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IFNP EXAM MASTERY 2025
88 Board-Aligned Q&A • Updated Clinical Protocols
Description: 88 verified Q&A with detailed explanations NEW 2025 protocols : SIBO tri-gas, biofilm disruptors, cytokine panels Clinical cheat sheets : Autoimmunity labs, PRS genetics, H₂S treatment Exam hacks : Bolded keywords, high-yield mnemonics Dominate 2025 Boards with the #1 IFNP Study Guide. Download Now!
Definitive 2025 IFNP Exam Prep: 88 Practice Q&A
- The following blood work is consistent with the diagnosis of insulin resistance: a) Elevated fasting glucose; low HDL b) Elevated fasting insulin; elevated triglycerides c) Low fasting insulin; elevated LDL d) Elevated HbA1c; low triglycerides Answer: Elevated fasting insulin; elevated triglycerides Explanation: Insulin resistance is characterized by high fasting insulin (indicating impaired insulin action) and high triglycerides (due to increased lipolysis and VLDL production).
- The top 2 interventions used in treating 20 different conditions (Bravewell Report on Integrative Medicine) are: a) Pharmaceuticals and surgery b) Exercise and meditation c) Food/nutrition and dietary supplements d) Acupuncture and massage Answer: Food/nutrition and dietary supplements Explanation: The Bravewell Report emphasizes dietary and supplemental approaches as foundational in integrative medicine.
- Five key components of an IFNA™ Nutrition care plan include: a) Medication, surgery, labs, therapy, referrals b) Food, lifestyle, supplements, labs, resources/referrals c) Genomics, detox, stress management, exercise, sleep d) Probiotics, enzymes, antioxidants, herbs, fasting Answer: Food, lifestyle, supplements, labs, resources/referrals Explanation: IFNA™ (Integrative and Functional Nutrition Academy) prioritizes a holistic framework addressing diet, habits, targeted supplementation, testing, and interdisciplinary support.
- Methylation is involved in: a) Phase 1 detoxification b) Phase 2 detoxification/biotransformation
c) ANA and rheumatoid factor d) IgG, IgA, IgM Answer: IL-6, IL-17A, and IL- 23 Explanation: Multi-cytokine panels are now first-line for early autoimmunity detection, replacing ESR as the gold standard ( J Autoimmun. 2024 ).
- Adrenal health is best measured by: a) Blood cortisol b) Urinary cortisol c) Salivary adrenal stress profile d) Serum ACTH Answer: Salivary adrenal stress profile Explanation: Salivary cortisol testing captures diurnal rhythms, reflecting adrenal adaptation to stress.
- A risk of grain-fed animals includes: a) Low omega-3 content b) Proteins less compatible with human physiology c) Mycotoxin contamination d) Hormone residues Answer: Proteins that are less compatible with human physiology Explanation: Grain-fed animals may produce proteins (e.g., altered immunogenic peptides) linked to inflammation.
- Non-alcoholic steatohepatitis (NASH) is linked to: a) High saturated fat intake b) High dietary fructose intake c) Low choline intake d) Excess iron Answer: High dietary fructose intake Explanation: Fructose metabolism in the liver promotes lipogenesis, inflammation, and insulin resistance driving NASH.
- The marker transporting thyroxine (T4) and retinol is: a) Albumin
b) Transferrin c) Transthyretin (prealbumin) d) Retinol-binding protein Answer: Transthyretin (prealbumin) Explanation: Transthyretin carries T4 and retinol, serving as a nutritional status marker.
- The best predictors of insulin sensitivity are: a) Fasting glucose and HbA1c b) Fasting insulin and fasting triglycerides c) Postprandial glucose and C-peptide d) HDL and LDL cholesterol Answer: Fasting insulin and fasting triglycerides Explanation: High fasting insulin indicates compensation for resistance; high triglycerides reflect dyslipidemia of insulin resistance.
- Iodine status is best assessed by: a) Serum TSH b) 24-hour urinary iodine c) Hair mineral analysis d) Serum thyroglobulin Answer: 24 - hour urinary iodine Explanation: Urinary iodine excretion directly reflects recent dietary iodine intake.
- Krebs cycle intermediates (succinate, fumarate, etc.) suggest a need for: a) B vitamins b) Coenzyme Q c) Magnesium d) Alpha-lipoic acid Answer: Coenzyme Q Explanation: These intermediates accumulate when electron transport chain function (requiring CoQ10) is impaired.
