Chapter 23: Nutrition Support in Cancer and AIDS Nursing School Test Banks

Chapter 23: Nutrition Support in Cancer and AIDS
Test Bank

MULTIPLE CHOICE

1. Ordinarily the cell operates in an orderly fashion under the influence of the
a. genetic code.
b. outside environment.
c. endoplasmic reticulum.
d. nutrients taken into the cell.
ANS: A
Cell operation is guided by a cells genes and genetic code.

DIF: Cognitive Level: Knowledge REF: 472 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

2. The point at which a mutagen causes irreversible damage to DNA is referred to as
a. neoplasms.
b. promotion.
c. initiation.
d. Progression.
ANS: C
Initiation is the point at which a mutagen causes irreversible damage to the DNA.

DIF: Cognitive Level: Knowledge REF: 472 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

3. Factors associated with the development of cancer include
a. processed foods.
b. radiation exposure.
c. food-borne disease.
d. diabetes mellitus.
ANS: B
Causes of cancer include mutations or changes in a cells genes; chemical carcinogens such as cigarette smoke; radiation from x-rays, radioactive materials, sunlight, or atomic wastes; viruses; epidemiologic factors; stress factors; and some dietary factors linking deficiencies of specific nutrients with and increased risk of DNA damage and cancer.

DIF: Cognitive Level: Knowledge REF: 473
TOP: Nursing Process: Assessment
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

4. The capacity of the immune system is compromised by
a. increased metabolism of water-soluble vitamins.
b. increased metabolism caused by emotional stress.
c. severe malnutrition with atrophy of organs and tissues.
d. increased hormonal levels associated with stress.
ANS: C
Severe malnutrition compromises the capacity of the immune system as a result of the atrophy of the organs and tissues that are involved in immunity.

DIF: Cognitive Level: Knowledge REF: 473 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

5. The cellular component of the immune system that is derived from the thymus is the
a. T cell.
b. cell.
c. phagocyte.
d. lymphocyte.
ANS: A
T cells are lymphocytes derived from the thymus cells, and cells are lymphocytes derived from the bursal intestinal cells.

DIF: Cognitive Level: Knowledge REF: 473 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

6. The cells responsible for synthesis and secretion of antibodies are the
a. immunoglobulins.
b. T cells.
c. cells.
d. lymphocytes.
ANS: C
The cells produce proteins known as antibodies, which also kill antigens.

DIF: Cognitive Level: Knowledge REF: 473 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

7. The nutrient primarily responsible for maintaining tissue integrity and immunocompetence is/are
a. carbohydrate.
b. protein.
c. vitamins.
d. minerals.
ANS: B
Antibodies, the core of the immune system, are proteins in structure. A direct and simple example of the important role of nutrition in immunity is the link between protein energy malnutrition and suppressed immune function.

DIF: Cognitive Level: Knowledge REF: 473 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

8. Cancer therapy that uses radioactive isotopes is
a. surgery.
b. radiation.
c. chemotherapy.
d. x-rays.
ANS: B
Radiation therapy involves treatment with high-energy radiography targeted on the cancer site to kill or shrink cancerous cells.

DIF: Cognitive Level: Knowledge REF: 474 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

9. Which of the following describes a disadvantage of abdominal radiation?
a. The structure and function of the bowel may be adversely affected.
b. The radiation can be dispersed to all the abdominal organs once it passes into the cavity.
c. It is hard to pinpoint the precise area to target the radiation.
d. There are no disadvantages.
ANS: A
Radiation to the bowel affects the intestinal mucosa, causing loss of villi and absorbing surface; therefore malabsorption problems may follow. Ulcers or inflammation and obstruction or fistulas also may develop from tissue breakdown.

DIF: Cognitive Level: Application REF: 474
TOP: Nursing Process: Intervention
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

10. Patients who receive chemotherapeutic drugs often develop
a. tremors.
b. anemia.
c. hypertension.
d. abnormal heart rhythms.
ANS: B
Chemotherapeutic drugs affect bone marrow and interfere with the production of red blood cells, causing anemia.

DIF: Cognitive Level: Knowledge REF: 475
TOP: Nursing Process: Assessment
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

11. A major systemic effect of cancer is
a. edema.
b. hypoglycemia.
c. dehydration.
d. negative nitrogen balance.
ANS: D
Negative nitrogen balance is a major systemic effect of cancer.

