SNLE Nutrition and Diet Therapy 2 — Questions and Answers
Question 1: A patient diagnosed with celiac disease must strictly avoid which dietary protein?
- Casein
- Albumin
- Gluten (Correct answer)
- Globulin
Correct answer: Gluten
Celiac disease is an autoimmune condition triggered by gluten, a protein found in wheat, barley, and rye that causes intestinal villous atrophy.
Question 2: Which type of enteral feeding formula is most appropriate for a patient with poorly controlled diabetes mellitus?
- High-carbohydrate standard formula
- Diabetic-specific formula with reduced carbohydrate content (Correct answer)
- High-protein formula without carbohydrate modification
- Elemental formula with simple sugars
Correct answer: Diabetic-specific formula with reduced carbohydrate content
Diabetic-specific enteral formulas contain modified carbohydrates and higher fat/fiber to reduce postprandial glucose excursions.
Question 3: A patient receiving total parenteral nutrition (TPN) develops sudden diaphoresis, tremor, and confusion. What is the nurse's priority action?
- Immediately stop the TPN infusion
- Check the blood glucose level (Correct answer)
- Administer an insulin bolus
- Notify the physician first
Correct answer: Check the blood glucose level
These symptoms suggest hypoglycemia; checking blood glucose is the priority assessment before any intervention to confirm the cause.
Question 4: Which dietary modification is most appropriate for a patient with hepatic encephalopathy?
- High-protein diet to support liver regeneration
- Moderate protein restriction with emphasis on branched-chain amino acids (Correct answer)
- High-fat diet to spare protein
- Sodium supplementation to maintain osmolarity
Correct answer: Moderate protein restriction with emphasis on branched-chain amino acids
Hepatic encephalopathy management involves moderating protein intake and preferring branched-chain amino acids to reduce ammonia production.
Question 5: A patient recovering from gastric bypass surgery experiences flushing, tachycardia, and diarrhea shortly after eating. The nurse should advise the patient to:
- Drink large amounts of fluids during meals to dilute food
- Eat large, infrequent meals to reduce meal frequency
- Eat small, frequent meals and avoid simple sugars (Correct answer)
- Increase dietary fiber intake significantly
Correct answer: Eat small, frequent meals and avoid simple sugars
Dumping syndrome follows rapid gastric emptying; small frequent meals and avoiding simple sugars slow gastric transit and reduce symptoms.
Question 6: At what gastric residual volume should a nurse typically pause nasogastric tube feeding and notify the physician?
- More than 50 mL
- More than 100 mL
- More than 200–250 mL (Correct answer)
- More than 500 mL
Correct answer: More than 200–250 mL
Most clinical guidelines recommend withholding enteral feeding when gastric residual volume exceeds 200–250 mL to reduce aspiration risk.
Question 7: Which electrolyte disturbance is most characteristic of refeeding syndrome when nutrition is reintroduced to a severely malnourished patient?
- Hypernatremia
- Hypophosphatemia (Correct answer)
- Hyperkalemia
- Hypercalcemia
Correct answer: Hypophosphatemia
Refeeding syndrome is defined by severe hypophosphatemia as cellular uptake of phosphate surges with insulin release during carbohydrate reintroduction.
SNLE Nutrition and Diet Therapy 2
A patient diagnosed with celiac disease must strictly avoid which dietary protein?