RD EXAM: Nutrition Care
After defining the nutrition problem, which of the following is the correct sequence of steps a community nutritionist should follow in assessing the needs of the community? Set the parameters of the assessment, collect data, analyze and interpret the data, share the findings, and set priorities. Set priorities, collect data, set the parameters of the assessment, analyze and interpret the data, and share the findings. Choose a plan of action, collect data, set the parameters of the assessment, share the findings, and analyze and interpret the data. Collect data, analyze and interpret the data, set the parameters, share the findings, and set the priorities.
The correct answer is A. A nutrition needs assessment must occur in the sequenced order listed in option A.
How many kilocalories per ounce does a standard infant formula provide? 20 22 25 28
The correct answer is A. A standard infant formula contains 20 kcal/oz. Higher-concentrated formulas are appropriate for preterm infants or for those with specific diseases.
In the Campinha-Bacote Model, cultural competence originates in the _____. individual family community society
The correct answer is A. According to the Campinha-Bacote model, culture competence originates in the individual.
All breastfed infants should receive how many IUs of vitamin D per day during the first 2 months of life? 400 500 600 800
The correct answer is A. Because breastmilk alone does not provide infants with an adequate intake of vitamin D, it is recommended that breastfed infants should be given 400 IU (5 mcg) vitamin D beginning within the first 2 months of life.
Which of the following foods should a pregnant woman avoid? King mackerel Tuna Trout Shrimp
The correct answer is A. Because of the mercury content of mackerel, pregnant women should avoid consuming it.
When considering cow's milk versus human breastmilk, which of the following is true? Human milk contains less protein. Human milk provides more calcium. Cow's milk provides less potassium and sodium. Cow's milk contains a lower proportion of casein compared to whey protein.
The correct answer is A. Breastmilk is lower in protein than cow's milk (6 to 7% of calories in human milk vs 20% in cow's milk). It also has less calcium, sodium, and potassium than cow's milk. Casein accounts for 80% of the protein in cow's milk, so it actually has a higher proportion of casein compared to whey protein.
Which set of nutrients and/or food components are associated with the formation of cataracts in older adults? Vitamin C, vitamin E, carotenoids Thiamin, niacin, riboflavin Vitamin C, vitamin E, phytosterols Calcium, zinc, magnesium
The correct answer is A. Carotenoids are high in oxidants and oxidative stress can cause cataracts.
The Centers for Disease Control and Prevention growth charts are appropriate for: healthy infants. children with cerebral palsy. children with Down syndrome. premature infants weighing less than 1500 g at birth.
The correct answer is A. It is appropriate to use the CDC's charts for plotting the growth of healthy US infants. Premature infants and children with Down syndrome or cerebral palsy require special growth considerations.
When reviewing 2 years of serial data on a Centers for Disease Control and Prevention growth chart, a pediatric patient is identified to be at risk on nutritional screening when experiencing a: change in rate of growth. continuation on his or her line of growth. growth spurt. plateau in growth.
The correct answer is A. Look for change in growth pattern over time to identify potential risk; expect growth spurts and plateaus.
The best way to address the mortality rate associated with low-birthweight (LBW) and preterm infants is by: improving the birthweight of newborn infants. reducing the incidence of pica among pregnant women. improving the infant formulas for LBW and preterm infants. increasing the emphasis on breastfeeding in hospitals.
The correct answer is A. Pica is not necessarily related to infant weight, and improving infant formulas and emphasizing breastfeeding are important after birth. To address mortality rates of preterm and low-birthweight infants, the birthweight needs to be improved. Birthweight is directly correlated to infant mortality.
Refeeding syndrome is characterized by low serum concentrations of phosphorus, potassium, magnesium. sodium, phosphorus, magnesium. sodium, potassium, phosphorus. potassium, magnesium, sodium.
The correct answer is A. Refeeding syndrome occurs when previously malnourished patients are fed with high carbohydrate loads; the result is a rapid fall in phosphate, magnesium, and potassium, along with an increasing extracellular fluid volume. This leads to a variety of complications, such as cardiac arrhythmia and seizures.
Imagine a client says, "I don't know if I can eat bananas or watermelon on this diabetic meal plan. I wonder if I need to be using exchanges." Which of the following is the best example of a reflective statement/question to ask this client? "You're uncertain about how to choose foods?" "You're interested in your health?" "Do you want a diabetic meal plan?" "I'm happy that you've come in today."
The correct answer is A. Reflective statements take what is said and reword it to better inform understanding of the speaker's intent. They usually include some "feeling" words. It also helps to clarify the problem.
The Institute of Medicine's recommended rate of weight gain per week during the second and third trimesters for pregnant women whose body mass index (BMI) is greater than 30 is_____pounds. 0.5 0.6 0.7 0.8
The correct answer is A. The Institute of Medicine's recommended rate of weight gain per week during the second and third trimesters for pregnant women whose BMI is greater than 30 is 0.5 pounds.