DIF: Cognitive Level: Knowledge REF: 476 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

12. Of the following, a side effect of protrease inhibitors is
a. hyperglycemia.
b. hypoglycemia.
c. yachycardia.
d. stroke.
ANS: A
Hyperglycemia is a major side effect of protease inhibitors. Food intolerances result from chemotherapy, which causes nausea and vomiting, loss of normal taste sensations, lack of appetite, diarrhea, ulcers, malabsorption, and stomatitis.

DIF: Cognitive Level: Knowledge REF: 491
TOP: Nursing Process: Intervention
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

13. Patients who receive chemotherapy drugs often develop anemia because the drugs
a. damage the bone marrow.
b. prevent iron absorption.
c. interfere with folate metabolism.
d. destroy hemoglobin.
ANS: A
Chemotherapy affects the bone marrow. Reduced red blood cell production causes anemia.

DIF: Cognitive Level: Knowledge REF: 475
TOP: Nursing Process: Assessment
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

14. The primary goal in nutrition care of patients with cancer is to
a. prevent further growth of the tumor.
b. reduce nutrients that the tumor feeds on.
c. prevent malnutrition.
d. promote weight gain.
ANS: C
The primary goal of nutrition care in cancer is to prevent malnutrition. Negative nitrogen balance is a major systemic effect of cancer. Adequate calories are necessary to spare protein for tissue building.

DIF: Cognitive Level: Knowledge REF: 477 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

15. To counteract the hypermetabolic state of cancer, it is important to increase the intake of
a. protein.
b. kilocalories.
c. vitamins.
d. fats.
ANS: B
It is important to increase the intake of kilocalories to supply adequate energy and spare protein to be used for tissue healing. The hypermetabolic nature of the disease and its healing requirements place great energy demands on a cancer patient.

DIF: Cognitive Level: Application REF: 478
TOP: Nursing Process: Implementation
MSC: NCLEX: Physiological Integrity: Physiological Adaptation, Reduction of Risk Potential

16. For patients with cancer, a good source of dietary protein could be
a. scrambled eggs.
b. applesauce.
c. orange sherbet.
d. green grapes.
ANS: B
Scrambled eggs are a good source of dietary protein, which is necessary for tissue synthesis for healing.

DIF: Cognitive Level: Application REF: 478
TOP: Nursing Process: Implementation
MSC: NCLEX: Physiological Integrity: Physiological Adaptation, Health Promotion and Maintenance

17. Given a functional gastrointestinal tract, the preferred method of feeding a patient with cancer is
a. normal oral intake.
b. a liquid formula diet.
c. tube feeding.
d. total parenteral feeding.
ANS: A
With a functional gastrointestinal tract, the preferred method of feeding is a normal oral diet supplied with adequate kilocalories and protein sources along with adequate fat, vitamins, and minerals.

DIF: Cognitive Level: Knowledge REF: 479 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

18. If salivary secretions are reduced or absent, it may be most helpful to
a. serve a clear liquid diet.
b. use a tube feeding.
c. serve food in semiliquid form.
d. serve water with the meal.
ANS: C
Food served in a semiliquid form may be better accepted by patients with decreased salivary secretions.

DIF: Cognitive Level: Application REF: 482 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

19. Mr. T has been undergoing treatment for cancer and has not felt like eating all day and complains of much discomfort and pain. Of the following, which may be an initial intervention to assist in increasing his appetite?
a. administering medication to increase appetite as soon as possible
b. assessing for weight loss and speaking with the physician regarding tube feeding
c. assessing pain and discomfort and providing pain relief measures
d. changing the diet plan to all liquids to make it easier to ingest food items
ANS: C
Patients are more able to eat if pain is controlled and if they are positioned as comfortably as possible.

DIF: Cognitive Level: Application REF: 482
TOP: Nursing Process: Implementation
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

20. An appropriate intervention for a patient with neutropenia would be to
a. serve only packaged food items.
b. cook food items immediately after thawing.
c. not serve any fresh fruits or vegetables.
d. serve soy-based milk rather than cows milk.
ANS: B
For those with neutropenia, foods should be cooked right after thawing to avoid possible microbial contamination.

DIF: Cognitive Level: Application REF: 482
TOP: Nursing Process: Implementation
MSC: NCLEX: Physiological Integrity: Physiological Adaptation, Reduction of Risk Potential

21. The cells that activate the phagocytes are the
a. T cells.
b. B cells.
c. lymphocytes.
d. antigens.
ANS: A
T cells are derived from thymus cells and activate the phagocytes, special cells that destroy invaders, as well as act as killer cells that attack and kill disease-carrying antigens.

