Test bank for Nutrition and Diet Therapy 11th Edition by Ruth Roth

Description

Test Bank for Nutrition and Diet Therapy 11th Edition by Ruth Roth

CHAPTER 3: DIGESTION, ABSORPTION, AND METABOLISM

MULTIPLE CHOICE

1.What area of the stomach does the bolus of food first enter?

a.

fundus

c.

body of the stomach

b.

pylorus

d.

duodenum

ANS: A PTS: 1 DIF: A TOP: Digestion

2.Which of the following is a hormone that triggers the release of gastric juices?

a.

gastrin

c.

trypsin

b.

pepsin

d.

secretin

ANS: A PTS: 1 DIF: A TOP: Digestion

3.Which hormone causes the release of sodium bicarbonate to neutralize the acidity of chyme?

a.

gastrin

c.

secretin

b.

pepsin

d.

none of the above

ANS: C PTS: 1 DIF: A TOP: Digestion

4.Projecting from the small intestine are microscopic fingerlike projections known as ____.

a.

villi

c.

capillaries

b.

cilia

d.

both a and b

ANS: A PTS: 1 DIF: A TOP: Absorption

5.What is the name of the process that takes released energy and builds new substances from simpler ones?

a.

anabolism

c.

oxidation

b.

catabolism

d.

metabolism

ANS: A PTS: 1 DIF: A TOP: Metabolism

6.Which of the following factors does not contribute to one’s basal metabolic rate (BMR)?

a.

lean body mass

c.

heredity

b.

daily activity

d.

climate

ANS: B PTS: 1 DIF: A TOP: Basal Metabolic Rate

7.Which statement is true?

a.

As lean body mass decreases, so does one’s BMR.

b.

As lean body mass decreases, one’s BMR increases.

c.

There is no relationship between BMR and lean body mass.

d.

BMR is inversely related to lean body mass.

ANS: A PTS: 1 DIF: B TOP: Basal Metabolic Rate

8.Metabolism is the body’s ____.

a.

use of energy to conserve nutrients

b.

use of food to create energy

c.

process whereby food is broken down into smaller parts

d.

all of the above

ANS: B PTS: 1 DIF: A TOP: Metabolism

9.The process of digestion begins in the ____.

a.

esophagus

c.

mouth

b.

stomach

d.

small intestine

ANS: C PTS: 1 DIF: A TOP: Digestion

10.What term is used to describe the movement caused by rhythmic contractions of the muscular wall of the gastrointestinal tract?

a.

mechanical

c.

peristalsis

b.

chemical

d.

hydrolysis

ANS: C PTS: 1 DIF: A TOP: Digestion

11.Where does the final chemical digestion of carbohydrates occur?

a.

mouth

c.

esophagus

b.

stomach

d.

small intestine

ANS: D PTS: 1 DIF: A TOP: Digestion

12.What is the lower end of the esophagus termed?

a.

bolus

c.

ileum

b.

cardiac sphincter

d.

duodenum

ANS: B PTS: 1 DIF: A TOP: Digestion

13.Which one is NOT a role of hydrochloric acid in the stomach?

a.

activate the enzyme pepsin

c.

destroys antibodies

b.

destroys bacteria in food

d.

aids in the solubility of iron and calcium

ANS: C PTS: 1 DIF: A TOP: Digestion

14.What do lacteals absorb?

a.

glucose and water-soluble vitamins

b.

amino acids and enzymes

c.

fatty acids, glycerol, and fat-soluble vitamins

d.

minerals only

ANS: C PTS: 1 DIF: A TOP: Absorption

15.After being absorbed into the small intestine, fructose and galactose are then carried to the ____.

a.

stomach

c.

kidney

b.

small intestine

d.

liver

ANS: D PTS: 1 DIF: A TOP: Absorption

16.____ is the process that uses released energy to convert substances to simpler products.

a.

Aerobic metabolism

c.

Anaerobic metabolism

b.

Catabolism

d.

Anabolism

ANS: B PTS: 1 DIF: A TOP: Metabolism

17.What factor might increase someone’s BMR?

a.

fever

c.

lactation

b.

pregnancy

d.

all of the above

ANS: D PTS: 1 DIF: B TOP: Basal Metabolic Rate

18.As people age, the lean body mass _______.

a.

increases

c.

decreases

b.

stays the same

d.

none of the above

ANS: C PTS: 1 DIF: B TOP: Energy

19.The thermic effect of food includes the energy required to ___________ food.

a.

digest

c.

transport

b.

absorb

d.

all of the above

ANS: D PTS: 1 DIF: C TOP: Energy

20._____________ is an enzyme that aids in the digestion of fats.

a.

Pancreatic amylase

c.

Salivary amylase

b.

Pancreatic lipase

d.

None of the above

ANS: B PTS: 1 DIF: B TOP: Digestion

21.The __________ is the end of the stomach nearest the small intestine.

a.

fundus

c.

duodenum

b.

cardiac sphincter

d.

pylorus

ANS: D PTS: 1 DIF: B TOP: Digestion

22._________is an enzyme that aids in the digestion of proteins.

a.

Trypsin

c.

