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NBNSC Certified Nutrition Support Clinician

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Question: 1053

Which of the following is a fat-soluble vitamin that acts as an antioxidant, protecting cells from damage caused by free radicals?

1. Vitamin A

   amin C amin K

   
   

   er: B

   
   

   nation: Vitamin E is a fat-soluble vitamin that acts as an antioxidant, protecting cells from da by free radicals. It helps maintain the integrity of cell membranes and is involved in immun

   on, DNA repair, and other vital processes.

   
   

   ion: 1054

   
   

   ent with celiac disease is advised to follow a gluten-free diet. Which of the following grains nsumption?

   
   

   eat ley

   
   

   inoa er: D

   nation: Quinoa is safe for consumption in a gluten-free diet for individuals with celiac diseas n-free grain that can be used as a substitute for wheat, barley, and rye, which contain gluten.

   
   

   ion: 1055

   Vitamin E

2. Vit

3. Vit Answ

Expla mage

caused e

functi

Quest

A pati is safe

for co

1. Wh

2. Bar

3. Rye

4. Qu

Answ

Expla e. It is

a glute

Quest

When examining the ethical considerations in nutrition support therapy, which scenario best illustrates a conflict between beneficence and autonomy?

1. A patient declines enteral nutrition despite a recommendation from the healthcare team.

2. A patient receives parenteral nutrition without informed consent.

3. A healthcare provider prescribes a nutrition regimen based on personal bias.

4. A family insists on aggressive nutrition support for a terminally ill patient. Answer: D

Explanation: This scenario illustrates a conflict between beneficence (acting in the patient's best interest) and autonomy (respecting the patient's wishes), especially when the patient's quality of life is at stake.

Question: 1056

During discharge planning, a nutrition support clinician is preparing a patient for home enteral nutrition. What is the most crucial aspect of education to ensure the patient can manage their therapy safely?

1. Recognizing signs of potential complications

   hniques for administering feeds

   derstanding the nutritional content of their formula er: A

   nation: Educating the patient on recognizing signs of potential complications ensures they ca intervention and manage their home enteral nutrition safely.

   
   

   ion: 1057

   
   

   luating a patient’s dietary intake, which assessment tool is most effective for identifying nutrient deficiencies over a long-term period?

   
   

   hour dietary recall

   od frequency questionnaire history

   ect observation er: B

   nation: A food frequency questionnaire provides a broader view of long-term dietary patterns ial micronutrient deficiencies compared to short-term recalls.

   
   

   ion: 1058

   Importance of maintaining proper hydration

2. Tec

3. Un

Answ

Expla n seek

timely

Quest

In eva micro

1. 24-

2. Fo

3. Diet

4. Dir Answ

Expla and

potent

Quest

Which of the following best describes the role of ethics in the provision of nutrition support therapy?

1. Ethics is irrelevant in clinical practice as all decisions are based on science

2. Ethical considerations guide the decision-making process to balance patient needs and clinical judgment

3. Ethics only applies to end-of-life decisions in nutrition support

4. Ethical principles can be ignored if they conflict with clinical protocols Answer: B

Explanation: Ethical considerations are integral to guiding decision-making in nutrition support therapy, ensuring that patient needs are balanced with clinical judgment.

Question: 1059

You are tasked with updating the nutrition support guidelines for patients with liver disease. What should be the primary focus when revising these guidelines based on emerging evidence?

1. Ensuring that the guidelines are strictly followed without exception

   miting the guidelines to only the most severe cases of liver disease egrating new research findings while considering individual patient needs

   
   

   er: D

   
   

   nation: Integrating new research while considering individual patient needs allows for a more alized and effective approach to nutrition support.

   
   

   ion: 1060

   
   

   of the following is a potential complication of excessive protein intake in patients with omised kidney function?

   
   

   potension pernatremia

   rsening of renal function percalcemia

   
   

   er: C

   
   

   nation: Worsening of renal function is a potential complication of excessive protein intake in

   with compromised kidney function. High protein intake can increase the workload on the kidneys tentially worsen renal function in individuals with existing kidney disease. Protein intake ne

   efully monitored and tailored to the individual's renal function to prevent further kidney dam

   Avoiding changes to prevent confusion among staff

2. Li

3. Int Answ

Expla person

Quest

Which compr

1. Hy

2. Hy

3. Wo

4. Hy

Answ Expla

patients

and po eds to

be car age.

