Nutrition Final

What is the most important nutrient?

water

List the six classes of nutrients in order from highest priority down

water proteins carbs fats minerals vitamins

When is Prevident indicated?

· Enables faster fluoride dispersion than paste-form Rx fluoride · Optimized fluoride delivery system that produces a temporary shift in pH, resulting in an 86% improvement in fluoride uptake2 · Ideal therapy for patients with o High caries risk o Crown and bridge work o Orthodontic decalcification

Vitamin B12 (cobalamin) deficiency

Pernicious animea

Vitamin B3 (niacin) deficiency

Scarlet tongue

Vitamin C deficiency

Scurvy Perifolicullar petechiae

Vitamin B3 (niacin) deficiency

Symmetric chapping of dorsum of hands

Sugar alcohols have anticariogenic properties and can protect the teeth by decreasing demineralization, enhancing remineralization, or increasing salivary flow, even in the presence of a fermentable carbohydrate. Name 3 sugar alcohols.

The commonly used sugar alcohols include sorbitol, mannitol, xylitol, maltitol, maltitol syrup, lactitol, erythritol, isomalt and hydrogenated starch hydrolysates.

Hypervitaminosis

bright red marginal discoloration of the gingiva, hyper Vitamin A

Vitamin A can be stored in the liver for at least: a) 1 month. b) 6 months. c) 1 year. d) 18 months.

c) 1 year. Correct Vitamin A can be stored in the liver to meet basic needs for at least 1 year.

The best way to prevent osteoporosis is through building bone mass during what stage of life? a) Infancy b) Early childhood c) Adolescence d) Young adulthood

c) Adolescence Correct It is thought that adolescence is the best time to build sufficient bone mass to prevent osteoporosis later in life. During this period, 45% of adult skeletal mass is formed. Calcium needs are greater at this period than at any other time. Additionally, vitamin D deficiency in adolescents can place them at greater risk.

Which vitamin acts most like a hormone? a) A b) C c) D d) E

c) D Correct Although vitamin D, also known as calciferol, has been called a vitamin, it is more appropriately classified as a hormone. Like hormones, vitamin D acts to control the function of other cell types. For example, it helps the body absorb and regulate skeletal calcium and phosphorus levels.

Each of the following accurately describe aspects of the dietary reference intakes (DRIs) published by the Food and Nutrition Board of the Institute of Medicine (IOM) except one. Which one is the exception? a) The DRIs replace the older recommended daily allowances. b) Current DRIs attempt to estimate required nutrients to improve long-term health. c) DRIs specifically address individuals whose requirements are affected by a disease state. d) The DRIs attempt to establish maximum safe levels of tolerance for nutrients.

c) DRIs specifically address individuals whose requirements are affected by a disease state.

Which term is used to describe medical practices that have been thoroughly evaluated using scientific methods? a) Meta-analysis b) Systematic reviews c) Evidence based d) Observational studies

c) Evidence based

Which term is used to describe populations located in lower income, inner city, and rural areas with few supermarkets but numerous small stores stocking limited nutritious food items? a) Food fad b) Food insecurity c) Food desert d) Food patterns e) Food quackery

c) Food desert

Located in the middle of the brain, what organ is responsible for satiety and hunger? a) Medulla Oblongata b) Pituitary Gland c) Hypothalamus d) Parathyroid

c) Hypothalamus The hypothalamus is located in the middle of the brain and responsible for the feeling of hunger and feeling full.

Which of the following best represents the goal of reflective listening? a) Repeating what the patent says b) Informing using direct advice c) Keeping the patient talking d) Warning the patient

c) Keeping the patient talking

Each correlation between vitamin D and sun exposure is accurate, except one. Which is the exception? a) The body has the ability to produce adequate amounts of vitamin D from sunlight. b) UV radiation penetrates uncovered skin and converts a precursor of vitamin D to vitamin D3. c) Sunscreen does not block the formation of vitamin D3. d) By the age of 70 years, the skin generally produces vitamin D at only half the level it did at the age of 20 years.

c) Sunscreen does not block the formation of vitamin D3. Correct Sunscreen does block formation of vitamin D3. UV radiation penetrates uncovered skin and converts a precursor vitamin D to previtamin D3, which becomes vitamin D3. Because UV radiation is the principal cause of sunburn and cellular damage that leads to skin cancer, dermatologists continue to advise sunscreen and clothing protection for anyone in the sun more than 20 minutes.

The nutrient facts panel was established by the USDA and the FDA to improve health and well-being by enhancing nutritional knowledge. Nutrient content claims describe a relationship between a food or food component and reduced risk of a disease or health-related condition. a) Both statements are true. b) Both statements are false. c) The first statement is true; the second is false. d) The first statement is false; the second is true.

c) The first statement is true; the second is false.

Each is beneficial for orthodontic patients, except one. Which is the exception? a) Daily fluoride use b) Alcohol-free antimicrobial rinse c) Warm salt water rinses d) Utility wax e) Foods high in citric acid

e) Foods high in citric acid Correct Foods and drinks that are high in citric acid lower the oral pH, resulting in increased demineralization and dental caries. The remaining selections all have benefit for the orthodontic patients. Warm salt water rinses are soothing to tissue damaged by sharp edges on orthodontic appliances. Utility wash can be used to protect soft tissues form sharp appliances between appointments. Daily fluoride use and antimicrobial rinses (possibly alcohol free) are well-documented components of orthodontic treatment protocols

An imbalance of which nutrient may elicit delayed tooth eruption, enlarged tongue, stillbirths, altered craniofacial growth, sensitivity to cold, dry skin, depression, and goiter? a) Zinc b) Iron c) Sodium d) Potassium e) Iodine Correct

e) Iodine Correct Goiter is the main disorder resulting from low iodine intake. Other iodine-deficiency disorders include stillbirths, abortions, and congenital anomalies; endemic cretinism, usually characterized by impaired mental development and deaf mutism related to fetal iodine deficiency; and impaired mental function. Children born to mothers with severe iodine deficiency have delayed eruption of primary and secondary teeth and an enlarged tongue. Craniofacial growth and development are altered; malocclusion is common.

Water loss can occur from each, except one. Which is the exception? a) Respiration inflammation b) Strenuous exercise c) Diarrhea d) Perspiration e) Metabolism of fat

e) Metabolism of fat Correct Water is liberated in the process of metabolism and becomes available for hydration of the cells and tissues of the body. Metabolism of fat produces approximately twice as much water as does the metabolism of protein or carbohydrate. Metabolism of fat supplies about 300 to 350 mL/day.

Consumers state each reason for choosing organic foods, except one. Which one is the exception? a) Environmental reasons b) Better taste c) Fresher food d) More humane treatment of animals e) More economical

e) More economical

Routine dental care during pregnancy is associated with an increased risk of: a) preterm delivery. b) spontaneous abortion. c) fetal abnormalities. d) All of the above. e) None of the above.

e) None of the above. Correct

A mother asks about healthy snacks for her three children under 4 years old. All are wise choices the dental hygienist can recommend, except one. Which is the exception? a) Low-fat milk or yogurt b) Whole-grain cereals c) Raw vegetable sticks d) Cheese cubes e) Nuts and seeds

e) Nuts and seeds Correct Until age 4, children are at risk for choking on food that gets caught in the airway. Food is not chewed thoroughly until the molars erupt. Small nuts and seeds are likely to cause choking. Other foods that cause choking include round, firm, smooth foods such as grapes, hard candy, hot dogs, and round candies. Note that raw carrots are also in the list of foods likely to cause choking; as with all foods, parental supervision is paramount. The remaining selections, under parental supervision, are excellent nutrient-dense snack choices.

Each is a physiologic role of vitamin D, except one. Which is the exception a) Hematopoiesis b) Cardiac and neuromuscular function c) Immune responses d) Serum calcium regulation e) Synthesis of blood-clotting factors

e) Synthesis of blood-clotting factors Correct Vitamin K, not D, functions as a catalyst for synthesis of blood-clotting factors. The remaining selections are physiologic roles of vitamin D. Hematopoiesis is the formation of red blood cells. The regulatory role of vitamin D helps keep serum calcium in an appropriate range to maintain cardiac and neuromuscular function. The hormone actions of vitamin D are integral to protecting immune responses.

Macronutrients include each of the following except one. Which one is the exception? a) Fat b) Polyunsaturated fatty acids c) Carbohydrate d) Protein e) Vitamins

e) Vitamins

List 4 of the 9 factors that affect Basil Metabolic Rate

A. Age B. Sleep C. Fastina/Starvation

The energy value of alcohol is approximately A. 3 kcal/g B. 7 kcal/g C. 10 kcal/g D. 25 kcal/g

B. 7 kcal/g

Regardless of whether excessive food intake is in the form of protein, carbohydrate, alcohol, or fat, most excess energy intake is stored in the liver. Fat is a good source of energy, but protein is the preferred fuel. A. Both statements are true. B. Both statements are false. C. The first statement is true; the second is false. D.The first statement is false; the second is true.

B. Both statements are false.

The small intestine is comprised of the cecum, colon, and rectum. The large intestine includes the duodenum, jejunum, and ileum. A. Both statements are true. B. Both statements are false. C. The first statement is true; the second is false. D.The first statement is false; the second is true.

