CNSC FINAL EXAM 2026 ACTUAL QUESTIONS AND
ANSWERS RATED A+
✔✔In an older adult who requires long term EN, which of the following complications is
most often overlooked?
1: Tube leaking
2: Constipation
3: Decreased urine output
4: Skin problems at tube site - ✔✔3: Decreased urine output
✔✔Vitamin D (25, hydroxyvitamin D) deficiency is defined as a serum level of less than
1: 100 ng/mL.
2: 20 ng/mL.
3: 50 ng/mL.
4: 120 ng/mL. - ✔✔2: 20 ng/mL.
✔✔Vitamin D (25, hydroxyvitamin D) deficiency can manifest as
1: muscle weakness.
2: decreased production and excretion of parathyroid hormone (PTH) levels.
3: hypotension.
4: less than normal serum lipid levels. - ✔✔1: muscle weakness.
✔✔Which of the following is the hallmark of frailty seen with older adults?
1: Sarcopenia
2: Chronic inflammation
3: Dementia
4: Chronic disease - ✔✔1: Sarcopenia
✔✔Which of the following complications of enteral nutrition (EN) is the most potentially
dangerous in the older adult?
1: Diarrhea
2: Abdominal distension
3: Leaking around the enterostomy tube insertion site
4: Aspiration - ✔✔4: Aspiration
✔✔A 75 year old male with history of aspiration pneumonia who was previously
deemed unsafe for an oral diet is now experiencing aspiration while receiving
continuous enteral nutrition via his percutaneous endoscopic gastrostomy (PEG) tube.
Which of the following long-term feeding options would be the most appropriate?
,1: Peipheral parenteral nutrition (PN)
2: Central parenteral nutrition (PN)
3: Nasojejunostomy tube placement
4: Percutaneous endoscopic jejunostomy (PEJ) feeding - ✔✔4: Percutaneous
endoscopic jejunostomy (PEJ) feeding
✔✔An older adult patient without IV access requires strict bowel rest and PN for 6
weeks. Which of the following vascular access devices should be employed?
1: A port
2: Peripherally inserted central catheter (PICC)
3: Small bore antecubital peripheral access
4: Intra-jugular (IJ) central venous catheter - ✔✔2: Peripherally inserted central catheter
(PICC)
✔✔According to the 2012 National Inpatient Sample (NIS) of hospital discharges, what
percentage of older adults greater than 65 years old, were diagnosed with malnutrition?
1: 10-20%
2: 30-40%
3: 50-60%
4: 70-80% - ✔✔According to the 2012 NIS, 34.8% of hospitalized patients greater than
65 years old were discharged with malnutrition coded as a diagnosis.
✔✔Which of the following represents the core set of clinical and functional status
elements which form the foundation of the comprehensive assessment for all residents
of long-term care facilities certified to participate in Medicare or Medicaid?
1: Minimum Data Set (MDS)
2: Resident Assessment Protocols (RAP)
3: UtilizationGuidelines
4: Trigger Legend - ✔✔1: Minimum Data Set (MDS)
✔✔Which one of the following vitamin deficiencies is most likely to occur in an older
adult who consumes alcohol on a regular basis?
1: Vitamin K
2: Vitamin B9
3: Vitamin D
4: Vitamin B1 - ✔✔4: Vitamin B1
✔✔Which of the following medications is most likely to contribute to hyponatremia in an
older adult?
,1: Hydrochlorothiazide
2: Amlodipine
3: Warfarin
4: Simvastatin - ✔✔Thiazide or thiazide-like diuretics are the most common causative
agent associated with diuretic-induced hyponatremia.
✔✔An older adult nursing home resident with a history of constipation has a newly
placed percutaneous endoscopic gastrostomy (PEG) tube. Which of the following fiber
formulas would most likely be the best choice?
1: Concentrated 2 kcal/mL formula
2: Standard 1 kcal/mL formula
3: High protein 1 kcal/mLformula
4: Elemental 1.5 kcal/mL formula - ✔✔2: Standard 1 kcal/mL formula
✔✔An assessment of functional status may aid in determining nutrition risk. Which of
the following provides an assessment of functional status?
1: Intelligence quotient exam
2: Handgrip strength assessment
3: Measurement of fat mass
4: Visual exam - ✔✔2: Handgrip strength assessment
✔✔Which of the following vitamin considerations is most important in an older adult
receiving a total nutrient admixture (3-in-1) parenteral nutrition (PN) as well as
anticoagulation (Warfarin) therapy?
