All Domains Jean Inman Questions with Explanations of Answers

Which piece of food service equipment may be restricted by a local law? a. toaster b. steam-jacketed kettle c. convection oven d. garbage disposal

d. garbage disposal

When planning a program for rural elderly, which is the most important? a. the number of participants b. what you will serve c. where it will be held d. how they will get to you

d. how they will get to you The additional factors listed will not matter if those in the rural community cannot access the services.

A serum sodium level of 150 mEq/L is a sign of: a. very high sodium intake b. very low sodium intake c. hyponatremia d. hypernatremia

d. hypernatremia Normal serum sodium: 135-145 mEq/L.

Considering the following smoke points of various fats, which would be the best to use for frying? a. 300F b. 323F c. 375F d. 400F

d. 400F Smoke point is the temperature at which an oil or fat begins to produce a continuous bluish smoke that becomes clearly visible. Most foods are fried between the temperatures of 350-450 degrees Fahrenheit so it is best to choose an oil with a smoking point above 400 degrees.

How much fluid is lost through insensible losses? a. 0.5 liters b. 1 liter c. 2 liters d. 3-4 liters

b. 1 liter Insensible fluid loss is the amount of body fluid lost daily that is not easily measured, from the respiratory system, skin, and water in the excreted stool. The exact amount is unmeasurable but is estimated to be 0.8-1.2L per day.

Which recipe ingredient should be adjusted if a cake has a crunchy crust and compact moist texture? a. milk b. flour c. sugar d. baking powder

c. sugar Sugar provides tenderness (as hydrogroscopic) and flavor in baking. When too much is added, this results in falling in the center and coarse texture. Not enough sugar causes poor volume.

What section of the intestine is more likely to be involved in Crohn's disease? a. ileum b. jejunum c. duodenum d. appendix

a. ileum The terminal ileum is most commonly affected in Crohn's disease.

An employee evaluation should be given: a. in a quiet place with privacy b. in the Diet Office c. at the end of the day d. at the beginning of the day

a. in a quiet place with privacy

The normal range for hemoglobin A1C is: a. 1-2% b. 4-6% c. 10-12% d. 35-40%

b. 4-6% Normal HgA1c is <5.7% in non-diabetic and <7% in diabetics. HgA1c of 5.7-6.5% indicates pre-diabetes and HgA1c over 6.5% indicates DM.

A child with AIDS needs a high calorie and _____ intake. a. megadose vitamins b. high protein c. low fat d. low residue

b. high protein

Lactase is produced in the: a. stomach b. small intestine c. gallbladder d. pancreas

b. small intestine Lactose is converted by lactase into glucose and galactose on the brush border membrane of the small intestine, where it is absorbed into the enterocyte.

Which of the following must be reduced before it can be further transported for absorption? a. dipeptides b. whey c. casein hydrolysate d. crystalline amino acids

b. whey Dipeptides, crystalline amino acids, and casein hydrolysate are all broken down. Whey needs to be further broken down (contains 95% of the original water, most of the lactose, 20% of the milk protein and traces of fat. The remaining milk solids, about 50%, are incorporated into cheese. The composition of whey depends upon the type of cheese produced.

A 75 year old female with adequate income would benefit from: a. SNAP b. Congregate Meals c. EFNEP d. WIC

b. Congregate Meals Congregate meals are provided to those who are ambulatory, transportation essential for rural elderly. No income requirements, just have to be 60 or older. The other programs are for lower income individuals.

Which of the following should be avoided on a low sodium diet? a. pork loin b. turkey roll c. beef sirloin d. lam chop

b. turkey roll Turkey roll is a processed meat so highest in sodium.

If a diabetic patient reduces his calorie intake from 2300 to 1800 calories per day, how much will he lose in one month? a. 4 pounds b. 6 pounds c. 2 pounds d. 8 pounds

d. 4 pounds 3500 kcal deficit per week = 1 lb weight loss 2300 kcal - 1800 kcal = 500 kcal per day 500 kcal per day x 7 days per week = 3500 kcal per week = 1 lb per week 1 lb per week x 4 weeks per month = 4 lbs per month

The Schilling test detects defects in the absorption of: a. folic acid b. cyanocobalamin c. pyridoxine d. iron

b. cyanocobalamin Vitamin B12

What is the best way to prevent contamination of foods? a. freeze it b. freeze it in sterile packages c. make employees wash hands frequently d. wash countertops regularly with sanitizing agent

c. make employees wash hands frequently Handwashing is one of the primary methods for preventing foodborne illness

Appearance, taste and texture are considered: a. quantity control b. safety control c. quality control d. production control

c. quality control

A PERT analysis must include: a. the total cost of each activity b. the person responsible for each activity c. the amount of time needed to complete each activity d. only those actions on the critical path

c. the amount of time needed to complete each activity PERT means Program Evaluation and Review Technique. PERT is used to calculate the total amount of time to complete a project.

The raw food cost of an item is $1.12 per serving. What is the hidden cost? a. $0.10 b. $0.07 c. $0.13 d. $0.11

d. $0.11 Hidden food costs are 10% of raw food cost.

What is the labor cost for 4 weeks if you have 5.5 FTEs earning $20/hour? a. $4400 b. $12,000 c. $14,500 d. $17,600

d. $17,600 $20/hr x 40 hrs/week = $800 $800 x 5.5 FTE = $4,400 $4,400 x 4 weeks = $17,600

Osteoporosis is most likely to occur in: a. the physically active adult b. a non-smoker c. a black female d. a white female

d. a white female

Before you teach a class on nutrition, you should: a. research all current materials at the library b. read a current nutrition textbook c. take a survey to determine what they are interested in d. assess the student's current nutrition knowledge

d. assess the student's current nutrition knowledge

Quality circles are useful in: a. employee evaluations b. job selection and placement c. policy development d. increasing productivity

d. increasing productivity Quality circles are a group of employees that meets regularly to consider ways of resolving problems and improving production in their organization.

Medicaid benefits apply to: a. healthy adults b. a 60 year old female c. those at nutritional risk d. low income individuals

d. low income individuals Medicaid is federally funded, state run program which provides payment for medical care for all eligible needy; all ages, blind, disabled, dependent children. Eligibility is based on income.

Where should a hand-washing sink be located? a. near the door entering the kitchen b. near the dish room c. near the cafeteria counter d. near the food preparation area

d. near the food preparation area Hand-washing sinks should be easily accessible to food handlers. May encourage frequent hand washing and reduce risk of foodborne illness.

A patient relates a story to the RD. The RD says: "this happened to me, too" This is: a. reflection b. clarification c. attribution d. self-disclosure

d. self-disclosure The RD is sharing personal information, likely in order to make the client feel more comfortable and know that the RD understands where they are coming from.

Which job would you not give to a Consultant Dietitian? a. planning future goals b. writing policies and procedures c. providing staff in-service d. supervision of dietary employees

d. supervision of dietary employees A consultant RD would not be a supervisory of dietary employees as they are staff, meaning they advise and support the line, but are not involved in daily operations.

If implementing a program costs $3 for each patient and the return is $6 per patient, the cost/benefit ratio is: a. 1:2 b. 2:1 c. 1:1 d. 3:1

a. 1:2 3/6 = 1:2

Two liters of a 5% dextrose solution provides how many calories? a. 170 b. 340 c. 212 d. 195

b. 340 5gm dextrose per 100mL 5 gm x 20 = 100 gm 100 gm x 3.4 kcal = 340 kcal

Which of the following will stabilize the egg in a recipe? a. a base b. an acid c. sugar d. salt

b. an acid An acid stiffens an egg white foam by tenderizing the protein and allowing it to extend more easily.

An infants failure to thrive can be seen in: a. their behavior b. comparison with growth charts c. weight for height d. height for age

B - comparison with growth charts For infants 0-2 years, length-for-age, weight-for-age, weight-for-length, and head-circumferance-for-age are the primary measuers used to assesses growth. At this age, the WHO growth chart is used which was developed based on growth of infants exclusively breastfed and provide a better description of physiological growth in infancy; shows optimal growth patterns during infancy. Subsequently, a infants FTT can be seen by comparing with growth charts.

The test that measures toxic levels of lead in the blood is the: a. prothrombin test b. free erythrocyte protopophyrin test c. hemoglobin value test d. MCV

b. free erythrocyte protopophyrin test

Funding for public health programs comes primarily from: a. foundation grants b. general revenue c. charitable organizations d. public/private partnerships

b. general revenue

Which of the following is a grade for fresh produce? a. US select b. US Grade A c. US No. 1 d. US standard

c. US No. 1 Best to worst grade: Fresh F/V: Fancy, Extra #1, #1, Combo, #2 Of note: Canned F/V: Grade A (Fancy), Grade B (Choice), Grade C (Select)

A tube feeding ran from 7PM till 6AM, providing 1800 calories, at 1.6 calories/cc how many cc/hour were given a. 100 b. 125 c. 210 d. 65

a. 100 7PM to 6AM = 11 hrs 1800 kcal / 1.6 kcal per cc / 11 hrs = 102 cc/hr Round to 100 cc/hr Check: 100 mL/hr x 11 hrs = 1,100 x 1.6 kcal/mL = 1760 kcal (~1800 kcal)

How much free water is in 1.5 liters of an enteral feeding that has 1.5 calories per cc? a. 1155 cc b. 1057 cc c. 926 cc d. 901 cc

a. 1155 cc 1.0 cals/ml: 83% - 85% per liter 1.2 cals/ml: 81% - 82% per liter 1.5 cals/ml: 76% - 78% per liter 2.0 cals/ml: 69% - 72% per liter So... 1500mL of formula x 0.77 = ~1,155 cc

A statement of affirmation in motivational interviewing would be: a. "taking a walk during your lunch hour shows how determined you are" b. I would like you to try to reduce portion sizes at dinner" c. "perhaps eating lunch away from you desk would be helpful" d. try to increase you intake of fruits and vegetables"

a. "taking a walk during your lunch hour shows how determined you are" Affirmations are statements and gestures that recognize client strengths and acknowledge behaviours that lead in the direction of positive change, no matter how big or small. Affirmations build confidence in one's ability to change. To be effective, affirmations must be genuine and congruent.

Margarine has fatty acids in this order of predominance: a. PUFA, MUFA, SAT b. SAT, MUFA, PUFA c. MUFA, SAT, PUFA d. MUFA, PUFA, SAT

a. PUFA, MUFA, SAT Margarine has more PUFAs and less saturated fat than butter.

Which of the following directly assists the greatest number of people? a. Supplemental Nutrition Assistance Program b. National School Lunch Program c. Child and Adult Care Program d. Supplemental Nutrition Program for Women, Infants, and Children

a. Supplemental Nutrition Assistance Program

Skinfold thickness measurements are best for assessing: a. an 18th month old with growth failure b. a 36 year old athlete c. a 54 year old women with significant weight loss d. an 82 year old man with diabetes

b. a 36 year old athlete May be better measure than BMI in those who have higher muscle mass.

For which disease would a low sodium diet be recommended? a. ascites b. esophageal varices c. pancreatitis d. appendicitis

a. ascites

To sanitize, immerse dishes in a chemical solution for _____ minute(s). a. 1 b. 2 c. 3 d. 4

a. 1 Use chemical solution for 1 minute in lukewarm water (75 degrees F)

BMI for age percentiles start at age: a. 24 months b. 36 months c. 48 months d. 5 years

a. 24 months Starts at age 2 yeras, age and sex specific.

Infants should be given solid foods at: a. 4-6 months b. 3-4 months c. 2-4 months d. 6-8 months

a. 4-6 months

Previously cooked hazardous food must be reheated to an internal temperature of 165 'F for fifteen seconds within: a. 1 hour b. 2 hours c. 4 hours d. 30 minutes

b. 2 hours When food reheated, it should be reheated to 165 degrees F and should not be in temperature danger zone for longer than 2 hrs

What is the mean of the following set of numbers: 3, 2, 2: a. 3 b. 2.3 c. 3.2 d. 2.5

b. 2.3 3 + 2 + 2 = 7/3 = 2.3

500ml of a 20% dextrose solution with 500ml of a 4% protein solution and 250ml of a 20% lipid emulsion How many grams of protein are provided in the above situation? a. 15 b. 20 c. 25 d. 30

b. 20 Protein: 4 gm per 100mL , so 4x 5 = 20 gm pro

A foodservice uses hamburger patties at an average rate of 6 cases per day. Lead time is 3 days. You want to have a safety supply of 2 cases. You need to order them when the supply drops to ____ cases. a. 18 b. 20 c. 36 d. 45

b. 20 Re-order time = (average daily use x lead time) + safety stock = (6 cases/day x 3 days) + 2 cases = 20 cases

Which of the following types of menus would be most appropriate for a new acute-care facility with an expected length of stay of 2 days? a. static b. 7 day cycle c. 14 day cycle d. 21 day cycle

b. 7 day cycle

How many grams of protein would you receive on a 1500 calorie diet which is 20% protein? a. 70 b. 75 c. 64 d. 300

b. 75 1500 x 20% = 300 kcal 300 kcal / 4 kcal/gm = 75 gm protein

The purpose of an emulsifier in margarine is to: a. keep water and fat from separating b. keep water and fat separated c. sustain the natural flavor of the ingredients d. retain the color

a. keep water and fat from separating An emulsifer is an additive which helps two liquids mix. The margarine is a fat (hydrophobic), and the water is a liquid (hydrophilic) which do not mix without an emulsifer.

WIC encourages women with babies to: a. formula feed b. breast feed c. food solid foods early d. feed a mixture of formula and solid foods early

b. breast feed

What may be lacking in the traditional diet for Asians living in America? a. iron b. calcium c. folic acid d. thiamin

b. calcium Asian individuals do not eat much dairy.

Which of the following must be included when preparing a budget? a. controlling expenses b. forecasting revenue c. controlling labor costs d. proper cash control

b. forecasting revenue A budget gives manager a basis for control in order to estimate future needs. Forecasting revenue/sales is the first step function of operating budgets

Which of the following has the most bacteria? a. roast chicken b. ground beef c. roast veal d. roast pork

b. ground beef

You are a supervising Dietitian and are very satisfied with one of your Diet Aides who works very hard. One year after hiring her, you realize the information on her application wasn't true. What should you do? a. say nothing and ignore it b. discuss it with her one on one in your office c. inform human resources about the situation d. fire her

b. discuss it with her one on one in your office The process they are asking about is the process of leadership and management of employees. When something goes wrong with employees, the first step is always to talk with people privately. Never stop the actual work to address a situation.

Where would this be placed in a research article: "most of the changes seen were probably due to..." a. introduction b. discussion c. results d. summary

b. discussion In the discussion, the results are interpreted, comparison with other studies. Discussing the results addresses the research question, objectives, and hypothesis. It places results in context of existing science. Provides implications for future research or cinical practice, limitation and strengths.

Decreased levels of serotonin are associated with: a. decrease in carbohydrate appetite b. increase in carbohydrate appetite c. decreased sensation of taste d. increased sensation of taste

b. increase in carbohydrate appetite Think: when your sad (low serotonin) you eat more carbs

When you request quotations from vendors on specific items by phone or in person, you are utilizing which method of purchasing? a. prime vendor b. informal c. competitive bid d. future contract

b. informal Informal Procurement Process: -Develop specifications in writing -Identify sources eligible, able, and willing to provide products -Contact sources -Evaluate bidders' response -Determine most responsive and responsible bidder at the lowest price If competitive bidding were to occur, written specifications and quantity needs would b submitted to a vendor who then submits a price. Bids would be opened together and subsequently the ordered placed with lowest bid price.

In interstate shipping of shellfish is monitored by the: a. USDA b. HHS c. FDA d. FTC

c. FDA The FDA is responsible for interstate shipping of shellfish.

Which group is responsible for nutrition labeling? a. USDA b. US Dept. of Commerce c. FDA d. UPI

c. FDA Under Food, Drug, and Cosmetic Act, FDA covers all interstate food except meat, fish, poultry and eggs; inspects food processing factories, raw materials and labeling. FDA also formulates mandatory standards for products shipped across state lines as well as any foods labeled imitation or substitute

A focus group contributes what data? a. analytical b. experimental c. attitudinal d. objective

c. attitudinal Attitudinal data is providing qualitive data about how someone feels about something. Focus groups are a great example of attitudinal data.

Which would you recommend to a Mexican American on a low fat diet? a. low fat cottage cheese b. skim milk c. beans and rice d. low fat yogurt

c. beans and rice

It takes _____ FTEs to fill one 8 hour, 7 day per week position a. 1.4 b. 1.6 c. 1.8 d. 2

a. 1.4 8hr/day x 7 days/wk = 56hrs 56hr/40hr = 1.4

The major function of management is: a. forecasting b. actuating c. planning d. organizing

c. planning Planning is the primary management function

Which can be included in a meal for gluten-induced enteropathy? a. spaghetti and tomato sauce b. cheese and crackers c. potatoes with butter d. oatmeal with sugar

c. potatoes with butter NO wheat, rye, oats, barley, bran, graham, malt, bulgar, couscous, durum, orzo, thickening agents *Note: oats may be contaminated by wheat so avoid unless certified GF OK: corn potato, rice, soybean, tapioca, arrowroot, carob bean, guar gum, flax, amaranth, millett, teff, quinoa

The treatment for hyperbilirubinemia is: a. high calorie b. high protein c. high fluid d. high fat

c. high fluid Hyperbilirubemia occurs in newborns when unconjugated bilirubin levels are elevated during first week of life as result of increased breakdown of red blood cells, or decreased intestinal mobility. Encourage 9-12 feedings per day of human milk or formula to promote hydration and intestinal motility.

Why do egg whites beat more easily at room temperature? a. the pH is increased b. the protein is denatured c. the surface tension is lower d. the surface tension is higher

c. the surface tension is lower

When you check overrun, you are checking a. excess stock in the storeroom b. surplus soap and rinse aids used in the dishmachine c. the weight of ice cream d. Total costs of unexpected meals served

c. the weight of the ice cream Overrun is the increase in volume from freezing and whipping which is used to determine the weight. In ice cream, overrun should be 70-80%

What best measures excess calorie reserves? a. weight b. creatinine c. triceps skinfold d. arm circumference

c. triceps skinfold Tricep skinfold measures body fat reserves and calorie reserves.

Meat graded "US standard" is the grade given at the: a. time of purchase b. time of delivery c. storage facility d. time of slaughter

d. time of slaughter

Processed chopped lettuce costs $0.69/lb. Whole-head lettuce costs $16.49/50lb. case. If the head of lettuce can be processed in two hours at $5.25/hour for labor, what is the relative value of processed and head lettuce if the yield is 75%? a. $0.69 processed; $0.72 head lettuce b. $0.69 processed; $0.89 head lettuce c. $0.72 processed; $0.69 head lettuce d. $0.72 processed; $0.89 head lettuce

a. $0.69 processed; $0.72 head lettuce Processed lettuce = $0.69/lb (EP) Whole-head lettuce = $16.49/50lb (AP) with 75% yield = 37.5 (EP) Labor cost = 2 hrs x $5.25 = $10.50 Food cost + Labor cost = $16.49 + $10.50 = $26.99 $26.99/37.5 (EP) = $0.72/lb (EP)

Using the following information, determine the selling price of the meal used to determine the break-even point. Fixed costs $100, Variable costs per meal $5, Break-even point 20 meals a. $10 b. $15 c. $5 d. $2.50

a. $10 BE = fixed costs/selling price - variable costs 20 = 100/(SP - 5) $100/20 = $5 $5 + Variable cost ($5) = $10

What is the gross food cost for June using the following information? June 1 inventory $5300 July 1 inventory $2700 Food purchases - month of June $3150 a. $5750 b. $3150 c. $4900 d. $6200

a. $5750 (Opening inventory + food purchases) - closing inventory ($5300 + $3150) - $2700 = $5750

Store frozen fruits and vegetables at: a. 0- -10'F b. -10- -20'F c. < 32'F d. 0-10'F

a. 0- -10'F Frozen foods should be stored at 0 to -10 degrees F

The dietary intake component of NHANES is: a. WWEIA b. BRFSS c. Ten State Nutrition Survey d. PNSS

a. WWEIA What We Eat in American is the dietary intake componenent of NHANES.

An example of a survey with a negative correlation is: a. when folic acid intake increases prior to pregnancy, the incidence of neural tube defects declines b. when LDL levels increase, the rate of heart disease increases c. when a person becomes more obese, their LDL levels likely rise d. as the intake of peanut butter and potato chips increases, dental caries increase

a. when folic acid intake increases prior to pregnancy, the incidence of neural tube defects declines Negative correlation does NOT mean "bad". Negative correlation means moving in oppositve directions, while positive correlation means moving in the same direction. In this example, a negative correlation would be A because when folic acid intake increases, neural tube defects move in the opposite direction (decreases).

What is the effect of excess caffeine intake? a. insomnia b. nausea c. bloating d. weight gain

a. insomnia

A natural plant hormone that is used to ripen fruits is: a. methanol b. ethylene c. acetyl acid d. ethanol

b. ethylene

The width of a main kitchen aisle should be: a. 24'' b. 36'' c. 48'' d. 60''

d. 60''

Cured meat is pink due to: a. sugar b. salt c. vinegar d. nitrites

d. nitrites

Which drink would a Mormon choose? a. cola b. 7-up c. tea d. coffee

B - 7-up Mormon's strictly avoid tea, coffee, and alcohol. There is mixed information of caffination, but a safe bet is to choice caffeine free drinks. Subsequently, 7-Up would be the best choice.

What type of food would you feed to a patient who has the athetoid form of cerebral palsey? a. milk-based products b. finger foods like a hot dog in a roll c. milk-free products d. galactose-free foods

B - finger foods like a hot dog in a roll Athetoid CP, also known as non-spastic CP, occurs when there are involuntary wormlike movements. Subsequently, these patients require high calorie, high protein, and can handle finger foods.

The immunosuppressant drug cyclosporine may cause: a. hypokalemia and hypoglycemia b. hyperlipidemia and hyperkalemia c. hypermagnesemia d. hyponatremia

B - hyperlipidemia and hyperkalemia Think from txp rotation. Cyclosporine can cause hyperlipidemia, hyperglycemia, hyperkalemia, hypertension.

The diet for hepatic coma is low in protein due to: a. low ammonia levels b. high cholesterol levels c. high ammonia levels d. high LDL

C - high ammonia levels Hepatic Encephalopathy is a major (reversible) complication of end-stage liver disease. In HE, portal blood is diverted into general circulation via the collateral vessels. Subsequently, toxic substances like ammonia accumulate in blood as a result of liver failure & impaired urea synthesis. The high levels of ammonia can cause impaired consciousness, memory loss, tremors, stupor, and coma. A low-protein diet may be indicated to prevent further ammonia accumulation.

Which of the following would be classified as NB in the NCP? a hypermetabolism b. inadequate enteral intake c. impaired ability to prepare foods d. excessive protein intake

C - impaired ability to prepare foods NB is Nutrition Behavioral-Environal domain of nutrition diagnosis. NB includes knowledge and beliefs, physical activity, food safety and acess. Inadequate enteral intake and excessive protein intake would fall into the NI category, and hypermetabolism would fall into the NC cateogory. Impaired ability to prepare foods is a knowledge deficit, and thus would be in NB.

The proper portion size of a dessert item is 1/3 cup. Which scoop should you use? a. #12 b. #8 c. #16 d. #10

a. #12 #12 = 12 scoops per quart (1/12 quart) If 4 cups = 1 quart, 4 cups/12 = 1/3 cup

Find the cost per meal if you serve 120,000 meals, spend $46000 in food purchases and $1250 worth of food was removed from the inventory. a. $0.39 b. $0.42 c. $0.37 d. $0.43

a. $0.39 Cost per meal = total cost/number of meals 46000 + 1250 = 5850 5850/120000 = 0.39

Your Nutrition Department has 6.5 FTE Dietitians at $20/hour. How much salary is that per week? a. $5200 b. $3960 c. $4850 d. $6550

a. $5200 $20.00 x 40 = $800 x 6.5 = $5200

A recipe requires 1 1/2 pints of cleaned, sliced strawberries. The yield for strawberries is 91%. One cup of clean, sliced strawberries weighs 7 ounces. At a minimum, how many pounds of strawberries need to be ordered? a. 1 1/2 b. 1 c. 1 1/4 d. 2

a. 1 1/2 1.5 pints = 3 cups Since 1 cup= 7 oz --> 3 cups x 7 oz = 21 oz (EP) 21 oz/0.91 = 23.07 oz (AP) 23.07/16 oz per lb= 1.44 lb

Which of the following is equivalent to a lean protein exchange? a. 1/4 cup low fat cottage cheese b. 2 T grated parmesan cheese c. 1 ounce mozzarella cheese d. 1 ounce swiss cheese

a. 1/4 cup low fat cottage cheese 1/4 cup low fat cottage cheese = 1 lean protein exchange (0 gm CHO, 7 gm protein, 3 gm fat, 55 kcal) ?? 2 T grated parmesan cheese also = 1 lean protein exchange 1 oz mozzarella cheese = 1 medium fat protein exchange (0 gm CHO, 7 gm protein, 5 gm fat, 75 kcal) 1 oz swiss cheese = 1 high fat protein exchange (0 gm CHO, 7 gm protein, 8 gm fat, 100 kcal)

How many quarts of batter are needed to make 144 muffins using a #12 scoop? a. 12 b. 16 c. 22 d. 6

a. 12 #12 scoop = 1/3 cup (1/12 quart), or 2.66 oz (1/3 cup x 8oz per cup) For 144 muffin = 2.66 * 144 = 384 oz # quarts = 384/32 = 12

How many oranges are needed to produce one quart of juice? a. 12 b. 15 c. 18 d. 20

a. 12 About 12 oranges = 1 quart apparently

How many calories are provided in 1.5 liters of D25W? a. 1275 b. 2275 c. 1500 d. 2000

a. 1275 25 gm dextrose per 100 mL 25 gm x 15 = 375 gm 375 gm x 3.4 kcal/gm = 1275 kcal

What would be the next number in this list with a moving average of 5? 1400, 1200, 1300, 1250, 1350, 1400, 1425 a. 1345 b. 1275 c. 1434 d. 1405

a. 1345 (1300 + 1250 + 1350 + 1400 + 1425)/5 = 1345

A diabetic wants to exchange his bedtime snack of 8 ounces whole milk. What do you suggest? a. 1oz cheese and 1/2 cup orange juice b. 2 graham crackers and 1/2 cup orange juice c. 1 ounce cheese d. 2 ounces cheese

a. 1oz cheese and 1/2 cup orange juice 8 oz whole milk = 12 gm CHO, 8 gm protein, 8 gm fat, 160 kcal; need some CHO in snack so can't just do cheese; graham crackers and OJ minimum protein 1 oz cheese = 1 high fat protein exchange (0 gm CHO, 7 gm protein, 8 gm fat, 100 kcal), 1/2 cup OJ = 1 fruit/fruit juice exchange (15 gm CHO, 60 kcal) Total = 15 gm CHO, 7 gm pro, 8 gm fat, 160 kcal which is comporable to previous snack

According to the Food Lists for Diabetes Exchanges, 2T peanut butter is equivalent to: a. 2 high fat proteins b. 1 high fat protein c. 2 fats d. 1 high fat protein plus 2 fats

a. 2 high fat proteins 1 tbsp = 1 high fat protein exchange

The cupcakes served to patients have a 75% acceptance rate. In a hospital where 90% of the 425 patients select their own menus, how many cupcakes are needed? a. 24 dozen b. 18 dozen c. 16 dozen d. 12 dozen

a. 24 dozen 0.9 x 425 = 382.5 382.5 x 0.75 = 286.9 286.9/12 = 24 dozen

An AIDS patient's temperature has risen to 102 degrees. his BMR has increased: a. 24% b. 36% c. 12% d. 5%

a. 24% BMR raises 7% for every degree F over normal body temperature. 102 degree F is 3.4 degrees higher than normal (98.6 degrees F). 7% x 3.4 = 23.8% = 24%

A sandwich with two pieces of white bread and two ounces of turkey provides how many calories? a. 250 b. 145 c. 198 d. 290

a. 250 2 slices white bread = 2 starch exchanges (30 gm CHO, 6 gm protein, 2 gm fat, 160 kcal) 2 oz turkey = 2 lean fat protein exchanges (0 gm CHO, 14 gm protein, 6 gm protein, 90 kcal) 160kcal + 90kcal = 250 kcal

Fresh eggs in the shell can be stored in a refrigerator at 40F for: a. 3 weeks b. 2 weeks c. 10 days d. 4-6 days

a. 3 weeks How to remember: egg has three letters, so three weeks

How many 4 ounce servings can you get from 1 gallon of ice cream? a. 32 b. 26 c. 22 d. 44

a. 32 1 gallon = 128oz 128oz / 4 oz servings = 32oz

The cafeteria serves lunch from 11 AM to 2:30 PM with a seat turnover rate of 1.5/hour. They need to seat 250 customers. How many chairs do they need? a. 48 b. 56 c. 72 d. 125

a. 48 3.5 hrs x 1.5/hr = 5.25 customers 250/5.25 = 48 chairs

When estimating the desirable body weight of a patient who has a below the knee amputation of hid right leg, decrease the estimate by: a. 6% b. 8% c. 12% d. 16%

a. 6%

Which level of HgA1c suggests good compliance with dietary recommendations in a diabetic? a. 6.8 mg/dl b. 3.0 mg/dl c. 8.8 mg/dl d. 9.2 mg/dl

a. 6.8 mg/dl For a non-diabetic, the goal is less than 5.7%. A prediabetic range would be 5.7-6.4%. A person would classify with diabetes with a HgA1c of 6.5%. Once a person is dx with diabetes, the goal is to maintain a HgA1c less than 7%. Subsequently, 6.8 would be the answer.

Children and adolescents need what level of physical activity? a. 60 min every day b. 30 minutes every day c. 60 minutes at least 3 days each week d. 90 minutes at least three days each week

a. 60 min every day

The minimum recommended temperature for a chemical sanitizer is: a. 75 F b. 140 F c. 100 F d. 170 F

a. 75 F Minimum recommended time/temperature for chemical solution is 1 minute in lukewarm water (75 degrees F)

The level of significance of test results is measured using the p value. Which of the following represents the most significant factor? a. <0.0002 b. <0.002 c. <0.02 d. <0.20

a. <0.0002 Statistically significant --> p</= 0.5 The smaller the value, the more statistically significant.

How can you encourage preschool children to eat more fruits and vegetables? a. Have them participate in preparing fruits and vegetables b. Have them draw pictures of fruits and vegetables c. Give examples of food choices using a slide show d. Give examples of food choices using picture

a. Have them participate in preparing fruits and vegetables Children tend to be kinesthetic learners, so getting them involved in preparing fruits and vegetables will be the most effective.

French fries made from stored potatoes would have changes in: I. taste II appearance III. texture a. I, II, III b. II, III c. I d. I, III

a. I, II, III Stored/old potatoes taste sweeter, cook to a darker brown (Maillard reaction), and are softer in texture.

Which government agency would you contact regarding food distribution? a. USDA b. FDA c. HHS d. FTC

a. USDA USDA's food distribution programs strengthen the nutrition safety net through the distribution of USDA Foods and other nutrition assistance to children, low-income families, emergency feeding programs, Indian reservations, and the elderly. Ex: CSFP, TEFAP

Bitot's spots indicate a deficiency of: a. Vitamin A b. Vitamin E c. thiamin d. niacin

a. Vitamin A Vitamin A deficiency can lead to Bitot's spots, xerophalthmia, and eventually keratomalacia which is irreversible eye damage.

Who has the greatest water, protein, and calorie needs per unit of body weight? a. a 6 month old infant b. a 50 year old female c. a 16 year old male d. a 25 year old male

a. a 6 month old infant Infants rate of growth and development far exceesd other lifestyles. Think about nutritional needs: 108 kcal/kg in infants compared to 25 kcal/kg in adults,

A scale drawing of an area showing the path of a worker during a process is: a. a flow diagram b. a process chart c. an operation chart d. a cross chart

a. a flow diagram Flow diagram shows steps the worker must take, their sequence, the relation of working units to each other. A process chart shows the steps involved in process using symbols. An operational chart shows movement of hands; reduces transportation; use both hands simultaneously and effectively. A cross chart measures efficiency of equipment placement, studies work motions, and shows number of movements between pieces of equipment.

What is the product of pyruvate breakdown? a. acetyl CoA b. glycogen c. NADPH d. glucose-6-phosphate

a. acetyl CoA Pyruvate --> acetyl CoA --> TCA cycle

The immobilized state can lead to low levels of: a. albumin and calcium b. albumin and sodium c. calcium and potassium d. potassium and zinc

a. albumin and calcium Immobilization from paralysis decreases ability to absorb calcium and increases nitrogen losses.

Which would be a sentinel event? a. an NPO patient receiving a regular tray b. a low sodium patient receiving a regular tray c. a weight reduction patient receiving a regular tray d. a high potassium patient receiving a regular tray

a. an NPO patient receiving a regular tray A sentinel event is a patient safety event that results in death, permanent harm, or severe temporary harm. 0% = never, 100% = always. If an NPO patient receives a regular tray, it could cause death from choking or delay a life-saving surgery, for example.

The Family and Medical Leave Act guarantees: a. an equivalent position with equal benefits and pay status b. the same position you held before you left c. the first open position after you return d. a similar position in a different division

a. an equivalent position with equal benefits and pay status The Family and Medical Leave Act requires employers with 50 or more employees to allow up to 12 weeks of unpaid leave for family or medical reasons. Guarantees an equal job upon return, but NOT the same job

What procedure is binding and cannot be changed? a. arbitration b. mediation c. an injunction d. collective bargaining

a. arbitration Steps of collective bargaining are as follows: first, bargaining between union steward and management. If that fails, mediation (neutral person helps settle differences, non-binding decision). If that fails, arbitration (hearing to dissolve dispute, decision is usually binding)

The final step in a union dispute is: a. arbitration b. mediation c. injunction d. check-off

a. arbitration The steps of union dispute include the following: bargaining between union steward and management. If that fails, mediation (neutral person helps settle differences, non-binding decision). If that fails, arbitration (hearing to dissolve dispute, decision is usually binding)

Nursing can participate in which step of the Nutrition Care Process? a. assessment b. diagnosis c. intervention d. monitor and evaluation

a. assessment

Which of the following foods are safe? a. beef stew at 160' b. potato salad at 75' c. tuna casserole at 100' d. egg salad at 80'

a. beef stew at 160' The temperature danger zone of TCS foods is 40-140' (41-135' per updated guidelines); all other foods are within temperature danger zone

Creatine supplements may be beneficial for the: a. body builder b. marathon runner c. soccer player d. hockey player

a. body builder Creatine supplements do NOT enhance endurance and thus would not be helpful for a marathon runner, soccer player, or hockey player. A body builder does short and quick burst of energy expenditure so creatine would be most likely to help them. Science: Creatine is produced from arginine, glycine, methionine, and found high concentrations in blood, brain, muscle, and testes. About 95% of the body's total creatine is contained in skeletal muscle as one of two forms: - PCr (phosphocreatine, ~60%) and free creatine (Cr,~40%). • PCr is used as an energy source for quick, intense bouts of work. Creatine supplementation increases total Cr, but not necessarily PCr in skeletal muscle. Supplementation results in an initial increase in body. In many people, Cr supplementation enhances performance of particularly repeated and high-intensity exercise

According to HACCP, which would be the recommendation when preparing mixed dishes that include perishable ingredients? a. chill perishable components separately in small amounts b. combine all components and chill together c. hold completed dish at 120'F d. stir occasionally throughout holding time

a. chill perishable components separately in small amounts

A good source of MCT is: a. coconut oil b. vegetable oil c. canola oil d. olive oil

a. coconut oil

The kitchen layout below is characteristic of which foodservice system? Deck ovens / Range / Tilting skillet / Refrigerator / Freezer / Preparation counter / Bulk hot carts / Bulk cold carts a. commissary b. conventional c. ready prepared d. assembly-serve

a. commissary In commissary food production, there is centralized procurement and production. Food production (kitchen) and service areas (patients) are separate facilities and thus would require bulk hot and cold carts to deliver foods. Additionally, food production is occuring fully in this kitchen so the basic equipment would be required (deck ovens, range, tilting skillet, refrigerator, freezer, prep count).

A strict Muslim would not eat: a. congealed fruit salad b. egg salad c. tuna salad d. citrus fruit salad

a. congealed fruit salad Muslims often follow halal dietary laws. Prohibited foods, called haram, include pork, alcohol, gelatin, congealed salad.

Which food is highest in fiber? a. cooked dried beans b. a tomato c. wheat bread d. lettuce

a. cooked dried beans 1 cup cooked beans = ~15 gm fiber 1 cup tomato = ~1.5 gm fiber 1 slice wheat bread = ~1.9 gm fiber 1 cup lettuce = ~0.5 gm fiber

After a gastrectomy, the diet order should indicate a decrease in: a. disaccharides b. fats c. protein d. complex carbohydrates

a. disaccharides Following a gastrectomy, there is an increased risk for dumping syndrome. Subsequently, it would be advisable to limit intake of disccharides. Complex carbohydrates, proteins, and fats wouldn't need to be decreased and should be consumed as tolerated to meet estimated nutritional needs.

How do you determine the average check in the cafeteria? a. divide total sales by the number of customers b. divide entrée sales by the number of customers c. divide the number of customers by total sales d. divide the total sales by the cost of an average priced meal

a. divide total sales by the number of customers Average check is the average amount customers spend on a meal, which is helpful in detecting trends. To calculate, divide sales by the number of customers served

Which of the following would lower serum cholesterol levels? a. dried beans b. green beans c. yellow beans d. summer squash

a. dried beans Beans are a good source of soluble fiber. Soluble fiber lowers cholesterol by binding to it in the small intestine. Once inside the small intestine, the fiber attaches to the cholesterol particles, preventing them from entering your bloodstream and traveling to other parts of the body. Instead, cholesterol will exit the body through the feces.

Which is the best source of emulsification? a. eggs b. milk c. salt d. flour

a. eggs Eggs contain lecithin, which is a very effective emulsifier

Macrocytic, pernicious anemia resembles the anemia due to a deficiency of: a. folic acid b. iron c. megaloblastic cells d. pyridoxine

a. folic acid Macrocytic, pernicious anemia occurs when the body isn't able to absorb vitamin B12 due to a lack of intrinsic factor in stomach secretions. Intrinsic factor is needed for the body to absorb vitamin B12. Anemia due to deficiency of folic acid also produces macrocytic cells and thus resembles vitamin B12 deficiency anemia.

Which program provides food to needy individuals and families? a. food banks b. SNAP c. CACFP d. WIC

a. food banks Child and Adult Care Food Program supports public and non-profit food service programs for family day care centers, neighborhood houses, homeless shelters, nonresidential adult daycare centers. WIC is for women, infants, and children. SNAP provides monthly benefits from which participants can buy food. Food banks is where needy invidiuals and families can directly get food.

A strict Muslin would not consume: a. fruited gelatin, ham b. dairy products c. non-carbonated beverages d. eggs, cheese

a. fruited gelatin, ham Muslims follow Halal dietary laws, which prohibits foods are called haram (no pork, alcohol, gelatin, congealed salad). Overeating is discouraged and they fast sunrise to sunset during Ramadan.

Before adding new items to the menu: a. give samples to a few patients and ask for their comments b. ask patients in writing if they would like the new items c. have your managers decide which ones to offer d. ask for employee comments on new suggestions

a. give samples to a few patients and ask for their comments Think of this as a pilot test to see if the product would be successful/desired if added to the menu. This could be thought of as the "study" portion of the PDSA model- study the implemented change by implementing a pilot test prior to "acting" by adding it to the menu.

Lactic acid is produced through: a. glycolysis b. gluconeogenesis c. glycogenesis d. lactolysis

a. glycolysis Lactic acid is produced in anaerobic glycolysis. Think of lactic acid building up after sprinting.

A commercial muffin mix is described as a "rich formula", which means it contains: a. high proportions of sugar and shortening b. high fructose corn syrup instead of crystalline sugar c. high amounts of whey instead of nonfat dry milk solids d. more chemical leavening than is used in a "lean formula"

a. high proportions of sugar and shortening Rich cake: increased fat, sugar, and egg which increases keeping quality

What may cause EKG abnormalities? a. high serum potassium level b. low serum potassium level c. low serum sodium level d. high serum sodium level

a. high serum potassium level Potassium is vital for regulating the normal electrical activity of the heart. Increased extracellular potassium reduces myocardial excitability, with depression of both pacemaking and conducting tissues.Progressively worsening hyperkalaemia leads to suppression of impulse generation by the SA node and reduced conduction by the AV node and His-Purkinje system, resulting in bradycardia and conduction blocks and ultimately cardiac arrest.

You recently interviewed a top candidate for an administrative position, and are about to offer him the job. You then learn that he is planning on adopting a child. What should you do? a. hire him b. confront him about the possibility c. do not hire him d. wait two weeks to see if he does adopt a child

a. hire him

The statement "this further shows daily weighing is an effective weight loss tool" should be placed in which section of the research report? a. implications b. results c. analysis d. methodology

a. implications Implications are how the informaiton might be applied in practice.

Fiber, like that found in oats, beans and bran cereals, results in: a. increased water absorption from the intestine b. binding of bile acids c. decreased sodium excretion in the stool d. small, compact stools

a. increased water absorption from the intestine Oats, beans, and bran cereals all contain soluble fibers. Soluble fiber delays gastric emptying, absorbs water, and forms a soft gel in the small intestine.

The MNA and NSI screening tools are designed for use with: a. individuals over 65 years of age b. children ages 2 through 12 c. all adults d. infants and children up to age 10

a. individuals over 65 years of age MNA is the Mini Nutrition Assessment, which evaluates independence, medications, number of full meals consumed each day, protein intake, fruits and vegetables, fluid, and modes of feeding of those 65 years of age and older. NSI, or Nutrition Screening Index, is also used in elderly and uses the DETERMINE checklist.

When conducting a physical assessment of a patient, which method is used to estimate fat stores? a. inspection b. palpation c. pallor d. auscultation

a. inspection Assessing for fat stores includes inspection of orbital region, upper arm region, mid-axillary to iliac crest, and ribs. Fat stores are estimated to estimate by visualizing.

If an employee is not performing well, the first thing to do is to check the: a. job description b. job specification c. job analysis d. work schedule

a. job description A job description includes job title, tasks, duties, roles, and responsibilities for a certain job; what the candidate can expect to do if they get a job. Job descriptions are often used for employee appraisals. Job specification includes the desired qualifications, skills, and abilities needed to complete the job; characterizes the ideal candidate. A work schedule tells task and time.

Employees of a congregate feeding program serving an Orthodox Jewish community are not allowed to bring food items into the facility. This is related to Jewish dietary laws that state: a. kosher foods should not be allowed to mix with non-kosher foods b. consumption of fruits and vegetables are restricted to the noon meal c. only unleavened bread or matzo products are allowed in a 1 d. no pork or shellfish are allowed in a kosher kitchen

a. kosher foods should not be allowed to mix with non-kosher foods

Infants born to mothers with diabetes may be: a. larger than normal, and be hypoglycemia shortly after birth b. smaller than normal and be hyperglycemic shortly after birth c. larger than normal and be hyperglycemic shortly after birth d. smaller than normal and be hypoglycemic shortly after birth

a. larger than normal, and be hypoglycemia shortly after birth Neonate receiving lots of glucose in the womb, so grows BIG (macrosomia). Once the baby is born, they have quickly stop receiving high rates of glucose infusion from the mother's placenta. That dramatic shift can cause hypoglycemia.

If broccoli in a vegetable mixture turns olive green during holding, it may be due to: a. lemon juice b. baking soda c. salt d. sugar

a. lemon juice Chlorophyll + acid = pheophytin (olive green) Chlorophyll + base = chloryophillin (bright green)

A patient with diabetes has not eaten for more than three days. You should: a. liberalize the diet b. provide multivitamin/mineral supplements c. provide increased fluids d. stay with her plan and encourage small frequent feedings

a. liberalize the diet Not eating so don't have to limit CHO.

A renal patient has come for dialysis on Monday morning with a serum sodium of 130 mEq/L, a BUN of 100 mg/dl, creatinine 8.0, and a 4KG weight gain since his last dialysis on Friday morning. His laboratory indicators were in acceptable ranges on Friday afternoon. What would the lab values above have likely reflected if the patient had been nauseated and had averaged only 400 calories from primarily starchy foods over the weekend? a. little or no rise in potassium, BUN/creatinine ratio <10 b. increased phosphorous, BUN/creatinine ratio >15 c. typical rise in potassium, BUN/creatinine ratio >15 d. Metabolic alkalosis, BUN/creatinine ratio <10

a. little or no rise in potassium, BUN/creatinine ratio <10 No matter the size of this renal patient, we know 400 kcals is not enough intake. If the intake was primarily from starchy foods, we can infer they contain at least some potassium (think potatoes, bananas, etc). Subsequently, he may have a slight rise in potassium if he has 400 kcal of something like a potato, but maybe not raise it at all if had a lower potassium starch, such as white rice. A normal BUN:creatinine ratio is 10-15:1. A BUN: creatinine ratio of greater than 20:1 suggests that the patient may have an AKI. A BUN:creatinine ratio of less than 10:1 indicates a need for dialysis. This makes sense, given that the patient's BUN is above 100 and creatinine is 8, which indicates later stage of renal disease.

What is the diet for hypertension? a. low sodium b. low sodium, high potassium c. low sodium, high calcium d. low sodium, high potassium, high calcium

a. low sodium DASH diet used for HTN. Encourages intake of whole grains, fruits, vegetables, low fat dairy products, poultry, fish, limit alcohol, decrease sweets, calcium to meet DRI. While potassium intake may be higher in a diet that is high in fruits and vegetables, it is not specifically listed as "high potassium".

An appropriate menu for a Kosher meal is: a. macaroni and cheese, green beans b. roast beef, potato, vegetable, cream soup c. veal parmesan, noodles, green beans d. crabmeat salad, lettuce, milk

a. macaroni and cheese, green beans A Kosher diet avoids pork, shellfish, and meat mixed with dairy. Thus, veal parmesan, crabmeat, and roast beef are out. Macaroni and cheese with green beans would be appropriate.

A tube fed patient develops diarrhea. What is the most likely cause? a. medications b. the osmolality is too low c. the strength is too weak d. it is being given at an improper rate

a. medications TUBE FEEDS ARE USUALLY NOT THE CULPRIT OF DIARRHEA. First you would want to rule-out any potential sources, including medications, C. diff, etc. IF other culprit of diarrhea were ruled out, a more hydrolyzed formula could be trialed.

A patient with low hemoglobin and low MCV might have: a. microcytic anemia b. macrocytic anemia c. magaloblastic anemia d. normochromic anemia

a. microcytic anemia Microcytic anemia is characterized by low hemoglobin and low MCV. Macrocytic anemia would be characterized by low hemoglobin and high MCV.

Which pasta contains egg? a. noodles b. spaghetti c. macaroni d. linguini

a. noodles

Which of the following is an example of a secondary prevention program? a. offer health risk appraisals with referrals as needed for follow-up b. bring fruits instead of sweet rolls to all weekly staff meetings c. offer heart-healthy eating cooking classes at civic center d. set up walking programs during lunch breaks

a. offer health risk appraisals with referrals as needed for follow-up Recruiting those with elevated risk factors into treatment program; risk reduction. In this case, offering HRA with referrals as needed for follow-up would be a risk-reduction approach. Walking programs, bringing in fruit, and heart healthy cooking class would be primary prevention. Ex: regular screening (i.e. mammograms)

Children with a high risk for food allergies should initially avoid: a. peanut butter and milk b. eggs and strawberries c. oats and fish d. citrus fruits and chocolate

a. peanut butter and milk Peanuts and milk are the top allergens for children, as well the the top causes of death from anaphylaxis.

What method is used when you log in and out movement from the storeroom? a. perpetual inventory b. mini-max inventory c. physical inventory d. stage three inventory

a. perpetual inventory Perpetual inventory is a running record of balance on hand; updated each time an item is placed in or removed from storage. Physical inventory is an actual count of all goods on hand at the end of accounting period. Mini-max inventory allows inventory depletion to safety level before new order is placed based on established minimum and maximum amounts to have on hand.

Which nutrients would be most helpful when treating a patient with a progressive infection? a. phosphorus and zinc b. sodium and potassium c. sodium and chromium d. potassium and magnesium

a. phosphorus and zinc Zinc is crucial for normal development and function of cells mediating nonspecific immunity such as neutrophils and natural killer cells. Phosphorus is a component of many structural and regulatory molecules, such as ATP & DNA.

Which of the following has the fewest calories? a. plain hamburger on a bun b. chefs salad with dressing c. green salad with Thousand Island dressing, and shredded cheese d. fried fish sandwich

a. plain hamburger on a bun ***Dumb question because we don't know serving sizes. Fried fish sandwich would obviously have quite a few calories from the oil. The green salad would probably have ~300 kcal, depending on serving size. Chef salad, depending on what's on it, would probably be about 300 kcal. A plain hambuger with a bun is probably ~250 kcal.

What is the goal of the Dietary Guidelines? a. prevention of chronic disease b. provide standards for SNAP allocation c. provide standards for WIC d. provide standards for EFNEP

a. prevention of chronic disease While DGA's do provide standards for various federal programs, the program goal is to prevent chronic disease.

Sugar and salt act as preservatives because they: a. provide unfavorable osmotic pressure b. prevent microbial contact c. disguise flavors d. reduce the alkalinity

a. provide unfavorable osmotic pressure Salt and sugar act to increase osmotic pressure destroying some bacteria and slowing decay, promote the growth of beneficial bacteria and work together to improve taste. In other words, sugar and salt create a hypertonic environment, in which water will diffuse "out" from the cell and the cell will dehydrate and shrink and cellular metabolism will cease.

Which vitamin will interfere with Levodopa? a. pyridoxine b. cyanocobalamin c. thiamin d. riboflavin

a. pyridoxine Levodopa is used as a dopamine replacement agent for the treatment of Parkinson disease. Pyridoxine accelerates systemic metabolism of levodopa, thereby decreasing availability of the amino acid to brain parenchyma.

If protein intake is doubled, which nutrient needs to be increased? a. pyridoxine b. folic acid c. niacin d. vitamin c

a. pyridoxine Pyridoxine is essential for transamination reactions and thus needs would increase if protien intake increased.

Hemodialysis requires supplementation of: a. pyridoxine, folic acid, 1-25-dihydroxyvitamin D3 b. pyridoxine, folic and vitamin A c. Vitamin C, calcium, 25-hydroxyvitamin D3 d. vitamin C, calcium and vitamin A

a. pyridoxine, folic acid, 1-25-dihydroxyvitamin D3 Remember mnemonic: Ce, BeBe I am a FOol for you (vitamin C, vitamin B6, vitamin B12, folate); also remember vitamin D, iron, and zinc (BeBe is a DIZ)

The profit margin: a. reflects the portion of sales volume remaining after all bills are paid b. labor costs subtracted from total sales c. indirect costs substracted from total sales d. direct costs subtracted from total sales

a. reflects the portion of sales volume remaining after all bills are paid Profit margin is the most commonly used assessment of overall financial efficiency. It reflects the portion of sales volume remaining after paying all expenses

ANOVA is used when: a. several products compete against one another b. comparing two similar products c. testing whether results can be generalized to a larger group d. testing whether the difference between two groups is real

a. several products compete against one another The t-test is a method that determines whether two populations are statistically different from each other, whereas ANOVA determines whether three or more populations are statistically different from each other. Both of them look at the difference in means and the spread of the distributions (i.e., variance) across groups; however, the ways that they determine the statistical significance are different. A chi-square test is a statistical test used to compare observed results with expected results. The purpose of this test is to determine if a difference between observed data and expected data is due to chance, or if it is due to a relationship between the variables you are studying.

What does a fecal fat of 12 gram indicate? a. severe fat malabsorption b. normal fat absorption c. high normal fat absorption d. nothing

a. severe fat malabsorption Normal stool fat: 2-5 gm Malabsorption: >7 gm

An increased intake of which of the following might be the cause of diarrhea without malabsorption in children? a. sorbitol b. fat c. protein d. fruit

a. sorbitol Sorbitol is a sugar alcohol found in fruits and plants with diuretic, laxative and cathartic property. Unabsorbed sorbitol retains water in the large intestine through osmotic pressure thereby stimulating peristalsis of the intestine and exerting its diuretic, laxative and cathartic effect. A benefit of sorbitol is that it does not promote tooth decay.

When on Dicumarol, avoid increasing your intake of: a. spinach b. beets c. corn d. beef

a. spinach Dicumoral is an anticoagulant medication, and thus consistent vitamin K is essential to prevent issues with blood clotting. Spinach is a source of vitmain K.

Which of the following has the quickest onset of food-borne illness? a. staphylococcus aureus b. clostridium botulinum c. clostridium perfringes d. listeria monocytogens

a. staphylococcus aureus Staphylococcus aureus (steph is fast): onset 30 min to 8 hrs Clostridium botulinum: onset 18-36hrs Clostridium perfringes: onset 8-12 hrs Listeria monocytogens (pregnant women have a wide range of emotions, wide range for onset): 24hrs to 70 days

You have been promoted to a top management position. What adjustment in skills is needed? a. technical skills decrease, conceptual skills increase b. conceptual skills decrease, technical and human skills increase c. technical skills increase, conceptual skills decrease d. technical skills decrease, conceptual and human skills increase

a. technical skills decrease, conceptual skills increase The three skills necessary for a manager are technical, human/interpersonal, and conceptual. Technical skills are most important at lower levels of management, and decrease as enter high levels of manager. Human/interpersonal skills are important across all management levels. Conceptual skills increase as reach upper levels of management.

An appropriate purpose of analytical research is to _____. a. test the hypothesis... b. investigate the... c. formulate a hypothesis... d. distinguish between....

a. test the hypothesis... Analytical research tests hypotheses concerning the effects of specific factors of interest and allows causal associations to be determined.

Goals for a community nutrition program should be based on: a. the Dietary Guidelines for Americans b. the Nutrition Screening Initiative c. the Healthy People report d. the NHANES III report

a. the Dietary Guidelines for Americans The DGA's are used to determine community nutrition programs. They are also used to determine nutritional requirements of federal program such as NSLP.

Which law sets the minimum wage? a. the Fair Labor Standards Act b. the National Labor Relations Act c, The Equal Opportunity Act d. The Labor Management Act

a. the Fair Labor Standards Act The Fair Labor Standard Act was enacted to establish a minimum hourly wage, overtime pay and regulate child labor.

What is a formal study to verify that documentation and processes have been followed? a. the audit b. a quality assurance program c. a verification study d. statistical analysis

a. the audit An audit is a formal study that retrospectively monitors performance. Did performance meet the standards?

A patient with dysphagia waiting for a swallow test may receive: a. thick liquids b. thin liquids c. peripheral parenteral nutrition d. parenteral nutrition

a. thick liquids Assuming reduced risk of aspiration compared to thin liquids. Just think you would start parenteral nutrition for something this short-term.

When measuring a child's somatic protein mass, use the BMI and: a. upper arm muscle area b. triceps skinfold c. mid-arm muscle circumference d. knee to height ratio

a. upper arm muscle area MUAC is a measure of somatic protein mass. Remember Sharon did MUAC in PICU.

Which supplements should you give to a breast-fed baby? a. vitamin D and fluoride b. fluoride c. vitamin D d. vitamins A and C

a. vitamin D and fluoride Breastmilk is lacking in vitamin D breastfed infants should receive 400 IU vitamin D from birth and as well as 0.25 mg flouride/day after 6 months of age if water contains inadequate fluoride.

The best way to prevent the spread of food-borne illness is to: a. wash hands regularly b. cook all foods thoroughly c. purchase food from trusted vendors d. prepare food shortly before serving

a. wash hands regularly

Dishes are greasy when unloaded from the dishmachine. What should you check first? a. wash temperature b. rinse temperature c. amount of detergent d. amount of rinse agent

a. wash temperature Wash: 140-160 degrees F; lower temperature leads to greasy dishes

What is the labor cost per meal? Food purchased: $32,123 Cafe sales: $23,231 Labor expense: $25,790 Meal equivalent factor: $2.15 Patient meals served: 1923 a. $1.85 b. $2.03 c. $3.98 d. $4.36

b. $2.03 Meal equivalent factor is a measure of productivity defined as the amount of all food sales divded by the average cost of a typical (prototype) meal. In this question, meal equivalent must be included in as part of labor cost per meal. $23,231 / $2.15 = 10,805 meals prepared 10,805 + 1923 = 12,728 meals Labor cost = 25,790/12728 = 2.026

How much will it cost to prepare these scrambled eggs? Amount to be made: 25 Cost of eggs $0.83 per dozen 2 ounces margarine at $2.29 per pound 2 cups milk at $2.50 per gallon a. $1.47 b. $2.35 c. $1.02 d. $1.79

b. $2.35 $0.83/12 eggs per dozen = $0.069 x 25 people = $1.73 for eggs $2.29 per lb/16oz per lb = $0.14 per oz x 2oz = $0.29 for margarine $2.50 per gallon/16 cups per gallon = $0.156 per cup x 2 cups = $0.31 for milk $1.73 + $0.29 + $0.31 = $2.33 = ~$2.35

The hospital budget for the first 6 months is set for an 80% occupancy rate. Budget figures for this level are listed below. The second six months will have an occupancy rate of 60%. What would the food cost budget be for the second six months? Food cost $30000 Labor cost $25000 Operating costs $24000 a. $20,000 b. $22,500 c. $30,000 d. $32,000

b. $22,500 80/100 x = 30,000x = (30000 x 100)/80 = 37,500 Food cost budget = 60/100 x 37500 = $22,500

How many meals were served per labor minute if 34 FTE produced 3800 meals in one 40 hour week? a. 2.79 b. 0.05 c. 1.12 d. 0.25

b. 0.05 34 * 40 = 13603800/1360hr = 2.792.79/60 minutes = 0.05

If a patient's GFR is <50 ml/min, what should their protein intake be (in g/kg) a. 1 b. 0.6 - 0.8 c. 0.55 - 0.6 d. 0.2 - 0.4

b. 0.6 - 0.8 Stage 1 (GFR >/= 90) and Stage 2 (GFR 60-89): 0.8-1.4 g/kg Stage 3 (GFR 30-59) and Stage 4 (GFR 15-29): 0.6-0.8g/kg **I have NEVER used 0.6 gm/kg in actual practice. Would definetely feed 0.8 gm/kg, but just know if GFR is very low, use maintenance protein and just below.

According to the Diabetic Exchange Lists, when substituting 2% milk for fat-free milk, you must omit how many fat exchanges? a. 1/2 b. 1 c. 1 1/2 d. 2

b. 1 2% milk has 12 gm CHO, 8 gm protein, and 5 gm fat. Fat-free milk has 12 gm CHO, 8 gm protein and 0 gm fat. Subsequently, you are omitting 1 fat exchange, which is equal to 5 gm fat.

If a man normally consuming 2600 calories per day reduces his intake to 1500 calories per day, how much weight will he lost in one week a. 0.5 kg b. 1.0 kg c. 1.5 kg d. 2.0 kg

b. 1.0 kg 2600 kcal - 1500 kcal = 1,100 kcal less per day 1,100 kcal x 7 days per week = 7,700 kcal less per week 7,700 kcal / 3500 kcal per week to lose 1 lb = 2.2lb 2.2 lb /2.2 lbs per kg = 1 kg

The School Breakfast and School Lunch programs together provide approximately how much of the RDA's daily requirements? a. 1/3 b. 1/2 c. 1/4 d. 2/3

b. 1/2 School Breakfast provides 1/4 RDA and School Lunch provides 1/3, which combined provides ~1/2 RDA per week

The toxic level of vitamin A has been identified as: a. 5,000 IU b. 10,000 IU c. 15, 000 IU d. 20,000 IU

b. 10,000 IU Vitamin A RDA is 900 µg (3,000 IU) for men and 700 µg (2,300 IU) for women.

A patient weighing 104kg is placed on a 1.5 cal/ml formula with 75% free water, 54 grams protein/L. He needs 3000 calories per day Referring to the patient above, how much protein will he receive? a. 64 b. 108 c. 146 d. 150

b. 108 2L x 54 = 108 gm

How many calories are in 1.5 liters of a 25% dextrose solution? a. 850 b. 1275 c. 1000 d. 1500

b. 1275 25 gm dextrose in 100 mL 25 gm x 15 = 375 gm dextrose 375 gm x 3.4 = 1,275 kcal

Closed enteral nutrition systems can hang for: a. 12 hours b. 24-48 hours c. 12-24 hours d. unlimited because the container is closed

b. 24-48 hours Closed enteral systems are Ready to Hang. The containers are sterile until spiked for hanging. Can be used for continuous or bolus delivery. No flexibility in formula additives. Less nursing time. Increases safe hang time. Less risk of contamination. More expensive than canned formula. Overall, closed systems can be hung for 24-48 because of decreased risk of contamination. In open enteral systems, the product is decanted into a feeding bag. Allows modulars such as protein and fiber to be added to feeding formulas. Less waste in unstable patients (maybe). Shortens hang time. Increases nursing time. Increased risk of contamination. Overall, open systems can be hung for up to 8 hours because of increased risk of contamination.

A food item provides 45g of carbohydrate, 10g of protein, and 10g fat, what percent of total calories comes from fat? a. 34% b. 29% c. 23% d. 20%

b. 29% 45 gm CHO x 4 kcal/gm = 180 kcal 10 gm pro x 4 kcal /gm = 40 kcal 10 gm fat x 9 kcal/gm = 90 kcal 180 kcal + 40 kcal + 90 kcal = 310 kcal 90 kcal / 310 kcal = 29% from fat

A crate of oranges weighs 45 pounds and holds 128 oranges. How many crates are needed to produce 8 gallons of orange juice? a. 2 b. 3 c. 4 d. 5

b. 3 12 oranges = 1qt 1 gallon = 4 qt 128 oranges / 12 oranges = 10.66 qt 10.66 qt/ 4 qt = 2.66 gallons 8 gallons / 2.66 gallons = 3 crates Note: weight of crate of oranges not relevant to answer this question.

What temperature range is recommended for a dairy refrigerator? a. 28-32 degrees F b. 36-40 degrees F c. 45-50 degrees F d. 55-60 degrees F

b. 36-40 degrees F Temperature danger zone is 40-140 degrees F (per Jean Inman, 41-135 degrees F is updated range)

In a hospital with 300 patients, it takes 14 minutes to prepare one meal. How many FTE's are needed per week? a. 12 b. 37 c. 46 d. 10

b. 37 300 x 3 meals/day x 7 days/week = 6300 meals 6300 * 14minutes/meal = 88200 mins needed to make meals 88200 /60 minutes per hr = 1470 hrs 1470/40 hrs per week = 36.75

The maximum number of calories per serving in a product labeled "low calorie" is: a. 20 b. 40 c. 60 d. 80

b. 40

What is the administration rate of enteral feeding if the patient is receiving 1800 ml of a 1cal/ml solution daily? a. 65ml/hour b. 75 ml/hour c. 87 ml/hour d. 92ml/hour

b. 75 ml/hour 1800 mL / 24 hrs = 75 mL/hr

A patient receives 1800ml of a 1cal/cc formula with 44 grams protein per liter. How much protein will he receive? a. 44 b. 79 c. 65 d. 88

b. 79 1.8L x 44 gm = 79.2 gm

The most appropriate temperature for a sanitizing solution is: a. 50'F b. 79'F c. 90'F d . 140'F

b. 79'F Minimum recommended time/temperature for chemical sanitizer is 1 minute in lukewarm water (75 degrees F). 50'F is too lower, 90'F and 140'F are too high. 79'F would be the most appropriate

Infuse a peripheral solution at a maximum rate of how many mOsm/L? a. 300 b. 800 c. 1400 d. 2000

b. 800 The maximum rate of mOsm/L in PPN is 800-900 mOsm/L (also see 900-1100mOsm/L in other sources). The reason is because large amounts of nutrients cannot be provided through small peripheral veins. Small veins cannot handle hypertonic solution, which would lead to phlebitis or thrombosis (think of Sharon's PICU story).

Butter has fatty acids in this order of predominance: a. PUFA, MUFA, SAT b. SAT, MUFA, PUFA c. MUFA, SAT, PUFA d. MUFA, PUFA, SATq

b. SAT, MUFA, PUFA Butter has more saturated fat and less PUFAs than margarine.

If you worked overtime and did not get paid, which labor law would help your claim? a. The Equal Opportunity Act b. The Fair Labor Standards Act c. The Equal Pay Act d. The Civil Rights Act

b. The Fair Labor Standards Act The Fair Labor Standard Act set minimum wage and overtime standards as well as child labor laws and donated time to be paid. The Equal Opportunity Act prevents discrimination in employment based on race, color, religion, sex, political affiliation and national origin. The Civil Rights Act prevents discrimination on basis of race, color, national origin and prohibits sexual harassments. Equal Pay Act of 1963 prohibits discriminations on basis of sex, amended Fair Labor Standards Act.

To learn about prenatal problems in the community, go to: a. Center for Disease Control b. WIC c. NHANES d. FDA

b. WIC WIC addresses prenatal, perinatal, and postnatal needs of women. CDC serves as the national focus for developing and applying disease prevention and control, environmental health, and health promotion and health education activities designed to improve the health of the people of the United States. National Health and Nutrition Examination study is an ongoing (repeated) survey to obtain information on the health of American people. The FDA is responsible for is responsible for protecting the public health by ensuring the safety, efficacy, and security of human and veterinary drugs, biological products, and medical devices; and by ensuring the safety of our nation's food supply, cosmetics, and products that emit radiation

A graphic representation of the separate steps in a procedure using symbols is: a. a flow diagram b. a process chart c. an operation chart d. a cross chart

b. a process chart A process chart is a chart on which are graphically shown in sequence the separate details that make up a complete process. Flow diagram shows steps the worker must take, their sequence, the relation of working units to each other. An operational chart shows movement of hands; reduces transportation; use both hands simultaneously and effectively. A cross chart measures efficiency of equipment placement, studies work motions, and shows number of movements between pieces of equipment.

Which would be a sentinel event? a. a meat slicer left with the blade unguarded b. a wet floor near the dishmachine c. an unclean can opener d. MSDS sheets not posted

b. a wet floor near the dishmachine A sentinel event is a patient safety event that results in death, permanent harm, or severe temporary harm.

Carbohydrate, fat and protein are all converted into: a. pyruvic acid b. acetyl CoA c. Oxaloacetic acid d. ketoglutamic acid

b. acetyl CoA

Symptoms of nephrosis include: a. dehydration, hypocholesterolemia b. albuminuria, hypercholesterolemia c. edema, hypochelesterolemia d. hypotension, hyperalbuminemia

b. albuminuria, hypercholesterolemia Nephrosis/nephrotic syndrome is a defect in capillary basement membrane of glomerulus which permits escape of large amounts of protein into the filtrate moving through the tubules. Common sxs include albuminuria, edema, malnutrition, hyperlipidemia (increased synthesis and decreased clearance of VLDL).

Hypertension will decrease with a decrease in: a. fiber b. alcohol c. potassium d. calcium

b. alcohol Treatment for HTN includes diuretics, sodium restriction (1500-2300 mg/day); DASH- encourages WG, fruits, vegetables, low fat dairy products, poultry, fish, limit alcohol, decrease sweets, calcium to meet DRI

Which is the best flour to use when making cakes? a. graham flour b. all-purpose flour c. whole wheat flour d. durum wheat flour

b. all-purpose flour When making cakes, you want to use a lower protein, higher starch flour as it has the weakest and least gluten formation. Low protein flour = tender crumb, higher protein flour = chewy crumb (i.e. pizza). The preferred flour would be cake flour. If cake flour is not available, would use pastry flour. If pastry flour is not available, then all-purpose flour would be used. Graham flour is whole wheat flour, which would not be used in cakes. Durum wheat flour is used to make pasta.

To determine whether classes on lowering sodium intake have been effective, conduct: a. a process evaluation b. an impact evaluation c. a structure evaluation d. an efficiency evaluation

b. an impact evaluation An impact/outcome/effectiveness evaluation measures the effects the program had on the target population by assessing progress on outcomes; did the program accomplish the stated goal? Formative evaluation is made early or during course of education and it can change direction. It allows for revision of plans and methods to improve the process. An example would be a pilot test. Structure evaluations are used to determine if internal resources required to deliver program are adequate and/or effective.

An albumin of 5.0mg/dl in a patient who has consumed very few calories and limited fluids for several weeks is likely due to: a. increased liver production of albumin in response to poor intake b. an increase in albumin due to dehydration c. decreased intake of protein d. retention of albumin due to the low caloric intake

b. an increase in albumin due to dehydration Albumin will increase during dehydratation. Albumin is floating around in the blood and if there is less water, it is more concentrated in the blood.

The statement "After class, the patient will be able to write a day's menu following the guidelines" is... a. a goal b. an objective c. a plan d. a research hypothesis

b. an objective Objectives: specific, measurable, actions with a time frame Goals: broad direction, general purpose

In a study of the effects of following a low fat diet on the incidence of breast cancer, women were randomized to follow either their usual dietary pattern, or a low fat diet. The study design is: a. descriptive research b. analytical research c. cross-sectional d. qualitative research

b. analytical research Randomized, provided intervention (low fat diet) compared to control (usual dietary pattern). This is an experimental design and thus is analytical research.

Which type of anemia is likely to be seen in a patient with arthritis? a. Microcytic, hypochromic b. anemia secondary to chronic disease c. macrocytic d. megaloblastic

b. anemia secondary to chronic disease Anemia secondary to chronic disease is not diet-related. Instead inflammation of arthritis (in this example) preventions reuse of iron. Anti-inflammatory diet may help osteoarthritis.

A serum calcium level of 11.5 mg/dl will bring on a release of: a. PTH from parathyroid gland b. calcitonin from the thyroid glands c. calcium d. calcium-binding protein from the intestine

b. calcitonin from the thyroid glands Calcium in the body is tightly regulated at 8.5 - 10.5 mg/dL. When blood calcium levels rise too high, the thyroid gland releases the hormone, calcitonin. Calcitonin helps sequester calcium in the bone. Removing calcium from the bloodstream helps lower serum calcium to a normal level. PTH is involved in regulating serum calcium if levels are LOW.

Traditional diets of Asian populations in the United States are low in: a. iron b. calcium c. vitamin C d. essential fatty acids

b. calcium Traditional Asian diets include few dairy products, need non-dairy calcium sources such as tofu or fish paste.

Which pigment can be converted into a vitamin? a. chlorophyll b. carotenoids c. anthocyanin d. anthoxanthins

b. carotenoids A provitamin is a nutrient that can be converted into a vitamin. Beta-carotene (found in orange and yellow fruits and vegetables) is an important antioxidant and an example of provitamin A because it can be converted to Vitamin A by the human body.

The mean is a measure of: a. a normal curve b. central tendency c. a frequency curve d. a straight line

b. central tendency Mean, median, and mode are all measures of central tendency.

An 8 month old baby contracts botulism. What is likely the cause? a. cereal and evaporated milk b. cereal and honey c. cereal and table food d. cereal and fruit juice

b. cereal and honey Babies younger than 1 year old should not be given honey due to risk of botulism.

What would you suggest to decrease fat intake for a Hispanic patient? a. change from whole milk to 2% milk b. change beans from refried to boiled c. change to low fat yogurt d. serve low fat cheese

b. change beans from refried to boiled

What method of food service is used when one school delivers meals to another? a. ready-prepared b. commissary-satellite c. assembly serve d. cook-chill

b. commissary- satellite Commissary-satellite is a food production system in which there is centralized procurement and production; food production (kitchen) and service areas (patients) in separate facilities.

Before establishing a nutrition consulting business in your community: a. create promotional materials that will describe customer options b. conduct a market analysis c. analyze the success of existing nutrition consulting programs d. discuss the idea with other Dietitians in the area

b. conduct a market analysis Market analysis studies the attractiveness and the dynamics of a special market within a special industry. Through all of these analyses, the strengths, weaknesses, opportunities and threats of a company can be identified.

You are the Food Service Director and have received a note saying that last night's meat delivery had been improperly handled by two employees. Your first action is to: a. contact the delivery driver to see how the meat was delivered b. contact the two employees responsible for handling the meat c. inspect the meat for color and odor d. have the meat cooked immediately

b. contact the two employees responsible for handling the meat

Kidneys help control pH by: a. excreting sodium and calcium b. controlling the ratio of hydrogen irons to bicarbonate excretion c. excreting carbon dioxide and carbonic acid d. excreting NADPH

b. controlling the ratio of hydrogen irons to bicarbonate excretion The kidneys have two main ways to maintain acid-base balance - their cells reabsorb bicarbonate HCO3− from the urine back to the blood and they secrete hydrogen H+ ions into the urine. By adjusting the amounts reabsorbed and secreted, they balance the bloodstream's pH.

A post surgical patient experiences a drop in serum albumin. The reason is likely: a. the patient has not consumed adequate nutrition for three days b. decreased serum albumin levels are normal after catabolic stress c. the laboratory may have read the results incorrectly d. the patient has iatrogenic malnutrition

b. decreased serum albumin levels are normal after catabolic stress Albumin is a negative acute phase reactant, meaning it decreases in times of stress, infection, and inflammation.

Which is a good method of food handling? a. sanitize raw food before preparation b. defrost frozen food in the refrigerator c. refrigerate raw food at 48'F d. thaw frozen food quickly under running hot water

b. defrost frozen food in the refrigerator Proper thawing methods includes: -Refrigerated and under 41 degrees F -Submerged in running potable water at least 70 degrees F or below for a period of time that doesn't allow thawed portions of food above 41 degrees F for more than 4 hours, with that time including cooking and time needed to cool back to 41 degrees F -Thaw in microwave if will be used within 24 hours -Thaw as part of cooking process (i.e. increase cooking time)

A serum sodium level of 150 mEq/L indicates: a. sepsis b. dehydration c. hypertension d. hyperglycemia

b. dehydration Normal serum sodium: 135-145 mEq/L. If blood is more concentrated with sodium, means dehydrated.

The purpose of outcomes research is to: a. determine the best approach to solving a problem b. determine the most cost-effective way to solve a problem c. determine the most productive outcomes d. determine the best outcome desired

b. determine the most cost-effective way to solve a problem Outcomes research is a research designed to assess and document the effectiveness of health care services and interventions. It's used to predict the level of outcome that can reasonably be expected from a given intervention. Must assess the effectiveness of a nutrition intervention against one or more reasonable alternatives and determine value of health care resources consumed when each alternative is used. Type of cost-effectiveness analysis

Implementing the baby friendly hospital initiative begins with: a. advertising the initiative to members of the community b. developing the plan c. conducting in-service training for all disciplines involved d. recruit social service agencies to assist in informing the public

b. developing the plan The Baby Friendly Hospital Initiative is a global effort to increase incidence and duration of breastfeeding. You would need to develop the plan prior to taking any further steps.

Which of the following medications is an appetite suppressant? a. prednisone b. dextroamphetamine c. erythromycin d. Dronabinol

b. dextroamphetamine Think: someone on amphetamine doesn't have an appetite

Which is a common complication of AIDS? a. constipation b. diarrhea c. hypoglycemia d. hyperkalemia

b. diarrhea Diarrhea is common in people with HIV, particularly those with a low CD4 count. It can be caused by infection, malaborption, and is also a possible side-effect of some anti-HIV drugs.

Frozen chicken has been thawed in warm water. You should: a. prepare it immediately b. discard it c. refreeze it d. refrigerate it

b. discard it The only proper ways to thaw TCS foods are: -Refrigerated and under 41 degrees F -Submerged in running potable water at least 70 degrees F or below for a period of time that doesn't allow thawed portions of food above 41 degrees F for more than 4 hours, with that time including cooking and time needed to cool back to 41 degrees F -Thawed in microwave if will be used within 24 hours -Thaw as part of cooking process (i.e. increase cooking time)

Beef stew has been unrefrigerated for 4 hours after preparation. What should you do? a. reheat it to 140'F and refrigerate it in a shallow pan b. discard the stew c. reheat it to 165'F and refrigerate it d. refrigerate the stew in shallow pans

b. discard the stew Hot TCS food with initial temperature > 135 degrees F should be used or discarded within 4 hours. Since this was left out at room temperature for 4 hours, it should be discarded

The most important critical control point to monitor in the preparation and service of canned cream soup is the temperature: a. at delivery b. during steam table holding c. of storage d. during end-point cooking

b. during steam table holding The purpose of critical control points is to reduce/eliminate hazards that result in unacceptable safety risk. When foods are out for service, it poses the greatest risk to the public and thus is the most important CCP to monitor.

A side effect of the herb yohimbe is: a. lowering of blood pressure b. elevated blood pressure c. hyperglycemia d. hypoglycemia

b. elevated blood pressure Yohimbe is a herbal supplement that consumers may use for impotence, weight loss, chest pain, diabetic neuropathy, high blood pressure, and athletic performance. Side effects of Yohimbe include GI upset, tachycardia, anxiety, and high blood pressure. Ironically, elevated blood pressure is what it can be used for but also what it can cause.

The human relations theory of management stresses: a. tasks, structure, and authority b. employee's needs c. direct control by management d. management's needs

b. employee's needs The human relations theory is a theory that is informed by behavioral sciences. Employee participation is essential in decision-making. Includes Theory Z of Ouchi, in which everyone who will be affected by a decision is involved in making the decision (consensus decision making)

A patient on Lithium carbonate decreases his sodium intake to 2 grams/day. The effect will be: a. decreased activity of the drug b. enhanced activity of the drug c. no change in drug activity d. reduced response to the drug

b. enhanced activity of the drug A sudden decrease in sodium intake may result in higher serum lithium levels, while a sudden increase in sodium might prompt your lithium levels to fall. Caffeine might interact with serum lithium levels

The best way for you to follow-up on a patient's application of diet instruction provided is to: a. ask him how he is doing with the changes b. evaluate his actual intake over time c. ask him questions about different meal options d. look for non-verbal cues to determine his progress

b. evaluate his actual intake over time

Food iron is reduced in the stomach to the more absorbable form of: a. ferric b. ferrous c. transferrin d. ferritin

b. ferrous Ferric (3+) is found in foods (sometimes foods can be ICk). Ferritin is the storage form of iron. Transferrin is the the iron TRANSporter. Ferrous (2+, "s" looks like a 2) is what ferric iron is converted to in the body and is often the supplemental form of iron the body for that reason (ferrous sulfate).

A spastic quadriplegic requires: a. lower energy intake b. fewer calories c. increased fluid and fiber, acid ash diet d. lower energy intake, acid ash diet

b. fewer calories Those with spastic CP have limited activity, stiff movement, commonly obese so provide low calorie, high fluid, high fiber. Remember spaSTIC is STIFF movement, if stiff need less calories Those with non-spastic (athetoid) CP have involuntary wormlike movement, high calorie, high protein, finger foods. Remeber, worms look like fingers and so those with wormlike movement can have finger foods.

At your first counseling session with a new patient you should: a. tell him you have to change his diet b. find out what he eats c. give him instructional materials d. teach him meal exchanges

b. find out what he eats

In work simplification, which of the following tools is helpful? a. labor turnover rate b. flow chart c. meals per labor minute d. meals per labor hour

b. flow chart The pathway chart/flow diagram is a scale drawing showing path of worker during a process. This could help pinpoint areas that can be made more efficient in a process/operation.

An example of a primary prevention program for a local community would be: a. low sodium cooking classes for hypertensive patients b. have local farmers bring fresh fruits and vegetables into schools c. at health fairs, refer high risk individuals to appropriate programs d.education programs for those recently diagnosed with diabetes

b. have local farmers bring fresh fruits and vegetables into schools Primary prevention programs aim to reduce exposure to promoter of diseases- health promotion. Having local farmers bring fresh fruits and vegetables to schools would be an example of primary prevention as it is aiming to reduce incidence of chronic disease later in life by increasing intake of plant foods. Low sodium cooking class, education program for diabetics would be an example of teritary prevention. Refering high risk individiuals to programs would be considered screening and thus secondary prevention.

Maple syrup urine disease and homocystinuria: a. have non-dietary treatments b. have protein as the nutrient of concern c. require a fluids restriction d. have carbohydrate as the nutrient of concern

b. have protein as the nutrient of concern MSUD is an inborn error of metabolism of the BCAAs (leucine, isoleucine, valine). Homocystinuria is an inherited disorder of amino acid metabolism characterized by severe elevations of methionine and homocysteine in plasma, and excessive excretion of homocysteine in urine

Why would a man who eats very little protein have an albumin of 5.5g/dl a. carbohydrate keeps albumin levels elevated b. he is dehydrated c. serum albumin falls quickly with protein deprivation d. it is a sign of protein malnutrition

b. he is dehydrated Increased albumin can be caused by dehydration

A patient with cystic fibrosis, who is non-compliance with their nutritional prescription, may present with: a. hypernatremia b. hyponatremia c. hypokalemia d. hyperkalemia

b. hyponatremia CF is a disease of exocrine glands in which there is secretion of thick mucus that obstructs glands and ducts. Leads to chronic pulmonary disease, pancreatic enzyme deficiency, high perspiration, abnormal electrolyte levels, malabsorption. Those with CF lose large amounts of sodium and chloride in their sweat, especially with exercise, hot weather, fevers and infections. People with CF lose 3-4 times more salt through their sweat than those without CF. Subsequently, non-compliance to the nutrition prescription may lead to hyponatremia.

A nutrition surveillance program is designed primarily to: a. confirm results of annual nutritional surveys b. identify the nutritional needs of the population c. indicate the number of people at increased risk for medical conditions d. indicate the causes underlying the nutrition problems identified

b. identify the nutritional needs of the population Nutrition surveillance is the continuous collection of data which aims to identify problem, set baselines, set priorities, and detect changes in trends. Nutrition surveillance programs typically use height, weight, hematocrit, hemoglobin, serum cholesterol. Nutrition surveillance is an on-going system linked to active health program. The primary function is to identify the nutritional needs of the population.

When should you provide nutrition counseling to an AIDS patient? a. when nausea and vomiting become problems b. immediately upon diagnosis c. when diarrhea occurs d. no counseling is needed

b. immediately upon diagnosis

The number of individuals in a population diagnosed with a specific condition during a specified time is the: a. prevalence b incidence c. rate of the condition d. duration of the condition

b. incidence IncideNce = New cases, prEvelance = Existing cases

When a starved patient begins to eat, they might expect: a. constipation b. increased workload on the heart c. lethargy d. diarrhea

b. increased workload on the heart In a starvation state, the catabolism of muscle and fat leads to electrolyte losses (notably potassium, magnesium, and phosphate) which may or may not manifest in low lab values. When normal nutrition intake resumes, electrolytes shift into cells, causing low blood levels that manifests in test results and serious medical consequences. For example, hypervolemia and shifting of electrolytes increase cardiac workload and heart rate, which can lead to acute heart failure.

What We Eat in America (WWEIA): a. conducts telephone interviews asking about eating behaviors. b. is the dietary intake component of NHANES c. evaluates seven nutrients consumed by adults and households d. identifies nutritional needs and the kind of intervention that is needed

b. is the dietary intake component of NHANES

A long term care patient has normal intestinal function but cannot eat. What tube feeding should you provide? a. high protein, high calorie formula b. isotonic, polymeric formula c. elemental formula d. low fiber, low fat formula

b. isotonic, polymeric formula Provide standard formula to start and make changes if needed.

Research on the effects of a low sugar, low artificial flavor diet on hyperkinesis has shown that: a. it works in two out of three patients b. it has not been scientifically proven effective c. it has never been tested on humans d. it has been proven effective

b. it has not been scientifically proven effective

Which of the following is true about SGOT: a. it is increased with hepatitis and diabetes b. it is increased with hepatitis, decreased with diabetes c. it is decreased in both hepatitis and diabetes d. it is decreased with hepatitis and increased with diabetes

b. it is increased with hepatitis, decreased with diabetes SGOT = AST, SGPT = ALT. SGOT and SGPT are hepatic proteins that increase in times of liver disease, such as hepatitis. Can't find explanation on DM, but just know liver enzymes decrease in DM and malnutrition.

Current research on the relationship between cancer and diet includes all of the following except... a. cancer is associated with the intake of vitamin A b. it is related to demographic factors c. it is related to epidemiologic data d. it is associated with ascorbic acid

b. it is related to demographic factors Epidemiological data pertaining to cancer includes the interrelationship between host, agent, and environment in causing disease. There is some evidence that fruit and veg consumption are beneficial for overall cancer prevention (carotenoids and vitamin C). Finally, there is some evidence that exercise in post-menopausal women decreases risk of breast disease. Demographic factors would not be included as the research pertaining to demographic factors (post-meopausal women), is not related to diet; it's related to exercise.

The Cori Cycle: a. glucose into galactose b. lactate into pyruvate c. lactic acid into glycogen d. glycogen into glucose

b. lactate into pyruvate In the Cori cycle, glucose is metabolized to pyruvate and then to lactate in muscle, the lactate is released into the blood and carried to the liver, where it is reconverted to pyruvate and used for gluconeogenesis, and the resulting glucose is released and travels back to muscle.

A child is lethargic and irritable with diarrhea. The cause may be: a. zinc toxicity b. lead poisoning c. iron overload d. vitamin A toxicity

b. lead poisoning Lead depletes iron, leading to anemia. Iron-deficiency anemia can cause lethargy.

Following a cholecystectomy, bile is produced by the: a. pancreas b. liver c. spleen d. portal vein

b. liver Cholecystectomy is a surgical removal of gallbladder; bile now secreted from liver directly into intestine.

Replacing carbohydrate with fat in the diet will: a. raise the respiratory quotient b. lower the respiratory quotient c. increases the respiratory rate d. spares protein

b. lower the respiratory quotient Carbohydrates > protein > fat CHO RQ = 1 Proteins RQ = 0.82 Fats RQ = 0.7

Acid-base abnormalities in an uncontrolled diabetic are likely due to: a. respiratory alkalosis b. metabolic acidosis c. respiratory acidosis d. metabolic alkalosis

b. metabolic acidosis An uncontrolled diabetic is at increased risk for developing DKA. Diabetic acidosis (also called diabetic ketoacidosis and DKA) develops when substances called ketone bodies (which are acidic) build up during uncontrolled diabetes.

Children's diets are found to be low in iron due to emphasis on: a. vegetables b. milk c. fruits d. cereals

b. milk Children tend to be encouraged to drink a lot of milk. Calcium is high in milk, and calcium can inhibit iron absorption. While some vegetables can inhibit iron absorption (oxalates, phytates), vegetables are emphasized as much as milk in children's diets. Fruits/veg rich in vitamin C, such as oranges and strawberries, would increase iron absorption.

When counseling a hypertensive patient with limited education, which would be the most appropriate question to ask in assessing her comprehension level? a. do you enjoy salty foods? b. name a food that is high in sodium? c. do you have difficulty swallowing or chewing? d. how many meals and snacks do you consume each day?

b. name a food that is high in sodium Non-judgmental

Where is the most efficient place to locate the refrigerator and the freezer? a. close to the receiving dock b. near the production area c. close to the serving line d. away from cooked food service

b. near the production area Having refrigerator and freezer near production area minimizes travel time and thus makes production more efficient. It also may reduce risk of time-temperature control issues as it is convenient to put foods in refrigerator/freezer if you are preparing foods nearby.

The BMI for a woman who is 5'7" tall and weighs 148lb. Indicates: a. underweight b. normal weight c. overweight d. obese

b. normal weight BMI = kg/m^2 BMI = 67.3 / 1.7m^2 BMI = 23.3 kg/m^2, which is considered healthy

Which of the following can be reversed with vitamin A? a. xerophthalmia b. nyctalopia c. Wilson's disease d. homocysteinuria

b. nyctalopia Vitamin A deficiency causes night blindness (nyctalopia), which can be reversed by vitamin A supplementation. Xerophthalmia (dry eye) can also be caused by vitamin A deficiency. It often cannot be reversed.

A child is at the 95th percentile for BMI for age. He is: a. normal b. obese c. overweight d. tall for his age

b. obese BMI-for-age is used to evaluate for excess adiposity and undernutrition. -BMI-for-age above 95th percentile is considered obese -BMI-for-age between 85th and 95th percentile is considered overweight -BMI-for-Age below 5th percentile is considered underweight

Nutrition intervention with Alzheimer's disease should include: a. eating with TV on to provide stimulation b. offer one food at a time, avoid distractions c. encourage eating meals with others d. several small meals and snacks throughout the day

b. offer one food at a time, avoid distractions Want to minimize overwhelming them.

To determine the effectiveness of a nutrition program to be offered at fitness facilities throughout the city: a. first determine how many locations are willing to offer the program b. pilot test the program in one location c. request a review of the program by local dietitians d. offer an incentive for facilities to provide the program

b. pilot test the program in one location Pilot tests allow you to implement your program on a small scale in order to make any adjustments needed prior to actually implementing it.

Which of the following kitchen layouts will help prevent other employees from walking through the cook's work area? a. plan each work center with its own supply storage area b. plan work aisles separate from traffic aisles c. position work centers adjacent to the appropriate point of service d. design aisles wide enough to accommodate both

b. plan work aisles separate from traffic aisles

Which of the following would be used to analyze tray line accuracy? a. Gantt chart b. process control chart c. cause and effect diagram d. break-even analysis

b. process control chart A process control chart shows steps involved in process using symbols.

What would you do if an employee does not wash pots as required? a. fire her b. re-educate her as to proper procedures and provide follow-up c. take the job away from the employee d. discipline the employee

b. re-educate her as to proper procedures and provide follow-up

A blast freezer and rethermalization are part of the: a. commissary system b. ready-prepared system c. assemble serve system d. conventional system

b. ready-prepared system The ready-prepared system, also known as cook-chill, cook-freeze, is a food production system in which food is not produced for immediate service but for inventory and subsequent withdraw. Foods prepared on site, then frozen, chilled for later use; requires blast chiller or freezer and adequate storage

If you are working on a cost benefit analysis you would: a. record the number of patient complaints b. record the number of hours the dietitian spent providing nutrition education c. record the number of patients who were satisfied with the education provided d. keep a record of all who failed to attend

b. record the number of hours the dietitian spent providing nutrition education Cost-benefit analysis determines whether the goal of the intervention is worthwhile in terms of cost; state objectives clearly and quantifiably; calculates direct and indirect costs

Results of a three day food record were obtained in June and again three months later. What is this called? a. validity b. reliability c. sensitivity d. specificity

b. reliability The ReProducibility / abity to retest the test results and get same thing is Reliability / Precision. Validity is the accuracy- did we measure what we ended to measure? SensiTivity = # TRUE positive, speciFicity = # of FALSE test results that are truley false

If there is an increase in input and output, productivity will: a. increase b. remain constant c. decrease d. modulate

b. remain constant If there were an increase in input and output remained the same, then productivity would decrease. If there were a consistent input and increase output, productivity would increase. Since both input and output are increasing, the productivity will remain the same.

Six Sigma improves quality by: a. reducing waste b. removing defects and their causes c. decreasing labor minutes d. reorganizing workflow

b. removing defects and their causes Six Sigma is a data-driven approach for improving quality by removing defects and their causes. Sigma is a statistical unit of measurement used to define standard deviation. Achieving Six Sigma means there is very little variation in a process.

The ketogenic diet is used to help treat: a. cystic fibrosis b. seizures c. chronic renal failure d. hypotension

b. seizures

The organizational chart: a. is an organized list of duties b. shows the employee how he fits into the organization c. organizes departmental activities d. is an evaluation tool for productivity

b. shows the employee how he fits into the organization An organization chart shows how the employee fits into the organization.

Quality standards for fruits assure you of: a. wholesomeness b. specifications of minimum quality characteristics c. safety from pesticides and residues d. good taste

b. specifications of minimum quality characteristics Grading of fruits and vegetables is voluntary in US. Grading based on specific color, shape, size, maturity, and number/degree of defects present

A child has been measured several times before the age of two years. Results of the measurements were not accurate because the child was measured: a. first thing in the morning b. standing up c. after breakfast d. with light clothing

b. standing up A child should not be measured standing up until 24 months (2 years old).

Spaghetti sauce prepared on Monday is to be served on Wednesday. What should you recommend to the cook? a. cool the sauce and store it in a deep pan b. store the sauce in shallow pans in the refrigerator c. store the sauce in a deep pan in the refrigerator quickly d. cool completely on the counter, then refrigerate

b. store the sauce in shallow pans in the refrigerator Cooling can be done in a variety of ways, including putting food in shallow pans. Cooling foods on the counter is never recommended.

The Healthy People 2020 Goals are an outgrowth of a report by: a. ADA b. surgeon general, under HHS c. WHO d. FAO

b. surgeon general, under HHS Healthy People 2020 was born from the 1979 Surgeon General's Report on Health Promotion and Disease Prevention. This frameworks provide ambitious, measurable, 10-year objectives with the overall goal of improving health and well-being across America and include tools to track progress towards those objectives.

A client who takes orlistat may need to: a. use MCT as a supplement b. take a multivitamin supplement c. take an omega 3 fatty acid supplement d. avoid caffeinated and carbonated beverages

b. take a multivitamin supplement Orlistat is a weight loss drug that works by inhibiting gastric and pancreatic lipases (fat digestion). Subsequently, those on this medication typically experience diarrhea. Multi-vitamins can help prevent nutrient-deficiencies. Taking omega-3 supplements would not help because they would just malabsorb it as well. MCT would provide direct absorption of fats into the portal vein; however if someone is trying to lose weight providing additional fat would not be appropriate as is energy dense. There is no specific indication to avoid caffeine or carbonated beverages while on Orlistat- this would be true if someone got gastric bypass surgery for weight loss instead

The allowance for SNAP is based on: a. the average cost of food used by a family of the same size b. the USDA Thrifty Food Program c. Data from the Congregate Meal Program d. the cost of the MyPlate components

b. the USDA Thrifty Food Program SNAP maximum allotments are updated each year based on the cost of the Thrifty Food Plan in June and take effect on October 1. The Thrifty Food Plan is the cost of groceries needed to provide a healthy, budget-conscious diet for a family of fou

Which defines the statistical term "mean" a. the number that occurs most frequently b. the average c. the central tendency d. a value in an ordered set of numbers below and above which fall in an equal set of numbers

b. the average

In a study on custards which would be the dependent variable? a. the amount of milk and sugar in the recipe b. the cooked custard c. the temperature of the oven d. the time of cooking

b. the cooked custard Dependent variables are outcomes. Independent variables are what you manipulate in the study. For example, treatment for diseases are independent (you can change the treatment to affect disease). Another example is the effect that cholesterol levels (independent) have on heart attacks (dependent). In this example, the custard is the independent variable (what you manipulate in the study) and the cooked custard is the dependent variable (the outcome).

Which is not shown on an organizational chart? a. relationships of positions to one another b. the degree of authority and informal relationships c. advisory responsibilities d. lines of communication

b. the degree of authority and informal relationships Organizational charts show relationship of positions and functions, lines of authority with solid lines, advisory (staff) positions with dotted lines. Organizational charts do NOT show the degree of authority at each level and informal relationships

Why might a child with PKU have an increased incidence of dental caries? a. phenylalanine is not converted to tyrosine b. the diet is high in carbohydrates, low in protein c. pyruvate is not converted to alanine d. the diet is devoid of protein

b. the diet is high in carbohydrates, low in protein In children with PKU, you restrict the substrate phenylalanine (PHE), supplement the product tyrosine (TYR). Avoid aspartame. Low protein, high CHO intake is recommneded and can cause dental caries as dental caries form from fermentable CHO.

NHANES III increased the number of participants in which age group? a. infant and children b. the elderly c. adolescents d. pregnant women and infants

b. the elderly NHANES III increased participation by not capping adults at age 74 years old. They did also extend limit down to infants age 2 months and older. NHANES II had extended lower age limit down to infants 6 months of age or older

The breast fed infant is *drinking primarily colostrum* for: a. the first 24 hours b. the first few days c. 1-2 weeks d. 3 months

b. the first few days Colustrum is the yellowish transparent fluid secreted from the breast during the first few days, which meets all infant needs during the first week. Colustrum has more protein, less fat, and less CHO than mature milk. It also contains antibodies.

The first control in the receiving process is: a. the invoice b. the purchase order c. the list of items prepared by the vendor d. the receipt of items prepared by the vendor

b. the purchase order Receiving process: -Compare purchase order to invoice -Inspect items against invoice -Accept or reject items -Complete receiving records and sign the invoice -Place products in appropriate storage

A useful application of counting FTE's is in planning: a. the menu b. the type of service c. the kitchen layout d. the budget for wages

b. the type of service

Increased plasma pyruvate is an indication of a: a. riboflavin deficiency b. thiamin deficiency c. pyridoxine deficiency d. iron deficiency

b. thiamin deficiency Vitamin B1 (thiamine) is a co-factor for pyruvate dehydrogenase, an essential enzyme for aerobic metabolism. In the absence of thiamine, the conversion of pyruvate to acetyl-CoA is inhibited and pyruvate cannot enter the Kreb's cycle.

Which hormone greatly influences the BMR? a. the endocrine hormone b. thyroxine c. the growth hormone d. insulin

b. thyroxine BMR, or basal metabolic rate, is typically measured in the morning when reclining, awake, relaxed, at normal body termpature, for at least 12 hours after last meal, and several hours after strenuous exercise. It measures the oxygen consumed and carbon dioxide produced. BMR is primarily effected by sex (women 5-10% lower BMR than men), age (0-2 have highest BMR, lower BMR in older adults), body composition/body surface area, and endocrine glands, specifically thyroid. Thyroid hormones stimulate diverse metabolic activities, leading to an increase in basal metabolic rate. Thyroxine is a thyroid hormone and thus would impact BMR the most.

An athlete needs 4000 calories. The cornflakes nutrient label says that one serving provides 25% of the RDA for CHO. How many servings of cornflakes does he need to get his 25%? a. one b. two c. three d. four

b. two RDA on nutrition label is based on 2,000 kcal diet. If this athlete needs 4,000 kcal per day, they would need two servings of cornflakes to get 25% of RDA. Think since double calories, double servings.

Homemade rolls are crumbly and fall apart easily, the most likely cause of the poor texture in the yeast bread is: a. use of a high-protein flour b. use of a lower-protein flour c. insufficient proofing time d. excessive proofing time

b. use of a lower-protein flour Doughs from high-protein flours are physically stronger and more stable than those made with lower protein content. For yeast dough, use high protein bread flour, as low protein flour causes crumbly products with poor texture.

If the temperature on the dishmachine rinse cycle is 135'F, you should: a. add additional sanitizer b. use paper products until the problem has been resolved c. nothing- that is the proper temperature d. increase length of rinse cycle

b. use paper products until the problem has been resolved Proper temperature for rinse cycle is 170-180'F

A performance objective should be based on: a. a review of the literature for the latest research b. what the learner should know or be able to do c. existing standards of practice d. a SWOT analysis

b. what the learner should know or be able to do Employee performance objectives are goals and targets agreed between the employee and their employer. They help employees understand their role and their contribution to the business, so they can focus on activities, development and progression that contribute to the organization's overall goals.

The employee turnover rate refers to the following: a. total replacement employees divided by average work force b. % of turnover rate divided by number of replacements c. # employees terminated divided by total number of positions d. # total positions divided by number of part-time employees

c. # employees terminated divided by total number of positions

An 8lb roast beef cost $2.79/lb. The edible portion is 65%, what is the AP price of the roast? a. $21.19 b. $22.00 c. $22.32 d. $23.04

c. $22.32 8lb x $2.79/lb = $22.32 *EP doesn't impact in this case as given AP and cost per lb

A patient with a GFR of 20ml/min should receive how many grams of protein/kg a. 1.1 b. 0.8 c. 0.6 d 0.2

c. 0.6 Again, would never typically recommend 0.6 g/kg in actual practice (not even in txp). However, Jean indicates that for ERSD, as indicated by GFR of 20mL/min, the patient would need 0.6 g/kg. The idea is that the kidneys are failing and cannot properly metabolize proteins via urea cycle, resulting in an increase in toxic ammonia. By minimizing protein intake, less toxic byproducts will build up.

If the productivity goal for a patient tray assembly unit is 4 trays per minute, the unit should be able to assemble approximately 350 trays in: a. 1 hour b. 1 hour 45 minutes c. 1 hour 30 minutes d. 1 hour 45 minutes

c. 1 hour 30 minutes 350 trays/4 trays per min = 87.5 minutes = 1 hr 27.5 minutes = ~1 hour 30 minutes OR 4 trays per min x 60 minutes = 240 trays per hr 350 trays - 240 trays/hr = 110 trays left 110 trays / 4 trays per min = additional 27.5 minutes 60 minuts + 27.5 minutes = ~ 1 hr 30 minutes

Which of the following is the appropraite diet for peritoneal dialysis? a. 0.8 grams protein, 35 cals/kg b. 2.0 grams protein, 30 cals/kg c. 1.3 grams protein, 35 cals/kg d. 1.0 grams protein, 35 cals/kg

c. 1.3 grams protein, 35 cals/kg Moderate-high protein, high calorie

The #12 scoop measures: a. 1/4 cup b. 1/2 cup c. 1/3 cup d. one cup

c. 1/3 cup #12 scoop = 12 scoops in a quart 32oz/12 = 2.666oz/8 oz per cup = 1/3 cup Check: 1/3 cup x 12 = 4 cups (1 quart)

Based on an 8 hour day, the number of hours worked was 32,567 per year. The total number of hours paid was 36,341 per year. Calculate the number of productive FTE's. a. 2.27 b. 17.47 c. 15.66 d. 28.80

c. 15.66 Productive (absolute) FTE's count productive hours, or the hours actually worked. Adjusted FTE also takes into account the benefit days and days off. In this example, 32,567 was the number of hours actually worked. FTE per year = # hours worked per year / 2080 hours FTE per year = 32,567/2080 = 15.66

The elderly need how many ml per KG? a. 35 - 40 b. 45 c. 25 - 30 d. 25

c. 25 - 30 The elderly are at an increased risk of dehydration for a variety of reasons, including physiological, psychological, and medication.

A cafeteria seats 80 customers. Lunch runs from 11:15am to 1:00pm. Turnover is 2.5 customers/hour. How many can be served during those hours? a. 125 b. 216 c. 350 d. 550

c. 350 11:15am to 1:00pm = 1.75hrs 2.5 x 1.75 = 4.375 80 x 4.375 = 350

According to the ADA exchange lists, what is the nutrient content of the following... 1 cup raspberries, 1/2 cup cereal, 1 cup 1% milk, 1 tsp margarine, black coffee, 1 slice toast, 1 egg. a. 397 kcal, 12 pro, 61 CHO, 6.5 fat b. 346kcal, 12 pro, 52 CHO, 9 fat c. 365 kcal, 21 pro, 57 CHO, 14 fat d. 327 kcal, 13 pro, 58 CHO, 10 fat

c. 365 kcal, 21 pro, 57 CHO, 14 fat 1 cup raspberries: 1 fruit exchange (15gm CHO, 60 kcal) 1/2 cup cereal: 1 starch exchange (15 gm CHO, 3 gm pro, 1 gm fat, 80 kcal) 1 cup 1% milk: 1 low fat milk exchange (12 gm CHO, 8 gm protein, 0-3 gm fat, 100 kcal) Black coffee: minimal 1 tsp margarine: 1 fat exchange (5 gm fat, 45 kcal) 1 slice toast: 1 starch exchange (15 gm CHO, 3 gm pro, 1 gm fat, 80 kcal) 1 egg: 1 medium-fat protein (0 gm CHO, 7 gm protein, 5 gm fat, 75 kcal) Total kcal: ~440 kcal (her kcal seem very off) Total pro: ~22 gm Toatl CHO: ~57 gm Total fat: ~15 gm

A 140lb female on dialysis should have how many grams of protein? a. 38-55 b. 58-63 c. 70-89 d. 30-38

c. 70-89 HD protein requirements ~1.1-1.4gm/kg 140 lb/ 2.2 = 63.6 kg 63.6 kg x 1.1 = 70gm 63.6 x 1.4 = 89 gm

Determine the calorie contribution of carbohydrate from the following parenteral formula. The amounts stated are given per liter. 300ml 60% dextrose; 500ml 10% amino acids; 200ml 20% lipid; Total nutrient mixture administered at 65 ml/hour for 24 hours a. 393 calories per day b. 1550 calories per day c. 955 calories per day d. 1572 calories per day

c. 955 calories per day 65mL/hr x 24 hours = total 1.56 L Current volume = 300 mL + 500 mL + 200 mL = 1000mL Requires 1.56 MORE volume than what is provided Dextrose: 60gm per 100 mL = 60 x 3 = 180 gm x 3.4 kcal/gm = 612 kcal from dextrose x 1.56 = 955 kcal per day

The Dietitians analytical skills are needed most in which component of the NSI? a. DETERMINE checklist b. Level I c. Level II d. Level III

c. Level II Screening at level two of NSI provides more specific diagnostic info on nutritional status.

An 80 year old female receives Meals on Wheels. What other nutrition assistance program would she qualify for? a. CACFP b. TEFAP c. SFMNP d. TANF

c. SFMNP Senior Farmer's Market Nutrition Program and Meals on Wheels are both for those over the age of 60. SFMNP however would depend on income and Meals on Wheels does not.

If a female is hired and does not receive the same pay as a male in the same position, she can seek help from: a. The Equal Opportunity Act b. The Fair Labor Standards Act c. The Equal Pay Act d. The Fair Wage Act

c. The Equal Pay Act The Equal Pay Act of 1963 prohibits discriminations on basis of sex, amended Fair Labor Standards Act. The Fair Labor Standard Act set minimum wage and overtime standards as well as child labor laws and donated time to be paid. The Equal Opportunity Act prevents discrimination in employment based on race, color, religion, sex, political affiliation and national origin.

The following are required for the conversion of pyrivic acid into active acetate: a. thiamine, NAD, oxaloacetic acid, magnesium b. oxygen, pantothenic acid, vitamin E c. thiamine, niacin, riboflavin, pantothenic acid, magnesium d. pantothenic acid, oxaloacetate, citric acid

c. Thiamine, niacin, riboflavin, pantothenic acid, magnesium Pyruvate to acetyl CoA requires thiamin, riboflavin, niacin, pantothenic acid and magnesium. Oxaloacetete and ctiric acid are essential in Kreb's cycle, which is prior to pyruvate to acetyl CoA.

A man with a peptic ulcer should consume a. milk every two hours b. a bland diet c. a balanced diet he can tolerate d. a low roughage diet

c. a balanced diet he can tolerate An ulcer is an eroded mucosal lesion. Diet therapy includes eating as tolerated, well-balanced, avoid late night snacks. Omit cayenne and black pepper, large amounts of chili powder, and avoid excess caffeine and alcohol.

During motivational interviewing, the question "Do you think you can try this" is: a. an affirmation b. a reflection c. a closed question d. an exploration

c. a closed question This is a closed-ended question because it can be answered with yes or no.

A homeless patient who is deficient in all nutrients is to be discharged. What organization may help? a. WIC b. EFNEP c. a local social services organization d. a shelter for the homeless

c. a local social services organization WIC is not appropriate given information, a shelter would likely not provide food. EFNEP could help teach a homeless patient how to cook but does not provide food itself. Subsuquently, a local social service organization would be best equiped to help this patient.

Nitrites added to cured meats may cause: a. a slightly salty taste b. a slightly sour taste c. a slight pink color d. a slightly brown color

c. a slight pink color

An obese person with Type 2 diabetes should: a. time meals b. decrease the frequency of feedings c. achieve DBW d. increase the frequency of feedings

c. achieve DBW (desired body weight) Reducing body weight by even 5-10% can increase insulin sensitivity. Timing meals (small frequent) is also very important but weight loss would be priority.

A food is bacteria-safe if it is: a. neutral and moist b. neutral and dry c. acidic and dry d. acidic and moist

c. acidic and dry Remember mneumonicf for things bacteria needs to grow: FAT TOM Food, acidity (grows at low pH, aka acidic), time, temperature, oxygen, and moisture (more moisture = more growth)

The immune system reacts to foods that are normally harmless. This is: a. food intoxication b. an inflammatory response c. an immunoglobulin E (IgE) mediated reaction d. food intolerance

c. an immunoglobulin E (IgE) mediated reaction IgE mediated reaction is what we think of as a food allergy.

A serum sodium level of 150 mEq/L may be due to: a. an increase in the intake of sodium-rich food b. decreased steroid formation c. an increased level of aldosterone d. a decrease in the intake of sodium-rich foods

c. an increased level of aldosterone Normal serum sodium: 135-145 mEq/L. Aldosterone is a hormone produced by the adrenal glands that tells the kidneys to increase sodium retention and decrease potassium retention in order to increase BP when it falls low. Subsequently, an increased aldosterone level would cause an increase in sodium retention and potentially hypernatremia.

In reviewing the patient's medical record, you note a hemoglobin of 10 g/dl and an MCV of 110 cu mm. You should document: a. anemia due to intrinsic factor b. anemia without nutritional implications c. anemia with larger than normal erythrocytes d. that the iron content of the diet should be increased

c. anemia with larger than normal erythrocytes Normal Hgb: males 14-18 g/dL, females 12-16 g/dL Normal MCV: 80-95 fL Subsequently, this patient has low Hgb, high MCV. This indicates macrocytic anemia, and thus anemia with larger than normal erythrocytes would be the answer.

Cross-sectional studies: a. describe past events and conditions b. are useful in predicting future-events c. are a snap-shot look at one point in time d. measure before and after an intervention occurs

c. are a snap-shot look at one point in time

Glycogenolysis is the: a. catabolism of carbohydrate b. creation of glucose from glycerol and amino acids c. breakdown of glycogen releasing glucose d. creation of glycogen

c. breakdown of glycogen releasing glucose Lysis = breakdown.

