CNSC REAL EXAM AND STUDY GUIDE 300 QUESTIONS AND CORRECT ANSWERS LATEST VERSION//ALREADY GRADED A+
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CNSC REAL
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CNSC REAL
CNSC REAL EXAM AND STUDY GUIDE 300 QUESTIONS
AND CORRECT ANSWERS LATEST
VERSION//ALREADY GRADED A+
CNSC REAL EXAM AND STUDY GUIDE 300 QUESTIONS
AND CORRECT ANSWERS LATEST
VERSION//ALREADY GRADED A+
CNSC REAL EXAM AND STUDY GUIDE 300 QUESTIONS
AND CORRECT ANSWERS LATEST
VERSION//ALR...
CNSC REAL EXAM AND STUDY GUIDE 300 QUESTIONS
AND CORRECT ANSWERS 2024-2025 LATEST
VERSION//ALREADY GRADED A+
Standard for glucose checks in a patient with DM on PN - CORRECT ANSWER-Every 2-6 hours
Maximum glucose infusion rate for patients with DM on PN - CORRECT ANSWER-5 mg/kg/min
Estimated amount of insulin to add to PN for a diabetic - CORRECT ANSWER-0.05-0.1 unit insulin/gm
dextrose, increased daily to achieve glycemic goals by adding 2/3 of previous days sliding scale insulin
Patients with DM on PN have an increased risk for - CORRECT ANSWER-infection
The best approach to preventing PN-induced cholelithiasis is - CORRECT ANSWER-Early initiation of
enteral feeding
CMS standards for coverage determination of HPN - CORRECT ANSWER-1. Disease of small intestine
and/or exocrine glands that significantly impairs nutrient absorption
2. Motility disorders of the GI tract which results in severe nutrient malabsorption
3. Meet test of permanence (>3 months duration needed)
Most common complication seen after PEG placement is - CORRECT ANSWER-Peristomal infection
(~30% of patients)
Third party payers are most likely to reimburse for which home enteral nutrition expenses? - CORRECT
ANSWER-Enteral administration supplies
Which trace element deficiency
is most likely to occur in long term PN-dependent patients after 3-6 months of therapy? - CORRECT
ANSWER-Iron
,Iron can be added to which type of PN solution? - CORRECT ANSWER-2-in-1
What form of iron can be added to PN? - CORRECT ANSWER-Iron dextran
How often should serum iron and ferritin levels be monitored in patients receiving iron in PN? -
CORRECT ANSWER-1-3 months
How does PNAC typically present? What is the prime indicator? - CORRECT ANSWER-Elevated alkaline
phosphatase, gamma-glutamic transpeptidase, and conjugated (direct) bilirubin. Bilirubin of >2 mg/dL is
the prime indicator.
What trace elements may become elevated in patients with cholestasis? - CORRECT ANSWER-
Manganese and Copper
Types of VADs approved for HPN include: - CORRECT ANSWER-1. Tunneled central venous catheters
2. Implanted ports
3. PICCs
What is the best way to determine chromium deficiency? - CORRECT ANSWER-There is no known
reliable indicator of chromium status.
What is the best way to treat chromium deficiency? - CORRECT ANSWER-Treat hyperglycemia patients
with chromium supplementation and observe for resolution of symptoms.
Symptoms of Zinc deficiency: - CORRECT ANSWER-Loss of taste, altered smell, skin rash, growth failure,
alopecia, decreased muscle work capacity, gonadal hypofunction. Pica, dysgeusia, skin loss, hair lesions.
What criteria must be met for home enteral nutrition (HEN) under Medicare coverage guidelines? -
CORRECT ANSWER-1. A permanent no function or disease of the structures that normally permit food to
reach the small bowel
2. A disease of the small bowel that impairs digestion and absorption of an oral diet.
3. Test of permanence met (>3 months)
,4. Must require tube feeding to maintain weight and strength commensurate with overall health status
5. Adequate nutrition must not be possible by dietary adjustment and/or ONS
What solution removes the luminal biofilm inside VADs in which microorganisms are harbored? -
CORRECT ANSWER-70% ethanol lock (ELT) solution
What are disadvantages of ELT? - CORRECT ANSWER-1. ELT can cause increased breakages and weaken
VADs made from polyurethane.
2. Ethanol is incompatible with heparin.
PN compounding involving only transfer, measuring, and mixing manipulations with closed or sealed
packaging systems is classified at what risk level? - CORRECT ANSWER-Low risk
PN compounding using manual or automated devices during which there are multiple injections,
detachments, and attachments of nutrient source products to the device or machine to deliver all
nutritional components to a final sterile container is classified at what risk level? - CORRECT ANSWER-
Medium risk
PN compounding involving non-sterile ingredients or non-sterile devices prior to terminal sterilization is
classified at what risk level? - CORRECT ANSWER-High risk
What reduced the risk of calcium phosphate precipitation in PN? - CORRECT ANSWER-1. Increased
amino acid concentration
2. Storage under refrigeration
3. Lower pH of PN
In what order should you add calcium and phosphate when compounding PN? - CORRECT ANSWER-It is
recommended to add phosphate first, and then add calcium near the end of compounding to utilize max
volume of the PN formulation to dilute the salts
Rapid intravenous infusion of potassium may result in: - CORRECT ANSWER-Thrombophlebitis
, Infusion rates of phosphate should not exceed - CORRECT ANSWER-7 mmol/hr
Risk of thrombophlebitis increased after - CORRECT ANSWER-Day 4
What may worsen hypokalemia by stimulating insulin release and promoting intracellular shifts of K+? -
CORRECT ANSWER-Dextrose solutions
Hypophosphatemia may cause - CORRECT ANSWER-Neuromuscular adverse affects such as rhabdo
Which serum electrolyte level should be monitored most closely in metabolic acidosis? - CORRECT
ANSWER-Potassium
What should be on inpatient PN label according to ASPEN? - CORRECT ANSWER-2 patient identifiers
Patient location or address
Dosing weight in metric units
Administration date and and time
Beyond use date and time
Route of administration
Prescribed volume and overfill volume
Infusion rate in mL/hr
Duration of infusion
Size of in-line filter
Complete name of all ingredients
Barcode
Institution or Pharmacy
Institution or pharmacy contact info including phone number
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