NTR 330 FINAL (exams 1-3 answers)
From 1987-1997, the American Diabetes Association followed 5,873 senior adults to see if they developed diabetes. In 1991, 894 had developed diabetes (15.2%). Normally, 25.9% of senior adults have diabetes. What is the incidence of diabetes?
15.2%
Ilo had his dietary intake assessed as part of a research study. The researcher interviewed Ilo and asked detailed questions about who Ilo ate yesterday. The researcher asked him how much cereal he ate, the type of milk he used, whether or not he drank the milk, etc. What type of dietary assessment method did the researchers use to determine Ilo's dietary intake
24 hour food recall
Gertrude goes to her doctor because she is having trouble shedding baby weight. She is done having children, and her children are now in elementary school. Her doctor tells her that she is overweight. Which of the following could be Gertrude's BMI
27.7
Which of the following would be an appropriate intervention, given the health risks and cultural practices of the listed cultural group
A series of workshops for Hispanic mothers about how to engage the whole family in preparation of meals rich in fruit and vegetables and whole grains
Impaired metabolism and growth, goiter, spontaneous abortion, and stillbirth are most associated with deficiency of
Iodine
Afua is a child living in a country that has been experiencing famine for the past 3 months. A team of doctors visits her village and notices she has a large belly and skin lesions. For what condition should they be treating Afua?
Kwashiorkor
Courtney is a single mother with 2 teenagers and an elementary school-aged child. She makes minimum wage at her job, an her employer just cut her hours so she will not be able to qualify for health insurance through her work. Would Courtney qualify for Medicare
No, because medicare is for the elderly
That National WIC Association (NWA) requires that WIC clinics:
a. Be a breastfeeding friendly environment b. Present breastfeeing as the norm at all client meetings c. Train all staff to promote breastfeeding d. Develop procedures to limit wait time ALL OF THE ABOCE
Which of the following characteristics will qualify a woman for the WIC program
a. Being pregnant b. Being a non-breastfeeding mother with a baby who is 6 months old or less c. Being a breastfeeding mother with a baby who is 12 months old or less ALL OF THE ABOVE
How can dietitians become involved in setting policy?
a. By providing testimony regarding the consequences of food insecurity b. By writing an article to a local newspaper about the lack of nutrition education c. By asking members of Congress to sponsor a bill d. By meeting with a state legislator about protection of licensure of dietitians
Why is inadequate sanitation a problem with regard to nutrition inequalities
a. Coca-Cola is cheaper than water and is consumed in places where the water is unclean, which can lead to obesity and dental caries. b. Food that has been prepared with unclean water can cause disease, making malnutrition worse. c. Inadequate sanitation can increase susceptibility to disease, decreasing the productivity of the workforce (ALL OF THE ABOVE)
Which of the following is true regarding optimal infant and young child feeding
a. Common barriers include poverty and lack of knowledge. b. Breastfeeding is increasing in many nations, but global levels of exclusive breastfeeding for 6 months remain around 40%. c. A micronutrient powder known as "sprinkles" is an example of a new product that can enrich children's diets. ALL OF THE ABOVE
Approaches within the Global Strategy for Infant and Young Child Nutrition DO NOT include:
a. Distribute breast milk substitutes (formula) more widely and promote their use over human milk.
Helen is an employee at a nonprofit that helps refugees adapt to life in the U.S. She is creating a nutrition assessment tool to help the dietitians at a partnering agency provide adequate nutritional guidance to her clients. Her assessment tool should include which of the following information to help the dietitians determine the clients' cultural food practices
a. Foods that are accepted and/or preferred by the families b. The types of foods available in close proximity to the refugees' new homes c. Who is responsible for selecting foods for the family d. Food safety practices ALL OF THE ABOVE
Using the National Health and Nutrition Examination Survey (NHANES) to detect changes in the nation's iron status is an example of which of the following core functions of public health?
assessment
Which of the following programs is/are implemented by the USDA
School Lunch WIC School BReakfast SNAP (all of the above)
A researcher wants to develop an evidence-based obesity prevention program for teens. All of the following statements would be appropriate to include as justification in the grant proposal to her funding agency EXCEPT
Since body image is important in teens, the intervention will focus on safe dieting practices for teens
Why might a Stage 4 treatment not be appropriate in an obese elementary school-aged child
Stage 4 treatment typically requires surgery, which would greatly impact the child's growth and development.
