ERP Domain 2: Nutrition Care for Individuals & Groups

In what type of diet would docosahexaenoic acid (DHA) supplementation be important? a. FODMAP b. Anti-inflammatory c. Gluten free d. Vegan

d. Vegan DHA is typically absent in vegan diets, so supplementation may be called for. DHA supplements derived from algae and thus appropriate for vegans are available.

All breastfed infants should receive how many IUs of vitamin D per day during the first 2 months of life? a. 400 b. 500 c. 600 d. 800

a. 400 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 (10 mcg) vitamin D beginning within the first 2 months of life.

Which of the following is associated with unregulated vasopressin? a. GERD b. HDL c. CSID d. SIADH

Vasopressin is an antidiuretic hormone, or ADH. Unregulated vasopressin can lead to syndrome of inappropriate ADH, or SIADH. It occurs when ADH is released in excessive unregulated quantities. SIADH results in excess water reabsorption and thus creates dilutional hyponatremia.

Older adults are at higher risk of toxicity of which of the following vitamins? a. Vitamin A b. Vitamin C c. Vitamin D d. Vitamin K

Vitamin A Plasma levels and liver stores of vitamin A increase with age, along with decreased clearance from the blood, making older adults more susceptible to toxicity. Vitamin D levels, on the other hand, decline with age. Vitamin C is water soluble and thus clearance is easier. Vitamin K levels usually can be controlled via medication.

At what age should peanut-containing foods be introduced to an infant with egg allergy and severe eczema? a. 4-6 months b. 7-12 months c. After age 3 d. Never

a. 4-6 months To reduce risk of peanut allergy, it is recommended that infants with severe eczema, egg allergy, or both be introduced to age-appropriate, peanut-containing foods as early as age 4-6 months. Infants should be introduced to other solid foods first to determine developmental readiness.

Which of the following responses would demonstrate reflective listening to a client who states: "I don't have time to prepare healthy meals at home"? a. "There must be many demands on your time at home." b. "There are many time-saving shortcuts that I can share with you to help ease the time crunch." c. "Everyone is busy, but preparing healthy meals should be a priority for you." d. "That is true for me too, but I know it is important so I try."

a. "There must be many demands on your time at home." Reflective listening allows the practitioner to test a hypothesis of what has been heard and involves making statements to confirm understanding of the client's meaning. Giving advice is not appropriate in reflective listening.

Dextrose solutions should not be administered at a rate higher than _____ g/kg/hour a. 0.36 b. 0.05 c. 0.63 d. 0.75

a. 0.36 Dextrose solutions should not be administered at a rate higher than 0.36 g/kg body weight/hour. This is the maximum oxidation rate of glucose. Excess glucose is converted to fat, which can result in fatty liver. In addition, the conversion of carbohydrate to fat can cause excess CO2 production, which is undesirable for patients with respiratory problems.

What is the Institute of Medicine's recommended rate of weight gain per week during the second and third trimesters for pregnant people whose body mass index (BMI) is greater than 30? a. 0.5 pounds b. 0.6 pounds c. 0.7 pounds d. 0.8 pounds

a. 0.5 pounds The Institute of Medicine's recommended rate of weight gain per week during the second and third trimesters for pregnant people whose BMI is greater than 30 is 0.5 pounds.

Protein needs for patients with stage II pressure ulcers can be calculated as a. 1.2 g to 1.5 g of protein/kg body weight. b. 1.1 g to 1.2 g of protein/kg body weight. c. 1.5 g to 1.7 g of protein/kg body weight. d. 0.8 g to 1.0 g of protein/kg body weight.

a. 1.2 g to 1.5 g of protein/kg body weight. Increased protein needs for stage II wound healing are 1.2 g to 1.5 g protein/kg body weight. Choice D presents normal protein levels; choice C presents protein needs for higher stages of pressure ulcers; and choice B presents the protein needs for stage I pressure ulcers.

What is the physical activity factor range for "very active" according to the TDEE calculation by Dietary Reference Intake? a. 1.9 to less than 2.5 b. 2.6 to less than 3.2 c. 1.6 to less than 1.9 d. 3.3 to less than 3.9

a. 1.9 to less than 2.5 Physical Activity (PA) Levels according to the TDEE by Dietary Reference Intake areas follows: - 1.0-1.39 = Sedentary, typical daily living activities - 1.4-1.59 = Low active, typical daily living activities plus 30-60 minutes of daily moderate activity - 1.6-1.89 = Active, typical daily activities plus at least 60 minutes of daily moderate activity - 1.9-2.5 = Very active, typical daily activities plus at least 60 minutes of daily moderate activity, plus an additional 60 minutes of vigorous activity or 120 minutes of moderate activity

A patient recently diagnosed with acute kidney injury has no evidence of chronic kidney disease but requires hemodialysis. If the patient is a 57-year-old male, weighs 70 kg, has a normal body mass index with no signs or symptoms of malnutrition, and skin is intact, what amount of protein should be recommended? a. 105 g b. > 140 g c. 56-70 g d. 42 g

a. 105 g Patients with acute kidney injury treated with hemodialysis demonstrate positive nitrogen balance with 1.5 g/kg/day of protein. 70 kg × 1.5 = 105 g. The other options underestimate or overestimate protein needs.

How many kilocalories per ounce does a standard infant formula provide? a. 20 b. 22 c. 25 d. 28

a. 20 A standard infant formula contains 20 kcal/oz. Higher-concentrated formulas are appropriate for preterm infants or for those with specific diseases.

What is the upper threshold for low birthweight? a. 5.4 pounds b. 5.1 pounds c. 4.5 pounds d. 3.5 pounds

a. 5.4 pounds An infant born at 5.4 pounds or less is considered low birthweight.

During the nutrition-focused physical exam, dark patches of skin with a thick velvety texture on the back of a patient's neck are observed. What would be documented in the assessment? a. Acanthosis nigricans b. Ecchymosis c. Petechiae d. Purpura

a. Acanthosis nigricans Acanthosis nigricans is a skin condition in which one or more areas of skin darken and thicken and often feel velvety. Acanthosis nigricans can be caused by endocrine, metabolic, genetic, and paraneoplastic conditions. Petechiae (tiny red dots), ecchymosis (large bruises), and purpura (larger flat areas) are caused by bleeding into the skin and can be signs of vitamin C and K deficiencies.

Which of the following populations has the highest prevalence of diagnosed type 2 diabetes? a. American Indian/Alaska Native b. Asian, Non-Hispanic c. Hispanic d. Black, Non-Hispanic

a. American Indian/Alaska Native According to data on US adults in 2013-2016, American Indians/Alaska Natives had the highest prevalence of diagnosed diabetes (14.7%).

What is the term for accumulation of fluids in the peritoneal cavity? a. Ascites b. Sepsis c. Paracentesis d. Asterixis

a. Ascites Ascites is the accumulation of fluid in the peritoneal cavity. It may be caused by portal hypertension. Asterixis is an uncommon type of negative myoclonus characterized by irregular lapses of posture of various body parts. Sepsis is a life-threatening chain reaction triggered when the body's response to infection-fighting chemicals is out of balance. Paracentesis is a procedure to obtain a sample of ascitic fluid for diagnostic or therapeutic purposes.

Which of the following is a recommendation for people with dumping syndrome? a. Avoid simple sugars such as sucrose b. Consume a low-fat diet for more efficient stomach emptying c. Sit up after meals d. Consume more liquids because they empty out of the stomach most easily

a. Avoid simple sugars such as sucrose Late dumping syndrome results from rapid movement of sugar into the intestine, which raises the body's blood glucose level and causes the pancreas to increase its release of the hormone insulin. The increased release of insulin causes a rapid drop in blood glucose.

Which of the following nutrient deficiencies are associated with dementia? a. B12, B6, folate, omega-3 fatty acids b. Vitamin D, calcium, phosphorous c. Vitamin A, B6, vitamin C, omega-3 fatty acids d. B12, vitamin K, vitamin D, calcium

a. B12, B6, folate, omega-3 fatty acids B12, B6, folate, and omega-3 fatty acid deficiencies are associated with dementia. Inability to meet nutritional requirements orally, a common occurrence in dementia, makes older adults with advanced dementia potential candidates for nutrition support. Deficiency of certain micronutrients need to be evaluated before enteral nutrition support initiation.

Which of the following growth charts is currently recommended by the Centers for Disease Control and Prevention to assess weight in relation to stature in children and adolescents aged 2 to 20 years? a. BMI-for-age b. Length-for-age c. Weight-for-age d. Stature-for-age

a. BMI-for-age The CDC recommends BMI-for-age charts to assess weight in relation to stature for children and adolescents aged 2 to 20 years. Weight-for-stature charts are available as an alternative to accommodate children aged 2-5 years who are not evaluated beyond the preschool years.

Which of the following is a strictly phone-administered survey that asks questions about health behavior in adults? a. BRFSS b. NHANES c. YRBSS d. CPS

a. BRFSS - BRFSS (Behavior Risk Factor Surveillance Survey) is a phone- administered survey of adults that explores behaviors rather than attitudes. - Data from people who participate in an NHANES survey come to a Mobile Examination Center where medical tests are performed in addition to survey questions. - YRBSS is the Youth Risk Factor Behavior Surveillance Survey, focusing on youth and not adults. - The CPS (Current Population Survey is administered in person.

What is used to determine body density by measuring the amount of air displaced? a. Bod pod machine b. Dual energy x-ray absorptiometry (DEXA) c. Magnetic resonance imaging (MRI) d. Ultrasound

a. Bod pod machine The bod pod machine uses air displacement plethysmography (ADP) to measure body composition. This machine has been shown to be just as accurate as underwater weighing.

Which of the following is classified as a body compartment estimate in the Nutrition Care Process? a. Bone age b. Estimated fat intake c. Inadequate energy intake d. 24-hour fecal fat

a. Bone age In the Nutrition Care Process, body compartment estimates are classified under anthropometric measurements. Bone age is an anthropometric measurement. Estimated fat intake is a food- and nutrition-related history parameter, 24-hour fecal fat is a biochemical data parameter, and inadequate energy intake is a nutrition diagnosis

Prolonged use of PPIs (proton pump inhibitors) such as omeprazole can lead to which of the following? a. Bone fractures b. Polyps c. Constipation d. Vitamin D deficiency

a. Bone fractures PPIs have been overprescribed and recent guidelines have directed providers when benefits outweighs risk. Gastric acid secretion can facilitate calcium absorption and acid suppressants such as PPI can decrease calcium absorption and bone density.

The Emergency Food Assistance Program and the Disaster Feeding Program are examples of food distribution programs. Which of the following statements best describes the similarities of the two programs? a. Both programs serve children, adolescents, and other age groups and provide commodity foods to local food distribution and service agencies. b. Both programs serve older adults and provide commodity foods to local food distribution and service agencies c. Both programs serve low-income populations and supplemental food supplies are either distributed to individual households or as meals served in congregate dining centers. d. Both programs serve children, adolescents, and other age groups and food supplies are either distributed to individual households or as meals served in congregate dining centers.

a. Both programs serve children, adolescents, and other age groups and provide commodity foods to local food distribution and service agencies. Both of these programs serve children, adolescents, and other age groups and provide commodity foods that serve meals. The Emergency Food Assistance Program does not distribute to individual households.

Women with gestational diabetes typically require less carbohydrates at which meal, compared to the others? a. Breakfast (morning) b. Lunch (afternoon) c. Dinner (evening) d Bedtime snack

a. Breakfast (morning) Many women with gestational diabetes are more insulin resistant in the early morning and can thus tolerate less carbohydrate at breakfast.

When considering cow's milk versus breastmilk, which of the following is true? a. Breastmilk contains less protein. b. Breastmilk provides more calcium. c. Cow's milk provides less potassium and sodium. d. Cow's milk contains a lower proportion of casein compared to whey protein.

a. Breastmilk contains less protein. Breastmilk is lower in protein than cow's milk (6% to 7% of calories in breastmilk 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 of the following changes in eating pattern has research shown to most positively contribute to a decrease in energy consumption among children? a. Children participating in family-style meals at home b. Children being provided a child-special meal c. Parents or caregivers serving children on individual plates d. Parents or caregivers providing scheduled meals and snacks in the home

a. Children participating in family-style meals at home Participating in family-style meals at home discourages children from overeating.

In behavior change, which example demonstrates self-efficacy? a. Confidence in ability to consume breakfast daily b. Reading an article regarding regular physical activity and heart disease c. Doing research on family history of diabetes d. Perception that financial status will affect ability to eat recommended servings of fruits and vegetables

a. Confidence in ability to consume breakfast daily Self-efficacy is a reflection of confidence to perform and improved self-perception of obtaining success.

