RDN Exam Practice Questions

Dry food should be stored between: A. 40°F to 60°F. B. 32°F to 52°F. C. 50°F to 70°F. D. 65°F to 85°F.

The correct answer is C. Storage temperatures over 70°F may shorten the shelf life and temperatures less than 50°F are not needed since the dry foods are not potentially hazardous. National Restaurant Association Education Foundation.ServSafe Coursebook. 6th ed. Chicago: NRA; 2012.

Which agency would regulate the manufacture of canned chicken breast? A. Food Safety and Inspection Service (FSIS) B. Food and Drug Administration (FDA) C. US Department of Agriculture (USDA) D. US Public Health Service (USPHS)

The correct answer is A. The FSIS is responsible for the inspection of canned products that contain at least 2% cooked meat or poultry. Brown AC. Understanding Food: Principles and Preparation. 5th ed. Boston, MA: Cengage; 2014.

Which of the following foods is the best source of omega-3 fatty acids? A. Olive oil B. Shrimp C. Avocado D. Sardines

Solution: The correct answer is D. Sources of omega-3 fatty acids include fatty fish, such as salmon, tuna, and halibut; some plants; and nut oils. Whitney EN, Rolfes S. Understanding Nutrition. 13th ed. Boston, MA: Cengage; 2012.

In the Campinha-Bacote Model, cultural competence originates in the _____. A. individual B. family C. community D. society

The correct answer is A. According to the Campinha-Bacote model, culture competence originates in the individual. Goody CM, Drago L, eds. Cultural Food Practices. Chicago: ADA; 2010: xiv-xvii.

A food provides 28 grams of carbohydrates, 8 grams of protein, and 7 grams of fat. What percent of this food's calories comes from fat? A. 30% B. 33% C. 36% D. 38%

The correct answer is A. (28 g carbohydrate x 4 kcal/g) + (8 g protein x 4 kcal/g) + (7 g fat x 9 cal/g) = 112 kcal from carbohydrate + 32 kcal from protein + 63 kcal from fat = 207 total kcal 63 kcal from fat ÷ 207 total kcal = 0.30 or 30% of the energy from fat Whitney EN, Rolfes S. Understanding Nutrition. 13th ed. Boston, MA: Cengage; 2012.

According to the Uniform Requirements for Manuscripts Submitted to Biomedical Journals, to be designated as an author, one must have made substantial contributions to A. design or analysis and interpretation of the data. B. selection and assignment of the subjects. C. acquisition of funding and administration of the department. D. general supervision of the research group.

The correct answer is A. A designated author should be involved in all aspects of the research from the design of the study to the interpretation of the data (results). Monsen ER. Research: Successful Approaches. 3rd ed. Chicago: ADA; 2008:35.

What is the purpose of a roux? A. To thicken liquids like soups, sauces, and gravies B. To thin out cooking pastes before adding them to a recipe C. To preserve fruits that continue to ripen after they are picked To reduce the bitter taste in high-tannin foods

The correct answer is A. A roux is a cooked mixture that typically contains flour and fat (such as butter or milk) and is used to thicken liquids like soup, sauce, gravy, and gumbo. Edelstein S. Food Science: An Ecological Approach. 2nd ed. Burlington, MA: Jones & Bartlett; 2018.

How many kilocalories per ounce does a standard infant formula provide? A. 20 B. 22 C. 25 D. 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. American Academy of Pediatrics. Pediatric Nutrition Handbook. 7th ed. Elk Grove Village, IL: American Academy of Pediatrics; 2013.

Which of the following accurately describes how alcohol is digested and absorbed? A. Alcohol requires no digestion and is absorbed by simple diffusion. B. Alcohol is digested in the stomach and absorbed primarily from the small intestine. C. Alcohol is digested in and absorbed primarily from the stomach. D. Alcohol requires no digestion and is absorbed by active transport.

The correct answer is A. Alcohol requires no digestion once in the body; it enters the bloodstream immediately through the stomach or small intestine lining. Simple diffusion is a process whereby a substance passes through a membrane without the aid of an intermediary such as an integral membrane protein. Carbon dioxide, oxygen, and ethanol are hydrophobic and pass through the membrane. McGuire M, Beerman KA. Nutritional Sciences: From Fundamentals to Food. 3rd ed. Boston, MA: Cengage; 2012.

Upon quarterly audit, the accountant found an error: The beginning inventory for the month of January was overstated. How would this affect the cost of goods sold (COGS) and net income for the month of January? A. The COGS for January would be more than it actually was, and the net income would be less than it actually was. B. The COGS for January would be less than it actually was, and the net income would be less than it actually was. C. The COGS for January would be more than it actually was, and the net income would be more than it actually was. D. The COGS for January would not be affected, and the net income for February would be less than it actually was.

The correct answer is A. Beginning inventory serves as the basis for calculations of cost of goods purchased to meet production needs, the resulting cost of goods sold, and, consequently, the net income of the facility. Beginning with an overstated figure will appear as if the cost of goods sold was higher (adding the higher beginning inventory figure to the actual purchases made to meet production needs). This will also result in the appearance that it cost more to produce what was sold and therefore net income was lower. Weygant, JJ, Kieso, DE, Kimmel, PD, DeFranco, AL. Hospitality Financial Accounting. 2nd ed. Hoboken, NJ: Wiley; 2009.

Using the following figures, calculate the break-even point for The Green Café: Fixed costs = $52,000; variable costs = $85,000; total sales = $210,000. A. $86,666.66 B. $113,333.33 C. $130,000.00 D. $473,000.00

The correct answer is A. Break-even point in sales = Fixed costs/Contribution margin ratio Contribution margin ratio = Contribution margin/Total sales Contribution margin = Total sales - Variable costs To figure out the break-even point in this question: 1. Determine contribution margin $210,000- $85,000= $125,000 2. Determine contribution ratio $125,000/$210,000=.595 Round this figure to .60 3. Determine break-even point $52,000/.60=$86,666.66 Gregoire MB, Spears MC. Foodservice Organizations: A Managerial and Systems Approach. 9th ed. Upper Saddle River, NJ: Pearson; 2016.

Which is an example of chemical contamination? A. Acidic action of foods with metal-lined containers B. Metal curls from a worn-out can opener that fell into the food when the can is being opened C. Development of an off-flavor due to uncontrolled enzyme reaction D. Anisakis contamination from fish

The correct answer is A. Chemical contamination occurs in preserved foods, especially high-acid canned foods like fruit juice, sauerkraut, tomatoes, and lemonade, that are stored in metal-lined containers. Chemical contamination is usually the result of interaction between the contents and an imperfect container. There may be gas produced or discoloration of the tin and can result in metal poisonings. Gregoire MB, Spears MC. Foodservice Organizations: A Managerial and Systems Approach. 9th ed. Upper Saddle River, NJ: Pearson; 2016.

Another name for irradiation is _____. A. cold pasteurization B. ohmic heating C. gamma bombarding D. pulsed light

The correct answer is A. Cold pasteurization is also known as irradiation or irradiation pasteurization. Brown AC. Understanding Food: Principles and Preparation. 5th ed. Boston, MA: Cengage; 2014.

