Practice Questions

Question 1

A 55 year old man (H 165cm, 5’9’) weight, 122.5kg (270lb) is admitted with a new diagnosis of cancer. He has lost 6.8kg (15lb) in the last 4 months. Which of the following would be the most appropriate characterization of his nutrition status?

A. Normal, healthy nutrition status
B. Marasmus
C. Acute, disease related malnutrition
D. Chronic, disease related malnutrition

Answer 1

D. Chronic, disease related malnutrition

Question 2

You are working with an interdisciplinary nutrition support team to design a nutrition screening program for your hospital. Which of the following diagnoses should be included as a trigger to identify patients at high risk for nutrition-related complications?

A. Asthma exacerbation
B. Short bowel syndrome
C. New onset seizures
D. Community acquired pneumonia

Answer 2

B. Short bowel syndrome

Question 3

Using his ideal body weight (IBW), how would you characterize the nutrition status of a 65 year old man whose weight is 79.5 kg (175 lb) and height 190.5cm (6’ 3”)?

A. Normal, healthy
B. Mild malnutrition
C. Moderate malnutrition
D. Severe malnutrition

Answer 3

C. Moderate malnutrition

Question 4

A 39 year old woman weights 113.4kg (250lb) and is 165cm (5’5”). Based on BMI, what is the best interpretation of her current nutrition status?

A. Normal, healthy
B. Overweight
C. Moderate obesity
D. Severe or morbid obesity

Answer 4

D. Severe or morbid obesity

Question 5

A patient suffering from severe anorexia/bulimia is to be started on supplemental nutrition via a feeding tube. Which of the following visceral proteins would be the most appropriate to measure the acute response (first 3-4 days) to refeeding in this patient?

A. Serum albumin concentration
B. Serum transferrin concentration
C. Serum prealbumin concentration
D. Serum C reactive protein concentration

Answer 5

C. Serum prealbumin concentration

Question 6

A patient has been on home parenteral nutrition (PN) for 15 years. His PN regimen has always included a standard trace element cocktail (zinc, chromium, copper, manganese and selenium daily). Routine laboratories are within reference ranges, except that his total and direct bilirubin concentrations are moderately elevated. Since his last visit 4 months ago, he has developed a tremor and his wife describes more aggressive behavior. These symptoms are most consistent with which of the following?

A. Chromium deficiency
B. Copper toxicity
C. Manganese toxicity
D. Zinc deficiency

Answer 6

C. Manganese toxicity

Question 7

A patient has an ileostomy after suffering a bowel injury. His daily ostomy output has been high (>2L/day) consistently over the past 3 months. He recently developed alopecia and dermatitis. Which trace element deficiency would best explain his symptoms?

A. Manganese
B. Selenium
C. Copper
D. Zinc

Answer 7

D. Zinc

Question 8

A child with biliary atresia has significant fat malabsorption. On routine laboratory assessment, his serum alkaline phosphatase is elevated, but the other hepatic enzymes are within the reference range. Which of the following laboratory tests should be done to further evaluate the increase in alkaline phosphatase?

A. Serum 25-OH vitamin D
B. Serum vitamin A (retinol)
C. Serum vitamin E
D. Serum prothrombin/international normalized ratio (INR)

Answer 8

A. Serum 25-OH vitamin D

Question 9

Which of the following would be the most appropriate initial calorie recommendation for a man who weights 150kg (330 lb), is 180cm (5’11”) tall and is in the intensive care unit with multiple injuries including head trauma suffered in a motor vehicle crash?

A. 1,100 kcal/day (~4600kJ/day)
B. 2,100 kcal/day (~8800 kJ/day)
C. 3,750 kcal/day (~15,700 kJ/day)
D. 4,500 kcal/day (~18,800kJ/day)

Answer 9

B. 2,100 kcal/day (~8800kJ/day)

Question 10

You are conducting an initial nutrition assessment for a critically ill man (50 years old, weight 134kg (295lb) height 180cm (5’11”) BMI 41kg/m^2 in the surgical/trauma ICU. Which of the following is the most appropriate assessment of this patient’s daily protein requirements during this critical illness?

A. 132 g
B. 188g
C. 225g
D. 335g

Answer 10

B. 188g

Question 11

A 65 year old man (weight 65kg, 143lb), height 180cm 5’11” is in the ICU after suffering several injuries in a motor vehicle accident. He is currently receiving a PN solution which provides 115g of protein/day. A 24 hour urine was collected and sent for UUN. The results are reported as 12.4g N per 24 hour. What is his nitrogen balance?

A. -6
B. +6
C. -2
D. +2

Answer 11

D. +2