Clinical Nutritionist CCN Clinical Nutritionist CCN MCQ 3 — Questions and Answers
Question 1: A clinical nutritionist is counseling a breastfeeding woman who follows a strict vegan diet. Which nutrient supplementation is most critical for the infant's neurological development?
- Vitamin D
- Vitamin B12 (Correct answer)
- Calcium
- Iron
Correct answer: Vitamin B12
Breast milk from strict vegans is often deficient in vitamin B12, and infantile B12 deficiency causes severe, potentially irreversible neurological damage.
Question 2: Which type of dietary fiber is most effective at lowering LDL cholesterol through bile acid sequestration?
- Insoluble cellulose
- Resistant starch
- Soluble viscous fiber such as beta-glucan (Correct answer)
- Lignin
Correct answer: Soluble viscous fiber such as beta-glucan
Soluble viscous fibers like beta-glucan (found in oats and barley) bind bile acids in the gut, increasing their excretion and forcing the liver to use cholesterol to synthesize new bile acids.
Question 3: A male athlete reports muscle cramps, fatigue, and cardiac arrhythmias after intense training in heat. Which electrolyte imbalance is most likely?
- Hypercalcemia
- Hyponatremia
- Hypokalemia (Correct answer)
- Hypermagnesemia
Correct answer: Hypokalemia
Heavy sweat losses and inadequate potassium replacement lead to hypokalemia, which impairs neuromuscular function and can cause muscle cramps and cardiac arrhythmias.
Question 4: In nutrition assessment, which anthropometric measurement is most strongly associated with visceral adiposity and metabolic syndrome risk?
- Body mass index (BMI)
- Skinfold thickness at the tricep
- Waist circumference (Correct answer)
- Wrist circumference
Correct answer: Waist circumference
Waist circumference directly reflects abdominal visceral fat accumulation, which is a stronger predictor of cardiometabolic risk than overall body weight or BMI alone.
Question 5: Which enzyme deficiency causes phenylketonuria (PKU), requiring lifelong dietary phenylalanine restriction?
- Tyrosinase
- Phenylalanine hydroxylase (Correct answer)
- Homogentisate oxidase
- Fumarylacetoacetase
Correct answer: Phenylalanine hydroxylase
PKU results from a deficiency of phenylalanine hydroxylase, which normally converts phenylalanine to tyrosine; accumulation of phenylalanine is neurotoxic.
Question 6: Which nutrient deficiency is most likely in a patient who underwent a total gastrectomy and is not receiving supplementation?
- Vitamin C
- Vitamin B12 (Correct answer)
- Vitamin K
- Vitamin E
Correct answer: Vitamin B12
Total gastrectomy eliminates intrinsic factor production by parietal cells, making dietary B12 absorption impossible and leading to deficiency within 2–5 years.
Question 7: During a nutrition consultation, you identify that a client's estimated energy needs are 2,200 kcal/day using the Mifflin-St Jeor equation. What does this equation primarily calculate?
- Total daily energy expenditure (TDEE)
- Resting metabolic rate (RMR) (Correct answer)
- Thermic effect of food (TEF)
- Exercise energy expenditure (EEE)
Correct answer: Resting metabolic rate (RMR)
The Mifflin-St Jeor equation calculates resting metabolic rate (RMR), which must then be multiplied by an activity factor to estimate total daily energy expenditure.
Clinical Nutritionist CCN Clinical Nutritionist CCN MCQ 3
A clinical nutritionist is counseling a breastfeeding woman who follows a strict vegan diet.
Which nutrient supplementation is most critical for the infant's neurological development?