Deck 17: Nutrition and Upper Gastrointestinal Disorders

Question 1

Xerostomia is a side effect of many medications and can make speaking and swallowing more difficult.

Answer 1

True

Question 2

What factor is most likely a cause of xerostomia?

A) poorly controlled cardiovascular disease
B) h igh cholesterol levels
C) e xcessive nose breathing
D) p oor taste sensation
E) r adiation therapy to the head and neck

Answer 2

E

Question 3

People with _____ often complain of food "sticking" in the esophagus.

A) esophageal dysphagia
B) oropharyngeal dysphagia
C) dyspepsia
D) gastritis
E) xerostomia

Answer 3

A

Question 4

Symptoms of dumping syndrome are due to a shift of fluid from the bloodstream to the intestinal lumen that increases intestinal distention and lowers blood volume.

Question 5

Pneumonia may be associated with which condition affecting the upper gastrointestinal tract?

A) dysphagia
B) x erostomia
C) x erostomia
D) g astritis
E) p eptic ulcer disease

Question 6

Caries develops when the bacteria that reside in dental plaque metabolize dietary carbohydrates and produce acids that attack tooth enamel.

Question 7

Oropharyngeal dysphagia is common in elderly persons and frequently follows a stroke.

Question 8

Psychological stress by itself is not believed to cause ulcers, but it has effects on physiological processes and behaviors that may increase a person's vulnerability.

Question 9

The most effective medications for suppressing gastric acid secretion are:

A) H2 blockers.
B) proton-pump inhibitors.
C) antacids.
D) NSAIDs.
E) antibiotics.

Question 10

Antimicrobial mouth rinses are the primary form of treatment for dental caries.

Question 11

What condition would most likely contribute to development of GERD?

A) advancing age
B) u nderweight
C) H. pylori infection
D) p regnancy
E) head and neck cancer

Question 12

A patient with oropharyngeal dysphagia would most likely demonstrate which symptom?

A) a  gurgling noise after swallowing
B) b ad breath
C) g um ulcerations
D) h eartburn
E) a bdominal distention

Question 13

A condition in which a portion of the stomach protrudes above the diaphragm is known as:

A) hiatal hernia.
B) Barrett's esophagus.
C) gastritis.
D) gastric ulcer.
E) gastroesophageal reflux.

Question 14

What method would most likely improve a patient's acceptance of pureed foods in a dysphagia diet?

A) c hanging the foods so that they are watery and thin
B) s erving brightly colored foods
C) a voiding spices and seasonings
D) u sing paper plates and plastic cutlery
E) a voiding pureeing a patient's favorite foods.

Question 15

Following gastrectomy, the patient may require as many as eight to twelve small meals and snacks per day.

Question 16

Even occasional vomiting can cause esophagitis and fluid and electrolyte imbalances and may require medical care.

Question 17

According to the National Dysphagia Diet, what food is allowed for a patient in Level 2: Dysphagia Mechanically Altered foods?

A) h ot dogs
B) apple
C) p ineapple
D) c anned peaches
E) peanut butter

Question 18

What condition is known as a potential cause of esophageal dysphagia?

A) Parkinson's disease
B) c erebral palsy
C) s cleroderma
D) m ultiple sclerosis
E) m uscular dystrophy

Question 19

Clinical studies indicate that the gastric banding procedure is more effective and has fewer long-term complications than gastric bypass surgery.

Question 20

In the dietary treatment of gastritis, it is important to eliminate irritating foods and beverages.

Question 21

Following bariatric surgery, the gastric pouch may eventually stretch to hold about _____ of food.

A) 1/4 cup
B) 1/2 cup
C) 1 cup
D) 1 ¹/₂ cups
E) 2 cups

Question 22

Nutrition interventions to ease the symptoms of nausea include:

A) eating dry, starchy foods.
B) drinking hot beverages.
C) adding butter and oil to foods.
D) eating raw vegetables.
E) drinking beverages with meals.

Question 23

General discomfort in the upper abdominal area with complaints of stomach pain, gnawing sensations, fullness, nausea, and bloating is descriptive of:

A) peptic ulcer disease.
B) dyspepsia.
C) hiatal hernia.
D) Sjögren's syndrome.
E) H. pylori infection.

Question 24

What treatment is most often used in the management of ulcers?

