Module 4: Condition Specific Nutrition Support exam with 100% correct answers
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Module 4: Condition Specific Nutrition Support
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Module 4: Condition Specific Nutrition Support
What is the inpatient glycemic target in mg/dl for critically ill patients?
A. 80-110
B. 140-180
C. 181-210
D. 211-240 correct answersB. 140-180
For the critically ill patient, blood glucose levels should be maintained between 140-180mg/dL. Lower glucose targets may be appropriate for sel...
What is the inpatient glycemic target in mg/dl for critically ill patients?
A. 80-110
B. 140-180
C. 181-210
D. 211-240 correct answersB. 140-180
For the critically ill patient, blood glucose levels should be maintained between 140-180mg/dL. Lower
glucose targets may be appropriate for selected patients, but targets <110mg/dL are not recommended.
A critically ill patient with hyperglycemia receiving continuous enteral nutrition with a history of insulin
dependent diabetes should ideally be placed on:
A. prandial subcutaneous insulin.
B. oral glucose-lowering agents.
C. continuous IV insulin infusion.
D. correction subcutaneous insulin. correct answersC. continuous IV insulin
Insulin should be used to treat diabetes during enteral nutrition. In the critical care setting, continuous
intravenous insulin infusion has been shown to be the best method for achieving glycemic targets and
allows for off cycles during the 24-hour period when enteral feeding is held or discontinued.
In pulmonary insufficiency, excessive calorie administration may cause increased blood pCO2 resulting
in:
A. metabolic acidosis.
,B. metabolic alkalosis.
C. respiratory acidosis.
D. respiratory alkalosis. correct answersC. respiratory acidosis
Respiratory acidosis results from disorders producing alterations in ventilatory control, increased
production of CO2, and respiratory muscle weakness. The increased CO2 production is greatest when
overfeeding occurs (2 x BEE) due to an excess generation of CO2 relative to O2 consumption during
carbohydrate metabolism.
What are the protein requirements for a stable patient receiving peritoneal dialysis (PD)?
A. 0.6-0.8 grams per kilogram per day
B. 1.0 - 1.2 grams per kilogram per day
C. 1.5-1.8 grams per kilogram per day
D. 2.0-2.2 grams per kilogram per day correct answersB. 1-1.2 g/kg/d
Protein losses through the peritoneum take place routinely while on PD. KDOQI guidelines recommend
1.0 - 1.2 grams per kilogram per day in clinically stable patients.
Hypoglycemia, requiring dextrose infusions to maintain euglycemia, is most likely to occur in which type
of liver disease?
A. Hepatic steatosis
B. Viral hepatitis
C. Decompensated cirrhosis
D. Acute liver failure correct answersD. acute liver failure
Hypoglycemia is a significant complication of acute liver failure (ALF), also known as fulminant hepatic
failure. During ALF, glycogen stores are rapidly depleted, insulin metabolism is impaired and leads to
increased serum insulin levels, and gluconeogenesis is reduced. Oral intake is also generally diminished
due to lack of appetite and anorexia in the setting of the proinflammatory state. Hypoglycemia is
typically managed with continuous dextrose infusions.
, Increased mortality in patient on maintenance hemodialysis (HD) has been associated with:
A. low baseline body fat percentage and low muscle mass.
B. elevated albumin and decreased CRP values.
C. increased BMI.
D. increased serum cholesterol. correct answersA. low baseline BF% and low muscle mass
Low muscle mass or sarcopenia reflects poor nutritional status and can reflect inflammation. Low fat
mass reflects low body stores of energy. Elevated CRP levels are increased with HD and are associated
with greater weight loss, decreased albumin and decreased appetite. A BMI of 30-34.9 is considered
protective in HD patients. A BMI less than 23 and hypoalbuminemia (< 3.2g/dL) are strong predictors of
mortality in HD patients. Serum cholesterol level is inversely correlated with the risk for death. It has
been noted that serum cholesterol concentration is elevated in the long-term dialysis survivors.
Patients with short bowel syndrome would benefit most from octreotide injections in the presence of:
A. recent bowel resection with loss of ileocecal valve.
B. short bowel secondary to mesenteric ischemia.
C. short bowel secondary to inflammatory bowel disease.
D. refractory diarrhea not controlled with diet and medication. correct answersD. refractory diarrhea not
controlled with diet and meds
Octreotide reduces the production of a variety of gastrointestinal secretions and slows jejunal transit.
However, its effects are often short lasting and have not been shown to improve absorption or lead to
the elimination of the need for parenteral nutrition. Due to an increased risk for cholelithiasis, expense
and the potential for octreotide to inhibit bowel adaptation, use of octreotide should be reserved for
patients with large volume stool losses in whom fluid and electrolyte management is problematic and
should be avoided in the early adaptation stage.
Patients with chronic heart failure are typically on a loop diuretic. These patients are at highest risk for:
A. hyperkalemia.
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