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ASPEN PRACTICE EXAM 202 5 - 2026 /ACTUAL EXAM
QUESTIONS WITH ACCURATE ANSWERS.VERIFIED/A+
GRADE
Medicare approved indications for home parenteral nutrition include which of the following? a. supplement to enteral nutrition b. end-stage renal disease c. long-term loss of gastrointestinal function d. delayed gastric emptying – c. long-term loss of gastrointestinal function Which of the following is true concerning manganese and patients on long-term parenteral nutrition? a. manganese deficiency occurs in patients on PN for greater than 1 year b. hypermanganesemia has been reported only in patients with cholestasis c. manganese in commercial trace element preparations may result in hypermanganesemia d. the best indicator of manganese status is serum manganese
- c. manganese incommercial trace element preparations may result in hypermanganesemia Which of the following are most likely to result in malnutrition of mild to moderate inflammatory response? a. anorexia nervosa b. cancer c. closed head injury
d. sepsis
- b. cancer In patients with severe acute pancreatitis enteral nutrition has been documented to provide the following benefits over parenteral nutrition EXCEPT: a. decreased infection rate b. decreased hospital length of stay c. decreased pain d. decreased mortality
- c. decreased pain Indirect calorimetry calculates: a. total energy expenditure b. nitrogen balance c. heat released from the subject d. resting energy expenditure
- d. resting energy expenditure A seven month-old infant fed reconstituted infant formula and other age-appropriate complementary foods may be at risk of over-supplementation with which of the following? a. Vitamin A
- b. 25 - 35 ml/kg/day In the first 1-3 months after a bone marrow transplant the nutritional needs of a patient are best met with: a. 20 - 25 kcal/kg daily with >/=1.5 g protein per kg body weight b. 20 - 25 kcal/kg daily with 80% of total calories from carbohydrate c. 30 - 35 kcal/kg daily with >/=1.5 g protein per kg body weight d. 30-35 kcal/kg daily with 80% of total calories from carbohydrate - c. 30-35 kcal/kgdaily with >/=1.5 g protein per kg body weight 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: a. consult with a lawyer regarding physician orders for life-sustaining treatment b. have a psychiatric evaluation in order to be declared competent to make decisions in the patient's care c. honor the patient's expressed wish to withdraw nutrition and hydration by medical means d. decide, based upon own values, whether or not to withdraw the patient's nutrition and hydration by medical means
- c. honor the patient's expressed wish to withdraw nutrition and hydration by medical means 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? a. hepatic steatosis b. cholestasis c. gallbladder sludging d. fulminant hepatic failure
- a. hepatic steatosis Which of the following is NOT appropriate to tell a family regarding nutrition at the end of life? a. dying patients rarely feel hungry or thirsty b. fewer calories are needed at the end of life c. the experience of eating remains unchanged at the end of life d. patients should not be made to feel guilty if they do not wish to eat - c. theexperience of eating remains unchanged at the end of life Which of the following preterm growth charts allows for comparison for preterm infants from 22 weeks gestational age up through 10 weeks post term age? a. Fenton b. Ehrenkranz c. Dancis d. Lubchenco - a. Fenton Which of the following is a common clinical sign or symptom seen in a patient with vitamin D toxicity? a. hypocalcemia b. metabolic bone disease
c. 75 d. 95 - b. 55 Which of the following amino acids is most crucial in small intestinal structure and function? a. alanine b. leucine c. aspartate d. glutamine - d. glutamine What is the primary advantage of a direct percutaneous endoscopic placed jejunal tube (PEJ) versus a percutaneous endoscopic transgastric-placed jejunal tube (PEG-J)? a. reduced difficulty of placement b. reduced incidence of bleeding c. reduced incidence of migration d. reduced incidence of gastric outlet obstruction - c. reduced incidence of migration Which of the following complications is most likely to occur when transitioning a critically ill adult patient from parenteral to enteral nutrition? a. hypokalemia b. hyperkalemia c. hypoglycemia d. hyperglycemia - d. hyperglycemia Which of the following is the best choice for feeding a pancreatic insufficient infant with cystic fibrosis?
