CNSC PRACTICE QUESTIONS AND
CORRECT VERIFIED ANSWERS
InA2anA2intensiveA2careA2setting,A2whichA2ofA2theA2followingA2complicationsA2associatedA2
withA2malnutritionA2isA2mostA2likelyA2toA2occurA2asA2aA2resultA2ofA2theA2failureA2toA2beginA2n
utritionA2supportA2earlyA2inA2theA2treatmentA2regimen?A2-A2Ans--
A2IncreasedA2serumA2levelsA2ofA2protein-boundA2drugs
WhichA2ofA2theA2followingA2isA2theA2inpatientA2glycemicA2targetA2forA2criticallyA2illA2patients
?A2
1:A280-110A2mg/dL
A22:A2140-180A2mg/dL
A23:A2181-210A2mg/dL
A24:A2211-240A2mg/dLA2-A2Ans--A22:A2140-180A2mg/dL
TargetsA2<110mg/dLA2areA2notA2recommended
UnderA2conditionsA2ofA2sepsisA2andA2stress,A2whichA2ofA2theA2followingA2metabolicA2altera
tionsA2areA2mostA2likelyA2toA2occur?A2
1:A2IncreasedA2glucoseA2productionA2andA2increasedA2glucoseA2uptake
2:A2IncreasedA2glucoseA2productionA2andA2decreasedA2glucoseA2uptake
3:A2DecreasedA2glucoseA2productionA2andA2decreasedA2glucoseA2uptake
4:A2DecreasedA2glucoseA2productionA2andA2increasedA2glucoseA2uptakeA2-A2Ans--
A22:A2IncreasedA2glucoseA2productionA2andA2decreasedA2glucoseA2uptake
StressA2hormonesA2induceA2insulinA2resistanceA2andA2hyperglycemiaA2isA2commonlyA2ob
servedA2withA2nutritionA2support.A2ItA2isA2recommendedA2thatA2glucoseA2levelsA2beA2adeq
uatelyA2controlledA2toA2avoidA2polyuriaA2andA2electrolyteA2disturbances.
WhichA2ofA2theA2followingA2immunomodulatingA2nutrientsA2mayA2beA2harmfulA2inA2patients
A2withA2severeA2sepsis?A2
1:A2Arginine
2:A2Selenium
3:A2NucleicA2acids
4:A2Omega-3A2fattyA2acidsA2-A2Ans--A21:A2Arginine
NitricA2oxideA2canA2beA2detrimentalA2byA2leadingA2toA2coagulationA2abnormalitiesA2andA2al
teredA2hemodynamicA2status.A2InA2thisA2case,A2arginineA2couldA2beA2consideredA2harmful.
A2BecauseA2ofA2theseA2effects,A2thereA2isA2stillA2muchA2debateA2overA2theA2valueA2ofA2argi
nineA2inA2nutritionA2supportA2forA2criticallyA2illA2patients.
,WhichA2ofA2theA2followingA2bestA2describesA2enteralA2glutamineA2supplementationA2inA2th
eA2criticallyA2illA2patientA2notA2inA2multiA2organA2failure?A2
1:A2EnteralA2glutamineA2decreasesA2mortality
2:A2EnteralA2glutamineA2decreasesA2ventilatorA2days
3:A2EnteralA2glutamineA2decreasesA2hospitalA2lengthA2ofA2stay
4:A2EnteralA2glutamineA2decreasesA2nosocomialA2infectionsA2-A2Ans--
A24:A2EnteralA2glutamineA2decreasesA2nosocomialA2infections
WhichA2ofA2theA2followingA2areA2counter-
regulatoryA2hormonesA2responsibleA2forA2theA2hypercatabolismA2observedA2inA2criticallyA2i
llA2traumaA2patients?A2
1:A2Glycogen,A2insulin,A2norepinephrine
A22:A2Glucagon,A2epinephrine,A2cortisol
A23:A2Glycerol,A2serotonin,A2thymoglobulin
A24:A2Glycerin,A2leptin,A2adenosineA2-A2Ans--A22:A2Glucagon,A2epinephrine,A2cortisol
InA2patientsA2withA2burns,A2providingA2caloricA2supportA2aboveA2energyA2expenditureA2has
A2beenA2foundA2toA2
1:A2significantlyA2decreaseA2hospitalA2lengthA2ofA2stay.
