NHM 412 ENTERAL NUTRITION EXAM READY - VERIFIED QUESTIONS
AND ANSWERS - COMPREHENSIVE LATEST VERSION (2026/2027)
Q1: What is enteral nutrition (EN)?
ANSWER Enteral nutrition is the delivery of nutrients directly into the
gastrointestinal (GI) tract via a tube, bypassing the oral route, used when a
patient cannot meet nutritional needs by mouth but has a functional GI tract.
Q2: What is the primary indication for enteral nutrition?
ANSWER The primary indication is a functional GI tract in a patient who is
unable or unwilling to consume adequate nutrition orally to meet their metabolic
needs.
Q3: What is the guiding principle 'If the gut works, use it'?
ANSWER This principle states that as long as the GI tract is functioning, enteral
nutrition should be preferred over parenteral nutrition because it maintains gut
integrity, prevents bacterial translocation, and is safer and more cost-effective.
Q4: How does enteral nutrition differ from parenteral nutrition?
ANSWER Enteral nutrition delivers nutrients into the GI tract via a tube, while
parenteral nutrition delivers nutrients directly into the bloodstream via a central or
peripheral vein, bypassing the GI tract entirely.
Q5: What are the main advantages of enteral over parenteral nutrition?
ANSWER Advantages include maintenance of gut mucosal integrity, stimulation
of gut motility, reduced risk of bacterial translocation, lower cost, fewer infectious
complications, preservation of immune function, and physiologic nutrient delivery.
Q6: What are contraindications to enteral nutrition?
ANSWER Contraindications include complete bowel obstruction, severe
hemodynamic instability, high-output proximal fistulas, intractable vomiting or
diarrhea, paralytic ileus unresponsive to treatment, and short bowel syndrome
with insufficient absorptive surface.
Q7: What is the definition of malnutrition in the clinical setting?
, ANSWER Malnutrition is a state of nutrition in which a deficiency or excess of
energy, protein, and other nutrients causes measurable adverse effects on
tissue, body composition, function, and clinical outcomes.
Q8: What is the ASPEN definition of enteral nutrition?
ANSWER ASPEN (American Society for Parenteral and Enteral Nutrition)
defines enteral nutrition as the delivery of a nutritionally complete formula into the
stomach, duodenum, or jejunum via a tube.
Q9: What are the goals of enteral nutrition therapy?
ANSWER Goals include meeting caloric and protein requirements, maintaining
or improving nutritional status, supporting immune function, promoting wound
healing, preserving lean body mass, and reducing complications of malnutrition.
Q10: What patient populations most commonly require enteral nutrition?
ANSWER Common populations include critically ill ICU patients, neurological
patients with dysphagia (e.g., stroke, ALS), cancer patients, patients with GI
disorders (Crohn's disease, short bowel syndrome), surgical patients, and
premature infants.
Section 2: Nutritional Assessment and Screening
Q11: What tools are used for nutritional screening in hospitalized patients?
ANSWER Common tools include the Malnutrition Universal Screening Tool
(MUST), Nutritional Risk Screening 2002 (NRS-2002), Mini Nutritional
Assessment (MNA), and the Malnutrition Screening Tool (MST).
Q12: What is the NRS-2002 and when is it used?
ANSWER The Nutritional Risk Screening 2002 is a validated screening tool for
hospitalized patients. It assesses nutritional status impairment and disease
severity; a score ≥3 indicates nutritional risk requiring nutritional support.
Q13: What is the MUST screening tool?
ANSWER The Malnutrition Universal Screening Tool assesses BMI, unplanned
weight loss percentage, and acute disease effect to categorize patients as low,
medium, or high risk for malnutrition; it is primarily used in community settings.
Q14: What is a comprehensive nutritional assessment?
ANSWER It includes dietary intake history, anthropometric measurements
(weight, height, BMI, skin folds), biochemical data (albumin, prealbumin, CRP),
clinical examination (physical signs of deficiency), and functional assessment.
Q15: What is prealbumin (transthyretin) used for in nutrition assessment?