B. Both statements are false.

The small intestine is comprised of the cecum, colon, and rectum. The large intestine includes the duodenum, jejunum, and ileum. A. Both statements are true. B. Both statements are false. C. The first statement is true; the second is false. D. The first statement is false; the second is true.

B. Both statements are false.

What physiologic role does magnesium play in the body? A. Blood clotting, transmission of nerve impulses, muscle contraction and relaxation B. Calcium homeostasis, structural integrity of heart muscle C. No known metabolic function, caries-preventing properties D. ATP energy release; metabolism of fats, carbohydrates, proteins; regulates acid-base balance

B. Calcium homeostasis, structural integrity of heart muscle Magnesium plays an important function in maintaining calcium homeostasis and preventing skeletal abnormalities. Magnesium is involved in more than 300 enzymatic reactions, including energy metabolism, insulin activity, and glucose use. Magnesium is vital to the structural integrity of heart muscle and other muscles and nerves. Its role in enzymes is fundamental to energy (ATP) production. It is also crucial in controlling blood pressure and stroke.

Each is true of water-soluble vitamins, except one. Which is it? A. Act as coenzymes B. Deficiencies develop rapidly C. Daily intake is necessary D. Absorbed in the jejunum

B. Deficiencies develop rapidly Deficiencies develop rapidly due to the body not storing for long amounts of time. Must be obtained through food constantly.

Which set a guidelines is intended to assess nutrient adequacy or planning intake of population group, not individuals? A. RDA B. EAR C. DRA D. UL

B. EAR

A person with Celiac disease will be able to eat Poptarts. A. True B. False

B. False

The metabolic rate is the highest after a few hours of sleep. A. True B. False

B. False

Each is characteristic of fat, except one. Which is the exception? A. 95% of ingested fats are absorbed. B. Hard fats are digested more quickly than soft fats that are liquid at body temperature. C. Fats that contribute to palatability and flavor of foods. D. Cooked fats improve texture of foods

B. Hard fats are digested more quickly than soft fats that are liquid at body temperature.

Which substance is most essential for hydrolyzing large protein molecules? A. Gastric lipase B. Pepsin C. Mucus D. Intrinsic factor

B. Pepsin - Although many enzymes are involved in hydrolysis and digestion, pepsin is essential for hydrolysis large protein molecules. Mucus forms an alkaline coating that protects the stomach lining from digestion by pepsin. Gastric lipase is involved in digestion of short-and medium-chain triglycerides. Intrinsic factor is secreted by the stomach and is essential for absorption of vitamin B12.

Proteolytic enzymes are most likely to break down which food type? A. Carbohydrates B. Proteins C. Fats D. Lipids

B. Proteins - Proteolytic enzymes target and break down proteins. Notice that the names of most enzymes begin with the type of food it targets and end in -ase. For example, lipase breaks down fats, also known as lipids. Other enzymes, such as pancreatic enzymes, contain the full name of the organ from which it originates.

Hyperkeratosis

Thickening of the skin caused by a mass of keratinocytes, vitamin A deficiency

List the three nutrients that provide energy:

Carbohydrates Fats Protein

Hypervitaminosis A

Too much vitamin A

Night Blindness

Vitamin A deficiency Xerophthalmia

Hypercarotenosis

Vitamin A hyperstate

List the water-soluble vitamins:

Vitamin C and B- Vitamins (Thiamine, Niacin, Riboflavin, Pantothenic acid, biotin, Vit B6, Vit B12, & Folate

Ascorbic Acid

Vitamin C deficiency

Rickets/Osteomalacia

Vitamin D deficiency

List the fat-soluble vitamins:

Vitamins A, D, E, K

One 12oz can of Red Bull contains 37 grams of sugar. About how many level tsp's is that?

___ABOUT 9 TSP___

Oral candidiasis, hairy leukoplakia, herpetic ulcerations, Kaposi's sarcoma, xerostomia, and severe periodontal disease characterize: a) AIDS. b) acute leukemia. c) anorexia nervosa. d) bulemia.

a) AIDS.

Which of the following food provides the most protein? a) Beans b) Red peppers c) Asparagus d) Celery

a) Beans

Polysaccharides

Carbohydrates that are made up of more than two monosaccharides cellulose, starch and glycogen

What are the contraindications for using MI Paste?

Children under six and milk casein allergy

Kayser-Fleischer

Copper deposits in eyes

What physiologic role does phosphorus play in the body? A. Blood clotting, transmission of nerve impulses, muscle contraction and relaxation B. Calcium homeostasis, structural integrity of heart muscle C. No known metabolic function, caries-preventing properties D. ATP energy release; metabolism of fats, carbohydrates, proteins; regulates acid-base balance

D. ATP energy release; metabolism of fats, carbohydrates, proteins; regulates acid-base balance

Each nonnutritive sweetener can be recommended to patients with phenylketonuria, except one. Which one is the exception? A. Cyclamate B. Acesulfame-K C. Saccharine D. Aspartame E. Sucralose

D. Aspartame

Each nonnutritive sweetener can be recommended to patients with phenylketonuria, except one. Which one is the exception? A. Cyclamate B. Acesulfame-K C. Saccharine D. Aspartame E.Sucralose

D. Aspartame - Aspartame is contraindicated for individuals with phenylketonuria, which is a genetic disorder.

Which are the biggest food contributors of saturated fats consumed by Americans? A. Butter, coconut, and palm oils B. Corn oil C. Meat and milk D. Cheese, pizza, desserts, and chicken E. Fish, canola, and olive oils

D. Cheese, pizza, desserts, and chicken

Which has the most satiety value? A. Complex carbohydrates B. High-quality protein C. Low-quality protein D. Fat

D. Fat

In each condition, underconsumption of fat is a concern, except one. Which is the exception? A. Malabsorption syndromes B. Cystic fibrosis C. AIDS D. Hypertension

D. Hypertension

When carbohydrates are eliminated from the diet to lose weight, which nutrients are most likely to become insufficient? A. Iron, fiber, and protein B. Iron, fiber, and vitamin K C. Vitamin A and vitamin C D. Iron, fiber, and B vitamins

D. Iron, fiber, and B vitamins - When complex carbohydrates are eliminated from the diet, an insufficient intake of B vitamins, iron, and fiber can occur. Complex carbohydrates are polysaccharides and contain more than 10 monosaccharides.

Which biomolecule is responsible for storage and transfer of genetic information? A. Carbohydrates B. Proteins C. Lipids D. Nucleic acids

D. Nucleic acids

It is well established that removing sucrose from the diet results in significant reduction of dental caries. Although the total elimination of sweets permanently is unrealistic, the best advice includes consuming sugar in moderation and limiting the frequency of sugar exposure. A. Both statements are true. B. Both statements are false. C. The first statement is true; the second is false. D. The first statement is false; the second is true.

D. The first statement is false; the second is true. - The first statement is false; the second is true. For many years, sucrose, the most frequently consumed form of sugar, has been incorrectly considered the "arch villain" in dental caries formation. Although sucrose and other carbohydrates have unusual biochemical properties that promote bacterial growth, most experts recognize that carbohydrates provide energy required for optimal nutrition. Consequently, the American Dental Association joins other experts in recommending strategies for moderating and limiting the consumption of all sugars. An example is the American Dental Association's recommendation to replace sucrose containing cough drops and breath mints with products containing noncariogenic sweeteners, preferably xylitol.

Match the definitions to the term by (a) Elimination (b) Absorption (c) Digestion Eliminates waste products_______ Delivers nutrients to cells _______ Makes nutrients available________

Eliminates waste products____A____ Delivers nutrients to cells _____B___ Makes nutrients available_____C____

Vitamin A deficiency

Enamel hyperplasia Hyperkaratosis

Excess intake of proteins, fats, alcohol, and carbs result in energy being stored as

Fat

Folic acid deficiency

Fiery red tongue completely devoid of papillae

Hypomineralization of enemal

Fluorosis, happens during tooth formation

Vitamin B6 deficiency

Fungiform papillary hypertrophy

Vitamin B2 (riboflavin) deficiency

Glossitis

Vitamin B1 (thiamine) deficiency

Glossitis Beriberi Wernicke-Korsakoff

Iodine deficiency

Goiter (enlarged thyroid gland)

Wilson Deficiency

Hyperstate of copper Kayser-Fleischer

is a hormone that lowers blood glucose levels.

Insulin

2 types of chemical bonds

Ionic bonds and covalent bonds

Copper Hyperstates

Kayser-Fleischer ring- brown or green ring, wilson disease

is the PEM in which children ages 18-24 months display edema of the extremities, torso, and face, fatty liver, sparse yellow hair. They receive adequate kilocalories but not enough high-quality proteins.

