Ch22 Complete Test Bank Nursing Care Of Patients With - Medical Surgical Nursing 7e | Test Bank by LeMone, Burke, Bauldoff by LeMone, Burke, Gerene Bauldoff. DOCX document preview.
LeMone & Burke's Medical-Surgical Nursing, 7e (Bauldoff/Gubrud/Carno)
Chapter 22 Nursing Care of Patients with Nutritional Disorders
1) The nurse is caring for an adolescent with anorexia nervosa. What should the nurse include in this patient's plan of care?
1. Provide a variety of cold or room-temperature foods.
2. Serve the patient three balanced meals per day.
3. Discuss weight-gain needs with the patient.
4. Observe the patient's activities for 15 minutes after eating.
Page Ref: 686
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Basic Care and Comfort
Standards: QSEN Competencies: I.B.3. Provide patient-centered care with sensitivity and respect for the diversity of human experience | AACN Essentials Competencies: IX.5. Deliver compassionate, patient-centered, evidence-based care that respects patient and family preferences | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Planning
Learning Outcome: 22.3 Describe the pathophysiology and manifestations of eating disorders, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 4. Determine appropriate nursing interventions for patients with nutritional disorders.
2) A patient diagnosed with obesity asks about the appetite suppressant phentermine to assist with a weight loss program. Which information in the patient's health history might restrict the patient's ability to take this medication?
1. Frequent use of alcohol
2. History of narcolepsy
3. A family history of thrombophlebitis
4. A body mass index of 31 kg/m2
Page Ref: 664
Cognitive Level: Analyzing
Client Need & Sub: Physiological Integrity: Pharmacological and Parenteral Therapies
Standards: QSEN Competencies: I.B.3. Provide patient-centered care with sensitivity and respect for the diversity of human experience | AACN Essentials Competencies: IX.5. Deliver compassionate, patient-centered, evidence-based care that respects patient and family preferences | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 22.1 Describe the pathophysiology, manifestations, and complications of obesity, and outline the interprofessional care and nursing care of patients with obesity.
MNL Learning Outcome: 2. Consider intraprofessional care for patients with nutritional disorders.
3) After following a structured diet, a patient diagnosed with diabetes mellitus is surprised to learn that blood glucose levels have decreased and oral medications are no longer required. What explanation regarding the impact of diet on diabetes management should the nurse give the patient?
1. Less body mass means less insulin is needed to maintain constant glucose levels.
2. Body mass reduces cellular resistance to insulin.
3. Reduced dietary intake of carbohydrates is responsible for the weight loss.
4. Reduced dietary intake results in a reduced need for insulin.
Page Ref: 662
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Physiological Adaptation
Standards: QSEN Competencies: I.B.3. Provide patient-centered care with sensitivity and respect for the diversity of human experience | AACN Essentials Competencies: IX.4. Communicate effectively with all members of the healthcare team, including the patient and the patient's support network | NLN Competencies: Relationship-Centered Care; Practice-Know-How; Communicate information effectively | Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 22.1 Describe the pathophysiology, manifestations, and complications of obesity, and outline the interprofessional care and nursing care of patients with obesity.
MNL Learning Outcome: 1. Examine the pathophysiology, incidence, risk factors, and clinical manifestations for patients with nutritional disorders.
4) The nurse is planning care for a patient with anorexia nervosa. Which problem should the nurse identify as a priority for this patient?
1. Inadequate oral intake
2. Feelings of adequacy
3. Loss of control
4. Skewed opinion of appearance
Page Ref: 682-683
Cognitive Level: Analyzing
Client Need & Sub: Physiological Integrity: Physiological Adaptation
Standards: QSEN Competencies: I.B.3. Provide patient-centered care with sensitivity and respect for the diversity of human experience | AACN Essentials Competencies: IX.5. Deliver compassionate, patient-centered, evidence-based care that respects patient and family preferences | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Planning
Learning Outcome: 22.3 Describe the pathophysiology and manifestations of eating disorders, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 3. Analyze assessment data to determine a plan of care for patients with nutritional disorders.
5) A patient reports often eating excessive amounts of food when alone and when not hungry, and has intense feelings of self-disgust afterward. Which health problem is this patient at risk for developing?
