RD Practice Exam 1
A patient who undergoes a gastric resection is most at risk for developing a deficiency of A. riboflavin B. vitamin B12 C. folic acid D. manganese
A gastric resection decreases the volume of the stomach. Intrinsic factor is secreted in the stomach. Absorption of Vitamin B12 requires intrinsic factor. Therefore reduction of the stomach would result in a reduced absorption of vitamin B12.
Feeding via a PEG would be appropriate for a patient with A. short bowel syndrome B. a duodenal ulcer C. pancreatitis D. head and neck cancer
A periepigastric tube (PEG) feeds into the stomach. A patient with head and neck cancer would be likely to have swallowing problems, and therefore require a feeding method that bypasses this area. A patient with short bowel syndrome would likely require a modified formula, but not necessarily this type of feeding tube. A duodenal ulcer does not indicate a need for enteral feeding. Patients with pancreatitis are usually NPO.
Your supervisor asks you to have a physical inventory report on her desk by noon today, for her lunch time meeting with the hospital's vice president of operations. What do you need to include in your report? A. information about the range of foods needed every month by the facility B. an estimate of your department's inventory C. information about the actual quantities of food in storage D. a copy if your computerized menu accounting
A physical inventory shows the actual amount of food in stock. The other options are not relevant to the report requested, which was a physical inventory report.
Based on the following cafeteria data for November, Total revenue $909,009.00 Net income $173,010.00 FTEs 27.9 Number of customers 32,613 the average check for November was ___________. A. $27.87 B. $6.29 C. $5.30 D. $33.04
A; $909,009 (revenue) / 32,613 (# of customers) = $27.87
How many cups are in a #6 scoop? A. 2/3 B. 1/2 C. 1/4 D. 3/8
A; A #6 scoop is 2/3 of a cup. Scoop numbers are based upon the number of level scoops it takes to fill a 32 oz container. 8 oz = 1 cup
Which of the following is not one of the Health People 2020 Nutrition Objectives? A. Reduce iron deficiency among adults over 65 years of age B. Increase consumption of calcium in the population aged 2 years and older. C. Increase food security among U.S. households and in so doing reduce hunger D. Increase the contribution of whole grains to the diets of the population aged 2 years and older
A; According to Health People 2020: (NWS-21) Iron deficiency is a problem among young children, women of childbearing age, and pregnant women; and objectives have been set in regard to these groups; however, iron deficiency does not continue to be a concern among the elderly. The calcium intake objective is NWS -20. The grain product objective is NWS-16. The food security objective is NWS-13.
Which of the following would be acceptable to give to a child with PKU? A. a bag of potato chips B. a plate of spaghetti and meatballs C. a pack of sugar-free gum D. a peanut butter and jelly sandwich
A; Children with phenylketoneuria (PKU) should be provided with foods with low-protein content because these will also have low phenylalanine content. Potato chips provide minimal amounts of phenylalanine. High-protein foods such as dairy, meats, and peanut butter would provide too much phenylalanine. Also, regular breads, pastas, and baked goods may be too high in phenylalanine. Aspartame is the sweetener that is commonly used in sugar-free and diet products; however, as aspartame contains phenylalanine, these foods should be avoided by a child with PKU.
The average amount of time that it takes for foods eaten to pass through the entire gastrointestinal tract is A. 24 - 72 hours B. 96 - 102 hours C. 3 - 6 hours D. 10 - 12 hours
A; Complete digestion of food takes on average anywhere between 24 to 72 hours and depends on several factors, including the type of food eaten and the presence of digestive issues.
Enteral feeding products that contain protein in the form of small peptides and amino acids are recommended for patients who have A. short-bowel syndrome B. undergone jejunostomy C. undergone colectomy D. undergone gastrectomy
A; Elemental feedings are more quickly and easily absorbed, thus making them appropriate for patients with short bowel syndrome. With gastrectomy, the concern would be about dumping syndrome, which could be exacerbated by an elemental feeding formula. A colectomy would have no impact on intestinal absorption of protein or amino acids. While a jejunostomy would decrease some intestinal absorption, a standard feeding formula would be recommended unless there were other indicators of malabsorption.
To assess the need for a program, which epidemiological indicator should be examined? A. All of the "5 Ds" (death, disease, disability, discomfort, and dissatisfaction) B. incidence of a given disease of concern C. morbidity from a given disease of concern D. mortality from a given disease of concern
A; Epidemiologist look at the entire impact of a disease on a given population. Death, disease, impacts of disability status, level of discomfort (how people feel about the disease), and their satisfaction/dissatisfaction levels with their health (both physiological and psychological) are analyzed.
Which of the following is an example of a fixed cost? A. rent paid for use of a facility B. china and service ware purchases C. a previously paid off bank loan D. a correction in a ledger
A; Fixed costs are costs that remain consistent regardless of sales volume or rate of services provided, such as rent, taxes, mortgage payments, salary to salaried (non-hourly) employees, etc. A previously paid bank loan is no longer a "cost". China and service ware are variable costs. Correction in a ledger to "fix" an error is not an actual cost.
Which of these ICD-10-CM comorbidities is defined as "severe tissue wasting or loss of subcutaneous fat"? A. 261—Marasmus B. 262—Other severe protein-calorie malnutrition C. 260—Kwashiorkor D. 263.2—Arrested development following protein-calorie malnutrition
A; Marasmus refers to tissue wasting. Kwashiorkor is defined as severe protein deficiency marked by changes in/of skin and hair pigments. Arrested development following protein-calorie malnutrition is defined as nutritional dwarfism.