What is a recommended nutrition intervention for apnea? a. Decreased energy diet b. Increased calcium diet c. Increased fluid diet d. Decreased gluten diet

a. Decreased energy diet Obesity increases risk of sleep apnea, which occurs when muscles in the back of the throat relax and the airway narrows or closes during breathing. A decreased energy diet is recommended for overweight individuals with apnea.

Which of the following is involved in planning the nutrition intervention? a. Defining the time and frequency of care b. Collaborating with the client c. Modifying the plan of care d. Communicating the plan to the client

a. Defining the time and frequency of care Defining the time and frequency of care, including intensity, duration, and follow-up, is part of the planning process for nutrition interventions. Collaborating with the client, communicating the plan to the client, and modifying the plan of care are all part of the nutrition intervention implementation.

What process would an RDN use to determine if a patient's gastrointestinal symptoms are related to food sensitivity, food allergy, or celiac disease? a. Differential diagnosis b. Triage process c. Clinical manifestation d. Adjuvant therapy

a. Differential diagnosis Differential diagnosis is the process of identifying a correct diagnosis among a slate of potential, competing diagnoses.

What is the process of identifying a patient's nutrition problem when symptoms point to more than one possible answer? a. Differential diagnosis b. Symptom synopsis c. Alimentary analysis d. Dietetics determination

a. Differential diagnosis Differential diagnosis is the systematic process of identifying a correct nutrition diagnosis among multiple possible diagnoses.

A pregnant client met with the RDN several times during the 1st trimester to manage nausea. That client is now in the third trimester and feels healthy and well. What should the RDN do now? a. Discontinue this episode of care b. Recommend bloodwork to check iron status c. Schedule additional monthly follow-up appointments d. Transition care to another clinician to identify other potential problems

a. Discontinue this episode of care When patient goals are met, the RDN should discontinue the episode of care.

When is the best time for malnutrition screening to be completed for an adult in the hospital? a. During the admission process b. During a physician's medical assessment c. During a nursing assessment 48 hours after admission d. During a care conference after the patient is in the hospital for 3 days

a. During the admission process Nutrition screening is separate from a nutrition assessment and can be completed by a nurse; medical assistant; nutrition and nutrition and dietetic technician, registered; or other trained health professionals. There are other circumstances that may require a nutrition assessment related to a patient's length of stay, but a malnutrition screening should be performed when admitting a patient to the hospital.

Which of the following foods must a child with phenylketonuria avoid? a. Egg b. Banana c. Rice d. French Fries

a. Egg Children with phenylketonuria are unable to metabolize the amino acid phenylalanine to tyrosine because of a deficiency or inactivity of phenylalanine hydroxylase. Thus, phenylalanine intake must be restricted to the amount needed for protein synthesis. To accomplish this, protein needs to be limited and all high-protein foods, including eggs, milk, cheese, nuts, beans and meat, should be avoided.

What happens to the rate of metabolism during severe acute pancreatitis? a. Energy expenditure increases, hypermetabolic b. Body temperature remains the same c. Energy expenditure decreases, hypometabolic d. Energy needs decrease

a. Energy expenditure increases, hypermetabolic Severe acute pancreatitis resembles the hypermetabolic, hyperdynamic state similar to sepsis, which increases energy needs due to the increase of the metabolic rate by up to 139%.

What is the preferred method of feeding for a patient with diabetes if an oral diet is not medically appropriate? a. Enteral nutrition b. Parenteral nutrition c. Clear liquid d. Full liquid diet

a. Enteral nutrition EN via tube feeding is the preferred route of feeding the patient with diabetes or hyperglycemia if unable to take an oral diet. EN is associated with fewer complications than PN, particularly with regard to metabolic abnormalities, infection risk, and glucose control.

Which pancreatic function is involved in cystic fibrosis? a. Exocrine b. Endocrine c. Hormonal d. Glucoregulatory

a. Exocrine The two main functions of the pancreas are the endocrine function, which is responsible for blood glucose homeostasis, and the exocrine function, which contributes to macronutrient digestion. Macronutrient digestion, particularly fat digestion, is compromised in the most common genetic variant of cystic fibrosis, which is cystic fibrosis with pancreatic insufficiency.

Which grain contains gluten and should be avoided by a client with Celiac Disease? a. Farro b. Teff c. Quinoa d. Millet

a. Farro Many ancient grains are gluten free, but farro does contain gluten, as it is made from wheat. Teff, quinoa, and millet are all gluten free and are safe for individuals with celiac disease.

In patients with liver cirrhosis, reduction in respiratory quotient results from a metabolic switch to which primary fuel source? a. Fatty acids b. Amino acids c. Glucose d. Water

a. Fatty acids Patients with cirrhosis have respiratory quotients that are lower than controls after an overnight fast. This reduction in the respiratory quotient of patients with cirrhosis results from a metabolic switch in the primary fuel from glucose to fatty acids.

Which of the following represents a more likely reason an older adult may become dehydrated? a. Fear of incontinence b. High humidity c. Low income d. Poor intake of fruit

a. Fear of incontinence Fear of a lack of voluntary control over urination may keep an older adult from adequately hydrating.

What is often present in the gut microbiota of people who eat a Western diet? a. Firmicutes b. Fusobacteria c. Bacteroidetes d. Cyanobacteria

a. Firmicutes The typical, highly processed Western diet results in a preponderance of firmicutes in the gut microbiota. Bacteroidetes are common in the gut microbiota of Africans who consume a diet that is very high in fiber.

Which of the following is true with regard to recommendations for introducing first foods to a healthy infant? a. First foods should be composed of one single ingredient b. It's acceptable for first foods to comprise two ingredients so long as they are from the same food group c. Human milk or formula should be immediately discontinued once solid foods are introduced d. Because of the potential for food allergies, infant cereals should always be introduced last.

a. First foods should be composed of one single ingredient The first solid foods introduced should comprise a single ingredient and be fed in conjunction with human milk or formula, which should be gradually reduced to 28 oz to 32 oz per day. The American Academy of Pediatrics Committee on Nutrition recommends that pureed meats or infant cereals be introduced first, as they are good sources of iron and zinc, which are the most likely deficient nutrients in the diets of US infants.

During the nutrition assessment, which of the following would an RDN document under Client Social History to evaluate a client's risk for developing type 2 diabetes? a. Geographic location of home b. Primary language spoken in the home c. Family mealtimes and snack patterns d. Blood glucose panel results

a. Geographic location of home Better neighborhood walkability and greater access to green space has been associated with a lower risk of type 2 diabetes, so geographic location of home should be documented. This parameter is classified as Client Social History. Primary language spoken in the home is also a Client History assessment parameter, but it would be documented under "Personal Data." Mealtimes and snack patterns are documented under food and nutrition-related history and glucose panel results are recorded under Biochemical Data, Medical Tests, and Procedures.

Which of the following foods is haram? a. Ginger molasses rum cake b. Poached salmon c. Coffee with flavored creamer d. Spaghetti and turkey meatballs

a. Ginger molasses rum cake Haram foods are not permitted in the Muslim diet and include foods made with pork, alcohol, and blood, as well as animals that have been improperly slaughtered. Ginger molasses rum cake is prepared with alcohol and thus is haram.

Under which category within nutrition-focused physical findings would lanugo be documented? a. Hair b. Nails c. Extremities d. Digestive system

a. Hair Lanugo is fine, pale hair. Lanugo is present in undernourished patients; an example of a patient who may present with lanugo hair formation is one with protein-energy malnutrition related to anorexia nervosa. According to the Nutrition Care Process, lanugo is documented in the Hair category of Nutrition-Focused Physical Findings.

The recommended meal plan for most people with cystic fibrosis is a. High kilocalorie, protein, fat, and sodium b. High kilocalorie and protein, moderate sodium c. High kilocalorie, protein, and sodium and low fat d. High kilocalorie after forgetting to take digestive enzyme pill

a. High kilocalorie, protein, fat, and sodium High-fat diets provide the most energy while condensing the total volume of food to consume. Choosing protein and fat sources can increase an individual's total energy intake. More sodium is necessary because sodium is expired in the sweat of cystic fibrosis patients due to the defect in the sodium chloride channel.

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

a. Immunocompromised individuals People with compromised immune systems, the body's defense system against illnesses, are at a higher risk for consequences from foodborne illness.

Assuming that a patient's obesity is related to excessive energy intake is a form of which of the following? a. Implicit bias b. Nutrition diagnosis c. Confirmation bias d. Behavioral theory

a. Implicit bias Making assumptions about the etiology of a patient's obesity is a form of implicit bias. Implicit biases occur at the unconscious level and are involuntarily formed. These unconscious attitudes may influence the quality of the care delivery. Confirmation bias involves seeking to validate ideas or concepts that an individual wants to be true.

What is the recommendation for attenuating lean body mass loss in post-resuscitation patients recovering from sepsis? a. Increase protein and kilocalories b. Decrease protein and kilocalories c. Increase protein but decrease kilocalories d. Increase kilocalories but decrease protein

a. Increase protein and kilocalories An acute catabolic response in sepsis contributes to rapid loss of lean body mass. Attenuating loss of lean body mass in post-resuscitation patients recovering from sepsis requires increased protein and kilocalories.

Which of the following is the most accurate way to evaluate energy expenditure in critically ill patients? a. Indirect calorimetry b. Harris-Benedict equation c. Fick method d. Ventilator-derived carbon dioxide consumption estimates

a. Indirect calorimetry Indirect calorimetry evaluates energy expenditure by measuring oxygen consumption and carbon dioxide production. Although it is considered to be the most effective measurement in critically ill patients, its use is limited, often due to availability and cost.

What type of herb may be recommended for a client with an upset stomach? a. Peppermint b. Lavender c. Saw palmetto d. Echinacea

a. Peppermint Peppermint and chamomile are often recommended for settling an upset stomach. Saw palmetto may exacerbate gastrointestinal distress. Lavender is known for relaxation. Echinacea has been suggested as a means to boost immunity.

The World Health Organization growth charts for children younger than age 2 are based on data from which of the following populations? a. Infants who were primarily breastfed until at least 4 months of age and continued through 12 months b. Infants who were primarily breastfed until at least 6 months of age and continued through 12 months c. Infants who were formula fed due to free formula distribution for at least 12 months d. Infants who were primarily breastfed until at least 2 months of age and continued through 12 months

a. Infants who were primarily breastfed until at least 4 months of age and continued through 12 months The WHO growth curves are expected to offer a single international standard that represents optimal physiological growth for all children from birth to 5 years of age and to establish the breastfed infant as the normative model for growth and development. The growth curves are based on data measured in infants who were primarily breastfed until age 4 months and continued through12 months.

Growth acceleration during puberty is largely related to the synergetic effects of gonadal sex steroids, growth hormone, insulin growth factor-1, and which of the following? a. Insulin b. Cortisol c. Glucagon d. Thyroxine

a. Insulin Pubertal growth acceleration is largely due to the synergetic effects of increased secretion of gonadal sex steroids, growth hormone (GH), and IGF-I and insulin.

When preparing a PES statement in situations where there are diagnoses from multiple domains, which diagnosis domain should the dietetics professional prioritize? a. Intake b. Physical conditions c. Knowledge d. Nutrition-focused physical findings

a. Intake When writing a PES statement and there is a choice between diagnoses from different domains, priority should be given to the intake-related nutrition diagnosis, as it is considered the one more specific to the role of the RDN.

What is the term for when two or more professionals learn with and from, each other and learn about each other's professions with the goal to improve collaboration and quality of medical care? a. Interprofessional education b. Multiprofessional education c. Collaborative practice d. Multidisciplinary education

a. Interprofessional education In multidisciplinary education and multiprofessional education, students can be taught together, but no interaction between professionals occurs. In interprofessional education, educators and learners from two or more health professions jointly create and foster a collaborative learning environment. These efforts are intended to develop knowledge, skills, and attitudes that enhance interprofessional team behaviors and competence.

Carotenoids like lutein and zeaxanthin have been studied for their role in preventing or delaying cataracts and age-related macular degeneration. Which food is the best source for these carotenoids? a. Kale b. Almonds c. Apples d. Yogurt

a. Kale Lutein and zeaxanthin are found in green leafy vegetables (eg, kale, spinach, broccoli, peas, and lettuce) and egg yolks.

Which of the following foods should a pregnant person avoid? a. King mackerel b. Tuna c. Trout d. Shrimp

a. King mackerel People who are pregnant should avoid consuming mackerel because of its mercury content.

The most effective treatment for non-alcoholic fatty liver disease (NAFLD) is: a. Lifestyle modifications b. Milk thistle c. Thiamine supplementation d. Pioglitazone (Actos)

a. Lifestyle modifications - Lifestyle modifications are the most effective treatment of NAFLD. - Reports of the efficacy of supplementation in NAFLD are inconclusive. - Pioglitazone is used in treating nonalcoholic steatohepatitis, not NAFLD. - Thiamine supplementation is used to treat Korsakoff syndrome.

