RD study Practice test

Which of the following is the best way to obtain information during an interview about a potential applicants experience with managing a large-scale cafeteria? A. "Are you able to handle managing a busy cafeteria?" B. "Give me an example of a day where staffing levels were short, the cafeteria was busy, and how you handles it." C. Describe a situation that has occurred in the cafeteria recently. Ask the applicant if this has ever happened to them. D. Call the applicants references on the spot and ask the same questions of them.

B

Which of the following skills would be considered the most desirable for an upper-level manager to have? A. Human skills B. Conceptual skills C. Technical skills D. Negotiating skills

B

Which of the following statements does NOT reflect the goals or objectives of nutrition intervention as part of the NCP? A. Goals and objectives must be reasonably attainable B. The dietitian should set the most appropriate goals and objectives for the client or patient. C. Goals and objectives must be able to be quantified D. Goals and objectives should be centered on the patient or client.

B

Which of the following would be the MOST IMPORTANT nutrition intervention for a person identified as having pre-diabetes with a BMI of 27 kg/m²? A. Reduction of total fat intake B. Moderate weight loss C. Reduction of sodium intake D. Elimination of concentrated sweets

B

Which response best describes the purpose of websites such as www.uptodate.com, www.acpmedicine.com, or www.clinicalevidence.com? A. Websites available for use by the general population B. A subscription-based source of medical information and recommendations based on current medical research C. A source of medical information and recommendations based on current medical research available free of charge D. Database portals allowing access to search medical literature

B

A client is requesting information on meatless meals. You suggest using tofu, which the client has never heard of. All of the following are benefits of using tofu EXCEPT: A. Tofu contains high biological value protein B. Tofu is high in soluble fiber and is relatively easy to digest C. Tofu can help to lower LDL cholesterol D. Tofu is a good source of calcium and B vitamins

B Reason : tofu is low in fiber because the fiber is removed during processing of the soybean.

All of the following are important in quantity food production. Which of the following is the MOST important factor? A. Quality food is the end result B. To promote the maximum retention of nutrients through appropriate preparation C. To maximize production schedules for the most efficient use of staff and equipment D. The use of standardized recipes to help control costs and provide consistent products

A Reason: The most important factor in quantity food production is the end result, which should be the quality product that is flavorful and visually appealing

In order for chlorine to be effectively used as a sanitizer in a food service operation, the pH level must be: A. Below 8 B. Below 5 C. Above 8 D. Above 5

A Reason: There are 2 ways to sanitize: heat and chemical. Three sanitizers used for chemical sanitizing are chlorine, iodine, and quaternary ammonium. In order for the sanitizer to be effective, the pH level of the water it is mixed with must be at a certain level: 7 for quaternary ammonium; <8 for chlorine; <5 for iodine.

Which of the following terms refers to the circulation of hot air to evenly distribute heat? A. Convection B. Conduction C. Radiant D. Conventional

A Reason: This kind of cooking is similar to conventional except that this cooking has a fan that circulates hot air throughout.

A client enters your office for his initial counseling session for management of hypertension. The physician has asked you to help this man with weight loss, reducing sodium intake, and overall risk reduction. The client sits down, immediately begins to frown, arms are crossed over his chest, and he does not make eye contact when you initiate conversation. What are the non-verbal clues telling you about this client? A. The client is relaxes, ready to listen B. The client is feeling defensive, cold towards you or the situation C. The client is bored or not interested D. The client is anxious about his medical condition

B

A large tertiary care hospital utilizes a cook/chill food service system. Food is prepared in the main preparation area. Trays are prepared on the tray line and then transported to galleys located on the inpatient units, where they are reheated later at meal time to serve to the patients. This type of distribution system is known as: A. Centralized B. Decentralized C. Patient-centered D. Cafeteria style

B

All of the following are true about essential fatty acid except: A. Good sources of essential FA include fatty fish such as salmon and tuna B. They are available mainly through diet but the human body is able to make a limited supply C. Essential fatty acid deficiency can affect growth, wound healing and vision and cause scaly skin rash D. Alpha-linoleic acid and linoleic acid cannot be synthesized by the human body

B

Which of the following best describes the characteristics of a bake shop or dessert preparation area within a foodservice department? A. It should be located close to the main production or preparation areas B. It should be laid out in a counterclockwise configuration to increase efficiency, with the final product finishing closest to where it will be served or transported C. It should be laid out in a typical triangle configuration for maximum efficiency D. It can be located within the main food prep area

B

Because hospital stays are becoming increasingly shorter, many hospital food service departments are changing the type of menu used to: A. Selective B. Semi-selective C. Non-selective D. Static

B Reason: Usually hospitals offer a full selective menu which provides the disadvantage of a requirement of a large amount of resources due to so many choices. Since length of time of hospital stay is decreasing, hospital food service is changing to a semi-selective menu because it offers some selection, but not as much. This type of menu helps reduce food and labor costs.

All of the following are important communication skills necessary in the facilitation of changes in behavior by the nutrition professional EXCEPT: A. Avoidance of putting the client on the defensive B. Helping the client to develop discrepancy C. Confrontation D. Expression of empathy

C

All of the following are steps in the purchasing process. Which step is the first? A. Desired quantity is determined and inventory is taken for each item. B. Purchase orders are written C. Needs are identified based on the master menu for the operation D. Negotiate with vendors

C

An RD moves to a new state and applies for a job as a clinical dietitian. Which of the following would be considered a breach of the American Dietetic Association professional Code of Ethics? A. The dietitian is licensed in her home state but has not yet applied for licensure in the new state of residence B. The dietitian has a side business selling nutritional supplements geared to helping patients with cancer improve their nutritional status C. The dietitian uses the credential of CSR (Certified Specialist in Renal Nutrition) even though she let the credential laps and did not retake the exam before the deadline. D. The dietitian took a break from practice in between jobs to work on an alcohol dependency issue