Jim has an income that is too high to qualify for state medical assistance and cannot obtain private insurance. He wants his children covered with insurance and does not know what to do. Which program was created by the federal government to help people like Jim?
State's Children Health Insurance Program
Adult nutrient intake as a risk factor for Parkinson's disease, what type of study is this?
Case-Control
Dietary Iron Intake and Risk of Parkinsons Disease, what kind of study is this?
Cohort
All of the following are Millennium Development Goals EXCEPT:
Combat nutrient deficiencies to foster optimal health
Local employment rates fall under which category of the 6 C's social ecological model for child weight status?
Community
Norms for oversized portions fall under which category of the 6 C's social ecological model for child weight status?
Culture
Which of the following groups of foods contribute the greatest proportion of energy to the average American diet?
grain based desserts, including cakes, cookies, and pastries
All of the following are reasons why it is difficult to promote prevention over treatment in the current health care landscape EXCEPT:
prevention programs cost more to implement than treatment programs
What is the social classification that relies on physical markers, such a skin color, to identify group membership?
race
James Lind's "A Treatise on Scurvy" described what type of experiment?
randomized control trial
Susan is a participant in a study in which the researchers are examining the relationship between dietary antioxidants and the incidence of breast cancer. Susan is a breast cancer survivor. She has had a healthy diet through her life; however, she reports that she always had a low fruit and vegetable intake. What kind of bias is involved in this study?
recall bias
A nurse attends a community-sponsored health fair at a local African American church to screen church members for indicators of diabetes. What level of prevention is the nurse using
secondary prevention
Which of the following statements is TRUE about malnutrition
severe acute malnutrition is also known as wasting
Which of the following groups makes up the greatest recipients of SNAP?
single mothers with children
Pizza, pasta, burgers, Mexican-style fast foods and rice dishes can contribute to cardiovascular disease because of their
sodium, which is associated with high BP
SNAP
supplemental nutrition assistance program
Stephen is analyzing the food environment in San Francisco. He finds that the homeless population in the Tenderloin (an urban district in San Francisco) does not have transportation to visit the local farmer's markets located downtown. To which aspect of the food environment is this disparity related?
the accessibility of foods
which of the following describes a food swamp
the strip of landing around Pitt Hospital full of only fast food restaurants
The following graph depicts data from an epidemiological study that examined, "per capita level of fat consumption and death from breast cancer around the world. Which of the following conclusions can be made based on the data?
there may be an association between a high fat diet and breast cancer mortality
Chris works for University Dining and wants to explore the effectiveness of health information on the food item menu tags in Fountain Dining Hall. What is the MOST APPROPRIATE sample for his study?
undergraduate students who live in dorms close to the dining hall
If a president or governor disapproves of a bill that has passed through the House and Senate, what is the next step he or she can take?
veto the bill
WIC provides all of the following EXCEPT:
vouchers for any food
Which of the following was a benefit for the micronutrient (MNP) home food fortification program implemented in Kakuma refugee camp?
was relatively inexpensive
If an agency in Raleigh wanted to replicate the Baltimore Healthy Carry-outs (BHC) project, what lessons could they glean with regard to cultural diversity?
when marketing new food choices, the term "fresh" has a better connotation than healthy
Sara and Sean have a 6-year-old daughter and are expecting their second baby. Sean makes about $40,000 per year, and Sara is planning to stay at home with their children. Sara has also been diagnosed with diabetes during their pregnancy. Will any members of Sara's family qualify for WIC? If so, who will qualify? See the chart below for income guidelines
yes, Sara and the new baby will qualify for WIC
A comparative study examined the association between gender and disordered eating. Results are summarized in the table below: what is the relative risk of disordered eating for men versus women
0.67
All of the following are true about childhood obesity except
An individual exposed to poverty, smoking, or drinking is more likely to develop chronic diseases than an overweight or obese individual.