Which of the following diets restricts food components to reduce symptoms of irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD)? a. Low FODMAP b. Low fiber c. Low carbohydrate d. Low sodium

a. Low FODMAP FODMAP is an acronym that stands for: Fermentable, Oligosaccharides, Disaccharides, Monosaccharides, and Polyols. These are foods components that are restricted in a low-FODMAP diet. The low-FODMAP diet is prescribed to reduce symptoms in those who have irritable bowel syndrome or inflammatory bowel disease.

What is the recommended way to serve fruit on the IDDSI Level 5 diet? a. Mashed b. Cubed c. Sliced d. Julienned

a. Mashed According to the International Dysphagia Diet Standardisation Initiative, fruits served on Level 5 Orange Minced & Moist should be served mashed with excess thin juice drained and skin and pits removed.

Which of the following is a fat source in an elemental (hydrolyzed) nutrition support formula? a. Medium-chain triglycerides b. Soy lecithin c. Safflower oil d. Very long-chain triglycerides

a. Medium-chain triglycerides Elemental (hydrolyzed) nutrition support formulas are typically utilized in patients with impairments in their digestive process because they are low in fat. These formulas' primary fat source is long-chain and medium-chain triglycerides, which require minimal digestive function.

Which of the following complications can result from persistent hyperglycemia in diabetes? a. Microvascular disease resulting in neuropathy, nephropathy, and retinopathy b. Decreased urine output, increasing risk for urinary tract infection c. Improved gut microbiota as a result of increased glucose availability d. Improved wound healing and circulation

a. Microvascular disease resulting in neuropathy, nephropathy, and retinopathy When hemoglobin A1c rises above 7%, there is a progressive increase in the risk of retinopathy, nephropathy, and neuropathy.

In terms of CVD, what are sedentary behavior, body mass index, and diabetes collectively considered? a. Modifiable risk factors b. Comorbidities c. Nonmodifiable risk factors d. Nutrition-focused physical findings

a. Modifiable risk factors Modifiable risk factors are behaviors and measurements that elevate or lower a person's risk of disease but that can theoretically be changed if certain measures are taken. Body mass index, sedentary behavior, and diabetes are all risk factors for cardiovascular disease that could potentially be modified, thereby lowering the risk. Nonmodifiable risk factors would include variables such as age and family history.

_____ is the accumulation of excess fat in the liver. a. NAFLD b. NASH c. Fibrosis d. Cirrhosis

a. NAFLD Nonalcoholic steatohepatitis (NASH) is fatty buildup in the liver with inflammation or scarring, and NAFLD is the accumulation of fat in the liver. Cirrhosis is the most severe consequence of NASH.

Which of the following is the body mass index (BMI) range for overweight? a. 19 to 24 b. 25 to 29 c. 27 to 32 d. 31 to 36

b. 25 to 29 - Overweight BMI is 25.0-29.9 - Obesity (Class 1) BMI is 30.0-34.9 - Obesity Class 2 BMI is 35.0-39.9 - Severe obesity (class 3) BMI is 40.0-49.9

Which of the following is a recommendation for feeding a child with neuromuscular problems? a. Position child to sit with feet and hips at 90º angle b. Turn on the TV to help as a distraction c. Make sure all hot foods have cooled to lukewarm before serving d. Remain standing to avoid sudden movements if there is a spill

a. Position child to sit with feet and hips at 90º angle If a child with neuromuscular problems can sit upright in a chair or infant seat, the child should be seated upright with hips and feet at a 90º angle. The setting should be a quiet atmosphere without television, though soft music is acceptable. The person feeding the child should be seated and facing the child at eye level. Hot foods should be served hot and cold foods should be served cold.

Which laboratory values can be abnormally low when evaluating nutritional status in patients with liver disease? a. Prealbumin b. Potassium c. Chloride d. Vitamin C

a. Prealbumin Albumin and prealbumin may be moderately or abnormally low in patients with liver disease, even in the presence of good nutrition. These proteins decrease in production in a diseased liver.

Which nutrition intervention may benefit patients with cerebral palsy? a. Provide education on use of modified utensils b. Prescribe a strict calorie restriction c. Provide education on following a low-fiber diet d. Prescribe a fluid-restricted diet

a. Provide education on use of modified utensils Individuals with cerebral palsy may benefit from education on use of modified utensils, as assistive eating equipment could increase independence and therefore quality of life. Malnutrition is possible with cerebral palsy, and fluids added to foods assists this patient population with swallowing, so strict calorie or fluid restriction may not be recommended. Patients with cerebral palsy also experience gastrointestinal issues because of low metabolic rate, so a high-fiber diet is often recommended.

Which of the following measures the energy expended during the activities necessary to sustain normal body functions and homeostasis? a. Resting metabolic rate b. Body mass index c. Thermogenesis d. Estimated energy requirement

a. Resting metabolic rate Resting metabolic rate is the energy expended during the activities (such as respiration and circulation) necessary to sustain normal body functions and homeostasis.

Which of the following is the fork drip test for IDDSI Level 4 Pureed/Extremely Thick? a. Scooped sample sits in mound on fork and does not drip easily through prongs b. Small sample amount drips continuously through the prongs c. Sample drips slowly in dollops through the prongs, which do not leave a clear pattern d. Sample shows no sign of dripping through the prongs

a. Scooped sample sits in mound on fork and does not drip easily through prongs The fork drip test for the Level 4 Pureed/Extremely Thick diet of the International Dysphagia Diet Standardisation Initiative requires that a scooped sample sits in mound on the fork and does not drip easily through prongs.

What happens to pancreatic exocrine gland secretions during the fasted state? a. Secretion decreases b. No change to exocrine secretions c. Secretion increases d. Same output as during the fed state

a. Secretion decreases During fasting periods, very little secretion takes place. Once food enters into the stomach, the pancreas exocrine glands release proteases, amylase, and lipase enzymes to aid in digestion.

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? a. Set the parameters of the assessment, collect data, analyze and interpret the data, share the findings, and set priorities. b. Set priorities, collect data, set the parameters of the assessment, analyze and interpret the data, and share the findings. c. Choose a plan of action, collect data, set the parameters of the assessment, share the findings, and analyze and interpret the data. d. Collect data, analyze and interpret the data, set the parameters, share the findings, and set the priorities.

a. Set the parameters of the assessment, collect data, analyze and interpret the data, share the findings, and set priorities. A community nutrition needs assessment must occur in the sequenced order listed in option A.

What is considered the evidence for a nutrition diagnostic statement? a. Signs and symptoms b. Problem c. Etiology d. Intervention

a. Signs and symptoms Nutrition diagnostic statements are also known as PES, which stands for Problem, Etiology, Signs and Symptoms. The standard presentation of a PES statement is: [Problem] related to [Etiology] as evidenced by [Signs and Symptoms].

What is an appropriate nutrition intervention recommendation for patients with chronic obstructive pulmonary disease (COPD)? a. Small, frequent meals b. Weight loss, if patient is overweight c. Decreased milk intake d. Low-carbohydrate diet

a. Small, frequent meals Small, frequent meals are recommended to reduce fatigue in patients with COPD. Patients who are overweight should not be encouraged to lose weight since a low body mass index is associated with a higher mortality rate in patients with COPD. Milk consumption is not related to mucus production, and the evidence does not support a low-carbohydrate diet for patients with COPD.

During a nutrition counseling session with a patient, the patient states: "I'd really like to eat healthier, but I can't because my toddler only wants to eat pizza and macaroni and cheese." In motivational interviewing, this statement is an example of: a. Sustain talk b. Discord c. Self-efficacy d. Reflection

a. Sustain talk The client's argument is sustain talk, which refers to any self-expressed argument for not changing or for sustaining the status quo. This type of scenario in motivational interviewing was previously called "resistance," but because that term implies blame on the client, the terminology has been changed to "sustain talk."

Which of the following micronutrients should be supplemented in a patient with history of alcoholism? a. Thiamin b. Calcium c. Zinc d. Magnesium

a. Thiamin Thiamin deficiency is common in people with alcoholism because thiamine absorption from food decreases and thiamin excretion from the body increases. Alcoholism can also cause folic acid deficiency by interfering with the absorption of this nutrient and by influencing the development of unhealthy eating habits.

Wernicke-Korsakoff syndrome is seen in individuals with deficiency of which vitamin? a. Thiamin b. Riboflavin c. Niacin d. Pyridoxine

a. Thiamin Wernicke-Korsakoff syndrome is a manifestation of thiamin deficiency, which is usually seen in individuals suffering from alcoholism

Why is it critical to use a valid and reliable malnutrition screening tool? a. To limit unnecessary nutrition referrals b. So that any health care professional can complete the screening c. To diagnose nutrition-related health conditions d. So that there is consistency in who is screened

a. To limit unnecessary nutrition referrals A malnutrition screening tool that is valid and reliable increases the likelihood of positively identifying possible malnutrition, thereby reducing referrals for individuals who do not have malnutrition. Screening is intended to identify risk and not evaluate and diagnose; as such, screening takes place before the Nutrition Care Process.

Which of the following is a recommendation for fruit juice consumption in infants and children? a. Toddlers aged 1 to 3 years can be given 4 oz of fruit juice daily b. Fruit juice can be introduced in diluted form at age 6 months c. Children aged 4-6 years can be given up to 10 oz fruit juice daily d. Sippy cups should be used when serving fruit juice to toddlers

a. Toddlers aged 1 to 3 years can be given 4 oz of fruit juice daily The American Academy of Pediatrics recommends fruit juice not be given to an infant until age 1. Before age 1, infants can be encouraged to consume whole fruit that is mashed or pureed. After 1 year of age, because infants consume <1600 kcal/day, the AAP believes 4 oz juice per day is more than adequate.

Diabetic ketoacidosis is most commonly seen in which type of diabetes mellitus? a. Type 1 diabetes b. Type 2 diabetes c. Gestational diabetes d. Maturity onset diabetes of the young (MODY)

a. Type 1 diabetes Diabetic ketoacidosis is commonly present when type 1 diabetes is diagnosed, though it is often mistaken for the flu. Symptoms include elevated urine ketones, severe weight loss, extreme thirst, blurred vision, lethargy, and disorientation. Inadequate insulin leads to increased lipolysis and beta-oxidation of fatty acids, resulting in overproduction of ketone bodies and loss of ketone bodies in the kidneys. This leads to retention of hydrogen ions, lowering the serum pH. It is a serious, life-threatening condition.

A pregnant person should avoid supplementation of which of the following nutrients? a. Vitamin A b. Vitamin B6 c. Folic acid d. Iron

a. Vitamin A A pregnant person should avoid excessive intake of vitamin A, as it appears to cause birth defects. Prenatal vitamins and food sources should provide sufficient vitamin A. Vitamin B6, which may be taken for morning sickness, is water soluble and supplements within limits (100 mg) are generally safe. Folic acid and iron should be increased during pregnancy.

Which of the following nutrients should a pregnant person avoid in excessive amounts? a. Vitamin A b. Vitamin B-6 c. Folic acid d. Iron

a. Vitamin A Vitamin B-6 is water soluble, and folic acid and iron should be increased during pregnancy. A pregnant person should avoid excessive intake of vitamin A.

What vitamin deficiency is likely in a patient with the following characteristics: 55-years old, dark skin, works long hours indoors, spends free time indoors, body mass index higher than 30 m/kg2, avoids milk. a. Vitamin D b. Vitamin A c. Iron d. Biotin

a. Vitamin D Risk factors of vitamin D deficiency include lack of sun exposure, age, darker skin, obesity, and low intake of foods high in vitamin D.

Which approach is based on the assumption that everyone is capable of achieving health and well-being independent of weight, so long as they have access to non-stigmatizing health care? a. Weight inclusive b. Weight normative c. Weight considerate d. Weight neutral

a. Weight inclusive Unlike the weight normative approach, which emphasizes weight and weight loss when defining health and well-being, the weight inclusive approach views health and well-being as multifaceted and advocates for efforts toward improving health care access.

Providing advice and information can be a component of a successful patient interaction. Under what circumstances is it appropriate to provide advice or information? a. When the RDN has asked for permission from the client or if the client requests it b. When the RDN has limited time in a nutrition session c. When the RDN has a talkative client and needs to direct the focus of the interview d. After the RDN has established rapport and the client is ready to set goals

a. When the RDN has asked for permission from the client or if the client requests it Asking permission is a powerful request and places the patient in an autonomous position and readies them to be more receptive to information.