A 58-year-old postmenopausal female client presents to an ambulatory clinic with the following physical exam components: Blood pressure: 110/62; heart rate 78; BMI: 30; blood work: Fasting blood glucose: 86 mg/dl; total cholesterol: 182 mg/dl; LDL: 98 mg/dl; HDL 50 mg/dl; triglycerides (TG): 132 mg/dl. Social history: Married, + smoking half-pack per day X 30 years, negative for drinking alcohol, reports she works a desk job and does little activity during the week and has no structured exercise program. Family history: + cancer in mother, + CVD in father at age 72 years. Which risk factors are modifiable? BMI, smoking, and inactivity BMI, family history of CVD, fasting blood glucose HDL, TG, and fasting blood glucose smoking, TG, and inactivity
The correct answer is A. The modifiable risk factors include smoking, physical inactivity and BMI. Her age, of course, is nonmodifiable. Family history isn't considered a factor because the father's illness had to present before age 55 and her mother's illness before age 65.
Which of the following nutrients should a pregnant woman avoid excessive intake of? Vitamin A Vitamin B-6 Folic acid Iron
The correct answer is A. Vitamin B-6 is water soluble, and folic acid and iron should be increased during pregnancy. A pregnant woman should avoid excessive intake of vitamin A.
After defining the nutritional problem while conducting a community needs assessment, what is your next step? Identify community groups and their leaders. Determine the purpose of the needs assessment. Collect information on health and nutrition resources available in the community. Review available data such as Census records.
The correct answer is B. After identifying the problem, the next step is setting the parameters of the assessment, which includes determining the purpose. The actions described in the other options would not be performed this early in the process.
Rosa wants to plan a community nutrition program to encourage children ages 11-15 to consume healthier afterschool snacks. She has reviewed the results of the community needs assessment, defined program goals and objectives, and developed a program plan. Next, she should: identify funding sources. define the management system. implement the program. seek support from the parents and schools of intended participants.
The correct answer is B. Defining the management system comes next. Identifying funding systems, seeking support from parents and schools, and implementing the program come later.
Which classic vitamin deficiency is known for the four Ds: dermatitis, dementia, diarrhea, and death? Thiamine Niacin Biotin Folic acid
The correct answer is B. Dermatitis, dementia, diarrhea, and death are the typical symptoms of pellagra, a disease caused by niacin deficiency.
What is the primary regulatory agency responsible for the safety of imported fish? Environmental Protection Agency (EPA) Food and Drug Administration (FDA) United States Department of Agriculture (USDA) United States Department of International Commerce (USDIC)
The correct answer is B. Each of these entities govern aspects of the food supply, but the FDA regulates safety of imported products, including imported fish.
Which of the following must be true for a serving of food to be labeled as low fat? Contain less than 0.5 g fat Contain less than 3 g fat Contain 25% less fat than the full fat food Contain 13 fewer calories or 50% less fat than the full fat food
The correct answer is B. Following food labeling laws, to be identified as low in fat, a serving of food must contain less than 3 g fat.
Which of the following gastrointestinal hormones has the effect of increasing the consumption of food? Cholecystokinin Ghrelin Enterostatin Peripheral hormone peptide YY
The correct answer is B. Ghrelin is a gastrointestinal hormone produced by epithelial cells lining the fundus of the stomach; it appears to be a stimulant for appetite and feeding but is also a strong stimulant of growth hormone secretion from the anterior pituitary.
The nutritionist employed by the local county wants her nutrition objectives for the next 5-7 years to reflect the goals of Healthy People 2020. Which of her goals listed below most closely reflects the goals of Healthy People 2020? Reduce among residents the severity of chronic diseases such as diabetes and heart disease. Promote, across every stage of life, healthy behaviors that positively affect the nutritional status of residents. Improve the nutrition of residents by eliminating disparities in treatment plans. Eliminate social and physical environments that threaten the nutrition of residents.
The correct answer is B. Healthy people 2020 advocates for improvement in the health of all people across the life course. (Options A and D incorporate only one determinant and option C isn't inclusive enough.)
Julia is a 10-year-old fifth grader with ADHD who takes Adderall. Her BMI-for-age is less than the 5th percentile. The most appropriate nutrition intervention for her is to: provide snacks for her to eat during recess. offer her a high-calorie bedtime snack. send a lunch consisting of her favorite foods. have the teacher monitor her intake.
The correct answer is B. If Julia's nutrition intervention calls for helping her to gain weight, she should be encouraged to eat a snack high in kilocalories at bedtime, as this gives less time to burn off the energy consumed.
Which of the following components comprise the core of motivational interviewing? Collaboration, empathy, autonomy, and patient-centered care Partnership, acceptance, compassion, and evocation Rolling with resistance, unconditional positive regard, empowerment, and empathy Partnership, autonomy, setting smart goals, and evocation
The correct answer is B. In the 3rd edition of the groundbreaking Motivational Interviewing, the authors added compassion to the core of motivational interviewing and elaborate on the concept of what acceptance really is.
