Deck 19: Carbohydrate- and Fat-Modified Diets for Malabsorption Disorders

Question 1

Someone with malabsorption problems who is experiencing flatulence and diarrhea may benefit from avoiding:

A)decaffeinated beverages.
B)lightly seasoned foods.
C)lactose-containing foods.
D)low-fat foods.

Answer 1

C

Question 2

Case Study
Cook with Cholelithiasis: Marcia Brown is a 42-year-old Pima Indian who works as a cook in a casino in Arizona.She has just been diagnosed with cholelithiasis.She is 5'4" tall and once weighed 210 pounds.One year ago she underwent gastric bypass surgery and has lost 75 pounds.For several months she had been experiencing episodes of pain in the right upper part of her abdomen.The pain usually began after eating and lasted for several hours.Lately she began to experience nausea and vomiting with the pain and began to run a fever.
MCT oil does not require bile for digestion and absorption.

Answer 2

True

Question 3

Which of the following is not true of MCT oil?

A)It is inexpensive.
B)It should not be used to fry food.
C)It should be added to the diet gradually.
D)It may have an unpleasant taste.

Answer 3

A

Question 4

minerals commonly malabsorbed as a consequence of fat malabsorption are:

A)iron and selenium.
B)zinc and manganese.
C)calcium and magnesium.
D)phosphorous and calcium.

Question 5

malabsorption is associated with all of the following except:

A)weight loss.
B)essential fatty acid deficiency.
C)loss of sodium and potassium.
D)increased risk of kidney stones.

Question 6

Malabsorption of certain minerals is common in persons with fat malabsorption.This can ultimately result in:

A)fluid and electrolyte imbalances.
B)increased risk of bone loss.
C)loss of taste acuity.
D)insulin resistance.

Question 7

Severe liver disease can lead to fat malabsorption because:

A)it reduces the availability of bile.
B)it decreases the production of pancreatic lipase.
C)it results in damage to the intestinal wall.
D)it causes motility disorders.

Question 8

Case Study
Cook with Cholelithiasis: Marcia Brown is a 42-year-old Pima Indian who works as a cook in a casino in Arizona.She has just been diagnosed with cholelithiasis.She is 5'4" tall and once weighed 210 pounds.One year ago she underwent gastric bypass surgery and has lost 75 pounds.For several months she had been experiencing episodes of pain in the right upper part of her abdomen.The pain usually began after eating and lasted for several hours.Lately she began to experience nausea and vomiting with the pain and began to run a fever.
Most often, acute pancreatitis is caused by high blood triglycerides.

Question 9

Which of the following are not allowed on a fat-controlled diet?

A)angel food cake, fat-free milk, and pears
B)cherry pie, chocolate milk, and spareribs
C)marshmallows, fat-free yogurt, and green beans
D)oranges, jelly beans, and noodles

Question 10

Malabsorption of fat results in:

A)steatorrhea.
B)loss of amino acids.
C)loss of water-soluble vitamins.
D)weight gain.

Question 11

laboratory test can help to diagnosis lactose intolerance?

A)stool fat test
B)Schilling test
C)hydrogen breath test
D)D-xylose test

Question 12

Malabsorptive disorders and their treatments can cause all of the following problems except:

A)altered food intake.
B)increased nutrient needs.
C)altered nutrient absorption.
D)weight gain.

Question 13

Case Study
Cook with Cholelithiasis: Marcia Brown is a 42-year-old Pima Indian who works as a cook in a casino in Arizona.She has just been diagnosed with cholelithiasis.She is 5'4" tall and once weighed 210 pounds.One year ago she underwent gastric bypass surgery and has lost 75 pounds.For several months she had been experiencing episodes of pain in the right upper part of her abdomen.The pain usually began after eating and lasted for several hours.Lately she began to experience nausea and vomiting with the pain and began to run a fever.
Vitamin B₁₂ is absorbed through the:

A)duodenum.
B)stomach.
C)ileum.
D)colon.

Question 14

Case Study
Cook with Cholelithiasis: Marcia Brown is a 42-year-old Pima Indian who works as a cook in a casino in Arizona.She has just been diagnosed with cholelithiasis.She is 5'4" tall and once weighed 210 pounds.One year ago she underwent gastric bypass surgery and has lost 75 pounds.For several months she had been experiencing episodes of pain in the right upper part of her abdomen.The pain usually began after eating and lasted for several hours.Lately she began to experience nausea and vomiting with the pain and began to run a fever.
Celiac disease is characterized by an abnormal immune response to certain amino acids.

Question 15

Schilling test helps to diagnose malabsorption of:

A)fat.
B)vitamin B₁₂.
C)lactose.
D)vitamin B₆.

