QUIZ #15

The chef purchased 1 lb of ground beef at $3.97 per pound to make hamburgers. Ground beef has an 8% cooking loss and a 2% handling loss. What is the edible portion price?

Correct Answer: $4.41 Explanation: Test taking strategy: find the key words Key words: 1 lb, $3.97 per pound, 8% cooking loss, 2% handling loss The edible portion cost is the cost per unit of the edible portion of the food item. The formula for the calculation is: As-Purchased (AP) Cost ÷ Yield % = Edible Portion (EP) cost This question is asking for the EP cost of 1 lb of ground beef. Add the 8% cooking loss plus the 2% handling loss to get a total loss of 10%. The yield percent is 100 - 10% = 90% (how much is left after cooking) • $3.97 As-Purchased (AP) cost ÷ 90% (aka 0.9) = $4.41 as the edible portion cost of a pound of ground beef Note: The number is higher to account for the losses. The edible portion of the ground beef is more valuable.

Which disease tends to more commonly present due to chronic alcoholism?

Correct Answer: Beriberi Explanation: Test taking strategy: find the key words Key words: more commonly, chronic alcoholism Chronic alcoholism often creates deficiencies in the major B vitamins and can cause severe damage to the liver. Beriberi, or a thiamin deficiency, is the most commonly found disease cause by chronic alcoholism among this list. You will also find progressions of liver disease in chronic alcoholism.

Chef Monty purchased 25 whole zucchinis for $8.25 to make zucchini noodles for his patrons. What is the as-purchased cost per whole zucchini?

Correct Answer: $0.33 Explanation: Test taking strategy: find the key words Key words: 25 zucchinis, $8.25 The as-purchased cost is the actual price that was paid for the food item prior to processing (trimming, coring, deboning, etc). This question is asking what the cost per unit (per each zucchini) is. The equation is As-Purchased Cost ÷ number of units = cost per unit Simply divide $8.25 (As-Purchased Cost) by 25 zucchinis (number of units) to get $0.33 cost per unit (per zucchini).

Which is the correct order of flour from least amount of protein to the most?

Correct Answer: Cake, pastry, all-purpose, bread, whole wheat Explanation: The order of flour from the least amount of protein to the most is: • Cake (soft wheat): 5% to 8% protein • Pastry (soft wheat): 8% to 9% protein, but can be as low as 7.9% • All-purpose (blend of hard and soft wheat): 10% to 12% protein • Bread (hard wheat): 12% to 14% protein, but can go as low as 11.8% • Whole wheat: 14% protein

Chef Jules purchased 20 lbs of pears for $17.63 to use in a fruit salad. What is the as-purchased cost?

Correct Answer: $17.63 Explanation: Test taking strategy: find the key words, eliminate the distractors Key words: $17.63, as-purchased cost Distractors: 20 lbs. This information is irrelevant in this question. The as-purchased cost is the actual price that was paid for the food item prior to processing (trimming, coring, deboning, etc). In this question, no math is needed. The as-purchased cost of the pears was $17.63.

According to the CDC growth charts, a 19-year-old male child is in the 90th percentile for BMI. How should his weight status be classified?

Correct Answer: Overweight Explanation: Test taking strategy: find the key words Key words: child, 90th percentile BMI, classify weight status The CDC has three main growth charts to show children's physical growth from ages 2-20: weight-for-age, stature-for-age, and BMI-for-age. Only BMI-for-age is used to classify children as underweight, overweight, or obese. Underweight: <5th percentile Normal: 5th-84th percentile Overweight: >85th percentile Obese: >95th percentile This child is in the 90th percentile, placing him in the overweight BMI category.

What Transtheoretical Model stage of change would a person be in if they said "It's hard to follow the diet when I live across the street from a fast-food restaurant."

Correct Answer: Preparation Explanation: In the Transtheoretical Model (TTM) Stages of Change, the Preparation stage is when the individual has the determination to start making the changes, but may run into some obstacles. Some examples are, "I'm trying to stick to the diet recommendations, but some of the food is too expensive" or "It's hard to follow the diet when we travel so often."

An infant with maple syrup urine disorder needs to have the following amino acids limited:

Correct Answer: Valine, leucine, isoleucine Explanation: Test taking strategy: find the key words Key words: Maple syrup urine disorder, limit amino acids Maple syrup urine disorder (MSUD) is the result of the abnormal metabolism of leucine, isoleucine, and valine. These three amino acids make up the branched chain amino acids (BCAAs). With MSUD, the body is unable to breakdown the BCAAs, resulting in toxic accumulation. It is important to limit valine, leucine, and isoleucine to prevent this.

An infant weighs 2lbs at birth. This is classified as:

Correct Answer: Very low birth weight Explanation: Test taking strategy: find the key words Key words: infant, 2lbs Infant birthweight is the first weight taken at birth and has four classifications. High birth weight: >8.8lbs (>4000g) Normal birth weight: 5.5-8.8lbs (2500-4000g) Low birth weight (LBW): <5.5lbs (<2500g) Very low birth weight (VLBW): <3.3lbs (<1500g) Extremely low birth weight: <2.2lbs (<1000g) At only 2lbs, this infant has a very low birth weight and is likely very pre-term.

You are reading through a patient's chart and note that the patient has hypercalcemia, kidney stones, weakness, and constipation. Which of the following is most indicative of these symptoms?