Which of these requires compliance with safety standards? MSDS OSHA HACCP None of the above
The correct answer is B. OSHA is the Occupational Safety and Health Administration. They require employers to comply with the Hazard Communication Standard, also known as Right-to-Know, which requires employers to train employees on how to safely use the chemicals they work with.
Which of the following reflects long-term folate status? Serum folate Red blood cell folate Homocysteine concentration in the blood Serum methylmalonic acid
The correct answer is B. Red blood cells (RBC) collect folate during formation. Because red blood cells live for 2 to 3 months and contain the folate since formation, RBC assessment provides longer-term folate status.
Which of the following foods is not a common pediatric food allergen? Cow's milk Rice Wheat Peanuts
The correct answer is B. Rice cereal is less allergenic; it is typically the first grain introduced to infants.
Which electronic health record style was created to reflect the nutrition care process? SOAP ADIME PIE Focus
The correct answer is B. SOAP is the oldest type of medical chart documentation; PIE and Focus are a blending of chart notes types. ADIME, which stands for "assessment, diagnosis, intervention, monitoring, and evaluation," reflects the nutrition care process.
Consider the following clinical scenario: Age: 52-year-old male; weight 163 lb; Height: 5'11" BMI: 22.7; Current medications: Metformin 1 g; Saxagliptin 5 mg; Glucotrol XL 10 mg. Laboratory work: Hemoglobin A1c: 13.9%; fasting blood glucose: 356 mg/dl; + glutamic acid decarboxylase (GAD) auto antibodies test). The referring physician note states: "Patient needs diet instruction." Which of the following is the best action for the RDN to take? Educate the patient about low carbohydrate foods to minimize glucose elevations. Contact the referring physician to consider insulin therapy. Emphasize meal spacing and carbohydrate consistency. Negotiate a weight loss of 5% to 7% body weight loss.
The correct answer is B. The GAD shows that the patient has type 1 diabetes and will need insulin therapy for glucose control. Options A, C, and D would be appropriate actions for individuals with type 2 diabetes mellitus who have insulin resistance. Dietary or nutrition approaches will not fix the glucose problem for this patient
Making homemade dried meat products such as jerky is a very popular home food preservation practice. Which of the following procedures would be considered appropriate and safe for this process, considering that the meat type has not been specified? A. Marinate the meat for directed amount of time in the recipe, then place in dehydrator set at 130°F - 140°F, process until dry. B. Marinate the meat for directed amount of time in the recipe, then cook in a preheated oven until the meat reaches a minimum internal temperature of 165°F, move to the dehydrator set at 130°F - 140°F, and continue to process until dry. C. Marinate the meat for directed amount of time in the recipe, then cook in a preheated oven until the meat reaches a minimum internal temperature of 160°F, move to the dehydrator set at 130°F - 140°F, and continue to process until dry. D. Marinate the meat for directed amount of time in the recipe, move to the dehydrator set at 130°F - 140°F, and continue to process until dry, then cook in a preheated oven until the meat reaches a minimum internal temperature of 160°F.
The correct answer is B. The USDA's current recommendation for making jerky safely is to heat meat to 160°F and poultry to 165°F before the dehydrating process. This step ensures that any bacteria present will be destroyed by wet heat. After heating to 160°F or 165°F, maintaining a constant dehydrator temperature of 130°F to 140°F during the drying process is important because the process must be fast enough to dry food before it spoils and it must remove enough water so that microorganisms are unable to grow.
Based on this client statement, determine which stage of change he or she is in: "I know what you are going to tell me, and I know a lot about nutrition. I know what I need to do to lose weight, but I just can't do it." Precontemplation Contemplation Preparation Action
The correct answer is B. The classic indicator for a patient in the contemplation stage of change is a "yes, but" statement. The majority of RDNs' clients are in the contemplation stage when they come to their first appointment.
A patient in residential care receives a parenteral formula of D40W of 500 ml in one day. The number of kilocalories delivered is 560 kcal 680 kcal 800 kcal 920 kcal
The correct answer is B. The kilocalories delivered by dextrose in solution is 3.4 kcal/g—not the typical 4 kcal/g—so the correct answer is 680 kcal. In 1 L of D40W, there is 400 g dextrose, but the patient is only receiving 500 ml; thus, 200 g dextrose x 3.4 kcal/g = 680 kcal.
An isotonic enteral formula would have an osmolality of 0 mOsm/L. 300 mOsm/L. 550 mOsm/L. 700 mOsm/L.
The correct answer is B. The osmolality of an isotonic solution (one that is similar to the osmolality of the blood) is approximately 300 mOsm/L.