1. Type 2 diabetes mellitus
2. Type 1 diabetes mellitus
3. Dehydration
4. Electrolyte imbalances
Page Ref: 683
Cognitive Level: Analyzing
Client Need & Sub: Physiological Integrity: Physiological Adaptation
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 22.3 Describe the pathophysiology and manifestations of eating disorders, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 1. Examine the pathophysiology, incidence, risk factors, and clinical manifestations for patients with nutritional disorders.
6) An adolescent is reported being interested in losing weight and measures weight several times a day, but at times ingests large amounts of food. What should the nurse suspect is occurring with this patient?
1. Bulimia nervosa
2. Early-onset anorexia nervosa
3. Binge-eating disorder
4. Metabolic disorder
Page Ref: 683
Cognitive Level: Analyzing
Client Need & Sub: Physiological Integrity: Physiological Adaptation
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 22.3 Describe the pathophysiology and manifestations of eating disorders, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 3. Analyze assessment data to determine a plan of care for patients with nutritional disorders.
7) The nurse teaches a patient about the medication orlistat (Xenical). Which patient statement indicates the need for additional teaching?
1. "I should take this medication 30 minutes before eating."
2. "This medication will reduce the amount of fat my body absorbs."
3. "I will need to take supplements of vitamins A, D, E, and K daily."
4. "A low-calorie diet will need to be followed."
Page Ref: 664
Cognitive Level: Analyzing
Client Need & Sub: Physiological Integrity: Pharmacological and Parenteral Therapies
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.9. Monitor client outcomes to evaluate the effectiveness of psychobiological interventions | NLN Competencies: Relationship-Centered Care; Practice-Know-How; Communicate information effectively | Nursing/Integrated Concepts: Nursing Process: Evaluation/Teaching/Learning
Learning Outcome: 22.1 Describe the pathophysiology, manifestations, and complications of obesity, and outline the interprofessional care and nursing care of patients with obesity.
MNL Learning Outcome: 2. Consider intraprofessional care for patients with nutritional disorders.
8) The nurse is helping a patient identify ways to adhere to a weight reduction plan. What should the nurse suggest to help this patient?
1. Set aside small nonfood rewards when you meet a goal.
2. Eat alone to reduce outside distractions.
3. Drink water or a diet beverage after eating to promote feelings of fullness.
4. Allow at least 45 minutes to 1 hour to promote full enjoyment of a meal.
Page Ref: 666
Cognitive Level: Applying
Client Need & Sub: Psychosocial Integrity: Behavioral Interventions
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.8. Implement evidence-based nursing interventions as appropriate for managing the acute and chronic care of patients and promoting health across the lifespan | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 22.1 Describe the pathophysiology, manifestations, and complications of obesity, and outline the interprofessional care and nursing care of patients with obesity.
MNL Learning Outcome: 4. Determine appropriate nursing interventions for patients with nutritional disorders.
9) A patient planning to begin a weight loss diet asks the nurse for suggestions as to how to balance eating. What information should the nurse provide to the patient?
1. The diet should reduce calories to 1000‒1600 per day, with less than 10% of the total calories coming from fat.
2. The diet should be between 750 and 1000 calories per day, with less than 15% of the total calories coming from fat.
3. The diet should simply cut 500 calories per day from the normal intake.
4. The best diet will be between 1250 and 1500 calories per day, with 15% of the calories being sources of protein.
Page Ref: 666
Cognitive Level: Applying
Client Need & Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.8. Implement evidence-based nursing interventions as appropriate for managing the acute and chronic care of patients and promoting health across the lifespan | NLN Competencies: Relationship-Centered Care; Practice-Know-How; Communicate information effectively | Nursing/Integrated Concepts: Nursing Process: Implementation/Teaching/Learning
Learning Outcome: 22.1 Describe the pathophysiology, manifestations, and complications of obesity, and outline the interprofessional care and nursing care of patients with obesity.
MNL Learning Outcome: 4. Determine appropriate nursing interventions for patients with nutritional disorders.
10) A patient desiring to begin a very-low-calorie diet (VLCD) for rapid weight reduction is concerned about the safety of the diet. What information should the nurse provide to the patient?
