CDR Enteral and Parenteral Nutrition 3

Question 1

Which formula characteristic makes semi-elemental formulas preferable to standard polymeric formulas in a patient with pancreatic insufficiency?

Accepted Answer

Pre-hydrolyzed protein and medium-chain triglycerides (MCTs) requiring less digestion

Answer

Higher fat content for caloric density

Answer

Higher osmolality for better absorption

Answer

Greater fiber content to improve gut motility

Question 2

A patient on home parenteral nutrition develops line sepsis. What is the MOST common causative organism?

Accepted Answer

Staphylococcus epidermidis (coagulase-negative staphylococci)

Answer

Escherichia coli

Answer

Pseudomonas aeruginosa

Answer

Candida albicans

Question 3

In calculating the non-protein calorie-to-nitrogen ratio (NPC:N) for a PN formulation, how many grams of nitrogen are in 100 g of amino acids?

Accepted Answer

16 g

Answer

8 g

Answer

10 g

Answer

20 g

Question 4

Which clinical sign indicates INTOLERANCE to enteral nutrition and should prompt evaluation and possible rate reduction?

Accepted Answer

Abdominal distension, pain, and high gastric residuals consistently above 500 mL

Answer

Gastric residual volume of 150 mL in a critically ill patient

Answer

Passing flatus during tube feeding

Answer

Serum albumin rising during tube feeding

Question 5

What is the metabolic complication associated with excessive glucose infusion rates in parenteral nutrition?

Accepted Answer

Hepatic steatosis and elevated liver enzymes due to lipogenesis

Answer

Lactic acidosis from underutilized glucose

Answer

Hypoglycemia rebound effect

Answer

Metabolic alkalosis from glucose oxidation

Question 6

Which access device is preferred for long-term home parenteral nutrition (expected >3 months)?

Accepted Answer

Tunneled cuffed central venous catheter (e.g., Hickman) or implanted port

Answer

Peripheral IV catheter

Answer

Non-tunneled central venous catheter (CVC)

Answer

Nasogastric tube with PN delivery

Question 7

During a nutrition assessment for a patient requiring parenteral nutrition, which laboratory value best reflects acute changes in nutritional status over 1–2 days?

Accepted Answer

Serum prealbumin/transthyretin (half-life ~2 days)

Answer

Serum albumin (half-life ~20 days)

Answer

Serum transferrin (half-life ~8–10 days)

Answer

Hemoglobin (half-life ~120 days)