Kushawer

Please describe the benefits of MI Paste, include what the active ingredients are (hint: there are 2 active ingredients)

MI Paste® products release RECALDENT™ (CPP-ACP) - a natural milk protein peptide that adheres to soft tissue, plaque, pellicle, and enamel's hydroxyapatite delivering amorphous calcium and phosphate (ACP) into the saliva. The mechanism of action is similar to that of the salivary protein statherin and the supply of bio-available calcium and phosphate is able to drive remineralization by Fluoride (MI Paste Plus® and MI Paste® ONE), buffer acid, and reduce the plaque acid effect on tooth structure.

is the PEM in children, homeless, older adults, and substance abusers display symptoms such as muscle weakness, hanging skin, delayed tooth eruption, and changes in saliva

Marasmus

The most common nutritional disorder fir the older adult is

Obesity

Cariogenic foods and beverages are fermentable carbohydrates that can be metabolized by oral bacteria and reduce salivary PH below: a) 5 b) 5.5 c) 6 d) 6.5

b) 5.5

What is the first thing you should do prior to sharing information with a patient? a) Provide background knowledge b) Ask permission c) Remove PPE d) Remind patient you are the authority

b) Ask permission

After reviewing the health and dental histories, the dental hygienist has adequate information to begin dietary counseling with the patient. Providing a standardized, low-carbohydrate menu is sufficient for most patients with a high caries rate. a) Both statements are true. b) Both statements are false. c) The first statement is true; the second is false. d) The first statement is false; the second is true.

b) Both statements are false.

Cardiovascular disease (CVD) produces numerous oral effects. A causative relationship has been established between periodontal disease and CVD. a) Both statements are true. b) Both statements are false. c) The first statement is true; the second is false. d) The first statement is false; the second is true.

b) Both statements are false.

Healthy People (HP 2020), issued by the U.S. Department of Health and Human Services has resulted in a reduction of deaths from cardiovascular disease, stroke, and some cancers. It also has resulted in decreased dental caries in children aged 2 to 4 years and adults aged 53 to 44 years. a) Both statements are true. b) Both statements are false. c) The first statement is true; the second is false. d) The first statement is false; the second is true.

b) Both statements are false.

Weight loss therapies that rely on juicing typically provide increased fiber, vitamins, and minerals. As an added incentive, juices contain a lower concentration of sugar than the whole fruit. a) Both statements are true. b) Both statements are false. c) The first statement is true; the second is false. d) The first statement is false; the second is true.

b) Both statements are false.

Studies suggest that leukoplakia is caused by excess vitamin A (a fat-soluble vitamin), retinoids, and beta-carotene. Leukoplakia is an erythematous lesion that appears on the lateral borders of the tongue. a) Both statements are true. b) Both statements are false. c) The first statement is true; the second is false. d)The first statement is false; the second is true

b) Both statements are false. Correct Both statements are false. Studies suggest that leukoplakia, a white plaque that forms on oral mucous membranes, can be resolved by vitamin A, retinoids, and beta-carotene. Despite the potential to resolve leukoplakia, relapse is common. Also pertinent, evidence does not indicate that any of these nutrients prevent malignant transformation.

Energy drinks cause each condition, except one. Which is the exception? a) Nervousness b) Bradycardia c) Seizures d) Dental caries e) Cardiac arrest

b) Bradycardia Correct Although energy drinks might contain vitamins and minerals, the main ingredients are added sugars and stimulants such as caffeine. The consumption of energy drinks is not associated with slow heart rate (bradycardia) but is associated with a rapid heart rate (tachycardia). Energy drinks are also associated with insomnia, nervousness, headache, seizures, and cardiac arrest. The amount of caffeine varies widely among drinks, but can be as high as 500 mg caffeine per can, which is comparable to approximately 14 cans of caffeinated soda.

A dental hygienist finds several new carious lesions in a patient with chronic obstructive respiratory disease (COPD). While conducting the medical and dental histories, the dental hygienist is most likely to find an increased use of which of the following? a) Protein b) Cough drops c) Fluoride d) Xylitol

b) Cough drops

Each is a sign of vitamin B12 deficient megaloblastic anemia, except one. Which is the exception? a) Angular cheilosis b) Dark red oral mucosa c) Recurrent aphthous ulcers d) Erythematous mucositis

b) Dark red oral mucosa

Which metabolic disease is characterized by poor healing, more severe forms of periodontal disease, necrosis, xerostomia, and candidiasis? a) Hypopituitarism b) Diabetes mellitus c) Hyperthyroidism d) Renal disease

b) Diabetes mellitus

Vitamin D and Calcium deficiency

Osteoporosis

Match the Correct Diabetic type to the fact/symptom A.) Type B.) Type -90% to 95% of cases are >65 years older with -Obesity and inactivity are associated with -Polydipsia, polyphagia, and ketoacidosis are primarily seen in -Onset is typically during childhood or puberty -BMI is usually >25 with an increased weight in the abdominal area

-90% to 95% of cases are >65 years older with B -Obesity and inactivity are associated with B -Polydipsia, polyphagia, and ketoacidosis are primarily seen in A -Onset is typically during childhood or puberty A -BMI is usually >25 with an increased weight in the abdominal area B

DRI's are appropriate for healthy people over the age of

10

One pound of fat equals:

3500 calories

Disaccharide

A double sugar, consisting of two monosaccharides joined by dehydration synthesis. sucrose, lactose, and maltose

List the vitamins that are considered antioxidants

A,C,E

What physiologic role does calcium play in the body? A. Blood clotting, transmission of nerve impulses, muscle contraction and relaxation B. Calcium homeostasis, structural integrity of heart muscle C. No known metabolic function, caries-preventing properties D. ATP energy release; metabolism of fats, carbohydrates, proteins; regulates acid-base balance.

A. Blood clotting, transmission of nerve impulses, muscle contraction and relaxation Calcium controls body functions such as blood clotting, transmission of nerve impulses, muscle contraction and relaxation, membrane permeability, and activation of certain enzymes. Calcium intake has been suggested to be important not only for bone health, but also for reducing the risk of a host of other disorders ranging from hypertension to obesity to colon cancer.

Poor nutrition results in delayed eruption and exfoliation of deciduous teeth and increased dental caries, Increased caries susceptibility in at-risk children may be related to changes in salivary composition caused by malnutrition. A. Both statements are true. B. Both statements are false. C. The first statement is true; the second is false. D. The first statement is false; the second is true.

A. Both statements are true.

LDL's are known as the "bad" type of cholesterol because they adhere to the arterial walls and narrow the lumen. A. Both the statement and the reason are correct and related. B. Both the statement and the reason are correct but are not related. C. The statement is correct, but the reason is not correct. D. The statement is not correct, but the reason is correct. E. Neither the statement nor the reason is correct.

A. Both the statement and the reason are correct and related.

Patients with periodontal disease might require increased protein intake because the physiologic response to inflammation and infection can negatively affect protein synthesis. A. Both the statement and the reason are correct and related. B. Both the statement and the reason are correct but are not related. C. The statement is correct, but the reason is not correct. D. The statement is not correct, but the reason is correct. E. Neither the statement nor the reason is correct.

A. Both the statement and the reason are correct and related.

Protein-energy malnutrition (PEM) may be responsible for increased incidence of noma and necrotizing ulcerative gingivitis (NUG) because these conditions are associated with depressed immune responses caused by nutritional deficiencies. A. Both the statement and the reason are correct and related. B. Both the statement and the reason are correct but are not related. C. The statement is correct, but the reason is not correct. D. The statement is not correct, but the reason is correct. E. Neither the statement nor the reason is correct.

A. Both the statement and the reason are correct and related.

Which enzyme is most essential for digestion of triglycerides found in butterfat? A. Gastric lipase B. Pepsin C. Mucus D. Intrinsic factor

A. Gastric lipase - Gastric lipase is essential for digestion of short- and medium-chain triglycerides, such as those found in butter fat. Pepsin is essential for hydrolysis of large protein molecules. Mucus forms an alkaline coating that protects the stomach lining from digestion by pepsin. Intrinsic factor is secreted by the stomach and is essential for absorption of vitamin B12.

List 3 out of the 9 Indispensable amino acids.

A. Lysine B. Methonine C.Trytophan

List 3 of the 7 Physiological roles in which protein are required.

A. Requlation of Fluid balance B. Repair tissue C. Resistance to disease

The hypothalamus controls the feeling of hunger and satiety. Fats are the best nutrient in creating the feeling of satiety. A. True B. False

A. True

Men required a higher RDA then woman, except during stages of pregnancy and lactation. A. True B. False

A. True Men's RDA is (700mcg) whereas women's (700mcg) except in pregnancy (770mcg) or lactation (1300mcg).

The most significant dietary influence on the development of dental caries is: A. carbohydrates. B. vitamins. C. minerals. D. fats. proteins.

A. carbohydrates. - The potential for dental caries and acid production exists every time a carbohydrate is eaten. The other nutrients do not have the same ability to reduce salivary pH to acidic levels. Of interest to dental hygienists and their patients, proteins and fats are cariostatic because they cannot be metabolized by microorganisms in plaque biofilm; therefore, these nutrients are considered to inhibit caries. Vitamins and minerals are essential to metabolism and maintenance of health.

Which is formed by a positively charged metal ion and negatively charged nonmetal join? A. lonic bond B. Covalent bond C. Functional group

A. lonic bond

Monosaccharides are converted into glucose in the liver in order to provide an energy supply to the cells. A.Both statements are true. B.Both statements are false. C.The first statement is true; the second is false. D.The first statement is false; the second is true.

A.Both statements are true.