Rates of childhood obesity are the lowest in which group of people
Asian
Exclusive breastfeeding, complementary feeding, and dietary diversification are examples of which approach to improving nutrient status among populations?
Behavior Change
What are the federally-mandated state position(s) required of programs receiving federal WIC dollars?
Breastfeeding coordinator WIC Director
Which program administers the MAJORITY of public health and nutrition programs in the US
DHHS
A family in Costa Rica is experiencing malnutrition. The mother and father are both obese, and the children are undernourished. Which term BEST describes what this family is experiencing
Double burden of malnutrition
All of the following are foods given to partially breastfed infants in the WIC program EXCEPT:
Eggs
According to the Expert Committee Recommendations, pediatricians should be recommending the following to their patients EXCEPT
Encourage consumption of diets with recommended quantities of fruits and vegetables, balanced micronutrient content, and low in calcium and fiber
Pamela is a nutrition researcher who has been conducting research on Americans' food purchasing habits based on the information provided on food labels. She wants to share her findings with the organization that is responsible for regulating food and nutrition labeling. Which organization should she contact?
FDA
Lorraine is developing a public health intervention for African Americans. It is important for her to know that their culture is centered on which of the following?
Family Religion
Recommendations for complementary feeding include
Feeding only foods that are appropriate for a child's abilities
Lauree's insurance requires her to pay a monthly capitation payment and sometimes a co-payment, but as a whole, her costs are very low. What type of insurance plan does Lauree have?
HMO
Which government agencies implement laws that affect nutrition, food, and health
USDA DHHS
Bob has a group contract insurance that requires him to choose a primary care physician in his insurance network. What type of insurance does Bob have
PPO
Which of the following groups is LEAST likely to misclassify their child's weight status?
Parents of high school aged children
Which of the following is TRUE about Medicare
Part B coverage pays for physician visits and some services by dietitians.
A mother and her children, ages 16 months and 7 years, visit your nutrition clinic. The family's income is at 150% of the poverty line. For which of the following programs is at least one of the family members eligible?
WIC
All of the following are ways in which WIC supports breastfeeding EXCEPT:
WIC Reduces expenditures by accepting free infant formula to distribute as samples to mothers
You are asked to review your colleague's plan for an epidemiological study. Your colleague plans to study weight status in low-income mothers by measuring their age, weight, height, and BMI, and comparing it to the same measurements in medium and high-income mothers. Which key aspect of epidemiology is missing
a multidisciplinary approach
Which of the following would impact the "Clan" level of the 6 C's social ecological model for child weight status?
a program that improves maternal grocery shopping knowledge
Sydney is a middle school teacher who has read that obesity can lead to chronic health conditions. She would like to do something to help prevent these health conditions in the children in her class. Which of the following is an example of a primary prevention strategy aimed to accomplish her goal
a program that teaches children and their parents how to cook healthy foods and gives examples of fun ideas for physical activity
What is the difference between a cohort and a case-control study
a) a case control study is retrospective and a cohort study is prospective b) cohort studies start with healthy people and a case control study starts with people who have the disease of interest
When researching a diet-disease relationship, it is important to consider the effect of confounding factors. Which of the following is TRUE about confounding factors?
a) confounding factors are associated with the independent and dependent variables and make the two appear more related than they are C) confounding factors over predict the magnitude of the relationship
Which of the following statements represent difficulties associated with studying diet-disease relationships?
a) in order to study the influence of nutritional factors you have to know they exist b) chronic diseases are multifactorial c)chronic diseases take a long time to develop
Human milk should provide approximately what percentage of energy to infants and young children?
a. 100% for the first 6 months, decreasing after that point but continuing through at least 24 months
Which of the following is TRUE about the current healthcare spending patterns in the US?
