Mega CNS Practice Test Questions 1-500

b. deadly (Beerman CH 5, p. 205)

24. Creutzfeldt-Jakob disease is of concern because it is _____. a. common b. deadly c. contagious d. self-limiting

a. Fluoride (Beerman, 12)

32. Though it is not an essential nutrient, consumption of what can increase bone strength? a. Fluoride b. Cobalt c. Chromium d. Molybdenum

a. can make in the amount needed CH 1 Beerman, pg 6

A "nonessential nutrient" is one that the body_____. a. can make in the amount needed b. doesn't need c. cannot use d.stores for later use

d. anion gap. (Gropper CH 12, pg 462)

A clinically useful parameter in establishing metabolic disorders that can alter electrolyte balance is: a. blood urea nitrogen. b. creatinine. c. homeostatic ion regulation. d.anion gap.

c. megaloblastic, macrocytic anemia. (Beerman chapter 10, pg 442)

A folate deficiency can be characterized by: a. macrocytic, hypochromic anemia. b. megaloblastic, microcytic anemia. c. megaloblastic, macrocytic anemia. d.microcytic, hypochromic anemia.

c. less than 140 mg. (Gropper CH 12, pg 463)

A food may be labeled "low sodium" if each serving provides a. less than 5 mg. b. less than 35 mg. c. less than 140 mg. d.less than 240 mg.

c. glycogen phosphorylase (Gropper Chap 9, pg 361)

A good source of vitamin B6 is muscle meats because PLP is predominantly bound to the enzyme _____. a. alanine aminotransferase b. cystathionine synthase c. glycogen phosphorylase d.aspartic aminotransferase

b. increase in fatty acid synthesis (Gropper CH 5, pg. 177)

A high rate of ethanol ingestion causes an _____. a. increase in gluconeogenesis b. increase in fatty acid synthesis c. increase in protein breakdown d.increase in glycogen synthesis

a. ≤55. (Beerman CH 4, pg 134)

A low-glycemic index (GI) food has a GI rating of: a. ≤55. b. ≤60. c. ≤65. d. ≤70.

b. ingest liquids or pureed foods. (CH 27 Krause, p. 523) Patients with gastroparesis often have preserved emptying of liquids, so shifting the diet to a more pureed and liquefied form is often useful. Fiber and fat slow gastric emptying and can therefore worsen symptoms. Small, frequent meals are often helpful.

A recommendation to a patient with gastroparesis who needs to gain weight would be: a. increase the amount of dietary fiber. b. ingest liquids or pureed foods. c. eat more high-fat foods. d. eat meals and avoid snacks.

a. only single (Beerman CH 6, p. 220)

A saturated fatty acid contains _____ carbon-to-carbon bonds. a. only single b. only double c. more single than double d. more double than single

a. Ingested to affect structure or function of the body (CH 12 Krause, pg 194) A dietary supplement will be taken to either affect structure or function of the body or to supplement the diet. Food is consumed for its taste, aroma, or nutritive value. Only drugs are classified as being able to diagnose, cure, mitigate, treat, or prevent disease. Cosmetics are applied to the body for cleansing, beautifying, or altering appearance.

According to the FDA, which of the following descriptions applies to a dietary supplement? a. Ingested to affect structure or function of the body b. Consumed for its taste, aroma, or nutritive value c. Used to diagnose, cure, mitigate, treat, or prevent disease d. Applied to the body for cleansing, beautifying, or altering appearance

d. mind-body therapies. (CH 12 Krause, pg 192) Art and music therapy, along with meditation and prayer, are classified as mind-body therapies by the NCCAM. Manipulative therapies include massage, yoga, and chiropractic medicine. Energy therapies include magnetic therapy and Reiki. Alternative medical systems include traditional Oriental medicine, ayurveda, and homeopathy.

According to the National Center for Complementary and Alternative Medicine, art and music therapy are classified as a. manipulative therapies. b. energy therapies. c. alternative medical systems. d. mind-body therapies.

b. 12 g (Beerman CH 5, p. 188)

According to the RDA, how much more protein would John, who weighs 95 kg, need each day than Bob, who weighs 80 kg? a. 9 g b. 12 g c. 15 g d. 18 g

c. Water (CH 18 Krause, pg 348) Although athletic activity increases the need for almost all nutrients, the one that has the most likelihood of inadequate intake is water. Dehydration that occurs from inadequate replenishment of fluids during physical activity and accompanying heat illness is the second most common noncardiac cause of death among adolescent athletes. Athletes need more carbohydrate to meet energy demands and more protein to prevent muscle loss. Iron intake may be a problem when working with female adolescents.

Adequate intake of which nutrient is of greatest concern when working with adolescent athletes? a. Carbohydrate b. Protein c. Water d. Iron

d. essential (Beerman CH 5, pp. 163-164)

Amino acids that cannot be made by the body are called _____ amino acids. a. conditionally essential b. hydrolyzed c. α-keto d. essential

c. 10 fold Gropper CH 2 page 54

Anaerobic bacteria populate the gut in _____ greater quantities than aerobic bacteria. a. 2 fold b. 5 fold c. 10 fold d.100 fold

c.Ascorbic acid reduces the tochopheroxy radical to the tocopherol form; ascorbic acid is oxidized to semi-dehydroascorbate. (Gropper Chap 9, pg 314, 315)

Ascorbic acid can reduce the oxidized form of vitamin E. Choose the phrase that describes this. a. Ascorbic acid reduces the tocopheroxy radical to the quinone form; ascorbic acid is oxidized to dehydroascorbic acid. b. Ascorbic acid reduces the hydroquinone form to the quinone form; ascorbic acid is reduced to semi-dehydroascorbic acid. c.Ascorbic acid reduces the tochopheroxy radical to the tocopherol form; ascorbic acid is oxidized to semi-dehydroascorbate.

a. macrocytic anemia. (Beerman chapter 10, pg 444)

B12 deficiency is characterized by: a. macrocytic anemia. b. microcytic anemia. c. neural tube defects. d. a and b e.a and c

glycine, taurine Gropper CH 2, page 49

Bile acids are conjugated with amino acids, _____ and _____, to make them more useful in forming micelles.

d.pancreas, small intestine (beerman CH 4, pg. 130)

Carbohydrate digestion requires a variety of enzymes produced in the salivary glands, ____, and _____. a. small intestine, liver b. gallbladder, large intestine c. gallbladder, liver d.pancreas, small intestine

c. polypeptides (Beerman CH 5, pp. 168-169)

Cell signaling, transcription, and translation result in the production of thousands of different _____. a. mutations b. individuals c. polypeptides d. DNA strands

c. riboflavin (Gropper Chap 9, pg 329)

Cheilosis is a symptom of a dietary deficiency of which vitamin? a. niacin b. ascorbic acid c. riboflavin d.biotin

a. Scabies—fingers, wrists, waist (Gould CH 8, pg 153)

Choose the correct match of the skin condition and its usual location. a. Scabies—fingers, wrists, waist b. Impetigo—legs, feet c. Pediculosis humanus corporis—scalp d. Seborrheic keratosis—feet, hands

b. liver (Gropper Chap 10, pg 372)

Choose the food that is high in vitamin A palmitate. a. spinach b. liver c. carrots d.pumpkin

a. 120 (Beerman CH 5, p. 184)

Consuming an entrée containing 700 kcalories, 30 grams of protein, 100 grams of carbohydrate, and 20 grams of fat would provide how many kcalories from protein? a. 120 b. 210 c. 240 d. 270

all of the above. (CH 4, Krase) pg 40 Cytochrome P450 enzymes are essential for the production of cholesterol, steroids, prostacyclin, and thromboxane A2. They are involved in the hydroxylation of endogenous and exogenous toxic molecules in the detoxification transport of toxins.

Cytochrome P450 enzymes are essential for a. production of cholesterol. b. detoxification transport of toxins for elimination. c. production of prostacyclins. d. all of the above.

d. a and b (Beerman, 12)

DEXA measures: a. bone mass. b. bone density. c. blood calcium levels. d. a and b e. all of the above

a. magnesium (Gropper Chap 11, pg 426, 447)

Deficiency of which major mineral is usually associated with muscular weakness, neuromuscular hyperexcitability, and tetany? a. magnesium b. calcium c. sulphur b.chloride

d.1 week (Gropper CH 4, pg. 135)

Dosages of ~2.5 to 10-15 g/day of prebiotics taken for at least _____ are required to increase the intestinal flora population. a. 3 months b. 1 month c. 2 weeks d.1 week

a. glucose and fatty acids. (CH23 Krause, p. 428) With prolonged physical activity, aerobic production of energy is predominant. The primary substrates for this are glucose and fatty acids. Muscle glycogen are used in short-term, anaerobic activity. Ketones become an energy source when a person has no nutritional intake. Amino acids may be lost to promote gluconeogenesis if an athlete has inadequate carbohydrate intake.

During extended physical activity, such as endurance events, the major fuels used for cellular energy are a. glucose and fatty acids. b. glycogen and ketones. c. amino acids and fatty acids. d. glucose and ketones.

a. thiamin. (Gropper Chap 9, pg 324)

Erythrocyte transketolase activity is an assay to assess the status of: a. thiamin. b. B6. c. riboflavin. d.B12.

a. ester (Beerman C 6, p. 229)

Fatty acids are bonded to glycerol via _____ linkages. a. ester b. hydrogen c. peptide d. sulfur

c. antioxidants. (Gropper CH 4, p. 130)

Flavonoids are phytochemicals that can function in the body as a. free radicals. b. saponins. c. antioxidants. d.conjugates.

c. A hormone (Beermann CH 6, p. 236)

Gastrin circulates in the blood and stimulates the release of gastric lipase that is produced in stomach cells. What is gastrin? a. An enzyme b. A very-low-density lipoprotein (VLDL) c. A hormone d. A high-density lipoprotein (HDL)

b. improved (Gropper CH 4, page 124)

Glycemic control is _____ in response to foods rich in fiber or to fiber supplements. a. unchanged b. improved c. reduced d.not known

D p. 498-499 (Gropper CH 13)

Hemoglobin and hematocrit are common measurements for assessment of nutriture for which mineral? a. iodine b. zinc c. chromium d. iron

b. Through genetic engineering (Beemer CH 4, p 147)

How is human insulin currently produced? a. From the pancreatic extracts of cattle b. Through genetic engineering c. From the pancreatic extract of pigs d. Manipulation of viruses

b. 9 (Beerman CH 5, pp. 163-164)

How many different amino acids must humans get from their food? a. 7 b. 9 c. 11 d. 13

c. 1 kg (Beerman, 12)

How much does the calcium in an average adult's body weigh? a. 1 lb. b. 2 lb. c. 1 kg d. 2 kg

c. four (Beerman CH 4, p 151)

In the U.S., diabetes has become so widespread that it is estimated that one in every _____ people either have type 2 diabetes, will have it eventually, or have a family member with it. a. two b. three c. four d. five

a. hepatocyte, glucose Ch 3 Gropper, page 85-86

In the _____ galactose is eventually converted to _____. a. hepatocyte, glucose b. Kupffer cell, fructose c. enterocyte, glucose d.chylomicron, glucose

c. pancreas Gropper Ch 2 page 48

In what organ are enzymes produced that are responsible for digestion of 50% of carbohydrate and protein and 90% of fat? a. liver b. esophagus c. pancreas d.gallbladder

c. mitochondrion Ch 3 Gropper, page 86

In what organelle are the enzymes that catalyze the citric acid cycle located? a. cytoplasmic matrix b. endoplasmic reticulum c. mitochondrion d.lysosome

d. type 2 diabetes (Beerman CH 4 p. 157)

Infants born to women with gestational diabetes may be at risk for developing _____. a. gallbladder disorders b. kidney failure c. type 1 diabetes d. type 2 diabetes

a-macrominerals (Beerman, CH 12)

Inorganic atoms or molecules required by the body in amounts greater than 100 mg daily are: a. macrominerals. b. trace minerals. c. macronutrients. d. trace elements.

a. hormones (Beerman CH 4, p. 153)

It has recently been discovered that adipose tissue produces _____ that may influence insulin resistance. a. hormones b. enzymes c. ketones d. cofactors

b. 240 (Beerman CH 4, p. 157)

Kelly has been diagnosed with gestational diabetes and requires 2400 kcalories per day. What is the maximum number of grams of carbohydrates she should consume in a day? a. 210 b. 240 c. 270 d. 300

b. a bacterium. (Gould CH 8, pg. 149)

Leprosy (Hansen's disease) is caused by: a. a fungus. b. a bacterium. c. a virus. d. a helminth.

c. Oat bran, barley, and legumes (Beerman CH 4, pg. 126)

Liam sometimes suffers from constipation. What foods might he eat because they are the best sources of fiber with high water-holding capacity, and thus make the fecal matter easier to eliminate? a. High-pectin fruits b. Leafy green vegetables c. Oat bran, barley, and legumes d. Gelatin salads and grains

d. Estrogen (Beerman, 12)

Lori was anorexic from the age of 14 until she was 20. As a result, her risk of osteoporosis is greater because her nutrition was poor and because her levels of what were low? a. Testosterone b. Progesterone c. ADH d. Estrogen

c. less than 140 mg of sodium per serving. (Beerman, 12)

Low-salt foods must have: a. less than 5 mg of sodium per serving. b. less than 35 mg of sodium per serving. c. less than 140 mg of sodium per serving. d. less than 200 mg of sodium per serving.

b. hexose (Beerman CH 4, pg. 115)

Monosaccharides have 6 carbon atoms and are called _____ sugars. a. pentose b. hexose c. xylose d. ribose

b. stroke, sleep apnea (pg 286 Gropper Ch 8)

Obesity has grown rapidly in the last 30 years and is associated with increased risk for which of the following disorders? a. stunting, wasting b. stroke, sleep apnea c. osteoporosis, osteopenia d.hepatitis, tuberculosis

sodium, potassium, calcium Gropper CH 2, pg 49

Owing to the alkaline pH of bile, the conjugated bile acids combine with _____, _____, or _____ to form bile salts.

b. Niacin (Beerman chapter 10, pg 432)

People with Hartnup disorder have a genetic abnormality that impairs absorption of which of the following? a. Thiamin b. Niacin c. Tryptophan d.Riboflavin

c. both a and b (Gropper CH 5, pg. 144)

Phospatidylinositol is a membrane phospholipid that can _____. a. anchor surface proteins to the plasma membrane b. create 2 second messengers in cell signaling c. both a and b d.none of the above

a. Amino acids (Beerman, CH 5 p. 163)

Proteins are macromolecules made from which of the following subunits? a. Amino acids b. Glucose c. Fatty acids d.Glycerol

a. nitrogen (Beerman CH 5, p. 163)

Proteins are unique in terms of their chemical structure when compared to carbohydrate and lipids because they contain _____. a. nitrogen b. oxygen c. hydrogen d.carbon

all of the above (CH 6 Krause) ANS: D Refeeding syndrome occurs when a starved patient is fed and there is rapid utilization of phosphorus for phosphorylation of glucose. ATP production also requires magnesium. As the body begins making ATP, serum magnesium and phosphorus drop. If not treated this can be a life-threatening condition

Refeeding syndrome can result in a. low serum phosphorus. b. low serum magnesium. c. death. d. all of the above.

d.isoflavones. (Gropper CH 4, pg. 129)

Soy is rich in a. glucosinolates. b. lignans. c. organosuphides d.isoflavones.

b. modulators Gropper CH 1

Substances that bind with allosteric sites and alter the activity of regulatory enzymes are called _____. a. transport proteins b. modulators c. Na pumps d.sarcoplasmic reticula

c. 45%-65% (Beemer CH 4, p. 142)

The Institute of Medicine recommends a range of _____ of total energy from carbohydrates. a. 5%-25% b. 20%-40% c. 45%-65% d.55%-75%

Answer: mutation (Beerman CH 5, p. 174)

The alteration of a gene is a _______________.

b. 1 to 1.2 (CH 13 Krause, pg 214) Most standard enteral formulas for use with the general patient population provide 1 to 1.2 kcal/ml. When a fluid restriction is required, formulas that are concentrated to 1.5 to 2 kcal/ml are appropriate.

The calorie concentration provided by most general-purpose formulas is _____ kcal/ml. a. 0.5 b. 1 to 1.2 c. 1.5 d. 2

d. 4 to 24 (Gropper CH 5, pg. 138)

The fatty acid chains found in foods and body tissues range from _____ carbon atoms in length. a. 1 to 3 b. 2 to 6 c. 3 to 12 d. 4 to 24

C p. 491-493 (Gropper CH 13)

The following vitamins/ minerals are required for heme synthesis: a. vitamin E, vitamin C, and iron. b. folate, B12, and iron. c. B6, zinc, and iron. d.copper, zinc, and folate.

a. carbohydrate content of a food and glycemic index of a food. (Beerman CH 4, pg. 134)

The glycemic load takes into account the: a. carbohydrate content of a food and glycemic index of a food. b. fiber content of a food and glycemic index of a food. c. carbohydrate and fiber content of a food. d.calorie content and glycemic index of a food.

d. fructose, galactose (Beerman CH 4, pg. 115)

The most abundant monosaccharides found in food include glucose, _____, and _____. a. lactose, fructose b. sucrose, maltose c. sucrose, lactose d. fructose, galactose

a. Electrolytes (Beerman, CH 12)

The movement of which of the following primarily regulates water balance within different compartments of the body? a. Electrolytes b. Phospholipids c. Fatty acids d. Glucose

d. hydrolyzed proteins Gropper CH 2 page 40

The product(s) of pepsin's action is/are _____. a. disaccharides b. amylose c. short-chain fatty acids d. hydrolyzed proteins

c. scalp. (Gould CH 8, pg. 150) - Tinea capitis is a fungal infection of the scalp, involving both the skin and hair

Tinea capitis is an infection involving the: a. trunk. b. feet. c. scalp. d. nails.

a. Between the 5th and 85th percentiles (CH 18 Krause, pg 341) When BMI (weight-for-height) is plotted, a BMI that falls below the 5th percentile is interpreted as underweight, and a BMI at or above the 85th percentile is interpreted as at risk for overweight.

To determine if weight is appropriate for height at a given age for a given gender, where should the data plotted on the NCHS growth chart appear? a. Between the 5th and 85th percentiles b. Between the 10th and 50th percentiles c. Between the 75th and 95th percentiles d. Between the 5th and 25th percentiles

True (Gropper CH 5, pg 150)

True or False: Unlike long-chain fatty acids, short-chain fatty acids from the diet leave the enterocyte via the portal vein and go directly to the liver.

True (Gropper CH 5, pg 173)

True or False: HMG-CoA reductase is a key enzyme in the synthesis of cholesterol from acetyl-CoA.

False: (Beerman CH 5, p. 174)

True or False: A mutation is an alteration of the amino acid sequence of a gene.

false (Beerman CH 5, p. 199)

True or False: All microbes in food are harmful

False: (Beerman CH 5, p. 207)

True or False: MSG may be added to foods without listing it on the label.

a. beta-glucans (Gropper CH 4, pg 115)

What are the homopolymers of glucopyranose found in cereal brans such as oats and barley that are effective in reducing serum cholesterol? a. beta-glucans b. fructans c. fructooligosaccharides d.chitin

d. gums (Gropper CH 4, pg. 114-115)

What are the hydrocolloids that are secreted at a site of injury on a plant or surround the endosperm of some seeds and that are used as thickening agents? a. lignin b. cellulose c. pectins d. gums

Oxygen consumption and carbon dioxide excretion (CH 2, Krause) pg 20 Indirect calorimetry measures gas exchange that results from metabolism. The oxygen consumption and carbon dioxide excretion can be used to estimate a resting metabolic rate. Direct calorimetry measures heat production, either from humans in a controlled environment, or from food, by incinerating the food and measuring the amount of heat released.

What does indirect calorimetry measure? a. The amount of heat produced by the body at rest b. The energy potential of foods consumed c. Oxygen consumption and carbon dioxide excretion d. The resting metabolic rate

b. A carboxylic acid group (Beerman CH 6, p. 219)

What does the alpha (α) end of a fatty acid contain? a. A phosphorus atom b. A carboxylic acid group c. A methyl group d. A nitrogen atom

b. Urea (Beerman CH 5, p. 186)

What does the body convert ammonia (NH3) to after it is released from deaminated amino acids? a. Uric acid b. Urea c. Ammonium d. Nitrogen

a. hypercalcemia (Gropper Chap 10, pg 399)

What is a symptom of a vitamin D toxicity? a. hypercalcemia b. hypocalcemia c. rickets d.osteoporosis

b. 30 minutes (Beerman CH 4, p. 154)

What is the approximate minimum amount of daily exercise thought to benefit people with diabetes? a. 15 minutes b. 30 minutes c. 1 hour d. 2 hours

c. 35 (Beerman CH 4, pg117)

What is the consumption of high-fructose corn syrup (in pounds per year per person) by Americans estimated by the USDA? a. 12 b. 22 c. 35 d. 44

c. Hydroxyapatite (Beerman, 12)

What is the crystal-like, structural molecule in bones and teeth that contains calcium called? a. Osteoblasts b. Osteoclasts c. Hydroxyapatite d. Calcitonin

b. Stimulate the adrenal glands to release more aldosterone (Beerman, 12)

What is the function of angiotensin II? a. Prevent the adrenal glands from releasing aldosterone b. Stimulate the adrenal glands to release more aldosterone c. Prevent the lungs from producing renin d. Stimulate the lungs to produce renin

c. hydrostatic pressure (Gropper CH 12, pg 457)

What is the major filtration force in the capillaries that is responsible for controlling movement of water from plasma to interstitial fluid and from interstitial fluid into plasma? a. colloid osmotic pressure b. theoretic osmotic pressure c. hydrostatic pressure d.effective osmotic pressure

b. Weight bearing (CH 24 Krause, p. 460) Weight-bearing activities place stress on the skeleton and stimulate osteoblast activity during the developmental periods of bone accretion. Swimming, regular walking, and isometrics do not place as much stress on the skeleton and are not associated with improvements in BMD.

What is the most beneficial type of exercise to include in an exercise program for a patient at risk for osteoporosis? a. Swimming b. Weight bearing c. Nonweight bearing d. Isometric

d. starch Gropper CH 3 page 68

What is the most common digestible homopolysaccharide existing as both amylose and amylopectin? a. glycogen b. cellulose c. hemicellulose d. starch

c. Their weight (Beerman CH 5, p. 188)

What is the most important fact to know in order to determine an adult's protein requirement? a. Their age b. Their height c. Their weight d.Their gender

b. Calcium (Beerman, 12)

What mineral is required in blood clotting, muscle contractions, the transmission of nerve impulses, healthy vision, regulation of blood glucose, and cell differentiation? a. Phosphorous b. Calcium c. Potassium d. Chloride

a. Iron (Beerman chapter 10, pg 422)

What mineral must be added to a food for it to be labeled "enriched"? a. Iron b. Zinc c. Calcium d.Magnesium

c. Partial hydrogenation (Beerman CH 6, pp. 222-223)

What process is used to convert corn oil into sticks of corn-oil margarine? a. Complete condensation b. Partial saturation c. Partial hydrogenation d. Complete oxygenation

b. From 4 months' gestation through the preteen years (CH 25 Krause, p. 468) Tooth formation begins at 2 to 3 months' gestation, and tooth mineralization begins at 4 months' gestation. Tooth mineralization continues into the preteen years as the baby teeth are replaced by the adult teeth.

When and for how long does tooth mineralization occur? a. From 2 months' gestation through 5 years of age b. From 4 months' gestation through the preteen years c. From 2 months' gestation through the preteen years d. From 4 months' gestation through 5 years of age

a. In the morning before breakfast (Beerman CH 4, pg 135)

When are blood glucose levels lowest for most people? a. In the morning before breakfast b. Late afternoon c. Late evening d.When asleep

d.Tagamet Gropper CH 2 page 42

Which medication inhibits hydrogen release into the gastric juice, which reduces GI mucosal irritation? a. Pepcid b. Nexium c. Tums d.Tagamet

d. potassium (Gropper CH 12, pg 466)

Which mineral serves as the major intracellular fluid cation? a. calcium b. chloride c. sodium d. potassium

d. Glucose (Beerman CH 4, pg. 117)

Which monosaccharide is the preferred energy source for the nervous system and the sole source for the red blood cells? a. Sucrose b. Fructose c. Galactose d. Glucose

b. Fructose (Beerman CH 4, pg 133)

Which monosaccharide, once digested, is absorbed into the enterocytes through facilitated diffusion? a. Glucose b. Fructose c. Galactose d. Maltose

b. beta-carotene (Gropper Chap 10, pg 372)

Which of the carotenoid pigments has the greatest vitamin A activity? a. alpha-carotene b. beta-carotene c. gamma-carotene d.delta-carotene

d. Bowman's capsule (Gropper CH 12, pg 457)

Which of the components comprising the nephron includes the capillary network called the glomerulus? a. collecting duct b. distal convoluted tubule c. loop of Henle d.Bowman's capsule

b. Sprinting (CH 23 Krause, p. 427) Activities that involve high intensity and short duration rely on anaerobic metabolism for energy. Sprints or running drills use muscle glycogen anaerobically to provide the energy quickly. Longer duration activities such as jogging, hiking, and dancing cause a switch to aerobic glycolysis of the glucose produced from muscle glycogen breakdown.

Which of the following activities relies heavily on the anaerobic pathway in muscle cells? a. Jogging b. Sprinting c. Hiking d. Dancing

a. Wheat, rye, barley, and oats (CH 28 Krause, p. 533) Wheat, rye, barley, and oat products all contain gluten peptide fractions and should be excluded from the diet. Corn, potatoes, rice, soybeans, tapioca, arrowroot, amaranth, quinoa, millet, and buckwheat are sources of grains that may be used in creating products for people with celiac disease.

Which of the following are NOT included in the gluten-restricted, gliadin-free diet to treat celiac disease? a. Wheat, rye, barley, and oats b. Corn, rice, soybeans, and tapioca c. Potatoes, hydrolyzed vegetable protein, and arrowroot starch d. Wheat, rice, barley, and corn

ANS: C ALA is found in the oil of seeds and some nuts. Walnuts are the best source. REF: p. 842 (Krause CH 41)

Which of the following are sources of alpha linoleic acid? a. Cod b. Spinach c. Walnuts d. Oysters

a. Helper T lymphocytes (CD4 lymphocytes) (Gould CH 7, pgs. 130-131)

Which of the following are the target cells for HIV? a. Helper T lymphocytes (CD4 lymphocytes) b. B lymphocytes c. Natural killer cells d. Macrophages

a. Epidermis (Gould CH 8, pg 142)

Which of the following areas lacks blood vessels and nerves? a. Epidermis b. Dermis c. Subcutaneous tissue d. Fatty tissue

a. Equal® (Beerman CH 4, pg. 122)

Which of the following artificial sweeteners contains phenylalanine and thus poses a potential risk to people who have the genetic condition phenylketonuria? a. Equal® b. Sugar Twin® c. Sweet One® d. Splenda®

a. Root caries (CH 25 Krause, p. 471) When the gingiva recedes, this exposes the root of the tooth to plaque formation, causing root caries. Lingual caries, which occurs on the tongue side of the anterior teeth, is seen in people with bulimia or anorexia-bulimia. Caries development is associated with decreased salivation and erosion of tooth enamel.

Which of the following can commonly occur after a patient develops gingival recession? a. Root caries b. Lingual caries c. Increased salivation d. Increased enamel production

a. α (1-4) CH 3 Gropper, page 70

Which of the following carbon bonds is digested by α-amylase? a. α (1-4) b. α (1-6) c. β (1-4) d.β (1-6)

D p. 512 (Gropper CH 13)

Which of the following dietary components impedes copper absorption? a. gluconate b. phosphate c. citric acid d.phytic acid

b. Cleaved from proteins prior to absorption (Beerman chapter 10, pg 419)

Which of the following is a general characteristic of water-soluble vitamins in foods? a. Bound to carbohydrates b. Cleaved from proteins prior to absorption c. Not destroyed by cooking d.Not destroyed by light

a. Galactose (Beermen CH 4, pg. 115)

Which of the following is a simple carbohydrate? a. Galactose b. Amylose c. Raffinose d.Glycogen

c. Fundoplication (CH 27 Krause, pp. 512 -13) In a fundoplication surgery, the fundus of the stomach is wrapped around the lower esophagus to limit reflux. Billroth I, Billroth II, and the roux-en-Y procedure are different gastric surgeries that involve either gastrectomy or gastric partitioning.

Which of the following surgeries would be used to treat a patient with GERD? a. Billroth I b. Billroth II c. Fundoplication d. Roux-en-Y procedure

B. p. 283. Gropper Ch 8

Which of the following techniques for measuring body composition is best for determining regional body composition? a. hydrodensitometry b. computerized (axial) tomography c. total body water d.bioelectrical impedance

d.G-cell Gropper CH 2 page 38

Which specialized cell of the gastric epithelium secretes a hormone? a. neck b. parietal c. chief d.G-cell

c. liver CH 3 Gropper, page 108

Which tissue metabolizes fructose? a. muscle b. adipose tissue c. liver d.all of these

b. Gestational (Beerman CH 4, p 157)

Which type of diabetes develops during pregnancy? a. Type 1 b. Gestational c. Type 2 d. Pre-birth

b. Enterohemorrhagic (Beerman CH 5, p. 203)

Which type of pathogen invades the cells of the intestine and causes bloody diarrhea? a. Intestinal invaders b. Enterohemorrhagic c. Traveler's diarrhea d. Dysentery

c. Biotin (Beerman chapter 10, pg 438)

Which vitamin is required by the enzyme that converts pyruvate to oxaloacetate, a key step in gluconeogenesis? a. Thiamin b. Niacin c. Biotin d.Vitamin B12

CDC (CH 9 Krause) The Centers for Disease Control and Prevention (CDC) collects information regarding morbidity and mortality, as do state and local public health agencies. The Census Bureau collects demographic information useful in describing the population base of a community. The CDC and the Administration on Aging are two agencies within the U.S. Department of Health and Human Services. The local Area Office on Aging is able to provide information about the elderly population in the local community.

While performing a community assessment, you determine that you need information about local cardiovascular morbidity and mortality. Which of the following would be an appropriate resource for this information? a. Census Bureau b. Centers for Disease Control and Prevention c. Department of Health and Human Services d. Area Office on Aging

b. insulin will be secreted by your pancreas. (Beerman CH 4 pg 137)

You are a healthy individual, and you just ate breakfast. Therefore: a. glucagon will be secreted by your pancreas. b. insulin will be secreted by your pancreas. c. your liver will break down glucagons. d.your blood glucose levels will decrease

d.margarine. (Beerman CH 6, p. 223)

You are purchasing a spread for your dinner rolls. The spread most likely to contain substantial amounts of trans fatty acids is: a. jelly. b. apple butter. c. butter. d.margarine.

b. aspartame. (Beerman CH 4, pg. 122)

Your diet soda is sweetened with a compound composed of phenylalanine plus aspartic acid. The sweetener is: a. saccharin. b. aspartame. c. acesulfame K. d. sucralose.

B. p. 501 (Gropper CH 13)

ZIP4 a. mutations result in zinc toxicity due to acrodermatitis enteropathica. b. is the primary transporter of zinc into enterocytes. c. is expressed only in the liver. d.degrades more rapidly when zinc intakes are low.

b. Parathyroid hormone, (Gropper Chap 11, pg calcitriol 429)

_____ is secreted in response to low plasma calcium concentrations and acts on the kidney to increase synthesis of _____, which promotes renal reabsorption of calcium. a. Parathyroid hormone, calcitonin b. Parathyroid hormone, calcitriol c. Calcitonin, calcitriol d.Calcitriol, calmodulin

tetany

condition affecting nerves causing muscle spasms as a result of low amounts of calcium in the blood caused by a deficiency of the parathyroid hormone

b. Secretin (Beerman CH 6, p. 240)

hat substance stimulates the pancreas to release pancreatic lipase? a. Thyroxin b. Secretin c. Homocysteine d.Phospholipids

c. insulin injections (Beerman CH 4 p 150)

reatment of type 1 diabetes focuses on balancing _____ with a healthy diet and physical activity. a. weight control b. blood pressure control c. insulin injections d. glucose injections

d.parasites (Beerman CH 5, p. 204)

rotozoa are considered to be _____. a. bacteria b. mold c. fungi d.parasites

c. autoimmune (Beerman CH 4, p. 149)

ype 1 diabetes is a(n) _____ disorder. a. inherited b. contagious c. autoimmune d.infectious

b. glucose (Beerman CH 5, p. 194)

Adults with PEM can experience extreme muscle loss because the muscle is broken down to provide _____ and energy. a. glycogen b. glucose c. glycerol d. glucosamine

a. hawthorn. (Gropper CH 4, p. 129)

All of the following are among the seven top-selling herbs in America EXCEPT a. hawthorn. b. ginkgo biloba. c. saw palmetto. d.ginseng.

a. somatostatin Gropper CH 2 page 50

Among the regulatory peptide molecules, some are recognized as true hormones. Which of the following is a paracrine rather than a hormone? a. somatostatin b. secretin c. cholecystokinin d.gastrin

ANS: C Iron excess is associated with increased risk of bipolar disorder, so screening some ferritin is warranted. Magnesium is a potentially useful supplement for bipolar disorder. Chromium and vitamin C excess have not been associated with bipolar disorder. REF: p. 853 (Krause CH 41)

An excess of which nutrient has been associated with bipolar disorder? a. Chromium b. Magnesium c. Iron d. Vitamin C

b. contains less than or equal to 3 g of fat per serving. (CH 11 Krause, pg 186) Nutrient content terms such as low-fat must now meet government definitions that apply to all foods. To qualify as low-fat, it must be 3 g or less per serving. When a product contains 25% less fat than a reference product, it can be labeled as "reduced fat."

"Low-fat" on a food label means that food a. contains 25% less fat than a reference product. b. contains less than or equal to 3 g of fat per serving. c. contains one-third fewer fat calories than a reference product. d. is naturally low in fat.

a. vitamin B6 (Beerman chapter 10, pg 435)

A deficiency of _____ results in microcytic, hypochromic anemia. a. vitamin B6 b. niacin c. thiamin d.vitamin B12

a. biotin (Gropper Chap 9, pg 343)

A deficiency of what vitamin is associated with these symptoms: hallucinations, lethargy, skin rash, alopecia, and muscle pain? a. biotin b. thiamin c. vitamin C d.vitamin B12

c. Canada's Food Guide recognizes cultural, spiritual, and physical importance of Aboriginal foods. (CH 11 Krause, pg 182) The Canadian Food Guide recognizes the cultural, spiritual, and physical importance of traditional Aboriginal foods as well as the role of nontraditional foods in contemporary diets. MyPyramid does not make the same distinction.

A major difference between MyPyramid in the United States and Canada's Food Guide to Healthy Eating is a. the Canadian guide recommends daily servings of milk. b. MyPyramid emphasizes eating vegetables. c. Canada's Food Guide recognizes cultural, spiritual, and physical importance of Aboriginal foods. d. only MyPyramid includes a recommendation for physical activity.

c. 8-12 (Beerman CH 6, p. 220)

A medium-chain fatty acid contains _____ carbon atoms. a. 2-4 b. 4-8 c. 8-12 d. 12-20

b. yogurt, cheese, milk, and ice cream (Beerman CH 4, pgs 130,132)

A person who does not have sufficient lactase will experience difficulty in digesting _____. a. most disaccharides b. yogurt, cheese, milk, and ice cream c. foods containing high-fructose corn syrup d. most monosaccharides

d. catalyst (Beerman CH 5, p. 181)

A(n) _____ is a substance that speeds up a chemical reaction but is not consumed or altered in the process. a. hormone b. amino acid c. protein d. catalyst

Key: phosphofructokinase

ADP can positively modulate the activity of the rate-limiting allosteric enzyme in glycolysis, _____.

d. denaturing (Beerman CH 5, p. 173)

ou are making a scrambled egg for breakfast. When you heat the egg, you are _____ the protein. a. destroying b. metabolizing c. hydrolyzing d. denaturing

a. ionize and form micelles. Gropper CH 2 page 49

Conjugation of bile acids with glycine and taurine improves their ability to a. ionize and form micelles. b. undergo enterohepatic recirculation. c. be excreted in the feces, thus keeping serum cholesterol normal. d. promote the formation of bile salts.

d. promote satiety (Beerman CH 4, pg. 126)

Dietary fiber has been shown to contribute to healthy bowel function and _____. a. diminish blood glucose regulation b. increase blood cholesterol levels c. prevent colon cancer d. promote satiety

bisphosphonates (ch 12, Beerman)

Drugs classified as ______________ work by inhibiting bone breakdown, especially in the spine and hip regions.

c. is the structure into which granulation tissue grows. (Gould CH 9, pg. 166)

During the fracture healing process, the hematoma: a. is broken down and absorbed immediately. b. provides the base for bone cells to produce new bone. c. is the structure into which granulation tissue grows. d. produces fibroblasts to lay down new cartilage.

c. Pima (Beerman CH 4, p. 156)

For the past 30 years, the _____ Indians have been studied by the NIH because the prevalence of diabetes within this population is 34% among men and 41% among women. a. Inca b. Sioux c. Pima d. Iroquois

c. ribosome (Beerman CH 5, p. 169)

For translation to occur, the messenger RNA must bind to a(n) _____ in the cytoplasm. a. amino acid b. nucleic acid c. ribosome d. peptide

d.facilitated diffusion. (Beerman CH 4, pg 137)

Glucose enters cells via: a. endocytosis. b. osmosis. c. exocytosis. d.facilitated diffusion.

Answer (key points): By maintaining blood sugar at near-normal levels, staying physically fit, and maintaining a recommended body weight. (Beerman CH 4, pp. 151, 154)

How can the long-term complications associated with diabetes and insulin resistance be avoided?

b. These compounds tend to cause dilation or constriction of blood vessels. (Beerman CH 6, p. 227)

How do alterations in the balance of ω-3 to ω-6 (omega) eicosanoids influence a person's risk of heart disease? a. These compounds tend to cause a heightened immune response in reaction to trauma. b. These compounds tend to cause dilation or constriction of blood vessels. c. These compounds tend to cause a lesser immune response in reaction to trauma. d. These compounds tend to cause increased production of white blood cells.

c. Active transport (Beerman, 12)

How do electrolytes move into and out of cells? a. Simple diffusion b. Facilitated diffusion c. Active transport d. Exocytosis

a. 3-10 (Beerman CH 4, pg. 121)

How many monosaccharides are contained in an oligosaccharide? a. 3-10 b. 10-50 c. >50 but less than 100 d. >100

a. attached to RBP and transthyretin (Gropper Chap 10, pg 379)

How will retinol, once secreted from the liver, be found in the blood? a. attached to RBP and transthyretin b. attached to albumin c. attached to a chylomicron d.attached to RBP and stellate cells

b. 60 to 210 grams (Beerman CH 5, p. 189)

If Mark needs 2400 kcalories per day, how much protein does he need to consume daily based on the AMDR recommendation for protein for adults? a. 40 to 150 grams b. 60 to 210 grams c. 80 to 120 grams d. 100 to 320 grams

c. Cow's milk is a reliable source of vitamin D in the food supply. (Gropper Chap 10, pg 391-393)

Imagine you are a nutritionist working in a country other than the U.S. Which is an assumption about vitamin D status that is NOT true? a. The latitude makes a difference as regards how much vitamin D can be self-synthesized. b. Customs of dress make a difference as regards how much vitamin D can be self-synthesized. c. Cow's milk is a reliable source of vitamin D in the food supply. d.Skin color makes a difference as regards how much sun is needed to synthesize vitamin D.

a. irradiation (Beerman CH 5, p. 210)

In 1963, the FDA approved a form of food processing called _____, sometimes referred to as "cold pasteurization." a. irradiation b. aseptic packaging c. IQF (individually quick frozen) d. blast chilling

a. Tiburon, California (Beerman CH 6, p. 224)

In 2004, which city claimed to be the first "trans fat-free city," leading the movement on establishing trans fat-free zones? a. Tiburon, California b. Chicago, Illinois c. New York City, New York d. Seattle, Washington

oxidized Gropper CH 1

In electron transfer, an electron donor reduces the electron receptor and in the process becomes a. oxidized. b. transformed. c. reduced. d.flavin mononucleotide.

d. albumin (Beerman CH 6, pp. 240 - 241)

In order for short- and medium-chain fatty acids to be circulated away from the small intestine in the blood, they are first bound to _____. a. cholesterol b. vitamin D c. triglycerides d. albumin

B. p. 279. Gropper Ch 8

In the reference man and woman, respectively, what percentage of body weight is fat? a. 10, 20 b. 15, 27 c. 30, 40 d.45, 55

b. cytosol CH 3 Gropper, pg 83

In what part of the cell does glycolysis occur? a. mitochondrion b. cytosol c. nucleus d. endoplasmic reticulum

b. Bulimia nervosa (CH 22 Kruase pgs. 408 & 412) People with bulimia nervosa of the nonpurging type engage in compensatory activities such as exercise or fasting to make up for the intake of a binge episode. People with eating disorder not otherwise specified may use inappropriate compensatory activities less frequently than people with bulimia nervosa or may do so after eating small amounts of food.

In which eating disorder might a person exercise excessively after an episode of binge eating? a. Anorexia nervosa b. Bulimia nervosa c. Eating disorder not otherwise specified d. Binge eating disorder

d. mitochondrion Gropper CH 1

In which organelle do the TCA cycle and fatty acid oxidation occur? a. Golgi apparatus b. nucleus c. microsomes d. mitochondrion

a. ascending loop of Henle (Gropper CH 12, pg 461)

In which part of the nephron is most of the filtered sodium reabsorbed? a. ascending loop of Henle b. distal convoluted tubule c. collecting ducts d.proximal tubule

31. c. triacylglycerols pg. 154 32.b. VLDLs pg. 154 33. a. B.100 pg. 153 (Gropper CH 5, pg. 153-154)

Instructions: For questions 38-40, select the best choice to fill in each blank and complete the statements. A diet rich in simple sugars increases the hepatic formation of de novo fatty acids and the neutral lipids called 31._____ from glucose. These neutral lipids are transported from the liver to the adipose tissues by lipoproteins called 32._____, whose signal apolipoprotein is 33._____. 31. a. cholesterol b. phospholipids c. triacylglycerols 32. a. LDLs b. VLDLs c. chylomicrons 33. a. B-100 b. B-48 c.A-1

A-ATP (Beerman CH 12)

Magnesium is vital for energy metabolism as it stabilizes: a. ATP. b. DNA. c. NaCl. d. RNA.

a. lifestyle (Beerman CH 4, p. 147)

Most case of type 2 diabetes are attributed to _____. a. lifestyle b. environmental pollution c. genetics d. infection

a. proximal small intestine Gropper CH 2 page 57

Secretin is released from the enteroendocrine S-cell in the _____. a. proximal small intestine b. gastric mucosa c. esophagus d.colon

c. myelin sheath of nerves (Gropper CH 5, pg. 145)

Sphingomyelins are important phospholipids found in the _____. a. pacemaker of the heart b. kidney tubules c. myelin sheath of nerves d.human blood groups A, B and O

c. aflatoxin (Beerman CH 5, p. 202)

The Aspergillus mold produces a dangerous preformed toxin called _____. a. botulism b. yeast c. aflatoxin d.blue-green mold

a. greater than (Gropper Chap 10, pg 398)

The RDA for vitamin D for people over the age of 70 is _____ the RDA for teenagers. a. greater than b. less than c.equal to

c. noting the location and size of the lesion. (Gould CH 8, pg 145)

The cause of contact dermatitis can often be identified by: a. using a culture and sensitivity test on the exudate. b. checking the frequency of the exacerbations. c. noting the location and size of the lesion. d. the type of pain associated with the lesion.

a. 3, linolenic (Gropper CH 5, pgs. 169-170)

The fatty acid structure below is an omega-_____ fatty acid called _____. CH3CH2CH=CHCH2CH=CHCH2CH=CH(CH2)7COOH a. 3, linolenic b. 6, linoleic c. 6, eicosapentaenoic d.9, oleic

a. a detailed clinical history. (CH 26 Krause, p. 491) Diagnosis of adverse food reactions requires identification of the suspected food, proof that the food causes adverse reactions, and verification of an immune- or nonimmune-mediated response. The first step in this process is a detailed clinical history

The first diagnostic tool to use in diagnosing a food allergy is a. a detailed clinical history. b. biochemical tests. c. immunologic tests. d. an oral food challenge.

c. antibodies (Beerman CH 5, p. 182)

The immune system fights infection by producing proteins called _____. a. antigens b. antibacterial agents c. antibodies d. antimicrobials

b. exocrine in function Gropper Ch 2 page 47

The majority of the pancreatic tissue is _____. a. endocrine in function b. exocrine in function

c. adipose (Gropper Chap 10, pg 379)

The majority of vitamin A is stored in the liver, while carotenoids are stored mainly in the _____ tissue. a. muscle b. eye c. adipose d.skin

a. peroxisome Gropper CH 1

The organelle that detoxifies by oxidizing molecules such as hydrogen peroxide and ethanol is the _____. a. peroxisome b. endosome c. lysosome d.ribosome

a. hydrochloric acid and intrinsic factor

The parietal cells secrete _____. a. hydrochloric acid and intrinsic factor b. instrinsic factor and gastrin c. gastrin and zymogens d.zymogens and hydrochloric acid

Answer: nutrigenomics (Beerman CH 5, p. 175)

The science of how genetics and nutrition together influence health is called _______________.

c. D (Gropper Chap 10, pg 399)

Toxicity of which vitamin is related to increased deposition of calcium in soft tissues? a. lipoic acid b. biotin c. D d.E

d. action and maintenance. (CH 14 Krause, pg 228) Change matched to action and maintenance is the focus of traditional nutrition counseling. However, many people with a dietary behavioral problem are in a preaction stage and therefore not ready for change. This may be one of the reasons that traditional nutrition counseling has not always demonstrated long-term success.

Traditional nutritional counseling focuses on change matched to a. action and relapse. b. empathy. c. precontemplation and preparation. d. action and maintenance.

c. elevate serum LDL while decreasing HDL (Gropper CH 5, pgs 162-3)

Trans unsaturated fatty acids are now considered more atherogenic than saturated fatty acids because they a. are unnatural and only formed during fat processing. b. cause excess blood clotting. c. elevate serum LDL while decreasing HDL. d.were found to cause sudden cardiac arrest in women.

d.solid fats (Gropper CH 5, pg. 141)

Triacylglycerols with saturated fatty acids of longer chain length tend to be _____ at room temperature. a. liquid oils b. emulsified c. non-esterified fats d.solid fats

False: (Beerman CH 5, p. 170)

True or False: Sickle cell anemia is an infectious disease

True (Beerman CH 5, p. 175)

True or False: The study of the interaction of nutrition and genetics to influence health is called nutrigenomics.

True (Beerman CH 5, pp. 187, 188)

True or False: There are no Tolerable Upper Intake Levels for amino acids or protein.

False (Beerman CH 4 p. 148)

True or False: Type 1 diabetes always presents itself during childhood.

false (Beerman CH 5, p. 207)

True or Flase: The USDA requires food manufacturers to label all foods containing sulfites in concentrations of at least 100 parts per million.

False (Beerman CH 5, p.. 183,184)

True or Flase: The body utilizes protein as its primary energy source.

c. ileum (Gropper Chap 9, pg 355)

Vitamin B12 is absorbed in the _____. a. duodenum b. jejunum c. ileum d.colon

a. collagen synthesis. (Gropper Chap 9, pg 312)

Vitamin C acts as a cofactor by maintaining iron in a reduced state in: a. collagen synthesis. b. methylation of homocysteine. c. release of energy from nutrients. d. red blood cell synthesis.

c. Donates an electron or electrons to reduce a mineral cofactor (Gropper Chap 9, pg 314-315) *OXIDIZE = lose *REDUCE = gain OIL RIG Oxidation Is Lost Reduction Is Gained

Vitamin C's actual participation in biochemical reactions usually involves its antioxidant ability. Choose the description of this activity. a. Donates an electron or electrons to oxidize a mineral cofactor b. Accepts an electron or electrons to reduce a mineral cofactor c. Donates an electron or electrons to reduce a mineral cofactor d.Accepts an electron from the quinone form of vitamin E

c. These are inappropriate for infants during the first year. (CH 16 Krause, pg 306) All forms of cow's milk are not recommended for provision to infants younger than the age of 1 year. Cow's milk may cause gastrointestinal blood loss, may provide an excessive renal solute load, and is an inadequate source of iron and linoleic acid.

What are the recommended guidelines regarding the use of low-fat and nonfat milk for infants? a. These are appropriate for overweight infants during the first year. b. These are appropriate for any infant during the first year. c. These are inappropriate for infants during the first year. d. These are inappropriate for infants during the first 3 months of life.

a. Hypertension, proteinuria, and edema (CH 15 Krause, pg 268) Pregnancy-induced hypertension is evident when a pregnant woman has a blood pressure greater than 140/90 mm Hg, protein spilling into the urine, and subsequent edema. The edema results from the increased blood pressure and protein loss. Weight loss is not common; however, impairment of uterine blood flow can result in reduced placental size and fetal intrauterine growth restriction.

What are the signs and symptoms of pregnancy-induced hypertension? a. Hypertension, proteinuria, and edema b. Hypotension, hyperalbuminemia, and excessive urine output c. Abdominal cramping and weight loss d. Weight loss, edema, and hypertension

c. chief cells Gropper CH 2 page 38

What cells found in oxyntic glands in the body of the stomach secrete pepsinogens? a. neck cells b. parietal cells c. chief cells d. enteroendocrine cells

c. The tissue requires insulin to stimulate the uptake of glucose. (Beerman CH 4, pg 137)

What does it mean if a tissue has "insulin-requiring glucose transporters"? a. The tissue is said to have impaired glucose regulation. b. The tissue functions less effectively in the presence of insulin. c. The tissue requires insulin to stimulate the uptake of glucose. d.The tissue is not dependent on insulin for the uptake of glucose

d. Acetylcholine (Gould CH 9, pg161)

What is the chemical transmitter released at the neuromuscular junction? a. Norepinephrine b. GABA c. Serotonin d. Acetylcholine

d. Mild tingling along the nerve or on the lips (Gould CH 8, pg 150)

What is the common signal that a recurrence of herpes simplex infection is developing? a. Severe pain around the mouth b. Malaise and fatigue c. Fever and severe headaches d. Mild tingling along the nerve or on the lips

c. To provide a source of energy to cells (Beerman CH 4, pg 116)

What is the primary function of glucose? a. To facilitate synthesis of some amino acids b. To provide a ready source of glycosidic bonds c. To provide a source of energy to cells d. To facilitate synthesis of glycogen

c. Cross-contamination (Beerman CH 5, p. 208)

What is the term for the process in which contaminants are transmitted from food to food? a. Flow of food b. Foodborne illness c. Cross-contamination d. Foodborne outbreak

a. Fasting or refraining from food (CH 18 Krause, pg 340) Seventeen percent of female and 7% of male high school students reported fasting or refraining from food as means of weight control. A total of 7% of females and 4% of males reported using diet pills. A total of 53% of females and 28% of males reported using exercise as a means of weight control.

What method of weight control is most used by adolescents? a. Fasting or refraining from food b. Eating fewer calories and less fat c. Use of diet pills, laxatives, or diuretics d. Exercise

d.calcium (Gropper CH 4, pg 125)

What mineral that is released in the colon by fermentation of fiber is considered to improve the proliferation of normal colon cells, thus inhibiting cancer? a. zinc b. riboflavin c. iron d.calcium

a. Carnitine (Beerman chapter 10, pg 450)

What nutrient can be produced in the body from the amino acids methionine and lysine? a. Carnitine b. Vitamin C c. Choline d.Niacin

b. prothrombin time (Gropper Chap 10, pg 414)

Which is the best measure of vitamin K status? a. des-γ-carboxyglutamic prothrombin b. prothrombin time c. INR d.PTH concentration

b. phosphorus (Gropper Chap 11, pg 438. 443)

Which mineral is LEAST likely to be deficient in anyone's diet? a. calcium b. phosphorus c. iodine d.chromium

d. K (Gropper Chap 10, pg 409)

Which of the fat-soluble vitamins is consumed in the form of phylloquinone from plant foods? a. A b. D c. E d.K

c. 2, 4 (Gould CH 7, pgs. 135, 137)

Which of the following characteristics apply to HIV? 1. It contains two strands of DNA. 2. It tends to mutate frequently to form new strains. 3. The incubation period is extremely short. 4. It is inactivated by heat and many disinfectants. a. 1, 2 b. 1, 3 c. 2, 4 d. 3, 4

d. nuts (Gropper CH 12, pg 476)

Which of the following foods is associated with reduced blood pressure? a. sugar b. alcohol c. red meat d.nuts

b. Milk (Beerman CH 6, p. 235)

Which of the following foods provides the most cholesterol in a single 3-ounce serving? a. Peanut butter b. Milk c. Avocado d. Bagel

b natural starch in hot corn starch pudding (Gropper CH 4, pg 115-116)

Which of the following is NOT a form of resistant starch? a. natural starch in cell walls of steel-cut oats b natural starch in hot corn starch pudding c. starch crystals in cooled, cooked foods, such as potatoes d.chemically modified starch, such as cross-bonded starch

C. p. 297 (Gropper CH 8)

Which of the following is NOT a suggested reason for the effectiveness of a high-protein weight-loss diet? a. Protein provides satiety over a longer period of time. b. Thermogenesis from protein is greater. c. Dyslipidemia is altered by high protein intake. d.Fat-free mass is preserved and basal metabolism is maintained.

a. Membranes are symmetrical. Gropper CH 1

Which of the following is NOT an attribute common to all membranes? a. Membranes are symmetrical. b. Membranes form sheet-like structures. c. Membranes are fluid structures. d. Membranes protect cellular components.

c. shortened transit time (Gropper CH 4, pg. 135)

Which of the following is a mechanism for the constipation relief provided by fructooligosaccharides and inulin? a. decreases in microbial mass b. decreases in osmotic pressure in the colon c. shortened transit time d.increased time available for water absorption

a. Being of African, Hispanic, Native American, or Pacific Island descent (Beerman CH 4, p. 151)

Which of the following is a risk factor associated with type 2 diabetes? a. Being of African, Hispanic, Native American, or Pacific Island descent b. Having triglycerides ≤ 250 mg/dL c. Having HDL cholesterol ≥ 35 mg/dL d. Being under the age of 20

b. sodium (Gropper Chap 11, pg 425)

Which of the following is considered a major mineral in the body? a. iron b. sodium c. selenium d.iodine

c. fructans (Gropper CH 4, p. 134)

Which of the following is considered a prebiotic? a. brans b. galactose c. fructans d.lactose

c. Exclude all high-sugar foods (Beerman CH 4, pgs 154-155)

Which of the following is not one of the nutritional guidelines developed by the American Diabetes Association for the management of type 2 diabetes? a. Consume carbohydrates mainly from fruits, vegetables, whole grains, legumes, and low-fat milk b. Reduce energy intake to reduce body weight c. Exclude all high-sugar foods d. Limit foods high in saturated fat and trans fatty acids, cholesterol, and sodium

a. Maintain blood glucose at close to normal levels (Beerman CH 4, p 151)

Which of the following is the best defense in preventing long-term complications of diabetes? a. Maintain blood glucose at close to normal levels. b. Avoid consuming concentrated sources of sugar and sweets. c. Eat roughly the same amount of food at each meal. d. Eat at roughly the same time each day.

a-Potassium (Beerman, CH 12)

Which of the following major minerals is most likely to be found abundantly in fruits? a. Potassium b. Phosphorous c. Sodium d. Chloride

Oxandrolone (Oxandrin) (Ch 8 Krause, pg 134) Commonly used appetite stimulation medications include oxandrolone, megestrol acetate, somatropin, and dronabinol. Dextroamphetamine, sibutramine, and phentermine are appetite suppressant medications.

Which of the following medications could be given to a patient with cancer or AIDS to stimulate food intake? a. Dextroamphetamine (Dexedrine) b. Sibutramine (Meridia) c. Phentermine (Adipex-P) d. Oxandrolone (Oxandrin)

d. Increased protein (CH 29 Krause, p. 575) In the acute postliver transplant phase, nutrient needs are increased to promote healing, deter infection, provide energy for recovery, and replenish depleted body stores. Nitrogen requirements are elevated.

Which of the following recommendations should be included in the nutrition care plan for a patient in the acute post liver transplant phase? a. Calorie restriction b. Increased sodium c. Decreased protein d. Increased protein

b. legumes, beans (Gropper CH 4, pg 127)

Which of the following types of foods contributes the most fiber in a usual serving? a. whole-grain breads b. legumes, beans c. meat, dairy d.leafy vegetables

a. Fungus (Gould CH 8, pg 150)

Which type of microbe causes Tinea infections? a. Fungus b. Virus c. Gram-negative bacterium d. Mite

Answer (key points): The amount of botulism used in Botox treatments is too small to cause botulism. (Beerman CH 5, p. 202)

Why don't people who get Botox treatments get botulism?

b. Parathyroid hormone (CH 24 Krause, p. 457) Vitamin D deficiency is associated with secondary hyperparathyroidism. This results in excessive parathyroid hormone secretion, which then stimulates bone resorption to maintain serum calcium concentrations. Excessive use of thyroid hormone or corticosteroids as medications can also contribute to bone loss. Glucagon has not been associated with risk of osteopenia.

A chronic elevation of which circulating hormone typically leads to an increase in bone resorption and bone loss? a. Thyroid hormone b. Parathyroid hormone c. Corticosteroid hormone d. Glucagon

c. Niacin (Beerman chapter 10, pg 432)

A deficiency of which vitamin was originally called mal del sol? a. Thiamin b. Riboflavin c. Niacin d.Biotin

a. lowers glycogen stores and promotes the use of fat for fuel. (CH 21 Krause, pg. 392) Aerobic activity benefits weight management by promoting calorie expenditure. As the duration of aerobic activity continues, glycogen stores are used, and then fat stores start being used as the body's energy source. This results in a decrease in body fat. In combination with resistance training, lean body mass is maintained or increased, causing an increase in resting energy expenditure and continued loss of body fat. Aerobic exercise improves the body's sensitivity to insulin.

Aerobic exercise is effective in weight management because it a. lowers glycogen stores and promotes the use of fat for fuel. b. decreases lean body mass in proportion to fat. c. increases resistance to insulin. d. decreases sensitivity to insulin.

ANS: B Ketone utilization disorder affects the metabolism of ketones; however, the provision of carnitine can help promote transport of fatty acids into the mitochondria and thus promote a decrease in ketone production. Patients with isovaleric acidemia, ornithine transcarbamylase deficiency, and tyrosinemia are all to be treated with protein restriction. In the case of tyrosinemia, this restriction would focus on tyrosine. REF: p. 902 (krause Ch 43)

Beyond fatty acid oxidation disorders, which other metabolic disorder is treated with supplemental carnitine? a. Isovaleric acidemia b. Ketone utilization disorder c. Ornithine transcarbamylase deficiency d. Tyrosinemia

c. matrix (CH 24 Krause, p. 456) The organic matrix or osteoid phase of bone consists mostly of collagen, which provides both the strength and flexibility of the bone. Osteocalcin and osteopontin are two proteins that occur in the osteoid phase. Cartilage is the connective tissue that occurs at the epiphyseal ends of bone.

Bone tissue consists of the mineral phase and the organic _____ phase. a. collagen b. cartilage c. matrix d. osteocalcin

c. cysts (Beerman CH 5, p. 204)

Both worms and protozoa form _____ that contaminate food. a. toxins b. mold c. cysts d. parasites

b. facilitating all immune system activity. (Gould CH 7, pg. 117)

CD4-positive helper T cells function by: a. direct cytotoxic action. b. facilitating all immune system activity. c. producing immunoglobulins. d. inactivating allergens.

d. It is a protein and would be destroyed by digestive enzymes (Beerman CH 4, p 150)

Why isn't insulin effective if taken orally? a. It is a very large molecule and cannot be absorbed b. It requires a transport protein that the body doesn't have c. It becomes "entangled" in the products of digestion in the intestines d. It is a protein and would be destroyed by digestive enzymes

b. inactive (Beerman CH 5, p. 177)

epsinogen is considered to be a proenzyme because it is_____. a. active b. inactive c. gastric in origin d. intestinal in origin

c. every 5 years. (CH 11 Krause, pg 184) The U.S. Dietary Guidelines were first published in 1980 and are revised every 5 years. The most recent guidelines were released in 2010.

Dietary Guidelines for Americans are revised a. every 2 years. b. every 10 years. c. every 5 years. d. as needed.

b. water (Gropper CH 12, pg 480)

During a marathon it is important to provide _____ to prevent dehydration from excessive sweat loss. a. electrolyte-fortified drinks b. water c. fruit juices d.carbonated beverages

a. Alcohol breakdown depletes NADPH. (Gropper CH 5, pgs 177,178)

During starvation, or when following a very-low-carbohydrate diet, the consumption of alcohol may cause hypoglycemia. Which of the following is NOT a contributing factor? a. Alcohol breakdown depletes NADPH. b. Alcohol breakdown favors the reduction of DHAP to glycerol-3-phosphate. c. Alcohol breakdown diminishes formation of alpha-ketoglutarate. d.Alcohol breakdown creates a high NADH:NAD ratio.

Answer: translation (Beerman CH 5, pp. 169)

During the process of _______________, amino acids are linked together via peptide bonds on ribosomes, using mRNA and tRNA

a. the entire genome for that organism. Gropper CH 1

Encoded within the nuclear DNA of each cell is a. the entire genome for that organism. b. the genes coding for proteins needed by that particular cell in the organism. c. chromatin. d.a cell-specific histone.

B p. 486,496 (Gropper CH 13)

Excessive intake of non-heme iron interferes with absorption of which mineral by an unknown mechanism? a. manganese b. zinc c. chromium d.selenium

Key:Citrate - allosterically stimulates acetyl-CoA carboxylase to promote FA synthesisPalmitate - allosterically inhibits acetyl-CoA carboxylase in FA synthesis (Gropper CH 5, pg 174)

Explain the regulation of the allosteric enzyme acetyl-CoA carboxylase by citrate and palmitoyl-CoA

b. triglycerides (Beerman CH 6, p. 229)

Fatty acids are typically found in food and in our bodies in the form of _____. a. enzymes b. triglycerides c. hormones d. glycerol

a. triglycerides, adipocytes (Beerman CH 6, p. 230)

Fatty acids not required for energy or other bodily functions are stored as _____ in specialized cells called _____. a. triglycerides, adipocytes b. fatty acids, fat depositories c. glycerol, lipid silos d.ketones, ketose depositories

Key: liver (and pancreas), muscle

Glucokinase located in the _____ is induced by insulin, and hexokinase located in the _____ is inhibited by glucose-6-phosphate.

a. By metabolizing fat and muscle protein (Beerman CH 4, p. 149)

How do the cells of diabetics compensate for the lack of glucose? a. By metabolizing fat and muscle protein b. By utilizing glycogen c. By metabolizing enzymes d. By utilizing glucagons

b. by inhibiting the activity of pancreatic lipase (Gropper CH 5, p. 147)

How does orlistat reduce absorption of dietary fat? a. by replacing dietary fat with a synthetic, indigestible substitute b. by inhibiting the activity of pancreatic lipase c. by binding free fatty acids and causing their excretion d.by inhibiting HMG-CoA reductase

Fluid balance is highly regulated and dependent on several essential minerals—sodium and chloride ions in extracellular fluid, and potassium and phosphate ions in intracellular fluid. To maintain the right balance of ions, cells make frequent adjustments by moving electrolytes into or out of cells. Plasma proteins (albumin) help maintain healthy fluid distribution between intravascular and interstitial compartments. (Beerman, CH 12)

How is fluid balance maintained in the body?

b. two (Beerman CH 6, p 231)

How many fatty acids does a phospholipid contain? a. one b. two c. three d.four

c. B lymphocytes (B cells). (Gould CH 7, pg. 115)

Humoral immunity is mediated by: a. natural killer cells. b. T lymphocytes (T cells). c. B lymphocytes (B cells). d. neutrophils.

tetany (Beerman, CH 12)

If Rick's muscles tighten and are unable to relax, Rick is experiencing _______________.

a. Insulin (Beerman CH 6, p. 231)

If you have just eaten a big holiday meal, which hormone stimulates your body to store triglycerides? a. Insulin b. Lipase c. Glucagons d. Epinephrine

c. cancer patients (Beerman CH 5, pp. 193,194)

In industrialized countries such as the U.S., one would be most likely to see protein-energy malnutrition among _____. a. vegetarians b. athletes c. cancer patients d. teenagers

a. choline (Beerman chapter 10, pg 450)

In order to be absorbed, _____ obtained from lecithin needs to be cleaved from its glycerol backbone by pancreatic enzymes. a. choline b. vitamin B12 c. vitamin B6 d.niacin

oxidized, cholic, chenodeoxycholic Gropper CH 2 page 49

In the hepatocyte, cholesterol is _____ into the two primary bile acids, _____ and _____ acids.

c. calcium (Beerman CH 4, pg. 132)

It is important for lactose intolerant individuals to be sure that their diet provides excellent sources of ____, the mineral abundant in milk. a. sodium b. zinc c. calcium d. iron

c. grapes (Beerman CH 5, pp. 212, 213)

José will soon be traveling to several foreign countries. To decrease his chances of contracting a foodborne illness, he should avoid drinking water from the local source and eating _____. a. cooked beef b. bread c. grapes d. grilled chicken

a. LDL, increases (Gropper CH 5, pg 163)

Lp(a) is a genetic variant of _____; its presence _____ a genetic predisposition to heart disease. a. LDL, increases b. HDL, decreases c. LDL, decreases d.HDL, increases

a. increasing the synthesis of constitutive enzymes Gropper CH 1

Maintaining balance in the regulation of metabolic pathways necessary for life of the organism includes all of these catalytic regulatory mechanisms EXCEPT _____. a. increasing the synthesis of constitutive enzymes b. covalent modification through hormone stimulation c. modulation of allosteric enzymes d.increasing adaptable enzyme concentration by induction

c. phosphorus (Gropper Chap 11, pg 443)

Malnourished individuals being refed who exhibit the "refeeding syndrome" may have low serum concentrations of _____. a. calcium b. sodium c. phosphorus d.chloride

b. serotypes (Beerman CH 5, p. 199)

Microorganisms have several genetic strains or types called _____. a. genotypes b. serotypes c. mutants d.variants

c. Riboflavin (Beerman chapter 10, pg 428)

Milk is packaged in opaque containers to protect which one of the following vitamins from being destroyed by exposure to light? a. Niacin b. Thiamin c. Riboflavin d.Folate

d. blood, liver (Beerman CH 5, p. 178)

Most amino acids enter your _____ and circulate to the _____. a. lymph, liver b. lymph, pancreas c. blood, pancreas d. blood, liver

c. at the brush border. Gropper CH 2 page 44

Most of the digestive enzymes produced by the intestinal enterocytes function a. in the stomach. b. in the intestinal lumen. c. at the brush border. d. within the cytoplasm of the enterocytes.

b.increased (Gropper Chap 10, pg 412)

Mr. S. takes warfarin due to his valve replacement surgery. He is an avid gardener and enjoys eating the many green leafy vegetables he grows. You caution Mr. S. to tell his physician about this because the amount of warfarin he takes may need to be _____ a. decreased b.increased

a. FDA (Beerman CH 5, p. 206)

Several federal agencies including the USDA, EPA, and _____ are charged with determining whether compounds in foods can be dangerous to consume. a. FDA b. ADA c. AMA d. WHO

d. type 2 diabetes. (Beerman, Ch 12)

Several scientific studies has shown evidence that coffee reduces the risk of: a. multiple sclerosis. b. breast cancer . c. heart disease. d. type 2 diabetes.

a. plant sterols (Beerman CH 6, p. 236)

The FDA has approved a health claim that indicates that including at least 3.4 grams of _____ in two meals daily may reduce the risk of heart disease. a. plant sterols b. aspirin c. "light" margarine d.yogurt

D p. 531, 534 (Gropper CH 13)

The addition to the diet of which food will alleviate the problem of endemic goiter? a. cabbage b. broccoli c. cassava d.iodized salt

c. 50% (Beerman CH 4, p. 143)

The average daily intake of fiber in the U.S. equals about _____ of what is recommended. a. 25% b. 33% c. 50% d.66%

b. glycerol (Beerman CH 6,p. 236)

The basic goal of triglyceride digestion is to separate most of the fatty acids from the _____ molecule they are attached to. a. glucose b. glycerol c. sterol d.phosphate

c. zymogens Gropper Chapter 2 page 38-39

The chief cells secrete _____. a. gastrin b. mucus c. zymogens d.hydrochloric acid

c. ATP. Gropper CH 1

The energy pool that serves as the major linking intermediate between energy-yielding and energy-demanding chemical reactions is: a. activation energy. b. NAD. c. ATP. d.free energy.

True Beerman, CH 12

The kidneys appear to be the main regulators of magnesium levels in the body.

d.all of the above (Gropper CH 4, p. 129)

The kind and amount of phytochemicals in a plant varies with a. environmental conditions during plant growth. b. stage of ripeness. c. storage conditions. d.all of the above

a. nucleus (Beerman CH 5, p. 174)

The master plan for all the proteins synthesized in the body can be found in the DNA located in a cell's _____. a. nucleus b. cytoplasm c. ribosome d. membrane

c. Pneumocystis carinii pneumonia. (Gould CH 7 pg. 135)

The most common cause of death in patients who have AIDS is: a. HIV encephalopathy. b. tuberculosis. c. Pneumocystis carinii pneumonia. d. Candida infection.

b. cow's milk allergy. (CH 26 Kruase, p. 487) Allergy to cow's milk protein is the most common food allergy among infants, with a prevalence of 2.5% in the first 3 years of life. During this same period, limiting exposure to peanuts and tree nuts will reduce the chances of the infant developing allergies to these foods.

The most common food allergy found among infants is a. cereal allergy. b. cow's milk allergy. c. fruit allergy. d. vegetable protein allergy.

d.in vivo functional tests. (Gropper Chap 9, pg 324-325)

The most common tests of thiamin status include all the following EXCEPT: a. static tests of urinary thiamin metabolites. b. a static test of serum thiamin. c. an in vitro functional test of RBC enzyme. d.in vivo functional tests.

c. natural product use. (CH 12 Krause, pg 193) Use of "natural products" is the most commonly reported CAM practice, particularly among women, people with higher education, and people who had been hospitalized within the past 12 months. Prayer is a commonly used CAM practice among blacks. Non-Hispanic whites use meditation and herbals more frequently than other ethnic groups.

The most commonly reported CAM practice in the United States is a. prayer. b. meditation. c. natural product use. d. herbal supplement use.

a. hyperthermia (Gropper CH 12, pg 479)

The most important problem resulting from dehydration during exercise is _____. a. hyperthermia b. hyponatremia c. loss of electrolytes d.excessive sweating

d.carnitine synthesis (Gropper Chap 9, pg 317)

The necessity of ascorbic acid for its role in _____ is believed to be the reason that people with scurvy have no energy and are very tired. a. collagen synthesis b. creatine synthesis c. hormone activation d.carnitine synthesis

c. acinar exocrine cells that produce digestive enzymes. Gropper CH 2 page 47

The pancreas is a digestive system accessory organ with two types of active tissue, the ductless endocrine cells that secrete insulin and glucagon and the a. liver-like cells that produce bile. b. ductless absorptive tissue that controls bicarbonate. c. acinar exocrine cells that produce digestive enzymes. d.erythropoietic cells that produce red blood cells.

sodium, bicarbonate Gropper CH 2 page 53

The proximal colonic epithelial cells absorb water and the major cation _____. In contrast, potassium and the anion _____ are secreted into the lumen of the colon.

c. recognize the antigen and stimulate the immune response. (Gould CH 7, pg. 115)

The role of memory cells is to: a. change into an antibody-secreting cell following activation. b. immediately secrete antibodies following the first exposure to antigen. c. recognize the antigen and stimulate the immune response. d. bind complement to the antibody.

b. Endosperm (Beerman CH 4, pg 128)

The starch can be found in which component of grain? a. Germ b. Endosperm c. Bran d. All of the above

Answer: gene therapy (Beerman CH 5, p. 171)

The use of altered genes to enhance health is known as _______________.

c. in the nucleus. (Gropper Chap 10, pg 394, 395)

The vitamin D response element (VDRE) is found a. on the enterocyte membrane. b. on the renal tubule. c. in the nucleus. d.in the pancreatic duct cell.

c. ariboflavinosis (Beerman chapter 10, pg 429)

The vitamin deficiency _____ is characterized by cheilosis, stomatitis, glossitis, muscle weakness, and confusion. a. beriberi b. pellagra c. ariboflavinosis d.pernicious anemia

D. p. 289-290 (Gropper CH 8)

Thermogenesis is the a. generation of water. b. burning of fat. c. synthesis of fat. d.generation of heat.

c. are structurally "organic." (Beerman chapter 10, pg 419)

Though each vitamin is chemically distinct from the others, all vitamins: a. contain nitrogen. b. consist of sugar units. c. are structurally "organic." d.contain only double bonds.

a. glycerol (Beerman CH 6, p. 229)

Triglycerides consist of a _____ molecule chemically bonded to three fatty acids. a. glycerol b. glycogen c. glucose d. glucagon

False: (Beerman CH 4, pgs 130,131.

True of False: The majority of starch digestion takes place in the mouth

False: (Beerman CH 5, p. 169)

True or False: The number of sequences of amino acids in a single polypeptide chain is called the sequential structure of a protein.

True (Beerman CH 5, p. 202)

Ture or False: Noroviruses are examples of pathogens that produce enteric toxins.

b. epinephrine and glucagon CH 3 Gropper, page 83

Two hormones that stimulate glycogenolysis in the muscle and liver, respectively, are _____. a. cortisol and epinephrine b. epinephrine and glucagon c. insulin and epinephrine d.glucagon and insulin

ANS: C Wernicke encephalopathy is a potentially reversible, yet serious disorder caused by thiamin deficiency. It is commonly associated with heavy alcohol consumption. It can also be seen after bariatric surgery. Although EPA and DHA are important to brain health, they are not used to treat this disorder. REF: p. 845 (Krause CH 41)

Wernicke encephalopathy can be treated with what nutrient(s)? a. EPA and DHA b. Vitamin C c. Thiamin d. Zinc

Answer (key points): Since freezing kills many parasites, it may be prudent to choose to consume only sushi that has been made with previously frozen fish. (Beerman CH 5, p. 205)

What can you do to protect yourself from foodborne illnesses while enjoying sushi made from fish?

a. Dry beriberi (Beerman chapter 10, pg 427)

What disease is characterized by severe muscle wasting, leg cramps, tenderness, and decreased feeling in the feet and toes? a. Dry beriberi b. Wet beriberi c. Infantile beriberi d.Cerebral beriberi

b. Copper or iron atoms (Beerman chapter 10, pg 445)

What does vitamin C "re-charge" via redox reactions so that enzymes are able to catalyze another reaction? a. Iron and zinc atoms b. Copper or iron atoms c. Copper or zinc atoms d.Iron and magnesium

b. Thiamin deficiency (Beerman chapter 10, pg 427)

What is beriberi? a. Niacin deficiency b. Thiamin deficiency c. Folate deficiency d.Iron deficiency

d.50 to 80 mg/dL (Gropper CH 5, pg. 176)

What is considered the toxic level of blood ethanol? a. less than 10 mg/dL b. 11 to 24 mg/dL c. 25 to 45 mg/dL d.50 to 80 mg/dL

d.National Health and Nutrition Examination Survey CH 1 Beerman, page 16

What is the large, ongoing epidemiologic study to simultaneously monitor nutrition and health in the U.S. population called? a. Nutrition, Health, and Nurturing Exploratory Study b. Nationwide Historic and Nutritional Examination Study c. Nationwide Home and Nutritional Exploratory Survey d.National Health and Nutrition Examination Survey

d. Milk (Beerman CH 4, 118)

What is the major food source of galactose? a. Fruit b. Whole grains c. Vegetables d. Milk

a. oxidative phosphorylation Gropper CH 1

What is the major route for ATP production? a. oxidative phosphorylation b. hydrolysis c. peroxidation d.transformation

c. Sodium (Beerman, 12)

What is the most abundant cation in the extracellular fluids? a. Potassium b. Magnesium c. Sodium d. Chloride

a. Potassium (Beerman, 12)

What is the most abundant cation in the intracellular fluids? a. Potassium b. Magnesium c. Sodium d. Chloride

c. cholesterol (Gropper CH 5, pg. 142)

What is the most common lipid characterized by a four-ring core structure found in animals? a. prostaglandins b. leukotrienes c. cholesterol d.glycolipids

c. Glycemic response (Beerman CH 4, pg. 133)

What is the term for the impact of different foods on the size and duration of the rise in blood glucose after a meal? a. Sugar spine b. Glucagon spike c. Glycemic response d. Carbohydrate reaction

d.To yield glucose, fructose, and galactose (Beerman CH 4, pg. 129,133)

What is the ultimate goal of carbohydrate digestion? a. To yield maltose, sucrose, and insoluble fiber b. To yield soluble fiber, lactose, and sucrose c. To yield glucose, sucrose, and maltose d.To yield glucose, fructose, and galactose

a. 2300 mg/day (Beerman, 12)

What level of sodium intake should be the maximum for the general population? a. 2300 mg/day b. 3000 mg/day c. 3800 mg/day d. 4400 mg/day

small intestines, kidneys (Beerman, CH 12)

What regulates blood levels of magnesium? a. Bone, hormones b. Small intestine, kidneys c. Large intestine, liver d. Stomach, chylomicrons

b-kidneys (Beerman, 12)

What tissues do both parathyroid hormone (PTH) and vitamin D act on to increase calcium reabsorption? a. Bone b. Kidneys c. Liver d. Small intestine

a. Cellulose (Beerman CH 4, pg . 126)

What type of dietary fiber is most prevalent in whole-grain flour, seeds, carrots, and peppers? a. Cellulose b. Hemicellulose c. Lignin d. Pectin

c. RS3 (Gropper CH 4, pg 116)

What type of resistant starch is formed during food processing such as the cooking and cooling of starchy foods? a. RS1 b. RS2 c. RS3 d.RS4

d. Peppermint (CH 27 Krause, p. 513) Peppermint is known to decrease the lower esophageal sphincter pressure, contributing to the development of esophageal reflux. High-acid foods may cause pain in the esophagus when it is already inflamed. Milk, yogurt, and high-protein foods may temporarily buffer gastric secretions, but they also stimulate the secretion of gastrin, pepsin, and acid

What type(s) of foods should be avoided in a patient with GERD because it(they) decrease(s) LES pressure? a. High-acid foods b. Low-fat milk and yogurt c. High-protein foods d. Peppermint

b. serves as a splint across the fracture site. (Gould CH 9, 166)

When a fracture is healing, the procallus or fibrocartilaginous callus: a. can bear weight. b. serves as a splint across the fracture site. c. is the tissue that lays down new cartilage. d. is made up of new bone.

b. acidosis. (Gropper CH 12, pg 470)

When the plasma concentration of H ions exceeds the normal range the condition is called: a. alkalosis. b. acidosis.

c. excreted in the urine. (Gropper Chap 9, pg 308)

When water-soluble vitamins are consumed in excess of body needs, generally the excess is: a. excreted in the feces. b. stored in liver, bone, and adipose tissue. c. excreted in the urine. d.not absorbed.

a. In the mouth (Beerman CH 6, p. 236)

Where does lipid digestion begin? a. In the mouth b. In the stomach c. In the small intestine d.In the large intestine

b. Stomach (Beerman CH 5, p. 177)

Where does the chemical digestion of protein begin? a. Mouth b. Stomach c. Duodenum d. Ileum

a. 0 to 2 years of age (CH 26 Krause, p. 479) Infants younger than 2 years of age are more likely to develop food allergies than are older children and adults. The incidence of food allergies is estimated to be 4% to 7% in children and from 1% to 2% in adults.