Regarding food-drug interactions, which food-drug combination requires client counseling? Warfarin and vitamin D-containing foods MAO inhibitors and tyramine-containing foods Prednisone and grapefruit juice Sibutramine and vitamin C-containing foods
The correct answer is B. There are no known interactions between warfarin and vitamin D foods, and prednisone and sibutramin do not interact with vitamin C foods or juices.
Where in the body is vitamin D hydroxylated to 25-hydroxyvitamin D? Kidney Liver Skin Blood
The correct answer is B. Vitamin D is considered to be devoid of direct biological activity. It must be first hydroxylated in the liver by a 25-hydroxylase, then in the kidney by a 1 alpha-hydroxylase which is responsible for the synthesis of the active metabolite 1,25-dihydroxyvitamin D.
Using the Hamwi formula, what is the ideal body weight for a female who is 70 inches tall and has a small body frame? 120 pounds 135 pounds 150 pounds 165 pounds
The correct answer is B. Women: 100 lbs for first 5 ft + 5 lb for every inch over 60 in (100 + 50 = 150). Small frame −10% (150 −15 = 135)
All of the following statements about patient-centered medical homes (PCMH) are true, EXCEPT: the cost for chronic care is reduced. electronic medical records are essential. patients are responsible for access to care. the team of providers changes as the health care needs differ.
The correct answer is C One of the biggest advantages of a PCMH is access to care, regardless of what is needed. All other statements are true about PCMH.
What daily energy intake should result in a weight loss of 2 pounds per month if one had been consuming 2,000 kcal per day? 1,500 kcal 1,650 kcal 1,750 kcal 1,850 kcal
The correct answer is C. 3,500 kcal/pound = 7,000 kcal deficiency needed for 2 pound weight loss over 4 weeks; 7,000/28 (4 weeks x 7 days/week) = 250 kcal. 2000-250 = 1750 kcal.
The best studied and most frequently recommended weight-loss dietary strategy is: a low-carbohydrate, high-protein diet. a low fat, high-protein diet. a low-fat, reduced-energy diet. a low carbohydrate, reduced-energy diet.
The correct answer is C. A low-fat, reduced-energy diet is the best studied weight-loss dietary strategy and is most frequently recommended by governing health authorities. The Academy of Nutrition and Dietetics' Evidence Analysis Library recommends with a strong, imperative rating that an individualized reduced-energy diet is the basis of dietary component of a comprehensive weight management program. Reducing dietary fat and/or carbohydrates is a practical way to create an energy deficit of 500 kcal to 1,000 kcal below estimated energy needs and should result in a weight loss of 1 - 2 pounds per week.
How many pounds are recommended for an overweight woman to gain during her pregnancy? 0 5-10 15-25 28-40
The correct answer is C. All women should gain weight during pregnancy. Recommendations for gaining 28 to 40 lb in pregnancy are applicable to underweight women. It is recommended that overweight women gain 15 to 25 lb during pregnancy.
Which type of eggs should be served to patients in a nursing home? Freshly cracked sunny-side up Over easy Pasteurized scrambled eggs Pool cracked scrambled eggs
The correct answer is C. Elderly adults in nursing homes are at high risk for foodborne illness because they have issues with their immune systems. Pasteurization is the best way to reduce the risk of pathogens in the eggs.
In order to absorb folate consumed from green, leafy vegetables, _________________. phosphate groups must be removed by the action of alkaline phosphatase glutamate must be transaminated to form alpha-ketoglutarate glutamic acid molecules must be removed glutamic acid molecules must be added
The correct answer is C. Food folate contains multiple glutamic acid molecules whereas folic acid, the folate form found in supplements, contains only one glutamic acid. These multiple glutamic acids must be hydrolyzed in order for folate to be absorbed from food sources.
Motivational interviewing is best described as a style of counseling that: challenges clients to face their issues of denial. helps clients establish contracts and follow rules. enhances intrinsic motivation and is a person-centered, directive method of counseling. identifies stages of change and guides the client toward action.
The correct answer is C. Health care professionals must be aware of this style of counseling, which represents an effective, brief intervention that has been around for more than 25 years in the field of addiction and is becoming very prominent in all realms of health care, especially nutrition and dietetics. The key to motivational interviewing is that it focuses on the client's values, beliefs, and internal motivations that guide them to action, if any.
In the ETHNIC model of culturally competent care, the "E" stands for _____. education empathy explanation expectations
The correct answer is C. In the ETHNIC model, explanation about the culture by the client is the first step.
When talking about program planning for community nutrition, what would the term "management" refer to? Controlling and providing oversight for financial resources Managing time effectively and efficiently Managing personnel and data systems Coordinating and classifying objectives
The correct answer is C. In the context of community nutrition program planning, the term "management" refers to two types of structures needed to implement the program. The personnel structure consists of employees responsible for overseeing the program and determining if it meets its objectives; the structure of the data management system is the manner in which data are recorded or analyzed.
