ASPEN Certified Nutrition Support Clinician (CNSC) Practice Exam

These questions are part of the practice quiz. Start practicing

• Iron and calcium are absorbed primarily in which part of the small intestine?
• In PN with elevated bilirubin, which statement about trace element management is accurate?
• What is the metabolic role of choline?
• What is the AMDR defined as?
• Insensible losses from lungs and skin in a 100 kg afebrile person are approximately how many milliliters per day?
• Which statement about aluminum contamination in long-term PN is true?
• What is the recommended dosage of selenium supplementation in term neonates weighing 3-10 kg with normal organ function?
• Doses as high as what have been advocated to promote positive nitrogen balance in CRRT?
• If a patient cannot afford formula, which option is appropriate?
• Bacterial contamination is correlated with which factor?
• For ascites, what is the recommended protein intake for repletion?
• Which statement lists the four objective criteria used by the Prognostic Nutrition Index (PNI)?
• Which statement is true regarding the effects of dietary fiber on the GI tract?
• Which fat type is more prevalent in preterm formulas compared with standard infant formulas, and why?
• What does the MDS stand for in long-term care assessments?
• What protein level do recent ICU studies suggest for ICU patients on continuous renal replacement therapy (CRRT)?
• Which of the following occurs during the ebb phase regarding body temperature?
• Which statement best describes the general impact of regular alcohol intake on nutrient absorption?
• Which clinical factors can prompt adjustment of Holliday-Segar fluid rates?
• What is the hallmark energy expenditure pattern during the ebb phase?
• Do liquid medications contain lactose?
• In Vitamin D deficiency rickets, which vitamin D metabolite is typically decreased?
• Which statement correctly describes the solubility of monosaccharides?
• Which statement about Vitamin K in parenteral nutrition is true?
• With excessive tightening of the external bolster, what complication may occur and what is the incidence?
• What is the unit of body surface area produced by Mosteller's formula?
• Why should REE measured by indirect calorimetry be used as the caloric target without addition of stress or activity factors?
• Which of the following could be causes of zinc deficiency?
• Are there reliable indicators of chromium deficiency?
• Why are maximally concentrated nutrition solutions used in patients with ascites?
• What may occur with calorically dense or high-fiber formulas that decreases tube patency?
• Hydrolyzed protein and free amino acid–containing formulas have osmolality slightly higher than standard formulas due to smaller particle size.
• Which medications (2) may be beneficial in post-operative patients with high GRVs?
• Which statement describes the appropriate environment for HBMs preparation?
• Why is cysteine not included in standard parenteral amino acid solutions? How is it provided for infants?
• Which factor directly drives the decision to initiate PN in fistula patients?
• How often should closed enteral systems be changed?
• Which oil is NOT a good source of alpha-linolenic acid?
• Handgrip strength is used as an objective measure of functional status because it reflects which attribute?
• What can occur with long term vitamin D toxicity?
• Which statement best describes how energy needs change with age?
• What must be documented to qualify a patient for HPN under Medicare guidelines?
• A 70 kg adult following the 30-40 mL/kg/day guideline would require approximately how many milliliters per day?
• In the Swinamer equation, which variable is multiplied by 945?
• What is the most common complication following gastrostomy placement?
• What is the electrolyte content of D51/2NS?
• In patients receiving home parenteral nutrition, affiliation with a national support or educational organization was associated with which outcomes compared with nonaffiliated controls?
• What is the recommended initial dietary change for suspected cow's milk protein allergy?
• Ferritin levels during the acute phase response tend to:
• How many AMDRs are established for fat?
• Which of the following is considered diagnostic of infantile anorexia?
• NOT a physical examination factor?
• The osmolality of standard infant formulas at a caloric density of 20 kcal/oz generally falls within which range?
• What is the primary energy storage molecule for glucose in humans?
• In the Swinamer equation, what do T and VT represent?
• Which is a potential complication of tube feeding syndrome?
• In DKA, why does hypophosphatemia occur?
• Which statement about infectious complications with enteral feedings is true?
• List 3 aspects of home parenteral nutrition (HPN) that require specific justification for Medicare coverage.
• How does the colon produce short chain fatty acids?
• What is required for vitamin B12 absorption?
• The CMS guidelines are issued by which agency?
• What is the incidence of colocutaneous fistula with PEG tube placement?
• What is the preferred way to prevent feeding tube occlusion?
• Which finding indicates protein malnutrition on physical examination?
• Insurance coverage for home parenteral and enteral nutrition varies by type of program and by plan. Which statement best reflects typical coverage?
• Which of the following is a component of treatment for infantile anorexia?
• What is required for the formal diagnosis of celiac disease?
• Which medication has shown to be most successful in suppressing gastric hypersecretions after significant small bowel resection?
• What does the recent retrospective trial suggest about early enteral nutrition in hemodynamically unstable patients on mechanical ventilation?
• What legal principle underpins the provision of SNS according to the Cruzan decision?
• What is the hang time for expressed human milk when used for continuous enteral feedings?
• Which physiological condition requires adjustment of selenium supplementation?
• Which area of the gastrointestinal tract has the LEAST impact on nutrient absorption and intestinal adaptation following significant intestinal resection?
• Which of the following is an advantage of the 'teach back' process?
• Which tube feeding order best reflects an intermittent schedule?
• How does Medicare define eligibility for coverage of home enteral nutrition?
• Which statement best describes the normal mechanism for oxalate excretion?
• In liver disease, energy expenditure is usually increased especially in which conditions?
• In a 2-in-1 PN regimen, which components are typically combined in the same bag?
• What is a hallmark of aging-related body composition changes?
• Which combination of elements is used in the subjective global assessment to evaluate nutritional status?
• Which statement is TRUE regarding aspiration in critically ill children?
• When using REE from indirect calorimetry as caloric target in a critically ill patient, how should energy delivery be adjusted?
• Which condition warrants monitoring and potential reduction of copper supplementation due to excretion considerations?
• What was the IOM conclusion about the evidence for skeletal vs extraskeletal outcomes?
• Lipase and colipase are produced in which organ?
• What is the rationale for withholding feeding in end-of-life nutrition?
• Regarding fiber in abdominal distention, which statement is true?
• Which insulin strategy is least favored in hospitalized patients?
• Why is the significance of GRV controversial?
• Which daily fistula output would indicate PN according to the rule?
• Infantile anorexia is typically associated with trauma.
• How is ARDS defined?
• Which form of nutrition is recommended as first-line therapy in pediatric Crohn's disease?
• Should recommendations for laboratory monitoring be included on the PN order form?
• After NGT placement in a patient with head/neck pathology, what is the recommended practice?
• Would a patient with a permanent non-function of the small bowel be eligible for home enteral nutrition coverage under Medicare?
• List the three components of the Resident Assessment Instrument (RAI).
• Foul-smelling drainage around the tube exit site is a sign of what?
• Which is a primary cause of oozing stools in a tube-fed patient?
• After 2 weeks of fasting where does most energy come from?
• What is methotrexate and how does it work?
• Which statement about the effect of the distal ileum on gastric emptying is true?
• Hang time for human breast milk in enteral nutrition guidelines is best described as:
• Describe bolus feeding.
• Cheilosis is a physical symptom associated with a deficiency of
• Who should evaluate a new G-tube pain to prevent serious complications?
• Which statement best describes the hang time for a closed system enteral feeding container?
• Which statement about home enteral nutrition planning is NOT recommended?
• Which statement best reflects recommended protocols to decrease contamination in hospital enteral feedings of human milk for neonates or immunocompromised infants?
• Which statement about the Mifflin-St. Jeor equation is most consistent with the material?
• Which of the following is NOT listed among abnormalities seen with vitamin D deficiency?
• Anabolism begins during which burn metabolism phase?
• What is a benefit of using an electromagnetic placement device for nasogastric tube placement?
• Which nutrient may be related to PN-associated liver dysfunction, with evidence that there is no commercially available injectable form and benefits are unproven?
• Which statement best describes the principle behind adjusting oral rehydration solution sodium concentration in short bowel patients?
• In which older adult population is toxicity with fat-soluble drugs most likely?
• Are aluminum toxicity manifestations specific to a single organ system?
• Which of the following is NOT a research-based method to restore patency to clogged feeding tubes?
• In an end-stage liver disease patient with refractory ascites and hyponatremia, which nutrition strategy is most appropriate?
• A decrease in food intake in older adults is most likely attributable to which factor?
• In the Plan-Do-Study-Act cycle, which phase involves implementing the process improvement?
• Are hepatic encephalopathy, jaundice, and elevated liver enzymes considered markers of malnutrition?
• Which statement describes carbohydrate intake in PN for a stable infant?
• Which of the following is a data category to be included in the home care nutrition support performance improvement plan?
• Which of the following are factors that affect the measurement of GRVs?
• Zinc is an essential trace mineral necessary for which functions?
• How many feet of small bowel beyond the ligament of Treitz is typically considered for HPN coverage?
• How can EFAD be prevented in pediatric patients receiving parenteral nutrition support?
• Which statement about the incidence of buried bumper syndrome is correct?
• What are metabolic bone disease complications associated with inflammatory bowel disease? Why?
• Name the three infant populations deemed at risk for iron deficiency according to AAP selective screening.
• Powdered formulas reconstituted in advance should be refrigerated after preparation and discarded within 24 hours if not used. What is the maximum room temperature exposure time?
• Using the Holliday-Segar method, what is the maintenance fluid requirement for a 60 kg child per day?
• GFR for stage 2 kidney damage with mild low GFR?
• Which practice is recommended to minimize GRV measurement errors?
• What is the purpose of indirect calorimetry in critically ill neonates?
• Which of the following is most suggestive of malnutrition?
• The sodium gradient used for secondary active transport of glucose into intestinal mucosal cells is maintained by which primary transport mechanism?
• Which of the following are counter-regulatory hormones responsible for the hypercatabolic state observed in critically ill trauma patients?
• Which adjustment is commonly recommended when delayed gastric emptying is suspected?
• What is the initial action before nutrition therapy for hyperemesis gravidarum?
• Which of the following is NOT among the six possible causes of constipation with enteral nutrition?
• Copper deficiency can cause paresthesias in the extremities.
• What is the main purpose of preparing enteral formulas in a centralized location when feasible?
• What marker is used primarily to monitor protein intake during nutrition support?
• Why must vascular access devices for home PN be placed in the central venous system?
• What is the nutrition therapy for phenylketonuria (PKU)?
• An 87-year-old woman with ileostomy output of 1.5-2.0 liters per day after colectomy; supplementation of which micronutrient should be considered?
• Why is iron supplementation routinely restricted during the early stages of HSCT?
• What is a form of parenteral nutrition?
• Infantile anorexia is not due to an associated GI disorder or other medical condition. Is this statement true or false?
• Which of the following is not typically considered a modular product component?
• Can children with burns covering > 20% TBSA have nutrition support by oral intake?
• What is valproic acid?
• How should the dosage for vitamins be documented in PN ingredient orders?
• What fraction of total body water is extracellular fluid?
• Which item is included as part of proper discharge components?
• Selenium is active as an antioxidant and is vital for development of which organ system in infants?
• Which option best reflects the current stance on arginine use in severe sepsis?
• Failure to monitor which micronutrient in long-term PN patients is most likely to result in toxicity?
• Which growth chart allows comparison for preterm infants from 22 weeks gestational age through 10 weeks post-term age?
• Which strategy may increase the amount of feeding delivered in patients with high GRVs?
• What is the purpose of published safe enteral nutrition guidelines?
• Where should enteral formulas be prepared to minimize contamination?
• Which of the following best describes the use of artificial nutrition and hydration (ANH) in terminally ill patients?
• An older adult nursing home resident with constipation and a new PEG tube — which formula would be the best choice?
• Which of the following is NOT a mechanism contributing to malnutrition in Crohn's disease?
• Which type of enteral feeding tube requires immediate replacement if it becomes dislodged?
• Which of the following is a sign of moderate dehydration in infants?
• True or False: Growth can occur in postoperative neonates while the stress response is still active.
• Iron is absorbed in what form, and what maintains that form during absorption?
• Which statement best describes aluminum labeling for PN products?
• Which of the following is most likely to be associated with delayed bone age?
• A patient receiving PN with high ileostomy output should have which PN change?
• What functions does vitamin A have in wound healing?
• What is the predicted length of usage for a midline catheter?
• Describe continuous feeding.
• How does vitamin B6 interact with levodopa therapy?
• Which of the following is a characteristic finding in wet beriberi due to thiamin deficiency?
• Which statement correctly defines overweight and obesity BMI percentiles in children?
• What is a potential consequence of administering enteral acidic liquid medications?
• Which vitamin is primarily absorbed in the terminal ileum?
• Which combination represents modular products used to enhance the nutrient profile of a feeding regimen?
• What is the recommended daily calcium supplementation for reducing oxalate absorption in SBS?
• Which segment of the small intestine has greater adaptive capacity after resection?
• In critically ill children, predictive equations compared to indirect calorimetry generally show:
• Which of the following lists the phases of metabolism after burns?
• After solid organ transplant, cyclosporine is commonly used for which purpose?
• According to guidelines (2013 American College of Gastroenterology), what is the recommended route of nutrition in severe acute pancreatitis?
• Why are modified release dosage medication forms (XL, XR, SR, CD, etc.) inappropriate to crush for administration via enteral feeding?
• Name 3 signs/symptoms that meconium ileus and fibrosing colonopathy share. What is the major difference?
• Up to 26% of enterally fed patients report nausea and/or vomiting. If delayed gastric emptying is suspected as the causative factor, which of the following is LEAST likely to improve the patient's symptoms?
• Is enteral formula covered under Medicare Part B?
• What is the recommended blood glucose level for critically ill patients?
• In hepatic encephalopathy, which balance do BCAA enriched formulas aim to correct?
• At what gestational age is the ability to suck and swallow fully coordinated?
• During the catabolic phase, what is the focus of metabolic support?
• Dexamethasone is a potent steroid used to assist with which process in premature infants?
• Which statement about PN labeling is true?
• What is the purpose of therapeutic intervention during the inflammatory response following a traumatic injury?
• Which of the following is a benefit of closed enteral feeding systems?
• Which of the following is a sign of the ebb response after a burn injury?
• Exceeding 7 mmol/hour of phosphate infusion is associated with which risks?
• Which statement best describes continuous feedings?
• Which statement correctly describes serum albumin as a nutritional biomarker?
• What hormonal condition promotes fatty acid oxidation during starvation?
• What is the stated average nitrogen content of protein?
• What type of formula is recommended for exclusive enteral nutrition in pediatric Crohn's disease?
• There is currently no clear evidence to support that soluble fiber lowers the risk of developing colon cancer or reducing recurrence.
• What special requirement is needed when replacing/placing jejunostomy tubes?
• Which pair of medications is cited as prokinetic options to increase motility?
• Which supplement competes with copper for absorption when given enterally?
• Which form of nutrition therapy is commonly used as first-line induction in pediatric Crohn's disease?
• Which syringe size is recommended for flushing small-bore feeding tubes?
• In which part of the body are essential amino acids oxidized?
• What is the electrolyte content of half normal saline (0.45% sodium chloride)?
• Very long chain fatty acids are defined as having how many carbons?
• Linoleic acid and alpha-linolenic acid are essential fatty acids for humans because
• Which factor has been associated with an increase in PN prescribing errors?
• How are medium-chain triglycerides (MCTs) absorbed?
• What is the prevalence of hypermanganesemia in home PN patients?
• Why is cysteine not included in usual amino acid solutions for PN?
• What may be used other than serum retinol concentration for assessing vitamin A status?
• Which statement about ferric iron (Fe3+) is true?
• The BSA method for calculating fluid needs is based on the assumption that caloric expenditure is proportional to which parameter?
• Which of the following is an indication for the use of parenteral nutrition (PN)?
• Which of the following is a documented cause of abdominal distention in patients receiving enteral nutrition?
• Which action should be specified in discharge instructions for late or missed administration?
• Which method uses enteral pump or gravity drip over 20-60 minutes 4-6xs/daily?
• What is sarcopenia?
• Proton pump inhibitors can affect vitamin B12 absorption. Which statement accurately describes their effect and the risk with long-term use.
• In a study of 1023 critically ill patients, which outcomes were significantly greater for those with a serum albumin < 2.6 g/dL?
• Which feeding method allows meeting nutrient goals with an infusion period less than 24 hours, down to as few as 8 hours?
• Expressed human milk contains a variety of what type of flora?
• Which option lists the five elements required on the EN formula label?
• Is carnitine deficiency a common concern?
• In addition to aggressive refeeding, which places a patient at risk for hypophosphatemia?
• Which key concept should be included in post-discharge teaching for a home parenteral nutrition patient?
• What head-of-bed elevation is recommended to minimize aspiration risk in critically ill patients receiving enteral nutrition?
• What is the recommended practice when administering medications via an enteral tube to minimize risk?
• What statement best describes HIV-associated lipodystrophy syndrome?
• Which GI function tends to be slower to recover after surgery?
• What does fluoroscopy require?
• Glucose absorption in the intestine involves co-transport with which ion?
• Which statement about lab monitoring frequency is correct for home PN?
• Under which condition is phosphofructokinase inhibited?
• What is a major contributing factor in the development of metabolic bone disease in patients with IBD?
• Define the ethical principle of autonomy.
• Which statement accurately describes the relationship between meconium ileus and high-dose pancreatic enzyme therapy?
• What types of significant complications accompany hypermagnesemia in home PN patients?
• Which of the following is NOT a sign or symptom of infantile anorexia?
• What must be done with the result of the nutrition screen in home care patients?
• How many calories are in 1 gram of dextrose?
• Precocious puberty is usually associated with which bone age finding?
• What is the incidence of peristomal infection in PEG tube placement?
• Is physical therapy provided by the home infusion company?
• Enterokinase activates which enzyme in digestion?
• What factor during hemodialysis can alter indirect calorimetry measurements?
• For a pancreatic insufficient infant with CF, which feeding is best?
• What is the second element of treatment for infantile anorexia?
• What does the Holliday-Segar method estimate?
• Under Holliday-Segar, how many mL/kg/day are allotted for the first 10 kg?
• Which statement about GRV and risk is accurate?
• In children with high juice, soda, and sweetened beverage intake, which minerals are at risk for deficiency due to displacement of bone-promoting beverages?
• In a postoperative patient with documented high gastric residual volumes who is receiving bolus feedings, which strategy is most likely to improve feeding tolerance?
• Which method of enteral nutrition delivery is preferred for critically ill patients?
• A parenteral nutrition formulation contains 95 grams of protein. How many grams of nitrogen does it contain?
• Which criterion defines short bowel syndrome in the Medicare HPN criteria?
• Which BMI range is considered protective in dialysis patients according to recent practice patterns?
• What is the impact of pediatric Crohn's disease on growth and nutritional status?
• In cancer-related malnutrition, weight loss varies with cancer type, location, grade, and stage. This statement is:
• All of the following are clinical features of SIAD except:
• In acutely ill patients receiving continuous renal replacement therapy (CRRT), what is the recommended protein intake?
• Do all patients with wounds require zinc supplementation?
• Why does cystic fibrosis-related diabetes occur?
• What is often the primary goal in neonatal nutrition?
• During illness and trauma, which combination of hormones is increased?
• What is the daily maintenance fluid requirement for a 5 kg infant?
• Which set of substances are monosaccharides?
• Proximal high-output fistulas are associated with what systemic risk?
• Which statement about the teach-back process is accurate?
• What is the aluminum labeling requirement for PN products?
• Which of the following is a consequence of vitamin D deficiency?
• Which service is reimbursed by Medicare for home and community-based professional nutrition education?
• Which trace elements may become elevated in cholestasis in PN patients?
• True or false: Osmolality above 460 mOsm/kg is associated with tolerance issues in infants.
• Which of the following is NOT a reason infants with chronic lung disease often have high calorie needs?
• The Lawton-Brody Instrumental Activities of Daily Living (IADL) scale measures which of the following?
• Is expressed human milk sterile?
• Enteral glutamine content is difficult to determine because?
• Which of the following is NOT a factor to consider when converting IV medications to the enteral route?
• Is there a clear indication that existing constipation can be effectively resolved by increasing the intake of dietary fiber?
• The MNA-SF is used as a screening tool to detect nutritional problems in which population?
• Baseline zinc deficiency risk in older adults is best described as due to what?
• Which statement describes guidelines to use with expressed human milk continuous feedings to reduce potential contamination?
• What degree of head-of-bed elevation is recommended to reduce aspiration risk in critically ill patients?
• What dose and form of cysteine is used for parenteral nutrition in preterm infants to address solubility concerns?
• In safe EN guidelines, which statement is correct regarding hang times for formulas used in open systems?
• Which statement about nitrogen balance measurement is true?
• The Resident Assessment Instrument is used primarily in which setting?
• Which equation is used to calculate REE and RQ from VO2 and VCO2?
• The majority of dietary folate is reabsorbed via which mechanism?
• Why are high MCT content included in preterm formulas?
• Medium chain fatty acids are defined as having how many carbons?
• When is it within the scope of practice for registered nurses to insert nasogastric feeding tubes?
• Why are higher amounts of taurine and tyrosine included in neonatal PN solutions as compared with adult PN solutions?
• Patient education materials for home enteral and parenteral patients should be written at what grade level?
• Describe the inflammatory response following a traumatic injury.
• Which intervention has NOT been proven effective in reducing the risk of aspiration for critically ill patients receiving enteral nutrition?
• Which statement best defines the ethical principle of beneficence?
• Is patient harm typically a significant concern in EN?
• Standard parenteral amino acid solutions available for neonates differ from standard adult parenteral amino acid solutions by having a higher content of
• How are complications such as the formation of an esophageal or intestinal bezoar with fiber administration avoided?
• Which practice supports safe home EN by ensuring patient and caregiver understanding?
• Should medications be mixed directly into the enteral formula for administration?
• Which option is NOT an appropriate initiate-and-advance strategy for enteral feeds based on the material provided?
• Do electromagnetic nasogastric placement devices monitor gastric pH?
• Cranberry juice flush is considered not to be a research-based method to restore patency because it has which of the following characteristics?
• During human breast milk administration, which practice is supported by guidelines?
• In adults, cysteine can be synthesized from methionine via which metabolic pathway?
• How are glucose and galactose transported into the enterocyte?
• Which of the following compromises the reliability of urinary urea nitrogen to calculate nitrogen balance?
• What is the primary mechanism behind calcium oxalate nephrolithiasis in short bowel syndrome?
• What is the recommended hang time for closed-system enteral feeding containers?
• Which statement best describes cross-reactivity between cow's milk protein allergy and soy protein allergy in infants?
• Reason small-bowel feeding may deliver more calories is because...
• Which statement best describes management strategies to reduce complications at gastrostomy exit sites?
• What is a major advantage of the Fenton growth chart?
• Which vitamin deficiencies are associated with macrocytic anemia?
• NOT a component of a micronutrient assessment in PN patients?
• Which of the following is a sign of glucose intolerance in infants on PN?
• Which of the following are recommendations for measuring GRVs?
• Which statement about cyclic feedings is true?
• What is the incidence of gastric ulceration with PEG tube placement?
• What amino acid is conditionally essential during wound healing?
• Which of the following is a feature of the ebb response?
• Which statement about iron needs for exclusively breastfed infants is correct?
• One concern with blue dye for detecting aspiration is its low sensitivity.
• Up to how many carbon atoms can fatty acids be absorbed directly through the intestinal villi?
• Hypoglycemia requiring dextrose is most likely in which liver disease?
• Which nutrition therapy is currently favored in early post transplant hematopoietic cell transplant patients?
• Which of the following is the most appropriate situation for nurses to insert a nasogastric feeding tube without physician supervision?
• Which two conditions comprise the high-risk profile for aluminum toxicity in PN patients?
• Which statement best reflects coping differences among HPN patients according to the material?
• The use of Lactobacillus GG in pediatric practice has been found to be most effective in which outcome?
• What is the most likely cause of watery diarrhea and bloating in the enterally fed adult patient?
• The maximum time an open system enteral feeding formulation container should be used in the home setting is:
• In adults with persistently elevated gastric residual volumes (GRVs), which intervention is most appropriate to consider?
• Have increased gastric residuals been linked to an increased risk for aspiration?
• Which of the following has been shown to reduce plasma homocysteine concentrations?
• EFAD leads to which two outcomes?
• Which imaging method is required to verify a jejunostomy tube replacement?
• How should medications be administered via enteral routes to prevent interactions?
• A 13-year-old boy with BMI percentile 97th would be classified as which weight status?
• Enteral nutrition is contraindicated in the early post transplant period due to which major factor in adult hematopoietic cell transplants?
• Which method to determine energy expenditure incorporates body surface area?
• In the context of GERD management in neurologically impaired children, what is the primary purpose of surgical intervention such as fundoplication?
• Which combination of conditions increases the risk of zinc deficiency?
• Which statement best describes bone age testing?
• Bone age is evaluated by radiography of which bones using norms for different ages and sexes?
• Which statement about hyperemesis gravidarum and nutrition support is true?
• Which electrolyte disturbance can occur with sorbitol administration?
• Why is zinc the trace element most commonly suspected to be abnormal in long-term PN?
• According to the Institute of Medicine, calcium and vitamin D play a key role in which health outcome?
• Anabolism is established during which phase of the flow response?
• Which population is not appropriate for using the Body Surface Area (BSA) method to calculate maintenance fluids?
• Rapid intravenous infusion of potassium phosphate may result in which complication?
• What is the half-life of retinol-binding protein?
• What is the AAP recommendation for infants at 4-8 weeks who are not receiving human milk?
• Iron is absorbed in which region of the small intestine?
• What is the formula for RQ?
• Fibrosing colonopathy is a complication associated with which therapy?
• In Waterlow criteria, what does length/age index represent?
• What is the most widely used tool to measure generic health-related quality of life?
• Which of the following is a sign of the flow phase after a burn injury?
• In the context of refeeding, which electrolyte disturbance is most concerning?
• Nephrolithiasis risk factors: which statement is true for patients with short bowel syndrome?
• Is cisapride useful in patients with high GRVs?
• How does insulin affect potassium and phosphorus?
