Clinical Module Exams Flashcards
A 50 year old patient is started on Coumadin to reduce his risk of blood clotting after minor surgery. What should the patient be advised about Coumadin?
a. Avoid intake of foods with Vitamin E
b. Avoid intake of food with Vitamin K
c. Maintain consistent intake of Vitamin E
d. Maintain consistent intake of Vitamin K
d. Maintain consistent intake of Vitamin K
A 70 year old female is admitted for SOB related to acute exacerbation of heart failure. Past medical history includes CAD and HTN. BMI is 29 and physical exam reveals 3+ edema in her lower extremities.
What nutrition prescription is recommended?
a. 1,500 mg Sodium Diet with no fluid restriction
b. Calorie controlled meal plan to promote weight loss
c. Therapeutic Lifestyle Diet with 1500 cc fluid restriction
d. 2,000 mg Sodium Diet with < 2000 cc fluid/day
d. 2,000 mg Sodium Diet with < 2000 cc fluid/day
A 56 year old male patient with PMH of heart failure, HTN and Type 2 diabetes mellitus is admitted for a cholecystectomy. The patient’s RBC count, hemoglobin are below standard for gender with hematocrit and iron just below standard for gender. His MCV is normal.
What do these values suggest?
a. Anemia related to B12 deficiency
b. Anemia related to folate deficiency
c. Anemia related to iron deficiency
d. Anemia related to chronic disease
d. Anemia related to chronic disease
A 42-year-old male landscaper is admitted with acute abdominal pain and reoccurring diarrhea (2 to 3 episodes daily) for 6 weeks with occult + blood in his stools. He complains of worsening fatigue and poor appetite with intermittent nausea. Symptoms are independent of what he eats. He is 5’10 and admission weight 145 lbs, usual body weight 156 lbs (last assessed 4 months ago). Admission labs: Albumin-2.9 mg/dL, Prealbumin-17 mg/dL, K+-3.4 mg/dL, Hct- 40%, Hgb-12 g/dL, MCV- 75 mm3. He is pending a colonoscopy r/o causes.
Based on the patients presenting signs and symptoms what is the priority to evaluate?
a. Folate level
b. B12 level
c. Ferritin level
d. Iron level
c. Ferritin level
Which of the following is important to avoid when taking beta blockers or ace inhibitors to manage Heart Failure?
a. Milk
b. Grapefruit juice
c. Coffee
d. Green tea
b. Grapefruit juice
All of the following are known nutrition implications of taking long term corticosteroids except for which of the following?
a. Weight gain
b. Glucose intolerance
c. Hypokalemia
d. Osteoporosis
c. Hypokalemia
A 46 year-old male is admitted with acute hepatitis. He consumes 6 to 8 beers per day and PMH reveals +EOTH use for 15 years. Height: 5’10 Weight: 142 lbs. Usual weight: 158 lbs (6 months ago).
He is found to have cirrhosis after his medical work-up. Hct- 41%, Hgb-12 g/dL, MCV- 106 mm3.
Based on the assessment information and diagnosis what are the patient’s protein requirements?
a. 0.6 to 0.8 g/kg
b. 0.8 to 1.0 g/kg
c. 1.0 to 1.2 g/kg
d. 1.2 to 1.4 g/kg
c. 1.0 to 1.2 g/kg
Which of the following has shown to be beneficial in improving hepatic fibrosis in cirrhosis?
a. Thiamine supplementation
b. Vitamin D supplementation
c. Zinc supplementation
d. Vitamin C supplementation
c. Zinc supplementation
A patient is admitted for acute mental status changes secondary to advanced cirrhosis. Assessment indicators reveal compromised nutritional status with a BMI of 18 and energy and protein intake less than 75% of estimated needs. Patient is started on lactulose.