Which of the following will occur in iron deficiency? A. microcytic anemia B. high reticulocyte count C. macrocytic anemia D. high MCV
A; Microcytic anemia is most associated with iron deficiency. Macrocytic anemia, which would be reflected by a high MCV value, is usually caused by either folate or vitamin B12 deficiency. Reticulocytes are large, nucleated, immature red blood cells that are released in small numbers with mature red blood cells. Presence of these may indicate erythropoiesis in response to blood loss, hemolysis, or iron, folate, or vitamin B12 therapies.
Which of the following is the most accurate way to assess a patient's food acceptance? A. observe plate waste left on meal trays B. calculate weight change C. obtain food preferences upon admission D. review patient satisfaction survey upon discharge
A; Observing someone's plate waste can give the dietitian an immediate evaluation of food acceptance. Obtaining food preferences may not determine acceptance of the actual foods received. Patient satisfaction surveys examine overall satisfaction with hospital services. Weight changes may be due to other factors, such as fluid status. Also weight changes due to poor PO intake may not be measurable during an acute care stay.
Which of the following are biologically active, naturally occurring substances in plants that act as natural defense systems and show potential for reducing the risk for cancer and cardiovascular disease? A. phytochemicals B. butyrates C. prebiotics D. xenobiotics
A; Phytochemicals include substances such as flavonoids, anthocyanins, and carotenoids that provide color, aroma, and flavor to foods. Prebiotics are carbohydrates that are used by beneficial gastrointestinal bacteria to promote their growth and inhibition of growth of harmful bacteria. Butyrate is a short-chain fatty acid that is used by colonic mucosal cells as an energy source. A xenobiotic is a compound foreign to the body, usually harmful.
From infancy to adulthood, protein requirements per kilogram A. trend downward B. trend upward C. remain constant D. are entirely dependent on lean body mass
A; Protein requirements are the highest during phases of rapid growth, such as infancy, and slows as people reach adulthood. Although the amount of total protein intake in grams increases as the body grows, the grams per kilogram of body weight decrease.
What labor legislation guarantees an employee the right to join a union and prohibits discrimination against union members? A. the National Labor Relations Act B. the Labor-Management Reporting and Disclosure Act C. the Civil Rights Act D. the Taft-Hartley Act
A; The National Labor Relations Act was enacted in 1935 to protect the rights of employees, to encourage collective bargaining, and to protect the rights of union members.
For which of the following serum levels has the National Cholesterol Education Program not set a recommendation? A. VLDL cholesterol B. HDL cholesterol C. Total cholesterol D. LDL cholesterol
A; Very-low-density lipoproteins, although their remnants have been identified as promoting atherogenesis, have not had recommended guidelines established in regard to serum levels. Both LDL and total cholesterol have been targeted for decreases, with overall level of decrease dependent upon a patient's risk factors. HDL has been identified as a value to increase, with levels set for both men and women
An edematous person may actually be dehydrated if A. intravascular fluid is retained B. intravascular fluid is diluted C. fluid is retained extracellularly D. fluid is retained intracellularly
A?; Hydration status is determined by intravascular fluid. Edema is an accumulation of extracellular fluid.
A patient is receiving an intravenous solution that provides 120 grams of dextrose monohydrate. How many calories does this provide the patient? A. 1480 kcals B.240 kcals C. 132 kcals D.408 kcals
As dextrose monohydrate is a molecule of glucose and water, it has a lower calorie concentration than other carbohydrates (3.4 kcal/g vs. 4 kcal/g). 120 g × 3.4 kcal/g = 408 kcal. 10% lipid emulsions provide 1.1 kcal/mL solution. 20% lipid emulsions provide 2 kcal/g solution.
A food service is being converted from a conventional system to a ready-prepared system. The dietitian should first consider the adequacy of the A. steam table space B. low-temperature storage capacity C. dry storage space D. oven capacity
B. low-temperature storage capacity; Both foods to be reheated and foods to be served cold require cold storage space (refrigerator or freezer). These needs will be increased with a change from a conventional to a ready-prepared food service system.
If the food cost is 42% of the cafeteria selling price, what is the revenue generated by a hamburger that sells for $2.50? A. $2.42 B. $1.45 C. $2.00 D. $1.05
B; $2.50 X .42 = $1.05 food cost $2.50 selling price - $1.05 food cost = $1.45 revenue
How many grams of protein would be provided on a 1500 calorie diet that is formulated to be 20% protein? A. 64 grams B. 75 grams C. 70 grams D. 300 grams
B; 1500 kcals X .20 = 300 kcals from protein 300/4 kcals/gm = 75 gms
In a TPN admixture, what volume of the amino acid solutions listed would come closest to providing 185 calories? A. 500 ml of 10% amino acids B. 850 ml of 5.5% amino acids C. 1000 ml of 8.5% amino acids D. 500 ml of 7.0% amino acids
B; 185 kcals X (1 gm protein/ 4 kcals) = 46.25 grams protein 8.5% x 1000mLs = 85 gms protein x 4 kcals/gm = 340 kcals 5.5% x 850mLs = 46.25 gms protein x 4 kcals/gm = 187 kcals 7.0% x 500mLs = 35 gms protein x 4 kcals/gm = 140 kcals 10% x 500mLs = 50 gms protein x 4 kcals/gm = 200 kcals To solve this calculation, you need to know that the Atwater value for amino acids is the same as for protein (4 kcals/ gram). Calculate the grams of amino acids found in each solution, then multiply by 4 to get the approximate total calories.
