Pocket Prep RD Domain 2

What item would you not recommend to a client experiencing diarrhea? A. caffeine B. Sports drinks C. Prebiotics D. Probiotics

Caffeine The recommended nutrition therapy for diarrhea is to remove the cause, let the bowel rest, and replace lost fluids and electrolytes. It is recommended that caffeine be avoided or limited, due to its ability to irritate the digestive system and worsen diarrhea. Foods that are recommended for diarrhea include prebiotics (oats, bran), probiotics (yogurt), and fluids high in electrolytes (sports drinks).

The measure of long-term blood glucose control is known as: A. Fasting blood glucose B. Glycosylated hemoglobin C. Estimated average blood glucose D. Insulin sensitivity

Glycosylated hemoglobin (HgbA1C) measures the percentage of hemoglobin that glucose is carrying. This measure of long-term blood glucose control (2-3 months) can diagnose diabetes and determine how well an individual is controlling their diabetes. The higher the HgbA1C%, the higher the blood glucose has been elevated. Estimated average blood glucose provides an average blood glucose level based on point of care testing. Fasting blood glucose is the blood glucose level when there is not food in the system. Insulin sensitivity refers to resistance to the hormone insulin, resulting in elevated blood sugars.

Which lipoprotein transports dietary cholesterol to cells? A. HDL B. VLDL C. IDL D. LDL

LDL LDL transports cholesterol from the diet to all cells and is known as the number one transporter of cholesterol. VLDL transports endogenous triglycerides from the liver to adipose cells. HDL transports cholesterol from the liver to be excreted in reverse cholesterol transport and is known as the "good" cholesterol. IDL is the precursor to LDL that enables fats and cholesterol to move within the water-based solution of the bloodstream.

Using the Hamwi formula, determine the ideal body weight for a 65-year-old female who is 57 inches tall, weighs 116 pounds, and has a small frame. A. 101.75 lbs B. 83.25 lbs C. 87.87 lbs D. 88.56 lbs

83.25 lbs The Hamwi formula computes a person's ideal body weight (IBW) according to the following: Male: 106 lbs for first 5 ft + 6 lbs for each additional inch Female: 100 lbs for first 5 ft + 5 lbs for each additional inch *Subtract 2.5 lbs for each inch below 5 ft (may vary from 2 to 5 lbs based on institution), and allow +/-10% range for small to large frame for individual differences To calculate the IBW for this person, the equation is 100 lbs - 2.5 lbs x 3 in. (57 in = 4 ft 9 in = 3 in below 5 ft) = 92.5 lbs x .90 (-10% for small frame) = 83.25 lbs The other choices are calculated incorrectly by subtracting only 5%, adding 10%, and using the formula for men.

Joe is a single father with a 14-year-old daughter and a 10-year-old son. His primary care physician has referred him to you for medical nutrition therapy for hypertension and prediabetes. During the nutritional assessment, Joe tells you the following: He normally eats three meals per day. He can't afford to cook healthy meals at home, so he often eats out at fast food restaurants. He relies on low-cost food (such as frozen pizza, prepackaged noodles, and canned vegetables) to feed his family. Based on the available information, how would you classify his food security status? A. Low food security B. High food security C. Very low food security D. Marginal food security

: Low food security The food security status of households ranges on a continuum from high to very low, divided into four ranges and characterized as follows: High Food Security: Households do not have problems with or anxiety about accessing adequate food. Marginal Food Security: Households sometimes have problems with or anxiety about accessing adequate food, but the quality, quantity, and variety of food are not significantly reduced. Low Food Security: Households have reduced quality, desirability, and variety in their diets, but quantity of food and normal eating patterns are not significantly disrupted. Very Low Food Security: One or more household members experiences disrupted eating patterns and decreased food intake due to lack of money and resources for food. Joe describes reduced quality, variety, and desirability in his family's diet, but they do not experience a disruption in the amount of food or normal eating patterns; therefore, this would classify his household as low food security.

Sally is a 5'5" female and she states that she usually weights 125 lbs. When she weighs in at the doctor's office today, she weighs 114 lbs. What is her percentage weight change? A. +11% B. +8.8% C. -8.8% D. -11%

Correct answer: -8.8% Usual body weight (UBW) is how much an individual usually weighs, and current or actual body weight (CBW/ABW) is how much an individual weighs now. To assess the significance of weight change, the percentage weight change (% wt change) can be found by the following formula: [(UBW - ABW) / UBW] x 100. In our example, [ (125 - 114) / 125 ] x 100 = 8.8% weight loss Sally's percentage weight change is -8.8%.

Which of the following is equal to 1 ounce-equivalent protein food? A. 1 large egg B. 1 slice of bread C. 2 Tbs peanut butter D. 1-oz portion of walnuts

Correct answer: 1 large egg Portion sizes do not always align with one cup or one ounce-equivalent, due to variations in foods' concentration and water content. For example, 1 large egg is equal to 1 ounce-equivalent protein food. Two tablespoons of peanut butter is equal to 2 ounce-equivalent protein foods; a 1-oz. portion of walnuts is equal to 2 ounce-equivalent protein foods; 1 slice of bread is equal to 1 ounce-equivalent grain.

Susie has a BEE of 1,050 kcals. She goes on a 30-minute walk three times per week and considers herself active. What is her TDEE when activity factor is applied? A. 1,260 kcals B. 1,050 kcals C. 1,574 kcals D. 1,365

Correct answer: 1,365 kcals Total Daily Energy Expenditure (TDEE) accounts for basal energy expenditure (BEE) plus additional activity, known as activity factor (AF). Activity factor ranges from sedentary (BEE x 1.2) to active (BEE x 1.3) to stress (BEE x 1.5). To determine Susie's TDEE: 1,050 (BEE) x 1.3 (active AF) = 1,365 kcals (TDEE)

Over the course of one year, during a research study, 63 women are diagnosed with breast cancer and 21 women die of breast cancer, out of a total female population of 450. At the beginning of the study, 0 out of 450 women had breast cancer. What is the incidence rate?

Correct answer: 14% Incidence is the measure that allows you to determine a person's probability of being diagnosed with a disease during a given time period. An incidence rate is the number of new cases of a disease over a period of time divided by the number of persons at risk for the disease. In our example, there are 63 new diagnoses of breast cancer out of a total population of 450. The incidence rate is 63 new cases / 450 total number of people at risk = 0.14 x 100 = 14%.

Kate is a female who is 165 cm. tall and weighs 133 lbs. What is her BMI? A. 22.1 B. 31.4 C. 23.3 D. 24.5

Correct answer: 22.1 Body mass index (BMI) is the ratio of weight to height. To determine BMI, use the following formula: wt (kg) / ht^2 (m) OR wt (lbs) / ht^2 (in) x 703. To solve our example, first convert 165 cm. into inches (165 cm. / 2.54 in. = 65 in.) Then, (133 lbs / 65 in. x 65 in.) --> (133 / 4225) x 703 = 22.1 BMI.

For which of the following disease states would you recommend PERT? A. Cystic fibrosis B. Gastroduodenostomy C. Lactose Intolerance D. Hepatic Failure

Correct answer: Cystic fibrosis Pancreatic enzyme replacement therapy (PERT) involves taking digestive enzymes in the form of a tablet to assist in the digestion of fat, carbohydrates, and proteins. PERT is used with meals and snacks to prevent fat malabsorption due to the lack of pancreatic lipase. PERT therapy may help treat the disease states of pancreatitis, cystic fibrosis, gastrojejunostomy, Crohn's disease, and other diseases with pancreatic insufficiencies.