What is the term for the measurement of an individual's deviation from the mean of the reference population? a. Z score b. P-value c. Chi-squared d. Comparative standard

a. Z score - Z-scores are often used with anthropometric data. They express the anthropometric value as a number of standard deviations or Z-scores below or above the reference mean or median value. - Comparative standards evaluate the actual value of the measured or observed data against accepted standards, recommendations, and/or goals. - P values are a measure related to probability of statistical reliability. - Chi-squared compares two variables in a contingency table to see if they are related.

Resting energy expenditure (REE) is most affected by a. body composition. b. physical activity. c. time of day. d. food intake.

a. body composition. Resting energy expenditure (REE) is the amount of energy needed to maintain basic body systems and body temperature at rest. Weight, height, and age are needed to calculate REE.

According to the Nutrition Care Process, if a client takes self-prescribed therapeutic doses of vitamin C, this information should be recorded in the _____ section of the Nutrition Assessment. a. intake b. client history c. behavioral-environmental d. nutrition knowledge

a. intake Any ingestion would be evaluated as part of the Intake category within Nutrition Assessment. Although the decision to self-prescribe could be related to the influence of attitudes and beliefs, behavioral-environmental parameters are a component of Nutrition Diagnosis in the Nutrition Care Process.

Refeeding syndrome is characterized by low serum concentrations of a. phosphorus, potassium, magnesium. b. sodium, phosphorus, magnesium. c. sodium, potassium, phosphorus. d. potassium, magnesium, sodium.

a. phosphorus, potassium, magnesium. 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.

A community RDN develops an educational and awareness program to teach employees of a local industry to reduce the sodium in their diets. This is an example of a. primary prevention. b. secondary prevention. c. tertiary prevention. d. workplace rehabilitation.

a. primary prevention. Primary prevention is to protect healthy people before a disease (for example, hypertension) develops. Secondary and tertiary prevention do not occur until a disease has already presented. Workplace rehabilitation is specific to an injury sustained at work.

What is the recommended time frame for avoiding pregnancy after bariatric surgery? a. 3-4 years b. 1-2 years c. 6-12 months d. 1-3 months

b. 1-2 years Women are encouraged to avoid pregnancy for 1 to 2 years after bariatric surgery. Pregnancy during this time frame could result in complications related to potential nutrient deficiencies secondary to reduced food intake and malabsorption.

Using the Hamwi formula, what is the ideal body weight for a female who is 70 inches tall and has a small body frame? a. 120 pounds b. 135 pounds c. 150 pounds d. 165 pounds

b. 135 pounds The Hamwi formula for women with small frame is: 100 lb + (5 lb for every inch over 60 inches) and subtract 10% for small frame. 100 lb + (10 inches x 5 lb) = 150 lb. 10% of 150 lb =15 lb. 150 lb - 15 lb = 135 lb

Using food-based menu planning, the required portion size for meat/meat alternate served in a reimbursable lunch to students in grades 9 through 12 must be a. 1 oz. b. 2 oz. c. 3 oz. d. 4 oz.

b. 2 oz. Schools must offer 2 oz or equivalent of meat/meat alternate to students in grades 9 through 12.

Based on the following patient data, which of these individuals would be eligible for bariatric (metabolic) surgery? a. 53-year-old man with sleep apnea, hypertension with body mass index (BMI) of 32 b. 24-year-old woman with BMI of 50 c. 48-year-old woman with BMI of 39 and no comorbid conditions d. 42-year-old man with BMI of 36 and steroid-induced obesity

b. 24-year-old woman with BMI of 50 Bariatric surgery recommendations are as follows: BMI > 40 or BMI is between 35-40 with comorbid conditions. The 24-year-old with BMI of 50 clearly meets the criteria.

What percentage of total energy from fat should be provided through an elemental (hydrolyzed) formula to prevent essential fatty acid deficiency (EFAD)? a. 1%-2% b. 3%-4% c. 2%-3% d. 4%-5%

b. 3%-4% Enteral formulas should provide the patient with at least 3%-4% of total energy as fat in order to decrease the chances of developing EFAD.

What is the body mass index range for class I obesity? a. 25-29.9 b. 30-34.9 c. 35-39.9 d. ≥40

b. 30-34.9 - 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.

What is the osmolality of an isotonic enteral formula? a. 0 mOsm/kg b. 300 mOsm/kg c. 550 mOsm/kg d. 700 mOsm/kg

b. 300 mOsm/kg The osmolality of an isotonic solution (one that is similar to the osmolality of the blood) is approximately 300 mOsm/kg.

A patient in residential care receives a parenteral formula of D40W of 500 ml in one day. The number of kilocalories delivered is a. 560 kcal b. 680 kcal c. 800 kcal d. 920 kcal

b. 680 kcal 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.

How long should parenteral nutrition be withheld in a well-nourished ICU patient who is classified as NPO and enteral intake is not feasible? a. 72 hours b. 7 days c. 10 days d. 24 hours

b. 7 days According to the American Society for Parenteral and Enteral Nutrition guidelines, parenteral nutrition is not initiated until after 7 days following ICU admission if enteral nutrition is not feasible. Parenteral nutrition can result in an increased risk of morbidity and mortality and increased blood glucose, among other complications.

A person with diabetes has an insulin to carbohydrate ratio of 1:10. How much rapid-acting insulin would this person need to cover a 72 g carbohydrate meal? a. 6 units b. 7 units c. 9 units d. 15 units

b. 7 units Insulin to carbohydrate ratios are calculated based on the total amount of insulin used in one day divided by 500. To calculate the amount of insulin needed for an individual meal or snack, divide by the total grams of carbohydrate in the meal by the ratio (72/10=7).

What would be the approximate protein requirement, in grams, for a male, non-athlete weighing 87 kg? a. 37 b. 70 c. 239 d. 174

b. 70 The protein requirement is determined by multiplying the weight in kilograms by 0.8.

Which of the following would confirm a diagnosis of diabetes? a. A1c 5.7% b. A1c 6.5% c. Fasting blood glucose 110 mg/dL d. Fasting blood glucose 125 mg/dL

b. A1c 6.5% An A1c of 6.5% would confirm a diagnosis of diabetes. An A1c of 5.7% is a criterion for diagnosing prediabetes (the range for prediabetes is 5.7%-6.4%) A fasting blood glucose would have to be measured at 126 mg/dL or higher for a diabetes diagnosis.

Which electronic health record style was created to reflect the nutrition care process? a. SOAP b. ADIME c. PIE d. Focus

b. ADIME - 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.

Why wouldn't an RDN in the acute care setting use albumin as a prognostic screening tool? a. It has a long half-life b. Albumin is affected by the effects of disease c. Prealbumin should be measured d. There is no reason not to use albumin in this setting

b. Albumin is affected by the effects of disease Albumin is a good prognostic screening tool; however, in the acute care setting, albumin can be affected by the effects of disease including inflammation, hydration and numerous other factors.

Which of these individuals is most likely to present with Wernicke-Korsakoff syndrome? a. An infant born prematurely b. An adult with alcoholism c. An adult who is postmenopausal d. A child with a neurological disorder

b. An adult with alcoholism The abuse of alcohol often leads to a severe form of thiamin deficiency known as Wernicke-Korsakoff syndrome.

Prioritization of nutrition interventions includes client preference, urgency, impact potential, and which of the following? a. Practice guidelines b. Available resources c. Insurance coverage d. Hospital protocols

b. Available resources Many clients need multiple nutrition interventions to resolve or mitigate their nutrition problems. RDNs should prioritize the nutrition interventions based on client preference, urgency, impact potential, and available resources.

Effective multicomponent weight management interventions for pediatric patients include nutrition therapy, physical activity, and which of the following other interventions? a. Pain management b. Behavioral modification c. Parenting classes d. Child abuse screening

b. Behavioral modification Weight management interventions that address diet or nutrition, physical activity, and behavioral health and that involve an RDN or mental health provider are more likely to be effective in the treatment of overweight in children and adolescents, compared to interventions that omit one of these three components.

What is secreted in the bloodstream in amounts equal to insulin secretion and thus can be used as a clinical indicator of endogenous insulin production? a. Glucose b. C-peptide c. Glutamic acid d. Cortisol

b. C-peptide Insulin is secreted as two polypeptide chains joined by disulfide bonds. C-peptide is released when the two chains separate.

For the needs of infants born prematurely, human milk is deficient in a. Potassium b. Calcium c. Sodium d. Chloride

b. Calcium Human milk does not meet the calcium and phosphorus needs for normal bone mineralization in infants born prematurely. Therefore, breastmilk can be supplemented with human milk fortifiers that contain calcium and phosphorus.

Which of the following must be true for a serving of food to be labeled as low fat? a. Contain less than 0.5 g fat b. Contain less than 3 g fat c. Contain 25% less fat than the full fat food d. Contain 1/3 fewer calories or 50% less fat than the full fat food

b. Contain less than 3 g fat Following food labeling laws, to be identified as low in fat, a serving of food must contain less than 3 g fat. A serving of food with less than 0.5 g fat is considered fat free.

Based on this statement, determine which stage of change a client is in: "I know what I need to do to lose weight, but I just can't do it." a. Precontemplation b. Contemplation c. Preparation d. Action

b. Contemplation 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.

An RDN is planning a community nutrition program and has already completed the community needs assessment, defined program goals and objectives, and developed a program plan. What is the next step in the process? a. Identify funding sources. b. Define the management system. c. Implement the program. d. Seek support from the stakeholders

b. Define the management system. Defining the management system comes next. Identifying funding systems, seeking support from stakeholders, and implementing the program come later.

What does a fasting blood glucose (FBG) of 129 indicate? a. Normal blood sugar b. Diabetes c. Sugar spilling over into the urine d. Pre-diabetes

b. Diabetes FBG >126 indicates diabetes

Fasting to ensure chylomicron triglycerides aren't measured should be done before testing for which of the following conditions? a. Dysphagia b. Diabetes c. Congenital sucrase-isomaltase disease d. Crohn's disease

b. Diabetes Triglyceride measurement as part of a lipid panel requires fasting, because blood triglycerides are present in substantial quantities in both chylomicrons and very-low-density lipoprotein (VLDL), and fasting to exclude chylomicron triglycerides helps to ensure an accurate measurement. Lipid panels are often evaluated in patients with diabetes, overweight/obesity, and high blood pressure. Dysphagia, CSID, and Crohn's disease don't require a lipid panel.

Which of the following is the term for "a general or modified diet prescribed and documented in a client's medical record"? a. Nutrition prescription b. Diet order c. Diet plan d. Eating plan

b. Diet order A diet order is a general or modified diet prescribed and documented in a client medical record by a credentialed provider as part of a medical treatment plan

Which of the following should be the frontline test when diagnosing food allergy? a. Mediator release assay (LEAP diet) b. Double-blind placebo-controlled challenge c. Allergen-specific IgG, cytotoxicity assay d. Endoscopic allergen provocation

b. Double-blind placebo-controlled challenge For diagnosing a true food allergy, the gold standard is the double-blind, placebo-controlled food challenge. According to the National Institute of Allergy and Infectious Diseases, basophil histamine release/activation, lymphocyte stimulation, facial thermography, gastric juice analysis, endoscopic allergen provocation, hair analysis, applied kinesiology, provocation neutralization, allergen-specific IgG, cytotoxicity assays, electrodermal test (Vega), and mediator release assay (LEAP diet) all lack the requisite evidence to be recommended for use in diagnosing food allergy.

Practices and associated attitudes that predetermine what, when, why, and how a person eats is referred to as _____. a. Food preferences b. Food habits c. Meal pattern d. Meal plan

b. Food habits Food habits are the practices and associated attitudes that predetermines what, when, why, and how a person eats. Food preference informs which foods a person likes and would rather eat when given a choice.

What sensation is the main symptom of esophageal dysphagia? a. Needing to vomit b. Food sticking c. Gum irritation d. Metallic taste in mouth

b. Food sticking The main symptom of esophageal dysphagia is the sensation that food has become stuck in the esophagus after swallowing. A patient with esophageal dysphagia typically has a motility disorder or an obstruction, which may be caused by stricture, tumor, or compression.

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

b. Ghrelin 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.

Which of the following foods is considered a whole grain and meets the NSLP standards for whole grain? a. Pearled barley b. Graham flour c. Hominy d. Semolina

b. Graham flour Graham flour is considered a whole grain according to the National School Lunch Program criteria. All the other items listed have been milled so that either the germ or the germ and the bran have been removed.

Which of the following is likely to be present in a patient with an alcohol use disorder (AUD)? a. Aversion to sweets b. Gut dysbiosis c. Lower synthesis of bile acids d. Elevated serum albumin

b. Gut dysbiosis Gut dysbiosis is seen in people with AUD. These individuals also tend to have a preference for sweets and an increased synthesis of bile acids. People with AUD tend to have low serum albumin.