If a patient tray assembly line can plate 4 trays per minute, and the patient census is 350, about how long will the tray line need to run to serve all patients? A. 1 hour B. 1 hour and 30 minutes C. 2 hours D. 1 hour and 15 minutes
B; 350 trays X 4 trays/1 minute = 350/4 = 87.5 minutes 87.5 minutes = 60 minutes/1 hour + 27.5 minutes = 1 hour and 27.5 minutes 1 1/2 hours is the closest answer option
An employee consistently telephones out sick the day before a scheduled weekend off. The supervising dietitian should first: A. file a letter of understanding with the human resources department B. schedule a counseling session with the employee C. complain to other staff members D. telephone the employee to verify the illness
B; A consistent pattern of absences from work is a cause for concern for a supervisor. A counseling session should be scheduled with the employee to discuss the situation.
How does an elevation in body temperature with a fever affect the metabolic rate? A. It does not change the metabolic rate. B. It increases the metabolic rate by 7% per 1°F above normal. C. It increases the metabolic rate by 14% per 1°F above normal. D. It decreases the metabolic rate by 7% per 1°F above normal.
B; A fever causes an increase in body temperature. For every 1° F above the normal 98.6° F, the BMR increases by 7%.
Which group of foods includes the best sources of flavanoids? A. carrots and squash B. berries and cherries C. salmon and tuna D. spinach and kal
B; Berries, cherries, red grapes, green tea, and cocoa are good sources of flavonoids. Carrots and squash are sources of beta-carotene. Salmon and blue fin tuna are sources of eicosapentaenoic acid (EPA). Green leafy vegetables are sources of lutein.
In a discussion with a patient, which of the following questions best encourages them to take responsibility for making appropriate dietary changes? A. "These changes shouldn't be too difficult for you, should they?" B. "What change do you think you'll be most comfortable trying to achieve first?" C. "Do you think you'll be able to do that?" D. "Do you think you'll have family support for these changes?"
B; Correct: The question pertains to motivational interviewing. In motivational interviewing, the client is to set his/her own goals.
Patients on prolonged bed rest are likely to have a negative balance of these two nutrients. A. nitrogen and sodium B. nitrogen and calcium C. potassium and sodium D. calcium and phosphorus
B; Decreased Nitrogen is an indicator of decreasing protein status; decreased Calcium is an indicator of bone demineralization. Both occur with prolonged immobilization.
The dietitian is asked to collect information and write a report to justify renewal of public funding for congregate meal sites for the elderly. Which piece of evidence is the most likely to be convincing for this purpose? A. 95% of the participants surveyed indicated that they are highly satisfied with the program. B. Program statistics show that hospital days for participants have dropped 28% in the past year. C. Program intake statistics show that 85% of the elderly in the community who live alone participate. D. A survey of the community shows that revenues of businesses close to the meal sites have risen 20% in the past year.
B; Decreased hospital days for participants would be consistent with improved health status. It would also show a cost savings from health care needed, which would justify funding the program. While participation rates and satisfaction are important metrics, they are not as likely to convince a funder as a decrease in health care utilization rates. The statistics for local businesses could be due to factors other than the congregate meals program.
A patient who has been treated for chronic renal failure during the past year must now begin hemodialysis. The patient's diet should be modified to include more A. fluids B. protein C. potassium D. sodium
B; Increased protein requirements with hemodialysis mean that an increased amount of dietary protein is needed. Sodium, potassium and fluids all continue to be restricted while on hemodialysis.
The statement "the country's infant mortality rate is 12.8, and the state's infant mortality rate is 10.5" means that A. two more infants died in the country than in the state B. for every 1000 live births in the country, 12.8 infants died C. more infants died in the country than in the state D. 12.8% of infants born in the country died before the age of 1 year
B; Infant mortality refers to deaths and is generally reported per 1000 for health statistics for state and country data. In order to make direct comparisons it is necessary to convert both country and state rates to absolute numbers. The percent is calculated as the rate multiplied by 100 (12/1000 X 100). Therefore, 1.28% of the infants born in the country died before the age of 1 year, not 12.8%.
The purpose of nutritional screening is to A. write a PES statement. B. identify patients at nutritional risk. C. assess the patient's nutritional status. D. determine a patient's nutritional problem
B; Nutrition screening is a quick means of identifying whether or not a person may be at risk for a nutritional problem. Usually, only a few well selected parameters related to nutrition are evaluated to determine this risk. If screening does identify potential risk, then a more complete nutrition assessment should be performed. The assessment will identify any specific nutrition problems the patient may have.
A dietitian is asked to develop quality control guidelines for receiving purchased foods. The most important guideline would define A. proper weights of foods received B. proper temperatures of foods received C. accurate prices on the invoice D. proper counts of foods received
B; Temperature is the most important for quality control, counts, weights, and prices do not impact the quality of the food.
Which of the following has developed fact sheets about dietary supplements that can be used by health professionals to educate clients? A. FDA B. ODS C. NCCAM D. AHRQ
B; The Office of Dietary Supplements (ODS) has prepared information available to assist in educating consumers about various dietary supplements. The National Center for Complementary and Alternative Medicine (NCCAM) promotes research into alternative medicine. The Food and Drug Administration (FDA) has published tips for supplement users in regard to making informed decisions when selecting supplements. The Agency for Healthcare Research and Quality (AHRQ) maintains a database of evidence-based practices in treatments of various conditions, and some of these include aspects of CAM.
Once assessment of a patient has determined that PO intake is inadequate, what is the next determination to be made? A. What type of feeding tube should be placed? B. Is the GI tract functional? C. What type of enteral feeding formula should be used? D. What rate of TPN is required?