2:A2improveA2woundA2healingA2andA2graftA2success.
3:A2decreaseA2fatA2accumulationA2andA2steatosis.
4:A2haveA2noA2effectA2onA2preservationA2ofA2leanA2bodyA2mass.A2-A2Ans--
A24:A2haveA2noA2effectA2onA2preservationA2ofA2leanA2bodyA2mass.
AlthoughA2patientsA2withA2burnsA2haveA2increasedA2needs,A2feedingA2inA2excessA2ofA2ene
rgyA2expenditureA2mayA2causeA2hyperglycemia,A2hepaticA2steatosis,A2andA2prolongedA2ve
ntilatorA2dependence.A2OneA2studyA2ofA2criticallyA2illA2burnA2patientsA2showedA2thatA2calori
cA2deliveryA2beyondA21.2A2xA2measuredA2restingA2energyA2expenditureA2didA2notA2conserv
eA2leanA2bodyA2massA2butA2wasA2associatedA2withA2increasedA2fatA2massA2accumulation.
InA2pulmonaryA2insufficiency,A2excessiveA2calorieA2administrationA2mayA2causeA2increase
dA2bloodA2pCO2A2resultingA2inA2
1:A2metabolicA2acidosis.
A22:A2metabolicA2alkalosis.
A23:A2respiratoryA2acidosis.
A24:A2respiratoryA2alkalosis.A2-A2Ans--A23:A2respiratoryA2acidosis.
WhichA2ofA2theA2followingA2isA2trueA2ofA2essentialA2fattyA2acidA2deficiencyA2(EFAD)A2inA2pa
tientsA2withA2cysticA2fibrosisA2(CF)?A2
1:A2RoutineA2supplementationA2ofA2omega-
3A2fattyA2acidsA2isA2essentialA2inA2theA2managementA2ofA2CF
,2:A2EFADA2usuallyA2doesA2notA2manifestA2inA2CFA2patientsA2untilA2theA2secondA2decade.
3:A2CFA2patientsA2withoutA2pancreaticA2insufficiencyA2rarelyA2developA2EFAD
4:A2EFAA2profilesA2haveA2beenA2shownA2toA2improveA2inA2CFA2patientsA2afterA2lungA2trans
plantationA2-A2Ans--
A24:A2EFAA2profilesA2haveA2beenA2shownA2toA2improveA2inA2CFA2patientsA2afterA2lungA2tran
splantation
EFAA2statusA2isA2usuallyA2evaluatedA2byA2measuringA2theA2triene:A2tetraeneA2ratio.A2Altho
ughA2supplementationA2withA2omegaA23A2fattyA2acidsA2areA2sometimesA2usedA2inA2theA2m
anagementA2ofA2CF,A2resultsA2fromA2clinicalA2trialsA2haveA2shownA2mixedA2resultsA2andA2f
urtherA2trialsA2areA2neededA2toA2determineA2theA2efficacyA2ofA2routineA2EFAA2supplementa
tionA2inA2theA2managementA2ofA2CF.
WhichA2ofA2theA2followingA2isA2theA2bestA2choiceA2forA2feedingA2aA2pancreaticA2insufficient
A2infantA2withA2cysticA2fibrosis?A2
1:A2ProteinA2hydrolysateA2formulaA2withA2mediumA2chainA2triglycerideA2(MCT)
A22:A2FreeA2aminoA2acidA2formulaA2withA2MCT
A23:A2HumanA2milk
A24:A2StandardA2infantA2formulaA2-A2Ans--
A2HumanA2milkA2isA2theA2optimalA2choiceA2overA2standardA2formulaA2forA2anyA2infantA2dueA
2toA2multipleA2beneficialA2componentsA2includingA2immunologicA2properties,A2growthA2fact
ors,A2andA2bothA2pre-
A2andA2probiotics.A2HumanA2milkA2orA2standardA2infantA2formulaA2withA2appropriateA2enzy
meA2dosingA2isA2recommended.A2ProteinA2hydrolysateA2orA2freeA2aminoA2acidA2formulasA2
containingA2MCTA2areA2notA2indicatedA2forA2infantsA2withA2cysticA2fibrosisA2(CF)A2unlessA2t
hereA2isA2anotherA2medicalA2reasonA2suchA2asA2bowelA2resectionA2resultingA2inA2malabsor
ptionA2orA2liverA2abnormalities.
