1. When the food is directly given in the
carbohydrates, proteins
veins, it is called ______ nutrition.
a. Parenteral
b. Enteral
c. Intravenous
d. Saline
Parenteral nutrition is given to people directly in
their veins. The food is in its most basic form,
like Amino Acids instead of protein pulses, and
can be absorbed by the body directly. It is given
when the person is unconscious, has had an
operation in the GI tract etc.
2. When food is given in the stomach or
intestines directly then it is ________
nutrition.
a. Intravenous
b. Saline
c. Enteral
d. Parenteral
This type of nutrition is given to those who have
been unconscious or comatose for a longer
period of time. The food is normal food but
churned into a paste and diluted sufficiently.
This food is given directly in the stomach with
the help of tubes.
3. A person who has had a renal transplant
should regulate the intake of ______
a. carbohydrates
b. proteins
c. fats
d. vitamins
Kidneys are the site of blood purification and
the waste that is flushed out is mostly nitrogen
in nature. This nitrogenous waste is produced
due to the breakdown of proteins and amino
acids. Thus, to reduce the pressure on kidneys,
the intake of proteins is reduced.
4. To overcome diabetes, a person can
increase the intake of ______ and reduce
the intake of ___________.
a.
b. proteins, fats
c. fats, carbohydrates
d. carbohydrates, fats
Diabetes is of two kinds, one where the body
cannot produce insulin and the second in which
the cells have developed resistance to insulin
so absorption of glucose has gone down. Thus,
the amount of sugar in blood increases. To
control this, the level of fat intake can be
increased. The lesser amount of fat is needed
to satisfy hunger as compared to
carbohydrates. Also, the energy produced by
oxidation of fat is much higher. Thus, to control
diabetes, consumption of carbohydrates is
reduced and the intake of fats is increased.
5. For a person suffering from problems like
slow neural transmission, eg dementia,
they should be given __________
a. increased sodium
b. increased potassium
c. increased calcium
d. increased magnesium
The cell systems use sodium and potassium to
transmit impulses. The neural systems also use
these two ions. However, the body uses
potassium more than sodium when it comes to
transmitting impulses. Thus, when a person is
suffering from neural problems, especially when
the impulses are being transmitted slowly,
increasing the levels of potassium in the body
helps stabilize it.
6. A person who is suffering from high blood
pressure should cut down on _______
a. sodium
b. potassium
c. calcium
d. magnesium
Sodium and potassium are used by the body to
conduct impulses but unlike potassium, sodium
Clinical Nutrition | 1
 is a much smaller ion. This means it has higher
electropositivity and a higher capacity to attract
negatively charged ions. It attracts water
molecules and causes water retention,
something which is very harmful to a patient
suffering from high blood pressure. Thus, their
sodium intake is reduced so that the excess
water is not held back in blood and the
pressure on the heart to circulate the larger
volume of blood reduces.
7. Long periods of parenteral nutrition is not
recommended because of ______
a. increases the toxicity of blood
b. it puts pressure on the kidney
c. it puts pressure on the heart
d. it causes the GI tract to
degenerate
When the functioning of an organ system
reduces, it starts degenerating. The same
happens with the GI tract. If parenteral nutrition
is given for a long period of time, then even
though the body will meet its nutritional needs
the GI tract will start degenerating.
8. In cases of renal insufficiency, what should
take in place of proteins?
a. Triglycerides
b. Essential Amino Acids
c. Glucose
d. Vitamin K
A protein is a long chain of various amino acids
which may or may not be needed by the body.
Since proteins are the building blocks of the
body, doing away with proteins cannot be done;
however taking proteins will harm the damaged
kidney. In such cases, essential amino acids
are ingested instead of taking in proteins.
These essential amino acids are directly
absorbed by the body. This allows the body to
function normally and the pressure on the
kidney is kept at the minimum.
9. In cases of muscle fatigue, which of the
vitamins should be taken?
a. A
b. D
c. E
d. K
Vitamin D helps the bones and muscles in
absorbing various nutrients. When the levels of
Vitamin D in the body go down, the muscles
feel fatigued as they are not able to absorb the
nutrients. The melanin pigments of the skin in
the presence of sunlight produce Vitamin D but
in case the levels go down, then Vitamin D is
orally taken or injected in the muscles.
10. Which Vitamin in large amounts harms the
bones?
a. A
b. B
c. C
d. D
Vitamin C is essentially Citric Acid. It is found in
citric fruits like oranges and lemons. Necessary
amounts are needed to keep away colds and
reduce the levels of toxicity of the body. It helps
keep the skin clean and pimple free but it is still
acidic in nature. Excess consumption of
Vitamin C can cause the acid to react with the
bones where most of the minerals are and
causes the bones to become weak.
