RD Exam Set 3 - PP RD

You are assigned as project coordinator to open six new green grocery stores across the Midwest. You want to calculate the minimum amount of time it will take to complete the project. Which method would best help you and why? Operating budget because you can forcast the revenue, expenses, and profits during the project's time frame Critical Path method because it can help you keep your project on track by finding the sequencce of activities with the longest duration Performance budget because you can detail the costs for this specific project Value analysis because you can ensure that the project's cost is no greater than necessary to carry out the project's goal

Correct answer: Critical Path method because it can help you keep your project on track by finding the sequence of activities with the longest duration The Critical Path Method (CPM) can help you keep your project on track by Helping you identify the activities that must be completed on time in order to complete the whole project on time Showing you which tasks can be delayed and for how long without impacting the overall project schedule Calculating the minimum amount of time it will take to complete the project Telling you the earliest and latest dates each activity can start on in order to maintain the schedule

Cheese is peeled off a cheeseburger to make it a hamburger. What type of transfer has occurred? Biological contamination Cross-contact Cross-connection Cross-contamination

Correct answer: Cross-contact Cross-contact happens when one food comes into contact with another food and their proteins mix. As a result, each food then contains small amounts of the other food. An example of cross-contact is peeling cheese off a cheeseburger to make it a hamburger. Cross-contamination usually refers to bacteria or viruses that get on food and make it unsafe to eat. A cross-connection is a physical link between safe water and dirty water. Biological contamination is when food is contaminated by a bacteria, parasite, fungus, or virus.

If an ice cream is made with low-fat milk, what characteristic will be increased? In order to compensate for this, what ingredient should be increased? Smoothness; salt Crystal size; fat Flavor; fat Crystal size; sugar

Correct answer: Crystal size; fat The purpose of fat in ice cream production is to form small and smooth ice crystals. When fat is decreased, large crystals form to produce a grainy ice cream. To produce a smoother ice cream, increase the fat by using whipped cream, heavy cream, or whole milk instead of non-, low-, or reduced fat cream or milk.

An outpatient diabetes clinic wants to determine if their nutrition education program is worthwhile in terms of its costs. The cost to run the program includes RD staffing, educational materials, and overhead costs, while the measured outcomes include HgA1C%, diabetes complications, and dietary changes. Which quality improvement study should be used and why? Cost-effectiveness analysis because it compares alternatives Cost-benefit analysis because it provides comparisons of alternative courses of action in terms of their costs Cost-effectiveness analysis because it determines whether the goal of the intervention is worthwhile in terms of costs Cost-benefit analysis because it examines program outcomes in terms of money saved

Correct answer: Cost-benefit analysis because it examines program outcomes in terms of money saved A cost-benefit analysis should be used because the goal is to determine whether the nutrition education program is worthwhile in terms of its overall costs. Cost-benefit analysis examines program outcomes in terms of money saved and determines whether the goal of the intervention is worthwhile in terms of costs. Cost-effectiveness analysis compares alternatives and provides comparisons of alternative courses of action in terms of their costs, financial gains, savings, and effectiveness in obtaining objectives. This analysis would be useful if the goal was to determine which nutrition education program or class was most useful.

A low-income 55-year-old male is diagnosed with type 2 diabetes mellitus and makes an appointment with a registered dietitian. What should the RD focus on during the consultation to best relate to her client? Using written materials and client participation Peer pressure and attitudes toward authority Goal orientation Costs and traditional food habits

Correct answer: Costs and traditional food habits A needs assessment is the first step in program development and planning for nutrition education. In order to best relate to the client, the needs assessment should take into consideration the demographics of the client. For example, a lower-income adult is generally interested in cost, traditional food habits, and solving current problems. The other answers are appropriate methods for relating to other demographic groups. Middle- and higher-income adults are goal-oriented and desire relatable activities. When working with adolescents, relate to their interests and be aware of peer pressure and attitudes toward authority. The elderly have a decreased attention span, so encourage audience participation, stay on topic, and utilize written materials.

The López family moved from Guatemala to New York City last year. The father asks his daughter, Alessandra, to learn more about New York's food and traditions from her classmate Kate, who was born and raised in New York. He tells Alessandra to share her experiences as a girl growing up in Guatemala and encourages her to find common ground with Kate. What strategy to engage in culture is the father implementing? Cultural awareness Cultural encounter Cultural skill Cultural knowledge

Correct answer: Cultural knowledge Cultural knowledge is learning about another culture's worldview from a native perspective, assessing how people in other cultures view your culture, sharing experiences and finding common ground with persons from other cultures. Cultural awareness begins with cultural self-awareness, awareness of stereotypes and personal stereotypic beliefs, willingness to learn from others, and learning to value differences. Cultural skill is the process of learning how to assess one's values, beliefs, and practices in order to provide culturally competent services by developing cross-cultural interaction skills. Cultural encounter encourages one to directly engage in cross-cultural interactions with individuals from diverse cultural backgrounds; this process allows one to validate, negate, or modify existing cultural knowledge and gain a culturally specific knowledge base to develop culturally relevant interactions.

A restaurant owner wants to determine his average food-cost percentage since the opening of his restaurant one month ago. Which report would give him the best picture of his operation to date? Daily food-cost report Cumulative food-cost report Profit and loss statement End-of-the-month report

Correct answer: Cumulative food-cost report The cumulative food-cost report should be used to determine the food-cost percentage because it can average out an operation's daily variation and give a picture of the operation to date. A daily food-cost report is a statement that contains total food costs, total food sales, and cost percentages. The end-of-the-month report, or profit and loss statement, shows the actual cost of food used based on purchases and all other actual expenditures.

What occurs in market segmentation? The need that is not being filled is identified Objectives are achieved to satisfy the target market The group of people with similar needs is identified Customers are categorized based on characteristics

Correct answer: Customers are categorized based on characteristics Market segmentation categorizes customers based on demographic, geographic, psychographic, and behavioristic variables. During this process, the market is divided into groups of people with similar product needs. The target market is the group of people or places with similar needs with the potential of purchasing your product. The first step of the marketing process is identifying the market niche, or the need that is not being filled. The marketing mix includes the 4 Ps (product, place, price, promotion), which are used to achieve an organization's objective and satisfy the target market.

What is the name of the thin film on the outside of the shell of an egg? Vitelline membrane Cuticle Chalaza Shell membrane

Correct answer: Cuticle On an egg, the thin film on the outside of the shell is called the cuticle. The other answers are all different structures of an egg. The yolk is surrounded by the vitelline membrane. The chalaza is the yolk anchor and holds the yolk in the center of the egg. The shell membrane is the clear film that lines the inside of the shell and is often visible when you peel a hard-boiled egg.

A long-term care facility, Sunshine Living, provides their residents with two-week cycles of menus with four choices. Today, the facility is serving the following breakfast options: banana pancakes, vegetable omelet, egg burrito, or fruit parfait. What type of menu does Sunshine Living use? Limited choice fixed static cycle

Correct answer: Cycle A cycle menu, or standing menu, is the repetition of menus in designated sequences. These menus are planned for 3-4 weeks and then repeated. Sunshine Living provides two-week cycles with four choices, which describes a cycle menu. A limited choice menu provides choices for some items. For example, a special event may offer select dishes from a restaurant. A static menu is also known as fixed or set menu and provides the same menu items every day when the clients change daily. A restaurant menu is an example of a static menu.

A patient is admitted to a hospital for three weeks. During his stay, he receives the same meals in his first week and his third week. What type of menu is the hospital most likely using? Fixed Static Set Cycle

Correct answer: Cycle Cycle menus are predetermined menus that repeat in a designated sequence. These menus are typically used at hospitals, and the cycle length increases with a patient's length of stay. In this example, the hospital is likely operating on a two-week menu cycle. With a static, fixed, or set menu, the same menu is offered every day and clients change daily. This menu is typically used at restaurants.

What type of menu might be most appropriate for a school lunch program? Menu pattern Cycle menu Single-use menu Static menu

Correct answer: Cycle menu A cycle menu is a planned set of menus that rotate at different intervals, such as by the week, month, or season. A single-use menu is planned and used only once, such as for a special function, catering event, or holiday. A static menu is repeated daily, such as in a restaurant. A menu pattern is an outline of menu items that are offered at each meal and the available choices for each category.

For which of the following disease states would you recommend PERT? Cystic fibrosis Gastroduodenostomy Lactose intolerance Hepatic failure

Correct answer: Cystic fibrosis Pancreatic enzyme replacement therapy (PERT) involves taking digestive enzymes in the form of a tablet to assist in the digestion of fat, carbohydrates, and proteins. PERT is used with meals and snacks to prevent fat malabsorption due to the lack of pancreatic lipase. PERT therapy may help treat the disease states of pancreatitis, cystic fibrosis, gastrojejunostomy, Crohn's disease, and other diseases with pancreatic insufficiencies.

In what part of the cell does aerobic glycolysis occur? Cytoplasm Cristae Matrix Mitochondria

Correct answer: Cytoplasm Glycolysis is the breakdown of glucose to pyruvate with the production of two molecules of ATP and occurs in the cytoplasm of the cell. Aerobic (with oxygen) glycolysis yields pryuvate, and anaerobic (without oxygen) glycolysis yields lactate. The Krebs cycle (also known as the TCA or citric acid cycle) takes place in the matrix of the mitochondria of the cell. Cristae are the folded inner membranes inside the mitochondrion; the electron transport chain takes place here during cellular respiration to create ATP.

A patient is diagnosed with congestive heart failure. What diet would most likely benefit the patient? Gluten-free TLC DASH Mediterranean

Correct answer: DASH The DASH (Dietary Approaches to Stop Hypertension) diet would most likely benefit the cardiac patient with congestive heart failure (CHF) because it provides a low-sodium diet. CHF dietary treatment includes low sodium (2-3 g/day restriction) and fluid restriction if needed. The DASH diet emphasizes low sodium, whole grains, fruits, vegetables, low-fat dairy, poultry, and fish; and it limits alcohol and decreases sweets. The Mediterranean and TLC (Therapeutic Lifestyle Changes) diets would be more helpful for the treatment of hypertension, atherosclerosis, metabolic symptom, or hyperlipidemia. These diets focus on healthy fats with omega-3s (Mediterranean) and/or low fat with soluble fiber (TLC). Gluten-free diets are helpful for gluten intolerances, such as Crohn's disease.

When baking at high altitudes, atmospheric pressure is reduced and there are necessary adjustments that need to be made to correct for this. What needs to be adjusted when baking at high altitudes? Increase baking soda and increase fat Decrease bakign soda and increase liquid Increase baking powder and increase liquid Decrease bakign soda and decrease flour

Correct answer: Decrease baking powder and increase liquid The inverse relationship between altitude and pressure (high altitude, low pressure vs. low altitude, high pressure) requires alterations in cooking. At high altitudes, boiling point is decreased and cooking time is decreased. Therefore, foods take longer to cook at lower temperatures because temperatures decrease as elevation increases. During the high altitude cooking process, decreased air pressure causes gas to expand faster and steam to form earlier. As a result, gas expansion may occur before the protein has coagulated and starch has gelatinized, leaving an unstable structure. Therefore, baking powder should be decreased and liquid should be increased.

A clinical dietitian is planning to start PN on a patient. Which of the following lab values would indicate the appropriate time to initiate feeding the patient? Increased CRP, increased creatinine Decreased albumin, decreased pre-albumin Increased CRP, decreased pre-albumin Decreased CRP, increased pre-albumin

Correct answer: Decreased CRP, increased pre-albumin C-reactive protein (CRP) is a marker of acute inflammatory stress, and pre-albumin is a marker of nutritional status. When CRP decreases and pre-albumin increases, nutrition therapy is indicated. Nutrition therapy would be contraindicated by increased CRP and decreased pre-albumin. Malnutrition might be indicated by decreased albumin and decreased pre-albumin; however, CRP would have to be evaluated to determine the patient's stress. Inflammatory stress and muscle wasting or renal disease might be indicated by increased CRP and increased creatinine.

What is a potential effect of following a high-fiber diet? Increased HDL and postprandial blood glucose levels Decreased intestinal function Increased risk of constipation Decreased LDL and postprandial blood glucose levels

Correct answer: Decreased LDL and postprandial blood glucose levels Fiber provides indigestible bulk and promotes intestinal function. A high-fiber diet helps decrease LDL and postprandial blood glucose levels, which provides benefits for gastrointestinal health and weight control and protects against cardiovascular disease and diabetes. A low-fiber diet may lead to constipation.

Which of the following altered lab values would you expect to see in renal disease? Decreased BUN Decreased serum creatinine Increased glemerular filtration rate Decreased creatinine clearance

Correct answer: Decreased creatinine clearance The following lab tests will likely be altered in renal diseases: decreased glomerular filtration rate, decreased creatinine clearance, increased serum creatinine, and increased BUN. As renal function decreases, the BUN:creatinine ratio further decreases.

A patient has hyperalbuminemia and hypernatremia. What would you infer about his nutritional intake? Decreased medium-chain triglyceride intake Decreased fluid intake Increased protein and salt intake Increased saturated fat intake

Correct answer: Decreased fluid intake Albumin and sodium are lab values that typically indicate fluid status. If a patient has high albumin (hyperalbuminemia) and high sodium (hypernatremia), the patient is typically hypovolemic (volume depleted). Therefore, you could infer that the patient has had a decreased fluid intake leading to his current nutritional and medical status.

Which of the following reactions occurs during the "ebb" phase of injury response? Decreased metabolic rate Fluid resuscitation Oxygen return Hypervolemia

Correct answer: Decreased metabolic rate The "ebb and flow" response to injury is the body's reaction to physiological trauma, such as critical illness, injury, and/or sepsis. This is associated with a hypermetabolic and catabolic response following the trauma. Immediately following the injury is the "ebb" phase, characterized by hypovolemia, shock, tissue hypoxia, and decreased metabolic rate. During the "flow" phase there is fluid resuscitation, and oxygen transport returns.

An increase in solutes (BUN), tachycardia, and rapid weight loss are signs and symptoms of what? Overhydration Dehydration Hypoventilation Respiratory acidosis

Correct answer: Dehydration Dehydration is caused by decreased water intake, excessive water output, and/or heavy solute load (BUN). Signs and symptoms include nausea, dizziness, sunken eyes, fever, hyperventilation, excessive seating, concentrated urine, dry inelastic skin, increase in solutes (BUN), tachycardia, headache, fatigue, decreased appetite, and/or rapid weight loss. Dehydration is associated with hypernatremia, while overhydration is associated with hyponatremia. Serum sodium is the best assessment parameter for fluid status. Respiratory acidosis is caused by CO2 retention, hypoventilation, and emphysema. Signs and symptoms include decreased ventilation, headache, confusion, anxiety, drowsiness, and stupor.

What do elevated levels of serum albumin indicate? Excessive protein intake Iron deficiency Dehydration Stage IV pressure ulcer

Correct answer: Dehydration Serum albumin is a visceral protein that measures the amount of protein in blood and organs, which helps assess fluid status. Elevated levels of albumin are associated with dehydration, rather than excessive protein intake. Decreased levels of albumin are associated with edema, surgery, cirrhosis, chronic low protein intake, stage IV pressure ulcers, decreased synthesis, and/or unusual losses. Decreased levels of transferrin and ferritin are associated with iron deficiencies.

The process of dividing a total market into groups of people based on things such as their sex, age, religion, and race is known as what? Psychographic segmentation Demographic segmentation Market segmentation Geographic segmentation

Correct answer: Demographic segmentation Demographic segmentation is the process of dividing the total market into groups of people based on variables such as sex, age, religion, education, income, or race. Geographic segmentation divides a market into groups based on variables such as neighborhoods, cities, regions, states, or nations. Psychographic segmentation divides a market into groups based on variables such as lifestyle, personality traits, or social class. Market segmentation is the process of dividing the total market into subgroups based on different characteristics, such as demographics, geographic location, or psychographic traits.

A 40-year-old male is admitted to the hospital with stage IV pancreatic cancer. He has lost a significant amount of body weight due to poor appetite throughout chemotherapy treatment over the past 5 months. Which of the following would you expect to find during his physical exam? Depressions between ribs Bulging interosseous muscle Slight swelling of lower extremities Underdeveloped gastrocnemius muscle

Correct answer: Depressions between ribs Severe muscle wasting in the scapular bone region is noted when there are prominent, visible bones and depressions between ribs/scapulae or shoulders/spine. Slight swelling indicates mild edema. An underdeveloped gastrocnemius (or calf region) indicates mild to moderate wasting. A bulging interosseous muscle (or dorsal hand) indicates a well-nourished patient.

A complication of uncontrolled diabetes, caused by failure to follow the diet by overeating of carbohydrates and omission of an insulin regimen, may result in: Diabetic ketoacidosis Dawn phenomenon Acute hypoglycemia Reactive hypoglycemia

Correct answer: Diabetic ketoacidosis Diabetic ketoacidosis (DKA) is hyperglycemia caused by a failure to follow the diabetic diet, by overeating of carbohydrates, decreased use or omission of the insulin regimen, and/or infection. The signs and symptoms include polyuria, polydipsia, hyperventilation, dehydration, fatigue, and a fruity urine odor. Dawn phenomenon is a natural early-morning (around 2 a.m. to 8 a.m.) increase in blood sugar relevant to people with diabetes. This is associated with hyperglycemia and leads to an increased need for insulin in the evening. Acute hypoglycemia is caused by an excess of insulin and/or lack of food (carbohydrates) leading to low blood sugar. Reactive hypoglycemia occurs 2 to 5 hours after eating and is caused by the overstimulation of the pancreas or increased insulin sensitivity, leading to low blood sugar.

Which of the following factors determines payment during a patient's hospital stay? Number of medical services rendered Type of services rendered Length of stay Diagnosis

Correct answer: Diagnosis Hospitals pay a specific amount of money per patient based on the diagnosis, regardless of the length of stay or number and type of medical services rendered.

Which function of management requires the greatest allotment of time? Organizing Directing and coordinating Evaulating Planning

Correct answer: Directing and coordinating The functions of management include planning, organizing, directing, controlling, and evaluating. Directing and coordinating require the greatest allotment of time in management. This function includes the distribution of work to the qualified and appropriate people, where managers must provide instruction, training, and establish appropriate control. Planning is a basic and major function of management that determines its objectives, policies, and procedures. Organizing is the identification of tasks and activities, which are delegated to positions. Evaluating is the ongoing measure of performance against standards to determine whether goals have been reached.

At the end of a nutritional assessment, if the registered dietitian determines that the problem cannot be modified by further nutrition care, what is the appropriate next step? Send a referral to outpatient nutrition services Discontinue nutrition care Initiate enteral feeding Establish a new nutrition diagnosis

Correct answer: Discontinue nutrition care At the end of the nutritional assessment, if the registered dietitian determines that the problem cannot be modified by further nutrition care, discharge or discontinuation from this episode of nutrition care may be appropriate (NCM). The other choices are continuations of care in the nutrition care process.

Which of the following factors contributes to increased food costs over time? Buying produce in bulk Checking received items against the invoice Discounted employee meals during shift Menu planning

Correct answer: Discounted employee meals during shift Food costs are the most controlled item and subject to the greatest fluctuations over time. Food costs can increase over time by wasting food or providing discounted food to employees during their shift. To better control and decrease food costs, take time during menu planning (can you use an ingredient several different ways?), receiving control by checking items against the invoice (did you receive everything you ordered?), purchasing methods (buying produce in bulk), and determining the type of service (selective menus reduce waste and costs).

In a research paper, what section is found after the results, and what is the purpose of this section? Conclusion; To summarize the results Implication; To describe how the research might be applied in practice Discussion; To interpret the results Methodology; To state the research methods used

Correct answer: Discussion; To interpret the results In a research report, the discussion is found after the results and the purpose is to provide the researchers' interpretation of the results and compare them with other studies. The sections of a research report are organized as follows: Abstract: A summary of the research report Introduction: An introduction to the research's objectives, definitions, background, limitations, and order of report presentation Review of Existing Literature: A summary of previous research on the subject Methodology: The description of methods used and the hypothesis Results: The subjective or objective findings Discussion: The interpretation of the results Conclusion: A summary of results, limitations, and recommendations for future research Implications: How the research may be applied in practice

A food service operation offers made-to-order pasta and stir-fry stations to enhance interaction between the kitchen and customers. What type of service system is this? Russian-style French-style Display cooking Traditional

Correct answer: Display cooking Display cooking is a restaurant design that fosters transparency between the kitchen and customers, by displaying and preparing food in front of them. The traditional service system is where menu items are prepared in the kitchen and held until serving time, and employees may be found behind the counter. In waiter service, French-style brings dishes to the table and completes the preparation there (e.g., finishing the sauce). Russian-style waiter service brings family style (large portions for sharing) finished dishes to the table.

To start identifying a target market, a manager should address all of the following questions, except which one? Who are the current customers? Does the product meet our customers' needs? How many customers are in the potential market? What are the unique needs of the customers?

Correct answer: Does the product meet our customers' needs? To start identifying a target market, a manager should address all of the following questions: Who are the current customers? How many customers are in the potential market? What are the unique needs of the customers? Can we attract new customers? In promotional planning, the manager can brainstorm ideas for certain objectives by asking the following: What is it that we are trying to accomplish with this promotion? Is this consistent with our mission statement? Is this designed to meet our customers' needs? How can we measure the success of this promotion?

Grace believes her school policy for supervised practice placement is unfair. During a meeting with the assistant director of the nutrition program, Professor Kirstin, she explains why the policy is unfair and her ideas for alternative solutions. Professor Kirstin sets a department-wide meeting to resolve the conflict by a majority vote. What type of conflict resolution method is Professor Kirstin using? Dominance and suppression Compromise Integrative problem-solving Forcing

Correct answer: Dominance and suppression Conflict resolution methods include dominance and suppression, compromise, and integrative problem-solving. Dominance and suppression represses conflict rather than settling it, by creating a win-lose environment. These tactics include forcing (one party making a decision without argument or compromise), smoothing, avoidance, and resolving conflict by majority vote (for example, Professor Kirsten hosting a vote about the current school policy). Compromise involves finding the middle ground during conflict. Integrative problem-solving is when conflict is converted into a joint problem where both parties try to find a solution that they can accept.

Which of the following pathogens has been shown to significantly contribute to food-borne illnesses and economic costs in the US? Anthrax Methylene E. coli Bacillus cereus

Correct answer: E. coli Every year, over 48 million Americans get sick, 128,000 are hospitalized, and 3,000 die from food-borne illnesses, according to the Centers for Disease Control. According to the Economic Research Service of the U.S. Department of Agriculture, five bacterial pathogens result in over $6.9 billion in annual costs: Campylobacter, Salmonella, Listeria monocytogenes, E. coli O157:H7, and E. coli non-O157:H7 STEC. (USDA) Bacillus cereus is a food intoxication that forms spores and is found in soil and foods such as cereal, rice, and pasta. Methylene is used as a decaffeinating agent and is commonly added to coffee to decaffeinate it. Anthrax is rare in the United States, but sporadic outbreaks do occur in wild and domestic grazing animals such as cattle or deer. (CDC)

"The intake level for a nutrient at which the needs of 50 percent of the population will be met," is an example of which dietary guideline? RDA EAR TUL AI

Correct answer: EAR The term dietary reference intakes (DRI) encompasses the four categories of reference values: RDA, EAR, AI, and TUL. Estimated Average Requirement (EAR) is the intake level for a nutrient at which the needs of 50% of the population will be met. Recommended dietary allowance (RDA) is the specific amount of a nutrient that is required to maintain good health and prevent deficiencies in the diet. Adequate intake (AI) is a recommended average daily nutrient intake level, assumed to be adequate, based on approximations of nutrient intake by a group of apparently healthy people. Tolerable upper limit (TUL) is the highest level of nutrient intake that is likely to pose no risk of adverse health effects for almost all individuals in the general population.

The umbrella term that encompasses all laws and regulations that prohibit discrimination and/or require affirmative action is known as which of the following? EEO ADA OSHA EEOC

Correct answer: EEO Equal employment opportunity (EEO) is the umbrella term that encompasses all laws and regulations that prohibit discrimination and/or require affirmative action. The Equal Employment Opportunity Commission (EEOC) regulates and interprets guidelines in order to provide guidance to management for compliance with EEO statutes. The Americans with Disabilities Act (ADA) prohibits discrimination against persons with disabilities in aspects of employment. The Occupational Safety and Health Act of 1970 (OSHA) requires employers to provide employment that is free from safety hazards.

An outpatient diabetes dietitian is providing a free diabetes clinic next month. She wants to understand the population that might attend her clinic. Which of the following would provide demographic information about her expected population? Education level HgbA1c number Amount of carbohydrates eaten per week Number of diabetic complications

Correct answer: Education level Demographic data is statistically socioeconomic in nature, such as age, sex, education level, income level, marital status, occupation, religion, birth rate, death rate, the average size of a family, and the average age at marriage. The other answer choices represent information that may be obtained during a nutritional assessment with a diabetic patient. A food frequency questionnaire (FFQ) would assess the amount of a specific food group eaten per week. HgbA1c is a common blood test used to diagnose type 1 and type 2 diabetes and then to gauge how well you're managing your diabetes. Diabetic complications result from long-term poorly controlled diabetes and may include cardiovascular disease, neuropathy, nephropathy, retinopathy, foot damage, skin conditions, and poor wound healing.

A severely burned patient's estimated nutrition needs are: 1,800-2,100 calories and 120-150 grams of protein. A tube feeding formula rate at 75 mL provides 1,800 calories and 115.2 grams of protein. What adjustments do you recommend to reach the estimated needs? I. Keep the tube feeding rate at 75 mL and add one packet of a protein supplement to the tube feeding (e.g., Beneprotein provides 25 kcals, 6 gm protein each). II. Increase the rate to 85 mL/hr.

Correct answer: Either I or II A severely burned patient's (>20% TBSA) estimated nutrition needs are increased 30-35 kcals/kg and 1.5-2.0 g protein/kg due to the hypermetabolic state and for wound healing. To understand tube feeding rate, first work backwards to determine the protein per liter in the formula: 24 hrs x 75 mL = 1800 mL / 115.2 grams protein = 64 grams protein / L formula. Now let's move on to determine what adjustments to make: 1. Can you meet the estimated calorie and protein needs if you maintain the current rate and only add a packet of a protein supplement (Beneprotein)? YES. This rate will provide 1,825 calories and 121.2 grams protein. 2. Can you meet the estimated calorie and protein needs by increasing the rate? YES. 85 mL x 24 hr = 2,040 mL/hr --> 2.040 L x 1,000 kcals = 2,040 kcals. 2.040 x 64 g protein = 130.56 grams protein.

A patient is diagnosed with severe acute pancreatitis and is not able to tolerate solid foods. The medical team is planning to start feeding the patient enterally. What type of diet is most appropriate for this patient? Enteral nutrition with a standard polymeric formula No oral diet for the first 72 hours of admission Enteral nutrition with an elemental formula Total parenteral nutrition

Correct answer: Enteral nutrition with a standard polymeric formula A standard polymeric formula is appropriate for initiating early enteral nutrition (EN) for patients with moderate to severe acute pancreatitis. Elemental formulas are easier to digest, making them better suited for patients with malabsorption problems, such as short bowel syndrome or inflammatory bowel disease. The use of EN is recommended over total parenteral nutrition (TPN) in patients with severe acute pancreatitis who require nutrition therapy. TPN may be used if the patient is unable to tolerate EN or unable to obtain distal feeding access. Failure to initiate EN therapy for > 72-96 hours following admission in a patient with moderate to severe acute pancreatitis runs the risk of rapid deterioration of nutrition status and its inherent complications.

To determine if excess or inadequate intake exists, what evidence-based norms and standards can a registered dietitian use? Estimated energy needs IIFYM calculator Healthy People 2020 Food survey

Correct answer: Estimated energy needs Comparative standards include data from the nutrition assessment to compare evidence-based norms and standards to determine if excesses or inadequacies exist. Comparative standards include the following: Estimated energy needsTotal energy expenditure is derived from measured or estimated resting metabolic rate (RMR) and physical activity factor that is based on the intensity of daily physical activity. Estimated RMR is calculated using the Mifflin-St. Jeor equation with actual body weight. Recommended body weight and BMI Estimated vitamin and mineral needs, based on the Dietary Reference Intakes The IIFYM (If It Fits Your Macros) calculator is not an evidence-based standard, but rather a meal planning tool. Food surveys are used to monitor and assess food consumption and food-related behaviors. Healthy People 2020 is a program of a nationwide health promotion and disease prevention goals set by the HHS.

Joshua opened his own nutrition consulting business and wants to hire a few nutrition consultants. To locate the most qualified RD's, he posted ads at a nearby university's nutrition department. How is Joshua attempting to find potential applicants? Unstructured selection process Structured selection process External recruiting Internal recruiting

Correct answer: External recruiting Recruiting is attempting to locate and encourage potential applicants to apply for job openings, and it can be achieved through external or internal sources. External sources include ads, agencies, unions, etc. Internal sources include promotions, transfers, or rehiring within a company. The structured selection process and unstructured selection process have to do with job interview methods.

Which of the following is one of the seven principles of HACCP? Ask if contamination with identified hazards could increase to unacceptable levels Determine if preventative measures exist Establish procedures to verify the system is working Decide if the step reduces the likelihood of a hazard occurrence

Correct answer: Establish procedures to verify the system is working The seven principles of HACCP: Identify hazards and assess their severity and risks. Identify the critical control points (CCPs). Establish critical limits for preventative measures associated with each identified CCP. Establish procedures to monitor CCPs. Establish the corrective action to be taken when monitoring shows a critical limit has been exceeded. Establish effective record-keeping systems that document the HACCP systems. Establish procedures to verify the system is working. The other choices are critical control points in a decision tree, which are as follows: Do preventative measures exist at this step or previous steps for the identified hazard? Does this step eliminate or reduce the likelihood of a hazard occurrence to an acceptable level? Could contamination with identified hazards occur outside of acceptable levels? Will a previous step eliminate the identified hazards or reduce the likelihood of an occurrence to an acceptable level?

Which of the following practices is showing HIPAA compliance? Reporting an unencrypted laptop stolen that contains patients' nutritional assessments Storing patients' nutritional assessments on an unencrypted business laptop Establishing written policies for how one will use, share, store, and discard any material with PHI Taking a photo of a patient's tattoo on a personal device

Correct answer: Establishing written policies for how one will use, share, store, and discard any material with PHI The Health Insurance Portability and Accountability Act (HIPAA) is United States legislation that provides data privacy and security provisions for safeguarding medical information. To remain compliant with HIPAA and protect PHI (protected health information), RDs should establish written policies for how one will use, share, store, and discard any material with PHI. The other answers are examples of HIPAA violations and would be subject to fines because PHI is being used on unencrypted devices.

What is the regulatory body and standard that "requires oleomargarine to have not less than 80 percent fat as determined by a specified method"? USDA; Standards of quality FDA; Standards of identity CDC; Food standards DHHS; Standard of fill of containers

Correct answer: FDA; Standards of identity The FDA regulates food standards called Standards of Identity, Standards of Quality, and Standards of Fill of Container. They are to be distinguished from grade standards, often referred to as "U.S. Standards," which are regulated by the U.S. Department of Agriculture. Standards of Identity specifies "the required ingredients and the optional ingredients that are permitted in the food. For example, the identity standard requires oleomargarine to have not less than 80 percent fat as determined by a specified method." Standards of Quality specifies "the quality factors covered by the standard and objective methods for measuring these factors. For example, green beans that are highly fibrous do not have good eating quality. The quality standard for canned green beans sets a limit for fiber and prescribes the method to be followed to determine the fiber content." Standard of Fill of Container prescribes "how much of the defined product must be in the container." For example, how many potato chips must be in the package.

You want to measure the dietary fiber intake of 350 people living in a suburban town outside of Denver, Colorado. You want to send the survey to the participants online, you have a small budget for this project, and you need to get the survey responses back as soon as possible. Which method of diet history collection would be best for you to perform? Food diary FFQ 24-hour recall Calorie count

Correct answer: FFQ A food frequency questionnaire (FFQ) measures energy and/or nutrient intake by determining how frequently a person consumes a number of foods that are major sources of nutrition or of a particular dietary component of interest. The advantages of an FFQ are that it can be self-administered and completed online, is practical for studies with a large number of subjects, is quick, is inexpensive, and can focus on specific nutrients. Therefore, an FFQ would be the best option in this scenario. Food diaries, calorie counts, and 24-hour recalls require labor-intensive data entry and analyses, which would not be best in this instance.

The question "How often do you eat tomatoes?" would likely be part of which of the following dietary intake assessments? Food record Diet history FFQ 24-hour recall

Correct answer: FFQ The food frequency questionnaire (FFQ) or food frequency list, is a dietary intake assessment method used to determine how often an item is consumed. This method is a quick way to determine intake for large numbers of people and is mostly used in the community setting. 24-hour recall is a quick tool to estimate sample intakes in the clinical setting with the helming of an RD. This would include a client providing a mental recall of everything they ate in the past 24 hours. Food record is an exact record of everything eaten in a specific time period. This method can be tracked used a devise, such as MyFitnessPal or MySuperTracker. Diet history is a discussion between a client and provider to assess dietary intake based on the client's present pattern of eating.

An outpatient renal center is adding a nutrition clinic to their facility next year. This year, the center is pilot testing the nutrition clinic by providing 25 percent of their clients with a series of five nutrition education classes led by a dietitian. What step of the educational process is this? Formative Summative Preparatory Objective

Correct answer: Formative Testing before a program begins, known as pilot testing, is a formative step in the educational process. This part of the process helps identify parts of the plan that may need revision. Other examples include focus groups and pretests. Summative is part of the education process that is designed during the initial planning stages but conducted at the end. This part of the process aims to find out if the goal was achieved. For example, the renal nutrition clinic could provide a post-survey to gain feedback about the nutrition class. Other examples are grading, evaluation, or post-testing. Objective is a type of test evaluation strategy that measures factual and standardized performance. Preparation is a step in the interviewing process that involves collecting background information on the client and establishing objectives or intervention strategies for collecting information during a session.

A hospital has a listing of pharmaceutical agents with information on how to procure, prescribe, dispense, and administer drugs. The hospital uses this to obtain volume purchasing discounts. What is this list known as? Requisition Drug list Formulary Purchase order

Correct answer: Formulary A formulary is a list with descriptions of approved products used by an organization. In the hospital system, the formulary lists pharmaceutical agents with important information and is used to obtain volume purchasing discounts. Drug lists are generic names of drugs and are not used to obtain volume discounts. A requisition is an official order laying claim to the use of property or materials; for example, a manager using an internal form to request items from a purchasing manager. A purchase order is a commercial document issued by a buyer to a seller, indicating types, quantities, and agreed-upon prices for products or services.

Which monosaccharide is absorbed using facilitated diffusion? Sorbitol Fructose Glucose Galactose

Correct answer: Fructose Carbohydrates are absorbed differently based on their physical properties. In monosaccharides, fructose is absorbed differently than glucose and galactose. Fructose enters the cell from the intestinal lumen using facilitated diffusion through another transporter (GLUT-5). Glucose and galactose are absorbed using active transport. These molecules are taken into the enterocyte by co-transport with sodium using the same transporter (GLUT-1). Sorbitol is not a type of monosaccharide; it is a by-product (ETOH) of glucose that is absorbed with passive diffusion.

Jason is the director of food service at Hospital Food Corporation Inc. He wants to understand how to best conduct an effective in-service training for his employees. During this process, he evaluates all of the possible causes and effects related to this particular event. What type of problem-solving process is Jason most likely using? Intuition Fishbone diagram Pareto charts Delphi technique

Correct answer: Fish diagram Decision-making or problem-solving is the recognition and analysis of a problem to determine a solution. Different problem-solving techniques include nominal groups, Delphi, fishbone diagrams, Pareto charts, and queuing theory. The cause and effect (aka fishbone) diagram focuses on brainstorming the root causes of an event and potential effects. This diagram is composed of a series of connected arrows to show relationships. Since Jason is evaluating the causes and effects of an in-service training, he is most likely using this fishbone diagram for problem-solving. The Delphi technique is a method of group decision-making and forecasting that involves successively collating the judgments of experts. In this technique, participants do not have to meet in person. Pareto charts are used to graphically summarize and display the relative importance of the differences between groups of data. Intuition is when a decision is made based not on gathering data but on unsubstantiated facts or overlooking the facts. Flag Question

A kitchen manager determines when to reorder flour based on the average daily use of flour, the number of days it takes from placing the flour order until delivery, and his backup flour supplies. Which method of inventory management is the kitchen manager using? Fixed order quantity Physical Perpetual Par stock

Correct answer: Fixed order quantity A person using the fixed order quantity inventory system determines when to reorder an item (order point) based on average daily use of an item, the number of days it takes from placing the order until delivery (lead time), and backup supplies (safety stock). Perpetual inventory management involves the recording of all purchases, and how much of a given item is in stock at any time is always known. Physical inventory management is the counting and recording of all products on hand at the end of the month or accounting period. The par stock method determines how much to order based on typical usage of a product.

To treat hyperlipidemia, which fat source should be recommended and why? Safflower oil because it decreases hepatic production of triglycerides Linoleic acid because it can replace carbohydrate to decrease HDL Flax seeds because they inhibit VLDL synthesis None, because fat sources will exacerbate the hyperlipidemia

Correct answer: Flax seeds because they inhibit VLDL synthesis To treat hyperlipidemia, alpha-linolenic (omega-3) sources should be recommended because they can inhibit VLDL synthesis by decreasing hepatic production of triglycerides. Examples of these omega-3 sources are walnuts, flax seeds, and canola oil. Safflower oil is the best source of linoleic acid (omega-6). When linoleic acid replaces carbohydrate in the diet, LDL decreases and HDL increases.

Multiple glutamic acid molecules must be hydrolyzed off to absorb which nutrient? Copper Glutamine Pantothenic acid Folate

Correct answer: Folate Food sources of folate contain multiple glutamic acid molecules, which must be hydrolyzed off or removed in order to be absorbed. Examples of folate food sources include green leafy vegetables, fortified cereals, liver, kidney, citrus fruits, lentils, and beans. Glutamine is a nonessential amino acid used in the biosynthesis of proteins and conditionally essential during catabolic stress. Examples of glutamine food sources include protein-rich foods such as beef, chicken, fish, dairy products, and eggs. Pantothenic acid, or vitamin B-5, is synthesized by intestinal bacterial to be absorbed and function in the synthesis of fatty acids. Examples of vitamin B-5 food sources include animal foods, grains, and legumes. Copper is a trace mineral attached to a protein, ceruloplasmin, and absorbed in the duodenum. Copper functions in hemoglobin formation and aids in iron absorption. Examples of copper food sources include liver, kidney, and shellfish.

A farmer purchases one ton of fertilized soil from a garden company at $1,900 for next season. The garden company agrees to ship the soil to his farm in 12 months. Then the farmer's son purchases seeds from another garden company. What type of contract does the farmer make in his soil purchase? Group or co-op organization Prime vending Futures contract Centralized purchasing

Correct answer: Futures contract A futures contract is the purchase of goods at a set price to be shipped at a future point in time. Prime vending is the use of a single vendor for the majority of purchases. Since the farmer is using another company to purchase seeds, this is not an example of prime vending. Centralized purchasing is the control by one department of all purchasing in an organization, which allows for centralized management, cost-effectiveness, and time-savings. Since the farmer and his son both purchased items, this is not an example of centralized purchasing. A group or co-op organization is an entity created to leverage the purchasing power of a group of businesses to obtain discounts from vendors. This is a common practice in the grocery, healthcare, electronic, industrial manufacturing, and agricultural industries. Since the farmer is not working with other farmers to leverage purchasing power, this is not an example of group or co-op organization.

View the supporting details to answer the following question. Michelle is the project coordinator for XYZ Medical Foods Inc. She is planning a project and wants to visualize the overall structure and timeline of the project. Her tentative project outline is shown in the provided image. What type of tool is she using? Production schedule CMP PERT Gantt progress chart

Correct answer: Gantt progress chart A Gantt progress chart, commonly used in project management, is a bar chart that shows what has to be done (activities) and when (schedule). It can be used to show: What the various activities are When each activity begins and ends How long each activity is scheduled to last Where activities overlap with other activities, and by how much The start and end date of the whole project The Program Evaluation and Review Technique (PERT) is a method of analyzing the tasks involved in completing a given project, especially the time needed to complete each task and to identify the minimum time needed to complete the total project. PERT is commonly used in conjunction with the Critical Path Method (CMP), which determines the minimum time to complete a project to help determine labor costs. This method uses a network diagram to connect activities with arrows. A production schedule tells employees what to do when during their work day to assure efficient use of time and minimize production problems.

What would you possibly find during a nutrition-focused physical exam in a person with severe vitamin B deficiency? Gray-brown spots on the teeth Petechiae Brittle nails Glossitis

Correct answer: Glossitis Glossitis (inflammation of the tongue, which can make it sore, red, and swollen) is related to a deficiency in riboflavin, iron, zinc, and pyridoxine. Gray-brown spots or mottling on the teeth is associated with an increased fluoride intake. Brittle nails are associated with a protein deficiency. Petechiae (tiny brown-purple spots on the skin) are associated with a vitamin C deficiency. Nutrition Care of the Older Adults: A Handbook for Nutrition Throughout the Continuum of Care, Third Edition

What hormone releases glucose from liver glycogen? Insulin Epinephrine Glucocorticoids Glucagon

Correct answer: Glucagon Glucagon is an important hormone in controlling blood sugar levels and is released in response to low blood sugar to induce glycogenolysis (breakdown of liver glycogen to release glucose). This hormone helps raise blood sugar and is found in the alpha cells of the pancreas. Insulin is released in response to high blood sugar to induce glycogenesis and lipogenesis. This hormone helps lower blood sugar by increasing cell permeability to glucose and is found in the beta cells of the pancreas. Glucocorticoids are hormones that help to raise blood sugar by inducing gluconeogenesis (breakdown of protein to glucose). Epinephrine is a hormone that helps to raise blood sugar by stimulating liver and muscle glycogenolysis (breakdown of glycogen to glucose). This hormone stimulates the sympathetic nervous system and is found in the adrenal medulla.

What is maltose made up of? Glucose and fructose Glucose, fructose, and galactose Glucose and galactose Glucose and glucose

Correct answer: Glucose and glucose Carbohydrates are categorized by their physical properties into monosaccharides, disaccharides, and polysaccharides. Monosaccharides are simple sugars, known as glucose, fructose, and galactose. Disaccharides contain two monosaccharide molecules, known as sucrose (glucose and fructose), maltose (glucose and glucose), and lactose (glucose and galactose). Polysaccharides are complex molecules, known as starch, cellulose, pectin, glycogen, and dextrin.

Which of the following nutrition interventions would be most effective for a client with anorexia nervosa? Work solely with a registered dietitian Have regular meal times Reach calorie goal as soon as possible Have a structured meal plan

Correct answer: Have regular meal times Anorexia nervosa is an eating disorder that causes people to become preoccupied about their weight and what they eat, which results in a disordered body image and severe weight loss. Nutrition intervention should be multidisciplinary (including an RD, doctor, psychologist, etc.) and the RD should facilitate the planning of regular meal times, gradual re-introduction of feared foods, a healthy relationship with food, and slow progression to the calorie goal to prevent refeeding syndrome.

Which of the following would increase an outpatient dietitian manager's span of control? Increasing how often the manager reports to her director Having a larger geographic dispersion of outpatient dietitians Decreasing the number of patients that the manager sees per week Decreasing the number of outpatient dietitians that report to the manager

Correct answer: Having a larger geographic dispersion of outpatient dietitians Span of control is the term that refers to the number of subordinates a supervisor has and is determined by complexity, proximity of jobs, quality of people, and abilities of the supervisor. An increased span of control, or wide span, requires less supervision, fewer levels, fewer managers, and is used with highly trained personnel. Examples include having a larger geographic dispersion of outpatient dietitians (increased responsibility with a decreased proximity of jobs). A reduced span of control, or narrow span, requires more supervision, more levels, more managers, and is used with less trained or newly hired personnel. Examples include decreasing the number of outpatient dietitians that report to the manager (less responsibility), decreasing the number of patients that the manager sees per week (fewer complexities or abilities), and increasing how often the manager reports to her director (more supervision). Flag Question

Mark is 19 years old and has a fasting serum glucose of 150 mg/dL, HgbA1C of 6.4, blood pressure of 140/90, LDL of 100 mg/dL, and HDL of 20 mg/dL. Based on the given information, what can be presumed about Mark's condition? He has metabolic syndrome He has type 1 diabetes mellitus He has type 2 diabetes mellitus He is healthy

Correct answer: He has metabolic syndrome Metabolic syndrome is diagnosed when a patient has at least three of the following five conditions: Fasting glucose ≥100 mg/dL (hyperglycemia) Blood pressure ≥130/85 mm Hg (hypertension) Triglycerides ≥150 mg/dL (hypertriglyceridemia) HDL-C <40 mg/dL in men or <50 mg/dL in women Waist circumference ≥102 cm (40 in) in men or ≥88 cm (35 in) in women Mark has three of the five risk factors that diagnose metabolic syndrome. Based on the given information, Mark has hyperglycemia (fasting serum glucose of 150 mg/dL), hypertension (blood pressure of 140/90), and low HDL (HDL of 20 mg/dL). HgbA1C of 6.4 is indicative of prediabetes, and LDL of <100 is an optimal goal set by the American Heart Association (AHA).

The Wholesome Meat Act of 1967 was enacted to assure consumers that the animal used for the meat was: Healthy at the time of slaughter and wholesome Healthy at the time of slaughter and pesticide-free Organically raised and wholesome Pesticide-free and fit for human consumption

Correct answer: Healthy at the time of slaughter and wholesome The Wholesome Meat Act of 1967 was enacted to assure consumers that the animal was healthy at the time of slaughter and the meat is fit for human consumption, or wholesome. This is indicated with a "USDA Inspected and Passed" round purple stamp. The grade appears on the shield and grading is based on the maturity of the animal, marbling of fat, and color and texture of lean. "Organic" and "pesticide-free" were not terms included in the Wholesome Meat Act of 1967. Organic is a labeling term that indicates a product has been produced through approved methods. To use the "USDA Organic" label, a product must meet specific requirements and be verified by a USDA-accredited certifying agent. Pesticide-free is a term that indicates a product has been produced without the use of artificial pesticides. The FDA enforces and sets tolerable residue limits for pesticides on food.

Which ratio is not commonly used in the foodservice industry to analyze costs and labor productivity? Hidden food costs to markup per meal Labor minutes per meal Meals per FTE Meals per labor hour

Correct answer: Hidden food costs to markup per meal In the foodservice industry, the following ratios are commonly used to analyze costs and labor productivity: meals per full-time equivalent (FTE), meals per labor hour, and labor minutes per meal. Hidden food costs to markup per meal is not a ratio that can analyze costs and labor productivity. Hidden food costs account for losses in preparation, cooking, and service; markup is determined by dividing the desired food-cost percentage into 100.

A popular local bakery released a seasonal custard, and they have sold out of it every single day this spring. The customers claim it is the best and most tender custard they have ever had. Which of the following objective methods of rating quality would most likely reflect the quality of this seasonal custard? Small crystal size Grade AA High percent sag Low percent sag

Correct answer: High percent sag Percent sag (% sag) is an objective measure of quality used for custards. The larger the percentage of sag, the more tender the gel is. A high quality and tender custard will have a high percent sag, while an overcooked and less tender custard will have a low percent sag. Grading is used for rating egg quality and may classify eggs as AA, A, or B. Grade AA eggs are nearly perfect because the whites are thick and the yolks are free from defects. Crystal size is used for measuring candy quality. For example, in crystalline sugar candies, such as fudge, small crystal sizes are associated with creamier fudges.

Which of the following is not one of the characteristics beyond good pay and benefits that are common to companies considered the best to work for in the United States today? Hiring external candidates Encouraging open communication Making people feel part of the team Creating a pleasant workplace environment

Correct answer: Hiring external candidates The characteristics beyond good pay and benefits that are common to companies considered the best to work for in the United States today include encouraging open communication, promoting from within (versus hiring external candidates), stressing quality to foster employee pride, allowing employees to share profits, reducing distinction between ranks, creating pleasant workplace environments, encouraging employees to be active in community service, matching employee funds, and making people feel part of the team.

In the Hawthorne studies, researchers investigated ways to increase productivity in the workplace and found that certain variables increased employees' productivity. Which of the following variables would most likely increase an employee's productivity? Good working conditions Awards and prizes Monetary incentives Special attention

Correct answer: Special attention In the Hawthorne studies, researchers investigated ways to increase productivity and found that employees reacted to psychological and social conditions at work. Productivity increased when employees were given special attention, were well-treated by supervisors, and were given work breaks. They found that monetary incentives and good working conditions are generally less critical to improving employee productivity than meeting employees' needs and their desire to belong to a group and be included in decision-making and work.

John is the owner and manager of a nutrition and fitness company, Nutritious Fitness. This week he is hosting a company-wide training to provide information, ideas, and the latest research in sports nutrition to his employees. According to Mintzberg's theory, which managerial role category is John in during the training? Negotiator Interpersonal Informational Decisional

Correct answer: Interpersonal Management expert and professor Henry Mintzberg argued there are ten primary roles that can be used to categorize a manager's different functions. The 10 roles are divided into 3 categories: Interpersonal: The managerial roles in this category involve providing information and ideas. Since John is providing information, ideas, and research at this training, he is in the interpersonal category role. Informational: The managerial roles in this category involve processing information. Decisional: The managerial roles in this category involve using information.Negotiator is a role under decisional, where you may be needed to take part in, and direct, important negotiations within your team, department, or organization.

Which of the following steps should be included in a diet tech's employee orientation program? Introduction to food service employees Survey of the sources of labor supply Get information, give information, and make a friend Selection of the most capable person for the position

Correct answer: Introduction to food service employees The 10 steps that should be included in an orientation program: Introduction to the company Review of important policies and practices Review of benefits and services Benefit plan enrollment Completion of employment documents Review of employer expectations Setting of employee expectations Introduction to fellow workers Introduction to facilities Introduction to the job In the employment process, recruitment is surveying the sources of labor supply and determining which ones are used to bring in the most qualified prospective employees. After prospective employees are recruited, the next step is selection. Here, the employer selects the most capable person available for a particular position. The next step is the interview process, where the most capable persons undergoes a selection interview. The purpose of the selection interview is to get information, give information, and make a friend.

The hydrolysis of sucrose with an acid to form a mixture with equal amounts of fructose and glucose is referred to as what? Dextrinization Cross-linking Gelatinization Inversion

Correct answer: Inversion Inversion is the hydrolysis of sucrose with an acid to form a mixture with equal amounts of fructose and glucose. Invert sugar is an example of an inversion, and the result yields a product that is sweeter, higher in moisture, and less prone to crystallization than sucrose. Cross-linking is the linking of polymer bonds that prevents deterioration in starches by creating a shorter texture. Gelatinization is the swelling that occurs when starch is heated in almost boiling water and causes a paste to thicken. Dextrinization is the process of heating starch without water, causing starch molecules to break into fragments.

Milk is a good source of all of the following nutrients, except which? Iron Vitamin A Phsophorus Riboflavin

Correct answer: Iron Milk is a good source of calcium, phosphorus, riboflavin, vitamin A, and vitamin D. Milk is low in iron, vitamin C, and fiber.

In which of the following situations would you expect to see a patient with increased serum transferrin? Iron deficiency Protein-energy malnutrition Proper nutrition Muscle wasting

Correct answer: Iron deficiency Serum transferrin is a visceral protein that binds and transports iron. During iron deficiency, there is an increase in transferrin because there is a decrease in iron to bind and transport. Patients with muscle wasting may have a decreased creatinine, those with proper nutrition would have lab values within normal limits (WNL), and patients with protein-energy malnutrition (PEM) may have decreased total lymphocyte count (TLC) and albumin.

A meal of scrambled eggs, turkey bacon, low-fat yogurt, and orange juice would be inappropriate for which of the following cultural groups? Mormon Korean Jewish Chinese

Correct answer: Jewish Some people in the Jewish culture group follow a kosher diet, which requires the following: All flesh foods must originate from a kosher animal. The mixing of meat and milk or byproducts of the aforementioned animals is forbidden. Separate sets of dishes, utensils, and cookware for meat and dairy. Waiting periods in between eating foods of opposing groups. Since this meal mixes meat (turkey bacon) with a milk byproduct (yogurt), it would be inappropriate for the Jewish cultural group. The traditional Korean meal plan is high in vegetable foods and low in animal foods, and the traditional Chinese meal plan is high in ying (raw, cold foods) and yang (hot foods) with rice (neutral). Although our example may not be a traditional Korean or Chinese meal, it is not forbidden. Mormons do not consume alcohol or caffeine. They are allowed to eat meat and poultry, but the church advises them to eat these foods in smaller portions.

The following is an example of what? Registered Dietitian Collaborates with providers to identify and connect with patients Establishes treatment plans and communicates with patients Education: At least a Master's degree in nutrition and RD/RDN credential within 3 months Job description Job analysis Job breakdown Job specification

Correct answer: Job specification A job specification is a more detailed job description that includes the duties, conditions, personal qualifications (education; experience), and skills required to perform that job. Job analysis is the process of identifying and determining all aspects of a particular job, in order to collect information for a job description. A job breakdown lists the steps of a job, what to do when and how to do it; it's basically an instruction guide. A job description matches applicants to jobs by describing the required skills and responsibilities of a specific position.

Which of the following scenarios is an example of upward communication? The nutrition department head sends a list of dietetic internships to the program coordinator Josh meets with his food service manager on his last day of work for an exit interview The RD tells the RN the patient hasn't had a bowel movement in five days The building inspector provides information about the inspection to the director of food service

Correct answer: Josh meets with his food service manager on his last day of work for an exit interview Upward communication is the process of information flowing from the lower levels of a hierarchy to the upper levels. Examples of upward communication are an exit interview, an open-door policy, suggestion boxes, and grievance procedures. Feedback is the process by which a system continually receives information from its internal and external environments. An example of feedback is when the internal system interacts with the external system, such as the building inspector providing information about the inspection to the director of food service. Downward communication is the flow of information and messages from a higher level inside an organization to a lower one. Examples of downward communication are an organization's mission statement, procedure manuals, policy statements, and memos. Our example is the nutrition department head sending a list of dietetic internships to the program coordinator. Horizontal communication is the flow of information and messages between individuals within the same level of organizational hierarchy. An example of horizontal communication is within lateral departments, such as nursing and nutrition, when the RD tells the RN the patient hasn't had a bowel movement in five days.

A nutrition bill is sent through legislation and signed into law. What branch of government can discard the law if it considers it in violation of a person's basic rights? Legislative Executive Presidential Judiciary

Correct answer: Judiciary The judiciary branch is the system of courts (Supreme court and federal courts) that interprets and applies the law in the name of the state. This branch may discard a law if it considers it in violation of a person's basic rights and freedoms. The legislative branch includes the two houses of Congress (House of Representatives and Senate). The main task of these two bodies is to make the laws. Its powers include passing laws, originating spending bills (House), impeaching officials (Senate), and approving treaties (Senate). The executive branch is broadly responsible for implementing, supporting, and enforcing the laws made by the legislative branch and interpreted by the judicial branch. The executive branch includes the president, vice president, and cabinet.

Which of the following is an intracellular electrolyte? K+ Cl- Na+ Ca++

Correct answer: K+ Electrolytes are located in the extracellular and intracellular fluids of cells to maintain homeostasis and fluid balance. Intracellular electrolytes include K+, Mg++, and P. Extracellular electrolytes include Na+, Ca++, Cl-, and HCO3-.

During starvation, what does the brain use as an energy source? Isoleucine Valine Ketone bodies Glucose

Correct answer: Ketone bodies When the body is nourished, the brain uses glucose exclusively as an energy source. However, during starvation, the brain uses ketone bodies as energy. Ketone bodies are produced by the liver from fatty acids during periods of low energy intake, such as fasting, carbohydrate-restricted diets, starvation, prolonged exercise, or untreated type 1 diabetes. Examples of ketone bodies are acetoacetate, beta-hydroxybutyrate, and acetone. Isoleucine and valine are branched-chain amino acids (BCAAs).

Theo is a 23-year-old student in nutrition graduate school and he is studying for his final exam. He takes lots of notes, meets with a group of 5-6 classmates every weeknight to study, and reviews his notes while walking on the treadmill in the mornings. Which type of learner is Theo? Auditory Visual Introverted Kinesthetic

Correct answer: Kinesthetic The three types of learners are visual, auditory, and kinesthetic. Kinesthetic learners, like Theo, learn best through their sense of touch and/or motion. Some of the best activities for these types of learners are taking notes, studying in groups, making models/charts/diagrams, and adding movement when studying (such as walking on a treadmill). Visual learners learn through their sense of sight and do best when studying written materials, taking notes in colors, drawing pictures, and visualizing information. Auditory learns learn through their sense of sound and do best when listening (not talking), focusing on what the instructor is saying, talking to themselves or others about the information, and studying in groups. Introverts prefer individual rather than group activities.

A child has a starved appearance and a distended belly. What type of malnutrition does the child likely have? Iatrogenic Kwashiorkor Cachexia Marasmus

Correct answer: Kwashiorkor Kwashiorkor is a protein-energy malnutrition produced by a severely inadequate amount of protein in the diet. It is characterized by edema, distended belly, irritability, and enlarged liver with fatty infiltrates. This form of malnutrition is most commonly found in children in developing countries. Marasmus is a protein-energy malnutrition characterized by severe fat and muscle wasting with a starved appearance. Unlike in Kwashiorkor, there is no edema and the individual is at a reduced ideal body weight percentage. Iatrogenic malnutrition is brought on by medical treatment, hospitalization, and medications. Cachexia is associated with cancer and is characterized by general wasting due to the hypermetabolic disease state and decreased appetite.

Which lipoprotein transports dietary cholesterol to cells? HDL VLDL IDL LDL

Correct answer: LDL LDL transports cholesterol from the diet to all cells and is known as the number one transporter of cholesterol. VLDL transports endogenous triglycerides from the liver to adipose cells. HDL transports cholesterol from the liver to be excreted in reverse cholesterol transport and is known as the "good" cholesterol. IDL is the precursor to LDL that enables fats and cholesterol to move within the water-based solution of the bloodstream.

A nursing home screen asks all newly admitted patients to fill out a form about their body weight, eating habits, living environment, and social status. What type of screen is the nursing home using? MNA LEVEL II GNRI LEVEL 1

Correct answer: LEVEL I The nutrition screening initiative (NSI) promotes nutritional care for the elderly to identify nutritional risk and problems. This initiative uses a DETERMINE checklist as a screening tool for nutritional status to highlight warning signs of poor nutritional status and identify people at nutritional risk. This list looks at disease, tooth loss, economic status, social factors, medication list, involuntary weight changes, activities of daily living (ADLs), and years over age 80. Under the NSI, a LEVEL I screen identifies individuals who need a more comprehensive assessment. Under the NSI, a LEVEL II screen provides more specific diagnostic information on nutritional status. The Geriatric Nutritional Risk Index (GNRI) evaluates serum albumin and weight changes. The Mini Nutritional Assessment (MNA) evaluates independence, medication, number of meals consumed per day, protein intake, fruit/vegetable consumption, fluid, and mode of feeding for those 65 years and older.

At a hospital, which of the following is an example of an input? Labor Trays Employee satisfaction Meals

Correct answer: Labor Inputs, or resources, include labor, money, materials, facilities, and/or energy. Outputs, or units of service, include trays, customer/employee satisfaction, meals, patient days, and/or consults.

Which of the following is a source of potential employees during recruitment? EEO ADA Labor unions EEOC

Correct answer: Labor unions During recruitment, sources of potential employees include internal sources and external sources. The most common external sources are employment agencies, schools, and labor unions, and the use advertising. Equal Employment Opportunity (EEO) laws, the Equal Employment Opportunity Commission (EEOC), and the Americans with Disabilities Act (ADA) all have to do with regulatory compliance.

Which of the following foods is safe to eat? Meat roasted in an oven at 275°F for 3 hours Lamb chops cooked to 145°F and rested for 3-4 minutes before serving Leftover fettuccine Alfredo reheated to 150°F in a microwave oven Broccoli casserole held at 130°F for 4-6 hours until served

Correct answer: Lamb chops cooked to 145°F and rested for 3-4 minutes before serving Beef, pork, veal, and lamb (steaks, chops, roasts) should be cooked to a minimum internal temperature of 145°F (62.8°C) and allowed to rest for at least 3 minutes. When roasting meat and poultry, the oven temperature should be no lower than 325°F. Foods should be reheated to an internal temperature of 165°F or until hot, steaming, and cooked thoroughly. If hot food isn't going to be served right away, it's important to keep it at 140°F or above.

Which element of an egg helps the yolk act as an emulsifier? Lipoprotein Collagen Lecithin Myofibrils

Correct answer: Lecithin Lecithin is a phospholipid that helps the egg yolk act as an emulsifier. Lipoproteins help stabilize the emulsion in the egg yolk by interacting at the surface of the oil droplets to form a layer. Myofibrils are the basic rod-like units of a muscle cell. Collagen is the structural part of a tendon that surrounds muscles.

Casey is a representative for Abbott Nutrition and she is going to a conference this weekend. At the conference, she is responsible for transmitting information about her company's new enteral formulas to people both inside and outside of the company. According to Mintzberg's theory, what type of management role is Casey in at the conference? Disseminator Spokesman Monitor Figurehead

Correct answer: Spokesman Management expert and professor Henry Mintzberg argued that there are ten primary roles that can be used to categorize a manager's different functions. The ten roles are as follows: Figurehead: People look up to you as a person with authority and a source of inspiration. You have social, ceremonial, and legal responsibilities. Leader Liaison Monitor: You seek out information related to your organization and industry, looking for relevant changes in the environment. You also monitor your team, in terms of both their productivity and their well-being. Disseminator: You communicate potentially useful information to your colleagues and your team. Spokesperson: Managers represent and speak for their organization. You're responsible for transmitting information about your organization and its goals to the people outside it. Entrepreneur Disturbance Handler Resource Allocator Negotiator

Which of the following is a not a side effect of cirrhosis? Malnutrition Decreased appetite Steatorrhea Severe weight loss

Correct answer: Steatorrhea Cirrhosis is chronic liver damage resulting from a variety of causes (alcoholism, hepatitis, etc.) leading to scarring (fibrosis) and liver failure. The side effects include malnutrition, malabsorption, severe weight loss, fluid and sodium retention, and decreased appetite. Steatorrhea is a side effect of fat malabsorption, not cirrhosis, and is characterized by foul-smelling fecal matter presenting with fat. This occurs in patients with malabsorption disorders, such as Crohn's, inflammatory bowel disease (IBD), cystic fibrosis, and others.

A fecal fat test determines a stool has 8 grams of fat. What can this result imply? B-12 deficiency Diarrhea Lactose intolerance Steatorrhea

Correct answer: Steatorrhea Steatorrhea is a consequence of malabsorption, in which fat is not absorbed and lost in the stool. A fecal fat test can determine steatorrhea by testing the amount of fat in the stool. Normal stool fat is 2-5 grams, and more than 7 grams of fat is indicative of malabsorption. Diarrhea is indicated by three or more loose stools in a day. Lactose intolerance is indicated by the lactose tolerance test, or the inability to break lactase into glucose and galactose. B-12 deficiency is indicated by a blood test to show vitamin deficiencies.

According to French and Raven's power study, which combination of powers is most important for a leader to be able to produce compliance in his or her followers? Legitimate and expert Expert and referent Reward and referent Coercive and expert

Correct answer: Legitimate and expert In 1959, researchers French and Raven identified five sources of power in leadership: Legitimate, Reward, Expert, Referent, and Coercive. Six years later, Raven added an extra power base: Informational. By understanding these different forms of power, you can learn to use the positive ones to full effect, while avoiding the negative power bases that managers can instinctively rely on. The bases of power most important for obtaining compliance are legitimate and expert. Legitimate: This comes from the belief that a person has the formal right to make demands, and to expect others to be compliant and obedient. Reward: This results from one person's ability to compensate another for compliance. Expert: This is based on a person's high levels of skill and knowledge. Referent: This is the result of a person's perceived attractiveness, worthiness and right to others' respect. Coercive: This comes from the belief that a person can punish others for noncompliance. Informational: This results from a person's ability to control the information that others need to accomplish something.

Which of the following phytochemicals should be recommended for a woman at risk for breast cancer? Lignans Thiols Soy Polyphenols

Correct answer: Lignans Lignans are known for their phytoestrogens and anti-cancer properties and are found in flaxseeds, wheat bran, oats, and barley. Therefore, they may be a useful phytochemical for women at risk for breast cancer. Phytochemicals, or phytonutrients, are found in fruits, vegetables, whole grains, legumes, beans, herbs, spices, nuts, and seeds and are classified according to their chemical structures and functional properties. In the diet, phytochemicals may help to prevent or treat chronic diseases. They can also be used for detoxification, as blocking agents, and in other ways. Thiols detoxify carcinogens and are found in cruciferous vegetables like brussels sprouts. Soy foods are isoflavones and may lower elevated cholesterol. Polyphenols are found in cocoa and are associated with reduced risk of cardiovascular disease by improving endothelial function through blood vessel dilation.

During a food quality evaluation, each panelist is given three cookie samples and asked to taste each sample and score it on a 1-9 scale. What type of sensory test is this? Ranking Descriptive Paired preference Likeability

Correct answer: Likeability Affective, acceptance, or preference tests are used to determine whether a specific customer group prefers a particular product. The test types include ranking, likeability, paired preference, and descriptive. In likeability tests, panelists are asked to taste a sample and score it on a 9-point hedonic scale from "dislike extremely" to "like extremely." In ranking tests, panelists are given two or more samples and asked to rank them in order of preference. In paired preference tests, panelists are given two samples and asked to circle the one they prefer. In descriptive tests, panelists try to determine differences between two samples and are asked to rate particular aspects of flavor on a scale.

A researcher wants to measure the viscosity of liquids that flow on a flat surface, using different levels of thickened beverages (honey and nectar-like thickness levels). Which measurement method would be most useful? Specific gravity Line-spread test Viscosimeter Penetrometer

Correct answer: Line-spread test Objective testing uses equipment to evaluate food products instead of variable human sensory organs. Objective tests include the line-spread test, specific gravity, penetrometer, and viscosimeter. The line-spread test measures the viscosity of liquids or semi-solid foods that flow on a flat surface. Specific gravity compares the ratio of the density of a substance to the density of a standard (usually water for a liquid or solid, and air for a gas). This test is typically used for comparing the lightness of egg-white foam. A penetrometer measures tenderness and firmness, and is typically used in baked custard testing. A viscosimeter measures viscosity of liquids that flow on an inclined plane or on a rotational basis, typically used in syrup testing.

A mission statement is typically required in what type of planning? Strategic Long-range Short-range Operational

Correct answer: Long-range Long-range planning focuses on goals and objectives for up to five-year cycles and requires a mission statement of a long-range vision. Short-range or operational planning focuses on the upcoming year, months, weeks, or days. Strategic planning focuses on long-term goals and evaluating the best way to approach them. This type of planning typically uses SWOT analysis (strengths, weaknesses, opportunities, threats).

The CDC chart item "stature/length for age" can be used to reflect which of the following? Distinguish between stunting and wasting Short-term nutritional status Short-term marker of growth Long-term nutritional status

Correct answer: Long-term nutritional status Stature/length for age is used to define shortness/tallness, to reflect long-term nutritional status, and to determine the extent of stunting. This parameter can be affected by long-term nutritional stress or chronic illness. Weight for length/stature is used in infants and young children to identify over-, under-, or within-normal limits for weight, to detect short-term changes in nutritional status, and to distinguish between stunting and wasting. This chart is the most accurate indicator of risk. Weight for age is used as a short-term marker of growth and is affected by acute nutritional stress or illness.

Danny's Donuts is advertising this week, "Buy 4, Get 8 Free Donut Holes!" They are discounting the donut holes ($0.50 each) in hopes of getting more people to come in and buy other donuts at full price, such as the kolaches ($1.29 each) or apple fritters ($3.00 each). What type of pricing technique is this? Promotions pricing Loss leaders Positioning statement Focus strategy

Correct answer: Loss leaders A loss leader is a product that is sold at a loss to attract customers. In this case, the donut shop is losing money on donut hole sales with the goal of attracting more customers. Promotions pricing is the sale of a product(s) for a temporary time to increase sales during a slow period. Focus strategy uses cost leadership or differentiation strategy to target a specific, niche market. A positioning statement tells the marketplace how you would like your product to be viewed.

View the supporting details to answer the following question. Based on the nutrition facts, what nutrition claim might be added to the label for this item? Low cholesterol, gluten-free Low saturated fat, low calorie Low cholesterol Low cholesterol, low sodium

Correct answer: Low cholesterol The Nutrition Labeling and Education Act (NLEA) provides the FDA with specific authority to require nutrition labeling on most foods and to require that all nutrient content claims (i.e., "high fiber," "low fat," etc.) and health claims be consistent with agency regulations. Based on label regulations, this nutrition facts label qualifies for low cholesterol as it has < 0 mgs of cholesterol per serving. The label regulations are as follows: Low cholesterol = ≤ 20 mg/serving Low calories = No more than 40 kcals/serving Low fat = 3 g or less/serving Very low sodium = No more than 35 mgs/serving Low sodium = No more than 140 mgs/serving Low saturated fat = 1 g or less per serving Gluten-free = < 20 mg gluten

A mother with three children uses coupons from manufacturers, looks for local grocery store discounts, and shops at discount food stores to provide food for her family. What is the mother's food security status? Low food security High food security Very low food security Very high food security

Correct answer: Low food security Food security is the state when "all people, at all times, have physical and economic access to sufficient, safe and nutritious food to meet their dietary needs and food preferences for an active and healthy life." High or very high food security is when people have readily available nutritional and safe foods without fear of becoming hungry. Low food security is represented by the ability to use strategies to avoid hunger, such as clipping coupons and bargain shopping. Very low food security can be present at different times of the year when eating patterns of one or more household members are disrupted and food intake is reduced. This may be a result of the household lacking money and/or other resources to obtain food.

Joe is a single father with a 14-year-old daughter and a 10-year-old son. His primary care physician has referred him to you for medical nutrition therapy for hypertension and prediabetes. During the nutritional assessment, Joe tells you the following: He normally eats three meals per day. He can't afford to cook healthy meals at home, so he often eats out at fast food restaurants. He relies on low-cost food (such as frozen pizza, prepackaged noodles, and canned vegetables) to feed his family. Based on the available information, how would you classify his food security status? Low food security High food security Very low food security Marginal food security

Correct answer: Low food security The food security status of households ranges on a continuum from high to very low, divided into four ranges and characterized as follows: High Food Security: Households do not have problems with or anxiety about accessing adequate food. Marginal Food Security: Households sometimes have problems with or anxiety about accessing adequate food, but the quality, quantity, and variety of food are not significantly reduced. Low Food Security: Households have reduced quality, desirability, and variety in their diets, but quantity of food and normal eating patterns are not significantly disrupted. Very Low Food Security: One or more household members experiences disrupted eating patterns and decreased food intake due to lack of money and resources for food. Joe describes reduced quality, variety, and desirability in his family's diet, but they do not experience a disruption in the amount of food or normal eating patterns; therefore, this would classify his household as low food security.

Which manager reflects a systems approach to management? Ted, who formally organizes and administers his employees' work in a scholar principle Maggie, who considers the external and internal factors before making a decision Martina, who tells her employees that everyone will be involved in decisions and that they are the keys to the company's productivity Jeff, who inspires employees to become leaders and to motivate each other towards the group mission

Correct answer: Maggie, who considers the external and internal factors before making a decision Maggie uses a systems approach by considering both the external and internal environments that can impact her company before making a decision or allocating resources. Ted uses a traditional or classical approach by administering work in a scalar principle, where authority and responsibility flow in a one-way direction from high to low. Martha uses a human relations or Theory Z approach by preaching to her employees that everyone is involved in the decision-making process and that employee involvement is the key to productivity. Jeff uses a transformational management style where he uses activities to transform inputs to outputs to link, manage, and build functional systems by inspiring agents of change.

All of the following dry storage regulations are correct except: Maintain storage spaces at 32-40°F Store food off floors and away from walls Check the temperature of the storeroom daily Place a thermometer on the wall

Correct answer: Maintain storage spaces at 32-40°F Many items such as canned goods, baking supplies, grains, and cereals may be held safely in dry storage areas. The guidelines below should be followed: Keep dry storage areas clean with good ventilation to control humidity and prevent the growth of mold and bacteria. Store dry foods at 50°F for maximum shelf life. However, 70°F is adequate for dry storage of most products. Place a thermometer on the wall in the dry storage area. Check the temperature of the storeroom daily. Store foods away from sources of heat and light, which decrease shelf life. Store foods off the floor and away from walls to allow for adequate air circulation. The incorrect option is a regulation for refrigerated storage.

Which of the following is an example of a "Healthy People 2020" goal? Maintenance of healthy body weight Increase in omega-3 consumption Increase in lean protein consumption Decrease in saturated fat intake

Correct answer: Maintenance of healthy body weight Healthy People 2020 provides a comprehensive set of ten-year national goals and objectives for improving the health of all Americans. These goals are related to overall quality of nutritional intake rather than specific nutrient intake. Therefore, maintenance of healthy body weight is the the best choice since it's the only answer not related to specific types of foods. Healthy People's nutrition and weight status objective: "Promote health and reduce chronic disease risk through the consumption of healthful diets and achievement and maintenance of healthy body weights."

Juan is a 45-year-old male with a wife and four children. He works as a construction worker and supports his family making $40,000 per year. Based on market segmentation, into which group would you categorize Juan? Innovators Experiencers Makers Achievers

Correct answer: Makers Market segmentation is the process of dividing a broad consumer base or market into subgroups of consumers based on characteristics. Makers: Lower income, self-sufficient, family-oriented. Achievers: Successful individuals, higher income. Innovators: High income, self-sufficient. Experiencers: Young, impulsive, variety seekers.

The following data has been collected on a patient in the past 24 hours: 80 g protein intake, urinary urea nitrogen 26 gm N. What can you deduce about the nutritional status of this patient? Adolescent Well-nourished Pregnant Malnourished

Correct answer: Malnourished Based on the available data (protein intake and nitrogen output), nitrogen balance can be used to assess the nutritional status of the patient. The formula for nitrogen balance is (protein intake in grams / 6.25) - (urinary urea nitrogen + 4). For example, (80 g protein intake / 6.25) - (26 + 4) = -17.2 = negative nitrogen balance. A negative nitrogen balance indicates erosion of body proteins and is associated with burns, serious injuries, fevers, hyperthyroidism, wasting diseases, and malnourishment. A positive nitrogen balance indicates a net gain of body proteins and is associated with periods of growth (infant, teenager, pregnancy, healing). A zero nitrogen balance indicates protein maintenance and equilibrium, such as in a healthy adult.

"Plan" and "control" are two functions of: Human resources Marketing Management Strategy

Correct answer: Management The basic functions of management are plan, organize, direct, control and evaluate. The basic functions of marketing are known as the marketing mix, or the 4 P's of marketing: product, place, price, and promotion. Strategy is used in strategic planning and marketing to set direction for an organization by determining long-term goals and the best way to approach them. The basic functions of human resources are employment processes and procedures (promotion, transfer, separation, compensation, benefits).

During a meeting, clinical dietitians each establish performance goals with their clinical nutrition manager. For example, Sarah's goal is to be able to effectively write nutritional assessments for tube feeding patients without a team leader signing off on her notes after her first 90 days. What type of management style is this? Benevolent Scientific Management by objective Transactional

Correct answer: Management by objective Management by objective is a type of democratic management that provides control from within, where precise, measurable performance objectives are established between manager and employee. Transactional leadership, or managerial leadership, focuses on supervision, organization, and performance, where leaders promote compliance by using rewards and punishments. Scientific leadership focuses on the "one best way" and on physical aspects of the job rather than the human aspect. Pay increases as production increases. Benevolent, or autocratic, is a job-centered approach to management.

What is a potential impact of unionization on a foodservice management operation? The ability for a manager to set wages and fringe benefits Management losing the right to hire Disciplining workers without being subject to appeal the union The ability to use volunteer workers in the kitchen

Correct answer: Management losing the right to hire When unionization takes place, certain rights of management may be lost. Some of the potential freedoms that are lost include the right to hire or fire, changing work assignments and schedules, setting wages and fringe benefits, changing policies without appeal, disciplining workers without being subject to appeal the union, acting on grievances directly, and losing the right to utilize volunteer workers.

Which of the following individuals would you avoid recommending a low-sodium diet to? Marcy, 35-year-old female taking a lithium carbonate Martha, a 55-year-old woman on megestrol acetate Jake, a 21-year-old obese male Frank, a 64-year-old man with pre-hypertension

Correct answer: Marcy, 35-year-old female taking a lithium carbonate Lithium carbonate is an antidepressant mendicant, and consistent sodium and caffeine intake are required to stabilize lithium levels. If sodium or caffeine is restricted, lithium excretion decreases and may lead to toxicity. Therefore, it is recommended to keep daily sodium intake consistent. Obese and pre-hypertensive individuals may benefit from a low-sodium diet. Megestrol acetate is an appetite stimulant, and a low-sodium diet would not be contraindicated.

Which of the following medications would be most likely recommended for a geriatric patient with a poor appetite who was otherwise healthy? Marinol Ritlin Dextroamphetamine Elavil

Correct answer: Marinol A geriatric patient with a poor appetite who is otherwise healthy may be recommended an appetite stimulant, such as megestrol acetate or marinol. Other drugs that stimulate appetite include antidepressants (lithium carbonate, Elavil); however, these would not be indicated for use in an otherwise healthy patient. Dextroamphetamine and Ritalin are used for treatment in ADHD and may cause decreased appetite, weight loss, and nausea.

The CEO of a food distribution company understands that all his employees have needs that must be satisfied. He tries to motivate his employees by offering his top-selling managers incentive trips, promotions, and advanced training. What motivational theory is the CEO applying? McGregor's Theory X McClelland's human motivation theory Herzberg's two-factor theory Maslow's hierarchy of needs

Correct answer: Maslow's hierarchy of needs Maslow's hierarchy of needs is the theory that all people have basic needs that must be satisfied before the next levels of motivation can be addressed. Basic needs include survival needs such as food, clothing, shelter, security, and safety. Motivators higher in the hierarchy include human needs such as social activities (incentive trips), self-esteem (job promotion), and job enrichment (advanced training). Herzberg's two-factor theory states that there are certain factors in the workplace that cause job satisfaction (good) or dissatisfaction (bad). McClelland's human motivation theory states that every person has one of three main driving motivators: achievement, affiliation, or power. McGregor's Theory X assumes people inherently dislike work, will avoid it if possible, are negative and are autocratic.

Which steps are in the correct order for mixing a quick bread (e.g., muffin, biscuit, popover)? Mix dry ingredients, mix wet ingredients, add dry to wet ingredients, mix Mix dry ingredients, mix wet ingredients, add wet to dry ingredients, mix Cut fat into flour and salt, add liquid, mix Cream fat with sugar, add egg, add mixed dry ingredients slowly, alternating with portions of liquid

Correct answer: Mix dry ingredients, mix wet ingredients, add wet to dry ingredients, mix An example of a quick bread is a muffin, biscuit, or popover that is mixed using the "muffin method of mixing." The correct steps in order are: 1) mix dry ingredients, 2) mix liquid ingredients and add all at once to dry ingredients, and 3) mix enough to dampen. The second option is incorrect because the third step is out of order. In the muffin method, wet ingredients should be added to dry ingredients, not dry to wet. The other choices represent other methods of mixing. To mix a cake, the steps are: 1) cream fat with sugar, 2) add egg, 3) add mixed dry ingredients slowly and alternate with portions of liquid. To mix a pastry, the steps are: 1) cut fat into flour and salt, 2) add liquid.

"Tools, materials, and controls should be located close by and directly in front of the operator" is a principle for what type of procedure? Flow diagram Process chart Operation chart Motion economy

Correct answer: Motion economy The principle of motion economy is to reduce motions and time required to perform a task by focusing on rhythmic, habitual, simultaneous, symmetrical, and natural movements. Process charts use symbols to shows steps involved in a process. Operation charts are graphical and symbolic representations of the manufacturing operations used to produce a product. A pathway chart, or flow diagram, is a scale drawing that shows the path of a worker during a process.

Which of the following statements is a correct MyPlate guideline? Choose vegan and vegetarian proteins Eat fewer calories from foods high in unsaturated fat Make half your plate complex carbohydrates Move to low-fat and fat-free dairy

Correct answer: Move to low-fat and fat-free dairy MyPlate is a nutrition guide published by the USDA that focuses on a healthy eating style with simple key guidelines. The key guidelines include the following: Focus on variety, amount, and nutrition: Make choices from all five food groups including fruits, vegetables, grains, protein foods, and dairy. Choose an eating style low in saturated fat, sodium, and added sugars: Eater few calories from foods high in saturated fat, sodium, and added fat. Make small changes to create a healthier eating style: Make half your plate fruits and vegetables, make half your grains whole, move to low-fat and fat-free dairy, and vary your protein routine. Support healthy eating for everyone

Which of the following regulations is false regarding the NSLP? Must provide on average 1/3 of the daily recommended levels of protein, Ca, Fe, vitamin A, and vitamin C No more than half of the fruit requirement may be met by 100% fruit juice Must provide on average 1/4 of the daily recommended levels of protein, Ca, Fe, vitamin A, and vitamin C One vegetable serving is considered 3/4 cup

Correct answer: Must provide on average 1/4 of the daily recommended levels of protein, Ca, Fe, vitamin A, and vitamin C The National School Lunch Program (NSLP) is an entitlement program by the USDA that implements dietary guidelines into lunch programs to improve the nutrition of low-income children and families. Regulations for the NSLP include the following: Must provide on average 1/3 of the daily recommended levels of protein, Ca, Fe, vitamin A, and vitamin C; No more than 1/2 of the fruit requirement may be met by 100% fruit juice; One vegetable serving is considered 3/4 cup. The School Breakfast Program (SBP) under the USDA must provide on average 1/4 of the daily recommended levels of protein, Ca, Fe, vitamin A, and vitamin C.

The kitchen staff meets to vote on a new soup to add to next week's menu. Every member of the staff gives a vote, duplicates are eliminated, members rank the soups, and finally they vote on a final decision. What type of decision-making process is the kitchen staff using? Brainstorming Nominal group technique Queueing theory Delphi technique

Correct answer: Nominal group technique The nominal group technique is a group process involving problem identification, solution generation, and decision making. In this process, every member of the group gives their view of the solution, with a short explanation. Then, duplicate solutions are eliminated from the list of all solutions, and the members proceed to rank the solutions, 1st, 2nd, 3rd, 4th, and so on. This technique is a creative and prioritized form of brainstorming, yet yields more ideas than traditional brainstorming. The Delphi technique is a method of group decision-making and forecasting that involves successively collating the judgments of experts, where participants do not actually meet. Queueing theory is the mathematical study of waiting lines, or queues. This theory is often used to make business decisions about the resources need to provide a service.

North Park Community College's cafeteria serves buffalo wings on Wednesdays. What type of operation is this cafeteria? Commercial Non-selective Non-commercial Cycle

Correct answer: Non-commercial North Park Community College's cafeteria is a non-commercial operation, where the sale of food, or buffalo wings, is a secondary activity. Non-commercial operations may provide onsite food service, but that is not the primary goal of the operation. This type of operation is found in hospitals, schools, and the military. A commercial operation sells food as the primary activity, and profit is the desire. This type of operation is found at restaurants and sports events. Cycle and non-selective are types of menus. A cycle menu is a standing, repeating menu. A non-selective menu may be cycle or single use, but it does not provide its clients with choices.

John visits his primary care doctor for his first wellness appointment this year. During the visit, the doctor takes his blood pressure, which reads 150/90 mm Hg. The doctor informs John that, based on the blood pressure reading, he has stage 1 hypertension. What type of variable is the blood pressure reading? Nominal Numerical discrete Rank order Numerical continuous

Correct answer: Numerical continuous Variables are characteristics that may have different values, so they are categorized into different rankings. Numerical continuous is used for underlying continuous scales, such as blood pressure readings. Numerical discrete refers to data with numbers, such as the first wellness appointment. Rank order, or ordinal scale, is a variable with different stages, such as stages of a disease. Nominal, or non-ordered, variables fit into a category without a special order, such as gender, race, or marital status.

A widowed, Caucasian 72-year-old female makes $85,000/year working from home. What program would be able to provide her with meal assistance? SNAP OAA Nutrition Program Meals on Wheels She does not qualify for meal assistance

Correct answer: OAA Nutrition Program The Older Americans Act Nutrition Program (OAA) provides one hot meal per day, five days per week, and provides 1/3 of the RDAs. All individuals over 60 years of age, as well as their spouses, are eligible for this program, regardless of income. Participants in the program are more likely to have low income, be part of a minority group, live alone, or be over age 75; however, they are not required to have these characteristics. Targeting for the program is based on need. Meals on Wheels (under OAA) provides home-delivered meals for homebound individuals. The Supplemental Nutrition Assistance Program (SNAP) is a USDA food assistance program that assists low-income people with monthly benefits. To receive SNAP benefits, households must meet certain tests, including resource and income tests.

Which of the following factors promotes employee retention? Unpleasant work environment Lack of employee training On-boarding for all new employees Low pay

Correct answer: On-boarding for all new employees Employee retention refers to the ability of an organization to retain, or keep, its employees. This is driven by shared beliefs, good relationships between management and staff, a written mission statement, integrity, trust, adequate training (on-boarding, training, programs), and positive work-life culture. Employee turnover is driven by lack of these things, such as lack of employee training, low pay, and an unpleasant work environment.

Food and labor costs make up the: Fixed costs Cash budget Capital budget Operating budget

Correct answer: Operating budget The operating budget is the forecast of revenues, expenses, and profit for a specific period of time. The revenue (income) is first predicted, then it is budgeted for expenses (food, labor, operating expenses). The capital budget is the budget allocating money for the acquisition or maintenance of fixed assets such as land, buildings, and equipment. This budget includes expenditures whose returns are expected to last beyond one year. The cash budget projects revenues and expenses to determine if funds will be available when necessary. Fixed (indirect) costs are business costs, such as rent, taxes, insurance, and depreciation, that are constant despite the quantity of goods or services produced.

What areas are most useful in a physical exam for determining subcutaneous fat loss? Gastrocnemius orbital temple quadriceps

Correct answer: Orbital In a physical exam, there are certain body areas that can help determine subcutaneous fat loss versus muscle loss. The most useful areas for detecting subcutaneous fat loss are the orbital region (surrounding the eyes), upper arm region (triceps/biceps), and thoracic and lumbar regions (ribs, lower back, midaxillary line).

Richard is hired as a dietitian and is required to spend one week at the corporate office to learn the goals, policies, and responsibilities of his new company and position. What is this process called? Orientation Training Promotion Development

Correct answer: Orientation Orientation the process that informs employees of goals and policies and explains responsibilities; this typically occurs once a new employee is hired. Training is designed to improve skills, either after an employee is hired or to enhance their skills during the course of employment. Development prepares employees for more responsibility. Promotion involves the change to a job involving higher pay, status, and/or performance needs.

During osteoporosis, which cells are most active in the bone? Osteoclasts Osteoblasts Mesenchyme Osteocytes

Correct answer: Osteoclasts During osteoporosis, there is a loss of bone tissue and osteoclasts are more active than other bone cells. Osteoclasts resorb and remove bone, and thus are associated with the breakdown of bone. Osteoblasts reform bone and are more active during times of growth or rebuilding of the bone matrix. Osteocytes are formed when an osteoblast becomes embedded in the matrix, and thus they are found in formed bone. Mesenchyme are mesodermal embryonic tissues that develop into connective and skeletal tissues, including blood and lymph.

Vitamin D deficiency in adults can be identified as: Osteomalacia Arthritis Homocystinuria Rickets

Correct answer: Osteomalacia A vitamin D deficiency can occur through a lack of sunlight or vitamin D in the diet. In adults, this deficiency is known as osteomalacia (also called adult rickets), which results in demineralization and reduction of bone density. In children, a vitamin D deficiency is called rickets, which results in soft bones. Arthritis is the inflammation of peripheral joints. Homocystinuria is a disorder of methionine metabolism, leading to an abnormal accumulation of homocysteine and its metabolites in blood and urine. This disorder is associated with low levels of folate, B-6, and B-12.

Which menu item would be appropriate for a patient on a "level 2 dysphagia" diet? Apple with smooth peanut butter Ice cream sundae with peanuts and syrup Peanut butter and jelly on white bread Pancakes with syrup

Correct answer: Pancakes with syrup A level 2 dysphagia diet includes only moist and soft foods. Regular foods should be modified to make them easier to chew and swallow by blending, chopping, grinding, mashing, shredding, or cooking the food. Examples of foods appropriate for this level include soft pancakes with syrup, ground meat with soft cooked vegetables, and canned fruits. Foods that are not appropriate include peanut butter and jelly on white bread (no bread), ice cream sundae with peanuts and syrup (no nuts), and apple with smooth peanut butter (no raw fruit or sticky foods).

A nutrition professor is teaching a class on Wednesday from 6 to 7 pm with 55 graduate students. The first 45 minutes the professor is delivering a presentation on the metabolism of carbohydrates, and the last 15 minutes the students are breaking up into small groups to answer five questions about carbohydrate metabolism. Which of the following is a disadvantage of the lecture-style format? Passive audience Time-consuming Difficult to provide complex information in a logical way Not effective for large groups

Correct answer: Passive audience The disadvantages of lecture-style formats are that the audience is passive, experts are not always good teachers, and learning is difficult to assess. The advantages are that they provide factual information in a direct and logical way, they are useful for large groups, they stimulate thinking to open discussion, and they contain experiences that inspire. Being time-consuming is a disadvantage of the teaching style of brainstorming.

How are water-soluble nutrients, such as vitamin C, absorbed? Passive diffusion Active transport Sodium pump Simple diffusion

Correct answer: Passive diffusion Water-soluble nutrients, such as vitamins C and B, are absorbed through passive diffusion. In passive or carrier-facilitated diffusion, water-soluble nutrients attach to carriers and flow from high to low concentration and do not require energy. Some water and electrolytes are absorbed through simple diffusion. In simple diffusion, nutrients diffuse from high to low concentrations, for example, absorption from the intestine to blood to lymph. Active transport, or sodium pump, requires a carrier (Na) and energy (ATP). During this transport, nutrients flow across a gradient from low to high. This absorption method is used for most nutrients, including glucose, amino acids, Na, K, Mg, Ca, and Fe.

In the aging process of fruit, enzymes cause chemical changes and starch changes to sugar. During this process, protopectin is converted to pectin, which is then converted what? Pectic acid Turgor Pectin acid Ethylene gas

Correct answer: Pectic acid In the aging process of fruit, enzymes cause chemical changes to occur. During this process, starch changes to sugar. Protopectin is converted to pectin (ripe fruit) and then converted to pectic acid (overripe fruit). Ethyne gas accelerates the ripening of fruits during storage, thereby enhancing the process from pectin to pectic acid. Turgor refers to the swelling from osmotic pressure of water-filled vacuoles. Pectin acid is a fabricated term.

A hospital wants to gain insight on the nutritional status and nutrition-related health measures for low-income, high-risk children. What survey would provide the appropriate information on this population? PNSS NSI NHANES PedNSS

Correct answer: PedNSS PedNSS (Pediatric Nutrition Surveillance System) under HHS, surveys low-income, high-risk children from 0-17 years of age. This would be the appropriate survey for the desired population. PNSS (Pregnancy Nutrition Surveillance System) surveys low-income, high-risk pregnant women to identify and reduce pregnancy-related health risks. NHANES (National Health and Nutrition Examination Survey) is an ongoing and repeated survey that obtains information on the nutritional status of the United States population. NSI (Nutrition Screening Initiative) promotes nutrition for the elderly population to identify nutrition problems sooner.

The finding that "African-American children have the highest rate of low birth weight and anemia" would be most likely related to which nutrition program? BRFSS PNSS YRBS PedNSS

Correct answer: PedNSS The Pediatric Nutrition Surveillance System (PedNSS) is a program under Health and Human Services (HHS) that monitors the growth and nutritional status of low-income, high-risk children from birth to 17 years. The program monitors height, weight, birth weight, hematocrit, hemoglobin, cholesterol, breastfeeding, and infant-feeding practices. The statement that "African-American children have the highest rate of low birth weight and anemia" would most likely be a PedNSS finding. The Pregnancy Nutrition Surveillance System (PNSS) is a program under HHS to identify and reduce pregnancy-related health risks in low-income, high-risk pregnancies. The Youth Risk Behavior Survey (YRBS) is a survey under HHS for youth in grades 9 to 12 to assess their risk behaviors (smoking, alcohol, weight changes, exercise, eating habits). The Behavioral Risk Factor Surveillance System (BRFSS) is a survey under HHS for adults over 18 that collects information on risk behaviors (height, weight, smoking, alcohol, FFQ, health problems, diabetes).

In a relationship between minutes of exercise and servings of fruit per week, r = 0.899. Based on the r value, what can you deduce about this relationship? People who exercise more eat less fruit Minutes of exercise is moderately related to servinge of fruit per week There is no linear relationship People who exercise more eat more fruit

Correct answer: People who exercise more eat more fruit Correlations represent the relationship between varying types of data. The linear correlation coefficient (r) measures the degree to which the points gather around a straight line, where the value of r is always between -1 (perfect negative) and 1 (perfect positive). When r = 1, the points are on a straight line with a positive slope going up to the right. For our example, "when people who exercise more eat more fruit," the strength of the correlation is 0.899, representing a strong or high correlation. The option "minutes of exercise is moderately related to servings of fruit per week" reflects a moderate correlation, or r = 0.4-0.7. When r = -1, the points are on a straight line with a negative slope going up to the left—for example, when people who exercise more eat less fruit. When r = 0, there is no linear relationship.

A client is complaining of migraines and asking about a tyramine-restricted diet. Which of the following foods would you recommend avoiding on a tyramine-restricted diet? Cucumbers Pickles Roasted chicken Grilled salmon

Correct answer: Pickles Nutrition therapy for clients with headaches and migraines may include recommending a tyramine-restricted diet. Tyramine is found in aged, fermented, dried, pickled, cured, smoked, processed, and/or spoiled foods. Examples include hard or aged cheeses, lunch meats, sausages, yogurt, pickles, tofu, and more.

What is the first step in menu development and why? Determining if menus meet nutritional guidelines, so you can make necessary changes before implementing the menu Planning a light dessert with a heavy meal and vice versa, because customers will appreciate the complementary pairing Deciding on the side dishes, so that you can complement the entree appropriately Planning the meat and entrees for the entire cycle, because these are usually the most expensive items on the menu

Correct answer: Planning the meat and entrees for the entire cycle, because these are usually the most expensive items on the menu The suggested first step in the procedure for planning menus is planning the meat and entrees for the entire cycle or period, because these are usually the most expensive items on the menu. Later steps include deciding on the appropriate side dishes to complement the entree and planning a light dessert with a heavy meal and richer desserts with lighter meals. Determining if menus meet nutritional guidelines is the first step in the checklist for menu evaluation.

The statement "All food service employees must wash their hands before returning to work" is an example of a: Procedure Policy Vision Objective

Correct answer: Policy A policy indicates what should be done. It reflects current realities of the workplace, consistent expectations, and fair employee treatment; therefore, this statement is an example of a policy. A procedure indicates how the operation or policy should be done. An objective is a goal in which management directs its efforts to serve as a motivator and to provide direction. A vision is a statement of what a company wants to achieve in the future.

A 65-year-old male patient has chronic obstructive pulmonary disease and hypertension; he requires enteral nutrition (EN) initiation. What type of EN formula is best for this patient? Glucerna Elemental Nepro Polymeric

Correct answer: Polymeric A standard polymeric enteral nutrition formula is the best formula to use when a patient has a functioning GI tract and does not have a disease state requiring a specialized formula. An example of a standard formula is Jevity. Elemental formulas are used for patients with malabsorption problems and contain hydrolyzed proteins in the form of amino acids. An example of an elemental standard formula is Impact Peptide. Specialized formulas are used for patients with specific disease states that require specialized nutrition, such as Nepro for renal patients and Glucerna for diabetic patients.

Joshua is a restaurant manager and has a "country club" management style. Which of the following actions is he most likely to take? Exert minimum effort to get work done Focus on both people and production Focus on production and managing tasks Promote a friendly atmosphere, seek approval and acceptance

Correct answer: Promote a friendly atmosphere, seek approval and acceptance The answer choices describe leadership styles from the "Leadership Grid" by Blake and Mouton, which plots leader's concern for people (employees) versus their concern for production. Country club management is an employee-centered leadership style that promotes a friendly atmosphere and seeks approval and acceptance. Team management focuses on both people and production, and is the most desirable leadership style. Authority-obedience focuses on production and managing tasks. Impoverished management has minimal concern for people and production, and leadership exerts minimum effort to get work done.

A school nutritionist has collected the BMIs of middle school students over the past year. What is the best way for the nutritionist to interpret and share her data? Line graph Histogram Pie chart Bar chart

Correct answer: Histogram The best way for the school nutritionist to interpret and share her data for BMIs over the past school year is by using a histogram, a diagram consisting of rectangles whose area is proportional to the frequency of the variable and whose width is equal to the class interval. This type of chart helps to summarize data from a process that has been collected over time. A pie chart is a type of graph in which a circle is divided into sectors that each represent a proportion of the whole. This would work best for showing percentages of students in each BMI group. A bar chart, or bar graph, is a diagram in which the numerical values of variables are represented by the height or length of lines or rectangles of equal width. It shows measurements on the vertical access in ascending or descending order. This would work best for showing the different grade levels on the x-axis and the number of students in a specific category of BMI on the y-axis. A line graph displays information as a series of data points connected by straight line segments. This type of graph shows frequency on a vertical scale and method of classification on a horizontal scale. This may work best for showing a BMI-for-age growth chart.

A 93-year-old female patient has dysphagia and uses a PEG tube to receive enteral nutrition. After she was admitted to the hospital due to an infection around the PEG site, the family decided to discontinue the PEG to improve her quality of life in her remaining time (estimated at less than six months). What type of care is the patient and family now pursuing? Palliative care Medical care Hospice care Curative care

Correct answer: Hospice care In end-of-life care, the registered dietitian's assessment requires practitioners to consider not only the clinical nutritional needs of the person, but their medical goals (hospice vs. palliative vs. curative). Hospice care focuses on caring for people who are dying or near the end of life. Hospice and palliative care are very similar; the main difference is that hospice care begins after treatment for the disease has stopped and when it is clear the patient is not going to survive the illness. Palliative care focuses on comfort care for a patient when curative measures are no longer an option. Curative care is the active medical care and treatment for a medical condition where a cure is considered achievable.

Metabolic syndrome is diagnosed when a patient has at least three of five conditions. Which of the following conditions is not included in the determination? Hypertension Hyperglycemia Hypertriglyceridemia Hyperinsulinemia

Correct answer: Hyperinsulinemia Metabolic syndrome is comprised of a combination of risk factors linked to increased risk for coronary heart disease, diabetes, fatty liver, and several cancers. Metabolic syndrome is diagnosed when a patient has at least three of the following five conditions: Fasting glucose ≥100 mg/dL (hyperglycemia) Blood pressure ≥130/85 mm Hg (hypertension) Triglycerides ≥150 mg/dL (hypertriglyceridemia) HDL-C <40 mg/dL in men or <50 mg/dL in women Waist circumference ≥102 cm (40 in) in men or ≥88 cm (35 in) in women

The reduced ability to taste food is referred to as: Cacogeusia Hypogeusia Xerostomia Stomatitis

Correct answer: Hypogeusia Hypogeusia is the reduced ability to taste food and may be caused by chemotherapy. Chemotherapy may also cause xerostomia (dry mouth syndrome), stomatitis (painful swelling and sores in the mouth), and cacogeusia (unpleasant or revolting taste in the mouth).

After a gastrectomy, a patient is on a clear liquid diet. The patient drinks 12 ounces of organic apple juice at 4 pm. Which of the following symptoms is the patient most likely to experience? Decreased heart rate and decreased insulin production Hyperglycemia and constipation Hypoglycemia and diarrhea Increased blood pressure and weakness

Correct answer: Hypoglycemia and diarrhea The patient will most likely experience dumping syndrome. Dumping syndrome may occur after a gastrectomy when a patient digests too much simple or concentrated carbohydrate, resulting in hypoglycemia and diarrhea. After a gastrectomy the holding capacity of the stomach is decreased, and when too much food or liquid enters the stomach it is dumped into the intestines, causing cramps, rapid pulse, weakness, perspiration, and dizziness. This dumping leads to an overproduction of insulin, causing a drop in blood sugar, and water to be drawn into the intestines, causing diarrhea.

The following medical conditions are risk factors for the development of kidney stones, except: Colitis UTIs Gout Hypotension

Correct answer: Hypotension Renal calculi, or kidney stones, is the presence of calculi within the urinary tract. Risk factors that increase the risk for developing kidney stones include inadequate fluid intake, reduced urine output, increased sodium/oxalate/protein intake, sedentary lifestyle, and obesity. The following medical conditions are risk factors for developing kidney stones: Arthritis Colitis: inflammation of the colon that causes chronic diarrhea, dehydration, and chemical imbalances Crohn's disease Gout: caused by excessive uric acid in the blood, which leads to high urinary uric acid levels High blood pressure, or hypertension Hyperparathyroidism Medullary sponge kidney Renal tubular acidosis Urinary tract infections Inherited condition in which the kidneys are unable to excrete acid

How would you interpret the following statement: "A blood glucose meter gives readings within a five-point range every day for a month." Internally valid Reliable Sensitive Specific

Correct answer: Reliable Reliability refers to the consistency with which a device measures something in the same way in each situation. For example, a blood glucose meter providing readings within a 5-point range every day for a month would be a reliable measurement. Specificity, or the true negative, is the proportion of non-afflicted identified as non-afflicted, for example, the percentage of healthy people who are correctly identified as not having diabetes. Sensitivity, or the true positive, is the proportion of afflicted individuals who test positive, for example, the percentage of diabetics who are correctly identified as having the condition. Internal validity refers to how well an experiment was conducted and tests whether the difference between the two groups in a study is real. An experiment that is high in internal validity is able to prove that the independent variable is caused the dependent variable and not by another variable.

Restaurant A has an inventory turnover rate of 1.5 and Restaurant B has an inventory turnover rate of 6.75. What can you infer about their asset management? Restaurant A has a limited amount of inventory on hand Restaurant B has a larger amount of money tied up in inventory Restaurant A consumes and replenishes inventory more often than Restaurant B Restaurant B is using just-in-time purchasing

Correct answer: Restaurant B is using just-in-time purchasing Inventory turnover rate measures how often inventory is consumed and replaced. A desirable turnover rate is 2-4 times per month. A high turnover rate indicates a limited amount of inventory. For example, Restaurant B has a high inventory turnover rate, might be using just-in-time purchasing, has a limited amount of inventory on hand, and consumes and replenishes inventory more often than Restaurant A. A low turnover rate indicates a large amount of money tied up in inventory. For example, Restaurant A has a low turnover rate and likely has more inventory on hand than Restaurant B.

A new American restaurant, Taste, seats 60 guests and serves daily soups, local produce, and seasonal dishes. For their one-year anniversary, they are having a special event where they are serving their three top-selling dishes. What type of menu is Taste using for their special event? Limited choice Static Single use Set

Correct answer: Single use Taste is using a single-use menu for their special event. A single use menu is used for one day only, such as an event or special function. A static menu is also known as a fixed or set menu and provides the same menu items every day when the clients change daily. This type of menu would be used in Taste's restaurant, but not during their special event. A limited choice menu provides choices for some items. Since the special event is not offering choices and is only serving three items, this is not the correct answer.

Severe and prolonged vomiting can cause all of the following side effects except: Small bowel obstruction Mallory-Weiss tear Metabolic alkalosis Tooth decay

Correct answer: Small bowel obstruction Severe and prolonged vomiting can cause a Mallory-Weiss tear, metabolic alkalosis, and tooth decay. A small bowel obstruction (SBO) may cause vomiting, but vomiting does not cause SBO. A Mallory-Weiss tear is a tear in the mucous membrane, or inner lining, where the esophagus meets the stomach resulting from excessive, prolonged, and/or forceful vomiting. Metabolic alkalosis occurs from excessive loss of stomach acid from emesis. Tooth decay results from repeated purging, exposing the teeth to stomach acid.

Which of the following statements is an example of "change talk" in motivational interviewing? "My work schedule makes it hard for me to change my medication regimen timing" "I wish I could stick to my medication regimen" "You want to change your medication regimen" "Deciding to stick to your medication regimen shows how determined you are"

Correct answer: I wish I could stick to my medication regimen In motivational interviewing (MI), change talk is client speech that favors movement toward a goal, such as "I wish I could stick to my medication regimen." Sustain talk is ambivalence and client speech that favors the status quo rather than movement toward a goal, such as "My work schedule makes it hard for me to change my medication regimen timing." Affirmation is a foundational skill of MI, where the counselor instills hope and makes statements of appreciation to the client, such as "Deciding to stick to your medication regimen shows how determined you are." Reflective listening is a foundational skill of MI, where the counselor makes a statement to reflect their understanding of what the client said by paraphrasing or repeating, such as "So what I hear you saying is that you want to change your medication regimen." Flag Question

The registered dietitian nutritionist (RDN) must meet the following criteria to earn the RDN credential: I. Complete a minimum of a bachelor's degree approved by Accreditation Council for Education in Nutrition and Dietetics (ACEND) of the Academy of Nutrition and Dietetics (AND) II. Completed an ACEND-accredited supervised practice program at a healthcare facility, community agency, or foodservice corporation III. Passed a national examination administered by the Commission on Dietetic Registration (CDR) IV. Hold additional certifications in specialized areas of practice, such as pediatrics, geriatrics, renal nutrition, nutrition support, or diabetes education V. Take 100 CEUs per five-year time period I, II, III, IV, V I, II, III I, II, III, V I, II

Correct answer: I, II, III Registered Dietitian Nutritionists (RDNs) are food and nutrition experts who have met the following criteria to earn the RDN credential: Completed a minimum of a bachelor's degree at a U.S. regionally accredited university or college and course work accredited or approved by the Accreditation Council for Education in Nutrition and Dietetics (ACEND) of the Academy of Nutrition and Dietetics. Completed an ACEND-accredited supervised practice program at a health-care facility, community agency, or a foodservice corporation or combined with undergraduate or graduate studies. Typically, a practice program will run six to 12 months in length. Passed a national examination administered by the Commission on Dietetic Registration (CDR). Completed continuing professional educational requirements to maintain registration.

The characteristics of sustainable food systems include which of the following? I. The ability to meet the needs of the present without compromising the ability to meet the needs of future generations. II. People working within the food system are treated fairly. III. Foods that benefit human health are culturally acceptable and economically accessible. IV. Utilization of both oil and coal promotes energy efficiency. I, II, III, IV I, II, III I, III II, IV

Correct answer: I, II, III Sustainability is the ability to meet the needs of the present without compromising the ability to meet the needs of future generations. Sustainable food systems are built on a foundation of inputs that include the following: Production, distribution and consumption practices Human, natural and economic resources Social, political and technological agendas Coal and oil are not sustainable resources; therefore, they not part of a sustainable food system.

Which factor(s) could lead to a vitamin D deficiency? I. Limited sunlight II. Institutionalized or homebound state III. Medications IV. Vegetarian lifestyle

Correct answer: I, II, III Vitamin D deficiency may be caused by low dietary intakes (avoidance of dairy, some vegan diets), limited sunlight, institutionalized or homebound state (resulting in lack of sunlight), and medications (antifungals, anticonvulsants, glucocorticoids, HIV/AIDS medications). Iron deficiency may be a result of a vegetarian diet, but vitamin D deficiency is not common.

A nutrition diagnosis should be which of the following? I. Clear and concise II. Specific to the patient III. Related to all present problems IV. Related to the primary and secondary etiology V. Based on reliable and accurate assessment data I, II, III, IV, V III, IV I, II, III, V I, II, V

Correct answer: I, II, V A nutrition diagnosis should be Clear and concise Specific to the patient Related to one problem Related to one etiology Based on reliable and accurate assessment data

A patient with an ileostomy has increased need for which of the following nutrients? I. Water II. Water-soluble vitamins III. Salt IV. Protein

Correct answer: I, III A patient with an ileostomy has increased need for water and sodium to compensate for excessive losses in their stools. In general, oral intake should exceed ostomy output. For example, patients should drink at least one liter more than their ostomy output daily. The jejunum remains intact; therefore, water-soluble vitamins and protein needs are not affected.

Which of the following food service dishwashers is/are noncompliant? I. High-temperature dishwasher at 150-165°F during wash cycle II. Low-temperature dishwasher at 100-110°F during final cycle III. Dishes sanitized in a solution of chlorine at 50-100 ppm for 10 seconds II III I, III I, II

Correct answer: II Dishwashing machines use either heat or chemical sanitization methods. The following are specifications according to the U.S. Department of Health and Human Services, Public Health Services, and Food and Drug Administration Food Code. High-temperature dishwasher (heat sanitization): Wash: 150-165°F Final rinse: 180°F or 165°F for a stationary rack, single-temperature machine. Low-temperature dishwasher (chemical sanitization): Wash: 120°F Final rinse: 50 ppm hypochlorite on dish surfaces in the final rinse. Manual washing and sanitizing: 1st step: Wash using hot water and detergent after food particles have been scraped. 2nd step: Rinse with hot water to remove all soap residues. 3rd step: Sanitize with either hot water or a chemical solution maintained at the correct concentration.Hot water: (at least 171°F) for 30 seconds; orChlorine: 50-100 ppm minimum 10 second contact time;Iodine: 12.5 ppm minimum 30 second contact time;QAC space (Quaternary): 150-200 ppm concentration and designated contact time.

What are the similarities between WIC and SNAP? I. Entitlement program II. Have low-income criteria III. For infants and children up to 5 years of age IV. Regulated by the USDA I, II, IV I, II, III I, III II, IV

Correct answer: II, IV WIC and SNAP are both regulated by the USDA, and low-income criteria determine eligibility. Women, Infants, and Children (WIC) is a USDA program that provides supplemental foods and offers nutrition education for qualifying participants. Eligibility is based on sex (women who are pregnant, postpartum, or breastfeeding), age (children and infants up to 5 years old), financial need (must be low-income), and nutrition risk (such as abnormal weight gain, BMI status, history of high risk, anemia, etc.). The Supplemental Nutrition Assistance Program (SNAP) is a USDA program administered at the state level that offers nutrition assistance to millions of eligible, low-income individuals and families and provides economic benefits to communities. SNAP is the largest program in the domestic hunger safety net. The amount of SNAP benefits received by a household depends on the household's size, income, and expenses. Eligibility is based on residential and financial factors and cooperation with a job-training program.

Which of the following is an eligibility guideline for receiving Medicaid? I. Over the age of 65 II. End-stage renal disease III. Low income IV. All disabilities III, IV I, III, IV I, II I, IV

Correct answer: III, IV The guidelines for receiving Medicaid include low income and all disabilities. Medicaid provides payment for medical care for all eligible needy that are United States citizens, including people of all ages, the blind, the disabled, dependent children, and pregnant women. Medicare is a federal health insurance program for people over the age of 65 or of any age with end-stage renal disease.

In the business of community nutrition, a dietitian in a management position must be able to do all of the following except: Set a direction for the business or program Motivate people to help the organization reach its goals Organize the delivery of the product or service Influence political decisions by lobbying

Correct answer: Influence political decisions by lobbying Individuals need strong management skills, whether they work in the public or the private sector of nutrition, and must be able to do the following: Set a direction for the business or program. Define goals and objectives. Organize the delivery of the product or service. Motivate people to help the organization reach its goals. Allocate materials, equipment, personnel, and funds to operations. Control data systems. Provide leadership. Influencing political decisions is a type of advocacy that may be more prevalent when a public health dietitian is lobbying to encourage support of a certain issue (e.g., a nutrition bill).

According to the ADA, which of the following is a "reasonable accommodation" to make a workplace and dining area accessible to a person with disabilities? installing elevators widening aisles to at least 46" instaling wheelchair ramps widening doorways at a company with 10 employees

Correct answer: Installing wheelchair ramps The Americans with Disabilities Act (ADA) went into effect in 1994 for companies with 15 or more employees. It provides general guidelines for implementing reasonable accommodations for persons with disabilities in the workplace and dining areas. Accommodations may include installing ramps, widening doorways, and lowing shelves and counters. Installing elevators might be an undue hardship and therefore an unreasonable accommodation due to its nature and cost. Aisles must be at least 36" wide to accommodate persons with wheelchairs. Companies with fewer than 15 employees are not mandated by the ADA to implement reasonable accommodations.

What is the best nutrition education for a person with type 1 diabetes? Facilitate changes in eating that will reduce insulin resistance Integrate insulin regimens into usual eating and exercise habits Implement lifestyle strategies that will improve metabolic status Use A1C tests to determine whether adjustments in meal planning are necessary

Correct answer: Integrate insulin regimens into usual eating and exercise habits Type 1 diabetes (T1DM) patients are insulin-dependent, and goals include integrating insulin regimens into their usual eating and exercise habits. The other choices are correct for type 2 diabetes (T2DM) patients who are insulin-independent; goals include facilitating changes in eating that will reduce insulin resistance, implementing lifestyle strategies that will improve metabolic status, and using A1C tests to determine whether adjustments in meal planning are necessary. Insulin is not the primary measure, since T2DM patients are not insulin-dependent.

"Designed to Move is a call to action supported by a community of public, private, and civil sector organizations dedicated to ending the growing epidemic of physical inactivity. The Designed to Move Report, which provides a framework for getting kids active and re-integrating physical activity into everyday life, may be downloaded here." What type of marketing is this? Business Strategic Media promotion Social

Correct answer: Social Social marketing is an approach used to develop activities aimed at changing or maintaining people's behavior for the benefit of individuals and society as a whole. An example of social marketing is Designed to Move by SNAP-Ed. Business marketing is the practice of individuals or organizations selling products or services to fill the customer's needs or desires. Strategic marketing is a long-term overall view of marketing to set objectives, analyze the target market, and create an effective marketing mix. Media promotion is mainstream promotion of your content or service into news feeds of social media users.

During a nutrition counseling session, a client tells you, "I look forward to my mom's bread pudding and eggnog all year. I can't say no to them on holidays." What is this statement an example of? Emotional barrier to change Behavior readiness to change Body language readiness to change Social barrier to change

Correct answer: Social barrier to change A social barrier to change is resistance to change that is rooted in concern for how it will affect others in the group. Example of barriers include family, traditions, eating out, and ethnic food or cultural considerations. Emotional barriers to change include emotional and mental factors, such as self-image, self-esteem, locus of control, energy levels, and payback potential.

A television commercial suggests that eating a certain food before your workout will energize you and make you a better athlete. As a result, an individual watching the commercial buys the food and then takes a high-intensity interval training exercise class. Which learning theory does this reflect? Social learning Cognitivism Cognitive development Constructivism

Correct answer: Social learning In social learning theory, behavior is explained by continuous reciprocal interaction between cognitive, behavioral, and environmental influences. Here, individuals are likely to adopt a behavior if it results in outcomes they value, if the model is familiar to the observer and has respectable status, and if the behavior has functional value. Cognitivism is the idea of remodeling experiences based on what the learner already knows. Cognitive development is the idea of learning through adaptation to the environment. Constructivism is the idea that learning is an active process where learners construct new ideas and/or concepts based on their past and current knowledge.

Jason is a 33-year-old male with syndrome of inappropriate antidiuretic hormone secretion (SIADH). Which of the following lab values would you expect to be decreased? Triglycerides Sodium Carbon Dioxide Magnesium

Correct answer: Sodium Syndrome of inappropriate antidiuretic hormone secretion (SIADH) is a condition in which the body makes too much antidiuretic hormone (ADH). ADH helps the kidneys control the amount of water your body excretes through the urine. SIADH causes the body to retain too much water. As a result, individuals with SIADH are likely to develop hyponatremia (or decreased sodium levels) in the setting of fluid retention

Which of the following food additives inhibits mold in soda beverages? Titanium dioxide Glycerol monostearate EDTA Sodium benzoate

Correct answer: Sodium benzoate Sodium benzoate is a mold inhibitor and preservative commonly found in sodas. Glycerol monostearate is a humectant that retains moisture and increases firmness. An example of a glycerol monostearate is sorbitol. EDTA, or ethylenediaminetetraacetic acid, is a sequestrate that reacts with trace metal to prevent decomposition. EDTA can be used to maintain whiteness in potatoes. Titanium dioxide is a white food color agent.

What is a potential long-term consequence of chronic hyperphosphatemia? Soft-tissue calcification Respiratory paralysis Cardiac arrhythmia Muscle weakness

Correct answer: Soft-tissue calcification Serum phosphorous generally ranges (in adults) from 2.5 to 4.5 mg/dL. Hyperphosphatemia is abnormally high serum phosphate levels, which can result from increased phosphate intake, decreased phosphate excretion, or disorders that shift intracellular phosphate to extracellular spaces. Acutely, this is not a severe clinical issue; however, a potential long-term consequence of hyperphosphatemia is soft-tissue calcification. Hyperkalemia is abnormally high serum potassium levels, which include acute symptoms of nausea, vomiting, muscle weakness, and tingling and may lead to more serious symptoms of slow heartbeat, cardiac arrhythmia, and respiratory paralysis.

Potatoes contain green pigment under their skin due to chlorophyll that develops during light exposure in storage. This may be accompanied by a natural toxicant resulting in nausea, vomiting, and possibly death. What is the name of this toxicant? Solanum tuberosum Solanine Pheophytin Chlorophyllin

Correct answer: Solanine Solanine is a glycoalkaloid poison and a natural toxin found in species of the nightshade family, such as the potato, tomato, and eggplant. It can occur naturally in any part of the plant. If ingested, symptoms include nausea, diarrhea, vomiting, stomach cramps, cardiac dysrhythmia, nightmares, headache, dizziness, and possibly death. Solanum tuberosum is the scientific name for potato. Pheophytin is the olive green pigment found when chlorophyll is exposed to an acidic medium, while chlorophyllin is the bright green pigment found when chlorophyll is exposed to an alkaline medium.

What type of milk should a 10-year-old with galactosemia drink? Almond milk with whey protein powder Soy milk Reduced fat milk Chocolate milk

Correct answer: Soy milk Galactosemia is a rare genetic disorder that affects the ability to metabolize the sugar galactose properly. This disorder is treated by a galactose-free and lactose-free diet, because the enzyme is missing that converts galactose into glucose. Acceptable food alternatives include soy, hydrolyzed casein, lactate, lactic acid, lactalbumin, and pure MSG. Foods that are not acceptable and should never be eaten are organ meats, MS extenders, milk, lactose, galactose, whey, casein, dry milk solid, curds, Ca or Na caseinate, dates, and bell peppers.

How does the diet of a child with PKU differ from that of a child without PKU? The child with PKU has increased need for exogenous glucose Aspartame should be used instead of raw sugar for the child with PKU The child with PKU must restrict PHE and supplement TYR The child with PKU has increased protein needs

Correct answer: The child with PKU must restrict PHE and supplement TYR Phenylketonuria (PKU) is a genetic disorder and birth defect that causes an amino acid called phenylalanine (PHE) to build up in the body due to the missing enzyme phenylalanine hydroxylase. This missing enzyme would have converted PHE into tyrosine (TYR) and as a result PHE can build up in the blood, leading to poor intellectual function. The PKU diet has energy needs similar to those of a healthy child. The only diet differences include the restriction of PHE, supplementation of TYR, and avoidance of aspartame. Glycogen liver storage disease is the deficiency of glucose-6-phosphate in the liver, which impairs gluconeogenesis and glycogenolysis, and increases the dietary needs for exogenous glucose (in the form of raw cornstarch with a high-CHO, low-fat diet).

View the supporting details to answer the following question. What does this symbol represent? The food is permitted under Islamic Law The food has been treated with radiation The product can be recycled The product is non-GMO

Correct answer: The food has been treated with radiation Food irradiation (the application of ionizing radiation to food) is a technology that improves the safety and extends the shelf life of foods by reducing or eliminating microorganisms and insects.

An individual drinks a glass of cow's milk and their blood sugar rises less than 25 mg/dL above fasting. What can be inferred from this result? The individual has celiac disease The individual is post-gastrectomy The individual is lactose intolerant The individual is gluten-intolerant

Correct answer: The individual is lactose intolerant Normally, lactase is broken down into glucose and galactose to be more easily absorbed in the body. However, when an individual has a lactase deficiency (lactose intolerance) lactase is not split into glucose and galactose. The lactose tolerance test determines if an individual is tolerant by providing an oral dose of lactose after a fast. Tolerance of lactose is indicated by blood glucose rising above 25 mg/dL. Intolerance of lactose is indicated when blood glucose does not rise above 25 mg/dL due to lactase not being split into glucose and galactose molecules.

A patient is medically diagnosed with gestational diabetes and is admitted to the hospital for the remainder of her pregnancy (20 weeks). Which of the following is most likely to change as the patient's response changes? Both the nutrition diagnosis and the medical diagnosis The medical diagnosis The nutrition diagnosis Neither the nutrition diagnosis nor the medical diagnosis

Correct answer: The nutrition diagnosis A nutrition diagnosis is often a temporary label; ideally, with intervention, the nutrition diagnosis resolves. It changes as the patient's response changes. For example, the nutrition diagnosis "excessive carbohydrate intake" may change as you educate a gestational diabetes patient on the diabetic diet. A medical diagnosis is the identification of a disease or pathology of a specific body/organ/system and does not change as long as the condition exists. For example, gestational diabetes is a medical diagnosis; after the woman gives birth it may change to "diabetes" or "resolved."

A patient's lab values show decreased RBC, low hemoglobin, and high MCV. What can you infer based on the lab values? The patient has macrocytic anemia The patient has microcytic anemia The patient has a chronic infection The patient has an iron deficiency

Correct answer: The patient has macrocytic anemia Macrocytic, megaloblastic anemia is associated with the following lab values: decreased RBC, low hemoglobin, low hematocrit, high MCV (mean corpuscular volume), high MCH (mean corpuscular hemoglobin), and normal MCHC (mean corpuscular hemoglobin concentration). There are few, large blood cells caused by a folate or cobalamin (B-12) deficiency. Microcytic, hypochromic anemia is characterized by small, pale red blood cells caused by an iron deficiency. This type of anemia is commonly due to chronic infection, poor diet, impaired absorption, increased demand, malignancies, or renal disease.

The Joint Commission mandates that nutrition risk must be identified in hospital patients within 24 hours of admission by using which of the following screening tools? MDS MNA SGA The screening tool is not mandated

Correct answer: The screening tool is not mandated The Joint Commission mandates that nutrition risk must be identified in hospital patients within 24 hours of admission; however, they do not mandate a method of screening or a specific screening tool. The hospital determines who will conduct the screening and complete the documentation and which screening tool will be used. Subjective Global Assessment (SGA) is a screening tool that uses medical history and physical examination information to evaluate the patient based on history, intake, GI symptoms, functional capacity, physical appearance, edema, and weight changes. Mini Nutritional Assessment (MNA) is a screening tool primarily used for patients 65 or older that evaluates independence, medication, number of meals consumed per day, protein intake, fruit/vegetable intake, fluid, and mode of eating. Minimum Data Set (MDS) is a standardized screening and assessment tool for health status in long-term care facilities. Flag Question

How does the hormone thyroxine raise blood sugar? Stimulating the thyroid gland to produce more hormones Increasing cell permeability to glucose and stimulating lipogenesis Stimulating liver glycogenolysis and gluconeogenesis Stimulating the sympathetic nervous system and decreasing release of insulin from the pancreas

Correct answer: Stimulating liver glycogenolysis and gluconeogenesis. The hormone thyroxine (T4) raises blood sugar by stimulating liver glycogenolysis (glycogen --> glucose) and gluconeogenesis (noncarbohydrate substrate --> glucose). When the level of thyroid hormones (T3 and T4) drops too low, the pituitary gland produces thyroid-stimulating hormone (TSH) to stimulate the thyroid gland to produce more hormones. TSH indirectly raises blood sugar by producing more T4. Insulin is a hormone located in the beta cells of the pancreas; it lowers blood sugar levels by increasing cell permeability to glucose, fostering glycogenesis, and lipogenesis. Epinephrine is a hormone located in the adrenal medulla that raises blood sugar by stimulating the sympathetic nervous system, stimulating liver and muscle glycogenolysis, and decreasing release of insulin from the pancreas during catabolic stress. Flag Question

Where does protein digestion begin, and what enzyme is required? Pancreas, trypsin Mouth, amylase Stomach, protease pepsin Small intestine, lipase

Correct answer: Stomach, protease pepsin Protein digestion begins in the stomach with the enzyme protease pepsin and HCL. During proteolysis, pepsinogen and HCl in the stomach denature protein to pepsin. Then, pepsin acts on the protein to yield peptides (protease, peptones). Protein digestion ends in the pancreas with the enzymes trypsin, chymotrypsin, carboxypeptidase, and aminopeptidase in the intestine. Carbohydrate digestion begins in the mouth with amylase. Fat digestion begins in the small intestine with lipase.

Mary is a preschool teacher and is planning a picnic for the children's end-of-the-school-year party. Which of the following foods would be the best for Mary to bring? Hot dogs Strawberries Grapes Milk

Correct answer: Strawberries The best foods to bring to a picnic involving children would be those that do not commonly cause choking or allergic reactions. Foods that most commonly cause choking include tough meats, hot dogs, nuts, grapes, hard candies, popcorn, and peanut butter. Cow's milk protein is the most common single allergen for infants. Foods that most commonly cause allergies include milk, eggs, peanuts, tree nuts, fish, shellfish, soy, and wheat.

The statement, "Vitamin K helps support normal blood clotting," is an example of what type of claim? Structure/function claim Legal claim Health claim Disease claim

Correct answer: Structure/function claim According to the FDA, structure/function claims may describe the role of a nutrient or dietary ingredient intended to affect the normal structure or function of the human body. For example, "vitamin K helps support normal blood clotting." According to the FDA, a disease claim is when a product states it can diagnose, cure, mitigate, treat, or prevent disease. A claim such as this requires prior approval by the FDA. An FDA-authorized health claim requires a product description to use "may." For example, "This product may reduce the risk of heart disease." There is currently no legal definition for functional foods. The USDA regulates claims that manufacturers make about functional foods' nutrient content and effects on disease, health, or body function. Flag Question

A community needs assessment includes all of the following processes except: Studying the distribution and determinants of health-related states in specific populations Identifying gaps and barriers to services Determining what the community's health needs are Identifying places where nutritional needs are not being met

Correct answer: Studying the distribution and determinants of health-related states in specific populations A community needs assessment is the process of Determining the community's health and nutritional needs Establishing places and/or groups where nutritional needs are not being met Pinpointing gaps and barriers to services Distinguishing priorities and selecting resources that exist to deal with the problem Epidemiology is the study of the distribution and determinants of health-related states in specific populations and is not related to a community needs assessment.

A coffee shop wants to use the practice of benchmarking in hopes of improving their sales performance. All of the following are examples of potential benchmarking strategies for the coffee shop, except which one? Compare customer satisfaction with baked goods to that of local bakeries Analyze the espresso offerings of the top three closest coffee shops Subtract the cost of a cup of coffee from its selling price and categorize into high and low margins to optimize sales Identify additional services offered by regional coffee shops

Correct answer: Subtract the cost of a cup of coffee from its selling price and categorize into high and low margins to optimize sales Benchmarking is a technique that measures a company's performance against the best-in-class companies, determines how those companies achieved their success, and uses the information to improve its own performance. Potential benchmarking strategies are analyzing products or services offered by similar companies or competitors. Subtracting the cost of a cup of coffee from its selling price and categorizing it into high and low margins to optimize sales is an example of calculating contribution margin. Contribution margin, or profitability, is calculated by subtracting an item's cost from its selling price, then categorizing it into low or high contribution margins based on the average contribution margin for the entire menu. Flag Question

A flavor enhancer is added to foods to enhance their flavor profile without adding a recognizable flavor of its own. Thus, it is detected at sub-threshold levels. Which of the following is an example of a flavor enhancer? Sugar Butter Honey Soy sauce

Correct answer: Sugar Examples of flavor enhancers include salt, monosodium glutamate (MSG), acids, and sugars. Honey, butter, and soy sauce are all detectable above sub-threshold levels and add a recognizable flavor of their own. Honey is a type of sweetener and a form of sugar, butter is a type of saturated fat, and soy sauce is a condiment made from a fermented paste of soybeans.

Wine, pickles, and yogurt are all examples of fermented foods. During the process of fermentation, what substance is converted into acids, gases, or alcohol? Water Sugar Salt Soy

Correct answer: Sugar Fermentation is the chemical breakdown of a substance by bacteria, yeasts, or other microorganisms in a metabolic process that converts sugars to acids, gases, or alcohol under anaerobic conditions. For example, during the process of fermentation involved in making beer, wine, and liquor, sugars are converted to ethyl alcohol. Examples of fermented food products are beer, wine, miso, tempeh, kimchi, pickled foods, yogurt, tofu, soy sauce, cheese, and others.

A nutrition professor delivered a lecture on macronutrients to a 55-person classroom of college students. After the lecture, he provided a piece of paper to each student, which asked them to rate the presentation on a scale of 1 (very uninteresting) to 5 (very interesting) and write down the top three things they learned from the lecture. What method of evaluation is the professor using? Formative Summative Criterion-referenced Norm-referenced

Correct answer: Summative Summative evaluation occurs at the end of a learning activity (such as after a lecture), evaluates results, judges effectiveness, and is quantitative. Formative evaluation occurs before or during learning, helps diagnose problems or improvements, and is qualitative. Norm-referenced evaluation compares group norms or typical performance. Criterion-referenced evaluation compares predefined objectives, compares performance with specified objectives, and is diagnostic.

Which of the following characteristics is not an aesthetic factor of a menu? Sustainability Consistency Texture Color

Correct answer: Sustainability The aesthetic characteristics of a menu are flavor, consistency, shape, color, and texture. Sustainability is a factor that affects menu planning.

A 55-year-old father and his 8-year-old daughter need food assistance. Which of the following programs could provide them assistance? CSFP TANF WIC NSIP

Correct answer: TANF Temporary Assistance to Needy Families (TANF) is offered by the government to provide benefits and services to eligible families. TANF is the only option listed here that the 55-year-old father and his 8-year-old daughter would be eligible for. The family is not eligible for the other programs due to their ages (the daughter is too old for CSFP and WIC and the father is too young for NSIP). Commodity Supplemental Food Program (CSFP) by the USDA provides monthly commodity canned or packaged foods to low-income women, infants and children up to 6 years old, and some elderly. Women, Infants, and Children (WIC) provides supplemental food to infants and children up to 5 years old and women who are pregnant, postpartum, or breastfeeding. Nutrition Services Incentive Program (NSIP) is a service to foster independent living for older Americans. Under this program, those 60 years old and above are eligible for the Older Americans Act Nutrition Program that provides one hot meal five days per week. Flag Question

What is the best way to provide nutrition education for a special needs patient? Teaching rather than testing Using an emergency food program Testing periodically Visiting a food bank

Correct answer: Teaching rather than testing When working with special needs or disabled clients, teaching rather than testing is the best way to educate about nutrition. Information should be kept simple. One in five clients may have a disability that requires special accommodations and half of clients may have a disability. Testing periodically may be more effective with older adult populations with high motivation and education levels. Using an emergency food program and visiting a food bank may be a more appropriate for nutrition intervention and education for homeless or low-income populations.

Which of the following is a HIPAA violation? Texting patient information to the responsible medical team Submitting a late copy and documenting the time it should have been recorded Paging a patient's room number and MRN to the responsible medical team Writing a nutritional assessment in black ink

Correct answer: Texting patient information to the responsible medical team The Health Insurance Portability and Accountability Act (HIPAA) is the United States legislation that provides data privacy and security provisions for safeguarding medical information, such as protected health information (PHI). Texting patient information is a HIPAA violation because texting is not safeguarded and therefore PHI could be exposed to cyberspace. In order to discuss patient information within HIPAA guidelines, the communication sources must be encrypted. The other options are all in accordance with HIPAA guidelines.

What organization is responsible for establishing a standard definition of what makes an organization culturally competent? The Joint Commission Centers for Medicare and Medicaid Academy of Nutrition and Dietetics World Health Organization

Correct answer: The Joint Commission The Joint Commission is working to define cultural competence and establish a standard definition of what makes an organization or institution culturally competent. Cultural competence is described as a set of congruent attitudes, behaviors, and policies. According to The Joint Commission, it is defined as "The ability of health care providers and health care organizations to understand and respond effectively to the cultural and language needs brought by the patient to the health care encounter. Cultural competence requires organizations and their personnel to do the following: (1) value diversity; (2) assess themselves; (3) manage the dynamics of difference; (4) acquire and institutionalize cultural knowledge; and (5) adapt to diversity and the cultural contexts of individuals and communities served." The Academy of Nutrition and Dietetics (AND) is a nongovernmental and professional organization that represents credentialed practitioners holding degrees in nutrition and dietetics. The World Health Organization (WHO) is a specialized agency of the United Nations concerned with international public health. It helps develop RDAs for developing countries. The Centers for Medicare and Medicaid is a federal agency in the United States Department of Health and Human Services (HHS) that administers Medicare, Medicaid, State Children's Health Insurance Program (SCHIP), and health insurance portability standards.

During the USDA Automated Multiple-Pass Method, which step collects information on the food and beverages consumed the previous day? The Time & Occasion List The Quick Step The Detailed Cycle The Final Review

Correct answer: The Quick Step The USDA Automated Multiple-Pass Method is a computerized interactive method for 24-hour recall used in government-sponsored nutritional studies. This method includes a five-step interview process: The Quick Step: Collects food and beverages consumed the previous day. The Forgotten Food List: Probes for food and beverages forgotten during the first step. The Time & Occasion List: Collects the time and eating occasion of each food. The Detailed Cycle: Collects detailed information on the description and amount of food consumed. The Final Review: Reviews the 24-hour recall.

A loaf of bread is stored at an AW level of 0.97 for three days. What is the most likely outcome of the bread? The bread will become stale The bread will become moldy The bread will be ready to eat The bread will become dry

Correct answer: The bread will become moldy The water activity (AW) represents the ratio of the water vapor pressure of the food to the water vapor pressure of pure water under the same conditions. Microorganisms grow at AW levels of 0.91-0.99. Therefore, food is more likely to spoil when stored in these conditions. The bread would become stale from getting old because of water in the starch moving to other parts of the bread, such as the crust. As a result, the starch returns to a dense and hard state. The bread would become dry if too much flour was used in the recipe, because flour is a toughener and can make the dough too stiff to rise properly. The bread would be ready to eat when fresh, stored properly, and used by the "best by" date.

During a cookout, ground lamb burgers are cooked on the grill to 145°F and then served. What will be the likely outcome? The burgers may be infected with Vibrio parahaemolyticus The meat was cooked to a safe internal temperature The burgers may be infected with Campylobacter jejuni The carry-over cooking will bring the meat to a safe internal temperature

Correct answer: The burgers may be infected with Campylobacter jejuni The safe minimum internal temperature is 160°F for ground beef, ground veal, and ground lamb. Therefore, the ground lamb burger should be cooked to 160°F before serving. If meat is not cooked to this temperature, the food-borne infections Salmonella, Campylobacter jejuni, or Escherichia coli may infect the undercooked food. Carry-over cooking occurs for about 10 minutes, and the internal meat temperature will rise 15-25°F during this time. But the question did not state that this occurred. Vibrio parahaemolyticus is a food-borne infection caused by eating raw or undercooked seafood, such as shellfish and oysters.

Which of the following best describes the purpose of nutritional epidemiology? To determine the condition of a population's health influenced by intake and utilization of nutrients To express a certain quantity, amount, or range To obtain information on processes, meaning, and more in-depth understandings To determine the relationship between dietary factors and their influence on etiology, occurrence, prevention, and treatment of disease

Correct answer: To determine the relationship between dietary factors and their influence on etiology, occurrence, prevention, and treatment of disease Nutritional epidemiology: The use of epidemiological approaches to determine relationships between dietary factors and their influence on etiology, occurrence, prevention, and treatment of disease. Quantitative: Data that is often numerical, which expresses a certain quantity, amount, or range. Qualitative: Data collection based on text rather than numerical data; used to obtain information on processes, meaning, and more in-depth understandings. Nutritional status: The condition of a population's or individual's health influenced by intake and utilization of nutrients and non-nutrients.

What is the purpose of total quality management? To encourage employees to identify problems and find solutions to improve the overall performance of the organization To document appropriate care patterns and identify areas needing improvement To plan what is to be done, do it, study the results, and act on the results To encourage employees to ask how the company is doing and how they can do it better

Correct answer: To encourage employees to identify problems and find solutions to improve the overall performance of the organization Total quality management (TQM) encourages employees to identify problems and find solutions to improve the overall performance of the organization. It is the philosophy of improving processes in response to customer needs and expectations. An audit is a formal study to retrospectively monitor performance. Its purpose is to document appropriate care patterns and identify areas needing improvement. PDSA/PDCA represents the PDCA cycle theory, which includes Plan-Do-Check/Study-Act. Continuous Quality Improvement (CQI) encourages employees to ask how the company is doing and how they can do it better.

What is the purpose of nutrition screening? To address the nutrition problem with measurable outcomes To identify patients who are malnourished or at risk of becoming so To determine if the RD should progress further with the plan of care To identify and label the nutrition problem

Correct answer: To identify patients who are malnourished or at risk of becoming so The nutrition care process (NCP) is a standardized structure to provide nutrition care based on the consequential steps of assessment, diagnosis, intervention, monitoring, and evaluation (ADIME). Nutrition screening is the preliminary process to identify patients who are malnourished or who are at risk of becoming malnourished, and this takes place before beginning the ADIME process. Nutrition screening should include nutritional parameters to review the patient's history, labs, weight, and physical signs. Assessment (A) is initiated by the nutrition screen to determine if the RD should progress further into the plan of care. Diagnosis (D) identifies and labels the nutrition problem. Intervention (I) addresses the nutrition problem with specific and measurable outcomes. Monitoring/Evaluation (M/E) scrutinizes, measures, and assesses changes in the nutrition care indicators.

Which of the following describes the purpose of the nutrition screening? To describe alterations in the patient's nutritional status To pinpoint individuals that are at nutritional risk or already malnourished To provide cost-effective and high quality care in health care organizations To obtain, verify, and interpret data needed to identify nutrition-related problems

Correct answer: To pinpoint individuals that are at nutritional risk or already malnourished A nutrition screening pinpoints an individual that is at nutritional risk or already malnourished and determines if further nutritional assessment is indicated. A nutritional assessment is used to obtain, verify, and interpret data needed to identify nutrition-related problems. This is the first step in the nutrition care process, which is essential for providing cost-effective and high quality care in health care organizations. Describing alterations in the patient's nutritional status is part of a PES statement.

What is the role of the food additive carrageenan in fat-free chocolate milk? To enhance flavor To prevent sedimentation To increase sweetness To extend shelf life

Correct answer: To prevent sedimentation Food additives are substances added to foods to enhance taste, improve appearance, extend shelf-life, and for other reasons. Carrageenan is a commonly used food additive that's extracted from seaweed and used to thicken, stabilize, or emulsify various processed products. For example, it is used in chocolate milk, forming a dense gel that prevents particles from sedimenting.

The purpose of the Occupational Safety and Health Act includes all of the following, except: To provide research, information, education, and training in the field of occupational safety and health To assist and encourage the states in their efforts to assure safe and healthful working conditions To provide workers with procedures for safely handling or working with particular substances To assure safe and healthful working conditions

Correct answer: To provide workers with procedures for safely handling or working with particular substances The purpose of the Occupational Safety and Health Act of 1970 is "To assure safe and healthful working conditions for working men and women, by authorizing enforcement of the standards developed under the Act; by assisting and encouraging the States in their efforts to assure safe and healthful working conditions; by providing for research, information, education, and training in the field of occupational safety and health..." A material safety data sheet (MSDS) is a document that provides workers with procedures for safely handling or working with a particular substance.

What is the primary goal of the CDC's REACH program? To reduce racial and ethnic health disparities To improve the health of communities and reduce the prevalence of chronic disease To promote healthy communities, prevent chronic diseases, and reduce health disparities To implement sustainable changes in communities where people live, learn, work, and play

Correct answer: To reduce racial and ethnic health disparities Racial and Ethnic Approaches to Community Health (REACH) is a national program administered by the Centers for Disease Control and Prevention (CDC) to reduce racial and ethnic health disparities. Partnerships to Improve Community Health (PICH) is a three-year initiative that aims to improve the health of communities and reduce the prevalence of chronic disease. Also, PICH builds on a previously funded program to implement sustainable changes in communities where people live, learn, work, and play. The National Implementation and Dissemination for Chronic Disease Prevention program is a three-year initiative that helps national organizations and local networks promote healthy communities, prevent chronic diseases, and reduce health disparities.

Which of the following is legal for a union? To require the company to release any employee who loses union membership To require the employer to hire only union members To require engagement in collective bargaining To require an employee to become a union member in order to obtain employment

Correct answer: To require engagement in collective bargaining The Taft-Hartley Act, also known as the Labor Management Relations Act, prevents unions from coercing employees to join, outlaws the union shop (which requires an employee to become a union member in order to obtain employment) and the closed shop (which obligates an employer to hire only union members and to release any employee who loses union membership), and makes it illegal for unions to refuse to engage in collective bargaining (an obligation to discuss terms with an open mind).

During a food quality evaluation, each panelist is given three cookie samples, two of which are alike, and is asked to indicate the odd sample. The panelists taste the samples from left to right and circle the number on the ballot that corresponds to the sample they think is different. What type of sensory test is this? Triangle Paired comparison Ranking Duo-trio

Correct answer: Triangle Triangle is an analytic food quality test where three samples are presented, two are alike, and panelists determine which one is different. Duo-trio is an analytic food quality test where each panelist is given a reference and two samples, then asked to determine which sample is the same as the reference. Paired comparison is an analytic food quality test where panelists are given two samples to compare for a specific quality (e.g., saltier, more tender). Ranking is a preference food quality test where panelist are given two or more samples and asked to rank them in order of preference.

A lifetime of healthy eating helps to prevent all of the following chronic diseases except which? High blood pressure Heart disease Type 1 diabetes Obesity

Correct answer: Type 1 diabetes According the 2015-2020 Dietary Guidelines for America, a lifetime of healthy eating helps to prevent chronic diseases like obesity, heart disease, high blood pressure, and type 2 diabetes. Type 1 diabetes (T1DM), also known as juvenile diabetes or insulin-dependent diabetes, is an autoimmune disease and chronic condition where the pancreas produces little or no insulin. T1DM is primarily managed through exogenous use of insulin. Healthy eating does not prevent this disease but can help manage it.

Liver enzymes are increased in all of the following diseases states except: alcoholism fatty liver uncontrolled diabetes hepatitis

Correct answer: Uncontrolled diabetes Liver function tests include the enzymes alkaline phosphatase (ALP), lactic acid dehydrogenase (LDH), aspartate amino transferase (AST, SGOT), and alanine aminotransferase (ALT, SGPT). Abnormal liver tests are detected when tissue damage causes the liver enzymes to leak into blood circulation. Increased liver enzymes are present in liver disease, bone disease, hepatitis, myocardial infarction, muscle malignancies, hepatitis, acute or chronic alcohol use, and fatty liver. Liver enzymes are decreased in scurvy, malnutrition, and uncontrolled diabetes.

Metabolic acidosis may be caused by: Anxiety Uncontrolled diabetes Hyperventilation Severe exercise

Correct answer: Uncontrolled diabetes Metabolic acidosis is failure related to the renal system to control the body's acid-base balance. In this condition, the kidneys retain/produce too much hydrogen (↑H+) or excrete too much base (↓HCO3). To compensate, the respiratory system increases ventilation to remove carbon dioxide to decrease carbonic acid. Metabolic acidosis may be caused by uncontrolled diabetes, diet (starvation, high-fat or low-carbohydrate diet), increased hydrogen production or retention by kidneys, excessive base excretion by kidneys, uremia, or diarrhea. Respiratory alkalosis is failure related to the pulmonary system and may be caused by loss of CO2, hyperventilation, anxiety, or severe exercise (e.g., running a marathon).

How should most vegetables (such as green beans, corn, beans, etc.) be canned, and why? Using a pressure cooker because the pH is high Using a pressure cooker because the pH is low Using boiling water because the pH is high Using boiling water because the pH is low

Correct answer: Using a pressure cooker because the pH is high Most vegetables have low acidity, with a pH of 4.6 and up, and should be canned using a pressure cooker because the pH is high. When the pH is low, acidity is high, and the food should be canned using boiling water.

You are responsible for the purchase of a new nutrient analysis software program. You need to investigate which program will eliminate unnecessary costs while providing the most usefulness. Which investigation would be most appropriate to conduct? Market analysis Budget projection Value added Value analysis

Correct answer: Value analysis Value analysis is the systematic and critical assessment by an organization of a product to ensure that its cost is no greater than is necessary to carry out its functions. This process focuses on increasing value (e.g., market value) and looking at ways to maintain effectiveness for the consumer. Value added is the amount by which the value of an article is increased at each stage of its production, exclusive of initial costs. This process focuses on lowering costs by estimating and quantifying the positive and negative effects. Market analysis is the quantitative and qualitative assessment of a market and the dynamics of achieving a need within a specific industry. Budget projections forecast the expected costs in the future by determining actual costs for this year and multiplying them by the expected increases for the next year.

Which of the following nutrients is a gastric bypass patient most likely to become deficient in, and why? Vitamin E due to decreased intake Zinc due to decreased intrinsic factor Vitamin B-12 due to decreased absorption Vitamin C due to decreased gastric acid

Correct answer: Vitamin B-12 due to decreased absorption Thirty percent of gastric bypass patients become deficient in vitamin B-12 due to decreased mechanical digestion and absorption of iron, B-12, and other nutrients. The etiology of the deficiency is due to inadequate contact with intrinsic factor, decreased gastric acid, and low intake of foods rich in vitamin B-12. Other common nutrient deficiencies include iron, protein, calcium, folate, and vitamin D. Vitamin C, vitamin E, and zinc are not common deficiencies for gastric bypass patients.

Bile salts are required for the absorption of which nutrients? Calcium, Iron Vitamins A, D, E, K Vitamins B-1, B-2, B-12 Intrinsic factor, B-12

Correct answer: Vitamins A, D, E, K Fat-soluble vitamins (A, D, E, K) require assistance from bile salts for absorption. For B vitamin absorption, thiamin (B-1) requires acid, riboflavin (B-2) requires phosphorous, and cobalamin (B-12) requires HCl and intrinsic factor (IF). For mineral absorption, calcium requires an acid, vitamin D, and lactose, while iron requires HCl and calcium to bind oxalates.

Which food program would likely provide the most assistance for homeless breastfeeding women? TEFAP WIC SMP NSLP

Correct answer: WIC WIC is a USDA special supplemental nutrition program for women (pregnant, postpartum, breastfeeding), infants, and children up to 5 years of age. WIC provides supplemental food, nutrition education, and health care. WIC would be the best program to provide support to a homeless breastfeeding woman. The Special Milk Program (SMP) is a USDA program that encourages milk consumption by children. The National School Lunch Program (NSLP) is a USDA entitlement program that aims to improve the nutrition of low-income children by providing cash grants, food donations, and reimbursement for school-based meals. The Emergency Food Assistance Program (TEFAP) is a USDA program that distributes commodity foods to local food distributors, but does not distribute to individual households.

Paul is hired as an entry-level dietitian at a dialysis clinic. He is paid $23.23/hour and works 40 hrs/wk. What type of compensation is Paul receiving? Wages Compensatory Supplementary Salary

Correct answer: Wages Compensation is the money received by an employee from an employer as a salary (annual earnings for managerial and professional positions) or wages (hourly earnings of employees under the Fair Labor Standards Act). Benefits are offered by companies as statutory (payment required by law in event of unemployment, death, or injury), compensatory (benefits or payment for time not worked), and supplementary (additional life and health insurances).

Which environment does mold grow best in? Warm, damp, and humid Sugar, moisture, and moderate temperature Abundant moisture, protein-rich, and neutral to low pH Cool, dry, and high pH Next Question

Correct answer: Warm, damp, and humid Mold grows best in a warm, damp, and humid environment. Yeast grows best in sugar with a moist and moderate temperature environment. Bacteria grows best in a place of abundant moisture that is protein-rich with neutral to low pH. Cool, dry, and high pH is a distractor.

If a child is chronically malnourished, which growth parameter will be affected first? Length Head circumference BMI Weight

Correct answer: Weight If a child is chronically malnourished, growth parameters will first affect weight, then length, and finally head circumference. BMI for children is age and gender specific. This growth parameter can be used starting at the age of two years; adult BMI charts should not be used for interpretation.

Which of the following is not a symptom of celiac disease? Macrocytic anemia Diarrhea Weight gain Malabsorption

Correct answer: Weight gain Celiac disease is an autoimmune disorder characterized by a genetic sensitivity to gluten (found in wheat, barley, and rye). When these grains are consumed, an autoimmune response is triggered that damages the small intestine's mucosa. This damage reduces the small intestine's absorptive surface, leading to malabsorption of macro- and micronutrients. A lifelong gluten-free nutrition prescription is recommended to treat this disease. The signs and symptoms include malabsorption, macrocytic anemia, iron-deficiency anemia, weight loss, diarrhea, and steatorrhea. Weight gain is not a symptom of celiac disease.

Which symptom and recommended diet is associated with Addison's disease? Hyperglycemia; consistent carbohydrate intake Weight loss; high-protein diet Weight gain; low-sodium diet Hypertension; low-sodium diet

Correct answer: Weight loss; high-protein diet Addison's disease is a disorder in which the adrenal glands do not produce enough hormones. The atrophy of the adrenal cortex leads to decreased cortisol (glycogen depletion, hypoglycemia), decreased aldosterone (sodium loss, potassium retention, dehydration), and decreased androgens (tissue wasting, weight loss). The recommended diet for Addison's disease is a high protein, high salt diet with frequent meals to prevent weight loss, hypoglycemia, and dehydration. The other choices do not reflect signs/symptoms or appropriate diets for an individual with Addison's disease.

An infomercial is selling a "special" vitamin and makes several weight loss claims about the product. What is the best question to ask to help evaluate the information? How many people have bought the product this year? How much does the product cost in comparison to other weight loss products? What are the product manufacturer's credentials? How much money has the product made this fiscal year?

Correct answer: What are the product manufacturer's credentials? When evaluating health care information, determine the legitimacy of the product based on the CARS checklist: Credibility: What are the author's credentials? Accuracy: Is the information current, factual, and comprehensive? Reasonableness: Is the information fair, balanced, and consistent? Support: Is there supporting documentation cited for scientific information?

A dietitian wants to ask her client about his alcohol consumption and facilitate dialog to better understand the client's feelings about alcohol use. Which of the following questions would be best for the dietitian to ask? What has your alcohol use been like during the past week? To start, I'd like you to tell me about your alcohol use. On a typical day, how much do you drink? How has your alcohol use been this week, compared to last: more, less, or about the same? When do you plan to stop drinking?

Correct answer: What has your alcohol use been like during the past week? Asking open-ended questions is a strategy of motivational interviewing that helps you understand your clients' point of view and facilitate dialog. These questions cannot be answered with a single word or phrase and encourage the client to do most of the talking. The other choices are examples of closed-ended questions.

A salad dressing is clear and not cloudy when refrigerated. What process prevents this salad dressing from crystallizing when cold? Sublimation Hydrogenation Gelatinization Winterization

Correct answer: Winterization Winterization is the process of chilling oil to 45°F to remove the fatty acids with higher melting points (such as triglycerides) and filtering them out. This process creates winterized oils that are clear and not cloudy when refrigerated. Examples of winterized oils are corn, soy, and cottonseed oils, which are primarily used in salad dressings. Hydrogenation is the process of adding hydrogen atoms to the double bonds in unsaturated fatty acids to increase saturation and stability. Examples of hydrogenated products include margarine, shortening, and frying fats. Sublimation is the transition of a solid to the gas phase without passing through the liquid phase. Sublimation is used to prepare high-quality preserved foods using freeze-drying. Gelatinization is the process of breaking a starch bond in the presence of water and heat to dissolve a starch granule in water. The result of the reaction is a gel; common examples include sauces, puddings, and pasta preparations.

Which of the following populations is at increased risk for iron-deficiency anemia? Individuals consuming too little fiber Individuals following the Atkins diet Women with heavy menstrual periods Individuals consuming a vegetarian diet with mineral supplementation

Correct answer: Women with heavy menstrual periods The following populations are at increased risk for iron-deficiency anemia: Individuals consuming a vegetarian meal plan without vitamin/mineral supplementation Individuals following low-energy diets/skipping meals Individuals consuming too much dietary fiber, coffee, and/or tea Women with heavy menstrual periods Women who are pregnant and/or lactating Recent loss of blood (surgery, ulcers, hemorrhoids) Endurance athletes, who may have increased red blood cell breakdown Individuals taking certain medications that decrease absorption and/or utilization *Information cited from Nutrition Care Manual The Atkins diet is a low-carbohydrate meal plan for weight loss that is not a risk for iron deficiency since it contains animal-based proteins.

Marcy is a 47-year-old female with metabolic syndrome, and over the past two years she has worked with a registered dietitian. She reports significant weight loss, a healthy eating style, and a better quality of life. What is a potential direct nutrition outcome of the medical nutrition therapy? Increased hemoglobin A1C by 0.33% Increased triglycerides by 21mg/dL to 35mg/dL Increased high-density liproproteins cholesterol by 2.4 mg/dL Increased low-density lipoprotein cholesterol by 2.4mg/dL

Increased high-density liproproteins cholesterol by 2.4 mg/dL A direct nutrition outcome helps to evaluate the efficacy of a nutrition intervention. In adults with metabolic syndrome, research regarding the impact of medical nutrition therapy reported significant outcome improvements (NCM): Decreased fasting blood glucose by 2.5 mg/dL to 9 mg/dL (0.1 mmol/L to 0.5 mmol/L) Decreased hemoglobin A1c by 0.12% to 0.23% Decreased triglycerides by 21 mg/dL to 35 mg/dL (0.2 mmol/L to 0.4 mmol/L) Increased high-density lipoprotein cholesterol by 2.4 mg/dL (0.06 mmol/L) Decreased body weight by 2.5 kg to 4.1 kg Decreased waist circumference by 1.9 cm to 4.8 cm Decreased systolic blood pressure by 4.9 mm Hg

A manager performs in a decisional role when committing an organization to a specific course of action or strategy. Whose management theory is this an example of? Taylor's Scientific Management Mintzberg's Management Roles Katz's Skills Management Drucker's Management by Objectives

Mintzberg's Management Roles Mintzberg's Management Roles argued there are ten primary roles that can be used to categorize a manager's different functions to accomplish work and use skills. Katz's Skill Management identified three managerial skills essential to successful management: technical, human, and conceptual. Drucker's Management by Objectives (MBO) is the process of defining specific objectives within an organization that management can convey to organization members, then deciding how to achieve each objective in sequence. Taylor's Scientific Management is a theory that analyzes and synthesizes workflows, with the main objective being to improve economic efficiency, especially labor productivity.

What can be inferred about a patient with a HgbA1C of 5.7%? T2DM Prediabetic T1DM GDM

Prediabetic Prediabetes is indicated by an HgbA1C of 5.7-6.4, which puts a patient at risk for developing diabetes. Diabetes (T1DM/T2DM) is diagnosed by a fasting plasma glucose of ≥126 mg/dL, a glucose tolerance test of ≥200 mg/dL, or an HgbA1C of ≥ 6.5%. Gestational diabetes (GDM) is diagnosed at 24-28 weeks of gestation with a glucose tolerance test of ≥140mg/dL to indicate further testing.

A patient weighs 64 kg and requires a tube feeding initiation. His estimated needs are 30 kcals/kg and 1.5-2.0 grams protein/kg. If the tube feed runs continuously, what is the tube feeding goal rate? The chosen enteral formula nutrition facts are 1000 kcal, 64 g protein, and 840 mL H2O per 1000 mL of formula. 60 mL/hr 80 mL/hr 90 mL/hr 64 mL/hr

orrect answer: 80mL/hr To determine his estimated calorie needs: Multiply weight by estimated calorie needs: 64 kg x 30 kcals/kg = 1,920 kcals To determine his estimated protein needs: Multiply weight by estimated protein needs: 64 kg x 1.5-2.0 g protein/kg = 96 - 128 g protein To determine the rate: Multiply volume by kcals per mL and divide by hours the feeding will run: 1.920 mL x 1000 kcal/mL = 1,920 kcal / 24 hours = 80 mL/hr To check if the rate meets the estimated protein needs: Multiply volume by protein per mL: 1.920 mL x 64 g protein = 122.88 g protein

Which of the following food items represents the sol phase of dispersion? Turkey gravy Chocolate sponge cake Balsamic vinaigrette Lemon custard

Correct answer: Turkey gravy Turkey gravy is an example of a sol, or the state of matter of a solid in a liquid. Balsamic vinaigrette is an example of an emulsion, or the state of matter of a liquid in a liquid. Lemon custard is an example of a gel, or the state of matter of a liquid in a solid. Chocolate sponge cake is an example of a suspension, or the state of matter of a gas in a solid.

An employee of an organization who represents and defends the interests of her/his fellow employees but who is also a labor union member and official is referred to as any of the following except: Union shopper Shop steward Union steward Union representative

Correct answer: Union shopper A union representative, union steward, or shop steward is an employee of an organization or company who represents and defends the interests of her/his fellow employees but who is also a labor union member and official. The person in this position does not get paid extra for serving and may be involved in labor disputes. Union shopper is not a legitimate term. Union shop is a type of union membership where employees must join the union after being hired.

If your food service facility has hard water, what should you do to ensure clean dishes? Purchase a low-energy chemical dishwasher Use more detergent Add a drying agent Decrease the temperature during the wash cycle

Correct answer: Use more detergent Hard water is water that has a high mineral content, in contrast with soft water. This makes it more difficult for surfactants to form lather; therefore, you should use more detergent to compensate and ensure clean dishes. Adding a drying agent helps prevent water spots. Decreasing the temperature during the wash cycle leads to greasy dishes. A low-energy chemical dishwasher saves energy, but requires even more detergent to clean dishes.

What type of obesity is associated with metabolic syndrome? Visceral Subcutaneous Healthy Morbid

Correct answer: Visceral Visceral obesity, or central fat, is associated with metabolic syndrome and refers to fat stored around the organs. Metabolic syndrome is a cluster of conditions (including hyperglycemia, hypertension, and hyperlipidemia) that increase the risk of heart disease, stroke, and diabetes. Subcutaneous obesity refers to fat under the skin and belly, which is not necessarily hazardous to your health. Healthy obesity is when an individual with a BMI greater than 30 has elevated LDL, but normal to low HDL. Morbid obesity is when an individual has a BMI greater than 40.

What nutrient would you recommend to a leukemia patient and why? Vitamin K to synthesize bacteria Vitamin C to neutralize free radicals Vitamin E to ward off tumors Calcium to inhibit bone resorption

Correct answer: Vitamin C to neutralize free radicals Leukemia is a cancer of blood-forming tissues that hinders the body's ability to fight infection. The potential action of vitamin C and decreased cancer risk is associated with the vitamin's ability to neutralize free radicals and "wall off" tumors from collagen formation. Vitamin E is an antioxidant and is important for red blood cell formation. Vitamin K is an antioxidant and is important for blood clotting. Calcium is a mineral and is important for blood clotting, cardiac function, nerve transmission, smooth muscle contractility, and functions to inhibit bone resorption.

In which of the following conditions would the patient likely be at a normal or above-normal weight? Bulimia Anorexia nervosa Marasmus Stunting

Correct answer: Bulimia Bulimia nervosa is an eating disorder characterized by episodes of excessive eating ("bingeing") followed by compensatory behavior for weight control ("purging"). Purging methods are not necessarily effective in preventing weight gained by bingeing, so bulimia patients may be at a normal or above-normal weight. If a patient with bulimia is underweight, the diagnosis is anorexia nervosa—purging type. Marasmus is severe protein-energy malnutrition in children characterized by an emaciated look, <60% expected weight for age, and low fat and muscle storage. Stunting is a reduced growth rate due to under-nutrition, chronic infection, or malnutrition.

Ralph is a 62-year-old male in his second round of chemotherapy for esophageal cancer. A meeting is scheduled with the oncology RD to discuss his current diet and appetite. Which of the following foods would be permissible for Ralph? None of these Tiramisu made with unpasteurized eggs Over-easy eggs made with unpasteurized eggs Cake made with unpasteurized eggs

Correct answer: Cake made with unpasteurized eggs Elderly and immunocompromised patients should consume unpasteurized eggs only in dishes where the eggs are cooked all the way through, for example, cake. So it would be permissible for Ralph to eat cake made with unpasteurized eggs. Pasteurized eggs should be used when the dish may contain raw or undercooked eggs, for example, over-easy eggs, tiramisu, mousse, or Caesar salad dressing.

The Academy of Nutrition and Dietetics' 2017 Scope of Practice was revised to include which of the following key updates to nutrition and dietetic practice? Changes in ethical billing practices Changes to the CDR's professional development portfolio Changes in the Academy membership classifications New electronic medical record charting guidelines

Correct answer: Changes in ethical billing practices The 2017 Scope of Practice was revised to include the following key updates to nutrition and dietetic practice: changes in ethical billing practices, ordering privileges and delegated orders for RDNs, and new practice areas of coaching, global health, and telehealth.

View the supporting details to answer the following question. What is the average check price for 2014 Quarter One? $30.13 $25.06 $28.00 $17.36 Quarter 1: Guest count -435; Total Sales - $10,900

Correct answer: $25.06 To determine average check (the average amount customers spend on a meal), divide total sales by the guest count (total number of customers served). To solve: $10,900 ÷ 435 = $25.057 $25.06 is the average check price.

Thirteen FTEs produced 1,756 meals during a 40-hour work week. How many meals were produced per labor hour? 43.9 3.38 0.296 570.7

Correct answer: 3.38 To determine the number of meals per labor hour, divide the number of meals produced by the number of hours worked. To solve: 13 FTEs x 40-hour per week = 520 hours 1,756 meals / 520 hours = 3.376 = round to 3.38

What is the popularity index for hamburgers on Monday? 32.86% 29.3% 92% 9.25%

Correct answer: 32.86% To determine popularity index: Number of servings of an item / Total number of servings of all items that day To solve: 92 / (92 + 101 + 87) = 92 / 280 = 0.3286 x 100 = 32.86%

A chef is making a tomato basil soup and the recipe calls for three 300# cans of tomato paste. How many cups of tomato paste does the recipe call for? 5 3/4 5 1/4 10 1/2 13

Correct answer: 5 1/4 A 300# can holds 1 3/4 cups. Therefore, a recipe that calls for three 300# cans is equivalent to 5 1/4 cups: 1 3/4 cups x 3 = 5 1/4 cups. A 10# can holds 13 cups, a 3# can holds 5 3/4 cups, a 2 1/2# can holds 3 1/2 cups, and a 2# can holds 2 1/2 cups.

Which of the following insulin types requires a bedtime snack? Novolin NovoLog Regular Lantus

Correct answer: Novolin Intermediate-acting insulin, known as NPH (Humulin, Novolin), requires a bedtime snack with some protein and carbohydrate to prevent hypoglycemia in the middle of the night. The hypoglycemia is caused by PM NPH administration with a peak 4-10 hours later. Rapid-acting insulin (NovoLog) is taken right before eating because of the rapid onset time (5-15 minutes). Short-acting insulin, or regular, is taken 30-45 minutes before eating and peaks 2-3 hours later. Long-acting insulin (Lantus or Levemir) has an onset time of 2-4 hours and a duration of 20-24 hours.

Which of the following parameters should not be reviewed during the nutrition screening process? Nutrition diagnosis Labs Past medical history Weight

Correct answer: Nutrition diagnosis During the nutrition screening process, the patient's history, lab results, weight, and physical signs should be reviewed to identify whether they are malnourished or at risk for malnutrition. The nutrition diagnosis will be determined after the nutrition screening process and nutritional assessment are both complete.

Which of the following individuals is the most susceptible to vitamin A toxicity? 28-year-old Hispanic male 16-month-old African American female 65-year-old African American male 86-year-old Caucasian male

Correct answer: 86-year-old Caucasian male Vitamin A liver storage and plasma levels increase with age. Due to decreased clearance of vitamin A from the blood, the elderly are more susceptible to toxicity. Therefore, of the choices given, the 86-year-old is most susceptible to vitamin A toxicity.

Which of the following additives may be used to prevent gelatinization? Sorbitol Alpha-tocopherol Papain Carrageenan

Correct answer: Papain Papain is an enzyme present in papaya and is used to prevent gelatinization, or keep something from forming a gel. Bromelin is another enzyme present in pineapple that also prevents gelatinization. Carrageenan is a stabilizer used in foods such as chocolate milk to prevent particles from sedimenting in the milk. Sorbitol is a humectant used to retain moisture and increase firmness in foods. Alpha-tocopherol is a natural antioxidant used as a food additive to reduce oxidation of fatty acids and vitamins.

Most produce can be stored in the refrigerator (34-36 degrees Fahrenheit); however, some fruits ripen best at room temperature. Which of the following fruits should you store at room temperature? Oranges Apples Mushrooms Pears

Correct answer: Pears Pears, avocados, bananas, and tomatoes ripen best at room temperature. Dried fruit should also be stored at room temperature. The aging process (ripening) is delayed by storing fruits in the controlled atmosphere of a refrigerator or freezer due to the reduced-oxygen environment. Apples, mushrooms, and oranges are examples of produce that should be stored in the refrigerator.

George started at an enteral nutrition company as a field sales representative in 2015. Based on his performance, he was promoted to regional field sales representative in 2017. Over the course of the following year, his performance continued to improve, so in 2019 his boss promoted him to a management position. George's performance significantly declined from 2019-2020 and consequently, he was demoted. Which principle does this performance pathway represent? Theory Z Unity of direction Scalar principle Peter principle

Correct answer: Peter principle The Peter principle is a concept in management that states that the selection of a candidate for a position is based on the candidate's performance in their current role, rather than on abilities relevant to the future role. Thus, employees only stop being promoted once they can no longer perform effectively, and "managers rise to the level of their incompetence." Ouchi, or Theory Z, says that workers accept responsibility when they understand the big picture, and employee involvement is the key to productivity. The Scalar principle teaches that authority and responsibility flow in a one-way direction from high to low. Unity of direction is a coordinated approach toward the same objective.

Which of the following nutrients may severely decrease during refeeding syndrome? Sodium Protein Fluid Phosphorous

Correct answer: Phosphorous Refeeding syndrome is the body's adverse response that may occur with the initiation of nutrition after a period of poor intake or starvation, such as in the already malnourished patient. Signs and symptoms include low serum electrolyte abnormalities (specifically phosphate, potassium, and magnesium), vitamin deficiencies, and sodium and fluid retention. The main complications are due to hypophosphatemia, hypokalemia and hypomagnesemia, which may lead to cardiac arrhythmia, seizures, heart failure, or death.

Which of the following characteristics is responsible for the color of an egg yolk? Size of the egg Grade of the egg Color of the shell Pigment in the hen's diet

Correct answer: Pigment in the hen's diet The color of an egg yolk depends on the amount and type of pigment in a hen's diet. The color of the shell is unrelated to food value or quality. The size of the egg is classified based on weight per dozen eggs; sizes include jumbo (30 oz.), extra large (27 oz.), large (24 oz.), medium (21 oz.), small (18 oz.), and peewee (15 oz.). The grade of egg is determined by candling, or passing an egg in front of a bright light to view its contents. This test judges the thickness of the egg white, the location of the yolk, and the condition of the yolk. The grades of egg include AA, A, and B. The grading does not take into account the color of the shell or the size of the egg.

What are the written guidelines for decision-making meant to ensure that organizational members' actions are consistent with the organization's objectives and strategies? Policies Rules Procedures Vision

Correct answer: Policies Policies are the written guidelines for decision-making intended to ensure that organizational members' actions are consistent with the organization's objectives and strategies; simply put, policies are guides for decision-making. Procedures are detailed guidelines for planned activities. Rules are written statements of what must be done. Vision is an organization's philosophy or view of the future.

When free fatty acids link together during frying, the oil becomes more viscous, more prone to foaming, and the oil quality decreases. This process is referred to as what? hydrogenation retrogradation polymerization recrystalization

Correct answer: Polymerization Polymerization is the process in which small molecules, called monomers, combine to produce a larger chain-like or network molecule, called a polymer. An example of this process occurs during frying when free fatty acids (FFAs) link together. This makes the oil more viscous and more prone to foaming, and decreases the oil's quality. Hydrogenation is the process of making fats and oils more solid at room temperature. An example of this process is the manufacturing of butter. Retrogradation is the process of reforming hydrogen bonds into crystalline regions in starches. During the storage or cooling of a starch paste, the hydrogen bonds between amylose molecules break and rearrange themselves into tighter organized structures. This rearrangement and recrystallization gives the product a gritty texture. An example of this process is the thawing of gravy.

During an initial nutrition assessment, an RD identifies that a client is anemic and encourages her to eat more foods with iron. The RD provides the client with a handout of high-iron foods, shows her pictures of high-iron foods, and develops a high-iron meal plan with foods the client prefers. When the client returns for a follow-up nutrition assessment, she reports that she has increased her consumption of iron-rich foods and has higher energy levels. The RD praises the client and encourages continuation of the new eating patterns. What type of change strategy is the RD using? Avoidance learning Positive reinforcement Extinction Positive cause-effect

Correct answer: Positive reinforcement Positive reinforcement is a behavior modification method that focuses on encouraging repetition of a certain behavior and provides meaningful attention from a superior. Avoidance learning is when a client learns to escape undesirable consequences or avoid criticism by improving future performance. Extinction focuses on reducing an undesirable behavior until it goes away, or becomes extinct. Positive cause-effect is a fabricated term.

For which of the following conditions would TPN be indicated? IBS Postoperative ileus PKU Gastric bypass surgery

Correct answer: Postoperative ileus TPN is indicated when a patient has unavailability of the GI tract (short bowel syndrome, short bowel obstruction, ileus, malabsorption), minimized GI function (acute irritable bowel disease, fistula, acute pancreatitis), or is unable to meet >60% of their needs by the enteral route alone (as soon as possible in severely malnourished patients or 7-10 days in previously nourished patients). TPN is not indicated in gastric bypass surgery, IBS, or PKU, unless one of the above situations is present.

Which of the following nutrients is now required on the new Nutrition Facts label? Potassium Vitamin A Vitamin C Phosphorous

Correct answer: Potassium Some required or permitted nutrients have been updated on the new Nutrition Facts label. Vitamin D and potassium are now required to be on the label because Americans do not always get the recommended amounts. Vitamins A and C are no longer required, since deficiencies of these vitamins are rare today. The actual amount in addition to the percent daily value must be listed for vitamin D, calcium, iron, and potassium. https://www.fda.gov/food/food-labeling-nutrition/changes-nutrition-facts-label https://www.fda.gov/files/food/published/The-New-and-Improved-Nutrition-Facts-Label---Key-Changes.pdf

"Now that you have described the foods that you typically eat when you go out, can you tell me about what you usually eat when you are home?" What type of question is the question above and what is the purpose of using this type of question in a nutrition interview? Leading; to direct the individual to one answer Closed; to require less time and effort from the individual Primary; to introduce new topics Secondary; to obtain further explanation

Correct answer: Primary; to introduce new topics A primary question introduces new topics or areas. An example of a primary question is "Now that you have described the foods that you typically eat when you got out, tell me about what you usually eat when you are home." A secondary question is a follow-up question or attempt to obtain further information that a primary question failed to elicit. An example of a secondary question is "How are the foods prepared at your favorite restaurant?" A leading question directs an individual to one answer in preference to another. Leading questions should be avoided to prevent bias. An example of a leading question is "What did you eat for breakfast?" A closed question can be answered by a simple response, gives control, and takes less time/effort. An example of a closed question is "How would you rate your current eating habits?"

During an interview, a client expresses that he feels like he makes poor menu choices when dining out and that's why he's gaining weight. The dietitian asks, "What do you consider a poor menu choice?" What is this type of response called? Clarification Probing Understanding Evaluation

Correct answer: Probing Probing questions are about more than clarifying specific details; instead, these questions dig deeper under the surface by attempting to gain more information. An effective probing question helps get a person to talk more about their personal opinions and feelings and promotes critical thinking. The questions often begin with "what" or "how." Evaluation questions often lead to offering advice or making judgments about a person's feelings, and often do not lead to resolution. For example, "If you think you make poor choices when dining out, I suggest you not go to restaurants." Understanding questions attempt to "put yourself in someone else's shoes," by recreating or paraphrasing the person's message. An understanding question is one of the most effective ways to respond to clients because it usually leads to more cooperation and acceptance on the part of the client. For example, "You seem to be saying that you feel poor menu choices are leading to your weight gain..." Clarification questions are simple questions of fact. These questions clarify the issue so the counselor can then ask good probing questions and provide feedback. For example, "Did I understand you when said you are making poor menu choices when eating out?"

What are the 4 P's of the marketing mix? Packaging, positioning, people, perishables Intangibility, perishability, heterogenicity, inseparability Product, place, price, promotion Marketing niche, marketplace, market segmentation, marketing strategy

Correct answer: Product, place, price, promotion A marketing mix is developed to achieve an organization's objectives and satisfy the target market. The 4 P's of the marketing mix are product, place, price, and promotion. Once the marketing mix is established, the 7 P's of marketing include product, price, promotion, place, packaging, positioning and people. Service marketing includes intangibility, perishability, heterogenicity, and inseparability. A marketing plan includes the following: marketing niche, marketplace, market segmentation, marketing objective, marketing strategy, and the marketing mix (4 P's).

Mike and Ryan formed a partnership and together created a sports nutrition company called Mr. Nutrition. After five years, they have acquired 7,345 clients, generated $5,743,904 in sales, and spent $3,633,700 since starting the company in 2012. What ratio can they use to measure their company's ability to generate excess income in relation to their sales? Activity ratio Liquidity ratio Profitability ratio Solvency ratio

Correct answer: Profitability ratio A profitability ratio measures a company's ability to generate excess income in relation to sales. A solvency ratio refers to an organization's ability to meet its long-term debt. An activity ratio refers to how effectively an organization utilizes its assets (e.g., inventory turnover). A liquidity ratio refers to an organization's ability to meet its short-term debt and current financial obligations.

You are writing a blog article about the benefits of oatmeal and are plugging your signature oatmeal brand in the article. Which component of the "marketing mix" are you using? Place Price Product Promotion

Correct answer: Promotion The "marketing mix" consists of the 4 Ps of marketing: product, place, price, and promotion. An article plugging a particular product is an example of promotion. Promotion increases consumer awareness about the product/service, includes publicity (article), mail packages, paid advertisements, personal promotional visits, public visibility, networking, and contest promotions. Product is the good, service, or idea; for example, the signature oatmeal brand. Place refers to the channel, or route, through which goods move from the source to the final consumer. Price is a source of income and profits.

Which of the following food additives acts as a preservative and mold inhibitor in sausage? Propyl gallate Benzoyl peroxide Ascorbic acid Monoglycerides

Correct answer: Propyl gallate Propyl gallate is a food additive used as a preservative and mold inhibitor that is commonly found in processed sausage. The other choices are all examples of food additives, but they are not found in processed sausage. Ascorbic acid is used to enhance appearance by preventing browning, monoglycerides are emulsifiers, and benzoyl peroxide is a bleaching agent used in flour.

The SOP/SOPP is utilized by RDs or RDNs to: Create patient education material Reflect the minimum competent level of practice and professional performance Write regulations when laws are passed Develop international standards and codes to protect customers

Correct answer: Reflect the minimum competent level of practice and professional performance According to EatRight, the SOP/SOPP is utilized by RDs/RDNs to Evaluate practice and performance through self-assessment; Reflect the minimum competent level of practice and professional performance; Measure quality and performance improvement through outcome examples; Outline quality indicators for practice and performance; and Guide professional continuum growth and practice development. The Codex Alimentarius Commission (CAC) is funded by FAO and WHO to develop international standards and codes to protect customers. The appropriate federal agency is responsible for writing regulations when laws are passed.

The Nutrition Labeling and Education Act (NLEA), which amended the FD&C Act, requires most foods to bear nutrition labeling and requires food labels that bear nutrient content claims and certain health messages to comply with specific requirements. What is NLEA an example of? Federal Register Regulation Bill Congressional Record

Correct answer: Regulation Regulations are guidelines that detail how a law will be implemented and any penalties that may be imposed if the law is violated. NLEA is an example of a nutrition label regulation by the FDA. The Federal Register is the daily journal of the United States government, which provides weekly updates for public hearings, proposed/final rules, and agency decisions. The Congressional Record is the official record of the proceedings and debates of the United States Congress, published by the United States Government Publishing Office and issued when Congress is in session. A bill is a form or draft of a proposed statute presented to a legislature, but not yet enacted or passed and made law.

Stacy is hired as a PRN dietitian at her local hospital. What type of position does she have? Absolute FTE Adjusted FTE Relief worker Full-time

Correct answer: Relief worker Relief workers are typically temporary, PRN (pro re nata), part-time, agency, temporary hires, and seasonal hires; they are not permanent hires. These workers don't typically have a set schedule or receive benefits; however, pay is usually higher due to the lack of benefits. They can cover up to 2.5 FTEs based on an 8-hour day. An adjusted FTE considers adjustments needed to account for time off (days off and benefit days). To determine number of adjusted FTEs, multiply the total number of FTEs by 0.55 (129 days off / 365 days per year). Absolute FTE is the bare minimum number of employees needed to run an organization, which counts only for productive labor hours worked. These workers are usually full-time with benefits.

The normal limits for phosphorus are 2.5-4.5 mg/dL. Your patient has a phosphorous level of 8.9 mg/dL. What could this lab value indicate about your patient? Malnutrition Renal dysfunction Sepsis Refeeding syndrome

Correct answer: Renal dysfunction An increased phosphorous value, or hyperphosphatemia, is associated with renal dysfunction, increased dietary or IV intake, aldosterone-inhibiting diuretics, and/or dehydration. A decreased phosphorous value, or hypophosphatemia, is associated with refeeding syndrome, malnutrition, and/or sepsis.

Someone from which of the following groups would most likely order a ham and cheese sandwich on whole wheat bread? Hindu Roman Catholic Seventh Day Adventist Orthodox Jew

Correct answer: Roman Catholic Cultural and religious groups that do not consume pork include Hindu, Jewish (Orthodox Jew), Seventh Day Adventist, and Muslim. Therefore, people from these groups would not likely order a sandwich with a pork-based product (ham).

All of the following are desired outcomes of food service, except: No lost time due to work-related injuries Selection of the appropriate nutrition care indicator Maintaining food cost within budget Meeting the goals of the customer

Correct answer: Selection of the appropriate nutrition care indicator Food service desired outcomes include the following: Customer/employee satisfaction: Meeting the goals of the customer Financial accountability: Maintaining food cost within budget Appropriate use of resources: No lost time due to work-related injuries Desired outcomes for registered dietitians (RDs) according to the Nutrition Care Process (NCP) include: Selection of the nutrition care indicator(s) to measure the desired outcomes

Which of the following is not included in the list of the eight most common food allergies? Shellfish Eggs Soy Sesame

Correct answer: Sesame The eight most common food allergies are referred to as the "Big 8." These encompass 90% of all food allergies, which include the following: milk, eggs, peanuts, tree nuts, fish, shellfish, soy, and wheat. Sesame is a common food allergy, but it is not one of the Big 8.

What causes the puckering, dry taste sensation found in tea, wine, chocolate, and underripe fruits? Pectic acid Cruciferae Umami Tannins

Correct answer: Tannins Tannins cause an astringent feeling in the mouth, which is the puckering dry sensation found in tea, wine, chocolate, and underripe fruit. Pectic acid is a compound found in overripe fruit. Cruciferae is a family of flowering plants that includes cabbage, brussels sprouts, and cauliflower. Umami is one of the categories of taste in food (besides sweet, sour, salty, and bitter) that corresponds to the flavor of glutamates, such as monosodium glutamate.

The USDA grades produce as Fancy, Extra #1, #1, Combination, and #2. These grades are based on all of the following characteristics except: maturity taste firmness color

Correct answer: Taste The USDA grades are based on quality, firmness, color, maturity, freedom from defects, uniform size, and shape. Taste is not a characteristic that determines grade.

Which class of fire extinguisher would be used to put out a fire involving vegetable oil in a deep fat fryer and is required to be installed in all applicable restaurant kitchens? Class A Class B Class C Class K

Correct answer: Class K Class K fire extinguishers should be used to put out fires involving vegetable oil in deep fat fryers and are now required to be installed in all applicable restaurant kitchens. (OHSA) Class A - Ordinary Combustibles: Fires in paper, cloth, wood, rubber, and many plastics require a water-type extinguisher labeled A. Class B - Flammable Liquids: Fires in oils, gasoline, some paints, lacquers, grease, solvents, and other flammable liquids require an extinguisher labeled B. Class C - Electrical Equipment: Fires in wiring, fuse boxes, energized electrical equipment, computers, and other electrical sources require an extinguisher labeled C. Class D - Metals: Fires involving powders, flakes or shavings of combustible metals such as magnesium, titanium, potassium, and sodium require special extinguishers labeled D. Class K - Kitchen Fires: Fires involving combustible cooking fluids such as oils and fats require extinguishers labeled K.

"Swallowing difficulty" is a nutritional diagnostic label under which of the following domains? Intake Medical Clinical Behavioral-environmental

Correct answer: Clinical Nutritional diagnostic labels include three domains: clinical (NC), intake (NI), and behavioral-environmental (NB). Clinical refers to nutritional findings or problems that relate to medical or physical conditions, such as swallowing difficulty. Intake refers to actual problems related to intake, such as inadequate or excess energy intake. Behavioral-environmental refers to problems related to knowledge, access to food, and food safety. "Medical" is not a nutritional diagnostic label.

The community and public health RDN is expected to provide a competent level of performance in which of the following professional domains? Administration of medicine Delivery of a diagnosis Compounding of parenteral formula Application of research

Correct answer: Application of research The Standards of Professional Performance (SOPP) consist of the following six domains of professional performance for community and public health RDNs: Quality in Practice, Competence and Accountability, Provision of Services, Application of Research, Communication and Application of Knowledge, and Utilization and Management of Resources. A doctor's SOPP includes the delivery of a diagnosis and administration of medicine, and a pharmacist's SOPP includes the compounding of parenteral formula.

The normal limits for sodium are 135-145 mEq/dL. Your patient has a sodium level of 128 mEq/dL. What could this value indicate in your patient? Trauma Dehydration Refeeding syndrome Ascites

Correct answer: Ascites A decreased sodium value, or hyponatremia, is associated with fluid overload (especially congestive heart failure or dialysis), SIADH, and/or ascites. An increased sodium value, or hypernatremia, is associated with dehydration, excessive diuresis, and/or recent trauma, surgery, or shock. Refeeding syndrome is a distractor.

Which of the following best defines productivity as it relates specifically to foodservice management? Improving the content of a foodservice position and providing a safe, healthy kitchen for working Accomplishing foodservice-based tasks that eliminate the uneconomical use of foodservice time, equipment, materials, space, and/or human effort The measure of output of goods produced or services rendered in relation to the input of labor hours, money, and resources used The advocacy for relationship between employees and management to incorporate cooperation

Correct answer: The measure of output of goods produced or services rendered in relation to the input of labor hours, money, and resources used Productivity, especially in food service, measures the output of goods produced and/or services rendered in relation to the input of labor hours, money, and resources used. The quality of work life (QWL) is an approach that advocates for relationship between employees and management to incorporate qualities of cooperation, involvement, respect, rapport, trust, and openness. The goals of work design include improving the content of the job; providing a safe and healthy work environment; and designing a staff of fit persons, an optimum work environment, and both effective and efficient work methods. Work simplification is the philosophy that there is a more effective way of completing a task by eliminating the uneconomical use of time, equipment, materials, space, and/or human effort.

A 2% milk is placed in a medium with a pH of 4.6. What effect will the pH have on the milk? The milk will become pasteurized The milk will become homogenized The lactose will crystallize The milk will form a curd

Correct answer: The milk will form a curd The protein in milk (casein) is acid-sensitive and will form a curd in an acidic medium (pH of 4.6). When this curd forms, whey is the protein that drains out. It includes lactose, lactalbumin, lactoglobulin, water-soluble vitamins, and minerals. The addition of a milk solid may lead to the crystallization of lactose. Lactose is the least soluble of common sugars and can crystallize, giving a sandy texture when too many milk solids are present. Homogenization is a mechanical process that breaks the fat molecules in milk into smaller droplets using high pressure. As a result, the fat molecules stay integrated rather than separating as cream in the milk. Pasteurization is a process that heats, then cools, milk to eliminate certain bacteria. This process destroys pathogenic bacteria when milk is heated to 145°F for 30 minutes or 160°F for 15 seconds.

Which of the following risk factors is modifiable? Gender Family medical history Age BMI

Correct answer: BMI Risk factors are conditions that increase your risk of developing a disease. Risk factors can be either modifiable (you can take measures to change them) or non-modifiable (you cannot change them). Modifiable risk factors include smoking, physical inactivity, and BMI. High blood pressure, diabetes, smoking, and cholesterol are considered modifiable as well. Non-modifiable risk factors include age, race, sex, and family history.

Longevity depends on all of the following factors except: Lifestyle Basal metabolic rate Environment Genetics

Correct answer: Basal metabolic rate Longevity depends on lifestyle, environment, genetics, and access to health care. Basal metabolic rate (BMR) is a measure of energy expenditure and does not directly effect longevity.

Ellen is a clinical nutrition manager at a hospital. She believes her employees love to work as clinical dietitians, will constantly learn new things, and will continue to work more efficiently as a team. Which theory describes the type of attitude Ellen has? Theory X Theory Y Theory Z Game theory

Correct answer: Theory Y Theory Y describes a participative style of management which "assumes that people will exercise self-direction and self-control in the achievement of organizational objectives to the degree that they are committed to those objectives." This theory assumes people view work as positive, participative, and democratic. Theory X assumes that individuals inherently dislike work and avoid it if possible. This theory assumes people view work as negative. Theory Z assumes workers accept responsibility when they understand the big picture; employees are the greatest assets of a company. Game theory is a decision-making technique focusing on the highest gain with the smallest amount of losses, regardless of what the competition does.

Which of the following is not within a registered dietitian's scope of practice? Diagnosing diabetes Providing pediatric nutrition Providing diabetes care Managing food services

Correct answer: Diagnosing diabetes The scope of practice (SOP) for a registered dietitian nutritionist (RDN) describes the roles and activities within which the RDN performs. For RDNs, the scope of practice focuses on food and nutrition-related services provided to the public to enhance their health and well-being and deliver quality products, programs, and services, including medical nutrition therapy. Medical doctors and physicians are responsible for the diagnosis of diseases such as diabetes.

Which teaching method requires initial guidance by an educator and then allows learners to work independently to manipulate information? Discovery Exhibits Lecture Role Playing

Correct answer: Discovery The teaching method of discovery requires initial guidance by the educator and then allows learners to work independently to manipulate the information to learn. In this situation, learners are exposed to a variety of experiences which encourage them to actively develop relationships in their own minds. Lecture is the transfer of knowledge from the educator to the audience, where the learner is passive. Exhibits are a collection of related materials that are put on display to aid learning. Role playing is when members of a group act out a problem or situation without a script.

A client with T1DM tells her RD she is sick with the flu. All of the following sick day guidelines for diabetics are appropriate, except: Do not take insulin Check urine for ketones Liberalize diet Encourage fluids

Correct answer: Do not take insulin The sick day guidelines for diabetes recommends taking usual doses of insulin, testing urine for ketones, consuming ample amounts of liquid, and selecting liquid or soft carbohydrate foods.

A 69-year-old man was evaluated for unintentional weight loss and underwent a modified barium swallow test. He aspirated some of the barium and failed the diagnostic test. What condition does the man likely have? Pneumonia Dysphagia Significant weight loss ESRD

Correct answer: Dysphagia Dysphagia is difficulty swallowing, which can lead to unintentional or significant weight loss. This can be diagnosed by the barium swallow test. Aspiration can be a side effect of dysphagia that can lead to pneumonia. In the barium swallow test, mouthfuls of barium are swallowed and X-ray films are taken of the esophagus at several points in time while boluses of barium traverse the esophagus. This process helps to diagnose moderate to severe external compression, tumors, and strictures of the esophagus. ESRD, or end-stage renal disease, is not related to dysphagia. Flag Question

Which of the following is an example of the Maillard reaction? Yellowing Browning Fallen center Coarse texture

Correct answer: Browning The Maillard reaction is a form of non-enzymatic browning and gives browned foods their distinct flavor. This chemical reaction takes place in the presence of an alkaline environment and results in changes in taste, color, and texture. Examples of foods that undergo this reaction include baked goods, seared steaks, fried rice, toasted marshmallows, and others. The other answers are causes of variations in cakes or other baked goods. Yellowing is a result of an alkaline batter or excess baking soda. Fallen center is a result of excess sugar, fat, or baking powder, poor mixing, low oven temperature, or opening of oven door during early part of baking. Course texture is a result of too much baking powder or sugar, low oven temperature, or poor mixing.

Angie is attempting to improve how the clinical RDs rotate floors in the hospital, and she has organized weekly meetings with the clinical RD team to discuss the process. Now she is talking with the RD team leaders and managers (people who are most involved with the process) to collect information and data about the floor's patient loads and responsibilities. Which step in FOCUS-PDCA is Angie at? U - Understand O - Organize S - Select C - Clarify

Correct answer: C - Clarify FOCUS-PDCA is a management and systematic process improvement method, which developed in the healthcare industry (Hospital Corporation of America, HCA). FOCUS-PDCA is an extension the PDCA cycle, which includes Plan-Do-Check-Act. F - Find a process to improve O - Organize to improve the process C - Clarify current knowledge of the process. This step includes collecting data and information about the process and should include talking with those who are most involved with it. U - Understand the source of process variation S - Select the process improvement

Which of the following can be used as a clinical indicator of endogenous insulin production? C-peptide Insulin Fasting plasma glucose HgbA1C

Correct answer: C-peptide Insulin is secreted as two polypeptide chains joined by disulfide bonds and C-peptide is released as the two chains separate. Since insulin and C-peptide are secreted in the bloodstream in equal amounts, C-peptide can be used as a clinical indicator of endogenous insulin production. HgbA1C measures the percentage of hemoglobin that glucose has attached, which measures long-term blood glucose control (2-3 months). Fasting plasma glucose indicates glycemic control and ranges from 100-125 mg/dL in normal, healthy individuals.

What item would you not recommend to a client experiencing diarrhea? Caffeine Sports drinks Prebiotics Probiotics

Correct answer: Caffeine The recommended nutrition therapy for diarrhea is to remove the cause, let the bowel rest, and replace lost fluids and electrolytes. It is recommended that caffeine be avoided or limited, due to its ability to irritate the digestive system and worsen diarrhea. Foods that are recommended for diarrhea include prebiotics (oats, bran), probiotics (yogurt), and fluids high in electrolytes (sports drinks).

John has end-stage liver disease. Which lab value would you least expect to be abnormal? Sodium Bilirubin Carbon dioxide Albumin

Correct answer: Carbon dioxide Liver failure patients may develop decreased values of albumin, blood urea nitrogen, cholesterol, high density lipoprotein, and sodium, as well as increased values of alanine aminotransferase, alkaline phosphatase, aspartate aminotransferase, bilirubin, low density lipoprotein, phosphorus, and triglycerides. Carbon dioxide may be increased in chronic obstructive pulmonary disease (COPD), overfeeding, and/or with some medications (such as loop diuretics and steroids), and may be decreased with some medications (such as thiazide diuretics) and diabetic ketoacidosis (DKA).

After a company-wide performance evaluation, the CEO states, "Most of the employees seem pretty average." What is this bias known as? Leniency error Halo effect Recency Central tendency error

Correct answer: Central tendency error Central tendency error is the tendency to rate all or most of the employees or interviewees as average. The halo effect is the tendency for an impression in one area to influence opinion in another area, or to judge someone overall on their most positive trait. Leniency error is when the rater rates everyone higher than they deserve. Recency focuses only on recent performance within the evaluation period, which is a common error in performance evaluations.

Paul is taking monoamine oxidase inhibitors (MAOIs). Which food item would you recommend that he avoid? Cheese plate with smoked sausage Fried chicken with french fries Bran cereal with whole milk Chocolate ice cream with syrup

Correct answer: Cheese plate with smoked sausage A low tyramine diet is recommended when taking certain medicines, such as monoamine oxidase inhibitors (MAOIs). Tyramine is primarily found in foods that are aged, dried, cured, fermented, or smoked. When taking MAOIs, eating foods that are high in tyramine can cause side effects, including high blood pressure, headaches, fast heartbeat, nausea, vomiting, blurred vision, and chest pain. Therefore, since a cheese plate with smoked sausage would be high in tyramine, it should be avoided. The other answers are incorrect because they do not contain foods that are aged, dried, cured, fermented, or smoked.

All of the following actions can prevent foodborne illness by safely handling food in the home, except: Cook chicken to 165°F. Use a separate cutting board for raw chicken and raw vegetables. Chill leftovers within three hours and keep the fridge at 45°F. Wash hands and surfaces often.

Correct answer: Chill leftovers within three hours and keep the fridge at 45°F. Foodborne illness can be prevented through four easy steps: Clean, Separate, Cook and Chill. Clean: Wash hands and surfaces often. Separate: Don't cross-contaminate. Cook: Cook to proper temperatures. Chill: Refrigerate promptly. Leftovers should be chilled within two hours and the fridge should be kept at 40°F or below.

An outpatient diabetes dietitian is providing a free diabetes clinic next month. She wants to understand the population that might attend her clinic. Which of the following would provide demographic information about her expected population? Education level HgbA1c number Amount of carbohydrates eaten per week Number of diabetic complications Next Question

Correct answer: Education level Demographic data is statistically socioeconomic in nature, such as age, sex, education level, income level, marital status, occupation, religion, birth rate, death rate, the average size of a family, and the average age at marriage. The other answer choices represent information that may be obtained during a nutritional assessment with a diabetic patient. A food frequency questionnaire (FFQ) would assess the amount of a specific food group eaten per week. HgbA1c is a common blood test used to diagnose type 1 and type 2 diabetes and then to gauge how well you're managing your diabetes. Diabetic complications result from long-term poorly controlled diabetes and may include cardiovascular disease, neuropathy, nephropathy, retinopathy, foot damage, skin conditions, and poor wound healing.

A manager tells you to focus on "doing things right" and putting in the least amount of time to produce the desired result. What is the manager emphasizing? Effectiveness Expediency Efficiency Economy

Correct answer: Efficiency Efficiency refers to "doing things right" and getting the most output from the least amount of input. The manager is requesting efficiency by asking for the desired work (output) with the minimization of resources (input, labor, time). Effectiveness refers to "doing the right things" and the degree to which something is successful in producing a desired result. Economy is the prudent use of resources. Expediency is doing something quickly.

Vinaigrette and mayonnaise are examples of a/an: Gel Sol Suspension Emulsion

Correct answer: Emulsion A dispersion is a mixture of solids, liquids, and/or gases and can be classified according to the stage of matter in each phase of the dispersion. An emulsion is liquid in liquid, such as vinaigrette and mayonnaise. A sol is solid in liquid, such as turkey gravy. A gel is liquid in solid, such as a custard. A suspension is gas in solid, such as a sponge cake.

The USDA is responsible for: Ensuring the safety of our nation's food supply, cosmetics, and products that emit radiation Regulating the manufacturing, marketing, and distribution of tobacco products to protect the public health and to reduce tobacco use by minors Ensuring the safety, efficacy, and security of human and veterinary drugs, biological products, and medical devices Ensuring that our nation's meat, poultry and processed egg supply is wholesome, safe and properly labeled

Correct answer: Ensuring that our nation's meat, poultry and processed egg supply is wholesome, safe and properly labeled The USDA (US Department of Agriculture) is responsible for ensuring that our nation's meat, poultry and processed egg supply is wholesome, safe and properly labeled. Read more about the USDA's responsibilities here. https://www.usda.gov/topics/health-and-safety The other answer choices are responsibilities of the FDA (Food and Drug Administration). Read more about the FDA's responsibilities here. https://www.fda.gov/aboutfda/whatwedo/

Caitlin applies at a local company that regularly hires college students to work on construction crews. The construction manager tells her to apply for a secretarial job at the company's headquarters. As Caitlin is leaving, she overhears the manager tell a coworker that he did her a favor, since construction is really a man's job. Caitlin believes the manager has discriminated against her by not interviewing her for the higher-paying crew position, and she wants to file a claim. What regulatory compliance is she protected under? Civil Rights Act Equal Pay Act Unemployment compensation National Labor Relations Act

Correct answer: Civil Rights Act The Civil Rights Act prevents discrimination on the basis of race, color, or national origin, and prevents sexual harassment. This act is overseen by the EEOC (Equal Employment Opportunity Commission). Therefore, Caitlin would file a claim through them. The Equal Pay Act prevents discrimination in employment based on race, color, religion, sex, national origin, and political affiliation, and is overseen by the EEOC. This act does not apply since Caitlin is not hired yet. Unemployment compensation is insurance against loss of income; however, the individual must be employed for a specific amount of time and be able and willing to work. The National Labor Relations Act guarantees the right to organize and join labor unions.

Rebecca is 64 inches tall and weighs 77 kg. Her BMI could indicate any of the following scenarios except: She is overweight Class 1 obesity Her BMI is overestimated due to her remarkably high muscle mass Her BMI is inaccurate because she is fluid-overloaded from ascites

Correct answer: Class 1 obesity The formula for BMI in metric units: weight (kg) / [height (m)]2 In imperial units: (weight (lbs) / height (in)2) x 703 Method 1: To determine BMI using the metric formula: Step 1: Convert inches to meters: 64 in x 2.54 cm/in = 162.56 / 100 cm/m = 1.62 m Step 2: Plug numbers into BMI formula: 77 kg / [1.62]2 = 29.34 Method 2: To determine BMI using the imperial formula: Step 1: Convert kg to lbs: 77 kg x 2.2 lb/kg = 169.4 lbs Step 2: Plug numbers into BMI formula: (169.4 lbs / 64 in^2) x 703 = 29.07. Since Rebecca's BMI falls in the category of 25.0-29.9, she is considered overweight. However, BMI can be inaccurate and falsely high when a person is fluid-overloaded from ascites or has high muscle mass. Class 1 obesity is when BMI is 30.0 to 34.9.

Which management theory reflects the basic tenet that there is one best way to complete every job, that there is one best way to create an organization, and that the organization should be arranged in a rational manner? Human relations Classical Unity of command Unity of direction

Correct answer: Classical The classical theory is a grouping of several ideas that purport that 1) there is one best way to complete every job, 2) there is one best way to create an organization, and 3) the organization should be arranged in an impersonal and rational manner. Principles of the classical theory include the tenets of unity of command (each person reports to only one supervisor) and unity of direction (all units should be moving toward the same objective). The human relations theory is a theory of management that was developed in response to the deficiencies of the classical theory; here, the organization is viewed as a social system.

During a diabetes education session, a dietitian asks her client to point to a carbohydrate source. What learning domain is the dietitian assessing? Psychomotor Cognitive Affective Physical

Correct answer: Cognitive According to Bloom's taxonomy, there are three domains of educational activities or learning, categorized as cognitive, affective, and psychomotor. Cognitive skills, or knowledge, involves the development of mental skills and the acquisition of knowledge about subject matter. For example, learning what a carbohydrate is and being able to identify one is a cognitive skill. The affective domain, or attitude/self, is the development of feelings, emotions, attitudes, and/or values. For example, understanding how diabetes may impact one's health and making preventative changes to increase one's well-being involves the affective domain. The psychomotor domain involves the development of muscular or physical skills, for example, learning how to prepare a diabetic-friendly meal. The answer choice "physical" falls under the psychomotor domain.

"Given a variety of carbohydrate sources, participants will be able to differentiate between complex and simple carbohydrates with an accuracy of 90%." What is the statement above an example of? Visual objective Affective objective Psychomotor objective Cognitive objective

Correct answer: Cognitive objective Cognitive objectives measure intellectual processes, such as knowing, perceiving, recognizing, thinking, conceiving, judging, and reasoning. Affective objectives measure feeling, emotion, attitude, appreciate, and valuing. Psychomotor objectives measure behaviors or physical skills. Visual objective is a fabricated term.

Which of the following grades of beef is not fit for human consumption? Commercial Choice Standard Select

Correct answer: Commercial Beef is graded at slaughter by the USDA. In order of quality, the grades are prime, choice, select, standard, commercial, utility, cutter, and canner. The grades that are not fit for human consumption are commercial, utility, cutter, and canner.

South Park Community College's cafeteria received a food delivery of tomato soup in thermoses and individually wrapped grilled cheese sandwiches from their kitchen. What type of production system does their cafeteria most likely use? Ready-prepared Decentralized conventional Commissary Centralized conventional

Correct answer: Commissary The commissary system is a one where food production (kitchen) and service area (cafeteria) are in separate facilities. The cafeteria in this question is an example of a commissary system because the production and service areas are separate and the school is receiving a food delivery of prepared meals. Ready-prepared (cook-chill, cook-freeze) is a production system where foods are prepared on site, then frozen/chilled for later use. Production and service areas are in the same facility, but there is separation between the time of preparation and service. A conventional system is where production and service occur in the same facility and foods are prepared and served on the same day. In centralized delivery, trays are set up in the centralized serving area and delivered to the customer on heated/refrigerated carts. In decentralized delivery, trays are set up in the serving area and the distance to the customer is great (requiring duplication of equipment).

Which of the following is one of the four Cs of effective communication? Complete Coach Challenger Concrete

Correct answer: Complete The 4 Cs of effective communication are clear, concise, complete, and correct. A challenger is the preferred instructor role of an intuitor (Jung), and sensors prefer a coach. Concrete, rather than abstract, is recommended for written communication.

A steak is prepared medium-rare in a cast iron skillet on a flattop range. What type of cooking method is this? Conduction Induction Convection Radiation

Correct answer: Conduction Conduction is the direct transfer of heat between adjacent molecules. Good conductors include copper, black cast iron, and aluminum, while poor conductors include glass and stainless steel. An example of conduction is cooking on a flattop range, where heat is transferred from the molecules of the hot range surface to the molecules of the adjacent pan bottom, then from the pan bottom to the pan sides and the food contained within the pan. The pan must be in direct contact with the range for conduction to occur. Convection is the transfer of heat through gases or liquids by circulation of hot air. Induction transfers heat through electric magnetic vibrations (induction), instead of thermal conduction from a flame or an electrical heating element. Radiation is the transfer of energy through electromagnetic waves and does not require direct contact between the energy source and food.

Which of the following tips would not be supported by MyPlate? Move to low-fat and fat-free dairy products Make half your plate fruits and vegetables Vary your protein routine Consume 6 ounces of protein per day

Correct answer: Consume 6 ounces of protein per day The MyPlate consumer messages help to communicate the 2015-2020 Dietary Guidelines for Americans, which include these recommendations: Make half your plate fruits and vegetables; focus on whole fruits and vary your veggies. Make half your grains whole grains. Switch to low-fat and fat-free milk or yogurt. Vary your protein routine. Drink and eat less sodium, saturated fat, and added sugars. The amount of protein intake depends on age, sex, and level of physical activity. Therefore, the recommendation of a standard amount would be inappropriate.

Which of the following is an indicator of nutritional risk and poor-quality diet? Consuming one alcoholic drink per day (women) and two drinks per day (men) Consuming 1,500mg of sodium per day among persons who are 51 and older Consuming fast food more than three times per week Increased consumption of fortified soy beverages

Correct answer: Consuming fast food more than three times per week Consuming fast food more than three times per week is an indicator of nutritional risk and poor-quality diet. Common indicators of nutritional risk include overweight, underweight, hyperlipidemia, hypertension, iron-deficiency anemia, food insecurity, eating disorders, substance use, and excessive intake of foods and beverages that have high fat or sugar content (such as fast food meals). General, healthful nutrition indicators include consuming up to one drink per day for women and up to two drinks per day for men; consuming 1,500 mg of sodium per day among persons who are 51 and older and those of any age who are African American or have hypertension, diabetes, or chronic kidney disease; and increasing intake of fat-free or low-fat milk and milk products, such as yogurt, cheese, or fortified soy beverages.

Matt is a 45-year-old obese man with HTN, HLD, and T2DM. He currently weighs 250 lbs and has a BMI of 32.4. His HgbA1c is 12.8%. His doctor has referred him to a registered dietitian for medical nutrition therapy to help lower his HgbA1c and for weight loss. At his initial nutrition assessment, Matt tells the dietitian that he has difficulty controlling his blood sugar because he doesn't understand what carbohydrates are and he has failed to lose weight over the past year despite trying three different diets. He wants to lose weight and have better blood sugar control, but he feels that he won't be able to eat his favorite foods or have a social life with the diabetic diet constraints. What stage of change is Matt in? Preparation Contemplation Precontemplation Action

Correct answer: Contemplation Contemplation is the second stage of change in the trans-theoretical model, where a client recognizes that a problem exists and begins to think about overcoming it. Here, the client may identify the pros and cons of a behavior change and may struggle with decision balancing. Precontemplation is the first stage of change, in which the client has no intention to change their behavior in the foreseeable future. Preparation is the third stage of change, when the client decides or makes a plan to change. Action is the fourth stage of change, when the client practices the modified behavior.

Marketing focuses on all of the following objectives except: Profit Future growth Customer wants Coordination of subsystems

Correct answer: Coordination of subsystems Marketing focuses on customer wants, profit, and future growth to reach the goal of maximizing net profit. Management focuses on the coordination of subsystems to achieve objectives.

Which of the following is an example of strategic management? Coordinating subsystems to achieve objectives Establishing one gallon of water per person per day for a minimum of 3 days Showing the command relationship from top to bottom levels Creating and implementing strategies to move toward goals

Correct answer: Creating and implementing strategies to move toward goals Strategic management is organizational and environmental analysis to achieve goals. This principle is exemplified by a company creating and implementing strategies to move toward goals, and evaluating progress. Emergency preparedness includes disaster planning protocols, such as establishing one gallon of water/person/day for a minimum of 3 days. Management is used to coordinate subsystems to achieve objectives. Chain of command establishes command relationships from top to bottom, beginning with one person (top or highest level of authority) and extending downward (bottom or lowest level of authority).

In the ETHNIC model of cultural competency, what does the "E" stand for? Explanation Ethics Ethnic Education

Correct answer: Explanation The ETHNIC Model is a culturally sensitive medical interviewing tool and uses a framework for practicing culturally competent care. The E in ETHNIC stands for "explanation." The mnemonic is as follows: E: Explanation (How do you explain your illness?) T: Treatment (What treatment have you tried?) H: Healers (Have you sought any advice from folk healers?) N: Negotiate (What are mutually acceptable options?) I: Intervention (What can you agree on?) C: Collaborate (How can you work with the patient, family, and healers?) Flag Question

In a chart note using ADIME, which of the following statements should be documented under Assessment? Provided pt with verbal and written education on low-residue diet Pt will be able to develop 3-day menu using dietary recommendations Food- and knowledge-related deficit related to lack of prior education as evidenced by client having no prior knowledge of need for low-residue diet Current diet is low residue with pt consuming 30% of documented meals

Correct answer: Current diet is low residue with pt consuming 30% of documented meals The assessment, diagnosis, interventions, monitoring, evaluation (ADIME) format is used in many nutrition departments to demonstrate the nutrition care process steps. The statement "Current diet is low residue with pt consuming 30% of documented meals" would be documented under Assessment. Under Diagnosis: Food- and knowledge-related deficit related to lack of prior education as evidenced by client having no prior knowledge of need for low-residue diet. Under Intervention - Education: Provided pt with verbal and written education on low-residue diet. Under Intervention - Goals: Pt will be able to develop 3-day menu using dietary recommendations.

Which of the following is a tool and a source of data for the nutrition intervention step of the nutrition care process? Mail or telephone follow-up Current research literature Client surveys Anthropometric measurements

Correct answer: Current research literature The third step of the nutrition care process (NCP) is nutrition intervention. Sources of data and tools for nutrition intervention include the following: Nutrition Care Manual® nutrition intervention topics The AND's (Academy of Nutrition and Dietetics) Evidence-Based Nutrition Practice Guides or other guidelines from professional organizations AND's Evidence Analysis Library and other secondary evidence source Current research literature Results of outcome-management studies The fourth step of the NCP is nutrition monitoring and evaluation. Sources and tools for nutrition monitoring and evaluation include the following: Self-monitoring data or data from other records including forms, spreadsheets, and computer programs Anthropometric measurements, biochemical data, medical tests, and procedures Patient/client surveys, pretests, posttests and/or questionnaires Mail or telephone follow-up

Which components best reflect the goals of Continuous Quality Improvement? Customer satisfaction, data collection, team involvement Data-driven, little variation, eliminate errors Customers, culture, counting Using less human effort, space, capital, and time

Correct answer: Customer satisfaction, data collection, team involvement Continuous Quality Improvement (CQI) components include customer satisfaction, data collection, and team involvement. CQI emphasizes organizations and structures instead of individuals. Total quality management (TQM) components include processes, improvement, and customer satisfaction. Its three elements include customers, culture, and counting. Lean focuses on using less human effort, space, capital, and time to make products/services more efficiently. Six Sigma is a data-driven approach for improving quality by establishing a standard deviation and achieving 6 standard deviations from the mean to achieve little variation in the process to eliminate errors and get them as close to zero as possible.

On what day does a patient's discharge plan begin? Once discharge orders are placed Day 1 Day 7 Once interdisciplinary rounds are completed for the day

Correct answer: Day 1 Discharge plans begins on day 1 of the patient's hospital stay. A discharge note includes a summary of nutrition therapies and desired outcomes. The other choices are incorrect: day 7 is the number of days before a dietitian assesses a patient with a negative nutrition screen; interdisciplinary rounds are when health care providers discuss the plan of care for patients, which may occur daily or weekly; and discharge orders are placed by the doctor and all remaining orders must be completed within two hours of the time the discharge order was placed.

Which of the following physiological changes occur through adulthood and into later life? Decrease in muscle mass Weight loss Decrease in fat mass Increase in bone mass

Correct answer: Decrease in muscle mass There are physiological changes that occur through adulthood and into later life, which affect energy and nutrient needs. Normal aging is associated with shifts in body composition and subsequent loss of physical resilience. This leads to an increase in fat mass, decrease in muscle mass, and decrease in bone mass/quality. Weight gain occurs with aging due to decreased resting metabolic rate and activity.

Last week, twenty FTEs produced 1.75 nutrition consults per labor hour. How can productivity be increased? Increase time spent with each patient Add a PRN dietitian Increase number of meals served Decrease overtime hours

Correct answer: Decrease overtime hours To increase productivity, increase the output or decrease the input. By decreasing overtime hours, input is decreased. Input is further increased by adding a PRN dietitian or increasing time spent with each patient. The number of meals served is not relevant to consult productivity.

How should you treat calciphylaxis? Decreased dialysis frequency Decreased dialysis duration Increased calcium and phosphate in the diet Decrease phosphate in the diet and increase use of phosphate binders

Correct answer: Decrease phosphate in the diet and increase use of phosphate binders Calciphylaxis is the calcification of blood vessels, blood clots, and skin necrosis, typically seen in the stage V CKD patient. It occurs when excess calcium phosphate begins to deposit in soft tissues. The recommended treatment is decreased intake of phosphate in the diet and increased use of phosphate binders. Also, some benefits may be achieved with increasing the frequency or duration of dialysis sessions. The other choices are contraindicated for the treatment of calciphylaxis.

Which of the following signs and symptoms is not associated with dehydration? Increased urine concentration Increased body temperature Decreased skin turgor Decreased BUN:Cr

Correct answer: Decreased BUN:Cr The signs and symptoms of dehydration include weight loss, decreased skin turgor, dry mucous membrane, postural hypertension, weak and rapid pulse, increased body temperature, decreased urine output (UOP), increased urine concentration, and elevated BUN:Cr ratio

"The metropolitan area of Dallas-Fort Worth" The statement above is an example of which type of parameter in a community needs assessment? Lead organization Definition of community Purpose of the assessment Target population

Correct answer: Definition of community Parameters for a community needs assessment include the following: Lead organization Statement of nutrition problem Definition of community Purpose of the assessment Target population Goals and objectives

A high-fiber diet is contraindicated for which of the following disease states? Diverticulitis Diverticulosis Constipation Obesity

Correct answer: Diverticulitis A high-fiber diet may be helpful for the treatment of diverticulosis, constipation, or obesity. A high-fiber diet would be contraindicated for the treatment of diverticulitis, which is the inflammation of diverticula and is initially treated with a clear-liquid, low-fiber diet. Diverticulosis is the presence of diverticula and is treated with a high-fiber diet. Constipation may be related to an atonic colon or a weakened colon muscle and can be treated with a high-fiber and high-fluid diet. A high-fiber diet is related to decreased LDL and decreased post-prandial blood glucose levels. It can benefit individuals with CVD, obesity, and diabetes.

A non-diabetic patient is 39 years old with an LDL of 180 mg/dL. What recommendations would you provide to improve his cholesterol levels? Prescribe a statin due to the high LDL level Eat more plant stanols and sterols to lower LDL Avoid soluble fiber to inhibit cholesterol absorption Consume 40% of calories from unsaturated fat to reduce dietary cholesterol levels

Correct answer: Eat more plant stanols and sterols to lower LDL Therapeutic lifestyle changes (TLC) recommends 2-3 grams/day of plant stanols and sterols to inhibit cholesterol absorption and lower LDL levels. Soluble fiber decreases serum cholesterol by binding bile acids, which helps convert more cholesterol into bile. According to the ACC/ADD guidelines, a stain should be prescribed if the following conditions apply: 1) LDL >190 mg/dL, 2) 40-65 years old with diabetes and LDL 70-189 mg/dL, or 3) diagnosis of atherosclerotic CVD (ASCVD). Consuming up to 35% of calories from fat may help reduce dietary cholesterol levels, based on the TLC recommendations.

A small food company needs to make decisions about how much inventory to keep on hand, how many items to order, and how often to reorder items to incur the least possible cost. What approach may be most beneficial for the company? economic order quantity exponential smoothing time series delphi technique

Correct answer: Economic order quantity The economic order quantity (EOQ) is a quantitative approach used to determine ordering quantities based on the relationship between ordering and holding costs. The purpose is to achieve cost balance based on the assumption that order costs decrease as order size increases and holding costs increase in direct relation to the size of the order. This can be a valuable way for the small food company to make ordering decisions to bear the least possible costs. The other answer choices are all types of forecasting methods: Time series is a planning tool that assumes purchase trends based on moving averages. Exponential smoothing is a type of forecasting that assumes actual occurrences follow an identifiable pattern over time. The Delphi technique is a subjective type of forecasting that uses expert opinion, market research, and panel consensus to make purchasing assumptions.

Which of the following is not a long-term consequence of uncontrolled diabetes? Neuropathy Retinopathy Nephropathy Elevated fasting glucose

Correct answer: Elevated fasting glucose Long-term consequences of uncontrolled diabetes include neuropathy (peripheral and autonomic damage, such as gastroparesis), retinopathy (leading to blindness), and nephropathy (decreased renal function). Short-term consequences of uncontrolled diabetes include elevated fasting glucose, elevated 2-hour postprandial glucose, and ≥6.5% HgbA1C.

Josh and Mary have both been clinical dietitians at a local hospital for five years. Mary was recently recognized for excellence in patient care by the hospital and has an advanced certification in diabetes (CDE). However, Josh is paid more than Mary and he does not have any additional certifications or awards. What amendment was created to prevent this type of discrimination? Equal Pay Act Family and Medical Leave Act Fair Labor Standards Act HIPAA

Correct answer: Equal Pay Act The Equal Pay Act prohibits discrimination on the basis of sex. It is an amendment under the Fair Labors Standards Act, which sets minimum wage and standards for overtime work (over 40+ hours in one week). The Family and Medical Leave Act (FMLA) is a United States federal law requiring covered employers to provide employees with job-protected and unpaid leave for qualified medical and family reasons. The Health Insurance Portability and Accountability Act (HIPAA) is United States legislation that provides data privacy and security provisions for safeguarding medical information.

You notice that your patient's hair is dull, dry, and lacks shine. What is a possible nutrition-related cause of this? Essential fatty acid deficiency (EFA) Vitamin C deficiency Vitamin A deficiency Hyperlipidemia

Correct answer: Essential fatty acid deficiency (EFA) A sign of a protein-energy deficiency and/or essential fatty acid deficiency (EFA) is hair that is dull, dry, lacks shine, and/or is easily plucked. A sign of a vitamin C deficiency is corkscrew, unemerged, coiled hairs. A sign of hyperlipidemia is small, yellowish nodules around the eyes (xanthoma) and/or white rings around the eyes (arcus corneae). A sign of a vitamin A deficiency is white spots in the eyes (Bitot's spots). Nutrition Care of the Older Adults: A Handbook for Nutrition Throughout the Continuum of Care, Third Edition

In planning a foodservice menu, all of the following factors should be considered except which one? Limitations on equipment Food habits of the individuals in the group for which the menu is being planned The number of employees Establishing a three-meal plan for corresponding meal patterns

Correct answer: Establishing a three-meal plan for corresponding meal patterns In planning a foodservice menu, all of the following factors should be considered: The nutritional requirements, food habits, and preferences of the individuals in the group for which the menu is being planned The goals of the organization The budget The limitations on equipment and physical facilities The number and skills of employees The type of service Establishing a three-meal plan for corresponding meal patterns may only be necessary for operations that offer breakfast, lunch, and dinner.

In management, the control function involves all of the following except: Establishing policies and procedures Developing corrective actions Establishing standards Measuring performance

Correct answer: Establishing policies and procedures Controlling is the management function concerned with regulating organizational activities so that actual performance meets accepted organizational standards and goals. The control function involvesDetermining which activities need controlEstablishing standardsMeasuring performanceCorrecting deviations Planning is the management function concerned with developing policies, procedures, and objectives.

Which of the follow is an etiology of osteoporosis? Minimize bone loss later in life Excessive bone resorption and inadequate bone formation Enhanced osteoclast function by estrogen Advanced age, Caucasian female

Correct answer: Excessive bone resorption and inadequate bone formation Osteoporosis is defined by low bone mineral density, mass, and quality. The three main etiologies for osteoporosis are inadequate peak bone mass, excessive bone resorption, and suppression of osteoclast function by estrogen. The non-modifiable risk factors include being female, advanced age, European/Asian ancestry, family history of fractures, history of previous fractures (>2x), rheumatoid arthritis, and gastrointestinal diseases. Strategies to reduce osteoporosis risk are maximizing peak bone mass early in life and minimizing bone loss later in life.

You look inside the refrigerator storage and notice dairy products are arranged from the front of the shelf to the back of the shelf with the following expiration dates, "1/12, 1/15, 1/25, 2/5, 2/10, 3/1." What type of stock rotation is this? FIFO LILO ABC Par stock

Correct answer: FIFO First in, first out (FIFO) is a method of arranging merchandise so that older items are used before newer items. Last in, last out (LILO) is a method of arranging merchandise so that newer items are used before older items. The ABC inventory classification system classifies inventory according to its value, where A items have the highest value (protein, meats), B items are of moderate value, and C items are least valuable. Par stock determines how much of an item to order based on typical usage of the product.