C

As a restaurant manager, you are trying to market "Generation Y." Which of the following would be the LEAST effective marketing strategy for this age group? A. Set up Facebook, Twitter, or Evite accounts B. Maintain an interesting and informative website C. Play background music from classical selections D. Host entertainment-type events such as karaoke, trivia games, or live music to attract you target audience

C

Important factors in planning the facilities for a university food service with multiple dormitories and a large commuter population would include all of the following EXCEPT: A. A first floor location near the main hallways B. A state-of-the-art ventilation system to prevent odors from the kitchen from reaching public spaces such as classrooms C. Avoiding duplicate purchases of large pieces of food service equipment to cut down on costs D. Planning for a cook/chill or cook/freeze system in order to reduce the amount of cooking equipment needed

C

Which of the following is an acronym used by the Nutrition Screening Initiative (NSI) to help measure an older individuals nutrition risk? A. DEPENDABLE B. COMPETENT C. DETERMINE D. DEFENST

C Reason: D (disease) E (eating poorly) T (tooth loss or mouth pain) E (economic hardship) R (reduced social contact) M (multiple medicines) I (involuntary weight loss or gain) N (needs assistance in self-care) E (elder years above 80).

The use of a pre-selective menu would be the MOST appropriate for: A. An acute pediatric inpatient ward B. A hospital cafeteria C. A maternity ward at a local hospital D. A catering function

C Reason: A pre-selective menu is also known as a non-selective menu because it does not offer any choices. This is used most effectively in a maternity ward because the length of stay is often only 24 hours. A no-selective menu is often used in long term care facilities, where it is rotated on a cycle to prevent repetition.

A cookie recipe calls for cake flour but none is available. Bread flour is substituted. What could be a possible consequence of this substitution on the end product? A. The cookie rise too high B. The cookies are over-caramelized C. The cookies do not spread enough D. The cookies spread too much

C Reason: Bread flour contains more protein than cake flour and therefore may not allow proper spread while baking. A better option than bread flour would be all purpose flour.

Which of the following would LEAST LIKELY be considered an example of functional foods? A. Orange juice B. Garlic C. Iodized salt D. Tomatoes

C Reason: Functional food is defined as any food that may reduce the risk of developing certain diseases and/or promote the best possible health status. Examples of functional foods are garlic, tomatoes, and oj due to their cancer fighting, antioxidant and vitamin C properties.

For Evidenced-Based Practice (EBP), which of the following resources would NOT be a primary source of information? A. Databases such as MEDLINE or Cochrane Library B. ACP Journal Club C. Clinical Evidence or eMedicine D. Wikipedia or Medpedia

D

The best choice for measuring long-term glucose control would be A. Fasting glucose B. Pre-prandial capillary plasma glucose C. Glucose tolerance test D. HbA1c

D

Which of the following is the best initial nutrition prescription for a patient with gastroparesis? A. Liquid or puree meals that are high-calorie, high protein, and low-fat B. Small frequent meals that are high fiber and moderate fat, plus a minimum of 30 minutes of physical activity daily C. Jejunostomy tube placement for enteral nutrition D. Small, frequent meals that are low-fiber and low-fat followed by mild exercises such as a walk

D

Which of the following would be considered the most appropriate time frame in which to complete a nutritional screening of an adult patient admitted to an acute care hospital? A. 14 days. B. 48 hours C. 12 hours D. 24 hours

D. 24 Hours Reason: This is a realistic time frame to identify those individuals at risk for malnutrition and it is also a requirement of the JCAHO. -Long term care facilities- 14 days is acceptable.

Beriberi is a deficiency of what vitamin?

Thiamin

In performing a nutrition-focused physical assessment in the area of the mouth, you notice bleeding, spongy gums. What vitamin or mineral may be deficient? A. Vitamin A B. Vitamin C C. Iron D. Zinc

Vitamin C

Total Quality Management (TQM) is based on which of the following assumptions? A. Most employees do not have an innate desire to do their job well and in fact require substantial extrinsic motivators such as salary or bonuses B. A management approach that encourages independent thinking and competition within the workplace to get the best results possible C. Most employees have self-motivation, an innate desire to do their job well, and a desire to learn an improve themselves within their job D. A management approach that focuses on the end result, which is the product

C

When beginning the menu development process for a 3-week cycle menu, which of the following is the first step in the process: A. Planning the soups B. Planning the side dishes C. Planning the entrees D. Planning the dinner meals

C

When evaluating an adolescent female for the possibility of an eating disorder, what clinical signs may indicate a diagnosis of bulimia nervosa instead of anorexia nervosa? A. Irregular menstrual periods B. Hypokalemia C. Erosion of the enamel of the teeth D. Weakness and delayed gastric emptying

C

When following a recipe, the term "fold" refers to A. Layering wet and dry ingredients B. Rapidly combining fat and sugar in order to incorporate air C. Using a spatula or large spoon to add an ingredient such as whipped cream to other ingredients, using a gentle turning motion D. Gently stirring ingredients together to form a batter

C

When preparing a performance review, the most important aspects to cover would be: A. Employee goals for the coming year B. Your goals for the employee for the coming year C. Describing the employees strengths, areas that need improvement, and an action plan for addressing areas that need change D. Determining training needs for the coming year

C

Which of the following best describes the labs that would normally be obtained when monitoring liver function? A. Bilirubin (direct and indirect), BUN, Creatinine, CHEM-7 B. Alkaline phosphatase, PT/PTT, ferritin C. ALT, AST, bilirubin, LDH, ammonia D. Ceruloplasmin, zinc, ALT, AST

C

You have a client with a nutrition diagnosis of overweight/obesity and a family history of coronary heart disease and diabetes. The client needs help with weight reduction. All of the following may be appropriate monitoring/evaluation plans for this client EXCEPT: A. Readiness to change, level of knowledge, physical activity, and total energy intake B. Fat and cholesterol intake, total fiber intake, BMI C. Lipid profile, fasting blood glucose, triglyceride and cortisol levels D. Percentage of usual body weight or ideal body weight, waist circumference, BMI, Percent weight change

C Reason: Cortisol is not a part of biochemical data that could be monitored; it is not a lab value that can be impacted by nutrition intervention.