Which of the following is true regarding flour? a. all-purpose is made from soft wheat b. all-purpose flour has more protein than bread flour c. cake flour has the least and the weakest gluten d. cake flour has less starch than bread flour

c. cake flour has the least and the weakest gluten Cake flour has the least gluten, least protein and most starch while bread flour has the most gluten and most protein. Cake flour and pastry flour made from soft wheat.

Which additive improves crispness in vegetables? a. BHA b. BHT c. calcium d. pectin

c. calcium Calcium compounds are used as humectants to retain moisture, increase firmness, tenderness.

A good source of vitamin A for pre-school children would be: a. grapes b. watermelon c. cantaloupe pieces d. banana

c. cantaloupe pieces Cantaloupe is high in beta-carotene. Grapes are a choking hazard. Banana and watermelon would have to be cut to an appropriate size

Which pigment does not change color in an acid or an alkaline solution? a. anthocyanin b. chlorophyll c. carotenoid d. flavones

c. carotenoid Carotenoids have little to no change when exposed to acid or base. Anthocyanin is a type of flavone and turns bright red in acid, blue in base. Chlorophyll turns olive green in acid (pheophytin), and bright green in base (chlorophyllin).

During trauma, the catecholamine epinephrine: a. induce diuresis b. cause hypoglycemia c. causes hyperglycemia d. cause potassium retention

c. causes hyperglycemia Epinephrine increases hepatic glucose production by stimulating glycogenolysis and gluconeogenesis. Although its effect on glycogenolysis rapidly wanes, hyperglycemia continues because the effects of epinephrine on gluconeogenesis and glucose disposal persist.

Results of a patient food satisfaction survey indicate that patients think servings are too large. The dietitian should first a. conduct a plate waste survey b. reduce the serving size c. check the serving utensils on the line d. review regulations concerning nutrient requirements

c. check the serving utensils on the line

Underwrite Laboratory does which of the following? a. inspects facilities for safety b. inspects facilities for cleanliness c. checks safety of electrical equipment d. inspects gas equipment

c. checks safety of electrical equipment

Which of the following may help decrease cavities? a. raisins b. carrots c. cheese d. yogurt

c. cheese Cavities are caused by fermentation of bacteria from CHO on teeth. Cheese has the lowest CHO level and thus is least likely to cause cavities

If a child with cystic fibrosis has daily large, foul-smelling stools you should first check their: a. fecal fat b. total fat intake c. compliance with PERT d. calorie intake

c. compliance with PERT Pancreatic Enzyme Replacement Therapy is used in kids with CF to prevent fat malabsorption. If a child with CF was having large, foul-smelling stools, it's likely he wasn't taking his enzymes/wasn't taking them properly, causing malabsorption/maldigestion.

A dietitian ordering canned goods can be assured of a reliable product if they: a. buy directly from the manufacturer b. accept the most reasonable bid c. conduct a can cutting analysis d. buy the same brand, grade, size as the last time

c. conduct a can cutting analysis A can cutting analysis occurs when samples are requested from vendors and the manager opens the cans and compare qualities (texture, aroma, taste).

Which of the following food service systems has the lowest labor costs? a. cook freeze b. cook chill c. convenience d. conventional

c. convenience Convenience/assembly serve requires no/minimal labor; just reheating/thawing as needed.

The appropriate diet therapy following a Billroth II is: a. high carbohydrate, low fat, high protein b. high fat, high protein, high carbohydrate c. decrease simple carbohydrates, high protein, moderate fat, B12 supplements d. low fat, low protein, high carbohydrate

c. decrease simple carbohydrates, high protein, moderate fat, B12 supplements Billroth II is a gastrojejunectomy. The appropriate diet therapies following a Billroth II include frequent, dry feedings, fluids before or after meals, restrict hypertonic concentrated sweets, give 50-60% complex CHO, protein at each meal, moderate fat, potential B12 injections.

An amylase deficiency would result in: a. decreased gluconeogenesis b. decreased lipolysis c. decreased glycolysis d. decreased proteolysis

c. decreased glycolysis Amylase = enzyme involved in CHO metabolism (lipase = fat, protease = protein). If amylase was not present, the breakdown of glucose (glycolysis).

When alpha linolenic acid is substituted for saturated fatty acids in the diet, the results will be: a. increased HDL, reduced LDL b. decreased triglycerides, lower total cholesterol c. decreased triglycerides, little change in total cholesterol d. lower HDL, increased LDL

c. decreased triglycerides, little change in total cholesterol When alpha-linolenic (omega-3) is substituted for saturated fatty acids, there is decreased hepatic production of triglyercides (inhibits VLDL synthesis) and has little effect on total cholesterol levels. Lioleic acid, or omega 6, is an essential fatty acid. Replacing carbohydrates with omega 6 causes LDL to decrease and HDL to increase. If linoleic acid (omega 6) replaces saturated fat, total cholesterol decreases and HDL decreases

You discover an incorrect diet order entered in the patient's chart. a. chart the order as incorrect b. file the order because it was written by a physician c. discuss the order with the physician and make suggestions d. change the order in the chart

c. discuss the order with the physician and make suggestions

Good advice for a patient with a hiatal hernia is to: a. increase intake of complex carbohydrates b. lower the fat content of the diet c. don't eat before bed d. avoid coffee

c. don't eat before bed A hiatal hernia is a protrusion of part of the stomach into the mediastinum through the esophageal hiatus of the diaphragm. Nutritional therapies for hiatal hernia include small, bland feedings, avoiding late night snacks, avoiding caffeine, chili powder, and black pepper, as heart burn is common symptom

Which of the following is not a sign of marasmus? a. severe protein and calorie wasting b. weight loss c. edema d. low anthropometric measurements

c. edema Marasmus is a protein-calorie malnutrition. Those with marasmus will be extremely thin/emaciated, and would not experience edema as lacking in protein intake as well as calorie intake. All other answers would be a sign.

Which of the following most affects osmolarity? a. protein b. sugar c. electrolytes d. fat

c. electrolytes Electrolytes affect osmolarity the most, followed by sugar. Think sodium- it is the major solute in extracellular fluids, so it effectively determines the osmolarity of extracellular fluids.

The span of control refers to the number of: a. supervisors b. part-time employees c. employees under the direction of one person d. staff positions

c. employees under the direction of one person A span of control is defined as the number of individuals or departments under the direction of one individual.

After you review the patient's medical record, the first step in counseling is: a. assess the patient's nutritional status b. collect all relevant data c. establish a climate of trust d. establish an overall evaluation plan for the patient

c. establish a climate of trust Steps of interviewing: -Prepare (collect background information, establish objectives for collecting information during interview) -Build rapport (first step when meeting client) - Collect data (open-ended, non-judgemental)

A supervising Dietitian who wishes to delegate specific responsibilities should first: a. organize a task force b. check the production schedule c. establish expected outcomes d. establish expected time frames to accomplish the tasks

c. establish expected outcomes When delegating tasks/responsibilities, managers must have a clear understanding of what they want done, give specific instructions, motivate, provide training, require complete work, and establish adequate controls

A cake with a fallen center may be the result of: a. too little fat b. too little sugar c. excess sugar and excess fat d. too little baking powder

c. excess sugar and excess fat Sugar and fat are HEAVY, and typically work to add tenderness and shape to a cake. If too much of either or both of these are added, the cake will be "weighed down" and thus collapse.

A side effect of antidepressants is: a. chronic diarrhea b. muscle wasting c. excess weight gain d. nausea and vomiting

c. excess weight gain Ex: Seroquel

Ketones are most associated with: a. complex carbohydrates b. simple sugars c. fats d. amino acids

c. fat

What is the first thing you should do if an employee frequently comes to work without the proper uniform? a. fire time b. give him a written warning c. find out why d. give him a warning, and fire him the next time it happens

c. find out why Getting to the root cause of an issue can be more beneficial in problem solving as compared to disciplinary action. If the employee continued to wear the wrong uniform, then a verbal/written warning may be warranted.

To maintain hydration during continuous endurance physical activity of 4 hours, consume: a. fluids b. fluids and sodium c. fluids, sodium, carbohydrates d. non-CHO electrolyte solutions

c. fluids, sodium, carbohydrates Fluid/sodium to replace loss through sweating, CHO to replete glycogen stores

How can you enhance usage of commodity foods from a food donation program? a. teach food donation staff how to use the items b. make a poster on usage c. give each participant recipes using the food items d. calculate the amounts of nutrients provided in the donated foods

c. give each participant recipes using the food items

Which nutrient would most effectively reduce starvation ketosis? a. corn oil b. MCT oil c. glucose d. essential amino acids

c. glucose Ketosis occurs when there is no glucose availble for energy, and all glycogen stores have been utilized via glycolysis. Gluconeogenesis takes over for a while, producing glucose from non-CHO sources, including glucogenic AA, glycerol, and lactate. Gluconeogenesis uses up a bunch oxaloacetate and thus it gets to a point where the TCA cycle cannot occur because there is not oxaloacetate. Without oxaloacete, TCA cycle doesn't work. Subsequently, the body must now rely on fats, in the form of ketone bodies, for energy through ketolysis. If glucose were introduced, this would most effectively reduce starvation ketosis and glucose, the preferred energy source, could be used to generate ATP again.

Apples stored in a controlled environment would: a. ripen quickly b. last one or two years c. have extended life and improved marketing quality d. only be used as processed fruit

c. have extended life and improved marketing quality

The mother of an infant who weighed 4.5KG at birth and was hypoglycemic may: a. have gained excessive amounts of weight during pregnancy b. not have gained enough weight during pregnancy c. have had gestational diabetes d. have reactive hypoglycemia

c. have had gestational diabetes This baby is large (macrosomia), as typical range would be ~2.5-4 kg. The baby being hypoglycemic is also a clue of GDM, as neonate was receiving high amounts of glucose in the womb. Once the baby is born, they have quickly stop receiving high rates of glucose infusion from the mother's placenta. That dramatic shift can cause hypoglycemia.

A female has a 36" waist and a 40" hip measurement. She is at risk for: a. nothing b. cancer c. heart disease d. malnutrition

c. heart disease Waist to hip ratio (WHR) of greater than 1 in men and greater than 0.8 in women is indicative of android obesity and increased risk for obesity-related disease. In this woman, her WHR = 36/40 = 0.9. Subsequently, she is at increased risk for obesity-related disease, such as heart disease.

Which fiber is insoluble in water? a. pectin b. gums c. hemicellulose d. polysaccharide

c. hemicellulose Soluble fiber dissolves in water, and includes plant pectin and gums. Insoluble fiber doesn't dissolve in water. It includes plant cellulose and hemicellulose.

A patient is diagnosed with iatrogenic malnutrition. Nutritional therapy should be: a. high calorie b. high protein c. high calorie, high protein d. low calories, high protein

c. high calorie, high protein Iatrogenic malnutrition is protein-calorie malnutrition brought on by treatment, hospital, medications.

Before discontinuing a parenteral feeding, provide enteral support to prevent: a. development of fatty liver b. ketoacidosis c. hypogylcemia d. hepatic encephalopathy

c. hypogylcemia D/c'ing PN feeds, which provide dextrose directly into blood stream, would put the patient at high risk for hypoglycemia. The patient has likely not being using their gut much if at all while on PN, so there would be an adjustment period to get the gut functioning normally. The patient may not eat much and thus risks hypoglycemia.

A PN patient is receiving 45 calories/kg. What may be the result? a. hypocalcemia b. hyperkalemia c. hypokalemia d. hyperphosphatemia

c. hypokalemia Providing 45 kcal/kg would WAYYYY overfeed a PN patient. Subsequently, refeeding syndrome would likley occur as glucose is infused directly into blood stream. Refeeding syndrome would result in hypokalemia and hypophosphatemia, as well as hyperglycemia. Hypertriglyceridemia would also occur.

If you are concerned that the receiver is not accurately checking incoming stock, you should a. begin purchasing by bid b. use a prime vendor c. implement blind receiving d. conduct random checks of food cases

c. implement blind receiving In blind receiving, the clerk is given a blind invoice or purchase order listing incoming merchandise but omitting quantities and weights. Receiving clerk inserts these numbers into the order on the basis of a check of the delivery. This method forces clerk to make serious check of delivery.

Cabbage should be cooked: a. covered b. in a small amount of water c. in a large quantity of water d. covered in a small amount of water

c. in a large quantity of water To minimize the development of a strong flavor, cook for a short time, keep the lid off initially to let acids escape, and cook in a large amount of water.

Constipation in an infant would most likely be due to: a. GI distress b. lack of fruits c. inadequate fluid intake d. excessive formula

c. inadequate fluid intake

Which examines how effectively an organization is utilizing its assets? a. assets to liabilities b. debt to equity c. inventory turnover d. break-even point

c. inventory turnover Inventory turnover rate shows current effectiveness of inventory control, and thus utilization of assets. If inventory turnover rate is high, that means limited inventory is being kept. If inventory turnover rate is low, large amounts of money are tied up in stock. Assets-to-liabilities ratio is the percentage of assets divided by debt Debt-to-equity ratio is the percentage of assets funded by shareholders equity and debt. Break-even point is when sales revenue (income) will exactly cover fixed and variable cost.

In cereal production, enrichment adds: a. vitamin A b. vitamin D c. iron d. iodine

c. iron Enrichment adds back some lost nutrients. These restored nutrients include iron and B vitamins (folic acid, riboflavin, niacin, and thiamine).

A flexible monthly budget would be recommended for a hospital which: a. expects no change in expenses or revenue b. expects to be at 90% occupancy c. is planning to close some of its wings for renovation for three months d. has less than 100 employees

c. is planning to close some of its wings for renovation for three months A flexible budget is adjusted to various levels of operation with varying levels of sales or revenues throughout the year. A flexible budget would be appropriate for closing wings of building for renovation as there will be fluctuation in operation costs, sales or revenue during that three month period.

Which would be the least expensive enteral nutrition formula? a. elemental b. chemically-defined c. isotonic, intact protein, polymeric d. modular

c. isotonic, intact protein, polymeric This is a standard formula, all others are hydrolyzed and would cost more.

All of the following are operational costs except: a. utilities b. cleaning c. labor costs d. laundry service

c. labor costs Operational costs include utilities (electricity), laundry, and cleaning. Labor costs are a separate category of costs.

A job breakdown: a. can be used for employee appraisal b. studies and analyzes all aspects of the job c. lists what steps to do and how to do them d. lists time limits on all aspects of the job

c. lists what steps to do and how to do them A job breakdown lists what to do and how to do it - no time limits. A job analysis studies and analyzes all aspects of the job. A work schedule lists hour by hour, training, tasks and time.

What is the appropriate diet for heart failure? a. low potassium b. low calcium c. low sodium d. low fat

c. low sodium Following a low sodium diet reduces risk of fluid accumulation, which can increase cardiac workload and increase blood pressure.

A foodservice productive system is being converted from a conventional system to a ready-prepared system. The Dietitian should first consider the adequacy of the: a. steam table space b. dry storage space c. low-temperature storage capacity d. oven capacity

c. low-temperature storage capacity In ready-prepared/cook-chill/cook-freeze systems, food is not produced for immediate service but for inventory and subsequent withdrawn. Foods prepared on site, then frozen, chilled for later use. Requires blast chiller or freezer and adequate storage. Subsequently, low-temperature storage capacity would be needed for ready-prepared, as it is not as vital in conventional systems to have that type of frozen storage capacity.

A common result of treating an AIDS patient with zidovudine is? a. diarrhea b. constipation c. macrocytic anemia d. hypokalemia

c. macrocytic anemia Zidovudine is an NRTI (nucleotide nucleoside reverse transciptase inhibitor. Use of Zidovudine can lead to anemia, loss of appetite, low vitamin B12, copper, zinc, and carnitine. Subsequently, low vitamin B12 status can cause macrocytic anemia.

Menu items you wish to sell more of should be placed so that they are the first and the last items a customer sees. This strategy is: a. menu design b. menu placement c. menu psychology d. menu structure

c. menu psychology Menu psychology refers to the design and layout in such a way as to influence the sale of the foods served, including that menu items you wish to sell more of should be placed so that they are the first and the last items a customer see.

What is not found in a standardized recipe? a. seasonings to be included in the recipe b. time and temperature of cooking c. mixing bowls, measuring spoons d. amount of ingredient to include

c. mixing bowls, measuring spoons Standardized recipes include name, ingredients, procedures, pan size, baking time, temperature, quantity, number of portions of specific size, standard of quality expected

A critically ill patient will likely need hospitalization for many days. When should the discharge plan begin? a. as soon as it is known when the patient is being discharged b. once the patient is stable c. on the first day of admission d. at least two days prior to discharge

c. on the first day of admission Begin discharge planning on first day of admission.

The diet for galactosemia should exclude: a. high fat foods b. high cholesterol foods c. organ meats, MSG d. simple carbohydrates

c. organ meats, MSG Galactosemia is a genetic disease where there is a deficiency in converting galactose to glucose. The diet followed should be low in galactose. Foods to be avoided include organ meats, MSG extenders, milk, lactose, galactose, whey, casein, dry milk, calcium or sodium caseinate, dates, bell peppers. Foods okay for those with galactosemia include soy, hydrolyzed casein, lactate, lactic acid, lactalbumin, pure MSG.

Which is most associated with the incidence of type 2 diabetes? a. sugar intake b. protein intake c. overweight d. salt

c. overweight In an obese individual, the amount of NEFA, glycerol, hormones, cytokines, proinflammatory substances, and other substances that are involved in the development of insulin resistance are increased. Insulin resistance with impairment of β-cell function leads to the development of diabetes.

Odynophagia is: a. difficulty in swallowing b. lump in the throat c. painful swallowing d. lack of salvia

c. painful swallowing Odyno = pain, phagia = swallowing

Which enzymes are involved in protein digestion? a. ptyalin, lipase, sucrase b. amylase, lipase, trypsin c. pepsin, trypsin, chymotrypsin, carboxypeptidase d. trypsin, lipase, amylase

c. pepsin, trypsin, chymotrypsin, carboxypeptidase Pepsinogen (zymogen form) is converted to pepsin (active form) in the stomach by HCl. Pepsin then hydrolyzes peptide bonds. Zymogens (trypsinogen, chymotrypsinogen, procarboxypeptidase) are converted to active form on the brush border membrane of the enterocyte. Trypsinogen is converted to active form trypsin by enterokinase on brush border membrane. Tyrpsin then converted the other zymogens (chymotrypsinogen, procarboxypeptidase) into their active forms (chymotrypsin, carboxypeptidase), which can then hydrolyze to di and oligosaccharides.

To evaluate quality patient care: a. determine criteria for consultations b. monitor treatment for a nutrition problem c. periodically assess the outcomes of nutrition therapy d. assign individuals responsibility for monitoring activities

c. periodically assess the outcomes of nutrition therapy

A Crohn's patient who was previously well-nourished has a fever and ileus 7 days NPO. Which feeding method should you recommend? a. central venous hyperalimentation b. full liquids c. peripheral IV infusion d. half-strength tube feeding

c. peripheral IV infusion PN with ileus.

Which term relates to scientific management? a. psychological b. intellectual c. physical d. sociological

c. physical Scientific management is a work-centered management style in which the worker has to do repeated tasks to maximize efficiency. Focus's on physical aspects of job vs human aspects

When developing educational plans, when do you plan the evaluation criteria? a. before implementation of the plan b. do it before you plan anything else c. plan evaluation criteria at each step in the process d. plan it just before you offer the program

c. plan evaluation criteria at each step in the process Assessment, planning, implementation, and evaluation of outcomes

A primary use of the Dietary Reference Intakes is to: a. calculate parenteral nutrition requirements b. assess nutrient intakes of at-risk populations c. plan menus for healthy people d. educate an individual with hyperlipidemia

c. plan menus for healthy people DRI is used to guide nutrient intake in healthy people, sorted by factors such as age, sex, pregnancy and breastfeeding.

Which of the following would reduce direct expenses in a foodservice? a. increase selling prices b. reduce rent c. reduce food costs d. increase part-time labor

c. reduce food costs Food cost is a major direct expense in foodservice.

Which supplements are recommended with peritoneal dialysis? a. same as those for hemodialysis b. only the water-soluble vitamins c. same as those for hemodialysis plus thiamin d. only iron and folate

c. same as those for hemodialysis plus thiamin Remember mnemonic for supplements for HD: Ce, BeBe I am a FOol for you (vitamin C, vitamin B12, vitamin B6, folate); also iron, zinc, and vitamin D. Thiamin is added to PD because of increase CHO absorption. Remember, thiamin is required for conversion of pyruvate to acetyl CoA. Thus, A is correct.

Which would provide the best source of omega-3 fatty acids? a. walnuts, flaxseeds b. tuna, cod c. sardines, herring, mackerel d. canola oil

c. sardines, herring, mackerel Omega-3 rich foods are typically FISH. Mackerel (4,107 mg per serving), Salmon (4,123 mg per serving), Cod liver oil (2,682 mg per serving), Herring (946 mg per serving), Oysters (370 mg per serving), Sardines (2,205 mg per serving), Anchovies (951 mg per serving), Caviar (1,086 mg per serving).

What is the most important reason for a microwave oven in food service? a. saves energy b. saves money c. saves time d. saves cleanup

c. saves time

Which of the following extinguishers is best to use on a grease fire? a. triangle symbol b. circle symbol c. square symbol d. inverted triangle symbol

c. square symbol A triangle symbol is for class A fires (wood, paper, cloth). A square symbol is for class B fires (flammable liquids, gases, greases). A circle symbol is for class C fires (electrical).

The cleanliness of on-line steam is not an issue when purchasing a: a. convection oven b. combination oven c. steam-jacketed kettle d. compartment steamer

c. steam-jacketed kettle With a steam-jacketed kettle, the food does not touch the steam. Subsequently, cleanliness of the steam is not a major concern.

A 5 month old is diagnosed with salmonella. What is likely the cause? a. fruit juice b. milk c. table food d. evaporated milk

c. table food Typical foods for Salmonella include low acid foods at body or room temperature, raw/undercooked meat and poultry, eggs, raw dairy, seafood, melons. Cross-contamination would be most likely the cause of salmonella in a 5 month old, as they put things in their mouths constantly.

The best indicator that children applied knowledge from a nutrition education program about vitamin D is: a. their parents know about good sources of vitamin D b. the children can name good sources of vitamin D c. the children request more snacks with vitamin D d. the children know the reasons for including the vitamin

c. the children request more snacks with vitamin D Answer A would show that the child was discussing what they learned with their parents, but not that they were actually applying that knowledge. This same logic can be applied to B and D. The answer is C becaues this shows that the childen understood the information provided and realized the importance of vitamin D in the diet, so they are applying that knowledge by trying to get more foods with vitamin D.

Hormones that control blood pressure and blood components are produced in: a. the heart b. the liver c. the kidneys d. the lungs

c. the kidneys The RAAS system is a mult-organ process that regulates blood pressure. When BP falls, the kidneys release renin into the bloodstream. Renin splits angiotensinogen, released from the liver, into angiotensin I. Angiotensin I (relatively inactive) is spilt by angiotensin-converting enzyme (ACE), produced by the lungs, into angiotensin II, which is very active. Angiotensin II causes muscular wall of small arteries (arterioles) to constrict, which increases BP. This triggers the release of aldosterone from the kidneys. Aldosterone causes kidney to retain sodium and water and excrete potassium. Ultimately, this causes an increase in blood volume and BP

Equipment purchases depend on: a. the budget b. what the cook wants c. the menu d. the type of facility

c. the menu The menu determines equipment, food, space, and personnel needed in a foodservice operation

Asian, Hispanic, and Native Americans have the following in common: a. they consume few green vegetables b. they consume significant amounts of dairy products c. they consume little milk d. they consume few root vegetables

c. they consume little milk Think how ~ 95% of Asians are lactose intolerant, so they will avoid dairy, including milk.

Patients with cardiac cachexia on a loop diuretic should be evaluated for: a. riboflavin status b. acidosis c. thiamin status d. alkalosis

c. thiamin status Cardiac cachexia is unintended weight loss in CHF caused by blood backing up into liver and intestines causing nausea and decreased appetite. A loop diuretic may be used to treat cardiac cachexia. Loop diuretics deplete thiamin, potassium, magnesium, calcium, sodium, and chloride. Subsequently, C is the answer.

Roman Catholic dietary laws state that fish is: a. to be served every friday all year b. to be served on Ash Wednesday and Good Frirday c. to be served on Ash Wednesday and Friday during Lent d. no longer required on Fridays

c. to be served on Ash Wednesday and Friday during Lent

Coarse texture in a cake is due to: a. too little baking powder b. over-mixing c. too much baking powder or sugar d. oven temperature too high

c. too much baking powder or sugar A coarse texture in a cake can be caused by excess sugar, excess baking powder, low temperature, and inadequate gluten formation (too little mixing).

What should a Jewish patient include in his diet to increase the intake of zinc? a. fresh green vegetables b. pork c. turkey d. wheat bread

c. turkey Zinc is high in red meat, poultry, and oysters. It is also found in grains and milk products. Because this patient is Jewish, turkey would be the best source of zinc since Jewish individuals avoid pork, shellfish, and meat and dairy mixed.

When substitution butter for lard in pastry: a. use the same amount b. use less c. use more d. use less and decrease the water content

c. use more Butter contains less fat than lard, and thus more would be needed to get the correct flakiness/texture.

The efficiency of a foodservice employee is increased if the work center is designed to allow the employee to: a. sit and reach b. stand and reach c. use two hands d. use zigzag motions

c. use two hands Using two hands allows the employee to work efficiently. If the employer has to sit/stand and reach for items, they are wasting time and energy and may get hurt with repetitive motions. Use zig zap motions also would not be an efficient ergodynamic movement.

A patient with a redundant ileum may develop a deficiency of: a. fat-soluble vitamins b. folic acid c. vitamin B12 d. vitamin K

c. vitamin B12 Redundant = elogonated If the ileum is abnormal, vitamin B12 absorption will be impacted as it is absorbed in the ileum. I couldn't find much information about a redundant ileum (seems to mostly be colon), but I assume this may mess with surface area as well, which would decreas absorption. Fat-soluble vitamins and folic acid are digested in small intestine, at various locations. Vitamin K is absorbed in the ileum but can also be synthesized in the colon.

When can a citizen have impact on a bill? a. during debate in the Senate b. when the bill goes to committee c. when the bill is in public hearings d. during debate in the House

c. when the bill is in public hearings

A patient with chronic pancreatitis should consume oral pancreatic enzymes: a. with large meals and fatty foods b. only if steatorrhea increases c. with all meals and snacks d. only if consuming a high fat, low protein diet

c. with all meals and snacks Pancreatic enzymes should be taken with all meals/snacks to aid in digestion. Those with chronic pancreatitis have irreversible inflammation leading to fibrosis with tissue calcification.

Which would you give to a person who is mildly hypokalemic? a. 1 cup blueberries b. 1 cup cranberries c. 1/2 cup applesauce d. 1 piece cantaloupe

d. 1 piece cantaloupe High potassium foods include bananas, oranges, cantaloupe, honeydew, apricots, grapefruit, cooked spinach, cooked broccoli, potatoes, sweet potatoes, mushrooms. Remember in renal rotation would recommend berries and apples as a lower potassium food source. Cranberries are also lower in potassium.

Using the factor method, determine the selling price using the data below. raw food cost $3.14; prepared food cost $5.21; labor cost $ $3.30; overhead cost $ 1.12; factor 3.37 a. 6.40 b. 7.84 c. 8.10 d. 10.58

d. 10.58 Selling price = markup factor x raw food cost Selling price = 3.37 x $3.14 = $10.58

What is the labor turnover rate if 6 employees in a department of 55 were terminated and replaced? a. 12% b. 10% c. 9% d. 11%

d. 11% Labor turnover rate = # employees (separated) terminated / total positions in department x 100 6/55 * 100 = 11%

A patient requires 1800 calories per day and is restricted to 1500ml fluid. The enteral formula selected has 1.5 cal/cc, 55g protein per liter, and 77% water. How much formula does she need daily? a. 1500ml b. 1400ml c. 1300ml d. 1200ml

d. 1200ml Restricted 1500mL, 77% water 1500 x 0.77 = 1,155 mL = ~1200mL Check: 1000 mL x 1.5 kcal/cc = 1800 kcal

A #12 scoop was used to serve 600 servings of mashed potatoes instead of a #16 scoop. How many servings were they short? a. 90 b. 25 c. 210 d. 156

d. 156 #12 scoop = 12 scoops per quart 32oz/12 = 2.666oz #16 scoop = 16 scoops per quart 32oz/16 = 2 oz 600 servings x 2 oz (supposed to be #16 scoop) = 1200oz (intended) 1200oz/2.7 oz (what was used) = 444 servings actually made 600-444 = 156 servings short

How many FTE's can you hire with a weekly budget of $8640 if the salary is $12.00 per hour? a. 10 b. 13 c. 16 d. 18

d. 18 $12 x 40hrs = $480 $8640/$480 = 18

A patient weighing 104kg is placed on a 1.5 cal/ml formula with 75% free water, 54 grams protein/L. He needs 3000 calories per day Referring to the above patient, how much additional water should be provided per hour? a. 52ml b. 89ml c. 78.5ml d. 64ml

d. 64ml 2000mL formula x 0.75 = 1500mL free water If 1 mL/kcal provided, need additional 1500mL (3000mL - 1500mL free water) 1500 mL /24 hrs= 62.5 mL/hr = ~64mL/hr

In a normal curve, what % of data falls between +1 and -1 standard deviation? a. 52 b. 93 c. 35 d. 68

d. 68 68% of data falls BETWEEN +1 and -1 SD (w/in 1 SD, not 2) Others to know for exam: 32% of data lies OUTSIDE the range of +1 / -1 SD (outside 1 SD) 95% of data falls WITHIN +/- 2 SD (2 SD)

What are the caloric needs of a 4 month old infant weighing 14 lbs? a. 510 b. 582 c. 602 d. 687

d. 687 4 month old needs ~108 kcal/kg 14 lbs = 6.4 kg 6.4 kg x 108 = ~687 kcal

How much hamburger will it take to make 300 three ounce patties with 20% shrinkage? a. 52lbs b. 68lbs c. 90lbs d. 70lbs

d. 70lbs 300oz x 3 = 900oz 20% shrinkage = 80% yield 900oz/.8 = 1125 oz 1125oz/16oz = ~70lbs

The interstate shipping of shellfish is monitored by the: a. DHHS b. USDA c. Department of Commerce, Marine Fisheries Service d. FDA

d. FDA Under Food, Drug, and Cosmetic Act, FDA covers all interstate food except meat, fish, poultry and eggs; inspects food processing factories, raw materials and labeling.

Which organization regulates the irradiation of foods? a. DHHS b. USDA c. Department of Commerce, Marine Fisheries Service d. FDA

d. FDA Under Food, Drug, and Cosmetic Act, FDA covers all interstate food except meat, fish, poultry and eggs; inspects food processing factories, raw materials and labeling. Irradiation of foods is included in FDA regulation powers.

What is included in the study of demographics? I. age of individuals II. population statistics III. sex of individuals IV. socioeconomic factors a. I only b. all of the above c. II, III d. I, II, III

d. I, II, III Demographics include population by age, ethnic groups, sex, birth rates, and deaths. Socioeconomic factors are a different category, and include census data, housing statistics, etc.

Which fat source would be best for a patient with pancreatitis? a. essential fatty acid supplements b. polyunsaturated fats c. LCT d. MCT

d. MCT MCT is absorbed directly into the portal vein. The facile absorption of MCTs without the need for bile or pancreatic enzymes makes them a good source of calories in the setting of malabsorption and steatorrhea from diseases, such as pancreatic or bile insufficiency.

What law guarantees workers the right to organize and join labor unions? a. Taft Hartley b. Equal Employment Act c. Labor Management Relations Act d. National Labor Relations Act

d. National Labor Relations Act Also known as the Wagner Act; guarantees the right to organize and join labor unions; created National Labor Relations Board which listens to claims of "unfair labor practices"; pro-labor

What can be done to lower the respiratory quotient of a tube fed pulmonary patient? a. add MCT oil to decrease energy required for growth b. change the type of fat to improve oxygen exchange c. add carbohydrate to decrease the respiratory quotient d. add a fat emulsion to replace some of the carbohydrate

d. add a fat emulsion to replace some of the carbohydrate RQ is he ratio of the volume of carbon dioxide evolved to that of oxygen consumed in a given time. Carbohydrates have the highest RQ (fat ~0.7 , proteins ~0.8, carbohydrates ~1). Subsequently, replacing some CHO with fat would reduce the RQ.

An outpatient would like to take a vitamin C supplement. You should: a. ignore the request and talk about incorporating better balanced foods into her diet b. ignore her request and advise her to drink more juices c. explain the dangers of taking too much vitamin C d. ask her to keep a food diary to see where she is lacking

d. ask her to keep a food diary to see where she is lacking

An employee returns to work after recovering from a broken leg, but is still not able to perform essential job functions. You should: a. create a new position that the employee can perform b. transfer the employee to another department c. hire another employee to assist them at their job d. ask the employee to provide written recommendations from their physician

d. ask the employee to provide written recommendations from their physician

An example of self-actualization is: a. breathing unassisted b. companionship c. safety d. asking for additional training

d. asking for additional training Self-actualization is the highest level of Maslow's Hierarchy of Needs. Self-actualization is achieving full potential, job enrichment. Asking for additional training would be an example of self-actualization.

What gas is released from a grease fire? a. helium b. hydrogen c. carbon dioxide d. carbon monoxide

d. carbon monoxide

Food was held at 70F for a long time in anaerobic conditions. Eight hrs after eating it you become ill. What is the culprit? a. salmonella b. staphylococcus c. campylobacter jejuni d. clostridium perfringens

d. clostridium perfringens Clostridium = anaerobic; onset typically 8-12 hrs; commonly affects foods held warm too long

The primary focus of nutrition care for a man with hypertension and a BMI of 32 should be to: a. decrease sodium intake b. increase potassium intake c. increase calcium intake d. decrease body weight

d. decrease body weight

A tube fed patient receiving bolus feedings develops a distended abdomen. What should you recommend? a. change the tube feeding to isotonic, lactose-free b. decrease the osmolality of the feeding c. decrease the amount of water flush d. decrease the rate

d. decrease the rate Decreasing the rate would be the best answer, as "too much too quickly" can be a major cause of gas, abdominal discomfort, etc. Isotonic formula should be well tolerated, and using a lactose-free formula does not necessarily mean it will be better tolerated. Decreasing the osmolality of the feed would require higher volume of formula to meet needs, which would likely not be well tolerated in bolus feeds. Water flushes are important to prevent clogging as well as to help meet fluid needs.

Adding bran to a bread recipe will: a. increase the volume b. decrease the volume c. require an increase in oven temp d. require a decrease in oven temp

d. decrease the volume Adding bran decrease the volume of the end product, as bran is heavy/weighing down the product.

Which is the best way to teach food service workers to prepare a new menu item? a. show a video of the process b. have them prepare it following a recipe c. provide and review detailed, written instructions d. demonstrate the process, then watch them prepare it

d. demonstrate the process, then watch them prepare .

Which of the following would be most productive when conducting a workshop for teenage mothers about proper portion sizes for feeding toddlers? a. role-playing b. lecture c. discussion d. demonstration

d. demonstration Teenagers may get bored with lecture/discussion. Role-playing may feel awkward to them, so demonstration (kinesthetic learning) is the best option.

Glucophage (metformin) functions by: a. stimulates insulin secretion b. inhibits digestive enzyme action c. decreases peripheral resistance d. enhances insulin action

d. enhances insulin action Metformin (Glucophage); suppresses hepatic glucose production; take with food; check B12 levels- deficiency can lead to anemia or peripheral neuropathy

Induction heating is: a. fast, even, with an open flame b. fast, uneven, without an open flame c. slow, even, without an open flame d. fast, even, without an open flame

d. fast, even, without an open flame Induction heating is the use of electrical magnetic vibrations to excite the molecules of metal cooking surfaces; ex burner has no flame

In cystic fibrosis, the most impaired nutrient is: a. protein b. disaccharides c. electrolytes d. fat

d. fat CF is an inherited disease affecting the epithelial cells & endocrine glands that produce mucus, sweat, saliva & digestive juices. Most CF patients malabsorb dietary fats because of pancreatic insufficiency, which leads to impaired lipolysis. PERT is used to minimize risk of fat malabsorption and steatorrhea.

Biotin is considered a coenzyme in the synthesis of: a. protein b. carbohydrate c. glycogen d. fatty acids

d. fatty acids Biotin serves as a carboxyl (adds CO2) carrier in 4 carboxylase enzymes (carboxylations), including fatty acid synthesis (acetyl CoA to malonyl CoA).

Immediately following a severe burn, nutritional therapy should include: a. high calories b. high protein c. high calories, vitamins, minerals d. fluid and electrolyte replacement

d. fluid and electrolyte replacement In the first 24-48 hours following burn injury, fluids and electrolytes should be restored. When fluid status is stabilized, feeding can begin. The diet should be high calorie, high protein, high fluid, and high in vitamin C and zinc. Calorie needs should increase by 20 - 30% and may be as high as 2 x REE.

A patient needs a 2000 calorie, 2 gram sodium feeding. Which formula is best? a. formula 1: 1kcal/cc, 2g Na/L b. formula 2: 1.5kcal/cc, 2g Na/L c. formula 3: 2kcal/cc, 1g Na/L d. formula 4: 1kcal/cc, 1g Na/L

d. formula 4: 1kcal/cc, 1g Na/L If getting 2000 kcal... Formula 1: 2L, 4 gm Na/L Formula 2: 1.33L, 4 gm Na/L Formula 3: 1L, 1 gm Na/L Formula 4: 2L, 2 gm Na/L

A patient on parenteral nutrition is to be transitioned to enteral feeding. He should receive: a. half-strength enteral feeding initially b. half-strength, then 3/4 strength enteral feeding c. half-strength enteral feeding with a low osmolality d. full strength enteral feeding at a low rate

d. full strength enteral feeding at a low rate

What is the best way to increase attendance at a nutrition seminar for dentists? a. hold it in a location convenient to large numbers of dentists b. have it held in a medical facility c. hold it on weekends when their offices are likely closed d. have it sponsored by a dental organization

d. have it sponsored by a dental organization

The theory that a person must perceive the severity of a condition, and that making a change may help him prevent the condition from occurring is the: a. stages of change model b. diffusion of innovation model c. theory of planned behavior d. health belief model

d. health belief model The Health Belief Model focuses on individuals' beliefs about their disease/condition because those beliefs help predict health-related behaviors. The constructs include perceived susceptibility, perceived severity, perceived benefits, cues to action, and self-efficacy.

When purchasing food service equipment, first consider: a. reputation of the vendor b. ease of use c. safety and ease of use d. how it will be used

d. how it will be used

Which of the following would be classified as NI in the NCP? a. not ready for diet change b. altered GI function c. involuntary weight loss d. increased energy expenditure

d. increased energy expenditure NI is the nutrition intake domain of diagnosis. The answer related to nutrition intake is increased energy expenditure. Not ready for diet change would be the NB domain. Altered GI function and involuntary weight loss would be in the NC domain.

To estimate energy needs in the critically ill, use: a. Harris Benedict b. Mifflin St Jeor c. BMR d. indirect calorimetry

d. indirect calorimetry Indirect calorimetry is the method by which measurements of respiratory gas exchange are used to estimate the type and amount of substrate oxidized and the amount of energy produced by biological oxidation. This is most helpful in critically ill patients as it is more difficult to effective estimate RMR when critically ill. Indirect calorimetry would give the most accurate estimate of nutritional needs, but is often unable to be done due to cost and reality.

In starvation, the brain uses which nutrient as an energy source? a. fatty acid b. lactic acid c. glucose d. ketone bodies

d. ketone bodies Glucose is the preferred fuel source for the brain. Those in starvation ketosis will have to use ketone bodies in place of glucose and all glycogen stores have been depleted and gluconeogenesis can no longer occur.

A child is lethargic, irritable with diarrhea. The cause may be: a. zinc toxicity b. lead poisoning c. iron overload d. vitamin A toxicity

d. lead poisoning Lead depletes iron, leading to anemia. Iron-deficiency anemia can cause lethargy.

Which is not absorbed directly into the portal blood? a. monosaccharides b. amino acids c. medium chained fatty acids d. long chained fatty acids

d. long chained fatty acids

The organized gathering of data and information for the purpose of analyzing a service for clients is: a. an experimental design b. a relationship analysis c. product development d. market research

d. market research Market research is an organized effort to gather information about target markets and customers: know about them, starting with who they are. It is a very important component of business strategy and a major factor in maintaining competitiveness

A child who is below the 5th percentile weight for height.. a. is tall for his age b. has a condition inhibiting growth c. may have experienced long term under-nutrition d. may have experienced short term under-nutrition

d. may have experienced short term under-nutrition Weight for length/stature identifies under/over nutrition and detects short term changes to nutritional status. <5th percentile may reflect acute illness or wasting; > 95th percentile may reflect overnutrition. Stature/length for age defines shortness/tallness and reflects long term nutritional status; determines extent of stunting. Weight for age is NOT used to classify under/over weight and is a short term marker of growth that cannot distinguish between stunting and wasting becuase it does not include height

A non-direct interview provides: a. the same information on all applicants b. a structured set of questions c. the least amount of information d. more information than a directed interview

d. more information than a directed interview A non-directed, or unstructured, interview has no definite checklist of questions to ask. There is more participation from the applicant. A directed, or structured, interview uses a checklist or preplanned strategy, which provides the same information on all applicants and minimizes personal bias.

The lecture: a. increases teacher-student involvement b. is student oriented c. reinforces material presented d. provides the most material covered in a short time

d. provides the most material covered in a short time The lecture is the portion where you provide as much material as possible in a short period of time.

To determine how profitable a department has been, determine the profit margin, which is: a. ratio of income to revenue b. ratio of costs to income c. ratio of overhead to sales d. ratio of profit to sales

d. ratio of profit to sales Profit margin is the most commonly used assessment of overall financial efficiency. It reflects the portion of sales volume remaining after paying all expenses. Profit margin= net profit / sales

The dietitian days to the client: "I hear you say that on some days you just cannot stay with the plan. Is that right?" this is: a. a statement of affirmation b. an open-ended question c. a reassuring response d. reflective listening

d. reflective listening Active/reflective listening is paraphrasing or repeating back what was just said.

Fresh meat contamination comes mainly from: a. botulism b. staphylococcus c. clostridium d. salmonella

d. salmonella Salmonella is a bacterial foodborne infection commonly caused by low acid foods at body or room temperature, raw/undercooked meat and poultry, eggs, raw dairy, seafood, melons.

After an outbreak of food-borne illness in the cafeteria, you discover one of your employees has an infected cut on his finger. You should: a. call the state public health office to investigate b. have the lab culture the kitchen c. fire the employee d. send the employee home until the cut has healed

d. send the employee home until the cut has healed

Unions usually advance employees based on: a. age b. skill c. merit d. seniority

d. seniority

Your patient is on Coumadin. Which foods would you make sure to consistently include in their diet? a. orange, peaches b. sweet potatoes c. beef, lamb d. spinach, collard greens

d. spinach, collard greens Consistent vitamin K to minimize bleeding risk. Vitamin K is rich in dark greens.

You called a meeting for 9AM. Three out of the five people arrived on time. What is the general guideline for starting meetings? a, wait until all participants have arrived b. wait 10 minutes past the stated starting time c, wait until the most significant members have arrived d. start on time

d. start on time

The tartness in fruits and vegetables is due to: a. flavones b. chlorophyll c. anthoxanthins d. tannins

d. tannins Tannins provides the tart taste in fruits/vegetables.

In order to influence a legislator one day before a vote, the Dietitian should: a. visit the legislative aide b. write a letter to the legislator c. send a postcard to the legislator d. telephone or email the legislator

d. telephone or email the legislator

Why are open-ended questions better during an interview? a. they provide the same info on all applicants b. there is less personal bias c. they are less time-consuming d. they provide more info

d. they provide more info

The main reason for keeping an inventory is: a. to plan next year's budget b. to prevent thievery c. to see how well you are following the budget d. to determine when and how much to reorder

d. to determine when and how much to reorder Inventory is a vital component of the re-ordering point, safety stock, etc.

Phenylalanine is a precursor for: a. serotonin b. catecholamines c. tryptophan d. tyrosine

d. tyrosine Remember by: Alaine can be a tyrant

What is the best way to reduce the fat content of a brownie recipe? a. use margarine instead of butter b. cut out all the fat c. cut out half the fat d. use prune puree in place of half the fat

d. use prune puree in place of half the fat Prune puree is a sugar, and thus the tenderidizing properties of sugar take place for the half fat. Using margarine instead of butter and cutting out half the fat would reduce the amount of tenderizing agent (fat), making a hard product. Cutting out all the fat would make it very hard.

Athletes should receive... a. salt pills only during the summer months b. extra protein c. carbohydrate loading two weeks prior to an event d. water during an event to replace lost fluids

d. water during an event to replace lost fluids Hydration/replacing fluid loses during exercise is vital. 16 oz fluid per lb weight lost.

When using the ABC inventory classification system, the tightest controls are needed for the: a) A items b) B items c) C items d) A, B, and C items

a) A items A items= vital, high value; accounts for 15-20% of total # of items but 75-80% of total value B items= moderate, medium value; items between A and C C items= trivial, low value; accounts for 60-65% of inventory items but only 5-10% of the value

How many minutes are needed to sanitize dishes when washing by hand using chlorine? a. 1 b. 2 c. 3 d. 4

a. 1 In the sanitizing portion of dish washing, can use chemical solution for 1 minute in lukewarm water (75 degrees F)

When goods are received, the delivery slip included is: a. an invoice b. a standing order c. the receiving order d. a purchase requisition

a. an invoice An invoice is an itemized bill for goods sold or services provided, containing individual prices, the total charge, and the terms (delivery slip).

The flour with the most starch is: a. cake b. whole wheat c. instantized d. durum

a. cake

To determine the reading level of a text: a. count the number of words with more than one syllable b. count the number of paragraphs c. count the average number of letters in the words d. count the number of sentences in a paragraph

a. count the number of words with more than one syllable Reading level is typically determined by finding the average number of polysyllabic words using readibility index such as SMOG index. Reading materials should be kept around 8th grade reading level for general public and 6th grade for audiences of low literacy.

Using the scientific approach to management, which of the following would result? a. decreased labor minutes per meal b. decreased labor hours per week c. increased labor minutes per meal d. increased labor hours per week

a. decreased labor minutes per meal Scientific approach is a work-centered management style in which the worker has to do repeated tasks to maximize efficiency. Labor minutes per meal may be one metric to assess efficiency

A facility with a labor turnover rate of 50% also experiences numerous equipment malfunctions. Both problems might be resolved through improved: a. employee training b. repair standards c. equipment quality d. ergonomics

a. employee training If equipment is malfunctioning frequently and there is a high turnover rate, this suggests that training may not have been sufficient for employees. Additional employee training may reduced turnover and occasions of equipment malfunctions

NADPH is: a. essential in the synthesis of fatty acids b. essential in the synthesis of glycogen c. involved in the catabolism of protein d. essential in transamination

a. essential in the synthesis of fatty acids Lipogenesis requires NADPH (think NADPH, ends with PH which sounds like "f", "f" for fat)

A Director from another Department sends you an email regarding construction. This is an example of what kind of communication? a. horizontal b. downward c. straight d. informal

a. horizontal Horizontal communication is between departments (i.e. nursing and nutrition) or between production and service within a department. Downward communication is from department head down to workers (chain of command). Informal channels (grapevine): meets social needs of group

What do these values represent... 2.5 mg/dl serum phosphorus level and 1.3 mEq/L serum magnesium level? a. hypophosphatemia, hypomagnesemia b. hyperphosphatermia, hypomagnesemia c. hyperphosphatemia, hyponatremia d. hyperkalemia, hypermagnesemia

a. hypophosphatemia, hypomagnesemia Normal phosphorus: 3-4.5 mg/dL Normal magnesium: 1.7-2.2 mg/dL

Freezing will: a. inhibit bacterial growth b. destroy toxins c. destroy bacteria d. destroy enzymes

a. inhibit bacterial growth Freezing food slows down decomposition by turning residual moisture into ice, inhibiting the growth of most bacterial species. Freezing temperatures curb the spoiling effect of microorganisms in food, but can also preserve some pathogens unharmed for long periods of time.

What is the main purpose of water in the body? a. it acts as a medium for cell metabolism b. it helps transport calcium through cell membranes c. it maintains electrolyte balance d. to maintain body temp

a. it acts as a medium for cell metabolism

A customer who has eaten lunch in the cafeteria becomes ill one hour after eating a chicken sandwich. What should the dietitian do first? a. listen carefully, take the complaint seriously and conduct an investigation b. accept responsibility and offer a coupon for a complimentary meal c. report the complaint immediately to the risk-management department d. ask where the person ate the night before and deny any responsibility

a. listen carefully, take the complaint seriously and conduct an investigation

A work schedule: a. lists both tasks and time b. lists only tasks to be performed c. is used for employee appraisal d. studies all aspects of the job

a. lists both tasks and time A work schedule lists hour by hour, training, tasks and time. A job breakdown lists what to do and how to do it - no time limits. A job analysis studies and analyzes all aspects of the job. Job description lists duties involved, conditions, and qualification; does not have detailed information as to what to do or time involved.

What medication is affected by serum sodium levels? a. lithium carbonate b. mallril c. valproate d. tetracycline

a. lithium carbonate Recommended to maintain consistent sodium and caffeine intake to stabilize levels while on lithium.

Bile is produced in the ____ and stored in the ______. a. liver; gallbladder b. gallbladder; liver c. liver; liver d. gallbladder; gallbladder

a. liver; gallbladder

Excess food soil in a dishmachine wash tank will result in foam that interferes with satisfactory dishwashing. The most appropriate corrective action is to: a. pre-rinse dishes before washing b. increase the amount of detergent c. increase water pressure in the wash tank d. drain the wash tank during meals and refill

a. pre-rinse dishes before washing Pre-rinsing liquefies fat, removes food before hot water coagulates proteins

Which hormone is involved in developing the placenta? a. progesterone b. estrogen c. lactogen d. testosterone

a. progesterone Progesterone develops Placenta

A patient with hyperphosphatemia, hyperkalemia, and hypermagnesemia may have: a. renal disease b. re-feeding syndrome c. pancreatic disease d. liver disease

a. renal disease When kidneys are not working properly, they can not properly filter out electrolytes and thus they accumulate in the body, causing hyperphosphatemia, hyperkalemia, and hypermagnesia. ***Note: don't get confused with hypophosphatemia, hypokalemia, and hypomagnesemia in refeeding syndrome.

In severe cirrhosis with ascites, diet therapy should be: a. restrict sodium b. restrict CHO and fat c. restrict protein and sodium d. restrict fat

a. restrict sodium Restrict sodium to prevent further ascites/fluid accumulation. Diet therapy would NOT include restricting protein. In severe cirrhosis, protein is essential as there is decreased synthesis of serum albumin, transport proteins, and clotting factors.

Cheilosis, stomatitis and a magenta tongue are signs of a: a. riboflavin deficiency b. niacin deficiency c. thiamin deficiency d. biotin deficiency

a. riboflavin deficiency

A hospital cafeteria that currently serves 500 meals at noon must increase service to 800 without adding food production staff. The best action would be: a. simplify the menu b. redesign the kitchen c. rearrange employee work schedules d. replace current equipment with fast-performance equipment

a. simplify the menu To quickly response to this situation, the best action would be to simplify the menu so less labor is required making variations of meals.

All baking powders contain: a. sodium bicarbonate b. tartrate c. phosphate d. acetate

a. sodium bicarbonate Baking soda = sodium bicarbonate Baking powder = sodium bicarbonate + acid *Remember difference by baking powder has more power than baking soda

If dishes are not cleaned properly in the dishmachine, the first thing to check is: a. the temperatures of the various cycles b. the number of items being serviced in a short time c. the length of time between a meal and dishwashing d. the number of employees assigned to the process

a. the temperatures of the various cycles If a dishwasher is not working properly, the first thing you want to check is whether the temperature of the solution is where it should be.

A parenteral solution includes 65 grams of protein, 200 grams dextrose and a 20% fat emulsion at 7ml per hour. How many total calories will this provide in a 24 hour period? a. 1155 b. 1276 c. 1307 d. 1385

b. 1276 65g protein x 4 = 260 kcal 200g dex x 3.4 = 680 kcal 2 kcal/mL x 168 mL = 336 kcal 260 + 680 +336 = 1276 kcal

A #10 can holds how many cups of product? a. 10 b. 13 c. 12 d. 5

b. 13 #10 can = 6 cans per case, 6 lb 9 oz, 13 cups, 20-25 servings (it is also considered 3 quarts but dont get confused about cups because 3 quarts = 12 cups, most sources indicate 13 cups so just use that)

You have invested in new hardware and software that will reduce the labor hours needed to complete a task. What is the payback period? Hardware $3500 Software $2400 Staff instruction $1000 Labor hours saved: 6 per week at $20/hour a. 6 years b. 13 months c. 20 months d. one year

b. 13 months Payback period = sum of costs / labor hours saved $3500 + $2400 + $1000 = $6900 6 hrs/week x $ 20/hr = $ 120/week 6900/120 = 57.5 weeks (13 months) (To calculate months from weeks, divide by 4.34)

What is the lowest acceptable holding temperature while serving? a. 120' F b. 140' F c. 160' F d. 180' F

b. 140'F The temperature danger zone ranges from 40-140'F, so anything below 140'F would not be acceptable.

What is normal weight gain during the first trimester? a. 1-2 lb b. 2-5 lb c. 5-8 lb d. 8-10 lb

b. 2-5 lb Normal weight gain: 1 lb / month in first three months 1 lbs per week thereafter Subsequently, normal weight gain in the first trimester (12 weeks) is about 3 lbs. After the first trimester, 4 lbs a month is normal. This makes sense because think of how much more growth occurs in 2nd and 3rd trimester vs 1st, so it would make sense you want to gain more weight (and eat more!).

How much protein is needed for a patient with a stage 3 burn? a. 10-20% total calories b. 20-25% of total calories c. 25-30% total calories d. 25-40% total calories

b. 20-25% of total calories

Forty entrees of fish cost $2 per serving. Total sales for the fish came to $240. What was the food cost percentage? a. 25% b. 33% c. 50% d. 60%

b. 33% 40 entrees x $2 = $80 $80/$240 = 33%

The maximum hang time for open enteral systems is: a. 2 hours b. 8 hours c. 6 hours d. 4 hours

b. 8 hours Open EN system maximum hangtime is 8 hours, while closed EN system maximum hangtime is 24-48 hours. Open EN systems are at increased risk for contamination, while closed systems are more sterile and thus can hang longer.