Question 16

Case Study
Cook with Cholelithiasis: Marcia Brown is a 42-year-old Pima Indian who works as a cook in a casino in Arizona.She has just been diagnosed with cholelithiasis.She is 5'4" tall and once weighed 210 pounds.One year ago she underwent gastric bypass surgery and has lost 75 pounds.For several months she had been experiencing episodes of pain in the right upper part of her abdomen.The pain usually began after eating and lasted for several hours.Lately she began to experience nausea and vomiting with the pain and began to run a fever.
Many lactose-intolerant individuals can tolerate up to 2 cups of milk a day when intake is divided throughout the day and taken with food.

Question 17

patients with fat malabsorption problems, fat is better tolerated if it is:

A)provided in small portions.
B)monounsaturated.
C)limited to one meal per day.
D)consumed as fried food.

Question 18

Lactose intolerance is prevalent among all of the following ethnic groups except:

A)Native Americans.
B)Asians.
C)Latinos.
D)Caucasians.

Question 19

Bacterial overgrowth in the stomach and small intestine can result in:

A)a deficiency of fat-soluble vitamins.
B)weight gain.
C)vitamin B₆ deficiency.
D)abnormal glucose tolerance.

Question 20

Kaufman has fat malabsorption and is at risk for developing oxalate stones.Which of the following foods should he avoid?

A)green beans
B)spinach
C)potatoes
D)milk

Question 21

Which of the following conditions is not a potential cause of bacterial overgrowth?

A)atrophic gastritis
B)use of acid-suppressing medications
C)lactose intolerance
D)certain gastrectomy procedures

Question 22

After intestinal resection, the absorptive efficiency of the intestine is improved through:

A)intestinal adaptation.
B)enzyme replacement therapy.
C)following a high-fiber diet.
D)further surgery.

Question 23

Case Study Questions
Use the following case study to answer questions
Kati is a 27-year-old Caucasian who works as a bank teller.She is 5'3" tall and weighs 102 pounds.She began experiencing recurrent gastrointestinal disturbances such as diarrhea, steatorrhea, and flatulence several months ago.She made an appointment with her physician after noticing that she was losing weight.Laboratory tests confirmed a diagnosis of celiac disease.
After Kati's diagnosis, she should be instructed to avoid _____ until her intestine has recovered.

A)sodium
B)fat
C)lactose
D)fructose

Question 24

Patients with celiac disease often cannot tolerate:

A)vitamin B₆.
B)lactose.
C)fat.
D)glucose.

Question 25

Celiac disease affects intestinal tissue and results in:

A)a significant reduction in mucosal surface area.
B)ulceration, irritation, and bleeding.
C)cessation of the production of digestive enzymes.
D)bacterial overgrowth.

Question 26

Evidence that a child with cystic fibrosis needs an increase in enzyme dosages might include any of the following except:

A)poor growth.
B)steatorrhea.
C)abdominal pain.
D)dysphagia.

Question 27

absorption of vitamins and minerals begins in the _____.

A)duodenum/jejunum
B)jejunum/ileum
C)ileum
D)colon

Question 28

Case Study Questions
Use the following case study to answer questions
Kati is a 27-year-old Caucasian who works as a bank teller.She is 5'3" tall and weighs 102 pounds.She began experiencing recurrent gastrointestinal disturbances such as diarrhea, steatorrhea, and flatulence several months ago.She made an appointment with her physician after noticing that she was losing weight.Laboratory tests confirmed a diagnosis of celiac disease.
gastrointestinal symptoms Kati is experiencing are due to:

A)severe damage to the intestinal mucosa and subsequent malabsorption.
B)a lack of pancreatic enzymes and resulting malabsorption.
C)gastrointestinal obstructions caused by the secretion of thick mucus.
D)bacterial overgrowth causing a disruption in fat digestion and absorption.

Question 29

Patients with celiac disease must avoid foods that contain:

A)iron.
B)protein.
C)gluten.
D)sugar.

Question 30

Case Study Questions
Use the following case study to answer questions
Kati is a 27-year-old Caucasian who works as a bank teller.She is 5'3" tall and weighs 102 pounds.She began experiencing recurrent gastrointestinal disturbances such as diarrhea, steatorrhea, and flatulence several months ago.She made an appointment with her physician after noticing that she was losing weight.Laboratory tests confirmed a diagnosis of celiac disease.
is at greatest risk of malabsorption of:

A)the macronutrients.
B)the water-soluble vitamins.
C)the B vitamins.
D)sodium, potassium, and chloride.

Question 31

Which of the following would you recommend for a patient with cystic fibrosis who experiences persistent steatorrhea, gas, and abdominal distention?

A)an increase in pancreatic enzyme replacements
B)a severely fat-restricted diet
C)a hydrolyzed formula
D)liberal use of table salt

Question 32

Nutrient deficiencies may occur with chronic pancreatitis due to:

A)malabsorption and alcohol abuse.
B)malabsorption of water-soluble vitamins.
C)malabsorption of protein and abdominal pain.
D)malabsorption of carbohydrate.

Question 33

primary goal of initial therapy for the patient with acute pancreatitis is:

A)to reduce stimulation of the pancreas by withholding oral foods and fluids.
B)to increase insulin production.
C)stimulation of the pancreas to release protective enzymes.
D)to reduce hydrochloric acid in the stomach.

Question 34

Which of the following foods is included in a gluten-restricted diet?

A)wheat
B)rice
C)barley
D)rye

Question 35

Nutritional therapy for cystic fibrosis involves all of the following except:

A)liberal use of table salt.
B)multivitamin supplements.
C)pancreatic enzyme replacement therapy.
D)a low-protein diet.

Question 36

Generally, up to _____% of the small intestine can be resected without serious nutrition consequences.

A)25
B)30
C)45
D)50

Question 37

Case Study Questions
Use the following case study to answer questions
Kati is a 27-year-old Caucasian who works as a bank teller.She is 5'3" tall and weighs 102 pounds.She began experiencing recurrent gastrointestinal disturbances such as diarrhea, steatorrhea, and flatulence several months ago.She made an appointment with her physician after noticing that she was losing weight.Laboratory tests confirmed a diagnosis of celiac disease.
Kati does not eliminate gluten from her diet, she could likely experience all of the following except:

A)anemia.
B)infertility.
C)bone disorders.
D)hypertension.

Question 38

initial diet order for the patient with acute pancreatitis should be:

A)clear liquids.
B)a fat-controlled diet.
C)nothing by mouth.
D)a regular diet.

Question 39

People with lactose intolerance may tolerate all of the following except:

A)chocolate milk.
B)nonfat milk.
C)aged cheese.
D)yogurt with active bacterial cultures.

Question 40

Pancreatitis may develop as a complication of all of the following except:

A)gallstones.
B)exposure to toxins.
C)stress.
D)alcohol abuse.

Question 41

Hernandez, a 59-year-old female, has been experiencing diarrhea and increased intestinal gas after drinking milk.She is diagnosed with lactose intolerance and subsequently worries about her bone health if she cannot drink milk.The nurse reassures her that she may still be able to tolerate some dairy foods and consume adequate calcium by all of the following means except:

A)drinking chocolate milk.
B)consuming yogurt with live bacterial cultures.
C)dividing her milk intake into small portions throughout the day.
D)consuming processed cheeses.

Question 42

Case Study
Child with Cystic Fibrosis: Julia Franklin is a 6-year-old child who was diagnosed with cystic fibrosis at age 2.She has a poor appetite, and her height and weight are below normal for her age.Her parents have been instructed to feed her a high-calorie, high-protein, high-fat diet with extra salt and to provide snacks between all meals.She takes supplemental enzymes each time she eats.She experiences frequent respiratory infections, and has had numerous hospitalizations for cystic fibrosis exacerbation since her diagnosis.
If Julia cannot swallow the supplemental enzymes, suggest ways her parents might provide the enzymes to her.

Question 43

nurse is planning for the nutritional care of a patient with acute pancreatitis.The nurse understands that initially:

A)all oral fluids and food should be withheld.
B)the patient can have liquids only.
C)tube feeding with an elemental formula should begin immediately.
D)TPN should be started immediately.

Question 44

Case Study
Child with Cystic Fibrosis: Julia Franklin is a 6-year-old child who was diagnosed with cystic fibrosis at age 2.She has a poor appetite, and her height and weight are below normal for her age.Her parents have been instructed to feed her a high-calorie, high-protein, high-fat diet with extra salt and to provide snacks between all meals.She takes supplemental enzymes each time she eats.She experiences frequent respiratory infections, and has had numerous hospitalizations for cystic fibrosis exacerbation since her diagnosis.
Why were her parents instructed to feed Julia a high-calorie, high-protein, high-fat diet? Why does she need extra salt?

Question 45

Explain how enzyme replacement preparations avoid being digested by the acid of the stomach.

Question 46

Case Study Questions
Use the following case study to answer questions
Kati is a 27-year-old Caucasian who works as a bank teller.She is 5'3" tall and weighs 102 pounds.She began experiencing recurrent gastrointestinal disturbances such as diarrhea, steatorrhea, and flatulence several months ago.She made an appointment with her physician after noticing that she was losing weight.Laboratory tests confirmed a diagnosis of celiac disease.
will require nutrition education aimed at eliminating gluten from her diet.The dietitian will teach Kati to:

A)avoid all cereal and grain products.
B)substitute whole-wheat flour for enriched wheat flour when cooking.
C)check ingredient lists on food labels carefully.
D)avoid all milk and milk products.

