which of the following should NOT be used to assess malnutrition in an iron-deficient patient AND WHY
a. transferrin
b. shape of the fingernails
c. anthropometrics
d. prealbumin - Answer -transferrin-NOT ACCURATE BC TRANSFERRIN IS ELEVATED WITH IRON
DEFICIENCY ANEMIA DUE TO IT TRYING TO INCREASE THE TRANSPORT OF FERRITIN (THE STORAGE
FORM OF IRON)
a type 1 DM has an A1c of 9.0%. the client should:
a. continue their current level of dm management
b. decrease their CHO intake to prevent hyperglycemia
c. be assessed to determine where changes are needed in insulin, diet, and/or exercise platforms
d. begin a daily intensive exercise program - Answer -c
a patient is admitted to the hospital after 3 days of vomiting and diarrhea and has lost 4% of his BW.
Assessment of lab data would likely show...AND WHY
a. 3.4 albumin and 5 BUN
b. 3.7 albumin and 128 sodium
c. 10.4 ca and 1.9 phos
d. 145 sodium and 32 BUN - Answer -D-BECAUSE ASKING FOR DEHYDRATION AND WHICH VALUES
WOULD INDICATE IT
an elderly patient's labs show a hgb of 10.5 g/dL, MCV of 105 fl, and MCHC of 33 g/dL. his family reports
the patient has also recently had fatigue, irritability and forgetfulness. the likely cause is
a. alzheimers
b. anemia of chronic disease
,c. folic acid deficiency
d. iron deficiency anemia - Answer -folic acid deficiency. NOTICE WITH THIS THAT IF THIS QUESTION
ONLY LISTED SYMPTOMS IT SOUNDS LIKE B12 DEFICIENCY BUT THAT ISNT LISTED, SO ITS NOT THAT.
a post surgery pt has been NPO for 10 days due to an ileus. he has been receiving 2L of 5% dextrose
solution per day. his weight has increased from 75 kg to 78 kg and his albumin is 1.9 g/dL. the pt has
developed:
a. marasmus
b. hepatorenal syndrome
c. kwashiorkor
d. iron deficiency anemia - Answer -kwashiorkor-BC CHO ARE PROVIDED BUT PROTEIN IS NOT, INSULIN IS
PRESENT AND IS PREVENTING MUSCLE BREAKDOWN, CAUSING LOW ALBUMIN INTRACELLULARLY
a pt suspected of having pancreatic lipase insufficiency has a fecal fat test that shows he had 15g of fat
remaining in his feces. what conclusion can be drawn?
a. the pt has pancreatic lipase insufficiency
b. the pt has no fat malabsorption
c. the pt has protein energy malnutrition
d. the test shows an abnormally high amount of fat in the feces, but more disease specific tests are
needed before a dx can be made - Answer -D- BC THE TEST DOES NOT DETERMINE THE ETIOLOGY OF
THE ABNORMALITY
a pt has lung cancer with liver and bone metastases. his albumin is 2.4g/dL and his serum ca is 10.6 mg.
his spouse reports that his appetite has been poor but that he eats a pint of strawberry ice cream every
night. the dietitian should encourage the pt to:
a. stop eating the ice cream to lower serum ca
b. eat a variety of nutrient dense foods as tolerated and not be concerned
c. substitute sherbert for the ice cream
d. continue to eat the ice cream but only 1 day/wk - Answer -b
,the preferred method of testing albumin is the... - Answer -BCG (bromocresol) green method-measures
albumin without any pretreatment of samples
a pt in the surgical ICU has abnormal lab values: phos 2.0, K 3, mg .8. the pt's current nutrition support is
hyperalimentation. the most likely dx is... (AND WHY)
a. inadequate energy intake
b. excessive intake from parenteral nutrition
c. inadequate protein intake
d. decreased nutrient needs - Answer -excessive intake from PN- THESE LAB VALUES ALL INDICATE
REFEEDING SYNDROME
which AA is classified as a nonessential AA, which may be essential for the metabolically stressed
patient?
a. tyrosine
b. arginine
c. leucine
d. lysine - Answer -arginine
A severely malnourished pt gets TPN @ a rate of 125 cc/hr. what could result? AND WHY/HOW - Answer
-hypophosphatemia-ASC WITH REFEEDING SYNDROME; 3 CLASSIC SIGNS OF REFEEDING SYNDROME ARE
HYPOKALEMIA, HYPOPHOSPHATEMIA, HYPOMAGNESEMIA
an elderly male pt is 3 days p/o with a probable ileus. nursing reports faint bowel sounds and no bowel
movement in 48 hours. the recommended route of nutr support is...
a. enteral nutrition
b. PN
c. by mouth
d. provision of oral nutr supplements - Answer -b
a critical care pt has a serum albumin of 2.0 mg/dl with nursing reporting an increased abdominal girth
and edema of the extremities. this patient has...:
, a. metabolic water
b. 3rd spacing of fluids
c. insensible water loss
d. dehydration - Answer -3rd spacing of fluids-THE ACCUMULATION OF FLUIDS IN THE 3RD SPACE IS
WHAT CAUSES EDEMA
a pt was admitted following a CVA, and the dietitian is informed that a swallowing eval indicates they
have dysphagia. the RDs first step would be to..
a. interview the pt's family to find out if there were previous swallowing difficulties/eating problems PTA
b. recommend a level 1 pureed dysphagia diet to be advanced as tolerated
c. review the results and reccs of the swallowing eval to determine the degree of dysphagia present
d. inform the food service staff that the pt will need thickened liquids - Answer -c. review the results and
reccs of the swallowing eval to determine the degree of dysphagia present
a pt has a percutaneous endoscopic G tube placed and will require a general purpose formula. which
formula is most appropriate? AND WHY
a. Jevity 1.2
b. Impact 1.5
c. Glucerna
d. peptamen - Answer -Jevity 1.2- BC ITS THE ONLY ONE LISTED THAT IS A GENERAL PURPOSE FORMULA,
THE OTHERS ARE SPECIALIZED
metabolic alterations of systemic inflammatory response syndrome (SIRS) or sepsis include all the
following except:
a. hypermetabolism
b. hypoglycemia
c. accelerated lipolysis