1: Vitamin K
2: Vitamin E
3: Vitamin C
4: Vitamin B1 - ✔✔1: Vitamin K
✔✔Enteral nutrition formulas supplemented with fiber are often used in the older adult
to prevent constipation. Which of the following considerations is most important if this
type of formula is chosen?
1: Addition of a prokinetic agent
2: Avoidance of lactose
3: Lowering feeding rate to prevent bloating
4: Provision of adequate water - ✔✔4: Provision of adequate water
, ✔✔Which of the following is most likely to be observed first, for a patient with no history
of diabetes who is overfed?
1: Hepatobiliary effects
2: Hyperglycemia
3: Weight gain
4: Accumulation of carbon dioxide - ✔✔2: Hyperglycemia
✔✔Which of the following is most likely to occur as the result of an age-related
functional change in the gastrointestinal (GI) tract?
1: Increased anorectal tone
2: Decreased vitamin A absorption
3: Increased calcium absorption
4: Decreased gastric emptying - ✔✔4: Decreased gastric emptying
✔✔The Plan/Do/Study/Act (PDSA) cycle is employed as a
1: quality improvement problem-solving model.
2: medical nutrition protocol.
3: tool for measuringhand grip strength among institutions.
4: benchmarking tool for standardizing days of TPN therapy to compare institutions. -
✔✔1: quality improvement problem-solving model.
✔✔Which of the following medication classes used in the older adult population will
LEAST likely contribute to anorexia?
1: Narcotic analgesics
2: Antihistamines
3: Histamine receptor antagonists
4: Antihypertensive agents - ✔✔2: Antihistamines
✔✔A patient receiving digoxin and parenteral nutrition who is experiencing signs of
digoxin toxicity should be assessed for
1: hypokalemia.
2: hypocalcemia.
3: hypermagnesemia.
4: hypophosphatemia. - ✔✔Digoxin has a narrow therapeutic range. In patients with
hypokalemia or hypomagnesemia, digoxin toxicity may occur despite therapeutic
concentrations because depletion of potassium of magnesium will sensitize the
myocardium to digoxin.
ANSWERS RATED A+
✔✔In an older adult who requires long term EN, which of the following complications is
most often overlooked?
1: Tube leaking
2: Constipation
3: Decreased urine output
4: Skin problems at tube site - ✔✔3: Decreased urine output
✔✔Vitamin D (25, hydroxyvitamin D) deficiency is defined as a serum level of less than
1: 100 ng/mL.
2: 20 ng/mL.
3: 50 ng/mL.
4: 120 ng/mL. - ✔✔2: 20 ng/mL.
✔✔Vitamin D (25, hydroxyvitamin D) deficiency can manifest as
1: muscle weakness.
2: decreased production and excretion of parathyroid hormone (PTH) levels.
3: hypotension.
4: less than normal serum lipid levels. - ✔✔1: muscle weakness.
✔✔Which of the following is the hallmark of frailty seen with older adults?
1: Sarcopenia
2: Chronic inflammation
3: Dementia
4: Chronic disease - ✔✔1: Sarcopenia
✔✔Which of the following complications of enteral nutrition (EN) is the most potentially
dangerous in the older adult?
1: Diarrhea
2: Abdominal distension
3: Leaking around the enterostomy tube insertion site
4: Aspiration - ✔✔4: Aspiration
✔✔A 75 year old male with history of aspiration pneumonia who was previously
deemed unsafe for an oral diet is now experiencing aspiration while receiving
continuous enteral nutrition via his percutaneous endoscopic gastrostomy (PEG) tube.
Which of the following long-term feeding options would be the most appropriate?
,1: Peipheral parenteral nutrition (PN)
2: Central parenteral nutrition (PN)
3: Nasojejunostomy tube placement
4: Percutaneous endoscopic jejunostomy (PEJ) feeding - ✔✔4: Percutaneous
endoscopic jejunostomy (PEJ) feeding
✔✔An older adult patient without IV access requires strict bowel rest and PN for 6
weeks. Which of the following vascular access devices should be employed?
