CNSC, nutrition assessment questions with correct answers

Copper deficiency is associated with 1: leukocytosis. 2: macrocytic anemia. 3: microcytic hypochromic anemia. 4: erythrocytosis. CORRECT ANSWER 3: microcytic hypochromic anemia. Patients on long-term parenteral nutrition have developed anemia, leukopenia, neutropenia and skeletal abnormalities. Deficiencies of iron or copper result in microcytic hypochromic anemia (small red blood cells that are pale in color due to decreased heme pigment). Deficiencies of B12 or folate result in macrocytic anemia (large red blood cells). Other symptoms of copper deficiency include: sensory ataxia, lower extremity spasticity, parathesis in extremities, leukopenia, neutropenia, hypercholesterolemia, increased erythrocyte turnover, decreased ceruloplasmin and erythrocyte copper/zinc superoxide dismutase (SOD), abnormal EKG patterns, myeloneuropathy. References: McKeever, Liam. "Vitamins and Trace Elements." The ASPEN Adult Nutrition Support Core Curriculum. 3rd ed. Silver Spring: American Society for Parenteral and Enteral Nutrition, 2017. 139-182. A patient receiving PN has high ileostomy output. Which of the following changes to the PN prescription is most appropriate to recommend? 1: increase sodium and increase fluid volume. 2: decrease water and decrease sodium. 3: increase sodium and decrease protein.