, ANSWER Prealbumin has a short half-life of 2-3 days, making it a more
sensitive marker of recent nutritional changes than albumin; however, it is also
an acute-phase reactant and decreases during inflammation regardless of
nutritional status.
Q16: Why is albumin a poor marker of acute nutritional status?
ANSWER Albumin has a long half-life (~20 days) and is an acute-phase
reactant; it decreases during inflammation and illness independent of nutritional
intake, making it unreliable for assessing acute changes in nutrition.
Q17: What does the Subjective Global Assessment (SGA) evaluate?
ANSWER The SGA evaluates weight change, dietary intake changes, GI
symptoms, functional capacity, and physical signs of malnutrition to classify
patients as well-nourished (A), mildly/moderately malnourished (B), or severely
malnourished (C).
Q18: What is the Global Leadership Initiative on Malnutrition (GLIM)
criteria?
ANSWER GLIM criteria for diagnosing malnutrition require at least one
phenotypic criterion (weight loss, low BMI, reduced muscle mass) AND one
etiologic criterion (reduced food intake/assimilation OR inflammation/disease
burden).
Q19: What role does C-reactive protein (CRP) play in nutrition assessment?
ANSWER CRP is an acute-phase protein that rises during inflammation and
illness; elevated CRP indicates that low albumin or prealbumin values may reflect
the inflammatory response rather than malnutrition, aiding clinical interpretation.
Q20: How is percent weight loss calculated and interpreted?
ANSWER % weight loss = [(Usual weight - Current weight) / Usual weight] ×
100. A loss of >5% in 1 month, >7.5% in 3 months, or >10% in 6 months is
considered clinically significant.
Q21: What is sarcopenia and how does it relate to enteral nutrition?
ANSWER Sarcopenia is the progressive loss of skeletal muscle mass and
strength associated with aging and illness. Enteral nutrition with adequate protein
helps prevent and treat sarcopenia by providing substrates for muscle protein
synthesis.
Q22: What is the Harris-Benedict equation used for?
ANSWER The Harris-Benedict equation estimates basal metabolic rate (BMR)
using weight, height, and age; it is then multiplied by activity and stress factors to
estimate total energy expenditure and guide caloric prescription.
AND ANSWERS - COMPREHENSIVE LATEST VERSION (2026/2027)
Q1: What is enteral nutrition (EN)?
ANSWER Enteral nutrition is the delivery of nutrients directly into the
gastrointestinal (GI) tract via a tube, bypassing the oral route, used when a
patient cannot meet nutritional needs by mouth but has a functional GI tract.
Q2: What is the primary indication for enteral nutrition?
ANSWER The primary indication is a functional GI tract in a patient who is
unable or unwilling to consume adequate nutrition orally to meet their metabolic
needs.
Q3: What is the guiding principle 'If the gut works, use it'?
ANSWER This principle states that as long as the GI tract is functioning, enteral
nutrition should be preferred over parenteral nutrition because it maintains gut
integrity, prevents bacterial translocation, and is safer and more cost-effective.
Q4: How does enteral nutrition differ from parenteral nutrition?
ANSWER Enteral nutrition delivers nutrients into the GI tract via a tube, while
parenteral nutrition delivers nutrients directly into the bloodstream via a central or
peripheral vein, bypassing the GI tract entirely.
Q5: What are the main advantages of enteral over parenteral nutrition?
ANSWER Advantages include maintenance of gut mucosal integrity, stimulation
of gut motility, reduced risk of bacterial translocation, lower cost, fewer infectious
complications, preservation of immune function, and physiologic nutrient delivery.
Q6: What are contraindications to enteral nutrition?
ANSWER Contraindications include complete bowel obstruction, severe
hemodynamic instability, high-output proximal fistulas, intractable vomiting or
diarrhea, paralytic ileus unresponsive to treatment, and short bowel syndrome
with insufficient absorptive surface.
Q7: What is the definition of malnutrition in the clinical setting?
, ANSWER Malnutrition is a state of nutrition in which a deficiency or excess of
energy, protein, and other nutrients causes measurable adverse effects on
tissue, body composition, function, and clinical outcomes.
Q8: What is the ASPEN definition of enteral nutrition?
