ASPEN Practice Test Questions
A seven month-old infant fed reconstituted infant formula and other age-appropriate
complementary foods may be at risk of over-supplementation with which of the
following?
a. Vitamin A
b. Fluoride
c. Vitamin E
d. Iron - ✔️✔️b. Fluoride
Zinc supplementation should be considered for patients:
a. with chronic wounds
b. with unexplained skin rashes and alopecia
c. who are elderly
d. who have below normal zinc levels - ✔️✔️b. with unexplained skin rashes and
alopecia
Which of the following is true concerning manganese and patients on long-term
parenteral nutrition?
a. manganese deficiency occurs in patients on PN for greater than 1 year
b. hypermanganesemia has been reported only in patients with cholestasis
c. manganese in commercial trace element preparations may result in
hypermanganesemia
d. the best indicator of manganese status is serum manganese - ✔️✔️c. manganese
in commercial trace element preparations may result in hypermanganesemia
Medicare approved indications for home parenteral nutrition include which of the
following?
a. supplement to enteral nutrition
b. end-stage renal disease
c. long-term loss of gastrointestinal function
d. delayed gastric emptying - ✔️✔️c. long-term loss of gastrointestinal function
Which of the following are most likely to result in malnutrition of mild to moderate
inflammatory response?
a. anorexia nervosa
b. cancer
c. closed head injury
d. sepsis - ✔️✔️b. cancer
In patients with severe acute pancreatitis enteral nutrition has been documented to
provide the following benefits over parenteral nutrition EXCEPT:
a. decreased infection rate
,b. decreased hospital length of stay
c. decreased pain
d. decreased mortality - ✔️✔️c. decreased pain
Indirect calorimetry calculates:
a. total energy expenditure
b. nitrogen balance
c. heat released from the subject
d. resting energy expenditure - ✔️✔️d. resting energy expenditure
A long term parenteral nutrition patient begins to experience Parkinson-like symptoms.
Which trace element toxicity is most likely to present with these symptoms?
a. manganese
b. copper
c. zinc
d. selenium - ✔️✔️a. manganese
How much fluid per day is required to maintain fluid balance in an average healthy
adult?
a. 10-21 ml/kg/day
b. 25-35 ml/kg/day
c. 45-55 ml/kg/day
d. 60-70 ml/kg/day - ✔️✔️b. 25-35 ml/kg/day
In the first 1-3 months after a bone marrow transplant the nutritional needs of a patient
are best met with:
a. 20-25 kcal/kg daily with >/=1.5 g protein per kg body weight
b. 20-25 kcal/kg daily with 80% of total calories from carbohydrate
c. 30-35 kcal/kg daily with >/=1.5 g protein per kg body weight
d. 30-35 kcal/kg daily with 80% of total calories from carbohydrate - ✔️✔️c. 30-35
kcal/kg daily with >/=1.5 g protein per kg body weight
A patient has an advanced directive stating a desire to forego medical technology,
including nutrition and hydration, in order to prolong life. The patient is now in an
irreversible vegetative state. In deciding whether to continue nutrition and hydration by
medical means, the patient's surrogate decision-maker must:
a. consult with a lawyer regarding physician orders for life-sustaining treatment
b. have a psychiatric evaluation in order to be declared competent to make decisions in
the patient's care
c. honor the patient's expressed wish to withdraw nutrition and hydration by medical
means
d. decide, based upon own values, whether or not to withdraw the patient's nutrition
and hydration by medical means - ✔️✔️c. honor the patient's expressed wish to
withdraw nutrition and hydration by medical means
, A 70 kg adult patient receiving PN providing 3000 kcal/day presents with mild to
moderate elevations of serum aminotransferases and mild elevations of bilirubin and
serum alkaline phosphatase. This patient is most likely exhibiting what type of PN-
associated liver disease?
a. hepatic steatosis
b. cholestasis
c. gallbladder sludging
d. fulminant hepatic failure - ✔️✔️a. hepatic steatosis
Which of the following is NOT appropriate to tell a family regarding nutrition at the end
of life?
a. dying patients rarely feel hungry or thirsty
b. fewer calories are needed at the end of life
c. the experience of eating remains unchanged at the end of life
d. patients should not be made to feel guilty if they do not wish to eat - ✔️✔️c. the
experience of eating remains unchanged at the end of life
Which of the following preterm growth charts allows for comparison for preterm infants
from 22 weeks gestational age up through 10 weeks post term age?
a. Fenton
b. Ehrenkranz
c. Dancis
d. Lubchenco - ✔️✔️a. Fenton
Which of the following is a common clinical sign or symptom seen in a patient with
vitamin D toxicity?
a. hypocalcemia
b. metabolic bone disease
c. soft tissue calcification
d. tetany - ✔️✔️c. soft tissue calcification
A 65 year old female had complications associated with GI surgery, and was admitted
to the intensive care unit with pneumonia and septic shock. After she became
hemodynamically stable, she was started on parenteral nutrition secondary to a
prolonged ileus. Prior to surgery, she was at her ideal weight. Currently her labs include
albumin 2.0 mg/dl and creatinine 1.0 mg/dl. Her urine output is adequate. Which of the
following best estimates her protein needs for initiation of parenteral nutrition therapy?
a. 0.6 grams/kg
b. 0.8 grams/kg
c. 1.5 grams/kg
d. 2.5 grams/kg - ✔️✔️c. 1.5 grams/kg
The risk of metastatic calcification in soft tissues begins to increase when the product of
serum calcium and phosphorus exceeds:
a. 25
A seven month-old infant fed reconstituted infant formula and other age-appropriate
complementary foods may be at risk of over-supplementation with which of the
following?
