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WorksheetsSP 22 Nutrition Practice
Total questions: 70
Worksheet time: 42mins
How many kcals do we get from 1 gram of protein in enteral nutrition? (a) kcal/g (Hint: enter number only, no units)
How many kcals do we get from 1 gram of amino acids in parenteral nutrition? (a) kcal/g (Hint: enter number only, no units)
How many kcals do we get from 1 gram of intravenous lipids in parenteral nutrition? (a) kcal/g (Hint: enter number only, no units)
How many kcals do we get from 1 gram of fat in enteral nutrition? (a) kcal/g (Hint: enter number only, no units)
How many kcals do we get from 1 gram of carbohydrates in enteral nutrition? (a) kcal/g (Hint: enter number only, no units)
How many kcals do we get from 1 gram of dextrose in parenteral nutrition? (a) kcal/g (Hint: enter number only, no units)
A 55 year old male has had a stroke and is now being provided enteral nutrition through a nasogastric tube due to difficulty swallowing. He is underweight. What is the maximum weekly weight gain we should target? (a) kg/week (hint: numerical only)
What is the body's preferred source of fuel?
glucose
fat
protein
all macronutrients are equally used as energy/fuel
Which of the following would slow gastric emptying?
Using a nasogastric tube
high osmolality feeds
Low protein content
high carbohydrate content
Which macronutrient takes the longest to breakdown in the gastrointestinal system?
carbohydrates
proteins
fats
free water
Parasympathetic nerves system is associated with acetylcholine which facilitates:
Rest and Digest
Fight or flight
Sympathetic nerves system is associated with norepinephrine or epinephrine release which facilitates:
Rest and Digest
Fight or flight
What is the hormone released during starvation that promotes the breakdown of glucose storage and lipid stores to increase serum glucose?
(a)
Excess carbohydrates can result in increased production of:
chloride
carbon dioxide
oxygen
bicarbonate
what is the smallest functional unit of protein?
(a)
Glutamine is an example of a ______amino acid
nutritionally essential
conditionally essential
non-essential
True/False: Some amino acids may be broken down into glucose and used for energy
True
False
True/False: Some amino acids may be broken down into acetyl-CoA and then ketone bodies or fatty acids and used for energy
True
False
Which of the following is considered an omega 6 fatty acid?
linoleic acid
alpha-linolenic acid
EPA
DHA
What type of fat needs to have transported into the mitochondrial matrix with levocarnitine to be utilized?
free fatty acids
short chain fatty acids
long chain fatty acids
all fats need levocarnitine to be properly utilized
A patient that is 95% of their ideal body weight is considered:
malnourished
normal
overweight
obese
A patient with celiac disease with a BMI of 17 kg/m2 would likely have which of the following types of malnutrition?
starvation
chronic disease related
acute disease related
This patient is not at risk for malnutrition
Which of the following is true about starvation related malnutrition?
heavily inflammation driven
is rarely associated with social behaviors
albumin is not a reliable marker for identifying this malnutrition
can be a result of food supply issues
Which of the following malnutrition classifications can be characterized by central edema/asities, hypoalbuminemia, and possibly impaired immune function?
kwashiorkor
marasmus
essential fatty acid deficiency
macrocytic anemia
True/False: Most healthy adults will not develop essential fatty acid deficiency if lipids are excluded from TPN for 7-10 days
True
False
A patient with a serum calcium of 7 mg/dL and an albumin of 1.5 has hypocalcemia. (Calcium reference range: 8.4-10.2 mg/dL)
True
False
The corrected calcium for a patient with a serum calcium of 8 mg/dL and an albumin of 3.5 is:
(no units, just numerical response)
(a)
Refeeding syndrome is characterized by:
hypomagnesemia, hypocalcemia, hypokalemia
hypocalcemia, hypophosphatemia, hypokalemia
hypokalemia, hypophosphatemia, hypomagnesemia
hypophosphatemia, hypocalcemia, hypokalemia
Patients with alcoholism are at high risk of deficiency of:
vitamin B12
thiamine
copper
selenium
Patients with history of bowel surgery to the ilium and no ileocecal valve are at high risk of malnutrition of which micronutrient?
vitamin B12
thiamine
copper
selenium
Which of these trace elements is eliminated via biliary excretion?
manganese
iron
zinc
selenium
Which of these trace elements is eliminated via biliary excretion?
copper
iron
zinc
selenium
Which of these trace elements is needed for thyroid hormone production?
copper
iron
zinc
selenium
iodine
What route is preferred for potassium replacement?
IV
oral
rectal
What route is preferred for magnesium replacement?
IV
oral
rectal
A patient has an IV fluid containing potassium running at 5 mEq/hr and needs potassium IV replacement to fix hypokalemia. The provider orders the replacement of 40 mEq to be infused over 2 hours. Can this be safely be infused?