1. VLCDs are not recommended for people over age 50.
2. VLCDs result in significant losses of muscle mass in response to the protein restriction.
3. VLCDs are safe for patients who have a lower body mass index and need to lose a small amount of weight rapidly.
4. VLCDs are safest for middle-aged and senior patients.
Page Ref: 665-666
Cognitive Level: Applying
Client Need & Sub: Health Promotion and Maintenance: Lifestyle Choices
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.4. Communicate effectively with all members of the healthcare team, including the patient and the patient's support network | NLN Competencies: Relationship-Centered Care; Practice-Know-How; Communicate information effectively | Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 22.1 Describe the pathophysiology, manifestations, and complications of obesity, and outline the interprofessional care and nursing care of patients with obesity.
MNL Learning Outcome: 1. Examine the pathophysiology, incidence, risk factors, and clinical manifestations for patients with nutritional disorders.
11) A patient who is 5 feet 5 inches tall and weighs 144 lbs. asks the nurse if this is obesity. How should the nurse respond to this patient?
1. "You are a normal weight for your height."
2. "Yes, you are slightly obese for your height."
3. "You are slightly overweight."
4. "You are moderately obese."
Page Ref: 663
Cognitive Level: Applying
Client Need & Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.4. Communicate effectively with all members of the healthcare team, including the patient and the patient's support network | NLN Competencies: Relationship-Centered Care; Practice-Know-How; Communicate information effectively | Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 22.1 Describe the pathophysiology, manifestations, and complications of obesity, and outline the interprofessional care and nursing care of patients with obesity.
MNL Learning Outcome: 3. Analyze assessment data to determine a plan of care for patients with nutritional disorders.
12) The nurse is preparing information for a community seminar on the hazards of obesity. Which disorder should the nurse include as being complications of obesity? Select all that apply.
1. Cardiovascular diseases
2. Obstructive sleep apnea
3. Diabetes mellitus type 2
4. Hypotension
5. Renal insufficiency
Page Ref: 662
Cognitive Level: Applying
Client Need & Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care | NLN Competencies: Relationship-Centered Care; Practice-Know-How; Communicate information effectively | Nursing/Integrated Concepts: Nursing Process: Planning/Teaching/Learning
Learning Outcome: 22.1 Describe the pathophysiology, manifestations, and complications of obesity, and outline the interprofessional care and nursing care of patients with obesity.
MNL Learning Outcome: 1. Examine the pathophysiology, incidence, risk factors, and clinical manifestations for patients with nutritional disorders.
13) A patient is suspected of having protein calorie malnutrition (PCM) with a body mass index of less than 18. Which laboratory test should the nurse expect to be prescribed for this patient? Select all that apply.
1. Serum albumin
2. Lymphocyte count
3. Serum electrolytes
4. Complete blood count (CBC)
5. Urinalysis
Page Ref: 676
Cognitive Level: Analyzing
Client Need & Sub: Physiological Integrity: Reduction of Risk Potential
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Planning
Learning Outcome: 22.2 Describe the pathophysiology and manifestations of malnutrition, and outline the interprofessional care and nursing care of patients with malnutrition.
MNL Learning Outcome: 1. Examine the pathophysiology, incidence, risk factors, and clinical manifestations for patients with nutritional disorders.
14) The nurse is reviewing data collected from an adolescent patient suspected of having anorexia nervosa. Which finding should the nurse identify as contributing to this diagnosis? Select all that apply.
1. Distorted body image
2. Loss of control over food intake
3. Purging
4. Binge eating
5. Normal or above average body weight
Page Ref: 682
Cognitive Level: Analyzing
Client Need & Sub: Physiological Integrity: Physiological Adaptation
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 22.3 Describe the pathophysiology and manifestations of eating disorders, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 3. Analyze assessment data to determine a plan of care for patients with nutritional disorders.
15) A middle-aged female patient who weighs 130 lbs. (59.09 kg) and is 5 feet 2 inches tall (1.57 meters) wants assistance to develop a weight reduction plan. What is this patient's body mass index (BMI), which will help the nurse with nutritional planning? Record your answer rounding to the nearest whole number.
Page Ref: 663
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Physiological Adaptation
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Planning
Learning Outcome: 22.1 Describe the pathophysiology, manifestations, and complications of obesity, and outline the interprofessional care and nursing care of patients with obesity.
