Mnt II - Exam 1 Review

50 Questions

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Nutrition Quizzes & Trivia

Questions and Answers
  • 1. 
    • A. 

      Massive bowel resection

    • B. 

      Diseases of the small intestine (leading to severe malabsorption)

    • C. 

      Radiation enteritis (after radiation cancer therapy)

    • D. 

      Intractable vomiting

    • E. 

      High dose chemotherapy or radiation

    • F. 

      Bone marrow transplant

    • G. 

      Moderate to severe pancreatitis

    • H. 

      Functional, useable GI tract

    • I. 

      Not desired by pt/gaurdian

    • J. 

      During end of life nutrition support

    • K. 

      Risks exceed potential benefit (increased infection risk)

  • 2. 
    • A. 

      Massive bowel resection

    • B. 

      Diseases of the small intestine (leading to severe malabsorption)

    • C. 

      Radiation enteritis (after radiation cancer therapy)

    • D. 

      Intractable vomiting

    • E. 

      High dose chemotherapy or radiation

    • F. 

      Bone marrow transplant

    • G. 

      Moderate to severe pancreatitis

    • H. 

      Functional, useable GI tract

    • I. 

      Not desired by pt/gaurdian

    • J. 

      During end of life nutrition support

    • K. 

      Risks exceed potential benefit (increased infection risk)

  • 3. 
    PN nutrition is used for pts who can't maintain nutritional status via enteral nutrition (at risk for malnutrition if nothing is done).
    • A. 

      True

    • B. 

      False

  • 4. 
    PN nutrition does NOT provide complete nutrition to the pateint.
    • A. 

      True

    • B. 

      False

  • 5. 
    • A. 

      It is a route of access

    • B. 

      Infused into peripheral IV line

    • C. 

      The extended dwell catheter option requires large veins for 5-7 inch catheter

    • D. 

      Extended dwell catheter has to be changed more than peripheral IV

    • E. 

      Peripheral vein can NOT handle concentrated solutions

    • F. 

      Peripheral vein can handle high infusion rates

    • G. 

      Used when nutrient need is VERY high (little fat used)

    • H. 

      Used for short term (< 3 weeks)

    • I. 

      Can be used with abnormal lipid metabolism

    • J. 

      Can be used with fluid restriction

    • K. 

      Used in Peds as supplement to tube feed when enteral goals not met

    • L. 

      Maximum dextrose concentration for adults 10%, infant up to 12%

    • M. 

      Used to provide kcal

    • N. 

      Maximum 1.5gm/kg/d in a peripheral vein

    • O. 

      Maximum 3-5 % AA final concentration

    • P. 

      Maximum osmolality is 1000 mOsm/l

  • 6. 
    • A. 

      Solution is infused into a central vein

    • B. 

      Used an extended dwell catheter

    • C. 

      Multiple lumen catheters can be used to infuse medication, solution, draw blood (these increase infection risk)

    • D. 

      Single lumen can be used to infuse medications

    • E. 

      Can be used for short term and long term

    • F. 

      Short term is 1-6 weeks and uses subclavian central venous catheter

    • G. 

      Long term access is PICC only

    • H. 

      Long term access tunneled catheter, R atrial catheter, ports, PICC

    • I. 

      Ports (medport ect.) used for chemo

    • J. 

      Pts going home get tunnel cath and PICC (lowest infection risk) and more mobility

  • 7. 
    CHO in PN solutions is dextrose monohydrate and ranges from D5-D70 concentrations
    • A. 

      True

    • B. 

      False

  • 8. 
    CHO provides [black] kcal/gm parenterally?
  • 9. 
    CHO provides [black] kcal/gm enterally?
  • 10. 
    • A. 

      Final concentration 35% (D70)

    • B. 

      Final concentration 30% (D60)

    • C. 

      Final concentration 25% (D50)

  • 11. 
    • A. 

      Final concentration 35% (D70)

    • B. 

      Final concentration 30% (D60)

    • C. 

      Final concentration 25% (D50)

  • 12. 
    • A. 

      Critically-ill adult can handle max 5-6 mg/kg/min

    • B. 

      Critically-ill Peds can handle max 10 mg/kg/min

    • C. 

