CDN Medical Nutrition Therapy 2 — Questions and Answers
Question 1: A patient with chronic kidney disease (CKD) stage 4 is experiencing hyperkalemia. Which food should be most restricted?
- White rice
- Bananas (Correct answer)
- Apples
- White bread
Correct answer: Bananas
Bananas are high in potassium and must be restricted in CKD patients with hyperkalemia.
Question 2: Which enteral formula is most appropriate for a patient with glucose intolerance and need for tube feeding?
- Standard polymeric formula
- Carbohydrate-modified formula (Correct answer)
- High-protein formula
- Elemental formula
Correct answer: Carbohydrate-modified formula
Carbohydrate-modified formulas (e.g., Glucerna) are designed to blunt postprandial glucose spikes in patients with glucose intolerance.
Question 3: A patient with short bowel syndrome has had the terminal ileum resected. Which vitamin deficiency is most likely to develop?
- Vitamin C
- Vitamin B12 (Correct answer)
- Vitamin K
- Folate
Correct answer: Vitamin B12
Vitamin B12 is absorbed exclusively in the terminal ileum; its resection leads to B12 malabsorption and eventual deficiency.
Question 4: Which MNT goal is the primary focus in the acute phase of pancreatitis?
- High-protein oral diet
- Bowel rest and IV hydration (Correct answer)
- Low-fat enteral feeding started within 6 hours
- Immediate parenteral nutrition
Correct answer: Bowel rest and IV hydration
Traditional management of acute pancreatitis begins with bowel rest and IV hydration to reduce pancreatic stimulation.
Question 5: A patient with celiac disease must avoid which protein?
- Casein
- Gluten (Correct answer)
- Albumin
- Zein
Correct answer: Gluten
Gluten (found in wheat, barley, and rye) triggers the autoimmune response that damages the intestinal villi in celiac disease.
Question 6: What is the recommended protein intake for a critically ill patient on mechanical ventilation, per ASPEN guidelines?
- 0.6–0.8 g/kg/day
- 1.2–2.0 g/kg/day (Correct answer)
- 2.5–3.0 g/kg/day
- 0.8–1.0 g/kg/day
Correct answer: 1.2–2.0 g/kg/day
ASPEN guidelines recommend 1.2–2.0 g/kg/day of protein for critically ill patients to support recovery and prevent muscle wasting.
Question 7: In a patient with hepatic encephalopathy, which dietary modification is currently recommended by evidence-based guidelines?
- Severely restrict all protein to <0.5 g/kg/day
- Maintain adequate protein (1.2–1.5 g/kg/day) and prefer plant-based sources (Correct answer)
- Eliminate all branched-chain amino acids
- Restrict fluids to 500 mL/day
Correct answer: Maintain adequate protein (1.2–1.5 g/kg/day) and prefer plant-based sources
Current evidence discourages protein restriction; adequate protein with preference for plant and dairy sources is recommended to support liver function.
CDN Medical Nutrition Therapy 2
A patient with chronic kidney disease (CKD) stage 4 is experiencing hyperkalemia.
Which food should be most restricted?