Pernicious anemia results from a deficiency of

Mr. Stanley Edward, a 58-year-old African American male, was admitted to the emergency room of the medical center upon being found unconscious in his car in a parking lot and resuscitated. His history was obtained by contacting his daughter. The patient presents with:

• end-stage adenocarcinoma of the gastroestophageal juncture. • chronic malnutrition and significant weight loss × 1 year. Low BMI, loss of muscle, loss of subcutaneous fat, bitemporal wasting. • acute pancreatitis with intractable vomiting. Medical Hx: Hypertension; S/P stroke @ age 56; cataract surgery. Meds: antilipemic medication, antihypertensive medication. Hx: Lifelong chain smoker (2 packs per day); alcohol abuse since his late 20s. Ht: 5'8". Admission Wt: 107 lbs. Usual Wt, 1 year ago: 170 lbs. Social Hx: Lives alone; cooks and shops for himself despite illness. Dietary Hx: Previously followed a low-cholesterol, low-sodium, high-potassium diet. Mr. Edward is not being actively treated for cancer at his request. Plan is to keep Mr. Edward NPO and place a peripheral line for hydration and nutrition support. To avoid liver impairment associated with parenteral feeding, the nutrition support team will need to avoid which of the following when calculating Mr. Edward's PPN orders? a. giving the patient excess energy b. giving the patient excess dextrose c. giving the patient excess lipids d. all of the above

Which statement is true?

a. Children don't like to eat at little tables with other children b. Children should be served large portions of foods. c. Rewarding children for eating vegetables always results in a preference for them. d. Food jags in young children should not be allowed by parents. e. Children should be encouraged to stop eating when they are full.

When the blood glucose level rises after a meal, the first organ to respond is the: a. pancreas

b. liver. c. stomach. d. gallbladder. e. kidney.

Your service organization wants to volunteer for a local food pantry. What would be one of the activities that they could participate in? a. Distribute recovered foods to federal food assistance programs

b. Organize and fill emergency food boxes for those in need. c. Cook and serve meals at a local soup kitchen using food pantry foods. d. Encourage farmers' markets to sell their goods to the food pantry. e. Serve breakfast in low-income children in schools.