      100-150 gm/day CHO minimum for protein sparing

    • D. 

      Initiate peds at 4-6 mg/kg/min and increase up to max over 3-4 days

    • E. 

      Peds get about 40% kcal from CHO

    • F. 

      Excess glucose can cause decreased CO2 production

    • G. 

      Can tell excess glucose by: fasting gluc >200, increased serum osmolality, glucosuria (>2+)(criticall pts already high due to stress)

  • 13. 
    Protein provides 9 kcal/gm in parenteral nutrition solutions.
    • A. 

      True

    • B. 

      False

  • 14. 
    • A. 

      Standard AA

    • B. 

      Pediatric specific

    • C. 

      Specialized therapeutic

  • 15. 
    3-20% concentrations of protein are found in adult PN solution.
    • A. 

      True

    • B. 

      False

  • 16. 
    The most common adult protein PN solution concentration is 10%AA
    • A. 

      True

    • B. 

      False

  • 17. 
    • A. 

      Adults - 15-20% of kcal should come from protein

    • B. 

      Adults - 25-30% of kcal should come from protein

    • C. 

      Peds - 8-15% of kcal should come from protein

    • D. 

      Peds - 10-18% of kcal should come from protein

    • E. 

      Peds - provide 1.5-3.5 gm/kg/day protein to maintain nl growth

    • F. 

      Peds - provide 2.5-4 gm/kg/day protein to maintain nl growth

  • 18. 
    • A. 

      Azotemia

    • B. 

      Hyperammonemia

    • C. 

      Acidosis

    • D. 

      Increased BUN

    • E. 

      Increased creatinine

    • F. 

      Increased blood glucose

  • 19. 
    Some facilites don't count protein calories when calculating the kcal provided from a solution.
    • A. 

      True

    • B. 

      False

  • 20. 
    Nonprotein calorie - nitrogen ratio for unstressed adults is:
    • A. 

      150:1

    • B. 

      100:1

    • C. 

      80:1

    • D. 

      300:1

  • 21. 
    Nonprotein calorie - nitrogen ratio for stressed adults is:
    • A. 

      150:1

    • B. 

      100:1

    • C. 

      80:1

    • D. 

      300:1

  • 22. 
    Nonprotein calorie - nitrogen ratio for severely stressed adults is:
    • A. 

      150:1

    • B. 

      100:1

    • C. 

      80:1

    • D. 

      300:1

  • 23. 
    Calorie - nitrogen ratio for unstressed adults is:
    • A. 

      150:1

    • B. 

      100:1

    • C. 

      80:1

    • D. 

      300:1

  • 24. 
    Nonprotein calorie - nitrogen ratio for peds is:
    • A. 

      150-250:1

    • B. 

      100-150:1

    • C. 

      80-120:1

    • D. 

      300:1

  • 25. 
    • A. 

      It is used to meet essential fatty acid needs (EFA)

    • B. 

      Used to as an source for kcals (energy)

    • C. 

      Composed of aqueous solution of soybean or safflower oil with egg yolk phospholipid as emulsifer

    • D. 

      Composed of aqueous solution of olive or coconut oil with egg yolk phospholipid as emulsifer

  • 26. 
    • A. 

      10% kcal/d from fat will prevent EFA deficiency(~4% kcal/d from linoleic acid)

    • B. 

      20% kcal/d from fat will prevent EFA deficiency (~12% kcal/d from linoleic acid)

    • C. 

      500ml 10% fat emulsion 1-2x week meets EFA needs

    • D. 

      250ml 10% fat emulsion 1-2x week meets EFA needs

    • E. 

      30% kcal/d reduces risk of liver complications from high glucose TPN

    • F. 

      25% kcal/d reduces risk of liver complications from high glucose TPN

    • G. 

      Maximum kcal from fat per day is 60% (2.5gm/kg/d)

    • H. 

      Maximum kcal from fat per day is 55% (2.5gm/kg/d)

    • I. 

      Linoleic acid can be immunosuppressive ,kcal from fat 20-30% reduces this

    • J. 

      Linoleic acid can be immunosuppressive ,kcal from fat 25-35% reduces this

  • 27. 
    • A. 