When using the plan-do-study-act (PDSA) process, which of the following occurs during the plan phase? A. Determine how to collect data B. Train staff on new process C. Evaluate the effectiveness of the project D. Reduce wait time for appointments

The correct answer is A. Determination of data collection methods occurs during the planning phase. Staff training and evaluation of effectiveness occur after a project has been implemented. Reduction of appointment waiting times would be an example of a quality improvement project goal. Joint Commission Resources. Cost-Effective Performance Improvement in Hospitals. Oakbrook Terrace, IL: JCAHO; 2005:94.

When comparing 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: A. change in rate of growth. B. continuation on his or her line of growth. C. growth spurt. D. 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. Charney P, Malone A. Academy of Nutrition and Dietetics Pocket Guide to Pediatric Nutrition Assessment. 3rd ed. Chicago: IL: Academy of Nutrition and Dietetics; 2015.

At what levels do leptin and ghrelin promote excess food intake? A. Low leptin, high ghrelin B. High leptin, low ghrelin C. Low leptin, low ghrelin D. High leptin, high ghrelin

The correct answer is A. Low leptin and high ghrelin promote excess food intake. Klok MD, Jakobsdottir, Drent ML. The role of leptin and ghrelin in the regulation of food intake and body weight in humans: A review. Obes Rev. 2007;1:21-34.

What population experiences the most serious consequences of foodborne illness? A. Immunocompromised individuals B. Teenagers C. Women of childbearing age D. Children in daycare settings

The correct answer is A. People with compromised immune systems, the body's defense system against illnesses, are at a higher risk for consequences from foodborne illness. Academy of Nutrition and Dietetics. Position of the Academy of Nutrition and Dietetics: food and water safety. J Acad Nutr Diet. 2014;114(11):1819-1829.

Which food processing method has been linked to cancer in laboratory animals? A. Smoke curing B. Pickling C. Freeze-drying D. Irradiation

The correct answer is A. Several studies link high consumption of smoked foods with an increased risk of some cancers. Brown AC. Understanding Food: Principles and Preparation. 5th ed. Boston, MA: Cengage; 2014.

Which federal agency is charged with tracking outbreaks of foodborne illness? A. CDC (Centers for Disease Control and Prevention) B. Federal Trade Commission (FTC) C. USDA (US Department of Agriculture) D. WHO (World Health Organization)

The correct answer is A. The CDC tracks foodborne illnesses, whereas the other entities monitor other health-related issues. Brown AC. Understanding Food: Principles and Preparation. 5th ed. Boston, MA: Cengage; 2014.

The Food Safety Modernization Act (FSMA) enables the Food and Drug Administration (FDA) to better protect public health because it allows FDA to now focus more on A. preventing food safety problems. B. inspecting food production systems. C. scrutinizing the importation of food. D. ordering prompt recalls of tainted foods and beverages.

The correct answer is A. The Food Safety Modernization Act (FSMA), signed into law by President Obama on January 4, 2011, enables the Food and Drug Administration (FDA) to better protect public health by strengthening the food safety system. It allows FDA to focus more on preventing food safety problems, rather than reacting to problems after they occur. US Food and Drug Administration. FDA Food Safety Modernization Act (FSMA) Page Last Updated March 23, 2015. Available at: http://www.fda.gov/Food/GuidanceRegulation/FSMA/default.htm. Accessed December 8, 2016.

The Standards of Professional Performance for dietetics practitioners includes which of the following? A. Professional accountability B. Nutritional intervention C. Nutrition monitoring and evaluation D. Nutrition diagnosis

The correct answer is A. The Standards of Professional Performance refer to actions and accountability of the dietetic practitioner. The SOPP are not a part of the Nutrition Care Process; rather, they are focused on the behavior and competence of the practitioner. Nutrition diagnosis, monitoring and evaluation, and nutrition intervention refer to steps in the Nutrition Care Process. The Academy Quality Management Committee and Scope of Practice Subcommittee of the Quality Management Committee. Academy of Nutrition and Dietetics Revised 2012 Standards of Practice and Standards of Professional Performance for Registered Dietitians. J Acad Nutr Diet. 2013;113(6):S29-S45.

Which of the following is a characteristic typically associated with the discussion method of teaching? A. Helps learners master higher-level cognitive objectives B. Appeals to several of the learner's senses simultaneously C. Works well for accomplishing objectives in the psychomotor domain D. Provides the instructor with more control of the teaching-learning situation than most other methods

The correct answer is A. The cognitive domain involves knowledge and the development of intellectual skills. This includes the recall or recognition of specific facts, procedural patterns, and concepts that serve in the development of intellectual abilities and skills. Holli BB, Williams AB. Communication & Education Skills for Dietetics Professionals. 5th ed. Baltimore, MD: Williams & Wilkins; 2008:262-264.

The observed result or outcome of interest in a research project is the A. dependent variable. B. independent variable. C. population variable. D. individual variable.

The correct answer is A. The dependent variable indicates changes, if any, that are a result of the research. It is the measurable outcome indicator. Monsen ER. Research: Successful Approaches. 3rd ed. Chicago: ADA; 2008:11.

Which grouping of established USDA standards contains the correct relationship? A. Round inspection stamp, wholesomeness, mandatory process B. Grade shield, quality, mandatory process C. Round inspection stamp, quality, voluntary process D. Grade shield, wholesomeness, voluntary process

The correct answer is A. The round federal inspection stamp on meat and poultry means that the food has been inspected for wholesomeness, which is mandatory. The grade shield on meat and poultry provides information about the quality of the product. Grading is voluntary. Gregoire MB, Spears MC. Foodservice Organizations: A Managerial and Systems Approach. 9th ed. Upper Saddle River, NJ: Pearson; 2016.

Which flavor enhancer from seaweed might be included in a recipe to provide "umami"? A. Monosodium glutamate B. Magnesium sulfate C. Carrageenan D. Calcium alginate

The correct answer is A. Umami is a savory taste that is enhanced by the addition of monosodium glutamate, which has no distinct flavor of its own. Brown AC. Understanding Food: Principles and Preparation. 5th ed. Boston, MA: Cengage; 2014.

Which nutrients are most susceptible to loss in foods? A. Water-soluble vitamins B. Fat-soluble vitamins C. Carbohydrates D. Proteins

The correct answer is A. Water-soluble vitamins are the most susceptible to loss from foods because they migrate from the food to the cooking liquid. Brown AC. Understanding Food: Principles and Preparation. 5th ed. Boston, MA: Cengage; 2014.

What are transitional foods? A. Foods that do not freeze well B. Foods that change texture in the mouth C. Foods prescribed once enteral nutrition is discontinued D. Foods prescribed in the final diet progression stage after bariatric surgery

The correct answer is B. "Transitional foods" are substances that change quickly to become easier to chew or swallow with added moisture (eg, water or saliva) or a change in temperature. Frozen desserts such as ice cream, sherbet, malts, frozen yogurt and some potato chips are considered transitional foods. Reference: International Dysphagia Diet Standardisation Initiative. What are transitional foods? Accessed September 22, 2019.

