RD Competency Quiz Questions

1) What are the four parts of the Nutrition Care Process and why are
they important?
- Nutrition Assessment
- Nutrition Diagnosis
- Nutrition Intervention
- Nutrition monitoring and evaluation
* The nutrition care process is important because it creates clear
lines of communication to al dietitians.
2) The process of identifying an individual who is malnourished or
who is at risk for malnutrition to determine if a full nutrition
assessment should be started is known as _______________
- Screening
3) A male patient you are assessing is 56 ft tall (66 ) and weighs
195 lbs, what is his Ideal body weight (IDW)? % IBW? BMI?
Adjusted body weight? Show your work.
4) On your prior patient what specific weight classification would he
be placed in? At what percent IBW should you use patients ABW
for nutrition calculations (i.e. calories/protein needs)?

5) What are the 3 of the 5 risk factors for malnutrition/nutritional

risk? How many risk factors are needed to place a patient at
moderate risk?
6) What are other ways in which you can assess a patient for
malnutrition?
7) If you place a patient at moderate risk, how often should you
follow up with patients assessment?
8) A patient comes in and is screened at moderate malnutrition risk
due to recent weight loss, poor PO intake, and wounds? She is
58 (68) and weighs 100 lbs. using the Harris Benedict equation
below calculate her energy needs?

Female: 655 + (9.6 x W) + (1.8 x H) (4.7 x A) =

W= weight in kg, H= ht in cm, A= age in years
9) What is an alternate way of calculating the energy needs
assuming the patients condition is normal other than small
wounds?
10)
What might you offer the patient to encourage increase
calories?

11)
Determine the patients protein needs considering that
wounds are present? What are the average protein requirements
for a normal patient (not under stress)? Moderately stressed
(infection, surgery, and wounds? Severely stressed (burns,
fractures)?

12)

What is one method to determine a patients fluid needs?

13)
What are some methods for acquiring a diet history from a
patient? Why might this be useful in your plan of care?

14)
You just received a consult to see a type 2 diabetic for
diabetes education? This patients blood sugar is 188mg/dL, AIC
is 9.6. How would you educate this patient on lowering their
blood sugar?
15)
What does AIC stand for? What are normal blood sugar
readings (fasting/2 hr post meal)?
16)
For these next questions, each disease requires key
nutrition education points. Describe important dietary
changes/lifestyle changes in order to better manage certain
conditions.

Diverticulitis

Crohns, Ulcerative colitis

Diabetes

Pancreatitis

Kidney Disease (Hemo-dialysis patient)

Liver disease

Obesity

Coronary heart failure (CHF)

Gastric Bypass surgery

Gastroparesis

Clinical Competency
1. When is enteral nutrition support indicated? Total parenteral
nutrition (TPN)?
- When a patient has a functional GI tract and whose oral
energy/nutrient intake is insufficient to meet estimated needs
due to lack of nutrition through the mouth. TPN is initiated when
GI is non-functional, not tolerating tube feeds, intestinal
obstruction, inability to gain GI acess, gastrointestinal ischemia,
short bowel syndrome (examples).

2. Feeding tubes should be flushed with ___________ ml water every

4-6 hours during continuous feeding to maintain patency in
addition to flushes before and after administering a medication.
- 25-30 ml H20
3. What is the recommended tube placement for a patient with
severe pancreatitis?

- Jejunal feedings helps to not stimulate the pancreatic secretions

4. Give an example of a bolus feeding regimen (including times)
- can every 3 hours for two feedings, increase by can every
feeding until final goal volume of 5 cans/day @ (06-09-12-16-20)
5. What is one way to treat diarrhea on a patient receiving a tube
feed.
- Pectin

6. What is the difference in nutrient admixture between CPN and

PPN
-

current maximum recommended osmolarity of PPN should be

900 mOsm/L

7. Why might PPN (peripheral parenteral nutrition be a better

choice than TPN)
-

Nutrition anticipated for less than 2 weeks

Less risk of infection

8. Your patient has lost a substantial amount of weight within the

last few months, and has not been eating orally for the past few
weeks. Your plan is to start TPN due to intolerance of Tube feeds,
and non-functional GI tract. What might you consider when
starting TPN.
-

Refeeding syndrome (risk factors include: prolonged fasting

NPO > 1 week, weight loss, and low IBW. Start TPN rate low
10-20 ml/hr increasing 10-15 ml every 2-3 hours until at goal
rate. Check serum electrolytes.

9. Recommend at least 1 tube feed formula for the following

conditions : A fluid restricted patient? Critically obese patient?
Severely burned patient? Normal patient who has limited PO
intake?
-

Fluid restriction (Two Cal HN, Jevity 1.5)

10.
-

Critically obese (promote)

Severely burned (two cal, promote, jevity 1.5)
Normal ( Jevity 1.2)
How many calories does dextrose contain? Lipids?
3.4 kcals
10 kcals

11.
What is the maximum glucose oxidizing capacity of the
liver
12.

>5mg/kg/min to prevent hyperglycemia and/or fatty liver