B; The choice for use of enteral vs. parenteral nutrition should be made based on whether the gastrointestinal tract is functioning and capable of supporting the use of enteral nutrition. If the GI tract works, patient's nutritional needs can be met through enteral nutrition. Tube type, formula type, and TPN rate are all decisions that may need to be determined later.
If a bottle of whiskey is labeled 70-proof, what percentage of ethanol does it contain? A. 17.5% B. 35% C. 140% D. 70%
B; The percentage of ethanol in an alcoholic beverage is equal to the proof divided by two (70 ÷ 2 = 35%).
What is a popularity index? A. an inventory of food items not sold B. an analysis of sales to predict the demand for various foods C. a record of sales income D. a survey of food preferences of customers
B; The popularity index is used to analyze and predict sales of specific items. Day to day variations in sales are recorded, and used to predict future sales and production needs for each item.
Which of these is not an essential amino acid for adults? A. valine B. histidine C. methionine D. lysine
B; There are 8 essential amino acids - isoleucine, leucine, lysine, methionine, phenlyalanine, threonine, typtophan and valine. Histidine is essential only for infants.
Which organization(s) have responsibility for the Dietary Guidelines for Americans? A. FAO B. USDA and DHHS C. FNB and IOM D. FDA
B; Under the National Nutrition Monitoring and Related Research Act, the USDA and DHHS are jointly responsible for the updating and publication of the Dietary Guidelines for Americans every 5 years. The Food and Agriculture Organization (FAO) and the World Health Organization (WHO) of the United Nations establish international guidelines. The Food & Drug Administration (FDA) is responsible for food labeling. The Food and Nutrition Board (FNB) develops the Dietary Reference Intakes (DRIs).
The dietitian is to implement a new policy regarding the procedure for discharge instructions. The dietitian develops an outline for a plan of action, presents the information to the staff, and encourages them to make suggestions. This type of leadership style is described as ___________. A. dictatorial B. democratic C. autocratic D. laissez-faire
B; democratic Autocratic or dictatorial managers would not consult employees prior to implementing a new policy. For laissez-faire, the manager would not have developed an outline or prepared for a discussion.
A client consumes a meal that contains 52 g of carbohydrate, 25 g of protein, and 12 g of fat. According to the Exchange Lists for Meal Planning, the exchange value of this meal is _________________. A. 1 starch, 1 fruit, 1 medium-fat meat, 2 low-fat milks B. 2 starches, 1 medium-fat meat, 2 vegetables, one 2% milk C. 3 starches, 2 medium-fat meats, 2 vegetables, one 2% milk D. 2 starches, 1 fruit, 2 medium-fat meats, 1 vegetable
B; see exchanges
Which of the following food groupings has the greatest iron content? A.Milk, raisins, and a pork chop B.Kidney beans, pistachio nuts, and chicken liver C.Broccoli, Rice Krispies, and black beans D.Tuna fish, beef tenderloin steak, and spinach
B;Foods with the highest iron content include liver, kidney, beef, egg yolk, dried fruits, dried beans and peas, nuts, green leafy vegetables, molasses, whole-grain breads and cereals, and fortified cereals.
Which of the following types of label claims was first established under the Dietary Supplement Health and Education Act (DSHEA)? A. nutrition claims B. health and disease claims C. structure and function claims D. authoritative statements
C. structure and function claims; Structure and function claims were developed under DSHEA of 1994, to provide for label statements that address physiologic effects of product content in supplements. This was a compromise with the supplement industry so that the supplement producers did not have to provide documented evidence to support health claims. The problem with these claims is that consumers cannot distinguish between these and health claims. Authoritative statements were established under the FDA Modernization Act of 1997 to allow for health claims based on published statements from authoritative organizations. Both health and nutrition claims were established under the Nutrition Labeling and Education Act of 1990.
Which of the following does NIH identify as being an appropriate candidate for bariatric surgery? A. A patient with BMI of 25 to 29 with high blood pressure B. A person with metabolic syndrome C. A patient with BMI of 40 or higher D. A patient with BMI of 30 to 34
C; A person with a BMI greater than 40 or person with a BMI greater than 35 with co-morbidities would be an ideal candidate. Combinations of diet therapy, exercise, and lifestyle modification should be attempted before surgical intervention is sought.
A nutrition educator is assessing the results of a program for a final report on a grant. This is an example of a _________ evaluation method. A. formative B. outcome oriented C. summative D. developmental
C; A summative evaluation is conducted of the results of a program at it's conclusion. A formative assessment is conducted by teachers during the learning process in order to modify teaching and learning activities to improve student attainment. Outcome-based education is an educational theory that bases each part of an educational system around goals (outcomes). By the end of the educational experience, each student should have achieved the goal. Developmental Evaluation is an evaluation approach used to develop social change initiatives in complex or uncertain environments.
How could a heart-healthy cooking class and demonstration be a form of primary prevention? A. If the class is made available to spouses and caregivers of people with heart disease. B. If the class is made available to people with a history of heart disease. C. If the class is made available to the general public. D. If the class is made available to people who have had surgery for heart disease.
C; As primary prevention focuses on health promotion prior to actually having a disease, making the class available to anybody in the general public would be a type of primary prevention. Secondary prevention would focus the class for those at risk of developing heart disease. Tertiary prevention would be for those who already have the disease and their spouses and care providers.
Which of the following foods should be avoided by a patient with celiac disease? A. vegetarian chili with beans B. baked potato with broccoli and grated cheese C. avocado toast on whole wheat bread D. chicken and vegetable stir fry with rice noodles
C; Celiac disease is caused by an intolerance of gluten, a protein found in wheat, rye, and barley. The disease is managed by avoidance of foods containing these grains. Beans, rice, and potatoes do not contain gluten.