To estimate REE in normal weight and obese individuals, use: a. Harris Benedict b. Mifflin St. Jeor c. BMR d. indirect calorimetry

b. Mifflin St. Jeor Mifflin St. Jeor measures REE/RMR Harris Benedict measures BEE/BMR (Benedict = BMR)

If a patient cannot metabolize urea properly, what will accumulate in his blood? a. uric acid b. ammonia c. protein d. glucose

b. ammonia The urea cycle (also known as the ornithine cycle) is a cycle of biochemical reactions that produces urea from ammonia. During the urea cycle, highly toxic ammonia is converted to urea for excretion. If body can't excrete urea normally, ammonia will build up.

Several patients receiving pureed foods at a long term care facility have developed salmonella infections. The most likely cause is: a. pots and pans were washed and left to air dry b. blender was washed in warm soapy water c. the canned pureed meat was stored at 70 degrees d. the eggs from breakfast were held on the hot line at 165F

b. blender was washed in warm soapy water Salmonella is typically caused by poultry, eggs, dairy, or produce contaminated with salmonella. Prevention includes preventing cross-contamination, washing hands, and cooking foods to minimum temperatures. In this example, hot held eggs were held at/above recommended temperature of 155 degrees F for 17 seconds and thus the risk of salmonella is mitigated. Pots and pans that are cleaned and sanitized properly do not pose a risk of salmonella when left to air dry. Canned pureed meat at 70 degrees is also appropriate storage temperature/conditions. The most likely cause of salmonella infections is blender that was washed in warm soapy water, as this does not indicate that the blender was sanitized which would be necessary to kill the Salmonella bacteria.

Which of the following would likely be a cause of marasmus? a. leaving a patient for two weeks on D5W b. chemotherapy c. following a 20 gram protein diet for two months d. antibiotic therapy

b. chemotherapy Marasmus is protein-calorie malnutrition. As opposed to Kwashiorkor where the patients have big bellies, these patients would cachectic. Chemotherapy would most likely cause marasmus due to side effects of treatment. Common side-effects include stomatitis/mucositis, N/V, anorexia, fatigue. Subsequently, those on chemo are at high risk for developing protein-energy malnutrition based on side-effects for treatment that makes them not want to eat. A patient being on just D5W for two weeks is not acceptable and they are acutely undernourished, but at this point it wouldn't classify will full on protein-calorie malnutrition. The body would utilize it's energy stores and D5W calories. Of course, if this continued, they would develop marasmus. Following a 20 gm protein diet for two months may cause protein-malnutrition, or Kwashiorkor, but not protein-energy malnutrition if otherwise eating enough kcals. Antibiotic therapy doesn't make sense either.

Which minerals are involved in carbohydrate metabolism a. cobalt, zinc b. chromium, zinc c. copper, chromium d. iron, zinc

b. chromium, zinc Chromium aids in insulin action and zinc enhances insulin action.

What would a vegan not eat? a. coleslaw made with oil and vinegar b. congealed fruit salad c. salad with tofu dressing d. peanut butter

b. congealed fruit salad Contains gelatin

The kitchen layout below is characteristic of which foodservice system? Deck ovens / Range / Tilting skillet / Refrigerator / Freezer / Preparation counter / Meal assembly / Delivery carts a. commissary b. conventional c. ready prepared d. assembly-serve

b. conventional In conventional food production systems, all preparation done on premises where meal are served, foods are prepared and served the same day. Subsequently, all the standard preparation equipment would be needed, along with meal assembly and delivery carts at meal times.

What is the best way to cook roast? a. sear the meat first, roast at 400F b. cook slowly in the oven at 325F c. cook it at 400F for 10min, then at 350F d. brown the meat, then cook it at 350F

b. cook slowly in the oven at 325F

Which is permitted on a diet which excludes gluten? a. rye b. corn c. barley d. wheat bread

b. corn NO wheat, rye, oats, barley, bran, graham, malt, bulgar, couscous, durum, orzo, thickening agents OK: corn potato, rice, soybean, tapioca, arrowroot, carob bean, guar gum, flax, amaranth, millett, teff, quinoa

What must be fortified with folic acid? a. skim milk b. cornmeal c. orange juice d. canned vegetables

b. cornmeal To further improve folic acid intake in women of childbearing age, the US Food and Drug Administration (FDA) mandated in 1996 that by January 1, 1998, all enriched cereal-grain products (e.g., wheat flour and related products, corn meal, and rice) would be fortified with folic acid at 140 micrograms per 100 grams of product. Cornmeal contains flour. During processing, folate is lost and thus must be fortified.

The process of comparing a program's benefits to net savings is called: a. cost-effectiveness analysis b. cost-benefit analysis c. formative evaluation d. program evaluation

b. cost-benefit analysis Cost-benefit analysis determines whether the goal of the intervention is worthwhile in terms of cost; state objectives clearly and quantifiably; calculates direct and indirect costs

Pyridoxine acts as a coenzyme in: a. iron transfer b. deamination and transamination c. fat transfer through the lymphatic system d. osmotic pressure of body fluids

b. deamination and transamination Pyridoxine (vitamin B siX), is a coenzyme in deamination and transamination (protein metabolism). More specifically, pyridoxine is the coenzyme for AST/ALT enzyme that is inolved in transamination process. Ex: alpha ketoglutamate + amino acid --- vit B6 --> glutamate + alpha keto acid

You are preparing dinner for a 500 bed facility. The menu includes roast beef, mashed potatoes, and carrots. Which equipment is best suited for this task? a. a convection oven and a tilting braising pan b. deck ovens and pressure steamers c. a microwave oven and trunion kettle d. a rotary oven and a steamer

b. deck ovens and pressure steamers A deck oven can be used when production is high and space is limited. Pressure steamers facilitate batch cooking (vegetables) and reduces long holding periods.

When switching from a conventional to a convection oven, a. increase the temperature by 15 degrees b. decrease the temperature by 25 degrees c. increase the temperature by 12 degrees d. decrease the temperature by 5 degrees

b. decrease the temperature by 25 degrees A conventional oven has inconsistent heating, uneven cooking, and slow cook times requiring a higher temperature. A convection oven evenly distributes heat, requires a lower temp (25-35 degrees lower than conventional oven) and takes less time.

A renal patient has come for dialysis on Monday morning with a serum sodium of 130 mEq/L, a BUN of 100 mg/dl, creatinine 8.0, and a 4KG weight gain since his last dialysis on Friday morning. His laboratory indicators were in acceptable ranges on Friday afternoon. What would you expect happened over the weekend? Looking at the above question, what else would you expect to see? a. increased bicarbonate, increased potassium, decreased phosphorus b. decreased bicarbonate, increased potassium, increased phosphorus c. decreased bicarbonate, decreased potassium, increased phosphorus d. increased bicarbonate, increased potassium, increased phosphorus

b. decreased bicarbonate, increased potassium, increased phosphorus Since this is a renal patient, automatically think metabolic vs respiratory in terms of acid-base. The kidneys are responsible for managing bicarbonate. If kidneys are functioning poorly, you would expect that they are not releasing bicarbonate (decrease bicarbonate), which may lead to metabolic acidosis. In addition to acid-base balance, since kidneys are not working properly and the patient is non-compliant with the renal diet, you would expect to see an increase in potassium and phosphrous.

When green vegetables begin to lose their color during serving, consider: a. changing vendors or brands b. decreasing holding time during heating c. use different cooking equipment d. changing the storage temperature

b. decreasing holding time during heating Reduce holding time to preserve color.

An athlete weighs more than the average person of his height. What should you do first? a. put him on a slow weight reduction diet b. examine other anthropometric measurements c. have him increase his exercise d. suggest he drink more water

b. examine other anthropometric measurements Athletes may have much larger muscle mass than the average person and thus typical anthropometrics like BMI are not reliable measures.

A food service manager who supervises 35 employees has a problem with discipline and increased absenteeism. Why? a. decreased unity among managers b. excessive span of control c. decreased unity of control d. excessive unity of command

b. excessive span of control If a foodservice manager is supervising too many employees, it can be more difficult to effectively manage them, especially if they aren't motivated or require additional training.

An example of a tertiary prevention program is: a. at the workplace, coordinate walking groups at lunchtime b. exercise classes in a cardiac rehabilitation program c. cooking classes for heart-healthy eating d. workplace screening for hypertension

b. exercise classes in a cardiac rehabilitation program The purpose of tertiary prevention programs is to reduce severity, manage complications as disease progresses. Focus on rehabilitation efforts Ex: cardiac rehab programs

If an IDDM tells you she eats meals on an irregular schedule, you should: a. obtain more information about her usual eating habits b. explain that insulin therapy is related to intake c. do nothing if blood sugar levels are okay d. ask her to complete a detailed food record

b. explain that insulin therapy is related to intake Since she is insulin dependent, you need to address insulin and the relationship to diet first. If she does not understand this, it would be difficult to talk more about the importance of diet in managing DM.

A patient comes to you with a diet that you know is not good to follow. What should you do? a. tell him its not good b. explain why its not good c. tell him to only follow what you have provided d. let him do as he wishes

b. explain why its not good

The catecholamines released during stress cause: a. hypertension b. hyperglycemia c. diuresis d. elevated BUN

b. hyperglycemia Epinephrine, a catecholamine, suppresses insulin secretion during trauma, leading to hyperglycemia.

A new mother may hesitate to become involved with a breast-feeding informational program due to: a. lack of funds b. lack of social support c. lack of knowledge about benefits d. lack of medical care

b. lack of social support

The first step in planning a continuing education program is to: a. locate the guest speaker b. survey participants to see what interests them c. survey other groups to see what they are doing d. select a topic that has not been offered lately

b. survey participants to see what interests them

If an employee works 5 days each week, how many regular employees can be covered by one relief employee? a. 1.5 b. 2 c. 2.5 d. 3

c. 2.5 5/2 = 2.5

Work simplification studies: a. looks at the job as a whole b. increase worker responsibility c. decrease costs and increases productivity d. increase worker interest in the job

c. decrease costs and increases productivity Work simplification aims to eliminate unnecessary parts of the job and those that add no value. They increase productivity and decrease costs.

Which of the following foods is the best source of omega-3 fatty acids a. shrimp b. anchovies c. sardines d. olive oil

c. sardines

A hospital administrator would be most concerned with: a. the increase in the number of elderly admissions b. the increasing growth of outpatient services c. the increase in patient's length of stay d. the increase in diabetic admissions

c. the increase in patient's length of stay

Which is a measure of somatic protein? a. serum albumin b. serum transferrin c. mid-arm muscle circumference d. triceps skinfold

C - mid-arm muscle circumference Somatic protein status is a measure of skeletal muscle. Visceral protein status is a measure of all other proteins (organs, viscera, serum, blood cells, white blood cells). Serum albumin and serum transferrin are visceral proteins (in blood). Triceps skinfolds measures body reserves. Arm muscle area measure skeletal muscle mass

A 60kg female receives 2700 calories on PN. The calorie to nitrogen ratio is 150:1. How many grams of nitrogen is she getting? a. 14 b. 16 c. 18 d. 20

c. 18 150:1 = 150 kcals to 1 gm nitrogen 2700/150 = 18 gm nitrogen

Which of the following indicates protein calorie malnutrition? a. a creatinine height index of 93% b. height for weight ratio of 89% c. triceps skinfold and arm muscle circumference of 79% d. serum albumin of 4.5; transferrin of 410

C - triceps skinfold and arm muscle circumference of 79% Protein-calorie malnutrition would be indicated by triceps skinfold and AMC of 79%. Triceps skinfold assesses body fat reserves and thus could assess fat loss. Tricep skinfold and AMC together tell arm muscle area. Cretinine height index is the ratio of creatinine excreted/24 hours to height; stimates lean body mass- somatic protein. Normal creatinine height index is >/=80%, so this is a normal range. Serum albumin would not be an indicator of nutrition malnutrition.

You are planning the budget for next year. Labor costs will increase by 10%. Food costs will increase by 5%. Operating costs will increase by 2%. This year, total sales totaled $1,000,000. Labor costs were 40% of income, food cost was 40% of income, and operating costs were 20% of income. What is the projected budget? a. $1,064,000 b. $1,640,000 c. $1,840,000 d. $1,170,000

a. $1,064,000 .4 x 1,000,000 = 400,000 x 0.1 = 40,000 .4 x 1,000,000 = 400,000 x 0.05 = 20,000 .2 x 1,000,000 = 200,000 x 0.02 = 4,000 40,000 + 20,000 + 4,000 = 640,000 + 1,000,000 = 1,064,000

Financial data for 1 month is shown. What is the net profit? Cafeteria revenue $119,984 Patient meals revenue $146,250 Catering sales $1,850 Food costs $110,234 Labor costs $147,446 Other costs $10,204 a. $200 b. $10,404 c. $167,850 d. $268,084

a. $200 119984 + 146250 + 1850 = $268084 (revenue) 110234 + 147446 + 10204 = $267884 (costs) $268084 - $267884 = $200

Normal saline has ___mEq sodium/L a. 154 b. 100 c. 50 d. 200

a. 154

In the Dietary Guidelines, what represents the fat included? a. 20-35% calories, <10% saturated fat b. 30% calories, <6% saturated fat c. 35% calories, <15% saturated fat d. 35% calories, <10% saturated fat

a. 20-35 calories, <10% saturated fat ***New DGA's recommend <10% saturated fat but don't give specifics on overall fat intake. However, typically recommend that patients get ~20-35% fat anyways so just remember that as reference.

A $240 income was generated selling 40 pieces of fish with a raw food cost of $2.00 each. What is the %food cost? a. 33% b. 40% c. 20% d. 10%

a. 33% FC = amount sold of item/total sales $2 x 40 = $80 $80/$240 = 33%

How many non-protein calories are provided by 2 liters of a 7% Aminosyn and 1 liter of 10% dextrose in water? a. 340 b. 390 c. 170 d. 255

a. 340 Aminosyn = amino acid solution; protein calories 10 gm per 100mL 10 x 10 = 100 gm 100 gm x 3.4 kcal = 340 kcals

The primary reason for portion control in food service is: a. cost control b. to standardize serving sizes c. customer satisfaction d. weight reduction data

a. cost control Standardizing portions are one of the primary cost control methods in food service. Other methods include menu planning, type of service, purchasing methods, receiving control, and storage and production control.

Green peas held on the serving line may turn olive green due to: a. pheophytin c. chlorophyllin c. anthoxanthins d. flavones

a. pheophytin

Cost-effectiveness studies: a. use the results of outcomes research b. evaluate direct and indirect benefits c. compare costs to benefits d. determine whether the goal is worthwhile in terms of its cost

a. use the results of outcomes research Cost-effectiveness analysis assumes that the goal of project is worthwhile. The method of intervention is the most effective in terms of value. Compares costs of alternative strategies. Utilizes outcomes research, which assesses the effectiveness of a nutrition intervention against one or more reasonable alternatives and determine value of health care resources consumed when each alternative is used

Costs which are proportionately responsive to changes in volume are: a. variable b. sunk c. hidden d. fixed

a. variable Variable (indirect) costs are costs that change in sales; directly involved in service to customer. Ex: silver, china, food, uniforms, laundry, repairs, benefits. Sunk costs are cost that has already been incurred and cannot be recovered. Ex: cost involved in studying merits of new computer. Hidden costs of 10% may be added to food cost to cover unproductive costs Ex: losses in preparation, cooking, serving, unavoidable waste. Fixed costs are not affected by sales volume, not evident in day to day activities. Ex: rent, taxes, insurance, interest on debt, depreciation.

Retrovir (NRTI) can lead to low levels of: a. vitamin B12, copper, zinc b. water-soluble vitamins c. calcium and phosphorous d. folate, pyridoxine, vitamin C

a. vitamin B12, copper, zinc Retrovir is an NRTI, which is a medication used in the treatment of HIV.

Which supplements are recommended with hemodialysis? a. vitamins C, B6, folate, B12 b. vitamins A, D, E, K c. thiamin, riboflavin, vitamin C d. thiamin, folate, vitamins E and C

a. vitamins C, B6, folate, B12 Water soluble vitamins are most effected by HD, as during dialysis, blood is cleaned/purified in a dialysate and water-soluble vitamins and some proteins are lost. Mneumonic: Ce, BeBe I am a FOol for you (vitamin C, vitamin B6, vitamin B12, folate); iron, zinc and vitamin D may potentially be supplemented as well. Vitamins A, D, E, and K are fat-soluble vitamins, D may supplemented by not the others. RDA for thiamin and riboflavin are recommended, but not additional supplementation.

Metabolites of the Kreb's cycle are: a. water, energy, carbon dioxide b. energy and pyruvic acid c. electrolytes and water d. lactic acid and glycogen

a. water, energy, carbon dioxide Kreb's cycle produces NADH and FADH2, which are essential in ECT. In addition, a lot of CO2 and water are produced.

Which of the following responses by a counselor indicates "reflection"? a. "yes, you can do that" b. "you said, 'you want to lose weight?'" c. "explain what you mean by that please" d. "I can help you"

b. "you said, 'you want to lose weight?'" Active/reflective listening is paraphrasing or repeating back what was just said.

How wide should an aisle be for two people with a mobile cart to move through? a. 40" b. 50" c. 60" d. 72"

b. 50"

How does a new supervisor gain respect? a. show employees different ways to do their job b. work with a different employee each day c. communicate regularly with them to keep them informed d. smile a lot

c. communicate regularly with them to keep them informed

Publicity is a component of which part of the marketing mix? a. product b. place c. promotion d. price

c. promotion Promotion strategies include publicity (news release, media, radio), direct mail packages, and paid ads.

A standing height should first be obtained when an infant is how many months old? a. 18 b. 20 c. 22 d. 24

d. 24

What is the food cost percentage if the cost of food is $325 and the income is $865? a. 38% b. 36% c. 34% d. 32%

a. 38% Food cost percentage = daily food cost/daily income 325/865 * 100 = 38%

According to the diabetic exchange lists, which of the following is equivalent to one medium fat protein? a. 4 ounces tofu b. 2 ounces pork c. 2 eggs d. 2 T peanut butter

a. 4 ounces tofu 4 oz tofu = 1 medium-fat protein (0 gm CHO, 7 gm pro, 5 gm fat, 75 kcal) 2 oz pork = 2 medium-fat protein (0 gm CHO, 14 gm protein, 10 gm fat, 150 kcal) 2 eggs = 2 medium-fat protein exchanges (0 gm CHO, 14 gm protein, 10 gm fat, 150 kcal) 2 T peanut butter = 2 high-fat protein (0 gm CHO, 14 gm protein, 16 gm fat)

How many calories are in 300ml of a 5% dextrose solution a. 51 b. 60 c. 15 d. 200

a. 51 5 gm dextrose per 100 mL 5 gm x 3 = 15 gm dextrose per 300mL 15 gm x 3.4 = 51 kcal

What percent of protein and fat converts to glucose? a. 58% protein, 10% fat b. 10% protein, 60% fat c. 30% protein, 30% fat d. 20% protein, 40% fat

a. 58% protein, 10% fat 58% of amino acids are glucogenic amino acids, meaning they yield glucose following deamination. 10% of fat in the form of glycerol can be coverted to glucose.

A patient's I/O form indicates the following data. What is his total insensible fluid loss? Input(ml) Oral fluids: 1800 Solid foods: 800 Metabolic water: 250 Total: 2850 Output (ml) urine: 1900 intestinal: 250 lungs and skin: 700 total: 2850 a. 700ml b. 950ml c. 1900ml d. 2850ml

a. 700ml Insensible fluid loss is the amount of body fluid lost daily that is not easily measured, from the respiratory system, skin, and water in the excreted stool. Urine would not be an insensible loss because it can be easily measured. I am assuming that "intestinal" losses means total stool output, not the amount of water in excreted stool. Subsequently, the insensible losses would be just from lungs and skin.

300ml 60% dextrose; 500ml 10% amino acids; 200ml 20% lipid; The amounts stated are given per liter. Total nutrient mixture administered at 65 ml/hour for 24 hours Using the above formula, determine the protein intake per day in grams a. 78 b. 80 c. 84 d. 86

a. 78 65mL/hr x 24 hours = total 1.56 L Current volume = 300 mL + 500 mL + 200 mL = 1000mL Requires 1.56 MORE volume than what is provided Protein: 10 kcal per 100 m, so 10 kcal x 5 = 50 gm protein x 1.56 = 78 gm

A female, 5'7" tall, weighs 115 lbs. Six months ago she weighed 130 lbs. What is her percent of ideal body weight a. 85% b. 83% c. 81% d. 87%

a. 85% IBW= 100 + 5lb for every inch over 5' IBW = 100 + 5 (7) = 135lbs Current wt = 115lbs 115lbs/135lbs = 85% of IBW

A TPN solution is to be delivered at 50ml per hour at 3/4 strength. What is the appropriate order? a. 900ml formula, 300ml water b. 600ml formula, 600ml water c. 800ml formula, 400ml water d. 300ml formula, 900ml water

a. 900ml formula, 300ml water 50mL x 0.75 (because 3/4 strength) = 37.5mL/hr of FORMULA, 12.5mL/hr of WATER For formula: 37.5mL/hr x 24 hrs = 900mL formula For water: 12.5mL/hr x 24 hrs = 300mL water

What is not a likely cause of failure to thrive in a child? a. a vegetarian diet b. a chronic illness c. parental food restrictions due to them being overly concerned with obesity d. lack of fiber in the diet

a. a vegetarian diet Failure to thrive is defined as slow physical development in a baby or child. It's caused by a baby or child not having enough nutrition. A child with FTT is at risk for problems such as short height, behavior problems, and developmental delays. FTT has many possible causes. Chronic illness and parents restricting foods are obvious potential causes. Lack of fiber in diet apparently may also cause FTT. If a child is constipation, they are will be more likely to experience anorexia, nausea, and overall malaise so their intake will decrease. The correct answer is vegetarian diet. A vegetarian diet including fruits, vegetables, whole grains, and protein-sources will support a child's growth and development.

Which patient has marasmus? Patient A - Male Serum albumin 3.5 Transferrin 275 Triceps skinfold 3 MAMC 15 TLC ----- Patient B - female Serum albumin 2.6 Transferrin 125 Triceps skinfold 16.8 MAMC 24.1 TLC 1000 Patient C - male Serum albumin 4.0 Transferrin 450 Triceps skinfold 17 MAMC 28.1 TLC 3500 a. A b. B c. C d. A, B

a. A Patient A is the only one who has marasmus. Serum albumin is not a good indicator of nutritional status so disregard it. **Note, Jean indicates serum albumin normal in marasmus. Transferrin is WNL. Triceps skinfold is 3mm, which is well below the standard for males of 12.5mm. Finally, the AMC is 15cm. Normal arm muscle area (AMA) is 25.3 cm in males, which this patient falls well below. Subsequently, this patient has severe fat depletion and thus marasmus is likely. Patient B: tricep skinfold WNL, AMC WNL, TLC is low (likely infection as albumin also low) Patient C: transferrin high, triceps WNL, AMC WNL, TLC WNL Normal albumin: 3.5-5 g/dL Normal transferrin: greater than 200 mg/dL (204-360 mg/dl) Normal triceps skin fold: 12.5mm in males, 16.5 mm in females Normal arm muscle area (AMA): 25.3 cm in males, 23.2 cm in females

Which supplements are recommended with cirrhosis? a. B complex, calcium ,zinc, magnesium b. fat-soluble vitamins and zinc c. water-soluble vitamins and magnesium d. chromium, zinc, riboflavin, thiamin

a. B complex, calcium, zinc, magnesium Cirrhosis is inflammation associated with liver dz that leads to formation of fibrous scar tissue. Cirrhosis messes with fluid status and doesn't allow vitamins to be stored, and thus water soluble B-vitamins are recommended. ***

Which surveillance system monitors changes in health risk behaviors over time and can be used to target those most at risk? a. BFRSS b. NHANES c. TANF d. Health and Diet survey

a. BFRSS Behavioral Risk Factor Surveillance System IS A Health-related telephone survey that collects data from US adults about health-related behaviors, chronic health conditions, and use of preventative services. Data collected include health status, access to healthcare, use of tobacco/alcohol, injury control behaviors (i.e., seat belt), food frequency intake, dieting, preventative services utilized

The absorption of calcium and iron is likely to be affected by the: a. Billroth II procedure b. Ileostomy c. Cholecystectomy d. Billroth I procedure

a. Billroth II procedure Billroth II procedure is a gastrojejunostomy, in which the remaining stomach is attached to the jejunum, bypassing the duodenum. Calcium and iron are primarily absorbed in the duodenum and thus are most likely to be affected. In Billroth I, (gastroduodenostomy), the remaining stomach is attached to the duodenum

Which program supports public and non-profit food service programs for homeless shelters? a. CACFP b. SFSP c. SNAP d. CSFP

a. CACFP Child & Adult Care Food Program. Supports foodservice programs for family day care centers, adult day care centers, neighborhood houses, and homeless shelters. It has the same eligibility as NSLP and is regulated by USDA.

Which guideline is used in planning meals for healthy people? a. EAR b. UL c. AI d. DRI

a. EAR Estimated average requirements the amount of a nutrient that is estimated to meet the requirement for a specific criterion of adequacy of half of the healthy individuals of a specific age, sex, and life-stage.

Where can a pregnant teen learn to cook? a. EFNEP b. child nutrition services c. UNICEF d. WIC

a. EFNEP EFNEP improves food practice of low income homemakers with young children. Works with small groups. Does not provide food. WIC does not provide regular cooking classes so EFNEP would be most appropriate.

A poor, healthy 19 year old mother is unsure how to feed her 4 year old child. Which program may offer her the most help? a. EFNEP b. WIC c. HHS d. CACFP

a. EFNEP Since this mother is unsure of HOW to feed her 4 year old, and the question doesn't indicate she needs help obtaining foods, EFNEP would be the best option. EFNEP would be able to teach the mother cooking skills.

Responsibility, recognition by management, and participation in decision-making are all considered true motivators by: a. Hertzberg b. Taylor c. Maslow d. Likert

a. Hertzberg Hertzberg's Two Factory Theory states that satisfaction stems from hygiene factors (prevent dissatisfaction) and motivating factors (encourage members). Hygiene factors do not produce motivation but can prevent motivation from occuring. Examples of hygiene factors include fair wage, working conditions, retirement benefits. Motivators call forth energy/enthusiasm, job enrichment

Which of the following should be included in the diet for celiac disease? I. decrease intake of eggs II. use potato and rice flour III. MVI vitamin B12 and iron IV. Low calorie, high fat, high protein a. II, III b. II, IV c. I, II, IV d. II, IV

a. II, III Celiac disease (a type of Non-tropical sprue) is a immune reaction to gliadin, which affects the jejunum and ileum. Treatment for Celiac disease includes a gliadin-free, gluten-restricted diet. Foods okay for Celiac disease include corn, potato, rice, soybean, tapioca, arrowroot, carob bean, guar gum, flax, amaranth, millet, teff, quinoa. Foods NOT okay for Celiac disease include wheat, rye, oats, barley, bran, graham, malt, bulgur, couscous, durum, orzo, thickening agents.

Which survey is repeated every few years? a. NHANES b. WHO c. Ten State d. FAO

a. NHANES National Health and Nutrition Examination study is an ongoing (repeated) survey to obtain information on the health of American people. Evaluates clinical, chemical (hemoglobin, hematocrit, cholesterol), anthropometrics, nutritional data. WHO is the world health organization, not a survey. Ten State was a survey that was conducted between 1968 and 1970 to describe the magnitude of malnutrition and nutrition problems in the country among those living at the lowest income quartile. Ten state was conduceted because no nutrition data to answer these questions existed at this time; this was the first survey to evaluate nutritional status among large segment of US population. FAO is Food and Agricultural Organization, which is an international organization aimed at increasing efficiency of production and distribution of foods.

An angel food cake is made without cream of tartar. What is the result? a. a yellowy cake b. a bright white cake c. a cake with large volume d. a very tender cake

a. a yellowy cake A cake will be yellow if excess baking soda is added (alkaline). Similarly if you do not add something acidic (like cream of tartar), then the cake will be too alkaline and still become yellowish.

A program that links sources of unused, cooked and fresh foods with social service agencies that serve the hungry is the: a. PPFP b. USDA c. CACFP d. TEFAP

a. PPFP Prepared and Perishable Food Programs (PPFPs) fall under the Community Food Security Initiative. These nonprofit programs link sources of unused, cooked and fresh foods with social service agencies that serve the hungry. USDA is a federal program responsible for developing and executing federal laws related to farming, forestry, rural economic development, and food. CACFP, Child and Adult Care Food Program, supports public and non-profit food service programs for family day care centers, neighborhood houses, homeless shelters, nonresidential adult daycare centers. TEFAP, The Emergency Food Assistance Program, provides quarterly distributions of commodity foods by local, public, or private nonprofit agencies, food banks, soup kitchens, homeless shelters- short term hunger relief.

The formula that counts the number of polysyllabic words in text to calculate the reading level is the: a. SMOG index b. BACM index c. Smith Reading index d. Text index

a. SMOG index Reading level is typically determined by finding the average number of polysyllabic words using readibility index such as SMOG index. Reading materials should be kept around 8th grade reading level for general public and 6th grade for audiences of low literacy.

Which of the following is a non-nutritive sweetener? a. Stevia b. Sorbitol c. Mannitol d. Agave

a. Stevia Stevia is a constituents of the leaves of Stevia rebaudiana (Bertoni) Bertoni, a plant native to parts of South America. They are non-nutritive sweeteners and are reported to be 200 to 400 times sweeter than table sugar. Sorbitol and mannitol are types of sugar alcohols. Sugar alcohols provide fewer calories (about a half to one-third less calories) than regular sugar. This is because they are converted to glucose more slowly, require little or no insulin to be metabolized and don't cause sudden increases in blood sugar. Agave is a sweetener from plants that contains fructose.

Which of these work center designs discourages through traffic? a. U-shaped b. back to back parallel c. straight line d. square

a. U-shaped A U-shaped design maximizes space and would discourage through traffic. A straight design would be more likely to be used for through traffic.

Who is most at risk from protein calorie malnutrition? a. a cancer patient on chemotherapy b. a patient with gastric ulcers c. a patient with Crohns disease d. a patient with megaloblastic anemia

a. a cancer patient on chemotherapy A patient actively on chemotherapy treatment would be most at risk for protein-calorie malnutrition due to the likely side effects of said treatment, including dygeusia, mucositis/stomatitis, nausea/vomiting, etc. A patient with megaloblastic aemia and gastric ulcers are least at risk of malnutrition compared to other answers. If the Crohn's patient was having an active flare, that may be the answer but since it doesn't specific that we assume they are undercontrol/in remission, so in that case it wouldn't be as much of a risk.

A study design that tracts the occurrence of infections in patients who are at nutritional risk and in the hospital for longer than seven days is: a. a cohort study b. a time series method c. a case control study d. descriptive research

a. a cohort study A cohort study looks at exposures, either retrospectively or retrospectively. For example, a prospective cohort would look at smokers vs non-smokers and follow them for 5 years so see who develops lung cancer among exposed and non-exposed. In this example, they plan to follow one group who are at nutrition risk (exposed) and those in the hospital for greater than seven days (non-exposed) to compare rates of infection. This is a prospective cohort. In order to be a case control, it would have to be retrospective and look at those with infections vs those without and then look back at exposures.

The line type of organizational chart shows: a. a direct flow of authority from top to bottom b. authority flows from side to side c. all advisory positions d. informal relationships

a. a direct flow of authority from top to bottom A line type organizational chart would show the direction of authority from top to bottom (upper management to staff)

Quality assurance is: a. a measurement of the quality of care provided to patients b. food service oriented c. control of the distribution and service of food d. control of the budget

a. a measurement of the quality of care provided to patients Outcomes, meeting standards, prevention, standard procedures, and diagnostics are key aspects of quality assurance programs.

The Health Risk Appraisal (HRA) calculate: a. a population's general health status b. the health status of individuals c. the health status of an individual over the age of 65 living independently d. the health status of an outpatient with chronic disease

a. a population's general health status Health Risk Appraisal (HRA) survey categorizing a populations general health status. Consists of questionnaire, calculations that predict risk of disease, educational message to participants.

A written record of items ordered, with quantities and specifications is: a. a purchase requisition b. a standing order c. an invoice d. a receiving order

a. a purchase requisition A purchase requisition, thee first document used in the purchasing process, is internal form used to request items from the purchasing manager. A standing order is a type of purchase order issued to establish an account with a specific supplier to obtain specific services during a specified time period. An invoice is an itemized bill for goods sold or services provided, containing individual prices, the total charge, and the terms (delivery slip).

Sugar tenderizes a baked good by: a. absorbing some of the water that gluten needs b. increasing the strength of the gluten c. increasing the action of the leavening agent d. starting gluten development

a. absorbing some of the water that gluten needs Sugar is hygroscopic, meaning it modifies texture by tenderizing. Sugar softens gluten and prevent gluten development by absorbing some of the water that gluten needs.

A concern with parenteral feeding is: a. hypokalemia b. hypercalcemia c. hyponatremia d. hypernatremia

a. hypokalemia PN has increased risk of refeeding syndrome, which is characterized by hypokalemia, hypophosphatemia, hypomagnesemia. Hyperglycemia is also common.

Which of the following is a current asset? a. accounts receivable b. china c. small equipment d. retained earnings

a. accounts receivable Current assets are liquid assets, or those easily converted to cash (ex: accounts receivable). Accounts receivable: money owed to the company that will be fulfilled promptly, such as pending credit card payments or pending payments from a large catering order. Retained earnings is the income set aside by the company instead of being distributed to shareholders.

Which stage of change is represented by this comment: "I served the vegetable dish to my family and surprisingly we all enjoyed it" a. action b. preparation c. maintenance d. contemplation

a. action The action phase of the Transtheoretical Stages of Change Model is when someone tries to make the change. An example would be "I removed the salt shaker from the kitchen table". The example provided would also be the action stage because the individual actually served a vegetable dish.

A Food Service Director uses a 4 month moveable average to determine how many chicken breasts are needed for August given the number served in April, May, June, and July. How would they forecast the need for September? a. add August and delete April b. add August c. add August and delete July d. look at last year's September production tally

a. add August and delete April Moveable/moving average is a type of time-series forecasting which uniformly weighs past observations, so numbers are weighted equally. Subsequently, using the moveable average, we would use May-August to calculate 4 month moveable average.

A client says: "I want to change my eating habits." You ask why. The learning domain is: a. affective b. cognitive c. psychomotor d. psychosocial

a. affective The three types of learning domains are cognitive, affective and psychomotor. Cognitive is acquisition of knowledge or subject matter (factual information). Affective is acquisition of attitude and value, growth in feelings or emotions. Psychomotor learning is the acquisition of muscular skills (exercises, food prepartion). This example is affective because it is showing that the client values and is motivated to change their eating habits.

Which amino acid is especially glucogenic? a. alanine b. threonine c. valine d. methionine

a. alanine Alanine is the most glucogenic amino acid. Glutamine is also glucogenic. In humans, the glucogenic amino acids are: Alanine, Arginine, Asparagine, Aspartic acid, Cysteine, Glutamic acid, Glutamine, Glycine, Histidine, Methionine, Proline,, Serine, Valine Amino acids that are both glucogenic and ketogenic (mnemonic "PITTT"): Phenylalanine, Isoleucine, Threonine, Tryptophan, Tyrosine Only leucine and lysine are not glucogenic (they are only ketogenic).

The full function of the gastrointestinal tract is utilized with which type of nutrition support? a. an isotonic, polymeric formula delivered by a nasogastric tube b a BCAA formula delivered by a nasogastric tube c. peripheral parenteral nutrition d. parenteral nutrition

a. an isotonic, polymeric formula delivered by a nasogastric tube

The full function of the gastrointestinal tract is utilized with which type of nutrition support? a. an isotonic, polymeric formula delivered by a nasogastric tube b. a BCAA formula delivered by a nasogastric tube c. peripheral parenteral nutrition d. parenteral nutrition

a. an isotonic, polymeric formula delivered by a nasogastric tube

Formularies are descriptions of: a. approved treatment regimens b. pharmacy drug specifications c. capital budget items d. semi-variable costs

a. approved treatment regimens Formularies are descriptions of approved products that an organization (or department) would like all personnel who need such product to use. Volume discounts can be obtained. Standardizes usage.

Which of the following is a hearing between labor and management during an impasse to aid in settling disputes? a. arbitration b. mediation c. injunction d. collective bargining

a. arbitration a. arbitration Steps of collective bargaining are as follows: first, bargaining between union steward and management. If that fails, mediation (neutral person helps settle differences, non-binding decision). If that fails, arbitration (hearing to dissolve dispute, decision is usually binding)

Which of the following nonessential amino acids may be considered conditionally essential in catabolic stress such as heart failure? a. arginine b. asparagine c. proline d. leucine

a. arginine Arginine and glutamine are conditionally essential amino acids. They are found in a lot of formulas for this reason, such as Peptamen VHP.

Research suggests that in order to guard against cancer you should ingest: a. carotene and vitamin C b. vitamins C and B12 c. protein and vitamin A d. vitamins E and K

a. carotene and vitamin C There is scientific evidence that fruits and vegetables are beneficial in overall cancer prevention, specifically carotenoids and vitamin C.

A food delivery arrived during trayline service. What should the Dietitian do? a. ask the driver to wait b. ask the driver to verify the shipment and sign the invoice c. direct the available security guard to verify the shipment d. stop the trayline service and receive the delivery

a. ask the driver to wait The process they are asking about is the process of leadership and management of employees. When something goes wrong, never stop the actual work to address a situation and do not rush to accept the shipment. Ask the driver to wait until the situation could be addressed correctly.

The first function of the public health nutritionist is: a. assess the needs of the community b. counsel patients with special dietary needs c. write pamphlets for educational purpose d. expand the role of dietitians

a. assess the needs of the community The needs assessment is the first step when attempting to implement community-based intervention/project. The steps include: -Conducting a community needs assessment -Developing program goals and objectives -Developing a program plan -Identifying funding sources -Seeking support from stakeholders

The first step in developing a training program is to: a. assess the needs of the group b. review training programs offered in other locations c. provide the trainer with detailed instructions d. estimate approximate length of time needed to complete training

a. assess the needs of the group Community needs assessment to see what the individuals actually need from you, not what you think they need.

At which step in the educational process do you begin evaluation? a. assessment b. planning c. implementation d. evaluation

a. assessment Program evaluation occurs at every step of the the educational process (assessment, planning, implementation, and evaluation of outcomes). Subsequently, evaluation starts right in the beginning with assessment.

The Dietitian finds that the ice cream freezer is not working and everything inside has melted. She decides to throw it all out and substitute another item for dessert. She is demonstrating what type of leadership? a. autocratic b. bureaucratic c. democratic d. participatory

a. autocratic Autocratic: demands obedience, control, full responsibility; good in crisis control Bureaucratic: by the book, follows procedures Participative: encourages workers to participate in decision-making; uses quality circles Democratic is type of participative

A patient on warfarin should avoid: a. black cohosh, ginseng b. thiamin supplements c. simple carbohydrates d. B vitamin supplements

a. black cohosh, ginseng Those on anticoagulants should avoid Gingko biloba extract, garlic, ginger (may increase bleeding), avoid high doses vitamin A, E

Gastric irritants include: a. black pepper, chili powder, caffeine, alcohol, cocoa b. seeds, nuts, chili powder, black pepper, alcohol c. caffeine, black pepper, nuts, alcohol d. orange juice, black pepper, chili powder, alcohol

a. black pepper, chili powder, caffeine, alcohol, cocoa Black pepper, chili powder, caffeine and alcohol are well known. Cocoa can cause the intestinal cells that relax the esophageal sphincter to release a surge of serotonin. When this muscle relaxes, gastric contents can rise.

Which mineral is involved in blood clotting? a. calcium b. phosphorus c. iron d. selenium

a. calcium Calcium functions include bone metabolism, blood coagulation, neuromuscular excitability, cellular adhesiveness, transmission of nerve impulses, maintenance and function of cell membranes, and activation of enzyme reactions and hormone secretions. Both calcium and vitamin K are needed to synthesize Protein C, an anticoagulant that prevents excessive coagulation after the coagulation cascade occurs. Deficiency of any of these clotting cofactors will cause an impaired ability for blood to coagulate, which can contribute to excessive bleeding and hemorrhage.

Following an ileal resection, which supplements are recommended? a. calcium, magnesium, zinc, fat-soluble vitamins b. water-soluble vitamins, calcium and phosphorus c. zinc, thiamin, iron d. fat-soluble vitamins

a. calcium, magnesium, zinc, fat-soluble vitamins Following ileal resection, limit fat, use MCT, supplement fat-soluble vitamins, Ca, Mg, Zn, and use parenteral B12 followed by monthly injections if more than 100 cm of terminal ileum is removed. Since the ileum is essential for bile salt recycling, lipids are not emulsified, leads to malabsorption of fat-soluble vitamins. The malabsorbed fatty acids combine with Ca, Zn, Mg leading to ''soaps", resulting in increased levels of free oxalate available for absorption. Colonic absorption of oxalate increases, leading to kidney stones. Subsequently, it is essential to supplement with calcium, magnesium, zinc, and fat-soluble vitamins.

A job description: a. can be used for employee appraisal b. studies and analyzes all aspects of the job c. lists what steps to do and how to do them d. lists time limits on all aspects of the job

a. can be used for employee appraisal A job description reflects required skills and responsibilities; matches applicants to job, orientation/training, can be used for employee appraisal

Which nutrient may be absorbed during peritoneal dialysis and continuous renal replacement therapy, thus requiring a modification of his diet? a. carbohydrate b. protein c. fat-soluble vitamins d. water-soluble vitamins

a. carbohydrate Peritoneal dialysis is generally more liberalized than HD, as occuring for longer duration per session (10-12hrs per day, 3x/week on PD vs 4-6hrs per day, 3x/week on HD). With that being said, this also means there will be increased protein losses, so protein needs are higher in PD. In terms of carbohydrates, the dialysate in PD contains high levels of glucose, which are instilled into peritoneum. Subsequently, glucose control/carbohydrate intake must be monitored more closely in PD than HD.

PERT is a tool that will help you: a. control large projects and calculate the time needed to get the job done b. assign workers to various tasks c. determine productivity levels d. determine the average check

a. control large projects and calculate the time needed to get the job done PERT (Program Evaluation Review Technique) is a project management evaluation tool used for effective planning at the management level. It's used to schedule, organize, and coordinate tasks within a project. It's helpful for project managers to evaluate and analyze which resources (labor, time, materials) are needed for a project and track progress.

When preparing a budget, which management function is involved? a. controlling b. organizing c. evaluating d. projecting

a. controlling Controlling is a management function which measures present performance against standard performance, determine whether goals reached, on-going, shows strengths/weaknesses, solves problems. Budgeting is involved in controlling

Which oven is most energy efficient? a. convection oven b. rotary oven c. deck oven d. microwave oven

a. convection oven A convection oven evenly distributes heat and can handle higher quantity at lower temp while taking less time. A rotary oven is used for large volume baking and meat cookery, food is in motion while inside oven. A deck oven has units stacked to save space, used when production is high and pace is limited (Ex: pizza oven)

Which system is not labor efficient? a. conventional b. vending c. cafeteria d. assembly serve

a. conventional In conventional food production system, all preparation done on premises where meal are served, foods are prepared and served the same day. Conventional food production system has high labor costs and uneven workload during rush hour times.

Which mineral is absorbed through the intestine and transported with ceruloplasmin in the blood? a. copper b. iodine c. sodium d. calcium

a. copper Ceruloplasmin is a protein that is made in the liver. It stores and carries copper from the liver into the bloodstream and to the parts of your body that need it. Copper is a mineral that is found in several foods, including nuts, chocolate, mushrooms, shellfish, and liver.

Excess amounts of zinc may lead to a deficiency of: a. copper b. magnesium c. folate d. cobalt

a. copper Zinc supplementation is also a common cause of copper deficiency. This is because zinc and copper compete for absorption in the stomach, with zinc being the usual winner. As a result, copper isn't absorbed.

An acid ash would be created by ingesting: a. corn, cranberries b. milk c. vegetables d. fruits

a. corn, cranberries Creating "acid ash" in urine would be a dietary intervention to prevent alkaline stones. An acid ash is created by increasing anions through increased consumption of food such as meat, fish, fowl, eggs, shellfish, cheese, corn, oats, and rye. Creating an "alkaline ash" in urine would be a dietary intervention to prevent acidic stones. An alkaline ash is created by adding cations thorugh increased consumption of vegetables, fruits, brown sugar and molasses. ***This is rarely done as use medications now.

The following oils can be winterized: a. corn, soy, cottonseed b. olive, corn, soy c. cottonseed, olive d. olive, corn

a. corn, soy, cottonseed Winterized oils are oil that is chilled to 45 degrees F, and then fatty acids with high melting points crystallize and are filtered out. Subsequently, winterized oil will not crystillize when cold and is CLEAR not cloudy. Winterized oils are commonly used for salad dressings and include corn, soy and cottonseed oils. Olive oil is NOT winterized.

What should be the final consideration in the make-or-by decision of a product? a. cost analysis b. labor requirements c. storage space available d. personal relationship with supplier

a. cost analysis A make-or-buy decision is an act of choosing between manufacturing a product in-house or purchasing it from an external supplier.

Which of the following increase the risk of developing heart disease? a. elevated small dense LDL-c particles b. elevated large buoyant LDL particles c. elevated total cholesterol d. decreased triglycerides

a. elevated small dense LDL-c particles LDL transports cholesterol from the diet and liver to all cells. LDL = "bad cholesterol". Small dense LDL-c is associated with incrased risk of heart disease and is responseive to dietary changes. Larger buoyant LDL is NOT associate with increased risk of heart disease. Decreased TG's would not be associated with heart disease, increased TG's would be. Not sure why elevated total cholesterol would not be an increased risk- per Mayo Clinic total cholesterol less than 200 mg/dl decreases risk of developing heart disease.

A Dietitian who wishes to delegate work to a subordinate should first: a. evaluate employee skills and task difficulty b. give the employee the authority to make decisions c. given the employee the information needed to complete each task d. ensure that the employee has the necessary materials and funds

a. evaluate employee skills and task difficulty Delegation is the distribution of work to qualified people. Managers must have a clear understanding of what they want done, give specific instructions, motivate, provide training, require complete work, establish controls

What is the best practical way to measure energy balance? a. evaluate weight gain and weight loss b. utilize food intake records c. use activity factors d. calculate the number of calories consumed

a. evaluate weight gain and weight loss Food intake records may be inaccurate and time consuming. Weight gain and weight loss would be the best method.

Why might a patient with ascites be dehydrated? a. fluid has moved to interstitial spaces b. fluid has moved to intravascular spaces c. fluid has moved to vascular spaces d. fluid has moved to the lung

a. fluid has moved to interstitial spaces Ascites occurs when blood cannot leave the liver. Connective tissue overgrowth blocks blood flow out of liver into vena cava. The liver expands. When storage capacity has been exceeded, pressure caused by increased blood volume forces fluid to sweat through the liver into the peritoneal cavity. This fluid is almost pure plasma with a high osmolar load, pulling more fluid in to dilute the load, leading to sodium and water retention. Subsequently, a patient with ascites may be dehydrated as fluid has moved into the interstitial space.

To restore hydration after continuous endurance activity of 2 hours, consume: a. fluid, carbohydrate, sodium b. non-CHO electrolyte solutions c. fluids d. fluids and sodium

a. fluid, carbohydrate, sodium Fluid/sodium to replace loss through sweating, CHO to replete glycogen stores

Which is a quick diet assessment tool for a large group? a. food frequency lists b. diet history forms c. weighing food samples and recording intake d. food records

a. food frequency lists FFQ is the most appropriate dietary intake tool for the community setting. FFQ is a retrospective questionnaire ascertaining frequency of food groups. FFQ's can be comprehensive (100 questions) or short, and are useful in research studies with large sample sizes.

Which item would appear in a capital budget? a. food service equipment b. food costs c. labor costs d. paper supplies

a. food service equipment A capital budget is a budget for expenditures on items that will serve for the long term, such as equipment, roads, and buildings. Subsequently, food service equipment would be a capital budget item.

Phytochemicals, which may influence the development of tumors, are found in: a. fruits, vegetables, grains b. lean poultry and fish c. low fat dairy products d. polyunsaturated fats

a. fruits, vegetables, grains Phytochemicals are compounds that are produced by plants ("phyto" means "plant"). They are found in fruits, vegetables, grains, beans, and other plants. Some of these phytochemicals are believed to protect cells from damage that could lead to cancer. Phytochemicals include compounds such as salicylates, phytosterols, saponins, glucosinolates, polyphenols, protease inhibitors, monoterpenes, phytoestrogens, sulphides, terpenes, lectins, and many more.

A PEG feeding would be useful in a patient with: a. head or neck cancer, who will not be able to eat normally for weeks b. short bowel syndrome c. duodenal ulcers d. pancreatitis

a. head or neck cancer, who will not be able to eat normally for weeks A PEG tube is used for those requiring NS for at least 3-4 weeks. Head and neck cancer patients notoriously require PEG needs due to the nature of the condition and treatments.

You are planning a health promotion program for employees. To assess employees needs, use information from: a. health risk appraisals b. nutrition assessments c. medical records d. interviews

a. health risk appraisals Health risk appraisal (HRA) is a survey categorizing a populations general health status. Consists of questionnaire, calculations that predict risk of disease, educational message to participants.

Which of the following is the most useful for evaluating long term nutrition in children? a. height for age b. weight for height c. weight for age d. length for weight

a. height for age Stature/length for age defines shortness/tallness and reflects long term nutritional status; determines extent of stunting Weight for length/stature identifies under/over nutrition and detects short term changes to nutritional status. Weight for age is NOT used to classify under/over weight and is a short term marker of growth that cannot distinguish between stunting and wasting becuase it does not include height

Nutritional therapy for hepatitis includes: a. high protein, high carbohydrate, moderate fat, high calories b. high protein, low carbohydrate, low fat, moderate calories c. low protein, high carbohydrate, low fat, high calories d. low protein, high carbohydrate, low fat, low calories

a. high protein, high carbohydrate, moderate fat, high calories Nutrition therapy for hepatitis includes increase fluid to prevent dehydration, 50-55% CHO to replenish liver glycogen and spare protein, 1-1.2 g/kg, moderate to liberal fat if tolerated, small frequent feedings, multi-vitamin.

A patient with the nephrotic syndrome will likely exhibit: a. hypercholesterolemia, hypoalbuminemia, edema b. hypertension, hypocholesterolemia c. hypotension, azotemia d. malnutrition, hyperalbuminemia

a. hypercholesterolemia, hypoalbuminemia, edema Nephrotic syndrome is a defect in capillary basement membrane of glomerulus which permits escape of large amounts of protein into the filtrate moving through the tubules. Sxs include albuminuria, edema, malnutrition, hyperlipidemia (increased synthesis and decreased clearance of VLDL). Since albumin is being excreted excessively in the urine, hypoalbuminemia would occur. Hypercholesterolemia and edema would also occur.

Aseptically packaged milk should be stored: a. in dry storage b. in the refrigerator c. in the freezer d. below 40 degrees

a. in dry storage Aseptic milk is processed using ultra-high temperature pasteurization, which kills any harmful bacteria in the milk and then it is bottled immediately in a sterile environment into special packaging that prevents any air reaching it. This procedure makes the milk shelf stable. Ultra-high temperature pasteurization (UHT) is done under sterile and aseptic conditions, resulting in product that does not need to be refrigerated. Aspetically packaged milk can be stored without refrigeration if unopended.

You will be introducing new methods of production to your staff. The most effective method would be to: a. include them during discussions of proposed methods b. introduce the new method quickly c. let them know it is a better process d. ask employees if they will go along with the decision

a. include them during discussions of proposed methods

A patient is on a high protein, low carbohydrate diet. What advice should you offer? a. increase fluid intake b. decrease the intake of complex carbohydrates c. decrease fluid intake d. decrease the intake of saturated fats

a. increase fluid intake High-protein intakes impact renal function via excretion of nitrogenous waste products generated from protein metabolism. A high protein diet might increase renal solute load, thereby increasing fluid necessary for efficient renal handling of solute load. Subsequently, increasing fluid intake is essential for those on high protein diet

An example of a positive nutrition care outcome is: a. increased intake of foods high in iron and vitamin C b. increase in the number of participants in a weight management class c. increase in physician referrals to the outpatient department d. decrease in the number of complaints regarding low sodium meals

a. increased intake of foods high in iron and vitamin C Nutrition care outcomes prove the value of the intervention. They represent the nutrition professionals specific contribution to care. Subsequently, increasing intake of high iron and vitamin C foods would be the nutrition care outcome. Increased # of participants, increase physician referrals, and decreased complaints about low-sodium meals aren't direct nutrition care outcomes.

An example of a positive nutrition care outcome would be: a. increased intake of foods high in iron and vitamin C b. increase in the number of participants in a weight management class c. increase in physician referrals to the outpatient department d. decrease in the number of complaints regarding low sodium meals

a. increased intake of foods high in iron and vitamin C Nutrition care outcomes prove the value of the intervention. They represent the nutrition professionals specific contribution to care. Subsequently, increasing intake of high iron and vitamin C foods would be the nutrition care outcome. Increased the number of participants, increase physician referrals, and decreased complaints about low-sodium meals aren't direct nutrition care outcomes

Which is an example of an indirect cost? a. insurance b. travel costs c. food d. china

a. insurance Indirect costs are fixed, meaning not affected by sales volume, not directly evident in day to day activities, and are required for the business to exist even if it produces nothing. Examples of indirect costs include rent, taxes, interest on debt, insurance, and depreciation. China, travel, and food are direct/variable/flexible costs.

Which menu item generates the highest profit? Lasagna: units sold 1500 selling price $3.00 raw food cost $1.35 prime cost $2.00 Vegetarian chili: units sold 100 selling price $1.25 raw food cost $0.57 prime cost $1.00 Hamburger: units sold 400 selling price $2.00 raw food cost $0.90 prime cost $1.50 Enchilada: units sold 100 selling price $3.00 raw food cost $1.14 prime cost $1.75 a. lasagna b. vegetarian chili c. hamburger d. enchilada

a. lasagna Profit = (selling price - prime cost) x number of units sold Lasagna: $3.00 - $2.00 x 1500 = $1500 (answer) Vegetarian chili: $1.25 - $1.00 x 100 = $25 Hamburger: $2.00 - $0.90 x 400 = $440 Enchilada: $3.00 - $1.75 x 100 = $125

Sorbitol is: a. less sweet than sucrose and has a lower glycemic index than sucrose c. sweeter than sucrose d. sweeter than sucrose and has a lower glycemic response than sucrose

a. less sweet than sucrose and has a lower glycemic index than sucrose Sweetness of carbohydrates from sweetest to least sweet: fructose, invert sugar, sucrose, glucose, sorbitol, mannitol, galactose, maltose, lactose. Sorbitol is slowly absorbed by passive diffusion in the small intestine and thus has a lower glycemic index than sucrose.