a. Vitamin A
b. Fluoride
c. Vitamin E
d. Iron - ✔️✔️b. Fluoride
Zinc supplementation should be considered for patients:
a. with chronic wounds
b. with unexplained skin rashes and alopecia
c. who are elderly
d. who have below normal zinc levels - ✔️✔️b. with unexplained skin rashes and
alopecia
Which of the following is true concerning manganese and patients on long-term
parenteral nutrition?
a. manganese deficiency occurs in patients on PN for greater than 1 year
b. hypermanganesemia has been reported only in patients with cholestasis
c. manganese in commercial trace element preparations may result in
hypermanganesemia
d. the best indicator of manganese status is serum manganese - ✔️✔️c. manganese
in commercial trace element preparations may result in hypermanganesemia
Medicare approved indications for home parenteral nutrition include which of the
following?
a. supplement to enteral nutrition
b. end-stage renal disease
c. long-term loss of gastrointestinal function
d. delayed gastric emptying - ✔️✔️c. long-term loss of gastrointestinal function
Which of the following are most likely to result in malnutrition of mild to moderate
inflammatory response?
a. anorexia nervosa
b. cancer
c. closed head injury
d. sepsis - ✔️✔️b. cancer
In patients with severe acute pancreatitis enteral nutrition has been documented to
provide the following benefits over parenteral nutrition EXCEPT:
a. decreased infection rate
,b. decreased hospital length of stay
c. decreased pain
d. decreased mortality - ✔️✔️c. decreased pain
Indirect calorimetry calculates:
a. total energy expenditure
b. nitrogen balance
c. heat released from the subject
d. resting energy expenditure - ✔️✔️d. resting energy expenditure
A long term parenteral nutrition patient begins to experience Parkinson-like symptoms.
Which trace element toxicity is most likely to present with these symptoms?
a. manganese
b. copper
c. zinc
d. selenium - ✔️✔️a. manganese
How much fluid per day is required to maintain fluid balance in an average healthy
adult?
a. 10-21 ml/kg/day
b. 25-35 ml/kg/day
c. 45-55 ml/kg/day
d. 60-70 ml/kg/day - ✔️✔️b. 25-35 ml/kg/day
In the first 1-3 months after a bone marrow transplant the nutritional needs of a patient
are best met with:
a. 20-25 kcal/kg daily with >/=1.5 g protein per kg body weight
b. 20-25 kcal/kg daily with 80% of total calories from carbohydrate
c. 30-35 kcal/kg daily with >/=1.5 g protein per kg body weight
d. 30-35 kcal/kg daily with 80% of total calories from carbohydrate - ✔️✔️c. 30-35
kcal/kg daily with >/=1.5 g protein per kg body weight
A patient has an advanced directive stating a desire to forego medical technology,
including nutrition and hydration, in order to prolong life. The patient is now in an
irreversible vegetative state. In deciding whether to continue nutrition and hydration by
medical means, the patient's surrogate decision-maker must:
a. consult with a lawyer regarding physician orders for life-sustaining treatment
b. have a psychiatric evaluation in order to be declared competent to make decisions in
the patient's care
c. honor the patient's expressed wish to withdraw nutrition and hydration by medical
means
d. decide, based upon own values, whether or not to withdraw the patient's nutrition
and hydration by medical means - ✔️✔️c. honor the patient's expressed wish to
withdraw nutrition and hydration by medical means
, A 70 kg adult patient receiving PN providing 3000 kcal/day presents with mild to
moderate elevations of serum aminotransferases and mild elevations of bilirubin and
serum alkaline phosphatase. This patient is most likely exhibiting what type of PN-
associated liver disease?
a. hepatic steatosis
b. cholestasis
c. gallbladder sludging
d. fulminant hepatic failure - ✔️✔️a. hepatic steatosis
Which of the following is NOT appropriate to tell a family regarding nutrition at the end
of life?
a. dying patients rarely feel hungry or thirsty
b. fewer calories are needed at the end of life
c. the experience of eating remains unchanged at the end of life
d. patients should not be made to feel guilty if they do not wish to eat - ✔️✔️c. the
experience of eating remains unchanged at the end of life
Which of the following preterm growth charts allows for comparison for preterm infants
from 22 weeks gestational age up through 10 weeks post term age?
a. Fenton
b. Ehrenkranz
c. Dancis
d. Lubchenco - ✔️✔️a. Fenton
Which of the following is a common clinical sign or symptom seen in a patient with
vitamin D toxicity?
a. hypocalcemia
b. metabolic bone disease
c. soft tissue calcification
d. tetany - ✔️✔️c. soft tissue calcification
A 65 year old female had complications associated with GI surgery, and was admitted
to the intensive care unit with pneumonia and septic shock. After she became
hemodynamically stable, she was started on parenteral nutrition secondary to a
prolonged ileus. Prior to surgery, she was at her ideal weight. Currently her labs include
albumin 2.0 mg/dl and creatinine 1.0 mg/dl. Her urine output is adequate. Which of the
following best estimates her protein needs for initiation of parenteral nutrition therapy?
a. 0.6 grams/kg
b. 0.8 grams/kg
c. 1.5 grams/kg
d. 2.5 grams/kg - ✔️✔️c. 1.5 grams/kg
The risk of metastatic calcification in soft tissues begins to increase when the product of
serum calcium and phosphorus exceeds:
a. 25
