Deck 16: Nutrition in Metabolic and Respiratory Stress

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Question
Protein synthesis is inhibited by _____.​

A) ​cortisol
B) ​eicosanoids
C) ​mast cells
D) ​phagocytes
E) ​aldosterone
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Question
If stress continues for a long period, growth retardation and illness can occur.​
Question
What compound is produced by white blood cells and participates in the inflammatory process?​

A) ​glucagon
B) ​catecholamines
C) ​cytokines
D) ​cortisol
E) ​aldosterone
Question
The major precursor to eicosanoids in the inflammatory process is _____.​

A) ​cortisol
B) ​arachidonic acid
C) ​epinephrine
D) ​glucagon
E) ​norepinephrine
Question
Weight loss and wasting are common in the advanced stages of COPD and may result from hypermetabolism, poor food intake, and the actions of various inflammatory proteins.​
Question
Overfeeding an acutely stressed patient improves nitrogen balance and decreases lean tissue losses.​
Question
Excessive energy intake in patients with ARDS can worsen respiratory function.​
Question
An excessive response to metabolic stress can worsen illness and lead to death.​
Question
The high nutrient requirements of acutely stressed patients often require a patient to be fed via the enteral or parenteral route to meet his or her nutritional needs.​
Question
If the reduction in blood flow from inflammation is severe enough to deprive the body's tissues of oxygen and nutrients, SIRS can result.​
Question
Recovery from an injury or illness can be hastened by hypermetabolism and positive nitrogen balance.​
Question
The inflammatory process can alter immune cell function in the body.​
Question
To maintain lean tissue, the protein intakes recommended during acute stress are higher than DRI values.​
Question
Nutrition care for patients in acute respiratory failure is aimed at providing a low-fat, high-carbohydrate diet.​
Question
The symptoms associated with the initial inflammatory response are collectively called the systemic inflammatory response syndrome.​
Question
​The increase in basal metabolic rate as a part of the stress response can be attributed to _____.

A) ​catecholamines
B) ​cortisol
C) ​eicosanoids
D) ​cytokines
E) ​hepcidin
Question
During the inflammatory response, mast cells release _____, which causes vasodilation and capillary permeability.​

A) ​erythropoietin
B) ​cortisol
C) ​anti-diuretic hormone
D) ​cytokine
E) ​histamine
Question
A patient with lung disease would most likely prevent or reverse loss of muscle mass by decreasing activity levels and incorporating more rest.​
Question
Smoking is the primary risk factor in most cases of COPD.​
Question
Patients under 55 years old are several times more likely to develop MODS than are older patients.​
Question
Laura is a critically ill patient. She is 5'4" tall and weighs 150 pounds. What are Laura's protein needs?​

A) ​34-40 g
B) ​54-68 g
C) ​82-136 g
D) ​136-158 g
E) ​160-184 g
Question
The protein needs of a non-obese critically ill patient would be _____.​

A) ​0.8-1.0 g/kg body weight per day
B) ​1.0-1.2 g/kg body weight per day
C) ​1.2-2.0 g/kg body weight per day
D) ​2.0-2.5 g/kg body weight per day
E) ​2.5-3.0 g/kg body weight per day
Question
A COPD patient who complains of abdominal discomfort and dyspnea may benefit from _____.​

A) ​small, frequent meals
B) ​a low-fat diet
C) ​a high-fiber diet
D) ​consuming more liquids
E) ​increased energy consumption
Question
What describes the immediate care concerns of the clinician during a patient's time of severe stress?​

A) ​Educating the patient about nutrient needs
B) ​Providing psychological counseling
C) ​Determining the level of the patient's understanding about his condition
D) ​Providing nutrition therapy
E) ​Restoring fluids and electrolytes
Question
Nutrition therapy for management of COPD involves _____.​

A) ​promoting weight gain
B) ​supporting wound healing
C) ​improving food intake
D) ​relieving chronic cough
E) ​decreasing supplemental oxygen needs
Question
Which amino acid may have beneficial effects on surgical healing of postoperative patients?​

A) ​tryptophan
B) ​tyrosine
C) ​arginine
D) ​phenylalanine
E) ​leucine
Question
When caring for a patient who is suffering from acute illness and metabolic stress, how would clinicians best estimate protein and energy needs?​

A) ​Adjust nutrient intakes according to patient responses
B) ​Underfeed the patient to minimize tissue loss
C) ​Maintain the patient at NPO status to promote bowel rest
D) ​Overfeed the patient to prevent hypoglycemia
E) ​Increase carbohydrate intake to promote weight gain and appropriate energy use
Question
What complication is most closely associated with severe cases of SIRS or sepsis?​

A) ​hypertension
B) ​fluid retention
C) ​hypertriglyceridemia
D) ​poor glucose control
E) ​intestinal bleeding
Question
Excessive kcalorie intake in COPD patients may _____.​

A) ​interfere with catabolic processes
B) ​alter taste perception
C) ​interfere with drug therapy
D) ​increase gas formation
E) ​increase respiratory distress
Question
In critically ill patients, a high intake of _____ may suppress immune function and increase the risk of developing infections.​

A) ​fat
B) ​dextrose
C) ​protein
D) ​zinc
E) ​vitamin A
Question
Emphysema associated with COPD is most often diagnosed by _____.​

A) ​serial chest x-rays
B) ​clinical signs and lung function tests
C) ​oxygen saturation readings
D) ​24-hour halter monitoring
E) ​culture and sensitivity of mucus samples
Question
A 25-year-old woman is critically ill after surviving a motor vehicle accident. The patient is 5'4" and weighs 120 pounds. This patient's energy needs would require how many kcalories for energy?​

A) ​15-20 kcal/kg body weight per day
B) ​22-25 kcal/kg body weight per day
C) ​25-30 kcal/kg body weight per day
D) ​30-35 kcal/kg body weight per day
E) ​38-40 kcal/kg body weight per day
Question
Adequate fluid intake will help the person with COPD by _____.​

A) decreasing carbon dioxide output​
B) ​preventing the secretion of overly thick mucus
C) ​aiding in weight loss
D) ​improving oxygen consumption
E) ​reducing abdominal distention
Question
In critically ill patients, _____ is used to measure the resting metabolic rate (RMR).​

A) ​skinfold measurement
B) ​BMI
C) ​the stress factor equation
D) ​indirect calorimetry
E) ​a clinical body weight growth chart
Question
The most common risk factor associated with development of COPD is _____.​

A) ​alpha-1 anti-trypsin deficiency
B) ​environmental exposure to pollutants
C) ​lung cancer
D) ​cigarette smoking
E) ​cystic fibrosis
Question
Which amino acid has been shown to have beneficial effects on critically ill patients?​

A) ​leucine
B) ​glutamine
C) ​valine
D) ​isoleucine
E) ​phenylalanine
Question
What micronutrient plays a role in immunity and wound healing?​

A) ​Zinc
B) ​Choline
C) ​Selenium
D) ​Vitamin K
E) ​Iron
Question
A parenteral feeding should supply no more than _____ milligrams of dextrose per kilogram of body weight per minute to prevent hyperglycemia.​

A) ​1
B) ​2
C) ​3
D) ​4
E) ​5
Question
What method was developed for estimating energy needs in a patient with traumatic injuries?​

A) ​Parkland formula
B) ​Jackson/Pollock method
C) ​Harris-Benedict equation
D) ​Lund-Browder formula
E) ​Ireton-Jones energy equation
Question
Once patients can tolerate oral feedings, what type of diet is often prescribed?​

A) ​high fiber
B) ​low sodium
C) ​high-kcalorie, high-protein
D) ​low fat
E) ​low carbohydrate
Question
A patient who is on a tube feeding gains nine pounds in three days. The nurse realizes that this may most likely indicate _____.​

A) ​inadequate nutritional intake
B) ​excess protein intake
C) ​a fluid imbalance
D) ​low levels of vitamin D
E) ​refeeding syndrome
Question
​The first organ to fail in MODS is often the _____.

