NTR 604 final REAL EXAM QUESTIONS AND
CORRECT ANSWERS 2026 LATEST//ALREADY
GBADED A+ | pdf
Which of the following in excess contributes the most to carbon dioxide
retention?
Calories
👀 Rationale: Total calorie excess (overfeeding) increases CO₂ production
more than any single macronutrient composition, as shown in the Talpers 1992
study.
Several factors can modulate REE. Place the right factors/conditions in the
right category.
Increase REE: stress, burns, inflammation, severe obesity | Decrease REE:
coma, paralysis, underfeeding, hypoventilation
👀 Rationale: Stress, burns, and inflammation elevate metabolism, while
coma, paralysis, and underfeeding reduce metabolic rate.
Patients with the following symptoms should be evaluated for potential
overfeeding and their energy provision reduced
Fluid overload, Liver dysfunction, Azotemia
👀 Rationale: Overfeeding causes hyperglycemia, lipogenesis, liver
dysfunction, azotemia, and fluid overload. These signs indicate the need to
reduce caloric provision.
Which of the following is an ASPEN guideline for Nutrition Support in
patients with pulmonary failure?
Consider hypocaloric PN dosing with adequate protein.
👀 Rationale: ASPEN recommends hypocaloric PN (≤20 kcal/kg/day or ≤80%
,of needs) with adequate protein (≥1.2 g/kg/day) to prevent overfeeding and
preserve lean mass.
For patients in the prone position, the head of bed can be elevated using
the Trendelenburg strategy at 10-20 degrees.
True
👀 Rationale: In ARDS, the Trendelenburg 10-20° strategy allows head
elevation during prone positioning to reduce aspiration risk while maintaining
enteral feeding.
Indirect calorimetry can be used to measure REE in both mechanically
ventilated and spontaneous breathing patients
True
👀 Rationale: Indirect calorimetry can measure REE in ventilated patients via
the ventilator circuit and in spontaneous patients using a canopy or handheld
device.
The physiological range of RQ is ____ to ____
0.67 to 1.3
👀 Rationale: The physiological range of respiratory quotient (RQ) is 0.67-1.3,
reflecting the balance of substrate oxidation (fat → 0.7, CHO → 1.0)
Which of the following is NOT a contraindication for Indirect Calorimetry?
Fluid overload
👀 Rationale: Fluid overload affects body weight estimates but does not
interfere with IC measurement; ECMO, HD, and poor cooperation are true
contraindications.
You have performed an indirect calorimetry study in a patient admitted to
the ICU 3 days ago. The test was valid and shows a measured REE of 2300
kcal. What is the patient's energy requirement?
, 2300 kcal
👀 Rationale: ASPEN recommends feeding to 100% of the measured REE
from IC without adding stress/activity factors; this best reflects true energy
needs.
Which of the following are common factors contributing to malnutrition in
cancer patients?
Inflammation and Depression, Rationale: Inflammation increases metabolic rate
and protein breakdown, while depression reduces appetite and oral intake. Both
are common contributors to cancer-related malnutrition.
Which of the following are common metabolic changes seen in cancer?
Increased protein catabolism, Increased lipolysis and hypertriglyceridemia,
Insulin resistance, Rationale: Cancer promotes protein and fat breakdown while
increasing glucose production and insulin resistance, leading to a catabolic and
hypermetabolic state.
Cancer cachexia is characterized by which of the following?
Weight loss and Muscle wasting, Rationale: Cachexia involves severe loss of fat
and muscle mass despite adequate intake, with increased energy expenditure
and inflammation driving the process.
Weight loss in cancer patients is associated with a lower survival rate.
True, Rationale: Weight and muscle loss are linked with poor treatment
tolerance, reduced immune function, and lower survival rates.
Malnutrition in cancer patients is NOT associated with which of the
following?
Correct Answer: Better tolerance to therapy, Rationale: Malnutrition worsens
outcomes, causing higher infection risk, delayed treatment recovery, and lower
tolerance to therapy.
EC is a 62 YO male with esophageal cancer, odynophagia, and poor intake.
