CNSC Practice Questions with Answers (100%)
1. In an intensive care setting, which of the following complications associated
with malnutrition is most likely to occur as a result of the failure to begin
nutrition support early in the treatment regimen-ANSWER- Increased serum
levels of protein-bound drugs
2. Which of the following is the inpatient glycemic target for critically ill pa-
tients?
1: 80-110 mg/dL
2: 140-180 mg/dL
3: 181-210 mg/dL
4: 211-240 mg/dL: 2: 140-180 mg/dL
Targets <110mg/dL are not recommended
3. Under conditions of sepsis and stress, which of the following metabolic
alterations are most likely to occur?
1: Increased glucose production and increased glucose uptake
2: Increased glucose production and decreased glucose uptake
3: Decreased glucose production and decreased glucose uptake
4: Decreased glucose production and increased glucose uptake: 2: Increased
glucose production and decreased glucose uptake
Stress hormones induce insulin resistance and hyperglycemia is commonly ob-
served with nutrition support. It is recommended that glucose levels be adequately
controlled to avoid polyuria and electrolyte disturbances.
4. Which of the following immunomodulating nutrients may be harmful in
patients with severe sepsis?
1: Arginine
2: Selenium
3: Nucleic acids
4: Omega-3 fatty acids: 1: Arginine
,Nitric oxide can be detrimental by leading to coagulation abnormalities and altered
hemodynamic status. In this case, arginine could be considered harmful. Because of
these effects, there is still much debate over the value of arginine in nutrition support
for critically ill patients.
5. Which of the following best describes enteral glutamine supplementation in
the critically ill patient not in multi organ failure?
,1: Enteral glutamine decreases mortality
2: Enteral glutamine decreases ventilator days
3: Enteral glutamine decreases hospital length of stay
4: Enteral glutamine decreases nosocomial infections: 4: Enteral glutamine
decreases nosocomial infections
6. Which of the following are counter-regulatory hormones responsible for the
hypercatabolism observed in critically ill trauma patients?
1: Glycogen, insulin, norepinephrine
2: Glucagon, epinephrine, cortisol
3: Glycerol, serotonin, thymoglobulin
4: Glycerin, leptin, adenosine: 2: Glucagon, epinephrine, cortisol
7. In patients with burns, providing caloric support above energy expenditure
has been found to
1: significantly decrease hospital length of stay.
2: improve wound healing and graft success.
3: decrease fat accumulation and steatosis.
4: have no effect on preservation of lean body mass.: 4: have no effect on
preservation of lean body mass.
Although patients with burns have increased needs, feeding in excess of energy
expenditure may cause hyperglycemia, hepatic steatosis, and prolonged ventilator
dependence. One study of critically ill burn patients showed that caloric delivery
beyond 1.2 x measured resting energy expenditure did not conserve lean body mass
but was associated with increased fat mass accumulation.
8. In pulmonary insufficiency, excessive calorie administration may cause
increased blood pCO2 resulting in
1: metabolic acidosis.
2: metabolic alkalosis.
3: respiratory acidosis.
4: respiratory alkalosis.: 3: respiratory acidosis.
9. Which of the following is true of essential fatty acid deficiency (EFAD) in
patients with cystic fibrosis (CF)?
1: Routine supplementation of omega-3 fatty acids is essential in the manage-
ment of CF
, 2: EFAD usually does not manifest in CF patients until the second decade.
3: CF patients without pancreatic insufficiency rarely develop EFAD
4: EFA profiles have been shown to improve in CF patients after lung trans-
plantation: 4: EFA profiles have been shown to improve in CF patients after lung
transplantation
EFA status is usually evaluated by measuring the triene: tetraene ratio. Although
supplementation with omega 3 fatty acids are sometimes used in the management of
CF, results from clinical trials have shown mixed results and further trials are needed
to determine the efficacy of routine EFA supplementation in the management of CF.
10. Which of the following is the best choice for feeding a pancreatic insuffi-
cient infant with cystic fibrosis?
1: Protein hydrolysate formula with medium chain triglyceride (MCT)
2: Free amino acid formula with MCT
3: Human milk
4: Standard infant formula: Human milk is the optimal choice over standard
formula for any infant due to multiple beneficial components including immunologic
properties, growth factors, and both pre- and probiotics. Human milk or standard
infant formula with appropriate enzyme dosing is recommended. Protein hydrolysate
or free amino acid formulas containing MCT are not indicated for infants with
cystic fibrosis (CF) unless there is another medical reason such as bowel resection
resulting in malabsorption or liver abnormalities.
11. Which of the following blood chemistries will most effectively indicate
the response to the protein component of nutrition support in a patient on
hemodialysis?
1: Albumin
2: Prealbumin
3: Urea nitrogen appearance
4: Normalized protein equivalent of total nitrogen: 4: Normalized protein equiv-
alent of total nitrogen
12. For a patient requiring nutrition support therapy, which of the following
may be necessary for a patient with acute kidney injury (AKI) receiving con-
tinuous renal replacement therapy (CRRT)?