A) ​lungs
B) ​liver
C) ​kidneys
D) ​heart
E) ​brain
Question
While caring for a patient who has been injured, the nurse recognizes which sign of inflammation that accompanies altered blood flow?​

A) ​Hyperglycemia
B) ​Swelling
C) ​Pale skin
D) ​Hypotension
E) ​Confusion
Question
A nurse is treating a patient who is experiencing fluctuations in hormone levels as a result of stress. Based on her understanding of the metabolic effects associated with certain hormones, the nurse knows that aldosterone is responsible for _____.​

A) ​increasing the patient's metabolic rate
B) ​producing glucose from amino acids
C) ​reabsorbing sodium in the kidneys
D) ​releasing fatty acids from adipose tissue
E) ​reabsorbing water in the kidneys
Question
Kati is a 19-year-old female who suffered a head injury and multiple broken bones in a motorcycle accident. She is currently in a coma, on a mechanical ventilator, and receiving enteral nutrition. Kati is 5'2" tall and weighs 115 pounds.
​
The stress of Kati's condition places her at risk of hypermetabolism. What kind of complication is most closely associated with hypermetabolism as a result of stress?​

A) ​wasting
B) ​fractures
C) ​kidney failure
D) ​bone pain
E) ​pulmonary edema
Question
Because the immediate stress response can cause a variety of systemic effects, the nurse should closely monitor her patient's _____.​

A) ​heart rate, respiratory rate, and blood pressure
B) ​appetite, temperature, and weight
C) ​pain rating, level of consciousness, and posture
D) ​abdominal girth, reflexes, and edema
E) ​hearing, vision, and sense of smell
Question
John has been hospitalized with a severe infection in his foot. The nurse recognizes that increasing his intake of _____ may help to suppress the inflammation.​

A) ​protein
B) ​omega-3 fatty acids
C) ​carbohydrate
D) ​omega 6-fatty acids
E) ​vitamin D
Question
Mr. Morgan is a critically ill patient in the ICU who is on TPN. The nurse understands that monitoring his _____ can help to determine if he is being overfed.​

A) ​glucose levels
B) ​cholesterol levels
C) ​iron levels
D) ​albumin levels
E) ​calcium levels
Question
Kati is a 19-year-old female who suffered a head injury and multiple broken bones in a motorcycle accident. She is currently in a coma, on a mechanical ventilator, and receiving enteral nutrition. Kati is 5'2" tall and weighs 115 pounds.
​
Kati's protein needs are estimated at 1.2 to 2 g/kg of body weight based on her condition. Based on this estimation, her daily protein intake would then be _____ g per day.​

A) ​36 to 58 g
B) ​62 to 104 g
C) ​116 to 138 g
D) ​154 to 168 g
E) ​180 to 200 g
Question
One factor that increases the risk of a patient developing MODS is _____.​

A) ​age over 40 years
B) ​an increased length of hospital stay
C) ​uncontrolled blood glucose
D) ​obesity
E) ​the severity of SIRS infection
Question
In what way does nutrition support play a role in treatment of MODS?​

A) ​Supporting gas exchange
B) ​Preventing excessive wasting
C) ​Promoting excretion of waste products
D) ​Maintaining blood pressure
E) ​Increasing cardiac output
Question
Kati is a 19-year-old female who suffered a head injury and multiple broken bones in a motorcycle accident. She is currently in a coma, on a mechanical ventilator, and receiving enteral nutrition. Kati is 5'2" tall and weighs 115 pounds.
​
If Kati's enteral feeding is not providing adequate energy and protein to meet her nutritional needs, she will experience _____.​

A) ​a loss of lean tissue
B) ​hyperglycemia
C) ​pulmonary edema
D) ​sepsis
E) ​organ failure
Question
​Mr. Jones, a critically ill patient, is 5'9" tall and weighs 176 pounds. The nurse recommends that he receive a minimum of _____ grams of protein daily.

A) ​64
B) ​80
C) ​96
D) ​136
E) ​240
Question
Kati is a 19-year-old female who suffered a head injury and multiple broken bones in a motorcycle accident. She is currently in a coma, on a mechanical ventilator, and receiving enteral nutrition. Kati is 5'2" tall and weighs 115 pounds.
​
Estimate Kati's energy needs using the Ireton-Jones equation: 1925 + [5 ´ wt (kg)] - [10 ´ age (yr)] + (281 ´ sex) + (292 ´ trauma) + (851 ´ burn).​

A) ​2288
B) ​2681
C) ​2828
D) ​3420
E) ​3240
Question
The principal infection most often associated with MODS is _____.​

A) ​pneumonia
B) ​urinary tract infection
C) ​herpes simplex virus infection
D) ​meningitis
E) ​hepatitis B infection
Question
Kati is a 19-year-old female who suffered a head injury and multiple broken bones in a motorcycle accident. She is currently in a coma, on a mechanical ventilator, and receiving enteral nutrition. Kati is 5'2" tall and weighs 115 pounds.
​
As a result of the acute-phase inflammatory response, Kati's plasma concentrations of _____ would be expected to decrease.

A) ​glucose and cholesterol
B) ​sodium and potassium
C) ​iron and glucose
D) ​albumin and iron
E) ​magnesium and chloride
Question
A patient who has developed MODS would most likely demonstrate what signs or symptoms associated with liver failure?​

A) ​Abnormal bleeding
B) ​Sepsis
C) ​Altered metabolic processes
D) ​Impaired gas exchange
E) ​Low blood pressure
Question
Kati is a 19-year-old female who suffered a head injury and multiple broken bones in a motorcycle accident. She is currently in a coma, on a mechanical ventilator, and receiving enteral nutrition. Kati is 5'2" tall and weighs 115 pounds.
​
To decrease the risk of infection, it will be important to keep Kati's _____ under control while she is recovering.​

A) ​serum albumin
B) ​blood glucose
C) ​blood pressure
D) ​serum prealbumin
E) ​nitrogen
Question
Mrs. White is in the ICU for complications following surgery. She has been diagnosed with sepsis and is on a ventilator. In order to most accurately estimate her energy needs, the nurse recognizes that the preferred method to use is _____.​

A) ​the Harris-Benedict equation
B) ​the Penn State equation
C) ​direct calorimetry
D) ​the Mifflin-St. Jeor equation
E) ​the permissive protein balance method
Question
Severe hypercapnia associated with respiratory failure can cause _____, which interferes with normal functioning of the central nervous system.​

A) ​sepsis
B) ​SIRS
C) ​cardiac failure
D) ​COPD
E) ​acidosis
Question
Matching​
a. ​the breakdown of muscle tissue that results from disease or malnutrition
b. ​an acute-phase protein involved in the regulation of iron metabolism
c. ​the main airways of the lungs
d. ​cells within connective tissue that produce and release histamine
e. ​the volume of air a person inhales or exhales each minute
f. ​the surgical removal of dead, damaged, or contaminated tissue resulting from burns or wounds
g. ​respiratory failure triggered by severe lung injury
h. ​the chemical and physical changes that occur within the body during stress
i. ​progressive lung disease characterized by the breakdown of the lungs' elastic structure and destruction of the walls of the respiratory bronchioles and alveoli
j. ​a group of metabolic abnormalities that may result from aggressive refeeding in severely malnourished persons
k. ​a method of estimating resting energy expenditure by measuring a person's oxygen consumption and carbon dioxide production
l. ​insufficient oxygen in the blood
m. ​a group of plasma proteins that assist the activities of antibodies
n. ​insufficient oxygen in body tissues
o. ​a severe reduction in blood flow that deprives the body's tissues of oxygen and nutrients
p. ​a lung disorder characterized by persistent inflammation and excessive secretions of mucus in the main airways of the lungs
q. ​shortness of breath
r. ​a whole-body inflammatory response caused by infection
s. ​a bluish cast in the skin due to the color of deoxygenated hemoglobin
t. ​accumulations of pus
​stress response
Question
Matching​
a. ​the breakdown of muscle tissue that results from disease or malnutrition
b. ​an acute-phase protein involved in the regulation of iron metabolism
c. ​the main airways of the lungs
d. ​cells within connective tissue that produce and release histamine
e. ​the volume of air a person inhales or exhales each minute
f. ​the surgical removal of dead, damaged, or contaminated tissue resulting from burns or wounds
g. ​respiratory failure triggered by severe lung injury
h. ​the chemical and physical changes that occur within the body during stress
i. ​progressive lung disease characterized by the breakdown of the lungs' elastic structure and destruction of the walls of the respiratory bronchioles and alveoli
j. ​a group of metabolic abnormalities that may result from aggressive refeeding in severely malnourished persons
k. ​a method of estimating resting energy expenditure by measuring a person's oxygen consumption and carbon dioxide production
l. ​insufficient oxygen in the blood
m. ​a group of plasma proteins that assist the activities of antibodies
n. ​insufficient oxygen in body tissues
o. ​a severe reduction in blood flow that deprives the body's tissues of oxygen and nutrients
p. ​a lung disorder characterized by persistent inflammation and excessive secretions of mucus in the main airways of the lungs
q. ​shortness of breath
r. ​a whole-body inflammatory response caused by infection
s. ​a bluish cast in the skin due to the color of deoxygenated hemoglobin
t. ​accumulations of pus
​shock
Question
Matching​
a. ​the breakdown of muscle tissue that results from disease or malnutrition
b. ​an acute-phase protein involved in the regulation of iron metabolism
c. ​the main airways of the lungs
d. ​cells within connective tissue that produce and release histamine
e. ​the volume of air a person inhales or exhales each minute
f. ​the surgical removal of dead, damaged, or contaminated tissue resulting from burns or wounds
g. ​respiratory failure triggered by severe lung injury
h. ​the chemical and physical changes that occur within the body during stress
i. ​progressive lung disease characterized by the breakdown of the lungs' elastic structure and destruction of the walls of the respiratory bronchioles and alveoli
j. ​a group of metabolic abnormalities that may result from aggressive refeeding in severely malnourished persons
k. ​a method of estimating resting energy expenditure by measuring a person's oxygen consumption and carbon dioxide production
l. ​insufficient oxygen in the blood
m. ​a group of plasma proteins that assist the activities of antibodies
n. ​insufficient oxygen in body tissues
o. ​a severe reduction in blood flow that deprives the body's tissues of oxygen and nutrients
p. ​a lung disorder characterized by persistent inflammation and excessive secretions of mucus in the main airways of the lungs
q. ​shortness of breath
r. ​a whole-body inflammatory response caused by infection
s. ​a bluish cast in the skin due to the color of deoxygenated hemoglobin
t. ​accumulations of pus
​chronic bronchitis
Question
Matching​
a. ​the breakdown of muscle tissue that results from disease or malnutrition
b. ​an acute-phase protein involved in the regulation of iron metabolism
c. ​the main airways of the lungs
d. ​cells within connective tissue that produce and release histamine
e. ​the volume of air a person inhales or exhales each minute
f. ​the surgical removal of dead, damaged, or contaminated tissue resulting from burns or wounds
g. ​respiratory failure triggered by severe lung injury
h. ​the chemical and physical changes that occur within the body during stress
i. ​progressive lung disease characterized by the breakdown of the lungs' elastic structure and destruction of the walls of the respiratory bronchioles and alveoli
j. ​a group of metabolic abnormalities that may result from aggressive refeeding in severely malnourished persons
k. ​a method of estimating resting energy expenditure by measuring a person's oxygen consumption and carbon dioxide production
l. ​insufficient oxygen in the blood
m. ​a group of plasma proteins that assist the activities of antibodies
n. ​insufficient oxygen in body tissues
o. ​a severe reduction in blood flow that deprives the body's tissues of oxygen and nutrients
p. ​a lung disorder characterized by persistent inflammation and excessive secretions of mucus in the main airways of the lungs
q. ​shortness of breath
r. ​a whole-body inflammatory response caused by infection
s. ​a bluish cast in the skin due to the color of deoxygenated hemoglobin
t. ​accumulations of pus
​refeeding syndrome
Question
A critically ill patient with ARDS is on a tube feeding and requires a fluid restriction. The nurse understands that an appropriate enteral formula would be a _____ formula.​

