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ACVN Veterinary Nutrition study materials
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ACVN Veterinary Nutrition practice questions

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Question 1Nutritional Assessment and Requirements

Which nutrient class supplies the most concentrated source of energy per gram in a typical canine or feline diet?

  1. Nitrogen-free extract
  2. Fat Correct answer.
  3. Protein
  4. Crude fiber

Explanation

Fat provides roughly 8.5 kcal per gram of metabolized energy, whereas protein and carbohydrate each provide about 3.5 kcal per gram. Fiber contributes little usable energy because it is poorly fermented and largely excreted.

Question 2Nutritional Assessment and Requirements

In a healthy adult dog at maintenance, what is the standard first step of a nutritional assessment?

  1. Submit a full serum biochemistry panel
  2. Perform an abdominal ultrasound
  3. Measure resting energy expenditure by indirect calorimetry
  4. Collect a dietary history and screen the animal's body condition Correct answer.

Explanation

Nutritional assessment begins with screening the animal's history, current diet, and body condition, then extends to a more detailed evaluation if a risk factor is identified. Laboratory and imaging tests are not routine first steps in an apparently healthy animal.

Question 3Nutritional Assessment and Requirements

Which body condition score system is most widely used in small animal practice and ranges from 1 to 9?

  1. The 5-point Henneke system
  2. The 1-to-6 muscle condition score
  3. The 1-to-4 body fat index
  4. The 9-point Purina-style body condition score Correct answer.

Explanation

The 9-point body condition score, where 1 is emaciated and 9 is obese, is the standard tool for adult dogs and cats in small animal practice. The Henneke system is a 1-to-9 scale used for horses, not dogs or cats.

Question 4Nutritional Assessment and Requirements

A cat's maintenance energy requirement is best estimated using which reference point?

  1. Resting energy requirement multiplied by a life-stage factor Correct answer.
  2. A fixed 60 kcal per kilogram of body weight regardless of status
  3. The animal's body condition score alone
  4. Total daily water intake in milliliters

Explanation

Maintenance energy is estimated as the resting energy requirement (about 70 times body weight in kg to the 0.75 power) multiplied by a factor that reflects life stage, activity, and neuter status. A single fixed value per kilogram does not account for individual variation.

Question 5Nutritional Assessment and Requirements

Which of the following is the most appropriate way to assess muscle mass during a nutritional evaluation?

  1. Record the brand of food being fed
  2. Palpate the spine, scapulae, and skull and assign a muscle condition score Correct answer.
  3. Count the number of meals fed per day
  4. Measure the animal's body weight on a single visit

Explanation

Muscle condition is assessed by palpation over bony prominences such as the spine, scapulae, and skull and graded on a 0-to-3 scale. Body weight alone does not distinguish fat from lean tissue loss.

Question 6Nutritional Assessment and Requirements

Which statement best describes the purpose of the Association of American Feed Control Officials (AAFCO) nutritional adequacy statements on pet food labels?

  1. They guarantee the food is free of pathogens
  2. They certify that the food has been tested in a clinical trial
  3. They indicate whether a diet meets recognized nutrient profiles for a given life stage Correct answer.
  4. They specify the exact calorie content per cup

Explanation

AAFCO statements indicate whether a diet is formulated to meet the nutrient profiles or has been substantiated by feeding trials for a particular life stage. They do not certify clinical testing or guarantee microbiological safety.

Question 7Nutritional Assessment and Requirements

A growing large-breed puppy is overfed a high-calcium diet. Which problem is most likely?

  1. Increased lean muscle mass
  2. Improved bone density with no adverse effect
  3. Disturbed bone development and growth abnormalities Correct answer.
  4. Acute zinc deficiency

Explanation

Excess calcium in growing large-breed dogs impairs normal endochondral ossification and can cause developmental orthopedic disease. Calcium should be fed within the recommended range rather than in excess.

Question 8Nutritional Assessment and Requirements

Which physiologic state raises a cat's energy and protein requirements the most per unit body weight?