Which nutrition prescription would be most appropriate for a stressed patient with cirrhosis and ascites? A. 15-20 kcal/kg, 0.8g protein/kg B. 30-35 kcal/kg, 2.0g fat/kg, 3.0 L fluid restriction C. 25 kcal/kg, 0.8-1.0g protein/kg D. 30-35 kcal/kg, 2.0g protein/kg, 1.5 L fluid restriction

Correct answer: 30-35 kcals/kg, 2.0 g protein/kg, 1.5L fluid restriction The most appropriate nutrition prescription for a stressed patient with cirrhosis and ascites is a high-calorie, high-protein, fluid-restricted diet. A stressed patient requires more calories (30-35 kcals/kg) to provide energy for the hypermetabolic state, cirrhosis requires high protein (2.0 g protein/kg) to help prevent fatty liver and spare protein, and fluid restriction (1.5L) to help reduce edema and fluid retention. The other answer choices do not provide the appropriate high-calorie, high-protein, and fluid-restricted nutrition prescription.

Which individual would be most likely eligible to apply for Medicare Part A? 25-year-old pregnant female 64-year-old blind female 34-year-old male with ESRD 60-year-old male with a BMI >30

Correct answer: 34-year-old male with ESRD Medicare is a health insurance program for people over 65 and/or of any age with end stage renal disease (ESRD). Medicare Part A provides hospital insurance. Medicare Part B provides optional insurance for supplementary benefits, such as doctor visits, test, and procedures. Medicaid provides payment for medical care for the eligible needy of all ages, the blind, the disabled, and dependent children. For example, Medicaid would provide assistance to a pregnant woman, a minor/teenager living alone, and/or someone aged/blind/disabled.

What is the DRI for carbohydrates? 1.2-1.5 g/kg 10-25% 20-35% 45-65%

Correct answer: 45-65% The DRI for carbohydrates is 45-65% (0.8-1.0 g protein/kg). The DRI for fat is 20-35%, and for protein, 10-25%.

Which of the following persons would most likely have hypercalcemia? A. A 72 year old male with hypoparathyroidism B. A 45 year old male with stage IV gastric cancer and bone metastasis C. A 24 year old female with an acute kidney injury complicated by hyperphosphatemia D. A 32 year old female with cirrhosis complicated by hypoalbuminemia

Correct answer: 45-year-old male with stage IV gastric cancer with bone metastasis Calcium is increased with hyperparathyroidism and bone metastasis; it is decreased with hypoalbuminemia, hyperphosphatemia, renal failure, and hypoparathyroidism

What is the IBW for a 4'11" woman with a small frame? 87.8 pounds 95.2 pounds 85.5 pounds 104.5 pounds

Correct answer: 87.8 pounds Ideal body weight (IBW) is an anthropometric measure based on height to determine how much an individual should weigh. IBW is determined for women with medium frame sizes by the following formula: 100 pounds for the first 5 feet plus 5 pounds for each additional inch. If the woman is less than 5 feet tall, subtract 2.5 pounds for each inch under 5 feet. For small frame sizes, subtract 10%. For large frame sizes, add 10%. 100 pounds - (2.55 pounds x 1 inch) × 0.90 = 87.8 pounds.

A patient is at risk if he or she has experienced unintentional weight change of how much? >10% in the last twelve months >6% in the last three months >5% in the last month >1% in the last week

Correct answer: >5% in the last month A patient is at risk if he or she has experienced significant unintentional weight change of >2% in the last week >5% in the last month >7.5% in the last 3 months >10% in the last 6 months

Which of the following is an example of an endocrine gland? Adrenal Gastric Sweat Salivary

Correct answer: Adrenal Endocrine glands release substances directly into the bloodstream or tissues. Examples of these glands include the thyroid, pituitary, and adrenal glands. Exocrine glands release substances through ducts to the outside of the body. Examples of these glands include the sweat, gastric, and salivary glands.

Which of the following health care professionals is not allowed to participate in the nutrition screening process? A. Registered dietitian B. All healthcare team members can participate C. dietetic technician D. Registered nurse

Correct answer: All health care team members can participate All health care team members can participate in the nutrition screening process and serve a supportive role in this preliminary step. The health care member that performs this step can vary, but it is usually done by an RN upon the patient's admission. The nutrition screen is not part of the ADIME process, which is conducted by the RD.

In which step of the nutrition care process should the RD continually reevaluate a patient's status (e.g., BMI) against a specific criterion? A. Diagnosis B. Intervention C. Assessment D. Screening

Correct answer: Assessment During the assessment, the RD should continually reevaluate a patient's status, such as BMI, against a specific criterion. This step is an ongoing, dynamic process that involves continuous reassessment and analysis of the patient's needs. During the screening, the RD uses preliminary nutritional parameters to identify patients who are malnourished or at risk to become malnourished. This step evaluates a patient's status against a specific criterion on a one-time basis. During the intervention, the nutrition diagnosis should be prioritized. The intervention is a specific activity used to address the problem identified as the nutrition diagnosis.

Which of the following risk factors is modifiable? A. Gender B. Family Medical History C. Age D. BMI

Correct answer: BMI Risk factors are conditions that increase your risk of developing a disease. Risk factors can be either modifiable (you can take measures to change them) or non-modifiable (you cannot change them). Modifiable risk factors include smoking, physical inactivity, and BMI. High blood pressure, diabetes, smoking, and cholesterol are considered modifiable as well. Non-modifiable risk factors include age, race, sex, and family history.

Longevity depends on all of the following factors except: A. Lifestyle B. Basal Metabolic Rate C. Genetics D. Environment

Correct answer: Basal metabolic rate Longevity depends on lifestyle, environment, genetics, and access to health care. Basal metabolic rate (BMR) is a measure of energy expenditure and does not directly effect longevity.

On what day does a patient's discharge plan begin? Once discharge orders are placed Day 1 Day 7 Once interdisciplinary rounds are completed for the day

Correct answer: Day 1 Discharge plans begins on day 1 of the patient's hospital stay. A discharge note includes a summary of nutrition therapies and desired outcomes. The other choices are incorrect: day 7 is the number of days before a dietitian assesses a patient with a negative nutrition screen; interdisciplinary rounds are when health care providers discuss the plan of care for patients, which may occur daily or weekly; and discharge orders are placed by the doctor and all remaining orders must be completed within two hours of the time the discharge order was placed.

Which of the following disorders or procedures would most likely result in steatorrhea? A. H. Pylori bacterial infection B. Billroth I C. Billroth II D. Hiatal hernia

Correct answer: Billroth II A Billroth II (gastrojejunostomy) is a procedure that attaches the stomach to the jejunum. Since food then bypasses the duodenum, there is less duodenal hormonal secretion and in turn less pancreatic secretion. As a result, steatorrhea is likely to occur after this procedure due to the lack of pancreatic enzymes to break down fat. Steatorrhea is the presence of fat in the feces. A Billroth I (gastroduodenostomy) is a procedure that attaches the stomach to the duodenum. The disorder most likely to occur after this procedure is dumping syndrome. A hiatal hernia is a disorder where a portion of the stomach protrudes into the diaphragm. The most likely symptom to occur is heartburn. H. Pylori bacteria causes stomach ulcers and can be treated with antacids and antibiotics. The most likely symptom to occur is increased stomach acidity with pain.

