CNSC UPDATED 2026 EXAM SCRIPT QUESTIONS AND
ANSWERS RATED A+
✔✔What is the recommended dietary protein intake in acutely ill adult patients receiving
continuous renal replacement therapy (CRRT)?
1: 0.5-0.8 g/kg per day
2: 1.2-1.5 g/kg per day
3: 1.5-2 g/kg per day
4: 2.5-3 g/kg per day - ✔✔3: 1.5-2 g/kg per day
✔✔What are the protein requirements for a stable patient receiving peritoneal dialysis
(PD)?
1: 0.6-0.8 grams per kilogram per day
2: 1.2-1.3 grams per kilogram per day
3: 1.5-1.8 grams per kilogram per day
4: 2.0-2.2 grams per kilogram per day - ✔✔2: 1.2-1.3 grams per kilogram per day
✔✔Which of the following is NOT a cause of protein-energy malnutrition in a patient
with liver disease?
1: Malabsorption
2: Decreased caloric intake
3: Abnormal fuel metabolism
4: Reduced energy expenditure - ✔✔4: Reduced energy expenditure
✔✔Protein-energy malnutrition is most common in which of the following types of liver
disease?
1: Viral hepatitis
2: Cirrhosis
3: Hepatic steatosis
4: Nonalcoholic steatohepatitis (NASH) - ✔✔2: Cirrhosis
✔✔Patients with chronic heart failure are typically on a loop diuretic. These patients are
at risk for
1: hyperkalemia.
2: azotemia.
3: hypermagnesium.
4: hypoglycemia. - ✔✔Loop diuretics are known to cause electrolyte abnormalities as a
result of increased urine output. Specific disturbances include excess potassium and
magnesium excretion which can result in hypokalemia and hypomagnesemia. Loop
,diuretics are not associated with hypoglycemia. Azotemia can occur related to volume
depletion.
✔✔Hypoglycemia, requiring dextrose infusions to maintain euglycemia, is most likely to
occur in which type of liver disease?
1: Hepatic steatosis
2: Well-compensated cirrhosis
3: Decompensated cirrhosis
4: Fulminant hepatic failure - ✔✔Hypoglycemia is seen in the majority of patients with
fulminant hepatic failure and may result from impaired glycogenolysis, glycogenesis,
gluconeogenesis and hyperinsulinemia requiring aggressive glucose administration.
Patients are usually in a hypercatabolic state with an increase in energy expenditure
and can become rapidly malnourished.
✔✔In cirrhotic patients, which of the following should be implemented to assist in
avoiding fasting-associated starvation during the night?
1: Late evening snack
2: Nocturnal tube feeding
3: Branched-chain amino acids supplement
4: Nocturnal parenteral nutrition - ✔✔1: Late evening snack
✔✔Which of the following is an important indicator of protein-energy malnutrition in
chronic liver disease?
1: Jaundice
2: Muscle wasting
3: Elevated liver function tests
4: Hepatic encephalopathy - ✔✔2: Muscle wasting
✔✔Treatment for patients with overt hepatic encephalopathy who have impairments in
cognitive and neuromuscular function include all EXCEPT:
1: Correction of electrolyte abnormalities
2: Treatment with lactulose or other FDA approved medication
3: Meal pattern of 3 meals and 3 snacks
4: Diet low in total protein - ✔✔1: Correction of electrolyte abnormalities
a temporary protein restriction may be utilized until cause of the encephalopathy is
diagnosed and eliminated. In hepatorenal syndrome a modest reduction in protein can
be made on a temporary basis until renal function improves.
✔✔The highest prevalence and severity of weight loss is found in patients with which of
the following types of cancer?
,1: Lung and colon
2: Breast and ovarian
3: Prostate and testicular
4: Pancreatic and gastric - ✔✔4: Pancreatic and gastric
✔✔Which of the following best describes the benefit of megestrol acetate in patients
with cancer-associated cachexia?
1: Increase in lean muscle mass
2: Decreases the risk of thromboembolic events
3: Improves blood glucose control in diabetes mellitus
4: Improves appetite and ameliorates weight loss - ✔✔4: Improves appetite and
ameliorates weight loss
✔✔In the first 1 - 3 months after a bone marrow transplant the nutritional needs of a
patient are best met with
1: 20-25 kcal/kg daily with >= 1.5 g protein per kg body weight.
2: 20-25 kcal/kg daily with 80% of total calories from carbohydrate.
3: 30-35 kcal/kg daily with >= 1.5 g protein per kg body weight.
4: 30-35 kcal/kg daily with 80% of total calories from carbohydrate. - ✔✔3: 30-35 kcal/kg
daily with >= 1.5 g protein per kg body weight.
✔✔Supplementation with which of the following nutrients is routinely restricted during
the early stages following hematopoietic stem cell transplantation (HSCT)?