  1. A sedentary indoor lifestyle
  2. Late gestation and lactation Correct answer.
  3. Maintenance in a neutered adult
  4. Recovery from a mild, self-limiting gastroenteritis

Explanation

Late gestation and especially lactation are the most energy- and protein-demanding states in the cat's life cycle. Energy needs during lactation can exceed maintenance several-fold.

Question 9Nutritional Assessment and Requirements

A dog with chronic kidney disease is being fed a renal diet. Which dietary modification is a core principle of such therapeutic diets?

  1. Removing all protein from the diet
  2. Increasing phosphorus to support renal repair
  3. Increasing sodium to stimulate thirst
  4. Restricting phosphorus while maintaining adequate protein and energy Correct answer.

Explanation

Renal diets limit phosphorus and moderate protein while keeping energy density high so the animal maintains weight. Phosphorus restriction helps slow progression of renal disease.

Question 10Nutritional Assessment and Requirements

Which method is the reference standard for determining the digestibility of a diet in dogs?

  1. Estimating digestibility from the ingredient list
  2. Measuring the food's crude fiber content
  3. A total fecal collection feeding trial Correct answer.
  4. A single-portion food recall survey

Explanation

Total fecal collection during a controlled feeding trial is the reference method for measuring apparent digestibility. It quantifies nutrient intake and output directly.

Question 11Nutritional Assessment and Requirements

A 10 kg dog is estimated to have a resting energy requirement of about 400 kcal per day. If a factor of 1.6 is applied for maintenance, what is the approximate daily energy target?

  1. 250 kcal
  2. 400 kcal
  3. 1600 kcal
  4. 640 kcal Correct answer.

Explanation

Multiplying the resting energy requirement by the maintenance factor gives the daily target: 400 kcal times 1.6 equals 640 kcal. This value is then adjusted based on body condition over time.

Question 12Nutritional Assessment and Requirements

Which of the following best describes 'essential' nutrients in a pet diet?

  1. Nutrients that provide the majority of dietary energy
  2. Nutrients that are optional if the animal is healthy
  3. Nutrients that cannot be synthesized in adequate amounts and must be supplied in the diet Correct answer.
  4. Nutrients that are only needed during illness

Explanation

Essential nutrients must be provided in the diet because the body cannot make them in sufficient quantities. They are required continuously, not only during illness.

Question 13Nutritional Assessment and Requirements

Which amino acid is considered essential for cats but not for adult dogs?

  1. Taurine Correct answer.
  2. Glutamine
  3. Alanine
  4. Glycine

Explanation

Cats have a limited ability to synthesize taurine and must obtain it from the diet; deficiency causes dilated cardiomyopathy and retinal degeneration. Dogs can synthesize adequate taurine under normal conditions.

Question 14Nutritional Assessment and Requirements

Which fatty acid is essential for cats and is typically supplied by animal-source fats in their diet?

  1. Oleic acid
  2. Stearic acid
  3. Palmitic acid
  4. Arachidonic acid Correct answer.

Explanation

Cats lack sufficient delta-6 desaturase activity to synthesize arachidonic acid from linoleic acid, so it must be provided preformed. Animal fats are the usual dietary source.

Question 15Nutritional Assessment and Requirements

A dog is fed a home-prepared diet consisting only of cooked chicken breast and rice. Which nutrient deficiency is of greatest immediate concern?

  1. Sodium
  2. Vitamin C
  3. Calcium Correct answer.
  4. Chloride

Explanation

Meat is high in phosphorus and low in calcium, so an all-meat-and-rice diet is markedly calcium deficient and unbalanced in calcium-to-phosphorus ratio. This can cause skeletal and neuromuscular problems.

Question 16Nutritional Assessment and Requirements

Which water-soluble vitamin is synthesized by intestinal bacteria in dogs and cats and is therefore rarely deficient in healthy animals?

