Medical Nutrition Therapy Flashcards

A patient with chronic kidney disease (CKD) stage 4 who is not on dialysis should have their dietary protein intake restricted to approximately:

Answer: 0.6–0.8 g/kg/day

For non-dialysis CKD patients, protein restriction of 0.6–0.8 g/kg/day helps slow progression and reduce uremic symptoms.

Which of the following lab values is most indicative of long-term glycemic control in a patient with type 2 diabetes?

Answer: Hemoglobin A1c (HbA1c)

HbA1c reflects average blood glucose over the preceding 2–3 months and is the gold standard for monitoring long-term glycemic control.

A patient post-Roux-en-Y gastric bypass is at highest risk for deficiency of which nutrient due to bypass of the primary absorption site?

Answer: Iron

Iron is primarily absorbed in the duodenum and proximal jejunum, which are bypassed in RYGB, placing patients at high risk for iron deficiency anemia.

For a patient with acute pancreatitis who can tolerate oral intake, the preferred feeding approach is:

Answer: Low-fat oral diet as tolerated

Current evidence supports initiating a low-fat oral diet as tolerated in mild acute pancreatitis rather than prolonged NPO status.

Which dietary modification is the primary MNT recommendation for a patient newly diagnosed with nephrotic syndrome?

Answer: Sodium restriction to manage edema

Sodium restriction is the primary MNT goal in nephrotic syndrome to manage edema and hypertension, while excessive protein supplementation is no longer recommended.

A patient on warfarin therapy asks about vitamin K intake. The best dietary counseling advice is to:

Answer: Maintain a consistent daily intake of vitamin K-rich foods

Consistency in vitamin K intake allows stable INR management; sudden increases or decreases can destabilize anticoagulation therapy.

In a patient with cirrhosis, which MNT strategy helps prevent hepatic encephalopathy while maintaining adequate nutrition?

Answer: Provide adequate protein (1.2–1.5 g/kg/day) with branched-chain amino acids if needed

Current guidelines recommend 1.2–1.5 g protein/kg/day for cirrhosis; protein restriction is no longer advised as it worsens outcomes, and BCAA supplementation may help refractory encephalopathy.