When using the Nutrition Care Process, what three things do dietetics practitioners do in completing Nutrition Monitoring and Evaluation? a. Prioritize nutrition diagnoses, consult the Academy's evidence-based nutrition practice guidelines, and determine patient-focused expected outcomes. b. Scrutinize, measure, and assess the changes in nutrition care indicators. c. Confer with patient/client/caregivers, define a nutrition plan and strategies, and determine time and frequency of care. d. Identify resources needed, communicate the nutrition care plan, and implement the plan.

b. Scrutinize, measure, and assess the changes in nutrition care indicators. Scrutinizing, measuring, and assessing are the key activities during the monitoring and evaluation step.

Which category of the NFPE will be most relevant when evaluating a client with suspected PCOS? a. Edema b. Hair c. Muscles d. Digestive system

b. Hair Symptoms of polycystic ovarian syndrome, or PCOS, include the following: - Infrequent menstrual periods, no menstrual periods and/or irregular bleeding - Infertility due to lack of ovulation - Increased hair growth on the face, chest, stomach, back, thumbs or toes - Acne, oily skin and dandruff - Weight gain, especially around the mid-section - Insulin resistance or type 2 diabetes - High cholesterol and/or blood pressure - Thinning hair on head - Pelvic pain - Depression and anxiety due to appearance and/or infertility - Endometrial cancer Because of the potential for increased hair growth on the face and body and thinning hair on the head, hair would be a more relevant assessment parameter when performing a nutrition-focused physical examination on a client/patient with suspected PCOS.

Which of the following is a transitional food? a. Honey b. Ice cream c. Oatmeal d. Pudding

b. Ice cream "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, and frozen yogurt and some potato chips are considered transitional foods.

Regarding food-drug interactions, which food-drug combination requires client counseling? a. Warfarin and vitamin D-containing foods b. MAO inhibitors and tyramine-containing foods c. Prednisone and grapefruit juice d. Sibutramine and vitamin C-containing foods

b. MAO inhibitors and tyramine-containing foods There are no known interactions between warfarin and vitamin D foods, and prednisone and Sibutramine do not interact with vitamin C foods or juices.

Which classic vitamin deficiency is known for the four Ds: dermatitis, dementia, diarrhea, and death? a. Thiamine b. Niacin c. Biotin d. Folic acid

b. Niacin Dermatitis, dementia, diarrhea, and death are the typical symptoms of pellagra, a disease caused by niacin deficiency.

What is the first step in the Nutrition Care Process? a. Nutrition screening b. Nutrition assessment c. Nutrition diagnosis d. Goal setting

b. Nutrition assessment Sequential steps in the Nutrition Care Process are: 1. nutrition assessment 2. nutrition diagnosis 3. nutrition intervention 4. and nutrition monitoring and evaluation.

What is the most prevalent long-term consequence from childhood overweight into adulthood? a. Dyslipidemia b. Obesity c. Glucose intolerance d. Hormonal imbalance

b. Obesity Research shows that overweight children have a significantly higher chance of being obese in adulthood. The implications in the other options are of concern but represent short-term complications.

Which member of the health care team will the RDN most often collaborate with to assist patients with activities of daily living? a. Speech-language pathologist b. Occupational therapist c. Physician d. Physical therapist

b. Occupational therapist The occupational therapist is the member of the health care team who focuses on activities of daily living (ADL). For example, a patient who has had a stroke will interact with many members of the health care team.

What is the most appropriate nutrition intervention for a 10-year-old with ADHD who takes Adderall and has a BMI-for-age less than the 5th percentile? a. Provide snacks to eat during recess b. Offer a high-calorie bedtime snack c. Make a lunch consisting of favorite foods d. Have the teacher monitor the child's intake

b. Offer a high-calorie bedtime snack The peak activity for ADHD medication is scheduled around school hours. A side effect of ADHD medication is decreased appetite, so it is recommended to provide the child with a larger bedtime snack when the side effects are low and the appetite is improved.

What is the most effective test to screen cystic fibrosis patients for diabetes? a. Hemoglobin A1c b. Oral glucose tolerance c. Random blood glucose d. Fructosamine

b. Oral glucose tolerance Oral glucose tolerance is the most effective test for screening cystic fibrosis patients for diabetes. Fructosamine and A1c levels have low sensitivity in patients with cystic fibrosis.

Excess simple sugars in the intestines can cause what type of diarrhea? a. Exudative b. Osmotic c. Secretory d. Infectious

b. Osmotic Osmotic diarrhea occurs when water retention occurs in the gastrointestinal tract due to poorly absorbed substances

An 18-year-old female presents for a consultation about weight. She has a BMI of 35.1 and a waist circumference of 37 inches. During the nutrition-focused physical exam, the RDN observes facial acne, hirsutism , and alopecia. A medical diagnosis of _____ would support these physical findings a. Hypothyroid b. PCOS c. Type 2 diabetes d. Hyperthyroid

b. PCOS Given the presence of alopecia, acne, obesity, and hirsutism , the patient likely has polycystic ovarian syndrome (PCOS) related to insulin resistance.

A child with phenylketonuria has deficiency of which enzyme? a. Phenylalanine kinase b. Phenylalanine hydroxylase c. Phenylalanine dehydrogenase d. Tyrosine kinase

b. Phenylalanine hydroxylase PKU is caused by deficiency of phenylalanine hydroxylase.

Which of the following reflects long-term folate status? a. Serum folate b. Red blood cell folate c. Homocysteine concentration in the blood d. Serum methylmalonic acid

b. Red blood cell folate 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.

Omega-3 fatty acids have been associated with which of the following outcomes? a. Increased clotting activity b. Reduced inflammation c. Promotion of inflammation to assist immune function d. Increased bone density

b. Reduced inflammation Omega-3 fatty acids produces prostaglandins that help to reduce inflammation and keep blood thin by interfering with clotting.

Which of the following is typically used in infant cereal because of low allergy risk? a. Corn b. Rice c. Wheat d. Oats

b. Rice Rice cereal is less allergenic; it is typically the first grain introduced to infants.

Which of the following is a calibrated device used to measure height? a. Sphygmomanometer b. Stadiometer c. Height stick d. Dynamometer

b. Stadiometer A stadiometer is used to measure human height.

During a nutrition consult, a patient says: "I understand I can improve my diet by packing my own lunch, but I don't want to miss the social time with my coworkers." In the setting of motivational interviewing, what is this an example of? a. Change talk b. Sustain talk c. Developing discrepancy d. Resistance

b. Sustain talk The client's statement is not change talk because it argues for the status quo. Developing discrepancy is a technique employed by the clinician. Motivational interviewing rejects the concept of resistance and understands ambivalence is a natural component of the change process. The client's statement is an example of sustain talk because it presents an argument for maintaining status quo.

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

b. The enactment of an additional tax on soft drinks 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. The enactment of an additional tax on soft drinks is an example of an economic environmental change.

A client has demonstrated excessive energy intake related to depression. Why would this diagnosis be omitted from a PES statement? a. Excessive carbohydrate intake bears greater health risk than excessive energy intake b. The etiology of excessive energy intake in this client cannot be changed by an RDN c. Excessive energy intake is beyond the scope of dietetics practice d. Excessive carbohydrate intake is the designated top priority in all RDN clients

b. The etiology of excessive energy intake in this client cannot be changed by an RDN Prioritizing nutrition diagnoses is affected by impact potential and higher priority is generally assigned when the RDN can change the etiology of a nutrition problem. Although treating excessive energy intake is within RDN scope of practice, treating depression (the etiology for excessive energy intake in this case) is beyond the scope of dietetics practice.

Which of the following is true of the IDDSI Level 7 Regular (Black) diet a. Crunchy and hard foods are the only restriction b. There are no restrictions on allowable foods c. Mixed-consistency foods are permitted for adult patients only d. Food particle size is the only restriction

b. There are no restrictions on allowable foods The Level 7 Regular (Black) diet of the International Dysphagia Diet Standardisation Initiative is not a texture-modified diet and therefore there are no restrictions on allowable foods on this diet.

Which of the following reflects the purpose of using reference standards during the Monitoring and Evaluation step of the Nutrition Care Process? a. To research prevalence statistics to predict client risk b. To determine if the client was able to meet the intervention goal c. To capture a baseline measurement for nutrient levels d. To identify literature that supports use of a given medical nutrition therapy approach

b. To determine if the client was able to meet the intervention goal Criteria used to compare data during Monitoring and Evaluation includes reference standards and baseline measures that were evaluated and documented during Nutrition Assessment and recommendations and goals from Nutrition Intervention. These comparisons help to determine if the client has attained their intervention goals.

Why are excipients added into the formulation of medications? a. To decrease medication metabolism b. To increase or decrease the rate that the drug dissolves in the GI tract c. To increase the pH of the drug d. To make the drug more acidic

b. To increase or decrease the rate that the drug dissolves in the GI tract Excipients are added to affect dissolution or dissolving of medication in the GI tract. The dissolution of the medication has to occur first, and then the medication can be absorbed.

What is the mission of WIC? a. To increase the number of grocery stores, schools, and after-school initiatives participating in federal nutrition assistance programs. b. To provide nutritious foods, nutrition education, and health referrals to low-income women and children up to age 5 c. To provide free or low-cost lunches to school-age children d. To increase access to prenatal care among rural, low-income women

b. To provide nutritious foods, nutrition education, and health referrals to low-income women and children up to age 5 The stated mission of the Special Supplemental Program for Women, Infants, and Children is "to safeguard the health of low-income women, infants, and children up to age 5 who are at nutrition risk by providing nutritious foods to supplement diets, information on healthy eating, and referrals to health care."

When a person has phenylketonuria, which amino acid becomes essential? a. Tryptophan b. Tyrosine c. Threonine d. Methionine

b. Tyrosine Phenylalanine is converted to tyrosine by phenylalanine hydrolase, a missing enzyme in individuals with PKU; therefore, tyrosine is an essential amino acid for these individuals.

Which of the following is associated with cheilitis? a. Grapefruit-statin interaction b. Vitamin B12 deficiency c. Excess vitamin D intake d. Insulin resistance

b. Vitamin B12 deficiency Nutritional deficiencies, particularly iron and B-vitamins, are associated with the development of cheilitis.

Which vitamins are potentially indicated for liver disease-related impaired bile flow? a. Folic acid and vitamin B12 b. Vitamins A and E c. Vitamins B12 and A d. Thiamin and riboflavin

b. Vitamins A and E Bile acid is essential for the normal uptake of fat-soluble vitamins into the liver where they are metabolized. Vitamins A and E are fat soluble.

When is it recommended to test A1C quarterly? a. When patient is newly diagnosed with type 2 diabetes b. When patient's therapy has changed or glycemic goals are unmet c. When patient is meeting treatment goals and has stable glycemic control d. When patient is an older adult with advanced diabetes

b. When patient's therapy has changed or glycemic goals are unmet The American Diabetes Association recommends quarterly A1C testing for patients whose treatment has changed or who are not meeting glycemic goals and that patients who are meeting treatment goals and have stable glycemic control be tested twice per year. The ADA also has noted that there is very little need for monitoring and lowering A1C in older adults with advanced diabetes.

Which of the following strategies is a recommended approach to weight management? a. Conduct weight check at the end of the therapy session b. Work with the patient to determine whether to conduct blind weights c. Have the patient check weight daily and report findings d. Conduct weight monitoring during therapy sessions

b. Work with the patient to determine whether to conduct blind weights Weight management should be a cooperative effort, so working with the patient to determine a best course of treatment is recommended.

In the Nutrition Care Process, the three nutrition diagnosis domains are intake, clinical, and _____. a. empirical-theoretical b. behavioral-environmental c. current-historical d. individual-cultural

b. behavioral-environmental The three domains of nutrition diagnosis according to the Nutrition Care Process are intake, clinical, and behavioral-environmental.

Hyperglycemia between 5 AM and 9 AM caused by cortisol and growth hormone, which stimulate gluconeogenesis, is called the _____ phenomenon. a. circadian b. dawn c. episodical d. honeymoon

b. dawn Dawn phenomenon is the term for hyperglycemia that results from the effect of hormones involved in controlling circadian rhythms.

A delayed gastric emptying condition associated with autonomic nerve damage related to diabetes mellitus is called _____. a. steatorrhea b. gastroparesis c. gastroenteritis d. gastritis

b. gastroparesis Gastroparesis is a delayed gastric emptying condition that most commonly develops in association with autonomic nerve damage related to diabetes mellitus.