A tube-feeding patient is transitioning to an oral diet and has shown adequate oral intake on this diet. Which of the following PES statements is most appropriate? Inadequate oral intake related to decreased ability to consume sufficient energy as evidenced by 40% oral intake over the past 4 days with supplemental enteral nutrition to meet estimated energy requirements Excessive energy intake related to overfeeding of enteral nutrition as evidenced by 70% oral intake over the past 5 days with supplemental enteral nutrition exceeding estimated energy requirements Inadequate energy intake related to decreased ability to consume sufficient energy as evidenced by failure to maintain appropriate body weight Excessive energy intake related to decreased ability to consume sufficient energy as evidenced by swallowing difficulty requiring enteral nutrition for nutritional support

Correct answer: Excessive energy intake related to overfeeding of enteral nutrition as evidenced by 70% oral intake over the past 5 days with supplemental enteral nutrition exceeding estimated energy requirements A PES statement describes the nutrition problem diagnosis (P), the etiology or root cause (E), and the signs and symptoms (S). The appropriate format of the PES statement is "[Nutrition problem] related to ___ as evidenced by ___." The correct answer is the only PES with the correctly identified problem, etiology, and signs for this patient scenario. Distractors 1 and 2 indicate that the patient has inadequate oral intake, and Distractor 3 has an incorrect etiology.

What is not a risk factor for impaired wound healing? Morbid obesity Inadequate protein intake Significant weight loss Excessive exercise

Correct answer: Excessive exercise Risk factors for impaired wound healing: Significant weight loss Inadequate protein and nutrient intake Extreme BMI (high or low)

An individual suffering from bulimia might have all of the following symptoms except which one? Dental caries Rectal bleeding Extreme weight loss Sore throat

Correct answer: Extreme weight loss The Nutrition Care Manual (NCM) characteristics for bulimia include uncontrolled binge episodes that sometimes alternate with restrictive episodes; abuse of laxatives, diuretics, or syrup of ipecac; compulsive exercise; knuckle bruising (Russell's sign); poor body image; and history of engaging in risky behaviors.

Which government agency would you contact with a question regarding food labeling, such as for cereals, canned goods, and packaged products? HHS USDA SNAP FDA

Correct answer: FDA The Food and Drug Administration (FDA) is responsible for the inspection of food and the labeling of food products. This does not include the labeling of meat, livestock, poultry, and eggs, which are monitored by the USDA. The United States Department of Agriculture (USDA) helps farmers, ensures food safety through food inspections, and provides education and commodity food programs. The USDA is responsible for the grading and labeling of meat, livestock, poultry, and eggs. The United States Department of Health and Human Services (HHS) includes Medicare, Medicaid, CHIP, the health insurance marketplace, patient safety, and health IT management. The Supplement Nutrition Assistance Program (SNAP) administers food stamps through the USDA. Flag Question

A coffee shop uses older coffee beans before newer coffee beans. Which inventory management method is the coffee shop most likely using? FIFO LIFO ABC Mini-max

Correct answer: FIFO First in, first out (FIFO) is a stock rotation process where merchandise is rearranged so that older items are used before newer items. Since the coffee shop is using older beans before newer beans, they are most likely using this inventory management method. Last in, last out (LIFO) is a stock rotation process where merchandise is rearranged so that newer items are used before older items. This is also a method to determine the value of inventory on hand by using the oldest prices that were paid for an item in inventory. Mini-max stock is an inventory management method where stock is reordered when it reaches a "mini," or minimum, level. The "max," or maximum value, represents the targeted stock level following the reorder. ABC is an inventory classification system where inventory items are classified according to their value, with A items being the most expensive, B items having moderate value, and C items having low value

John is a 37-year-old American Indian male. He lives in a small town in Oklahoma and is classified as low-income. Which of the following food and nutrition assistance programs would be best for him to participate in? CSFP SNAP NSLP FDPIR

Correct answer: FDPIR The Food Distribution Program on Indian Reservations (FDPIR) provides USDA food to income-eligible households living on Indian reservations and to American Indians residing in specified areas near reservations or in Oklahoma. The Supplemental Nutrition Assistance Program (SNAP) is a federal program that provides nutrition benefits to low-income individuals and families to purchase food at stores. This would not be the best option for John because he may not have easy access to SNAP offices or authorized food stores; for this reason many households choose to participate in FDPIR instead of SNAP. The Commodity Supplemental Food Program (CSFP) provides nutritious USDA foods to low-income persons at least 60 years of age. John does not meet the age requirement for this program. The National School Lunch Program (NSLP) is a federally assisted meal program that operates in public schools, nonprofit private schools, and residential child care institutions. John is not eligible for this program because he is not a child in school. USDA, Food and Nutrition Service Nutrition Program Fact Sheet. January 2018. "Food Distribution Program on Indian Reservations." https://fns-prod.azureedge.net/sites/default/files/fdpir/pfs-fdpir.pdf

Matt is a 45-year-old obese man with HTN, HLD, and T2DM. He currently weighs 250 lbs and has a BMI of 32.4. His HgbA1c is 12.8%. His doctor has referred him to a registered dietitian for medical nutrition therapy to help lower his HgbA1c and for weight loss. At his initial nutrition assessment, Matt tells the dietitian that he has difficulty controlling his blood sugar because he doesn't understand what carbohydrates are and he has failed to lose weight over the past year despite trying three different diets. He wants to lose weight and have better blood sugar control, but he feels that he won't be able to eat his favorite foods or have a social life with the diabetic diet constraints. What stage of change is Matt in? Preparation Contemplation Precontemplation Action

Correct answer: Contemplation Contemplation is the second stage of change in the trans-theoretical model, where a client recognizes that a problem exists and begins to think about overcoming it. Here, the client may identify the pros and cons of a behavior change and may struggle with decision balancing. Precontemplation is the first stage of change, in which the client has no intention to change their behavior in the foreseeable future. Preparation is the third stage of change, when the client decides or makes a plan to change. Action is the fourth stage of change, when the client practices the modified behavio

A health program spends $100 per participant on nutrition counseling, which results in reduced medical costs of $800. In a cost-benefit analysis, which of the following might represent an indirect benefit? Reduced blood pressure rate Change in dietary habits Decreased length of stay Decreased fat-free mass

Correct answer: Decreased length of stay In a cost-benefit analysis, the benefits can be calculated as any outcome attributed to the project as a direct or indirect benefit. Indirect benefits might include decreased length of stay or admission and savings of the health care provider's time. Direct benefits might include change in dietary habits, change in body habits (weight, fat-free mass or muscle mass), and/or change in body functions (GI tract, blood pressure, lab results).

A bakery set their price for croissants at $4.25 because this is the amount they believe their customers are willing to pay for their croissants. Which type of pricing method is the bakery using? Demand-oriented Conventional Prime-cost Competitive

Correct answer: Demand-oriented The demand-oriented method bases prices on what customers perceive the value of the item/service to be and how much they are willing to pay for it. With this method, prices can be set as high as what the customer is willing to pay above raw-food costs. The conventional method bases selling prices on raw-food costs plus the markup factor. The prime-cost method bases selling prices on raw-food costs plus labor costs. The competitive method sets selling prices in comparison to those of the competition.

"Fruit-For-All" is a community nutrition program focused on increasing accessibility of fresh fruits in low-income areas. Fruit-For-All is in the beginning stages of program development, and their community nutrition RD has conducted a needs assessment. What is the next step the RD should take in program development? Seek support from stakeholders Develop program plan Develop program goals and objectives Identify funding sources

Correct answer: Develop program goals and objectives The steps of program development and planning are as follows: 1) Conduct a needs assessment, 2) Develop program goals and objectives, 3) Develop program plan, 4) Identify funding sources, and 5) Seek support from stakeholders.

You purchase a 26-lb. turkey at $.54/lb. The raw purchase price is $14.04. After deboning and cooking, the edible portion is 14.3 lbs. What is the edible portion cost per pound? $1.85 $.54 $.55 $.98

Correct answer: $.98 To determine the edible portion (EP) cost per pound, divide the as-purchased (AP) price by the edible weight. To solve: raw purchase price (AP) = $14.04 / cooked edible weight 14.3 lbs = EP cost/lb $.98

On average, how much water does a person lose per day due to insensible water loss? 2.0 L 1.0 L 0.5 L 1.5 L

Correct answer: 1.0 L On average, a person loses between 0.8 and 1.2 liters of water per day due to insensible water loss. Insensible water losses include transepidermal diffusion (water that passes through the skin and is lost by evaporation) and evaporative water loss through the respiratory tract—in other words, water lost through skin and breathing. A sensible water loss can be seen, felt, and measured; for example, urine output.

What is the recommended limit of caffeine consumption per day for children? 400 mg 100 mg 70 mg 3 mg/kg

Correct answer: 100 mg It is recommended that caffeine be limited to 100 mg/day for children. For 5- to 12-year-olds, the recommended limit is 3 mg/kg. Up to 400 mg/day appears to be safe for most healthy adults. A 12-oz. can of cola has about 71 mg/serving.

A recipe calls for two #3 cans of tomato sauce. How many cups of tomato sauce will this yield? 5 3/4 11 1/2 10 1/4 12

Correct answer: 11 1/2 A #3 can size holds 5 3/4 cups. Since the recipe calls for two #3 cans, 5 3/4 + 5 3/4 = 11 1/2 cups.

Assuming an 81% yield, how many pounds of broccoli should be purchased for a desired edible portion of 176 ounces? 14 217 218 18

Correct answer: 14 As purchased (AP) refers to the ingredient weight before trimming or removal of any undesired parts, and the edible portion (EP) is the amount that will be served after the food item has been prepared. To solve for AP: 176 oz / 0.81 yield = 217.28 oz 217.28 / 16 oz per lb = 13.58 lbs Round up to purchase 14 lbs of broccoli

A diner needs to produce 3-ounce portions of broccoli for 55 people. If the broccoli yield is 65%, how many pounds of fresh broccoli should be purchased? 16-18 lbs 15 lbs 101 lbs 22-23 lbs

Correct answer: 16-18 lbs To calculate the amount to purchase: 3 oz x 55 portions = 165 oz / 16 oz = 10.3125 lbs of edible portion (EP) needed 10.3125 lbs / 0.65 lb yield from 1 lb as purchased = 15.86 lbs to purchase Convert to purchase unit, 16-18 lbs

A food service company has thirteen 40-hour employees, seven 20-hour employees, and five 10-hour employees. How many FTEs does the company have? 17.75 710 88.75 13

Correct answer: 17.75 FTE / week = (hours worked/week) / 40 hour normal work load To solve: (13)(40) + (7)(20) + (5)(10) = 710 hours / 40 hours / 1 week = 17.75 FTEs

A farmer's market uses a time-series model to determine how much product to purchase. Based on the following information, how many cases will be needed in March? December: 187 January: 196 February: 204 196 204 212 213

Correct answer: 196 Time series is a type of usage forecasting method and planning tool that assumes purchase trends based on moving averages. To solve: 187 + 196 + 204 = 587 total cases / 3 months = 195.66 196 cases are forecast for March.

How many FTEs can a food service company hire with a weekly budget of $9,200 if the salary is $10/hour? 2.3 230 23 26

Correct answer: 23 To solve: $9,200 / $10 = 920 hours / 40 hours per week = 23 FTEs

How many FTEs can a restaurant hire at $11.50/hour with a weekly budget of $1,489? 0.15 3.2 0.308 6.47

Correct answer: 3.2 A full-time equivalent (FTE) is the hours worked by one employee on a full-time basis. An FTE is considered to be an 8-hour work day, a 40-hour work week, or 2,080 hours per year. To solve: $1,489 / 11.5 = 129.478 129.478 / 40 = 3.236

A restaurant is open on Friday evening from 5 pm to 11 pm. They predict a seat turnover of 1.3 times per hour and need to seat 275 customers. How many seats does the restaurant need? 8 211 275 35

Correct answer: 35 Determine how many people can be served from one seat: 6 hours of operation x 1.3 seat turnover = 7.8 people can be served from one seat Determine seats needed: 275 customers / 7.8 people per one seat = 35.256 --> 35 seats are needed To determine seat turnover: Divide the customers per meal by the number of seats (e.g., 275 / 35 = 7.8).

A lunch includes the following: sandwich (1/2 whole grain bagel, 3 ounces of low-sodium turkey, 1/8 avocado, 1 ounce of reduced-fat cheese), side salad (1 cup lettuce, 1/2 cup cooked asparagus, 1 tbsp olive oil) and 1 small apple with 2 tbsp peanut butter. Using the carbohydrate exchange, how many grams of carbohydrates does this meal provide? 35 g CHO 45 g CHO 60 g CHO 22 g CHO

Correct answer: 35 g CHO Using the carbohydrate exchange, the lunch includes: 1 oz serving of starch/bread = 1/2 bagel = 15 g CHO 1 servings of vegetables = 1/2 cup cooked asparagus = 5 g CHO 1 serving of fruit = 1 small apple = 15 g CHO Note: 1 cup of raw lettuce counts as a "free vegetable" because there is fewer than 10 calories per serving. 15 + 5 + 15 = 35 g CHO total for lunch The Diabetic Exchange List: http://glycemic.com/DiabeticExchange/The%20Diabetic%20Exchange%20List.pdf

Based on the numbers below, determine the percent of income spent for food. Cost of food used today: $850 Income for today: $2,180 Number of employees: 23 Hourly salary per employee: $11.20 Average check: $10.09 Number of meals served: 216 51% 66% 35% 39%

Correct answer: 39% To determine the food-cost percentage, or the percentage of income spent on food, divide the cost of food used today by the income for today. To solve, food cost: $850 / income: $2,180 = 0.3899 x 100 = 38.99% = rounded up to 39%. The other variables are not necessary to solve for food-cost percentage.

What is the temperature range of the "danger zone" and why is it referred to this way? 140°F - 165°F because this zone prevents some bacterial growth but allows for survival of some disease-causing bacteria 32°F - 40°F because bacterial growth is slowed at this range, which promotes production of toxins 41°F - 135°F because disease-causing bacteria are capable of rapid multiplication in this temperature range 35°F - 141°F because this zone is ideal for rapid growth of bacteria and production of toxins by some bacteria

Correct answer: 41°F - 135°F because disease-causing bacteria are capable of rapid multiplication in this temperature range According to the Food Code, the temperature range from 41 degrees Fahrenheit to 135 degrees Fahrenheit is known as the "danger zone" because disease-causing bacteria are able to multiply rapidly in this temperature range. The range 140°F - 165°F is the holding temperature for cooked foods, but does allow survival of some bacteria. The range 32°F - 40°F prevents slow growth of some bacteria that cause spoiling.

What is the DRI for Carbohydrates?

Correct answer: 45-65% The DRI for carbohydrates is 45-65% (0.8-1.0 g protein/kg). The DRI for fat is 20-35%, and for protein, 10-25%

You purchase 20 pounds of bananas at $0.58/lb. After they are peeled, the weight is 208 ounces. What is the percent yield? 54% 65% 7.54% 35%

Correct answer: 65% Percent yield determines the remaining (edible) amount of a product by the following equation: [edible portion (EP) / as purchased portion (AP)] x 100 To solve: Convert ounces to pounds: 208 oz / 16 = 13 lbs Determine percent yield: 13 lbs / 20 lbs = 0.65 x 100 = 65%

How much ground meat should be bought to produce 150 burgers of 6-oz. portions each? The ground meat has a 75% yield. 56.25 lbs 100 lbs 43 lbs 75 lbs

Correct answer: 75 lbs To determine needs based on number to be served, portion sizes, and amount of waste, use this equation: edible portion (EP) / % yield (lb). To solve: Determine desired EP: 150 servings x 6 oz = 900 oz Convert to pounds: 900 oz / 16 = 56.25 lbs Determine percent yield: 56.25 lbs / .75 yield = 75 lbs You should purchase 75 pounds of ground meat.

Casey Coffee House is expecting 275 customers next Saturday. Last Saturday they sold 66 bagels, 102 black coffees, 72 lattes, and 14 cookies. Last Sunday they sold 55 bagels, 98 black coffees, 68 lattes, and 4 cookies. How many serving of latte can they expect to serve next Saturday? 78 81 83 88

Correct answer: 78 Popularity index is used to analyze and predict sales. The following equation is used: number of servings of an item divided by total number of servings of all offered items that day. Determine the popularity index of lattes on Saturday: 72 / 66 + 102 + 72 + 14 = 0.2834 = 23.34% 0.2834 x 275 expected customers = 77.935 --> round up to 78 expected servings

A healthy eating pattern should limit added sugar to what percentage of calories? <5% <10% <15% <20%

Correct answer: <10% Healthy eating patterns limit added sugars in the diet. According to the 2015-2020 Dietary Guidelines for America, less than 10% of your daily calories should come from added sugars, which are sugars and syrups that are added to processed and prepared foods or beverages. This does not include naturally occurring sugars, such as those found in milk (lactose) and fruits (sucrose).

Which of the following is an example of lobbying? A group of RDs meets with legislators to encourage support of an issue An appropriations committee provides funding for a nutrition bill A food service manager informs employees of goals, policies, and responsibilities Nutritionists present their views in front of a bill's sponsors

Correct answer: A group of RDs meets with legislators to encourage support of an issue Lobbying is performing activities aimed at influencing public officials and legislators. An example of lobbying is when a group of RDs meets with legislators to encourage support of an issue. Orientation is informing employees of goals, policies, and responsibilities. A public hearing is when testimony is heard by a bill's sponsors. An appropriations committee provides money for programs, which attaches funding to legislation. An example would be an appropriations committee providing funding for a nutrition bill.

A skin condition characterized by dark, velvety patches in body folds and creases is known as: Acanthosis nigricans Goiter Hypochromic anemia Gout

Correct answer: Acanthosis nigricans Acanthosis nigricans is skin condition characterized by dark, velvety patches in body folds and creases. This condition is a risk factor for diabetes. Goiter is the enlargement of the thyroid gland due to insufficient thyroid hormone. Gout is a disorder of purine metabolism characterized by pain and swelling in the joints. Microcytic, hypochromic anemia is an iron deficiency characterized by small, pale cells.

Which of the following diseases and recommendations would be most likely related to a 78-year-old nursing home patient? Gastroparesis; high fat meals Achlorhydria; small, frequent meals Atrophic gastritis; high fiber meals Bezoar formation; large meals

Correct answer: Achlorhydria; small, frequent meals Gastric function decreases with age; therefore, elderly patents commonly experience decreased gastric emptying and HCl in the stomach. As a result, common gastric problems for the elderly include achlorhydria, atrophic gastritis, gastroparesis, and bezoar formation. The treatment of these gastric problems include small frequent meals, pureed foods, and avoidance of high fiber or high fat foods. The only correct recommendation is small, frequent meals to treat achlorhydria; the other answers provide incorrect recommendations.

Which of the following is an example of an endocrine gland? Adrenal Gastric Sweat Salivary

Correct answer: Adrenal Endocrine glands release substances directly into the bloodstream or tissues. Examples of these glands include the thyroid, pituitary, and adrenal glands. Exocrine glands release substances through ducts to the outside of the body. Examples of these glands include the sweat, gastric, and salivary glands.

In which step of the nutrition care process should the RD continually reevaluate a patient's status (e.g., BMI) against a specific criterion? Diagnosis Intervention Assessment Screening

Correct answer: Assessment During the assessment, the RD should continually reevaluate a patient's status, such as BMI, against a specific criterion. This step is an ongoing, dynamic process that involves continuous reassessment and analysis of the patient's needs. During the screening, the RD uses preliminary nutritional parameters to identify patients who are malnourished or at risk to become malnourished. This step evaluates a patient's status against a specific criterion on a one-time basis. During the intervention, the nutrition diagnosis should be prioritized. The intervention is a specific activity used to address the problem identified as the nutrition diagnosis.

Which nutrition screening and surveillance system assesses the prevalence of personal health practices that are related to the leading causes of death? BRFSS NHANES II YRBSS NHEFS

Correct answer: BRFSS The Behavior Risk Factor Surveillance System (BRFSS) assesses the prevalence of personal health practices that are related to the leading causes of death and is used by state health departments to plan, initiate, and guide health promotion and disease prevention programs, and to monitor their progress over time. The National Health and Nutrition Examination Survey (NHANES) II Mortality Study was conducted from 1976 to 1980 and the purpose was to establish the vital status of adults who were 30 to 75 years of age at the time of their baseline NHANES II examination. The Youth Risk Behavior Surveillance System (YRBSS) monitors priority health risk behaviors among adolescents through national, state, and local surveys. The National Health and Nutrition Examination Survey I Epidemiologic Follow-up Study (NHEFS) investigates the relationships between clinical, nutritional, and behavioral factors assessed in NHANES I and the subsequent morbidity, mortality, and hospital utilization. Flag Question

What food would you recommend for a client taking loop diuretics? Fortified cereal with orange juice Baked potato with cheese Kale salad with olive oil Salmon with broccoli

Correct answer: Baked potato with cheese Loop diuretics deplete potassium, so you should recommend foods high in potassium, such as a baked potato with cheese, cantaloupe, or a milkshake. Kale salad with olive oil and salmon with broccoli are high in vitamin K and omega-3s. Fortified cereal with orange juice is high in B vitamins and vitamin C.

The measure of long-term blood glucose control is known as: Fasting blood glucose Glycosylated hemoglobin Estimated average blood glucose Insulin sensitivity

Correct answer: Glycosylated hemoglobin Glycosylated hemoglobin (HgbA1C) measures the percentage of hemoglobin that glucose is carrying. This measure of long-term blood glucose control (2-3 months) can diagnose diabetes and determine how well an individual is controlling their diabetes. The higher the HgbA1C%, the higher the blood glucose has been elevated. Estimated average blood glucose provides an average blood glucose level based on point of care testing. Fasting blood glucose is the blood glucose level when there is not food in the system. Insulin sensitivity refers to resistance to the hormone insulin, resulting in elevated blood sugars.

The statement, "To provide high quality, nutritious meals within the federal and state guidelines" is an example of a: Procedure Goal Policy Mission statement

Correct answer: Goal A goal is a broad statement that describes the reason a department exists. A mission statement is a statement of purpose which incorporates the ideas of what a company wants to offer its customers. A policy indicates what should be done. A procedure indicates how it should be done.

Which of the following is not an example of an individual behavior determinant of health? Diet HIV status Hand washing Physical activity

Correct answer: HIV status Determinants of health are the range of personal, social, economic, and environmental factors that influence health status. Determinants of health include biological and genetic makeup, individual behavior, social interactions and norms, physical environment, and access to health services. Diet, physical activity, alcohol/tobacco/drug use, and hand washing are examples of individual behavior determinants of health. HIV status is an example of a biological and genetic determinant of health. https://www.healthypeople.gov/2020/about/foundation-health-measures/Determinants-of-Health

Which of the following is an example of a tangible foodservice product? Dishwasher Hamburger Lack of friendliness by wait staff Indifference on the part of the wait staff

Correct answer: Hamburger Food itself is tangible, which means it is capable of being perceived by the customer through smell, taste, and touch. An example of a tangible component is a hamburger. Service is intangible because it cannot be possessed, but the customer is aware of its presence and absence. An example of is lack of friendliness or indifference by the wait staff. Appliances, such as dishwashers, are consumer goods that are possessed but not consumed, so they are not tangible foodservice products.

A dietitian is hosting a four-hour weight loss seminar for twenty clients. How should the seminar be structured so the clients remember the information? Use a PowerPoint presentation during the seminar Provide a handout with all of the seminar topics and information Have the clients share their stories and plans for future diet changes Have the clients participate in a demonstration during the seminar

Correct answer: Have the clients participate in a demonstration during the seminar The best way to remember information is through active participation. People remember 10% of what they read, 20% of what they hear, 30% of what they see, 50% of what they hear and see, 70% of what they say themselves, and 90% of what they say and do themselves. The clients' participation in a demonstration during the seminar, such as reading and cooking a recipe, would yield the highest memory retention rate (90%). The other choices would yield lower memory retention: providing a handout (10%), using a PowerPoint (30%), and sharing stories (70%).

A cake is prepared with all-purpose flour and bran. When the cake is finished, the baker notices the end product has decreased volume compared to her usual cakes made with all-purpose flour only. What ingredients should be increased to prevent this decreased volume in the cake? Egg and liquid Egg and sugar Sugar and liquid Flour and liquid

Correct answer: Flour and liquid Bran is the heavy and hard outer layer of cereal grains. When bran is added to a baked flour mixture, the volume of the end product decreases due to its heaviness. Flour and liquid should be increased to prevent this decrease in the cake's volume.

Based on Katz's three skills of managers, which of the following positions would predominantly use conceptual skills to perform their primary job functions? Dietary aide Food service coordinator Dietitian Food and environmental services director

Correct answer: Food and environmental services director Robert L. Katz developed a method of classifying managerial skills in terms of the three-skill approach, which identifies the categories that every successful manager must have in varying degrees of technical, human, and conceptual skills. Conceptual skills are the ability to understand and integrate all the organization's activities and interests toward a common goal. These skills are most important at upper levels of management due to the need for policy decisions and larger-scale actions. For example, a director-level position such as food and environmental services director. Technical skills allow a worker to perform specific activities and are usually more important for lower-level managers (such as dietitians and dietary aides). Human skills include understanding and motivating individuals and groups. These skills are needed at all levels of management, but are usually less important for top-level managers (such as directors) than for lower-level managers (such as food service coordinators).

What might a cost-benefit ratio of 1:4 indicate? For every $1 saved on doctor's appointments, $4 is spent on medications For every $10 required to run an exercise facility, there is $4 of medical savings For every 1 renal patient admitted, 4 doctors are required to provide care For every $1 required to run a nutrition clinic, there is $4 of medical savings

Correct answer: For every $1 required to run a nutrition clinic, there is $4 of medical savings Cost-benefit analysis examines program outcomes in terms of money saved and determines whether the goal of the intervention is worthwhile in terms of costs. A cost-benefit ratio of 1:4 (cost:benefit) reflects the statement, "For every $1 required to run a nutrition clinic, there is $4 of medical savings."

Which carbohydrates are most and least sweet, respectively? Sucrose; maltose Fructose; lactose Lactose; fructose Glucose; sucrose

Correct answer: Fructose; lactose Carbohydrates in order of sweetness are as follows: fructose (most sweet), invert sugar, sucrose, glucose, sorbitol, mannitol, galactose, maltose, lactose (least sweet).

What type of dietary modification would be appropriate for a client with elevated T3 and T4? Weight reduction High-caloric foods Low-purine foods Goitrogen-free foods

Correct answer: High-caloric foods Hyperthyroidism is the excess secretion of thyroid hormones with elevated levels T3 and T4. As a result, BMR is increased and weight loss is common. An appropriate dietary modification would be to increase the calories in the diet. Hypothyroidism is a deficiency of thyroid hormones associated with decreased BMR and weight gain. An appropriate dietary modification is weight reduction. Goiter is the enlargement of the thyroid gland due to insufficient thyroid hormones. A diet free of goitrogens is recommended. Goitrogens are substances that disrupt the production of thyroid hormones by interfering with iodine uptake in the thyroid gland. An example is Brussels sprouts. Gout is a disorder of purine metabolism associated with increased levels of serum uric acid, leading to deposits in the joint that cause pain and swelling. High-purine foods should be avoided.

An individual has the athetoid form of cerebral palsy. What dietary modification would be most beneficial? High-fluid, high-fiber diet Low-calorie diet, finger foods High-calorie, high-protein diet High-fat, very-low-carbohydrate diet

Correct answer: High-calorie, high-protein diet Cerebral palsy is a congenital disorder of movement, muscle tone, or posture. There are spastic and non-spastic (athetoid) forms. The non-spastic (athetoid) form is characterized by involuntary wormlike movements with constant irregular motions that lead to increased energy expenditure and weight loss. The most beneficial dietary modifications include high-calorie, high-protein finger foods that don't require utensils. The spastic form is characterized by difficult, stiff movements that lead to decreased activity and weight gain. The most beneficial dietary modification is a low-calorie, high-fluid, and high-fiber diet. Epilepsy and seizures can be treated with a ketogenic diet, which is characterized by foods high in fat and very low in carbohydrates.

Which of the following describes an objective measure of good quality custard? Higher percent sag Taste Ratio of sugar to egg Lower percent sag

Correct answer: Higher percent sag Objective evaluation of foods involves instrumentation and use of physical and/or chemical techniques. Percent sag is an objective evaluation that measures gel strength; the higher the percent sag, the more tender the gel. When custards are overcooked, they become less tender and have a lower percent sag. Taste is a subjective measure. Ratio of sugar to egg may affect quality, but it is not a standard objective measure.

The prevalence of food insecurity varies considerably by household type. The rate of food insecurity is higher than the national average for which of the following groups? Household with children headed by a single man Married couple without children Elderly woman living at a nursing home Asian household

Correct answer: Household with children headed by a single man Based on the USDA Economic Research Service from the December 2017 Current Population Survey Food Security Supplement, the prevalence of food insecurity varied significantly by household type. The rate of food insecurity was higher than the national average for the following groups: All households with children Households with children under age 6 Households with children headed by a single woman Households with children headed by a single man Women living alone Men living alone Black, non-Hispanic households Hispanic households https://www.ers.usda.gov/topics/food-nutrition-assistance/food-security-in-the-us/key-statistics-graphics/#householdtype

Which of the following is an indicator associated with increased risk for wound healing problems in the lower extremity amputation population? Hyperglycemia Plasma protein concentrations affected by stress and the inflammatory response Anthropometric measurements are not sensitive because of acute changes Values for weight following fluid resuscitation may not be accurate

Correct answer: Hyperglycemia The following indicators (alone or in conjunction) have been associated with increased risk for wound healing problems in the lower extremity amputation population: Serum albumin <3.5 g/dL Total lymphocyte count (TLC) <1,500 cells/mL Hyperglycemia (fasting glucose >126 mg/dL) Patients who are having problems with prosthesis fit Any weight gain or loss >5 lbs The other choices are indicators for burn patients, not amputation patients.

What is a potential effect of thiazide diuretics? Hypertension Hypokalemia Hypervolemia Hypernatremia

Correct answer: Hypokalemia A thiazide diuretic is a medication used to treat hypertension or high levels of potassium, and/or to reduce fluid in the body. This medication works by reducing the kidney's ability to reabsorb salt from the water and into the body, as a result increasing the production and output of urine. A potential side effect includes hypokalemia due to pulling potassium from the blood and excreting too much in the urine. Hypertension, hypernatremia, and hypervolemia are typical symptoms that are solved with use of a thiazide. However, if too much thiazide is used, the potential side effects may be the opposite: hypotension, hyponatremia, and hypovolemia.

A restaurant manager conducts a customer satisfaction survey and learns that customers are bored with the menu. What is the most effective solution to address this complaint? Rewrite the menu Introduce a daily special Update the facility Change to a cycle menu

Correct answer: Introduce a daily special If staff or customers complain of menu boredom, an effective solution is to introduce a daily special or theme days to break up the monotony of the menu. Rewriting the menu, changing to a cycle menu, or updating the facility are time-consuming and expensive options by which to address the complaint of menu boredom.

A patient has a pale tongue and spoon-shaped nails. What deficiency would you suspect this patient has? Iron Vitamin C Calcium Protein

Correct answer: Iron An iron deficiency may be identifiable during a physical exam by a pale tongue, fatigue, anemia, spoon-shaped nails, and/or pale conjunctivae (mucous membrane lining the eyelid). Vitamin C deficiency may be identifiable by gums that are sore, red, swollen, and/or bleeding. Protein deficiency may be identifiable by easily pluckable hair, brittle or thin nails, or underweight. Calcium deficiency may be identifiable by missing teeth or loss of enamel.

Which food is most likely to cause a food-borne illness? Leftover pork reheated to 165°F for 15 seconds within 2 hours of when it was cooked Turkey meatloaf transported at 168°F Frozen chicken stored at -1°F Leftover chili cooled from 135°F to 80°F within 4 hours, then cooled from 80°F to 41°F within 6 hours

Correct answer: Leftover chili cooled from 135°F to 80°F within 4 hours, then cooled from 80°F to 41°F within 6 hours The leftover chili is mostly likely to cause a food-borne illness because the leftovers were not properly cooled. The two-stage cooling process should take a total of 6 hours, where food is cooled quickly from 135°F to 70°F within 2 hours, then cooled from 70°F to 41°F within an additional 4 hours. The other foods are compliant with the FDA Food Code Temperatures and are less likely to cause a food-borne illness.

A meal's respiratory quotient is measured and the result is 0.85. What is the most likely composition of the meal? Fat alone Mixed intake Carbohydrates alone Protein alone

Correct answer: Mixed intake The respiratory quotient (RQ) is the ratio of volume of carbon dioxide (CO2) expired to volume of oxygen (O2) inspired, used to measure energy. The RQ changes based on the fuel mixture being metabolized. For example, 1 = carbohydrates alone, 0.82 = protein alone, 0.7 = fat alone, and 0.85 = mixed intake. Therefore, the meal's RQ of 0.85 reflects a mixed intake.

"On a scale of 1 to 3, where 1 is below expectations, 2 meets expectations, and 3 exceeds expectations, how would you rate yourself on providing patient care? If you select 3, please justify with a written explanation." On what type of form would you most likely find the statement above? Personnel records Performance evaluation Job breakdown Grievance control form

Correct answer: Performance evaluation A performance evaluation is the formal procedure to measure an employee's work and progress. The performance evaluation may be completed through methods such as rating scales, checklists, personal discussion, and management by objectives. A grievance control form is a written record of a grievance or formal complaint over something believed to be wrong or unfair, and the action to be taken. A job breakdown is the analysis of a job, which includes a list of essential steps of what to do and how to do them. Personnel records are records pertaining to the employees of an organization, such as names, addresses, former employment, wage rate, health benefits, and other items. Flag Question

Jessica has worked at a home health company as a full-time RD for 90 days. Her manager, Joshua, has set up a meeting to discuss her performance and provide feedback on her work so far. What type of meeting is this and how might Joshua provide feedback? Performance evaluation; merit rating Injunction; critical incident Collective bargaining; mediation Disciplinary action; suspension

Correct answer: Performance evaluation; merit rating A performance evaluation is a management function used to evaluate employees to help improve their performance by providing feedback. Examples of types of feedback include merit rating, checklist, critical incident, and/or self-assessment. A merit rating is the rating of an employee by systematic evaluation of his proficiency in a job. Collective bargaining is when one person represents a group of people to bargain with the employee. Mediation is a technique where a neutral person helps settle the differences. Disciplinary action is steps taken to correct negative or poor behavior. Examples include oral/written warning, suspension (forced leave of absence without pay), and dismissal. An injunction is an authoritative or judicial warning or order; critical incident is associated with a performance evaluation method.

A food service company at a large hospital tracks their inventory on an ongoing basis and knows how much of a given item is in stock at any given time. What type of inventory system do they use? Fixed order quantity inventory system Just-in-time inventory system Physical inventory system Perpetual inventory system

Correct answer: Perpetual inventory system A perpetual inventory system tracks the number of items in inventory on a constant basis. This system allows for the ability to know how much of a given item is in stock at any given time. A physical inventory system tracks stock every so often (typically at the end of an accounting period) by visually inspecting or actually counting to determine the quantity on hand. A just-in-time (JIT) inventory system coordinates demand and supply so that suppliers deliver parts and raw materials just before they are needed. A fixed order quantity inventory system determines the order point based on average use, lead time, and safety stock.

A patient history includes all of the following parameters, except: GI symptoms Weight changes Dietary intake Physical exam

Correct answer: Physical exam According the to Subjective Global Assessment (SGA), the patient history (Part A) includes weight changes (patterns of loss or gain), dietary intake (duration and degree of changes), GI symptoms (N/V/C/D), and energy/functional capacity (presence of weakness or fatigue). The physical exam (Part B) is conducted separately and after the patient history is collected. These two steps are both important in determining the nutritional status of a patient.

Kate wants to conduct a case control study for clinical nutrition research to demonstrate a link between omega-6 consumption and coronary artery disease. She has established her topic, research, question, and hypothesis. What is her next step in the study? Collect and analyze relevant data Write the research paper Prepare a methodology Organize research methods and materials

Correct answer: Prepare a methodology There are seven steps in the research process, and Kate has completed the first three (identified topic, research question, and hypothesis). The next step of the process is to prepare a research protocol or methodology for the study. The seven steps in the research process are as follows: Identify a relevant and important topic Develop a research question Develop a hypothesis Prepare a research protocol Organize methods and materials Collect and analyze data Study the results

Which of the following is a potential advantage of break-even pricing? Prevention of new entrants to the market Raised prices with continued quality in product Competitors responding with lower prices Financially stronger competitors being driven out of the market

Correct answer: Prevention of new entrants to the market The following are advantages of using the break-even pricing method: Entry barrier: If a company continues with a break-even pricing strategy, possible new entrants to the market might be deterred by the low prices. Reduced competition: Financially weaker competitors might be driven out of the market. Market dominance: Increased production volume while reducing costs and earning a profit may lead to achieving market dominance. The following are disadvantages of using the break even pricing method: Customer loss: If a company only engages in break-even pricing without also improving its product quality or customer service, customers may leave if/when it raises prices. Perceived value: If a company reduces prices substantially, it creates a perception among customers that the product/service is no longer as valuable, which may interfere with responses to increased prices. Price war: Competitors may respond with even lower prices, so that the company does not gain any market share. Cited: Accounting Tools

Which of the following factors plays a role in menu psychology? Sustainbility Nutritional Influences Sociocultural Factors Primacy and Recency

Correct answer: Primacy and recency The factors that play a role in menu psychology include eye gaze motion, font size and style, primacy and recency, color and brightness, and spacing and grouping. The factors that affect menu planning include customer satisfaction, sociocultural factors, food habits and preferences, nutritional influences, aesthetic factors, sustainability, government regulations, and management decisions.

The items on a menu, the cafeteria service, and a pleasant atmosphere are all examples of which element in the marketing mix? Branded concept Place Product Marketing concept

Correct answer: Product The marketing mix includes the elements of product, place, price, and promotion. Product is the combination of goods and services that satisfies the customer's wants and needs. Foodservice products include all of the items on a menu; the various service options, such as the cafeteria, catering, and vending machines; and desirable attributes, such as a pleasant atmosphere. Place is how the products are sold and the distribution method. A marketing concept is the management philosophy that the primary organization's objectives are determining and satisfying the customer's wants and needs; this is not part of the marketing mix. A branded concept is the marketing strategy that communicates a recognizable and consistent identity of a brand to the customer; this is not part of the marketing mix.

Your client, Rachel, provides you with a three-day food diary. On average, she is consuming 1,427 calories daily, which is composed of 143 grams of carbohydrates, 47 grams of fat, and 108 grams of protein. Which of her macronutrients are within the AMDR's recommended ranges? Protein and fat Carbohydrates, protein, and fat Carbohydrates and protein Carbohydrates and fat?

Correct answer: Protein and fat The Acceptable Macronutrient Distribution Ranges (AMDR) recommend that 45-65% of your daily calories come from carbohydrates, 10-35% from protein, and 20-35% from fat. In this scenario, about 30% of Rachel's intake is coming from fat (ex: 47 g fat x 9 kcals/g fat = 423 kcals / 1427 total daily kcals = 0.2964 x 100 = 29.6%) and about 30% of her intake is coming from protein (ex: 108 g protein x 4 kcals/g protein = 432 kcals / 1427 total daily kcals = 30.27 x 100 = 30.3%). Her carbohydrate intake falls below the AMDR for carbohydrates (ex: 143 g carbohydrates x 4 kcals/g carbohydrate = 572 kcals / 1427 total daily kcals = .04008 x 100 = 40%).

What is a key element in disciplinary action? Comparing employee's performance against that of other employees Providing consistency If unionized, settling informally between the employee and supervisor If non-unionized, settling using a written formal grievance procedure

Correct answer: Providing consistency A key element in positive discipline practices is to provide consistency. An employee's performance should not be compared against that of other employees, rather it should be compared against department standards. If non-unionized, grievances should be settled informally between the employee and supervisor. If unionized, grievances should be settled by a contract that states a written formal grievance procedure.

Which of the following program interventions is an example of tertiary prevention? Free HIV screening Passing out condoms on a college campus Setting up a blood pressure machine at a grocery store Providing renal cookbooks at a dialysis clinic

Correct answer: Providing renal cookbooks at a dialysis clinic Program interventions may be aimed at primary, secondary, or tertiary prevention. Primary prevention programs reduce risk of exposure to a disease through health promotion and early screening, such as free HIV screening or setting up a blood pressure machine at a grocery store. Secondary prevention reduces risk of developing a disease due to an elevated risk factor. For example, passing out condoms on a college campus, where the risk of unprotected sex is higher. Tertiary prevention reduces risk as a disease develops and works to manage complications, such as providing renal cookbooks at a dialysis clinic.

The scope of practice for the RDN includes all of the following components except which one? State and federal regulations Education and credentialing Public health and safety regulations Accreditation standards

Correct answer: Public health and safety regulations The scope of practice for the RDN includes the practice components used in nutrition and dietetics: education and credentialing, practice resources, standards of practice and professional performance, codes of ethics, accreditation standards, state and federal regulations, national guidelines, organizational policy and procedures, and resources for practice management.

A dietitian is providing a newly diagnosed type 2 diabetes patient with diabetic education. In the first part of the session, the dietitian explains which foods will raise blood sugar and which will not, and gives examples of both type of foods. After the first part of the lesson, the dietitian asks the client to name one food that will raise blood sugar and one food that will not. What type of communication principle is the dietitian using? Establishing rapport Clarification Empathy Feedback

Correct answer: Feedback Feedback is an effective communication principle that elicits a response from the listener about something that was observed or heard, for example, information that a client repeats back to a dietitian after learning a new nutrition lesson. This technique enables the dietitian to know what the client knows and has retained from the lesson. Clarification is a listening response used to make a previous message more clear. For example, the dietitian might ask a follow-up question after an ambiguous client message. Establishing rapport is a communication principle used to encourage clients to voice their concern and to help them feel comfortable with the provider. Empathy is a communication principle that allows you to respond without giving advice, for example, putting yourself in the client's shoes as a newly diagnosed diabetic.

Using the information below, determine the net profit: Sales: $177,567 Payroll: $86,750 Rent: $20,850 Taxes: $4,580 Depreciation: $1,998 Supplies: $3,248 $60,141 $60,151 $39,711 $294,993

$60,141

Using the chart below and the moving average model, determine the second forecast for the seven-day moving average. Day # | #of Patients who selected fish 1 50 2 54 3 60 4 56 5 53 6 63 7 69 8 62 9 64

59.57 The moving average model is a time series method of forecasting where a group of past records are averaged and used as the forecast. The next forecast (second) is calculated by dropping the first number and adding the next. To solve for the second forecast (total of days 2 through 8): 54+60+56+53+63+69+62 = 417 / 7 = 59.57

A 1.5-pound sirloin is roasted at 325°F for 45 minutes. When the sirloin is removed from the oven, the temperature of the meat reads 130°F. The sirloin is scheduled to be carved and served in 30 minutes. Should it be served, and why or why not? No, because it may be contaminated with E. coli Yes, because it reached the safe minimum internal temperature in the oven Yes, because carry-over cooking will bring it to the safe minimum internal temperature No, because carry-over cooking will not assure it reaches the safe minimum internal temperature

Correct answer: Yes, because carry-over cooking will bring it to the safe minimum internal temperature Tender cuts of meat near the backbone (loin, sirloin) should be cooked using dry heat methods. Dry heat methods include frying, broiling, and roasting. When meat is removed from the oven, "carry-over cooking" occurs for about 10 minutes and the internal meat temperature rises 15-25°F. For this reason, it is recommended that meat be left sitting for at least 10 minutes before serving. This carry-over cooking principle is the reason this sirloin is safe to be served; the original temperature of 130°F would have been brought to 145-155°F by the time it was served.

The hospital is developing a Healthy Eating for Diabetes book for client nutrition education. The hospital population is low-income and has a low education level, and the hospital accepts patients without insurance. When creating client nutrition education written material, what should the reading level be? 3rd grade 8th grade 12th grade 6th grade

Grade: 6th grade When creating written educational materials, the reading level should be around the 6th grade for audiences of lower literacy. For the general population, the reading level should be around 8th grade, for example, for a hospital serving a population with an average education level. When determining readability, the SMOG index is a useful tool for determining grade level, by finding the average number of polysyllabic words in a block of text. After conducting a SMOG index on the written education material, one may choose to set the reading level at a 3rd or 12th grade level, but for this question, 6th grade level is most appropriate.

Jessica is a newly hired registered dietetic technician at a small family-owned medical clinic, and she is wheelchair-dependent. Which of the following is an example of a "reasonable accommodation" the employer can make? Adjusting the job's salary Firing Jessica and hiring a non-wheelchair-dependent employee to better perform the job Installing elevators in the building Modifying the height of desks and equipment

Correct answer: Modifying the height of desks and equipment The Americans with Disabilities Act (ADA) prohibits employment discrimination on the basis of workers' disabilities and requires employers to provide "reasonable accommodations." These may include changes to the workplace or job to allow employees with disabilities to do their jobs, such as providing accessible parking, lavatories, and workstations; modifying the height of desks and equipment; and having wide aisles (36") and doors (32"). The ADA does not require employers to make accommodations that would cause them an undue hardship resulting in significant difficulty or expense. Examples of undue hardship include installing elevators in a small business that has fewer resources. Examples of noncompliance with the ADA and discrimination include adjusting the job salary and firing the individual due to their disability.

Which of the following is not one of the seven widely accepted functions of management? Coordinating Monitoring Reporting Budgeting

Correct answer: Monitoring The seven major functions of management are 1) planning, 2) organizing, 3) staffing, 4) directing, 5) coordinating, 6) reporting, and 7) budgeting. Monitoring is part of a clinical dietitian's function: to monitor, assess, and optimize nutrition status.

Which of the following groups would most likely order a bacon cheeseburger with french fries on a Friday in March? Those who practice Kosher Mormons Roman Catholics Muslims

Correct answer: Mormon Mormon dietary guidelines restrict the consumption of coffee, tea, alcohol, tobacco, and illegal drugs. They observe a monthly fast on the first Sunday of each month and practice proper eating. However, this meal would not be prohibited by this group. Roman Catholics do not consume meat on Fridays during Lent (which is the 40 days preceding Easter, usually encompassing March). Those who practice Kosher do not eat meat and dairy at the same meal. Muslims do not consume pork.

Frank is researching infant death rates due to hospital-acquired pneumonia. He would like to find out how many infants die under one year of age per 1,000 live births. Which source of assessment information would help him express this rate? Morbidity rate Disease rate Mortality rate Incidence

Correct answer: Mortality rate Mortality rates express the number of deaths, and this rate would be most helpful for Frank's research. Morbidity rates reflect disease rates, as opposed to death rates. This rate would be helpful if Frank was concerned about the number of cases of hospital-acquired pneumonia. Incidence refers to the number of new cases of a disease over a period of time. For example, incidence represents the number of new cases of hospital-acquired pneumonia over a period of time.

Which resource could provide client education material for a weight-loss patient? JSTOR CDR PubMed NCM

Correct answer: NCM The Academy of Nutrition and Dietetics' Nutrition Care Manual (NCM) provides client-based information for a variety of conditions. It is internet-based and requires membership in the Academy to access the benefits of the client education materials. PubMed is a free full-text archive of biomedical and life sciences journal literature that can be used by providers to stay up-to-date with the latest research in the field. The Commission on Dietetic Registration (CDR) is the credentialing agency and organization unit of the Academy of Nutrition and Dietetics. JSTOR is a digital library of academic journals, books, and primary sources.

Which survey would be most useful for studying aging related to nutrition? WHO OAA FAO NHANES

Correct answer: NHANES The National Health and Nutrition Examination Survey (NHANES) is administered through the CDC and is useful for the study of aging related to nutrition. It is an ongoing survey that obtains information on the health and nutritional status of the US population by assessing nutritional, clinical, and biochemical parameters. It is used to determine the prevalence of disease and risk factors and is the basis for national standards. The World Health Organization (WHO) is the coordinating authority on international health concerns within the United Nations. The Food and Agricultural Organization (FAO) is a specialized agency of the United Nations that leads international efforts to defeat hunger. Its main goals are food security and sustainability. The Older Americans Act (OAA) is not a survey, but rather an act under the DHHS that provides a nutrition incentive program to eligible older Americans; for example, Congregate Meals and Meals on Wheels.

Which demographic group is at an increased risk for cardiovascular disease and diabetes? Caucasians Native Americans Asian Americans African Americans

Correct answer: Native Americans Native Americans and Alaskan natives are at an increased risk for cardiovascular disease and diabetes. According to the Strong Heart Study, Native Americans have significantly higher rates of heart disease and diabetes, even though they consume 12% fewer calories than the average American. In addition, obesity and alcoholism are more prevalent, and infant and maternal mortality rates are four times the US average.

Which of the following can your body manufacture from tryptophan, an essential amino acid? Tyrosine Glutamine Arginine Niacin

Correct answer: Niacin Niacin is one of eight vitamins that make up the B complex. It is a water-soluble vitamin that your body cannot store. You obtain niacin from many common foods, especially beets, beef liver, fish and yeast-based foods. However, if your diet is deficient in niacin, your body can manufacture it from tryptophan, an essential amino acid. Tryptophan is a precursor of serotonin and niacin. 60 mg of tryptophan is equivalent to 1 mg of niacin. Arginine and glutamine are nonessential amino acids that are conditionally essential during catabolic stress. Phenylalanine is converted to tyrosine.

What is the largest contributor to renal solute load? Ammonia Creatinine Nitrogen Uric acid

Correct answer: Nitrogen The largest contributor to renal solute load is nitrogenous waste. Renal solute load is the end waste products of metabolism and mainly measures nitrogen (~60%) and electrolytes (Na). Other contributors to renal solute load include uric acid, creatinine, and ammonia (found in smaller amounts).

A 55-year-old patient weighs 55 kg and is 63 inches tall. He has a past medical history significant for chronic kidney disease stage III, type 2 diabetes mellitus, gastroparesis, and hypertension. His diet order is 2,000 calories with consistent carbohydrates, 60-80 grams protein, 1.5 liter fluid restriction, high fiber with Boost Glucose Control twice per day. What changes would you make to his current diet order, if any? Remove the high-fiber diet order Decrease to 1,500 calories with consistent carbohydrates Increase protein to 125-145 grams The current diet order is appropriate

Correct answer: Remove the high-fiber diet order Gastroparesis is also called delayed gastric emptying and is characterized by abnormally delayed emptying of foods from the stomach (NCM). A common cause of gastroparesis is diabetes. Nutrition therapy for gastroparesis includes: low fiber, low fat, and 5-6 small meals per day. Therefore, the high-fiber diet order is contraindicated for this patient. The remaining diet orders are appropriate for the patient based on his estimated needs and associated past medical history, thus no additional changes are indicated.

Which of the following statements is an example of a psychomotor objective? List foods high in vitamin C Plan a sodium-restricted menu for one week Arrange food in appropriate macronutrient food groups Reorganize tray lines to accommodate a new type of disposable tray

Correct answer: Reorganize tray lines to accommodate a new type of disposable tray Psychomotor objectives are specific to physical movements, coordination, and manual tasks. The other choices are all examples of cognitive objectives, which measure intellectual processes.

Which of the following signs/symptoms complete the PES statement below? Inadequate energy intake related to decreased ability to consume sufficient energy as evidenced by... BMI >25 Increased body adiposity Intake of energy in excess of estimated energy needs Failure to maintain appropriate weight

Correct answer: Failure to maintain appropriate weight The appropriate and complete PES statement is "Inadequate energy intake related to decreased ability to consume sufficient energy as evidenced by failure to maintain appropriate weight." The other signs and symptoms are incorrect because they are related to the diagnosis of excessive energy intake.

What does the term "anuria" mean? Failure to produce urine Burning with urination Less than 500mL of urine production Increased urea in blood

Correct answer: Failure to produce urine Anuria is the failure to produce urine. Oliguria is small urine output, which is defined as less than 500mL of urine production. Azotemia is increased urea in the blood. Dysuria is burning with urination.

What nutrient is most impaired in cystic fibrosis? Carbohydrate Fluid Protein Fat

Correct answer: Fat Cystic fibrosis is a disease of the exocrine glands characterized by pancreatic enzyme deficiency, high electrolyte perspiration levels, thick mucus secretions, and malabsorption. Fat is the most impaired nutrient due to pancreatic enzyme deficiency. As a result, pancreatic enzyme replacement therapy (PERT) is recommended with all meals and snacks to aid in fat absorption to prevent steatorrhea and promote normal growth.

During a nutrition-focused physical exam, you are closely examining your patient's eyes. You notice redness in his eyelid corners and an inflamed conjunctiva. What micronutrient could he be deficient in? Vitamin A, zinc Thiamine, phosphorus Riboflavin, pyridoxine Vitamin B-12, folate, iron

Correct answer: Riboflavin, pyridoxine During a nutrition-focused physical exam, you can check the eyes for signs that indicate the possible nutrition-related causes of the following: Redness of the eyelid corners, red/inflamed conjunctiva, and swollen eyelids indicate a riboflavin and pyridoxine deficiency. Impaired night vision, night blindness, chronic dry eyes, and/or a dull cornea indicate a vitamin A and zinc deficiency. Paralysis of the muscles within or surrounding the eye (ophthalmoplegia) indicates a thiamine and phosphorus deficiency. Pale eyes and mucous membranes indicates a vitamin B-12, folate, and/or iron deficiency.

During a nutrition counseling session, a client says, "I know you want me to stop eating out, but I'm not ready to do that!" The dietitian responds by saying, "You can see that there are some issues, but you're not willing to think about stopping altogether." Which principle of motivational interviewing is the dietitian using? Roll with resistance Avoid argumentation Develop discrepancy Express empathy

Correct answer: Roll with resistance The 5 principles of motivational interviewing are to express empathy, develop discrepancy, avoid argumentation, roll with resistance, and support self-efficacy. Rolling with resistance is affirming the client's freedom of choice and telling the client reluctance is normal. Expressing empathy verbally reflects an understanding of the client and clarifies feeling, meaning, or experience. Developing discrepancy compares and contrasts present and desired behaviors. Avoiding argumentation is not arguing or attempting persuasion.

Which is an example of a program that provides coupons and electronic debit cards, known as electronic benefit transfer (EBT) cards, to the eligible needy? CCP WIC SNAP Food banks

Correct answer: SNAP The Supplemental Nutrition Assistance Program (SNAP) provides coupons and electronic debit cards, known as electronic benefit transfer (EBT) cards, to the eligible needy. Each month SNAP food stamp benefits are directly deposited to the household's EBT card account, and the funds may be used to pay for food at supermarkets, convenience stores, and other food retailers. Food banks provide actual food products, not debit cards. The Child Care Program (CCP) is administered through HHS and provides quality, affordable childcare. Women, Infants, and Children (WIC) helps families by providing an Electronic Benefits Transfer card, called the "eWIC" card, for buying healthy foods from WIC-authorized grocery stores.