A) ​low residue
B) ​high protein
C) ​nutrient dense
D) ​hydrolyzed
E) ​low fat
Question
Matching​
a. ​the breakdown of muscle tissue that results from disease or malnutrition
b. ​an acute-phase protein involved in the regulation of iron metabolism
c. ​the main airways of the lungs
d. ​cells within connective tissue that produce and release histamine
e. ​the volume of air a person inhales or exhales each minute
f. ​the surgical removal of dead, damaged, or contaminated tissue resulting from burns or wounds
g. ​respiratory failure triggered by severe lung injury
h. ​the chemical and physical changes that occur within the body during stress
i. ​progressive lung disease characterized by the breakdown of the lungs' elastic structure and destruction of the walls of the respiratory bronchioles and alveoli
j. ​a group of metabolic abnormalities that may result from aggressive refeeding in severely malnourished persons
k. ​a method of estimating resting energy expenditure by measuring a person's oxygen consumption and carbon dioxide production
l. ​insufficient oxygen in the blood
m. ​a group of plasma proteins that assist the activities of antibodies
n. ​insufficient oxygen in body tissues
o. ​a severe reduction in blood flow that deprives the body's tissues of oxygen and nutrients
p. ​a lung disorder characterized by persistent inflammation and excessive secretions of mucus in the main airways of the lungs
q. ​shortness of breath
r. ​a whole-body inflammatory response caused by infection
s. ​a bluish cast in the skin due to the color of deoxygenated hemoglobin
t. ​accumulations of pus
​wasting
Question
Matching​
a. ​the breakdown of muscle tissue that results from disease or malnutrition
b. ​an acute-phase protein involved in the regulation of iron metabolism
c. ​the main airways of the lungs
d. ​cells within connective tissue that produce and release histamine
e. ​the volume of air a person inhales or exhales each minute
f. ​the surgical removal of dead, damaged, or contaminated tissue resulting from burns or wounds
g. ​respiratory failure triggered by severe lung injury
h. ​the chemical and physical changes that occur within the body during stress
i. ​progressive lung disease characterized by the breakdown of the lungs' elastic structure and destruction of the walls of the respiratory bronchioles and alveoli
j. ​a group of metabolic abnormalities that may result from aggressive refeeding in severely malnourished persons
k. ​a method of estimating resting energy expenditure by measuring a person's oxygen consumption and carbon dioxide production
l. ​insufficient oxygen in the blood
m. ​a group of plasma proteins that assist the activities of antibodies
n. ​insufficient oxygen in body tissues
o. ​a severe reduction in blood flow that deprives the body's tissues of oxygen and nutrients
p. ​a lung disorder characterized by persistent inflammation and excessive secretions of mucus in the main airways of the lungs
q. ​shortness of breath
r. ​a whole-body inflammatory response caused by infection
s. ​a bluish cast in the skin due to the color of deoxygenated hemoglobin
t. ​accumulations of pus
​mast cells
Question
Matching​
a. ​the breakdown of muscle tissue that results from disease or malnutrition
b. ​an acute-phase protein involved in the regulation of iron metabolism
c. ​the main airways of the lungs
d. ​cells within connective tissue that produce and release histamine
e. ​the volume of air a person inhales or exhales each minute
f. ​the surgical removal of dead, damaged, or contaminated tissue resulting from burns or wounds
g. ​respiratory failure triggered by severe lung injury
h. ​the chemical and physical changes that occur within the body during stress
i. ​progressive lung disease characterized by the breakdown of the lungs' elastic structure and destruction of the walls of the respiratory bronchioles and alveoli
j. ​a group of metabolic abnormalities that may result from aggressive refeeding in severely malnourished persons
k. ​a method of estimating resting energy expenditure by measuring a person's oxygen consumption and carbon dioxide production
l. ​insufficient oxygen in the blood
m. ​a group of plasma proteins that assist the activities of antibodies
n. ​insufficient oxygen in body tissues
o. ​a severe reduction in blood flow that deprives the body's tissues of oxygen and nutrients
p. ​a lung disorder characterized by persistent inflammation and excessive secretions of mucus in the main airways of the lungs
q. ​shortness of breath
r. ​a whole-body inflammatory response caused by infection
s. ​a bluish cast in the skin due to the color of deoxygenated hemoglobin
t. ​accumulations of pus
​emphysema
Question
Mary is a 59-year-old patient who suffered multiple broken bones in a motor vehicle accident. She weighs 138 pounds. The nurse chooses a protein factor of 1.5 g/kg to estimate her protein needs and calculates that Mary's protein requirements are approximately _____ grams per day.​

A) ​94
B) ​103
C) ​121
D) ​180
E) ​208
Question
Matching​
a. ​the breakdown of muscle tissue that results from disease or malnutrition
b. ​an acute-phase protein involved in the regulation of iron metabolism
c. ​the main airways of the lungs
d. ​cells within connective tissue that produce and release histamine
e. ​the volume of air a person inhales or exhales each minute
f. ​the surgical removal of dead, damaged, or contaminated tissue resulting from burns or wounds
g. ​respiratory failure triggered by severe lung injury
h. ​the chemical and physical changes that occur within the body during stress
i. ​progressive lung disease characterized by the breakdown of the lungs' elastic structure and destruction of the walls of the respiratory bronchioles and alveoli
j. ​a group of metabolic abnormalities that may result from aggressive refeeding in severely malnourished persons
k. ​a method of estimating resting energy expenditure by measuring a person's oxygen consumption and carbon dioxide production
l. ​insufficient oxygen in the blood
m. ​a group of plasma proteins that assist the activities of antibodies
n. ​insufficient oxygen in body tissues
o. ​a severe reduction in blood flow that deprives the body's tissues of oxygen and nutrients
p. ​a lung disorder characterized by persistent inflammation and excessive secretions of mucus in the main airways of the lungs
q. ​shortness of breath
r. ​a whole-body inflammatory response caused by infection
s. ​a bluish cast in the skin due to the color of deoxygenated hemoglobin
t. ​accumulations of pus
​minute ventilation
Question
A patient with ARDS requires mechanical ventilation. The nurse recognizes that fluid accumulation is a potential problem that may make it difficult to assess his _____.​

