Exam (elaborations)
CNSC Exam Self Study With Correct Questions And Answers 2024
CNSC Exam Self Study With Correct Questions And Answers 2024
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cnsc exam self study with correct questions
modular products are used to enhance the nutrient
protein powders carbohydrate powders fat emulsio
early initiation of enteral feeding has been sugge
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CNSC Exam Self Study With Correct
Questions And Answers 2024
Modular .products .are .used .to .enhance .the .nutrient .profile .of .a .feeding .regimen. .Which .of
.the .following .combinations .represents .modular .products?
1. .Safflower .oil, .protein, .glucose .and .selenium
2. .Glucose, .glutamine, .water .and .MCT .oil
3. .Protein, .cholecalciferol, .fiber .and .safflower .oil
4. .MCT .oil, .glucose, .fiber .and .protein .- .correct .answer.4. .MCT .oil, .glucose, .fiber .and
.protein
Protein .powders, .carbohydrate .powders, .fat .emulsion, .MCT .oil, .fiber .and .specific .amino
.acids .are .examples .of .what? .- .correct .answer.Modular .products
Early .initiation .of .enteral .feeding .has .been .suggested .to .benefit .ICU .patients .by .reducing
.infectious .complications, .length .of .hospital .stay .and .even .possibly .reducing .mortality.
.Which .group .of .patients .might .be .at .significant .risk .from .early .enteral .feeding?
1. .Cancer .patients .who .underwent .surgery .of .the .GIT
2. .Patients .with .increasing .vasopressor .support
3. .TBI .patients .with .intracranial .pressure .controlled .by .hypertonic .saline
4. .Patients .admitted .to .the .hospital .with .acute .on .chronic .pancreatitis .- .correct .answer.2.
.Patients .with .increasing .vasopressor .support
What .is .the .risk .of .feeding .a .patient .before .hemodynamic .stability .has .been .achieved? .-
.correct .answer.May .increase .the .risk .of .intestinal .ischemia .as .blood .perfusion .of .the .gut
.may .be .compromised .in .a .patient .who .is .still .requiring .high .doses .of .vasopressor .drugs .to
.maintain .blood .pressure
When .should .EN .be .initiated .in .the .hemodynamically .unstable .patient? .- .correct
.answer.EN .should .be .delayed .until .fluid .resuscitation .is .complete
A .patient .with .acute .respiratory .distress .syndrome .(ARDS) .may .benefit .from .a .feeding
.formula .containing .supplemental
1. .arginine
2. .glutamine
,3. .nucleic .acids
4. .omega-3 .fatty .acids .- .correct .answer.4. .omega-3 .fatty .acids
Define .ARDS. .- .correct .answer.Acute .respiratory .distress .syndrome .- .inflammatory
.response .leading .to .diffuse .alveolar .damage .and .lung .capillary .endothelial .injury.
Why .are .formulas .containing .omega-3 .fatty .acids .recommended .in .ALI .and .ARDS? .-
.correct .answer.Inflammatory .mediators, .including .prostaglandins .and .leukotrienes
.derived .from .arachidonic .acid .metabolism .have .been .implicated .in .both .ALI .and .ARDS.
.Formulas .containing .omega-3 .fatty .acids .may .down .regulate .the .inflammatory .response
.through .the .production .of .less .inflammatory .prostaglnadins .and .leukotrienes
What .is .the .evidence .for .use .of .omega-3 .fatty .acids .in .ARDS .and .ALI? .- .correct
.answer.Based .on .3 .level .1 .studies .the .Guidelines .for .the .Provision .and .Assessment .of
.Nutrition .Support .Therapy .in .the .Adult .Critically .Ill .Patient .in .2009 .recommended .patients
.with .ARDS .and .severe .ALI .be .placed .on .an .enteral .formulation .characterized .by .an .anti-
inflammatory .lipid .profile. .Subsequent .to .the .publication .of .those .guidelines .and
.recommendations .have .been .studies .published .in .2011 .showing .that .enteral
.supplementation .of .omega-3 .fatty .acids .did .not .result .in .improved .biomarkers .of
.inflammation .or .clinical .outcomes
The .use .of .enteral .nutrition .formulas .enriched .with .BCAAs .is .best .used .for .patients .with:
1. .cirrhosis
2. .hepatic .failure
3. .liver .transplantation
4. .refractory .encephalopathy .- .correct .answer.4. .refractory .encephalopathy
What .is .the .theory .behind .use .of .BCAAs .in .hepatic .encephalopathy? .- .correct
.answer.There .is .believed .to .be .an .increased .ratio .of .aromatic .amino .acids .to .BCAAs .in
.patients .experiencing .hepatic .encephalopathy. .The .decrease .in .BCAA .is .suspected .to .be
.due .to .an .increased .breakdown .in .BCAA .from .skeletal .muscles .and .utilization. .The
.increased .levels .of .AAA .generate .false .neurotransmitters, .resulting .in .hepatic
.encephalopathy .symptoms.
What .is .the .evidence .for .BCAA .enriched .amino .acid .enteral .formulas? .- .correct
.answer.Published .randomized .trials .have .shown .mixed .results .in .patients .with .hepatic
.failure .receiving .these .specialized .formulas. .Due .to .the .lack .of .evidence .supporting .their
.use .and .the .increased .cost .of .such .products .it .has .been .suggested .that .the .use .of .these
.hepatic .fomulas .be .limited .to .patients .with .encephalopathy .refractory .to .standard .medical
.therapy .(lactulose, .non-absorbed .antibiotics)
Enteral .nutrition .may .be .contraindicated .in .the .early .post-transplant .period .in .adult
.patients .with .hematopoietic .cell .transplants .because .of:
1. .increased .incidence .of .sinusitis .with .enteral .feedings
,2. .lack .of .benefit .from .enteral .feedings .in .allogeneic .patients
3. .gastrointestinal .toxicities .related .to .the .conditioning .regimen
4. .improved .survival .seen .in .autologous .patients .receiving .PN .- .correct .answer.3.
