NTR 604 ASPEN EXAM QUESTIONS
WITH COMPLETE ANSWERS
Which best describes nutrient requirements during acute post transplant phase? -
Answer-Moderate energy high protein.
moderate energy is indicated unless sepsis occurs
What should be apart of the Nutrition Care Plan for a patient during and acute rejection
episode that is being treated with high dose corticosteroids? - Answer-Provide
increased amounts of dietary protein and monitor for signs of hyperglycemia
Corticosteroids accelerate the rate of protein catabolism therefore adequate protein
needs to provided.
What is most strongly correlated with improved mortality in TBI? - Answer-Early
initiation of nutrition
Which mediations are commonly used in TBI and associated with reduction in
measured energy expenditure? - Answer-Propranolol
Pentobarbital
Rocuronium
Metabolic changes during SCIs depend on the level of cord injury and the extent of the
injuries. Which of the following statements is true? - Answer-Energy expenditure
following SCI has been repeatedly reported to be almost 48% lower than following TBI.
Generally 20-23kcal/kg
Modified BMI of 18 to 22 is considered healthy
What is the best currently known nutrition intervention to minimize negative outcomes
associated with sarcopenia - Answer-Protein adequacy is the most important nutrition
related factor in preserving lean body mass
What is a reasonable justification to initiate enteral nutrition in an individual with
advanced dementia? - Answer-A specific and limited goal
What nutrition support intervention has demonstrated the best outcome in frail,
community-dwelling older adults in post operative orthopedic surgery populations? -
Answer-Oral nutritional supplements have demonstrated the best outcome
What is the definition for ANH? - Answer-A medical treatment that allows a person to
refuse nutrient and hydration when he or she is no longer able to consume them by
mouth
, Which core ethical principle is the predominant value in American bioethics? - Answer-
Respect for autonomy: the patient has a right to self-determination in healthy care
decision making
The following statement is true regarding the decision to withdraw or withhold ANH. -
Answer-The term forgoing refers to both withholding and withdrawing ANH.
What would be a reason for not placing al long-term feeding tube in a patient with
advanced dementia. - Answer-The patient's expected survival post feeding tube
placement is less than 30 days
A patient with type 2 diabetes presets with postprandial abdominal pain, nausea, and
vomiting. His diabetes is uncontrolled despite the use of insulin. He also has painful
peripheral neuropathy in his legs as well as diabetic retinopathy. His GI symptoms have
progressed over the past 6 months and he now reports eating very little due to fears his
abdominal pain and vomiting will worsen.
the emesis occurs 30 minutes to 2 hours after eating. A diagnostic upper endoscopy is
normal. Which diagnostic test is the ideal next step in determining the cause of his
symptoms? - Answer-Gastric Emptying Scan- the patient likely has diabetic
gastroparesis.
A 35 year old white women presents in the clinic with diarrhea, weight loss, and
abnormal liver function tests. Her primary care physician also noted the patient was
vitamin D and iron deficient with anemia. The patient has a very pruritic maculopapular
rash with vesicular eruptions on her lower legs. EDG is performed as a mosaic patter
with modularity is noted in the second portion of the duodenum. What is the most likely
cause of her symptoms? - Answer-Celiac Disease
A patient with a history of Crohn's ileitis presents for ongoing care. She is determined to
have failed medical management and undergoes an ileocescetomy. which vitamin is
she most likely going to need to take a a supplement? - Answer-Vitamin B12- the
terminal ileum is one of the most commonly affected sites in Crohn's disease and the
terminal ileum is the primary site of vitamin B12 absorption.
A nutrition support clinician was consulted on the second day of hospitalization about a
patient who presented with severe acute pancreatitis and needed mechanical
ventilation. A CT scan reveals necrosis involving 30% of the pancreatic gland and a
small pseudocyst in the tail of the gland which of the following should the clinician
recommend? - Answer-Place NJ tube and begin enteral tube feeding providing no more
than 10-20ml/hr
Which nutrition regimen is appropriate for a patient with less than 2 Ransom criteria and
APACHE II score of less than 9 (non-severe) who had no pancreatic necrosis on a CT
scan? - Answer-begin volume resuscitation, provide narcotic analgesia, and advance to
oral diet as soon as it is tolerated.
