StEP Exam Prep: Domain II_Nutrition Care for Individual and Groups
Consider the following scenario when the provider/client are talking. RD "Why don't you try spinach as a choice?" Client responds by rolling her eyes. Which of the following statements from the RD is the best example of the motivational Interviewing guiding principle "rolling with resistance"? a) "You don't like this idea." b) "You might try fresh spinach instead." c) "Maybe you can try other kinds of green leafy vegetables." d) "You've been talking about making changes, so I'm thinking this is a simple, straightforward change for you."
a) "You don't like this idea."
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? [NC:1472] 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."
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.]
The Institute of Medicine's recommended rate of weight gain per week during the second and third trimesters for pregnant women whose body mass index (BMI) is greater than 30 is_____pounds. a) 0.5 b) 0.6 c) 0.7 d) 0.8
a) 0.5
A general rule for appropriate portion sizes for toddlers and preschool children is to offer [NC:1315] a) 1 Tbsp of each food per meal for each year of the child's age. b) ¼ to ½ cup of each of three foods per meal. c) to need only breast milk or iron-fortified formula for the first 6 months of age. d) the same portions as adults.
a) 1 Tbsp of each food per meal for each year of the child's age. [Toddlers and preschool children should be given 1 Tbsp of each food for each year of age at meals.]
Guidelines to treat disorders of lipid metabolism in patients with diabetes include: [NC:1394] a) 25-35% of total energy from fat; less than 7% of total energy from saturated and trans fat. b) less than 25% of total energy from fat; less than 10% of total energy from saturated and trans fat. c) less than 15% of total energy from all fat. d) less than 200 mg of cholesterol per day; greater than 10% of total energy from saturated and trans fat.
a) 25-35% of total energy from fat; less than 7% of total energy from saturated and trans fat. [Guidelines include a recommendation that 25% to 35% of total energy comes from fat with less than 7% of total energy coming from saturated and trans fats.]
Dietetics professionals can expect more than one in _____ of their clients to have a disability that will require special accommodations. [NC:1456] a) 5 b) 15 c) 25 d) 50
a) 5 [Current statistics demonstrate that 50% of clients may have a disability.]
Older adults are more vulnerable to toxicity of vitamin [NC:1306] a) A. b) C. c) D. d) K.
a) A. [Plasma levels and liver stores of vitamin A increase with age, along with decreased clearance from the blood, making older adults more susceptible to toxicity. Vitamin D, on the other hand, declines with age. Vitamin C is water soluble and thus clearance is easier. Vitamin K levels usually can be controlled via medication. ]
A 58-year-old postmenopausal female client presents to an ambulatory clinic with the following physical exam components: Blood pressure: 110/62; heart rate 78; BMI: 30; blood work: Fasting blood glucose: 86 mg/dl; total cholesterol: 182 mg/dl; LDL: 98 mg/dl; HDL 50 mg/dl; triglycerides (TG): 132 mg/dl. Social history: Married, + smoking half-pack per day X 30 years, negative for drinking alcohol, reports she works a desk job and does little activity during the week and has no structured exercise program. Family history: + cancer in mother, + CVD in father at age 72 years. Which risk factors are modifiable? [NC:1485] a) BMI, smoking, and inactivity b) BMI, family history of CVD, fasting blood glucose c) HDL, TG, and fasting blood glucose d) smoking, TG, and inactivity
a) BMI, smoking, and inactivity
Which of the following growth charts is currently recommended by the Centers for Disease Control and Prevention to assess weight in relation to stature in children ages 2 to 20 years? [NC:1344] a) BMI-for-age b) Length-for-age c) Weight-for-age d) Stature-for-age
a) BMI-for-age [For children, body mass index (BMI) is age and sex specific and nutritional status is identified based on percentiles. For adults, BMI is neither age nor sex specific. BMI-for-age is the most accurate and best measure to assess weight in children.]
Women with gestational diabetes typically require less carbohydrates at which meal, compared to the others? [NC:1403] a) Breakfast (morning) b) Lunch (afternoon) c) Dinner (evening) d) Bedtime snack
a) Breakfast (morning)
Which is a functional food and has been labeled to have a qualified health claim for essential and gestational hypertension? [NC:1405] a) Calcium supplement b) Green tea c) Selenium supplement d) Dried tomatoes
a) Calcium supplement [According to the FDA, the claim that calcium supplements influence hypertension, pregnancy-induced hypertension, and preeclampsia meets the general requirements for health claims in 21 CFR 101.14, except for the requirement that the evidence for the claim meets the significant scientific agreement standard and that it be made in accordance with an authorizing regulation (21 CFR 101.14(c)).]
If the community nutritionist needed information about residents who are at least 65 years old, the best source of existing information would be the: a) Department of Health and Human Services. b) Department of Agriculture. c) Department of Education. d) Centers for Disease Control and Prevention
a) Department of Health and Human Services.
Which of the following foods must a child with phenylketonuria avoid? [NC:1302] a) Egg b) Banana c) Rice d) French fries
a) Egg
Which of the following situations best describes why an older adult may become dehydrated? a) Fear of incontinence b) Living alone c) Low income d) Poor intake of fruit
a) Fear of incontinence
When considering cow's milk versus human breast milk, which of the following is true? a) Human milk contains less protein. b) Human milk provides more calcium. c) Cow's milk provides 50% of the calories. d) Cow's milk contains a lower proportion of casein compared to whey protein.
a) Human milk contains less protein.
A 73 years-old woman with chronic heart failure and symptomatic edema and who is on enteral feeding, is treated with thiazide medication. What would you expect her labs to reveal as a result of this medication and its delivery method? a) Hypokalemia b) Hypernatremia c) Hypocalcemia d) Hypoglycemia
a) Hypokalemia (Thiazide is a diuretic that pulls potassium from the blood. Hypokalemia should be expected in the laboratory results)
For Chinese Americans, challenges to dietary compliance typically include which of the following? [NC:1453] a) Inability to control portion sizes b) Reliance on non-nutritive herbs for flavor and color c) Size of portions is dictated by status in the family and community d) Frequent fasting in association with religious holidays
a) Inability to control portion sizes [Chinese Americans do not fast frequently, use many non-nutritive herbs or associate portions with status; however, portion sizes may increase as they become more acculturated.]
Which of the following statements is accurate concerning fruit juice? [NC:1318] a) Intake of juice should be limited to 4-6 oz per day for children ages 1 to 6 years. b) Juice may be introduced at 4 months of age. c) Juice should be given in the bedtime bottle to help infants sleep all night. d) It is safe to give young children unpasteurized juice.
a) Intake of juice should be limited to 4-6 oz per day for children ages 1 to 6 years. [ Juice should not be introduced until 6 months of age, and bedtime bottle feeding and unpasteurized juice in young children are unsafe health practices.]
Which of the following foods should a pregnant woman avoid? [NC:1338] a) King mackerel b) Tuna c) Cottage cheese d) Mozzarella cheese
a) King mackerel [ Because of the mercury content of mackerel, pregnant women should avoid consuming it.]
