CDN Medical Nutrition Therapy 3 — Questions and Answers
Question 1: A patient recovering from a stroke has dysphagia. Which texture modification is appropriate for someone who can manage soft, moist pieces but not regular foods?
- IDDSI Level 7 (Regular)
- IDDSI Level 5 (Minced & Moist) (Correct answer)
- IDDSI Level 2 (Mildly Thick)
- IDDSI Level 1 (Slightly Thick)
Correct answer: IDDSI Level 5 (Minced & Moist)
IDDSI Level 5 (Minced & Moist) is designed for patients who can chew soft, moist, small pieces but cannot manage regular textures safely.
Question 2: Which lab value is the best short-term indicator of protein status and nutritional repletion in a hospitalized patient?
- Albumin
- Prealbumin (transthyretin) (Correct answer)
- Total lymphocyte count
- Hemoglobin
Correct answer: Prealbumin (transthyretin)
Prealbumin has a half-life of 2–3 days, making it a more sensitive short-term marker of protein status than albumin (half-life ~20 days).
Question 3: A Type 1 diabetic patient on insulin uses carbohydrate counting. One carbohydrate serving equals how many grams of carbohydrate?
- 5 grams
- 10 grams
- 15 grams (Correct answer)
- 20 grams
Correct answer: 15 grams
One carbohydrate serving (exchange) is standardized as 15 grams of carbohydrate in diabetes meal planning.
Question 4: In MNT for heart failure, which dietary intervention has the strongest evidence for reducing fluid retention?
- Limiting potassium to <2 g/day
- Restricting sodium to 2 g/day or less (Correct answer)
- High-protein diet >2 g/kg/day
- Eliminating all dietary fat
Correct answer: Restricting sodium to 2 g/day or less
Sodium restriction (≤2 g/day) reduces fluid retention and edema by decreasing the osmotic drive for water reabsorption in heart failure.
Question 5: A patient with phenylketonuria (PKU) must restrict which amino acid?
- Tyrosine
- Phenylalanine (Correct answer)
- Leucine
- Methionine
Correct answer: Phenylalanine
PKU results from deficient phenylalanine hydroxylase activity, requiring strict dietary restriction of phenylalanine to prevent neurological damage.
Question 6: Which electrolyte abnormality is most commonly associated with refeeding syndrome?
- Hypernatremia
- Hypophosphatemia (Correct answer)
- Hyperkalemia
- Hypercalcemia
Correct answer: Hypophosphatemia
Refeeding syndrome is characterized by severe hypophosphatemia as insulin release drives phosphate into cells when carbohydrates are reintroduced.
Question 7: For a patient with iron-deficiency anemia, which pairing best enhances non-heme iron absorption?
- Iron supplement with milk
- Fortified cereal with orange juice (Correct answer)
- Red meat with tea
- Spinach with coffee
Correct answer: Fortified cereal with orange juice
Vitamin C (ascorbic acid) in orange juice converts ferric iron to ferrous iron, significantly enhancing non-heme iron absorption.
CDN Medical Nutrition Therapy 3
A patient recovering from a stroke has dysphagia.
Which texture modification is appropriate for someone who can manage soft, moist pieces but not regular foods?