Which suggestion is most appropriate?
CORRECT ANSWERS 2026 LATEST//ALREADY
GBADED A+ | pdf
Which of the following in excess contributes the most to carbon dioxide
retention?
Calories
👀 Rationale: Total calorie excess (overfeeding) increases CO₂ production
more than any single macronutrient composition, as shown in the Talpers 1992
study.
Several factors can modulate REE. Place the right factors/conditions in the
right category.
Increase REE: stress, burns, inflammation, severe obesity | Decrease REE:
coma, paralysis, underfeeding, hypoventilation
👀 Rationale: Stress, burns, and inflammation elevate metabolism, while
coma, paralysis, and underfeeding reduce metabolic rate.
Patients with the following symptoms should be evaluated for potential
overfeeding and their energy provision reduced
Fluid overload, Liver dysfunction, Azotemia
👀 Rationale: Overfeeding causes hyperglycemia, lipogenesis, liver
dysfunction, azotemia, and fluid overload. These signs indicate the need to
reduce caloric provision.
Which of the following is an ASPEN guideline for Nutrition Support in
patients with pulmonary failure?
Consider hypocaloric PN dosing with adequate protein.
👀 Rationale: ASPEN recommends hypocaloric PN (≤20 kcal/kg/day or ≤80%
,of needs) with adequate protein (≥1.2 g/kg/day) to prevent overfeeding and
preserve lean mass.
For patients in the prone position, the head of bed can be elevated using
the Trendelenburg strategy at 10-20 degrees.
True
👀 Rationale: In ARDS, the Trendelenburg 10-20° strategy allows head
elevation during prone positioning to reduce aspiration risk while maintaining
enteral feeding.
Indirect calorimetry can be used to measure REE in both mechanically
ventilated and spontaneous breathing patients
True
👀 Rationale: Indirect calorimetry can measure REE in ventilated patients via
the ventilator circuit and in spontaneous patients using a canopy or handheld
device.
The physiological range of RQ is ____ to ____
0.67 to 1.3
👀 Rationale: The physiological range of respiratory quotient (RQ) is 0.67-1.3,
reflecting the balance of substrate oxidation (fat → 0.7, CHO → 1.0)
Which of the following is NOT a contraindication for Indirect Calorimetry?
Fluid overload
👀 Rationale: Fluid overload affects body weight estimates but does not
interfere with IC measurement; ECMO, HD, and poor cooperation are true
contraindications.
You have performed an indirect calorimetry study in a patient admitted to
the ICU 3 days ago. The test was valid and shows a measured REE of 2300
kcal. What is the patient's energy requirement?
, 2300 kcal
👀 Rationale: ASPEN recommends feeding to 100% of the measured REE
from IC without adding stress/activity factors; this best reflects true energy
needs.
Which of the following are common factors contributing to malnutrition in
cancer patients?
Inflammation and Depression, Rationale: Inflammation increases metabolic rate
and protein breakdown, while depression reduces appetite and oral intake. Both
are common contributors to cancer-related malnutrition.
Which of the following are common metabolic changes seen in cancer?
Increased protein catabolism, Increased lipolysis and hypertriglyceridemia,
Insulin resistance, Rationale: Cancer promotes protein and fat breakdown while
increasing glucose production and insulin resistance, leading to a catabolic and
hypermetabolic state.
Cancer cachexia is characterized by which of the following?
Weight loss and Muscle wasting, Rationale: Cachexia involves severe loss of fat
and muscle mass despite adequate intake, with increased energy expenditure
and inflammation driving the process.
Weight loss in cancer patients is associated with a lower survival rate.
True, Rationale: Weight and muscle loss are linked with poor treatment
tolerance, reduced immune function, and lower survival rates.
Malnutrition in cancer patients is NOT associated with which of the
following?
Correct Answer: Better tolerance to therapy, Rationale: Malnutrition worsens
outcomes, causing higher infection risk, delayed treatment recovery, and lower
tolerance to therapy.
EC is a 62 YO male with esophageal cancer, odynophagia, and poor intake.
Which suggestion is most appropriate?
