Deck 31: Determinants and Assessment of Nutrition and Metabolic Function

Question 1

A patient is admitted with poor wound healing and malnutrition.To best address issues of wound healing,the nurse designs interventions to support intake of which nutrient?

A)Protein
B)Minerals
C)Carbohydrates
D)Lipids

Answer 1

Protein

Question 2

The nurse is reviewing laboratory results and the dietician's analysis of a hospitalized patient's normal home diet.The nurse would plan to support additional amounts of nutrients based on which percentages? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Select all that apply.

A)Carbohydrates 35%
B)Fat 7%
C)Protein 45%
D)Thiamine 18 ng/mL
E)Magnesium 2.2 mEq/L

Answer 2

Carbohydrates 35%
Fat 7%

Question 3

A patient who is being mechanically ventilated is demonstrating respiratory acidosis.The nurse suspects that which metabolic process is malfunctioning?

A)Anaerobic metabolism
B)Catabolism
C)Aerobic metabolism
D)Anabolism

Answer 3

Aerobic metabolism

Question 4

A patient,diagnosed with malnutrition and who has known exposure to Candida,was given an intradermal Candida test dose 3 days ago.The site is currently showing no signs of induration.How would the nurse evaluate this finding?

A)There is lack of anergy.
B)There is no current infection with Candida.
C)The immune system has been impaired,possibly by malnutrition.
D)The test should be repeated in 48 hours.

Question 5

A patient in the intensive care unit is at risk for developing malnutrition.Indirect calorimetry is planned to estimate the patient's caloric needs.Which information would the nurse provide to this patient? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Select all that apply.

A)"You will be taken to a special chamber where you can be isolated."
B)"You will be required to exercise on a treadmill for this testing."
C)"You can expect this test to take about 15 to 20 minutes."
D)"In order for results to be accurate,I will need to measure your height."
E)"We will not be able to do this test until you are off the mechanical ventilator."

Question 6

It is necessary to measure a patient's height,but the patient's legs are suspended in traction.Which nursing action is indicated?

A)Measure from the patient's head to the iliac crest and use a standard table to estimate height.
B)Remove the traction weights long enough to quickly measure length of one leg.
C)Measure the patient's arm span.
D)Estimate the patient's height from his stated weight.

Question 7

It has been calculated that a patient in the intensive care unit needs 1800 calories each day to sustain normal metabolic functioning.The nurse calculates that which number of calories is needed to sustain central nervous system (CNS)functioning?

A)1440 calories
B)360 calories
C)900 calories
D)720 calories

Question 8

The nurse is going to calculate a patient's metabolic needs by using the Harris-Benedict equation.Which information should the nurse collect for this calculation? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Select all that apply.

A)Height in centimeters
B)Weight in kilograms
C)Age in months
D)Body mass index (BMI)
E)Body temperature

Question 9

A patient who is hemodynamically stable has been receiving protein replacement therapy for several days.The nurse realizes that which laboratory test would be the best to determine the patient's current nutritional status?

A)Total lymphocyte count
B)Albumin
C)Transferrin
D)Vitamin assay

Question 10

A patient in the intensive care unit is surprised to learn that he has an elevated blood glucose level since he has not been diagnosed with diabetes.How should the nurse explain this elevation?

A)"Many people are not diagnosed with diabetes until they are admitted to an intensive care unit."
B)"Increasing blood glucose is the body's way of making sure there is enough energy for brain functioning."
C)"Many people have diabetes but are not aware of it."
D)"When stressed,the body releases more glucose into the blood,raising the blood glucose level."

Question 11

A patient has been in the intensive care unit for 10 days after a traumatic injury requiring intubation and multiple blood transfusions.The patient now has assessment findings consistent with protein malnutrition.Which laboratory result would the nurse evaluate as supporting this diagnosis?

A)Prealbumin level 15 mg/dL
B)Transferrin level 325 mcg/dL
C)BUN level 10 mg/dL
D)Albumin level 4 g/dL

Question 12

A patient's blood oxygen level is measured to be 78%.The nurse implements interventions to improve this level to avoid development of which situation?

A)Anabolism
B)Catabolism
C)Anaerobic metabolism
D)Aerobic metabolism

Question 13

The patient was admitted to the emergency department after being injured in a drive-by shooting.Despite very serious injuries,the patient is awake and alert and cries continuously that "someone tried to kill me." The nurse tries to calm the patient because of which catecholamine effects? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Select all that apply.

A)Increased heart rate
B)Increased blood pressure
C)Constriction of coronary vessels
D)Constriction of blood vessels in skeletal muscles
E)Increase in blood glucose

Question 14

A patient with poorly controlled diabetes has elevated lipid levels in spite of her attempts to decrease fat and carbohydrate intake.How should the nurse explain this finding?

A)"You are not eating enough and your proteins are breaking down."
B)"Your body is using your high glucose levels to produce lipids."
C)"You are not eating enough carbohydrates."
D)"Most persons with diabetes are not able to efficiently metabolize fats."

Question 15

The nurse is explaining the mechanics of collecting a 24-hour urine urea nitrogen test to the patient.The nurse would also explain which purpose of this test?

A)Fluid status
B)Kidney function
C)Blood volume
D)Nitrogen balance

Question 16

A male patient is 6 feet 2 inches tall with a body weight of 145 lbs.The nurse would calculate this patient's body mass index (BMI)to be in which category?

A)Underweight
B)Normal
C)Overweight
D)Obese

Question 17

The nurse is monitoring a patient's metabolic status with a thermodilution catheter to determine oxygen saturation of venous blood.How would the nurse report the findings of this test?

A)As oxygen extraction
B)Using the Fick equation
C)As indirect calorimetry
D)As direct calorimetry

Question 18

A patient has a pituitary adenoma that has increased secretion of thyroid-stimulating hormone.Which nutritional effect,if any,will the nurse note in this patient?

A)Metabolism will be increased.
B)The patient's appetite will be suppressed.
C)No changes will be noted.
D)The patient will crave salt.

Question 19

The nurse notices that a patient in the intensive care unit has lost muscle mass and tone in her arms and legs.The nurse would attribute this loss to changes in which process?

A)Energy
B)Catabolism
C)Adenosine triphosphate
D)Anabolism