Both a and b

b.

Carboxypeptidase

d.

None of the above

ANS: C PTS: 1 DIF: B TOP: Digestion

SHORT ANSWER

1.Describe the function and the actions of the gallbladder. Include the action of the substances produced by the gallbladder.

ANS:

When food enters the small intestine, the gallbladder is triggered by the hormone cholecystokinin (which is produced by intestinal mucosal glands when fats enter) to release bile. Bile is produced in the liver and stored in the gall bladder. Bile aids in digestion by emulsifying fat. This allows the body to absorb fat more easily.

PTS: 1 DIF: B TOP: Digestion

2.What are the activities of absorption that occur in the large intestine? Describe the movement of food residue through the large intestine that results in watery, liquid stools.

ANS:

Some nutrient and water absorption occurs in the large intestine. The colon wall secretes mucus as a protection from the acidic digestive juices in the chyme. The major functions of the large intestine are to absorb water, synthesize some B vitamins and vitamin K, and collect food residue. Undigested food is excreted as feces by way of the rectum. If diarrhea is present, this means the chyme and liquids have moved through the colon too rapidly to be absorbed; therefore, a liquid stool results, with little water or nutrient absorption taking place.

PTS: 1 DIF: B TOP: Digestion

3.Describe the purpose of fiber in the diet. List the best food sources. What effects does metabolism of fiber have on the medical conditions diverticulosis and spastic colon?

ANS:

Fiber promotes health of the large intestine by helping soften stools and promoting regular bowel movements. The best sources include corn, wheat, celery, and apple skins. Diverticulosis is present when fiber collects in pouches or sacs that open from the intestine. These become inflamed and cause obstruction, perforation, or bleeding. Irritable bowel syndrome occurs when fiber is an irritant that results in certain signs and symptoms, including constipation, gas, and bloating. These are caused by uncoordinated and inefficient contractions of the large intestine.

PTS: 1 DIF: B TOP: Absorption

4.Describe the progression of the basal metabolic rate (BMR) throughout the life cycle. What factors, in addition to age, result in a change in the BMR?

ANS:

Children require more kilocalories per pound of body weight because they are growing. As people age, the basal metabolic rate decreases. Women require more kilocalories during pregnancy and lactation. BMR increases during fever and for people living and working in extremely hot or cold climates. A person’s BMR resembles that of his or her parents.

PTS:1DIF:BTOP:Basal Metabolic Rate

5.Calculate your basal metabolic rate. Calculate your usual caloric intake. Discuss the implications of your intake versus your metabolic rate.

ANS:

The students should easily determine their total energy requirements. If the caloric intake exceeds their BMR, they will gain weight. If it is less, weight loss will occur.

PTS:1DIF:CTOP:Basal Metabolic Rate

6.What is digestion?

ANS:

Digestion is the process whereby food is broken down into smaller parts, chemically changed, and moved through the gastrointestinal system.

PTS: 1 DIF: B TOP: Digestion

7.What is the purpose of mechanical digestion?

ANS:

Mechanical digestion helps prepare food for chemical digestion by breaking it into smaller pieces.

PTS: 1 DIF: B TOP: Digestion

MODIFIED TRUE/FALSE

1.The cardiac sphincter prevents acid from flowing back into the esophagus. _________________________

ANS: T PTS: 1 DIF: B

TOP: Digestion

2.Digestion is the process whereby food is broken down into smaller parts and is chemically changed. Digestion occurs in the stomach and small intestine only. _________________________

ANS: F, entire gastrointestinal system

PTS: 1 DIF: B TOP: Digestion

3.To be absorbed, nutrients must be in their most complex form. _________________________

ANS: F, simplest

PTS: 1 DIF: B TOP: Absorption

4.The hydrochloric acid that is secreted by the stomach lining makes iron and calcium more soluble. _________________________

ANS: T PTS: 1 DIF: B

TOP: Metabolism

5.The inner wall of the small intestine is smooth. _________________________

ANS: F, contains folds called villi

PTS: 1 DIF: A TOP: Absorption

6.A mouthful of food ready to be swallowed is called chyme. _________________________

ANS: F, bolus

PTS: 1 DIF: C TOP: Digestion

7.Acid reflux disease is caused by malfunction of the pyloric sphincter. _____________________

ANS: F, cardiac sphincter

PTS: 1 DIF: B TOP: Digestion

8.One kilocalorie is equal to 4.184 kilojoules. _______________________

ANS: T PTS: 1 DIF: A

TOP: Energy

CASE

Joe Brian, 6’3” tall and 265 pounds, came to the physician with complaints of indigestion, heartburn, a bloated feeling, and occasional vomiting. He states that he sometimes wakes up with the taste of vomit in his mouth. He also complains of chest pain and states, “Sometimes I feel like I am having a heart attack.” After performing an endoscopy, the physician diagnoses a hiatal hernia with esophageal reflux and esophagitis. The physician prescribes a histamine receptor antagonist and antacids before meals and at bedtime.

1.Describe the pathology that occurs when a hiatal hernia exists. Correlate each symptom with the medical diagnosis and describe the cause.

