Medical Nutrition Therapy Flashcards

A patient undergoing chemotherapy for colorectal cancer develops mucositis and is unable to tolerate solid foods. The most appropriate MNT intervention is:

Answer: Transition to soft, cool, non-acidic foods or oral supplements

For mild-to-moderate chemotherapy-induced mucositis, modifying food texture and temperature to soft, cool, non-irritating options or oral supplements maintains oral intake before escalating to artificial nutrition.

A hemodialysis patient presents with hyperkalemia. In addition to dialysis adequacy, which dietary counseling is most appropriate?

Answer: Leach or double-boil potatoes and vegetables to reduce potassium content

Leaching high-potassium vegetables by peeling, cutting small, soaking in water, and boiling with discarded water can reduce their potassium content by 30–50%.

A patient with gestational diabetes mellitus (GDM) has fasting glucose consistently above 95 mg/dL despite MNT. The dietitian should recommend:

Answer: Inform the physician, as pharmacologic therapy may be required

When MNT alone fails to achieve fasting glucose targets in GDM, the dietitian should communicate findings to the physician promptly as insulin or pharmacologic therapy is likely needed to prevent adverse fetal outcomes.

In a patient receiving total parenteral nutrition (TPN), which electrolyte disturbance is most commonly associated with refeeding syndrome?

Answer: Hypophosphatemia

Refeeding syndrome is characterized by a rapid drop in serum phosphate due to intracellular shifts driven by insulin release when carbohydrates are reintroduced after prolonged starvation.

A patient with end-stage renal disease on peritoneal dialysis has persistent malnutrition. Which unique nutrient consideration applies to peritoneal dialysis compared to hemodialysis?

Answer: Significant glucose absorption from dialysate must be counted in caloric intake

Peritoneal dialysis uses a glucose-based dialysate that provides a significant and often unrecognized caloric load (400–800 kcal/day), which must be factored into total energy calculations to prevent obesity and dyslipidemia.

A registered dietitian is developing a MNT protocol for bariatric surgery patients 6 months post-sleeve gastrectomy. Which supplement regimen is most critical to include?

Answer: Multivitamin with iron, calcium citrate, vitamin D, and vitamin B12

Post-sleeve gastrectomy patients require lifelong supplementation with a multivitamin, iron, calcium citrate (preferred over carbonate), vitamin D, and B12 to prevent common deficiencies caused by reduced intake and gastric acid.

A patient with hypothyroidism asks when to take their levothyroxine in relation to meals. As a dietitian, the correct guidance is:

Answer: Take on an empty stomach 30–60 minutes before breakfast, avoiding coffee and high-fiber foods

Levothyroxine absorption is significantly impaired by food, coffee, calcium, iron, and high-fiber diets; it must be taken on an empty stomach 30–60 minutes before eating for consistent absorption.