 
B) Metabolic stress 
C) Acute-phase response 
D) Bacterial translocation 
A) Respiratory stress 
B) Metabolic stress 
C) Acute-phase response 
D) Bacterial translocation

Question 14

Which of the following hormones increase(s) water reabsorption by the kidneys?

Accepted Answer

A) Antidiuretic hormone 
B) Aldosterone 
C) a and b 
D) None of the above 
A) Antidiuretic hormone 
B) Aldosterone 
C) a and b 
D) None of the above

Question 15

The initial task for the health care team for a client under major stress is to

Accepted Answer

A) institute total parenteral nutrition to prevent negative nitrogen balance. 
B) place a nasogastric tube to begin enteral nutrition. 
C) restore fluid and electrolyte balance. 
D) determine calorie needs via indirect calorimetry. 
A) institute total parenteral nutrition to prevent negative nitrogen balance. 
B) place a nasogastric tube to begin enteral nutrition. 
C) restore fluid and electrolyte balance. 
D) determine calorie needs via indirect calorimetry.

Question 16

In response to metabolic and respiratory stress the body experiences

Accepted Answer

A) hypometabolism. 
B) breakdown of muscle mass. 
C) a decrease in carbon dioxide in the blood. 
D) only minor complications. 
A) hypometabolism. 
B) breakdown of muscle mass. 
C) a decrease in carbon dioxide in the blood. 
D) only minor complications.

Question 17

Cytokines are proteins that help regulate _____ development and activity.

Accepted Answer

A) immune system 
B) inflammatory 
C) hormonal 
D) GI tract 
A) immune system 
B) inflammatory 
C) hormonal 
D) GI tract

Question 18

Which of these statements is false?

Accepted Answer

A) The Ireton-Jones equation is considered to be inaccurate when used with obese patients. 
B) The amounts of protein and energy to provide during acute illness are controversial and still under investigation. 
C) Energy needs of acutely stressed patients are often estimated by multiplying the RMR by a stress factor appropriate to the condition. 
D) Protein recommendations for stressed patients are higher than the DRI. 
A) The Ireton-Jones equation is considered to be inaccurate when used with obese patients. 
B) The amounts of protein and energy to provide during acute illness are controversial and still under investigation. 
C) Energy needs of acutely stressed patients are often estimated by multiplying the RMR by a stress factor appropriate to the condition. 
D) Protein recommendations for stressed patients are higher than the DRI.

Question 19

Which of the following are nonessential amino acids that are sometimes supplemented in patients undergoing metabolic stress?

Accepted Answer

A) Aspartic acid and arginine 
B) Arginine and glutamine 
C) Glycine and glutamine 
D) Alanine and glycine 
A) Aspartic acid and arginine 
B) Arginine and glutamine 
C) Glycine and glutamine 
D) Alanine and glycine

Question 20

Which classification of burns involves both the epidermis and dermis; are wet, red and blistery; and are extremely painful because the nerve endings are exposed?

Accepted Answer

A) 1st degree 
B) 2nd degree 
C) 3rd degree 
D) 4th degree 
A) 1st degree 
B) 2nd degree 
C) 3rd degree 
D) 4th degree

Exam 22: Metabolic and Respiratory Stress

The registered dietitian is completing her initial assessment for Mr.Delgado.When estimating his energy needs she selects _____ for his stress factor.

Dave has 2nd degree burns on his back torso, left arm, and left leg.This represents about _____% of his total body surface area (TBSA).

Which of these statements is false?

Which of these statements is true?

Having burns increases Joseph's risk for all of the following except:

Which symptom is associated with systemic inflammatory response syndrome (SIRS)?

The nurse orders a nutrition consult due to Joseph's poor intake.All of the following are likely contributing to his low intake, except for:

Which of the following can raise the energy needs of a critically ill patient?

Randall is a 54-year-old man who has recently been involved in an accident.His injuries include multiple open wounds and two broken ribs.Inflammatory responses at the injury site would include all of the following except

What are the current findings of research on glutamine supplementation?

An estimate of the kcalorie needs of a 70-kg man who has sepsis would be

Fish oils are rich in

After a patient sustains trauma from a car accident, his heart rate, respiratory rate, and blood pressure increase.What is happening?

Which of the following hormones increase(s) water reabsorption by the kidneys?

The initial task for the health care team for a client under major stress is to

In response to metabolic and respiratory stress the body experiences

Cytokines are proteins that help regulate _____ development and activity.

Which of these statements is false?

Which of the following are nonessential amino acids that are sometimes supplemented in patients undergoing metabolic stress?

Which classification of burns involves both the epidermis and dermis; are wet, red and blistery; and are extremely painful because the nerve endings are exposed?

An Overview of Nutrition

Planning a Healthy Diet

Digestion, Absorption, and Transport

The Carbohydrates: Sugars, Starches and Fibers

The Lipids: Triglycerides, Phospholipids, and Sterols

Protein: Amino Acids

Metabolism: Transformations and Interactions

Energy Balance and Body Composition

Weight Management: Overweight, Obesity, and Underweight

The Water-Soluble Vitamins: B Vitamins and Vitamin C

The Fat-Soluble Vitamins: A, D, E, and K

Water and the Major Minerals

The Trace Minerals

Life Cycle Nutrition: Pregnancy and Lactation

Life Cycle Nutrition: Infancy, Childhood, and Adolescence

Life Cycle Nutrition: Adulthood and the Later Years

Nutrition Care and Assessment

Nutrition Intervention

Medications, Diet-Drug Interactions, and Herbal Products

Enteral Nutrition Support

Parenteral Nutrition Support

Upper Gastrointestinal Disorders

Lower Gastrointestinal Disorders

Liver Disease and Gallstones

Diabetes Mellitus

Cardiovascular Diseases

Kidney Diseases

Cancer and Hiv Infection

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