Clinical Nutrition Exam 4 Questions &
Answers (Grade A+)
Discuss the impact of illness on the risk of malnutrition. -
correct answer ✅Illness leads to malnutrition by:
Reduced food intake due to nausea, difficulty chewing, depression,
inability to feed
Altered digestion/absorption due to GI inflammation, medications
Altered nutrient metabolism/excretion due to muscle wasting,
dehydration, immobilization, bleed
Identify the four steps in the development of medical nutrition
therapy for a patient. -
correct answer ✅Four steps - each documented in medical records
o Nutrition assessment and reassessment - use data from screening
o Nutrition diagnosis - identify existing and potential nutrition
problems
o Each nutritional problems receive a separate diagnosis using a
PES statement
o Nutrition intervention - evidence based
o Aim to correct dietary & lifestyle practices that interfere with
nutritional status or health
Target cause of problem identified by nutrition diagnosis (when
possible)
o Intervention can include
,Clinical Nutrition Exam 4 Questions &
Answers (Grade A+)
Counseling/education about appropriate diet and lifestyle practices
Change in medication or treatment
Adjust meals and/or service offered to patient
o Successful intervention must consider individuals food habits,
lifestyle and personal factors
Goals include measurable patient outcomes - lab or
anthropometric result (BMI, blood glucose)
o Nutrition monitoring and evaluation - periodically
o Updated assessment data and diagnosis as required
Adjust goals/outcomes as appropriate
o Must be flexible plan - adapt as needed
o If progress slow or patient unable or unwilling to make changes -
redesign care plan
New plan should include motivational techniques or additional
education
o May need to wait until patient is more
o Identify the problem, etiology and symptom in a PES statement.
# Problem, Etiology (cause), Symptom (evidence)
o Example - Unintended weight gain (P) related to long-term use of
corticosteroids (E) as evidenced by an involuntary weight gain of 10
% of body weight over the past 6 months (S).
,Clinical Nutrition Exam 4 Questions &
Answers (Grade A+)
Discuss the data collected in the nutrition screening and its role in
determining dietary requirements. -
correct answer ✅Assess patient within 24 hrs of admission to
identify malnourish (or risk of)
Screen for protein-energy malnutrition (PEM) or other nutrient
issues
• Screen adequate to identify patients requiring nutrition care - 10-
15 min screen
Information collected varies by patient population, facility &
medical problem
• Admission data - age, diagnosis, severity
• Anthropometric data - height, weight (BMI), weight loss (muscle
or fat)
o Unintentional weight loss of 2% 1 wk, 5% 1 month, 7.5% 3
months, 10% 6 months - nutritional risk
• Functional assessment date - handgrip strength (wasting),
weakness, mobility
• Historical information - disease history, medications, dietary
restrictions, dementia, nutrition support
• Laboratory results - blood tests
o Transferrin - iron status ( indicated reduced iron)
, Clinical Nutrition Exam 4 Questions &
Answers (Grade A+)
o Transthyretin & retinol-binding protein - rapidly during protein-
energy malnutrition (change quickly)
o Albumin - stable protein only after prolonged protein-energy
malnutrition (very slow to change)
o C-reactive peptide - elevated marker of inflammation/infection
• Signs and symptoms - appetite, intake issues, edema, sores
Lab tests to look for malnutrition -
correct answer ✅Laboratory results - blood tests
o Transferrin - iron status ( indicated reduced iron)
o Transthyretin & retinol-binding protein - rapidly during protein-
energy malnutrition (change quickly)
o Albumin - stable protein only after prolonged protein-energy
malnutrition (very slow to change)
o C-reactive peptide - elevated marker of inflammation/infection
• Signs and symptoms - appetite, intake issues, edema, sores
Explain the 3 categories of nutritional diagnosis. -
correct answer ✅Intake - inadequate or excessive ingestion of
nutrients
Answers (Grade A+)
Discuss the impact of illness on the risk of malnutrition. -
correct answer ✅Illness leads to malnutrition by:
Reduced food intake due to nausea, difficulty chewing, depression,
inability to feed
Altered digestion/absorption due to GI inflammation, medications
Altered nutrient metabolism/excretion due to muscle wasting,
dehydration, immobilization, bleed
Identify the four steps in the development of medical nutrition
therapy for a patient. -
correct answer ✅Four steps - each documented in medical records
o Nutrition assessment and reassessment - use data from screening
o Nutrition diagnosis - identify existing and potential nutrition
problems
o Each nutritional problems receive a separate diagnosis using a
PES statement
o Nutrition intervention - evidence based
o Aim to correct dietary & lifestyle practices that interfere with
nutritional status or health
Target cause of problem identified by nutrition diagnosis (when
possible)
o Intervention can include
,Clinical Nutrition Exam 4 Questions &
Answers (Grade A+)
Counseling/education about appropriate diet and lifestyle practices
Change in medication or treatment
Adjust meals and/or service offered to patient
o Successful intervention must consider individuals food habits,
lifestyle and personal factors
Goals include measurable patient outcomes - lab or
anthropometric result (BMI, blood glucose)
o Nutrition monitoring and evaluation - periodically
o Updated assessment data and diagnosis as required
Adjust goals/outcomes as appropriate
o Must be flexible plan - adapt as needed
o If progress slow or patient unable or unwilling to make changes -
redesign care plan
New plan should include motivational techniques or additional
education
o May need to wait until patient is more
o Identify the problem, etiology and symptom in a PES statement.
# Problem, Etiology (cause), Symptom (evidence)
o Example - Unintended weight gain (P) related to long-term use of
corticosteroids (E) as evidenced by an involuntary weight gain of 10
% of body weight over the past 6 months (S).
,Clinical Nutrition Exam 4 Questions &
Answers (Grade A+)
Discuss the data collected in the nutrition screening and its role in
determining dietary requirements. -
correct answer ✅Assess patient within 24 hrs of admission to
identify malnourish (or risk of)
Screen for protein-energy malnutrition (PEM) or other nutrient
issues
• Screen adequate to identify patients requiring nutrition care - 10-
15 min screen
Information collected varies by patient population, facility &
medical problem
• Admission data - age, diagnosis, severity
• Anthropometric data - height, weight (BMI), weight loss (muscle
or fat)
o Unintentional weight loss of 2% 1 wk, 5% 1 month, 7.5% 3
months, 10% 6 months - nutritional risk
• Functional assessment date - handgrip strength (wasting),
weakness, mobility
• Historical information - disease history, medications, dietary
restrictions, dementia, nutrition support
• Laboratory results - blood tests
o Transferrin - iron status ( indicated reduced iron)
, Clinical Nutrition Exam 4 Questions &
Answers (Grade A+)
o Transthyretin & retinol-binding protein - rapidly during protein-
energy malnutrition (change quickly)
o Albumin - stable protein only after prolonged protein-energy
malnutrition (very slow to change)
o C-reactive peptide - elevated marker of inflammation/infection
• Signs and symptoms - appetite, intake issues, edema, sores
Lab tests to look for malnutrition -
correct answer ✅Laboratory results - blood tests
o Transferrin - iron status ( indicated reduced iron)
o Transthyretin & retinol-binding protein - rapidly during protein-
energy malnutrition (change quickly)
o Albumin - stable protein only after prolonged protein-energy
malnutrition (very slow to change)
o C-reactive peptide - elevated marker of inflammation/infection
• Signs and symptoms - appetite, intake issues, edema, sores
Explain the 3 categories of nutritional diagnosis. -
correct answer ✅Intake - inadequate or excessive ingestion of
nutrients
