ASPEN Test bank Questions with complete solutions 2023

ASPEN Test bank Questions with complete solutions 2023Medicare 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 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 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 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 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 b. 55 c. 75 d. 95 b. 55 Which of the following amino acids is most crucial in small intestinal structure and function? a. alanine b. leucine c. aspartate d. glutamine d. glutamine What is the primary advantage of a direct percutaneous endoscopic placed jejunal tube (PEJ) versus a percutaneous endoscopic transgastric-placed jejunal tube (PEG-J)? a. reduced difficulty of placement b. reduced incidence of bleeding c. reduced incidence of migration d. reduced incidence of gastric outlet obstruction c. reduced incidence of migration Which of the following complications is most likely to occur when transitioning a critically ill adult patient from parenteral to enteral nutrition? a. hypokalemia b. hyperkalemia c. hypoglycemia d. hyperglycemia d. hyperglycemia Which of the following is the best choice for feeding a pancreatic insufficient infant with cystic fibrosis? a. protein hydrolysate formula with medium chain triglyceride (MCT) b. free amino acid formula with MCT c. human milk d. standard infant formula c. human milk Which of the following is true of aluminum toxicity in patients receiving long-term parenteral nutrition? a. the clinical manifestations of aluminum toxicity are specific and sensitive b. aluminum toxicity is the primary etiology of parenteral nutrition-associated bone disease c. increased risk of aluminum toxicity exists in the setting of renal failure or iron deficiency anemia d. modern manufacturing practices have eliminated the risk of aluminum toxicity c. increased risk of aluminum toxicity exists in the setting of renal failure or iron deficiency anemia Pancreatic enzymes supplemented at high doses in children with cystic fibrosis could result in: a. steatorrhea b. meconium ileus c. fibrosing colonopathy d. cystic fibrosis related diabetes d. fibrosing colonopathy A patient receiving PN has high ileostomy output. Which of the following changes to the PN prescription is most appropriate to recommend? a. increase sodium and increase fluid volume b. decrease water and decrease sodium c. increase sodium and decrease protein d. decrease sodium and increase fluid volume a. increase sodium and increase fluid volume Which of the following patients is at lowest risk of pulmonary injury from small bore feeding tube misplacement? a. a patient status post stroke on the inpatient medical unit b. a patient who is alert and cooperative c. a patient with head and neck trauma admitted to the ICU d. a patient status post Roux-en-Y gastric bypass b. a patient who is alert and cooperative Copper toxicity is associated with: a. liver disease b. kidney disease requiring hemodialysis c. aggressive zinc supplementation d. lung disease a. liver disease A patient with acute kidney injury (AKI) who requires parenteral nutrition support would most likely benefit from a solution containing which of the following? a. essential amino acids only b. essential amino acids with arginine only c. essential amino acids and nonessential amino acids d. essential amino acids and branched-chain amino acids c. essential amino acids and nonessential amino acids Which of the following is NOT a common clinical symptom of celiac disease in childhood? a. failure to thrive b. constipation c. precocious puberty d. anemia c. precocious puberty The presence of which of the following facilitates the absorption of sodium in the lumen of the small intestine? a. glucose b. potassium c. vitamin D d. protein a. glucose