.Gastrointestinal .toxicities .related .to .the .conditioning .regimen
Why .is .EN .contraindicated .in .the .early .post-transplant .period .in .adult .patients .with
.hematopoietic .cell .transplants? .- .correct .answer.GI .toxicities .such .as .nausea, .vomiting,
.delayed .gastric .emptying .and .diarrhea .seen .in .the .first .2-3 .weeks .post-stem .cell
.transplant .may .preclude .EN. .GI .toxicity .is .most .often .related .to .chemotherapy .and .total
.body .irradiatin, .however .GI .toxicity .may .also .result .from .other .medications .or .early .acute
.graft-versus-host .disease .in .this .patient .population.
Which .nutrition .therapy .is .preferred .in .early .post-transplant .hematopoietic .cell .transplant
.patients .(adult)? .- .correct .answer.Currently .there .is .insufficient .data .to .establish .benefits
.of .enteral .nutrition .over .parenteral .nutrition .with .hematopoietic .cell .transplants. .In .one
.study, .parenteral .nutrition .was .found .to .increase .survival .in .allogeneic .patients
Which .of .the .following .medications .would .be .appropriate .to .crush .and .deliver .via .an
.enteral .feeding .tube?
1. .Nifedipine .XL
2. .Metoprolol .immediate .release
3. .Enteric .coated .aspirin
4. .Diltiazem .CD .- .correct .answer.2. .Metoprolol .immediate .release
What .type .of .tablets .should .be .crushed .for .administration .via .an .enteral .feeding .tube? .-
.correct .answer.Only .immediate .release .tablets .should .be .crushed .fro .administration .via
.an .enteral .feeding .tube.
Why .are .enteric .coated .and .film .coated .tablets .not .crushed .for .administration .via .an .EN
.feeding .tube? .- .correct .answer.Enteric .coated .or .film .coated .tablets .do .not .crush .well .and
.tend .to .clump .and .increase .the .risk .of .clogging .the .tube.
Why .are .modified .release .dosage .forms .of .drugs .inappropriate .to .crush .and .give .via .EN
.feeding .tubes? .- .correct .answer.Modified .release .dosage .forms .(often .designated .with
.abbreviations .such .as .XL, .XR, .SR, .CD .etc.) .are .inappropriate .to .crush .and .give .via .EN
.feeding .tube .because .crushing .these .dosage .forms .destroys .their .modified .releasing
.properties. .This .may .lead .to .an .excessive .dose .of .the .drug .being .released .at .one .time
.(instead .of .slowly .over .a .longer .period .of .time), .which .can .lead .to .adverse .effects .and
.has .even .been .reported .as .a .cause .of .death
Which .of .the .following .describes .an .optimal .method .of .preparing .and .administering
.medications .via .an .enteral .feeding .tube?
1. .Crush .tablets .and .add .them .directly .in .the .EN .formula
2. .Administer .liquid .formulations .undiluted .to .minimize .fluid .overload
, 3. .Flush .the .tube .with .water .before .and .after .each .medication .administered
4. .Add .crushed .tablets .to .liquid .medication .sand .administer .the .mixture .all .together .-
.correct .answer.3. .Flush .the .tube .with .water .before .and .after .each .medication
.administered
Why .should .the .EN .tube .be .flushed .before .and .after .each .medication? .- .correct
.answer.Helps .to .avoid .physical .interactions .both .between .medications .and .between
.medications .and .formula.
How .should .liquid .formulations .be .administered? .Why? .- .correct .answer.Many .liquid
.medications .are .hyperosmolar .which .can .lead .to .diarrhea .and/or .have .high .viscosity
.which .can .lead .to .tube .clogging, .so .liquid .dosage .forms .should .be .diluted .with .water .prior
.to .administration
In .patients .with .severe .acute .pancreatitis .enteral .nutrition .has .been .documented .to
.provide .the .following .benefits .over .parenteral .nutrition .EXCEPT:
1. .decreased .infection .rate
2. .decreased .hospital .LOS
3. .decreased .pain
4. .decreased .mortality .- .correct .answer.3. .Decreased .pain
List .5 .benefits .in .patients .with .severe .acute .pancreatitis .on .EN .vs. .PN .nutrition .support .-
.correct .answer.1. .significant .reduction .in .infectious .morbidity
2. .decreased .hospital .LOS
3. .Reduced .need .for .surgical .intervention
4. .Reduced .multiple .organ .failure
5. .Decreased .mortality
In .patient .with .fat .malabsorption, .an .enteral .product .containing .which .of .the .following .can
.provide .a .concentrated .source .of .energy?
1. .MCT
2. .Free .amino .acids
3. .Fructooligosaccharides
4. .Long .chain .triglycerides .- .correct .answer.1. .MCTs
What .nutrient .can .be .used .to .provide .a .concentrated .source .of .energy .to .patients .with .fat
.malabsorption .or .damage .to .lymphatic .vessels? .Why? .- .correct .answer.MCT
MCT .are .absorbed .directly .into .the .bloodstream .and .enter .portal .circulation .bypassing
.the .need .for .pancreatic .enzymes, .bile, .bile .transport .in .the .lymphatic .system .and
.carnitine .dependent .transport .into .the .mitochondria.
Which .of .the .following .is .true .regarding .infectious .complications .associated .with .enteral
.feedings?