11. The cells of the small intestine have a
special structure that helps in the
absorption of food. This structure is
________
a. villi
b. pseudopodia
c. flagella
d. attachment sites
The inner lining of the intestines are lined with
villi which help increase the surface area of
absorption. These villi have blood and lymph
supply and have microvilli which further
increase the surface area for absorption.
Clinical Nutrition | 2
 12. Fats effectively begin digesting due to
__________
a. Salivary emulsification
b. Esophageal emulsification
c. Acidic emulsification
d. Bile emulsification
Fat molecules are usually a clumped mass and
it is difficult to act upon them to digest them.
Due to their large size, their surface area is too
small. Bile salts cause emulsification which
breaks down the fats into smaller globules
which allows the various digestive enzymes to
work on them and finally digest them.
13. Fats are absorbed by ________ in the
form of a ________
a. micelles, lacteal
b. lacteal, enterocytes
c. enterocytes, micelles
d. micelles, enterocytes
The fats in their digested state consist of free
fatty acids, monoglycerides, cholesterol and
lysolipids. They cannot be absorbed directly
by the enterocytes of the villi. Thus, the
digested fats are encapsulated into small
balls of bile which allow them to enter the villi
and get absorbed by the enterocytes. These
enterocytes have microvilli to allow better
absorption. On entering the enterocytes,
monoglycerides, cholesterol and lysolipids
react with 2 units of Fatty acids to form these
enter the lacteals, a part of the lymphatic
system. From here, they can enter blood as
needed.
14. Enzyme secreted by the small intestine to
digest protein is ____________
a. trypsin
b. chymotrypsin
c. zymogens
d. peptidase
Peptidase is the last enzyme that is secreted
for the digestion of the proteins. Trypsin and
chymotrypsin are secreted by the pancreas in
their inactive forms called zymogens. When
trypsinogen and chymotrypsinogen are
secreted by the pancreas and they enter the
duodenum, they get converted into trypsin and
chymotrypsin due to the activation action of
enterokinase.
15. The enzyme that breaks ________ into 2
glucose molecules is ________
a. maltose, lactase
b. lactose, lactase
c. maltose, maltase
d. lactose, maltase
Maltose is a disaccharide which is made of two
molecules of glucose. Maltase is secreted by
the small intestine and it breaks down maltose
into two glucose. Lactase breaks lactose into
glucose and galactose while sucrase breaks
sucrose into glucose and fructose.
16. An enzyme that is secreted by infants but
not by adults
a. Renin
b. Gelatinase
c. Pepsinogen
d. Amylase
Renin is the enzyme that helps in the digestion
of milk in infants. As the children grow up, the
production of this enzyme goes down and so it
is not found in adults. Renin is found in all
mammalian infants which feed on their
mother’s milk.
17. Amylase works in pH as _________
a. 1.3 – 2.5
b. 2.5 – 5.7
c. 5.7 – 6.8
d. 6.8 – 7.2
Amylase is a slightly basic enzyme and so it
needs a basic medium to work. When the food
is ingested, the mouth has a basic medium due
to the presence of saliva. Thus, the salivary
amylase starts digesting the food. When the
food enters the stomach, the acidic medium
stops the work of the salivary amylase. When
the food moves to the duodenum, the
pancreatic amylase starts working.
18. pH in the small intestine is __________
a. 2
b. 5
c. 7
d. 8
Clinical Nutrition | 3
The digestive enzymes mostly work in the basic
or mildly basic mediums. When the food
reaches the stomach, the high pH content of
the stomach destroys the microbes and any
other harmful material in the food. Then the
food moves down to the small intestine where
the bile salts help neutralize the acidity of the
food and then make them slightly basic to allow
the intestinal enzymes to work on them.
19. The _______ connects the small intestine
and liver.
a. pulmonary vein
b. renal vein
c. hepatic portal
d. cardiac vein
The hepatic portal connects the small intestine
and the liver. After food has been digested by
the intestines, the extracted nutrients and
toxins move to the liver to allow the liver to
purify the blood. The liver breaks down the
toxic substances into less harmful substances
and allows the blood to carry it away to the
kidney where it gets filtered out.
20. . What is the pH of an empty stomach?
a. 0.13
b. 1.3
c. 13
d. 130
The stomach produces acid to destroy any
harmful substances and microbes that may
enter the body through food. It also produces
pepsin which starts the digestion of proteins.
Pepsin requires an acidic medium to work.
When the stomach is full, the acidity may fall to
pH 4.