• What is the top priority for intervention following a traumatic injury?
• Which term describes the rapid breakdown of protein in acutely ill patients?
• What is a good estimate of nutritional needs of a patient with a bone marrow transplant? (protein and energy)
• In patients with severe acute pancreatitis enteral nutrition has been documented to provide the following benefits over Parenteral nutrition EXCEPT: decreased infection rate, decreased hospital length of stay, decreased pain, decreased mortality
• What condition is an indication for PN in fistula management?
• When considering higher fiber content in an enteral formula, what is a plausible effect on distention?
• Why should holding of feedings be minimized?
• In PKU, which amino acid becomes deficient due to the metabolic block?
• A 75-year-old male with aspiration pneumonia on continuous enteral nutrition via NG tube, unsafe for oral diet. Which long-term feeding option would be most appropriate?
• For term infants not receiving human milk between 4-8 weeks, what is the recommended iron source?
• Low-output fistulas are typically defined as output under how many mL per day?
• Intrinsic factor–B12 complex is taken up by receptors in the
• List 5 requirements for Medicare coverage of home parenteral nutrition (HPN) under the Prosthetic device act?
• What procedure is essential prior to discharging a patient on home parenteral nutrition (HPN)?
• Which of the following is considered an upper limit for the osmolality of infant formulas to avoid tolerance issues?
• In the 2010 HCUP NIS, discharge data were collected from approximately how many hospitals?
• Which statement about cancer-related malnutrition is a criterion for diagnosis?
• Which pharmacologic approach is included in ASPEN/SCCM guidelines to reduce aspiration risk in critically ill patients?
• What two nutrients should oral rehydration fluids include?
• What is the most important nutrition intervention to prevent nephrolithiasis?
• Which method has been reported as an enzymatic therapy to break down a bezoar?
• Why is glutamine considered conditionally essential in some clinical conditions?
• What energy-containing product is formed by anaerobic fermentation in the colon?
• Copper toxicity is most likely to occur when which process is impaired?
• Which statement best describes the effect of granulation on PEG site skin health?
• What is the initial step recommended by the AAP for an infant showing signs of intolerance on an exclusively cow's milk-based formula?
• In preterm formulas, what is the carbohydrate composition?
• Immediately following neonatal cardiac surgery, which range best estimates parenteral caloric requirements?
• Which term describes respect for a patient's right to make medical decisions, including continuation or discontinuation of feeding?
• Which set of amino acids is given in smaller amounts to neonates compared with adults?
• Describe the digestive processes required for vitamin B12 absorption.
• How can refeeding syndrome impact weaning from mechanical ventilation?
• Are vitamins, minerals and water considered modular products?
• Which statement best describes the response of heart failure symptoms in wet beriberi to thiamin supplementation?
• Why should liquid dosage forms be diluted with water prior to administration through an enteral tube?
• Under Medicare, the two criteria for home enteral nutrition are:
• A patient on long-term home enteral nutrition suddenly develops nausea and vomiting. The most likely cause is
• Which substance has a half-life closest to 12 hours?
• Regarding the effect of fiber on mineral absorption, what is the current understanding?
• Which professionals are allowed to replace a nasogastric tube (NGT)?
• What portion of the small bowel is dietary fat absorbed in?
• An assessment of functional status may aid in determining nutrition risk. Which assessment provides information on functional status?
• Which of the following is a factor associated with metabolic bone disease in inflammatory bowel disease?
• During the acute phase response, what happens to serum iron and ferritin levels?
• Which statement correctly describes iron in human milk compared with cow's milk?
• Is gastrointestinal surgery a contraindication to early enteral nutrition?
• Which statement describes an age-related change in gastrointestinal motility?
• In hepatic encephalopathy, what contributes to the symptoms due to amino acid imbalance?
• Which form of glutamine supplementation is most beneficial?
• In a patient with head or neck pathology, how should a nasogastric tube be placed?
• What is the simplest way to deliver gastric feeding that is popular with home care patients?
• Does indirect calorimetry measure total energy expenditure?
• Mosteller's formula is commonly used to calculate which physiologic measurement?
• What may be required with liquid enteral medication administration to minimize tube occlusion and adverse effects?
• Which deficiency syndrome may result from long-term alcohol abuse?
• Continued nasogastric output results in loss of gastric secretions; what is the most common electrolyte abnormality?
• Which age range is specified for universal screening in the AAP's iron deficiency anemia recommendations?
• Which statement best describes the use of elemental versus polymeric formulas in exclusive enteral nutrition?
• In the large multicenter study, which cancers had the lowest prevalence of weight loss at diagnosis?
• Why should the EN tube be flushed before and after each medication?
• What is the appropriate education to provide to family members regarding the dying process?
• What volume of water is recommended to dissolve crushed immediate-release tablets prior to administration through a feeding tube?
• In this body fluid model, what is the intravascular space volume?
• Who is the Holliday-Segar method not suitable for?
• Which two clinical conditions decrease serum albumin?
• Why might small bowel feeding increase the amount of feeding delivered in postoperative patients with high GRVs?
• In older adults receiving cyclic parenteral nutrition, which metabolic change is most likely compared to middle-aged adults?
• What is the generally accepted treatment plan for eating disorders?
• Define tube feeding syndrome.
• Why might vitamin D deficiency contribute to hyperlipidemia?
• What Medicare act is home parenteral nutrition (HPN) covered under?
• What does evidence demonstrate about adaptation to prescribed home enteral nutrition regimens?
• Which combination of strategies can reduce gastrostomy exit-site leakage?
• What happens to glucose oxidation with age during cyclic PN?
• Define continuous feeding.
• Sarcopenia, a loss of lean body mass that occurs with aging, is also associated with which change?
• What does weight for length represent in the Waterlow criteria?
• To meet the Medicare payer criteria for home enteral or parenteral nutrition, the patient's condition must be considered to be 'of long and indefinite duration'. Which length of time below meets Medicare's test of permanence?
• In fat malabsorption, which lipid source should be used to provide concentrated energy?
• The estimated risk of enamel fluorosis in infants fed reconstituted infant formula correlates with which factor?
• Which of the following is not a listed TBW compartment?
• In eating disorders, which intervention has been shown to significantly increase weight and BMI compared to oral refeeding therapy alone?
• Which statement best describes the timing of complications after PEG tube placement?
• Observation of which drainage at the tube exit site signals infection in a patient with a newly placed gastrostomy or jejunostomy tube?
• In a 65-year-old female with GI surgery, pneumonia, and septic shock started on PN, which protein intake is best for initiation?
• Which vitamin requires bile salts for emulsification and integration into the micelle for intestinal absorption?
• How does protein concentration in preterm milk change over lactation?
• Which of the following is NOT listed as a contamination point when using human milk for enteral feeding?
• Underfeeding is associated with which of the following conditions?
• What result of thiamin deficiency can be fatal?
• Myeloneuropathy is a possible feature of deficiency in which trace element?
• Which statement describes the carbohydrate content difference between enteral products designed for oral use and oral supplements?
• How has psyllium fiber been successfully administered via feeding tubes?
• What is required for formal diagnosis of celiac disease?
• What symptom may manifest with impaction and why?
• Why is D-lactic acidosis more likely in a patient with an intact colon and short bowel?
• A 30 kcal/oz concentrated standard infant formula typically has osmolality around which value?
• A 62-year-old female with impaired renal function is prescribed sulfamethoxazole/trimethoprim for a urinary tract infection. Which electrolyte disorder is most likely to occur?
• Persistent hyperglycemia in patients with type 2 diabetes can result in which metabolic condition?
• Which statement about the components of basal-bolus insulin therapy is NOT a component?
• Stage 5 kidney failure is defined by a GFR value less than what threshold (mL/min/1.73 m2)?
• Which statement is true regarding aluminum toxicity risk in PN patients?
• What is parenteral nutrition-associated cholestasis (PNAC)?
• What are the two most common surgical techniques used to treat severe reflux in the United States?
• What is the role of soy protein–based formulas in preventing allergy or managing non-specific gastrointestinal symptoms (such as colic and regurgitation) in infants?
• What proportion of cancer patients present with weight loss at the time of diagnosis?
• What statement best describes nutrition support adequacy for mechanically ventilated patients?
• Which protein is primarily responsible for transporting fatty acids in the blood?
• Which term describes the average daily nutrient intake level estimated to meet the needs of half of healthy individuals in a life stage and gender group?
• Do standard infant formulas and pediatric trace element products contain selenium?
• Under Holliday-Segar, how many mL/kg/day are allotted for the next 10 kg (from 10 to 20 kg)?
• When medically possible, when can enteral feeds begin in neonates and what is the preferred formula?
• What specific area is required for home parenteral nutrition patients?
• The initial protein requirements for a critically ill trauma patient weighing 70 kg are which range?
• The viscosity of an enteral formula depends on the concentration and characteristics of which two components?
• In an infant with complete ileal resection with preservation of the ileocecal valve, what is the primary nutrition-related concern?
• Which statement about guidelines for pancreatitis nutrition is true?
• When should early enteral feeding be initiated in critically ill patients?
• Which occurs in chromium deficiency?
• Should the home enteral nutrition patient be separated from the family during meal times?
• Which vitamin deficiency is most likely to occur in an older adult who consumes alcohol regularly?
• What is the purpose of pancreatic enzyme therapy?
• If a PD patient has not demonstrated stable protein status with 1.2 g/kg/day, what should be used?
• Does protein and calorie provision need to be included in discharge instructions?
• What have low plasma choline levels in long term PN patients been associated with?
• What is mixed state malnutrition?
• Methotrexate acts by interfering with the normal intracellular metabolism of which of the following nutrients?
• Which of the following is NOT listed as a risk factor for aspiration in critically ill patients?
• What happens to the body during starvation?
• Which statement best describes lactose content in adult enteral products and medications?
• Which of the following is NOT associated with a delayed bone age in a child with short stature?
• Skeletal muscle glycogen stores are approximately how many grams?
• In the Swinamer calculation, what does BSA stand for?
• How should PN ingredients be expressed on the PN label?
• What should be avoided with enteral feeding when possible to optimize meeting calorie and protein needs?
• What is the primary purpose of measuring handgrip strength in older adults receiving nutrition support?
• Which type of formula should be used for exclusive enteral nutrition front-line therapy?
• Why does resection of the ileocecal valve result in malabsorption?
• Do gastric residual volumes correlate to increased risk of aspiration?
• The MNA-SF is designed to screen nutritional problems in which population?
• Are teenagers considered high risk for problems when PN is initiated in the home setting?
• Which position is associated with increased aspiration risk in critically ill patients?
• Which of the following are monosaccharides?
• What do parietal cells secrete?
• Describe cyclic feeding.
• Which study shows enteral nutrition beyond the ligament of Treitz in severe pancreatitis reduces infectious complications, maintains nitrogen balance, and reduces hyperglycemia?
• Is PN indicated for a fistula with daily output of 600 mL?
• During illness and trauma hepatic glucose production may exceed how many grams per day?
• In which part of the intestine is vitamin B12 absorbed?
• Compared with healthy neonates, how do the energy needs of critically ill and postoperative neonates typically compare?
• What is the primary complication of hyperphosphatemia?
• Is an isolated infusion area and dedicated refrigerator needed for home parenteral nutrition?
• Which component is commonly used as a modular fat source in enteral nutrition formulas?
• In pediatric Crohn's disease, which of the following is a negative effect of corticosteroids?
• The most common complication after PEG tube placement is:
• What are fluid requirements for healthy adults > 75 years old?
• Why are cations especially Iron dextran destabilizing to TNA?
• Which statement best describes Kwashiorkor?
• Is the use of blue dye in detecting aspiration currently recommended?
• In cystic fibrosis with pancreatic insufficiency, what is added to enteral feeds to aid digestion and absorption of nutrients?
• Which statement best describes growth in neonates during a stress response?
• Is a caregiver always required for home parenteral nutrition (HPN)?
• What is the maximum recommended duration for peripheral parenteral nutrition (PPN), and why is longer use discouraged?
• Continuous feeding in critically ill patients may decrease aspiration risk by preventing gastric distention.
• What percent decrease in average energy needs is observed per decade in adults?
• Why is short-acting insulin (regular) typically used when initiating enteral nutrition?
• Which of the following is included among the PINI inflammatory response markers?
• Which statement correctly identifies the two medication types used to treat gastric hypersecretions and notes which is preferred?
• In context of enteral tube medication administration, which statement is true?
• Octreotide exerts its effect in short bowel syndrome by which mechanism?
• Early introduction of minimum enteral feeds in preterm infants is associated with which benefits?
• In most cases what accounts for the majority of fluid losses?
• What disease has hyperhomocysteinemia been linked to?
• Which of the following represents the calcium RDA for children ages 4–8 years old?
• Which measurements are used to assess subcutaneous fat and muscle mass?
• What is the revised recommendation for vitamin D status in infants, including those who are exclusively breastfed?
• How does fuel oxidation change during fasting?
• Which two roles of selenium are described for infants?
• Which two amino acids are higher in standard parenteral amino acid solutions for neonates than those from standard adult parenteral amino acids?
• Renal tubular acidosis commonly shows abnormalities in which two laboratory values?
• Which of the following factors may affect the measurement of GRV?
• Which strategy is most effective in moving critically ill patients toward the target enteral feeding rate?
• Between which days after burn injury does the acute phase peak?
• Crohn's disease can appear anywhere along the GI tract from the mouth to which end?
• Which statement best describes enteral glutamine supplementation in critically ill patients not in multi-organ failure?
• Which description accurately defines the teach-back process in discharge education?
• Which type of insulin should be used when initiating enteral nutrition in a hospitalized diabetic patient?
• Which statement best describes the management of mild hypercalcemia?
• Enteral nutrition is recommended initially over parenteral nutrition in pregnancy to avoid several complications. Which of the following is a complication more common with PN that EN helps avoid?
• Which condition is a cause of nausea and vomiting in the enterally fed patient due to gastric outlet obstruction caused by feeding tube migration?
• In PN for a stable infant, which macronutrient is provided at roughly 10-20% of total kcals?
• Short-term feeding tubes have a recommended change interval described as which of the following?
• For pediatric PN patients, selenium supplementation is typically started after how long on PN?
• What is the purpose of ketone metabolism in starvation?
• What is the hang time for blenderized or reconstituted formulas at home?
• What is the typical duration of an intermittent feeding session?
• What is carnitine?
• Which vitamin consideration is most important for an older adult receiving a 3-in-1 PN while on Warfarin therapy?
• Why is flushing the tube with water before and after each medication recommended?
• Why is jejunal feeding delivered by continuous pump?
• Stearic acid is classified as which type?
• There are no clinically proven points at which tube feeding should be discontinued with adequacy of oral intake; a general guideline is that oral intake should meet at least 66% of nutrient intake. Which statement best reflects this?
• What is the evidence for using omega-3 fatty acid formulas in ARDS?
• Which statement is NOT an extraskeletal outcome considered in the 2010 IOM calcium and vitamin D assessment?
• Why is a high complex carbohydrate diet recommended for patients with short bowel and a colon in continuity?
• Under Medicare, which statement about Part B home enteral nutrition coverage is true?
• Which factor after GI surgery may impact absorptive function related to the absence of colon and/or ileocecal valve?
• What are bile acids?
• Which of the following statements best describes vitamins that require bile salts for emulsification and micelle absorption into the enterocyte?
• Why are patients with renal failure at increased risk for aluminum toxicity?
• The sodium content of ileostomy output can be as high as 120 mEq/L. What value does this represent?
• Which parameter is used to determine PN indication in fistula patients?
• Hartnup's syndrome is an autosomal recessive disorder causing poor absorption of which amino acids, potentially producing pellagra-like dermatitis, diarrhea and dementia?
• Which process has been shown to be most effective for understanding discharge teaching?
• In nonalcoholic steatohepatitis, nutrition status is
• Would a back-up electrical generator be needed in the home environment for a patient receiving parenteral nutrition?
• What does NASPGHAN recommend as first line induction therapy in pediatric Crohn's disease?
• Which grouping of amino acids is given in smaller amounts to neonates compared with adults?
• Why is cysteine considered likely essential in preterm infants but not in adults?
• Which statement best describes modular products?
• Which lipid source is most appropriate for fat malabsorption to provide energy?
• Why are ileal resections generally more poorly tolerated than jejunal resections?
• Define intermittent feeding.
• Zinc deficiency is most commonly associated with which condition?
• In Waterlow criteria, what is weight-for-length used to assess?
• Describe the accuracy of predictive equations in pediatric intensive care patients.
• What is the usual onset age range for infantile anorexia?
• What is the scope of practice for registered nurses in NGT placement?
• In the setting of steatorrhea, which statement best describes oxalate absorption?
• In aging, what happens to plasma free fatty acids?
• Sarcopenia is most commonly seen in which population?
• Regurgitation in neonates is related to relaxation of the lower esophageal sphincter.
• Why is cysteine non-essential in adults?
• What mechanism explains malabsorption after ileocecal valve resection?
• Which patients should be given IV calcium gluconate in a hyperkalemic emergency and why?
• What is the incidence of buried bumper syndrome in PEG tube placement?
• In cirrhosis, when would a temporary protein restriction be appropriate?
• What is one of the most useful diagnostic tests in assessing a child with abnormal growth?
• Which statement best describes the fat composition of preterm formulas and the reason for it?
• What is a time-limited trial of SNS in patients with a DNR order?
• Which medication change can help reduce nausea in enteral nutrition?
• Which data should be collected in the home care provider's performance improvement plan?
• Which item on the EN formula label helps ensure the formula is not expired or hung beyond the recommended hang time?
• How does megestrol acetate affect diabetes?
• A patient with chronic heart failure on high-dose furosemide is started on enteral nutrition for an inability to consume adequate oral nutrition. Despite a slow advancement to goal feeding rate, he suffers from electrolyte imbalance and peripheral neuritis. Deficiency of which vitamin should be suspected?
• Why does hypoglycemia occur in the majority of patients with fulminant hepatic failure?
• What did a meta-analysis conclude about Lactobacillus GG in pediatric patients?
• Why has valproic acid been shown to induce carnitine deficiency?
• What is one proposed mechanism by which valproic acid may cause carnitine deficiency?
• Which data element is a key indicator of quality in home care nutrition support?
• In home PN, hypermanganesemia is associated with which complications?
• Is a soy formula recommended in infants with acute diarrhea associated with gastroenteritis who develop secondary lactase deficiency?
• What is the RDA for vitamin D for children aged 1-18 years?
• What intervention can alleviate the most common symptom of dryness when feeding is withheld?
• Which index includes serum albumin as one of its objective criteria?
• Should you change to an elemental formula in patients with C. difficile?
• What is the preferred treatment for an otherwise healthy infant with acute dehydration?
• Carnitine deficiency has been documented in which two populations?
• selenium supplementation should be reduced in TPN-dependent neonates under which circumstance?
• Compared with enteral products, oral nutrition supplements generally contain more of which macronutrient to improve palatability?
• Which predictive equation has demonstrated the greatest accuracy in estimating actual resting metabolic rate in healthy obese and non-obese adults?
• Which factor can contribute to abdominal distention due to cold formula in enteral feeding?
• Which nutrition supplement has been shown to reduce the incidence of involuntary stool leakage?
• Which parts of the gut are the primary sites for secretion of cholecystokinin and secretin?
• Which segment of the small intestine is the primary site for absorption of most nutrients, including water-soluble vitamins?
• Which statement best describes the SGA assessment method?
• Which of the following is NOT listed as a common gastrointestinal toxicity in the first 2-3 weeks after stem cell transplant?
• Incidence range of buried bumper syndrome in PEG tube placements?
• What is the proposed theory behind using BCAAs in hepatic encephalopathy?
• List the three types of vascular access devices (VADs) approved for home parenteral nutrition (HPN) administration.
• Which statement about PEG tube complications is true?
• In electromagnetic placement for NGT placement, is pH monitoring used to confirm placement?
• What is the Holliday-Segar method?
• Which of the following statements is true about blue dyes used to detect aspiration in enteral feeding?
• In enteral nutrition formula safety, which practice is recommended?
• Which statement best describes the fate of most ingested glucose?
• What is the function of arginine?
• Which populations are at risk for manganese toxicity in total parenteral nutrition?
• Which other patient group is contraindicated for blind placement of a feeding tube?
• What is Lactobacillus GG?
• What evidence shows cancer is highly likely to result in malnutrition?
• Which of the following is NOT a contributor to constipation in enterally fed patients?
• Which indices are maintained when energy intake is adequate in dialysis PN?
• Are bowel sounds/evidence of bowel function needed prior to initiation of enteral nutrition?
• Which option best describes the definition of excessive granulation tissue in adults?
• During fasting, which statement about ketone bodies is true?
• What is lipase?
• What is RQ?
• According to the ASPEN PN Safety Consensus, which item is NOT mandatory for the PN order form?
• What is the usual cause of challenges in early delivery of enteral nutrition in the critically ill patient?
• Which of the following is NOT among the elements excreted at higher rates in urine during the flow phase after burn injury?
• Describe intermittent feeding.
• How does fermented fiber increase fecal bulk?
• How often should short-term nasogastric tubes be changed?
• How much fluid does the average healthy adult require to maintain fluid balance?
• When should enteral nutrition be initiated in the hemodynamically unstable patient?
• Soluble fiber included in meals with purified pectin slows gastric emptying. Which statement is true?
• Which statement best describes the current evidence-based recommendation for Lactobacillus GG use in children?
• Bile acids are secreted from which organ?
• What is the etiology of colocutaneous fistula with PEG tube placement?
• Which organ is the primary source of intrinsic factor?
• Which item is NOT listed among those that should be addressed prior to discharge of an HPN patient?
• Which statement about mixed state malnutrition is accurate?
• What is important about FiO2 during measurement of indirect calorimetry?
• How is cysteine added to parenteral nutrition, given its instability in aqueous solutions?
• Which oils are included in commercial enteral formulas to provide a high supply of linoleic and alpha-linolenic acids?
• Skin care around a feeding tube site should be accomplished by cleaning with which?
• What is the glycemic target for the majority of critically ill adult patients?
• What are current recommendations for probiotics and prebiotics in IBD?
• Glucose, fructose, and galactose are examples of what?
• IVFEs in the US are composed of what?
• What is the theory behind omega-3 supplementation in cystic fibrosis?
• Define bolus feedings.
• The risk of enamel fluorosis in infants drinking reconstituted infant formula is positively associated with which factor?
• What is the test of permanence for HEN coverage guidelines under Medicare?
• In bowel rest, parenteral glutamine supplementation is associated with which outcome for atrophic changes?
• Under Medicare guidelines for Home Enteral Nutrition (HEN), which of the following is one of the two criteria?
• For patients accepted by a home care provider, within what timeframe should nutrition screening be completed?
• What should be done with the result of nutrition screening?
• Should feeding be delayed in the patient at risk of refeeding syndrome?
• When are lower glucose targets (less than the recommended 140-180 mg/dL) considered appropriate?
• With aging, which combination best describes changes in substrate utilization?
• How is folic acid absorbed in the small intestine?
• How long can the MNA-SF typically take to administer?
• Which criterion involves bowel rest for at least 3 months as a component of HPN eligibility?
• Define cyclic feeding.
• Why is plasma carotenoid not used as marker of vitamin A status?
• Powdered infant formulas pose potential risk for which patient group?
• Is routine use of antibiotic ointments advisable for the care of feeding tube sites?
• Which of the following statements is true about energy expenditure estimates in pediatric ICU patients?
• Which intervention has NOT been proven effective in reducing the risk of aspiration in critically ill patients?
• Soluble fiber's effect on the upper GI tract includes which statement?
• High levels of fluoride increase enamel porosity by disrupting which process during enamel maturation?
• Private payers and managed care organization programs determine coverage for home parenteral/enteral nutrition in general?
• Which factor is known to limit folate absorption?
• Which statement about gastric feeding is true?
• In the Swinamer equation, what is the purpose of the constant term -4349?
• Why have vitamin D recommendations expanded to include all infants, including those exclusively breastfed?
• Who should perform the first replacement of gastrostomy and PEG tubes? What about subsequent replacements?
• What is the upper limit for pancreatic enzyme usage?
• Does body weight below ideal indicate malnutrition?
• NOT listed as a population at risk for hypophosphatemia?
• Which mediators are inflammatory mediators produced from arachidonic acid metabolism?
• Fat malabsorption in biliary atresia places deficiency risk in which group of vitamins?
• The weight change associated with megestrol acetate is largely due to which components?
• 3 factors that can alter urinary urea nitrogen resulting in unreliable results?
• Is pancreatitis a contraindication to early enteral nutrition?
• Do over-consumed juice intakes in children necessarily reduce milk or other food intake?
• Which enteral formula type is associated with lower cost and better tolerance in exclusive enteral nutrition?
• Which of the following is a Medicare-approved indication for home parenteral nutrition?
• What is the caloric prescription for HPN under Medicare?
• Which of the following is NOT a reason infants with chronic lung disease have high calorie needs?
• In infants with cow's milk protein allergy and gastroenteritis, which type of formula is recommended as a trial?
• What part of Medicare covers home enteral nutrition?
• How do critically ill and postoperative neonates compare to healthy neonates in terms of energy needs?
• Ursodiol is which of the following?
• What is the role of bile acids secreted by the liver as well as lipase and colipase produced by the pancreas?
• In a pediatric case with low calcium and phosphorus, high alkaline phosphatase and high parathyroid hormone, along with low 25-OH vitamin D and low 1,25(OH)2 vitamin D, which diagnosis is most likely?
• Which population should not have their fluid needs estimated by the Body Surface Area method?
• Cheilosis is cracking at the corners of the mouth; deficiency of which vitamin is most associated?
• Which statement is true regarding manganese and patients on long‑term parenteral nutrition (PN)?
• In maintenance hemodialysis patients, increased mortality has been associated with which nutritional profile?
• Which of the following is a major risk factor for aspiration?
• How are closed enteral feeding systems packaged, and what is the benefit?
• What percentage of kcals should come from carbohydrates in infant parenteral nutrition for a stable patient?
• Which statement about the ileocecal valve is true?
• Which trace element is most likely to improve hepatic encephalopathy?