Jacob was recently prescribed the drug lithium carbonate to treat his bipolar disorder. Which of the following meals would you recommend for him?

Correct answer: Blood cannot enter the liver Esophageal varices occurs when blood cannot enter the liver because connective tissue overgrowth causes resistance to blood from the portal vein. This pressure forces blood back into the collateral veins, enlarging the esophageal, abdominal, and collateral veins. This occurs in people with advanced liver disease. Ascites occurs when blood cannot leave the liver because connective tissue overgrowth blocks blood flow from the liver to the vena cava. As a result, the liver expands and pressure forces fluid into the peritoneal cavity, and more protein-containing fluid is drawn in, causing sodium and water retention. This occurs in many disorders, but is usually found in cirrhosis.

For a nutrition screen to be effective, it must have: A. Both specificity and sensitivity B. Specificity C. Neither specificity nor sensitivity D. Sensitivity

Correct answer: Both specificity and sensitivity For a nutrition screening to be effective, the methodology must be based on specificity and sensitivity to be accurate. Specificity is the ability to identify patients without a particular condition and sensitivity is the ability to identify patents who have the condition.

John is complaining of constipation. What foods would you recommend to help relieve his constipation? A. Banana and toast B. white rice and applesauce C. bran cereal and milk D. Cheese and crackers

Correct answer: Bran cereal and milk Constipation can be treated with a high-fluid and high-fiber diet with exercise. Foods highest in fiber include dried fruit and bran cereal. The best of the options to relieve constipation is a bowl of bran cereal with milk because this provides both fiber and fluid. Diarrhea can be treated with a BRAT diet (Banana, Rice, Applesauce, Toast) and/or probiotics (cheese, yogurt).

When taking Coumadin, you should avoid increasing your intake of which food? A. bananas B. red meat C. broccoli D. yogurt

Correct answer: Broccoli Coumadin is a brand name for an anticoagulant drug that inhibits the synthesis of vitamin-K-dependent clotting factors and is used in the prevention/treatment of thromboembolic disorders. Since this drug inhibits synthesis of vitamin K, it is important to maintain consistent intakes of dietary vitamin K. Therefore, you should avoiding increasing or decreasing your intake. Vitamin K is found in green leafy vegetables, such as broccoli, spinach, and kale.

Paul is taking monoamine oxidase inhibitors (MAOIs). Which food item would you recommend that he avoid? Cheese plate with smoked sausage Fried chicken with french fries Bran cereal with whole milk Chocolate ice cream with syrup

Correct answer: Cheese plate with smoked sausage A low tyramine diet is recommended when taking certain medicines, such as monoamine oxidase inhibitors (MAOIs). Tyramine is primarily found in foods that are aged, dried, cured, fermented, or smoked. When taking MAOIs, eating foods that are high in tyramine can cause side effects, including high blood pressure, headaches, fast heartbeat, nausea, vomiting, blurred vision, and chest pain. Therefore, since a cheese plate with smoked sausage would be high in tyramine, it should be avoided. The other answers are incorrect because they do not contain foods that are aged, dried, cured, fermented, or smoked.

Which of the following is the most common risk factor for developing COPD? A. cigarette smoking B. sedentary lifestyle C. overweight D. stressful work environment

Correct answer: Cigarette smoke Chronic obstructive pulmonary disease (COPD) is a term used to describe progressive lung diseases, including emphysema, chronic bronchitis, refractory asthma, and some forms of bronchiectasis. Cigarette smoking is the most common cause of COPD; however, other causes include secondhand cigarette smoke, air pollutants/chemical fumes in the home or work-place, and dust.

The nutrition diagnostic label "involuntary weight loss" is categorized under which domain? A. Clinical B. Nutritional C. Intake D. Behavioral-environmental

Correct answer: Clinical The nutrition diagnostic labels include clinical (NC), intake (NI), and behavior-environmental (NB). The clinical label includes nutritional findings that relate to the medical or physical condition, such as functional, biochemical, and weight balance, including involuntary weight loss. The intake label includes actual problems related to intake, such as energy balance, oral intake, fluid intake, substances, and nutrient balance. The behavior-environmental label includes problems related to knowledge, access to food, and food safety, such as knowledge and beliefs, physical activity balance and function, and food access. Nutritional is not a diagnostic label.

Which of the following is an incorrect Joint Commission safety standard? A. Use medication safety B. Correctly identify patient using at least one patient identifier C. Improve safety of clinical alarm systems D. Communicate accurate patient medication information

Correct answer: Correctly identify a patient using at least one patient identifier The Joint Commission's safety standards include the following: correctly identify a patient using at least two (not one) patient identifiers, practice safe use of medications, maintain and communicate accurate patient medication information, improve the safety of clinical alarm systems, and several more standards. An example of using two patient identifiers could be asking for a patient's full legal name and date of birth.

A clinical dietitian is planning to start PN on a patient. Which of the following lab values would indicate the appropriate time to initiate feeding the patient? A. Increased CRP, increased creatine B. decreased albumin, decreased pre-albumin C. Increased CRP, decreased pre-albumin D. Decreased CRP, increased albumin

Correct answer: Decreased CRP, increased pre-albumin C-reactive protein (CRP) is a marker of acute inflammatory stress, and pre-albumin is a marker of nutritional status. When CRP decreases and pre-albumin increases, nutrition therapy is indicated. Nutrition therapy would be contraindicated by increased CRP and decreased pre-albumin. Malnutrition might be indicated by decreased albumin and decreased pre-albumin; however, CRP would have to be evaluated to determine the patient's stress. Inflammatory stress and muscle wasting or renal disease might be indicated by increased CRP and increased creatinine.

A patient has hyperalbuminemia and hypernatremia. What would you infer about his nutritional intake? Decreased medium-chain triglyceride intake Decreased fluid intake Increased protein and salt intake Increased saturated fat intake

Correct answer: Decreased fluid intake Albumin and sodium are lab values that typically indicate fluid status. If a patient has high albumin (hyperalbuminemia) and high sodium (hypernatremia), the patient is typically hypovolemic (volume depleted). Therefore, you could infer that the patient has had a decreased fluid intake leading to his current nutritional and medical status.

Which of the following factors determines payment during a patient's hospital stay? Number of medical services rendered Type of services rendered Length of stay Diagnosis

Correct answer: Diagnosis Hospitals pay a specific amount of money per patient based on the diagnosis, regardless of the length of stay or number and type of medical services rendered.

A client with T1DM tells her RD she is sick with the flu. All of the following sick day guidelines for diabetics are appropriate, except: Do not take insulin Check urine for ketones Liberalize diet Encourage fluids

Correct answer: Do not take insulin The sick day guidelines for diabetes recommends taking usual doses of insulin, testing urine for ketones, consuming ample amounts of liquid, and selecting liquid or soft carbohydrate foods.

