NCP Tutorial Questions

32. Which would be the most appropriate intervention (s) for the following nutrition diagnostic statement? PES Statement: Patient has inadequate calcium intake related to food and nutrition related knowledge deficit as evidenced by statements that the only dietary source of calcium is milk and she believes that she is lactose intolerant

-in‐depth education on alternative food sources of calcium -Recommendation for mineral supplement

which steps provide data that will likely lead to the selection of data for monitoring and evaluations?

-nutrition assessment -nutrition diagnosis

which of the following reflect the way a RD actually completes the nutrition care process

-you may return to add more data to nutrition assessment and then revise your nutrition diagnosis, intervention if the patient provides additional information during your intervention counseling intervention -often during the course of providing nutrition care, the steps do not occur in a linear fashion

Which of the following lists correctly orders the parts of a chart note?

A chart note can vary among styles as long as all the information is present and the relationships are clearly articulated.

when dietitians refer to the nutrition diagnosis reference sheets to see which diagnosis best fits the situation, they are not required to:

Compare interventions and assessments (Reference sheets for nutrition dx include signs and symptoms and etiologies, however the connection to interventions is only shown in the intervention reference sheets used after the nutrition dx and PES statement have been selected).

When determining the intervention it should ideally focus on the

Etiology in the PES statement (Ideally, the intervention would affect the underlying cause or etiology; however, with some cases, we may only be able to improve signs and symptoms, and not resolve the problem. )

What is the nutrition M&E activity where there is a systematic comparison of current findings with previous patient status, intervention goals, and/or a reference standard?

Evaluating

What is the first step in planning the Nutrition Intervention?

Prioritize nutrition diagnoses

The nutrition diagnostic term can be found in which portion of the PES statement?

Problem

the NCP and Model and standardized language can be incorporated into which of the following methods of medical record documentation

SOAP DAR Narrative ADI or ADIME

What is the nutrition monitoring & evaluating (M&E) activity where data collection occurs?

Measuring

The data collected for the monitoring and evaluation step often refers back to the

Signs & Symptoms in the PES statement

Lab values or weight status may be used in which part of the PES statement?

Signs and symptoms

During a reassessment of a patient, the RD usually refers to which portion of the PES Statement to determine whether the patient has improved?

Signs/symptoms

which of the following is considered a bioactive substance

alcohol (bioactive substances are substances that are not formally classified s a nutrient in the Dietary reference intakes. other substance in this category are stannous and sterols)

in which domain is the diagnosis "involuntary weight loss"

clinical

the "problem" in the nutrition diagnosis describes

current nutrition issue

which is not a nutrition diagnosis

dumping syndrom (it is a medical diagnosis, not a nutrition diagnosis)

what is the first step in the nutrition care process

nutrition assessment

etiology is documented in which step of the nutrition care process

nutrition diagnosis

the nutrition diagnostic terms are used by

registered dietitians

outcomes management includes aggregating data from multiple patients to allow for evaluation of your interventions or program's effectiveness

true

The terms "nutrition education" and "nutrition counseling" are purposefully separated. What is the MAIN difference in meaning behind these two intervention categories?

Nutrition education works to fill a knowledge deficit, whereas nutrition counseling works to facilitate the client identifying what changes to make and how

Which of the following is not a nutrition intervention domain?

Nutrition prescription

What 2 components are outside the nutrition care process model?

Nutrition screening and Outcomes management

Evaluating the patients' knowledge regarding nutrition falls under which category of nutrition monitoring and evaluating?

Nutrition‐related behavioral and environmental outcomes

The connectors used in a PES statement are:

Related to, as evidence by

In an example situation where a patient not following the doctors diet order, is unhappy to see the RD, and is aware what health changes they need to make but not convinced it is necessary at this time, which would be the most appropriate nutrition counseling theory to use strategies from?

Transtheoretical/ Stages of change

True/False: Standardized Language have been developed to reflect Nutrition Screening and Outcomes Management

false (these two activities are outside the actual nutrition care process and are not reflected in the nutrition care process terms)

which of the following terms is the standardized term to use when describing intake?

inadequate (is the term selected to identify intake that is less than recommended)

in which domain is the diagnosis "inadequate oral intake"

intake

which of the following are the domains of the nutrition diagnosis

intake, clinical and behavioral/environment

or a patient with the following PES statement and interventions which would be the most appropriate monitoring and evaluating data? PES Statement: Patient has inadequate calcium intake related to food and nutrition related knowledge deficit as evidenced by statements that the only dietary source of calcium is milk and she believes that she is lactose intolerant. Patient's nutrition prescription is for a diet providing 1200 mg calcium per day. Patient was provided with in‐depth nutrition education on alternative dietary and supplement sources of calcium.