What is the suggested nutrition intervention?
a. High calorie high protein meal plan
b. Provide low protein meal plan providing no greater than 50 g protein/day
c. Initially provide 0.8 g/protein per kg and advance protein to 1.0 to 1.2 g/day
d. Provide 40 g fat modified diet with MCT supplementation to increase calories
c. Initially provide 0.8 g/protein per kg and advance protein to 1.0 to 1.2 g/day
What diet intervention may help in managing and preventing the reoccurrence of hepatic encephalopathy?
a. Diet high in soluble fiber
b. Diet high in casein or whey protein
c. Diet high in MCT oil
d. Diet high in B vitamins
a. Diet high in soluble fiber
A 59 year old female is referred to the dietitian for evaluation. Referral data: Ht-5’8, Wt- 190 lbs, BMI 29, waist circumference 38 inches, BP- 129/80 mm Hg, fasting blood glucose- 108 mg/dL, triglycerides 250 mg/dL and HDL-cholesterol 45 mg/dL.
How many risk factors presented by the patient meets diagnostic criteria for metabolic syndrome?
a. 2
b. 3
c. 4
d. 5
c. 4
A 59 year old female is referred to the dietitian for evaluation. Referral data: Ht-5’8, Wt- 190 lbs, BMI 29, waist circumference 38 inches, BP- 129/80 mm Hg, fasting blood glucose- 108 mg/dL, triglycerides 250 mg/dL and HDL-cholesterol 45 mg/dL.
What modification in the prescribed diet plan is suggested for this patient based on her metabolic profile?
a. Provide 30% of total calories from carbohydrate and < 25% of total calories from fat
b. Provide 40% of total calories from carbohydrate and < 25% of total calories from protein
c. Provide 50% of total calories from carbohydrate and < 35% of total calories from fat
d. Provide 60% of total calories from carbohydrate and < 30% of total calories from fat
c. Provide 50% of total calories from carbohydrate and < 35% of total calories from fat
Based on the evidence, which of the following occurs as a result of consuming foods containing trans fatty acids?
a. Decrease LDL-cholesterol and increase HDL-cholesterol
b. Decrease LDL-cholesterol and increase Total cholesterol
c. Increase LDL-cholesterol and decrease HDL-cholesterol
d. Increase LDL-cholesterol and decrease Total cholesterol
c. Increase LDL-cholesterol and decrease HDL-cholesterol
Which of the following provides the most significant dietary source of trans fatty acids in the American diet?
a. Butter
b. Margarine
c. Canola oil
d. Olive oil
b. Margarine
According to the latest evidence, which of the following produces a greater increase in ratio of LDL-cholesterol and HDL-cholesterol increasing risk for coronary heart disease events?
a. Saturated fats
b. Polyunsaturated fats
c. Monounsaturated fats
d. Trans fatty acids
d. Trans fatty acids
A dietary pattern that follows the Therapeutic Lifestyle Changes cardioprotective recommendations can reduce serum LDL-cholesterol levels by which of the following?
a. 5 to 10%
b. 10 to 15%
c. 15 to 20%
d. 20 to 25%
b. 10 to 15%
Which of the following statements is NOT true regarding omega-3 fatty acids?
a. Consuming 1,000 mg of EPA plus DHA preferably from oily fish per day or in the form of supplements with physician supervision is advised for persons with existing CHD
b. Consuming at least 2 fish meals per week is advised for all persons for prevention of CHD
c. Consuming 1,000 mg of EPA plus DHA as fish oil supplements is a therapeutic option for hypertriglyceridemia
d. Consuming 1.5 g/day of food sources high in alpha-linolenic acid is associated with 40% to 65% reduced risk of death from cardiac events
? c. Consuming 1,000 mg of EPA plus DHA as fish oil supplements is a therapeutic option for hypertriglyceridemia
Which of the following are recommended therapeutic options for preventing or reducing risk of coronary heart disease?
[Select all that apply]
a. Consuming 15 g soy protein daily
b. Consuming 5 oz nuts per week
c. Consuming 2 to 3 g of plant stanol or sterol ester containing foods daily
d. Consuming 300 mg vitamin E supplement daily
b. Consuming 5 oz nuts per week
c. Consuming 2 to 3 g of plant stanol or sterol ester containing foods daily
Which of the following statements is true with regards to consuming alcohol in excess of current recommendations (2 drinks/day for men; > 1 drink/day for women)?
a. Excess alcohol can cause high blood pressure
b. Excess alcohol can reduce cardiovascular risk
c. Excess alcohol reduces triglycerides
d. Excess alcohol is cardioprotective
a. Excess alcohol can cause high blood pressure
John would like to have guidance regarding his blood pressure. His blood pressure has steadily been increasing over the last few years and his average readings are 135/82 mm Hg. He has not exercised on a regular basis in the last 2 years due to his highly demanding job. His BMI is 26 with no other significant medical history.