a. 75% of healthcare spending goes to treat chronic diseases. b. Healthcare spending makes up almost 18% of our nation's GDP. c. Investing $10 per year per person towards preventive measures could save $2.8 billion annually in healthcare costs within 2 years. (all of the above)
Which of the following are factors related to the "Child" level of the 6 C's social ecological model for child weight status?
a. Amount of sleep b. Food preferences c. Lack of physical activity d. BMI ALL OF THE ABOVE
Why is adequate education important in ensuring proper nutrition and food security in the population?
a. If children are not educated, they will not be able to get jobs that will pay enough to allow them to purchase healthy foods. b. Without an education, especially nutrition education, individuals are not aware of what foods they should consume and how to prepare those foods. c. Children with out an education are more likely to be vitamin A deficient because school lunches are high in vitamin A ALL OF THE ABOVE
Which of the following describes a component of the cycle of inadequate dietary intake and disease?
a. Inadequate food and nutrient intake can lead to nutrient loss, malabsorption, and/or nutrient deficiencies. b. Nutrient deficiencies can lead to weight loss, growth failure, kwashiorkor, and/or marasmus c. Malnutrition can lead to higher incidences of disease, and ultimately death. d. Diseased states can make going to work more difficult, leading to an increased likelihood of inadequate food intake.
Infant mortality is lower in the presence of which of the following
a. Maternal education b. Breastfeeding support c. Control of communicable diseases d. Nutrition interventions
Barriers to optimal complementary feeding in Bangladesh include which of the following?
a. Mothers who are often too busy doing laundry, gardening, or performing other chores to take enough time to feed their young children. b. Grandparents or school-aged children who have the responsibility of feeding young children and may try to force-feed them. c. Feeding of non-nutritious foods such as chips, sugary drinks, and biscuits ALL OF THE ABOVE
Would a physician recommend for a child whose BMI is in the 5th-84th percentile to be enrolled in a Stage 3 Comprehensive Multidisciplinary Intervention at a pediatric weight management clinic?
a. No, the child is normal weight, so the physical should encourage healthy behaviors and seek to limit less healthy behaviors through prevention
What impact does the food environment have on individual food choices and health?
a. Portion sizes of processed foods, restaurants, and beverages have increased. b. A higher number of fast food restaurants per capita is associated with faster BMI gain in children. c. Each meal eaten away from home is associated with consumption of an additional 134 calories. d. Fast food outlet and restaurant prevalence is correlated with prevalence of obesity.
In her lecture, Ms. Sullivan discussed limitations to the WIC package. Which of the following is NOT a limitation discussed
a. Stores typically run out of WIC package-eligible foods because they are cheaper than other foods, forcing mothers to waste time visiting multiple stores.
Which of the following is TRUE concerning the three branches of government's role in nutrition policy?
a. The judicial branch can interpret what the Healthy, Hunger-Free Kids Act means within the context of a legal dispute between a corporation and a school food service program. b. The House of Representatives, part of the legislative branch, can promote a bill that alters the Healthy, Hunger-Free Kids Act to change the whole grain requirements. d. Senators from the legislative branch can debate the Bake Sale Act's impact on the existing Healthy, Hunger-Free Kids Ac
A client opting to enroll in a Point-of-Service plan would expect the following:
a. The primary care physicians usually make referrals to other providers in the plan. b. If the physician makes a referral out of the network, the plan pays all or most of the bill. c. If the client refers him/herself to a provider outside of the plan and service is covered by the plan, co-payment and deductibles would increase significantly. (ALL OF THE ABOVE)
Which of the following are recent improvements in hunger rates and child mortality related to the Millennium Development Goals?
a. The proportion of undernourished people globally decreased from 23.2% in 1990-1992 to 14.9% in 2010-2012. b. The percentage of children enrolled in primary education increased from 82% to 90% between 1999 and 2010. c. The proportion of people living on less than $1.25 per day fell from 47% to 22% between 1990 and 2010.
