RD EXAM PREP-MNT WITH 100%
CORRECT SOLUTIONS
which of the following should NOT be used to assess malnutrition in an iron-deficient
patient AND WHY
a. transferrin
b. shape of the fingernails
c. anthropometrics
d. prealbumin - ANS-transferrin-NOT ACCURATE BC TRANSFERRIN IS ELEVATED
WITH IRON DEFICIENCY ANEMIA DUE TO IT TRYING TO INCREASE THE
TRANSPORT OF FERRITIN (THE STORAGE FORM OF IRON)
a type 1 DM has an A1c of 9.0%. the client should:
a. continue their current level of dm management
b. decrease their CHO intake to prevent hyperglycemia
c. be assessed to determine where changes are needed in insulin, diet, and/or exercise
platforms
d. begin a daily intensive exercise program - ANS-c
a patient is admitted to the hospital after 3 days of vomiting and diarrhea and has lost
4% of his BW. Assessment of lab data would likely show...AND WHY
a. 3.4 albumin and 5 BUN
b. 3.7 albumin and 128 sodium
c. 10.4 ca and 1.9 phos
d. 145 sodium and 32 BUN - ANS-D-BECAUSE ASKING FOR DEHYDRATION AND
WHICH VALUES WOULD INDICATE IT
an elderly patient's labs show a hgb of 10.5 g/dL, MCV of 105 fl, and MCHC of 33 g/dL.
his family reports the patient has also recently had fatigue, irritability and forgetfulness.
the likely cause is
a. alzheimers
b. anemia of chronic disease
c. folic acid deficiency
d. iron deficiency anemia - ANS-folic acid deficiency. NOTICE WITH THIS THAT IF
THIS QUESTION ONLY LISTED SYMPTOMS IT SOUNDS LIKE B12 DEFICIENCY
BUT THAT ISNT LISTED, SO ITS NOT THAT.
,a post surgery pt has been NPO for 10 days due to an ileus. he has been receiving 2L
of 5% dextrose solution per day. his weight has increased from 75 kg to 78 kg and his
albumin is 1.9 g/dL. the pt has developed:
a. marasmus
b. hepatorenal syndrome
c. kwashiorkor
d. iron deficiency anemia - ANS-kwashiorkor-BC CHO ARE PROVIDED BUT PROTEIN
IS NOT, INSULIN IS PRESENT AND IS PREVENTING MUSCLE BREAKDOWN,
CAUSING LOW ALBUMIN INTRACELLULARLY
a pt suspected of having pancreatic lipase insufficiency has a fecal fat test that shows
he had 15g of fat remaining in his feces. what conclusion can be drawn?
a. the pt has pancreatic lipase insufficiency
b. the pt has no fat malabsorption
c. the pt has protein energy malnutrition
d. the test shows an abnormally high amount of fat in the feces, but more disease
specific tests are needed before a dx can be made - ANS-D- BC THE TEST DOES
NOT DETERMINE THE ETIOLOGY OF THE ABNORMALITY
a pt has lung cancer with liver and bone metastases. his albumin is 2.4g/dL and his
serum ca is 10.6 mg. his spouse reports that his appetite has been poor but that he eats
a pint of strawberry ice cream every night. the dietitian should encourage the pt to:
a. stop eating the ice cream to lower serum ca
b. eat a variety of nutrient dense foods as tolerated and not be concerned
c. substitute sherbert for the ice cream
d. continue to eat the ice cream but only 1 day/wk - ANS-b
the preferred method of testing albumin is the... - ANS-BCG (bromocresol) green
method-measures albumin without any pretreatment of samples
a pt in the surgical ICU has abnormal lab values: phos 2.0, K 3, mg .8. the pt's current
nutrition support is hyperalimentation. the most likely dx is... (AND WHY)
a. inadequate energy intake
b. excessive intake from parenteral nutrition
c. inadequate protein intake
d. decreased nutrient needs - ANS-excessive intake from PN- THESE LAB VALUES
ALL INDICATE REFEEDING SYNDROME
which AA is classified as a nonessential AA, which may be essential for the
metabolically stressed patient?