• Can Cisapride be used for increased motility?
• A 32-year-old female presents to the clinic seeking treatment for a sunburn-like rash. She also reports that she feels very sad and has no energy. Which deficiency should be considered?
• Which statement best describes the mechanism by which unfermented dietary fiber affects stool water content?
• What is the most common symptom when nutrition and hydration are withheld?
• Regurgitation in infants is best described as:
• Why should patients considered not-at-risk be included in the protocol for refeeding syndrome?
• Which data source was used to develop the Fenton growth chart?
• Ileal resection increases diarrhea risk primarily due to loss of what?
• Length for age is an index of what?
• What do the PINI, NRI, and PNI have in common?
• Are home infusion providers responsible for physical therapy?
• What is the primary purpose of IV calcium gluconate in hyperkalemic emergencies?
• Lactated Ringer's solution includes which of the following?
• In CF management, what is the current consensus on omega-3 supplementation?
• Which test is not used to assess vitamin A status?
• Which factor increases fat-soluble drug distribution in obesity?
• Which patient group is usually not severely malnourished?
• Potential metabolic causes for a respiratory quotient (RQ) greater than 1 include all of the following EXCEPT
• Which of the following does NOT describe the use of minimum enteral feeds in preterm neonates?
• What is the average nitrogen content of protein?
• How are conditionally indispensable amino acids defined?
• The anabolic phase can last for how long?
• Which factor best describes improved tolerance when using continuous infusion in enteral nutrition?
• Which scheduling pattern is not a continuous infusion?
• Which term describes the highest daily nutrient intake likely to pose no risk of adverse health effects to almost all individuals?
• What is the most abundant substance in the body?
• Where are vitamin D receptors (VDR) located in the body?
• What is infantile anorexia characterized by?
• Patients receiving home parenteral nutrition (HPN) who belong to a support group have been shown to experience which outcome?
• Why is regular insulin typically used when initiating enteral nutrition in a diabetic patient?
• What is the purpose of glutamine supplementation?
• What is the suggested daily amount of potassium for maintenance in an infant receiving parenteral nutrition?
• Which statement about glutamine supplementation is true?
• Which statement about the IOM's stance on calcium and vitamin D's effect on skeletal health is correct?
• Which of the following options best describes items not traditionally part of a performance improvement plan but part of planning for home nutrition support?
• EFAD can present with which immune-related symptom?
• Which of the following is NOT a research-based method used to restore patency to clogged feeding tubes?
• What is a goal of initiating minimum enteral feeds early in preterm neonates?
• Where does the majority of protein digestion occur after the stomach?
• C. difficile should be ruled out in which patients?
• What is the Oley Foundation?
• Which statement about nutrient infusion stability prior to indirect calorimetry is true?
• What is the appropriate use of powdered infant formula in healthcare facilities?
• Which statement is true regarding a refeeding syndrome electrolyte replacement protocol?
• What is SIAD?
• What are the clinical manifestations of aluminum toxicity?
• Which is the hang time for expressed human milk when used for continuous enteral feedings?
• Which of the following is NOT listed as a possible cause of abdominal distention during enteral tube feeding?
• Red blood cells generate ATP primarily through glycolysis because they do not contain which organelle?
• In preterm formulas, what makes up the remainder of carbohydrate calories besides lactose?
• Impairment of which excretion pathway would most directly cause copper toxicity?
• Which of the following is a Medicare criterion for home parenteral nutrition (HPN) eligibility?
• In PN-associated metabolic bone disease, which statement is true regarding screening recommendations for patients on PN longer than 1 year?
• Which of the following is NOT an evidence-based ASPEN/SCCM recommendation for minimizing aspiration risk?
• Describe GER.
• Which statement best describes the relationship between DNAR orders and SNS?
• What is the recommended approach to cleaning around a feeding tube site during routine care?
• Which of the following is characteristic of cachexia in pediatric oncology patients?
• What effect does the ileal brake have on gastric emptying and intestinal transit?
• Which of the following is NOT a documented disadvantage of high protein delivery in CRRT?
• Why are powdered infant formulas used in health care facilities only when clinically necessary and when alternative sterile liquid products are not available?
• In 2010 the Institute of Medicine concluded that calcium and vitamin D have a key role in which outcome?
• Which energy intake level induces neutral nitrogen balance in maintenance hemodialysis patients?
• Why is zinc deficiency commonly associated with diarrhea?
• What is the RDA for vitamin D for children 1-18 years of age?
• Triglycerides that require bile acids to facilitate enzymatic digestion and absorption are typically:
• What does an RQ of 0.85 indicate?
• Which is a characteristic of acute disease-associated malnutrition?
• What are common symptoms with the introduction of a new or large amount of dietary fiber?
• What is the osmolality of a 30 kcal/oz concentrated standard infant formula?
• What is the purpose of EN formula label requirements?
• Which form of glutamine is used in oral nutrition supplements?
• What measurement is used to determine nitrogen balance?
• Which sources were used to validate the Fenton growth chart?
• Fiber in the lower GI tract tends to hasten GI transit due to which mechanisms?
• In the study, affiliated patients were connected with which type of organization?
• Are there definite guidelines on when to begin diarrhea treatment in IBD?
• The development of liver complications with PN usage is primarily due to which factor?
• What does the evidence show is the preferred mode for feeding in eating disorders?
• What is the evidence for providing parenteral nutrition containing both essential amino acids and nonessential amino acids in AKI?
• During which phase is gluconeogenesis a key metabolic process?
• Is sorbitol an ingredient in enteral formulas?
• What does the American Academy of Pediatrics recommend in infants with acute diarrhea associated with gastroenteritis? Why?
• Which organization provides guidelines for iron deficiency anemia screening in infants and children?
• What is the purpose of diluting liquids used for enteral administration?
• What preventative education should be emphasized to help prevent hypergranulation?
• Hartnup's syndrome is an autosomal recessive disorder causing poor absorption of which amino acids, potentially producing pellagra-like symptoms?
• After 1-2 weeks of starvation, which organ adapts to use ketones as an energy source?
• In cirrhosis, what metabolic change supports the use of fat as energy during overnight fasting?
• Which of the following is a monosaccharide?
• In an uncomplicated enterally fed patient, is routine culture testing indicated?
• What is the recommended dietary action upon symptom identification of suspected celiac disease?
• According to the 2010 HCUP National Inpatient Sample, what percentage of hospitalized patients with a malnutrition diagnosis were over age 65?
• Do soy protein-based formulas have a role in preventing allergy or in managing non-specific gastrointestinal symptoms such as infantile colic and regurgitation?
• Which sequence correctly describes dietary folate metabolism?
• Is parenteral nutrition with branched-chain amino acids (BCAAs) recommended in AKI?
• How is copper usually excreted from the body?
• What is the recommended storage guideline for powdered formulas after reconstitution when not used?
• Is soy formula recommended in acute diarrhea due to gastroenteritis? Why?
• What are two disadvantages of many liquid medications for enteral administration?
• What is the best method to monitor manganese status in patients on PN?
• Which of the following is NOT a top priority in initial traumatic resuscitation?
• Which statement about decreased intake during the dying process is true?
• Which clinical sign in an infant with diarrhea indicates that dehydration is not severe?
• In early post transplant nutrition, when might parenteral nutrition be favored over enteral nutrition?
• Which are the two forms of glutamine dipeptides used in PN admixtures?
• During the flow phase, the glucagon-to-insulin ratio is typically:
• Early enteral feeding in critically ill patients has been suggested to reduce which of the following outcomes?
• Essential fatty acid deficiency is associated with biliary atresia when which dietary condition is used?
• Which factor contributes to intolerance when using concentrated formulas?
• Which electrolyte abnormality may necessitate modification of nutrition support in solid-organ transplant patients taking cyclosporine?
• Which zinc supplementation dose is recommended to prevent deficiency in a 1-month-old infant fed human milk?
• Which statement best describes management of diarrhea due to C. difficile after treatment?
• The Resident Assessment Instrument (RAI) is used as a problem identification model for which settings?
• Which statement best describes indirect calorimetry REE measurement?
• Which is commonly required by insurance for EN and PN coverage?
• A morbidly obese 12-year-old female is evaluated for sleep apnea. Her diet includes soda, juice, and chocolate milk daily. In which mineral may she be deficient?
• What is the primary rationale for using a 70% ethanol lock solution?
• Why are essential fatty acids defined as essential for humans?
• What is the metabolic function of chromium?
• Which of the following is NOT listed as a component of proper discharge for enteral nutrition patients?
• Which of the following are reasons enteral feeding might not be chosen in hyperemesis gravidarum?
• Describe the ebb response following burn injury.
• Vitamin D deficiency is associated with which of the following conditions?
• Which enteral nutrition delivery method is preferred for critically ill patients?
• What is normally the primary goal in neonatal nutrition?
• Which scenario best aligns with Medicare Part B home enteral nutrition eligibility?
• Lactobacillus GG has been studied in regard to which property?
• What is the definition of classic phenylketonuria (PKU)?
• Which of the following is a listed reason constipation can occur with enteral nutrition?
• Which statement about vascular access devices for home PN is true?
• Two categories of parameters the SGA uses to evaluate nutritional status?
• A patient has an advanced directive stating a desire to forego medical technology, including nutrition and hydration, in order to prolong life. The patient is now in an irreversible vegetative state. In deciding whether to continue nutrition and hydration by medical means, the patient's surrogate decision maker must:
• If PN contains 120 g protein, the nitrogen content is approximately how many grams?
• Excessive feeding volume during enteral nutrition is most likely to cause which symptom?
• Which outputs are considered insensible losses and are estimated at approximately 10 mL/kg/day?
• How is tube feeding syndrome prevented and/or treated?
• How should home enteral feeding schedules be prepared?
• High-output fistula is defined as an output exceeding how many milliliters per day?
• Is supplemental home parenteral nutrition (HPN) typically covered at home by Medicare?
• Dumping syndrome is most likely to develop after which surgery?
• In infants with gastroenteritis and diarrhea, lactase deficiency may develop. Which formula would not provide benefit from soy-based formula?
• What is produced by bacteria in the colon when they ferment dietary fiber?
• How does the electromagnetic placement device indicate nasogastric tube placement?
• For HEN coverage, which statement accurately reflects nutrition feasibility?
• Which two patient populations may require thiamin supplementation?
• What calcium balance was observed in cyclic PN regarding calcium excretion?
• Which practice helps prevent contamination when transferring formula within the feeding system?
• Which healthcare professional is authorized to replace a nasogastric tube (NGT)?
• What is the typical hang time range for closed enteral feeding systems?
• During electromagnetic placement for NGT placement, where is the receiver placed?
• Hypervolemia affects serum albumin by
• TLS most often occurs after the initiation of which type of therapy?
• What is the maximum parenteral dextrose infusion rate for a term infant?
• What is the treatment for PKU?
• What is the recommended method for immediate-release tablets via enteral feeding?
• What are the two screening options for iron deficiency anemia offered by the AAP?
• Which statement best describes the appropriate use of powdered infant formula in healthcare facilities?
• In a patient with a newly placed gastrostomy or jejunostomy tube, which exit-site finding signals concern for infection?
• In terminally ill patients, what is a key consideration regarding enteral feeding?
• Where is the receiver placed when using an electromagnetic NGT placement device?
• Which nutrition support increases metabolic demand for thiamin?
• What protein is required for retinol transport?
• Why is liver failure associated with copper toxicity?
• What is the current recommended protein intake for stressed trauma patients?
• One of the quoted conditions for EN/PN coverage specifies that the impairment must be permanent for a duration of at least how long?
• Which item is considered an important planning component for home nutrition support patients but is not typically part of a performance improvement plan?
• Which has greater adaptive capacity: ileum or jejunum?
• What typically interferes with fluid intake in older adults?
• Most enteral formulas designed for oral consumption are composed primarily of?
• A fistula producing 260 mL/day falls under which PN indication status according to the material?
• Where are lactase and maltase located, and what is their primary function in digestion?
• What is the hang time for open system enteral feeding containers at home?
• Following initial Medicare certification for parenteral nutrition, after what length of time is recertification required?
• Vitamin A supplementation is contraindicated or should be used with caution in which patient populations?
• In tube feeding syndrome, inadequate fluid delivery can lead to which complications?
• Why is the hang time shorter for open system enteral feedings?
• Which infection-control concept should be included in discharge instructions?
• Protein powders, carbohydrate powders, fat emulsion, MCT oil, fiber and specific amino acids are examples of what?
• Medicare reimbursement for home and community-based professional nutrition educational services provided by a registered dietitian is restricted to patients who:
• Hypergranulation develops under which condition at the PEG exit site?
• Wilson's disease features copper accumulation due to what defect?
• Ketonemia is defined as which of the following?
• What metabolic consequence occurs in PKU due to PAH deficiency?
• EFAD in CF is associated with malabsorption of which nutrients?
• Which factor after GI surgery may impact absorptive function due to residual disease in the remaining intestine?
• Which measurements are considered in the Waterlow criteria?
• One major advantage of human milk over formula.
• Is head trauma a contraindication to early enteral nutrition?
• How was the 2010 IOM recommendation developed?
• Before considering anti-reflux surgery in neurologically impaired children with severe reflux, what is recommended?
• Most enteral formulas designed for oral consumption are composed primarily of which macronutrient?
• When starting dietary fiber in enteral feeding, what is a key hydration recommendation?
• List the four nutrient disorders frequently associated with cyclosporine use after solid organ transplant.
• What is true about gastric residual volumes and risk of regurgitation or pneumonia?
• Which two steps help avoid contamination when hanging an enteral feeding set?
• Affiliation with a national support or educational organization was associated with which outcome in HPN patients?
• In infants with galactosemia, which formula is appropriate to use as a milk substitute?
• What should be supplemented in patients on long-term steroids to reduce osteopenia?
• Which of the following are commonly reported caregiver concerns with home enteral nutrition?
• Choline supplementation is thought to improve which hepatic condition?
• Which of the following is a sign of celiac disease in childhood?
• How should enteral medications be administered to minimize potential drug interactions?
• Which statement about monitoring Warfarin therapy during PN transitions is true?
• The decision to terminate enteral feeding in a patient in a persistent vegetative state whose wishes have been made known through an advance directive is based on the ethical principle of
• Interstitium accounts for what fraction of extracellular fluid?
• Which enteral feeding schedule should be recommended for home enteral nutrition?
• Which combination represents modular products used to enhance the nutrient profile of a feeding regimen?
• What vitamins are typically added during hyperemesis gravidarum management to address suboptimal intake and prevent complications?
• If a patient is being transferred to the OR and requires enteral access who should place the tube?
• Which long-term enteral access is preferred in patients at increased risk for aspiration?
• How is essential fatty acid status usually evaluated?
• Vitamin D deficiency can manifest as:
• What does fluoroscopy require?
• Is human milk a good source of iron?
• GFR for stage 1 kidney damage with normal or high GFR?
• What is the preferred method of feeding to the small bowel?
• What procedure is essential prior to discharging a patient on home parenteral nutrition therapy?
• Which statement best summarizes the relationship between aging and sarcopenia?
• TBW is distributed among what 3 compartments?
• Glycogen is mainly stored in which tissues?
• What plasma/serum selenium concentration is considered adequate?
• Is protein restriction recommended as a strategy to reduce the risk of developing hepatic encephalopathy?
• Which of the following enzymes initiates the digestive process of carbohydrates in the mouth?
• What is the MAXIMUM parenteral dextrose infusion rate for a term infant?
• Continuous infusion of enteral nutrition in critically ill patients may lower the risk of aspiration by preventing gastric distention.
• Which option is NOT a common first-line therapy for pediatric Crohn's disease?
• Glutamine supplementation in parenteral nutrition is used to mitigate which condition?
• Why is aspiration a greater concern as a complication of EN in older adults?
• An NPO postoperative patient on 2-in-1 PN for three weeks develops dermatitis, hair loss, anemia, and thrombocytopenia. What is the probable cause?
• Holding enteral feedings is generally not indicated unless abdominal girth increases by how much compared to baseline?
• How often should short-term feeding tubes be changed?
• What should be included in the refeeding syndrome electrolyte replacement protocol?
• Constipation in the enterally fed patient is most often associated with all of the following EXCEPT:
• Why are NGT feedings not contraindicated in CF patients with pancreatic insufficiency?
• During diarrheal illness in an infant, what is the best approach to nutrition?
• Why are human milk fortifiers added to human milk for preterm infants?
• How do colocutaneous fistulas occur with PEG placement, and what is their prevalence?
• Infant regurgitation is not necessarily a sign of disease.
• For children aged 4-8 years, how many eight-ounce glasses of milk per day are recommended to meet calcium intake?
• What consistency of medications should be used with enteral feedings?
• Which factor increases aspiration risk in critically ill children?
• Which group may not be ideal for initiation of home PN?
• Which item is NOT listed as a Medicare justification requirement for home parenteral nutrition (HPN) coverage?
• Describe the Swinamer Equation.
• EFAD signs can appear earlier in which population?
• Crohn's disease commonly involves which part of the GI tract, contributing to malnutrition through malabsorption?
• How much fluid per day is required to maintain fluid balance?
• In short bowel syndrome, octreotide injections are most beneficial when there is which condition?
• Is adding fresh formula to a formula that is already hanging in an administration set recommended?
• Malnutrition is most common in which form of inflammatory bowel disease?
• Which individual would best benefit from cyclic tube feedings?
• What verification is required when replacing a jejunostomy tube?
• What action should be taken regarding manganese dosing in PN if cholestasis is present?
• Which metabolite increases due to nucleic acid breakdown in TLS?
• Bone age assessment is used to determine the degree of skeletal maturation by comparing radiographs to normative data for different ages and sexes. Which factor best describes those norms?
• If over consumption of juice is not necessarily linked to reduced intake of milk and other foods, nutrition guidance should prioritize which approach?
• During testing for suspected celiac disease, what must be done with gluten in the diet until testing is complete?
• Which type of medication formulations should not be crushed and given through feeding tubes?
• Which vitamin deficiency can cause both anemia and peripheral neuropathy?
• Tubefeeding syndrome is defined by which combination of findings?
• Which factor after GI surgery may impact the absorptive function of the bowel?
• Which of the following is an expected physiological change over time in older adults?
• Which process is used to produce energy from fatty acids?
• Was there sufficient evidence in the 2010 IOM review to support a cause-and-effect relationship between calcium and vitamin D and extraskeletal outcomes (cancer, cardiovascular disease, diabetes and autoimmune disorders)?
• What is the new evidence about starting enteral nutrition in hemodynamically unstable patients on mechanical ventilation?
• Which fistula type is associated with the greatest degree of nutritional loss?
• Which of the following are approved VADs for HPN administration?
• Which statement best describes the course of infant regurgitation?
• Which statement about electrolyte replacement in refeeding syndrome is false?
• What does RMR stand for in the context of metabolic calculations?
• Which of the following is a comprehensive consequence of hyperphosphatemia?
• In patients with liver disease, a low protein restriction may be considered for which condition?
• What does NEC stand for?
• What can be done for bezoar if they do not respond to treatment?
• Why are taurine and tyrosine considered essential in neonates but not in adults?
• Which group would be considered the lowest risk candidate for initiation of home parenteral nutrition?
• Which statement best summarizes prevention of hypergranulation around the PEG exit site?
• Which method of estimating energy requirements in critically ill children is LEAST accurate when compared to indirect calorimetry?
• Gastrectomy patients are at risk for deficiency of which vitamin?
• Are teenagers considered high-risk for home parenteral nutrition initiation?
• What is the function of enterokinase in digestion?
• Buried bumper syndrome is caused by what mechanism, and what is its prevalence?
• Which protein intake is recommended for patients with cirrhosis?
• The anabolic phase begins after the acute phase and can last for months.
• Immediately following neonatal cardiac surgery, which of the following is the best estimate of parenteral caloric requirements?
• Enteral nutrition (EN) may be contraindicated in the early post-transplant period in adult patients with hematopoietic cell transplants because of:
• What is the recommended daily protein intake for stable infant parenteral nutrition?
• Are isolated infusion area and dedicated refrigerator required for home infusion? What is required in the home?
• In terms of lactose load, how do preterm formulas compare to standard term formulas?
• What does REE stand for in the context of neonatal nutrition?
• How does the prevalence of chronic cholestasis relate to the duration of PN usage?
• Which protein has the longest half-life among the following plasma proteins?
• Which component is commonly used as a modular fat source in enteral nutrition formulas?
• For closed-system EN formulas, hang time is determined by:
• A serum 25(OH)D level of 25 ng/mL corresponds to which vitamin D status category?
• Which feeding schedule is most appropriate for a critically ill patient with labile and poorly controlled blood glucose concentrations?
• Which PN strategy may benefit patients on fat-free PN?
• How does fluoride intake during development relate to the prevalence of enamel fluorosis?
• A pediatric patient with cerebral palsy and a gastric feeding tube is evaluated for fundoplication. This procedure is used to treat which condition?
• Are midline catheters approved VAD for HPN?
• What is the general conclusion about early minimal enteral feeding and NEC risk?
• The most predominant clinical change seen with EFAD is?
• What is the recommended water flush amount between medications when administering via enteral tube?
• In home enteral feeding planning, which practice is encouraged to support family dynamics?
• Which option describes the feeding regimen that most effectively stabilizes blood glucose in critically ill patients?
• Which enteral feeding method provides 240 mL of formula via a syringe over as few as 4-10 minutes?
• Which of the following is a symptom of hypocalcemia?
• What typical body composition change accompanies aging, contributing to lower energy-related requirements?
• How many hallmarks of frailty are listed?
• Why does the body sequester iron into storage forms after injury and infection?
• Long chain fatty acids are defined as having how many carbons?
• Biliary atresia is characterized by what primary change?
• Delayed bone age is associated with which of the following sets of conditions?
• Which growth chart is used to compare preterm infants from 22 weeks gestational age through 10 weeks post-term age?
• Which statement about the SGA is true?
• When IV fat emulsion (IVFE) is infused separately, what is the maximum recommended duration of the infusion?
• Which statement best describes the relationship between energy intake and wound healing in pediatric burn patients?
• In cyclic PN, what type of calcium balance can be expected?
• When is fundoplication considered in GERD management?
• Which statement best summarizes the current recommendation for initiating enteral feedings in adults and children?
• Describe the manganese content of current trace element additives for PN?
• If the enteral nutrition (EN) trial fails during HEG management, when is parenteral nutrition considered?
• One research-based method utilized to restore patency to clogged feeding tubes is pancreatic enzyme with sodium bicarbonate.
• In pediatric patients on total parenteral nutrition, when should selenium supplementation be initiated?
• Which medication is most likely to contribute to hyponatremia in an older adult?
• MCT do not require micelles or bile salts for absorption because they are
• Which statement is NOT supported by current pediatric research about Lactobacillus GG?
• Who should place an NGT if a patient is being transferred to the OR and requires enteral access?
• Which statement best characterizes infantile anorexia?
• Which statement defines intermittent feedings?
• Which of the following is true regarding volume measurement for GRV?
• Which statement about powdered formulas is correct regarding reconstitution and storage?
• Which statement best explains why the 2-4 mg/kg/day iron dose is recommended during early infancy?
• Which statement accurately describes the full Mini Nutritional Assessment (MNA)?
• Which child is at greatest risk for iron deficiency anemia?
• What types of medications are documented to result in constipation?
• What is the hang time for open system enteral feeding containers at the hospital?
• Valproic acid has been shown to induce a deficiency in which nutrient?
• The Nutrition Risk Index (NRI) uses which two objective criteria?
• How is urinary urea nitrogen calculated?
• Which change can help reduce osmotic load and improve tolerance in an enteral feeding?
• The ideal sodium concentration for an oral rehydration solution depends on which factor?
• What is the physiological role of carnitine?
• What form of vitamin B12 is used in supplements and fortified foods?
• Which scenario would best reflect a Medicare HPN eligibility criterion?
• Which statement about exclusive enteral nutrition is true?
• How does the Subjective Global Assessment determine malnutrition?
• Describe the 'teach back' process.
• What is the typical starting rate for full-strength formula when initiating enteral feeds?
• What are the two routes of bacterial contamination of enteral feeds?
• Which statement accurately describes the major site of fat digestion?
• What does current evidence suggest about BCAA enriched enteral formulas in hepatic failure?
• Which sign is observed in PN patients with inadequate chromium intake?
• Which subgroup of HSCT patients did one study suggest parenteral nutrition increases survival?
• Which data should be collected in the home care provider's performance improvement plan?
• What describes the etiology of PN-associated bone disease?
• Which of the following is listed as a symptom of manganese toxicity?
• Which nonessential amino acids become conditionally essential in AKI?
• Does permanence exclude the possibility of improvement?
• The etiology of PN-associated bone disease is best described as?
• In a preterm infant, which amino acid is separately added to parenteral nutrition solutions due to solubility concerns?
• Which amino acid is most crucial for small intestinal structure and function?
• Which metabolic alteration is NOT associated with tube feeding syndrome?
• If a PN solution contains 70 g of protein, the nitrogen content would be closest to:
• Which action correctly follows nutrition screening in home PN care?
• Which statement about EN formula safety is most accurate?
• Which statement about regurgitation in infants is false?
• For infants under 6 months with acute diarrhea, what is the recommended daily zinc dose?
• What is the incidence range of buried bumper syndrome?
• Which statement best describes EFAD prevention in pediatric PN?
• Which patient would most benefit from cyclic tube feeding?
• When possible, where should enteral formulas be mixed, reconstituted or diluted?
• Symptoms such as diarrhea, bloating, and flatulence after consuming sugar are caused by which of the following?
• Which statement about risks of a sedentary lifestyle in older adults is true?
• Which statement accurately describes the handling of cysteine in PN formulations due to its chemical properties?
• What is the half-life of serum albumin (visceral hepatic protein)?
• During fasting, which statement about leucine is correct?
• What lock solution is recommended to reduce CRBSIs?
• Which statement is diagnostic of infantile anorexia?
• Which statement best describes why gastric feedings can be delivered by bolus and intermittent methods?
• Fanconi syndrome is listed among the populations at risk for which electrolyte disorder?
• Is medical therapy for severe GERD in neurologically impaired children highly effective?