      1.0 gm/kg/d prevents EFA deficiency

    • B. 

      0.5 gm/kg/d prevents EFA deficiency

    • C. 

      Usually provide 25-30% kcal from fat (sometimes up to 40%)

    • D. 

      Usually provide 20-30% kcal from fat (sometimes up to 40%)

    • E. 

      Use 0.5-1.0 gm/kg/d for peds with respiratory problems, hyperbilirubinemia, sepsis, thrombocytopenia

    • F. 

      Use 1-1.5 gm/kg/d for peds with respiratory problems, hyperbilirubinemia, sepsis, thrombocytopenia

  • 28. 
    For PN, a 10% lipid emulsion provides how many kcal/ml?
    • A. 

      1

    • B. 

      1.1

    • C. 

      10

    • D. 

      1.2

  • 29. 
    For PN, a 20% lipid emulsion provides how many kcal/ml?
    • A. 

      1.2

    • B. 

      2

    • C. 

      2.2

    • D. 

      20

  • 30. 
    For PN, a 30% lipid emulsion provides how many kcal/ml?
    • A. 

      3

    • B. 

      3.1

    • C. 

      2.5

    • D. 

      2.9

  • 31. 
    • A. 

      Due to its isotonicity (increase kcal without increasing osmolality)

    • B. 

      Increases CO2 production

    • C. 

      Decreases CO2 production

    • D. 

      Able to decrease glucose administration

    • E. 

      Able to increase glucose administration

  • 32. 
    • A. 

      Pts with abnormal lipid metabolism

    • B. 

      Pts with hyperlipidemias

    • C. 

      Pts with severe pancreatitis

    • D. 

      Severe egg allergies

    • E. 

      Blood coagulation disorders

    • F. 

      Immunosuppressed pts

    • G. 

      Bowel obstruction

  • 33. 
    • A. 

      Adults - serum triglycerides increase ^300-350mg/dl after 6 hours from infusion

    • B. 

      Adults - serum triglycerides increase ^200-250mg/dl after 6 hours from infusion

    • C. 

      Peds - serum triglycerides increase ^200mg/dl after 6 hours from infusion

    • D. 

      Peds - serum triglycerides increase ^300mg/dl after 6 hours from infusion

  • 34. 
    Use of  LCT (long chain triglycerides) can immunosupress the pt.
    • A. 

      True

    • B. 

      False

  • 35. 
    Use of MCT oil in PN infusions can immunosupress the pt.
    • A. 

      True

    • B. 

      False

  • 36. 
    Vitamin and mineral needs are less than the DRI when pt is feed parenterally because digestion/absorption is bypassed and everything is directly infused into the bloodstream. (no unabsorbed nutrients).
    • A. 

      True

    • B. 

      False

  • 37. 
    Vitamins are added to all liters of PN infusions given to a pt per day.
    • A. 

      True

    • B. 

      False

  • 38. 
    MVI given PN includes all vitamins
    • A. 

      True

    • B. 

      False

  • 39. 
    • A. 

      Available in 5 ml units

    • B. 

      Available in 10 ml units

    • C. 

      Infants less than 1 kg receive 30% of the unit

    • D. 

      Infants less than 1 kg receive 20% of the unit

    • E. 

      Infants 1-3 kg receive 55% of the unit

    • F. 

      Infants 1-3 kg receive 65% of the unit

    • G. 

      Infants/children greater than 3kg receive 90% of the unit

    • H. 

      Infants/children greater than 3kg receive 100% of the unit

  • 40. 
    Cystic Fibrosis pts need greater amounts of water soluble vitamins.
    • A. 

      True

    • B. 

      False

  • 41. 
    Renal patients with decreased urinary output need more water soluble vitamins
    • A. 

      True

    • B. 

      False

  • 42. 
    Whis is true regarding minerals and PN?
    • A. 

      Minerals are ordered as trace elements

    • B. 

      They include iron

    • C. 

      They exclude iron

    • D. 

      Zn, Cu, chromium, Mn standard in solution

    • E. 

      Se, Io are standard in solution

    • F. 

      Mn and chromium should be monitored for overload

    • G. 

      Zn and Cu should be monitored for overload

    • H. 