Correct Answer: Vitamin D toxicity Explanation: Vitamin D is a fat-soluble vitamin and excessive intake of vitamin D can lead to toxicity. This toxicity may lead to increased serum calcium (hypercalcemia), increased serum phosphorus (hyperphosphatemia), calcification of soft tissues, headache, nausea, constipation, and kidney stones. The tolerable upper intake level (UL) for vitamin D in adults are 100 mcg (aka 4,000 IU).

Which of the following is most likely to antagonize Vitamin K metabolism?

Correct Answer: Vitamin E Explanation: Excess intake of Vitamin E or supplementation increases the risk of a vitamin K deficiency by inhibiting its metabolism and increasing its excretion.

Jeremiah and Maxine just had a newborn, and the pediatrician entered the hospital room with a shot in hand. What shot do infants need at birth?

Correct Answer: Vitamin K Explanation: Infants receive a Vitamin K shot in the hospital at birth with parent's consent. Newborn infants are especially at risk for vitamin K deficiency because their immature liver does not utilize vitamin K efficiently and the placenta does not transfer the vitamin well from mother to fetus. Vitamin K encourages coagulation of the blood. Unfortunately, human breast milk does not contain enough vitamin K to correct this, so a shot is needed.

What is the difference between whole wheat and all-purpose flour?

Correct Answer: Whole wheat flour contains the germ and endosperm, while all-purpose does not Explanation: Whole wheat flour still contains the germ and endosperm from the wheat as it is the least processed and highest in protein (14%). All-purpose flour is a blend of hard and soft wheat flours and contains moderate amount of protein (10-12%). Only whole wheat flour contains the whole wheat seed including the germ and endosperm, hence the name "whole".

What is the enzyme that is found in pineapple that breaks down protein and prevents gelation?

Correct Answer: bromelain Explanation: Bromelain is an enzyme found in fresh and frozen pineapple that breaks down protein and prevents gelation. It is inactivated by heat at 170-180F.

Marylin is making a white sauce and already has her roux. What should she add next to create a clear, shiny, translucent sauce?

Correct Answer: cornstarch Explanation: Corn starch should be added to a white sauce to obtain the clear, shiny, translucent appearing sauce. If it is starchy and grainy, this is due to uncooked flour. Sugar adds sweetness and absorbs water but is not considered a thickening agent.

A researcher seeks to survey community attitudes towards eating a vegan diet. He would be conducting what type of research?

Correct Answer: descriptive Explanation: Descriptive statistics "describes", organizes, and summarizes data and alone is not used to test a hypothesis. Data collection using descriptive statistics is typically done through surveys, case studies, cross-sectional studies, or qualitative studies.

You are counseling a patient who is saying that she has to eat beef twice a day to "eat healthy" and she told you that she read that on the internet, so it has to be true. You know she is misinformed, but you decide to use a motivational interviewing tactic. What is the first tactic you need to use?

Correct Answer: resist the righting reflex Explanation: By resisting the righting reflex, you can then spend quality time trying to understand your client's point of view to be able to help guide her on adjusting her behavior. You are using RULE: Resist the righting reflex, Understand your client's motivation, Listen to, then help Empower your client.

Grace is a dietetic intern and is assigned to practice motivational interviewing on a client. What is an important component of motivational interviewing?

Correct Answer: resisting the righting reflex Explanation: By resisting the righting reflex, you can then spend quality time trying to understand your client's point of view to be able to help guide his/her on adjusting his/her behavior. You are using RULE: Resist the righting reflex, Understand your client's motivation, Listen to, then help Empower your client.

A random or non-random selected subset of a population is a __________.

Correct Answer: sample Explanation: A selected subset of the population is a sample and may be representative or non-representative of the population. The sample can be taken at random or non-random.

Marylin is making a white sauce and already has her roux. What should she add next to create a clear, shiny, translucent sauce?

cornstarch Correct Answer: cornstarch Explanation: Corn starch should be added to a white sauce to obtain the clear, shiny, translucent appearing sauce. If it is starchy and grainy, this is due to uncooked flour. Sugar adds sweetness and absorbs water but is not considered a thickening agent.

The dining room at Harbor College serves 750 students every lunchtime. The dining room seats 85 people at a time. What is the seat turnover rate?

Correct Answer: 9 Explanation: The formula for the seat turnover rate is: Seat turnover (the average amount of times the seat will be occupied) = # customers in a given time period ÷ number of seats • 750 customers ÷ 85 seats = 8.8 (round to 9) seat turnover rate

A hospital uses a #12 disher to serve their pudding portions. How many servings are in a 2-gallon container of pudding?

Correct Answer: 96 Explanation: Test taking strategy: find the key words Key words: #12 disher, 2 gallons, servings The size of the disher represents the number of scoops it takes to fill one quart and there are 4 quarts to a gallon. So simply multiply the disher number by 4 to get the number of servings in 1 gallon. • #12 disher = 12 scoops per quart • #12 disher x 4 = 48 scoops per gallon Lastly multiply the 48 servings per gallon by 2 gallons to get 96 servings of pudding. • #12 x 4 x 2 = 96

Cynthia recently finished a nutrition education lesson on the benefits of ginger to a group of adults. What is the best indicator that these adults are using this knowledge outside of class?

Correct Answer: Adults are purchasing more ginger Explanation: Outside the classroom, adults are purchasing ginger on their own, indicating they have processed the information and decided that is beneficial to use more ginger in their daily lives.