When given as the sole energy source, isocaloric amounts of which energy substrate would most effectively reduce starvation ketosis? A. MCT oil B. corn oil C. glucose D. essential amino acids
C; Corn oil and Medium Chain Triglyceride (MCT) Oils are fats. Fats and amino acids do not reduce ketosis. Glucose is a carbohydrate, which will reduce starvation ketosis.
A food service supervisor plans to serve turkey enchiladas next week. It is forecast that 110 customers will each eat 2 enchiladas. Each enchilada contains 2 ounces of cooked turkey. One pound of raw turkey yields .75 pounds of cooked turkey meat. How many pounds of raw turkey needs to be purchased? A. 14 pounds B. 21 pounds C. 37 pounds D. 55 pounds
C; First calculate how much cooked turkey meat you will need: 110 customers x 2 enchiladas each x 2 ounces meat per enchilada = 440 ounces/16 = 27.5 lbs Then, given that there is a yield of .75 lb of cooked meat per pound of raw turkey, 27.5/.75 yield = 36.6 lbs (round to 37 lbs) of raw turkey to be purchased
What is measured when carrying out indirect calorimetry? A. the amount of heat produced by the body at rest B. oxygen consumption and carbon dioxide excretion C. the resting metabolic rate D. the energy potential of the foods consumed
C; Indirect calorimetry measures gas exchange that results from metabolism. The oxygen consumption and carbon dioxide excretion can be used to estimate a resting metabolic rate. Direct calorimetry measures heat production, either from humans in a controlled environment, or from food, by incinerating the food and measuring the amount of heat released.
________________ interferes with the utilization of vitamin B6 in the body. A. phenobarbytol B. cyclamate C. isoniazid D. insulin
C; Isoniazid is an antibiotic used to treat tuberculosis. Since it is a B6 antagonist, B6 supplements are usually recommended for patients taking this drug. Insulin does not have any significant nutrient/drug interactions with B vitamins. Cyclamate is a type of artificial sweetener banned from use in the US due to concerns over it being potentially carcinogenic. Phenobarbitol is a sedative that is used to treat seizures. It does not decrease B6 activity, but may decrease biotin and/or folic acid levels with long-term use.
The rate of weight loss for men on energy-deficient diets is usually more rapid than for women because men A. are always more compliant with weight-reduction programs. B. are more likely to exercise while trying to lose weight. C. have higher RMR and LBM than women. D. generally have less fat to lose.
C; Men will lose weight faster than women of similar size because of their higher proportion of lean body mass and the resulting increase in resting metabolic rate. This results in higher calorie expenditure in males, leading to weight loss occurring more quickly. The amount of fat men and women have is affected by a variety of genetic and lifestyle factors, and so, men do not necessarily have less fat than women. The use and success of additional therapies beyond diet are dependent upon individual choice and commitment to weight loss
What is the name of the survey that collects information on nutrient intake and health status in the United States? A. Continuing Survey of Food Intake of Individuals B. Nationwide Food Consumption Survey C. National Health and Nutrition Examination Survey D. Diet and Health Knowledge Survey
C; NHANES was the original, and continues to be, survey that includes assessment of health status of Americans. The Nationwide Food Consumption Survey, the Continuing Survey of Food Intake of Individuals, and the Diet and Health Knowledge Survey all focused only the dietary and nutrient intake of Americans. The DHKS also included some examination of nutrition knowledge and attitudes.
Which Chinese regional cuisine uses noodles rather than rice in dishes? A. Hunan cousine B. Southern cousine C. Northern cousine D. Cantonese cousine
C; Northern Chinese cuisine is characterized by use of more noodle dishes as well as garlic, leeks, and scallions. Southern or Cantonese cuisine includes steamed and stir-fried dishes with fish and shellfish. Western or Hunan cuisine uses chili and hot peppers in dishes that tend to be hotter and oilier than those in other regions.
Sodium is increased the most by the intake of A. fresh meats B. frozen vegetables C. luncheon meats D. fresh vegetables
C; One ounce of luncheon meat could provide 400 mg of sodium. Fresh meat provides 30 mg of sodium per ounce if no salt, flavored salt, or flavor enhancers are used. Fresh vegetables provide very little sodium, and processing of cup of frozen vegetables without salt will provide about 10 mg of sodium.
What causes pernicious anemia? A. A loss of blood through the gastrointestinal tract B. A lack of iron from both heme and nonheme iron sources C. A deficiency of vitamin B12 D. Interference with pyridoxine metabolism
C; Pernicious anemia results from a vitamin B12 deficiency, usually resulting from a lack of intrinsic factor to ensure adequate absorption. GI blood loss and inadequate iron intake are more likely to be associated with an iron-deficiency anemia. Sideroblastic anemia results from an impairment in heme synthesis, which is dependent upon adequate pyridoxine availability.
What are the components of the "female athlete triad"? A. anorexia nervosa, amenorrhea, iron deficiency B. bulimia nervosa, low body weight, amenorrhea C. disordered eating, amenorrhea, osteoporosis D. low body weight, delayed menstruation, disordered eating
C; The female athlete triad may be experienced by females in competitive activities that stress lean body type, such as gymnastics, figure skating, or ballet. The syndrome is characterized by disordered eating behaviors to promote weight loss, loss of body fat resulting in amenorrhea, and loss of bone mass.
The "four P's" of marketing are product, price, promotion, and A. people B.posture C.place D.position
C; The marketing mix is a tool to help understand what a product or service can offer and how to plan for a successful product offering. The marketing mix is most commonly executed through the 4 P's of marketing: Price, Product, Promotion, and Place.
