CNC Special Populations & Supplementation 3 — Questions and Answers
Question 1: A client with irritable bowel syndrome (IBS) wants to try probiotics. Which strain has the MOST evidence for IBS symptom relief?
- Lactobacillus acidophilus NCFM
- Bifidobacterium infantis 35624 (Correct answer)
- Saccharomyces boulardii only
- Lactobacillus rhamnosus GG
Correct answer: Bifidobacterium infantis 35624
Bifidobacterium infantis 35624 (Align) has robust clinical trial evidence specifically for reducing IBS symptoms including bloating and abdominal discomfort.
Question 2: Which supplement interaction is MOST dangerous for a client taking warfarin (blood thinner)?
- Vitamin C at 500mg/day
- High-dose Vitamin E and fish oil combined (Correct answer)
- Probiotic supplements
- Zinc at 15mg/day
Correct answer: High-dose Vitamin E and fish oil combined
Both high-dose vitamin E and fish oil have antiplatelet effects that, combined with warfarin, significantly increase bleeding risk.
Question 3: For an elderly client at risk of sarcopenia, which supplement strategy has the best evidence?
- Glutamine supplementation at 10g/day
- Leucine-enriched protein with resistance training (Correct answer)
- HMB alone without exercise
- Carnitine supplementation
Correct answer: Leucine-enriched protein with resistance training
Leucine-enriched protein supplementation combined with resistance training is the most evidence-based strategy for preserving muscle mass in elderly populations.
Question 4: A client with celiac disease is concerned about nutrient deficiencies. Which deficiency is MOST common in newly diagnosed celiacs?
- Vitamin B12
- Iron and folate (Correct answer)
- Vitamin C
- Potassium
Correct answer: Iron and folate
Iron and folate deficiencies are most common in celiac disease because they are primarily absorbed in the proximal small intestine, which is damaged by gluten.
Question 5: Which supplementation approach is appropriate for a teenage female athlete experiencing the Female Athlete Triad?
- Iron supplementation regardless of serum levels
- Calcium and vitamin D alongside increased caloric intake (Correct answer)
- Estrogen supplements to restore menstrual function
- High-dose multivitamin to compensate for low energy availability
Correct answer: Calcium and vitamin D alongside increased caloric intake
Calcium and vitamin D supplementation, combined with addressing low energy availability through increased food intake, is the cornerstone of managing the Female Athlete Triad.
Question 6: A 65-year-old client reports fatigue and muscle weakness. Lab work shows low serum 25(OH)D. What is the MOST appropriate initial vitamin D repletion dose?
- 400 IU/day (RDA level)
- 1000–2000 IU/day for maintenance
- 50,000 IU/week prescribed by physician for 8–12 weeks (Correct answer)
- 10,000 IU/day self-supplemented indefinitely
Correct answer: 50,000 IU/week prescribed by physician for 8–12 weeks
Clinically deficient patients are typically repleted with 50,000 IU/week (ergocalciferol or cholecalciferol) for 8–12 weeks under physician supervision, then maintained at lower doses.
Question 7: Which supplement is generally considered safe during lactation and may benefit both mother and infant?
- Ephedra-based fat burners
- High-dose vitamin A (retinol) above 10,000 IU
- DHA (docosahexaenoic acid) (Correct answer)
- Herbal thermogenics with caffeine
Correct answer: DHA (docosahexaenoic acid)
DHA supplementation during lactation supports infant brain and visual development and is considered safe, with recommended intake of 200–300 mg/day for nursing mothers.
CNC Special Populations & Supplementation 3
A client with irritable bowel syndrome (IBS) wants to try probiotics.
Which strain has the MOST evidence for IBS symptom relief?