A 69-year-old man was evaluated for unintentional weight loss and underwent a modified barium swallow test. He aspirated some of the barium and failed the diagnostic test. What condition does the man likely have? Pneumonia Dysphagia Significant weight loss ESRD

Correct answer: Dysphagia Dysphagia is difficulty swallowing, which can lead to unintentional or significant weight loss. This can be diagnosed by the barium swallow test. Aspiration can be a side effect of dysphagia that can lead to pneumonia. In the barium swallow test, mouthfuls of barium are swallowed and X-ray films are taken of the esophagus at several points in time while boluses of barium traverse the esophagus. This process helps to diagnose moderate to severe external compression, tumors, and strictures of the esophagus. ESRD, or end-stage renal disease, is not related to dysphagia.

Which government agency would you contact with a question regarding food labeling, such as for cereals, canned goods, and packaged products? A. HSS B. USDA C. SNAP D. FDA

Correct answer: FDA The Food and Drug Administration (FDA) is responsible for the inspection of food and the labeling of food products. This does not include the labeling of meat, livestock, poultry, and eggs, which are monitored by the USDA. The United States Department of Agriculture (USDA) helps farmers, ensures food safety through food inspections, and provides education and commodity food programs. The USDA is responsible for the grading and labeling of meat, livestock, poultry, and eggs. The United States Department of Health and Human Services (HHS) includes Medicare, Medicaid, CHIP, the health insurance marketplace, patient safety, and health IT management. The Supplement Nutrition Assistance Program (SNAP) administers food stamps through the USDA.

The functions of the liver include all of the following except: A. metabolize nutrients B. store and release blood C. Filter toxic elements D. Filter red red blood cells

Correct answer: Filter red blood cells The functions of the liver include storing and releasing blood, filtering toxic elements, metabolizing and storing nutrients, and regulating fluid and electrolyte balance. The filtration of red blood cells is a function of the kidneys.

Mark is 19 years old and has a fasting serum glucose of 150 mg/dL, HgbA1C of 6.4, blood pressure of 140/90, LDL of 100 mg/dL, and HDL of 20 mg/dL. Based on the given information, what can be presumed about Mark's condition? He has metabolic syndrome He has type 1 diabetes mellitus He has type 2 diabetes mellitus He is healthy

Correct answer: He has metabolic syndrome Metabolic syndrome is diagnosed when a patient has at least three of the following five conditions: Fasting glucose ≥100 mg/dL (hyperglycemia) Blood pressure ≥130/85 mm Hg (hypertension) Triglycerides ≥150 mg/dL (hypertriglyceridemia) HDL-C <40 mg/dL in men or <50 mg/dL in women Waist circumference ≥102 cm (40 in) in men or ≥88 cm (35 in) in women Mark has three of the five risk factors that diagnose metabolic syndrome. Based on the given information, Mark has hyperglycemia (fasting serum glucose of 150 mg/dL), hypertension (blood pressure of 140/90), and low HDL (HDL of 20 mg/dL). HgbA1C of 6.4 is indicative of prediabetes, and LDL of <100 is an optimal goal set by the American Heart Association (AHA).

What type of dietary modification would be appropriate for a client with elevated T3 and T4? Weight reduction High-caloric foods Low-purine foods Goitrogen-free foods

Correct answer: High-caloric foods Hyperthyroidism is the excess secretion of thyroid hormones with elevated levels T3 and T4. As a result, BMR is increased and weight loss is common. An appropriate dietary modification would be to increase the calories in the diet. Hypothyroidism is a deficiency of thyroid hormones associated with decreased BMR and weight gain. An appropriate dietary modification is weight reduction. Goiter is the enlargement of the thyroid gland due to insufficient thyroid hormones. A diet free of goitrogens is recommended. Goitrogens are substances that disrupt the production of thyroid hormones by interfering with iodine uptake in the thyroid gland. An example is Brussels sprouts. Gout is a disorder of purine metabolism associated with increased levels of serum uric acid, leading to deposits in the joint that cause pain and swelling. High-purine foods should be avoided.

A 93-year-old female patient has dysphagia and uses a PEG tube to receive enteral nutrition. After she was admitted to the hospital due to an infection around the PEG site, the family decided to discontinue the PEG to improve her quality of life in her remaining time (estimated at less than six months). What type of care is the patient and family now pursuing? A. Palliative Care B. Medical Care C. Hospice Care D. Curative Care

Correct answer: Hospice care In end-of-life care, the registered dietitian's assessment requires practitioners to consider not only the clinical nutritional needs of the person, but their medical goals (hospice vs. palliative vs. curative). Hospice care focuses on caring for people who are dying or near the end of life. Hospice and palliative care are very similar; the main difference is that hospice care begins after treatment for the disease has stopped and when it is clear the patient is not going to survive the illness. Palliative care focuses on comfort care for a patient when curative measures are no longer an option. Curative care is the active medical care and treatment for a medical condition where a cure is considered achievable.

The prevalence of food insecurity varies considerably by household type. The rate of food insecurity is higher than the national average for which of the following groups? A. Household with children headed by a single man B. Married couple without children C. Elderly woman living in a nursing home D. Asian Family

Correct answer: Household with children headed by a single man Based on the USDA Economic Research Service from the December 2017 Current Population Survey Food Security Supplement, the prevalence of food insecurity varied significantly by household type. The rate of food insecurity was higher than the national average for the following groups: All households with children Households with children under age 6 Households with children headed by a single woman Households with children headed by a single man Women living alone

What is a potential effect of thiazide diuretics? A. Hypertension B. Hypokalemia C. Hypervolemia D. Hypernatremia

Correct answer: Hypokalemia A thiazide diuretic is a medication used to treat hypertension or high levels of potassium, and/or to reduce fluid in the body. This medication works by reducing the kidney's ability to reabsorb salt from the water and into the body, as a result increasing the production and output of urine. A potential side effect includes hypokalemia due to pulling potassium from the blood and excreting too much in the urine. Hypertension, hypernatremia, and hypervolemia are typical symptoms that are solved with use of a thiazide. However, if too much thiazide is used, the potential side effects may be the opposite: hypotension, hyponatremia, and hypovolemia.

A patient with an ileostomy has increased need for which of the following nutrients? I. Water II. Water-soluble vitamins III. Salt IV. Protein

Correct answer: I, III A patient with an ileostomy has increased need for water and sodium to compensate for excessive losses in their stools. In general, oral intake should exceed ostomy output. For example, patients should drink at least one liter more than their ostomy output daily. The jejunum remains intact; therefore, water-soluble vitamins and protein needs are not affected.

Choose the PES statement that is written in the correct format: Decreased energy intake as evidenced by decreased ability to consume sufficient energy, related to poor appetite, 5#/10% weight loss in 3 months, and 75% IBW Inadequate energy intake related to decreased ability to consume sufficient energy as evidenced by current NPO diet order and decreased appetite Excessive carbohydrate intake and increased energy intake related to dietary noncompliance as evidenced by food record showing 455 g CHO intake over 24 hours, HgbA1C 8.7%, and 13# weight gain in 1 month 40-pound weight loss in 3 months related to decreased appetite as evidenced by dysphagia and decreased ability to consume food

Correct answer: Inadequate energy intake as related to decreased ability to consume sufficient energy as evidenced by current NPO diet order and decreased appetite The PES statement is also known as the nutrition diagnosis statement, which is a structured sentence that describes a specific nutrition problem (P) that the dietitian is responsible for treating and working toward resolving, the etiology (E) or cause(s) of the problem, and the signs/symptoms (S) of the existing problem. If there is more than one problem, each requires its own PES statement. The PES statement is written as: "P... related to E... as evidenced by S." P - Intake domain (excess/inadequate intake) E - Clinical or behavioral/environmental domain (provides link to intervention) S - Clinical domain (provides link to evaluation/monitoring)

You are looking at a sample population of 175 people and want to determine the number of new cases AIDS over a 12-year period. What variable are you trying to determine? A. Risk factor B. confounding factor C. Incidence D. Prevalence

Correct answer: Incidence Incidence: The number of new cases of a disease or other condition during a specific time period. For example, the number of new cases AIDS over a 12-year period. Prevalence: The number of existing cases of a disease or other condition in a given population. Risk factor: A clinically important sign associated with an increased likelihood of acquiring a disease or other condition. Confounding factor: The factor that distorts the association or effect between an exposure and an outcome.