• The biochemical defect in phenylketonuria (PKU) is a deficiency of phenylalanine hydroxylase, which catalyzes the para-hydroxylation of phenylalanine to yield which amino acid?
• How is aluminum toxicity best avoided?
• Which statement about iron dextran's destabilizing effect on emulsions is true?
• Regular alcohol intake may affect absorption and utilization of which six vitamins and minerals?
• Which two gas exchange measurements are used to calculate REE and RQ?
• How many levels of undernutrition are defined by the Waterlow criteria?
• What is the preferred approach for subcutaneous insulin administration in hospitalized adults with diabetes mellitus?
• What action did the FDA take regarding FD&C Blue #1 after reports of systemic toxicity?
• What is the current evidence on hypermagnesemia in PN patients?
• What is the correct daily enteral iron dose for preterm infants one month after birth?
• The threshold for PN indication in fistulas is greater than 500 mL/day.
• Which statement best describes the mitochondria's role in energy production?
• Zinc deficiency is very common in liver disease; supplementation with oral zinc is associated with improvement in what?
• The basic structure of a triglyceride is:
• Which two consequences commonly occur with ileal resection due to bile salt reabsorption?
• Which amino acid is considered conditionally essential and serves as a major energy source for intestinal cells?
• Transferrin half-life is approximately how many days?
• How many elements are included in discharge instructions for home enteral nutrition?
• When does glycogenolysis begin during fasting?
• Which medication would be appropriate to crush and deliver via an enteral feeding tube?
• In CLD infants, what is the recommended formula type and why?
• Where does oxidation of fatty acids for ATP production occur?
• Which statement is NOT appropriate to tell a family regarding nutrition at the end of life?
• Describe the impact of fiber on the upper and lower GI tract.
• What is the appropriate nutrition therapy for ascites?
• Which lipid profile was recommended for enteral formulas in ARDS/ALI by the 2009 guidelines?
• During discharge education, which of the following is the BEST way for a home nutrition support provider to know if a patient and/or caregiver understands enteral tube feeding delivery?
• What is the role of the ileocecal valve in nutrient absorption?
• The transition from the acute phase to the adaptive phase of the flow response is described as?
• Before, between, and after medication administration, what volume of water flush is recommended?
• Which statement reflects the recommended approach to prevent impaction and distention in patients with abdominal distention?
• Which statement about GRV measurement practices is true?
• Refeeding syndrome is defined as electrolyte disturbances when attempting to initially feed the undernourished patient. Which electrolytes need to be closely monitored?
• Why is weight status important in drug dosing of fat soluble drugs?
• Which of the following is a contraindication to nasogastric tube feedings?
• In comparison to parenteral nutrition, enteral nutrition in severe pancreatitis is associated with which outcome?
• Which organ is primarily responsible for copper excretion from the body?
• During starvation, which energy source becomes predominant?
• What is the American Academy of Pediatrics' recommended daily maximum juice intake for children aged 7 to 18 years?
• At what FiO2 is the accuracy of indirect calorimetry of mechanically-ventilated patients decreased?
• In transitioning from enteral tube to oral feeding, discontinue when adequacy of oral intake meets at least what percent of nutrient needs?
• Which of the following is a consequence of decreased vitamin D binding to VDRs?
• Hyperemesis gravidarum is defined as what?
• What is the volume of IVFE used in the PN example?
• What is the range of centrally infused protein losses into CRRT effluent?
• Which of the following is included in proper discharge components?
• What is the most likely cause of diarrhea leading to mild dehydration in an infant?
• What is the electrolyte composition of jejunal fluid?
• In clinical practice, what is the primary purpose of the MNA-SF?
• What do current guidelines from AACE/ADA recommend for the glycemic target range in most critically ill adults?
• During the flow phase after burns, which element is excreted at higher rates?
• Which deficiency causes neuropathy but not anemia?
• What is the ideal environment for indirect calorimetry measurement?
• Which of the following is NOT among the five data categories to be collected in home care performance and outcome measurement for nutrition support?
• What is the primary reason EFAD occurs in CF?
• Why is soy or hypoallergenic formula recommended in galactosemia versus lactose-free cow's milk?
• Which BMI percentile range indicates overweight in children?
• Which of the following is NOT a hallmark of frailty?
• Copper deficiency can present with which of the following neurological findings?
• What term describes amino acids that are normally nonessential but become essential under certain conditions?
• Which organ is the primary site of intrinsic factor production?
• Which statement accurately describes the linoleic and alpha-linolenic acid content in soybean oil-based IVFE?
• In the home setting, how quickly do patients and caregivers typically adapt to the prescribed enteral feeding regimen?
• Why is B12 deficiency a concern after gastrectomy?
• Metastatic calcification is a complication of which electrolyte abnormality?
• In long-term PN patients, which statement about zinc status is true?
• The calcium-phosphorus product threshold above which metastatic calcification can occur is closest to which value?
• Which of the following is one of the four types of home and community-based professional nutrition educational services provided by a registered dietitian with a Medicare provider number that are reimbursed?
• Why is feeding a patient before hemodynamic stability has been achieved not recommended?
• Which of the following is a reason why critically ill and postoperative neonates have lower energy needs?
• The highest prevalence and severity of weight loss is found in patients with which types of cancer?
• Is evidence of bowel function (bowel sounds) required prior to starting enteral nutrition?
• Which two cell types require a constant supply of glucose?
• What test is used for assessing vitamin A status? Why?
• Which trace element accumulation is associated with Wilson's disease?
• How many calories are in 1 mL of 20% IVFE?
• Glycogen is predominantly stored in which tissues?
• Which parameter is used to classify malnutrition into four levels in the Waterlow criteria?
• What is the target range of fluid provision to prevent tube feeding syndrome in an average adult?
• In the home PN setting, which item is required for safety and ongoing care as part of patient evaluation?
• How does the World Health Organization define persistent diarrhea?
• In the referral process to a home infusion company for parenteral and enteral therapy, which item is NOT included?
• Zinc supplementation should be provided to patients with wounds.
• Which are the two forms of glutamine dipeptides used in PN admixtures?
• Which statement best describes the difference in amino acid composition between neonatal and adult PN solutions?
• A physical requirement for the use of proton pump inhibitors is the presence of at least how many centimeters of jejunum to ensure absorption?
• Long-chain triglycerides require bile salts for both digestion and micelle formation. Which category describes this requirement?
• What is the BEST indication for the use of a soy-based infant formula?
• Which act established the standardized assessment framework including the MDS for long-term care facilities?
• Which of the following is one of the three elements of treatment for infantile anorexia?
• Why are enteric coated or film coated tablets not appropriate to be crushed for administration via enteral feeding?
• Cisapride was withdrawn from the US market in which year?
• Which health care professionals can replace nasogastric or nasoduodenal tubes?
• Where are vascular access devices placed and why?
• Do mature red blood cells contain mitochondria?
• Which statement correctly states the vitamin D RDA for children age 1–18 years?
• Which of the following is NOT a contraindication to nasogastric tube feedings?
• What is the appropriate initial action when a tube-fed patient with pneumonia develops new diarrhea?
• Contamination of expressed human milk can occur during which stages?
• Which treatment has been shown to induce remission in up to 85% of children with newly diagnosed Crohn's disease?
• Which statement best reflects how quality of life relates to stability in personal life for HPN patients?
• Gastric residual volumes have been associated with pneumonia and mortality.
• Peristomal infection is best described as infection around the insertion site.
• Why is a concentrated enteral formula recommended for nutritional management of chronic lung disease?
• What is a common fallacy about nutrition and hydration in terminally ill patients, and what evidence counters it?
• Why is iron often not included in PN formulations?
• Lipase and colipase are produced by which organ?
• Which three nutrients have studies shown to reduce plasma homocysteine concentrations?
• In small burns, which route is typically sufficient?
• Iron is primarily absorbed in which region of the small intestine?
• How does overfeeding in pulmonary insufficiency lead to respiratory acidosis?
• Which test or tests are included in the weekly lab monitoring for home PN?
• Protein-energy malnutrition is most common in which liver disease type?
• During inflammatory states, what happens to serum albumin and prealbumin?
• Which amino acids are considered essential for neonates due to enzyme immaturity?
• Which statement best describes the relationship between corticosteroid dose and osteopenia in IBD patients?
• Which strategy is a common cause for feeding tube occlusion?
• Which PN component is typically provided separately in a 2-in-1 regimen?
• Based on bone health evidence, what is the RDA for calcium in children and adolescents 9-18 years of age?
• What does PN stand for in the context of nutrition support?
• Presence of dietary fat in the distal ileum contributes to
• Why would nasogastric tube feedings not be contraindicated in cystic fibrosis patients with pancreatic insufficiency?
• What is the evidence for choline supplementation in steatosis?
• Which chemical should not be present in administration sets for human breast milk?
• In the PN scenario, how many grams of dextrose are included?
• What test is used to diagnose C. difficile infection?
• Why is timing of fiber and medications important?
• Which of the following is a component of the micronutrient assessment in PN patients?
• According to safe EN guidelines, how often should the administration set be changed for open systems?
• Indirect calorimetry (IC) calculates
• What is the maximum recommended infusion rate for phosphate to avoid complications such as thrombophlebitis and metastatic calcium-phosphate deposition?
• What happens to dietary fiber that is not degraded or fermented in the colon?
• Buried bumper syndrome is caused by erosion of which structure?
• Which statement best describes the goal of aligning home enteral nutrition schedules with mealtime routines?
• Which statement best describes Wilson's disease?
• Which organ stores glycogen to provide glucose during fasting?
• Which intervention is recommended to prevent feeding tube occlusion during GRV assessment in adults?
• Given a total body water of 48 L, extracellular fluid is approximately what volume?
• Rationale for using preterm formula or fortified human milk for premature infants during the first year
• Which nutrient is typically a very small percentage of the total formula in enteral products?
• Which trace element deficiency is most likely to occur after 3-6 months of long-term PN?
• Which of the following is NOT an example of modular products?
• Which vascular access device should not be used for home parenteral nutrition?
• When should cow's milk be introduced to an infant's diet, and what is the current recommendation regarding milk intake?
• Why does furosemide contribute to hyponatremia?
• Which of the following is a known risk factor for aspiration in critically ill patients?
• Low plasma choline levels in long-term PN patients have been associated with which liver-related change?
• Which formula approach is most appropriate in infants with chronic lung disease?
• In parenteral nutrition, adverse effects from zinc have been observed at what minimum daily dose?
• Which type of system provides the most opportunity for contamination and why?
• During bowel rest, mucosal atrophy is best described as which of the following?
• What is the etiology of parenteral nutrition-associated bone disease?
• Approximately what is the normal length of the small intestine in adults?
• Which of the following is a major risk factor for aspiration in critically ill patients?
• Which of the following does NOT describe the use of minimum enteral feeds in preterm neonates?
• Which statement is most accurate about PN indication in fistulas?
• Which of the following is NOT listed as a major risk factor for aspiration?
• Copper toxicity may lead to which severe outcome?
• Copper deficiency is associated with decreased activity of which enzyme in erythrocytes?
• Which statement best describes how the Waterlow criteria differ from simple weight-for-age assessments?
• Which laboratory finding is commonly associated with pediatric celiac disease?
• What is the Holliday-Segar maintenance rate per kilogram for the first 10 kg?
• In stress hyperglycemia, how does gluconeogenesis contribute to hyperglycemia?
• In decisions about artificial nutrition and hydration for incompetent patients without an advance directive, which ethical principle is most central?
• Medicare reimbursement for home and community-based professional nutrition educational services provided by a registered dietitian is restricted to patients who
• What is the purpose of the recertification process for parenteral nutrition under Medicare?
• Which statement about buried bumper syndrome is true?
• The catabolic phase occurs after resuscitation and lasts typically for how many days?
• A 2-month-old infant exclusively fed cow's milk-based formula develops a full-body rash. What is the most appropriate next step?
• Dietary fiber may help to regulate normal defecation by
• What is the evidence for addition of fiber to tubefed patients?
• Which complication is a risk if antidiarrheal therapy is used before infectious etiology is ruled out in IBD?
• Which statement about selenium status testing is true?
• Which type of feeding delivery method is most commonly used for patients with a jejunal feeding tube?
• Why is bone age assessment useful in evaluating children with short stature?
• Describe preterm human milk's protein concentration and fortification needs.
• Which information helps ensure the formula is received as ordered and not expired or hung past hang time?
• What is the objective measure used to assess functional status?
• Which pair are both minerals among the nutrients whose absorption may be affected by regular alcohol intake?
• In malnourished women with hyperemesis gravidarum who require specialized nutrition support, which nutrient supplementation is most likely required?
• Which minerals are commonly included in fortification to support bone mineralization in premature infants?
• Which practice should be taught regarding external bolsters around a feeding tube site?
• Fundoplication is a surgical procedure used to treat which condition in children?
• In pulmonary insufficiency, excessive calorie administration may cause increased blood pCO2 resulting in
• A patient with ARDS may benefit from a feeding formula containing supplemental:
• Which statement best describes how macronutrient concentration affects viscosity of an enteral formula?
• What is the treatment for idiopathic encephalopathy associated with carnitine deficiency? What happens if left untreated?
• What may be needed in the case of frequent interruption of electrical service in the home environment of a patient receiving parenteral nutrition?
• Which intervention is recommended to prevent tube occlusion associated with GRV assessment?
• In a stable infant, what percent of kcals should come from fat in PN?
• In quality improvement practice, the Plan-Do-Study-Act (PDSA) cycle is best described as which of the following?
• EFAD is associated with which effect on wound healing?
• How should human breast milk be prepared for patient use?
• Which statement describes a mechanism by which chronic steroid use contributes to osteopenia?
• Fat malabsorption in liver disease is caused by what?
• Does indirect calorimetry measure heat released from the subject?
• The RDA for vitamin D was determined based on what consideration?
• Which is NOT a recommended approach to reduce gastrostomy exit-site leakage?
• Which organ systems are affected by aluminum toxicity?
• Which of the following is a reason blue dye is no longer recommended for detection of aspiration?
• Which statement about fiber and medications is most accurate?
• When administering multiple medications via enteral feeding tubes, how should they be administered?
• How does fecal impaction usually present?
• What is the consensus daily protein delivery for patients undergoing CRRT?
• Under Medicare guidelines, enteral infusion pumps are covered when which circumstance is documented?
• Expressed human milk contains which of the following?
• Which of the following is a contamination point in enteral feeding with human milk?
• Current vitamin D recommendations for infants require a minimum daily intake of how many IU of vitamin D?
• To prevent essential fatty acid deficiency in PN, what is the minimum fat emulsion intake (long-chain fatty acids) per day for an adequately fed infant?
• Which statement is NOT true regarding EFAD in CF?
• Which mechanism can cause diarrhea in patients on enteral nutrition due to drugs?
• Initially, how often should electrolytes be monitored in a patient on home parenteral nutrition support?
• Which two medications are prokinetic agents used to increase motility?
• Bone age assessment relies on normative data for which characteristics?
• In soybean oil-based IVFE, linoleic acid accounts for approximately what percentage of total calories?
• Three 8-ounce glasses of milk per day will achieve adequate calcium intake for which age group?
• Which water-soluble vitamins do not require Na+ co-transporters for absorption?
• Which type of formula tends to have higher osmolality due to smaller particle size?
• Parenteral glutamine has what effect on mucosal atrophy during bowel rest?
• Which of the following is a consequence of decreased glutamine levels?
• The incidence of aspiration due to enteral nutrition in critically ill children is difficult to determine because:
• When using indirect calorimetry, what is the primary goal of determining energy provision?
• What is the primary benefit of PEJ feeding in high aspiration risk patients?
• What is the role of oxalic acid in metabolic bone disease?
• Which of the following is one of the elements reflected on the enteral nutrition (EN) formula label?
• Which phase is characterized by increased cardiac output?
• When a micronutrient is added or omitted in PN, what is the recommended monitoring approach?
• What is a common source of tube-feeding intolerance?
• Recent findings suggest that caloric beverages consumed by children are complementary, and weight management should focus on which aspect?
• Which statement about fat in preterm formulas is true?
• Which statement about obesity and fat-soluble drug dosing is true?
• Which statement is NOT recommended for managing hypergranulation at an exit site?
• Why is arginine considered an 'immune-enhancing' agent?
• Which metabolic alteration is NOT associated with the development of tube feeding syndrome?
• Which of the following is true about taurine and tyrosine in neonatal PN compared to adult PN?
• A seven-month-old infant fed reconstituted infant formula and other age-appropriate complementary foods may be at risk of over-supplementation with which nutrient?
• What is the third element of treatment for infantile anorexia?
• What is the etiology of NEC?
• What is the range for sodium concentrations of homemade or commercial oral rehydration solutions?
• Which statement is true regarding antidiarrheal use in Clostridium difficile infection?
• Which statement about human milk versus standard formula in CF infants is true?
• Which statement about RQ and interpretation is true?
• In Mosteller's approach, the BSA is multiplied by which baseline daily maintenance fluid to obtain daily maintenance?
• How long is the ebb response following burn injury?
• Which trace element should be monitored in a child with chronic diarrhea?
• Which statement about exclusive enteral nutrition is true?
• During diarrheal illness in infants who normally receive human milk, what is recommended regarding feeding?
• When implementing early enteral nutrition in critically ill patients, which factor is most likely to increase success in moving toward the target feeding rate?
• Lactic acidosis can be a result of deficiency of which vitamin?
• Lauric acid is characterized as which type?
• How much formula is provided in a ready to feed bag?
• How should the rate be advanced when using a full-strength formula?
• In Medicare criteria for HEN, permanence is determined by whom and documented in the medical record?
• Describe the difference between prolonged fasting/starvation versus cachexia in children with cancer.
• Which statement about the gastrostomy tube outer bumper is accurate?
• What is the recommended water flush volume between medications via enteral tube?
• Which deficiency is rare but presents with anemia, leucopenia, neutropenia, and peripheral neuropathy?
• Which statement about glucose targets in critically ill patients is true?
• Which of the following is a treatment option for lactose intolerance?
• Which mechanism explains the increased risk of calcium oxalate stones in short bowel syndrome?
• If REE is measured while fasting or feedings are intermittently provided, what adjustment is reasonable?
• Which statement defines cyclic feedings?
• Methotrexate is best described as which type of drug and what is its core mechanism?
• Why do we use the term SIAD instead of SIADH?
• What is the function of glucokinase?
• Which statement best summarizes arginine supplementation in critical illness?
• According to Waterlow criteria, what are the four levels of malnutrition?
• Which medication form is preferred for enteral administration?
• In the absence of an advance directive, which guidance best describes surrogate decision making for nutrition and hydration?
• Which phase is most associated with growth and rebuilding processes?
• Which acute changes in serum chemistries would be expected in a patient who is experiencing tumor lysis syndrome?
• Why is it important to identify iron deficiency anemia in young infants and children?
• A 13-year-old boy with BMI at the 97th percentile would be classified as:
• Copper deficiency is associated with which type of anemia?
• Postpyloric placement of feeding tubes in pregnancy is associated with which of the following?
• What is the nutrition therapy for pediatric patients with small burns (< 20% TBSA) not complicated by facial injury, psychologic problems, inhalation injury or pre-burn malnutrition?
• Why is iron deficiency anemia screening important in young infants and children?
• Upper GI transit is generally slower with which type of fiber?
• Which set of electrolytes is most commonly monitored to detect refeeding syndrome?
• What is the typical duration for cyclic enteral feedings per day?
• Which adaptation is associated with starvation?
• Would a patient with a functioning GI tract that is unable to meet nutrition needs due to anorexia or nausea be eligible for Medicare coverage of home enteral nutrition?
• Which statement about blue dye in enteral feedings is correct?
• Bolus feeding is typically delivered over a short period using a syringe. This period is commonly between which of the following times?
• Which electrolyte abnormality is most strongly linked to digoxin toxicity risk?
• Which statement about zinc and copper interaction in enteral nutrition is true?
• Is expressed human milk sterile?
• In patients with severe acute pancreatitis, EN has several benefits over PN. Which of the following is NOT a listed benefit?
• Which statement best describes the trade-off of adding fiber to an enteral formula?
• Why is jejunal feeding usually delivered by a continuous pump?
• Which medication would be appropriate to crush and deliver via an enteral feeding tube?
• Which feeding approach is associated with improved tolerance and delivery in critically ill patients?
• Which statement about C-reactive protein is true?
• What should be recommended to short bowel syndrome patients who have a colon to decrease the risk of oxalate nephropathy?
• Which factor is NOT among the criteria for EN/PN coverage under the prosthetic device benefit?
• Are other blue dyes such as methylene blue and FD&C Blue #2 suitable alternatives to detect aspiration in enterally fed patients?
• List the five historical factors used in the SGA?
• Which statement about essential fatty acids and CF status testing is accurate?
• For term neonates weighing 3 to 10 kg on long-term TPN with normal organ function, what is the recommended daily selenium supplementation?
• Is it acceptable to crush enteric-coated tablets for tube feeding?
• How much formula should be poured into an open administration set?
• What is the only way to treat galactosemia? What formula should be used in infants with galactosemia?
• Which statement best describes the difference between closed and open enteral feeding systems?
• What is the onset time for regular insulin with dextrose in the treatment of hyperkalemic emergencies?
• Which statement about nutritional management for cirrhosis with a functioning gut is true?
• What is an abnormal tricep skinfold thickness?
• If liver dysfunction persists after addressing other causes in PN, which supplement may be added if a deficiency exists?
• Fibrosing colonopathy is associated with which therapy in cystic fibrosis?
• Which metabolic process is common in both stress and starvation-related malnutrition?
• How often does the American Academy of Pediatrics recommend screening for iron deficiency anemia?
• With Medicare guidelines, what is the critical condition required for HPN eligibility?
• In pediatric ICU patients, predictive equations for energy expenditure yield results that are not consistent with measured energy expenditure, leading to under or overfeeding.
• Non-nutritive sucking should be used in the enterally fed neonate less than 32 weeks corrected gestational age to promote which outcome?
• To avoid fasting-associated starvation during the night in cirrhosis, which is recommended?
• 5 common factors associated with PN prescribing errors?
• Which is NOT part of proper discharge components for enteral nutrition patients?
• What is the primary purpose of education, training and evaluation of patient/caregiver competency in a quality teaching program?
• When is the ability to suck and swallow fully coordinated?
• Which of the following could be a consequence of increased parathyroid hormone secretion due to vitamin D deficiency?
• How do DNR orders impact SNS?
• Which daily fistula output best defines high-output for PN indication?
• Which of the following is NOT one of the seven components for how PN ingredients should be ordered?
• Which statement best describes a key role of thiamine in metabolism?
• Which statement best describes the effect of soluble fiber on HDL cholesterol?
• What is the maximum hang time for an open-system enteral feeding formulation in the home setting?
• In biliary atresia, what is the consequence of reduced intraluminal bile acids?
• In neurologically impaired children, what is the primary risk factor for aspiration pneumonia?
• Which of the following is NOT a typical biochemical finding in Vitamin D deficient rickets?
• Which practice is not recommended for maintaining feeding tube patency?
• Which enteral nutrition component may help to promote regular bowel movements in patients receiving enteral nutrition, but may also lead to excess gas production and increased abdominal distention? What can be done to prevent this?
• Which statement is NOT a component of treatment for infantile anorexia?
• What is the energy requirement for the growing neonate?
• How should immediate release tablets be administered enterally?
• What vitamin absorption is most likely to be impaired with chronic use of proton pump inhibitor therapy?
• Which statement is a listed discharge component?
• Which type of water is recommended for reconstituting enteral formulas and why?
• A 4 month old male has acute onset of diarrhea for 48 hours. He has mild dehydration. What is the most appropriate nutrition intervention for this infant?
• In children with short stature, bone age is typically which of the following relative to chronological age?
• Do gastric residual volumes correlate with the incidence of regurgitation, aspiration or pneumonia?
• Which enteral feeding method is most appropriate for a patient with a jejunal feeding tube to minimize tolerance issues?
• When should Clostridium difficile toxin stool testing be performed?
• Which statement about medium-chain triglycerides absorption is true?
• In severe acute pancreatitis, the use of enteral nutrition via nasojejunal feeding tube rather than parenteral nutrition is associated with
• Tube feeding syndrome is primarily related to which of the following?
• A patient awaiting liver transplant is on diuretics to control ascites and peripheral edema. Which acid-base disorder is expected?
• Which of the following is a sign of iron deficiency anemia?
• Which IV fluids most closely resemble jejunal electrolyte content?
• Which infection-control concept should be included in discharge instructions?
• In terminally ill patients, which statement about electrolyte values during dehydration and the use of ANH is supported by evidence?
• Which of the following best describes the benefit of megestrol acetate in patients with cancer-associated cachexia?
• Compared with soy formulas, lactose-free cow's milk formula has galactose content that is
• Which sequence correctly lists the four phases of the Plan-Do-Study-Act cycle in order?
• Which statement explains why early enteral feeding might be delayed in critically ill patients?
• Which description defines intermittent feeding?
• In an older adult who requires long-term enteral nutrition, which complication is most often overlooked?
• What is the ileal brake?
• Describe the hypocaloric feeding recommendations for obese patients on PN?
• During fasting, which process increases to provide fatty acids?
• In a preterm infant, which amino acid is separately added to parenteral nutrition solutions due to solubility concerns?
• Among the available evidence, which outcome has glutamine supplementation been shown to reduce in critically ill patients?
• Which of the following is FALSE regarding regurgitation in infants?
• Which of the following is a sign or symptom of celiac disease in childhood related to dental health?
• What is a possible benefit of using soluble fiber in tube feeding?
• Which statement accurately describes total nutrient admixture (3-in-1) parenteral nutrition?
• Using Mosteller's formula, a child with height 110 cm and weight 22 kg would have an estimated daily maintenance fluid of approximately which amount?
• Which statement about the Fenton chart is true regarding its validation data sources?
• Why are patients with ileostomy at risk for hyponatremia?
• Why is 30-35 kcal/kg/day considered acceptable for older adults on dialysis?
• What are the two screening options provided by the American Academy of Pediatrics for iron deficiency anemia?