After completing this step in the Nutrition Care Process, the dietetics professional can decide whether or not a nutrition diagnosis/problem exists. [NC:1416] a) Nutrition Assessment b) Nutrition Diagnosis c) Nutrition Intervention d) Nutrition Monitoring and Evaluation
a) Nutrition Assessment
Which of the steps in the Nutrition Care Process is a systematic method for obtaining, verifying, and interpreting data needed to identify nutrition-related problems? [NC:1413] a) Nutrition Assessment b) Nutrition Diagnosis c) Nutrition Intervention d) Nutrition Monitoring and Evaluation
a) Nutrition Assessment
During which step in the Nutrition Care Process is it important to continually reevaluate the patient's/client's status compared to specified criteria? [NC:1425] a) Nutrition Assessment b) Nutrition Diagnosis c) Nutrition Intervention d) Nutrition Monitoring and Evaluation
a) Nutrition Assessment [In order to perform an assessment, the patient's data must be compared to a standard. For example, if a practitioner is evaluating a patient's BMI, comparing that number to the standard indicates if that person is in the normal range or obese. The only other step that involves comparison is monitoring and evaluation, but that compares data to the patient's baseline based on goals set.]
In the Nutrition Care Process, what should determine the dietetics practitioner's selection of a Nutrition Intervention? a) Nutrition diagnosis and etiology b) Time and other available resources c) Client's history of compliance d) Practitioner's level of education and experience
a) Nutrition diagnosis and etiology
In the Nutrition Care Process, what should determine the dietetics practitioner's selection of a Nutrition Intervention? [NC:1435] a) Nutrition diagnosis and etiology b) Time and other available resources c) Client's history of compliance d) Practitioner's level of education and experience
a) Nutrition diagnosis and etiology
When evaluating print and audiovisual patient education material for understandability and "actionability," which of the following is the BEST tool? [NC:1734] a) PEMAT (Patient Education Materials Assessment Tool) b) REALM (Rapid Estimate of Adult Literacy in Medicine) c) SMOG d) Ask Me 3™
a) PEMAT (Patient Education Materials Assessment Tool)
You are developing a heart disease prevention program for a worksite and need to locate several nutrition research articles. The best database to use is: [NC:1349] a) PubMed b) Merck Index Online c) Scopus d) The Cochrane Library
a) PubMed
After having defined the nutritional problem, which of the following is the correct sequence of steps a community nutritionist should follow in assessing the needs of the community? [FULL:1364] 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.
a) Set the parameters of the assessment, collect data, analyze and interpret the data, share the findings, and set priorities.
Which of the following foods is most appropriate for a level 2 dysphagia, mechanically altered diet? [NC:1389] a) Soft pancakes with extra syrup b) Pineapple c) Licorice candy d) Sausage
a) Soft pancakes with extra syrup
Which of the following nutrients should a pregnant woman avoid excessive intake of? [NC:1290] a) Vitamin A b) Vitamin B6 c) Folic acid d) Iron
a) Vitamin A [ Vitamin B-6 is water soluble, and folic acid and iron should be increased during pregnancy. A pregnant woman should avoid excessive intake of vitamin A.]
Which set of nutrients and/or food components are associated with the formation of cataracts in older adults? [NC:1335] a) Vitamin C, vitamin E, carotenoids b) Thiamin, niacin, riboflavin c) Vitamin C, vitamin E, phytosterols d) Calcium, zinc, magnesium
a) Vitamin C, vitamin E, carotenoids [Carotenoids are high in oxidants and oxidative stress can cause cataracts.]
Providing advice and information can be a component of a successful patient interaction. Under what circumstances is it appropriate to provide advice or information? [NC:1473] a) When you asked for permission from the client or if the client requests it b) When you have limited time in your nutrition session c) When you have a talkative client and you need to direct the focus of the interview d) After you've established rapport and the client is ready to set goals
a) When you asked for permission from the client or if the client requests it
When reviewing 2 years of serial data on a Centers for Disease Control and Prevention growth chart, a pediatric patient is identified to be at risk on nutritional screening when experiencing a [NC:1311] a) change in rate of growth. b) continuation on his or her line of growth. c) growth spurt. d) plateau in growth.
a) change in rate of growth. [Look for change in growth pattern over time to identify potential risk; expect growth spurts and plateaus.]
The first step toward attaining cultural competence is for the dietetics professional to _____. [NC:1448] a) examine his/her own cultural background b) study the relevant cultural norms, values, and practicalities of the daily lives of clients c) identify cultural variations in family relationships d) note culturally-specific health beliefs and practices
a) examine his/her own cultural background [According to this book, dietetics practitioners must first examine themselves before understanding others.]
A community nutritionist can best elicit opinions as to why a particular nutrition program is not working by [NC:1357] a) forming a focus group. b) examining the results of the pre- and post-tests. c) sharing the problem with similar agencies. d) redefining the target population.
a) forming a focus group. [Forming a focus group would be the preferred method for eliciting opinions from members of a target group as to what are their perceived needs and barriers, or even why certain programs aren't working.]
Centers for Disease Control and Prevention growth charts are appropriate for [NC:1320] a) healthy infants. b) children with cerebral palsy. c) children with Down syndrome. d) premature infants weighing less than 1500 g at birth.
a) healthy infants.
The best way to address the mortality rate associated with low-birthweight (LBW) and preterm infants is by [NC:1294] a) improving the birth weight 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.
a) improving the birth weight 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]
According to the Nutrition Care Process, if a client takes self-prescribed therapeutic doses of Vitamin C, this information should be recorded in the _____ section of the Nutrition Diagnosis. a) intake b) clinical c) behavioral-environmental d) nutrition knowledge
a) intake
When preparing a PES statement in situations where there are diagnoses from multiple domains, the dietetics professional should give preference to the diagnosis related to: [NC:1432] a) intake. b) physical conditions. c) knowledge. d) food safety.
a) intake. [Intake is the only area of concern at this point in the process so it is the priority.]
Public health policy is generally created by [NC:1358] a) legislators. b) judges and magistrates. c) political action committees. d) the President and his cabinet.
a) legislators.
A group of dietitians meets with a member of the legislature to encourage her support of an important nutrition issue. This activity is termed: [NC:1351] a) lobbying. b) advocacy. c) sponsorship. d) petitioning.
a) lobbying. [Although all of these activities are part of the political process, the action described reflects lobbying. Advocacy and lobbying goals are similar but the process is different because lobbying involves influencing legislators.]
Successful family-based group intervention programs that target reducing overweight in school-age children include: [NC:1441] a) parent training, dietary counseling/nutrition education/physical activity counseling, and behavioral counseling. b) parent training, individual psychotherapy, dietary counseling/nutrition education. c) dietary counseling/nutrition education, physical activity counseling, behavioral counseling. d) low calorie diet plan, parent training.
a) parent training, dietary counseling/nutrition education/physical activity counseling, and behavioral counseling.
