Nutrition Curriculum MCQ Pre-Test

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1
Nutrition MCQ
June 2007
The following Multiple Choice Questions have ONE single best answer. Please circle the
best answer.
Nutrition Curriculum MCQ Pre-Test
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1. Which of the following nutritional factors has been shown to BEST re!ict
long ter" "orbi!it# an!$or "ortalit#%
!. "M# $%& or '1(
". $1&) weight gain in the previous * months
C. Percent bo+, fat $) -men. or $%/) -women.
0. Total fat inta1e $%&) of consume+ calories
2. Total protein inta1e '3&) of consume+ calories
. There is "uch e&i!ence in fa&or of !iets high in "onounsaturate! fat' The
otential !rawbac( of this !iet co"are! with !iets high in co"le)
carboh#!rates is that "onounsaturate! fat "a# result in*
!. 4igher energ, inta1e
". 4igher cholesterol levels
C 4igher trigl,ceri+e levels
0. 5ower 405 levels
2. 4igher insulin resistance
%. Which one of the following otions reresents historical features of the
Sub+ecti&e ,lobal -ssess"ent%
!. 6eight loss an+ gastrointestinal s,mptoms
" Malignanc, an+ nausea
C. 7amil, histor, of #"0 an+ personal histor, of weight loss
0. 7amil, histor, of Celiac 0isease
2. 7unctional impairment an+ recent hospitali8ation
3. Which of the following is an -BSO./TE contrain!ication to arenteral
nutrition%
!. 0iarrhea
". 5iver cirrhosis
C. Malignanc,
0. !ctive #nfection
2. 9steoporosis
Nutrition Curriculum MCQ Pre-Test
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/. Which one of the following otions reresents otential co"lications of
enteral nutrition%
!. 9steoporosis an+ refee+ing s,n+rome
". 0iarrhea an+ cholestasis
C. 2sophagitis an+ pancreatitis
0. !spiration an+ refee+ing s,n+rome
2. !spiration an+ Constipation
*. Enteral nutrition is referre! o&er arenteral nutrition for all of the following
reasons E0CE1T*
!. 5ower ris1 of electrol,te abnormalities
". 5ower ris1 of refee+ing
C. 5ower ris1 of liver +isease
0. #mprove+ :l,cemic control
2. ;timulate gut barrier function
Questions 7 an! 2 refer to the following ste"*
3ou are as(e! to see a 24 #ear ol! "an with Crohn5s !isease' 6e has been a!"itte!
to hosital 7 !a#s ago with a s"all bowel obstruction secon!ar# to fibrostenotic
!isease of the ter"inal ileu"' 1rior to 7 !a#s ago8 his oral inta(e was nor"al
!esite ongoing ab!o"inal ain an! !iarrhea relate! to his Crohn5s !isease' 6e has
lost 2(g since hositali9ation8 but his weight was stable rior to that' 6e is
sche!ule! for surger# to"orrow for ter"inal ileal resection'
4is surgeon as1s for ,our a+vice regar+ing nutrition support.
7' Woul! #ou start T1N to!a#8 e)ecting ost:oerati&e benefit%
!. No< stu+ies of benefit of pre-operative nutrition have shown benefit onl, in
patients who receive TPN for $ = +a,s prior to surger,.
". >es< he is at ris1 for poor woun+ healing an+ infection base+ on his recent
weight loss
C. >es< stu+ies of benefit of pre-operative nutrition have shown benefit in patients
who receive TPN in the imme+iate peri-operative setting
0. >es< stu+ies of benefit of pre-operative nutrition have shown benefit in
preventing recurrence of Crohn?s +isease at the anastomotic site
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2. No< he is ,oung with no ma@or comorbi+ities therefore at low ris1 of nutritional
complications.
2' Woul! #ou reco""en! !ela#ing surger# for T1N to i"ro&e outco"e%
!. >es< he is at ris1 for poor woun+ healing an+ infection base+ on his un+erl,ing
+isease an+ recent weight loss
". >es< he ma, have re+uce+ oral inta1e post-operativel, an+ lose more weight
C. No< he is ,oung with no ma@or comorbi+it, therefore at low ris1 of nutritional
complications
0. NoA however he shoul+ maBimi8e enteral nutrition for 3 hours pre-operativel,
2. No< patients who are severel, malnourishe+ are most li1el, to benefit.
C. Which of the following state"ents regar!ing enteral nutrition for"ulas is
T;/E%
!. Pol,meric formulas are those that contain all macronutrients in whole -ie non-
h,+rol,8e+. form< semi-elemental formulas +o not contain all three
macronutrients
". 7or acute pancreatitis within 3( hours of hospital a+missionA @e@unal +eliver, of
semi-elemental formulas is the preferre+ form of nutrition support
C. 2nteral formulas are formulate+ to provi+e a+eDuate micronutrients if caloric
reDuirements are being met
0. ;pecialt, formulas for liver an+ pulmonar, +isease are superior to regular
pol,meric formulas in patients with cirrhosis an+ C9P0A respectivel,
2. ;emi-elemental formulas are more cost-effective than pol,meric formulas
1&. Which of the following is an accetable "etho! for !eter"ining caloric nee!s
for nutrition suort%
!. Caloric nee+s per 1ilogram of bo+, weight -ie /-%& 1calE1g bo+, weight.
