Nutrition Past Paper PDF

Objective 1: Differentiate Between Enteral and Parenteral Nutrition Which of the following is an indication for parenteral nutrition? A. Functional gastrointestinal tract B. Short bowel syndrome C. Dysphagia D. Mild malnutrition Answer: B. Short bowel syndrome Explanation: Parenteral nutrition is i...

Objective 1: Differentiate Between Enteral and Parenteral Nutrition Which of the following is an indication for parenteral nutrition? A. Functional gastrointestinal tract B. Short bowel syndrome C. Dysphagia D. Mild malnutrition Answer: B. Short bowel syndrome Explanation: Parenteral nutrition is indicated for non-functional GI tracts, such as in short bowel syndrome. Dysphagia is managed with enteral nutrition if the GI tract is functional. Which complication is most commonly associated with enteral nutrition? A. Hypertriglyceridemia B. Tube site infections C. Liver dysfunction D. Pneumothorax Answer: B. Tube site infections Explanation: Tube-related complications, such as infections and dislodgement, are common in enteral nutrition. Pneumothorax is a rare complication of central line placement for PN. What is a contraindication for peripheral parenteral nutrition (PPN)? A. Short-term nutrition needs B. Severe malnutrition C. Temporary inability to use the GI tract D. Mild electrolyte imbalances Answer: B. Severe malnutrition Explanation: PPN cannot meet the high caloric and nutritional needs of patients with severe malnutrition due to its osmolality limitations. What is the primary advantage of enteral nutrition over parenteral nutrition? A. Higher nutrient content B. Maintains gut integrity C. Prevents refeeding syndrome D. Faster initiation Answer: B. Maintains gut integrity Explanation: Enteral nutrition preserves gut integrity by stimulating microvilli and preventing bacterial translocation. Which of the following is a hallmark complication of parenteral nutrition? A. Aspiration pneumonia B. Hypophosphatemia C. Hyperglycemia D. Mechanical obstruction Answer: C. Hyperglycemia Explanation: Hyperglycemia is a common complication of parenteral nutrition due to the high glucose content in PN solutions. Objective 2: Manage Enteral and Parenteral Nutrition Which enteral feeding method is most appropriate for a critically ill patient with poor glycemic control? A. Bolus feeding B. Cyclic feeding C. Continuous feeding D. Intermittent feeding Answer: C. Continuous feeding Explanation: Continuous feeding provides a steady delivery of nutrients, minimizing glycemic variability and reducing intolerance in critically ill patients. What is the preferred feeding route for a patient requiring enteral nutrition for 4-6 weeks? A. Nasojejunal tube B. PEG tube C. J-tube D. Parenteral nutrition Answer: A. Nasojejunal tube Explanation: Nasojejunal tubes are suitable for short-term (4-6 weeks) enteral nutrition needs. PEG tubes are used for longer durations (>6 weeks). What is a characteristic of total parenteral nutrition (TPN)? A. Administered through peripheral veins B. Limited to 900 mOsm/L C. Delivered via central venous access D. Used only for mild malnutrition Answer: C. Delivered via central venous access Explanation: TPN requires central venous access to accommodate its high osmolarity and nutrient content. A patient with esophageal cancer undergoing surgery needs enteral nutrition. Which feeding tube is most appropriate? A. NGT B. G-tube C. J-tube D. NJT Answer: C. J-tube Explanation: A J-tube bypasses the stomach and esophagus, making it ideal for patients with esophageal cancer requiring long-term nutrition. Which hospital diet is appropriate for a patient recovering from a bowel resection and starting oral intake? A. Regular diet B. Clear liquid diet C. Low-fat diet D. Full liquid diet Answer: B. Clear liquid diet Explanation: A clear liquid diet is typically initiated as a transition to oral intake after GI surgeries. Objective 3: Refeeding Syndrome What is the hallmark electrolyte abnormality in refeeding syndrome? A. Hypokalemia B. Hypophosphatemia C. Hypermagnesemia D. Hypercalcemia Answer: B. Hypophosphatemia Explanation: Hypophosphatemia is the hallmark of refeeding syndrome, resulting from cellular uptake of phosphate during refeeding. Which patient is at the highest risk for refeeding syndrome? A. A patient with chronic kidney