A) ​weight
B) ​temperature
C) ​kcalorie intake
D) ​fluid intake
E) ​heart rate
Question
Matching​
a. ​the breakdown of muscle tissue that results from disease or malnutrition
b. ​an acute-phase protein involved in the regulation of iron metabolism
c. ​the main airways of the lungs
d. ​cells within connective tissue that produce and release histamine
e. ​the volume of air a person inhales or exhales each minute
f. ​the surgical removal of dead, damaged, or contaminated tissue resulting from burns or wounds
g. ​respiratory failure triggered by severe lung injury
h. ​the chemical and physical changes that occur within the body during stress
i. ​progressive lung disease characterized by the breakdown of the lungs' elastic structure and destruction of the walls of the respiratory bronchioles and alveoli
j. ​a group of metabolic abnormalities that may result from aggressive refeeding in severely malnourished persons
k. ​a method of estimating resting energy expenditure by measuring a person's oxygen consumption and carbon dioxide production
l. ​insufficient oxygen in the blood
m. ​a group of plasma proteins that assist the activities of antibodies
n. ​insufficient oxygen in body tissues
o. ​a severe reduction in blood flow that deprives the body's tissues of oxygen and nutrients
p. ​a lung disorder characterized by persistent inflammation and excessive secretions of mucus in the main airways of the lungs
q. ​shortness of breath
r. ​a whole-body inflammatory response caused by infection
s. ​a bluish cast in the skin due to the color of deoxygenated hemoglobin
t. ​accumulations of pus
​hepcidin
Question
Matching​
a. ​the breakdown of muscle tissue that results from disease or malnutrition
b. ​an acute-phase protein involved in the regulation of iron metabolism
c. ​the main airways of the lungs
d. ​cells within connective tissue that produce and release histamine
e. ​the volume of air a person inhales or exhales each minute
f. ​the surgical removal of dead, damaged, or contaminated tissue resulting from burns or wounds
g. ​respiratory failure triggered by severe lung injury
h. ​the chemical and physical changes that occur within the body during stress
i. ​progressive lung disease characterized by the breakdown of the lungs' elastic structure and destruction of the walls of the respiratory bronchioles and alveoli
j. ​a group of metabolic abnormalities that may result from aggressive refeeding in severely malnourished persons
k. ​a method of estimating resting energy expenditure by measuring a person's oxygen consumption and carbon dioxide production
l. ​insufficient oxygen in the blood
m. ​a group of plasma proteins that assist the activities of antibodies
n. ​insufficient oxygen in body tissues
o. ​a severe reduction in blood flow that deprives the body's tissues of oxygen and nutrients
p. ​a lung disorder characterized by persistent inflammation and excessive secretions of mucus in the main airways of the lungs
q. ​shortness of breath
r. ​a whole-body inflammatory response caused by infection
s. ​a bluish cast in the skin due to the color of deoxygenated hemoglobin
t. ​accumulations of pus
​abscesses
Question
Matching​
a. ​the breakdown of muscle tissue that results from disease or malnutrition
b. ​an acute-phase protein involved in the regulation of iron metabolism
c. ​the main airways of the lungs
d. ​cells within connective tissue that produce and release histamine
e. ​the volume of air a person inhales or exhales each minute
f. ​the surgical removal of dead, damaged, or contaminated tissue resulting from burns or wounds
g. ​respiratory failure triggered by severe lung injury
h. ​the chemical and physical changes that occur within the body during stress
i. ​progressive lung disease characterized by the breakdown of the lungs' elastic structure and destruction of the walls of the respiratory bronchioles and alveoli
j. ​a group of metabolic abnormalities that may result from aggressive refeeding in severely malnourished persons
k. ​a method of estimating resting energy expenditure by measuring a person's oxygen consumption and carbon dioxide production
l. ​insufficient oxygen in the blood
m. ​a group of plasma proteins that assist the activities of antibodies
n. ​insufficient oxygen in body tissues
o. ​a severe reduction in blood flow that deprives the body's tissues of oxygen and nutrients
p. ​a lung disorder characterized by persistent inflammation and excessive secretions of mucus in the main airways of the lungs
q. ​shortness of breath
r. ​a whole-body inflammatory response caused by infection
s. ​a bluish cast in the skin due to the color of deoxygenated hemoglobin
t. ​accumulations of pus
​sepsis
Question
Matching​
a. ​the breakdown of muscle tissue that results from disease or malnutrition
b. ​an acute-phase protein involved in the regulation of iron metabolism
c. ​the main airways of the lungs
d. ​cells within connective tissue that produce and release histamine
e. ​the volume of air a person inhales or exhales each minute
f. ​the surgical removal of dead, damaged, or contaminated tissue resulting from burns or wounds
g. ​respiratory failure triggered by severe lung injury
h. ​the chemical and physical changes that occur within the body during stress
i. ​progressive lung disease characterized by the breakdown of the lungs' elastic structure and destruction of the walls of the respiratory bronchioles and alveoli
j. ​a group of metabolic abnormalities that may result from aggressive refeeding in severely malnourished persons
k. ​a method of estimating resting energy expenditure by measuring a person's oxygen consumption and carbon dioxide production
l. ​insufficient oxygen in the blood
m. ​a group of plasma proteins that assist the activities of antibodies
n. ​insufficient oxygen in body tissues
o. ​a severe reduction in blood flow that deprives the body's tissues of oxygen and nutrients
p. ​a lung disorder characterized by persistent inflammation and excessive secretions of mucus in the main airways of the lungs
q. ​shortness of breath
r. ​a whole-body inflammatory response caused by infection
s. ​a bluish cast in the skin due to the color of deoxygenated hemoglobin
t. ​accumulations of pus
​indirect calorimetry
Question
Matching​
a. ​the breakdown of muscle tissue that results from disease or malnutrition
b. ​an acute-phase protein involved in the regulation of iron metabolism
c. ​the main airways of the lungs
d. ​cells within connective tissue that produce and release histamine
e. ​the volume of air a person inhales or exhales each minute
f. ​the surgical removal of dead, damaged, or contaminated tissue resulting from burns or wounds
g. ​respiratory failure triggered by severe lung injury
h. ​the chemical and physical changes that occur within the body during stress
i. ​progressive lung disease characterized by the breakdown of the lungs' elastic structure and destruction of the walls of the respiratory bronchioles and alveoli
j. ​a group of metabolic abnormalities that may result from aggressive refeeding in severely malnourished persons
k. ​a method of estimating resting energy expenditure by measuring a person's oxygen consumption and carbon dioxide production
l. ​insufficient oxygen in the blood
m. ​a group of plasma proteins that assist the activities of antibodies
n. ​insufficient oxygen in body tissues
o. ​a severe reduction in blood flow that deprives the body's tissues of oxygen and nutrients
p. ​a lung disorder characterized by persistent inflammation and excessive secretions of mucus in the main airways of the lungs
q. ​shortness of breath
r. ​a whole-body inflammatory response caused by infection
s. ​a bluish cast in the skin due to the color of deoxygenated hemoglobin
t. ​accumulations of pus
​bronchioles
Question
Mark is a 23-year-old firefighter who experienced severe burns while fighting a house fire. The nurse recognizes the fact that he may benefit from supplements of _____ to reduce the risk of infection.​

A) ​zinc, vitamin C, and vitamin A
B) ​iron, magnesium, and calcium
C) ​sodium, potassium, and chloride
D) ​phosphorus, thiamin, and riboflavin
E) ​calcium, vitamin D, and vitamin K
Question
Matching​
a. ​the breakdown of muscle tissue that results from disease or malnutrition
b. ​an acute-phase protein involved in the regulation of iron metabolism
c. ​the main airways of the lungs
d. ​cells within connective tissue that produce and release histamine
e. ​the volume of air a person inhales or exhales each minute
f. ​the surgical removal of dead, damaged, or contaminated tissue resulting from burns or wounds
g. ​respiratory failure triggered by severe lung injury
h. ​the chemical and physical changes that occur within the body during stress
i. ​progressive lung disease characterized by the breakdown of the lungs' elastic structure and destruction of the walls of the respiratory bronchioles and alveoli
j. ​a group of metabolic abnormalities that may result from aggressive refeeding in severely malnourished persons
k. ​a method of estimating resting energy expenditure by measuring a person's oxygen consumption and carbon dioxide production
l. ​insufficient oxygen in the blood
m. ​a group of plasma proteins that assist the activities of antibodies
n. ​insufficient oxygen in body tissues
o. ​a severe reduction in blood flow that deprives the body's tissues of oxygen and nutrients
p. ​a lung disorder characterized by persistent inflammation and excessive secretions of mucus in the main airways of the lungs
q. ​shortness of breath
r. ​a whole-body inflammatory response caused by infection
s. ​a bluish cast in the skin due to the color of deoxygenated hemoglobin
t. ​accumulations of pus
​debridement
Question
Mr. Winslett is a COPD patient who is complaining of poor appetite, abdominal discomfort, and bloating. Which suggestion from the nurse is most appropriate for improving his food intake?​

A) ​"Consume larger meals."
B) ​"Substitute beans for meat."
C) ​"Drink a supplement before eating."
D) ​"Eat smaller, more frequent meals."
E) ​"Increase fluid intake throughout the day."
Question
Matching​
a. ​the breakdown of muscle tissue that results from disease or malnutrition
b. ​an acute-phase protein involved in the regulation of iron metabolism
c. ​the main airways of the lungs
d. ​cells within connective tissue that produce and release histamine
e. ​the volume of air a person inhales or exhales each minute
f. ​the surgical removal of dead, damaged, or contaminated tissue resulting from burns or wounds
g. ​respiratory failure triggered by severe lung injury
h. ​the chemical and physical changes that occur within the body during stress
i. ​progressive lung disease characterized by the breakdown of the lungs' elastic structure and destruction of the walls of the respiratory bronchioles and alveoli
j. ​a group of metabolic abnormalities that may result from aggressive refeeding in severely malnourished persons
k. ​a method of estimating resting energy expenditure by measuring a person's oxygen consumption and carbon dioxide production
l. ​insufficient oxygen in the blood
m. ​a group of plasma proteins that assist the activities of antibodies
n. ​insufficient oxygen in body tissues
o. ​a severe reduction in blood flow that deprives the body's tissues of oxygen and nutrients
p. ​a lung disorder characterized by persistent inflammation and excessive secretions of mucus in the main airways of the lungs
q. ​shortness of breath
r. ​a whole-body inflammatory response caused by infection
s. ​a bluish cast in the skin due to the color of deoxygenated hemoglobin
t. ​accumulations of pus
​complement
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Deck 16: Nutrition in Metabolic and Respiratory Stress
1
Protein synthesis is inhibited by _____.​