The chef needs to make 175 chicken salad sandwiches. Each sandwich requires 3 oz of cooked chicken. A cooked 7 lb oven roaster yields an average of 4 lbs of cooked meat. How many roasters must the chef purchase to yield enough chicken for the salad? A. 8 B. 9 C. 4 D. 5

The correct answer is B. 4/7= 57% (yield %) 175 sandwiches x 3 oz = 525 oz/16 = 32.81 lbs or 33 lbs 33 lbs/0.57 = 57.89 total weight (round up to 58) 58/7 = 8.28, so 9 oven roasters are needed Gregoire MB, Spears MC. Foodservice Organizations: A Managerial and Systems Approach. 9th ed. Upper Saddle River, NJ: Pearson; 2016.

What name is given to the chronological sequence of activities to carry out organizational behavior? A. Policy B. Procedure C. Method D. Rule

The correct answer is B. A procedure shows chronological sequence of activities. A policy is a general guide to organizational behavior developed by top-level management. A method is even more detailed than a procedure and is related to only one step of a procedure. Rules specify action by stating what must or must not be done. Gregoire MB, Spears MC. Foodservice Organizations: A Managerial and Systems Approach. 9th ed. Upper Saddle River, NJ: Pearson; 2016.

Freezing is both a simple and successful method of food preservation. To ensure high quality results, it is recommended to keep salt content of prepared foods to a minimum. The reason for this is _____. A. freezing intensifies flavor and the food will taste saltier when reheated B. salt accelerates rancidity of fats within the food C. salt increase the risk for microbial growth when foods are thawed D. salt accelerates the freezing process and reduces the shelf life of the food

The correct answer is B. Adding salt to foods being frozen causes loss of flavor and has the tendency to increase rancidity of any item containing fat. National Center for Home Food Preservation. General Freezing Information. Available at: http://nchfp.uga.edu/how/freeze/dont_freeze_foods.html. Accessed December 17, 2016.

The astringent taste of fruits and vegetables is the result of the following component: A. Anthocyanin B. Tannin C. Carotene D. Monosodium glutamate

The correct answer is B. Because of its property of naturally occurring in plants, tannin causes the astringent taste in fruits and vegetables. The other options listed provide other properties to foods, such as color and intense enhancement of taste. Vidal S, Francis L, Noble A, Kwiatkowski M. Taste and mouthfeel properties of different types of tannin-like polyphenolic compounds and anthocyanins in wine. Anal Chim Acta

Relationship-building skills include a task referred to as "legitimation." Which of the following phrases is the best example of a "legitimation statement"? A. "I'm looking forward to working together to resolve this concern." B. "Your anger is understandable. Most people would feel angry if they experienced what you did." C. "I really admire you for being able to lose weight while maintaining such a hectic work schedule." D. "I don't think that I would have been as understanding as you are if I had experienced what you have had happen in your life."

The correct answer is B. By acknowledging that there was a reason for the behavior, it indicates the response from the client was legitimate. Boyle MA, Holben DH. Community Nutrition in Action: An Entrepreneurial Approach. 6th ed. Boston, MA: Cengage; 2012.

In order to prevent deterioration by slowing respiration, ____________________ would be stored in modified-atmosphere packaging. A. bottled water B. apple slices C. ground turkey D. orange juice

The correct answer is B. By modifying the atmosphere in which the food is packaged, spoilage is markedly reduced and the shelf life of the product is increased. Sliced apples are packaged this way to reduce spoilage and oxidation. Specifically, the type and proportion of gas used in the packaging is largely dictated by the type of food in the package and the sort of decay or change that the food undergoes. To package a product in a modified atmosphere requires sophisticated machinery to flush out air from the packaging chamber and replace it with a different gas or precisely defined mixture of gases, then seal the product in the packaging so that only the modified atmosphere and not any other unwanted gas surrounds the product. Brown AC. Understanding Food: Principles and Preparation. 5th ed. Boston, MA: Cengage; 2014.

Which quick-freezing process incorporates very low temperatures with liquid nitrogen or carbon dioxide? A. Air blast freezing B. Cryogenic freezing C. Plate or contact freezing D. Immersion freezing

The correct answer is B. Cryogenic freezing requires very low temperatures. Typically, cryogenic freezing relies on the use of liquefied gases such as nitrogen or carbon dioxide. These gases can only exist in a liquid state at extremely cold temperatures, which means that once the gas is in liquid form, it can be used to generate freezing temperatures. James SJ, James C. Chilling and freezing of foods. In: Clark S, Jung S, Lamsal B, eds. Food Processing: Principles and Applications. 2nd ed. Hoboken, NJ: Wiley Blackwell; 2014. Available at: pdfs.semanticscholar.org/01d3/7868d451dfe0e8ed1e0b65eb5df08fbecdd5.pdf. Accessed July 31, 2019.

To lower LDL cholesterol, the Academy's Evidence Analysis Library recommends which level of daily plant sterol consumption? A. 1-2 g/day B. 2-3 g/day C. 4-5 g/day D. 6-7 g/day

The correct answer is B. EAL (2008) recommends 2 g to 3 g plant sterol daily to reduce total cholesterol by 4% to 11% and LDL concentration by 7% to 15%. Academy of Nutrition and Dietetics Evidence Analysis Library. Available at: https://www.andeal.org/topic.cfm?cat=1574&evidence_summary_id=71&highlight=plant%20sterols&home=1. (Login required.) Accessed December 25, 2016.

What is the upper limit of fat, in grams, that should be consumed by a healthy person requiring 2,500 kcal per day? A. 875 B. 97 C. 218 D. 71

The correct answer is B. Fat should be 35% or less of energy. 2500 kcal x 0.35 = 875 kcal from fat; 875 kcal from fat ÷ 9 kcal/g fat = 97 g fat Whitney EN, Rolfes S. Understanding Nutrition. 13th ed. Boston, MA: Cengage; 2012.

The practices and attitudes that influence an individual's food choices are known as A. food preferences. B. food habits. C. food satisfaction. D. food connection.

The correct answer is B. Food habits are the practices and associated attitudes that predetermine what and when a person will eat. Food preferences are the foods a person likes to eat and food satisfaction measures the level of eating enjoyment of an individual. Gregoire MB, Spears MC. Foodservice Organizations: A Managerial and Systems Approach. 9th ed. Upper Saddle River, NJ: Pearson; 2016.

Which of the following gastrointestinal hormones has the effect of increasing the consumption of food? A. Cholecystokinin B. Ghrelin C. Enterostatin D. 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. McGuire M, Beerman KA. Nutritional Sciences: From Fundamentals to Food. 3rd ed. Boston, MA: Cengage; 2012.

Glycogenolysis is the breakdown of glycogen into glucose that occurs in the cells of the _____. A. stomach and small intestine B. liver and muscle C. kidney and brain small intestine and kidney

The correct answer is B. Glycogenolysis is the process by which glycogen, the primary carbohydrate stored in the liver and muscle cells of animals, is broken down into glucose to provide immediate energy and to maintain blood glucose levels during fasting. Glycogenolysis occurs primarily in the liver. McGuire M, Beerman KA. Nutritional Sciences: From Fundamentals to Food. 3rd ed. Boston, MA: Cengage; 2012

Of the following, which is the type of skill that must develop within and be nurtured in both the personal and professional life of a manager? A. Hard B. Soft C. Networking D. Communication

The correct answer is B. Hard skills can be taught. Soft skills must develop and be nurtured within our personal and professional lives. Gould RA, Canter DD. Management matters. J Am Diet Assoc. 2008;108(11):1834-1836.

