ASPEN Pre course Study Guide Exam
Questions and Verified for Accuracy Answers
2024/2025
Which is considered appropriate management of hypergranulation around the PEG
site?
1: Keeping the area dry2: Using a tube stabilizing device3: Applying an occlusive
dressing4: Cauterization with silver nitrate - correct answer 4
An 82 year old woman s/p CVA with dysphagia and subsequent PEG tube placement
weighing 45kg is initiated on tube feeds which provide 1500kcal and 63gm protein per
liter. The team added a modular protein supplement providing 15gm additional protein
per day. She's discharging to home and will be taken care of by family. During tube
feeding education what is important to discuss with the family to prevent tube feeding
syndrome?
1: The importance of checking weekly weights2: The importance of providing goal
volume of formula each day3: The importance of providing adequate free water each
day4: The importance of ensuring adequate bowel movements - correct answer 3
In critically ill patients receiving early enteral nutrition (EN), which is most likely to
increase success in achieving goal feeding rate?
1: Use of small bowel feeding2: Use of a standard EN feeding protocol3: Use of gastric
feeding4: Use of a volume-based EN feeding protocol - correct answer 4
In the critically ill obese patient, specific guidelines for the provision of calories and
protein have been recommended by both the Society of Critical Care Medicine and the
American Society for Parenteral and Enteral Nutrition. For a patient with a BMI 33.4
kg/m2, which of the following choices best reflects the calorie recommendations for
parenteral and enteral nutrition?
1: 11- 14 Kcal/kg ideal body weight/day2: 11 - 14 Kcal/kg actual body weight/day3: 22 -
25 Kcal/kg actual body weight/day4: 22 - 25 Kcal/kg ideal body weight/day - correct
answer 2
Oxidation of fatty acids for adenosine triphosphate (ATP) production occurs in
,1: cells that contain mitochondria.2: the mitochondria of the adipocyte only.3: the red
blood cells only.4: the blood stream. - correct answer 1
A 68-year-old female with normal liver function and a lactate of 1 mmol/L is in acute
kidney injury status-post colon resection and is receiving PN. She has the following
arterial blood gas (ABG) results: pH=7.31, PCO2=36 mm Hg, and serum
bicarbonate=20 mEq/L. What is the most appropriate PN intervention?
1: Maintain current chloride:acetate ratio2: Increase chloride:acetate ratio3: Decrease
chloride:acetate ratio4: Decrease calorie content of PN - correct answer 3
Which of the following concentrations is considered to be an upper limit for the
osmolality of infant formulas to avoid tolerance issues?
1: 460 mOsm/kg2: 360 mOsm/kg3: 260 mOsm/kg4: 560 mOsm/kg - correct answer 1
A PN-dependent patient with an average daily ileostomy output of 3L presents with
BUN/serum creatinine ratio of 30:1 and mild hyponatremia. What is the most
appropriate PN intervention for this patient?
1: Increase sodium, restrict protein2: Increase sodium, increase fluid3: Increase fluid,
restrict protein4: Decrease sodium, increase fluid - correct answer 2
The initial daily protein requirements for a critically ill trauma patient weighing 70 kg and
having a BMI of 23.4 kg/m2 are
1: 55-70 grams.2: 70-105 grams.3: 105-140 grams.4: 140-175 grams. - correct answer
1.5-2 g/ kg
Which of the following types of feeding delivery methods is most appropriate for patients
with a jejunostomy?
1: Bolus2: Gravity3: Intermittent4: Continuous pump - correct answer 4
What is the recommended daily intake of selenium for term infants receiving parenteral
nutrition?
1: <1 mcg/kg/day2: 2 mcg/kg/day3: 3 - 4 mcg/kg/day4: 5 - 6 mcg/kg/day - correct
answer 2
, The Subjective Global Assessment used to evaluate the nutritional status of patients
includes
1: dietary intake, delayed hypersensitivity skin testing, and weight history.2: weight
history, dietary intake, and gastrointestinal symptoms.3: laboratory indices, weight
history, and gastrointestinal symptoms.4: arm anthropometry, dietary intake, and
laboratory indices. - correct answer 2
The Short-Form Mini-Nutritional Assessment (MNA-SF) was derived from the Mini-
Nutritional Assessment (MNA) in order to
1: adapt the MNA for use in pediatric patients.2: eliminate the need to obtain height and
weight data for nutrition assessment.3: allow patients to generate their own nutrition
assessment with a questionnaire method.4: obtain high diagnostic accuracy for
detecting nutritional problems in older adults with a brief screening tool. - correct
answer 4
Consumption of soluble fiber contributes to
1: lower levels of high density lipoprotein cholesterol.2: lower levels of total and low
density lipoprotein cholesterol.3: lower risk of developing colon cancer.4: increase in
blood glucose concentrations. - correct answer 2
A 14-year-old with a 4-month history of intentional weight loss of 15% of her usual
weight and a BMI less than the 5th percentile is diagnosed with anorexia nervosa. She
is admitted to the hospital for medical stabilization and is unwilling to consume enough
food to meet her nutritional needs. A 24-hour calorie count reveals that the patient is
consuming a very restricted diet averaging 850 calories daily. Which of the following is
the most appropriate nutrition intervention at this time?
1: Peripheral parenteral nutrition2: High calorie diet with a calorie count3: Structured
meal plan with supplemental enteral feedings4: Total parenteral nutrition - correct
answer 3
A respiratory quotient (RQ) of 0.87 most likely suggests
1: primarily fat oxidation.2: mixed substrate utilization.3: primary carbohydrate
oxidation.4: primary protein oxidation. - correct answer 2
Questions and Verified for Accuracy Answers
2024/2025
Which is considered appropriate management of hypergranulation around the PEG
site?