A) surgery
B) r elaxation therapy
C) a spirin
D) v itamin C
E) a ntibiotics

Question 25

What condition is considered a cause of acute gastritis?

A) food allergies
B) v iral infection
C) r epeated use of NSAIDS
D) r adiation therapy
E) stomach cancer

Question 26

Hypochlorhydria may most likely result from what condition?

A) e sophageal dysphagia
B) p eptic ulcer disease
C) d yspepsia
D) b ariatric surgery
E) gastritis

Question 27

Peptic ulcers are a major cause of _____, which occurs in up to 15 percent of ulcer cases.

A) pain
B) dysphagia
C) gastrointestinal bleeding
D) reflux esophagitis
E) dry mouth

Question 28

What strategy would be most effective to suggest for management of GERD?

A) Only drink liquids with meals.
B) Avoid gas-forming foods.
C) Eat large food portions.
D) Eat a peppermint candy after a meal.
E) Avoid alcohol.

Question 29

Dietary adjustments after a gastrectomy are influenced by:

A) the size of the remaining stomach.
B) the patient's fluid intake.
C) the type of surgical procedure performed.
D) the patient's food preferences.
E) the resulting slower gastric emptying.

Question 30

Liquids are restricted during meals following a gastrectomy because they:

A) can increase stomach emptying rate.
B) lead to urinary retention.
C) add unwanted kcalories.
D) are likely to cause aspiration.
E) can decrease stomach emptying rate.

Question 31

The protein recommendation for bariatric surgery patients is:

A) 0.8-1.0 g/kg ideal body weight per day.
B) 1.0-1.5 g/kg ideal body weight per day.
C) 1.8-2.2 g/kg ideal body weight per day.
D) 2.5-3.0 g/kg ideal body weight per day.
E) 3.3-3.5 g/kg ideal body weight per day.

Question 32

What substance has been reported to be a cause  of dyspepsia?

A) apples
B) t urkey
C) c offee
D) p eanut butter
E) c orn

Question 33

What symptoms are most closely associated with early dumping syndrome?

A) anxiety
B) c onfusion
C) h unger
D) p alpitations
E) d iarrhea

Question 34

A major factor associated in the development of both gastritis and peptic ulcer disease is:

A) infection with H. pylori.
B) stress.
C) overeating.
D) cigarette smoking .
E) decreased physical activity.

Question 35

Rapid weight loss following bariatric surgery increases the risk of developing:

A) cirrhosis.
B) hypertension.
C) type 2 diabetes.
D) gallbladder disease.
E) Sjögren's syndrome.

Question 36

Clients with reflux esophagitis should be instructed to:

A) eat small, frequent meals.
B) drink liquids with meals.
C) lie down after eating.
D) consume caffeine-containing foods and beverages.
E) avoid physical activity.

Question 37

What food should be limited in a post-gastrectomy diet unless tolerated by the patient?

A) m ilkshakes
B) l ean meat
C) b ananas
D) l ettuce
E) c heese

Question 38

What is the diet progression following bariatric surgery?

A) clear liquid, liquid, pureed, regular
B) liquid, mechanical soft, low-fat, regular
C) pureed, chopped, regular
D) pureed, chopped, soft, regular
E) clear liquid, soft, regular

Question 39

What complication is most closely associated with surgical gastrectomy?

A) o steoporosis
B) weight gain
C) p rotein malabsorption
D) v itamin D deficiency
E) h ypoglycemia

Question 40

To prevent dumping syndrome, a patient should be advised to:

A) limit the amount of fluid consumed with a meal .
B) avoid fiber-rich foods.
C) drink a cold beverage with each meal.
D) avoid lying down after eating.
E) avoid tight-fitting clothing.

