Deck 34: Medical Nutrition Therapy for Pulmonary Disease

Question 1

Which vitamins are most likely to be deficient in a child with cystic fibrosis?

A)Vitamins A, E, and C
B)Water-soluble vitamins and K
C)Vitamins A, D, E, and K
D)Fat-soluble vitamins and B12

Answer 1

C
Even with pancreatic enzyme replacement therapy, fat-soluble vitamin absorption is still impaired.Water-soluble versions of the vitamins A, D, E, and K are often needed to prevent deficiencies.

Question 2

Long-term pulmonary improvement requires special monitoring of what in the infant with BPD?

A)Fluid and electrolytes
B)Lipid intake
C)Head circumference
D)Serum albumin

Answer 2

A
Most infants are managed with a modest fluid restriction of 140 to 150 ml/kg/day.Though diuretic therapy may improve short-term pulmonary status, there is no evidence that it improves clinical outcomes.Use of diuretics leads to serum electrolyte abnormalities like hyponatremia and hypokalemia.Though lipids remain a vital component in providing essential fatty acids and meeting energy goals, the role of lipid administration remains controversial.

Question 3

Which of the following is a dietary modification needed for treatment of cystic fibrosis?

A)Increased sodium for infants
B)Reduction of fat to less than 20% of calories
C)Increased carbohydrates
D)Additional water-soluble vitamins

Answer 3

A
Infants with CF require sodium supplementation to compensate for excessive losses of sodium through sweat and because the sodium content of breastmilk, formula, and infant foods is low.Usually 2 tsp is adequate to replenish sodium losses.Fat should provide 35% to 40% of calories or more as tolerated because it provides a concentrated form of calories, thus limiting the total amount of food needed to be eaten.Fat-soluble vitamins need to be provided in water-soluble form to prevent deficiency.

Question 4

What term refers to rapid breathing?

A)Dyspnea
B)Hemoptysis
C)Tachypnea
D)Aspiration

Question 5

What is the effect of pulmonary disease on a patient's energy requirements?

A)Decreased need for energy because of loss of lean body mass
B)Increased need for energy because of increased work of breathing
C)Decreased need for energy because of a lack of physical activity
D)Decreased need for energy because of starvation

Question 6

Which of the following is(are) synthesized in the lungs?

A)Angiotensin I
B)Arachidonic acid
C)Prostaglandins
D)Hemoglobin

Question 7

What vitamin supplementation may be necessary for patients with tuberculosis?

A)Vitamins C and E
B)Folate and vitamin B12
C)Vitamins B6 and D
D)Pyridoxine and folate

Question 8

Fluid in the pleural space with a milky appearance is a symptom of

A)chylothorax.
B)respiratory distress syndrome.
C)acute respiratory distress syndrome.
D)asthma.

Question 9

What pulmonary condition is a common complication of critical illness?

A)Cor pulmonale
B)Emphysema
C)Pneumonia
D)Acute respiratory distress syndrome

Question 10

Which of the following is TRUE regarding pancreatic enzyme replacement therapy?

A)It is needed to treat all patients with CF.
B)It is needed to treat CF patients with malabsorption.
C)It is provided in approximately the same dosages for all CF patients.
D)It is not used to treat CF patients.

Question 11

Which of the following is NOT true of pulse oximetry?

A)It is a pulmonary function test.
B)It gives information on lung volume.
C)It uses light waves to measure oxygen saturation of arterial blood.
D)It measures the ability of the respiratory system to exchange O2 and CO2.

Question 12

Which vitamins are thought to be of particular importance in the prevention and treatment of bronchopulmonary dysplasia?

A)Pyridoxine, niacin, and folate
B)Vitamins A, C, and E
C)Folate, B12, and K
D)Thiamin, riboflavin, and vitamin D

Question 13

Which of the following is TRUE about chronic obstructive pulmonary disease?

A)COPD is rarely caused by chronic bronchitis.
B)COPD can progress to cor pulmonale.
C)COPD leads to emphysema.
D)COPD is not seen in obese patients.

Question 14

The primary cause of aspiration pneumonia is

A)drinking water or other thin liquids.
B)tube feeding at a high rate per hour.
C)weak muscles.
D)excessive lung secretion.

Question 15

Which of the following explains why nutritional wasting is commonly seen in patients with COPD?

A)Increased energy expenditure, decreased energy intake, and impaired oxygenation
B)Decreased oxygen consumption and increased energy expenditure
C)Decreased energy expenditure and decreased oxygen consumption
D)Increased oxygen consumption and increased energy intake

Question 16

What is the recommendation for determining energy needs for patients with COPD?

A)Provide 30 to 35 kcal/kg of body weight.
B)Provide 130% to 150% of the BEE.
C)Use indirect calorimetry.
D)Provide the EER.

Question 17

Which of the following is a disease of bronchial hyperresponsiveness?

A)Cystic fibrosis
B)Emphysema
C)Tuberculosis
D)Asthma

Question 18

Which of the following recommendations should be made to the parents of an infant who has both BPD and esophageal reflux?

A)Thicken formula with baby cereal.
B)Thin formula with a glucose solution.
C)Feed the infant positioned in the supine position.
D)Delay introduction of baby food until 9 months of age.

Question 19

Although cigarette smoking is considered a major risk factor for developing COPD, what percentage of smokers develop the disease?

A)5%
B)20%
C)35%
D)50%

Question 20

Which results from a sweat test indicate that a patient may have CF?

A)Elevated levels of sodium and chloride
B)Decreased levels of sodium and chloride
C)Elevated levels of sodium and potassium
D)Decreased levels of potassium and chloride