ACBN Case Studies & Practical Application 5

Question 1

A 40-year-old woman with non-alcoholic fatty liver disease (NAFLD) and a BMI of 33 asks about dietary strategies. Which approach has the strongest evidence for reducing hepatic fat content?

Accepted Answer

5-10% body weight loss through caloric restriction with reduced refined carbohydrates and saturated fat

Answer

A 5-10% reduction in body weight through caloric restriction targeting refined carbohydrates and saturated fat is the most evidence-based intervention for reducing hepatic steatosis in NAFLD.

Question 2

An infant born at 28 weeks gestation is in the NICU. The nutritionist calculates energy needs. Which factor primarily distinguishes preterm infant nutrition needs from full-term infant needs?

Accepted Answer

Preterm infants need higher energy (110-135 kcal/kg/day) and protein (3.5-4.5 g/kg/day) for catch-up growth

Answer

Preterm infants missed the third-trimester nutrient deposition period and have immature digestive function, requiring higher energy and protein density to support accelerated catch-up growth.

Question 3

A school nutritionist is evaluating a 10-year-old with attention difficulties and frequent afternoon energy crashes. The 24-hour recall shows skipped breakfast and a high-sugar lunch. What intervention should be recommended first?

Accepted Answer

Establish consistent balanced breakfast with protein, complex carbohydrates, and fat to stabilize blood glucose

Answer

Breakfast consumption stabilizes blood glucose throughout the morning, improving attention span and reducing the energy crashes associated with glycemic variability from high-sugar meals.

Question 4

A client with Crohn's disease in remission asks about nutrition during a flare. Which approach is most appropriate during an active flare to minimize GI symptoms while maintaining nutrition?

Accepted Answer

Low-residue, low-fiber diet with easily digestible foods and adequate hydration

Answer

During active Crohn's flares, a low-residue, low-fiber diet reduces mechanical irritation of inflamed intestinal tissue while maintaining caloric and nutrient intake.

Question 5

A nutritionist is counseling a client on warfarin therapy who eats variable amounts of leafy greens. The client's INR is unstable. What is the most clinically sound advice?

Accepted Answer

Maintain a consistent daily vitamin K intake rather than eliminating vitamin K foods

Answer

Consistency in vitamin K intake allows the warfarin dose to be calibrated accurately; drastic daily variation is what causes INR instability, not the presence of vitamin K itself.

ACBN - Nutritionist Exam Practice Test

ACBN - Nutritionist Exam Practice Test

ACBN Case Studies & Practical Application 5