← Back

Chapter 18: Special Nutritional Considerations for Gastrointestinal Health

Every problem in the chapter beside the book’s answer, a chapter at a time as you scroll.

Chapter 18: Special Nutritional Considerations for Gastrointestinal Health

14 problems · 0 figures

Case Study 18.1.1 §18.1 source ↗

Read the following clinical scenario and then answer the questions that follow. This case study will evolve throughout the chapter.

Hein Nhung has had a difficult pregnancy. She has experienced hyperemesis gravidarum and worsening of her gastroesophageal reflux disease. Because of her inability to gain the recommended amount of weight and to consume nutrient-rich foods during the pregnancy, Hein’s gut microbiome has severely changed. These difficulties contributed to her baby, Bao Nhung, being delivered at 37 weeks’ gestation, with a low birth weight for age.

Which nutritional option would be best for the nurse to recommend to promote Bao’s gastrointestinal health?
  1. a.
    Breastfeeding
  2. b.
    Parenteral nutrition
  3. c.
    High-calorie formula
  4. d.
    Additional water to prevent constipation

Answer

A. Breastfeeding
Breastfeeding increases the chances that an infant will absorb the proper nutrients because the nutrients provided in breast milk are more bioavailable than those in formula.

Case Study 18.1.2 §18.1 source ↗

Read the following clinical scenario and then answer the questions that follow. This case study will evolve throughout the chapter.

Hein Nhung has had a difficult pregnancy. She has experienced hyperemesis gravidarum and worsening of her gastroesophageal reflux disease. Because of her inability to gain the recommended amount of weight and to consume nutrient-rich foods during the pregnancy, Hein’s gut microbiome has severely changed. These difficulties contributed to her baby, Bao Nhung, being delivered at 37 weeks’ gestation, with a low birth weight for age.

During testing, Bao is found to have a deficiency in galactose-1-phosphate uridyltransferase. Which change should the nurse expect in Bao’s diet?
  1. a.
    None until later in life
  2. b.
    An increase in the number of breastfeedings daily
  3. c.
    A switch to a low-protein formula
  4. d.
    A switch to a lactose-free formula

Answer

D. A switch to a lactose-free formula
Children with galactosemia need to be on a lactose-free diet their entire lives to prevent life-threatening problems.

Case Study 18.1.3 §18.1 source ↗

Read the following clinical scenario and then answer the questions that follow. This case study is a follow-up to Case Study Part A.

Bao has adjusted well to the special diet at birth and transitioned well in late infancy and childhood to an altered diet. At the age of 13, he begins having diarrhea, blood in the stool, fatigue, and abdominal pain and eventually is diagnosed with Crohn’s disease. Bao is here today for a wellness visit with Hein.

Hein asks how Bao has gotten Crohn’s disease because it does not run in their family. Given Bao’s history, what put him at increased risk for developing Crohn’s disease?
  1. a.
    Inability to consume lactose
  2. b.
    Hein’s pregnancy complications
  3. c.
    Bao had no increased risk
  4. d.
    Bao’s lack of adherence to the prescribed diet

Answer

B. Hein’s pregnancy complications
The problems that Hein faced in pregnancy drastically altered her microbiome and contributed to her infant’s low birth weight and birth at 37 weeks’ gestation. These complications all increased her infant’s risk for Crohn’s disease.

Case Study 18.1.4 §18.1 source ↗

Read the following clinical scenario and then answer the questions that follow. This case study is a follow-up to Case Study Part A.

Bao has adjusted well to the special diet at birth and transitioned well in late infancy and childhood to an altered diet. At the age of 13, he begins having diarrhea, blood in the stool, fatigue, and abdominal pain and eventually is diagnosed with Crohn’s disease. Bao is here today for a wellness visit with Hein.

The nurse is educating Hein and Bao about managing inflammatory periods. Which food should be avoided during inflammatory periods?
  1. a.
    Beans
  2. b.
    Yogurt
  3. c.
    White rice
  4. d.
    Chicken

Answer

A. Beans
High-fiber foods such as beans should be avoided during inflammatory phases of the disease because they can irritate the inflamed intestinal lining.

18-1 §18.RQ source ↗

A nurse is educating a pregnant client about factors that affect the fetal microbiome. Which choice, when asked what factors affect their fetus’s microbiome, indicate the need further teaching?
  1. a.
    The father’s microbiome
  2. b.
    The mother’s microbiome
  3. c.
    The child’s diet
  4. d.
    Interaction with the environment

Answer

A. The father’s microbiome
The father’s microbiome is not shown to be a contributing factor to the child’s microbiome.

18-2 §18.RQ source ↗

What is the caloric intake a nurse should expect the provider to order for a premature infant?
  1. a.
    2000 kcal/day
  2. b.
    120 kcal/kg/day
  3. c.
    100 kcal/kg/day
  4. d.
    1500 kcal/day

Answer

B. 120 kcal/kg/day
Premature newborns need more calories per kilogram of body weight than a full-term infant does and should get 110–135 kcal/kg/day.