The most common manifestation of thiamin deficiency is

Correct Answer: Beriberi Explanation: Test taking strategy: find the key words Key words: manifestation, deficiency Dry or Wet Beriberi is the most common manifestation of thiamin (vitamin B1) deficiency. It is seen more commonly in people suffering from chronic alcoholism.

Health disparities are not impacted by:

Correct Answer: Lower taxes Explanation: Health disparities consist of variations of health outcomes based on a variety of factors such as environmental status, socioeconomic status, or other social factors.

The foods with the highest amount of thiamin include

Correct Answer: enriched rice, fortified cereals, fortified pasta, pork Explanation: Test taking strategy: find the key words Key words: highest amount Thiamin (vitamin B1) is found in higher amounts in whole grains, beans, fish, and meat, especially pork. In the United States, cereals, bread products, and infant formula tend to be fortified with thiamin and wheat tends to be enriched with thiamin.

In descriptive statistics, one method that data is summarized is by using

Correct Answer: measures of central tendency Explanation: Descriptive statistics "describes", organizes, and summarizes data and alone is not used to test a hypothesis. Data collection using descriptive statistics is typically done through surveys, case studies, cross-sectional studies, or qualitative studies. Measures of central tendency (mean, median, and mode) is one method used to help summarize the data.

At the Sand Dollar Nursing Home, Chef Mario purchased 47 onions at $0.19 each. Each onion has a 96% yield. What is the as-purchased cost?

Correct Answer: $8.93 Explanation: Test taking strategy: find the key words, eliminate the distractors Key words: 47 onions, $0.19 each Distractors: 96% yield. This information is irrelevant in this question. The as-purchased cost is the actual price that was paid for the food item prior to processing (trimming, coring, deboning, etc). The formula for the calculation is: Number of units x cost per unit = As-Purchased cost Simply multiply the 47 onions (number of units) by the $0.19 (cost per unit) • 47 x $0.19 = $8.93 (As-Purchased cost) $8.93 is the As-Purchased Cost, or the total price paid for the item.

One whole chicken weighs 3.5 lbs and has a yield of 62%. Chef Cody purchased the whole chicken for $6.99 each. He plans to cook the chicken rotisserie style. What is the cost to serve 30 lbs of cooked chicken after the bones, skin, and fat were removed?

Correct Answer: $97.86 Explanation: Test taking strategy: find the key words Key words: 1 chicken, 3.5 lbs, 62% yield, $6.99 each, needs 30 lbs EP The first equation is As-Purchased (AP) x Yield % = Edible Portion (EP) Divide the 3.5 lbs (EP) by the yield percent of 62% (aka 0.62) • 3.5 lbs (AP) x 0.62 (Yield %) = 2.17 lbs EP Next, divide the 30 lbs of usable meat for the recipe by 2.17 lbs EP per whole chicken • 30 lbs ÷ 2.17 lbs = 13.8 rounded to 14 whole chickens that the chef needs to purchase to get 30 lbs of edible meat The second equation is number of units x cost per unit = As-Purchased cost • 14 whole chickens x $6.99 (cost of each chicken) = $97.86

The Patient Service Manager needs to figure out the schedule for next week of her staff of 78 employees. She looked back at her past schedules and noticed that she ha d terminated 1 employee, 5 left voluntarily, and she replaced 7. What is her labor turnover rate?

Correct Answer: 0.17 Explanation: The labor turnover rate helps us learn what percent of employees are leaving a company within a specified time period, usually calculated on a monthly, quarterly, or annual basis. It is calculated by taking the average number of employees who were terminated, replaced, or voluntarily left, and dividing it by the total number of employees. Then multiply by 100 to get the turnover rate percent. In this case, the labor turnover rate was not turned into a percent. The labor turnover rate might appear on the RD exam this way as well. Labor turnover rate (%) = number of employees who were terminated, replaced, or left voluntarily ÷ total number of employees = ___ x 100 Add the 1 terminated, 5 left voluntarily, and 7 replaced. employees together. • 1+5+7 = 13 Then divide by the 85 positions on staff • 13 ÷ 78 = 0.1667 Multiply by 100 to get the percent 0.1667 x 100 = 16.7% rounded to 17% (or 0.17 if not in percent form)

Marlon has to create a large batch of chocolate, peanut butter, banana swirl frozen yogurt. The recipe calls for a #8 disher of banana yogurt, a #30 disher of chocolate sauce, and a #60 disher of peanut butter. How many gallons of banana yogurt will be needed to make 300 servings?

Correct Answer: 10 gallons Explanation: Test taking strategy: find the key words, eliminate the distractors Key words: #8 disher (aka scoop), banana yogurt, 300 servings The question is asking how many gallons of banana yogurt will be needed, so you can eliminate the distractors of the disher (aka scoop) sizes of the chocolate and the peanut butter. Simply multiply the #8 disher by 4 quarts to a gallon to get 32 scoops in a gallon. • #8 * 4 = 32 scoops in a gallon You need 300 servings (aka scoops), so divide the 300 by 32 scoops per gallon to get 9.4. You need to round up to 10 gallons because the yogurt is ordered per gallon.

How many hours per year does 1 part-time employee equal?