A low birth weight infant weighs: a. less than 2500 grams b. between 500 and 150 grams c. between 100 and 500 grams d. between 100 and 500 grams

a. less than 2500 grams Normal BW: 2500-4000 gm LBW: <2500 gm VLBW: <1500 gm ELBW: <1000 gm

Which of the following weight gains puts pregnant women at risk? a. less than 4lb/month in the last half of pregnancy b. less than 5lb/month in the last half of pregnancy c. less than 6lb/month in the last half of pregnancy d. more than 2lb/month in the last half of pregnancy

a. less than 4lb/month in the last half of pregnancy Normal weight gain: 1 lb / month in first three months 1 lb per week thereafter Less than 4 lb per month in last half of pregnancy would fall below goal of minimum 4 lbs per month (1 lb per week).

The rate of oxidation of which branched-chain amino acid increases significantly during moderate exercise? a. leucine b. phenylalanine c. tyrosine d. threonine

a. leucine Mneumonic (off PVT TIM HLL mneumonic for essential AA's) Tim LIVs for this BRANCH of the military- branched amino acids are leucine, isoleucine, and valine.

A female who eats a wide variety of foods and take supplemental iron and birth control pills may be: a. marginally deficient in folic acid b. low in calcium c. low in vitamin A d. low in zinc

a. marginally deficient in folic acid Oral contraceptives can cause low levels of folate, B6, and C. Since this female is eating a wide varity of foods, it is unlikely she would be very deficient in any of these nutrients. However, it would be possible she is marginally deficient in folic acid.

To implement an efficient staffing plan and adhere to budget constraints, the Dietitian can ensure labor costs are controlled by: a. master schedules b. job descriptions c. compensation changes d. cross-training

a. master schedules A master schedule serves as overall plan and is used as basis for developing weekly schedules; includes information like vacation days

The amino acid tryptophan can be converted into: a. serotonin b. catecholamines c. phenylalanine d. tyrosine

a. serotonin Tryptophan --> serotonin Remember by thinking going on a TRIP will make you happier (increase serotonin)

Clostridium perfringens is often associated with: a. meat and gravied mixtures in large quantities b. fresh fruits and vegetables c. dairy products held within the danger zone d. uncured cheese

a. meat and gravied mixtures in large quantities Clostridium perfringens is "cafeteria illness". Outbreaks commonly in hospitals, cafeterias, nursing homes, prisons- areas where large quantities of foods prepared and kept warm for too long

When meat is irradiated, the best flavor comes from: a. meat that has been frozen b. fresh meat c. aged meat d. young meat

a. meat that has been frozen Irradiation is a type of cold sterilization used to prevent off-flavors in meat. The temp of food does not rise much even though large amounts of energy are used

The incidence of xeropthalmia in children between the ages of 1-5 is 5:1000. This means: a. morbidity rate of xeropthalmia is 5 in every 1000 children ages 1-5 b. mortality rate of xeropthalmia is 5000 in this age group c. morbidity rate of xeropthalmia is 5000 in this age group d. mortality rate is 5 in every 1000 children aged 1-5

a. morbidity rate of xeropthalmia is 5 in every 1000 children ages 1-5 IncideNce = # NEW cases, so morbidity (sickness)

Within 2-3 hours of continuous exercise at 60-80% of maximum: a. muscle glycogen is depleted b. muscle glycogen is the main energy source c. amino acids begin to contribute a source of energy d. fatty acids are the favored substrates

a. muscle glycogen is depleted Muscle glycogen is the storage form of CHO. It is utilized first as energy source during high-intensity exercise. Low intensity exercise would utilized fats.

Where should a class B fire extinguisher be placed? a. near the range b. near the dish machine c. near the freezer d. near the refrigerator

a. near the range A Class B fire occurs with flammable liquids and gases, such as gasoline or natural gas. Dry chemical extinguisher or CO2 or foam smothering is necessary to put out these fires. Subsequently, placing a class B fire extinguisher near the range makes sense in cash there is a fire related to the gas.

When trying to cut down on the number of employees on a tray assembly line, evaluate the: a. number of work stations b. amount of idle time c. line speed d. capacity

a. number of work stations

A substitute is legally differentiated from another food by: a. nutrient content b. calorie content c. fat content d. color

a. nutrient content A substitute is nutritionally equal or superior in some ways and inferior in others compared to the food it is being compared to.

What should most be encouraged in a Headstart program? a. nutrition activities related to food b. participation for at least one year c. class instructions d. healthy snacks

a. nutrition activities related to food Headstart is a federal program, run by USDHHS, that helps low income children (ages 3-5) by introducing new foods and teaching good food habits. Children's participation in food activities is important. However, there isn't a set duration set for participation. Subsequently, the most encouraged would be nutrition activites related to food.

Hospital use formularies to... a. obtain volume purchasing discounts b. limit use of certain products c. develop process charts d. organize departments in a concentric pattern

a. obtain volume purchasing discounts Formularies are descriptions of approved products that an organization (or department) would like all personnel who need such product to use. Volume discounts can be obtained. Standardizes usage

Fats high in monounsaturated fatty acids include: a. olive and canola b. safflower and corn c. coconut and palm d. soy and peanut

a. olive and canola Most predominant (from greatest to least) MUFAs: olive, canola, peanut, sunflower, coconut oil PUFAs: safflower, corn, soybean, cottonseed, sunflower, palm kernel Saturated fat: coconut oil, palm kernel, cocoa butter, butter, palm oil, canola

Which of the following provides 45g of CHO? a. one cup pasta b. one cup black beans c. 1 1/2 cups blueberries d. 2 small tortillas

a. one cup pasta 1 cup pasta = 3 starch exchanges (45 gm CHO, 9 gm pro, 3 gm fat, 240 kcal) 1 cup black beans = 2 exchanges (30 gm CHO, 14 gm protein, ~3 gm fat, 250 kcal) 1 1/2 cup bluberries = 1.5 fruit exchanges (22.5 gm CHO, 120 kcal) 2 small tortilla = 2 starch exchanges (30 gm CHO, 6 gm pro, 2 gm fat, 160 kcal)

Which is the least common symptom in the elderly? a. osteomalacia b. osteoporosis c. obesity d. hypertension

a. osteomalacia Osteomalacia is considered "adult rickets". It occurs in response to vitamin D deficiency (lack of sunlight and/or dietary intake). Osteomalacia results in bone density demineralization. Osteoporosis is common among older, white women who do not engage in weight-bearing activity (typically petite). Obesity and hypertension can occur at any age, and does significantly impact elderly population.

A serum sodium level of 115 mEq/L may be due to: a. over-hydration b. dehydration c. a very high sodium intake d. a sodium intake of 5.5g per day

a. over-hydration Normal serum sodium 135-145 mEq/L. Overhydration would cause hyponatremia because the amount of sodium relative to volume would be much lower then normal.

Which foods are most likely to cause an allergic reaction? a. shellfish, peanuts, wheat b. wheat, chocolate, rice c. citrus fruits, milk, corn d. chocolate, milk, corn

a. shellfish, peanuts, wheat

A child is at the 85th percentile for BMI, he is: a. overweight b. tall for his age c. muscular for his age d. normal weight

a. overweight BMI-for-age is used to evaluate for excess adiposity and undernutrition. -BMI-for-age above 95th percentile is considered obese -BMI-for-age between 85th and 95th percentile is considered overweight -BMI-for-Age below 5th percentile is considered underweight

Fats used in frying can become rancid due to the: a. oxidation of unsaturated fats b. uptake of oxygen at the point of saturation c. removal of high-melting triglycerides d. prolonged exposure to high temperatures

a. oxidation of unsaturated fats Rancidification is the process of complete or incomplete oxidation or hydrolysis of fats and oils when exposed to air, light, or moisture or by bacterial action, resulting in unpleasant taste and odor. Specifically, it is the hydrolysis or autoxidation of fats into short-chain aldehydes, ketones and free fatty acids, which are objectionable in taste and odor. The process of hydrogenation (adding hydrogen to unsaturated fatty acids to increase saturation) is done to reduce rancidity of the fats.

Trypsin and chymotrypsin are: a. pancreatic enzymes that provide proteolytic action b. intestinal enzymes that digest starch c. liver hormones involved in fat digestion d. intestinal enzymes that digest protein

a. pancreatic enzymes that provide proteolytic action Pepsinogen (zymogen form) is converted to pepsin (active form) in the stomach by HCl. Pepsin then hydrolyzes peptide bonds. Zymogens (trypsinogen, chymotrypsinogen, procarboxypeptidase) are converted to active form on the brush border membrane of the enterocyte. Trypsinogen is converted to active form trypsin by enterokinase on brush border membrane. Tyrpsin then converted the other zymogens (chymotrypsinogen, procarboxypeptidase) into their active forms (chymotrypsin, carboxypeptidase), which can then hydrolyze to di and oligosaccharides.

Following resection of the small intestine, patients initially receive: a. parenteral nutrition b. elemental formula through an enteral feeding c. predigested nutrients through a gastrostomy tube d. lactose-free, low osmolar, jejunal feeding

a. parenteral nutrition Begin with PN initially, and then advance to EN or PO eating as tolerating.

Which stage of change is represented by this comment: "I asked for the recipe for the vegetable dish" a. preparation b. action c. contemplation d. pre-contemplation

a. preparation The prepartion phase of the Transtheoretical Stages of Change Model is when someone DECIDES to change and PLANS to change. An example would be "I bought a cookbook on low salt cooking". The example provided would be the prepartion stage because the individual plans to make a change and showed this by asking for a recipe for a vegetable dish.

What is a function of cream of tartar in a recipe? a. prevents the Maillard reaction b. enhances the Maillard reaction c. increases the alkalinity allowing for better leavening d. enhances gelation

a. prevents the Maillard reaction Maillard reacction is a chemical reaction (non-enzymatic) between amino acid and sugar that results in browning when heated; creates flavor and colors in foods. Maillard reaction is increased when there is alkalinity, and thus preventing when acidity is added. Subsequently, adding cream of tartar (an acid) would inhibit/prevent the Maillard reaction.

Inferential statistics are associated with: a. probability b. mean c. mode d. graphs

a. probability Inferential statistics makes inferences or conclusions from observed data (ex: probability hypothesis testing, variance).

Which hormone regulates breast milk production? a. prolactin b. progesterone c. estrogen d. oxytocin

a. prolactin Prolocatin stimulates milk Production. Oxytocin mOves milk throught the ducts ("let down")

Which is restricted in a diet for hepatic encephalopathy? a. protein, sodium, fluid b. protein, fluid, calories c. calories, protein, fat d. sodium, fat, calories

a. protein, sodium, fluid Protein may be restricted due to the buildup of ammonia. ***Just note: it has been found that protein intake should only be limited in patients with acute cases, with an initial dose of 0.5g/kg/day increasing to 1-1.5g/kg/day. Otherwise, up to 95% of patients with HE can tolerate diets with protein up to 1.5g/kg body weight. Sodium and fluid restrictions are likely in place as well due to ascites/fluid accumulation.

The main function of glycolysis is to provide: a. pyruvate for the TCA cycle b. lactic acid for energy use by muscles c. muscle and liver glycogen d. a substrate for the Cori cycle

a. pyruvate for the TCA cycle Glucose -- G6P --> pyruvate -----> acetyl CoA ---> oxaloacete in TCA cycle

Which of the following diets is appropriate for reactive hypoglycemia a. reduce intake of concentrated carbohydrates, 5-6 small meals b. increased complex carbohydrate, low fat, high protein c. decreased complex carbohydrate, low fat d. high protein, high fat, high carbohydrate

a. reduce intake of concentrated carbohydrates, 5-6 small meals Reactive/postprandial hypoglycemia occurs when there is an overstimulation of the pancreas or increased insulin sensitivity, causing BG to fall below normal 2-5 hours after eating. In order to reduce the incidence/severity of blood sugar drops, small frequent meals and reduced intake of simple sugars is recommended.

A single 19 year old female is 6 months pregnant. She has not gained any weight and has not seen a physician. Hemoglobin is 9. Hematocrit is 30. What is the most important recommendation for her? a. see a physician immediately b. apply for WIC immediately c. join a teenage pregnancy support group d. begin taking iron supplements

a. see a physician immediately Normal Hg for females is 12-16 g/dL, and normal Hct for females 36-48%. Subsequently, is is very likely that this patient has anemia and may benefit from iron supplements. However, the RDN would want to first have this patient evaluated by an MD to determine the best course of treatment.

Enteral feeding products that contain protein in the form of small peptides and amino acids may be recommended for patients who have: a. short bowel syndrome b. undergone a gastrectomy c. undergone a colectomy d. undergone a cholecystectomy

a. short bowel syndrome Amino acid digestion and absorption primary occurs in small intestine. Subsequently, a patient which short bowel sydrome has a portion of small intestine is missing/surgically removed and thus protein digestion/absorption will most be affected in SBS. Hydrolyzed formulas would be most appropriate since protein is hydrolyzed to small peptides and AA.

Chemically defined formulas are used for: a. short bowel syndrome b. post chemotherapy treatment c. hypermetabolism d. galactosemia

a. short bowel syndrome Chemically defined formulas refer to elemental formulas. Subsequently, SBS would be most appropriate to use an elemental formula. The severity of SBS depends on the length and location of resection, age of patient, health of remaining tract. However, elemental formulas are most commonly utilized for SBS to minimize malabsorption/maldigestion considering a portion of the small intestine is missing/removed.

If patients in a counseling session become restless: a. shorten the sessions b. use a series of guest speakers c. realize that this is to be expected d. cancel the sessions

a. shorten the sessions Be flexible, make adjustments to make the client comfortable.

Which of the following can be offered to a patient when his diet prescription is moved from NDD level 3 to level 2? a. soft pancake b. bread pudding c. rice pudding d. saltine crackers

a. soft pancake The levels of the National Dysphagia Diet are: Level 1: Dysphagia-Pureed (homogenous, very cohesive, pudding-like, requiring very little chewing ability). NDD Level 2: Dysphagia-Mechanically Altered (cohesive, moist, semisolid foods, requiring some chewing). NDD Level 3: Dysphagia-Advanced (soft foods that require more chewing ability). Regular (all foods allowed). The IDDSI replaced the National Dysphagis die, and includes: 0- Thin 1- Slightly Thick 2- Mildly Thick 3- Moderately Thick/Liquidized 4- Pureed Extremely Thick 5- Minced and Moist 6- Soft and Bite-Sized 7- Regular/Easy to Eat Bites

On your meal rounds you notice that elderly patients are not being fed properly. What is the best solution? a. speak with the Director of Nursing b. discuss it at a discharge planning meeting c. confer with the Nurse's Aide responsible d. assign your Diet Aide to help feed the patient

a. speak with the Director of Nursing

Large volume purchasing, centralized production, service areas in separate facilities are features of: a. the commissary system b. the ready-prepared system c. the assemble serve system d. the conventional system

a. the commissary system In the commissary system, there is centralized procurement and production. Food production (kitchen) and service areas (patients) in separate facilities

Which result is desirable? Before After Experimental group A B Control group C D a. the difference between A and B is more significant than the difference between C and D b. the difference between B and D is statistically significant c. the difference between A and C is more significant than the difference between B and D d. the difference between A and D is more significant than the difference between C and B

a. the difference between A and B is more significant than the difference between C and D Think of an example. If you were doing an experiment comparing intake of blueberries and blood glucose levels, Group A would get blueberries with breakfast and Group C would get their normal breakfast (no blueberries). After you conduct the study, you would want/desire that the blueberry group after the experiment (B) has a significantly lower blood sugar value than when they started (A). You would want that change to be more significant than any changes after the experiment in the control group (D) compared to when the experiment started (C). Subsequently, the answer is A.

Medicare is for: a. the elderly b. the financially needy c. those at nutritional risk d. those with medical needs

a. the elderly Medicare is a health insurance program for people over 65 years and those of any age with end-stage renal disease.

To determine whether promotional efforts have increased sales in a business use: a. the experimental design b. an observational study c. a survey d. a segmentation process

a. the experimental design An experimental design is the only test that can suggest causation. All other are just associations.

Productivity is measured by: a. the number of portions served per hour b. the number of employees working each day c. the number of food deliveries d. the inventory

a. the number of portions served per hour Productivity is the efficiency with which a product/service activity coverts inputs into outputs; expressed as ratio.

To calculate the estimated caloric needs of a patient who is significantly underweight the Dietitian should use: a. the patient's actual body weight b. the patient's adjusted body weight c. the patients desirable body weight d. 90% of the patient's desirable body weight

a. the patient's actual body weight

A decision to feed patients in their rooms, rather than in the cafeteria is based on: a. the philosophy of the institution b. the equipment in the kitchen c. the labor available d. federal regulations

a. the philosophy of the institution

If carbohydrate intake is increased, which vitamin needs to be increased? a. thiamin b. niacin c. riboflavin d. pyridoxine

a. thiamin Thiamin is essential for conversion of pyruvate to acetyl CoA. "Thiamine plays a vital role in metabolism of glucose. Thus, emphasis is placed on the fact that ingestion of excessive simple carbohydrates automatically increases the need for this vitamin."

The use of a sugar substitute is regulated by: a. NIH b. FDA c. WHO d. FTC

b. FDA Under Food, Drug, and Cosmetic Act, FDA covers all interstate food except meat, fish, poultry and eggs; inspects food processing factories, raw materials and labeling.

Which is a part of the nutritional therapy for IDDM in a lean person? a. time meals b. decrease caloric intake c. it is not crucial to maintain consistency of calories if average intake is low d. decrease frequency of feedings

a. time meals If an indivdiual is lean, the primary intervention would be improving meal timing to prevent any peaks or valleys in blood sugars.

The best use of performance appraisals is: a. to improve performance b. to motivate the employee c. to weed out the employees who perform poorly d. to reward those who do well

a. to improve performance

If linoleic acid replaces saturated fat in the diet: a. total cholesterol including HDL decrease b. HDL increases c. LDL increases d. no change in lipid levels

a. total cholesterol including HDL decrease If linoleic acid (omega 6) replaces saturated fat, total cholesterol decreases and HDL decreases Lioleic acid, or omega 6, is an essential fatty acid. Replacing carbohydrates with omega 6 causes LDL to decrease and HDL to increase

Muscle mass is determined using the: a. triceps skinfold and arm circumference b. skinfold caliper c. BEE d. urinary creatinine measurement

a. triceps skinfold and arm circumference Arm muscle area is detemined using triceps skinfold and AC

A patient who had an ileal resection is placed on a tube feeding and begins to have diarrhea. This may be due to: a. use of a hypertonic formula b. use of an isotonic formula c. blockage of the GI tract d. lactose intolerance

a. use of a hypertonic formula A hypertonic formula means that it has an osmolality greater than that of the body fluid. Hypertonic formulas create an osmotic gradient that attracts water from the body into the lumen of the GI tract, and thus can cause diarrhea. An isotonic formula has the same osmolality as blood and is less likely to cause diarrhea. A blockage of the GI tract would be more likely to cause constipation. Lactose intolerance would cause diarrhea but is not likley the cause in this situation.

The transfer of heat when cooking with an induction burner is the: a. use of electrical magnetic fields to energize the metal cooking surface b. movement of heat through direct contact c. distribution of heat by movement of liquid or vapor d. generation of heat by wave action within an object

a. use of electrical magnetic fields to energize the metal cooking surface Induction is the of electrical magnetic vibrations to excite the molecules of metal cooking surfaces, i.e. electric burner

The end products of cellular oxidation are: a. water, carbon dioxide, energy b. carbon, hydrogen, nitrogen c. indigestible fiber, nitrogen d. monosaccharides, amino acids, energy

a. water, carbon dioxide, energy Cellular respiration is an oxidative process whereby an electron donor is oxidized and oxygen is reduced to produce carbon dioxide, water, and energy.

Expected creatinine clearance is estimated from the clients: a. weight and height b. TSF, AMC c. height d. waist circumference

a. weight and height Creatinine clearance measures GFR, estimates include body surface area. It uses weight and height to calculate.

The best way to monitor an infants failure to thrive is to plot: a. weight for length b. length for age c. weight d. weight for age

a. weight for length Failure to thrive is slow physical development in a baby or child. Wt-for-ht (length) can be used to assess short-term changes in nutritional status, as well as wasting and FTT.

An 18 month old child should receive: a. whole milk b. 2% milk c. 1% milk d. skim milk

a. whole milk Infants should NOT receive cow's milk in the first year of life. Since this is an 18-month old, it is okay. Whole milk is desired because infants need the most calories, protein, and water / unit weight and thus it is not recommended to consume low-fat and non-fat milks during first two years of life.

If you are on a low phosphorous diet, what food should you most avoid? a. yogurt b. orange juice c. beef d. bread

a. yogurt Phosphorus = protein foods and grains. B and C are out based on that. Yogurt and other dairy products are particularly high in phosphorus and thus should be avoided.

Chicken has a popularity index of 45%. There are 380 total patients, 85% of whom are eating. How many will choose chicken? a. 202 b. 145 c. 196 d. 154

b. 145 0.85 x 380 = 323 pts 323 x 0.45 = 145 ppl

At what temperature should coffee and items such as thin soups be held for serving? a. 140-160'F b. 180-190'F c. 200-212'F d. over 212'F

b. 180-190'F The National Coffee Association of U.S.A., Inc., recommends that the temperature of coffee must be between 180 °F and 185 °F for optimal flavor notes. Higher temperatures can bring out bitterness from tannins in the coffee

What is a guide for calculating water needs with tube feedings? a. 1cc water/ 0.5 calories b. 1cc water/ 1.0 calories c. 1cc water/ 2.0 calories d. 1cc water/ 3.0 calories

b. 1cc water/ 1.0 calories

A 1500 calorie diabetic diet with 45% of the calories from carbohydrate is prescribed. One third of the carbohydrate grams is met with 1/2 cup orange juice, 1 cup milk, and: a. 1 slice toast b. 2 slices toast c. 2 slices toast and 1/2 cup oatmeal d. 1/2 slice toast

b. 2 slices toast 1500 kcal x 0.45 = 675 kcal from CHO 675 kcal / 4 kcal per gm = ~169 gm for day 1/3 of 169 gm = ~56 gm for this snack/meal 1/2 cup OJ (4 oz) = 15 gm CHO, 60 kcals 1 cup milk (whole) = 12 gm CHO, 8 gm pro, 8 gm fat, 160 kcals So far provides: 12+15 = 27 gm Remaining needs: 56 gm - 27 gm = 29 gm (~2 exchanges) 1 slice toast = 1 exchange, so 2 slices = 30 gm

How much additional water would a 65kg patient need when receiving 2400ml of a standard formula, 85% free water, was given daily? a. 125ml b. 235ml c. 155ml d. 270ml

b. 235ml They use 35 mL/kg for fluid* = 2275 mL 2400mL x 0.85 = 2040 mL free water from formula 2275 mL - 2040 mL **In hospital we usually did 1 mL/kcal fed so just remember 35 mL/kg

Dietitian: 40 hrs/wk Nurse: 40 hrs/wk Doctor: 30 hrs/wk Diet aides: 20 hrs/wk Secretary: 20 hrs/wk Clerk: 10 hrs/wk How many FTEs are in the above operation? a. 2 b. 4 c. 6 d. 8

b. 4 (40 + 40 + 30 + 20 + 20 + 10)/40 = 4

How many mEq of sodium are in 1 gram of sodium? a. 25 b. 43 c. 65 d. 110

b. 43 mEq = mg / atomic weight x valence AW in sodium: 23 (K+ is 39, Ca++ is 40) Valence in sodium: 1 (K+ is 1, Ca++ is 2) 1000mg / 23 x 1 = 43.5 mEq

A study showed the morbidity of children with anemia to be 5:1000. This means: a. 5 children out of 1000 died of anemia b. 5 children out of 1000 had anemia c. 1000 children had anemia d. 1000 children died of anemia

b. 5 children out of 1000 had anemia Morbidity = sickness, mortality = death (think mortal)

Pot roast: 70 servings, $1.50 (FC/serving) Chicken stew: 30 servings, $0.75 Spaghetti: 40 servings, $0.60 What is the popularity index for pot roast? a. 40% b. 50% c. 60% d. 70%

b. 50% PI= #servings/total # servings 70 servings/140 total = 50%

A sedated patient received 25cc of Propofol per hour. How many calories will he receive from the medication daily? a. 500 b. 660 c. 720 d. 785

b. 660 25 mL/hr x 24 hours = 600 mL 1.1 kcal/mL from propofol x 600 mL = 660 kcal (fat calories)

What reading level is appropriate for written materials for a population with low literacy skills? a. 4th grade b. 6th grade c. 8th grade d. 9th grade

b. 6th grade Reading level is typically determined by finding the average number of polysyllabic words using readibility index such as SMOG index. Reading materials should be kept around 8th grade reading level for general public and 6th grade for audiences of low literacy.

In a PN mixture, what volume of the amino acid solutions listed would come closest to providing 185 calories? a. 1000ml of 8.5% AA b. 850ml of 5.5% AA c. 500ml of 7.0% AA d. 500ml of 10% AA

b. 850ml of 5.5% AA 8.5 gm x 10 = 85 gm x 4 = 340 kcal 5.5 x 8.5 = 46.75 gm x 4 = 187 kcal (answer) 7 x 5 = 35 gm x 4 = 140 kcal 10 x 5 = 50 gm x 4 = 200 kcal

How many total calories are provided in 500ml of a 20% dextrose solution with 500ml of a 4% protein solution and 250ml of a 20% lipid emulsion? a. 870 b. 920 c. 1020 d. 1125

b. 920 Calories Dextrose: 20 x 5 = 100 gm dextrose x 3.4 = 340 kcal Protein: 4 x 5 = 20 gm pro x 4 = 80 kcal Fat: 2 x 250 = 500 kcal 340 kcal + 80 kcal + 500 kcal = 920 kcal

500ml of a 20% dextrose solution with 500ml of a 4% protein solution and 250ml of a 20% lipid emulsion What is the calorie:nitrogen ratio in the above solution? a. 287:1 b. 920:3.2 c. 1020:6.25 d. 318:1

b. 920:3.2 Calories (TOTAL calories, not just pro calories) Dextrose: 20 x 5 = 100 gm dextrose x 3.4 = 340 kcal Protein: 4 x 5 = 20 gm pro x 4 = 80 kcal Fat: 2 x 250 = 500 kcal 340 kcal + 80 kcal + 500 kcal = 920 kcal 1 gm N = 6.25g protein 20 gm protein / 6.25 gm = 3.2 920: 3.2

Which assessment tool might be given to clients prior to screening at a congregate meal site? a. PEACH survey b. DETERMINE checklist c. NSI Level I screen d. NSI level II screen

b. DETERMINE checklist DETERMINE checklist is used as a tool in Nutrition Screening Initiative (NSI), which identifies elderly at nutrition risk. DETERMINE stands for: Disease Eating Poorly Tooth Loss/Mouth Pain Economic Hardship Reduced Social Contact Multiple Medicines Involuntary Weight Loss/Gain Needs Assistance in Self- Care Elder Years Above Age 80

Which of the following guidelines should be used when you are estimating the prevalence of inadequate intake levels of vitamin A within a group of adults? a. Recommended Dietary Allowance RDA b. Estimated Average Requirement EAR c. Tolerable Upper Intake Level UL d. Adequate Intake AI

b. Estimated Average Requirement EAR Estimated Average Requirement (EAR): nutrient intake level estimated to meet the needs of 50% of people of a certain age and sex; used to determine RDA. Emphasis on a particular group of people. Recommended Dietary Allowance (RDA): average daily level of intake sufficient to meet the nutrient requirements for 97-98% of all healthy people; varies by sex, age and pregnancy/breastfeeding status Adequate intake (AI): when evidence is insufficient to develop an RDA, used to assume "nutritional adequacy" Tolerable Upper Intake Level (UL): maximum daily intake that is unlikely to cause adverse health effects

Adulterated food is regulated by the... a. HHS b. FDA under the Food, Drug, Cosmetic Act c. Department of Commerce d. USDA

b. FDA under the Food, Drug, Cosmetic Act Under Food, Drug, and Cosmetic Act, FDA covers all interstate food except meat, fish, poultry and eggs; inspects food processing factories, raw materials and labeling.

Programs that focus on providing fresh fruits and vegetables are: a. TANF and ASP b. FFVP and SFMNP c. TEFAP and NETP d. DHHS and SBP

b. FFVP and SFMNP Fresh Fruit and Vegetable Program and Senior Farmers Market Nutrition Program both primarily provide fruits and vegetables.

A single man with two daughters, ages 10 and 11, is looking for aid. Which program might approve assistance? a. WIC b. Food Stamps c. Child Care Food Program d. Headstart

b. Food Stamps Although not called Food Stamps anymore, SNAP/Food Stamps would be most appropriate. The children are too old to qualify to WIC and too old for Headstart. The Child [and Adult] Care Food Program supports public and non-profit food service programs for family day care centers, neighborhood houses, homeless shelters, nonresidential adult daycare center. Subsequently, SNAP would be most appropriate but would depend on household income.

A patient with Crohn's disease needs the following diet: I. high fat, high calorie, high protein II. low fat only with steatorrhea, vitamin C, B12 III. calories according to current BMI, high protein IV. high residue, low fat, fat soluble vitamins V. low calorie, low residue, fat soluble vitamins, B12 a. I b. II, III c. III, IV d. V

b. II, III A Crohn's disease patient will only need to restrict fat if they are experiencing steatorrhea. Vitamin C and vitamin B12 supplementation may be beneficial due to absorption in the small intestine, which is likely affected in Crohn's disease (especially terminal ileum). A Crohn's patient who is not in a flare can have calories according to BMI. A higher protein diet would be indicated. A high fat, high calorie, high protein diet would not necessarily be indicated in Crohn's. High fat diet may aggravate the patient's GI tract, and high calorie is not necessary if the disease is well controlled. Additionally, a low calorie, low residue diet is not necessary. If a patient is having a flare, they may minimize fiber in the diet until they are in remission, and then increase to higher fiber.

Based on the DRG's, Medicare reimbursement depends on: I. length of patient stay II. age of patient III. primary diagnosis a. I b. II, III c. I, II d. I, II, III

b. II, III DRG stands for Diagnostic Related Group. Remember, we care about our elders so we put them in long term care- Medicare. To qualify for Medicare, must be over 65 years OR any age with end-stage renal disease. Length of patient stay does not impact benefits

An infant formula for lactose intolerance might include: I. whey, coconut oil II. casein hydrolysate, corn oil, glucose III. soy protein, corn syrup solids IV. sodium caseinate, hydrolyzed cornstarch a. I, II, III b. II, III c. II d. I, III

b. II, III Lactose intolerance = lack of lactase enzyme. Whey is a non-hydrolyzed milk protein that contains lactose, so it would not be appropriate. Casein hydrolysate is hydrolyzed, meaning the lactose is broken down into it's amino acid form. Subsequently, casein hydrolysate would be appropriate. Sodium caseinate is not hydrolyzed, and thus is not suitable for lactose intolerance. The other listed ingredients do not contain dairy, and thus II and III would be the acceptable ingredients.

Which of the following is not a guideline for Medicaid? I. low income II. over the age of 60 only III. nutritional need a. I b. II, III c. II d. III

b. II, III Medicaid is run by DHHS- federal law administered by state. Medicaid is payment for medical care for all eligible needy; all ages, blind, disabled, dependent children. Subsequently, the only eligibility criteria that is true for Medicaid is low income.

Which best applies to nutritional screening? a. HIPAA standards must be followed b. It should include nutritional parameters are identified c. It is done after nutritional problems are identified d. It is only done on at risk patients

b. It should include nutritional parameters are identified Nutrition screening is the use of preliminary nutrition assessment techniques to identify people who are malnourished or at risk for malnutrition. Subsequently, nutrition screening should include nutritional parameters. Nutrition screening is done before the nutrition diagnosis is identified. Nutrition screening is done on all patients, not just those who are at nutritional risk. HIPPA.

Being well-treated by supervisors, being given special attention, and the importance of breaks in increasing productivity, are all considered motivators by: a. Herzberg b. Mayo c. Maslow d. MacGregor

b. Mayo Hawthorne studies were conducted on workers at the Hawthorne plant of the Western Electric Company by Elton Mayo and Fritz Roethlisberge. They found that if you involve people in the process, they become more productive. Productivity was due to employees being given special attention (placebo effect), being involved in interesting experience, and being well-trained by supervisors.

Which program helps provide nutritious meals to an adolescent residential facility? a. SNAP b. National School Breakfast Program c. Expanded Food and Nutrition Education Program d. The Emergency Food Assistance Program

b. National School Breakfast Program

A mother with 2 daughters, ages 8 and 11, does not earn enough money to feed her family. Which program would you suggest? a. WIC b. SNAP c. Child and Adult Care Food Program d. Medicaid

b. SNAP These children are too old to participate in WIC. Child and Adult Care Food Program would only be appropriate if the children were preschoolers enrolled at participating child-care center, homeless shelters, eligible after school programs (run by community organizations in areas with > 50% children eligible for free/reduced meals. Medcaid provides health insurance, not food. SNAP would be the best option to provide monthly benefits for food.

The main reason why commodity foods obtained from a USDA program may not be brought to a Kosher facility is: a. because meat cannot be served with diary products at the same meal b. kosher foods are not allowed to be mixed with non-kosher foods c. Jewish dietary practices are lacto-ovovegetarian d. Jewish dietary practices are lactovegetarian

b. kosher foods are not allowed to be mixed with non-kosher foods

Nitrogen equilibrium is associated with: a. a 25 year old pregnant female b. a 25 year old male c. a 15 year old girl d. a 4 year old child

b. a 25 year old male Nitrogen equilibrium means that there is a relatively equal nitrogen intake and nitrogen output (nitrogen balance). In a pregnant female, the body becomes anabolic and enters positive nitrogen balance. Positive nitrogen balance is also associated with periods of growth, such as in children. A 25 year old male would be the most likely to be in nitrogen equilibrium.

If you increase the size of the kitchen, what effect will there be on worker efficiency? a. an increase b. a decrease c. no change d. depends on menu

b. a decrease Workers will have increased "steps", meaning they have to move around more to get the same task done.

An elderly patient with high MCV, high MCH, irritability and fatigue may have: a. an iron deficiency b. a deficiency of folic acid c. hemochromatosis d. low serum ferritin levels

b. a deficiency of folic acid Folic acid deficiency anemia results in macrocytic cells. Folate is commonly deficient in the elderly as well. IDA and low serum ferritin is not correct as would be microcytic cells. Hemochormatosis is iron overload, which is not indicated here.

Trauma can place the patient in: a. an anabolic state b. a hypermetabolic state c. a hypothermic state d. a hypometabolic state

b. a hypermetabolic state Trauma creates increased demand on the body, and thus is in a hypermetabolic state.

Who is the most appropriate candidate for parenteral nutrition? a. a 12 year old girl coming in for an appendectomy b. a middle aged woman who will begin chemotherapy c. an elderly lady with emphysema d. a young man going in for gallbladder surgery

b. a middle aged woman who will begin chemotherapy PN should only be administered if absolutely necessary. A middle aged women who will begin chemotherapy is most likely to need PN because she could experience severe N/V, stomatitis/mucositis, and other side effects from her treatment that will make oral intake and EN not viable options. A 12-year old coming in for an appendectomy will likely have no problem going back to a normal PO following surgery. Similarly, a young man having gallbladder surgery should also tolerate PO intake. An elderly woman with emphysema also should not have an issue eating, and if she did, EN would be a appropriate intervention as there are no contraindications to EN.

Which of the following would likely have a very low albumin a few days after admission to an acute care hospital? a. a patient with anorexia nervosa b. a patient with a 30% full thickness burn c. a patient with newly diagnosed colon cancer d. a patient with COPD

b. a patient with a 30% full thickness burn Burns, especially full thickness burns (destroy first and second layer of skin), would cause a very low albumin due to a higher vascular permeability in the burn wounds that produces exudation with an important protein loss through the burn wound.

You are involved in planning a prospectus. This is: a. measuring the size of all food service equipment b. a planning guide for a kitchen c. how ot arrange the dairy box d. how to document nutrition care

b. a planning guide for a kitchen A prospectus is a planning guide for the kitchen, a formal summary of the proposed work.

What is the best example of delegation? a. tell the employee what to do b. allow the employee to change procedures to achieve desired outcome c. require the employee to provide daily progress reports d. select an employee who is interested in management

b. allow the employee to change procedures to achieve desired outcome Delegation is the distribution of work to qualified people. Managers must have a clear understanding of what they want done, give specific instructions, motivate, provide training, require complete work, establish controls.

Which of the following is a digestive enzyme secreted by the pancreas? a. pepsin b. amylase c. lactase d. maltase

b. amylase Pepsin is released by the chief cells in the stomach. Amylase is released by the pancreas into the duodenum. Lactase and maltase are released by the small intestine on the brush border membrane.

Which is considered a hazardous situation? a. a gauge on the coffee urn not working b. an employee washing floors during rush hour c. an employee cleaning the grill with steel wool d. an employee leaving the freezer door ajar

b. an employee washing floors during rush hour A hazardous situation is circumstance that exposes people, property or environment to one or more hazards. Having a wet floor during rush hour puts workers and patrons at risk for a fall.

What should you do with a new client who sits scowling at you during the session? a. presume she understands what you are saying b. ask her if she is uncomfortable about the session c. recognize that new clients are seldom relaxed d. presume that she just would rather be somewhere else

b. ask her if she is uncomfortable about the session

Which production system has the smallest production area? a. cook-chill b. assembly-serve c. conventional d. commissary-satellite

b. assembly-serve Advantages of assembly-serve include that is curtails labor time by separating manufacture from distribution, no skilled cooks or pre-pre needed, equipment and space requirement minimal

A muffin has long tunnels from top to bottom, next time you make this recipe you should: a. add more baking soda b. avoid over-mixing the batter c. add less butter d. cook it for a shorter time

b. avoid over-mixing the batter Over-developed gluten.

The diet for stomatitis is: a. low fat, high carb, normal protein b avoid spices, very hot, very cold, sour, tart foods c. high protein, high carbohydrate d. liquids, mostly carbohydrates

b. avoid spices, very hot, very cold, sour, tart foods Minimize discomfort.

How many actual relief employees are needed to cover 20 full-time employees? a. 12 b. 15 c. 11 d. 8

c. 11 To calculate the actual number of relief workers needed, multiply the number of full-time positions by 0.55 0.55 x 20 = 11

The report presenting the financial condition of an organization as of a particular date is a: a. budget b. balance sheet c. income statement d. funds flow sheet

b. balance sheet A balance sheet depicts assets, liabilities, stockholders equity; shows financial condition as of particular date (static). An income statement is a report of net income and expenses to be over a certain period of time (dynamic); aka profit and loss statement, revenue and expense statement. A budget gives the manager a basis for control in order to estimate future needs

When counseling an anorexic, the best advice is to: a. be real strict in their food choices b. be flexible and help them choose reasonable goals c. provide a large variety of menu items d. give them free rein with their intake

b. be flexible and help them choose reasonable goals

Which provides the most vitamin A for a Mexican? a. tortillas and refried beans b. cantaloupe and squash c. cheese d. tortillas and milk

b. cantaloupe and squash Dietary vitamin A either comes from preformed vitamin (eggs, liver, meat, dairy) or from provitamin A including beta-carotene (red/orange/yellow fruits and veggies). Subsequently, cantaloupe would be the best answer.

If the chlorine solution in the dishmachine is not working properly, the first action should be: a. change to quarternary ammonia b. check the concentration and temperature of the solution c. use disposable dishes d. change to an iodine solution

b. check the concentration and temperature of the solution If a dishwasher is not working properly, the first thing you want to check is whether the temperature of the solution is where it should be.

Which of the following is an outcome indicator? a. inventories are recorded weekly b. clients are satisfied with the meals provided c. assessments are recorded with 24 hours of admission d. diagnoses are recorded within the PES statement

b. clients are satisfied with the meals provided An indicator is a measurement tool that monitors and evaluates important aspects of patient care and management functions; direct attention to specific issues. An outcomes indicator would look at efficiency and effectiveness of the system, including client satisfaction.

Which type of power is ineffective in motivating behavioral change and may create resistance? a. referent b. coercive c. legitimate d. expert

b. coercive There are various types of power, including reward, coercive, position (legitimate), expert, referent. Coercive power utilizes threat and fear to get things done, and thus would not be an effective motivation behavioral change and could create resistance. Referent power is having influence over others because you are well-liked. In position (legitimate) power, the subordinate acknowledges that the influencer has the right to exert influence due to position (job title). Expert power is the belief that influencer has some relevant expertise that a subordinate does not; provides creditability; viewed as competent.

Following counseling, a client is able to plan a low sodium diet. The learning domain is: a. affective b. cognitive c. psychomotor d. psychosocial

b. cognitive The three types of learning domains are cognitive, affective and psychomotor. Cognitive is acquisition of knowledge or subject matter (factual information). Affective is acquisition of attitude and value, growth in feelings or emotions. Psychomotor learning is the acquisition of muscular skills (exercises, food prepartion). In this example, the client is able to perform the task of planning a low sodium diet, and thus is showing cognitive learning.

When cleaning _______ use chlorine or quaternary ammonia. a. laundry b. countertops c. oven d. floor

b. countertops In food service, chlorine, quaternary ammonia and iodorphors are used to sanitize food and food contact surfaces in foodservice, including countertops, pots, and pans.

Which test measure somatic protein: a. prealbumin, albumin b. creatinine clearance, serum creatinine c. serum transferrin d. prealbumin, albumin, transferrin

b. creatinine clearance, serum creatinine Somatic protein = measure of the protein in skeletal muscle

In the alanine cycle, alanine is released from muscle, taken up by the liver, and: a. excreted in the urine b. deaminated to release glucose c. converted into adipose d. oxidized to nitric acid

b. deaminated to release glucose Alanine = amino acid (MOST glucogenic amino acid), if alanine is released from muscle and taken up by the liver, it will be used to synthesis glucose in times of need via gluconeogenesis.

In behavior modification, the absence of reinforcement following an undesired behavior is referred to as: a. avoidance learning b. extinction c. negative reinforcement d. negative consequence

b. extinction The types of behavioral modification methods include positive reinforcement, avoidance learning, and extinction. Positive reinforcement is encourages reptition of a given behavior- it should be specific and immediate. Extinction is aimed at reducing undesirable behaviors- absense of reinforcement following an undesired behavior (ignore). The belief is, if extinction is repeated, behavior will eventually disappear. Avoidance learning is learning to escape from unpleasant consequences- avoiding futre critism by improving future behavior.

Which is the primary fuel used by resting muscle and at low intensity exercise? a. glucose b. fatty acids c. branch chain amino acids d. keto-acods

b. fatty acids As low- to moderate-intensity exercise continues using aerobic metabolism, fatty acids become the predominant fuel source for exercising muscles.

Which of the following combines with CoA in two carbon fragments to make acetyl CoA to then enter the Kreb's cycle to make energy? a. lactic acid b. fatty acids c. glucose d. fructose

b. fatty acids Beta-oxidation is the process of fatty acid oxidation. The end product of beta-oxidation is 2 carbon fragments of fatty acids that combine with CoA to make acetyl CoA, which can then go to the TCA cycle and then ETC to make energy (a LOT of energy compared to CHO or protein) due to more carbons and hydrogens.

What is the recommended weight gain during pregnancy for a woman with a BMI of 28? a. 25-35 pounds b. 28 - 40 pounds c. 15-25 pounds d. 11-20 pounds

c. 15-25 pounds For underweight BMI: 28-40 lbs For normal BMI: 25-35 lbs For overweight BMI: 15-25 lbs For obese: 11-20 lbs

The food service supervisor should carefully monitor a cook-chill production because of concerns about: a. work simplification techniques b. food safety c. portion control d. product acceptability

b. food safety In cook-chill production, the kitchen produces menu items ahead of time and then chills them. When it is time to use the items, they are heated back up for service. In the process of cooking originally, freezing, and reheating, there can be concerns for food safety.

The additive influence of foods are constituents which when eaten have a beneficial effect on health refers to: a. nutraceuticals b. food synergy c. positive corollaries d. medical foods

b. food synergy Food synergy is the concept that the non-random mixture of food constituents operates in conjunction doe the life of the organism eaten and presumably for the life of the eater. A nutraceutical is a food containing health-giving additives and having medicinal benefit.

The statement "the country's infant mortality rate is 12.8, and the state's infant mortality rate is 10.5" means that: a. more infants died in the country than in the state b. for every 1000 live births in the country, 12.8 infants died c. two more infants died in the country than in the state d. 12.8% of the infants born in the country died before the age of 1

b. for every 1000 live births in the country, 12.8 infants died Mortality = deaths

A vegan with macrocytic anemia needs which of the following? a. iron-rich foods b. fortified soy milk c. eggs, wheat bread d. meat, green vegetables

b. fortified soy milk Vegan diets are typically lacking in dietary B12. Subsequently, the macrocytic anemia a vegan would be most at risk for is vitamin B12 related. A vegan does not eat eggs or meat, so c and d are out. Iron-rich foods would be indicated if they had microcytic anemia. Subsequently, fortified soy milk is the best answer. Many plant-milks are fortified with B12 for this reason already.

Five pounds of pressure creates a temperature that is _______ the boiling point of water. a. less than b. greater than c. equal to d. twice

b. greater than Steam cooking is measure by PSI (pounds per square unit). PSI 15= temperature 250' F. If pressure is applied to the liquid, it must become hotter before it can boil.

Which of the following would lacto-ovo-vegetarian not eat? a. eggs b. halibut c. cheese d. beans

b. halibut Lacto-ovo vegetarianism or ovo-lacto vegetarianism is a type of vegetarianism which allows for the consumption of animal products, such as eggs and dairy. Unlike pescetarianism, it does not include fish or other seafood. Subsequently, halibut would not be allowed.

A neonate at birth was at the 75th percentile for weight for age. At 6 months he appears healthy and was at the 60th percentile weight for age. This indicates that: a. he has a low caloric intake b. he is experiencing normal growth c. he may have protein energy malnutrition d. birth measurements were incorrect

b. he is experiencing normal growth Weight for age is NOT used to classify under/over weight. Weight is for age is a short term marker of growth that CANNOT distinguish between stunting and wasting because it does not include height. Further evaluation if needed if below 5th or above 95 percentile.

Anasarca is extreme generalized edema and swelling of the skin associated with: a. uncontrolled diabetes b. heart, liver or renal failure c. short bowel syndrome d. pancreatitis

b. heart, liver or renal failure

Which of the following indicates stunted growth? a. weight for height b. height for age c. weight for age d. weight for length

b. height for age Stature/length for age defines shortness/tallness and reflects long term nutritional status; determines extent of stunting Weight for length/stature identifies under/over nutrition and detects short term changes to nutritional status. Weight for age is NOT used to classify under/over weight and is a short term marker of growth that cannot distinguish between stunting and wasting becuase it does not include height

An advantage of using focus groups to collect data is that they: a. help you generalize to larger populations b. help the researcher understand participants' perspectives c. help participants stay focused on the topic d. are inexpensive because many can be interviewed at once

b. help the researcher understand participants' perspectives Focus groups provide attitudinal data, which gives insight to the reseachers on what the participants believe about certain topics. This information cannot be generalized to a larger population as it is just qualitative and very subjective.

A patient with diabetic gastroparesis should avoid foods that are: a. high in simple sugars b. high in fat c. low in fiber d. low in protein

b. high in fat Diabetic with gastroparesis should avoid high fat foods. Gastroparesis is delayed gastric emptying, meaning that the food sits longer in the stomach. Fat can delay emptying of the stomach. Eating less fat-containing foods will decrease the amount of time food stays in the stomach. Those with gastroparesis should avoid high fiber foods to reduce abdominal discomfort. Because of the delay in gastric emptying, diabetics with gastroparesis are at risk for uncontrolled/difficult to manage blood sugars, specifically hypoglycemia as a meal will sit in the stomach and not be absorbed. Subsequently, simple sugars may be used to prevent hypoglycemia in gastroparesis.

Low levels of folate, pyridoxine, and cyanocobalamin are associated with: a. glycogen storage disease b. homocystinurias c. phenylketonuria d. galactosemia

b. homocystinurias Homocystiurias is a treatable inherited disorder of amino acid metabolism, characterized by severe elevations of methionine and homocysteine in plasma, and excessive excretion of homocysteine in urine. Those newly dx with homocystinuria require increased doses of folate, pyridoxine (B6), B12. The reason there are increased requirements for these vitamins is because vitamin B6, vitamin B12 and folate are all required to convert homocysteine to amino acids.

Quickly stopping a 25% dextrose solution leads to: a. hyperglycemia b. hypoglycemia c. hypophosphatemia d. hyperkalemia

b. hypoglycemia

The citric acid cycle occurs: a. in the cytoplasm of the cell and produces energy as ATP b. in the mitochondria and produces energy as ATP c. in the cytoplasm of the cell and produces pyruvic and lactic acids d. in the mitochondria and produces pyruvic and lactic acid

b. in the mitochondria and produces energy as ATP Glycolysis is in the cytoplasm, citric acid cycle and ETC are in the mitochondria. This makes sense, considering glycolysis makes very little energy and the vast majority comes from ETC and the mitochondria is the powerhouse of the cell

Beef bottom round should be cooked: a. at a high temp for a short time b. in water for an extended time c. in dry heat d. in moist heat for short time

b. in water for an extended time Connective tissue has two properties: collagen and elastin. Collagen becomes tender in heat (collagen + moist heat = gelatin). This is why we use MOIST HEAT for tought meat, such as flank, bottom round, brisket. Dry heat methods (no water involved) can be used for tender (soft) cuts which are near the backbone (loin, sirloin). The reason D is not the answer is because, while you would use moist heat, you would not cook if for a short time. Subsequently, B would be the answer.

The medication megestrol acetate may be used to: a. correct vitamin A deficiency b. increase appetite c. initiate weight loss d. promote sleep

b. increase appetite Megestrol acetate, think Meg has a big Appetite

In acute hepatitis, you would likely see: a. decreases in SGOT, increase in SGPT b. increase in both SGOT and SGPT c. decrease in both SGOT and SGPT d. increase in SGOT and decrease in SGPT

b. increase in both SGOT and SGPT SGOT = AST, SGPT = ALT. SGOT and SGPT are heptic proteins that increase in times of liver disease, such as acute hepatitis.

Propionate is used in foods to a. enhance flavor b. increase shelf life by inhibiting mold c. thicken d. retain color

b. increase shelf life by inhibiting mold Propionate is an antimicrobial preservative used to prevent mold and bacterial growth in breads.

St. John's wort has which effect of Coumadin? a. decreases drug metabolism and decreases its effect b. increases drug metabolism and decreases its effect c. decreases drug metabolism and increases its effect d. increases drug metabolism and increases its effect

b. increases drug metabolism and decreases its effect In the literature, St John's wort decreases the INR through induction of cytochrome P450-mediated metabolism of warfarin and increases warfarin clearance. In other words, St John's wort increases the metabolism of Coumadin which decreases Coudamin's effect.

The immediate post-stress release of glucagon: a. increases glucose uptake into cells b. increases glucose release into the blood stream c. increases insulin release d. increases fluid and sodium excretion

b. increases glucose release into the blood stream Epinephrine, a catecolamine, stimulate glucagon release after stress (flow phase of ebb and flow). Glucagon mobilizes glycogen from the liver to be used as energy. Subsequently, the post-stress release of glucagon increases glucose release into the blood stream, and can cause hyperglycemia.

Statistics that let you draw probable conclusions beyond your immediate universe of data, are called a. descriptive statistics b. inferential statistics c. variable interest statistics d. continuous statistics

b. inferential statistics Inferential statistics makes inferences or conclusions from observed data (ex: probability hypothesis testing, variance). Descriptive statistics summarizes and describes small amounts of numerical information (ex: mean, median, mode, range, SD).

How can you preserve thiamin when cooking pork? a. use the drippings after the fat has been removed b. insert a meat thermometer and cook it to 145F in an oven at 325F c. increase the cooking temperature to lessen cooking time d. add a small quantity of water during cooking

b. insert a meat thermometer and cook it to 145F in an oven at 325F To prevent thiamin loses from cooking, cook for the minimum amount of time possible; a high temperature for a short time is preferable.

When a manager updates the Director about activities occurring on the patient trayline, he is demonstrating which managerial role? a. informational b. interpersonal c. technical d. decisional

b. interpersonal *** Jean's answer-key said interpersonal, but sems to be more informational? The primary roles of a manager include informational, interpersonal, and decision-making. Interpersonal roles: provides information and include the roles of a figurehead, leader, and liaison -Figureheads have social, ceremonial, and legal responsibilities; serve as an authority figure and source of inspiration -Leaders manage performance and responsibilities -Liaisons communicate with internal and external contacts and network effectively Informational roles: process information and include roles of a monitor, disseminator, and spokesperson; -Monitors: seek information related to their industry, look for changes in the industry environment, and monitor the team on productivity and well-being -Disseminators: communicate useful information to team and colleagues -Spokespersons: represent and speak for their organization, and transmit information about their organization and goals to people outside of it Decisional roles: use information and include the roles of entrepreneurs, disturbance handler, resource allocator, and negotiator -Entrepreneurs: create and control change (including problem solving), generate new ideas, and implement them -Disturbance handlers: take charge when the team hits an unexpected roadblock and mediate disputes within the team -Resource allocator: determines where organizational resources should be applies, allocate funding, and assign staff and other resources -Negotiators: take part in and direct important negotiations within the team, department, and even organization

A PN regimen that contains 1L of D50W and 1L of 7% Aminosyn provides how many non-protein calories. a. 300 b. 1400 c. 1700 d. 2000

c. 1700 Aminosyn = protein so ignore 50 gm dextrose per 100 mL = 50 x 10 = 500 gm dextrose x 3.4 kcal/gm = 1700 kcal from dextrose (non-protein kcals)

Which of the following is an example of productivity management? a. labor turnover rate b. labor minutes per day c. food cost percentage d. edible portion cost

b. labor minutes per day Productivity management is an evaluation tool used to measure efficiency and provide data to enhance decision-making and resource allocation. Productivity is the efficiency with which a production or service activity converts inputs into outputs, expressed as ratios. An example of productivity management would be labor minutes per day.

Following a Billroth II, steatorrhea often results. What is the likely cause? a. bacterial overgrowth in the remaining loop b. lack of pancreatic secretion due to less duodenal hormone secretion c. a diet restricting simple carbohydrates d. rapid absorption of simple carbohydrates

b. lack of pancreatic secretion due to less duodenal hormone secretion Billroth II is a gastrojejunostomy, in which the remaining stomach is attached to the jejunum. Subsequently, the duodenum is removed. Typically when chyme enters the duodenum, pancreatic enzymes (such as secretin releasing bicarbonate and pancreatic lipase) are released to help digest foods as well as absorption on the brush border member. However, now that the duodenum is removed, diarrhea may occur as these enzymes are not secreted to help further digest/absorb the chyme.