Which of the following signs might indicate intolerance to a tube feeding advancement? A. Upgrading a patient from mild to moderately malnourished B. Patient's complaints of hunger C. Increased complaints fatigue D. Increased abdominal distention

Correct answer: Increased abdominal distension Enteral nutrition (EN) should be started early (within 24 to 48 hours) and advanced as tolerated. The following indicators should be used to monitor tolerance: Intake/output: Identify negative or positive balances Bowel movements: Constipation or diarrhea Tube placements: Ensure feeding tube is correctly placed Abdominal distension: Abdomen should be soft and non-distended, not hard and distended Weight: Desire stable weight; fluctuation may signify fluid intolerance Lab values: Look at electrolytes, glucose, and other nutrition-related lab values Complaints of hunger, increased fatigue, and changing of a patient's nutrition status are not indicators of intolerance.

Which of the following is not a step in a community needs assessment? Raise awareness in the community Collect data about the background conditions Collect data about individuals who represent the target population Define the nutritional problem

Correct answer: Raise awareness in the community The steps in a community needs assessment are as follows: Define the nutritional problem. Set the parameters of the assessment. Collect data about the community, background conditions, and individuals who represent the target population. Analyze and interpret the data. Share the findings of the assessment. Set priorities. Choose a plan of action. Raising awareness in the community is an example of a trigger for a community needs assessment.

Marcy is a 47-year-old female with metabolic syndrome, and over the past two years she has worked with a registered dietitian. She reports significant weight loss, a healthy eating style, and a better quality of life. What is a potential direct nutrition outcome of the medical nutrition therapy? A. Increased hemoglobin A1c by 0.33% B. Increased triglycerides by 21 mg/dl to 35 mg/dl C. Increased high density lipoprotein cholesterol by 2.4 mg/dl D. Increased low density lipoprotein cholesterol by 2.4 mg/dl

Correct answer: Increased high-density lipoprotein cholesterol by 2.4 mg/dL A direct nutrition outcome helps to evaluate the efficacy of a nutrition intervention. In adults with metabolic syndrome, research regarding the impact of medical nutrition therapy reported significant outcome improvements (NCM): Decreased fasting blood glucose by 2.5 mg/dL to 9 mg/dL (0.1 mmol/L to 0.5 mmol/L) Decreased hemoglobin A1c by 0.12% to 0.23% Decreased triglycerides by 21 mg/dL to 35 mg/dL (0.2 mmol/L to 0.4 mmol/L) Increased high-density lipoprotein cholesterol by 2.4 mg/dL (0.06 mmol/L) Decreased body weight by 2.5 kg to 4.1 kg Decreased waist circumference by 1.9 cm to 4.8 cm Decreased systolic blood pressure by 4.9 mm Hg Flag Question

A mother with three children uses coupons from manufacturers, looks for local grocery store discounts, and shops at discount food stores to provide food for her family. What is the mother's food security status? A. Low food security B. High food security C. Very low food security D. Very high food security

Correct answer: Low food security Food security is the state when "all people, at all times, have physical and economic access to sufficient, safe and nutritious food to meet their dietary needs and food preferences for an active and healthy life." High or very high food security is when people have readily available nutritional and safe foods without fear of becoming hungry. Low food security is represented by the ability to use strategies to avoid hunger, such as clipping coupons and bargain shopping. Very low food security can be present at different times of the year when eating patterns of one or more household members are disrupted and food intake is reduced. This may be a result of the household lacking money and/or other resources to obtain food.

An individual is required to attend a nutrition class. During the class, he develops little interest in the topic and feels there are more important things he could be doing than wasting his time in this class. How would you assess his readiness to learn? Low education Low motivation High education High motivation

Correct answer: Low motivation An educational readiness assessment can determine how to teach based on the needs and readiness of the learners. The assessment evaluates motivation, education, and sophistication levels. Motivation level can affect a learner's attention span. In this example, the boy is showing a low motivation level since he feels there are more important things he could do and he has little interest in paying attention to the topic. With high motivation, an individual shows interest, voluntarily participates, and sets high expectations to apply the subject to his life. Education level is not always related to the amount of formal education. High education includes the ability to understand complex ideas and sometimes a previous knowledge of the topic where new information can be added. Low education indicates a lack of formal education beyond high school; in that case, reinforcement is helpful.

Which of the following individuals would you avoid recommending a low-sodium diet to? A. Marcy, A 35 year old female taking lithium carbonate B. Martha, a 55 year old women taking megestrol acetate C. Jake, a 21 year old obese male D. Frank, a 64 year old man with hypertension

Correct answer: Marcy, 35-year-old female taking a lithium carbonate Lithium carbonate is an antidepressant mendicant, and consistent sodium and caffeine intake are required to stabilize lithium levels. If sodium or caffeine is restricted, lithium excretion decreases and may lead to toxicity. Therefore, it is recommended to keep daily sodium intake consistent. Obese and pre-hypertensive individuals may benefit from a low-sodium diet. Megestrol acetate is an appetite stimulant, and a low-sodium diet would not be contraindicated.

Children's diets are sometimes found to be inadequate in iron due to excessive intake of: A. Milk B. protein C. apple sauce D. enriched cereals

Correct answer: Milk If children drink too much cow's milk (e.g., more than 24 oz. per day) and eat few iron-rich foods (e.g., red meat, green leafy vegetables, etc.), they can develop "milk anemia." The signs and symptoms include irritability, shortness of breath, pica, decreased appetite, weakness/fatigue, brittle nails, and pale skin. Cow's milk is not a good source of iron and additionally makes it more difficult for the body to absorb iron, contributing to iron-deficiency anemia.

Which of the following regulations is false regarding the NSLP? Must provide on average 1/3 of the daily recommended levels of protein, Ca, Fe, vitamin A, and vitamin C No more than half of the fruit requirement may be met by 100% fruit juice Must provide on average 1/4 of the daily recommended levels of protein, Ca, Fe, vitamin A, and vitamin C One vegetable serving is considered 3/4 cup

Correct answer: Must provide on average 1/4 of the daily recommended levels of protein, Ca, Fe, vitamin A, and vitamin C The National School Lunch Program (NSLP) is an entitlement program by the USDA that implements dietary guidelines into lunch programs to improve the nutrition of low-income children and families. Regulations for the NSLP include the following: Must provide on average 1/3 of the daily recommended levels of protein, Ca, Fe, vitamin A, and vitamin C; No more than 1/2 of the fruit requirement may be met by 100% fruit juice; One vegetable serving is considered 3/4 cup. The School Breakfast Program (SBP) under the USDA must provide on average 1/4 of the daily recommended levels of protein, Ca, Fe, vitamin A, and vitamin C.

