Certified Specialist in Oncology Nutrition (CSO) Practice Exam

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• In a Macrobiotic diet, organic whole grains should make up about what percentage of daily intake?
• Which ethical principle is central when making nutrition support decisions for patients with limited prognosis in advanced cancer?
• What common barriers to effective nutrition in cancer care do oncology dietitians help to overcome, and which strategy is commonly effective?
• How does handgrip strength contribute to oncology nutrition assessment, and what might low grip strength indicate?
• Which of the following is a risk factor for anticipatory nausea and vomiting (ANV)?
• In the setting of febrile neutropenia, which nutrition and food-safety precautions are recommended?
• In total parenteral nutrition, which component provides the highest calories per gram?
• What is the target range for vitamin D repletion in cancer patients?
• Describe a practical nutrition plan for cancer patients with anorexia and early satiety.
• Streptozotocin (Zanosar) commonly causes which metabolic disturbance?
• Which statement best reflects nutrition considerations for head and neck cancer during radiation therapy?
• Which statement best describes the Macrobiotic diet's main dietary emphasis?
• Which statement correctly describes the two main types of targeted therapy?
• In oncology nutrition care, which statement about caregiver involvement is most accurate?
• Which drug helps move food through the stomach and can prevent early satiety in undernourished patients?
• What are key considerations when designing a nutrition plan for patients with dysphagia caused by tumor effects or therapy?
• Why are fortified foods often used in pediatric oncology nutrition?
• Which nutrition problem is most likely to occur after surgery for cancer of the gallbladder or bile duct?
• Which nutrition problem is most associated with pancreatic exocrine insufficiency after surgery?
• Which professional should be consulted for dysphagia management in cancer patients?
• What is the initiation rate for bolus or gravity feeding for the first 1-2 feedings, and how should it be increased?
• Which hematologic trends commonly seen in cancer influence nutrition planning?
• Which dietary supplement strategy is recommended when a patient is prescribed Zoledronic acid for stage IV breast cancer with bone metastasis?
• Zoledronic acid belongs to which drug class?
• An cancer patient who is fully active and able to carry on all pre-disease activities without restrictions corresponds to which ECOG grade?
• Why is serum albumin not a reliable sole marker of malnutrition in cancer patients, and what other measures should be used?
• What is a key safety consideration when IV iron is used in cancer patients?
• In the context of corticosteroid-induced weight gain, what is a practical nutritional approach?
• In the nutritional management of chyle leaks, which dietary strategy is NOT recommended?
• Total parenteral nutrition is most appropriate for which hospitalized patient scenario?
• Which of the following is an example of a monoclonal antibody?
• How is body composition monitoring used in oncology nutrition to personalize interventions, and which practical methods are available in clinics?
• What actions are recommended to reduce cold dysesthesia during Oxaliplatin treatment?
• Which statement correctly describes refeeding syndrome and its prevention during nutritional rehabilitation?
• Which rating indicates the highest level of evidence in nutrition recommendations?
• Pediatric oncology nutrition needs differ from adults in terms of growth, dosing, and appetite.
• Which of the following measures is used alongside GLIM criteria to assess malnutrition in cancer patients?
• Which drug is prescribed as an antidote to methotrexate?
• In hematopoietic stem cell transplantation (HSCT), what nutrition approach is preferred when the gut is functional?
• How should fat intake be adjusted in cancer patients with biliary obstruction or liver metastases?
• Which dietary patterns are commonly recommended for supportive care in cancer, and what is the evidence base?
• If the pyloric valve (located at the base of the stomach) was removed or manipulated during surgery, the patient is at risk for which condition?
• Ondansetron may cause constipation or diarrhea in cancer patients.
• During HSCT, which nutrition management step is recommended?
• What are the phenotypic and etiologic criteria in the GLIM framework for diagnosing malnutrition?
• Which of the following is NOT a nutrition impact symptom commonly associated with gastrectomy?
• Which is a common sign of iron deficiency anemia in cancer patients?
• Which inflammatory marker often correlates with malnutrition risk in cancer patients and guides prognosis?