  1. Vitamin K Correct answer.
  2. Vitamin A
  3. Vitamin E
  4. Vitamin D

Explanation

Vitamin K is produced by intestinal microflora, so deficiency is uncommon except with certain toxicities or malabsorption. The other listed vitamins are fat-soluble and depend on dietary supply.

Question 17Nutritional Assessment and Requirements

Which mineral is most closely associated with the development of nutritional secondary hyperparathyroidism in pets fed unbalanced meat-based diets?

  1. Iron
  2. Iodine
  3. Calcium Correct answer.
  4. Copper

Explanation

A diet low in calcium relative to phosphorus lowers ionized calcium and stimulates parathyroid hormone release, causing bone resorption. This is the mechanism of nutritional secondary hyperparathyroidism.

Question 18Nutritional Assessment and Requirements

A cat with obesity is being placed on a weight-loss plan. Which approach is most appropriate for monitoring progress?

  1. Switch to a high-fat diet to increase satiety
  2. Reduce protein to the minimum possible
  3. Fast the cat for several days to jump-start weight loss
  4. Weigh the cat regularly and adjust intake to achieve gradual loss while preserving lean mass Correct answer.

Explanation

Weight loss should be gradual, with regular weighing and adjustment of intake to preserve lean mass. Rapid weight loss in cats risks hepatic lipidosis.

Question 19Nutritional Assessment and Requirements

Which statement about the caloric content of a pet food is accurate?

  1. Digestible energy is always higher than gross energy
  2. Gross energy equals the energy available to the animal
  3. Metabolizable energy accounts for energy lost in feces, urine, and gases Correct answer.
  4. Metabolizable energy is unrelated to digestibility

Explanation

Metabolizable energy is the energy remaining after accounting for losses in feces, urine, and combustible gases. It is the value used to estimate how much energy the animal actually obtains.

Question 20Nutritional Assessment and Requirements

Which factor most strongly increases a dog's maintenance energy requirement?

  1. Feeding a high-fiber diet
  2. Increased physical activity such as working or sledding Correct answer.
  3. Neutering
  4. Aging into a sedentary senior lifestyle

Explanation

Heavy physical activity substantially raises energy expenditure and therefore maintenance energy needs. Neutering and sedentary aging tend to lower requirements.

Question 21Nutritional Assessment and Requirements

Which of the following is the best indicator of adequate hydration status during a nutritional assessment?

  1. Skin turgor and mucous membrane moisture Correct answer.
  2. Coat gloss
  3. Appetite score
  4. Body condition score

Explanation

Hydration is assessed clinically by skin turgor, mucous membrane moisture, and related physical findings. Coat and appetite do not directly reflect hydration.

Question 22Nutritional Assessment and Requirements

A diet change is being made for a dog with food-responsive gastrointestinal disease. Which strategy is most appropriate?

  1. Withhold food entirely for 72 hours before switching
  2. Switch abruptly to a new diet in a single meal
  3. Transition gradually over several days while monitoring clinical signs Correct answer.
  4. Feed two different novel diets simultaneously

Explanation

Gradual transition over about a week reduces the risk of gastrointestinal upset and allows monitoring of response. Abrupt changes can cause diarrhea even in healthy animals.

Question 23Nutritional Assessment and Requirements

Which nutrient is most likely to be limiting in a diet based primarily on cereal grains for a cat?

  1. Fiber
  2. Taurine Correct answer.
  3. Carbohydrate
  4. Vitamin C

Explanation

Cats require preformed taurine, which is found in animal tissue; grain-based diets can be limiting unless supplemented. Carbohydrate and fiber are generally abundant in cereal-based diets.

Question 24Nutritional Assessment and Requirements

Which of the following is a valid reason to recommend a therapeutic diet for a pet?