Question 47

Case Study
Child with Cystic Fibrosis: Julia Franklin is a 6-year-old child who was diagnosed with cystic fibrosis at age 2.She has a poor appetite, and her height and weight are below normal for her age.Her parents have been instructed to feed her a high-calorie, high-protein, high-fat diet with extra salt and to provide snacks between all meals.She takes supplemental enzymes each time she eats.She experiences frequent respiratory infections, and has had numerous hospitalizations for cystic fibrosis exacerbation since her diagnosis.
What is the cause of cystic fibrosis?

Question 48

Describe the dietary restrictions for a patient with celiac disease.

Question 49

type of anemia associated with vitamin B₁₂ and folate deficiency is called:

A)hemolytic anemia.
B)macrocytic anemia.
C)microcytic anemia.
D)anemia of chronic disease.

Question 50

type of diet should the nurse provide to help a patient with cystic fibrosis?

A)high-kcalorie, high-fat
B)low-kcalorie, low-protein
C)high-protein, low-fat
D)high-fiber

Question 51

nutrient deficiencies that most frequently cause anemia are those of:

A)iron, folate, and vitamin B₁₂.
B)carbohydrate, protein, and fat.
C)iron, folate, and vitamin B₆.
D)essential fatty acids.

Question 52

Hemolytic anemia is associated with a deficiency of:

A)iron.
B)vitamin C.
C)folate.
D)vitamin E.

Question 53

35-year-old male has developed chronic pancreatitis due to long-term excessive alcohol consumption.The nurse recognizes that he may be at nutritional risk.The best recommendation the nurse can make to this patient is to:

A)increase his fat intake.
B)avoid alcohol.
C)increase his protein intake.
D)choose high-kcalorie snacks.

Question 54

deficiency may manifest itself as low levels of all of the following laboratory tests except:

A)serum iron.
B)serum ferritin.
C)serum transferrin.
D)bone marrow iron.

Question 55

The nurse is reinforcing the dietitian's gluten-restricted diet instruction to a patient with celiac disease.The nurse correctly tells the patient that he may consume:

A)grilled chicken breast.
B)chicken-fried steak.
C)chicken and noodle soup.
D)creamed chicken and biscuits.

Question 56

Which of the following foods will the nurse include in the diet plan for a patient with celiac disease?

A)oatmeal
B)scrambled eggs
C)whole-wheat toast
D)pasta

Question 57

Case Study
Child with Cystic Fibrosis: Julia Franklin is a 6-year-old child who was diagnosed with cystic fibrosis at age 2.She has a poor appetite, and her height and weight are below normal for her age.Her parents have been instructed to feed her a high-calorie, high-protein, high-fat diet with extra salt and to provide snacks between all meals.She takes supplemental enzymes each time she eats.She experiences frequent respiratory infections, and has had numerous hospitalizations for cystic fibrosis exacerbation since her diagnosis.
Explain Julia's short stature and problem maintaining a normal body weight.

Question 58

Anemia may develop for all of the following reasons except:

A)inadequate production of erythrocytes.
B)rapid destruction of red blood cells.
C)loss of erythrocytes due to bleeding.
D)deficiency of oxygen in the tissues.

Question 59

Case Study Questions
Use the following case study to answer questions
Kati is a 27-year-old Caucasian who works as a bank teller.She is 5'3" tall and weighs 102 pounds.She began experiencing recurrent gastrointestinal disturbances such as diarrhea, steatorrhea, and flatulence several months ago.She made an appointment with her physician after noticing that she was losing weight.Laboratory tests confirmed a diagnosis of celiac disease.
What does Kati need to understand about the role of oats in her diet?

A)She should purchase only uncontaminated oats and consume limited quantities.
B)She should not consume oats in any form.
C)She should limit her consumption of oats to 1 cup of dry rolled oats per day.
D)She will need to learn how to prepare oats correctly for consumption.

Question 60

Why are young people with cystic fibrosis short and very lean for their age?

Question 61

Case Study
Child with Cystic Fibrosis: Julia Franklin is a 6-year-old child who was diagnosed with cystic fibrosis at age 2.She has a poor appetite, and her height and weight are below normal for her age.Her parents have been instructed to feed her a high-calorie, high-protein, high-fat diet with extra salt and to provide snacks between all meals.She takes supplemental enzymes each time she eats.She experiences frequent respiratory infections, and has had numerous hospitalizations for cystic fibrosis exacerbation since her diagnosis.
What types of complications might Julia develop as she gets older?