MNL Learning Outcome: 3. Analyze assessment data to determine a plan of care for patients with nutritional disorders.
16) A patient weighs 200 lbs. (90.91 kg) and is 5 feet 6 inches tall (1.68 meters). What should the nurse calculate this patient's body mass index to be? Record your answer rounding to the nearest whole number.
Page Ref: 663
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Physiological Adaptation
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 22.1 Describe the pathophysiology, manifestations, and complications of obesity, and outline the interprofessional care and nursing care of patients with obesity.
MNL Learning Outcome: 3. Analyze assessment data to determine a plan of care for patients with nutritional disorders.
17) The nurse suspects that a patient has a vitamin C deficiency. What did the nurse assess to come to this conclusion? Select all that apply.
1. Delayed wound healing
2. Swollen bleeding gums
3. Depression
4. Night blindness
5. Muscle wasting
Page Ref: 674
Cognitive Level: Analyzing
Client Need & Sub: Physiological Integrity: Physiological Adaptation
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 22.2 Describe the pathophysiology and manifestations of malnutrition, and outline the interprofessional care and nursing care of patients with malnutrition.
MNL Learning Outcome: 3. Analyze assessment data to determine a plan of care for patients with nutritional disorders.
18) A patient has been researching medications to help achieve a weight loss goal. What is the medication classification that the nurse should review with the patient that could help meet the patient's goal?
1. Lipase inhibitor
2. Antiepileptic
3. Anticholinergics
4. Adrenergics
Page Ref: 664
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Pharmacological and Parenteral Therapies
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care | NLN Competencies: Relationship-Centered Care; Practice-Know-How; Communicate information effectively | Nursing/Integrated Concepts: Nursing Process: Implementation/Teaching/Learning
Learning Outcome: 22.1 Describe the pathophysiology, manifestations, and complications of obesity, and outline the interprofessional care and nursing care of patients with obesity.
MNL Learning Outcome: 2. Consider intraprofessional care for patients with nutritional disorders.
19) The goal of reducing or eliminating binge eating and purging behavior has been established for a patient with bulimia nervosa. What intervention should the nurse expect to be prescribed to help the patient achieve this goal? Select all that apply.
1. Nutritional counseling
2. Cognitive‒behavioral therapy
3. Antidepressants
4. Vitamin therapy
5. Hospitalization
Page Ref: 685
Cognitive Level: Analyzing
Client Need & Sub: Physiological Integrity: Reduction of Risk Potential
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.5. Deliver compassionate, patient-centered, evidence-based care that respects patient and family preferences | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Planning
Learning Outcome: 22.3 Describe the pathophysiology and manifestations of eating disorders, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 2. Consider intraprofessional care for patients with nutritional disorders.
20) The nurse is helping a 57-year-old patient design an exercise plan to achieve weight loss goals. What does the nurse calculate this patient's target heart rate to be? Record your answer rounding to the nearest whole number.
Page Ref: 665
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Reduction of Risk Potential
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.5. Deliver compassionate, patient-centered, evidence-based care that respects patient and family preferences | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 22.1 Describe the pathophysiology, manifestations, and complications of obesity, and outline the interprofessional care and nursing care of patients with obesity.
MNL Learning Outcome: 4. Determine appropriate nursing interventions for patients with nutritional disorders.
21) The nurse is preparing to administer total parenteral nutrition intravenously to a patient with malnutrition. What fat soluble vitamin should the nurse note is absent from the nutritional mixture?
1. Vitamin K
2. Vitamin A
3. Vitamin D
4. Vitamin E
Page Ref: 677
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Pharmacological and Parenteral Therapies
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.3. Implement holistic, patient-centered care that reflects an understanding of human growth and development, pathophysiology, pharmacology, medical management, and nursing management across the health-illness continuum, across lifespan, and in all healthcare settings | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 22.2 Describe the pathophysiology and manifestations of malnutrition, and outline the interprofessional care and nursing care of patients with malnutrition.
MNL Learning Outcome: 2. Consider intraprofessional care for patients with nutritional disorders.
22) A patient has a body mass index (BMI) of 27. How should the nurse explain this finding to the patient?