WhichA2ofA2theA2followingA2bloodA2chemistriesA2willA2mostA2effectivelyA2indicateA2theA2res
ponseA2toA2theA2proteinA2componentA2ofA2nutritionA2supportA2inA2aA2patientA2onA2hemodial
ysis?A2
1:A2Albumin
2:A2Prealbumin
3:A2UreaA2nitrogenA2appearance
4:A2NormalizedA2proteinA2equivalentA2ofA2totalA2nitrogenA2-A2Ans--
A24:A2NormalizedA2proteinA2equivalentA2ofA2totalA2nitrogen
ForA2aA2patientA2requiringA2nutritionA2supportA2therapy,A2whichA2ofA2theA2followingA2mayA2
beA2necessaryA2forA2aA2patientA2withA2acuteA2kidneyA2injuryA2(AKI)A2receivingA2continuous
A2renalA2replacementA2therapyA2(CRRT)?A2
1:A2LowA2potassium
2:A2IncreasedA2phosphorus
, 3:A2LowA2protein
4:A2IncreasedA2fluidA2-A2Ans--A24:A2IncreasedA2fluid
AA2nutritionA2supportA2regimenA2needA2notA2beA2restrictedA2inA2fluidA2forA2patientsA2receivi
ngA2CRRT.A2However,A2increasedA2fluidA2provisionA2fromA2nutritionA2supportA2isA2notA2ne
cessary.
ForA2acuteA2renalA2failureA2patientsA2requiringA2parenteralA2nutritionA2support,A2recomme
ndationsA2includeA2
1:A2balancedA2mixtureA2ofA2essentialA2(EAA)A2andA2non-
essentialA2aminoA2acidsA2(NEAA).
2:A2essentialA2aminoA2acidsA2(EAA)A2plusA2dextrose.
3:A2non-essentialA2aminoA2acidsA2(NEAA).
4:A2dextroseA2alone,A2noA2aminoA2acids.A2-A2Ans--
A21:A2balancedA2mixtureA2ofA2essentialA2(EAA)A2andA2non-
essentialA2aminoA2acidsA2(NEAA).
WhatA2isA2theA2glomerularA2filtrationA2rateA2(GFR)A2ofA2aA2patientA2withA2end-
stageA2renalA2disease?A2
1:A2>90A2mL/min/1.73A2M2
2:A230-59A2mL/min/1.73A2M2
3:A215-29A2mL/min/1.73A2M2
4:A2<15A2mL/min/1.73A2M2A2-A2Ans--A24:A2<15A2mL/min/1.73A2M2
IncreasedA2mortalityA2inA2maintenanceA2hemodialysisA2patientsA2hasA2beenA2associatedA2
withA2
1:A2lowA2baselineA2bodyA2fatA2percentageA2andA2lowA2muscleA2mass.
2:A2elevatedA2albuminA2andA2decreasedA2CRPA2values.
3:A2increasedA2bodyA2massA2index.
4:A2decreasedA2serumA2cholesterol.A2-A2Ans--
A21:A2lowA2baselineA2bodyA2fatA2percentageA2andA2lowA2muscleA2mass.
AA2BMIA2betweenA230A2Kg/m^2A2andA234.9A2Kg/
m^2A2asA2demonstratedA2byA2DialysisA2OutcomesA2andA2PracticeA2PatternsA2StudyA2isA2c
onsideredA2protectiveA2inA2dialysisA2patients.A2AA2BMIA2ofA2lessA2thanA225A2Kg/
m^2A2isA2notA2consideredA2beneficialA2forA2patientsA2onA2HD.
