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CNSC, nutrition assessment Test and Answers
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CNSC, nutrition assessment Test and Answers
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CNSC, nutrition assessmentCopper deficiency is associated with
1: leukocytosis.
2: macrocytic anemia.
3: microcytic hypochromic anemia.
4: erythrocytosis. - Answer -3: microcytic hypochromic anemia.
Patients on long-term parenteral nutrition have developed anemia, leukopenia, neutropenia and
skeletal abnormalities. Deficiencies of iron or copper result in microcytic hypochromic anemia (small red
blood cells that are pale in color due to decreased heme pigment). Deficiencies of B12 or folate result in
macrocytic anemia (large red blood cells). Other symptoms of copper deficiency include: sensory ataxia,
lower extremity spasticity, parathesis in extremities, leukopenia, neutropenia, hypercholesterolemia,
increased erythrocyte turnover, decreased ceruloplasmin and erythrocyte copper/zinc superoxide
dismutase (SOD), abnormal EKG patterns, myeloneuropathy.
References:
McKeever, Liam. "Vitamins and Trace Elements." The ASPEN Adult Nutrition Support Core Curriculum.
3rd ed. Silver Spring: American Society for Parenteral and Enteral Nutrition, 2017. 139-182.
A patient receiving PN has high ileostomy output. Which of the following changes to the PN prescription
is most appropriate to recommend?
,1: increase sodium and increase fluid volume.
2: decrease water and decrease sodium.
3: increase sodium and decrease protein.
4: decrease sodium and increase fluid volume. - Answer -1: increase sodium and increase fluid volume.
Patients with high ileostomy or small bowel fistula output are at increased risk for water and electrolyte
losses. The sodium content of ileostomy output can be as high as 120 mEq/liter. Hyponatremia can
result when fluid replacement does not contain adequate sodium to correct for ileostomy losses.
References:
Rosner H. Metabolic Acidosis in Patients with Gastrointestinal Disorders: Metabolic and Clinical
Consequences. Pract Gastroenterol. 2009;73: 42-52.
Buchman AL. Etiology and initial management of short bowel syndrome. Gastroenterology. 2006;130:S5-
S15.
Willcutts K, Scarano K, Eddins CW. Ostomies and fistulas: A collaborative approach. Pract
Gastroenterol .2005;XXIX: 63-79.
Which of the following is a clinical characteristic of acute disease or injury related severe malnutrition?
1: Moderate depletion of body fat
2: Mild fluid accumulation
3: Mild depletion of muscle mass
4: 10% weight loss in 6 months - Answer -1: Moderate depletion of body fat
Clinical characteristics to diagnose malnutrition of acute or injury-related disease are weight loss of > 2%
in 1 week, > 5% in 1 month, > 7.5% in 3 months, energy intake of < 50% for > 5 days, moderate depletion
of body fat, moderate depletion of muscle mass, and moderate to severe fluid accumulation. Grip
strength is not recommended in intensive care units.
References:
, JeVenn AK, Galang M, Hipskind P, Bury C. "Malnutrition Screening and Assessment." The A.S.P.E.N. Adult
Nutrition Support Core Curriculum. 3rd ed. Silver Spring: American Society for Parenteral and Enteral
Nutrition, 2017. 185-212. Print.
Which of the following conditions are most likely to result in malnutrition of mild to moderate
inflammatory response?
1: Anorexia Nervosa
2: Cancer
3: Closed Head Injury
4: Sepsis - Answer -2: Cancer
In a large multicenter cooperative study, over half of cancer patients present with weight loss at
diagnosis (range 31-80%). Unintentional weight loss is a criterion for diagnosis of malnutrition. The
amount and frequency of weight loss varied with type of cancer, location, grade, and stage. Type of anti-
cancer treatments can also further impact nutritional status.
References:
JeVenn AK, Galang M, Hipskind P, Bury C. "Malnutrition Screening and Assessment." The A.S.P.E.N. Adult
Nutrition Support Core Curriculum. 3rd ed. Silver Spring: American Society for Parenteral and Enteral
Nutrition, 2017. 185-212. Print.
Granger DA, Kivlighan KT, el-Sheikh M. Salivary alpha-amylase in biobehavioral research: recent
developments and applications. Ann NY Acad Sci. 2007;1098:122-144.
Which of the following is most suggestive of malnutrition?
1: 10th percentile of tricep skinfold thickness
2: Voluntary body mass index change from 30 to 25 over 6 months
3: Involuntary weight loss of 10% usual body weight over six months
4: Albumin decrease from 4.0 to 3.5 - Answer -3: Involuntary weight loss of 10% usual body weight over
six months
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