What dietary guidance should be provided?
a. Recommend following the TLC diet meal plan for cardioprotection
b. Recommend following the DASH meal plan
c. Recommend following the Atkins diet for quick weight loss
d. Recommend regular physical activity at least 30 minutes daily if physician approves
b. Recommend following the DASH meal plan
When prescribing the DASH meal plan all of the dietary modifications should be followed except for which of the following?
a. Consume at least 2,400 mg sodium each day
b. Consumes 5 to 10 servings of fruits and vegetables each day
c. Consume 2 to 3 servings of low-fat dairy foods each day
d. Consume 4 to 5 servings of nuts each week
a. Consume at least 2,400 mg sodium each day
Based on evidence and current recommendations from Dietary Guidelines which of the following groups should target sodium intake less than 1,500 mg/day? [Select all that apply] African American Adults with hypertension Adults with diabetes mellitus Adults 51 years and older
All of the above: African American Adults with hypertension Adults with diabetes mellitus Adults 51 years and older
Which of the following meal plan approaches is recommended for hospitalized patients who have diabetes mellitus?
a. 1,800 to 2,000 Kilocalorie Diabetic Exchange meal plan
b. High Protein Low Carbohydrate meal plan
c. Therapeutic Lifestyle Changes meal plan
d. Consistent Carbohydrate meal plan
d. Consistent Carbohydrate meal plan
A 48 year old male is admitted to the ER with high blood pressure (195/90) and a persistent bronchial infection for 8 weeks that will not go away. Height: 5’10, current weight 145 lbs, and usual weight is 152-155 lbs. The patient has been losing weight without trying; however states his appetite remains very good. He also complains of thirst and frequent urination.
Which of the following laboratory values is priority to assess to determine a diagnosis of diabetes mellitus?
[Select all that apply]
a. Urine glucose
b. Plasma glucose
c. Microalbumin
d. Hemoglobin A1C
b. Plasma glucose
d. Hemoglobin A1C
A 48 year old male is admitted to the ER with high blood pressure (195/90) and a persistent bronchial infection for 8 weeks that will not go away. Height: 5’10, current weight 145 lbs, and usual weight is 152-155 lbs. The patient has been losing weight without trying; however states his appetite remains very good. He also complains of thirst and frequent urination.
The patient’s glucose comes back with a reading of 355 mg/dL and A1C test 8% confirming a diagnosis of type 1 diabetes mellitus.
What medications will initially be administered?
a. Metformin and insulin
b. Long-acting and short-acting insulin
c. Glyburide and Metformin
d. Exenatide
b. Long-acting and short-acting insulin
A newly diagnosed patient is being counseled on dietary strategies for type 2 diabetes. The patient refuses to consume sugar substitutes or alternatives due to taste aversion and preference to sucrose.
Which is the best advice for this patient?
a. Avoid sugar as the diagnosis of diabetes mellitus is serious and sugar must be avoided
b. When sugar is to be consumed, avoid consuming with meals and check blood sugar frequently
c. Sugar does not have to be avoided and amount consumed can be calculated into the allowed amount of carbohydrates prescribed
d. Adjust medications so sugar can be consumed as the patient desires
c. Sugar does not have to be avoided and amount consumed can be calculated into the allowed amount of carbohydrates prescribed
Patients on intensified insulin therapy are at greatest risk for which of the following?