WhichA2ofA2theA2followingA2hasA2NOTA2beenA2shownA2toA2delayA2weaningA2fromA2mechan
icalA2ventilationA2inA2patientsA2withA2chronicA2obstructiveA2pulmonaryA2diseaseA2whoA2are
A2receivingA2enteralA2nutrition?A2
1:A2RefeedingA2syndrome
2:A2TubeA2feedingA2syndrome
CORRECT VERIFIED ANSWERS
InA2anA2intensiveA2careA2setting,A2whichA2ofA2theA2followingA2complicationsA2associatedA2
withA2malnutritionA2isA2mostA2likelyA2toA2occurA2asA2aA2resultA2ofA2theA2failureA2toA2beginA2n
utritionA2supportA2earlyA2inA2theA2treatmentA2regimen?A2-A2Ans--
A2IncreasedA2serumA2levelsA2ofA2protein-boundA2drugs
WhichA2ofA2theA2followingA2isA2theA2inpatientA2glycemicA2targetA2forA2criticallyA2illA2patients
?A2
1:A280-110A2mg/dL
A22:A2140-180A2mg/dL
A23:A2181-210A2mg/dL
A24:A2211-240A2mg/dLA2-A2Ans--A22:A2140-180A2mg/dL
TargetsA2<110mg/dLA2areA2notA2recommended
UnderA2conditionsA2ofA2sepsisA2andA2stress,A2whichA2ofA2theA2followingA2metabolicA2altera
tionsA2areA2mostA2likelyA2toA2occur?A2
1:A2IncreasedA2glucoseA2productionA2andA2increasedA2glucoseA2uptake
2:A2IncreasedA2glucoseA2productionA2andA2decreasedA2glucoseA2uptake
3:A2DecreasedA2glucoseA2productionA2andA2decreasedA2glucoseA2uptake
4:A2DecreasedA2glucoseA2productionA2andA2increasedA2glucoseA2uptakeA2-A2Ans--
A22:A2IncreasedA2glucoseA2productionA2andA2decreasedA2glucoseA2uptake
StressA2hormonesA2induceA2insulinA2resistanceA2andA2hyperglycemiaA2isA2commonlyA2ob
servedA2withA2nutritionA2support.A2ItA2isA2recommendedA2thatA2glucoseA2levelsA2beA2adeq
uatelyA2controlledA2toA2avoidA2polyuriaA2andA2electrolyteA2disturbances.
WhichA2ofA2theA2followingA2immunomodulatingA2nutrientsA2mayA2beA2harmfulA2inA2patients
A2withA2severeA2sepsis?A2
1:A2Arginine
2:A2Selenium
3:A2NucleicA2acids
4:A2Omega-3A2fattyA2acidsA2-A2Ans--A21:A2Arginine
NitricA2oxideA2canA2beA2detrimentalA2byA2leadingA2toA2coagulationA2abnormalitiesA2andA2al
teredA2hemodynamicA2status.A2InA2thisA2case,A2arginineA2couldA2beA2consideredA2harmful.
A2BecauseA2ofA2theseA2effects,A2thereA2isA2stillA2muchA2debateA2overA2theA2valueA2ofA2argi
nineA2inA2nutritionA2supportA2forA2criticallyA2illA2patients.
,WhichA2ofA2theA2followingA2bestA2describesA2enteralA2glutamineA2supplementationA2inA2th
eA2criticallyA2illA2patientA2notA2inA2multiA2organA2failure?A2
1:A2EnteralA2glutamineA2decreasesA2mortality
2:A2EnteralA2glutamineA2decreasesA2ventilatorA2days
3:A2EnteralA2glutamineA2decreasesA2hospitalA2lengthA2ofA2stay
4:A2EnteralA2glutamineA2decreasesA2nosocomialA2infectionsA2-A2Ans--
A24:A2EnteralA2glutamineA2decreasesA2nosocomialA2infections
WhichA2ofA2theA2followingA2areA2counter-
regulatoryA2hormonesA2responsibleA2forA2theA2hypercatabolismA2observedA2inA2criticallyA2i
llA2traumaA2patients?A2
1:A2Glycogen,A2insulin,A2norepinephrine
A22:A2Glucagon,A2epinephrine,A2cortisol
A23:A2Glycerol,A2serotonin,A2thymoglobulin
A24:A2Glycerin,A2leptin,A2adenosineA2-A2Ans--A22:A2Glucagon,A2epinephrine,A2cortisol
InA2patientsA2withA2burns,A2providingA2caloricA2supportA2aboveA2energyA2expenditureA2has
A2beenA2foundA2toA2
1:A2significantlyA2decreaseA2hospitalA2lengthA2ofA2stay.
