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ASPEN Adult Nutrition Support Core Curriculum.Questions and answers 2023
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ASPEN Adult Nutrition Support CoreCurriculum - Chapter Questions
which of the following nutrition interventions have been shown to improve clinical
outcomes and quality of life in institutionalized older adults?
A. diet modification and liberalization
B. modification of dining environment
C. provision of aides to improve functional status and increased independence at meals
D. honoring food preference and providing snacks and fortified foods
E. All of the above - ANSWERE. all of the above
which of the following nutrition support interventions has demonstrated the best
outcomes in frail, community-dwelling older adults in post-operative orthopedic surgery
populations?
A. oral nutrition supplement
B. IV hydration
C. EN
D. PN - ANSWERA. oral nutrition supplement
- oral nutrition supplements display the best outcomes in this population
- EN, PN, and IV hydration have demonstrated limited success in achieving positive
outcomes in older adults
what is the most reasonable justification to initiate EN in an individual with advanced
dementia?
A. decreased morbidity
B. specific and limited goal
C. improved mortality
D. improved quality of life - ANSWERB. specific and limited goal
- EN has not been shown to be an effective intervention to decrease mortality, improve
morbidity outcomes, or improve QOL in patients with advanced dementia
- however, according to the AND, specific and realistically achievable goal may be a
reason to initiate tube feeding in and older adult with advanced dementia
of the following, which is the best currently known nutrition intervention to minimize
negative outcomes associated with sarcopenia?
A. protein supplementation
B. amino acid supplementation
,C. protein adequacy
D. omega-3 fatty acid adequacy - ANSWERC. protein adequacy
- adequacy of protein intake seems to be the most importance nutrition-related factor in
preserving lean body mass in older adults
- the type of protein, essential AA supplementation, and omega-3 fatty acid
supplementation may all play roles in preventing sarcopenia
what is the most accurate way to determine energy requirements for obese patients in
ICU requiring EN support?
A. harris-benedict
B. IC
C. mifflin-st jeor
D. penn state equation - ANSWERB. Indirect calorimetry
- most predictive equations were validated in patients without extremes of weight or age
- overestimation of energy requirements when using actual body weight and
underestimation when using IBW led to inadvertent overfeeding and underfeeding,
respectively
- efforts to account for altered body composition by using corrections for actual body
weight have led to even more confusion
- for this reason, IC should be used when available
according to most recent ASPEN and SSCM guidelines, what is the EN feeding strategy
based on energy requirements for obese people?
A. hypo caloric with normal protein
B. hypo caloric with low protein
C. hypo caloric with high protein
D. hypercaloric with high protein - ANSWERC. hypo caloric with high protein
- BMI >30: goal of EN should not exceed 60-70% of target energy requirements
- estimated protein requirements may be 2.0 gm/kg/day of IBW for pts with class 1-2
obesity and 2.5 gm/kg/day for pats with class 3 obesity
which of the following is criterion for selection patients to undergo gastric bypass
surgery?
A. BMI >/=35 and no history of substance abuse or psychiatric disorders
B. BMI equal to or greater than 35 and obesity-associated co-morbidities
C. BMI equal to or greater than 30 and obesity associated comobidities
D. BMI equal to or greater than 30 and inability to achieve weight control with low
calorie diets - ANSWERB. BMI equal to or greater than 35 and obesity-associated co-
morbidities
,- candidate if BMI >/=40 or >/=35 with co-morbidities and more conservative efforts at
weight loss have not resulted in adequate weight control
- pts with active bulimia, active substance abuse, or major disturbances of though or
mood should be evaluated carefully and these issues should be treated prior to surgery
which of the following statements regarding the current WHO and NIH classification of
overweight and obesity is true?
A. overweight is defined as BMI 25 to 29.9 and obesity is defined as BMI =/> than 30
B. obesity is defined as equal or greater to 120% of IBW
C. obesity is defined as body fat equal or greater than 20% of body weight for men and
equal to or greater than 30% for women
D. obesity is defined as BMI greater than 25, and morbid obesity is defined as BMI
greater than 30 - ANSWERA. overweight is defined as BMI 25 to 29.9 and obesity is
defined as BMI =/> than 30
- use of BMI is encouraged over iBW bc it provides a standardized method for
expressing weight relativly independent of heigh and correlates reasonably well with
body fat as well as mortality
- although BMI does not always accurately reflect excess body fat (eg when ascites or
edema is present), it represents a simple and reproducible method for categorizing
weight
what percentage of instilled dextrose is typically absorbed from peritoneal dialysate with
a 6 hour dwell time?
A. 25%
B. 50%
C. 75%
D. 100% - ANSWER
which is most likely to succeed in improving oral intake in pts with prolonged history of
weight loss due to poor intake, nausea, decreased appetite?
A. high cal oral liquid supplement x3 daily
B. six small, low fat meals per day
C. fiber supplemented snacks x3 daily
D. plan primarily solid meals; limit fluids - ANSWERB. six small, low fat meals per day
may be difficult to meet nutrient targets with 3 regular sized meals. fat, caloric density,
and fiber content slow gastric emptying. providing fluids (not limiting them) facilitates
gastric emptying
fermentable fiber is beneficial in enteral formulas because:
, A. colonic bacteria acts of to fiber to make SCFA that provide energy source to intestinal
mucosa
B. colonic bacteria acts of to fiber to make SCFAs, which in turn exert trophic effects of
the intestinal mucosa
C. fermentable fiber may help control diarrhea by slowing gastric emptying
D. all the above - ANSWERD. all the above
fermentable fibers (pectins, gum, fructooligosaccharides) are metabolized by colonic
bacteria to make SCFA. fiber is not recommended for tx of C Diff PMC
(pseudomembrane colitis) or during low flow states.
which of the following nutrients is added to rehydration liquids to promote sodium (Na+)
absorption in pts with diarrhea?
A. glucose
B. amino acids
C. long-chain fatty acids
D. alcohol - ANSWERA. glucose
the presence of glucose in the lumen of the small intestine facilitates the absorption of
sodium. when more sodium is absorbed, more water from the the lumen of the
intestines is absorbed. use NaCl in rehydration solutions
which of the following has the greatest influence on total energy expenditure (TEE)?
A. resting metabolic rate (RMR)
B. thermogenic effect of digestion
C. physical activity
D. metabolic stress - ANSWERA. resting metabolic rate (RMR)
thermogenic effect of digestion contributes no more than 10% to TEE. activity
contributes 5-30% of TEE. with exceptions for burn/sepsis, metabolic stress contributes
to less than 50% of TEE. RMR contributes 60-75% of TEE
the most commonly used method for assessing energy expenditure is
A. indirect calorimetry
B. predictive equations
C. The Reverse Fick equation
D. doubly labeled water - ANSWERB. predictive equations
indirect calorimetry is most accuracy but underused because of its expense and the
clinical expertise required for use/interpretation
reverse fick equation - oxygen content differences in arterial and mixed venous blood
multiplied by cardiac output measurements from pulmonary arterial catheters
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