Which of the following nutrients is required to be included as a Percent Daily Value on food labels? A. Vitamin A B. Potassium C. Vitamin C D. Iodine

The correct answer is B. Percent Daily Value on food labels is required for total fat, saturated fat, trans fat, cholesterol, sodium, total carbohydrate, total sugar, added sugars, dietary fiber, protein, vitamin D, potassium, calcium, and iron. US Food and Drug Administration. Changes to the Nutrition Facts Label. Updated February 2019. Available at: https://www.fda.gov/food/guidanceregulation/guidancedocumentsregulatoryinformation/labelingnutrition/ucm385663.htm. Accessed April 22, 2019

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? A. Reduce among residents the severity of chronic diseases such as diabetes and heart disease. B. Promote, across every stage of life, healthy behaviors that positively affect the nutritional status of residents. C. Improve the nutrition of residents by eliminating disparities in treatment plans. D. 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.) Boyle MA, Holben DH. Community Nutrition in Action: An Entrepreneurial Approach. 6th ed. Boston, MA: Cengage; 2012.

In a community needs assessment, which of the following is an example of an environmental change? A. The implementation of a national food program in schools B. The addition of healthy food options in a cafeteria C. The enactment of an additional tax on soft drinks The requirement that all fast-food menus include nutritional information

The correct answer is B. In community needs assessment, policy change comprises laws, regulations, rules, protocols, and procedures that are designed to guide and influence behavior. Environmental change concentrates on physical, social, and economic factors that influence individuals' practices and behaviors. Centers for Disease Control and Prevention. Community Needs Assessment Community Handbook. 2013. Accessed February 2, 2020. Available at:https://www.cdc.gov/globalhealth/healthprotection/fetp/training_modules/15/community-needs_pw_final_9252013.pdf

Oxidative rancidity occurs in foods that have a A. high saturated fatty acid content. B. high unsaturated fatty acid content. C. high protein content. D. high moisture content.

The correct answer is B. In oxidative rancidity, the double bonds of an unsaturated fatty acid can undergo cleavage, releasing volatile aldehydes and ketones. This process can be suppressed by the exclusion of oxygen or by the addition of antioxidants. Oxidation primarily occurs with unsaturated fats. McWilliams M. Foods: Experimental Perspectives. 8th ed. New York City, NY: Pearson; 2016.

What does the O in the FOCUS-PDCA performance improvement model represent? A. Identify a process to improve B. Develop a team C. Explain the current process D. Recognize sources of variation

The correct answer is B. In the FOCUS-PDCA model for performance improvement, O represents organizing a team. F = Find an improvement area O = Organize a team C = Clarify current practices U = Understand source of variation/problem S = Select a strategy PDCA = Plan Do Check Act SAMHSA HRSA Center for Integrated Health Solutions. FOCUS PCDA. September 2017.

Which of the following has been listed as an essential element in the provision of culturally competent community nutrition programming? A. Standardizing service delivery on the basis of an understanding of cultural diversity B. Having institutionalized cultural knowledge C. Minimizing the unplanned interactions of people from different cultures D. Having the capacity to avoid self-assessing the cultural diversity of others

The correct answer is B. Infusing cultural competence at every level includes providing competent community nutrition programs and involves having institutionalized cultural knowledge. Standardizing delivery of service, avoiding self-assessment, and minimizing interactions may be exclusive to some groups and do not contribute to being culturally competent. These are more likely to overlook some cultural differences that may exist in a diverse community population. Boyle MA, Holben DH. Community Nutrition in Action: An Entrepreneurial Approach. 6th ed. Boston, MA: Cengage; 2012.

Which of the following statements best defines the USDA quality grading system? A. All meat and poultry must meet strict quality standards to be sold in the US marketplace. B. Quality grading of meat and poultry is a voluntary process. C. Quality grading and inspection for wholesomeness are both mandatory for meat to enter into the marketplace. D. Quality grading is a free service provided by the USDA.

The correct answer is B. Inspection for wholesomeness is mandatory and is paid for with public funds. Grading for quality is voluntary, and the service is requested and paid for by meat and poultry producers/processors. US Department of Agriculture. Production and Inspection: Inspection & Grading of Meat and Poultry: What Are the Differences? Updated June 3, 2014. Available at: https://www.fsis.usda.gov/wps/portal/fsis/topics/food-safety-education/get-answers/food-safety-fact-sheets/production-and-inspection/inspection-and-grading-of-meat-and-poultry-what-are-the-differences_/inspection-and-grading-differences. Accessed December 7, 2016.

Home canning is a very popular method of food preservation. To ensure safe foods, appropriate canning methods must be used. Which of the following is the safe and recommended method for canning foods above pH 4.5? A. Boiling water canning B. Pressure canning C. Steam canning D. Oven method canning

The correct answer is B. McWilliams M. Foods: Experimental Perspectives. 8th ed. New York City, NY: Pearson; 2016. Foods that are low acid (pH of 4.6 or higher) include vegetables, meats, dried beans, and all soups. These will need to be preserved using a pressure canner. High acid foods contain enough acid to have a pH level of 4.6 or lower. These will need to be preserved using a water bath canner.

A recipe requires 1¾ cup quick-cooking tapioca. Tapioca is purchased in twelve 8-oz boxes in a case and costs $41.88 per case. Three cups of quick-cooking tapioca weighs 1 lb. What is the recipe cost for tapioca? A. $2.33 B. $4.07 C. $5.24 D. $6.98

The correct answer is B. One case of tapioca contains 12 8 oz boxes for a total of 6 lb (12 boxes x 0.5 lb = 6 lb). To calculate the price per pound, divide the total cost of the case $41.88 by 6 lb to get $6.98 per lb. Then you will find the price per cup knowing that 3 cups of tapioca weighs 1 lb. To get the price per cup, divide $6.98 by 3 cups to get $2.33 per cup. Finally, to get the price for 1¾ cups, multiply $2.33 per cup by 1.75 to get $4.07. Gregoire MB, Spears MC. Foodservice Organizations: A Managerial and Systems Approach. 9th ed. Upper Saddle River, NJ: Pearson; 2016.

The body mass index range for class I obesity is _______. A. 25-29.9 B. 30-34.9 C. 35-39.9 D. ≥40

The correct answer is B. Overweight BMI is 25.0-29.9. Obesity (class 1) BMI is 30.0-34.9. Class 2 obesity is marked by a BMI of 35.0-39.9. Class 3 obesity, classified as extreme or severe obesity, is marked by a BMI of 40.0-49.9. Centers for Disease Control and Prevention. Defining Adult Overweight and Obesity. Available at: https://www.cdc.gov/obesity/adult/defining.html. Accessed December 26, 2016.

Which of the following is an example of a positive correlation? A. "The amount of weight gained by pregnant women during the first trimester has been found to decrease as the number of episodes of nausea and vomiting increase." B. "The incidence of type 2 diabetes mellitus increases as central adiposity increases." C. "Consuming calories in excess of those needed results in generalized adiposity." D. "Blood pressure in certain genetic groups appears to decrease as the consumption of dietary sodium is reduced."