  1. The owner prefers an expensive brand
  2. The animal is healthy and at ideal body condition
  3. The animal has a diagnosed condition that responds to specific nutrient modification Correct answer.
  4. The pet is a picky eater

Explanation

Therapeutic diets are indicated when a diagnosed condition benefits from controlled nutrient levels, such as renal or urinary diets. They are not indicated based on cost preference or mere pickiness.

Question 25Nutritional Assessment and Requirements

Which statement about the calcium-to-phosphorus ratio in a balanced canine diet is correct?

  1. It should be maintained within a narrow range, roughly 1:1 to 2:1 Correct answer.
  2. It is irrelevant as long as total calories are adequate
  3. It should be below 0.5:1
  4. It should be as high as possible

Explanation

A calcium-to-phosphorus ratio of approximately 1:1 to 2:1 supports normal skeletal metabolism. Marked deviation, particularly low calcium relative to phosphorus, causes skeletal disease.

Question 26Nutritional Assessment and Requirements

In a standard nutritional assessment of a healthy adult dog, which combination of findings is used to establish body condition score (BCS)?

  1. Visual assessment and palpation of the ribs, spine, and waist Correct answer.
  2. Measurement of blood albumin and total protein concentrations
  3. Recording of daily food intake and fecal output volume
  4. Measurement of skinfold thickness with calipers at the flank

Explanation

Body condition score is a subjective but standardized tool based on visual inspection and palpation of key bony landmarks and body contours. Skinfold calipers, blood proteins, and intake records are not the basis for assigning a BCS.

Question 27Nutritional Assessment and Requirements

Which term describes the energy content of a pet food after accounting for losses in feces, urine, and combustible gases?

  1. Gross energy
  2. Atwater energy
  3. Metabolizable energy Correct answer.
  4. Digestible energy

Explanation

Metabolizable energy is the energy remaining after fecal, urinary, and gaseous losses are subtracted from gross energy, and it is the value typically used to describe a diet's usable energy. Digestible energy accounts only for fecal losses.

Question 28Nutritional Assessment and Requirements

Which statement correctly describes the concept of a 'life stage' nutrient profile in companion animal nutrition?

  1. It specifies nutrient levels only for animals with diagnosed disease
  2. It describes the physical form of the diet, such as dry or canned
  3. It lists the maximum safe intake for each nutrient regardless of age
  4. It sets nutrient levels appropriate for growth, reproduction, or adult maintenance Correct answer.

Explanation

Life-stage profiles define nutrient adequacy targets that differ by physiologic state, such as growth, gestation/lactation, and adult maintenance. They are not disease-specific, form-based, or simply safety ceilings.

Question 29Nutritional Assessment and Requirements

Which measurement is the most practical field method for estimating a pet's daily water intake in a home setting?

  1. Assessing skin turgor once daily
  2. Counting the number of times the pet visits the water bowl
  3. Estimating intake from the moisture content of the food alone
  4. Measuring water offered and subtracting water remaining after 24 hours Correct answer.

Explanation

Subtracting the water remaining from the water offered over a defined period gives a practical estimate of voluntary intake. Bowl visits and skin turgor do not quantify volume, and food moisture alone ignores drinking.

Question 30Nutritional Assessment and Requirements

A healthy adult dog weighs 20 kg. Using the standard exponential formula for resting energy requirement (RER = 70 x body weight in kg^0.75), what is the approximate RER?

  1. About 400 kcal per day
  2. About 200 kcal per day
  3. About 1,400 kcal per day
  4. About 660 kcal per day Correct answer.

Explanation

The exponential formula scales energy need to metabolic body size, and for 20 kg the calculation yields roughly 660 kcal per day. Linear scaling by body weight overestimates or underestimates need depending on size.

Question 31Nutritional Assessment and Requirements

A sedentary, neutered indoor cat has a body condition score of 8/9. Which adjustment to energy intake is most appropriate when beginning a weight-management plan?