Question 41

M.L. is a 34-year-old male computer programmer with a BMI of 26 who is seeking dietary counseling. His dose of Prilosec was recently increased, and although he now suffers less often from heartburn symptoms, he is also leery of medical side effects and would like any and all suggestions to manage his GERD "naturally." Having had GERD for the past eight years and been on some form of antacid or antisecretory medication continuously during that time, M.L. knows what foods or factors cause symptoms, and is able to generally avoid them; hence, he has not had reflux esophagitis in over a year. A 24-hour diet history reveals M.L. ate these foods yesterday: Breakfast: Skipped
Snack: Fresh pear; instant oatmeal made with water, eaten with brown sugar and two non-dairy creamers; skim milk
Lunch: Lean turkey lunch meat on whole-grain bread with lettuce, tomato, and mustard; 100% grape juice diluted with water; snack pack of carrots, no dressing
Snack: Sugar cookies; skim milk
Dinner: Tempura (deep-fried, breaded) salmon; buttered rice; salad with lettuce and tomato; vinegar and oil dressing; water
Snack, at bedtime: Ginger ale and ginger snap cookies
The practitioner gives M.L. a checklist of lifestyle changes that can help minimize GERD symptoms. Based on the diet recall above, M.L. would benefit from education about which topic?

A) Consume meals and liquids at the same time so that the stomach does not become overly distended.
B) Include foods that destroy gastric acid.
C) During periods of esophagitis, avoid foods and beverages that may irritate the esophagus.
D) Try eating bedtime snacks and lying down after meals.
E) Elevate the foot of the bed by placing blocks under the mattress.

Question 42

Current research suggests that periodontal disease may increase the risk of developing:

A) heart disease.
B) renal failure.
C) arthritis.
D) dermatitis.
E) reflux esophagitis.

Question 43

Jennie Wilson is a 42-year-old administrative assistant who recently underwent sleeve gastrectomy surgery to treat her obesity and weight-related problems: diabetes and hypertension. Ms. Wilson will need nutrition education before being discharged from the hospital.
On the day following surgery, Ms. Wilson will be allowed to consume what food or fluids?

A) chicken broth
B) saltine crackers
C) t omato soup
D) s kim milk
E) fruit smoothie

Question 44

To avoid dehydration, the patient who has undergone bariatric surgery should:

A) sip water and other non-caloric beverages throughout the day.
B) drink plenty of fluids with meals.
C) increase intake of foods with high water content.
D) drink sports drinks.
E) continue with a clear liquid diet instead of advancing to regular foods.

Question 45

Which risk factor is most closely associated with development of periodontal disease?

A) dysphagia
B) u se of antihypertensive drugs
C) epilepsy
D) celiac disease
E) p regnancy

Question 46

M.L. is a 34-year-old male computer programmer with a BMI of 26 who is seeking dietary counseling. His dose of Prilosec was recently increased, and although he now suffers less often from heartburn symptoms, he is also leery of medical side effects and would like any and all suggestions to manage his GERD "naturally." Having had GERD for the past eight years and been on some form of antacid or antisecretory medication continuously during that time, M.L. knows what foods or factors cause symptoms, and is able to generally avoid them; hence, he has not had reflux esophagitis in over a year. A 24-hour diet history reveals M.L. ate these foods yesterday: Breakfast: Skipped
Snack: Fresh pear; instant oatmeal made with water, eaten with brown sugar and two non-dairy creamers; skim milk
Lunch: Lean turkey lunch meat on whole-grain bread with lettuce, tomato, and mustard; 100% grape juice diluted with water; snack pack of carrots, no dressing
Snack: Sugar cookies; skim milk
Dinner: Tempura (deep-fried, breaded) salmon; buttered rice; salad with lettuce and tomato; vinegar and oil dressing; water
Snack, at bedtime: Ginger ale and ginger snap cookies
What outcome is M.L. at highest risk for because of his GERD?

A) p ernicious anemia
B) a trophic gastritis
C) b leeding in the small intestine
D) B arrett's esophagus
E) o steomalacia

Question 47

Jennie Wilson is a 42-year-old administrative assistant who recently underwent sleeve gastrectomy surgery to treat her obesity and weight-related problems: diabetes and hypertension. Ms. Wilson will need nutrition education before being discharged from the hospital.
Due to reduced food intake and nutrient malabsorption, Ms. Wilson will likely require supplements of:

A) vitamin B₁₂, iron, and calcium.
B) zinc, magnesium, and iron.
C) vitamin B₆, folate, and niacin.
D) calcium, iron, and vitamin C.
E) vitamin E, vitamin A, and magnesium.

Question 48

Nursing Exam Review A nurse is working with a patient who is suffering from dysphagia. The most appropriate foods the nurse can suggest might be:

A) dry foods, such as crackers.
B) sticky foods, such as peanut butter.
C) foods with mixed textures, such as casseroles.
D) soft foods, such as mashed potatoes.
E) thin liquids, such as fruit juice.