The correct answer is B. Positive, or direct, correlation is a statistical relation between two or more variables such that systematic changes in the value of one variable are accompanied by systematic changes in the other. In other words, two or more variables change in the same direction (increase or decrease) simultaneously. McGuire M, Beerman KA. Nutritional Sciences: From Fundamentals to Food. 3rd ed. Boston, MA: Cengage; 2012.

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? A. Educate the patient about low carbohydrate foods to minimize glucose elevations. B. Contact the referring physician to consider insulin therapy. C. 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 Franz MJ, Powers MA, Leontos C, Holzmeister LA, Kulkarni K, Monk A, Wedel N, Gradwell E. The evidence for medical nutrition therapy for type 1 and type 2 diabetes in adults. J. Am Diet Assoc. 2010; 110:1852-89.

The Standards of Professional _____ for dietetics professionals describes in general terms a competent level of behavior in the professional role. A. Practice B. Performance C. Preparation D. Proficiency

The correct answer is B. The Standards of Professional Performance describe competency levels of professional behavior by an individual. They specifically describe the performance of dietetics practitioners The Academy Quality Management Committee and Scope of Practice Subcommittee of the Quality Management Committee. Academy of Nutrition and Dietetics Revised 2012 Standards of Practice and Standards of Professional Performance for Registered Dietitians. J Acad Nutr Diet. 2013;113(6):S29-S45.

Which of these individuals is most likely to present with Wernicke-Korsakoff syndrome? A. A premature infant B. An alcoholic man C. A postmenopausal woman D. A disabled child

The correct answer is B. The abuse of alcohol often leads to a severe form of thiamin deficiency known as Wernicke-Korsakoff syndrome. Whitney EN, Rolfes S. Understanding Nutrition. 13th ed. Boston, MA: Cengage; 2012.

In the receiving process, what step should be taken first? A. Send items to storage. B. Compare the purchase order and invoice. C. Reject the items. D. Inspect items against the invoice.

The correct answer is B. The first step for receiving is comparing the purchase order to the invoice to make sure the products accepted were, in fact, ordered. The next step is to inspect items against the invoice, accept or reject items, complete receiving records, and then put products into storage. Gregoire MB, Spears MC. Foodservice Organizations: A Managerial and Systems Approach. 9th ed. Upper Saddle River, NJ: Pearson; 2016.

Which of the following lunch menus reflect proper menu planning principles? A. Steamed haddock, rice, roasted cauliflower, vanilla frozen yogurt with fresh pineapple B. Baked pork chop, sautéed broccoli, rice pilaf, vanilla frozen yogurt with strawberries C. Grilled chicken breast, mashed potatoes, steamed parsnips, lemon sorbet D. Meatballs, tiny whole potatoes, brussels sprouts, fresh bing cherries

The correct answer is B. The meal in option "B" (baked pork chop, sauteed broccoli, rice pilaf, vanilla frozen yogurt with strawberries) shows the best use of color in a lunch meal, as well as a variety of flavors, textures, consistency, and food shapes that are balanced. The meal is very colorful and the foods complement each other and employ a variety of cooking methods. The meals in options "A" and "C" are mostly white in color and not as visually appealing. The meal in option "D" has color but all the foods have the same shape (round). Gregoire MB, Spears MC. Foodservice Organizations: A Managerial and Systems Approach. 9th ed. Upper Saddle River, NJ: Pearson; 2016.

One of the key differences in value analysis and value added is A. value analysis strives to reduce costs whereas value added strives to bundle components. B. value analysis seeks to reduce costs whereas value added seeks to increase market value. C. value analysis seeks to reduce costs whereas value added seeks to add a quality component. D. value analysis seeks to change the value of the product whereas value added seeks to reduce costs.

The correct answer is B. Whereas value analysis focuses on lowering costs, value added looks for ways to increase the value of a product or service to the consumer. Gregoire MB, Spears MC. Foodservice Organizations: A Managerial and Systems Approach. 9th ed. Upper Saddle River, NJ: Pearson; 2016.

All of the following statements about patient-centered medical homes (PCMH) are true, EXCEPT: A. the cost for chronic care is reduced. B. electronic medical records are essential. C. patients are responsible for access to care. D. 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. Sauter C. The role of the registered dietitian, diabetes educators on the patient-centered medical home. On the cutting edge. Diabetes Care Educ. 2012;33(2): 26-28.

Which of the following is an anaerobic bacteria that poses a threat to the safety of home-canned foods? A. Staphylococcus aureus B. Saccharomyces C. Clostridium botulinum D. Aspergillus flavus

The correct answer is C. Clostridium botulinum is an anaerobic bacteria that produces spores that will release a deadly toxin if held in non-acidic anaerobic conditions for long periods of time. The other bacteria listed are aerobic and are not likely to survive the anaerobic conditions of vacuum-sealed canned foods. Saccharomyces is a genus of yeast. McWilliams M. Foods: Experimental Perspectives. 8th ed. New York City, NY: Pearson; 2016.

Choose the statement that best describes the function of copper. A. It is involved in taste perception. B. It is a component of the thyroid hormone. C. It is necessary for the formation of hemoglobin. D. It enhances insulin activity.

The correct answer is C. Copper helps the body make hemoglobin; serves as a part of many body enzymes; helps the body develop connective tissue, myelin, and melanin; and helps the body produce energy in the cells. Whitney EN, Rolfes S. Understanding Nutrition. 13th ed. Boston, MA: Cengage; 2012.

A facility director is charged with evaluating whether it is worthwhile to complete a project. The best approach would be to A. conduct a productivity study. B. determine the startup funds needed. C. conduct a cost-to-benefit analysis. D. determine the number of people involved.

The correct answer is C. Cost-benefit analysis (CBA) estimates and totals the monetary value of the benefits expected to be derived from a project and compares those to the costs of the project to determine whether the planned project is worthwhile financially. For example, if the costs of remodeling a foodservice kitchen is $3.4 million and the expected revenue generated after the renovation is $2.7 million, then the renovation would be judged as not being a good investment. A cost-benefit analysis would include all the other options listed as parts of the determination of project profitability. Hess MA. Review of Dietetics 2014-2016. Chicago, IL: Hess & Hunt Inc; 2014.

Which of the following is the recommended maximum amount of caffeine for healthy children aged 5 to 12? A. 5.5 mg/kg B. 3.5 mg/kg C. 2.5 mg/kg D. 1.5 mg/kg

The correct answer is C. Daily caffeine consumption should not exceed 2.5 mg/kg in children. A daily caffeine intake of 3 mg/kg is considered the adverse-effect level. Seifert SM, Schaechter JL, Hershorin ER, Lipshultz SE. Health effects of energy drinks on children, adolescents, and young adults. Pediatrics. 2011;127:511-528.