". Fn+erwater weighing
C. Coc1croft-:ault eDuation with activit, mo+ifier
0. !nthropometr, an+ "o+, impe+ance anal,sis
2. Maintaining an+ interpreting a =-+a, +etaile+ foo+ recor+
Nutrition Curriculum MCQ Pre-Test
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Nutrition Curriculum MCQ Pre-Test
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11. Which of the following is NOT a clinical conse<uence of refee!ing s#n!ro"e%
!. 4,pophosphatemia
". 4,pomagnesemia
C. 4,pervolemia
0. 4,perphosphatemia
2. 4,pergl,cemia
1. Which one of the following "icronutrients is routinel# a!!e! to T1N%
!. Gitamin 0
". #ron
C. vitamin 2
0. Gitamin H
2. Manganese
1%. - =0 #ear ol! "an ha! a "assi&e s"all bowel resection secon!ar# to a
&ol&ulus > #ear ago8 lea&ing hi" with 7=c" of s"all bowel' ?f he !i! not
recei&e a!e<uate nutrition suort8 how long woul! it ta(e to !e&elo
bioche"ical or clinical e&i!ence of essential fatt# aci! !eficienc#%
!.3 +a,s
". 3 wee1s
C. 3 months
0. 1 ,ear
2. 3 ,ears
13. Which one of the following "e!ications can be a!!e! to T1N in the
aroriate clinical circu"stance%
!. 4 Ieceptor !ntagonists
". Proton pump inhibitors
C. 7luroDuinolones
0. Narcotics
2. Cephalosporins
Nutrition Curriculum MCQ Pre-Test
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>=' Which one of the following state"ents is T;/E regar!ing central &enous
catheter infections in atients recei&ing long ter" ho"e total arenteral nutrition*
!. The most common organism causing catheter infection is ;taph,lococcus
!ureus.
". 0ouble lumen catheters re+uce the ris1 of catheter infection compare+ with
single lumen catheters.
C. 7emoral catheters re+uce the ris1 of catheter infection compare+ with
subclavian catheters
0. #n an uncomplicate+ catheter infection the accepte+ stan+ar+ of care is to start
antibiotic therap, without removing the catheter
2. Tunnele+ catheters ma, re+uce the ris1 of catheter infection compare+ with
implante+ catheters
>4' ?n which of the following clinical situations shoul! @>'0g rotein er (g bo!#
weight be ro&i!e! in nutrition suort%
!. Patients with renal failure on hemo+ial,sis
". 4ospitali8e+ patients
C. 9bese patients
0. Cirrhosis with hepatic encephalopath,
2. Gentilate+ patients
>7' Which one of the following gut hor"ones is resonsible for ro"oting
aetite%
!. 5eptin
". :rehlin
C. Pepti+e >>
0. CCH
2. #nsulin

Nutrition Curriculum MCQ Pre-Test
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>2. Which one of the following hor"ones la#s an i"ortant role in inhibiting
aetite%
!. :rehlin
". Iesistin
C. TN7 J
0. Pepti+e >>
2. Neurotensin
>A' Which of the following state"ents is T;/E regar!ing weight re!ucing agents
an! "echanis" of weight loss%
!. 9rlsitat eBerts its action b, selectivel, bloc1ing cannabinoi+-1 receptors
". ;ibutramine eBerts its action b, inhibiting pancreatic lipase
C. ;ibutramine eBerts its action b, selectivel, bloc1ing cannabinoi+- receptors
0. Iimonabant eBerts its action b, selectivel, bloc1ing cannabinoi+-1 receptors
2. Iimonabant eBerts its action b, selectivel, bloc1ing pancreatic lipase
&. Which of the following state"ents regar!ing the si!e effects of weight re!ucing
agents is T;/E*
!. 9rlistat can pre+ispose to car+iac arr,thmias
". Iimonabant can pre+ispose to car+iac arr,thmias
C. ;ibutramine can pre+ispose towar+ ab+ominal +iarrhea an+ steatorrhea
0. ;ibutramine can pre+ispose towar+ car+iac arr,thmias
2. Iimonabant can pre+ispose towar+ +iarrhea an+ steatorrhea
2>' Which of the following is NOT an a!ioc#to(ine*
!. 5eptin
". Iesistin
C. !+iponectin
0. :rehlin
2. #5-*
Nutrition Curriculum MCQ Pre-Test
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C
. Which of the following is an accetable in!ication for har"acothera# to
in!uce weight loss in o&erweight$obese a!ults%
!. "M# $ = an+ unsuccessful attempt at lifest,le mo+ification for prece+ing *
