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NUTRITION NBNSC-CNSC Exam Syllabus Topics:

SectionWeightObjectives
Process Management5%- Safety, compliance and regulatory standards
- Guidelines, protocols and quality improvement
- Documentation, ordering and inventory management
Professional Practice7%- Education, counseling and patient advocacy
- Ethics, scope of practice and interprofessional collaboration
- Legal and professional responsibilities
Clinical Management57%- Enteral nutrition: selection, access, formulation, administration
- Parenteral nutrition: access, formulation, compounding, administration
- Transition between nutrition support modalities
- Monitoring, evaluation and adjustment of nutrition therapy
- Management of complications and metabolic disorders
Nutrition Assessment31%- Determination of nutrition requirements and goals
- Patient screening and risk identification
- Anthropometric, biochemical, clinical and dietary assessment
- Assessment of disease impact on nutrition status

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NUTRITION NBNSC Certified Nutrition Support Clinician (CCN) Sample Questions (Q55-Q60):

NEW QUESTION # 55
Which of the following is the SECOND stage of change?

Answer: D

Explanation:
Prochaska and DiClemente's model, also known as the Transtheoretical Model of Behavior Change, outlines six stages through which individuals typically pass when they are trying to modify a behavior. The stages are: Precontemplation, Contemplation, Preparation, Action, Maintenance, and Termination. Each stage represents a different mindset and readiness to change.
The second stage, Contemplation, is marked by the individual's awareness of the need for change. During this stage, the person acknowledges that there is a problem and begins to think seriously about solving it. However, they have not yet made a commitment to take action. This stage is characterized by ambivalence - the individual may desire change but also resist it because of the perceived costs or effort involved.
In Contemplation, individuals spend time considering the pros and cons of changing their behavior and the potential impact it might have on their lives. They are weighing their options and recognizing the benefits of change but are often held back by fear, uncertainty, or the comfort of familiar habits.
This stage can last for a long time as the individual wrestles with these conflicting emotions. The progression to the next stage, Preparation, typically occurs when the balance tips in favor of the benefits of change, leading the individual to start planning actionable steps.


NEW QUESTION # 56
There are practice-specific SOPs and SOPPS that have been developed. Published currently are standards for all of the following except:

Answer: C

Explanation:
The question is asking to identify which area does not currently have published standards among the given options. The options provided are "functional medicine," "not extended care settings," "diabetes care," and "oncology nutrition care." Based on the information provided, the standards that have been published currently cover functional medicine, extended care settings, diabetes care, and oncology nutrition care. Additionally, the standards also include pediatric nutrition, nephrology care, and education of dietetics practitioners.
Since the options "functional medicine," "diabetes care," and "oncology nutrition care" are explicitly mentioned as areas for which standards have been published, they are not the correct answer.
The phrase "not extended care settings" suggests a negation of extended care settings, implying that standards for extended care settings might not exist. However, according to the provided details, standards for extended care settings have indeed been published.
Thus, the confusion arises from the repeated phrase "not extended care settings" which seems to be a typographical or formatting error in the question. Since the provided text confirms that standards for extended care settings have been published, none of the options correctly answer the question under usual circumstances as all listed areas have published standards.
Therefore, the correct answer should ideally indicate that all the mentioned areas do have published standards, suggesting either a problem with the question or a requirement for clarification/reformulation of the options provided.


NEW QUESTION # 57
If a person is on a low-residue diet, he or she should avoid which of the following?

Answer: D

Explanation:
A low-residue diet is designed to reduce the frequency and volume of stools while extending the time these stools remain in the intestines. This diet is typically recommended for individuals with digestive tract conditions such as inflammatory bowel disease (IBD), diverticulitis, or other conditions that may require bowel rest. It minimizes the intake of foods that add bulk to stools, which includes a significant reduction in fiber.
Fiber, which is crucial for regular bowel movements under normal circumstances, is found in high amounts in foods like fruits, vegetables, whole grains, and legumes. On a low-residue diet, the goal is to decrease fiber intake to lessen bowel activity. Dried fruits, in particular, are very high in fiber and are concentrated sources of it, as the dehydration process removes water, leaving behind a higher proportion of fiber and sugars.
Therefore, when considering which foods to avoid on a low-residue diet, dried fruits are a prime candidate. They not only have a high fiber content but also often contain skins and seeds, which can further irritate the digestive tract. In addition to dried fruits, other high-fiber foods such as fresh fruits and vegetables (especially those with skins and seeds), whole-grain breads, cereals, legumes, and tough, fibrous meats should also be avoided.
The diet might also exclude other items that could exacerbate symptoms or lead to increased residue in the colon. These include coconut, marmalade (which contains fruit peels), rich pastries (which can be high in fat and hard to digest), and dairy products if they exacerbate symptoms. Some forms of meat, particularly those with connective tissues and tougher cuts, and any vegetables with potentially indigestible skins, like potatoes, are also to be avoided unless properly peeled and cooked to a soft texture.
In summary, for a person on a low-residue diet, avoiding dried fruits is essential due to their high fiber content and potential to cause digestive discomfort. This diet requires careful selection of foods that are low in fiber and easy on the digestive system to reduce bowel activity and irritation.