[Select all that apply]
a. Hyperglycemia
b. Hypoglycemia
c. Weight gain
d. High blood pressure
b. Hypoglycemia
c. Weight gain
What is the recommended targeted blood glucose range for hospitalized critically ill patients who have diabetes and prescribed insulin for management of hyperglycemia?
a. 80 to 120 mg/dL
b. 100 to 140 mg/dL
c. 120 to 160 mg/dL
d. 140 to 180 mg/dL
d. 140 to 180 mg/dL
All of the following food items can be suggested options used to treat mild hypoglycemia except for which of the following?
a. 4 to 6 oz of fruit juice
b. 2 Tbsp raisins
c. 4 packets of granulated sugar
d. ¼ c applesauce
d. ¼ c applesauce (should be 1/2 cup)
A patient is admitted with severe vomiting and inability to keep liquids and food down for 48 hours. The patient has type 2 diabetes managed with Metformin. Admission blood sugar is 300 mg/dL, urinalysis reveals ketones 4 mmol/L and the patient is very lethargic.
Which of the following complications is the patient experiencing?
a. Gastroparesis
b. Diabetic Ketoacidosis
c. Glycosuria
d. Hyperosmolar Hyperglycemia Nonketoic Syndrome
b. Diabetic Ketoacidosis
A patient is admitted with severe vomiting and inability to keep liquids and food down for 48 hours. The patient has type 2 diabetes managed with Metformin. Admission blood sugar is 300 mg/dL, urinalysis reveals ketones 4 mmol/L and the patient is very lethargic.
Based on the presenting signs and symptoms, which of the following is not a recommended intervention for this patient?
a. Rehydration with IVF’s
b. Increase dosage of Metformin
c. Check electrolytes and assess need for supplementation
d. Begin insulin for management of hyperglycemia
b. Increase dosage of Metformin
What is the most important consideration for persons with diabetes prescribed Sulfonylureas class of oral glucose-lowering medications?
a. Can upset stomach so food should be consumed when taking the medication
b. Can cause elevation in lipid levels and triglycerides
c. Can lead to weight loss so kilocalories may need to be increased
d. Can cause hypoglycemia if food is not consumed every 4 to 5 hours
d. Can cause hypoglycemia if food is not consumed every 4 to 5 hours
Which of the following oral-glucose lowering medication is a suggested option for patients with type 2 diabetes requiring weight loss?
a. Glipizide
b. Metformin
c. Acarbose
d. Glyburide
b. Metformin
Which of the following indices is used to predict the later development of nephropathy and increased cardiovascular risk in persons with type 1 and type 2 diabetes?
a. Microalbumin
b. Blood Urea Nitrogen
c. Creatinine
d. Urine glucose levels
a. Microalbumin
A patient with ESLD secondary to cirrhosis is admitted with steatorrhea. What is the suggested nutritional management?
a. Modify intake of long chain triglycerides to 40 g/day
b. Restrict sodium 2,000 mg/day with fluid based on total output
c. Supplement with medium chain triglycerides to meet calorie needs
d. Provide consistent carbohydrate meal plan and supplement with MCT oil
c. Supplement with medium chain triglycerides to meet calorie needs
Which of the following is a known cause of Acute Kidney Injury (AKI)?
a. Streptococcal infection
b. Diabetes mellitus
c. Hypertension
d. Hyperlipidemia
a. Streptococcal infection
Based on evidence, which of the following is used to evaluate nutritional status in patients with chronic kidney disease who receive renal replacement therapy?
a. Albumin
b. Interdialytic weight gain
c. C-reactive protein
d. Normalized protein catabolic rate
d. Normalized protein catabolic rate
A 65 year old female with type 2 diabetes and hypertension has a GFR of 30 mL/min/1.73 m2 and is diagnosed with chronic kidney disease. She will be managed with which of the following?
a. Diet and hemodialysis
b. Diet and medications
c. Diet and peritoneal dialysis
d. Diet and continuous venovenous hemofiltration
b. Diet and medications
Which of the following renal replacement therapies can increase hyperglycemia in diabetics and hypertriglyceridemia in all patients?
a. Hemodialysis
b. Peritoneal dialysis
c. Continuous venovenous hemofiltration
d. Continuous venovenous hemodialysis
b. Peritoneal dialysis
When determining energy needs for CKD patients receiving peritoneal dialysis which of the following should the dietitian assess?
a. Protein catabolic rate
b. Glucose absorption from dialysate
c. Urea kinetic modeling
d. Resting metabolic rate
b. Glucose absorption from dialysate
A patient on hemodialysis three days/week averages an interdialytic weight gain of 6% over the last week. What is priority for the dietitian to assess?
