CNS Exam: Certified Nutrition Specialist
UPDATED ACTUAL QUESTION AND
ANSWERS
Dumping syndrome is associated with:
A. Osmotic movement of water into the jejunum due to the presence of carbohydrate
B. Reactive hypoglycemia
C. Gastric resection surgery
D. All of the above - CORRECT ANSWER Answer: D - Dumping syndrome is associated
with the movement of water into the jejunum due to the presence of carbohydrate. It often
accompanies gastric resection surgery and leads to diarrhea. Reactive hypoglycemia may result
when carbohydrate in the gut is rapidly digested and absorbed, leading to over-secretion of
insulin.
What do white specs in the nails indicate a deficiency in? - CORRECT ANSWER zinc
Q - Which of the following is a common side effect of immunosuppressive drug therapy used in
organ transplantation?
A. Sodium and fluid diuresis
B. Hyperphosphatemia
C. Hyperkalemia
D. Decreased vitamin C requirements - CORRECT ANSWER Answer: C - Hyperkalemia
(elevated potassium levels) is a common side effect of immunosuppressive drug therapy used in
organ transplantation, as a result of disturbances in renal hormone activity. Sodium and fluid
retention and hypophosphatemia (electrolyte disturbance with abnormally low level of phosphate
in the blood) are also side effects of immunosuppressive drugs.
Q - Which of the following is true for reactive hypoglycemia?
,A. It is defined as a plasma glucose level less than 70 mg/dl.
B. It is treated with a diet high in complex carbohydrates.
C. It is diagnosed by measuring blood glucose levels one hour after eating.
D. Peak insulin activity occurs 90-180 minutes after food is eaten. - CORRECT
ANSWER Answer: D - Initially after eating, blood glucose levels become dangerously
low following a meal. In reactive hypoglycemia peak insulin activity occurs 90-180 minutes after
food is eaten, vs. the normal insulin response which occurs 30-60 minutes after eating. Reactive
hypoglycemia is defined as a plasma glucose level LESS than 50 mg/dl, is treated with a
moderate carbohydrate (40 to 55%) diet, and is diagnosed by measuring blood glucose levels
immediately after eating. Some critical illnesses can cause it--liver and kidney disorders.
Q - Nutrient needs of infants diagnosed with bronchopulmonary dysplasia:
A. Are linked with linear growth
B. May include a resting energy expenditure 50% higher than that of normal infants
C. May include use of diuretics to regulate water balance
D. All of the above - CORRECT ANSWER Answer: D - Nutrient needs of infants
diagnosed with bronchopulmonary disease are linked with linear growth (a measure of lung
development), may include a resting energy expenditure that is 50% higher than that of normal
infants, and may include the use of diuretics to regulate water balance. Bronchopulmonary
disease is a common lung disorder in premature infants which increases energy needs. Diuretics
are often needed to regulate water balance as a result of respiratory compromise.
Q - A food frequency questionnaire differs from a 24-hour recall in what way:
A. A food frequency questionnaire does not inquire about portion sizes.
B. The 24-hour recall asks about typical meal patterns.
C. A food frequency questionnaire allows open-ended responses.
D. A food frequency questionnaire always asks about the same types of foods. - CORRECT
ANSWER Answer: B - A food frequency questionnaire differs from a 24-hour recall
because it does not ask about typical meal patterns. A food frequency questionnaire asks about
intakes of different types of foods and usual portion sizes over time, and does not allow open-
,ended responses. The types of foods asked about on a food frequency questionnaire may be
changed to reflect the population of interest.
Q - Examples of foods avoided on a low-purine diet are:
A. Eggs, cheese, peanut butter
B. Sardines, broth, organ meats
C. Carrots, tomatoes, corn
D. Bread, crackers, cold cereal - CORRECT ANSWER Answer: B - Examples of foods
avoided on a low-purine diet are sardines, broth, and organ meats. These foods are high in purine
and are eliminated in the treatment of gout, caused by high levels of uric acid in the blood.
Purines (chemical compound found in some foods) are broken down into uric acid.
Q - A 25-year old female patient recovering from surgery to correct an intestinal obstruction
needs complete bowel rest which necessitates the use of Total Parenteral Nutrition (TPN). The
patient was 10 pounds underweight prior to surgery and is occasionally febrile. Which of the
following formulations would be most appropriate for this patient?
A. 30 kcals, 1 g protein, 30 ml fluid per kg/body weight;100 mg vitamin C, 5 mg zinc per day
B. 45 kcals, 2 g protein, 35 ml fluid per kg/body weight; 200 mg vitamin C, 6 mg zinc per day
C. 60 kcals, 3 g protein, 40 ml fluid per kg/body weight; 500 mg vitamin C, 10 mg zinc per day
D. None of the above - CORRECT ANSWER Answer: B - The formula which would be
most appropriate for this patient would contain 45 calories, 2 grams of protein, and 35 ml water
per kg of body weight per day, as well as 200 mg of vitamin C and 6 mg of zinc. Starting with an
intermediate level of caloric and protein intake, along with moderate vitamin C and zinc to
promote healing, allows staff to monitor the patient's progress and determine if adjustment in the
formula is needed.