1: calcium
2: Folate
3: Iron
4: Vitamin B12 - ✔✔Blood product support is usually required before, during and
following HSCT with resultant iron overload. Iron overload may adversely affect overall
survival post-HSCT by increasing the likelihood of acute graft-versus-host disease,
blood stream infection, and sinusoidal obstruction syndrome of the liver.
✔✔Which of the following acute changes in the serum chemistry profile would be
expected in a patient who is experiencing tumor lysis syndrome(TLS)?
1: Hypercalcemia and hypomagnesemia
2: Hyperkalemia and hyperphosphatemia
3: Hypernatremia and hypermagnesemia
4: Hypocalcemia and hyperphosphatemia - ✔✔2: Hyperkalemia and
hyperphosphatemia
, ✔✔Which of the following best describes the treatment of diarrhea in inflammatory
bowel disease?
1: Cholestyramine is effective treatment for steatorrhea
2: Patients with diarrhea should be treated with prebiotics
3: Start antidiarrheal agents once infectious etiology is ruled out
4: Withhold pharmacological therapy until diarrhea exceeds 1 L/day - ✔✔3: Start
antidiarrheal agents once infectious etiology is ruled out
✔✔A patient with Crohn's disease that involves the distal ileum should be closely
monitored for malabsorption of
1: iron.
2: calcium.
3: vitamin B12.
4: folic acid. - ✔✔3: vitamin B12.
✔✔Which of the following is a major contributing factor in the development of metabolic
bone disease in patients with inflammatory bowel disease?
1: Corticosteroid use
2: Aluminum toxicity
3: Vitamin B12 deficiency
4: Oxalic acid deficiency - ✔✔1: Corticosteroid use
✔✔In patients with severe acute pancreatitis, the use of enteral nutrition via nasojejunal
feeding tube rather than parenteral nutrition is associated with
1: an increased incidence of hyperglycemia.
2: a lower risk of developing infectious complications.
3: a greater incidence of negative nitrogen balance.
4: a decreased frequency of pancreatic stimulation. - ✔✔2: a lower risk of developing
infectious complications.
✔✔A patient with chronic heart failure on high-dose furosemide is started on enteral
nutrition for an inability to consume adequate oral nutrition. Despite a slow
advancement to goal feeding rate, he suffers from electrolyte imbalance and peripheral
neuritis. Deficiency of which vitamin should be suspected in the cause of his symptoms?
1: Thiamin
2: Vitamin B12
3: Folate
4: Riboflavin - ✔✔1: Thiamin
ANSWERS RATED A+
✔✔What is the recommended dietary protein intake in acutely ill adult patients receiving
continuous renal replacement therapy (CRRT)?
1: 0.5-0.8 g/kg per day
2: 1.2-1.5 g/kg per day
3: 1.5-2 g/kg per day
4: 2.5-3 g/kg per day - ✔✔3: 1.5-2 g/kg per day
✔✔What are the protein requirements for a stable patient receiving peritoneal dialysis
(PD)?
1: 0.6-0.8 grams per kilogram per day
2: 1.2-1.3 grams per kilogram per day
3: 1.5-1.8 grams per kilogram per day
4: 2.0-2.2 grams per kilogram per day - ✔✔2: 1.2-1.3 grams per kilogram per day
✔✔Which of the following is NOT a cause of protein-energy malnutrition in a patient
with liver disease?
1: Malabsorption
2: Decreased caloric intake
3: Abnormal fuel metabolism
4: Reduced energy expenditure - ✔✔4: Reduced energy expenditure
✔✔Protein-energy malnutrition is most common in which of the following types of liver
disease?
1: Viral hepatitis
2: Cirrhosis
3: Hepatic steatosis
4: Nonalcoholic steatohepatitis (NASH) - ✔✔2: Cirrhosis
✔✔Patients with chronic heart failure are typically on a loop diuretic. These patients are
at risk for
1: hyperkalemia.
2: azotemia.
3: hypermagnesium.
4: hypoglycemia. - ✔✔Loop diuretics are known to cause electrolyte abnormalities as a
result of increased urine output. Specific disturbances include excess potassium and
magnesium excretion which can result in hypokalemia and hypomagnesemia. Loop
,diuretics are not associated with hypoglycemia. Azotemia can occur related to volume
depletion.
✔✔Hypoglycemia, requiring dextrose infusions to maintain euglycemia, is most likely to
occur in which type of liver disease?
1: Hepatic steatosis
2: Well-compensated cirrhosis
3: Decompensated cirrhosis
4: Fulminant hepatic failure - ✔✔Hypoglycemia is seen in the majority of patients with
fulminant hepatic failure and may result from impaired glycogenolysis, glycogenesis,
gluconeogenesis and hyperinsulinemia requiring aggressive glucose administration.
Patients are usually in a hypercatabolic state with an increase in energy expenditure
and can become rapidly malnourished.