Which statement best describes the "S" component of the PDSA performance improvement model? A. Determine how changes will be implemented B. Implement the intervention C. Determine the impact of the intervention D. Maintain and continue improvement

The correct answer is C. Determination of how changes will be made is part of the P component, implementation of the plan is included in D, and maintaining the improvement is part of A. Joint Commission Resources. Cost-Effective Performance Improvement in Hospitals. Oakbrook Terrace, IL: JCAHO; 2005:94.

Which of the following amino acids is classified as a nonessential amino acid? A. Valine B. Lysine C. Glycine D. Threonine

The correct answer is C. Essential amino acids are histidine, isoleucine, leucine, lysine, methionine, phenylalanine, threonine, tryptophan, and valine. Whitney EN, Rolfes S. Understanding Nutrition. 13th ed. Boston, MA: Cengage; 2012.

Taking folate supplements that exceed recommendations might mask deficiency of which of the following nutrients? A. Magnesium B. Vitamin D C. Vitamin B12 D. Calcium

The correct answer is C. Large doses of folate supplements might mask a vitamin B12 deficiency because they can correct the anemia caused by vitamin B12 deficiency. Vitamin B12 deficiency can result in permanent damage to the brain, spinal cord, and nerves. National Institutes of Health, Office of Dietary Supplements. Folate. Updated July 2019. Accessed February 13, 2020. Available at: Website

Which fat would be most susceptible to flavor reversion due to oxidative rancidity? A. Butter fat B. Coconut oil C. Soybean oil D. Olive oil

The correct answer is C. Oxidative rancidity is associated with the degradation by oxygen in the air. Oxidation primarily occurs with unsaturated fats. The more saturated fat contained in an oil, the less susceptible it is to rancidity. The greater the amount of unsaturated fat in an oil, the more likely it is to become rancid. Since the healthiest plant oils are all highly unsaturated, they are especially susceptible to rancidity. However, extra virgin olive oil is a little less susceptible to rancidity because a larger amount of its unsaturated fat is monounsaturated. Extra virgin olive is about 75% monounsaturated, which is somewhat unusual for a plant oil. Plant oils usually have more polyunsaturated fat than monounsaturated fat, which is one reason they are particularly susceptible to rancidity. Thus, soybean oil would be more susceptible than olive oil. Brown AC. Understanding Food: Principles and Preparation. 5th ed. Boston, MA: Cengage; 2014.

The primary substance required for the structure of gels in jams and jellies is A. acid B. sugar C. pectin water

The correct answer is C. Pectin is used in food, particularly jams and jellies, as a gelling agent. Pectin has the ability to cross-link to form a pectin gel and these cross-linked molecules form a solid phase where liquid remains trapped. Hydrogen bonding between these molecules results in a product that is semi-firm and spreadable. McWilliams M. Foods: Experimental Perspectives. 8th ed. New York City, NY: Pearson; 2016.

In order to be labeled as "pure" vanilla, the US Food and Drug Administration (FDA) requires that it A. be certified as an artificial flavor. B. contain the small black flecks from the vanilla pod. C. contain 35% alcohol by volume. D. contain 200 ppm vanillin.

The correct answer is C. Pure vanilla extract is made by macerating and percolating vanilla beans in a solution of ethyl alcohol and water. The FDA requires that the solution contain a minimum of 35% alcohol and 13.35 oz vanilla bean per gallon. Brown AC. Understanding Food: Principles and Preparation. 5th ed. Boston, MA: Cengage; 2014.

To maintain quality and freshness of refrigerated produce, upon receiving these items, they should be placed directly into cold storage and held at a temperature between A. 55°F and 60°F. B. 41°F and 48°F. C. 34°F and 36°F. 30°F and 35°F

The correct answer is C. Refrigerated produce should be held at a temperature between 34°F and 36°F. National Restaurant Association. ServSafe Manager. 6th ed. Chicago, IL: NRA; 2014.

The US Department of Agriculture School Meals Initiative for Healthy Children requires that the schools participating in the National School Breakfast Program provide _____ of the Recommended Dietary Allowance (RDA) for protein. A. 1/2 B. 1/3 C. 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 protein, calcium, iron, and vitamins A an dC for each age/grade group for lunch meals, whereas the USDA School Breakfast Program requires serving 1/4 of the RDA of those nutrients for each age/grade group for breakfast meals. Gregoire MB, Spears MC. Foodservice Organizations: A Managerial and Systems Approach. 9th ed. Upper Saddle River, NJ: Pearson; 2016.

According to regulations, what is the most caffeine that can be in a 12-oz serving of soda pop? A. 21 mg B. 55 mg C. 71 mg D. 100 mg

The correct answer is C. The US Food and Drug Administration (FDA) regulates caffeine in soda. A 12-oz can cannot exceed 71 mg caffeine. Seifert SM, Schaechter JL, Hershorin ER, Lipshultz SE. Health effects of energy drinks on children, adolescents, and young adults. Pediatrics. 2011;127:511-528.

Freezing foods at _____ is the least damaging to the food's original flavor, nutrient content, and texture compared to most other preservation methods. A. ≤10°F B. ≤32°F C. ≤0°F D. ≤20°

The correct answer is C. The optimum temperature for freezing foods is 0°F or slightly colder. At temperatures above 0°F, food quality is quickly lost, and flavor and texture are compromised. Brown AC. Understanding Food: Principles and Preparation. 5th ed. Boston, MA: Cengage; 2014.

A patient presents with lesions on his gums and pinpoint hemorrhages on his skin. What vitamin is this patient most likely deficient in? A. Thiamin B. Magnesium C. Vitamin C D. Selenium

The correct answer is C. Vitamin C helps keep your gums healthy, heal any cuts and wounds, and protect from bruising. Thiamin may contribute to maintaining mental function and help regulate metabolism. Magnesium signals muscles to relax and contract, may help maintain immune response, and promotes normal blood pressure. Selenium aids cell growth and boosts immune function. Whitney EN, Rolfes S. Understanding Nutrition. 13th ed. Boston, MA: Cengage; 2012.

What is ozone used for in food processing? A. Freezing food. B. Modifying atmospheric packaging. C. Blanching vegetables. D. Disinfecting and sanitizing.

The correct answer is D. Ozone is a safe, powerful disinfectant used by the food industry because of its ability to disinfect microorganisms without adding chemical by-products to the food being treated, to the food processing water, or to the atmosphere in which food is stored. Brown AC. Understanding Food: Principles and Preparation. 5th ed. Boston, MA: Cengage; 2014.

Which of the following foods is likely to be consumed by a lacto-vegetarian? A. Scrambled eggs B. Tuna fish salad C. Hamburger D. Grilled cheese sandwich

The correct answer is D. A lacto-vegetarian eats milk and dairy products but no meat, fish, poultry, or eggs. Rolfes SR, Pinna K, Whitney E. Understanding Normal and Clinical Nutrition. 10th ed. Boston, MA: Cengage; 2015.

What name is given to the purchasing document that is completed by the buyer and given to the supplier? A. FOB origin B. Purchase requisition C. Invoice D. Purchase order

The correct answer is D. A purchase order is completed by the buyer and lists the items to be purchased from the supplier. After the items are received, the supplier gives the buyer an invoice to request payment. A purchase requisition is an internal form used by a foodservice manager to request items from the purchasing manager or department within his or her facility. FOB origin means that the buyer takes ownership at the seller's location. Gregoire MB, Spears MC. Foodservice Organizations: A Managerial and Systems Approach. 9th ed. Upper Saddle River, NJ: Pearson; 2016.