• Why should a standard 1 kcal/mL formula with fiber be recommended as the first choice for older adults with PEG feedings?
• Which statement best describes absorption of nutrients in human milk versus formulas for preterm or term infants?
• Which statement accurately describes health literacy strategies in discharge teaching?
• The transition from acute to adaptive phase is which of the following?
• Has fiber been shown to affect absorption of calcium, zinc, or magnesium significantly?
• Which of the following statements regarding fluid requirements for healthy adults age 18-55 is correct?
• Which factor after GI surgery is associated with prior gastric resection?
• Is cysteine a component of standard parenteral amino acid solutions? Why?
• What is the most appropriate situation for nurses to insert a nasogastric feeding tube without physician supervision?
• Vitamin B12 absorption occurs primarily in which section?
• In transitioning from enteral tube to oral feeding, tube feeding may be discontinued when adequacy of oral intake meets at least:
• Which of the following statements about the prosthetic device act criteria for HPN coverage is NOT true?
• Why is gluconeogenesis important during fasting?
• The Prognostic Nutrition Index stands for which term?
• Which statement is true about home parenteral nutrition (HPN) management?
• What is the primary purpose of the AMDR?
• Teach-back process includes which of the following elements?
• How should protein requirements be determined for parenteral nutrition?
• Which statement best summarizes safety guidelines for using powdered infant formula in healthcare facilities?
• The catabolic phase of the metabolic response to critical illness lasts approximately how long?
• Where is Lactobacillus GG normally found in the body?
• What is the most common symptom when feeding or fluids are withheld?
• Which statement is true regarding effects of fiber-supplemented diets on altered bowel elimination?
• Which can decrease the accuracy of an indirect calorimetry study?
• EFAD may contribute to inflammatory pathways contributing to symptoms in CF. Which domains are affected?
• In a 45 year old patient with suspected vitamin A deficiency, supplementation of vitamin A (25,000 IU/day) should usually be given for a maximum of
• Which 3 amino acids are actually given in smaller amounts to neonates compared to adults?
• In a patient with Clostridium difficile infection, should the feeding formula be changed to elemental?
• Which represents the core set of clinical and functional status elements forming the foundation for comprehensive assessment in long-term care facilities certified for Medicare or Medicaid?
• In the Waterlow criteria, weight for length is evaluated as an index of which form of malnutrition?
• Which statement about the oxidation of essential amino acids is true?
• Which of the following is a documented complication of persistent diarrhea?
• What is the recommended maximum hang time for closed enteral nutrition formulas after opening?
• When evaluating the home environment for a patient receiving parenteral nutrition, which of the following is required?
• Which resource does the Oley Foundation provide to assist patients and caregivers?
• Which tube requires immediate replacement if it becomes dislodged?
• Which statement about carbohydrate digestion in the mouth is true?
• After approximately 2 days of starvation, what metabolic adaptation occurs?
• Which outcome is most likely to occur as a result of age-related functional changes in the gastrointestinal tract?
• In pediatric burn care, when TBSA is greater than 20%, oral intake cannot meet nutrient needs.
• The Fenton growth chart is designed to track growth over which age range?
• B12 is released from dietary proteins by which gastric factors?
• Which of the following is NOT a common cause of reflux in children receiving enteral nutrition?
• Ursodiol facilitates absorption of which nutrient?
• How long must bowel rest be required for Medicare coverage of HPN?
• Elevated catecholamines and elevated or normal plasma insulin are observed during which phase after burn injury?
• Which statement about medium-chain triglyceride absorption is true?
• How often should electrolytes be monitored in a patient on home parenteral nutrition support?
• Nitrogen balance assessment: urinary urea nitrogen accounts for what percentage of total urinary nitrogen losses?
• Which of the following is true about lactose content in adult enteral products and medications?
• Which factor can further impact nutritional status in cancer patients?
• BMI Percentiles in Children Are
• What is the purpose of nocturnal feeds?
• Which combination increases aspiration risk in critically ill children?
• Which of the following best defines the threshold for vitamin D adequacy based on 25(OH)D levels?
• Which intervention assists with maintaining feeding tube patency in the adult patient?
• Which two populations may require thiamin supplementation?
• What is the typical sodium concentration range for oral rehydration solutions?
• What is the main concern when granulation tissue forms at the PEG exit site?
• What is the maximum hang time for canned, ready-to-use formula?
• Which cancer types had an intermediate prevalence of weight loss at diagnosis?
• In the PN case, which lab value indicates malnutrition risk?
• Vitamin B12 absorption occurs primarily in which part of the small intestine?
• Brush border oligosaccharidase deficiency leads to diarrhea and bloating after ingestion of sugar due to which primary mechanism?
• In PN patients with elevated bilirubin, which trace elements may need to be reduced or eliminated?
• What effect does tumor lysis syndrome have on serum phosphate?
• What is the estimated reduction in mortality associated with zinc supplementation for childhood diarrhea?
• Which infants is at greatest risk for iron deficiency anemia?
• Which electrolyte is not typically monitored closely in refeeding syndrome?
• EN should be delayed until the following prerequisites are accomplished before starting to reduce the risk of intestinal ischemia?
• What percent of body weight is water approximately?
• Which form of PN is typically administered via a peripheral vein?
• Choline supplementation has been investigated for hepatic steatosis; what has been observed?
• Which home enteral nutrition expense is least likely to be reimbursed by third-party payers?
• How much TBW is contained in the intracellular fluid?
• Which form of thiamin deficiency is associated with edema and cardiovascular symptoms?
• Renal tubular acidosis is associated with abnormalities in which laboratory parameters?
• What is the deficiency in classic PKU? What is the consequence of this deficiency?
• In preterm infants, iron supplementation is advised starting in which age range?
• Which therapy has the potential to depress growth and bone mineral density in children with Crohn's disease?
• How often does the American Academy of Pediatrics recommend screening for iron deficiency anemia?
• Hyperphosphatemia can contribute to which bone-related condition?
• Increased intake of caloric beverages such as juice, soda, and sweetened drinks in children is associated with what health risk?
• Which factor contributes to higher caloric needs in chronic lung disease due to increased work of breathing?
• What is the hang time range for closed-system enteral feeding containers?
• In a pediatric patient with osteopenia and fractures, low calcium, low phosphorus, high alkaline phosphatase, low 25-OH vitamin D, low 1,25 (OH)2 vitamin D, and high PTH, the most likely diagnosis is which?
• The influence of dietary fiber on total oral to anal transit time depends on which factor?
• Where and how does carbohydrate digestion begin?
• Under Medicare guidelines when are enteral infusion pumps covered? Which of the following is NOT listed as an example supporting pump use?
• Which factor after GI surgery may impact absorptive function related to the specific segment of bowel that has been resected?
• What have studies indicated about increased intake of juices, sodas and sweetened beverages by children?
• Using the Holliday-Segar method, what is the maintenance fluid requirement per day for a 25 kg child?
• Do vitamins compose a large percentage of oral nutrition supplements?
• How does the addition of a fat modular affect osmolality?
• Which item is an example of a modular product?
• What is the rationale for maintaining higher protein intake in cirrhosis?
• Which choice best describes nocturnal feeds?
• In adults, cysteine can be synthesized from methionine via which pathway?
• If extracellular fluid is 16 L and intravascular space is 4 L, what is the interstitial fluid volume?
• Which patient population cope more effectively with HPN?
• Which statement about syringe size and feeding tube patency is correct?
• Phenylketonuria (PKU) is caused by deficiency of which enzyme, and what is the typical chronic dietary management?
• Pancreatic lipase primarily acts in which part of the digestive tract to digest triglycerides?
• Which factor is commonly used to manage nausea due to delayed gastric emptying?
• Which of the following is NOT a benefit of EN over PN in severe acute pancreatitis?
• How does psyllium impact IBS?
• Preservation of the ileocecal valve reduces the risk of SBBO after intestinal resection.
• What type of burns can usually be supported by an oral high protein, high calorie diet in children?
• What is the selenium content status of standard infant trace element products?
• For which population is fortification of human milk especially necessary?
• Why is zinc deficiency difficult to assess and detect?
• When are cyclic feedings typically given?
• The subjective global assessment includes which components?
• Which statement about lactose content of preterm formulas is true?
• Which deficiency may occur with biliary atresia, chronic malnutrition, cirrhosis and chronic stress that is difficult to assess and detect due to laboratory limitations?
• Which deficiency can cause skin rashes, hair loss, and loss of taste?
• Which option best describes two reasons critically ill children have an increased risk of aspiration?
• After gastric residual volume (GRV) assessment, which action is recommended to maintain patency?
• Which two nutrient-related substances are primarily absorbed in the ileum?
• Which laboratory marker is used to assess zinc status, and what factor can complicate its interpretation?
• What is the Tolerable Upper Intake Level (UL)?
• Define meconium.
• What is the new evidence for possible adjusting the guideline on waiting for hemodynamic stability, volume resuscitation and mesenteric perfusion prior to starting enteral feeds?
• How much energy is often required to meet the needs of the growing neonate?
• Which type of enteral system has higher contamination risk due to nursing manipulation when adding formula to the bag?
• Why don't many third party payers cover the cost of enteral formula?
• Which of the following sets of laboratory tests is recommended to be monitored weekly in home parenteral nutrition patients until clinically stable?
• Which of the following is NOT a benefit of closed enteral feeding systems?
• Port placement for PN is generally indicated for long-term use, defined as more than 6 weeks. Which option best matches this definition?
• Which statement about managing hypergranulation is correct?
• Should medications be mixed directly into the enteral formula for administration?
• How does volume depletion influence the risk of nephrolithiasis due to calcium oxalate stones?
• An 85-year-old man with gradual, nonvolitional weight loss and no major health problems is described. Which statement most accurately describes his weight loss?
• Enteral formulas supplemented with fiber are often used to prevent constipation in older adults. Which consideration is most important?
• In older adults receiving aggressive nutrition support, which electrolyte abnormality is most commonly associated?
• What is the recommended approach to glucose management in sepsis and stress?
• What is the sodium concentration in lactated Ringer's solution?
• What is the advantage of open enteral feeding systems?
• In a malnourished patient with aspiration risk whose gut is functional, which nutrition support is preferred?
• Which organ is identified as having the necessary enzymes for gluconeogenesis in the material?
• Which of the following is a significant complication associated with GERD?
• What is the GFR for ESRD?
• In obese patients with BMI > 30 kg/m2, which PN/EN recommendations best reflect the guidelines for calories and protein?
• Besides antimicrobial action, what is another reported use of ethanol in clinical practice?
• What outcome may result from chromium deficiency?
• Hyponatremia associated with loop diuretic use in older adults is typically:
• What is the primary role of pancreatic enzymes?
• For ascites, what is the recommended protein intake for maintenance?
• If RQ is 0.82, what is the recommended action?
• Why is cysteine added as cysteine HCl in PN for preterm infants?
• Which statement best describes transitional infant formulas for premature babies?
• Which practice is most associated with reducing aspiration risk in PEG-fed patients?
• Which statement best describes the SGA's approach to nutrition assessment?
• What disease causes copper toxicity?
• What is refeeding syndrome?
• Which of the following is listed as a contributor to frailty?
• Which molecule acts as an emulsifier in fat digestion?
• How is puberty generally affected by celiac disease?
• For feeding a pancreatic insufficient CF infant, which option is NOT indicated unless another medical reason exists?
• When should parenteral iron be considered for PN patients?
• Short chain fatty acids are produced by fermentation of which substrate?
• In mild dehydration due to viral gastroenteritis, which statement is true?
• How does the location of a fistula in the GI tract affect its output and metabolic risk?
• Which is a common symptom of celiac disease in childhood?
• Fatty acid molecules have an acidic carboxyl group at one end and what feature on the rest of the molecule?
• Powdered formulas reconstituted in advance should be refrigerated immediately after reparation and discarded within 24 hours if not used. They should also be exposed to room temperature for no longer than how many hours?
• Under sepsis and stress, which metabolic alterations are most likely to occur?
• What percentage of nutrient intake should oral intake meet as a general guideline to discontinue enteral feeds?
• Which vitamin is a cofactor for the enzyme pyruvate dehydrogenase, linking glycolysis to the citric acid cycle?
• How does cystic fibrosis related diabetes occur?
• Transcellular fluid is one of the compartments of total body water.
• What is the function of glutamine?
• What can be done to liquid dosages of medications to prevent tube clogging from the high viscosity?
• Which dietary component is restricted in the typical PKU management plan?
• Selective screening for iron deficiency anemia would be a better option in which scenario?
• How can chronic steroid use negatively affect nutritional status?
• Why is fluid restriction indicated in infants with chronic lung disease?
• For fatty acids longer than 10 carbon atoms, what is required for their digestion and absorption?
• Which metabolic alteration is noted during the ebb response following burn injury in a pediatric patient?
• What population has a lower tolerance of alcohol?
• What is the estimated mean US reading level?
• Which statement best describes the evidence for BCAA enriched enteral formulas in hepatic failure?
• Copper deficiency can present with abnormal EKG patterns.
• What does research show is the most effective way to improve understanding of discharge teaching while simultaneously addressing health literacy?
• Which of the following is NOT a responsibility of home infusion providers?
• What is the first step in treating hepatic encephalopathy?
• Which statement best defines the ethical principle of nonmalfeasance?
• The presence of which facilitates the absorption of sodium in the lumen of the small intestine?
• Which factor is a major risk factor related to gastric content?
• What is the optimal sodium concentration of an oral rehydration solution for patients with short bowel syndrome?
• Which type of medication should be crushed for administration via enteral feeding tube?
• Why do open-system enteral feedings have a shorter hang time?
• Why are linoleic acid and alpha-linolenic acid considered essential fatty acids?
• Gluconeogenesis from amino acids begins within how many hours after the last meal?
• What is the zinc dose recommended per day for infants under 6 months with acute diarrhea?
• Alcohol-related thiamine deficiency often presents as which condition?
• What does the evidence show about using dietary fiber to reduce diarrhea in tube-fed patients?
• What is a key absorption difference between MCTs and long-chain triglycerides?
• Which statement best describes the effect of concentrated enteral formulas on nausea due to delayed gastric emptying?
• Why is thiamin deficiency seen in patients with heart failure?
• Which option describes a typical bolus delivery method?
• Severe diarrhea due to Clostridium difficile toxin is most commonly associated with which acid-base disorder?
• Which weight range is specified for term neonates when determining the 2 mcg/kg/day selenium dose?
• Why is human milk considered optimal over standard formula?
• Why does the dislodged jejunostomy tube need to be replaced immediately?
• Which macronutrient typically provides the largest share of calories in PN for a stable infant?
• In patients with which condition should copper supplementation be reduced or eliminated due to excretion concerns?
• Osteogenesis imperfecta is best described as which of the following?
• Which is NOT a component of a complete PN order?
• Low fat mass in dialysis patients most clearly indicates what?
• During discharge education for home enteral nutrition, which method best determines whether a patient and/or caregiver understands enteral tube feeding delivery?
• Which of the following is NOT a reported benefit of non-nutritive sucking in the enterally fed patient?
• Which of the following statements about cyclic feeding is true?
• A patient with oral cancer on home bolus enteral feedings via gastrostomy tube reports abdominal pain and pressure inside the stomach, with no exterior site changes. What is the most appropriate next step?
• In a stable infant, how much protein should be provided by parenteral support?
• In an infant with mild dehydration from diarrhea, what is the most likely cause?
• How should PN ingredients be ordered for pediatric and neonatal patients?
• Which GFR range defines stage 2 kidney damage?
• What compounds are included in the vitamin A family?
• What is the macronutrient breakdown of most oral enteral products?
• What type of medication form is preferred for enteral medication administration?
• During the flow phase after a burn injury, which of the following occurs?
• Before giving antidiarrheal medications to a patient with diarrhea who recently completed antibiotic therapy, which test should be performed?
• Which populations have carnitine deficiency concern?
• Which of the following is a purpose of cyclic feedings?
• Total body water represents approximately what percent of body weight in typical adults?
• Which of the following is NOT associated with a delayed bone age in a child with short stature?
• What is the limiting factor for amounts of calcium and phosphorus provided by PN solution?
• How would glucose intolerance present in infants?
• What is the daily zinc dose for acute diarrhea in children aged 6 months and older, per WHO/UNICEF guidelines?
• What reading grade level is recommended for patient education materials?
• Why is feeding in excess of energy expenditure in burn patients not recommended?
• Which of the following has NOT been shown to delay weaning from mechanical ventilation in COPD patients receiving enteral nutrition?
• Should fresh formula be added to already hanging formula?
• Which of the following is listed as a symptom of vitamin D toxicity?
• Redistribution of polyvalent cations such as zinc and iron occurs during which burn metabolic phase?
• What is the rate of occurrence for peristomal infection when PEG tubes are placed?
• Which patient group is commonly considered to require cysteine provision in PN?
• Which of the following is NOT a listed benefit of a standardized interdisciplinary EN feeding protocol?
• The galactose content of lactose-free cow's milk formula is approximately how many milligrams per liter?
• A 68-year-old woman with cirrhosis receiving enteral nutrition due to recent gastrointestinal surgery and worsening hepatic encephalopathy. Which of the following should be tried first?
• Why might laboratory values not reliably reflect micronutrient status in PN patients?
• Which portion of the small intestine is capable of compensation and adaptation after ileal resections?
• Which weight loss criterion is listed for HPN eligibility under Medicare?
• Regarding blue dye added to enteral feedings, which statement is correct?
• Which statement best reflects the primary goal of discharge education for home enteral nutrition?
• What is a known electrolyte side effect of trimethoprin use?
• What was a common practice in the past to detect aspiration of enteral feedings?
• What is the recommended intake of selenium for term infants receiving long-term total parenteral nutrition?
• Calcification occurs when the product of calcium and phosphorus exceeds which value?
• What is galactosemia?
• What is the recommended daily energy intake (kcal/kg) for patients over 60 receiving dialysis?
• Which statement accurately describes the relationship between inflammation and zinc serum levels?
• How does the labeled aluminum content typically compare to the measured content in PN bags?
• Name a relatively common post-procedural complication reported in up to 30% of tubes placed?
• Which scenario is most associated with social embarrassment for someone caring for a patient on EN?
• Which of the following is a non-profit organization identified as a resource for home nutrition patients and their caregivers?
• Which two enteral feeding methods are most popular with home enteral nutrition?
• Which set contains only items that are modular products?
• Which flushing strategy is recommended to maintain tube patency during continuous feeding?
• In IBS, what do studies show about the effect of wheat bran?
• Which of the following is NOT among the six nutrients whose absorption may be affected by regular alcohol intake?
• Which tube placement reduces aspiration risk by delivering feeding beyond the stomach?
• Which mineral is central to the oxygen-carrying function of blood proteins?
• Which statement defines continuous feedings?
• What did the 2011 omega-3 trials show regarding ARDS?
• In a home enteral nutrition patient with new onset diarrhea after pneumonia, what is the first recommended intervention?
• Using the Waterlow criteria, weight-for-length is an index of which type of wasting?
• Which lab measurement reflects functional or long-term selenium status?
• Which of the following is a short-chain fatty acid by carbon number?
• In standard term formulas, what is the carbohydrate source?
• In adults, promotility agents should be considered under which circumstance?
• Which description best matches recommended skin care around the feeding tube site?
• How does the labeled aluminum amount compare to the measured content in PN products?
• An increase in formula sediment accumulation inside the feeding tube decreasing patency is seen more often with which two types of formulas?
• Is starting parenteral nutrition appropriate for a mildly dehydrated infant with viral gastroenteritis?
• What is the effect of ketogenesis rate during starvation when insulin is low?
• What is the rationale for starting iron supplementation in exclusively breastfed infants by 4-6 months?
• Why must vascular access devices (VADs) for home parenteral nutrition be placed in the central venous system?
• In plasma, retinol is transported primarily bound to which molecule?
• What is a major risk factor for thiamine deficiency in hospitalized patients receiving parenteral nutrition?
• Which factor can contribute to abdominal distention due to air in the gastrointestinal tract during enteral feeding?
• In a stable infant, what percent of kcals should come from carbohydrate in PN?
• Why do effects of fiber in the upper intestinal tract differ from those in the colon?
• Why is it vital for the patient and health care providers to understand the benefits provided by the patient's insurance coverage?
• According to WHO/UNICEF, what zinc regimen is recommended for acute diarrhea in children?
• Do enteral feeding and hydration ensure comfort in the end of life?
• What urine output target is recommended to prevent nephrolithiasis?
• According to the ASPEN PN safety rules, which item on the inpatient PN label is NOT mandatory?
• Why might temporary protein restriction be used in cirrhosis with acute encephalopathy?
• Which of the following is NOT a listed GERD complication in infants?
• Enteral feedings in which setting are more likely to cause social embarrassment?
• Which form of glutamine supplementation improves physical compatibility and stability for admixture in PN solutions?
• Which of the following is a cause of nausea and vomiting related to gastric motility in the enterally fed patient?
• According to the Waterlow criteria, wasting is a marker of what?
• Is there clear indication for increasing the intake of dietary fiber to resolve constipation?
• A previously well-nourished patient with fever is admitted to the hospital. His laboratory tests reveal albumin 2.1 g/dL, C-reactive protein 30 mg/L, serum calcium 7.2 mg/dL. Which of the following is the most likely etiology of the hypoalbuminemia?
• What measurement defines excessive hypergranulation?
• Which symptom class is commonly reported with the initial introduction of dietary fiber?
• What is the preferred flush solution to maintain feeding tube patency?
• Which of the following is a potential cause of abdominal distention due to enteral feeding?
• How much formula should be poured into an open administration set?
• Which nutrients are associated with macrocytic anemia?
• Which lipid source is absorbed directly into portal circulation, bypassing the lymphatic system?
• Which statement best describes the role of modular products in enteral nutrition?
• Why is withholding enteral feeds for prolonged periods of time a main strategy for reducing NEC risk?
• According to the WHO/UNICEF recommendation, what is the zinc supplementation plan for a child with acute diarrhea and for an infant under 6 months?
• Which formula is most likely to cause an occluded feeding tube?
• Which symptom is cited as an example of non-specific GI symptoms in relation to soy formulas?
• Which statement is NOT true of EFAD in patients with cystic fibrosis?
• What type of tablets should be crushed for administration via an enteral feeding tube?
• What is the first-line therapy for hyperkalemic emergencies?
• Which statement about valproic acid and carnitine deficiency is true?
• Which statement is NOT a benefit of non-nutritive sucking in the enterally fed neonate?
• Which set of labs does ASPEN recommend for weekly monitoring until the home PN patient is stable?
• Which electrolyte disturbance is typically seen with loop diuretics?
• Which statement describes the five components of a micronutrient assessment in PN patients?
• What is the typical volume status of a patient with SIADH?
• What is the most appropriate fluid requirement for a healthy 78 year old adult?
• How does excess protein intake impact calcium?
• Which immunomodulating nutrient may be harmful in patients with severe sepsis?
• Why is early delivery of enteral nutrition in critically ill patients extremely challenging in many cases?
• In hepatic encephalopathy, when might a branched-chain amino acid (BCAA) enriched formula be used?
• Resident assessment protocols are composed of which four elements?
• During the flow phase, which element groups are excreted at higher rates in urine?
• What does FIM stand for in rehabilitation settings?
• If gastric residual volumes remain elevated, which intervention is recommended?
• List the four physical exam factors used in the SGA?
• Which statement about zinc status measurement is true?
• Which feeding approach may promote more steady and predictable blood glucose concentrations in critically ill patients?
• Selenium status can be assessed by determining the selenium level in which specimen?
• Why is access to telephone required in the home environment for a patient receiving parenteral nutrition?
• Which factor increases zinc deficiency risk after colectomy with ileostomy?
• Lipase function statement: which is true?
• Which formula is NOT recommended for galactosemia?
• Does indirect calorimetry measure nitrogen balance?
• How does octreotide benefit refractory diarrhea?
• Which of the following is a documented benefit of early initiation of minimum enteral feeds in low birth weight or very low birth weight infants?
• Which of the following is a physiologic advantage of retaining the ileocecal valve and colon?
• Is ESRD an indication for parenteral nutrition (PN) under Medicare?
• What carbon chain length necessitates L-carnitine to enter the mitochondria?
• Which statement best describes a general guideline for medication administration via enteral tubes?
• Which statement about refeeding syndrome features is true?
• Compared with centers without an EN feeding protocol, centers with a formal EN protocol typically have which outcome?
• Which statement correctly identifies the nutrients whose absorption may be reduced due to age-related changes in the GI tract?
• Narcotics are a listed cause of constipation in enteral nutrition. True or False?
• The night feeding scenario described is an example of which feeding type?
• According to evidence, what nutrition support plan should be used for critically ill obese patients?
• Decreased vitamin D binding to VDRs can lead to which of the following regarding the renin-angiotensin system?
• Skin care around a feeding tube site should be accomplished by cleaning with
• The initiation of enteral tube feeding should be delayed when the patient is:
• A 50 year-old male weighing 80 kg has an estimated intravascular space of about how many liters?
• Biliary atresia in infancy is most frequently associated with which condition?
• For a 1 month old infant fed human milk, what daily vitamin D supplement is recommended?
• Phosphofructokinase is best described as...
• Which of the following is NOT a frequently reported concern of caregivers of patients receiving enteral tube feedings?
• What is the effect of hemodialysis on copper balance?
• Enteral fiber is commonly associated with which outcome regarding diarrhea?
• Into how many levels is degree of undernutrition categorized in Waterlow criteria?
• Which combination best describes factors contributing to lower energy needs in stressed neonates?
• Which of the following lists the four Medicare/Medicaid guidelines under the prosthetic device act that qualify a patient for HEN?
• When do post-procedural complications present with PEG tube placement?
• Total body water in an 80 kg adult with a TBW fraction of 0.6 is approximately how many liters?
• Which diagnosis would meet Medicare Part B coverage criteria to qualify a beneficiary for home enteral nutrition?
• How many calories are in 1 gram of protein?
• Stearic acid is an example of which fatty acid classification?
• Home infusion providers should have policies that address which of the following?
• BMI screening in children begins at what age?
• Which clinical scenario would most clearly indicate PN for a fistula?