disease B. A patient with an eating disorder C. A patient with acute pancreatitis D. A patient on corticosteroids Answer: B. A patient with an eating disorder Explanation: Patients with prolonged starvation or malnutrition (e.g., eating disorders) are at the highest risk for refeeding syndrome. What is a critical first step before initiating nutrition in a malnourished patient? A. Starting a full-calorie diet B. Correcting electrolyte abnormalities C. Administering insulin D. Administering lipids intravenously Answer: B. Correcting electrolyte abnormalities Explanation: Correcting electrolyte imbalances, especially phosphorus, potassium, and magnesium, is critical before initiating nutrition. What dietary modification minimizes refeeding syndrome risk in enteral feeding? A. High carbohydrate content B. Slow advancement of feeding rate C. Immediate bolus feeding D. High-fat diet initiation Answer: B. Slow advancement of feeding rate Explanation: Gradual advancement of caloric intake reduces the risk of refeeding syndrome. Which clinical feature is associated with refeeding syndrome? A. Hyperkalemia B. Fluid retention C. Hypercalcemia D. Metabolic acidosis Answer: B. Fluid retention Explanation: Fluid shifts and retention are common in refeeding syndrome, leading to edema and potential heart failure. Objective 4: Referral to RD or Speech Therapy Which condition warrants a referral to a speech therapist? A. Chronic pancreatitis B. Dysphagia with aspiration C. Severe malnutrition D. Refeeding syndrome Answer: B. Dysphagia with aspiration Explanation: Speech therapists evaluate and manage swallowing disorders, including aspiration risks. A patient with cirrhosis and severe malnutrition requires nutritional support. Who should be consulted? A. Occupational therapist B. Registered dietitian C. Speech-language pathologist D. Physical therapist Answer: B. Registered dietitian Explanation: RDs assess malnutrition and provide dietary recommendations tailored to specific medical conditions. What is the main dietary intervention for a patient with dysphagia? A. Low-sodium diet B. Pureed food and thickened liquids C. High-protein supplements D. Ketogenic diet Answer: B. Pureed food and thickened liquids Explanation: Modifying food textures and liquid consistencies helps prevent aspiration in patients with dysphagia. Which condition commonly requires a registered dietitian’s intervention? A. Fibromyalgia B. Celiac disease C. Migraine D. Osteoarthritis Answer: B. Celiac disease Explanation: RDs provide education on gluten-free diets and manage associated nutrient deficiencies. What is a clinical indicator for a speech therapy referral in stroke patients? A. Aphasia B. Chronic diarrhea C. Hyperglycemia D. Fluid overload Answer: A. Aphasia Explanation: Speech therapy helps manage communication deficits such as aphasia in stroke patients. Mixed Questions Which hospital diet is indicated for patients with dysphagia? A. Low-fat diet B. Pureed diet C. High-fiber diet D. Regular diet Answer: B. Pureed diet Explanation: A pureed diet is designed for patients with swallowing difficulties to reduce aspiration risks. What is the most appropriate feeding method for a patient with a GI fistula? A. Peripheral parenteral nutrition B. Total parenteral nutrition C. Nasogastric tube D. Oral feeding Answer: B. Total parenteral nutrition Explanation: TPN is appropriate for patients with GI fistulas when enteral nutrition is not feasible. Which feeding route is most appropriate for a patient with severe gastroparesis? A. PEG tube B. NJ tube C. NGT D. Oral diet Answer: B. NJ tube Explanation: Post-pyloric feeding (e.g., NJ tube) bypasses the stomach and is preferred for patients with severe gastroparesis. Which electrolyte abnormality requires correction before initiating TPN in a malnourished patient? A. Hypernatremia B. Hypophosphatemia C. Hyperchloremia D. Hypocalcemia Answer: B. Hypophosphatemia Explanation: Correcting hypophosphatemia is essential to prevent complications of refeeding syndrome. What is the best diet for a patient with acute diverticulitis? A. High-fiber diet B. Clear liquid diet C. Low-fat diet D. Regular diet Answer: B. Clear liquid diet Explanation: Patients with acute diverticulitis benefit from a clear liquid diet initially, advancing to low-fiber diets as tolerated.