A pediatric patient is diagnosed with petechiae and poor growth rate. Which of the following foods should the patient add to his diet? Safflower oil Canola oil Salmon Walnuts

Correct answer: Safflower oil The essential fatty acids are linoleic acid (omega-6) and a-linolenic (omega-3). An absence or deficiency in omega-6 leads to eczema, poor growth rate, and petechiae (red or purple skin spots). To reverse this deficiency, an omega-6-rich source should be recommended, such as safflower or sunflower oil. An omega-3 deficiency results in neurological changes such as numbness and blurred vision and changes in retinal function and brain development. Omega-3-rich sources are fish oils, such as fatty fish like salmon or shrimp; walnuts; flax seeds; and canola oil.

Jacob was recently prescribed the drug lithium carbonate to treat his bipolar disorder. Which of the following meals would you recommend for him? Omelette with cheese and ham Low-sodium tuna on unsalted crackers Italian deli-meat sandwich with potato chips Salad with grilled chicken

Correct answer: Salad with grilled chicken The drug lithium carbonate and the mineral sodium are known to interact because they compete with each other for reabsorption into the tubules of the kidneys. As a result, high dietary intake of sodium promotes lithium excretion and reduces the effectiveness of the drug. On the other hand, low dietary intake of sodium promotes reabsorption of lithium and increases the chance of drug toxicity. Therefore, the most appropriate meal recommendation would be a salad with grilled chicken because it does not contain foods significantly high or low in sodium. Italian deli meats, potato chips, cheese, and ham are all high in sodium; low-sodium tuna and unsalted crackers are obviously low in sodium. Gropper, S. A. S., Smith, J. L., & Groff, J. L.

During the summer, a local food service company hired high school students. The food service manager has asked 17-year-old Rachel to set up and operate the meat slicer. Is this allowed? Yes, because she is exempted from child labor laws due to her age No, because child labor laws prevent it No, because the Americans with Disabilities Act prevents it Yes, because she is enrolled in a food-related program

Correct answer: No, because child labor laws prevent it Child labor laws regulate work hours and duties of children. These laws restrict the operation of power-driven bakery machinery, such as a meat slicer, until a child reaches 18 years of age. In food service, students can handle, clean, and use meat slicers only if enrolled in food-related programs. We do not know if she is enrolled in a food-related program based on the information given, and we cannot make that assumption. Rachel is not exempted from child labor laws due to her age because she is still under 18 years of age. The Americans with Disabilities Act (ADA) prohibits discrimination and ensures equal opportunity for persons with disabilities in employment, state and local government services, public accommodations, commercial facilities, and transportation.

Raquel is hosting a dinner party for ten people and is serving roast chicken with mashed potatoes and a side salad. She used a cutting board to cut up the raw chicken, then used it to cut up raw vegetables for the salad. Her dinner party guests are most likely to get sick from: Salmonella Clostridium botulinum Clostridium perfringens Streptococcus pyogenes

Correct answer: Salmonella Salmonella is a food-borne infection commonly caused by unwashed hands or the cross-contamination of raw or undercooked meat, poultry, eggs, dairy, seafood, and some produce. Streptococcus pyogenes is a bacterial infection that causes a sore throat (it's not a food-borne illness) and spreads through mucus. Clostridium perfringens is a food intoxication found in human intestines, often raw meat/poultry, and grows best under anaerobic conditions (indicating why it is the wrong choice for our example). Clostridium botulinum is a food intoxication most commonly caused by improperly processed and canned foods. It is soil-based and also anaerobic.

Which of the following documents serves as the Academy of Nutrition and Dietetics' position on the essential roles and activities of the RDN in the direction and delivery of food and nutrition services? Standards of Practice in Nutrition Care Scope of Practice Code of Ethics Standards of Professional Performance

Correct answer: Scope of Practice The Scope of Practice for the RDN reflects the position of the Academy on the essential role of the RDN in the direction and delivery of food and nutrition services. The Standards of Practice in Nutrition Care address activities related to direct patient and client care. The Code of Ethics establishes the foundational principles and ethical standards for the nutrition and dietetics practitioner's roles and conduct. The Standards of Professional Performance address behaviors related to the professional role of RDNs.

"Severe neonatal hyperbilirubinemia (bilirubin >30 milligrams/deciliter)" has a threshold of 0%, and if this event occurs it signals the need for immediate investigation and response. What type of indicator is this? Comparative rate indicator Threshold for evaluation Sentinel event Rate-based indicator

Correct answer: Sentinel event A sentinel event is a patient safety event that results in death, permanent harm, and/or severe temporary harm, and intervention is required to sustain life. A sentinel event indicator signals the need for immediate investigation each time it occurs and has a threshold of 0% (never) or 100% (always). A rate-based, or comparative rate, indicator assesses what will happen with the best possible care and has thresholds between 1 and 99%. The threshold for evaluation is the level at which a stimulus is strong enough to elicit a signal to respond and then the determination of why the threshold was crossed.

Casey is a 46-year-old female with past medical history significant for diabetes, hyperlipidemia, hypertension, and congestive heart failure. She is admitted to the hospital for heart failure exacerbation. You are performing a nutrition-focused physical exam on Casey. You notice she has slightly dark circles under her eyes, slight depression on her temples, and visible clavicle bones. What does her physical exam indicate to you about her nutritional status? She is well-nourished She is edematous She has mild malnutrition She has severe malnutrition

Correct answer: She has mild malnutrition The exam areas and findings indicate mild to moderate malnutrition. The fat pad below the eyes would be more bulged on a nourished individual and significantly more hollowed on a severely malnourished patient. The edematous patient would have notable swelling on the lower extremities.

What type of kitchen equipment would you recommend for individuals with developmental delay? Toaster oven Spoons and forks with larger handles Food dehydrator Toaster

Correct answer: Spoons and forks with larger handles An individual with developmental delay may require special equipment to make preparing, serving, and eating meals easier. Some suggestions are a blender/food processor, juicer, cappuccino maker, pastry cutter/potato masher, dishes with sides, sports cups, spoons and forks with larger handles, rubber sleeves, and a heated baby dish. A toaster over, toaster, and food dehydrator may be okay kitchen equipment for an individual with developmental delay to have, but they would not be specifically recommended for any particular reason.

What is the difference between a regular recipe and a standardized recipe? Regular recipes ensure that people are receiving the required portions each time Standardized recipes are those that have been tried, adapted, and re-tried and produce the same results every time Standardized recipes are top-selling menu items with high customer ratings Regular recipes produce the same quality and quantity of product each time they are made

Correct answer: Standardized recipes are those that have been tried, adapted, and re-tried and produce the same results every time Standardized recipes should include the following: Recipe title Ingredients, name and measurable amount of each (by weight or volume) Preparation instructions Cooking temperature and time Serving size of one portion (volume or weight) Yield (total number of servings the recipe makes) How a serving contributes toward meeting meal pattern requirements As a result, standardized recipes are able to Ensure that people are receiving the required portions Produce the same quality and quantity of product each time Forecast the same costs

Which type of equipment would you choose if you were boiling large quantities of pasta? Microwave High-pressure steamer Deck oven Steam-jacketed kettle

Correct answer: Steam-jacketed kettle Steam-jacketed kettles are often used to boil and simmer large quantities of food, such as pasta, simmer sauces, stocks, and stews. This type of equipment cooks by conduction, where heat passes directly from the wall of the kettle into the food, making it very energy-efficient. A high-pressure steamer cooks small batches of food quickly. A deck oven is a stacked oven used to save space when production is high. Microwaves cook small amounts of food quickly.

A tube feeding is running continuously at 80mL/hr and provides 1,000 calories, 64 grams of protein, and 840 mL of water per 1,000 mL of formula. The patient requires 2,000 calories and 135 grams of protein. Does the current rate meet his estimated needs? Yes, but the feed should be changed to a 12-hour cyclic rate No, the rate should be changed to 85 mL/hr to meet his estimated needs Yes, the current rate meets his needs No, the rate should be changed to 90 mL/hr to meet his estimated needs

Correct answer: No, the rate should be changed to 90 mL/hr to meet his estimated needs First, determine the number of calories and grams of protein per mL of formula: Calories per mL: 1,000 Calories / 1,000 mL = 1 Cal/mL Protein per mL: 64g protein / 1,000 mL = .064 g/mL Next, determine the amount of formula delivered in a 24-hour period: mL per 24hr: 80mL x 24hr = 1,920 mL Now calculate the number calories and grams of protein the patient will receive during the tube feeding: Calories Delivered: 1,920 mL x 1 Cal/mL = 1,920 Cal Protein Delivered: 1,920 mL x .064 g/mL = 122.88 g of protein Therefore, the current rate does not meet the patient's needs of 2,000 calories and 135 grams of protein. To determine the correct rate, trial and error the rates to find the rate that provides adequate nutrition: Trial 1: 85 mL/hour does provide adequate calories, but does not provide enough protein. Calories per mL: 1,000 Calories / 1,000 mL = 1 Cal/mL Protein per mL: 64g protein / 1,000 mL = .064 g/mL mL per 24hr: 85mL x 24hr = 2040 mL Calories Delivered: 2,040 mL x 1 Cal/mL = 2,040 Cal Protein Delivered: 2,040 mL x .064 g/mL = 130.56 g of protein Trial 2: 90 mL/hour provides adequate calories and protein and therefore is the correct rate: Calories per mL: 1,000 Calories / 1,000 mL = 1 Cal/mL Protein per mL: 64g protein / 1,000 mL = .064 g/mL mL per 24hr: 90mL x 24hr = 2160 mL Calories Delivered: 2,160 mL x 1 Cal/mL = 2,160 Cal Protein Delivered: 2,160 mL x .064 g/mL = 138.24 g of protein

Would you recommend the Feingold diet to a patient with hyperkinesis? Why or why not? Yes, because sugar causes hyperactivity No, because consistent carbohydrate intake is important to control blood sugar No, because the efficacy of the diet is not proven Yes, because artificial colors decrease attention span

Correct answer: No, because the efficacy of the diet is not proven Attention-deficit/hyperactivity disorder is a chronic condition of attention difficulty, hyperactivity, and impulsiveness. The Feingold diet is an elimination diet initially devised following research in the 1970s that appeared to link food additives with hyperactivity; it was thought that eliminating these additives and other various foods would alleviate the condition. However, the efficacy was not proven because positive results may be due to the placebo effect. Sugar does not directly cause hyperactivity, and artificial colors do not directly decrease attention span. Consistent carbohydrate intake is important to control blood sugar for patients with diabetes.

A military base provides its service employees breakfast, lunch, and dinner at the base's cafeteria. The on-site food service is provided as a secondary activity and profit is not expected. What type of operation is the military cafeteria? Commercial Limited choice Non-selective Non-commercial

Correct answer: Non-commercial Non-commercial operations provide food service on-site as a secondary activity. Examples include the military, schools, and hospitals. Commercial operations sell food as the primary activity, and profit is desired. Examples include restaurants and sporting event arenas. Non-selective, or no choice, is a type of single-choice or cycle menu that serves persons who are unable or do not have a desire to choose. Limited choice is a type of menu that provides choices for only some menu items.

Matt is a 64-year-old male with a BMI of 34.8. What is his BMI classification? Morbid obesity Obesity class II Obesity class III Obesity class I

Correct answer: Obesity class I The body mass index (BMI) is used as a criterion to assign nutritional risk. Individuals are considered at nutritional risk if they are underweight, overweight, or obese. The BMI classifications are listed below: <18.5: Underweight 18.6-24.9: Normal weight 25-29.9: Overweight 30-34.9: Obesity class I 35-39.9: Obesity class II >40: Obesity class III or morbid obesity

During a nutrition counseling session, what type of questions should a dietitian ask to encourage the client to talk, and for what percentage of the time? Open-ended; 75% Primary; 25% Secondary; 50% Leading; 75%

Correct answer: Open-ended; 75% During a nutrition counseling session, it is important for the dietitian (or counselor) to talk ~25% of the time and the client ~75% of the time. The kind of questions that should be asked include open-ended, primary, secondary, and neutral questions to help facilitate this. Leading questions prompt or encourage a desired answer.

The idea that ignoring a student's misbehavior should extinguish the behavior represents which theory of learning? Social learning Connectionism Classical conditioning Operant conditioning

Correct answer: Operant conditioning Operant conditioning is the idea that learning is a function of change in overt behavior, and changes in behavior are the result of an individual's response to events in the environment. Here, the stimulus becomes the consequence. If the stimulus is positive, the behavior increases. If the stimulus is negative, the behavior decreases. In classical conditioning, two stimuli are paired together for a number of trials until a response is elicited. In connectionism, learning is the result of associations that are strengthened or weakened by the frequency of pairings. In social learning, behavior is explained by continuous reciprocal interaction between cognitive, behavioral, and environmental influences.

What is occurring in the following reaction? H2 → 2e- + 2H+ Respiration Reduction Oxidation Fermentation

Correct answer: Oxidation An oxidation-reduction reaction (redox) is a type of chemical reaction that involves a transfer of electrons between two elements. An oxidation-reduction reaction is any chemical reaction in which the oxidation number of a molecule, atom, or ion changes by gaining or losing an electron. Oxidation is the removal of electron(s) from a substance, such as H2 → 2e- + 2H+ Reduction is the addition of electron(s) to a substance, such as 1/2 O2 + 2 e- + 2H+ --> H2O. Respiration is the removal of electrons from an electron donor which passes them to an electron acceptor with energy generation (ATP formation) from proton motive force at a charged membrane (oxidative-level phosphorylation). Fermentation is the conversion of sugars to acids, gases, or alcohol. This process usually splits a molecule, where one part is oxidized and the other is reduced. Flag Question

What hormone moves human milk through ducts and facilitates birth? Prolactin Oxytocin Progesterone Colostrum

Correct answer: Oxytocin Oxytocin is a maternal hormone from the pituitary gland that moves human milk through ducts and facilitates birth. Prolactin is also a maternal hormone from the pituitary gland and serves to stimulate milk production. Colostrum is a yellowish transparent fluid secreted from the mother's breasts during the first few days. It helps to meet the infant's needs because it is higher in protein than mature milk and has antibodies. Progesterone is a hormone that develops the placenta after implantation.

Which patient's diet should be liberalized? Patient is morbidly obese and complains of hunger after finishing meals Patient is on a low sodium diet with CHF and complains of bland taste Patient is on a diabetic diet and complains of small portion sizes Patietn has intake of <50% for 72 hours and complains of poor appetite

Correct answer: Patient has intake <50% for 72 hours and complains of poor appetite Overly restrictive diets may limit food choices or provide unfamiliar/unpalatable food items for patients with a poor appetite. These practices may result in inadequate food and nutrient intake. By liberalizing this patient's diet (i.e., removing dietary restrictions), this patient may eat more food as a result of increased food selections. The other patients do not require a liberalized diet due to their disease state (CHF, diabetes, obesity) and chief complaint (not related to poor intake or appetite).

Functional foods are those that provide additional benefits beyond the basic nutritional benefits. Which functional food would you recommend to a 31-year-old male with a family history of prostate cancer? Salmon because it has omega-3 fatty acids Tomatoes because they have lycopene Fermented dairy products because they have probiotics Red wines because they have resveratrol

Correct answer: Tomatoes because they have lycopene Tomatoes contain lycopene, which may reduce prostate cancer risk. The other choices are all examples of functional foods, but they are not associated with prostate cancer risk. Fermented dairy products have probiotics that support gastrointestinal health. Red wine and grape juice have resveratrol, which reduces platelet aggregation. Salmon and other fatty fish have omega-3 fatty acids that reduce triglyceride levels.

A coworker brought homemade banana nut muffins to the office. The muffins are round with a pebbled top, thick walls, a shiny crust, and a crumbly interior. What caused the unpleasant texture and appearance of these muffins? Too little sugar Too much sugar Oven temperature too low Too much mixing

Correct answer: Too much sugar Variations in cakes may result from alterations in the amounts of ingredients (flour, liquid, leavening agent, salt, egg, fat, sugar) and/or oven temperatures (too low, too high). For example, too much sugar results in coarse cells, thick walls, a shiny crust, and a crumbly product, such as the coworker's banana nut muffins. Another variation is a fallen center, which may also be caused by too much sugar, or by too much fat or baking powder, poor mixing, or a low oven temperature.

Tracie is a senior manager for Synsco, a food distribution company, and she provides each of her operating units a specialized food budget for the upcoming year. What type of budget is Tracie most likely providing? Performance budget Bottom-up budget Owner's equity Top-down budget

Correct answer: Top-down budget A top-down budget is prepared by top management and given to each operating unit. A bottom-up budget is when individuals prepare their own budgets, which are then given to upper management. A performance budget details what it costs to perform a specific activity, for example, how much to resurface a kitchen. Owner's equity is the monetary value of a property or business beyond any amounts owed.

Jacob is a hired as a dishwasher at ABC Food Nations. The employer tells him he needs to join the United Food & Commercial Workers International Union within six months to retain his job. What type of union membership is this? Agency shop Union shop Open shop Closed shop

Correct answer: Union shop A union shop is a place of work where employers may hire nonunion workers who must join a labor union within an agreed-upon time. An open shop is place of work where employers are not required to join a labor union. A closed shop is a place of work where membership is required to be hired and for continued employment. This form of union is illegal in the public sector. An agency shop is a place a work where employees are not required to join the union but all workers (union or nonunion) must pay the agency fee.

Which of the following is a common energy "waster" in a foodservice operation? Switching to a room service concept where patients control food selection and delivery Chemical dilution stations and use of microfiber mops to clean walls, floors, and ceilings Use of a dishwasher at less than full capacity Elimination of mercury-containing thermometers

Correct answer: Use of a dishwasher at less than full capacity Using large foodservice equipment, such as dishwashers, at less than full capacity is one of the most common energy wasters. The other options are all actions by food and nutrition departments that can help them become more "green": elimination of mercy-containing thermometers, switching to a room service concept where patients control food selection and delivery (thereby reducing food waste), and chemical dilution stations and use of microfiber mops to clean walls, floors, and ceilings (which reduces chemical and water use).

John recently started on the anticoagulant Coumadin (warfarin). Which of the following nutrients should he avoid high intake of? Amines Vitamin K Sodium Caffeine

Correct answer: Vitamin K Vitamin K is known to antagonize the action of the anticoagulant drug Coumadin, or warfarin. Large intakes of vitamin K oppose the actions of this drug by promoting blood clotting and leading to drug resistance. Eating large quantities of vitamin-K-rich foods, such as green leafy vegetables, legumes, and liver, should be avoided. Caffeine counters the actions of tranquilizers; sodium diminishes the effects of anti-manic drugs (lithium carbonates); and amines (such as tyramine, dopamine, or histamine) interact with monoamine oxidase inhibitors (MAOIs). Gropper, S. A. S., Smith, J. L., & Groff, J. L. (2009). Advanced nutrition and human metabolism. Australia: Wadsworth/Cengage Learning.

The SWOT analysis tool would most likely be used during what type of planning? Strategic Long-range Short-range Operational

Correct answer: Strategic SWOT is an acronym for strengths, weaknesses, opportunities, and threats. It is used by organizations to identify their internal strengths and weaknesses and their external opportunities and threats. Since this analysis helps determine long-term goals and the best way to approach them, this tool is commonly used in strategic planning. Long-range planning focuses on goals and objectives, up to a five-year cycle. Short-range or operational planning focuses on the upcoming year, months, weeks, or days.

What is the phase transition that occurs in the production of freeze-dried foods? Sublimation Freezing Condensation Vaporization

Correct answer: Sublimation Freeze-dried foods are produced by removing water from a frozen product. During this process, frozen liquid transforms directly to a gaseous state without passing back through the liquid phase. When matter changes from one state to another it is called a phase transition, and this solid-to-gas phase transition is known as sublimation. Gas-to-liquid phase transitions are known as condensation. Liquid-to-solid phase transitions are known as freezing. Liquid-to-gas phase transitions are known as vaporization.

Josh is an independent sales professional who sells for multiple wholesale manufacturers and works entirely on commission. Which position does he most likely hold? Food vendor Purchasing agent Food broker Food service buyer

Correct answer: Food broker A food broker is an independent sales professional who usually sells for multiple wholesale manufacturers and works entirely on commission. Brokers do not take title to the goods being sold. A food vendor is a supplier (may be an individual or a company) that sells goods or services to someone else. They do take title to the goods being sold. Purchasing agent or food service buyer is the position concerned with obtaining the right amount of product at the right time.

A dietitian was asked by a preschool teacher to come and speak to the students about healthy eating. Based on the age group, which of the following would be an appropriate teaching method? Problem-solving discussions Food models Cooking demonstrations Goal setting

Correct answer: Food models The learning capabilities of preschoolers relate to basic connections and sensory experiences with food; therefore, the best teaching method for preschoolers would involve playing with food or using food models. Problem-solving discussions would be better for school-aged children, goal setting for adolescents, and cooking demonstrations for adults.

Which of the following nutrients is added to enriched flour? Potassium Biotin Folic acid Protein

Correct answer: Folic acid Nutrients added to enriched flour include thiamin, riboflavin, niacin, iron, and folic acid. Protein, potassium, and biotin may be in flour, but they are not added separately.

Calculate the selling price of the menu item below using the prime-cost method. Raw food cost of pizza: 0.76 Hidden costs: 10% Markup factor: 1.75 Labor cost of 15 minutes at $11.00/hr $6.15 $6.51 $4.27 $3.04

Correct answer: $6.15 To calculate the selling price of the menu item using the prime-cost method: 0.76 (raw-food cost) + 2.75 (labor cost of 15 minutes at $11.00/hr.) = 3.51 3.51 x 1.75 (markup factor) = 6.1425 or 6.15

Last month, the food costs for a nursing home facility were $23,078, inventory turned over 3.2 times that month, food cost per meal was $6.75, and 1,678 meals were served. What was the average inventory cost? $0.636 $6.52 $73,850 $7,212

Correct answer: $7,212 To solve: Equation: Inventory turnover rate = food costs / average inventory costs Plug in numbers: 3.2 = $23,078 / X Solve for X: X = $23,078 / 3.2 Average inventory costs = $7,211.875 = round to ~$7,212 Food cost per meal and number of meals served are not needed to solve for average inventory costs.

How much will it cost to prepare 8 servings of gumbo using the ingredients below? 12 lbs of sausage at $3.39/lb 1 gallon of fish stock at $.45/quart 6 lbs of okra at $.27/oz 18 oz of beans at $1.99/lb $49.61 $70.64 $78.57 $48.80

Correct answer: $70.64 First, convert ingredients to similar units and determine prices: 12 lbs of sausage at $3.39/lb: 12 lbs x $3.39 = $40.68 1 gallon of fish stock at $.45/quart: 4 qts / 1 G = 4 qts x $.45 = $1.80 6 lbs of okra at $.27/oz: 6 lbs x 16 oz = 96 oz x $.27 = $25.92 18 oz of beans at $1.99/lb: 18 oz / 16 = 1.125 lb x $1.99 = $2.24 Second, add the costs together: $40.68 + $1.80 + $25.92 + $2.24 = $70.64

A cafeteria spent 51.3% of their income on food last month. The total food cost for the month was $4,322. What was the total cafeteria income last month? $22,1718.60 $2,217.19 $84.25 $8,424.95

Correct answer: $8,424.95 The food cost report, or food cost percentage, tells you the amount of income that was spent on food sold. To solve for food cost percentage, the total food cost is divided by the total income. To solve: 51.3% (food cost percentage) = $4,322 (food costs) / X (income) 51.3 / 100 = 4,322 / X X = 4,322 / 0.513 X = income = $8,424.95

Based on the numbers below, determine the cost of food used. Beginning inventory: $1,567 Ending inventory: $2,985 Purchases: $10,327 Sales: $24,674 Sales tax: $1,401 Operating expenses: $3,861 $14,872 $11,894 $8,909 $13,305

Correct answer: $8,909 In a profit and loss statement, the cost of food used is determined by adjusting the cost of food purchased at the beginning and ending inventories for the month. To solve: Purchases + beginning inventory = cost of goods available to be used Cost of good available to to be used - ending inventory = cost of goods used Plug in numbers: $10,327 + $1,567 = $11,894 $11,894 - $2,985 = $8,909 The other variables are not needed to solve for cost of goods used.

Sally is a 5'5" female and she states that she usually weights 125 lbs. When she weighs in at the doctor's office today, she weighs 114 lbs. What is her percentage weight change? +11% +8.8% -8.8% -11%

Correct answer: -8.8% Usual body weight (UBW) is how much an individual usually weighs, and current or actual body weight (CBW/ABW) is how much an individual weighs now. To assess the significance of weight change, the percentage weight change (% wt change) can be found by the following formula: [(UBW - ABW) / UBW] x 100. In our example, [ (125 - 114) / 125 ] x 100 = 8.8% weight loss Sally's percentage weight change is -8.8%.

Which of the following is equal to 1 ounce-equivalent protein food? 1 large egg 1 slice of bread 2 tablespoons of peanut butter 1-oz. portion of walnuts

Correct answer: 1 large egg Portion sizes do not always align with one cup or one ounce-equivalent, due to variations in foods' concentration and water content. For example, 1 large egg is equal to 1 ounce-equivalent protein food. Two tablespoons of peanut butter is equal to 2 ounce-equivalent protein foods; a 1-oz. portion of walnuts is equal to 2 ounce-equivalent protein foods; 1 slice of bread is equal to 1 ounce-equivalent grain.

What is the storage time for refrigerated, whole fresh poultry? 3 to 5 days 1 week 1 to 2 days 3 to 4 months

Correct answer: 1 to 2 days The storage time for refrigerated fresh poultry (chicken or turkey, whole or pieces) is 1 to 2 days, and the freezer time is one year for whole chicken or turkey. The storage time for refrigerated fresh beef, veal, lamb and pork is 3 to 5 days. The freezer time for hamburger and other ground meats is 3 to 4 months.

What is the RDA of calcium for women over the age of 51? 1,300 mg 1,200 mg 1,000 mg 700 mg

Correct answer: 1,200 mg The RDA for calcium varies based on age, sex, and pregnancy/lactation. For women over 51 years of age, the RDA is 1,200 mg. Other calcium RDAs are 700 mg for 1- to 3-year-olds (male/female), 1,000 mg for 4- to 8-year-olds (male/female), and 1,300 mg for 14- to 18-year-olds (male/female) or during pregnancy or lactation.

Susie has a BEE of 1,050 kcals. She goes on a 30-minute walk three times per week and considers herself active. What is her TDEE when activity factor is applied? 1,260 kcals 1,050 kcals 1,575 kcals 1,365 kcals

Correct answer: 1,365 kcals Total Daily Energy Expenditure (TDEE) accounts for basal energy expenditure (BEE) plus additional activity, known as activity factor (AF). Activity factor ranges from sedentary (BEE x 1.2) to active (BEE x 1.3) to stress (BEE x 1.5). To determine Susie's TDEE: 1,050 (BEE) x 1.3 (active AF) = 1,365 kcals (TDEE)

The clinical nutrition service manager is developing a two-week schedule for her team of 22 clinical dietitians. This schedule shows each employee's on and off days, vacation days, and notes if they have additional responsibilities on a certain day (such as if they are precepting a dietitian intern). What type of work schedule serves as the overall plan for developing this weekly schedule? Shift Production Organizational chart Master

Correct answer: Master The master work schedule serves as the basis for developing weekly schedules; it includes employees' on and off days and vacation days and can indicate additional responsibilities. The shift schedule shows staffing patterns for shift workers and includes shift overlap, shift changes, vacation days, training, shift differentials, and holidays. The production schedule is a plan showing employee assignments and tells an employee what to do when. The organizational chart is a graphical representation of how employees fit into an organization.

A woman is admitted to the hospital with pneumonia and a high fever (102.6°). She is 26 years old, 5 feet 5 inches, and 125 pounds. What is her likely RMR? 1,784 kcals 1,136 kcals 1,393 kcals 1,420 kcals

Correct answer: 1,784 kcals Resting metabolic rate (RMR) is a way of measuring energy balance and uses the predictive equations of Mifflin-St. Jeor or Harris-Benedict. The Harris-Benedict equation is as follows: Men: 66.47 + 13.75(W) + 5(H) - 6.76(A) and women: 655.1 + 9.56(W) + 1.7(H) - 4.7(A), where weight (W) is in kilograms (kg), height (H) is in centimeters (cm), and age (A) is in years. In this example using the Harris-Benedict equation, the RMR is 1,393 kcals. However, due to her fever (102.6°), her RMR increases 7% for each degree rise in temperature over normal (98.6°). To account for the fever, 102.6 - 98.6 = 4 degrees over normal x 7% for each degree = 28% increase in RMR x 1,393 kcals = 390 additional kcals + 1,393 kcals = 1,784 kcals.

A female patient is 65 inches tall and weighs 130 pounds. She is receiving a TPN of D5W at 100 mL/hr/day. What is her GIR? 3.4 mg/kg/min 0.14 mg/kg/min 1.4 mg/kg/min 14 mg/kg/min

Correct answer: 1.4 mg/kg/min Glucose infusion rate (GIR) is a measure of how quickly the patient receives carbohydrates. The maximum rate should not exceed 4-6 mg/kg/min (or max 0.36 grams dextrose/kg/hr) to prevent hyperglycemia and steatosis. To determine GIR, simply convert the units into mg/kg/min. To solve: GIR = IV Rate (mL/hr) * Dextrose Conc (g/dL) * 1000 (mg/g) Weight (kg) * 60 (min/hr) * 100 (mL/dL) Add in the variables: GIR = 100 (mL/hr) * 5 (g/dL) * 1000 (mg/g) 59 (kg) * 60 (min/hr) * 100 (mL/dL) GIR = 1.4 mg/kg/min

Determine the popularity index for cookies on Sunday based on the sales information below: Friday: 76 bagels, 135 black coffees, 94 lattes, and 24 cookies Saturday: 66 bagels, 102 black coffees, 72 lattes, and 14 cookies Sunday: 55 bagels, 98 black coffees, 68 lattes, and 4 cookies 9.52 0.49 1.77 1.81

Correct answer: 1.77 Popularity index is used to analyze and predict sales. The following equation is used: number of servings of an item divided by total number of servings of all items offered that day. Determine the popularity index for cookies on Sunday: 4 / (55 + 98 + 68 + 4) = 0.0177 Multiply by 100 to convert to percentage for popularity index: 0.0177 x 100 = 1.77

Determine the break-even point for Christy's Cafeteria based on the following information: Total fixed costs = $22,250 Variable costs per average-priced meal = $2.60 Selling price per average-priced meal = $4.75 4,684 10,348 2.15 49,444

Correct answer: 10,348 The break-even point (BE) is the point where expenses (fixed costs [FC] and variable costs [VC]) and revenue (income) are equal. To solve for BE, use one of the following methods: BE in number of units sold (use to determine the number of units that need to sell to break even) = FC / Sales - VC BE in sales volume (use to determine the number of dollars that need to be earned to break even) = FC / 1- (VC/Sales) This question is asking for the number of units (meals) that need to be sold to break even, so method #1 should be used: 22,250 / 4.75 - 2.60 = 10,348 BE = 10,348 average-priced meals To break even, Christy's Cafeteria needs to sell 10,348 averaged-priced meals. If they sell less

What is the % IBW for a 6'2" male who weights 206 pounds? 190% 108% 92.2% 1.08%

Correct answer: 108% Ideal body weight (IBW) is an anthropometric measure based on height to determine how much an individual should weigh. IBW is determined for males with the following formula: 106 lbs. for the first 5 feet plus 6 lbs. for each additional inch. In our example, 106 lbs. + (6 lbs. x 14 inches) = 190 lbs. Percentage ideal body weight (% IBW) is an anthropometric measure that determines if an individual is above or below their ideal body weight. % IBW is determined by the following formula: actual body weight / ideal body weight. For example, 206 lbs. / 190 lbs. = 1.08 x 100 = 108%.

An American restaurant has 8 full-time employees, 6 part-time employees, and 4 twelve-hour employees. How many FTEs does the restaurant have? 8 11.3 12.2 18

Correct answer: 12.2 A full-time equivalent (FTE) is the hours worked by one employee on a full-time basis. An FTE is considered to be an 8-hour work day, a 40-hour work week, or 2,080 hours per year. To solve: (8 x 40) + (6 x 20) + (4 x 12) = 488 488 / 40 = 12.2 FTEs

What is the estimated IBW for a 5'4" male with a right BKA? 122.2 lbs. 106 lbs. 130 lbs. 117.8 lbs.

Correct answer: 122.2 lbs. Ideal body weight (IBW) is an anthropometric measure based on height to determine how much an individual should weigh. IBW is determined for males with the following formula: 106 lbs. for the first 5 feet plus 6 lbs. for each additional inch. For example, 106 lbs. + (6 lbs. x 4 inches) = 130 lbs. To determine estimated ideal body weight for people with amputations, the percentage body part amputation must be subtracted. In our example of a BKA (below knee amputation), 100 - 6% BKA = 94% x 130 lbs. = 122.2 lbs.

A company has 80 full-time positions. How many total employees are necessary for everyday coverage, including FTEs and relief workers? 124 168 44 80

Correct answer: 124 Full-time employees (FTEs) typically work 236 days per year due to days off and benefits days (129 days) and a relief worker covers days off for the FTE. About 1.55 employees are required for the daily coverage of a full-time position. To determine the total number of employees needed: Method 1: Multiply 1.55 by the number of full-time positions: 1.55 x 80 = 124 Method 2: Multiply 0.55 by the number of full-time positions: 0.55 x 80 = 44 relief workers + 80 = 124

John's food log shows he ate 1,900 calories yesterday. Of those calories, 800 came from carbohydrates and 66 gm came from fat. How many grams of protein did John consume yesterday? 506 209 126.5 92.8

Correct answer: 126.5 To solve: Calculate the calories of fat consumed: 66 gm fat x 9 gm fat/kcals = 594 kcals from fat Determine remaining calories for protein: 1,900 kcals - 800 kcals (CHO) - 594 kcals (FAT) = 506 kcals (PRO) Convert protein calories to grams: 506 kcals / 4 gm of protein/kcal = 126.5 gm protein

From 2016 to 2017, a meal prep company fired and replaced 6 employees out of their total of 45 employees. What is the employee turnover rate? 0.133% 15% 7.5% 13.3%

Correct answer: 13.3% Employee or labor turnover rate is the number of employees terminated and replaced during an annual time period in a company, expressed as a percentage. The rate can be determined by the following: (Number of employees fired and replaced / Total number of positions in a company) x 100 In this scenario: 6 / 45 = 0.133 x 100 = 13.3%

Over the course of one year, during a research study, 63 women are diagnosed with breast cancer and 21 women die of breast cancer, out of a total female population of 450. At the beginning of the study, 0 out of 450 women had breast cancer. What is the incidence rate? 4.6% 9.3% 14% 33.3%

Correct answer: 14% Incidence is the measure that allows you to determine a person's probability of being diagnosed with a disease during a given time period. An incidence rate is the number of new cases of a disease over a period of time divided by the number of persons at risk for the disease. In our example, there are 63 new diagnoses of breast cancer out of a total population of 450. The incidence rate is 63 new cases / 450 total number of people at risk = 0.14 x 100 = 14%.

Fish and shellfish should be cooked to what minimum internal temperature? 145°F (62.8°C) 165°F (73.9°C) 160°F (71.1°C) 140°F (60°C)

Correct answer: 145°F (62.8°C) Fish and shellfish should be cooked to a minimum internal temperature of 145°F (62.8°C). Fully cooked ham (to reheat; not packed in USDA-inspected plants), leftovers, and casseroles should be cooked to a minimum internal temperature of 165°F (73.9°C). Ground meats and eggs should be cooked to a minimum internal temperature of 160°F (71.1°C). Fully cooked hams (to reheat) packed in USDA-inspected plants should be reheated to a minimum internal temperature of 140°F (60°C).

Stacy is 5'5" and weighs 160 lbs. If she were to get pregnant, how much weight should she gain during her pregnancy? 25-35 lbs 11-20 lbs 15-25 lbs 28-40 lbs

Correct answer: 15-25 lbs Stacy has a BMI of 26.6 and is considered overweight. Overweight females (BMI 25-29.9) should gain 15-25 lbs during their pregnancy. Weight gain guidelines for normal-weight females (BMI 18.5-24.9) is 25-35 lbs, for underweight females (BMI < 18.5), 28-40 lbs, and for obese females (BMI ≥ 30), 11-20 lbs.

A three-month weight-loss program provides 1:1 nutrition counseling, meal planning, and workout regimens for ten participants. After the three-month program, the participants weighed in; their weight loss during the program is shown below. Determine the mean and median, respectively. Pounds of weight lost: 12, 7, 29, 9, 31, 5, 23, 22, 9, 9 10.5; 15.6 15.6; 10.5 10.5; 9 9; 31

Correct answer: 15.6; 10.5 The mean is the simple average of the total scores and is calculated by adding all of the values, then dividing by the number of values. For example, 5 + 7 + 9 + 9 + 9 + 12 + 22 + 23 + 29 + 31 = 156 / 10 = 15.6. The median is the value at the midpoint and is found by arranging the values in numerical order, then finding the number at the exact center. However, if there is an even number of values, the median is the average of the two numbers closest to the center. For example, 5, 7, 9, 9, 9, 12, 22, 23, 29, 31 --> 9 + 12 / 2 = 10.5.

A farmer's market stand used 5 cases of peaches on Monday, 3 cases on Tuesday, and 2 cases on Wednesday. The stand keeps 2 cases as safety stock, and it takes four days from placing the order to receive the delivery. What is the order point for peaches? 2 16 20 27

Correct answer: 16 The order point helps you determine when you must reorder an item based on average daily use, lead time, and safety stock. This can be calculated with the following equation: (average daily use) (lead time) + safety stock To solve: Determine average daily use: (5+3+2) / 3 = 3.33 Plug in variables: (3.3) (4) + 2 = 15.33 Round up to 16

If 550 customers are expected at the little league baseball game next Thursday, how many servings of nachos should the park prepare? 128 166 30.17 70

Correct answer: 166 To forecast future needs, use the popularity index (Number of servings of an item / Total number of servings of all items that day) and multiply it by expected number of servings/customers (Forecast of future needs). To solve: Determine the popularity index: 70 / (76 + 86 + 70) = 70 / 232 = 0.3017 x 100 = 30.17% Forecast future needs: 550 x 0.3017 = 165.935 --> 166 30.17% of 550 excepted customers = 166 nachos

An infant is born at 29 weeks gestation. If her actual age is now 7 months, what is her adjusted or corrected age? 7 months 11 weeks 17 weeks 3 months

Correct answer: 17 weeks Normal gestation is approximately 40 weeks. Corrected, or adjusted, age corrects for the baby's prematurity and is calculated by subtracting the number of weeks premature from the chronological age. The formula is actual age - weeks premature = correct or adjusted age. In our example, 28 weeks (actual age) - 11 weeks (weeks premature) = 17 weeks (corrected age). Actual age, or the baby's chronological age, is the number of days, weeks, months or years today is from his or her actual date of delivery, or birthday. For example, the infant's actual age is 7 months (or 28 weeks). Premature weeks is calculated by subtracting the number of weeks early from normal gestation. For example, 40 weeks normal gestation - 29 weeks early = 11 weeks premature.

In which trimester of gestation is folate supplementation most important? Lactation 1st trimester 3rd trimester 2nd trimester

Correct answer: 1st trimester Folate supplementation is most important during the first trimester because neural tube defects form in the first 18 days after conception. The recommended amount of folate (folic acid) is 600 mcg during pregnancy, with 400 mcg coming from supplements and 200 mcg from foods. Iron is important during the second and third trimesters of pregnancy. Vitamin D and fluoride are important for infants during lactation.

Joyce is a 46-year-old female patient with cirrhosis. During a physical exam, the RD presses her thumb 4-5 mm into Joyce's right leg. In 10-15 seconds the depression disappears. What grade of edema does Joyce most likely have? 1+ mild pitting edema 2+ moderate pitting edema 3+ moderately severe pitting edema 4+ severe pitting edema

Correct answer: 2+ moderate pitting edema Edema is swelling caused by fluid retention, which can be caused by diseases such as cirrhosis and congestive heart failure. The stages of edema are as follows: 0+ no pitting edema 1+ mild pitting edema: 2 mm depression disappears rapidly 2+ moderate pitting edema: 4 mm depression disappears in 10-15 secs 3+ moderately severe pitting edema: 6 mm depression that lasts more than 1 min 4+ severe pitting edema: 8 mm depression that lasts more than 2 min

The food cost for April is $19,867 and the average inventory cost is $8,555. What is the inventory turnover rate? 2.0 2.3 0.43 43%

Correct answer: 2.3 The inventory turnover rate demonstrates how effectively an organization is utilizing its assets. To determine inventory turnover rate, divide the cost of sales (food cost) by average inventory food costs. A turnover rate between two and four times per month is often desirable; high ratios indicate limited inventory and/or good sales, and low ratios indicate excessive inventory and/or poor sales. To solve: 19,867 / 8,555 = 2.322 = the inventory turned over 2.3 times in April.

Eighteen FTEs produced 1,990 meals during a 40-hour week. How many meals were produced per labor hour? 0.36 meals per labor hour 14.47 meals per labor hour 2.76 meals per labor hour 0.069 meals per lbor hour

Correct answer: 2.76 meals per labor hour Meals per labor hour = # meals produced / # hours worked To solve: 18 FTEs x 40 hours = 720 hours 1,900 meals / 720 hours = 2.76 meals per labor hour

How many relief employees do you need if you have 40 full-time employees? 22 42 62 72

Correct answer: 22 About 1.55 employees are needed for the everyday coverage of a full-time employee, or full-time equivalent (FTE). A relief worker covers days off for the FTE. FTEs typically work 236 days per year due to days off and benefits days, which add up to 129 days. To determine the actual number of relief workers needed, multiply the number of FTEs by 0.55 (129/236) to get the number of relief workers needed to cover 365 days per year. To solve: 40 FTEs x 0.55 = 22 relief workers

Kate is a female who is 165 cm. tall and weighs 133 lbs. What is her BMI? 22.1 31.4 23.3 24.5

Correct answer: 22.1 Body mass index (BMI) is the ratio of weight to height. To determine BMI, use the following formula: wt (kg) / ht^2 (m) OR wt (lbs) / ht^2 (in) x 703. To solve our example, first convert 165 cm. into inches (165 cm. / 2.54 in. = 65 in.) Then, (133 lbs / 65 in. x 65 in.) --> (133 / 4225) x 703 = 22.1 BMI.

How much daily fiber does a 10-year-old require? 26 grams 1300 mg 34 grams 10 grams

Correct answer: 26 grams The Adequate Intake (AI) for daily total fiber is: 31 grams for 9- to 13-year-old males 26 grams for 9- to 13-year-old females The RDA for protein for males and females ages 9 to 13 is 34 grams. The AI for calcium for males and females ages 9 to 13 is 1300 milligrams.

How many 4-ounce cooked servings can you make from 9 pounds of fish with 25% shrinkage? 9 17 20 27

Correct answer: 27 To solve: Determine waste: 9 lbs raw x 0.25 shrinkage = 2.25 lbs lost in cooking Determine edible portion: 9 lbs - 2.25 lbs = 6.75 lbs remaining Convert to ounces: 6.75 lbs x 16 oz = 108 oz Determine how many portions can be made: 108 oz / 4 oz = 27 portions

According to the RDA for protein, how many calories of protein should a diet provide for a 195.8-pound person? 250 285 356 71.2

Correct answer: 285 The RDA for protein is 0.8 grams per kilogram of body weight (10-15% of total energy intake) per day. To find the recommended number of protein calories per day for the 195.8-pound person: Convert pounds to kilograms: 195.80 pounds / 2.2 kilograms = 89 kg Calculate the required protein grams: 89 kg x 0.8 grams protein/kg body weight = 71.2 grams protein Convert grams to calories: 71.2 grams protein x 4 (4 calories/1 gram protein) = 284.8 calories ~ 285 protein calories per day

View the supporting details to answer the following question. Which number on the graph correlates with the break-even point?

Correct answer: 3 On a graph, the break-even point (BE) is the point where the total cost line crosses the sales line. Based on the BE, if the income is less than this point there is a loss (#2); if the income exceeds this point there is a profit (#4).

A deli shop has a par level of 10 cases for Swiss cheese, and they have 7 cases right now. Each day the deli uses about 6 cases of cheese, 3 cases are needed for the safety stock, and the lead time for the delivery is 3 days. Using the par stock method, how many cases of Swiss cheese should the deli shop order? 3 4 15 21

Correct answer: 3 Par stock determines how much of an item to order based on typical usage of the product. Therefore, the stock is brought up to the par level each time an order is placed regardless of how much is on hand. To solve: 10 (par level) - 7 (amount on hand) = 3 (order) The other choices provide information based on the fixed order quantity inventory system, which determines the order point (when an item should be reordered) based on its average daily use, lead time, and safety stock.

During food inventory, there are four #10 cans of applesauce reported. How many gallons of applesauce are there? 3.25 3.72 13 52

Correct answer: 3.25 A #10 can holds 13 cups. Since there are four #10 cans reported, 4 cans x 13 cups = 52 cups. There are 16 cups in one gallon, so 52 cups / 16 cups = 3.25 gallons. There are 3.25 gallons of applesauce in four #10 cans.

At the end of a 12-month period, a nutrition consulting practice has an 8.5% turnover rate and 40 positions in the department. How many employees were terminated and replaced? 2.55 3.4 4.7 0.825

Correct answer: 3.4 The labor turnover rate is the ratio of employees who leave a company to the total number of employees on the payroll during a given period. Labor turnover rate is found by dividing the number of employees terminated and replaced into the total positions in a department, then multiplying by 100 to get a percentage. To solve for the number of employees terminated and replaced: X (number of employees terminated and replaced) / 40 positions = 8.5% turnover rate / 100 X / 40 positions = 0.085 turnover X = 0.085 turnover x 40 positions X = 3.4 employees terminated and replaced

Which nutrition prescription would be most appropriate for a stressed patient with cirrhosis and ascites? 15-20 kcals/kg, 0.8 g protein/kg 30-35 kcals/kg, 2.0 g fat/kg, 3.0L fluid restriction 25 kcals/kg, 0.8-1.0 g protein/kg 30-35 kcals/kg, 2.0 g protein/kg, 1.5L fluid restriction

Correct answer: 30-35 kcals/kg, 2.0 g protein/kg, 1.5L fluid restriction The most appropriate nutrition prescription for a stressed patient with cirrhosis and ascites is a high-calorie, high-protein, fluid-restricted diet. A stressed patient requires more calories (30-35 kcals/kg) to provide energy for the hypermetabolic state, cirrhosis requires high protein (2.0 g protein/kg) to help prevent fatty liver and spare protein, and fluid restriction (1.5L) to help reduce edema and fluid retention. The other answer choices do not provide the appropriate high-calorie, high-protein, and fluid-restricted nutrition prescription.

Which individual is at the least risk for acquiring a food-borne illness? 6-year-old boy with dental cavities 26-year-old healthy pregnant woman 67-year-old female with osteoporosis 30-year-old obese male with type 1 diabetes

Correct answer: 30-year-old obese male with type 1 diabetes Groups at the greatest risk for food-borne illness include the following: Older adults (age 65 or older) Pregnant women and their fetuses Infants and young children Immune-compromised individuals Individuals with acquired immune deficiency syndrome Food safety practices are especially important for these high-risk groups. It is the role of the registered dietitian to provide nutrition education and resources on food safety to high-risk groups, with the goal of minimizing illness.

You are looking at a sample population of 175 people and want to determine the prevalence rate of developing AIDS over a 12-year period. At the beginning of the study, you note 12 existing cases of AIDS. The first follow-up at 6 years notes 15 new cases of HIV. The second follow-up at 12 years notes 28 new cases. What is the prevalence rate? 25% 377% 31% 45%

Correct answer: 31% Prevalence is the number of existing cases of a condition or disease in a given population. To measure prevalence rate, take the total number of cases (12 + 15 + 28 = 55) and divide by the sample population (175). Therefore, prevalence would be 55/175 = 0.31, or a 31% prevalence rate.

Which individual would be most likely eligible to apply for Medicare Part A? 25-year-old pregnant female 64-year-old blind female 34-year-old male with ESRD 60-year-old male with a BMI >30

Correct answer: 34-year-old male with ESRD Medicare is a health insurance program for people over 65 and/or of any age with end stage renal disease (ESRD). Medicare Part A provides hospital insurance. Medicare Part B provides optional insurance for supplementary benefits, such as doctor visits, test, and procedures. Medicaid provides payment for medical care for the eligible needy of all ages, the blind, the disabled, and dependent children. For example, Medicaid would provide assistance to a pregnant woman, a minor/teenager living alone, and/or someone aged/blind/disabled.

Kaitlin is opening a neighborhood craft coffee shop, and she desires a 25% food-cost percentage. What should her markup factor be? 4 2.5 0.25 25

Correct answer: 4 The markup is determined by dividing the desired food-cost percentage into 100, which represents total sales, or 100%. The resulting figure is known as the markup factor. To illustrate: a foodservice operation that wishes to maintain a 25% (of income) food cost, 100 (total sales) / 25 (percentage of income for food) = 4 (markup factor).

The scoop size #12 is roughly equivalent to all of the following except which measurement? 4 Tbps 2-3/4 oz 1/3 cup 79 mL

Correct answer: 4 Tbps The scoop size #12 is roughly equivalent to all of the following measurements: 1/3 cup, 2-3/4 oz, and 79 mL. To determine the number of ounces in a scoop, divide the scoop number into 32. Then, convert to additional measurements (1 oz = 2 Tbsp = 0.15 cups = 29.5 mL) The scoop size #16 is equivalent to 4 Tbsp.

In a 2007 study, 115 of the 260 men had diabetes and 75 of the 115 diabetic men died during the ten-year follow-up period. Calculate the morbidity rate for these men. 65.21% 28.85% 32.71% 44.23%

Correct answer: 44.23% Morbidity is the rate of disease. So in this case, the morbidity rate is 115 cases of diabetes / 260 total men = 0.4423 x 100 = 44.23%. Mortality is the rate of death. For example, the mortality rate is 75 deaths / 115 diabetic men = 0.6521 x 100 = 65.21%.

A lunch includes the following: sandwich (1 slice of white bread, 3 ounces of low-sodium turkey breast, 1 ounce of cheese) and 1 medium banana with 2 tbsp peanut butter. Using the carbohydrate exchange, how many calories and grams of protein does the meal provide? 54 g PRO, 601 kcals 75 g PRO, 700 kcals 35 g PRO, 300 kcals 45 g PRO, 610 kcals

Correct answer: 45 g PRO, 610 kcals Using the carbohydrate exchange, the lunch meal includes: 1 slice white bread = 1 starch/bread serving = 3 g PRO, 80 kcals 3 oz turkey = 3 lean protein servings = 21 g PRO, 135 kcals 1 oz cheese = 1 medium-fat protein serving = 7 g PRO, 75 kcals 1 medium banana = 2 servings fruit = 0 g PRO, 120 kcals 2 tbsp peanut butter = 2 servings high-fat protein = 14 g PRO, 200 kcals TOTAL PROTEIN = 3 + 21 + 7 + 0 + 14 = 45 g PRO TOTAL KCALS = 80 + 135 + 75 + 120 + 200 = 610 kcals The Diabetic Exchange List: http://glycemic.com/DiabeticExchange/The%20Diabetic%20Exchange%20List.pdf

Which of the following persons would most likely have hypercalcemia? 72-year-old male with hypoparathyroidism 45-year-old male with stage IV gastric cancer with bone metastasis 24-year-old female with an acute kidney injury complicated by hyperphosphatemia 32-year-old female with cirrhosis complicated by hypoalbuminemia

Correct answer: 45-year-old male with stage IV gastric cancer with bone metastasis Calcium is increased with hyperparathyroidism and bone metastasis; it is decreased with hypoalbuminemia, hyperphosphatemia, renal failure, and hypoparathyroidism.

How much more exercise per week (at minimum) does a 16-year-old require compared to a 36-year-old? 1.25 hours 7 hours 5.75 hours 2.5 hours

Correct answer: 5.75 hours It is recommended that people from 6 to 17 years of age do 60 minutes or more of physical activity daily. The recommendation for 18- to 64-year-olds is at least 150 minutes (2.5 hours) a week of moderate-intensity or 75 minutes (1.25 hours) a week of vigorous-intensity aerobic activity, or an equivalent combination of moderate- and vigorous-intensity aerobic activity. To determine how much more exercise the 16-year-old requires compared to the 36-year-old: The 16-year-old requires, at minimum, 1-hour x 7 days = 7 hours total per week The 36-year-old requires, at minimum, 1.25 hours of vigorous-intensity exercise per week 7 hours - 1.25 hours = 5.75 hours

What is the appropriate temperature range for a dry storage area? 50 - 70°F 85 - 90°F 32 - 40°F 77 - 86°F

Correct answer: 50 - 70°F 50 - 70°F is the recommended temperature range for dry storage. 32 - 40°F is the recommended temperature range for refrigerated meat, dairy, and eggs. 85 - 90°F is a distractor; 85 - 90 percent is the recommended humidity range for fresh fruits and vegetables. 77 - 86°F is the temperate range that molds and yeasts grow best in.

How many mEq are in 1 gram of calcium? 50 mEq 25 mEq 40 mEq 43.5 mEq

Correct answer: 50 mEq To convert from grams to mEq, use the following equation: mEq = (mg / atomic weight) x valence. Calcium (Ca) has an atomic weight (AW) of 40 and a valence of 2. To solve for mEq: (1000 mg / 40 AW) x 2 valence = 50 mEq

How many milligrams of potassium are in 13 mEq? 33 mg 3 mg 39 mg 507 mg

Correct answer: 507 mg To convert from mEq to milligrams, start with the following base equation: mEq = (mg / atomic weight) x valence. Potassium (K+) has an atomic weight (AW) of 39 and a valence of 1. Start by plugging in your available numbers and solve for X: (X mg / 39 AW) x 1 valence = 13 mEq 13 mEq / 1 valence = X mg / 39 AW X = 507 mg

On average, a deli shop uses 12 packages of roast beef each day; four packages are needed for the safety stock, and the lead time for the delivery is four days. What is the order point for roast beef? 44 4 28 52

Correct answer: 52 A fixed order quantity inventory system determines the order point (when an item should be reordered) based on its average daily use, lead time (number of days from placing the order until it is received), and safety stock (backup supply of the item for higher volumes of use). The equation is (average daily use x lead time) + safety stock. To solve: [ 12 (average daily use) x 4 (lead time) ] + 4 = 52 When the supply of roast beef drops to 52 packages, it is time to reorder this item.

You purchase a 26-lb. turkey at $0.54/lb. The raw purchase price is $14.04. After deboning and cooking, the edible portion is 14.3 lbs. What is the yield? 55% 18% 3.84% 98%

Correct answer: 55% To determine yield, divide the edible portion (EP) by the as-purchased portion (AP) and multiply by 100 to convert to a percentage. To solve: 14.3 (EP) / 26 lbs (AP) = 0.55 x 100 = 55%

Greg is a marathon runner who weighs 63 kilograms and is 65 inches tall. During his last marathon, he lost 3.5 pounds of sweat. How much fluid should he have drunk during the race? 84 oz 56 oz 63 oz 3.5oz

Correct answer: 56 oz. During endurance exercise, athletes should replace 100% of fluids lost during moderate to vigorous activity. For example, Greg lost 3.5 pounds (3.5 pounds = 56 ounces) so he should have drunk 56 oz. of fluid to replace 100% of his loss. The amount of fluids required during exercise can increase for high heat, high altitude, and/or high humidity situations. After endurance exercise, athletes should replace 100-150% of fluids lost during moderate to vigorous activity with carbohydrates and electrolytes (Na) to rehydrate. For example, Greg lost 3.5 pounds during exercise so he should drink 84 oz. to replace 150% of his losses (3.5 pounds = 56 ounces x 1.5 = 84 oz.).