A 19-year-old female was diagnosed with Type 1 diabetes 4 months ago. She has been doing fairly well trying to implement all the recommendations that have been given to her. She is a late sleeper and often does not have time in the morning to eat breakfast, which leads to issues with hypoglycemia. What would be the MOST appropriate intervention to help her make time for breakfast so she can avoid hypoglycemia? A. Help her come up with healthful breakfast ideas that are easy to eat quickly in the morning B. Explain to her the dangers of skipping breakfast and insist that she wake up 1 hour earlier in order to eat a healthy breakfast C. Advise her to keep snacks on hand to prevent hypoglycemia D. Acknowledge her difficulty waking up and encourage her to pick up breakfast on her way to school or work to ensure she gets her meal in even if it is not the most healthful

A

A 32 year old female who is 24 weeks pregnant has a random glucose test of 215 mg/dL. She has a pre gravid BMI of 31 kg/m². A fasting blood glucose done the next day is 110 mg/dL. She is referred to your office for management of gestational diabetes. What would be an appropriate first step in your nutrition intervention for this woman? A. Initiate counseling to reduce carb intake to 35-40% of total calories. B. Initiate counseling to reduce carb intake to 50-60% of total calories C. Recommend additional blood glucose testing in the form of a fasting glucose level or an oral glucose tolerance test D. Recommend the initiation of insulin or oral hypoglycemic agents to optimize blood glucose control

A

A client is referred to you after being diagnosed with T2DM. The client is visibly overweight, reeks of cigarette smoke, and is drinking a bottle of regular soda. As you being to interview the client, he is sitting with his arms crossed an keeps staring out the window. You learn this is the second time he has been referred to a dietitian. The first time was for assistance with weight loss and blood glucose levels borderline for diabetes, but he did not follow up. You assess one problem to be "not ready for diet/lifestyle change." Based on the information, which is the best choice for a PES statement? A. Not ready for diet/lifestyle change related to lack of interest as evidenced by negative body language and failure to engage in counseling. B. Not ready for diet/lifestyle change related to new diagnosis of diabetes as evidenced by elevated serum blood glucose levels C. Not ready for diet/lifestyle change related to failure to engage in counseling as evidenced by negative body language D. Not ready for diet/lifestyle change related to failure to keep appointments as evidenced by new medical diagnosis.

A

All of the following are TRUE about documentation of step 4 of the NCP (monitoring/evaluation) EXCEPT: A. The schedule for the frequency of monitoring is based solely on departmental policy and procedures B. It requires a definitive plan of action rather than just "watching" or "following." C. Components of this step include monitoring progress, measuring outcomes, and evaluating outcomes. D. Progress toward nutrition goals could be more objectively measured on a numerical scale such as 1-5.

A

All of the following are ratios used to analyze worker productivity in food service EXCEPT: A. Total food cost per labor hour B. Meals per labor hour C. Meals per FTE D. Labor minutes per meal

A

All of the following are ways that schools are working towards implementing the Dietary Guidelines for Americans EXCEPT: A. Using a la carte items to supplement calories to meet guidelines B. Using standardized recipes to incorporate commodity foods into meal plans C. Adjusting portion sizes to meet requirements for various age groups D. Voluntary participation in the National School Lunch Program (NSLP)

A

All of the following would be examples of appropriate behavior modification that may be used for children for weight control EXCEPT: A. Limiting TV and computer time to 2 hours max and providing a for reward if goal is met B. Substituting water for soda or sweetened beverages C. Eating at the table with family instead of in front of the TV D. Eating a healthy breakfast every morning that is low in sugar, contains fiber and protein, and is low in fat

A

How does the Senior Farmers Market Nutrition Program benefit older adults? A. It provides coupons for use by qualified low-income seniors to purchase fresh produce, herbs, and honey at locally sponsored farmers markets, roadside farm stands, or other community based agriculture program s. B. It provides direct delivery of fresh produce to low-income seniors C. It provides coupons for use by low-income seniors to purchase fresh produce in supermarkets D. It provides assistance with the purchase of locally grown fresh produce, herbs, or honey at farmers markets and other community-supported programs based on a sliding scale for income

A

If a case of food-borne illness is suspected, the first step would be to contact: A. The local health department (city or county) B. The state health department C. The CDC D. The National Outbreak Reporting System

A

In a facilities design project, which of the following would best describe the information contained in the prospectus? A. Project rationale, physical operations and characteristics, necessary regulatory data such as safety features, noise control, and energy use B. Members of the planning committee, architectural features, budget considerations C. Feasibility study, determination of the foodservice system to be implemented, spatial considerations D. Preliminary design plan, menu analysis, feasibility study

A

Once a menu is established for a long-term care facility, how are therapeutic and modified consistency diets accommodated? A. Modified menu extensions are written by the RD based on the master and are used in conjunction with the institutions diet manual. B. A separate menu is written as needed based on physician order C. Menu cycles are written for modified-consistency diets and the most common therapeutic diets D. The menu is served as written and items are substituted as necessary based on the diet order.

A

The Factor Method of menu pricing is commonly used. Which of the following is TRUE about the Factor Pricing Method? A. The same factor is used with the raw food cost to determine all menu prices taking into account supplies, labor, profit B. The same factor is used with the total cost of food and labor for each menu item to determine price C. This method often predicts prices that are reasonable for all menu items D. A separate factor for low, medium, and high labor-intensity food items can be used with the raw food cost to determine appropriate pricing

A

The primary role of the large intestine is: A. Water and sodium resorption B. Water and sodium excretion C. Fatty acid digestion D. Performs the majority of the digestive process

A

What 3 components comprise a nutrition diagnosis statement? A. PES B. DET (Diagnosis-Etiology-Treatment) C. ICS (Issue-Cause-Symptoms) D. POS (Problem-Origin-Signs/Symptoms)

A

What is the TQM problem solving tool that illustrates cause and effect of a specific problem? A. Fish diagram B. Pareto chart C. Process chart D. Scatter diagram

A

What is the following an example of? Payroll title: Department: Supervised by: Job Summary: Educational Requirements: Experience Required: Physical Requirements Personal Requirements Salary Code Opportunities for Advancement: A. Job Specification B. Job Description C. Work Schedule D. Job Posting

A

What was the definition of a cohort study? A. Subjects with the same condition or using the same treatment are followed and observed over time, then compared to subjects without the condition or treatment. B. Subjects with the same condition or using the same treatment are pared up with controls to track progress C. Subjects with the same condition are divided into groups and given different treatments, then followed over time to determine best practice. The subjects are not aware of exactly what treatment they are receiving. D. A retrospective review of subjects with the same disease.