-Calcium Intake (at subsequent visit) -Knowledge assessment by asking patient to identify food sources from menus and shopping list (at the end of the current visit

When evaluating the PES statement you should:

-Determine if the dietitian can resolve and improve the problem -Use the intake domain as the preferred problem -Determine if the etiology is the root cause

The nutrition diagnosis "not ready for a diet/lifestyle change" falls under which domain?

Behavioral environmental domain

A 60 year old female, 4'10", 87 lbs with a past history of COPD and lung cancer (treated and in remission) is seeing the dietitian for the first time and is asking for help with choices of herbs and botanical that will give her more energy and prevent cancer recurrence rather than focusing on the other nutritional and caloric intake from food. The following PES statements are considered: Choice A ‐ Food and nutrition‐related knowledge deficit related to lack of prior MNT as evidenced by asking for help with choices of herbs and botanicals that will give more energy and prevent cancer recurrence. Choice B - Harmful beliefs and attitudes about food and nutrition related topics related to food and nutrition related knowledge deficit and belief that the patient needs herbs and botanicals to prevent cancer recurrence. Choice C - Undesirable food choices related to previous medical diagnosis and treatment for cancer as evidenced by request for information about herbals and botanicals Choose the response that best describes the better choice of a PES statement and the best rationale for that choice:

Choice A is preferred since it reflects the patient's questions and reflects request for assistance

A 67 year old male living alone with a disability, 5'6" 135 lbs was diagnosed with heart failure 2 months ago. Since that time he has lost 20 lbs from dyspnea and shortness of breath and inability to consume large meals. Intake is documented. He states that he is unable to shop or cook and uses many processed foods with a high sodium intake. Here are two possible PES statements. Choice A: Inadequate energy intake related to dyspnea, shortness of breath as evidenced by 20 lb weight loss Choice B: Inadequate food and beverage intake related to inability to shop and cook as evidenced by calorie intake of 500 calories less than estimated requirements and 20 lb weight loss in 2 months Choose the response that best describes the better choice of a PES statement and the best rationale for that choice:

Choice B is preferred since it provides specific signs and symptoms that document the nutrition diagnosis*

all of the following are activities which pertain to monitoring and evaluation except:

Determining objectives (Defining goals and objectives are part of the intervention stage.)

Which of the following are not included in the Food and /or nutrient delivery terms?

Food allergies (Reported food allergies would be part of the food and nutrition‐related history in the Nutrition Assessment.)

All the following are true about the Nutrition Diagnosis except:

Provides a link between the Diagnosis and Intervention in the Nutrition Care Process.

Initial/brief nutrition education could include all except the following parameters:

Skill development (Skill Development would be considered in‐depth nutrition education.)

Which theory of counseling did you use in the following scenario: You are asked to counsel a single‐parent of a two‐year‐old due to excessive temper tantrums at meal‐time. You determine modeling healthy eating behavior at meal‐time and sharing parenting tips for this age‐group would be very beneficial.

Social Learning theory

Which would be the most appropriate intervention(s) for the following nutrition diagnostic statement? PES Statement: Patient has inadequate iron intake related to undesirable food choices and lack of access to foods as evidenced by 24 hour recall showing less than 35% of RDA for Iron and statements indicating she lacks funds to purchase foods of her choice. (Clarify language according to new guidelines....)

a. Coordination of care - referral to food assistance programs b. Recommendation for multiple vitamin and mineral supplement c. In depth education on food sources of iron d. Nutrition counseling with problem solving to address ways to make food choices that contain iron. e. All of the above except c

in which domain is the diagnosis "intake of unsafe food"

behavioral-environment

which of the following is a component of the nutrition care process that is new to the field of nutrition professionals?

using dietetics specific terminology (RDs have been familiar with a medical standardized language ICD-9 and CPT codes, but we did not have a dietetics specific standardized language)