a. tyrosine
,b. arginine
c. leucine
d. lysine - ANS-arginine
A severely malnourished pt gets TPN @ a rate of 125 cc/hr. what could result? AND
WHY/HOW - ANS-hypophosphatemia-ASC WITH REFEEDING SYNDROME; 3
CLASSIC SIGNS OF REFEEDING SYNDROME ARE HYPOKALEMIA,
HYPOPHOSPHATEMIA, HYPOMAGNESEMIA
an elderly male pt is 3 days p/o with a probable ileus. nursing reports faint bowel sounds
and no bowel movement in 48 hours. the recommended route of nutr support is...
a. enteral nutrition
b. PN
c. by mouth
d. provision of oral nutr supplements - ANS-b
a critical care pt has a serum albumin of 2.0 mg/dl with nursing reporting an increased
abdominal girth and edema of the extremities. this patient has...:
a. metabolic water
b. 3rd spacing of fluids
c. insensible water loss
d. dehydration - ANS-3rd spacing of fluids-THE ACCUMULATION OF FLUIDS IN THE
3RD SPACE IS WHAT CAUSES EDEMA
a pt was admitted following a CVA, and the dietitian is informed that a swallowing eval
indicates they have dysphagia. the RDs first step would be to..
a. interview the pt's family to find out if there were previous swallowing difficulties/eating
problems PTA
b. recommend a level 1 pureed dysphagia diet to be advanced as tolerated
c. review the results and reccs of the swallowing eval to determine the degree of
dysphagia present
d. inform the food service staff that the pt will need thickened liquids - ANS-c. review the
results and reccs of the swallowing eval to determine the degree of dysphagia present
a pt has a percutaneous endoscopic G tube placed and will require a general purpose
formula. which formula is most appropriate? AND WHY
a. Jevity 1.2
b. Impact 1.5
c. Glucerna
d. peptamen - ANS-Jevity 1.2- BC ITS THE ONLY ONE LISTED THAT IS A GENERAL
PURPOSE FORMULA, THE OTHERS ARE SPECIALIZED
, metabolic alterations of systemic inflammatory response syndrome (SIRS) or sepsis
include all the following except:
a. hypermetabolism
b. hypoglycemia
c. accelerated lipolysis
d. protein catabolism - ANS-hypoglycemia-USUALLY HYPERGLYCEMIC WITH
INSULIN RESISTANCE
"inflammaging" is a chronic inflammation that accompanies frailty, illness and death. it
may be seen in:
a. terminal cancer pt's
b. preemies
c. malnourished pts
d. elderly - ANS-elderly
a solution or TF is considered isotonic when the osmolality is the same as serum
osmolality (300 mOsm/L). the reason this is important is because...
a. helps maintain fluid balance in the body
b. helps extract sodium from the blood
c. causes edema and 3rd spacing
d. forces water through a semi permeable membrane - ANS-A-DOESNT CHANGE
CONCENTRATION BUT DOES ALLOW WATER TO MOVE FREELY
Diffusion refers to
a. its the same as dehydration
b. it provides 90% of the osmotic pressure in the ECF
c. where particles move from high to low concentrations
d. requires a semi permanent membrane - ANS-where particles move from high to low
concentrations
essential fatty acid deficiency can be prevented in patients on TPN by...
a. adding walnut oil to TPN solution
b. adding 10% lipid emulsion
c. adding coconut oil to TPN solution
d. adding essential fatty acids to the lipid emulsion - ANS-adding 10% lipid emulsion-
ALL LIPID EMULSIONS IN THE US PROVIDE THE NECESSARY EFA'S SO NO
ADDITIONAL FATS NEED TO BE ADDED
which of the following describes an eating behavior found commonly in individuals with
anorexia nervosa?