1. Normal weight
2. Overweight
3. Obese
4. Metabolic syndrome
Page Ref: 663
Cognitive Level: Applying
Client Need & Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.4. Communicate effectively with all members of the healthcare team, including the patient and the patient's support network | NLN Competencies: Relationship-Centered Care; Practice-Know-How; Communicate information effectively | Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 22.1 Describe the pathophysiology, manifestations, and complications of obesity, and outline the interprofessional care and nursing care of patients with obesity.
MNL Learning Outcome: 3. Analyze assessment data to determine a plan of care for patients with nutritional disorders.
23) A patient has a waist-to-hip ratio of 0.5. Which health problem is this patient at risk for developing?
1. Gastrointestinal dysfunction
2. Hyperinsulinemia
3. Heart disease
4. Obesity
Page Ref: 662
Cognitive Level: Applying
Client Need & Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Planning
Learning Outcome: 22.1 Describe the pathophysiology, manifestations, and complications of obesity, and outline the interprofessional care and nursing care of patients with obesity.
MNL Learning Outcome: 1. Examine the pathophysiology, incidence, risk factors, and clinical manifestations for patients with nutritional disorders.
24) A parent is overheard telling a child to behave in order to get an ice cream cone later. What should the nurse realize is occurring with the parent?
1. Rewarding behavior with food
2. Frustration with the child's behavior
3. Anxiety due to parenting
4. Hunger as a motivating factor
Page Ref: 661
Cognitive Level: Analyzing
Client Need & Sub: Psychosocial Integrity: Cultural Awareness/Cultural Influences on Health
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches | NLN Competencies: Context and Environment; Practice; conduct population-based transcultural health assessments and interventions Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 22.1 Describe the pathophysiology, manifestations, and complications of obesity, and outline the interprofessional care and nursing care of patients with obesity.
MNL Learning Outcome: 1. Examine the pathophysiology, incidence, risk factors, and clinical manifestations for patients with nutritional disorders.
25) During a physical assessment, the nurse suspects that the patient might be experiencing metabolic syndrome. Which assessment finding provides evidence for this nurse's assumption?
1. Blood pressure 150/96 mmHg
2. Difficulty ambulating
3. Low waist-to-hip ratio
4. Heart rate 72 and regular
Page Ref: 662
Cognitive Level: Analyzing
Client Need & Sub: Physiological Integrity: Physiological Adaptation
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 22.1 Describe the pathophysiology, manifestations, and complications of obesity, and outline the interprofessional care and nursing care of patients with obesity.
MNL Learning Outcome: 1. Examine the pathophysiology, incidence, risk factors, and clinical manifestations for patients with nutritional disorders.
26) The nurse is reviewing the lipid panel of a patient with a body mass index (BMI) of 31. What should the nurse expect this patient's values to be?
1. Low high-density lipoprotein (HDL)
2. Elevated HDL
3. Normal thyroid hormone (TH) level
4. Reduced low-density lipoprotein (LDL)
Page Ref: 662
Cognitive Level: Analyzing
Client Need & Sub: Physiological Integrity: Reduction of Risk Potential
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 22.1 Describe the pathophysiology, manifestations, and complications of obesity, and outline the interprofessional care and nursing care of patients with obesity.
MNL Learning Outcome: 1. Examine the pathophysiology, incidence, risk factors, and clinical manifestations for patients with nutritional disorders.
27) A patient with a BMI of 29 is upset because of not losing any weight despite cutting out all sweet snacks. How should the nurse respond to this patient?
1. "Let's calculate how many calories you are not eating each day."
2. "I recommend that you go see a dietician."
3. "I'll make a note in your file that you are no longer eating sweet snacks."
4. "You didn't gain the weight overnight."
Page Ref: 664
Cognitive Level: Applying
Client Need & Sub: Health Promotion and Maintenance: Lifestyle Choices
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.3. Implement holistic, patient-centered care that reflects an understanding of human growth and development, pathophysiology, pharmacology, medical management, and nursing management across the health-illness continuum, across lifespan, and in all healthcare settings | NLN Competencies: Relationship-Centered Care; Practice-Know-How; Communicate information effectively | Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 22.1 Describe the pathophysiology, manifestations, and complications of obesity, and outline the interprofessional care and nursing care of patients with obesity.