DIF: Cognitive Level: Knowledge REF: 473 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

22. Mucositis is an inflammation of the
a. stomach mucosa.
b. intestinal mucosa.
c. oral mucosa.
d. pancreas.
ANS: C
Mucositis is an inflammation of the tissues around the mouth or other orifices of the body.

DIF: Cognitive Level: Knowledge REF: 475 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

23. Symptoms that may occur during the asymptomatic HIV infection stage include
a. persistent fatigue, night sweats, thrush, and diarrhea.
b. a short bout of flulike syndrome.
c. pneumonia, lymphoma, Kaposis sarcoma, and tuberculosis.
d. hyperglycemia, heart arrhythmias, and loss of appetite.
ANS: B
Approximately 2 to 4 weeks after initial exposure and infection, a mild flulike episode lasting about 1 week may occur. This brief, mild response reflects the initial development of antibodies to the viral infection.

DIF: Cognitive Level: Application REF: 487
TOP: Nursing Process: Assessment
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

24. Category 2 CD4 T-Lymphocyte values are defined as
a. less than 200 cells/L.
b. more than 200 cells/L.
c. 200 to 499 cells/L.
d. 800 to 1000 cells/L.
ANS: B
Category 2 CD4 T-Lymphocyte values are defined as 200 to 499 cells/L.

DIF: Cognitive Level: Knowledge REF: 487 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

25. Protease inhibitors work by
a. inhibiting the enzyme protease.
b. preventing reverse transcriptase.
c. binding to HIV.
d. enhancing the enzyme lipase.
ANS: A
Protease inhibitors work by inhibiting the basic enzyme protease, which is essential to HIVs development.

DIF: Cognitive Level: Application REF: 490 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

26. Nutrition support is a vital care component throughout the progression of HIV infection because of its role in
a. controlling involuntary weight loss and tissue wasting.
b. maintaining cardiac function.
c. preventing the spread of the HIV virus.
d. preventing anemia and constipation.
ANS: A
The role of nutrition support is a vital component of care for the patient with HIV infection to control involuntary weight loss and tissue wasting.

DIF: Cognitive Level: Application REF: 493 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation, Health Promotion

27. A fundamental effect of HIV infection is
a. nausea.
b. vomiting.
c. major weight loss.
d. cirrhosis.
ANS: C
Patients with HIV typically have a decreased appetite and insufficient energy intake coupled with elevated resting energy expenditure. Major weight loss follows and eventually leads to extreme cachexia, similar to that seen in cancer patients.

DIF: Cognitive Level: Knowledge REF: 493
TOP: Nursing Process: Assessment
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

28. An HIV-positive patient should be referred to the clinical dietitian on the AIDS team
a. at the first contact with a health professional.
b. at stage 2 (AIDS-related complex).
c. at stage 3 (final stage of AIDS).
d. when the patient has nutrition-related problems.
ANS: A
An HIV-positive patient should be referred to the clinical dietitian at the first contact with a health professional. The initial evaluation is critical in providing guidelines for ongoing care.

DIF: Cognitive Level: Application REF: 493
TOP: Nursing Process: Assessment
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

29. The nutrition care plan for AIDS patients is
a. the same as for all patients.
b. consistent throughout the course of the disease.
c. based only on clinical observations and anthropometry.
d. individualized and continually adjusted throughout the course of the disease.
ANS: D
The nutrition care plan for patient with AIDS, as any other medical nutrition therapy, is individualized and adjusted throughout the course of the disease.

DIF: Cognitive Level: Application REF: 493|495
TOP: Nursing Process: Assessment
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

30. Guidelines for counseling a person with HIV infection include
a. recommending intake of specific combinations of food.
b. expecting significant changes in lifestyle behaviors.
c. promoting optimal nutrition while making the fewest food changes.
d. acting as a catalyst for selecting appropriate lifestyle changes.
ANS: C
Guidelines for counseling a person with HIV infection include promoting optimal nutrition while making the fewest food changes. Changing behavior in any area requires the motivation, desire, and ability to achieve ones goals, and AIDS is no exception. All information or actions should proceed in manageable steps, as small as necessary.

DIF: Cognitive Level: Application REF: 495
TOP: Nursing Process: Implementation
MSC: NCLEX: Physiological Integrity: Physiological Adaptation, Health Promotion and Maintenance

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