NTR 495 OA Exam 2

Use the BMI calculation shown to find the BMI of a 5 foot 2 inch woman who weighs 172lbs (round to 1 decimal place).

172/(62x62) x 704.5 = 31.5

A food record of dietary intake normally is collected for how long?

3 or 7 days

Adults over the age of 65 should be physically active for how many hours per week?

3-3.5 hours/week

Routine screening for colorectal cancer by colonoscopy is recommended starting at age

45

What age qualifies for the congregate or home-delivered nutrition program?

60

Why might creatinine excretion decline in the older adult?

A. Decrease in lean body mass B. Decrease in proportion of muscle in lean body C. Decrease in meat intake

Which of the following is a consequence of malnutrition in the older adult?

A. Increased risk for infection B. Increased length of hospital stay C. Increased mortality

Body mass index (BMI) should be used cautiously in the older adult because:

A. obtaining an accurate height can be difficult in older adults.

A person's food preferences falls under which of the following?

Acceptability

A family moves to the United States from another country, and they begin to consume more processed snacks and sugar sweetened beverages. This would be considered

Acculturation

Which of the following could lead to an increased risk of developing GERD?

An overly relaxed lower esophageal sphincter, Excess intragastric pressure, Decreased peristaltic activity related to advanced age

Which of the following is considered to be an invasive test for coronary artery disease (CAD)?

Angiogram

During which stage of a nutrition assessment are body size, weight and proportions measured?

Anthropometric measurements

What does the mnemonic "ABCD" in nutrition assessment stand for?

Anthropometrics; Biochemical data; Clinical assessment; Dietary history

To participate in Title IIC meal programs a person must be

At least 60 years old

The MNA is useful in identifying which of the following?

B. Malnutrition risk

Factors that increase the risk of esophageal cancer include

Barrett's esophagus, smoking, processed foods

If a patient's albumin, hemoglobin, and hematocrit levels were recorded, which type of assessment was conducted?

Biochemical

In the development of nutritional deficiencies, __________ precede __________ of deficiency.

C. biochemical changes; clinical signs

Celiac disease can lead to malabsorption of what nutrient(s)?

Calcium, folate, iron, Vitamins A, D, E, K

An obese COPD patient has chronic cough and shortness of breath, and recently developed edema. What type of COPD does this patient likely have?

Chronic bronchitis

What is the leading cause of Pancreatic Insufficiency (PI) in the US?

Chronic pancreatitis

Which of the following is not a component of anthropometric assessments?

Cognitive function

Meals on Wheels is an example of what kind of government program?

Congregate meal program

Which biochemical marker is paired with its correct assessment.

Corpuscular volume: indicates some types of anemia

Which is a physiological change that affects exercise capacity in older adults?

Decreased muscle mass

Sandy has diverticula shown on a lower endoscopy. She presents to the hospital with fever and severe abdominal pain. She is likely experiencing

Diverticulitis

Pancreatic enzymes should be taken

During the meal

What type of program guarantees benefits for participants who meet the requirements set by law?

Entitlement program

What are some factors that influence the quality of life?

Environment, socialization - all of the above

Height should be measured how frequently in the older adult?

Every year

__________ is defined as "planned, structured, and repetitive and purposive in the sense that the improvement or maintenance of one or more components of physical fitness is the objective."

Exercise

Cultural humility encourages generalizations of cultures to increase awareness and cultural sensitivity, while cultural competence emphasizes learning about individual clients.

False

Hypoglycemia leads to delayed stomach emptying.

False

Lactose intolerance is most common among those of Eastern European descent.

False

Participants can buy personal care items like soap and shampoo using SNAP benefits

False

What is the most common upper gastrointestinal diagnosis for older adults?

GERD

Which of the following gastrointestinal issues is found in 23% of older adults who live in nursing homes?

GERD

Sonya has heartburn after she lays down at night, voice hoarseness, and regurgitation of stomach contents. She is most likely experiencing symptoms of

Gastroesophageal reflux disease

Delayed gastric emptying is called

Gastroparesis

Which of the following is not a modifiable health risk?