A

Which of the following best describes the American Cancer Society`s nutrition recommendations for cancer prevention? A. Achieve and maintain a healthy weight, increase physical activity to at least 30 minutes per day, increase consumption of fruits and vegetables, choose whole grains, reduce consumption of red meat, limit alcohol intake B. Try to reach ideal body weight, limit alcohol intake, eat 3-5 servings of fruit and vegetables per day, increase exercise to 60 minutes per day C. Achieve and maintain a healthy weight, increase intake of antioxidants through nutrition supplements or foods, avoid aspartame D. Try to reach ideal body weight, reduce fat intake, reduce intake of processed foods, and increase activity to 60 minutes per day, 3 times per week

A

Which of the following is TRUE about the nutrition prescription? A. It is the nutrition treatment that is deemed correct for a certain nutrition diagnosis B. It is written prior to the PES C. It is equivalent of the physician diet order D. It is based on the nutrition and diet history along with the admitting diagnosis.

A

Which of the following parameters would most reliably indicate nutritional risk? A. Unintentional weight loss of 12% in 6 months B. Low serum albumin C. Weight low of 5% over 3 months D. Lactose intolerance

A Parameters that increase nutritional risk include: unintentional weight loss, change in appetite, decreased ability to chew, certain food allergies, BMI, certain lab data, and diet modifications. Two of the parameters that have been validated are: unintentional weight change and change in appetite or food intake.

The statement that best describes a nutrient intake analysis is: A. A tool used to obtain dietary information by recording an individuals actual intake over a 72 hour period B. A tool used to obtain dietary information from the previous 72 hours based on an individuals memory recall C. A tool that utilizes a questionnaire to determine how often certain foods are consumed D. A tool that offers a comprehensive and accurate measurement of an individuals dietary intake over 48-72 hours

A Reason: A nutrient intake analysis is commonly known as a calorie count or nutrient intake record. Actual intake is recorded over a certain period (usually 72 hours), by observing what is left on the individuals tray after meals. This is usually conducted in a hospital or long term care setting.

The most appropriate method of cooking a chuck roast is: A. Braising B. Grilling C. Broiling D. Roasting

A Reason: Any cut of meat that comes from an area on the animal that gets a lot of exercise will be less tender; ex: chuck roast. This requires a moist method of cooking in order to soften the meat and tenderize. Braising less tender cuts of meat allows time for the tougher connective tissue to break down and turn into gelatin.

A patient with ovarian cancer and malnutrition is being started on total parenteral nutrition. What are the MOST important lab values to monitor upon initiation of TPN? A. Serum phosphorus, potassium, glucose B. Serum phosphorus, renal function, glucose C. Serum potassium, glucose, triglycerides D. Serum sodium, potassium, liver function

A Reason: Any patient being started on TPN is at risk of developing referring syndrome. Metabolic consequences may include: hypokalemia, hypophophatemia, hypomagnesemia, hypoglycemia, and changes in fluid balance.

During a nutrition focused physical exam of an infant, the RD notices a yellowish tinge to the infants skin. What nutrient might this be associated with? A. Excessive intake of Vitamin A B. Deficiency of Vitamin A C. Deficiency of Vitamin E D. Excessive intake of Vitamin E

A Reason: Excessive intake of carotene or vitamin A sources such as carrot or other orange veggie can cause yellow skin pigmentation.

All of the following are domains within classifications of nutrition diagnosis EXCEPT: A. Medical B. Intake C. Behavioral-Environmental D. Clinical

A Reason: The 3 domains of nutrition diagnosis: Intake, clinical, and behavioral-environmental.

As the purchasing agent for a local food service operation, you are ordering meat from a vendor located in a neighboring state. Any meat purchased and shipped between states must meet requirements set forth by which of the following government agencies: A. USDA B. EPA C. FDA D. USDHHS

A Reason: The FDA is responsible for all food other than meat, poultry, and eggs.

Which of the following is NOT included on the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) official "Do Not Use" list? A. IV B. IU C. Q.D. D. @

A Reason: The abbreviation IU may not be used because it may be confused with the abbreviation IV.

You have prepared appraisal for an employee who has difficulty getting to work on time. The past week has been especially difficult because other employees have had vacation and you needed this employee to get to work on time to start the day. The performance review with the employee takes a long time because you keep focusing on your frustrations. The employee points out that, aside fro her tardiness, she does a good job but the performance appraisal does not appear to reflect that. This is known as: A. The Halo effect B. The Devil effect C. The Delusional effect D. The Glory effect

A Reason: The Halo effect occurs when a managers perceptions of an employee are clouded by either unusually bad or good performance in just one area.

What is the for of documentation that was developed with the NCP in mind? A. SOAP B. PES C. ADIME D. PIE

ADIME

As the RD for the dialysis clinic, you are following a 54-year old male patient with ESRD who started HD 4 months ago. He has reportedly received diet instruction at his previous dialysis clinic but seems to have trouble adjusting his potassium intake. You have identified the nutrition diagnosis as "excessive intake of potassium as evidenced by food and nutrition knowledge deficit related to elevated serum potassium of 5.5 and frequent consumption of high-potassium foods such as banana and oj." The planned nutrition intervention was comprehensive nutrition education on a potassium-modified diet including appropriate food substitutions that are lower in potassium. Which of the following is the best choice for monitoring/evaluation of this patient? A. Urine volume and specific gravity (Biochemical data, medical tests, and procedures domain) and level of food and nutrition knowledge (Food/nutrition-related history domain) B. Serum potassium (Biochemical data, medical tests, and procedures domain), food/meal selections, and self-reported adherence (Food/Nutrition-related history domain) C. Amount of food, types of food/meals, and variety (Food Nutrition-related history domain) D. Comparison to estimated potassium needs (Comparative standards domain) and serum potassium (biochemical data, medical tests, and procedures domain).

