Clinical Nutritionist CCN General 4 — Questions and Answers
Question 1: A client following a strict vegan diet is at highest risk for deficiency of which vitamin that cannot be obtained from plant foods?
- Vitamin C
- Vitamin B12 (Correct answer)
- Vitamin K
- Vitamin E
Correct answer: Vitamin B12
Vitamin B12 is found almost exclusively in animal-derived foods; vegans must supplement or consume fortified foods to meet requirements.
Question 2: Which type of dietary fiber is most effective at lowering LDL cholesterol through bile acid sequestration?
- Insoluble cellulose
- Soluble viscous fiber such as beta-glucan (Correct answer)
- Resistant starch
- Lignin
Correct answer: Soluble viscous fiber such as beta-glucan
Soluble viscous fibers like beta-glucan (oats) bind bile acids in the gut, reducing cholesterol reabsorption and lowering LDL levels.
Question 3: During a nutritional assessment, the clinical nutritionist measures a patient's mid-upper arm circumference (MUAC). This measurement primarily reflects which body compartment?
- Visceral fat stores
- Skeletal muscle and subcutaneous fat in the arm (Correct answer)
- Hepatic glycogen reserves
- Total body water
Correct answer: Skeletal muscle and subcutaneous fat in the arm
MUAC reflects the combined mass of skeletal muscle and subcutaneous fat in the upper arm and is used as a proxy for protein-energy nutritional status.
Question 4: A patient recovering from major surgery is placed on parenteral nutrition. Which electrolyte complication is most associated with refeeding syndrome in severely malnourished patients?
- Hypernatremia
- Hypercalcemia
- Hypophosphatemia (Correct answer)
- Hypermagnesemia
Correct answer: Hypophosphatemia
Refeeding syndrome is characterized by a dangerous drop in serum phosphate as insulin surges drive phosphate intracellularly during carbohydrate metabolism.
Question 5: Which of the following describes the Mifflin-St Jeor equation's primary clinical use?
- Estimating glomerular filtration rate in kidney disease
- Calculating resting metabolic rate for energy needs assessment (Correct answer)
- Predicting bone mineral density from body weight
- Determining ideal body weight for BMI classification
Correct answer: Calculating resting metabolic rate for energy needs assessment
The Mifflin-St Jeor equation estimates resting metabolic rate (RMR) using height, weight, age, and sex, and is widely used to set caloric targets.
Question 6: A clinical nutritionist advising a client with celiac disease must ensure avoidance of which protein found in wheat, barley, and rye?
- Casein
- Albumin
- Gluten (Correct answer)
- Zein
Correct answer: Gluten
Gluten (gliadin and glutenin components) triggers an autoimmune response in the small intestine of individuals with celiac disease.
Question 7: Which lipoprotein is synthesized by intestinal cells and transports dietary fats (triglycerides) through the lymphatic system?
- Very low-density lipoprotein (VLDL)
- Chylomicron (Correct answer)
- High-density lipoprotein (HDL)
- Intermediate-density lipoprotein (IDL)
Correct answer: Chylomicron
Chylomicrons are assembled in intestinal enterocytes and enter the bloodstream via the thoracic duct to deliver dietary triglycerides to peripheral tissues.
Clinical Nutritionist CCN General 4
A client following a strict vegan diet is at highest risk for deficiency of which vitamin that cannot be obtained from plant foods?