Genetics

What is one difference between dietary fructose intolerance (DFI) and hereditary fructose intolerance (HFI)?

HFI is rarer than DFI

Which of the following is NOT a factor that could influence lab data and possibly lead to a false interpretation?

Height and weight

What is the purpose of SNAP?

Help low-income families buy nutritional adequate food

In older adults, which disease is the major contributor to cardiovascular events such as myocardial infarction (MI), stroke, and heart failure (HF)?

Hypertension

Which of the following is true about gastroparesis?

It is more common in women

What enzyme is supplemented as part of pancreatic enzyme replacement therapy (PERT)?

Lipase

Joe is a generally healthy 75 year old man who lives alone. He tends to eat prepared foods (like microwave meals) because it is difficult for him to prepare and cook food. Joe does not drive and lives in a rural community; he has his groceries delivered weekly by the town grocery store. He is lactose intolerant, so he does not consume milk products and his prepared foods do not typically include fruits or vegetables. Based on this information, score his DETERMINE checklist and select from the following assessments.

Moderate nutritional risk, see what can be done to improve eating habits and lifestyle

Which of the following is true of Title IIIC of the OAA?

Must be 60 years of older and no other requirements to utilize programs

Mowing the lawn because your grass is too long is considered

Physical activity

Which are included in the healthy foods graphic for the Criollo plate?

Plantain, yam, beans

Reduced ability to perform daily acts of living, poor oral health, and dysphagia are risks for developing:

Pneumonia

Which ratio is the most important for controlling blood pressure.

Postassium:Sodium

Select which of the following skillls are considered instrumental activities of daily living (IADLs)

Preparing meals, doing laundry, basic home maintenance

Education about healthy habits would be considered

Primary prevention

Which of the following is considered to be a similarity between the DASH diet and the Mediterranean diet?

Promote the use of canola and olive oil

Which pairing of enzyme to macronutrient it digests is correct?

Protease/Protein

---------- status can be measured through albumin and prealbumin status.

Protein

__________ aging is defined by interchanges between a person and their psychological or social environments.

Psychological

Risk factors of ATHEROSCLEROTIC CARDIOVASCULAR DISEASE include

Race, genetics, age

What happens, respectively, to systolic and diastolic blood pressure functions when one has heart failure?

Reduced ejection fraction and preserved ejection fraction

Match the following levels of preventive care to the activities below.

Rehabilitation therapy - Tertiary Immunization - Primary Colonoscopy - Secondary

Which of the following does not contribute to the development of primary hypertension?

Renal disease

The anthropometric section of a nutrition assessment could include all of the following, except:

SGA rating

Which nutrition assistance program is the largest USA program and helps older adults to purchase food on a budget?

SNAP

What is the primary goal of the MUST nutrition screening method?

Screens for risk of malnutrition

An older woman checks her nutritional status using the tool DETERMINE, which factors increase her risk of malnutrition?

She has gained 15 pounds in the last 6 months

The following increase risk for gallstones:

Significant, rapid weight loss A diet high in animal fat, sugar, and refined carbohydrates

Treatment for gastroparesis includes which of the following?

Small frequent meals, soft or pureed foods, limiting alcohol

Which of the following is considered a good way to prevent or improve symptoms of diverticulosis?

Smoking cessation and regular physical activity

Which nutrients are considered to be the key dietary contributors to the development of hypertension?

Sodium, potassium, and alcohol

Someone with a blood pressure of 145/95 would be considered to have what class/degree of hypertension?

Stage 2 hypertension

Which of the following put you in a category for stage 2 hypertension?

Systolic greater than or equal to 140 and diastolic greater than or equal to 90

What impact do you think the pandemic has has on the socialization of older adults? What impact could that have on their quality of life?

