Medical Nutrition Therapy Flashcards

A patient with heart failure is prescribed a fluid restriction of 1.5 L/day. Which food item is most important to count toward this fluid allotment?

Answer: Gelatin desserts

Foods that are liquid at room temperature, including gelatin, ice cream, and soups, must be counted in fluid restriction for heart failure patients.

Which carbohydrate counting approach is recommended for patients with type 1 diabetes using intensive insulin therapy?

Answer: Carbohydrate-to-insulin ratio adjusted based on grams consumed

Patients on intensive insulin therapy use an individualized carbohydrate-to-insulin ratio to match insulin doses to actual carbohydrate intake, providing flexibility and better glycemic control.

A celiac disease patient reports persistent symptoms despite following a gluten-free diet. The FIRST step in MNT assessment should be:

Answer: Conduct a thorough dietary history to identify hidden gluten sources

A detailed dietary history is essential to identify inadvertent gluten exposure from cross-contamination or hidden sources before considering other interventions.

In HIV/AIDS patients with wasting syndrome, which combination of MNT strategies is most appropriate?

Answer: High-calorie, high-protein diet with micronutrient optimization

HIV wasting requires aggressive nutrition support with high calorie and protein intake alongside micronutrient repletion to preserve lean body mass and immune function.

For a patient with Crohn's disease in remission, which dietary approach has the strongest evidence for maintaining remission?

Answer: Individualized diet based on food tolerance with adequate fiber

Individualized dietary approaches based on tolerance, with adequate fiber intake and avoidance of personal trigger foods, are recommended for maintaining remission in Crohn's disease.

A 68-year-old woman with osteoporosis and vitamin D deficiency is recommended a daily calcium intake of 1,200 mg. She consumes 600 mg from food. How much supplemental calcium is needed, and what form is preferred if she takes omeprazole?

Answer: 600 mg as calcium citrate

Calcium citrate does not require stomach acid for absorption, making it preferable for patients on acid-suppressing medications like proton pump inhibitors.

Which indicator is most useful for monitoring adequacy of MNT in a patient receiving long-term home parenteral nutrition (HPN)?

Answer: Regular assessment of functional status, weight, labs, and trace minerals

Monitoring HPN adequacy requires a comprehensive approach including functional status, weight trends, metabolic labs, and trace mineral levels to detect deficiencies and complications.