Q - Steatorrhea (FAT IN STOOL) may be caused by:
A. Disruption in the activity of pancreatic enzymes
B. Excessive production of bile salts by the liver
, C. Lack of intrinsic factor
D. Intake of more than 70 grams of fat per day - CORRECT ANSWER Answer: A -
Steatorrhea may be caused by disruption in the activity of pancreatic enzymes that help to digest
fat. It may also be caused by inadequate production of bile salts, which are needed for fat
absorption.
Q - Maple-syrup urine disease (MSUD) is an autosomal (chromosome) recessive disorder in
infants caused by:
A. The inability to metabolize branched-chain amino acids
B. Plasma leucine levels exceeding 10 mg/dl
C. A defect in the gene that controls the activity of alpha-keto acid hydrogenase
D. A & C - CORRECT ANSWER Answer: D - Maple-syrup urine disease (MSUD) in an
autosomal recessive disorder in infants caused by the inability of the body to metabolize the
branched-chain amino acids leucine, isoleucine, and valine. The inability to break down
branched-chain amino acids is due to a mutation in the gene that controls the activity of the
enzyme alpha-keto acid dehyrogenase. Plasma levels of leucine exceeding 10 mg/dl are
associated with the symptoms of MSUD, including lethargy, vomiting, and neurologic changes.
Q - Food intolerance is distinguished from food allergy in what way:
A. Food intolerance is diagnosed by challenge tests.
B. One of the causes of food intolerance is the passage of intact proteins across the
gastrointestinal tract.
C. There is no immunologic reaction with food intolerance.
D. The body uses cellular immunity to combat food intolerance. - CORRECT
ANSWER Answer: C - Food intolerance is distinguished from food allergy by the lack of
immunologic reaction, which involves release of an antibody in response to an antigen (allergen).
Food allergy, not food intolerance, involves the reaction of the body's cellular immune system,
and is often caused by the passage of intact proteins across the GI tract.
Q - Cow's milk is unsuitable for infants less than a year of age due to:
UPDATED ACTUAL QUESTION AND
ANSWERS
Dumping syndrome is associated with:
A. Osmotic movement of water into the jejunum due to the presence of carbohydrate
B. Reactive hypoglycemia
C. Gastric resection surgery
D. All of the above - CORRECT ANSWER Answer: D - Dumping syndrome is associated
with the movement of water into the jejunum due to the presence of carbohydrate. It often
accompanies gastric resection surgery and leads to diarrhea. Reactive hypoglycemia may result
when carbohydrate in the gut is rapidly digested and absorbed, leading to over-secretion of
insulin.
What do white specs in the nails indicate a deficiency in? - CORRECT ANSWER zinc
Q - Which of the following is a common side effect of immunosuppressive drug therapy used in
organ transplantation?
A. Sodium and fluid diuresis
B. Hyperphosphatemia
C. Hyperkalemia
D. Decreased vitamin C requirements - CORRECT ANSWER Answer: C - Hyperkalemia
(elevated potassium levels) is a common side effect of immunosuppressive drug therapy used in
organ transplantation, as a result of disturbances in renal hormone activity. Sodium and fluid
retention and hypophosphatemia (electrolyte disturbance with abnormally low level of phosphate
in the blood) are also side effects of immunosuppressive drugs.
Q - Which of the following is true for reactive hypoglycemia?
,A. It is defined as a plasma glucose level less than 70 mg/dl.
B. It is treated with a diet high in complex carbohydrates.
C. It is diagnosed by measuring blood glucose levels one hour after eating.
D. Peak insulin activity occurs 90-180 minutes after food is eaten. - CORRECT
ANSWER Answer: D - Initially after eating, blood glucose levels become dangerously
low following a meal. In reactive hypoglycemia peak insulin activity occurs 90-180 minutes after
food is eaten, vs. the normal insulin response which occurs 30-60 minutes after eating. Reactive
hypoglycemia is defined as a plasma glucose level LESS than 50 mg/dl, is treated with a
moderate carbohydrate (40 to 55%) diet, and is diagnosed by measuring blood glucose levels
immediately after eating. Some critical illnesses can cause it--liver and kidney disorders.