a. Intake of potassium
b. Intake of fluid
c. Intake of phosphorus
d. Intake of sodium
b. Intake of fluid
Which of the following can cause hyperkalemia in patients with CKD and should be evaluated if hyperkalemia exists? [Select all that apply] a. Inadequate dialysis b. Hyperglycemia c. Diarrhea d. Gastrointestinal bleeding
? not a. Inadequate dialysis or a and b
Which of the following is priority for the treatment and prevention of secondary hyperparathyroidism and bone disease in CKD?
a. Low phosphorus intake
b. Low potassium intake
c. Low calcium intake
d. Low magnesium intake
a. Low phosphorus intake
Which of the following is considered a high-protein and high-phosphorus food?
a. 1 oz cheese
b. 1 oz beef
c. 1 large egg
d. 4 slices of bacon
a. 1 oz cheese
Which of the following best describes the nutritional management of persons with nephrotic syndrome?
a. Provide 0.6 g protein/kg/day with emphasis on potassium and phosphorus
b. Provide 0.8 g protein/kg/day with emphasis on TLC diet principles
c. Provide 1.0 g protein /kg/day with emphasis on low sodium and low carbohydrate diet
d. Provide 1.2 g protein/kg/day with emphasis on very low fat diet
b. Provide 0.8 g protein/kg/day with emphasis on TLC diet principles
A patient with CKD presents with normocytic, normochromic anemia.
Which of the following mechanisms most likely explains the associated anemia in patients with CKD?
a. Blood loss due to dialysis procedure
b. Folic acid deficiency
c. Decreased erythropoietin production
d. Thiamine deficiency
c. Decreased erythropoietin production
A 42 year old male landscaper is admitted with acute abdominal pain and reoccurring diarrhea (2 to 3 episodes daily) for 6 weeks with occult + blood in his stools. He complains of worsening fatigue and poor appetite with intermittent nausea. Symptoms are independent of what he eats. He is 5’10 and admission weight 145 lbs, usual body weight 156 lbs (last assessed 4 months ago). Admission labs: Albumin-2.9 mg/dL, Prealbumin-17 mg/dL, K+-3.4 mg/dL, Hct- 40%, Hgb-12 g/dL, MCV- 75 mm3. He is pending a colonoscopy r/o causes. A diagnosis of mild ulcerative colitis is confirmed after a colonoscopy and imaging scans. The patient is started on mesalamine and short term course of prednisone.
Which of the following diet plans is best to prescribe initially during the acute phase?
a. Lactose Diet
b. Low Fiber with no caffeine
c. High Fiber as tolerated
d. Regular as tolerated
b. Low Fiber with no caffeine
Which of the following patterns best describes the recommended dietary fat intake for patients prescribed the Therapeutic Lifestyle Changes cardioprotective diet?
a. < 5% saturated fat; < 150 mg/dL cholesterol; < 25% of total calories from fat
b. < 7% saturated fat; < 200 mg/dL cholesterol; < 35% of total calories from fat
c. < 10% saturated fat; < 250 mg/dL cholesterol; <30% of total calories from fat
d. < 7% saturated fat; < 250 mg/dL cholesterol; <25% of total calories from fat
b. < 7% saturated fat; < 200 mg/dL cholesterol; < 35% of total calories from fat
A 59 year old female is referred to the dietitian for evaluation. Referral data: Ht-5’8, Wt- 190 lbs, BMI 29, waist circumference 38 inches, BP- 129/80 mm Hg, fasting blood glucose- 108 mg/dL, triglycerides 250 mg/dL and HDL-cholesterol 45 mg/dL.
Based on assessment data what is the patients suggested weight loss goal?
a. 10 to 15 lbs
b. 15 to 20 lbs
c. 20 to 25 lbs
d. 25 to 30 lbs
b. 15 to 20 lbs
A 46 year-old male is admitted with acute hepatitis. He consumes 6 to 8 beers per day and PMH reveals +EOTH use for 15 years. Height: 5’10 Weight: 142 lbs. Usual weight: 158 lbs (6 months ago). He is found to have cirrhosis after his medical work-up. Hct- 41%, Hgb-12 g/dL, MCV- 106 mm3.