In the Nutrition Care Process, where should the dietetics professional note the client's BMI? Food/nutrition-related history Biochemical data, medical tests and procedures Anthropometric measurements Nutrition-focused physical findings
The correct answer is C. Like weight, height, and other physical measurements, BMI is an anthropometric measurement. Biochemical data encompass laboratory values, food and nutrition history includes intake data, and nutrition-focused findings identify physical effects like poor skin turgor or sunken eyes.
The most appropriate nutrition prescription for your patient with cirrhosis includes: 0.6 g protein/kg body weight 40%-45% fat 4-6 smaller meals per day 4-6 g sodium
The correct answer is C. Malnutrition and severe weight loss are common side effects of cirrhosis; therefore, the diet should contain adequate protein and calories. The distribution of carbohydrate, fat, and protein should be similar to that recommended for normal nutrition. High levels of sodium are contraindicated if ascites is present. Individuals who experience a loss of appetite may benefit from eating small, frequent meals throughout the day if regular meals are not tolerated.
If a client exploring readiness for change rates confidence as a "4" and importance as a "10," which of the following questions/comments would lead to the most productive conversation about change? "Why aren't you more motivated?" "What can I do to help you?" "What would need to happen in order for your confidence to increase to a '6'?" "It's encouraging that the importance rating is so high."
The correct answer is C. Moving the talk about readiness for change forward is an important component in motivational interviewing. Option A is a poor question to ask as one rarely uses "why" with change talk. Option B isn't specific enough with regard to the behavior. Option D is an affirmation and probably won't move the discussion forward. Option C is the best question to ask as it invites an evocative response.
What would the nitrogen balance be for a patient with a 24-hour urinary nitrogen excretion of 14.3 grams and a protein intake of 102 grams? +16.3 grams −16.3 grams −2 grams +2 grams
The correct answer is C. Nitrogen balance is calculated as follows: Convert protein "in" to nitrogen by dividing by 6.25. (102 g6.25 = 16.3 g Nitrogen) Nitrogen in (16.3 g) − nitrogen out (14.3 g) − 4 g for insensible loss = (−) 2 gram
Which of the following is the BEST example of an "open-ended" question? A. Why would you want to follow that meal plan? B. Do you use skim milk or whole milk? C. What are some of the challenges you've faced in your weight loss journey? D. Do you feel positive or negative about your weight loss goal?
The correct answer is C. Open-ended questions typically start with "What" or "How" and invite the client to tell a story. Open-ended questions should never begin with "why," as it risks putting the client on the defensive.
The US Department of Agriculture School Meals Initiative for Healthy Children requires that the schools participating in the National School Breakfast Program provide _____ RDA for age/grade group for breakfast. 1/2 1/3 1/4 1/5
The correct answer is C. Schools participating in the USDA School Lunch Program must provide 1/3 of the RDA for certain nutrients for each age/grade group for lunch meals, whereas the USDA School Breakfast Program requires 1/4 of the RDA for certain nutrients for each age/grade group for breakfast meals.
A child who consistently plots at the 5th percentile on the weight-for-length/stature Centers for Disease Control and Prevention growth chart demonstrates a negative pattern of growth. demonstrates failure to thrive. has a thin body habitus. reflects a change in growth velocity.
The correct answer is C. Successive measurements plotted on growth charts can be used to determine whether a child is maintaining rate of growth. A change in rate of growth pattern over time can identify potential risk. Therefore, it is important to look for pattern consistency; the child is most likely small for age given the consistency in these measurements.
Which of the following fish contains a higher level of methyl mercury and therefore should be avoided during pregnancy? Salmon Pollack Swordfish Tilapia
The correct answer is C. Swordfish is a large predatory fish and therefore exposed to more mercury. The US Food and Drug Administration has specifically identified swordfish as being high in mercury.
Which of the following statements is NOT true regarding the Codex Alimentarius Commission (CAC)? The CAC is funded by the Food and Agricultural Organization of the United Nations (FAO) and the World Health Organization (WHO). The CAC develops international standards and codes to protect consumers. The United States is required by international law to abide by Codex standards. The Codex has a standard for labeling of prepackaged foods.
The correct answer is C. The United States is not required by international law to abide by Codex standards.
The city manager wants to be sure that the tool the community nutritionist is using to collect data about the use of dietary supplements has validity. In order to ensure that the instrument is valid, the nutritionist needs to choose an instrument that: has been used previously many times. contains words and phrases familiar to participants. measures accurately what it is intended to measure. yields primarily quantitative data.
The correct answer is C. The defining feature of validity is whether the instrument accurately measures what it intends to.
Which of the following two components of the Nutrition Care Process are performed in one step? Assessment and Intervention Monitoring and Diagnosis Monitoring and Evaluation Diagnosis and Intervention
The correct answer is C. The fourth step of the nutrition care process is Nutrition Monitoring & Evaluation.