Question: 1061

In a scenario where a patient on parenteral nutrition presents with elevated liver enzymes, what adjustment in the nutritional support plan might be necessary to improve liver function and tolerance?

1. Increase lipid infusion rate

2. Decrease carbohydrate concentration

3. Change to a higher-protein formula

4. Add supplemental vitamins

Answer: B

Explanation: Decreasing carbohydrate concentration may help reduce the risk of hepatic steatosis and improve liver function in patients receiving long-term parenteral nutrition.

Question: 1062

Which of the following is an appropriate indication for the use of a peripherally inserted central catheter (PICC) for nutrition support?

ients with severe malabsorption

ients with a history of central line-associated bloodstream infections (CLABSIs) ients with adequate peripheral venous access

er: B

nation: A peripherally inserted central catheter (PICC) is commonly used for long-term nutrit in patients with severe malabsorption. It provides a more secure and stable access point for

ring parenteral nutrition compared to peripheral venous access. Short-term nutrition support ed through peripheral venous access, and patients with a history of central line-associated tream infections (CLABSIs) may require alternative access options.

ion: 1063

ent with a history of diabetes and renal failure is receiving nutritional support. Which electro nce should be monitored closely in this scenario?

pocalcemia perkalemia ponatremia pomagnesemia

er: B

nation: Patients with renal failure are at high risk for hyperkalemia due to impaired potassiu

Expla ion

support

delive can be

achiev bloods

Quest

A pati lyte

imbala

1. Hy

2. Hy

3. Hy

4. Hy

Answ

Expla m

excretion, particularly when receiving nutrition support that may include potassium.

Question: 1064

Which of the following conditions is associated with increased protein needs?

1. Hypothyroidism

2. Type 2 diabetes mellitus

3. Chronic kidney disease

4. Iron deficiency anemia

Answer: C

Explanation: Chronic kidney disease is associated with increased protein needs due to the loss of protein through urine and increased protein breakdown. Adequate protein intake is essential to prevent malnutrition and maintain muscle mass in individuals with kidney disease.

Question: 1065

trition. What is the recommended protein intake for this patient to meet his nutritional needs ting complications?

g protein/kg/day. g protein/kg/day. g protein/kg/day. g protein/kg/day.

er: D

nation: For patients with end-stage renal disease on hemodialysis, a protein intake of 1.2 g n/kg/day is recommended to compensate for protein losses during dialysis while maintaining onal status.

ion: 1066

a nutritional assessment, a patient reports significant financial difficulties affecting their acc nd healthcare. Which of the following factors should be prioritized in the nutrition support p ve the patient's overall well-being?

iating oral nutritional supplements plementing a high-protein diet

using solely on macronutrient intake erring the patient to a social worker

A 75-year-old male with end-stage renal disease is on hemodialysis and presents with symptoms of malnu while

preven

1. 0.6

2. 2.0

3. 1.5

4. 1.2

Answ Expla

protei nutriti

Quest

During ess to

food a lan to

impro

1. Init

2. Im

3. Foc

4. Ref Answer: D

Explanation: Addressing socio-economic factors is essential for improving access to food and healthcare. A referral to a social worker can help the patient navigate resources available to them.

Question: 1067

Which of the following is a potential complication of untreated hypothyroidism?

1. Depression

2. Weight loss

3. Hyperactivity

4. Heat intolerance Answer: A

weight gain is a common symptom. Heat intolerance (option D) is associated with hyroidism. Therefore, option C is the correct answer.

ion: 1068

ent on parenteral nutrition develops new-onset hypertriglyceridemia. Which of the following es would be most appropriate to manage this complication while continuing nutritional supp

rease the rate of dextrose infusion duce the lipid infusion rate

itch to a higher-calorie formula iate insulin therapy

er: B

nation: Reducing the lipid infusion rate directly addresses hypertriglyceridemia while allowin uation of nutritional support through other macronutrients.

ion: 1069

itically ill patient requiring nutrition support therapy, what is the most appropriate initial app ermining the feeding route?

iate parenteral nutrition to ensure nutrient delivery

enteral nutrition exclusively, regardless of the patient's condition

Explanation: Depression is a potential complication of untreated hypothyroidism. Hypothyroidism is a condition characterized by an underactive thyroid gland, which leads to a decrease in the production of thyroid hormones. Thyroid hormones play a role in regulating mood, and low levels of these hormones can contribute to symptoms of depression. Hyperactivity (option A) is more commonly associated with hyperthyroidism (overactive thyroid). Weight loss (option B) is not typically seen in hypothyroidism; instead,

hypert

Quest

A pati

chang ort?