List 2 Dispensable amino acids

Alanine Serine

Vitamin B2 (riboflavin) deficiency

Angular cheilitis

Each is a form of vitamin K, except one. Which is the exception? A. Phylloquinone B. Tocopherol C. Menaquinone D. Menadione

B. Tocopherol Tocopherol is another name for vitamin E. The remaining terms are forms of vitamin K, a fat-soluble vitamin. All forms belong to a group of chemical compounds known as quinones. Vitamin K1, phylloquinone, occurs in green plants. Vitamin K2, menaquinone, is formed by Escherichia coli bacteria in the large intestine and is found in animal tissues. Vitamin K3, menadione, is a synthetic compound, whereas the other two are naturally occurring.

The substance that is most supportive of bones and teeth is: A. hemoglobin. B. collagen. C. insulin. D. pepsin.

B. collagen.

The medical term for persistent, abnormal distortion of taste is: A.anosmia. B. dysgeusia. C.xerostomia. D. hypogeusia. E. hypergeusia.

B. dysgeusia.

Each of the following is a function of the liver except one. Which one is the exception? A. Regulatory control of nutrients in the bloodstream B.Conversion of monosaccharides to triglycerides C. Breakdown of polysaccharide glycogen into glucose D.Oxidation of digestive end products to provide energy

B.Conversion of monosaccharides to triglycerides

List 3 side effects of having too much vitamin A (hyperstate):

Birth defects reported in children of women taking 13-cis-retinoic acid (isotretinoin) for skin conditions during pregnancy, Catabolism of collagen and bone resorption by osteoclasts, Diplopia, Alopecia, Dry, rough skin and mucosa, Reddened gingiva, Cracked lips, Thinning of epithelium, Hypercarotenemia: skin turns deep yellow, especially on palms and soles

Which group is least susceptible to insufficient intake of protein? A. The elderly the B. Individuals with low income C. Adults participating in endurance exercise D. Patients who are chronically ill

C. Adults participating in endurance exercise

Loss of smell results in a condition that limits capacity to detect flavor of food and beverages called: A. hypergeusia. B. dysgeusia. C. anosmia. D. phantom taste. E. peristalsis.

C. Anosmia, or loss of smell, results in limited capacity to detect flavor of food and beverage. Upper respiratory infections, nasal or sinus problems, and neurological disorders can cause anosmia. Hypergeusia is heightened taste acuity. Dysgeusia is persistent, abnormal distortion of taste. Phantom taste is dysgeusia without identifiable taste stimuli. Peristalsis is a mechanical action involved in digestion. It involves involuntary rhythmic waves of contraction in the alimentary tract.

Which chemical structure is illustrated as glycerol + two fatty acids? A. Compound lipids B. Monoglycerides C. Diglycerides D.Structural lipids E. None of the above

C. Diglycerides

Which monosaccharide is the most sweet? A. Glucose B. Dextrose C. Fructose D. Sucrose

C. Fructose - Fructose is the sweetest of the monosaccharides. Note that glucose is also called dextrose and that sucrose is not a monosaccharide. It is a disaccharide.

Each is a portion of the alimentary canal, except one. Which is the exception? A. Oral cavity B. Pharynx C. Larynx D. Esophagus E. Small intestine

C. Larynx

Each is a function of vitamin A, except one. Which is the exception? A. Prevention of night blindness B. Growth of soft tissues and bone C. Maintenance of more than 200 genes D. Integrity of body openings and their linings

C. Maintenance of more than 200 genes Vitamin D, not A, is responsible for maintenance of more than 200 genes. Functions of vitamin A are many; the remaining selections correctly identify numerous important roles. Without the role of vitamin A in the production of the visual pigment, rhodopsin, and night blindness may result.

Vitamin C deficiency

Perifollicullar petchiae

Each is a characteristic manifestation of necrotizing ulcerative gingivitis (NUG), except one. Which is the exception? A. Gingival erythema B. Necrosis of interdental papilla C. Marasmus D. Metallic taste and foul odor

C. Marasmus

Which animal-derived food contains the most significant level of carbohydrates? A. Egg B. Beef C. Milk D. Poultry

C. Milk - The only animal foods supplying significant quantities of carbohydrate are milk and milk products, which furnish the disaccharide lactose. Interestingly, in cheese making the lactose is removed as a by-product.

Which consumption pattern of fermentable carbohydrate is considered most cariogenic? A. A single exposure to a large quantity B. A single exposure to a small quantity C. Multiple exposures of small quantities D. Multiple exposures followed by chewing sugarless gum

C. Multiple exposures of small quantities - The total amount of dietary fermentable carbohydrate seems of less importance than the form and frequency in which it is eaten. Generally, multiple exposures of even small quantities of fermentable carbohydrate throughout the day is considered a highly cariogenic behavior. Swishing with water and chewing sugarless gum following any exposure can reduce the fermentation potential. The American Dental Association has approved the use of the ADA seal on sugarless gums by several manufacturers.

Which type of nutritional deficiency results from inadequate absorption? A. Unmeasurable B. Primary deficiency C. Secondary deficiency D. Codependent

C. Secondary deficiency A nutritional deficiency as a result of decreased intake is called a primary deficiency. A vitamin deficiency caused by inadequate absorption or use, increased requirements, excretion, or destruction is called a secondary deficiency.

Each is true of fat-soluble vitamins, except one. Which is the exception? A. Fairly stable to heat, as in cooking B. Contains carbon C. Stored in the pancreas D. Absorbed in intestine along with fats and lipids in food

C. Stored in the pancreas

Each correlation between vitamin D and sun exposure is accurate, except one. Which is the exception? A. The body has the ability to produce adequate amounts of vitamin D from sunlight. B. UV radiation penetrates uncovered skin and converts a precursor of vitamin D to vitamin D3. C. Sunscreen does not block the formation of vitamin D3. D. By the age of 70 years, the skin generally produces vitamin D at only half the level it did at the age of 20 years.

C. Sunscreen does not block the formation of vitamin D3. Sunscreen does block formation of vitamin D3. UV radiation penetrates uncovered skin and converts a precursor vitamin D to previtamin D3, which becomes vitamin D3. Because UV radiation is the principal cause of sunburn and cellular damage that leads to skin cancer, dermatologists continue to advise sunscreen and clothing protection for anyone in the sun more than 20 minutes.

Each is true of swallowing and processing food, except one. Which is the exception? A. The swallowing reflex moves a bolus into the esophagus. B. A bolus is a mass of food. C. The bolus is transported to the stomach by osmosis and gravity. D. The bolus penetrates the diaphragm through the esophageal hiatus. E. The lower esophageal sphincter relaxes to permit food into the stomach.

C. The bolus is transported to the stomach by osmosis and gravity. - The bolus is transported to the stomach by peristalsis, not osmosis, and gravity. Peristalsis is a series of contractile waves that mechanically move the bolus through the alimentary tract. Note that osmosis is the passage of water through a semipermeable membrane to equalize osmotic pressure. This process involves ionic control of movement of water (fluids) across membranes.

Sucrose, lactose, and fructose can be metabolized by bacterial plaque. Fructose, also known as levulose and found naturally in honey, is less cariogenic than sucrose and lactose. A. Both statements are true. B. Both statements are false. C. The first statement is true; the second is false. D. The first statement is false; the second is true.

C. The first statement is true; the second is false. - The first statement is true; the second is false. Any fermentable carbohydrate, including sucrose, lactose, and fructose are readily metabolized by oral microorganisms, and can result in demineralization of tooth enamel. While fructose is a natural sugar found in honey, note that natural sugars in unprocessed foods such as bananas, honey, and raisins, are potentially as cariogenic as sucrose. The body cannot distinguish between natural honey, refined table sugar, or high fructose corn syrup. All are absorbed and metabolized in the same manner as the component sugars. Note that fructose is also known as levulose and is the sweetest of the monosaccharides.

Complex carbohydrates contain more than 10 monosaccharides. Complex carbohydrates are also called disaccharides. A. Both statements are true. B. Both statements are false. C. The first statement is true; the second is false. D. The first statement is false; the second is true.

C. The first statement is true; the second is false. - The first statement is true; the second is false. Complex carbohydrates are also called polysaccharides and contain more than 10 monosaccharides.

Fat-soluble vitamins are different from water-soluble vitamins because the body is able to store only small amounts of fat-soluble vitamins. A. Both the statement and the reason are correct and related. B. Both the statement and the reason are correct but are not related. C. The statement is correct, but the reason is not correct. D. The statement is not correct, but the reason is correct. E. Neither the statement nor the reason is correct.

C. The statement is correct, but the reason is not correct. The statement is correct, but the reason is not correct. A major difference between fat-soluble and water-soluble vitamins is that the body is able to store larger amounts of fat-soluble vitamins. Vitamins A and D are stored for long periods; therefore, minor shortages might not be identified until drastic depletion has occurred. Observable signs and symptoms of a dietary deficiency are often not identified until they are in an advance state.

Loss of smell results in a condition that limits capacity to detect flavor of food and beverages called: A. hypergeusia. B. dysgeusia. C. anosmia D. phantom taste. E. peristalsis.

C. anosmia

Each is true of vitamin K, except one. Which is the exception? A. Vitamin K is produced in the gut. B. Vitamin K functions as a catalyst for synthesis of blood-clotting factors. C. Vitamin K maintains prothrombin levels. D. Vitamin K absorption increases with high levels of vitamin E supplementation.