Which age group is most likely to develop food hypersensitivity? a. 0 to 2 years of age b. 3 to 12 years of age c. Adolescents d. Elderly

a. apo-C2 (Gropper CH 5, pg. 153)

Which apolipoprotein is key to the delivery of triacylglycerol to tissues? a. apo-C2 b. apoA-1 c. apoE d.apoB-100

d.osteoblasts (Gropper Chap 11, pg 432)

Which cells are considered the bone-building cells? a. osteonectins b. osteopontins c. osteoclasts d.osteoblasts

b. Macrophages (Gould CH 7, p. 115)

Which cells are required to process and present antigens from foreign material as the initial step in the immune response? a. T-helper cells b. Macrophages c. Eosinophils d. Monocytes

a. Germ (Beerman CH 4, pg. 128)

Which component of grain is rich in vitamins and minerals? a. Germ b. Endosperm c. Bran d. All of the above

a. pancreatic lipase (Gropper CH 5, pg. 147)

Which enzyme will act on corn oil in the small intestine? a. pancreatic lipase b. lecithin cholesterol acyl transferase c. cholesterol esterase d.lipoprotein lipase

d. K (Gropper Chap 10, pg 410-412)

Which fat-soluble vitamin appears to operate as a coenzyme that modifies proteins to bind with calcium? a. A b. β-carotene c. E d.K

b. vitamin E (Gropper Chap 10, pg 403, 404)

Which fat-soluble vitamin has as its principal function the maintenance of membrane integrity? a. vitamin D b. vitamin E c. vitamin A d.vitamin K

a. Fructose (Beerman CH 4, pg. 117)

Which monosaccharide is the most abundant "sugar" in fruits and vegetables? a. Fructose b. Glucose c. Maltose d. Galactose

b. Osteoblasts (CH 24 Kruase, p. 456) Osteoblasts are the cells responsible for the formation of bone tissue. Osteocytes are formed by osteoblasts and are incorporated into the mineralized bone. Osteoclasts are responsible for the resorption or breakdown of bone. Osteocalcin is a matrix protein of bone.

Which of the following are bone-forming cells? a. Osteocytes b. Osteoblasts c. Osteoclasts d. Osteocalcins

d. Begins as a red papule and develops into silvery plaques (Gould CH 8, pg. 147)

Which of the following best describes the typical lesion of psoriasis? a. Purplish papules that can erode and become open ulcers b. Firm, raised pruritic nodules that can become cancerous c. Moist, red vesicles, which develop into bleeding ulcers d. Begins as a red papule and develops into silvery plaques

b. fructans (Gropper CH4, pg 115)

Which of the following fibers stimulate the growth of bifidobacteria and thus are considered prebiotics? a. lignins b. fructans c. beta-glucans d.cellulose

b. Pork (Beerman chapter 10, pg 424, 425)

Which of the following foods provides a good source of thiamin? a. Apples b. Pork c. Milk d.Broccoli

b. amylopectin Ch 3 Gropper, pg 68

Which of the following homopolysaccharides made of glucose contributes the most energy to the ordinary diet? a. amylose b. amylopectin c. glycogen d.cellulose

d. bicarbonate (Gropper CH 12, pg 461)

Which of the following is NOT a cationic electrolyte of extracellular fluid? a. sodium b. potassium c. calcium d.bicarbonate

d. spleen Gropper Chapter 2 34, 47

Which of the following is NOT considered an accessory organ? a. pancreas b. liver c. gallbladder d. spleen

c. Increased glucose absorption and insulin response (CH 27 Krause, p. 522) Pectin and guar gums used in the treatment of patients with dumping syndrome provide the benefits of reducing upper GI transit time, slowing down or decreasing the rate of glucose absorption and the glycemic load, and decreasing the insulin response. A potential caution in regard to using pectin or bulk fiber sources is in regard to the development of intestinal obstructions from using large amounts.

Which of the following is NOT one of the benefits of using pectin to manage dumping syndrome? a. Reduced upper gastrointestinal tract transit time b. Reduced glycemic load and decreased insulin response c. Increased glucose absorption and insulin response d. Slow carbohydrate absorption

c. Lecithin (Beerman CH 6, p. 232)

Which of the following is a common phospholipid often used as a stabilizer in food? a. Agar b. Ascorbic acid c. Lecithin d. Gum Arabic

c. Proline (Beerman CH 5, p. 164)

Which of the following is a nonessential amino acid? a. Isoleucine b. Leucine c. Proline d. Valine

c. Changes in genital size (CH 23 Krause, p. 450) Androgenic effects of steroid use include the development of the secondary sex characteristics of men, such as changes in genital size and function and growth of auxiliary pubic and facial hair. Anabolic effects of steroid use include increases in muscle mass, bone mineral density, and blood cell production; a decrease in body fat; increased size of the heart, liver, and kidneys; changes in the vocal cords; and increased libido.

Which of the following is a potential androgenic effect of taking steroids? a. Decreased body fat b. Increased libido c. Changes in genital size d. Vocal cord changes

a. Brewed tea (CH 25 Krause, p. 472) Most foods, unless prepared with fluoridated water, contain minimal amounts of fluoride, except for brewed tea.

Which of the following is a significant food source of fluoride? a. Brewed tea b. Beef c. Coffee d. Spinach

b. The longer Michelle exercises, the more water she needs Beerman CH 1, page 14

Which of the following is an example of a positive correlation? a. The less John eats, the more muscle mass he loses b. The longer Michelle exercises, the more water she needs c. The more vitamins Sam consumes, the less energy he has d.The more kcalories Mike eats, the less energy he uses

a. 11-cis retinal (Gropper Chap 10, pg 380)

Which of the following is needed for the visual cycle? a. 11-cis retinal b. 9-cis retinoic acid c. lycopene d.cryptoxanthin

c. They tend to have extra body fat. (Beerman CH 4, p. 157)

Which of the following is true of babies born to mothers with poorly controlled diabetes? a. They tend to be underweight. b. They tend to be under developed. c. They tend to have extra body fat. d. They tend to be born with type 1 diabetes.

a. carnitine (Gropper Chap 9, pg 312)

Which of the following molecules synthesized with the help of vitamin C underscores the importance of vitamin C to fat metabolism? a. carnitine b. collagen c. tyrosine d.norepinephrine

c. Fat (Beerman CH 6, p. 231)

Which of the following nutrients can the body store the most of in the least amount of space? a. Protein b. Glucose c. Fat d.Glycogen

c. The infection is highly contagious. (Gould CH 8, pg 148). Impetigo is a common and highly contagious skin infection that mainly affects infants and children

Which of the following statements applies to impetigo? a. Lesions usually appear on the hands and arms. b. The cause is usually a virus. c. The infection is highly contagious. d. Scar tissue is common following infection.

d. Milk, eggs, and meat (Beerman CH 6, p. 228)

Which of the foods listed below is most likely to provide you with a dietary source of saturated fatty acids? a. Green, leafy vegetables b. Nuts, salad dressings, and cooking oils c. Fruits and whole grains d. Milk, eggs, and meat

d. Tofu (Beerman CH 6, p. 235)

Which of the grocery items below does not contain significant amounts of cholesterol? a. Lean beef b. Chicken breast c. Pork loin d. Tofu e.2% milk

a. Amylose (Beerman CH 4, pgs. 123,124)

Which type of starch is linear in appearance? a. Amylose b. Amylopectin c. Glycogen d. Dietary fiber

b. D (Beerman, 12)

. What vitamin is required for calcium absorption in the small intestine? a. A b. D c. E d. K

a. B12 (Gropper Chap 9, pg 349, 350)

5-methyl THF requires the action of which vitamin in order to form THF? a. B12 b. B2 c. niacin d.C

b. 200 to 350 g of carbohydrate and is low in fat. (CH 23 Krause, p. 434) Providing 200 to 350 g of carbohydrate (or 4 g/kg) is sufficient to replenish muscle glycogen and provide for additional blood sugar. The meal should be eaten 3 to 4 hours before the event, and it should not provide more than 25% of total calories from fat. This is to ensure adequate emptying of the stomach before the activity. Some protein can be included but should not be emphasized, particularly in relation to animal sources, because these can increase the fat intake during the meal.

A desirable pre-event meal 3 to 4 hours before competition is one that provides a. high fiber and vitamin content. b. 200 to 350 g of carbohydrate and is low in fat. c. an equal mix of protein and carbohydrate. d. 200 to 350 g of protein and fat and is low in carbohydrate.

d. the virus and its antibodies are present in the blood. (Gould CH 7, pg. 131)

A diagnosis of HIV positive means that: a. the number of T lymphocytes in the circulating blood is decreased. b. significant opportunistic infection is present in the body. c. the individual has AIDS. d. the virus and its antibodies are present in the blood.

d. a and c (Beerman CH 6, p. 223)

A fatty acid designated as 18:1 has: a. 18 carbons. b. 18 carbons in the backbone. c. 1 double bond. d. a and c e. b and c

B. p. 508 (Gropper CH 13)

At the cellular level, which mineral interacts with vitamin A by promoting growth and helping to synthesize retinol-binding protein? a. cobalt b. zinc c. silicon d. chromium

a-Blood (Beerman, Ch 12)

By what means do all major minerals circulate from the gastrointestinal tract to the liver? a. Blood b. Lymph c. Chylomicrons d. Micelles

c. caroxylation of osteocalcin and matrix Gla protein (Gropper Chap 11, pg 452)

By what mechanism is vitamin K thought to protect bone health? a. buffering for acid-base balance b. diminishing bone resorption c. caroxylation of osteocalcin and matrix Gla protein d.contributing to the integrity of bone collagen

c. Not used as food because of potential cross-reactivity (CH 26 Kruase,, pp 495-7) Goat's milk should not be used during the first year of life because of a potential cross-reactivity with beta-lactoglobulin in cow's milk. Also, goat's milk is low in folic acid and has a high renal load. Goat's milk needs to be supplemented with iron; folacin; and vitamins A, C, and D. It needs to be diluted to three-quarter strength, and carbohydrate has to be added to reduce the renal solute load.

If an infant is allergic to cow's milk, how should goat's milk be used? a. As a food source for the first 6 months of life b. As a food source for the first year of life c. Not used as food because of potential cross-reactivity d. Not used as food because it is too low in fat

b. bradycardia. (CH 22 Krause, pg 410) Cardiovascular complications may include bradycardia, orthostatic hypotension, cardiac arrhythmias, and pericardial effusion.

In conjunction with anorexia nervosa, cardiovascular complications may include a. amenorrhea. b. bradycardia. c. edema. d. ventricular enlargement.

d. Body image (CH 18 Krause, pg 340) During the early adolescence period, adolescents are concerned with their body size, shape, and image. Seeking increased independence and trusting in adults decreases during middle adolescence. Future orientation is characteristic of late adolescence.

In early adolescence, which of the following is most likely to be a concern to the adolescent? a. Independence b. The future c. Trusting adults d. Body image

c. 75% (CH 13 Krause, pg 223) When a patient is meeting 75% of nutrition needs through either enteral or parenteral nutrition, the parenteral nutrition may be discontinued. This process may take up to 2 to 3 days as the patient is weaned from parenteral nutrition. Parenteral nutrition administration is not stopped at once because this could contribute to fluid and electrolyte imbalances or rebound hypoglycemia.

In general, a patient's parenteral feeding can be discontinued when enteral nutrition meets _____ of the patient's need. a. 25% b. 50% c. 75% d. 100%

b. VLDLs (Gropper CH 5, pg. 153)

In response to excess dietary carbohydrate and chylomicron remnants, the liver synthesizes _____ to transport triacylglycerol. a. chylomicrons b. VLDLs c. LDLs d.HDLs

d. High-fiber diet (CH 28 Krause, p.544) The medical nutrition therapy for patients with inflammatory bowel disease is highly variable and individualized depending on acuteness and exacerbation of the disease. Because of problems with flare-ups and diarrhea, low-residue and lactose-free diets may be instituted. Commonly, parenteral nutrition may be used to promote nutritional repletion or to maintain nutritional status when oral and enteral intakes are not tolerated. A high-fiber diet is least likely to be used because the presence of fiber could aggravate the affected regions of the bowel. However, investigation into the use of prebiotic foods and fibers may help control the intestinal flora associated with IBD.

In the MNT for inflammatory bowel disease, which of the following is LEAST likely to be used? a. Low-residue diet b. Parenteral nutrition c. Lactose-free or reduced diet d. High-fiber diet

d.bile acids (Beerman CH 6, p. 234)

In the body, cholesterol is incorporated into cell membranes and is used to synthesize many hormones and _____. a. vitamin C b. digestive enzymes c. vitamin K d.bile acids

Bicarbonate and carbonic acid (Ch 6, Krause) Bicarbonate and carbonic acid buffer the production of hydrogen ions and carbon dioxide that results from cellular metabolism, and this occurs primarily in the extracellular space. The phosphate buffering system and protein buffering are activities that more commonly occur in the intracellular space. REF: p. 93 | p. 95

In the extracellular space, what is the primary buffer system? a. Phosphate b. Bicarbonate and carbonic acid c. Hydrogen d. Protein

a. micelles (Beerman CH 6, p. 238)

In the first phase of intestinal triglyceride digestion, large lipid molecules are dispersed into smaller lipid droplets called _____ so that they will not separate out into an oily layer and thus can be further digested. a. micelles b. emulsions c. suspensions d. globules

b. 10 to 15 lbs. (Beerman CH 4, p 154)

In the management of type 2 diabetes, how much weight loss is required to see a reduction in blood glucose levels? a. 5 to 10 lbs. b. 10 to 15 lbs. c. 15 to 20 lbs. d. 20 to 25 lbs.

c. biotin, avidin (Beerman chapter 10, pg 437)

In the movie "Rocky," the main character drank shakes with raw eggs. Consequently, the bioavailability of _____ may have been reduced by the _____ in the eggs. a. thiamin, avidin b. thiamin, antithiamin factors c. biotin, avidin d.biotin, cobalamin

Α p. 488 (Gropper CH 13)

In the presence of low intracellular iron, the binding of iron regulatory protein (IRE-BP) to iron response elements (IRE) present on the ferritin mRNA: a. results in a decrease in ferritin abundance. b. results in an increase in ferritin abundance. c. occurs only when intracellular iron concentrations are high. d.doesn't occur.

d. phosphorus (Gropper Chap 11, pg 442)

In the renal system, which mineral regulates body fluid pH by reacting with secreted hydrogen ions, releasing sodium ions in the process? a. sulphur b. magnesium c. calcium d.phosphorus

c. 20 (Beerman CH 5, p. 163)

In total, humans need how many different amino acids? a. 14 b. 18 c. 20 d.24

micelles (CH 1, Krause) pg 13 Fats must be emulsified into micelles so that they may cross the unstirred water layer that borders the brush-border membranes. These micelles leave monoglycerides and fatty acids at the brush border, where they are reabsorbed and reassembled as triglycerides. The triglycerides are packaged with cholesterol, fat-soluble vitamins, and phospholipids into chylomicrons, which pass into the lymphatic circulation. When these reach the liver, the chylomicron components are repackaged into low-density lipoproteins.

In what form is dietary fat absorbed from the lumen of the intestine? a. Chylomicron b. Micelle c. Triglyceride d. Lipoprotein

c. glycogenolysis. (Beerman CH 4, pg. 138)

Insulin does not promote: a. protein synthesis. b. uptake of glucose into muscle and adipose tissue cells. c. glycogenolysis. d. fat synthesis in adipose tissue.

b. the beta-cells of the pancreas (Beerman CH 4, pl 149)

Insulin is produced by: a. the alpha-cells of the pancreas. b. the beta-cells of the pancreas. c. the gamma-cells of the pancreas. d. a and b e. b and c

A p. 534 (Gropper CH 13)

Iodine deficiency associated with growth problems results in _____. a. cretinism b. Keshan disease c. goitrin d.goiter

b. fat (Beerman CH 4, p 149)

Ketoacidosis can result from the use of a large amount of _____ for energy. a. glycogen b. fat c. protein d. galactose

d.acetyl-CoA. (Gropper CH 5 pg 166)

Ketones are produced from: a. cholesterol. b. hormones. c. amino groups. d.acetyl-CoA.

c. choline. (Beerman chapter 10, pg 449)

Mayonnaise and salad dressings contain significant amounts of: a. vitamin B6. b. vitamin B12. c. choline. d.niacin.

c. the frequency of suckling. (CH 15 Krause, pg 285) Although the diet of the mother does affect the milk composition, the frequency of suckling has the biggest effect on milk production.

Milk production is most affected by a. calories consumed by the mother. b. mother's hydration status. c. the frequency of suckling. d. protein consumed by the mother.

a. glucose (Gropper Chap 9, pg 310)

Most animals synthesize their own ascorbic acid from _____. a. glucose b. glutamine c. glycogen d.alanine

c. Semi-volatile organic compounds (CH 21 Krause, pg 384) Semi-volatile organic compounds (SVOCs) accumulate in adipose tissues from exposure to toxins, chemicals, and pesticides. When adipose tissue is mobilized during weight loss, SVOCs are released. Obese women should lose weight before becoming pregnant because the impact of SVOCs on the developing fetal brain is not yet known. Ghrelin is a hormone produced primarily by the stomach and acts on the hypothalamus to stimulate hunger and feeding. Insulin acts in the central nervous system and the periphery nervous system to regulate food intake and is involved in the synthesis and storage of fat. Adipose tissue actively secretes a wide range of pro- and anti-inflammatory cytokines, but these have not been shown to be detrimental to pregnancy.

Obese women should lose weight before becoming pregnant because of the possible impact of what compound released when adipose tissue is mobilized? a. Ghrelin b. Insulin c. Semi-volatile organic compounds d. Pro- and antiinflammatory cytokines

c. Dried beans, soybeans, peas, and/or lentils (Beerman CH 4, pg. 121)

Oligosaccharides can be found in which of the following foods? a. Apples, oranges, and/or grapes b. Cereal, rice, and/or potatoes c. Dried beans, soybeans, peas, and/or lentils d. Hamburger, chicken, and/or pork

b. liver (Beerman CH 4, pg 133)

Once absorbed, monosaccharides are first carried in the blood away from the small intestine and to the _____. a. central nervous system b. liver c. muscle d.gallbladder

a. a delay in initial diagnosis. (Gould CH 8, pg 149)

One factor that is responsible for increasing the mortality rate among patients suffering with necrotizing fasciitis is: a. a delay in initial diagnosis. b. lack of proper antibiotics. c. the appearance of additional opportunistic infections. d. secondary fungal infections.

c. swelling of the cell. Gropper CH 1

One trigger of apoptosis is a. overexpression of Bcl-2. b. inactivation of Casp-9. c. swelling of the cell. d.release of mitochondrial cytochrome c.

d.all of the above (Gropper CH 4, pg 114)

Pectins are part of the cell wall and middle lamella and are _____. a. water soluble b. gel forming c. stable at acidic pHs d.all of the above

c. tyrosine (Beerman CH 5, p. 165)

People born with an inborn error of metabolism called PKU cannot convert phenylalanine to _____. a. tryptophan b. casein c. tyrosine d. aspartame

d. vitamin C. (Beerman chapter 10, pg 445)

Peppers, papayas, and peas contain a very good source of: a. niacin. b. vitamin B12. c. vitamin B6. d.vitamin C.

c. integral proteins Gropper CH 1

Proteins attached to the membrane through hydrophobic interactions and embedded in the membrane are called _____. a. peripheral proteins b. rough endoplasmic reticulum c. integral proteins d. Golgi apparatuses

that is caused by Clostridium difficile infection. (CH 8 Krause pg 132) The desired effects of medications often are accompanied by effects that are considered undesirable. Side effects are often an extension of the desired effects, such as bacterial overgrowth, as a result of use of an antibiotic. Overgrowth of C. difficile causes pseudomembranous colitis. Suppression of natural oral bacteria may lead to oral yeast overgrowth, or candidiasis.

Pseudomembranous colitis is a serious side effect of antibiotic therapy a. that results from a food-drug interaction. b. that is caused by Clostridium difficile infection. c. that can be avoided with good nutrition. d. related to hypertension.

c. potassium (Gropper CH 12, pg 475, 476)

Research has shown that supplements of which mineral are associated with significant reductions in both systolic and diastolic blood pressure, especially in individuals with hypertension? a. magnesium b. calcium c. potassium d.sodium

a. 1, 2 (Gould CH 7, p. 135)

Serious infections frequently occurring in patients with AIDS include: 1. tuberculosis. 2. Pneumocystis carinii pneumonia. 3. influenza. 4. tetanus. a. 1, 2 b. 1, 4 c. 2, 3 d. 3, 4

a. the government, which sets individual standards. (CH 11 Krause, pg 184) Serving sizes of products are set by the government based on reference amounts commonly consumed.

Serving size on nutrition labels is determined by a. the government, which sets individual standards. b. the manufacturer of the product. c. the types of stores that sell the product. d. the package size of the product.

c. disaccharides (Beerman CH 4, pg. 115)

Simple carbohydrates include monosaccharides and _____. a. amylose b. amylopectin c. disaccharides d. pectins

c. Staphlococcus aureus (Beerman CH 5, p . 201)

Some organisms such as _____ produce toxic substances that cause serious and rapid reactions such as nausea, vomiting, and sometimes neurological damage. a. Salmonella b. Camplybacter jejuni c. Staphlococcus aureus d. E. coli

d. less than 55 (Beerman CH 4, pg 134)

Suppose that Alicia wants to include foods in her diet that may lower her risk of developing cardiovascular disease. To do this, she should choose foods with a glycemic index of _____. a. at least 100 b. 75-95 c. 60-70 d. less than 55

True

T or F Although many enzymes in a given pathway are bidirectional, often the key enzymes are unidirectional (i.e., only work in one direction).

b. Reactive hyperglycemia (Beerman CH 4, pgs. 141-142)

Tammy, a type 1 diabetic, has been sick for more than a week. She has had no appetite at all and consequently has not been able to eat much of anything. What is likely causing the lack of appetite? a. Hypoglycemia b. Reactive hyperglycemia c. Ketosis

b. dihydrofolate reductase (Gropper Chap 9, pg 350)

Tetrahydrofolate is vitally important for dividing cells during growth and cancer and knowledge of this need is used in cancer treatment by giving the drug methotrexate to inhibit the enzyme _____. a. folylpolyglutamate synthetase b. dihydrofolate reductase c. formimino glutamate d.conjugase

c. 40 and 140 (Beerman CH 5, p. 209)

The "danger zone" —the environmental temperature range that most foodborne pathogens prefer to live in—is between _____ degrees Fahrenheit. a. 30 and 130 b. 35 and 135 c. 40 and 140 d. 45 and 145

d. 21, 38 (Beerman CH 4, p. 143)

The Adequate Intake (AI) for dietary fiber ranges from _____ to ______ grams of dietary fiber per day. a. 8, 16 b. 13, 15 c. 25, 52 d. 21, 38

b. to add polysaccharide or lipid moieties to polypeptides. Gropper CH 1

The Golgi apparatus is prominent in neurons and secretory cells and functions a. to stop the synthesis of proteins that may need carbohydrate additions. b. to add polysaccharide or lipid moieties to polypeptides. c. only for constitutive secretion of proteins. d.only for regulated secretion of proteins.

a. increased apoC-2 activity to reduce its triacylglycerol content (Gropper CH 5, pgs 159-160)

The HDL accomplishes its function in reverse cholesterol transport in two ways. Choose the phrase that does NOT describe one of these. a. increased apoC-2 activity to reduce its triacylglycerol content b. increased activity of LCAT on vascular endothelial cells c. increased activity of transferring cholesterol to other lipoproteins d.using its apoE component to bind to LDL receptors

c. 25 (Beerman CH 4, pg.142)

The Institute of Medicine recommends that added sugars contribute no more than _____% of total kcalories. a. 10 b. 18 c. 25 d. 28

d. Eating breakfast (CH 21 Krause, pg. 401) The NWCR consists of more than 5000 individuals who have been successful in long-term weight loss maintenance. It found that there was very little similarity in how individuals lost weight, but there were some common behaviors they all have for keeping weight off: (1) eating a relatively low-fat diet, (2) weighing themselves regularly, (3) engaging in high levels of physical activity, and (4) eating breakfast almost every day.

The NWCR identified which behavior that resulted in successful long-term weight loss? a. Use of very low-calorie diets b. Use of pharmaceuticals c. Attending support groups d. Eating breakfast

c. hormones (Beerman CH 5, p. 185)

The continuous breakdown and resynthesis of proteins is regulated mainly by _____. a. enzymes b. neural transmissions c. hormones d. muscular contractions

b. serine, 5,10-methylene tetrahydrofolate (Gropper Chap 9, pg 348, 350)

The degradation of _____ provides the majority of one-carbon groups for pyrimidine synthesis. In this process _____ is formed. a. methionine, tetrahydrofolate b. serine, 5,10-methylene tetrahydrofolate c. uridine, tetrahydrofolate d.homocysteine, 5-methyl tetrahydrofolate

ANS: A Regular checking of blood phenylalanine levels is necessary to monitor for excessive phenylalanine intake and to prevent development of mental retardation. The desirable range for blood phenylalanine concentration is 2 to 6 mg/dl. The diagnosis of PKU is made when phenylalanine levels are greater than 6 to 10 mg/dl. Phenylalanine levels greater than 20 mg/dl are the best predictor of IQ loss. REF: p. 896 (Krause CH 43)

The desirable range for blood phenylalanine in a child with PKU is _____ mg/dl. a. 2 to 6 b. 6 to 10 c. 8 to 12 d. 10 to 20

d.isomaltase, enterocyte CH 3 Gropper, pg 70

The enzyme needed to hydrolyze the α (1,6) bond of amylopectin is _____, which is secreted from the _____. a. amylase, enterocyte b. sucrase, pancreas c. lactase, enterocyte d.isomaltase, enterocyte

C p. 507 (Gropper CH 13)

The enzyme that converts retinol to retinal and ethanol to acetyl-aldehyde contains 4 ____ atoms. a. copper b. iodine c. zinc d.iron

c. amylases (Beerman CH 4, pg 130)

The enzymes involved in the digestion of starches include various _____. a. condensers b. amyloses c. amylases d. cofactors

c. preformed toxins (Beerman CH 5, p. 201)

The harmful substances that some pathogenic organisms produce while they are growing in foods are called _____. a. innate poisons b. inherent toxins c. preformed toxins d.intrinsic poisons

b. stimulation Gropper CH 2 page 57

The major role of gastrin in the GI tract is that of _____. a. inhibition b. stimulation c. transport d.no effect

a. wheat (Beerman CH 5, p. 178)

The majority of food allergies are caused by protein-containing foods such as eggs, milk, soy, peanuts, and _____. a. wheat b. beef c. pork d. walnuts

c. transamination (Beerman CH 5, p. 164)

The metabolic process used by the body to synthesize nonessential amino acids is called _____. a. reamination b. deamination c. transamination d.transmigration

d. Clostridium difficile. (CH 28 Krause, p. 529) Clostridium difficile is the most common cause of antibiotic-induced diarrhea. Escherichia coli has also been implicated. Lactobacillus and Saccharomyces boulardii are used as a supplement to recolonize the colon with beneficial bacteria.

The most common cause of antibiotic-induced diarrhea is a. Lactobacillus spp. b. Saccharomyces boulardii. c. Escherichia coli. d. Clostridium difficile.

d.gastrointestinal secretions and local blood flow. Gropper CH 2 pg 56

The neuronal network system located in the submucosa (plexus of Meissner) controls: a. peristalsis and local blood flow. b. ileal secretions and gastric motility. c. frequency and strength of gastric muscle contractions. d.gastrointestinal secretions and local blood flow.

d. translation (Beerman CH 5, p. 167)

The process of protein synthesis involves three basic steps: cell signaling, transcription, and _____. a. denaturation b. translocation c. deamination d. translation

d. protein turnover (Beerman CH 5, p. 185)

The processes by which proteins are continuously broken down and resynthesized are collectively known as _____. a. protein synthesis b. protein homeostasis c. protein balance d. protein turnover

D p. 495, 513 (Gropper CH 13)

The protein that plays a dual function in both iron and copper homeostasis is: a. ferritin. b. transferrin. c. metallothionein. d.ceruloplasmin.

a. pentose phosphates and NADPH. CH 3 Gropper, page 97

The purpose of the hexose monophosphate shunt is to produce a. pentose phosphates and NADPH. b. DNA and RNA. c. fatty acids. d.reducing substrates.

1 ml/kcal for adults and 1.5 ml/kcal for infants. (Ch 6, Krause) ANS: D Fluid intake of 1 ml/kcal for adults and 1.5 ml/kcal for infants provides about 35 ml/kg in adults and 150 ml/kg in infants. These levels help to maintain fluid balance within humans

The recommended fluid intake based on caloric intake is a. 2 ml/kcal for adults and 3 ml/kcal for infants. b. 0.5 ml/kcal for adults and infants. c. 2 ml/kcal for adults and 1 ml/kcal for infants. d. 1 ml/kcal for adults and 1.5 ml/kcal for infants.

c. phospholipid (Gropper CH 5, pg. 143-4)

The structure below is a _____. a. triacylglycerol b. cholesteryl ester c. phospholipid d. glycolipid

b. up (Beerman CH 5, p. 167)

The term _____-regulation is used to describe the "turning on" of protein synthesis by cell signaling. a. on b. up c. forward d. start

d. cancer (Beerman CH 5, p. 194)

There is growing evidence that very high consumption of red meat is associated with increased risk for some forms of _____. a. GERD b. heart disease c. obesity d. cancer

b. transketolase (Gropper Chap 9, pg 322)

Thiamin is important to fatty acid synthesis due to its requirement as a coenzyme for the pentose phosphate pathway enzyme _____. a. dopamine monooxygenase b. transketolase c. alpha-ketoglutarate dehydrogenase d.phenylalanine hydroxylase

d. vegans (Beerman CH 5, p. 192)

Those who avoid all animal products are referred to as _____. a. lacto-ovo-vegetarians b. lactovegetarians c. vegetarians d. vegans

b. arachidonic acid. (Gropper CH 5, pg 171)

Thromboxane A2 is a hormone-like substance made from: a. stearic acid. b. arachidonic acid. c. palmitic acid. d.myristic acid.

d.pro-aggregatory, anti-aggregatory (Gropper CH 5, pgs 171-2)

Thromboxanes that activate blood platelets are _____. When EPA is used to synthesize the thromboxane, it is _____. a. vasodilators, a vasoconstrictor b. pro-aggregatory, less pro-aggregatory c. anti-inflammatory, pro-inflammatory d.pro-aggregatory, anti-aggregatory

d. All of the above (CH 25 Krause, p. 473) Prolonged bottle feeding, especially at night, of juice, milk, formula, or other sweetened beverages is associated with early childhood caries.

To limit the chances of developing early childhood caries, which of the following should never be provided in a bottle as part of prolonged night feeding? a. Formula b. Milk c. Juice d. All of the above

ANS: C Standard formula that provides 20 calories/oz is the equivalent of breastmilk. All powdered infant formulas come with a scoop provided in the can. The proper mixing ratio for standard formula is 1 scoop for every 2 oz of water. Of course, the water should be purified to prevent the development of infant infection or diarrhea. REF: p. 926 (krause CH 44)

To make standard 20-calorie/oz formula, how much powdered formula needs to be mixed with every 2 oz of water? a. 1 tsp b. 1 Tbsp c. 1 scoop d. 2 scoops

a. ketones (Beerman CH 4, pg 141)

To protect itself from excessive muscle loss, the body decreases its need for glucose by using _____ as an energy source. a. ketones b. amino acids c. cortisol d. amylose

d. genetic information in an mRNA molecule specifies the sequence of amino acids in the protein product Gropper CH 1

Translation is the process by which a. the genetic information (base sequence) in a single strand of DNA is used to specify a complementary sequence of bases in an mRNA chain. b. a daughter duplex DNA molecule that is identical to the parental duplex DNA is synthesized. c. the polypeptide chain of the protein product is extended. d. genetic information in an mRNA molecule specifies the sequence of amino acids in the protein product.

a. Baking soda (Beerman chapter 10, pg 430)

Treating grain products with which of the following can increase niacin's bioavalability? a. Baking soda b. Vinegar c. Lemon juice d.Sugar water

True (Beerman, 12)

True or False Calbindin carries calcium into the enterocyte.

b. two CH 3 Gropper, page 86, 89

Under anaerobic conditions within a cell, how many net ATPs are formed from one glucose molecule by substrate-level phosphorylation? a. one b. two c. four d. six

a. epigenetic (Beerman CH 5, p. 175)

Variations in gene expression that occur without alterations in DNA sequence are called _____ modifications. a. epigenetic b. nutrigenomic c. nutrigenetic d. biogenetic

Answer: protein complementation (Beerman CH 5, pp. 166)

Vegans can take advantage of _______________ to obtain all essential amino acids in relatively adequate amounts

Α p. 281. Gropper Ch 8

Waist circumferences of >40 inches in men and >35 inches in women may be used to identify increased _____. a. risk for the development of obesity-associated conditions b. subcutaneous fat c. peripheral fat distribution d.age

c. 60% (Gropper CH 12, pg 455)

Water accounts for what percentage of the body weight in a normal adult? a. 20% b. 40% c. 60% d. 80%

d. (Gropper Chap 10, pg 50 392)

What % of vitamin D from the diet is absorbed? a. 20 b. 30 c. 40 d.50

d. They should eat two or three servings of low-mercury fish per week. (CH 15 Krause, pg 271) There are specific recommendations for DHA intake during pregnancy. The main food source is fatty, cold-water fish, but many of these sources have high levels of mercury. It is recommended that pregnant women eat two or three servings per week of low-mercury fish such as sardines. Vegetable sources of omega-3 fat are not as efficient sources as fish.

What advice should be given to a pregnant woman about eating fish? a. They should eat only vegetable sources of omega-3 fat. b. There is no specific recommendations about fish. c. They should eat two or three servings of fish per week. d. They should eat two or three servings of low-mercury fish per week.

b. 400 ug DFE (Gropper Chap 9, pg 351)

What amount of supplemental folic acid is recommended daily for women of childbearing age in the United States? a. 200 ug DFE b. 400 ug DFE c. 600 ug DFE d.800 ug DFE

b. eicosapentaenoic (Gropper CH 5, pg. 140)

What antithrombotic n-3 fatty acid is found in fish oil? a. alpha-linolenic b. eicosapentaenoic c. arachidonic d.stearic

Chelation (Ch 1, Krause) pg 15 Chelation refers to the binding of a cation mineral to a ligand, not a whole protein. Cotransporters carry two different minerals at a time, such as the case with sodium and phosphorus. An overlap of mineral transport mechanisms may lead to competitive absorption between minerals in the presence of other minerals, such as the case with iron or zinc supplementation, leading to a decrease in copper absorption.

What are primarily absorbed by the large intestine? a. Water and fats b. Carbohydrates c. Proteins d. Water and electrolytes

Key: Grading rubric - answer should include the following items: Non-fermentable fibers cannot readily be digested (fermented) by gut bacteria. Examples and the foods that contain this type of fiber include: -- Cellulose (cereal brans, legumes, nuts, root vegetables) -- Lignin (whole grains, especially wheat; mature root vegetables; seeds of berries; stalks of broccoli and asparagus) -- Waxes (suberin and cutin, which coat the external surfaces of apples, potatoes, and similar fruits and vegetables) (Gropper CH 4, pgs. 112,114,118,123)

What are the components that make up non-fermentable dietary fiber and in what foods are each found?

c. inflammation and serum lipids (Gropper CH 5, pg. 181)

What are two major components implicated in the mechanism of atherogenesis? a. growth factors and HDL b. enterocytes and endothelial cells c. inflammation and serum lipids d.primarily VLDL and IDL

Answer (key points): Eat a variety of healthy foods, especially whole-grain foods and high-fiber foods; stay physically fit; and maintain a recommended body weight. (Beerman CH 4, p. 155)

What can be done to prevent or delay the onset of type 2 diabetes?

b. n-3 (Gropper CH 5, pg. 140)

What dietary fatty acid family exerts anti-thrombotic properties? a. n-6 b. n-3 c. n-9 e.saturated

b. Hazard Analysis Critical Control Points (Beerman CH 5, p. 209)

What does the acronym HACCP stand for? a. Hazard Analysis Crisis Control Program b. Hazard Analysis Critical Control Points c. Hazard Assessment Crisis Control Program d. Hazard Assessment Critical Control Points

a. Cell membranes (Beerman, 12)

What is phosphorus most commonly a component of? a. Cell membranes b. Enzymes c. Hormones d. Vitamin D

C. p. 291 (Gropper CH 8)

What is the RQ for an ordinary mixed diet of carbohydrate, protein, and fat? a. 0.75 b. 0.80 c. 0.85 d.0.15

a. 130 (Beerman CH 4, p. 142)

What is the Recommended Dietary Allowance for carbohydrate for adults, in grams per day? a. 130 b. 150 c. 160 d.180

b- small intestine (beerman, CH 12)

What is the primary site for the absorption of major minerals? a. Stomach b. Small intestine c. Liver d. Large intestine

b-regulate fluidity Gropper CH 1

What is the role of cholesterol in plasma membrane structure? a. produce bile b. regulate fluidity c. reduce stability d. produce hormones

d. Liver (Beerman CH 5, p. 186)

What organ converts ammonia (NH3) to urea? a. Small intestine b. Pancreas c. Kidney d. Liver

c. intestine (Gropper CH 5, pgs. 151 & 154)

What organ provides the major site for lipoprotein formation from exogenously derived lipids? a. pancreas b. adipose tissue c. intestine d. liver

d. E. coli (Beerman CH 5, p. 203)

What organism is likely to be found in contaminated water and undercooked meats and seafood? a. Salmonella b. Camplybacter jejuni c. Staphlococcus aureus d. E. coli

a. Fasting plasma glucose (Beerman CH 4, p. 151)

What screening method is used for type 2 diabetes? a. Fasting plasma glucose b. Non-fasting blood glucose c. Two-hour oral glucose tolerance test d. None of the above

c. Zinc and potassium status (CH 28 Krause, p. 545) Although maldigestion, malabsorption, and drug-nutrient interactions may contribute to the need for overall vitamin and mineral supplementation in patients with Crohn disease, diarrhea experienced by the patient promotes the reduction of potassium, selenium, and zinc stores in particular.

What should patients with Crohn disease be monitored for when experiencing diarrhea? a. Calcium and phosphorus status b. Magnesium and iron status c. Zinc and potassium status d. Iron and selenium status

c. The adolescent is at risk for becoming overweight. (CH 18 Krause, pg 341) As in children, the plotting of an adolescent's BMI above the 85th percentile but below the 95th percentile is interpreted as being at risk for becoming overweight. A BMI above the 95th percentile is interpreted as being overweight. For an interpretation of obesity, the BMI would have to be significantly above the 95th percentile.

What would be the correct interpretation of an adolescent who has a BMI above the 85th percentile? a. The adolescent is overweight. b. The adolescent is obese. c. The adolescent is at risk for becoming overweight. d. The adolescent is overfat.

c. reframing. (CH 14 Krause, pg 234) Reframing is a technique where the counselor makes a statement that provides a different perspective to the patient's view. Self-motivational statements are created by the client when she recognizes that a problem or concern exists and that she can do something about it. Problem recognition, concern, intention to change, and optimism are types of questions that the counselor can ask that will result in the client developing self-motivational statements.

When a counselor elicits self-motivational statements, this includes all of the following EXCEPT a. optimism. b. problem recognition. c. reframing. d. intention to change.

a. Recent changes in the patient's weight (CH 25 Krause, p. 474) As dentures replace missing teeth, they need to be checked for appropriate fit. The fit of the dentures could be affected by weight changes. If a patient has lost weight recently, the dentures may fit loosely, and this could result in continuing decreased intake. Dentures do need to be cared for, so the patient or caregiver should perform regular cleaning. Fluid intake contributes to maintaining the dentures; however, adequacy of fluid intake is not associated with denture use. Dentures are made of materials that are not susceptible to cariogenicity.

When a patient is identified as wearing full dentures, what else should be included in the nutrition assessment of the patient? a. Recent changes in the patient's weight b. The patient's regular daily fluid intake c. When the patient last had her own teeth d. The patient's daily intake of cariogenic foods

b. raises it (Gropper CH 12, pg 471)

When a person hyperventilates and "blows off" CO2, what effect does this have on pH? a. lowers it b. raises it c. does not alter it significantly d.delays any changes in it

c. Vitamin B12 (CH 27 Krause, p 512) An H2 blocker is used to decrease stomach acid production. This can result in the development of achlorhydria and the loss of intrinsic factor. Patients should be monitored for serum vitamin B12 level to ensure that a deficiency in this vitamin does not develop.

When an H2 blocker is used in the treatment of peptic ulcer disease, the patient may be at risk for deficiency of which nutrient? a. Vitamin A b. Vitamin B6 c. Vitamin B12 d. Vitamin D

c. type I hypersensitivity. (Gould CH 7, pg. 122)

When an allergen binds with IgE antibodies on mast cells, resulting in release of chemical mediators, this reaction is called: a. cytotoxic hypersensitivity. b. immune complex hypersensitivity. c. type I hypersensitivity. d. type IV hypersensitivity.

a. Right after school (CH 18 Krause, pg 338-339) Teens more frequently visit fast-food restaurants on the way home from school. This may have to do with the location of the fast-food restaurants in relation to their schools because many are located within a short walking or driving distance. Weekday dinnertime is the next most frequently reported visit time. On the weekends, adolescents visit fast-food restaurants more during the lunchtime than during the dinnertime hours.

When are adolescents most likely to visit a fast-food restaurant? a. Right after school b. During dinnertime through the week c. During dinnertime on the weekend d. During lunchtime on the weekend

a. lost 2 electrons (Gropper Chap 9, pg 311, 317)

When ascorbic acid becomes dehydroascorbic acid it has _____. a. lost 2 electrons b. lost 1 electron c. gained 2 electrons d.gained 1 electron

a. ascites (Beerman CH 5, p. 193)

When fluid accumulates in the abdominal cavity, the condition is referred to as _____. a. ascites b. fatty liver c. bloating d. enlarged spleen

a. simple diffusion. (Beerman chapter 10, pg 445)

When the intake of vitamin C is high, absorption occurs by: a. simple diffusion. b. active transport. c. passive transport. d.passive diffusion.

A p. 488 (Gropper CH 13)

Where would you find iron regulatory element binding protein (IRE-BP)? cytosol nucleus mitochondria none of the above

b. nucleus (Gropper Chap 10, pg 383)

Where would you find retinoid X receptors (RXR)? a. cytosol b. nucleus c. mitochondria d.none of the above

b. extracellular (Gropper CH 12, pg 455)

Which body water reservoir is made up of plasma and interstitial fluid? a. intracellular b. extracellular c. total body water d.glomerular filtrate

b. niacin (Gropper Chap 9, pg 333)

Which classical vitamin deficiency is known for the four Ds: dermatitis, dementia, diarrhea, and death? a. thiamin b. niacin c. biotin d.folic acid

d. Lipases (Beerman CH 6, pp. 236, 240)

Which enzymes are responsible for the digestion of triglycerides? a. Lipidases b. Fat depredators c. Fat degradators d. Lipases

c. Insulin (Beerman CH 4, pg. 138)

Which hormone promotes the storage of excess glucose as glycogen and body fat? a. Glucagon b. Cortisol c. Insulin d. Epinephrine

b. Chylomicrons (Beerman CH 6, p. 242)

Which lipoprotein do intestinal cells synthesize in order to circulate long-chain fatty acids away from the gastrointestinal tract? a. VLDL b. Chylomicrons c. Triglycerides d. LDL

b. Osteoblasts (Gould CH 9, pg 159)

Which of the following cells produce new bone? a. Osteocytes b. Osteoblasts c. Osteoclasts d. Stem cells from the bone marrow

a. Pork fat (Beerman CH 6, pp. 228,229)

Which of the following contains the greatest percentage of saturated fatty acids? a. Pork fat b. Margarine c. Olive oil d. Flaxseed oil

D. p. 289 (Gropper CH 8)

Which of the following contributes the highest thermic effect of food? a. fats b. mixed diet with at least 50% carbohydrate c. carbohydrates d.proteins

c. Infants double their birth weight by 4 to 6 months of age. (CH 16 Krause, pg 300) Infants usually double their birth weight by 4 to 6 months of age and triple their weight by 1 year. Infants usually lose about 6% of their birth weight during the first few days postpartum, but this weight is usually regained by 7 to 10 days postpartum.

Which of the following describes the growth expectations for most infants? a. The birth weight is usually regained by the end of the first month. b. Infants triple their birth weight by 6 months of age. c. Infants double their birth weight by 4 to 6 months of age. d. Infants triple their length by 3 years of age.

a. Research has not linked a dietary cause to autism. (CH 17 Krause, pg 326-327) Although a number of dietary factors have been investigated, research has not demonstrated these to be the cause of autism or to be helpful in the treatment of autism.

Which of the following has been demonstrated by research to be TRUE regarding diet and autism spectrum disorder? a. Research has not linked a dietary cause to autism. b. Autism results from a food allergy. c. Gluten in the diet leads to autism. d. Fluoride in the water has been linked to autism.

B. p. 295,296 (Gropper CH 8)

Which of the following hormones or molecules increases the urge to eat? a. leptin b. ghrelin c. adiponectin d.insulin

advance directives (CH 10 Krause, pg 172) Advance directives are legal guidelines established by a patient that designate personal health care intervention preferences or identify a person to make decisions when the patient does not have the capacity to do so.

Which of the following identifies a patient's health care preferences in regard to end-of-life issues? a. Discharge planning b. Disease management c. Case management d. Advance directives

b. Delayed hypersensitivity (Gould CH 7, pg 130)

Which of the following is NOT a cause of immunodeficiency? a. Hypoplasia of the thymus b. Delayed hypersensitivity c. Immunosuppressive drugs d. Atrophy of the lymph nodes

a. increased glucose absorption (Gropper CH 4, Pg 118,120)

Which of the following is NOT a typical gastrointestinal response to ingestion of dietary fiber? a. increased glucose absorption b. delayed gastric emptying c. increased bile-acid excretion d.increased fecal bulk

b. Creatine phosphate (CH 23 Kruase, p. 427) The coenzyme called nicotinic acid dehydrogenase (NAD) converts pyruvic acid to lactic acid. Lactic acid is the end product of anaerobic glycolysis. Adenosine diphosphate is phosphorylated to create ATP.

Which of the following is NOT involved in the anaerobic production of ATP through the lactic acid pathway? a. Pyruvic acid b. Creatine phosphate c. Nicotinic acid dehydrogenase d. Adenosine diphosphate

Food security (CH 9 krause pg 145) Although how they are performed varies depending on the community setting, the three core functions of public health are community assessment, policy development, and public health assurance. Food security may be one of the issues addressed in public health but is not a focus in all public health programs.

Which of the following is NOT one of the core functions of public health? a. Community assessment b. Food security c. Policy development d. Public health assurance

a. temperature variation (Gropper CH 12, pg 470)

Which of the following is NOT one of the principal regulatory mechanisms for guarding against fluctuation in pH? a. temperature variation b. buffer systems c. respiratory center d.renal regulation

b. chylomicrons (Gropper CH 5, pg. 156)

Which of the following lipoproteins are normally NOT present in blood in the fasting state? a. VLDL b. chylomicrons c. LDL d.HDL

c. LDL (Gropper CH 5, pg 157)

Which of the following lipoproteins is the major carrier of cholesterol to tissues for use in construction of membranes or steroid hormones? a. VLDL b. HDL c. LDL d.chylomicrons

Genomic imprinting (ch 5, Krause) ANS: A Genomic imprinting refers to the process by which a change in the DNA results in a phenotype influenced by whether a gene variant was inherited from the mother or the father. Mutations or gene variants are changes in the nucleotide sequence. A single nucleotide polymorphism results in a change in the nucleotide sequence, but by only one nucleotide. REF: p. 73

Which of the following may promote a change in a DNA molecule affecting gene expression without changing the nucleotide sequence? a. Genomic imprinting b. Mutation c. SNP d. Gene variant

c. Gluconeogenesis (Beerman CH 4, pg 140)

Which of the following metabolic pathways increases glucose availability? a. Glycogenesis b. Ketogenesis c. Gluconeogenesis d.None of the above

d. phosphorus (Gropper Chap 11, pg 442)

Which of the following minerals plays a major role in regulating body fluid pH? a. calcium b. magnesium c. sulphur d.phosphorus

c. Consuming inadequate vitamin C results in a deficiency. Beerman CH 1, page 14

Which of the following statements is an example of a "simple relationship"? a. Avoiding exercise can reduce one's life expectancy. b. Eating organic foods may improve nutritional status. c. Consuming inadequate vitamin C results in a deficiency. d. Consuming inadequate calcium may result in osteoporosis.

d.Sickle cell (Beerman CH 5, pp. 170-171)

Which of the following types of anemia is caused by a single error in the amino acid sequence of hemoglobin? a. Microcytic b. Macrocytic c. Pernicious d.Sickle cell

a. Vitamin B12 (Beerman CH 5, p. 192)

Which of the following vitamins or minerals would most likely be deficient in a vegan diet? a. Vitamin B12 b. Vitamin A c. Folate d. Magnesium

D 483 (Gropper CH 13)

Which of the microminerals is considered essential for normal brain function? α chromium b. fluorine c. vanadium d. manganese

d.Magnesium metabolism is regulated by several hormones. (Gropper Chap 11, pg 445-446)

Which statement is false? a. About half of magnesium in the body is associated with the bones. b. Intracellular and serum magnesium levels are rigidly maintained. c. Magnesium in cells is associated with phospholipids and proteins. d.Magnesium metabolism is regulated by several hormones.

Α p. 490 (Gropper CH 13)

Which statement is false? a. Hemosiderin is the primary storage form of iron in cells. b. Iron is stored mainly in the liver, bone marrow, and spleen. c. Iron is released more slowly from hemosiderin than from ferritin. d.Ferritin is an unstable compound that is constantly being degraded and resynthesized.

a. The FDA recommends cooking seafood thoroughly to kill parasites (Beerman CH 5, p. 205)

Which statement is true? a. The FDA recommends cooking seafood thoroughly to kill parasites. b. All parasites are resistant to cold, even freezing, temperatures. c. Anisakis simplex is a single-celled parasite found in swimming pools. d. Parasites usually have very short incubation periods.

b. Marasmus (Beerman CH 5, p. 193) Marasmus: Is a form of malnutriton. It happens when the intake of nutrients and energy is too low for a person's needs. It leads to wasting, or loss of body fat and muscle. A child many not grow as children usurally do.

Which type of malnutrition is characterized by a "skin and bones-like" appearance without the presence of severe edema? a. Ascites b. Marasmus c. Kwashiorkor d.Malnutrition of mild degree

b. Parasites (Beerman CH 5, p. 204)

Which type of pathogen must live within or on another organism during part of its life cycle? a. Bacteria b. Parasites c. Fungi d.Mold

d. K (Beerman, Ch 12)

Which vitamin enables bone-building proteins to bind to calcium? a. A b. D c. E d. K

b. They are good sources of longer-chain ω-3 fatty acids (Beerman CH 6, p. 228)

Why do dietitians recommend that people eat salmon and other fatty fish and seafood? a. They are good sources of palmitic acid b. They are good sources of longer-chain ω-3 fatty acids c. They are good sources of arachidonic acid d. They are good sources of shorter-chain α-6 fatty acids

Answer (key points): Because many of the toxins produced by some pathogenic organisms and most noninfectious agents are not altered by the cooking process. (Beerman CH 5, pp. 201, 205)

Why doesn't cooking food render it incapable of causing foodborne illness?

c. growth of nonpathogenic organisms minimizes growth of pathogenic ones (Beerman CH 5, p. 209)

Wines are typically safe to drink because _____. a. the alcohol kills pathogenic organisms b. the fruit juice is sterilized prior to fermentation c. growth of nonpathogenic organisms minimizes growth of pathogenic ones d. wine is irradiated

a. Diverticulosis (Beerman CH 4, pg. 127)

With long-term constipation, areas along the colon wall can become weak and develop protruding pouches. What is this condition called? a. Diverticulosis b. Flatulence c. PKU d.Diabetes

d. Sucrase (Beerman Ch 4, pgs. 130,131)

_____ is not associated with the digestion of amylose and amylopectin. a. Salivary alpha-amylase b. Pancreatic alpha-amylase c. Maltase d. Sucrase e. Alpha-dextrinase

c. maintain water balance in the body as a whole and within cells. (CH 23 Krause, p. 430) Depending on the type of physical activity performed, athletes need to have adequate water intake to prevent dehydration. Fluid loss through sweating is affected by the length and intensity of activity as well as by the environment. Sweating provides a cooling mechanism for the body; however, if fluid is not replaced, dehydration will impair the body's thermoregulation and the athlete's ability to perform.

thletes need to increase their water intake to a. enhance renal excretion of waste products from muscle activity. b. improve intestinal absorption of nutrients after digestion. c. maintain water balance in the body as a whole and within cells. d. increase skin evaporation of water as a cooling mechanism.

f- all of above (Beerman, 12)

Calcium is important for: a. bone structure. b. muscle contraction. c. nerve impulse transmission. d. a and b e. a and c f. All of the above

c. cellular differentiation Gropper CH 2 page 45

Choose the phrase that best describes the function of the crypt of Lieberkühn. a. mucus secretion b. glucose oxidation c. cellular differentiation d.amylase secretion

c. 7% (Beerman CH 4, pg. 117)

Currently, high-fructose corn syrup accounts for what percentage of the total energy intake in the U.S.? a. 3% b. 5% c. 7% d.9%

Key: Grading rubric - answer should include the following items: -- Because acetyl-CoA is formed in the mitochondria and fatty acids are synthesized in the cytoplasm, a carrier system is required to transfer acetyl-CoA to the cytoplasm. -- Citrate from the combination of acetyl-CoA and oxaloacetate (first step of the TCA cycle) is able to pass through the mitochondrial membrane into the cytoplasm. -- In the cytoplasm, citrate is cleaved by citrate lyase to reform acetyl-CoA and oxaloacetate in the cytoplasm. -- The acetyl-CoA is then ready to be processed by acetyl-CoA carboxylase so that fatty acid synthesis can occur. (Gropper CH 5, pg. 168)

Describe the transport system that allows for fatty acid synthesis and the molecules involved in transferring acetyl-CoA into cytoplasm.

b. 14 (Beerman CH 4, pgs. 142-143)

Dietary Guidelines recommend that adults consume _____ grams of dietary fiber per 1,000 kcalories. a. 7 b. 14 c. 21 d. 28

b. condensation (Beerman CH 4, pg. 119)

Disaccharides are formed when two monosaccharides are bonded together as a result of a _____ reaction. a. hydrolysis b. condensation c. glycosidic d.synthesis

a. inflammation in multiple organs. (Gould CH 7, pg. 128)

Distinguishing clinical features of systemic lupus erythematosus include: a. inflammation in multiple organs. b. lack of a specific diagnostic blood test. c. acute onset and nonprogressive course. d. typical skin rash on the chest and back.

b. is characterized by the presence of pouches that form along the intestinal wall. (Beerman CH 4, pg 127)

Diverticular disease: a. development is associated with a high-fiber diet. b. is characterized by the presence of pouches that form along the intestinal wall. c. is always associated with development of diverticulitis. d. a and b e. a and c

Answer (key points): This is no longer thought to be true. Starchy foods that contain less fiber and are more refined such as potatoes, refined cereal products, white bread, and white rice have higher glycemic indices than many simple carbohydrates. Simple carbohydrates are rapidly absorbed but their effect on glucose response can be less than that of starches with higher glycemic indices. (Beerman CH 4, pp. 133-134)

Do complex carbohydrates break down more slowly and cause less of a rise in blood sugar as compared to simple carbohydrates?

b. muscle CH 3 gropper, page 82

Due to a lack of the enzyme glucose-6-phosphatase, which tissue capable of glycogenesis cannot contribute to blood glucose levels between meals? a. liver b. muscle c. brain d.kidney

b. language and foods. (CH 14 Krause, pg 230) Surface structure includes such things as food and language. Deep structure includes psychologic and social beliefs and the context of the intervention.

Educating and counseling with cultural competency should acknowledge surface and deep structure. Surface structure includes things like a. the client's appearance. b. language and foods. c. social beliefs. d. health diagnoses.

a. French size. (CH 13 Krause, pg 213) Feeding tube internal diameter is measured in French size.

Feeding tube diameter is measured in a. French size. b. millimeters. c. inches. d. centimeters.

Key Page(s) e 114 c 112-114 b 114-115 a 114 d 114 Gropper CH 4 pg. 112-115)

Fiber Description 1. pectin 2. cellulose 3. gum 4. lignin 5. hemicellulose a. The main noncarbohydrate component of fiber and a three-dimensional polymer of phenol. Found in carrots, berries, and wheat, and insoluble in water. b. A hydrocolloid composed of sugar and sugar derivatives commonly used as a food additive that is secreted from plant injuries or can also be found in oats, barley, and legumes. c. A long linear polymer that provides structure to the cell wall. Found in bran, legumes, root vegetables, and apples. d. Contains a number of sugars in its backbone and side chains. Some are water soluble and some are insoluble; found in bran and whole grains. e. A group of polysaccharides with galacturonic acid as a primary constituent. It is soluble and gel forming; plentiful in many fruits.

d. K (Gropper Chap 10, pg 414)

For which vitamin is a severe deficiency associated with an increased tendency for bleeding? a. A b. D c. E d.K

a. fructose-2,6-bisphosphate CH 3 Gropper, page 84, 103

Glucagon stimulates hepatic gluconeogenesis and suppresses glycolysis by reducing the concentration of _____, a positive modulator of phosphofructokinase. a. fructose-2,6-bisphosphate b. fructose-1,6-bisphosphate c. glucose-6-phosphate d.glucose-1-phosphate

c. contaminated blood. (Gould CH 8, pg.150)

Herpes virus is usually spread by all of the following EXCEPT: a. saliva during an exacerbation and for a short time thereafter. b. contact with the fluid in the lesion. c. contaminated blood. d. autoinoculation by fingers.

a. Transported via the blood to the liver (Beerman chapter 10, pg 419)

How are water-soluble vitamins initially circulated in the body? a. Transported via the blood to the liver b. Transported from the small intestine to the blood c. Transported via the blood to the pancreas d.Transported from the pancreas to the blood

d. The presence of nits at the base of hair shafts (Gould CH 8, pg 153) - Pediculosis is an infestation of the hairy parts of the body or clothing with the eggs, larvae or adults of lice.

How can pediculosis be diagnosed? a. Pruritus in hairy areas of the body b. Loss of blood due to lice bites c. Finding lice in clothing d. The presence of nits at the base of hair shafts

Answer (key points): Several factors determine whether food proteins are good sources of essential amino acids to your body. These include whether the protein is complete or incomplete in its pattern of amino acids, and your body's ability to digest and absorb them (i.e., its bioavailability). A protein that provides easily digested and absorbed amino acids has high bioavailability. If a food is a complete protein source and its protein is bioavailable, it is a high-quality protein source. In general, animal-derived foods are sources of high-quality protein, and foods containing incomplete proteins and/or those in which the protein has low bioavailability are low-quality protein sources. (Beerman CH 5, p. 166)

How is the quality of a food protein determined?

c. pantothenic acid (Gropper Chap 9, pg 334-335)

Which of the water-soluble vitamins is found widely distributed in all plant and animal foods, which makes a deficiency unlikely? a. riboflavin b. folic acid c. pantothenic acid d.pyridoxine

True : (Beerman CH 5, p. 166)

True of False: Generally, animal-derived foods are sources of quality protein.

True: (Beerman CH 5, pp. 163,164)

True of False: There are nine essential amino acids.

True (Beerman CH 4, pg. 115)

True or False: The most abundant saccharides in foods are the hexoses.

True (Beerman CH 5, p. 206)

True or False: The production of brevetoxins by algae is an example of shellfish poisoning.

False (Beerman CH 5, p. 187)

True or False: When protein intake exceeds loss, such as during adolescence, a person is in nitrogen balance.

True (Beerman CH 4, pgs 138-139.)

True or False: he liver determines how much glucose circulates in the blood, is stored as glycogen, and/or is stored as fat.

False (Beerman CH 5, p. 201)

True or Flase: Cooking contaminated foods to sufficiently high temperatures will destroy any toxins they contain.

a. Pantothenic acid (Beerman chapter 10, pg 434)

"Burning feet syndrome" is thought to be due to what vitamin deficiency? a. Pantothenic acid b. Thiamin c. Niacin d.Riboflavin

c. Bile emulsifies dietary lipid to increase its surface area. (Gropper CH 5, pg. 146-7)

. Choose the best description of the action of bile. a. Bile hydrolyzes ester bonds of the triacylglycerols. b. Bile anchors into dietary lipid so that pancreatic lipase can act. c. Bile emulsifies dietary lipid to increase its surface area. d.Bile digests the ester bond of the dietary cholesteryl ester.

D. p. 294 (Gropper CH 8)

A 25-year-old female college student weighs 137 lb and is 5'6" tall and has a medium frame. She is consuming approximately 2500 kcal daily. What are her total energy needs? (RMR + diet-induced thermogenesis + physical activity = total energy expenditure.) The Harris-Benedict equation for women is 655.1 + (9.56 × W) + (1.85 × H) - (4.7 × A). Use 1.5 for the physical activity factor. a. 1443 b. 1587 c. 2165 d.2309

Answer: chromosome, gene (Beerman CH 5, p. 168)

A _______________ is a strand of DNA in a cell's nucleus, whereas the portion of it that codes for the primary structure of a polypeptide is a _______________.

c. beriberi. (Gropper Chap 9, pg 324)

A consequence of thiamin deficiency is: a. pellagra. b. megaloblastic anemia. c. beriberi. d.rickets.

b. D (Gropper Chap 10, pg 399)

A deficiency of which vitamin is commonly associated with rickets? a. A b. D c. E d.K

a. 6 carbons. (Beerman CH 6, p. 224)

A food product information sheet states that the food you are eating contains omega-6 fatty acids. Therefore, you know that the fatty acids in this food each have a. 6 carbons. b. 6 double bonds. c. a double bond between carbons 6 and 7. d. All of the above

a. inhibits microbial growth (Beerman CH 5, p. 209)

A food that has been held consistently at a temperature of 35°F is more likely to be safe to eat than one held at 45°F because the lower temperature _____. a. inhibits microbial growth b. prevents the growth of harmful bacteria c. sterilizes the food d. destroys harmful bacteria

Answer: low-quality, high-quality (Beerman CH 5, p. 166)

A food that is either an incomplete protein source or one that has low amino acid bioavailability is considered a _______________ protein source, whereas a food that is a complete protein source with adequate amino acid bioavailability is rated as a _______________ protein source.

d.act as a bactericide agent. Gropper CH 2 page 39

A function of hydrochloric acid in the gastric juice is to a. digest protein, functioning as an endopeptidase. b. protect the stomach lining from damage. c. inhibit secretion of gastrin and CCK. d.act as a bactericide agent.

a. low; concentration (e.g., M; mM; μM) Gropper CH 1

A high Km means _____ affinity and is stated in units of _____. a. low; concentration (e.g., M; mM; μM) b. high; rate (e.g., molecules/sec; moles/min) c. high; time (e.g., hours; min; sec) d.low; does not have any units

d.starch; glucose CH 3 Gropper, pg 68

A homopolysaccharide that is important in human diets is _____ and the end product formed from the complete digestion of this homopolysaccharide is _____. a. cellulose; glucose b. lactose; galactose c. glycogen; glucose d.starch; glucose

c. a part of a coenzyme. (Gropper Chap 9, pg 308-309)

A major function of B vitamins is to serve as: a. antibodies. b. a source of energy. c. a part of a coenzyme. d.electrolytes.

d. polymorphism (Beerman CH 5, p. 175)

A particular genetic mutation that is present in at least 1% of the population is called a _____. a. mutant b. transformation c. condition d. polymorphism

d. a and b (Beermann CH 6, p. 229)

A triglyceride is composed of: a. glycerol. b. three fatty acids. c. omega-3 fatty acids only. d. a and b e. b and c f. All of the above

c. 25 g (CH 15 Krause, pg 283) During the first half of pregnancy, the protein requirement is the same as that of a nonpregnant woman; however, during the second half, the requirement increases from an average of 46 g for nonpregnant women to 71 g for pregnant women. This reflects a change of 25 g more per day to promote the protein deposition necessary for both the mother and the fetus.

According to the RDA, how much additional protein above that of a nonpregnant woman should a pregnant woman consume during the second half of her pregnancy? a. 10 g b. 15 g c. 25 g d. 35 g

c. small intestine. (Beerman CH 6,p pp. 236,237)

After fat is eaten, the majority of its digestion will take place in the: a. mouth. b. stomach. c. small intestine. d.large intestine.

a. Glycogenesis (Beerman CH 4, pg 139)

After she ate her usual dinner, Kamala had an ice cream sundae for dessert. Which metabolic process is predominating? a. Glycogenesis b. Glucose synthesis c. Glycogenolysis d.Gluconeogenesis

a. mitochondrial inner membrane Gropper CH 1

All components of the electron transport chain are embedded in the _____. a. mitochondrial inner membrane b. mitochondrial outer membrane c. mitochondrial matrix d.cytoplasmic matrix

C (Gropper Ch 8 pg. 284)

Bioelectrical impedance analysis, a method used to determine body composition, is based on which principle? a. Atomic nuclei behave like magnets when an external magnetic field is applied across the body. b. Adipose tissue is denser than lean body tissue. c. Electrical conductivity is greater in lean tissue than in adipose tissue. d.Fat-free mass is proportional to total body potassium.

d.carboxylations (Gropper Chap 9, pg 339, 341)

Biotin must be covalently bound to each of four different enzymes in order for them to carry out _____. a. decarboxylations b. oxidation-reduction reactions c. transfer of acetate groups d.carboxylations

a- increases, increases (Beerman, 12)

Blood levels of a nutrient will rise if absorption _____ or reabsorption _____. a. increases, increases b. increases, decreases c. decreases, increases d. decreases, decreases

d. cobalamin. (Beerman chapter 10, pg 422)

Bread rolls that are enriched do not have to contain: a. thiamin. b. niacin. c. riboflavin. d. cobalamin. e. iron. f.folate.

c. by adsorbing/interacting with lipids (Gropper CH 4, pg 120)

By what mechanism do soluble fibers decrease the absorption of lipids? a. by increasing growth of bacteria that use the lipids b. by lowering blood cholesterol c. by adsorbing/interacting with lipids d.by reducing mineral absorption

d. calbindin (Gropper Chap 11, pg 427)

Calcitriol can stimulate the absorption of calcium from the intestines by regulating _____and related proteins. a. calsequestrin b. calcitonin c. calmodulin d.calbindin

d.Retinol must be re-esterified to be carried in the chylomicron. (Gropper Chap 10, pg 375)

Choose the ONE correct statement. a. Beta-carotene is hydrolyzed in the jejunum before it is absorbed. b. Retinol does not need to form a micelle to cross the USW. c. Beta-carotene dioxygenase activity occurs in the lumen of the ileum. d.Retinol must be re-esterified to be carried in the chylomicron.

Key: Grading rubric - answer should include the following items: -- Following a meal, insulin increases the activity of lipoprotein lipase (LPL) in the blood vessels traversing the adipose tissue. -- LPL hydrolyzes triglycerides in the chylomicrons delivered in the blood and fatty acids and monoacylglycerol are taken up into the adipocytes. -- Insulin also increases the entry of glucose into the adipocytes and stimulates glycolysis. -- Acetyl-CoA from glycolysis not needed for energy production is used to create fatty acids through fatty acid synthase, also stimulated by insulin. -- Within the adipocyte these newly formed and/or taken up fatty acids and monoacylglycerols (or glycerol-3-P from glycolysis) are reformed into triglycerides. -- Triacylglycerols are stored in a large lipid droplet within the adipocyte. (Gropper CH 5, pp. 155-56)

Describe fat metabolism in the adipose cell following a meal.

Key: Grading rubric - answer should include the following items: -- Hypertension, dyslipidemia, and pro-inflammatory mediators stimulate endothelial cells lining the arteries to produce proteins on their outer matrix that cause platelets to adhere. -- Leukocytes, especially monocytes, enter the intima from the bloodstream. -- The monocytes differentiate into macrophages and take up LDL particles. -- When sufficient LDL cholesterol accumulation has turned the macrophages into foam cells, plaque can be detected on the arterial wall. (Gropper CH 5, pg. 181)

Discuss the factors that initiate the process that leads to plaque formation.

c. early adulthood (Gropper Chap 11, pg 433)

During which period of the life cycle does peak bone mass occur? a. childhood b. puberty c. early adulthood d.middle age

d. gene (Beerman CH 5, p. 168)

Each _____ provides instructions as to how to assemble a particular protein. a. polypeptide b. amino acid c. translation d. gene

d. R- (Beerman CH 5, p 163)

Each amino acid molecule contains a structurally unique part called the _____ group. a. amino b. amine c. carboxylic acid d. R-

Key: Grading rubric - answer should include the following items: -- When more ethanol than can be metabolized by the alcohol dehydrogenase pathway is present, the excess is metabolized through the cytochrome P-450 enzymes of the MEOS system. -- The enzymes and cytochromes of the MEOS system are inducible and increase over time with excess ingestion of alcohol. -- The more enzyme activity present in the system, the quicker that ethanol can be metabolized, and thus the more ethanol that can be ingested before intoxication begins. (Gropper CH 5, p 176)

Explain the role of the MEOS and cytochrome P-450 in developing metabolic tolerance to ethanol.

c. conjugases (Gropper Chap 9, pg 344)

Folate in foods can only be absorbed in the monoglutamate form; therefore, digestive enzymes called _____ are important for folate nutriture. a. hydrolases b. lipases c. conjugases d.legumes

b. ribosomes, and amino acids (Beerman CH 5, pp. 168-169)

For protein synthesis to occur, DNA, mRNA, tRNA, _____ are required. a. cytoplasm, and peptides b. ribosomes, and amino acids c. the nucleus, and polypeptides d. chromosomes, and peptides

b. carbohydrates that are nondigestible by human enzymes, have been isolated, extracted or manufactured, and have been shown to have beneficial physiological effects in humans. (Gropper CH 4, pg 111)

Functional fiber is currently defined as a. carbohydrates and lignin that are nondigestible by human enzymes and are intact and intrinsic in plants. b. carbohydrates that are nondigestible by human enzymes, have been isolated, extracted or manufactured, and have been shown to have beneficial physiological effects in humans. c. all dietary fiber. d.the same as crude fiber.

B Based on amount needed per day (Ch 12 Beerman)

How are minerals classified? a. Based on solubility b. Based on amount needed per day c. Based on food source d. Based on their chemical structure

d. aldosterone, kidneys (Beerman, Ch 12)

Hyponatremia stimulates the adrenal glands to secrete _____, which in turn causes the _____ to reabsorb sodium. a. antidiuretic hormone (ADH), bones b. angiotensin I, blood c. aldosterone, colon d. aldosterone, kidneys

c. some evidence suggests a protective effect of vitamin D. (Gropper Chap 10, pg 398, 399)

If asked about the relationship of vitamin D to autoimmune disease, the best information for a dietetic professional to provide is: a. the evidence does not support a relationship at this time. b. the evidence is only in animals, not humans. c. some evidence suggests a protective effect of vitamin D. d.take a supplement containing 2000 IU vitamin D each day.

d-3-4 (Beerman, Ch 12)

If one 8-ounce glass of milk provides 300 mg of calcium, about how many 8-ounce glasses does Mike, a 20-year-old college student, need to drink in order to get the Recommended Dietary Allowance (RDA) for calcium? a. 6 b. 1-2 c. 5 d. 3-4

a. esterified by lecithin retinol acyl transferase (Gropper Chap 10, pg 376)

In order to be carried in the chylomicron, retinol (once in the enterocyte) is _____. a. esterified by lecithin retinol acyl transferase b. converted to retinaldehyde by retinaldehyde reductase c. attached to a VLDL d.attached to an RXR receptor on the nucleus

b. triacylglycerols (Gropper CH 5, pg. 141)

In what form is most body fat stored? a. fatty acids b. triacylglycerols c. cholesterol d.phospholipids

a. adipose (Gropper Chap 10, pg 403)

In what type of tissue is the largest amount of vitamin E stored? a. adipose b. heart c. lung d.brain

d. mitochondrion CH 3 Gropper, page 83

In which cellular site is most of the energy released when carbohydrates are oxidized to carbon dioxide and water? a. cytoplast b. reticuloendothelial c. Golgi body d.mitochondrion

c. B12 (Gropper Chap 9, pg 355)

Intrinsic factor is required for the majority of absorption of which vitamin? a. C b. B6 c. B12 d.B2

c. Lipase (Beerman CH 6, p. 230)

Lipolysis is catalyzed by which of the following enzymes? a. Amylase b. Pancrease c. Lipase d.α-phosphatase

b. prions (Beerman CH 5, p. 205)

Mad cow disease is caused by _____. a. toxins b. prions c. parasites d. bacteria

b. coconut, palm (Beerman CH 6, p. 228)

Marie wants to limit her intake of saturated fatty acids. To accomplish this, she should avoid foods that have _____ oil or _____ oil as ingredients. a. flaxseed, canola b. coconut, palm c. soy, corn d. safflower, cottonseed

c. hemoglobin (Gropper CH 12, pg 470)

Of these blood proteins, which one contributes most to buffering? a. albumin b. gamma globulins c. hemoglobin d.transthyretin

a. relies on transmembrane proteins called claudins. (Gropper Chap 11, pg 427-428)

Paracellular absorption of calcium a. relies on transmembrane proteins called claudins. b. requires a membrane channel protein called TRPV6. c. requires energy and is saturable. d.increases with low dietary calcium intakes.

d. hydrochloric acid (Beerman CH 5, p. 177)

Pepsinogen is converted into its active form pepsin by _____. a. peptidase b. gastrin c. chymotrypsin d. hydrochloric acid

b. secondary (Beerman CH 5, p. 170)

Polypeptide chains are twisted and folded into a three-dimensional shape called the protein's _____ structure. a. primary b. secondary c. tertiary d. quaternary

a. completeness of the protein (Beerman CH 5, p. 166)

Protein quality is based on _____ and bioavailability. a. completeness of the protein b. sequence of amino acids c. number of amino acids d.structure of amino acids

Answer: down-regulation, up-regulation (Beerman CH 5, p. 167)

Protein synthesis is "turned off" via _______________ and "turned on" via _______________.

a. proenzymes (Beerman CH 5, pp. 177, 178)

Protein-digesting enzymes are released as _____. a. proenzymes b. proteases c. polypeptides d. amino acids

a. conditionally (Beerman CH 5, p. 163)

Proteins can be classified as essential, nonessential, or _____ essential. a. conditionally b. partially c. temporarily d. provisionally

Answer (key points): (Beerman CH 5, p. 191) Consume significant amounts of protein from at least 3 different food groups daily. Choose "reduced fat," "low fat," or "fat free" options for selections of high-protein dairy foods. For snacks, choose reasonable amounts of high-protein items such as nuts and seeds. When comparing similar foods, choose higher-protein, lower-fat options by comparing Daily Values found on Nutrition Facts labels. Add slivered almonds or other nuts to steamed vegetables and fresh salads. Experiment with ethnic cuisines—such as Indian or Mexican—that frequently utilize a variety of "pulses" (legumes) that are great sources of protein, nutrient dense, and low in fat. To maximize the nutrient density of meat products, trim excess fat prior to cooking.

Provide five food selection and preparation tips that will help people meet their overall nutrient requirements as well as those for protein.

Key: AMP, NAD

Pyruvate dehydrogenase is positively modulated by _____ and _____.

D. (pg. 285 Gropper Ch 8)

Quantification of total body water or total body potassium by the use of _____ permits calculation of body composition. a. neutron activation b. infrared light c. high-frequency ultrasonic energy d.radioactive or stable isotopes

c. falls under the Dietary Supplement Health and Education Act of 1994. (Gropper CH 4, pg. 132)

Regulation of herbal supplements in the United States a. is separate from the regulation of vitamins. b. guarantees that the herbal supplements are safe and effective. c. falls under the Dietary Supplement Health and Education Act of 1994. d.requires that therapeutic claims be clearly listed on the label.

a. newborns. (Gropper Chap 10, pg 414)

Risk of vitamin K deficiency is greatest in: a. newborns. b. children. c. adolescents. d.older people.

c. duodenum CH 3 Gropper, pg 70

Sucrose digestion is initiated in the _____. a. pylorus b. fundus c. duodenum d. mouth

a. glucose. (Beerman CH 4, pg 119)

Sucrose, maltose, and lactose all include the monosaccharide: a. glucose. b. fructose. c. galactose. d.raffinose

a. cutaneous production of the vitamin reaches a maximum (Gropper Chap 10, pg 399)

Sun exposure does not cause hypervitaminosis D because _____. a. cutaneous production of the vitamin reaches a maximum b. sunburned skin is not sensitive to the UV wavelength that causes previtamin D3 synthesis c. inactive products are synthesized from pre-vitamin D3 and D3 d.vitamin D-binding protein is not saturated with D3

d. immune complex deposits of antinuclear antibodies. (Gould CH 7, pgs. 127-128)

Systemic lupus erythematosus is caused by: a. a chronic allergic condition. b. development of an immune-deficient state. c. a deficiency of T lymphocytes. d. immune complex deposits of antinuclear antibodies.

True

T or F Glucose is transported from the lumen into the enterocyte by active transport using SGLT1 protein, which also requires Na as a co-transporter.

True

T or F RBCs do not have mitochondria; hence, they rely on glycolysis for energy needs and produce a lot of lactate.

True

T or F The Cori cycle would be active under anaerobic conditions, such as excessive muscle exertion.

True

T or F The muscle cannot convert amino acids to glucose and then secrete it because of a lack of glucose-6-phosphatase.

True

T or F The process of gluconeogenesis occurs partially in the mitochondria, and partially in the cytosol.

True

T or F The signal for glycogenolysis to occur in liver and muscle is glucagon for the liver, epinephrine for muscle.

True Beerman CH 1, page 6

T or F onessential nutrients do not need to be eaten to maintain health, as the body can make them in amounts needed to satisfy its physiological requirements.

false (Beerman CH 5, p. 210)

T or F: Because irradiated foods are safe, foods that have been irradiated are not labeled in any special way.

True (Beerman Ch 5, p. 209)

T or F: Foods can be preserved by drying, salting, smoking, fermentation, heating, freezing, and irradiation.

True (Beerman CH 5, p. 210)

T or F: It is not necessary to pasteurize fruit juices in order to sell them.

Answer: amino acid (Beerman CH 5, p. 163)

The central carbon of an _______________ is bonded to an amino group, carboxylic acid group, and a side-chain group (R-group)

d. a and c (Beerman chapter 10, pg 447)

Vitamin C enhances the absorption of: a. iron. b. selenium. c. copper. d. a and c e.b and c

c. antibiotic therapy. (Gropper Chap 10, pg 414)

Vitamin K deficiency in adults is most likely due to: a. oxalic acid in food. b. achlorhydria. c. antibiotic therapy. d.a high-fiber diet.

d. 50-70 (Beerman, 12)

Water accounts for what percentage of an adult's total body weight? a. 23-25 b. 28-40 c. 42-48 d. 50-70

a. Gastrin (Beerman CH 5, p. 176-177)

What hormone is released by some gastric cells when there is food in your stomach? a. Gastrin b. Pepsinogen c. Cholecystokinin d. Trypsin

C. p. 276. Gropper Ch 8

What is the BMI of a man who weighs 220 lbs and is 6 feet tall? a. 54.7 b. 36.7 c. 29.9 d.24.9

B. p. 277 (Gropper CH 8)

What is the IBW of the woman in question #25, calculated using the modified Devine formula? a. 127 lb b. 130 lb c. 137 lb d.140 lb

d. α-amylase CH 3 Gropper , page 70

What is the key enzyme in digestion of polysaccharides? a. starch amylopectin b. β-amylase c. α-dextranase d.α-amylase

c. Exposure to ultraviolet light (Gould CH 8, pg 154)

What is the major predisposing factor to squamous cell carcinoma? a. Viral infection b. Presence of nevi (moles) on the skin c. Exposure to ultraviolet light d. Frequent hypersensitivity reactions

c. lignin (Gropper CH 4, pg. 114)

What is the primary noncarbohydrate component of fiber? a. gums b. hemicellulose c. lignin d.cellulose

c. An increased ratio of fat mass to lean mass as an adult. (CH 17 Krause, pg 324-325) Adiposity rebound is associated with the gain of body fat starting between 4 and 6 years of age, and the earlier this occurs, the more likely it is that the person will be heavier as an adult. This will be reflected in a greater BMI (or weight-to-height ratio) as an adult and an increase in fat mass in proportion to overall body weight. The degree of fatness during adolescence is also a contributing factor to the development of adult obesity.

What may be a consequence of a child experiencing an early adiposity rebound? a. An increased ratio of lean mass to fat mass as an adolescent. b. An increased ratio of lean mass to fat mass as an adult. c. An increased ratio of fat mass to lean mass as an adult. d. An increased height-to-weight ratio as an adult.

a. mg/kg/day (Beerman CH 5, p. 187)

What unit is used to express the RDAs for amino acids? a. mg/kg/day b. mg/day c. g/kg/day d. g/day

C. p. 291 (Gropper CH 8)

When oxidized, which nutrient(s) provide(s) the lowest respiratory quotient? a. carbohydrate b. protein c. fat d.mixed diet

b. Aldosterone and renin secretion decrease, resulting in decreased salt reabsorption by the kidneys (Beerman, 12)

When the concentration of sodium in the blood increases, what happens to aldosterone and renin secretion, and what then results? a. Aldosterone and renin secretion increase, resulting in increased salt reabsorption by the kidneys b. Aldosterone and renin secretion decrease, resulting in decreased salt reabsorption by the kidneys c. Aldosterone and renin secretion increase, resulting in decreased salt reabsorption by the kidneys d. Aldosterone and renin secretion decrease, resulting in increased salt reabsorption by the kidneys

d. tryptophan (Gropper Chap 9, pg 331)

When the diet is adequate in protein, the body can synthesize niacin from which amino acid? a. phenylalanine b. valine c. tyrosine d.tryptophan

b. exothermic Gropper CH 1

When the terminal phosphate group of ATP is removed by hydrolysis, forming ADP and inorganic phosphate, the type of reaction that occurs is _____. a. endothermic b. exothermic c. standard d.free

Answer: cause-and-effect relationship or causal relationship (p. 14) CH 1 Beerman

When two variables are linked by a __________, an alteration in one of the variables directly causes a change the other.

d. Over 2,000 years ago (Beemer CH 4, p. 147)

When was diabetes mellitus first described? a. In the last 100 years b. 500 years ago c. 1,000 years ago d. Over 2,000 years ago

a. 16th century (Beemer CH 4, p. 147)

When was diabetes mellitus first treated by physicians with special diets? a. 16th century b. 17th century c. 18th century d. 19th century

Α p. 279. Gropper Ch 8

Which body component comprises more diverse tissues? a. lean body mass b.fat mass

d.proteases Gropper CH 2 page 36

Which is NOT a component of saliva? a. mucus b. enzymes c. water d.proteases

B p. 522 (Gropper CH 13)

Which mineral is an essential factor in the action of glutathione peroxidase (GPX) in the reduction of organic peroxides and hydrogen peroxide? a. molybdenum b. selenium c. silicon d.vanadium

c. Stress (Beerman CH 5, p. 187)

Which of the following conditions is most likely to result in a negative nitrogen balance? a. Pregnancy b. Growth c. Stress d. Recovery from illness

ANS: C Supplementation with long-chain fatty acids (LCFAs) improves depression. Other mental conditions that benefit from use of LCFA supplementation include bipolar disorder, postpartum depression, schizophrenia, dementia, alcoholism, and tardive dyskinesia. Anxiety disorder, eating disorders, and attention-deficit hyperactivity disorder benefit from the use of fish oils. REF: p. 857 (Krause CH 41)

Which of the following conditions may be improved by supplementation of long-chain fatty acids? a. Anxiety disorder b. Eating disorders c. Depression d. Attention-deficit hyperactivity disorder

C p. 486 (Gropper CH 13)

Which of the following dietary substances inhibits uptake of non-heme iron? ascorbic acid lactic acid tea MFP

a. Beans and rice (Beerman CH 5, p. 166)

Which of the following food combinations yields a complete protein? a. Beans and rice b. Rice and corn c. Potatoes and corn d. Tossed salad with nuts and cranberries

d. Dairy products (Beerman chapter 10, pg 428)

Which of the following food groups provides a good source of riboflavin? a. Fruits b. Vegetables c. Bread and pasta d.Dairy products

a. A salad with an oil and vinegar dressing (Beerman CH 6, pp. 227, 228)

Which of the following food selections is most likely to provide a source of essential fatty acids? a. A salad with an oil and vinegar dressing b. A smoothie made with strawberries and bananas c. A chicken salad whole-wheat wrap d. A vitamin- and mineral-fortified sports beverage

a. Chickpeas, fish, and chicken (Beerman chapter 10, pg 434)

Which of the following foods are especially good sources of vitamin B6? a. Chickpeas, fish, and chicken b. Broccoli, eggs, and canola oil c. Apples, wheat bread, and yogurt d.Cheese, pineapple, and pasta

a. Green, leafy vegetables (Beerman chapter 10, pg 438)

Which of the following foods are good sources of folate? a. Green, leafy vegetables b. Citrus fruits c. Red meats d.Dairy products

d. Seafood, meat, and dairy products (Beerman, 12)

Which of the following foods are the best sources of the major minerals? a. Legumes and nuts b. Whole-grain products c. Fruits and vegetables d. Seafood, meat, and dairy products

d.oat bran and legumes (Gropper CH 4, pg 120)

Which of the following high-fiber foods are most effective in lowering serum cholesterol? a. corn and wheat b. chitosan and chitin c. rice bran and wheat bran d.oat bran and legumes

a. Infant feeds from both breasts during a feeding. (CH 15 Krause, pg 289) When an infant feeds from both breasts during a feeding, it is an indication of the volume of milk the mother is producing between feedings. Usual signs for adequate infant growth are the weight and length gain and the wet diaper and stool frequency.

Which of the following is NOT an indication of adequate infant growth from breastfeeding? a. Infant feeds from both breasts during a feeding. b. Infant has at least six to eight wet diapers per day. c. Infant has frequent stools. d. Infant continues to gain weight and length steadily.

Trypsin, chymotrypsin, and carboxypeptidase (Ch 1, Krause) pg 8 Trypsin, chymotrypsin, and carboxypeptidase are three protein digestive enzymes secreted by the pancreas. Insulin is an endogenous hormone secreted by the pancreas. Secretin is a hormone secreted by the small intestine. Lactase and isomaltase (also known as dextrinase) are brush-border enzymes. Pepsin, which is a protease, and gastrin are hormones secreted by the stomach.

Which of the following is a list of enzymes released from the pancreas? a. Insulin, trypsin, and secretin b. Lactase, isomaltase, and dextrinase c. Protease, pepsin, and gastrin d. Trypsin, chymotrypsin, and carboxypeptidase

ANS: A Because patients with glycogen storage disease develop no provisional carbohydrate stores, they run the risk of developing hypoglycemia. Therefore, the provision of a high-carbohydrate, low-fat diet with intake of raw cornstarch at regular intervals throughout the day is used to prevent hypoglycemia. Carbohydrate feedings must occur throughout the day and should not be distributed to only three eating episodes or restricted. REF: p. 892 (Krause CH 43)

Which of the following is used in the nutritional management of patients with glycogen storage disease? a. Oral intake of cornstarch b. Small, frequent high-protein meals c. Severe restriction of all carbohydrates d. Three well-balanced meals a day

b. Bakery products and margarine (Beerman CH 6, p. 223)

Which of the following items in your grocery cart would be considered the main sources of trans fatty acids in your diet? a. Dairy products and fruits b. Bakery products and margarine c. Vegetables and fatty fish d. Salad dressings and cooking oils

b. Gluconeogenesis (CH 23 Krause, p. 432) Gluconeogenesis occurs in the liver, and although glucose produced by this pathway may travel to the muscle, energy generation in the muscle itself is not dependent on gluconeogenesis. During anaerobic conditions, glycogenolysis breaks down muscle glycogen stores to provide glucose for glycolysis. During aerobic conditions, glycolysis can still occur. Beta oxidation of fatty acids becomes a primary energy source for muscle cells as activity continues.

Which of the following pathways is NOT used to generate energy in muscle cells during any type of exercise? a. Glycogenolysis b. Gluconeogenesis c. Glycolysis d. Beta oxidation

c. 19-24 (Gropper Ch 8, pg 276)

Which of the following represents a BMI range considered to be healthy for most adult men and women? a. 10-14 b. 15-18 c. 19-24 d.25-30

B. Gropper Ch 8 p 283

Which of the following techniques for measuring body composition makes use of small exposures to radiation? a. MRI b. DEXA c. TOBEC d.BIA

c. vitamin B6 (Gropper Chap 9, pg 365)

Which of the following vitamins has a Tolerable Upper Intake Level established? a. thiamin b. riboflavin c. vitamin B6 d.vitamin B12

a. It is higher in fat than mature milk. (CH 15 Krause, pg 286) Colostrum is the thin, yellow, milky fluid that is the first milk available after birth. It is higher in protein and lower in fat and carbohydrates than mature milk. It is also lower in lactose and higher in immunoglobulins than mature milk.

Which of these statements is NOT true about colostrum? a. It is higher in fat than mature milk. b. It is higher in immunoglobulins than mature milk. c. It is higher in protein than mature milk. d. It is lower in lactose than mature milk.

a. Meat and dairy (Beerman CH 5, p. 165)

Which one of the following food lists provides the best sources of complete protein? a. Meat and dairy b. Breads and cereals c. Fruits and vegetables d.Rice and pasta

a. Albumin (Beerman CH 5, p. 182)

Which one of the following proteins helps draw fluid from the interstitial spaces back into the blood vessels? a. Albumin b. Hemoglobin c. Myoglobin d. Gastrin

d. 140 mg/dL (Beerman CH 4, pl 152)

Which one of the following would be considered an abnormal fasting plasma glucose level for a person with diabetes? a. 80 mg/dL b. 100 mg/dL c. 120 mg/dL d. 140 mg/dL

b. Liver (Beerman CH 4, pg 134)

Which organ is able to convert galactose and fructose into glucose? a. Muscle b. Liver c. Small intestine d. Large intestine

b. Pancreas (Beerman CH 4, pg. 136)

Which organ synthesizes the hormone glucagon? a. Liver b. Pancreas c. Gallbladder d. Large intestine

c. homeostasis (Gropper CH 12, pg 455)

Which process gives the body the capacity to maintain constancy in the internal environment? a. osmotic pressure b. osmolality c. homeostasis d.acid-base balance

d.somatastatin Gropper CH 2 page 58

Which regulatory peptide synthesized in the pancreatic and intestinal cells appears to inhibit release of gastrin, secretin, and motilin? a. neurotensin b. GRP c. insulin d.somatastatin

b. Contemplation (CH 14 Krause, pg 233) Ambivalence occurs when the patient has mixed feelings and is considering the "pros" and "cons" of behavior change. This is characteristic of the stage of contemplation. The precontemplation stage is characterized by the need for awareness of a problem existing. Preparation involves the need to identify acceptable change strategies. Maintenance has the challenge of sustaining an accomplished change without occurrence of relapse.

Which stage of change is characterized by the patient's feelings of ambivalence? a. Precontemplation b. Contemplation c. Preparation d. Maintenance

d. A type IV reaction occurs in affected areas. (Gould CH 7, pg. 126)

Which statement applies to contact dermatitis? a. It occurs when IgE antibodies on the skin react with the causative substance. b. It may result from ingested foods. c. Urticaria (hives) gradually spread over the body. d. A type IV reaction occurs in affected areas.

d. Infants test positive for HIV because of the presence of maternal antibodies. (Gould CH 7, pg 134)

Which statement is TRUE regarding infants born to HIV-infected mothers? a. Infants usually test negative for HIV after birth. b. There is little risk of infected mothers passing the virus to their infants during delivery. c. Breast milk does not contain HIV or antibodies. d. Infants test positive for HIV because of the presence of maternal antibodies.

a. Weight gain (Beerman CH 4, p 149)

Which symptom is not associated with type 1 diabetes? a. Weight gain b. Weight loss c. Extreme thirst d.Frequent urination

d.severe infections (Gropper Chap 10, pg 388)

Which symptom of a vitamin A deficiency is most likely responsible for deficiency-related deaths? a. its function as a teratogen b. poor cellular differentiation and growth c. keratinization of the cornea d.severe infections

c. Agreeing with a twist (CH 14 Krause, pg 234) When dealing with clients during the precontemplation stage, the goal is to facilitate their ability to consider change. For this to occur, strong communication skills are necessary. These include asking open-ended questions, listening reflectively, providing affirmation, and summarizing the client's statements. Agreeing with a twist is a means of dealing with resistant behavior by agreeing with the client and then redirecting the focus of the conversation.

Which technique is NOT useful in working with clients during a not-ready-to-change counseling session? a. Asking open-ended questions b. Affirming c. Agreeing with a twist d. Summarizing

D p. 537 (Gropper CH 13)

Which trace mineral is important for activating a key enzyme in gluconeogenesis? a. iron b. copper c. iodine d.manganese

b. Active artificial (Gould CH 7, pg. 119)

Which type of immunity is provided by a vaccination? a. Active natural b. Active artificial c. Passive natural d. Passive artificial

a. niacin (Gropper Chap 9, pg 332)

Which vitamin has a reduced coenzyme form important for fatty acid and cholesterol synthesis that is a product of the pentose phosphate pathway? a. niacin b. thiamin c. riboflavin d.vitamin C

b. D (Gropper Chap 10, pg 395)

Which vitamin has as its primary function the maintenance of calcium homeostasis? a. A b. D c. E d.K

c. Vitamin D (CH 16 Krause, pg 303) The breastmilk of an adequately fed, lactating woman provides all vitamins except vitamin D. Human milk provides only about 0.5 mcg of vitamin D, which is one-tenth of the amount recommended by the AAP to prevent vitamin D deficiency and rickets. Supplementation with 5 mcg of vitamin D daily is recommended for breast-fed infants.

Which vitamin is NOT adequately provided by breastmilk? a. Vitamin C b. Niacin c. Vitamin D d. Vitamin A

a. Pantothenic acid (Beerman chapter 10, pg 433)

Which vitamin's name is derived from the fact that it is found "everywhere" in the diet? a. Pantothenic acid b. Thiamin c. Niacin d.Riboflavin

a. Evans and Bishop (Gropper Chap 10, pg 401)

Who discovered vitamin E? a. Evans and Bishop b. McCollum and Davis c. Mellanby and Hopkins d.Simon and Garfunkel

C- Those who use medications containing magnesium for treatment of heartburn, indigestion, and constipation (Beerman, CH 12)

Who is at the greatest risk of developing magnesium toxicity? a. Those who consume "farmed" seafood as opposed to non-farmed seafood b. Those who consume foods grown near electrical power plants c. Those who use medications containing magnesium for treatment of heartburn, indigestion, and constipation d. Those who consume foods grown near nuclear power plants

a. nuclear retinoic acid receptors (Gropper Chap 10, pg 382-383)

Within the nucleus, all trans-retinoic acid and/or 9-cis retinoic acid binds to _____. a. nuclear retinoic acid receptors b. mannosylated glycoproteins c. cell aggregates d.transcription factors

c. an essential fatty acid deficiency (Beerman CH 6, p. 227)

Your friend Ashok is consuming a very-low-fat diet in an attempt to lose weight. He considers all dietary fats as "bad" for him and he thinks that the less fat he eats the better. You should point out to him that a very-low-fat diet could put him at risk for developing _____. a. diabetes b. gout c. an essential fatty acid deficiency d. an essential mineral deficiency

cystic fibrosis (Beerman, CH 12)

_______________ is a genetic disease in which a defective chloride transporter results in the inability of the body to transport chloride out of cells.

Answer: Transcription (Beerman CH 5, pp. 168)

_______________ is the process by which mRNA is made using DNA as a template

Answer: Ribosomes (Beerman CH 5, p. 169)

_______________, organelles associated with the endoplasmic reticulum in the cytoplasm, are involved in gene translation.

a. monosodium glutamate (MSG) (Beerman CH 5, p. 207)

"Chinese restaurant syndrome" is a term used to refer to a reaction some people experience after ingesting _____. a. monosodium glutamate (MSG) b. sulfites c. soy d. peanut oil

d. to prevent antibiotic resistance. (CH 9 Krause) Antibiotic-resistant strains of pathogenic bacteria is a growing problem. Antibiotics are in widespread use in the meat and dairy industry. Organic meats and dairy products are raised without the use of antibiotics. The American Medical Association has gone on record to oppose the nontherapeutic use of antibiotics in agriculture.

. One of the strongest arguments for the use of organic food is a. that the cost of organic food is decreasing. b. organic food is not more susceptible to contamination. c. to prevent sensitivity to pesticide contamination. d. to prevent antibiotic resistance.

a system of cost efficiency. (CH 10 Kruase, pg 169) Utilization management strives for cost efficiency by eliminating or reducing unnecessary tests, procedures, and services. HIPAA is a system for protecting personal health information. A critical pathway identifies essential elements that occur in a patient's care.

. Utilization management is a. a system to protect personal health information. b. a system of cost efficiency. c. a critical pathway. d. a medical staffing system.

d.All of the above (Gropper CH 4, pg 125)

. What characteristics of fiber may protect against developing colon cancer? a. Fibers adsorb primary bile acids to promote their excretion. b. Fibers increase fecal bulk and dilute carcinogen concentrations. c. Fibers can be fermented to butyric acid, which may slow proliferation of cancer cells. d.All of the above

ANS: C The Joint Commission requires that a qualified dietitian must be involved in establishing the nutrition care process but does not specify who should accomplish the process. Accreditation is voluntary but highly regarded by insurance reimbursement and in ensuring confidence in the institution by the community. Survey visits occur every 3 years. The sections of the "Accreditation Manual for Hospital" include patient-focused functions, organization-focused functions, and structures with functions. REF: p. 163 Ch 10 Krause

. Which of the following statements is TRUE regarding The Joint Commission? a. Accreditation by The Joint Commission is required by hospitals. b. To maintain accreditation, a hospital must undergo a Joint Commission survey every 5 years. c. The Joint Commission specifies that a qualified dietitian must be involved in establishing a hospital's nutrition care process. d. The three sections of the "Accreditation Manual for Hospital" are patient-focused functions, staff-focused functions, and structures with functions.

Escherichia coli (CH 9 Krause, pg 149) E. coli contamination was connected to undercooked ground beef in one fast-food restaurant chain in the 1990s. A common source for this pathogen is water contaminated with human waste. C. jejuni can cause bloody diarrhea but comes from consuming raw milk and undercooked chicken and shellfish. S. aureus promotes nausea and vomiting and affects foods that may be mixed by hand, such as meat and pasta salads. Y. enterocolitica can cause fever and bloody diarrhea in children but more often comes from contaminated and undercooked pork products.

. Which pathogen causes hemorrhagic colitis (painful, bloody diarrhea), which can result from eating undercooked ground beef and meats? a. Escherichia coli b. Campylobacter jejuni c. Staphylococcus aureus d. Yersinia enterocolitica

b. Osteoporosis (CH 21 Krause, pg. 390) Conditions such as diabetes, heart disease, hypertension, gallbladder disease, sleep apnea, osteoarthritis, and certain cancers worsen as the degree of obesity increases. Women of slight build and those who are underweight have a higher risk of developing osteoporosis.

1. An increased incidence of which of the following diseases is NOT associated with obesity? a. Heart disease b. Osteoporosis c. Gallbladder disease d. Sleep apnea

a. carbohydrates and lignin that are nondigestible by human enzymes and are intact and intrinsic in plants. (Gropper CH 4, pg 111)

1. Dietary fiber is currently defined as a. carbohydrates and lignin that are nondigestible by human enzymes and are intact and intrinsic in plants. b. carbohydrates that are nondigestible by human enzymes, have been isolated, extracted or manufactured, and have been shown to have beneficial physiological effects in humans. c. crude fiber. d.the same as functional fiber.

may indicate deficiency before clinical or anthropometric data does.(Ch 7 Krause pg 99) Laboratory-based nutrition testing, used to estimate nutrient concentration in biologic fluids and tissues, is critical for assessment of both clinical and subclinical nutrient deficiencies. Most of these states can be assessed in the laboratory so that nutritional intervention can occur before a clinical or anthropometric change or a frank deficiency occurs. Single test results may be useful for screening or to confirm an assessment based on changing clinical, anthropometric, and dietary status. The best biologic medium to test depends on the specific nutrient. Laboratory assessment is stringently controlled. It involves comparing control samples with predetermined substance or chemical constituent concentrations with every patient specimen. REF: p. 99

1. Laboratory tests for nutrients a. are not useful if you have only a single test result. b. are always best done on whole blood. c. may indicate deficiency before clinical or anthropometric data does. d. are currently not well controlled.

ANS: B Poor acceptance of meals in the hospital may be caused by improper food temperatures, unfamiliar foods, changes in the eating schedule, the patient's medical condition, or the effects of medical therapy. Having the option of selecting menu items, eating with others, and positive communications from nurses and other health care team members can help improve patient intake. REF: p. 171 CH 10 Krause

10. Which of the following has a negative influence on patient acceptance and intake of meals and food in the hospital? a. Patient selection of menus b. Improper food temperatures c. Eating with others d. Nurse's communication of the diet

ANS: C The hypothalamus controls sleep, temperature regulation, and autonomic systems. It has high energy needs for its size. Dysfunction has been associated with chronic fatigue syndrome and fibromyalgia. REF: p. 858 (Krause CH 41)

16. Chronic fatigue syndrome and fibromyalgia are associated with dysfunction of the a. pituitary gland. b. cerebral cortex. c. hypothalamus. d. glucose metabolism.

Ensuring that effective service delivery systems are in place (CH 9 Krause, pg 140) In the model of shared responsibility, the local health agency is most responsible for ensuring that services are available. The federal government functions in a supportive role, both in providing funding and in the development and dissemination of public health knowledge. Although community organizations and leaders may be involved, the state public health agency is responsible for assessment and monitoring activities in relation to the achievement of goals and objectives.

18. Although responsibility for public health is shared across different levels of government, which responsibility is usually handled by the local health agency? a. Providing funding to support the capacity to carry out public health functions b. Ensuring that effective service delivery systems are in place c. Supporting the development and dissemination of public health knowledge d. Assessing the capacity to perform essential public health functions

protein (Ch 7 Krause pg 102) Small amounts of protein, from 2 to 8 mg/dL, are expected in normal urine. Larger amounts are associated with damage to the kidneys. Results for glucose, ketones, and blood in the urine are expected to be negative.

19. In urinalysis tests, which of the following is expected to appear at some level in normal people? a. Glucose b. Ketones c. Blood d. Protein

Reliance on the patient's memory (ch 4, Krause) Both the food frequency and the 24-hour food recall depend on the patient's memory of past intake. This can be of particular difficulty when trying to evaluate the diet history of an elderly person or a child. To their benefit, both of these methods require little time or materials to administer, and they do not require the patient to write down and maintain his or her own record of intake. REF: p. 60

3. What is a limitation of using the 24-hour recall and the food frequency? a. The patient's level of literacy b. The time required to collect data c. The lack of tools for conducting these d. Reliance on the patient's memory

b. Hepatitis B (CH 29 Krause, p. 562) Hepatitis B and C are transmitted via blood, blood products, semen, and saliva. Hepatitis D also may be transported by blood and body fluids; however, it is rare in the United States and depends on hepatitis B virus for survival and propagation in humans. Hepatitis A and E are the infectious forms that are transmitted by the fecal-oral route.

3. Which is the most common hepatitis virus that is primarily transmitted by blood and body fluids? a. Hepatitis A b. Hepatitis B c. Hepatitis D d. Hepatitis E

all of the above. (ch 5, Krause) ANS: D Many legislators and legal experts believe the Americans with Disabilities Act sufficiently protects against discrimination, but as an added measure of protection, the GINA was passed by Congress and went into effect on November 21, 2009. GINA defines genetic testing and genetic information, bans discrimination based on genetic information, and penalizes those who violate the provisions of this law. Consumers and health care professionals can feel comfortable in adopting this new service. REF: p. 66 | p. 81

9. The purpose of the Genetic Information Nondiscrimination Act (GINA) is to a. define genetic testing and genetic information. b. ban discrimination based on genetic information. c. ensure the fair and positive use of genetic testing. d. all of the above.

d. Food intolerance (CH 26 Krause, p. 480) Food intolerance is a physiologic reaction that does not include immune responses. Patients with food allergies or hypersensitivities would have a response by the patient's immune system. A food aversion is an individual dislike or avoidance of a food for reasons that may be based more on knowledge and perception.

A child develops gastrointestinal symptoms after drinking fruit juice. This is an example of what type of condition? a. Food allergy b. Food aversion c. Food hypersensitivity d. Food intolerance

b. The child is at risk for becoming overweight. (CH 17 Krause, pg 324) A child's BMI between the 85th and 95th percentile is defined as being at risk for becoming overweight. An overweight child is one whose BMI is above the 95th percentile. For a child to be considered obese, the BMI has to be significantly above the 95th percentile.

A child's BMI is plotted on a growth chart at the 90th percentile. How would this child's BMI be interpreted? a. The child has a normal BMI. b. The child is at risk for becoming overweight. c. The child is overweight. d. The child is obese.

b. Contemplation (CH 14 Krause, pg 228) During contemplation, the client goes back and forth in considering the advantages and disadvantages of making a behavior change. In precontemplation, the client is not even aware that a problem may exist. During preparation, the client needs help in finding an acceptable change strategy to address the problem. In relapse, the client needs help to restart doing the actions that she had previously been doing to bring about the behavior change.

A client is aware that a dietary behavior problem exists but is not sure whether to do something about it. What stage of change is this client in? a. Precontemplation b. Contemplation c. Preparation d. Relapse

c. diarrhea. (CH 13 Krause, pg 211) Although diarrhea is the most commonly reported complication associated with enteral feeding, often the enteral nutrition is not the cause. More likely reasons for the diarrhea to occur include bacterial overgrowth, antibiotic use, gastrointestinal motility disorders, and administration of hyperosmolar medications and electrolyte supplements. Adjusting the medications and their administration can correct the diarrhea. The use of prebiotics and probiotics, pectin, bulking agents, and antidiarrheal medications are other ways to treat the diarrhea.

A common complication of enteral tube feeding is a. hyponatremia. b. refeeding syndrome. c. diarrhea. d. hypoalbuminemia.

d. VO2 max (CH 23 Krause, p. 428) A daily intake of less than one-third of the RDA for thiamin, riboflavin, B6, and vitamin C, even when other vitamins are supplemented, may lead to a significant decrease in VO2 max and the anaerobic threshold in less than 4 weeks

A daily intake of less than one-third of the RDA for thiamin, riboflavin, B6, and vitamin C can lead to a significant decrease in a. muscle tone. b. glutathione peroxidase. c. antioxidant levels. d. VO2 max.

d. Thiamin (CH 29 Krause =, p. 566) Wernicke encephalopathy is a common side effect of alcoholism and involves damage to the central nervous system caused by thiamin deficiency. The classic triad of disturbances includes encephalopathy, nystagmus (constant, involuntary movement of the eyeball), and ataxia (impaired muscular movement or gait).

A deficiency of which nutrient is associated with Wernicke encephalopathy? a. Copper b. Essential fatty acid c. Tryptophan d. Thiamin

Key: triacylglycerols, VLDLs (Gropper CH 5, pg 154)

A diet rich in simple sugars increases the hepatic formation of newly synthesized fatty acids and then neutral lipids called _____ from glucose. These neutral lipids are transported from the liver to the adipose tissue by compound lipids called _____.

f. b and d (Beerman CH 6, p. 220)

A fatty acid containing two or more carbon-carbon double bonds in its backbone is a(n) _____ fatty acid. a. saturated b. unsaturated c. monounsaturated d. polyunsaturated e. a and c f. b and d

f. a, b, c, and d (Beerman CH 6, pp. 220, 223)

A fatty acid designated as 18:2: a. has 18 carbons. b. has 2 double bonds. c. is unsaturated. d. is polyunsaturated. e. a and b only f. a, b, c, and d

d. larger polypeptides (Beerman CH 5, p 178)

A food allergy is the likely result of the absorption of intact _____. a. amino acids b. dipeptides c. enzymes d. larger polypeptides

d. functional food. (CH 11 Krause, pg 173) Functional food constituents have a biologic effect and may influence health and susceptibility to disease. Sustainable food and organic food are agricultural terms. A cariogenic food is one that promotes tooth decay.

A food constituent that is not defined as a nutrient but has a biologic effect that may influence health is a a. sustainable food. b. organic food. c. cariogenic food. d. functional food.

d.alpha-tocopherol transfer protein in the liver (Gropper Chap 10, pg 402)

A genetic deficiency in _____ leads to a vitamin E deficiency syndrome. a. RRR alpha-tocopherol b. gamma-tocotrienol c. tocopherol carrier protein in the jejunum d.alpha-tocopherol transfer protein in the liver

b. eats dairy products and eggs but no other animal products. (CH 11 Krause, pg 187) Vegetarians eliminate meat and poultry, but may eat fish. A vegan eats nothing of animal origin. A lactoovovegetarian eats nonanimal products and eggs and dairy.

A lactoovovegetarian a. eats only eggs and vegetables. b. eats dairy products and eggs but no other animal products. c. does not eat any food of animal origin. d. is a vegetarian who occasionally eats poultry.

a. energy transformation. (Gropper Chap 9, pg 320, 321)

A major role for thiamin is: a. energy transformation. b. blood coagulation. c. collagen formation. d.erythrocyte synthesis.

Consistency-modified diet (Ch 10 Krause, pg 170) When a patient has poorly fitting dentures, it affects the patient's ability to chew. Difficulties with chewing and swallowing are best accommodated by a consistency-modified diet. The regular house diet, although nutritionally complete, may include foods that the patient will have difficulty chewing and swallowing, and this may be reflected by a decreased or incomplete intake. Liquid diets tend to not be nutritionally complete, and in particular, they lack fiber. A person with poorly fitting dentures would need extra calories only in the instances when either increased energy needs are determined or there exists a concern in regard to the patient's weight.

A newly admitted patient is observed to have poorly fitting dental plates. Which type of diet would be most appropriate for this patient? a. General or regular house diet b. Liquid diet c. Consistency-modified diet d. Diet increased in energy value

72 (ch 4, Krause) With the availability of complete intake records, 72 hours is usually enough to reflect an individual's average intake. With incomplete records, the NIA may need to be extended beyond 72 hours. In a hospital setting, between the patient's health status and the foods and menus offered, intake will vary from meal to meal and from day to day. By tracking the intake across 3 days, the assessment can account for this variation. REF: p. 60

A nutrient intake analysis (NIA) or calorie count should be recorded for _____ hours. a. 48 b. 72 c. 24 d. 36

Cheese, salami, and Chianti wine (Ch 8 Krause, pg 131) Aged cheese and meats and fermented foods and beverages contain tyramine, a pressor agent that can promote a hypertensive crisis when eaten while a patient is receiving MAO inhibitors. In general, fresh fruits and vegetables, meats and poultry, and milk and unfermented cheeses are acceptable.

A patient is being treated for depression with a monoamine oxidase inhibitor. Which of the following should the patient be instructed to avoid while taking this medication? a. Milk, soy protein, and grapefruit b. Cheese, salami, and Chianti wine c. Tomatoes, onions, and poultry d. Cantaloupe, canned pineapple, and peanuts

c. 408 kcal (CH 13 Krause, pg 218-219) As dextrose monohydrate is a molecule of glucose and water, it has a lower calorie concentration than other carbohydrates (3.4 kcal/g vs. 4 kcal/g). 120 g ⋅ 3.4 kcal/g = 408 kcal. Ten percent lipid emulsions provide 1.1 kcal/ml solution. Twenty percent lipid emulsions provide 2 kcal/g solution.

A patient is receiving an intravenous solution that provides 120 g of dextrose monohydrate. How many calories does this provide the patient? a. 132 kcal b. 240 kcal c. 408 kcal d. 480 kcal

Maintain consistent vitamin K intake. (Ch 8 Krause, page 137) For warfarin to be effective as an anticoagulant, the dose of the drug must be balanced with the amount of vitamin K consumed. Therefore, the patient needs to maintain a consistent intake of vitamin K. Decreasing the intake of vitamin K runs the risk of the patient being unable to stop bleeding. Vitamin D is not affected by warfarin therapy.

A patient is receiving warfarin (Coumadin). What MNT education should this patient receive? a. Decrease intake of vitamin K foods. b. Maintain consistent vitamin K intake. c. Increase intake of vitamin D and calcium-rich foods. d. Maintain consistent vitamin D intake.

c. Moderate nutritional risk (CH 26 Krause, p. 502) A shrimp allergy would be considered a moderate nutritional risk as shrimp are widely available in food products yet their elimination from the diet does not limit a person's food choices or access to vital nutrients. In particular, this person should inquire about recipe ingredients when eating out and should also ask about and be careful about food preparation with equipment that may also be used in preparing shrimp. A low nutritional risk is associated with food allergies focused on a single vegetable or fruit because these can be replaced with others to ensure adequate nutrient intake. A high nutritional risk is associated with foods commonly used in the food supply that may provide vital nutrients that are difficult to replace. Milk, egg, and wheat allergies are examples of high nutritional risk food allergies.

A patient who has a food allergy to shrimp would be considered at what level of nutritional risk in allergy management? a. No nutritional risk b. Low nutritional risk c. Moderate nutritional risk d. High nutritional risk

a. Metoclopramide (CH 27 Krause, p. 512) Metoclopramide is a prokinetic agent. It increases the contractility of the stomach and shortens gastric emptying time.

A patient with gastroparesis may benefit by which of these drugs? a. Metoclopramide b. Aspirin c. Acarbose d. Simethicone

c. Normal or elevated (Beerman CH 4, p 152)

A person with type 2 diabetes has his blood insulin level checked by his doctor. Which of the following most likely describes his blood insulin level? a. Much below normal b. Somewhat below normal c. Normal or elevated d. Much above normal

b. antioxidant. (Gropper Chap 9, pg 314)

A primary function of vitamin C is to act as an: a. antiviral agent. b. antioxidant. c. antirachitic agent. d.acyl transferase.

d. Within 1-2 weeks (Beerman CH 5, p. 204)

A protozoan parasite, Giardia intestinalis, causes diarrhea, abdominal discomfort, and cramping. How soon after exposure do symptoms typically begin? a. Within 24 hours b. Within 2-3 days c. Within 5-7 days d. Within 1-2 weeks

a. it is more rapid than the primary response and results in higher antibody levels. (Gould CH 7, pg. 118)

A secondary immune response differs from the primary immune response in that: a. it is more rapid than the primary response and results in higher antibody levels. b. it is slower than the primary response and doesn't change the antibody levels. c. it occurs at the same time as the primary response but results in a decrease in antibodies. d. it only occurs in hyperallergic reactions and results in a decrease of antibodies.

d. someone older than 110 years. (CH 20 Krause, pg 369) A supercentenarian is a new group of individuals identified to be older than 110 years of age. This population is now big enough to warrant research.

A supercentenarian is a. a woman who is currently 65 years of age who is expected to live to be 100 years old. b. someone born today who can expect to live to be 100 years old or older. c. someone who is 100 years old or older with no disease. d. someone older than 110 years.

c. 24th (Beerman CH 4, p. 157)

A temporary form of diabetes develops in some women after which week of pregnancy? a. 8th b. 16th c. 24th d. 30th

c. Weight gain should be controlled to 15 to 25 lb. (CH 15 Krause, pg 263) An overweight BMI is defined as 25 to 29.9. Women with BMIs in this range before pregnancy should promote a weight gain of 15 to 25 lb. Overweight and obese women who are attempting to become pregnant should not promote any weight loss during the pregnancy.

A woman has a BMI indicating overweight before pregnancy. Which of the following guidelines for weight gain during pregnancy is recommended? a. Weight gain is contraindicated during this pregnancy. b. Guidelines for weight gain for overweight women are not currently established. c. Weight gain should be controlled to 15 to 25 lb. d. It is not necessary to control weight gain during pregnancy.

d.familial hypercholesterolemia (Gropper CH 5, p. 159)

Abnormal LDL receptors fail to remove cholesterol from the bloodstream, resulting in _____. a. suppression of acyl-CoA cholesteryl acyl transferase (ACAT) b. suppression of hydroxymethylglutaryl-CoA (HMG-CoA) reductase c. hypertriglyceridemia d.familial hypercholesterolemia

80, 20 (Beerman, CH 12)

About _______% of our total water intake comes from beverages and __________% comes from foods, so women and men need to drink about 2.2 and 3.0 L per day, respectively.

Alcohol (Ch 1, Krause) pg 6 The stomach is the site of digestion of small amounts of lipid and protein. Large proteins are broken down into peptides. Otherwise, the stomach breaks down food into smaller particles and passes it into the small intestine, where absorption of all nutrients EXCEPT alcohol takes place. Alcohol is absorbed through the stomach.

Absorption occurs in the stomach for which of the following nutrients? a. Vitamins b. Carbohydrates c. Minerals d. Alcohol

A p. 487 (Gropper CH 13)

Absorption of dietary iron is regulated by _____, produced by the liver when iron stores are high and released to the blood to act at the surface of enterocytes and macrophages. a. hepcidin b. hepaestin c. ferroportin d. hemoglobin

c. 50% (CH 22 Kruase, p. 414) The rule of thumb is that most purging activities cause only 50% of the calories taken in through a binge to be eliminated. This means that half of the calories taken in during the binge are retained in the body

After a binge episode, how much of the energy intake can be eliminated through purging? a. 100% b. 75% c. 50% d. None

a. Is the GI tract functional? (CH 13 Krause, pg 223) The choice for use of enteral versus parenteral nutrition should be made based on whether the GI tract is functioning and capable of supporting the use of enteral nutrition. If the GI tract works, the preference is to meet the patient's nutritional needs through enteral nutrition. Tube type, formula type, and TPN composition are all decisions that need to be made later.

After assessment of a patient has determined that oral intake is inadequate, what is the next determination to be made? a. Is the GI tract functional? b. What type of tube should be placed? c. What type of formula should be used? d. What amount and composition of TPN are appropriate?

ANS: C After discharge, most preterm infants need approximately 180 ml/kg/day of breastmilk or standard infant formula containing 20 kcal/oz. REF:p. 886 (Krause Ch 42)

After discharge, most preterm infants need approximately _______ ml/kg/day of breastmilk or standard infant formula. a. 124 b. 120 c. 180 d. 250

c. interference with the bioavailability of iron and copper. (Beerman, 12)

All of the following are associated with high calcium intakes except: a. impaired kidney function. b. formation of kidney stones. c. interference with the bioavailability of iron and copper. d. calcium deposition in muscle tissue.

a. calcium (Gropper Chap 11, pg 425)

All of the following are considered major electrolytes EXCEPT _____. a. calcium b. sodium c. potassium d.chloride

c. decreasing the density of the lipoprotein. (Gropper CH 5, pgs. 151 & 153)

All of the following are functions of apolipoproteins EXCEPT: a. stimulating enzymatic reactions that regulate the metabolic functions of lipoproteins. b. stabilizing circulating lipoproteins in the blood. c. decreasing the density of the lipoprotein. d.conferring specificity for recognition by receptors on cells.

c. neuropeptide Y Gropper Ch 2 page 58

All of the following are involved in satiety and suppression of food intake EXCEPT _____. a. cholecystokinin b. corticotropin-releasing hormone c. neuropeptide Y d.leptin

d.lysolecithin (Gropper CH 5, pg. 147)

All of the following are required for fat digestion EXCEPT _____. a. pancreatic lipase b. colipase c. bile d.lysolecithin

a. fatty acids. CH 3 Gropper, page 98

All of the following are substrates for gluconeogenesis EXCEPT a. fatty acids. b. lactate. c. glycerol. d.glucogenic amino acids.

c. hexokinase CH 3 Gropper, page 80, 103

All of the following enzymes are negatively regulated (allosterically inhibited) by increasing levels of ATP EXCEPT _____. a. phosphofructokinase b. pyruvate dehydrogenase complex c. hexokinase d.citrate synthase

b. They present as non-pruritic purplish macules. (Gould CH 8, pg 155)

All of the following statements apply to malignant melanoma EXCEPT: a. The malignant cell is a melanocyte. b. They present as non-pruritic purplish macules. c. The neoplasm grows rapidly and metastasizes early. d. The lesion is usually dark or multicolored with an irregular border.

ANS: D Allostasis is a condition of metabolic stability with adjustments for environmental influences and stresses. It will be established even under inflammatory conditions. This can lead to inflammation but allostasis is not a test for inflammation. REF: p. 29

Allostasis is a. a test for inflammation. b. a root cause of obesity. c. lysosomal degradation. d. a condition of metabolic stability with adjustments for environmental influences.

b. An available substrate for bacterial metabolism (CH 25 Kruase, p. 471) Oral bacteria require fermentable carbohydrate as a substrate for the production of the acids that contribute to tooth decay. Because the oral and nasal cavities expose these bacteria to oxygen, the bacteria do not function anaerobically. Adequate saliva production and alkaline pH reduce the likelihood of dental caries.

Along with tooth susceptibility, bacterial presence in the plaque, and sufficient exposure to promote acid production, what other factor is necessary for the development of dental caries? a. An anaerobic environment b. An available substrate for bacterial metabolism c. Adequate saliva d. Alkaline pH

a. pregnant women (Beerman CH 5, p. 212)

Although everyone is at risk for getting foodborne illness, certain people such as infants, the elderly, and _____ are more susceptible than others. a. pregnant women b. athletes c. teenagers d. adult males

d. 2000 mg (Gropper Chap 9, pg 312)

Although excess absorbed ascorbic acid is excreted in urine, the body has an estimated maximal body pool of about _____, which can be maintained with intakes of 100-200 mg vitamin C per day. a. 500 mg b. 1000 mg c. 1500 mg d. 2000 mg

d. 12-14 (Beerman CH 4, p. 148)

Although type 1 diabetes can develop at any age, it typically develops around _____ years of age. a. 6-8 b. 8-10 c. 10-12 d. 12-14

c. Disordered eating not otherwise specified (CH 18 Krause, pg 340) Because of the strict definitions used by the Diagnostic and Statistical Manual-IV (DSM-IV), many adolescents who demonstrate disordered eating may not fit the criteria associated with anorexia nervosa or bulimia nervosa. The definition for "eating disorder not otherwise specified" can accommodate the variations in growth, the presence of menstrual periods, and cognitive development associated with adolescence. Excessive eating disorder is not defined by the DSM-IV.

Among adolescents, which type of eating disorder is most likely to be diagnosed? a. Anorexia nervosa b. Bulimia nervosa c. Disordered eating not otherwise specified d. Excessive eating disorder

c. Y-linked (Ch 5, Krause) Y-linked disorders are associated with males, but no specific nutrition-related disorders have been associated with Y-linked inheritance. Nutrition-related autosomal recessive disorders include inborn errors of metabolism. An X-linked dominant nutrition-related disorder is fragile X syndrome, a type of mental disorder susceptible to folic acid deficiency. X-linked recessive nutrition-related disorders include nephrogenic diabetes insipidus and adrenoleukodystrophy. REF: p. 75

Among which types of inheritance have no nutrition-related disorders been identified? a. Autosomal recessive b. X-linked dominant c. Y-linked d. X-linked recessive

d. failure of the immune system to distinguish self from nonself. (Gould CH 7, pg. 127)

An autoimmune disease is: a. excessive formation of antibodies following exposure to foreign material. b. an extreme response to normally harmless material in the environment. c. an abnormal response to ingested food and drugs. d. failure of the immune system to distinguish self from nonself.

c. metal shavings in bean salad. (Beerman CH 5, p. 199)

An example of a foodborne physical hazard would be: a. mold on cheese. b. a fly in soup. c. metal shavings in bean salad. d.pesticide on an apple.

a. bacteria in potato salad. (Beerman CH 5, p. 199)

An example of an infectious agent found in food that could cause foodborne illness would be: a. bacteria in potato salad. b. nonbacterial toxins in canned beans. c. pesticides on salad greens. d. glass shards in pickles.

inactive ingredient. (filler such as flavorings and dyes) (Ch 8 Krause) An excipient is an inactive, filler ingredient, such as flavorings, dyes, and preservatives, mixed in with the active ingredient in drugs. Acetylation is a process of inactivating amines, hydrazines, and sulfonamides so as to detoxify a drug. A pressor agent is an organic compound that causes vasoconstriction and an increase in blood pressure. REF: pp. 134-135

An excipient is a(n) a. acetylation process. b. active ingredient in a drug. c. pressor agent. d. inactive ingredient.

ANS: B An infant born at 32 weeks' gestation is premature. Therefore, her chronologic age should be adjusted for prematurity. 40 Weeks term - 32 weeks' gestation = 8 weeks premature. Eight weeks is equal to 2 months. Therefore, her chronologic age of 6 months minus her correction factor of 2 months equals an adjusted age of 4 months. REF:p. 878 (Krause CH 42)

An infant born at 32 weeks' gestation is now 6 months old. Her adjusted age is _____ months. a. 6 b. 4 c. 3 d. 2

ANS: B A small-for-gestational age (SGA) infant has a birth weight below the 10th percentile. When this is combined with linear and head growth between the 10th and 90th percentiles, then the infant has SGA with asymmetric intrauterine growth restriction. An SGA infant whose linear growth and head growth are below the 10th percentile as well is classified as being SGA with symmetric IUGR. An appropriate-for-gestational age infant has a birth weight between the 10th and 90th percentiles. REF:p. 869 (Krause CH 42)

An infant has a birth weight below the 10th percentile, but her linear growth and head growth are between the 10th and 90th percentiles. This infant would be classified as a. AGA. b. SGA with asymmetric IUGR. c. SGA with symmetric IUGR. d. only SGA.

ANS: B An obturator is a device used to cover a cleft palate until a child can undergo surgery to close it. The obturator may be used by itself, or special nipples with obturators can be used to feed the child with a cleft palate. The use of obturators has been effective in improving intake, weight gain, and growth in children with cleft palate. The disadvantages of using obturators include the cost and the need to rebuild the device as the infant grows. A variety of adaptive feeding devices are available for use in improving the nutritional intake of children with developmental disabilities. A low-cost device useful in measuring children with scoliosis and contractures is a tape measure. In spina bifida, even though the spinal cord can be restored and maintained within the spinal column, the disorder continues because the damage to the spinal cord is permanent. REF: p. 927 (Krause CH 44)

An obturator is a a. feeding device. b. cover for a cleft palate. c. measuring device useful for children with scoliosis or contractures. d. surgical device used to restore and hold the spinal cord within the spinal column.

ANS: C Antibodies to casein, gluten, and soy have been noted in some children with autism spectrum disorder. There are anecdotal reports of success with exclusion diets. REF: p. 923 (Krause CH 44)

Antibodies to casein, gluten, and soy have been noted in individuals with a. Prader-Willi syndrome. b. cerebral palsy. c. autism. d. fetal alcohol syndrome.

a. inhibiting the formation of the active form of vitamin K (Gropper Chap 10, pg 412)

Anticoagulant drugs that act by inhibiting vitamin K activity do so by which mechanism? a. inhibiting the formation of the active form of vitamin K b. interfering with micelle formation so vitamin K is not absorbed c. not allowing calcium to interact with Gla residues d.stimulating osteocalcin synthesis

True (Beerman, Ch 12)

Antidiuretic hormone decreases water excretion by the kidneys and causes blood vessels to constrict.

is not an independent marker for CVD risk. (Ch 7 Krause, pg 109) The new ACC/AHA guidelines deemphasize use of any markers other than LDL cholesterol and HDL cholesterol. Emerging risk markers for atherosclerotic cardiovascular disease (ACVD) that are not recommended in ATP 4 include differentiating subparticles of LDL by size and grouping by pattern, apolipoprotein B (apoB), and apolipoprotein E (apoE) phenotype. The Cholesterol Expert Panel determined that these markers are not independent markers for risk and do not add to prediction equations.

Apolipoprotein B (apoB) a. is a subparticle of LDL cholesterol. b. is a subparticle of HDL cholesterol. c. should be measured as a risk factor for CVD according to ACC/AHA guidelines. d. is not an independent marker for CVD risk.

b. 6-10 mL Gropper CH 2 page 43

Approximately how much chyme per minute is allowed to enter the duodenum from the stomach? a. 1-5 mL b. 6-10 mL c. 11-15 mL d.16-20 mL

c. 31% (Beerman, 12)

Approximately what percentage of Americans have high blood pressure? a. 17% b. 23% c. 31% d. 39%

d.accumulation of foam cells filled with cholesterol. (Gropper CH 5, p. 181)

Arterial fatty steaks are formed primarily due to a. platelet aggregation at the endothelium. b. smooth muscle proliferation. c. toxicity of oxidized LDL to endothelial cells. d.accumulation of foam cells filled with cholesterol.

b. mobilizing ferric iron from storage. (Gropper Chap 9, pg 315, 318)

Ascorbic acid may act as a pro-oxidant by: a. reducing ferrous iron. b. mobilizing ferric iron from storage. c. reacting with transferrin-bound iron. d.reducing dehydroascorbic acid.

b.ferrous (Gropper Chap 9, pg 312)

Ascorbic acid provides a reducing equivalent so that iron is in the _____ form in lysyl hydroxylase. a. ferric b.ferrous

b. small, frequent meals throughout the day (Beerman CH 4, pg 140)

Ashley experiences nausea, dizziness, lethargy, and irritability within one to four hours after eating foods high in carbohydrates. She should be encouraged to eat _____. a. foods with a high glycemic index b. small, frequent meals throughout the day c. meals that are high in protein and fat d. meals that are high in soluble fiber

Key: Grading rubric - answer should include the following items: -- Aspirin is ionized and negatively charged at physiological pH. -- When aspirin enters the highly acidic environment of the intermembrane space, it acquires a hydrogen ion and becomes a small neutral molecule. -- As the small neutral molecule goes through the inner mitochondrial membrane into the matrix, it functions to uncouple electron transport from oxidative phosphorylation. -- Electron transport must increase to produce enough ATP for the toddler's basal metabolic rate. -- Because most of the energy released during electron transport is not being trapped as ATP, it is released as heat and the toddler develops a very high body temperature. (Gropper CH 5, pp. 174-175)

Aspirin at very high (acutely poisonous) doses can function to cause proton leaks from the intermembrane space back into the matrix of the mitochondria. Explain why a toddler who ate a bottle of about 150 flavored baby aspirin would develop a very high body temperature.

c. by the end of the first counseling session. (CH 14 Krause, pg 230-231) Because the first counseling session is used to establish rapport and the counseling relationship, as well as to obtain information to assess the patient's current eating behaviors, assessment of the patient's stage of change cannot occur before or early in the first session. Ideally, assessment of the stage of change occurs by the end of the first counseling session so that plans and goals in preparation for the next session can be shared with the patient.

Assessment of a patient's stage of change should be completed a. when the patient is referred for counseling. b. at the beginning of the first counseling session. c. by the end of the first counseling session. d. before the second counseling session.

d. liquids, solids (Beerman CH 6, p. 219)

At room temperature, oils can be distinguished from fats because oils are _____ while fats are _____. a. fluid, dense b. firm, stable c. unstable, dehydrated d. liquids, solids

a. data is promising but inconclusive (Gropper CH 4, pg. 135)

At this time, what is the state of the evidence for prebiotics use to prevent or treat diarrhea? a. data is promising but inconclusive b. most studies find no benefit c. benefits were found for adults but not infants d.no clinical trials in this area have been conducted

α. p. 289 (Gropper CH 8)

Basal metabolic rate represents _____. a. the rate of energy expenditure that sustains basic life processes in all cells in the awake state b. the rate of energy expenditure when the body is at rest and no food has been eaten in 4 hours c. minimal energy expenditure over a period of 24 hours d.all energy expenditure except that is attributable to physical activity

ANS: D Hyponatremia is a potential risk in premature infants because of their immature kidneys. The inability to concentrate urine could cause these infants to excrete excessive amounts of sodium. To safeguard against this, both urinary and serum sodium levels should be monitored. Sodium may be lost in the stool if these infants experience diarrhea. REF:p. 878

Because of a preterm infant's decreased ability to concentrate urine, in which of the following should sodium concentration be monitored regularly? a. Serum b. Urine c. Stool and urine d. Urine and serum

a. hypochromic, microcytic anemia. (Gropper Chap 9, pg 364)

Because vitamin B6 is involved in heme synthesis, a deficiency symptom is a. hypochromic, microcytic anemia. b. seizures. c. hyperhomocysteinemia. d.impaired calcium metabolism.

c. a disorder of bacterial overgrowth with resulting malabsorption (CH 28 Krause, p. 522) Blind loop syndrome is characterized by a bacterial overgrowth resulting from a stasis or obstruction of the GI tract, radiation enteritis, fistula, or surgical repair. Fat and carbohydrate malabsorption result. A fistula is an abnormal passage between two internal organs. Flatulence results from excessive gas formation in the bowel. Short-bowel syndrome, which results from excessive small bowel resection, promotes the development of malabsorption.

Blind loop syndrome is a. an abnormal passage between two internal organs. b. the presence of an excessive amount of gas in the GI tract. c. a disorder of bacterial overgrowth with resulting malabsorption. d. a malabsorptive condition resulting from massive bowel resection.

a. abdominal, lower body fat stores (Beerman CH 4, p 153)

Body fat stores in the _____ region of the body pose a greater risk for type 2 diabetes than do _____. a. abdominal, lower body fat stores b. lower, abdominal fat stores c. thigh, fat stores in the chest d. chest, fat stores in the thighs

a. appropriate weight for height. (Gropper Chap 8, pg 275)

Body mass index (BMI) is one way to estimate a. appropriate weight for height. b. actual body adiposity. c. body fat distribution. d.risk factors associated with obesity.

d. Throughout life (Beerman, 12)

Bone remodeling begins early in fetal development and continues until when? a. The age of 10 b. The age of 20 c. The age of 30 d. Throughout life

b- osteclasts (Beerman, 12)

Breakdown of bone is facilitated by: a. osteoblasts. b. osteoclasts. c. calcitriol. d. parathyroid hormone.

Key: Grading rubric - answer should include the following items: -- Energy is trapped as ATP because of the coupling of electron transport and oxidative phosphoryation. -- The coupling occurs because hydrogen ions are pumped through the inner mitochondrial membrane into the intermembrane space during electron transport, and the tremendous gradient that builds up as a result has sufficient energy to create ATP when hydrogen ions flow back down the gradient into the mitochondrial matrix through the ATP synthase structures F0 and F1. -- The energy released in electron transport that is not trapped by ATP is released as heat. -- Uncoupling protein is an integral protein in the inner mitochondrial membrane that functions as a hydrogen ion channel, allowing hydrogen ions to seep back into the mitochondrial matrix without passing through ATP synthase structures. This "uncouples" electron transport from oxidative phosphorylation. Electron transport still creates metabolic water, but much of the energy released becomes heat and is not trapped as ATP. -- This uncoupling "wastes" food energy because less is trapped as ATP and more is released as heat. Such an inefficient production of ATP from food energy would result in greater energy expenditure and less energy available for storage of energy as fat. (Gropper CH 5, pgs. 174-175)

Briefly describe the mechanism by which increased uncoupling protein opposes storage of energy as fat.

Increase in serum osmolality (CH 6 , Krause) A decrease in extracellular fluid volume results in a hemoconcentration of the blood, resulting in an increase in serum osmolality. The renin-angiotensin system is triggered by the decreased extracellular volume, and as a consequence, angiotensin II stimulates the thirst centers. REF: p. 87

By what mechanism is thirst stimulated in the hypothalamus? a. Increase in serum osmolality b. Decrease in serum osmolality c. Increase in both serum osmolality and in extracellular volume d. Decrease in serum osmolality and an increase in extracellular volume

d. contributing to the integrity of bone collagen (Gropper Chap 11, pg 452)

By what mechanism is vitamin C thought to protect bone health? a. buffering for acid-base balance b. diminishing bone resorption c. caroxylation of osteocalcin and matrix Gla protein d.contributing to the integrity of bone collagen

passive diffusion (CH 1, Krause) pg 13 Passive diffusion is limited by the number of channels available for nutrients to randomly pass through. Facilitated diffusion requires the presence of carrier proteins, which may be limited by the health and nutritional status of the person. Active transport requires energy, which also may be limited by the person's health and nutritional status. Osmosis occurs in regard to concentration gradient and only involves the movement of water, not vitamins.

By which transport mechanism are most vitamins absorbed from the small intestine into the blood? a. Passive diffusion b. Active diffusion c. Facilitative diffusion d. Passive osmosis

d. the most effective glycogen replacement occurs after a training session. (CH 23 Kruase, p. 436) The highest rates of muscle glycogen synthesis occur when large amounts of carbohydrate are consumed immediately and up until 5 hours after activity. Normally, when no carbohydrate is consumed, muscle glycogen synthesis occurs at a rate of 5% each hour after activity. This may be more beneficial for athletes participating in multiple day activities.

Carbohydrate intake immediately after a training session is important because a. energy stores are depleted. b. carbohydrate is needed to reverse the feeling of fatigue. c. hypoglycemia is a common end result of prolonged exercise. d. the most effective glycogen replacement occurs after a training session.

d.More than one is false. (Gropper Chap 9, pg 346)

Carbon in the one-carbon pool can be in the 5-methyl-THF form or the 5,10-methylene-THF form. Which statement is FALSE? a. Both forms of carbon (methyl and methylene) can be used directly for thymidylate synthesis. b. The methylene group of 5,10-methylene-THF can be oxidized to generate 5-methyl-THF and vice versa. c. B12 is a cofactor for utilization of the methyl group in the conversion of homocysteine to methionine. d.More than one is false.

b. extend the fatty acid into a linear shape. (Gropper CH 5, pg. 138)

Carbon-carbon double bonds in the trans form a. result in a kinking of the fatty acid into a U-shape. b. extend the fatty acid into a linear shape. c. are required to create saturated fatty acids. d. are the hallmark of essential fatty acids.

Given Susan's diet regime, what vitamin might she have the most potential to be deficient in? a. Thiamin b. B6 c. Folate d. B12 Which one of the following foods would be the best choice to improve the nutritional adequacy of Susan's diet? a. Cottage cheese b. Fortified breakfast cereal c. Citrus fruit d. Legumes Susan's blood tests showed that she is not pregnant but has megaloblastic, macrocytic anemia. Which of the following vitamins should Susan take? a. B6 & folic acid b. B1, B3 & B12 c. B1, B2 & folic acid d.Folic acid & B12 (Beerman chapter 10, pg 443, 444, 445)

Case Study 10-B: Susan is a 26-year-old administrative assistant. She is very health conscious, has followed a low-fat vegan diet for the last five years, and has managed to keep her weight on the lean side. She hasn't ever felt that she needed to take dietary supplements of any kind until recently, when she began to experience bouts of fatigue. Then again, she and her husband Nick have been trying to start a family over the last year. She decided to schedule a complete physical. Given Susan's diet regime, what vitamin might she have the most potential to be deficient in? a. Thiamin b. B6 c. Folate d. B12 Which one of the following foods would be the best choice to improve the nutritional adequacy of Susan's diet? a. Cottage cheese b. Fortified breakfast cereal c. Citrus fruit d. Legumes Susan's blood tests showed that she is not pregnant but has megaloblastic, macrocytic anemia. Which of the following vitamins should Susan take? a. B6 & folic acid b. B1, B3 & B12 c. B1, B2 & folic acid d.Folic acid & B12

d. inadequate intake, protein malabsorption, excessive blood loss, and infection (Beerman CH 5, p. 194)

Causes of PEM in adults include _____. a. being vegetarian, excessive lipid absorption, menstruation, and obesity b. being vegan, food allergies, excessive urinary losses, and chronic fatigue syndrome c. periods of rapid growth, taking herbal supplements, and excessive fiber in the diet d. inadequate intake, protein malabsorption, excessive blood loss, and infection

a. amphipathic (Beerman CH 6, p. 232)

Cell membranes effectively serve as barriers between cells and the surrounding spaces because they are made of _____ phospholipids. a. amphipathic b. hydrophilic c. hydrophobic d. lipogenic

a. induces an alkaline saliva. (CH 25 Krause, p. 470) Cheese stimulates alkaline saliva, which reduces plaque bacteria. Because of this, combining cheese with a fermentable carbohydrate can reduce the cariogenicity of the meal. As long as the oral pH remains above 5.5, enamel demineralization does not occur.

Cheese is considered to be anticariogenic because it a. induces an alkaline saliva. b. induces an acidic saliva. c. induces a neutral saliva. d. decreases saliva production.

ANS: D Because of the lack of coordination of muscle control, children with cerebral palsy are likely to experience oral motor problems in regard to feeding. Other children with developmental disabilities who experience oral motor feeding problems are those with Down syndrome and those with cleft palate. Infants with Prader-Willi syndrome may have weak sucking ability. Infants with spina bifida may have swallowing difficulties. In children with autism, feeding difficulties center around limited food selection and strong food dislikes. REF: p. 912 (krause Ch 44)

Children with which developmental disorder are most likely to experience oral motor problems? a. Prader-Willi syndrome b. Spina bifida c. Autism d. Cerebral palsy

ANS: C The height of children affected with autism spectrum disorders is comparable to that of children without developmental disorders. Down syndrome, Prader-Willi syndrome, spina bifida, and cerebral palsy all present with short stature in children. REF:p. 915 (Krause CH 44)

Children with which of the following disorders are LEAST likely to have short stature? a. Down syndrome b. Cerebral palsy c. Autism d. Prader-Willi syndrome

a. phospholipids (Gropper CH 5, pg. 142)

Cholesterol serves as a precursor for all of the following EXCEPT _____. a. phospholipids b. estrogens and androgens c. bile acids d.vitamin D

d. active transport with sodium CH 3 Gropper pg 72

Choose the best description of the main method of glucose absorption. a. passive diffusion down a concentration gradient b. active transport with fructose c. facilitated transport d. active transport with sodium

b. Small vesicles that rupture to produce a crusty brown pruritic mass (Gould CH 8, pg 149)

Choose the best description of the typical lesion of impetigo. a. Large, red, painful nodule filled with purulent exudates b. Small vesicles that rupture to produce a crusty brown pruritic mass c. Red, swollen, painful areas often with projecting red streaks d. Firm, raised papules that may have a rough surface and may be painful

d. 1, 4, 3, 6 (Gropper Chap 10, pg 395)

Choose the correct order of the phrases below to explain the response of the body to a decline in serum calcium levels. Choose the BEST answer. 1. Increased release of PTH 2. Decreased release of PTH 3. Increased synthesis of calbindin 4. Increased synthesis of 1,25-(OH)2 D3 5. Increased bone absorption 6. Increased calcium absorption 7. Decreased bone resorption 8. Increased calcium excretion 9. Increased bone resorption a. 1, 5, 4, 8 b. 1, 3, 5, 9 c. 2, 3, 9, 6 d.1, 4, 3, 6

b. bile, colipase, pancreatic lipase, micelles (Gropper CH 5, pgs. 147-8)

Choose the correct sequential order for participants in lipid digestion. a. colipase, pancreatic lipase, bile, micelles b. bile, colipase, pancreatic lipase, micelles c. bile, enterokinase, colipase, micelles d.micelles, bile, pancreatic lipase, colipase

d. Carotenoids absorb the extra energy that is held by the singlet oxygen. (Gropper Chap 10, pg 385)

Choose the correct statement about the quenching of singlet oxygen by carotenoids. a. Carotenoids donate an electron to the singlet oxygen to make it stable. b. Carotenoids covalently bond with the singlet oxygen to make it stable. c. Carotenoids donate energy so that the excited electron returns to its orbital. d.Carotenoids absorb the extra energy that is held by the singlet oxygen.

linolenic acid, 2-monoacylglycerols, cholesterol, vitamin D (Gropper CH 5, pgs. 147-8)

Choose the list of molecules that would be found in a micelle. a. vitamin A (retinol), glycerol, 2-monoacylglycerols, linolenic acid b. glycerol, butyric acid, cholesterol, 2-monoacylglycerols c. linolenic acid, 2-monoacylglycerols, cholesterol, vitamin D d.fructose, glucose, glycerol, vitamin A

d. intracellular cytosolic signal transduction (Gropper Chap 10, pg 394)

Choose the non-genomic effect of vitamin D. a. increased synthesis of calbindin b. bone accretion c. rapid calcium absorption d.intracellular cytosolic signal transduction

b. β-carotene is not the only health-promoting molecule in fruits and vegetables. (Gropper Chap 10, pg 385-386, 389)

Choose the phrase which best explains the following statement: "β-carotene is no magic bullet." a. β-carotene does not decrease the reactivity of singlet oxygen molecules. b. β-carotene is not the only health-promoting molecule in fruits and vegetables. c. β-carotene supplements cannot be manufactured cheaply enough. d.β-carotene can replace vitamin E in terminating the auto-oxidation of fatty acids.

A p 527 (Gropper CH 13)

Chromium absorption is inhibited by _____ and enhanced by _____. a. antacids, picolinate b. methionine, phytic acid c. picolinic acid, vitamin C d.phenylalanine, histidine

a. large protein molecules (Gropper CH 12, pg 456-457)

Colloid osmotic pressure attracts water into the plasma and is mainly due to _____. a. large protein molecules b. the pumping of the heart c. sodium ions d.chloride ions

b. complementation (Beerman CH 5, p. 166)

Combining foods with incomplete proteins in order to obtain adequate amounts of all essential amino acids is called protein _____. a. combining b. complementation c. coupling d. compounding

b. Human milk has anti-infective factors. (CH 16 Krause, pg 305) Human milk provides secretory immunoglobulin A, lactoferrin, and lysozymes, which all contribute to preventing infection in the infant's gastrointestinal tract. The lactoferrin contributes to improved bioavailability of the iron in breastmilk and makes the iron unavailable to gut flora. Commercial formula has higher iron content because of its reduced bioavailability compared with breastmilk. Human milk is higher in fat content than formula, but the arachidonic acid and docosahexaenoic acid present are more involved in the infant's neurologic development.

Compared with formula-fed infants, why do breast-fed infants experience a reduced incidence of infections? a. Human milk is higher in fat. b. Human milk has anti-infective factors. c. Commercial infant formula is higher in iron. d. Commercial infant formula is higher in fat.

ANS: A Preterm infants need more vitamin A compared with term infants. The reasons for this are increased need for facilitating tissue repair and because preterm infants have low vitamin A stores. Vitamin A is suggested for the prevention of BPD. REF:p. 875 (Krause CH 42)

Compared with term infants, preterm infants have an increased need for vitamin a. A. b. C. c. D. d. E.

Key: Grading rubric - answer should include the following items: 1. Cholesterol and bile acids adhere to the soluble fibers and are removed as waste rather than recirculated to the liver. This forces the liver to make new bile acids from cholesterol, increases uptake of LDL cholesterol from the blood, and thereby lowers blood cholesterol. 2nd. Microbial fermentation of fermentable soluble fibers produces short-chain fatty acids. Propionic acid has been shown to inhibit the rate-limiting enzyme in the synthesis of cholesterol (HMG-CoA reductase) by the liver. When synthesis is slowed, less cholesterol enters the blood. 3rd. For reasons unknown, the shift by fiber-inhibition of recirculation of bile acids to creating additional new bile acids promotes increased chenodeoxycholic acid formation. This bile acid also inhibits HMG-CoA reductase and lowers synthesis of cholesterol. (Gropper CH 4, pg 120)

Consistent evidence shows that soluble fibers can lower the levels of cholesterol in many people with high serum cholesterol. Discuss the three mechanisms by which fibers are proposed to lower serum cholesterol.

b. reference points based on a 2000-calorie diet. (CH 11 Krause, pg 185) For most nutrients, the nutrition fact label shows the percentage of the DV. DVs are not recommended intakes for individuals; they are reference points. DVs are listed as percentages, not in milligrams or grams.

Daily Values (DVs) shown on the nutrition facts label are a. recommended intakes for specific nutrients. b. reference points based on a 2000-calorie diet. c. the same as DRIs. d. listed as grams or milligrams.

d. boiling plant components for 30 to 60 minutes. (CH 12 Krause, pg 195) A decoction is the most concentrated type of water-based beverage, involving boiling the plant parts to extract the most active ingredients. A tea is a beverage made by steeping for a few minutes. Glycerite is an extraction that uses glycerol instead of alcohol to extract active components from an herb. Capsules use either an animal-derived gelatin shell or one made from cellulose.

Decoction is made by a. steeping fresh or dried herbs in hot water for a few minutes. b. extracting active components of an herb in glycerol. c. enclosing herbal material in a hard shell made from plant-derived cellulose. d. boiling plant components for 30 to 60 minutes.

leading to increased serum levels of free fraction of a drug. (Ch 8 Krause pg 123) Albumin is a primary carrier protein of drugs in the blood, and when albumin levels decrease, fewer binding sites for protein-bound drugs leave a larger free fraction of the protein available to leave the blood and affect target tissues. This results in an increased pharmacologic effect of the drug. Biotransformation systems in the liver and other tissues are not dependent upon albumin. REF: p. 123

Decreased serum albumin levels, which are seen in many conditions, including malnutrition and liver disease, affect medications by a. leading to decreased serum levels of free fraction of a drug. b. leading to increased serum levels of free fraction of a drug. c. leading to decreased metabolism of the drug by the liver. d. leading to decreased pharmacologic effects.

Key: Triacylglycerol synthesis - CM or VLDL, both containing TAG, deliver their contents to adipose tissue. Lipoprotein lipase is present on the capillary membrane that passes through the adipose tissue to hydrolyze the TAG inside to FAs, so they can cross the membrane and enter the adipocyte. Once inside, they are reassembled into TAG for storage. Insulin (fed state; high blood glucose) induces lipoprotein lipase activity and inhibits hormone-sensitive triacylglycerol lipase (which breaks down stored TAG to FAs inside the adipocyte). Triacylglycerol lipolysis - in the fasted state (low blood glucose), glucagon induces TAG lipase; the resulting FAs in the adipocyte can leave the cell and are transported by albumin to tissues for use as energy. (Gropper CH 5, pgs 155-156)

Describe the process of fat storage (triacylglycerol synthesis) AND mobilization (triacylglycerol lipolysis) in adipose tissue—be sure to include how these processes are regulated (i.e., the signals involved). [To answer this question, it is not necessary to talk about how insulin or glucagon stimulates FA synthesis or FA oxidation, respectively—just with respect to lipid storage and/or breakdown in adipose tissue.]

Key: Grading rubric - answer should include the following items: -- Detrimental effects include induced metabolic tolerance, which allows heavy consumption of alcohol. -- Alcohol dehydrogenase is the same enzyme that is called retinol dehydrogenase and that metabolizes vitamin A (retinol). As cytochrome P-450 is induced, a vitamin A deficiency can be developed unless extra vitamin A is eaten. -- A high NADH:NAD ratio can result from metabolism of excess alcohol. This promotes use of the acetyl-CoA from alcohol metabolism to synthesize fatty acids and can result in fatty liver. *Lactic academia is also a result of the high NADH:NAD ratio. * Impaired TCA cycle function and gluconeogenesis can also result from the NADH:NAD ratio because the reversible reaction catalyzed by isocitrate dehydrogenase favors the formation of glutamate in the presence of excess NADH. *Beneficial effects of moderate alcohol consumption include the inverse relationship with heart disease in epidemiological studies; elevation of HDL, which may protect against atherosclerosis; and a beneficial relationship of moderate alcohol consumption with risk of dementia. In addition, polyphenols found in red wine may dampen reactive oxygen species and thus protect against excess inflammation that may exacerbate atherosclerosis. (Gropper CH 5, pgs. 177-178)

Describe three detrimental physiological effects of excess alcohol consumption and three beneficial effects of moderate alcohol consumption.

a. liver, 25-hydroxycholecalciferol (Gropper Chap 10, pg 392)

Dietary cholecalciferol must be further hydroxylated in order to be active vitamin D. The first hydroxylation occurs in the _____ to produce _____. a. liver, 25-hydroxycholecalciferol b. kidney, 25-hydroxycholecalciferol c. skin, 7-dehydrocholesterol d.kidney, 1-hydrocholesterol

ANS: A Ch 3 Krause, pg 34 Dietary factors that help to maintain healthy fluid viscosity are hydration, vitamin E with significant gamma-tocopherol, polyunsaturated fatty acids, and monounsaturated fatty acids. Carbohydrate is not known to have an effect.

Dietary factors that help to maintain healthy fluid viscosity and therefore a healthy immune system include all EXCEPT a. carbohydrate. b. hydration. c. vitamin E. d. monounsaturated fat.

c. β-glycosidic (Beerman CH 4, pg. 125)

Dietary fiber is indigestible because it contains _____ bonds. a. α-glycosidic b. double c. β-glycosidic d. ionic

b. digested or absorbed by the human intestine. (Beerman Ch 4, pg 125)

Dietary fiber is not: a. a plant polysaccharide. b. digested or absorbed by the human intestine. c. composed of glucose units bonded together by beta-glycosidic bonds. d.found in whole grains, legumes, fruits, and vegetables.

b. plant cell walls. (Gropper CH 4, pg. 112)

Dietary fibers are mainly provided by a. proteins that have been heated with sugars. b. plant cell walls. c. chitin and chitosan. d. plant gums.

d. sodium (Gropper CH 12, pg 462)

Dietary intake of which mineral correlates positively with blood pressure? a. magnesium b. calcium c. potassium d.sodium

d.between the third and fourth carbons from the methyl (Beerman CH 6, p. 224)

Dietitians often recommend that we frequently consume foods containing omega-3 fatty acids. An omega-3 fatty acid is one that has its first double bond _____ end of the molecule. a. between the third and fourth carbons from the carboxylic acid b. between the second and third carbons from the carboxylic acid c. between the second and third carbons from the methyl d.between the third and fourth carbons from the methyl

Key: Grading rubric - answer should include the following items: -- Food items that are low in fat and a good source of dietary fiber without fortification (which means those based on whole grains, legumes, fruits, and vegetables) can claim to reduce risk for some types of cancer. -- Food items low in saturated fat and cholesterol and containing at least 0.6g of soluble fiber without fortification (which means products containing whole grains, legumes, fruits, and vegetables) can claim to reduce risk of heart disease. -- Food items low in fat and rich in fruits and vegetables that contain dietary fiber and antioxidant vitamins A and C may claim to reduce risk for some types of cancer. -- Food items with beta-glucan from various oat products or psyllium husk in defined quantities can claim that the soluble fiber contained in the food helps reduce the risk of heart disease.

Discuss four health claims relating to fiber that have been approved by the U.S. Food and Drug Administration.

Key: Grading rubric - answer should include the following items: -- Fermentable fibers are used by gut bacteria to produce lactic acid and short-chain fatty acids that have several benefits. --All these acids decrease the pH to a more acidic environment, reducing the solubility of bile acids and allowing calcium to bind them and make them less toxic to colon cells. The acidity also decreases growth of pathogenic bacteria. -- Short-chain fatty acids can be absorbed and used for energy. --Butyric acid is a preferred food for colonic mucosal cells (supplying 67% of their energy) and likely keeps them healthy, perhaps preventing colon cancer. --Propionic acid, when absorbed, can inhibit cholesterol synthesis, lowering blood cholesterol and risk for heart disease. (Gropper CH 4, pg. 121-123)

Discuss the benefits of fermentable fibers in terms of the production of short-chain fatty acids.

Key: Grading rubric - answer should include the following items: --Certain fermentable fibers promote the growth of beneficial gut bacteria, particularly lactobacilli and bifidobacteria, because they are preferred food for growth of those bacteria. --This extra growth in numbers of the beneficial bacteria promotes gut health because the beneficial bacteria can crowd out pathogenic bacteria and lower their numbers. (Gropper CH 4, pg 121)

Discuss the benefits of fermentable fibers in terms of their prebiotic function.

Key: Grading rubric - answer should include the following items: -- HDL is active in reverse cholesterol transport, which removes cholesterol from plaque, slowing accumulation. -- In addition, HDL has anti-inflammatory actions that can reverse the inflammation that drives the deposition of lipid into plaque. (Gropper CH 5, p. 181)

Discuss the role of HDL in counteracting risk by modifying plaque formation.

Key: Grading rubric - answer should include the following items: -- There are only 2 double bonds, but 3 locations for double bonds -- One location is at carbon 19, which does not exist in an 18-carbon chain -- Two double-bonds cannot be on two adjacent carbons (e.g., 8 and 9) (Gropper CH 5, pg 139)

Discuss three things that cannot be correct in the notation 18:2Δ8,9,19 when using the delta system of designating fatty acids.

Key: Grading rubric - answer should include the following items: -- Water-insoluble fiber will add fecal bulk and speed transit time of food through the GI tract. -- Limited evidence suggests that fiber may reduce risk for cancer by several mechanisms including these: by adsorbing bile acids to promote their fecal excretion; by helping acidify the lumen of the colon, which keeps bile acids from being converted into more toxic secondary bile acids; by increasing fecal bulk to dilute concentrations of carcinogens from the diet; by shortening time undigested foods and toxins remain in the gut and so lessen exposure to toxins; by releasing calcium through fermentation to allow normal cells to grow as fast as cancer cells; and by producing butyric acid through fermentation to maintain health of colon cells. -- Whole grains and vegetables have substantial amounts of insoluble cellulose and lignin. (Gropper CH 4, pp. 117,124,125)

Dr. Smith has prescribed a high-fiber diet (35-40 g/day) with special emphasis on the water-insoluble fibers for Mr. Brown. How would this diet protect against colorectal cancer? Give examples of foods that contain water-insoluble fibers.

a. The supplement's efficacy, its application to the cited health problem, and its safety (CH 12 Krause, pg 194) To effectively work with patients using supplements, the practitioner needs to maintain access to a variety of current resources identifying the efficacy of various supplements, their application to particular health problems, and safety issues in regard to the supplement. Sometimes adequate information is available from the manufacturer, but this may not be possible. Also, the Cochrane Database Review may not always be the most up-to-date resource in regard to investigating the efficacy of a supplement. Patients using supplements take them for specified reasons. Counseling should address whether the supplement can provide the health benefit being sought.

During a nutrition assessment, the patient indicates that she uses a particular dietary supplement. At a minimum, what aspects of the supplement should be researched and reviewed before making a recommendation for continued use? a. The supplement's efficacy, its application to the cited health problem, and its safety b. The source or origin of the supplement, its safety, and alternative treatments for the health problem c. The CDR's evaluation of the supplement, the administration instructions, and the potential side effects d. The form of the supplement, its application to the cited health problem, and its mechanism of action

a. drop in the RMR as much as 15% in 2 weeks. (CH 21 Krause, pg 385) The resting metabolic rate drops by 15% within 2 weeks of starvation to conserve energy as a protection against future lack of energy and food intake. As starvation continues, ketone production provides the primary energy substrate for most tissues throughout the body. However, the brain, nerve tissues, and red blood cells need glucose as their primary energy source. Without food intake, the only way to provide this glucose is through gluconeogenesis that uses protein from lean body tissue.

During starvation, the body's adaptive response is a a. drop in the RMR as much as 15% in 2 weeks. b. rise in the RMR as much as 15% in 2 weeks. c. drop in the RMR as much as 25% in 1 month. d. rise in the RMR as much as 25% in 1 month.

d. Positive behavioral reinforcement of weight gain (CH 22 Krause, p 418) The immediate, short-term goal in treatment of anorexia nervosa is to initiate weight gain. From a psychologic management point of view, this entails the positive encouragement of actions taken by the patient to initiate weight gain. Such actions include praise, reassurance, coaching, and encouragement. Long-term goals of psychologic management are more focused on understanding and changing attitudes and psychologic conflicts that promote disordered eating, as well as improving the patient's interpersonal and social functioning.

During the acute stage of anorexia nervosa, what is the focus of psychologic management in treatment? a. Understanding and changing dysfunctional attitudes related to eating b. Addressing psychopathology that reinforces eating-disordered behaviors c. Improving interpersonal and social functioning d. Positive behavioral reinforcement of weight gain

c. Emotions and feelings when eating (CH 22 Krause, p. 422) Because of bingeing, purging, and restrictive eating, the patient with bulimia nervosa often has impaired hunger and satiety cues. By recording emotions and feelings whenever she eats, the patient with bulimia nervosa can learn to recognize these cues. Additionally, patients with bulimia nervosa are more receptive to nutrition counseling than patients with anorexia nervosa, and discussion of the recorded feelings can be used in the counseling to help promote behavioral changes.

During the treatment of patients with eating disorders, which of the following is an additional feature that should be monitored in the food records of patients with bulimia nervosa as opposed to anorexia nervosa? a. Eating behaviors b. Exercise c. Emotions and feelings when eating d. Use of alternative sweeteners

a. Blood levels decrease because of decreased synthesis. (Ch 7 Krause page 103) because of decreased synthesis resulting from a downregulation of gene expression and translation. In the case of albumin, other aspects of the reduction include increased catabolism and transport to extravascular spaces. This is different from what happens to albumin during starvation because in that case, plasma albumin levels are maintained by a shift from the extravascular space.

During trauma, what happens to negative acute-phase respondent levels? a. Blood levels decrease because of decreased synthesis. b. Blood levels increase because of transport into the vascular space. c. Blood levels are not altered because of the catabolism of proteins. d. Blood levels are similar to what they would be during simple starvation.

b. Preoperational stage (CH 17 Krause, pg 318) Classifying foods as "good" or "bad" without explanation is a characteristic of preoperational thinking. Sensorimotor cognitive development occurs in the first 2 years of life as an infant progresses from automatic reflexes to interactions with the environment. Concrete operational cognition involves more cause-and-effect thinking. Formal operational cognition involves hypothetical and abstract thinking.

During which stage of cognitive development can children identify foods that are "good for you" but probably could not give a reason? a. Sensorimotor stage b. Preoperational stage c. Concrete operations stage d. Formal operations stage

Nutrition intervention (CH 10 Krause, pg 165) Patient-centered goals and objectives identify the desired outcomes of nutrition care, and these are established in the nutrition intervention step after the nutrition problems are identified. During nutrition assessment, data are collected and analyzed so as to identify the nutrition problems in the nutrition diagnosis step. Nutrition monitoring and evaluation watches for the progress and achievement toward the goals and objectives.

During which step of the nutrition care process should patient-centered goals and objectives be identified? a. Nutrition assessment b. Nutrition diagnosis c. Nutrition intervention d. Nutrition monitoring and evaluation

a. Not-ready-to-change session (CH 14 Krause, pg 232) One of the goals of the not-ready-to-change session is to identify and reduce the client's resistance and barriers to change. The unsure-about-change session may include a summary of perceived barriers to change. The ready-to-change session includes identification of barriers to adherence to change. The first counseling session is used to identify the stage of change of the client.

During which type of counseling session is one of the goals to identify barriers to change? a. Not-ready-to-change session b. Unsure-about-change session c. Ready-to-change session d. First counseling session

c. some people (Beerman CH 6,p. 235)

Eating a low-kcalorie or low-carbohydrate diet can decrease cholesterol synthesis in _____. a. everyone b. adults over 50 c. some people d. children under the age of 6

a. from the matrix into the intermembrane space. Ch 3 Gropper, page 91, 93

Electron flow through Complexes I, III, and IV is accompanied by the translocation of protons a. from the matrix into the intermembrane space. b. from the iron-sulfur centers into the cytosol. c. from cytochrome c to cytochrome c1. d.from cytochrome b to the iron-sulfur center.

a. low ascorbic acid. (Gropper Chap 9, pg 349-350)

Elevated homocysteine levels can be due to all the following EXCEPT: a. low ascorbic acid. b. low folacin. c. low cobalamin. d.low pyridoxine.

c. end products of metabolism of hormones. (CH 19 Krause, pg 360) Pollutants in water and drugs are exogenous toxins. The end products of hormone metabolism are endogenous toxins. Curcuminoids are antioxidants found in some foods such as turmeric and curry.

Endogenous toxins include a. pollutants in water. b. drugs. c. end products of metabolism of hormones. d. curcuminoids.

c. failure to use the gastrointestinal tract exacerbates the stress response. (CH 29 Krause, p. 582) The optimal route of nutrition in acute pancreatitis has been the subject of much controversy over the years. Failure to use the GI tract in patients with acute pancreatitis may exacerbate the stress response and disease severity, leading to more complications and prolonged hospitalization; thus, enteral nutrition is preferred for nutrition therapy. The cause of pseudocysts is unclear.

Enteral nutrition is preferred over parenteral nutrition when treating patients with severe, acute pancreatitis because a. enteral nutrition is more expensive. b. enteral nutrition can prevent pseudocysts from developing. c. failure to use the gastrointestinal tract exacerbates the stress response. d. it is not the preferred route of nutrition.

b. glycolysis Gropper CH 1

Enzymes of metabolic pathways that are associated with the cytoplasmic matrix so that the product of one enzyme is released in close proximity to the next enzyme for which it is a substrate to facilitate velocity of the overall pathway include enzymes of _____. a. beta-oxidation b. glycolysis c. ketone production d.the Krebs cycle

d.gallbladder. (Beerman CH 6, pp. 236-240)

Enzymes that can hydrolyze ester linkages are not produced in the a. mouth. b. stomach. c. pancreas. d.gallbladder.

Key Pages b 153 c 164 d 173 e 171 a 169-170 (Gropper CH 5, pp. 153, 164, 169-170, 171, & 173)

Enzymes: Match the enzymes with their functions in lipid metabolism. Enzyme 1. lipoprotein lipase 2. intracellular lipase 3. HMG-CoA reductase 4. cyclo-oxygenase 5. desaturase Function a. creates a double bond in a fatty acid b. removes triacylglycerol from plasma c. mobilizes stored triacylglycerols from adipocytes d. rate-limiting enzyme in cholesterol synthesis e. creates prostaglandins

Prostaglandins (CH 3, Krause) pg 36-37 Essential fatty acids and polyunsaturated fatty acids are converted into prostaglandins as part of the eicosanoid cascade. Interleukin-6 is a marker of inflammation. Adipokines and cytokines are proinflammatory molecules. Interleukin-6 is a marker of inflammation.

Essential fatty acids and polyunsaturated fatty acids are converted to what? a. Insulin b. Cytokines and adipokines c. Prostaglandins d. Interleukin-6

d. can be converted into other fatty acids needed by the body (Beerman CH 6, pp. 225, 226)

Essential fatty acids are themselves required for the proper functioning of the body and because they _____. a. help control the levels of circulating cholesterol b. can be converted into glycogen c. help regulate the levels of circulating vitamins d. can be converted into other fatty acids needed by the body

c. Vitamin B12 status (CH 27 Krause, pp. 515 & 520) Atrophic gastritis results in achlorhydria and decreased intrinsic factor production. Both stomach acid and intrinsic factor are necessary for the adequate absorption of vitamin B12. If upper GI bleeding is noted, in addition, iron status should be assessed.

Evaluation of which of the following should be included in the nutritional assessment of patients with atrophic gastritis? a. Essential fatty acid deficiency b. Vitamin B6 status c. Vitamin B12 status d. Iron deficiency anemia

Key: Grading rubric - answer should include the following items: -- HMG-CoA reductase catalyzes the reduction of 3-hydroxy-3-methylglutaryl-CoA to mevalonate, which is the rate-limiting step in the synthesis of cholesterol. -- This enzyme is inhibited by cholesterol to slow the in vivo production when dietary cholesterol is high or in vivo production has increased concentration of cholesterol sufficiently. -- This enzyme can be inhibited by statin drugs or by propionic acid from fermentation of dietary fiber. (Gropper CH 5, pgs. 158,161,173;120)

Explain how the HMG-CoA reductase regulates cholesterol synthesis.

c. denaturation (Beerman CH 5, p. 173)

Exposure to a heavy metal like mercury can alter proteins within a person's neurological system, resulting in difficulty walking. This is an example of _____. a. transamination b. deamination c. denaturation d.transcription

a. decreased transit time (Gropper CH 4, pg 119-120)

Fiber lowers serum cholesterol concentrations by all of the following mechanisms EXCEPT _____. a. decreased transit time b. increased excretion of bile acids in the feces c. a shift of bile acid pools toward chenodeoxycholic acid, which inhibits HMG-CoA reductase d.production of propionic acid from gut fermentation of fiber

Answer: Transfer, messenger (Beerman CH 5, p. 168-169)

Fill in the Blank 1._______________ RNA in the cytoplasm is involved in gene translation, while _______________ RNA is involved in gene transcription.

Key: Multiple correct answers are possible for this question, depending on which properties and effects are selected. Here is just one example of a correct answer: a. water solubility, b. lower serum cholesterol, c. lignin, d. decrease absorption of lipids, e. gums, f. fermentability (Gropper CH 4, pg 117,118)

Fill in the appropriate information in the following table with three different fiber components. The physico-chemical property and physiological effect associated with each fiber component must match. The physico-chemical property and the physiological effect you give for each fiber component must be different. Fiber component pectin c. e. Physico-chemical property a. adsorption f. Physiological/metabolic effect b. d. slow the proliferation & differentiation of colon cancer cells

ANS: D Evidence indicates that plant-based foods, especially foods with flavonoids, have nutritional and possibly pharmacologic effects in the brain. These foods include apples, berries, chocolate, citrus fruits, grapes, and tea. REF: p. 851 (Krause CH 41)

Flavonoid-rich foods include a. peaches, apricots, and sweet potatoes. b. fish and seafood. c. kale, broccoli, and spinach. d. apples, oranges, berries, and chocolate.

ANS: D Excessive sugar intake can cause wide fluctuations in blood glucose that can amplify aberrant moods and behavior. Both high and low blood glucose have been found to have a strong association with a myriad of psychiatric conditions including anxiety, depression, and schizophrenia. REF: p. 841 (Krause CH 41)

Fluctuations in blood glucose can amplify which condition/disease? a. Depression b. Schizophrenia c. Anxiety d. All of the above

d.purines and pyrimidines (Gropper Chap 9, pg 350)

Folate is vitally important for dividing cells during growth and cancer because of its essential role in the synthesis of _____. a. lipid bilayers b. mitochondria c. lysosomes and peroxisomes d.purines and pyrimidines

ANS: A Clients with some genetically linked psychiatric disorders have been shown to improve when given the methylated form of folate. This is because of folate's role in the production and function of dopamine and serotonin. REF: p. 846 (Krause CH 41)

Folic acid supplementation in the methylated form is useful in some psychiatric disorders because of its role in a. production of serotonin and dopamine. b. macrocytic anemia. c. histamine metabolism. d. preventing neural tube defects

c. Western blot test (Gould CH 7, pg. 135)

Following a positive HIV antibodies blood test and ELISA test, what is the test commonly used for confirmation? a. Agglutination b. Double immunodiffusion test c. Western blot test d. Sedimentation rate test

b. 3 years (CH 26 Kruase, p. 487) Most food hypersensitivities develop in the first 2 years of life, and most infants outgrow these sensitivities by 3 years of age.

Food allergies that are most likely to resolve with age are those that first manifest during the first _____ of life. a. year b. 3 years c. 10 years d. 15 years

d. all of the above. (CH 17 Krause, pg 320) In 2013 in the United States, 11% of households experienced food insecurity. Federal food assistance programs provided services to about 60% of them. Food insecurity is associated with poor outcomes in children. It increases the risk of iron deficiency anemia in children 3 years and under.

Food insecure families in the United States a. contribute to poor outcomes in children. b. are associated with inadequate iron intake in children 3 years and under. c. are served by SNAP, WIC, and school lunch. d. all of the above.

d. many, many (Beerman CH 5, p. 199)

Foodborne illness has _____ form(s) and _____ cause(s). a. one, several b. several, one c. several, three d. many, many

Answer: complete protein sources, incomplete protein sources (Beerman CH 5, p. 165)

Foods considered _______________ contain all the essential amino acids in relative amounts needed by the body, unlike _______________, which contain very low amounts of one or more essential amino acids.

d.complete (Beerman CH 5, p. 165)

Foods that contain relatively high amounts of all the essential amino acids in the appropriate proportions are considered to be _____ protein sources. a. complementary b. partially complete c. vegetable d.complete

d. Vitamin K (CH 16 Krause, pg 304) Most states require that infants receive a vitamin K injection soon after birth to prevent hemorrhagic disease of the newborn. This is more common among breast-fed infants than formula-fed infants because the vitamin K content is not adequate during the first week. Fluoride and iron supplementation is recommended after 6 months of age. Vitamin D supplementation is recommended daily but may be accommodated by providing the infant with adequate sun exposure.

For a breast-fed infant, which nutrient(s) should be the earliest to be supplemented? a. Fluoride and vitamin D b. Iron and magnesium c. Vitamin C d. Vitamin K

d. 1.5 (CH 13 Krause, pg 214) Patients with cardiopulmonary, renal, or hepatic failure may require fluid restriction. Most standard formulas of 1 to 1.2 kcal/ml concentration contain 80% to 85% water. A concentrated formula with 1.5 to 2 kcal/ml is about 70% water. All patients on enteral nutrition support require water flushes to maintain the integrity of the feeding tube and to ensure adequate fluid.

For a fluid-restricted patient, an appropriate formula to select for use would be _____ kcal/ml. a. 0.8 b. 1 c. 1.2 d. 1.5

e. all of the above Gropper CH 1

For active transport (e.g., of glucose), you need: a. ATP. b. a Na-K pump. c. Na. d. an integral protein. e. all of the above

b. It can increase muscle glycogen stores. (CH 23 Kruase, p. 434) Carbohydrate feedings consumed 3 to 4 hours before physical activity can restore liver glycogen stores and muscle glycogen stores and provide additional blood sugar for energy at the beginning of the activity. Additional intake of carbohydrate during the activity provides sufficient energy for later stages of the exercise and helps delay fatigue. During exercise, insulin efficiency prevents the development of hyperglycemia and hypotension.

For athletes participating in events lasting more than 1 hour, what can a pre-event high-carbohydrate intake do? a. It can cause hyperglycemia. b. It can increase muscle glycogen stores. c. It can cause hypotension. d. It can improve strength during an event.

b. 20 (Beerman CH 5, p. 211)

For hand washing to be effective, hands should be washed vigorously with soap for at least _____ seconds and then rinsed thoroughly under clean, warm running water. a. 10 b. 20 c. 30 d. 60

b. For 6 months (CH 16 Krause, pg 307) Both the AAP and the AND recommend breastfeeding as the sole source of infant nutrition until the infant is 6 months old. Afterward, they both recommend that breastfeeding continue with weaning foods supplemented until the age of 1 year.

For how long do both the American Academy of Pediatricians and the Academy of Nutrition and Dietetics recommend exclusive breastfeeding of infants? a. For 3 months b. For 6 months c. For the first year d. Up until the age of 2 years

ANS: D In PKU, as the conversion of phenylalanine to tyrosine is blocked, infants and children have to receive supplemental tyrosine to ensure adequate growth. Usually, the extra tyrosine is provided in specialty formula products that have no phenylalanine. Cysteine and methionine are the sulfur-containing amino acids, and intake needs of each depend on the intake and metabolism of the other. REF: p. 894 (Kraus CH 43)

For infants and children younger than 10 years of age with PKU, which amino acid has to be supplemented in the diet? a. Cysteine b. Methionine c. Phenylalanine d. Tyrosine

d. Magnesium (CH 15 Krause, pg 262) Magnesium lactate or citrate supplementation is suggested to relieve potential magnesium deficiencies that may occur with pregnancy and lactation. Leg cramps are one sign of this deficiency. Calcium has also been investigated; however, supplementation to treat leg cramps has not been demonstrated. Manganese and potassium have not been investigated in this regard.

For managing leg cramps in pregnancy, which of the following minerals has the most scientific support for its use? a. Manganese b. Potassium c. Calcium d. Magnesium

b. prosthetic (Beerman CH 5, p. 172)

For some proteins to function, nonprotein components called _____ groups must be precisely positioned within the protein. a. promoter b. prosthetic c. stabilizer d. cofactor

2700 (CH 6, Krause) A daily allowance of water from all sources, including beverages and foods, is about 2700 ml/day for women and 3700 ml/day for men. The general recommendation for water intake is approximately 35 ml/kg of usual body weight in adults. REF: p. 89

For the average woman, _____ ml/day would meet fluid needs. a. 1500 b. 1700 c. 2700 d. 3500

a. 20%, 50%, and 30% (CH 22 Kruase, pg. 419) Distribution of the calories is necessary as many people with anorexia nervosa try to avoid fat. A dietary fat range of 25% to 30% of calories is recommended to ensure overall caloric intake, which needs to increase for the person with anorexia nervosa to gain weight. Protein should provide 15% to 20% of total calories. This should be protein of high biologic value. Patients with anorexia nervosa often ask for vegetarian diets, but these should be discouraged. Carbohydrates should provide from 50% to 55% of total calories.

For the diet therapy in individuals with anorexia nervosa, what percentages of protein, carbohydrate, and fat are recommended, respectively? a. 20%, 50%, and 30% b. 10%, 50%, and 40% c. 30%, 40%, and 30% d. 25%, 40%, and 35%

b. 330 kcal more than the amount for nonpregnant women (CH 15 Krause, pg 252) During the first 6 months of lactation, breastfeeding women need 330 kcal more than nonpregnant women to promote adequate milk production. This is equal to the kilocalorie needs of a pregnant woman during her second trimester.

For the first 6 months of lactation, what is the recommended energy intake? a. 200 kcal less than the amount for pregnant women b. 330 kcal more than the amount for nonpregnant women c. 550 kcal more than the amount for pregnant women d. The same as the amount for pregnant women in the third trimester

d. nose into the duodenum or jejunum. (CH 13 Krause, pg 211) Nasoduodenal or nasojejunal tubes bypass the stomach, thus reducing the likelihood of instigating nausea or vomiting, not relying on the stomach's motility, and because they are post-pyloric, reducing the risk of aspiration as formula would have to go past two sphincters to work its way back to the trachea. Tubes placed through the mouth are not commonly used because they can interfere with a patient's ability to talk.

For the patient with delayed gastric emptying, nausea and vomiting, or other indications of risk of aspiration, the tube should be placed through the a. mouth into the stomach. b. nose into the stomach. c. mouth into the duodenum or jejunum. d. nose into the duodenum or jejunum.

a. messenger ribonucleic acid (mRNA) (Beerman CH 5, p. 168)

For transcription to happen, _____ must communicate the DNA code to organelles outside the cell nucleus. a. messenger ribonucleic acid (mRNA) b. messenger deoxyribonucleic acid (mDNA) c. transfer ribonucleic acid (tRNA) d. transfer deoxyribonucleic acid (tDNA)

c. Smokers (Beerman chapter 10, pg 449)

For which group of people is an additional 35 mg/day of vitamin C (beyond the RDA) recommended? a. Alcohol users b. Diabetics c. Smokers d.Athletes

d. Back pain (CH 12 Krause, pg 194) CAM was most used for treatment of back pain as reported by the Centers for Disease Control and Prevention. Head cold treatment was the second most common use of CAM. CAM treatment of arthritis is the fifth most commonly reported use, and treatment of headaches the eighth most commonly reported use.

For which medical diagnosis is CAM most frequently used in the United States? a. Headache b. Arthritis c. Head cold d. Back pain

c. E (Gropper Chap 10, pg 407)

For which vitamin is the Tolerable Upper Intake Level set because of increased tendency for bleeding? a. A b. D c. E d.K

c. niacin (Gropper Chap 10, pg 375)

Formation of retinol from beta-carotene requires the presence of what B vitamin? a. ascorbic acid b. folic acid c. niacin d.pyridoxal phosphate

a. washed (Beerman CH 5, p. 211)

Fresh fruits and vegetables but not meat should be _____ just before cooking to prevent foodborne illness. a. washed b. blanched c. chilled d.trimmed

d. Linolenic and linoleic (Beerman CH 6, pp. 225, 227)

From which fatty acids are the eicosanoids that assist and regulate the immune and cardiovascular systems made? a. Linoleic and arachidonic b. Palmitic and arachidonic c. Linolenic and palmitic d. Linolenic and linoleic

c. It requires an alkaline environment for optimal activity. (Gropper CH 5, pg. 146-7)

Gastric lipase is important for the suckling infant for all of the following reasons EXCEPT: a. It can readily penetrate milk fat globules without bile salt stabilization. b. It hydrolyzes short-chain fatty acids from the sn-3 position. c. It requires an alkaline environment for optimal activity. d.It is highly stable in an acid environment.

ANS: B Because premature infants have stomachs with very limited capacity, residual checks are necessary when feeding these infants through a tube to ensure that an obstruction has not occurred. When providing bolus gavage feeding, aspiration of stomach contents for gastric residuals should be performed before the feeding starts. If residuals are found, depending on the volume in relation to the last time of feeding, continued feedings may need to be held off. When providing feedings via continuous drip, intermittent checks for gastric residuals should be performed to ensure that gastric emptying is occurring. REF:p. 879 (Krause Ch 42)

Gastric residuals should be checked when feeding an LBW infant by bolus gavage feeding a. 1 hour after each feeding. b. before each feeding. c. once each day at the same time. d. when abdominal distension is suspected.

c. proteins vital to the production of ATP. Gropper CH 1

Genes contained in mitochondrial DNA are inherited only from the mother and code for a. all proteins functioning within the mitochondrial matrix. b. non-functional ancient proteins considered remnants of evolution. c. proteins vital to the production of ATP. d. antioxidant proteins.

Answer (key points): (p. 199) Infectious agents bacteria, viruses, molds, fungi, parasites, and worms Noninfectious agents Toxins, heavy metals, pesticides, herbicides, antibiotics, hormones glass/metal/plastic fragments

Give 4 examples of infectious and noninfectious agents that can cause foodborne illnesses.

b. Carrier-mediated active transport (Beerman CH 4, pg. 133)

Glucose and galactose are absorbed by which transport mechanism? a. Vesicular active transport b. Carrier-mediated active transport c. Facilitated diffusion d. Diffusion

A p. 522 (Gropper CH 13)

Glutathione loses two electrons when it acts as an antioxidant. Glutathione is _____. a. oxidized b.reduced

d.quantity and quality of carbohydrate Ch 3 Gropper page 77

Glycemic load considers the _____ in the food. a. protein and carbohydrate content b. fat and carbohydrate content c. fat to carbohydrate ratio d.quantity and quality of carbohydrate

b. constituent of cell and organelle membranes (Gropper CH 5, pg 144)

Glycerophosphatides serve which of the following functions? a. source of stored energy b. constituent of cell and organelle membranes c. precursor for long-chain n-3 fatty acids d.constituent of myelin sheaths

b. Amylopectin (Beerman CH 4, pg 124)

Glycogen is highly branched, just like which other polysaccharide? a. Amylose b. Amylopectin c. Dietary fiber d.None of the above

d.the formation of glycogen from glucose (Beerman CH 4, pg 139)

Glycogenesis is: a. the breakdown of glycogen into glucose. b. the synthesis of glucose. c. the breakdown of glycemia indices. d.the formation of glycogen from glucose

a. uric acid. (CH 21 Krause, pg. 394) Uric acid is produced as a result of protein breakdown for gluconeogenesis. As the ketones being used as a primary energy substrate impair the elimination of the uric acid, the uric acid can precipitate out into the joints, causing gout.

Gout may develop during fasting or after very low-calorie diets. This occurs because elevated ketones are impeding the elimination of a. uric acid. b. creatinine. c. sodium. d. potassium.

c. both humoral and cell-mediated immunity. (Gould Ch 7, pg 133)

HIV infection impairs: a. humoral immunity. b. cell-mediated immunity. c. both humoral and cell-mediated immunity. d. neither type of immunity.

b. fructose and glucose. (Beerman, CH 4, pg. 117)

High-fructose corn syrup (HFCS) is derived from corn and consists of almost equal amounts of: a. fructose and galactose. b. fructose and glucose. c. glucose and maltose. d. glucose and galactose.

c receptors Gropper CH 1

Highly specialized membrane proteins that modify the cell's response to its environment are _____. a. transport proteins b. enzymes c. receptors d.peroxisomes

b. low-acid (Beerman CH 5, p. 202)

Home-canned, _____ foods may put you at risk for botulism if the food was not processed properly. a. high-acid b. low-acid c. low-sugar d.high-sugar

b. USDHHS (CH 20 Krause, pg 377) In the U.S. Department of Health and Human Services, the Agency on Aging administers a network of local agencies to provide both home-delivered and congregate meals for elderly adults. This is the only food assistance program through USDHHS. All other food assistance programs are provided through the U.S. Department of Agriculture. Assisted-living facilities are residential programs that provide access to supportive health care to older residents. The Centers for Medicare and Medicaid Services provide health care services but no food assistance.

Home-delivered meals provided for under the Older Americans Act nutrition program are administered by what agency? a. USDA b. USDHHS c. ALF d. CMS

d. transplant rejection by the recipient's immune system. (gould CH 7, pg 121)

Host-versus-graft disease refers to: a. hyperacute rejection of tissue. b. T cells in grafted tissue attacking host cells. c. infection resulting from immunosuppression therapy. d. transplant rejection by the recipient's immune system.

b. They limit the acute stage and viral shedding. (Gould CH 8, pg. 150)

How are antiviral drugs effective in treating a viral infection? a. They destroy the virus if administered for at least 2 weeks. b. They limit the acute stage and viral shedding. c. They prevent any systemic effects of viruses. d. They prevent any secondary bacterial infection.

d. Symptoms appear more rapidly in type 1 diabetes (Beerman CH 4, pgs 149-150)

How are the symptoms of type 1 diabetes most likely to differ from those of type 2? a. Fatigue is present only in type 1 diabetes b. Frequent urination occurs only in type 1 diabetes c. Thirst is excessive only in type 1 diabetes d. Symptoms appear more rapidly in type 1 diabetes

a. Based on solubility (Beerman chapter 10, pg 417)

How are vitamins classified? a. Based on solubility b. Based on amount needed per day c. Based on food source d.Based on their chemical structure

d. By including eggs and dairy foods (CH 18 Krause, pg 341) By including eggs and dairy foods, a vegetarian can be assured that the diet includes adequate vitamin B12, calcium, and vitamin D. Diets that do not include these foods tend to be inadequate in these nutrients as well as zinc and iron. Unless the bones are eaten with the fish, which is not common across all cultures, only adding fish will not provide adequate calcium in the diet.

How can an adolescent plan a vegetarian diet that is in line with the DRIs and Dietary Guidelines for Americans? a. By focusing on a vegan diet b. By ensuring adequate legumes, nuts, and whole grains c. By including fish d. By including eggs and dairy foods

a. Increasing folic acid intake throughout the childbearing years (CH 15 Krause, pg 249) The Medical Research Council Vitamin Study in the early 1990s was stopped early because the results overwhelmingly supported the reduction of risk of neural tube defects with folic acid supplementation. Niacin needs during pregnancy coincide with the increased energy needs during pregnancy. Sufficient protein during pregnancy allows for the growth of tissues in both the mother and the fetus. Vitamin C may be beneficial in reducing the chance of developing preeclampsia.

How can the risk of neural tube defects occurring in utero be reduced? a. Increasing folic acid intake throughout the childbearing years b. Ensuring adequate niacin intake during the first 6 weeks of pregnancy c. Providing an adequate protein intake throughout the pregnancy d. Increasing vitamin C during the first trimester

d. Determine it is thoroughly cooked by measuring its internal temperature. (Beerman CH 5, p. 211)

How can you be sure that a hamburger is safe to eat? a. Freeze all ground meat before cooking it. b. Save the marinade used to season the raw meat to use as a sauce. c. Let it cool at room temperature after cooking, then reheat before eating. d. Determine it is thoroughly cooked by measuring its internal temperature.

b. They decrease the metabolic rate to lower than normal. (CH 22 Krause, pg 412) For patients who experience a loss of lean body tissue, a concurrent decrease in metabolic rate occurs. For patients with bulimia nervosa, this may be unpredictable; however, during times of dietary restraint between binge episodes, the patient with bulimia nervosa may experience a semistarvation state, which will result in a decrease in RMR

How do anorexia nervosa and bulimia nervosa commonly affect the patient's metabolic rate? a. They increase the metabolic rate to higher than normal. b. They decrease the metabolic rate to lower than normal. c. They have no effect on metabolic rate, maintaining it at the normal level. d. They promote an extreme increase in metabolic rate.

a. Promoting beta-cell secretion of insulin Sulfonylureas and meglitinides are oral glucose-lowering medications that act as insulin secretagogues. Their action is to stimulate the pancreatic secretion of insulin. Biguanides and thiazolidinediones are insulin-sensitizing medications that lower insulin resistance and decrease hepatic glucose production from glycogenolysis and gluconeogenesis.

How do sulfonylureas and meglitinides help to lower blood glucose levels? a. Promoting beta-cell secretion of insulin b. Decreasing the insulin sensitivity of the receptor cell c. Increasing glucose formation from liver glycogen d. Decreasing deamination of protein

Answer (key points): The type of glycosidic bond determines digestibility; alpha bonds are digestible by humans, whereas beta bonds are not. The arrangement of glucose molecules in starch can be linear (amylose) or highly branched (amylopectin). The numerous branch points when compared to linear points have a physiological advantage because enzymes can hydrolyze multiple glycosidic bonds simultaneously. (Beerman CH 4, pp. 123-125)

How do the chemical structures such as bonding and branching impact the structure, properties, and functions of the digestible carbohydrates and fibers found in food?

d. Intake of almost all nutrients is needed at higher levels during lactation. (CH 15 Krause, pg 283) Although nutrient needs are increased during both pregnancy and lactation above those of women before conception, lactation needs are greater when women must produce breastmilk, the sole source of food for the infant. Women expend 85 kcal for every 100 ml of milk they produce, and the nutritional profile of the milk reflects their nutritional status. Therefore, for the assured health of the infant, breastfeeding mothers have to continue to maintain and replete their nutritional stores.

How do the dietary recommendations for breastfeeding mothers differ from those for pregnant women? a. Intake of all nutrients is the same as preconception intake for lactating women. b. The intake level during lactation should be severely restricted to promote weight loss. c. Fluids are forced for pregnant women and limited during lactation. d. Intake of almost all nutrients is needed at higher levels during lactation.

b. location of methyl groups (Gropper Chap 10, pg 400, 401)

How does alpha-tocopherol differ from beta-tocopherol? a. saturation of side chain b. location of methyl groups c.source in the diet

It increases the metabolic rate by 7% per degree Fahrenheit above normal. (CH 2, Krause) pg 18 Fever causes an increase in body temperature. For every degree Fahrenheit above the normal 98.6° F, the BMR increases by 7%.

How does an elevation in body temperature with fever affect the metabolic rate? a. It does not change the metabolic rate. b. It increases the metabolic rate by 7% per degree Fahrenheit above normal. c. It increases the metabolic rate by 14% per degree Fahrenheit above normal. d. It decreases the metabolic rate by 7% per degree Fahrenheit above normal.

Decreases significantly with age and is higher in athletes than nonathletes (CH 6, Krause) At birth, an infant's body weight is about 75% to 85% water compared with a lean adult, who is 60% to 70% by body weight. As muscle mass decreases with age, total body water also decreases. Also, compared with the lean adult, an obese adult may be 45% to 55% water by body weight. This is because the weight is displaced by adipose tissue, which contains very little water. REF: p. 85 ANS: A A decrease in extracellular fluid volume results in a hemoconcentration of the blood, resulting in an increase in serum osmolality. The renin-angiotensin system is triggered by the decreased extracellular volume, and as a consequence, angiotensin II stimulates the thirst centers.

How does body water, as a percentage of body weight, change based on stage of the life cycle and lifestyle? a. Decreases significantly with age and is higher in athletes than nonathletes b. Decreases significantly with age and is lower in athletes than nonathletes c. Increases significantly with age and is higher in athletes than nonathletes d. Increases significantly with age and is lower in athletes than nonathletes

c. As intensity increases, carbohydrate is the larger fraction of the energy source. (CH 23 Krause, p. 432) High-intensity activities rely on anaerobic metabolism of carbohydrates. Moderate-intensity activities rely mostly on aerobic metabolism of carbohydrates and some utilization of fatty acids. Low-intensity activities also rely on aerobic metabolism of carbohydrate and fatty acids; however, as the duration of activity increases, more fatty acid utilization occurs. This is part of the reason that the Dietary Guidelines recommend 60 to 90 minutes of activity for people wishing to lose weight.

How does intensity of the exercise affect the use of fuel sources? a. As intensity decreases, carbohydrate is the larger fraction of the energy source. b. As intensity increases, fatty acids are the larger fraction of the energy source. c. As intensity increases, carbohydrate is the larger fraction of the energy source. d. As intensity decreases, fatty acids are the larger fraction of the energy source.

Answer (key points): The body transfers an amino group from one amino acid to another compound called an alpha-keto acid, which is basically an amino acid without its amino group. This process, called transamination, results in the synthesis of a new amino acid. (Beerman CH 5, p. 164)

How does the body synthesize a nonessential amino acid?

Answer (key points): The adrenal glands release the hormones epinephrine and cortisol to ensure that glucose is available under extreme circumstances when a person needs to fight or take flight (run quickly). Epinephrine stimulates glycogenolysis and gluconeogenesis, making glucose available. Cortisol allows glucose to get to the brain by blocking uptake by other tissues. (Beerman CH 4, p. 141)

How does the body's "fight-or-flight" response work?

c. At least 2 days/week for 6 months (CH 22 Krause, pg. 412) The DSM-5 definition of binge eating disorder specifies that binge episodes must occur for 2 days/week for 6 months. In regard to bulimia nervosa, the definition specifies binge episodes and inappropriate compensatory behaviors at least twice a week for 3 months.

How frequently should binge episodes occur for a binge eating disorder to be diagnosed? a. At least 5 days/week for 3 months b. At least 2 days/week for 3 months c. At least 2 days/week for 6 months d. At least 6 days/week for 2 months

d. Average of three blood pressure readings that exceed the 95th percentile (CH 18 Krause, pg 346) Blood pressure levels are different between adults and adolescents; therefore, a different set of standards is used for adolescents. Percentile charts are available that report blood pressures based on age, gender, and height. These standards should be used to determine hypertension in an adolescent as opposed to applying adult standards.

How is hypertension diagnosed in adolescents? a. Blood pressure of 130/85 mm Hg b. Blood pressure of 140/90 mm Hg c. Blood pressure of 160/100 mm Hg d. Average of three blood pressure readings that exceed the 95th percentile

b. It is increased in cholestasis. (CH 29 Krause, p. 561) Serum alkaline phosphatase is an enzyme that is widely distributed in the liver, bone, placenta, intestine, kidneys, and leukocytes. Increased levels suggest cholestasis but can also be increased with bone disorders, pregnancy, normal growth, and some malignancies. Prothrombin time is used to assess bleeding time.

How is serum alkaline phosphatase used to diagnose liver disease? a. It is decreased in cholestasis. b. It is increased in cholestasis. c. It indicates prolonged bleeding time. d. It precedes jaundice.

b. By replacing animal protein in the diet (CH 19 Krause, pg 362-363) The isoflavones in soy were originally thought to have a direct effect on the lipoprotein profile associated with serum cholesterol; however, recent evidence has not substantiated any effect on HDL cholesterol or triglycerides. The American Heart Association recommends the use of soy as an alternative to animal protein; therefore, the benefit is seen through a reduction in saturated fat intake. Isoflavones do not have antioxidant properties. Although isoflavones are associated with vasomotor symptoms (hot flashes) in menopausal women, effects on blood pressure have not been noted.

How is soy beneficial in promoting cardiovascular health? a. By reducing saturated fat intake b. By replacing animal protein in the diet c. By stimulating HDL production d. By promoting vasodilation and decrease in blood pressure

Answer (key points): While structurally different, the two forms of starch—amylose (linear) and amylopectin (highly-branched)—are broken down by many of the same enzymes. The process of digestion begins in the mouth. Salivary α-amylase hydrolyzes the α-1,4 glycosidic bonds in both amylose and amylopectin, yielding smaller chains called dextrins. Dextrins pass unchanged from the stomach into the small intestine (acidic environment of stomach stops the enzymatic activity). Pancreatic α-amylase found in the small intestine hydrolyzes α-1,4 glycosidic bonds, breaking dextrins down into the disaccharide maltose. Maltase, an enzyme found in the brush border of the small intestine, breaks down maltose into glucose. Because amylopectin contains α-1,6 glycosidic bonds, an additional step is required. Another brush border enzyme, α-dextrinase, is needed to hydrolyze the bond to complete the digestion of amylopectin. The glucose molecules are now ready to be transported into the enterocytes. (Beerman CH 4, pp. 129-130)

How is starch digested?

Answer (key points): The treatment goal is to maintain blood glucose levels within near-normal ranges and prevent long-term complications. Weight management, regular exercise, and a healthy diet are key. There may be a need to add glucose-lowering medication to help make cells more responsive to insulin. Some people with type 2 diabetes do need additional insulin to lower blood glucose and will require insulin injections. (Beerman CH 4, pp. 154-155)

How is type 2 diabetes treated, and what are the treatment goals?

b. 30 minutes Gropper Ch 2 page 52

How long does it take for most of the carbohydrate, protein, and fat to be absorbed from chyme after it enters the small intestine? a. 10 minutes b. 30 minutes c. 1 hour d. 2 hours

3 to 8 hours (Ch 1, Krause) pg 8 Travel of contents through the small intestine takes 3 to 8 hours. A liquid meal empties from the stomach within 1 to 2 hours of eating. A solid meal takes 2 to 3 hours. Total transport from mouth to anus takes 18 to 72 hours on average.

How long does it take for small intestine contents to reach the ileocecal valve? a. 18 to 72 hours b. 3 to 8 hours c. 1 to 2 hours d. 2 to 3 hours

b. 30 to 40 kcal/kg/day (CH 22 Kruase, pp. 417-18 Because of the low weight of patients with anorexia nervosa, 30 to 40 kcal/kg/day is sufficient to start weight gain. To continue to promote weight gain, increasing energy intake by 100 to 200 calories every 2 to 3 days is tolerated by patients with anorexia nervosa. To eventually reach healthy weight gain, some patients with anorexia nervosa may need to be advanced to 70 to 100 kcal/kg/day in their diet therapy.

How many calories should be provided in the diet of a patient with anorexia nervosa to initiate weight gain? a. 25 to 30 kcal/kg/day b. 30 to 40 kcal/kg/day c. 40 to 50 kcal/kg/day d. 70 to 100 kcal/kg/day

c. 175 (Beerman CH 4, pg 142)

How many grams of carbohydrate are required daily during pregnancy? a. 125 b. 150 c. 175 d.200

b. 48 (Beerman CH 5, p. 188)

How many grams of protein would someone weighing 60 kg need each day? a. 44 b. 48 c. 52 d. 56

b. 120 kcal (CH 16 Krause, pg 305) Breastmilk and standard infant formula provide 20 kcal/fl oz (6 · 20 = 120 kcal).

How many kilocalories are provided by 6 fl oz of breastmilk or standard infant formula? a. 60 kcal b. 120 kcal c. 180 kcal d. 300 kcal

b-6 (Beerman, CH 12)

How many major minerals are vital for health and are considered essential nutrients? a. 5 b. 6 c. 7 d. 8

Answer (key points): The Recommended Dietary Allowance (RDA) for carbohydrate is 130 g per day for adults, and represents the minimum amount of glucose required for the brain. Dietary Guidelines recommend that adults consume 14 grams of dietary fiber per 1,000 kcal. The Adequate Intake (AI) for dietary fiber ranges from 21 to 38 g per day for adults. Excellent sources of carbohydrates, particularly those high in fiber, include fruits, vegetables, whole-grain bread, cereals, and grains. (Beerman CH 4, pp. 142-143)

How much dietary carbohydrate and dietary fiber are required for good health, and which foods provide beneficial sources?

ANS: C Usually 80 to 105 ml fluid/kg of body weight is provided to a premature infant to meet insensible fluid losses and renal output on the first day of life. After fluid needs are evaluated, fluids should increase by 10 to 20 ml/kg/day. By the end of the second week of life, the preterm infant may need to receive 140 to 160 ml fluid/kg/day to ensure adequate hydration status. REF:p. 870 (Krause Ch 42)

How much fluid should be provided to an LBW infant during the first day of life? a. 40 to 85 ml/kg b. 50 to 100 ml/kg c. 80 to 105 ml/kg d. 1000 ml total

a. The equivalent to a half cup of milk (CH 28 Krause, p, 531) Most people with lactase deficiency can consume 6 g of lactose or the equivalent of a half cup of milk without experiencing symptoms. Many can ultimately adapt to consuming one whole cup of milk when it is introduced gradually and increased incrementally over the course of several weeks.

How much lactose can most lactase-deficient people consume without major symptoms? a. The equivalent to a half cup of milk b. The equivalent to one cup of milk c. 12 to 15 g of lactose d. Lactase-deficient people cannot consume any lactose without experiencing symptoms

c. 1.2 to 2 g/kg (CH 23 Krause, p. 436) The usual protein intake in the United States is above the RDA of 0.8 g/kg. If athletes in strength training continue with the usual protein intake of 1.2 to 2 g/kg (12% to 20% of total calories), they should be taking in enough protein to promote muscle hypertrophy. Higher protein intakes can compromise adequate intake of carbohydrate for energy. Also, high-protein intake can promote diuresis, dehydration, and possible calcium imbalance.

How much protein should be consumed daily by athletes in strength training? a. 0.8 to 1 g/kg b. 1 to 1.5 g/kg c. 1.2 to 2 g/kg d. 2 to 3 g/kg

every 3 to 5 days (CH 1, Krause) pg 3 Intestinal mucosal cells have a life span of 3 to 5 days before they are sloughed off and recycled. They are fully functional only for the last 2 to 3 days as they migrate to the distal third of the villi.

How often do the cells lining the intestinal tract recycle? a. Every 2 to 3 days b. Every 3 to 5 days c. Every 5 to 7 days d. Every 10 to 14 days

b. Stage 2 (CH 20 Krause, pg 372-373) A Stage 2 pressure ulcer involves a partial-thickness skin loss. Stage 1 pressure ulcers involve intact skin, but the skin may appear red, may feel firm or boggy, and may promote an itching or painful sensation. Stages 3 and 4 pressure ulcers are full-thickness wounds. Stage 3 pressure ulcers involve the subcutaneous tissue, and Stage 4 pressure ulcers go through the fascia and may affect muscle or bone.

How would a pressure ulcer be classified if it involves a partial-thickness skin loss involving the epidermis and dermis, presenting as an abrasion or shallow crater? a. Stage 1 b. Stage 2 c. Stage 3 d. Stage 4

Increased ventilation of carbon dioxide (CH 6, Krause) When excessive metabolic production of acids occurs, the body compensates by stimulating increased expiration of carbon dioxide to reduce acid concentrations in the body. Whereas increased kidney excretion of bicarbonate would be the compensation mechanism for dealing with respiratory alkalosis, decreased excretion of bicarbonate would compensate for respiratory acidosis. In metabolic alkalosis, the lungs would compensate by reducing expiration of carbon dioxide. REF: p. 95

How would the body compensate for metabolic acidosis? a. Increased kidney excretion of bicarbonate b. Increased ventilation of carbon dioxide c. Decreased kidney excretion of bicarbonate d. Decreased ventilation of carbon dioxide

ANS: D Human milk is the most ideal food for the preterm infant as well as the full-term infant. The milk of mothers is different for the first month after the birth of a preterm infant. Premature infants grow more rapidly when fed their own mother's milk. Human milk contains antimicrobial factors, hormones, and enzymes. REF:p. 880 (Krause Ch 42)

Human milk a. has a different composition in the mothers of preterm infants. b. has zinc and iron that is more readily absorbed. c. has hormones. d. all of the above.

α. p. 281. Gropper Ch 8

Hydrostatic or underwater weighing, a method used to determine body composition, is based on which principle? a. Lean body tissue is denser than adipose tissue. b. Adipose tissue is denser than lean body tissue. c. Adipose tissue is composed mostly of water. d.Body fluids are not being weighed using this method.

Phosphorus (Ch 8 Krause pg 130) Loop diuretics also promote the urinary excretion of sodium, magnesium, chloride, and calcium. With long-term use, magnesium and calcium supplementation may need to be prescribed to maintain serum blood levels. Phosphorus is not affected by loop diuretics, but care should be taken in maintaining normal levels of phosphorus because altered levels will affect calcium metabolism from bone.

Hypertensive patients who are taking loop diuretics for reduction of blood pressure may experience hypokalemia. Which other electrolyte does NOT need to be monitored for a potential secondary nutrient deficiency? a. Magnesium b. Sodium c. Phosphorus d. Calcium

e.secondary diabetes mellitus. (Beerman CH 4, p. 155)

If Joe starts to take a new medication and subsequently develops diabetes mellitus, the disease is called: a. type 2 diabetes mellitus. b. type 1 diabetes mellitus. c. gestational diabetes mellitus. d. primary diabetes mellitus. e.secondary diabetes mellitus.

b. Arrange for follow-up contact. (CH 14 Krause, pg 233) If a patient is not ready to change, the counselor should acknowledge the client's positive accomplishments and offer the client the opportunity to resume counseling when the patient is ready. Setting goals for the client or expressing disappointment may promote feelings of failure and resentment on the part of the client. Attempting to push, persuade, coax, confront, or tell the client what to do takes the client out of the decision making and does not motivate the client to carry through with dictated actions.

If a counseling session ends with the client not ready to change, which of the following should the counselor do? a. Establish goals for the client. b. Arrange for follow-up contact. c. Persuade the client to perform some change. d. Express disappointment with the client.

a. Also good (Beerman, 12)

If a food contributes sodium to the diet, what is its contribution of chloride likely to be? a. Also good b. Poor c. Marginal d. Inverse to that of sodium

By increasing medium-chain fatty acids in the diet (Ch 1, Krause) pg 7 Medium-chain fatty acids of 8 to 12 carbons can be absorbed directly by mucosal cells without the presence of bile. The long-chain fatty acids require micelle formation for absorption. Short-chain fatty acids result from bacterial fermentation of malabsorbed carbohydrates and fibers. As bile is produced from cholesterol, dietary restriction of cholesterol is negligible in regard to improvements in fat absorption.

If a patient experiences malabsorption of fat resulting from an impaired ability to produce adequate bile salts for micelle formation, how may fat absorption be improved? a. By increasing short-chain fatty acids in the diet b. By increasing medium-chain fatty acids in the diet c. By increasing long-chain fatty acids in the diet d. By restricting dietary intake of cholesterol

c. conditionally essential Beerman CH1 , pg 5-6

If a toddler's only source of a nutrient is from food but an adult can make the nutrient in an amount sufficient to meet his needs, the nutrient is considered to be _____. a. nonessential b. essential c. conditionally essential d.partially essential

c. fructose-1,6-bisphosphatase CH 3 Gropper, page 81-83

If an individual with no blood sugar abnormalities when eating regularly presented with severe hypoglycemia after 30 hours of fasting, which enzyme would you suspect might be malfunctioning? a. phosphofructokinase b. pyruvate kinase c. fructose-1,6-bisphosphatase d.glucose-6-phosphatase

b. increased translation. Gropper CH 1

If you measure the abundance of an enzyme (or any other protein) and it increases, that increase is most likely due to: a. decreased transcription. b. increased translation. c. posttranslational modification. d. allosteric regulation. e.two of the above

d. Periosteum, cortical bone, trabecular bone

If you removed the layers of bone working toward the center from the outside, in what order would the layers be? a. Cortical bone, trabecular bone, periosteum b. Periosteum, trabecular bone, cortical bone c. Cortical bone, periosteum, trabecular bone d. Periosteum, cortical bone, trabecular bone

Answer (key points): Today many "vegetarians" consume dairy products and eggs and are called lacto-ovo-vegetarians. Alternatively, lactovegetarians include dairy products, but not eggs, in their diets. Vegetarians who avoid all animal products are referred to as vegans. In general, a well-balanced lacto-ovo- or lactovegetarian diet can easily provide adequate protein, energy, and micronutrients. Dairy products and eggs are convenient sources of high-quality protein and many vitamins and minerals. However, because meat is often the primary source of bioavailable iron, eliminating it can lead to iron deficiency. Furthermore, vegans may be at increased risk of being deficient in several micronutrients, including calcium, zinc, iron, and vitamin B12. This risk is increased further during pregnancy, lactation, and periods of growth and development such as infancy and adolescence. (Beerman CH 5, pp. 191-192)

If you were providing nutritional guidance to someone who identified himself or herself as a vegetarian, why would it be important to know what type of vegetarian diet the person had chosen?

e.in chylomicrons in the lymphatic vessels and general circulation (Gropper Chap 10, pg 402)

Immediately following a balanced meal that contained vitamin E (such as fortified milk), where would you most likely find most of the vitamin E in the body? a. in the portal blood as α-tocopherol b. in the general circulation bound to RBC c. inside cells as free α-tocopherol d. stored in adipose tissue e.in chylomicrons in the lymphatic vessels and general circulation

a. opportunistic. (Gould CH 7, pg. 134)

Immunodeficiencies may result in an increased risk of infections by normally harmless microorganisms. These infections are referred to as: a. opportunistic. b. prophylactic. c. abnormal. d. transient.

b. Cancer (CH 20 Krause, pg 376-377) The addition of medical nutrition therapy to Medicare benefits began in 2002 with coverage for nutrition services in the treatment of diabetes and kidney disease. In 2005, expansion of Medicare benefits included the provision of MNT in preventive services for new Medicare beneficiaries. In 2006, CMS began working with long-term care improvement programs to address certain chronic conditions in an effort to reduce hospitalizations. Cancer has not been identified as one of the conditions covered.

In Medicare benefits, for which of the following are MNT services NOT included? a. Preventive services b. Cancer c. Diabetes d. Preend-stage kidney disease

D. p. 291 (Gropper CH 8)

In a clinical setting, which RQ suggests that the patient is synthesizing fat? a. <0.70 b. <0.80 c. <0.90 d.1.00

d-Magnesium, potassium (Beerman, CH 12)

In addition to calcium, phosphorus, sodium, and chloride, what other major minerals do humans require? a. Iron, sulfur b. Chromium, molybdenum c. Zinc, manganese d. Magnesium, potassium

a. Proteins (Beerman, 12)

In addition to electrolytes that help move water into and out of cells, what else helps move water back into the intravascular space? a. Proteins b. Glucose c. Enzymes d. Phospholipids

e. a, b and c (Beerman chapter 10, pg 432)

In addition to maintaining, replicating, and repairing DNA, what additional role(s) may niacin play in the body? a. Protein synthesis b. Glucose homeostasis c. Cholesterol metabolism d. Electrolyte balance e. a, b and c f. All of the above

c. Potassium, phosphate, chloride (Beerman, 12)

In addition to sodium, which of the following are considered to be predominant electrolytes? a. Chloride, phosphate, calcium b. Phosphate, potassium, magnesium c. Potassium, phosphate, chloride d. Magnesium, calcium, potassium

a. circulating 25-OH cholecalciferol (Gropper Chap 10, pg 400)

In assessing the vitamin D status of an individual, which measure would you use? a. circulating 25-OH cholecalciferol b. circulating 1,25-OH2 cholecalciferol c. circulating cholecalciferol d.serum calcium levels

b. entry of the virus into the body and the appearance of antibodies in the blood. (Gould CH 7, pg. 133)

In cases of HIV infection, the "window period" refers to the time between: a. entry of the virus into the blood and the initial manifestations. b. entry of the virus into the body and the appearance of antibodies in the blood. c. entry of the virus into the body and a significant drop in CD4 T-helper lymphocyte count. d. diagnosis of "HIV positive" and diagnosis of "AIDS."

a. Bolus feeding (CH 13 Krause, pg 215-216) Because the provision of the enteral nutrition will generally be by the family or caregivers in the home, the best method for administering enteral nutrition is the easiest, bolus feeding. This method does not require special equipment, such as a hanging pole, or equipment that may require maintenance, such as pumps. The family can be trained to start with half of one can of formula fed four to six times a day and can work their way up to the patient's total needs as tolerated.

In home care, what is the recommended administration method for enteral nutrition? a. Bolus feeding b. Gravity drip c. Cyclic pump d. Continuous pump

d. Decreased synthesis of albumin by the liver and the presence of edema and ascites (CH 29 Krause, p. 562) Liver disease affects albumin in several ways. Primarily, as the liver produces albumin, liver disease causes a decrease in its production. As liver disease progresses to cirrhosis, alterations in the structure of the liver affect blood flow to the liver. This leads to portal hypertension. A consequence of both the increased blood pressure and the decreased albumin production is a forcing of fluid into the interstitial and third spaces. The reduced fluid in the blood may falsely concentrate the serum albumin level.

In liver disease, which factor(s) affect the interpretation of serum albumin values? a. Increased synthesis of albumin by the liver b. Increased synthesis of albumin by the liver and increased nitrogen retention c. Decreased synthesis of albumin by the liver and increased urinary nitrogen excretion d. Decreased synthesis of albumin by the liver and the presence of edema and ascites

c. Inhalant exposure to antigen (CH 26 Krause, pp. 480-2) Children and adults who develop food allergies after 2 years of age are more likely to develop allergies by inhalant exposure as opposed to consumption. During fetal development and infancy, antigen exposure can occur through maternal diet, as has been seen in the development of peanut and tree nut allergies. However, these types of food allergies will normally manifest before 2 years of age.

In people who develop food allergies after 2 years of age, what is the most common means of initial food allergen exposure? a. Maternal consumption during fetal development b. Antigen exposure in breastmilk c. Inhalant exposure to antigen d. Ingestion of food antigen

b. methyl, 5-methyltetrahydrofolate, homocysteine (Gropper Chap 9, pg 349)

In the enzyme methionine synthase, vitamin B12 acts by accepting a _____ group from _____ and donating this group to _____ to form methionine. a. carbon, methionine, folate b. methyl, 5-methyltetrahydrofolate, homocysteine c. methyl, formiminoglutamic acid, succinyl-CoA d.carbon, serine, glycine

c. Listeria monocytogenes (Beerman CH 5, p. 212)

In the late 1990s, consumption of contaminated luncheon meat that contained _____ resulted in the deaths of 6 people and two miscarriages. a. Salmonella b. Shigella c. Listeria monocytogenes d. E. coli

b. trypsin (Gropper CH 5, pg. 147)

In the small intestine, which enzyme hydrolytically activates a pancreatic zymogen so that lipid digestion can occur? a. pepsin b. trypsin c. colipase d. maltase

b. pancreatic β-cells (Beerman CH 4, p 149)

In type 1 diabetes, the body's antibodies destroy _____. a. the virus responsible for the disease b. pancreatic β-cells c. glucose transporters d. glucose

c. can no longer produce insulin (Beerman CH 4 ,p 148)

In type 1 diabetes, the pancreas _____. a. makes some, but insufficient, insulin b. produces an insulin that is rapidly destroyed c. can no longer produce insulin d. makes an ineffective insulin

a. stellate (Gropper Chap 10, pg 379)

In what cells will you find most of the retinol and vitamin A stored? a. stellate b. gallbladder c. fundus d.antrum

c. High-protein plant or marine foods (CH 26 Kruase, p. 484) The most common foods associated with food allergies are milk, egg, peanut, soy, wheat, fish, and tree nuts. Meats and poultry are not commonly associated with food allergies.

In what types of foods are the most common food allergens found? a. High-simple-carbohydrate foods b. High-protein animal foods c. High-protein plant or marine foods d. High-saturated-fat foods

d. Binge eating disorder (CH 22 Krause, pg. 410) In binge eating disorder, a patient will demonstrate binge eating behaviors but no means of compensating for the excessive intake of food. These people tend to be overweight. The person with binge eating disorder feels incapable of controlling eating, which results in feelings of depression, disgust, and guilt. In the other eating disorders, binge eating is commonly followed by purging or some other compensatory mechanism, such as fasting or excessive exercise.

In which eating disorder might a person binge often but not try to compensate for this behavior? a. Anorexia nervosa b. Bulimia nervosa c. Eating disorder not otherwise specified d. Binge eating disorder

c. Eating disorder not otherwise specified (CH 22 Krause, pgs. 408-409) Eating disorder not otherwise specified is the category for disorders of eating that do not meet the criteria for other specific eating disorders. Although people with anorexia nervosa or bulimia nervosa may perform binge eating activities, these are generally associated with purging after the food is swallowed. A person with binge eating disorder will have recurrent episodes of binge eating but will not follow them with some inappropriate compensatory behavior.

In which eating disorder might a person chew and spit out, but not swallow, large amounts of food? a. Anorexia nervosa b. Bulimia nervosa c. Eating disorder not otherwise specified d. Binge eating disorder

a. Anorexia nervosa (CH 22 Krause, pg 410) Although a person with anorexia nervosa may have a low BMI, this person will have a body image distortion, causing the person to feel fat even when wasted in appearance. People with bulimia nervosa tend to be within normal weight standards but are also concerned with body image. People with eating disorder not otherwise specified may vary in their weight and perception of self and body image. People with binge eating disorder tend to be overweight.

In which eating disorder might a person have an intense fear of becoming overweight even though she is underweight? a. Anorexia nervosa b. Bulimia nervosa c. Eating disorder not otherwise specified d. Binge eating disorder

nutrition diagnosis. (CH 10 Krause, pg 166) PES statement refers to "problem" or diagnosis, "etiology," and "signs or symptoms." Inadequate energy intake is an example of a nutrition problem or diagnosis.

Inadequate energy intake" is an example of a. "S" of a PES statement. b. nutrition diagnosis. c. nutrition symptom. d. "E" of a PES statement.

c. average daily sodium intake (Gropper CH 12, pg 462)

Incidence of hypertension in populations is considered predictable by _____. a. serum sodium concentration b. urinary sodium excretion c. average daily sodium intake d.sodium filtration rate by the kidney

a. hemolysis of erythrocytes. (Gould CH 7, pg. 124) Hemolysis or haemolysis (/hiːˈmɒlɪsɪs/), also known by several other names, is the rupturing (lysis) of red blood cells (erythrocytes) and the release of their contents (cytoplasm) into surrounding fluid (e.g. blood plasma). Hemolysis may occur in vivo or in vitro (inside or outside the body)

Incompatible blood transfusions result in: a. hemolysis of erythrocytes. b. a type I immune response. c. deposits in multiple organs. d. immune deficiency.

c. Protein (CH 20 Krause, pg 372) Pressure ulcers require protein for wound healing. The amount of protein recommended depends on the stage of the pressure ulcer. Protein deficiency contributes to the development of the pressure ulcer. A multivitamin and mineral supplement is recommended, but there are no specific recommendations for increased vitamin B12 or potassium.

Increased intake of which nutrient may be required in a patient who has pressure ulcers? a. Water b. Vitamin B12 c. Protein d. Potassium

a. vitamin A. (Gropper Chap 10, pg 382-383)

Induction of a protein (i.e., increasing the amount of a protein) via increasing gene expression can be accomplished by: a. vitamin A. b. folate. c. vitamin C. d.more than one of these vitamins

ANS: D All infants lose weight after birth, and preterm infants lose more relative weight than term infants because they are born with more extracellular water. By 2 to 3 weeks postpartum, infants usually regain their birth weight, and with adequate nutrition, they begin to grow and exceed their birth weight. REF:p. 882 (Krause CH 42)

Infants begin to gain weight above their birth weight a. by the end of the first day postpartum. b. within 48 to 72 hours postpartum. c. by the end of the first week postpartum. d. by 2 to 3 weeks postpartum.

a. Provide only breastmilk to the infant for the first 6 months. (CH 26 Krause, p. 504) If they receive breastmilk exclusively for the first 6 months of life and their exposure to known food allergens is limited, infants have a greater probability of completing the first year of life without developing a food allergy. Continued avoidance of common food allergens for the first 2 to 3 years of age will reduce the chances of developing any food allergies.

Infants with a genetic predisposition to atopic disease have an increased probability of developing food allergies. Which of the following may help reduce the likelihood of the infant developing food allergies? a. Provide only breastmilk to the infant for the first 6 months. b. Provide only breastmilk and cereal for the first 6 months. c. Provide cereal between breastmilk feedings. d. Provide diluted cereal and formula for the first 6 months.

c. glycogenesis, gluconeogenesis (Beerman CH 4, pgs. 139-140)

Insulin stimulates _____ and inhibits _____. a. ketogenesis, glycogenolysis b. glycogenolysis, gluconeogenesis c. glycogenesis, gluconeogenesis d. glycogenolysis, ketogenesis

a. aspirin and warfarin. (Gropper CH 4, p. 131)

Interactions have been reported between gingko biloba and a. aspirin and warfarin. b. oral contraceptives. c. diuretics. d.hypertensive medications.

B p. 482 (Gropper CH 13)

Iron content of the average Western diet is estimated to be about α 1 to 4 mg iron per 1,000 kcal. b. 5 to 7 mg iron per 1,000 kcal. c. 8 to 15 mg/day. d. 18 g /day.

Answer (key points): Lifestyle can influence the development of diabetes. Case in point: The National Institutes of Health has been studying the Pima Indians living in both the U.S. (Arizona) and Mexico for the last thirty years. Despite the fact that both have similar genetics, only those living in the United State's obesogenic environment (abundant food supply, reduced physical activity, large portions, and readily available calorically-dense foods) developed diabetes. The Mexican Pima Indians still live in a remote area of Mexico and continue to consume a diet and live a lifestyle similar to those of 100 years ago. (Beerman CH 4, p. 156)

Is a chronic disease such as diabetes determined by our genes or by our lifestyle?

Answer (key points): No; insulin is a protein and if taken orally would be denatured by enzymes in the digestive tract. (Beerman CH 4, p. 150)

Is it likely that insulin can ever be given effectively in "pill" form?

d. six (Gropper Chap 10, pg 391, 398)

It's a good thing that milk is fortified with vitamin D so that we can consume the RDA if we drink the recommended number of glasses of milk each day. The DRI for 9-69 year olds is 600 IU (15 μg). This equals _____ cups of milk. a. two b. three c. four d.six

c. Biotin (Beerman chapter 10, pg 437) Avidin in raw egg whites binds to biotin!

Jake, a body builder, is drinking two protein shakes that contain 6 raw egg whites each daily. What vitamin deficiency could result? a. Vitamin B6 b. Niacin c. Biotin d.Vitamin B12

d. a and b (Beerman CH 4, pg 143)

Jane's one-day intake revealed that she consumed the following carbohydrate sources: 2 cups of cornflakes, 2 slices of whole-grain bread, 1 cup white rice, 1 cup of fresh fruit, 1 cup broccoli, and 1 cup tossed salad. What does she need to do to improve her intake to meet MyPlate recommendations? a. Replace the cornflakes or white rice with a whole-grain alternative b. Add at least an additional ½-cup serving of fruit c. Add at least an additional 1-cup serving of vegetable d. a and b e. b and c

c. transformed into fat and stored in adipose (fat) tissue (Beerman CH 5, pp. 184, 185)

Jasmine is trying to lose weight. She has decided to try a diet that lets her eat unlimited amounts of protein. The protein that Jasmine eats that is above and beyond what she needs is _____. a. excreted as protein in her urine b. excreted as amino acids in her feces c. transformed into fat and stored in adipose (fat) tissue d. transaminated into lipids and circulated in lymph

a. 76 to 110 (Beemer CH 4, pgs. 142-143)

Jasmine requires 1700 kcalories daily. If she follows the Acceptable Macronutrient Distribution Range, how many grams of carbohydrate should she consume? a. 76 to 110 b. 85 to 122 c. 150-170 d. 191 to 276

d. incubation periods (Beerman CH 5, p. 200)

Jeff became ill 24 hours after eating contaminated meat sauce while Tiffany, who ate the same sauce, did not become ill for 2 days. Jeff and Tiffany experienced different _____. a. variants b. toxicity levels c. genotypes d. incubation periods

d. 25 (Beerman CH 4, pg 142)

Jim's one-day diet record revealed that he consumed 2880 kcalories. What percent of his kcalories are coming from "added sugar" if his only sources of added sugar are the three 20-oz. colas he consumed (240 kcalories, 0 g fat, and 0 g protein per 20-oz. serving)? a. 10 b. 15 c. 20 d. 25

d. Calcium deficiency and demineralization of bone (Beerman, 12)

John, a senior in high school, routinely consumes 4-5 soft drinks daily and almost no dairy products. What is he at increased risk for developing? a. Magnesium toxicity and potentially obesity b. Potassium toxicity and potentially rickets c. Phosphorous toxicity and potentially loss of muscle tissue d. Calcium deficiency and demineralization of bone

c. French fries (Beerman CH 6, p. 239)

Kay has had her gallbladder removed. Which of the following foods is most likely to be difficult for her to digest? a. Spicy salsa b. Steamed shrimp c. French fries d. Poppy-seed rolls

d.during prolonged starvation (Gropper CH 5, p 167)

Ketogenesis would be the HIGHEST: a. after a high-CHO meal. b. after a high-protein meal. c. after a high-fat meal. d.during prolonged starvation

e. b and c (Beerman CH 4, pg 141)

Ketogenesis: a. occurs in the pancreas. b. is the formation of ketones. c. is stimulated by glucagon. d. a and b e. b and c

a. fatty acids, glucose (Beerman CH 4, pg 141)

Ketones are formed from _____ when there is a relative absence of _____. a. fatty acids, glucose b. glucose, glycogen c. glucose, fatty acids d.fatty acids, glycogen

Key: 1. R-group 2. Amino group 3. Central carbon 4.Carboxylic acid (Beerman CH 5, p. ??)

Label the parts of the amino acid.

a. associated with cramping, diarrhea, and flatulence. (Beerman CH 4, pgs. 130,132)

Lactose intolerance is: a. associated with cramping, diarrhea, and flatulence. b. not related to insufficient production of lactase. c. more common among Europeans than African, Native, or Asian Americans. d.associated with death within 6 months of diagnosis.

a. anorexia nervosa (CH 22 Krause, pg. 410) Lanugo is soft, downy hair growth associated with anorexia nervosa. People with anorexia nervosa also appear cachectic, and their prepubescent body habitus causes them to appear younger.

Lanugo is soft, downy hair growth associated with a. anorexia nervosa. b. binge eating disorder. c. bulimia nervosa. d. eating disorder not otherwise specified.

d. macrocytic anemia, nervous system (Gropper Chap 9, pg 353, 358)

Large amounts of folic acid can mask a vitamin B12 deficiency and prevent _____ from resulting. Over time the symptoms unique to a vitamin B12 deficiency will occur, and these are related to the _____. a. microcytic anemia, muscular system b. DNA and RNA synthesis, vascular system c. one-carbon transfer, nervous system d.macrocytic anemia, nervous system

c. produced commercially via a process called partial hydrogenation (Beerman CH 6, pp. 222-223)

Lea wants to limit her intake of trans fatty acids. Complete the following statement to assist her in identifying this type of fatty acid. Trans fats are _____. a. typically liquids at room temperature b. generally found in foods containing polyunsaturated fatty acids (PUFAs) c. produced commercially via a process called partial hydrogenation d. generally found in non-organic foods

a. Banting and Best (Beemer CH 4, p 147)

Leonard Thompson, a 14-year-old boy dying of diabetes, was the first human to be injected with a pancreatic extract that was later given the name insulin. Which scientists below are credited with creating this pancreatic extract? a. Banting and Best b. von Mering and Minkowski c. Macleod and Collip d.Best and von Mering

c. hydrophobic (Beerman CH 6, p. 219)

Lipids are generally soluble in organic solvents and insoluble in water. Thus, they are classified as_____. a. hydrophilic b. alpha oils c. hydrophobic d. beta oils

Answer (key points): (Beerman CH 5, pp. 180-185) Facilitating the communication among tissues and organs Protecting the body from physical danger and infection Regulating how fluids are distributed in the body Regulating how acidic or basic the body fluids are Providing sources of glucose and energy Regulating protein breakdown Participating in cell signaling Serving as messengers in the nervous system Stimulating or inhibiting the activity of enzymes Providing nitrogen for the synthesis of DNA and RNA

List five categories of the functions of proteins in humans.

a. low metabolic state associated with anorexia nervosa. (CH 22 Kruase, p. 411) Low T3 or active triiodothyronine is a characteristic of a reduced state of metabolism in patients with anorexia nervosa. Thyroid hormone production remains normal; however, peripheral deiodization of thyroxine favors the formation of reduced triiodothyronine. The reduced form of triiodothyronine is less metabolically active than the regular form. This alteration in metabolism resolves as weight gain occurs.

Low T3 syndrome is a a. low metabolic state associated with anorexia nervosa. b. reduction in thyroxine associated with anorexia nervosa. c. decrease in triiodothyronine associated with bulimia nervosa. d. decrease in reduced triiodothyronine associated with anorexia nervosa.

ANS: C An infant who weighs less than 2500 g (5.5 lb) at birth is classified as having low birth weight. Infants who weigh less than 1000 g (2.25 lb) at birth are classified as being extremely low birth weight. Infants that weigh less than 1500 g (3.30 lb ) at birth are classified as being very low birth weight. An infant born with a weight for age less than the 10th percentile is classified as being small for gestational age. REF: p. 868 (Krause CH 42)

Low birth weight is defined as birth weight a. less than 1000 g. b. less than 1500 g. c. less than 2500 g. d. for age less than the 10th percentile.

ANS: C MTHFR and COMT polymorphisms may increase the predilection for schizophrenia. MTHFR defects and elevated plasma homocysteine concentration have been suggested as risk factors for schizophrenia, but epidemiologic studies have been inconsistent. REF: p. 861 (Krause CH 41)

MTFHR mutations are associated with what psychiatric disorder? a. Alzheimer disease b. Anxiety disorder c. Schizophrenia d. Chronic fatigue syndrome

D- not convincing (Beerman, CH 12)

Magnesium deficiency has been investigated to determine whether it increases the risk for cardiovascular disease and predisposes people to type 2 diabetes. To date, how convincing is the evidence from clinical trials? a. Strongly convincing b. Moderately convincing c. Marginally convincing d. Not convincing

Key: Grading rubric - answer should include the following items: Different fibers have different helpful characteristics. Examples include: -- Cellulose, which increases fecal bulk and speeds transit time to remove toxins and carcinogens more quickly from the gut, probably reducing risk for cancer. -- Pectins and beta-glucans, which can keep bile acid and cholesterol from being absorbed into the blood, thereby reducing blood cholesterol and risk for heart disease. -- Fermentable fibers such as fructans and gums can produce beneficial short-chain fatty acids to reduce risk for both cancer and heart disease. To gain all these benefits, a variety of foods containing different fiber types need to be included in the diet daily. (Gropper CH 4, pp. 121-125)

Make an argument defending the statement: To remain healthy, it is best to eat foods containing a variety of fiber types each day.

b. legumes (Beerman CH 5, p. 165)

Meat, fish, eggs, dairy products, and _____ are especially good sources of proteins. a. fruits b. legumes c. vegetables d.whole grains

a-Phospholipids Gropper CH 1

Membrane lipid bilayers consist primarily of _____. a. phospholipids b. cholesterol c. proteins d. saturated fatty acids

b-detoxifiers Gropper CH 1

Membrane proteins serve as all of the following EXCEPT _____. a. pumps b. detoxifiers c. receptors d. enzymes

d.FMN (Gropper Chap 9, pg 327, 361)

Metabolism of vitamin B6 to the primary coenzyme form, pyridoxal phosphate, requires the action of what other B vitamin? a. GSH b. NAD c. THF d.FMN

d.so that methyl groups are available (Gropper Chap 9, pg 349-350)

Methionine is used to synthesize S-adenosylmethionine (SAM). Why is this important? a. so that 5-methyl THF is formed b. so that dUMP is catalyzed to dTMP c. so that fatty acids with an odd-numbered chain can be metabolized d.so that methyl groups are available

Α p. 293(Gropper CH 8)

Mr. Q., age 62, is 5'10" tall, weighs 150 pounds, and leads a sedentary life. The Harris-Benedict equation for men is 66.5 + (13.7 × W) + (5.0 × H) - (6.8 × A). Using the Harris-Benedict equation, calculate Mr. Q's RMR. a. RMR = 1468 kcal/day b. RMR = 1614 kcal/day c. RMR = 1790 kcal/day d.RMR = 2311 kcal/day

c. Cori cycle CH 3 Gropper, page 99

Muscle lactate is converted to glucose in the liver and returned to the muscle by means of the _____. a. malate-aspartate shuttle b. electron transport chain c. Cori cycle d.pentose phosphate pathway

c. protein (Beerman CH 5, p. 174)

Mutations in DNA can influence the cell's ability to produce a functional _____. a. essential amino acid b. non-essential amino acid c. protein d. dispensable amino acid

a. 1.5, 5 (Beerman CH 5, p. 189)

MyPlate recommends _____ to _____ ounces of lean meat, poultry, or eggs per day. a. 1.5, 5 b. 2, 4 c. 3.5, 9 d. 4, 8

a. USDA and Department of Health and Human Services (DHHS). (CH 11 Krause, pg 174) The MyPyramid offers a method for determining appropriate patterns for daily food choices and was developed by the USDA and DHHS. The Ministry of Health publishes Canada's food guide.

MyPyramid was developed by a. USDA and Department of Health and Human Services (DHHS). b. the National Cancer Institute. c. the Food and Drug Administration. d. the Ministry of Health.

a. health of the population CH 1 Beerman, page 16

NHANES simultaneously monitors nutrition and _____ in the U.S. a. health of the population b. weight gain among adults over 21 c. the incidence of diabetes in children over the age of 2 d.the incidence of vitamin and mineral deficiencies in low-income groups

c. pectin (Gropper, CH 4, pg. 114)

Name a water-soluble, gel-forming fiber that functions in the plant as intracellular cement and that is used commercially to make jellies and to provide fiber in enteral formulas. a. lignin b. gum c. pectin d.cellulose

a. are phagocytic cells. (Goulds CH 7, pg. 115)

Neutrophils: a. are phagocytic cells. b. produce histamine. c. produce antibodies. d. are elevated during an allergic response.

a. mostly long-chain (Beerman CH 6, p. 220)

Nigel wants to choose a lipid to use in stir-frying that is more stable and thus won't smoke and burn as readily when he cooks with medium-high heat. To accomplish this, he should select a lipid that contains _____ fatty acids. a. mostly long-chain b. mostly short-chain c. a mix of short- and medium-chain d. a mix of long- and medium-chain

ANS: B Ch3 Krause, pg 30 The concept of Nutrient Triage Theory states that during poor dietary supply, nutrients are preferentially utilized for functions that are important for survival. The nutrient partner principle refers to the symbiosis between two nutrients such as calcium and vitamin D. Long-latency nutrient insufficiencies result from chronic poor intake and contribute over a period of time to the development of chronic disease.

Nutrient Triage Theory refers to a. the nutrient partner principle. b. nutrients being preferentially used for functions important for survival during poor dietary supply. c. nutrients being preferentially used to fuel inflammation. d. nutrients being preferentially used to resolve long-latency nutrient insufficiencies.

d. those living below the poverty line. (CH 11 Krause, pg 177) Nutrient intakes are most likely to be low in persons living below the poverty level. Intakes of nutrients reported to be low in the general population are even lower in the poverty group.

Nutrient intakes are most likely to be low in a. populations living in the South. b. preschool children. c. those older than 65 years. d. those living below the poverty line.

c. come from the food we eat CH 1 Beerman, p 5-6

Nutrients considered essential must ____. a. be synthesized by the body daily b. be stored in the body c. come from the food we eat d.be consumed from organic foods

e. All of the above (Beerman, 12)

Nutrients that have DRI levels that are intended to promote both bone health and bone growth include: a. calcium. b. vitamin D. c. protein. d. a and b e. All of the above

b. may not be accurate because of body composition changes in elderly adults. (CH 20 Krause, pg 375) The MNA includes six questions and the BMI or calf circumference. However, BMI may not yield accurate results because fat mass increases and lean tissue decreases with aging. A measure such as the mid-arm muscle circumference more accurately reflects body composition.

Nutrition screening using the BMI as an indicator a. is the best indicator for those 85 years of age and older. b. may not be accurate because of body composition changes in elderly adults. c. is better than using mid-arm muscle circumference. d. is not part of the Mini Nutritional Assessment (MNA).

b. Cancer (ch 5, Krause) PPAR transcription factors function in lipid and lipoprotein metabolism, glucose homeostasis, adipocyte proliferation, and foam cell formation. Omega-3 and omega-6 fatty acids serve as ligands for PPARs, and as a result, potential beneficial effects could result in reduced expression of type 2 diabetes mellitus, atherosclerosis, and obesity. Research connecting nutrigenomics to cancer presently is investigating relationships to detoxification factors. REF: p. 78

Nutritional components of food affect genetic expression by acting as ligands for peroxisome proliferator-activated receptors (PPAR). Which disease may NOT be positively affected by this nutrigenomic relationship? a. Type 2 diabetes mellitus b. Cancer c. Obesity d. Atherosclerosis

This is really a GLUT4 question—all tissues can take up glucose because they have transporters (even when there isn't any insulin). Insulin stimulates increased uptake in muscle and adipose because it binds to the insulin receptor on these cells and causes the GLUT4 to translocate from the cytosol to the membrane. Note that insulin still binds to the insulin receptor on all the other cells—they all have changes in glycolytic enzymes, etc.—they just don't have the right type of GLUT to translocate in response to insulin. Also note that insulin does not enter cells—it (like glucagon) binds to its receptor and various signals are transmitted into the cell (i.e., signal transduction), which results in various responses (induction of genes; stimulation of enzymes; translocation of GLUT4); some of these responses occur in all cells, some in only specific cells.

Often you will hear the statement, "Insulin is important for the uptake of blood glucose by all tissues." What is wrong with this statement? Be specific.

d. 2000 mg/d (Gropper Chap 11, pg 436)

One health claim for calcium states that levels above _____ are unlikely to provide additional benefit. a. 800 mg/d b. 1000 mg/d c. 1200 mg/d d.2000 mg/d

d. culture is mutable and multiple. (CH 14 Krause, pg 229-230) Knowing about a culture does not eliminate racism, and part of cultural competency is to avoid any stereotyping, including how a specific culture wants to communicate. Culture is mutable and multiple, and any understanding of particular cultural context is always incompletely true, always partial, and always somewhat out of date.

One of the five tenets of cultural competency is a. you must know a culture's communication style to be an effective counselor. b. cultural competency eliminates racism. c. culture is defined as race, religion, and ethnicity. d. culture is mutable and multiple.

d.200 g Gropper Ch 2 page 53

One of the major molecules absorbed from the colon is water and one liter of chyme entering the large intestine is normally reduced to _____. a. 500 g b. 400 g c. 300 g d.200 g

d. Colon cancer (Beerman, 12)

One study has suggested that consuming even one additional serving of low-fat dairy foods each day is associated with a 40 to 50% reduction in risk of which of the following diseases? a. Breast cancer b. Prostrate cancer c. Heart disease d. Colon cancer

c. is inherited from one's parents (Beerman CH 5, p. 174)

One's genetic makeup or genotype _____. a. results from the expression of chromosomes after birth b. can be altered by changing one's diet c. is inherited from one's parents d.is remarkably similar to that of others of the same race

ANS: C CH 9 Krause Organic agriculture promotes a more sustainable food system by reducing soil erosion, rehabilitating poor soils, and sequestering carbon in soil. Organic foods meet all the food safety requirements that nonorganic foods meet. Because organic meat production does not allow antibiotics to be routinely used, it may help prevent antibiotic resistance in humans. Sales of organic foods in the United States grew by almost 16% in 2008. REF: p. 153

Organic agriculture a. is declining in the United States because of decreased demand. b. is dangerous because the food does not meet state and federal food standards. c. promotes a more sustainable food system. d. promotes antibiotic resistance.

a. transamination, pyruvic acid (Gropper Chap 9, pg 362, 193)

PLP functions as a coenzyme for _____ when alanine enters the liver. Alanine becomes its α-keto acid, _____. a. transamination, pyruvic acid b. transamination, α-ketoglutaric acid c. transmethylation, histidine d.desulfation, methioninie

b. intrinsic factor Gropper CH 2 page 47

Pancreatic juice that enters the duodenum through the sphincter of Oddi contains all of the following EXCEPT _____. a. digestive enzymes b. intrinsic factor c. anions such as bicarbonate and chloride d.cations such as sodium, potassium, and calcium

Folate and vitamin D (Ch 8 Krause, pg 129) Phenytoin and phenobarbital increase the metabolism of vitamin D, folic acid, and vitamin K. As a result, these nutrients are commonly supplemented to patients receiving these drugs.

Patients receiving anticonvulsant medications, such as phenytoin and phenobarbital, may need to be supplemented with which nutrients? a. Ascorbic acid and vitamin A b. Ascorbic acid and vitamin D c. Folate and vitamin D d. Iron and vitamin A

milk (Ch 8 Kraue pg 136) Tetracycline will chelate with calcium from dairy foods and supplements, making both the drug and the calcium unavailable for absorption. Calcium supplements should not be taken during the duration of this antibiotic's prescription. Dairy products should be taken 2 to 6 hours separate from tetracycline administration.

Patients receiving the antibiotic tetracycline should be taught to avoid taking it with what? a. Fruit juices b. Meat c. Milk d. Sucrose-containing desserts

A p. 542 (Gropper CH 13)

People living in regions that contain high soil molybdenum levels may develop _____. a. gout b. heart disease c. reduced urea production d.cretinism

d.lactic acid (Beerman CH 4, pg. 132)

People who are lactose intolerant may be able to tolerate cheese and yogurt, because during their manufacturing most of the lactose has been converted to _____. a. glucose b. lactase c. amylose d.lactic acid

a. Potassium, hypokalemia (Beerman, CH 12)

People who suffer from eating disorders are at increased risk for a mineral deficiency that can result in irregular heart function, muscular paralysis, decreased blood pressure, and difficulty breathing. What is this mineral, and what is the deficiency called? a. Potassium, hypokalemia b. Sodium, hyponatremia c. Calcium, hypocalcemia d. Phosphorous, hypophosphatemia

ANS: D Down syndrome is also known as trisomy 21 because the child inherits an extra chromosome 21 from each parent. Children usually inherit 23 chromosomes for a total of 46. Because children with Down syndrome inherit the extra chromosome 21, they have a total of 47 chromosomes. REF:p. 915 (Krause CH 44)

People with Down syndrome have a total of _____ chromosomes. a. 21 b. 23 c. 46 d. 47

d. Chloride ( Beerman, 12)

People with cystic fibrosis have significant respiratory difficulties and may have profound digestive complications because a genetic defect results in the inability to pump which ions across cell membranes? a. Sodium b. Potassium c. Phosphate d. Chloride

d.below-normal glucokinase activity because of low insulin levels. CH 3 Gropper, page 81

People with type 1 diabetes have a. slow translocation of GLUT4 receptors from the Golgi body. b. lack of mRNA synthesis for GLUT4 receptors in adipocytes or myocytes. c. increased glycogenesis in myocytes after a meal. d.below-normal glucokinase activity because of low insulin levels.

d.inhibiting the binding of histamine to the parietal cells Gropper CH 2 page 42

Pepcid, a drug that is classified as a H2 receptor antagonist, acts by _____. a. inhibiting the secretion of hydrogen ions by the parietal cells b. inhibiting the release of acetylcholine by the vagus nerve c. inhibiting the binding of gastrin to the parietal cells d.inhibiting the binding of histamine to the parietal cells

HCl (Ch 1, Krause) pg 7 Pepsinogen is secreted in the stomach and converted to its active form by the acid environment of the stomach. Enterokinase is secreted by the brush border of the small intestine in response to the presence of chyme. Trypsinogen is secreted by the pancreas and activated by enterokinase. Various peptidases are secreted by the either brush border or the pancreas.

Pepsinogen is converted to pepsin when it comes in contact with a. enterokinase. b. trypsinogen. c. hydrochloric acid. d. peptidases.

Autosomal recessive (ch 5, Krause) PKU, tyrosinemia, maple syrup urine disease, and other metabolic disorders known as inborn errors of metabolism result from autosomal recessive disorders. Examples of nutrition-related conditions that are autosomal dominant disorders include Albright hereditary osteodystrophy and familial hypercholesterolemia. One nutrition-related X-linked dominant disorder is fragile X syndrome. Diabetes insipidus and adrenoleukodystrophy are examples of X-linked recessive disorders with nutritional implications. REF: p. 75

Phenylketonuria is what type of genetic disorder? a. Autosomal dominant b. Autosomal recessive c. X-linked dominant d. X-linked recessive

a. renal excretion (Gropper Chap 11, pg 442)

Phosphate balance is achieved largely by _____. a. renal excretion b. fecal excretion c. control of absorption by vitamin D d.control of absorption by phytates

b. an endothermic reaction Gropper CH 1

Phosphorylation of ADP is an example of _____. a. an exothermic reaction b. an endothermic reaction c. an energy-releasing reaction d.a downhill reaction

b. Whole grains (Beerman, 12)

Phytates, which bind calcium in the intestine, are commonly found in raw beans, nuts, and which of the following? a. Cocoa b. Whole grains c. Tea d. Spinach

b. non-nutrient plant compounds that are biologically active. (Gropper CH 4, p. 129)

Phytochemicals are a. new vitamins being found in plants. b. non-nutrient plant compounds that are biologically active. c. mineral compounds derived from plants. d.another name for herbal medicines.

c. human papillomavirus. (Gould CH 8 pg 150)

Plantar warts are caused by: a. the fungus aspergillus. b. a parasitic arthropod. c. human papillomavirus. d. the bacterium Streptococcus pyogenes.

c. enter the intramicrovillus spaces to interact with the brush border (Gropper CH 5, pg 148)

Polymolecular aggregates called micelles are small enough to _____. a. enter the enterocytes b. stabilize circulating lipoproteins in the blood c. enter the intramicrovillus spaces to interact with the brush border d.confer specificity for recognition by receptors on cells

a. Jewish, Muslim, and Seventh Day Adventist (CH 11 Krause, pg 188) Pork is prohibited in the Jewish, Muslim, and Seventh Day Adventist religions. It is avoided by most in the Buddhist and the Hindu religions.

Pork is prohibited in which of the following religions? a. Jewish, Muslim, and Seventh Day Adventist b. Catholic, Muslim, and Buddhist c. Mormon, Jewish, and Muslim d. Mormon, Hindu, and Seventh Day Adventist

d. they can create a bond with the caretaker. (CH 13 Krause, pg 214) Generally homemade (real food) tube feedings are chosen because they offer the benefit of whole foods and can create a bond with the caretakers who are often the family. They can be less expensive if there is no reimbursement available. Only commercially prepared products are paid for through insurance and Medicare. They should not be used in immunocompromised patients and must be used with a large bore feeding tube to prevent clogging.

Possible advantages of using homemade tube feedings include a. they are better reimbursed by insurance. b. they may help an immunocompromised patient. c. they can be used with any French size feeding tube. d. they can create a bond with the caretaker.

b. asparagus. (Gropper CH 4, pg. 134)

Prebiotics are naturally abundant in: a. cow's milk yogurt. b. asparagus. c. mayonnaise dressings. d.oatmeal.

c. hearing loss. (CH 20 Krause, pg 370) Presbycusis is the most common type of hearing loss. It is usually greater in the high-pitched tonal range. Dysphagia is the inability to swallow. Dysgeusia is the loss of sense of taste or an altered sense of taste.

Presbycusis is a. inability to swallow. b. loss of sense of taste. c. hearing loss. d. lack of dentition.

a. canned green beans (Gropper CH 4, pg. 114)

Processed foods that may have cellulose purified from wood added to them include all of the following EXCEPT _____. a. canned green beans b. cake mixes c. sandwich spreads d. fruit juice mixes

a. attract blood monocytes into the intima. (Gropper CH 5, p. 181)

Proinflammatory cytokines such as tumor necrosis factor are atherogenic because they a. attract blood monocytes into the intima. b. oxidize membrane fatty acids. c. absorb cholesterol readily to become foam cells. d. delay clotting of platelets, which narrows the lumen, restricting blood flow.

c. secretin (Beerman CH 5, pp. 177-178)

Protein digestion involves the hormones gastrin, CCK, and _____. a. HCl b. pepsinogen c. secretin d. trypsin

c. walnuts and seeds (Beerman CH 6, p. 227)

Relatively high amounts of linoleic acid are found in soybean, safflower, and corn oils and _____. a. milk and dairy products b. leafy green vegetables c. walnuts and seeds d.squash and pumpkins

a. affirming. (CH 14 Krause, pg 231) Techniques used for addressing resistance to change include reflecting, double-sided reflection, shifting focus, agreeing with a twist, emphasizing personal choice, and reframing. Affirming is a technique used when counseling clients not ready to change. Affirmation involves acknowledgment that the counselor understands what the client is doing or thinking is normal.

Resistance to change can be overcome by all the following techniques EXCEPT a. affirming. b. double-sided reflection. c. agreeing with a twist. d. reflecting.

a. bicarbonate (Gropper CH 12, pg 472)

Restoration of normal pH is accomplished by the ratio of bicarbonate to carbonic acid. Which buffer is controlled by the kidneys? a. bicarbonate b.carbonic acid

b. HDL (Gropper CH 5, pg 159)

Reverse cholesterol transport that removes cholesterol from peripheral cells and returns it to the liver is carried out by _____. a. LDL b. HDL c. VLDL d.lipoprotein lipase

d.flavoproteins (Gropper Chap 9, pg 327)

Riboflavin coenzymes remain bound to their enzymes during the oxidation-reduction reactions and the complexes are called _____. a. apoenzymes b. flavokinases c. bound enzymes d.flavoproteins

d.being of Middle Eastern or Indian descent. (Beerman CH 4, p. 157)

Risk factors associated with the temporary form of diabetes that occurs in pregnancy include all of the following except: a. previous history of delivering a very large baby. b. weight gain between pregnancies. c. maternal age of over 35 years. d.being of Middle Eastern or Indian descent.

it is an active transporter of sodium and glucose. (CH 1, Krause) pg 12 The SGLT-1 is an active transporter of sodium and glucose and is key to the small intestine's ability to absorb 7 L of fluid a day. In addition to transporting sodium and glucose, SGLT-1 functions as a molecular water pump. For each molecule of glucose absorbed by SGLT-1, 2 molecules of sodium and 210 molecules of water are also absorbed.

SGLT-1 is key to the small intestine's ability to absorb water because a. it is an active transporter of sodium and glucose. b. it blocks the transport of sodium. c. it stimulates the body's thirst mechanism. d. it changes the pH of the small intestine.

b. at 24 to 28 weeks' gestation. (CH 30 Krause, p. 589) The need for insulin increases during the second and third trimesters of pregnancy because these are the periods during which much of the growth of tissue in both the mother and fetus occurs. Screening for GDM occurs between 24 and 28 weeks' gestation to monitor the maternal insulin response. Toward the end of pregnancy, 38 to 40 weeks, insulin needs and levels peak at two to three times the prepregnancy levels.

Screening for gestational diabetes should occur a. when assessment of pregnancy is first established. b. at 24 to 28 weeks' gestation. c. 38 to 40 weeks after conception. d. by the end of the first trimester.

Key: Grading rubric - answer should include the following items: -- Solubility/insolubility in water. Pectins, gums, beta-glucans, fructans, psyllium, some resistant starches, and some hemicelluloses are soluble. Cellulose, lignin, some heicelluloses and pectins, some resistant starches, chitosan, and chitin are insoluble. In general, soluble fibers delay gastric emptying and slow down transit time through the GI tract and slow glucose entry into the blood. Insoluble fibers increase fecal bulk and speed up transit time, which may expose the colon to fewer toxins. --Water-holding/hydration capacity and viscosity. Soluble fibers have greater water-holding capacity, which traps nutrients and slows absorption, than insoluble fibers. Characteristics other than solubility that affect water-holding capacity are pH of the GI tract and particle size of the fiber (coarsely ground has more holding capacity). The more coarsely ground whole grains hold more water, slow gastric emptying, and reduce enzyme functions by separating enzymes from substrates. --Adsorption or binding ability. Lignin, gums, pectins, beta-glucans, and a few other fibers attach to substances such as enzymes and nutrients and keep them from being absorbed. This is important for increasing fecal bile acid excretion, which helps lower blood cholesterol. This characteristic can also negatively affect the ability of some minerals and phytochemicals such as carotenes to be absorbed into the enterocytes and eventually into the blood for use. --Degradability/fermentability. Fiber always reaches the colon undigested because it cannot be digested by human enzymes. Gut bacteria can digest (i.e., ferment) some fibers. This helps gut bacteria grow and prebiotic fibers in particular support the growth of nonpathogenic, acid-producing bacteria that improve gut health. Some products of fermentation of fibers are the short-chain fatty acids that can improve health of colon cells and may inhibit synthesis of cholesterol to lower blood cholesterol levels. Short-chain fatty acids may also enhance gut immune function. Poorly-fermentable fibers such as cellulose and lignin increase fecal bulk and speed transit time to promote more frequent defecation and quicker removal of toxins that might harm colon cells. (Gropper CH 4, pg. 117-123)

Short Answer (with suggested answer key) Page(s) Discuss the four significant characteristics of dietary fiber that affect its physiological and metabolic roles.

c. sodium (Gropper CH 12, pg 465)

Significant loss of what mineral occurs when one exercises vigorously while the temperature is high? a. sulphur b. phosphorus c. sodium d.potassium

d.According to etiology (Beemer CH 4, p 148)

Since 1997, how has the American Diabetes Association classified the different types of diabetes? a. According to age at onset b. According to the severity of the disease c. According to the type of treatment required d.According to etiology

a. 10 g. (Gropper CH 12, pg 462)

Since the standard atomic weight of sodium is 22.99, the salt intake of an individual whose dietary sodium intake is 174 mmoles per day is: a. 10 g. b. 6000 mg. c.3 g.

d. general education on diet and exercise. (CH 18 Krause, pg 334) Overweight adolescents start out at Stage 1 and need only general information without a lot of restrictions. Stage 2 adds the component of food monitoring. A very structured meal plan and multidisciplinary medical team is indicated in the severely overweight at Stage 4. Vegan diets can be dangerous because of their very restrictive nature.

Stage 1 of obesity in adolescence should be treated with: a. structured meal plans and a multidisciplinary health team. b. a diet and recording of food intake and activity. c. a vegan diet and exercise. d. general education on diet and exercise.

Key: Grading rubric - answer should include the following items: Boiling a potato makes it very digestible when consumed hot and so glucose from the starch in the potato enters the blood stream quickly in larger quantities per minute, producing a high glycemic index. When the potato is cooled, the starch coalesces into a structure and is called retrograde starch, which is a type of resistant starch. This makes it difficult to digest, and thus less glucose enters the bloodstream per minute and the glycemic index is lower. (Gropper CH 4, pp. 116 & 77).

Suggest a hypothesis as to why boiled red potato while hot has a glycemic index of 89 and the same cooked potato when cold has a lower glycemic index of 56.

b. His blood concentration of insulin exceeds that of glucagon. (Beerman CH 4, pgs. 136,137)

Sunil finished his evening meal of curried chicken, rice, fruit, salad, cookies, and tea about 30 minutes ago. Which of the following best describes what is happening? a. His blood concentration of glucagon exceeds that of insulin. b. His blood concentration of insulin exceeds that of glucagon. c. His blood contains glucagon but no insulin. d. His blood contains insulin but no glucagon.

a. Saturated (Beerman CH 6, p. 221)

Susan is studying to be a chef and is making "compound butter"—butter that has been softened, mixed with a seasoning to make it more flavorful, chilled, and then served in a number of ways. What type of fat would compound butter be classified as? a. Saturated b. Unsaturated c. Monounsaturated d. Polyunsaturated e. a and c f.b and d

b. pantothenic acid (Gropper Chap 9, pg 336)

Synthesis of coenzyme A starts with the phosphorylation of which vitamin? a. pyridoxal phosphate b. pantothenic acid c. vitamin E d.folic acid

b. toxic shock and disorientation. (Gould CH 8, pg 149) Reminder: - Necrotizing fasciitis is a Flesh-eating bacteria. It is a rare infection of the skin and tissues below it.

Systemic effects of acute necrotizing fasciitis include: a. low-grade fever and malaise. b. toxic shock and disorientation. c. mild nausea and vomiting. d. headache and difficulty breathing.

True (Beerman CH 5, p. 213)

T or F: Milk and milk products from cows are not believed to pose any risk for transmitting BSE to consumers.

False-It generates NADPH for reducing power.

T or F: The purpose of the pentose phosphate pathway is to generate ribose, for nucleic acid synthesis, and NAD, for oxidizing power.

True (Beerman CH 5, p. 208)

T or F: You can reduce your exposure to BPA by using glass containers rather than polycarbonate ones, not putting plastics in the microwave, and washing plastic containers by hand instead of in the dishwasher.

d. all of the above. (CH 20 Krause, pg 377) The 2010 health care reform legislation changed Medicare to include an annual wellness visit and a personalized prevention assessment. Prevention services include referrals to education and preventive counseling or community-based interventions to address risk factors. It also expands medical nutrition therapy reimbursement for registered dietitians to cover therapy considered reasonable and necessary for the prevention of illness and disability.

The 2010 health care reform legislation expands Medicare to include a. an annual wellness visit. b. education and counseling. c. expanded coverage for reimbursement for dietitians. d. all of the above.

c. spices (Beerman CH 5, p. 210)

The FDA has approved the irradiation of meat, poultry, shellfish, eggs, fresh fruits, vegetables, and _____. a. cheese b. milk c. spices d. breakfast cereals

d. IBS patients (CH 28 Krause, p 541) Studies have shown that patients with IBS may not be able to tolerate a specific type of carbohydrate. Foods that contain highly fermentable carbohydrates in the presence of gut bacteria can exacerbate IBS symptoms. There is emerging research that a diet low in FODMAPs (Fermentable Oligo-, Di-, and Monosaccharides and Polyols) is an effective treatment.

The FODMAPs diet is showing success for which group of patients? a. Patients with diverticulosis b. Celiac disease patients c. Crohn disease patients d. IBS patients

d. all of the above. (CH 11 Krause, pg 182) The Healthy Food in Health Care Pledge was started by the Health Care Without Harm organization to encourage health care food service departments to change their practices. It includes eight areas of commitment. It encourages local sourcing of food, using products without harmful chemicals, and preventing food waste whenever possible. Other areas of focus include sustainable foods, patient education, and community engagement.

The Healthy Food in Health Care Pledge a. encourages vendors to supply foods without harmful chemicals and antibiotics. b. encourages hospital food service to minimize food waste and support the use of food packaging that is ecologically protective. c. promotes locally sourced foods when possible. d. all of the above.

24 hours of admission. (CH 10 Krause, pg 163) Although The Joint Commission does not specify how patients should be identified for nutrition risk, all patients need to be screened for nutrition risk within 24 hours of admission, regardless of whether the patient is admitted during the week or on the weekend. Many hospitals accommodate this by including questions regarding nutrition risk in the initial nursing assessment performed on the patient. If the patient meets the hospital's nutrition risk criteria, this is communicated to the clinical nutrition staff so that further nutrition assessment can be performed.

The Joint Commission requires the identification of nutrition risk of hospital patients to occur within a. 12 hours of admission. b. 24 hours of admission. c. 48 hours of admission. d. 24 hours of admission, except on the weekend.

ANS: C The MNA short form is a rapid and reliable screening tool for ambulatory and subacute elderly populations. MUST is used for medical and surgical populations. pg 56

The MNA short form has been validated for use in what population? a. Critically ill elderly b. Surgical populations c. Subacute and ambulatory elderly d. Children

c. Body mass index, weight loss, acute disease effect on intake (ch 4, Krause) The MUST screening tool determines a level of risk for patients based on the body mass index (BMI), recent unintentional weight loss, and an expectation of the disease affecting intake for 5 days or greater. Based on these factors, points are assigned to identify whether a patient is at low, medium, or high risk. The risk level indicates what type of care interventions are used with the patient. The Nutrition Screening Initiative uses BMI, eating habits, and functional status as part of its Level I screen. BMI, blood values for albumin and cholesterol, and identification of clinical signs of nutrient deficiency are included in the NSI's Level II screen. REF: p. 55

The Malnutrition Universal Screening Tool (MUST) relies on what factors for the determination of nutritional risk in adults? a. Body mass index, eating habits, functional status b. Body mass index, blood albumin and cholesterol levels, clinical signs c. Body mass index, weight loss, acute disease effect on intake d. Body mass index, medical diagnosis, blood albumin level

c. is reform legislation aimed at improving skilled nursing care. (CH 20 Krause, pg 378-379) In 1987, Congress passed OBRA to improve quality of care in skilled nursing facilities by strengthening standards. It does not apply to assisted living facilities or congregate meal sites. Although the legislation requires that nutritional assessments be done periodically, it does not directly pay for dietitian services.

The Omnibus Reconciliation Act (OBRA) a. is aimed at assisted living facilities. b. pays for dietitian consults for those older than 65 years of age. c. is reform legislation aimed at improving skilled nursing care. d. is reform legislation aimed at congregate meal sites.

c. 1300 mg; 3000 mg (CH 18 Krause, pg 336) Calcium intake is likely to be low in adolescents. The RDA for all adolescents is 1300 mg with an upper limit of 3000 mg. Calcium intake declines with age in adolescents, especially in females. Research suggests that the high soft drink consumption at this age contributes to decreased calcium intake by displacing milk intake.

The RDA for calcium for all adolescents is _________ with an upper level intake of _______. a. 800 mg; 1000 mg b. 3000 mg; 5000 mg c. 1300 mg; 3000 mg d. There is no RDA for calcium for adolescents

c. 90 mg, 2000 mg (Gropper Chap 9, pg 317, 318)

The RDA for vitamin C for adult men is _____ and the UL is _____. a. 75 mg, 500 mg b. 100 mg, 500 mg c. 90 mg, 2000 mg d.200 mg, 2000 mg

b. chill. (Beerman CH 5, pp. 211, 212)

The USDA and the Partnership for Food Safety Education's set of food safety guidelines emphasizes four main guidelines: clean, separate, cook, and a. store. b. chill. c. keep hot. d. disinfect.

d. 2.5 (CH 24 Kruase, p 461) Compared with the mean BMD of 20- to 29-year-old adults, the World Health Organization defines osteoporosis as a BMD greater than 2.5 standard deviations below the standard.

The WHO's definition of osteoporosis is a BMD greater than _____ standard deviations below the mean for healthy 20- to 29-year-old adults. a. 1 b. 1.5 c. 2 d. 2.5

Answer: Hawthorne effect (p. 17) CH 1 Beerman

The __________ is the phenomenon in which study results are influenced by an unexpected alteration of a behavior by the study participants.

ANS: C The neurologic system appears to be more vulnerable to toxic exposures because 90% of toxins are lipophilic or fat-loving and the central nervous system has a lot of fat-containing tissue. REF: p. 45 CH 3 Krause

The ___________system is more vulnerable to toxic exposures. a. cardiovascular b. gastrointestinal c. neurologic d. reproductive

b. in the liver. (Gropper Chap 10, pg 411)

The action of vitamin K is the post-translational synthesis of blood clotting factors occurs: a. in the blood. b. in the liver. c. in the small intestine. d.in the bone marrow.

B. 489 (Gropper CH 13)

The binding of iron by proteins defends the cells against a. iron deposition in kidneys and other organs. b. oxidative damage from free radicals. c. tissue hypoxia. d. stellate cells.

b. calmodulin. (Gropper Chap 11, pg 433)

The binding protein that regulates many of the calcium-dependent enzymes is: a. calcitonin. b. calmodulin. c. albumin. d.globulin.

d. ketones (Beerman CH 6, p. 230)

The body produces _____ from fatty acids when its supply of glucose is limited. a. glucose b. glycogen c. triglycerides d. ketones

d. liver, skeletal muscles (Beerman CH 4, pg. 124)

The body stores glycogen primarily in the _____ and _____. a. brain, skeletal muscles b. liver, central nervous system c. muscles, central nervous system d. liver, skeletal muscles

b. Carboxylation reactions (Beerman chapter 10, pg 438)

The body uses biotin to make enzymes that catalyze which of the following chemical reactions? a. Oxidation reactions b. Carboxylation reactions c. Reductions reactions d.Coupled reactions

c. limitless, irreversible (Beerman CH 4, pg 139)

The body's ability to store excess energy from glucose as fatty acids is _____ and _____. a. limitless, reversible b. limited, irreversible c. limitless, irreversible d.limited, reversible

b. duodenum (Beerman CH 5, p. 178)

The bulk of the absorption of amino acids occurs in the _____. a. stomach b. duodenum c. ileum d. jejunum

folate (Ch 8 Krause pg 129) Methotrexate binds with the enzyme dihydrofolate reductase, inhibiting its activity of converting folate to its active form. This could lead to the development of megaloblastic anemia. To prevent this from happening, leucovorin, or folinic acid, is administered with methotrexate and other folate antagonists

The cancer chemotherapeutic agent methotrexate acts as an antagonist to a. thiamin. b. vitamin B12. c. folate. d. vitamin B6.

a. outwardly, away from the cytoplasmic matrix Gropper CH 1

The carbohydrate moieties of the plasma membrane glycoproteins and glycolipids are oriented _____. a. outwardly, away from the cytoplasmic matrix b. inwardly, toward the lumen c. equally inwardly and outwardly to maintain symmetry d. between the bilayers of the membranes

c. 5.5 (CH 25 Kruase, p. 470) When oral pH falls below 5.5, oral bacteria can begin the demineralization process that leads to tooth decay.

The caries process begins when the pH drops below what level? a. 7 b. 6.5 c. 5.5 d. 5

Key: carnitine, mitochondrial (Gropper CH 5, pg 164)

The carrier molecule required for the transport of long-chain fatty acids for fat oxidation is _____, which is located in the _____ membrane.

ANS: C Because spina bifida can result in weakness in the lower extremities, paralysis, and nonambulation, the decrease in physical activity associated with these may place the affected child at risk for developing obesity. Therefore, to maintain weight, children with spina bifida should receive only 9 to 11 kcal/cm height compared with healthy children who should consume 16 kcal/cm. Children with mild cerebral palsy also have some limitations in regard to their mobility; however, in most cases, involuntary movements or muscle tension contribute to energy needs. Children with mild CP should receive about 14 kcal/cm to prevent potential weight loss. Children with Down syndrome run the risk of developing obesity; however, because they tend to be of shorter stature than healthy children, their energy needs are comparable to maintain weight: 14.3 kcal/cm for girls and 16.1 kcal/cm for boys. REF: p. 910 (Krause CH 44)

The child that would have the lowest energy needs is a a. healthy child. b. child with mild cerebral palsy. c. child with spina bifida. d. child with Down syndrome.

ANS: B Tandem mass spectrometry was developed in the 1990s and can screen for 30 or more disorders that affect newborns. Microarray technology is used to measure gene expression, which is useful in nutrigenomics but is too costly to use as a widespread screening methodology. The Guthrie bacterial inhibition assay was developed in the 1960s and became the basis for newborn screening. ELISA is used in immunologic testing. REF: p. 890 (Krause CH 43)

The current preferred method for screening for inborn errors of metabolism is a. microarray technology. b. tandem mass spectrometry. c. Guthrie bacterial inhibition assay. d. enzyme-linked immunosorbent assay.

b. Lanugo (Beerman CH 6, p. 231)

The development of which of the following is an indication that someone lacks sufficient subcutaneous adipose tissue? a. Wrinkled skin b. Lanugo c. Muscle weakness d. Lipiditis

a. amount of carbohydrate in a typical serving (Beerman CH 4, pg 134)

The difference between glycemic index and glycemic load is that glycemic load accounts for the _____. a. amount of carbohydrate in a typical serving b. body weight of the individual c. type of carbohydrate consumed d.timing of the consumption of carbohydrates

ANS: A Because parenteral nutrition bypasses the gastrointestinal tract, no loss of energy occurs because of energy cost of digestion and absorption and the inefficiency of absorption. As a result, infants receiving parenteral nutrition require less energy intake than those being fed enterally. Enterally fed premature infants need 105 to 130 kcal/kg, and parenterally fed premature infants need 90 to 100 kcal/kg. REF:p. 872 (Krause 42)

The energy needs of a premature infant fed parenterally differ from those of a premature infant fed enterally because parenterally fed infants a. require less energy per kilogram of body weight. b. require an equal amount of energy per kilogram of body weight. c. require more energy per kilogram of body weight. d. have very erratic energy requirements.

Answer: limiting amino acid (Beerman CH 5, p. 165)

The essential amino acid present in the lowest concentration in an incomplete protein source is that food's _______________.

C. p. 294 (Gropper CH 8)

The estimated energy requirements equations developed by the Food and Nutrition Board were based on a. data from indirect calorimetry. b. body surface area. c. data from total daily energy expenditure measured by the doubly labeled water method. d.body weight raised to the power of three-fourths.

d.soluble fiber (Beerman CH 4, pg. 126)

The fiber in oats, rice, bran, psyllium seeds, soy, and some fruits consists mostly of _____. a. insoluble fiber b. lignin c. endosperm d.soluble fiber

a. Thrombophlebitis (CH 13 Krause, pg 222) Thrombophlebitis is a complication of peripheral PN. Sinusitis, vocal cord paralysis, and pulmonary injury can all be complications of nasoenteric feeding tubes.

The following is NOT a potential complication of nasoenteric feeding tubes. a. Thrombophlebitis b. Sinusitis c. Vocal cord paralysis d. Pulmonary injury

a. positive and negative charges (Beerman CH 5, p. 170)

The formation of a protein's secondary and tertiary structures is due to the attraction and repulsion of _____. a. positive and negative charges b. nuclei c. cell membranes d. mRNA molecules

c. 50:50 Ch 3 Gropper page 107

The fructose : glucose ratio of high-fructose corn syrup is approximately _____. a. 100:1 b. 80:20 c. 50:50 d. 25:75

c. gastrointestinal (CH 13 Krause, pg 209) Enteral nutrition stimulates the gastrointestinal system and its immunity to maintain the integrity of the mucosal lining. This has been substantiated in numerous animal models but not always in animal models. Indirect evidence has suggested that enteral nutrition preserves mucosal integrity during critical illness in humans. However, in regard to possible bacterial translocation and the development of sepsis, these outcomes have been seen in patients with a very short bowel receiving parenteral nutrition.

The functions of the _____ system are better maintained with enteral feedings than with parenteral feedings. a. cardiovascular b. renal c. gastrointestinal d. pulmonary

d. all of the above. (CH 27 Krause, p. 513) The gastrointestinal effects of smoking include the reduction of lower esophageal and pyloric sphincter pressure, increased reflux, inhibition of pancreatic bicarbonate secretion, accelerated gastric emptying of liquids, and lower duodenal pH.

The gastrointestinal effects of smoking include a. reduction of LES pressure. b. lower duodenal pH. c. inhibition of pancreatic bicarbonate secretion. d. all of the above.

constipation. (Ch 8 Krause, pg 132) Narcotic medications affect peristalsis in the gastrointestinal tract, causing constipation to occur. Antineoplastic drugs commonly promote changes in taste. Nonsteroidal antiinflammatory drugs promote gastrointestinal irritation that results in bleeding. A wide variety of medications, including antiinfective agents and antineoplastic drugs, cause anorexia as a side effect.

The gastrointestinal side effect commonly seen when narcotic drugs such as codeine and morphine are administered is a. a change in taste. b. constipation. c. gastrointestinal bleeding. d. anorexia.

c. GLUT4. CH 3 Gropper page 75

The glucose transporter that is sensitive to insulin is a. GLUT1. b. GLUT2. c. GLUT4. d.SGLT1.

d. HACCP (Beerman CH 5, pp. 208,209)

The goal of _____ is to produce a product that is as pathogen free as possible and then to store it in a way that does not allow pathogenic growth. a. Fight Bac! b. the WHO c. the CDC d. HACCP

c. at 6 months of age. (CH 21 Krause, pg. 384) During normal growth, the greatest percentage of body fat (approximately 25%) is set at 6 months of age. At age 6 years in lean children, adiposity rebound occurs with an increase in body fat.

The greatest percentage of body fat is set a. at birth. b. at 6 years of age. c. at 6 months of age. d. before birth by genetics.

b. secretin Gropper CH 2 page 48, 57

The hormone whose major action is to alkalize intestinal contents by stimulating secretion of bicarbonate from the pancreas and by inhibiting gastric acid secretion and gastric emptying is _____. a. gastrin b. secretin c. cholecystokinin d.GRP

a. ω-3 and ω-6 (Beerman CH 6, p. 225)

The human body cannot create double bonds in fatty acids in the _____ positions. a. ω-3 and ω-6 b. ω-3 and ω-7 c. ω-6 and ω-9 d. ω-7 and ω-9

a. Sucrose, glucose, and fructose (CH 25 Krause, p. 470) Sucrose, glucose, and fructose are fermentable by oral bacteria that promote tooth decay. Some nonnutritive sweeteners, such as aspartame and saccharine, are cariostatic. Others, such as xylitol and other sugar alcohols, are anticariogenic.

The ingestion of which of the following is most likely to promote bacterial activity that promotes dental caries? a. Sucrose, glucose, and fructose b. Xylitol, mannitol, and lactose c. Aspartame, saccharin, and cyclamate d. Xylitol, saccharin, and galactose

c. apolipoprotein B-100 (Gropper CH 5, pg. 157)

The key to the cell's internalization of LDL is the interaction between the receptors and _____. a. cholesterol acyltransferase b. HMG-CoA reductase c. apolipoprotein B-100 d.apolipoprotein C-100

d. heart disease. (CH 19 Krause, pg 357) In the United States, the leading causes of death and debilitation among adults are (1) heart disease, (2) cancer, (3) cerebrovascular accident, (4) chronic lower respiratory disease, and (5) accidents.

The leading cause of death and debilitation among adults in the United States is a. accidents. b. cancer. c. diabetes. d. heart disease.

a. Vitamin B12 (Beerman chapter 10, pg 443)

The liver typically contains several years' worth of stores of which water-soluble vitamin? a. Vitamin B12 b. Pantothenic acid c. Folate d.Thiamin

b. growth; fatty acids (Gropper CH 4, pg. 134)

The main benefits of prebiotics relate to their capacity to promote the _____ of bacteria and production of _____. a. growth; amino acids b. growth; fatty acids c. death; amino acids d.death; fatty acids

Answer (key points): The English alphabet has 26 letters from which an astonishing variety of words can be made. Some words are short, some are long. Some words contain just a few different letters, others contain many different letters. The same holds true for proteins made from the 20 amino acids found in the human body; some are short, some are long, and some contain a handful of different amino acids, whereas others may contain all 20 amino acids. (Beerman CH 5, pp. 169)

The making of protein from 20 amino acids was compared in the chapter to the use of the English alphabet (26 letters) to make words and speak the English language. Why was this such a fitting analogy?

c. 800 to 900 (CH 13 Krause, pg 218) Because the cephalic and brachial veins are common sites used for peripheral parenteral nutrition, highly concentrated parenteral solutions with more than 800 to 900 mOsm/kg are not tolerated. The provision of fat is possible because it is isotonic, but protein and carbohydrate may have to be limited. Also, the addition of electrolytes, multivitamins, and trace elements increase osmolality, making it difficult to provide complete nutrition in a limited volume.

The maximum osmolality of parenteral solution that the cephalic or brachial vein may tolerate for infusion is _____ mOsm/kg. a. 300 to 500 b. 500 to 800 c. 800 to 900 d. 900 to 1200

ANS: B Preterm infants have a basal metabolic rate of 50 kcal/kg/day. Because premature newborns have little to no fat or carbohydrate energy reserves, without additional energy provision, catabolism of the newborn's protein stores will occur to provide energy. This will limit the survival time of the newborn. A provision of 30 kcal/kg/day with adequate protein is recommended to promote nitrogen balance in VLBW infants during the first 3 days postpartum. If fed enterally, a premature infant may grow by consuming at least 105 kcal/kg/day, but a parenterally fed premature infant will experience growth by receiving at least 90 kcal/kg/day. REF:p. 870 (krause Ch 42)

The metabolic rate of the premature newborn is _____ kcal/kg/day. a. 30 b. 50 c. 90 d. 105

ANS: A Urea cycle disorders are named as such because the lack of particular enzymes in the cycle impairs the production of urea. Urea production is the means for eliminating ammonia left from amino acid metabolism. If ammonia cannot be packaged into urea, ammonia levels increase in the blood and can cause neurologic damage, seizures, coma, and death. Ketoacid residues from amino acid metabolism may be reused for production of other amino acids or for substrate in energy metabolism. Ketone production occurs when regular fatty acid metabolism is limited from continuing into the Krebs cycle. REF: p. 902 (Krause CH 43)

The metabolic result that occurs in all of the urea cycle disorders is an accumulation of _____ in the blood. a. ammonia b. purines c. ketones d. ketoacid

c. Glucose intolerance, hyperlipidemia, and hypertension (CH 21 Krause, Pg 388) The metabolic syndrome emphasizes central body adiposity that is strongly related to cardiovascular disease, hypertension, and type 2 diabetes mellitus. In the assessment of the metabolic syndrome, a patient demonstrates three of the following five factors: large waist circumference, elevated serum triglycerides, depressed HDL, elevated blood pressure, and high blood pressure.

The metabolic syndrome is associated with which of the following groups of disorders? a. Glucose intolerance, gout, and hypertension b. Gout, hypertension, and hyperlipidemia c. Glucose intolerance, hyperlipidemia, and hypertension d. Hypoglycemia, hyperlipidemia, and hypertension

ANS: D Intellectual disability is the most common developmental disability, and it is associated with significantly below average intelligence. Mental retardation can be associated with other developmental disabilities, including autism and Down syndrome. Cerebral palsy is a disorder of motor control or coordination resulting from injury to the brain during its early development. REF: p. 909 (krause CH 44)

The most common developmental disability is a. autism. b. cerebral palsy. c. Down syndrome. d. intellectual disability.

d. general multivitamin-mineral supplement (CH 12 Krause, pg 195) General multivitamin-mineral supplements are used by 36% of women and 31% of men in the United States. Vitamin E and vitamin C supplements are each used by about 12% of the population, and calcium supplements are used by about 10% of the population. Calcium-based antacids are used by almost 25% of the population.

The most commonly used dietary supplement in the United States is a _____ supplement. a. calcium b. vitamin C c. vitamin E d. general multivitamin-mineral supplement

a. to position the patient at a 45-degree angle for feeding. (CH 13 Krause, pg 217) The role of enteral feeding in the development of aspiration is controversial. Many experts believe that the primary source of aspiration into the airway is saliva and throat contents, not formula. Aspiration can usually be prevented by positioning the patient with the head and shoulders above the chest whenever feeding occurs.

The most important technique for prevention of aspiration in an enterally fed patient is a. to position the patient at a 45-degree angle for feeding. b. to use a calorically dense enteral formula. c. to use a large bore feeding tube. d. to administer feedings at a slow rate.

a. the counseling relationship. (CH 14 Krause, pg 230) The counseling relationship needs to be developed during the first counseling session. The environment and the way the counselor communicates, both physically and verbally, can help establish rapport and trust on the part of the client. Without this, the client may not feel the necessity to continue with counseling.

The most important thing to establish in the first counseling session is a. the counseling relationship. b. likes and dislikes in the counseling environment. c. fees for service. d. reimbursement potential by insurance providers.

ANS: D Advanced age is the most proven risk factor for Alzheimer disease. Folic acid deficiency and insulin resistance have been identified as possible risk factors. Protein-energy malnutrition is a result of the disease rather than a cause. REF: p. 853 (Krause CH 41)

The most proven risk factor for Alzheimer disease is a. protein-energy malnutrition. b. folic acid deficiency. c. insulin resistance. d. advanced age.

d.exothermic Gropper CH 1

The net energy transformation when nutrients are systematically oxidized to carbon dioxide and water is _____. a. reversible b. catalytic c. endothermic d.exothermic

c. R protein and intrinsic factor, ileum (Gropper Chap 9, pg 355)

The normal digestion and absorption of cobalamin requires adequate protein digestion in the stomach; the presence of 2 nonenzymatic proteins: _____; and a receptor located in the _____. a. R binders and hydrochloric acid, colon b. pepsin and hydrochloric acid, ileum c. R protein and intrinsic factor, ileum d.R protein and intrinsic factor, duodenum

5 to 10 g protein and 500 to 600 kcal. (CH 10 Krause, pg 170) The clear liquid diet consists of foods such as tea, broth, carbonated beverages, clear juices without pulp, and gelatin. As a result, this diet is very nutritionally incomplete and usually only provides 500 to 600 kcal and 5 to 10 g protein. Ideally, a patient should be transitioned to a more nutritionally complete diet as soon as the patient can tolerate more solid foods.

The nutritional value of the average clear liquid diet is a. no protein and 500 to 700 kcal. b. 5 to 10 g protein and 500 to 600 kcal. c. 20 to 30 g protein and 100 to 1200 kcal. d. 40 to 50 g protein and 500 to 700 kcal.

b. 0.7 to 1.2 (CH 25 Kruase, p. 472) Standards for fluoridation of a water supply provide between 0.7 and 1.2 ppm. At this level, the incidence of caries development is reduced, and there is low likelihood of teeth staining or mottling occurring. Infants and children should receive fluoride supplementation if the water supply provides 0.6 ppm of fluoride or less.

The optimal level of water fluoridation to protect against dental caries is _____ ppm. a. 0.1 to 0.6 b. 0.7 to 1.2 c. 1.2 to 1.4 d. 1.4 to 2.0

d. 250 (CH 13 Krause, pg 218) The grams of dextrose in 1 L or 1000 ml of 5% dextrose are equal to 1000 ml ⋅ 5% = 50 g. For the osmolarity of a dextrose solution, multiply the grams of dextrose per liter by 5 (50 g ⋅ 5 = 250 mOsm/L).

The osmolarity of a 1-L bottle of 5% dextrose solution is _____ mOsm/L. a. 50 b. 500 c. 200 d. 250

c. collagen deposits in the small blood vessels of the skin and sometimes the viscera. (Gould CH 8, pg. 147)

The pathological change associated with scleroderma is: a. abnormal activation of T lymphocytes and an increase of cytokines. b. an autoimmune reaction damaging the epidermis. c. collagen deposits in the small blood vessels of the skin and sometimes the viscera. d. Type I hypersensitivity and increased serum IgE levels.

b. parenteral feeding initiated after 7 days NPO. (CH 13 Krause, pg 222) Although all patients who have received no nutrition for an extended period of time are at risk of developing refeeding syndrome, those who have been replenished by parenteral nutrition are at particular risk because of the direct infusion of carbohydrate, electrolytes, and fluids into the blood system. Digestion and absorption mediate the development of refeeding syndrome. With parenteral nutrition, electrolyte and fluid balances should be monitored to prevent potential imbalances and complications.

The patient most likely to experience refeeding syndrome is a patient who has a. enteral feeding initiated after 7 days NPO. b. parenteral feeding initiated after 7 days NPO. c. enteral feeding after 24 hours NPO. d. parenteral feeding after 24 hours NPO.

c. condensation (Beerman CH 5, p. 163)

The peptide bonds that join amino acids together to form proteins are the result of a _____ reaction. a. hydrolysis b. catabolic c. condensation d. synthetic

c. glycogen, dietary fiber (Beerman CH 4, pg. 123)

The polysaccharides include starch, _____, and _____. a. sucrose, amylose b. glucose, glycogen c. glycogen, dietary fiber d. sucrose, dietary fiber

a. supplements (Gropper CH 4, pg 116)

The predominant source of dietary chitin is _____. a. supplements b. bran c. vegetables d.fruits

c. cholecystokinin (CCK) (Beerman CH 5, pp. 177, 178)

The presence of small polypeptides and amino acids in the small intestine causes specialized cells there to release the hormone _____. a. gastrin b. pepsin c. cholecystokinin d. trypsin

D. p. 294 (Gropper CH 8)

The present diet of the student in question #25 provides 2500 kcal per day. This diet: a. is meeting her kcal needs. b. needs to be increased by 300 kcal. c. would cause about 1 lb per week weight loss. d.would cause weight gain of about 0.5 lb per week.

B p. 531 (Gropper CH 13)

The primary physiological role of which mineral is as a constituent in the thyroid hormones? a. fluorine b. iodine c. selenium d.chromium

d.enterohepatic circulation (Gropper CH 5, pg. 149)

The process by which bile salts are absorbed in the ileum and return to the liver is called _____ of the bile salts. a. micelle induction b. resecretion c. conjugation d.enterohepatic circulation

ANS: A Nutrition screening is a quick means of identifying whether or not a person may be at risk for a nutritional problem. Usually, only a few well-selected parameters related to nutrition are evaluated to determine this risk. If screening does identify a potential risk, then a more complete nutrition assessment should be performed. The assessment will identify any specific nutrition problems the patient may have. Generally, screening is not used to classify degree of risk—either the patient is at nutritional risk or not. REF: p. 52 Ch 5 Krause

The purpose of nutritional screening is to a. identify patients at nutritional risk. b. determine a patient's nutritional problem. c. categorize patients as high or moderate risk. d. assess the patient's nutritional status.

c. have higher testing metabolic rate and lean body mass than women. (CH 21 Krause, pg. 392) Men lose weight faster than women of similar size because of their higher proportion of lean body mass and the resulting increase in resting metabolic rate. This results in higher calorie expenditure in men, leading to weight loss occurring more quickly. The amount of fat men and women have is affected by a variety of genetic and lifestyle factors, so men do not necessarily have less fat than women. The use and success of additional therapies beyond diet depend on individual choice and commitment to weight loss.

The rate of weight loss for men on energy-deficient diets is more rapid than for women because men a. generally have less fat to lose. b. are more successful at weight reduction programs. c. have higher testing metabolic rate and lean body mass than women. d. are more likely to exercise while trying to lose weight.

b. is 14 g/kcal. (CH 17 Krause, pg 327) Dietary Recommended Intakes (DRIs) for fiber in children is the same as that for adults—14 g/kcal. Surveys indicate that current intake in the United States is much lower than this recommendation.

The recommendation for fiber in preschool and school age children a. is 5 g/day. b. is 14 g/kcal. c. is 14 g/day. d. is not part of the DRIs.

c. 350; 460 (CH 15 Krause, pg 251) The DRIs for energy needs for pregnancy add 340 to 360 kcal/day during the second trimester and another 112 kcal/day during the third trimester. These increases accommodate not only the growth of both the mother and fetus during the pregnancy but also an increase in the mother's metabolic rate.

The recommended energy intake in the second and third trimesters is the sum of the energy requirement for a nonpregnant woman and a daily addition of about _____ kcal in the second and _____ kcal in the third trimesters, respectively. a. 100; 160 b. 250; 350 c. 350; 460 d. 400; 550

Carbohydrate (CH 2, Krause) pg 20-21 The RQ compares the carbon dioxide produced with the oxygen consumed when energy substrates are metabolized. The RQ for carbohydrate is 1. The RQs for protein, fat, and a mixed diet are, respectively, 0.82, 0.7, and 0.85.

The respiratory quotient (RQ) is highest after consumption of a diet that is primarily composed of what? a. Carbohydrate b. Protein c. Fat d. Mixed macronutrients

d. all of the above. (CH 19 Krause, pg 359) The adult years offer opportunities for prevention as well as intervention. It is critical for the dietetic professional to consider how to assess clients and group needs and be able to address the total picture of optimal health.

The role of nutrition and dietetic professionals in the adult years involves a. addressing the role of nutrition in the leading causes of death and debility. b. incorporating basic education on food access, selection, and preparation. c. setting mutually acceptable, achievable goals for optimal performance and health. d. all of the above.

HCl (CH 1, Krause) pg 5 Parasympathetic innervation that causes release of hydrochloric acid helps prepare the stomach for the potential of receiving food. After food chyme is passed into the small intestine from the stomach, secretin and cholecystokinin are secreted to stimulate pancreatic secretion of water and bicarbonate. They also signal gallbladder contractions and colonic motility, all resulting in reductions in stomach emptying and duodenal motility. Motilin is secreted from the duodenal mucosa during fasting to stimulate gastric emptying and intestinal motility.

The sight or smell of food produces vagal stimulation of the parietal cells of the gastric mucosa, resulting in the increased production of what? a. Motilin b. Hydrochloric acid c. Cholecystokinin d. Secretin

a-lipid synthesis Gropper CH 1

The smooth endoplasmic reticulum (SER) is associated with a. lipid synthesis. b. protein synthesis. c. the calcium ion pump necessary for the contractile process. d. ribosomes and cytochrome P450 enzymes.

b. nutrigenomics (Beerman CH 5, p. 175)

The study of how nutrition and genetics interact to influence health is called _____. a. epigenetics b. nutrigenomics c. nutrigenetics d.biogenetics

a. pellagra (Beerman chapter 10, pg 432)

The symptoms of _____ are often referred to as the four D's: dermatitis, dementia, diarrhea, and death. a. pellagra b. beriberi c. ariboflavinosis d.pernicious anemia

c. food intolerance (CH 26 Kruase, p. 487) Food intolerance does not involve an immunologic reaction. Food intolerances may include toxic, pharmacologic, metabolic, or idiosyncratic reactions. A food allergy involves an immune reaction. Food sensitivity is another term for referring to a food allergy.

The term that refers to an adverse reaction to food that is caused by a nonimmunologic mechanism is a. food allergy. b. allergic reaction. c. food intolerance. d. food sensitivity.

b. the ability of the immune system to ignore "self" cells. (Gould CH 7, pg 118)

The term tolerance refers to: a. surveillance and destruction of new cancer cells by the immune system. b. the ability of the immune system to ignore "self" cells. c. the ability of T and B lymphocytes to work together. d. the role of lymphoid tissue in the body defenses.

C. p. 289. (Gropper CH 8)

The thermic effect of food represents _____. a. the BMR minus the energy used in physical activity b. the decrease in food energy due to cooking c. the increase in energy expenditure associated with the body's processing of food d.the body's storage of food as fat for insulation

c. cell signaling, transcription, and translation. (Beerman CH 5, p. 167)

The three steps of protein synthesis, in the correct order from left to right, are: a. translation, transcription, and cell signaling. b. transcription, translation, and cell signaling. c. cell signaling, transcription, and translation. d. cell signaling, translation, and transcription.

d.90% Gropper CH 2 page 49

The total bile acid pool in the human body is 2.5 to 5 g. What percentage of bile is reabsorbed in the ileum? a. 10% b. 30% c. 65% d.90%

ANS: A For preterm infants the total lipid load is usually 25% to 40% according to the American Academy of Pediatrics. This can be given in amounts up to 3 g/kg/day. In preterm infants, the use of 20% lipid emulsions is preferred as this promotes lower plasma triglyceride, cholesterol, and phospholipid levels than does 10% emulsion. REF:p. 873 (Krause Ch 42)

The total of IV lipid in an LBW infant is generally a. 25% to 40% of nonprotein calories. b. 10 g/kg/day. c. 10% to 15% of nonprotein calories. d. 60% of nonprotein calories.

d. weight maintenance. (CH 22 Krause, pgs. 420-421) The actions pursued by the person with bulimia nervosa are aimed at weight loss; however, the immediate goals for treatment should focus on interrupting the binge-purge cycle, restoring normal eating behaviors, and stabilizing body weight. Exercise may be used later to help with weight loss, but this is secondary to helping the patient with bulimia nervosa understand and avoid patterns of binge eating and purging.

The treatment goal for a patient with bulimia nervosa who is mildly overweight should be a. weight loss to ideal weight. b. daily exercise to help decrease weight. c. a structured exercise routine to help decrease weight. d. weight maintenance.

a. is not currently recommended. (Gropper CH 4, pg. 135)

The use of prebiotics for blood glucose regulation: a. is not currently recommended. b. is recommended for those with prediabetes but not diabetes. c. has been proposed but not investigated through research. d. is more effective than the use of other dietary fibers.

d.1.5 L (~ 6 cups) Gropper CH 2 page 38

The volume of a normal stomach ranges from 50 mL (~2 oz) when empty to _____ when full. a. 100 mL (~4 oz) b. 250 mL (~1 cup) c. 750 mL (~3 cups) d.1.5 L (~ 6 cups)

a. fiber. (CH 11 Krause, pg 185) The RDI for biotin is 0.3 mg, for iron is 18 mg, and for selenium is 70 mcg. There is no RDI for fiber.

There is an RDI for all of the following nutrients except a. fiber. b. biotin. c. iron. d. selenium.

c. trigger the body to become more efficient in its use of amino acids and proteins (Beerman CH 5,p 190)

There is now research that suggests that physical activity, especially resistance exercise, may decrease a person's dietary protein requirements because physical activity may _____. a. inhibit the breakdown of amino acids and proteins b. stimulate the synthesis of proteins from lipids c. trigger the body to become more efficient in its use of amino acids and proteins d. stimulate the synthesis of proteins from complex carbohydrates

Α p. 289-290 (Gropper CH 8)

Thermoregulation refers to _____. a. alterations in metabolism to maintain body core temperature b. alterations in food energy due to cooking c. the increase in energy expenditure associated with the body's processing of food d.the body's storage of food as fat for insulation

d.acetic, propionic, and butyric (Gropper CH 4, pg. 121)

Three short-chain fatty acids produced by bacterial fermentation of fiber in the colon are _____. a. lactate, sodium acetate, and carbon dioxide b. bifidobacteria, lactobacilli, and streptococci c. methane, sulfur dioxide, and hydrogen d.acetic, propionic, and butyric

Key: acetic, propionic, butyric (Gropper CH 4, pg. 121)

Three short-chain fatty acids produced by bacterial fermentation of fiber in the colon are: _____, _____ and _____.

c. isograft. (Gould CH 7, pg. 121) - Isograft is a graft of tissue between two individuals who are genetically identical - Allograft tissue, taken from another person, takes longer to incorporate into the recpient's body - Syngraft is a tissue or organ transplanted from one member of a species to another, genetically identical member of the species, as a kidney transplanted from one identical twin to the other. - augtograft a graft of tissue from one point to another of the same individual's body.

Tissue transferred between two genetically identical twins is referred to as a/an: a. allograft. b. syngraft. c. isograft. d. autograft.

c. glutamic acid molecules must be removed (Gropper Chap 9, pg 345)

To absorb folate consumed from green, leafy vegetables, _____. 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. 70 Beerman CH1, page 7

To be labeled as "organic," crackers must have at least _____% organic ingredients. a. 50 b. 65 c. 70 d.85

c. Begin giving fluoridated water when the baby's teeth erupt. (CH 16 Krause, pg 302) Because human milk has low fluoride content regardless of the mother's fluoride intake, after 6 months of age, when an infant's teeth begin to appear, the baby should start receiving fluoridated water on a daily basis. Fluoride supplementation is not recommended before 6 months of age, partially to prevent the likelihood of fluorosis. Fluoride provision through food depends on the water supply used in the preparation of the food. Because communities where fluoridation has not been instituted still exist, adequate fluoride provision through foods alone cannot be guaranteed.

To meet the fluoride needs of a breast-fed infant, what should parents be instructed to do? a. Begin giving fluoride supplements immediately after birth. b. Supplement the mother's diet with fluoride. c. Begin giving fluoridated water when the baby's teeth erupt. d. When the infant starts eating solid foods, the foods will provide enough fluoride.

b. reduce the risk of adverse toxic effects. (CH 11 Krause, pg 174) ULs were established for many nutrients to reduce the risk of adverse or toxic effects from consumption of nutrients in concentrated forms. RDAs are aimed at 97% to 98% of the healthy population's nutrient requirements. Estimated safe and adequate daily dietary intakes were established for nutrients known to be essential for life, but recommended intakes cannot be established because of insufficient data.

Tolerable upper intakes (UIs) of nutrients were established to a. define nutrient intakes that may promote health. b. reduce the risk of adverse toxic effects. c. define the level of nutrient that will meet the requirements of 97% to 98% of the healthy population. d. provide data on estimated safe and adequate daily dietary intakes.

b. decreases gastric acid production. (CH 27 Krause, p. 512) Cimetidine and ranitidine are two H2-receptor blocking agents commonly used in the treatment of patients with gastrointestinal disorders. In the management of mild cases of esophageal reflux that results in esophagitis, these medications reduce gastric acid production. Sucralfate is a mucoprotective agent used in the treatment of patients with ulcer disease. Lifestyle and dietary management are used to promote LES pressure. Prokinetic agents are used to stimulate gastric emptying.

Treating esophagitis with cimetidine, a histamine H2-receptor blocking agent, is effective because it a. provides a viscous protective barrier. b. decreases gastric acid production. c. increases LES pressure. d. promotes gastric emptying.

Answer: D - Treatment goals for cystic fibrosis include pancreatic enzyme replacement and increased intakes of energy, protein, and fat. Cystic fibrosis is a wasting disease characterized by increased need for all nutrients, including sodium, which is lost through excessive sweating. Because the pancreatic duct may be blocked by mucous, supplementation with pancreatic enzymes is usually part of treatment. CNS Question of the day

Treatment goals for cystic fibrosis include: -Pancreatic enzyme replacement -Increased energy, protein, and fat intakes -Sodium restriction -A & B

False: (Beerman CH 5, p. 168)

True Or False: Synthesis of a strand of mRNA results from translation of protein.

False (Beerman CH 4, pg 130)

True of False: Digestion of disaccharides takes place in the liver.

False (Beerman Ch 5, p. 194)

True of False: For most healthy individuals, excessive protein intake can eventually injure the kidneys, resulting in severe health complications.

False: (Beerman CH 4, p. 136)

True of False: Insulin is secreted by the alpha cells of the pancreas and in response to increased blood glucose.

True (Beerman CH 4, p. 148)

True of False: Little or no insulin is produced by the pancreas in those with type 1 diabetes.

True (Beerman CH 5, p. 205)

True of Flase: Freezing kills many parasites

True (Beerman, 12)

True or False Osteoblasts are involved in bone formation.

True (Beerman, 12)

True or False Parathyroid hormone stimulates the breakdown of bone and resorption of its calcium onto the blood.

True (Beerman, 12)

True or False People of northern European or Asian descent are at the greatest risk for osteoporosis

False Explanation: The addition of 2 carbons is at the carboxylic acid end and double bonds are placed no closer to the methyl carbon than the 9th carbon from the carboxylic acid end. (Gropper CH 5, pgs. 168-170)

True or False: The conversion of linoleic acid (18:2) to arachidonic acid (20:4) involves the addition of 2 carbons to the methyl end and 2 double bonds at the n-3 and n-6 positions of the omega end.

False Explanation: Adipocytes are like all cells in that they require energy, and thus need glycolysis and the TCA cycle to produce ATP. (Gropper CH 5, pgs. 155-56)

True or False: Adipocytes' primary function is to store fat as triacylglycerol; thus, they do not require glycolysis and the TCA cycle for energy needs.

False Explanation: Bile is not an enzyme; a lipase enzyme, especially pancreatic lipase, does this. (Gropper CH 5, pg 147)

True or False: Bile is the GI enzyme that hydrolyzes dietary triacylglycerol into free fatty acids and glycerol.

True (Gropper CH 5, pgs. 140, 170-171)

True or False: Essential fatty acids are classified as such because we cannot synthesize them from other fatty acids and they are required for the synthesis of prostaglandins, thromboxanes, and leukotrienes.

False Explanation: FAs cannot be used to increase net glucose. During starvation, FAs are broken down to acetyl-CoA and ketones to be used to produce energy. (Gropper CH 5, pps 164 & 98)

True or False: Fatty acids are converted into glucose by gluconeogenesis and used for energy during starvation.

False: Explanation: Ketogenesis occurs when CHO levels are low. (Gropper CH 5, p167)

True or False: Ketogenesis is the synthesis of ketone bodies from fatty acids for energy under conditions of excess glucose, such as in the fed state.

False Explanation: Dietary fat is mostly TAG (>90%); cholesterol together with phospholipids represent ~5%. (Gropper CH 5, pg. 141)

True or False: Most Americans consume approximately half of their total dietary lipid as triacylglycerols, and the other half as cholesterol; very little is taken in as phospholipids.

False Explanation: A micelle delivers the FAs, etc. to the enterocyte, where they are taken up, reesterified to TAG by the enterocyte, and repackaged into a new lipoprotein called the CM. (Gropper CH 5, pgs. 148-151)

True or False: Once a micelle, containing lipids and lipid-soluble compounds, enters the enterocyte, it is referred to as a chylomicron.

True (Gropper CH 5, pgs 143-144)

True or False: One of the primary functions of a phospholipid is possible because of its structure, which allows it to be both hydrophobic and hydrophilic.

True (Gropper CH 5, pgs 153-4)

True or False: The key organ in clearing (i.e., breaking down) lipoproteins is the liver.

True (Beerman CH 5, p. 180)

True or False: Amino acids are used to synthesize proteins needed for structure, catalysis, movement, transport, communication, and protection.

True (Beerman CH 5, p. 207)

True or False: Because a substantial amount of research indicates that bST is safe for human consumption, the FDA allows its use.

False (Beerman CH 5, p. 189)

True or False: Because of its vital role in regulating the body's functions, according to the AMDRs, protein should provide at least 40% of an individual's energy intake.

True (Beerman CH 4, p. 119)

True or False: Disaccharides are formed from the condensation of two monosaccharides.

false (Beerman CH 5, p. 168)

True or False: Each strand of DNA is called a gene, and each gene is subdivided into thousands of chromosomes.

True (Beerman CH 4, pg 130)

True or False: Enzymes that catalyze the hydrolysis of carbohydrates include salivary and pancreatic alpha-amylase.

True (Beerman, CH 4, 141)

True or False: Epinephrine, a hormone, helps increase blood glucose levels by promoting glycogenolysis.

False (Beerman Ch 4, pgs 126-127)

True or False: Fermentable fibers promote selective growth of beneficial microflora and include pectin and cellulose.

False (Beerman CH 4, pgs 117-118)

True or False: Galactose is typically found in its free state in foods such as milk and cheese.

False (Beerman CH 5, p. 177)

True or False: Hydrochloric acid is released from parietal cells of the stomach and is responsible for hydrolyzing the peptide bonds of the protein's primary structure.

False (Beerman CH 4, p 149)

True or False: In type 1 diabetes mellitus, hyperglycemia results from excessive insulin levels in the blood.

True (Beerman CH 5, p. 177)

True or False: Inactive forms of enzymes, or proenzymes, are produced in order to protect the body from the protein-digesting abilities of the active enzymes.

False (Beerman CH 4, pg. 127)

True or False: Inflammation of diverticula from trapped fecal material results in diverticulosis

True (Beerman CH 4, p. 136)

True or False: Insulin and glucagon play vital roles in blood glucose regulation as well as energy storage

True (Beerman Ch 5, p. 201)

True or False: It now appears that community-acquired infection can occur via consumption of MRSA-infected foods.

False (Beerman CH 5, p. 192)

True or False: Lactovegetarians consume dairy products, eggs, fruits, and vegetables, as well as other plant-based foods.

True (Beerman CH 4, pgs 151,153).

True or False: Obesity is a risk factor for type 2 diabetes mellitus

True (Beerman CH 4, p 120)

True or False: On food labels the term "sugar" usually refers to both added sugars and those that occur naturally.

False (Beerman CH 5, p. 205)

True or False: Prions are deformed proteins that are destroyed by cooking.

True: (Beerman CH 5, p. 166)

True or False: Protein complementation is combining incomplete protein sources to provide all essential amino acids in relatively adequate amounts.

True (Beerman CH 5, p. 172)

True or False: Proteins have a quaternary structure when two or more polypeptide chains come together to form the final protein.

True (Beerman CH 5, p. 173)

True or False: Shaking and the addition of alcohol, salts, or detergents can denature a protein.

False (Beerman CH 4, pgs 126-127)

True or False: Soluble fiber can alleviate constipation, whereas insoluble fiber cannot.

True (Beerman CH 4, pg. 122)

True or False: Sorbitol, mannitol, and xylitol are sugar alcohols and do not promote tooth decay.

False (Beerman CH 4, pg 128)

True or False: The endosperm of the wheat kernel contains most of the kernel's fiber.

False (Beerman CH 4, p. 133)

True or False: The glycemic response is the impact of a food on the magnitude and duration of the rise in glycogen production.

False (Beerman CH 5, p 203)

True or False: The noroviruses can be successfully treated with antibiotics if the medication is given at the onset of symptoms.

b. do not readily take up glucose (Beerman CH 4, p. 152)

Type 2 diabetes is caused by insulin resistance, which means that when insulin is present, insulin-sensitive cells _____. a. transfer glucose out of rather than into cells b. do not readily take up glucose c. utilize insulin too quickly d. utilize insulin to metabolize fat

a. At 6 months if breastfed in a fluoridated community (CH 25 Kruase, p. 472) Because fluoride is low in breastmilk, the infant will require additional fluoride around the time of tooth eruption, around 6 months of age. If an infant is only being breastfed without supplementation with drinking water between breastfeeding episodes, then the child should receive fluoride supplementation from a doctor.

Under which conditions should an infant receive fluoride supplementation? a. At 6 months if breastfed in a fluoridated community b. At 6 months if breastfed and given water in a fluoridated community c. At 3 months if breastfed in a fluoridated community d. At 3 months if breastfed and given water in a fluoridated community

b. delays the rate of emptying of stomach contents. (Gropper CH 5, pg. 147)

Undigested lipid in the stomach creates satiety because it a. speeds the rate of emptying of the stomach. b. delays the rate of emptying of stomach contents. c. enhances gastric motility. d.suppresses GIP and secretin.

b-Chloride, sodium, and potassium (Beerman, CH 12)

Unfortunately, Nicole has kidney disease. Her blood levels of which minerals are likely to be disrupted because her kidneys cannot regulate their levels in her blood as they normally would? a. Magnesium calcium, phosphorous b. Chloride, sodium, and potassium c. Chloride, magnesium, potassium d. Phosphorous, calcium, sodium

b. check for dehydration or fluid loading. (CH 22 Krause, p. 422.) scale, wearing only a gown, and before eating and after voiding. The urine is checked for urine specific gravity to determine its density. Concentrated urine reflects dehydration. A patient with an eating disorder may consume water to simulate weight gain, and a diluted urine specific gravity will reflect this. Other measures of the urine may be used to determine muscle wasting and ketosis.

Urine specific gravity should be checked when patients being treated for eating disorders are weighed to a. monitor for muscle wasting. b. check for dehydration or fluid loading. c. check for presence of ketones. d. identify use of medications to suppress appetite or promote purging.

b. synthesis of fatty acids (Gropper Chap 9, pg 363-364)

Vitamin B6 functions importantly in all of the following EXCEPT _____. a. transamination of amino acids b. synthesis of fatty acids c. synthesis of niacin d.glycogen breakdown

ANS: C Vitamin D affects hundreds of genes in the human body and is recognized as an important nutrient in brain health. Clinical research has associated vitamin D deficiency with the presence of mood disorders and with an increased risk of depression in older adults. REF: p. 846 (Krause CH 41)

Vitamin D deficiency has been associated with a. bipolar disorder. b. delusional disorder. c. active mood disorder. d. generalized anxiety.

d. Both DHHS and USDA (CH 9 Krause, pg 143) Both the DHHS and the USDA play a role in the completion of NHANES. DHHS is responsible for the sample design and data of the survey, and the USDA is responsible for dietary data collection methodology, maintenance of the database used to code and process data, and data review and processing.

What agency(ies) is(are) responsible for NHANES? a. DHHS b. FDA c. USDA d. Both DHHS and USDA

water and electrolytes (Ch 1, Krause) pg 11 Water and electrolytes are usually the only absorbable remnants of dietary intake that reach the large intestine. Fats, carbohydrates, and proteins from the diet are absorbed throughout the small intestine.

What are primarily absorbed by the large intestine? a. Water and fats b. Carbohydrates c. Proteins d. Water and electrolytes

Answer (key points): Prions are altered proteins created when the secondary structure of the normal protein is disrupted. These deformed proteins, which are found mainly in the nerves and brain, can cause other normal proteins to unravel, setting off a cascade of similar reactions converting hundreds of normal proteins into abnormal prions. Prions are extremely resilient and retain their ability to infect other cells even after exposure to extreme heat or acids. Prions can be absorbed into the bloodstream and begin the process of transforming normal proteins into prions in their new host. For this reason, the FDA has banned the use of innervated tissue (such as the brain and spinal cord) from slaughtered cattle in human food, dietary supplements, and cosmetics. (Beerman CH 5, p. 205)

What are prions, and why are they a consideration in foodborne illness?

a. 2-monoacylglycerols, free fatty acids (Gropper CH 5, pg 147)

What are some products of the reaction catalyzed by pancreatic lipase? a. 2-monoacylglycerols, free fatty acids b. free fatty acids, glycerol, cholesterol c. 2-monoacylglycerols, free fatty acids, phospholipids d.free fatty acids, glycerol, cholesteryl esters

Key: Grading rubric - answer should include the following items (see Table 4.2): Fermentable fibers must be able to be digested (fermented) by gut bacteria. Examples of fermentable fibers and foods that contain them include: * fructans (chicory, asparagus, onions, tomatoes, bananas; also added to yogurts, cereals) * pectins (fruits, legumes, nuts) * gums (guar gum, gum Arabic; added as food additives that thicken) * beta-glucans (oats, barley, mushrooms) * polydextrose (created from glucose; used as a food additive for bulk; a functional fiber) * resistant dextrins (extracted from cooked and cooled wheat to be added to foods; * considered a functional fiber rather than a natural fiber) * resistant starch 3 (cooked and cooled rice, potatoes, pasta) (Gropper CH 4, pp 112-118, 221)

What are the components that make up fermentable dietary fiber and in what foods are each found?

d. IgE (CH26 Krause, pp. 480-482) Immunoglobulin E antibodies are the ones involved in classic allergic reactions. IgG is the predominant antibody produced during the secondary immune response. IgG has been actively investigated as being involved with food allergies; however, its clinical usefulness has yet to be substantiated. IgM is the predominant antibody produced by new B cells and is secreted during the first immune response. T-cells are not antibodies but are involved with the cell-mediated immune response.

What are the most common antibodies involved in food allergies? a. IgG b. IgM c. T-cells d. IgE

c. C, D, and K (Beerman, 12)

What are the primary vitamins required for bone building and remodeling? a. D, A, and folic acid b. A, E, and thiamin c. C, D, and K d. D, A, and E

of "sugar" but still providing the sweet taste desired. In addition, they do not contribute to tooth decay. Safety concerns are central to the disadvantages of nonsugar sweeteners. Specifically, aspartame cannot be consumed by people with PKU and some people claim it has adverse effects including headaches, dizziness, nausea, and seizures. It is interesting to note that despite the increase in nonsugar usage, obesity rates continue to climb. Foods sweetened with nonsugar sweeteners, even if safe, may still be low in nutrient density and poor food choices. (Beerman CH 4, p. 122)

What are the pros and cons of consuming nonsugar sweeteners?

Answer (key points): (Beerman CH 5, pp. 176-178) A small amount of mechanical digestion of food protein occurs as you chew your food. The presence of food in your stomach causes some gastric cells to release a hormone called gastrin. Gastrin then enters the blood where it triggers the release of hydrochloric acid (HCl), pepsinogen, mucus, and substances from other stomach cells that make up the gastric pits. HCl disrupts the chemical bonds responsible for the protein's secondary, tertiary, and quaternary structure. (This denaturation process straightens out the complex protein structure so that the peptide bonds can be more completely exposed to the digestive enzymes present in the stomach and small intestine.) HCl converts pepsinogen into its active form, called pepsin. Pepsin hydrolyzes or breaks the peptide bonds between amino acids, resulting in shorter polypeptides and some free amino acids. In the small intestine amino acids and smaller polypeptides coming from the stomach stimulate the release of the hormones secretin and cholecystokinin (CCK) from intestinal cells into the blood. Secretin and CCK signal the pancreas to release bicarbonate into the lumen of the duodenum, neutralizing the acid from the stomach and inactivating pepsin. These hormones also cause the release of trypsinogen, chymotrypsinogen, proelastase, and procarboxypeptidase, all of which are proenzymes made in the pancreas. These inactive proenzymes are converted in the small intestine to their active protease forms: trypsin, chymotrypsin, elastase, and carboxypeptidase. Each of these enzymes then recognizes specific amino acids in polypeptide chains, breaking the peptide bonds holding them together and forming tripeptides, dipeptides, and free amino acids. Finally, the di- and tripeptides are further broken down by a multitude of enzymes produced in the brush border enterocytes.

What are the steps in the digestion of protein?

b. Linoleic and linolenic (Beerman CH 6, p. 225)

What are the two essential fatty acids for adults? a. Linoleic and arachidonic b. Linoleic and linolenic c. Arachidonic and palmitic d.Palmitic and docosahexaenoic (DHA)

c. Compact and cancellous (Gould CH 9, pg. 159)

What are the two types of bone tissue? a. Vascular and nonvascular b. Spongy and calcified c. Compact and cancellous d. Dense and pliable

Answer (key points): (Beerman CH 5, pp. 200, 212) a.) Because incubation times are often longer than several hours, people may have ingested a number of different foods from a number of different sources during that period, making it difficult to identify the offending food(s). b.) Because people may be more (or less) susceptible to an infectious or noninfectious agent due to their health status, everyone who ate the offending food may not become ill. c.) Some people may eat enough of an offending food to become ill while others may not consume that much.

What are two reasons why is it often difficult to pinpoint the cause of a foodborne illness?

-- Fairly consistent evidence supports the consumption of a high-fiber diet for weight control. -- Possible mechanisms include more bulk causing a full feeling, less calories provided because of the undigestibility of fiber, and reduction of hunger through satiety-inducing hormones. (Gropper CH 4, pg. 124)

What associations have been found between high fiber intake and obesity? What mechanisms may be at work? How clear/consistent is the evidence?

a. Lowers blood pressure (Beerman, 12)

What beneficial effect does adequate calcium consumption appear to play in lowering the risk for cardiovascular disease? a. Lowers blood pressure b. Increases HDL levels c. Lowers LDL levels d. Reduces blood cholesterol levels

b. Rapid digestion and absorption of sugars and elevation of insulin levels (CH 27 Krause, p. 522) Alimentary hypoglycemia is a consequence of the dumping syndrome that results from rapid delivery and absorption of carbohydrate into the blood system, producing an exaggerated increase in insulin and then a decrease in blood glucose levels. The gut peptides glucose insulinotropic polypeptide and glucagon-like polypeptide-1 play some role in this. Alimentary hypoglycemia is aggravated by intake of simple carbohydrates. The pancreas is functioning normally as evidenced by the secretion of insulin in response to the carbohydrate load.

What causes the hypoglycemia that occurs after meals in patients who have had a gastrectomy? a. Poor dietary intake b. Rapid digestion and absorption of sugars and elevation of insulin levels c. Pancreatic insufficiency d. Elevated levels of secretin and pancreozymin

b. Mites burrowing into the epidermis and reaction to their feces (Gould CH 8, pgs. 152-153)

What causes the pruritus associated with scabies? a. An allergic reaction to the causative microbe due to endotoxins b. Mites burrowing into the epidermis and reaction to their feces c. Bleeding and injected toxin from bites of the larvae d. Neurotoxins secreted by mites on the skin surface

b. parietal cells Gropper CH 2 page 38

What cells found both in oxyntic glands and pyloric glands of the stomach secrete hydrochloric acid and intrinsic factor? a. neck cells b. parietal cells c. chief cells d.enteroendocrine cells

c. Irritable bowel syndrome (CH 28 Krause, p.546) Symptoms of irritable bowel syndrome include abdominal discomfort and altered intestinal motility, including feelings of bloating, incomplete evacuation, presence of mucus in the stool, straining and increased urgency to defecate, and increased GI distress. Inflammatory bowel disease presents with diarrhea, fever, weight loss, anemia, malnutrition, and food intolerances. Constipation is defined by the frequency and quantity of stool, and it may be experienced by patients with IBS. Diverticulosis is often experienced without any symptomatology.

What condition is associated with the feeling of incomplete evacuation of the bowel? a. Inflammatory bowel disease b. Constipation c. Irritable bowel syndrome d. Diverticulosis

a. Cognitive behavioral therapy (CH 14 Krause, pg 228-229) Cognitive behavioral therapy focuses on changing maladaptive thoughts and beliefs through cognitive restructuring. This technique is particularly effective in working with patients with body image issues. The transtheoretical model is not a counseling activity itself but rather a model for setting up counseling related to the stage a person is in regarding a needed behavioral change. Reflective listening is a technique used with patients who are not ready for change and involves the counselor communicating understanding of the patient's feelings through a statement. Shifting focus is a means used for dealing with patient resistance that involves the counselor changing the focus of a patient from a perceived barrier to change to one more appropriate.

What counseling activity is based on the idea that thoughts and beliefs that affect behavior can be changed to promote behavior change? a. Cognitive behavioral therapy b. Transtheoretical model c. Reflective listening d. Shifting focus

a. The type of glycosidic bond (Beerman CH 4, pg. 120)

What determines whether a carbohydrate is digestible or indigestible? a. The type of glycosidic bond b. The amount of carbohydrate eaten at the same time c. Whether or not the food is cooked d. Whether or not the food contains monosaccharides

b. The relationship between intake and adverse outcomes is probably not causal. (Beerman CH 5, p. 194)

What did the DRI committee conclude regarding the association of high protein intakes with adverse health outcomes? a. Epidemiological studies provide no evidence of the relationship between intake and adverse outcomes. b. The relationship between intake and adverse outcomes is probably not causal. c. Experimental data support the relationship between intake and adverse outcomes. d. The DRI committee has not yet evaluated the research on this association.

b. Restrict sodium and chloride (Beerman, CH 12)

What dietary intervention would be most beneficial for treating edema (swelling) in the lower extremities? a. Restrict calcium b. Restrict sodium and chloride c. Restrict phosphate d. Restrict potassium

ANS: A The diagnosis of fetal alcohol syndrome requires the presence of the three identifiable facial features: a smooth filtrum, a thin upper lip, and small palpebral fissures. REF: p. 927 (Krause CH 44)

What disorder is associated with these three specific facial features: a smooth filtrum, small palpebral fissures, and a thin upper lip? a. Fetal alcohol syndrome b. Cerebral palsy c. Spina bifida d. Prader-Willi syndrome

b. Using the client's previously expressed ideas to show a discrepancy (CH 14 Krause, pg 234) Double-sided reflection is a technique used to overcome resistance behaviors. The intent behind this is to give the client the opportunity to think about and examine what is said so as to open the discussion more, allowing for the opportunity to facilitate change. Reframing involves offering a different perspective to what the client has said, not necessarily comparing current statements with past statements by the client.

What does double-sided reflection involve doing? a. Monitoring a counseling session from behind a two-way mirror b. Using the client's previously expressed ideas to show a discrepancy c. Asking questions multiple times d. Reframing

c. Lipogenesis in the liver (CH 30 Krause, 593) In regard to lipids, insulin stimulates the conversion of pyruvate to fatty acids in the liver as part of the process of lipogenesis. Insulin's anticatabolic activities in relation to lipids include the inhibition of lipolysis and the prevention of excessive ketone production. Insulin's transport activity includes the activation of lipoprotein lipase to facilitate the transport of triglycerides into adipose tissue.

What does insulin promote in regard to the metabolism of lipids? a. Lipolysis in the liver b. An increase in serum free fatty acids c. Lipogenesis in the liver d. The breakdown of fat stores in adipose tissue

b. Antibodies for HIV have been identified in the blood. (Gould CH 7, pgs. 119, 132)

What does seroconversion mean in relation to HIV and AIDS? a. The virus has been identified in the blood and body fluids. b. Antibodies for HIV have been identified in the blood. c. HIV was found in lymphocytes. d. Active infection has developed in the patient.

a. Limit fat calories to 30% of total caloric intake. (CH 17 Krause, pg 327) The AAP recommends that children older than 2 years of age adopt a lower-fat diet so that no more than 30% of calories come from fat by the age of 5 years. This recommendation comes from the knowledge that obesity and cardiovascular disease development begins during childhood.

What does the American Academy of Pediatrics recommend in regard to calories from fat in the diet of a young child? a. Limit fat calories to 30% of total caloric intake. b. Limit fat calories to 20% of total caloric intake. c. Fat calories should only be limited in extreme circumstances. d. Fat calories should be limited for every child older than 1 year of age.

d. Bone resorption both precedes and exceeds bone formation. (CH 24 Krause, p. 458) The uncoupling of bone remodeling explains why after peak bone mass is achieved, throughout the rest of the life cycle, bone mass declines. Normal bone remodeling involves first bone resorption and then bone formation. However, when uncoupling occurs, more resorption than formation occurs. This results in bone loss.

What does uncoupling of bone remodeling mean? a. Bone formation precedes bone resorption. b. Bone formation both exceeds and precedes bone resorption. c. Bone resorption precedes bone formation. d. Bone resorption both precedes and exceeds bone formation.

Decreased absorption of bile salts (CH 1, Krause) pg 11 The use of prebiotic carbohydrates favors the growth of friendly bacteria such as lactobacilli and bifidobacteria. These bacteria ferment the prebiotic carbohydrates, promoting increased short-chain fatty acid production. These types of carbohydrates have not been demonstrated to have a bile-sequestering effect. Impairments in absorption of cation minerals tend to be in relation to phytates and oxalates that are present in plant foods.

What effect may be achieved by eating a diet high in prebiotic carbohydrates? a. Decreased SCFA production in the bowel b. Increased growth of Lactobacillus spp. c. Decreased absorption of bile salts d. Increased absorption of cation minerals

a. Sodium, chloride (Beerman, 12)

What electrolytes does the body selectively move to where more water is needed in order to maintain fluid balance? a. Sodium, chloride b. Magnesium, calcium c. Chloride, calcium d. Sodium, magnesium

d. carbonic anhydrase (Gropper CH 12, pg 471)

What enzyme facilitates diffusion of carbon dioxide from tissue cells and its reaction with water so that carbon dioxide can be carried to the lungs? a. renin b. angiotensinogen c. angiotensin d.carbonic anhydrase

d. Lipoprotein lipase (Beerman CH 6, p. 243)

What enzyme produced by muscle and adipose tissues enables the cells in these tissues to release fatty acids from circulating chylomicrons? a. Lipoprotein dehydrogenase b. Lipid synthetase c. Lipid oxygenase d. Lipoprotein lipase

d. Foods and beverages sweetened with HFCS (Beerman CH 4, pg. 117)

What foods represent the most significant sources of fructose in the typical U.S. diet? a. Honey and fruits b. Fruits and vegetables c. Fruit drinks and fruit beverages d. Foods and beverages sweetened with HFCS

a. calcidiol (Gropper Chap 10, pg 392, 393)

What form of vitamin D is the major circulating form with a half-life of approximately 3 weeks? a. calcidiol b. calcitriol c. cholecalciferol d.vitamin D2

A p. 489, 516(Gropper CH 13)

What genetic disorder causes copper toxicity? a. hemochromatosis b. Keshan disease c. Menkes disease d.Wilson's disease

c. Pituitary (Beerman, 12)

What gland responds to a lack of water in the body by releasing a hormone? a. Pineal b. Hypothyroid c. Pituitary d. Thyroid

C p. 514 (Gropper CH 13)

What glycoprotein serves as a transporter of copper, an antioxidant, and an oxidative enzyme? a. albumin b. globulin c. ceruploplasmin d.free amino acid

ANS: A Ready.gov is an Internet education tool developed jointly by the USDA and DHS to teach the public how to prepare for national emergencies. PrepNet is a Food Safety and Inspection Service program that coordinates food safety activities to protect the food supply. CFSAN focuses on issues related to seafood HACCP, safety of additives, biotechnology, supplements, and labeling. FEMA provides support services after a disaster occurs but not prevention or emergency preparation training. REF: p. 153 CH 9 Krause

What government program educates the public about how to prepare for a national emergency? a. Ready.gov b. Center for Food Safety and Applied Nutrition c. PrepNet (Food Threat Preparedness Network) d. FEMA

a. The functionality of the protein is affected. (Beerman CH 5, p. 169)

What happens if the shape of a protein is altered? a. The functionality of the protein is affected. b. The nutritional value of the protein is decreased. c. The protein is destroyed. d. The nutritional value of the protein is increased.

a. it is esterified (Gropper Chap 10, pg 375-376)

What happens to retinal in the enterocyte? a. it is esterified b. it is reduced to retinol c. it is transported into the portal blood d.15, 15' dioxygenase acts to form beta-carotene

d. RMR increases as lean body mass is increased with exercise. (CH 21 Krause, pg. 396) Resistance training increases lean body mass, increasing the RMR and the ability to use more energy. This promotes weight loss through the loss of body fat in place of lean body tissue.

What happens to the resting metabolic rate (RMR) as a result of exercise as part of a weight management program? a. RMR increases as adipose tissue is increased with exercise. b. RMR decreases as adipose tissue is decreased with exercise. c. RMR decreases as lean body mass is decreased with exercise. d. RMR increases as lean body mass is increased with exercise.

c. The thyroid gland releases a hormone called calcitonin. (Beerman, 12)

What happens when blood calcium is high? a. The parathyroid gland produces more parathyroid hormone (PTH). b. Calcium resorption from bone increases. c. The thyroid gland releases a hormone called calcitonin. d. Less calcium is lost in urine.

Answer (key points): Glucagon stimulates the production of ketones in the liver (ketogenesis). Ketones are formed by the breakdown of fatty acids. Ketones are then released as an alternative fuel source to the brain, heart, skeletal muscle, and kidney. Ketosis occurs when ketone production exceeds the rate of ketone use, resulting in the accumulation of ketones in the blood, which cause a variety of health complications. (Beerman CH 4, pp. 141-142)

What happens when energy intake is very low or when the diet provides insufficient amounts of carbohydrate?

b. Cholecystokinin (CCK) (Beerman CH 6, p. 237)

What hormone stimulates the gallbladder to contract and release bile into the duodenum? a. Retinolase (RNS) b. Cholecystokinin (CCK) c. Insulin d. Glucagon

d. Antidiuretic hormone (Beerman, 12)

What hormone stimulates the kidneys to conserve water by decreasing urine production and output? a. Adrenalin b. Aldosterone c. Angiotensin d. Antidiuretic hormone

Answer (key points): A GMO is a genetically-modified organism and can be either a plant or animal. Genetic modification involves manipulating the genetic material of an organism to "force" it to produce different or altered proteins. Sometimes this is done by simply modifying the DNA that the organism has. Alterations in the genetic material (DNA) can influence the proteins a plant makes and ultimately affect the protein quality of foods that we make from the plant. Sometimes, DNA from another organism is inserted in the nucleus. In this way, a plant with one or more limiting amino acids can be "enriched" with those amino acids and, as a result, be transformed into a complete protein source. (Beerman CH 5, p. 167)

What is a GMO and how is it accomplished?

b. Segmental versus continuous distribution of the disease throughout the GI tract (CH 28 Krause, p. 542) Whereas Crohn disease appears as segments of diseased bowel separated by segments of healthy bowel, in ulcerative colitis, the disease is continuous throughout the bowel. Both diseases occur more frequently between the ages of 15 and 30 years. Diarrhea, food intolerances, and dehydration are experienced in both diseases. The medical management for both diseases involves treatment with corticosteroids and manipulation of the diet during flare-up episodes.

What is a characteristic difference between Crohn disease and ulcerative colitis? a. Age at disease onset b. Segmental versus continuous distribution of the disease throughout the GI tract c. Clinical features of diarrhea, food intolerance, and dehydration d. Medical management with steroids and diet

b. Facilitated diffusion is slower than active transport. CH 3 Gropper page 73

What is a likely reason that large quantities of fructose may cause gut discomfort? a. Diffusion of fructose only occurs from low to high concentrations. b. Facilitated diffusion is slower than active transport. c. Active transport is saturable. d.Pinocytosis reverses fructose and releases it to the gu

d.maintenance of gastric acidity (Gropper CH 12, pg 468)

What is a major function of chloride? a. protein synthesis in cells b. the principal intracellular electrolyte c. wound healing d.maintenance of gastric acidity

c. Vesicle (Gould CH 8, pg. 143) - A small fluid-filled bladder, sac, cyst, or vacuole within the body. - Papule is a solid elevation of skin with no visible fluid, varying in area from a pinhead to 1 cm - Pustle is a small blister or pimple on the skin containing pus - A macule is a flat, distinct, discolored area of skin less than 1 centimeter (cm) wide

What is a raised, thin-walled lesion containing clear fluid called? a. Papule b. Pustule c. Vesicle d. Macule

b. 2 Tbsp (CH 17 Krause, pg 322) The general recommendation for serving sizes for children is two tablespoons of food per year of age. This may be adjusted according to the child's appetite. Milk and juice may be served in 1/2-cup volumes or less. Cooked cereals may be 1/4 to 1/2 cup in volume, and dry cereal may be 1/2 to 1 cup in volume.

What is an appropriate food serving size for a 2-year-old child? a. 2 tsp b. 2 Tbsp c. 1/2 cup d. 1 cup

a. Polypeptide (Beerman CH 5, p. 163)

What is another name for a chain of more than 12 amino acids that are bonded together? a. Polypeptide b. Tripeptide c. Polysaccharide d. Glycogen

standards of care (Ch 10 Krause, pg 168) Standards of care are the basis for providing consistent quality of care to patients within a particular health care institution. They act as the overall guide to the care. A critical pathway more specifically pinpoints when particular activities of care will occur during the patient's time in the health care facility. Evidence-based practice refers to providing care based on the best, most successful practices in health care that have been demonstrated through research, consensus, or other evidence. Discharge planning prepares for taking care of the patient when the patient leaves the health care facility.

What is another name for the practice guidelines that define the appropriate and consistent care for a patient with a specific diagnosis or medical problem? a. Standards of care b. Critical pathway c. Evidence-based practice d. Discharge planning

b. Loss of sense of taste (CH 20 Krause, pg 370) Some change in the sense of taste is associated with aging; however, a total loss of taste sensation more often is associated with the use of medications, diseases of the kidney or liver, diabetes, hypertension, head injury, neurologic conditions, and zinc or niacin deficiencies. Hyposmia is a diminished sense of smell and can contribute to a reduced taste sensation. Xerostomia is dry mouth. A reduction in hydrochloric acid production in the stomach can result in nutrient malabsorption.

What is dysgeusia? a. Diminished sense of smell b. Loss of sense of taste c. Dry mouth from decreased salivation d. Result of hypochlorhydria

c. acetyl-CoA (Gropper CH 5, pgs 164-5)

What is formed when fatty acids are oxidized in the mitochondria (i.e., what is the end product of beta-oxidation)? a. glycerol b. pyruvate c. acetyl-CoA d.triacylglycerol

D p. 506,522 (Gropper CH 13)

What is important in antioxidant DEFENSE? a. iron b. superoxide dismutase (SOD) c. glutathione d. more than one of these e. all three of these

b. Glucose (Beerman CH 4, pg. 130)

What is produced as the result of the digestion of amylose and amylopectin? a. Disaccharides b. Glucose c. Sucrose d. Polysaccharides

b. No routine supplementation is needed except fluoride in nonfluoridated areas. (CH 17 Krause, pg 318) The American Academy of Pediatrics (AAP) supports the use of diet as the means for providing adequate intake of vitamins and minerals to healthy children. Fluoride is the only mineral advocated for supplementation in children. However, some children may be at risk for inadequate nutrition, and for these exceptions, the AAP is supportive of supplementation. These include children from deprived families, children with anorexia or those following fad diets, children with chronic disease, and children following diets to treat obesity.

What is the American Academy of Pediatrics' recommendation on the use of supplements for children? a. Routine multiple vitamin and mineral supplements should be given. b. No routine supplementation is needed except fluoride in nonfluoridated areas. c. Maximal doses of vitamins and minerals should be given because it is uncertain that children will eat enough of the nutrients in food. d. Supplements should not be restricted because children are growing so rapidly that overdosing is unlikely.

c. Provide moist, soft, nonspicy food. (CH 25 Krause, p. 476) Sjögren syndrome results in salivary gland dysfunction, which could cause xerostomia. Providing moist, soft, nonspicy foods and increasing fluid consumption make it easier for the patient to eat without experiencing pain. Pureed foods are more commonly used in situations in which the patient has either chewing or swallowing difficulties. Oral liquid supplements may be necessary when oral intake is severely impaired, such as when stomatitis or ulceration of the mouth occurs.

What is the appropriate dietary management for a patient with Sjögren syndrome? a. Provide foods that are pureed in form. b. Provide oral liquid supplements. c. Provide moist, soft, nonspicy food. d. Begin fluid restriction.

b. 1 Tbsp for each year of age (CH 16 Krause, pg 311) A general guide for serving infants and young children is 1 Tbsp of each food for each year of age. Foods should be served on plates appropriate to the child's size. The child will indicate hunger if the served amount does not provide satiety. Larger portions and forced feeding may lead to either over- or underfeeding of the child.

What is the appropriate serving size for foods offered to a small child? a. 1 tsp for each year of age b. 1 Tbsp for each year of age c. 1/2 cup of each food served d. 1 cup total food per meal

b. Glycogenolysis (Beerman CH 4 pg 140)

What is the breakdown of glycogen to release glucose called? a. Glycolysis b. Glycogenolysis c. Glycogenesis d.Gluconeogenesis

d.albumin (Gropper CH 5, pg. 149)

What is the carrier for medium-chain fatty acids in portal circulation? a. triacylglycerides b. cholesterol c. chylomicrons d.albumin

a. carnitine (Gropper CH 5, pg 164)

What is the carrier molecule needed for mitochondrial membrane transport of long-chain fatty acids and their CoA derivatives? a. carnitine b. creatine c. creatinine d.cysteine

Indirect calorimetry (CH 2, Krause) pg 20 Indirect calorimetry is commonly used in hospital settings. The piece of equipment is known as a metabolic cart or monitor. Other methods of measuring energy expenditure include doubly labeled water and direct calorimetry; however, these are not practical for clinical practice. Bomb calorimetry measures the energy available from food.

What is the clinical method for measuring human energy expenditure? a. Bomb calorimetry b. Indirect calorimetry c. Doubly labeled water d. Direct calorimetry

c. hyperkalemia (Gropper CH 12, pg 467)

What is the condition that may result in cardiac arrhythmias when extracellular potassium is increased? a. hypernatremia b. hypokalemia c. hyperkalemia d.hyponatremia

b.metabolic acidosis (Gropper CH 12, pg 472)

What is the condition that occurs in starvation or diabetes in which there is an increase in the urinary excretion of ammonia? a. metabolic alkalosis b.metabolic acidosis

b. 20-40 g (Gropper CH 4, pg. 126)

What is the desirable amount of dietary fiber recommended for most population groups each day? a. 10-15 g b. 20-40 g c. 50-60 g d. 70-90 g

Answer (key points): Preformed toxins are produced by organisms living in foods before these foods are consumed, whereas enteric or intestinal toxins are produced by organisms while they are in the GI tract. Enterohemorrhagic pathogens invade the cells of the intestine, seriously irritating the mucosal lining and causing severe abdominal discomfort and bloody diarrhea. (Beerman CH 5, pp. 201, 202, 203)

What is the difference between a preformed toxin, an enteric or intestinal toxin, and an enterohemorrhagic pathogen?

Answer (key points): Amino acids can be categorized as essential, nonessential, or conditionally essential depending on whether we need to consume them from the foods we eat. The 9 essential amino acids are those you must consume in your diet because your body cannot make them or cannot make them in required amounts. The remaining 11 amino acids are nutritionally nonessential because your body can make them from other compounds such as the essential amino acids or glucose. However, if conditions exist that prevent the body from synthesizing a nonessential amino acid in the required amounts, that amino acid becomes conditionally essential and must be obtained from the diet. (Beerman CH 5, pp. 163-165)

What is the difference between essential, nonessential, and conditionally essential amino acids?

Answer (key points): Severe PEM encompasses a continuum of malnutrition: at the extremes are two distinct types of severe PEM, and between them conditions that combine features of both. Marasmus is at one end of the continuum. It results from severe, chronic, overall malnutrition. In marasmus, fat and muscle tissue are depleted, and the skin hangs in loose folds, with the bones clearly visible beneath the skin. Children with marasmus tend at first to be alert and ravenously hungry, although with increasing severity they become apathetic and lose their appetites. Clinicians often say that marasmus represents the body's survival response to long-term, chronic dietary insufficiency. Kwashiorkor is the other extreme type of PEM. It is often distinguished from marasmus by the presence of severe edema. While edema sometimes is present in children with marasmus, those with kwashiorkor usually have more extensive edema, which typically starts in the legs but often involves the entire body. Fluid accumulates in the abdominal cavity. Children with kwashiorkor sometimes have large, distended abdomens due to ascites. Because malnourished children often have intestinal parasites, worms sometimes contribute to this abdominal distension as well. Children with kwashiorkor often are apathetic and have cracked and peeling skin, enlarged fatty livers, and sparse unnaturally blond or red hair. Although many characteristics of kwashiorkor were once thought simply to be caused by protein deficiency, this does not appear to be the case. Researchers now believe that many of the signs and symptoms of kwashiorkor are the result of micronutrient deficiencies, for example vitamin A deficiency, in combination with infection or other environmental stressors. (Beerman CH 5, p. 193)

What is the difference between kwashiorkor and marasmus?

c. Muscle glycogen (CH 23 Krause, p. 428) The breakdown of glycogen stored in the muscle makes glucose available for anaerobic metabolism at the beginning of physical activity. As muscle glycogen stores are used, blood glucose is taken up by the muscle for continued energy utilization. To maintain a supply of glucose for energy, liver glycogen will be broken down for release of glucose. Pyruvate and lactate can be recycled back to the liver for gluconeogenesis.

What is the first source of glucose for the exercising muscle? a. Blood glucose b. Liver glycogen c. Muscle glycogen d. Muscle protein

Stimulation of the pancreas to secrete water and bicarbonate (Ch 1, Krause) pg 6 Secretin is the hormone that works in opposition to gastrin. Whereas gastrin stimulates stomach digestion activities, secretin decreases gastric output and promotes pancreatic secretions to neutralize the acidity of chyme. Cholecystokinin is also secreted when chyme enters the duodenum, and it is responsible for stimulating the gallbladder.

What is the function of secretin? a. Stimulation of gastric secretions and increased motility b. Stimulation of gallbladder contraction and the release of bile c. Stimulation of the pancreas to secrete water and bicarbonate d. Stimulation of the parietal cells to secrete gastrin

a. Gastric ulcers can develop with low acid output, and duodenal ulcers develop with high acid secretion (CH 27 Kruase, p. 518) Because gastric ulcers occur most frequently along the lesser curvature of the stomach, they may develop even when acid secretion is decreased. Duodenal ulcers occur as a result of constant exposure to high acid secretion. H. pylori is involved with the development of both types of ulcers. Because the activity of both proton pump inhibitors and H2-receptor antagonists is to decrease acid secretion, either may be used in the treatment of both gastric and duodenal ulcers.

What is the major difference between gastric and duodenal ulcers? a. Gastric ulcers can develop with low acid output, and duodenal ulcers develop with high acid secretion. b. Gastric ulcers develop with high acid secretion, and duodenal ulcers develop with low acid output. c. H. pylori is the primary cause of gastric ulcers. d. Gastric ulcers are treated with proton pump inhibitors, and duodenal ulcers are treated with H2-receptor antagonists.

c- Calcium (Beerman, 12)

What is the most abundant mineral in the body? a. Iron b. Phosphorous c. Calcium d. Sodium

d. Based on calories per kilogram (CH 17 Krause, pg 316) Although the EER equations for children older than 3 years of age include age, weight, and height as factors, for children between 13 and 35 months of age, the EER equation only includes the weight factor. The growth rate is highly variable throughout childhood, so it should not be used as a base factor for determination of energy needs. Children vary in weight, height, and body size at any age, which is the basis for the development of growth charts. Because of this variation, age should not be used as the sole base factor for determining energy needs. Calorie needs can be determined on a per centimeter of height basis, but this is independent of the child's age.

What is the most accurate means for determining the energy requirements (EER) of a child? a. Based on growth rate b. Based on age and height c. Based on age d. Based on calories per kilogram

b. Avoid alcohol completely throughout the entire pregnancy. (CH 15 Krause, pg 272) The American College of Obstetricians and Gynecologists and the March of Dimes both recommend no alcohol through the entire pregnancy. Fetal alcohol syndrome results from fetal exposure to alcohol. This could be attributable to alcohol's effects on cell differentiation, dietary deficiencies associated with alcohol use, and alterations in metabolism.

What is the most appropriate recommendation to make when counseling a newly pregnant patient about alcohol consumption? a. Avoid alcohol for the first trimester; then no more than 1 oz of alcohol per day. b. Avoid alcohol completely throughout the entire pregnancy. c. Limit consumption to 1 oz of alcohol per day. d. Limit consumption to 2 oz of alcohol per day.

a. Lactose intolerance (CH 28 Krause, p. 539) Lactose intolerance or maldigestion is the most common carbohydrate intolerance. Some carbohydrate intolerances occur in newborns as rare congenital defects. Lactose tolerance is considered to be a genetic mutation that affects peoples in Northern Europe and some ethnic groups in India, Africa, and Mongolia. However, 90% of the world's population has a low tolerance to milk.

What is the most common carbohydrate intolerance that affects people of all ages? a. Lactose intolerance b. Galactose intolerance c. Sucrose intolerance d. Maltose intolerance

ANS: C To bring the omega-6:omega-3 ratio closer to the recommendation of 2:1, increasing the intake of fish and seafood will increase the intake of omega-3 fatty acids while still providing omega-6 fatty acids. Simply supplementing the diet with fish oil supplements does not bring the omega-6 fatty acid level down. Instead, it requires higher intakes of fish oil supplements to bring down the ratio. Part of the problem with the omega-6:omega-3 ratio that is consumed now is the decrease in saturated fat intake and increased vegetable intake. This trend in dietary intake increases the omega-6 intake while not providing omega-3 fatty acids. REF: p. 839 (Krause CH 41)

What is the most efficient way to improve the omega-6:omega-3 ratio in the diet? a. Supplement the diet with fish oil supplements. b. Decrease the intake of meat and poultry. c. Increase the intake of fish and seafood. d. Increase the intake of vegetables.

a. arachidonic acid (Gropper CH 5, pg. 170)

What is the most important unsaturated fatty acid serving as a precursor for eicosanoid synthesis? a. arachidonic acid b. palmitoleic acid c. oleic acid d.erucic acid

b. hard to form bolus Gropper ch 2 page 35

What is the most probable problem if the function of the parotid glands is decreased? a. lack of triglyceride digestion b. hard to form bolus c. saliva that is too thin - a high water to mucus ratio d.diarrhea due to malabsorption

c. Tetany (Beerman, 12)

What is the name given to the serious calcium deficiency that causes muscles to tighten and become unable to relax? a. Osteopenia b. Spasms c. Tetany d. Seizure

b. Succussion (CH 12 Krause, pg 192) Succussion is the shaking of a diluted remedy that leads to the potentization or increased power of a remedy. Moxibustion applies heat to points along the meridia of the chi to help bring it back into balance. Pharmacognosy is a type of botanical medicine.

What is the name of the process in which a homeopathic remedy is shaken more than 100 times? a. Moxibustion b. Succussion c. Pharmacognosy d. Potentization

National Health and Nutrition Examination Survey (CH 9 Krause pg 142) NHANES was the original survey that includes assessment of health status of Americans. The Nationwide Food Consumption Survey, the Continuing Survey of Food Intake of Individuals, and the Diet and Health Knowledge Survey all focused on only the dietary and nutrient intake of Americans. The DHKS also included some examination of nutrition knowledge and attitudes.

What is the name of the survey that currently collects information on nutrient intake and health status in the United States? a. Diet and Health Knowledge Survey b. National Health and Nutrition Examination Survey c. Nationwide Food Consumption Survey d. Continuing Survey of Food Intake of Individuals

c. palmitate (Gropper CH 5, pg 168)

What is the normal product of the fatty acid synthase system? a. triacylglycerol b. myristate c. palmitate d.butyrate

Answer (key points): Once we knew our personal genetic make-up, we could have dietary recommendations about specific amounts of foods, nutrients, supplements, and exercise to best help us prevent illness. For example, if your genes suggest that your risk for heart disease is high, your list of recommendations would likely stress a diet low in saturated fat, trans fatty acids, and sodium but high in other, cardio-protective foods Alternatively, if you were found to be at very low risk for cardiovascular disease, you may not have to be as concerned about these nutrients. In other words, you would receive a personalized dietary prescription. (Beerman CH 5, p. 176)

What is the potential nutrition benefit of each of us being able to inexpensively and non-invasively find out our personal genetic make-up?

Decreased partial pressure of carbon dioxide (CH 6, Krause) When excessive metabolic production of acids occurs, the body compensates by stimulating increased expiration of carbon dioxide to reduce acid concentrations in the body. Whereas increased kidney excretion of bicarbonate would be the compensation mechanism for dealing with respiratory alkalosis, decreased excretion of bicarbonate would compensate for respiratory acidosis. In metabolic alkalosis, the lungs would compensate by reducing expiration of carbon dioxide. REF: p. 95

What is the primary disturbance when respiratory alkalosis occurs? a. Increased bicarbonate b. Increased partial pressure of carbon dioxide c. Decreased bicarbonate d. Decreased partial pressure of carbon dioxide

normal tissue metabolism (CH 6, Krause) ANS: A Hydrogen ion and acid formation results from normal metabolism. All foods, not just acidic ones, may result in the production of organic acids. Carbon dioxide is a common volatile acid that results from oxidation of carbohydrates, fats, and proteins. Bicarbonate is considered to be a base, and control of its concentration, along with carbon dioxide concentrations, is a primary focus of acid-base regulation.

What is the primary means by which hydrogen ions are generated in the body? a. Normal tissue metabolism b. Ingestion of highly acidic foods c. Oxidation-reduction reactions d. Reabsorption of bicarbonate

a. Fatty acids (CH 23 Krause, p. 428) Low- to moderate-intensity activities use fatty acids as a primary source of energy. High-intensity activities rely on glycogen and glucose as energy sources because these can be broken down faster than fat. Amino acids may be used for gluconeogenesis when other substrates for this process are limited. Glycerol may be used as an energy source by entering partway through the glycolytic pathway.

What is the primary source of energy for exercise of low to moderate intensity? a. Fatty acids b. Glycogen c. Amino acids d. Glycerol

c. Lipolysis (Beerman CH 6, p. 230)

What is the process of breaking down triglycerides for the production of ATP called? a. Lipid breakdown b. Lipid degradation c. Lipolysis d. Lipogenesis

b. Ossification (Beerman, 12)

What is the process of converting the soft rubbery fetal bones into hard, mineralized bone called? a. Calcification b. Ossification c. Mineralization d. Marbleization

a. It is rarely needed. (CH 16 Krause, pg 304) Commercially prepared infant formulas are fortified with all necessary vitamins; therefore, infants being fed formulas rarely need supplementation. The Food and Drug Administration regulates the manufacture of infant formulas so that the nutrient levels provided are consistent with the Infant Formula Act of 1985.

What is the recommendation for vitamin supplementation of infants fed commercially prepared formula? a. It is rarely needed. b. Supplement only vitamins. c. Only water-soluble vitamins should be supplemented. d. Only fat-soluble vitamins should be supplemented.

ANS: B The ISSFAL makes a general recommendation for a daily minimum intake of 500 mg combined of EPA and DHA. However, this recommendation does not clarify whether this is for populations with significant or limited fish intake. A total intake of 500 mg of alpha linoleic acid is the AI for infants. A total intake of 1100 mg of alpha linoleic acid is the RDA for women, and a total intake of 1600 mg is the RDA for men. REF: p. 842 (Krause CH 41)

What is the recommendation of the International Society for the Study of Fatty Acids and Lipids (ISSFAL) for the daily intake of DHA and EPA? a. 220 mg of each daily b. 500 mg combined daily c. Total of 1100 mg daily d. Total of 1600 mg daily

a. Fight BAC! (Beerman CH 5, p. 211)

What is the set of food safety guidelines developed by the USDA and the Partnership for Food Safety Education called? a. Fight BAC! b. Safe Food America c. Safe Food Rules! d. Join the Food Safety Fight

Reduced penetrance (ch 5, Krause) Reduced penetrance refers to when a person has the genotype that does not express as the phenotype. This concept is usually applied to the genetic inheritance of disease, such as when the pedigree of a disease is tracked through a family history. Dominance refers to the phenotypic expression of a single allele, whether it is associated with an autosome or a sex-linked chromosome. Linkage refers to how genes are sequenced with others in the DNA strand. REF: p. 72

What is the term that describes a gene that is present but not expressing a particular phenotype? a. Pedigree b. Reduced penetrance c. Dominance d. Linkage

b. Subluxation (CH 12 Krause, pg 192) Subluxations are musculoskeletal problems that chiropractors focus on manipulating to promote healing and wellness. Moxibustion is the use of heat in the attempt to restore chi. Meridians are the channels that carry the chi in traditional Oriental medicine. Pharmacognosy is the science of natural substances and is one of the areas included in naturopathy.

What is the term that refers to the dislocation of part of the body, which is thought to interfere with normal nerve function? a. Moxibustion b. Subluxation c. Meridian d. Pharmacognosy

b. DCCT (Beerman CH 4, p 151)

What large clinical trial provided evidence that maintaining blood glucose levels as close to normal as possible can prevent many of the long-term complications associated with type 1 diabetes? a. NCEP b. DCCT c. DASH d.NIDDK

a. Diarrhea (CH 17 Krause, pg 322) The high osmolality of apple and pear juices can contribute to carbohydrate malabsorption and diarrhea and therefore should not be used in situations in which fluid replacement is needed. Additionally, excessive fruit juice consumption has been associated with growth failure in children. The juice can replace other food sources of energy and protein, contributing to the child's not feeling hungry but not providing the nutrients necessary for adequate growth. Constipation may result from a poor fiber intake.

What may a child be at risk for if she drinks large amounts of apple or pear juice throughout the day and limited amounts of water or milk? a. Diarrhea b. Hypervitaminosis A c. Overhydration d. Constipation

c. Diet, exercise, and lifestyle modification all combined(CH 21 Krause, pg. 392) Weight reduction programs that integrate diet with physical activity and lifestyle modifications are the most likely to succeed. Whereas the promotion of weight loss by decreasing calorie intake is a primary component, physical activity has been demonstrated as being necessary for helping to maintain the weight loss. Behavior modification helps the person seeking weight loss learn about lifestyle and environmental factors that contribute to the promotion of weight gain. Inclusion of the understanding of what beyond food and activity contributes to obesity can help the patient make lifestyle changes to support the weight loss.

What methods of weight reduction have the highest rates of success? a. Diet combined with exercise b. Diet combined with lifestyle modification c. Diet, exercise, and lifestyle modification all combined d. Exercise combined with lifestyle modification

a. May reduce the prevalence of allergy during the first year of life (CH 26 Kruase, p. 482) Avoiding exposing infants to potential allergenic foods during infancy only decreases the prevalence of food allergies during the first year of life and delays the onset of atopic dermatitis. Breastfeeding is the preferred means of feeding infants for the first 6 months. However, as solid foods are introduced into the infant's diet, they should be presented one at a time, and known common food allergens should be avoided to reduce the risk of developing food allergies. Wise selection in combination with adequate breastmilk or formula should prevent malnutrition. Commercial formulas may be modified to remove potential allergens. Although as the child grows older, the likelihood of developing food allergies later in life may decrease, research has not demonstrated a long-term benefit to avoiding food allergens.

What might happen if allergenic foods are limited or avoided during infancy? a. May reduce the prevalence of allergy during the first year of life b. May lead to malnutrition c. May result in eliminating all commercial infant formulas from the infant's diet d. May prevent allergy after the first year of life

d. Vitamin D (CH 15 Krause, pg 258) Because of reports of clinical rickets, the AAP recommends an additional 5 mcg of vitamin D daily for infants, starting at 2 months of age. The vitamin A status of the breastfeeding mother may affect the infant, but the DRIs have an increased value for vitamin A intake of lactating women. The DRIs for zinc are also increased for lactation. The calcium content of breastmilk is not related to the calcium intake of women, so the DRIs for calcium do not increase during lactation.

What nutrient does the American Academy of Pediatricians (AAP) recommend to be supplemented at 2 months of age for breast-fed infants, although the DRI for the nutrient in lactating women is at the same level as that in nonpregnant women? a. Vitamin A b. Calcium c. Zinc d. Vitamin D

The DRIs for many nutrients for bone health have been set at levels to promote healthy bone growth early in life and minimize bone loss later in life. Nutrients include: calcium, phosphorus, magnesium, vitamin D, vitamin C, vitamin K, and protein. To reach goals for calcium, vitamin D, and protein, the Dietary Guidelines for Americans and accompanying MyPlate food guidance system recommend consuming 2-3 cups of milk or equivalent dairy daily. To obtain enough vitamin C, consume 1-4 cups of vegetables and 1-2 ½ cups of fruit each day. Fish and dark green, leafy vegetables provide the highest amounts of vitamin K. Foods rich in magnesium include seafood, legumes, nuts, and unprocessed brown rice. Phosphorus is found in almost all foods, especially foods containing protein. (pp. 546, 547-548) Beerman Ch 12

What nutrients are essential for optimum bone health? And thus, what foods need to be included in the diet?

a. Staphlococcus aureus (Beerman CH 5, p. 201)

What organism is commonly found in raw or undercooked poultry, cream-filled pastries, and unpasteurized milk? a. Staphlococcus aureus b. Clostridium botulinum c. Listeria monocytogenes d. Shigella

a. Salmonella (Beerman CH 5, p. 203)

What organism that tends to be found in raw poultry, eggs, beef, unwashed fruit, alfalfa sprouts, and unpasteurized milk is one of the most common causes of foodborne illness in the United States? a. Salmonella b. Camplybacter jejuni c. Staphlococcus aureus d. E. coli

a. 25% (Gropper CH 12, pg 457)

What percentage of blood volume is circulated through the kidneys? a. 25% b. 50% c. 75% d.100%

a. 1-3% (Beerman, 12)

What percentage of bone loss in women has been reported to occur each year after menopause? a. 1-3% b. 2-4% c. 3-5% d. 4-6%

d.50% Gropper CH 2 page 49

What percentage of cholesterol in bile is used to form chylomicrons? a. none of it b. 10% c. 25% d.50%

a. 5 to 10 % (Beerman CH 4 p. 148)

What percentage of diabetics in the U.S. are reported to have type 1 diabetes? a. 5 to 10 % b. 10 to 15% c. 15 to 20 % d. 20 to 25%

d. 55 (Beerman, 12)

What percentage of people 50 years of age and older have osteoporosis as estimated by the National Osteoporosis Foundation? a. 25 b. 35 c. 45 d. 55

b. 18% (Beerman CH 4, p. 157)

What percentage of pregnant women develop gestational diabetes? a. 5% b. 18% c. 9% d. 21%

c. 15-40 (Beerman chapter 10, pg 444)

What percentage of the elderly population are estimated to have vitamin B12 deficiency? a. 5-30 b. 10-35 c. 15-40 d.20-45

d. 1% (Gropper CH 12, pg 458)

What percentage of the glomerular filtrate volume is excreted as urine each day? a. 100% b. 50% c. 25% d.1%

d. 90 to 95% (Beerman CH 4, p 151)

What percentage of the people in the U.S. with diabetes are reported to have type 2 diabetes? a. 20 to 25% b. 50 to 55 % c. 70 to 75% d. 90 to 95%

d. 80 (Beerman CH 4, p 153)

What percentage of the population with type 2 diabetes are overweight? a. 20 b. 40 c. 60 d. 80

b. 25% Gropper CH 2 page 55

What percentage of urea produced in the body is converted to ammonia by bacteria in the colon and reabsorbed? a. 10% b. 25% c. 50% d.100%

d.mucus Gropper CH 2 page 38-39

What product produced by neck cells in the oxyntic gland of the stomach protects the epithelium from mechanical and chemical damage? a. amylase b. pepsin c. gastrin d.mucus

b. Transcobalamin (Beerman chapter 10, pg 443)

What protein transports vitamin B12 in the portal blood to the liver? a. R protein b. Transcobalamin c. Cobalamin d.C protein

b. Excessive milk consumption (CH 17 Krause, pg 326) Milk anemia results from excessive intake of milk to the exclusion of other foods, and this could occur in a 1-year-old child because young children prefer milk to meat. Excessive fruit consumption is more associated with toddler ages, 2 to 3 years. At 1 year of age, a child will participate in feeding herself finger foods, but a caregiver should still assist in the feeding process. By 1 year of age, most children can eat the same foods as adults, and a well-selected diet can provide adequate iron.

What reason would most likely explain why a 1-year-old child is experiencing iron deficiency? a. Excessive fruit juice consumption b. Excessive milk consumption c. Child is feeding herself, particularly finger foods d. Child is eating table foods

b. Sodium intake should be above 2 to 3 g/day. (CH 15 Krause, pg 262) Pregnancy does not place any additional demands in regard to sodium restriction. Excessive sodium restriction runs the risk of promoting water intoxication, renal and adrenal necrosis, and neonatal hyponatremia.

What recommendation about sodium should be given for pregnant women? a. Aggressive restriction is warranted. b. Sodium intake should be above 2 to 3 g/day. c. Sodium intake should not exceed 1 g/day. d. Sodium intake should not exceed 2 g/day.

b. They are cariostatic. (CH 25 Kruase, p 470) Nuts do not contain a significant amount of fermentable carbohydrates and therefore are cariostatic. Other cariostatic foods include protein foods such as seafood, meat, eggs, and poultry; fats such as oils, butter, margarine, and seeds; and most vegetables.

What role do nuts play in regard to the development of dental caries? a. They are cariogenic. b. They are cariostatic. c. They are anticariogenic. d. They are cariogenic when eaten with fruit.

c. Eat small, frequent meals low in fat. (CH 15 Krause, pg 270) Eating small, frequent dry meals of either carbohydrate or protein seems to reduce nausea in pregnant women. Although taking liquids between meals has been historically advised, no research has validated the suggestion. Meals high in fat tend to stay in the stomach longer, more likely promoting nausea and vomiting. The best recommendation is to eat whatever does not promote nausea and avoid odors that trigger nausea in the individual.

What should a pregnant woman do to relieve nausea and vomiting during the early months of her pregnancy? a. Drink liquids with meals and have small, frequent feedings. b. Eat high-fat foods and include liquids with meals. c. Eat small, frequent meals low in fat. d. Eat three regular meals per day.

b. Glucose and electrolytes in water (CH 28 Krause, p. 532) Oral rehydration therapy solutions for infants and children should contain 2% glucose and sodium and potassium. Additional vitamins and minerals are not included because they would increase the osmolality of the solutions and promote potential intolerance. Chemically defined and lactose-free formulas are usually used for more complete nutrition repletion as opposed to simple rehydration.

What should be in the solution used for fluid replacement for acute diarrhea in infants and small children? a. Vitamins, minerals, and electrolytes b. Glucose and electrolytes in water c. Chemically defined formula d. Lactose-free formula

b. Replacement of lost fluids and electrolytes (CH 28 Krause, p. 528) To resolve or prevent fluid and electrolyte imbalances, the first step in treating diarrhea is replacing the lost fluids and electrolytes through use of electrolyte solutions, soups, broths, vegetable juices, or other isotonic liquids. Later, starchy carbohydrates and low-fat foods may be introduced to limit the secretion of fluids into the GI tract and to prevent rapid GI transit. This could include modest amounts of pectin and fiber (<20 g).

What should be included in the initial treatment of diarrhea? a. Low-fat, low-fiber diet b. Replacement of lost fluids and electrolytes c. Increase of high-pectin foods d. High-fiber diet to increase stool bulk and restore normal bowel motility

c. Promote weight maintenance and increased physical activity. (CH 21 Krause, pg 402) As children and adolescents are still in growth phases, restriction of energy and nutrient intake and promotion of weight loss may impair appropriate growth and physical maturation. Unless the child is experiencing other medical conditions aggravated by excessive weight, the recommended approaches to weight control are providing adequate calories to maintain weight and increasing the child's physical activity, allowing the child to grow into his weight. If a child or adolescent has exceeded his optimal adult weight, then a slow, 10- to 12-lb/year weight loss is recommended.

What should be the treatment goal in regard to a child or adolescent who is identified as overweight? a. Promote weight loss of 1 to 2 lb/week. b. Promote weight loss to reduce BMI below the 85th percentile. c. Promote weight maintenance and increased physical activity. d. Promote weight loss of 10 to 12 lb/year.

b. Grapes and hot dogs (CH 16 Krause, pg 310) Foods with skins or rinds, such as grapes and hot dogs, and foods that stick to the roof of the mouth, such as peanut butter, should not be offered to infants and young children. Foods should be well cooked, mashed, or finely chopped to limit the hazard of choking.

What should the caregiver avoid feeding an infant to reduce the risk of choking? a. Cheese and pudding b. Grapes and hot dogs c. Graham crackers and cheese d. Pasta, such as macaroni

a. lactose (Gropper Chap 11, pg 428)

What substance can improve calcium absorption? a. lactose b. unabsorbed fatty acids c. phytic acid d.magnesium

a. Nausea, abdominal cramping, and diarrhea (CH 27 Krause, pp. 521-522) Signs and symptoms in the early stage of dumping syndrome include abdominal fullness and nausea within 10 to 20 minutes after eating, flushing, rapid heartbeat, faintness, and sweating. In the intermediate stage of dumping syndrome, 20 to 60 minutes after eating, symptoms include abdominal bloating, flatulence, cramping pains, and diarrhea. In the late stage, 1 to 3 hours after eating, patients experience reactive hypoglycemia, which is exhibited through sweating and feelings of anxiety, weakness, or hunger.

What symptoms of dumping syndrome follow the total or subtotal removal of the stomach? a. Nausea, abdominal cramping, and diarrhea b. Elevated blood pressure, headache, and substernal pain c. Heartburn, vomiting blood, and hypoglycemia d. Decreased saliva production, steatorrhea, and bloating

d. erythrocyte Gropper CH 1

What type of cell depends solely on energy produced through anaerobic mechanisms? a. hepatocyte b. enterocyte c. glucocyte d. erythrocyte

c. Osmotic diarrhea (CH 28 Krause, p. 528) When a person with lactase deficiency consumes a lactose load, the presence of lactose in the bowel promotes an osmotic effect, drawing fluid into the bowel. Exudative diarrheas result from damage to the intestinal mucosa. Malabsorptive diarrheas occur when there is a reduction to the absorptive surface area of the bowel or rapid transit of bowel contents. Secretory diarrheas result in the loss of fluid and water into the bowel, but this is caused by bacterial toxins, viruses, or increased intestinal hormone secretions.

What type of diarrhea may be experienced by a patient with lactase deficiency? a. Exudative diarrhea b. Malabsorptive diarrhea c. Osmotic diarrhea d. Secretory diarrhea

a. Nasogastric (CH 13 Krause, pg 210) A nasogastric tube is inserted through the nares and runs down the throat and esophagus to end in the stomach. A nasojejunal tube is inserted in the same manner, but its terminus is in the jejunum. A PEG tube is placed through the abdominal wall, so it feeds directly into the stomach. A PEJ is similar except that it feeds into the jejunum.

What type of enteric tube enters the body at the nose and terminates at the stomach? a. Nasogastric b. Nasojejunal c. Percutaneous endoscopic gastrostomy d. Percutaneous endoscopic jejunostomy

c. Diets that provide whole grain and adequate amounts of dietary fiber (Beerman CH 4, p. 155)

What types of diets have been shown to be beneficial in preventing diabetes? a. Diets that are low in fat and cholesterol b. Diets that are high in vitamins and minerals c. Diets that provide whole grain and adequate amounts of dietary fiber d.Diets that are "natural" or organically based

d. D (Gropper Chap 10, pg 397)

What vitamin is associated with diminished proliferation and enhanced differentiation of cells, which serves as a basis for its use as treatment of skin diseases such as psoriasis? a. A b. E c. K d.D

b. Carnitine (Beerman chapter 10, pg 450)

What water-soluble compound is needed for fatty acid transport across biological membranes? a. Folate b. Carnitine c. Choline d.Vitamin B12

c. She plays with or throws her utensils. (CH 16 Krause, pg 307-309) By age 7 to 9 months, an infant has the developmental coordination to pick up and handle utensils through a refined pincer grasp. This allows her to be more active in participating in her feeding, as well as in signaling when she is done. Falling asleep when sated is common in infants up to 3 months of age. From 4 to 6 months, fussing, crying, or losing attentiveness toward the food and paying more attention to the surrounding environment are signals of being done eating. A 10- to 12-month-old infant will hand her mother her cup or bottle as a signal of being done.

What would be a behavior demonstrated by a 7- to 9-month-old to indicate that she is sated and finished eating? a. She falls asleep. b. She pays more attention to her surroundings. c. She plays with or throws her utensils. d. She hands her cup or bottle to her mother.

a. She would experience hyperglycemia and lose weight. (Beerman CH 4, pgs 137,138)

What would happen if Tammy, a type 1 diabetic, routinely decided to skip her evening insulin injection? a. She would experience hyperglycemia and lose weight. b. She would experience hypoglycemia and gain weight. c. Her body would eventually adjust to the lack of insulin. d. Her body would eventually adjust to the lack of insulin as long as she didn't eat in the evening.

b. Calcitriol and calcitonin (Beerman, 12)

What, in addition to parathyroid hormones, regulates the concentration of phosphorous in the blood? a. Aldosterone and renin b. Calcitriol and calcitonin c. Angiotensin I and angiotensin II d. Renin and antidiuretic hormone (ADH)

a. nonessential protein (Beerman CH 5, p. 165)

Wheat does not contain enough lysine for humans to synthesize proteins from wheat alone. Thus, in wheat, lysine is considered to be a(n) _____. a. nonessential protein b. incomplete protein c. limiting amino acid d. inadequate amino acid

b. incomplete protein (Beerman CH 5, p. 165)

Wheat does not contain enough lysine for humans to synthesize proteins from wheat alone. Thus, wheat is considered to be a(n) _____. a. nonessential protein b. incomplete protein c. limiting amino acid d. inadequate amino acid

b. methicillin-resistant Staphylococcus aureus (MRSA) (Beerman CH 5, p. 201)

When Steve goes to work out, he is required to wipe down athletic equipment he has used in order to prevent the spread of _____. a. E. coli b. methicillin-resistant Staphylococcus aureus (MRSA) c. Camplybacter jejuni d.preformed toxins

d. use a certified translator. (CH 14 Krause, pg 230) Unofficial translators are not usually a good choice because of the lack of understanding of nutrition and health. Using professional translators is also not without limitations but is the best option.

When counseling a client who speaks a different language, the most effective way to communicate is to a. use a family member or close friend who speaks the language and can translate. b. use a visual aid that has been developed using international symbols. c. find a counselor who speaks the same language and can do the counseling. d. use a certified translator.

a. Over the 18- to 24-month "growth spurt" period (CH 18 Krause, pg 333) Although linear growth occurs throughout the 4 to 7 years of puberty, the greatest increase is during the growth spurt. Growth slows down but continues after sexual maturation.

When does the greatest increase in height during puberty occur? a. Over the 18- to 24-month "growth spurt" period b. Continually over the entire time c. During the first year of puberty d. Primarily toward the end of puberty

a. an increased loss of CO2 and a decreased production of carbonic acid. (Gropper CH 12, pg 471)

When hyperventilation occurs there is: a. an increased loss of CO2 and a decreased production of carbonic acid. b.a decreased loss of CO2 and an increased production of carbonic acid.

b. Growth channel (CH 16 Krause, pg 300) As a growth pattern develops on a growth chart, the curve produced is known as the growth channel and is reported as a percentile based on the chart. Growth velocity is a measure of the rate of growth during a specified period of time and usually starts high in infancy and then decreases as the person gets older. Catch-up growth is when a smaller infant starts to reach his or her genetic growth potential by increasing growth rate during the first year of life, and lag-down growth is when a larger infant's growth rate decreases to its genetic potential.

When plotting an infant's weight or length on a percentile growth chart, a curve is produced that can be used to follow the infant's growth. What is this curve called? a. Growth velocity b. Growth channel c. Catch-up growth d. Lag-down growth

b. 4 to 6 months (CH 16 Krause, pg 303) The iron stores in infants are adequate enough to provide for growth up to double their birth weight, which, in most cases, comes around 4 to 6 months. Although the iron in breastmilk is highly bioavailable, continuing to only breastfeed an infant past 4 to 6 months of age will lead to depletion of the infant's iron stores by 6 to 9 months. To prevent this depletion, additional sources of iron are needed in the infant's diet.

When should the addition of iron to the diet of both formula-fed and breast-fed infants begin? a. 6 weeks b. 4 to 6 months c. 6 to 9 months d. 1 year

c. 4 to 6 months (CH 16 Krause, pg 309-310) Introduction of semisolid foods depends on both the infant's developmental readiness and his or her nutrient needs. To maintain iron nutriture, additional sources of iron need to be introduced into the diet by 4 to 6 months of age. However, to be able to feed an infant foods other than formula, the infant needs to be able to demonstrate head and neck control, voluntary movements of the tongue, chewing movements, and the ability to sit unsupported.

When should the introduction of semisolid and strained foods to the infant's diet begin? a. 6 to 8 weeks b. 2 to 4 months c. 4 to 6 months d. 6 to 8 months

C p. 522 (Gropper CH 13)

When superoxide radicals accumulate, superoxide dismutase catalyzes the formation of hydrogen peroxide. What happens to the hydrogen peroxide? a. It freely dissociates to water. b. It is excreted in the urine and through the lungs. c. It is converted to water and oxygen via catalase or glutathione peroxidase. d.It is used in the synthesis of DNA and RNA.

b. active transport. (Beerman chapter 10, pg 445)

When the intake of vitamin C is low, absorption occurs by: a. simple diffusion. b. active transport. c. passive transport. d.passive diffusion.

b. decreased protein digestion Gropper chapter 2 page 39

When the pH of the stomach is increased to avoid GERD, over time the stomach may not be acidic enough. Which of the following might occur? a. lack of carbohydrate digestion b. decreased protein digestion c. destruction of bacterial in the stomach d.gastric ulcer

It can provide 1.1 kcal/ml of lipid.(CH 8 Krause pg 136) Propofol provides fat calories to a patient, and this must be considered when determining total calories and other sources of fat to administer to a patient under sedation. Laxatives such as FiberCon and Fiber-Lax contain extra calcium, which may be nutritionally significant. Various drugs use lactose or wheat starch as excipients, and these must be considered when dealing with patients with lactose intolerance and celiac disease.

When the sedative propofol (Diprivan) is administered to a patient, what nutritional consequence must be considered? a. It can provide 1.1 kcal/ml of lipid. b. It can provide extra calcium. c. It contains lactose and may promote lactose intolerance. d. It contains wheat starch and may affect people with celiac disease.

Low serum sodium because water is retained (Chapter 6, Krause) Vasopressin, also known as antidiuretic hormone, stimulates renal reabsorption of water. In syndrome of inappropriate diuretic hormone, excessive secretion of vasopressin retains water and results in hyponatremia and low urine output. Aldosterone is the hormone that stimulates renal sodium retention, and when present, the kidneys excrete potassium in exchange for the sodium, which then attracts the retention of water. REF: p. 88

When vasopressin is excessively secreted in the blood, which of the following effects occurs? a. Low serum potassium because water is retained b. Low serum sodium because water is retained c. High serum potassium because water is excreted d. High serum sodium because water is excreted

c. The mouth (Beerman CH 4, pg 130)

Where does the digestion of starch begin? a. The stomach b. The large intestine c. The mouth d.The small intestine

c. Peanut butter (Beerman CH 6, pp. 224, 225)

Where is arachidonic acid found? a. Corn oil b. Palm oil c. Peanut butter d. Fish oils

b. Yoga (CH 12 Krause, pg 192) Yoga is considered to be a manipulative therapy because it involves manipulation of the body. Homeopathy is classified by NCCAM as an alternative medical system. Cognitive behavior therapy is a type of mind-body therapy. Magnetic therapy is a type of medicine that is based on energy therapy.

Which CAM would be considered a manipulative therapy? a. Homeopathy b. Yoga c. Cognitive behavior therapy d. Magnetic therapy

Metabolic alkalosis (CH 6, Krause) Metabolic alkalosis results from a loss of acid, such as HCl through gastric suctioning, and loss of extracellular fluid, such as would occur in diuretic use or vomiting. Respiratory alkalosis occurs when excessive respiration occurs, such as heavy breathing after exercise or in anxiety. Respiratory acidosis happens when there is damage to the lungs or respiration that does not allow for the exchange of carbon dioxide with oxygen. Metabolic acidosis results from medical conditions that lead to a buildup of metabolic acids in the body. REF: p. 96

Which acid-base imbalance can result from diuretics use, vomiting, and loss of chloride? a. Respiratory alkalosis b. Respiratory acidosis c. Metabolic alkalosis d. Metabolic acidosis

b. Proteomics (ch5, Krause) Proteomics focuses on studying the proteins produced by genes. Metabolomics focuses on the study of cellular metabolites that may be useful in the monitoring of disease progression. Nutrigenomics studies the influence of nutrient and other food factors on the expression of genes. Genomics is the all-encompassing study of genes and proteins and their relation to disease, including the influences of environmental factors. REF: p. 66

Which area of study focuses on the identification and understanding of the function of the end products of the genes within the human genome? a. Nutrigenomics b. Proteomics c. Metabolomics d. Genomics

b. Infusions (CH 12 Krause, pg 195) More concentrated than teas, infusions steep fresh or dried herbs in water for about 15 minutes. Extracts involve dissolving the active ingredients in herbs in an organic solvent. A tincture is a type of extract in which the herbs are placed in alcohol to draw out the active components. Tablets are a pill form of taking herbs.

Which botanical formulations involve water-based extraction and brewing? a. Extracts b. Infusions c. Tablets d. Tinctures

c. α-dextrinase (Beerman CH 4, pg. 130)

Which brush border enzyme is required to accomplish the hydrolysis of α-1,6 glycosidic bonds, completing the digestion of amylopectin? a. α-amylase b. maltase c. α-dextrinase d. sucrase

c. Chewing sugar-free gum (CH 25 Krause, p. 470) Chewing sugar-free gum after a meal can help reduce its cariogenicity by promoting salivary stimulation, which clears fermentable carbohydrates from the surface of the teeth. Eating dessert, pretzels, or fruit at the end of a meal can have a cariogenic effect by contributing to fermentable sugars being available for plaque formation.

Which can reduce the cariogenicity of a meal when it follows the meal? a. Eating dessert b. Eating a snack of pretzels c. Chewing sugar-free gum d. Eating fruit

a. Those who do not eat meat or seafood. (CH 17 Krause, pg 317) Primary sources of zinc in the diet are foods of animal origin. Because of the costs of meat and seafood, children from families with low incomes are more at risk for developing zinc deficiency. Milk and vegetables are not primary sources of zinc.

Which children are at risk for having a zinc intake lower than the recommended level? a. Those who do not eat meat or seafood. b. Those who do not receive zinc supplementation. c. Those who drink too much milk. d. Those who do not like many vegetables.

a. Severe acute pancreatitis (CH 13 Krause, pg 210) Severe acute pancreatitis may result in inadequate digestive and absorptive capacity in the gastrointestinal tract. In this situation, providing enteral feeding may not be able to provide adequate nutrition. Pancreatitis may be associated with severe abdominal pain associated with feeding or with ileus. Enteral nutrition can be provided to patients with HIV/AIDS, patients who have failure to thrive, and patients with oral or esophageal trauma because the gastrointestinal tract is still accessible in these conditions.

Which condition would most likely require parenteral nutrition as the medical nutrition therapy? a. Severe acute pancreatitis b. HIV/AIDS c. Failure to thrive d. Oral or esophageal trauma

ANS: D One of the greatest nutritional risks in children with Prader-Willi syndrome (PWS) has to do with the child's appetite control. Children with PWS begin to gain excessive weight between the ages of 1 and 4 years because of an uncontrollable appetite. This, along with a low basal metabolic rate and decreased activity, makes the child with PWS susceptible to obesity. Children with ADHD treated with medications have to be monitored for potential anorexia. Children with spina bifida and Down syndrome also are susceptible to excessive weight gain because of lowered basal metabolism and limited activity. REF: p. 918 (Krause CH 44)

Which developmental disorder is characterized by the child having an insatiable appetite? a. Attention-deficit hyperactivity disorder b. Spina bifida c. Down syndrome d. Prader-Willi syndrome

a. Pemphigus (Gould CH 8, pg. 147) - Pemphigus is a rare skin disorder characterized by blistering of your skin and mucous membranes _ Erysipelas also known as St. Anthony's fire, is a relatively common bacterial infection of the superficial layer of the skin _Contact dermatitis is a condition that makes skin red or inflamed after contact with an allergen or an irritant _Scleroderma or systemic sclerosis, is a chronic connective tissue disease generally classified as one of the autoimmune rheumatic diseases.

Which disease is considered an autoimmune disorder? a. Pemphigus b. Erysipelas c. Contact dermatitis d. Scleroderma

a. Increased volume of the brain cells (Ch 6, Krause) intracellular fluid volume increases. The increase in the volume of brain cells results in headaches, nausea, blindness, vomiting, and convulsions. Hypertension, decreased circulating blood volume, and changes in urinary output tend to be associated with or the cause of hypovolemia. REF: p. 88

Which effect is of greatest concern in water intoxication? a. Increased volume of the brain cells b. Hypertension c. Decreased circulating blood volume d. Increased urinary output

c. procarboxypeptidases Gropper CH 2 page 48

Which enzyme or zymogen is secreted from the pancreas? a. pepsinogen b. enterokinase c. procarboxypeptidases d. maltase e.acyl-CoA synthetase

b. Lipoprotein lipase (CH 21 Krause, pg 385) Lipoprotein lipase hydrolyzes triglycerides from VLDL into fatty acids and glycerol. The glycerol travels back to the liver while the fatty acids are incorporated into adipocytes. Hormone-sensitive lipase hydrolyzes triglycerides packaged within the adipocytes so that fatty acids and glycerol can be released back into circulation. CCK's action at the brain level is to inhibit food intake. Insulin is the hormone that promotes lipid storage.

Which enzyme removes dietary triglyceride from the blood? a. Hormone-sensitive lipase b. Lipoprotein lipase c. Cholecystokinin d. Insulin

d. Providing small, frequent meals (CH 17 Krause, pg 326) Because of children's small stomach size and variability in hunger sensation, providing small, frequent meals with age-appropriate, nutrient-dense foods promotes a child's intake of foods. Lack of appetite and inappropriate feeding practices contribute to failure to thrive. Parents may inappropriately restrict foods or amounts of food out of fear their children will develop obesity or other chronic diseases. Inadequate fiber intake is associated with constipation development, which can impair a child's appetite. Excessive fruit juice intake replaces calories from other nutrient-dense foods and limits intake of nutrients necessary for growth, such as protein.

Which factor has NOT been associated with failure to thrive? a. Food restriction caused by parental concerns about obesity b. Inadequate fiber intake c. Excessive fruit juice intake d. Providing small, frequent meals

d. All of the above (CH 27 Krause, p. 519) The etiology of gastric cancer is multifactorial, but more than 80% have been attributed to H. pylori infection. In addition, diet, lifestyle, and genetic factors contribute. A Western diet, high in processed meats, fat, and salt, is associated with an increased risk of gastric cancer. Populations that eat a lot of pickled foods, cured foods, and other high-salt foods have a higher incidence. Smoking and obesity have also been linked to gastric cancer

Which factor has been associated with developing gastric cancer? a. Smoking b. Obesity c. A diet high in salt and fat d. All of the above

c. linoleic acid (Gropper CH 5, Pg 139-140)

Which fatty acid is considered essential and must be supplied by the diet? a. arachidonic acid b. omega-9 fatty acid c. linoleic acid d.oleic acid

a. Nuts (CH 26 Kruase, p. 484) Peanuts and tree nuts are believed to cause the most near-fatal and fatal anaphylactic reactions to foods. About 30,000 anaphylactic reactions and 200 deaths occur per year in the United States.

Which food is the most common cause of near-fatal and fatal anaphylactic reactions? a. Nuts b. Shellfish c. Egg d. Wheat

c. Those with food allergies (CH 19 Krause, pg 360) People with food allergies are at particular risk because they are often forced to eliminate whole food groups from their diet. Several segments of the adult population fall into high-risk groups that are unlikely to meet their nutrient needs because of life stage, alcohol or drug dependency, food insecurity, chronic illness, or choosing a restrictive diet.

Which group is at risk of not eating the RDI of nutrients and may benefit by the use of multivitamin supplements? a. Athletes b. Premenopausal women c. Those with food allergies d. Men older than age 50 years

b. whole-grain cereals and bran (Gropper CH 4, pg. 112-114)

Which group of high-fiber foods contains the greatest quantities of hemicellulose? a. legumes b. whole-grain cereals and bran c. fruits d.vegetables

c. Oxytocin (CH 15 Krause, pg 286) Oxytocin stimulates the myoepithelial cells of the mammary gland to contract, causing milk to move toward the nipple for feeding. Progesterone promotes the development of the mammary glands during pregnancy. Prolactin promotes milk production. Colostrum is the first milk that a woman produces around term.

Which hormone promotes letdown? a. Colostrum b. Progesterone c. Oxytocin d. Prolactin

b. atrial natriuretic peptide (Gropper CH 12, pg 461)

Which hormone, stimulated by increased blood pressure stretching the heart, functions to inhibit sodium reabsorption to promote sodium excretion? a. vasopressin b. atrial natriuretic peptide c. aldosterone d.angiotensin II

c. Glucagon and insulin (Beerman CH 4, pg. 135)

Which hormones work together to maintain the blood glucose level within an acceptable range? a. Insulin and cholecystokinin b. Cortisol and epinephrine c. Glucagon and insulin d.Amylopectin and glucagon

albumin (Ch 7 Krause pg 104) Albumin has a half-life of about 3 weeks. Prealbumin has a half-life of 2 days. Retinol-binding protein has a half-life of about 12 hours. Transferrin has a half-life of 8 days.

Which indicator of protein status has the longest half-life? a. Albumin b. Prealbumin c. Retinol-binding protein d. Transferrin

d. regular (CH 30 Krause, p. 601) Regular insulin is short-acting insulin that peaks within 2 to 3 hours of injection. Lispro is rapid-acting insulin that peaks within 1 to 2 hours. NPH is intermediate-acting insulin that peaks between 4 and 10 hours after injection. Detemir is long-acting insulin that stays in the blood system from 18 to 24 hours without a "peak" time of activity. Patients receiving detemir should be monitored 10 to 12 hours after injection for effects of the insulin.

Which insulin peaks in activity 2 to 3 hours after injection? a. Lispro (Humalog) b. Detemir (Levemir) c. NPH d. Regular

d.used in the synthesis of leucine (Gropper Chap 9, pg 346, 349, 350)

Which is NOT a fate of homocysteine in the cell? a. methylated to methionine b. used to restore tetrahydrofolate c. used to synthesize cysteine d.used in the synthesis of leucine

a. neurological function (Gropper Chap 10, pg 380-384)

Which is NOT related to the functions of vitamin A? a. neurological function b. growth c. immunity d.cell differentiation

b. Introverted (CH 22 Krause, pgs. 408 & 410) Psychologic features of a person with anorexia nervosa include perfectionism, harm avoidance, overly restrained emotional expression, and limited social spontaneity. People with bulimia nervosa tend to be more extroverted and easygoing and are more likely to engage in risk-taking behaviors.

Which is a typical personality characteristic of people with anorexia nervosa? a. Extroverted b. Introverted c. Underachiever d. Easygoing

A p. 292 (Gropper CH 8)

Which method of estimating energy expenditure requires the measurement of food intake? a. doubly labeled water method b. Harris-Benedict prediction equation c. Mifflin-St. Jeor equation d.estimated energy requirement equation

b. zinc (Gropper Chap 10, pg 387, 389)

Which micromineral deficiency interferes with vitamin A metabolism by reducing retinol-binding protein? a. manganese b. zinc c. selenium d.iron

D p. 524 (Gropper CH 13)

Which micromineral is necessary for iodine metabolism? a. fluorine b. manganese c. chromium d.selenium

D. p. 493 (Gropper CH 13)

Which mineral facilitates transfer of electrons in the electron transport chain? a. calcium b. nickel c. zinc d.iron

b. magnesium (Gropper Chap 11, pg 446)

Which mineral has as its primary function to bind phosphate groups in ATP and ATP-dependent enzyme reactions? a. calcium b. magnesium c. potassium d.sodium

b. Sodium increases, potassium lowers (Beerman, Ch 12)

Which mineral increases blood pressure in some people, and which tends to lower it? a. Phosphorous increases, chloride lowers b. Sodium increases, potassium lowers c. Potassium increases, sodium lowers d. Chloride increases, phosphorous lowers

C p. 487 (Gropper CH 13)

Which mineral is critical for oxidizing iron to be bound by transferrin for delivery to the tissues from the gut and liver?α zinc b. manganese c. copper d. chromium

c. Phosphorous (Beerman,12)

Which mineral is most likely to be adequate in the diets of nearly everyone? a. Magnesium b. Iron c. Phosphorous d. Potassium

B p. 540 (Gropper CH 13)

Which mineral serves as a cofactor in xanthine oxidase in the metabolism of purines, pyrimidines, and pteridines? a. manganese b. molybdenum c. copper d.chromium

A-magnesium (Beerman, CH 12)

Which mineral stabilizes enzymes and neutralizes anions? a. Magnesium b. Chloride c. Potassium d. Sodium

a. calcium (Gropper Chap 11, pg 434)

Which mineral, when combined with unabsorbed dietary fat, forms soaps that cannot be absorbed and are excreted in the feces? a. calcium b. sulphur c. potassium d.chloride

a. Glucose (Beerman Ch 4, pg. 115)

Which monosaccaride is often called "blood sugar" and is the most abundant sugar in our bodies? a. Glucose b. Fructose c. Galactose d.Sucrose

C p. 525 (Gropper CH 13)

Which non-metal nutrient deficiency is associated with Keshan disease, characterized by cardiomyopathy? a. iodine b. zinc c. selenium d.molybdenum

anemia (CH 7 Krause pg 105) The fecal occult blood test is routinely ordered for adults older than age 50 years and younger adults with unexplained anemia. The presence of blood may indicate bleeding in the gastrointestinal tract that is causing the anemia.

Which nutrient-related disorder is likely to result in a stool test being ordered? a. Diabetes b. Anemia c. Night blindness d. Cheilosis

calcium, phosphorus, magnesium (Beerman, 12)

Which nutrients play an important role in energy metabolism? a. Calcium, phosphorus, and magnesium b. Calcium, magnesium, and chloride c. Calcium, magnesium, and sodium d. Calcium, phosphorus, and chloride

d.decrease LPL activity (Gropper CH 5, pgs. 158-9)

Which of the choices listed below is NOT a reaction of the hepatocyte to an excess amount of free cholesterol? a. increase ACAT activity to store cholesterol b. decrease HMG-CoA reductase activity c. down-regulate the apoB-100/E receptors d.decrease LPL activity

b. They arise on skin exposed to ultraviolet radiation. (Gould CH 8, pgs. 154-155) Reminder: Actinic keratoses is a rough, scaly patch on the skin caused by years of sun exposure.

Which of the following applies to actinic keratoses? a. They predispose to malignant melanoma. b. They arise on skin exposed to ultraviolet radiation. c. They occur primarily on dark-skinned persons. d. They are malignant and invasive.

c. Growth measurements of height, weight, and weight for height should be determined at regular intervals. (CH 17 Krause, pg 314) Children change their eating and activity patterns, causing changes in growth. Because these changes are not always predictable, by checking growth measures at regular intervals, potential growth problems can be identified and treated early. Depending on the child's eating and activity, a child for whom a growth channel had been established could stray from that channel.

Which of the following are appropriate general guidelines for measurements to assess the growth of a child? a. Growth measurements should be made at 1, 4, and 10 years. b. After the child's channel on the growth charts has been determined, it is not necessary to reevaluate on a regular basis. c. Growth measurements of height, weight, and weight for height should be determined at regular intervals. d. After the growth pattern is established, it will not change until adolescence.

a. High content of protein, calcium, and phosphorus (CH 25 Krause, p. 470) Milk and dairy products are considered to have low cariogenic potential because they have a high calcium and phosphorus content. Protein in food is considered to provide a cariostatic effect.

Which of the following are characteristics of foods having a low cariogenic potential? a. High content of protein, calcium, and phosphorus b. Low content of protein, calcium, and phosphorus c. Low content of phosphorus and protein d. High content of magnesium and fat

d. GMP (CH 12 Krause, pg 197) Good Manufacturing Practices are a joint endeavor between the government and industry to develop high quality manufacturing guidelines for all dietary supplements. The Cochrane Database Review only reviews studies in regard to the efficacy of use of supplements. The Dietary Supplement Health and Education Act of 1994 did not establish standards or guidelines in regard to supplement production, nor did it give the FDA authority to ensure the quality and efficacy of dietary supplements.

Which of the following assures that a dietary supplement is a quality product that contains what the label states? a. CDR b. DSHEA c. FDA d. GMP

b. Roux-en-Y gastric bypass (CH 21 Krause, pg 398) The roux-en-Y gastric bypass creates both a reduced stomach reservoir to limit food intake and connects the small intestine to an opening near the reservoir to bypass some of the absorptive surface of the small intestine. Gastric banding and vertical banded gastroplasty only create the limited size reservoir for food intake. Liposuction is technically a cosmetic surgery because it is usually limited to removal of subcutaneous tissue.

Which of the following bariatric surgeries promotes weight loss through a combination of food restriction and malabsorption? a. Gastric banding b. Roux-en-Y gastric bypass c. Vertical banded gastroplasty d. Liposuction

a. Low serum ferritin levels can have a detrimental effect on exercise performance. (CH 23 Krause, p. 443) As adequate iron is necessary for oxygen transport in both blood and muscle as well as in the production of ATP, low serum ferritin levels of iron can limit aerobic endurance and the capacity for work. Iron is also lost through sweat. Iron supplementation may help improve iron stores, but no evidence is available regarding the impact of iron supplementation on improving performance.

Which of the following best characterizes the role of iron in exercise? a. Low serum ferritin levels can have a detrimental effect on exercise performance. b. Exercise performance is affected only in cases of severe iron deficiency anemia. c. Mild iron deficiency has no detrimental effects. d. Iron plays no significant role in muscle activity.

b. BMD (CH 24 Krause, p. 457) After peak bone mass is achieved by about 30 years of age, bone mineral density is the term used to describe bone throughout the rest of life. Bone mineral content is used to describe the amount of bone accumulated before the end of growth (usually in height). Alkaline phosphatase measured in the blood is a marker of bone formation.

Which of the following bone measurements is more appropriate for individuals from late adolescence to the elderly years? a. BMC b. BMD c. PBM d. Alkaline phosphatase

d. Maternal illness (CH 15 Krause, pg 283) Illness in a breastfeeding mother diverts energy stores away from adequate milk production. Smoking is a factor that can interfere with the letdown reflex, impairing milk flow. Failure to thrive because of poor intake is commonly associated with improper breastfeeding technique and poor suck on the part of the infant. An infant who is small for gestational age may develop failure to thrive because of his or her increased energy needs but limited size to handle increased food intake.

Which of the following can promote failure to thrive in a breast-fed infant as a result of poor milk production? a. Poor latching or suck during the feeding episode b. Small for gestational age infant c. Maternal smoking d. Maternal illness

b. Diminished absorption of vitamin B12 (CH 20 Krause, pg 371) When the gastric mucosa atrophies, there is a reduction in the secretion of intrinsic factor. This is necessary to promote the absorption of vitamin B12 from dietary sources. Reduced acid production also affects the absorption of nonheme iron but not necessarily calcium. The acid is also needed for the denaturation of protein.

Which of the following can result from atrophic gastritis associated with aging? a. Decreased calcium and nonheme iron absorption b. Diminished absorption of vitamin B12 c. Decreased absorption of carbohydrates d. Increased intestinal transit time

a. A severe, systemic allergic reaction (Gould CH 7, pg. 124)

Which of the following causes anaphylaxis? a. A severe, systemic allergic reaction b. Type III hypersensitivity c. Cell-mediated hypersensitivity d. Immune complex deposits in many tissues

c. Increased renal excretion of calcium (CH 24 Kruase, p. 464) Although an excessive sodium intake may contribute to an increased renal excretion of calcium, aging itself does not result in this physiologic change. Aging is associated with decreased intestinal absorption of calcium through alterations in the gastrointestinal mucosa and in vitamin D biosynthesis and metabolism. In contrast to osteoblast activity, osteoclast activity increases because of the uncoupling of bone remodeling.

Which of the following changes related to nutrition and bone metabolism does NOT occur in elderly subjects? a. Decreased intake of protein b. Reduction of skin biosynthesis of vitamin D c. Increased renal excretion of calcium d. Decline in osteoblast function

d. Polyarthritis (Gould CH 7, pgs. 135-136) Polyarthritis, is arthritis in 5 or more joints - Kaposi's sarcoma is a type of cancer that can form masses in the skin, lymph nodes, or other organs. - Lymphoma is cancer that begins in infection-fighting cells of the immune system - Wasting syndrome refers to unwanted weight loss of more than 10 percent of a person's body weight, with either diarrhea or weakness and fever that have lasted at least 30 days.

Which of the following complications does NOT occur frequently in AIDS patients? a. Kaposi's sarcoma b. Wasting syndrome c. Lymphoma d. Polyarthritis

a. Delayed gastric emptying (CH 27 Krause, p. 509) Nighttime GERD is distinguished from daytime GERD by changes in physiology during sleep. Stomach emptying is delayed, saliva production and swallowing decrease, chyme is exposed to stomach acid for longer periods of time, and other gastrointestinal digestive secretions increase. These changes are partly explained by the supine or recumbent position that a person is in while sleeping.

Which of the following contributes to nighttime GERD? a. Delayed gastric emptying b. Increased swallowing c. Decreased digestive secretions d. Increased saliva production

ANS: B In galactosemia, a buildup of galactose in the blood results from the inability to convert galactose into glucose. This is characterized by either galactokinase deficiency or galactose-1-phosphate uridyl transferase deficiency. Lactase deficiency would result in the inability to break down lactose to galactose and glucose. REF: p. 904 (Krause Ch 43)

Which of the following conversions is defective in galactosemia? a. Glucose to galactose b. Galactose to glucose c. Lactose to galactose d. Galactose to lactose

Vitamin B12 (CH 7 Krause, pg 105) Vitamin B12 and folate deficiencies both may promote the development of macrocytic anemia because they are involved in DNA synthesis, and loss of either results in the impaired production of red blood cells. Homocysteine is a product of methionine metabolism. Levels of homocysteine increase when vitamin B12 and folate are deficient because these are necessary for its conversion back to methionine. Vitamin B6 affects homocysteine by converting it to cysteine. However, neither of these promote anemia. Iron is associated with microcytic anemia.

Which of the following deficiencies could cause macrocytic anemia? a. Vitamin B12 b. Vitamin B6 c. Homocysteine d. Iron

ANS: D Prader-Willi syndrome is a genetic disorder in which the child either inherits chromosome 15 from the father with a deletion in the q arm region of the chromosome or receives both chromosome 15s from the mother. ADHD is known as a neurobehavioral disorder that does not have a genetic influence. Cerebral palsy and autism result from neurologic defects. REF: p. 910 (krause Ch 44)

Which of the following developmental disorders results from a chromosomal aberration? a. Attention-deficit hyperactivity disorder b. Cerebral palsy c. Autism d. Prader-Willi syndrome

ANS: B Children with attention-deficit hyperactivity disorder (ADHD) have no nutrient needs or exclusions additional to those of otherwise healthy children. These children do run the risk of not getting enough to eat because of behaviors associated with the disorder. To promote adequate intake, parents should establish regular meal times and provide initial small portions in a distraction-free environment. Children with ADHD may eat a little and then walk away from the table, expecting to graze later. Some recommend removing the food and returning it only once after explaining to the child what behaviors are desired in relation to eating. Various dietary manipulations in the past have attempted to treat children with ADHD by eliminating sugars, eliminating artificial food colors, eliminating caffeine, and using megavitamin therapy. Research has not substantiated the effectiveness of any of these. REF: p. 925 (Krause CH 44)

Which of the following dietary interventions should be used in treating children with attention-deficit hyperactivity disorder? a. Eliminate table and added sugars from the child's diet. b. Serve meals at regular eating times and provide small servings. c. Prevent the child from consuming foods with caffeine. d. Provide large doses of vitamin supplements to the child.

b. Decreasing intake of liquids and simple sugars with meals (CH 27 Krause, p. 521) Dumping syndrome is a common problem that occurs after a gastrectomy with a vagotomy. Dietary management for dumping syndrome focuses on limiting hypertonic simple sugars, which can draw fluids into the gastrointestinal system and produce the side effects of the dumping syndrome. Because of the smaller stomach capacity and impaired control of gastric emptying, the intake of fluids with meals could promote rapid gastric emptying. A high-protein, moderate-fat diet including fibrous foods and complex carbohydrates is recommended. Patients may experience lactose intolerance after these surgeries; therefore, milk and dairy portions should be limited in quantity.

Which of the following dietary modifications minimize the problems associated with a gastrectomy with a vagotomy? a. Increasing carbohydrate intake, particularly simple sugars, and decreasing fat and protein b. Decreasing intake of liquids and simple sugars with meals c. Reducing the intake of fiber from fruits and vegetables d. Increasing the intake of milk at mealtimes and between meals

ANS: B Although two-thirds of the daily purine load comes from cellular turnover, a low-purine diet that limits intake of meats, seafood, and alcohol is usually advised. Additionally, increased intake of fluids of at least 3 L/day helps with the excretion of uric acids and minimizes the risk of renal calculi formation. The diet should emphasize complex carbohydrates and minimize sweeteners to assist in weight moderation. REF: p. 806 (Krause CH 39)

Which of the following dietary recommendations assists in the management of patients with gout? a. Fluid restriction and avoidance of coffee and chocolate b. Limit intake of animal foods, seafood, and alcohol c. High-fat, low-carbohydrate diet d. Low-pyrimidine diet with decreased carbohydrates

d. Excessive potassium (CH 24 Krause, pp.462-465) Bone mass is maintained by adequate vitamin D and calcium intake and adequate phosphorus to maintain the serum calcium-to-phosphate ratio. Too much phosphorus in relation to calcium stimulates parathyroid hormone, resulting in loss of bone. Oral doses of potassium bicarbonate by postmenopausal women neutralize endogenous acids that may contribute to bone resorption.

Which of the following dietary variables is NOT related to low bone mass? a. Inadequate calcium b. Excessive phosphorus c. Inadequate vitamin D d. Excessive potassium

d. Zone Diet (CH 21 Krause, pg 395) The Zone Diet and the South Beach Diet are two diets that promote an intake of carbohydrate to less than 40% of total calories. The claim behind this is that this level of carbohydrate intake will result in reduced insulin secretion. Insulin is responsible for fat storage, and if less is secreted, less fat deposition will occur. Typical low-carbohydrate diets tend to have levels of 20% of total calories or less. A protein-sparing modified diet is a type of very low-calorie diet (VLCD) that provides protein but limits calories. The idea behind this is that if protein were provided by the diet, lean body tissue could be preserved while the patient lost weight. VLCDs provide the patient with only 200 to 800 calories/day and should be conducted under the care of a physician.

Which of the following diets advocates that carbohydrates should contribute no more than 40% of the total calories? a. Low-carbohydrate diet b. Protein-sparing modified diet c. Very low-calorie diet d. Zone Diet

fat (CH 2, Krause) pg 19 Although dietary fat provides the highest concentration of energy, metabolism of fat is highly efficient, with only 4% of calories wasted. This partly explains the obesogenic aspect of dietary fat. The TEF after intake of carbohydrates and proteins tends to be higher than after fat intake. Following a regular eating schedule results in a higher TEF than irregular eating. The use of spice and mustard increases metabolism more than unspiced

Which of the following does NOT increase the thermic effect of food (TEF)? a. Carbohydrates b. Fat c. Regular eating schedule d. Spicy foods

Metronidazole (Flagyl) (CH 8 Krause pg 131) Metronidazole (Flagyl), cefoperazone, and chlorpropamide cause a reaction similar to that of Antabuse when taken with alcohol. The reaction is characterized by flushing, a rapid heartbeat, palpitations, and elevated blood pressure.

Which of the following drugs will produced an Antabuse (disulfiram)-like reaction when taken with ethanol? a. Metronidazole (Flagyl) b. Captopril (Capoten) c. Paclitaxel (Taxol) d. Eszopiclone (Lunesta)

c. Increase in immunosuppressed individuals (Gould CH 8, pg. 155) Reminder: Kaposi's sarcoma (KS) is a type of cancer that can form masses in the skin, lymph nodes, or other organs.

Which of the following factors has contributed to the increased incidence of Kaposi's sarcoma? a. Excessive sun exposure b. Increased number of nevi c. Increase in immunosuppressed individuals d. Presence of more seborrheic keratoses

c. A White woman who is underweight, had premature menopause, does not exercise, and smokes cigarettes (CH 24 Krause, p. 459) Risk factors for the development of osteoporosis include being a woman of European or Asian descent, being underweight or sarcopenic, having experienced menopause or oophorectomy, lack of exercise, cigarette smoking, excessive alcohol or caffeine use, and limited intake of calcium and vitamin D.

Which of the following female patients is at risk for osteoporosis? a. An African American woman who was normal age at menopause and has a large frame and poor intake of calcium. b. A White woman who is overweight, had multiple pregnancies and late menopause, and consumes alcohol. c. A White woman who is underweight, had premature menopause, does not exercise, and smokes cigarettes. d. An Asian woman who is premenopausal and has a large frame, a high calcium intake, and a sedentary lifestyle.

a. Coffee (Beerman chapter 10, pg 426) Raw fish contain these too!!!

Which of the following foods contains "antithiamin factors" that destroy thiamin or interfere with its absorption? a. Coffee b. Milk c. Eggs d.Grapes

d. Chicken, fish, and/or beef (Beerman chapter 10, pg 430)

Which of the following foods provides a good source of niacin? a. Citrus fruits b. Dark green, leafy vegetables c. Pasta, noodles, and/or rice d.Chicken, fish, and/or beef

ANS: C Children with PKU should be provided with foods with low-protein content because these also have low phenylalanine content. Potato chips provide relatively no phenylalanine. High-protein foods such as dairy foods, meats, and peanut butter provide too much phenylalanine. Also, regular breads, pastas, and baked goods may be too high in phenylalanine. Low-protein versions of these foods are available from specialty sources. Aspartame is the sweetener that is commonly used in sugar-free and diet products; however, because aspartame contains phenylalanine, these foods should be avoided in the diet of a child with PKU. REF: p. 899 (Krause Ch 43)

Which of the following foods would be allowed in the diet of a child with PKU? a. Peanut butter and jelly sandwich b. Sugar-free gum c. Potato chips d. Spaghetti and meatballs

d. Crackers and pretzels (CH 25 Kruase, p. 473) they are sources of fermentable carbohydrates. Crackers and pretzels provide these types of carbohydrates that can stick to the teeth. Raw carrots and apples have dietary fiber, which tends to be cariostatic. Cheddar cheese is anticariogenic because of its effect on oral pH. Butter is cariostatic.

Which of the following foods would be identified to a patient as being potentially cariogenic? a. Raw carrots and apples b. Cheddar cheese c. Butter d. Crackers and pretzels

a. Dried beans, dried fruits, and shellfish (CH 29 Krause, p. 567) Foods high in copper include shellfish, pork, game birds, soy protein, organ meats, avocado, chocolate, dried beans, wheat germ, sweet potatoes, mushrooms, nectarines, dried fruits, and Brewer's yeast.

Which of the following foods would be recommended to be avoided by a patient with Wilson disease, in which excretion of copper from the body becomes impaired? a. Dried beans, dried fruits, and shellfish b. Eggs, milk, and cheese c. Sweet potato, rice, and oatmeal d. Butter, cream, oil, and salad dressing

ANS: C Bell peppers, watermelon, tomatoes, dates, papayas, and persimmons are all fruits and vegetables that provide greater than 10 mg galactose per 100 g fresh weight. These are foods that should be avoided by patients with galactosemia. Raisins are not a concentrated source of galactose and can be consumed. REF: p. 905 (Krause Ch 43)

Which of the following fruits and vegetables would be allowed in the diet of a person with galactosemia? a. Bell peppers b. Watermelon c. Raisins d. Tomatoes

ANS: B Experts have recently suggested that a daily intake of 900 mg of DHA during pregnancy may be necessary to support both infant and maternal needs. Starting in 2002, DHA has been supplemented to infant formulas to ensure adequate fatty acid for brain development. The risk of deficiency of omega-3 fatty acids has not been identified in weight lifters or adolescent females. REF: p. 842 (Krause CH 41)

Which of the following groups is at high risk for deficiency of DHA? a. Formula-fed infants b. Pregnant women c. Weight lifters d. Adolescent girls

ANS: C Preterm infants are easily distracted and can be easily overstimulated. In addition, preterm infants tire easily and may have poor muscle tone. Because of these traits, a preterm infant needs to be supported in a position to properly align the head and neck to allow for adequate feeding. Also, distractions and stimulation can tire the infant and draw focus away from feeding. To help provide adequate feeding, the environment should be quiet and free of distractions. REF:p. 884 Krause CH 42)

Which of the following helps promote better feeding of a premature infant after being discharged from the hospital? a. Attracting the infant's attention with toys b. Playing with the infant at feeding time c. Supporting the infant's body during feeding d. Feeding while playing age-appropriate DVDs

critical pathway (Ch 10 Krause, pg 168)- A critical pathway is used by health care providers to identify what activities should occur at times throughout a patient's care. This is a key component of case management, which focuses on the achievement of patient-focused goals in the delivery of health care.

Which of the following identifies the essential elements and activities that should occur in a patient's care? a. Case management b. Critical pathway c. Utilization review d. DRG

c. Decrease in dietary calcium intake (CH 24 Krause, pp. 459-460) Although decreased dietary calcium intake is a risk factor for osteoporosis, it is not specific to either type of osteoporosis. Type I osteoporosis in women results after menopause when estrogen production ceases. The BMD of women with postmenopausal osteoporosis may fall as low as 25% to 40% of that of age-matched women without osteoporosis. Type I osteoporosis is associated with "crush" fractures of the wrists and lumbar vertebrae.

Which of the following is NOT a characteristic of hormone-related (type I) osteoporosis? a. Rapid rate of bone loss and therefore of BMD b. Cessation of ovarian estrogen production c. Decrease in dietary calcium intake d. Increased risk of fracture of wrist and vertebrae

serum glucose (Ch 7 Krause pg 103) Although high serum glucose levels in people with diabetes mellitus have a dehydrating effect, by itself, it is not a measure of hydration. Glucose, sodium, and blood urea nitrogen (BUN) are all factors in the calculation of serum osmolality. Serum osmolality, serum sodium, BUN, and urine specific gravity are all laboratory values that may be used to assess hydration status.

Which of the following is NOT a laboratory measure of hydration status (factors the serum osmolality)? a. Serum sodium b. Blood urea nitrogen c. Serum glucose d. Urine specific gravity

Hypotension (Ch 8 Krause, pg 130) Because corticosteroids such as prednisone promote sodium and water retention, they can contribute to an increase in blood pressure. Calcium is excreted in the place of sodium, and this coupled with corticosteroid impairment of intestinal calcium absorption and osteoblast activity can lead to bone loss. Corticosteroids promote gluconeogenesis and insulin resistance, both of which can cause hyperglycemia. Weight gain is a common side effect of corticosteroids because of both fluid retention and a stimulation of appetite.

Which of the following is NOT a possible side effect of use of corticosteroids? a. Bone loss b. Hyperglycemia c. Hypotension d. Obesity

d. High blood pressure (CH 24 Krause, pp. 462-3) Increased calcium intake has been associated with lowered blood pressure. In susceptible individuals, excessive calcium supplementation may result in urinary tract stones. Excessive calcium supplementation may cause constipation and can interfere with the absorption of other divalent cations.

Which of the following is NOT a risk associated with excessive calcium supplementation? a. Constipation b. Iron deficiency c. Urinary tract stones d. High blood pressure

b. Motivation (CH 14 Krause, pg 228) The transtheoretical model, or stages of change, includes the stages of precontemplation, contemplation, preparation, action, maintenance, and relapse. Motivation may be applied as a technique of interviewing to achieve a willingness to change in the client.

Which of the following is NOT a stage of change? a. Precontemplation b. Motivation c. Relapse d. Action

ANS: D Human milk fortifiers are supplements of protein, carbohydrates, fat, mineral, and vitamins that can be added to breastmilk to better meet the nutritional needs of preterm infants. However, iron is not always included as one of the nutrients in human milk fortifiers. Normally, the bioavailability of iron from breastmilk is high compared with formula, but preterm infants need more iron because of incomplete development of iron stores. Iron supplementation is needed. REF:p. 877 (Krause CH 42)

Which of the following is NOT adequately provided to preterm infants through the use of human milk fortifiers? a. Zinc b. Calcium c. Phosphorus d. Iron

c. Reframing (CH 14 Krause, pg 234) The six steps that are important when working with clients struggling with behavior change are expressing empathy, understanding cultural factors, developing discrepancy, avoiding arguments and defensiveness, rolling with resistance, and supporting self-efficacy. Reframing is a technique in which the counselor changes the client's interpretation of data by offering a new perspective. This is used when a client is demonstrating resistance to change.

Which of the following is NOT an activity that facilitates behavior change? a. Self-efficacy b. Empathy c. Reframing d. Discrepancy

Malnutrition (CH 7 Krause pg 104) Prealbumin levels may appear normal when a patient has uncomplicated or severe malnutrition. Prealbumin levels decrease in response to inflammation, protein-wasting diseases of the intestines and kidney, and in malignancy. As zinc is necessary in the synthesis of prealbumin, zinc deficiency will result in decreased levels

Which of the following is NOT associated with a decrease in prealbumin levels? a. Malnutrition b. Inflammation c. Protein-wasting disease of the gastrointestinal tract d. Zinc deficiency

c. Being underweight (CH 27 Krause, p. 515) Dyspepsia refers to nonspecific, persistent upper abdominal discomfort or pain. The discomfort may be related to organic causes such as esophageal reflux, gastritis, peptic ulcer, gallbladder disease, or other identifiable pathology. Diet, stress, and other lifestyle factors may contribute to the symptoms. An underlying mechanism may be altered gastric motility.

Which of the following is NOT associated with dyspepsia? a. Diet b. Abnormal gastric emptying c. Being underweight d. Upper abdominal discomfort

d. Bringing lunch from home (CH 17 Krause, pg 323) Although lunches brought from home tend to provide fewer nutrients and less variety than those served in school, they do provide school age children with some nutritional value. Children in poverty tend to be more likely to experience iron deficiency, food insecurity, and skipping of meals. These each have been demonstrated to result in poor performance in regard to academic skill development. The School Breakfast Program provides a means to ensure that children from families with lower incomes have the opportunity for a nutritious breakfast before the school day.

Which of the following is NOT associated with impaired academic performance in children? a. Iron deficiency b. Food insecurity c. Skipping breakfast d. Bringing lunch from home

d. Cleanses out metabolic end products by promoting diuresis (CH 23 Krause, p. 439) The diuretic effect of caffeine can have a negative effect on the athlete by promoting excessive fluid losses and potential dehydration. High intake of caffeine before events is banned by the International Olympics Committee because of the benefits of conserving glycogen by promoting fatty acid mobilization, enhancing muscle contractility, and reducing fatigue.

Which of the following is NOT one of the benefits of caffeine use as an ergogenic aid? a. Enhances fatty acid mobilization b. Facilitates calcium transport in muscle contractility c. Reduces fatigue by reducing plasma potassium accumulation d. Cleanses out metabolic end products by promoting diuresis

Easier to change and update forms used for documentation (CH 10 Krause, pg 166) Customized screens and drop-down menus are easier to incorporate before the EHR is implemented for use in a health care system than later as changes require access to the programming. Many forms included have extraneous options for selection in documentation so as to limit the need for revisions. When EHR is available, the records are available through most of the health care system's computer access sites, thus eliminating the need for waiting for other health care providers to complete using the record. Because all documentation is typed, records are easier to read.

Which of the following is NOT one of the benefits of electronic health records? a. Easier accessibility for health care team members b. Improved legibility of documentation c. Easier to change and update forms used for documentation d. Increased efficiency in documentation and providing care

ANS: B Preterm infants require more nutrients and more calories than term infants to facilitate growth and help develop the nutrient stores that they lack. To allow for this, some premature formulas provide 24 kcal/oz to facilitate growth at intrauterine rates. MCT oil is one of the types of fat included in premature formula to help increase the calorie concentration of the formula. Also, to prevent potential hyponatremia, additional sodium is provided in premature formula. In regard to the protein content of premature formula, although more total protein is provided, premature formula provides a whey:casein ratio of 60:40, which is similar to that of standard formula. REF:p. 876 (Krause Ch 42)

Which of the following is NOT one of the characteristics that make premature infant formula different from standard infant formula? a. Premature infant formula may provide 24 kcal/oz. b. Premature infant formula provides more casein than whey protein. c. Premature infant formula provides MCT oil. d. Premature infant formula provides more sodium.

ANS: B HMG-CoA reductase is an enzyme necessary for cholesterol synthesis, and it is not involved with the urea cycle. The five enzyme deficiencies involved with urea cycle disorders include carbamyl-phosphate synthetase, ornithine transcarbamylase, argininosuccinate synthetase, argininosuccinate lyase, and arginase. REF: p. 891 (Krause CH 43)

Which of the following is NOT one of the enzyme deficiencies associated with urea cycle disorders? a. Ornithine transcarbamylase b. HMG-CoA reductase c. Carbamyl-phosphate synthetase d. Arginase

b. Diabetes (CH 20 Krause, pg 374) The four syndromes known to be predictive of adverse outcomes in older adults that are prevalent in patients with frailty (known as failure to thrive) include impaired physical functioning, malnutrition, depression, and cognitive impairment.

Which of the following is NOT one of the four syndromes known to be predictive of adverse outcomes in older adults? a. Depression b. Diabetes c. Cognitive impairment d. Malnutrition

ANS: A The most common abnormalities in infants born to mothers with PKU and elevated phenylalanine levels are mental retardation, microcephaly, heart defects, and retarded growth. The function of the liver has not been shown to be affected by fetal exposure to high levels of phenylalanine. REF: p. 900 (Krause Ch 43)

Which of the following is NOT one of the possible infant outcomes of PKU mothers with elevated phenylalanine levels? a. Liver dysfunction b. Microcephaly c. Congenital heart disease d. Low birth weight

ANS: B The Developmental Disabilities Assistance and Bill of Rights Act does not specify the etiology of mental and physical impairments. The impairments are what evidence the disability. Usually, developmental disabilities appear in infancy or childhood and continue to affect the person for a lifetime. Disabilities tend to promote functional limitations in various life activities such as self-care, receptive and expressive language, learning, mobility, self-direction, capacity for independent living, and economic self-sufficiency. REF:p. 909 (krause CH 44)

Which of the following is NOT one of the qualifications of developmental disabilities as established by law? a. Manifests before the age of 22 years b. Attributable to malnutrition that causes mental or physical impairment c. Results in substantial functional limitations in three or more areas of major life activity d. Expected to continue through life indefinitely

c. Healthy Eating Index (HEI) (CH 11 Krause, pg 174) The DRI Model includes four reference points—AI, EAR, RDA, and Upper Intake Level (UL). The HEI measures how well people's diets conform to recommended healthy eating patterns.

Which of the following is NOT part of the Daily Reference Intake (DRI)? a. Adequate Intake (AI) b. Estimated Average Requirement (EAR) c. Healthy Eating Index (HEI) d. Recommended Dietary Allowance (RDA)

a. Eat foods with prebiotics and probiotics. (CH 11 Krause, pg 183) The Universal Prescription for Health and Nutritional Fitness is a compilation of various guidelines that represents an overall pattern of eating. It makes statements that are very widely accepted to be true and does not include prebiotics or probiotics.

Which of the following is NOT part of the Universal Prescription for Health and Nutritional Fitness? a. Eat foods with prebiotics and probiotics. b. Drink fluoridated water. c. Eat fewer high cholesterol foods. d. Limit or omit high-sodium foods.

ANS: A By law, schools must offer special diets at no additional cost for children whose disabilities restrict their diets. In the language of the law, this actually includes modifications for children with diabetes and heart problems. For a referral to be made, a statement signed by a physician must be provided to the school. This request must identify the conditions that require the special diet, what foods need to be omitted, and what foods should be substituted. REF: p. 928 (Krause CH 44)

Which of the following is NOT required for a child with a disability to receive a modified or special diet at school? a. Payment of additional cost for the special diet b. Identification of the medical condition requiring modification of diet c. List of foods to be omitted from the child's diet d. List of food substitutions to use in the child's diet

c. It counteracts the effects of insulin. (CH 30 Krause, p. 587) Amylin, a glucoregulatory hormone, is also produced in the beta-cells of the pancreas and is cosecreted with insulin. It works in concert with insulin to regulate postprandial serum glucose levels and suppresses glucagon secretion.

Which of the following is NOT true about amylin? a. It is a glucoregulatory hormone. b. It is produced in pancreatic beta-cells. c. It counteracts the effects of insulin. d. Deficiency is associated with TIDM.

b. Advance to full liquid diet. (CH 27 Krause, p. 512) Nissen fundoplication is a surgical treatment for severe reflux esophagitis. The fundus or top portion of the stomach is wrapped 360 degrees around the lower esophagus. Recommendations after surgery are to start with clear liquid and advance to small meals of soft, most foods. Dry, hard foods such as meat, nuts, rolls and bread, and raw fruits should be avoided for 3 to 6 months. A full liquid diet is no longer recommended.

Which of the following is NOT true for diet recommendations after Nissen fundoplication? a. Start with clear liquid diet. b. Advance to full liquid diet. c. Consume multiple, small meals. d. Avoid dry, hard foods.

c. They encourage strict dietary control for diabetes and heart disease (CH 20 Krause, pg 378) The Dining Practice Standards were developed by a multidisciplinary group who wanted to improve the dining experience and nutritional care for elders living in long-term care. They were endorsed by the Centers for Medicare and Medicaid. The standards promote person-centered care, liberalized diets, and food first with less reliance on canned supplements.

Which of the following is NOT true of The Dining Practice Standards? a. Are guidelines for long-term care dining b. Recommend against canned nutrition supplements c. They encourage strict dietary control for diabetes and heart disease d. They are endorsed by the Centers for Medicare and Medicaid

It marks a point in the care of the patient that will extend their DRG. (CH 10 Krause, pg 163) A sentinel event has nothing to do with DRGs or reimbursement. It is an unanticipated event that involves death or serious physical or psychologic injury. The outcomes of this event must be documented in the medical record.

Which of the following is NOT true of a sentinel event? a. It is an unanticipated event that involves serious injury or death. b. It marks a point in the care of the patient that will extend their DRG. c. The outcomes of the event must be documented in the medical record. d. It can be psychologic injury.

All of the above. (CH 7 Krause, page 115-116) Bioelectrical impedance analysis (BIA) is a body composition analysis technique based on the principle that, relative to water, lean tissue has a higher electrical conductivity and lower impedance than fatty tissue because of its electrolyte content. BIA has been found to be a reliable measurement of body composition (fat-free mass and fat mass). The equipment needed is portable, and the method has been shown to be safe and noninvasive. For accurate results the patient should be well hydrated; have not exercised in the previous 4 to 6 hours; and have not consumed alcohol, caffeine, or diuretics in the previous 24 hours. If the person is dehydrated, a higher percentage of body fat than really exists is measured.

Which of the following is TRUE about bioelectric impedance analysis? a. It measures lean body tissue. b. It is noninvasive and portable. c. It is not accurate in a dehydrated individual. d. All of the above.

a. The patient is of normal or near normal weight. (CH 22 Kruase, pg 412) A person with bulimia nervosa is commonly within the normal weight range, although some may be slightly under- or overweight. A person with bulimia nervosa is very concerned about body shape and size. Binge eating, which involves short periods (usually 2 hours or less) of intake of large amounts of food, and purging behaviors are commonly used by a person with bulimia nervosa.

Which of the following is a characteristic of bulimia nervosa? a. The patient is of normal or near normal weight. b. The patient binges but does not purge. c. The patient does not have a body image problem. d. A typical binge lasts all day.

Accumulation of acids from abnormal metabolism (Ch 6, Krause) Metabolic acidosis is simply named for the production of acids through metabolic processes. Diabetic ketoacidosis and lactic acidosis are two conditions that lead to metabolic acidosis. Metabolic alkalosis results from an accumulation of bicarbonate. Respiratory acidosis results from retention of carbon dioxide, but respiratory alkalosis is associated with excessive carbon dioxide respiration. REF: p. 95

Which of the following is a characteristic of metabolic acidosis? a. Accumulation of bicarbonate b. Decreased ventilation and retention of carbon dioxide c. Accumulation of acids from abnormal metabolism d. Excessive loss of carbon dioxide from the lungs

b. Loss of height occurs(CH 24 Krause, p. 460) Type II osteoporosis, or age-related osteoporosis, usually occurs after 65 years of age and affects both men and women. Type II osteoporosis affects both trabecular and cortical bone. Fractures of the hip and vertebrae are the most common to occur with this type of osteoporosis. Because of the latter, a loss of height, spinal deformity, and dowager's hump occur.

Which of the following is a characteristic of type II, or age-related, osteoporosis? a. Occurs after 50 years of age b. Loss of height occurs c. Only affects trabecular bone d. Rarely occurs in males

a. Self-efficacy (CH 14 Krause, pg 229) Self-efficacy is a goal of counseling as behavior change can only occur if the client believes that he is capable of changing. Self-management is a technique used by a counselor that involves the client's decisions in facilitating change. Self-monitoring refers to any means by which a client records or tracks activity related to behavior change. Self-reflection is when the client is given the opportunity to think about and express thoughts related to behavior change.

Which of the following is a client's belief in his ability to carry out change? a. Self-efficacy b. Self-management c. Self-monitoring d. Self-reflection

b. Urticaria (Gould CH 8, pg. 145) - Urticaria is also known as hives, is an outbreak of swollen, pale red bumps or plaques (wheals) on the skin that appear suddenly -- either as a result of the body's reaction to certain allergens, or for unknown reasons.

Which of the following is a common effect of a type I hypersensitivity response to ingested substances? a. Contact dermatitis b. Urticaria c. Discoid lupus erythematosus d. Psoriasis

d. Pasteurization (Beerman CH 5, p. 210)

Which of the following is a common means of destroying the microorganisms that could be found in spices? a. Fermentation b. Cooking c. Drying d. Pasteurization

a. Ascites (CH 29 Krause, p 566) Portal hypertension occurs secondary to cirrhosis because of obstruction of blood flow through the liver. With a decreased production of albumin by the liver, the increased pressure within the circulatory system can force fluid into the peritoneal cavity, resulting in ascites development. Cardiac arrhythmias can be affected by changes in the blood pressure, but this is not specific to portal hypertension. Pulmonary complications can result from hepatitis.

Which of the following is a common sign of portal hypertension secondary to cirrhosis? a. Ascites b. Cardiac arrhythmias c. Increased gastrointestinal motility and peristalsis d. Pulmonary fibrosis

d. Barrett esophagus (CH 27 Krause, p. 511) Barrett esophagus is partly responsible for the development of adenocarcinoma of the esophagus, although esophageal cancer may develop in the absence of Barrett esophagus. GERD is also a risk factor for esophageal cancer; however, the condition does not necessarily involve the histologic changes seen in Barrett esophagus. An esophageal stricture may result from a variety of conditions that lead to decreased esophageal tone and narrowing of the esophageal lumen. Hiatal hernia involves an outpouching of the stomach through the diaphragm.

Which of the following is a condition involving the cells lining the distal esophagus becoming abnormal and premalignant? a. Gastroesophageal reflux disease b. Esophageal stricture c. Hiatal hernia d. Barrett esophagus

ANS: B Insensible water losses occur through the skin of premature infants because of increased permeability of the skin to water and larger body surface area relative to weight. However, these insensible losses can be increased or decreased depending upon how the infant is kept warm. Radiant warmers and phototherapy lights can increase insensible water losses and increase need for fluids. Heat shields, thermal blankets, and humidified incubators can decrease insensible water losses. REF:p. 870 (Krause Ch 42)

Which of the following is a fluid loss that is preventable in the care of low birthweight (LBW) infants? a. Insensible water loss caused by increased permeability of the skin b. Insensible water loss caused by radiant warmers c. Sensible water loss caused by an inability to concentrate urine d. Insensible water loss caused by a larger surface area relative to body weight

ANS: B Ch 7 Krause The percentage of glycosolated hemoglobin (hemoglobin A1C) in the blood is directly related to the average blood glucose levels for the preceding 2 to 3 months. Homocysteine and hs-CRP are two inflammatory markers, higher levels of which are associated with increased risk of cardiovascular disease. Apolipoprotein B is the part of the protein present in low-density lipoprotein, and it is also associated with increased risk of atherogenesis, possibly through its susceptibility to oxidation by ROS and lipid peroxides. REF: p. 109

Which of the following is a measure of glucose control? a. Highly sensitive C-reactive protein b. Hemoglobin A1C c. Homocysteine d. Apolipoprotein B

ANS: B Ferritin is the storage protein that sequesters the iron gathered in the liver, spleen, and marrow. Total-iron binding capacity is a direct measure of all proteins available to bind iron dependent on the number of free iron-binding sites on transferrin. Transferrin is the primary blood transport protein of iron. Hemoglobin is the oxygen-carrying protein in red blood cells and uses iron as a functional component. REF: p. 105 Ch 7 Krause

Which of the following is a measure of iron storage? a. TIBC b. Serum ferritin c. Transferrin d. Hemoglobin

Urinary creatinine (Ch 7 Krause pg 108) Urinary excretion of creatinine is related to the skeletal muscle or somatic protein; however, as the value can be affected by the intake of muscle meats, use of this measure is more limited to research. C-reactive protein is used as an indicator of inflammation. Retinol-binding protein may be used as an indicator of protein calorie malnutrition. Urinary methylmalonic acid is a sensitive indicator of vitamin B12 deficiency.

Which of the following is a measure of somatic protein status? a. C-reactive protein b. Retinol-binding protein c. Urinary methylmalonic acid d. Urinary creatinine

c. Tanner stages (CH 18 Krause, pg 332-333) Tanner stages are used to determine degree of sexual maturation during puberty. "Periods of adolescence" refers to the years in age during which cognitive and emotional development occur. Gynecologic age is a reference to the number of years between menarche and chronologic age. Peak gain velocity refers to linear growth only.

Which of the following is a method for rating sexual maturation? a. Periods of adolescence b. Gynecologic age c. Tanner stages d. Peak gain velocity

C-reactive protein (CH 7 Krause pg 103) Positive acute-phase respondents include C-reactive protein, alpha-1-antichymotrypsin, alpha-1-antitrypsin, fibrinogen, ferritin, and complement components C3 and C4, just to name a few. Interleukin-1 is one of the cytokines triggered by trauma that reorients hepatic synthesis of plasma proteins. Albumin and transthyretin (prealbumin) are both negative acute-phase proteins.

Which of the following is a positive acute-phase respondent? a. Interleukin-1 b. Albumin c. Transthyretin d. C-reactive protein

ANS: C For a school to receive federal cash reimbursement, it must serve a lunch that meets one-third of the RDAs for protein, iron, calcium, vitamin A, vitamin C, and calories as well as the Dietary Guidelines, and the school must offer free and reduced-price lunches to children whose families meet the income guidelines. Location of the school does not matter as much as the income of the families of students who attend the school. The school does not have to serve a minimum number of meals. REF: p. 144 Ch 9 Krause

Which of the following is a qualification for a school to receive federal cash reimbursement and food donations under the National School Lunch Program? a. The school must be located in a low-income urban area. b. The school must be located in a low-income rural area. c. The school must serve a lunch meeting specific nutritional requirements. d. The school must serve a minimum of 200 meals per day 5 days each week.

c. Polyps (CH 28 Krause, p. 549) Colorectal polyps are considered to be precursors of colon cancer. Inflammatory bowel disease is also a risk factor. Diets high in calories, fat, and animal protein and low in fruits, vegetables, and grains are associated with increased risk of colon cancer.

Which of the following is a risk factor for developing colon cancer? a. IBS b. Lactase deficiency c. Polyps d. Diverticulitis

c. In the refrigerator (beerman CH 5, p. 212)

Which of the following is a safe way to thaw frozen foods? a. In a warm (80°F) oven b. In a bowl of hot water c. In the refrigerator d. On the counter in a paper bag

DRG (Ch 10 Krause, pg 169) Utilization management uses established standards to identify tests, procedures, and services in health care that have known benefits toward patient improvement. The utilization manager reviews the case management of a patient to ensure that only approved activities that will help the patient are being performed. Patient-focused care is organized around the concept that the patient is the focus of the health care team, and the patient ultimately makes the decisions in regard to health care. Case management is the overall management organized around the achievement of patient health care goals. DRG is a system of paying for the care based on the diagnosis of the patient.

Which of the following is a system of paying for the care of a patient based on their diagnosis? a. Utilization management b. Patient-focused care c. Case management d. DRG

b. "Diets high in whole-grain foods and other plant foods and low in total fat, saturated fat, and cholesterol may help reduce the risk of heart disease and certain cancers." (Beerman CH 4, 126)

Which of the following is an FDA-approved health claim for fiber? a. "Diets low in fat and rich in high-fiber foods reduce the risk of heart disease." b. "Diets high in whole-grain foods and other plant foods and low in total fat, saturated fat, and cholesterol may help reduce the risk of heart disease and certain cancers." c. "Diets low in fat and rich in fruits and vegetables reduce the risk of most cancers." d. "Diets low in fat and rich in whole oats and psyllium seed husk reduce the incidence of heart disease."

Stop the feeding and irrigate the tube with water before and after administering the medication. (CH 8 Krause page 127) Because of the potential for physical incompatibilities that result in the clogging of a feeding tube, medications should not be mixed directly with feeding formula. Protocols should be established in regard to which medications may be administered through a feeding tube. In these protocols, specification should be included in regard to stopping the feeding administration, irrigating the feeding tube to ensure patency, administering the medication, and irrigating the tube again with water. Sudafed and Robitussin are two medications that could lead to clogging of the feeding tube.

Which of the following is an appropriate procedure for administering oral medications through a feeding tube? a. Stop the feeding and irrigate the tube with water before and after administering the medication. b. Mix the medications with water and add them to the feeding formula. c. Crush the medications, mix them with water, and then add them to feeding formula. d. Sudafed cough syrup and Robitussin expectorant may be added directly to the feeding formula.

c. Increase in LDL levels (CH 19 Krause, pg 358) Estrogen has a protective effect in regard to bone and cardiovascular health. When estrogen circulation decreases, an increase is seen in LDL levels. Estrogen plays a role in bone remodeling, and with loss of estrogen, a decrease in bone mass occurs. Decreased estrogen is associated with a decrease in HDL. Symptoms of menopause include a decrease in energy level.

Which of the following is an effect of the decreased circulation of estrogen associated with menopause? a. Increase in bone remodeling b. Increase in HDL levels c. Increase in LDL levels d. Increase in energy levels

c. Collagen (Beerman CH 5, p. 180)

Which of the following is an example of a structural protein? a. Hemoglobin b. Enzymes c. Collagen d. Glucagon

a. Trabecular bone (CH 24 Kruase, p. 456) Trabecular bone is the spongy bone that is found in the knobby ends of the long bones. Cortical bone, which consists of osteons or Haversian systems, is found in the shaft regions of the long bones

Which of the following is associated with the bone tissue at the end of the long bones? a. Trabecular bone b. Cortical bone c. Haversian systems d. Osteons

c. Choledocholithiasis (CH 29 Krause, p. 577) Choledocholithiasis occurs when stones slip from the gallbladder into the bile ducts. Cholangitis or inflammation of the bile ducts can occur as a result of choledocholithiasis. Cholecystitis is an inflammation of the gallbladder, which can also be caused by gallstones. Cirrhosis is the final stage of liver deterioration, which involves the scarring and formation of fibrous tissue that interferes with the liver's normal structure.

Which of the following is characterized by the presence of gallstones in the common bile duct? a. Cholangitis b. Cholecystitis c. Choledocholithiasis d. Cirrhosis

a. Vitamin K (CH 24 Kruase, p. 464) Vitamin K is involved in the posttranslational carboxylation process or maturation of osteocalcin. Vitamin D's role in bone formation is in regard to the adequate absorption of calcium from the gastrointestinal tract as well as the stimulation of osteoblast activity. Adequate vitamin A intake is necessary for the promotion of bone growth and maintenance. Vitamin E does not have a direct role in bone formation.

Which of the following is necessary for the maturation of osteocalcin? a. Vitamin K b. Vitamin D c. Vitamin E d. Vitamin A

c. Muscle wasting (CH 22 Krause, pg. 410) Loss of lean body mass and muscle wasting are common physical attributes in individuals with anorexia nervosa. Enamel wasting, esophagitis, and Russell sign (scarring of the dorsum of the hand) are signs that a person uses vomiting as a purging behavior. Although some people with anorexia nervosa may be of the binge eating and purging type, these signs are more commonly seen in people with bulimia nervosa.

Which of the following is often exhibited in patients with anorexia nervosa? a. Enamel wasting b. Esophagitis c. Muscle wasting d. Russell sign

b. Achieve blood glucose control. (CH 30 Krause, p. 605) The first MNT goal for all people with diabetes is to achieve and maintain normal blood glucose levels and lipid and lipoprotein profiles and blood pressure levels that reduce the risk for vascular disease. The other MNT goals include preventing or slowing the progression of chronic complications of diabetes mellitus, addressing the individual's nutritional needs, and limiting food choices only based on evidence while maintaining the pleasure of eating. Diabetes may affect children and pregnant women, and weight loss is not important to maintaining health in these population groups. Diabetes is associated with CVD risk and MNT but dietary cholesterol is no longer restricted for CVD prevention. Research evidence does not substantiate a recommendation to limit simple carbohydrate intake in the treatment of diabetes.

Which of the following is one of the ADA's MNT goals for all people with diabetes? a. Promote weight loss. b. Achieve blood glucose control. c. Limit dietary cholesterol. d. Limit intake of simple carbohydrates.

ANS: C MSUD is also known as branched-chain ketoaciduria, and this results from a defect in the branched-chain alpha-ketoacid dehydrogenase complex. The branched-chain amino acids—leucine, isoleucine, and valine—cannot be metabolized; therefore, affected persons require the use of specialty formulas that lack BCAAs. The BCAAs are slowly introduced into the diet when plasma leucine levels are decreased as they are necessary for growth to occur. However, dietary manipulation must occur so that enough BCAAs are available to support growth but not too high to increase plasma levels of the BCAAs. REF: p. 901 (Krause CH 43)

Which of the following is reduced in the diet in the treatment of maple syrup urine disease (MSUD)? a. Fructose b. Aromatic amino acids c. Branched-chain amino acids d. Sulfur-containing amino acids

Primary prevention (CH 9 Krause, pg 139) The traditional public health approach to health care is through health promotion at the primary prevention level. Secondary prevention focuses on risk appraisal and reduction before development of disease. Tertiary prevention focuses on treatment and rehabilitation to prevent the progression of disease or to reduce the debilitating consequences of the disease.

Which of the following is the focus of the traditional public health approach to health care? a. Primary prevention b. Secondary prevention c. Tertiary prevention d. Patient care

a. People get shellfish poisoning when they eat contaminated shellfish or fish. (Beerman CH 5, p. 206)

Which of the following is true? a. People get shellfish poisoning when they eat contaminated shellfish or fish. b. Some shellfish or fish cause illness by producing a marine toxin in the GI tract of humans. c. The marine toxin that contaminates fish or shellfish comes from E. coli. d.Contaminated fish or shellfish is easy to spot because of the iridescent color of the toxin.

microcytic anemia (CH 7 Krause page 105) Microcytic anemia is mostly associated with iron deficiency. Macrocytic anemia, which would be reflected by a high MCV value, is usually caused by either folate or vitamin B12 deficiency. Reticulocytes are large, nucleated, immature red blood cells that are released in small numbers with mature red blood cells. The presence of these may indicate erythropoiesis in response to blood loss, hemolysis, or iron, folate, or vitamin B12 therapies.

Which of the following manifestations will occur in iron deficiency anemia? a. Microcytic anemia b. Macrocytic anemia c. High reticulocyte count d. High MCV

c. Scheduling feeding time right after play or activity. (CH 17 Krause, pg 322) Preschoolers tend to not eat well when they are tired, so a short rest or quiet activity should be scheduled before feeding time. Young children eat better with reduced size utensils that are easier for them to hold. Young children avoid foods with temperature extremes, and they tend to not want to eat mixed foods or foods that touch each other on the plate.

Which of the following may cause a preschool child to eat less food at a meal? a. Providing the child with a short-handled spoon or fork. b. Providing food at a warm temperature, not too hot or cold. c. Scheduling feeding time right after play or activity. d. Serving foods so they do not touch one another on the plate.

ANS: C High blood glucose can promote dehydration in a premature infant because it can promote diuresis. The high concentration of glucose in the blood draws fluid from the cells and increases the blood volume. Increased renal perfusion stimulates the excretion of glucose and water through the kidneys, increasing the likelihood that the infant will develop dehydration. High cholesterol does not affect hydration status. Hypovolemia is another word for dehydration. REF:p. 872 (Krause. 42)

Which of the following may contribute to dehydration in a premature infant? a. Hypoglycemia b. Hypercholesterolemia c. Hyperglycemia d. Hypovolemia

d. Odynophagia (CH 25 Krause, p. 476) Oral candidiasis is a fungal infection that causes a burning sensation in the mouth that can lead to pain during chewing, sucking, or swallowing (odynophagia). Tooth loss results from poor oral care and trauma to the mouth. Dry mouth can be caused by use of medications, cancer treatments, and different medical conditions. Ulcers may form in the mouth as a result of viral infections such as herpes simplex or cytomegalovirus.

Which of the following may result from oral candidiasis? a. Tooth loss b. Dry mouth c. Ulcer formation d. Odynophagia

Digoxin (Lanoxin) (Ch 8 Krause ph 127) The phytates in bran bind with the drug digoxin leading to a loss of therapeutic effect. Various food components impair the absorption of alendronate, iron supplements, and ciprofloxacin. REF: p. 127

Which of the following medications should not be taken with foods that contain bran? a. Alendronate (Fosamax) b. Iron supplements c. Ciprofloxacin (Cipro) d. Digoxin (Lanoxin)

ANS: A Hereditary glucose intolerance is not a known metabolic disorder. Carbohydrate metabolism disorders include hereditary fructose intolerance, galactosemia, fructose 1,6-disphosphatase deficiency, and the various glycogen storage diseases. REF: p. 904

Which of the following metabolic disorders is NOT a disorder of carbohydrate metabolism? a. Hereditary glucose intolerance b. Glycogen storage disease c. Galactosemia d. Fructose 1,6-diphosphatase deficiency

ANS: D Argininosuccinic aciduria is a urea cycle disorder that results in arginine deficiency. Methylmalonic metabolic disorder and propionic disorder promote the development of metabolic acidosis through the accumulation of organic acids. Isovaleric disorder is also an organic acidemia; however, this disorder can produce metabolic ketoacidosis. REF: pp. 891-892 (Krause CH 43)

Which of the following metabolic disorders is NOT classified as an organic acidemia? a. Methylmalonic metabolic disorder b. Propionic metabolic disorder c. Isovaleric metabolic disorder d. Argininosuccinic aciduria

ANS: D Galactosemia is a disorder of carbohydrate metabolism, and although galactose is only available in the diet through dairy products, these are the only protein sources that need to be avoided. Argininemia is a urea cycle disorder, and as with all urea cycle disorders, a protein-restricted diet is necessary in treatment. Methylmalonic acidemia and ketone use disorder are both organic acidemia disorders. Patients with these disorders are treated with protein restriction because protein contributes more acids to the body than carbohydrates and fats. REF: p. 904 (Krause CH 43)

Which of the following metabolic disorders is NOT treated with a low-protein diet? a. Argininemia b. Methylmalonic acidemia c. Ketone use disorder d. Galactosemia

c. Double-blind, placebo-controlled food challenge (CH 26 Kruase, p 490) The DBPCFC is considered to be the gold standard for establishing a food and symptom relationship. The DBPCFC provides objective results because both the patient and physician are unable to detect differences between placebo foods and foods with the allergen of interest. The physician is on hand to monitor for allergic reactions. A single-blind food challenge may be useful because the person receiving the challenge does not know what is being offered. An open challenge is used as a follow-up to a DBPCFC that has negative results. An elimination diet may be used for diagnosis but takes extensive time to complete, taking weeks to complete instead of hours.

Which of the following methods is effective for diagnosis when symptoms are subjective or when multiple food allergies are suspected? a. Open food challenge b. Single-blind food challenge c. Double-blind, placebo-controlled food challenge d. Elimination diet

Α p. 292-294 (Gropper CH 8)

Which of the following methods of estimating energy expenditure does NOT require knowledge of the individual's age? a. doubly labeled water method b. Harris-Benedict prediction equation c. Mifflin-St. Jeor equation d.estimated energy requirement equation

b. Acetyl CoA (CH 23 Krause, p. 427) Beta oxidation of fatty acids produces acetyl CoA, which enters the mitochondria and goes through the Krebs cycle to produce ATP. Carbon dioxide is one of the end products of energy metabolism. Myoglobin acts within the muscle as an oxygen acceptor to hold a supply of oxygen readily available for use by the mitochondria. Lactic acid is a product of anaerobic glycolysis.

Which of the following molecules is required in mitochondria of muscle cells to use fatty acids as energy resources? a. Carbon dioxide b. Acetyl CoA c. Myoglobin d. Lactic acid

ANS: B Osteopenia of prematurity results from early birth because two-thirds of the calcium and phosphorus body content is accumulated in term infants during the last trimester of pregnancy. Prematurity results in lower calcium and phosphorus stores. Although both parenteral nutrition and human milk provide calcium and phosphorus, the amount of these nutrients is not enough to build up the stores in the infant. Parenteral nutrition cannot provide increased calcium and phosphorus because, at high levels, these can precipitate out into crystals that make the minerals unavailable to the infant and could block the access site. Human milk needs to be fortified to provide for the additional calcium and phosphorus needs of premature infants. REF: p. 874 (Krause CH 42)

Which of the following must be supplemented to preterm infants fed parenterally or fed human milk to prevent the development of osteopenia? a. Protein b. Calcium and phosphorus c. Vitamins A and D d. All fat-soluble vitamins

ANS: C Vitamin D functions as a prohormone with multiple roles, including hormone and immune modulation, antiinflammatory, and antitumor effects and apoptosis support. This suggests that vitamin D is able to physiologically contribute to the regulation of all immune responses, by means of the vitamin D receptor. REF: p. 40 Krause Ch 3

Which of the following nutrients may contribute physiologically to all immune responses? a. Vitamin E b. Vitamin C c. Vitamin D d. Folate

a. Iron (CH 19 Krause, pg 358-359) Unless men are diagnosed with iron deficiency anemia, they should avoid intake of additional iron. Excessive iron intake is problematic because it is an oxidant in the body. Lycopene is an antioxidant found in tomato products, pink grapefruit, and watermelon, and increased intake of lycopene has been reported as reducing the risk of prostate cancer. Anthocyanin is a flavonoid that has antioxidant properties, particularly in regard to reducing oxidation of LDL. Vitamin D intakes have been found to be deficient in much of the population, and supplementation is not considered to be a risk.

Which of the following nutrients should men avoid taking as supplements during their adult years? a. Iron b. Anthocyanin c. Lycopene d. Vitamin D

Negative acute-phase respondents decrease. (Ch 7, Kraues page 103) Negative acute-phase proteins are those that are negatively affected by trauma, meaning that their levels and production decrease in response to the trauma. These include albumin, transferrin, prealbumin, and retinol-binding protein. Positive acute-phase respondents are those that increase in levels and production in response to trauma.

Which of the following occurs during acute illness or trauma? a. Negative acute-phase respondents increase. b. Positive acute-phase respondents decrease. c. Negative acute-phase respondents decrease. d. Both positive and negative acute-phase respondents increase.

a. Salmonella spp. (CH 9 Krause, pg 152) The seven foodborne pathogens identified by the CDC as potential bioterrorist weapons are tularemia, brucellosis, Clostridium botulinum toxin, epsilon toxin of Clostridium perfringens, Salmonella spp., E. coli, and Shigella spp.

Which of the following pathogens has been identified by the CDC as potentially usable by bioterrorists? a. Salmonella spp. b. Staphylococcus aureus c. Bacillus cereus d. Listeria monocytogenes

a. 40-year-old man with a jejunal resection (CH 28 Krause, p. 550) Although most patients with significant bowel resection need parenteral nutrition initially to restore and maintain nutritional status, a patient with a jejunal resection adapts to enteral nutrition and oral diet more quickly after surgery because the ileum can adapt to perform the functions of the jejunum. Risk factors for dependence on long-term parenteral nutrition include elderly age, extensive removal of the ileum, loss of the ileocecal valve, and residual disease in the bowel (e.g., radiation enteritis).

Which of the following patients with small bowel resection is the LEAST likely to need long-term parenteral nutrition? a. 40-year-old man with a jejunal resection b. 20-year-old woman who had radiation enteritis before resection c. 60-year-old woman with an almost total ileal resection d. 50-year-old woman with the ileocecal valve removed

ANS: D Transitioning of feedings must be performed slowly to accommodate the LBW infant's ability to tolerate either feeding modality. If parenteral nutrition is the primary source of nutrition for the infant, parenteral nutrition must be maintained until the infant tolerates an adequate volume of enteral formula to maintain nutritional status. For VLBW infants, this process may take 7 to 10 days for the transition to occur. Stable infants may be able to tolerate enteral feeding advances of 20 to 30 ml/kg/day. Enteral feeding is never started at full volume because prior disuse of the gastrointestinal tract leaves it unprepared for mature digestion and absorption. Stopping parenteral nutrition completely may result in fluid and electrolyte imbalances and hypoglycemia. REF:p. 868 (Krause Ch 42)

Which of the following procedures should be used in the transition from parenteral to enteral feedings with an LBW infant? a. Advance to enteral feeding as quickly as possible. b. Begin full-volume enteral feeding. c. Stop parenteral feeding until enteral feeding is well established. d. Maintain parenteral feeding until enteral feeding is well established.

b. red blood cell folate (Gropper Chap 9, pg 347)

Which of the following reflects long-term folate status? a. serum folate b. red blood cell folate c. homocysteine concentration in blood d.serum methylmalonic acid

c. 20% of the adult height and 50% of the adult weight (CH 18 Krause, pg 332) Although there is great variability in timing of growth among adolescents, the average adolescent gains 20% of his or her adult height during puberty and 40% to 50% of adult body weight. The gain in weight accompanies the gain in height; however, weight gain tends to continue after linear growth has stopped.

Which of the following represents the growth experienced by a child during adolescence? a. 50% of the adult height and 20% of the adult weight b. 30% of the adult height and 30% of the adult weight c. 20% of the adult height and 50% of the adult weight d. 10% of the adult height and 20% of the adult weight

ANS: C The Health Insurance Portability and Accountability Act (HIPAA) of 1996 is the federal law that called for improved efficiency and privacy in regard to the use of electronic transmission of patient data. Through this, patient information is considered private and confidential, and all health care providers are responsible for ensuring this. The Joint Commission is a peer review organization that accredits health care organizations that are in compliance with minimum standards. Managed care organizations finance and provide care to subscribers of the service at a preset charge as a means of trying to control the costs of health care. The Centers for Medicare and Medicaid Services is the federal division responsible for the administration of Medicare, Medicaid, and HIPAA. REF: p. 167 CH 10 Krause

Which of the following requires that health care providers ensure the protection of their patients' privacy? a. TJC b. MCOs c. HIPAA d. CMS

Increased urinary calcium excretion (CH 6, Krause) Persistent excessive sodium intake has been associated with the development of hypertension and increased calcium excretion. Hypotension does not occur as result of decreased sodium intake. Muscle cramping is more associated with imbalances in calcium and magnesium intake. Increased urinary output of potassium is a common side effect of the use of loop diuretics for the control of hypertension and fluid volume. REF: p. 91

Which of the following results from ingesting a large amount of sodium in a short time? a. Hypotension b. Muscular cramps c. Increased urinary calcium excretion d. Increased urinary output of potassium

b. An initial rapid weight loss from diuresis (CH 21 Krause, 394) More than half of the weight loss associated with fasting is caused by loss of fluid and loss of lean body tissue. Because of this, fasting is seldom prescribed for weight loss. Excessive weight gain after refeeding can occur when weight loss is associated with a decrease in metabolic rate from the body adapting to starvation.

Which of the following results from the use of fasting as a means of weight loss? a. Excessive weight gain after refeeding b. An initial rapid weight loss from diuresis c. A decrease in ketone formation d. Carbohydrate craving

b. Short stature (CH 17 Krause, pg 317) Zinc is necessary for growth, and improving zinc intake has been beneficial in treating stunted growth and underweight in children. Children develop increased fat stores by taking in an excess of calories compared with energy needs. Chronic diarrhea may be associated with excess intake of fruit juices. Mental retardation may result from a number of nutrient deficiencies and from lead toxicity.

Which of the following results from zinc deficiency in a child's diet? a. Increased fat stores b. Short stature c. Chronic diarrhea d. Mental retardation

c. Drink at least 2 L of water each day. (CH 28 Krause, p. 528) A high-fiber diet of up to 25 g/day for women and 38 g/day for men should be eaten with the intake of 2 L or quarts of water each day to promote effectiveness of the diet. Intake of this amount entails the consumption of whole-grain bread and cereal products, vegetables, legumes, fruits, nuts, and seeds. These foods provide additional iron and vitamin C.

Which of the following should be included in the advice given to a patient regarding eating a high-fiber diet? a. Increase polyunsaturated fat intake. b. Make sure to get more vitamin C. c. Drink at least 2 L of water each day. d. Make sure to get more iron.

a. Furuncles (Gould CH 8, pg 148) - Furuncles also known as a boil, is a painful infection that forms around a hair follicle and contains pus - Verrucae is a contagious and usually painful wart on the sole of the foot; a plantar wart -Scabies is caused by an infestation of the skin by the human itch mite - Tinea is the name of a group of diseases caused by a fungus. Types of tinea include ringworm, athlete's foot and jock itch.

Which of the following skin lesions are usually caused by Staphylococcus aureus? a. Furuncles b. Verrucae c. Scabies d. Tinea

c. Most elderly live in nursing homes. (CH 20 Krause, pg 378) Most of today's elderly adults (95%) live someplace other than a nursing home. Women tend to outlive men, so there are more women alive than men at ages 85 years and older. Because of this, there are more women available for men to marry. In 1900, the life expectancy was into the 40s. Now life expectancy is 77 years.

Which of the following statements about elderly adults is FALSE? a. Among the oldest old, there are more women than men. b. More elderly men than women are married. c. Most elderly live in nursing homes. d. The life expectancy of older adults is greater than it was 100 years ago.

b. Upper body strength activities may improve overall BMD. (CH 24 Kruase, p. 460) Use of upper body strength activities has been shown to improve the BMD of the femur. Regular weight-bearing exercise seems to have little influence on BMD of older persons but is beneficial during periods of bone accumulation. Walking and swimming similarly do not provide benefit to bone health in elderly adults.

Which of the following statements about exercise and bone is TRUE? a. Regular weight-bearing exercise has little influence on BMD. b. Upper body strength activities may improve overall BMD. c. Walking several miles each day has a large impact on hip BMD. d. Swimming regularly has a large impact on vertebral BMD.

b. Specific carbohydrate foods can have a variable GI. (CH 30 Krause, pp. 595-6) The difficulty of working with the GI concept is that the GI of an individual food may vary. This is part of the reason that the ADA has not fully adopted GI and glycemic load as approaches to meal planning. Low-GI foods are those with a GI of less than 55. Selection of low-GI foods may help in fine-tuning postprandial glycemic response, but research presents inconsistent results in relation to overall glycemic control. Equal amounts of starch and sucrose result in identical glycemic responses. The GI of glucose is 100. The GI of white bread is 70

Which of the following statements about glycemic index (GI) is TRUE? a. Consuming low-GI meals (<70) improves overall glycemic control. b. Specific carbohydrate foods can have a variable GI. c. When compared with an equal amount of starch, sucrose promotes a greater glycemic response. d. The GI of glucose is lower than the GI of white bread.

c. It consists of proteins in the blood that must be activated. (Gould CH 7, pg .118)

Which of the following statements applies to the complement system? a. It is activated by IgE. b. It blocks the inflammatory response. c. It consists of proteins in the blood that must be activated. d. It may destroy antibodies in the circulation.

b. All members of a family have identical MHCs. (Gould CH 7, pg 114)

Which of the following statements does NOT apply to major histocompatibility complex (MHC) proteins or molecules? a. They are genes on chromosome 6. b. All members of a family have identical MHCs. c. They alert the immune system to virus-infected cells. d. A close match is essential for successful tissue transplants.

b. H. pylori is a viral infection found in the intestine. (CH 27 Krause, p. 515) Helicobacter pylori is a gram-negative bacterium that has been associated with increased risk of atrophic gastritis, peptic ulcer, and gastric cancer. Treatment of an infection usually involves a combination of antibiotics and acid suppression medications

Which of the following statements is NOT associated with Helicobacter pylori? a. H. pylori increases the risk of atrophic gastritis and gastric cancer. b. H. pylori is a viral infection found in the intestine. c. H. pylori is a bacterial infection found in the gastric mucosa. d. H. pylori infection may be treated with antibiotics and acid suppression therapies.

c. Antibodies in the blood indicate presence of virus and possible transmission to others. (Gould CH 7, pg. 134)

Which of the following statements is TRUE regarding a patient who is HIV positive? a. No medication is required until the CD4 cell count drops below normal range. b. Antibodies are present, destroying the virus and preventing transmission to others. c. Antibodies in the blood indicate presence of virus and possible transmission to others. d. Enzymes have not yet converted RNA to DNA for replication.

a. MCTs are rapidly hydrolyzed and absorbed in the absence of bile acids. (CH 28 Krause, p. 545) MCTs of 8 and 10 carbon length are short enough to be absorbed directly into portal circulation without relying on bile acids for micelle formation or pancreatic lipase for digestion. Because of these benefits, MCTs may be provided to patients experiencing fat malabsorption caused by various conditions. They are provided to the patient in either enteral formula or through the intake of MCT oil.

Which of the following statements is TRUE regarding medium-chain triglycerides (MCTs)? a. MCTs are rapidly hydrolyzed and absorbed in the absence of bile acids. b. MCTs require pancreatic lipase for digestion. c. MCTs must be administered intravenously in PN. d. MCTs are contraindicated in steatorrhea and other malabsorptive conditions.

a. In muscle contraction, the roles of calcium and magnesium are antagonistic, with calcium promoting the process and magnesium being the inhibitor. (Gropper Chap 11, pg 446)

Which of the following statements is true? a. In muscle contraction, the roles of calcium and magnesium are antagonistic, with calcium promoting the process and magnesium being the inhibitor. b. Magnesium promotes phosphorus absorption. c. Calcium and magnesium promote each other's reabsorption in the kidney. d.Calcium may cause an alteration in magnesium distribution by changing the flux of magnesium across the cell membrane or displacing it on its binding sites.

d. Infection rapidly causes extensive tissue necrosis and toxic shock. (Gould CH 8 pg. 149) - Necrotizing fasciitis is a Flesh-eating bacteria. It is a rare infection of the skin and tissues below it.

Which of the following statements regarding acute necrotizing fasciitis is TRUE? a. Infection is localized in a small area of the epidermis. b. It is usually caused by S. aureus. c. Spontaneous recovery usually occurs in 48 hours. d. Infection rapidly causes extensive tissue necrosis and toxic shock.

a. They consist of a unique sequence of amino acids. (Gould CH 7 pg. 117)

Which of the following statements regarding immunoglobulins is TRUE? a. They consist of a unique sequence of amino acids. b. They are produced in the red bone marrow. c. They are attached to mucosal membranes at entry points into the body. d. IgA binds to allergens.

c. Steatorrhea (CH 29 Krause, p. 571) Steatorrhea occurs as a result of inadequate production of pancreatic lipase. This results in malabsorption of fats, leading to excessive fat in the stool. Constipation may result from motility problems with the colon, but this is not affected by pancreatic function. Because vitamin A is a fat-soluble vitamin, deficiency caused by malabsorption is more likely to occur secondary to pancreatitis than a condition of hypervitaminosis. Serum ammonia levels increase as a result of impaired liver function.

Which of the following symptoms appears when pancreatitis progresses to where the ability to secrete a sufficient quantity of enzymes is impaired? a. Constipation b. Hypervitaminosis A c. Steatorrhea d. Elevated serum ammonia

c. Establish an action plan. (CH 14 Krause, pg 232) During the ready-to-change session, the goal should be to work with the patient to set goals for change that include a plan of action. Eliciting self-motivational statements is used for the patient in the precontemplation stage to help create awareness of an existing problem in the patient. Negotiation for change occurs in the unsure-about-change session. Developing discrepancy is an activity used by the counselor throughout the counseling process that helps the patient identify the benefits and disadvantages of the behavior change.

Which of the following techniques is appropriate for use with a patient ready to change behavior? a. Elicit self-motivational statements. b. Negotiate change. c. Establish an action plan. d. Develop discrepancy.

b. Willingness to try new foods (CH 17 Krause, pg 323) Eating with other children affects food attitudes and choices. This can be both negative and positive. On the negative side can be the development of food refusals and behaviors associated with meal time. On the positive side, children who see other children trying different foods will be more willing to try the new foods as well. Children cannot differentiate foods based on nutritional value, so they cannot self-select nutritious foods over nonnutritious foods. Table manners are generally dictated by an adult influence.

Which of the following tends to be a positive development in childhood eating habits that can result from peer influences? a. Selection of nutritious versus nonnutritious foods b. Willingness to try new foods c. Table manners d. Adequate time to eat

a. Genetic theory (CH 20 Krause, pg 369) Predetermination theories of aging focus on a built-in mechanism that determines when aging and death will occur. The genetic theory explains that life span is determined by heredity, and thus this falls into the predetermination theory category. Another class of theories is the accumulated damage theories. These describe aging as a process in which the body's systems break down over time because of damage. Wear and tear, free radical, and somatic mutation theories identify different ideas behind how this damage occurs.

Which of the following theories of aging is a predetermination theory? a. Genetic theory b. Wear and tear theory c. Free radical theory d. Somatic mutation theory

d. Cross-link theory (CH 20 Krause, pg 369) Accumulated damage theories describe aging as a process in which the body's systems break down over time because of damage. The cross-link theory is one of these because it describes aging changes as results of inappropriate cross-links in protein, DNA, and structural molecules that inhibit the normal functions of the body. Predetermination theories of aging focus on a built-in mechanism that determines when aging and death will occur. Rate of living, pacemaker (or biologic clock), and immune system theory all focus on predetermined programming that leads to aging.

Which of the following theories of aging is an accumulated damage theory? a. Rate of living theory b. Pacemaker theory c. Immune system theory d. Cross-link theory

c. Supplements are used more frequently by people who read food labels. (CH 12 Krause, pg 195) Dietary supplement use is more frequent among people of better health, including those with BMIs below 25 kg/m2, nonsmokers, those who are physically active, and those who use food labels in making healthy eating decisions. Dietary supplement use increases with advancing age, white race, and women.

Which of the following trends regarding use of dietary supplements is TRUE? a. Supplements are used more frequently by younger as opposed to older adults. b. Supplements are used more frequently by minorities than whites. c. Supplements are used more frequently by people who read food labels. d. Supplements are used more frequently by people with BMIs above 25 kg/m2.

d. Structure-function claims (CH 12 Krause, pg 196) Structure-function claims were developed under DSHEA to provide for label statements that address physiologic effects of product content in supplements. This was a compromise with the supplement industry so that the supplement producers did not have to provide documented evidence to support health claims. The problem with these claims is that consumers cannot distinguish between these and health claims. Authoritative statements were established under the FDA Modernization Act of 1997 to allow for health claims based on published statements from authoritative organizations. Both health and nutrition claims were established under the Nutrition Labeling and Education Act of 1990.

Which of the following types of claims was first established under DSHEA? a. Authoritative statements b. Health claims c. Nutrition claims d. Structure-function claims

c. Replacing full calorie drinks with zero-calorie substitutes (CH 21 Krause, pg. 393) Artificial sweeteners and fat substitutes improve the acceptability of limited food intakes for some people (see Chapters 3 and 30). However, there is no evidence that using artificial sweeteners reduces food intake or results in weight loss, and they are not recommended by the NWCR.

Which of the following was NOT recommended by the National Weight Control Registry (NWCR) as a method to maintain weight? a. Eating a relatively low-fat (24%) diet b. Eating breakfast almost every day c. Replacing full calorie drinks with zero-calorie substitutes d. Engaging in high levels (60-90 min/day) of physical activity

ANS: D Phenylketonuria (PKU) is characterized by phenylalanine not being converted to tyrosine. As tyrosine is an end product of the metabolic process, insufficiency of tyrosine does not lead to PKU development. PKU may develop through the lack of three different enzymes. The classic PKU involves a deficiency of phenylalanine hydroxylase and prevents the conversion of phenylalanine to tyrosine. A deficiency of dihydropteridine reductase prevents the conversion of quinonoid (qBH4) to tetrahydrobiopterin (BH4), which is the cofactor in the phe to tyr conversion. BH4 is produced from biopterin precursor. Biopterin may be limited because of deficiency of a biopterin synthetase. REF: p. 894 (KrauseCH 43)

Which of the following will NOT result in the development of phenylketonuria? a. Deficiency in phenylalanine hydroxylase b. Deficiency in dihydropteridine reductase c. Insufficient synthesis of biopterin d. Insufficiency of dietary tyrosine

a. Decreased serum hemoglobin (CH 15 Krause, pg 243) As the blood volume expands by 50% during pregnancy, this results in a dilution of blood constituents, such as serum hemoglobin, albumin, and other blood proteins. This also promotes an increase in glomerular filtration rate; however, the kidneys do not increase the volume of urine excretion. Proteinuria occurs when damage occurs to the basement membrane of the glomerulus. Some glucosuria may occur because of decreased efficiency in renal tubule reabsorption during pregnancy but not to the level of promoting hypoglycemia. Constipation is more likely to occur when inadequate water is taken in by the pregnant woman.

Which of the following will result from the normal physiologic adaptation during pregnancy? a. Decreased serum hemoglobin b. Proteinuria c. Hypoglycemia d. Constipation

c. Fresh ground turkey (CH 11 Krause, pg 184) The Nutrition Labeling and Education Act excludes foods prepared on site such as bakery and deli items and raw foods such as meat and produce.

Which of the following would NOT be required to have a nutrition label? a. Canned corn b. Hot dogs c. Fresh ground turkey d. American cheese

ANS: B Krause CH 7 A CBC panel focuses on the analysis and descriptions of the red blood cells, including hemoglobin, hematocrit, and mean cell volume (the size of the red blood cells). Glucose, total cholesterol, and albumin are values on a common serum chemistry or blood panel.

Which of the following would be included in a complete blood count? a. Total cholesterol b. Mean cell volume c. Glucose d. Albumin

a. The skin and soft tissue are exposed at the fracture site. (Gould CH 9, 164)

Which of the following would identify an open or compound fracture? a. The skin and soft tissue are exposed at the fracture site. b. A bone is crushed into many small pieces. c. The bone appears bent with a partial fracture line. d. One end of a bone is forced into an adjacent bone.

d. accumulation of 5-methyl THF (Gropper Chap 9, pg 350-351)

Which of the following would you find under B12-deficient conditions and the methyl trap hypothesis? a. accumulation of 5-methylene THF b. depletion of homocysteine c. accumulation of THF d. accumulation of 5-methyl THF e.more than one of the above

c. Large meals, fatty foods, and alcohol (CH 29 Krause, pp. 582-583) For both chronic and acute pancreatitis, the introduction of food should be done in a manner to minimize pain, nausea, and vomiting. Smaller meals with minimal fat content are better tolerated and less likely to promote symptoms. Alcohol is avoided because it is commonly associated with the development and progression of pancreatitis.

Which of the following, when consumed by a patient with chronic pancreatitis, may cause symptoms to worsen? a. Fried foods, foods with a high sucrose content, and caffeine b. Carbohydrates, low-fat dairy products, and coffee c. Large meals, fatty foods, and alcohol d. Red meat, sweets, and coffee

b. High-fat foods (CH 29 Krause, p. 577) A diet limited in fat is used when a patient has cholecystitis because fat intake stimulates the contraction of the gallbladder. When this occurs, the patient experiences pain. Presence of fat in the bowel stimulates release of cholecystokinin, which triggers the release of bile acids from the gallbladder.

Which of the following, when eaten by a patient with cholecystitis, may cause pain? a. High-protein foods b. High-fat foods c. Complex carbohydrates d. Simple carbohydrates

b. Sodium, chloride, potassium (Beerman, 12)

Which of the major minerals function primarily in maintenance of fluid balance? a. Calcium, phosphorus, magnesium b. Sodium, chloride, potassium c. Chloride, potassium, calcium d. Phosphorus, chloride, sodium

a-Calcium, phosphorus, magnesium (Beerman, 12)

Which of the major minerals function together to form and strengthen the structure of the skeleton? a. Calcium, phosphorus, magnesium b. Sodium, chloride, potassium c. Chloride, potassium, calcium d. Phosphorus, chloride, sodium

c. active transport Gropper Ch 2 page 52

Which of the mechanisms responsible for absorption of nutrients into the epithelial cell of the villus requires energy? a. diffusion b. facilitated diffusion c. active transport d.pinocytosis

d. proteins (Gropper CH 12, pg 470)

Which of the physiological buffers has the most potent buffering capacity? a. bicarbonate-carbonic acid system b. hydrochloric acid system c. phosphates d. proteins

c. butyric (Gropper CH 4, pg 125)

Which of the volatile short-chain fatty acids is said to have antineoplastic properties affecting colorectal cancer? a. acetic b. propionic c. butyric d.capric

d.B12 (Gropper Chap 9, pg 356)

Which of the water-soluble vitamins is able to be stored and retained in the body for long periods of time? a. folic acid b. niacin c. thiamin d.B12

It increases as a result of fetal growth and maternal cardiac output. (CH 2, Krause) pg 18 Hormonal changes that occur during pregnancy support the changes in the maternal body to support the growth of the fetus. These changes include the growth of metabolically active tissue in the uterus, placenta, and fetus. Additionally, blood volume is increased, and cardiac workload increases. Because the metabolic rate is dependent on metabolically active tissues, as these increase and the heart's work increases, the overall metabolic rate increases.

Which of these best describes the change in the metabolic rate during pregnancy? a. It decreases as a result of a decrease in maternal physical activity. b. It increases as a result of fetal growth. c. It increases as a result of fetal growth and maternal cardiac output. d. It decreases as a result of an increase in maternal adipose tissue.

c. alcohol dehydrogenase (Gropper CH 5, pg 176)

Which of these enzymes is the primary system for oxidizing alcohol after 1 drink? a. catalase b. microsomal ethanol oxidizing enzyme c. alcohol dehydrogenase d.aldehyde carboxylase

Emergency Food and Shelter Program (CH 9 Krause pg 146-147) The Emergency Food and Shelter Program is funded through the Federal Emergency Management Agency to aid those in need in response to disaster. This program provides persons in need with funds to acquire food and temporary shelter. The CACFP, CSFP, and TEFAP are all FNS programs through USDA.

Which of these food programs is NOT funded through the USDA Food and Nutrition Service? a. Child and Adult Care Food Program b. Commodity Supplemental Food Program c. Emergency Food Assistance Program d. Emergency Food and Shelter Program

a. Peanuts (Beerman CH 5, p. 202)

Which of these foods are most likely to be contaminated with Aspergillus mold? a. Peanuts b. Fresh dairy products c. Aged cheeses d. High-acid canned foods

c. Add peanut butter when eating crackers.(CH 25 Krause, p. 471) Xerostomia is a condition of dry mouth. Usually this results from a lack of or decrease in salivation that can occur from the use of medications or from medical conditions such as uncontrolled diabetes mellitus and several autoimmune conditions. Sticky foods such as peanut butter should be avoided.

Which of these is NOT a recommendation for people with xerostomia? a. Drink water with lemon. b. Chew xylitol-containing gum. c. Add peanut butter when eating crackers. d. Eat moist foods.

a. Hispanic ethnicity (CH 24 Krause, p. 459) People of European and Asian ethnicity experience more osteoporotic fractures than Blacks or Hispanics, who usually have a greater bone density. Cigarette smoking is a risk factor, probably because of toxic effects on bone. Young women with the female athlete triad of disordered eating, amenorrhea, and low BMD are at increased risk of having fractures.

Which of these is NOT a risk factor for developing osteoporosis? a. Hispanic ethnicity b. European or Asian ethnicity c. Cigarette smoking d. Female athlete triad

b. Peripherally inserted central catheter (CH 13 Krause, pg 218) PICC lines are inserted into a vein in the antecubital area of the arm and threaded into the subclavian vein, allowing greater mobility for the patient and decreased infection risk. Tunneled versions of single- or multiple-lumen catheters into the subclavian or the external jugular vein are also types of long-term access. Peripheral IV catheters and single-lumen, nontunneled catheters placed in the subclavian or internal or external jugular veins are also short-term catheters.

Which one of these routes of parenteral access is considered long term? a. Peripheral intravenous catheter b. Peripherally inserted central catheter c. Single-lumen catheter inserted into the subclavian vein d. Catheter inserted into the external jugular vein

a. hypothalamus and kidney (Gropper CH 12, pg 458)

Which organs are responsible for regulation of extracellular water osmolarity and volume? a. hypothalamus and kidney b. liver and pancreas c. pancreas and kidney d.spleen and bone marrow

d. Small intestine and kidneys (Beerman, CH 12)

Which organs regulate, either individually or collectively, the amount of each major mineral in the body? a. Small intestine and liver b. Large intestine and liver c. Large intestine and kidneys d. Small intestine and kidneys

a. Isothiocyanates (CH 19 Krause, pg 361) Isothiocyanates promote the production of phase II enzymes in the liver biotransformation system. Carotenoids, phytic acid, and phenols all have antioxidant properties that are protective of different tissues and cells throughout the body.

Which phytochemicals are thought to promote the detoxification systems of the body? a. Isothiocyanates b. Carotenoids c. Phytic acid d. Phenols

d. Fermentation (Beerman Ch 5, p. 209)

Which preservation method is represented by the following foods: sauerkraut, yogurt, and wine? a. Canning b. Cooking c. Pasteurization d. Fermentation

a. Amylopectin (Beerman CH 4, pgs. 123,124)

Which starch consists of glucose molecules bonded together in a highly branched arrangement? a. Amylopectin b. Soluble fiber c. Amylose d. Insoluble fiber

A p. 521 (Gropper CH 13)

Which statement about selenium metabolism is true? a. Free selenide can be converted into selenophosphate. b. Selenocysteine is degraded to yield selenomethionine. c. Dietary selenocysteine can be utilized directly to produce selenium-dependent enzymes. d.Significant cellular damage occurs only with complete cessation of selenoprotein synthesis.

c. Diabetics who correctly follow all the guidelines for managing their disease are guaranteed success in controlling their blood glucose levels. (Beerman CH 4, p. 157)

Which statement is false? a. The medical expenses of diabetes are about 2.3 times higher than those of non-diabetics. b. Managing diabetes requires difficult lifestyle changes, and often the assistance of medical professionals who specialize in diabetes care. c. Diabetics who correctly follow all the guidelines for managing their disease are guaranteed success in controlling their blood glucose levels. d. Living with diabetes can take an emotional as well as a physical and financial toll on an individual.

c. myenteric plexus Gropper Chapter 2 page 34, 56

Which structural component of the gastrointestinal tract is within the muscularis externa and controls the contractions that cause motility? a. muscularis mucosae b. submucosal plexus c. myenteric plexus d. lumen

Pharmacokinetics (Ch 8 Krause, page 122) Pharmacokinetics focuses on the time course of a drug through the body. Pharmacodynamics focuses directly on the drug's effect on the body. Pharmacogenomics involves the study of genetic variations that are affected by drugs. Polypharmacy refers to the use of multiple drugs, which could lead to interactions and have additional consequences in regard to health. REF: p. 122

Which term is used to describe the movement of a drug through the body by absorption, distribution, metabolism, and excretion? a. Pharmacodynamics b. Pharmacogenomics c. Pharmacokinetics d. Polypharmacy

d. Visceral (Beerman CH 6, p. 230)

Which term refers to body fat or adipose tissue that is found around the vital organs? a. Subcutaneous b. Hidden c. Concealed d. Visceral

a. Food biosecurity (Beerman CH 5, p. 213)

Which term refers to the prevention of terrorist attacks on our food supply? a. Food biosecurity b. Food security c. Food anti-terrorism d. Bioterrorism preparedness

c. niacin, biotin, pantothenic acid (Gropper Chap 9, pg 332)

Which three vitamins are involved in the synthesis of fatty acids? a. biotin, vitamin D, thiamin b. thiamin, riboflavin, niacin c. niacin, biotin, pantothenic acid d.riboflavin, B12, folate

d.skeletal muscle CH 3 Gropper, page 97

Which tissue has the least activity of the pentose phosphate pathway? a. liver b. adrenal cortex c. mammary gland d.skeletal muscle

B- Heart (Beerman, CH 12)

Which tissue is especially susceptible to the effects of magnesium deficiency? a. Liver b. Heart c. Kidneys d. Lungs

a. alpha (Gropper Chap 10, pg 400, 401)

Which tocopherol form provides the most vitamin E activity in the U.S. food supply? a. alpha b. beta c. gamma d.delta

a. An adherence ruler (CH 14 Krause, pg 235) An adherence ruler or scale used in coordination with the question, "On a scale from 1 to 12, how ready are you right now to ___?" is adequate to establish readiness to change. A food diary and food models can help identify eating habits, but in the case of a food diary, often clients do not have the training necessary to produce one for the first session. Weighing the patient provides a baseline, and repeated weighings can help demonstrate progress, but weight change is not always the desired result of nutrition counseling.

Which tool can be used to assess a client's readiness to change? a. An adherence ruler b. A food diary c. A weight scale d. Food models

d. Phosphorus (CH 13 Krause, pg 222) When refeeding syndrome occurs, serum levels of phosphorus, potassium, and magnesium fall below normal levels, resulting in the electrolyte imbalances associated with refeeding syndrome. As a patient's stores of these nutrients may be depressed after extended time without eating, infusion of glucose contributes to further decreasing blood levels of these minerals as they are shifted into cells with glucose. Potential cardiac and pulmonary complications can be avoided by supplementing the patient with phosphorus, potassium, and magnesium and by limiting the initial amounts of glucose administered when feeding resumes.

Which trace element needs to be initially given at higher levels when there is a risk of refeeding syndrome? a. Zinc b. Copper c. Chromium d. Phosphorus

A p. 505 (Gropper CH 13)

Which trace mineral participates in the greatest number of enzyme systems? a. zinc b. iron c. selenium d.copper

c. Cortisol and epinephrine (Beerman CH 4, pg 141)

Which two hormones are released by the adrenal glands in the fight-or-flight response? a. Glucagon and cortisol b. Insulin and cortisol c. Cortisol and epinephrine d. Epinephrine and insulin

c. calcium, phosphorus (Gropper Chap 11, pg 432)

Which two minerals are the major part of the crystal, hydroxyapatite, formed in ossification of bone? a. sodium, chloride b. sulphur, magnesium c. calcium, phosphorus d.calcium, potassium

d. Cerebral beriberi (Beerman chapter 10, pg 427)

Which type of beriberi is also called Wernicke-Korsakoff syndrome? a. Dry beriberi b. Wet beriberi c. Infantile beriberi d.Cerebral beriberi

ANS: D Spastic cerebral palsy (CP) is characterized by increased muscle tone and increased deep tendon reflexes that lead to hemiplegia, diplegia, or quadriplegia. Ataxic CP is characterized by abnormalities in voluntary movements and balance. People with dyskinetic CP experience uncontrolled and continuous involuntary movements in the body because of abnormal muscle tone. Athetoid dyskinetic CP is demonstrated in people with normal intelligence by difficulty in walking, sitting, or speaking clearly. REF: p. 910 (Krause CH 44)

Which type of cerebral palsy is characterized by paralysis on one side of the body, in the legs, or in all four extremities? a. Ataxic cerebral palsy b. Athetoid dyskinetic cerebral palsy c. Dyskinetic cerebral palsy d. Spastic cerebral palsy

ANS: D A diet for diabetes may modify the regular hospital diet by rearranging the number or frequency of meals so as to promote blood glucose control in relation to patient activity and medication provision. A high-fiber diet is a diet modified in consistency for increased fiber. A sodium-restricted diet is a diet modified by a decrease in sodium. An allergy diet is a diet that calls for the elimination of specific foods or food substances. REF: p. 170 Ch 10 Krause

Which type of diet reflects a modification of the regular hospital diet by rearrangement of the number or frequency of meals? a. High-fiber diet b. Sodium-restricted diet c. Allergy diet d. Diet for diabetes

Autosomal recessive diseases (ch 5, krause) Autosomal recessive diseases are the most common as two copies of an abnormal autosomal allele are necessary for the phenotype to be expressed. Both autosomal and X-linked dominant diseases only need one abnormal allele for expression to occur. An X-linked recessive condition could only occur in a woman if she inherits two copies of the recessive trait. Because males only have one X chromosome, if the recessive trait is present, it will be expressed. REF: p. 75

Which type of disorders are the most common of the mendelian inherited disorders? a. Autosomal recessive diseases b. Autosomal dominant diseases c. X-linked dominant diseases d. X-linked recessive diseases

ANS: B Before the 2000 version, the focus of the Dietary Guidelines for Americans was on the prevention of chronic disease; however, because of concerns regarding foodborne illness outbreaks, food safety was included in the 2000 and 2005 versions. Food safety continues to be a concern because many Americans eat away from home, and inappropriate food handling is the means by which food becomes contaminated. REF: p. 145 Ch 9 Krause

Which version of the Dietary Guidelines for Americans was the first to include food safety? a. 2005 b. 2000 c. 1980 d. 1977

d.cholecalciferol - vitamin D3 (Gropper Chap 10, pg 391)

Which vitamin D molecule would you expect to see in fortified foods? a. ergocalciferol - vitamin D2 b. calcidiol - 25-OH D3 c. calcitriol - 1,25-OH2 D3 d.cholecalciferol - vitamin D3

c. Choline (Beerman chapter 10, pg 449)

Which vitamin acts more as a conditionally essential nutrient than an essential nutrient? a. Folate b. Vitamin C c. Choline d.Niacin

b. Riboflavin (Beerman chapter 10, pg 429)

Which vitamin can be converted to a coenzyme that is needed to activate vitamin B6? a. Thiamin b. Riboflavin c. Niacin d.Pantothenic acid

d. Vitamin C (Beerman chapter 10, pg 445)

Which vitamin can be made from glucose in all plants and most animals, but not in humans? a. Niacin b. Vitamin B12 c. Vitamin B6 d.Vitamin C

c. Vitamin C (Beerman chapter 10, pg 426)

Which vitamin can counteract the "antithiamin factors"? a. Niacin b. Biotin c. Vitamin C d.Folate

b. Vitamin B12 (Beerman chapter 10, pg 443)

Which vitamin cannot be made by plants or higher animals? a. Thiamin b. Vitamin B12 c. Vitamin B6 d.Folate

b. Folate (Beerman chapter 10, pg 438)

Which vitamin consists of a nitrogen-containing double ring structure, a nitrogen-containing single ring structure, and a glutamic acid? a. Biotin b. Folate c. Pantothenic acid d.Vitamin B12

d. vitamin A (Gropper Chap 10, pg 383)

Which vitamin directs cellular differentiation of epithelial cells? a. riboflavin b. vitamin K c. vitamin E d.vitamin A

b. Vitamin C (Beerman chapter 10, pg 447)

Which vitamin enhances the absorption of iron? a. Folate b. Vitamin C c. Vitamin B6 d.Niacin

c. E (Gropper Chap 10, pg 406)

Which vitamin is associated with improved plasma membrane structure and glucose transport/metabolic control in people with type 2 diabetes? a. A b. D c. E d.K

c. vitamin D (Gropper Chap 10, pg 394)

Which vitamin is believed to function like a steroid hormone? a. choline b. vitamin A c. vitamin D d.vitamin E

c. Vitamin B6 (Beerman chapter 10, pg 435)

Which vitamin is involved in producing nonprotein substances such as the neurotransmitters serotonin and dopamine? a. Vitamin B3 b. Vitamin B5 c. Vitamin B6 d.Vitamin B12

d.vitamin B6 (Gropper Chap 9, pg 361)

Which vitamin is most involved in amino acid metabolism? a. biotin b. vitamin E c. vitamin A d.vitamin B6

d. Vitamin C (Beerman chapter 10, pg 445)

Which vitamin is not a coenzyme? a. Niacin b. Vitamin B12 c. Vitamin B6 d.Vitamin C

d.Vitamin B5 (Beerman chapter 10, pg 434)

Which vitamin is required for synthesizing heme, a portion of hemoglobin found in blood? a. Vitamin B1 b. Vitamin B2 c. Vitamin B3 d.Vitamin B5

b. A (Gropper Chap 10, pg 384)

Which vitamin is said to be essential for growth and immune system function? a. K b. A c. D d.E

C p. 511 (Gropper CH 13)

Which vitamin may enhance copper reduction? a. niacin b. biotin c. ascorbic acid d.β-carotene

b. Vitamin C (Beerman chapter 10, pg 445)

Which vitamin requires glucose transport proteins for absorption? a. Folate b. Vitamin C c. Vitamin B6 d.Vitamin B12

d. Folate and vitamin B12 (Beerman chapter 10, pg 440)

Which vitamins are required for the production of methionine from homocysteine? a. Thiamin and vitamin B12 b. Niacin and vitamin B6 c. Vitamin B6 and vitamin B12 d. Folate and vitamin B12

a. Thiamin, niacin, riboflavin, and folate (Beerman chapter 10, pg 422)

Which vitamins must be added to a food for it to be labeled "enriched"? a. Thiamin, niacin, riboflavin, and folate b. Thiamin, B6, riboflavin, and folate c. Thiamin, niacin, pantothenic acid, and folate d.Thiamin, B12, riboflavin, and folate

c. propionic (Gropper CH 4, pg 123)

Which volatile short-chain fatty acid is believed to lower serum cholesterol by acting as an inhibitor of cholesterol biosynthesis? a. acetic b. butyric c. propionic d.palmitic

c. Biotin (Beerman chapter 10, pg 436)

Which water-soluble vitamin can be produced by bacteria in the large intestine? a. Vitamin B6 b. Niacin c. Biotin d.Vitamin B12

c. vitamin C (Gropper Chap 9, pg 312)

Which water-soluble vitamin contributes to "intracellular cement" in the formation of scar tissue and wound healing? a. thiamin b. riboflavin c. vitamin C d.vitamin B12

d. Men in their late 40s (CH 19 Krause, pg 352) According to the Dietary Guidelines for Americans, men older than 45 years of age and women older than 55 years of age receive the most benefit from limited alcohol intake. Among younger adults, the benefit of reducing risk of cardiovascular disease is offset by the increased risk of accidents resulting from alcohol abuse.

Who may benefit the most from the light to moderate intake of alcohol in reducing the risk of cardiovascular disease? a. Men in their late 30s b. Women in their 20s c. Women in their late 40s d. Men in their late 40s

Answer (key points): Symptoms are caused by high levels of blood glucose. The kidneys work overtime drawing water out of the blood to filter excess glucose out of the blood. This results in frequent urination, dehydration, and thirst. Glucose can't get into the cells to nourish the cells, so the person feels hungry and weak (fatigued) because the cells are starving for energy. (Beerman CH 4, pp. 149-150)

Why are extreme thirst, hunger, frequent urination, and fatigue symptoms of diabetes?

b. They promote saliva flow. (CH 25 Krause, p. 470) Foods that require chewing stimulate saliva production, which then reduces the cariogenicity of the meal by cleansing the teeth. This leads to a decrease in fermentable carbohydrate and reduced oral acidity.

Why are foods that require a lot of chewing effective in promoting good dental health? a. They cleanse the tooth surface. b. They promote saliva flow. c. They lower the acidity level of the mouth. d. They decrease the fermentation of carbohydrate.

Answer (key points): Fiber contains β-glycosidic bonds that are resistant to digestive enzymes, so fiber passes intact (undigested) through the small intestine to the large intestine. Intestinal bacteria break down the fiber, producing gas, lipids, and other substances that nourish the cells that line the colon. Fiber prevents the overgrowth of unhealthy (pathogenic) bacteria by promoting the growth of healthy bacteria. (Beerman CH 4, pp. 125-126)

Why are humans unable to digest fiber, and why is this beneficial?

c. Their renal concentrating ability is less than that of older children. (CH 16 Krause, pg 301) Under normal conditions, breastmilk and formula provide infants with adequate water. However, if formula is boiled, water evaporation can lead to concentration of formula solids. This places stress on the immature kidneys of the infant. This is also why providing commercially prepared adult foods to an infant could be problematic—the higher sodium concentration of these foods could exceed the infant's renal solute load. Infants should be monitored when they live in hot, humid conditions and when they have episodes of diarrhea or vomiting. Watching for the number of wet diapers is one of the ways to do this.

Why are infants particularly susceptible to developing dehydration? a. Their mass-to-surface ratio is low. b. Their insulation is poor, resulting in increased water loss. c. Their renal concentrating ability is less than that of older children. d. The increased liquidity of their stools results in greater fluid loss.

nswer (key points): Plants that produce legumes are unique in that their roots are associated with bacteria that can take nitrogen from the air and incorporate it into amino acids. These amino acids are then used by the associated plant. This is why legumes tend to be better sources of protein than most other plants. (Beerman CH 5, p. 165)

Why are legumes better sources of protein than most other plants?

Answer (key points): The Diabetes Control and Complications Trial (DCCT) provided evidence that maintaining blood glucose levels as close to normal as possible can prevent many of the long-term complications associated with type 1 diabetes. Similarly, the United Kingdom Prospective Diabetes Study provided evidence that controlling blood glucose within near-normal ranges could help reduce long-term complications associated with type 2 diabetes. (Beerman CH 4, pp. 151, 154)

Why are near-normal glucose levels recommended as a treatment goal for people with diabetes?

a. Muscle contractions can activate movement of glucose transporters from the cytoplasm to the cell membrane (Beerman CH 4, pg. 138)

Why are skeletal muscle cells able to take up glucose without insulin during exercise? a. Muscle contractions can activate movement of glucose transporters from the cytoplasm to the cell membrane. b. The cell membranes of muscle cells contain glucose receptors. c. Muscle cells can take up glucose without insulin. d.Muscle cells do not depend on glucose transporters for uptake of glucose.

c. Malabsorption of calcium, zinc, and magnesium (CH 28 Krause, p. 550) The increase in renal oxalate stone formation resulting from ileal resection occurs because of impaired bile salt reabsorption. The ileum is the primary site of bile salt reabsorption, and without it, bile salts are eliminated instead of recycled. This leads to a decrease in bile secretion, which impairs lipid digestion and absorption. The resultant increase in fatty acids in the bowel can combine with divalent cations such as calcium, zinc, and magnesium to form insoluble soaps. Normally, these cations would be free to bind with oxalate to prevent colonic absorption of oxalate. However, with the divalent cations already bound as soaps, the colonic absorption of oxalate increases.

Why do renal oxalate stones form as a consequence of ileal resection? a. Inadequate intake of dietary fiber and water b. Malabsorption of fat-soluble vitamins c. Malabsorption of calcium, zinc, and magnesium d. Malabsorption of vitamin B12 and intrinsic factor complex

b. Entry of resident flora while scratching the lesion (Gould CH 8, pg. 148) - Pruritus or itch is defined as an unpleasant sensation of the skin that provokes the urge to scratch

Why do secondary infections frequently develop in pruritic lesions? a. Loss of protective sebum b. Entry of resident flora while scratching the lesion c. Blockage of sebaceous glands d. Increased sweat production

Answer (key points): Symptoms are easily ignored until more advanced. Symptoms tend to develop gradually: e.g. fatigue, frequent urination, and excessive thirst. Diagnosis usually occurs when symptoms such as blurred vision, frequent urinary tract infections, slow wound healing, or vaginal itching become pronounced. (Beerman CH 4, p. 154)

Why do so many cases of type 2 diabetes remain undiagnosed?

d. Decreased motility in the large intestine (CH 20 Krause, pg 371) Constipation involves a reduction of bowel movements, and one potential reason is a decrease in the motility in the large intestine. The longer intestinal contents remain in the colon, the more water is absorbed and the harder the stool is to transit and eliminate. Delayed transit time, medications, and reduced stimulation of the gut through reduced physical activity all contribute to the development of constipation.

Why does constipation occur in elderly adults? a. Increased motility in the small intestine b. Decreased motility in the small intestine c. Increased motility in the large intestine d. Decreased motility in the large intestine

Answer (key points): Irradiation of foods damages or kills bacteria, making foods safer to eat. Irradiation dramatically increases shelf life. Irradiation neither damages nutrients nor makes the foods radioactive. Irradiated foods must be labeled with the radura symbol. (Beerman CH 5, p. 210)

Why is irradiation used for food preservation, and why is it considered safe?

Answer (key points): Since the brain and other components of the nervous system rely heavily on glucose as their main energy source, it is critical to maintain blood glucose levels. Insulin and glucagon, while they have the opposite effect, work together to maintain blood glucose levels and energy stores. Insulin functions to facilitate the uptake of glucose into cells, thus lowering blood glucose levels. Insulin promotes energy storage in the form of glycogen and fat. Glucagon acts in opposition to insulin. Glucagon stimulates the breakdown of glycogen stores, ultimately resulting in an increase in blood sugar. (Beerman CH 4, pp. 136-140)

Why is it important that blood glucose levels be regulated, and how is this accomplished?

Answer (key points): Parasites called protozoa form cysts that are excreted in the feces of animals. Any plants, animals, or water sources that come in contact with these cysts will become contaminated too. People and animals that drink contaminated water will likely develop foodborne illness. Boiling, chemically treating, or filtering the water, however, can kill or remove the parasites. (Beerman CH 5, p. 204)

Why is it important to boil, chemically treat, or filter water from ponds, streams, and lakes before drinking it?

a. It has receptors on the nucleus and causes a change in protein synthesis. (Gropper Chap 10, pg 382-383)

Why is retinoic acid considered a hormone? a. It has receptors on the nucleus and causes a change in protein synthesis. b. It has a biologic function similar to insulin. c. It is synthesized in the same tissue that it affects. d. It causes the catabolism (break down) of body proteins.

nswer (key points): Mercury is a protein denaturing agent. It can disrupt disulfide bonds and thus the tertiary structure of proteins. High levels of mercury exposure can cause numbness, hearing loss, visual problems, difficulty walking, and severe emotional and cognitive difficulties. The potential for damage due to exposure to mercury is highest for growing fetuses and young children. (Beerman CH 5, p. 173-174)

Why is the level of mercury in fish an important health and nutrition issue?

Answer (key points): Since there is no vaccine to prevent infection, virtually everyone is susceptible, and the key is to avoid exposure to these viruses. Norovirus infection can be prevented by following all of the food safety guidelines—such as preventing food service workers who are ill from having any role in food preparation and service; having all of those who come into contact with food wash their hands frequently; sanitizing food preparation and service utensils; cooking foods properly; and holding and serving foods at proper temperatures. Unfortunately, the way food is handled and served in a buffet increases the patrons' risk. Self-service buffets are susceptible to norovirus contamination from not only food preparers but also from other patrons who may be ill and contaminate the food that others will consume. Particularly risky habits include having hand to mouth contact while serving yourself. This happens if people "taste" foods while serving themselves. Patrons may not have washed their hands before handling serving utensils, which can easily make contact with the yet-to-be-consumed food. (Beerman CH 5, pp. 202-203, 208, 211-212)

Why might patrons at self-service buffets be vulnerable to foodborne illnesses caused by a norovirus?

Answer (key points): Physical activity may trigger your body to become more efficient in its use of amino acids and proteins, resulting in decreased protein turnover and ultimately a decreased requirement for dietary protein. (Beerman CH 5, p. 190)

Why might physical activity, and especially resistance exercise, actually decrease a person's dietary protein requirements?

a. High levels of NADH produced by ADH shift the direction of the lactate dehydrogenase reaction. (Gropper CH 5, pg 177)

Why might someone who is drunk have high blood lactate levels? a. High levels of NADH produced by ADH shift the direction of the lactate dehydrogenase reaction. b. High levels of NADH produced by the MEOS stimulate lactate dehydrogenase activity. c. Consuming calorie-yielding compounds and not providing enough oxygen to cells increases anaerobic respiration. d.Reducing equivalents inhibit the synthesis of lactic acid and increase the synthesis of acetaldehyde.

d. The infant has no immunity to the botulism spore that may be present. (CH 16 Krause, pg 302) Honey may be a carrier of Clostridium botulinum spores, which can reproduce and make toxins that can cause death. The spores are resistant to heat treatment and are not destroyed by current processing methods. Infants are born with a preferential taste for sweets; therefore, providing sweet foods will not necessarily exert a craving for more. The simple carbohydrates in honey are digestible by infants. Only water, breastmilk, and rice cereal should be mixed with infant formula—nothing else.

Why should honey NOT be used in home-prepared formulas for infants? a. The added sweetener will cause the infant to crave sweets. b. The sugars present cannot be digested by the infant. c. The honey will settle out in the formula and cause a curdled appearance. d. The infant has no immunity to the botulism spore that may be present.

d. It is associated with lower intakes of iron and linoleic acid. (CH 16 Krause, pg 303) Cow's milk is a poor source of both iron and linoleic acid. Protein and other nutrients in cow's milk increase the renal solute load, placing stress on the infant's kidneys. Also, the protein in cow's milk may cause gastrointestinal bleeding in the infant, promoting an increased need for iron. Use of whole milk for feeding young children has not been demonstrated to promote obesity.

Why should whole cow's milk NOT be given to infants younger than 1 year of age? a. It decreases the renal solute load. b. It can lead to obesity in toddlers. c. It lacks the anti-infective quality of formulas. d. It is associated with lower intakes of iron and linoleic acid.

Answer (key points): Proteins are involved in regulation of how acidic or basic body fluids are. One way that blood pH is maintained is through the buffering action of proteins such as hemoglobin. Amino acids can readily accept and donate charged hydrogen ions. When the hydrogen ion concentration in the blood is too high (acidic), negatively charged proteins can bind excess hydrogen ions, restoring the blood to its proper pH. Conversely, proteins can release hydrogen into the blood when the hydrogen concentration is too low (basic). As a result of its reliance on protein buffers, the body can have difficulty maintaining its optimal pH balance during periods of severe protein deficiency. (Beerman CH 5, pp. 183, 193)

Why would you expect children suffering from PEM to have difficulty maintaining a normal blood pH?

Cytosine-guanine (ch 5, Krause) ANS: D In DNA, only two potential base pairings are possible: adenine with thymine and cytosine with guanine. In RNA, uracil may take the place of thymine to be paired with adenine.

Within a strand of DNA, which of the following nucleotide base pairing is possible? a. Adenine-guanine b. Cytosine-thymine c. Adenine-uracil d. Cytosine-guanine

b. contains white blood cells and protects against ingested microorganisms. Gropper Chapter 2 page 34

Within the lamina propria, lying just below the epithelium, is the mucosa-associated lymphoid tissue, which a. controls secretions from the mucosal glands. b. contains white blood cells and protects against ingested microorganisms. c. initiates peristalsis. d. secretes mucus, hormones and digestive juices into the lumen.

a. Within 2 hours (CH 26 Krause, p. 486) Anaphylactic reactions to food usually occur within the first 2 hours after exposure. These are usually IgE-mediated allergies. Chronic and relapsing forms of food allergies may take more than 2 hours because they tend to be either a mix of IgE- and cell-mediated reactions or nonIgE- and cell-mediated reactions. A food-dependent, exercise-induced anaphylaxis is a particular type of physical allergy that occurs within 2 hours of rigorous activity after eating a specific food that is normally tolerated.

Within what frame of time is the onset of symptoms related to a food allergy most likely to occur? a. Within 2 hours b. Within 2 to 14 hours c. More than 24 hours d. More than 48 hours

c. be under-hydroxylated (Gropper Chap 9, pg 312)

Without enough vitamin C, collagen would _____. a. be too tightly coiled b. be over-hydroxylated c. be under-hydroxylated d.too strong and less flexible

d. type 2 diabetes (Beerman CH 4, p. 157)

Women who develop gestational diabetes are at increased risk for developing _____. a. gallbladder disorders b. kidney failure c. type 1 diabetes d. type 2 diabetes

c. No—β-carotene supplements may be harmful to smokers and are their use is not advised for the general public. (Gropper Chap 10, pg 386, 389)

Would you recommend β-carotene supplementation to a smoker to decrease risk to lung cancer? a. Yes—β-carotene can quench singlet oxygen. b. Yes—smoking increases free radical formation; β-carotene can decrease free radicals. c. No—β-carotene supplements may be harmful to smokers and are their use is not advised for the general public. d.No—β-carotene supplements can cause a vitamin A toxicity and liver cirrhosis.

c. epidemiologic study. CH 1 Beerman page 15

You are involved in a study observing the eating and health behaviors of African Americans across the United States. You are conducting a(n): a. Hawthorn study. b. intervention study. c. epidemiologic study. d.cell culture study.

a. Formula lacks some of the conditionally essential long-chain polyunsaturated fatty acids (PUFAs) (Beerman CH 6 ,p. 228)

You are observing an outpatient dietitian working in a busy prenatal clinic. Which of the following reasons is justification for promoting breastfeeding over formula feeding? a. Formula lacks some of the conditionally essential long-chain polyunsaturated fatty acids (PUFAs) b. Formula provides too much of the conditionally essential long-chain PUFAs c. Formula provides too much of the conditionally essential monounsaturated fatty acids (MUFAs) d. Formula lacks some of the conditionally essential MUFAs

e. b and c (Beerman CH 4, p 147)

Your child was just diagnosed with type 1 diabetes mellitus. She presented with the following symptom(s): a. weight gain. b. weight loss. c. extreme thirst. d. a and b e. b and c

a. severe muscle wasting. (Beerman chapter 10, pg 427)

Your patient's intake of thiamin is severely low. Deficiency is characterized by: a. severe muscle wasting. b. inflammation of the mouth. c. severe skin irritation. d.severe diarrhea.

a. <100 mg/ dL. (Beerman CH 4, p 152)

Your physician has just reported that your fasting glucose is within the normal range. It is: a. <100 mg/ dL. b. <150 mg/dL. c. <200 mg/dL. d.<250 mg/dL.

C p. 508 (Gropper CH 13)

Zinc is important for taste perception as a component of _____. a. carbonic anhydrase b. alcohol dehydrogenase c. gustin d.thionein

d. Enteric toxins (Beerman CH 5, p. 202)

_____ are harmful substances produced by organisms after they enter the gastrointestinal tract.

d. Minerals (Beerman CH 5, p. 172)

_____ are often contained in the prosthetic groups needed for some proteins to function. a. Vitamins b. Enzymes c. Lipids d. Minerals

a. Impaired thermoregulation (CH 23 Kruase, p. 437) Adequate fluid replacement is necessary to maintain body temperature. When fluid is not replaced, the body's core temperature can increase, promoting heat stress. Replacement of electrolytes should accompany fluid replacement because sodium and potassium are both lost through sweat. Calcium balance is maintained through adequate intake of calcium from food sources. Cerebral edema and bradycardia occur in situations of fluid overload. With decreases in body water, the kidneys conserve fluid as opposed to promoting elimination. Osmotic diarrhea may occur if highly osmotic fluids, such as apple juice, are used for fluid replacement.

________ can be the result of inappropriately low fluid replacement after athletic competition. a. Impaired thermoregulation b. Decreased calcium levels and fatigue c. Cerebral edema and bradycardia d. Diuresis and osmotic diarrhea

b. Glutamine (CH 28 Krause, p. 551) Glutamine is the preferred fuel for small intestinal enterocytes and thus may be valuable in enhancing adaptation. Short-chain fatty acids (e.g., butyrate) produced from microbial fermentation of carbohydrate and fibers are the major fuels of colonic epithelium.

__________ is the preferred fuel for the small intestinal enterocytes and is considered important to adaption after bowel resection. a. Glucose b. Glutamine c. MCT d. Butyrate

b. Headache, flushing, abdominal pain, and nausea (CH 26 Kruase, p 488) Adverse reactions to MSG include headache, nausea, flushing, abdominal pain, and asthma occurring several hours after ingestion. Symptoms related to nonimmunologic reactions to other food additives include hives, rash, and asthma in response to FD&C yellow #5, benzoic acid, and sodium benzoate and acute asthma and anaphylaxis or loss of consciousness in response to various sulfite additives

hat symptoms are likely to occur in the person with a perceived intolerance to monosodium glutamate (MSG)? a. Decreased heart rate, constipation, and hives b. Headache, flushing, abdominal pain, and nausea c. Steatorrhea, edema, proteinuria, and nausea d. Anaphylaxis, toxic shock syndrome, and headache

c. prions (Beerman CH 5, pl 205)

lthough not living organisms, _____ are altered proteins created when the secondary structure of the normal protein is disrupted. a. amines b. peptides c. prions d. priamines

Lipitor (CH 8 Krause pg 129) Statin drugs, such as Lipitor, are also known as HMG-CoA reductase inhibitors. They affect the formation of CoQ10 and the result is decreased circulating levels. Methotrexate is a folic acid antagonist. Cholestyramine absorbs fat-soluble vitamins, and carbamazepine affects the metabolism of biotin, vitamin D, and folic acid.

upplementation of coenzyme Q10 (CoQ10) should be considered in a patient taking which drug? a. Carbamazepine b. Methotrexate c. Lipitor d. Cholestyramine

D p. 537 (Gropper CH 13)

A key enzyme in liver urea production requires four _____ atoms per molecule. a. iron b. copper c. zinc d.manganese

Answer: protein (Beerman CH 5, p. 163)

A_______________ is a nitrogen-containing macronutrient made from amino acids.

c. 11% (Beerman CH 4, p. 147)

According to the Centers for Disease Control and Prevention, what percentage of the U.S. adult population has diabetes? a. 3% b. 5% c. 11% d.19%

b. the same amount of (Beerman CH 5, p. 189)

According to the DRI committee, people who participate in high levels of exercise need _____ protein on a body-weight basis as compared to those who do not participate in high levels of exercise. a. less b. the same amount of c. more (but not significantly more) d. significantly more

c. 25 to 35 lb (CH 15 Krause, pg 263) Women with BMIs between 18.5 and 24.9 before conception are considered to be of normal weight and are advised to gain between 25 and 35 lb during the course of the pregnancy. Underweight women who start their pregnancies with a BMI under 18.5 are advised to gain 28 to 40 lb. Women with a prepregnancy BMI of 25 to 29.9 are advised to gain 15 to 25 lb. No standard is established for women who are obese. Women giving birth to twins should gain from 40 to 45 lb during pregnancy.

According to the National Academy of Sciences, women with normal preconception weight should gain how much during pregnancy? a. 10 to 15 lb b. 20 to 25 lb c. 25 to 35 lb d. 35 to 45 lb

c. the control of the hydrogen ion concentration in body fluids. (Gropper CH 12, pg 469)

Acid-base balance refers to a. the ratio of acidic and basic foods consumed each day. b. the concentration of the bicarbonate ion in the red blood cells. c. the control of the hydrogen ion concentration in body fluids. d.homeostasis.

b. Liver glycogen (Beerman CH 4, 125)

Amy got up late this morning so she skipped breakfast and went straight to her soccer practice. Which fuel source is her body relying upon to supply the glucose that her brain needs to function? a. Fatty acids b. Liver glycogen c. Glycolysis d. Muscle glycogen

c. a linear chain of glucose (Beerman CH 4, p. 124)

Amylose is _____, unlike amylopectin. a. a branched chain of glucose b. not absorbed by the body c. a linear chain of glucose d. found in the liver

d. Up to 40 lb (CH 18 Krause, pg 348) Before her pregnancy, this girl's BMI would be interpreted as underweight; therefore, she should attempt to gain from 28 to 40 lb, with a goal toward the upper part of the range. A BMI over 29 would require a weight gain of 15 lb. For a BMI between 26.1 and 29, the goal would be the upper end of the 15- to 25-lb range. For a normal BMI of 19.8 to 26, the goal would be the upper end of the 25- to 35-lb range.

An adolescent female of gynecologic age of 3 years becomes pregnant. Her prepregnancy BMI was 19.0. According to the IOM, how much weight should she try to gain during her pregnancy? a. 15 lb b. Up to 25 lb c. Up to 35 lb d. Up to 40 lb

ANS: B Genetic metabolic disorders are mostly autosomal recessive inherited disorders that affect metabolic processes in the body through the absence or reduced activity of specific enzymes. In these metabolic disorders, body functions may become impaired by buildup of certain proteins that did not undergo conversion because of deficiency of the enzyme or lack of the end product of metabolism because of the missing enzyme. REF:p. 890 (Kraus Ch 43)

An appropriate description of a metabolic disorder is an autosomal recessive disorder that a. involves amino acids. b. results in the reduced activity or absence of a specific enzyme. c. occurs because the body cannot use dietary amino acids, fatty acids, or monosaccharides. d. results in the buildup of metabolites in the blood, urine, or both.

c. diets low in sodium may reduce the risk of high blood pressure. (CH 11 Krause, pg 186) A health claim is allowed only on appropriate food products that meet specified standards. The government requires that healthy claims be worded in ways that are not misleading. A claim cannot imply that the food product itself helps prevent disease. Grapefruit helping burn calories is misleading as is the statement that eating fish can improve immunity. Health benefits of fish are specific to levels of omega-3 fat contained in the fish.

An example of an approved health claim is: a. acai berries help prevent cancer. b. grapefruit can assist in weight loss because it helps burn calories. c. diets low in sodium may reduce the risk of high blood pressure. d. eating fish meals twice a week can improve immunocompetence.

a. greater (Gropper Chap 10, pg 389)

An individual with poor vitamin A status would have a _____ RDR than someone with a good vitamin A status. a. greater b.lesser

decreased bioavailability caused by change in gastrointestinal pH. (CH 8 Krause, pg 127) Changes in gastrointestinal pH may occur because of the use of antacids, H2-receptor antagonists, and proton pump inhibitors because these drugs inhibit gastric acid secretion or alter the pH of the stomach. An acidic pH is necessary for the absorption of vitamin B12. However, acidic pH is also necessary for the oxidation of various minerals to improve their bioavailability and absorption. Increasing the gastrointestinal pH may decrease the absorption of these minerals.

Antacids, H2-receptor antagonists, and proton pump inhibitors affect the absorption of calcium, iron, and magnesium through a. decreased bioavailability caused by change in gastrointestinal pH. b. decreased bioavailability caused by inhibition of small intestine enzymes. c. decreased bioavailability caused by damage to the intestinal mucosa. d. increased bioavailability caused by change in gastrointestinal pH.

b. gluconeogenesis (Gropper Chap 9, pg 362)

B6-dependent transamination reactions are important in which process? a. glyconeogenesis b. gluconeogenesis c. heme synthesis d.more than one of the above

less than 23 (Ch 7 Krause, pg 113) Differences in race, sex, and age must be considered when evaluating the BMI. BMI values tend to increase with age, yet the relationship between BMI and mortality appears to be U-shaped in adults aged 65 and older. The risk of mortality increased in older adults with a BMI of less than 23.

BMIs of _______ are associated with increased risk of mortality in those 65 and older. a. less than 23 b. less than 18.5 c. greater than 24.9 d. there is no association between BMI and risk of mortality

d. Sodium, chloride (Beerman, 12)

Baby Ann, age 9 months, is vomiting and has diarrhea. This can be life threatening because of the losses of water and which two minerals? a. Sodium, magnesium b. Magnesium, potassium c. Chloride, phosphorus d. Sodium, chloride

a. enzymes (Beerman FCH 4, pg. 125)

Because humans lack the _____ needed to digest two of the oligosaccharides commonly found in dried beans, soybeans, peas, and lentils, these foods are fermented by bacteria in the large intestine. a. enzymes b. gastric acid c. raffinose d. stachyose

a. phospholipids (Beerman CH 6, pp. 232, 233)

Because lipids are not water soluble, they require _____ to facilitate their circulation in the body. a. phospholipids b. sodium c. bile acids d. cholesterol esters

c. 45 (Beerman CH 4, p. 151)

Because of the high prevalence of type 2 diabetes, the American Diabetes Association is recommending that all adults be screened for type 2 diabetes beginning at what age? a. 35 b. 40 c. 45 d. 50

c. inhibiting osteoclasts. (CH 24 Kruase, p. 465) Alendronate sodium, risedronate sodium, and zoledrosonic acid, which are bisphosphonates, are approved for the prevention of osteoporosis, especially for postmenopausal women. The bisphosphonates act as inhibitors on osteoclasts to reduce bone resorption.

Bisphosphonates treat osteoporosis by a. stimulating estrogen production. b. increasing calcium absorption. c. inhibiting osteoclasts. d. inhibiting phosphorus absorption.

a. scurvy. (Beerman chapter 10, pg 448)

Bleeding gums, skin irritations, bruising, and poor wound healing are signs and symptoms of a condition called: a. scurvy. b. beriberi. c. pellagra. d.ariboflavinosis.

ANS: B Down syndrome and Prader-Willi syndrome are both genetic disorders and the cause of autism has yet to be identified, but the neural tube defect associated with spina bifida can be prevented by adequate maternal intake of folic acid. REF: p. 919 (krause Ch 44)

By current methods, which developmental disorder is preventable? a. Down syndrome b. Spina bifida c. Autism d. Prader-Willi syndrome

b. parathyroid hormone, calcitonin, and calcitriol. (Beerman, 12)

Calcium homeostasis is regulated by: a. calbindin, calitonin, and parathyroid hormone. b. parathyroid hormone, calcitonin, and calcitriol. c. calcitriol, calbindin, and calcitonin. d. calcitriol, calbindin, and parathyroid hormone.

Based on the information provided, what vitamin deficiency do the signs and symptoms suggest? a. B1 b. B2 c. B3 d.B6 What could be the cause? a. Poor dietary intake b. Alcohol abuse c. Thyroid disease d.All of the above What might be another sign that the MD may report upon examining John, or a symptom that you would expect John to complain of? a. Enlarged and inflamed tongue (glossitis) b. Rough, red skin that eventually turns dark c. Bleeding gums d.Fishy body odor Which of the following diagnoses best fits the description? a. Pernicious anemia b. Wernicke-Korsakoff syndrome c. Pellagra d.Ariboflavinosis Based on the information provided, what vitamin(s) would you recommend supplementing? a. B1, B2, B3, & folate b. B1, B3, B12, & choline c. B1, B2, B6, & vitamin C d.All of them What food(s) would provide the most significant source of the vitamin missing in his diet? a. Dairy products b. Fish c. Legumes d.Pork (Beerman chapter 10, pg 428-429)

Case Study 10-A: John is a 52-year-old factory worker. He has been admitted to the hospital and presents with muscle weakness and inflammation of his mouth. He is a bit confused and states that he isn't drinking now although he has a history of alcohol abuse. He has lost quite a bit of weight in the last six months, and his dietary intake has been poor. He was laid off a year ago but he is back to work part-time. Further testing has been ordered to determine the cause for concern and confirm the diagnosis. Based on the information provided, what vitamin deficiency do the signs and symptoms suggest? a. B1 b. B2 c. B3 d.B6 What could be the cause? a. Poor dietary intake b. Alcohol abuse c. Thyroid disease d.All of the above What might be another sign that the MD may report upon examining John, or a symptom that you would expect John to complain of? a. Enlarged and inflamed tongue (glossitis) b. Rough, red skin that eventually turns dark c. Bleeding gums d.Fishy body odor Which of the following diagnoses best fits the description? a. Pernicious anemia b. Wernicke-Korsakoff syndrome c. Pellagra d.Ariboflavinosis Based on the information provided, what vitamin(s) would you recommend supplementing? a. B1, B2, B3, & folate b. B1, B3, B12, & choline c. B1, B2, B6, & vitamin C d.All of them What food(s) would provide the most significant source of the vitamin missing in his diet? a. Dairy products b. Fish c. Legumes d.Pork

a. Vitamin D and calcium (Beerman, 12)

Children are likely to develop rickets if their diet provides insufficient quantities of which nutrients? a. Vitamin D and calcium b. Vitamin C and magnesium c. Vitamin C and chloride d. Vitamin D and potassium

ANS: B Arnold Chiari malformation of the brain is a structural disorder affecting the cerebellum that can affect swallowing and gagging. This occurs in many children with spina bifida. Children with autism have problems with eating behaviors as opposed to difficulties with swallowing. During infancy, children with Down syndrome have difficulty coordinating sucking, swallowing, and breathing. Infants with Prader-Willi syndrome also experience weak sucking ability. REF: p. 920 (krause Ch 44)

Children with _____ may be affected by Arnold Chiari malformation of the brain. a. autism b. spina bifida c. Down syndrome d. Prader-Willi syndrome

c. chicory, onions, and Jerusalem artichokes (Gropper CH 4, pg 115)

Common food sources of fructans are _____. a. strawberries, apples, and citrus fruits b. whole grains c. chicory, onions, and Jerusalem artichokes d.legumes

c. It is higher on a per-kilogram basis than that of an adult. (CH 16 Krause, pg 301) Infancy is a period of rapid growth, with the infant doubling in weight around 4 to 6 months. At no other time postpartum does a human gain in weight and size this quickly. To allow for this growth, the protein needs on a weight basis are greater than those at any other point in the life cycle.

Compared with later stages of the life cycle, which of the following describes the infant's protein requirement? a. It is lower on a per-kilogram basis than that of the older child. b. It is lower on a per-kilogram basis than that of an adult. c. It is higher on a per-kilogram basis than that of an adult. d. It is the same on a per-kilogram basis as that of an adult.

Key:, thromboxane A3, thromboxane A2, platelets (Gropper CH 5, pp. 171-172 (T. 5.5)

Compounds affecting clotting through anti-aggregation and aggregation are formed from the 20:5 n-3 fatty acid and 20:4 n-6 fatty acid. These compounds are _____ and _____, respectively, and their effect on _____ is to inhibit or activate them, respectively.

a. 10 (CH 11 Krause, pg 277) Because nutrient needs are highly individualized depending on age, sexual development, and reproductive status of females, the DRI framework has 10 age groupings, including age-group categories for children, men, and women 51 to 70 years and those older than 70 years of age. It separates three age-group categories each for pregnancy and lactation; the groups are younger than 18 years, 19 to 30 years of age, and 31 to 50 years of age.

DRIs have _____ age groupings. a. 10 b. 5 c. 8 d. 16

c. anorexia nervosa. (CH 22 Kruase, p 419) Complaints of gastric discomfort associated with distention are common in anorexia nervosa because of delayed gastric emptying. The complaints generally occur as the calorie prescription is increased and between-meal snacks become necessary.

Delayed gastric emptying and gastric distension are common in a. binge eating disorder. b. bulimia nervosa. c. anorexia nervosa. d. eating disorder not otherwise specified.

d. glucose, blood (Beerman CH 4, p. 147)

Diabetes is characterized primarily by elevated levels of _____ in the _____. a. glucose, urine b. ketones, blood c. ketones, urine d. glucose, blood

d. chromosome (Beerman CH 5, p. 168)

Each strand of DNA is called a _____. a. gene b. translator c. translation d. chromosome

2000 (Beerman, CH 12)

One teaspoon of salt provides around ____________ mg of sodium

c. 28 (Beerman CH pgs. 142-143)

Tammy, a type 1 diabetic, consumes 2000 kcalories a day. How many grams of fiber should she consume per day? a. 21 b. 25 c. 28 d. 32

a. niacin. (Beerman chapter 10, pg 430)

The amino acid tryptophan can be converted to: a. niacin. b. thiamin. c. folate. d.vitamin B6.

c. enterocyte CH 3 GrH 3 Gropper,

The disaccharidases are synthesized by the _____. a. pancreas b. liver c. enterocyte d. chief cell

Answer: genetic makeup or genotype (Beerman CH 5, p. 174)

The particular DNA contained in a person's cells is his or her ______________

False (Beerman CH 4, p. 121)

True or False: Practically speaking, a "natural" sweetener like maple sugar is more nutrient dense than table sugar.

c. Increased mitosis and shedding of epithelium (Gould CH 8, pg 147)

What change occurs in the skin with psoriasis? a. Recurrent hypersensitivity reactions b. Autoimmune response c. Increased mitosis and shedding of epithelium d. Basal cell degeneration

b. Riboflavin (Beerman chapter 10, pg 429)

What vitamin assists in reduction-oxidation reactions, as well as several reactions that protect biological membranes from oxidative damage? a. Thiamin b. Riboflavin c. Niacin d.Pantothenic acid

a. Antral and pyloric dysfunction, poor peristalsis, and diminished gastric acid secretion (CH 27 Kruase, p 521) The vagus nerve controls the motility of the stomach, the tone of the pylorus, and the secretion of gastrin and stomach acid. Depending on the type of vagotomy, the antrum and pylorus will exhibit decreased motility and tone, resulting in delayed stomach emptying and decreased gastric acid secretion. The vagotomy is performed below the point of innervation to the lower esophageal sphincter (LES) and therefore will not affect swallowing or LES tone. Some impairments in digestion may result due to decreased acid secretion; however, these can be accommodated for by diet manipulation and do not require lifelong need for parenteral nutrition.

When a gastrectomy is performed with an accompanying vagotomy, what physiologic changes occur? a. Antral and pyloric dysfunction, poor peristalsis, and diminished gastric acid secretion b. Antral and pyloric dysfunction, poor peristalsis, and high gastric acid secretion c. Impaired digestion leading to the need for parenteral nutrition almost all the time d. Dysphagia because of a relaxed LES

b. carbon dioxide, energy, and water. (Gropper CH 5, pgs 165-166)

When fatty acids are completely oxidized the end products are: a. fatty acid and glycerol. b. carbon dioxide, energy, and water. c. urea and acetate. d.carbon, hydrogen, and phosphate.

a. Gastric emptying is delayed or slowed. (Gropper CH 4, pg 118)

When fibers form viscous gels in the stomach, which of the following occurs? a. Gastric emptying is delayed or slowed. b. Satiety is decreased significantly. c. Digestion of fats and carbohydrates increases. d.The nutrient diffusion rate is increased.

b. By approximately 30 years of age (CH 24 Krause, p. 457) Peak bone mass occurs by about 30 years of age. Through adolescence, the opportunity exists to increase bone mineral density by promoting calcium intake, maintaining weight-bearing activity, and limiting use of alcohol and cigarettes. Around the age of 40 years, BMD gradually declines. After menopause, the rate of loss averages from 1% to 2% per year.

When is the peak bone mass of a female typically achieved? a. By the end of adolescence b. By approximately 30 years of age c. Within the decade preceding menopause d. After the onset of menopause

a. deamination (Beerman CH 5, p. 184)

When protein is needed for energy, the nitrogen-containing amino group is removed in a process called _____. a. deamination b. catabolism c. metabolism d. transamination

b. 0.8 mg/dL (Gropper Chap 11, pg 437)

When serum albumin levels decline by 1 g/dL, serum calcium will decrease by _____. a. 0.4 mg/dL b. 0.8 mg/dL c. 1.0 mg/dL d.0.5 g/dL

a. Converted to lipids (Beerman CH 5, pp. 184, 185)

When the body has ample glucose and energy, what happens to excess protein? a. Converted to lipids b. Stored in the muscles c. Stored in the protein pool in the body d. Converted to bone marrow

a. Small intestine (Beerman CH 4, pg. 130)

Where does most of the digestion of starch occur? a. Small intestine b. Liver c. Large intestine d. Stomach

a. Loss of lean body mass, decreased metabolic rate, and decreased function (CH 20 Krause, pg 369-370) As lean body mass decreases, the loss of muscle mass results in decreased strength, function, and metabolic rate. Sarcopenia occurs more rapidly in people with limited physical activity; therefore, elderly adults who are also obese tend to be less active and retain excessive adipose tissue.

Which changes are associated with the normal process of aging? a. Loss of lean body mass, decreased metabolic rate, and decreased function b. Loss of lean body mass, increased metabolic rate, and increased physical activity c. Increased lean body mass, increased metabolic rate, and increased physical activity d. Increased muscle strength and function

ANS: C Positioning of children for feeding is related to the child's motor development, head control, trunk stability, and the ability to have the hips and legs at a right angle. The infant or child has to be in a proper position to allow for feeding. Otherwise, correction of oral motor problems may not be possible. Children with spina bifida, Down syndrome, and cerebral palsy are likely to have positioning problems. REF: p. 912 (Krause CH 44)

Which class of feeding problems is associated with head control and trunk stability? a. Behavioral feeding problems b. Oral motor feeding problems c. Positioning feeding problems d. Self-feeding problems

c. Bran (Beerman CH 4, pg. 128)

Which component of grain is the best source of fiber? a. Germ b. Endosperm c. Bran d. All of the above

ANS: C Lack of muscle coordination associated with CP can promote feeding problems while the child uses energy to support involuntary movements and muscle tension. Combined, these two factors could lead to inadequate nutrient intake and promote failure to thrive. Children with Prader-Willi syndrome, spina bifida, and Down syndrome tend to run the risk of developing obesity because of limited or, in the case of Down syndrome, delayed gross motor ability. REF: p. 910 (Krause Ch 44)

Which developmental disability is associated with problems with childhood growth failure? a. Prader-Willi syndrome b. Spina bifida c. Cerebral palsy d. Down syndrome

ANS: B Pierre Robin syndrome is a birth condition that involves the development of either a smaller-sized lower jaw or an upper jaw that is set back. As a result, the tongue tends to be displaced toward the back of the throat, where it can obstruct the airway. This occurs in infants with cleft palate. Spina bifida results in spinal lesions that affect many systems of the body but has no effect in regard to the development of the mouth. Rett syndrome is a neurologic disorder that involves a loss of motor skills and is characterized by a decrease in head growth between 5 to 48 months postpartum. Individuals with Pierre Robin syndrome present with short stature, small hands and feet, and obesity. REF: p. 926 (Krause CH 44)

Which developmental disorder is associated with Pierre Robin syndrome? a. Spina bifida b. Cleft palate c. Rett syndrome d. Prader-Willi syndrome

d. CAP-FEIA (CH 26 Krause, p. 491) CAP-FEIA is a quantitative assessment of allergen-specific IgE antibodies; higher levels of antibodies are often, but not always, predictors of clinical symptoms. It has been approved for only six foods: egg, milk, peanut, fish, wheat, and soy.

Which diagnostic methods for determining food allergy by immunologic function are the most accurate? a. Skin-prick test, ELISA, and RAST b. Cytotoxic testing and ELISA c. Sublingual testing, RAST, and skin-prick test d. CAP-FEIA

b. Diverticulitis (CH 28 Krause, p. 548) Diverticular disease is one of the most common medical conditions in industrialized countries and incidence increases with age. It is more common in people over 50 years. UC, Crohn disease, and tropical sprue generally occur earlier in life.

Which disease is associated with advanced age? a. Crohn disease b. Diverticulitis c. Ulcerative colitis d. Tropical sprue

d.HMG-CoA reductase inhibitors (Gropper CH 5, pg 173)

Which drug therapy is associated with reduced cholesterol synthesis in the liver? a. insulin b. niacin c. gene therapy d.HMG-CoA reductase inhibitors

ANS: B Whereas most fatty acid oxidation disorders are considered to be rare in prevalence, medium-chain acyl-CoA dehydrogenase deficiency occurs at a rate of one in 20,000. All fatty acid oxidation disorders present with vomiting, lethargy, and hypoglycemia. Patients with these disorders are generally treated with low-fat diet and carnitine diet. The diet is particularly low in the particular type of fatty acid. Additionally, fasting is limited so as not to stimulate increased mobilization of fatty acids from adipose stores. REF: p. 906 (Krause Ch 43)

Which fatty acid oxidation disorder is the most common? a. Short-chain acyl-CoA dehydrogenase deficiency b. Medium-chain acyl-CoA dehydrogenase deficiency c. Long-chain acyl-CoA dehydrogenase deficiency d. Long-chain 3-hydroxy acyl-CoA dehydrogenase deficiency

c. Put the infant to bed without a bottle. (CH 16 Krause, pg 310) Giving an infant a bottle at bedtime with either milk or fruit juice allows the teeth to be bathed in the simple carbohydrate that promotes dental caries development. To promote dental health, infants should be fed and burped and then put to bed without a bottle. Also, infants and young children should be limited to 4 to 6 fl oz of juice per day.

Which feeding practice will avoid the development of tooth decay in infants? a. Give the infant a bottle with fruit juice at bedtime. b. Give the infant a bottle with milk at bedtime. c. Put the infant to bed without a bottle. d. Give the infant a bottle at bedtime only when he or she appears fussy.

d.cellulose (Gropper CH 4, pg. 112)

Which fiber component is provided primarily by the outer layers of cereal grains? a. lignin b. pectin c. fructans d.cellulose

a. lignin (Gropper CH 4, pg 114,121)

Which fiber type is poorly fermentable? a. lignin b. pectin c. gums d.resistant starch

d. Sweet potatoes (Beerman chapter 10, pg 443)

Which food below contains the least amount of vitamin B12? a. Clams b. Beef c. Fortified cereal d.Sweet potatoes

c. Banana (CH 26 Krause, p. 486) Bananas, avocados, chestnuts, and kiwi are the most frequent food-latex cross-reactive allergies. Milk allergies have not been seen to cross-react with latex. Wheat and fish have been associated with latex cross-reactions but not as frequently as various fruits

Which food has one of the most frequent cross-reactivity allergies between latex and food? a. Milk b. Wheat c. Banana d. Fish

ANS: C The best sources of vitamin D are exposure of a large amount of skin to sunlight or foods such as oily fish, egg yolks, and vitamin D fortified foods such as cow's milk and soy milk. Cereals are only a good source if they are fortified. REF: p. 846 (Krause CH 41)

Which food is a good source of vitamin D? a. Butter b. Flax seed c. Egg yolk d. Steel cut oat

a. prostaglandins (Gropper CH 5, pg 171)

Which group of 20-carbon fatty acid derivatives can exhibit either pro-arrhythmic or anti-arrhythmic physiological actions in the body? a. prostaglandins b. thromboxanes c. leukotrienes d.sterols

c. parathyroid hormone (Gropper Chap 11, pg 440)

Which hormone both increases release of bone phosphorus into the blood and promotes urinary excretion of phosphorus? a. calcitonin b. calcitriol c. parathyroid hormone d.insulin

b. Epinephrine (Beerman CH 4, pg. 140)

Which hormone is an important regulator of glycogenolysis in skeletal muscle? a. Glucagon b. Epinephrine c. Norepinephrine d. Insulin

a. insulin (gropper CH 5, p. 174)

Which hormone is considered to be an antagonist of lipolysis? a. insulin b. epinephrine c. glucagon d.thyroxine

c. vasopressin Gropper Ch 2 page 53

Which hormone is responsible for decreasing sodium absorption in the colon? a. glucocorticoids b. mineralcorticoids c. vasopressin d.glucagon

b. aldosterone (Gropper CH 12, pg 460, 461)

Which hormone, mediated by the enzyme renin, is primarily responsible for active reabsorption of sodium ions in the distal and collecting tubules? a. antidiuretic hormone b. aldosterone c. androsterone d. adrenocortical

b. Follow a nutrient-dense, phytochemical-rich food plan. (CH 19 Krause, pg 359) The Dietary Guidelines for Americans focus on eating nutrient-dense foods, but there is the added benefit that the identified foods tend to also be phytochemical rich. Focusing on lipid intake limits awareness of the variety of benefits that arise from the intake of whole grains, fruits, and vegetables. Dietary recommendations for adolescents focus on the promotion of adequate growth and development during adolescence, and in many cases, they exceed the needs of the average adult. A carefully chosen vegan diet supplemented with specific nutrients can be healthy, but vegan diets (and other very restrictive diets) are generally considered a risk factor for inadequate nutrition.

Which is an appropriate nutritional guideline for the adult years? a. Focus primarily on lipid intake. b. Follow a nutrient-dense, phytochemical-rich food plan. c. Follow a high-protein, low-carbohydrate diet. d. Follow a vegan diet.

b. the relative dose response (Gropper Chap 10, pg 389)

Which is the best technique to assess status of vitamin A liver stores? a. serum retinol levels b. the relative dose response c.clinical eye examinations

c. potassium (Gropper CH 12, pg 466)

Which is the chief cation of intracellular fluid for which maintenance of normal levels is essential to life of the cells? a. calcium b. sodium c. potassium d.bicarbonate

d. lycopene (Gropper Chap 10, pg 385)

Which is the strongest antioxidant? a. beta-carotene b. alpha-tocopherol c. beta-cryptoxanthin d.lycopene

a. Albumin (Ch 7 Krause, pg 101-102) The Centers for Medicare and Medicaid Services established that for the BMP, the following tests are reimbursable: glucose, calcium, potassium, carbon dioxide, chloride, blood urea nitrogen, and creatinine. For the CMP, the following are added: albumin, total protein, alkaline phosphate, alanine aminotransferase, aspartate aminotransferase, and bilirubin. WBC would appear on a CBC, which may include a differential identifying the levels of the different types.

Which laboratory value would be added in a comprehensive metabolic panel (compared with a BMP)? a. Albumin b. Glucose c. Blood urea nitrogen d. White blood cells

c. Erythematous ring of vesicles with a clear center (Gould CH 8, pg 150)

Which lesion distinguishes Tinea corporis? a. Small, brown pruritic lines b. Painful and pruritic fissures c. Erythematous ring of vesicles with a clear center d. Firm, red, painful nodule or pustule

a. magnesium (Gropper Chap 11, pg 444)

Which mineral is part of the green chlorophyll pigment in green leafy vegetables? a. magnesium b. sodium c. potassium d.sulfur

b. chloride (Gropper CH 12, pg 462, 467)

Which mineral is the most abundant anion found in extracellular fluid? a. sodium b. chloride c. phosphorus d.magnesium

c. calcium (Gropper Chap 11, pg 425)

Which mineral is the most abundant cation in the human body? a. phosphorus b. magnesium c. calcium d.potassium

A p. 528 (Gropper CH 13)

Which mineral is thought to potentiate the action of insulin? a. chromium b. manganese c. copper d.cobalt

c. magnesium (Gropper Chap 11, pg 446)

Which mineral participates in all aspects of energy metabolism including glycolysis, beta-oxidation, and the TCA cycle? a. calcium b. iron c. magnesium d.sulphur

a. The distal radius is broken. (Gould CH 9, pg. 165) - A Colles' fracture is a type of fracture of the distal forearm in which the broken end of the radius is bent backwards

Which of the following describes a Colles' fracture? a. The distal radius is broken. b. The distal fibula is broken. c. A vertebra appears crushed. d. A spontaneous fracture occurs in weakened bone.

d- Lactose (Beerman, 12)

Which of the following does not inhibit the absorption of calcium? a. Oxalates b. Phytates c. Older age d. Lactose e. a and d f. a, b, and c

d. A patient with BMI of 40 or higher (CH 21 Kruase, pg 398) Bariatric surgery is an acceptable treatment for people with extreme obesity. A person with a BMI greater than 40 or person with a BMI greater than 35 with comorbidities would be an ideal candidate. Combinations of diet therapy, exercise, and lifestyle modification should be attempted before surgical intervention is sought.

Which of the following does the NIH identify as being an appropriate candidate for bariatric surgery? a. A person with metabolic syndrome b. A patient with BMI of 25 to 29 with high blood pressure c. A patient with BMI of 30 to 34 d. A patient with BMI of 40 or higher

c. isozymes of lactate dehydrogenase Gropper CH 1

Which of the following enzymes has diagnostic value for disease? a. isocitrate dehydrogenase b. ornithine carbomoyl transferase c. isozymes of lactate dehydrogenase d. isozymes of phosphofructokinase

d. Erythropoietin (EPO) (CH 23 Krause, p. 450) EPO is a hormone produced by the body that stimulates red blood cell production. This can result in an increase in serum hematocrit and increased oxygen-carrying capacity. Iron supplements may improve iron stores but have not been shown to enhance performance. Beta-HMB and steroids are generally taken as means of increasing muscle mass. Steroids can have an anabolic effect in regard to increasing blood cell production.

Which of the following ergogenic aids is used to increase the oxygen-carrying capacity to increase VO2 max and endurance? a. Beta-hydroxy-beta-methylbutyrate (HMB) b. Iron supplements c. Steroids d. Erythropoietin (EPO)

a. CAM is not as expensive as conventional medicine. (CH 12 Krause, pg 194) Unlike conventional medicine, most CAM is not generally covered by health insurance. The cost of this care must be borne by the patient, and it is not necessarily cheaper than conventional care. CAM will be an option for people who believe that medical conditions such as cancer or migraines cannot be treated effectively by conventional medicine. Conventional medicine's treatment of back pain or neck pain may focus on surgical interventions that patients will see as having significant risk involved. CAM has been shown to be effective in the treatment of pain and arthritis.

Which of the following is NOT one of the reasons that there has been an increased usage of CAM in the United States? a. CAM is not as expensive as conventional medicine. b. CAM is used when conventional medicine has little to offer in effective treatment. c. CAM is used when conventional medicine has significant risks and side effects. d. CAM has a history of efficacy in treatment of some conditions.

a. activate and stimulate proliferation of B and T lymphocytes. (Gould CH 7, pg 115)

Which of the following is an effect of cytokines? They: a. activate and stimulate proliferation of B and T lymphocytes. b. destroy antigens quickly. c. increase the rate of mitosis in tumors. d. cause immediate pain.

ANS: A GSD Ia involves a defect in the enzyme glucose-1,6-phosphatase. This defect results in impairments in gluconeogenesis and glycogenolysis, which can result in severe hypoglycemia. Fructose-1,6-diphosphatase deficiency is a rare fructose metabolism disorder that promotes metabolic acidosis when fructose is consumed, but fructose levels do not increase in the blood or urine. Hereditary fructose intolerance is associated with a defect in fructose-1-phosphate aldolase that causes a depletion of inorganic phosphate and adenosine triphosphate. This disorder can result in renal and liver damage. Metabolic disorders involving hexokinase have not been identified. REF: p. 892 (Krause CH 43)

Which of the following is the deficient enzyme in glycogen storage disease Ia (GSD Ia)? a. Glucose-1,6-phosphatase b. Fructose-1,6-diphosphatase c. Fructose-1-phosphate aldolase d. Hexokinase

b. ODS (CH 12 Krause, pg 197) The Office of Dietary Supplements has prepared information available to assist in educating consumers about various dietary supplements. The National Center for Complementary and Alternative Medicine promotes research into alternative medicine. The Food and Drug Administration has published tips for supplement users in regard to making informed decisions when selecting supplements. The Agency for Healthcare Research and Quality maintains a database of evidence-based practices in treatments of various conditions, and some of these include aspects of CAM.

Which program has developed fact sheets about dietary supplements that can be used by health professionals to educate clients? a. NCCAM b. ODS c. FDA d. AHRQ

c. Traditional Chinese medicine (CH 12 Krause, pg 192) Qi or chi refers to the life-force or energy that is the center of the body functions. Health and wellness are assumed when chi is balanced and in harmonious flow with the body. Illness occurs when there are disturbances in this flow.

Which type of holistic therapy is based on the belief that Qi is the balancing force of the body? a. Homeopathy b. Naturopathy c. Traditional Chinese medicine d. Phytotherapy

a. Homeopathy (CH 12 Krause, pg 192) Homeopathy helps the body heal itself through the law of similars in which remedies to symptoms are diluted substances that cause the symptoms. Naturopathy focuses on nature as the provider of healing and uses phytotherapy, treatment with plant-based preparations, as one aspect of treatment. Traditional Oriental medicine focuses on establishing balance in regard to life-force energy and uses a variety of techniques in health care.

Which type of holistic therapy is based on the belief that you treat like with like? a. Homeopathy b. Naturopathy c. Traditional Oriental medicine d. Phytotherapy

a. Vitamin B6 (Beerman chapter 10, pg 434-435)

Which vitamin is needed to synthesize nonessential amino acids from essential amino acids? a. Vitamin B6 b. Niacin c. Thiamin d.Vitamin B12

d. Carnitine (Beerman chapter 10, pg 450)

Which water-soluble compound is considered a conditionally essential nutrient for infants? a. Folate b. Vitamin C c. Choline d.Carnitine

d. Folate (Beerman chapter 10, pg 439) Think: one-carbon metabolism.

_____ is a coenzyme for many reactions, all of which involve the transfer of single-carbon groups. a. Thiamin b. Riboflavin c. Biotin d.Folate

b. Conformational epitopes (CH 26 Kruase, p. 480) Recent studies suggest that 70% to 80% of young children allergic to milk or eggs can tolerate baked (heat-denatured) forms of the protein but not the unbaked form. It is suggested that these children make IgE antibodies primarily to conformational epitopes (antigenic determinants on the surface of the food proteins that are recognized by the immune system). Haptens are small molecules that can elicit an immune response only when attached to a large protein carrier. Mast cells release histamines. Cytokines are proteins released by cells and serve as communicators with the immune system.

_________ are antigenic determinants on the surface of food proteins that are recognized by the immune system. a. Cytokines b. Conformational epitopes c. Mast cells d. Haptens