A) ​cortisol
B) ​eicosanoids
C) ​mast cells
D) ​phagocytes
E) ​aldosterone
A
2
If stress continues for a long period, growth retardation and illness can occur.​
True
3
What compound is produced by white blood cells and participates in the inflammatory process?​

A) ​glucagon
B) ​catecholamines
C) ​cytokines
D) ​cortisol
E) ​aldosterone
C
4
The major precursor to eicosanoids in the inflammatory process is _____.​

A) ​cortisol
B) ​arachidonic acid
C) ​epinephrine
D) ​glucagon
E) ​norepinephrine
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5
Weight loss and wasting are common in the advanced stages of COPD and may result from hypermetabolism, poor food intake, and the actions of various inflammatory proteins.​
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6
Overfeeding an acutely stressed patient improves nitrogen balance and decreases lean tissue losses.​
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7
Excessive energy intake in patients with ARDS can worsen respiratory function.​
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8
An excessive response to metabolic stress can worsen illness and lead to death.​
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9
The high nutrient requirements of acutely stressed patients often require a patient to be fed via the enteral or parenteral route to meet his or her nutritional needs.​
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10
If the reduction in blood flow from inflammation is severe enough to deprive the body's tissues of oxygen and nutrients, SIRS can result.​
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11
Recovery from an injury or illness can be hastened by hypermetabolism and positive nitrogen balance.​
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12
The inflammatory process can alter immune cell function in the body.​
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13
To maintain lean tissue, the protein intakes recommended during acute stress are higher than DRI values.​
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14
Nutrition care for patients in acute respiratory failure is aimed at providing a low-fat, high-carbohydrate diet.​
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15
The symptoms associated with the initial inflammatory response are collectively called the systemic inflammatory response syndrome.​
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16
​The increase in basal metabolic rate as a part of the stress response can be attributed to _____.

A) ​catecholamines
B) ​cortisol
C) ​eicosanoids
D) ​cytokines
E) ​hepcidin
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17
During the inflammatory response, mast cells release _____, which causes vasodilation and capillary permeability.​

A) ​erythropoietin
B) ​cortisol
C) ​anti-diuretic hormone
D) ​cytokine
E) ​histamine
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18
A patient with lung disease would most likely prevent or reverse loss of muscle mass by decreasing activity levels and incorporating more rest.​
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19
Smoking is the primary risk factor in most cases of COPD.​
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20
Patients under 55 years old are several times more likely to develop MODS than are older patients.​
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21
Laura is a critically ill patient. She is 5'4" tall and weighs 150 pounds. What are Laura's protein needs?​

A) ​34-40 g
B) ​54-68 g
C) ​82-136 g
D) ​136-158 g
E) ​160-184 g
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22
The protein needs of a non-obese critically ill patient would be _____.​

A) ​0.8-1.0 g/kg body weight per day
B) ​1.0-1.2 g/kg body weight per day
C) ​1.2-2.0 g/kg body weight per day
D) ​2.0-2.5 g/kg body weight per day
E) ​2.5-3.0 g/kg body weight per day
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23
A COPD patient who complains of abdominal discomfort and dyspnea may benefit from _____.​

A) ​small, frequent meals
B) ​a low-fat diet
C) ​a high-fiber diet
D) ​consuming more liquids
E) ​increased energy consumption
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24
What describes the immediate care concerns of the clinician during a patient's time of severe stress?​

A) ​Educating the patient about nutrient needs
B) ​Providing psychological counseling
C) ​Determining the level of the patient's understanding about his condition
D) ​Providing nutrition therapy
E) ​Restoring fluids and electrolytes
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25
Nutrition therapy for management of COPD involves _____.​

A) ​promoting weight gain
B) ​supporting wound healing
C) ​improving food intake
D) ​relieving chronic cough
E) ​decreasing supplemental oxygen needs
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26
Which amino acid may have beneficial effects on surgical healing of postoperative patients?​

A) ​tryptophan
B) ​tyrosine
C) ​arginine
D) ​phenylalanine
E) ​leucine
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27
When caring for a patient who is suffering from acute illness and metabolic stress, how would clinicians best estimate protein and energy needs?​

A) ​Adjust nutrient intakes according to patient responses
B) ​Underfeed the patient to minimize tissue loss
C) ​Maintain the patient at NPO status to promote bowel rest
D) ​Overfeed the patient to prevent hypoglycemia
E) ​Increase carbohydrate intake to promote weight gain and appropriate energy use
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28
What complication is most closely associated with severe cases of SIRS or sepsis?​

A) ​hypertension
B) ​fluid retention
C) ​hypertriglyceridemia
D) ​poor glucose control
E) ​intestinal bleeding
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29
Excessive kcalorie intake in COPD patients may _____.​

A) ​interfere with catabolic processes
B) ​alter taste perception
C) ​interfere with drug therapy
D) ​increase gas formation
E) ​increase respiratory distress
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30
In critically ill patients, a high intake of _____ may suppress immune function and increase the risk of developing infections.​

A) ​fat
B) ​dextrose
C) ​protein
D) ​zinc
E) ​vitamin A
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31
Emphysema associated with COPD is most often diagnosed by _____.​

A) ​serial chest x-rays
B) ​clinical signs and lung function tests
C) ​oxygen saturation readings
D) ​24-hour halter monitoring
E) ​culture and sensitivity of mucus samples
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32
A 25-year-old woman is critically ill after surviving a motor vehicle accident. The patient is 5'4" and weighs 120 pounds. This patient's energy needs would require how many kcalories for energy?​

A) ​15-20 kcal/kg body weight per day
B) ​22-25 kcal/kg body weight per day
C) ​25-30 kcal/kg body weight per day
D) ​30-35 kcal/kg body weight per day
E) ​38-40 kcal/kg body weight per day
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33
Adequate fluid intake will help the person with COPD by _____.​

A) decreasing carbon dioxide output​
B) ​preventing the secretion of overly thick mucus
C) ​aiding in weight loss
D) ​improving oxygen consumption
E) ​reducing abdominal distention
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34
In critically ill patients, _____ is used to measure the resting metabolic rate (RMR).​

A) ​skinfold measurement
B) ​BMI
C) ​the stress factor equation
D) ​indirect calorimetry
E) ​a clinical body weight growth chart
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35
The most common risk factor associated with development of COPD is _____.​

A) ​alpha-1 anti-trypsin deficiency
B) ​environmental exposure to pollutants
C) ​lung cancer
D) ​cigarette smoking
E) ​cystic fibrosis
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36
Which amino acid has been shown to have beneficial effects on critically ill patients?​

A) ​leucine
B) ​glutamine
C) ​valine
D) ​isoleucine
E) ​phenylalanine
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37
What micronutrient plays a role in immunity and wound healing?​

A) ​Zinc
B) ​Choline
C) ​Selenium
D) ​Vitamin K
E) ​Iron
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38
A parenteral feeding should supply no more than _____ milligrams of dextrose per kilogram of body weight per minute to prevent hyperglycemia.​

A) ​1
B) ​2
C) ​3
D) ​4
E) ​5
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39
What method was developed for estimating energy needs in a patient with traumatic injuries?​

A) ​Parkland formula
B) ​Jackson/Pollock method
C) ​Harris-Benedict equation
D) ​Lund-Browder formula
E) ​Ireton-Jones energy equation
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40
Once patients can tolerate oral feedings, what type of diet is often prescribed?​

A) ​high fiber
B) ​low sodium
C) ​high-kcalorie, high-protein
D) ​low fat
E) ​low carbohydrate
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41
A patient who is on a tube feeding gains nine pounds in three days. The nurse realizes that this may most likely indicate _____.​

A) ​inadequate nutritional intake
B) ​excess protein intake
C) ​a fluid imbalance
D) ​low levels of vitamin D
E) ​refeeding syndrome
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42
​The first organ to fail in MODS is often the _____.

