ASPEN Chapter Questions
Which of the following practices is most likely to succeed in improving oral nutrient
intake in patients with a prolonged history of weight loss due to poor intake, nausea,
and depressed appetite?
A. Providing a high-energy oral liquid supplement 3 times daily
B. Offering 6 small, low-fat meals daily
C. Ordering fiber-supplemented snacks 3 times daily
D. Planning primarily solid meals and limiting fluids - ANSWERB. Offering 6 small, low-
fat meals daily
Prolonged negative energy balance results in stomach's adaptive accommodation
function to decline. Three meals may cause fullness, nausea, slow gastric emptying.
Which of the following statements explains why fermentable fiber is a beneficial addition
to enteral formulas?
A. Colonic bacteria act on the fiber to produce SCFAs that provide an energy source to
the intestinal mucosa.
B. Colonic bacteria act on the fiber to produce SCFAs, which, in turn, exert trophic
effects on the intestinal mucosa.
C. Fermentable fiber may help control diarrhea by slowing gastric emptying.
D. All of the above. - ANSWERD. All of the above. Fermentable fibers (pectin, gums,
fructooligosaccharides [FOS]) are metabolized by colonic bacteria to produce SCFAs,
which provide a significant source of energy for & exerting trophic effects on intestinal
lining. Not recommended for diarrhea casued by C. diff.
Which of the following nutrients is added to rehydration liquids to promote water
absorption in patients with diarrhea?
A. Sodium and glucose
B. Amino acids
C. Long-chain fatty acids
D. Alcohol - ANSWERA Sodium and glucose. The presence of sodium in the lumen
facilitates glucose absorption. When more sodium is absorbed, more water from the
lumen is absorbed.
Which of the following is the largest component of total energy expenditure (TEE)?
A. RMR
B. Thermogenic effect of digestion
C. Physical activity
D. Metabolic stress - ANSWERA. RMR
RMR constitutes 60-75% of TEE. Thermogenic effect of digestion contributes no more
than 10%. Activity contributes 5-30%. Metabolic stress contributes less than 50%, with
the exception of burns and sepsis.
, Which of the following is the most commonly used method for assessing energy
expenditure?
A. Indirect calorimetry (IC)
B. Predictive equations
C. The reverse Fick equation
D. Doubly labeled water - ANSWERB. Predictive equations. IC is more accurate than
predictive equations, but us underused d/t equipment expense to purchase and operate;
and some pts cannot be measured for various technical/physiological reasons.
Which parameter is measured when using IC?
A. Heat loss
B. Catabolic rate
C. Gas exchange
D. Free energy balance - ANSWERC. Gas exchange. IC measures respiratory gas
exchange (the difference between inspired and expired oxygen and carbon dioxide).
Gas exchange data is converted to RMR using the Weir equation.
You are determining the energy intake target for a 53-year-old, critically ill, male patient
who is about to start enteral feeding. He is 170 cm in height and weighs 150 kg. His BMI
is 51.9 and his ideal body weight is 70 kg. Body temperature is 37.3 degrees Celsius
and minute ventilation is 12.5 L/min. Based on the 2016 ASPEN guideline for
calculating a goal energy intake for such a critically ill patient, what energy value would
you use as the basis for the feeding plan?
A. 1750 kcal/d (25 kcal/kg IBW)
B. 1225 kcal/d (70% of the calculated 25 kcal/kg IBW)
C. 2250 kcal/d (25 kcal/kg adjusted body weight)
D. 2615 kcal/d (Penn State equation) - ANSWERA. 1750 kcal/d (25 kcal/kg IBW). For
class III obesity (BMI > 40) an intake of 22-25 kcal/kg IBW is recommended. ASPEN
guidelines emphasize the kcal/kg method. (For all classes of obesity, energy goals
should not exceed 65%-70% of target energy expenditure measured by IC.)
Which of the following is true about the net chemical reaction of glucose catabolism?
A. Pyruvate is the final product.
B. Oxygen is required for adenosine triphosphate (ATP) synthesis.
C. Both water and carbon dioxide (CO2) are produced.
D. CO2 is produced but water is not.
E. Water is produced but CO2 is not. - ANSWERC. Both water & CO2 are produced.
Pyruvate is the final product of glycolysis.
Which of the following incorrectly pairs a metabolic process with its site of occurrence?
A. Glycolysis and cytosol.
B. Tricarboxylic acid (TCA) cycle & mitochondrial membrane.
C. ATP phosphorylation & cytosol & mitochondria.
D. Electron transport chain & mitochondrial membrane.
E. Oxidative decarboxylation of pyruvate & mithcondria. - ANSWERB. Tricarboxylic acid
(TCA) cycle & mitochondrial membrane. The TCA cycle is the metabolic reaction of cell
Which of the following practices is most likely to succeed in improving oral nutrient
intake in patients with a prolonged history of weight loss due to poor intake, nausea,
and depressed appetite?