      Does is based on wt for pediatric pts under 30kg

    • I. 

      Does is based on wt for pediatric pts under 40kg

  • 43. 
    • A. 

      Standard includes Na, K, Mg, Ca, P, Cl

    • B. 

      Standard includes Na, K

    • C. 

      Added to all liters of solution

    • D. 

      Added to the 1st liter of solution

    • E. 

      Additional on top of standard K, Mg, and P are often ordered

    • F. 

      Additional on top of standard Na, K, Ca are often ordered

  • 44. 
    RDs should look at the pts peripheral IV order and recommend changes based on fluid provided via PN. 
    • A. 

      True

    • B. 

      False

  • 45. 
    Overhydration can adversely affect the heart and kidneys
    • A. 

      True

    • B. 

      False

  • 46. 
    • A. 

      Adult - max tolerated fluid qd is 3L

    • B. 

      Adult - max tolerated fluid qd is 4L

    • C. 

      Adult - nnl fluid amount given is 1.5-3L qd

    • D. 

      Adult - nnl fluid amount given is 1-2L qd

    • E. 

      Peds - radiat warmers & UV light tx ^ needs by 20-25%

    • F. 

      Peds - radiat warmers & UV light tx ^ needs by 25-30%

    • G. 

      Just meet the fluid needs with Peds

    • H. 

      Exceeding fluid needs is OK with Peds

  • 47. 
    • A. 

      Contain 500ml dextrose and 500ml AA

    • B. 

      Contain 250ml dextrose and 250ml AA

    • C. 

      Require fat emulsions piggy-backed

    • D. 

      Fat is included in the overall fluid count

    • E. 

      Fat is excluded from the overall fluid count

  • 48. 
    • A. 

      Contains dextrose, AA, and fat

    • B. 

      Contains dextrose, AA only

    • C. 

      Provides 4-7 kcal/kg/day from fat

    • D. 

      Provides 5-10 kcal/kg/day from fat

    • E. 

      Usually includes MVI, lytes, minerals.

    • F. 

      Not used with Peds due to ^ Ca need

    • G. 

      Used routinely with peds to decrease volume given

    • H. 

      Fat is included in the overall fluid count

    • I. 

      Fat is excluded from the overall fluid count

  • 49. 
    • A. 

      Adults - initiate at 25-50 ml/hr and ^ by 25-50 ml increments every 12-24 hours

    • B. 

      Adults - initiate at 25-50 ml/hr and ^ by 25-50 ml increments every 8 hours

    • C. 

      Adults - initiate at 35-60 ml/hr and ^ by 25-50 ml increments every 12-24 hours

    • D. 

      Adults - can be initiated based on grams of dextrose

    • E. 

      Child - initiate at 2/3 goal for stable child and advance slowly

    • F. 

      Child - initiate at 1/2 goal for stable child and advance slowly

    • G. 

      Infant - initiate at 30-35 kcal/kg/d with 5-7mg Glucose/kg/min, 2-3gm Protein/kg/d, 1gm lipid/kg/d and advance slowly

    • H. 

      Infant - initiate at 20-25 kcal/kg/d with 5-7mg Glucose/kg/min, 1-2gm Protein/kg/d, 1gm lipid/kg/d and advance slowly

    • I. 

      Cessation should be gradual to avoid hypoglycemic attack

    • J. 

      Cessation should be gradual to avoid hyperglycemic attack

  • 50. 
    • A. 

      Typically done overnight

    • B. 

      Done over 8-10 hour period

    • C. 

      Done over 12-15 hour period

    • D. 

      Not appropriate for children less than 3kg

    • E. 

      Appropriate for everyone including infants

    • F. 

      Used in hospitals only

    • G. 

      Common for home use

    • H. 

      Provides freedom from equipment

    • I. 

      Advance same as continuous method

    • J. 

      If switching from continuous to cyclic, decrease infusion time and ^ rate at once to desired time/rate

    • K. 

      If switching from continuous to cyclic, decrease infusion time and ^ rate gradually to desired time/rate

    • L. 

      Taper rate of infusion 1 hour before and after each infusion to prevent hypoglycemia

    • M. 

      Taper rate of infusion 2 hours before and after each infusion to prevent hypoglycemia