CDN Medical Nutrition Therapy 4 — Questions and Answers
Question 1: A bariatric patient 6 months post-Roux-en-Y gastric bypass presents with tingling in hands and feet. Which deficiency is most likely?
- Vitamin A
- Thiamine (B1) (Correct answer)
- Calcium
- Zinc
Correct answer: Thiamine (B1)
Thiamine deficiency causing peripheral neuropathy is common after gastric bypass due to reduced gastric acid and rapid transit impairing absorption.
Question 2: In MNT for HIV/AIDS, what is the primary goal of nutrition intervention?
- Restrict fat to prevent lipodystrophy
- Maintain lean body mass and prevent wasting (Correct answer)
- Limit carbohydrates to control lipids
- Eliminate dairy to reduce inflammation
Correct answer: Maintain lean body mass and prevent wasting
Preserving lean body mass is the primary nutrition goal in HIV/AIDS as wasting syndrome significantly worsens prognosis and quality of life.
Question 3: Which diet modification is the first-line MNT approach for gastroesophageal reflux disease (GERD)?
- High-fiber diet with bran supplements
- Avoid trigger foods and eat smaller, more frequent meals (Correct answer)
- Liquid diet for 2 weeks
- High-protein, low-carbohydrate diet
Correct answer: Avoid trigger foods and eat smaller, more frequent meals
Avoiding trigger foods (caffeine, alcohol, fatty foods, chocolate) and eating smaller meals reduces lower esophageal sphincter pressure and reflux symptoms.
Question 4: A patient with Type 2 diabetes has an HbA1c of 9.2%. According to MNT guidelines, what is the primary dietary focus?
- Eliminate all carbohydrates
- Consistent carbohydrate intake and portion control to improve glycemic control (Correct answer)
- High-fat ketogenic diet only
- Increase fruit intake to improve fiber
Correct answer: Consistent carbohydrate intake and portion control to improve glycemic control
Consistent carbohydrate distribution across meals combined with portion control is the evidence-based MNT approach to reduce HbA1c in Type 2 diabetes.
Question 5: A patient on warfarin therapy should be counseled about maintaining consistent intake of which nutrient?
- Vitamin C
- Vitamin K (Correct answer)
- Vitamin B12
- Vitamin D
Correct answer: Vitamin K
Vitamin K directly affects warfarin's anticoagulant effect; consistent intake (not elimination) is recommended to maintain stable INR levels.
Question 6: Which condition requires the MOST significant phosphorus restriction in addition to protein and potassium management?
- Type 1 Diabetes
- End-stage renal disease (ESRD) on dialysis (Correct answer)
- Crohn's disease
- Liver cirrhosis
Correct answer: End-stage renal disease (ESRD) on dialysis
ESRD patients cannot excrete phosphorus, leading to hyperphosphatemia which causes vascular calcification and bone disease, requiring strict dietary restriction.
Question 7: A patient with Crohn's disease involving the small intestine is at risk for deficiency of all the following EXCEPT:
- Vitamin B12
- Iron
- Vitamin C (mild deficiency from diet) (Correct answer)
- Vitamin D
Correct answer: Vitamin C (mild deficiency from diet)
Vitamin C deficiency from Crohn's disease is uncommon as it is absorbed throughout the small intestine and colon; B12, iron, and D are commonly deficient.
CDN Medical Nutrition Therapy 4
A bariatric patient 6 months post-Roux-en-Y gastric bypass presents with tingling in hands and feet.
Which deficiency is most likely?