Which survey would be most useful for studying aging related to nutrition? WHO OAA FAO NHANES

Correct answer: NHANES The National Health and Nutrition Examination Survey (NHANES) is administered through the CDC and is useful for the study of aging related to nutrition. It is an ongoing survey that obtains information on the health and nutritional status of the US population by assessing nutritional, clinical, and biochemical parameters. It is used to determine the prevalence of disease and risk factors and is the basis for national standards. The World Health Organization (WHO) is the coordinating authority on international health concerns within the United Nations. The Food and Agricultural Organization (FAO) is a specialized agency of the United Nations that leads international efforts to defeat hunger. Its main goals are food security and sustainability. The Older Americans Act (OAA) is not a survey, but rather an act under the DHHS that provides a nutrition incentive program to eligible older Americans; for example, Congregate Meals and Meals on Wheels.

Would you recommend the Feingold diet to a patient with hyperkinesis? Why or why not? Yes, because sugar causes hyperactivity No, because consistent carbohydrate intake is important to control blood sugar No, because the efficacy of the diet is not proven Yes, because artificial colors decrease attention span

Correct answer: No, because the efficacy of the diet is not proven Attention-deficit/hyperactivity disorder is a chronic condition of attention difficulty, hyperactivity, and impulsiveness. The Feingold diet is an elimination diet initially devised following research in the 1970s that appeared to link food additives with hyperactivity; it was thought that eliminating these additives and other various foods would alleviate the condition. However, the efficacy was not proven because positive results may be due to the placebo effect. Sugar does not directly cause hyperactivity, and artificial colors do not directly decrease attention span. Consistent carbohydrate intake is important to control blood sugar for patients with diabetes.

What areas are most useful in a physical exam for determining subcutaneous fat loss? A. gastrocnemius B. orbital C. temporal D. quadriceps

Correct answer: Orbital In a physical exam, there are certain body areas that can help determine subcutaneous fat loss versus muscle loss. The most useful areas for detecting subcutaneous fat loss are the orbital region (surrounding the eyes), upper arm region (triceps/biceps), and thoracic and lumbar regions (ribs, lower back, midaxillary line)

Which patient's diet should be liberalized? Patient is morbidly obese and complains of hunger after finishing meals. Patient is on a low-sodium diet with CHF and complains of bland taste Patient is on a diabetic diet and complains of small portion sizes Patient has intake <50% for 72 hours and complains of poor appetite

Correct answer: Patient has intake <50% for 72 hours and complains of poor appetite Overly restrictive diets may limit food choices or provide unfamiliar/unpalatable food items for patients with a poor appetite. These practices may result in inadequate food and nutrient intake. By liberalizing this patient's diet (i.e., removing dietary restrictions), this patient may eat more food as a result of increased food selections. The other patients do not require a liberalized diet due to their disease state (CHF, diabetes, obesity) and chief complaint (not related to poor intake or appetite).

A hospital wants to gain insight on the nutritional status and nutrition-related health measures for low-income, high-risk children. What survey would provide the appropriate information on this population? A. PNSS B. NSI C. NHANES D. PedNSS

Correct answer: PedNSS PedNSS (Pediatric Nutrition Surveillance System) under HHS, surveys low-income, high-risk children from 0-17 years of age. This would be the appropriate survey for the desired population. PNSS (Pregnancy Nutrition Surveillance System) surveys low-income, high-risk pregnant women to identify and reduce pregnancy-related health risks. NHANES (National Health and Nutrition Examination Survey) is an ongoing and repeated survey that obtains information on the nutritional status of the United States population. NSI (Nutrition Screening Initiative) promotes nutrition for the elderly population to identify nutrition problems sooner.

Which of the following nutrients may severely decrease during refeeding syndrome? A. Sodium B. protein C. fluid D. phosphorus

Correct answer: Phosphorous Refeeding syndrome is the body's adverse response that may occur with the initiation of nutrition after a period of poor intake or starvation, such as in the already malnourished patient. Signs and symptoms include low serum electrolyte abnormalities (specifically phosphate, potassium, and magnesium), vitamin deficiencies, and sodium and fluid retention. The main complications are due to hypophosphatemia, hypokalemia and hypomagnesemia, which may lead to cardiac arrhythmia, seizures, heart failure, or death.

A patient history includes all of the following parameters, except: GI symptoms Weight changes Dietary intake Physical exam

Correct answer: Physical exam According the to Subjective Global Assessment (SGA), the patient history (Part A) includes weight changes (patterns of loss or gain), dietary intake (duration and degree of changes), GI symptoms (N/V/C/D), and energy/functional capacity (presence of weakness or fatigue). The physical exam (Part B) is conducted separately and after the patient history is collected. These two steps are both important in determining the nutritional status of a patient.

A 65-year-old male patient has chronic obstructive pulmonary disease and hypertension; he requires enteral nutrition (EN) initiation. What type of EN formula is best for this patient? Glucerna Elemental Nepro Polymeric

Correct answer: Polymeric A standard polymeric enteral nutrition formula is the best formula to use when a patient has a functioning GI tract and does not have a disease state requiring a specialized formula. An example of a standard formula is Jevity. Elemental formulas are used for patients with malabsorption problems and contain hydrolyzed proteins in the form of amino acids. An example of an elemental standard formula is Impact Peptide. Specialized formulas are used for patients with specific disease states that require specialized nutrition, such as Nepro for renal patients and Glucerna for diabetic patients.

Your client, Rachel, provides you with a three-day food diary. On average, she is consuming 1,427 calories daily, which is composed of 143 grams of carbohydrates, 47 grams of fat, and 108 grams of protein. Which of her macronutrients are within the AMDR's recommended ranges? Protein and fat Carbohydrates, protein, and fat Carbohydrates and protein Carbohydrates and fat

Correct answer: Protein and fat The Acceptable Macronutrient Distribution Ranges (AMDR) recommend that 45-65% of your daily calories come from carbohydrates, 10-35% from protein, and 20-35% from fat. In this scenario, about 30% of Rachel's intake is coming from fat (ex: 47 g fat x 9 kcals/g fat = 423 kcals / 1427 total daily kcals = 0.2964 x 100 = 29.6%) and about 30% of her intake is coming from protein (ex: 108 g protein x 4 kcals/g protein = 432 kcals / 1427 total daily kcals = 30.27 x 100 = 30.3%). Her carbohydrate intake falls below the AMDR for carbohydrates (ex: 143 g carbohydrates x 4 kcals/g carbohydrate = 572 kcals / 1427 total daily kcals = .04008 x 100 = 40%).

What component makes up the largest percentage of total energy expenditure? A. Exercise B. REE C. NEAT D. TEF

Correct answer: REE Energy is expended by the body in the form of basal energy expenditure, or resting energy expenditure (REE), the thermic effect of food (TEF), and activity thermogenesis (exercise and non-exercise activity). These components make up a person's total daily energy expenditure (TDEE). REE accounts for the largest percentage of total energy expenditure.