MNL Learning Outcome: 3. Analyze assessment data to determine a plan of care for patients with nutritional disorders.
28) A patient who lives alone has a BMI of 34. What strategy should the nurse suggest to help this patient reduce overeating?
1. Prepare a meal and eat it in the dining room.
2. Eat out more often to control portion size.
3. Read a book while eating as a distraction from the food.
4. Cook once a week and store the leftovers to reduce the need to cook again.
Page Ref: 666
Cognitive Level: Applying
Client Need & Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.5. Deliver compassionate, patient-centered, evidence-based care that respects patient and family preferences | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 22.1 Describe the pathophysiology, manifestations, and complications of obesity, and outline the interprofessional care and nursing care of patients with obesity.
MNL Learning Outcome: 4. Determine appropriate nursing interventions for patients with nutritional disorders.
29) An overweight patient reports not being able to stop eating bagels that are provided every Monday morning at work. What should the nurse realize this patient is describing?
1. Appetite stimulation by external cues
2. Extreme hunger from calorie restriction
3. Carbohydrate addiction in its early stage
4. Metabolic syndrome development
Page Ref: 666
Cognitive Level: Analyzing
Client Need & Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 22.1 Describe the pathophysiology, manifestations, and complications of obesity, and outline the interprofessional care and nursing care of patients with obesity.
MNL Learning Outcome: 1. Examine the pathophysiology, incidence, risk factors, and clinical manifestations for patients with nutritional disorders.
30) A patient regained 15 lbs. that had been lost the previous year. What should the nurse suggest to this patient?
1. Return to the diet, exercise, and behavior change techniques that worked before.
2. Switch to a new diet in which the weight could be lost again in two weeks.
3. Consider the possibility that the patient's body needs to have the extra 15 lbs.
4. Understand that the increased weight does not make the patient obese.
Page Ref: 668
Cognitive Level: Applying
Client Need & Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.5. Deliver compassionate, patient-centered, evidence-based care that respects patient and family preferences | NLN Competencies: Relationship-Centered Care; Practice-Know-How; Communicate information effectively | Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 22.1 Describe the pathophysiology, manifestations, and complications of obesity, and outline the interprofessional care and nursing care of patients with obesity.
MNL Learning Outcome: 4. Determine appropriate nursing interventions for patients with nutritional disorders.
31) An overweight patient tries to adhere to a diet and exercise plan but family members say the patient does not need to lose any weight. What type of problem is this patient experiencing?
1. Lack of family and social support to adhere to the plan
2. Eating more than is required for bodily functions
3. Difficulty with exercise and activity
4. Generalized feelings of self-reproach
Page Ref: 671
Cognitive Level: Analyzing
Client Need & Sub: Psychosocial Integrity: Support Systems
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 22.1 Describe the pathophysiology, manifestations, and complications of obesity, and outline the interprofessional care and nursing care of patients with obesity.
MNL Learning Outcome: 3. Analyze assessment data to determine a plan of care for patients with nutritional disorders.
32) An older patient who uses a walker reports feeling alone since all family members are gone. Which health problem is this patient at risk for developing?
1. Malnutrition
2. Obesity
3. Psychosis
4. Immobility
Page Ref: 673
Cognitive Level: Analyzing
Client Need & Sub: Psychosocial Integrity: Support Systems
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 22.2 Describe the pathophysiology and manifestations of malnutrition, and outline the interprofessional care and nursing care of patients with malnutrition.
MNL Learning Outcome: 1. Examine the pathophysiology, incidence, risk factors, and clinical manifestations for patients with nutritional disorders.
33) A patient is being evaluated for malnutrition. Which laboratory test result should the nurse recognize will support that finding? Select all that apply.
1. Low serum potassium
2. Low white blood cell count
3. Elevated serum albumin
4. Elevated red blood cell count
5. Low serum sodium
Page Ref: 676
Cognitive Level: Analyzing
Client Need & Sub: Physiological Integrity: Reduction of Risk Potential
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 22.2 Describe the pathophysiology and manifestations of malnutrition, and outline the interprofessional care and nursing care of patients with malnutrition.