Correct Answer: 1040 Explanation: Multiply 1 employee x 8 hours per day x 5 workdays per week x 52 weeks per year and you get a total of 2080 hours per year. For a part-time employee, you just substitute 0.5 employee instead of the 1 employee and you get a total of 1040 hours per year.

In the kitchen at Fine Foods, Chef Huan is preparing 16 lbs of ground pork for a gyoza recipe that serves 25 people. Ground pork has a yield of 75%. How many pounds of ground pork will there be left after cooking?

Correct Answer: 12 lbs Explanation: Test taking strategy: find the key words, eliminate the distractors Key words: 16 lbs, 75%, left after cooking Distractors: serves 25 people. This information is irrelevant in this question. The equation is As-Purchased (AP) x Yield % = Edible Portion (EP) Simply multiply the 16 lbs by the yield percent • First convert the 75% into the decimal of 0.75 • Then multiply 16 lbs oz by 0.75 • 16 lbs x 0.75 = 12 lbs (EP) 12 lbs is the Edible Portion (EP) amount of ground pork after cooking.

The Happy Egg Restaurant employs 12 full-time employees, five part-time employees who only work twenty hours per week and five part-time employees who only work sixteen hours per week. How many FTEs does the manager need to budget for?

Correct Answer: 16.5 Explanation: A full-time position implies that they work 40-hours per week. • 12 employees x 40 hours per week = 480 hours per week 5 part-time positions who work 20-hours per week. • 5 employees x 20 hours per week = 100 hours per week 5 part-time positions who work 16-hour shifts per week. • 5 employees x 16 hours per week = 80 hours per week Add all the hours per week together then divide by a typical 40-hour work week to get the FTEs (full-time equivalents). 480 + 100 + 80 = 660 hours per week ÷ 40 = 16.5 FTEs

What is the recommended daily allowance of iron for an adult female, age 48 with coronary artery disease?

Correct Answer: 18mg Explanation: Test taking strategy: find the key words, eliminate the distractors Key words: Recommended daily allowance, iron, 48-year-old female This question is asking the RDA for iron in an adult female. Having CAD does not affect iron needs and is a distractor. Adults greater than 19 years of age need 8mg (Males) and 18mg (Females). Above the age of 51, older men and women only need 8mg each. Teenagers (ages 14-18) require 11mg (Males) and 15mg (Females).

The Local Yolk Restaurant served 194 meals at breakfast and 161 meals at lunch. They are closed for dinner. It took 21 FTEs to produce. How many meals did they produce per labor hour?

Correct Answer: 2.1 Explanation: Formula: Meals per labor hour = total meals per day ÷ labor hours per day Start by adding all the meals together to get a total of meals produced per day. • 194 breakfast meals + 161 lunch meals + 0 dinner meals = 355 total meals per day Next figure out the labor hours per day. You need to multiply the FTEs by an 8-hour full time workday. • 21 FTEs x 8-hours = 168 labor hours per day Lastly divide the total meals served per day by the labor hours per day • 355 total meals per day ÷ 168 labor hours per day = 2.1 meals per labor hour

The tray line at Jefferson Hospital serves 110 patients at breakfast, 150 patients at lunch and 165 patients at dinner. There are 3 people on the tray line at each meal. They produce 2 meals per minute. How many labor hours are needed to staff the tray line?

Correct Answer: 3.54 Explanation: Formula: labor hours per day = total meals per day ÷ meals per labor hour Start by adding all the meals together to get a total of meals produced per day. • 110 breakfast meals + 150 lunch meals + 165 dinner meals = 425 total meals per day Next, we multiply the 2 meals per minute by 60 minutes in an hour to get 120 meals per labor hour. • 2 meals per minute x 60 minutes = 120 meals per hour Then divide the 425 meals per day by 120 meals per labor hour to get 3.5 labor hours per day. • 425 meals ÷ 120 meals per hour = 3.5 labor hours per day If you got 1.2 hours, you went too far and found how many hours per person it takes to produce those meals on tray line.

Raul is using a disher that scoops 4 oz serving sizes. How many scoops will he get from 1 gallon of caramel swirl ice cream?

Correct Answer: 32 Explanation: Test taking strategy: find the key words, possible outlier to eliminate Key words: 4 oz, 1 gallon, how many scoops? Possible outlier: 128 scoops The size of the disher represents the number of scoops it takes to fill one 32 fluid ounce quart. First, calculate the disher number. Divide the 32 ounces by 4 ounces to get the #8 disher. Then, multiply the disher number by 4 quarts to a gallon to get 32 scoops in a gallon.

At the Beagle Café, dinner is served from 5pm to 10pm. The Café has a seat turnover rate of 2 per hour and they usually have around 400 patrons. How many chairs do they need in the café?

Correct Answer: 40 Explanation: The formula for the seat turnover rate is: Seat turnover (the average amount of times the seat will be occupied) = # customers in a given time period ÷ number of seats This question is asking for number of seats, so turn the formula around to: 400 customers ÷ seat turnover rate = number of chairs To calculate the seat turnover rate, start with the rate of 2 per hour and multiply by the number of hours: • 2 per hour x 5 hours = 10 Now complete the equation: 400 customers ÷ 10 (seat turnover rate) = 40 (number of chairs)

Chef Marcus is making a side dish of chopped pineapples for 120 guests who will be attending the banquet. He purchased 30 lbs of fresh pineapples and peeled them himself. After peeling, the edible portion came to 13.5 lbs. What is the yield percent?