B

Food-borne illness caused by Staphylococcus aureus has an incubation period of: A. 6-48 hours B. 1/2-6 hours C. 8-22 hours D. 18-36 hours

B

How does a nutrition diagnosis differ from a medical diagnosis? A. They are essentially the same except the nutrition diagnosis is written by the dietitian B. A nutrition diagnosis is a problem or issue that can be addressed through the nutrition intervention of a dietitian or other dietetics professionals C. A dietitian cannot diagnose medical conditions. Therefore, a nutrition diagnosis must be substituted. D. A nutrition diagnosis enables the dietitian to bill for services rendered.

B

If an average adult consumed 20 kcal/kg per day, what so you think the consequence would be? A. Weight gain B. Weight loss C. Weight maintenance D. Depends on how much exercise the person gets

B

The method of budgeting that uses the information from the previous years budget and then makes adjustments based on predicted changes in revenue and expenses is called: A. Level budgeting B. Incremental budgeting C. Zero-based budgeting D. Performance budgeting

B

The type of purchasing method that involves a submission of bids by vendors followed by a formal contract agreement that states the agreed-upon vendor will supply the majority of items needed such as meat, poultry, produce, and dairy is called: A. Blanket purchase agreement B. Prime vending agreement C. Cost-plus purchase agreement D. Competitive agreement

B

What is the appropriate action for a patient who does not have a nutrition diagnosis? A. If the patient has potential for a nutrition diagnosis or is at risk for developing nutrition diagnosis, this should be documented. B. No nutrition diagnosis at this time but a plan for reassessment should be documented in the Monitoring/Evaluation step. C. No documentation is required. D. All patients will have some sort of nutrition diagnosis. You will need to delve further to determine one.

B

What is the daily protein requirement for a patient with uncomplicated cirrhosis without encephalopathy? A. 0.4-0.6 g/kg B. 0.8-1.0 g/kg C. 1.3-1.5 g/kg D. 1.5-2.0 g/kg

B

What is the name of the data source through the CDC and Prevention that obtains information for individuals in the form of interviews and physical examinations in order to assess the overall nutritional and health status of the US? A. Dietary Guidelines for Americans B. National Health and Nutrition Examination Survey (NHANES) C. Nationwide Food Consumption Survey D. Nutrition Screening Initiative (NSI)

B

What is the primary purpose of nutrition screening? A. To identify patients who need nutrition education B. To identify patients with factors that place them at risk for malnutrition or nutritional issues C. To identify patients who are obese D. To identify patients who need to be considered for government food programs

B

Which of the following are the 4 modifiable risk factors that have been identified as key in the prevention and control of high blood pressure? A. Weight, sodium, potassium, and physical activity B. Weight, sodium, physical activity, and alcohol C. Physical activity, alcohol, sodium, and potassium D. Sodium, calcium, weight, and physical activity

B

A 30-year-old man is admitted to the hospital with a flare up of his Crohns disease. He is 6`tall and his usual weight is 170 lbs, which he weighed 1 month ago. His weight on admission is 160 lbs. His BMI is 21.7 kg/m². He has not been eating well due to abdominal pain that has been worsening over the past month. Which of the following might be a potential PES statement for this patient? A. Increased energy requirements r/t decreased intestinal function due to Crohns disease a/e/b unintentional weight loss of 10% in the past month B. Increased energy requirements r/t decreased intestinal function due to Crohns disease a/e/b unintentional weight loss of 6% in the past month C. Increased energy requirements r/t decreased intestinal function due to Crohns disease a/e/b loss of muscle mass D. Increased energy requirements r/t decreased intestinal function due to Crohns disease a/e/b a BMI of 21.7 kg/m².

B Reason: 10 lbs lost over 1 month; 10 lbs ÷170 lbs = 0.05888= ~6% weight loss in 1 month.

A financial services company has been experiencing an increasing number of absences by employees. Many of the sick days are related to chronic health conditions. The company decides to implement a voluntary nutrition education program that involves seminars on healthy eating, weight loss, increasing physical activity, and managing chronic health conditions such as diabetes. After a period of 9 months of participation, the company wants to evaluate the effectiveness of the program. Which of the following would be the best advice? A. Provide a detailed questionnaire to the employees about participation and sick day use. B. Determine a baseline for the average amount of sick time used per employee over a period of time and reassess at predetermined intervals. C. Compare use of sick time for each employee before and after attending seminars D. Ask employee health services to release information on employees with chronic diseases and determine if use of sick time has declined after participation in the seminars.

B Reason: A baseline can be determined for how much sick time is sued on average per employee related to chronic health conditions. You would need this information in order to evaluate the effectiveness of the program in reducing absenteeism.

All of the following are appropriate reasons for discontinuation of care by the dietitian EXCEPT: A. The patient has met goals for nutrition intervention B. The client is discharged from the hospital C. The client is not ready to make the necessary changes to meet intervention goals at this time. D. No further change in nutrition diagnosis is expected and reasons for lack of progress are documented.

B Reason: Even if the client is discharged from the hospital, the RD will need to find ways to monitor progress (ex: calling patient, email, mailing a survey or a questionnaire).

The term kwashiorkor refers to: A. Form of protein-calorie malnutrition characterized by severe weight loss and protein depletion B. Form of malnutrition where protein deficiency causes edema and depletion of visceral protein C. A mild form of malnutrition commonly seen in developing countries D. Form of malnutrition rarely seen because of improved food supply and access to food

B Reason: Kwashiorkor is a form of malnutrition characterized by preservation of weight but depletion of visceral proteins such as albumin.