Which of the following best meets the patient’s kilocalories needs?
a. 1800 to 2000 kcal/day
b. 2100 to 2300 kcal/day
c. 2400 to 2600 kcal/day
d. 2500 to 2700 kcal/day
b. 2100 to 2300 kcal/day
30-35 kcal/kg (or 32-35)
An adult patient with stage 4 CKD secondary to chronic HTN has a GFR of 25 mL/minute/1.73 m2. The patient is being managed with diet and medications at this time.
What is the recommended protein intake based on a standard body weight of 75 kg?
a. 35 to 45 g/day
b. 45 to 55 g/day
c. 55 to 65 g/day
d. 65 to 75 g/day
b. 45 to 55 g/day
Which of the following nutrition strategies is important for persons with type 1 and type 2 diabetes mellitus who are taking insulin?
a. Avoiding sucrose and foods with sugar
b. Consuming a consistent amount of total carbohydrate at regular meals and snacks
c. Eating protein with each meal snack
d. Limiting fat intake to < 25% of total calories
b. Consuming a consistent amount of total carbohydrate at regular meals and snacks
A 39 year old female is referred to the dietitian for evaluation. Referral data includes: BMI of 29 with fasting plasma glucose of 110 mg/dL and A1C test of 5.9%.
What nutrition intervention is indicated?
a. Consistent carbohydrate meal plan
b. Weight loss and weight reduction meal plan
c. 1600 kilocalorie diabetic exchange meal plan
d. Low glycemic meal plan
b. Weight loss and weight reduction meal plan
When evaluating the diet of a patient with chronic kidney disease which of the following are most important to assess?
a. Vitamin C, vitamin B6, folic acid
b. Vitamin B6, vitamin E, vitamin D
c. Vitamin B12, vitamin A, thiamine
d. Folic acid, vitamin C, niacin
a. Vitamin C, vitamin B6, folic acid
Which of the following if presented would determine the need for iron supplementation in a male patient with CKD?
a. Iron levels below standard for gender
b. Hemoglobin and hematocrit below standard for gender
c. Ferritin level less than 100 ng/dL
d. Transferrin saturation greater than 40%
c. Ferritin level less than 100 ng/dL
Which hormone moves milk through the mammary ducts? prolactin progesterone estrogen oxytocin
oxytocin
Compared to breast milk, commercially prepared infant formula is:
similar in nutrient content
equivalent to human milk in nutrient content and antibodies
higher in protein and iron but lacks antibodies
lower in protein and iron and lacks antibodies
higher in protein and iron but lacks antibodies
A child has been measured several times before the age of two years. Results of the measurements were not accurate because the child was measured first thing in the morning standing up after breakfast with light clothing
standing up
A single man with two daughters age 10 and 11, is looking for aid. Which program might provide assistance? WIC SNAP Child Care Food Program Headstart
SNAP
The Prader Willi syndrome is associated with: hyperactivity deficiency of glucose-6-phospate macrocytic anemia obesity
obesity
A 2 year old child with iron-deficiency anemia has anorexia, vomiting, weight loss and restlessness. Look for: excessive milk and fruit juice intake excessive vitamin C and D intake asthma and respiratory distress pica and lead poisoning
pica and lead poisoning
The effectiveness of a group education program for decreasing the number of anemic pregnant women enrolled in a community nutrition program is best indicated by:
improved scores on nutrition knowledge posttest
improved scores on a Likert-type attitudinal scale
an increase in hemotocrit or hemoglobin levels
an increase in the intake of dietary iron
an increase in hemotocrit or hemoglobin levels
How long should a new mother breast-feed? at least 6 months at least 12 months until 6 months, then add cow’s milk until 4 months then switch to cow’s milk
at least 12 months
Infants born to mothers with diabetes may be:
larger than normal, and be hypoglycemic shortly after birth
smaller than normal and be hyperglycemic shortly after birth
larger than normal and be hyperglycemic shortly after birth
smaller than normal and be hypoglycemic shortly after birth
larger than normal, and be hypoglycemic shortly after birth
Your client’s pre-pregnancy weight was 150 lbs at 5’6”. She is currently starting her 3rd trimester of pregnancy and weighs 170 lbs. What are your weight gain recommendations for her during her last trimester? 0.5 lb/wk 1 lb/wk 1.5 lb/wk 2 lb/wk
1 lb/wk
In which of the following has the use of medical food supplements shown to minimize weight loss and is associated with fewer radiation treatment interruptions? Pancreatic cancer Head and neck cancer Colon cancer Breast cancer
Head and neck cancer
Which of the following statements is true regarding use of oral vitamin E supplementation in the form of alpha tocopherol in cancer patients?