Question 49

Dental caries are caused by:

A) bacteria that produce acids that attack tooth enamel.
B) excessive fluoride intake that attacks tooth enamel.
C) high-fiber foods that cause carbohydrate to stick to teeth.
D) excessive consumption of sugar that eats into teeth.
E) a genetic predisposition to the breakdown of tooth enamel.

Question 50

Nursing Exam Review The nurse is reviewing a patient's chart and notices that the patient has a history of Sjögren's syndrome. The nurse recognizes that the patient may have nutritional problems due to:

A) anemia.
B) uncontrolled blood sugar .
C) impaired digestion.
D) malabsorption.
E) acid reflux.

Question 51

Jennie Wilson is a 42-year-old administrative assistant who recently underwent sleeve gastrectomy surgery to treat her obesity and weight-related problems: diabetes and hypertension. Ms. Wilson will need nutrition education before being discharged from the hospital.
What best describes Ms. Wilson's procedure?

A) A pouch was created by placing a band around the stomach.
B) A piece of the stomach was removed and connected to the duodenum.
C) A large portion of the stomach was removed, leaving a narrow tube.
D) A pouch was created and connected to the jejunum.
E) The stomach was removed and the esophageal sphincter was connected to the jejunum.

Question 52

What food would most likely stimulate saliva flow and neutralize acids in the mouth?

A) a  hamburger
B) l egumes
C) o range juice
D) c heese
E) p ickles

Question 53

M.L. is a 34-year-old male computer programmer with a BMI of 26 who is seeking dietary counseling. His dose of Prilosec was recently increased, and although he now suffers less often from heartburn symptoms, he is also leery of medical side effects and would like any and all suggestions to manage his GERD "naturally." Having had GERD for the past eight years and been on some form of antacid or antisecretory medication continuously during that time, M.L. knows what foods or factors cause symptoms, and is able to generally avoid them; hence, he has not had reflux esophagitis in over a year. A 24-hour diet history reveals M.L. ate these foods yesterday: Breakfast: Skipped
Snack: Fresh pear; instant oatmeal made with water, eaten with brown sugar and two non-dairy creamers; skim milk
Lunch: Lean turkey lunch meat on whole-grain bread with lettuce, tomato, and mustard; 100% grape juice diluted with water; snack pack of carrots, no dressing
Snack: Sugar cookies; skim milk
Dinner: Tempura (deep-fried, breaded) salmon; buttered rice; salad with lettuce and tomato; vinegar and oil dressing; water
Snack, at bedtime: Ginger ale and ginger snap cookies
The medication M.L. takes is a proton-pump inhibitor medication that works by:

A) decreasing gastric acid production.
B) neutralizing gastric acid.
C) coating the esophagus.
D) preventing tissue inflammation.
E) inhibiting the lower esophageal sphincter.

Question 54

Nursing Exam Review The nurse is working with a client who recently suffered from a stroke. The client complains of painful swallowing, nasal regurgitation during swallowing, and coughing during meals. The nurse recognizes these as symptoms of:

A) dysphagia.
B) GERD
C) reflux esophagitis.
D) hiatal hernia.
E) peptic ulcer disease.

Question 55

Jennie Wilson is a 42-year-old administrative assistant who recently underwent sleeve gastrectomy surgery to treat her obesity and weight-related problems: diabetes and hypertension. Ms. Wilson will need nutrition education before being discharged from the hospital.
What foods should Ms. Wilson be advised to avoid to prevent possible obstruction of the gastric outlet?

A) b ananas
B) c elery
C) f ish
D) m ashed potatoes
E) chicken

Question 56

M.L. is a 34-year-old male computer programmer with a BMI of 26 who is seeking dietary counseling. His dose of Prilosec was recently increased, and although he now suffers less often from heartburn symptoms, he is also leery of medical side effects and would like any and all suggestions to manage his GERD "naturally." Having had GERD for the past eight years and been on some form of antacid or antisecretory medication continuously during that time, M.L. knows what foods or factors cause symptoms, and is able to generally avoid them; hence, he has not had reflux esophagitis in over a year. A 24-hour diet history reveals M.L. ate these foods yesterday: Breakfast: Skipped
Snack: Fresh pear; instant oatmeal made with water, eaten with brown sugar and two non-dairy creamers; skim milk
Lunch: Lean turkey lunch meat on whole-grain bread with lettuce, tomato, and mustard; 100% grape juice diluted with water; snack pack of carrots, no dressing
Snack: Sugar cookies; skim milk
Dinner: Tempura (deep-fried, breaded) salmon; buttered rice; salad with lettuce and tomato; vinegar and oil dressing; water
Snack, at bedtime: Ginger ale and ginger snap cookies
M.L. should be made aware that use of antacids and antisecretory medication:

A) have short term effects.
B) cures GERD.
C) are effective in healing esophagitis .
D) causes a vitamin A deficiency .
E) causes a vitamin K deficiency .

Question 57

What food would be most likely to contribute to dental caries?

A) raw carrots
B) milk
C) dried fruit
D) cheese
E) tuna

Question 58

What suggestion for achieving and maintaining weight loss following bariatric surgery is most appropriate?

A) Understand that initial meals after surgery may only be 2-3 cups.
B) Consume food throughout the day instead of just at designated meal times.
C) Drink plenty of water and other beverages to suppress appetite.
D) Eat slowly and chew food thoroughly.
E) Avoid physical activity and get plenty of rest.

Question 59

Jennie Wilson is a 42-year-old administrative assistant who recently underwent sleeve gastrectomy surgery to treat her obesity and weight-related problems: diabetes and hypertension. Ms. Wilson will need nutrition education before being discharged from the hospital.
Once she is able to tolerate regular foods, what type of foods should Ms. Wilson be encouraged to eat before consuming other foods in a meal?

A) c omplex carbohydrates
B) h igh-protein foods
C) l ow-fat foods
D) h igh-fat foods
E) l ow-sodium foods

Question 60

Nursing Exam Review The nurse understands that a patient with GERD will benefit from education on managing the disease. What suggestion should be included in the nurse's teaching?

A) Avoid eating at bedtime.
B) Limit carbohydrate intake.
C) Consume liquids with meals.
D) Avoid high-impact exercise.
E) Keep a glass of water next to the bed at night.

Question 62

Discuss how chronic illnesses contribute to oral diseases and how this affects nutritional health.

Question 63

Define dysphagia and explain the dietary treatment for this disorder.

Question 64

Describe the nutritional concerns for a patient following bariatric surgery.

Question 65

Nursing Exam Review Mr. Green uses NSAIDs regularly to control chronic pain and complains of frequent stomach pain. The nurse recognizes this as gastritis and realizes that he may be at risk for deficiencies of:

A) calcium and phosphorous .
B) iron and vitamin B_12.
C) sodium and potassium.
D) vitamins C and E.
E) magnesium and vitamin D.

Question 66

Discuss the potential complications of gastritis.

Question 67

List the symptoms of dumping syndrome and explain the sequence of events that results in these symptoms.

Question 68

Nursing Exam Review A patient experiences nausea, vomiting, abdominal cramping, diarrhea, and lightheadedness after meals following gastric bypass surgery. The nurse recognizes these as symptoms of:

A) malabsorption.
B) high blood sugar.
C) gastroesophageal reflux.
D) Sjögren's syndrome.
E) dumping syndrome.

Question 69

Nursing Exam Review The nurse recognizes that a patient with peptic ulcer disease should avoid foods that may irritate the gastrointestinal lining, such as:

A) alcohol, coffee, and pepper.
B) eggs, spareribs, and cheese.
C) tea, orange juice, and potato chips.
D) apples, broccoli, and sweet potatoes.
E) yogurt, ice cream, and margarine.

Question 70

Nursing Exam Review The nurse is reinforcing the dietitian's instructions for a post-gastrectomy diet. The nurse realizes the client understands his diet when he states that he should:

A) emphasize grains, fruits, and vegetables in his diet.
B) avoid sweets, such as colas, honey, and jam.
C) eliminate meat and eggs.
D) exclude decaffeinated coffee, tea, and artificially sweetened drinks.
E) eliminate all dairy products.

Question 71

Nursing Exam Review Following gastric resection, the nurse understands the need to limit _____ in the patient's diet.

A) fiber
B) meat
C) vegetables
D) sugar
E) dairy