CNSC Practice Questions and Answers Correctly Solved!!

CNSC Practice Questions and Answers Correctly Solved!! In an intensive care setting, which of the following complications associated with malnutrition is most likely to occur as a result of the failure to begin nutrition support early in the treatment regimen? - Answer Increased serum levels of protein-bound drugs Which of the following is the inpatient glycemic target for critically ill patients? 1: 80-110 mg/dL 2: 140-180 mg/dL 3: 181-210 mg/dL 4: 211-240 mg/dL - Answer 2: 140-180 mg/dL Targets 110mg/dL are not recommended Under conditions of sepsis and stress, which of the following metabolic alterations are most likely to occur? 1: Increased glucose production and increased glucose uptake 2: Increased glucose production and decreased glucose uptake 3: Decreased glucose production and decreased glucose uptake 4: Decreased glucose production and increased glucose uptake - Answer 2: Increased glucose production and decreased glucose uptake Stress hormones induce insulin resistance and hyperglycemia is commonly observed with nutrition support. It is recommended that glucose levels be adequately controlled to avoid polyuria and electrolyte disturbances. Which of the following immunomodulating nutrients may be harmful in patients with severe sepsis? 1: Arginine 2: Selenium 3: Nucleic acids 4: Omega-3 fatty acids - Answer 1: Arginine Nitric oxide can be detrimental by leading to coagulation abnormalities and altered hemodynamic status. In this case, arginine could be considered harmful. Because of these effects, there is still much debate over the value of arginine in nutrition support for critically ill patients. Which of the following best describes enteral glutamine supplementation in the critically ill patient not in multi organ failure? 1: Enteral glutamine decreases mortality 2: Enteral glutamine decreases ventilator days 3: Enteral glutamine decreases hospital length of stay 4: Enteral glutamine decreases nosocomial infections - Answer 4: Enteral glutamine decreases nosocomial infections CNSC Practice Questions Correctly Solved!! Which of the following are counter-regulatory hormones responsible for the hypercatabolism observed in critically ill trauma patients? 1: Glycogen, insulin, norepinephrine 2: Glucagon, epinephrine, cortisol 3: Glycerol, serotonin, thymoglobulin 4: Glycerin, leptin, adenosine - Answer 2: Glucagon, epinephrine, cortisol In patients with burns, providing caloric support above energy expenditure has been found to 1: significantly decrease hospital length of stay. 2: improve wound healing and graft success. 3: decrease fat accumulation and steatosis. 4: have no effect on preservation of lean body mass. - Answer 4: have no effect on preservation of lean body mass. Although patients with burns have increased needs, feeding in excess of energy expenditure may cause hyperglycemia, hepatic steatosis, and prolonged ventilator dependence. One study of critically ill burn patients showed that caloric delivery beyond 1.2 x measured resting energy expenditure did not conserve lean body mass but was associated with increased fat mass accumulation. In pulmonary insufficiency, excessive calorie administration may cause increased blood pCO2 resulting in 1: metabolic acidosis. 2: metabolic alkalosis. 3: respiratory acidosis. 4: respiratory alkalosis. - Answer 3: respiratory acidosis. Which of the following is true of essential fatty acid deficiency (EFAD) in patients with cystic fibrosis (CF)? 1: Routine supplementation of omega-3 fatty acids is essential in the management of CF 2: EFAD usually does not manifest in CF patients until the second decade. 3: CF patients without pancreatic insufficiency rarely develop EFAD 4: EFA profiles have been shown to improve in CF patients after lung transplantation - Answer 4: EFA profiles have been shown to improve in CF patients after lung transplantation EFA status is usually evaluated by measuring the triene: tetraene ratio. Although supplementation with omega 3 fatty acids are sometimes used in the management of CF, results from clinical trials have shown mixed results and further trials are needed to determine the efficacy of routine EFA supplementation in the management of CF. CNSC Practice Questions Correctly Solved!! Which of the following is the best choice for feeding a pancreatic insufficient infant with cystic fibrosis? 1: Protein hydrolysate formula with medium chain triglyceride (MCT) 2: Free amino acid formula with MCT 3: Human milk 4: Standard infant formula - Answer Human milk is the optimal choice over standard formula for any infant due to multiple beneficial components including immunologic properties, growth factors, and both pre- and probiotics. Human milk or standard infant formula with appropriate enzyme dosing is recommended. Protein hydrolysate or free amino acid formulas containing MCT are not indicated for infants with cystic fibrosis (CF) unless there is another medical reason such as bowel resection resulting in malabsorption or liver abnormalities. Which of the following blood chemistries will most effectively indicate the response to the protein component of nutrition support in a patient on hemodialysis? 1: Albumin 2: Prealbumin 3: Urea nitrogen appearance 4: Normalized protein equivalent of total nitrogen - Answer 4: Normalized protein equivalent of total nitrogen For a patient requiring nutrition support therapy, which of the following may be necessary for a patient with acute kidney injury (AKI) receiving continuous renal replacement therapy (CRRT)? 1: Low potassium 2: Increased phosphorus 3: Low protein 4: Increased fluid - Answer 4: Increased fluid A nutrition support regimen need not be restricted in fluid for patients receiving CRRT. However, increased fluid provision from nutrition support is not necessary. For acute renal failure patients requiring parenteral nutrition support, recommendations include 1: balanced mixture of essential (EAA) and non-essential amino acids (NEAA). 2: essential amino acids (EAA) plus dextrose. 3: non-essential amino acids (NEAA). 4: dextrose alone, no amino acids. - Answer 1: balanced mixture of essential (EAA) and non-essential amino acids (NEAA). What is the glomerular filtration rate (GFR) of a patient with end-stage renal disease? CNSC Practice Questions Correctly Solved!! 1: 90 mL/min/1.73 M2 2: 30-59 mL/min/1.73 M2 3: 15-29 mL/min/1.73 M2 4: 15 mL/min/1.73 M2 - Answer 4: 15 mL/min/1.73 M2 .