• How many grams of glycogen are stored in the liver?
• Which statement best describes how aging of the GI tract can affect immunoglobulin A (IgA) responsiveness?
• Will Medicare approve HPN for fat malabsorption?
• The Katz ADL is a tool that measures what?
• What type of fat is contained in standard infant formulas?
• Where is enterokinase secreted from?
• In hemodialysis patients, what does low muscle mass indicate about nutrition and inflammation?
• What is the most common complication following gastrostomy placement?
• Which acid-base disturbances are associated with hypophosphatemia according to the risk factors?
• Prolonged nasogastric suction results in loss of gastrointestinal secretions primarily from which portion of the GI tract?
• Which of the following has been reported to be a significant independent predictor of morbidity and mortality in critically ill patients?
• In PN patients with cholestasis, how should manganese be adjusted?
• Although enteral feeding is often preferred, what is a major disadvantage in HEG?
• Which of the following is NOT a cause of malnutrition in a patient with liver disease?
• Many insurance policies establish their own criteria for EN and PN, while others follow guidelines set forth by which program?
• Which lab can be used to determine vitamin D adequacy, and how should it be interpreted?
• What is the fluid provision recommendation when using a fiber-containing enteral regimen?
• Return demonstration primarily verifies which aspect?
• Transitional infant formulas are fortified with iron to meet the needs of infants with a history of prematurity.
• A PN-associated bone disease is thought to have a component of aluminum toxicity.
• Which of the following is a component of bile?
• What clinical presentation does SIADH cause?
• What is the purpose of modular products?
• In diarrhea-induced metabolic acidosis, what is the typical anion gap?
• What is an optimal method of preparing and administering medications via an enteral feeding tube?
• Which of the following should not be crushed and given through the feeding tube?
• Which of the following is NOT a reason older adults are at higher risk for vitamin D deficiency?
• Which tube is inserted through the nose to access the stomach?
• What is one of the most common causes of hyponatremia?
• The estimated intravascular space in this example represents approximately what percent of body weight?
• Which GI toxicities are commonly observed in the first 2–3 weeks after stem cell transplant that may preclude enteral nutrition?
• Which type of enteral system has higher risk for contamination due to nursing manipulation?
• The clinical manifestations of copper deficiency can be similar to deficiency of which micronutrient?
• Which statement about insensible fluid losses is true?
• Which phase of fasting involves the brain adapting to using ketones for energy?
• How does small bowel bacterial overgrowth lead to fat malabsorption?
• The biochemical defect in phenylketonuria (PKU) is a deficiency of the liver enzyme phenylalanine hydroxylase, which catalyzes the para-hydroxylation of phenylalanine to yield which amino acid?
• When implementing early enteral nutrition in critically ill patients, which factor is most likely to increase success in moving patients toward target feeding rate?
• Which measurements does Waterlow criteria take into account?
• The intrinsic factor–B12 complex is absorbed in which part of the digestive tract?
• Which statement best describes the overall evidence for fiber's effect on constipation?
• In phenylketonuria, tyrosine becomes an essential amino acid due to deficiency in which enzyme?
• In nutritional management of chronic lung disease, which therapy is considered most appropriate?
• A seven-month-old infant who is fed reconstituted infant formula and complementary foods may be at risk of over-supplementation with which nutrient?
• In cystic fibrosis, pancreatic enzymes supplemented at high doses could result in:
• Managed care and private insurance companies often use which established criteria/guidelines when approving coverage for home parenteral nutrition?
• Extraskeletal outcomes such as cancer and cardiovascular disease have what level of evidence according to the IOM review?
• How does acute kidney injury affect serum phosphate levels?
• Megestrol acetate downregulates the synthesis and release of which type of molecules, contributing to its anti-inflammatory effects?
• What practice has persisted since 1999 that maintains risk of thiamin deficiency in PN?
• How does insoluble fiber impact gastric emptying?
• Why is a test dose of iron dextran used before adding to PN?
• The recommendation to administer 2-4 mg/kg/day of iron during the period from 4-8 weeks to 12-15 months is based on which growth phase?
• Mid-arm muscle circumference and hand grip strength are sensitive markers for what?
• What is BMI used for in pediatric populations?
• The Minimum Data Set (MDS) is part of which larger assessment framework?
• In an elderly patient with unintentional weight loss and inadequate intake, which factor is least likely to contribute?
• How does soluble fiber intake impact cholesterol levels?
• In a nocturnal cyclic feeding example, what is the typical night feeding rate?
• Cyclic feeding is best described as an infusion where the rate increases to meet goals within 8-24 hours.
• Which nutrition support method increases risk of thiamin deficiency due to high glucose loads?
• What grade level is recommended for patient education materials?
• What are the main causes of fatigue in caregivers of enteral nutrition patients?
• Treatment for gastric phytobezoars includes all of the following EXCEPT
• Under what conditions may arginine supplementation be harmful?
• Which data sources contributed to validating the Fenton chart?
• For acute diarrhea, what is the duration of zinc treatment recommended by guidelines?
• Should antidiarrheal medications be used in patients with Clostridium difficile infection?
• If there is drainage from the feeding tube site, what is the recommended practice regarding dressings?
• Loss of bile salts in the colon affects water and salt reabsorption by causing:
• Which pattern of iron labs is typical in the acute phase response?
• How much TBW is contained in the extracellular fluid?
• What is the impact of both non-fiber and fructooligosaccharide (FOS) containing enteral formulas on stool?
• Achlorhydria and crystalline B12 absorption.
• What is the hang time for canned ready-to-use formulas?
• Which of the following is NOT a symptom associated with EFAD?
• Which percentage/time frame is used as a significant weight loss indicator for malnutrition?
• When ATP is abundant, inhibition of phosphofructokinase is important because it...
• What is the typical energy intake when indirect calorimetry is not available?
• Which antiretroviral drug class is most strongly associated with HIV-associated lipodystrophy?
• Which statement best describes buried bumper syndrome migration?
• The MNA-SF was derived from the MNA to achieve what?
• In terminally ill patients at home on hospice, what is a key rationale for not relying on enteral feeding to ensure comfort?
• Does Medicare cover professional intervention/monitoring for home parenteral nutrition?
• Are laboratory values a good assessment of micronutrient status?
• Which of the following is a sign of EFAD?
• Would enteral nutrition be covered for nausea?
• If a patient has supplemental insurance, what is typical about the 20% Medicare coinsurance for enteral formula?
• Which lab finding would differentiate Vitamin D dependent rickets type 2 from vitamin D deficiency rickets?
• Which feeding order best reflects an intermittent schedule?
• Which type of malnutrition is characterized by hypoglycemia, ketosis, and lipolysis?
• Insurance coverage for EN and PN typically requires that the therapy is what?
• Which statement about bone health in pediatric celiac disease is true?
• Which of the following is a best practice recommendation in enteral nutrition (EN) formula safety?
• Which factor contributes to abdominal distention due to gas, specifically excess air in the stomach or intestines?
• Which of the following is NOT a clinical feature of acute disease-associated malnutrition caused by an acute inflammatory response?
• Which population is the Holliday-Segar method not suitable for?
• NOT a common reason for decreased food intake in older adults?
• Which criterion qualifies a patient for home enteral nutrition (HEN) under Medicare?
• Which amino acid is described as the principal metabolic fuel for intestinal cells?
• Which of the following can result in an invalid indirect calorimetry measurement?
• Who should place a feeding tube in a patient with head or neck pathology?
• A Crohn's disease patient involving the distal ileum should be monitored for malabsorption of which nutrient?
• In postoperative high GRV, which feeding route yields adequate calories?
• Which element relates to how the feeding is delivered in an enteral nutrition order?
• What is the physiological function of chromium?
• Which of the following is NOT among the six conditionally indispensable amino acids?
• Manganese brain deposition can occur at what daily intravenous manganese administration level?
• In pediatric patients receiving parenteral nutrition, what percentage of total calories should be provided as fat to prevent essential fatty acid deficiency (EFAD)?
• Which of the following is considered an upper limit for the osmolality of infant formulas to avoid tolerance issues?
• What is the role of gluconeogenesis in fasting?
• Which of the following combinations may indicate overfeeding in an adult receiving enteral nutrition?
• How should enteral feeding schedules be designed for the home?
• In terminal patients, intravenous hydration is generally avoided because it can increase the risk of which outcome?
• What is the sodium concentration range of homemade or commercial oral rehydration solutions?
• Which of the following is a common cause of nausea and vomiting in enterally fed patients?
• Which statement about fundoplication procedures is true?
• What is the approximate daily protein range (in g/kg/day) recommended for stressed trauma patients?
• Based on bone health evidence, what is the RDA for calcium in children 4-8 years of age?
• Where are B12 and bile salts absorbed?
• Under Medicare Part B, who is responsible for the 20% coinsurance for enteral formula?
• For a child with suspected cow's milk protein allergy, what is the initial recommended formula?
• Which sign is specifically associated with dehydration severity in infants?
• What is the most common nutritional deficiency in childhood?
• Mobilization of metabolic reserves occurs during which burn metabolic phase?
• Why is zinc supplementation recommended in hepatic encephalopathy?
• In standard term infant formulas, what percentage of carbohydrate calories comes from lactose?
• What is the Holliday-Segar maintenance rate per kilogram for the next 10 kg (11–20 kg)?
• Which trace element is present in current PN additives at greater than five times the current estimated requirement?
• Which is the most appropriate indicator of malnutrition?
• A patient with acute kidney injury (AKI) requiring parenteral nutrition would most likely benefit from a solution containing which of the following?
• Copper toxicity is associated with which disease?
• Older adults are at an increased risk of zinc deficiency at baseline primarily due to what?
• Which statement about essential versus nonessential amino acids in AKI PN is most accurate?
• What provides the energy for glucose transport into intestinal mucosal cells?
• In patients treated with levodopa, how should vitamin B6 intake be managed?
• What is the most serious complication of hyperphosphatemia?
• Are clinically significant protein deficiencies common?
• Which variable is NOT included in the Mifflin-St. Jeor equation according to the source material?
• Which of the following is NOT a typical sign of iron deficiency anemia?
• Which statement best describes carnitine's role in fatty acid metabolism?
• Which enzyme catalyzes the hydroxylation of phenylalanine to tyrosine?
• Compared with jejunal fluid, which statement is true about ileal fluid bicarbonate concentration?
• Which practice reduces the risk of microbial contamination when initiating enteral feedings?
• What is the suggested daily amount of potassium required for maintenance in an infant receiving parenteral nutrition?
• For the PN order described as 2400 mL with 300 grams dextrose and 90 grams protein plus 225 mL of 20% IVFE, what is the total caloric content, protein, fat, and final volume?
• Which of the following should always appear on the label of an enteral feeding product given to a patient in the hospital?
• In critically ill children, how do predictive equations compare to indirect calorimetry for assessing energy needs?
• Fatty acids are characterized by carbon atoms and what other feature?
• What is encouraged regarding dinner table socialization for home enteral nutrition patients?
• For coverage of HPN under the prosthetic device act, which scenario is typical?
• Following initial certification of parenteral nutrition by Medicare, after what length of time is recertification required?
• An exclusively cow's milk-based formula-fed 2-month-old infant develops a full-body rash. What is the most appropriate next step?
• Which feeding is preferred initially to minimize NEC risk in neonates when medically feasible?
• Which statement about irrigation for patency is accurate?
• Why is calcium supplementation recommended in short bowel syndrome?
• What type of malnutrition are hyperglycemia, hypermetabolism and lipolysis characteristics of?
• How should immediate release tablets be prepared for enteral administration?
• Which statement is true regarding ESRD and PN?
• Describe electromagnetic placement device for NGT placement.
• For feeding a pancreatic insufficient CF infant, which option NOT indicated?
• Length for age indicates which condition in the Waterlow criteria?
• Which of the following is not a common change in body composition of healthy older adults?
• Patients with chronic heart failure on loop diuretics are at risk for which complication?
• Which statement best describes energy expenditure components?
• What method is recommended to calculate energy prescriptions in critically ill and postoperative neonates?
• What nutrition should be provided to infants who normally receive human milk ad libitum?
• Are branched-chain amino acids (BCAAs) recommended in AKI PN?
• Which criterion indicates malabsorption and is part of Medicare HPN eligibility?
• Which dose and duration is recommended for vitamin A supplementation in suspected deficiency?
• Why can sorbitol from liquid medications cause diarrhea in enterally fed patients even if sorbitol is not an ingredient of the enteral formula?
• Which of the following is a primary cause of oozing stools in a tube fed patient?
• In PKU, why is tyrosine supplementation often included in the diet?
• Do adult enteral products contain lactose?
• In steatorrhea, what mechanistic change increases the risk of calcium oxalate nephrolithiasis?
• Why is the significance of GRV controversial?
• When initiating and advancing enteral feedings in the hospitalized patient, which option is most appropriate?
• Which statement best describes the role of ketone bodies during fasting?
• During extended periods of fasting (starvation), the main source of energy is from:
• Which of the following is NOT a frequently reported concern of caregivers of patients receiving enteral tube feedings?
• Why is the incidence of aspiration directly caused by enteral nutrition difficult to determine?
• The normal length of the small intestine can be described as which range?
• Dietary fat is predominantly absorbed in which region of the gastrointestinal tract?
• What is the typical macronutrient breakdown for most oral nutrition supplements?
• Precocious puberty is defined as puberty beginning before what ages in girls and boys, respectively?
• What does the display on an electromagnetic placement device show?
• What is the typical dietary management for chronic PKU?
• Which component is not part of the ebb response?
• What may be required with liquid medications when administered enterally?
• Which trace element’s status is best monitored by whole blood levels that correlate with MRI abnormalities?
• Which molecules are primarily transported by lipoproteins in the bloodstream?
• Should small syringes be used for feeding tube flushes? Why?
• Why is immediate replacement of a jejunostomy tube important?
• When interpreting zinc levels, which condition can mislead interpretation?
• Which sequence lists the three phases of the metabolic response to critical illness?
• In the described anorexia nervosa case, the patient's BMI was less than which percentile?
• Which is the most common complication associated with PN administration?
• How does calcium RDA change with age?
• Which of the following is a life-threatening etiology of pain after starting bolus feeds via a G-tube?
• Enteral intact protein formulations may coagulate with contact with which condition?
• Early initiation of enteral feeding has been suggested to benefit ICU patients by reducing infectious complications, length of hospital stay and possibly reducing mortality. Which group of patients might be at significant risk from early enteral feeding?
• Which factor can contribute to buried bumper syndrome due to mechanical pressure?
• In what situations is tricep skinfold thickness not reliable?
• A patient who weighs 75 kg is receiving 65 mL/hour of a 2-in-1 PN solution that contains 117 g protein and 273 g dextrose in addition to 250 mL of 20% IVFE. What is the daily caloric content of this regimen per kg body weight?
• Does infantile anorexia typically follow a traumatic event?
• What are two advantages of closed enteral feeding systems?
• What are the two primary nutrition concerns when planning care for a high-output GI fistula?
• For SBS patients with a colon, which macronutrient distribution is associated with improved outcomes?
• HIV-associated lipodystrophy has been strongly associated with which antiretroviral therapy?
• In postoperative neonatal nutrition, growth is often the primary goal but cannot occur until which condition is met?
• Which element indicates the formulation type, such as TNA versus dextrose/amino acids and separate IVFE?
• Severe hypercalcemia is treated with which regimen?
• How many items are in the full Mini Nutritional Assessment (MNA), and does it require special anthropometric measures?
• How should electrolytes be expressed on the PN label?
• Which statement describes the conversion of pepsinogen to pepsin?
• Which item is included as part of a complete PN order?
• In SIADH, what is typically observed in urine?
• What do plasma or serum levels of selenium primarily reflect?
• After a 48-hour fast, what becomes the brain's primary fuel source?
• Approximately what percent of ingested glucose is polymerized into glycogen?
• Into which part of the gastrointestinal tract does acid chyme move after leaving the stomach?
• Can serum zinc be used to diagnose zinc deficiency? Why?
• Why is cysteine considered essential in preterm infants?
• EFAD is usually seen after how long of fat-free PN?
• How long does the ebb response following burn injury last?
• What erythrocyte selenium concentration value indicates deficiency?
• Which amino acid is the key fuel for the small intestine?
• Which statement best describes PN indication for fistulas based on daily output?
• Which scenario would most clearly meet Medicare criteria for HEN?
• What is the primary goal of nutrition support in pediatric burn care?
• List 4 patient populations who qualify for Medicare reimbursement for home and community-based professional nutrition educational services provided by a registered dietitian
• Which screening option is better for communities with historically low incidence of anemia and generally good infant dietary practices?
• Is starting parenteral nutrition appropriate for treating mild dehydration due to diarrhea in an infant?
• How often should open system feeding administration sets be changed?
• Why would women with hyperemesis gravidarum be at risk for Wernicke's encephalopathy, and what is the recommended treatment when starting dextrose-containing fluids?
• Hypoventilation would tend to what effect on respiratory quotient (RQ) measurements?
• Is cow's milk a sufficient source of iron for babies?
• Which term is commonly used to describe infants with gastroesophageal reflux who are thriving and have no significant complications?
• The competitive interaction between zinc and copper occurs when zinc is taken through which route?
• The radiographic views commonly used to assess bone age are
• Are dressings necessary for feeding tube site care?
• Which statement best describes the recommended use of the MNA-SF?
• Arginine supplementation is used to increase production of nitric oxide; which drawback is highlighted?
• Up to what percentage of enterally fed patients report nausea and/or vomiting?
• What may result with high dose pancreatic enzyme therapy?
• Which statement about BMI and dialysis outcomes is true?
• What is the mechanism by which IV calcium gluconate helps in hyperkalemia?
• Glutamine dipeptide products in PN admixtures improve which properties?
• Nutrition therapy for pediatric patients with less than 20% total body surface area burns typically includes
• What causes buried bumper syndrome?
• In a patient on long-term home enteral nutrition who develops nausea, what is the most likely cause?
• Which electrolyte disturbance is expected with prolonged nasogastric output?
• Which of the following is NOT a reason postoperative and critically ill neonates have lower energy needs?
• An 85-year-old nursing home resident with anorexia and probable aspiration pneumonia; which nutrition plan would be most appropriate?
• In a large multicenter cooperative study, what proportion of cancer patients presented with weight loss at diagnosis?
• Which of the following statements is true about home PN candidacy, given the listed risk groups?
• In addition to bile salt malabsorption, cholestyramine can be used with antidiarrheal agents in which clinical scenario?
• What is a phytobezoar?
• What should be the dose limit on pancreatic enzymes?
• Which hormone is a counterregulatory hormone that opposes insulin action?
• Which organ is primarily affected by copper accumulation in Wilson's disease?
• Which statement about REDOX trials is accurate?
• Which event marks the transition to the catabolic phase?
• How does ulceration of the gastric mucosa occur with PEG placement, and what is its prevalence?
• What should be done for any new occurrence of pain at or near the G-tube site?
• Which statement is accurate regarding celiac disease diagnosis?
• Is antibiotic ointment recommended with feeding tube site care?
• What is the function of glucose-dependent insulinotropic polypeptide (GIP)?
• Which statement would NOT be a Medicare-eligible condition for home EN?
• Which statement best describes the relationship between renal function and aluminum toxicity risk?
• When do post procedural complications present after PEG tube placement?
• Which of the following is listed as an additional factor not considered major, that may increase risk?
• What is considered excessive granulation tissue at a PEG site in adults or pediatric patients?
• What is the current recommendation for initiating enteral feedings in adults and children?
• What is an alternative method to estimate fluid needs in infants instead of the Holliday-Segar method?
• Supplementation with which of the following nutrients is routinely restricted during the early stages of hematopoietic stem cell transplantation (HSCT)?
• How should manganese be adjusted in PN patients with hepatobiliary disease such as cholestasis?
• Which component does not contribute to osmolality in infant formulas?
• During the ebb response, what happens to plasma insulin?
• Which of the following methods of estimating energy requirements in critically ill children is LEAST accurate when compared to resting energy expenditure measured by indirect calorimetry?
• Which protein transports oxygen from the lungs to other parts of the body?
• In the event that an incompetent individual has an advance directive regarding artificial nutrition and hydration, how should the decision be made using ethical principles?
• In ALI and ARDS, which inflammatory mediators are produced from arachidonic acid metabolism?
• Which of the following is a common gastrointestinal toxicity observed in the first 2-3 weeks after stem cell transplant that often precludes enteral feeding?
• Which statement regarding aspiration in critically ill children is TRUE?
• Which statement is true about the environment for indirect calorimetry?
• Which of the following is a nutritional impact of SBBO?
• Which description best defines the Act phase of the Plan-Do-Study-Act cycle?
• Which statement about home infusion roles is correct?
• Why is a home or cellular telephone important for patients receiving home parenteral nutrition?
• Based on bone health evidence what is the RDA for calcium in children 1-3 years of age?
• Which statement best reflects the use of specialized nutrition support (SNS) in patients with a Do Not Resuscitate (DNR) status?
• What is hepatic steatosis?
• How are modular products prepared for use?
• The ideal sodium concentration for oral rehydration solutions depends on which factor?
• Which of the following is NOT a potential indicator of pain at a G-tube site?
• Discharge instructions should include which of the following about the home care company?
• Which statement about AMDRs for fat is true?
• In pediatric oncology, cachexia is characterized by which of the following?
• Calcium gluconate in hyperkalemia is indicated for which patients?
• What type of medications are preferred for enteral administration?
• An RQ greater than 1.0 indicates excessive CO2 production; what should be done?
• Why is the rate-limiting enzyme phosphofructokinase necessary?
• How does soluble fiber impact gastric emptying?
• Which statement is true regarding contraindications to early enteral nutrition?
• For preterm infants, what is the recommended elemental iron intake from 1-12 months of age?
• Which is most appropriate when initiating and advancing enteral feedings in a hospitalized patient?
• Zinc supplementation in childhood diarrhea has been associated with which outcome?
• What is a benefit of ethanol as a lock solution for catheters?
• Which entity's guidelines do some insurers follow when determining EN and PN coverage?
• Which condition is NOT a basis for Part B eligibility for home enteral nutrition?
• In pediatric patients with cystic fibrosis, which condition is NOT a contraindication to nasogastric tube feedings?
• Which biomarker is used as an alternative marker to assess vitamin A status aside from serum retinol?
• What is the hang time for closed system enteral feeding, and how does it compare to open feeding systems?
• Which statement describes marasmus?
• Which of the following are examples of conditionally indispensable amino acids?
• In PKU dietary management, which amino acid becomes conditionally essential and is supplemented?
• What is the primary fuel for colonocytes?
• In inflammatory bowel disease, when should antidiarrheal agents be used?
• Which patient group should not have blindly placed feeding tubes?
• In addition to reducing diarrhea duration, zinc supplementation has been associated with what other outcome?
• Which of the following factors impact total body water (TBW)?
• What is necessary for infused nutrients prior to indirect calorimetry measurement?
• What is the effect of gastrointestinal losses on zinc in long-term PN?
• Which statement best describes why diarrhea leads to metabolic acidosis?
• In burn patients, caloric support above energy expenditure has what effect on lean body mass preservation?
• Which fluid status is most often implicated in difficulty weaning from mechanical ventilation?
• Methotrexate impairs the synthesis of which cellular components due to folate antagonism?
• What is megestrol acetate and its primary function?
• In an infant with adequate energy intake, what is the minimum amount of fat emulsion containing long-chain fatty acids needed to prevent essential fatty acid deficiency?
• How much do insensible losses from the lungs and skin contribute to overall fluid losses?
• Which is a clinical indication for parenteral nutrition in hyperemesis gravidarum?
• What is the main concern when granulation tissue forms at a PEG site?
• Within how many hours should nutrition screening be performed for all patients admitted to a home care provider?
• What is the electrolyte composition of ileal fluid?
• How do some experts define chronic diarrhea?
• Non-nutritive sucking in the infant can stimulate secretion of which substances in the oral mucosa via vagal innervation?
• Which statement most accurately describes GER in infancy?
• What is the preferred flush solution to maintain feeding tube patency?
• Which of the following lists the three components of total energy expenditure?
• The Short-form Mini Nutritional Assessment (MNA-SF) was derived from the Mini Nutritional Assessment (MNA) in order to:
• Which BMI percentile indicates obesity in children?
• Mortality from acute diarrhea is usually primarily due to what?
• Absorption of large polypeptides, oligopeptides, and free amino acids occurs primarily in which part of the gastrointestinal tract?
• What is the overall conclusion about empiric zinc therapy for childhood diarrhea in low-income countries?
• What are 3 components of geriatric nutrition assessment?
• Weight gain after feeding tube placement increases risk of:
• The energy for glucose transport is provided by the active transport of which ion?
• Which of the following is a contributing factor to gastrointestinal toxicity in the first 2-3 weeks after stem cell transplant?
• To minimize refeeding syndrome risk, an electrolyte replacement protocol should be started before nutrition therapy begins.
• Which item is most likely reimbursed by third-party payers for home enteral nutrition?
• For PN-associated metabolic bone disease risk in IBD patients requiring long-term PN, which of the following is implicated?
• Medicare Part B coverage for home enteral nutrition requires the beneficiary to require tube feeding to provide sufficient nutrients to maintain weight and strength commensurate with their overall health status. This statement is:
• The use of Lactobacillus GG in pediatric practice has been found to be most effective in which of the following?
• If conjugated bilirubin is elevated in a patient on a 12-hour cycle of 3-in-1 HPN, which action is most appropriate?
• Which statement describes a consequence of increased short-chain fatty acid production in SBBO?
• What is the physiological impact of biliary atresia?
• How does the Holliday-Segar method work?
• Which of the following is a component of bile?
• Which statement describes continuous feeding?
• When estimating nitrogen balance from urinary urea nitrogen, which statement best describes the underlying assumption and a more reliable alternative?
• Loperamide is primarily used to achieve which therapeutic effect?
• Patient education material for home enteral and parenteral nutrition should be written at what grade level?
• What percentage of body weight loss triggers initiation of parenteral nutrition when EN fails in HEG management?
• What could hyperglycemia indicate in a non-diabetic older adult being enterally fed?