• Which medication is used to reduce the severe dry mouth caused by radiation treatment for head and neck cancer?
• Which nutrient combination is commonly malabsorbed after small bowel surgery?
• In colorectal cancer patients undergoing pelvic radiation, weekly MNT with an individualized nutrition prescription may improve which outcomes?
• How does mucositis severity influence nutrition delivery and oral intake strategies?
• According to evidence-based guidelines, what is the rating of the pretreatment evaluation and weekly radiation visits for head and neck cancer MNT?
• Which nutrition problem is most likely after surgery affecting the pancreas?
• An oral prodrug that is converted to 5-FU in the body
• St. John's Wort may do what to the activity of Vinblastine (Velban) and Vincristine (Oncovin)?
• The ketogenic diet limits carbohydrate intake to 5-10% of the total diet, typically between 15-50 grams daily.
• Biotherapy is a treatment to ...
• Which nutrition strategies are effective for managing cancer-related fatigue?
• Which chemotherapy agent requires restriction of tyramine-containing foods due to a monoamine oxidase–inhibitor–like action?
• Which medication is a progesterone hormone derivative used to improve appetite and weight gain in cancer patients?
• Which foods are known to alter CYP3A4 enzyme activity and potentially affect drug efficacy or toxicity?
• The antidote for a 5-FU overdose is uridine triacetate (Vistogard).
• Which herbal supplements are listed as affecting CYP3A enzymes?
• For mucositis, which nutrition approach is recommended?
• Which of the following is a primary reason for performing nutrition screening in cancer patients?
• What components are used to diagnose sarcopenia in cancer patients?
• In chyle leak management, what percentage of total calories should come from essential fatty acids to avoid deficiency?
• What is the typical target range for 25-hydroxyvitamin D [25(OH)D] in cancer patients to optimize vitamin D status?
• Which nutrition symptom is listed as a high-risk criterion due to dysphagia?
• Nestle Health Science suggests limiting MCT oil to _____ mL/day.
• Which OTC medication should be avoided within 2 hours of taking Tamoxifen?
• Which daily activity guideline does the American Institute for Cancer Research (AICR) emphasize for cancer prevention?
• How does neutropenia influence nutrition risk and dietary planning?
• Where is intrinsic factor produced, which is necessary for Vitamin B12 absorption?
• Which is a phenotypic criterion in GLIM malnutrition diagnosis?
• Which method is preferred to determine energy requirements when possible?
• What are the reported rates of constipation and diarrhea with Ondansetron in cancer patients?
• What is the rating for the colorectal cancer pelvic radiation MNT guideline?
• When addressing anemia in cancer patients, which nutrition-focused approach is appropriate?
• A patient with a new ileostomy should avoid both soluble and insoluble fiber after surgery.
• What are the four steps of the Nutrition Care Process (ADIME) used in oncology nutrition practice?
• Nadir in chemotherapy refers to:
• The high-risk criteria based on site or stage includes how many items?
• Which herbal supplement is listed among those that affect CYP3A enzymes?
• Leucovorin given with fluorouracil (5-FU) can cause the side effects of 5-FU to be more severe.
• In adults with cancer, what is the typical protein intake target per kilogram of body weight per day, and how can this be adjusted for severe catabolic burden?
• When treating vitamin D deficiency in cancer patients, which monitoring is appropriate?
• Evidence-based MNT during radiation for head and neck cancer has been shown to improve which outcomes?
• Which of the following is an example of a monoclonal antibody used in targeted cancer therapy?
• Which drug is used as an adjunct antiemetic due to its anxiolytic effects?
• Which cancer site is included in the high-risk nutrition screening criteria based on site or stage?
• ANV is more likely with drugs that have what emetogenic potential?
• 100 mL/day of MCT oil provides approximately how many kcals?
• Targeted cancer therapy works by primarily targeting what in cancer biology?
• Esophageal cancer patients undergoing concurrent chemoradiation should receive MNT with a pretreatment evaluation and weekly visits for six weeks during treatment. Which option describes this plan?
• What do GLIM criteria require to diagnose malnutrition?
• Intrinsic factor is required for absorption of which vitamin?