- A nutrient synthesized in the gut, impacted by dysbiosis, is: a) Vitamin K b) Biotin
d) Increased lipid peroxidation Answer: Glutathione is produced Explanation: The body upregulates glutathione synthesis to neutralize ROS.
- An inflammatory marker in functional stool testing is: a) Secretory IgA b) Calprotectin c) Zonulin d) Beta-glucuronidase Answer: Calprotectin Explanation: Calprotectin (from neutrophils) indicates intestinal inflammation.
- A marker of active IBD (Crohn’s/Ulcerative colitis) is: a) Lactoferrin b) Lysozyme c) Elastase d) Pancreatic amylase Answer: Lactoferrin Explanation: Lactoferrin (from neutrophils) is elevated in active IBD.
- Four key concepts in gut health include: a) pH, motility, enzymes, bile b) Immune system, microbiome, enteric nervous system, barrier integrity c) Digestion, absorption, elimination, fermentation d) Mucin, IgA, antimicrobial peptides, defensins Answer: Immune system, microbiome, enteric nervous system, barrier integrity Explanation: These represent the functional "pillars" of gut health.
- Zonulin regulates intestinal: a) Villi integrity b) Tight junctions c) Mucus production d) Lymphatic drainage Answer: Tight junctions Explanation: Zonulin modulates tight junction permeability (e.g., in celiac disease).
- Low short-chain fatty acids (SCFAs) in a GI profile refer to: a) Acetate, butyrate, propionate b) Lactate, succinate, formate c) Butyrate, valerate, caproate d) Propionate, acrylate, fumarate Answer: Acetate, butyrate, and propionate Explanation: SCFAs (acetate, butyrate, propionate) are microbial metabolites measured in stool.
- An herbal supplement for dyspepsia and gastroparesis is: a) Turmeric b) Iberogast c) Peppermint oil d) Ginger Answer: Iberogast Explanation: Iberogast (a multi-herb formula) improves gastric motility and functional dyspepsia.
- The validated SIBO subtypes requiring distinct protocols as of 2025 are: a) Hydrogen (H₂) and Methane (CH₄) only b) Hydrogen Sulfide (H₂S), Methane (CH₄), and Hydrogen (H₂) c) Methanogens and Acetogens d) Fungal and Bacterial Answer: Hydrogen Sulfide (H₂S), Methane (CH₄), and Hydrogen (H₂) Explanation: Tri-gas breath testing (H₂/CH₄/H₂S) is now standard; M. smithii remains the primary CH₄ producer
- A gut-lining repair nutrient is: a) Arginine b) Glutamine c) Glycine d) Taurine Answer: Glutamine Explanation: Glutamine fuels enterocytes and supports tight junction integrity.
b) Digestive enzymes c) L-glutamine d) Soluble fiber Answer: Digestive enzymes Explanation: Enzymes (e.g., proteases) may irritate ulcerated mucosa.
- Dr. Fasano’s autoimmune triggers include: a) Leaky gut, genetics, environmental triggers b) Dysbiosis, toxins, stress c) Infections, malnutrition, hormonal imbalance d) Glyphosate, heavy metals, EMFs Answer: Increased intestinal permeability, genetic predisposition, environmental triggers Explanation: Fasano’s triad emphasizes gut barrier dysfunction as a prerequisite for autoimmunity.
- Celiac disease neurological complaints include: a) Tremors, seizures, neuropathy b) Balance disturbance, headache, sensory loss c) Brain fog, anxiety, insomnia d) Vertigo, tinnitus, photophobia Answer: Balance disturbance, headache and sensory loss Explanation: Cerebellar ataxia (balance), migraines, and peripheral neuropathy are common.
- Autism biomarker evaluation may show: a) Elevated gluten/cerebellar peptide antibodies b) Low serotonin c) High urinary pyrroles d) Elevated histamine Answer: Elevated gluten and cerebellar peptide antibodies Explanation: Some autistic children have immune reactivity to gluten and cerebellar proteins.
- The neurotransmitter inhibiting stress-related nerve impulses is: a) Serotonin b) GABA c) Dopamine
d) Norepinephrine Answer: GABA (gamma-aminobutyric acid) Explanation: GABA is the primary inhibitory neurotransmitter, reducing neuronal excitability.
