CERTIFIED NUTRITION SPECIALIST
FINAL PREPARATION 2026
COMPREHENSIVE REVIEW GUIDE
◉ What do white specs in the nails indicate a deficiency in?.
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.
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..
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.
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..
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.
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.
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
FINAL PREPARATION 2026
COMPREHENSIVE REVIEW GUIDE
◉ What do white specs in the nails indicate a deficiency in?.
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.
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..
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.
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..
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.
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.
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
