Pre Test TNT Ver.4.

0 Course, 20-21
Agustus 2022
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Soal Pre Test

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1. All of the following are manifestations of zinc deficiency EXCEPT:

A. Poor wound healing
B. Coagulation defects
C. Skin changes and typical facial and extremity rash
D. Alterations of taste and smell perception
E. Loss of hair .

Clear selection

2. All of the following are manifestations of selenium deficiency EXCEPT: 

A. Cardiomyopathy and congestive heart failure
B. Mental changes and confusion
C. Muscle cramps and myositis (inflammation of muscles)
D. A and B
E. None of the above

3. Which of the following general statements regarding micronutrients is true: 

A. Toxicity from administration of water-soluble vitamins does not occur even if the dose
administered is 10 times the Recommended Daily Allowance
B. Each trace element has a distinct function in the body and does not require the presence
of other trace elements
C. Serum trace element levels accurately reflect body stores and deficiency states
D. Routine monitoring of vitamin status is needed in all patients receiving enteral or
parenteral nutritional support.
E. Serves only functional role

4. Which statement is not true about malnutrition? 

A. Malnutrition is a continuum
B. Patients can be malnourished and yet present with adequate body composition
C. Obesity and undernutrition may co-exist
D. Considerable loss of body mass occurs before symptoms appear
E. Unrelated with outcome of disease.
5. Malnutrition affects which organ system? 
A. Cardiovascular
B. Gastrointestinal
C. Immune
D. Kidney
E. All are correct

6. Malnutrition-related complications include: 

A. Delayed wound healing, wound dehiscence, granulocytosis
B. Pressure ulcers, infection
C. Infection, sepsis, poor wound healing
D. Multiple organ dysfunction syndrome
E. Deep vein thrombosis

7. Hospital malnutrition is prevalent. Why is this so? 

A. Stress-related hypermetabolism increases nutritional requirements
B. Physicians are not aware that malnutrition is an issue
C. Nutrition intervention is frequently not provided
D. All of the above
E. None of the above

8. Which is not true about nutritional assessment? 

A. Useful clinical tools include Subjective Global Assessment
B. Anthropometry is an excellent parameter for assessing hospitalized patients
C. Recent dietary intake is considered
D. Considers the effects of illness or injury
E. GLIM focused on building a global consensus around core diagnostic criteria for
malnutrition in adults in clinical setting

9. The Subjective Global Assessment evaluates all of the following except: 

A. Weight change
B. Changes in dietary intake
C. Functional capacity
D. Triceps skinfold
E. Gatro-intesttinal symptoms

10. Biochemical data evaluated as part of the Subjective Global Assessment

includes which of the following? 
A. No biochemical data are evaluated
B. Serum albumin
C. Blood lipids
D. Total cholesterol
E. Blood Urea

11. Which of the following metabolic events is LEAST likely to be enhanced as

part of hypermetabolic response to stress? 
A. Lipogenesis
B. Gluconeogenesis
C. Acute-phase protein synthesis
D. Protein catabolism
E. Muscle breakdown

12. Fatty acid transport from the cytosol to the mitochondria require which of
the following compounds? 
A. Glycerol
B. Arginine
C. Carnitine
D. Amino acid-based carriers
E. Glycerol

13. Hypermetabolic stress increases requirements for which of the following

amino acids? 
A. Carnitine, arginine, valine
B. Glutamine, arginine, valine
C. Proline, valine, arginine
D. Leucine, glutamine, carnitine
E. Carnitine

14. To calculate energy needs in obese people, which weight could be used?
A. Current body weight
B. Ideal body weight
C. Adjusted body weight
D. B and C
E. Usual Body weight

15. Protein requirements vary according to the metabolic response to stress

and starvation. In calculating protein needs, which statement is true: 
A. Healthy human beings need 1.5 grams of protein/kg/day
B. Protein needs increase during simple starvation
C. SIRS does not affect protein requirements
D. Hypercatabolic patients may need as much as 2 g protein/kg/day
E. Protein requirements is not increase.

16. Enteral nutrition therapy is an option for which of the following? 

A. Patients whose GI tract is inaccessible
B. Critically ill patients with functioning GI tract
C. Post-surgical patients with functioning GI tract
D. B and C
E. None of above.