1: A port
2: Peripherally inserted central catheter (PICC)
3: Small bore antecubital peripheral access
4: Intra-jugular (IJ) central venous catheter - ✔✔2: Peripherally inserted central catheter
(PICC)
✔✔According to the 2012 National Inpatient Sample (NIS) of hospital discharges, what
percentage of older adults greater than 65 years old, were diagnosed with malnutrition?
1: 10-20%
2: 30-40%
3: 50-60%
4: 70-80% - ✔✔According to the 2012 NIS, 34.8% of hospitalized patients greater than
65 years old were discharged with malnutrition coded as a diagnosis.
✔✔Which of the following represents the core set of clinical and functional status
elements which form the foundation of the comprehensive assessment for all residents
of long-term care facilities certified to participate in Medicare or Medicaid?
1: Minimum Data Set (MDS)
2: Resident Assessment Protocols (RAP)
3: UtilizationGuidelines
4: Trigger Legend - ✔✔1: Minimum Data Set (MDS)
✔✔Which one of the following vitamin deficiencies is most likely to occur in an older
adult who consumes alcohol on a regular basis?
1: Vitamin K
2: Vitamin B9
3: Vitamin D
4: Vitamin B1 - ✔✔4: Vitamin B1
✔✔Which of the following medications is most likely to contribute to hyponatremia in an
older adult?
,1: Hydrochlorothiazide
2: Amlodipine
3: Warfarin
4: Simvastatin - ✔✔Thiazide or thiazide-like diuretics are the most common causative
agent associated with diuretic-induced hyponatremia.
✔✔An older adult nursing home resident with a history of constipation has a newly
placed percutaneous endoscopic gastrostomy (PEG) tube. Which of the following fiber
formulas would most likely be the best choice?
1: Concentrated 2 kcal/mL formula
2: Standard 1 kcal/mL formula
3: High protein 1 kcal/mLformula
4: Elemental 1.5 kcal/mL formula - ✔✔2: Standard 1 kcal/mL formula
✔✔An assessment of functional status may aid in determining nutrition risk. Which of
the following provides an assessment of functional status?
1: Intelligence quotient exam
2: Handgrip strength assessment
3: Measurement of fat mass
4: Visual exam - ✔✔2: Handgrip strength assessment
✔✔Which of the following vitamin considerations is most important in an older adult
receiving a total nutrient admixture (3-in-1) parenteral nutrition (PN) as well as
anticoagulation (Warfarin) therapy?
1: Vitamin K
2: Vitamin E
3: Vitamin C
4: Vitamin B1 - ✔✔1: Vitamin K
✔✔Enteral nutrition formulas supplemented with fiber are often used in the older adult
to prevent constipation. Which of the following considerations is most important if this
type of formula is chosen?
1: Addition of a prokinetic agent
2: Avoidance of lactose
3: Lowering feeding rate to prevent bloating
4: Provision of adequate water - ✔✔4: Provision of adequate water
, ✔✔Which of the following is most likely to be observed first, for a patient with no history
of diabetes who is overfed?
1: Hepatobiliary effects
2: Hyperglycemia
3: Weight gain
4: Accumulation of carbon dioxide - ✔✔2: Hyperglycemia
✔✔Which of the following is most likely to occur as the result of an age-related
functional change in the gastrointestinal (GI) tract?
1: Increased anorectal tone
2: Decreased vitamin A absorption
3: Increased calcium absorption
4: Decreased gastric emptying - ✔✔4: Decreased gastric emptying
✔✔The Plan/Do/Study/Act (PDSA) cycle is employed as a
1: quality improvement problem-solving model.
2: medical nutrition protocol.
3: tool for measuringhand grip strength among institutions.
4: benchmarking tool for standardizing days of TPN therapy to compare institutions. -
✔✔1: quality improvement problem-solving model.
✔✔Which of the following medication classes used in the older adult population will
LEAST likely contribute to anorexia?
1: Narcotic analgesics
2: Antihistamines
3: Histamine receptor antagonists
4: Antihypertensive agents - ✔✔2: Antihistamines
✔✔A patient receiving digoxin and parenteral nutrition who is experiencing signs of
digoxin toxicity should be assessed for
1: hypokalemia.
2: hypocalcemia.
3: hypermagnesemia.
4: hypophosphatemia. - ✔✔Digoxin has a narrow therapeutic range. In patients with
hypokalemia or hypomagnesemia, digoxin toxicity may occur despite therapeutic
concentrations because depletion of potassium of magnesium will sensitize the
myocardium to digoxin.
