ASPEN Certified Nutrition Support Clinician (CNSC) Practice Exam

These questions are part of the practice quiz. Start practicing

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