NUR 102 LEC & LAB P-3

LECTURE

SESSION 16: Medications, Diet-Drug Interactions and Herbal Supplements

1. Over-the-counter drugs
rarely cause adverse effects.
are unlikely to interact with dietary components.
are usually taken for longer periods than prescription medications.
are used to treat illnesses that are typically self-diagnosed and self-treated

2. Recommendations for reducing the incidence of medication errors include:

avoiding the use of confusing terms on clinical documents.
advising patients to take only one medication at a time.
requiring that prescriptions be handwritten instead of typed.
physician supervision whenever drugs are administered.

3. Adverse drug effects are most likely when:

multiple medications are used.
generic drugs are substituted for brand-name drugs.
patients begin using a new medication.
medications are taken for just one or two days.

4. Examples of medication-related symptoms that can significantly limit food

intake include:
ringing in the ears.
persistent nausea and vomiting.
insomnia
skin rash.

5.  Medications that reduce stomach acidity can impair the absorption of:
fat-soluble vitamins.
thiamin and riboflavin.
sodium and potassium.
vitamin B12, folate, and iron.

SESSION 17:  Specialized Nutrition Support: Enteral and Parenteral Nutrition

6. For a patient who is at high risk of aspiration and is not expected to be able to
eat table foods for several months, an appropriate placement of a feeding tube
might be:
nasogastric
nasoenteric.
gastrostomy.
jejunostomy.
7. In selecting an appropriate enteral formula for a patient, the primary
consideration is:
formula osmolality.
the patient’s nutrient needs.
availability of infusion pumps.
formula cost.

8. An important measure that may prevent bacterial contamination in tube feeding

formulas is:
nonstop feeding of formula
using the same feeding bag and tubing each day.
discarding opened containers of formula not used within 24 hours.
adding formula to the feeding container before it empties completely.

9. The nurse using a feeding tube to deliver medications recognizes that:

medications given by feeding tubes generally do not cause GI complaints.
medications can usually be added directly to the feeding container.
enteral formulas do not interact with medications in the same way that foods do.
thick or sticky liquid medications and crushed tablets can clog feeding tubes

10. For a patient receiving central TPN who also receives intravenous lipid
emulsions two or three times a week, the lipid emulsions serve primarily as a
source of:
essential fatty acids.
cholesterol.
fat-soluble vitamins.
concentrated energy

SESSION 18:  Foods and Food Consistency for Upper GI Disorders, Fiber-

Modified Diets for Lower Gastrointestinal Tract Disorders
11. Foods permitted on the clear liquid diet include all of the following except:
milk.
fruit ices.
flavored gelatin.
consommé.

12. If a patient with dysphagia has difficulty swallowing solids but can easily
swallow liquids:
the problem is most likely a motility disorder.
the patient may have achalasia.
the problem is probably an esophageal obstruction.
the patient most likely has oropharyngeal dysphagia.

13. Possible consequences of GERD include all of the following except:

reflux esophagitis.
dysphagia.
Barrett’s esophagus.
gastric ulcer

14. Chronic gastritis may increase risk of:

dumping syndrome.
bone disease.
iron and vitamin B12 deficiencies.
gallbladder disease.

15. The main dietary recommendation for patients with gastritis or peptic ulcers is
to consume foods that:
neutralizes stomach acidity.
is well tolerated and does not cause discomfort.
coat the stomach lining.
promotes healing of mucosal tissue.

16. The health practitioner advising an elderly patient with constipation

encourages the patient to:
consumes a low-fat diet low in sodium.
consumes a high-protein diet rich in calcium.
gradually adds high-fiber foods to the diet.
eliminates gas-forming foods from the diet.

17. Osmotic diarrhea often results from:

excessive colonic contractions.
excessive fluid secretion by the intestines
nutrient malabsorption.
viral, bacterial, or protozoal infections

18. Symptoms of irritable bowel syndrome most often include:

constipation and/or diarrhea and flatulence.
weight loss and malnutrition.
strong odors and obstructions.
nausea and vomiting.

19. Ulcerative colitis may afflict which region of the digestive tract?
Ileum, rectum, and colon
Rectum and colon
Stomach and duodenum
Most regions of the GI tract can be affected

20.  After an ileostomy, the most serious concern is that:

The diet is too restrictive to meet nutrient needs.
waste disposal causes frequent daily interruptions.
incompletely digested foods may cause obstructions.
fluid restrictions prevent patients from drinking beverages freely
SESSION 19:  Carbohydrate- and Fat-Modified Diets for Malabsorption Disorders
Nutrition Therapy for Liver and Gallbladder Diseases
21. Possible causes of malabsorption include all of the following except: 
inflammatory bowel disease.
pancreatic dysfunction.
flatulence
liver disease

22. Nutrition problems that may result from fat malabsorption include all of the
following except: 
weight loss.
essential amino acid deficiencies.
bone loss.
oxalate kidney stones.

