Handbook Questions

Question 1

In a patient receiving intravenous fat emulsion, which of the following levels should be
monitored?

1. Serum glucose
2. Serum ammonia
3. Serum cholesterol
4. Serum triglyceride

Answer 1

Serum triglyceride

Question 2

Increased acetate supplementation in parenteral nutrition is most likely to be required in
1. respiratory failure.
2. intractable diarrhea.
3. prolonged vomiting.
4. furosemide treatment.

Answer 2

2. intractable diarrhea.

Question 3

Dermatitis and alopecia are symptoms of
1. hypophosphatemia.
2. magnesium deficiency.
3. vitamin A deficiency.
4. essential fatty acid deficiency.

Answer 3

essential fatty acid deficiency.

Question 4

A 58-year-old patient has acute renal failure following abdominal aortic aneurysm repair. Dialysis
is planned. If the patient’s BUN is 90 mg/dL and creatinine 8 mg/dL, the most appropriate enteral
formula for this patient would provide

1. 0.5 g protein/kg/day mainly as essential amino acids.
2. 1 g protein/kg/day mainly as essential amino acids.
3. 0.5 g protein/kg/day as both essential and nonessential amino acids.
4. 1 g protein/kg/day with both essential and nonessential amino acids.

Answer 4

4. 1 g protein/kg/day with both essential and nonessential amino acids.

Question 5

Complaints of altered taste and smell are common symptoms of deficiency of which trace
element?
1. Zinc
2. Copper
3. Selenium
4. Chromium

Answer 5

1. Zinc

Question 6

Indirect calorimetry provides a measure of
1. basal metabolic rate.
2. past 24-hour dietary intake.
3. energy expenditure.
4. calorie needs for weight gain.

Answer 6

3. energy expenditure.

Question 7

Which of the following is most appropriate during transition from central parenteral nutrition
support to enteral nutrition support?
1. Dextrose should be infused peripherally to avoid hypoglycemia
2. Transition to enteral nutrition should be discontinued if diarrhea develops
3. Some parenteral nutrition should be maintained until the patient has demonstrated
tolerance to enteral nutrition
4. Central venous access should be discontinued as soon as the patient’s nutritional
requirements are met by a combination of enteral and peripheral parenteral support

Answer 7

3. Some parenteral nutrition should be maintained until the patient has demonstrated tolerance to enteral nutrition

Question 8

During parenteral nutrition, the infusion of large amounts of dextrose increases electrolyte
requirements for

1. sodium and potassium.
2. sodium and phosphorus.
3. potassium and chloride.
4. potassium and phosphorus.

Answer 8

4. potassium and phosphorus.

Question 9

Metabolic consequences of the refeeding syndrome include
1. hyperkalemia.
2. hypoglycemia.
3. hypermagnesemia.
4. hypophosphatemia.

Answer 9

4. hypophosphatemia.

Question 10

An 85-year-old man receiving tube feeding due to dysphagia develops increased stooling and has
a temperature of 38.3° C. Which of the following should be done?
1. Obtain stool cultures
2. Decrease water flushes
3. Begin diphenoxylate/atropine
4. Change to a fluid-restricted tube feeding formula

Answer 10

1. Obtain stool cultures

Question 11

Which of the following is a metabolic adaptation to simple starvation?
1. Decrease in urinary nitrogen losses
2. Increase in hepatic glucose production
3. Decrease in utilization of body fat stores
4. Increase in cerebral glucose utilization

Answer 11

1. Decrease in urinary nitrogen losses

Question 12

The small bowel usually has an absorption capacity of approximately
1. 400 mL/day.
2. 1 L/day.
3. 2 L/day.
4. 9 12 L/day.

Answer 12

4. 9 12 L/day.

Question 13

Tunneled IJ line

Answer 13

Needs to be surgically removed

Question 14

Midline

Answer 14

Used for PPN and less than 2 weeks

Question 15

Deficiencies of iron and copper result in what kind of anemia?

Answer 15

Microcytic hypochromic anemia (small red blood cells that are pale in color due to decreased heme pigment).

Question 16

Deficiencies of B12 or Folate result in what kind of anemia?

Answer 16

Deficiencies of B12 or folate result in macrocytic anemia (large red blood cells).