Vitamin E supplementation may be beneficial in breast cancer patients undergoing radiation to reduce side-effects
Vitamin E should be avoided in breast or head neck cancer due to multiple adverse effects
Vitamin E supplements may reduce the risk of developing a secondary cancer in head and neck cancer patients
Vitamin E can be used to improve treatment outcomes in cancer patients undergoing chemotherapy
Vitamin E should be avoided in breast or head neck cancer due to multiple adverse effects
A newly diagnosed patient with stage II colon cancer is preparing for colorectal surgery for removal of the distal colon. The patient wants to learn about the use of high dose vitamin and mineral supplements to optimize his health for surgical recovery and cancer treatment. What should be advised?
Acknowledge his concern for health and advise to begin a daily multiple vitamin and mineral supplement with antioxidants
Validate his concerns and discuss potential side effects of taking supplements during this phase in cancer treatment
Suggest he try a macrobiotic diet versus taking multiple supplements to optimize his health
Suggest he avoid all processed foods and begin a vegetarian diet to provide vitamin/minerals in their natural state
Validate his concerns and discuss potential side effects of taking supplements during this phase in cancer treatment
A patient undergoing radiation treatment for reoccurrence of stage III mediastinal large cell carcinoma secondary to lung cancer has lost 6 lbs in 2 weeks. He has received 4 weeks of daily radiation with 2 weeks pending. Simultaneously he is receiving 6 rounds of chemotherapy (carboplatin/taxol). Upon assessment the patient’s worse complaint is severe acid reflux impacting his ability to tolerate foods and beverages. He is prescribed PepcidTM twice daily.
Which of the following should the dietitian suggest? [Select all that apply]
Suggest drinking cool medical food supplements throughout the day
Use honey to reduce mucosal irritation and damage associated with reflux
Reinforce the importance of using prescribed acid reducing medications
Suggest small frequent meals and limit acid containing foods and spicy foods
Suggest drinking cool medical food supplements throughout the day
Reinforce the importance of using prescribed acid reducing medications
Suggest small frequent meals and limit acid containing foods and spicy foods
A cancer patient undergoing aggressive chemotherapy is experiencing anorexia and altered taste perception. Which of the following is important to evaluate? Calcium deficiency Magnesium deficiency Zinc deficiency Selenium deficiency
Zinc deficiency
A 45 year old female who is receiving weekly chemotherapy following surgery for breast cancer. Which of the following nutrition recommendations can help control her complaints of nausea after treatment?
Consume clear or ice cold drinks
Eat favorite foods to stimulate intake
Eating larger meals in the middle of the day
Consume adequate fiber intake
Consume clear or ice cold drinks
Which of the following side effects of radiation treatment is most likely to affect a patient’s nutritional status? Alopecia Pneumonia Nausea and vomiting Oral mucositis
Nausea and vomiting
Which of the following meal plans is currently suggested for patients undergoing hematopoietic cell transplant or chemotherapy?
Neutropenic diet avoiding all raw foods
High protein high calorie diet
Macrobiotic diet
Regular diet encouraging low-microbial foods
Regular diet encouraging low-microbial foods
What is the energy and protein requirement for a male patient who is 6’0 and weighs 185 lbs with hematologic malignancy undergoing allogeneic HCT? 2200 kcal; 140 g protein 2500 kcal; 160 g protein 2800 kcal; 180 g protein 3100 kcal; 200 g protein
2800 kcal; 180 g protein
30-35 kcal/kg, 2.2 gm/kg protein