What is the critical window of opportunity?
a. The window of time from conception to 24 months during which undernutrition can cause irreversible damage in children
Why is anemia a concern for women in both developed and developing countries?
a. Women need more iron than men. b. Women lose iron every month during their menstrual cycle. c. Pregnant women who do not have proper iron stores are more likely to have babies with iron deficiency and problems with growth and development. d. Anemia is associated with pre-term births
Hypertension is the leading health problem in this population
african Americans
Which of the following are parts of the epidemiology triangle?
agent host environment
Which of the following is an example of the Essential Public Health Services (EPHS)?
all of the above developing, conducting , research, offering courses
The nutrition-related problems experienced by many developing nations can be described by
all of the above increased obesity and chronic disease, dual burden, continued struggles
Which of the following explains the discrepancy between resources for the "rich" and the "poor
b. Industrialized countries hold 97% of all patents and global corporations hold 90% of all technology and product patents. c. The richest 20% of the world's population shares a global income that is 86 times that of the poorest 20%.
Which of the following is NOT TRUE regarding the composition of human milk?
b. It provides important immune factors, but these can also be provided by formula substitutes
which of the following most accurately describes the goal of SNAP
b. Permit low-income households to obtain a more nutritious diet by increasing their purchasing power.
A type II error is:
b. The probability that a person is not diagnosed with a nutritional disease when they in reality do not have it.
Which of the following is an advantage of human milk
b.It provides anti-infective factors that are important because the baby's immune system is not fully formed. c. It is lower in protein than other milks, thus making it easier on the kidneys.
Which of the following is classified as a food away from the home (FAFH)
bowl of noodles from noodles and company hungry man frozen dinner from store chips and dip from the grocery store
Which of the following is NOT required as part of the Breast Pump/Breastfeeding Aids Program?
breast pads
Which of the following is FALSE about John Snow
c. He used a descriptive approach to determine that people below London were 5x more likely to be affected by cholera than those who lived above London
Fatima is a child growing up in a developing nation. Which of the following is NOT TRUE regarding childhood nutrition in Fatima's country?
c. More children die from obesity-related disease than from conditions related to nutrient deficiencies.
All of the following are foods given to mothers in the WIC program EXCEPT:
cash vouchers for $20 of fruits and vegetables
In PBH who is the patient?
community
The health of school lunch meals falls under which category of the 6 C's social ecological model for child weight status?
community
Which of the following is NOT a recommendation for successful breastfeeding
giving up after an unsuccessful first try because it is a sign that it will not work
Which of the following is true about a child's weight status
d. An overweight child is one whose BMI is at or above the 85th percentile and below the 95th percentile.
Infant mortality:
decreases as maternal education increases
All of the following are foods given to children in the WIC program EXCEPT
desserts, such as cookies and ice cream
A local food pantry wants to help change policy around the social safety net for the low-income by forming an alliance with researchers who study the impact of hunger on health, healthcare professionals who interact with the food insecure, and religious groups who frequently serve hot meals to the hungry and food insecure in the local community. This is an example of which of the following policy-making strategies?
developing broad support
The superintendent of schools and school governance council decide that French fries will no longer be served at lunch, and each student must be offered at least one fresh fruit and vegetable. This is an example of
developing policies and plans that support individual and community health efforts
All of the following are roles of the public health nutritionist EXCEPT:
diagnose health problems among individuals in the community
A family in Ecuador is experiencing malnutrition. The mother and father are both obese and the children are undernourished. What term BEST describes what this family is experiencing?
double burden of malnutrition
Which of the following accurately describes justice?