21. islets of Langerhans are found
__________
a. Liver
b. Stomach
c. Pancreas
d. Intestines
Pancreas is one of the organs which has both
endocrine and exocrine functions. The islets of
Langerhans are dense clusters of cells which
act as the endocrine systems of the pancreas.
They produce various hormones for the
regulation of glucose, the most important one
being insulin.
22. Digestion of fats begins in _______
a. Mouth
b. Esophagus
c. Stomach
d. Duodenum
Fats are in the form of large globules and so
because of their small surface area, they
cannot be digested easily. When the food in the
form of chyme enters the duodenum of the
small intestine, it comes in contact with the bile
salts which break fat into smaller globules. The
pancreatic juices contain enzymes for the
digestion of fats.
23. Chewing of food is called ______
a. Emulsification
b. Mastication
c. Injection
d. Peristalsis
The chewing process is called mastication. The
incisors bite and cut, the canines rip, the
premolars and molars chew. Since the molars
and premolars are at the back of the mouth,
they receive the most muscle and skeletal
support. These teeth cause mastication.
24. Which organ contributes the most
enzymes and hormones towards
digestion?
a. Liver
b. Pancreas
c. Duodenum
d. Ileum
in The major sites of digestion are mouth,
stomach, duodenum and ileum. However, the
duodenum does not secrete any digestive
juices. It is simply the receiving site for the
incoming food from the stomach and the
secretions from the bile duct. The bile salts are
produced in the liver but it is finally the
pancreas that brings in juices for the digestion
of proteins, fats and carbohydrates. After
digestion is done and food has been absorbed
by the blood, it is the pancreatic hormonal
secretions that help in regulating the amount of
glucose in the blood.
Clinical Nutrition | 4
 25. The movement of an esophagus to help
the food down the GI tract __________
a. Mastication
b. Emulsification
c. Peristalsis
d. Ejection
After chewing, the tongue rolls the food in the
form of a bolus and shifts the food to the
esophagus. The walls of the esophagus
contract and relax and slowly allow the food to
move down and enter the stomach. This allows
the food to enter the stomach slowly and avoid
an acid splash. This movement is peristalsis.
26. The three different cells found in the
stomach
a. Chief cells, renal cells, nephron
b. Renal cells, mucous cells, hepatic
cells
c. Nephrons, hepatic cells, parietal
cells
d. Chief cells, parietal cells,
mucous cells
Chief cells are also called zymogen cells as
they secrete enzymes. Parietal cells are
oxygentic cells and they secrete HCl to destroy
the microbes and any other harmful
substances. The mucous cells secrete mucus
to protect the walls of the stomach being
harmed by the HCl. It also allows for the
smooth passage of food.
27. The band of muscles guarding the two
openings of the stomach towards the
esophageal and intestinal sides is called
as _______________
a. pyloric sphincter and pyruvic
sphincter
b. diaphragm and pyloric sphincter
c. cardiac sphincter and lower
sphincter
d. cardiac sphincter and pyloric
sphincter
The sphincters are basically a band of muscles
that regulate the opening and closing of any
opening in the body. The sphincter muscles
towards the esophagus are called the cardiac
sphincter because they are close to the heart or
the lower sphincter because it brings the food
down. The opening towards the intestine is
called the pylorus and the muscles guarding
them are the pyloric sphincter.
28. How are the blood cells and plasma
separated?
a. hematocrit
b. hot plate
c. centrifuge
d. water bath
The blood is collected, heparin is added to it
and then the blood is centrifuged at 10,000
RPM. Then the blood is left to settle down. The
cells due to higher weight settle down and the
plasma floats up. The RBCs have the highest
density so they settle down at the bottom. Then
comes a layer of WBCs and then platelets. The
plasma is collected above the platelets.
29. Where are the RBCs destroyed?
a. Liver
b. Pancreas
c. Stomach
d. Intestines
The liver is responsible for detoxifying the body.
Just like the kidney filters blood and removes
all the waste, the liver detoxifies the blood and
ensures that the dead and dying cells are
destroyed and removed.
30. . Prolonged bed rest can lead to which
problem?
a. Tuberculosis
b. Diarrhea
c. Cholera
d. Hypertension
When a person is lying down for long periods of
time, the most commonly known problem that
occurs is bed sores. However, long periods of
bed rest also causes water to be slowly
accumulated in the lungs. Due to the horizontal
posture of the body, the body is not able to
expel microorganisms as properly as it does in
the vertical posture. The existing and
accumulated water in the lungs becomes their
breeding ground and the person suffers from
tuberculosis.
Clinical Nutrition | 5