Chapter 42: Alterations in Metabolism and Nutrition

Chapter 42: Alterations in Metabolism and Nutrition

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

MULTIPLE CHOICE
1. When released into the circulation, fatty acids are bound to ________ for assimilation into tissue.
a. serum IgG
b. total protein
c. albumin
d. creatinine
ANS: C
When released into circulation, the fatty acids, bound to albumin, are quickly assimilated into tissue. Fatty acids are not bound to
serum IgG for release into the tissue. Total protein is not bound to fatty acids for release into the circulation. Creatinine does not
play a role in the release of fatty acids into tissue.
REF: Pg. 845
2. The metabolic response to physiologic stress is characterized by
a. loss of somatic protein.
b. preservation of visceral protein.
c. body weight less than 80% of ideal.
d. stress-induced protein catabolism.
ANS: D
During times of disease, stress, fever, or starvation or during the release of certain hormones such as thyroid hormone and cortisol,
catabolism dominates the body’s metabolic processes. Loss of somatic protein does not occur in response to physiologic stress.
Tissue wasting associated with catabolism may lead to cellular injury. Body weight less than 80% of ideal is not characteristic of a
metabolic response to stress.
REF: Pg. 841
3. Starvation is associated with
a. loss of visceral protein.
b. low serum albumin levels.
c. loss of somatic fat and protein.
d. generalized edema.
ANS: C
With physiologic stress, conservation of lean body mass does not occur. The metabolic rate increases rather than decreases, and a
high sustained rate of catabolism (breakdown of protein to meet energy needs) results. Adipose is not well used for energy.
Starvation is associated with protein being used as an energy source. Low serum albumin levels are not associated with starvation.
Retention of fluid and sodium occurs in the immediate phase of stress on the body.
REF: Pg. 848
4. What patient is most at risk for severe protein malnutrition?
a. A postsurgical patient who has been NPO for 3 days
b. A postburn patient who has a deep partial-thickness burn
c. A febrile patient who has had a temperature of 102.6° F for 3 days
d. An immobile patient who has been in skeletal traction for 1 week
ANS: B
A burn is an extreme stressor that results in significant hypermetabolism. The energy needs of a burn patient increase 50% to 100%
from the basal metabolic requirement. Burn wounds increase the negative nitrogen balance and burns leak soluble proteins from the
wound. The postoperative energy requirement can increase from 10% to 35% above BMR. A combination of increased need with
decreased intake can have a major impact on wound healing. The metabolic response to fever is both anabolic and catabolic, which
greatly increases nutrient requirements. An effect of immobilization is nitrogen loss as tissue mass is decreased from diffuse
atrophy.