CDN Medical Nutrition Therapy 5 — Questions and Answers
Question 1: A patient with pressure injuries (stage 3) requires nutrition support. Which nutrient has the strongest evidence for wound healing supplementation?
- Omega-3 fatty acids
- Vitamin C and zinc (Correct answer)
- Vitamin E alone
- Selenium
Correct answer: Vitamin C and zinc
Vitamin C is essential for collagen synthesis and zinc supports immune function and cell proliferation; both are well-supported for wound healing in pressure injury MNT.
Question 2: For a patient with dumping syndrome after gastric surgery, which dietary modification is most important?
- Increase simple carbohydrates at each meal
- Separate liquids from solids and limit simple sugars (Correct answer)
- Drink large amounts of fluid with meals
- Follow a high-fiber diet only
Correct answer: Separate liquids from solids and limit simple sugars
Separating fluids from solids and limiting simple sugars slows gastric emptying and reduces the rapid transit that causes dumping syndrome symptoms.
Question 3: Which nutrition intervention is recommended for a patient with non-alcoholic fatty liver disease (NAFLD)?
- High-fat, low-carbohydrate diet with no caloric restriction
- 5–10% weight loss through caloric restriction and increased physical activity (Correct answer)
- Protein restriction to <0.5 g/kg/day
- Supplementation with high-dose vitamin A
Correct answer: 5–10% weight loss through caloric restriction and increased physical activity
A 5–10% reduction in body weight through diet and exercise has been shown to significantly improve liver histology and reduce steatosis in NAFLD.
Question 4: A patient with maple syrup urine disease (MSUD) must restrict which group of amino acids?
- Aromatic amino acids (phenylalanine, tyrosine, tryptophan)
- Branched-chain amino acids (leucine, isoleucine, valine) (Correct answer)
- Sulfur-containing amino acids (methionine, cysteine)
- Basic amino acids (lysine, arginine, histidine)
Correct answer: Branched-chain amino acids (leucine, isoleucine, valine)
MSUD is caused by deficient branched-chain alpha-keto acid dehydrogenase, leading to accumulation of leucine, isoleucine, and valine requiring dietary restriction.
Question 5: Which route of nutrition support is preferred for a patient with a functional GI tract who cannot meet needs orally after major abdominal surgery?
- Total parenteral nutrition (TPN)
- Enteral nutrition via nasogastric or nasoenteric tube (Correct answer)
- Peripheral parenteral nutrition only
- Oral supplements exclusively
Correct answer: Enteral nutrition via nasogastric or nasoenteric tube
Enteral nutrition is preferred over parenteral when the GI tract is functional because it maintains gut integrity, reduces infection risk, and is more cost-effective.
Question 6: A patient with congestive heart failure and cardiac cachexia has poor appetite. What caloric density strategy is most appropriate for oral supplements?
- Standard 1.0 kcal/mL formula with large volumes
- High-calorie dense formula (≥1.5–2.0 kcal/mL) in small portions (Correct answer)
- Clear liquid diet only
- Fat-free supplements to protect the heart
Correct answer: High-calorie dense formula (≥1.5–2.0 kcal/mL) in small portions
High-calorie dense formulas allow patients with poor appetite and volume restrictions to meet caloric goals in smaller, more tolerable amounts.
Question 7: Which dietary pattern has the strongest evidence for reducing cardiovascular risk in patients with hyperlipidemia?
- Carnivore diet with unrestricted saturated fat
- Mediterranean diet rich in olive oil, fish, fruits, vegetables, and whole grains (Correct answer)
- Very low-fat diet with less than 10% fat from all sources
- High-protein diet with greater than 35% of calories from protein
Correct answer: Mediterranean diet rich in olive oil, fish, fruits, vegetables, and whole grains
The Mediterranean diet is supported by multiple large trials (including PREDIMED) showing significant reduction in cardiovascular events and LDL cholesterol.
CDN Medical Nutrition Therapy 5
A patient with pressure injuries (stage 3) requires nutrition support.
Which nutrient has the strongest evidence for wound healing supplementation?