1: Keeping the area dry2: Using a tube stabilizing device3: Applying an occlusive
dressing4: Cauterization with silver nitrate - correct answer 4
An 82 year old woman s/p CVA with dysphagia and subsequent PEG tube placement
weighing 45kg is initiated on tube feeds which provide 1500kcal and 63gm protein per
liter. The team added a modular protein supplement providing 15gm additional protein
per day. She's discharging to home and will be taken care of by family. During tube
feeding education what is important to discuss with the family to prevent tube feeding
syndrome?
1: The importance of checking weekly weights2: The importance of providing goal
volume of formula each day3: The importance of providing adequate free water each
day4: The importance of ensuring adequate bowel movements - correct answer 3
In critically ill patients receiving early enteral nutrition (EN), which is most likely to
increase success in achieving goal feeding rate?
1: Use of small bowel feeding2: Use of a standard EN feeding protocol3: Use of gastric
feeding4: Use of a volume-based EN feeding protocol - correct answer 4
In the critically ill obese patient, specific guidelines for the provision of calories and
protein have been recommended by both the Society of Critical Care Medicine and the
American Society for Parenteral and Enteral Nutrition. For a patient with a BMI 33.4
kg/m2, which of the following choices best reflects the calorie recommendations for
parenteral and enteral nutrition?
1: 11- 14 Kcal/kg ideal body weight/day2: 11 - 14 Kcal/kg actual body weight/day3: 22 -
25 Kcal/kg actual body weight/day4: 22 - 25 Kcal/kg ideal body weight/day - correct
answer 2
Oxidation of fatty acids for adenosine triphosphate (ATP) production occurs in
,1: cells that contain mitochondria.2: the mitochondria of the adipocyte only.3: the red
blood cells only.4: the blood stream. - correct answer 1
A 68-year-old female with normal liver function and a lactate of 1 mmol/L is in acute
kidney injury status-post colon resection and is receiving PN. She has the following
arterial blood gas (ABG) results: pH=7.31, PCO2=36 mm Hg, and serum
bicarbonate=20 mEq/L. What is the most appropriate PN intervention?
1: Maintain current chloride:acetate ratio2: Increase chloride:acetate ratio3: Decrease
chloride:acetate ratio4: Decrease calorie content of PN - correct answer 3
Which of the following concentrations is considered to be an upper limit for the
osmolality of infant formulas to avoid tolerance issues?
1: 460 mOsm/kg2: 360 mOsm/kg3: 260 mOsm/kg4: 560 mOsm/kg - correct answer 1
A PN-dependent patient with an average daily ileostomy output of 3L presents with
BUN/serum creatinine ratio of 30:1 and mild hyponatremia. What is the most
appropriate PN intervention for this patient?
1: Increase sodium, restrict protein2: Increase sodium, increase fluid3: Increase fluid,
restrict protein4: Decrease sodium, increase fluid - correct answer 2
The initial daily protein requirements for a critically ill trauma patient weighing 70 kg and
having a BMI of 23.4 kg/m2 are
1: 55-70 grams.2: 70-105 grams.3: 105-140 grams.4: 140-175 grams. - correct answer
1.5-2 g/ kg
Which of the following types of feeding delivery methods is most appropriate for patients
with a jejunostomy?
1: Bolus2: Gravity3: Intermittent4: Continuous pump - correct answer 4
What is the recommended daily intake of selenium for term infants receiving parenteral
nutrition?
1: <1 mcg/kg/day2: 2 mcg/kg/day3: 3 - 4 mcg/kg/day4: 5 - 6 mcg/kg/day - correct
answer 2
, The Subjective Global Assessment used to evaluate the nutritional status of patients
includes
1: dietary intake, delayed hypersensitivity skin testing, and weight history.2: weight
history, dietary intake, and gastrointestinal symptoms.3: laboratory indices, weight
history, and gastrointestinal symptoms.4: arm anthropometry, dietary intake, and
laboratory indices. - correct answer 2
The Short-Form Mini-Nutritional Assessment (MNA-SF) was derived from the Mini-
Nutritional Assessment (MNA) in order to
1: adapt the MNA for use in pediatric patients.2: eliminate the need to obtain height and
weight data for nutrition assessment.3: allow patients to generate their own nutrition
assessment with a questionnaire method.4: obtain high diagnostic accuracy for
detecting nutritional problems in older adults with a brief screening tool. - correct
answer 4
Consumption of soluble fiber contributes to
1: lower levels of high density lipoprotein cholesterol.2: lower levels of total and low
density lipoprotein cholesterol.3: lower risk of developing colon cancer.4: increase in
blood glucose concentrations. - correct answer 2
A 14-year-old with a 4-month history of intentional weight loss of 15% of her usual
weight and a BMI less than the 5th percentile is diagnosed with anorexia nervosa. She
is admitted to the hospital for medical stabilization and is unwilling to consume enough
food to meet her nutritional needs. A 24-hour calorie count reveals that the patient is
consuming a very restricted diet averaging 850 calories daily. Which of the following is
the most appropriate nutrition intervention at this time?
1: Peripheral parenteral nutrition2: High calorie diet with a calorie count3: Structured
meal plan with supplemental enteral feedings4: Total parenteral nutrition - correct
answer 3
A respiratory quotient (RQ) of 0.87 most likely suggests
1: primarily fat oxidation.2: mixed substrate utilization.3: primary carbohydrate
oxidation.4: primary protein oxidation. - correct answer 2