Yes, only with telemetry/cardiac monitoring
Yes, no telemetry/cardiac monitoring required
No, this potassium rate is too fast
No, this combination will result in precipitation
A patient has an IV fluid containing potassium running at 10 mEq/hr and needs potassium IV replacement to fix hypokalemia. The provider orders the replacement of 40 mEq to be infused over 6 hours. Can this be safely be infused?
Yes, only with telemetry/cardiac monitoring
Yes, no telemetry/cardiac monitoring required
No, this potassium rate is too fast
No, this combination will result in precipitation
What is the maximum osmolality we can put through a peripheral IV line? (a) mosm/L (numerical response only)
A 9 year old patient should get which type of amino acids in their TPN?
Pediatric
Standard
What is the maximum dose we should initiate for lipids on an adult patient that is critically ill
<1 g/kg/day
1 g/kg/day
2 g/kg/day
3 g/kg/day
What is the maximum dose we should order for intravenous lipids on a pediatric patient?
4 g/kg/day
1 g/kg/day
2 g/kg/day
3 g/kg/day
How many kcals/mL are provided when a patient is getting Propofol? (a) kcal/mL (just numerical answer)
What is the maximum dextrose dose that should be in the INITIAL adult TPN with no comorbid conditions?
(a)
What is the maximum dextrose dose that should be in the INITIAL adult TPN with high risk of refeeding syndrome?
(a)
A patient is at high risk of refeeding syndrome. The provider initiates a dextrose infusion with normal saline for the patient at a GIR of 1 mg/kg/min. The patient becomes disoriented, confused, and combative. What vitamin/mineral should have been added to this patient's dextrose fluid?
(a)
True/False: Fat soluble vitamins should be eliminated from TPN in all patients due to complications associated with toxicity
True
False
Patient with chronic severe diarrhea of malabsorption need what trace element added to their TPN?
(a)
A patient with metabolic acidosis should have which of the following added to their TPN to help correct the acid-base problem?
Sodium Chloride
Potassium Chloride
Sodium acetate
Calcium gluconate
Magnesium sulfate
A patient with metabolic alkalosis should have which of the following added to their TPN to help correct the acid-base problem?
Sodium Chloride
Potassium acetate
Sodium acetate
Calcium chloride
Magnesium sulfate
Which of the following salts drastically increases the risk of precipitation
Sodium phosphate
calcium chloride
potassium acetate
magnesium phosphate
What is the maximum infusion rate of potassium for a pediatric patient NOT on telemetry that weights 40 kg?
(a)
True/False: We can add bicarbonate to the TPN when a patient has metabolic acidosis
True
False
Which type of enteral formula tastes better?
Polymeric
Oligomeric
Peptide based
Elemental
Which type of enteral formula has the highest osmolality and may cause diarrhea?
Polymeric
Soy based
Peptide based
Elemental
True/False: Enteral formulas provide all free water the patient needs?
True
False
True/False: Adult formulas are lactose free
True
False
True/False: Infant formulas are always lactose free
True
False
True/False: bolus feeds may be used for feeds that are jejunostomy provided in the jejunum (example: through a jejnuostomy tube)
True
False
Which of the following is NOT a benefit of continuous enteral feeds?
lower risk of aspiration
better tolerated that bolus feeds
more absorption of nutrients
minimizes medication-feed interactions
True/False: Patients can experience refeeding syndrome with enteral nutrition
True
False
When administering medications via an enteral tube we should:
always use sweetened products incase the patient has emesis
use enteric coated products to protect them from the stomach acid
tablets are preferred over liquid products
dilute liquids 3:1 with water if viscous
Which of the following is true regard medication interactions with enteral feeds?
Warfarin can be reliability used in patients continuous feeds
ciprofloxacin requires feeds to be held for 30 minutes prior to administration
ciprofloxacin suspension is preferred for administration
calcium carbonate should not be administered post pyloric
Who needs iron supplementation?
13 day old infant that is breastfeed
30 day old infant that is formula fed
5 month old infant that is breastfeed
7 month old infant that is formula fed
Who does NOT need vitamin D supplementation?
13 day old infant that is breastfeed
30 day old infant that is formula fed 15 oz/day
5 month old infant that is breastfeed
7 month old infant that is formula fed 35 oz/day
What is the EARLIEST solids should be introduced into the infant diet?
(a)
What dose of vitamin D should be provided to infants?
(a)
A patient requires fluoride supplementation because they have no fluoride in their water. What is the dose for a 10 month old?
none, this patient is too young
0.25 mg/day
0.5 mg/day
1 mg/day
A patient requires fluoride supplementation because they have no fluoride in their water. What is the dose for a four year old?
none, this patient is too young
0.25 mg/day
0.5 mg/day
1 mg/day
A patient requires fluoride supplementation because they have no fluoride in their water. What is the dose for a 10 year old?
none, this patient is too young
0.25 mg/day
0.5 mg/day
1 mg/day
Which of the following should not be in a starter TPN?
amino acids
dextrose
calcium gluconate
trace elements
