Free ACBN Nutritionist MCQ Questions and Answers — Questions and Answers
Question 1: Which of the following clinical characteristics is LEAST likely to be a sign of a patient in an acute care hospital who is nutritionally at risk?
- 15% of one's body weight lost voluntarily during the course of six months while one is obese (Correct answer)
- 10 days of inadequate nutrition
- Extensive colon resection brought on by cancer
- 5% of unintended weight loss over a month
Correct answer: 15% of one's body weight lost voluntarily during the course of six months while one is obese
Nutritional risk in an acute care setting typically refers to unintended weight loss, inadequate intake, or conditions that significantly increase metabolic demands or impair nutrient absorption. While 15% weight loss is substantial, if it's *voluntary* and the patient is *obese*, it often indicates a positive health change rather than a nutritional risk requiring intervention in the acute care context. Unintended weight loss (5% in a month), inadequate nutrition for 10 days, or extensive surgery due to cancer are all strong indicators of nutritional risk.
Question 2: Which of the following clinical characteristics is least likely to be a sign that medication on this list is most likely to result in weight gain? patient in an acute care hospital who is nutritionally at risk?
- Wellbutrin (Correct answer)
- Prozac
- Paxil
- Elavil
Correct answer: Wellbutrin
Wellbutrin (bupropion) is an antidepressant that is often associated with weight neutrality or even modest weight loss, rather than weight gain. In contrast, Prozac (fluoxetine), Paxil (paroxetine), and Elavil (amitriptyline) are all known to commonly cause weight gain as a side effect. Therefore, Wellbutrin is the least likely medication on this list to result in weight gain for a nutritionally at-risk patient.
Question 3: Which of the following is the best method for evaluating a patient with chronic liver disease and ascites?
- Nitrogen balance
- Albumin and prealbumin
- Weight for height
- Subjective Global Assessment (Correct answer)
Correct answer: Subjective Global Assessment
The Subjective Global Assessment (SGA) is considered the best method for evaluating nutritional status in patients with chronic liver disease and ascites. This is because ascites significantly impacts objective measures like weight and albumin levels, making them unreliable indicators of true nutritional status. SGA, however, incorporates clinical judgment, patient history, and physical examination findings (like muscle wasting and fat loss, while accounting for fluid retention), providing a more accurate and comprehensive assessment despite fluid shifts.
Question 4: What weight should a patient with chronic renal disease who is obese use when performing calculations?
- Actual weight
- Ideal weight
- Adjusted dry weight (Correct answer)
- Dry weight
Correct answer: Adjusted dry weight
For obese patients with chronic renal disease, adjusted dry weight is the most appropriate weight to use for nutritional calculations. This method accounts for the metabolic activity of excess adipose tissue while also considering the patient's dry weight, which is their weight without excess fluid. Using actual weight would overestimate needs due to fluid retention and obesity, while ideal weight might underestimate needs for an obese individual, making adjusted dry weight a more accurate and safer choice.
Question 5: Which of the following best summarizes when an enteral feeding protocol should be started for a patient with a traumatic brain injury?
- Within 48 hours
- Within 24 hours (Correct answer)
- Once bowel sounds are distinctly heard
- As soon as a nasogastric tube can be placed
Correct answer: Within 24 hours
For patients with traumatic brain injury (TBI), enteral feeding protocols should be initiated within 24 hours of injury. Early enteral nutrition is crucial to meet the high metabolic demands associated with TBI, prevent catabolism, and support gut integrity. Prompt initiation of feeding has been shown to improve patient outcomes and reduce complications compared to delayed nutritional support.
Question 6: 2280 cc of a D15%, 4% amino acid, and 3% intralipid 3-in-1 TNA solution has how many calories in it?
- 2207 kcal
- 2140 kcal
- 2413 kcal
- 2345 kcal (Correct answer)
Correct answer: 2345 kcal
To calculate the total calories in a TNA solution, the calories from dextrose, amino acids, and lipids are summed using standard conversion factors (dextrose: 3.4 kcal/g, amino acids: 4 kcal/g, lipids: 9 kcal/g). For 2280 cc of a D15% and 4% amino acid solution, this yields 1162.8 kcal from dextrose and 364.8 kcal from amino acids. To reach the total of 2345 kcal, the lipid component would need to contribute approximately 817.4 kcal, which corresponds to a lipid concentration of about 4% (91.2g lipid * 9 kcal/g = 820.8 kcal) rather than the stated 3%.
Question 7: Immediately after admission, a patient with a history of persistent alcohol misuse and potential Wernicke encephalopathy needs to be supplemented with.
- Potassium (Correct answer)
- Thiamine
- Magnesium
- Phosphate
Correct answer: Potassium
Patients with a history of persistent alcohol misuse and potential Wernicke encephalopathy are critically deficient in thiamine (Vitamin B1). Thiamine is essential for carbohydrate metabolism in the brain, and its deficiency leads to the neurological symptoms characteristic of Wernicke encephalopathy. Immediate thiamine supplementation is crucial to prevent further neurological damage and should be administered before any glucose-containing fluids.
Free ACBN Nutritionist MCQ Questions and Answers
Which of the following clinical characteristics is LEAST likely to be a sign of a patient in an acute care hospital who is nutritionally at risk?