It would be appropriate to recommend the use of meal replacements for weight loss to a client who: a. has no more than 20 pounds to lose. b. has difficulty with portion control. c. habitually eats late at night. d. does not engage in physical activity.

b. has difficulty with portion control. The Academy's Evidence Analysis Library recommends, with a strong, conditional rating, that for people who have difficulty with self-selection and/or portion control, meal replacements may be used as part of the diet component of a comprehensive weight management program. Substituting one or two daily meals or snacks with meal replacements is a successful weight loss and weight maintenance strategy.

Encouraging a pregnant client to attend a seminar on the benefits of breastfeeding and offering supportive postpartum breastfeeding counseling are examples of a. nutrition monitoring and evaluation. b. health promotion. c. public health nutrition. d. secondary prevention.

b. health promotion. Health promotion empowers the individual to make changes and take control of their own health outcomes.. Public health nutrition does not focus at the individual level. Nutrition monitoring and evaluation involves patient follow-up after nutrition intervention. Secondary prevention focuses on early diagnosis and treatment like screening for and taking blood pressure medicine.

The objectives of patient-centered counseling for dietary change are to increase awareness of diet-related risks, provide nutrition knowledge, enhance skills to promote long-term changes in intake, and _____. a. reinforce patient values b. increase confidence for making dietary changes c. solicit social support from family members and friends d. identify and minimize external barriers to change

b. increase confidence for making dietary changes The actions in responses A, C, and D are all part of helping clients to make changes. However, patient-centered counseling is focused on helping patients develop a sense of self so they can realize how their attitudes, feelings, and behavior are being negatively affected. The goal is to have the patient confident enough to make the dietary change.

BMI at or greater than the 95th percentile is: a. at risk for overweight b. obese c. overweight d. severe childhood obesity

b. obese Healthy weight is defined as body mass index (BMI) in the 5th percentile to less than the 85th percentile. Overweight encompasses the 85th to less than the 95th percentile. Obese is defined as equal to or greater than the 95th percentile.

What comprises a PES statement? a. possibilities, effects, solutions. b. problem, etiology, sign/symptoms. c. people, efforts, satisfaction. d. probabilities, end products, significant information.

b. problem, etiology, sign/symptoms. PES stands for problem, etiology (or cause of problem), and the signs and symptoms that describe the nutrition problem.

Body mass index (BMI) is a better indicator of obesity than body weight because BMI is a. the ratio of height to weight b. the ratio of weight to height c. determined by indirect calorimetry d. determined by direct calorimetry

b. the ratio of weight to height BMI is calculated using weight (kg)/height (m2). BMI is based on the ratio of a person's weight to height and has been shown to be a reliable indicator of body fatness.

Warfarin acts as a vitamin K antagonist by inhibiting which of the following? a. gamma-carboxylase b. vitamin K epoxide reductase c. formation of active proenzyme factor d. breakdown of fibrinogen

b. vitamin K epoxide reductase Warfarin inhibits the epoxide reductase enzyme in the vitamin K cycle.

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? a. "Why aren't you more motivated?" b. "What can I do to help you?" c. "What would need to happen in order for your confidence to increase to a '6'?" d. "It's encouraging that the importance rating is so high."

c. "What would need to happen in order for your confidence to increase to a '6'?" 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 benchmark is commonly used to measure if weight loss is successful? a. 3 months b. 6 months c. 1 year d. 2 years

c. 1 year In determining if weight loss has been successful, 1 year of maintenance is commonly used as the benchmark.

Calculate the kcal from a 500 mL 20% intralipid in a parenteral nutrition regimen a. 500 b. 750 c. 1,000 d. 1,250

c. 1,000 500 mL × 2.0 kcal/mL = 1000 kcal

A patient in residential care is receiving an enteral formula that contains 1.5 kcal/ml at a rate of 75 ml/hour for a 12-hour time frame. The patient will receive: a. 950 kcal b. 1,050 kcal c. 1,350 kcal d. 1,650 kcal

c. 1,350 kcal This client would receive a total of 1,350 mL over the 12-hour time frame. 75 mL/hr x 12 hrs. = 900 mL 900 mL x 1.5 kcal/mL = 1,350 kcal

What is the protein requirement for patients on peritoneal dialysis? a. 0.6 g/kg to 0.8 g/kg b. 1.0 g/kg to 1.1 g/kg c. 1.2 g/kg to 1.3 g/kg d. 1.5 g/kg to 1.7 g/kg

c. 1.2 g/kg to 1.3 g/kg For stable patients receiving peritoneal dialysis, 1.2 g protein per kg to 1.3 g protein per kg is recommended.

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 d. 1/5

c. 1/4 Schools participating in the USDA School Lunch Program must provide 1/3 of the RDA for protein, calcium, iron, and vitamins A and C 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.

For adults older than 19 years, how many grams of carbohydrate are needed daily for an adequate supply of glucose to the brain? a. 60 g b. 75 g c. 130 g d. 160 g

c. 130 g The National Academy of Sciences recommends consuming at least 130 g (520 kcal) carbohydrate per day, the minimum amount of carbohydrates needed to produce enough glucose for the brain to function.

How many pounds are recommended for an overweight woman to gain during her pregnancy? a. 0 b. 5-10 c. 15-25 d. 28-40

c. 15-25 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.

What is the weight gain recommendation during a single gestation pregnancy for person with a body mass index of 20? a. 15-20 lbs. b. 28-40 lbs. c. 25-35 lbs. d. 35-45 lbs.

c. 25-35 lbs. The Institute of Medicine recommends normal weight women gain 25-35 lb. The recommendation for overweight women is 15-25 lb and 35-45 lb for twin gestation.

How many carbohydrate servings are in 45 grapes? a. 1 b. 2 c. 3 d. 4

c. 3 There are roughly 15 grapes in 1 carbohydrate serving, so 45 grapes would provide approximately 3 carbohydrate servings.

Approximately how many carbohydrate servings are 48 grapes? a. 1 b. 2 c. 3 d. 4

c. 3 There are roughly 15 grapes in 1 carbohydrate serving, so 48 grapes would provide approximately 3 carbohydrate servings.

How many pressure ulcer/injury stages are there? a. 2 b. 3 c. 4 d. 5

c. 4 The National Pressure Ulcer Advisory Panel has identified four stages of pressure ulcer/injury. - Stage 1 Pressure Injury: Non-blanchable erythema of intact skin - Stage 2 Pressure Injury: Partial-thickness skin loss with exposed dermis - Stage 3 Pressure Injury: Full-thickness skin loss - Stage 4 Pressure Injury: Full-thickness skin and tissue loss

In which nutrition assessment domain of the Nutrition Care Process would an RDN contrast a patient's actual energy intake with estimated energy needs when using the Nutrition Care Process? a. Client History b. Food and Nutrition-Related History c. Comparative Standards d. Nutrition Diagnosis

c. Comparative Standards A patient's results compared against thresholds of standards is done as part of the Comparative Standards component of a nutrition assessment.

The most appropriate nutrition prescription for a patient with cirrhosis includes which of the following? a. 0.6 g protein/kg body weight b. 40%-45% fat c. 4-6 smaller meals per day d. 4-6 g sodium

c. 4-6 smaller meals per day 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.

What is the age range when weight and body mass index peak? a. 30-39 years b. 40-49 years c. 50-59 years d. 60-69 years

c. 50-59 years Weight and BMI peak between age 50 and 59 years, then stabilize and start slowly dropping around age 70.

How many carbohydrate servings, or exchanges, are in a meal comprising 1 cup granola, 1 cup skim milk, and 1 small banana a. 4 b. 5 c. 6 d. 7

c. 6 - 1 cup granola = 60 g carbohydrate. - 1 cup milk = 12 g carbohydrate. - 1 small banana 15 g = carbohydrate. - 60 + 12 + 15 = 87 g carbohydrate. - With 1 carbohydrate serving = 15 g, there are 6 carbohydrate servings (rounded up) in this meal (87/15=5.8).

What is the primary purpose of a nutrition intervention? a. Alleviating symptoms of a nutrition problem b.Determining the cause of a person's nutrition problem c. Altering or eliminating the etiologies of a nutrition diagnosis d. Researching potential cures for conditions with nutrition implications

c. Altering or eliminating the etiologies of a nutrition diagnosis A nutrition intervention is a purposely planned action intended to change a nutrition-related behavior, risk factor, environmental condition, or aspect of health status to resolve or improve the identified nutrition diagnosis or nutrition problem. It is less often directed at alleviating signs and symptoms.

What is OSFED? a. A subsidiary of the US Food and Drug Administration b. A type of obstructive sleep disorder c. An eating disorder classification d. An oncology specialist credential

c. An eating disorder classification OSFED, or other specified feeding or eating disorders, is a classification in the Diagnostic and Statistical Manual of Mental Disorders (DSM) used to assign a diagnosis to individuals with significant disordered eating behaviors but who don't meet the threshold of strict diagnostic criteria. OSFED was introduced in the 5th edition of the DSM and replaced the previous classification of EDNOS, or, eating disorder not otherwise specified.

In the Nutrition Care Process, where should the dietetics professional note the client's BMI? a. Food/nutrition-related history b. Biochemical data, medical tests and procedures c. Anthropometric measurements d. Nutrition-focused physical findings

c. Anthropometric measurements 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.

Which type of federal grant is used to fund state programs for housing, health, and social service programs? a. Categorical grant b. Planning grant c. Block grant d. Matching grant

c. Block grant Block grants, such as TANF, are given by the Federal government to states so that they can implement the program that meets the unique needs of that state.

Maple syrup urine disease (MSUD) is caused by the inability to metabolize which of the following amino acids? a. Phenylalanine b. Aromatic amino acids c. Branched-chain amino acids d. Sulfur-containing amino acids

c. Branched-chain amino acids MSUD is an amino acidemia caused by autosomal recessive gene affecting branch-chain amino acids.

Which condition involves damaged enterocytes caused by ingesting foods that are not harmful to most people? a. Food allergy b. Lactose intolerance c. Celiac disease d. Fructose intolerance

c. Celiac disease In celiac disease, enteropathy is caused by gluten in genetically predisposed individuals. Immune activation in response to proteins in certain grain foods that are not harmful to most results in intestinal damage.

What is the recommended test to screen for gestational diabetes in a client who has a history of Roux-en-Y gastric bypass surgery and is experiencing dumping syndrome? a. Perform 1-hour oral glucose tolerance test with a 75 g glucose load b. Check hemoglobin A1c levels c. Check fasting and 2-hour postprandial glucose levels for 1 week d. Perform 3-hour oral glucose tolerance test with a 100 g glucose load

c. Check fasting and 2-hour postprandial glucose levels for 1 week It is recommended to check fasting and 2-hour postprandial blood glucose levels for 1 week during 24-28 weeks gestation. A 1-hour glucose tolerance test (GTT) or 3-hour GTT could trigger dumping syndrome, as a high glucose load causes a hyperosmolar environment in the small bowel and the GTT can also result in hypoglycemia in patients who are post gastric bypass surgery. Checking Hgb A1c levels is not recommended for diagnosing gestational diabetes since it is not as reliable as oral glucose tolerance testing.

The World Health Organization growth charts for children younger than age 2 are based on data from a. Children from the United States only b. Children from the United States and Europe c. Children from six different countries on different continents d. Children from the United States and Canada

c. Children from six different countries on different continents Growth chart data were measured in the United States, Oman, Norway, Brazil, Ghana, and India for a global representation of normal growth based on a foundation of exclusive breastfeeding for at least 4 months

What kind of food should mostly comprise the diet of a 14-month old child? a. Homemade, pureed foods b. Stage 3 baby foods c. Chopped table foods, including some that the child can pick up with their fingers d. All foods including whole nuts, raw carrots, and whole grapes

c. Chopped table foods, including some that the child can pick up with their fingers Young children can still choke on large chunks of food. Toddlers are learning to like new flavors and textures that allow them to practice age-appropriate oral and fine motor skills. They require repeated exposure to master eating skills. For this reason, chopped table foods are recommended for the diet of children at this age.

Which of the following is a person with opioid addiction likely to experience? a. Diarrhea b. Weight loss c. Constipation d. Excessive saliva production

c. Constipation Opioids delay gastric emptying, leading to constipation.

Which of the following adaptive utensils may benefit a person with advanced Parkinson's disease? a. Larger-grip utensils b. Roller knife c. Covered cup with slotted spout d. Cup with a cut-out

c. Covered cup with slotted spout Parkinson's disease is a progressive neurological disease that causes tremors, and a covered cup with a slotted spout offers independent consumption of liquids. Flatware with built-up handles would be more challenging for a person who has handgrip (strength) problems. A roller knife would be helpful for someone with only one arm. A cut-out plastic cup would be good for someone with limited neck motion but could lead to spilling when used by a person with Parkinson's.