23.  Lactose intolerance is a direct consequence of: 

insufficient lactase.
milk allergy.
fluid imbalance.
pancreatic dysfunction.

24. The majority of chronic pancreatitis cases can be attributed to: 

bacterial and viral infections.
gallstones.
alcohol abuse.
elevated triglyceride levels

25. A person on a gluten-free diet must avoid products containing:

wheat, barley, and rye.
lactose.
excessive fat.
corn, rice, and millet

26. In cases of fatty liver that are unrelated to excessive alcohol intakes, the
primary risk factor is:
following a high-protein diet.
use of illicit drugs.
following a high-fat diet.
insulin resistance.

27. Which of the following statements about hepatitis is true?

Chronic hepatitis can progress to cirrhosis.
Whatever the cause of hepatitis, symptoms are typically severe.
Vaccines are available to protect against hepatitis A, B, and C viruses.
HCV infection can be spread through contaminated foods and water.
28. Esophageal varices are a dangerous complication of liver disease primarily
because they:
interferes with food intake.
can lead to massive bleeding.
diverts blood flow from the GI tract.
contributes to hepatic encephalopathy.

29. A complication of cirrhosis that contributes to the development of ascites is:

portal hypertension.
elevated serum ammonia levels.
bile obstruction.
insulin resistance.

30. Regarding the major risk factors for gallstone disease:

prevalence is much higher in men than in women.
gallstone risk is increased during pregnancy.
rapid weight loss can temporarily shrink gallstones.
risk is generally similar among ethnic groups.

SESSION 20:   Carbohydrate Controlled Diets for Diabetes Mellitus

31. Which of the following is characteristic of type 1 diabetes?
Abdominal obesity increases risk
The pancreas makes little or no insulin.
It is the predominant form of diabetes.
It often arises during pregnancy.

32. Which of the following is true about type 2 diabetes?

It is usually an autoimmune disease.
The pancreas makes little or no insulin.
Diabetic ketoacidosis is a common complication.
Chronic complications may develop before it is diagnosed.

33. Most chronic complications associated with diabetes result from:

altered kidney function.
infections that deplete nutrient reserves.
weight gain and hypertension.
damage to blood vessels and nerves.

34. The most effective meal-planning strategy for managing diabetes is:
carbohydrate counting.
an eating plan based on food lists created for persons with diabetes.
following menus and recipes provided by a registered dietitian.
the approach that best helps the patient control blood glucose levels.

35. Which dietary adjustment may be helpful for women with gestational
diabetes?
Consuming most of the day’s carbohydrate allotment in the morning
Restricting carbohydrate to about 30 grams at breakfast
Avoiding food intake after dinner
Reducing energy intake to about 50 percent of the calculated requirement

SESSION 21:  Fat-Controlled, Mineral-Modified Diets for Cardiovascular Diseases

36.  Ischemia in the coronary arteries is a frequent cause of:
angina pectoris.
hemorrhagic stroke.
aneurysm.
hypertension

37.  Dietary lipids with the strongest LDL cholesterol–raising effects are:
monounsaturated fats.
polyunsaturated fats
saturated fats.
plant sterols.

38. Hemorrhagic stroke:

is the most common type of stroke
results from obstructed blood flow within brain tissue.
comes on suddenly and usually lasts for up to 30 minutes.
results from bleeding within the brain, which damages brain tissue.

39. Hypertensive patients can benefit from all of the following dietary and lifestyle
modifications except:
including fat-free or low-fat milk products in the diet.
reducing total fat intake.
consuming generous amounts of fruit, vegetables, legumes, and nuts.
reducing sodium intake

40.  Nutrition therapy for a patient with heart failure usually includes:
weight loss.
reducing total fat intake.
sodium restriction
cholesterol restriction.

SESSION 22:   Protein-, Mineral-, and Fluid Modified Diets for Kidney Diseases
41. Which of the following is not a function of the kidneys?
Activation of vitamin K
Maintenance of acid-base balance
Elimination of metabolic waste products
Maintenance of fluid and electrolyte balances

42. The nephrotic syndrome frequently results in:

the uremic syndrome.
oliguria.
edema.
renal colic.