Patients with early signs of xerophthalmia should consume? a. chicken, fish, summer squash b. liver, milk, eggs c. oatmeal, almonds, berries d. high fiber cereals, salad greens

b. liver, milk, eggs There are two types of vitamin A- preformed vitamin A and provitamin A (mainly beta-carotene). Preformed vitamin A comes from animal produces, include liver, milk, and eggs

A 6'2" male, large frame, 230lbs with type II diabetes should: a. gain 5lb to be at a desirable body weight b. lose 20lb slowly following balanced diet c. lose 20lb in 4 weeks on a 800 calorie diet d. lose 10lb slowly by following a balanced diet

b. lose 20lb slowly following balanced diet Weight loss of 5-10% can improve insulin sensitivity. Rapid weight loss/extreme dieting is not appropriate.

The nutrition prescription for an infant with phenylketonuria includes: a. high phenylalanine, low tyrosine b. low phenylalanine, high tyrosine c. low phenylalanine, high isoleucine d. low phenylalanine, high valine

b. low phenylalanine, high tyrosine Phenylalanine is converted into tyrosine, which then becomes converted into catecholamine neurotransmitters. Subsequently, in a patient with PKU who avoid phenylalanine, tyrosine supplementation is needed.

Nutritional prescription for a patient with cardiac cachexia includes: a. <1 liter fluid, low sodium b. low sodium, low saturated fat, low cholesterol, high calorie c. restricted calorie, 0.8 protein/kg, fluid restriction d. normal protein, follow DASH

b. low sodium, low saturated fat, low cholesterol, high calorie Cardiac cachexia is unintended weight loss that occurs when blood backs up into liver and intestines causing nausea and decreased appetite. Since these individuals are experiencing weight loss, high calorie needs are indicated. However, since they are cardiac patients, low sodium (<2gm), low saturated fat needs are indicated for a heart healthy diet. ***Of note, Jean says low cholesterol as well. However, we know from research that dietary cholesterol does not impact serum cholesterol so while this is included I don't think this is actually correct.

Compared to whole milk, breast milk is: a. higher in protein and fat, lower in carbohydrate b. lower in protein, higher in carbohydrate and fat c. lower in protein, carbohydrate, and fat d. has the same nutrient composition

b. lower in protein, higher in carbohydrate and fat Breast milk is lower in protein, higher in CHO and fat, higher in antibodies

A patient with low hemoglobin, low hematocrit, high MCV has: a. microcytic anemia from lack of folate or B12 b. macrocytic anemia from lack of folate or B12 c. microcytic anemia from lack of iron d. macrocytic anemia from lack of iron

b. macrocytic anemia from lack of folate or B12 Folate deficiency anemia and pernicious anemia are characterized by low Hg, low Hct and, high MCV.

Which of the follow is most important in determining the space required for a food production unit in a new facility? a. number of hours the foodservice will be operating b. market form of foods purchase c. number of foodservice employee d. length of menu

b. market form of foods purchase Overall space planning is determined by "market form" of foods purchased (raw, prepared, partially prepared).

In interpreting statistical data, if half the observations are above the number 8, and half are below the number 8, the number 8 is the: a. mode b. median c. mean d. average

b. median Median = middle. We don't know mean (average) because we don't know the actual number for the observations. Similarly, for mode (the most) we would need to know the actual numbers. Median = middle, so the 8th value would be the median.

A fecal excretion of __grams of fat/24 hours is considered fat malabsorption a. less than 1 b. more than 7 c. 3-5 d. 2-4

b. more than 7 Normal stool fat: 2-5 gm Malabsorption: >7 gm

A patient consumed 12 grams of protein and released 8 grams of nitrogen in the urine, this is: a. nitrogen balance b. negative nitrogen balance c. positive nitrogen balance d. plus 4 nitrogen balance

b. negative nitrogen balance To determine nitrogen balance: Nitrogen intake: 12 gm protein consumed / 6.25 = 1.92 Nitrogen output: 8 gm in urine + 4 gm = 12 1.92 - 12 = -10.08

In the quasi-experimental design "time series", there is: a. a series of control groups b. no control groups c. an experimental and a control group d. a placebo group

b. no control groups Quasi-experimental deisng (aka time series or before and after study) measures something before and after the intervention to see how successful the intervention was

A 50 bed hospital has limited kitchen space for refrigeration, dry storage, and food production. The most appropriate type of menu is a. restaurant style b. nonselective c. selective d. single-use

b. nonselective Nonselective menus would be most appropriate in this case due to storage and food production limitations. Nonselective menus are not ideal for customer satisfaction, but in this case are justified given that it is a 50-bed hospital with space limitations. A more selective style menu would require greater storage and food production needs.

Food service employees should wash their hands for at least: a. 30 sec b. 25 sec c. 20 sec d. 15 sec

c. 20 sec

A dietitian who is developing policies and procedures for nourishment distribution and service should first: a. evaluate the nourishment distribution schedule b. note how nourishments are being distributed and served c. assign the foodservice supervisor the task of gathering data d. review policies and procedures manual from other facilities

b. note how nourishments are being distributed and served The question is asking about the process for developing policies and procedures for something new. First she needs to assess if she actually has to create new policies. Review against current standards, see if they are meeting needs, and with that determine if you need to continue creating the new policies and procedures.

If there is no statistical difference between study groups, the hypothesis is: a. negative b. null c. even d. positive

b. null Null = NO association between variables Alternative = affirmation of relationship between variables (Ex: eating vegan and lower rates of heart disease)

What change should be made in the following menu if it is to be served to Seventh Day Adventists? tomato juice, cottage cheese fruit plate or egg salad sandwich, milk, coffee, tea a. offer fortified soy milk b. offer decaffeinated beverages c. off tofu as an alternative to cottage cheese d. offer a meat analog as an alternative to egg salad

b. offer decaffeinated beverages Seventh Day Adventists typically follow a vegetarian or vegan diet. They avoid caffeine, espeically coffee, and thus decaffeniated beverages would be best to switch from coffee and tea.

Green beans cooked in tomato sauce turn ____ due to _____. a. bright green; chlorophyllin b. olive green; pheophytin c. brown; carotenoids d. black; anthoxanthins

b. olive green; pheophytin Chorophyll (in green vegetables) turns olive green in an acidic environment (tomato sauce) due to the enzyme pheophytin.

How much water should be available per person per day in a disaster? a. one gallon for two days b. one gallon for a minimum of three days c. one gallon for a minimum of one week d. one gallon for a maximum of two days

b. one gallon for a minimum of three days

A patient who is iron-deficient should consume ____ with a good iron source: a. apple juice b. orange juice c. milk d. cheese

b. orange juice Vitamin C enhances iron absorption.

An AIDS patient should select the following fresh fruit: a. grapes, orange b. orange, banana, pineapple c. apple, grapes, peach d. grapes, pear

b. orange, banana, pineapple In AIDS patients, they are at a very high risk for food borne illness due to severly compromised immune system. Subsuquently, chose fruits that have a peel and can be scrubbed prior to peeling/preparing. Orange, banana, and pineapple are the best options.

A patient is recovering from an ileocecal resection, where 100cm was removed. What are your recommendations? a. oral vitamin B12, increase fluids b. parenteral vitamin B12, increase fluids, increase protein c. decrease fluids, increase protein, parenteral B12 d. decrease protein, decrease fluids, oral B12

b. parenteral vitamin B12, increase fluids, increase protein An ileocecal resection is the surgical removal of the cecum along with the most distal portion of the small bowel—specifically, the terminal ileum. Deficiency of nutrients typically absorbed in the ileum must be supplemented. The primary nutrient of concern is vitamin B12. Vitamin B12 is bound to R protein in the stomach, travels to the duodenum where IF by gastric parietal cells is released and binds to vitamin B12 in place of R protein. Vitamin B12 absorption occurs in the ileum. Parenteral vitamin B12 is provided because if the pt were given oral B12, the B12 not absorb since the ileum is removed and that is the site of B12 absorption. Subsequently, parenteral B12 is given directly into blood circulation. Fluid needs increase as the ileum is typically involved in absorbing water/fluids. Protein needs increase to aid in healing.

Levodopa is used in the treatment of : a. rheumatoid arthritis b. parkinsons disease c. diabetic ketoacidosis d. nephrotic syndrome

b. parkinsons disease Levodopa is used as a dopamine replacement agent for the treatment of Parkinson disease. Pyridoxine accelerates systemic metabolism of levodopa, thereby decreasing availability of the amino acid to brain parenchyma.

Four patients are admitted to your service. Who would you address first? a. patient who had a recent MI b. patient with gastric distress c. patient with cancer d. patient admitted for an appendectomy

b. patient with gastric distress Most likely to need nutrition support, specifically PN.

A 2 year old child with iron-deficiency anemia has anorexia, vomiting, weight loss and restless. Look for: a. excessive milk and fruit juice intake b. excessive vitamin C and D intake c. asthma and respiratory distress d. pica and lead poisoning

b. pica and lead poisoning Lead competes with iron for absorption, and thus lead poisoning would lead to IDA. Pica, or consumption of non-food items, can also be a sign of mineral deficiency such as iron. Lead poisoning can also cause N/V, weight loss, and anorexia.

Esophageal varices may be caused by: a. portal hypotension b. portal hypertension c. a high fiber diet d. a high fiber, high residue diet

b. portal hypertension Fibrosis and nodules of regenerating hepatocytes cause resistance to blood flow through the liver, leading to increased pressure in the portal vein. When portal pressure rises to 10 mm Hg, collateral circulation develops between it and nearby veins so that blood can be diverted into the systemic veins. Increased pressure causes edema, both general and ascites. Pressure can also lead to esophageal varices

Management by objectives refers to a management process which employs: a. periodic, preplanned, broad objectives b. precise, measurable objectives c. determination of goals by department superiors d. objectives of instructions set by top management

b. precise, measurable objectives Management by objectives is a democratic (participative) management style in with goals and objectives are made with employees. This style gives higher incentive value to employees, overall control is achieve through self-control by employees, and management stresses accomplishments and results.

What is the benefit:cost ratio of a program intervention that cost $1,890,000 if the savings as a result of the program were $5.67 million? a. 1:1 b. 2:1 c. 3:1 d. 1:3

c. 3:1 5,670,000/1,890,000 = 3:1 (benefit:cost)

Urea excretion is related to ___, while creatinine excretion is related to ____. a. muscle mass, protein intake b. protein intake, muscle mass c. protein intake, adipose reserves d. protein intake, calcium intake

b. protein intake, muscle mass Urea production changes in parallel to the degradation of dietary and endogenous proteins. Subsequently, urea excretion is related to protein intake. Creatinine is a byproduct of muscle breakdown. Creatinine will increase during renal disease as the kidneys cannot clear creatinine. Creatinine excretion is thus related to muscle mass.

A patient with liver disease needs adjustments in the intake of: a. protein, fat, and sodium b. protein, fluids, sodium c. protein, calories, sodium d. fluids, calories, fat

b. protein, fluids, sodium When the liver is damaged, you want to reduce fat accumulation. Subsequently, adequate protein intake will spare the need for fatty oxidation. Low sodium is important in liver disease to reduce risk of fluid accumulation/ascites, as high sodium diet will draw water out into interstitial spaces and cause ascites/edema. Fluids may be limited as well to minimize edema. Fluid accumulates within the abdomen (ascites) and on the legs (pedal edema). This is due to both increased pressure inside the liver and because of the decreased production of proteins (especially albumin) by the liver.

When a patient is receiving an isotonic, polymeric enteral feeding and the medication Propofol, your concern is: a. not providing adequate protein b. providing too many calories c. delivery of excess sodium d. development of diarrhea

b. providing too many calories Propofol 1.1 kcal of fat calories

If you measure a group before and after a treatment to see whether or not there has been a significant change, the study design is: a. experimental b. quasi-experimental c. descriptive d. qualitative

b. quasi-experimental Quasi-experimental deisng (aka time series or before and after study) measures something before and after the intervention to see how successful the intervention was. There is no control group which is what makes it different from experimental.

If a union member repeatedly arrives late, you should... a. fire him b. report him to management c. say nothing but make a note of it d. forget it

b. report him to management

A Dietitian documents their work on time. This is an example of: a. accountability b. responsibility c. courtesy d. good time management

b. responsibility Responsibility: obligation to perform an assigned activity, or see that someone else performs it; both manager and employee are responsible for task Accountability: being responsible for oneself, to an organization, or to a manger; both manager and employee are accountable for task

What is the major reason for installing automated equipment? a. easier to use b. rising labor costs c. easier to clean d. greater flexibility

b. rising labor costs Labor costs have continued to rise; thus utilizing automated equipment when possible will be a cost savings

Fats high in polyunsaturated fatty acids include: a. olive and canola b. safflower and corn c. coconut and palm d. soy and peanut

b. safflower and corn Most predominant (from greatest to least) MUFAs: olive, canola, peanut, sunflower, coconut oil PUFAs: safflower, corn, soybean, cottonseed, sunflower, palm kernel Saturated fat: coconut oil, palm kernel, cocoa butter, butter, palm oil, canola

Which of the following items is appropriate for a Muslim diet: a. sweet and sour pork b. salad with imitation bacon bits c. pork-fried rice d. chicken in wine sauce

b. salad with imitation bacon bits Muslims follow Halal dietary laws, which prohibits foods are called haram (no pork, alcohol, gelatin, congealed salad). Overeating is discouraged and they fast sunrise to sunset during Ramadan. Imitation bacon bites are made from TVP and thus acceptable.

The foodborne illness associated with poultry, egg products, and produce that has an onset of 6-48 hours causing pain, headache, nausea, vomiting, fever, and diarrhea is: a. listeria monocytogenes b. salmonella c. shigella d. staphylococcus aureus

b. salmonella Salmonella is commonly caused by poultry, eggs, dairy, and produce contaminated with salmonella. Symptoms include diarrhea, vomiting, fever, and stomach cramping.

Patients with decubitus ulcers will likely demonstrate low: a. serum sodium b. serum albumin c. serum potassium d. serum glucose

b. serum albumin Decubitus ulcers are pressure injuries, or injuries to skin and underlying tissue resulting from prolonged pressure on the skin. Those with pressure injuries are most likely to have low serum albumin as albumin is a negative acute phase reactant that decreases in times of infection, inflammation and stress. Subsequently, albumin would decrease with pressure injuries.

Iron deficiency anemia has the following characteristics: a. large cells laden with hemoglobin, hypochromic, microcytic b. small, pale cells, hypochromic, microcytic c. large cells laden with hemoglobin, macrocytic, megaloblastic

b. small, pale cells, hypochromic, microcytic IDA is a microcytic-hypochromic anemia. Most common cause of anemia include chronic blood loss most common cause (GI bleeding - NSAIDs, aspirin). IDA is associated with deficiency of iron intake or absorption, eating disorders such as pica. IDA sxs typically include fatigue, weakness, SOB, pale earlobes, spooned and brittle nails (symptomatic when hgb 7-8). IDA is evaluated using serum ferritin. Treat IDA with iron supplement (ferrous sulfate), eliminate blood loss. Vitamin C increases iron absorption

A swallowing test has been ordered for a patient who holds food in his mouth for a long time and is coughing. Which food can he have for dessert? a. ice cream b. smooth pudding c. gelatin d. bread pudding

b. smooth pudding Thick liquids until SLP can evaluate?

A diabetic needs 1800 calories, 50% from carbohydrates. How many CHO choices can he have at each meal if he has 2 snacks with 2 CHO choices each? a. 2 b. 3 c. 4 d. 5

c. 4 1800 kcal x .5 = 900 kcal from CHO 900 kcal / 4 kcal per gm = 225 gm CHO 1 exchange is 15 gm, so 225 / 15 = 15 exchanges in day 15 exchange - 4 (2 snacks w/ 2 CHO choices) = 11 exchanges 11 exchanges / 3 meals per day = 3.666 = 4

What elements of the diet vary the most in hepatic disease? a. fat, carbohydrate, potassium b. sodium, fluid, protein c. sodium, potassium, protein d. fat, sodium, potassium

b. sodium, fluid, protein Sodium and fluid go hand-in-hand. Fluid is attracted to sodium, so the more sodium a person consumes, the more fluid will be attracted to the interstitial fluids. Ascites occurs when blood cannot leave the liver. Connective tissue overgrowth blocks blood flow out of liver into vena cava. The liver expands. When storage capacity has been exceeded, pressure caused by increased blood volume forces fluid to sweat through the liver into the peritoneal cavity. This fluid is almost pure plasma with a high osmolar load, pulling more fluid in to dilute the load, leading to sodium and water retention. Protein is also essential in liver disease because protein promotes tissue repair & prevents further injury and provides lipotropic agents like methionine and choline needed to convert fats to lipoproteins for removal from the liver, thus, preventing fatty infiltration. Since much of protein metabolism occurs in the liver (deamination/transamination, synthesis and processing of lipoproteins, formation of plasma protein such as albumin and prealbumin), disease to the liver will undoubtedly make an impact to protein metabolism.

A typical meal of a pregnant teenager consists of a hamburger. French fries and diet soda. Which of the following changes would be most beneficial? a. substitute fresh vegetables for french fries b. substitute a milkshake for diet soda c. add fresh fruit to the meal d. add another hamburger

b. substitute a milkshake for diet soda Diet soda provides empty calories, and the milkshake provides a good source of fat and calcium. There is also some research that suggests expectant mothers who consume artificially sweetened beverages may double their children's risk of being overweight at 1 year old. Subsequently, to avoid any potential risk, B is the answer.

A patient with dehydration exhibits the symptoms of: a. high blood pressure, dizziness b. sunken eyes, decreased renal function, increased tachycardia c. decreased BUN, decreased serum creatinine d. low blood pressure, low serum sodium

b. sunken eyes, decreased renal function, increased tachycardia Sxs of dehydration include rapid breathing, sunken eyes, sleepiness, lack of energy, confusion or irritability and fainting. Sunken eyes will occur because when the body is dehydrated, layers of tissue become less plump. The skin around the eyes is already thinner than other parts of the body, so any reduction in plumpness is visible relatively quickly. As a result, dehydration can cause the eyes area to appear darker, discolored, sunken, or hollow. Tachycardiac will occur as a result of the heart attempting to compensate for the lack of fluid in the body.

The National Sanitation Foundation standard for equipment construction that is most related to microbiological food safety requires that: a. outside corners are bull-nosed b. surfaces do not have open seams or cracks c. equipment surfaces are without sharp edges d. bolts are securely fastened

b. surfaces do not have open seams or cracks Open seams/cracks are difficult to clean so bacteria can grow and increase risk of contamination or food borne illness. The other options may be important for employee safety.

What is fluid seeping from a congealed product called? a. retrogradation b. syneresis c. coagulation d. gelatinization

b. syneresis Syneresis is the extraction or expulsion of liquid from gel.

You teach food service workers about pot-washing temperatures. How do you know if the workers then follow the rules? a. ask them to repeat the rules b. test the water temperatures at frequent intervals c. ask them to write down the guidelines d. check to see if the pots are clean

b. test the water temperatures at frequent intervals The first step in knowing whether a worker follows a rule is to put it to the test. Since this question is pertaining to pot-washing temperatures, you would randomly check temperatures of the water to see if it is where it should be.

To find out about the new regulations developed by the FDA you would check: a. the Congressional Record b. the Federal Register c. current newspapers d. the Congressional Index

b. the Federal Register The Federal Register is considered the Daily Journal of the U.S. government. It provides updates on new regulations developed by the FDA regarding human and veterinary drugs, biological products, medical devices, the Nation's food supply, cosmetics, and products that emit radiation

Which outcome would justify continuing a WIC program? a. the number of participants enrolled increased b the infant morbidity rate decreased c. maternal weight gains during pregnancy increased d. the number of diverse cultures participating increased

b. the infant morbidity rate decreased Think of an outcome as something that justifies the expense and continuation of a program. While an increased number of participants and number of diverse cultures is positive, it won't in itself justify the expense of the program. Maternal weight gain during pregnancy may be a good or bad outcome depending on circumstance (i.e. obese individual gaining excessive weight is not good). The rate of infant morbidity rate decreasing shows the IMPACT of the program. The intervention itself (WIC), is decreasing the number of infants getting sick. This proves the value of the program and thus would most justify continuing WIC.

In interpreting correlation data, if the r value is greater than 1: a. the relationship is strong b. the result is not valid c. the relationship is weak d. is it within 1 standard deviation

b. the result is not valid r= =/- 1 is perfect correlation; cannot have correlation outside of this range. </= 0.4 would be a poor correlation, 0.4-0.7 would be moderate correlation, >/= 0.7 would be a strong correlation (this is true for positive or negative values.

Memory loss may be associated with a deficiency of: a. riboflavin b. thiamin c. protein d. electrolytes

b. thiamin Research suggests that thiamine deficiency is associated with neurological problems, including cognitive deficits and encephalopathy. Think about how thiamin is needed in synthesis of neurotrasmitter acetylcholine.

A component of the DRI's is the EAR which is used: a. to assess the nutrient adequacy of an individual b. to assess the nutrient adequacy of a population c. when evidence is not available to calculate an RDA d. to reduce the risk of adverse health effects from overconsumption

b. to assess the nutrient adequacy of a population EAR is Estimated Average Requirement and is used to estimated to meet the requirement of half the healthy individuals in a group. The RDA is the average daily level of intake sufficient to meet the nutrient requirements of nearly all (97%-98%) healthy people. AI (adequate intake) is used when evidence is insufficient to develop an RDA and is set at a level assumed to ensure nutritional adequacy.

Which of the following is permitted on a diet restricting tyramine? a. hard cheese like cheddar or swiss b. uncured cheese like cottage and ricotta c. pickled or smoked foods d. tofu

b. uncured cheese like cottage and ricotta Tyramine is an amino acid that helps regulate blood pressure. It occurs naturally in the body, and it's found in certain foods. Foods to avoid include aged cheese (cheddar, Swiss), pickled foods, fermented foods, smoked foods, tofu, luncheon meats. Foods ok: cottage cheese, cream cheese

To decrease sodium intake, substitute: a. carrots for celery b. unsalted margarine for regular margarine c. diet margarine for regular margarine d. carrots for pepper

b. unsalted margarine for regular margarine Don't get confused on wording. Substitute unsalted margarine FOR regular margarine.

A vegan is allergic to milk. Which nutrients would you expect might be deficient in her intake? a. protein, calories b. vitamin B12, D c. vitamin C, calcium d. vitamin A, D

b. vitamin B12, D Vegans, without supplementation, can become deficient in vitamin B12 as the primary sources come from animal products. Since this individual is also allergic to milk (which she wouldn't drink anyways as a vegan), she could be low in vitamin D, which is fortified in milk. She should drink a plant-based milk fortified with vitamin D and calcium (and B12 if possible).

When taking an anticoagulant, avoid the following: a. thiamin supplements b. vitamin E supplements above 400 IU per day c. supplements of calcium and vitamin D d. niacin supplements

b. vitamin E supplements above 400 IU per day EXCESS vitamin E interacts with vitamin K and can reduce clotting ability, leading to hemorrhage. The RDA for vitamin E is 15 mg/day, so a 400 IU would greatly exceed needs (15 mg of natural alpha-tocopherol would equal 22.4 IU).

Following a colectomy, the absorption of which of the following would be of the most concern? a. vitmains D and E b. water and sodium c. B vitamins d. vitamin C

b. water and sodium Colectomy is excision of the colon. The colon is responsible for reabsorbing water and electrolytes, and thus these would be of most concern. Vitamins D and E are fat-soluble vitamins that are absorbed in small intestine (primarily jejunum) and stored in liver. The water soluble vitamins, including B vitamins and vitamin C, are also primarily absorbed in the jejunum.

A man with HIV disease presents with the following data. What should be your primary concern as his dietitian? Height: 5' 10" Weight: 115lb Hematocrit: 35% MCV: 103 fl BUN: 11 mg/dl Serum albumin: 2.8 g/dl CD4: 280 Total lymphocytes: 1200/cubic mm a. anemia b. weight c. renal failure d. protein deficiency

b. weight Anemia: hematocrit is low (normal 42-52%), MCV high (ref range 80-95 fL); should be address but not a HUGE concern; maybe folate or vit B12 deficiency anemia, not IDA since megaloblastic cells Weight: IBW = 166lbs, actual BW = 115lbs; this patient weighs 69% of IBW and has a BMI of 16.5 kg/m^2; this is a major concern Renal failure: BUN is WNL (10-20 mg/dl); not a concern Protein deficiency: normal albumin is 3.5 - 5 mg/dL; HOWEVER albumin is not a good indicator of nutritional status so not super relevant that albumin is low; could have a protein deficiency potentially but the information provided does not indicate this is a primary concern.

Meal replacements for weight loss may be recommended to a client: a. who needs to lose more than 10% of his current weight b. who has difficulty with portion control c. who eats at least one of his meals away from home d. who needs to lose less than 10% of his current weight

b. who has difficulty with portion control Dumb question, but since a meal replacement is portioned out, it could help someone who has difficulty with portion control.

According to Chinese beliefs, foods and herbs that may be used to treat illnesses are grouped as: a. yin (bright, hot)/ yang (dark, cold) b. yin (dark,cold)/ yang (bright, hot) c. action/ maintenance d. harmful/ beneficial

b. yin (dark,cold)/ yang (bright, hot) Yin foods (cold, raw: fish, vegetables, fruits), Yang foods (bright, hot: chicken soup, eggs, warmed spices) Think: "Dang- that's hot!" for bright/warm/hot Yang foods

Strict vegans may need supplements of: a. chromium b. zinc c. iron d. thiamin

b. zinc Zinc is primarly found in meat and animal products, which a vegan does not eat.

Using the following data, the average check for September is: Total revenue $909,009 Net income 173,010 FTEs 27.9 Number of customers 32,613 a. $5.30 b. $6.29 c. $27.87 d. $33.04

c. $27.87 Average check = average amount customers spend on a meal, which is helpful in detecting trends Divide sales by the number of customers served $909,009/32,613 = $27.87

A business pays 4% of its income as rent ($1200), 70% towards labor and food costs, and $2500 towards other monthly expenses. How much profit does this business make per month? a. $6000 b. $4200 c. $5300 d. $7200

c. $5300 Total Income = 1200 * 100/4 = $30000 Labor and Food Cost = 70/100 x $30,000 = $21000 $1200 + $21000 + $2500 = $24700 $30000 - $24700 = $5300

If you purchase an oven for $10000. It is expected to last for 10 years after which it can be sold for $3000. What is its depreciation cost each year? a. $2,000 b. $1,500 c. $700 d. $500

c. $700 Depreciation = amount paid - salvage value / # years useful life $10,000-$3,000 / 10 = $700

A nephrotic syndrome patient should receive how many grams of protein per KG? a. 0.5 - 0.6 b. 0.6 - 0.8 c. 0.8 - 1.0 d. 1.0 - 1.4

c. 0.8 - 1.0 A nephrotic syndrome patient should have a moderate protein restriction, meaning 0.8-1 g/kg. ***Not really a restriction. I would say more like maintenance protein needs.

Which exhibits a definite positive correlation? a. 0.05 - 0.07 b. 1.2 - 1.3 c. 0.8 - 1.0 d. 0.2 - 0.9

c. 0.8 - 1.0 r= =/- 1 is perfect correlation; cannot have correlation outside of this range. </= 0.4 would be a poor correlation, 0.4-0.7 would be moderate correlation, >/= 0.7 would be a strong correlation (this is true for positive or negative values. Subsequently, 0.8-1.0 would show a definite positive correlation.

An alcoholic patient has a low serum albumin, low hemoglobin, high ammonia, abnormal liver function tests and ascites. Why is he on a 500mg sodium diet? Which of the following should the patient in the above question have for lunch? a. 4 ounces cottage cheese b. 1 ounce cheddar cheese c. 1 ounce roast beef d. 1 ounce cold cuts

c. 1 ounce roast beef 1 oz of roast beef has only ~16mg of sodium. Foods higher in sodium would include processed meats and cheeses. Lower sodium would be unseasoned meats, eggs, etc. 4 oz of cottage cheese has ~411mg of sodium. 1 oz of cheddar cheese has ~176 mg sodium, 1 oz cold cuts has ~376 mg.

There are seven foodservice employees in the tray assembly unit. The patient census is 350. If 1 1/2 hours of assembly time is allowed, a feasible productivity goal for the unit is to assemble how many trays per minute? a. 2 b. 3 c. 4 d. 5

c. 4 350 pts/90 min= 4

When screening pregnant women for gestational diabetes, the amount of oral glucose used is: a. 25g b. 40g c. 50g d. 100g

c. 50g Give 50 gm oral glucose, and if 2hr post prandial blood glucose is greater than 140, may have GDM.

A baker makes a batch of cookies in 18 minutes. What is the maximum number of batches he can make in 2 hours? a. 4 b. 5 c. 6 d. 7

c. 6 2 hrs= 120 minutes 120 minutes/18 minutes = 6.66 = 6 full batches

Pot roast: 70 servings, $1.50 (FC/serving) Chicken stew: 30 servings, $0.75 Spaghetti: 40 servings, $0.60 If the above entrees had been served on Tuesday, how many servings of spaghetti will you need next Tuesday, if you expect to serve 300 total entrees? a.150 b.63 c.87 d.101

c. 87 40/140 = 28.57% 0.2857 x 300 = ~87

What reading level is appropriate for educational material for the general population? a. 4th grade b. 5th grade c. 8th grade d. 10th grade

c. 8th grade Reading level is typically determined by finding the average number of polysyllabic words using readibility index such as SMOG index. Reading materials should be kept around 8th grade reading level for general public and 6th grade for audiences of low literacy.

During an interview, which of the following can you ask? a. Do you have a car? b. How will you get to work? c. Can you get to work on time without any problems? d. Do you own a car?

c. Can you get to work on time without any problems? The other questions are inappropriate to ask. The only thing a manager should be concerned with is if the employee can get to work without any issues, but doesn't need to know specifics.

What may be asked during an interview? a. Do you own or rent your home? b. Of what country are you a citizen? c. Have you worked at the company under a different name? d. Will you list all organizations, clubs and lodges to which you belong?

c. Have you worked at the company under a different name? Two questions that can be asked during an interview are "Have you worked under a different name? and "Are you of legal working age?"

Which bacteria may cause gastric ulcers a. salmonella b. streptococcus aureus c. Helicobacter pylori d. clostridium perfringens

c. Helicobacter pylori

Meats cured with whey won't be tolerated by someone with: I. lactose intolerance II. diabetes III. post-gastrectomy of 3 months IV. duodenectomy a. I, II, III b. II, III, IV c. I d. I, III, IV

c. I Whey is a protein from milk, which requires further breakdown prior to digestion. If someone is lactose intolerant and thus lacking the lactase enzyme, whey would not be tolerated. Whey isolate, on the other hand, is lactose-free and thus may be tolerated.

The FDA: I. Inspects meat, poultry, fish, eggs II. inspects factories III. enforces the Food, Drug and Cosmetic Act IV. monitors interstate shipping of shellfish a. I, II, III b. III, IV c. II, III, IV d. I, III

c. II, III, IV Under Food, Drug, and Cosmetic Act, FDA covers all interstate food except meat, fish, poultry and eggs; inspects food processing factories, raw materials and labeling. The USDA is responsible for inspecting meat, poultry, and eggs. NOAA inspects US supply of fish.

Congregate meals and home delivered meals fall under: a. WIC b. EFNEP c. Older Americans Nutrition Act Program Title III d. Medicare

c. Older Americans Nutrition Act Program Title III The OAA provides one hot meal each day, 5 days/week. Provides ~1/3 recommended intake. Congregate meals are provided to those who are ambulatory, transportation essential for rural elderly. Home delivered meal/Meals on Wheels, must be homebound. Services provided include counseling, nutrition education, referrals, social interaction Eligibility: all aged 60 and older plus spouse regardless of income

An example of formative evaluation is: a. IQ test b. RD exam c. Pretest quiz d. Comparative evaluation

c. Pretest quiz A formal evalution includes an objective test, which is not well-suited for clinic or community setting, and a performance test, in which the client is asked to complete a task based on learning objectives. A pretest quiz would be an example of a performance test. An informal evaluation would be an unstructured observation of food selection and behaviors.

Which is an example of an entitlement program run by the government? a. EFNEP b. SFMNP c. SNAP d. CACFP

c. SNAP

A father needs help feeding his children, ages 6 and 8, which are the best options: a. WIC and TANF b. Head Start and SNAP c. SNAP and School Lunch d. Commodity Foods and WIC

c. SNAP and School Lunch Children are too old for WIC, so rule out A and D right away. They are also too old for Head Start as it is for 3-5 year olds. SNAP and School Lunch would be the best option. SNAP provides monthly benefits for the family, and School Lunch would provide a meal for the kids while they are at school.

Four hours after eating you develop nausea and diarrhea without fever. The cause may be: a. Streptococcus b. Clostridium botulinum c. Staphylococcus aureus d. Clostridium perfringens

c. Staphylococcus aureus Staphylococcus = Steph is fast (30 minutes to 8hrs); no fever; diarrhea, vomiting, nausea, stomach cramping Streptococcus = onset 1 to 3 days, sore throat, fever Clostridium botulinum = onset usually 18-36 hrs, CNS affects typically Clostridium perfringens: onset typically 8-12 hrs, also does not cause vomiting/nausea, fever

Which of the following amino acids is a precursor for serotonin? a. Phenylalanine b. Methionine c. Tryptophan d. Tyrosine

c. Tryptophan

Water soluble nutrients are absorbed through: a. active transport b. simple diffusion c. carrier-facilitated passive diffusion d. inactive transport

c. carrier-facilitated passive diffusion Water-soluble vitamins, minerals and the simple sugar fructose are absorbed in a process called facilitated diffusion. Nutrients become attached to specific molecules outside the absorptive cell surface. These carrier molecules take the nutrients across the cell membrane and free them once inside the cell.

Which program teaches good nutrition practices and provides foods with certain nutrients? a. EFNEP b. FFVP c. WIC d. CACFP

c. WIC WIC provides nutrition education and foods that are rich in nutrient that are typically deficient in this population to those who are eligible. EFNEP provides nutrition education but does not provide food. FFVP provides fruits and vegetables specifically. CACFP supports public and non-profit food service programs for family day care centers, neighborhood houses, homeless shelters, nonresidential adult daycare centers. Reimburses operators for meal costs, provides commodity foods and nutrition education materials. Meals must meet guidelines, must offer free or reduced-price to eligible, which are same as NSLP (1/3 RDA)

The number of work movements between pieces of equipment is indicated on: a. a flow diagram b. a Gantt chart c. a cross chart d. Johari's window

c. a cross chart A cross chart shows the number of steps/movements between pieces of equipment. A flow diagram shows steps the worker must take, their sequence, the relation of working units to each other. A Gantt chart is used to schedule and control work; concerned with TIME of production, not cost

To increase potassium intake, consume a snack of: a. cheese and crackers, plums, cranberry juice b. a bagel, milk and an apple c. a grilled cheese and tomato sandwich and strawberries d. tuna salad, a wheat roll, and cola

c. a grilled cheese and tomato sandwich and strawberries Fruit is the primary source of potassium, so D is out. Apple is a low potassium fruit, so B is out. Plums are a decent source of potassium, but cranberry juice is not. Strawberries are typically a berry to have for a lower potassium diet, but tomatoes are high. Subsequently, C is the answer.

If you were an employee and member of the union, and were involved in initial labor dispute talks, you would be called: a. an arbitrator b. a mediator c. a shop steward d. a union agent

c. a shop steward A shop steward is an employee who is elected by union members to represent them. The shop steward would be involved in the bargaining process. A mediator would be included in the second step, and an arbitrator in the third step.

If there is not enough oxaloacetic acid available to the TCA cycle: a. pyruvic acid cannot be converted to pyruvic acid b. glucose-6-phosphate cannot be converted to pyruvic acid c. acetyl CoA coming in from fat cannot be handled properly d. glycogen cannot be converted back to glucose-6-phosphate

c. acetyl CoA coming in from fat cannot be handled properly Oxaloacetate is the essential start and ending substrate of the TCA cycle. Without oxaloacete, acetyl CoA builds up as the TCA cycle cannot occur. Subsequently, the acetyl CoA molecule produced by beta-oxidation can't be used properly and ketone bodies must be formed.

If dishes come out of the dishmachine with water spots: a. use more detergent b. add a drying agent to the wash cycle c. add a drying agent to the rinse cycle d. use less detergent

c. add a drying agent to the rinse cycle Adding dryer agent to the rinse minimizes water spots during booster heating.

A processed food entree includes TVP which is used to: a. add color b. improve taste c. add protein d. act as an emulsifier

c. add protein Textured or texturized vegetable protein, also known as textured soy protein, soy meat, or soya chunks is a defatted soy flour product, a by-product of extracting soybean oil. It is often used as a meat analogue or meat extender. It is quick to cook, with a protein content comparable to certain meats

You are explaining to a new client how making a few changes in his food choices will benefit his overall health. The learning domain is: a. psychomotor b. cognitive c. affective d. human

c. affective The three types of learning domains are cognitive, affective and psychomotor. Cognitive is acquisition of knowledge or subject matter (factual information). Affective is acquisition of attitude and value, growth in feelings or emotions. Psychomotor learning is the acquisition of muscular skills (exercises, food prepartion). In this example, you are not actually providing factual information. You are trying to target his values- his health.

A meat slicer should be cleaned: a. at the end of each day b. at the end of each shift c. after each use d. after each meal

c. after each use A meat slicer should be cleaned after each use to prevent the spread/growth of bacteria as well as cross-contamination

Which is not a fiber in the diet? a. cellulose b. hemicellulose c. amylose d. pectin

c. amylose Cellulose, hemicellulose, and pectin are all types of fiber. Amylose is a type of starch.

Which is an example of line authority? a. a part time consultant for WIC b. a consulting dietitian for an outpatient department c. an administrative dietitian in a 600 bed hospital d. a consulting dietitian for a nursing home

c. an administrative dietitian in a 600 bed hospital Line authority occurs when multiple employees report to a single administrator, such as 20 clinical RD's reporting to one nutrition manager.

The drug methylphenidate may have the adverse effect of: a. increased excretion of folate requiring supplementation b. type 2 diabetes c. anorexia affecting growth d. involuntary weight gain

c. anorexia affecting growth Methylphenidate is a central nervous system stimulant. It affects chemicals in the brain and nerves that contribute to hyperactivity and impulse control. Methylphenidate is used to treat attention deficit disorder, attention deficit hyperactivity disorder, and narcolepsy. In therapeutic doses, methylphenidate can cause anorexia, insomnia, headache, abdominal pain, nausea and irritability.

Which bill requests government funding? a. budget bill b. markup bill c. appropriations bill d. spending grant bill

c. appropriations bill An appropriations bill is legislation to appropriate federal funds to specific federal government departments, agencies and programs.

An athlete complains of weakness, rapid weight gain and muscle spasms. What may be the cause? a. lack of adequate rest b. too much exercise c. carbohydrate loading d. not enough iron

c. carbohydrate loading Carbohydrate loading can result in rapid weight gain, muscle spasms, weakness, and digestive discomfort.

A child with PKU can eat: a. spaghetti with tomato sauce b. vanilla ice cream c. carrots and celery sticks d. aspartame-sweetened gelatin

c. carrots and celery sticks Those with PKU lack the enzyme to break down phenylalanine, an amino acid (phenylalanine hydroxylase). Subsequently, they need to eat a very low phenylalanine diet or they will have damage to CNS. Phenylalanine is found in most protein-containing foods such as milk, eggs, cheese, nuts, wheat products, soybeans, chicken, beef, pork, beans and fish. This means vanilla ice cream is out, as it is a dairy product. Spaghetti is also out, as it is a wheat containing product. It is also found in the sweetener aspartame. Subsequently, aspartame-sweetened gelatin is out. Carrots and celery sticks are appropriate for kids with PKU. They are low in protein and thus contain very low/no phenylalanine.

Which of the following tube feeding ingredients might precipitate an allergic reaction in a child with a milk allergy? a. hydrolyzed maltodextrin b. modified starch c. casein d. carrageenan

c. casein Casein, the chief protein in milk and the essential ingredient of cheese. Subsequently, it would likely cause an allergic reaction in a child with a milk allergy. Carrageenan is an extract from a red seaweed that is commonly used as a thickner. Hydrolyzed maltodextrin and modified starch do not contain dairy.

A 5 month old infant has changed from the 65th to the 95th percentile weight for height. The dietitian should first: a. suggest the infant receives more solid foods b. change the feeding formula c. check to see if weights have been plotted properly d. increase the amount of formula provided

c. check to see if weights have been plotted properly That's a really big change and subsequently the RD would want to check the chart and check with the nurse to make sure that is correct. If there is any uncertainity, re-measure the infant.

Which of the following has a slow onset and is anaerobic? a. staphylococcus aureus b. clostridium perfringens c. clostridium botulinum d. salmonella

c. clostridium botulinum "Clostridium" foodborne illnesses (on exam) always anaerobic. Botulinium has slower onset (18-36hrs) than perfringens (8-12hrs)

A renal patient has come for dialysis on Monday morning with a serum sodium of 130 mEq/L, a BUN of 100 mg/dl, creatinine 8.0, and a 4KG weight gain since his last dialysis on Friday morning. His laboratory indicators were in acceptable ranges on Friday afternoon. What would you expect happened over the weekend? a. consumed too little sodium, too much water, too little protein b. consumed too little sodium, not enough eater, too much protein c. consumed too much sodium, too much water, too much protein d. consumed too much sodium, too little water, too little protein

c. consumed too much sodium, too much water, too much protein Serum sodium is low (ref range 135-145 mEq/L), BUN is very high (ref range 10-20 mg/dL), creatinine is very high (ref range ~0.5-1.2 mg/dL), and rapid weight gain. Based on these parameters, I would generally assume he was not compliant with his diet. More specifically, hyponatremia is most likely caused by overhydration. Rapid weight gain is likely caused by excessive sodium intake. Worsening BUN and creatinine likely related to increased renal solute load, which is influenced by protein and water. High protein = higher renal solute load and increased need for work in kidneys.

The management function in which performance is measured and corrective action is taken to ensure accomplishment of an organizational goal is known as: a. planning b. directing c. controlling d. organizing

c. controlling In controlling, measure performance and take corrective action to ensure accomplishment of an organizational goal; ensure effective and efficient utilization of organizational resources.

Which of the following is a medium fat protein? a. peanut butter b. tuna fish packed in water c. corned beef d. chicken without skin

c. corned beef PB = 1 high-fat protein + 1 fat exchange (0 gm CHO, 7 gm protein, 13 gm fat, 145 kcal); serving is 1 tbsp Tuna in water = 1 lean protein (0 gm CHO, 7 gm protein, 3 gm fat, 55 kcal); serving size 1 oz Corned beef = 1 medium protein (0 gm CHO, 7 gm protein, 5 gm fat, 75 kcal); serving 1 oz Chicken without skin = 1 lean protein (0 gm CHO, 7 gm fat, 3 gm fat, 55 kcal); serving size 1 oz **If chicken with skin, would have been medium-fat protein.

Of the following oils, which is highest in vitamin E? a. safflower b. corn c. cottonseed d. olive

c. cottonseed Wheat Germ Oil — 135% DV per serving, Hazelnut Oil — 43% DV per serving, Sunflower Oil — 37% DV per serving, Almond Oil — 36% DV per serving, Cottonseed Oil — 32% DV per serving, Safflower Oil — 31% DV per serving, Rice Bran Oil — 29% DV per serving, Grapeseed Oil — 26% DV per serving

Methylene is added to some types of coffee to: a. retain the flavor b. retain the color c. decaffeinate it d. destroy the bacteria

c. decaffeinate it Decaffeination can be done using solvent method or nonsolvent method. The solvent method commonly uses dichloromethane or ethyl acetate. The non-solvent method uses liquid carbon dioxide to release caffeine. The methylene chloride process is thought by some in the coffee industry to maintain coffee flavor better than other processes. Based on extensive research data, the FDA has determined that methylene chloride is safe for use in coffee decaffeination.

Which may help to relieve the symptoms of hepatic encephalopathy a. increase AAA and decrease BCAA b. decrease ammonia production c. decrease AAA and increase BCAA d. decrease AAA

c. decrease AAA and increase BCAA During ESLD, BCAA's decrease as they are used by muscles for energy, AAA increase because the damaged liver is unable to clear them. Adding BCAA adds calories and protein. Used when standard therapy does not work and when patient does not tolerate standard protein. This is called the altered neurotransmitter theory.

What is a major reason for constipation in the elderly? a. a diet low in high residue foods b. a diet high in low reside foods c. decreased gastric motility d. lack of physical exercise

c. decreased gastric motility Gastric motility decreases with age for a variety of reasons, including medications, concomitant diseases, and polypharmacy

If you are comparing the prevalence of heart disease in two states, the study design is: a. analytical research b. case control research c. descriptive research d. quasi-experimental

c. descriptive research Descriptive research is research that cannot determine causal relationships (cause/effect); only associations. For example, if you looked at prevelance of heart disease in Mississippi vs Massachusetts and found that more people currently have HD in Mississippi, you can't say living in Mississippi causes HD. In the example provided, the researchers could not determine causation because this is not an experimental design.

When providing nutrition education to a pregnant teenager, which characteristic of adolescents should be kept in mind? a. interested in planning for the future b. responds more to emotional stimuli c. desire to be like their peers d. has well-defined self-image

c. desire to be like their peers Teenagers often have a desire to be liked by their peers and thus must be taken into consideration when counseling adolescents, especially teenagers.

The food service director who wants to hire a dietitian should first: a. contact local hospitals for possible applicants b. evaluate applicants' resumes looking for proper credentials c. develop a job description and specification for the position d. post a job listing in the local paper

c. develop a job description and specification for the position A job description reflects required skills and responsibilities; matches applicants to job, orientation/training, employee appraisal. Job specification lists duties involved, conditions, qualifications (education, experience); written for each job; used in hiring process; does not have detailed information as to what to do or time involved.

The steps in planning community based nutrition programs are: a. goals, develop mission statement, objectives b. develop measurable goals, develop mission statement c. develop mission statement, goals and measurable objectives d. goals, objectives, develop mission statement

c. develop mission statement, goals and measurable objectives Per Jean, steps in planning community based nutrition programs include: develop a mission statement, set goals, set objectives. Per All Access, steps in planning community based nutrition programs include reviewing nutrition assessment, set goals/objectives, develop program plan, set/define management system, identify budgeting/funding, seek support ($), and finally implement.

An example of nominal (frequency) data is: a. temperature b. weight c. differentiate between men and women d. rank in class

c. differentiate between men and women NOminal data = variables that fit into categories with NO order (ex: gender, race, marital status, ethnicity). Differentiating between men and women (M or W), would be an example of nominal data. Weight would be numerical discrete. Rank in class would be rank order/ordinal scale (I think). Temperature would be numerical continous, because it is a numerical variable that is part of a continous scale (I think).

Which management functions should require the greatest allotment of time by a production manager? a. planning and organizing b. organizing and directing c. directing and controlling d. organizing and controlling

c. directing and controlling Directing includes delegation of work to qualified employees, effective communication, appropriate motivation/leadership skills. Directing is where the work actually starts getting done. Controlling includes measuring present performance against standard performance, and taking corrective action as needed. Directing and controlling are ongoing processes.

A person with the dumping syndrome cannot handle: a. complex carbohydrates b. polysaccharides c. disaccharides d. amino acids

c. disaccharides In a person with dumping syndrome, when rapidly hydrolyzed carbohydrate enters the jejunum, water is drawn in to achieve osmotic balance. This causes a rapid decrease in the vascular fluid and signs of cardiac insufficiency appear. About two hours later, the CHO is digested and absorbed rapidly. Blood sugar rises, stimulating an overproduction of insulin, causing a drop in blood sugar below fasting. This is called reactive/alimentary hypoglycemia Subsequently, those with dumping syndrome should avoid simple carbohydrates, such as disaccharides. Complex carbohydrates digest slower and thus may be better tolerated.

What gives the structure to quick breads? a. flour and milk b. flour and water c. eggs and flour d. eggs

c. eggs and flour Eggs provide stability. Flour provides gluten, meaning the elastic properties of the bread.

When determining the labor turnover rate in one period look at the number of: a. employees at the beginning of the period and the number of new employees b. employees at the beginning of the period and the number who left c. employees at the end of the period and the number who left d. employees at the end of the period and the number of new employees

c. employees at the end of the period and the number who left Labor turnover rate = # employees (separated) terminated / total positions in department x 100

Why are mono- and di-glycerides added to the shortening used in cakes? a. increase spreadibility b. thickeners c. emulsifiers d. coloring agents

c. emulsifiers Emulsifiers allow ingredients to mix well together, keep emulsified products stable, reduce product "stickiness", control levels of crystallization, and can help products dissolve easier in liquid. Mono-and di-glycerides are types of emulsifiers.

The most useful data in evaluating the nutritional status of children is: a. sex and age b. iron and vitamin intake c. energy intake and health history d. height and weight

c. energy intake and health history

If a patient is about to be discharged when you receive the discharge diet order, you should... a. give him something to take home b. there is not enough time so forget it c. enroll him in the outpatient clinic and schedule an appointment d. teach him what you can in the time you have now

c. enroll him in the outpatient clinic and schedule an appointment

An annual audit shows that you have successfully met the indicator "95% of high risk patients are assessed within 24 hours of admission". The next step is to: a) establish a new indicator b) report the successful completion of intervention c) evaluate the need to continue monitoring the indicator d) evaluate the need to revise the standard of care

c. evaluate the need to continue monitoring the indicator Indicators are clearly defined markers that can be observed and measured. They are also used to monitor and evaluate progress towards nutrition outcomes. Once an indicator is met, you would evaluate the need to continue monitoring the indicator.

Which cheese has the highest moisture content: a. cheddar b. swiss c. mozzarella d. gorgonzola

c. mozzarella Percent moisture content from high to low: cottage cheese, cream cheese, mozzarella cheese, camembert cheese, blue cheese, Swiss cheese, cheddar cheese, gorgonzola cheese, parmesean cheese

Tube-fed patients should have gastric residuals checked: a. once a day until volume goals have been met b. 2 hours after feeding begins c. every 4 hours during the first 48 hours of feeding d. only if abdomen becomes distended

c. every 4 hours during the first 48 hours of feeding Dumb question because we don't actually check GFR. Research shows it is not a helpful indicator of EN tolerance. Instead, would monitor output (vomiting, diarrhea), nausea, abdominal distention/gas.

In metabolic acidosis, which of the following is involved? a. excretion of potassium b. excess calcium retention c. excretion of sodium bicarbonate d. excess calcium loss

c. excretion of sodium bicarbonate Metabolic = kidneys, respiratory = lungs Alkalosis = retention of bicarb by kidneys, acidosis = excretion of bicard by kidneys. Subsuquently, if the kidneys are excreting more sodium bicarbonate (base), then metabolic acidosis is occuring.

What is the best therapy for weight loss? a. reducing 500 calories per day, and exercise b. support groups, exercise, diet control c. exercise, diet, behavior modification d. exercise and diet control

c. exercise, diet, behavior modification

The absence of reinforcement following an undesirable behavior is: a. positive reinforcement b. punishment c. extinction d. avoidance

c. extinction The types of behavioral modification methods include positive reinforcement, avoidance learning, and extinction. Positive reinforcement is encourages reptition of a given behavior- it should be specific and immediate. Extinction is aimed at reducing undesirable behaviors- absense of reinforcement following an undesired behavior (ignore). The belief is, if extinction is repeated, behavior will eventually disappear. Avoidance learning is learning to escape from unpleasant consequences- avoiding futre critism by improving future behavior.

A patient suffering from bulimia may have all of the following symptoms except: a. a sore throat b. dental problems c. extreme weight loss d. rectal bleeding

c. extreme weight loss Bulimia is a condition characterized by repeat episodes of binge eating, recurrent inappropriate compensatory behaviors to prevent weight-gain (at least 1x/week for 3 months), selfevaluation heavily influenced by body shape and weight; often 18.5 ≤ BMI < 30. Inappropriate compensatory behaviors to prevent weight gain include self-induced vomiting, misuse of enemas, diuretics, laxatives, fasting, excessive exercise. Subsequently, extreme weight loss is not likely.

Exponential smoothing and moving average are forecasting methods that: a. having a linear regression b. have no relationship c. follow an identifiable pattern over time d. do not follow an identifiable pattern over time

c. follow an identifiable pattern over time Exponential smoothing and moving average are the two types of time-series/project forecasting. In time-series forecasting, scientific predictions are made based on historical time stamped data. Moving average uniformly weighs past observations, so numbers are weighted equally. Exponential smoothing uses software to forecast usage, giving more recent values more weight and does NOT uniformly weigh past observations

Which food items require the highest humidity? a. meat b. dairy c. fruits, vegetables d. poultry

c. fruits and vegetables Since F/V have a high water activity, they require the highest humidity (85-90%)

Pernicious anemia is likely to occur following a: a. colectomy b. colostomy c. gastretomy d. esophagostomy

c. gastrectomy Pernicious anemia, also known vitamin B12 deficiency anemia, can occur s/p gastrectomy, or excision of the stomach. In stomach vitamin B12 binds to R protein, allowing it to travel to GI tract where it will be spilt away from R protein and bind to IF in ileum before being absorbed there· IF is glycoprotein produced by gastric parietal cells Patients undergoing gastrectomy can develop IF deficiency resulting in vitamin B12 deficiency due to inadequate absorption and requires intramuscular vitamin B12

Which test helps you determine if a diabetic has been following his diet? a. blood glucose b. urine ketones c. glycosylated hemoglobin d. urine sugar

c. glycosylated hemoglobin HgA1c, or glycosylated hemoglobin, measures % of hemoglobin that has glucose attached. A high concentration of glucose forms chemical bond with hemoglobin, meaning the longer the BG is high, the higher the HgA1c.

Increased serum uric acid levels may lead to: a. galactosemia b. glycogen storage disease c. gout d. PKU

c. gout Gout is a disorder of purine metabolism characterized by increase serum uric acid. Uric acid deposits in joints causing pain and swelling.

Policies are: a. predetermined goals of management b. statements that provide direction and motivate c. guides that define the scope of permissible activity d. specific tasks to be performed

c. guides that define the scope of permissible activity Policies are general decision-making guides which provide boundaries within you must operate. Of note, procedures are chronological sequences of activities which provide specific guidance for daily operations. In other words, procedures detail steps in operation/activities.

What is the best way to assess what a group of students has learned after diet instruction? a. list their skills b. have them explain their skills c. have them demonstrate their skills d. post-test on their skills

c. have them demonstrate their skills

The hospital food service department has developed several high-quality, sugar-free desserts that are identified as unique to the department. This product represents what type of branding? a. manufacturer b. retail item c. signature d. specific

c. signature A signature item is one that sets itself apart. It's likely a reason for customers come to a specific establishment, in order to eat the singature item that they cannot get anywhere else.