A) ​lungs
B) ​liver
C) ​kidneys
D) ​heart
E) ​brain
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43
While caring for a patient who has been injured, the nurse recognizes which sign of inflammation that accompanies altered blood flow?​

A) ​Hyperglycemia
B) ​Swelling
C) ​Pale skin
D) ​Hypotension
E) ​Confusion
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44
A nurse is treating a patient who is experiencing fluctuations in hormone levels as a result of stress. Based on her understanding of the metabolic effects associated with certain hormones, the nurse knows that aldosterone is responsible for _____.​

A) ​increasing the patient's metabolic rate
B) ​producing glucose from amino acids
C) ​reabsorbing sodium in the kidneys
D) ​releasing fatty acids from adipose tissue
E) ​reabsorbing water in the kidneys
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45
Kati is a 19-year-old female who suffered a head injury and multiple broken bones in a motorcycle accident. She is currently in a coma, on a mechanical ventilator, and receiving enteral nutrition. Kati is 5'2" tall and weighs 115 pounds.
​
The stress of Kati's condition places her at risk of hypermetabolism. What kind of complication is most closely associated with hypermetabolism as a result of stress?​

A) ​wasting
B) ​fractures
C) ​kidney failure
D) ​bone pain
E) ​pulmonary edema
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46
Because the immediate stress response can cause a variety of systemic effects, the nurse should closely monitor her patient's _____.​

A) ​heart rate, respiratory rate, and blood pressure
B) ​appetite, temperature, and weight
C) ​pain rating, level of consciousness, and posture
D) ​abdominal girth, reflexes, and edema
E) ​hearing, vision, and sense of smell
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47
John has been hospitalized with a severe infection in his foot. The nurse recognizes that increasing his intake of _____ may help to suppress the inflammation.​

A) ​protein
B) ​omega-3 fatty acids
C) ​carbohydrate
D) ​omega 6-fatty acids
E) ​vitamin D
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48
Mr. Morgan is a critically ill patient in the ICU who is on TPN. The nurse understands that monitoring his _____ can help to determine if he is being overfed.​

A) ​glucose levels
B) ​cholesterol levels
C) ​iron levels
D) ​albumin levels
E) ​calcium levels
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49
Kati is a 19-year-old female who suffered a head injury and multiple broken bones in a motorcycle accident. She is currently in a coma, on a mechanical ventilator, and receiving enteral nutrition. Kati is 5'2" tall and weighs 115 pounds.
​
Kati's protein needs are estimated at 1.2 to 2 g/kg of body weight based on her condition. Based on this estimation, her daily protein intake would then be _____ g per day.​

A) ​36 to 58 g
B) ​62 to 104 g
C) ​116 to 138 g
D) ​154 to 168 g
E) ​180 to 200 g
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50
One factor that increases the risk of a patient developing MODS is _____.​

A) ​age over 40 years
B) ​an increased length of hospital stay
C) ​uncontrolled blood glucose
D) ​obesity
E) ​the severity of SIRS infection
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51
In what way does nutrition support play a role in treatment of MODS?​

A) ​Supporting gas exchange
B) ​Preventing excessive wasting
C) ​Promoting excretion of waste products
D) ​Maintaining blood pressure
E) ​Increasing cardiac output
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52
Kati is a 19-year-old female who suffered a head injury and multiple broken bones in a motorcycle accident. She is currently in a coma, on a mechanical ventilator, and receiving enteral nutrition. Kati is 5'2" tall and weighs 115 pounds.
​
If Kati's enteral feeding is not providing adequate energy and protein to meet her nutritional needs, she will experience _____.​

A) ​a loss of lean tissue
B) ​hyperglycemia
C) ​pulmonary edema
D) ​sepsis
E) ​organ failure
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53
​Mr. Jones, a critically ill patient, is 5'9" tall and weighs 176 pounds. The nurse recommends that he receive a minimum of _____ grams of protein daily.

A) ​64
B) ​80
C) ​96
D) ​136
E) ​240
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54
Kati is a 19-year-old female who suffered a head injury and multiple broken bones in a motorcycle accident. She is currently in a coma, on a mechanical ventilator, and receiving enteral nutrition. Kati is 5'2" tall and weighs 115 pounds.
​
Estimate Kati's energy needs using the Ireton-Jones equation: 1925 + [5 ´ wt (kg)] - [10 ´ age (yr)] + (281 ´ sex) + (292 ´ trauma) + (851 ´ burn).​

A) ​2288
B) ​2681
C) ​2828
D) ​3420
E) ​3240
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55
The principal infection most often associated with MODS is _____.​

A) ​pneumonia
B) ​urinary tract infection
C) ​herpes simplex virus infection
D) ​meningitis
E) ​hepatitis B infection
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56
Kati is a 19-year-old female who suffered a head injury and multiple broken bones in a motorcycle accident. She is currently in a coma, on a mechanical ventilator, and receiving enteral nutrition. Kati is 5'2" tall and weighs 115 pounds.
​
As a result of the acute-phase inflammatory response, Kati's plasma concentrations of _____ would be expected to decrease.

A) ​glucose and cholesterol
B) ​sodium and potassium
C) ​iron and glucose
D) ​albumin and iron
E) ​magnesium and chloride
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57
A patient who has developed MODS would most likely demonstrate what signs or symptoms associated with liver failure?​

A) ​Abnormal bleeding
B) ​Sepsis
C) ​Altered metabolic processes
D) ​Impaired gas exchange
E) ​Low blood pressure
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58
Kati is a 19-year-old female who suffered a head injury and multiple broken bones in a motorcycle accident. She is currently in a coma, on a mechanical ventilator, and receiving enteral nutrition. Kati is 5'2" tall and weighs 115 pounds.
​
To decrease the risk of infection, it will be important to keep Kati's _____ under control while she is recovering.​

A) ​serum albumin
B) ​blood glucose
C) ​blood pressure
D) ​serum prealbumin
E) ​nitrogen
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59
Mrs. White is in the ICU for complications following surgery. She has been diagnosed with sepsis and is on a ventilator. In order to most accurately estimate her energy needs, the nurse recognizes that the preferred method to use is _____.​

A) ​the Harris-Benedict equation
B) ​the Penn State equation
C) ​direct calorimetry
D) ​the Mifflin-St. Jeor equation
E) ​the permissive protein balance method
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60
Severe hypercapnia associated with respiratory failure can cause _____, which interferes with normal functioning of the central nervous system.​

A) ​sepsis
B) ​SIRS
C) ​cardiac failure
D) ​COPD
E) ​acidosis
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61
Matching​
a. ​the breakdown of muscle tissue that results from disease or malnutrition
b. ​an acute-phase protein involved in the regulation of iron metabolism
c. ​the main airways of the lungs
d. ​cells within connective tissue that produce and release histamine
e. ​the volume of air a person inhales or exhales each minute
f. ​the surgical removal of dead, damaged, or contaminated tissue resulting from burns or wounds
g. ​respiratory failure triggered by severe lung injury
h. ​the chemical and physical changes that occur within the body during stress
i. ​progressive lung disease characterized by the breakdown of the lungs' elastic structure and destruction of the walls of the respiratory bronchioles and alveoli
j. ​a group of metabolic abnormalities that may result from aggressive refeeding in severely malnourished persons
k. ​a method of estimating resting energy expenditure by measuring a person's oxygen consumption and carbon dioxide production
l. ​insufficient oxygen in the blood
m. ​a group of plasma proteins that assist the activities of antibodies
n. ​insufficient oxygen in body tissues
o. ​a severe reduction in blood flow that deprives the body's tissues of oxygen and nutrients
p. ​a lung disorder characterized by persistent inflammation and excessive secretions of mucus in the main airways of the lungs
q. ​shortness of breath
r. ​a whole-body inflammatory response caused by infection
s. ​a bluish cast in the skin due to the color of deoxygenated hemoglobin
t. ​accumulations of pus
​stress response
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62
Matching​
a. ​the breakdown of muscle tissue that results from disease or malnutrition
b. ​an acute-phase protein involved in the regulation of iron metabolism
c. ​the main airways of the lungs
d. ​cells within connective tissue that produce and release histamine
e. ​the volume of air a person inhales or exhales each minute
f. ​the surgical removal of dead, damaged, or contaminated tissue resulting from burns or wounds
g. ​respiratory failure triggered by severe lung injury
h. ​the chemical and physical changes that occur within the body during stress
i. ​progressive lung disease characterized by the breakdown of the lungs' elastic structure and destruction of the walls of the respiratory bronchioles and alveoli
j. ​a group of metabolic abnormalities that may result from aggressive refeeding in severely malnourished persons
k. ​a method of estimating resting energy expenditure by measuring a person's oxygen consumption and carbon dioxide production
l. ​insufficient oxygen in the blood
m. ​a group of plasma proteins that assist the activities of antibodies
n. ​insufficient oxygen in body tissues
o. ​a severe reduction in blood flow that deprives the body's tissues of oxygen and nutrients
p. ​a lung disorder characterized by persistent inflammation and excessive secretions of mucus in the main airways of the lungs
q. ​shortness of breath
r. ​a whole-body inflammatory response caused by infection
s. ​a bluish cast in the skin due to the color of deoxygenated hemoglobin
t. ​accumulations of pus
​shock
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63
Matching​
a. ​the breakdown of muscle tissue that results from disease or malnutrition
b. ​an acute-phase protein involved in the regulation of iron metabolism
c. ​the main airways of the lungs
d. ​cells within connective tissue that produce and release histamine
e. ​the volume of air a person inhales or exhales each minute
f. ​the surgical removal of dead, damaged, or contaminated tissue resulting from burns or wounds
g. ​respiratory failure triggered by severe lung injury
h. ​the chemical and physical changes that occur within the body during stress
i. ​progressive lung disease characterized by the breakdown of the lungs' elastic structure and destruction of the walls of the respiratory bronchioles and alveoli
j. ​a group of metabolic abnormalities that may result from aggressive refeeding in severely malnourished persons
k. ​a method of estimating resting energy expenditure by measuring a person's oxygen consumption and carbon dioxide production
l. ​insufficient oxygen in the blood
m. ​a group of plasma proteins that assist the activities of antibodies
n. ​insufficient oxygen in body tissues
o. ​a severe reduction in blood flow that deprives the body's tissues of oxygen and nutrients
p. ​a lung disorder characterized by persistent inflammation and excessive secretions of mucus in the main airways of the lungs
q. ​shortness of breath
r. ​a whole-body inflammatory response caused by infection
s. ​a bluish cast in the skin due to the color of deoxygenated hemoglobin
t. ​accumulations of pus
​chronic bronchitis
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64
Matching​
a. ​the breakdown of muscle tissue that results from disease or malnutrition
b. ​an acute-phase protein involved in the regulation of iron metabolism
c. ​the main airways of the lungs
d. ​cells within connective tissue that produce and release histamine
e. ​the volume of air a person inhales or exhales each minute
f. ​the surgical removal of dead, damaged, or contaminated tissue resulting from burns or wounds
g. ​respiratory failure triggered by severe lung injury
h. ​the chemical and physical changes that occur within the body during stress
i. ​progressive lung disease characterized by the breakdown of the lungs' elastic structure and destruction of the walls of the respiratory bronchioles and alveoli
j. ​a group of metabolic abnormalities that may result from aggressive refeeding in severely malnourished persons
k. ​a method of estimating resting energy expenditure by measuring a person's oxygen consumption and carbon dioxide production
l. ​insufficient oxygen in the blood
m. ​a group of plasma proteins that assist the activities of antibodies
n. ​insufficient oxygen in body tissues
o. ​a severe reduction in blood flow that deprives the body's tissues of oxygen and nutrients
p. ​a lung disorder characterized by persistent inflammation and excessive secretions of mucus in the main airways of the lungs
q. ​shortness of breath
r. ​a whole-body inflammatory response caused by infection
s. ​a bluish cast in the skin due to the color of deoxygenated hemoglobin
t. ​accumulations of pus
​refeeding syndrome
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65
A critically ill patient with ARDS is on a tube feeding and requires a fluid restriction. The nurse understands that an appropriate enteral formula would be a _____ formula.​