The establishment of minimum stock levels for reorder points is based primarily on A. available storage space and the menu B. food cost parameters and forecasted needs C. daily usage and the time needed to receive new stock D. inventory records and issue procedures
C; The minimum stock level is determined for each item and represents the anticipated usage and the time required to restock the item. Available storage space influences the frequency of deliveries, but it is not a primary consideration in setting the minimum stock level. Food cost parameters have no relationship to establishing minimum stock levels; forecasted needs predict the amount of the item required but do not include a delivery time factor. Inventory records and issue procedures are not related to establishing minimum or maximum stock levels.
A dietitian who wants to ensure patient acceptance of a menu being adapted for multi-institution use should first consider A. staffing patterns within the home institution B. the distance between the institutions C. cultural and ethnic differences between patients at each site D. communication methods between the staff and the patients
C; The question is about patient acceptance. While communication with patients is important, cultural and ethnic differences among patients at the sites are most likely to impact patient acceptance of a menu. The other 2 answers are not about patients.
What is the average % of total energy expenditure attributed to the thermic effect of foods eaten? A. 30% B. 40% C. 10% D. 20%
C; The thermic effect of food is one of the components of total energy expenditure, along with resting metabolic rate (RMR) and physical activity. The most commonly used estimate of the thermic effect of food is about 10% though the effect varies substantially for different food components.
The food preparation method used to combine fat and simple carbohydrates is called A. cutting in B. beating C. creaming D. folding
C; This process is called "creaming" for example when mixing butter and sugar when making cookies. Beating can apply to incorporating air into any ingredient or combination of ingredients. Cutting In is the incorporation of a fat such as butter or vegetable shortening into flour, as in making biscuits or pie crust. Folding is a method for combining beaten egg whites with other ingredients without dissipating the incorporated air.
Which group of foods provides the most Vitamin A? A. beef, chicken, fish B. milk, yogurt, cheese C. carrots, yellow squash, sweet potatoes D. canned tomato soup, bacon, bottled salad dressing
C; While vegetables do not contain pre-formed Vitamin A, the beta-carotene provided by these vegetables is converted to Vitamin A in the body. All three foods listed in this group therefore provide Vitamin A.
How does MyPlate address the "fats, sweets, and oils" that used to be at the apex of the Food Guide Pyramid? A. MyPlate has no group for these, but takes total calorie density into consideration from all foods. B. MyPlate eliminated this group entirely since it demonstrates a fat-free diet C. MyPlate continues to include this group in the graphic as a spoon alongside the plate. D. MyPlate grouped these with alcohol and recommended limited intake as shown by the glass alongside the plate.
C?
An adult weighs 90 kg and is 1.83 m tall. This person's BMI wouldChronic alcohol abuse reduces absorption of A. co-enzyme Q10 B. folic acid C. pantothenic acid D. thiamin
Chronic alcohol use interferes with the absorption of thiamin. This is the cause of deficiency of this vitamin in alcoholics, known as "alcoholic pellagra".
A facility serves 4500 meals per day, and establishes a productivity standard of 3.75 labor minutes per meal. Each FTE covers a schedule of 8 hours per day. The minimum daily staffing needs of the facility would be approximately A. 56 FTEs B. 562 FTEs C. 150 FTEs D. 35 FTEs
D. 35 FTE's
Which of the following is a common characteristic of bulimia nervosa? A. A typical binge lasts all day. B. The patient binges but does not purge. C. The patient does not have a body image problem. D. The patient is of normal or near normal weight.
D; A person with bulimia nervosa will commonly be within the normal weight range, although some may be slightly under- or overweight. A person with bulimia nervosa is very concerned about body shape and size. Binge eating, which involves short periods (usually 2 hours or less) of intake of large amounts of food, and purging behaviors are commonly used by a person with bulimia nervosa.
A ______________ is defined as the legal requirement for a food to contain established percentages of specific ingredients in order to be called by a given product name. A. a food exchange B. standard of quality C. a food code standard D. standard of identity
D; According to the USDA Standards of Identity, a food product must contain a specified percentage of specific ingredients in order to be called by a given name. Some examples of foods with a Standard of Identity are mayonnaise, ice cream, and bread.
Which of the following B vitamins is not involved in energy production? A. Thiamin B. Niacin C. Pantothenic D. Folate
D; Although most B vitamins serve as coenzymes in various energy metabolic pathways, folate is necessary for the synthesis of DNA, proteins, and red blood cells.
An infant born at 32 weeks' gestation is now 6 months old. Her adjusted age is _____ months. A. 3 B. 2 C. 6 D. 4
D; An infant born at 32 weeks gestation is premature. Therefore, her chronological age should be adjusted for prematurity. 40 weeks term - 32 weeks gestation = 8 weeks premature. Eight weeks is equal to 2 months. Therefore, her chronological age of 6 months minus her correction factor of 2 months equals an adjusted age of 4 months.
What is the primary type of lipid found in an avocado? A. saturated fatty acids B. polyunsaturated fatty acids C. omega-3 fatty acids D. monounsaturated fatty acids
D; Avocados contain proportionally more monounsaturated fats.
Baking powder added to a cake will produce A. oxygen B. helium C. sulfur dioxide D. carbon dioxide
D; Baking powder is added to a cake because the carbon dioxide it releases will increase the volume of the cake. Sulfur dioxide is the gas given off by rotten eggs. Oxygen is not usually used in baking due to it's tendency to cause fires and/or explode. Helium is used to inflate balloons, not in baking.
Which of the following is true about basal metabolism? A. It is the energy cost to perform one's activities of daily living (ADLs). B. It represents about 30% of total energy expenditure. C. It is dependent primarily on the amount of adipose tissue in the body. D. It represents about 60 - 75% of total calories used by the body each day.