MNL Learning Outcome: 1. Examine the pathophysiology, incidence, risk factors, and clinical manifestations for patients with nutritional disorders.
34) A patient with malnutrition is experiencing ongoing diarrhea after every meal. Which health problem could this patient be experiencing?
1. Malabsorption
2. A food allergy
3. Carbohydrate intolerance
4. Pending cardiovascular overload
Page Ref: 676
Cognitive Level: Analyzing
Client Need & Sub: Physiological Integrity: Physiological Adaptation
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 22.2 Describe the pathophysiology and manifestations of malnutrition, and outline the interprofessional care and nursing care of patients with malnutrition.
MNL Learning Outcome: 3. Analyze assessment data to determine a plan of care for patients with nutritional disorders.
35) A patient is prescribed a hypertonic solution with vitamins and minerals to be administered through a peripheral intravenous access line. Which type of treatment should the nurse prepare teaching for this patient?
1. Intravenous fluid support
2. Total parenteral nutrition
3. Enteral nutrition
4. Short-term total parenteral nutrition
Page Ref: 678
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Pharmacological and Parenteral Therapies
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care | NLN Competencies: Relationship-Centered Care; Practice-Know-How; Communicate information effectively | Nursing/Integrated Concepts: Nursing Process: Planning/Teaching/Learning
Learning Outcome: 22.2 Describe the pathophysiology and manifestations of malnutrition, and outline the interprofessional care and nursing care of patients with malnutrition.
MNL Learning Outcome: 2. Consider intraprofessional care for patients with nutritional disorders.
36) The parent of a preadolescent patient reports the child seeing an overweight adolescent and has since refused to eat. What behavior is this patient most likely demonstrating?
1. An irrational fear of gaining weight
2. Defiance directed at the parent
3. Normal preadolescent behavior
4. An internal power struggle
Page Ref: 682
Cognitive Level: Analyzing
Client Need & Sub: Psychosocial Integrity: Coping Mechanisms
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 22.3 Describe the pathophysiology and manifestations of eating disorders, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 1. Examine the pathophysiology, incidence, risk factors, and clinical manifestations for patients with nutritional disorders.
37) A young adult patient reports eating anything that is desired and has a laxative "for dessert." Which behavior is this patient demonstrating?
1. Bulimia
2. Anorexia
3. Effective weight control
4. Distorted body image
Page Ref: 683
Cognitive Level: Analyzing
Client Need & Sub: Physiological Integrity: Reduction of Risk Potential
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 22.3 Describe the pathophysiology and manifestations of eating disorders, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 1. Examine the pathophysiology, incidence, risk factors, and clinical manifestations for patients with nutritional disorders.
38) The parent of an adolescent patient being evaluated for bulimia asks what diagnostic tests can be done. What is the nurse's best response?
1. "There is no specific test that can determine bulimia."
2. "You should ask the doctor about this."
3. "Your child will need a psychiatric evaluation to determine the diagnosis."
4. "Bulimia is rarely diagnosed correctly."
Page Ref: 685
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Reduction of Risk Potential
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.4. Communicate effectively with all members of the healthcare team, including the patient and the patient's support network | NLN Competencies: Relationship-Centered Care; Practice-Know-How; Communicate information effectively | Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 22.3 Describe the pathophysiology and manifestations of eating disorders, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 2. Consider intraprofessional care for patients with nutritional disorders.
39) A patient is admitted for treatment of malnutrition. What assessment finding does the nurse identify that indicates the patient is experiencing a vitamin C deficiency?
1. Bleeding gums
2. Smooth tongue
3. Muscle cramps
4. Ataxia
Page Ref: 674
Cognitive Level: Analyzing
Client Need & Sub: Physiological Integrity: Physiological Adaptation
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 22.2 Describe the pathophysiology and manifestations of malnutrition, and outline the interprofessional care and nursing care of patients with malnutrition.
MNL Learning Outcome: 3. Analyze assessment data to determine a plan of care for patients with nutritional disorders.
40) At the conclusion of a physical assessment the nurse determines that a patient is experiencing health-related problems of obesity. What information from the patient's health history does the nurse use to make this decision? Select all that apply.