Correct Answer: 45% Explanation: Test taking strategy: find the key words, eliminate the distractors Key words: 30 lbs fresh, edible portion 13.5 lbs, yield percent Distractors: 120 guests. This information is irrelevant in a yield percent question. The equation is Yield % = (Edible Portion (EP) ÷ As-Purchased portion (AP)) x 100 • The x 100 is added to the equation to turn the decimal point into a whole % The edible portion of the pineapple after trimming and peeling weighed 13.5 lbs, divide this by the as-purchased portion of 30 lbs. • 13.5 lbs ÷ 30 lbs = 0.45 Now to turn the yield into a percent, multiply the decimal answer by 100%. • 0.45 x 100% = 45% The yield percent of the pineapple is 45%. This means that only 45% of the whole pineapples were edible and 55% was the trim (or waste).

Chef Monroe is making banana pudding for the residents at Sunset Senior Home. Bananas have a yield of 78% and each batch of pudding calls for 4 lbs of bananas. How many batches of the pudding can be made from 30 lbs of bananas?

Correct Answer: 5.85 Explanation: Test taking strategy: find the key words Key words: yield 78%, 4 lbs of bananas, batches from 30 lbs of bananas This question implies that the 4 lbs is the edible portion (EP) of bananas and the 30 lbs is the as-purchased amount. The equation is Step 1: As-Purchased (AP) X Yield % = Edible Portion (EP) Multiply the 30 lbs (AP) by the yield percent of 78%. • First convert the 78% onto the decimal of 0.78 • Then multiply the 30 lbs by 0.78 • 30 lbs x 0.78 = 23.4 lbs Step 2: Edible Portion (EP) ÷ Edible Portion (EP) per batch = total batches Divide the 23.4 lbs (EP) by the 4 lbs per batch (EP) • 23.4 lbs ÷ 4 lbs = 5.85 batches

Which of the following studies is an example of a study about incidence?

Correct Answer: A study examining new cases of breast cancer Explanation: Test taking strategy: find the key words, echo options Key words: incidence Incidence reflects how many new cases of a condition (in this case, breast cancer) are occurring. Prevalence reflects how many cases are already present at a point in time. Using our echo options, we see both as choices. The other two choices are various studies. The study asking patients to try a new form of chemotherapy is an example of an experimental study, and the study comparing treated and untreated breast cancer patients is an example of a case-control study.

Which of the following is an example of a qualitative, descriptive study?

Correct Answer: A study that uses a focus group to discuss the availability of sodas in children's schools Explanation: Test taking strategy: find the key words Key words: qualitative, descriptive A qualitative descriptive research study develops a comprehensive summary of events by focusing on the "why" rather than "what" in data collection. Unstructured interviews and focus groups are large parts of qualitative, descriptive research. The study regarding overall mortality is an example of an ecological study and is at the population level. A study interviewing students about household income is an example of a cross-sectional study, since it is a snapshot in time. The study replacing the soda machines is an experimental study, since there is an intervention.

A researcher uses a crossover design, rather than a parallel design. What is a disadvantage of this decision?

Correct Answer: A washout period is required Explanation: Test taking strategy: find the key words, eliminate the distractors Key words: crossover design, disadvantage Crossover and parallel designs are used in randomized control trials. Crossover designs allow each participant to serve as their own control, which decreases the number of participants needed, but increases the time required for the study due to the need for a washout period. There is decreased variability, because that one person serves as a control to their own response to the intervention. Comparatively, a parallel design takes less time, but requires more participants to serve in either the control or treatment groups.

What is a not an advantage of a cohort study?

Correct Answer: Able to measure prevalence Explanation: Test taking strategy: find the key words, echo options Key words: NOT, advantage, cohort study Cohort studies analyze data from a selected group of people over a period of time. They have a high level of evidence, establish temporality, can study several outcomes, and can measure incidence. However, cohort studies are also expensive and time-consuming; they may have issues with internal validity. They do not measure prevalence, and, using our echo options, we can predict the answer is either incidence or prevalence.

A graduate student has the following idea for a research study: A lengthy set of interviews with individuals with congenital sucrase-isomaltase deficiency and exploration of their nutrition interventions. What type of study would this be?

Correct Answer: Case series Explanation: Test taking strategy: find the key words, eliminate the distractors, echo options Key words: lengthy interviews, individuals congenital sucrase-isomaltase deficiency (CSID) (rare disease), over time Initially, this study looks like several studies. We know that this study occurs over time (prospective), so it can't be a cross-sectional study because that is a snapshot, or one moment in time. It can't be a case report/study either, since it has multiple individuals instead of only one. At first, it looks like this study could be a cohort study. However, this is a case series since it's focusing on a few individuals and their experiences with CSID, which is a relatively rare disease. Cohort studies do not work well with rare diseases, typically have a larger population, and analyze the data provided, rather than exploring what each individual experiences. We can also use echo options here, noticing that both case report and case series are listed. If we can realize that this study is likely to be plural studies (multiple case reports), we can choose the correct answer.

Which of the following studies would explore the incidence of patients with celiac disease?