What production forecasting method would be used if an assumption was made that actual occurrences follow an identifiable pattern over time? A. Exponential smoothing B. Moving average C. Linear regression D. Both A and B

The correct answer is D. According to Gregoire and Spears, "The frequently used time series forecasting model involves the assumption that actual occurrences follow an identifiable pattern over time." Options A and B are examples of times series models. Gregoire MB, Spears MC. Foodservice Organizations: A Managerial and Systems Approach. 7th ed. Upper Saddle River, NJ: Prentice-Hall; 2009:173.

Which is the best tool for the community nutritionist to use to learn what locally grown foods residents consume most frequently? A. Health Risk Appraisal B. Screening C. Focus Group D. 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. Boyle MA, Holben DH. Community Nutrition in Action: An Entrepreneurial Approach. 6th ed. Boston, MA: Cengage; 2012.

Why does the American Academy of Pediatrics (AAP) recommend that early care and education programs (ECEs) serve limited or no juice to children in their charge? A. Cross-contact can harm the health of children with allergies to foods found in juice B. Students who are not served juice at home may be hesitant to accept a serving of juice C. Budget constraints may affect an ECE's ability to offer juice consistently D. Daily intake recommendations may be exceeded by consuming juice at home

The correct answer is D. Because children may drink juice at home, the AAP recommends that ECEs limit or omit juice servings so that the daily recommended intake of 4 oz (120 mL) to 6 oz (180 mL) is not exceeded. Benjamin-Neelon SE. Position of the Academy of Nutrition and Dietetics: Benchmarks for nutrition in child care. J Acad Nutr Diet. 2018;118(7):1291-1300.

Which of these foods are considered generally safe for consumption by people with compromised immune systems? A. All salad dressings B. Soft cheeses such as feta or brie C. Uncooked tofu D. Canned soup

The correct answer is D. Canned soup is generally considered safe for consumption by immunocompromised individuals. Soft cheeses contain live mold, Caesar salad dressing contains raw eggs, and tofu should be cooked before eaten if one's immune system is compromised. American Academy of Pediatrics. Pediatric Nutrition Handbook. 7th ed. Elk Grove Village, IL: American Academy of Pediatrics; 2013.

Which of the following is an example of a climacteric fruit? A. Grapefruit B. Pomegranate C. Pineapple D. Tomato

The correct answer is D. Climacteric fruit continue to ripen post-harvest. Examples of climacteric fruit include tomatoes, pears, peaches, bananas, apricots, and apples. Whether a fruit is classified as climacteric or non-climacteric depends on respiration rate after maturation. Non-climacteric fruit does not have an accelerated rate post-harvest (as climacteric fruit does) and will not ripen once harvested; examples include melons, cherries, citrus fruits, pomegranates, and grapes. McWilliams M. Foods: Experimental Perspectives. 8th ed. New York City, NY: Pearson; 2016.

Dietetics students finishing supervised practice should be able to A. develop a virtual learning environment. B. use project management tools. C. 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. Ayres EJ. Nutrition Informatics Competencies across All Levels of Practice: A National Delphi Study. J Acad Nutr Diet. 2012;112(12):2042-2053.

The breakdown of fatty acids to yield acetyl-CoA is called A. glycolysis. B. lipolysis. C. ketogenesis. D. beta-oxidation.

The correct answer is D. Fatty acid catabolism involve three stages. The first stage of fatty acid catabolism is beta-oxidation. The second stage is acetyl coA oxidation to carbon dioxide. The third stage is electron transfer from electron carriers to the electron transfer chain. McGuire M, Beerman KA. Nutritional Sciences: From Fundamentals to Food. 3rd ed. Boston, MA: Cengage; 2012.

Which kind of damage results from dehydration of a frozen breaded chicken patty due to extreme cold? A. Caking B. Contamination due to excessive additives C. Crystallization D. Freezer burn

The correct answer is D. Freezer burn is a condition that occurs when frozen food has been damaged by dehydration and oxidation, due to air reaching the food. It is generally induced by substandard (non-airtight) packaging. Brown AC. Understanding Food: Principles and Preparation. 5th ed. Boston, MA: Cengage; 2014.

Which food is most likely to deteriorate due to hydrolytic rancidity during storage at room temperature? A. Fish oil B. Soybean oil C. Olive oil D. Butter

The correct answer is D. Hydrolytic rancidity occurs when water splits fatty acid chains away from the glycerol backbone in triglycerides (fats). The chemical term is ester hydrolysis. Usually this hydrolysis process goes unnoticed, since most fatty acids are odorless and tasteless. However, when the triglyceride is derived from short-chain fatty acids, the released carboxylic acid can confer strong flavors and odors. A particular problem arises with butter, which contains triglycerides with a high content of butyric acid derivatives and acetic acids. Brown AC. Understanding Food: Principles and Preparation. 5th ed. Boston, MA: Cengage; 2014.

What does the U in the FOCUS-PDCA performance improvement model represent? A. Identify a process to improve B. Develop a team C. Explain the current process D. Recognize cause of a problem

The correct answer is D. In the FOCUS-PDCA model for performance improvement, U represents understanding the source of variation or problem. F = Find an improvement area O = Organize a team C = Clarify current practices U = Understand source of variation/problem S = Select a strategy PDCA = Plan Do Check Act SAMHSA HRSA Center for Integrated Health Solutions. FOCUS PCDA. September 2017. Joint Commission Resources. Cost-Effective Performance Improvement in Hospitals. Oakbrook Terrace, IL: JCAHO; 2005:94.

Data reviewed for nutrition assessment are also reviewed during the following step: A. monitoring and evaluation. B. nutrition diagnosis. C. goal setting. D. 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. Academy of Nutrition and Dietetics. Nutrition Care Process and Terminology (NCPT). Last Updated 2016. Available at: https://ncpt.webauthor.com/encpt-tutorials. Accessed December 15, 2016.

Which statement best describes the "A" component of the PDSA performance improvement model? A. Determine how changes will be implemented B. Implement the intervention C. Determine the impact of the intervention D. Maintain and continue improvement

The correct answer is D. Maintaining and continuing improvement is included in the A component of the PDSA model. Determination of how changes will be implemented is part of P, implementation of the plan is included in D, and determination of the impact of the plan is included in S. Joint Commission Resources. Cost-Effective Performance Improvement in Hospitals. Oakbrook Terrace, IL: JCAHO; 2005:94.

Whole, bone-in hams weigh 18 lb as purchased (AP), have an AP to edible portion waste of 44%, and cost $1.83 per AP pound. What is the invoice cost to serve 85 lb of cooked, sliced ham? A. $155.55 B. $223.99 C. $277.78 D. $296.46

The correct answer is D. Multiplying 18 lb (weight of each ham) by 0.44 (waste percent) results in (approximately) 8 pounds of waste. So, for each 18 lb ham, only about 10 lbs represent an edible portion. Therefore, it will be necessary to buy 9 hams to serve 85 pounds of cooked, sliced ham (since 8 whole hams would only produce 80 lbs of cooked, sliced ham, so 9 whole hams must be purchased to meet the required 85 lbs.). The cost for the 9 hams is 18 lb × $1.83 × 9 = $296.46. Molt M, Shugart G. Food for Fifty. 13th ed. Upper Saddle River, NJ: Pearson Prentice Hall; 2011:190.