Compared to human milk, commercially prepared infant fomula is: a. similar in nutrient content b. equivalent to human milk in nutrient content and antibodies c. higher in protein and iron but lacks antibodies d. lower in protein and iron and lacks antibodies

c. higher in protein and iron but lacks antibodies Exclusively breastfed mom's must give iron to infant after 6 months of age. Up until that point, the infant has a good supply from mom's placenta. Protein is higher in infant formula (remember fortifying formula vs breastmilk during peds rotation). Presence of antibodies cannot be replicated in formula.

Gastric proteolysis requires: a. pyridoxine b. ascorbic acicd c. hydrochloric acid d. the intrinsic factor

c. hydrochloric acid Proteolysis is the breakdown of proteins into smaller polypeptides or amino acids. HCl is required to being protein denaturation in the stomach and to convert pepsinogen to pepsin, which breaks peptide bonds.

An elevated T4 indicates: a. galactosemia b. hypothyroidism c. hyperthyroidism d. ketonuria

c. hyperthyroidism Hyperthyroidism is characterized by increased T3 and T4 hormones which increases the metabolic rate leading to weight loss. Hypothyroidism is characterized by T4 low; T3 low or normal which decreases BMR leading to weight gain.

What would you first advise a constipated patient to do? a. take a mild laxative b. eat less fat c. increase fluids and fiber intake d. eat more protein

c. increase fluids and fiber intake

The kidneys respond to respiratory acidosis by: a. increasing the secretion of magnesium b. exchanging sodium for calcium c. increasing the retention of bicarbonate d. exchanging potassium for hydrogen

c. increasing the retention of bicarbonate Metabolic = kidneys, respiratory = lungs Alkalosis = retention of bicarb by kidneys, acidosis = excretion of bicard by kidneys Subsequently, if respiratory acidosis the kidneys would respond by increasing retention or decreasing excretion of bicarbonate to try to increase pH.

How do you begin an interview with a patient? a. obtain height and weight b. get a nutritional history c. introduce yourself and make them comfortable d. give the diet instruction

c. introduce yourself and make them comfortable Build rapport and make the client feel comfortable talking with you.

A normal pregnancy requires supplementation of: a. iron b. vitamin C, calcium, iron c. iron and folic acid d. calcium and zinc

c. iron and folic acid 30 mg ferrous sulfate in 2nd and 3rd trimester 400 mcg folic acid

A patient with hepatitis needs a high protein intake. Besides helping the liver to regenerate, what other purpose is served? a. it helps increase iron absorption b. it restores glycogen reserves c. it helps prevent a fatty liver d. it helps prevent necrosis of the liver

c. it helps prevent a fatty liver Having a high protein provides lipotropic agents like methionine and choline needed to convert fats to lipoproteins for removal from the liver, thus, preventing fatty infiltration.

Preventing a Listeria monocytogenes outbreak requires special care because: a. it is insensitive to light b. it is sensitive to low temperatures c. it is able to grow at temperatures of 34 - 113F d. it is able to grow at temperatures of 140 - 160F

c. it is able to grow at temperatures of 34 - 113F Listeria grows in cool, moist environments (including refrigerators).

Which of the following best describes a cash-flow budget? a. it outlines the assets b. it outlines expenditures and assets c. it is an estimate of income and expenditures over time d. it compares assets to liabilities

c. it is an estimate of income and expenditures over time Cash budget projects revenues in expenses, showing inflow and output of cash. The purpose is to determine if funds will be available when needed.

Which is true with osteoporosis? a. it is more common in men than in women b. it is treated with 500mg calcium per day c. it is common in those 65 years of age and older d. weight bearing exercise exacerbates the problem

c. it is common in those 65 years of age and older

To determine whether your client has applied your suggestions on decreasing his fat intake, ask him to: a. name a few foods that should be consumed infrequently b. name four foods to avoid c. list the foods he has consumed over the past three days d. select an appropriate breakfast from a menu

c. list the foods he has consumed over the past three days

A male patient has hypertension, high cholesterol, diabetes, and is 55 pounds above his desirable body weight. What do you recommend? a. low sodium b. low carbohydrates c. low calories d. low fat

c. low calories The idea for this question is that reducing body weight is a very effective strategy in managing diabetes, and thus a lower calorie diet would result in weight loss. Low sodium would also be appropriate for this patient (DASH diet), but since he is so overweight I guess low calorie is the best answer.

What should you do if you believe theft is occurring in the storeroom? a. install a video camera b. lock the store room c. make everyone sign in and out of the store room d. limit access to certain hours of the day

c. make everyone sign in and out of the store room

A press conference announcing your new business is: a. advertising b. networking c. media promotion d. personal selling

c. media promotion Promotion is one of the four P's of marketing (product, price, place, promotion). Promotion is used to increase or renew awareness, short term. Publicity is an example of promotion, such as new release, media, paid aids, public visibility. Advertising is also a type of promotion. However advertising is a permanent strategy that involves marketing and sales, whereas sales promotions have a limited time frame, such as a media promotion.

A study reported a 10% morbidity rate in infants in the country and a 12% morbidity rate for infants in the city. This means that: a. 10% of infants died in the country b. more infants died in the city than in the country c. more disease in infants in the city than in the country d. more disease in infants in the country than in the city

c. more disease in infants in the city than in the country Morbitity = sickness

Ground meat will spoil faster than sliced meat because: a. it has more enzyme activity b. it has more fat c. more surface area is exposed d. it has less fat

c. more surface area is exposed

An example of an educational objective for a low fat cooking class given at a seniors center would be to: a. appreciate the importance of lowering fat intake b. understand the relationship between fat intake and heart disease c. name two ways to decrease fat intake at breakfast d. consider ways decrease their risk of heart disease

c. name two ways to decrease fat intake at breakfast Educational objectives, or learning outcomes, are statements that clearly describe what the learner will know or be able to do as a result of having attended an educational program or activity.

Nutritional advice to a parent with a child with autism spectrum disorder should include: a. oral supplements between meals b. high sodium, high fiber foods c. normal intake based on age d. low fiber, high calories

c. normal intake based on age There is no special diet that is backed by research for children with ASD at this time.

Orlistat is a medication used in the treatment of: a. renal disease b. liver disease c. obesity d. gastroparesis

c. obesity Orlistat is an approved weight loss medication that works by inhibiting pancreatic lipase, thereby decreasing digestion & absorption of dietary fats. Side effects include diarrhea, malabsorption.

You are asked to give an in-service to the staff. What should you do first? a. ask them what they want to learn b. read up on the subject c. observe the staff at work to identify problems d. see what other hospitals are teaching

c. observe the staff at work to identify problems

The first step in implementation of a community based program is: a. obtain support from staff members b. prepare a realistic budget based on goals and objectives c. obtain administrative support d. reach out to the target population

c. obtain administrative support 1. Administrative support 2. Realistic budget 3. Staff commitment 4. Support of target population

Which condition benefits from the use of indirect calorimetry? a. post-gastrectomy b. patient receiving chemotherapy c. patient with third degree burns d. post-surgical patient

c. patient with third degree burns In a patient with a serious burn, there is an increase in REE as high as 100% above normal as consequence of a strong catabolic response mediated by endogenous catecholamines and inflammatory cytokines. Subsequently, it can be difficult to estimate needs in a burn patient and indirect calorimetry would be the best tool to estimated needs, if available.

Which food should someone on an MAOI not eat? a. cottage cheese b. herbal tea c. pepperoni d. butter

c. pepperoni Those on MAOI's need to avoid tyramine. Tyramine is high in foods including aged cheese, processed meats, beer/wine, overripe fruits. Subsequently, pepperoni should be avoided as is processed meat.

An example of a "Healthy People 2020" goal is: a. a decrease in saturated fat consumption b. an increase in iron intake c. promote healthy behaviors across every stage of life d. an increase in the intake of complex carbohydrates

c. promote healthy behaviors across every stage of life Goals of Healthy People 2020: -Attain high-quality, longer lives free of disease, disability, injury, and premature death -Achieve health equity, eliminate disparities, and improve health of all groups -Create social and physical environments promoting good health for all -Promote quality of life, healthy development, and healthy behaviors across all life stages ***Note goals of Healthy People 2030 which could be asked: -Attain healthy, thriving lives and well-being free of preventable disease, disability, injury, and premature death -Eliminate health disparities, achieve health equity, and attain health literacy to improve health and well-being of all -Create social, physical, and economic environments that promote attaining full potential for health and well-being for all -Promote healthy development, healthy behaviors, and well-being across all lie stages -Engage leadership, key constituents, and public health across multiple sectors and take action and design policies that improve the health and well-being of all

The oral-glucose lowering medication Glucotrol: a. enhances insulin action b. inhibits enzymes that digest carbohydrates c. promotes insulin secretion d. decreases glucagon production

c. promotes insulin secretion Glucotrol is a sulfonylurea. Sulfonylurea's work by promoting secretion of insulin.

A tactic that increases the sale of services through publicity is known as: a. pricing b. targeting c. promotion d. segmentation

c. promotion Promotion strategies include publicity (news release, media, radio), direct mail packages, and paid ads.

You are asked to develop quality control guidelines for receiving purchased foods. The most important guideline would be: a. proper counts of the foods received b. proper weights of the foods received c. proper temperatures of the foods received d. accurate prices on the invoices

c. proper temperatures of the foods received Quality control is concerned with whether products are within the specifications. The purpose is to determine any needs for corrective actions, which helps companies meet consumer demands for better products

What nutrients most affect the renal solute load? a. protein and carbohydrate b. sodium and carbohydrate c. protein and sodium d. sodium and fat

c. protein and sodium Renal solute load is the solutes excreted in 1 L of urine; daily fixed load of 600mOsm - mainly measures N (60%) and electrolytes (Na). The two nutrients that most affect RSL are protein and sodium.

Iatrogenic malnutrition is: a. vitamin and mineral malabsorption b. protein malabsorption c. protein, calorie malnutrition d. kwashiorkor

c. protein, calorie malnutrition Iatrogenic malnutrition is a protein-calorie malnutrition that is brought on by treatment, hospital, and/or medications.

Psychographic marketing includes the following categories: a. age, gender, race, education b. urban, suburban, cultural values c. social class, lifestyle, motive behind purchases d. income, education

c. social class, lifestyle, motive behind purchases Psychographic segmentation of marketing includes personality, interests, beliefs. Geographic: urban, suburban, climate, resources Demographic: age, gender, race, education, income Behavioral: occasions, loyalty

Which of the following may result in hypoalbuminemia? a. amino acid supplementation prior to surgery b. a high protein diet with inadequate water c. providing only a 5% dextrose in water solution after stress d. giving a trauma patient enteral feeding only

c. providing only a 5% dextrose in water solution after stress Albumin is a negative acute phase reactant that decreases in times of stress, infection, and inflammation. It has a long half-life and thus is not a great indicator of nutritional status. If I am understanding this question correctly, the other answers do not address the underlying fact that albumin wouldn't decrease from underfeeding in a short period of time. However, stress would impact albumin and thus this answer is correct because of the stress the patient is enduring ***

In the Cori cycle, lactate is converted into: a. ribose b. NADPH c. pyruvate d. acetyl coA

c. pyruvate In the Cori cycle, glucose is metabolized to pyruvate and then to lactate in muscle, the lactate is released into the blood and carried to the liver, where it is reconverted to pyruvate and used for gluconeogenesis, and the resulting glucose is released and travels back to muscle.

Prior to conducting a healthy eating class to local residents, assess their: a. medical histories b. physical activity levels c. readiness to make life-style changes d. occupations and lifestyle

c. readiness to make life-style changes

A new patient with a BMI of 32 and HTN comes to you for counseling. What is you first recommendation? a. achieve DBW b. maintain weight and exercise c. reduce sodium intake d. reduce sodium, reduce fluid, reduce caloric intake

c. reduce sodium intake For a patient with HTN, recommend the DASH diet, which includes encouraging WG, fruits, vegetables, low fat dairy products, poultry, fish, limit alcohol, decrease sweets, calcium to meet DRI, and limiting sodium intake to 2-3 grams/day.

What should you do with leftover sliced beef from lunch? a. throw it out b. let the meat cool at room temp and then serve within two days c. refrigerate immediately and then serve within two days d. keep it in the warmer until dinner time

c. refrigerate immediately and then serve within two days Assuming it hasn't been out for more than 6 hrs if kept at <70 degrees F. Otherwise, would discard within 4 hrs. Given this question, that assumption is being made. Subsequently, you would want to refrigerate it immediately and serve within two days.

An infant with acute diarrhea should receive: a. glucose and electrolytes only for the first 24 hours b. a half-strength formula until the diarrhea stops c. rehydration within 4-6 hours d. a formula that is low in fiber

c. rehydration within 4-6 hours

Which of the following diseases may lead to anemia a. myocardial infarction b. galactosemia c. renal failure d diabetes mellitus

c. renal failure Anemia may occur during renal failure may d/t decreased renal synthesis of erythropoietin, which acts to stimulate bone marrow to produce RBC

A tube fed patient develops diarrhea. What needs to be done first? a. review their nutritional needs b. increase the rate of the feeding c. review the osmolality of the feeding d. discontinue the feeding until the diarrhea stops

c. review the osmolality of the feeding If hypertonic formula, may want to switch to lower osmolality formula. But always check other causes first (meds, C. diff, etc) but it is rarely the TF.

Illness due to Bacillus cereus is due to contaminated: a. dairy products b. eggs c. rice products and starchy foods d. fruits

c. rice products and starchy foods Bacillus cereus, think of cereal which is a starchy food. Can be diarrheal or vomiting illness; vomiting illness mainly from starchy foods

OSHA requires documentation on the use of the following: a. latex gloves b. respiratory masks c. safety goggles d. hairnets

c. safety goggles OSHA requires documentation on the use of personal protective equipment such as rubber gloves and protective glasses

Use separate cutting boards for raw chicken and vegetables to avoid illness due to: a. clostridium botulinum b. clostridium perfringens c. salmonella d. streptococcus

c. salmonella Salmonella is commonly caused by poultry, eggs, dairy, and produce contaminated with salmonella. Prevention methods include preventing cross-contamination, such as produce and raw meat on same cutting board.

Which of the following is not associated with anorexia nervosa? a. food aversions b. distorted body image c. schizophrenia d. constant concern about weight status

c. schizophrenia Anorexia nervosa is restricted eating leading to a significantly low body weight (BMI < 18.5), intense fear of gaining weight even though at a low weight, and distorted perception of body image. Schizophrenia is a seperate psychological condition all together.

Which is not included in a subjective global assessment? a. dietary intake information from a 24 hour recall b. info from patient regarding weight changes c. serum albumin levels d. physical appearance

c. serum albumin levels Albumin is not a good indicator of nutritional status. Subjective Global Assessment looks at history, intake, GI symptoms, functional capacity, physical appearance, edema, weight changes are all assessed

Which is most characteristic of marasmus? a. serum albumin of 2.5 g/dl b. edema c. severe fat and muscle wasting d. decreased lymphocytes

c. severe fat and muscle wasting Marasmus, or protein-calorie malnutrition, may have ne characterized by wasted appearance and depresses somatic and visceral protein stores. The patient will have a low weight, muscle wasting, and low body temperature and/or cold intolerance. Subsequently, marasmus is charactersized by severe fat and muscle wasting. Edema and albumin are not indicators of marasmus. Lymphocytes measure immunocompetency and may be decreased in protein-energy malnutrition. However, it is not characteristic.

How do you convince administration that a former nutrition program should be reinstated? a. show that 95% of patients enjoyed the program b. show that 85% of those who attended came to all sessions c. show that 75% of those who attended have fewer hospital stays d. show that only 10% felt the program was not worthwhile

c. show that 75% of those who attended have fewer hospital stays Administration would primarily be concerned with factors such as length of stay, morbidity, and mortality.

What is the inventory turnover rate? Net profit: $41,137 Cost of goods sold: $145,350 Average inventory value: $7330 Total meals served per day: 200 a. 205.68 b. 726.75 c. 5.6 d. 19.83

d. 19.83 Inventory turnover rate is determined by dividing the COGS by the average inventory value. 145,350/7330 = 19.83

An employee consistently calls in sick the day before a holiday. His Supervisor should: a. discuss this with other managers b. telephone the employee to verify the illness c. speak with the employee about the reasons for the absence d. note the issue in his personnel record

c. speak with the employee about the reasons for the absence The process they are asking about is the process of leadership and management of employees. When something goes wrong with employees, the first step is always to talk with people privately. Never stop the actual work to address a situation.

A pan of au gratin potatoes has been cooked to an endpoint temperature of 140'F. Serving is scheduled to begin in 10 minutes. You should: a. delay service until the potatoes are done b. begin service without the potatoes and deliver them when done c. substitute mashed potatoes until the au gratin are done d. complete the cooking process in the hot holding unit

c. substitute mashed potatoes until the au gratin are done

Which of the following would be classified as NC in the NCP? a. inadequate vitamin intake b. limited access to food c. swallowing difficulty d. inappropriate intake of food fats

c. swallowing difficulty NC is the clinical domain of nutrition diagnosis. Clinical includes functional, biochemical, and weight. Inadequate vitamin intake and inappropriate intake of food fats would be in the NI domain. Limited access to food would be in the NB domain. Swallowing difficulty is a functional issues and thus would classify as NI.

What can an employer do regarding an employee who wishes to join the union? a. prevent him from going to the union b. talk to him against the union c. tell him about union dues d. tell him he may lose his job if he goes

c. tell him about union dues An employer does not have the right to prevent/threaten an employee from going into the union, cannot try to coerce an employee from joining the union, or threaten that he/she will lose their job. Employers can ask about benefits and union dues.

What is the most effective tool for providing nutrition education to the community a. the RDIs b. the Healthy People 2020 report c. the MyPlate Food Guidance System d. The Healthy Eating Index

c. the MyPlate Food Guidance System MyPlate is a visual and intended for the general population so is best to use in nutrition education. The RDI's will not mean much to people without a nutrition background. Similarly, Health People 2020 and Healthy Eating Index are used in research and for those in the nutrition field.

Which would be the best tool for rating foods in a pediatric hospital? a. the triangle test b. paired comparison test c. the facial hedonic scale d. the paired preference test

c. the facial hedonic scale The facial hedonic scale is when foods are rated from extremely like to extremely dislike based on facial expression. This is an especially helpful method for children.

Which process results in creative, prioritized, decision-making? a. a focus group b. the Delphi technique c. the nominal group technique d. operational analysis

c. the nominal group technique The nominal group technique is a decision-making technique, also known as Delbecq, in which participants silently generation ideas, the leader records ideas, and then group ranks items in priority order with vote for final decision

The sensitivity of a screening tool evaluates: a. the proportion of non-afflicted individuals identified as non-afflicted b. the consistency or reproducibility of test results c. the proportion of afflicted individuals who tested positive d. the amount of variation that occurs randomly within the population

c. the proportion of afflicted individuals who tested positive SensiTiviTy = number of TRUE positive; speciFicity = number of FALSE (negative) that are actually false (negative). The consistency/reproducibility of test results is reliability / precision.

Which of the following is a paid employee who represents other union workers? a. a mediator b. the department head c. the shop steward d. the bargaining agent

c. the shop steward The union/shop steward is an employee who represents fellow employees as the union representative. They do not get extra pay for serving.

If energy needs increase, which vitamins are needed in higher amounts? a. A, C, folate b. A, C, thiamin c. thiamin, niacin, riboflavin, pantothenic acid d. pyridoxine, cyanocobalamin

c. thiamin, niacin, riboflavin, pantothenic acid B vitamins = energy! Essential in CHO metabolism particularly but also used in lipid and protien metabolism.

The dishwasher temperatures are as follows: pre-wash 140 'F, wash 150 'F, rinse 200 'F. You should: a. turn up the rinse temperature b. turn down the pre-wash temperature c. turn down the rinse temperature d. do nothing, they are fine

c. turn down the rinse temperature A mechanical dishwasher should be: -Pre-rinse 110-140'F -Wash 140-160'F -Rinse 170-180'F -Airdry 45 seconds Subsequently, the rinse temperature is too high and should be turned down to between 170-180'F

You are conducting a nutrient analysis of a recipe that uses 10lbs of 80/20 raw ground beef. To best ensure analysis accuracy: a. use data for the "pre-portioned" cooked ground beef b. use data for the "edible portion" weight of the raw ground beef c. use data for the "edible portion" weight of the cooked ground beef d. cooking and draining the ground beef, weighing the fat, then reducing the quantity of beef in the recipe by this amount

c. use data for the "edible portion" weight of the cooked ground beef Edible portion is the amount the portion of food that will be served to a customer after the food has been cut and cooked.

To increase the number of patrons served in the cafeteria during the lunch meal: a. increase the number of cafeteria employees b. add a second tray line c. use the scramble system d. add another cashier

c. use the scramble system Also called hollow-square or scramble. In this cafeteria system, there are separate counters for hot foods, salads, etc. This serves greater number of people if used with repeat customers (i.e. school cafeteria or employee cafeteria)

Which is the best way to maximize meat storage? a. cut the meat into small pieces b. store it in oxygen in packages c. vacuum-packaged in oxygen-impermeable film d. pack it in oxygen-permeable film

c. vacuum-packaged in oxygen-impermeable film Vacuum-packaged meats in oxygen-impermeable film protects against exposure to oxygen and heat, which contribute to spoilage and bacteria growth.

Which is the dependent variable? a. leavening b. storage days c. volume d. oven temperature

c. volume Dependent variables are outcomes. Independent variables are what you manipulate in the study. For example, treatment for diseases are independent (you can change the treatment to affect disease). Another example is the effect that cholesterol levels (independent) have on heart attacks (dependent). In this example, volume is the outcome. Leavening, storage days and oven temperatures would all be independent variables, or what is manipulated in the study.

Which of the following affects bioelectrical impedance analysis? a. adipose stores b. muscle mass c. water d. protein stores

c. water Bioelectrical impedance analysis is used at bedside to evaluate fat free mass and total body water. Must be well hydrated, no caffeine, no alcohol, and no diuretics in past 24 hours, no exercise in past 4-6 hours. Fever, electrolyte imbalance, and extreme obesity may affect reliability.

A Rabbi is admitted to the hospital. What question might he ask the Dietitian? a. what time are meals served b. who cooks the food? c. what is the mixture of foods in combination dishes d. where will I eat?

c. what is the mixture of foods in combination dishes Those who follow a Kosher diet do not milk dairy products and meats in same meal, so knowing the food mixtures would be important to the rabbi.

You find out that next year's budget will change by the following: 10% increase in labor cost 5% increase in food cost 2% increase in overhead What will the total budget be if the following info is from the current year? Labor costs $100,000 Food cost $100,000 Overhead cost $40,000 a. $156,800 b. $234,800 c. $267,000 d. $255,800

d. $255,800 $100,000 + $100,000 + $40,000 = $240,000 $100,000 x 10% = $10,000 $100,000 x 5% = $5000 $40,000 x 2% = $800 $10,000 + $5000 + $800 = $15,800 $15,800 + $240,000 = $255,800

A food service operates with a 35% food cost. If a menu item has a raw food cost of $1.25, and it takes an employee 45 minutes at $6 an hour to prepare, what is the traditional selling price? a. $2.75 b. $3.25 c. $2.50 d. $3.58

d. $3.58 Selling price = cost to make per unit/food cost (decimal) SP = 1.25 / 0.35 = $3.58

What denotes a high correlation? a. 0.2 b. 0.4 c. 0.6 d. 0.8

d. 0.8 r= =/- 1 is perfect correlation; cannot have correlation outside of this range. </= 0.4 would be a poor correlation, 0.4-0.7 would be moderate correlation, >/= 0.7 would be a strong correlation (this is true for positive or negative values. 0.8 is the answer because it is closet to 1.

A patient receives 4 ounces whole milk and 6 graham crackers as a snack. Which of the following substitutes would lower the glycemic index? a. skim milk in place of whole milk b. fruit juice in place of whole milk c. 12 saltines in place of 6 graham crackers d. 1 T peanut butter in place of 3 graham crackers

d. 1 T peanut butter in place of 3 graham crackers 4 oz milk = 1/2 cup = 0.5 milk exchange (6 gm CHO, 4 gm pro, 4 gm fat, 75 kcal) 6 graham cracker = 2 starch exchanges (30 gm CHO, 6 gm protein, 0-2 gm fat, 160 kcal) Total from snack: 36 gm CHO, 10 gm protein, 4-6 gm fat, 235 kcal The glycemic index is a system of assigning a number to carbohydrate-containing foods according to how much each food increases blood sugar. In this example, the graham cracker are the highest glycemic index food. Ways to reduce the affect of glycemic index foods include adding protein/fat to CHO sources. Subsequently, replacing 3 of the crackers with 1 tablespoon peanut butter would lower glycemic index.

Which of the following would be appropriate for a hemodialysis patient on 60 gm protein diet, with 75% from HBV protein? a. 2 eggs, 2 ounces chicken, 3 ounces beef, 1/2 cup milk b. 1 egg, 2 ounces chicken, 3 slices bread, 3 ounces beef c. 2 eggs, 3 ounces chicken, 3 ounces beef, 1 cup milk d. 1 egg, 3 ounces chicken, 2 cups milk, 5 slices bread

d. 1 egg, 3 ounces chicken, 2 cups milk, 5 slices bread HBV protein = high biological value, meaning it contains a sufficient amount of amino acids to form all the proteins your body needs. HBV foods include meats, eggs, yogurt, poultry. Keep in the back of your mind the HD patients lose a lot of water-soluble vitamins via dialysis (specifically vitamin C, vitamin B12, vitamin B6, folate). Focus on getting good sources of those foods. Ultimately, we want some meat sources (B12, protein), some milk (riboflavin), and some folate (fortified bread) Based on that, look at answer D. 1 egg = 7 gm protein, 3 oz chicken = 21 gm protein, 2 cups milk = 16 gm protein, 5 slices bread = 15 gm protein. In total, that is 59 gram protein. Meat, eggs, and milk are HBV proteins, which make up 75% of total protein (44 gm from HBV / 59 gm total). Thus, D is the best answer.

A patient with severe acute pancreatitis experiences nausea and vomiting and requires 2500 calories/day. Which of the following would you recommend? a. 3000cc of a 1cal/cc tube feeding through the jejunum b. 1500cc of a 2cal/cc nasogastric tube feeding c. 1000 cc of D50W, 1000cc of 7% amino acids, 650cc of 20% lipids d. 1000cc of D50W, 1000cc of 7% amino acids, 500cc of 10% lipids

d. 1000cc of D50W, 1000cc of 7% amino acids, 500cc of 10% lipids Since this is a patient with severe acute pancreatitis and N/V, PN is indicated. In those with severe acute pancreatitis, steatorrhea is common and thus want to watch how much fat we are providing. D50W = 50 gm per 100mL, so 50 gm x 10 = 500 gm dextrose 500 gm dextrose x 3.4 kcal/gm = 1,700 kcal dextrose 7% AA = 7 gm per 100mL, so 7 gm x 10 = 70 gm protein 70 gm protein x 4 kcal/gm = 280 kcal protein 10% lipids = 1.1 kcal/mL x 500 mL = 550 kcal fat Total: 1,700 kcal dextrose + 280 kcal pro + 550 fat = 2530 kcal This TPN provides ~22% kcal from fat. In the other answer, it provides ~40% kcal from fat. It also overfeeds the patient 700 kcal (provides 3280 kcal total). Thus, D is the answer.

How many 5 ounce servings will be available from 9 lbs raw meat with a 65% yield? a. 12 b. 14 c. 16 d. 18

d. 18 9lbs x 16oz = 144oz 0.65 x 144oz = 93.6oz 93.6oz/ 5oz servings = 18.72 = 18 full servings

A patient weighing 104kg is placed on a 1.5 cal/ml formula with 75% free water, 54 grams protein/L. He needs 3000 calories per day. How much formula should he receive daily to meet his needs? a. 2000ml b. 3000ml c. 2275ml d. 2575ml

d. 2000ml 3000 kcal / 1.5 kcal per mL / 24 hrs = 83mL/hr 83 mL/hr x 24 hrs = 2L

At what age should children be measured standing up? a. 6 months b. 12 months c. 18 months d. 24 months

d. 24 months 2 years

One pound of boneless turkey yields 0.7 lbs cooked turkey. How many pounds must be purchased to yield 21 lbs cooked turkey? a. 18 b. 25 c. 28 d. 30

d. 30 AP quantity = EP quantity/ yield 0.7lb/1 = 70% yield AP = 21 lbs / 0.70 = 30lbs

Which infant is at the greatest risk? a. 20lb, hemoglobin 10 b. 22lb, hemoglobin 10.5 c. 19lb, hemoglobin 11 d. 30lb, hemoglobin 9

d. 30 lb, hemoglobin 9 Normal hemoglobin for infants is 10 mg/dL. Subsequently, the baby that has a hemoglobin of 9 would be at greatest risk for anemia. Weight does not impact risk given the information provided.

How much water does an athlete need if they have lost 2 pounds during a marathon? a. 8 ounces b. 16 ounces c. 24 ounces d. 32 ounces

d. 32 ounces 2 lbs = 32 oz (1lb = 16 oz)

With a CHO:insulin ratio of 16:1 how much insulin is needed with this meal: 2 ounces beef 2/3 cup steamed brown rice 1/2 cup cooked beets 1 slice bread 1 teaspoon butter 1/2 cup vanilla ice cream a. 7 units b. 6 units c. 5 units d. 4 units

d. 4 units Beef and butter no CHO 2/3 brown rice = 2 exchanges (30 gm) 1/2 cup cooked beets = 1 NON-STARCH exchange (5 gm) 1 slice bread = 1 exchange (15 gm) 1/2 cup vanilla ice cream = 1 exchange (15 gm) Total: 65 gm / 16 (because 16:1 ratio) = 4 units

An infant requires 340 calories/24 hours. How many ounces of formula should be given every 6 hours? a. 2oz b. 3oz c. 3.5oz d. 4.25oz

d. 4.25oz Standard formula: 20 kcal/oz 340 kcal / 20 = 17 oz daily 17 oz / 4 feeds (q6hrs) = 4.25 oz per feeding

Approximately how many patient trays per minute must a centralized tray assembly unit produce in order to serve 400 patients during 90 minutes? a. 3 b. 3.5 c. 4 d. 4.5

d. 4.5 400 patients/90 minutes

In dry storage, the humidity should be: a. 20-30% b. 30-40% c. 40-50% d. 50-60%

d. 50-60%

Which of the following lab values would most likely indicate that dialysis is necessary? Serum creatinine/ BUN a. 2.0 80 b. 3.0 90 c. 4.0 100 d. 6.0 70

d. 6.0 & 70 BUN: creatinine ratio less than 10:1 indicates need for dialysis 80/2 = 40:1 90/3 = 30:1 100/4 = 25:1 70/6 = 11.7:1 (closet to less than 10:1)

300ml 60% dextrose; 500ml 10% amino acids; 200ml 20% lipid; The amounts stated are given per liter. Total nutrient mixture administered at 65 ml/hour for 24 hours Using the above formula, determine the calories coming from lipids per day a. 519 b. 561 c. 577 d.624

d. 624 65mL/hr x 24 hours = total 1.56 L Current volume = 300 mL + 500 mL + 200 mL = 1000mL Requires 1.56 MORE volume than what is provided Fat: 2 kcal/mL x 200 mL = 400 kcal x 1.56 = 624 kcal

How many servings are there in 10 gallons of ice cream using a #16 scoop? a. 320 b. 480 c. 560 d. 640

d. 640 #16 scoop = 16 scoops in quart 32 oz = 1 quart, so 32/16 = 2 oz for #16 scoop 1 gallon = 128 oz 128 x 10 = 1280 oz in 10 gallons 1280oz/2oz= 640 servings

A patient receives an enteral feeding providing 1 cal/ml from 8PM until 9AM. What rate is needed to provide 1200 calories in 24 hours? a. 75ml/hr b. 79ml/hr c. 87ml/hr d. 92ml/hr

d. 92ml/hr 8PM to 9AM = 13 hrs 1200 kcals / 13 hrs = 92 mL/hr in 24 hours (on 13 hrs, off 11 hrs)

Which diet follows the AHA recommendations for healthy hearts? a. 25-30% calories from fat, <10% saturated fats, <200mg cholesterol b. </=35% calories from fat, <2g sodium, <200mg cholesterol c. 25-30% calories from fat, <10% saturated fats, <200mg cholesterol, 5-10% MUFA, 20% PUFA d. </=35% calories from fat, <7% saturated fats, 5-10% PUFA, up to 20% MUFA, <200mg cholesterol

d. </=35% calories from fat, <7% saturated fats, 5-10% PUFA, up to 20% MUFA, <200mg cholesterol

Which of the following is not a governmental agency? a. Health and Human Services b. Food and Drug Administration c. Food and Nutrition Board d. American Heart Association

d. American Heart Association American Heart Association is a nonprofit organization.

Who is most at risk for gestational diabetes? a. BMI <30 b. age <25, overweight c. BMI >30, history of GDM d. conception within 10 months of last pregnancy

d. BMI >30, history of GDM Risk factors for GDM include BMI>30, history of GDM

Which religious group CAN consume alcohol? a. Mormons b. Muslims c. Hindus d. Buddhists

d. Buddhists Mormons and Muslims is no alcohol. Between Buddhist and Hindus, both religions also have an inclination towards vegetarianism. Remember by Hindus HINDER ability to drink alcohol. Buddhists enjoy BEVERAGES, like alcohol in moderation

Which of the following is lowest in fat? a. hamburger b. salami c. goat cheese d. Canadian bacon

d. Canadian bacon Hamburger = (as beef); high-fat protein exchange Salami = high-fat protein exchange Goat cheese = high-fat protein exchange Canadian bacon = lean-fat protein exchange

A family enrolled in the SNAP program is unsure of the best way to plan meals and budget. Refer them to: a. a congregate meal site b. TANF c. WIC d. EFNEP

d. EFNEP Expanded Food & Nutrition Education. They don't need food, they need to be taught skills/given education so that's why EFNEP.

The dumping syndrome: I. follows a gastrectomy II. is secondary to carbohydrate overload III. draws fluid into the intestine IV. needs a high carbohydrate diet a. I, III, IV b. II, III, IV c. I d. I, II, III

d. I, II, III Dumping occurs following gastric surgery (i.e. gastrectomy). When rapidly hydrolyzed carbohydrate enters the jejunum, water is drawn in to achieve osmotic balance. This causes a rapid decrease in the vascular fluid and signs of cardiac insufficiency appear. About two hours later, the CHO is digested and absorbed rapidly. Blood sugar rises, stimulating an overproduction of insulin, causing a drop in blood sugar below fasting. This is called reactive/alimentary hypoglycemia. The only answer that is not correct is high carbohydrate diet. In fact, a diet limiting simple carbohydrate is essential.

The stasis of pancreatic juice and bile could result in: I. autodigestion II. fat malabsorption III. obstructive jaundice a. I and II b. I and III c. II and III d. I, II, and III

d. I, II, and III Lack of bile in the duodenum is usually due to blockage of the main bile duct, or papilla. The liver continues to produce bile, which then spills backwards into the blood stream. Eventually this causes jaundice, or a buildup of excess bilirubin and typically caused by obstruction of the bile duct, by liver disease, or by excessive breakdown of red blood cells. Lack of pancreatic juices results in inadequate digestion, particularly of fat which causes steatorrhea. Autodigestion occurs when there is premature activation of enzymes within pancreas leads to autodigestion.

What are the similarities between WIC and SNAP? I. regulated by USDA II. have at risk criteria III. have income criteria IV. a health exam is required a. I, II, III, IV b. I, II, III c. II, III, IV d. I, III

d. I, III SNAP and WIC are both federal programs regulated by USDA, administered by states. WIC does have risk criteria (maternal nutritional risk, including abnormal weight gain, history of high risk, LBW, underweight, overweight, anemia), while SNAP does not. Both WIC and SNAP have income requriements. A health exam is required for WIC, but not SNAP. WIC is NOT an entitlement program, while SNAP is an entitlement program.

Which of the following may be the cause of loose stools in a tube fed patient? I. feeding was administered at too rapid a rate II. the osmolality of the feeding was too low III. the patient is constipated IV. an inadequate amount of intestinal surface area a. I b. I, II c. II, III d. I, IV

d. I, IV If the rate of EN feeds is too rapid, loose stools can occur (too much too quickly). If the patient had inadequate intestinal surface area, absorption/digestion would be impaired and thus loose stools may occur. If the osmolality of the feed was low, it would not cause loose stools (would have to be too high). The patient being constipation also does not make sense.

Who resolves differences in bills from the House and the Senate? a. House Committee b. Senate Committee c. Committee on Resolutions d. Joint Conference Committee of the House and Senate

d. Joint Conference Committee of the House and Senate A conference committee is a joint committee of the United States Congress appointed by the House of Representatives and Senate to resolve disagreements on a particular bill. A conference committee is usually composed of senior members of the standing committees of each house that originally considered the legislation.

the program that provides nutrition education training to teachers and food service personnel is the: a. TEFAP b. CACFP c. EFNEP d. NETP

d. NETP Nutrition Education Program is the amendment to School Lunch Act. Provides nutrition education training to teachers and school foodservice personnel. Run by USDA TEFAP is The Emergency Food Assistance Program; Quarterly distributions of commodity foods by local, public, or private nonprofit agencies, food banks, soup kitchens, homeless shelters; supplements diet of low income households, short term hunger relief. Run by USDA. CACFP is the Child and Adult Care Food Program. Federal entitlement program;guarantes reimbursement for meals/snacks served to eligible children, youth, and adults;children: preschoolers enrolled at participating child-care center, homeless shelters, eligible after school programs (run by community organizations in areas with > 50% children eligible for free/reduced meals Adults: over 60 years old, those with disabilities enrolled in day care facility (i.e. adult day care center)Meals must meet guidelines, must offer free or reduced-price to eligible, which are same as NSLP (1/3 RDA). Run by USDA EFNEP is the Expanded Food and Nutrition Education program. Grants to universities that assist in community development. Trains nutrition aides to educate the public. Improves food practice of low income homemakers with young children. Works with small groups. Does not provide food. Run by USDA

The amount of ceruloplasmin is affected by what disease? a. Addison's disease b. Pheochromocytoma c. Cushing's syndrome d. Wilson's disease

d. Wilson's disease Ceruloplasmin is a protein that is made in the liver. It stores and carries copper from the liver into the bloodstream and to the parts of your body that need it. Copper is a mineral that is found in several foods, including nuts, chocolate, mushrooms, shellfish, and liver. Wilson's disease is an inherited disorder that causes too much copper to accumulate in the organ. Subsequently, the amount of ceruloplasmin in the blood would increase as copper accumulates.

Synergistics is: a. two people working together b. two people working in separate areas c. a person working alone d. a group of people working together to solve a problem

d. a group of people working together to solve a problem Synergy: the group production (decision) is superior to what the most resourceful individual within the group could have produced by working alone

A nephrotic syndrome patient with edema has a declining serum albumin level. A contributing factor would be: a. diversion of protein to intracellular spaces b. decreased synthesis by the liver due to catabolic state c. a decreased appetite and less food consumption d. a loss of protein in the urine

d. a loss of protein in the urine Nephrotic syndrome is a defect in capillary basement membrane of glomerulus, which permits escape of large amounts of protein into the filtrate moving through the tubules. Sxs of nephrotic syndrome include albuminuria, edema, malnutrition, hyperlipidemia (increased synthesis and decreased clearance of VLDL). Subsequently, loss of protein in the urine is the answer. Think: nePhrotic Syndrome Seeps Proteins, increase albumin in urine

A snack food kiosk staffed with a full-time employee would be considered __________ in a college dormitory foodservice. a. a technical core b. an interface c. an input d. a subsystem

d. a subsystem A system is a part of the whole, meaning the snack food kiosk is a small part of the whole foodservice operation.

a. 20lb, hemoglobin 10 b. 22lb, hemoglobin 10.5 c. 19lb, hemoglobin 11 d. 30lb, hemoglobin 9 Which of the infants in the above question have a normal hemoglobin? a. a, b, d b. b, d c. c, d d. a, b, c

d. a, b, c Normal hemoglobin for infants can vary based on age, but 9.5 to 13 g/dL is the reference range listed for "infants". Subsequently, all other infants aside from the one with a Hg of 9, have a normal hemoglobin.

What is the most important advice to give a patient with a peptic ulcer? a. drink milk every 1-2 hours b. consume small portions c. eat everything in balance d. abstain from spicy food

d. abstain from spicy food Gastric irritant

Which statement applies to nutritional screening? a. only a physician makes the referral b. only a dietitian makes the referral c. it is exclusively done by nursing d. all health team members can participate according to policy

d. all health team members can participate according to policy Per Joint Commission, nutrition risk screening must be completed within 24 hours and can be performed by anyone who the hospital designates (does not have to be RDN).

Which food service system is least likely to have microbial contamination? a. conventional b. cook-chill c. cook-freeze d. assembly serve

d. assembly serve In assembly serve, purchase completely prepared individual portions and finish by thawing, heating on premises. There is no on-site food production, thus minimizing food safety concerns. In conventional, there are concerns for holding foods at proper temperature and food handling. In cook-chill/cook-freeze, there are concerns for proper reheating and temperature control.

The kitchen layout below is characteristic of which foodservice system? Refrigerator / Freezer / Steamer / Ovens / Microwave / Meal assembly / Delivery carts a. commissary b. conventional c. ready prepared d. assembly-serve

d. assembly-serve Not much equipment or prep space would be needed for assembly serve. All that may need to be done if heating or keeping cold. Subsequently, refrigerator, freezer, steam, oven, and microwave would be the standard equipment required. Meal assembly and delivery charts would be the final step to help finalize the food and get it to the patron.

A food service worker confides in you that he has tested HIV positive, What should you do? a. ask him to report to the health clinic b. instruct him to wear gloves on duty c. reassign him to another area of the kitchen d. assure him that confidentiality will be respected

d. assure him that confidentiality will be respected First step in discussing a sensitive topic such as HIV status with an employee is to always assure them that confidentiality will be respected.

Which is the least time efficient way for a dietitian to evaluate a new piece of equipment for purchase? a. read specifications provided by the manufacturer b. discuss it with other dietitians via telephone c. meet with the company representations d. attend food service trade fairs

d. attend food service trade fairs

A patient on parenteral support develops sepsis. What is the likely cause? a. lack of immune-enhancing nutrients b. poor care of the entry site c. related to the condition that created the need for parenteral support d. bacterial translocation

d. bacterial translocation Bacterial translocation is the passage of viable bacteria from the GI tract to extra-intestinal sites, such as the mesenteric lymph node complex, liver, spleen, kidney, and bloodstream. If the gut is not utilized, such as in those in PN, the tight junctions in the enterocytes become more permeable, allowing bacteria from GI tract to travel to the bloodstream which leads to sepsis. This is known as bacterial translocation.

If a foodservice operation has a 1.93 current ratio, they most likely will: a. not be able to meet long term financial obligations b. not be able to generate profit in relation to sales c. be able to control expenses d. be able to pay bills when due

d. be able to pay bills when due To calculate current ratio, divide current assets by current liabilities; represents an organization's ability to meet current financial obligations (bill-paying activity); used by creditors to determine if an organization has sufficient assets to repay debts over the next 12 months; a current ratio greater than 1 indicates an ability to pay bills when due and over the next 12 months

To ensure that the employee performance appraisal process is objective and fair, the evaluation criteria should: a. be evaluated and adjusted annually b. be developed with input from the employees c. emphasize the employees best skills d. be clear and reasonable

d. be clear and reasonable Think of RUMBA- reasonable, understandable, measurable, believable, and achievable.

Which correlates best with energy intake? a. lean body mass b. triceps skinfold c. body mass index d. body weight

d. body weight Body weight is used consistently in the hospital setting as a way to assess energy intake. If a patient loses 5% of body weight in a week, there is concern is that energy intake is poor.

Following a Roux-en-Y bypass, which should be recommended first? a. potassium, megnesium b. folate, vitamin B12, iron c. multi-vitamin with iron d. calcium and multi-vitamin with iron

d. calcium and multi-vitamin with iron In a Roux-en-Y bypass, the surgeon reduces the size of the upper stomach to a small pouch about the size of an egg. The surgeon does this by stapling off the upper section of the stomach. Subsequently, the duodenum is bypassed. When the duodenum is bypassed, secretion of secretin and pancreozymin by the duodenum is reduced. These hormones normally stimulate the pancreas, so there is little pancreatic secretion. Calcium and iron are adversely affected, as calcium is most rapidly absorbed in duodenum and iron requires an acidic environment for absorption. More specifically, in the stomach, heme iron (III) is reduced to iron (II). This reduction is favored by the low pH. Reducing agents, such as ascorbic acid, assist this process, which is why vitamin C enhances iron absorption.

The two most abundant minerals in the body are: a. zinc and chromium b. calcium and zinc c. iron and calcium d. calcium and phosphorus

d. calcium and phosphorus Calcium is the most abundant- involved in bone metabolism, blood coagulation, neuromuscular excitability, cellular adhesiveness, transmission of nerve impulses, maintenance and function of cell membranes, and activation of enzyme reactions and hormone secretions. Phosphorus is also very abundant, as it is a component of many structural and regulatory molecules, such as ATP & DNA. Think: phospholipid bilayers

A pork chop is which type of protein exchange? a. high fat protein b. medium fat protein c. medium fat protein plus one fat exchange d. lean protein

d. lean protein Pork chop is a lean protein, which provides 0 gm CHO, 7 gm protein, 3 gm fat, and 45 kcal per 1 oz serving)

A patient with inflammatory bowel disease has steatorrhea. In addition to limiting the fat intake, which minerals should be assessed? a. iron and phosphorus b. calcium and phosphorous c. iron and zinc d. calcium, magnesium, and zinc

d. calcium, magnesium, and zinc The malabsorbed fatty acids combine with Ca, Zn, Mg leading to ''soaps", resulting in increased levels of free oxalate available for absorption. Subsequently, supplement with Ca, Mg, ZN

What diet is typically recommended for a patient who has undergone a gastrectomy? a. low fiber foods and two glasses of milk each day b. high fiber foods and restriction of fluids with meals c. carbohydrate, protein and fat at each meal, and no dairy products d. carbohydrate, protein and fat at each meal, and restriction of fluids with meals

d. carbohydrate, protein and fat at each meal, and restriction of fluids with meals In a gastrectomy, 80% of stomach removed but food pathway not altered (mouth to esophagus to stomach to small intestines to large intestine). Encourage carbohydrates, proteins, and fats at meals. However, limit fluids with meals as it may fill someone up since stomach is so much smaller. Iron, vitamin B12, folate, calcium, vitamin D, vitamin B1, and copper are nutrients of concern s/p gastrectomy.

The dietitian reviewed a monitoring sheet for a dairy refrigerator at 9AM on Wednesday. What should the initial action be? Monday: 5:30AM = 36F 6:00PM = 40F Tuesday: 5:30AM = 38F 6:00PM = 44F Wednesday: 5:30AM = 48F a. discard the products immediately b. review the temperatures with the maintenance department c. monitor the temperature every 4 hours d. check the temperature of the products

d. check the temperature of the products

When instructing a patient on diet therapy needing during intake of a monoamine oxidase inhibitor, which would not be included? a. milk, cottage cheese, yogurt b. yogurt, ricotta cheese c. swiss cheese, yogurt d. cheddar cheese, swiss cheese

d. cheddar cheese, swiss cheese When a patient is taking an MAOI, they need to limit the amount of tyromine in their diet, as it will cause hypertension as MAOI interact with releasing norepinephrine which elevates BP. Foods to avoid include aged cheese (cheddar, Swiss), pickled foods, fermented foods, smoked foods, tofu, luncheon meats. Foods ok: cottage cheese, cream cheese

Which is the most appropriate bedtime snack for a diabetic on NPH insulin a. apple juice and crackers b. graham cracker and diet soda c. fresh fruit and crackers d. cheese and crackers

d. cheese and crackers Evening snack with carbohydrates and protein is important for someone using an intermediate insulin so they do not wake up hypoglycemic since onset is about 2-4 hrs. If a person takes intermediate insulin at night (common because duration is 10-16hrs so usually take 2x per day), then they would peak around 2-4hrs after going to sleep.

The kitchen floor will be changed. What do you recommend? a. asphalt tiles b. terrazzo c. concrete blocks d. clay tiles

d. clay tiles Unglazed red clay tiles are non-porous quarry tiles, highly recommended for kitchen and heavy traffic Asphalt tiles are good for light traffic areas (i.e. dining room). Terrazzo is cement and crushed marble; use in dining room. Concreate blocks are good for light traffic, absorbs grease; used in storeroom and receiving areas.

What is the first step in the receiving process? a. compare items received to invoice b. complete all receiving records c. send items to storage d. compare purchase order to invoice

d. compare purchase order to invoice When receiving a shipment, compare invoice against purchase order first, then items against invoice. Inspect items, list on receiving report, store promptly.

A viscosimeter measures: a. temperature b. pH c. stability d. consistency

d. consistency A viscosimeter measures the viscosity of liquids that flow on incline plane or rotational basis. Viscosity relates to thickness/consistency.

In the TM model, which stage of change is represented by this comment: "Although I do not like and therefore do not eat many vegetables I saw an interesting vegetable side dish at a friends cookout" a. pre-contemplation b. preparation c. action d. contemplation

d. contemplation The contemplation phase of the Transtheoretical Stages of Change Model is when someone thinks about making a change in the near future. An example would be "I know what to do but..." or "I was looking at the salt content in the foods I have at home". The example provided would be the contemplation stage because the individual has some resistance to making a change but showed they may have interest in making a change by saying they saw an interesting vegetable recipe at a friends cookout.

If a food service reconstitutes frozen food that is made on site, what type of production system is it? a. convenience b. conventional c. satellite d. cook-freeze

d. cook-freeze Ready-prepared, known as cook-chill, cook-freeze, is a food production system in which food not produced for immediate service but for inventory and subsequently withdraw. Foods are prepared on site, then frozen, chilled for later use. Requires blast chiller or freezer and adequate storage

The greatest effect on the yield of meat cooked to a uniform internal temp is produced by the: a. type of oven and source of the heat b. weight of meat and the oven load c. degree of tempering and the grade of meat d. cooking time and the oven temp

d. cooking time and the oven temp Cooking time and oven temp would have the greatest impact. Think: if recipe called for 45 minutes at 325 degrees F, and you cooked it at 425 for an hour, that would the impact on internal temperature. Type of oven wouldn't have a major impact on internal temperature if put at the correct temperature (ex: 325 degrees F). Tempering involves warming the frozen meats to temperatures slightly below their freezing point—for example, between -4 and -1 °C (25 and 30 °F). Tempering of frozen foods is often carried out in industrial-scale microwave ovens.

Which will cause the most delay in gastric emptying? a. lean baked meat b. broiled cod c. shrimp d. corned beef

d. corned beef Corned beef is a high fat, high protein food with no fiber and thus will digest slowly. Lean baked meat, broiled cod, and shrimp are all lower in fat and thus will digest quicker.

Which of the following dish machine temperatures should be adjusted? pre-rinse: 121F wash: 145F final rinse: 205F a. increase the temperature of the pre-rinse b. increase the temperature of the wash cycle c. decrease the temperature of the wash cycle d. decrease the temperature of the rinse cycle

d. decrease the temperature of the rinse cycle Pre-rinse/pre-wash: 110-140 degrees Wash: 140-160 degrees F Rinse: 170-180 degrees F Air dry: 45 seconds

The Y Theory of management is: a. authoritarian b. autocratic c. based on managing tasks d. democratic

d. democratic McGregor Theory Y has more faith in team; work is as natural as play; positive and participative. It is democratic in that decisions are often made as a group.

OSHA's responsibilities do not include: a. establishing minimum safety standards b. inspecting facilities c. examining records of occupational injuries d. developing a better safety program for a facility

d. developing a better safety program for a facility OSHA regulates minimum safety standards, maintains record keeping of accidents and illnesses, provides inspections of facilities looking for safety hazards, fire extinguishers, handrails on stairs, and first-aid supplies. They are not responsible for developing improved safety programs for the facility.

When assessing nutritional status, which would be the most beneficial? a. 24 hour recall, history of weight changes b. medical history, diet order, socioeconomic status c. clinical observation, weight status, cultural habits d. diet intake info, clinical data, laboratory data

d. diet intake info, clinical data, laboratory data ABCD's of nutrition assessment- anthropometrics, biochemical data, clinical data, and dietary information. Clinical data would include NFPE, which is an essential component of nutrition assessment. Other answers, including socioeconomic status and cultural habits are very important, but not the most critical.

What is the chemical composition of a class ABC fire extinguisher? a. water under pressure b. carbon dioxide under pressure c. carbon monoxide under pressure d. dry inert chemicals under pressure

d. dry inert chemicals under pressure Class ABC fire extinguisher = multi-purpose dry chemical

The Ouchi Theory Z management theory states that: a. decision-making is a centralized function b. committed employees can exercise self-control c. employee potential is only partially utilized d. employee involvement is the key to productivity

d. employee involvement is the key to productivity Theory Z of Ouchi states that everyone who will be affected by a decision is involved in making the decision (consensus decision making).

Why should a manager not allow employees to wear long jewelry in the kitchen? a. to prevent showing off to other workers b. sanitation considerations c. possible theft d. employee safety and sanitation

d. employee safety and sanitation Long jewelry is physical hazard, as it could break and/or fall into food and contaminate it. In addition, long jewelry could be a hazard for the employee, as it could get stuck in a piece of equipment or catch fire if using/near range.

Which of the following has the least amount of saturated fat? a. 2% milk b. half and half c. non-dairy creamer d. evaporated skim milk

d. evaporated skim milk Skim milk itself has <0.5% fat, and thus evaporated skim milk would have the least (?) Half and half has no less than 10.5% fat, 2% milk has 1.50-2.25% fat, non-dairy creamer would vary dependent on source (coconut, soy, almond, etc).

What can you do if your company denies you the right to organize and form a labor union? a. nothing b. quickly form a union c. change jobs d. file a claim with the NLRB

d. file a claim with the NLRB The Wagner Act, or National Labor Relations Act, guarantees the right to organize and join labor unions; created National Labor Relations Board which listens to claims of "unfair labor practices"; pro-labor

An edematous person may actually be dehydrated because: a. intravascular fluid is retained b. intravascular fluid is diluted c. fluid is retained intracellularly d. fluid is retained extracellularly

d. fluid is retained extracellularly When someone is experiencing edema, fluid is pulled interstitially, meaning extracellularly.