1: Low potassium
2: Increased phosphorus
1. In an intensive care setting, which of the following complications associated
with malnutrition is most likely to occur as a result of the failure to begin
nutrition support early in the treatment regimen-ANSWER- Increased serum
levels of protein-bound drugs
2. Which of the following is the inpatient glycemic target for critically ill pa-
tients?
1: 80-110 mg/dL
2: 140-180 mg/dL
3: 181-210 mg/dL
4: 211-240 mg/dL: 2: 140-180 mg/dL
Targets <110mg/dL are not recommended
3. Under conditions of sepsis and stress, which of the following metabolic
alterations are most likely to occur?
1: Increased glucose production and increased glucose uptake
2: Increased glucose production and decreased glucose uptake
3: Decreased glucose production and decreased glucose uptake
4: Decreased glucose production and increased glucose uptake: 2: Increased
glucose production and decreased glucose uptake
Stress hormones induce insulin resistance and hyperglycemia is commonly ob-
served with nutrition support. It is recommended that glucose levels be adequately
controlled to avoid polyuria and electrolyte disturbances.
4. Which of the following immunomodulating nutrients may be harmful in
patients with severe sepsis?
1: Arginine
2: Selenium
3: Nucleic acids
4: Omega-3 fatty acids: 1: Arginine
,Nitric oxide can be detrimental by leading to coagulation abnormalities and altered
hemodynamic status. In this case, arginine could be considered harmful. Because of
these effects, there is still much debate over the value of arginine in nutrition support
for critically ill patients.
5. Which of the following best describes enteral glutamine supplementation in
the critically ill patient not in multi organ failure?
,1: Enteral glutamine decreases mortality
2: Enteral glutamine decreases ventilator days
3: Enteral glutamine decreases hospital length of stay
4: Enteral glutamine decreases nosocomial infections: 4: Enteral glutamine
decreases nosocomial infections
6. Which of the following are counter-regulatory hormones responsible for the
hypercatabolism observed in critically ill trauma patients?
1: Glycogen, insulin, norepinephrine
2: Glucagon, epinephrine, cortisol
3: Glycerol, serotonin, thymoglobulin
4: Glycerin, leptin, adenosine: 2: Glucagon, epinephrine, cortisol
7. In patients with burns, providing caloric support above energy expenditure
has been found to
1: significantly decrease hospital length of stay.
2: improve wound healing and graft success.
3: decrease fat accumulation and steatosis.
4: have no effect on preservation of lean body mass.: 4: have no effect on
preservation of lean body mass.
Although patients with burns have increased needs, feeding in excess of energy
expenditure may cause hyperglycemia, hepatic steatosis, and prolonged ventilator
dependence. One study of critically ill burn patients showed that caloric delivery
beyond 1.2 x measured resting energy expenditure did not conserve lean body mass
but was associated with increased fat mass accumulation.
8. In pulmonary insufficiency, excessive calorie administration may cause
increased blood pCO2 resulting in
1: metabolic acidosis.
2: metabolic alkalosis.
3: respiratory acidosis.
4: respiratory alkalosis.: 3: respiratory acidosis.
9. Which of the following is true of essential fatty acid deficiency (EFAD) in
patients with cystic fibrosis (CF)?
1: Routine supplementation of omega-3 fatty acids is essential in the manage-
ment of CF
, 2: EFAD usually does not manifest in CF patients until the second decade.
3: CF patients without pancreatic insufficiency rarely develop EFAD
4: EFA profiles have been shown to improve in CF patients after lung trans-
plantation: 4: EFA profiles have been shown to improve in CF patients after lung
transplantation
EFA status is usually evaluated by measuring the triene: tetraene ratio. Although
supplementation with omega 3 fatty acids are sometimes used in the management of
CF, results from clinical trials have shown mixed results and further trials are needed
to determine the efficacy of routine EFA supplementation in the management of CF.
10. Which of the following is the best choice for feeding a pancreatic insuffi-
cient infant with cystic fibrosis?
1: Protein hydrolysate formula with medium chain triglyceride (MCT)
2: Free amino acid formula with MCT
3: Human milk
4: Standard infant formula: Human milk is the optimal choice over standard
formula for any infant due to multiple beneficial components including immunologic
properties, growth factors, and both pre- and probiotics. Human milk or standard
infant formula with appropriate enzyme dosing is recommended. Protein hydrolysate
or free amino acid formulas containing MCT are not indicated for infants with
cystic fibrosis (CF) unless there is another medical reason such as bowel resection
resulting in malabsorption or liver abnormalities.
11. Which of the following blood chemistries will most effectively indicate
the response to the protein component of nutrition support in a patient on
hemodialysis?
1: Albumin
2: Prealbumin
3: Urea nitrogen appearance
4: Normalized protein equivalent of total nitrogen: 4: Normalized protein equiv-
alent of total nitrogen
12. For a patient requiring nutrition support therapy, which of the following
may be necessary for a patient with acute kidney injury (AKI) receiving con-
tinuous renal replacement therapy (CRRT)?
1: Low potassium
2: Increased phosphorus