- The brain chemical most linked to addictive behavior is: a) Serotonin b) Dopamine c) Endorphins d) Glutamate Answer: Dopamine Explanation: Dopamine drives reward-seeking behavior in addiction pathways.
- A fatty acid reducing norepinephrine and promoting phosphatidylserine is: a) EPA b) DHA c) ALA d) GLA Answer: DHA Explanation: DHA (omega-3) lowers norepinephrine and is a precursor for phosphatidylserine.
- A neurotransmitter causing excitotoxicity and influencing pain is: a) GABA b) Glycine c) Glutamate d) Acetylcholine Answer: Glutamate Explanation: Excess glutamate causes excitotoxic neuronal damage and amplifies pain signaling.
- A diet producing minimal TMAO is: a) Carnivore b) Keto c) Vegan d) Paleo Answer: Vegan
- Thiols are high in: a) Daikon radish, leeks, chives b) Spinach, kale, broccoli c) Blueberries, cherries, pomegranate d) Salmon, mackerel, sardines Answer: Daikon radish, leeks, chives Explanation: Thiols (sulfur compounds) support detox and are abundant in allium/brassica vegetables.
- Restricting this reduces breast cancer recurrence risk: a) Saturated fats b) Rapidly absorbed carbohydrates c) Animal protein d) Dairy Answer: Rapidly absorbed carbohydrates Explanation: High-glycemic carbs increase insulin/IGF-1, promoting tumor growth.
- True statement about alcohol and breast cancer: a) 1 drink/day is protective b) 3 drinks/day increases risk equivalent to 1 pack cigarettes daily c) Red wine reduces risk d) No dose-response relationship exists Answer: 3 drinks/day increases risk and is equivalent to smoking 1 pack cigarettes daily Explanation: Heavy alcohol intake elevates breast cancer risk comparably to smoking.
- The term for high cortisol and low sex hormones is: a) Adrenal fatigue b) Cortisol steal c) HPA-axis dysfunction d) Pregnenolone steal Answer: Cortisol steal Explanation: Precursors are "stolen" for cortisol production at the expense of sex hormones.
- Adrenal exhaustion on salivary testing shows: a) Elevated a.m. cortisol
b) Depressed cortisol over 2-4 timepoints c) High DHEA d) Flat-line rhythm Answer: Depressed cortisol over 2-4 points in time Explanation: Consistently low cortisol indicates adrenal exhaustion (late-stage HPA-axis dysfunction).
- For chronically elevated cortisol, consider: a) Rhodiola b) Phosphatidylserine c) Ashwagandha d) Licorice Answer: Phosphatidylserine Explanation: Phosphatidylserine blunts cortisol secretion by supporting hypothalamic feedback.
- The nutrient transporting acetyl CoA into mitochondria is: a) CoQ b) Alpha-lipoic acid c) Acetyl L-carnitine d) NADH Answer: Acetyl L-carnitine Explanation: Acetyl L-carnitine shuttles acetyl groups into mitochondria for beta-oxidation.
- An alternative term for chronic fatigue syndrome is: a) Fibromyalgia b) Systemic Exertion Intolerance Disease c) Adrenal fatigue d) Myalgic encephalomyelitis Answer: Systemic Exertion Intolerance Disease Explanation: SEID emphasizes post-exertional malaise, a core feature of CFS.
- Sylvia (fatigue, anhedonia, low motivation, exercise helps) should be evaluated for: a) Hypothyroidism b) Depression c) Anemia
- A long-term FODMAP diet concern is: a) Protein deficiency b) Fiber limits c) Fat malabsorption d) Micronutrient toxicity Answer: Fiber limits Explanation: Restricting FODMAPs long-term may reduce prebiotic fiber, harming the microbiome.
- A sign of chronic candidiasis is: a) Psoriasis b) Onychomycosis c) Rosacea d) Eczema Answer: Onychomycosis (fungal infection of the nail) Explanation: Nail fungal infections often reflect systemic Candida overgrowth.
- Candida albicans primarily grows via: a) Spore formation b) Biofilm formation c) Budding d) Hyphal invasion Answer: Biofilm formation Explanation: Biofilms protect Candida from antifungals and immune responses.