  1. Feed at the calculated maintenance energy for the cat's current weight
  2. Feed free-choice to allow the cat to self-regulate intake
  3. Feed at or slightly below the calculated maintenance energy for the cat's ideal weight Correct answer.
  4. Increase energy intake to meet the RER for the current weight

Explanation

For weight loss, energy should be based on the ideal or target weight rather than current weight, with a modest restriction. Feeding to current weight or above maintains or worsens obesity.

Question 32Nutritional Assessment and Requirements

During a nutritional assessment, a dog is found to have muscle wasting, poor coat quality, and a history of inadequate intake over several weeks. Which domain of the assessment do these findings primarily reflect?

  1. Diet formulation method
  2. Environmental and husbandry factors
  3. Body composition and muscle condition Correct answer.
  4. Client financial constraints

Explanation

Muscle condition score and coat quality reflect body composition and protein status, which are core components of the nutritional assessment. The other options describe context or formulation, not the physical findings.

Question 33Nutritional Assessment and Requirements

Which factor most directly determines the protein requirement of a growing puppy compared with an adult dog of the same breed?

  1. The higher fat content of puppy diets
  2. The higher demand for tissue growth and development Correct answer.
  3. The lower digestive efficiency of young animals
  4. The greater surface area relative to body weight

Explanation

Growth requires additional amino acids for tissue accretion, so protein needs per unit energy are higher in puppies. Surface area, digestive efficiency, and dietary fat do not directly set the protein requirement.

Question 34Nutritional Assessment and Requirements

A diet provides 4 g of crude fiber per 100 g of dry matter and has high digestibility of other nutrients. Which statement best describes the role of this fiber level in a healthy adult dog?

  1. It is the primary energy source for the dog
  2. It contributes little energy but supports normal intestinal function Correct answer.
  3. It is entirely fermented to short-chain fatty acids
  4. It prevents absorption of all dietary protein

Explanation

Moderate fiber contributes minimal metabolizable energy but supports motility and fecal quality. Dogs are not reliant on fiber fermentation as a primary energy source, and fiber does not block protein absorption entirely.

Question 35Nutritional Assessment and Requirements

A cat's diet is being evaluated for taurine adequacy. Which characteristic of feline metabolism makes dietary taurine essential?

  1. Excessive renal excretion of all amino acids
  2. High dependence on carbohydrate as an energy source
  3. Complete inability to absorb dietary taurine
  4. Limited activity of the enzyme that synthesizes taurine from precursors Correct answer.

Explanation

Cats have limited capacity to synthesize taurine from cysteine and methionine precursors, so it must be supplied preformed in the diet. They can absorb dietary taurine, and the issue is synthesis, not generalized amino acid loss.

Question 36Nutritional Assessment and Requirements

A dog is eating a commercial diet that meets a nutrient profile, but the owner reports the dog is losing weight. Which is the most appropriate first step in the nutritional assessment?

  1. Verify the actual amount fed and the diet's energy density Correct answer.
  2. Switch immediately to a high-protein therapeutic diet
  3. Increase the feeding amount without further assessment
  4. Assume the diet is nutritionally inadequate and replace it

Explanation

Weight loss despite an adequate diet usually reflects an energy deficit from underfeeding or a lower-than-expected energy density, so quantifying intake and energy content comes first. Blind changes bypass the assessment.

Question 37Nutritional Assessment and Requirements

Which statement about the calcium-to-phosphorus ratio in a balanced adult canine diet is correct?

  1. Phosphorus should greatly exceed calcium to support bone
  2. The ratio should be maintained within a moderate range with adequate absolute amounts of both minerals Correct answer.
  3. A ratio of 1:1 is mandatory for all life stages
  4. The ratio is irrelevant as long as total calcium is high

Explanation

Both the absolute amounts and the ratio of calcium to phosphorus matter; the ratio should remain within a moderate range so that neither mineral is excessive or deficient relative to the other. Extreme ratios, in either direction, can impair mineral balance.

Question 38Nutritional Assessment and Requirements

A cat with a history of calcium oxalate urolithiasis is being assessed. Which dietary approach is most consistent with reducing recurrence risk?