Which is an example of a program that provides coupons and electronic debit cards, known as electronic benefit transfer (EBT) cards, to the eligible needy? CCP WIC SNAP Food banks

Correct answer: SNAP The Supplemental Nutrition Assistance Program (SNAP) provides coupons and electronic debit cards, known as electronic benefit transfer (EBT) cards, to the eligible needy. Each month SNAP food stamp benefits are directly deposited to the household's EBT card account, and the funds may be used to pay for food at supermarkets, convenience stores, and other food retailers. Food banks provide actual food products, not debit cards. The Child Care Program (CCP) is administered through HHS and provides quality, affordable childcare. Women, Infants, and Children (WIC) helps families by providing an Electronic Benefits Transfer card, called the "eWIC" card, for buying healthy foods from WIC-authorized grocery stores.

Jacob was recently prescribed the drug lithium carbonate to treat his bipolar disorder. Which of the following meals would you recommend for him? A. Omelet with cheese and ham B. low-sodium tuna on unsalted crackers C. Italian deli meat sandwich with potato chips D. Salad with grilled chicken

Correct answer: Salad with grilled chicken The drug lithium carbonate and the mineral sodium are known to interact because they compete with each other for reabsorption into the tubules of the kidneys. As a result, high dietary intake of sodium promotes lithium excretion and reduces the effectiveness of the drug. On the other hand, low dietary intake of sodium promotes reabsorption of lithium and increases the chance of drug toxicity. Therefore, the most appropriate meal recommendation would be a salad with grilled chicken because it does not contain foods significantly high or low in sodium. Italian deli meats, potato chips, cheese, and ham are all high in sodium; low-sodium tuna and unsalted crackers are obviously low in sodium.

Casey is a 46-year-old female with past medical history significant for diabetes, hyperlipidemia, hypertension, and congestive heart failure. She is admitted to the hospital for heart failure exacerbation. You are performing a nutrition-focused physical exam on Casey. You notice she has slightly dark circles under her eyes, slight depression on her temples, and visible clavicle bones. What does her physical exam indicate to you about her nutritional status? She is well-nourished She is edematous She has mild malnutrition She has severe malnutrition

Correct answer: She has mild malnutrition The exam areas and findings indicate mild to moderate malnutrition. The fat pad below the eyes would be more bulged on a nourished individual and significantly more hollowed on a severely malnourished patient. The edematous patient would have notable swelling on the lower extremities.

What type of kitchen equipment would you recommend for individuals with developmental delay? A. Toaster oven B. Spoons and forks with larger handles C. Food dehydrator D. Toaster

Correct answer: Spoons and forks with larger handles An individual with developmental delay may require special equipment to make preparing, serving, and eating meals easier. Some suggestions are a blender/food processor, juicer, cappuccino maker, pastry cutter/potato masher, dishes with sides, sports cups, spoons and forks with larger handles, rubber sleeves, and a heated baby dish. A toaster over, toaster, and food dehydrator may be okay kitchen equipment for an individual with developmental delay to have, but they would not be specifically recommended for any particular reason.

During the USDA Automated Multiple-Pass Method, which step collects information on the food and beverages consumed the previous day? A. The Time and Occasion List B. The Quick Step C. The detailed cycle D. The Final Review

Correct answer: The Quick Step The USDA Automated Multiple-Pass Method is a computerized interactive method for 24-hour recall used in government-sponsored nutritional studies. This method includes a five-step interview process: The Quick Step: Collects food and beverages consumed the previous day. The Forgotten Food List: Probes for food and beverages forgotten during the first step. The Time & Occasion List: Collects the time and eating occasion of each food. The Detailed Cycle: Collects detailed information on the description and amount of food consumed. The Final Review: Reviews the 24-hour recall.

An individual drinks a glass of cow's milk and their blood sugar rises less than 25 mg/dL above fasting. What can be inferred from this result? A. The individual has celiac disease B. The individual is post-gastrectomy C. The individual is lactose-intolerant D. The individual is glucose intolerant

Correct answer: The individual is lactose intolerant Normally, lactase is broken down into glucose and galactose to be more easily absorbed in the body. However, when an individual has a lactase deficiency (lactose intolerance) lactase is not split into glucose and galactose. The lactose tolerance test determines if an individual is tolerant by providing an oral dose of lactose after a fast. Tolerance of lactose is indicated by blood glucose rising above 25 mg/dL. Intolerance of lactose is indicated when blood glucose does not rise above 25 mg/dL due to lactase not being split into glucose and galactose molecules.

A patient's lab values show decreased RBC, low hemoglobin, and high MCV. What can you infer based on the lab values? The patient has macrocytic anemia The patient has microcytic anemia The patient has a chronic infection The patient has an iron deficiency

Correct answer: The patient has macrocytic anemia Macrocytic, megaloblastic anemia is associated with the following lab values: decreased RBC, low hemoglobin, low hematocrit, high MCV (mean corpuscular volume), high MCH (mean corpuscular hemoglobin), and normal MCHC (mean corpuscular hemoglobin concentration). There are few, large blood cells caused by a folate or cobalamin (B-12) deficiency. Microcytic, hypochromic anemia is characterized by small, pale red blood cells caused by an iron deficiency. This type of anemia is commonly due to chronic infection, poor diet, impaired absorption, increased demand, malignancies, or renal disease.

Which of the following medications is contraindicated for a T2DM patient with CHF? A. Insulin secretagogues B. Thiazolidinediones C. Glimepiride D. Glucotrol

Correct answer: Thiazolidinediones Thiazolidinediones (Actos) improve peripheral insulin sensitivity. This oral glucose-lowering medicine can worsen CHF by promoting weight gain and edema; therefore, it is not appropriate for patients with type 2 diabetes mellitus (T2DM) and congestive heart failure (CHF). Glimepiride, or Amaryl, stimulates the pancreas to make more insulin, thereby causing the possibility of low blood sugar. Therefore, this medication requires education on hypoglycemia. Insulin secretagogues, such as Glucotrol, promote insulin secretion and work to lower glucose levels.

Liver enzymes are increased in all of the following diseases states except: A. alcoholism B. Fatty Liver C. Uncontrolled diabetes D. hepatitis

Correct answer: Uncontrolled diabetes Liver function tests include the enzymes alkaline phosphatase (ALP), lactic acid dehydrogenase (LDH), aspartate amino transferase (AST, SGOT), and alanine aminotransferase (ALT, SGPT). Abnormal liver tests are detected when tissue damage causes the liver enzymes to leak into blood circulation. Increased liver enzymes are present in liver disease, bone disease, hepatitis, myocardial infarction, muscle malignancies, hepatitis, acute or chronic alcohol use, and fatty liver. Liver enzymes are decreased in scurvy, malnutrition, and uncontrolled diabetes.

Which food program would likely provide the most assistance for homeless breastfeeding women? TEFAP WIC SMP NSLP

Correct answer: WIC WIC is a USDA special supplemental nutrition program for women (pregnant, postpartum, breastfeeding), infants, and children up to 5 years of age. WIC provides supplemental food, nutrition education, and health care. WIC would be the best program to provide support to a homeless breastfeeding woman. The Special Milk Program (SMP) is a USDA program that encourages milk consumption by children. The National School Lunch Program (NSLP) is a USDA entitlement program that aims to improve the nutrition of low-income children by providing cash grants, food donations, and reimbursement for school-based meals. The Emergency Food Assistance Program (TEFAP) is a USDA program that distributes commodity foods to local food distributors, but does not distribute to individual households.