The pandemic has impacted older adults' socialization by limiting them to who they can see, talk to, where they can go, and ultimately limiting their already limited lifestlye from the basic things that really keep them alive. As it does not take long for their physical and mental health to decline if they do have accessibility to the care they need and/or not being able to see people (prevents stress and isolation), as mental health plays a greater role in this situation (the mindset depicts the outcome); ultimately, affecting their overall quality of life.

What are some reasons older adults who qualify may not use some federal support programs to purchase food?

There is a stigma around programs, application processes are long, there are few benefits associated with the program

Which of the following factors can influence lab results?

Tobacco use, stress, prescription medications, equipment calibration

True or False? Management of the chronic bronchitis form of COPD is similar to HF, and management of emphysema is similar to that of cardiac cachexia.

True

True or False? Most older adults with peripheral artery disease (PAD) are asymptomatic.

True

True or False? Older adults who have Barrett's esophagus are at increased risk for developing esophageal cancer.

True

True or False? Patients with IBS have a higher rate of psychological disorders such as depression and anxiety.

True

True or False? The Nutrition Services Incentive Program (NSIP) provides incentives in the form of cash or food commodities to programs that deliver meals efficiently to older adults.

True

True or False? The recommendation to eliminate nuts and seeds in the diet of patients with diverticulosis is not evidence-based.

True

True or False? When sedentary older adults decide to increase physical activity, it is important they implement changes gradually.

True

John, a 70 year old has gastroparesis. What dietary supplements might he need? What are we concerned about?

Vitamin A, B6, C, K, iron, potassium and zinc

PPIs can reduce the absorption of which of the following along with decreasing the symptoms of GERD?

Vitamin B12, iron, calcium

Which vitamin/mineral combination should be supplemented for people who are taking proton pump inhibitors (PPIs)?

Vitamin D/calcium

Which of the following has been shown to have the greatest reduction in foodborne illnesses?

Washing hands

Anthropometrics, Biochemical, Clinical and

dietary

Excessive intake of __________ can exacerbate heart failure and lead to edema.

fluids

People older than age 70 have a __________ optimal body mass index (BMI) than younger people.

higher

Biochemical data can be difficult to use in assessing an older adult's nutrition status for all of the following reasons, except:

most older adults are too dehydrated to use biochemical data.

A diet high in __________ may reduce the inflammation associated with COPD.

omega-3 fatty acids

An example of tertiary prevention is:

rehabilitation after a fall

Mean corpuscular volume measures

the average volume of a single red blood cell

24 hr recall intake methods tends to the __________ amount of food a person consumes.

underestimate

Which of the following is a risk factor for primary hypertension?

Family history

GERD occurs due to fluid coming back up from the stomach through the

Lower esophageal sphincter

True or False? Diverticulosis is more common in older adults in the United States than in older adults living in Asia or Africa.

True

You are working with a family that has recently immigrated from China. Describe how a provider would work with this family differently depending on if they were using the cultural humility vs cultural competence perspective.

****** A recently immigrated family from China would be dealt with by a provider in different ways if they used cultural humility perspective or cultural competence perspective. For the cultural humility perspective there is no achievement as it is an ongoing process whereas cultural competence perspective can be mastered. Moreover, for a family that has a cultural humility perspective a provider would be open and listen to their experiences, what is important to them and what can be avoided. They would also be self-aware and aware of others, meaning that that family's former lifestyle could be greatly influenced by their culture, including, beliefs, lifestyle, experiences (negative and positive), etc. To maintain and establish this relationship it must be known and respected that this life long process of learning, but will have support and understanding throughout the process. Whereas if this family had a culture competence perspective then a provider would highlight the existing practices, laws that are already in place that can be reflected across multiple cultures. Acknowledgment and respect should be shown by the provider based upon their specific culture, but also with acknowledgment of other cultures, how can they build upon ethnic and social diversity? This perspective is a prime example of how many cultures coexist with each other by learning and incorporating them all into different lifestyles.

During a nutrition assessment, how many nutrition diagnosis statements should be made per patient?

1-2