educating a low income father to help him make smart choices about purchasing healthy foods on a budget at a grocery store to help him have the same knowledge as a higher income father
All of the following are characteristics of epidemiology EXCEPT:
epidemiology is focused on the health of the individual
Jamal is an African American man who is visiting a dietitian because he was recently diagnosed with obesity. Without referring to his diet records, the dietitian instructs Jamal to stop eating friend chicken, collard greens, black-eyed peas, and biscuits in order to lose weight. How would you categorize the dietitian's actions
ethnocentrism
Illiani is a working mother who has a dangerous job where she works with dyes that are known to cause breathing problems and increase her likelihood of infection. She makes just above minimum wage and is able to visit the local market, but cannot always afford the freshest fruits and vegetables for her family. She makes a deal with vendors at the market to buy cast-off fruits and vegetables, which she feeds to her family. Which of the following social determinants of nutrition and food security is of MOST concern for Iliani?
exposure to a healthy environment
SNAP benefits are given to participants using an EBT card (like a debit card). Which of the following items are SNAP recipients allowed to purchase using their benefits?
fruits and vegetables
Lauren lives in a rural community in Western North Carolina. Which of the following is likely to be TRUE regarding the food environment in Lauren's community?
gardening, hunting, and food exchange systems are common but unreliable food sources in her food environment
Which of the following factors is NOT related to the "Cell" leave of the 6 C's social ecological model for child weight status
genetic predisposition to decreased physical activity
You are a nutrition educator teaching a nutrition class to low-income parents. Jeremy is a father in your class who share a tip that when purchasing food for his children, he chooses the items on the menu that are the least expensive and have the greatest number of calories. Which of the following is the MOST LIKELY reason that Jeremy thinks this is a good decision for his family?
he wants to get the most for his limited budget by spending the least amount of money on the most energy dense foods
Jamaiya is a young adult who consumes the majority of her diet on the go. Much of her diet consists of processed foods, and she is overweight. Her diet is low in micronutrients because of the type of foods that she consumes. What term BEST describes what Jamaiya is experiencing
hidden hunger
When individuals from this people group adapt their traditional food practices, they tend to consume more processed foods that are high in fat and sugar.
hispanic or latino Americans
Eligibility for SNAP is based on which of the following criteria?
household size, income, disability, medical conditions
The goal of SNAP-Ed is to:
improve the likelihood that persons eligible for SNAP will make healthy food choices within a limited budget
Which of the following are the TOP THREE nutrition-related insecurities affecting the world population?
inadequate sanitation, lack of micronutrients, low iodine
Thomas is a registered dietitian who is trying to develop cultural awareness using a series of steps he learned about in his Public Health Nutrition class. He has read about how some cultures are similar and others are different, though he has not experienced these cultures himself. This describes cultural
knowledge
All of the following are indicators that the Nutrition Environmental Measurement Survey-Restaurants (NEMS-R) measures EXCEPT:
knowledge of wait Staff about healthy eating
Recipients of SNAP benefits may have some unique nutritional challenges compared to those who are more food secure. All of the following are examples of those unique nutritional challenges EXCEPT:
limited access to energy dense foods
Harley is a single father who works as a cashier in a fast food restaurant in an urban food desert. All of the following are factors that are likely to prevent him from achieving good nutrition status EXCEPT
limited access to foods that provide him adequate caloric needs
Virginia is trying to determine preschoolers' fruit and vegetable consumption. She asks parents what their children ate for school in the last 3 days. What type of bias is she likely to experience?
measurement bias
Hans is interested in studying the effectiveness of nutrition education programs in elementary schools. He conducts a literature review and analyzes the results of the studies to determine a pooled estimate of the effectiveness of nutrition education programs in elementary schools. What type of study is this?
meta analysis
The traditional food practices of this population complement the indigenous crops of North America. While diets may differ based on regional availability, they are more significantly impacted by lack of transportation and limited or no refrigeration.
native Americans
The House and the Senate are upset that the President's veto of their bill to enforce new labeling laws for organic foods. What can the representatives and senators do
override the veto with a 2/3 majority vote
All of the following are examples of chronic diseases EXCEPT:
pellagra
Why is there such a low participation in SNAP
people may be too prideful to enroll
All of the following statements represent difficulties associated with studying diet-disease relationships EXCEPT:
people typically over report what they eat