Correct Answer: Cohort study Explanation: Test taking strategy: find the key words, eliminate the distractors Key words: incidence Incidence reflects the number of new cases of a condition (celiac disease) that are occurring. Cohort studies are also known as incidence studies, because they take a group of people and see if they develop the outcome of interest (celiac disease). Cross-sectional studies are also known as prevalence studies, because they reflect a single point in time, or a snapshot of data. They are used to measure prevalence, not incidence. Qualitative and case-control studies do not track incidence or prevalence.

A disadvantage of a retrospective study comparing individuals with and without leukemia is:

Correct Answer: Concerns with temporality Explanation: Test taking strategy: find the key words Key words: disadvantage, retrospective study comparing The question is describing a case-control study. Case-control studies compare individuals with and without a given condition and look backward in time (retrospective). They are usually quick and cheap and work well for investigating rare outcomes or diseases with long latency periods. Since everyone already has the outcome of interest, fewer subjects are needed. Since case-control studies are usually low cost, require fewer participants (not a large number), and struggle with low internal validity (not external), the correct answer is concerns with temporality. Other disadvantages include difficulty determining temporality, low internal validity, and recall bias.

What is the main difference between a cake and a cookie?

Correct Answer: Cookies contain more fat than cakes Explanation: A cookie is classified as a modified shortened cake. It is higher in fat, but lower in sugar and liquid than a traditional shortened cake.

You are making an apple pie for a baking competition and first need to make a tender, flaky crust. What is the best way to do this?

Correct Answer: Cut cold butter into small pieces before mixing into crust Explanation: Tenderness in pie crust is enhanced by using oil, soft fats, or fat cut into small pieces. However, this will not produce a flaky crust unless the fat is solid, allowing for air pockets to develop while baking. Keep butter chilled when making pie crust or else too much handling will cause it to melt prior to baking.

When working with the aging population, it is important to be aware of:

Correct Answer: Decreased mobility Explanation: Test taking strategy: find the key words, echo options Key words: aging population This question tests your ability to understand common issues with the aging population. Common problems in the elderly include dentition, decreased appetite, increased fat mass as the percentage of lean body mass decreases, and mobility issues. Decreased mobility can lead to obesity, osteoporosis, and changes. Mentation also changes with elderly adults, and it is common for older adults to live on a fixed income, with worsening socioeconomic status.

Measures of central tendency (mean, median, mode) and measures of spread (frequency) are commonly used to detect patterns in what type of research?

Correct Answer: Descriptive statistics Explanation: Central tendency (mean, median, and mode) and frequency are commonly used to detect patterns in descriptive statistics.

A client with binge-eating disorder reports she feels ashamed after eating candy at her office. Using the ABC framework, which of the following is the behavior?

Correct Answer: Eating candy Explanation: Test taking strategy: find the key words Key words: eating candy, ABC framework, behavior The ABC framework (antecedent, behavior, consequence) is a commonly used tool in cognitive behavioral therapy. It looks at the antecedent, or what triggers a specific behavior, leading to its consequence. In this case, being at the office is the antecedent, which causes the behavior (eating candy), leading to the consequence (feeling ashamed).

Amanda is going through the educational process to develop a diabetes weight loss program. What is the last stage of this process?

Correct Answer: Evaluation Explanation: This question is referring to the four steps in the educational process. Step 1: Assess needs (survey, patron populations) Step 2: Plan (develop the program) Step 3: Implement (program occurs) Step 4: Evaluation (exit surveys)

Which Act specifically addresses the requirement for the protection and confidential handling of protected health information?

Correct Answer: Health Insurance Portability and Accountability Act of 1996 Explanation: The Health Insurance Portability and Accountability Act, commonly known by the acronym HIPAA, was enacted to help protect the American people with regards to their health insurance. It provides the ability for American workers to transfer and continue health insurance coverage when they change or lose their jobs. It also requires health care providers and organizations to develop and follow procedures that ensure the confidentiality and security of protected health information (PHI) when it is transferred, received, handled, or shared.

You are assessing a new patient who presents with muscle weakness and pseudofractures in their spine and femur. You determine that your patient may have a vitamin or a mineral deficiency. What deficiency might your patient have?

Correct Answer: Osteomalacia, a vitamin D deficiency Explanation: Osteomalacia is an outcome of vitamin D deficiency in adults. Osteomalacia consists of the softening of bones with pseudofractures, muscle weakness, increased fall risk, and possible bone pain. Osteoporosis, resulting from a calcium deficiency, causes the bones to become more brittle, weaken, and porous.

Which part of the brain does ghrelin act on to induce hunger?

Correct Answer: Hypothalamus Explanation: Test taking strategy: find the key words Key words: part of the brain, ghrelin acts on The hypothalamus helps maintains the body's homeostasis by regulating many functions, including body temperature, hunger, thirst, and satiety, and blood pressure. Ghrelin is produced in the stomach and acts on the hypothalamus to regulate food intake and induce satiety. The pituitary gland is responsible for the glands of the brain (including the hypothalamus) and regulates their flow of hormones. The thyroid gland is located in the neck, and is responsible for regulating heart rate, blood pressure, body temperature, and metabolic rate. The medulla is part of the brain stem and is responsible for breathing, blood flow, oxygen levels, and produces important reflexes, such as sneezing and coughing.

Which part of the brain does leptin act on to induce satiety?

