ASPEN Practice Test 105 Questions and 100% Verified Correct Answers Guaranteed A+ At First Attempt A 24-year old woman is in the 10th week of her pregnancy. She has persistent nausea and vomiting for the past 6 weeks that has been associated with a 10% weight loss. Her nausea and vomiting is refractory to a 48 hour trial of anti-emetics and IV fluids. The decision to provide nutrition support is made to minimize further deterioration of the mother's nutritional status and possible negative effects on the fetus. What is the most appropriate initial nutrition therapy to implement?
- EN with isotonic formula via Nasogastric tube
- EN with isotonic formula via Gastrostomy tube
- EN with polymeric formula via Nasogastric tube
d. EN with polymeric formula via Gastrostomy tube - Correct Answer:c. EN with
polymeric formula via Nasogastric tube
A 60 year old female (height 152 cm, weight 45 kg) is receiving PN for a rectovaginal fistula. The PN formula consists of the following components: 70 grams protein, 400 grams dextrose, and 25 grams fat in total volume of 1,5 liters, including all electrolytes and additives, which is infused continuously over 24 hours daily. Which one of the following complications is she at greatest risk for developing?
- hypertriglyceridemia
- azotemia
- hyperglycemia
d. pulmonary edema - Correct Answer:c. hyperglycemia
A 60-year old female is admitted with a stroke and fails a swallowing evaluation. A nasogastric tube is placed, and the physician requests an isotonic formula. Which of the following caloric densities of enteral formula is isotonic?
- 1.0 kcal/ml
- 1.2 kcal/ml
- 1.5 kcal/ml
d. 2.0 kcal/ml - Correct Answer:a. 1.0 kcal/ml
A 65 year old female had complications associated with GI surgery, and was admitted to the intensive care unit with pneumonia and septic shock. After she became hemodynamically stable, she was started on parenteral nutrition secondary to a prolonged ileus. Prior to surgery, she was at her ideal weight. Currently her labs include albumin 2.0 mg/dl and creatinine 1.0 mg/dl. Her urine output is adequate. Which of the following best estimates her protein needs for initiation of parenteral nutrition therapy?
- 0.6 grams/kg
- 0.8 grams/kg
- 1.5 grams/kg
d. 2.5 grams/kg - Correct Answer:c. 1.5 grams/kg
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A 70 kg adult patient receiving PN providing 3000 kcal/day presents with mild to moderate elevations of serum aminotransferases and mild elevations of bilirubin and serum alkaline phosphatase. This patient is most likely exhibiting what type of PN- associated liver disease?
- hepatic steatosis
- cholestasis
- gallbladder sludging
d. fulminant hepatic failure - Correct Answer:a. hepatic steatosis
A 72-year old female with impaired renal function was prescribed sulfamethoxazole/trimethoprim for a urinary tract infection. What electrolyte disorder is MOST likely to occur?
- hypermagnesemia
- hyperkalemia
- hypercalcemia
d. hyperphosphatemia - Correct Answer:b. hyperkalemia
A critically ill 42 year old male status post small bowel resection for Crohn's disease is receiving PN for severe post-operative ileus with NG tube output of 2.5-3 liters per day.
He has the following ABG results: pH=7.49, PCO2=45 mm Hg, and serum
bicarbonate=34 mEq/L. What is the most appropriate PN intervention?
a. maintain current chloride:acetate ratio
b. increase chloride:acetate ratio
c. decrease chloride:acetate ratio
- decrease calorie content of PN - Correct Answer:b. increase chloride:acetate ratio
A long term parenteral nutrition patient begins to experience Parkinson-like symptoms.Which trace element toxicity is most likely to present with these symptoms?
- manganese
- copper
- zinc
d. selenium - Correct Answer:a. manganese
A long-term PN patient presents with involuntary movements, tremor, and rigidity.Which of the following etiologies may explain these symptoms?
- manganese deficiency
- manganese toxicity
- selenium deficiency
d. selenium toxicity - Correct Answer:b. manganese toxicity
A patient has an advanced directive stating a desire to forego medical technology, including nutrition and hydration, in order to prolong life. The patient is now in an irreversible vegetative state. In deciding whether to continue nutrition and hydration by
medical means, the patient's surrogate decision-maker must:
- consult with a lawyer regarding physician orders for life-sustaining treatment 2 / 3
- have a psychiatric evaluation in order to be declared competent to make decisions in
- honor the patient's expressed wish to withdraw nutrition and hydration by medical
the patient's care
meCorrect Answer:
- decide, based upon own values, whether or not to withdraw the patient's nutrition
and hydration by medical meCorrect Answer:- Correct Answer:c. honor the patient's expressed wish to withdraw nutrition and hydration by medical means
A patient is receiving enteral nutrition during her second trimester of pregnancy.Nutritional assessment data reflect an average maternal weight gain of 0.42 lbs per week, normal fetal growth, an albumin of 2,0 gm/dl, and a nitrogen balance of +2 grams/day. Based on the data provided, which of the following parameters is not useful in assessing the efficacy of enteral nutrition in pregnancy?
- maternal weight gain
- fetal growth
- serum albumin
d. nitrogen balance - Correct Answer:c. serum albumin
A patient receiving chronic PN therapy develops an intraluminal clot in his/her central venous access device. What is the most appropriate pharmacological intervention to clear this access device?
- heparin 100 units/ml
- alteplase 2 mg/2ml
- argatroban 350 mcg/kg
d. streptokinase 10,000 units - Correct Answer:b. alteplase 2 mg/2ml
A patient receiving PN has high ileostomy output. Which of the following changes to the PN prescription is most appropriate to recommend?
- increase sodium and increase fluid volume
- decrease water and decrease sodium
- increase sodium and decrease protein
- decrease sodium and increase fluid volume - Correct Answer:a. increase sodium
and increase fluid volume
A patient with acute kidney injury (AKI) who requires parenteral nutrition support would most likely benefit from a solution containing which of the following?
- essential amino acids only
- essential amino acids with arginine only
- essential amino acids and nonessential amino acids
- essential amino acids and branched-chain amino acids - Correct Answer:c. essential
amino acids and nonessential amino acids
A patient with end stage liver disease with refractory ascites awaiting liver transplantation is on PN due to intolerance to tube feeding. His sodium is 124 mEq/L. In addition to fluid restriction, which of the following changes to his PN prescription is most appropriate to recommend?
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