A. Providing a high-energy oral liquid supplement 3 times daily
B. Offering 6 small, low-fat meals daily
C. Ordering fiber-supplemented snacks 3 times daily
D. Planning primarily solid meals and limiting fluids - ANSWERB. Offering 6 small, low-
fat meals daily
Prolonged negative energy balance results in stomach's adaptive accommodation
function to decline. Three meals may cause fullness, nausea, slow gastric emptying.
Which of the following statements explains why fermentable fiber is a beneficial addition
to enteral formulas?
A. Colonic bacteria act on the fiber to produce SCFAs that provide an energy source to
the intestinal mucosa.
B. Colonic bacteria act on the fiber to produce SCFAs, which, in turn, exert trophic
effects on the intestinal mucosa.
C. Fermentable fiber may help control diarrhea by slowing gastric emptying.
D. All of the above. - ANSWERD. All of the above. Fermentable fibers (pectin, gums,
fructooligosaccharides [FOS]) are metabolized by colonic bacteria to produce SCFAs,
which provide a significant source of energy for & exerting trophic effects on intestinal
lining. Not recommended for diarrhea casued by C. diff.
Which of the following nutrients is added to rehydration liquids to promote water
absorption in patients with diarrhea?
A. Sodium and glucose
B. Amino acids
C. Long-chain fatty acids
D. Alcohol - ANSWERA Sodium and glucose. The presence of sodium in the lumen
facilitates glucose absorption. When more sodium is absorbed, more water from the
lumen is absorbed.
Which of the following is the largest component of total energy expenditure (TEE)?
A. RMR
B. Thermogenic effect of digestion
C. Physical activity
D. Metabolic stress - ANSWERA. RMR
RMR constitutes 60-75% of TEE. Thermogenic effect of digestion contributes no more
than 10%. Activity contributes 5-30%. Metabolic stress contributes less than 50%, with
the exception of burns and sepsis.
, Which of the following is the most commonly used method for assessing energy
expenditure?
A. Indirect calorimetry (IC)
B. Predictive equations
C. The reverse Fick equation
D. Doubly labeled water - ANSWERB. Predictive equations. IC is more accurate than
predictive equations, but us underused d/t equipment expense to purchase and operate;
and some pts cannot be measured for various technical/physiological reasons.
Which parameter is measured when using IC?
A. Heat loss
B. Catabolic rate
C. Gas exchange
D. Free energy balance - ANSWERC. Gas exchange. IC measures respiratory gas
exchange (the difference between inspired and expired oxygen and carbon dioxide).
Gas exchange data is converted to RMR using the Weir equation.
You are determining the energy intake target for a 53-year-old, critically ill, male patient
who is about to start enteral feeding. He is 170 cm in height and weighs 150 kg. His BMI
is 51.9 and his ideal body weight is 70 kg. Body temperature is 37.3 degrees Celsius
and minute ventilation is 12.5 L/min. Based on the 2016 ASPEN guideline for
calculating a goal energy intake for such a critically ill patient, what energy value would
you use as the basis for the feeding plan?
A. 1750 kcal/d (25 kcal/kg IBW)
B. 1225 kcal/d (70% of the calculated 25 kcal/kg IBW)
C. 2250 kcal/d (25 kcal/kg adjusted body weight)
D. 2615 kcal/d (Penn State equation) - ANSWERA. 1750 kcal/d (25 kcal/kg IBW). For
class III obesity (BMI > 40) an intake of 22-25 kcal/kg IBW is recommended. ASPEN
guidelines emphasize the kcal/kg method. (For all classes of obesity, energy goals
should not exceed 65%-70% of target energy expenditure measured by IC.)
Which of the following is true about the net chemical reaction of glucose catabolism?
A. Pyruvate is the final product.
B. Oxygen is required for adenosine triphosphate (ATP) synthesis.
C. Both water and carbon dioxide (CO2) are produced.
D. CO2 is produced but water is not.
E. Water is produced but CO2 is not. - ANSWERC. Both water & CO2 are produced.
Pyruvate is the final product of glycolysis.
Which of the following incorrectly pairs a metabolic process with its site of occurrence?
A. Glycolysis and cytosol.
B. Tricarboxylic acid (TCA) cycle & mitochondrial membrane.
C. ATP phosphorylation & cytosol & mitochondria.
D. Electron transport chain & mitochondrial membrane.
E. Oxidative decarboxylation of pyruvate & mithcondria. - ANSWERB. Tricarboxylic acid
(TCA) cycle & mitochondrial membrane. The TCA cycle is the metabolic reaction of cell
