Medical Nutrition Therapy Flashcards

A premature infant born at 28 weeks gestation requires parenteral nutrition. The appropriate initial protein provision should be:

Answer: 3.5–4.0 g/kg/day

Extremely premature infants require aggressive early protein provision of 3.5–4.0 g/kg/day via PN to replicate intrauterine accretion rates and support brain development.

Which serum marker is most reliable for assessing visceral protein status in the context of acute illness or inflammation?

Answer: C-reactive protein (CRP)

CRP is the most reliable indicator because albumin and prealbumin are negative acute-phase reactants that fall with inflammation regardless of nutritional status, making CRP essential for interpreting protein markers.

A patient with phenylketonuria (PKU) becomes pregnant. The most critical MNT intervention before and during pregnancy is:

Answer: Maintain strict low-phenylalanine diet with blood Phe levels below 6 mg/dL

Maternal PKU syndrome causes severe fetal damage; strict control of blood phenylalanine below 6 mg/dL ideally beginning before conception is essential to prevent microcephaly, heart defects, and intellectual disability.

A patient with short bowel syndrome has had resection of the terminal ileum. Which specific nutrient requires monitoring and supplementation due to this anatomical loss?

Answer: Vitamin B12

Vitamin B12 (cobalamin) is exclusively absorbed in the terminal ileum via intrinsic factor; resection of this segment requires lifelong B12 supplementation, usually by injection.

In a critically ill patient receiving enteral nutrition, which finding best indicates that gastric feeding should be held and a different approach considered?

Answer: Persistent vomiting with signs of aspiration risk

Persistent vomiting with aspiration risk is a clinical indication to hold gastric feeding and consider post-pyloric feeding, as GRV alone is no longer used as the primary indicator for intolerance.

A patient with type 2 diabetes and obesity is prescribed a meal replacement plan for weight loss. Which outcome best demonstrates successful MNT for this patient?

Answer: 5–10% weight loss with improved HbA1c, blood pressure, and lipids

A 5–10% weight loss is associated with clinically significant improvements in glycemic control, blood pressure, and lipid levels, representing successful MNT outcomes for this patient.

Which MNT intervention is most appropriate for a patient with non-alcoholic fatty liver disease (NAFLD) without cirrhosis?

Answer: Caloric restriction with 7–10% weight loss and reduced added sugars

A 7–10% weight loss achieved through caloric restriction, combined with reduction in added sugars and refined carbohydrates, is the most evidence-based MNT strategy for improving NAFLD.