All of the following foods are on the FDA`s Potentially Hazardous Food list EXCEPT: A. Sliced cantaloupe B. Peanut butter C. Sliced tomatoes D. Cooked pinto beans

B Reason: Potentially Hazardous Food List includes foods that can possibly cause food-borne illness if temperature control guiltiness are not followed. The following guidelines identify foods that make the PHF list: water activity greater than 0.85, containing protein, and/or having a pH between 4.6 and 7.5, making the food neutral to slightly acidic. Foods on this list include: meats, chicken, turkey, fish, shellfish, eggs, dairy products, mushrooms, raw sprouts, baked potatoes, and any cooked plant-based food. Most fruits and veggies are not considered hazardous unless they are cut.

What are the estimated daily maintenance fluid requirements for a 30 year old female weighing 130 lbs? A. 1500 mL B. 2100 mL C. 3000 mL D. 3600 mL

B Reason: Rule of thumb is 35 mL/kg for adults; 50-60 mL/kg for children; 150 mL/kg for infants

The physician in the hospital has written an order for 10U of regular insulin. The order is transcribed as 100U and given to the patient. Within minutes, the patient begins to have a severe hypoglycemic reaction with a blood glucose level of 15 mg/dL and it transferred to the ICU for management. According to the JCAHO, this would be known as: A. Medical error B. Sentinel event C. Advere event D. Root cause analysis

B Reason: Sentinel event means an unexpected death or serious physical or psychological injury that requires immediate attention.

Using the HAMWI method, calculate the ideal body weight for a 47 year old male with a height of 6`2" and a weight of 175 pounds. A. 171-190 lbs B. 171-209 lbs C. 190-209 lbs D. 180-200 lbs

B Reason: The HAMWI method uses a different equation according to gender. An adjustment is applied of ±10% of the weight. For men, 106 pounds is given for the first 5 feet of height and an additional 6 lbs for each inch over 5 feet. For women, 100 pounds is given for the first 5 feet and then 5 lbs for each additional inch. This equation does not take into account the age of the individual.

The National Institutes of Health initiated the Women`s Health Initiative (WHI) in 1991. This was the largest prevention research study done to date. This study is an example of what type of research design? A. Epidemiological study B. Randomized controlled clinical trial C. Cohort study D. Phase 1 trial

B Reason: The WHI was a 15 year study that began enrolling participants in 1993 and stopped enrolling in 1998. It was designed mainly as a RCT but also had components of an observational study to predict disease and look at community approached to the development of healthful behaviors.

Which of the following individuals is LEAST LIKELY to require magnesium supplementation? A. An individual taking long-term furosemide B. A breastfed infant C. An individual with chronic alcoholism D. An older adult

B Reason: The only vitamin or mineral a breastfed infant may need is iron or vitamin D. Certain medications, alcohol abuse and older adults are more in need of a magnesium supplementation.

All of the following would be an acceptable inventory method for food service EXCEPT: A. Physical inventory B. LIFO C. Mini-max system D. Par-stock system

B Reason: This would not work for food items because of the expiration dates; items would spoil before they are used. FIFO would be a better choice

A hospital has an open position for an entry level clinical dietitian. What would be the LEAST effective recruiting tool? A. Advertising at local area hospitals or colleges with internship programs B. Web-based recruiting such as Monster.com or indeed.com C. The help wanted section of the local Sunday newspaper D. The American Dietetic Association`s career center or state affiliate job bank

C

Which of the following best describes the primary principles of the Classical Theory of Management? A. The highest level of authority within the organization is the one who makes the decisions and distributes instructions. Employees instinctively divide themselves into groups within the organization. B. There is a chain of command that starts at the top with the CEO. Disciplinary action is used to improve performance of employees. Mathematical tools and models are used to help managers make decisions. C. There is a defined division of work with only one person giving orders. There should be a chain of command starting with the lowest level employee all the way up to the top. Teamwork is the basis for success of the organization. Employees derive great motivation from salary and raises. D. Managers must adapt their leadership to the needs to the employee. The motivating factor for each employee must be determined and used to effectively enhance productivity and efficiency.

C

Which of the following foods would not be allowed on a gluten-free diet? A. Canned pears B. Cream of rice cereal C. Beer D. Cottage cheese

C

Which of the following has the most dangerous implications of pregnant women? A. Staph. aureus B. Bacillus cereus C. Listeria monocytogenes D. Campylobacter jejuni

C

Which of the following would NOT be appropriate use of nutrition outcome measures in quality improvement? A. Evaluation of the healthcare savings associated with a reduced length of stay for certain types of patients B. Evaluation of the effectiveness of nutrition care C. Evaluation of progress towards national obesity goals D. Evaluation of patient-centered outcomes such as quality of life or self-management skills

C

In school food service operations, the unit measure most often used to quantify the effectiveness of the program is: A. A la carte items B. Student reimbursable breakfast C. Student reimbursable lunch D. All student reimbursable meals

C Reason: A formula is used to estimate how much of each item or meal equals one student lunch.

What factor has the most significant impact on the course of Short Bowel Syndrome (SBS)? A. Resection of the jejunum B. Age at time of surgery C. Resection of the distal ileum D. Resection of the duodenum

C Reason: If the jejunum is resected, the ileum will adapt and take over many of the jejunum functions. Resection of the distal ileum will have the most significant impact on the course of SBS because of its unique functions (absorb several liters of fluid throughout the day; only site for absorption of B12 and bile salts). Malabsorption of bile salts may lead to an inability to digest fats. Additional consequences include dehydration and massive diarrhea.

All of the following are leading health indicators for Health People 2020 EXCEPT: A. Physical Activity B. Obesity C. Diabetes Mellitus D. Substance abuse

C Reason: Leading health indicators include physical activity, overweight and obesity, use of tobacco, substance abuse, sexual behavior, mental health, violence, quality of environment, immunizations, and overall access to healthcare. Diabetes is a focus area that is a PART of several leading health indicators.