Which enteral feeding access device will deliver nutrition past the ligament of Treitz? Nasogastric Nasoduodenal Percutaneous jejunostomy Percutaneous gastrostomy
The correct answer is C. The ligament of Treitz ligament marks the separation of the duodenum and jejunum. To bypass it, one would need to use percutaneous jejunostomy for feeding access.
A dietitian is working with a client to reduce blood cholesterol levels. The client is knowledgeable about a hyperlipidemia diet and is able to devise healthful meal plans, but has moderate readiness in being independent in nutrition care. To be most effective, what would be the dietitian's approach? Continue to provide dietary instructions to the client and closely monitor compliance. Help the client gain confidence through listening, advising, and coaching. Listen to the client. Encourage and support the skills the client has developed. Turn over responsibility for nutrition care to the client.
The correct answer is C. The patient is knowledgeable with moderate readiness so the dietitian needs to find out what the client knows by listening to, encouraging, and supporting the client to help him or her be fully ready to execute the diet to reduce blood cholesterol.
A registered dietitian nutritionist is working with a client to reduce blood cholesterol levels. The client is knowledgeable about a hyperlipidemia diet and is able to devise healthy meal plans, but he has moderate readiness in independently following the nutrition care plan. To be most effective in meeting the client's needs, what would be the RDN's approach? A. Continue to provide dietary instructions to the client and closely monitor compliance. B. Help the client gain confidence through listening, advising, and coaching. C. Listen to the client. Encourage and support the skills the client has developed. D. Turn over responsibility for nutrition care to the client.
The correct answer is C. The patient is knowledgeable with moderate readiness, so the RDN needs to find out what the client knows by listening to, encouraging, and supporting the client to help him be fully ready to execute the diet to reduce blood cholesterol.
A teenager with diabetes typically snacks on 40 to 45 grapes each afternoon. The registered dietitian nutritionist teaching him about carbohydrate counting could explain that his snack is equal to how many carbohydrate servings? 1 2 3 4
The correct answer is C. There are roughly 15 grapes in 1 carbohydrate serving, so 40 to 45 grapes would provide approximately 3 carbohydrate servings.
Approximately how many carbohydrate servings are 48 grapes? 1 2 3 4
The correct answer is C. There are roughly 15 grapes in 1 carbohydrate serving, so 48 grapes would provide approximately 3 carbohydrate servings.
All of the following statements are true regarding cardiovascular disease (CVD) and women, EXCEPT heart disease is the number one killer of women. the highest rates of cardiovascular morbidity and mortality occur in black women. for primary prevention, all women older than 40 should take a baby aspirin daily. specific nutrition recommendations for women include quantitative limits on the amount of sugar consumed per week.
The correct answer is C. There is no benefit for all women to take aspirin; in fact, in women younger than 65, there may be harm in anti-platelet therapy. This is not true for men, however.
A 56-year-old male client presents to the ambulatory clinic for a team visit. Physical exam reveals: Height: 5'9"; weight: 223 pounds; body mass index (BMI) 33; blood pressure: 168/96; heart rate 74. Pertinent laboratory results : hemoglobin A1c: 7.0%, thyroid-stimulating hormone (TSH): 2.0 mU/L, Medications: Metformin (Glucophage 1000 mg daily), Hydrochlorothiazide 25 mg, Lisinopril 20 mg. Review of symptoms: positive for daytime sleepiness, wife complains of loud snoring. Mood: affect appears to be good. Despite excellent adherence to DASH (Dietary Approaches to Stop Hypertension) meal plan, blood pressure continues to be elevated. What is the best explanation for his elevation in blood pressure and daytime somnolence? A. A drug/drug interaction of hydrochlorothiazide and Metformin B. Untreated thyroid disease C. Undiagnosed obstructive sleep apnea D. Untreated depression
The correct answer is C. There is no drug/drug interaction with these two medications, TSH is normal, and mood has been assessed as positive so depression can be ruled out. All symptoms point to the likely possibility of obstructive sleep apnea
In the Nutrition Care Process, statements in the format of "[Nutrition problem] related to ____ as evidenced by ____" are classified as: intake critiques. NCP links. PES statements. nutrition concerns.
The correct answer is C. These statements are written in the style of the classic PES statement.
Children on strict vegan diets may be deficient in vitamin B-6. magnesium. vitamin B-12. iron.
The correct answer is C. Vegans do not consume meat, eggs, or dairy, which are high in vitamin B-12. Children have periods of rapid growth, so careful planning is needed to prevent a vitamin B-12 deficiency. It is suggested that children on a vegan diet consume vitamin B-12 fortified foods, such as most breakfast cereal, soy beverages and plant-based meat substitutes to avoid deficiency.
A deficiency of vitamin B-12 in older adults is most likely due to diverticulosis. fat malabsorption. atrophic gastritis. gallbladder disease.