43. If a patient with acute kidney injury should require a high protein intake, which
additional treatment may be necessary?
Frequent dialysis
Use of diuretics
Enteral nutrition support
Fluid restrictions

44. The most common cause of chronic kidney disease is:

diabetes mellitus.
hypertension.
autoimmune disease.
exposure to toxins.

45.  A person with chronic kidney disease who has been following a renal diet for
several years begins hemodialysis treatment. An appropriate dietary adjustment
would be to:
reduce protein intake.
consume protein more liberally.
increase intakes of sodium and water.
consume potassium and phosphorus more liberally

SESSION 23:   Energy- and Protein-Modified Diets for Metabolic and Respiratory

Stress Energy- and Protein-Modified Diets for Cancer and HIV Infection
46.  Which of the following metabolic changes accompanies acute stress?
Hypoglycemia
Reduced heart and respiratory rates
Elevated immune responses
Muscle protein catabolism

47.  Which of the following statements concerning protein and energy

recommendations during acute metabolic stress is true?
Protein and energy recommendations are similar to those for healthy people.
Protein and energy recommendations are reduced because a stressed individual cannot
metabolize nutrients normally.
Acutely stressed individuals can benefit from as much protein and energy as can be provided.
Protein and energy recommendations are often increased to minimize muscle tissue losses.

48.  A primary feature of emphysema is:

obstruction within the bronchi.
obstruction within the bronchioles.
destruction of the walls separating the alveoli.
excessive lung elasticity.

49.  The weight loss and wasting that often occur in COPD can be caused by:
reduced food intake.
increased metabolic rate.
reduced exercise tolerance.
all of the above

50.  Nutrition therapy for a person with respiratory failure includes:

careful attention to providing enough, but not too much, energy.
a generous fluid intake to facilitate mucus clearance.
a high fat intake to prevent weight loss and wasting.
a high carbohydrate intake to increase carbon dioxide production.

51. Which of these dietary substances may help to protect against cancer?

Alcoholic beverages
Well-cooked meats, poultry, and fish
Animal fats
Compounds in fruits and vegetables

52. An advantage of radiation therapy over chemotherapy is that:

radiation is not damaging to rapidly dividing cells.
side effects of radiation therapy do not include malnutrition.
radiation can be directed toward the regions affected by cancer.
the radiation used is too weak to damage GI tissues

53. Which food below should be avoided by a patient consuming a low-microbial

diet?
Baked potato
Pasteurized yogurt
Banana
Leftover luncheon meat

54. HIV can enter and destroy:

epithelial cells.
helper T cells.
liver cells.
intestinal cells.

55.   In people with HIV infection, mouth sores may be caused by all of the
following except:
cryptosporidiosis.
Kaposi’s sarcoma.
herpes simplex virus.
candidiasis.
LABORATORY

SESSION 19_ DIETS FOR RENAL DISEASES (PART 1)

1. Medically speaking, which term refers to kidney function? 
a. Hepatic
b. Dialysis
c. Renal
d. Urinary

2. Common non-specific symptoms of chronic kidney disease include: 

a. Increased urination at night
b. Swelling of hands and feet
c. Loss of appetite
d. All of the above

3. People on dialysis should maintain diets high in __________________. 

a. Protein
b. Fats
c. Fibe
d. Carbohydrates

4. Patients with kidney diseases must manage fluid intake because fluid... 
a. Retention can cause swelling and weight gain
b. Overload can result in heart trouble
c. Affects blood pressure
d. All of the above

5. You are seeing a patient on hemodialysis for a monthly lab review. During the
review, you notice that his albumin  level is 2.6 g/dL. He says he eats one meal
per day and would like advice on what meats and meat alternatives to  prepare.
Which proteins are among those you would advise your patient to eat? 

a. Chicken, fish, beef, eggs, soybeans, quinoa

b. Legumes
c. Potatoes, rice, breads, and pasta
d. Sesame seeds, pumpkin seeds, almonds, walnuts

SESSION 20_DIETS FOR RENAL DISEASES (PART 2)

1. A patient with stage 4 chronic kidney disease asks what type of diet they
should follow. You explain the patient should  follow a: 
a. Low protein, low sodium, low potassium, low phosphate diet
b. High protein, low sodium, low potassium, high phosphate diet
c. Low protein, high sodium, high potassium, high phosphate diet
d. Low protein, low sodium, low potassium, high phosphate diet