CORRECT SOLUTIONS
which of the following should NOT be used to assess malnutrition in an iron-deficient
patient AND WHY
a. transferrin
b. shape of the fingernails
c. anthropometrics
d. prealbumin - ANS-transferrin-NOT ACCURATE BC TRANSFERRIN IS ELEVATED
WITH IRON DEFICIENCY ANEMIA DUE TO IT TRYING TO INCREASE THE
TRANSPORT OF FERRITIN (THE STORAGE FORM OF IRON)
a type 1 DM has an A1c of 9.0%. the client should:
a. continue their current level of dm management
b. decrease their CHO intake to prevent hyperglycemia
c. be assessed to determine where changes are needed in insulin, diet, and/or exercise
platforms
d. begin a daily intensive exercise program - ANS-c
a patient is admitted to the hospital after 3 days of vomiting and diarrhea and has lost
4% of his BW. Assessment of lab data would likely show...AND WHY
a. 3.4 albumin and 5 BUN
b. 3.7 albumin and 128 sodium
c. 10.4 ca and 1.9 phos
d. 145 sodium and 32 BUN - ANS-D-BECAUSE ASKING FOR DEHYDRATION AND
WHICH VALUES WOULD INDICATE IT
an elderly patient's labs show a hgb of 10.5 g/dL, MCV of 105 fl, and MCHC of 33 g/dL.
his family reports the patient has also recently had fatigue, irritability and forgetfulness.
the likely cause is
a. alzheimers
b. anemia of chronic disease
c. folic acid deficiency
d. iron deficiency anemia - ANS-folic acid deficiency. NOTICE WITH THIS THAT IF
THIS QUESTION ONLY LISTED SYMPTOMS IT SOUNDS LIKE B12 DEFICIENCY
BUT THAT ISNT LISTED, SO ITS NOT THAT.
,a post surgery pt has been NPO for 10 days due to an ileus. he has been receiving 2L
of 5% dextrose solution per day. his weight has increased from 75 kg to 78 kg and his
albumin is 1.9 g/dL. the pt has developed:
a. marasmus
b. hepatorenal syndrome
c. kwashiorkor
d. iron deficiency anemia - ANS-kwashiorkor-BC CHO ARE PROVIDED BUT PROTEIN
IS NOT, INSULIN IS PRESENT AND IS PREVENTING MUSCLE BREAKDOWN,
CAUSING LOW ALBUMIN INTRACELLULARLY
a pt suspected of having pancreatic lipase insufficiency has a fecal fat test that shows
he had 15g of fat remaining in his feces. what conclusion can be drawn?
a. the pt has pancreatic lipase insufficiency
b. the pt has no fat malabsorption
c. the pt has protein energy malnutrition
d. the test shows an abnormally high amount of fat in the feces, but more disease
specific tests are needed before a dx can be made - ANS-D- BC THE TEST DOES
NOT DETERMINE THE ETIOLOGY OF THE ABNORMALITY
a pt has lung cancer with liver and bone metastases. his albumin is 2.4g/dL and his
serum ca is 10.6 mg. his spouse reports that his appetite has been poor but that he eats
a pint of strawberry ice cream every night. the dietitian should encourage the pt to:
a. stop eating the ice cream to lower serum ca
b. eat a variety of nutrient dense foods as tolerated and not be concerned
c. substitute sherbert for the ice cream
d. continue to eat the ice cream but only 1 day/wk - ANS-b
the preferred method of testing albumin is the... - ANS-BCG (bromocresol) green
method-measures albumin without any pretreatment of samples
a pt in the surgical ICU has abnormal lab values: phos 2.0, K 3, mg .8. the pt's current
nutrition support is hyperalimentation. the most likely dx is... (AND WHY)
a. inadequate energy intake
b. excessive intake from parenteral nutrition
c. inadequate protein intake
d. decreased nutrient needs - ANS-excessive intake from PN- THESE LAB VALUES
ALL INDICATE REFEEDING SYNDROME
which AA is classified as a nonessential AA, which may be essential for the
metabolically stressed patient?