• Why isn't hemodialysis used as first-line therapy for hyperkalemic emergencies?
• What is the osmolality of a 30 kcal/oz concentrated standard infant formula?
• How do calories in CLD infants typically compare?
• Soluble fiber impact on blood glucose?
• Which of the following best describes simple carbohydrates?
• According to CMS, which of the following is an indication for home parenteral nutrition (HPN)?
• Which statement best describes the relationship between hypoalbuminemia and hypocalcemia?
• What can the dietitian recommend in the event the patient cannot afford the cost of their enteral formula?
• In HIV-associated lipodystrophy syndrome, which fat distribution pattern is most characteristic?
• Managed care and private insurance companies often use which established criteria/guidelines when approving coverage for home parenteral nutrition?
• What is the current understanding of choline's role in PN-related liver disease?
• In the stomach, what effect does hydrochloric acid have on proteins?
• Glucose and galactose gain access to enterocytes via which transporter?
• Which feeding schedules may cause fluctuations in blood glucose concentrations, increasing risk of hypoglycemia and hyperglycemia?
• When would a temporary protein restriction be indicated in hepatic encephalopathy?
• How does preterm human milk compare to full-term human milk in terms of protein concentration?
• Which of the following statements about MNA-SF accuracy is correct?
• Standard infant formulas with a caloric density of 20 kcal/oz generally have osmolality in which range?
• Compared with standard term infant formulas, preterm formulas have what carbohydrate composition?
• What is the role of correctional insulin in basal-bolus therapy?
• How does beta oxidation compare to carbohydrate oxidation in terms of energy yield?
• Which statement is true regarding GI losses for HPN coverage?
• GFR for stage 4 kidney damage with severe, low GFR?
• A patient on parenteral nutrition containing glucose develops mental status changes after 3 days. The most likely vitamin deficiency is:
• Is there a universally proven cut-off for discontinuing tube feeding based solely on oral intake adequacy?
• When a patient is identified as nutritionally at-risk on the initial screen, what action should be taken?
• Why should zinc interpretation be cautious in hypoalbuminemia?
• What is a strong contributor to stress in the specialized nutrition support patient that is not medical/health related?
• What is a major advantage of the Fenton growth chart?
• What is considered the hallmark feature of refeeding syndrome?
• Which four nutrients should be fortified in human milk to meet the needs of rapidly growing premature infants?
• Which statement is true regarding maintaining sterility when using human milk for neonatal enteral feeding?
• When should octreotide be used in short bowel syndrome and why?
• What form of carbohydrate should be avoided in short bowel syndrome? Why?
• Which statement best describes the clinical value of bone age in growth assessment?
• Loss of parietal cells after a gastrectomy may lead to a deficiency of
• Which set of nutrients is cited as potentially having reduced absorption due to age-related GI changes?
• What is the purpose of radiographic verification with contrast medium during jejunostomy tube placement?
• Which medications are used to lower blood ammonia in hepatic encephalopathy?
• Which of the following is true about granulation tissue around a PEG site?
• Which statement best describes the rationale for avoiding powdered formulas when possible in immunocompromised patients?
• Bone age imaging is obtained from radiographs of which locations?
• Which factor is NOT listed as a reason for decreased oral intake by older adults?
• Intravascular space is part of which TBW compartment?
• Which phase follows the stress phase?
• RNA and DNA are hydrolyzed to form mononucleotides during the digestion of which biomolecule?
• True or False: High-output fistula (>500 mL/day) is an indication for PN.
• What happens to transit time after ileocecal valve resection?
• For each kilogram beyond 50 kg, Holliday-Segar maintenance rate is which value?
• Fibrosing colonopathy is a potential adverse effect of which therapy in cystic fibrosis?
• Which condition warrants applying a stress factor of 1.2-1.5 to REE when estimating energy needs?
• The use of enteral nutrition formulas enriched with branched-chain amino acids (BCAAs) is best used for patients with which condition?
• Mild hypercalcemia is defined as a total serum calcium of which range?
• Which fundoplication procedures are most commonly used in the United States for severe reflux?
• Standard term infant formulas contain lactose at what proportion?
• Which amino acid is completely oxidized for energy within skeletal muscle?
• What is the most common post-procedural complication after PEG tube placement?
• What is the effect of emulsification and micelle formation on lipid digestion?
• How is energy expenditure impacted in liver disease?
• Which condition is a known risk factor for aspiration in critically ill patients?
• If a patient is not nutritionally at risk on screening, what is the recommended follow-up plan?
• Should antidiarrheal medications be ordered in patients with diarrhea prior to receiving C. difficile test results?
• Cystic fibrosis-related diabetes occurs due to what mechanism?
• What is the recommended hang time for open-system enteral feeding in the hospital?
• How should skin care around a feeding tube site be done?
• Which process in the stomach is initiated by hydrochloric acid?
• Aluminum in parenteral solutions is best described as which of the following?
• In PN-related metabolic bone disease, which combination is considered a risk factor for patients with inflammatory bowel disease who require long-term PN?
• What is the current understanding of omega-3 fatty acids in ARDS and ALI based on the available studies?
• Which statement about SIADH is true?
• A patient with oral cancer on home bolus enteral feedings via gastrostomy tube develops stomach pain after starting feeding; choose best management:
• What is a key limitation in studies evaluating dietary fiber to resolve diarrhea in tube-fed patients?
• What was the Waterlow criteria developed to determine?
• What was found to be superior to cranberry juice as an irrigant to maintain feeding tube patency in several clinical trials?
• When does infant regurgitation resolve and why?
• During diarrheal illness in an infant, what is recommended regarding human milk?
• What do 2000 KDOQI guidelines recommend for protein delivery in peritoneal dialysis patients?
• Closed enteral nutrition formulas have a specified hang time after opening; the statement 'closed EN formulas can be safely used for 24-48 hours after opening, depending on manufacturer guidelines' is true.
• In a patient receiving a continuous isotonic enteral formula who develops bloating and mild abdominal distention, what is the best initial strategy to reduce these symptoms?
• Which of the following is NOT a selenium status indicator?
• Do fluid balances need to be even daily?
• Which of the following is a direct metabolic benefit of short chain fatty acids to colonocytes?
• Why does cyclosporine lead to hyperkalemia, and what education should be provided to patients?
• What effect does dietary fiber have on gastric emptying?
• Which option is LEAST likely to improve nausea and vomiting if delayed gastric emptying is suspected?
• Glutamine is a vital fuel for rapidly dividing cells, including enterocytes, fibroblasts, reticuloendothelial cells, and malignant cells. Which cell type is explicitly listed as a target of glutamine energy?
• In a stable infant, what is the macronutrient breakdown recommended for parenteral nutrition support?
• Which statement best describes the ethical principle of justice?
• Which group is explicitly listed as at risk for refeeding syndrome in the context of home PN initiation?
• Why do caregivers of patients receiving enteral nutrition often report guilt?
• In SIAD, which hormones are inhibited or increased to regulate extracellular fluid?
• Aside from meeting one of the two HEN criteria, which of the following is NOT one of the three additional criteria?
• A patient with acute respiratory distress syndrome (ARDS) may benefit from a feeding formula containing supplemental
• Which scenario represents the highest risk for iron deficiency anemia among young children?
• Amylase is produced by which gland?
• Which statement accurately describes Medicare eligibility for home enteral nutrition?
• Chronic use of steroids in premature infants has been associated with which condition?
• An enzyme deficiency commonly seen in African Americans and Native Americans is:
• Another concern with blue dye use is systemic toxicity.
• What is the relation between liver function and manganese toxicity risk in PN?
• Dumping syndrome is most likely to develop if all or part of the stomach has been removed.
• What is the hang time range for closed system enteral feeding containers?
• What may be done to treat excessive hypergranulation tissue?
• What is the primary purpose of the teach-back process?
• What is a source of cosmetic concern for most HPN patients?
• Which management is considered inappropriate for hypergranulation around a PEG site?
• What percentage range is lactase deficiency reported among African Americans, Native Americans, Asian, and Mediterranean descendants?
• Beyond head/neck pathology or patients going to the OR, which group should not have blindly placed NGT?
• What GI effect is commonly seen with medications such as narcotics or diphenhydramine?
• Standard parenteral amino acid solutions for neonates differ from those for adults by having a higher content of which amino acids?
• Kwashiorkor is most directly diagnosed by which finding?
• Which of the following is a metabolic alteration noted during the ebb response following burn injury to a pediatric patient?
• Bile salts are primarily absorbed in which segment?
• What is the typical hang time for open enteral feeding systems?
• How should human breast milk be prepared for patient use?
• Why are PN ingredients ordered per day for adults and per kilogram per day for pediatric and neonatal patients?
• Which of the following sets of biochemical findings is consistent with Vitamin D deficient rickets?
• Which statement is most true about marasmus?
• What does evidence show about home enteral feeding schedules?
• Which foods should be avoided in galactosemia?
• Overweight in children is defined as BMI between which percentiles?
• For neonates or immunocompromised infants, feeding systems should not be used beyond which time frame?
• Where are free fatty acids converted to ketone bodies?
• Crushing modified-release dosage forms may lead to which potential outcome?
• Which mechanism explains the metabolic alkalosis observed with chronic diuretic therapy for ascites and edema?
• What is the only site for oxidation of essential amino acids?
• The MNA was developed and validated in which population?
• EFAD in CF is primarily due to malabsorption of which nutrient category?
• Direct calorimetry requires the subject to remain inside an enclosed chamber.
• Which statement about HIV-associated lipodystrophy is true?
• Which statement about aluminum toxicity risk factors is true?
• Which of the following is NOT typically associated with delayed bone age?
• In brush border oligosaccharidase deficiency, what is the primary cause of diarrhea and bloating after sugar ingestion?
• Which of the following data is NOT listed as part of the performance improvement plan data for home care providers of nutrition support?
• FiO2 stands for?
• Prior to GRV assessment, how much air should be injected into the tube?
• Once an enteral feeding tube is placed what can be done for medications?
• How does the addition of a carbohydrate modular affect osmolality?
• What stool output threshold should prompt evaluation and intervention for diarrhea in IBD?
• What should be done every time a nutrient is omitted or added to standard micronutrient recommendations?
• Which feeding delivery method is most commonly used for patients with a jejunal feeding tube?
• Which lab is an indicator of cholestasis?
• When can cow's milk be introduced into the diet? Why?
• Which statement accurately reflects Medicare reimbursement for home and community-based professional nutrition educational services provided by a registered dietitian?
• Under Medicare guidelines, which documentation is required for HPN coverage when a malnourished patient has a partial small bowel obstruction and limited oral intake?
• Regarding iron absorption in human milk, which statement is true?
• Administration sets used for human breast milk should be DEHP-free and changed every how many hours?
• Which phase emphasizes tight glucose control as a metabolic goal?
• Which option is NOT listed as a cause of mucosal atrophy during bowel rest?
• What is the evidence for the use of fiber to treat constipation?
• What is a typical intermittent feeding volume per administration?
• Which strategy best prevents or resolves nausea in an enterally fed patient?
• What intervention may help to decrease distention when using a fiber-containing enteral formula?
• Which nutritional deficiency can be a complication of celiac disease?
• Which statement is true regarding the relative acid-suppressing ability of proton pump inhibitors compared with histamine-2 receptor antagonists?
• GFR for stage 3 kidney damage with moderate low GFR?
• A patient has a nasogastric tube on suction for 48 hours after surgery. Which electrolyte is most likely lost?
• In what form are the overwhelming majority of enteral dietary lipids ingested?
• Which of the following is a contributor to frailty?
• Which components does the Waterlow criteria compare to determine malnutrition?
• Protein requirements for hepatic failure should be determined in the same manner as which group?
• Which of the following is NOT among the five data categories to be collected for home care performance and outcome measurement?
• Which statement best describes the use of enteral nutrition support in hyperemesis gravidarum?
• In a scenario where a patient receives oral foods during the day and a night tube feeding is used, which feeding pattern does the night regimen exemplify?
• How do you calculate the nitrogen content of a PN solution from protein?
• Is professional intervention/monitoring for home parenteral nutrition patients by a registered dietitian a covered benefit under Medicare?
• Which anatomical structure predisposes patients to SBBO if removed during intestinal resection?
• Which statement about copper excretion is true according to the material?
• A patient receiving continuous isotonic enteral formula experiences bloating and mild abdominal distention. What is the best initial strategy?
• Normal copper homeostasis is maintained primarily by which process?
• Regarding infectious complications, which statement is true?
• Which of the following is a sign of EFAD?
• Ileal resection may lead to fat malabsorption due to depletion of which pool?
• Which of the following is a non-drug treatment option in the management of hyperkalemia?
• In cystic fibrosis, what is the evidence for omega-3 supplementation?
• Which two types of medications have case reports shown an association of decreased effectiveness with the intake of dietary fiber?
• Why was cisapride withdrawn from the US market?
• What is the main difference between Vitamin D deficiency rickets and Vitamin D dependent type 2 rickets?
• Upon initiation of home parenteral nutrition, within how many hours should laboratory data be obtained?
• Which statement best reflects a prevention strategy for gastrostomy exit-site leakage?
• Regarding the dying patient in hospice with nausea during enteral feedings, which statement is true regarding withholding nutrition and hydration?
• In indirect calorimetry, REE stands for Resting Energy Expenditure and RQ stands for Respiratory Quotient. Which option best matches this?
• Which of the following is an example of a modular product?
• Prealbumin half-life is approximately how many days?
• What complication can result with high dose pancreatic enzyme usage?
• What percentage of amino acids extracted by the liver are used for protein synthesis and oxidation?
• What is the primary purpose of cyclic feeding regimens?
• What is meconium ileus?
• What can exacerbate zinc loss after colectomy with ileostomy?
• Decreased serum albumin indicates what?
• For Medicare home nutrition education services, which statement best describes the role of referrals?
• Which of the following statements is true regarding enteral access placement for OR transfer?
• Which management action is inappropriate for hypergranulation around a PEG exit site?
• Are dressings needed for the care of feeding tube sites?
• The vitamin D RDA was determined based on which consideration?
• What is the primary reason biliary atresia leads to fat-soluble vitamin malabsorption?
• Which predictive equation is shown to be the most accurate?
• Which action follows GRV assessment to help prevent occlusion?
• Do nutrition interventions improve outcomes in frailty?
• How do burns impact metabolism?
• What is the preferred treatment in an otherwise healthy infant who is mildly dehydrated from diarrhea?
• The ileum is the primary site for absorption of vitamin B12 and bile salts.
• Carnitine is best described as which?
• Which medications may be used to increase GI motility in patients with increased gastric residual volumes?
• Insensible losses are estimated at approximately 10 mL/kg/day. Which of the following values represents this estimate?
• A respiratory quotient (RQ) of 0.87 most likely suggests
• Why are resections of the proximal bowel generally better tolerated?
• Zinc supplementation for childhood diarrhea has been shown to do which of the following?
• Which item should always appear on the label of an enteral feeding formula?
• What is the current status of evidence for carnitine in preventing PN-associated cholestasis in adults?
• What is a primary reason for starting iron supplementation in exclusively breastfed infants at 4-6 months?
• How should PN ingredients be ordered for adults?
• Which element is essential to identify the patient on an enteral feeding product label?
• In the context of HEN, what does permanence mean?
• Which assessment method evaluates subcutaneous fat and muscle wasting at multiple body sites?
• How does indirect calorimetry calculate resting energy expenditure (REE) and respiratory quotient (RQ)?
• In soybean oil-based IVFE, alpha-linolenic acid accounts for approximately what percentage?
• Which statement about ursodiol is true?
• Which method is similar to continuous infusion but with the rate increasing to meet nutrient goals within 8-24 hours?
• What is the osmolality recommendation for infant formulas?
• What is the RDA for calcium in children and adolescents aged 9-18 years?
• What is galactosemia?
• Which is most likely to improve tolerance of enteral feeding in a postoperative patient with documented high GRV receiving bolus tube feedings?
• Which vascular access device should not be used for home parenteral nutrition (HPN)?
• Hepatic steatosis may occur as the first stage of hepatic insufficiency due to which cause?
• Which feeding schedule is most appropriate for a critically ill patient with labile and poorly controlled blood glucose concentrations?
• What was found to be the most common problem in a group of elderly patients receiving home enteral nutrition, and what is its etiology?
• Is cysteine considered an essential amino acid in infants?
• Weight history is part of which SGA category?
• Which electrolytes should be closely monitored with nutrition therapy in eating disorders?
• What happens if the diet is void of linoleic acid and alpha-linolenic acid?
• Which nutrition support increases the metabolic demand for thiamin?
• Which of the following statements about gastric residual volumes (GRV) is true?
• What is the preferred iron formulation for PN dosage and what must be done before administration?
• A home enteral nutrition patient recently treated for pneumonia has new diarrhea. The first intervention should be to:
• Are powdered infant formulas sterile?
• Which statement about preparing modular products is true?
• Which statement is true about the proportion of glucose that is oxidized versus stored as glycogen?
• What is the primary purpose of using basal/bolus insulin regimen in enteral nutrition patients?
• Which statement about selenium supplementation in infants on PN is true?
• A patient on digoxin who is also receiving parenteral nutrition develops signs of digoxin toxicity. Which electrolyte abnormality should be assessed?
• Which type of liquid medications is preferred for enteral administration?
• What is the recommended rate and interval for advancing a full-strength formula toward the goal rate when initiating enteral nutrition?
• In cystic fibrosis with pancreatic insufficiency, what is routinely given with meals to aid digestion?
• Is lactose intolerance a common cause of watery diarrhea in adults receiving enteral nutrition?
• Which statement about hyperhomocysteinemia and vascular disease is accurate?
• Retinol-binding protein half-life is how long?
• Dexamethasone is a potent steroid used to assist with which clinical process in premature infants?
• What is the advantage of medium-chain triglycerides (MCTs) in fat malabsorption?
• How many grams of fat per 100 mL are in 20% IVFE?
• How may immune function be affected by functional age-related changes in the gastrointestinal tract?
• Why was the MNA-SF developed?
• Why are patients lacking a colon at a greater risk of dehydration?
• Albumin and prealbumin are what type of acute phase proteins?
• Do gastric residual volumes correlate with the incidence of regurgitation, aspiration or pneumonia?
• The flow phase peaks between which days after burn injury?
• In what percentage of TBSA burns do children usually require nutrition support?
• Which medication is LEAST likely to cause diarrhea in a patient receiving enteral nutrition?
• Sorbitol-induced hypokalemia is caused by which mechanism?
• Why does the American Academy of Pediatrics recommend iron fortified formula or supplemental iron starting at 4-8 weeks?
• Under Medicare Part B, EN and PN are primarily covered under which benefit?
• What may happen if you do not dilute a liquid enteral medication?
• What is the hang time for human breast milk decanted into an open delivery system for use in neonates and immunocompromised pediatric patients?
• What is the estimated mean US reading level?
• What is the optimal sodium concentration of an oral rehydration solution for patients with short bowel syndrome?
• Why is glycogen considered a bulky energy storage method?
• Which organizations have provided guidelines on calories and protein for critically ill obese patients?
• What is the most accurate description of stage 5 kidney failure in terms of GFR and dialysis need?
• Bone age norms are matched to which factors?
• Which nutrient deficiency is described as a risk after gastric bypass surgery and is also one of the classic five deficiencies?
• What study design was used to compare affiliated and nonaffiliated PN patients?
• The Fenton growth chart data are cross-sectional. Which of the following is true?
• What is the half-life of albumin?
• During extended fasting, which metabolic pathway is primarily responsible for producing energy from fatty acids?
• What is the purpose of the Medicare recertification process for parenteral nutrition?
• How is manganese eliminated normally?
• Older adults, particularly women with reduced olfaction, may have what nutritional concern?
• Which of the following is NOT a common symptom of celiac disease in childhood?
• What is the recommended daily fluid provision per kg to prevent tube feeding syndrome?
• Which statement best describes cyclic feeding?
• In Mosteller's approach, the calculated BSA is multiplied by which maintenance fluid amount per day?
• Can disposable feeding administration sets be reused?
• Has the association between gastric residual volume amount and aspiration risk been validated?
• How does chromium influence insulin action?
• Which is a benefit of using an electromagnetic placement device for nasogastric tube placement?
• Which statement best describes essential fatty acids?
• What is the maximum hang time for human breast milk (HBM)?
• Which of the following is NOT a contraindication to nasogastric tube feedings in a pediatric patient with cystic fibrosis?
• How does the presence of glucose in the lumen of the small intestine impact sodium absorption?
• Which deficiency is most classically linked to microcytic hypochromic anemia?
• Ileocecal valve resection can lead to malabsorption due to which mechanism?
• What is the recommended IV calcium gluconate dosage and onset time in hyperkalemia?
• The absorption of the B12-intrinsic factor complex occurs in which part of the small intestine?
• Why would a thiamin deficiency result in lactic acidosis?
• What is the risk of feeding a patient before hemodynamic stability has been achieved?
• What are fluid requirements for healthy adults age 55-75?
• Which feeding type is characterized by delivering nutrition for a portion of the day and pausing for a period overnight?
• How do Government insurance programs determine coverage for home parenteral nutrition in general?
• Which of the following is NOT a mechanism by which a 70% ethanol lock reduces CRBSIs?
• What energy expenditure measurement uses heat released from the subject?
• How long does the stress phase usually last?
• Which feeding pattern has been associated with prolonged ventilator dependence in mechanically ventilated patients?
• Usual clinical presentation for buried bumper syndrome?
• Which statement about bone density monitoring in long-term PN is correct?
• Which statement is true regarding gastric residual volumes (GRV)?
• How does the colon salvage calories?
• Which of the following GI complications is most likely to preclude enteral nutrition in the first 2–3 weeks after stem cell transplantation?
• Which statement correctly describes the effect of regular alcohol intake on thiamin?
• For adolescents, how many eight-ounce glasses of milk or equivalent are recommended daily?
• HCUP stands for which organization?
• Regurgitation in children usually resolves around which age range due to maturation of the lower esophageal sphincter?
• Which insulin provides basal coverage?
• Long-term use of proton pump inhibitors beyond what duration may lead to a fall in circulating vitamin B12 levels?
• What is the most common reason for gastrointestinal toxicity in the first 2-3 weeks after stem cell transplant?
• The nutritional needs of a patient with a bone marrow transplant are best met with:
• What is the most appropriate feeding strategy for a morbidly obese trauma patient?
• In end-of-life care, increased ketone production during starvation can lead to what subjective state?
• Which cells in the stomach are responsible for producing intrinsic factor?
• According to AAP guidelines, how many ounces of 100% juice per day are appropriate for children aged 7-18 years?
• Which additive has greatest risk of destabilizing IVFE in a TNA?
• Is regurgitation rare in infants?
• Why is creatine taken as a dietary supplement?
• There is a correlation between prolonged hang-time and bacterial contamination. Which option states this correctly?
• For HEN eligibility, the patient must require tube feeding to maintain weight and strength and adequate nutrition must not be possible by dietary adjustment and/or oral supplements. Which statement is true?
• What are fluid requirements for healthy adults age 18-55?
• Should papain be used to break down bezoar? Why?
• What is the general length for cyclic feedings per day?
• Which statement about aluminum in parenteral nutrition components is most accurate?
• Elevated C-reactive protein indicates?
• Vitamin D (25-hydroxyvitamin D) deficiency is defined as a serum level less than:
• In tubefeeding patients, fiber addition has been shown to produce which stool change, although benefits are not consistently observed?
• Which of the following is a possible consequence of copper toxicity?
• The usual treatment for mild hypercalcemia is which of the following?
• Skeletal muscle glycogen stores yield about how many kilocalories?
• Providing additional free water flushes for patients with abdominal distention may help by:
• Which amino acid is the most abundant in the human body?
• Another research-based method utilized to restore patency to clogged feeding tubes is a mechanical declogging device.
• Which diet should be recommended for patients with short bowel and colon in continuity?
• Between cranberry juice and water, which has been shown to better irrigate feeding tubes and maintain patency?
• In patients undergoing hematopoietic stem cell transplantation, current evidence comparing enteral nutrition to parenteral nutrition shows which of the following?
• Which statement best describes fat allowance in PN for a stable infant?
• When do breastfed infants require an iron supplement?
• Which description best captures the teach-back method?
• Which amino acid becomes conditionally essential in AKI and is listed among commonly conditionally essential amino acids?
• Which of the following is a potential complication of central venous access for parenteral nutrition in pregnancy, as listed in the material?
• Meconium ileus is most commonly associated with which condition?
• Which set of signs indicates dehydration is worsening in infants?
• Is patient harm typically a concern in EN administration?
• Bile acids are metabolites of which substance?
• The majority of fat digestion occurs in which part of the digestive tract?
• For Medicare coverage, how long must HPN therapy be required to qualify?
• Which statement about crushing enteric-coated tablets is correct?
• Which phase follows the ebb phase in burn metabolism?
• Which fatty acids are included in the fat AMDR framework?
• Which intestinal segment is a primary site for cholecystokinin and secretin secretion?
• How is bone age evaluated?
• What should be considered in patients with abdominal distention?
• Which statement about bicarbonate concentration in ileal versus jejunal fluid is correct?
• What is the best practice when delivering multiple medications via enteral feeding tube?
• What is the recommended approach to minimize aluminum exposure in parenteral nutrition?
• What is the daily maintenance fluid requirement for a 5 kg infant?
• Which forms of thiamin administration have been shown to correct thiamin deficiency in wet beriberi?
• What is the bolus feeding schedule in terms of daily frequency?
• Which formulation is indicated for chronic lung disease?
• Which statement best describes a key advantage of closed enteral feeding systems?
• After prolonged fasting, what energy source does the brain predominantly use?
• Can patients be sent home with a temporary catheter for HPN use?
• What is the suggested daily amount of potassium in preterm infants, term infants and children?
• Should elemental feeding be used in a patient with Clostridium difficile infection?
• Is there a need for routine cultures in the uncomplicated enterally fed patient?
• All patients admitted to the home care provider shall undergo nutrition screening within:
• In comparing nutrition status, which statement reflects the difference between compensated viral diseases and alcoholic liver disease?