NEW QUESTION # 58
A guided goal setting intervention called EatFit using computer technology with middle school adolescents in various school and community settings uses constructs of SCT to improve eating and fitness choices. These goals were reinforced through lessons that focused on all of the following except:

Answer: A

Explanation:
The question presents a scenario where a guided goal-setting intervention named EatFit, utilizes computer technology to influence the eating and fitness choices of middle school adolescents. The intervention is built on the constructs of Social Cognitive Theory (SCT), which emphasizes observational learning, self-efficacy, and behavioral reinforcements. The question asks which of the listed focus areas was not emphasized during the lessons that were part of the EatFit intervention.
Let's analyze the options given: 1. **Learning to read food labels** - This option is likely included as part of the intervention. Reading food labels is a practical skill that can directly influence one's dietary choices, aligning well with the goals of improving eating habits. 2. **Only using input from the adolescent** - This option seems inconsistent with the SCT framework, which often involves social influences and guidance from others (such as teachers or peers). Solely relying on the adolescent's input could limit the effectiveness of the intervention by not incorporating a broader perspective or expert guidance. 3. **Verbal encouragement** - Verbal encouragement fits well within the SCT framework as it can enhance self-efficacy and motivation. Positive reinforcement through encouragement can help adolescents feel supported in achieving their dietary and fitness goals. 4. **Self-regulation** - Teaching self-regulation skills is a core aspect of SCT as it helps individuals control their behaviors and maintain changes over time. Skills like setting personal goals, monitoring progress, and adjusting behaviors are crucial for long-term adherence to healthy eating and fitness habits.
Given these analyses, the option "only using input from the adolescent" is the least likely to be reinforced through the lessons in the EatFit intervention. This approach would contradict the collaborative and guided nature of SCT-based interventions, which typically involve inputs from multiple sources including peers, educators, and guided self-assessment. Instead, effective interventions would integrate advice from knowledgeable sources, peer interactions, and guided self-reflection to encourage broader learning and sustainable behavior change.


NEW QUESTION # 59
Mealtime should be pleasant and food should not be forced on the child. Forcing a child to eat can cause all of the following except:

Answer: A

Explanation:
The question you've asked focuses on the negative outcomes that can arise when a child is forced to eat, rather than allowing them to choose how much to eat based on their own hunger cues. The correct approach to mealtime, as suggested, should involve creating a pleasant atmosphere where nutritious food is provided, and the child is given the autonomy to decide whether and how much to eat. Forcing a child to eat can have several adverse effects, but not all the options listed in the question are correct. Let's expand on each option provided to understand which one does not fit as a consequence of forcing a child to eat:
**Anorexia Nervosa:** This is an eating disorder characterized by an obsessive fear of gaining weight and a refusal to maintain a healthy body weight. Forcing a child to eat can contribute to the development of unhealthy relationships with food, including disorders like anorexia. This can occur as children might begin to associate eating with stress or punishment, potentially leading them to avoid eating to regain a sense of control.
**A Healthy Appetite:** This option is the correct answer to "all of the following except." A healthy appetite is a natural, positive response to hunger that should be encouraged. It involves eating when hungry and stopping when full. Forcing a child to eat disrupts this natural cueing system, potentially leading them to override feelings of fullness or to eat when they are not hungry, which is not indicative of a healthy appetite. Thus, forcing food does not promote a healthy appetite; instead, it likely hampers it.
**Bulimia:** Bulimia nervosa is another serious eating disorder marked by periods of binge eating followed by purging to avoid weight gain. Like anorexia, bulimia can also stem from unhealthy relationships with food developed during childhood. Forcing a child to eat can instill feelings of powerlessness about food choices, which might later manifest as binge eating (a lack of control) followed by purging as a regain of that control.
**Chronic Overeating:** Chronic overeating can develop when individuals habitually eat more than their bodies require, often not in response to true hunger cues. This behavior can be fostered from a young age if children are pushed to eat beyond satiety, leading them to ignore their internal cues and continue eating despite being full. Over time, this can evolve into habitual overeating, significantly impacting health and wellbeing. In summary, the only outcome from the list that is not a likely consequence of forcing a child to eat is "a healthy appetite." All other options listed can potentially be negative consequences of such behavior.


NEW QUESTION # 60
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