WITH COMPLETE ANSWERS
Which best describes nutrient requirements during acute post transplant phase? -
Answer-Moderate energy high protein.
moderate energy is indicated unless sepsis occurs
What should be apart of the Nutrition Care Plan for a patient during and acute rejection
episode that is being treated with high dose corticosteroids? - Answer-Provide
increased amounts of dietary protein and monitor for signs of hyperglycemia
Corticosteroids accelerate the rate of protein catabolism therefore adequate protein
needs to provided.
What is most strongly correlated with improved mortality in TBI? - Answer-Early
initiation of nutrition
Which mediations are commonly used in TBI and associated with reduction in
measured energy expenditure? - Answer-Propranolol
Pentobarbital
Rocuronium
Metabolic changes during SCIs depend on the level of cord injury and the extent of the
injuries. Which of the following statements is true? - Answer-Energy expenditure
following SCI has been repeatedly reported to be almost 48% lower than following TBI.
Generally 20-23kcal/kg
Modified BMI of 18 to 22 is considered healthy
What is the best currently known nutrition intervention to minimize negative outcomes
associated with sarcopenia - Answer-Protein adequacy is the most important nutrition
related factor in preserving lean body mass
What is a reasonable justification to initiate enteral nutrition in an individual with
advanced dementia? - Answer-A specific and limited goal
What nutrition support intervention has demonstrated the best outcome in frail,
community-dwelling older adults in post operative orthopedic surgery populations? -
Answer-Oral nutritional supplements have demonstrated the best outcome
What is the definition for ANH? - Answer-A medical treatment that allows a person to
refuse nutrient and hydration when he or she is no longer able to consume them by
mouth
, Which core ethical principle is the predominant value in American bioethics? - Answer-
Respect for autonomy: the patient has a right to self-determination in healthy care
decision making
The following statement is true regarding the decision to withdraw or withhold ANH. -
Answer-The term forgoing refers to both withholding and withdrawing ANH.
What would be a reason for not placing al long-term feeding tube in a patient with
advanced dementia. - Answer-The patient's expected survival post feeding tube
placement is less than 30 days
A patient with type 2 diabetes presets with postprandial abdominal pain, nausea, and
vomiting. His diabetes is uncontrolled despite the use of insulin. He also has painful
peripheral neuropathy in his legs as well as diabetic retinopathy. His GI symptoms have
progressed over the past 6 months and he now reports eating very little due to fears his
abdominal pain and vomiting will worsen.
the emesis occurs 30 minutes to 2 hours after eating. A diagnostic upper endoscopy is
normal. Which diagnostic test is the ideal next step in determining the cause of his
symptoms? - Answer-Gastric Emptying Scan- the patient likely has diabetic
gastroparesis.
A 35 year old white women presents in the clinic with diarrhea, weight loss, and
abnormal liver function tests. Her primary care physician also noted the patient was
vitamin D and iron deficient with anemia. The patient has a very pruritic maculopapular
rash with vesicular eruptions on her lower legs. EDG is performed as a mosaic patter
with modularity is noted in the second portion of the duodenum. What is the most likely
cause of her symptoms? - Answer-Celiac Disease
A patient with a history of Crohn's ileitis presents for ongoing care. She is determined to
have failed medical management and undergoes an ileocescetomy. which vitamin is
she most likely going to need to take a a supplement? - Answer-Vitamin B12- the
terminal ileum is one of the most commonly affected sites in Crohn's disease and the
terminal ileum is the primary site of vitamin B12 absorption.
A nutrition support clinician was consulted on the second day of hospitalization about a
patient who presented with severe acute pancreatitis and needed mechanical
ventilation. A CT scan reveals necrosis involving 30% of the pancreatic gland and a
small pseudocyst in the tail of the gland which of the following should the clinician
recommend? - Answer-Place NJ tube and begin enteral tube feeding providing no more
than 10-20ml/hr
Which nutrition regimen is appropriate for a patient with less than 2 Ransom criteria and
APACHE II score of less than 9 (non-severe) who had no pancreatic necrosis on a CT
scan? - Answer-begin volume resuscitation, provide narcotic analgesia, and advance to
oral diet as soon as it is tolerated.