ANSWER ASPEN (American Society for Parenteral and Enteral Nutrition)
defines enteral nutrition as the delivery of a nutritionally complete formula into the
stomach, duodenum, or jejunum via a tube.
Q9: What are the goals of enteral nutrition therapy?
ANSWER Goals include meeting caloric and protein requirements, maintaining
or improving nutritional status, supporting immune function, promoting wound
healing, preserving lean body mass, and reducing complications of malnutrition.
Q10: What patient populations most commonly require enteral nutrition?
ANSWER Common populations include critically ill ICU patients, neurological
patients with dysphagia (e.g., stroke, ALS), cancer patients, patients with GI
disorders (Crohn's disease, short bowel syndrome), surgical patients, and
premature infants.
Section 2: Nutritional Assessment and Screening
Q11: What tools are used for nutritional screening in hospitalized patients?
ANSWER Common tools include the Malnutrition Universal Screening Tool
(MUST), Nutritional Risk Screening 2002 (NRS-2002), Mini Nutritional
Assessment (MNA), and the Malnutrition Screening Tool (MST).
Q12: What is the NRS-2002 and when is it used?
ANSWER The Nutritional Risk Screening 2002 is a validated screening tool for
hospitalized patients. It assesses nutritional status impairment and disease
severity; a score ≥3 indicates nutritional risk requiring nutritional support.
Q13: What is the MUST screening tool?
ANSWER The Malnutrition Universal Screening Tool assesses BMI, unplanned
weight loss percentage, and acute disease effect to categorize patients as low,
medium, or high risk for malnutrition; it is primarily used in community settings.
Q14: What is a comprehensive nutritional assessment?
ANSWER It includes dietary intake history, anthropometric measurements
(weight, height, BMI, skin folds), biochemical data (albumin, prealbumin, CRP),
clinical examination (physical signs of deficiency), and functional assessment.
Q15: What is prealbumin (transthyretin) used for in nutrition assessment?
, ANSWER Prealbumin has a short half-life of 2-3 days, making it a more
sensitive marker of recent nutritional changes than albumin; however, it is also
an acute-phase reactant and decreases during inflammation regardless of
nutritional status.
Q16: Why is albumin a poor marker of acute nutritional status?
ANSWER Albumin has a long half-life (~20 days) and is an acute-phase
reactant; it decreases during inflammation and illness independent of nutritional
intake, making it unreliable for assessing acute changes in nutrition.
Q17: What does the Subjective Global Assessment (SGA) evaluate?
ANSWER The SGA evaluates weight change, dietary intake changes, GI
symptoms, functional capacity, and physical signs of malnutrition to classify
patients as well-nourished (A), mildly/moderately malnourished (B), or severely
malnourished (C).
Q18: What is the Global Leadership Initiative on Malnutrition (GLIM)
criteria?
ANSWER GLIM criteria for diagnosing malnutrition require at least one
phenotypic criterion (weight loss, low BMI, reduced muscle mass) AND one
etiologic criterion (reduced food intake/assimilation OR inflammation/disease
burden).
Q19: What role does C-reactive protein (CRP) play in nutrition assessment?
ANSWER CRP is an acute-phase protein that rises during inflammation and
illness; elevated CRP indicates that low albumin or prealbumin values may reflect
the inflammatory response rather than malnutrition, aiding clinical interpretation.
Q20: How is percent weight loss calculated and interpreted?
ANSWER % weight loss = [(Usual weight - Current weight) / Usual weight] ×
100. A loss of >5% in 1 month, >7.5% in 3 months, or >10% in 6 months is
considered clinically significant.
Q21: What is sarcopenia and how does it relate to enteral nutrition?
ANSWER Sarcopenia is the progressive loss of skeletal muscle mass and
strength associated with aging and illness. Enteral nutrition with adequate protein
helps prevent and treat sarcopenia by providing substrates for muscle protein
synthesis.
Q22: What is the Harris-Benedict equation used for?
ANSWER The Harris-Benedict equation estimates basal metabolic rate (BMR)
using weight, height, and age; it is then multiplied by activity and stress factors to
estimate total energy expenditure and guide caloric prescription.