A) ​low residue
B) ​high protein
C) ​nutrient dense
D) ​hydrolyzed
E) ​low fat
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66
Matching​
a. ​the breakdown of muscle tissue that results from disease or malnutrition
b. ​an acute-phase protein involved in the regulation of iron metabolism
c. ​the main airways of the lungs
d. ​cells within connective tissue that produce and release histamine
e. ​the volume of air a person inhales or exhales each minute
f. ​the surgical removal of dead, damaged, or contaminated tissue resulting from burns or wounds
g. ​respiratory failure triggered by severe lung injury
h. ​the chemical and physical changes that occur within the body during stress
i. ​progressive lung disease characterized by the breakdown of the lungs' elastic structure and destruction of the walls of the respiratory bronchioles and alveoli
j. ​a group of metabolic abnormalities that may result from aggressive refeeding in severely malnourished persons
k. ​a method of estimating resting energy expenditure by measuring a person's oxygen consumption and carbon dioxide production
l. ​insufficient oxygen in the blood
m. ​a group of plasma proteins that assist the activities of antibodies
n. ​insufficient oxygen in body tissues
o. ​a severe reduction in blood flow that deprives the body's tissues of oxygen and nutrients
p. ​a lung disorder characterized by persistent inflammation and excessive secretions of mucus in the main airways of the lungs
q. ​shortness of breath
r. ​a whole-body inflammatory response caused by infection
s. ​a bluish cast in the skin due to the color of deoxygenated hemoglobin
t. ​accumulations of pus
​wasting
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67
Matching​
a. ​the breakdown of muscle tissue that results from disease or malnutrition
b. ​an acute-phase protein involved in the regulation of iron metabolism
c. ​the main airways of the lungs
d. ​cells within connective tissue that produce and release histamine
e. ​the volume of air a person inhales or exhales each minute
f. ​the surgical removal of dead, damaged, or contaminated tissue resulting from burns or wounds
g. ​respiratory failure triggered by severe lung injury
h. ​the chemical and physical changes that occur within the body during stress
i. ​progressive lung disease characterized by the breakdown of the lungs' elastic structure and destruction of the walls of the respiratory bronchioles and alveoli
j. ​a group of metabolic abnormalities that may result from aggressive refeeding in severely malnourished persons
k. ​a method of estimating resting energy expenditure by measuring a person's oxygen consumption and carbon dioxide production
l. ​insufficient oxygen in the blood
m. ​a group of plasma proteins that assist the activities of antibodies
n. ​insufficient oxygen in body tissues
o. ​a severe reduction in blood flow that deprives the body's tissues of oxygen and nutrients
p. ​a lung disorder characterized by persistent inflammation and excessive secretions of mucus in the main airways of the lungs
q. ​shortness of breath
r. ​a whole-body inflammatory response caused by infection
s. ​a bluish cast in the skin due to the color of deoxygenated hemoglobin
t. ​accumulations of pus
​mast cells
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68
Matching​
a. ​the breakdown of muscle tissue that results from disease or malnutrition
b. ​an acute-phase protein involved in the regulation of iron metabolism
c. ​the main airways of the lungs
d. ​cells within connective tissue that produce and release histamine
e. ​the volume of air a person inhales or exhales each minute
f. ​the surgical removal of dead, damaged, or contaminated tissue resulting from burns or wounds
g. ​respiratory failure triggered by severe lung injury
h. ​the chemical and physical changes that occur within the body during stress
i. ​progressive lung disease characterized by the breakdown of the lungs' elastic structure and destruction of the walls of the respiratory bronchioles and alveoli
j. ​a group of metabolic abnormalities that may result from aggressive refeeding in severely malnourished persons
k. ​a method of estimating resting energy expenditure by measuring a person's oxygen consumption and carbon dioxide production
l. ​insufficient oxygen in the blood
m. ​a group of plasma proteins that assist the activities of antibodies
n. ​insufficient oxygen in body tissues
o. ​a severe reduction in blood flow that deprives the body's tissues of oxygen and nutrients
p. ​a lung disorder characterized by persistent inflammation and excessive secretions of mucus in the main airways of the lungs
q. ​shortness of breath
r. ​a whole-body inflammatory response caused by infection
s. ​a bluish cast in the skin due to the color of deoxygenated hemoglobin
t. ​accumulations of pus
​emphysema
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69
Mary is a 59-year-old patient who suffered multiple broken bones in a motor vehicle accident. She weighs 138 pounds. The nurse chooses a protein factor of 1.5 g/kg to estimate her protein needs and calculates that Mary's protein requirements are approximately _____ grams per day.​

A) ​94
B) ​103
C) ​121
D) ​180
E) ​208
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70
Matching​
a. ​the breakdown of muscle tissue that results from disease or malnutrition
b. ​an acute-phase protein involved in the regulation of iron metabolism
c. ​the main airways of the lungs
d. ​cells within connective tissue that produce and release histamine
e. ​the volume of air a person inhales or exhales each minute
f. ​the surgical removal of dead, damaged, or contaminated tissue resulting from burns or wounds
g. ​respiratory failure triggered by severe lung injury
h. ​the chemical and physical changes that occur within the body during stress
i. ​progressive lung disease characterized by the breakdown of the lungs' elastic structure and destruction of the walls of the respiratory bronchioles and alveoli
j. ​a group of metabolic abnormalities that may result from aggressive refeeding in severely malnourished persons
k. ​a method of estimating resting energy expenditure by measuring a person's oxygen consumption and carbon dioxide production
l. ​insufficient oxygen in the blood
m. ​a group of plasma proteins that assist the activities of antibodies
n. ​insufficient oxygen in body tissues
o. ​a severe reduction in blood flow that deprives the body's tissues of oxygen and nutrients
p. ​a lung disorder characterized by persistent inflammation and excessive secretions of mucus in the main airways of the lungs
q. ​shortness of breath
r. ​a whole-body inflammatory response caused by infection
s. ​a bluish cast in the skin due to the color of deoxygenated hemoglobin
t. ​accumulations of pus
​minute ventilation
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71
A patient with ARDS requires mechanical ventilation. The nurse recognizes that fluid accumulation is a potential problem that may make it difficult to assess his _____.​

