RD Exam Practice - Clinical with 100% correct answers
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Course
RD E Practice - Clinical
Institution
RD E Practice - Clinical
1) A resident of a long-term care facility is receiving a nocturnal tube feeding from 8 p.m. to 8 a.m. The formula has a concentration of 1.3 kcal/ml. What rate is needed to provide 1400 calories?
a. 79 ml/hr
b. 90 ml/hr
c. 105 ml/hr
d. 95 ml/hr correct answersb. 90 ml/hr
Rationale:
volume...
1) A resident of a long-term care facility is receiving a nocturnal tube feeding from 8 p.m. to 8 a.m. The
formula has a concentration of 1.3 kcal/ml. What rate is needed to provide 1400 calories?
a. 79 ml/hr
b. 90 ml/hr
c. 105 ml/hr
d. 95 ml/hr correct answersb. 90 ml/hr
Rationale:
volume/hours = rate
time: 12 hours
Total volume = 1400 kcal per day/1.3 kcal per ml = 1077 ml per day
1077 ml per day/12 hours = 90 ml per hour
2) A continuous-drip tube feeding of a 1.5 kcal/ml formula is being infused at 70 ml/hr. The formula is
55% carbohydrate, 19% protein, and 26% fat. How many calories and grams of protein are delivered in a
24-hour period?
a. 2160 kcal and 97 g protein
b. 2520 kcal and 75 g protein
c. 2160 kcal and 86 g protein
d. 2520 kcal and 120 g protein correct answersd. 2520 kcal and 120 g protein
Rationale:
Total volume = rate x hours
= 70 ml per hour x 24 hours per day
= 1680 ml per 24 hours
1680 ml/24 hours x 1.5 kcal per ml = 2520 kcal/24 hours
2520 kcal x 0.19 = 479 kcal from protein
,479 kcal/4 kcal per g protein = 119.7 g protein
3) A patient is receiving an intermittent tube feeding of 325 ml formula, four times per day. The formula
provides 1.2 kcal/ml and 855 ml water/liter. The patient's estimated daily fluid requirement is 1900
ml/24 hours. How much additional water will be required per feeding?
a. 197 ml per feeding
b. 101 ml per feeding
c. 239 ml per feeding
d. 212 ml per feeding correct answersa. 197 ml per feeding
Rationale:
Total volume = volume per feeding x number of feedings
= 325 ml x 4 feeding per day
= 1300 ml per day
Total water provided = 1.3 liters x 855 ml water per liter
= 1111 ml per day (from formula)
1900 ml (estimated fluid needs) - 1111 ml = 789 ml of additional water needed
789 ml/4 feedings per day = 197 ml water per feeding
4) A TPN prescription consists of the following:
- 750 ml 50% dextrose
- 500 ml 10% amino acids
- 250 ml 20% lipids
This will provide how many total calories and how many grams of protein?
a. 1975 total kcal and 50.0 g protein
b. 1570 total kcal and 21.3 g protein
c. 2020 total kcal and 42.5 g protein
d. 1570 total kcal and 42.5 g protein correct answersa. 1975 total kcal and 50.0 g protein
Dextrose: 750 ml x 0.5 = 375 g x 3.4 kcal/g dextrose = 1275 kcal
Amino acids: 500 ml x 0.1 = 50 g x 4.0 kcal/gram = 200 kcal
Lipids: 250 ml x 2 kcal/ml = 500 kcal
1275 + 200 + 500 = 1975 total kcal
5) A TPN prescription consists of the following:
- 750 ml 50% dextrose
- 500 ml 10% amino acids
- 250 ml 20% lipids
What is the nonprotein calorie:nitrogen ratio?
a. 58 nonprotein calories: 1 g nitrogen
b. 222 nonprotein calories: 1 g nitrogen
c. 52 nonprotein calories: 1 g nitrogen
d. 231 nonprotein calories: 1 g nitrogen correct answersb. 222 nonprotein calories: 1 g nitrogen
Rationale:
Step 1: Determine nonprotein kcal: 1975 total kcal-200 kcal from amino acids = 1775
Step 2: Determine g nitrogen: 50 g protein/6.25 = 8 g nitrogen
Step 3: Determine ratio: 1775 nonprotein kcal/8 g nitrogen = 221.8:1 ratio
6) A patient in the critical care unit is on a TPN solution (25% CHO, 5% AA) @ 85 cc/hour with 10% lipids
QOD. The patient information includes ht: 5'10"; wt: 185# (84 kg); age: 67; sex: Male. Calculate the
glucose utilization rate for this nutrition support regimen.
a. 2.4 mg/kg/min
b. 4.2 mg/kg/min
, c. 4/2 kg/mg/min
d. 5.6 kg/mg/min correct answersb. 4.2 mg/kg/min
Rationale:
Step 1: volume x strength = grams dextrose
2040cc (85cc/hour x 24) x 0.25 = 510 g dextrose
Step 2: grams dextrose x 1000 mg/g = mg dextrose
510 g dextrose x 1000 mg/g = 510,000 mg
Step 3: mg dextrose/(kg (body wt) x 1440 minutes) = GUR
510,000 mg/(84 kg x 1440 min) = 4.2 mg/kg/min
Glucose utilization rate is calculated to determine the maximum amount of carbohydrates that can be
tolerated without metabolic complications. The desired range is 4-6 mg/kg/min. The range should not
exceed 5-6 mg/kg/min in the critically ill.
7) A diabetic client is to eat 60 g carbohydrate at lunch. He can do this with:
a. 1 c 2% milk, 1 c cooked broccoli, 1/2 bagel
b. 1 c mashed potatoes, 1 c cranberry juice cocktail
c. 2 slices bread, 1/2 c corn, 1/2 kiwi
d. 1 hamburger bun, 1/3 c baked beans, 12 cherries correct answersd. 1 hamburger bun, 1/3 c baked
beans, 12 cherries
Rationale:
a. 1 c 2% milk (12), 1 c cooked broccoli (10), 1/2 bagel (30) = 52 g
b. 1 c mashed potatoes (30), 1 c cranberry juice cocktail (45) = 75 g
c. 2 slices bread (30), 1/2 c corn (15), 1/2 kiwi (7.5) = 52.5 g
d. 1 hamburger bun (30), 1/3 c baked beans (15), 12 cherries (15) = 60 g
8) During a 24-hour study, a hospitalized patient consumes 95 grams of protein and has a urine urea
nitrogen of 13 grams. What conclusion can be drawn?
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