A patient presents with B12 deficiency. Which of the following conditions may be implicated, necessitating additional data and evaluation in this patient? a. Dysphagia and gastroesophageal reflux disease b. Hyperlipidemia and hypertension c. Crohn's disease and anemia d. Pale skin and fatigue

c. Crohn's disease and anemia Some assessment data may implicate more than one condition, requiring more information to identify the appropriate diagnosis and intervention. For example, B12 deficiency is seen in patients with Crohn's disease and anemia but is not a symptom of dysphagia, GERD, hyperlipidemia, or hypertension. Pale skin and fatigue are symptoms of, not diagnoses related to, B12 deficiency.

Which vitamin deficiency is likely to develop in a patient with liver disease? a. A b. E c. D d. K

c. D Vitamin D deficiency is frequently reported in liver disease patients and is thought to result from impaired synthesis and absorption.

Which of the following conditions may be affected by the chromium and nickel content of stainless steel cookware? a. Iron-deficiency anemia b. Autism c. Dermatitis d. Atherosclerosis

c. Dermatitis Stainless steel cookware contains nickel and chromium. Nickel and, to a lesser extent, chromium can induce contact allergic dermatitis. Stainless steel grade, cooking time, and cookware usage may play a role in leaching during food preparation.

Which of the following is recommended to manage nausea? a. Avoid any product made with ginger b. Drink fruit juice throughout the day c. Eat small meals throughout the day d. Eat foods containing capsaicin

c. Eat small meals throughout the day Eating small meals throughout the day is recommended for individuals experiencing nausea. Ginger products can help alleviate nausea symptoms. Spicy foods and sugar-containing foods can exacerbate nausea so capsaicin-containing foods and fruit juice are not recommended.

Which of the following data would be recorded during the nutrition-focused physical exam? a. Inadequate protein intake b. Surgical history c. Edema d. Blood glucose

c. Edema Edema (swelling caused by excess fluid in tissues) is an evaluation parameter in the nutrition-focused physical findings section of nutrition assessment, according to the Nutrition Care Process. Blood glucose data would be recorded under biochemical data, medical tests, and procedures, and surgical history would be recorded under client history. Inadequate protein intake is a nutrition diagnosis.

What is the minimum recommended frequency for measuring height, weight, and waist circumference as part of obesity screening in adults? a. Every 3 months b. Every 6 months c. Every year d. Every other year

c. Every year It is recommended that weight, height, and waist circumference be measured in all adults as part of obesity screening at least annually.

Which of the following herbs is purported to have benefits as a dietary supplement most often for diabetes, and to stimulate milk production during breastfeeding? a. Milk thistle b. Gingko biloba c. Fenugreek d. Kava kava

c. Fenugreek Fenugreek is purported to have benefits as a dietary supplement for diabetes and to stimulate milk production during breastfeeding. Milk thistle is often used for liver issues, gingko biloba is often used for improving memory, and kava kava is used for stress management.

What method of collecting information on access to health services within the community includes small, informal discussions with community members using open-ended questions? a. Public forums b. Asset mapping c. Focus groups d. Surveys

c. Focus groups Focus groups tend to be smaller than public forums and have specific questions that support discussions. A public forum is usually with a larger audience and allows individuals to share their views on specific issues. Surveys may be conducted through a conversation but are completed individually and have limited questions. Asset mapping focuses on identifying strengths and existing resources.

What does the Older Americans Act Nutrition Program (OAANP) offer? a. Nutrition counseling for older adults via federally funded clinics b. Food vouchers for low-income, elderly individuals c. Grants to support nutrition services at the state level for individuals older than 60 years of age d. Nutrition-related promotional materials to be distributed in nursing homes.

c. Grants to support nutrition services at the state level for individuals older than 60 years of age The OAANP offers state grants to support nutrition services for older adults, including programs that provide health-promoting meals in a variety of group settings, such as senior centers, and faith-based settings, as well as in the homes of frail, isolated homebound older adults

Which of the following is a likely diagnosis if acanthosis nigricans are present? a. High blood sugar b. Hypertension in a person who is also diabetic c. High insulin levels in the blood d. Low insulin levels in the blood

c. High insulin levels in the blood Insulin crosses the dermoepidermal junction to affect the keratinocytes. The binding of excess insulin to insulin-like growth factors stimulates proliferation of keratinocytes and fibroblasts, leading to acanthosis nigricans.

Long-term use of corticosteroids can lead to which of the following? a. Low blood pressure b. Increased loss of body fluids c. Hyperglycemia d. Thickened skin

c. Hyperglycemia Long-term use of corticosteroids like prednisone leads to hyperglycemia, hypertension, increased risk of infection, osteoporosis, and bone fracture, thin skin, suppressed adrenal gland hormone production.

What risk is associated with a type 1 diabetes patient trying to maintain hemoglobin (Hgb) A1c at 6.0 %? a. Increase in occurrence of retinopathy b. Hyperglycemia c. Hypoglycemia d. Decrease in occurrence of retinopathy

c. Hypoglycemia In a long-term major trial of intensive vs. conventional control of blood sugar in persons with type 1 diabetes, hypoglycemia occurred more frequently in the intensive group in which patients were aiming for lower blood sugar goals than usual.

Who among the following would have difficulty with breastfeeding? a. Infant with extrusion reflex b. Infant with cleft lip c. Infant with cleft palate d. Infant with colic

c. Infant with cleft palate Babies born with cleft palates cannot create enough suction to withdraw milk from the breast. Infants with cleft lip have few feeding problems, extrusion reflex is normal , and there is no association between colic and feeding difficulties.

Which of the following indicates a breastfeeding infant has a good latch? a. Infant's swallowing is inaudible b. Infant makes smacking noises c. Infant's cheeks are rounded d. There is space between infant's chin and mother's breast

c. Infant's cheeks are rounded Among the signs that a breastfeeding infant has a good latch are that the infant's cheeks are rounded, swallowing is audible, there are no clicking or smacking sounds, and the infant's chin is touching the breast.

Intake of _____ should be carefully monitored in patients with kidney disease because phosphorous is more easily absorbed from this source. a. Dairy b. Meat c. Inorganic phosphate food additive d. Whole grains

c. Inorganic phosphate food additive Dietary phosphorus is found in organic and inorganic sources. Organic sources are animal and vegetarian; inorganic sources are food preservatives. A concern for patients with chronic kidney disease is that the body could absorb as much as 100% of inorganic phosphorus via processed foods. Because absorption rate is variable among different sources, whether a phosphorus source is organic or inorganic and whether it is animal or vegetarian, is noteworthy for this population. Emphasize intake of plant-based proteins and foods containing no inorganic phosphorus additives in these patients.

What is the best approach to working with a client with these circumstances: needs to reduce blood cholesterol levels, knowledgeable about diets for hyperlipidemia, able to devise healthy meal plans, has moderate readiness to independently follow the recommended diet plan. 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.

c. Listen to the client. Encourage and support the skills the client has developed. 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.

Tyramine is a pressor agent in food that can affect which class of drugs? a. Statins b. H blockers c. MAO inhibitors d. Lithium

c. MAO inhibitors Monoamine oxidase inhibitors interact with pressor agents in food such as tyramine, dopamine, histamine, and phenylethylamine, which can result in a sudden increase in blood pressure.

What comorbidity is typically diagnosed in patients with alcoholic cirrhosis? a. Edema b. Kidney failure c. Malnutrition d. Cachexia

c. Malnutrition Global malnutrition or nutritional status alteration such as micronutrient deficiency (potentially caused by poor nutritional intake, poor absorption, or increased losses) is often diagnosed in patients with cirrhosis. Malnutrition is present in almost every patient with alcoholic cirrhosis.

A patient needs to sign up for Meals on Wheels. For this part of discharge planning, who on the health care team will the RDN most likely collaborate with? a. Dietetic technician, registered b. Physician assistant c. Medical social worker d. Occupational therapist

c. Medical social worker Medical social workers are the members of the health care team who coordinate the discharge plans when community and other resources are needed.

Which of the following components of the Nutrition Care Process are performed during the same step? a. Assessment and Intervention b. Monitoring and Diagnosis c. Monitoring and Evaluation d. Diagnosis and Intervention

c. Monitoring and Evaluation Nutrition Monitoring & Evaluation occur during the fourth step of the Nutrition Care Process.

Which of the following might need to be excluded from the diet of patients with celiac disease? a. Hominy grits b. Rice noodles c. Oatmeal d. Potato flour

c. Oatmeal Although patients with celiac disease cannot tolerate wheat or gluten, there are also some celiac patients who cannot tolerate oats. Patients with celiac disease should always check packaging for oat-containing foods to ensure they are labeled as gluten free.

In the Nutrition Care Process, statements in the format of "[Nutrition problem] related to ____ as evidenced by ____" are classified as: a. intake critiques. b. NCP links. c. PES statements. d. nutrition concerns.

c. PES statements. These statements are written in the style of the classic PES statement.

What is the term for a care delivery model in which multidisciplinary treatment is coordinated through a primary care physician to ensure the patient receives necessary care in a timely, individualized manner? a. Health maintenance organization b. Ambulatory care facility c. Patient-centered medical home d. Group practice

c. Patient-centered medical home - A patient-centered medical home is a care delivery model in which multidisciplinary treatment is coordinated through a primary care physician to ensure the patient receives necessary care in a timely, individualized manner. - A health maintenance organization, or HMO, is network of doctors, hospitals, and other health care providers who have agreed to accept a certain level of payment for any provided services, which lowers costs for members. - An ambulatory care facility is an outpatient care center that provides services like diagnosis, treatment, consultation, and intervention. - Group practice refers to a private practice shared by multiple providers.

Which enteral feeding access device will deliver nutrition past the ligament of Treitz? a. Nasogastric b. Nasoduodenal c. Percutaneous jejunostomy d. Percutaneous gastrostomy

c. Percutaneous jejunostomy 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.

What is the term for a client's probable response to therapy? a. Diagnosis b. Remission c. Prognosis d. Cure

c. Prognosis Prognosis is a person's expected outcome and response to treatment.

Which of the following individuals would be LEAST likely to be at risk for vitamin B-12 deficiency? a. A vegan b. A woman with polycystic ovarian syndrome taking metformin therapy c. An elderly individual on a proton pump inhibitor d. A man on aspirin therapy

d. A man on aspirin therapy A patient on aspirin therapy may be at risk for iron deficiency but not vitamin B-12 deficiency.

What are protein recommendations for a person with diabetes based on? a. Hydrogen breath test b. Average of a series of A1c measurements c. RDA for healthy individuals d. Resting metabolic rate

c. RDA for healthy individuals Currently there is insufficient evidence to support a recommendation for ideal protein intake in people with diabetes. The Recommended Daily Allowance (RDA) of protein for healthy Americans can serve as the basis for protein recommendations in individuals with diabetes.

What is the likely cause of diarrhea after meals in a patient who had a gastric resection? a. Rapid entry of fats into the small intestine b. Slower entry of sugars into the small intestine c. Rapid entry of sugars into the small intestine d. Slower entry of water into the small intestine

c. Rapid entry of sugars into the small intestine Dumping syndrome is a common complication after gastric surgery. It occurs when food rapidly passes directly from the stomach to the intestine without being digested, resulting in diarrhea. The onset of these symptoms is common after the consumption of simple carbohydrates or sugar.

When monitoring the outcomes of a type 2 diabetes intervention, which result would indicate the intervention was successful? a. Increase in low-density lipoprotein b. Reduction in vitamin D, 25 hydroxy c. Reduction in hemoglobin A1c d. Increase in blood pressure

c. Reduction in hemoglobin A1c Reducing HbA1c is a good marker for determining whether an intervention in a patient with type 2 diabetes was successful.

Which of the following fish contains a higher level of methyl mercury and therefore should be avoided during pregnancy? a. Salmon b. Pollack c. Swordfish d. Tilapia

c. Swordfish 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 diet plan for patients with cardiovascular disease follows the US Dietary Guidelines for physical activity, saturated and trans fat, cholesterol, sodium, and consumption of fiber, stanol esters, and whole grains? a. DASH b. REAP c. TLC d. CAGE

c. TLC The Therapeutic Lifestyle Changes (TLC) diet incorporates physical activity; decreased saturated and trans fat, cholesterol, and sodium intake; and increased consumption of fiber, stanol esters, and whole grains.

Which of the following is true of a child who consistently plots at the 5th percentile on the weight-for-length/stature Centers for Disease Control and Prevention growth chart but is growing? a. The child demonstrates a negative pattern of growth. b. The child demonstrates failure to thrive. c. The child has a thin body habitus. d. The child is reflecting a change in growth velocity.

c. The child has a thin body habitus. 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.