D. Vitamin K absorption increases with high levels of vitamin E supplementation. Vitamin K absorption decreases with high levels of vitamin E supplementation because in larger amounts, vitamin E is an anticoagulant. Pertinent to dental hygienists, vitamin K functions as a catalyst for synthesis of blood-clotting factors primarily in maintaining prothrombin levels, which is the first stage in clot formation. A low prothrombin level results in impaired blood coagulation. Many dental patients take anticoagulants for stroke prevention, a fact that highlights the critical nature of an up-to-date medical history.

A patient who reports stomach ulcers should avoid all the following foods, except one. Which is the exception? A. Proteins B. Caffeine C. Calcium D. Wheat

D. Wheat - Patients with ulcers of certain gastrointestinal tract disorders should avoid dietary constituents that increase hydrochloric acid and pepsin secretion. Foods to avoid include proteins, calcium, caffeine, coffee, and alcohol. Conversely, wheat (a whole grain), brown rice, and pastas are usually well tolerated because they do not typically stimulate gastric secretions. Note that although wheat is problematic in patients with gluten sensitivity, it is not contraindicated in patients with ulcers.

The physiologic role of proteins does NOT include: A. resistance to disease. B. regulation of fluid balance. C. repair of tissue. D. providing the primary source of energy.

D. providing the primary source of energy.

Which fatty acid has carbons connected by two or more double bonds? A.Saturated fatty acids B.Monounsaturated fatty acids C.Trans fatty acids D.Polyunsaturated fatty acids

D.Polyunsaturated fatty acids

Physiological and biochemical reactions within the body?

Digestion Absorption Elimination

Follicular Hyperkeratosis

Dry, bumpy skin associated with vitamin A deficiency

Follicular hyperkeratosis

Dry, bumpy skin associated with vitamin A deficiency

Hypomineralization of Enamel

During tooth formation, Fluorosis

Which best conveys the main message(s) of the MyPlate graphic? A. Balance in food and choice B. Consuming a variety of foods C. Certain foods should be consumed in moderation D. Adequate nutrient consumption E. All of the above F. None of the above

E. All of the above

Which physiologic role does vitamin C play in the body? A. Transcribing DNA to RNA B. Absorption and regulation of calcium C. Protects integrity of cellular membranes D. Catalyst for synthesis of blood-clotting factors E. Collagen production for wound healing

E. Collagen production for wound healing Vitamin C produces collagen for wound healing. Vitamin A facilitates the transcription of DNA to RNA. Calcium absorption and regulation is facilitated by vitamin D; the integrity of cellular membranes is protected from hemolysis by vitamin E; and vitamin K functions as a catalyst for synthesis of blood-clotting factors and maintaining prothrombin levels.

Which food group in MyPyramid always contains fat? A. Fruits B. Vegetables C. Milk D. Grains E. Meat

E. Meat

Each is a physiologic role of vitamin D, except one. Which is the exception? A. Hematopoiesis B. Cardiac and neuromuscular function C. Immune responses D. Serum calcium regulation E. Synthesis of blood-clotting factors

E. Synthesis of blood-clotting factors Vitamin K, not D, functions as a catalyst for synthesis of blood-clotting factors. The remaining selections are physiologic roles of vitamin D. Hematopoiesis is the formation of red blood cells. The regulatory role of vitamin D helps keep serum calcium in an appropriate range to maintain cardiac and neuromuscular function. The hormone actions of vitamin D are integral to protecting immune responses.

Scurvy is caused by a deficiency of which vitamin? A. Vitamin A B. Vitamin D C. Vitamin E D. Vitamin K E. Vitamin C

E. Vitamin C Scurvy, caused by vitamin C deficiency, can occur in 20 days. It is characterized by spontaneous gingival hemorrhaging, perifollicular petechiae, follicular hyperkeratosis, diarrhea, fatigue, depression, and cessation of bone growth.

Each is a function of saliva, except one. Which is the exception? A. Saliva is essential to gustatory sensations. B. Saliva lubricates oral tissues. C. Saliva provides antibacterial action. D. Saliva buffers bacterial acids. E. Saliva extracts calcium and phosphate from demineralized tooth surfaces.

E.Saliva extracts calcium and phosphate from demineralized tooth surfaces. - Saliva restores or returns calcium, phosphates, and other minerals into surfaces of teeth that have been damaged by caries, erosion, or abrasion. Saliva is supersaturated with calcium phosphates

Name 4 of the 12 discussed groups at risk for nutritional deficiencies.

Elderly, low income, vegans, chronic disease, alcoholics, smokers, periods of growth, medical conditions, physical stress, physiological stress, polypharmacy, inadequate intake

Taste perception declines with age. Individuals taking three or more medications are likely to have less taste sensitivity and require greater amounts of sodium and sugar to perceive these tastes. a) Both statements are true. b) Both statements are false. c) The first statement is true; the second is false. d) The first statement is false; the second is true.

a) Both statements are true.

The purpose of the health history is to identify health-related considerations and medications that may cause nutritional risk. Many medications, such as prednisone, have drug-nutrient interactions that can influence nutrient needs. a) Both statements are true. b) Both statements are false. c) The first statement is true; the second is false. d) The first statement is false; the second is true.

a) Both statements are true.

Approximately 75% of reputable producers of bottled water use groundwater as their water source. Plain tap water is the most natural source of fluids. a) Both statements are true. b) Both statements are false. c) The first statement is true; the second is false. d) The first statement is false; the second is true.

a) Both statements are true. Although the bottled water market has been increasing, as a result of environmental concerns and the revelation that approximately 75% of reputable producers of bottle water use groundwater (same source as the public water supply) or tap water, the rate of increase has declined. Environmental concerns include the energy required to produce plastic, non-biodegradable bottles, the bisphenol A content of bottles, and the marketing and shipping costs.

Because orthodontic patients are frequently adolescents, nutrition and oral self-care are often less than ideal. The dental hygienist may be successful in motivating noncompliant patients by reminding them that optimal nutrition and oral self-care are worthwhile endeavors that improve their appearance. a) Both statements are true. b) Both statements are false. c) The first statement is true; the second is false. d) The first statement is false; the second is true.

a) Both statements are true. Correct Both statements are true. An important role of the dental hygienist is to motivate patients to care for themselves. During orthodontic treatment, the frequency and timing of fermentable carbohydrates is a factor that adolescents often ignore. Helping patients to understand that foods with a low nutrient value and fermentable carbohydrates minimize success of orthodontic treatment and increase the risk of oral complications is a major challenge for proactive hygienists. Stressing the aesthetic value of self-care in nutrition and oral hygiene is often a successful tactic.

When rickets occurs, the alveolar bone is affected similar to other bones in the body. The trabeculae of the alveolar bone also weaken. a) Both statements are true. b) Both statements are false. c) The first statement is true; the second is false. d) The first statement is false; the second is true.

a) Both statements are true. Correct Both statements are true. In addition to damaged alveolar bone caused by vitamin D deficiency, dental changes include delayed dentition and small molars.

Generally, patients who wear dentures have reduced masticatory efficiency. Mandibular implant-supported dentures can have positive effects on the clinical aspects of mastication and swallowing. a) Both statements are true. b) Both statements are false. c) The first statement is true; the second is false. d) The first statement is false; the second is true.

a) Both statements are true. Correct Both statements are true. Patients who wear dentures have 75% to 85% less masticatory efficiency than their dentate counterparts do. After edentulous individuals fully adjust to new dentures, caloric intake increases, but dietary intake of magnesium, folic acid, fluoride, zinc and calcium levels continue to be low because of food selection. Mandibular implant-supported dentures can positively affect chewing because these appliances provide stability not possible with traditional dentures.

During early tooth development, vitamin A deficiency leads to enamel hypoplasia and defective dentin formation. Because of its effect on soft tissues and bone, vitamin A contributes to normal spacing of teeth. a) Both statements are true. b) Both statements are false. c) The first statement is true; the second is false. d) The first statement is false; the second is true.

a) Both statements are true. Correct Both statements are true. The effect of vitamin A on growth of soft tissues and bones naturally extends to the teeth and surrounding structures. Enamel hypoplasia, involving defective enamel matrix and incomplete calcification of enamel and dentin, can be due to vitamin A deficiency. The effect of this vitamin upon surrounding bone has a directly affects spacing patterns of the teeth within the bone and dentition.

Loss of teeth or supporting periodontium is frequently associated with poor food selection and limited chewing ability. The patients' masticatory efficiency and biting force decline with each tooth lost. a) Both statements are true. b) Both statements are false. c) The first statement is true; the second is false. d) The first statement is false; the second is true.

a) Both statements are true. Correct Both statements are true. The number of teeth and presence of advanced mobility determine food choices. A patient with complete dentures, less than 20 functioning teeth, or few pairs of opposing teeth has lower nutrient intake than a patient with adequate dentition does. Because of the number of variables that can affect nutrition, it is imperative that a personalized nutritional education be prepared for all patients.

Systemic disease often manifests in the oral cavity first. Disease within the oral cavity can cause systemic complications. a) Both statements are true. b) Both statements are false. c) The first statement is true; the second is false. d) The first statement is false; the second is true.

a) Both statements are true. Correct Both statements are true. The oral cavity can reflect systemic disease before other signs and symptoms become evident; the condition in the oral cavity may also cause systemic problems by affecting the patient's nutrient intake.