✔✔In cirrhotic patients, which of the following should be implemented to assist in
avoiding fasting-associated starvation during the night?
1: Late evening snack
2: Nocturnal tube feeding
3: Branched-chain amino acids supplement
4: Nocturnal parenteral nutrition - ✔✔1: Late evening snack
✔✔Which of the following is an important indicator of protein-energy malnutrition in
chronic liver disease?
1: Jaundice
2: Muscle wasting
3: Elevated liver function tests
4: Hepatic encephalopathy - ✔✔2: Muscle wasting
✔✔Treatment for patients with overt hepatic encephalopathy who have impairments in
cognitive and neuromuscular function include all EXCEPT:
1: Correction of electrolyte abnormalities
2: Treatment with lactulose or other FDA approved medication
3: Meal pattern of 3 meals and 3 snacks
4: Diet low in total protein - ✔✔1: Correction of electrolyte abnormalities
a temporary protein restriction may be utilized until cause of the encephalopathy is
diagnosed and eliminated. In hepatorenal syndrome a modest reduction in protein can
be made on a temporary basis until renal function improves.
✔✔The highest prevalence and severity of weight loss is found in patients with which of
the following types of cancer?
,1: Lung and colon
2: Breast and ovarian
3: Prostate and testicular
4: Pancreatic and gastric - ✔✔4: Pancreatic and gastric
✔✔Which of the following best describes the benefit of megestrol acetate in patients
with cancer-associated cachexia?
1: Increase in lean muscle mass
2: Decreases the risk of thromboembolic events
3: Improves blood glucose control in diabetes mellitus
4: Improves appetite and ameliorates weight loss - ✔✔4: Improves appetite and
ameliorates weight loss
✔✔In the first 1 - 3 months after a bone marrow transplant the nutritional needs of a
patient are best met with
1: 20-25 kcal/kg daily with >= 1.5 g protein per kg body weight.
2: 20-25 kcal/kg daily with 80% of total calories from carbohydrate.
3: 30-35 kcal/kg daily with >= 1.5 g protein per kg body weight.
4: 30-35 kcal/kg daily with 80% of total calories from carbohydrate. - ✔✔3: 30-35 kcal/kg
daily with >= 1.5 g protein per kg body weight.
✔✔Supplementation with which of the following nutrients is routinely restricted during
the early stages following hematopoietic stem cell transplantation (HSCT)?
1: calcium
2: Folate
3: Iron
4: Vitamin B12 - ✔✔Blood product support is usually required before, during and
following HSCT with resultant iron overload. Iron overload may adversely affect overall
survival post-HSCT by increasing the likelihood of acute graft-versus-host disease,
blood stream infection, and sinusoidal obstruction syndrome of the liver.
✔✔Which of the following acute changes in the serum chemistry profile would be
expected in a patient who is experiencing tumor lysis syndrome(TLS)?
1: Hypercalcemia and hypomagnesemia
2: Hyperkalemia and hyperphosphatemia
3: Hypernatremia and hypermagnesemia
4: Hypocalcemia and hyperphosphatemia - ✔✔2: Hyperkalemia and
hyperphosphatemia
, ✔✔Which of the following best describes the treatment of diarrhea in inflammatory
bowel disease?
1: Cholestyramine is effective treatment for steatorrhea
2: Patients with diarrhea should be treated with prebiotics
3: Start antidiarrheal agents once infectious etiology is ruled out
4: Withhold pharmacological therapy until diarrhea exceeds 1 L/day - ✔✔3: Start
antidiarrheal agents once infectious etiology is ruled out
✔✔A patient with Crohn's disease that involves the distal ileum should be closely
monitored for malabsorption of
1: iron.
2: calcium.
3: vitamin B12.
4: folic acid. - ✔✔3: vitamin B12.
✔✔Which of the following is a major contributing factor in the development of metabolic
bone disease in patients with inflammatory bowel disease?
1: Corticosteroid use
2: Aluminum toxicity
3: Vitamin B12 deficiency
4: Oxalic acid deficiency - ✔✔1: Corticosteroid use
✔✔In patients with severe acute pancreatitis, the use of enteral nutrition via nasojejunal
feeding tube rather than parenteral nutrition is associated with
1: an increased incidence of hyperglycemia.
2: a lower risk of developing infectious complications.
3: a greater incidence of negative nitrogen balance.
4: a decreased frequency of pancreatic stimulation. - ✔✔2: a lower risk of developing
infectious complications.
✔✔A patient with chronic heart failure on high-dose furosemide is started on enteral
nutrition for an inability to consume adequate oral nutrition. Despite a slow
advancement to goal feeding rate, he suffers from electrolyte imbalance and peripheral
neuritis. Deficiency of which vitamin should be suspected in the cause of his symptoms?
1: Thiamin
2: Vitamin B12
3: Folate
4: Riboflavin - ✔✔1: Thiamin