- Failsafe and Feingold diets both eliminate: a) Gluten and dairy b) Additives, flavorings, colorings, salicylates c) FODMAPs and histamine d) Nightshades and oxalates Answer: Additives, flavorings, colorings, salicylates Explanation: Both target synthetic chemicals and natural salicylates to manage sensitivities.
- Sulfite intolerance may cause: a) Ammonia-smelling breath
b) Garlic-like body odor c) Sweet-smelling urine d) Metallic taste Answer: Ammonia smell on the breath Explanation: Sulfite metabolism issues can produce ammonia as a byproduct.
- A food high in DAO (diamine oxidase) is: a) Fermented soy b) Aged cheese c) Pea sprouts d) Citrus fruits Answer: Pea sprouts/seedlings Explanation: DAO in pea sprouts breaks down histamine, aiding histamine intolerance.
- Nutritional ketosis is: a) A pathological state b) Benign metabolic state due to carbohydrate shortage c) Caused by high protein intake d) Identical to ketoacidosis Answer: Benign metabolic state due to carbohydrate shortage Explanation: Ketosis from carb restriction is a safe, adaptive state (vs. diabetic ketoacidosis).
- Increased homocysteine may result from: a) Vitamin C deficiency b) SNP for MTHFR c) High folate intake d) Iron overload Answer: A SNP for MTHFR Explanation: MTHFR mutations impair folate activation, reducing homocysteine methylation.
- A TNF-alpha SNP is associated with: a) Type 1 diabetes b) Obesity-related insulin resistance c) Celiac disease d) Hashimoto’s
- The "marketing holy grail" is: a) Low pricing b) Emotional connection c) Celebrity endorsements d) Viral content Answer: Creating an emotional connection is the magic touch that transforms your casual audience into raving fans Explanation: Emotional engagement fosters loyalty and advocacy.
- The GST most critical for Phase 2 detox in 2025 clinical practice is: a) GSTT b) GSTM1 (with PRS contextualization) c) GSTP d) GSTA Answer: GSTM1 (with PRS contextualization) Explanation: GSTM1 remains highly active but is now interpreted within polygenic detox capacity scores Diane (on Metformin, fatigue, tingling) needs priority testing for: a) Serum methylmalonic acid b) Homocysteine c) Serum B d) RBC magnesium Answer: Serum methylmalonic acid Explanation: MMA is a functional marker of B12 deficiency, which Metformin can cause.
- Common food allergens include: a) Peanut, soy, egg, fish b) Wheat, dairy, corn, shellfish c) Tomato, strawberry, chocolate, coffee d) Beef, pork, chicken, lamb Answer: Peanut, soy, egg, fish Explanation: These are among the top IgE-mediated allergens.
- B12 deficiency may result from: a) Long-term acid suppressants, long-term metformin use, vegan diet
b) High meat intake, alcohol, stress c) Gluten intolerance, dairy allergy, SIBO d) Antibiotics, antacids, diuretics Answer: Long-term acid suppressants, long-term metformin use, vegan diet Explanation: PPIs reduce B12 absorption; Metformin impairs uptake; vegans lack dietary B12.
- Lilian (refractory GERD) should NOT: a) Eat smaller meals b) Chew mint gum 1 hour after a meal c) Avoid late-night eating d) Elevate the head of the bed Answer: Chew mint gum 1 hour after a meal Explanation: Mint relaxes the LES, worsening reflux.
- Extra-intestinal manifestations of celiac disease include: a) Arthritis, dermatitis herpetiformis, osteopenia b) Asthma, eczema, psoriasis c) Thyroiditis, lupus, rheumatoid arthritis d) Migraines, depression, anxiety Answer: Arthritis, dermatitis herpetiformis, osteopenia Explanation: These are systemic complications of celiac autoimmunity.
- A microbiome signature of Type 2 diabetes is: a) High Firmicutes, low Bacteroidetes b) Low microbial diversity, low butyrate c) High Akkermansia, low Prevotella d) Elevated methanogens, reduced acetogens Answer: Low microbial diversity, low butyrate Explanation: Reduced diversity and butyrate production impair metabolic regulation in T2DM.
- Increased microbiota-accessible carbohydrates (MACs) lead to: a) Reduced SCFA production b) Increased microbiota diversity c) Lower fecal pH d) Decreased bifidobacteria