2:A2improveA2woundA2healingA2andA2graftA2success.
3:A2decreaseA2fatA2accumulationA2andA2steatosis.
4:A2haveA2noA2effectA2onA2preservationA2ofA2leanA2bodyA2mass.A2-A2Ans--
A24:A2haveA2noA2effectA2onA2preservationA2ofA2leanA2bodyA2mass.
AlthoughA2patientsA2withA2burnsA2haveA2increasedA2needs,A2feedingA2inA2excessA2ofA2ene
rgyA2expenditureA2mayA2causeA2hyperglycemia,A2hepaticA2steatosis,A2andA2prolongedA2ve
ntilatorA2dependence.A2OneA2studyA2ofA2criticallyA2illA2burnA2patientsA2showedA2thatA2calori
cA2deliveryA2beyondA21.2A2xA2measuredA2restingA2energyA2expenditureA2didA2notA2conserv
eA2leanA2bodyA2massA2butA2wasA2associatedA2withA2increasedA2fatA2massA2accumulation.
InA2pulmonaryA2insufficiency,A2excessiveA2calorieA2administrationA2mayA2causeA2increase
dA2bloodA2pCO2A2resultingA2inA2
1:A2metabolicA2acidosis.
A22:A2metabolicA2alkalosis.
A23:A2respiratoryA2acidosis.
A24:A2respiratoryA2alkalosis.A2-A2Ans--A23:A2respiratoryA2acidosis.
WhichA2ofA2theA2followingA2isA2trueA2ofA2essentialA2fattyA2acidA2deficiencyA2(EFAD)A2inA2pa
tientsA2withA2cysticA2fibrosisA2(CF)?A2
1:A2RoutineA2supplementationA2ofA2omega-
3A2fattyA2acidsA2isA2essentialA2inA2theA2managementA2ofA2CF
,2:A2EFADA2usuallyA2doesA2notA2manifestA2inA2CFA2patientsA2untilA2theA2secondA2decade.
3:A2CFA2patientsA2withoutA2pancreaticA2insufficiencyA2rarelyA2developA2EFAD
4:A2EFAA2profilesA2haveA2beenA2shownA2toA2improveA2inA2CFA2patientsA2afterA2lungA2trans
plantationA2-A2Ans--
A24:A2EFAA2profilesA2haveA2beenA2shownA2toA2improveA2inA2CFA2patientsA2afterA2lungA2tran
splantation
EFAA2statusA2isA2usuallyA2evaluatedA2byA2measuringA2theA2triene:A2tetraeneA2ratio.A2Altho
ughA2supplementationA2withA2omegaA23A2fattyA2acidsA2areA2sometimesA2usedA2inA2theA2m
anagementA2ofA2CF,A2resultsA2fromA2clinicalA2trialsA2haveA2shownA2mixedA2resultsA2andA2f
urtherA2trialsA2areA2neededA2toA2determineA2theA2efficacyA2ofA2routineA2EFAA2supplementa
tionA2inA2theA2managementA2ofA2CF.
WhichA2ofA2theA2followingA2isA2theA2bestA2choiceA2forA2feedingA2aA2pancreaticA2insufficient
A2infantA2withA2cysticA2fibrosis?A2
1:A2ProteinA2hydrolysateA2formulaA2withA2mediumA2chainA2triglycerideA2(MCT)
A22:A2FreeA2aminoA2acidA2formulaA2withA2MCT
A23:A2HumanA2milk
A24:A2StandardA2infantA2formulaA2-A2Ans--
A2HumanA2milkA2isA2theA2optimalA2choiceA2overA2standardA2formulaA2forA2anyA2infantA2dueA
2toA2multipleA2beneficialA2componentsA2includingA2immunologicA2properties,A2growthA2fact
ors,A2andA2bothA2pre-
A2andA2probiotics.A2HumanA2milkA2orA2standardA2infantA2formulaA2withA2appropriateA2enzy
meA2dosingA2isA2recommended.A2ProteinA2hydrolysateA2orA2freeA2aminoA2acidA2formulasA2
containingA2MCTA2areA2notA2indicatedA2forA2infantsA2withA2cysticA2fibrosisA2(CF)A2unlessA2t
hereA2isA2anotherA2medicalA2reasonA2suchA2asA2bowelA2resectionA2resultingA2inA2malabsor
ptionA2orA2liverA2abnormalities.