All of the following would fall under the regulation of OSHA EXCEPT: A. The right to receive training on chemicals you may be exposed to in the workplace B. The right to file a discrimination complaint for refusing to work in an unsafe environment C. The right to reasonable accommodations in the workplace for a disability D. The right to request that safety hazards be addressed even if they are not in violation of OSAH standards

C Reason: OSHA is responsible for keeping American workers safe in the workplace.

What would be an appropriate substitution for a formula-fed infant who has just been diagnosed with a cows milk protein allergy? A. Enfamil B. Neosure C. Nutramigen D. Neocate

C Reason: Roughly, 15% of infants develop an allergy to cows milk protein. One of the first symptoms is the presence of blood in the infants stool. For breastfed infants, the maternal diet needs to be modified with the removal of cow`s milk protein containing foods. For infants who are formula fed, it requires a change to a hypoallergenic, extensively hydrolyzed formula such as Nutramigen or Alimentum. Sometimes an amino-acid based formula such as Neonate is required, but not usually the first step.

What was the name of the largest randomized controlled study to date that looked at the effects of dietary protein restriction on how renal disease progresses? A. The effect of Dietary Protein Restriction on the Progression of Renal Disease B. The Protein Restriction and End Stage Renal Disease C. The Modification of Diet in Renal Disease D. Dietary Protein and its effect on the Progression of Renal Disease

C Reason: The Modification of Diet in Renal Disease is an excellent example of an RCT.

The final step of the NCP is Monitoring/Evaluation. Which of the following domains would NOT be the most appropriate starting point in choosing the nutrition outcome indicators? A. Nutrition-Focused Physical Findings B. Comparative Standards C. Client History D. Knowledge/Beliefs/Attitudes

C Reason: The Monitoring/Evaluation step in the NCP is to determine the progress that has been made through nutrition interventions. Client history is a domain of the Nutrition assessment step and can't be used for monitoring and evaluation because it does not alter any of its subclasses (gender, past medical history, medical treatment, social history).

All of the following are True about Dietary Reference Intake (DRI) except: A. The DRI`s take into account both gender and age B. Recommended Dietary Allowances (RDA`s), Adequate Intake (AI), and guidelines for safer upper limits all fall under the umbrella of the DRI C. The DRI`s are updated every 5 years D. The DRI`s were originally written as RDA`s to help prevent nutrient deficiencies.

C Reason: The RDA`s are revised every 10 years. The DRI include the RDA, AI, EAR, and UL`s.

What would be the easiest way to increase the number of muffins prepared from a small-scale recipe from 1 dozen to 10 dozen? A. Use the forecasting method B. Use the percentage method C. Use the factor method D. Conduct a recipe yield evaluation

C Reason: The are 2 methods of adjusting recipes for a different yield: the factor method and the percentage method. The easiest for converting a muffin recipe to a larger yield is the factor method (divide the desired yield or end yield by the current yield).

A client is telling you how difficult it is for her to eat healthy when she travels with close friends who are not following the same diet modifications. Which of the following is an example of reflection on the part of the dietitian? A. "You find it difficult to make healthy food choices while traveling so perhaps we need to rethink these vacation plans so you do not lost ground." B."I understand. When I travel, I eat what I want then try twice as hard to get back." C. "You feel ashamed that you need to diet while all your friends can eat whatever they want." D. "You find it difficult to make healthy food choices while on vacation because all you friends are able to eat whatever they want and you find it frustrating."

D

A fast food restaurant is considering getting up an operation in a foreign country where people do to eat beef for religious reasons. There are many more vegetarians in this foreign country than in the United states. Which would NOT be an effective marketing tool for this fast food restaurant to employ in order to be successful? A. Develop a more extensive vegetarian menu to meet the needs of the majority of the population B. Remove all beef from the menu in order to show respect for the religious beliefs of the area C. Maintain separate work areas that are designated for vegetarian items and non-vegetarian items D. Implement the same menu used in the US

D

According to the Transtheoretical Model, at which change would an individual be most ready to make nutritional changes? A. Precontemplation B. Contemplation C. Preparation D. Action

D

All of the following are included on a balance sheet EXCEPT: A. Assets such as cash on hand, petty cash, and accounts receivable B. Liabilities such as accounts payable, salaries, and sales tax owed C. Assets such as money due from state or federal funds and purchased food and supplies D. Liabilities such as equipment or furniture

D

All of the following are part of the menu evaluation. Which is the most important for a long term care foodservice operation? A. Attractiveness of the menu (color, contrast, textures, flavors) B. Repetition of food items throughout the cycle C. Determining if the workload is manageable with the available staff and equipment D. Determining if the menu meets nutritional guidelines

D

An 80-year old female is admitted to the hospital with a stage 2 pressure ulcer on her coccyx. She weighs 100 lbs on admission with a height of 5`2". She has a BMI of 18.3 and a serum albumin level of 2.2 g/dL. She needs at least 1500 kcal and 68 g protein per day. She is unable to eat and has been prescribed a high protein, high calorie diet with supplements Bid. What is the best way to measure her response to nutritional intervention? A. Daily weights B. Monitoring for increases in serum albumin and her serum zinc level C. Monitoring her protein intake as well as her intake of vitamins and minerals D. Consulting with the skin care nurse on progress with healing of the pressure ulcer

D

An employee is fired recently due to excessive absenteeism has given your name as a reference for a new job he is applying for. Which of the following would be the LEAST appropriate response? A. Agree to give the reference but only provide information on dates of employment and job assignment B. Call the former employee and let him known you will not be able to provide a food reference for him C. Refuse to give a reference D. Provide general information to the potential employer about why you think the employee is absent so much as whether the situation has changed enough to merit them hiring this individual

