CNSC 2016

  1. The determination of heat production from the amount of oxygen consumed (VO2) and carbon dioxide produced (VCO2) is called what?      

    B.  Indirect calorimetry
  2. Which minerals are involved in carbohydrate metabolism?  

    D. Chromium, zinc
  3. The inability to aspirate blood from a central venous catheter is called what?        

    B. Withdrawal occlusion
  4. Which of the following does NOT demonstrate aseptic practice during central catheter placement?

    C. Clean gloves
  5. Which of the following is NOT an indication to use a thrombolytic agent to declot a catheter?

    A.  Flushes easily, and has blood return
  6. The most accurate laboratory assessment of vitamin D includes:

    B.  Total 25 hydroxy vitamin D level
  7. Gastric bypass patients are at risk of developing all of the following deficiencies except:

    D. Vitamin A
  8. What is the primary fuel source after traumatic injury?

    B. Amino Acids
  9. Which of the following is not a consequence of metabolic stress?
    A. Increased levels of plasma glucagon
    B. Low blood glucose levels C. Shifts in fluid balance
    D. Increased protein utilization
    B. Low blood glucose levels
  10. Which of the following medications are LEAST likely to cause diarrhea in tube fed patients?

    A. Oxycodone
  11. Which variable(s) listed below would preclude using enteral feedings?

    B. A gastric residual > 500 ml
  12. What is considered the gold standard for confirming correct placement of a blindly inserted enteral access device?                      

    C. Radiographic
  13. The term to identify an inadvertent connection between an enteral feeding system and a non-enteral system such as a vascular access device is called what?        

    B. Enteral misconnection
  14. Which of the following is an irreversible reaction?  

    B. Glucose-6-phosphate into glycogen
  15. How does acidic chime become neutralized in the duodenum?       

    A. Mixes with bicarbonate and fluids
  16. A patient with a tunneled catheter presents to the emergency department with local tenderness, purulent exudate and erythema at the catheter exit site in the absence of fever and leukocytosis. What is the likely diagnosis?      

    B. Tunnel site infection
  17. Which of the following amino acids must be present in an adult parenteral solution?        

    B. Tryptophan, phenylalanine, threonine, isoleucine
  18. Parenteral nutrition must be infused through an appropriate in line filter. Which of the following is true for 2 in 1 solutions and 3 in 1 solutions?      

    A. A 2 in 1 solution requires a 0.22 micron filter. A 3 in 1 solution requires a 1.2 micron filter
  19. Which antibiotic should never be administered within 48 hours of calcium containing products or solutions including TPN due to risk of a fatal precipitate forming: A. Metronidazole
    B. Vancomycin
    C. Linezolid
    D. Ceftriaxone
    CeftriaxoneThere have been fatal cases in neonates of a ceftriaxone-calcium precipitate and although no cases noted in adults, ceftriaxone should never be administered within a 48 hours of a calcium containing product or solution even through a separate IV line.
  20. Which 2 additives to a TPN are at highest cause for concern with regards to risk of incompatibility:           
    A. sodium and phosphate
    B. calcium and phosphate
    C. magnesium and phosphate
    D. potassium and phosphate
    calcium and phosphateThere were 2 cases of  calcium-phosphate precipitation in TPN which occurred in the 1980’s which highlighted concern for this interaction. A section of Trissel’s Handbook of Injectible Drugs discusses this potentially serious interaction.
  21. Cysteine should NOT be added to a neonatal TPN solution if:

    A. the patient is acidotic
  22. A risk factor for osteopenia of prematurity is:

    D. Prolonged TPN course
  23. The GIR (glucose infusion rate) for a neonate should be increased by no more than:        

    D. 1-2 mg/kg/min/day
  24. A 24 calorie/ounce formula at 150ml/kg/day in a 1200g baby provides:     

    A. 120 kcal/kg/day
  25. The American Academy of Pediatrics recommends all breastfed infants be supplemented with __ IU Vitamin D/day

    B. 400
  26. If a patient is at risk for developing refeeding syndrome, electrolyte abnormalities should be normalized and the nutrition support should be initiated at: 

    D. 25% of estimated calorie needs and advance to goal over 3-5 days
  27. Which of the following place a patient at risk for aspiration pneumonia?    

    A. Sedation
  28. According to the new 2009ASPEN Guidelines for Adult Critically Ill Patients, with an evidence level of B, glutamine should be added to enteral formulas for which patient population?    

    D. Burn, trauma and mixed ICU patients will benefit from supplementation
  29. Metabolic Acidosis is a bicarbonate depletion and the compensatory response is the following:    

    B. Increased ventilation rate/Increased HCO3
  30. There is approximately 700-800 grams of phosphate in the human body, what percentage is in the bone?           

    A. 85%
  31. According to the “ASPEN Enteral Nutrition Practice Guidelines, 2009”:“Transitional orders” for enteral nutrition (EN) delivery refer to:    
    A. The incremental decreases in EN formula volume over time as oral intake increases.
    B. The incremental increases in EN formula volume over time as oral intake decreases. C. The change in EN formula from hydrolyzed or semi-elemental to standard polymeric EN formula as the patient’s gastrointestinal function improves.
    D. The incremental decreases in parenteral nutrition volume over time as oral intake increases.
    A. The incremental decreases in EN formula volume over time as oral intake increases.
  32. A “Practice Recommendation” for hang time for EN formulas is which of the following:  
    A. Reconstituted powdered enteral formulas decanted into an open system may be safely hung up to eight hours. (4 hrs. is suggested) B. Administration sets for open systems should the changed every 48 hours. (24 hrs is suggested)
    C. Sterile, liquid EN formulas should be used in preference to powdered, reconstituted formulas whenever possible.
    D. Sterile, decanted formulas should have an 8 hour hang time for both adults and neonates. (8 hrs, adult, 4 hrs neonate)
    C. Sterile, liquid EN formulas should be used in preference to powdered, reconstituted formulas whenever possible.
  33. Arginine is termed “a conditionally essential amino acid” following trauma and surgery, and is necessary for:                       

    D. Both A and B
  34. Which of the following has not been shown to be an effective antioxidant?

    C. Vitamin B1 (thiamine)
  35. A potential complication of enteral nutrition is diarrhea, which is defined as:                     A.  >500mL stool every 8 hours
    B. 200-300mL stool every 8 hours
    C. > 3 stools per day for at least 2 consecutive days                  
    D. A and C only
    D. A and C only
  36. The following fluid should be used for J-tube flushes:

    C. Normal saline
  37. A TPN patient has been tolerating his/her goal solution for  >1 week, and is now started on dexamethasone. Labs checked the following morning reveal hyperglycemia and new onset hyponatremia, what adjustments should be made in the TPN?                      

    D. Regular insulin should be added to the TPN to cover hyperglycemia
  38. A promotility agent should be considered when a second gastric residual volume is greater than:             

    C. 300 ml
  39. What is the recommended dietary protein intake in acutely ill patients receiving continuous renal replacement therapy (CRRT)?       

    B. 1.5-2 g/kg
  40. Patients at risk for refeeding syndrome often require supplementation of

    A. thiamine.
Card Set
CNSC 2016
cnsc 2-16 jksrd