Q - Nutrient needs of infants diagnosed with bronchopulmonary dysplasia:
A. Are linked with linear growth
B. May include a resting energy expenditure 50% higher than that of normal infants
C. May include use of diuretics to regulate water balance
D. All of the above - CORRECT ANSWER Answer: D - Nutrient needs of infants
diagnosed with bronchopulmonary disease are linked with linear growth (a measure of lung
development), may include a resting energy expenditure that is 50% higher than that of normal
infants, and may include the use of diuretics to regulate water balance. Bronchopulmonary
disease is a common lung disorder in premature infants which increases energy needs. Diuretics
are often needed to regulate water balance as a result of respiratory compromise.
Q - A food frequency questionnaire differs from a 24-hour recall in what way:
A. A food frequency questionnaire does not inquire about portion sizes.
B. The 24-hour recall asks about typical meal patterns.
C. A food frequency questionnaire allows open-ended responses.
D. A food frequency questionnaire always asks about the same types of foods. - CORRECT
ANSWER Answer: B - A food frequency questionnaire differs from a 24-hour recall
because it does not ask about typical meal patterns. A food frequency questionnaire asks about
intakes of different types of foods and usual portion sizes over time, and does not allow open-
,ended responses. The types of foods asked about on a food frequency questionnaire may be
changed to reflect the population of interest.
Q - Examples of foods avoided on a low-purine diet are:
A. Eggs, cheese, peanut butter
B. Sardines, broth, organ meats
C. Carrots, tomatoes, corn
D. Bread, crackers, cold cereal - CORRECT ANSWER Answer: B - Examples of foods
avoided on a low-purine diet are sardines, broth, and organ meats. These foods are high in purine
and are eliminated in the treatment of gout, caused by high levels of uric acid in the blood.
Purines (chemical compound found in some foods) are broken down into uric acid.
Q - A 25-year old female patient recovering from surgery to correct an intestinal obstruction
needs complete bowel rest which necessitates the use of Total Parenteral Nutrition (TPN). The
patient was 10 pounds underweight prior to surgery and is occasionally febrile. Which of the
following formulations would be most appropriate for this patient?
A. 30 kcals, 1 g protein, 30 ml fluid per kg/body weight;100 mg vitamin C, 5 mg zinc per day
B. 45 kcals, 2 g protein, 35 ml fluid per kg/body weight; 200 mg vitamin C, 6 mg zinc per day
C. 60 kcals, 3 g protein, 40 ml fluid per kg/body weight; 500 mg vitamin C, 10 mg zinc per day
D. None of the above - CORRECT ANSWER Answer: B - The formula which would be
most appropriate for this patient would contain 45 calories, 2 grams of protein, and 35 ml water
per kg of body weight per day, as well as 200 mg of vitamin C and 6 mg of zinc. Starting with an
intermediate level of caloric and protein intake, along with moderate vitamin C and zinc to
promote healing, allows staff to monitor the patient's progress and determine if adjustment in the
formula is needed.
Q - Steatorrhea (FAT IN STOOL) may be caused by:
A. Disruption in the activity of pancreatic enzymes
B. Excessive production of bile salts by the liver
, C. Lack of intrinsic factor
D. Intake of more than 70 grams of fat per day - CORRECT ANSWER Answer: A -
Steatorrhea may be caused by disruption in the activity of pancreatic enzymes that help to digest
fat. It may also be caused by inadequate production of bile salts, which are needed for fat
absorption.
Q - Maple-syrup urine disease (MSUD) is an autosomal (chromosome) recessive disorder in
infants caused by:
A. The inability to metabolize branched-chain amino acids
B. Plasma leucine levels exceeding 10 mg/dl
C. A defect in the gene that controls the activity of alpha-keto acid hydrogenase
D. A & C - CORRECT ANSWER Answer: D - Maple-syrup urine disease (MSUD) in an
autosomal recessive disorder in infants caused by the inability of the body to metabolize the
branched-chain amino acids leucine, isoleucine, and valine. The inability to break down
branched-chain amino acids is due to a mutation in the gene that controls the activity of the
enzyme alpha-keto acid dehyrogenase. Plasma levels of leucine exceeding 10 mg/dl are
associated with the symptoms of MSUD, including lethargy, vomiting, and neurologic changes.
Q - Food intolerance is distinguished from food allergy in what way:
A. Food intolerance is diagnosed by challenge tests.
B. One of the causes of food intolerance is the passage of intact proteins across the
gastrointestinal tract.
C. There is no immunologic reaction with food intolerance.
D. The body uses cellular immunity to combat food intolerance. - CORRECT
ANSWER Answer: C - Food intolerance is distinguished from food allergy by the lack of
immunologic reaction, which involves release of an antibody in response to an antigen (allergen).
Food allergy, not food intolerance, involves the reaction of the body's cellular immune system,
and is often caused by the passage of intact proteins across the GI tract.
Q - Cow's milk is unsuitable for infants less than a year of age due to:
