Nutrition Care
Imagine a client says, "I don't know if I can eat bananas or watermelon on this diabetic meal plan. I wonder if I need to be using exchanges." Which of the following is the best example of a reflective statement/question to ask this client? a. "You're uncertain about how to choose foods?" b. "You're interested in your health?" c. "Do you want a diabetic meal plan?" d. "I'm happy that you've come in today."
The correct answer is A. *"You're uncertain about how to choose foods?"* Reflective statements take what is said and reword it to better inform understanding of the speaker's intent. They usually include some "feeling" words. It also helps to clarify the problem. Kellogg M. Step by Step: A Program for Dietetic Interns to learn counseling Skills . Available at: http://www.mollykellogg.com/programs/dietetic-intern-step-by-step-program/. (Login required.) Accessed December 15, 2016.
The Centers for Disease Control and Prevention growth charts are appropriate for: a. Healthy infants. b. Children with cerebral palsy. c. Children with Down syndrome. d. Premature infants weighing less than 1500 g at birth.
The correct answer is A. *Healthy infants.* It is appropriate to use the CDC's charts for plotting the growth of healthy US infants. Premature infants and children with Down syndrome or cerebral palsy require special growth considerations. Charney P, Malone A. Academy of Nutrition and Dietetics Pocket Guide to Pediatric Nutrition Assessment. 3rd ed. Chicago: IL: Academy of Nutrition and Dietetics; 2015.
After defining the nutrition problem, which of the following is the correct sequence of steps a community nutritionist should follow in assessing the needs of the community? a. Set the parameters of the assessment, collect data, analyze and interpret the data, share the findings, and set priorities. b. Set priorities, collect data, set the parameters of the assessment, analyze and interpret the data, and share the findings. c. Choose a plan of action, collect data, set the parameters of the assessment, share the findings, and analyze and interpret the data. d. Collect data, analyze and interpret the data, set the parameters, share the findings, and set the priorities.
The correct answer is A. *Set the parameters of the assessment, collect data, analyze and interpret the data, share the findings, and set priorities.* A nutrition needs assessment must occur in the sequenced order listed in option A. Boyle MA, Holben DH. Community Nutrition in Action: An Entrepreneurial Approach. 6th ed. Boston, MA: Cengage; 2012.
The best way to address the mortality rate associated with low-birthweight (LBW) and preterm infants is by: a. Improving the birthweight of newborn infants. b. Reducing the incidence of pica among pregnant women. c. Improving the infant formulas for LBW and preterm infants. d. Increasing the emphasis on breastfeeding in hospitals.
The correct answer is A. *improving the birthweight of newborn infants.* Pica is not necessarily related to infant weight, and improving infant formulas and emphasizing breastfeeding are important after birth. To address mortality rates of preterm and low-birthweight infants, the birthweight needs to be improved. Birthweight is directly correlated to infant mortality. Brown J. Nutrition Throughout the Life Cycle. 6th ed. Boston, MA: Cengage; 2017.
Consider the following clinical scenario: Age: 52-year-old male; weight 163 lb; Height: 5'11" BMI: 22.7; Current medications: Metformin 1 g; Saxagliptin 5 mg; Glucotrol XL 10 mg. Laboratory work: Hemoglobin A1c: 13.9%; fasting blood glucose: 356 mg/dl; + glutamic acid decarboxylase (GAD) auto antibodies test). The referring physician note states: "Patient needs diet instruction." Which of the following is the best action for the RDN to take? a. Educate the patient about low carbohydrate foods to minimize glucose elevations. b. Contact the referring physician to consider insulin therapy. c. Emphasize meal spacing and carbohydrate consistency. d. Negotiate a weight loss of 5% to 7% body weight loss.
The correct answer is B. * Contact the referring physician to consider insulin therapy.* The GAD shows that the patient has type 1 diabetes and will need insulin therapy for glucose control. Options A, C, and D would be appropriate actions for individuals with type 2 diabetes mellitus who have insulin resistance. Dietary or nutrition approaches will not fix the glucose problem for this patient Franz MJ, Powers MA, Leontos C, Holzmeister LA, Kulkarni K, Monk A, Wedel N, Gradwell E. The evidence for medical nutrition therapy for type 1 and type 2 diabetes in adults. J. Am Diet Assoc. 2010; 110:1852-89.
Using the Hamwi formula, what is the ideal body weight for a female who is 70 inches tall and has a small body frame? a. 120 pounds b. 135 pounds c. 150 pounds d. 165 pounds
The correct answer is B. *135 pounds* Women: 100 lbs for first 5 ft + 5 lb for every inch over 60 in (100 + 50 = 150). Small frame −10% (150 −15 = 135) Boullata J, Carney LN, Guenter P. A.S.P.E.N. Enteral Nutrition Handbook. Silver Spring, MD: American Society for Parenteral and Enteral Nutrition; 2010:13.
Based on this statement, determine which stage of change a client is in: "I know what you are going to tell me, because I know a lot about nutrition. I know what I need to do to lose weight, but I just can't do it." a. Precontemplation b. Contemplation c. Preparation d. Action
The correct answer is B. *Contemplation* The classic indicator for a patient in the contemplation stage of change is a "yes, but" statement. The majority of RDNs' clients are in the contemplation stage when they come to their first appointment. Sauter C, Constance A. Inspiring and Supporting Behavior Change: A Food and Nutrition Professional's Counseling Guide. 2nd ed. Chicago, IL: Academy of Nutrition and Dietetics; 2016.
Rosa wants to plan a community nutrition program to encourage children ages 11-15 to consume healthier afterschool snacks. She has reviewed the results of the community needs assessment, defined program goals and objectives, and developed a program plan. Next, she should: a. Identify funding sources. b. Define the management system. c. Implement the program. d. Seek support from the parents and schools of intended participants.
The correct answer is B. *Define the management system.* Defining the management system comes next. Identifying funding systems, seeking support from parents and schools, and implementing the program come later. Boyle MA, Holben DH. Community Nutrition in Action: An Entrepreneurial Approach. 6th ed. Boston, MA: Cengage; 2012.
Making homemade dried meat products such as jerky is a very popular home food preservation practice. Which of the following procedures would be considered appropriate and safe for this process, considering that the meat type has not been specified? a. Marinate the meat for directed amount of time in the recipe, then place in dehydrator set at 130°F - 140°F, process until dry. b. Marinate the meat for directed amount of time in the recipe, then cook in a preheated oven until the meat reaches a minimum internal temperature of 165°F, move to the dehydrator set at 130°F - 140°F, and continue to process until dry. c. Marinate the meat for directed amount of time in the recipe, then cook in a preheated oven until the meat reaches a minimum internal temperature of 160°F, move to the dehydrator set at 130°F - 140°F, and continue to process until dry. d. Marinate the meat for directed amount of time in the recipe, move to the dehydrator set at 130°F - 140°F, and continue to process until dry, then cook in a preheated oven until the meat reaches a minimum internal temperature of 160°F.
The correct answer is B. *Marinate the meat for directed amount of time in the recipe, then cook in a preheated oven until the meat reaches a minimum internal temperature of 165°F, move to the dehydrator set at 130°F - 140°F, and continue to process until dry.* The USDA's current recommendation for making jerky safely is to heat meat to 160°F and poultry to 165°F before the dehydrating process. This step ensures that any bacteria present will be destroyed by wet heat. After heating to 160°F or 165°F, maintaining a constant dehydrator temperature of 130°F to 140°F during the drying process is important because the process must be fast enough to dry food before it spoils and it must remove enough water so that microorganisms are unable to grow. US Department of Agriculture. Jerky and Food Safety. Available at: https://www.fsis.usda.gov/wps/portal/fsis/topics/food-safety-education/get-answers/food-safety-fact-sheets/meat-preparation/jerky-and-food-safety/ct_index. Accessed December 23, 2016.
Julia is a 10-year-old fifth grader with ADHD who takes Adderall. Her BMI-for-age is less than the 5th percentile. The most appropriate nutrition intervention for her is to: a. Provide snacks for her to eat during recess. b. Offer her a high-calorie bedtime snack. c. Send a lunch consisting of her favorite foods. d. Have the teacher monitor her intake.
The correct answer is B. *Offer her a high-calorie bedtime snack.* If Julia's nutrition intervention calls for helping her to gain weight, she should be encouraged to eat a snack high in kilocalories at bedtime, as this gives less time to burn off the energy consumed. Brown J. Nutrition Throughout the Life Cycle. 6th ed. Boston, MA: Cengage; 2017.
Which of the following components comprise the core of motivational interviewing? a. Collaboration, empathy, autonomy, and patient-centered care b. Partnership, acceptance, compassion, and evocation c. Rolling with resistance, unconditional positive regard, empowerment, and empathy d. Partnership, autonomy, setting smart goals, and evocation
The correct answer is B. *Partnership, acceptance, compassion, and evocation* In the 3rd edition of the groundbreaking Motivational Interviewing, the authors added compassion to the core of motivational interviewing and elaborate on the concept of what acceptance really is. Miller W, Rollnick SR. Motivational Interviewing: Helping People Change. 3rd ed. New York: Guilford; 2013.
If the community nutritionist is concerned that the new educational activities provided for SNAP recipients have been ineffective in increasing the amount of fresh vegetables consumed, the best approach would be to conduct which type of evaluation: a. Efficiency b. Process c. Structure d. Impact
The correct answer is D. *Impact* Although each answer is a form of evaluation, the only right answer would be an outcome-focused evaluation. An impact evaluation would assess whether the program's methods and activities resulted in the desired changes in the client. Boyle MA, Holben DH. Community Nutrition in Action: An Entrepreneurial Approach. 6th ed. Boston, MA: Cengage; 2012.
What component of serum cholesterol do plant stanols/sterols lower? a. Total cholesterol b. High-density lipoprotein (HDL) c. Triglycerides d. Low-density lipoprotein (LDL)
The correct answer is D. *Low-density lipoprotein (LDL)* Plant stanols are often used in place of statin therapy for lowering LDL, especially for those patients who are unable to tolerate statins. Academy of Nutrition and Dietetics. Disorders of lipid metabolism. Evidence-based nutrition practice guidelines. Chicago, IL: Academy of Nutrition and Dietetics; 2014.
Stacey has been asked to complete a formative evaluation of her community nutrition program designed to encourage more first-time mothers to breastfeed. To do this, she should: a. Determine the percentage of first-time mothers who breastfeed as a result of seeing a motivational DVD during prenatal checkups. b. Calculate the increase in the number of first-time mothers who breastfeed after viewing a motivational DVD during prenatal checkups. c. Choose a DVD that includes young mothers from varied ethnic backgrounds. d. Pilot-test the motivational DVD she plans to use.
The correct answer is D. *Pilot-test the motivational DVD she plans to use* Pilot testing the DVD represents formative evaluation as this is a process of testing elements of a program before it is begun. Boyle MA, Holben DH. Community Nutrition in Action: An Entrepreneurial Approach. 6th ed. Boston, MA: Cengage; 2012.
The nutritionist employed by the local county wants her nutrition objectives for the next 5-7 years to reflect the goals of Healthy People 2020. Which of her goals listed below most closely reflects the goals of Healthy People 2020? a. Reduce among residents the severity of chronic diseases such as diabetes and heart disease. b. Promote, across every stage of life, healthy behaviors that positively affect the nutritional status of residents. c. Improve the nutrition of residents by eliminating disparities in treatment plans. d. Eliminate social and physical environments that threaten the nutrition of residents.
The correct answer is B. *Promote, across every stage of life, healthy behaviors that positively affect the nutritional status of residents.* Healthy people 2020 advocates for improvement in the health of all people across the life course. (Options A and D incorporate only one determinant and option C isn't inclusive enough.) Boyle MA, Holben DH. Community Nutrition in Action: An Entrepreneurial Approach. 6th ed. Boston, MA: Cengage; 2012.
All of the following statements about patient-centered medical homes (PCMH) are true, EXCEPT: a. The cost for chronic care is reduced. b. Electronic medical records are essential. c. Patients are responsible for access to care. d. The team of providers changes as the health care needs differ.
The correct answer is C *patients are responsible for access to care.* One of the biggest advantages of a PCMH is access to care, regardless of what is needed. All other statements are true about PCMH. Sauter C. The role of the registered dietitian, diabetes educators on the patient-centered medical home. On the cutting edge. Diabetes Care Educ. 2012;33(2): 26-28.
The city manager wants to be sure that the tool the community nutritionist is using to collect data about the use of dietary supplements has validity. In order to ensure that the instrument is valid, the nutritionist needs to choose an instrument that: a. Has been used previously many times. b. Contains words and phrases familiar to participants. c. Measures accurately what it is intended to measure. d. Yields primarily quantitative data.
The correct answer is C. * Contains words and phrases familiar to participants.* The defining feature of validity is whether the instrument accurately measures what it intends to. Boyle MA, Holben DH. Community Nutrition in Action: An Entrepreneurial Approach. 6th ed. Boston, MA: Cengage; 2012.
If a client exploring readiness for change rates confidence as a "4" and importance as a "10," which of the following questions/comments would lead to the most productive conversation about change? a. "Why aren't you more motivated?" b. "What can I do to help you?" c. "What would need to happen in order for your confidence to increase to a '6'?" d. "It's encouraging that the importance rating is so high."
The correct answer is C. *"What would need to happen in order for your confidence to increase to a '6'?"* Moving the talk about readiness for change forward is an important component in motivational interviewing. Option A is a poor question to ask as one rarely uses "why" with change talk. Option B isn't specific enough with regard to the behavior. Option D is an affirmation and probably won't move the discussion forward. Option C is the best question to ask as it invites an evocative response. Berg-Smith SM, Stevens VJ, Brown KM, Van Horn L, Gernhofer N, Perters E, Greenberg R, Snetselaar L, Ahrens L, Smith K. A brief motivational intervention to improve dietary adherence in adolescents. Health Ed Res. 1999;14:399-410.
What daily energy intake should result in a weight loss of 2 pounds per month if one had been consuming 2,000 kcal per day? a. 1,500 kcal b. 1,650 kcal c. 1,750 kcal d. 1,850 kcal
The correct answer is C. *1,750* 3,500 kcal/pound = 7,000 kcal deficiency needed for 2 pound weight loss over 4 weeks; 7,000/28 (4 weeks x 7 days/week) = 250 kcal. 2000-250 = 1750 kcal. Raynor HA, Champagne CM. Position of the Academy of Nutrition and Dietetics: Interventions for the Treatment of Overweight and Obesity in Adults. J Acad Nutr Diet. 2016;116(1):129-147.
How many pounds are recommended for an overweight woman to gain during her pregnancy? a. 0 b. 5-10 c. 15-25 d. 28-40
The correct answer is C. *15-25* All women should gain weight during pregnancy. Recommendations for gaining 28 to 40 lb in pregnancy are applicable to underweight women. It is recommended that overweight women gain 15 to 25 lb during pregnancy. Institute of Medicine. Weight Gain During Pregnancy: Reexamining the Guidelines. Consensus Report Brief. May 2009:2. Available at: http://www.nationalacademies.org/hmd/~/media/Files/Report%20Files/2009/Weight-Gain-During-Pregnancy-Reexamining-the-Guidelines/Report%20Brief%20-%20Weight%20Gain%20During%20Pregnancy.pdf#. Accessed December 25, 2016.
The best studied and most frequently recommended weight-loss dietary strategy is: a. A low-carbohydrate, high-protein diet. b. A low fat, high-protein diet. c. A low-fat, reduced-energy diet. d. A low carbohydrate, reduced-energy diet.
The correct answer is C. *A low-fat, reduced-energy diet.* A low-fat, reduced-energy diet is the best studied weight-loss dietary strategy and is most frequently recommended by governing health authorities. The Academy of Nutrition and Dietetics' Evidence Analysis Library recommends with a strong, imperative rating that an individualized reduced-energy diet is the basis of dietary component of a comprehensive weight management program. Reducing dietary fat and/or carbohydrates is a practical way to create an energy deficit of 500 kcal to 1,000 kcal below estimated energy needs and should result in a weight loss of 1 - 2 pounds per week. Raynor HA, Champagne CM. Position of the Academy of Nutrition and Dietetics: Interventions for the Treatment of Overweight and Obesity in Adults. J Acad Nutr Diet. 2016;116(1):129-147.
A dietitian is working with a client to reduce blood cholesterol levels. The client is knowledgeable about a hyperlipidemia diet and is able to devise healthful meal plans, but has moderate readiness in being independent in nutrition care. To be most effective, what would be the dietitian's approach? a. Continue to provide dietary instructions to the client and closely monitor compliance. b. Help the client gain confidence through listening, advising, and coaching. c. Listen to the client. Encourage and support the skills the client has developed. d. Turn over responsibility for nutrition care to the client.
The correct answer is C. *Listen to the client. Encourage and support the skills the client has developed.* The patient is knowledgeable with moderate readiness so the dietitian needs to find out what the client knows by listening to, encouraging, and supporting the client to help him or her be fully ready to execute the diet to reduce blood cholesterol. Gregoire MB, Spears MC. Foodservice Organizations: A Managerial and Systems Approach. 9th ed. Upper Saddle River, NJ: Pearson; 2016.
A registered dietitian nutritionist is working with a client to reduce blood cholesterol levels. The client is knowledgeable about a hyperlipidemia diet and is able to devise healthy meal plans, but he has moderate readiness in independently following the nutrition care plan. To be most effective in meeting the client's needs, what would be the RDN's approach? a. Continue to provide dietary instructions to the client and closely monitor compliance. b. Help the client gain confidence through listening, advising, and coaching. c. Listen to the client. Encourage and support the skills the client has developed. d. Turn over responsibility for nutrition care to the client.
The correct answer is C. *Listen to the client. Encourage and support the skills the client has developed.* The patient is knowledgeable with moderate readiness, so the RDN needs to find out what the client knows by listening to, encouraging, and supporting the client to help him be fully ready to execute the diet to reduce blood cholesterol. Gregoire MB, Spears MC. Foodservice Organizations: A Managerial and Systems Approach. 9th ed. Upper Saddle River, NJ: Pearson; 2016.
A 56-year-old male client presents to the ambulatory clinic for a team visit. Physical exam reveals: Height: 5'9"; weight: 223 pounds; body mass index (BMI) 33; blood pressure: 168/96; heart rate 74. Pertinent laboratory results : hemoglobin A1c: 7.0%, thyroid-stimulating hormone (TSH): 2.0 mU/L, Medications: Metformin (Glucophage 1000 mg daily), Hydrochlorothiazide 25 mg, Lisinopril 20 mg. Review of symptoms: positive for daytime sleepiness, wife complains of loud snoring. Mood: affect appears to be good. Despite excellent adherence to DASH (Dietary Approaches to Stop Hypertension) meal plan, blood pressure continues to be elevated. What is the best explanation for his elevation in blood pressure and daytime somnolence? a. A drug/drug interaction of hydrochlorothiazide and Metformin b. Untreated thyroid disease c. Undiagnosed obstructive sleep apnea d. Untreated depression
The correct answer is C. *Undiagnosed obstructive sleep apnea* There is no drug/drug interaction with these two medications, TSH is normal, and mood has been assessed as positive so depression can be ruled out. All symptoms point to the likely possibility of obstructive sleep apnea Adult Obstructive Sleep Apnea Task Force of the American Academy of Sleep Medicine. Clinical Guideline for the Evaluation, Management and Long term Care of Obstructive Sleep Apnea in Adults. J Clin Sleep Med. 2009;5(3):263-276.
Which of the following is the BEST example of an "open-ended" question? a. Why would you want to follow that meal plan? b. Do you use skim milk or whole milk? c. What are some of the challenges you've faced in your weight loss journey? d. Do you feel positive or negative about your weight loss goal?
The correct answer is C. *What are some of the challenges you've faced in your weight loss journey?* Open-ended questions typically start with "What" or "How" and invite the client to tell a story. Open-ended questions should never begin with "why," as it risks putting the client on the defensive. King K, Klawitter B. Nutrition Therapy Advanced Counseling Skills. 3rd ed.. Baltimore, MD: Lippincott Williams and Wilkins; 2007.
Approximately how many carbohydrate servings are 48 grapes? a. 1 b. 2 c. 3 d. 4
The correct answer is C.*3* There are roughly 15 grapes in 1 carbohydrate serving, so 48 grapes would provide approximately 3 carbohydrate servings. Rolfes SR, Pinna K, Whitney E. Understanding Normal and Clinical Nutrition. 10th ed. Boston, MA: Cengage; 2015.
What would the nitrogen balance be for a patient with a 24-hour urinary nitrogen excretion of 14.3 grams and a protein intake of 102 grams? a. +16.3 grams b. −16.3 grams c. −2 grams d. +2 grams
The correct answer is C.*−2 grams* Nitrogen balance is calculated as follows: Convert protein "in" to nitrogen by dividing by 6.25. (102 g6.25 = 16.3 g Nitrogen) Nitrogen in (16.3 g) − nitrogen out (14.3 g) − 4 g for insensible loss = (−) 2 gram Boullata J, Carney LN, Guenter P. A.S.P.E.N. Enteral Nutrition Handbook. Silver Spring, MD: American Society for Parenteral and Enteral Nutrition; 2010:26.
According to the CDC growth chart, in what percentile is a 1-year-old boy measuring 82 cm? a. <5% b. 25% c. 75% d. >95%
The correct answer is D. *>95%* 82 cm (32") is tall for a 1-year-old boy, so he would be above the 95th percentile. Centers for Disease Control and Prevention. CDC Growth Charts, Birth to 36 months: Boys Length-for-age and Weight-for-age percentiles. 2000. Available at: http://www.cdc.gov/growthcharts/data/set1clinical/cj41l017.pdf#. Accessed December 21, 2016.
Data reviewed for nutrition assessment are also reviewed during the following step: a. Monitoring and evaluation. b. Nutrition diagnosis. c. Goal setting. d. All of the above.
The correct answer is D. *All of the above.* In the Nutrition Care Process, data reviewed for nutrition assessment are also reviewed in all other steps. Academy of Nutrition and Dietetics. Nutrition Care Process and Terminology (NCPT). Last Updated 2016. Available at: https://ncpt.webauthor.com/encpt-tutorials. Accessed December 15, 2016.
A patient with acute renal failure will have a higher need of _____ compared with a similar patient with optimal renal function? a. Protein b. Potassium c. Fluid d. Energy
The correct answer is D. *Energy* Studies have shown a significant and strong negative correlation between creatinine clearance and resting metabolic rate, indicating that energy expenditure increases as kidney function declines. Mahan LK, Escott-Stump S. Krause's Food, Nutrition, and Diet Therapy. 11th ed. Philadelphia, PA: WB Saunders Company; 2000:968.
In order to ensure quality and consistency, this agency established standards of identity for common food products. a. Federal Trade Commission (FTC) b. Centers for Disease Control and Prevention (CDC) c. US Department of Agriculture (USDA) d. Food and Drug Administration (FDA)
The correct answer is D. *Food and Drug Administration (FDA)* The FDA established standards of identity for common food products to ensure quality and consistency. Brown AC. Understanding Food: Principles and Preparation. 5th ed. Boston, MA: Cengage; 2014.
The first step in conducting a community needs assessment is to: a. Describe the problem and state why a needs assessment is necessary. b. Specify the data needed and design a plan for acquiring it. c. Determine the purpose, goals, and objectives of the needs assessment. d. Identify the target population and nutrition problem of concern.
The correct answer is D. *Identify the target population and nutrition problem of concern.* Specifying the data needed and determining the purpose, goals, and objectives are part of the process, but the first step in conducting a community needs assessment is identifying the target population and problem of concern. Edelstein S. Nutrition in public health: a handbook for developing programs and services. 3rd ed. Sudbury, MA: Jones & Bartlett; 2010.
All of the following statements about the intensive behavioral therapy (IBT) benefit for obese Medicare Part B beneficiaries are true, EXCEPT: a. Coverage for the benefit is granted only in the primary care setting. b. In order to qualify, the beneficiary's BMI must be >30. c. Continued treatment for obesity is contingent on weight loss assessed after 6 months of treatment. d. RDNs may provide the service and bill Medicare using a unique physician identification number.
The correct answer is D. *RDNs may provide the service and bill Medicare using a unique physician identification number.* The IBT bill is very clear that the benefit can only be provided by a physician (as of April 2013). It is true that qualifications are specific about BMI and the appropriate setting for receiving this benefit and treatment length is contingent on progress. Academy of Nutrition and Dietetics. Meeting the Need for Obesity Treatment : A Toolkit for the RD/PCP Partnership. Chicago, IL: Academy of Nutrition and Dietetics; 2012: 3-6.
What government agency's funding supports the National School Lunch Program? a. Medicaid b. Health and Human Services c. CACFP d. USDA
The correct answer is D. *USDA* Funding from the USDA supports the National School Lunch Program. US Department of Agriculture. National School Lunch Program. Available at: https://www.fns.usda.gov/nslp/national-school-lunch-program-nslp. Accessed December 21, 2016.
Dietetics students finishing supervised practice should be able to a. Develop a virtual learning environment. b. Use project management tools. c. Use computer application for advanced statistical analysis. d. Utilize an electronic health record and food and nutrition management systems and print educational materials for clients.
The correct answer is D. *Utilize an electronic health record and food and nutrition management systems and print educational materials for clients.* Entry-level practitioners need to have a general awareness of entry-level informatics skills, which include electronic health records, food and nutrition management systems, and educational print materials. Ayres EJ. Nutrition Informatics Competencies across All Levels of Practice: A National Delphi Study. J Acad Nutr Diet. 2012;112(12):2042-2053.