The correct answer is C. Vitamin B-12 requires hydrochloric acid in the stomach to be released from its peptide bonds. It then binds with intrinsic factor in the stomach and is absorbed in the ileum. If a person has atrophic gastritis, which increases significantly with age, there is reduced hydrochloric acid secretion. This can result in decreased bioavailability of vitamin B-12.
According to the CDC growth chart, in what percentile is a 1-year-old boy measuring 82 cm? <5% 25% 75% >95%
The correct answer is D. 82 cm (32") is tall for a 1-year-old boy, so he would be above the 95th percentile.
Which of the following individuals would be LEAST likely to be at risk for vitamin B-12 deficiency? A vegan A woman with polycystic ovarian syndrome taking metformin therapy An elderly individual on a proton pump inhibitor A man on aspirin therapy
The correct answer is D. A patient on aspirin therapy may be at risk for iron deficiency but not vitamin B-12 deficiency.
Which is the best tool for the community nutritionist to use to learn what locally grown foods residents consume most frequently? Health Risk Appraisal Screening Focus Group Survey
The correct answer is D. All options listed are methods for obtaining data. A health risk appraisal characterizes a population's general health, screening represents a preventive health activity, and, although a focus group would be plausible, it is a very expensive way of obtaining both qualitative and quantitative information. Surveys are the least expensive systematic study of a cross-section of individuals.
If the community nutritionist is concerned that the new educational activities provided for SNAP recipients have been ineffective in increasing the amount of fresh vegetables consumed, the best approach would be to conduct which type of evaluation: Efficiency Process Structure Impact
The correct answer is D. Although each answer is a form of evaluation, the only right answer would be an outcome-focused evaluation. An impact evaluation would assess whether the program's methods and activities resulted in the desired changes in the client.
The minimum amount of fiber recommended for a 10-year-old child is 8 grams. 10 grams. 12 grams. 15 grams.
The correct answer is D. Beginning at age 2, it is recommended that fiber intake be equal to or greater than a child's age plus 5 grams. So a 10-year-old would be encouraged to have 15 grams of fiber per day.
The optimal length of time to breastfeed an infant is 3 months 6 months 9 months 12 months
The correct answer is D. Breastfeeding is recommended for the first 12 months of life and for as long as is mutually desired by the mother and baby.
Which of the following types of adolescents is at greatest nutritional risk? One who drinks water rather than juice One who consumes more than three servings of fruit per day One who has irregular eating patterns One who consumes fast food three or more times per week
The correct answer is D. Consuming fast food three or more times per week is a key indicator for nutritional risk and indicates a poor-quality diet.
Cultural _____ is the ability to collect culturally relevant information from clients and perform culturally based assessments and interventions. knowledge awareness desire skill
The correct answer is D. Cultural skill is the ability to collect culturally relevant information from clients and perform culturally relevant assessments and interventions.
Dietetics students finishing supervised practice should be able to develop a virtual learning environment. use project management tools. use computer application for advanced statistical analysis. utilize an electronic health record and food and nutrition management systems and print educational materials for clients.
The correct answer is D. Entry-level practitioners need to have a general awareness of entry-level informatics skills, which include electronic health records, food and nutrition management systems, and educational print materials.
What government agency's funding supports the National School Lunch Program? Medicaid Health and Human Services CACFP USDA
The correct answer is D. Funding from the USDA supports the National School Lunch Program.
A child's weight is plotted at the 50th percentile on the growth chart. This means that the child's weight is greater than or equal to that of half the children of the same gender and ethnicity. greater than or equal to that of half the children of the same age. greater than or equal to that of half the children of the same ethnicity. greater than or equal to that of half the children of the same age and gender.
The correct answer is D. Growth charts consider the child's age and sex, not ethnicity.
The purpose of the nutrition diagnosis step in the Nutrition Care Process is to: identify the medical diagnosis of the client. plan interventions to address the nutrition problem. determine interventions, goals and expected outcomes. identify and label the nutrition problem.
The correct answer is D. Identification and labeling of the nutrition problem occur during the nutrition diagnosis step.
Data reviewed for nutrition assessment are also reviewed during the following step: monitoring and evaluation. nutrition diagnosis. goal setting. all of the above.
The correct answer is D. In the Nutrition Care Process, data reviewed for nutrition assessment are also reviewed in all other steps.
Which of the following is true of Mexican-American culture? In general, it is better to ask questions about work than about family. It is generally preferable to address elders and leaders informally. Nodding affirmatively usually means agreement. Polite, agreeable, and respectful interactions are the cornerstone of the culture.
The correct answer is D. Mexican-American culture typically is marked by polite and respectful interactions
Currently, which of the following nutrients is determined to be the most deficient among children and adolescents in the United States? Calcium Fiber Vitamin A Iron
The correct answer is D. Of all nutrients listed, iron has shown to be the most deficient in US children and adolescents.