What is the minimum amount of time recommended for a newborn baby to be exclusively breastfed? 6 months 1 month 1 year 3 months

Correct answer: 6 months Exclusive breastfeeding, or breastfeeding only, is recommended for at least the first 6 months of life, followed by continued breastfeeding with appropriate complementary foods beginning at 6 months (WHO, 2003). Breastfeeding should continue for at least one year as long as mutually desired by mother and child. https://www.nutritioncaremanual.org/topic.cfm?ncm_category_id=12&lv1=255490&ncm_toc_id=255490&ncm_heading=&

What factor indicates that a newborn is getting adequate nourishment? Fewer than 8 feedings per day 6-8 wet diapers a day Slow weight gain during first three months, rapid weight gain thereafter Sleeping more than two hours at a time

Correct answer: 6-8 wet diapers a day Indications of adequate nourishment include at least 6 wet diapers and 3-4 defecated diapers a day. Also, the baby should be alert and responsive, nursing every 1½ to 2 hours, and experiencing rapid weight gain during the first three months with a gradual decrease throughout the first year. Slow Weight Gain vs Failure to Thrive (Lawrence, 2011)

In a community of 680 people, 350 of those people were living with osteoporosis. Five years later, 120 more people were diagnosed with osteoporosis. What is the prevalence rate of osteoporosis in this community? 1.76% 69.11% 51.47% 33.8%

Correct answer: 69.11% Prevalence is a measure of disease that allows you to determine a person's likelihood of having the disease. A prevalence rate is the total number of people with a disease during a time period, divided by the total population. Since 120 were recently diagnosed with osteoporosis and 350 were already living with osteoporosis, there are 470 people living with the disease during the time period of the study. To find the prevalence rate, divide 470 (total number of people with osteoporosis) by 680 (total number of people) to get 0.6911. Multiply by 100 to get 69.11%.

The structure of linoleic acid is written as C18:2ω6. Where is the first double bond located? At the carboxyl group 6th carbon 18th carbon 2nd carbon

Correct answer: 6th carbon Fatty acid structures are composed of a straight hydrocarbon chain with a methyl group (CH3) at one end and a carboxyl group (COOH) at the other terminating end. They are classified by the number of carbons in the chain, the position of the first double bond, and the number of double bonds. The location of the first double bond is counted from the methyl end and is designated by the omega sign (ω). For example, linoleic acid structure (C18:2ω6) tells us that there are 18 carbons, 2 double bonds, and the first double bond is located at the 6th carbon.

What is the minimum number of additional competencies that ACEND requires a program to have to supports its emphasis area? 3 5 7 Not established

Correct answer: 7 ACEND requires a program to have a minimum of seven additional competencies to support its emphasis area. According to the Commission on Dietetic Registration (CDR), the development and validation of the essential practice competencies are accomplished in seven key steps: Literature review and global environmental scan of nutrition and dietetics competencies; Development of the competencies' framework and outline; Competencies writing sessions; Stakeholder consultations; Mapping of the competencies to the CDR Professional Development Portfolio's existing Learning Need Codes (LNCs); National validation study of the essential practice competencies by CDR's credentialed nutrition and dietetics practitioners; Finalization and CDR approval.

Employees at a local sandwich shop work 8-hour shifts and can make 9 sandwiches per labor hour. On a normal business day, the shop sells at least 250 sandwiches. Next Tuesday, the shop is having a "Buy 1, Get 1 Free" promotion and is expecting to sell at least 450 sandwiches. What is the minimal number of total employees needed next Tuesday? 6 7 10 22

Correct answer: 7 To determine staffing needs: 9 sandwiches x 8 hours per day = 72 sandwiches per employee 450 total sandwiches / 72 sandwiches per employee = 6.25 employees --> 7 minimal total employees are needed next Tuesday

What is the minimum number of additional competencies that ACEND requires a program to have to supports its emphasis area? 3 5 7 Not established

Correct answer: 7 ACEND requires a program to have a minimum of seven additional competencies to support its emphasis area. According to the Commission on Dietetic Registration (CDR), the development and validation of the essential practice competencies are accomplished in seven key steps: Literature review and global environmental scan of nutrition and dietetics competencies; Development of the competencies' framework and outline; Competencies writing sessions; Stakeholder consultations; Mapping of the competencies to the CDR Professional Development Portfolio's existing Learning Need Codes (LNCs); National validation study of the essential practice competencies by CDR's credentialed nutrition and dietetics practitioners; Finalization and CDR approval.

Josh is a four-month-old baby boy and weighs 15 lbs. What are his daily energy needs? 170 kcals 1,620 kcals 612 kcals 734 kcals

Correct answer: 734 kcals The energy needs for 0- to 6-month-olds is 108 kcals/kg. To determine Josh's energy needs: Convert lbs to kgs: 15 pounds / 2.2 kg = 6.8 kg Multiply weight by energy needs: 6.8 kg x 108 kcal / kg = 734.4 kcals / day (round down to 734 kcals/day)

An ice cream store serves ice cream with a #8 scoop. How many ounces of ice cream is in a double-scoop cone? 8 oz 6 oz 12 oz 4 oz

Correct answer: 8 oz Scoop sizes are based on how many scoops it takes to fill a 32-fluid-ounce container. To determine the number of ounces in a scoop, divide the scoop in 32 (e.g., 32 fl oz / #8 = 4 oz) A #8 scoop size measures 1/2 cup, or 4 ounces. To solve: 4 ounces (#8 scoop) x 2 scoops = 8 ounces

How much water needs to be removed from food in order to qualify as a method of food preservation? 50% 75% 80% 90%

Correct answer: 80% In food processing, dehydration is a method of preserving foods for indefinite periods of time by extracting the moisture and inhibiting the growth of microorganisms. At least 80% of the water needs to be removed from the food to be a method of food preservation. Foods commonly dehydrated include fruit, vegetables, and meats. 80% of water is removed for fruits, and 95% of water is removed for vegetables.

Using the Hamwi formula, determine the ideal body weight for a 65-year-old female who is 57 inches tall, weighs 116 pounds, and has a small frame. 101.75 lbs 83.25 lbs 87.87 lbs 88.56 lbs

Correct answer: 83.25 lbs The Hamwi formula computes a person's ideal body weight (IBW) according to the following: Male: 106 lbs for first 5 ft + 6 lbs for each additional inch Female: 100 lbs for first 5 ft + 5 lbs for each additional inch *Subtract 2.5 lbs for each inch below 5 ft (may vary from 2 to 5 lbs based on institution), and allow +/-10% range for small to large frame for individual differences To calculate the IBW for this person, the equation is 100 lbs - 2.5 lbs x 3 in. (57 in = 4 ft 9 in = 3 in below 5 ft) = 92.5 lbs x .90 (-10% for small frame) = 83.25 lbs The other choices are calculated incorrectly by subtracting only 5%, adding 10%, and using the formula for men.

What is the IBW for a 4'11" woman with a small frame? 85.5 pounds 95 pounds 104.5 pounds 90 pounds

Correct answer: 85.5 pounds Ideal body weight (IBW) is an anthropometric measure based on height to determine how much an individual should weigh. IBW is determined for women with medium frame sizes by the following formula: 100 pounds for the first 5 feet plus 5 pounds for each additional inch. If the woman is less than 5 feet tall, subtract 5 pounds for each inch under 5 feet. For small frame sizes, subtract 10%. For large frame sizes, add 10%. 100 pounds - (5 pounds x 1 inch) x 0.90 = 85.5 pounds

Which of the following clinical characteristics would be categorized as chronic, moderate malnutrition? 3% weight loss in 1 week <80% of energy intake for 3 months <70% of energy intake for 8 days <60% of energy intake for 1 month

Correct answer: <60% of energy intake for 1 month Based on the ADA/A.S.P.E.N. chart of clinical characteristics to support diagnosis of malnutrition, chronic moderate malnutrition is categorized as <75% of energy intake for >=1 month, 5% weight loss in 1 month, 7.5% weight loss in 3 months, 10% weight loss in 6 months, and 20% weight loss in 1 year. <80% of energy intake for 3 months would be categorized as chronic, severe malnutrition. <70% of energy intake for 8 days would be categorized as acute, moderate malnutrition. 3% weight loss in 1 week would be categorized as acute, severe malnutrition. Eat Right: American Dietetic Association. ADA/A.S.P.E.N. Clinical characteristics that the RD can obtain and document to support a diagnosis of malnutrition. http://www.cmcgc.com/media/handouts/320121/t21_jane_white.pdf

Which of the following assigns the most risk in sickle cell disease risk factor scoring? >10% weight loss in children, adolescents, and infants >3.5 g/dL visceral protein stores (albumin) ≥90% of recommended body weight or BMI 5% weight loss in adults

Correct answer: >10% weight loss in children, adolescents, and infants Sickle cell disease (SCD) is an inherited condition and the most common hemoglobinopathy in the United States. It mainly affects individuals of African and Mediterranean descent. The deformed cells are fragile and increase hemolysis through blood vessels, which may result in severe anemia, pain crises, impeded blood flow, organ damage, and possibly death. Sickle cell disease risk factor scoring is a system that assigns risk points to a variety of factors to measure the severity of the disease.

A patient is at risk if he or she has experienced unintentional weight change of how much? >10% in the last 12 months >6% in the last 3 months >5% in the last month >1% in the last week

Correct answer: >5% in the last month A patient is at risk if he or she has experienced significant unintentional weight change of >2% in the last week >5% in the last month >7.5% in the last 3 months >10% in the last 6 months

Which of the following cooking scenarios will prevent curdling? Add cream to tomato sauce on the stovetop Boil milk before using it in tomato soup Prepare hollandaise sauce over high heat Add tomato sauce to cream at room temperature

Correct answer: Add tomato sauce to cream at room temperature Curdling is the breakdown of an emulsion that causes separation into lumps or curds, typically seen in milk and milk products. Curdling occurs when acid is added too quickly, when acid is added over heat, or when milk or a milk product is overheated. To prevent curdling, add acid slowly and agitate at room temperature. Adding cream to tomato sauce on a hot stovetop, preparing hollandaise sauce over high heat, and boiling milk are all scenarios that will lead to curdling.

During which stage of the life cycle is a person most likely to have interest in food fads and concern with body image? Adulthood Old age Adolescence Childhood

Correct answer: Adolescence It is important for providers to be able to recognize characteristics throughout the life cycle. Adolescents are most likely to be concerned with body image, food fads, the struggle to discover who they are, the need for privacy, and the importance of peers and their acceptance.

The nutrition education goal of enhancing one's knowledge to improve diet and decrease risk of developing chronic disease is most appropriate for which age group? Preschoolers Adults Adolescents School-aged children

Correct answer: Adults A nutrition education goal appropriate for adults is enhancing their knowledge and skills to improve their diet and decrease their physiological risk developing chronic disease. A nutrition education goal best for adolescents is creating positive attitudes about healthy eating, demonstrating how healthy eating can help in the development of a positive body image, and encouraging them to value the importance of food and other lifestyle factors that can prevent common nutrition-related problems. A nutrition education goal for school-aged children is enhancing their knowledge, skills, and attitudes about broad, contemporary food/nutrition topics. A nutrition education goal for preschoolers is creating positive attitudes toward food, encouraging acceptance of healthy foods, and promoting understanding of the relationship between food and health. Flag Question

Which group is more at risk for developing high blood pressure, obesity, and diabetes? Hispanics Asian-Americans African-Americans Caucasians

Correct answer: African-Americans High blood pressure, obesity, and diabetes are the most common conditions that increase the risk for heart disease and stroke. The risk of developing these diseases is highest for African-Americans than for any other ethnic group.

What lab value is the most accurate measure of long-term nutritional status? C-reactive protein Pre-albumin Prothrombin time Albumin

Correct answer: Albumin Serum albumin is the most accurate measure of long-term nutritional status; it measures the amount of protein in the organs and blood. Albumin has a long half-life; therefore, it better reflects long-term protein intake (versus current protein intake). Pre-albumin has a shorter half-life and can pick up changes in protein status more readily; therefore, it better reflects acute or short-term nutritional status. C-reactive protein (CRP) is a marker of acute inflammatory stress. Prothrombin time (PT) is a measure of blood clotting time.

Which of the following health care professionals is not allowed to participate in the nutrition screening process? Registered dietitian All health care team members can participate Dietietic technician Registered nurse

Correct answer: All health care team members can participate All health care team members can participate in the nutrition screening process and serve a supportive role in this preliminary step. The health care member that performs this step can vary, but it is usually done by an RN upon the patient's admission. The nutrition screen is not part of the ADIME process, which is conducted by the RD.

Which nutrition diagnosis is most likely to be associated with a patient who has a distended belly and steatorrhea? Altered GI function Impaired nutrient utilization Food- and knowledge-related deficit Excessive carbohydrate intake

Correct answer: Altered GI function The nutrition diagnosis "altered GI function" is indicated by abdominal distension, nausea, vomiting, diarrhea, steatorrhea, and/or constipation. This nutrition diagnosis looks at problems specifically inside of the GI tract and exocrine functions. "Impaired nutrient utilization" is indicated by a thin, wasted appearance. This nutrition diagnosis looks at problems with the metabolism of nutrients and endocrine functions. "Excessive carbohydrate intake" may be indicated by overweight/obese BMI, elevated HgbA1C, elevated blood glucose levels, diabetes-related diagnoses, and/or other medical diagnoses related to overconsumption of carbohydrate. "Food- and knowledge-related deficit" may be indicated by lack of adherence to dietary recommendations, over- or underweight due to deficits, and/or medical diagnosis due to dietary noncompliance.

Which of the following is not a symptom of overhydration? Hyponatremia Hyperalbuminemia Weight gain Shortness of breath

Correct answer: Hyperalbuminemia Overhydration, known as hypervolemia or fluid overload, is a condition in which the volume of the liquid portion of the blood (plasma) is too high. The signs and symptoms include shortness of breath, weight gain (>3 kg), hyponatremia, and decreased albumin (hypoalbuminemia). This can be caused by excess fluid or salt intake and/or failure of the heart, kidney, or liver.

What is marketing and why is it referred to as a cyclic management function? A continuing series of events designed to meet the wants and needs of consumers; because it is driven by consumer feedback An organizational function that includes product, price, place, and promotion An organization that has needs for products and the ability to make a purchase; because it is a cycle driven by consumer feedback An activity directed at satisfying the wants and needs of consumers; because it required planning, implementation, and evaluation

Correct answer: An activity directed at satisfying the wants and needs of consumers; because it requires planning, implementation, and evaluation Marking is an activity directed at satisfying the wants and needs of consumers. It is a cyclical function that requires planning, implementation, and evaluation. A target market is a group of people (individuals or an organization) that has needs for products and the ability to make a purchase. The marketing cycle is the continuing series of events designed to meet the wants and needs of consumers and is driven by consumer feedback. The marketing mix includes the elements of product, price, place, and promotion.

Which of the following is an example of benchmarking? A coffee shop analyzes and predicts latte sales based on item popularity in relation to other items A hospital kitchen examines the amount of food left on each patient's plate An organic food company compares their sales per square foot with those of industry peers A restaurant examines how to design a menu to influence what a customer chooses to eat

Correct answer: An organic food company compares their sales per square foot with those of industry peers Benchmarking is the process of comparing your results to those of industry peers to understand competitive advantages and disadvantages. It is the concept of setting goals based on what others have accomplished and using front-runners in the field to raise your company standards. A popularity index analyzes and predicts item sales and ranks their popularity in relation to other items. Plate waste analyzes the amount of food left on a plate to estimate waste. Menu psychology is the examination of how to design a menu to influence what a customer eats.

The steps in stock handling of produce include all of the following except: Analyzing the sales information to determine inventory turnover Delivering the produce to a place to be used, stored, or displayed for sale Marking the perishable packages with information Receiving the produce

Correct answer: Analyzing the sales information to determine inventory turnover The steps in stock handling include the following: Receiving goods Checking them Marking the goods with information Delivering them to a place to be used, stored, or displayed for sale Inventory control includes the analysis of sales information to determine inventory turnover.

During a nutrition counseling session with a new client, you notice his lower lip quivering and his fists occasionally clenching, and he frequently crosses and uncrosses his legs. What is the most likely interpretation of this nonverbal communication? Stress Anxiety Respect Avoidance

Correct answer: Anxiety In nonverbal communication, anxiety can be expressed by quivering of the lower lip, clenching of fists, and/or crossing and uncrossing of legs. Respect, deference, or avoidance of interpersonal exchange would more likely be expressed by a lack of sustained eye contact. Stress would more likely be indicated by tight lips.

During a nutrition consultation, the client verbally attacks the nutrition counselor, stating that the weight loss goals are unrealistic and that no one could ever actually achieve them; then she starts crossing and uncrossing her legs. What nonverbal message is the client most likely trying to express? Anxiety Aggression Discomfort Avoidance

Correct answer: Anxiety Nonverbal communication can affect the direction of an interview by portraying emotion through physical movements and postures. In this situation, the client's verbal communication expresses aggression when she directly attacks the source of frustration (the counselor), but her nonverbal communication expresses anxiety by the physical act of crossing and uncrossing her legs. Other nonverbal communication methods include folding arms across the chest to express avoidance and moving a chair farther away to express discomfort.

Which of the following is an example of a motion economy principle? When breading and frying foods, arrange food containers, flour, egg mixture, crumbs, and cooking pan in a correct sequence, so that no wasted movements are made The elimination of uneconomical use of foodservice equipment to increase productivity The coordination to ensure that a hospital consistently meets or exceeds quality standards Enacting measurement methods to eliminate waste and pursue improvement

Correct answer: When breading and frying foods, arrange food containers, flour, egg mixture, crumbs, and cooking pan in a correct sequence, so that no wasted movements are made The principles of motion economy involve the use of the human body, arrangement of the workplace, and design of tools and equipment in such a way as to reduce the motion and time required for a job, to increase efficiency. The philosophy of work simplification is that there is always a better way to do something; the elimination of uneconomical use of foodservice equipment to increase productivity is an example of work simplification. Total quality management (TQM) is a management process that coordinates to ensure that a company consistently meets or exceeds quality standards set by customers. TQM companies enact measurement methods, tools, and programs to eliminate waste and pursue continuous improvement.

Raw meat, poultry, and fish should be stored in the following top-to-bottom order in the refrigerator: Whole fish, whole cuts of beef and pork, ground meats and fish, and whole and ground poultry. Whole and ground poultry, ground meats and fish, whole cuts of beef and pork, and whole fish. Whole and ground poultry, whole fish, whole cuts of beef and pork, and ground meats and fish. Whole fish, whole cuts of beef and pork, ground meats and fish, and whole and ground poultry, and fully cooked meats.

Correct answer: Whole fish, whole cuts of beef and pork, ground meats and fish, whole and ground poultry Store raw meat, poultry, and fish separately from prepared and ready-to-eat food. If these items cannot be stored separately, store them below prepared or ready-to-eat food. Raw meat, poultry, and fish should be stored in the following top-to-bottom order in the refrigerator: whole fish, whole cuts of beef and pork, ground meats and fish, and whole and ground poultry.

Rachel was hired as a diet technician at a local community hospital. During her orientation, she was given material that outlined the work she was expected to perform, the procedures to use, and a time schedule. What type of material was she given? Work schedule Job description Organizational chart Job specification

Correct answer: Work schedule A work schedule is an outline of the work to be performed, the procedures to be used, and a time schedule for a particular position. This material is helpful in training new employees and is usually given to them right after they have been hired. A job specification is a statement of minimum standards that must be met in order to apply for a particular job. A job description is an organized list of required duties, skills, and responsibilities for a particular position. An organizational chart is a graphic representation of the relationships and groupings between positions and their functions.

What is the following an example of? 5:00-7:30 a.m. Read breakfast menu Make coffee Obtain food items to be served cold Obtain food items to be served hot Check in with supervisor regarding correct portion sizes 7:30-9:00 a.m. Open restaurant doors for breakfast service Make additional coffee as needed Clean countertops and wipe up spilled food 9:00-9:30 a.m. Break Eat breakfast Work Schedule Organizational WOrk Schedule Job Specification Skills Matrix System

Correct answer: Work schedule A work schedule is an outline of work to be performed for a specific position, including required procedures. Organizational work schedules give assignments by 30-minute increments for all employees; this type of schedule shows the overall workload and its division among employees. A skills matrix system is an organizational plan that allows employees to plan their growth within an organization. A job specification is a written statement of minimum standards that must be met for an applicant to apply for a certain job.

What is the following an example of? 5:00-7:30 a.m. Read breakfast menu Make coffee Obtain food items to be served cold Obtain food items to be served hot Check in with supervisor regarding correct portion sizes 7:30-9:00 a.m. Open restaurant doors for breakfast service Make additional coffee as needed Clean countertops and wipe up spilled food 9:00-9:30 a.m. Break Eat breakfast Work schedule Organizational work schedule Job specification Skills matrix system

Correct answer: Work schedule A work schedule is an outline of work to be performed for a specific position, including required procedures. Organizational work schedules give assignments by 30-minute increments for all employees; this type of schedule shows the overall workload and its division among employees. A skills matrix system is an organizational plan that allows employees to plan their growth within an organization. A job specification is a written statement of minimum standards that must be met for an applicant to apply for a certain job.

A restaurant has decided to change its name to either Jane's Steakhouse or The Texas Steak House. The CEO is hosting a vote on the new name and will be accepting the majority decision. What type of leadership style is this? Democratic consensus Autocratic Participative

Democratic Leadership styles and techniques reflect the personality of the management. The democratic style accepts the majority decision. The consensus style requires the entire group to come to an agreement. For example, the CEO might require everyone to meet and discuss until they all agree on which restaurant name to go with. The participative style seeks input from and shares power with employees. A participative CEO might have used this method to brainstorm ideas for the new name with the employees. The autocratic style takes control, makes decisions, and assumes full responsibility. An autocratic CEO would choose the new restaurant's name on his own without input from the employees.

Kaitlin is reopening a neighborhood craft coffee shop, and she wants to maintain a food-cost percentage of 40%. A portion cost of her ham and cheese croissant is $0.4819. What should her selling price be? $1.20 $1.68 $1.97 $0.67

Correct answer: $1.20 The markup is determined by dividing the desired food cost percentage into 100, which represents total sales or 100%. The resulting figure is known as the markup factor and is multiplied by raw-food costs to determine the selling price. Step 1. Solve for markup factor: 100 (total sales) / 40 (percentage of income for food) = 2.5 (markup factor) Step 2. Determine suggested selling price: $0.4819 (cost of portion) x 2.5 (markup factor) = $1.20

Maggie's meal prep company wants to determine a selling price for their newest breakfast item, protein buttermilk pancakes. Using the cost plus pricing method, how much should this item be sold for? Fixed costs = 23% Labor costs = 44% Profit costs = 15% Food cost = $1.87 $3.40 $2.20 $7.49 $10.38

Correct answer: $10.38 Cost plus pricing is a pricing method that ensures a predetermined percentage of profit by establishing profit as a cost. Add up all the percentage costs: 23% + 44% + 15% = 82% (total costs) Find the targeted food cost percentage: 100% - 82% = 18% or .18 (desired food cost) Determine the selling price of the item: $1.87 / .18 = $10.38 The item should be sold for $10.38

Becky's BBQ Restaurant wants to determine the selling price for a beef brisket sandwich. The restaurant spent $133.05 on the recipe (yields 30 servings) and determined that the percentage food cost will be 35%. Based on the available information, what should be the selling price of the beef brisket sandwich? $1.55 $4.44 $7.21 $12.67

Correct answer: $12.67 The factor pricing method, also known as the traditional or markup method, uses the raw cost of food and food cost percentage to determine the selling price (markup). Based on the available information, this is the best pricing method to use. To determine the markup factor: 100 / food cost percentage To determine the selling price: raw cost of food x markup To determine raw food cost: $133.05 / 30 servings = $4.435 per recipe To determine the markup factor: 100 / 35 = 2.857 To determine the selling price: 4.435 x 2.857 = 12.671 The beef brisket sandwich should be sold for $12.67 Factor pricing method shortcut: Divide the food cost percentage (as a decimal) into the raw food costs: $4.435 / 0.35 = 12.671

National Foodie Corporation purchases the Deluxe Dishwasher machine for $23,053.80. It has an estimated salvage value of $2,636 and a useful life of nine years. What is the annual depreciation? $4,595.80 $670.20 $20,417.80 $2,268.64

Correct answer: $2,268.64 Straight line depreciation is a method used to determine the estimated useful life of a fixed asset. Purchase cost of $23,053.80 - estimated salvage value of $2,636 = depreciable asset cost of $20,417.80 1 / 9-year useful life = 11.11% depreciation rate per year 11.11% depreciation rate x $20,417.80 depreciable asset cost = $2,268.64 annual depreciation

ReDefined is a coffee shop that sells specialty lattes, local pastries, and coffee beans. Based on the following information, how much money does ReDefined need to bring in to break even? Fixed costs: $1,075 Variable costs: $3,300 Sales: $5,999 $8,224 $2,150 $6,600 $2,389

Correct answer: $2,389 The break-even point (BE) is the point where sales revenue (income) and expenses (fixed costs [FC] and variable costs [VC]) are equal. When you want to determine how much money you need to bring in to break even, solve for BE in sales volume. BE sales volume ($ to BE) = FC / 1- (VC / Sales) BE = 1,075 / 1 - (3,330 / 5,999) BE = 1,075 / 1 - (0.55) BE = 1,075 / 0.45 BE = 2,389.375 --> 2,389 ReDefined needs to bring in $2,389 to break even.

Alicia's cafe added a new menu item (banana parfait) this month. The raw food cost is $1.02 per serving and their overall food costs are 45%. What is the selling price for the banana parfait using the factor pricing method? $1.45 $1.48 $2.22 $2.26

Correct answer: $2.26 The factor-pricing method, also known as the traditional or markup method, uses the raw cost of food and food cost percentage to determine the selling price (markup). To determine the markup factor: 100 / food cost percentage To determine the selling price: raw cost of food x markup To determine the markup factor: 100 / 45 = 2.22 To determine selling price: 1.02 x 2.22 = 2.26 The banana parfait should be sold for $2.26

Joshua is the manager at Brewer's Bagels. His raw-food cost of an onion bagel is $0.9874 and he has a markup factor of 2.5. In order to account for hidden losses in preparation, cooking, and serving, what should his realistic selling price be? $1.38 $2.47 $2.72 $2.76

Correct answer: $2.72 To compensate for hidden losses in preparation, cooking, and serving, many foodservice managers add 10% to the recipe cost prior to markup. The suggested selling price of $2.47 with markup would be changed as follows: Raw-food cost of $0.9874 x .10 = 0.09874 $0.09874 + $0.9874 = $1.08614 $1.08614 x 2.5 = $2.71535, rounded to $2.72

Cody's Prime Seafood & Steakhouse introduced a special "surf & turf" menu item this month. What should the selling price be for the new menu item using the prime cost method? Raw food cost = $18.60 Food cost percentage = 35% Labor cost = 12 minutes at $13 / hour Labor cost percentage = 48% $22.32 $25.44 $34.04 $21.20

Correct answer: $25.44 The prime cost method accounts for both raw food costs and direct labor costs involved in making the item. To determine prime cost, add raw food costs and direct labor costs. To determine prime cost: Raw food (18.60) + labor costs ($13/60 minutes x 12 minutes = $2.60) = prime cost (21.20) To determine markup factor: Food cost % (35%) + labor cost percentage (48%) = 83%. 100 / 83 = markup factor (1.20) To determine selling price: Prime cost (21.20) x markup factor (1.20) = selling price (25.44) The surf & turf should be sold for $25.44 using the prime cost method to account for both food and labor costs.

ABC Breads wants to enter the gluten-free-bread market. The fixed cost of manufacturing this product is $20,000, and the variable cost per unit is $0.60. ABC expects to sell 8,000 bread loaves. What is the break-even price of the gluten-free bread loaf? $3.60 $0.42 $0.60 $3.10

Correct answer: $3.10 The break-even (BE) point is the place where expenses (fixed costs and variable costs) and revenue/income are equal. Therefore, the break-even price of the gluten-free bread is: ($20,000 fixed costs / 8,000 units) + $.60 variable cost = $3.10 break-even price Assuming that ABC actually sells 8,000 units in the period, $3.10 will be the price at which they break even. However, if ABC were to sell fewer units, it would lead to a loss, because the price point does not cover fixed costs. Or, if ABC were to sell more units, it would earn a profit, because the price point cove

Before providing nutrition advice to a client, what step should the dietitian take to make the client more receptive? Perform a cost-benefit analysis Ask at least two patient identifiers Ask the client's permission Conduct supportive scientific research

Correct answer: Ask the client's permission Asking permission is a powerful strategy and places the client in an autonomous position, making them more receptive to incoming information. On the other hand, if the provider gives advice to the client without asking permission or acts in a more authoritative way, the client may be less receptive, less engaged in learning, and may feel targeted or judged. A cost-benefit analysis determines if the goal of the intervention is worthwhile in terms of cost. For example, a cost-benefit analysis studies the overhead cost of a dietitian leasing an office compared to the income made through client appointments. Asking at least two patient identifiers is a standard set by The Joint Commission to properly identify a patient and decrease wrong-patient clinical errors. For example, a dietitian can ask a patient their name and birthdate before starting an assessment. Conducting supportive scientific research is an important part of providing clinical advice. However, this a hard skill (knowledge) and a client may be more receptive to soft skills (friendliness, politeness, personality).

The primary function of the public health nutritionist is to: Create nutrition educational material Work one-on-one with individual clients Assess the needs of the community Counsel patients with specialized dietary needs

Correct answer: Assess the needs of the community The primary function of the public health nutritionist is to assess the needs of the community. Public health nutrition is an area of concentration emphasizing the application of food and nutrition knowledge, policy, and research to the improvement of the health of populations. This area of nutrition works at larger-scale levels (city, state, national, worldwide), rather than individualized levels.

"Over time, spaghetti became widely accepted by Americans, and Italians began to eat cold cereal." Which value does the statement above reflect? Assimilation Cultural competence Cultural sensitivity Ethnocentrism

Correct answer: Assimilation Assimilation is when people of one cultural group shed part or all of their ethnic identity and merge into the majority culture. Cultural sensitivity is the understanding of needs and emotions of one's own culture and the culture of others. Cultural competence is the dynamic and ongoing process of seeking cultural awareness, knowledge, skill, and encounters. Ethnocentrism is when people consider their values and practices to be absolute truths, and they may judge others based on their own beliefs.

The employees at a food management company are shown in an organizational chart. In this chart, Employee A is connected with a solid line to Employee B. Employee B is connected with a solid line to Employee C and a dotted line to Employee D. What type of position does Employee A hold at the company? Consultant Advisory Authority Staff

Correct answer: Authority An organizational chart shows how employees fit into the organizational structures of a company by showing relationships of positions and functions. The chart uses solid lines to depict authority (e.g., administrative, manager) and dotted lines to depict advisory or staff positions (e.g., consultant, part-time).

Rachel has heart failure and her doctor has prescribed Lasix (furosemide). Which of the following foods would you recommend for her to include in her diet? Watermelon Avocado Hummus Applesauce

Correct answer: Avocado Loop diuretics, such as Lasix (furosemide), are used to reduce excess fluid accumulation in the body caused by conditions like heart failure, hypertension, kidney disease, and liver disease. This drug promotes the urinary excretion of sodium and water; however, it also increases loss of potassium. Therefore, dietary replacement of potassium is important to prevent hypokalemia. Avocados are high in potassium, but applesauce, hummus, and watermelon are low in potassium. Gropper, S. A. S., Smith, J. L., & Groff, J. L. (2009). Advanced nutrition and human metabolism. Australia: Wadsworth/Cengage Learning. Eat Right: Nutrition Care Manual. Lower-Potassium Foods List.

What advice would you give to a person complaining of symptoms of gastroesophageal reflux disease? Use pepper instead of salt for seasoning Chew spearmint gum Avoid eating before bed Eat small meals with high-fat snacks

Correct answer: Avoid eating before bed Gastroesophageal reflux disease (GERD) is a digestive disease where stomach acid or bile irritates the food pipeline, causing a feeling of heartburn and pain. The nutrition intervention for GERD involves avoidance of the following: eating before bed, large and high-fat meals, caffeine, chocolate, alcohol, pepper, peppermint, and spearmint.

Which product is used to prevent lipid oxidation and might be found in snack foods (chips and cookies), vegetable oils, and cured meats? Sorbitol BHA and BHT FD&C Blue Nos. 1 and 2 Carrageenan

Correct answer: BHA and BHT BHA and BHT are chemical preservatives used to prevent lipid oxidation and commonly found in snack foods (chips and cookies), vegetable oils, and cured meats. FD&C Blue Nos. 1 and 2 are color additives used to enhance colors in colorless and "fun" foods. Sorbitol is a sweetener used to add sweetness without extra calories. Carrageenan is a fat replacer used to enhance mouthfeel in reduced-fat foods.

Which of the following risk factors is modifiable? Gender Family medical history Age BMI

Correct answer: BMI Risk factors are conditions that increase your risk of developing a disease. Risk factors can be either modifiable (you can take measures to change them) or non-modifiable (you cannot change them). Modifiable risk factors include smoking, physical inactivity, and BMI. High blood pressure, diabetes, smoking, and cholesterol are considered modifiable as well. Non-modifiable risk factors include age, race, sex, and family history.

Colin owns a nutrition consulting firm and he is establishing the company's budget for next year. To establish the budget, he begins with the existing budget and adjusts for current conditions using an inflation factor. What method of budgeting is this? Fixed budget Flexible budget Zero-based budget Baseline budget

Correct answer: Baseline budget\ A baseline budget, also known as a traditional or incremental budget, starts with a previous or existing budget as a baseline and adjusts in incremental amounts for current conditions by using an inflation factor. A zero-based budget starts with no previous figures before costs, then an inflation factor is added, and each expense must be justified. A fixed budget is prepared at one level of sales with no expected major changes during the year. A flexible budget is a budget that adjusts based on changes in the volume of activity throughout the year.

Manuel, a foodservice director at a Valley High Hospital, wants to know whether his Northwest or Southwest clinic scores higher overall for patient satisfaction. He monitors this measure to see which issues need to be addressed with the kitchen and foodservice staff to improve practices next quarter. What technique is Manuel using here? Popularity index Benchmarking Requisition Hedonic scaling

Correct answer: Benchmarking Benchmarking is a method for comparing satisfaction levels and setting goals based on internal, competitor, or functional measures. This scenario is an example of internal benchmarking, since it takes place between divisions within the same hospital. A popularity index is used to analyze and predict sales of an item. Using hedonic scales is a way to measure customer satisfaction by rating on a scale from extreme dislike to extreme like. A requisition is an internal form for managers to request items from a purchasing manager.

The technique that measures a company's performance against the best-in-class companies, determines how those companies achieved their success, and uses the information to improve its own performance, is know as what? Sentinel event indicator Benchmarking Evaluation threshold Rate-based indicator

Correct answer: Benchmarking Benchmarking is a technique that measures a company's performance against the best-in-class companies, determines how those companies achieved their success, and uses the information to improve its own performance. A rate-based indicator is a comparative rate indicator that measures and evaluates aspects of patient care. Sentinel events are unanticipated events in healthcare resulting in death or serious injury. An evaluation threshold, or threshold for evaluation, is the level at which a stimuli is strong enough to signal a response; at this point a process should be initiated to understand why the threshold was crossed.

What does an "adjusted FTE" account for that an "absolute FTE" does not? Hours actually worked Minimum number of employees Productive hours Benefit days and days off

Correct answer: Benefit days and days off Full time equivalent (FTE) is the hours worked by one employee on a full-time basis (40-hour week) and is counted as either an absolute or adjusted FTE. An adjusted FTE accounts for benefit days and days off, while an absolute FTE accounts for the minimum number of employees needed to staff the business and counts productive hours only (hours actually worked).

Leaving food out too long at certain temperatures can cause bacteria to grow to dangerous levels that can cause illness. What is the range of temperatures that bacteria grow most rapidly in? Between 40°F and 140°F Between 140°F and 165°F Between 0°F and 40°F 165°F and above

Correct answer: Between 40°F and 140°F Leaving food out too long at room temperature can cause bacteria (such as Staphylococcus aureus, Salmonella enteritidis, Escherichia coli O157:H7, and Campylobacter) to grow to dangerous levels that can cause illness. Bacteria grow most rapidly in the range of temperatures between 40°F and 140°F, doubling in number in as little as 20 minutes. This range of temperatures is often called the "danger zone." (FSIS).

Which of the following disorders or procedures would most likely result in steatorrhea? H. Pylori bacterial infection Billroth I Billroth II Histal hernia

Correct answer: Billroth II A Billroth II (gastrojejunostomy) is a procedure that attaches the stomach to the jejunum. Since food then bypasses the duodenum, there is less duodenal hormonal secretion and in turn less pancreatic secretion. As a result, steatorrhea is likely to occur after this procedure due to the lack of pancreatic enzymes to break down fat. Steatorrhea is the presence of fat in the feces. A Billroth I (gastroduodenostomy) is a procedure that attaches the stomach to the duodenum. The disorder most likely to occur after this procedure is dumping syndrome. A histal hernia is a disorder where a portion of the stomach protrudes into the diaphragm. The most likely symptom to occur is heartburn. H. Pylori bacteria causes stomach ulcers and can be treated with antacids and antibiotics. The most likely symptom to occur is increased stomach acidity with pain.

Caitlin is a 6-year-old African American girl who was born with sickle cell anemia. She lives in an urban area and takes the bus to school. There are not any parks close to her home, so she watches several hours of television after school. Her inherited condition of sickle cell anemia is an example of which determinant of health? Biological and genetic Access to health services Physical Social

Correct answer: Biological and genetic Determinants of health are the range of personal, social, economic, and environmental factors that influence health status. They include the categories of biological and genetic makeup, individual behavior, social interactions and norms, physical environment, and access to health services. Caitlin's inherited health condition, sickle cell anemia, is an example of a biological and genetic social determinant of health. Her age and sex would also fall under this determinant. Her neighborhood and school are an example of a physical determinant. Her transportation options and exposure to mass media are examples of social determinants. https://www.healthypeople.gov/2020/about/foundation-health-measures/Determinants-of-Health

The receiver of a food delivery writes the description of the merchandise, counts the quantities received, and lists them on a blank form. What type of receiving method is this? Spot check method Direct check method Quality check method Blind check method

Correct answer: Blind check method The blind check method requires the receiver to write the merchandise description, count the quantities received, and list them on a blank form. This method is the most accurate but can be very time-consuming. In the direct check method, the merchandise is checked directly against the actual invoice or purchase order. In the spot check method, the receiver of a delivery conducts a check of one carton in a shipment to see if the correct goods and quantity were delivered. In the quality check method, the merchandise is checked to determine whether the quality of goods received matches the quality of the products ordered. Cited: Eriesd

Esophageal varices occurs when: Blood cannot enter the liver Blood cannot leave the liver Connective tissue overgrowth blocks blood flow into the vena cava The liver expands and pressure causes fluid to enter the peritoneal cavity

Correct answer: Blood cannot enter the liver Esophageal varices occurs when blood cannot enter the liver because connective tissue overgrowth causes resistance to blood from the portal vein. This pressure forces blood back into the collateral veins, enlarging the esophageal, abdominal, and collateral veins. This occurs in people with advanced liver disease. Ascites occurs when blood cannot leave the liver because connective tissue overgrowth blocks blood flow from the liver to the vena cava. As a result, the liver expands and pressure forces fluid into the peritoneal cavity, and more protein-containing fluid is drawn in, causing sodium and water retention. This occurs in many disorders, but is usually found in cirrhosis.

During diabetic ketoacidosis, what is the relationship between blood pH and respiration? Blood pH decreases, respiration increases Blood pH increases, respiration decreases Blood pH decreases, respiration decreases No change in pH or respiration

Correct answer: Blood pH decreases, respiration increases During diabetic ketoacidosis (DKA), blood pH decreases as a result of ketone bodies. As pH decreases, respiration is stimulated (hyperpnea) to excrete CO2. This increased rate of breathing labors the individual, leading to dyspnea, and eventually deep, gasping breaths (Kussmaul respirations).

A study was conducted to gather data on women 18-32 years of age to determine what factors significantly affected their self-image. The four factors studied were body composition, BMI, education level, and income level. The results are as follows: p = 0.001 for body composition, p = 0.518 for BMI, p = 0.100 for education level, and p = 0.05 for income level. What was the most significant factor affecting the women's self-image? Body composition Income level Education level BMI

Correct answer: Body composition This question is addressing levels of significance, or p values, of the research data. The lower the p value, the higher the significance of the results. The purpose of a p value is to show how strong or weak the evidence is in support of a hypothesis and if the results are reliable. For example, p ≤ 0.05 shows a significant difference and reliable results, as shown in the value p = 0.001 for body composition. A value of p < 0.01 shows a very significant difference and a more reliable result, p < 0.0001 shows very very significant differences and reliable results, and p > 0.05 shows an insignificant difference and an unreliable result, such as those of the other choices in our question: p = 0.518 for BMI, p = 0.100 for education level, and p = 0.05 for income level.

What characteristic would you expect to be elevated in an individual with Prader-Willi syndrome? Body fat mass Testosterone Stature Lean body mass

Correct answer: Body fat mass Prader-Willi syndrome is a genetic disorder of chromosome 15 deletion that causes obesity, intellectual disability, and shortness in height. Levels of ghrelin are elevated, which stimulates growth hormone secretion, appetite, food intake, and fat mass deposition. As a result, individuals with this syndrome tend to become obese by a young age (2-3 years old), have high body fat mass, short stature, and hypogonadism (low testosterone levels).

For a nutrition screen to be effective, it must have: Both specificity and sensitivity Specificity Neither specificity nor sensitivity Sensitivity

Correct answer: Both specificity and sensitivity For a nutrition screening to be effective, the methodology must be based on specificity and sensitivity to be accurate. Specificity is the ability to identify patients without a particular condition and sensitivity is the ability to identify patents who have the condition.

During chronic nutrition deprivation, what is one way the body decreases BMR to conserve protein and bodily function? Becoming hyperthermic Becoming hypertensive Decreasing heart rate Increasing thyroid hormone secretion

Correct answer: Bradycardia During chronic nutrition deprivation, the body decreases BMR (basal metabolic rate) to conserve protein and bodily function. To decrease BMR, the body may decrease body temperature (hypothermia), blood pressure (hypotension), heart rate (bradycardia), or thyroid hormone secretion. To increase BMR, the body may increase body temperature (hyperthermia), blood pressure (hypertension), heart rate (tachycardia), physical activity, or thyroid hormone secretion.

John is complaining of constipation. What foods would you recommend to help relieve his constipation? Banana and toast White rice and applesauce Bran cereal and milk Cheese and crackers

Correct answer: Bran cereal and milk Constipation can be treated with a high-fluid and high-fiber diet with exercise. Foods highest in fiber include dried fruit and bran cereal. The best of the options to relieve constipation is a bowl of bran cereal with milk because this provides both fiber and fluid. Diarrhea can be treated with a BRAT diet (Banana, Rice, Applesauce, Toast) and/or probiotics (cheese, yogurt).

Which of the following is the terminology for when an operation has $0 net income? Prime cost Contribution margin Break-even point Fixed cost Next Question Flag Question

Correct answer: Break-even point The break-even point (BEP) is the point in business activity when total revenue equals expenses, or when an operation has $0 net income. The contribution margin represents the amount of sales that can be contributed to fixed costs and profits after variable costs have been accounted for. Prime cost is a method of pricing based on food and labor costs. Fixed costs are those that are incurred regardless of the amount of sales; rent and utilities are examples of fixed costs. Flag Question

Which of the following foods should not be recommended to patients with AIDS? Brie cheese Whole milk Mashed potatoes with brown gravy Unpasteurized scrambled eggs

Correct answer: Brie cheese Soft cheeses, such as Brie, should be avoided by individuals with compromised immune systems, including patients with HIV, AIDS, and/or cancer, due to the live mold in the cheese. Neutropenic diets are low in bacteria and should be followed for this patient population. Milk should be pasteurized, eggs should be pasteurized when eaten undercooked or raw, but eggs may be unpasteurized when fully cooked.

When taking Coumadin, you should avoid increasing your intake of which food? Bananas Red Meat Broccoli Yogurt

Correct answer: Broccoli Coumadin is a brand name for an anticoagulant drug that inhibits the synthesis of vitamin-K-dependent clotting factors and is used in the prevention/treatment of thromboembolic disorders. Since this drug inhibits synthesis of vitamin K, it is important to maintain consistent intakes of dietary vitamin K. Therefore, you should avoiding increasing or decreasing your intake. Vitamin K is found in green leafy vegetables, such as broccoli, spinach, and kale.

What breakfast meal would you recommend for a patient with gestational diabetes? Cereal with milk and hard-boiled eggs Scrambled eggs with toast and orange juice Strawberry-banana smoothie with almond milk Whole-grain bagel with reduced-fat cream cheese and a banana

Correct answer: Cereal with milk and hard-boiled eggs During gestational diabetes (GDM), carbohydrates are less tolerated at breakfast meals due to more insulin resistance in the morning. Therefore, lower carbohydrate meals are recommended in the morning (15-30 grams carbohydrates) with any servings of fruit. Of the options, cereal with milk and hard-boiled eggs is the only meal that follows the GDM breakfast guidelines.

A food service leader can address the issue of diversity by: Setting minimum safety requirements for all employees regardless of race. Mandating affirmative action across the entire food service company. Establishing short-term commitments to an employee's personal growth. Changing the organization's culture to allow participation at all levels.

Correct answer: Changing the organization's culture to allow participation at all levels. There are compelling moral and business reasons for foodservice leaders to address the issue of diversity in the workforce. To address the issue of diversity: An organization's culture often changes so that all employees feel welcome and are able to participate across all levels. Requires long-term commitments to measurable change. Separating diversity from affirmative action. Affirmative action is a government mandated program that is sometimes unwelcome by organizations. The Occupational Safety and Health Administration (OSHA) is the governmental agency that sets minimum safety requirements.

Which type of food would you recommend to prevent dental caries and why? Cheddar cheese because it is a low cariogenic food Chicken because it is a weak buffer Lemon because it metabolizes bacteria Nuts because they decrease salivary pH

Correct answer: Cheddar cheese because it is a low cariogenic food Dental caries is the scientific term for tooth decay, or cavities. To prevent dental caries, non-cariogenic foods are recommended. Non-cariogenic foods do not promote tooth decay because they are not metabolized by bacteria in plaque and do not decrease salivary pH. Some characteristics of these foods are high protein, moderate fat, low concentration of fermentable carbohydrates, strong buffers, high mineral content (Ca, P), pH >6, and stimulation of saliva production. Examples include cheddar cheese, eggs, fish, poultry, nuts, meat, and sugarless gum.

The cafeteria served green beans for lunch starting at 11 a.m. By 1 p.m., the remaining green beans have become overcooked and mushy. What pigment is found in the green beans at 1 p.m.? Chlorophyllase Chlorophyll Pheophytin Chlorophyllin

Correct answer: Chlorophyllin The green pigment found in green beans is known as chlorophyll. This green pigment turns to bright green in alkaline environments and is known as chlorophyllin. During this chemical change, the alkaline softens the cellulose, and the hemicellulose is broken down, becoming mushy. Green pigment turns to olive green in acid environments and is known as pheophytin. Chlorophyllase is a plant enzyme that splits off from chlorophyll to form chlorophyllide.

Fluid restriction is indicated in all of the following disease states except: Cholecystitis Liver disease with ascites Chronic renal failure Congestive heart failure

Correct answer: Cholecystitis Fluid restriction is indicated for liver disease with ascites, chronic renal failure, and congestive heart failure, due to the abnormal levels of sodium and potassium, to help reduce edema and fluid retention. Fluid restriction is not indicated in cholecystitis. Cholecystitis is inflammation of the gallbladder that causes excess water to be absorbed, which leads to the precipitin of cholesterol and formation of gallstones. The appropriate nutrition therapy includes a low fat diet.

What particles transport dietary lipids in the bloodstream? Glycerol Micelles Chylomicrons Fatty acids

Correct answer: Chylomicrons Chylomicrons are lipoprotein particles made of triglycerides, phospholipids, cholesterol, and proteins. They are formed during fat digestion and transport dietary lipids in the bloodstream. Micelles are the end products of fat digestion composed of monoglycerides, diglycerides, long-chain fatty acids and bile salts. This water-soluble particle is absorbed into the intestinal cells. The end products of fat digestion are monoglycerides, diglycerides, glycerol, and fatty acids. These end products are directly absorbed into portal blood.

Which of the following is the most common risk factor for developing COPD? Cigarette smoking Sedentary lifestyle Overweight Stressful work environment

Correct answer: Cigarette smoke Chronic obstructive pulmonary disease (COPD) is a term used to describe progressive lung diseases, including emphysema, chronic bronchitis, refractory asthma, and some forms of bronchiectasis. Cigarette smoking is the most common cause of COPD; however, other causes include secondhand cigarette smoke, air pollutants/chemical fumes in the home or work-place, and dust.

Which nutrient is not required to convert pyruvic acid to acetyl CoA? Thiamin Pantothenic acid Lactic acid Citric acid

Correct answer: Citric acid Pantothenic acid, thiamin, riboflavin, and niacin are coenzymes needed for energy production. These four nutrients are required to produce acetyl CoA from pyruvic acid in this irreversible reaction. Citric acid is a required nutrient in the first step of the TCA cycle, in which acetyl CoA becomes citric acid to product the end products ATP, CO2, and H2O. Lactic acid is the anaerobic result of the Cori Cycle, where pyruvic acid converts to lactic acid (reversible reaction) due to oxygen debt.

The nutrition diagnostic label "involuntary weight loss" is categorized under which domain? Clinical Nutritional Intake Behavioral-environmental

Correct answer: Clinical The nutrition diagnostic labels include clinical (NC), intake (NI), and behavior-environmental (NB). The clinical label includes nutritional findings that relate to the medical or physical condition, such as functional, biochemical, and weight balance, including involuntary weight loss. The intake label includes actual problems related to intake, such as energy balance, oral intake, fluid intake, substances, and nutrient balance. The behavior-environmental label includes problems related to knowledge, access to food, and food safety, such as knowledge and beliefs, physical activity balance and function, and food access. Nutritional is not a diagnostic label.

According to McClelland's human motivation theory, which career is a person with an achievement motivation most likely to gravitate toward? Dishwasher Dietetic technician Dietary clerk Clinical nutrition manager

Correct answer: Clinical nutrition manager McClelland's human motivation theory states that every person has one of three main driving motivators: achievement, affiliation, or power. The achievement motivator is the motivation to do something better, more effectively, and/or more efficiently. These people tend to gravitate toward management and sales positions, such as clinical nutrition manager. Dishwasher, dietary clerk, and dietetic technician do not reflect the achievement motivator.

The statement "Completion of a malnutrition screening within 24 hours of admission," is an example of a: Scope of practice Clinical quality measure Standard of practice Performance improvement measure

Correct answer: Clinical quality measure Clinical quality measures, or CQMs, are tools that help measure and track the quality of health care services provided by eligible professionals, eligible hospitals and critical access hospitals in our health care system. An example of a measure is the statement "Completion of a malnutrition screening within 24 hours of admission." Performance improvement is the systematic process of detecting and analyzing performance problems, developing interventions to address problems, implementing interventions, evaluating results, and sustaining improvement. Scope of practice in nutrition and dietetics encompasses the range of roles, activities and regulations within which nutrition and dietetics practitioners perform. Standards of professional performance are tools used by credentialed dietetics practitioners for self-assessment, professional development and advancement of their practice.

Using a SWOT analysis, what might be identified as a "T" for a college's dining division? Proving catering services to collegiate events High food quality at reasonable prices Lack of a modern dining hall Close proximity of restaurants that compete for college students' money

Correct answer: Close proximity of restaurants that compete for college students' money SWOT stands for Strengths, Weaknesses, Opportunities, and Threats. A SWOT analysis helps develop business strategy. A college's dining division might identify high food quality at reasonable prices as a strength; lack of a modern dining hall as a weakness; providing catering services to collegiate events as an opportunity; and close proximity of restaurants that compete for college students' money as a threat.

Which of the following microorganisms is known as the "cafeteria bug" and results in symptoms of nausea, vomiting, abdominal pain, and diarrhea within 8-18 hours after ingestion? Clostridium perfringens Escherichia coli Ciguatoxin Shigella

Correct answer: Clostridium perfringens Clostridium perfringens is a food intoxication known as the "foodservice germ" or "cafeteria bug," which results in 24-hour flu-like symptoms, including nausea, vomiting, abdominal pain, and diarrhea, within 8-18 hours after ingestion. Ciguatoxin is a toxin linked to suspect fish products, such as barracuda, grouper, jack, and snapper fish. Escherichia coli is a food-borne infection found in raw or undercooked meats, raw fruits or vegetables, raw milk, and unpasteurized apple juice. It has a slow onset of 3-8 days after ingestion and lasts 5-10 days, with the symptoms of bloody diarrhea and severe cramping. Shigella is a food-borne infection caused by lack of proper hygiene and causes bloody diarrhea and abdominal pain within 12-50 hours after ingestion and lasts 4-7 days.

A client tells his dietitian, "Yes, I really want to try the DASH diet, but I didn't realize all my recipes include salt." Based on the Transtheoretical Stages of Change model, what stage of change is the client in? Contemplation maintenance pre-contemplation action

Correct answer: Contemplation The Transtheoretical Stages of Change model is a behavior change process that assesses a client's readiness to change in a series of consequential steps: Pre-contemplation: Individual unaware of or not interested in making a change within the next six months. Contemplation: Individual is thinking about making a change within the near future. This stage is commonly identified with a "Yes, but" comment. Preparation: Individual actively decides to change and plans a change very soon. Action: Individual makes the desired change and has been working at it for less than six months. Maintenance: Individual sustains change for six months or longer.

Jaclyn enjoys hands-on experiments and learning through trial and error. She prefers group discussion to facilitate her learning. Which learning style best describes Jaclyn? Thinker Lumper Assimilator Converger

Correct answer: Converger People who prefer to learn through the teaching methods of hands-on experimentation, trial/error, and discussion reflect the learning styles of a Splitter (Kirby), Sensor (Jung), Converger (Kolb), and Common Sense (4MAT). People who prefer to learn through lecture, independent study, and research reflect the learning styles of a Lumper (Kirby), Thinker (Jung), Assimilator (Kolb), and Analytic (4MAT).

