Case Studies & Practical Application Flashcards
7 cards from real ACBN practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Case Studies & Practical Application flashcards as text
A 55-year-old male with type 2 diabetes and hypertension reports fasting blood glucose of 180 mg/dL and BP of 145/92 mmHg. Which dietary modification should be prioritized first?
Answer: Reduce sodium to <2,300 mg/day and refined carbohydrates simultaneously
Addressing both sodium reduction and refined carbohydrate restriction simultaneously targets both hypertension and glycemic control, the two primary concerns.
A breastfeeding mother asks about her increased nutrient needs. Which nutrient has the highest percentage increase above baseline DRI during lactation?
Answer: Iodine
Iodine requirements increase by approximately 90 mcg/day during lactation, representing the largest percentage increase above baseline DRI.
A client with celiac disease presents with persistent fatigue and lab results showing low ferritin, low folate, and low vitamin D. What is the most likely explanation?
Answer: Small intestinal damage causing malabsorption of multiple nutrients
Celiac disease causes villous atrophy in the small intestine, impairing absorption of iron, folate, vitamin D, and many other nutrients even with dietary compliance.
A 70-year-old woman with osteoporosis is prescribed bisphosphonate therapy. What nutritional counseling is most critical regarding calcium supplementation timing?
Answer: Separate calcium supplements by at least 30 minutes from bisphosphonate administration
Calcium significantly impairs bisphosphonate absorption; supplements must be separated by at least 30 minutes (and ideally 2 hours) from medication intake.
A collegiate wrestler is cutting 8 lbs in 5 days before a weigh-in using severe fluid and food restriction. Which acute risk should the nutritionist emphasize most urgently?
Answer: Cardiac arrhythmia from electrolyte imbalance
Rapid dehydration and electrolyte depletion—particularly potassium and sodium—can trigger life-threatening cardiac arrhythmias in the short term.
A 28-year-old vegan woman in her first trimester of pregnancy has a serum B12 of 180 pg/mL (normal >200). What is the most appropriate intervention?
Answer: Recommend immediate B12 supplementation of at least 2.4 mcg/day (preferably higher)
Low B12 during pregnancy risks fetal neural tube defects and neurological damage; supplementation above the baseline DRI is warranted immediately.
A patient post-Roux-en-Y gastric bypass surgery reports tingling in hands and feet 18 months post-op. Labs show normal glucose but low copper. What dietary or supplement recommendation is most appropriate?
Answer: Copper supplementation and review zinc-to-copper ratio in current supplement regimen
Post-bypass copper deficiency causes peripheral neuropathy; excess zinc supplementation (common post-surgery) competitively inhibits copper absorption and should be evaluated.