Assessment V2 Exam | Questions And
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Question 1
A 45-year-old male with a history of chronic alcoholism presents with
confusion, nystagmus, and ataxia. The clinical team suspects Wernicke-
Korsakoff syndrome. Which of the following coenzymes is deficient in
this patient?
A. Flavin adenine dinucleotide (FAD)
B. Pyridoxal phosphate (PLP)
C. Thiamine pyrophosphate (TPP)
D. Nicotinamide adenine dinucleotide (NAD)
Correct Answer: C
Rationale: Wernicke-Korsakoff syndrome is caused by a severe
deficiency of thiamine (vitamin B1). Thiamine pyrophosphate (TPP) is the
active coenzyme required for critical metabolic pathways, including the
pyruvate dehydrogenase complex and the alpha-ketoglutarate
,dehydrogenase complex. Chronic alcohol use impairs thiamine
absorption and utilization, leading to these classic neurological
symptoms.
Question 2
A registered dietitian is evaluating an 82-year-old resident in a long-term
care facility who has developed a deep Stage 3 pressure injury. Which
structural amino acid is conditionally essential under these metabolic
stress conditions to promote collagen synthesis and wound healing?
A. Arginine
B. Alanine
C. Valine
D. Leucine
Correct Answer: A
Rationale: Arginine is a conditionally essential amino acid. While the
body can typically synthesize it in sufficient quantities under normal
conditions, severe tissue injury, trauma, or major wounds increase the
physiological demand beyond the body's synthetic capacity. Arginine
serves as a precursor to proline, which is vital for collagen synthesis and
tissue repair.
,Question 3
A patient presents with peripheral edema, tachycardia, and
cardiomegaly. The medical history reveals a diet consisting almost
exclusively of polished white rice. Which classical nutritional deficiency
state is demonstrated?
A. Wet beriberi
B. Dry beriberi
C. Pellagra
D. Scurvy
Correct Answer: A
Rationale: Wet beriberi is the cardiovascular manifestation of severe
thiamine (vitamin B1) deficiency, characterized by high-output heart
failure, peripheral vasodilation, and severe edema. Dry beriberi presents
primarily with neurological deficits. Polished rice lacks the thiamine-rich
outer bran layer.
Question 4
An infant is born at 32 weeks of gestation. Due to the immaturity of the
liver and low stores of fat-soluble vitamins, the newborn is at elevated
risk of hemorrhagic disease of the newborn. Which vitamin must be
administered intramuscularly at birth?
, A. Vitamin A
B. Vitamin E
C. Vitamin D
D. Vitamin K
Correct Answer: D
Rationale: Newborns have low tissue stores of vitamin K because
placental transfer is poor and their sterile intestinal tracts lack the
bacteria necessary to synthesize it. Vitamin K is a necessary cofactor for
the gamma-carboxylation of clotting factors II, VII, IX, and X; thus, an
injection is given at birth to prevent hemorrhagic disease.
Question 5
A clinical assessment of an adult patient reveals inflamed, cracked
corners of the mouth (angular cheilosis) and a bright red, painful tongue
(glossitis). A deficiency in which of the following water-soluble vitamins
is most consistent with these physical findings?
A. Vitamin B6
B. Riboflavin (B2)
C. Biotin
D. Vitamin C
Correct Answer: B