ANS:

At the lower end of the esophagus is the cardiac sphincter, which prevents stomach acid from flowing back into the esophagus. When a hiatal hernia is present, the stomach protrudes through the opening and allows acidic content to flow back into the esophagus. After meals, the client should be positioned upright to prevent regurgitation that occurs with the reflux of the acidic content. The condition also causes pain and a bloating sensation. Treatment aims at preventing acid from being in contact with the esophageal tissue, which could predispose to cancer.

PTS:1DIF:CTOP:Care Planning

2.What additional symptoms that may occur should the client be made aware of? What are the complications of a hiatal hernia?

ANS:

Chronic irritation from the acids may result in cancer. If the hernia is unmanageable with medical treatment, surgery may be performed.

PTS:1DIF:BTOP:Care Planning

3.Describe the relationship between the symptom “heartburn” and the heart.

ANS:

The stomach acidity causes pain that is located in close proximity to the heart, thus “heartburn.” There is no direct relation to the heart.

PTS:1DIF:BTOP:Care Planning

4.What is the goal of the initial medical treatment?

ANS:

Alleviating the symptoms.

PTS:1DIF:BTOP:Care Planning

5.What is the focus of nursing care?

ANS:

To facilitate client education related to the lack of knowledge regarding the disease process. To teach behaviors, including dietary approaches, to relieve pain/discomfort from regurgitation of acidic gastric contents.

PTS:1DIF:BTOP:Care Planning

6.What nursing measures will the nurse perform?

ANS:

Include diet instructions, meal plans, and foods to avoid. Describe positioning after meals and physical activity. Evaluate the client’s height and weight and describe the impact on his medical condition. Explain the relationship between the diagnoses and caffeine.

PTS:1DIF:BTOP:Care Planning

7.What assessment data will be monitored to evaluate if the goals have been met?

ANS:

Evaluate the symptoms, indigestion, pain, heartburn, and bloating. Evaluate weight to determine if this remains a factor in the symptoms. Monitor caffeine intake. Have client keep a food and exercise diary that can be used to document progress.

PTS:1DIF:BTOP:Care Planning

Mary Moore, who is three months pregnant with her fourth child, comes to the clinic for her monthly prenatal visit. You are doing client education regarding her nutritional status. She is 5’4” tall and currently weighs165 pounds. She is planning on breast-feeding her baby.

8.Determine her current recommended body weight based on her height and sex.

ANS:

111–146 pounds

PTS:1DIF:BTOP:Care Planning

9.Determine the number of additional calories she will need to ingest for proper nutrition for the fetus.

ANS:

An increase of 300 calories is recommended.

PTS:1DIF:BTOP:Care Planning

10.How many additional calories will be needed for lactation? What other substances need to be ingested in adequate amounts?

ANS:

Five hundred (500) extra calories a day and increased amounts of fluids

PTS:1DIF:BTOP:Care Planning

11.Is it appropriate for a pregnant woman to go on a weight loss program? Describe the rationale for your answer.

ANS:

A pregnant woman must increase caloric intake by 300 calories daily. Moderate exercise in the form of walking or swimming is recommended. A weight loss program is not recommended. The only weight adjustments that should occur are when the person changes prepregnancy bad food habits and begins to eat a well-balanced diet with appropriate calories and nutrients.

PTS:1DIF:CTOP:Care Planning

12.Ms. Moore tells you that she always ate the same whether she was pregnant or not. She also says that she never took vitamins or iron with her other pregnancies and that she doesn’t see the need now. How will you teach her the importance of these dietary measures?

ANS:

Keep in mind the general health, culture, religion, likes, and dislikes of the woman. Explain the needed changes in terms of the effect on the fetus. Emphasize and explain the need for increased nutrients such as iron and folic acid. Offer supporting literature from credible sources as needed. There is information available regarding the need for supplementation that may have not been available with her past pregnancies.

PTS:1DIF:CTOP:Care Planning

13.What additional assessment data will you need before planning her dietary goals and nursing measures?

ANS:

Health history, physical examination data, family health history, usual dietary intake, cultural or religious beliefs that affect diet, socioeconomic status, activity or physical exercise, blood tests including hemoglobin and hematocrit, and vital signs.

PTS:1DIF:BTOP:Care Planning

14.List one dietary goal with nursing measures.

ANS:

Demonstrate progressive, moderate weight gain, not to exceed 3–5 pounds the first trimester and one pound per week during the second and third trimesters. Diet education including foods with quality nutritional value; eat variety; avoid empty calories; increase fluids; avoid rich, highly-spiced and fried foods, etcetera. Have normal bowel elimination. Increase fluid intake; encourage intake of fresh fruits and vegetables; add high fiber foods; moderate exercise; avoid laxatives and enemas.

PTS:1DIF:CTOP:Care Planning

15.What nutrients, vitamins, and minerals will she need to increase in order to sustain a good nutritional status? List foods that are good sources.

ANS:

Calcium, 3–4 cups of milk; most vitamins need to be increased, fresh fruits and vegetables; protein, fish, eggs, cheese, milk, meats; water, ten glasses daily.

PTS:1DIF:CTOP:Care Planning