EGEL Nutrition Q-Bank: Questions,Answer,
Rationale
Clinical Nutrition & Diet Therapy
,Question 1
A 25-year-old pregnant woman (G1P0) at 28 weeks gestation comes for a nutritional assessment.
Her pre-pregnancy BMI was 22 kg/m². According to the IOM guidelines, what is the recommended
total weight gain for this patient?
A) 5-9 kg
B) 7-11.5 kg
C) 11.5-16 kg
D) 12.5-18 kg
Answer: C) 11.5-16 kg
Rationale: For a woman with a normal pre-pregnancy BMI (18.5-24.9), the Institute of Medicine
recommends a total weight gain of 11.5-16 kg. The weight gain pattern is typically 0.5-2 kg in the
first trimester and approximately 0.4 kg per week thereafter. Different recommendations apply for
underweight, overweight, and obese women.
,Question 2
A patient has just undergone a total gastrectomy for gastric adenocarcinoma. Which vitamin
deficiency is of greatest concern post-surgery and requires mandatory supplementation?
A) Vitamin B6
B) Vitamin C
C) Vitamin B12
D) Vitamin A
Answer: C) Vitamin B12
Rationale: Intrinsic factor, which is produced by the parietal cells in the stomach, is essential for
the absorption of vitamin B12 in the ileum. A total gastrectomy removes these cells, leading to
pernicious anemia if B12 is not supplemented parenterally or sublingually.
Question 3
, A patient is being started on Total Parenteral Nutrition (TPN). One of the main components of the
TPN solution is dextrose. What is a key consideration when administering a high-glucose TPN
solution?
A) It causes a higher incidence of osmotic diarrhea.
B) It can lead to hyperglycemia and increased CO2 production.
C) It has the lowest osmolarity compared to other macronutrients.
D) It is the least efficient source of energy for the body.
Answer: B) It can lead to hyperglycemia and increased CO2 production.
Rationale: High dextrose loads in TPN can cause hyperglycemia and stimulate lipogenesis.
Additionally, the metabolism of glucose produces a high respiratory quotient (RQ), which
increases CO2 production. This can be problematic for patients with respiratory compromise.
Question 4
Rationale
Clinical Nutrition & Diet Therapy
,Question 1
A 25-year-old pregnant woman (G1P0) at 28 weeks gestation comes for a nutritional assessment.
Her pre-pregnancy BMI was 22 kg/m². According to the IOM guidelines, what is the recommended
total weight gain for this patient?
A) 5-9 kg
B) 7-11.5 kg
C) 11.5-16 kg
D) 12.5-18 kg
Answer: C) 11.5-16 kg
Rationale: For a woman with a normal pre-pregnancy BMI (18.5-24.9), the Institute of Medicine
recommends a total weight gain of 11.5-16 kg. The weight gain pattern is typically 0.5-2 kg in the
first trimester and approximately 0.4 kg per week thereafter. Different recommendations apply for
underweight, overweight, and obese women.
,Question 2
A patient has just undergone a total gastrectomy for gastric adenocarcinoma. Which vitamin
deficiency is of greatest concern post-surgery and requires mandatory supplementation?
A) Vitamin B6
B) Vitamin C
C) Vitamin B12
D) Vitamin A
Answer: C) Vitamin B12
Rationale: Intrinsic factor, which is produced by the parietal cells in the stomach, is essential for
the absorption of vitamin B12 in the ileum. A total gastrectomy removes these cells, leading to
pernicious anemia if B12 is not supplemented parenterally or sublingually.
Question 3
, A patient is being started on Total Parenteral Nutrition (TPN). One of the main components of the
TPN solution is dextrose. What is a key consideration when administering a high-glucose TPN
solution?
A) It causes a higher incidence of osmotic diarrhea.
B) It can lead to hyperglycemia and increased CO2 production.
C) It has the lowest osmolarity compared to other macronutrients.
D) It is the least efficient source of energy for the body.
Answer: B) It can lead to hyperglycemia and increased CO2 production.
Rationale: High dextrose loads in TPN can cause hyperglycemia and stimulate lipogenesis.
Additionally, the metabolism of glucose produces a high respiratory quotient (RQ), which
increases CO2 production. This can be problematic for patients with respiratory compromise.
Question 4
