ACBN Case Studies & Practical Application 4

Question 1

A nutritionist is reviewing a 3-day food record for a 35-year-old woman trying to conceive. Her folate intake averages 250 mcg DFE/day. What recommendation is most appropriate?

Accepted Answer

Recommend 400 mcg folic acid supplement daily in addition to dietary folate

Answer

The CDC recommends all women of childbearing age supplement with 400 mcg folic acid daily to prevent neural tube defects, regardless of dietary folate intake.

Question 2

A 5-year-old child is brought in with night blindness, dry skin, and poor growth. Parents report a diet very low in animal foods and no fortified products. Which deficiency best explains all three symptoms?

Accepted Answer

Vitamin A deficiency

Answer

Vitamin A deficiency causes xerophthalmia (night blindness, dry eyes), hyperkeratosis (dry skin), and impairs growth, particularly in children in developing regions.

Question 3

An 80-year-old nursing home resident is assessed for malnutrition. BMI is 18.5, unintentional weight loss is 8% in 3 months, and she eats <50% of meals. Using the ASPEN criteria, how is her nutritional status classified?

Accepted Answer

Malnutrition (moderate to severe)

Answer

Meeting at least two of ASPEN/AND's malnutrition indicators (significant weight loss, inadequate intake) in the context of chronic illness qualifies as moderate-to-severe malnutrition.

Question 4

A client with irritable bowel syndrome (IBS-D) reports worsening symptoms after consuming apples, onions, wheat bread, and milk. Which dietary approach is most evidence-based for managing her symptoms?

Accepted Answer

Low-FODMAP elimination diet followed by systematic reintroduction

Answer

The low-FODMAP diet has the strongest clinical evidence for reducing IBS symptoms, with systematic reintroduction identifying individual triggers rather than permanent elimination.

Question 5

A competitive marathon runner complains of GI distress and fatigue during long runs despite adequate training. A 24-hour recall shows very low carbohydrate intake. What is the most likely performance and GI issue?

Accepted Answer

Glycogen depletion causing GI blood flow shunting and cramping

Answer

Insufficient carbohydrate intake depletes glycogen stores; the body shunts blood away from the GI tract during high-intensity exercise, exacerbating GI symptoms and causing fatigue.

ACBN - Nutritionist Exam Practice Test

ACBN - Nutritionist Exam Practice Test

ACBN Case Studies & Practical Application 4