Correct Answer: Hypothalamus Explanation: Test taking strategy: find the key words Key words: part of the brain, leptin acts on The hypothalamus helps maintains the body's homeostasis by regulating many functions, including body temperature, hunger, thirst, and satiety, and blood pressure. Leptin is produced in adipose tissue and acts on the hypothalamus to regulate food intake and induce satiety. The pituitary gland is responsible for the glands of the brain (including the hypothalamus) and regulates their flow of hormones. The thyroid gland is located in the neck, and is responsible for regulating heart rate, blood pressure, body temperature, and metabolic rate. The medulla is part of the brain stem and is responsible for breathing, blood flow, oxygen levels, and produces important reflexes, such as sneezing and coughing.

What type of statistics allows us to make conclusions beyond the data and can be used to test a hypothesis?

Correct Answer: Inferential Explanation: Inferential statistics can be used to test a hypothesis. Descriptive statistics "describes", organizes, and summarizes data and alone is not used to test a hypothesis.

If a study is free from flaws and can establish cause and effect, we say it is high in:

Correct Answer: Internal validity Explanation: Test taking strategy: find the key words, echo options Key words: free from flaws, high If a study is free from flaws and we can establish cause and effect, then we say the study is high in internal validity. Meanwhile, external validity addresses whether or not the study results can be generalized to the real world. These are our echo options that look similar but have very different definitions. Causality is being able to determine cause and effect. Just because we can find a cause and effect does not necessarily make it high in internal validity. Temporality is the requirement that the exposure must precede the effect. It helps determine causality.

Which of the following is an advantage of a case-control study?

Correct Answer: Investigates diseases with rare outcomes Explanation: Test taking strategy: find the key words, echo options Key words: advantage, case-control Case-control studies compare individuals with and without a given condition and look backward in time (retrospective). They are usually quick and cheap and work well for investigating rare outcomes or diseases with long latency periods. Since everyone already has the outcome of interest, fewer subjects are needed. Using echo options, we see two options that look similar. The correct answer is that case-control studies investigate diseases with rare outcomes or long latency periods, not short ones.

It is important to use a low-protein flour in pastry making for which of the following reasons:

Correct Answer: It creates a more tender product Explanation: Low protein content in flour is important in baking to create a tender, moist product. Too much gluten protein will create a firm, tougher product and interfere with tenderness in baking. Gluten has elastic properties, forming the framework and holding in the leavening agent.

A new dairy company has started selling their cow's milk in clear glass bottles. What issue might this cause?

Correct Answer: Loss of riboflavin Explanation: Test taking strategy: find the key words Key words: cow's milk, issue Riboflavin, or Vitamin B2, is a water-soluble vitamin. It is lost in UV light, so milk is sold in opaque containers to help block out the UV.

Which of the following are all essential amino acids?

Correct Answer: Lysine, methionine, tryptophan Explanation: Test taking strategy: find the key words Key words: ALL essential amino acids The human body encodes 20 amino acids for protein synthesis. Nine of these are considered essential, or that they must be obtained from the diet. These nine include phenylalanine, valine, threonine, tryptophan, isoleucine, methionine, histidine, leucine, and lysine. Use the mnemonic PVT TIM HaLL to remember the nine essential ones. However, it is important to remember that there is no "A" amino acid that is essential. Leucine, isoleucine, and valine or (LIV) are the branched chain amino acids. While some answers contain a mix of essential and non-essential amino acids, only "lysine, methionine, tryptophan" are all classified as essential.

After 11-months on intense behavior changes, Cindy has kept up her healthy lifestyle without a problem and doesn't anticipate any potential barriers that she can't overcome. What stage of change is Cindy in?

Correct Answer: Maintenance Explanation: In the Transtheoretical Model (TTM) Stages of Change, the Maintenance stage is when the individual maintains the behavior change for at least 6-months. Some examples are "It's been 8 months and I'm still following my diet" or "After 6-months, I am determined to maintain my new healthy lifestyle."

The food sources with the highest amount of riboflavin include

Correct Answer: Milk, eggs, liver, enriched grains Explanation: Test taking strategy: find the key words Key words: highest amount Riboflavin is found mainly in cow's milk, yogurt, eggs, liver, kidney meat, and lean meats, but it can also be found in fortified cereals and enriched grains.

A newborn weighed 3000g at birth. What is the birth weight classified as?

Correct Answer: Normal birth weight Explanation: Infants born at normal birth weight weigh between 2500-4000g. Low birth weight (LBW) weighs less <2,500g (<5.5Ibs). Very low birth weight (VLBW) weighs less <1,500g (<3.3Ibs). Extremely low birth weight (ELBW) weighs less <1,000g

Which of the following beverages most enhance the absorption of iron?

Correct Answer: Orange juice Explanation: Test taking strategy: find the key words, eliminate the distractors Key words: beverages, enhance, iron absorption Iron absorption is aided by consuming ascorbic acid, or Vitamin C, sources, like orange juice, bell peppers, and strawberries. While cranberry juice contains some Vitamin C, it has significantly less than orange juice. Foods that contain calcium, like milk, or tannins in tea and coffee can decrease iron absorption.

Dorothy is counseling a client on a diabetic diet. The client states that "I know how many carbs are in my favorite foods. I am going to decrease my carbs at lunch." What stage of change is this client in?