D

At the local community center, you are starting a nutrition education series on Heart Healthy Cooking and Eating. What would be a way to evaluate the effectiveness of the program? A. At the last session, ask each participant open-ended questions to determine comprehension. B. Assess for changes in BMI or serum cholesterol levels C. After the series is completed, send participants home with a survey asking for feedback D. Test participants` knowledge before and after they attend the series, then compare the results

D

The delivery truck is met at the loading dock for delivery of the dairy order. The employee chats with his coworkers as the order is unloaded. The temperatures are quickly checked and recorded. The employee then begins to chat with the driver for a few minutes before he loads up the order and puts it away within 30 minutes of delivery. What important step was missing from this process? A. Putting the inventory away B. The employee did not check the actual delivery against the purchase order to make sure the delivery was accurate C. The employee did not open all the crates and boxes to check the quality of each item D. The employee did not check the actual delivery against the purchase order and then against the invoice for accuracy

D

What is the main goal of the Dietary Guidelines for Americans? A. To reduce the incidence of diabetes mellitus B. To teach parents how to feed their children appropriately C. To provide a sample 2,000 calorie meal plan for the majority of Americans to follow in order to lose weight. D. To try to reduce the overall risk for developing certain chronic diseases through improvement of diet and physical activity.

D

Which of the following enzymes assist in the digestion of protein? A. Lipase and amylase B. Ptyalin and maltase C. Sucrase and desxtrinase D. Pepsin and trypsin

D

Which of the following individuals is known as the "Father of Scientific Mangement?" A. Henry Gantt B. Frank Gilbreth C. Max Weber D. Frederick Taylor

D

Which of the following is NOT a potential consequence of hypercalcemia? A. Soft tissue calcification B. Interference with the absorption of iron and zinc C. Nausea, vomiting, constipation D. Vitamin D toxicity

D

Which of the following is NOT an example of an essential report used for financial accountability in food service? A. Year End Summary B. Profit and Loss Statement C. Daily Food Cost Report D. Daily Beverage Report

D

Which of the following is TRUE regarding the Hand Hygiene recommendations from the JCAHO for individuals passing trays to patients in a hospital? A. Artificial nails are acceptable if scrubbed well before serving B. The person serving the trays should stop and wash their hands with soap and water after each tray is delivered C. The person should put on a pair of gloves at the beginning of tray delivery then remove them when trays have been completely passed. D. The person passing the food tray should practice proper hand hygiene if direct contact is made with the patient while delivering the tray.

D

Which of the following most accurately describes the Healthy Diet Goals of the American Heart Association (AHA)? A. Consume less than 2300 mg of sodium, less than 300 mg of cholesterol, 4-5 servings of fruits and vegetables per day, and reduce sugar consumption B. Consume less than 1500 mg of sodium, less than 200 mg of cholesterol, 5-10 servings of fruits and vegetables per day, reduce sugar consumption, and limit alcohol to 1 drink per day for both men and women C. Consume less than 2300 mg of sodium per day, increase consumption of soy, eat fish twice per week, and reduce cholesterol intake to less than 300 mg per day. D. Consume less than 1500 mg of sodium, less than 300 mg of cholesterol, 8-10 servings of fruits and vegetables per day, limit alcohol to 1 drink per day for women and 2 per day for men, and reduce consumption of sugar.

D

Which of the following would be considered an advantage of using food frequency to obtain dietary information? A. Food frequency allows for the recording of actual intake throughout the day B. Food frequency provides information on how food is prepared C. Food frequency does not require the individual responding to be able to estimate portion sizes D. Food frequency can be very useful when it is used in conjunction with other methods of obtaining dietary information.

D

Which of the following would increase the risk for Clostridium botulinum in the canning process? A. Leaving an inch of headspace for canned veggies B. Processing canned foods in a pressure canner C. Allowing the canner to cool to room temperature on its own D. A low acid, moist environment

D

You are beginning to counsel the woman in the previous question on her meal plan. What would be the most appropriate strategy for counseling? A. Provide a weeks worth of pre-planned menus B. Teach a No Concentrated Sweets Diet C. Provide a meal plan using the diabetic exchange system D. Provide a meal plan using carbohydrate counting

D

You have identified "excessive fat intake" as a problem for one of your clients and "food and nutrition related knowledge deficit" as the etiology. Which of the following would be most appropriate to use as signs/symptoms? A. Decreased serum amylase B. HDL cholesterol level of 45 mg/dL C. Observation of client eating an order of french fries prior to counseling session D. Serum cholesterol of 260 mg/dL

D

The maximum temperature that the water in a multi-temperature dish machine should reach is: A. 170* B. 165* C. 212* D. 194*

D Reason temperatures higher than 194* may cause problems such as: turning to vapor and not effectively sanitizing or pipes bursting due to the hot water.

All of the following agencies help to regulate food safety EXCEPT: A. USDA B. FDA C. EPA D. CSPI

D Reason: CSPI stands for the Center for Science and public Interest. It is an advocacy group whose mission is to inform the public about current issues in health and nutrition.

All of the following are advantages to a conventional food service system EXCEPT: A. This type of system lends itself well to incorporating regional food items and ethnic recipes B. Menus can be easily adapted to incorporate seasonal food items such as fresh produce or to alter the menu based on price fluctuations C. There are less freezer space requirements because food is made from scratch instead of pre-purchased food items D. The production schedule is more predictable and utilization of employee productive time is maximized.

D Reason: Conventional foodservice systems is where all food is purchased in the raw state, prepared, and then served all in the same location. Benefits of a conventional food service system is that the menu can be easily changed, less freezer space is required. The main disadvantage is the schedule-it is difficult to plan sue to the changing menu selections.

Which of the following is NOT an example of ways that the Dietary Guidelines for Americans are utilized? A. Development of educational materials and tools based on the guidelines B. Placement of information from the guidelines on food labels and the Nutrition Facts Panel C. Programs such as the Elderly Nutrition Program, national child nutrition programs, and SNAP D. Development of laws such as the Dietary Supplement Health and Education Act

D Reason: The guidelines are not a direct basis for the implementation of the Dietary supplement health and education act.