What is another name for high-pressure processing? A. Ohmic heating B. Irradiation C. Pulsed light D. Pascalization

The correct answer is D. Pascalization, or high-pressure processing, is a method of preserving and sterilizing food, in which a product is processed under very high pressure, leading to the inactivation of certain microorganisms and enzymes in the food. Brown AC. Understanding Food: Principles and Preparation. 5th ed. Boston, MA: Cengage; 2014

What is the name of the substance that denatures protein in the stomach during digestion? A. Chymotrypsin B. Elastase C. Pepsin D. Hydrochloric acid

The correct answer is D. Pepsin is a digestive enzyme found in gastric juice that catalyzes the breakdown of protein to peptides. However, hydrochloric acid is the substance that denatures the protein and is critical for creating the environment for pepsin activity in digestion. Chymotrypsin is a pancreatic digestive enzyme that catalyzes the hydrolysis of certain proteins in the small intestine into polypeptides and amino acids. Elastase is an enzyme found especially in pancreatic juice that catalyzes the hydrolysis of elastin. Heda R, Tombazzi CR. Physiology, Pepsin. Last updated October 2018. Available at: Website. Whitney EN, Rolfes S. Understanding Nutrition. 13th ed. Boston, MA: Cengage; 2012.

Which of these symptoms should be the most concerning to a foodservice establishment and lead to excluding an employee from working? A. Sore throat B. Coughing C. Nausea D. Jaundice

The correct answer is D. Sore throat, coughing, and nausea are not necessarily indicative of transmittable disease and are not necessarily reasons to exclude a worker. The most concerning symptoms for foodservice establishments should be vomiting, diarrhea, sore throat with fever, infected cuts and burns with pus on hands and wrist, and jaundice. Jaundice is a symptom of hepatitis A, which is highly contagious and can be transmitted via food and beverage. More specifically, the virus can be transmitted if small, undetected amounts of stool from an infected person contaminate food or drinks. National Restaurant Association Education Foundation. ServSafe Coursebook. 6th ed. Chicago: NRA; 2012. US Food and Drug Administration. Retail Food Protection: Employee Health and Hygiene Handbook. Last updated April 2018.

All of the following statements about the intensive behavioral therapy (IBT) benefit for obese Medicare Part B beneficiaries are true, EXCEPT: A. coverage for the benefit is granted only in the primary care setting. B. in order to qualify, the beneficiary's BMI must be >30. C. Continued treatment for obesity is contingent on weight loss assessed after 6 months of treatment. D. 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. Academy of Nutrition and Dietetics. Meeting the Need for Obesity Treatment : A Toolkit for the RD/PCP Partnership. Chicago, IL: Academy of Nutrition and Dietetics; 2012: 3-6.

Which of the following elements is NOT part of the Institute of Medicine's (IOM) framework for health care quality? A. Patient-centered B. Equitable C. Timely D. Focused on choosing a process to improve

The correct answer is D. The IOM defines health care quality as care that is patient-centered, equitable (no disparities), timely, safe, effective, and efficient. Selection of a process that needs improvement is a component of a quality improvement program. Agency for Healthcare Research and Quality. Talking Quality: Guidance for Sponsors of Consumer Reports on Health Care Quality. Available at: http://www.ahrq.gov/professionals/quality-patient-safety/talkingquality/index.html. Accessed December 12, 2016.

Which set of directives best describes the management process? A. Controlling, directing, transforming, planning, staffing B. Planning, staffing, establishing objectives, organizing, directing C. Planning, staffing, controlling, establishing objectives, transforming D. Directing, controlling, organizing, staffing, planning

The correct answer is D. The five management functions are planning, organizing, staffing, directing, and controlling. Gregoire MB, Spears MC. Foodservice Organizations: A Managerial and Systems Approach. 9th ed. Upper Saddle River, NJ: Pearson; 2016.

Which USDA grade of beef is not purchased for general foodservice use? A. Choice B. Select C. Standard Commercial

The correct answer is D. The grades for beef from highest to lowest are prime, choice, select, standard, commercial, utility, cutter, and canner. Commercial, utility, cutter, and canner are not purchased for general foodservice use because of their poor taste quality. Molt M, Shugart G. Food for Fifty. 13th ed. Upper Saddle River, NJ: Pearson Prentice Hall; 2011:110.

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? A. Hard boiled egg and water B. Chocolate milk and grapes C. Apple slices and orange wedges D. 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. Furthermore, to be eligible for reimbursement, any milk must be unflavored if provided to children age 1-5 years. The foods listed in choice D represent the only answer where two different groups were combined and meet the reimbursement requirements. Reference: Academy of Nutrition and Dietetics. Position of the Academy of Nutrition and Dietetics: Child and Adolescent Federally Funded Nutrition Assistance Programs. J Acad Nutr Diet. 2018;118(8):1490-1497. US Department of Agriculture. Nutrition Requirements for Fluid Milk and Fluid Milk Substitutions in the Child and Adult Care Food Program, Questions and Answers. Memo code CACFP-17-2016. Available at: Website. Accessed July 26, 2019.

An item with less than _____ kcal per serving can be considered "calorie free." A. 45 B. 35 C. 15 D. 5

The correct answer is D. The standard definition for "calorie free" is less than 5 kcal per serving. US Food and Drug Administration. Food Labeling Guide. Published January 2013. https://www.fda.gov/regulatory-information/search-fda-guidance-documents/guidance-industry-food-labeling-guide . Accessed February 2, 2020.

Which of the following measures of obesity correlate best with obesity-associated disease risk? A. BMI B. Skinfold thickness C. Abdominal body shape index D. Waist circumference

The correct answer is D. Waist circumference is the best correlate to obesity-associated disease risk.Skinfold thickness accuracy can vary greatly. BMI accuracy decreases with muscle wasting and increases based on muscularity, age, sex, and ethnicity. There is no abdominal body shape index that has been validated. National Heart Lung and Blood Institute (NHLBI) National Institutes of Health. The Practical Guide: Identification, Evaluation and Treatment of Overweight and Obesity in Adults. Bethesda MD: NHLBI; 2000. NIH publication 00-4084.

The chef is preparing to make seasonal changes in the cafeteria menu and wants to make similar changes in the patient menu. How will this change help to control menu cost? A. It will decrease food cost. B. It will decrease labor or production costs. C. It will optimize inventory and food usage. D. All of the above

The correct answer is D. When the cooking staff prepares similar foods for both the patients and the cafeteria (instead of different menu items), it decreases food cost (partly through decreasing food waste), decreases labor cost (it's quicker for a cook to prepare more of one menu item than two separate menu items), and optimizes inventory and food usage (fewer items in inventory). Keiser J, DeMicco FJ. Contemporary Management Theory: Controlling and Analyzing Costs in Foodservice Operations. Upper Saddle River, NJ: Prentice Hall; 2000:191.