Dental hygienists are in a key position to assess and detect signs and symptoms of systemic disease because more than one third of the patients treated in a dental office frequently do not interact with a general health care provider. a) Both the statement and the reason are correct and related. b) Both the statement and the reason are correct but are not related. c) The statement is correct, but the reason is not correct. d) The statement is not correct, but the reason is correct. e) Neither the statement nor the reason is correct.

a) Both the statement and the reason are correct and related.

Inadequate intake of vitamin A occurs in lower socioeconomic groups because these individuals often lack resources to purchase and consume vegetables and fruits. a) Both the statement and the reason are correct and related. b) Both the statement and the reason are correct but are not related. c) The statement is correct, but the reason is not correct. d) The statement is not correct, but the reason is correct. e) Neither the statement nor the reason is correct.

a) Both the statement and the reason are correct and related. Correct Both the statement and the reason are correct and related. Average intake in the United States meets the RDA for vitamin A intake, except in lower socioeconomic groups. This is most likely because these individuals lack resources to purchase, prepare, and consume an adequate supply of fruits and vegetables. Note that because vitamin A can be stored in the liver, most adults have sufficient quantities to maintain health.

A multivitamin supplement containing folic acid is recommended for all young women because of the number of unintentional pregnancies in women 15 to 24 years old. a) Both the statement and the reason are correct and related. b) Both the statement and the reason are correct but are not related. c) The statement is correct, but the reason is not correct. d) The statement is not correct, but the reason is correct. e) Neither the statement nor the reason is correct.

a) Both the statement and the reason are correct and related. Correct Both the statement and the reason are correct and related. Folate (folic acid) supplementation is considered prudent if adequacy of intake is questionable. Because a deficiency of this nutrient, as well as others, has the potential to harm the embryo from the moment of conception, and the high percentage of unplanned pregnancies in this age group, it is prudent to recommend a multivitamin-multimineral supplement. In support of this recommendation, most women do not know they are pregnant for at least several weeks.

Milk and other dairy products are preferred sources of calcium because lactose enhances calcium absorption. a) Both the statement and the reason are correct and related. b) Both the statement and the reason are correct but are not related. c) The statement is correct, but the reason is not correct. d) The statement is not correct, but the reason is correct. e) Neither the statement nor the reason is correct.

a) Both the statement and the reason are correct and related. Correct Both the statement and the reason are correct and related. Milk and other dairy products supply most of the available calcium, so they are the preferred sources of calcium. Not only are dairy products naturally high in calcium content, but also their inherent lactose and other nutrient content enhance calcium absorption. Milk also provides other essential nutrients.

The RDA for iron is higher in premenopausal women than for men or postmenopausal women because of the blood loss during menstruation. a) Both the statement and the reason are correct and related. b) Both the statement and the reason are correct but are not related. c) The statement is correct, but the reason is not correct. d) The statement is not correct, but the reason is correct. e) Neither the statement nor the reason is correct.

a) Both the statement and the reason are correct and related. Correct Both the statement and the reason are correct and related. The Institute of Medicine (IOM) recommends 18 mg of iron per day for women 19 to 50 years old, 8 mg/day for women 51 years old and older and men 19 years old and older. Note that during the reproductive phase of a woman's life, iron loss is at least twice that of a man or of a postmenopausal woman.

Which mental health disease can lead to the erosion of lingual enamel, enlarged parotid glands, palatal bruising, and dentinal hypersensitivity? a) Bulimia b) Anorexia nervosa c) Depression d) Schizophrenia

a) Bulimia

Which vitamin's recommended dietary allowance (RDA) is significantly increased during pregnancy? a) Folate Correct b) Thiamin (B1) c) Riboflavin (B2) d) Niacin (B3) e) Biotin (B7) f) Cobalamin (B12)

a) Folate Correct The RDA for folate (600 μg) during pregnancy is significantly more than the RDA for a nonpregnant person. The role of folate as a coenzyme is essential for nucleic acid synthesis. A folate deficiency that impairs cell growth and replication may cause fetal anomalies. Folate is also required for red blood cell (RBC) formation, which is increased in pregnancy. Orofacial clefts and neural tube defects, such as spina bifida and anencephaly (absence of a major portion of the brain and skull), have been attributed to inadequate folate intake before conception and during the first trimester.

Which systemic disease is best controlled with the DASH diet, monitoring blood pressure, limiting sodium, alcohol, and caffeine, reducing stress, and losing weight? a) Hypertension b) Diabetes mellitus c) Parkinson's disease d) Malabsorption conditions e) Anemia

a) Hypertension

List 3 factors associated with an increased malnutrition risk:

a) Less education and income b) Housebound, especially those living alone c) Physical disabilities d) Depression and other mental health issues e) Drastic changes, such as death of spouse

Primary bacteria involved in initiation of dental caries are: a) Streptococcus mutans and Lactobacillus species. b) Salmonella and Listeria species. c) Streptococcus, Lactobacillus, and Salmonella species. d) Listeria and Botulinum species and Escherichia coli.

a) Streptococcus mutans and Lactobacillus species. Correct As a by-product of the metabolism of sucrose and glucose, bacteria produce acids that lower the pH, resulting in a more favorable environment for the development of cariogenic bacteria. Primary bacteria implicated in initiation of dental caries are those that ferment carbohydrates including Streptococcus mutans, Lactobacillus species, and other mutans streptococci.

Which is NOT a prudent recommendation for a menopausal patient? a) Supplement calcium and vitamin D slightly beyond upper intake (UI) level because of increased metabolic needs. b) Encourage lean protein and regular exercise to maintain muscle mass. c) Avoid alcohol and alcohol-containing oral hygiene products if xerostomia is present. d) Consumption of 90 mg daily of isoflavones in soy products helps to increase bone mass.

a) Supplement calcium and vitamin D slightly beyond upper intake (UI) level because of increased metabolic needs. Correct Calcium and vitamin D supplementation beyond the tolerable upper intake level should be discouraged unless taken under the supervision of a health care provider. The dental hygienist can help menopausal patients by explaining the links between declining hormone levels and diminishing bone mass/increased risk of fractures. Many medications and products cause dry mouth, xerostomia, and dental hygienists can provide valuable preventive and therapeutic advice to minimize oral conditions related to diminished salivary flow.

Wernicke-Korsakoff syndrome is associated with which vitamin deficiency? a) Thiamin (B1) b) Riboflavin (B2) c) Niacin (B3) d) Pyridoxine (B6) e) Biotin (B7) f) Cobalamin (B12)

a) Thiamin (B1) Correct Severe thiamin deficiency results in beriberi, which causes extensive damage to the nervous and cardiovascular systems. Wernicke-Korsakoff syndrome is another thiamin deficiency disease typically associated with alcoholism. Because thiamin is essential for carbohydrate metabolism, a thiamin deficiency is closely linked to aberrations of brain function. For patients who are confused or have altered thought processes, assess nutrient intake. Vitamin deficiencies seldom occur in isolation. If a deficiency is suspected, symptoms of other vitamin B deficiencies may also be present. Primary dietary deficiency usually occurs in developing countries where polished rice is the staple diet.

The prevalence is seen in approximately 5% to 10% of cases. a) Type 1 Diabetes b) Type 2 Diabetes

a) Type 1 Diabetes

The ideal time to begin taking folate to prevent neural tube defects is: a) before conception. b) once pregnancy begins. c) at 6 weeks. d) upon completion of the first trimester.

a) before conception. Correct Maternal health and fetal growth and development are affected by nutrient intake during pregnancy and before conception. Low levels of folic acid (folate) before pregnancy have been linked to neural tube defects. Also pertinent, low levels of iron and folate before pregnancy have been linked to premature births and stunted growth. The concept of preventive care before pregnancy extends to all aspects of health.

To help prevent early childhood caries (ECC), the dental hygienist should recommend the infant: a) not be given nighttime bottles. b) drink pasteurized skim milk. c) eat iron-rich foods. d) drink fruit juice.

a) not be given nighttime bottles. Correct All expectant parents should be educated about techniques for avoiding early childhood caries, including avoidance of using a bottle or sippy cup as a pacifier at bedtime, naptime, or throughout the day. Fruit juice provides no nutritional benefit for infants younger than 6 months and is highly cariogenic. To decrease the risk of dental caries, fruit juice should not be given in bottles or sippy cups. After weaning from breast or bottle feeding, babies should be given whole vitamin D-fortified milk. All children require iron, with the need increasing after 6 months.

The dental hygienist's main goal when making dietary recommendations for a patient with a new dental prosthesis is to: a) promote healing and repair by ensuring an adequate and nutrient-dense diet. b) promote healing and repair by recommending consumption of only liquids for the first week. c) promote a balanced diet by recommending a variety of fibrous foods. d) encourage the patient to become accustomed to prosthesis by eating as usual.

a) promote healing and repair by ensuring an adequate and nutrient-dense diet. Correct Because adjusting to a new dental appliance is challenging and requires time, nutrient deficiencies frequently interfere with maintenance and repair of oral soft and hard tissues. Ensuring adequate intake is a top priority; therefore, a liquid nutritional supplement may be needed to meet caloric and nutrient needs. Days 1 and 2 after placement may necessitate a full liquid diet. During the next 2 to 3 days, the patient should advance to a mechanical soft diet as tolerated. Firmer textured foods should be added as sore spots heal. During this period of adjustment, any chewy, hard, or fibrous foods are often avoided because of low masticatory performance.