A) ​weight
B) ​temperature
C) ​kcalorie intake
D) ​fluid intake
E) ​heart rate
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72
Matching​
a. ​the breakdown of muscle tissue that results from disease or malnutrition
b. ​an acute-phase protein involved in the regulation of iron metabolism
c. ​the main airways of the lungs
d. ​cells within connective tissue that produce and release histamine
e. ​the volume of air a person inhales or exhales each minute
f. ​the surgical removal of dead, damaged, or contaminated tissue resulting from burns or wounds
g. ​respiratory failure triggered by severe lung injury
h. ​the chemical and physical changes that occur within the body during stress
i. ​progressive lung disease characterized by the breakdown of the lungs' elastic structure and destruction of the walls of the respiratory bronchioles and alveoli
j. ​a group of metabolic abnormalities that may result from aggressive refeeding in severely malnourished persons
k. ​a method of estimating resting energy expenditure by measuring a person's oxygen consumption and carbon dioxide production
l. ​insufficient oxygen in the blood
m. ​a group of plasma proteins that assist the activities of antibodies
n. ​insufficient oxygen in body tissues
o. ​a severe reduction in blood flow that deprives the body's tissues of oxygen and nutrients
p. ​a lung disorder characterized by persistent inflammation and excessive secretions of mucus in the main airways of the lungs
q. ​shortness of breath
r. ​a whole-body inflammatory response caused by infection
s. ​a bluish cast in the skin due to the color of deoxygenated hemoglobin
t. ​accumulations of pus
​hepcidin
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73
Matching​
a. ​the breakdown of muscle tissue that results from disease or malnutrition
b. ​an acute-phase protein involved in the regulation of iron metabolism
c. ​the main airways of the lungs
d. ​cells within connective tissue that produce and release histamine
e. ​the volume of air a person inhales or exhales each minute
f. ​the surgical removal of dead, damaged, or contaminated tissue resulting from burns or wounds
g. ​respiratory failure triggered by severe lung injury
h. ​the chemical and physical changes that occur within the body during stress
i. ​progressive lung disease characterized by the breakdown of the lungs' elastic structure and destruction of the walls of the respiratory bronchioles and alveoli
j. ​a group of metabolic abnormalities that may result from aggressive refeeding in severely malnourished persons
k. ​a method of estimating resting energy expenditure by measuring a person's oxygen consumption and carbon dioxide production
l. ​insufficient oxygen in the blood
m. ​a group of plasma proteins that assist the activities of antibodies
n. ​insufficient oxygen in body tissues
o. ​a severe reduction in blood flow that deprives the body's tissues of oxygen and nutrients
p. ​a lung disorder characterized by persistent inflammation and excessive secretions of mucus in the main airways of the lungs
q. ​shortness of breath
r. ​a whole-body inflammatory response caused by infection
s. ​a bluish cast in the skin due to the color of deoxygenated hemoglobin
t. ​accumulations of pus
​abscesses
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74
Matching​
a. ​the breakdown of muscle tissue that results from disease or malnutrition
b. ​an acute-phase protein involved in the regulation of iron metabolism
c. ​the main airways of the lungs
d. ​cells within connective tissue that produce and release histamine
e. ​the volume of air a person inhales or exhales each minute
f. ​the surgical removal of dead, damaged, or contaminated tissue resulting from burns or wounds
g. ​respiratory failure triggered by severe lung injury
h. ​the chemical and physical changes that occur within the body during stress
i. ​progressive lung disease characterized by the breakdown of the lungs' elastic structure and destruction of the walls of the respiratory bronchioles and alveoli
j. ​a group of metabolic abnormalities that may result from aggressive refeeding in severely malnourished persons
k. ​a method of estimating resting energy expenditure by measuring a person's oxygen consumption and carbon dioxide production
l. ​insufficient oxygen in the blood
m. ​a group of plasma proteins that assist the activities of antibodies
n. ​insufficient oxygen in body tissues
o. ​a severe reduction in blood flow that deprives the body's tissues of oxygen and nutrients
p. ​a lung disorder characterized by persistent inflammation and excessive secretions of mucus in the main airways of the lungs
q. ​shortness of breath
r. ​a whole-body inflammatory response caused by infection
s. ​a bluish cast in the skin due to the color of deoxygenated hemoglobin
t. ​accumulations of pus
​sepsis
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75
Matching​
a. ​the breakdown of muscle tissue that results from disease or malnutrition
b. ​an acute-phase protein involved in the regulation of iron metabolism
c. ​the main airways of the lungs
d. ​cells within connective tissue that produce and release histamine
e. ​the volume of air a person inhales or exhales each minute
f. ​the surgical removal of dead, damaged, or contaminated tissue resulting from burns or wounds
g. ​respiratory failure triggered by severe lung injury
h. ​the chemical and physical changes that occur within the body during stress
i. ​progressive lung disease characterized by the breakdown of the lungs' elastic structure and destruction of the walls of the respiratory bronchioles and alveoli
j. ​a group of metabolic abnormalities that may result from aggressive refeeding in severely malnourished persons
k. ​a method of estimating resting energy expenditure by measuring a person's oxygen consumption and carbon dioxide production
l. ​insufficient oxygen in the blood
m. ​a group of plasma proteins that assist the activities of antibodies
n. ​insufficient oxygen in body tissues
o. ​a severe reduction in blood flow that deprives the body's tissues of oxygen and nutrients
p. ​a lung disorder characterized by persistent inflammation and excessive secretions of mucus in the main airways of the lungs
q. ​shortness of breath
r. ​a whole-body inflammatory response caused by infection
s. ​a bluish cast in the skin due to the color of deoxygenated hemoglobin
t. ​accumulations of pus
​indirect calorimetry
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76
Matching​
a. ​the breakdown of muscle tissue that results from disease or malnutrition
b. ​an acute-phase protein involved in the regulation of iron metabolism
c. ​the main airways of the lungs
d. ​cells within connective tissue that produce and release histamine
e. ​the volume of air a person inhales or exhales each minute
f. ​the surgical removal of dead, damaged, or contaminated tissue resulting from burns or wounds
g. ​respiratory failure triggered by severe lung injury
h. ​the chemical and physical changes that occur within the body during stress
i. ​progressive lung disease characterized by the breakdown of the lungs' elastic structure and destruction of the walls of the respiratory bronchioles and alveoli
j. ​a group of metabolic abnormalities that may result from aggressive refeeding in severely malnourished persons
k. ​a method of estimating resting energy expenditure by measuring a person's oxygen consumption and carbon dioxide production
l. ​insufficient oxygen in the blood
m. ​a group of plasma proteins that assist the activities of antibodies
n. ​insufficient oxygen in body tissues
o. ​a severe reduction in blood flow that deprives the body's tissues of oxygen and nutrients
p. ​a lung disorder characterized by persistent inflammation and excessive secretions of mucus in the main airways of the lungs
q. ​shortness of breath
r. ​a whole-body inflammatory response caused by infection
s. ​a bluish cast in the skin due to the color of deoxygenated hemoglobin
t. ​accumulations of pus
​bronchioles
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77
Mark is a 23-year-old firefighter who experienced severe burns while fighting a house fire. The nurse recognizes the fact that he may benefit from supplements of _____ to reduce the risk of infection.​

A) ​zinc, vitamin C, and vitamin A
B) ​iron, magnesium, and calcium
C) ​sodium, potassium, and chloride
D) ​phosphorus, thiamin, and riboflavin
E) ​calcium, vitamin D, and vitamin K
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78
Matching​
a. ​the breakdown of muscle tissue that results from disease or malnutrition
b. ​an acute-phase protein involved in the regulation of iron metabolism
c. ​the main airways of the lungs
d. ​cells within connective tissue that produce and release histamine
e. ​the volume of air a person inhales or exhales each minute
f. ​the surgical removal of dead, damaged, or contaminated tissue resulting from burns or wounds
g. ​respiratory failure triggered by severe lung injury
h. ​the chemical and physical changes that occur within the body during stress
i. ​progressive lung disease characterized by the breakdown of the lungs' elastic structure and destruction of the walls of the respiratory bronchioles and alveoli
j. ​a group of metabolic abnormalities that may result from aggressive refeeding in severely malnourished persons
k. ​a method of estimating resting energy expenditure by measuring a person's oxygen consumption and carbon dioxide production
l. ​insufficient oxygen in the blood
m. ​a group of plasma proteins that assist the activities of antibodies
n. ​insufficient oxygen in body tissues
o. ​a severe reduction in blood flow that deprives the body's tissues of oxygen and nutrients
p. ​a lung disorder characterized by persistent inflammation and excessive secretions of mucus in the main airways of the lungs
q. ​shortness of breath
r. ​a whole-body inflammatory response caused by infection
s. ​a bluish cast in the skin due to the color of deoxygenated hemoglobin
t. ​accumulations of pus
​debridement
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79
Mr. Winslett is a COPD patient who is complaining of poor appetite, abdominal discomfort, and bloating. Which suggestion from the nurse is most appropriate for improving his food intake?​

A) ​"Consume larger meals."
B) ​"Substitute beans for meat."
C) ​"Drink a supplement before eating."
D) ​"Eat smaller, more frequent meals."
E) ​"Increase fluid intake throughout the day."
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80
Matching​
a. ​the breakdown of muscle tissue that results from disease or malnutrition
b. ​an acute-phase protein involved in the regulation of iron metabolism
c. ​the main airways of the lungs
d. ​cells within connective tissue that produce and release histamine
e. ​the volume of air a person inhales or exhales each minute
f. ​the surgical removal of dead, damaged, or contaminated tissue resulting from burns or wounds
g. ​respiratory failure triggered by severe lung injury
h. ​the chemical and physical changes that occur within the body during stress
i. ​progressive lung disease characterized by the breakdown of the lungs' elastic structure and destruction of the walls of the respiratory bronchioles and alveoli
j. ​a group of metabolic abnormalities that may result from aggressive refeeding in severely malnourished persons
k. ​a method of estimating resting energy expenditure by measuring a person's oxygen consumption and carbon dioxide production
l. ​insufficient oxygen in the blood
m. ​a group of plasma proteins that assist the activities of antibodies
n. ​insufficient oxygen in body tissues
o. ​a severe reduction in blood flow that deprives the body's tissues of oxygen and nutrients
p. ​a lung disorder characterized by persistent inflammation and excessive secretions of mucus in the main airways of the lungs
q. ​shortness of breath
r. ​a whole-body inflammatory response caused by infection
s. ​a bluish cast in the skin due to the color of deoxygenated hemoglobin
t. ​accumulations of pus
​complement
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Unlock Deck
Unlock for access to all 90 flashcards in this deck.