months
". "M# $ %& an+ unsuccessful lifest,le mo+ification for prece+ing * months
C. 6aist circumference $ 1& cm in males
0. 6aist circumference $ ((cm in females
2. 6aist circumference $ 1& cm in males an+ $ ((cm in females an+ an
unsuccessful attempt to lose weight through lifest,le mo+ification for the
prece+ing * months
27' Which of the following state"ents is T;/E regar!ing probiotics%
!. Probiotics are organisms that contribute towar+ intestinal microbial balance
". Probiotics are non-+igestible foo+ pro+ucts that selectivel, stimulates the
growth of one or a limite+ number of bacteria in the colon to confer
health benefit for the host
C. There is goo+ evi+ence to suggest that probiotics have a beneficial role in
preventing post-operative recurrence of Crohn?s 0isease
0. G;5K% probiotic consists of strains of lactobacillusA bifi+obacterium an+
;accharom,ces boular+i
2. Mil1 is an eBample of a foo+ source containing probiotics.
2B' Which of the following in an e)a"le of a prebiotic%
!. >ogurt
". #nulin
C. Creatinine
0. 7ish 9il
2. Gitamin C
Nutrition Curriculum MCQ Pre-Test
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1&
/. -ll of the following are "anifestations of 9inc !eficienc# E0CE1T*
!. +iarrhea
". +,sgeusia
C. alopecia
0. rash
2. parasthesias
Questions 24 an! 27 refer to the following ste"*
*. 3ou are as(e! to assess a =0 #'o "ale with short bowel s#n!ro"e' This atient
ha! a s"all bowel resection secon!ar# to "esenteric ische"ia 2 "onths ago8 lea&ing
hi" with >=0 c" of resi!ual s"all bowel an! an en! +e+unosto"#' 6e is now
!een!ant on T1N = !a#s er wee(' 6e is ha&ing 7 . of stool outut er !a#' There
is no e&i!ence of enteric infection' Which of the following har"acological otions is
the "ost reasonable ne)t theraeutic otion%
!. 7lag,l /&&mg po bi+
". cipro /&&mg po bi+
C. cipro /&&mg #G D1h
0. co+eine %&mg po Di+
2. 7lag,l /&&mg #G D1h
27' The atient in Question 2 abo&e !e&elos gra!ual onset of shortness of breath8 7:
illow orthonea8 an! aro)#s"al nocturnal !#snea with "il! an(le e!e"a o&er a
erio! of eight "onths' These s#"to"s "a# be a result of which of the following*
!. Linc +eficienc,
". Chromium +eficenc,
C. ;elenium +eficienc,
0. Manganese +eficienc,
2. Gitamin 2 +eficienc,
22' When !oes M-0?M-. s"all bowel a!atation occur ost s"all bowel
resection%
!. months
". * months
Nutrition Curriculum MCQ Pre-Test
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11
C. ( months
0. 1( months
2. 3 ,ears
2A' Which of the following foo!s !oes not contain gluten an! is accetable for
atients with celiac !isease to consu"e%

!. "ran
". ;pelt
C. Iice
0. :raham
2. "eer
70' - 2= #'o "ale atient has !ecrease! his inta(e of ani"al rotein an! increase!
his inta(e of whole grain toast8 cereal an! sala!s o&er the ast >2 "onths' Which of
the following "icronutrient !eficiencies is he at ris( for%
!. Chromium
". ;elenium
C. 7olate
0. Linc
2. Magnesium
7>' - 7= #ear ol! "orbi!l# obese fe"ale un!erwent &ertical ban! gastrolast#
CDB,E 4 "onths ago' She has lost =0 lbs of weight o&er 4 "onths' She is now
co"laining of 4:2 loose water# bowel "o&e"ents er !a# ongoing for the ast 2
"onths' 1rior to 2 "onths ago she was ha&ing > for"e! bowel "o&e"ent er !a#
for #ears' Which of the following state"ents regar!ing this scenario is T;/E%
!. The +iarrhea is li1el, relate+ to malabsorption from the G": an+ is the
primar, mechanism of weight loss
". The +iarrhea is li1el, a conseDuence of small bowel bacterial overgrowth
which ma, be a conseDuence of the G":
C. ;he is immunosuppresse+ secon+ar, to the weight loss an+ the +iarrhea ma, be
relate+ to C. 0ifficle colits
0. The +iarrhea is not relate+ to the G": an+ reDuires a full wor1-up
2. ;he has been consuming mainl, liDui+s +ue to the small pouch capacit,A
conseDuentl, this limits formation of stools.