1. Inc

2. Re

3. Sw

4. Init Answ

Expla g the

contin

Quest

In a cr roach

to det

1. Init

2. Use

3. Begin with oral nutrition to maintain normalcy

4. Assess the patient's gastrointestinal function before deciding the route Answer: D

Explanation: Assessing gastrointestinal function is critical in determining the most appropriate feeding route, ensuring that the chosen method is safe and effective for the patient's condition.

Question: 1070

When reviewing a patient’s current clinical status, which laboratory value would provide the most direct

insight into their protein status, particularly in the context of malnutrition?

1. Blood urea nitrogen (BUN)

2. Hemoglobin

3. Serum albumin

4. Serum electrolytes Answer: C

mation.

ion: 1071

ent on long-term TPN suddenly presents with chills and fever. What is the most appropriate diate course of action?

rease the TPN infusion rate itch to enteral nutrition

minister antipyretics and continue TPN tain blood cultures and discontinue TPN

er: D

nation: Obtaining blood cultures and discontinuing TPN is critical to rule out catheter-related ons, which are a common risk associated with long-term TPN use.

ion: 1072

of the following is a common symptom of vitamin B12 deficiency? igue

ht blindness kets

urvy

Explanation: Serum albumin is a key marker for protein status and nutritional adequacy. Low levels can indicate malnutrition and are often seen in patients with chronic diseases and those undergoing

inflam

Quest

A pati imme

1. Inc

2. Sw

3. Ad

4. Ob

Answ Expla

infecti Quest Which

1. Fat

2. Nig

3. Ric

4. Sc

Answer: A

Explanation: A common symptom of vitamin B12 deficiency is fatigue. Vitamin B12 plays a crucial role in the production of red blood cells and the maintenance of nerve cells. When levels of vitamin B12 are low, it can lead to a condition called pernicious anemia, which is characterized by fatigue, weakness, and shortness of breath. Night blindness is associated with vitamin A deficiency, rickets is associated with vitamin D deficiency, and scurvy is associated with vitamin C deficiency. Therefore, option A is the correct answer.

Question: 1073

A patient in the ICU has been on enteral nutrition for three days but is not meeting their caloric goals due to gastrointestinal intolerance. Their current prescription is 1500 kcal/day. What would be the most effective strategy to optimize their nutrition support therapy?

1. Switch to total parenteral nutrition (TPN)

2. Increase the caloric density of the enteral formula

3. Administer medications to enhance gastric motility

   er: B

   
   

   nation: Increasing the caloric density allows the patient to meet nutritional requirements with sing the volume, which can help reduce gastrointestinal intolerance.

   
   

   ion: 1074

   
   

   ent on long-term parenteral nutrition has developed metabolic bone disease. Which modificat be made to their nutrition support therapy to address this complication?

   
   

   mit phosphorus intake to prevent further bone loss

   rease the calcium and vitamin D content in their parenteral solution itch to a higher-calorie parenteral formula

   duce the rate of infusion to enhance tolerance er: B

   nation: Increasing calcium and vitamin D in the parenteral solution is essential to help mitiga of metabolic bone disease and promote bone health.

   
   

   ion: 1075

   
   

   ontext of nutrition support therapy, which of the following represents a violation of ethical ples when making decisions about patient care?

   Reduce the enteral feeding rate Answ

Expla out

increa

Quest

A pati ion

should

1. Li

2. Inc

3. Sw

4. Re

Answ

Expla te the

effects

Quest

In the c princi

1. Utilizing a standardized protocol for all patients

2. Failing to consider the patient's cultural beliefs in treatment decisions

3. Collaborating with the healthcare team to develop a care plan

4. Educating patients about their nutrition options Answer: B

Explanation: Failing to consider a patient's cultural beliefs violates ethical principles of respect for autonomy and beneficence, as it disregards the patient's values and preferences in care decisions.