18-3 §18.RQ source ↗

The nurse is educating a group of pregnant clients about genetic diseases. Which disease should the nurse explain will need lifelong management due to the individual’s inability to convert lactose into glucose?
  1. a.
    Diverticulitis
  2. b.
    Ulcerative colitis
  3. c.
    Crohn’s disease
  4. d.
    Galactosemia

Answer

D. Galactosemia
Galactosemia is a genetic disease in which the individual lacks the proper enzymes to convert lactose into glucose.

18-4 §18.RQ source ↗

The nurse is teaching a client about the nutritional needs of their adolescent child. Which information should be included in the education?
  1. a.
    Young males need fewer calories than young females do.
  2. b.
    Adolescent females require 3000 kcal/day.
  3. c.
    Fast foods need to be supplanted with healthier options.
  4. d.
    Adolescents need less iron intake daily than other age groups.

Answer

C. Fast foods need to be supplanted with healthier options.
Adolescents like to be autonomous, but many tend to prefer convenience foods such as fast food. Parents should be instructed to provide a healthy diet whenever possible rather than simply incorporating healthy items into unhealthy diet.

18-5 §18.RQ source ↗

The nurse is teaching an adult client how to maintain good gut bacteria. Which foods would be appropriate for the client to include in their diet to maintain good gut bacteria?
  1. a.
    Blueberries, strawberries, and kiwi
  2. b.
    Salmon and tuna
  3. c.
    Broccoli and cauliflower
  4. d.
    Yogurt, kimchi, and honey

Answer

D. Yogurt, kimchi, and honey
Consuming prebiotic or probiotic foods is conducive to maintaining good gut bacteria. Yogurt, kimchi, and honey are examples of prebiotic foods.

18-6 §18.RQ source ↗

An older adult reports a problem with constipation. Which dietary recommendation is appropriate for this client?
  1. a.
    Decrease water intake.
  2. b.
    Increase sodium intake.
  3. c.
    Decrease calcium intake.
  4. d.
    Increase fiber intake.

Answer

D. Increase fiber intake.
Increasing water and fiber intake is important to prevent and manage constipation, a frequent problem among older adults.

18-7 §18.RQ source ↗

The nurse is providing teaching to a client with ulcerative colitis. Which nutritional component should be adjusted when the client is in remission?
  1. a.
    Water intake
  2. b.
    Fiber intake
  3. c.
    Iron intake
  4. d.
    Potassium intake

Answer

B. Fiber intake
The client should be on a high-fiber diet when not in exacerbation but should be on a low-fiber diet due to inflammatory cycles.

18-8 §18.RQ source ↗

The nurse is teaching a client about food substitutions to help improve gut health. Which substitution is appropriate for milk?
  1. a.
    Ice cream
  2. b.
    Greek yogurt
  3. c.
    Kefir
  4. d.
    Kombucha

Answer

C. Kefir
Kefir has anti-inflammatory properties that will help protect the microbiome.

18-9 §18.RQ source ↗

The nurse is working with a client who has diverticulitis and has been prescribed ciprofloxacin. Which food should this client avoid while taking this medication?
  1. a.
    Red meat
  2. b.
    Milk
  3. c.
    Tomatoes
  4. d.
    Oatmeal

Answer

B. Milk
Ciprofloxacin, frequently used for diverticulitis, should not be taken with calcium-rich or calcium-fortified foods because the calcium can hinder ciprofloxacin’s absorption.

18-10 §18.RQ source ↗

The nurse is providing discharge education to a client who has been prescribed amoxicillin. Which food should the nurse instruct the client to incorporate into their diet to help prevent medication-related nutrient depletion?
  1. a.
    Beans
  2. b.
    Whole grains
  3. c.
    Sunflower seeds
  4. d.
    Kale

Answer

D. Kale
Kale can help prevent vitamin K deficiency. Amoxicillin is known to deplete vitamin K and vitamin B12.

Loading chapter 19…

Problems and answers are adapted from Nutrition for Nurses by Emerald Charity Bilbrew, Jody Vogelzang and Kelli Whittington, OpenStax, and are used under the CC BY-NC-SA 4.0 licence. Access for free at https://openstax.org/books/nutrition/pages/1-introduction. Illustrations: Copyright Rice University, OpenStax, under CC BY-NC-SA 4.0 license. This adaptation is released under the same licence, is non-commercial, and is neither affiliated with nor endorsed by OpenStax or Rice University.