Stacey has been asked to complete a formative evaluation of her community nutrition program designed to encourage more first-time mothers to breastfeed. To do this, she should: determine the percentage of first-time mothers who breastfeed as a result of seeing a motivational DVD during prenatal checkups. calculate the increase in the number of first-time mothers who breastfeed after viewing a motivational DVD during prenatal checkups. choose a DVD that includes young mothers from varied ethnic backgrounds. pilot-test the motivational DVD she plans to use.
The correct answer is D. Pilot testing the DVD represents formative evaluation as this is a process of testing elements of a program before it is begun.
What component of serum cholesterol do plant stanols/sterols lower? Total cholesterol High-density lipoprotein (HDL) Triglycerides Low-density lipoprotein (LDL)
The correct answer is D. Plant stanols are often used in place of statin therapy for lowering LDL, especially for those patients who are unable to tolerate statins.
Which foods should not be consumed by people with compromised immune systems? Eggs cooked to 165°F Pasteurized cider Rare steak Soft cheeses such as feta or brie
The correct answer is D. Soft cheeses contain live mold, which is not considered safe if one's immune system is compromised.
The first step in conducting a community needs assessment is to: describe the problem and state why a needs assessment is necessary. specify the data needed and design a plan for acquiring it. determine the purpose, goals, and objectives of the needs assessment. identify the target population and nutrition problem of concern.
The correct answer is D. Specifying the data needed and determining the purpose, goals, and objectives are part of the process, but the first step in conducting a community needs assessment is identifying the target population and problem of concern.
A patient with acute renal failure will have a higher need of _____ compared with a similar patient with optimal renal function? Protein Potassium Fluid Energy
The correct answer is D. Studies have shown a significant and strong negative correlation between creatinine clearance and resting metabolic rate, indicating that energy expenditure increases as kidney function declines.
The Academy of Nutrition and Dietetics takes the position that pediatric overweight intervention programs require a combination of which of the following programs: school-based multi-component programs and community-based interventions. family-based multi-component programs and environmental interventions. community-based interventions and environmental interventions. family-based and school-based multi-component programs.
The correct answer is D. The Academy's position is that family-based and multi-component programs are the most effective in reducing obesity.
Which one of the following foods should be avoided in treatment of gout? Low-fat yogurt Rye bread Banana Regular soft drinks
The correct answer is D. The American College of Rheumatology Guidelines for the Management of Gout state that these patients should avoid high-fructose corn syrup, which is found in regular soft drinks. Low-fat dairy products, fruits and vegetables, and whole grains are recommended.
In order to ensure quality and consistency, this agency established standards of identity for common food products. Federal Trade Commission (FTC) Centers for Disease Control and Prevention (CDC) US Department of Agriculture (USDA) Food and Drug Administration (FDA)
The correct answer is D. The FDA established standards of identity for common food products to ensure quality and consistency.
All of the following statements about the intensive behavioral therapy (IBT) benefit for obese Medicare Part B beneficiaries are true, EXCEPT: coverage for the benefit is granted only in the primary care setting. in order to qualify, the beneficiary's BMI must be >30. Continued treatment for obesity is contingent on weight loss assessed at the seventh month of treatment. RDNs may provide the service and bill Medicare using a unique physician identification number.
The correct answer is D. The IBT bill is very clear that the benefit can only be provided by a physician (as of April 2013). It is true that qualifications are specific about BMI and the appropriate setting for receiving this benefit and treatment length is contingent on progress.
Which of the following foods would you suggest limiting if your patient has diarrhea? Oatmeal Potatoes Banana Coffee
The correct answer is D. The caffeine found in coffee can irritate the digestive system and worsen diarrhea that already is present.
Which of the following examples of a snack provided at a child care center would meet reimbursement guidelines and comply with USDA regulations for Child and Adult Care Food Program meals? Hard boiled egg and water Chocolate milk and grapes Apple slices and orange wedges Whole grain crackers and peanut butter
The correct answer is D. The nutritional requirement for snacks is that they must provide a combination of at least two food items from the meat, milk, grains, and fruit/vegetable categories. The foods listed in choice D represent the only answer where two different groups were combined.
Which category of oral hyperglycemic medication would NOT be appropriate for a client with congestive heart failure? Sulfonylureas Biguanides Meglitinides Thiazolidinediones
The correct answer is D. Thiazolidinediones can worsen congestive heart failure by promoting weight gain/edema.
Which one of the following statements is INCORRECT regarding the concept of weight bias? Weight bias is more prevalent among registered dietitian nutritionists than mental health workers. Weight bias is more common than sexual orientation bias. Weight bias is comparable to racial discrimination. Weight bias does not exist among registered dietitian nutritionists who often work with obese clients.
The correct answer is D. Weight bias exists in clinical settings and research from the Yale University Rudd Center for Food Policy and Obesity demonstrates that it is more common among registered dietitian nutritionists than mental health professionals. It is noteworthy that even RDNs who work with obese clients have weight bias and may not know it.