  1. Promoting increased water intake and moderate urinary pH control Correct answer.
  2. Feeding a diet very high in calcium and oxalate precursors
  3. Increasing dietary phosphorus to very high levels
  4. Restricting water intake to concentrate the urine

Explanation

Higher urine volume dilutes stone-forming solutes, and appropriate pH management supports stone prevention. Concentrating urine or loading stone precursors increases risk.

Question 39Nutritional Assessment and Requirements

A performance sled dog in peak training has a much higher energy requirement than a sedentary dog of the same weight. Which explanation best accounts for this difference?

  1. The dog's basal metabolic rate is permanently elevated by breed
  2. The dog absorbs a smaller fraction of dietary energy
  3. Sustained high physical activity markedly increases energy expenditure Correct answer.
  4. The dog's body weight is lower than that of the sedentary dog

Explanation

The maintenance energy requirement is multiplied by an activity factor that rises with workload, so intense sustained exercise greatly increases expenditure. Basal rate, absorption, and body weight do not explain the large gap.

Question 40Nutritional Assessment and Requirements

An older dog with reduced appetite and mild chronic kidney disease is being assessed. Which principle best guides dietary adjustment?

  1. Eliminate all dietary protein to reduce nitrogen load
  2. Balance palatability, adequate energy, and moderated protein and phosphorus within the animal's tolerance Correct answer.
  3. Maximize protein intake regardless of kidney status
  4. Prioritize high phosphorus to support renal function

Explanation

In kidney disease, diets moderate protein and phosphorus while remaining palatable and energy-dense enough to meet needs, since inadequate intake is a major risk. Extreme protein restriction or phosphorus loading is inappropriate.

Question 41Enteral and Parenteral Nutrition Support

Which statement best describes the primary rationale for choosing enteral nutrition over parenteral nutrition when the gastrointestinal tract is functional?

  1. Enteral feeding preserves intestinal mucosal integrity and supports normal gut barrier function Correct answer.
  2. Enteral feeding guarantees a faster rate of weight gain than parenteral feeding
  3. Enteral feeding eliminates the need for any monitoring of electrolyte status
  4. Enteral feeding delivers more calories per milliliter of fluid than parenteral solutions

Explanation

Enteral nutrition maintains mucosal trophism, supports villous architecture, and helps preserve the gut barrier, which reduces bacterial translocation and sepsis risk. Calorie density and fluid restriction are not the deciding rationale, and monitoring remains necessary with any feeding route.

Question 42Enteral and Parenteral Nutrition Support

A patient requires a feeding tube placed for long-term home feeding with the lowest practical risk of aspiration and esophagitis. Which tube placement is generally preferred?

  1. Nasoesophageal tube
  2. Nasogastric tube
  3. Gastrostomy tube Correct answer.
  4. Nasojejunal tube passed only to the stomach

Explanation

Gastrostomy tubes bypass the esophagus and pharynx, are suitable for long-term use, and reduce the risk of reflux-related esophagitis and aspiration compared with nasal tubes. Nasal tubes are typically used for short-term support.

Question 43Enteral and Parenteral Nutrition Support

What is the primary purpose of initiating enteral feeding at a low rate and gradually increasing it over 24 to 48 hours?

  1. To sterilize the feeding tube lumen before full use
  2. To increase the viscosity of the diet for easier delivery
  3. To prevent the feeding tube from migrating into the esophagus
  4. To reduce the risk of refeeding syndrome and gastrointestinal intolerance Correct answer.

Explanation

Gradual escalation allows the gut to adapt and limits the osmotic and metabolic load, reducing diarrhea, vomiting, and the electrolyte shifts of refeeding syndrome. Tube position and diet viscosity are unrelated to the ramp-up schedule.

Question 44Enteral and Parenteral Nutrition Support

Which fluid is recommended for flushing a feeding tube between medications and feedings in most patients?