A meal equivalent is determined by: a. total sales received during one week of operation b. average dollars spent per customer per meal c. labor costs divided by the average cost of a typical meal d. food sales divided by the average cost of a typical meal

d. food sales divided by the average cost of a typical meal Meal equivalent is a measure of productivity defined as the amount of all food sales divided by the average cost of a typical meal

If you open sealed bids and place the order with the lowest bid, you are using which buying method? a. informal b. open market c. future contracts d. formal, competitive bid

d. formal, competitive bid In formal, competitive bidding, written specifications are submitted and quantity needs to vendor who then submit a price. Bids are opened together and ordered placed with lowest bid price

Bacillus cereus intoxication is most likely to occur following consumption of: a. macaroni and cheese b. baked beans c. corn pudding d. fried rice

d. fried rice Bacillus cereus, think of cereal which is a starchy food. Can be diarrheal or vomiting illness; vomiting illness mainly from starchy foods

HACCP standards would be similar for which of the following foods? a. canned corn and frozen corn b. fresh chicken and frozen chicken c. fresh beef and frozen chicken d. frozen beef and frozen corn

d. frozen beef and frozen corn Frozen foods should be stored at 0 to-10 degrees F. All other options are combination of fresh, frozen and canned foods which all require different temperature for storage.

Which of the following is true? a. fructose has sucrose b. fructose is less concentrated than glucose c. fructose take longer to digest than glucose d. fructose is sweeter than glucose

d. fructose is sweeter than glucose The order of carbohydrates from sweetest to least sweet is as follows: fructose, invert sugar, sucrose, glucose, sorbitol, mannitol, galactose, maltose, lactose. Mainly remember that fructose is the sweetest, sucrose is sweeter than glucose, and glucose is sweeter than sorbitol and mannitol.

If you have a lactose intolerance, which food could you most likely tolerate? a. whole milk b. skim milk c. ice cream d. yogurt

d. yogurt Yogurt may be better tolerated in those with lactose intolerance as has lower levels of lactose compared to milk and ice cream.

For which of the following diseases is diet therapy the primary treatment? a. peptic ulcer b. diabetes c. wilson's disease d. galactosemia

d. galactosemia Galactosemia is a genetic disease in which there is a deficiency in converting galactose to glucose. Galactosemia is only treated with diet. Diet followed should be low in galactose, avoiding organ meats, MSG extenders, milk, lactose, galactose, whey, casein, dry milk, calcium or sodium caseinate, dates, bell peppers. The other conditions have a dietary component, but other factors are involved in treatment (i.e. physical activity, medications, insulin in DM).

Which snack would you not give an infant? a. yogurt b. cheese sticks c. graham crackers d. grapes

d. grapes Grapes are a choking hazard.

An appropriate measurement for iron status in a local community is: a. serum iron b. transferrin c. TIBC d. hematocrit

d. hematocrit Hematocrit is the ratio of the volume of red blood cells to the total volume of blood; volume of packed cells in whole blood. Worldwide, the most common method of screening individuals or populations for iron deficiency involves determining the prevalence of anemia by measuring blood hemoglobin or hematocrit levels.

Which of the following would be considered by HACCP to be of the most concern: a. storage temperature of canned peaches on a hot day b. holding temperature of canned peaches in individual serving dishes c. frozen ground beef patties held at minus 5 degrees F d. holding temperature of cream of mushroom soup on the serving line

d. holding temperature of cream of mushroom soup on the serving line Critical control points; loss of control would result in unacceptable safety risk. Since holding temperature on the serving line is directly impacting customers and is likely to affect the greatest number of customers at one tim, it would be highest priority.

An alcoholic patient has a low serum albumin, low hemoglobin, high ammonia, abnormal liver function tests and ascites. Why is he on a 500mg sodium diet? a. secondary renal failure b. hypoaldosteronism c. hypoalbuminemia d. hyperammonemia

d. hypoalbuminemia Albumin is essential to maintain the oncotic pressure within the vascular compartments, preventing leaking of fluids into the extravascular spaces. It accounts for around 80% of the colloid osmotic pressure. Excessively low albumin levels may cause/exacerbate the abnormal accumulation of fluid in the abdomen (i.e., ascites), which may worsen the impaired blood flow through the patient's already damaged liver. Subsequently, a low sodium diet is indicated to prevent exacerbation of ascites based on his low serum albumin.

The two financial statements primarily used by foodservice managers to analyze operational effectiveness are the: a. inventory valuation and budget b. balance sheet and inventory valuation c. budget and income statement d. income statement and balance sheet

d. income statement and balance sheet An income statement is a report of net income and expenses to be over a certain period of time (dynamic); aka profit and loss statement, revenue and expense statement. A balance sheets shows assets, liabilities, stockholders equity; financial condition as of particular date (static). Both are used to analyze operational effectiveness.

When adding bran to a flour mixture, what should be changed? a. baking temperature b. increase the fat and liquid c. increase the oxidizing agent d. increase the flour and liquid

d. increase the flour and liquid Adding bran decrease the volume of the end product, as bran is heavy/weighing down the product. To compensate for the added volume you would increase the flour and liquid. Flour provides gluten, which provides the elastic property of breads and such. The liquids are what hydrates the gluten and contributes to gelatinizaiton.

Which of the following forms of pudding would be purchased in an assembly/serve foodservice system? a. frozen bulk b. instant c. canned d. individual portions

d. individual portions In assembly-serve, purchase completely prepared individual portions; finish by thawing, heating on premises; no on-site food production

Pale conjunctiva is associated with a deficiency of: a. vitamin C b. vitamin D c. zinc d. iron

d. iron Iron gets prioritized to most vital regions of body. The conjunctiva is not prioritized, so the amount of red-colored oxyhemoglobin circulating in the dermal and subconjunctival capillaries and venules is reduce (hypochromic).

Which of the following represents cow's milk? a. it creates a low renal solute load b. high in iron, low in vitamin C c. low in phosphorus, low in iron d. it creates a high renal solute load

d. it creates a high renal solute load Cow's milk is high in protein (casein 80%, whey 20%). Subsequently, infants fed cow's milk receive much more protein and minerals than they need. The excess has to be excreted in the urine. The high renal solute load leads to higher urine concentration during the feeding of cow's milk than during the feeding of breast milk or formula.

Why would you add bicarbonate to a solution for a person with hyperkalemia? a. it forces magnesium out of the cell to attract potassium b. it forces chloride out of the cell to attract potassium c. it exchanges phosphorus for potassium d. it exchanges hydrogen for potassium

d. it exchanges hydrogen for potassium Bicarbonate is a base, meaning hydrogen ions will be added to make a solution more alkaline.

The symbol U on the food label indicates: a. it is treated with ultraviolet light b. it is treated with radiation c. vitamin retention has be retained during processing d. it is a kosher designation

d. it is a kosher designation The letter "U" on a food means that the food is kosher. There are other Kosher designations (Google for pictures)

Which of the following menu items generate the most revenue? Shrimp alfredo: Selling price $12.95 Raw food cost $4.05 Units sold 75 Chicken marsala: Selling price $11.50 Raw food cost $3.83 Units sold 193 Prime rib: Selling price $14.95 Raw food cost $4.39 Units sold 172 Lemon halibut: Selling price $13.50 Raw food cost $4.29 Units sold 210 a. shrimp alfredo b. chicken marsala c. prime rib d. lemon halibut

d. lemon halibut Shrimp alfredo = $12.95 x 75 = $971.25 Chicken marsala = $11.50 x 193 = $2219.5 Prime rib = $14.95 x 172 = $2571.4 Lemon halibut = $13.50 x 210 = $2835

What would be an expected outcome of WIC? a. fewer women breast feed b. fewer babies, better birth control c. low income women have better knowledge concerning nutrition d. less anemia, increased HG and HT levels in women

d. less anemia, increased HG and HT levels in women WIC encourages breastfeeding so answer A is not correct. WIC does not discuss family planning directly, so answer B is not correct. With the two answers remaining, think about what would be a direct nutrition outcome. Less anemia, increased HG and HT levels in women show the value in the nutrition care provided. Increasing knowledge about nutrition may also occur, but it is not specific.

In most patients, a normal gastric residual volume would be: a. less than 100ml b. less than 200ml c. less than 200ml d. less than 250ml

d. less than 250ml High GRV is considered above 500 mL output, although we do not recommend checking GFV in actual practice as not a helpful measure of EN tolerance.

When making decisions, a consultative leader is one who: a. relies on input from others b. does not ask for input from the team c. uses the compromise to determine the best solution d. listens to others but makes the decision themselves

d. listens to others but makes the decision themselves A consultative leader asks for input, but makes major decisions alone.

In community surveys, a frequent symptom of malnutrition is: a. scurvy b. rickets c. low serum albumin d. low hemoglobin

d. low hemoglobin Low hemoglobin (<14 mg/dL in men, <12 mg/dL in women) can be indicative of malnutrition. Hemoglobin is often used in nutrition surveillance programs along with ht, wt, hematocrit, and serum cholesterol, to monitor health status of a population. Scurvy is a disease caused by vitamin C deficiency, which doesn't necessarily indicate overall malnutrition. Similarly, rickets is a condition caused by vitamin D deficiency. Finally low serum albumin does not indicate malnutrition, as it is a negative acute phase reactant which is influenced by factors such as stress and inflammation. Additionally, albumin has a long half life and thus is not a great indicator of nutritional status.

Which of the following substitutions will most decrease the sodium content of a biscuit? I. Low sodium milk for whole milk II. Egg substitute for egg III. Low sodium baking powder for baking powder a. I b. I, II c. all of the above d. I, III

d. low sodium milk for whole milk & low sodium baking powder for baking powder Substituting low sodium milk for whole milk would of course reduce sodium content. Substituting low sodium baking powder for regular baking powder would also reduce sodium content as baking powder contains baking soda (sodium bicarbonate).

Which stage of change is represented by this comment: "Each week I prepare a vegetable dish found on a great website recommended by my friend" a. preparation b. contemplation c. action d. maintenance

d. maintenance The maintenance phase of the Transtheoretical Stages of Change Model is when change is sustained for six months or longer. An example would be "I found a website that helps me plan low sodium meals". The example provided would be the maintenance stage because the change that they have made is sustained weekly.

Employees are consistently late returning from breaks. The Dietitian should first: a. have all employees clock in and out for breaks b. analyze activities to identify the best break times c. discipline tardy employees the next time they are late returning from breaks d. meet with all employees as a group and solicit recommendations for improvement

d. meet with all employees as a group and solicit recommendations for improvement Managers should seek input from employees and have more participative decision-making styles.

A home-delivered meals program for the elderly chooses a nonselective menu primarily to: a. control food volume b. encourage client participation c. minimize food drop-off time d. minimize labor costs

d. minimize labor costs

A patient on Levodopa should: a. increase protein intake at breakfast b. consume no more than 40 grams protein per day c. evenly divide protein intake throughout the day d. minimize protein at breakfast and lunch, and add it to dinner

d. minimize protein at breakfast and lunch, and add it to dinner Levodopa = Parkinson's treatment; Vitamin B6 and protein decrease effectiveness. Take drug in morning with limited protein

Theory Z is based on the following premise: a. workers accept responsibility b. self-direction and control are emphasized c. task, structure and authority d. mutual worker-employer loyalty

d. mutual worker-employer loyalty Theory Z is a theory in which everyone who will be affected by a decision is involved in making the decision (consensus decision making)

When you change from a conventional to a cook-chill system, which should be considered? a. need less storage space b. need outside delivery equipment c. need fewer employees d. need additional equipment and storage

d. need additional equipment and storage Cook-chill is not used for immediate service but for inventory and subsequent withdrawl. Foods are prepared on site, then frozen, chilled for later use. Cook-chill systems require a blast chiller or freezer and adequate storage space.

A narrow span of management should be employed with: a. routine, repetitive, homogeneous work b. health care professionals who don't require close supervision c. well motivated, highly trained group d. newly hired employees

d. newly hired employees Newly hired employees may be M1 or M2 for maturity, meaning unable and unwilling (M1) or unable but willing (M2). A narrow span of management means that the manager will provide more attention to these new employees who have high task behavior. Managers should use S1-Telling or S2-Selling dependent on the employee.

Dermatitis, diarrhea, dementia, pellagra, are signs of a: a. riboflavin deficiency b. thiamin deficiency c. pyridoxine deficiency d. niacin deficiency

d. niacin deficiency Niacin deficiency causes pellegra, which is characterized by the four D's: diarrhea, dermatitis, dementia and death. Riboflavin deficiency causes ariboflavinosis, which is characterized by agular glossitis, stomatitis, bright red tongue. Thiamin deficiency cause beriberi, which can be wet or dry beriberi. Wet beriberi causes cardiovascular complications (think wet = fluid buildup). Dry beriberi causes neurological impairements. Vitamin B6 deficiency would cause issues with transamination and deamination, as well as seizures, anemia, glossitis, and peripheral neuropathy

Meat loaf has been left out for 5 hours. Should you serve it? a. yes b. yes because bacteria was destroyed during the heating process c. no because of the risk of botulism d. no because of the risk of staphylococcus

d. no because of the risk of staphylococcus A TCS food must be used or discarded within 4 hours of being at proper temperature. Staphylococcus is a bacterial pathogen which can be prevented with temperature/time control. Botulism is an anaerobic pathogen which would not be the culprit in this circumstance.

A patient presents with the following lab values: ALP: 100 U/L AST: 30 U/L ALT: 35 U/L This indicates... a. hepatic encephalopathy b. hepatitis c. cirrhosis d. normal liver function

d. normal liver function ALP: 30-120 AST: 0-35 ALT: 4-36

Which best determines whether or not to intervene with a new patient? a. the patient's current medical diagnosis b. the patient's nutritional status history c. a request by the patient's family d. nutrition screening results

d. nutrition screening results Nutrition screening should be done on all patients within 24 hrs, regardless of nutritional status. The results of the nutrition screening process determine whether or not further nutrition intervention is required.

The NHANES study looks at which parameters? a. nutritional b. nutritional, biochemical c. nutritional, biochemical d. nutritional, clinical, biochemical

d. nutritional, clinical, biochemical National Health and Nutrition Examination study is an ongoing (repeated) survey to obtain information on the health of American people. Evaluates clinical, chemical (hemoglobin, hematocrit, cholesterol), anthropometrics, nutritional data. Run by CDC

The Prader Willi syndrome is associated with... a. hyperactivity b. deficiency of gucose-6-phosphatase c. macrocytic anemia d. obesity

d. obesity Prader-Willi Syndrome is a condition in which partial deletion of chromosome 15 interferes with control of appetite, muscle development, and cognition. Ghrelin levels are elevated and satiety is not achieved after eating. Because of this, obesity ensues. Typical intervention for this condition includes keep foods away from patient when not meal/snack time.

An infant wants a bottle at bedtime. You should counsel the parents to: a. give the bottle only at bedtime b. give the bottle only if the baby insists c. only give milk in the bottle d. only give water in the bottle

d. only give water in the bottle Giving a bottle with juice/milk increases risk of dental caries.

Energy expenditure of humans can be measured by: a. heat intake b. food intake c. nitrogen output d. oxygen consumption

d. oxygen consumption With indirect calorimetry, the energy expenditure is calculated from gaseous exchange of oxygen and carbon dioxide. The result is the total energy expenditure of the body for heat production and work output. With direct calorimetry, only heat loss is measured.

Which hormone moves milk through the mammary ducts? a. prolactin b. progesterone c. estrogen d. oxytocin

d. oxytocin The two hormones of milk production are prolactin and oxytocin. Prolactin stimulates milk production/synthesis from alveoli. Oxytocin is released during letdown and causes milk to be ejected into ducts. Subsequently, oxytocin moves milk through mammary glands

Active listening in counseling sessions involves: a. probing into specific areas of behavior b. empathizing c. selective perception d. paraphrasing and responding

d. paraphrasing and responding

A post-surgical patient with prolonged ileus should be treated with: a. a high fiber diet b. enteral nutrition with added fiber c. enteral nutrition d. parenteral nutrition

d. parenteral nutrition

After one year, which of the following would justify continuing a monthly heart - healthy eating class? a. all of the participants attended at least 90% of the classes b. other community members have inquired about joining the program c. physicians have begin referring their patients to the class d. participants report decreased cholesterol levels

d. participants report decreased cholesterol levels Measurable, direct nutrition outcomes.

A Hispanic woman needs more calcium in her diet. What do you recommend? a. milk b. plantains c. avocados d. pinto beans

d. pinto beans Milk is not commonly consumed in Hispanic culture. There is ~10.1 mg calcium in one cup plantains, ~18 mg calcium in avocados, and pinto beans contain ~110 mg calcium per 1 cup. Good sources of calcium include dark greens, pinto beans, soybeans, almonds, chickpeas, seeds, etc. the most culturally appropriate option in this example is pinto beans.

If you inform an employee that, as his supervisor, you wish to have him perform a certain task, you are utilizing: a. expert power b. coercive power c. dominant power d. position power

d. position power With position (legitimate) power, the subordinate acknowledges that the influencer has the right to exert influence due to position (job title) Expert power is the belief that influencer has some relevant expertise that a subordinate does not; provides creditability; viewed as competent. Coercive power uses threats to get subordinates to perform.

Which of the following best reflects protein status? a. serum albumin b. serum transferrin c. retinol-binding protein d. prealbumin

d. prealbumin Prealbumin/transthyretin is a hepatic protein and negative acute phase reactant that has a short half-life, meaning it quickly detects changes in protein status. Serum albumin is also hepatic protein and negative acute phase reactant. However, albumin has a long half life and thus is not a good indicator of nutritional status. RBP is a protein that is necessary to transport vitamin A from the liver to other tissues. RBP circulates with prealbumin, but in itself is not a good indicator of overall nutritional status. Transferrin is a visceral protein that transports iron to bone marrow and is most helpful in identifying anemia.

Which of the following components is a form of business promotion? a. the form used to place an order b. price and availability of products c. location of the business d. printed materials describing the current sales

d. printed materials describing the current sales Promotion is aimed to increase or renew awareness, short term. Publicity provides information about product, in form of new release, local media, radio, TV, etc. Direct mail packages, paid ads, and public visibility are also examples of promotion. Business marketing is focused on filling a customer's need or desires.

Quality control is: a. outcome or output oriented b. a measure of the quality of care produced c. patient care oriented d. proactive- focuses on the prevention of errors in food service

d. proactive- focuses on the prevention of errors in food service Quality control is concerned with whether products are within the specifications. The purpose is to determine any needs for corrective actions, which helps companies meet consumer demands for better products.

Which has the greatest effect on the renal solute load? a. potassium b. sodium c. glucose d. protein

d. protein Renal Solute Load mainly measures nitrogen (60%) and sodium.

You are analyzing a client's physical ability to prepare meals. The learning domain is: a. conceptual b. affective c. human d. psychomotor

d. psychomotor The three types of learning domains are cognitive, affective and psychomotor. Cognitive is acquisition of knowledge or subject matter (factual information). Affective is acquisition of attitude and value, growth in feelings or emotions. Psychomotor learning is the acquisition of muscular skills (exercises, food prepartion). This is an example of psychomotor because you are assessing the client's physical ability to prepare meals.

Salmonella source are often: a. reheated foods b. starchy foods and mixtures like casseroles c. foods cooled slowly and reheated d. raw produce and uncooked foods of animal origin

d. raw produce and uncooked foods of animal origin Salmonella is commonly caused by poultry, eggs, dairy, and produce contaminated with salmonella.

In making a decision take the following steps: a. gather data, choose solution, take action, follow-up b. determine workable solutions, choose one, take action c. choose solution, take action, follow-up d. recognize and analyze the problem, gather data, choose solution, take action, follow-up

d. recognize and analyze the problem, gather data, choose solution, take action, follow-up The steps of the decision making process are Recognize and analyze the problem, determine workable solutions, gather data, choose solution, take action, follow-up the action

Which of the following is an achievable outcome for a weight loss program? a. promote desirable body weight among young adults b. Increase by 25% the number of physicians who refer patients for weight-management counseling c. screen and refer for treatment within two years those whose body weight is 10% above desirable d. reduce by 10% the number of obese adults, ages 25-49, within two years of starting the program

d. reduce by 10% the number of obese adults, ages 25-49, within two years of starting the program

Which of the following strategies is most likely to increase revenue? Pot roast: low sales, low contribution margin Beef tacos: low sales, high contribution margin Barbecued ribs: high sales, low contribution margin Beef stew: high sales, high contribution margin a. replace beef tacos b. replace beef stew c. offer pot roast more often d. replace pot roast

d. replace pot roast Pot roast is a dog, low sales & low profit

The temperature of a beef casserole drops below 140' within an hour. What should you do? a. throw it out b. return it to the hot-holding cabinet to reheat it to a temperature of 165'F c. return it to the oven to reheat it to a minimum of 140'F d. return it to the oven to reheat it to a minimum of 165'F

d. return it to the oven to reheat it to a minimum of 165'F You would want to reheat this hot TCS food to 165'F within two hours. Reheating would not be done in a hot-holding cabinet, but instead an oven to get it to the 165'F within the one hour that is remaining.

Which of the following components is projected first during the budgeting process? a. cash b. labor c. operating expenses d. revenue

d. revenue Forecasting revenue/sales is the first step in developing a budget. Cash, labor, and operating expenses are determined later in the budgeting process.

Which of the following is appropriate for treatment for gastroparesis? a. gingerale b. oranges c. bran cereal d. rice

d. rice Gastroparesis is delayed gastric emptying. Foods to avoid include high fiber foods, foods high in simple sugars, high fat, and avoid caffeine, mint, alcohol, and carbonation. It is also instructed to avoid fibrous fruits and vegetables, such as oranges and broccoli, which may cause bezoars. A bezoar is a mass of undigested food. Because the stomachs of people with gastroparesis don't effectively break down food and move it into the intestines, food can collect into a mass, which can be detected on X-ray, ultrasound, or CT scan. Subsequently, rice would be the correct answer.

When substituted for saturated fats in the diet, which of the following oils will likely lower total cholesterol but also lower HDL cholesterol? a. olive oil b. canola oil c. peanut oil d. safflower oil

d. safflower oil When alpha-linolenic (omega-3) is substituted for saturated fatty acids, there is decreased hepatic production of triglyercides (inhibits VLDL synthesis) and has little effect on total cholesterol levels. If linoleic acid (omega 6) replaces saturated fat, total cholesterol decreases and HDL decreases. Subsequently, omega 6 should lower total cholesterol. The best source of omega 6 is safflower oil.

The FDA is responsible for: a. pesticide residue tolerance levels b. standard of fill, assuring meat wholesomeness, nutrition labels c. grading of meat d. standard of identity, nutrition labels, imitation foods

d. standard of identity, nutrition labels, imitation foods The FDA is responsible for interstate shipping. The three standards pertaining to interstate shipping of foods include: -Standard of identity: defines what a product must be to be called by a certain name (i.e. mayonnaise) -Standard of quality: specifies minimum quality below which foods must not fall (i.e. fruit) -Standard of fill of containers: protects against deception through use of containers that appear to hold more than they do (i.e. canned goods). The FDA is also responsible for labeling of foods and imitation foods via Food, Drug, and Cosmetic Act.

When should an explanation of how a worker will be evaluated be given to them? a. one month prior to their eval b. they should not be shown to the worker c. the day of the evaluation before you meet with them d. the day they are hired

d. the day they are hired

What is your first concern when deciding how to teach? a. the time you and the students have b. what learning resources are available c. what you are best at d. the needs and abilities of your students

d. the needs and abilities of your students The needs assessment is the first step when attempting to implement community-based intervention/project.

To complete a subjective global assessment evaluate: a. his lab values over the past 6 months b. current body weight compared to ideal body weight c. usual dietary intake using a food frequency questionnaire d. the presence of edema and wasting or dehydration

d. the presence of edema and wasting or dehydration Subjective Global Assessment includes history, intake, GI symptoms, functional capacity, physical appearance, edema, weight changes are all assessed.

Why is an affluent couple (the man with diabetes, 67 years old and the wife with a broken arm, 50 years of age) not eligible for Meals on Wheels? a. she is too young b. they are affluent c. this program does not cater to special diets d. they can leave the house

d. they can leave the house To qualify for Meals on Wheels, the individual must be homebound. The wife's arm is broken, which means she is not homebound. If she were homebound, they would have qualified as those who are eligible for Meals on Wheels include all aged 60 and older plus spouse regardless of income.

A patient with heart failure on a loop diuretic needs to have the status of which vitamin evaluated? a. pantothenic acid b. niacin c. riboflavin d. thiamin

d. thiamin Loop diuretics deplete thiamin, potassium, magnesium, calcium, sodium, and chloride.

The gauge of metal refers to: a. ply b. finish c. polish d. thickness

d. thickness Gauge refers to the durability of stainless steel; the lower the gauge, the more durable (14 gauge is most durable, butchers use)

Two of the listed ingredients on a frozen food label are BHA and BHT. What is their function? a. flavor enhancers b. emulsifiers c. to prevent enzymatic oxidation d. to prevent lipid oxidation

d. to prevent lipid oxidation BHA and BHT are antioxidants used for fatty products and prevent oxidation of lipids, thus extending shelf-life

Which anthropometric measurements are useful in assessing adults? a. triceps skinfold, head circumference, arm muscle circumference b. head circumference, arm muscle circumference, height, weight c. serum albumin, triceps skinfold d. triceps skinfold, arm muscle circumference, height, weight

d. triceps skinfold, arm muscle circumference, height, weight Head circumference is only used in infants. Serum albumin is not a good indicator of nutritional status. Subsequently, triceps skinfold, AMC, height, and weight are the most useful.

Which of the following is poor management? a. one supervisor for one employee b. one supervisor for every two employees c. one supervisor for the entire department d. two supervisors for one employee

d. two supervisors for one employee This is poor management as two supervisors for one employee is unnecessary and a waste of resources.

When does a breakeven point increase? a. when sales decrease b. when profits decrease c. when profit increases d. when costs increase

d. when costs increase Breakeven point is the point at which sales revenue (income) will exactly cover fixed and variable costs. Breakeven point increases when cost increases as it will require more units of an item to be sold or more dollars sold of an item to reach the point where revenue will cover costs. Profit is when more revenue is generated than the breakeven point.

When is breastfeeding contraindicated? a. when the mother is underweight b. when the mother has hyperlipidemia c. when the mother has a breast infection d. when the mother has AIDS

d. when the mother has AIDS In the U.S. and in other countries when women have access to clean water, breastfeeidng is contraindicated to reduce risk of transmisison

If linoleic acid replaces carbohydrates in the diet: a. LDL decreases, HDL increases b. LDL and HDL decrease c. LDL and HDL increase d. LDL increases, HDL decreases

A - LDL decreases, HDL increases Lioleic acid, or omega 6, is an essential fatty acid. Replacing carbohydrates with omega 6 causes LDL to decrease and HDL to increase If linoleic acid (omega 6) replaces saturated fat, total cholesterol decreases and HDL decreases

Which of the following may result in metabolic acidosis? a. decreased retention of bicarbonate b. decreased retention of hydrogen c. decreased retention of chloride d. increased retention of bicarbonate

a. decreased retention of bicarbonate Metabolic = kidneys, respiratory = lungs Alkalosis = retention of bicarb by kidneys, acidosis = excretion of bicard by kidneys Subsequently, if metabolic acidosis, there was increased excretion/decreased rention of bicarb

A provitamin is: a. a nutrient that can be converted into a vitamin b. a vitamin that can be converted into a nutrient c. the endogenous form of a vitamin d. the man-made copy of a vitamin

a. a nutrient that can be converted into a vitamin Beta-carotene (found in orange and yellow fruits and vegetables) is an important antioxidant and an example of provitamin A because it can be converted to Vitamin A by the human body.

The oxidation of fatty acids forms: a. acetyl CoA b. pyruvic acid c. lactic acid d. oxaloacetate

a. acetyl CoA Oxidation of fatty acids is a process that occurs to spare protein/muscle breakdown for energy during periods of starvation/fasting/malnutrition. Glucagon or epinephrine will trigger beta-oxidation to occur. The end product of beta-oxidation is 2 carbon fragments of fatty acids that combine with CoA to make acetyl CoA, which can then go to the TCA cycle and then ETC to make energy (a LOT of energy compared to CHO or protein) due to more carbons and hydrogens.

Iron absorption is enhanced by: a. acidic chyme in the duodenum b. the alkalinity of the duodenum c. oxalates and phytates d. the absence of ascorbic acid

a. acidic chyme in the duodenum Gastric acid lowers the pH in the proximal duodenum, enhancing the solubility and uptake of ferric iron. When gastric acid production is impaired (for instance by acid pump inhibitors such as the drug, prilosec), iron absorption is reduced substantially. Ascorbic acid ENHANCES absorption of iron. Oxalates and phytates INHIBIT iron absorption.

What causes egg yolk color to change? a. alteration of the feed provided b. storage length c. shell color d. storage conditions

a. alteration of the feed provided Color of the yolk depends on the amount and type of pigmen in the hen's diet.

Which enzymes are secreted by the pancreas? a. amylase, lipase, cholesterol esterase, trypsin, chymotrypsin b. sucrose, maltase, lactase, aminopeptidase c. ptyalin d. aminopeptidase, dipeptidase

a. amylase, lipase, cholesterol esterase, trypsin, chymotrypsin When food enters the duodenum, the pancreas releases digestive enzymes including pancreatic amylose, pancreatic lipase, cholesterol esterase, trypsin, and chymotrypsin.

Which of the following stabilizes an egg white foam? a. an acid b. water c. flour d. salt

a. an acid An acid stiffens an egg white foam by tenderizing the protein and allowing it to extend more easily.

In the human, vitamin K is affected by: a. anticoagulants and antibiotics b. iodine c. water-soluble vitamins d. gluten

a. anticoagulants and antibiotics Vitamin K = Koagulation (coagulation), blood clotting. Vitamin K increase prothrombin time and thus consistent vitmain K is necessary when someone in on a anticoagulant. Vitamin K (in form of menaquinone) can be sythnesized by gut bacteria in the colon, and thus antibiotics would limit this ability.

Which of the following are synthesized by intestinal bacteria? a. biotin, pantothenic acid, vitamin K b. vitamin E, vitamin K, biotin c. Pyridoxine, vitamin E d. ascorbic acid, pyridoxine, vitamin K

a. biotin, pantothenic acid, vitamin K Vitamin K (in form of menaquinone) can be sythenzied by gut bacteria in the colon. Several bacterial genera that are common in the distal intestine (e.g., Bacteroides, Bifidobacterium, and Enterococcus) are known to synthesize vitamins. Thiamine, folate, biotin, riboflavin, and panthothenic acid are water-soluble vitamins that are plentiful in the diet, but that are also synthesized by gut bacteria.

Examples of moist heat cooking include: a. braising, stewing b. grilling, frying c. broiling, braising d. steaming, frying

a. braising, stewing TIP: remember moiSt heat meathods (aside from roasting) all contain "s": braiSing, Simmering, Steaming, Stewing Dry heat methods: frying, broiling, roasting, grilling

What is the difference between cake flour and bread flour? a. cake flour has less gluten, weaker gluten, less protein b. bread flour has less gluten, weaker gluten, less protein c. cake flour has weaker gluten, but has more protein d. bread flour has stronger gluten and less protein

a. cake flour has less gluten, weaker gluten, less protein Think of cakes vs breads. Breads are have stronger gluten because it's typically firmer/tougher. Cakes are moister. Bread also has more protein content (chewy crumb vs lower protein content = tender crumb), and thus A is the answer.

Glycolysis is the: a. catabolism of carbohydrate b. creation of glucose from glycerol and amino acids c. breakdown of glycogen releasing glucose d. creation of glycogen

a. catabolism of carbohydrate Glycolysis is the breakdown of glucose into pyruvate.

Which oil is highest in saturated fat? a. coconut b. palm c. cocoa butter d. butter

a. coconut Most predominant (from greatest to least) Saturated fat: coconut oil, palm kernel, cocoa butter, butter, palm oil, canola MUFAs: olive, canola, peanut, sunflower, coconut oil PUFAs: safflower, corn, soybean, cottonseed, sunflower, palm kernel

Cholecystokinin causes: a. contraction of the gallbladder b. peristalisis c. secretion of pancreatic juice d. contraction of the liver

a. contraction of the gallbladder CCK causes contraction of gallbladder, releasing bile for fat emulsification, and release of pancreatic digestive enzymes, including trypsinogen.

Vitamin A is involved in: a. growth and development b. blood clotting c. growth of bones and teeth d. development of tissue and skin

a. development of tissue and skin Vitamin A has a variety of functions. Vitamin A is involved in the visual cycle (uses 11-cis-retinal, which binds with protein opsin to form rhodopsin), maintenance of epithelial tissue (skin and lining of eyes, gut, lungs, vagina & bladder), growth (stimulates growth of epithelial cells, possibly by increasing cell surface receptors for growth factors), cellular differentiation, reproduction, and immune function. Assuming growth in the above mentioned function would fall more under development of tissue/skin. Growth and development would be different in that case and thus not the answer.

Fat produces more calories than carbohydrate because: a. fat has more carbon and hydrogen in relation to oxygen b. fat has less carbon and hydrogen in relation to oxygen c. fat is a larger molecule d. fat is a smaller molecule

a. fat has more carbon and hydrogen in relation to oxygen

Food iron is in the ____ form a. ferric b. ferritin c. transferrin d. ferrous

a. ferric Ferric (3+) is found in foods (sometimes foods can be ICk). Ferritin is the storage form of iron. Transferrin is the the iron transporter. Ferrous (2+, "s" looks like a 2) is what ferric iron is converted to in the body and is often the supplemental form of iron the body for that reason (ferrous sulfate).

If the sole source of protein is gelatin, growth is inhibited because: a. gelatin has no tryptophan and is low in methionine and lysine b. gelatin has no methionine and is low in tryptophan c. gelatin has no lysine or methionine, and is low in tryptophan d. gelatin has no arginine

a. gelatin has no tryptophan and is low in methionine and lysine Gelatin is not a complete protein source. It has no tryptophan and is low in methionie and lysine. Can to remember this by thinking gelaTiN has No Tyrpotophan, and geLatiN is LOW in LYSINE and methioNeNe.

Riboflavin, thiamine, niacin are all involved in the: a. metabolism of carbohydrate b. metabolism of fat c. metabolism of protein d. production of amino acids

a. metabolism of carbohydrate Riboflavin = FAD, FMN Thiamin = coenzyme is TTP; cofactor for enzymes that break down glucose for energy production; plays a role in the synthesis of ribose from glucose Niacin = NAD, NADP

Acidic chyme becomes neutralized in the duodenum by: a. mixing with bicarbonate and fluids b. mixing with alkaline intestinal enzymes c. mixing with sodium and potassium d. mixing with bile

a. mixing with bicarbonate and fluids When the acidic chyme from the stomach enters the duodenum, secretin from pancreas releases bicarbonate and CCK. CCK releases digestive enzymes as well as "squeezes" the gallbladder to release bile. Bicarbonate + digestive enzymes is called "pancreatic juices". Bicarbonate and fluids work to neutralize the aciditity from chyme.

Which oil is highest in monounsaturated fatty acids? a. olive b. canola c. peanut d. sunflower

a. olive Most predominant (from greatest to least) MUFAs: olive, canola, peanut, sunflower, coconut oil PUFAs: safflower, corn, soybean, cottonseed, sunflower, palm kernel Saturated fat: coconut oil, palm kernel, cocoa butter, butter, palm oil, canola

The scientific process by which water makes lettuce crisp is: a. osmotic pressure of water-filled vacuoles b. diffusion c. transamination d. water acitve diffusion

a. osmotic pressure of water-filled vacuoles Think of adding water to a stalk of celery to make it seem fresh again.

Which has the lowest cholesterol content? a. peanut butter and crackers b. yogurt with fruit c. chocolate cake d. roast beef sandwich

a. peanut butter and crackers Dietary cholesterol is found in animal products/byproducts. Subsuquently, peanut buter and crackers would have the lowest cholesterol content.

Which vitamin acts as a coenzyme in transamination? a. pyridoxine b. thiamine c. riboflavin d. vitamin B12

a. pyridoxine Pyridoxine (vitamin B siX), is a coenzyme in deamination and transamination (protein metabolism). More specifically, pyridoxine is the coenzyme for AST/ALT enzyme that is inolved in transamination process.

Evaporated milk has: a. slightly more than half of the water removed b. added sugar c. a fat content of 3-6% d. lactose removed

a. slightly more than half of the water removed Evaporated milk has ~60% of water removed, must contain not less than 7.9% milk-fat, and brown color is due to carmelization of lactose in canning.

Where is lactose absorbed a. small intestine b. stomach c. pancreas d. liver

a. small intestine Lactose is converted by lactase into glucose and galactose on the brush border membrane of the small intestine, where it is absorbed into the enterocyte. The pancreas releases digestive enzymes when food enters the duodenum, including pancreatic amylase.

When analyzing correlations, when r=1: a. there is a perfect correlation from one to the other b. there is no correlation among data presented c. the data presented move in opposite directions d. there is a weak correlation among data presented

a. there is a perfect correlation from one to the other r= =/- 1 is perfect correlation; cannot have correlation outside of this range. </= 0.4 would be a poor correlation, 0.4-0.7 would be moderate correlation, >/= 0.7 would be a strong correlation (this is true for positive or negative values.

The flakiness of pie crust depends on: a. type of fat b. oxidation of fat c. temperature of the fat d. oven temperature

a. type of fat Flakiness is promote by leaving fat in coarse particles. Fat in pieces melts and flows, leaving a hole where steam colleccts and pushes upward against the upper surface of the resulting cell. The cell is locked into that extended position, resulting in a flaky crust

Ascorbic acid aids in healing, which of the following applies? a. collagen --> hydroxyproline b. Proline --> hydroxyproline --> collagen c. hydroxyproline --> proline --> collagen d. hydroxyproline --> proline

b. Proline --> hydroxyproline --> collagen Major function of vitamin C is collagen synthesis. Vitamin C is needed to form hydroxylysine (from lysine) and hydroxyproline (from proline), which help form the crosslinks that strengthen the collagen molecule.

If you replace half and half with whipping cream in ice cream, the effects on the ice crystals will be: a. an increase in size because there is less fat b. a decrease in size because there is more fat c. no change d. an increase in size because there is more fat

b. a decrease in size because there is more fat The % fat in half and half is no less than 10.5% fat, and the % fat in whipped cream 35%. Subsequently, you are increasing the amount of fat in the ice cream. When increasing the amount of fat in ice cream, it decreases in size because fat inferes with crystal formation, making crystals small and smoother. More fat = smaller crystals, less fat = bigger crystals.

Which cooking method would best convert collagen to gelatin in a bottom round roast? a. grilling it to medium rare b. braising c. broiling d. searing

b. braising Connective tissue has two properties: collagen and elastin. Collagen becomes tender in heat (collagen + moist heat = gelatin). This is why we use MOIST HEAT for tought meat, such as flank, bottom round, brisket. TIP: remember moiSt heat meathods (aside from roasting) all contain "s": braiSing, Simmering, Steaming, Stewing. Thus, braising is the answer.

Winterized oil is: a. cloudy when refrigerated b. clear when refrigerated c. cloudy when stored for long periods of time d. clear only if kept at room temperature

b. clear when refrigerated Winterized oils are oil that is chilled to 45 degrees F, and then fatty acids with high melting points crystallize and are filtered out. Subsequently, winterized oil will not crystillize when cold and is CLEAR not cloudy. Winterized oils are commonly used for salad dressings and include corn, soy and cottonseed oils. Olive oil is NOT winterized.

Gluconeogenesis is the: a. catabolism of carbohydrate b. creation of glucose from glycerol and amino acids c. breakdown of glycogen releasing glucose d. creation of glycogen

b. creation of glucose from glycerol and amino acids Gluconeogenesis is the creation of glucose from non-CHO sources, specifically, glycerol, glucogenic amino acids, and lactate.

Research has show that neural tube defects can be reduced with proper supplementation of: a. iron b. folic acid c. glutamine d. arginine

b. folic acid Supplement 400 mcg per day in pregnant women to prevent neural tube defects, such as spina bifida and anencephaly.

When substituting buttermilk for whole milk in pastry: a. decrease the liquid b. increase the baking soda c. increase the amount of butter d. increase the liquid

b. increase the baking soda Buttermilk is cultured by adding lactic acid bacteria to skimmed or partly skimmed milk. The recipe includes 1 Tbsp vinegar or lemon juice or 1 3/4 tsp cream of tartor. Subsequently, buttermilk is more acidic than whole milk. To make it more alkaline when using buttermilk in place of regular milk in a reciple, increase the baking soda.

Which of the following inhibits gluconeogenesis? a. glycogen b. insulin c. catecholamines d. glucocorticoids

b. insulin Gluconeogenesis is the formation of glucose from non-CHO sources (glycerol, glucogenic AA, lactate). Gluconegenesis is a ANABOLIC reactant (building, creating), so insulin glucagon of epinephrine would be release to initiate the process. This question acts what would INHIBIT gluconeogenesis. Insulin is release when there is ENOUGH glucose in the body. If insulin were released, you know that there is circulating glucose that must be uptaken by the cells. Subsequently, insulin would inhibit gluconeogenesis. Glucocorticoids stimulate gluconeogenesis. Catecholamines, including epinephrine, can also stimulate gluconeogenesis espeically during metabolic stress. Glycogen is the storage form of glucose, which doesn't make sense for the question.

Which would aid the absorption of an iron supplement? a. cows milk, eggs b. orange juice, hamburger c. milk, eggs, cheese d. dates, eggs

b. orange juice, hamburger Vitamin C source OJ.

The end product of aerobic glycolysis is: a. acetyl - CoA b. pyruvic acid c. lactic acid d. glycogen

b. pyruvic acid Glucose --> pyruvate in aerobic Glucose --> lactic acid in anaerobic

The following is an irreversible reaction: a. pyruvic acid into lactic acicd b. pyruvic acid into acetyl coA c. glucose-6-phosphate into glycogen d. glucose-6-phosphate into pyruvate

b. pyruvic acid into acetyl coA

The hormone epinephrine: a. lowers blood glucose during catabolic stress b. raises blood glucose during catabolic stress c. is secreted from the pituitary gland d. dtimulates glycogen production

b. raises blood glucose during catabolic stress

Protein digestion begins in the: a. mouth b. stomach c. small intestine d. ileum

b. stomach No protein digestion in the mouth. Protein digestion begins with gastric hormone, gastrin, releasing HCl and pepsinogen. HCl (from parietal cells) begins protein denaturation. HCl also converts the zymogen pepsinogen to pepsin, which hydrolyzes peptide bonds.

Which amino acids must be present in a parenteral solution? a. valine, leucine, glycine, alanine b. tryptophan, phenylalanine, threonine, isoleucine c. phenylalanine, methionine, arginine, tyrosine d. lysine, glutamic acid, alanine, glycine

b. tryptophan, phenylalanine, threonine, isoleucine A parenteral solution requires adequate supplementation of all essential amino acids. Essential amino acids = those that cannot be produced by the body. Mneumonic: PVT TIM HLL: phenylaline, valine, tryptophan, threonine, isoleucine, methionine, histadine, lysine, leucine. Last two L's are ketogenic amino acids (lysine and leucine). Mneumonic: Tim LIVs for this BRANCH of the military- branched amino acids are leucine, isoleucine, and valine. Note: arganine and glutamine are conditionally essential.

Which best describes sorbitol and glucose? a. sorbitol is sweeter than glucose b. they each provide 7 calories per gram c. sorbitol is absorbed more slowly d. they both convert into fructose

c. sorbitol is absorbed more slowly Sweetness of carbohydrates from sweetest to least sweet: fructose, invert sugar, sucrose, glucose, sorbitol, mannitol, galactose, maltose, lactose. Sorbitol a sugar alcohol. Sorbitol is degraded to fructose, but glucose is already a monosaccharide and isn't converted to fructose. Sorbitol is slowly absorbed by passive diffusion in the small intestine. CHO provides 4 kcal / gm.

Which data is needed to convert weight into volume? a. mass b. temperature c. specific gravity d. pH

c. specific gravity Relative density, or specific gravity, is the ratio of the density of a substance to the density of a given reference material. In other words, the ratio of the density of any substance to the density of some other substance taken as standard, water being the standard.

Which government agency inspects and grades meat? a. FDA b. DHHS c. USDA d. department of commerce

c. USDA Inspection of meat is mandatory per Whole Meat Act of 1967 and is done at slaughter by USDA.

Glucocorticoids are: a. thyroid hormones b. pituitary hormones c. adrenal hormones d. parathyroid hormones

c. adrenal hormones Glucocorticoids are steroid hormones produced by the zona fasciculata of the adrenal cortex. Glucocorticoids promote gluconeogenesis in liver, converting proteins to glucose (GLUCOcorticoids promote GLUCOneogenesis)

Dietary fat enters the blood as ____ and leaves the liver as ______. a. phospholipids; chylomicrons b. chylomicrons; phospholipids c. chylomicrons; lipoproteins d. lipoproteins; chylomicrons

c. chylomicrons; lipoproteins After passing through the brush border membrane of the enterocyte as a micelle, triglycerides re-esterfy into triglycerides. TG's, cholesterol, monoglycerides, and phospholipids join together to form chlyomicron. Chylomicrons enter the lymphatic system via lacteals in the villi. Chylomicrons travel to the thoraic duct where they are sent to the portal vein adn ultimately sent to the liver for processing. The liver then produces various lipoproteins, such as VLDL, LDL, and HDL, which can leave the liver into circulation.

Which method of bread making is not as dependent on the length of time the dough sits to rise? a. straight dough method b. sponge dough method c. continuous method d. prime bake method

c. continuous method The continuous bread-making method is a commerical process that substitutes intense mechanical energy to a large degree for traditional bulk fermentation, which reduces processing time. Straight dough method is when all ingredients are added before a dough is allowed to rise. The sponge method is when you combine liquid with yeast and part of flour and allow the batter (sponge) to ferment for several hours. You then add sugar, salt, fat, rest of flour and knead

What is the process by which the water content of a vegetable is replaced by a concentrated salt solution? a. gelling b. osmosis c. diffusion d. retro-gradation

c. diffusion Diffusion is when particles move from higher to lower concentration. In this example, the concentrated salt (higher concentration) moves towards the area of lower concentration (the water in the vegetable). Osmosis is when fluid moves from less to more concentrated side of memebrane (semi-permeable membrane).

The best laboratory value to use in assessing iron status is: a. hemoglobin b. hematocrit c. ferritin d. serum iron

c. ferritin Ferritin is the storage form of iron, and thus indicates if adequate stores. Ferritin indicates the size of iron storage pool. Hemoglobin and hematocrit will be low in IDA, pernicious anemia, and folate deficiency anemia so while it is a helpful indicator, it is not the best lab value to assess iron status specifically.

Carbohydrates listed in order of decreasing sweetness are: a. fructose, glucose, sucrose, sorbitol b. sucrose, glucose, fructose, sorbitol c. fructose, sucrose, glucose, sorbitol d. sorbitol, fructose, sucrose, glucose

c. fructose, sucrose, glucose, sorbitol The order of carbohydrates from sweetest to least sweet is as follows: fructose, invert sugar, sucrose, glucose, sorbitol, mannitol, galactose, maltose, lactose. Mainly remember that fructose is the sweetest, sucrose is sweeter than glucose, and glucose is sweeter than sorbitol and mannitol.

In the fed state, the brain uses which nutrient as a source of energy? a. fatty acid b. lactic acid c. glucose d. ketone bodies

c. glucose Glucose is the preferred fuel source for the brain. Those in starvation ketosis will have to use ketone bodies in place of glucose and all glycogen stores have been depleted and gluconeogenesis can no longer occur.

Which hormone regulates calcium levels: a. insulin b. thyroid c. parathyroid d. aldosterone

c. parathyroid When blood calcium levels fall too low: Parathyroid gland releases are stimulated to produce parathyroid hormone (PTH). PTH stimulates the kidney to convert 25(OH) vitamin Dà1,25 (OH)2 vitamin D. 1, 25 (OH)2 vitamin D then travels to the intestine where it increases synthesis of calcium transport proteins (i.e. calbindin) which increases calcium absorption. 1, 25 (OH)2 vitamin D also increases renal calcium and phosphorus reabsorption in kidney. 1, 25 (OH)2 vitamin D and PTH help to mobilize calcium and phosphorus from bone by increasing osteoclast activity (resorption).

To prevent frozen gravy from separating when thawed a. reheat slowly and stir constantly b. thaw it before heating and stir constantly c. prepare it with modified starch d. cook it longer before freezing to stabilize the gravy

c. prepare it with modified starch Starch is a thickner, which would prevent seperating with thawed. Gelatinization is the swelling that occurs when starch is heated in water close to the boiling point- heat dissociates the bonds, water moves in, and swell granules which causes the paste to thicken.

Which foods should be washed just before serving? a. plums and grapes b. peaches and carrots c. strawberries and mushrooms d. apples and celery

c. strawberries and mushrooms Berries and mushrooms should be washed right before serving, as it they are washed well before they are intended to be eaten, they will become mushy.

The colon functions in the absorption of: a. amino acids, fatty acids b. unsaturated fatty acids, electrolytes c. water, salts, vitamin K, thiamine, riboflavin d. glucose and fatty acids

c. water, salts, vitamin K, thiamine, riboflavin In the colon, the majority of water absorption occurs. Think about if someone has a colectomy and colostomy. Output will be greater since the colon isn't there to absorb the water. Bile salts are also absorbed to be recycled. Vitamin K can be synthesized and absorbed by gut bacteria in the colon. Thiamin and riboflavin are primarily absorbed in the jejunum but some are absorbed when water is absorbed in colon as they are water-soluble.

A patient with metabolic alkalosis would have: a. excess excretion of base through the kidneys b. retention of base by the lungs c. excretion of base by the lungs d. retention of base by the kidney

d. retention of base by the kidney Metabolic = kidneys, respiratory = lungs Alkalosis = retention of bicarb by kidneys, acidosis = excretion of bicard by kidneys Subsequently, metabolic alkalosis would be retention of base by the kidneys.

An increased plasma pyruvate level is an indication of: a. iron deficiency b. riboflavin deficiency c. excess carbohydrate ingestion d. thiamine deficiency

d. thiamine deficiency Vitamin B1 (thiamine) is a co-factor for pyruvate dehydrogenase, an essential enzyme for aerobic metabolism. In the absence of thiamine, the conversion of pyruvate to acetyl-CoA is inhibited and pyruvate cannot enter the Kreb's cycle.

The formula for producing the active form of vitamin D is: a. vitamin D3 converting into 7-dehydrocholesterol b. ergosterol converting into calciferol c. cholesterol converting into calciferol d. 7-dehydrocholesterol converting into cholecalciferol

d. 7-dehydrocholesterol converting into cholecalciferol In cutaneous Vitamin D synthesis, the skin absorbs UVB rays at a specific wavelength with the precursor 7-dehydrocholesterol. 7-dehydrocholesterol is converted to previtamin D when it is absorbed by the skin. Previtamin D is then converted into vitamin D3 (cholecalciferol) in the bloodstream. Once vitamin D is in the bloodstream, whether from cutaneous synthesis or dietary intake, it must undergo two hydroxylation reactions. First hydroxylation reaction: in the liver, vitamin D is converted to 25-hydroxyvitamin D3, 25(OH)vitamin D3, the main blood form. Second hydroxylation: 25-hydroxyvitamin D3 travels to the kidneys where it is hydroxylated into 1,25 dihydroxyvitamin D3 (1,25(OH)2 vitamin D3), the active form of the vitamin.

Which conversion requires glucose-6-phosphatase? a. glucose into liver glycogen b. glucose into pyruvic acid c. pyruvic acid into lactic acid d. liver glycogen into glucose

d. Liver glycogen into glucose Glycogen --- G6P --> glucose *Muscles are selfish, so liver is only one that releases glycogen stores in body. Muscles do not have G6P enzyme It is NOT glucose into liver glycogen. Glucose --- hexokinase (in muscles) --> glycogen Glucose --- glucokinase (in liver) --> glycogen

Glucocorticoids: a. convert glucose into protein b. convert fatty acids into glucose c. convert glucose into fat d. convert protein into glucose

d. convert protein into glucose Glucocorticoids are steroid hormones produced by the zona fasciculata of the adrenal cortex. Glucocorticoids promote gluconeogenesis in liver, converting proteins to glucose (GLUCOcorticoids promote GLUCOneogenesis).

Which nutrient is added for flour enrichment? a. vitamin A b. iodine c. fluorine d. iron

d. iron Enriched flour is flour with specific nutrients returned to it that have been lost while being prepared. These restored nutrients include iron and B vitamins (folic acid, riboflavin, niacin, and thiamine).

What does the term "USDA graded" on meat tell the consumer? a. it assures wholesomeness b. it was free of disease at the time of slaughter c. the meat is fit for human consumption d. it defines quality

d. it defines quality Inspection of meat is mandatory under the Wholesome Meat Act, while grading is voluntary. The purpose of inspection is to determine if meat is fit for human consumption, and this is done at the time of slaughter. Grading however determines the quality of the meat, which is based on the marbling of the cut of meat. The order of meat grading, from best to lowest quality, is prime, choice, select, and standard. In other words, standard has the least marbling.

Protein-bound iodine (PBI) measures: a. nutritional status b. toxic levels of iodine c. deficiency of epinephrine d. level of thyroxine being produced

d. level of thyroxine being produced Protein-bound iodine test, also called PBI test, laboratory test that indirectly assesses thyroid function by measuring the concentration of iodine bound to proteins circulating in the bloodstream. Makes sense since the major function of iodine is the synthesis of thyroid hormones (thyroxine & triiodothyronine).

Dry heat cookery should be used for which cut of meat? a. shoulder b. neck c. brisket d. near the backbone

d. near the backbone Connective tissue has two properties: collagen and elastin. Collagen becomes tender in heat (collagen + moist heat = gelatin). This is why we use MOIST HEAT for tought meat, such as flank, bottom round, brisket. Dry heat methods (no water involved) can be used for tender (soft) cuts which are near the backbone (loin, sirloin).

An amino acid that cannot be produced by the body is: a. alanine b. glycine c. tyrosine d. tryptophan

d. tryptophan Essential amino acids = those that cannot be produced by the body. Mneumonic: PVT TIM HLL: phenylaline, valine, tryptophan, threonine, isoleucine, methionine, histadine, lysine, leucine. Last two L's are ketogenic amino acids (lysine and leucine). Mneumonic: Tim LIVs for this BRANCH of the military- branched amino acids are leucine, isoleucine, and valine. Note: arganine and glutamine are conditionally essential. Since this question is asking which cannot be produced by the body, it is asking which is essential. Tryptophan is an essential amino acid.

When a white sauce tastes starchy and grainy, the likely cause is: a. too much starch b. improper proportions of ingredients c. starch was added before the fat melted d. uncooked flour

d. uncooked flour If a product is starchy tasting and grainy, this is due to uncooked flour. To get a shiny, clear, translucent sauce, use cornstarch as a thickner.

What color do onions turn when cooked in an aluminum pan? a. purple b. blue c. red d. yellow

d. yellow Onions are anthoxanthin, and thus turn yellow in base or in aluminum pan.