The principal cation in plasma and interstitial fluid is: a) sodium. b) potassium. c) calcium. d) magnesium.

a) sodium. Correct Cations include sodium, potassium, calcium, and magnesium; the principal cation in plasma and interstitial fluids is sodium.

List the psychological factors that lead to decreased appetites and interest in food:

a. Apathy b. Depression

List 2 risk factors for Pica.

a. Lower socioeconomic groups b. Less than a high school education c. Poor nutritional health d. Behavioral/environmental factors, such as substance abuse

Which set of guidelines is intended to assess nutrient adequacy or planning intakes of population groups, not individuals? a) Old recommended dietary allowances (RDA) b) Estimated average requirement (EAR) c) New recommended dietary allowances (RDA) d) Tolerable upper intake level (UL)

b) Estimated average requirement (EAR)

Nutritional goals for a patient wishing to modify eating patterns should adhere to each, except one. Which is the exception? a) Measurable b) Immediate c) Realistic d) Achievable

b) Immediate

Each has cariostatic properties, except one. Which is the exception? a) Eggs b) Instant oatmeal c) Cheese d) Seafood e) Meat

b) Instant oatmeal Correct Some food components can provide a protection to teeth be decreasing demineralization, enhancing the remineralization process, or increasing salivary flow, even in the presence of a fermentable carbohydrate. Eggs, cheese, seafood, meat, nuts, seeds, margarine, and oils are examples of potentially cariostatic foods. Alternatively, processed foods such as instant oatmeal, are often more fermentable than their nonprocessed counterparts because of partial hydrolysis or diminution of particle size. Dental hygienists can help parents understand that when starches and simple carbohydrates are combined (as in pastries or sugar-coated cereals), their potential to produce caries is equal to or greater than that of sucrose.

Which nutrient deficiency produces microcytic anemia, fatigue, faulty digestion, blue sclerae, pale conjunctivae, and tachycardia? a) Zinc b) Iron Correct c) Sodium d) Potassium e) Iodine

b) Iron Correct A deficiency in iron can lead to various symptoms, such as microcytic anemia, fatigue, faulty digestion, blue sclerae, pale conjunctivae, and tachycardia. Iron-deficiency anemia may be caused by inadequate dietary intake; accelerated demand or losses; and inadequate absorption secondary to diarrhea, decreased acid secretions, or antacid therapy. Iron deficiency is frequently the result of postnatal feeding practices and has a serious impact on growth and mental and psychomotor development in infants and children.

Each is true regarding oral exposure to fermentable carbohydrates, except one. Which is the exception? a) Longer exposure leads increases risk of demineralization. b) Longer exposure increases opportunity for remineralization. c) The Stephan curve shows pH changes within plaque after rinsing with a sugar solution. d) The critical pH at which enamel decalcification occurs is 5.5 or less. e) Frequency of carbohydrate consumption increases caries risk.

b) Longer exposure increases opportunity for remineralization. Correct Longer exposure to fermentable carbohydrates increases acid exposure to teeth. The result is an increased risk of demineralization and a corresponding decreased opportunity for remineralization. The Stephan curve, which demonstrates pH changes after rinsing with a sugar solution, provides an excellent aid for dental hygienists to illustrate the destructive effects of fermentable carbohydrates. Inherent to such discussions should be the effects of physical form, intake frequency, retentiveness of the food, and oral hygiene interventions.

Which neuromuscular disease is characterized by abnormal chewing and swallowing patterns; tremors of mandible, lip, and tongue; frequent drooling; and holding food in the mouth for extended periods? a) Developmental disabilities b) Parkinson's disease c) Epilepsy d) Diabetes mellitus

b) Parkinson's disease

Each is true of rickets, except one. Which is the exception? a) Rickets is being diagnosed more frequently in the United States. b) Rickets is caused by vitamin C deficiency. c) Tachetic deformities such as bow legs or knock-knees develop. d) A narrow and distorted chest occurs.

b) Rickets is caused by vitamin C deficiency. Correct Rickets is caused by vitamin D, not C, deficiency, and it usually occurs in children who are 1 to 3 years old. The name rickets came from the word wrikken, meaning to "to bend or twist." Another manifestation is failure of the epiphyses of bones to develop normally. This results in bones that are twisted and warped.

Each is true of proteins, except one. Which is the exception? a) Proteins are composed of building blocks called amino acids. b) The classification of the 20 common amino acids is based on the structure of their amino group. c) The general structure of an amino acid varies considerably. d) Amino acids polymerize to form long chains called polypeptides. e) Amino acids contain strong covalent peptide bonds.

b) The classification of the 20 common amino acids is based on the structure of their amino group.

BMI is typically >25 with an increased percentage of body fat in the abdominal region. a) Type 1 Diabetes b) Type 2 Diabetes

b) Type 2 Diabetes

Frequently onset is >40 years old. a) Type 1 Diabetes b) Type 2 Diabetes

b) Type 2 Diabetes

Although a balanced diet is essential to tissue healing and repair, which of the following should the dental hygienist identify as the nutrient of highest priority for a patient with gingivitis or periodontal disease? a) Carbohydrates b) Vitamin C c) Vitamin D d) Monosaccharides

b) Vitamin C Correct The dental hygienist should stress consumption of vitamin C for the periodontal or gingivitis patient. Vitamin C is especially important for collagen and connective tissue formation, which are two important components of periodontal and gingival wound healing. In general, the dental hygienist should encourage a nutrient-dense food that are not retentive as well as the RDA for vitamin C.

Each is a fat-soluble vitamin, except one. Which is the exception? a) Vitamin A b) Vitamin C c) Vitamin D d) Vitamin K

b) Vitamin C Correct Vitamin C is not a fat-soluble vitamin. It is water-soluble. The fat-soluble vitamins are A, D, E, and K.

Each is true, except one. Which is the exception? a) Infant formulas should be discontinued at approximately 1 year of age. b) Vitamin D c) Low-fat milk is not recommended for children younger than 2 years. d) Special toddler formulas are available but are unnecessary.

b) Vitamin D-fortified whole milk should not be provided until 2 years. Correct After discontinuing breast feeding or infant formulas, vitamin D-fortified whole milk should be provided until age 2. The remaining selections are true. Note also that lactose-free and reduced lactose-containing cow's milk formulas are available and could be used for circumstances in which elimination or a reduction in lactose is required.

Individuals with loss of smell are NOT inclined to: a) use more spices. b) eat less. c) eat and drink more sweets. d) lose weight.

b) eat less.

The term associated with loss of taste is: a) xerostomia. b) hypogeusia. c) dysphagia. d) sarcopenia. anosmia.

b) hypogeusia. Correct Hypogeusia (loss of taste) may be associated with certain disorders rather than being a normal component of the aging process. Older adults may confuse taste sensations, describing sour foods as metallic and salty foods as tasteless.

Study of life at the molecular level

biochemistry

Children with cerebral palsy, Down syndrome, and intellectual disabilities are likely to have abnormal sensory input and muscle tone. A small, underdeveloped tongue is common in many such disorders and results in diminished nutritional status. a) Both statements are true. b) Both statements are false. c) The first statement is true; the second is false. d) The first statement is false; the second is true.

c) The first statement is true; the second is false. Correct The first statement is true; the second is false. Common to children with special needs is tongue thrust, which jeopardizes nutritional status because of significant food waste during feeding. Difficulties with sucking, swallowing, spoon-feeding, chewing development, and independent feeding are common.

Vitamin deficiencies, especially the B-complex vitamins, seldom occur in isolation. Folate, a B-complex vitamin, is the exception because it functions separately from other vitamins. a) Both statements are true. b) Both statements are false. c) The first statement is true; the second is false. d) The first statement is false; the second is true.

c) The first statement is true; the second is false. Correct The first statement is true; the second is false. If a deficiency of one vitamin is suspected, symptoms of other vitamin B deficiencies also may be present. Folate deficiencies usually occur with other nutrient deficiencies. Specifically, folate functions in conjunction with vitamins B12 and C in maintaining normal levels of mature red blood cells.

Nonnutritive sweeteners are not metabolized by microorganisms and do not promote dental caries. Products made with a nonnutritive sweetener can be used as frequently as 8 to 10 times per day. a) Both statements are true. b) Both statements are false. c) The first statement is true; the second is false. d) The first statement is false; the second is true.

c) The first statement is true; the second is false. Correct The first statement is true; the second is false. Products made with a nonnutritive sweetener, such as aspartame, should be used in moderation; two to three times per day is advised. Some patients might not tolerate large amounts. The dental hygienist should recommend alternative noncariogenic food items and oral self-care. Note that foods made from these sweeteners are generally higher in cost and might not be feasible for low-income patients.

Bacterial growth and plaque formation are enhanced by a diet with frequent intake of retentive carbohydrates. Gingivitis is an irreversible change in the interdental papillary tissues. a) Both statements are true. b) Both statements are false. c) The first statement is true; the second is false. d)The first statement is false; the second is true

c) The first statement is true; the second is false. Correct The first statement is true; the second is false. Retentive fermentable carbohydrates are prime culprits in the propagation of bacteria responsible for initiation of gingivitis. Tissue changes in gingivitis are numerous, including alterations in the interdental papillary tissues; however, gingivitis is often reversible with appropriate oral hygiene techniques. This disease illustrates the preventive and therapeutic role of dental hygienists in helping patients learn to prevent and treat oral diseases.