Nutrition Curriculum MCQ Pre-Test
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1
72' Which of the following state"ents regar!ing rotein inta(e in atients with
chronic li&er !isease is T;/E*
!. Protein restriction shoul+ N9T be consi+ere+ routinel, in patients with
chronic liver +isease inclu+ing in those with hepatic encephalopath,
". Patients with chronic liver +isease an+ encephalopath, shoul+ receive
protein in Duantities between &./-&./gE1gE+
C. !nimal sources of protein shoul+ be consume+ more freDuentl, in patients
with chronic liver +isease
0. Patients with chronic liver +isease shoul+ receive protein in Duantities
between -./gE1gE+a,
2. Patients with chronic liver +isease shoul+ receive protein in Duantities
between &./-&.=/gE1gE+
77' Which of the following state"ents regar!ing "acronutrient energ# &alue is
T;/E*
!. Carboh,+rates provi+e C1calEgram consume+
". Protein provi+es 1calEgram consume+
C. 7at provi+es =1calEgram consume+
0. Protein provi+es 3 1calEgram consume+
2. 7at provi+es 11calEgram consume+
7B' Which of the following state"ents regar!ing Fiber is T;/E%
!. #nsoluble fiber has been shown to re+uce total cholesterol
". #nsoluble fiber has been shown to improve bloo+ sugar control in +iabetics
C. ;oluble fiber enhances gastric empt,ing
0. ;oluble fiber has been shown to lower the ris1 of pancreatic cancer
2. ;oluble fiber has been shown to re+uce total cholesterol
7=' Which of the following &alues reresent the reco""en!e! !ail# inta(e of fiber
er !a#%
!. %/-3&g
". /-%&g
Nutrition Curriculum MCQ Pre-Test
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1%
C. 1/-&g
0. 1&-1/g
2. /-1&g
74' ?n stu!ies that ha&e co"are! enteral nutrition to corticosteroi!s in a!ult
atients with acti&e Crohn5s Gisease8 what ercentage of atients treate! with
enteral nutrition alone enter into clinical re"ission%
!. &)
". 3&)
C. *&)
0. (&)
2. $(&)
77' Which of the following atients with short bowel s#n!ro"e is li(el# to re<uire
long ter" 6o"e Total 1arenteral Nutrition%
!. ;mall bowel length of &&cm with en+ @e@unostom,
". ;mall bowel length &&cm with @e@unocolic anastomosis
C. ;mall bowel length 1&&cm with @e@unocolic anastomosis
0. ;mall bowel length =/ cm with en+ @e@unostom,
2. ;mall bowel length *& cm with @e@unocolic anastomosis
72' - ro!uct lists the following nutrition infor"ation*
;erving si8e Co8
;ervings per pac1age 1
Calories 3&
Protein 1Cg
Carboh,+rate 1Cg
7at 1&g
What is the ercentage of calories ro&i!e! b# fat in this ro!uct%
!. %&)
". %3)
C. %()
0. 3)
2. /&)
7A' Which of the following co"onents of energ# e)en!iture generall# accounts for
the largest roortion of the 2Bh energ# e)en!iture total%
!. Thermic 2ffect of 7oo+
Nutrition Curriculum MCQ Pre-Test
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13
". Iesting 2nerg, 2Bpen+iture
C. !ctivit, relate+ energ, eBpen+iture
0. 2nerg, of fi+geting
2. 2nerg, of Catabolism
B0' - =0 #ear ol! "ale is a!"itte! to the ?C/ with resirator# !istress secon!ar# to
neu"onia' 6e is now &entilator !een!ant' 6e is starte! on ol#"eric enteral
fee!s at 20cc$hour' -fter 2 !a#s of fee!s8 his nurse notices that the gastric resi!ual is
>00cc an! she is concerne! about the ris( of asiration' The best reco""en!ation in
this situation is*
!. ;top enteral fee+s an+ start parenteral nutrition
". Ie+uce the rate of the enteral fee+ to 1&ccEhour
C. Change the pol,meric formula to semi-elemental formula
0. ;tart 0omperi+one 1&mg Di+
2. Ma1e no change to the current rate or t,pe of fee+ as the ris1 of aspiration is low