17. Which placement verification technique should be used with small-narrow

bore nasogastric tubes?
A. Blind placement at the bedside
B. Radiologic examination of chest or abdomen
C. Auscultation with air insufflation
D. Aspiration of gastric contents
E. Verification with endoscopic technique
18. Which of the following procedures can enhance the safety and comfort of
patients receiving nasogastric tube feeding? 
A. Properly taping the feeding tube to the nose to prevent tube migration
B. Checking initial tube placement with auscultation and aspiration of gastric contents
C. Selecting a small bore feeding tube made from biocompatible materials
D. Initiating small bowel feeding with full-strength at 100 mL/hour
E. Selecting a siliconized feeding tube.

19. When should early enteral nutrition be initiated?

A. Within the first hour after trauma
B. Not until bowel sounds are present
C. Independent of hemodynamic status
D. Within 24-72 hours post-injury
E. When the patient feels hungry

20. The protein in an enteral formula containing hydrolyzed protein has been
treated to 
A. Alter essential amino acid content
B. Break protein down to smaller peptides
C. Remove all allergenic substances
D. Digest protein completely to its constituent amino acids.
E. None of the above.

21. An EPA and antioxidant supplemented enteral formula is clinically shown

to help accomplish which of the following clinical goals in patients with
cancer? 
A. Stabilize weight loss
B. Maintain or prevent lean body mass loss
C. Ameliorate the cancer-induced metabolic changes
D. All of the above
E. None of the above

22. Which of the following is not an indication for parenteral nutrition? 

A. Non-functional or inaccessible gastrointestinal tract
B. High output intestinal fistula
C. Nothing per orem for three days in well nourished patients
D. Complete bowel obstruction
E. All of the above

23. Which of the following solutions is appropriate for delivery via peripheral
venous access? 
A. PN Solutions > 1000 mOsm/L
B. pH < 5 or pH > 9
C. Medications > 500 mOsm/L
D. PN solutions < 850 mOsm/L
E. PN solutions contain only glucose
24. Which of the following is not a potential metabolic complication of
parenteral nutrition? 
A. Hyperglycemia
B. Catheter embolus
C. Hypernatremia
D. Acid base imbalance
E. Refeeding syndrome

25. Studies of enteral nutrition in critically ill patients support which of the
following conclusions? 
A. Parenteral nutrition is associated with less septic shock than early enteral nutrition
B. Early enteral nutrition is associated with the same degree of severe complications as
parenteral nutrition
C. Mortality appears to be decreased when comparing enteral to parenteral nutrition
D. The window for early enteral nutrition is 0-70 hours after admission

26. What is an accepted definition for immune-modulating nutrients? 

A. Nutrients that are supplied enterally
B. Functional nutrition given in higher than required amounts that can affect clinical
outcomes
C. Glutamine, arginine, eicosapentanoic acid (EPA) and gamma-linolenic acid (GLA)
D. Nutrients that should not be given to hospitalized patients because they affect the
immune system
E. All of the above

27. What effect does eicosapentaenoic fatty acid have on cancer-induced

metabolic abnormalities? 
A. A 6-g daily dose is the most effective dose for stabilizing body weight
B. It has limited effectiveness
C. EPA is effective in reducing inflammation and supporting weight gain
D. EPA in combination with other nutrients supports improvement in weight and lean body
mass
E. All of the above

28. Which of the following statements is true about ERAS ? 

A. Allow patients to recover less quickly from surgery.
B. Evidenced-based perioperative strategies which work synergistically to expedite recovery
after surgery
C. Prolonged hospital stay
D. Avoid early Oral Nutrition
E. Patient should be bed-rest minimally until day-3 post-operative.

29. Nutrition-related aspects of ERAS :

A. Fluid and carbohydrate loading
B. No prolonged fasting
C. Early oral nutrition
D. All of above.
E. Patient is given with liquid diet minimal until day-5 post operative
30. Which of the following statements is true about Insulin in surgery   ? 
A. Main anabolic hormone
B. Governs all parts of metabolism
C. Regulates recovery after surgery
D. Insulin resistance emerges as neuroendocrine response to surgery.
E. All of above

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