2. Your kidneys are what part of which system in your body? 

a. Reproductive system
b. Gastrointestinal tract
c. Respiratory system
d. Urinary system

3. What is the most common cause of kidney disease? 

a. Drug abuse and smoking
b. Uncontrolled diabetes
c. High blood pressure
d. B and C

4. How do most kidney-damaging diseases affect the kidneys? 

a. They damage nephrons, the kidney's filtering mechanisms
b. They damage urethras
c. They damage the bladder
d. They damage all tissue

5. If you have decreased kidney function, you should monitor which of these in
your diet? 
a. Protein
b. Food dyes
c. Sodium
d. a and c

SESSION 21_NUTRITION COUNSELING AND DIETARY INSTRUCTIONS (PART 1)

1. Nurses are in an ideal position to 
a. screen patients for risk of malnutrition
b. conduct comprehensive nutrition assessments
c. order therapeutic diets
d. calculate a patient's calorie and protein needs

2. Which of the following criteria would most likely be on a nutrition screen in the
hospital? 
a. prealbumin value c. weight change
b. serum potassium value
c. weight change
d. cultural food preferences

3. Patient Sinthia has a question about the cardiac diet the dietitian reviewed with
her yesterday. What is the nurse's  best response? 
a. "ask your doctor when you go for your follow-up appointment"
b. "What is the question? If I can't answer it, I will get the dieting to come back to answer it"
c. "Just do your best. The handout she gave you is simply a list of guidelines, not rigid
instructions"
d. "If I see the dieting around, I will tell her you need to see her."
Other:

4. Characteristics of successful dieters include all of the following except: 

a. Maintaining a daily food journal
b. Adhering to a strict eating plan
c. Counting calories
d. Eliminating all carbohydrates from their diets

5. Motivating clients to participate in health promotion activities requires a variety

of appealing strategies such as: 
a. Adapting the program educational materials to the demographic characteristics of the target
audience
b. Considering education level of the participants
c. Finding convenient class times and locations
d. Performing health-risk assessments
e. All of the above

SESSION 22_ NUTRITION COUNSELING AND DIETARY INSTRUCTIONS (PART 2)

1. Which of the following is a systematic problem-solving method that dietitians
use critical-thinking skills to make  evidence-based decisions addressing the
nutrition-related problems of their patients? 
a. nutritional assessment
b. the nutrition care process
c. nutritional screening
d. nutrition monitoring
Other:

2. What snack choice would be the best suggestion by the nurse for a patient on
a renal diet
a. Peanut butter
b. Diet cola
c. Bananas
d. Carrot sticks
3. Assists people to learn about themselves, their environment, and the methods
of handling their roles and  relationships. 
a. Interview
b. Assessment
c. counseling
d. relationship

4. Analysis of nutrition science, psychology and physiology, and eventual

negotiated treatment plan followed by an  evaluation; requires assessment and
diagnosis prior to intervention 
a. Nutrition counseling
b. Motivational Interview
c. Nutrition education
d. Assessment

5. Directive, client-centered counseling style for eliciting behavior change by

helping clients to explore and resolve  ambivalence to change 
a. Nutrition counseling
b. Motivational Interview
c. Nutrition education
d. Assessment

SESSION 23_ FOOD PREPARATION AND SERVICE 

1. The minimum time food workers should wash their hands is:  
a. 5 seconds
b. 30 seconds
c. 20 seconds
d. 40 seconds

2. Workers should not handle food or eating and drinking utensils when they
have or recently had any of the  following symptoms: 
a. Vomiting, diarrhea, fever, sore throat with fever, jaundice, infected cuts
b. Runny nose, sneezing, cough, congestion, cold symptoms
c. A and B
d. None of the above

3. Examples of cross-contamination are: 

a. Raw chicken is processed on cutting board then lettuce is sliced on same surface
b. Food worker handles raw meat then assembles sandwich without washing hands
c. Liquids from raw hamburger drip onto vegetables for salad
d. All of the above

4. Examples of how to rapidly cool food include: 

a. Portioning large quantities of foods into smaller units by slicing and pouring
b. Using metal rather than plastic containers
c. Ensuring vigorous air circulation around food
d. All of the above

5. Food workers should wash their hands after which of the following: 
a. Coughing, sneezing, scratching, wiping nose, cleaning
b. Touching exposed body parts, handling raw animal food, handling money
c. Before putting on disposable gloves or after using the restroom
d. All of the above