• Which of the following is a nutrition-related mechanism by which chronic steroid use can contribute to osteopenia?
• In postoperative neonates, growth cannot occur until which of the following?
• Most likely cause of watery diarrhea and bloating in the enterally fed adult patient?
• Why are omega-3 fatty acids indicated in ARDS?
• Define marasmus.
• Which enteral feeding schedule should be recommended to patients and their families when preparing for home enteral nutrition?
• How does high luminal sodium concentration affect glucose absorption?
• The use of enteral formulas enriched with BCAAs is best used for patients with:
• Which of the following is an example of a short chain fatty acid?
• What is the daily potassium maintenance for a preterm infant, term infant or child receiving parenteral nutrition?
• Why is a late evening snack indicated in cirrhosis?
• Is there an established association between gastric residual volumes and aspiration risk?
• Psyllium is which type of dietary fiber?
• What does evidence show about enteral vs. parenteral feeding strategies in severe, acute pancreatitis?
• Can hypermagnesemia occur in PN patients with normal liver function?
• How does the addition of a carbohydrate modular to increase caloric density affect osmolarity?
• Would the diagnosis of partial small bowel obstruction alone qualify a person for HPN under present Medicare guidelines? Why?
• Gluten-free diet is primarily indicated for which condition?
• Under Holliday-Segar, how many mL/kg/day are allotted for each additional kilogram above 50 kg?
• What is the preferred method of feeding in the small bowel?
• Which practice is identified by ASPEN/SCCM guidelines as reducing aspiration risk in critically ill patients requiring enteral feeding?
• During discharge education for home enteral nutrition, which item is NOT essential?
• What is the function of bile salts in digestion?
• What has evidence shown about glutamine supplementation?
• What bone age is associated with genetic short stature?
• If powdered formula reconstituted in advance is not used immediately, what are the storage requirements?
• Obesity in children is defined as BMI greater than which percentile?
• During the flow phase, plasma insulin is typically which of the following?
• Which statement about hang times is correct?
• What is the principal metabolic fuel for intestinal cells?
• Which two upper GI enzymes contribute to fat digestion, albeit limited, in healthy adults?
• Do standard infant and pediatric trace element commercial products contain selenium?
• In short bowel syndrome with small bowel bacterial overgrowth (SBBO), which metabolic complication is most likely to occur?
• Bile pigments are responsible for which property of bile?
• What factor places a patient at greater risk of pressure necrosis and ulceration at the tube site?
• What type of data was used to develop the Fenton growth chart?
• Which statement about cyclosporine-associated metabolic disturbances is most accurate?
• Which of the following is the correct threshold used to define high-output fistulas for PN indication?
• What is the role of bile acids in fat digestion?
• What is the effect of managing biliary atresia with MCT oil predominantly without LCT formula?
• Is there a reimbursement structure for compensation of phone consultations in the United States?
• What nutrition concern is present in all forms of cirrhosis?
• Extraskeletal outcome evidence included which of the following?
• One of the most useful diagnostic tests in assessing a child with abnormal growth is which?
• At what calcium-phosphorus product does metastatic calcification occur?
• Which statement is NOT a reason to flush water around each medication during enteral administration?
• Which of the following is NOT an approved VAD for HPN administration?
• What population is at higher risk for vitamin D deficiency?
• Which diagnosis would meet Medicare Part B coverage criteria to qualify a beneficiary for home enteral nutrition?
• What happens to BCAA levels in hepatic encephalopathy?
• What is the storage form of glucose in the body?
• What does an RQ of 0.82 indicate?
• Who should perform the initial replacement of a gastrostomy or PEG tube?
• Which of the following blood findings can accompany copper deficiency?
• Cholestyramine is primarily used to treat which condition?
• During illness and trauma, metabolic changes include increased hepatic glucose production, decreased peripheral glucose utilization, and increased protein breakdown.
• In oral consumption formulas, vitamins are typically which of the following?
• Which of the following is a demonstrated benefit of EN over PN in severe acute pancreatitis?
• All of the following hydrolyze fat in the small intestine EXCEPT
• Fibrosing colonopathy is a manifestation associated with high-dose pancreatic enzyme therapy. Which option below is a manifestation?
• What combination of signs and symptoms is typical of Wernicke's encephalopathy?
• What is the purpose of emulsification by bile acids in fat digestion?
• What determines the rate of ketogenesis during starvation?
• The acute phase response impacts iron transport by which of the following?
• Would enteral nutrition be covered for anorexia?
• Which action is an appropriate management step for exit-site hypergranulation when indicated?
• Which option lists the correct potassium concentration range for jejunal fluid?
• Frequent use of sorbitol-containing medications in enterally fed patients often causes which symptom?
• Upon initiation of home parenteral nutrition (HPN), laboratory data should be obtained within:
• Which option is NOT recommended for galactosemia?
• In the home PN environment, what is the role of a back-up battery-powered infusion pump?
• In Vitamin D deficient rickets, which statement is true regarding 25(OH) vitamin D levels?
• Which enzyme deficiency is commonly associated with lactose intolerance?
• Which factor reduces morbidity and mortality associated with exit-site infections?
• How does the World Health Organization define acute diarrhea?
• Once enteral nutrition administration is stable what type of insulin regimen should be used?
• Which intervention helps maintain feeding tube patency in the adult patient?
• Which statement about antibiotic use for feeding tube site care is accurate?
• Which gas pair is produced by colonic bacteria from remaining oligosaccharides and contributes to bloating?
• What is a common consequence of excessive milk intake in children?
• Among neurologically impaired children, aspiration and pneumonia are primarily associated with which condition?
• Copper deficiency is associated with decreased ceruloplasmin.
• Early enteral feeding has been suggested to reduce which outcome?
• Neuromuscular disease is considered which type of risk factor for aspiration?
• The RDA for vitamin D is based on which of the following factors?
• According to CMS, which of the following is an indication for home parenteral nutrition?
• Which statement best describes a key benefit of starting feedings with full-strength formulas at a slow rate?
• What is the electrolyte content of normal saline (0.9% sodium chloride)?
• Disaccharides consist of how many sugar units?
• Is soy formula recommended in children who have a cow's milk protein allergy?
• What is the osmolality range for hydrolyzed protein and free amino acid–containing infant formulas?
• Which of the following is NOT listed as a mortality risk associated with persistent diarrhea?
• Which information is included on a PN order to specify when the order was submitted?
• Define biliary atresia.
• Plasma or serum selenium levels primarily reflect which of the following?
• How often should DEXA be performed in long-term PN patients?
• What is the one advantage of open enteral feeding systems?
• Name the three short chain fatty acids.
• Folic acid is absorbed in which part of the small intestine?
• What is the recommended intake of selenium for term infants receiving long-term total parenteral nutrition?
• Refeeding syndrome is characterized by depletion of which electrolytes as a result of aggressively refeeding malnourished patients?
• The best method to administer psyllium soluble fiber via feeding tube is to:
• Which statement about IVFE composition in the United States is correct?
• What fraction of extracellular fluid is located in the intravascular space?
• Which of the following describes a feeding method where the infusion is delivered in cycles, with pauses between cycles?
• Which unintentional weight loss threshold is listed among frailty hallmarks?
• Which mineral is bound by the oxygen-carrying protein in red blood cells?
• Using the Holliday-Segar method, what is the maintenance fluid requirement for an 18 kg child per day?
• Hypokalemia is almost always the result of what?
• Which of the following is NOT a characteristic of the flow response after burns?
• Which organization conducted the 2010 calcium and vitamin D review?
• Which factor is a major risk factor for aspiration in critically ill patients?
• Is prone positioning recommended in patients with elevated GRVs? Why?
• Why are modified release dosage forms inappropriate to crush for enteral feeding tubes?
• What is the incidence range for the complication caused by excessive external bolster tightening?
• Which of the following are current practice recommendations to maintain feeding tube patency in the adult patient?
• What grade level is recommended for patient education materials?
• Are overt signs of EFAD common in people with CF?
• Which body temperature pattern is typical of the ebb response after burn injury?
• Discharge instructions should contain guidance on which product handling item?
• What is true about choline in PN-related liver dysfunction based on current evidence?
• Which of the following is a benefit of closed enteral feeding systems?
• What is the best way to determine chromium deficiency?
• In the Plan-Do-Study-Act cycle, which phase determines whether changes should become permanent and standardized?
• Arginine supplementation should be used most cautiously in which patients?
• To prevent iron deficiency anemia in children, which dietary practice is recommended?
• In a 14-year-old with anorexia nervosa, which nutrition intervention is most appropriate at admission?
• Which item is the EXCEPT in education for home enteral nutrition discharge?
• In the Mifflin-St. Jeor equation, which two body measurements are included besides age?
• What is the theory behind use of BCAA enriched formulas in refractory encephalopathy?
• What adjustment may be necessary in patients with tube feeding syndrome if the body cannot adequately excrete byproducts of protein metabolism?
• A potential consequence of pressure necrosis at the gastrostomy tube site is:
• Where is the primary site of absorption for most nutrients, including water-soluble vitamins?
• Which feeding characteristic can contribute to abdominal distention due to osmolarity?
• Which of the following is NOT a feature of the ebb response?
• What is the primary benefit of centralizing mixing, reconstitution or dilution of enteral formulas?
• Consumption of soluble fiber contributes to: lower HDL, lower total and LDL, lower colon cancer risk, or increased blood glucose?
• When transitioning a patient from hospital to home parenteral nutrition (HPN) support, which screening criterion should be included?
• Which of the following are considered the lowest risk candidates for initiation of parenteral nutrition PN in the home setting?
• What is ketonemia?
• In fasting leucine metabolism, what happens to pyruvate and lactate produced by muscle?
• During stress states in neonates, insensible losses are reduced. This leads to what effect on energy needs?
• What amount of intravenous fat emulsion (IVFE) in grams per kilogram per day should be provided to prevent EFAD in pediatric patients on parenteral nutrition?
• Is it necessary for the patient to know the protein and calories provision of their enteral feeding prescription at discharge?
• Bile salts are salts of which substances?
• Hyperglycemia in acutely ill and septic patients occurs due to which three mechanisms?
• Which statement correctly describes the origin and validation of the Fenton growth chart?
• What is tumor lysis syndrome (TLS)?
• How does enamel fluorosis develop?
• Zinc's role in wound healing includes which of the following?
• Which description best defines a bolus feeding?
• Which of the following is NOT one of the three conditions for EN and PN to be covered under the Medicare Part B prosthetic device benefit?
• Why would concentrated enteral solutions not be recommended for nausea/vomiting?
• According to ASPEN PN Safety Consensus, the best method to express the dextrose content on the PN label?
• Ileal resection can impair fat digestion due to a change in which pool?
• Biliary atresia in infancy is most frequently associated with which of the following?
• The risk of metastatic calcification increases when the product of calcium x phosphorus exceeds which value?
• Who should perform the first replacement of a gastrostomy or PEG tube, and who may perform subsequent replacements?
• What is the evidence-based recommendation for initiating enteral feeds in neonates at risk of NEC?
• What have more recent studies on caloric beverages in children suggested?
• Which formula is most likely to cause an occluded feeding tube?
• Which practice is most likely to worsen nausea related to delayed gastric emptying?
• For suspected cow's milk protein allergy, why is trial use of hydrolyzed or free amino acid containing formula recommended instead of soy-based formula?
• How should the administration set be handled by staff to avoid contamination?
• What factors determine the viscosity of an enteral formula?
• What is the etiology of gastric ulceration associated with PEG tube placement?
• Which policy area should home infusion providers have addressing to meet quality standards?
• Which item is included on the PN label?
• Which option describes possible causes of reflux in children receiving enteral nutrition?
• Which statement best describes the current evidence regarding the relationship between GRV and aspiration pneumonia?
• Are acidic liquid medications recommended enterally? Why?
• Supplemental arginine is considered therapeutic for which of the following?
• What is the final digestive process for nucleosides?
• What is the half-life of transferrin?
• Kwashiorkor is associated with visceral protein wasting causing hypoalbuminemia, with preservation of fat and somatic muscle. Which option best describes it?
• How do zinc levels typically change in systemic inflammatory response syndrome (SIRS)?
• Even if HPN is cycled at night what can impact the social quality of life?
• Which trace element deficiency is linked to encephalopathy and amino acid metabolism when supplemented in hepatic disease?
• Free glutamine is unstable in parenteral solutions?
• Which statement about selenium status tests is true?
• Which statement about osmotic load and formula tolerance is correct?
• Which of the following is NOT listed as a symptom of hyperphosphatemia?
• Which of the following describes an optimal method of preparing and administering medications via an enteral feeding tube?
• Which trio of enzymes are involved in fat digestion in the duodenum?
• In critically ill and postoperative neonates, which method is recommended to estimate energy needs?
• Name the three components of basal-bolus insulin therapy.
• During fasting, which statement best describes leucine metabolism in muscle?
• Which statement about the SF-36 is true?
• Which dimension is included as a component of geriatric nutritional assessment?
• Which enzymes hydrolyze RNA and DNA to form mononucleotides?
• Compared with prolonged fasting, cancer cachexia in children is characterized by which of the following?
• Why are enteric coated and film coated tablets not crushed for administration via an enteral feeding tube?
• What GI symptom may result from fluid restriction, physical inactivity and narcotic usage?
• Ethanol lock solution has been shown to prevent which process in the catheter lumen?
• Which of the following is NOT a common clinical symptom of celiac disease in childhood?
• Which two amino acids are essential in neonates but not in adults?
• What is the mitochondrion and its primary function?
• What is the physiologic function of aluminum?
• After enteral nutrition administration is stable in the diabetic patient, what insulin regimen is recommended?
• Which statement is NOT true about the Oley Foundation?
• Which CF patients are at high risk for EFAD?
• In a patient on enteral nutrition with abdominal distention, which intervention is recommended to reduce distention?
• Which measurement is commonly used to assess subcutaneous fat in nutrition assessments?
• CRRT effluent protein losses should be considered when determining what?
• How is aluminum toxicity treated?
• Which burn-related phase is signaled by elevated catecholamines and elevated or normal plasma insulin?
• What is the Mifflin-St. Jeor equation?
• What is the most common nutritional deficiency in childhood?
• Which of the following is a component of treatment for infantile anorexia?
• What is the iron supplement protocol for infants exclusively fed human milk?
• Which of the following is insoluble fiber?
• How is cysteine added to total parenteral nutrition (TPN) in terms of form and dosage?
• Which of the following represents two nutritional strategies to reduce the risk of calcium-oxalate nephrolithiasis in short bowel syndrome?
• What does the research say about the use of BCAA enriched formulas for refractory encephalopathy?
• Which option is NOT a commonly described complication of persistent diarrhea?
• Which statement best describes the additional tests that must be met beyond the primary criteria for HEN?
• When is selenium supplementation recommended in the pediatric PN patient?
• Match the nutrient to its primary absorption site correctly.
• Current research does not support Lactobacillus GG as therapy for which conditions in infants or children?
• In PKU, what happens to phenylalanine levels if the condition is not treated?
• Which statement distinguishes Gastroesophageal Reflux (GER) from Gastroesophageal Reflux Disease (GERD) in infants?
• Which statement best describes how closed enteral feeding systems affect nursing workload?
• Glycogen is predominantly found in which tissues?
• Which patient type would NOT be ideal for initiation of home parenteral nutrition due to the need for frequent monitoring and clinical assessment?
• Which of the following is a common sign seen in a patient with vitamin D toxicity?
• Which agent is commonly used for cauterization of excessive granulation tissue around a PEG site?
• Constipation in the enterally fed patient is most often associated with all of the following except:
• Liver glycogen stores of 100 grams provide approximately how many kilocalories?
• Vitamins, minerals and water are considered modular products.
• Metastatic calcification due to hyperphosphatemia tends to involve which tissues?
• What is the osmolality of hydrolyzed protein and free amino acid–containing infant formulas?
• Which of the following is a possible complication of dietary fiber-containing enteral formulas?
• Which statement about the weighting in the Subjective Global Assessment is true?
• What is the American Academy of Pediatrics recommendation for daily juice intake for children aged 1 to 6 years?
• Which clinical sign is a direct indicator of protein-energy malnutrition in chronic liver disease?
• What is the MOST practical approach for managing micronutrients in long-term PN patients?
• How does the addition of a fat modular to increase caloric density affect osmolarity?
• Which scenario is NOT a fistula situation in which enteral nutrition may be possible?
• When administering multiple medications via enteral feeding tubes, how should the medications be given?
• What bone age is typically associated with precocious puberty?
• What type of water is used to reconstitute enteral formula?
• Why is IV hydration not recommended in the care of the terminal patient?
• Which of the following is a commonly reported complication of home enteral nutrition?
• Which of the following is NOT a component of geriatric nutritional assessment?
• What is the onset time for furosemide in the treatment of hyperkalemic emergencies?
• C-reactive protein is which type of acute phase protein?
• Choline supplementation has been investigated as a treatment for which of the following disease states?
• Are bowel sounds/evidence of bowel function needed prior to the initiation of enteral nutrition?
• Why are formulas containing omega-3 fatty acids recommended in ALI and ARDS?
• Regarding electrolyte replacement protocols to prevent refeeding syndrome, which statement is true?
• Chronic use of steroids in premature infants has been associated with which condition?
• What are the clinical manifestations of aluminum toxicity?
• Which medication class is least likely to contribute to anorexia in the older adult population?
• Which statement about fat metabolism and aging is correct?
• What is the EAR?
• Which statement best reflects patient education to prevent hypergranulation?
• Which mechanism contributes to weight gain with megestrol acetate?
• What is a main strategy for reducing the risk of NEC, and what do studies show about early initiation of minimum enteral feeds?
• Does parenteral nutrition solution require refrigeration?
• Early initiation of enteral feeding has been suggested to reduce infectious complications and length of stay. Which patient group might be at significant risk from early enteral feeding?
• Which is an important indicator of protein-energy malnutrition in chronic liver disease?
• What level of abdominal distention would indicate that holding enteral feedings is appropriate?
• What is the impact of Wheat Bran (insoluble fiber) on IBS?
• What is the usual clinical presentation for buried bumper syndrome?
• Which statement about Crohn's disease distribution is supported by the source?
• What is the half-life of prelbumin?
• What percentage of total calories as fat is considered sufficient to prevent EFAD?
• Which statement best describes sarcopenia body composition changes?
• Which restriction is recommended for ascites management?
• What is the RDA for calcium in children aged 4-8 years?
• Home-prepared or blenderized enteral nutrition formulations should be discarded after which time?
• Which statement best describes octreotide's effect on short bowel syndrome outcomes?
• Which statement correctly describes arginine as a semi-essential amino acid?
• Is it necessary to have social workers available for reimbursement of home infusion providers?
• How does codeine usually impact GI function?
• Which method is recommended for checking gastric residual volumes (GRVs) during the first two days of tube feeding?
• During ebb, which of the following occurs?
• Based on bone health evidence, what is the RDA for calcium in children 1-3 years of age?
• What is the only way to treat galactosemia?
• In a morbidly obese 12-year-old who drinks soda, juice, and chocolate milk daily, in which mineral may she be deficient?
• Are transitional infant formulas sufficient in iron for premature babies?
• What is the recommended approach to milk consumption to minimize iron deficiency risk in young children?
• In a healthy 70 kg man, glycogen stores can sustain normal activities for approximately how long?
• What is a key purpose of having a back-up infusion pump in home PN care?
• What vitamin deficiency is considered a worldwide epidemic?
• Weight for length is an index of what in Waterlow criteria?
• Which nutrient is fermented by bacteria in the colon into short chain fatty acids?
• Which beverage is displaced by excessive juice and sugary beverages and is also known to promote bone health?
• Transformation of free long-chain fatty acids into acylcarnitines requires which nutrient?
• Megestrol acetate exerts its appetite-stimulating effect partly by inducing release of which hypothalamic neuropeptide?
• What was the Waterlow criteria developed to determine?
• Rationale for using preterm formula or fortified human milk includes which statement?
• Why is the basal-bolus approach preferred?
• Which is the best indicator of manganese status?
• In the Plan-Do-Study-Act cycle, which phase is responsible for measuring the results of the improvement effort?
• During an inflammatory response, serum albumin and prealbumin typically do what?
• Which lab is not part of the weekly monitoring labs for home PN?
• What symptom is associated with carnitine deficiency?
• Which of the following is most likely to be observed first in a non-diabetic older adult who is overfed?
• Midline catheters are typically used for therapies lasting how long?
• Glutamine is a vital fuel for rapidly dividing cells. Which of the following statements best describes one of these cell types that utilizes glutamine as an energy source?
• Short chain fatty acids are defined as having how many carbon atoms?
• In fat malabsorption, which enteral component provides a concentrated source of energy?
• To meet calcium intake recommendations, how many 8-ounce glasses of milk per day are suggested for children aged 4 to 8 years?
• In tube feeding syndrome, what adjustment may be necessary if the ability to excrete byproducts is compromised?
• What happens to terminal glucose oxidation during fasting?
• For neurologically impaired children with severe GERD, medical therapy should be tried before anti-reflux surgery?
• In 2009 guidelines for critically ill patients, what lipid profile should be used in enteral formulas for ARDS/severe ALI?
• CRBSI stands for which of the following?
• Which description best defines eligibility for Medicare Part B home enteral nutrition benefit?
• Is lactose-free cow's milk infant formula recommended in galactosemia?
• Nutrition therapy for pediatric patients with < 20% total body surface area TBSA burn typically includes
• What is the Mosteller formula for calculating body surface area (BSA)?
• Which of the following is a potential complication of untreated celiac disease in children?
• Which is the BEST indication for the use of a soy-based infant formula?
• Do current PN admixtures contain choline?
• How do predictive equations compare with indirect calorimetry when predicting energy expenditure in children?
• Which of the following is NOT a category used by the Subjective Global Assessment for nutritional status?
• Which statement accurately describes the inflammatory and metabolic response following trauma?
• Hydrolyzed protein formulas generally have osmolality that is higher than standard formulas. This statement is:
• In home infusion patients with frequent interruption of electrical service, which item is recommended to support continuity of therapy?
• What enteral feeding method delivers formula from an administration set into the feeding tube via enteral pump to guarantee a steady rate?
• What is the major advantage of ethanol as a lock solution?
• An older adult patient requires parenteral nutrition for 6 weeks but has no IV access. Which vascular access device is most appropriate?
• How often should administration sets for human breast milk be changed?
• According to the concept of glucolipotoxicity, glucolipotoxicity requires which conditions?
• Which of the following is a common effect of enteral fiber on the intestinal tract?
• An infant with complete ileal resection and preserved ileocecal valve has which primary nutrition-related concern?
• Meconium ileus etiology statement.
• Which test is commonly used to monitor anticoagulation status in patients taking warfarin?
• Is glucose still used for glycogen synthesis during fasting?
• Powdered infant formulas should be used in health care facilities only under which condition?
• Which of the following is the most comprehensive approach to reduce gastrostomy exit-site leakage?
• In the United States, intravenous fat emulsions are composed mainly of which oil?
• During the early phase of fasting, which tissues use ketone bodies as fuel to spare glucose for the brain?
• Oleic acid is characterized as?
• Which oil is NOT among the three oils rich in linoleic acid?
• Which of the following populations is NOT listed as a group in which the SGA has been found to predict complications?
• What is the usual osmolality of standard infant formulas with a caloric density of 20 kcal/oz?
• Infantile anorexia usually occurs during which age range?
• Macrocytic anemia is characterized by macrocytosis due to which deficiencies?
• Which trace mineral deficiency is noted as difficult to assess due to laboratory limitations in certain chronic conditions?
• What is the protein requirement for a stable patient receiving peritoneal dialysis (PD)?
• What act of Medicare covers HPN?
• Which statement about teenage PN candidacy is accurate?
• Which of the following is a responsibility of the home infusion company?
• How often should serum iron and ferritin be monitored with PN supplementation after starting a repletion dose?
• Would primary sclerosing cholangitis, alcoholic liver disease, and hepatocellular carcinoma require protein restrictions?
• Which list contains patient groups that may not be ideal for initiation of home parenteral nutrition in the home setting?
• Which complication of enteral nutrition is the most potentially dangerous in the older adult?
• Which practice best describes maintaining enteral tube patency?
• What is the function of adipocytes?
• What is the most appropriate nutrition intervention for a 4-month-old with acute diarrhea?
• Non-nutritive sucking should be used in the enterally fed neonate less than 32 weeks corrected gestational age to promote which outcome?
• Which therapy has NASPGHAN recommended as first-line induction therapy in pediatric Crohn's disease and has shown remission in up to 85% of cases?
• Mucosal atrophy that accompanies bowel rest may result from the absence of which nutrient?
• Which type of insulin should be used when initiating enteral nutrition in a hospitalized diabetic patient?
• The initiation of enteral tube feeding should be delayed when the patient is
• Describe acute respiratory distress syndrome ARDS.
• Which statement correctly reflects Medicare criteria regarding weight maintenance?
• What can be done if granulation tissue is excessive?
• Would prone position be recommended in a patient with elevated GRVs?
• A 51-year-old woman who is 10 years after gastric bypass presents with numbness and tingling in the distal lower extremities and significant anemia with neutropenia, but normal vitamin B12, iron, ferritin, and transferrin. Which nutritional deficiency is the most likely cause of these findings?
• Interventions for diarrhea with high stool output aim to reduce risk of which conditions?
• Nutrition support is considered high-risk, problem-prone treatment.
• Which statement defines continuous pump feeding?
• Which enteral feeding method provides 240 mL via a syringe over 4-10 minutes?
• EN initiation should be delayed until what 3 things are achieved to reduce the risk of intestinal ischemia?
• Which vitamin has been shown to reverse the effects of levodopa?
• Why should D-lactic acidosis be suspected in a patient with short bowel syndrome who has an intact colon?
• What are the potential consequences of aluminum toxicity?
• Which is another common gastrostomy site complication, and how can it be prevented?
• What is body mass index (BMI)?
• What is the definition of impaired functional status?
• Which scenario would most appropriately use cyclic feeding?
• Why should Vitamin K be closely monitored in patients on 3-in-1 PN and warfarin therapy?
• Which of the following is NOT a component of RAPs?