RDN Clinical Nutrition 2

Question 1

A patient with chronic kidney disease (CKD) stage 4 requires dietary phosphorus restriction. Which food group poses the greatest phosphorus burden due to phosphate additives?

Accepted Answer

Processed meats and fast foods

Answer

Processed meats and fast foods contain inorganic phosphate additives that are nearly 100% bioavailable, far exceeding the phosphorus burden of natural food sources.

Question 2

Which indirect calorimetry measurement indicates a patient is in a hypermetabolic state?

Accepted Answer

Measured REE 125% of predicted REE

Answer

A measured REE that is ≥120–130% of predicted REE indicates hypermetabolism, commonly seen in burn, sepsis, or trauma patients.

Question 3

A post-bariatric surgery patient (Roux-en-Y gastric bypass) presents with paresthesias and ataxia 18 months post-op. Which nutrient deficiency is most likely?

Accepted Answer

Copper

Answer

Copper deficiency after RYGB presents with neurological symptoms including peripheral neuropathy and myelopathy, often misdiagnosed as B12 deficiency.

Question 4

In the ESPEN guidelines, what is the recommended protein intake for critically ill patients receiving nutrition support?

Accepted Answer

1.3–2.0 g/kg/day

Answer

ESPEN recommends 1.3–2.0 g protein/kg/day for critically ill patients to attenuate muscle catabolism and support immune function.

Question 5

Which lab value most accurately reflects chronic protein-energy malnutrition over a 3-month period?

Accepted Answer

Serum albumin

Answer

Although not highly sensitive to acute changes, serum albumin's 20-day half-life and volume of distribution make it a marker of chronic nutritional and inflammatory status.

(RDN) Registered Dietitian Nutritionist Practice Test

(RDN) Registered Dietitian Nutritionist Practice Test

RDN Clinical Nutrition 2