• In a cancer patient unable to self-care with rapidly progressing disease, which Karnofsky Performance Status score is most likely?
• Which antiemetic is a neurokinin-1 receptor antagonist used for chemotherapy-induced nausea?
• By the fourth cycle of chemotherapy, approximately what percentage of patients develop anticipatory nausea and vomiting (ANV)?
• Which of the following is recommended for managing cancer-associated constipation through diet and hydration?
• When is enteral nutrition (EN) preferred over parenteral nutrition (PN) in cancer patients?
• To achieve adequate GI absorption with TF, the required lengths are: Jejunum 100 cm and Ileum 150 cm with ileocecal valve.
• In the Scored Patient-Generated Subjective Global Assessment (PG-SGA©), an additive score of 10 indicates what level of intervention is required?
• Which statement correctly describes the decision criterion for choosing PN over EN in cancer patients?
• Which drug is a selective 5-HT3 receptor antagonist commonly used to prevent chemotherapy-induced nausea and vomiting?
• Which statement is NOT a high-risk criterion based on cancer treatment?
• Among hospitalized oncology patients, which would be your first nutrition priority?
• What is Protein-Energy Wasting (PEW) in cancer, and how is it identified conceptually?
• Vitamin and mineral supplementation in cancer care should be:
• Amino acids provide how many kilocalories per gram in PN?
• When weight loss occurs despite adequate intake, what are the main steps to address it?
• Tumor lysis syndrome can lead to which electrolyte and metabolite changes?
• Which imaging modality is often considered the gold standard for measuring muscle mass in oncology patients?
• Which of the following is a small-molecule targeted therapy?
• What is a purpose of GLIM criteria in clinical practice?
• Which condition is listed as a high-risk nutrition condition in cancer centers?
• Outline a practical approach to constructing a new oncology nutrition care plan for a newly diagnosed patient, including initial assessment, goal setting, and monitoring milestones.
• Once electrolytes are restored to the normal range, enteral nutrition should start at what percentage of estimated energy needs and advance over 3-5 days?
• In patients at high risk for tumor lysis syndrome, which preventive measures are recommended?
• Which statement best describes the consequences of malnutrition for patients with cancer?
• What is the purpose of the high-risk nutrition screening criteria list in cancer centers?
• In head and neck cancer, what does MNT guidelines recommend for pretreatment evaluation and ongoing care during radiation?
• Which statement best describes a nutrition-related effect of corticosteroids in cancer patients?
• What is the general energy target range for cancer patients who are not hypermetabolic, and how should energy requirements be determined?
• What is essential when planning nutrition care for a patient with head and neck cancer during radiation therapy?
• Zoledronic acid (Zometa®) is a supportive care drug in the category of bisphosphonates that can be used to decrease complications produced by metastasis to the:
• Which drug is associated with the unusual side effect 'cold dysesthesia'?
• Which statement about intravenous lipids in patients with chyle leaks is correct?
• Which of the following food sets is known to alter CYP3A4 enzyme activity?
• In cancer survivors, how should physical activity relate to nutrition management?
• Which statement best describes the evidence base for Mediterranean-style or plant-based dietary patterns in relation to cancer recurrence?
• Which high-risk condition is listed as part of nutrition screening criteria?
• Methotrexate exerts its chemotherapeutic effect by counteracting and competing with which nutrient in cancer cells?
• For patients with swallowing difficulties due to cancer or therapy, what is a key nutritional approach?
• Avoid holding EN for gastric residual volumes of less than how many mL in the absence of other signs of intolerance?
• Pernicious anemia is caused by deficiency of which vitamin?
• Which statement correctly identifies validated indicators of nutritional status among adults with cancer?
• Myelosuppression is best defined as what?
• When refeeding syndrome is suspected in a patient receiving enteral nutrition, what is the most appropriate RD recommendation?
• Reglan (metoclopramide) is a dopamine receptor antagonist that can be used as an antiemetic and to treat loss of appetite.
• Which of the following best describes the typical composition of the Macrobiotic diet as described?
• Which statement best describes the nature of anticipatory nausea and vomiting?