D; Basal metabolic rate (BMR) is the amount of energy per unit time that a person needs to keep the body functioning at rest. Some of those processes are breathing, blood circulation, controlling body temperature, cell growth, and brain and nerve function. BMR affects the rate that a person burns calories and ultimately whether that individual maintains, gains, or loses weight. The basal metabolic rate accounts for about 60 to 75% of the daily calorie expenditure by individuals.
A patient who has insulin-dependent diabetes has been having nocturnal hypoglycemia. You check the timing and dosage of insulin, and also recommend trying ________________ as a bedtime snack. A. a 12 ounce glass of orange juice B. 1/2 cup of instant chicken noodle soup C. an everything bagel with one teaspoon sugar-free jelly D. two ounces of cheddar cheese with two whole wheat crackers
D; Cheese contains protein and fat, which slow the absorption of carbohydrates from the snack. A slow rate of carbohydrate absorption from the PM snack can help to maintain blood glucose level and prevent nocturnal hypoglycemia. The other 3 choices are incorrect: The bagel with sugar-free jelly contains carbohydrate, but very little fat or protein. Instant soup also contains very little fat or protein. Orange juice will result in a rapid increase in blood glucose. None of these choices will produce the slow sustained increase in glucose level that would help to prevent nocturnal hypoglycemia.
The primary site of the absorption of lipids is in the A. stomach B. esophagus C. colon D. small intestine
D; Correct: Pancreatic lipase breaks down about 95% of fats in the small intestine, where they are absorbed.
In patients with fluid retention, what happens to biochemical indicators of nutritional status, such as serum proteins and electrolytes? A. They are increased due to increased urinary output. B. They are increased due to hemoconcentration. C. They are decreased due to poor nutritional status. D. They are decreased due to hemodilution.
D; Fluid excess, such as with renal failure or congestive heart failure, will affect blood measures by causing them to be lower. This is a reflection of the concentration of the specific blood components in relation to the increased water in the body.
Which of the following foods provide significant amounts of folate in the diet? A. milk and dairy products B. eggs and poultry C. fish and seafood D. fresh fruits and vegetables
D; Fresh, uncooked fruits and vegetables are good sources of folate, along with legumes, tofu, and organ meats. Poultry, fish, eggs, meat, and dairy products provide small amounts of folate but not as much as fruits and vegetables. Due to fortification, grain products are also significant sources of folate in the United States.
Which type of cells store the most vitamin A in the body? A. red blood cells B. adipose cells C. squamous cells D. hepatic cells
D; Hepatic, aka liver cells, store the most vitamin A. (Think about food sources of vitamin A, such as beef or chicken livers.) Adipose, aka fat cell, do not contain a high amount of vitamin A. Neither do squamous, aka skin cells or red blood cells.
Which of the following must be reduced in the diet for the treatment of maple syrup urine disease (MSUD)? A. fructose B. aromatic amino acids C. sulfur-containing amino acids D. branched-chain amino acids
D; MSUD is also known as branched-chain ketoaciduria, and this results from a defect in the branched-chain alpha-ketoacid dehydrogenase complex. The branched-chain amino acids—leucine, isoleucine, and valine—cannot be metabolized, and therefore, affected persons require the use of specialty formulas that lack BCAAs. The BCAAs are slowly introduced into the diet when plasma leucine levels are decreased as they are necessary for growth to occur. However, dietary manipulation must occur so that enough BCAAs are available to support growth but not too high to increase plasma levels of the BCAAs.
Which of the following factors is most important in determining the space required for a food production unit in a new facility? A. the number of hours the food service will be operating B. the length of the cycle menu C. the number of food service employees hired D. the market form of the the foods purchased to be prepared on site
D; Market form (i.e. fresh, frozen, pre-packaged, etc.) will determine how much space is needed to prepare meals at a site. The hours of operation are not relevant to the size of the food production unit. The number of employees needed is determined after production needs are identified. The length of a cycle menu, if any is used, has little to do with the space requirement of a production facility.
A hospital cafeteria that currently serves 500 meals at noon must increase service to 800 without adding food production staff. The most appropriate action would be to A. replace current equipment with fast-performance equipment B. rearrange employee work schedules C. redesign the kitchen D. simplify the menu
D; Simplifying the menu offered would allow for production of a larger number of servings of the items retained, without hiring additional staff, thus making it possible to serve a larger number of clients. Redesigning the kitchen would not necessarily increase the amount of food produced without also increasing the number of staff required. It would also be much more expensive than simply reducing the number of different items served. If the same number of employees are retained, rearranging their work schedules would not help with this change because, unless there are many superfluous employees, increasing the number of employees available at lunch would necessarily decrease them elsewhere. Replacing the current kitchen equipment with fast-performance equipment is not possible, because there is no such thing
To improve the quality of decision making in real life, learners are presented with a realistic situation and asked to work through the scenario. This educational method is called A. think pair share B. dialectical learning C. observational learning D. simulation
D; Simulation is when learners are given realistic scenarios and given an opportunity to address these problems as they would in real life. In observational learning, learners observe an action or process carried out by an instructor, as for example in watching a cooking demonstration. In the think pair share method, learners discuss a set topic with a partner to help clarify their own view and positions about a given class topic. In dialectical learning, the learner has a didactic conversation with the instructor in order to draw out things that the learner already knows.