  1. Carbonated beverages
  2. Sterile hypertonic saline
  3. Tap water at room temperature
  4. Warm water Correct answer.

Explanation

Warm water effectively clears the tube lumen and dissolves residual formula without adding unnecessary solutes. Hypertonic saline adds a sodium load, and carbonated beverages can promote clogging and are not recommended.

Question 45Enteral and Parenteral Nutrition Support

Which statement about the osmolality of enteral formulas is correct?

  1. Osmolality has no relationship to gastrointestinal tolerance
  2. Isosmolar formulas cannot be delivered by bolus feeding
  3. Hyperosmolar formulas are more likely to cause osmotic diarrhea when delivered rapidly into the small intestine Correct answer.
  4. Hypoosmolar formulas always cause dumping syndrome regardless of delivery rate

Explanation

Rapid delivery of hyperosmolar formula into the small bowel draws water into the lumen and can produce osmotic diarrhea. Slower delivery or dilution mitigates this effect, and osmolality clearly influences tolerance.

Question 46Enteral and Parenteral Nutrition Support

Which parameter is most appropriate for confirming correct placement of a nasogastric tube before the first feeding?

  1. Measurement of the pH of a fluid aspirate only
  2. Observation of the patient swallowing during placement
  3. Radiographic confirmation of tube position Correct answer.
  4. Auscultation of air insufflated through the tube

Explanation

Radiography remains the reference method for confirming tube position before initial use. Auscultation of insufflated air is unreliable, and pH testing alone has limitations in patients on acid suppression.

Question 47Enteral and Parenteral Nutrition Support

In parenteral nutrition, what is the main reason dextrose solutions for central administration are formulated at high concentration?

  1. To limit the total volume needed to meet energy requirements Correct answer.
  2. To sterilize the solution during compounding
  3. To prevent precipitation of calcium and phosphate
  4. To reduce the osmolarity of the final admixture

Explanation

Concentrated dextrose allows adequate energy to be delivered in a smaller volume, which is essential in fluid-restricted patients. Higher dextrose concentration increases, rather than reduces, osmolarity and requires central venous delivery.

Question 48Enteral and Parenteral Nutrition Support

Which patient is the most appropriate candidate for peripheral parenteral nutrition rather than central parenteral nutrition?

  1. A patient with recurrent central line infections
  2. A patient requiring highly concentrated dextrose and amino acid solutions
  3. A patient needing a brief course of partial nutritional support with adequate peripheral access Correct answer.
  4. A patient requiring long-term home parenteral nutrition for short bowel syndrome

Explanation

Peripheral parenteral nutrition suits short-term, partial support because osmolarity must be kept low to avoid phlebitis. Long-term or highly concentrated needs generally require central access.

Question 49Enteral and Parenteral Nutrition Support

A dog on parenteral nutrition develops hyperglycemia shortly after the infusion rate is increased. Which is the most appropriate initial action?

  1. Administer additional dextrose to stimulate insulin release
  2. Reduce the infusion rate and reassess glucose Correct answer.
  3. Discontinue all nutrition abruptly
  4. Increase the lipid fraction while keeping dextrose constant

Explanation

Hyperglycemia during parenteral nutrition is managed first by slowing the infusion rate and rechecking glucose, since abrupt cessation risks hypoglycemia and refeeding complications. Insulin or formula adjustments follow if needed.

Question 50Enteral and Parenteral Nutrition Support

Which finding is a classic early sign of refeeding syndrome in a malnourished patient started on enteral feeding?

  1. Hypophosphatemia and hypokalemia Correct answer.
  2. Hypernatremia and hyperchloremia
  3. Hyperkalemia and hyperphosphatemia
  4. Hypercalcemia and hypermagnesemia

Explanation

Refeeding syndrome is driven by an insulin surge that shifts phosphate, potassium, and magnesium intracellularly, producing hypophosphatemia, hypokalemia, and hypomagnesemia. Monitoring and correcting these electrolytes before and during feeding is essential.