WhichA2ofA2theA2followingA2bloodA2chemistriesA2willA2mostA2effectivelyA2indicateA2theA2res
ponseA2toA2theA2proteinA2componentA2ofA2nutritionA2supportA2inA2aA2patientA2onA2hemodial
ysis?A2
1:A2Albumin
2:A2Prealbumin
3:A2UreaA2nitrogenA2appearance
4:A2NormalizedA2proteinA2equivalentA2ofA2totalA2nitrogenA2-A2Ans--
A24:A2NormalizedA2proteinA2equivalentA2ofA2totalA2nitrogen
ForA2aA2patientA2requiringA2nutritionA2supportA2therapy,A2whichA2ofA2theA2followingA2mayA2
beA2necessaryA2forA2aA2patientA2withA2acuteA2kidneyA2injuryA2(AKI)A2receivingA2continuous
A2renalA2replacementA2therapyA2(CRRT)?A2
1:A2LowA2potassium
2:A2IncreasedA2phosphorus
, 3:A2LowA2protein
4:A2IncreasedA2fluidA2-A2Ans--A24:A2IncreasedA2fluid
AA2nutritionA2supportA2regimenA2needA2notA2beA2restrictedA2inA2fluidA2forA2patientsA2receivi
ngA2CRRT.A2However,A2increasedA2fluidA2provisionA2fromA2nutritionA2supportA2isA2notA2ne
cessary.
ForA2acuteA2renalA2failureA2patientsA2requiringA2parenteralA2nutritionA2support,A2recomme
ndationsA2includeA2
1:A2balancedA2mixtureA2ofA2essentialA2(EAA)A2andA2non-
essentialA2aminoA2acidsA2(NEAA).
2:A2essentialA2aminoA2acidsA2(EAA)A2plusA2dextrose.
3:A2non-essentialA2aminoA2acidsA2(NEAA).
4:A2dextroseA2alone,A2noA2aminoA2acids.A2-A2Ans--
A21:A2balancedA2mixtureA2ofA2essentialA2(EAA)A2andA2non-
essentialA2aminoA2acidsA2(NEAA).
WhatA2isA2theA2glomerularA2filtrationA2rateA2(GFR)A2ofA2aA2patientA2withA2end-
stageA2renalA2disease?A2
1:A2>90A2mL/min/1.73A2M2
2:A230-59A2mL/min/1.73A2M2
3:A215-29A2mL/min/1.73A2M2
4:A2<15A2mL/min/1.73A2M2A2-A2Ans--A24:A2<15A2mL/min/1.73A2M2
IncreasedA2mortalityA2inA2maintenanceA2hemodialysisA2patientsA2hasA2beenA2associatedA2
withA2
1:A2lowA2baselineA2bodyA2fatA2percentageA2andA2lowA2muscleA2mass.
2:A2elevatedA2albuminA2andA2decreasedA2CRPA2values.
3:A2increasedA2bodyA2massA2index.
4:A2decreasedA2serumA2cholesterol.A2-A2Ans--
A21:A2lowA2baselineA2bodyA2fatA2percentageA2andA2lowA2muscleA2mass.
AA2BMIA2betweenA230A2Kg/m^2A2andA234.9A2Kg/
m^2A2asA2demonstratedA2byA2DialysisA2OutcomesA2andA2PracticeA2PatternsA2StudyA2isA2c
onsideredA2protectiveA2inA2dialysisA2patients.A2AA2BMIA2ofA2lessA2thanA225A2Kg/
m^2A2isA2notA2consideredA2beneficialA2forA2patientsA2onA2HD.
WhichA2ofA2theA2followingA2hasA2NOTA2beenA2shownA2toA2delayA2weaningA2fromA2mechan
icalA2ventilationA2inA2patientsA2withA2chronicA2obstructiveA2pulmonaryA2diseaseA2whoA2are
A2receivingA2enteralA2nutrition?A2
1:A2RefeedingA2syndrome
2:A2TubeA2feedingA2syndrome