The average cafeteria check should be calculated by _________________. A. dividing the raw food costs by the number of customers B. multiplying the raw food costs by the percent it is of food sales C. dividing the sum of food and labor costs by the number of sales D. dividing the total revenue from sales by the number of customers
D; The average cafeteria check should be calculated by dividing the total revenue from sales by the number of customers. It is an indicator of the average amount spent per customer served.
A serum sodium level of 150 mEq/L is most likely indicative of A. a high level of aldosterone B. insufficient levels of antidiuretic hormone C. an excessive intake of sodium D. dehydration
D; The normal range for blood sodium levels is 135 to 145 milliequivalents per liter (mEq/L). Higher sodium levels are an indicator of dehydration.
When a green ring is seen around the yolk of a boiled egg, it is an indicator that A. the egg was old B. the egg was from a free-range hen C. the egg has spoiled and should not be eaten D. a cooked egg was cooled too slowly
D; The surface of an egg yolk will turn green if the egg is overcooked, or is cooled too slowly after cooking. This is due to sulfur and iron in the egg yolk forming ferrous-sulfide, which is green in color.
Based on the data below, what is the labor cost per meal? Productive labor $100,000 Nonproductive labor $10,000 Food purchases $50,000 Number of meals served 55,000 A.$2.91 B.$1.82 C.$0.91 D.$2.00
D; Total labor (productive + nonproductive) divided by meals served equals labor cost/meal
Which of the following deficiencies could cause macrocytic anemia? A. Iron B. Vitamin B6 C. Homocysteine D. Vitamin B12
D; Vitamin B12 and folate deficiencies both may promote the development of macrocytic anemia as they are involved in DNA synthesis, and loss of either results in the impaired production of red blood cells. Homocysteine is a product of methionine metabolism. Levels of homocysteine increase when vitamin B12 and folate are deficient as these are necessary for its conversion back to methionine. Vitamin B6 affects homocysteine by converting it to cysteine. However, neither of these promote anemia. Iron is associated with microcytic anemia.
A newly admitted patient is observed to have poorly fitting dentures. Which type of diet would be most appropriate? A. a liquid diet B. a high calorie-density diet C. a regular house diet D. a consistency-modified diet
D; When a patient has poorly fitting dentures, this will affect the patient's ability to chew. Difficulties with chewing and swallowing are best accommodated by a consistency-modified diet. The regular house diet, although nutritionally complete, may include foods that the patient will have difficulty chewing and swallowing, and this may be reflected by a decreased or incomplete intake. Liquid diets tend to not be nutritionally complete, and in particular, lack fiber. A person with poorly fitting dentures would need extra calories only in the instances when either increased energy needs are determined or there exists a concern in regard to the patient's weight.
The component of a cut of meat that is tough before cooking, but becomes tender when cooked with moist heat is A. fat B. elastin C. myosin D. collagen
D; When cooked via a moist heat method, collagen turns to gelatin and becomes soft and tender.
"Red" cabbage is actually purple in color because it contains A. anthroxanthin B. chlorophyll C. carotentoids D. anthocyanins
D; anthocyanins have a reddish-purple pigment chlorophyll creates a green coloring carotentoids provide a yellow or orange pigment anthoxanthins are white
An elevated serum level of uric acid is an indicator that the patient most likely has a diagnosis of A. pre-diabetes B. phenlyketonuria C. osteoporosis D. gout
Gout is a condition characterized by elevated levels of uric acid in the blood, and accumulation of crystalized urate in the joints. None of the other diseases listed is related to serum uric acid level.
The efficacy of a nutrition education program for decreasing anemia in high-risk pregnant women would best be demonstrated by A. an increase in self-reported intake of foods high in iron B. an improvement in measured hematocrit and hemoglobin levels C. improved scores on a Likert-type attitudinal scale D. improved scores on a nutrition knowledge post-test
Hemoglobin and Hematocrit are the most objective measures for monitoring anemia. Improvement on a knowledge test would not necessarily result in positive diet changes to reduce anemia. Changes on a measure of attitudes likewise would not necessarily result in positive diet changes to reduce anemia. Self-reported diet intakes, especially under these conditions, are likely to be inaccurate.
The calorie concentration provided by most general-purpose isotonic enteral feeding formulas is _____ kcal/mL. A. 1.0 B. 1.5 C. 2.0 D. 0.5
Most standard isotonic enteral formulas for use with the general patient population provide 1 kcal/mL. When a fluid restriction is required, formulas that are concentrated to 1.5-2 kcal/mL are appropriate.
Self-rising flour has baking powder and _______ added to it. A. cream of tartar B. dehydrated egg whites C. baking soda D. salt
Self-rising flour is a combination of all-purpose flour, baking powder, and salt.
An assessment of failure to thrive can best be made by evaluating an infant's A. sequential growth measurements B. weight-for-height percentile rank C. dietary intake record D. behavioral patterns
Sequential measurements are important to know when a child is consistently maintaining growth along their channel on the growth chart. Deviation from a channel is more noteworthy than the actual percentile relationship. Behavioral patterns may be of any nature, and therefore refer to more than food intake or physical activity patterns. Dietary intake records assesses adequacy of dietary intake rather than growth. Weight-for-height is an indicator of degree of fatness or thinness only.
An adult weighs 90 kg and is 1.83 m tall. This person's BMI would be classified as: A. obese B. overweight C. underweight D. healthy weight
This person's BMI would be calculated as 90/1.832 = 26.9 kg/m2. This value falls into the overweight category, 25-29.9. If your BMI is less than 18.5, it falls within the "underweight" range. If your BMI is 18.5 to 24.9, it falls within the "normal" or Healthy Weight range. If your BMI is 25.0 to 29.9, it falls within the "overweight" range. If your BMI is 30.0 or higher, it falls within the "obese" range.