Correct Answer: Preparation Explanation: The client is in the preparation stage of change. Dorothy has a plan of action for her next steps, with decreasing her carbs at lunch. People in the precontemplative stage have no intention of changing and resist attempts at change. The contemplation stage has individuals recognizing that they need to change but are wavering between the cost of changing vs staying the same. People can be in this phase for years. The preparation stage is when people are getting ready to take action and preparing their next steps forward. Action phases are behavior changes from 1 day - 6 months. These changes aren't considered permanent. Relapse is most common at 3-6 months. The maintenance phase occurs when people stay with the new behavior.

Which of the following represents the number of current cases of Crohn's disease in New York?

Correct Answer: Prevalence Explanation: Test taking strategy: find the key words, eliminate the distractors, echo options Key words: current cases Prevalence reflects the number of cases (of Crohn's disease) that already exist. Incidence reflects the number of new cases of a condition that are occurring. Immediately, we see these pairs as our echo options, increasing the changes that one of them is the correct answer. Exposure is another term for the independent variable in a study, and causality is the relationship between cause and effect in a study. The key word is "current", indicating we are talking about prevalence, rather than incidence.

Which of the following needs remain the same in older adults?

Correct Answer: Protein Explanation: Test taking strategy: find the key words Key words: needs, same, older adults During the aging process, older adults typically require fewer total calories (carbohydrates and fat). However, protein needs remain the same or are slightly higher (1-1.2g/kg) to prevent the percentage loss of lean mass. Hydration needs are decreased, but are of higher concern due to loss of the thirst mechanism.

You have decided to hold a nutrition education seminar for inner city youth. What is the most important to consider when planning this event?

Correct Answer: Proximity to bus stations Explanation: When planning nutrition programs, it is critical to examine how your participants are going to get to your location. Inner city youth may not have access to cars and therefore may be dependent on walking or public transportation.

Vitamin A is required in the formation of which protein that helps the eyes to see, especially at night?

Correct Answer: Rhodopsin Explanation: Test taking strategy: find the key words Key words: protein, helps eyes to see Vitamin A is required in the formation of the protein rhodopsin, the photopigment located in the rod cells of a person's retina that especially helps the eyes to see at night. Without vitamin A, night blindness can occur. Retinol and retinal are precursors for the formation of rhodopsin.

Carla developed cheilosis and angular stomatitis. Her doctor ran a blood test and found that she was deficient in which vitamin?

Correct Answer: Riboflavin Explanation: Test taking strategy: find the key words Key words: cheilosis, angular stomatitis, deficient Riboflavin, or Vitamin B2, is a water-soluble vitamin. Signs of a riboflavin deficiency include magenta tongue, cheilosis (or cracked lips), and angular stomatitis (sores on the corner of the mouth). Riboflavin is found in milk, liver, and lean meats, as well as enriched grain products. It is lost in UV light.

Food sources that contain high amounts of preformed vitamin A are

Correct Answer: Salmon, liver, and eggs Explanation: Test taking strategy: find the key words Key words: Food, high amounts, preformed vitamin A Preformed vitamin A, the most active form, is more likely to cause liver toxicity. It is mostly found in animal-based foods such as dairy products, fish and meats, especially liver, and in supplements. Provitamin A, mostly in the form of carotenoids, is a nutrient that is converted to vitamin A within the intestinal cells and is mainly found in plant-based foods such as yellow- and orange-colored fruits and vegetables and dark leafy greens.

The best lab indicator used to detect iron deficiency early is

Correct Answer: Serum ferritin Explanation: Test taking strategy: find the key words, eliminate the distractors Key words: best lab, iron deficiency, early Serum ferritin concentration is the best indicator to catch iron-deficiency early, because the test checks the body's iron stores and shows a decrease before the hemoglobin or hematocrit levels do.

According to the CDC growth charts, a 10-year-old female child is in the 3rd percentile for BMI-for-age, and the 60th percentile for stature-for-age. How should her weight status be classified?

Correct Answer: Underweight Explanation: Test taking strategy: find the key words, eliminate the distractors Key words: child, 3rd percentile BMI, classify weight status The CDC has three main growth charts to show children's physical growth from ages 2-20: weight-for-age, stature-for-age, and BMI-for-age. Weight-for-age reflects body weight relative to age; it does not classify children as over- or under-weight. Stature-for-age is used to define shortness, or tallness; it also does not classify children as over- or under-weight. Only BMI-for-age is used to classify children as underweight, overweight, or obese. Thus, the stature-for-age provided is a distractor. Only the 3rd percentile BMI matters in this question. Underweight: <5th percentile Normal: 5th-84th percentile Overweight: >85th percentile Obese: >95th percentile According to BMI-for-age, this child is underweight. However, since she is tall for her age (>50th percentile), this may not be a significant nutritional concern, but should be monitored.

Alex is a vegan athlete and has been told that he might need to take some essential amino acid supplements, especially if he is consuming very little soy protein. He decided to start taking a BCAA (branched chain amino acid) supplement that contains these 3 essential amino acids:

Correct Answer: Valine, Leucine, Isoleucine Explanation: Humans and other vertebrates cannot synthesize from metabolic intermediates the nine essential amino acids. Foods must be consumed that contain these amino acids since the human body lacks the metabolic pathways required to synthesize them. The nine essential amino acids are: • Phenylalanine • Valine • Tryptophan • Threonine • Isoleucine • Methionine • Histidine • Leucine • Lysine During prolonged aerobic endurance exercise, muscle glycogen may become depleted and the muscle may increase its reliance on BCAAs for fuel. These particular amino acids are valine, leucine, and isoleucine.