Which of the following is an incorrect Joint Commission safety standard? Use medications safely Correctly identify a patient using at least one patient identifier Improve the safety of clinical alarm systems Communicate accurate patient medication information

Correct answer: Correctly identify a patient using at least one patient identifier The Joint Commission's safety standards include the following: correctly identify a patient using at least two (not one) patient identifiers, practice safe use of medications, maintain and communicate accurate patient medication information, improve the safety of clinical alarm systems, and several more standards. An example of using two patient identifiers could be asking for a patient's full legal name and date of birth.

Which of the following is an incorrect Joint Commission safety standard? Use medications safely Correctly identify a patient using at least one patient identifier Improve the safety of clinical alarm systems Communicate accurate patient medication information

Correct answer: Correctly identify a patient using at least one patient identifier The Joint Commission's safety standards include the following: correctly identify a patient using at least two (not one) patient identifiers, practice safe use of medications, maintain and communicate accurate patient medication information, improve the safety of clinical alarm systems, and several more standards. An example of using two patient identifiers could be asking for a patient's full legal name and date of birth.

If inventory in January is overstated, how would cost of goods sold and net income be affected? Cost of goods sold would be less and net income would be more than it actually was Cost of goods sold would be more and net income would be more than it actually was Cost of goods sold would be less and net income would be less than it actually was Cost of goods sold would be more and net income would be less than it actually was

Correct answer: Cost of goods sold would be more and net income would be less than it actually was If inventory in the first month is overstated, the cost of goods sold would be more and net income would be less than it actually was. This is because beginning inventory serves as a basis for calculations of cost of goods purchased to meet production needs, resulting cost of goods sold, and net income.

Which of the following nutrient deficiencies is associated with delayed or poor wound healing? Iron Zinc Vitamin B-12 Folic acid

Correct answer: Zinc Delayed or poor wound healing is associated with nutrient deficiencies of protein, zinc, vitamin C, and vitamin A. Deficiencies of folic acid, iron, and vitamin B-12 are associated with pallor, or paleness of the skin.

What do "assets" refer to? Accured expenses Accounts Payable Accounts receivable Mortgage Payables

Correct answers: Accounts receivable A balance sheet lists assets and liabilities at a given time. Assets are goods and products owed to you, including accounts receivable, cash, and inventory. Liabilities are amounts owed to others, including accounts payable, accrued expenses, and mortgages payable.

What is the name for the active form of vitamin D?

Calcitriol Calcitriol, also called 1,25-dihydroxycholecalciferol or 1,25-dihydroxyvitamin D3, is the active form of vitamin D. Vitamin D can be absorbed and metabolized through sunlight and/or dietary intake. Cholesterol is a precursor for vitamin D metabolism. To metabolize vitamin D by sunlight, first our skin absorbs previtamin D in the form of 7-dehydrocholestrol to become precalciferol (previtamin D3). Thermal isomerization occurs to produce cholecalciferol (vitamin D3). Cholecalciferol is the form of vitamin D found in animal food products. Then, cholecalciferol goes to the liver and converts to 25-OH-D3 (calcidiol), which is the storage form of vitamin D. This form travels to the kidneys to become 1,25-OH2-D3 (calcitriol), which is the active form of vitamin D.

Which statement best reflects a client who is in the precontemplation stage of change? "I ate leftover sausage all last week and I knew I shouldn't because it's a high-sodium food, but I got back to my low-sodium diet again yesterday." "I don't need diet education because I am going to eat what I want, whenever I want." "I want to better control my heart failure, but I don't have the money to cook all my meals at home." "Next time I go to the grocery store, I am going to start reading the nutrition labels for sodium content."

Correct answer: "I don't need diet education because I am going to eat what I want, whenever I want." Based on the trans-theoretical model, the first stage of change is precontemplation, in which the client has no intention of changing their behavior in the foreseeable future. When a client is at this stage, their statements reveal that they are uninterested, unaware, or unwilling to change.

Which of the following people, based on their statement, is least likely to take a health-related action? "I can use the carbohydrate exchange to control my diabetes." "I can reduce my carbohydrate intake to prevent pre-diabetes." "I feel that I can avoid developing diabetes." "I will have high blood sugar even if I count carbohydrates."

Correct answer: "I will have high blood sugar even if I count carbohydrates." The Health Belief Model is based on the understanding that an individual will take health-related action (e.g., controlling blood sugar) if that person... ...feels that a negative health condition (e.g., development of diabetes) can be avoided or managed. ...believes that by taking a recommended action, he or she will avoid negative health consequences (e.g., good blood sugar control will prevent diabetes). ...believes he or she can do the recommended action (e.g., I can use carbohydrate counting and control my diet with confidence).

On the new Nutrition Facts label, which of the following is not a key change? Precent daily value has been removed Calories is now larger and bolder Calories from fat has been removed Added Sugar is now required

Correct answer: "Percent Daily Value (%DV)" has been removed On May 20, 2016, the FDA announced the new Nutrition Facts label for packaged foods to reflect more current scientific information, including the link between diet and chronic diseases (such as obesity and heart disease). A few of the key changes on the new and improved Nutrition Facts label include the following: "Calories" is now larger and bolder, "Calories from Fat" has been removed, and "Added Sugar" is now required, along with other updates. "Percent Daily Value (%DV)" was not removed from the new label.

Determine the food cost per meal using the information below: March 1 inventory: $42,089 April 1 inventory: $40,980 Food purchased in March: $61,429 Meals served in March: 261,024 Income spent on food: 43.4% March inventory turnover rate: 4.3 $1.57 $179.98 $0.08 $0.23

Correct answer: $0.23 To determine food cost per meal, the following variables are necessary: number of meals served, food purchased, and food removed from inventory. To solve: [ (42,089 - 40,980) + 61,429 ] / 261,024 (1,109 + 61,429) / 261,024 62,539 / 261,024 $0.23 per meal Income spent on food and March inventory turnover rate are not needed to solve for food cost per meal.

Which of the following is an example of a pricing strategy in a marketing program? An elementary school offers free dessert with each meal during National School Lunch Week to increase participation. A cafeteria manager offers soda at a reduced price during slow times in hope that customers will make an additional purchase, such as fries, candy, or popcorn. A restaurant manager puts candles on tables, dims the lights, and sprays incense before dinner service to add desirable attributes for customers. A large community hospital sets up kiosks on inpatient units during busy lunch periods as a convenience for medical staff with limited break times.

Correct answer: A cafeteria manager offers soda at a reduced price during slow times in hope that customers will make an additional purchase, such as fries, candy, or popcorn. In the "marketing mix," price is the amount of money that is charged for a product/service or the perceived value of a product/service in exchange for its benefit. A cafeteria manager offering soda at a reduced price during slow times in hope that customers will make an additional purchase is practicing strategic pricing. A restaurant manager adding candles on tables, dimming the lights, and spraying incense before dinner service is an example of contributing to the product in the marketing mix. A large community hospital setting up kiosks on inpatient units during busy lunch periods as a convenience for medical staff with limited break times is an example of contributing to place in the marketing mix. An elementary school offering free dessert with each meal during National School Lunch Week to increase participation is an example of a promotion.

Which of the following disciplinary actions is most inappropriate? A unit manager disciplining a nurse every time she is late for her shift. A clinical service director announcing to his management team that if they do not review the stroke guidelines with their team they will be subject to suspension. A clinical nutrition manager disciplining a clinical dietitian in her private office for personality traits and characteristics that led to an incorrect tube feeding prescription. A food service manager directly disciplining a meal attendant immediately after the attendant delivers the incorrect tray to a patient.

Correct answer: A clinical nutrition manager disciplining a clinical dietitian in her private office for personality traits and characteristics that led to an incorrect tube feeding prescription. Disciplinary action should give advance warning and be immediate, consistent, and impersonal. In this scenario, the clinical nutrition manager correctly took disciplinary action in private; however, it was inappropriate to make the disciplinary action personal (punishing the person rather than the act).

Which of the following is an example of a "ready-prepared" production system? A gas station does nto have a kitchen and receives individual meals that they finish by thawing or reheating Menu items are delivered from a satellite area then reheated for serving A company cafeteria has large volume purchases and their porduction area is separate from their service area A hospital cafeteria uses rethermalization and reconstitutes frozen foods that are made on site

Correct answer: A hospital cafeteria uses rethermalization and reconstitutes frozen foods that are made on site Ready-prepared (cook-chill, cook-freeze) is a production system where foods are prepared on site, then frozen/chilled for later use. Key features are when food service reconstitutes frozen foods made on site and utilizes blast freezing and rethermalization. A commissary is a production system where food production (kitchen) and service area (cafeteria) are in separate facilities. Key features are when meals are delivered to the facility and there is separation of production and service areas. Assembly-serve (convenience) is a production system that purchases completely prepared individual portions, which they finish by thawing or reheating, and there is no on-site food production.

Which of the following is incorrect regarding a disaster menu? A short-term contingency plan should be determined to plan what to do if the disaster continues for more than 72-hours. A hospital should consider an inventory of food products for 96 hours. Each health care facility is required to have a 7-day disaster menu with a nutrient analysis. The disaster menu should be adapted to use fresh produce and dairy products first.

Correct answer: A short-term contingency plan should be determined to plan what to do if the disaster continues for more than 72-hours. After 9/11, foodservice operations in the United States realized the importance of having a disaster plan, or menu to utilize in the event of an emergency. The following are true regarding planning disaster menus: Determine a long-term contingency plan to plan what to do if the disaster continues for more than 72-hours. Develop a long-term contingency plan to use if the disaster continues for more than 72 hours. Each health care facility is required to have a 7-day disaster menu with a nutrient analysis. The disaster menu should be adapted to use fresh produce and dairy products first. A hospital should consider an inventory of food products for 96 hours.

Which by-product of alcohol metabolism causes the most significant damage to the liver? Acetate Excess water Carbon dioxide Acetaldehyde

Correct answer: Acetaldehyde During the first step of alcohol metabolism, ADH metabolizes alcohol to acetaldehyde, a highly toxic substance and known carcinogen. Acetaldehyde is a significant cause of liver damage function that disrupts mitochondrial function in alcoholic liver diseases such as hepatic steatosis, alcoholic hepatitis, and cirrhosis. In the second step of alcohol metabolism, acetaldehyde is further metabolized down to a less active by-product called acetate. Acetate is further broken down into water and carbon dioxide for elimination.

Madison reports that she has lost 6 pounds of her usual body weight of 112 pounds in the past two weeks. She states that she has not eaten over the past 9 days due to nausea and emesis after any oral intake. Based on these clinical characteristics, how would you diagnosis her malnutrition status? Mild malnutrition Chronic moderate malnutrition Acute severe malnutrition Nourished

Correct answer: Acute severe malnutrition Madison has lost 5.3% of her body weight in two weeks (6 lbs lost / 112 lbs usual wt = 0.53 x 100 = 5.3% wt loss) and has had inadequate energy intake for 9 days. Based on the ADA/A.S.P.E.N. chart of clinical characteristics to support diagnosis of malnutrition, Madison's clinical characteristics categorize her under acute, severe malnutrition based on </=50% energy intake for >/=5 days and >5% weight loss in 1 month. The other choices are not supported by her clinical characteristics (time frame, energy intake, percentage of weight loss). Eat Right: American Dietetic Association. ADA/A.S.P.E.N. Clinical characteristics that the RD can obtain and document to support a diagnosis of malnutrition. http://www.cmcgc.com/media/handouts/320121/t21_jane_white.pdf

During a nutrition intervention, a registered dietitian targets a client's unhealthy thought ("I am so fat") and influences the client to modify that thought. The RD recommends that the client keep a diary of her thoughts and behaviors for their next appointment. What type of therapy is the RD using? The Transtheoretical Model Cognitive-behavioral therapy Social Cognitive Theory The Health Belief model

Correct answer: Cognitive-behavioral therapy Cognitive-behavioral therapy (CBT) assumes that all behavior is learned and is directly related to internal triggers (e.g., thoughts and thinking patterns) and external triggers (e.g., environmental stimuli and reinforcement), which results in specific problematic behaviors. The intervention targets identification of inaccurate thoughts or beliefs that lead to unhealthy moods and behaviors (e.g., "I am so fat") and modification of those thoughts and responses. Techniques may include keeping a diary of feelings, thoughts, and behaviors. Social Cognitive Theory, or Social Learning Theory, is a theoretical framework for understanding, predicting, and changing behavior. Reinforcement strategies are used to increase or decrease the likelihood that a behavior will be repeated. The Health Belief Model is based on the assumption that an individual will be motivated to take action if that person feels that a negative health condition can be avoided/managed, believes that by taking a recommended action he/she will avoid negative health consequences, and believes he/she can do the recommended action. The Transtheoretical Model is a model developed to explain how behavior change involves progress through the stages of change.

What is the following statement describing? "...Where individuals can connect to others who are either struggling with an eating disorder, in recovery, or supporting someone with an eating disorder." Synergy Community Nutritional informatics Culture

Correct answer: Community Community can be defined by common interests, geographic boundaries, and values. For example, the National Eating Disorder Association's (NEDA's) online community forum serves as "an online community where individuals can connect to others who are either struggling with an eating disorder, in recovery, or supporting someone with an eating disorder." Nutritional informatics is the effective retrieval, organization, storage, and optimum use of information, data, and knowledge for food- and nutrition-related problem solving and decision-making. Informatics is supported by the use of information standards, processes, and technology. An example of nutritional information is an electronic health record (EHR). Synergy is the theory that a group decision is superior to what an individual could have produced by working alone. For example, a group of RDs will provide a better plan of care for a patient than the most resourceful RD could have formulated solely. Culture is the accumulation of a group's learned and shared behaviors in everyday life.

A university posts a public announcement of goods and services they need, suppliers respond to these announcements by submitting bids, and then a final selection of the supplier is made. What type of purchasing method is this? Just-in-time purchasing Informal purchasing Open market purchasing Competitive bid buying

Correct answer: Competitive bid buying Formal, competitive bid buying involves opening the procurement process to bids and tenders to obtain the best value. Informal, open market purchasing is the purchase of goods usually in smaller quantities without contracts or negotiations. Just-in-time purchasing is the purchasing of products only as they are needed for production and consumption, in order to increase efficiency, decrease waste, and reduce inventory costs.

The food service management team is developing a HACCP plan. Currently, the team is formulating a list of biological, chemical or physical agents within the facility that are reasonably likely to cause illness or injury in the absence of control. What HACCP principle is the team working on? Determining the critical control points (CCPs) Establishing record-keeping and documentation procedures Establishing critical limits Conducting a hazard analysis

Correct answer: Conducting a hazard analysis HACCP is a systematic approach to the identification, evaluation, and control of food safety hazards based on the following seven principles: Principle 1: Conduct a hazard analysis. The purpose of the hazard analysis is to develop a list of hazards which are of such significance that they are reasonably likely to cause injury or illness if not effectively controlled. Principle 2: Determine the critical control points (CCPs). Principle 3: Establish critical limits. Principle 4: Establish monitoring procedures. Principle 5: Establish corrective actions. Principle 6: Establish verification procedures. Principle 7: Establish record- keeping and documentation procedures.

Which dietary recommendation is appropriate for an individual with Crohn's disease? Consume a high-calorie and high-protein diet Take vitamin E and omega-3 supplements Take anti-constipation medication regularly Consume a high-fat diet when steatorrhea is present

Correct answer: Consume a high-calorie and high-protein diet Crohn's disease is a chronic inflammatory bowel disease that affects the lining of the digestive tract, specifically the terminal ileum. Appropriate dietary recommendations for a person with Crohn's disease include consuming a high-calorie and high-protein diet, taking vitamin C and vitamin B-12 supplementation, and eating a low-fat diet when steatorrhea is present. Since diarrhea and steatorrhea are more common side effects, anti-diarrhea medication is more likely to be recommended.

Which of the following is a key recommendation from the 2015-2020 Dietary Guidelines? Consume less than 2,300 milligrams per day of sodium Consume less than 1% of calories per day from added sugars Women should consume one alcoholic drink per day Consume at least 10% of calories per day from saturated fats

Correct answer: Consume less than 2,300 milligrams per day of sodium The 2015-2020 Dietary Guidelines' key recommendations include the following: Consume less than 10 percent of calories per day from added sugars Consume less than 10 percent of calories per day from saturated fats Consume less than 2,300 milligrams per day of sodium If alcohol is consumed, it should be consumed in moderation (up to one drink per day for women and up to two drinks per day for men) and only by adults of legal drinking age https://health.gov/dietaryguidelines/2015/guidelines/executive-summary/

How do nutrition needs change when a stage I pressure ulcer becomes a stage IV? Decreased calories, increased protein Decreased zinc Increased calories and protein Increased fluid requirements

Correct answer: Increased calories and protein A pressure ulcer is injury to the skin and underlying tissue resulting from prolonged pressure. Pressure ulcers are common in the elderly, in those with gunshot wounds and spinal cord injuries, and in patients with immobilization. Pressure ulcers are indicated by stages I, II, III, and IV (increasing in severity) and require increased calorie and protein needs. The nutrition recommendations are as follows: Stage I/II: 30-40 kcal/kg, 1.2-1.5 g protein/kg; Stage III/IV: 30-40 kcal/kg, 1.5-2.0 g protein/kg.

Which law aims to ensure that the U.S. food supply is safe by shifting the focus of federal regulations from responding to contamination to preventing it? The Food Code FSMA NSSP HACCP

Correct answer: FSMA The Food Safety Modernization Act (FSMA) was signed into law by President Obama on January 4, 2011. It aims to ensure the U.S. food supply is safe by shifting the focus of federal regulators from responding to contamination to preventing it. Hazard analysis and critical control points (HACCP) is a management system in which food safety is addressed through the analysis and control of biological, chemical, and physical hazards from raw material production, procurement and handling, to manufacturing, distribution and consumption of the finished product. The Food Code is a model for safeguarding public health and ensuring food is unadulterated and honestly presented when offered to the consumer. It represents the FDA's best advice for a uniform system of provisions that address the safety and protection of food offered at retail and in food service. The National Shellfish Sanitation Program (NSSP) is the federal/state cooperative program recognized by the U.S. Food and Drug Administration (FDA) and the Interstate Shellfish Sanitation Conference (ISSC) for the sanitary control of shellfish produced and sold for human consumption. The purpose is to promote and improve the sanitation of shellfish (oysters, clams, mussels, and scallops) moving in interstate commerce through federal/state cooperation and uniformity of state shellfish programs.

Maggie's Meals and Munchies is a start-up meal prep company, and they want to determine how to price their menu items. If they want to price the items based on raw food costs using a markup factor and hidden costs, which pricing method should they use? Prime cost method Competitive pricing method Factor pricing method Cost plus pricing method

Correct answer: Factor pricing method Maggie's Meals and Munchies wants to determine menu pricing based on raw food costs, a markup factor, and hidden costs; therefore, they should use the factor pricing method. The factor pricing method, also known as the traditional or markup method, uses the raw cost of food and food cost percentage to determine the selling price (markup). Hidden costs of 10% can be added to the food cost to account for unproductive costs, such as unavoidable waste in cooking, serving, and/or preparation. The prime cost method accounts for both raw food costs and direct labor costs involved in making an item. To determine prime cost, add raw food costs and direct labor costs. The cost plus pricing method ensures a predetermined percentage of profit by establishing profit as a cost. The competition pricing method assigns prices based on the general market price or those of the competition by pricing items the same as a competitor's, lower to attract those looking for a deal, or higher to attract those looking for higher quality

What is the largest hunger-relief organization in the United States? UNICEF Feeding America WIC SNAP

Correct answer: Feeding America Feeding America is a US-based nonprofit organization comprised of over 200 food banks that feed more than 46 million people through food pantries, soup kitchens, shelters, and other community-based agencies. It is the third largest US charity and the nation's largest hunger-relief organization. SNAP is the largest food assistance program that partners with Feeding America to provide food stamps and other benefits. UNICEF is a hunger-relief organization for the United Nations that provides humanitarian and developmental assistance to children and mothers in developing countries. WIC is a US-based food program for mothers, infants, and children.

Which demographic groups are most at risk for food insecurity? Male head of household and children Male head of household and rural poor Female head of household and children Urban poor and infants

Correct answer: Female head of household and children Food insecurity is limited access to food, resulting in hunger. Food insecurity can affect all ages, ethnicities, and locations. Poverty and hunger, which in combination typically result in food insecurity, most affect female heads of household, children, and the rural poor. These groups are most at risk for food insecurity.

What is the name for the stored form of iron? Ferritin Ferric Heme iron Ferrous

Correct answer: Ferritin Ferritin is the stored form of iron, and the best assessment parameter for iron status. Ferric is the food form of iron, and can be categorized as heme or non-heme. Heme iron sources are more absorbable than non-heme and are found in animal foods, meat, fish, and poultry. Non-heme iron sources are better absorbed when digested with sources of vitamin C and are found in cereals and vegetables. Ferrous is the absorbable form of iron.

The functions of the liver include all of the following except: Metabolize nutrients Store and release blood Filter toxic elements Filter red blood cells

Correct answer: Filter red blood cells The functions of the liver include storing and releasing blood, filtering toxic elements, metabolizing and storing nutrients, and regulating fluid and electrolyte balance. The filtration of red blood cells is a function of the kidneys.

The director of the hospital has assigned you responsibility for the creation of a complex work task. According to the FOCUS-PDCA model, what is the first step you should take? Focus on a strategy for continued improvement Determine how to collect data Figure out the current knowledge about a process Find a process to improve

Correct answer: Find a process to improve FOCUS-PDCA is a management and systematic process improvement method, which developed in the healthcare industry (Hospital Corporation of America, HCA). FOCUS-PDCA is an extension the PDCA cycle, which includes Plan-Do-Check-Act. F - Find a process to improve O - Organize to improve the process C - Clarify current knowledge of the process. This step includes collecting data and information about the process and should include talking with those who are most involved with it. U - Understand the source of process variation S - Select the process improvement

Which cooking method is known for its energy efficiency, does not use a flame, and delivers fast and even heating? Electric Induction Radiation Gas burner

Correct answer: Induction Induction cooking heats a cooking vessel through electric magnetic vibrations (induction) instead of thermal conduction from a flame or an electrical heating element. This type of cooking is known for its energy efficiency (less heat waste), does not use a flame, and gives fast and even cooking. Electric cooks unevenly with no flame. A gas burner cooks evenly and slowly with an open flame. Radiation cooks unevenly and fast, but it lacks the ability to brown food since heat is transferred indirectly to the food from infrared waves.

Choose the PES statement that is written in the correct format: Decreased energy intake as evidenced by decreased ability to consume sufficient energy, related to poor appetite, 5#/10% weight loss in 3 months, and 75% IBW. Inadequate energy intake related to decreased ability to consume sufficient energy as evidenced by current NPO diet order and decreased appetite. Excessive carbohydrate intake and increased energy intake related to dietary noncompliance as evidenced by food record showing 455 g CHO intake over 24 hours, HgbA1C 8.7%, adn 13# weight gain in 1 month. 40 pound weight loss in 3 months related to decreased appetite as evidenced by dysphagia and decreased ability to consume food.

Correct answer: Inadequate energy intake as related to decreased ability to consume sufficient energy as evidenced by current NPO diet order and decreased appetite The PES statement is also known as the nutrition diagnosis statement, which is a structured sentence that describes a specific nutrition problem (P) that the dietitian is responsible for treating and working toward resolving, the etiology (E) or cause(s) of the problem, and the signs/symptoms (S) of the existing problem. If there is more than one problem, each requires its own PES statement. The PES statement is written as: "P... related to E... as evidenced by S." P - Intake domain (excess/inadequate intake) E - Clinical or behavioral/environmental domain (provides link to intervention) S - Clinical domain (provides link to evaluation/monitoring)

Which of the following PES statements is written most appropriately? Inadequate oral intake related to decreased ability to consume sufficient energy as evidenced by 10% weight loss over the past 6 months Intake of high-caloric-density foods related to food- and knowledge-related deficit as evidenced by excessive energy intake Excessive oral intake as evidenced by 12% weight gain over the past 4 months related to intake of energy in excess of estimated energy needs Inadequate oral intake related to 8% weight loss over the past 3 months as evidenced by decreased ability to consume sufficient energy

Correct answer: Inadequate oral intake related to decreased ability to consume sufficient energy as evidenced by 10% weight loss over the past 6 months A PES statement describes the nutrition problem diagnosis (P), the etiology or root cause (E), and the signs and symptoms (S). The appropriate format of the PES statement is "[Nutrition problem] related to ___ as evidenced by ___." The only PES statement that is written in the correct format is "Inadequate oral intake (P) related to decreased ability to consume sufficient energy (E) as evidenced by 10% weight loss over the past 6 months (S)." The other choices are written in an incorrect format.

A dialysis company wants to research how frequently ESRD occurs in Asian-Americans and the percentage of Asian-Americans that develop ESRD over time. What type of research does the company want to conduct? Cross-sectional Incidence Quasi-experimental Prevalence

Correct answer: Incidence An incidence study is a type of cohort study that researches the risk of developing a disease. For example, an incidence study would be used to discover how frequently end-stage renal disease occurs in the Asian-American population and the proportion of the population that develops the disease over time. A prevalence study, also called a cross-sectional study, researches all the cases of a specific disease among a group of people in a specific time period. While an incidence study looks at the incidence of new disease, a prevalence study looks at existing disease. Quasi-experimental is a type of time-series research that takes measures before and after a program begins to show patterns or significant changes, for example, starting a dialysis program and taking measures of patients' BUN:Cr before and after the program.

You are looking at a sample population of 175 people and want to determine the number of new cases AIDS over a 12-year period. What variable are you trying to determine? Risk factor Confounding factor Incidence Prevalence

Correct answer: Incidence Incidence: The number of new cases of a disease or other condition during a specific time period. For example, the number of new cases AIDS over a 12-year period. Prevalence: The number of existing cases of a disease or other condition in a given population. Risk factor: A clinically important sign associated with an increased likelihood of acquiring a disease or other condition. Confounding factor: The factor that distorts the association or effect between an exposure and an outcome.

Jay was recently promoted to a top management position; what shifts should he make in his skill sets to be most effective in his new position? Increase human skills, decrease conceptual skills Increase conceptual skills, decrease technical skills Increase technical skills, decrease conceptual skills Increase technical skills, decrease human skills

Correct answer: Increase conceptual skills, decrease technical skills Managerial positions require technical, human, and conceptual skill sets. When promoted to top levels of management, a skill shift is required to increase conceptual and decrease technical skills. Technical skills are most important at lower levels of management because the process, procedure, and method of understanding specific kinds of activities is required. Human skills are important at all levels but very important at lower levels because the ability to work effectively as a group member is required. Conceptual skills are more important as authority increases within an organization because the ability to visualize the organization as a whole is required.

Which of the following scenarios may cause hyponatremia? Increased ADH secretion Decreased H2O intake Increased sweating Decreased vasopressin excretion

Correct answer: Increased ADH secretion The normal range for Na+ is 136-145 mEq/L. Hyponatremia (Na < 135 MEq/L) can be caused by increased use of thiazide diuretics or by antidepressants, burns, kidney or liver problems, severe diarrhea or vomiting, heart failure, increased H2O intake, ketonuria, and/or increased anti-diuretic hormone (ADH) excretion. Hypernatremia (Na > 146 mEq/L) can be caused by decreased H2O intake, increased NaCl intake, increased sweating, decreased vasopressin excretion, and/or glycosuria.

Which of the following signs might indicate intolerance to a tube feeding advancement? Upgrading a patient from mild to moderately malnourished Patient's complaints of hunger Increased complaints of fatigue Increased abdominal distension

Correct answer: Increased abdominal distension Enteral nutrition (EN) should be started early (within 24 to 48 hours) and advanced as tolerated. The following indicators should be used to monitor tolerance: Intake/output: Identify negative or positive balances Bowel movements: Constipation or diarrhea Tube placements: Ensure feeding tube is correctly placed Abdominal distension: Abdomen should be soft and non-distended, not hard and distended Weight: Desire stable weight; fluctuation may signify fluid intolerance Lab values: Look at electrolytes, glucose, and other nutrition-related lab values Complaints of hunger, increased fatigue, and changing of a patient's nutrition status are not indicators of intolerance. Flag Question

Joe is a single father with a 14-year-old daughter and a 10-year-old son. His primary care physician has referred him to you for medical nutrition therapy for hypertension and prediabetes. During the nutritional assessment, Joe tells you the following: He normally eats three meals per day. He can't afford to cook healthy meals at home, so he often eats out at fast food restaurants. He relies on low-cost food (such as frozen pizza, prepackaged noodles, and canned vegetables) to feed his family. Based on the available information, how would you classify his food security status? Low food security High food security Very low food security Marginal food security Next Question Flag Question

Correct answer: Low food security The food security status of households ranges on a continuum from high to very low, divided into four ranges and characterized as follows: High Food Security: Households do not have problems with or anxiety about accessing adequate food. Marginal Food Security: Households sometimes have problems with or anxiety about accessing adequate food, but the quality, quantity, and variety of food are not significantly reduced. Low Food Security: Households have reduced quality, desirability, and variety in their diets, but quantity of food and normal eating patterns are not significantly disrupted. Very Low Food Security: One or more household members experiences disrupted eating patterns and decreased food intake due to lack of money and resources for food. Joe describes reduced quality, variety, and desirability in his family's diet, but they do not experience a disruption in the amount of food or normal eating patterns; therefore, this would classify his household as low food security.

An individual is required to attend a nutrition class. During the class, he develops little interest in the topic and feels there are more important things he could be doing than wasting his time in this class. How would you assess his readiness to learn? Low education Low motivation High education High motivation

Correct answer: Low motivation An educational readiness assessment can determine how to teach based on the needs and readiness of the learners. The assessment evaluates motivation, education, and sophistication levels. Motivation level can affect a learner's attention span. In this example, the boy is showing a low motivation level since he feels there are more important things he could do and he has little interest in paying attention to the topic. With high motivation, an individual shows interest, voluntarily participates, and sets high expectations to apply the subject to his life. Education level is not always related to the amount of formal education. High education includes the ability to understand complex ideas and sometimes a previous knowledge of the topic where new information can be added. Low education indicates a lack of formal education beyond high school; in that case, reinforcement is helpful. Flag Question

When looking at your client's lab values, you note elevated blood urea nitrogen, creatinine, and potassium. Diet education about which of the following could potentially be most appropriate? Low sodium Consistent carbohydrate Low fat, low cholesterol High fiber

Correct answer: Low sodium The lab values in patients with renal dysfunctions, such as an acute kidney injury or chronic kidney disease, may show elevated blood urea nitrogen, creatinine, potassium, magnesium, and/or phosphorous. Therefore, a renal diet education that included information on low sodium, potassium, and/or phosphorous intake would be appropriate.

A 55-year-old male patient has a past medical history of type 2 diabetes mellitus, hyperlipidemia, and hypertension. He presents to the hospital complaining of shortness of breath and is admitted for new onset of congestive heart failure. His labs are as follows: Albumin 3.0 g/dL, Na 130 mEq/L, HgbA1C 9.8% What nutrition intervention should take priority? Low sodium, low fluid diet education Diabetes diet education High protein diet education Low fat diet education

Correct answer: Low sodium, low fluid diet education Nutrition intervention is composed of planning and implementation. Planning includes prioritizing diagnoses based on urgency, impact, and available resources. In this step, the registered dietitian (RD) may identify nutrition diagnoses for immediate treatment and nutrition diagnoses for which treatment should be delayed until a more favorable environment is available or more resources exist. (EatRight) In this scenario, the priority diagnosis is the new onset congestive heart failure (CHF). Therefore, the intervention is to educate the patient on the CHF diet (low sodium, low fluid). Since the patient has CHF, his lab values for sodium and albumin are abnormally low due to the fluid overload. After the primary CHF nutrition problem is addressed/resolved, the next pertinent nutrition problem to address is his uncontrolled diabetes (as evidenced by HgbA1C 9.8%).

Which of the following characteristics should a liquid have in order to foam? High vapor content Low surface tension High surface tension Low vapor content

Correct answer: Low surface tension In order for a liquid to foam, the liquid must have low surface tension. For example, egg whites at room temperature whip quicker and yield a larger volume due to the low surface tension. If the egg whites were cold, the surface tension would be higher and the mixture would collapse. If the egg whites had a high vapor content, the mixture would also collapse.

Kate was told by a health practitioner to avoid blue cheese, sauerkraut, sausage, and soy sauce. What type of diet might she be following and why? High fat diet for attention deficit disorder Low tyramine diet for migraines Low fiber diet for indigestion High sodium diet for hypertension

Correct answer: Low tyramine diet for migraines Tyramine is a protein found naturally in foods, especially foods that are aged, fermented, or stored for long periods of time. Examples of high-tyramine foods include blue cheese, sauerkraut, sausage, and soy sauce. Tyramine is well-accepted as a migraine trigger; therefore, a low or restricted tyramine diet is recommended for individuals with chronic headaches or migraines. A low fiber diet for indigestion and a high fat diet for ADHD are distractors; a high sodium diet is contraindicated for hypertension.

Which of the following nutritional problems is not common in the elderly? polypharmacy sore mouth hypercholesterolemia diarrhea

Diarrhea The elderly are considered individuals over 65 years of age and are categorized as young old (65-74), aged (75-84), and oldest old (>85), according to the US Census Bureau. Common nutritional problems for the elderly include sore mouth, polypharmacy, chronic disease, protein energy malnutrition, decreased absorption, hypercholesterolemia, and tooth loss. Diarrhea is not a common nutrition problem; rather, constipation is more common due to decreased gastric mobility and decreased HCl stomach secretion in the elderly.

n after-school community nutrition program teaches ways to increase iron intake in children. What is the best way to evaluate the effectiveness of the program? Provide a food frequency survey of iron-containing foods every month and compare the results Measure the percentage of correctly identified iron-containing foods before and after the program Measure hemoglobin levels of children before and after the program Distribute a post-test survey asking the participants to rank the effectiveness of the program

Correct answer: Measure hemoglobin levels of children before and after the program Learning objectives should be specific and measurable. Therefore, the best way to evaluate the effectiveness of a program is by using quantitative variables that can change based on the program's intervention goals—in this case, measuring a nutritional lab value, such as iron, before and after the program to see if the children had succeeded in eating more sources of iron. A food frequency questionnaire (FFQ), or survey, is not a good method for measuring long-term program effectiveness because it relies on long-term memory, estimates of portion sizes are often inaccurate, and the test taker may not provide honest answers. Measuring percentages of correctly identified foods does not reflect food intake; rather, it reflects the users' ability to identify certain iron-containing foods. A post-test survey is a qualitative feedback method that does not measure specific objectives, but instead gathers opinionated data

A patient claims she was billed for medical services she did not receive. What type of claim is the patient reporting and what is the corresponding agency to handle this claim? Financial identify theft; FTC Insurance identity theft; FDA Medical identity theft; FTC Insurance; USDA

Correct answer: Medical identity theft; FTC Medical identity theft occurs when someone uses another person's name or insurance information to get medical treatment, prescription drugs or surgery (FTC). Complaints are filed with the federal trade commission (FTC) for all issues regarding identify theft. Other forms of identify theft include child, medical, social security, criminal, financial, employment, driver's license, and insurance. https://www.ftc.gov/tips-advice/business-center/guidance/medical-identity-theft-faqs-health-care-providers-health-plans

Procurement involves all of the following processes, except: Purchase planning Menu design Price negotiation Inventory control and storage

Correct answer: Menu design Procurement is the act of obtaining or buying goods and services. Someone who procures is responsible for the receiving, purchasing, storage, and inventory control of good/services. Procurement often involves the following processes: Purchase planning, Standards determination, Specifications development, Supplier research and selection, Value analysis, Financing, Price negotiation, Making the purchase, Supply contract administration, Inventory control and stores, and Disposal and other related functions.

A vegetarian reports that she consumes the majority of her protein from soybeans and legumes. Which essential amino acid might she be low in? Phenylalanine Methionine Lysine Tryptophan

Correct answer: Methionine Amino acids are missing or low in most vegetables. Furthermore, soybeans are low in methionine; legumes are low in methionine, cystine, and tryptophan; gelatin is low in methionine and lysine and has no tryptophan. Therefore, a vegetarian who consumes the majority of her protein from soybeans and legumes might be low in methionine.

Which essential amino acid contains sulfur? Cystine Methionine Leucine Cysteine

Correct answer: Methionine Sulfur is found in the following amino acids: cysteine, cystine, and methionine. The essential amino acids include threonine, valine, tryptophan, isoleucine, leucine, lysine, phenylalanine, methionine, and histidine. Therefore, the only essential amino acid that contains sulfur is methionine.

During a physical exam in a male patient, you notice a visible clavicle bone and a slight depression in his temple region. How would you assess the patient based on this information? Moderate fat loss Mild muscle loss Mild fat loss Severe muscle loss

Correct answer: Mild muscle loss During this physical exam, the two sites indicate muscle loss areas (clavicle bone region and temple region) and not subcutaneous fat loss areas (orbital, upper arm, thoracic/lumbar region). The slight depression of the temples and the visible clavicle bone in males indicates mild to moderate malnutrition.

Children's diets are sometimes found to be inadequate in iron due to excessive intake of: Milk Protein Applesauce Enriched cereals

Correct answer: Milk If children drink too much cow's milk (e.g., more than 24 oz. per day) and eat few iron-rich foods (e.g., red meat, green leafy vegetables, etc.), they can develop "milk anemia." The signs and symptoms include irritability, shortness of breath, pica, decreased appetite, weakness/fatigue, brittle nails, and pale skin. Cow's milk is not a good source of iron and additionally makes it more difficult for the body to absorb iron, contributing to iron-deficiency anemia.

A company called World Wide Healthy Food Inc. writes the following statement: "To organize the world's fresh produce and make healthy food universally accessible and useful." What type of statement is this an example of? Mission Policy Strategy Vision

Correct answer: Mission A mission statement describes what a company does that is different from others. It should reflect the goals of the company. In this example, Word Wide Healthy Food Inc. is describing their mission statement. A vision statement refers to what a company wants to achieve in the future. For example, "World Wide Healthy Food Inc. aims to expand into low-income countries in the next decade." Strategy refers to decisions and actions that assist a company to meet its objectives. For example, World Wide Healthy Food Inc. plans to negotiate five ventures in five different low-income countries each week to expand into low-income countries. This strategy directly supports the vision of the company. A policy indicates what should be done in a company. For example, World Wide Healthy Food Inc. employees must wear a polo shirt and dress pants to work every day.

"Accelerate improvements in global health and well-being through food and nutrition" is an example of which type of statement? Mission Strategy Vision Objective

Correct answer: Mission A mission statement describes what a company does that is different from others. The example in this question is the Academy of Nutrition and Dietetics' (AND) mission statement. A vision statement describes what a company wants to achieve in the future. AND's vision statement is "A world where all people thrive through the transformative power of food and nutrition." Strategy is decisions and actions that assist a company in meeting its objectives. An objective is a predetermined goal toward which management directs its efforts to serve as motivators and provide direction.

A group of scientists are researching what specific personality traits are associated with obesity. They hypothesize that specific personality traits are associated with weight fluctuations and changes in BMI across the human lifespan. What type of research does this describe? Case study Qualitative Analytical Cohort

Correct answer: Qualitative This is an example of qualitative research because it is exploring a topic of interest (personality traits) as a prelude to theory development (obesity cause). This is a type of descriptive research that often precedes other research and collects data. Another descriptive research method is a case study, also known as a case report or case series. This type of research reports observations about subjects that describe the quantitative relationship between a group of cases and a disease, for example, a research study that reports personality trait observations of obese subjects to identify variables related to the etiology, care, or outcomes of the condition. Analytical research is a type of research that involves critical thinking and evaluation of information to prove a causal association (cause and effect). This type of research includes clinical trials, follow-up studies, and case control studies, for example, researching personality traits with an experimental and a control group of obese subjects. Cohort studies are a type of analytical research that follows a cohort (a group of people with something in common) over time to see if they develop a specific disease, for example, a research study that follows a group of people with bipolar disorder to see if they develop obesity.

What is the preferred flooring material in a foodservice kitchen and why? Abrasive slip-resistant tile because it is easier to clean, making it more hygienic Quarry tile because it is thick and abrasive Ceramic tile because it is easy to maintain Hard surfaces because they are slip-resistant

Correct answer: Quarry tile because it is thick and abrasive Quarry tile, or unglazed red clay tile, is the preferred flooring for foodservice kitchens because it is abrasive, slip-resistant, and thick. Hard surfaces can be slippery when wet and and quickly tire out employees' feet; therefore, this type of flooring would not be recommended for the kitchen work area. Abrasive or rough slip-resistant tile is safer but more difficult to clean and therefore less hygienic. Ceramic tile is long-lasting and easy to maintain, but is more suitable for walls.

Which of the following foods would you recommend to a celiac disease patient? Bran Barley Rye Quinoa

Correct answer: Quinoa Celiac disease is gluten-induced enteropathy, and medical nutrition therapy recommends the need for a gluten-restricted diet. Gluten is found in wheat, rye, barley, triticale, bran, graham, malt, bulgur, couscous, durum, orzo, and thickening agents. Gluten-free options include corn, potato, rice, soybean tapioca, arrowroot, carob bean, guar gum, flax, amaranth, quinoa, millet, teff, and buckwheat.

What component makes up the largest percentage of total energy expenditure? Exercise REE NEAT TEF

Correct answer: REE Energy is expended by the body in the form of basal energy expenditure, or resting energy expenditure (REE), the thermic effect of food (TEF), and activity thermogenesis (exercise and non-exercise activity). These components make up a person's total daily energy expenditure (TDEE). REE accounts for the largest percentage of total energy expenditure.

Which of the following is not a step in a community needs assessment? Raise awareness in the community Collect data about the background conditions Collect data about individuals who represent the target population Define the nutritional problem

Correct answer: Raise awareness in the community The steps in a community needs assessment are as follows: Define the nutritional problem. Set the parameters of the assessment. Collect data about the community, background conditions, and individuals who represent the target population. Analyze and interpret the data. Share the findings of the assessment. Set priorities. Choose a plan of action. Raising awareness in the community is an example of a trigger for a community needs assessment.

Which of the following fruits/vegetables should be washed just before serving? cucumbers mangos carrots raspberries

Correct answer: Raspberries Mushrooms and berries (strawberries, raspberries, blackberries) should be washed just before serving because these fruits/vegetables readily absorb water and become mushy. Other fruits and vegetables, such as cucumbers and carrots, can be washed before storing to wash away dust and spray residues. Some fruits and vegetables, such as bananas and mangos, do not require washing because the skin is not eaten.

Which of the following is an incorrect reason for recalling a food product? Discovery of an organism in prepackaged chips that may make consumers sick Meatloaf contains eggs, but that ingredient is not listed on label Receiving a refund for canned tuna as part of a recall Discovery of a potential allergen in trail mix

Correct answer: Receiving a refund for canned tuna as part of the recall Receiving a refund for canned tuna as part of a recall is not a reason for a food recall, but rather is a possible outcome of a food recall. Potential reasons for recalling food include the following: Discovery of organism in a product that may make consumers sick Discovery of a potential allergen in a product Mislabeling or misbranding of a product. For example, a food that contains an allergen, such as eggs, but that ingredient is not listed on the label

Which of the following is an example of an HACCP prerequisite program? Washing fruits to prevent cross-contamination Purchasing gluten-free foods Recipe development for potentially hazardous foods Sourcing produce from local farmers

Correct answer: Recipe development for potentially hazardous foods Prerequisite programs serve as the foundation for HACCP's development and implementation. Their purpose is to document procedures that address operational conditions required for the service and production of safe foods. Examples of standard prerequisite programs for a foodservice operation include recipe development for potentially hazardous foods and approving vendors.

Thomas is a new dietitian on staff and has come to you, the manager, to tell you he is struggling with his workload and finds his job too demanding. What should you do to enhance Thomas's performance? Reduce his patient load Increase nutritional education assignments Add extra employee trainings Incorporate a 1:1 manager meeting each week

Correct answer: Reduce his patient load If an employee finds a job too demanding, you can do the following to enhance their performance: simplify tasks, lessen the workload, and reduce time pressures. One way to lessen the workload would be reducing patient load. Adding more training, incorporating a 1:1 manager meeting each week, and increasing nutritional education assignments would increase overall workload, thus exacerbating Thomas's current job stress.

During a hospital employee in-service training session, health care professionals are given instructions on the diabetic diet. The in-service materials briefly cover the types of diabetic meal plans available, how to order different diabetic diets, and how to make a registered dietitian referral. What would a situational assessment tell you about this audience? They are inexperienced They are highly motivated They are moderately experienced They are very experienced

Correct answer: They are moderately experienced A situational assessment determines the needs and readiness of learners based on their sophistication level. The audience in this in-service training session would be classified as moderately experienced based on their profession (health care professionals) and the brief training (not requiring a thorough introduction and training on the topic). Moderately experienced audiences are typically teachers or patients that have been previously educated and only require emphasis or review of the materials. Very experienced audiences would include health care professionals receiving training in their unique field, for example a nutrition seminar for a registered dietitian. Inexperienced audiences include young children or adults lacking knowledge of the topic being addressed (nutrition). This audience requires thorough introduction and background. Motivation level cannot be assessed based on the available information. High motivation level is represented by individuals with a keen interest in the topic and who voluntarily participate.

Which nutrient is responsible for the metabolism of pyruvate to generate energy in the TCA cycle? Zinc Thiamin Chromium Magnesium

Correct answer: Thiamin Thiamin (vitamin B1) is responsible for the metabolism of pyruvate to generate energy in the TCA cycle. Without thiamin pyrophosphate, pyruvate is unable to convert to acetyl CoA for the TCA cycle, resulting in energy deprivation of the heart muscle. Chromium and zinc are important nutrients for glucose metabolism. Magnesium is responsible for the metabolism of glucose to glucose 6-phosphate in glycolysis.

What vitamins would you recommend for an alcoholic and why? Folate to prevent tetany Fiber to decrease esophageal varices Thiamin to prevent Wernicke's encephalopathy Sodium to reduce ascites

Correct answer: Thiamin to prevent Wernicke's encephalopathy An alcoholic may experience decreased absorption of vitamins from food and increased excretion from the body; therefore, B-complex vitamins, vitamin C, vitamin K, zinc, and magnesium should be recommended. Thiamin may help prevent Wernicke's encephalopathy and folic acid may help prevent macrocytic anemia. Low fiber is recommended when esophageal varices are present. Low sodium and fluid restriction is recommended when ascites are present. Tetany is a result of a calcium deficiency, not folate deficiency.

Which of the following medications is contraindicated for a T2DM patient with CHF? Insulin secretagogues Thiazolidinediones Glimepiride Glucotrol

Correct answer: Thiazolidinediones Thiazolidinediones (Actos) improve peripheral insulin sensitivity. This oral glucose-lowering medicine can worsen CHF by promoting weight gain and edema; therefore, it is not appropriate for patients with type 2 diabetes mellitus (T2DM) and congestive heart failure (CHF). Glimepiride, or Amaryl, stimulates the pancreas to make more insulin, thereby causing the possibility of low blood sugar. Therefore, this medication requires education on hypoglycemia. Insulin secretagogues, such as Glucotrol, promote insulin secretion and work to lower glucose levels.

Joshua works as a nutrition spokesperson for a major supplement company. When developing new pitches for media stories, he conducts a formal literature review on the topic, arranges his materials in a pragmatic manner, and presents his pitch in a lecture-based format. Joshua would most likely fall into which learning style category? Thinkers Sensors Intuitors Feelers

Correct answer: Thinkers Based on Jung's model, there are four learning styles: feelers, thinkers, sensor, and intuitors. Thinkers are pragmatic data collectors, interested in ideas and concepts, and prefer lectures. Sensors use common sense, prefer practice and application over theory, test and solve problems, and prefer one-on-one coaching or demonstrations. Intuitors are self-motivated risk-takers and prefer nontraditional learning and guided challenges. Feelers seek meaningful applications of knowledge, learn by listening and sharing ideas, and prefer discussion groups.

Butter, oil, and egg yolks are all examples of fat-containing ingredients commonly found in baking recipes. What is the function of fat in baking? To control the fermentation rate of yeast To develop gluten To provide stability To add tenderness

Correct answer: To add tenderness Common ingredients in baking recipes include flour, liquid, leavening agents, salt, egg, fat, and sugar. Each of these ingredients serves a functional purpose. For example, fat adds tenderness by coating gluten particles. Examples of fats are butter, oil, and egg yolk. The purpose of egg is to provide stability, retain the leavening agent, emulsify shortening, introduce air, add color, and add flavor. The purpose of salt is to add flavor, control the fermentation rate of yeast, and strengthen gluten. The purpose of water is to hydrate and develop gluten, start the action of chemical leavening agents, dissolve salt and sugar, and gelatinize starch.

Which of the following describes the registered dietitian's role in a community assessment? To determine individual macronutrient needs for the community To measure diet quality to assess how well a set of foods aligns with the US Dietary Guidelines for Americans To assess the nutritional status of a population or area To advocate for funding of federal school meal and nutrition programs

Correct answer: To assess the nutritional status of a population or area The registered dietitian's role in community assessment includes the following: To assess the nutritional status of a population or geographic area To identify target populations at nutritional risk To initiate and participate in nutrition-related data collection The Healthy Eating Index is a measure of diet quality that can be used to assess compliance with the US Dietary Guidelines for Americans and to monitor changes in dietary patterns. The Healthy and Hunger-Free Kids Act of 2010 provides funding for federal school meal and nutrition programs, improves access to healthy food, and promotes student wellness.

Carla is a new professor who will be teaching her first Introduction to Nutrition course at a local community college this fall. Which of the following should she do to provide effective education in this setting? Use 11-point Arial text for written documents Establish a spacial relationship of less than 18" when giving instructions to students Write cognitive, affective, and psychomotor performance objectives Create lesson plans that are simple, repeat concepts, and use large visual models

Correct answer: Write cognitive, affective, and psychomotor performance objectives The 7 steps to effective education: Assess the learning needs of individual and group Write performance objectives in three domains of learning (cognitive, affective, and psychomotor) Determine content based on assessment and objective Select methods, techniques, materials, and resources Implement learning and allow practice Evaluate progress and outcomes Document outcomes and results Formatting guidelines for educational materials recommend at least 12-point Times New Roman font (larger for elderly of at least 14-18-point), using active voice, and avoiding the use of past tense. The spatial relationship of less than 18 inches is known as the "intimate zone" and is used for very close friends and business handshakes; while giving instructions or working closely, the "personal zone" of 18 inches to 4 feet is more appropriate. The teaching methods for elderly age groups use simple lesson plans, repetition of concepts, and large visual models; adult-aged college students would do better with active learning and participation techniques.

What is a common oral health issue in older adults, along with the appropriate nutritional recommendation? Xerostomia, Drink more liquids CLeft lip, speech therapy Constipation, decrease fiber intake GERD, high-fat diet

Correct answer: Xerostomia; drink more liquids Xerostomia is dry mouth due to lack of saliva, which may result in dysphagia, and is commonly found in older adults. The appropriate nutrition recommendations are drink more liquids, use artificial saliva substitutes, chew sugarless gum, and eat a healthful diet. Cleft lip is a condition present at birth and characterized by openings or splits in the roof of the mouth and lip, which can be treated with surgery or speech therapy. Gastroesophageal reflux disease (GERD) is weakened lower esophageal sphincter muscles that leads to stomach acid regurgitating up the esophagus. It is common in older adults. The nutritional remedies include a low-fat diet, avoidance of large meals, sitting upright after eating, and avoiding foods that stimulate acid secretion. Constipation is characterized by abdominal discomfort, hard stools, and more than three days without a bowel movement. The intervention is increased fiber intake, a target of three bowel movements per week, and use of laxatives.

If an anthoxanthin is cooked in an aluminum pan, what color will the end product be? Yellow Bluish Colorless No change

Correct answer: Yellow Antoxanthins, or flavones, are water-soluble white pigments. An example of a plant rich in anthoxanthin is the onion. Anthoxanthins are colorless in acid and yellow in alkaline. Aluminum is an alkaline environment. Anthocyanin is a water-soluble red, blue, or purple pigment. An example of a plant rich in anthocyanin is blueberries. Anthocyanins are bright red in acid (such as metals) and bluish in alkaline. Flag Question

A 35-year-old man is 5'5", weighs 150 pounds, and has a calculated BMR of 1,595 kcals/day. During a follow-up assessment, the man states he drinks coffee and smokes cigarettes daily. Should his BMR be adjusted? If so, what should his new BMR be? Yes; 1,915 kcal/day No; 1,595 kcal/day Yes; 1,675 kcal/day Yes; 1,754 kcal/day

Correct answer: Yes; 1,754 kcal/day Basal metabolic rate (BMR) is the minimum amount of energy needed at rest in fasting to carry on the involuntary work of the body. BMR is primarily affected by sex, age, body composition, and thyroid hormones. But it is also affected by extremes in environmental temperature; a tropical climate can induce a 5-20% increase in BMR. Also, metabolic stimulants (caffeine, alcohol, nicotine) can induce a 7-15% increase in BMR. Therefore, the man's current BMR (1,595) could be multiplied by about 10% (159) to estimate the new BMR (about 1,754). The other answers are incorrect due to not accounting for the stimulants and to multiplying the BMR by too low of a rate (5% for 1,675) or too high of a rate (20% for 1,915).

James is reducing the budget at his dialysis clinic. Which component of his business should he consider reducing first? Sunk costs Fixed costs Semi-variable costs Variable costs

Correct answers: Variable costs Variable costs, also known as direct or flexible costs, are those that proportionately vary with the level of output and changes in volume. Examples of variable costs include food, uniforms, and benefits. When reducing a budget, first look at variable costs. Fixed costs, also known as indirect costs, are those not affected by sales volume and that stay fixed within a range of sales volume. Examples of fixed costs include rent, taxes, and depreciation. Semi-variable costs include both fixed and variable components, where costs are fixed for a set level of production/consumption and become variable after this production level is exceeded. Examples include labor, maintenance, and utilities. Sunk costs are those that have already been incurred and cannot be recovered by a new decision.

At the end of a fiscal year, a line chef is not promoted to head chef, so he decides to seek a position outside of his current food service company. What type of behavior is the chef demonstrating? Rationlization Withdrawal Substitution Regression

Correction answer: Substitution Substitution is when an employee puts something else in place of his or her original objective. For example, if the employee is not promoted and they seek a position outside of the company. Regression is reverting to child-like behavior, such as horse-play. Rationalization is using a less ego-deflating rationale than true reason to explain a situation. Withdrawal is avoiding a frustrating situation.

You want to convey timely and relevant food and nutrition-related news to the public. All of the following activities would help you, except: Attending continuing education meeting and scientific conferences Reading Food & Nutrition Magazine Visiting your local bookstore to browse the shelves of diet books, cookbooks and sef-help books Developing the appropriate marketing mix

Developing the appropriate marketing mix The marketing mix is developed to achieve an organization's objectives and satisfy the target market. The 4 P's of the marketing mix are product, place, price, and promotion. When working with the media, it is important to follow professional literature and know what the public wants to read, view, and hear. Examples include: Reading Food & Nutrition Magazine Visiting your local bookstore to browse the shelves of diet books, cookbooks and self-help books Attending continuing education meeting and scientific conferences