• Which validated tool is commonly used in oncology to screen for malnutrition risk and collects data on weight change, intake, symptoms, and function?
• Grapefruit juice can increase a drug's activity by inhibiting the enzyme CYP3A4.
• How should fluids and electrolytes be managed in cancer patients with chemotherapy-induced nausea, vomiting, or diarrhea?
• Which of the following is NOT listed as a risk factor for anticipatory nausea and vomiting (ANV)?
• Which immune-related adverse events (irAEs) from immunotherapy commonly require adjustments to a cancer patient's nutrition plan due to GI involvement?
• Which antiemetic is a fixed-dose combination of netupitant and palonosetron (Akynzeo)?
• What is the rationale for including omega-3 fatty acids in cancer cachexia management, and what does the evidence suggest?
• For Cancer Prevention: The American Institute for Cancer Research (AICR) recommends that Americans stay physically active for at least ____ minutes every day.
• For patients with head and neck cancer undergoing radiotherapy or surgery, what protein target is typically recommended?
• Which antiemetic is a corticosteroid widely used in antiemetic regimens with chemotherapy?
• On Karnofsky Performance Status, a score of 100 indicates no evidence of disease.
• Which of the following is not a common side effect of cyclophosphamide?
• Grapefruit juice with docetaxel results in reduced clearance by more than 15%.
• What is the role of nutrition in cancer survivorship care plans with respect to weight management and recurrence risk?
• Which statement best describes cancer cachexia compared with starvation?
• Megaloblastic anemia is typically caused by deficiency of which vitamins?
• What dietary guidance is recommended for patients taking procarbazine due to potential hypertensive crises?
• In pelvic radiation for colorectal cancer, nutrition therapy should include what?
• For new TPN patients, what is the typical initial administration pattern?
• What is the primary goal of the Nutrition Care Process (ADIME) in oncology?
• What percentage threshold defines high-risk emesis according to ASCO?
• Which is NOT a preventive step for refeeding syndrome when initiating nutrition support in severely malnourished cancer patients?
• In cancer patients with inflammation, why is IV iron often preferred over oral iron?
• Why is early nutrition risk screening essential at cancer diagnosis and during therapy?
• Which of the following is NOT among the validated indicators of nutritional status in cancer patients?
• Which nutrition strategy is recommended for nausea and vomiting in cancer patients?
• Refeeding syndrome is characterized by severe electrolyte abnormalities such as which of the following?
• If Gastric Residual Volume (GRV) is >= how many mL, HOLD EN and perform assessment?
• Which statement about iron management in cancer patients with inflammation is correct?
• Which of the following is a common nutrition problem after surgery affecting the colon and/or rectum?
• Which combination of problems is commonly observed after colon or rectal surgery?
• Which chemotherapy drug is known to cause pharyngolaryngeal dysesthesia?
• Which nutrition impact symptom is listed as part of high-risk criteria?
• Netupitant-Palonosetron is a fixed-dose antiemetic combination.
• Which medication is a cannabinoid used to stimulate appetite in cancer patients?
• How many validated nutrition screening tools exist for adult cancer patients that may be used in the inpatient setting?
• For dysgeusia or taste changes, what nutrition strategy is advisable?
• What is the primary role of CYP3A4 in drug metabolism?
• Which of the following is NOT listed as high-risk emetogenic therapy by ASCO?
• Why are CT scans commonly utilized to evaluate body composition in cancer care?
• Which nutrition strategies are recommended to manage dysgeusia in cancer patients?
• During antibiotic therapy in cancer patients, which statement best describes probiotic use?
• How does physical activity complement nutrition therapy in oncology, and what general guidelines exist?
• To minimize potential interactions with cancer therapies, how should supplementation be approached?
• In older adults with cancer, how should nutrition care address sarcopenia and polypharmacy?
• Which of the following is NOT one of the six criteria used to diagnose malnutrition in adults with chronic illness?
• Which statement correctly describes leucovorin's interaction with 5-FU?
• Which nutrition problem is associated with surgery affecting the small bowel?
• Which of the following is an example of a nutrition impact symptom?
• Which part of the small intestine is the primary site for Vitamin B12 absorption?