a. tyrosine
,b. arginine
c. leucine
d. lysine - ANS-arginine
A severely malnourished pt gets TPN @ a rate of 125 cc/hr. what could result? AND
WHY/HOW - ANS-hypophosphatemia-ASC WITH REFEEDING SYNDROME; 3
CLASSIC SIGNS OF REFEEDING SYNDROME ARE HYPOKALEMIA,
HYPOPHOSPHATEMIA, HYPOMAGNESEMIA
an elderly male pt is 3 days p/o with a probable ileus. nursing reports faint bowel sounds
and no bowel movement in 48 hours. the recommended route of nutr support is...
a. enteral nutrition
b. PN
c. by mouth
d. provision of oral nutr supplements - ANS-b
a critical care pt has a serum albumin of 2.0 mg/dl with nursing reporting an increased
abdominal girth and edema of the extremities. this patient has...:
a. metabolic water
b. 3rd spacing of fluids
c. insensible water loss
d. dehydration - ANS-3rd spacing of fluids-THE ACCUMULATION OF FLUIDS IN THE
3RD SPACE IS WHAT CAUSES EDEMA
a pt was admitted following a CVA, and the dietitian is informed that a swallowing eval
indicates they have dysphagia. the RDs first step would be to..
a. interview the pt's family to find out if there were previous swallowing difficulties/eating
problems PTA
b. recommend a level 1 pureed dysphagia diet to be advanced as tolerated
c. review the results and reccs of the swallowing eval to determine the degree of
dysphagia present
d. inform the food service staff that the pt will need thickened liquids - ANS-c. review the
results and reccs of the swallowing eval to determine the degree of dysphagia present
a pt has a percutaneous endoscopic G tube placed and will require a general purpose
formula. which formula is most appropriate? AND WHY
a. Jevity 1.2
b. Impact 1.5
c. Glucerna
d. peptamen - ANS-Jevity 1.2- BC ITS THE ONLY ONE LISTED THAT IS A GENERAL
PURPOSE FORMULA, THE OTHERS ARE SPECIALIZED
, metabolic alterations of systemic inflammatory response syndrome (SIRS) or sepsis
include all the following except:
a. hypermetabolism
b. hypoglycemia
c. accelerated lipolysis
d. protein catabolism - ANS-hypoglycemia-USUALLY HYPERGLYCEMIC WITH
INSULIN RESISTANCE
"inflammaging" is a chronic inflammation that accompanies frailty, illness and death. it
may be seen in:
a. terminal cancer pt's
b. preemies
c. malnourished pts
d. elderly - ANS-elderly
a solution or TF is considered isotonic when the osmolality is the same as serum
osmolality (300 mOsm/L). the reason this is important is because...
a. helps maintain fluid balance in the body
b. helps extract sodium from the blood
c. causes edema and 3rd spacing
d. forces water through a semi permeable membrane - ANS-A-DOESNT CHANGE
CONCENTRATION BUT DOES ALLOW WATER TO MOVE FREELY
Diffusion refers to
a. its the same as dehydration
b. it provides 90% of the osmotic pressure in the ECF
c. where particles move from high to low concentrations
d. requires a semi permanent membrane - ANS-where particles move from high to low
concentrations
essential fatty acid deficiency can be prevented in patients on TPN by...
a. adding walnut oil to TPN solution
b. adding 10% lipid emulsion
c. adding coconut oil to TPN solution
d. adding essential fatty acids to the lipid emulsion - ANS-adding 10% lipid emulsion-
ALL LIPID EMULSIONS IN THE US PROVIDE THE NECESSARY EFA'S SO NO
ADDITIONAL FATS NEED TO BE ADDED
which of the following describes an eating behavior found commonly in individuals with
anorexia nervosa?