Refeeding syndrome is characterized by low serum concentrations of: [NC:1387] a) phosphorus, potassium, magnesium. b) sodium, phosphorus, magnesium. c) sodium, potassium, phosphorus. d) potassium, magnesium, sodium.
a) phosphorus, potassium, magnesium.
When completing a physical assessment, inadequate hydration may present as: [NC:1381] a) poor skin turgor. b) scaly appearance of skin. c) dull and thin hair. d) angular stomatitis.
a) poor skin turgor. [Physical findings related to inadequate hydration include a drop in systolic pressure upon standing, sternal skin turgor, and tongue dryness.]
Inadequate weight gain and a low birth weight infant are concerns among: [FULL:1337] a) pregnant adolescents. b) pregnant women over the age of 35. c) overweight women who become pregnant. d) women with a history of gestational diabetes.
a) pregnant adolescents.
A study that looks back in time to reconstruct exposures and the resulting health outcomes for a group of people free of the disease or condition being studied is termed a: [NC:1375] a) retrospective cohort study. b) correlational study. c) prospective cohort study. d) prevalence study.
a) retrospective cohort study. [A retrospective cohort study looks back; the cohort is the group of people studied to see who develops the characteristics of interest and who do not]
The following micronutrients should be supplemented in a patient with history of alcoholism: a) thiamin and folic acid. b) folic acid and magnesium. c) calcium and thiamin. d) calcium and magnesium.
a) thiamin and folic acid. ["Thiamine deficiency is common in alcoholics because thiamine absorption from food decreases, and thiamine excretion from the body increases. Alcoholism can cause folic acid deficiency by interfering with the absorption of this nutrient and by causing unhealthy eating habits.]
Using the Hamwi formula, what is the ideal body weight for a female who is 70 inches tall and has a small body frame? [NC:1384] a) 120 pounds b) 135 pounds c) 150 pounds d) 165 pounds
b) 135 pounds
The recommended weight gain during pregnancy for a woman with a BMI between 19.8 and 26 is: [NC:1332] a) 15 to 20 pounds. b) 25 to 35 pounds. c) 28 to 40 pounds. d) 35 to 45 pounds.
b) 25 to 35 pounds.
An isotonic enteral formula would have an osmolality of: [NC:1383] a) 0 mOsm/kg. b) 375 mOsm/kg. c) 550 mOsm/kg. d) 700 mOsm/kg.
b) 375 mOsm/kg. [The osmolality of an isotonic solution is approximately 300 mOsm/L.]
All breastfed infants should receive how many IUs of vitamin D per day beginning within the first 2 months of life? a) 200 b) 400 c) 600 d) 800
b) 400
A patient in residential care receives a parenteral formula of D40W of 500 ml in one day. The number of kilocalories delivered is [NC:1492] a) 560 kcal b) 680 kcal c) 800 kcal d) 920 kcal
b) 680 kcal [The kilocalories delivered by dextrose in solution is 3.4 kcal/g—not the typical 4 kcal/g—so the correct answer is 680 kcal. In 1 L of D40W, there is 400 g dextrose, but the patient is only receiving 500 ml; thus, 200 g dextrose x 3.4 kcal/g = 680 kcal.]
_____ have the highest prevalence rates of diabetes of all the racial and ethnic groups in the United States. [NC:1455] a) Chinese Americans b) American Indians and Alaska Natives c) Jews d) Muslims
b) American Indians and Alaska Natives
The Emergency Food Assistance Program and The Disaster Feeding Program are two examples of Food Distribution Programs. Which of the following statements best describes the similarities of the two programs? [NC:1348] a) Both programs serve children and adolescents and provide commodity foods to local food distribution and service agencies. b) Both programs serve low-income populations and provide commodity foods to local food distribution and service agencies. c) Both programs serve low-income populations and supplemental food supplies are either distributed to individual households or as meals served in congregate dining centers. d) Both programs serve children and adolescents and food supplies are either distributed to individual households or as meals served in congregate dining centers.
b) Both programs serve low-income populations and provide commodity foods to local food distribution and service agencies. [Both of these programs serve children and adolescents and provide commodity foods that serve meals. The program does not distribute to individual households, however.]
Which of the following eating pattern changes does research show most positively contributes to a decrease in energy consumption among children? [NC:1322] a) Participating in family-style meals at home b) Children serving themselves on individual plates at mealtimes c) Parents or caregivers serving children on individual plates d) Providing scheduled meals and snacks in the home
b) Children serving themselves on individual plates at mealtimes [Children are good predictors of their own satiety. More food on the plate encourages overeating.]
The Food and Drug Administration (FDA) provides a strict definition for functional foods. [NC:1404] a) TRUE b) FALSE
b) FALSE [Currently no legal definition exists for functional foods. The US Food and Drug Administration (FDA) regulates claims that manufacturers make about functional foods' nutrient content and effects on disease, health, or body function.]
The largest hunger-relief organization in the United States is: [NC:1354] a) UNICEF. b) Feeding America. c) SHARE. d) The Hunger Project.
b) Feeding America.
Which of the following objectives is the best example of a statement that contains the components expected to be incorporated in all objectives? [FULL:1169] a) Students enrolled in basic nutrition will score passing grades on all class quizzes this semester if they study prior to taking each quiz. b) Given the appropriate recipe, the cook will know how to prepare the quantity of beef stroganoff needed to serve 100 people. c) Individuals with diabetes will like the foods that they sample in their class for new diabetics. d) After watching the video, the tray line workers will portion foods carefully.
b) Given the appropriate recipe, the cook will know how to prepare the quantity of beef stroganoff needed to serve 100 people. [Objectives need to be specific, measurable, attainable, relevant, and time bound. ]
Which of the following has been listed as an essential element in the provision of culturally competent community nutrition programming? [FULL:1138] a) Standardizing service delivery on the basis of an understanding of cultural diversity b) Having institutionalized cultural knowledge c) Minimizing the unplanned interactions of people from different cultures d) Having the capacity to avoid self-assessing the cultural diversity of others
b) Having institutionalized cultural knowledge [Infusing cultural competence at every level includes providing competent community nutrition programs and involves having institutionalized cultural knowledge. Standardizing delivery of service, avoiding self-assessment, and minimizing interactions may be exclusive to some groups and do not contribute to being culturally competent. These are more likely to overlook some cultural differences that may exist in a diverse community population.]
The DASH diet plan has been shown to be beneficial for which medical condition? [NC:1397] a) Diabetes b) Hypertension c) Heart failure d) Chronic Obstructive Pulmonary Disease (COPD)
b) Hypertension
Regarding food-drug interactions, which food-drug combination requires client counseling? [NC:1465] a) Warfarin and vitamin D-containing foods b) MAO inhibitors and tyramine-containing foods c) Prednisone and grapefruit juice d) Sibutramine and vitamin C-containing foods
b) MAO inhibitors and tyramine-containing foods [There are no known interactions between warfarin and vitamin D foods, and prednisone and sibutramin do not interact with vitamin C foods or juices.]
Which classic vitamin deficiency is known for the four Ds: dermatitis, dementia, diarrhea, and death? [NC:1726] a) Thiamine b) Niacin c) Biotin d) Folic acid
b) Niacin [Dermatitis, dementia, diarrhea, and death are the typical symptoms of pellagra, a disease caused by niacin deficiency.]
Which of the following viruses is the most common cause of sporadic cases and outbreaks of foodborne illness? [FULL:1516] a) Hepatitis A b) Norovirus c) Rotovirus d) All of the above
b) Norovirus
What is the first step in the Nutrition Care Process? [NC:1392] a) Nutrition screening b) Nutrition assessment c) Nutrition diagnosis d) Goal setting
b) Nutrition assessment
Which of the following components comprise the core of motivational Interviewing? [NC:1479] 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
b) Partnership, acceptance, compassion, and evocation [In the 3rd edition of the groundbreaking Motivational Interviewing, the authors add compassion to the core of motivational interviewing and elaborate on the concept of what acceptance really is.]
When using the Nutrition Care Process, what does the dietetics professional use to describe alterations in the patient's/client's nutritional status? [NC:1431] a) Cause/Contributing risk factors b) Problem or nutrition diagnosis labels c) Signs/symptoms d) Knowledge, attitudes, and beliefs
b) Problem or nutrition diagnosis labels
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? [NC:1362] 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 impact 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.
b) Promote, across every stage of life, healthy behaviors that positively impact the nutritional status of residents.
Which of the following reflects long-term folate status? [NC:1727] a) Serum folate b) Red blood cell folate c) Homocysteine concentration in the blood d) Serum methylmalonic acid
b) Red blood cell folate [Red blood cells (RBC) collect folate during formation. Because red blood cells live for 2 to 3 months and contain the folate since formation, RBC assessment provides longer-term folate status]
When using the Nutrition Care Process, what three things do dietetics practitioners do in completing Nutrition Monitoring and Evaluation? [NC:1436] a) Prioritize nutrition diagnoses, consult ADA's Evidence-based Nutrition Practice Guidelines, and determine patient-focused expected outcomes. b) Scrutinize, measure, and assess the changes in nutrition care indicators. c) Confer with patient/client/caregivers, define a nutrition plan and strategies, and determine time and frequency of care. d) Identify resources needed, communicate the nutrition care plan, and implement the plan.
b) Scrutinize, measure, and assess the changes in nutrition care indicators. [ Scrutinizing measuring, and assessing are the key activities during the monitoring and evaluation step.]
Which of the following is a contraindication to enteral nutrition support in an elderly patient? [NC:1328] a) Dysphagia b) Severe acute pancreatitis c) Advanced osteoporosis d) Oncologic disease
b) Severe acute pancreatitis
Because insulin and _____ are secreted in the bloodstream in equal amounts, ____ can be used as a clinical indicator of endogenous insulin production. [NC:1468] a) glucose b) c-peptide c) glutamic acid d) cortisol
b) c-peptide
Tertiary prevention efforts in childhood weight management target: [NC:1438] a) children living within low-income urban or rural populations. b) children who are already overweight. c) children who typically live in areas classified as "food deserts". d) Children who participate in childcare environments or after-school programs.
b) children who are already overweight.
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
b) define the management system.
Initially, a dietetics professional undertaking Nutrition Diagnosis as part of the Nutrition Care Process should identify and _____ a specific nutrition problem that he or she is responsible for treating independently. [NC:1418] a) manage b) label c) measure d) coordinate
b) label
Vision problems in older adults may be due to dietary factors such as a/an [NC:1308] a) excess intake of sodium. b) low intake of antioxidant nutrients. c) excess intake of fat and cholesterol. d) low intake of B vitamins.
b) low intake of antioxidant nutrients. [Low intake of antioxidants can lead to vision problems later in life, as antioxidants repair cell damage.]
The 2007 Expert Committee Recommendations for the Prevention, Assessment, Treatment, and Recommendations for Pediatric Childhood and Adolescent Obesity defines BMI greater than the 95th percentile as: [NC:1408] a) at risk for overweight. b) obese. c) overweight d) severe childhood obesity
b) obese. [Healthy weight is defined as the 5th percentile to less than the 85th percentile. Overweight encompasses the 85th to less than the 95th percentile. Obese is defined as equal to or greater than the 95th percentile.]
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 [NC:1304] 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.
b) offer her a high-calorie bedtime snack. [ 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. ]
Overeating and poorer self-regulation of energy intake in preschool-age children is associated with: [NC:1443] a) excessive soft drink consumption. b) parents assuming control of food portions and coercing children to eat. c) family-style meal service. d) excessive food choices as family-style meals.
b) parents assuming control of food portions and coercing children to eat. [Parental control causes children to have less self-regulation, thus causing overeating.]
In the Nutrition Care Process, a PES statement consists of: [NC:1415] a) possibilities, effects, solutions. b) problem, etiology, sign/symptoms. c) people, efforts, satisfaction. d) probabilities, end products, significant information.
b) problem, etiology, sign/symptoms.
One of the primary goals of WIC food supplements is a) increasing income for participating grocery stores. b) reducing or preventing iron deficiency anemia in infants and children. c) providing low-cost lunches to school-age children. d) increasing the number of women who get prenatal care.
b) reducing or preventing iron deficiency anemia in infants and children. [The ultimate goal of WIC is to provide supplemental foods/nutrition education to low-income women, infants, and children up to age 5.]
Consider the following quotation from a patient during a nutrition consult: "I really want to improve my lunch choices by packing my own lunch, but I'm afraid I'll miss the social time with my coworkers." In the setting of motivational interviewing, this is an example of: [NC:1736] a) change talk. b) sustain talk. c) developing discrepancy. d) resistance.
b) sustain talk. [The client's statement is not change talk because it argues for the status quo. Developing discrepancy is a technique employed by the clinician. Motivational interviewing rejects the concept of resistance and understands ambivalence is a natural component of the change process. The client's statement is an example of sustain talk.]
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? [NC:1480] 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."
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.]
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? [NC:1378] a) +16.3 grams b) -16.3 grams c) -2 grams d) +2 grams
c) -2 grams [Nitrogen balance is calculated as follows: Convert protein "in" to nitrogen by dividing by 6.25. (102 g/6.25 = 16.3 g Nitrogen) Nitrogen in (16.3 g) - nitrogen out (14.3 g) - 4 g for insensible loss = (-) 2 gram ]
A patient in residential care is receiving an enteral formula that contains 1.5 kcal/ml at a rate of 75 ml for a 12-hour time frame. The patient will receive: [NC:1491] a) 950 kcal b) 1,050 kcal c) 1,350 kcal d) 1,650 kcal
c) 1,350 kcal [This client would receive a total of 900 ml over the 12-hour time frame x 1.5 kcal/ml = 1,350 kcal]
What daily energy intake should result in a weight loss of 2 pounds per month if one is currently consuming 2,000 kcal per day? [NC:1470] a) 1,500 kcal b) 1,650 kcal c) 1,750 kcal d) 1,850 kcal
c) 1,750 kcal [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.]
How many pounds are recommended for overweight woman gain during her pregnancy? [NC:1289] a) 0 b) 5-10 c) 15-25 d) 28-40
c) 15-25
The most appropriate nutrition prescription for your patient with cirrhosis includes: [NC:1402] a) 0.6 grams protein/kg body weight b) 40-45% fat c) 4-6 smaller meals per day d) 4-6 grams sodium
c) 4-6 smaller meals per day
What are the estimated kilocalorie needs of a 4-month-old breastfed infant girl who weighs 14 pounds? [FULL:1299] a) 509 b) 636 c) 686 d) 724
c) 686 [Energy needs are based on 108 kcal/kg for infants age 6 months and younger. For a 14-pound (6.35 kg) girl, 687 kcal is needed. ]
In the Nutrition Care Process, where should the dietetics professional note the client's BMI? [NC:1424] a) Food/nutrition-related history b) Biochemical data, medical tests and procedures c) Anthropometric measurements d) Nutrition-focused physical findings
c) Anthropometric measurements
While conducting a community needs assessment, after defining the nutritional problem, which of the following is your next step? [NC:1339] a) Identify community groups and their leaders. b) Determine the purpose of the needs assessment. c) Collect information on health and nutrition resources available in the community. d) Search the Census Bureau records to determine the percentage of single-family households in the community with children in the 2- to 5-year-old age range.
c) Collect information on health and nutrition resources available in the community. [After identifying the problem, the next step is setting the parameters of the assessment, which includes determining the purpose. The actions described in the other options would not be performed this early in the process.]
Which of the following is one of the four domains of Nutrition Intervention in the Nutrition Care Process? [NC:1421] a) Client history b) Nutrition-focused physical findings c) Coordination of care d) Food/nutrition-related history
c) Coordination of care
Which of the following population groups of children does research show to be at the highest risk for iron deficiency? [NC:1321] a) School-age children and children ages 3 to 5 years old b) Infants and school-age children c) Infants and adolescents d) Children ages 3 to 5 years old and adolescents
c) Infants and adolescents
Which of the following is a disadvantage of a cohort study? [NC:1376] a) It is difficult to select a suitable comparison group. b) It is difficult if not impossible to validate data. c) It is rarely possible to study the mechanism of a disease. d) Incidence rates among participants cannot be calculated.
c) It is rarely possible to study the mechanism of a disease. [Finding comparable groups (A) is and validating data (B) are both disadvantages of case control studies, and being unable to calculate incidence rates among participants is an advantage of cohort study. The correct answer is C.]
Which would be an appropriate food or beverage item to serve to your patient on postoperative day #1 following gastric bypass surgery? [NC:1401] a) Ginger ale b) Sherbet c) Low-fat chicken broth d) Cranberry juice
c) Low-fat chicken broth
For which two steps in the Nutrition Care Process are the terms combined? [NC:1428] a) Assessment and Intervention b) Monitoring and Diagnosis c) Monitoring and Evaluation d) Diagnosis and Intervention
c) Monitoring and Evaluation
Which of the following food programs is the largest federally funded child nutrition assistance program? [NC:1345] a) Supplemental Nutrition Assistance Program b) Child and Adult Care Food Program c) National School Lunch Programs d) Summer Food Service Program
c) National School Lunch Programs
Which step in the Nutrition Care Process involves the dietetics professional coordinating nutrition care with other health care providers, institutions, or agencies? [NC:1434] a) Nutrition Assessment b) Nutrition Diagnosis c) Nutrition Intervention d) Nutrition Monitoring and Evaluation
c) Nutrition Intervention
Nutrition Care Process, statements in the format of "Nutrition problem label related to ____ as evidenced by ____" are classified as: [FULL:1430] a) intake critiques. b) NCP links. c) PES statements. d) nutrition concerns.
c) PES statements.
Which health education planning model demonstrates that lasting behavior change is voluntary and must include input from the client? [NC:1355] a) PATCH b) The 10-step Planning Model c) PRECEDE-PROCEED d) CDCynergy
c) PRECEDE-PROCEED [Although each of the models listed are planning models, the distinguishing characteristic of the PRECEDE-PROCEED model is that behavior change is voluntary.]
Which food allergy is the leading cause of fatal and near-fatal food allergic reactions in the United States each year? [NC:1410] a) Egg b) Fish c) Peanut d) Wheat
c) Peanut
When talking about program planning for community nutrition, to what would the term management refer? a) Controlling and providing oversight for financial resources b) Utilizing time effectively and efficiently c) Personnel and data systems d) Coordinating and classifying objectives
c) Personnel and data systems [ In this context, the term "management" refers to 2 types of structures needed to implement the program. The personnel structure consists of employees responsible for overseeing the program and determining if it meets its objectives; the structure of the data management system is the manner in which data are recorded or analyzed.]
Which of the following does the Braden Scale measure? [NC:1325] a) Risk factors that may lead to undernutrition b) Medical conditions that affect the ability to feed oneself c) Risk assessment for pressure ulcers d) Appetite stimulants in the patient or client's environment
c) Risk assessment for pressure ulcers
Which of the following fish contains a higher level of methyl mercury and therefore should be avoided during pregnancy? [NC:1483] a) Salmon b) Pollack c) Swordfish d) Tilapia
c) Swordfish
Which of the following social or economic trends is thought to have the most important consequences for future community nutrition practice? [FULL:1363] a) The segment of the US population growing most rapidly is children ages 12 years and younger b) Different generations in the United States having similar values and attitudes about health c) The deteriorating global environmental indicators such as climate change, degradation of topsoil, and increased use of many chemical pollutants. d) The food purchasing practices and preferences in the United States that indicate a desire for an extensive variety of "value-added" pre-prepared foods.
c) The deteriorating global environmental indicators such as climate change, degradation of topsoil, and increased use of many chemical pollutants. [Deteriorating global environmental indictors are projected to affect future community nutrition practice more than any other. The other options are incorrect because the fastest growing segment of the population is those older than 65, there is generational diversity in health-related values and attitudes, and purchasing practices indicate a desire and awareness of locally grown and fresh food.]
What is the intended purpose of Healthy People 2020? [NC:1729] a) To guide the efforts of health professionals who provide care for individuals with chronic diseases. b) To guide the allocation of federal money intended to promote wellness. c) To establish a set of national goals and objectives designed to guide health promotion and disease prevention efforts. d) To establish nationally approved guidelines for improving food selection behaviors among the
c) To establish a set of national goals and objectives designed to guide health promotion and disease prevention efforts.
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
c) Undiagnosed obstructive sleep apnea
Which of the following lists of the side effects of contraceptive injections, such as Depo-Provera, is accurate and complete? [NC:1323] a) Weight loss, decreased blood levels of HDL-cholesterol, and decreased bone density b) Weight gain and increased blood levels of LDL-cholesterol and insulin c) Weight gain, increased blood levels of LDL-cholesterol and insulin, decreased blood levels of HDL-cholesterol, and decreased bone density d) Increased blood levels of LDL-cholesterol and insulin, weight loss, and decreased blood levels of HDL-cholesterol
c) Weight gain, increased blood levels of LDL-cholesterol and insulin, decreased blood levels of HDL-cholesterol, and decreased bone density [Contraceptives may cause weight gain, increased LDL cholesterol, decreased HDL cholesterol, and decreased bone density.]
Which of the following is the BEST example of an "open-ended" question? [NC:1471] 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?
c) What are some of the challenges you've faced in your weight loss journey?
Which of the following nutrients is essential for growth and sexual maturation in adolescents? [NC:1305] a) Calcium b) Selenium c) Zinc d) Iron
c) Zinc [Zinc deficiency is the hallmark sign of growth retardation and sexual immaturity.]
Interpretation of BMI for children is [NC:1313] a) age specific. b) gender specific. c) age and gender specific. d) the same as adults.
c) age and gender specific.
A deficiency of vitamin B12 in older adults is most likely due to [NC:1307] a) diverticulosis. b) fat malabsorption. c) atrophic gastritis. d) gallbladder disease.
c) atrophic gastritis.
Calculating protein needs at 1.5 g/kg body weight in an elderly patient with Stage III pressure ulcer and impaired renal function may cause [NC:1327] a) hyperglycemia. b) dyslipidemia. c) dehydration. d) increased wound healing.
c) dehydration.
The Campinha-Bacote Model of Cultural Competence includes the interdependent constructs of cultural awareness, cultural knowledge, cultural skill, cultural desire, and cultural _____. [NC:1446] a) understanding b) communication c) encounter d) integration
c) encounter [Encounter is the additional construct in the Campinha-Bacote Model.]
In the ETHNIC model of culturally competent care, the "E" stands for _____. a) education b) empathy c) explanation d) expectations
c) explanation
All of the following statements are true regarding cardiovascular disease (CVD) and women, EXCEPT [NC:1484] a) heart disease is the number one killer of women. b) the highest rates of cardiovascular morbidity and mortality occur in black women. c) for primary prevention, all women older than 40 should take a baby aspirin daily. d) specific nutrition recommendations for women include quantitative limits on the amount of sugar consumed per week.
c) for primary prevention, all women older than 40 should take a baby aspirin daily. [There is no benefit for all women to take aspirin; in fact, in women younger than 65, there may be harm in anti-platelet therapy. This is not true for men, however.]
In order to absorb folate consumed from green, leafy vegetables, _________________. [NC:1724] a) phosphate groups must be removed by the action of alkaline phosphatase b) glutamate must be transaminated to form alpha-ketoglutarate c) glutamic acid molecules must be removed d) glutamic acid molecules must be added
c) glutamic acid molecules must be removed
A child who plots consistently at the 5th percentile on the weight-for-length/stature Centers for Disease Control and Prevention growth chart [NC:1310] a) demonstrates a negative pattern of growth. b) demonstrates failure to thrive. c) has a thin body habitus. d) reflects a change in growth velocity.
c) has a thin body habitus.
One part of the brain that is critical to regulating hunger and satiety is the _____. [FULL:1228] a) cerebral cortex b) cerebellum c) hypothalamus d) medulla
c) hypothalamus [The hypothalamus is the area of the brain that produces hormones that control body temperature, hunger, moods, sleep, thirst, and sex drive]
4) The dominant force in how a patient views health care is likely to be ______. a) social hierarchy b) race c) individual experience d) ethnicity
c) individual experience
The Academy of Nutrition and Dietetics defines tertiary prevention related to pediatric overweight interventions as: [NC:1439] a) overweight prevention efforts that include identifying and intervention efforts targeting children who are at risk for overweight. b) education and prevention programs targeting children and adolescents before they are overweight. c) interventions targeting overweight children designed to slow down or reverse the increase in BMI.
c) interventions targeting overweight children designed to slow down or reverse the increase in BMI.
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 [NC:1368] 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.
c) measures accurately what it is intended to measure.
In a Community Needs Assessment report, the statement; "...the southeast region of Essex County, including the adjoining municipalities of Kardon, Greenwalt, and Addison...," is an example of: [FULL:1341] a) the target population. b) the lead organizations. c) the definition of the community. d) the stakeholders.
c) the definition of the community. [The statement defines the community, in this case a geographical region]
A typical feeding/eating pattern for infants is [NC:1314] a) to need apple juice at age 4 months to regulate stooling. b) to need cereal at bedtime after age 3 months to be able to sleep through the night. c) to need only breast milk or iron-fortified formula for the first 6 months of age. d) hard to predict since their interest in eating is so variable.
c) to need only breast milk or iron-fortified formula for the first 6 months of age.
When performing a nutritional assessment on a child, head circumference should be measured up to the age of: [NC:1331] a) 12 months. b) 18 months. c) 24 months. d) 36 months.
d) 36 months.
How many times might a parent need to expose a child to a food before acceptance of that food occurs? [NC:1295] a) 1 to 2 b) 3 to 5 c) 6 to 7 d) 8 to 10
d) 8 to 10
According to the CDC growth chart, in what percentile is a 1-year-old boy measuring 82 cm? [NC:1291] a) <5% b) 25% c) 75% d) >95%
d) >95%
Which of the following individuals would be LEAST likely to be at risk for vitamin B12 deficiency? [NC:1735] a) Vegan b) A woman with polycystic ovarian syndrome taking metformin therapy c) An elderly individual on a proton pump inhibitor d) A man on aspirin therapy
d) A man on aspirin therapy
The local WIC nutritionist has collected considerable data about pregnant women and infants in her community. Which of the following would be correctly categorized as qualitative data? [FULL:1365] a) The number of live births per 1000 deliveries b) The mean age of women with documented cases of gestational diabetes c) A graph of the gestational ages and birth weights of all infants born alive d) A tally that notes the reasons that pregnant women report for omitting dairy products from their diets
d) A tally that notes the reasons that pregnant women report for omitting dairy products from their diets
Which of the following disease states may require a fluid restriction? [NC:1396] a) Liver disease with ascites b) Chronic renal failure c) Congestive heart failure d) All of the above
d) All of the above
Your patient is a newly diagnosed type 2 diabetic who tells you she is relieved to only have a touch of sugar and will avoid dessert when she goes out for a big steak after leaving the hospital. Which lab results will you review with your patient? [NC:1395] a) Glucose and hemoglobin A1c b) Triglycerides c) Cholesterol panel, including HDL, LDL, VLDL d) All of the above.
d) All of the above. [All of the listed blood tests reveal important information about the diabetic's health.]
Which of the following statements best describes the similarities between the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) and the Supplemental Nutrition Assistance Program (SNAP)? [NC:1346] a) Both programs are regulated by the USDA, provide referrals to health care and other social services providers, and are entitlement programs. b) Both programs are regulated by the USDA, contain income eligibility guidelines, and are entitlement programs. c) Both programs are regulated by the USDA, contain income eligibility guidelines, are entitlement programs, and recipients must have a documented medical or nutritional risk. d) Both programs are regulated by the USDA and contain income eligibility guidelines.
d) Both programs are regulated by the USDA and contain income eligibility guidelines. [Both programs are regulated by the USDA and they both impose eligibility guidelines, but WIC is not an entitlement program, and SNAP eligibility isn't based on nutritional risk. ]
Which of the following foods would you suggest limiting if your patient has diarrhea? [NC:1380] a) Oatmeal b) Potatoes c) Yogurt d) Coffee
d) Coffee
In the Nutrition Care Process, estimated energy needs, estimated fiber needs, and recommended body weight/body mass index/growth are examples of: [NC:1426] a) Anthropometric measurements b) Food/nutrition-related history c) Physical activity and function measurements d) Comparative standards
d) Comparative standards [Comparative standards are set by research experts in the field and based on science.]
Which of the following examples of a snack provided at a child care center would meet reimbursement guidelines and comply with USDA regulations for Child and Adult Care Food Program meals? [NC:1347] a) Carrot sticks and 100% fruit juice b) Oatmeal, corn muffins, and water c) Apple slices and orange wedges d) Cottage cheese, mandarin oranges, and water
d) Cottage cheese, mandarin oranges, and water
The following blood test result puts a patient at greatest risk for developing heart disease: [NC:1487] a) elevated cholesterol. b) low triglycerides. c) elevated low-density lipoprotein (LDL)-buoyant particles of cholesterol d) Elevated LDL-dense particles of cholesterol
d) Elevated LDL-dense particles of cholesterol [Elevated LDL-dense particles of cholesterol are most likely to lead to inflammatory heart disease and plaque formation. ]
Patients with acute renal failure have higher needs of which nutrient compared to a similar patient with optimal renal function? [NC:1386] a) Protein b) Potassium c) Fluid d) Energy
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.]
An elevated homocysteine level could be an indicator of which vitamin deficiency? a) Vitamin A b) Vitamin C c) Biotin d) Folate
d) Folate [A role of folate in the body is to break down homocysteine. Without adequate levels of folate, homocysteine accumulates.]
Which of the following glucose-lowering medications would require patient education about treatment of hypoglycemia? [NC:1482] a) Metformin (Glucophage) b) Sitagliptin (Januvia) c) Pioglitazone (Actos) d) Glimepiride (Amaryl)
d) Glimepiride (Amaryl)
Which of the following glucose-lowering medications would require patient education about treatment of hypoglycemia? [NC:1482] a) Metformin (Glucophage) b) Sitagliptin (Januvia) c) Pioglitazone (Actos) d) Glimepiride (Amaryl)
d) Glimepiride (Amaryl) [Among the options, glimepiride (Amaryl) is the only secretagogue, which means the mechanism of action is stimulating the pancreas to make insulin, thereby causing the possibility of low blood glucose.]
Currently, which of the following nutrients is determined to be the most deficient among children and adolescents in the United States? [NC:1340] a) Calcium b) Fiber c) Vitamin A d) Iron
d) Iron [Of all nutrients listed, iron has shown to be the most deficient in US children and adolescents.]
What organization is working to establish a standard definition of what makes an organization or institution culturally competent? [FULL:1460] a) The American Dietetic Association b) US Dept. of Education c) US Dept. of Health and Human Services d) Joint Commission on Accreditation of Healthcare Organizations
d) Joint Commission on Accreditation of Healthcare Organizations
What component of serum cholesterol do plant stanols/sterols lower? [NC:1476] a) Total cholesterol b) High-density lipoprotein (HDL) c) Triglycerides d) Low-density lipoprotein (LDL)
d) Low-density lipoprotein (LDL)
Which step in the Nutrition Care Process has as its purpose to quantify progress made by the patient/client in meeting nutrition care goals? a) Nutrition Assessment b) Nutrition Diagnosis c) Nutrition Intervention d) Nutrition Monitoring and Evaluation
d) Nutrition Monitoring and Evaluation
Which of the following adolescents is at greatest nutrition risk? [NC:1303] a) One who watches more than 2 hours of television per day. b) One who consumes more than three servings of fruit per day. c) One who engages in vigorous physical activity five or more times per week. d) One who consumes fast food three or more times per week.
d) One who consumes fast food three or more times per week.
What is the best way to determine the type of nutrition program that will attract baby boomers who use a city recreation center? [NC:1353] a) Give a nutrition knowledge pre-test and post-test to baby boomers who use the facility. b) Determine what nutrition programs are successful with baby boomers in cities of similar size. c) Offer several screening programs and see which one draws the biggest crowd of baby boomers. d) Perform a needs assessment of baby boomers who use the facility.
d) Perform a needs assessment of baby boomers who use the facility. [The best way to make an accurate and focused determination is to perform a needs assessment of the target population.]
Which of the following is an appropriate method to prevent aspiration during enteral feeding? [NC:1388] a) Use a fiber-containing formula b) Elevate the head of the bed >15 degrees c) Place a percutaneous gastrostomy d) Place a nasojejunal tube
d) Place a nasojejunal tube [ Compared with gastric tube feeding, duodenojejunal (small intestine) tube feeding may be associated with a lower incidence of aspiration. This is especially true if the patient has significantly slowed gastric motility. Some clinicians believe that enteral nutrition delivered to the small bowel is a better choice than feedings delivered to the stomach and will place a nasojejunal feeding tube.]
Which of the following is true of Mexican American culture? [NC:1450] a) In general, it is better to ask questions about work than about family. b) It is generally preferable to address elders and leaders informally. c) Nodding affirmatively usually means agreement. d) Polite, agreeable, and respectful interactions are the cornerstone of the culture.
d) Polite, agreeable, and respectful interactions are the cornerstone of the culture. [Mexican-American culture typically is marked by polite and respectful interactions]
Which one of the following foods should be avoided in treatment of gout? [NC:1738] a) Low-fat yogurt b) Rye bread c) Banana d) Regular soft drinks
d) Regular soft drinks [Management of Gout is that patients should avoid high-fructose corn syrup, which is found in regular soft drinks. Low-fat dairy products, fruits and vegetables, and whole grains are recommended. ]
Which is the best tool for the community nutritionist to use to learn what locally grown foods residents consume most frequently? [NC:1367] a) Health Risk Appraisal b) Screening c) Focus Group d) Survey
d) Survey [All are methods for obtaining data. A health risk appraisal characterizes a population's general health, screening represents a preventive health activity, and, although a focus group would be plausible, it is a very expensive way of obtaining both qualitative and quantitative information. Surveys are the least expensive systematic study of a cross-section of individuals.]
Which category of oral hyperglycemic medication would NOT be appropriate for a client with congestive heart failure? [NC:1469] a) Sulfonylureas b) Biguanides c) Meglitinides d) Thiazolidinediones
d) Thiazolidinediones [Thiazolidinediones can worsen congestive heart failure by promoting weight gain/edema.]
When the diet is adequate in protein, the body can synthesize niacin from which amino acid? [NC:1725] a) Phenylalanine b) Valine c) Tyrosine d) Tryptophan
d) Tryptophan [Tryptophan is an amino acid that is converted to niacin in the liver. An estimated 1 mg niacin is made from the ingestion of 60 mg tryptophan.]
What government funding supports the school lunch program? a) Medicaid b) Health and Human Services c) CACFP d) USDA
d) USDA
Which of the following is not a risk determinant of metabolic syndrome? [NC:1406] a) Waist circumference b) Blood pressure c) Triglycerides d) Weight
d) Weight [Metabolic syndrome is a commonly encountered clinical phenotype presenting as concurrent metabolic abnormalities, including central obesity, dysglycemia, dyslipidemia, and hypertension. Weight per se is not a consideration.]
Which one of the following statements is INCORRECT regarding the concept of weight bias? [NC:1737] a) Weight bias is more prevalent among registered dietitians than mental health workers. b) Weight bias is more common than sexual orientation bias. c) Weight bias is comparable to racial discrimination. d) Weight bias does not exist among registered dietitians who often work with obese clients.
d) Weight bias does not exist among registered dietitians who often work with obese clients.
Critical nutrition concerns in children ages 2-11 years of age include: [NC:1444] a) excessive intakes of dietary fat, especially saturated fats. b) decreased intakes of foods that are good sources of calcium, fiber, iron, vitamin E, folate, magnesium and potassium. c) sedentary lifestyles. d) all of the above.
d) all of the above.
Data reviewed for nutrition assessment is also reviewed during the following step: a) monitoring and evaluation. b) nutrition diagnosis. c) goal setting. d) all of the above.
d) all of the above.
Symptoms associated with hypersensitivity to the ingestion of a food may stem from: [NC:1411] a) chemical contaminants. b) microbiological contaminants. c) parasitic contaminants. d) all of the above.
d) all of the above.
The Nutrition Care Process model consists of: [NC:1490] a) the outcomes management systems. b) dietetics Knowledge. c) critical thinking skills. d) all of the above.
d) all of the above.
The Nutrition Care Process model consists of: [NC:1490] a) the outcomes management systems. b) dietetics Knowledge. c) critical thinking skills. d) all of the above.
d) all of the above.
The Academy of Nutrition and Dietetics takes the position that pediatric overweight intervention programs require a combination of which of the following programs: [NC:1437] a) school-based multi-component programs and community-based interventions. b) family-based multi-component programs and environmental interventions. c) community-based interventions and environmental interventions. d) family-based and school-based multi-component programs.
d) family-based and school-based multi-component programs. [The Academy's position is that family-based and multi-component programs are the most effective in reducing obesity. ]
A child's weight is plotted at the 50th percentile on the growth chart. This means that the child's weight is: [NC:1330] a) greater than or equal to that of half the children of the same gender and ethnicity. b) greater than or equal to that of half the children of the same age. c) greater than or equal to that of half the children of the same ethnicity. d) greater than or equal to that of half the children of the same age and gender.
d) greater than or equal to that of half the children of the same age and gender.
The purpose of the nutrition diagnosis step in the Nutrition Care Process is to: [NC:1488] a) identify the medical diagnosis of the client. b) plan interventions to address the nutrition problem. c) determine interventions, goals and expected outcomes. d) identify and label the nutrition problem.
d) identify and label the nutrition problem.
The first step in conducting a community needs assessment is to [NC:1356] 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 nutritional problem of concern.
d) identify the target population and nutritional problem of concern.
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 a(n) ___________ evaluation. [NC:1373] a) efficiency b) process c) structure d) impact
d) impact [only right answer would be an outcome-focused evaluation. The process of determining whether the program's methods and activities resulted in the desired changes in the client or, in other words, the impact.]
In the Nutrition Care Process, it is expected that all Nutrition Diagnoses will fall within one of three domains - clinical, behavioral-environmental, and _____. [NC:1419] a) social b) ethnic/cultural c) anthropometric d) intake
d) intake
Hyperosmolar hyperglycemic state, a rare condition that presents with extremely high blood glucose levels, elevated serum osmolality, extreme dehydration, and low amounts of ketones, usually occurs in [NC:1329] a) preterm infants. b) obese adolescents. c) adults ages 18 to 35 with hypertension. d) persons older than 65 with type 2 diabetes mellitus.
d) persons older than 65 with type 2 diabetes mellitus.
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: [NC:1372] 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.
d) pilot-test the motivational DVD she plans to use.
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: [NC:1372] 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.
d) pilot-test the motivational DVD she plans to use. [Pilot testing the DVD represents formative evaluation as it clearly defines that this is a process of testing elements of a program before it is begun.]
Cultural _____ is the ability to collect culturally relevant information from clients and perform culturally based assessments and interventions. [NC:1449] a) knowledge b) awareness c) desire d) skill
d) skill [Skill is the ability to collect culturally relevant information from clients and perform culturally relevant assessments and interventions.]
Which of the following is a secondary characteristic of culture? [NC:1464] a) occupation b) age c) gender d) socioeconomic status
d) socioeconomic status
The Nutrition Care Process includes: [NC:1427] a) recommended goals. b) required courses of treatment. c) consistent expected outcomes. d) standardized language.
d) standardized language.
When working with disabled adults, it is suggested that the dietetics professional _____. [NC:1457] a) use the children's My Pyramid because it contains pictures b) speak initially to the guardian rather than the client c) limit options presented to prevent confusing the client d) teach rather than test
d) teach rather than test
A diagnosis of hypersensitivity to food requires [NC:1412] a) conducting a food challenge without restricting the suspected food. b) documented atopic dermatitis. c) using an elimination diet for 3 weeks. d) verifying the food that causes an adverse reaction and excluding other causes of adverse reactions.
d) verifying the food that causes an adverse reaction and excluding other causes of adverse reactions. [To confirm a food hypersensitivity diagnosis, the clinician is required to verify that the food allergen alone causes the adverse reaction.]
A family is having difficulty providing food for all its members. The father skips meals occasionally and the mother eats very little to ensure that the children have enough to eat. Using established categories of food security status, this family would be classified as having [NC:1361] a) high food security. b) marginal food insecurity. c) low food security. d) very low food security.
d) very low food security
Consumption of high levels of folate supplements can mask a(n) _____________ deficiency. a) niacin b) vitamin B6 c) iron d) vitamin B12
d) vitamin B12
The group of people that best exemplifies the term "target population" are those [NC:1350] a) with similar nutrition and fitness goals. b) with common characteristics or a common bond. c) who will conduct a community needs assessment. d) who are the focus of a community needs assessment.
d) who are the focus of a community needs assessment.
In the Cajun and Creole culture, the traiteur is the one _____. [NC:1452] a) who provides valued health and wellness information b) who is considered the most revered member of the community c) who blesses the food before it is consumed d) who believes he or she possesses a divine gift for healing
d) who believes he or she possesses a divine gift for healing [ Similar to a shaman in other cultures, a traiteur believes he or she possesses an ability to heal.]