a. protein hydrolysate formula with medium chain triglyceride (MCT) b. free amino acid formula with MCT c. human milk d. standard infant formula - c. human milk Which of the following is true of aluminum toxicity in patients receiving long-term parenteral nutrition? a. the clinical manifestations of aluminum toxicity are specific and sensitive b. aluminum toxicity is the primary etiology of parenteral nutrition-associated bone disease c. increased risk of aluminum toxicity exists in the setting of renal failure or iron deficiency anemia d. modern manufacturing practices have eliminated the risk of aluminum toxicity - c. increased risk of aluminum toxicity exists in the setting of renal failure or iron deficiencyanemia Pancreatic enzymes supplemented at high doses in children with cystic fibrosis could result in: a. steatorrhea b. meconium ileus
most likely benefit from a solution containing which of the following? a. essential amino acids only b. essential amino acids with arginine only c. essential amino acids and nonessential amino acids d. essential amino acids and branched-chain amino acids - c. essential amino acids and nonessential amino acids Which of the following is NOT a common clinical symptom of celiac disease in childhood? a. failure to thrive b. constipation c. precocious puberty d. anemia - c. precocious puberty The presence of which of the following facilitates the absorption of sodium in the lumen of the small intestine? a. glucose b. potassium c. vitamin D d. protein - a. glucose
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? a. hypermagnesemia b. hyperkalemia c. hypercalcemia d. hyperphosphatemia - b. hyperkalemia An 80 year old man, living alone at home, has experienced a 15 lb unintentional weight loss over the last year and a half. The clinician assessing his nutrition status finds that he has inadequate intake. Which of the following is LEAST likely to contribute to his weight loss? a. decreased taste sensation b. social isolation c. a liberalized diet d. polypharmacy - c. a liberalized diet Which of the following tools includes the assessment of a long-term care resident's ability to maintain adequate nutrition and hydration and is mandated by the Center for Medicare and Medicaid (CMS) for certified long-term care facilities? a. minimum data sets (MDS) b. resident assessment protocols (RAP) c. utilization guidelines d. trigger legend - a. minimum data sets (MDS)
ERAS (Enhanced Recovery After Surgery) is a care program that has been shown to improve outcomes after major surgery. The key mechanism behind the ERAS effectiveness is: a. comprehensive preoperative nutrition counseling b. decrease the stress of surgery and support recovery c. decreased NPO duration and optimized nutrition before/after surgery d. the multi-professional and multidisciplinary approach - b. decrease the stress of surgery and support recovery 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? a. EN with isotonic formula via Nasogastric tube b. EN with isotonic formula via Gastrostomy tube c. EN with polymeric formula via Nasogastric tube d. EN with polymeric formula via Gastrostomy tube - c. EN with polymeric formula via Nasogastric tube The FDA-approved lipid injectable emulsion (ILE) that contains four oils differs from soybean oil-based fat emulsion in that it: a. contains egg yolk phospholipid as an emulsifying agent b. may be infused via peripheral or central intravenous line c. also contains MCT oil, olive oil, and fish oil
d. provides essential fatty acids (EFAs) - c. also contains MCT oil, olive oil, and fish oil Which of the following can result in an invalid indirect calorimetry (IC) measurement? a. ascites b. chest tube leak c. hemodynamic stability d. inspired oxygen (FiO2) less than 20% - b. chest tube leak Which of the following is true regarding the concept of quality of life in home parenteral nutrition patients? a. most patients believe that the HPN access catheter has little effect on their self- image or self-esteem b. patients with chronic bowel disease seem to cope less effectively than patients with acute gastrointestinal trauma c. social isolation is not an issue since most infusions are cycled overnight d. adjusting to HPN is easier for patients who structure HPN around their specific lifestyles - d. adjusting to HPN is easier for patients who structure HPN around their specific lifestyles
c. opioid induced constipation d. diarrhea in tube fed patients - d. diarrhea in tube fed patients Which of the following is LEAST likely to facilitate transpyloric placement of a nasoenteric feeding tube? a. endoscopic placement b. bedside electromagnetic imaging system c. fluoroscopic placement d. weighted tube tips - d. weighted tube tips Which type of insulin should be used when initiating enteral nutrition in a hospitalized patient? a. premixed NPH/regular insulin b. regular insulin c. NPH insulin d. insulin glargine - b. regular insulin Which of the following central venous catheters is the LEAST favorable for PN infusion? a. peripherally inserted central catheter (PICC) b. femoral catheter
c. subclavian catheter d. internal jugular catheter - b. femoral catheter In the critically ill obese patient, specific guidelines for the provision of calories and protein have been recommended by both the Society of Critical Care Medicine and the American Society for Parenteral and Enteral Nutrition. For a patient with a BMI of 33.4, which of the following choices best reflects the calorie recommendations for parenteral and enteral nutrition? a. 11 - 14 kcal/kg ideal body weight/day b. 11 - 14 kcal/kg actual body weight/day c. 22 - 25 kcal/kg actual body weight/day d. 22 - 25 kcal/kg ideal body weight/day - b. 11 - 14 kcal/kg actual body weight/day 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? a. hypertriglyceridemia b. azotemia c. hyperglycemia d. pulmonary edema - c. hyperglycemia Linoleic acid and alpha-linolenic acid are referred to as essential fatty acids for humans because: a. they are the only fatty acids that can be used for adenosine triphosphate production
b. inhibiting the growth of colonic bacteria c. reducing incidence of constipation d. removing water from the colon - a. increasing stool weight and bulk Which of the following medications has NOT been shown to lead to diarrhea in a patient receiving enteral nutrition? a. sorbitol-containing preparations b. Alpha- 2 adrenergic agonists c. antibiotics d. magnesium-containing preparations - b. Alpha- 2 adrenergic preparations Which protein transports oxygen from the lungs to other parts of the body? a. albumin b. hemoglobin c. lipoprotein d. retinol-binding protein - b. hemoglobin Which of the following best describes a lipid injectable emulsion (ILE) produced by the transesterification of fatty acids to form a composite triglyceride molecule? a. single oil b. multi-oil c. structured d. physical mixture - c. structured Which of the following is a clinical characteristic of acute disease or injury related severe malnutrition?
a. moderate depletion of fat b. mild fluid accumulation c. mild depletion of muscle mass d. 10% weight loss in 6 months - a. moderate depletion of fat The initial daily protein requirements for a critically ill trauma patient weighting 70 kg and having a BMI of 23.4 are a. 55 - 70 grams b. 70 - 105 grams c. 105 - 140 grams d. 140 - 175 grams - c. 105 - 140 grams Which of the following is the MOST practical approach for managing micronutrients in long-term parenteral nutrition patients? a. obtain serum values for all vitamins and trace elements yearly b. perform a micronutrient assessment every 6 months c. provide micronutrients only when laboratory values indicate abnormal levels d. a nutrition focused physical assessment should be performed annually to determine micronutrient deficiencies - b. perform a micronutrient assessment every 6 months