Which symptom and recommended diet is associated with Addison's disease? Hyperglycemia; consistent carbohydrate intake Weight loss; high-protein diet Weight gain; low-sodium diet Hypertension; low-sodium diet

Correct answer: Weight loss; high-protein diet Addison's disease is a disorder in which the adrenal glands do not produce enough hormones. The atrophy of the adrenal cortex leads to decreased cortisol (glycogen depletion, hypoglycemia), decreased aldosterone (sodium loss, potassium retention, dehydration), and decreased androgens (tissue wasting, weight loss). The recommended diet for Addison's disease is a high protein, high salt diet with frequent meals to prevent weight loss, hypoglycemia, and dehydration. The other choices do not reflect signs/symptoms or appropriate diets for an individual with Addison's disease.

An infomercial is selling a "special" vitamin and makes several weight loss claims about the product. What is the best question to ask to help evaluate the information? A. How many people have bought the product this year? B. How much does the product cost in comparison to other weight loss products? C. What are the product manufacturer's credentials? D. How much money has the product made this fiscal year?

Correct answer: What are the product manufacturer's credentials? When evaluating health care information, determine the legitimacy of the product based on the CARS checklist: Credibility: What are the author's credentials? Accuracy: Is the information current, factual, and comprehensive? Reasonableness: Is the information fair, balanced, and consistent? Support: Is there supporting documentation cited for scientific information?

Which of the following reactions occurs during the "ebb" phase of injury response? A. Decreased metabolic rate B. Fluid resuscitation C. Oxygen return D. Hypovolemia

Decreased metabolic rate The "ebb and flow" response to injury is the body's reaction to physiological trauma, such as critical illness, injury, and/or sepsis. This is associated with a hypermetabolic and catabolic response following the trauma. Immediately following the injury is the "ebb" phase, characterized by hypovolemia, shock, tissue hypoxia, and decreased metabolic rate. During the "flow" phase there is fluid resuscitation, and oxygen transport returns.

What nutrient is most impaired in cystic fibrosis? A. Carbohydrate B. Fluid C. Protein D. Fat

Fat. Cystic fibrosis is a disease of the exocrine glands characterized by pancreatic enzyme deficiency, high electrolyte perspiration levels, thick mucus secretions, and malabsorption. Fat is the most impaired nutrient due to pancreatic enzyme deficiency. As a result, pancreatic enzyme replacement therapy (PERT) is recommended with all meals and snacks to aid in fat absorption to prevent steatorrhea and promote normal growth.

The reduced ability to taste food is referred to as:

Hypogeusia Hypogeusia is the reduced ability to taste food and may be caused by chemotherapy. Chemotherapy may also cause xerostomia (dry mouth syndrome), stomatitis (painful swelling and sores in the mouth), and cacogeusia (unpleasant or revolting taste in the mouth).

A widowed, Caucasian 72-year-old female makes $85,000/year working from home. What program would be able to provide her with meal assistance? A. SNAP B. OAA Nutrition Program C. Meals on Wheels D. She does not qualify for meal assistance

OAA Nutrition Program The Older Americans Act Nutrition Program (OAA) provides one hot meal per day, five days per week, and provides 1/3 of the RDAs. All individuals over 60 years of age, as well as their spouses, are eligible for this program, regardless of income. Participants in the program are more likely to have low income, be part of a minority group, live alone, or be over age 75; however, they are not required to have these characteristics. Targeting for the program is based on need. Meals on Wheels (under OAA) provides home-delivered meals for homebound individuals. The Supplemental Nutrition Assistance Program (SNAP) is a USDA food assistance program that assists low-income people with monthly benefits. To receive SNAP benefits, households must meet certain tests, including resource and income tests.

Which resource could provide client education material for a weight-loss patient? A. JSTOR B. CDR C. PubMed D. NCM

The Academy of Nutrition and Dietetics' Nutrition Care Manual (NCM) provides client-based information for a variety of conditions. It is internet-based and requires membership in the Academy to access the benefits of the client education materials. PubMed is a free full-text archive of biomedical and life sciences journal literature that can be used by providers to stay up-to-date with the latest research in the field. The Commission on Dietetic Registration (CDR) is the credentialing agency and organization unit of the Academy of Nutrition and Dietetics. JSTOR is a digital library of academic journals, books, and primary sources.

Which of the following describes the registered dietitian's role in a community assessment? A. To determine individual macronutrient needs for the community B. To measure the diet quality to assess how well a set of foods aligns with U.S dietary guidelines for Americans C. To assess the nutritional status of a population or area D. To advocate for funding of federal school meal and nutrition programs

To assess the nutritional status of a population or area. The registered dietitian's role in community assessment includes the following: To assess the nutritional status of a population or geographic area To identify target populations at nutritional risk To initiate and participate in nutrition-related data collection The Healthy Eating Index is a measure of diet quality that can be used to assess compliance with the US Dietary Guidelines for Americans and to monitor changes in dietary patterns. The Healthy and Hunger-Free Kids Act of 2010 provides funding for federal school meal and nutrition programs, improves access to healthy food, and promotes student wellness.

Which of the following nutrients is a gastric bypass patient most likely to become deficient in, and why? A. Vitamin E d/t decreased intake B. Zinc d/t decreased intrinsic factor C. B-12 d/t decreased absorption D. Vitamin C d/t decrease in gastric acid.

Vitamin B-12 due to decreased absorption Thirty percent of gastric bypass patients become deficient in vitamin B-12 due to decreased mechanical digestion and absorption of iron, B-12, and other nutrients. The etiology of the deficiency is due to inadequate contact with intrinsic factor, decreased gastric acid, and low intake of foods rich in vitamin B-12. Other common nutrient deficiencies include iron, protein, calcium, folate, and vitamin D. Vitamin C, vitamin E, and zinc are not common deficiencies for gastric bypass patients.

What is a common oral health issue in older adults, along with the appropriate nutritional recommendation? A. Xerostomia; drink more fluids B. Cleft lip; speech therapy C. constipation; decrease fiber intake D. GERD; high fat diet

Xerostomia is dry mouth due to lack of saliva, which may result in dysphagia, and is commonly found in older adults. The appropriate nutrition recommendations are drink more liquids, use artificial saliva substitutes, chew sugarless gum, and eat a healthful diet. Cleft lip is a condition present at birth and characterized by openings or splits in the roof of the mouth and lip, which can be treated with surgery or speech therapy. Gastroesophageal reflux disease (GERD) is weakened lower esophageal sphincter muscles that leads to stomach acid regurgitating up the esophagus. It is common in older adults. The nutritional remedies include a low-fat diet, avoidance of large meals, sitting upright after eating, and avoiding foods that stimulate acid secretion. Constipation is characterized by abdominal discomfort, hard stools, and more than three days without a bowel movement. The intervention is increased fiber intake, a target of three bowel movements per week, and use of laxatives.

You are looking at a sample population of 175 people and want to determine the prevalence rate of developing AIDS over a 12-year period. At the beginning of the study, you note 12 existing cases of AIDS. The first follow-up at 6 years notes 15 new cases of HIV. The second follow-up at 12 years notes 28 new cases. What is the prevalence rate? 25% 377% 31% 45%

orrect answer: 31% Prevalence is the number of existing cases of a condition or disease in a given population. To measure prevalence rate, take the total number of cases (12 + 15 + 28 = 55) and divide by the sample population (175). Therefore, prevalence would be 55/175 = 0.31, or a 31% prevalence rate.