1. Osteoarthritis
2. Varicose veins
3. Low back pain
4. Allergy to sulfa
5. Lactose intolerance
Page Ref: 660
Cognitive Level: Analyzing
Client Need & Sub: Physiological Integrity: Physiological Adaptation
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 22.1 Describe the pathophysiology, manifestations, and complications of obesity, and outline the interprofessional care and nursing care of patients with obesity.
MNL Learning Outcome: 3. Analyze assessment data to determine a plan of care for patients with nutritional disorders.
41) The nurse is reviewing prescribed medications for a patient with obesity. Which medication would the nurse recognize as contraindicated for patients taking lorcaserin (Belviq)? Select all that apply.
1. Aspirin (ASA)
2. St. John's wort
3. Ibuprofen (Motrin)
4. Furosemide (Lasix)
5. Bupropion (Wellbutrin)
Page Ref: 663
Cognitive Level: Analyzing
Client Need & Sub: Physiological Integrity: Pharmacological and Parenteral Therapies
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 22.1 Describe the pathophysiology, manifestations, and complications of obesity, and outline the interprofessional care and nursing care of patients with obesity.
MNL Learning Outcome: 2. Consider intraprofessional care for patients with nutritional disorders.
42) A patient is prescribed a 1750 kilocalorie eating plan where 15% of the daily intake is to be protein. How many kilocalories of protein should the nurse instruct the patient to ingest each day? ________ kcal Record your answer rounding up to the nearest whole number.
Page Ref: 666
Cognitive Level: Applying
Client Need & Sub: Health Promotion and Maintenance: Lifestyle Choices
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care | NLN Competencies: Relationship-Centered Care; Practice-Know-How; Communicate information effectively | Nursing/Integrated Concepts: Nursing Process: Implementation/Teaching/Learning
Learning Outcome: 22.1 Describe the pathophysiology, manifestations, and complications of obesity, and outline the interprofessional care and nursing care of patients with obesity.
MNL Learning Outcome: 4. Determine appropriate nursing interventions for patients with nutritional disorders.
43) The nurse is providing discharge teaching to a patient recovering from bariatric surgery. Which patient statement indicates that teaching about dumping syndrome has been effective? Select all that apply.
1. "I should eat three large meals each day."
2. "I should have tea and toast for breakfast."
3. "I should not drink fluids while eating a meal."
4. "I should lie down for 30 minutes after eating a meal."
5. "I should avoid eating foods high in simple carbohydrates."
Page Ref: 667-668
Cognitive Level: Analyzing
Client Need & Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care | NLN Competencies: Relationship-Centered Care; Practice-Know-How; Communicate information effectively | Nursing/Integrated Concepts: Nursing Process: Evaluation/Teaching/Learning
Learning Outcome: 22.1 Describe the pathophysiology, manifestations, and complications of obesity, and outline the interprofessional care and nursing care of patients with obesity.
MNL Learning Outcome: 4. Determine appropriate nursing interventions for patients with nutritional disorders.
44) A patient with protein-calorie malnutrition has been ingesting a hyperosmolar nutritional supplement three times a day for a week. Which assessment finding indicates that this patient is experiencing dehydration? Select all that apply.
1. Weight loss
2. Dry mucous membranes
3. High urine specific gravity
4. New skin blister on sacrum
5. Change in level of consciousness
Page Ref: 681
Cognitive Level: Analyzing
Client Need & Sub: Physiological Integrity: Physiological Adaptation
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Evaluation
Learning Outcome: 22.2 Describe the pathophysiology and manifestations of malnutrition, and outline the interprofessional care and nursing care of patients with malnutrition.
MNL Learning Outcome: 3. Analyze assessment data to determine a plan of care for patients with nutritional disorders.
Document Information
Connected Book
Medical Surgical Nursing 7e | Test Bank by LeMone, Burke, Bauldoff
By LeMone, Burke, Gerene Bauldoff
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Chapter 20 Nursing Care Of Patients With Diabetes Mellitus
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Chapter 21 Assessing The Gastrointestinal System
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Chapter 22 Nursing Care Of Patients With Nutritional Disorders
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Chapter 23 GI Disorders – Nursing Care
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Chapter 24 Nursing Care Of Patients With Bowel Disorders
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