Each of the following accurately describes features of MyPlate except one. Which one is the exception? a) MyPlate replaces the well-known food guide, MyPyramid. b) The interactive website is intended to help consumers apply personalized dietary guidance. c) Whereas MyPyramid was more specific in many areas, MyPlate provides more general information. d) Foods providing similar types of nutrients are grouped together and emphasizes proportionality of food selections. e) MyPlate is designed as a food guidance tool for the general public.

c) Whereas MyPyramid was more specific in many areas, MyPlate provides more general information.

Pain in the tongue is called: a) glossopharyngeal. b) glossitis. c) glossodynia. d) macroglossia.

c) glossodynia.

1.) Equalization of solute concentration of intracellular fluids (ICFs) and extracellular fluids (ECFs) is accomplished by: a) semipermeable membranes. b) hydration. c) osmotic pressure. d) perspiration.

c) osmotic pressure. Correct Osmotic pressure within the body equalizes the solute concentration of ICFs and ECFs by shifting small amounts of water in the direction of higher concentration solute. Semipermeable membranes separate one fluid compartment from another. Hydration and perspiration are important elements of fluid balance.

Fluoride supplements should never be taken with: a. water. b. juice. c. milk. d. soda.

c. milk. Correct Fluoride supplements should never be taken with milk; fluoride binds with milk and soy proteins, significantly decreasing the availability of fluoride.

Xerophthalmia

condition of dry eye, can cause night blindness, vitamin A deficiency

The oral cavity is the site of a wide variety of systemic disease manifestations due to: a) rapid cellular turnover. b) constant attack by microorganisms. c) trauma-intense environment. d) All of the above. e) None of the above.

d) All of the above. Correct The oral cavity is the site of a wide variety of systemic disease manifestations for several reasons: (1) it has a rapid cellular turnover rate, (2) it is under constant assault by microorganisms, and (3) it is a trauma-intense environment.

Which type of medication is most likely to induce xerostomia? a) Antibiotics b) Diuretics c) Local anesthetics d) Anticholinergic

d) Anticholinergic

Which is NOT a characteristic or function of lipids? a) Involve energy metabolism and storage. b) Provide insulation and protection. c) Act as hormones that regulate the body. d) Are hydrophilic.

d) Are hydrophilic.

Each is true of calcium within saliva, except one. Which is the exception? a) Saliva is supersaturated with calcium. b) Saliva is a source of calcium to mineralize an immature of demineralized enamel surface. c) Calcium and phosphate in saliva provide a buffering action. d) Calcium within saliva increases dental caries.

d) Calcium within saliva increases dental caries. Correct The buffering action provided by calcium and phosphate in saliva inhibit caries formation by preventing dissolution of enamel by plaque biofilm.

Each accurately describes the physical effects of food on periodontal health, except one. Which is the exception? a) Supragingival plaque biofilm adhesion is influenced by frequent consumption of monosaccharides. b) Supragingival plaque biofilm adhesion is influenced by frequent consumption of disaccharides. c) Poor nutrition has an adverse effect on the periodontium. d) Chewing soft, spongy foods stimulates salivary flow.

d) Chewing soft, spongy foods stimulates salivary flow. Correct Chewing firm, coarse, and fibrous foods such as fruits and vegetables stimulates salivary flow. Conversely, foods with soft and spongy texture tend to stick in pits and fissures, and they have minimal ability to stimulate salivary flow. Supragingival plaque and biofilm adhesion is influenced by frequent consumption of both monosaccharides and disaccharides, particularly sucrose. Note that frequency of consumption is more of a determinant of cariogenicity than the amount of carbohydrate consumed is.

Each food should be avoided by patients experiencing xerostomia, except one. Which is the exception? a) Saltines b) Salsa c) Alcohol d) Dill pickles

d) Dill pickles Correct Tart, sour, and citrus foods and drinks can help to stimulate saliva flow. Dill pickles are an excellent example. Sugar-free lemonade, sour candies formulated with sugar alcohols, or nonnutritive sweeteners can provide the same benefit.

Which is most likely to initiate periodontal disease? a) Nutrient deficiencies b) Nutrient excesses c) Nutrient imbalances d) Plaque biofilm e) Megadoses of supplements

d) Plaque biofilm Correct The primary initiating agent of periodontal disease is plaque biofilm accumulation around teeth and gingiva. Nutrient deficiencies, excesses, or imbalances do not initiate periodontal disease. Megadoses of supplements neither prevent nor cure periodontal disease.

Patients with this chronic nutrient deficiency may feel tired, weak, and irritable while being unable to pinpoint why. Hypertension, heart attack, stroke, kidney stones, and osteoporosis are associated with the chronic deficiency of which nutrient? a) Zinc b) Iron c) Sodium d) Potassium e) Iodine

d) Potassium Correct Chronic potassium deficiency is often unrecognized, but results in hypertension, heart attack, stroke, kidney stones, and osteoporosis. Patients with this chronic nutrient deficiency may feel tired, weak, and irritable while being unable to pinpoint why.

Each describes the physiologic roles of water, except one. Which is the exception? a) Acts as a solvent for chemical reactions. b) Maintains stability of body fluids. c) Enables transport of nutrients and excretion of waste. d) Regulates temperature by pooling as perspiration on skin.

d) Regulates temperature by pooling as perspiration on skin. Correct Water regulates body temperature by evaporating, not pooling, as perspiration from skin. Similarly, water regulates temperature by evaporating as vapor from the mouth and nose.

When counseling a teenager about fast food, a dental hygienist could correctly cite the following facts, except one. Which is the exception? a) Most fast food menus lack a rich source of vitamin A. b) Consumer demands have driven establishment of salads and other healthy menu items. c) Shortages of biotin, folate, pantothenic acid, and copper are reported in fast foods. d) Studies reveal that protein is lacking in most menu items. e) A hamburger or roast beef sandwich supplies substantial amounts of iron.

d) Studies reveal that protein is lacking in most menu items.

Increasing the variety of foods often causes nutrient excesses and toxicities. A dietary change to eliminate or increase intake of one specific food or nutrient usually alters the intake of other nutrients. a) Both statements are true. b) Both statements are false. c) The first statement is true; the second is false. d) The first statement is false; the second is true.

d) The first statement is false; the second is true.

Because of increasing cases of fluorosis, low levels of fluoride are added to commercial infant formula. Breast milk provides low levels of fluoride. a) Both statements are true. b) Both statements are false. c) The first statement is true; the second is false. d) The first statement is false; the second is true.

d) The first statement is false; the second is true. Correct The first statement is false; the second is true. Because of increasing cases of fluorosis, no fluoride is added to infant formulas. However, they contain a small amount of inherent fluoride as a result of some of the ingredients and processing. Breast milk provides approximately 0.01 mg/day of fluoride, regardless of drinking water and maternal plasma levels. Despite this low level, dental caries does not seem to increase. The American Dental Association and American Academy of Pediatric Dentistry recommend delaying fluoride supplements for all infants until 6 months of age.

Dental hygienists should encourage patients with eating disorders such as bulimia to brush immediately after vomiting because self-induced vomiting causes erosion of tooth enamel and dentin hypersensitivity. a) Both the statement and the reason are correct and related. b) Both the statement and the reason are correct but are not related. c) The statement is correct, but the reason is not correct. d) The statement is not correct, but the reason is correct. e)Neither the statement nor the reason is correct

d) The statement is not correct, but the reason is correct.

Increase in consumption of which of the following has the greatest effect on an increase in body weight? a) Carbohydrate intake b) Protein intake c) Fat intake d) Total kilocalories

d) Total kilocalories

Which is NOT a classification of carbohydrate? a) Monosaccharides b) Disaccharides c) Polysaccharides d) Triglycerides

d) Triglycerides

Each of the following nutrients provide energy except one. Which one is the exception? a) Proteins b) Carbohydrates c) Fats d) Vitamins e) Alcohol

d) Vitamins

During nutritional counseling, it is most important to: a) consult the patient's family. b) formulate a sample diet plan before presenting it to the patient. c) include members of the dental team in the dietary formulation. d) include the patient in formulation of the dietary plan.

d) include the patient in formulation of the dietary plan.

The movement of water from an area of lower solute concentration to one of a higher solute concentration is: a) hypodipsia. b) hypernatremia. c) hypokalemia. d) osmosis. e) alkalosis.

d) osmosis. Correct Osmosis is the movement of water from an area of lower solute concentration to one of a higher concentration. Osmotic pressure within the body equalizes the solute concentration of intracellular and extracellular fluids by shifting small amounts of water in the direction of higher concentration of solute.

List the three that provide energy

fats/lipids protein carbs

Vitamin C (ascorbic acid)

gingiva is blue-red and grossly swollen

Hypercaratenosis

hyper too much Vitamin A, skin turns yellow on palms, face, eyes

Catabolism

is the process of splitting complex substances into simpler substances.

Anabolism

is the process that requires energy in order to build more complex substances.

Waste products are removed from the blood using a filtration and reabsorption process and excess nutrients are excreted via the

kidney

Calcium and Vitamin D

osteoporosis

Vitamin D deficiencies

rickets in children and osteomalacia in adults

Monosaccharides

single sugar molecule glucose, fructose, galactose