CDN Clinical Nutrition & Assessment 5 — Questions and Answers
Question 1: A patient presents with night blindness and dry, scaly skin. These clinical signs are most consistent with deficiency of:
- Vitamin D
- Vitamin A (Correct answer)
- Vitamin C
- Vitamin K
Correct answer: Vitamin A
Vitamin A deficiency causes nyctalopia (night blindness) due to impaired rhodopsin synthesis and xerosis (dry, scaly skin) due to impaired epithelial differentiation.
Question 2: When assessing dietary intake in a patient with suspected metabolic syndrome, which macronutrient pattern warrants the most concern?
- High monounsaturated fat intake
- High intake of added sugars and refined carbohydrates (Correct answer)
- Moderate protein intake of 0.8 g/kg/day
- High intake of omega-3 fatty acids
Correct answer: High intake of added sugars and refined carbohydrates
High intake of added sugars and refined carbohydrates promotes de novo lipogenesis, hypertriglyceridemia, insulin resistance, and visceral adiposity—all hallmarks of metabolic syndrome.
Question 3: A dietitian is calculating the estimated protein needs for a burn patient covering 40% TBSA. Which protein range is most appropriate?
- 0.8–1.0 g/kg/day
- 1.2–1.5 g/kg/day
- 1.5–2.0 g/kg/day (Correct answer)
- 2.5–4.0 g/kg/day
Correct answer: 1.5–2.0 g/kg/day
Major burns cause severe catabolism and protein losses; current guidelines recommend 1.5–2.0 g/kg/day to support wound healing, immune function, and lean mass preservation.
Question 4: Which condition is characterized by fat malabsorption, steatorrhea, and is most likely to cause deficiencies of fat-soluble vitamins (A, D, E, K)?
- Irritable bowel syndrome (IBS)
- Lactose intolerance
- Exocrine pancreatic insufficiency (EPI) (Correct answer)
- Helicobacter pylori infection
Correct answer: Exocrine pancreatic insufficiency (EPI)
Exocrine pancreatic insufficiency reduces lipase and colipase secretion, impairing fat digestion and absorption, leading to steatorrhea and fat-soluble vitamin deficiencies.
Question 5: Indirect calorimetry measures energy expenditure by analyzing:
- Carbon dioxide production and respiratory quotient (RQ) (Correct answer)
- Heat production directly from the body surface
- Blood glucose utilization rate
- Creatinine clearance from urine
Correct answer: Carbon dioxide production and respiratory quotient (RQ)
Indirect calorimetry measures oxygen consumption (VO₂) and CO₂ production (VCO₂) to calculate resting energy expenditure via the Weir equation and determine the respiratory quotient.
Question 6: A patient with phenylketonuria (PKU) must restrict which amino acid to prevent neurological damage?
- Tyrosine
- Phenylalanine (Correct answer)
- Leucine
- Methionine
Correct answer: Phenylalanine
PKU is caused by deficiency of phenylalanine hydroxylase, leading to toxic accumulation of phenylalanine; dietary restriction of phenylalanine is the primary treatment to prevent intellectual disability.
Question 7: Which of the following best describes the purpose of the Subjective Global Assessment (SGA) in clinical nutrition?
- To calculate precise caloric needs using anthropometric data
- To diagnose specific nutrient deficiencies via laboratory testing
- To classify nutritional status based on history and physical examination findings (Correct answer)
- To determine ideal body weight using standardized growth charts
Correct answer: To classify nutritional status based on history and physical examination findings
SGA classifies patients as well-nourished (A), mildly-moderately malnourished (B), or severely malnourished (C) based on weight history, dietary changes, GI symptoms, functional capacity, and physical examination.
CDN Clinical Nutrition & Assessment 5
A patient presents with night blindness and dry, scaly skin.
These clinical signs are most consistent with deficiency of: