NSC 325 Exam Questions with Correct
Answer
Evidence-based Medicine (EBM) - Answer-EBM:
- apply literature/evidence to personal judgement and decision-making
The EBM Triad:
- Individual Clinical Expertise
- Best External Evidence
- Patient Values & Expectations
Clinical Question: PICO
- Patient/problem
- Intervention
- Comparison
- Outcome
RDN & the Healthcare System - Answer-- RDN member of interdisciplinary team;
maybe assisted by a NDTR
- Team members: Providers (MD/PA/NP, Pharmacist, RN, Speech, OT, PT,
Respiratory, etc.)
- Provider responsible for directing care
- Provider writes diet order
- RN: may complete nutrition screen
- NDTR: implements RDN plan
Nutrition Care Process - Answer-- Screening precedes the process - is not part of the
process
- Screening is required in most medical care setting EXCEPT in Ambulatory Care
- ADIME
--> Nutrition Assessment: A, B, C, D
- Diagnosis: P, E, S - nutrition root cause
--> Intake common problem
- Intervention:
-->Plan/Outcomes
- Monitoring
--> Evaluates success of intervention
- Evaluation
--> Determines need to adjust intervention
Anthropometric Data - Answer-- Height
- Weight:
--> Use current weight when the weight is within the IBW "range"
--> Use current weight when the weight is less than the IBW "range"
, --> Use current weight when using the Mifflin or BEE equations
--> Use upper IBW when the weight is > IBW "range"
Biochemical Data: Sensitivity & Specificity - Answer-- Basic Metabolic Panel
--> Sodium - fluid status, not sodium intake
--> Potassium - dietary intake can impact; kidney fx affects
--> Chloride - diet not really a factor; reflects acid/base/fluid status
--> Bicarbonate - diet not really a factor; reflects acid/base
--> Blood Urea Nitrogen - renal disease, decreases with malnutrition
--> Creatinine - renal disease & protein catabolism, decreases with malnutrition
--> Glucose - fasting > 125 indicates DM; assess for impact of inflammation and stress;
medications
--> Calcium - not related to dietary intake. If intake inadequate, body takes Ca+ from
bone
Comprehensive Metabolic Panel - Answer-- BMP +:
- LFTs (Liver Function Tests): liver inflammation
- alanine aminotransferase, alkaline phosphatase, aspartate aminotransferase
--> protein requirements may be altered
--> Maybe related to ETOH intake
- Bilirubin - decrease Cu & Mn intake with levels > 10
- Phosphorus - dietary factors affect
- Albumin/Tranferrin/Prealbumin - inadequate dietary intake/protein-calorie malnutrition;
non-nutritional: blood loss, hydration status, liver function, inflammatory response/stress
- Total protein - dietary factors affect
Refeeding Syndrome - Answer-- A serious syndrome consisting of metabolic
disturbances that occur as a result of reinstitution of nutrition to patients who are
starved/severely malnourished
- Common with initiation of nutrition support
- Check Phosphorus, K & Mg levels prior to initiation of nutrition support & in high risk
populations:
--> Chronic diseases associated with undernutrition
--> Unfed for 7-10 days
--> Alcohol abuse
--> Gastric bypass surgery
Nutritional Anemias - Answer-- Deficiency in size/number of RBCs
- Low H/H:
--> non-nutritional causes: blood loss, overhydration, medication usage
- Poor nutrition major cause
- Microcytic - iron deficiency; low hemoglobin & hematocrit
--> decreased MCV/MCHC
- Macrocytic - folate and/or B12
--> Increased MCV/MCHC
- Assess specific laboratory data = check B12 & folate levels
Answer
Evidence-based Medicine (EBM) - Answer-EBM:
- apply literature/evidence to personal judgement and decision-making
The EBM Triad:
- Individual Clinical Expertise
- Best External Evidence
- Patient Values & Expectations
Clinical Question: PICO
- Patient/problem
- Intervention
- Comparison
- Outcome
RDN & the Healthcare System - Answer-- RDN member of interdisciplinary team;
maybe assisted by a NDTR
- Team members: Providers (MD/PA/NP, Pharmacist, RN, Speech, OT, PT,
Respiratory, etc.)
- Provider responsible for directing care
- Provider writes diet order
- RN: may complete nutrition screen
- NDTR: implements RDN plan
Nutrition Care Process - Answer-- Screening precedes the process - is not part of the
process
- Screening is required in most medical care setting EXCEPT in Ambulatory Care
- ADIME
--> Nutrition Assessment: A, B, C, D
- Diagnosis: P, E, S - nutrition root cause
--> Intake common problem
- Intervention:
-->Plan/Outcomes
- Monitoring
--> Evaluates success of intervention
- Evaluation
--> Determines need to adjust intervention
Anthropometric Data - Answer-- Height
- Weight:
--> Use current weight when the weight is within the IBW "range"
--> Use current weight when the weight is less than the IBW "range"
, --> Use current weight when using the Mifflin or BEE equations
--> Use upper IBW when the weight is > IBW "range"
Biochemical Data: Sensitivity & Specificity - Answer-- Basic Metabolic Panel
--> Sodium - fluid status, not sodium intake
--> Potassium - dietary intake can impact; kidney fx affects
--> Chloride - diet not really a factor; reflects acid/base/fluid status
--> Bicarbonate - diet not really a factor; reflects acid/base
--> Blood Urea Nitrogen - renal disease, decreases with malnutrition
--> Creatinine - renal disease & protein catabolism, decreases with malnutrition
--> Glucose - fasting > 125 indicates DM; assess for impact of inflammation and stress;
medications
--> Calcium - not related to dietary intake. If intake inadequate, body takes Ca+ from
bone
Comprehensive Metabolic Panel - Answer-- BMP +:
- LFTs (Liver Function Tests): liver inflammation
- alanine aminotransferase, alkaline phosphatase, aspartate aminotransferase
--> protein requirements may be altered
--> Maybe related to ETOH intake
- Bilirubin - decrease Cu & Mn intake with levels > 10
- Phosphorus - dietary factors affect
- Albumin/Tranferrin/Prealbumin - inadequate dietary intake/protein-calorie malnutrition;
non-nutritional: blood loss, hydration status, liver function, inflammatory response/stress
- Total protein - dietary factors affect
Refeeding Syndrome - Answer-- A serious syndrome consisting of metabolic
disturbances that occur as a result of reinstitution of nutrition to patients who are
starved/severely malnourished
- Common with initiation of nutrition support
- Check Phosphorus, K & Mg levels prior to initiation of nutrition support & in high risk
populations:
--> Chronic diseases associated with undernutrition
--> Unfed for 7-10 days
--> Alcohol abuse
--> Gastric bypass surgery
Nutritional Anemias - Answer-- Deficiency in size/number of RBCs
- Low H/H:
--> non-nutritional causes: blood loss, overhydration, medication usage
- Poor nutrition major cause
- Microcytic - iron deficiency; low hemoglobin & hematocrit
--> decreased MCV/MCHC
- Macrocytic - folate and/or B12
--> Increased MCV/MCHC
- Assess specific laboratory data = check B12 & folate levels