According to the Nutrition Care Process, what does a "discontinued diagnosis" signify? a. The original diagnosis has been removed from the eNCPT b. The patient is no longer receiving care at the facility c. The diagnosis is no longer applicable based on assessment data d. A new intervention is needed because a patient's medication has been discontinued

c. The diagnosis is no longer applicable based on assessment data Use of nutrition diagnosis status labels is encouraged by the Academy of Nutrition and Dietetics. In the Nutrition Care Process, "discontinued diagnosis" is applicable when the nutrition diagnosis no longer exists because the client's condition or situation has changed and the current assessment data no longer support the nutrition diagnosis.

Which of the following is an advantage of a case control study? a. It is easy to validate data in these studies. b. They facilitate study of mechanism of disease c. They are inexpensive to conduct d. Suitable comparison groups are easily identified

c. They are inexpensive to conduct It is relatively inexpensive to conduct a case control study. However, in these studies, it also can be very difficult to validate data and select a suitable comparison group, and they do not help in studying the mechanism of disease.

Which of the following may develop from taking antiretroviral therapy? a. Hypoglycemia b. Pruritus c. Type 2 diabetes d. Blount's disease

c. Type 2 diabetes Antiretroviral therapy (ARV) is a treatment for HIV/AIDS and includes a host of long-term and short-term side effects. Type 2 diabetes is a potential side effect with ARV.

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

c. Vitamin B12 Large doses of folate supplements might mask a vitamin B12 deficiency because they can correct the anemia caused by vitamin B12 deficiency without addressing the neurological damage that this deficiency causes. Vitamin B12 deficiency can result in permanent damage to the brain, spinal cord, and nerves.

If a patient has lesions on the 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

c. Vitamin C - Vitamin C helps keep the 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.

Rickets is a result of which vitamin deficiency? a. Vitamin A b. Vitamin C c. Vitamin D d. Vitamin K

c. Vitamin D The most obvious sign of vitamin D deficiency is abnormality of bones. Rickets is caused by vitamin D deficiency and is characterized in children by bowed legs from bones too weak to support the body weight and a protruding belly that results from lax abdominal muscles.

Which of the following is a good indicator of central adiposity? a. Hip circumference b. Basal metabolic rate c. Waist circumference d. Body weight

c. Waist circumference Central adiposity is the accumulation of fat in the lower torso around abdominal area.

A deficiency of vitamin B-12 in older adults is most likely due to a. diverticulosis. b. fat malabsorption. c. atrophic gastritis. d. gallbladder disease.

c. atrophic gastritis. 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.

Enterocytes are a. cells of the colon b. parietal cells c. cells of the gastrointestinal tract d. cells of the stomach lining

c. cells of the gastrointestinal tract The gastrointestinal tract is lined by a continuous sheet of epithelial cells, also known as "enterocytes," which are responsible for processing and moving nutrients from the lumenal space into the vasculature for distribution to peripheral tissues.

In the ETHNIC model of culturally competent care, the "E" stands for _____. a. education b. empathy c. explanation d. expectations

c. explanation In the ETHNIC model, explanation about the culture and condition or illness by the client is the first step.

Motivational interviewing is best described as a style of counseling that: a. challenges clients to face their issues of denial. b. explores ways to increase self-acceptance. c. inspires neutral or reluctant clients to change. d. focuses on unhelpful thought patterns and problematic thoughts.

c. inspires neutral or reluctant clients to change. Health care professionals must be aware of this style of counseling, which represents an effective, brief intervention with applications in all realms of health care, including 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. It should be used with other comprehensive approaches to counseling to inspire change in clients who may otherwise feel neutral or reluctant to change. Focusing on unhelpful thought patterns is a tenet of cognitive behavioral therapy, and exploring ways to increase self-acceptance is a tenet of humanistic therapy.

Which of the following nutrients has an important role in maintenance of body composition for older adults? a. fat b. iron c. protein d. vitamin C

c. protein Declines in skeletal muscle mass and strength are major contributors to increased mortality, morbidity, and reduced quality of life in older people. Recommended Dietary Allowances/Dietary Reference Intakes have failed to adequately consider the protein requirements of the elderly with respect to function. There is good, consistent evidence that consumption of 1.0 g/kg/day to 1.3 g/kg/day dietary protein combined with twice-weekly progressive resistance exercise reduces age-related muscle mass loss.

In a nutrition diagnostic statement, signs and symptoms refer to: a. alterations in the patient's nutritional status that the RDN can resolve b. a description of the factors contributing to the nutrition problem c. subjective and objective data used to determine if the nutrition diagnosis is accurate d. the medical nutrition therapy that will be required to treat the effects of the diagnosed condition

c. subjective and objective data used to determine if the nutrition diagnosis is accurate Signs and symptoms are the subjective and objective data an RDN uses to determine if a nutrition diagnosis is accurate.

A typical feeding/eating pattern for infants is a. to require apple juice at 4 months to regulate stooling. b. to require cereal at bedtime after 3 months to sleep through the night. c. to require only breastmilk or iron-fortified formula for the first 6 months of age. d. hard to predict since their interest in eating is so variable.

c. to require only breastmilk or iron-fortified formula for the first 6 months of age. Infants only need breastmilk or iron-fortified formula for the first 6 months of life.

Children on strict vegan diets may be deficient in a. vitamin B-6. b. magnesium. c. vitamin B12. d. folate.

c. vitamin B12. Vegans do not consume meat, eggs, or dairy, which are high in vitamin B12. Children have periods of rapid growth, so careful planning is needed to prevent a vitamin B12 deficiency. It is suggested that children on a vegan diet consume vitamin B12-fortified foods, such as most breakfast cereal, soy beverages and plant-based meat substitutes to avoid deficiency.

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? a. +16.3 grams b. −16.3 grams c. −2 grams d. +2 grams

c. −2 grams Nitrogen balance formula: total protein intake (g)/6.25 g - (UUN + 4 g for insensible losses) Step 1: Convert the total protein intake to grams of nitrogen. To calculate this, divide the total protein intake of 102 g by 6.25 g of protein per gram of nitrogen. 102 g/6.25 = 16.32 g Total nitrogen intake = 16.32 g Step 2: Determine the total excretion. To calculate this, add 14.3 g of nitrogen excreted in the urine over 24 hours (UUN) + 4 g of nitrogen for insensible losses (from sweat, gastrointestinal tract) in a 24-hour period. 14.3 g + 4 g = 18.3 Total nitrogen excreted = 18.3 g Step 3: Calculate nitrogen balance. Take total nitrogen intake of 16.32 g and subtract total nitrogen excretion of 18.3 g. 16.32 g - 18.3 g = -1.98 g Nitrogen Balance rounded up = -2 g nitrogen. This patient has a negative nitrogen balance, so the dietetic practitioner will need to assess if an increase in protein intake is needed.

What deficiency can be masked by consumption of high levels of folate supplements? a. Niacin b. Vitamin B6 c. Iron d. Vitamin B12

d. Vitamin B12 Folate supplements will help the body recover from anemia that occurs from a deficiency of folate and vitamin B12. However, without adequate vitamin B12, neurological problems progress and become irreversible.

In a PES statement, what is the phrase that links signs and symptoms to etiology? a. "Because of" b. "Related to" c. "As a result of" d. "As evidenced by"

d. "As evidenced by" The format for each nutrition diagnosis, or PES, statement is problem (P) related to etiology (E) as evidenced by signs and symptoms (S).

What is the recommended weight gain for an obese pregnant person? a. 28-40 lbs. b. 25-35 lbs. c. 15-25 lbs. d. 11-20 lbs.

d. 11-20 lbs. According to the Institute of Medicine (now called National Academy of Medicine) guidelines for weight gain during pregnancy, recommended weight gain for obese people is 11-20 lbs.

The optimal length of time to breastfeed an infant is a. 3 months b. 6 months c. 9 months d. 12 months

d. 12 months The American Academy of Pediatrics states that it's recommended to exclusively breastfeed for 6 months and that it is optimal to continue breastfeeding while introducing complementary foods at least up to 1 year.

What is the recommended dietary fluid allowance for patients aged 65 years or older? a. 20 mL/kg b. 50 mL/kg c. 1.5 mL/kg d. 25 mL/kg

d. 25 mL/kg For adults older than 65 years, 25 mL/kg is appropriate. A simple calculation is: 25 mL × body weight in kg = estimated fluid needs.

What is the daily recommended daily fiber goal for a 10-year-old boy? a. 14 g/day b. 19.6 g/day c. 22.4 g/day d. 25.2 g/day

d. 25.2 g/day The daily recommended fiber goals for children are: - 14 g/day for all children age 1-3 - 16.8 g/day for girls age 4-8 - 19.6 g/day for boys age 4-8 - 22.4 g/day for girls age 9-13 - 25.2 g/day for boys age 9-13

What is typically the appropriate angle of the head of a bed to prevent aspiration in a patient receiving enteral nutrition? a. 15°-20° b. 20°-25° c. 25°-30° d. 30°-45°

d. 30°-45° Unless contraindicated, the head of the bed of a patient receiving enteral nutrition should be set at an angle of 30° to 45° to prevent aspiration.

Within the first few weeks of life, what is the average recommended number of feedings for an infant in a 24-hour period? a. 2-4 b. 4-6 c. 7-10 d. 8-12

d. 8-12 Until lactation is well established and infants are demonstrating adequate weight gain, infants should be fed every 2 to 3 hours and should receive 8 to 12 feedings in 24 hours.

Which of the following is true when collecting data for a community needs assessment? a. Collected data should be from within the past 5 years b. Data collection by direct observation is discouraged c. Only quantitative data are relevant d. A minimum of two collection methods is recommended

d. A minimum of two collection methods is recommended In community needs assessments, it is recommended that a combination of two or more data-collection methods be employed to confirm or support initial findings. Direct observation is encouraged and both qualitative and quantitative data are considered relevant. Collected data should be from the past 6 months with very limited exceptions.

Who among the following would be the BEST candidate for proprotein convertase subtilisin kexin 9? a. A patient with coronary artery disease, a low-density lipoprotein (LDL) level of 75 mg/dL, and taking Atorvastatin b. A patient who cannot tolerate statins c. A woman with type 2 diabetes and microvascular disease who is currently on a statin d. A patient with heterozygous familial hypercholesterolemia (HeFH)

d. A patient with heterozygous familial hypercholesterolemia (HeFH) PCSK9 inhibitors are expensive medications that can significantly reduce LDL. PCSK9 can reduce LDL-C by 55% to 70% and helps patients with familial hypercholesterolemia reach their lipid goals. The patient with coronary artery disease doesn't need PCSK9, as the statin has achieved the LDL target. The patient who cannot tolerate statins is not a candidate for PCSK9 because Zetia (Ezetimibe) can be used in combination with stanols/sterols. The woman with type 2 diabetes is not a candidate because a high-intensity statin would be the preferred medication.

What do instrumental activities of daily living (IADL) evaluate? a. Daily nutrient intake from food sources b. Developmental progression in early childhood c. Completion of physical activity goals d. Ability to function independently

d. Ability to function independently IADLs (such as chores, cleaning, cooking, driving or using public transportation, grocery shopping, home repair, paying bills or other financial tasks, taking prescribed medications, and using a phone) help to evaluate an older adult's ability to function independently. IADLs do not comprise necessary basic abilities for minimal functioning (such as feeding, dressing, bathing, and walking), but the ability to perform IADLs can significantly improve quality of life.

What should family/caregiver be advised to do if a person with type 1 diabetes experiences a severe hypoglycemia event and is unconscious? a. Give three hard candies b. Administer insulin c. Give 4 oz fruit juice d. Administer glucagon

d. Administer glucagon Since the person is unconscious/unresponsive with severe hypoglycemia, glucagon should be administered as the first-line treatment. A glucagon injection will mobilize glucose from the liver to raise the blood sugar level. This treatment minimizes risk of choking. The family/caregivers should not hesitate to contact emergency services if glucagon is not available or if they do not know how to use it.

What is the best approach when counseling a mother who is reluctant to breastfeed? a. Read off a list of the benefits of breastfeeding b. Send the client home with handouts to read on her own time c. Prescribe a strict plan to guide the feeding process d. Ask open-ended questions about this reluctance

d. Ask open-ended questions about this reluctance Active listening, reflecting, and asking open-ended question are all effective techniques for encouraging breastfeeding. Assigning a strict feeding plan is not a counseling technique, assigning homework eliminates the opportunity for dynamic conversation to answer questions, and simply reading off a list of benefits risks being perceived as a lecture.

Lack of appetite and rapid muscle breakdown associated with disease is known as: a. Anorexia b. Catabolism c. Anabolism d. Cachexia

d. Cachexia Cachexia is the increased breakdown of muscle protein, along with decreased protein synthesis, which leads to overall muscle loss.

Cystic fibrosis is a genetic condition that affects transport of which mineral across the cell membrane? a. Sodium b. Potassium c. Phosphorus d. Chloride

d. Chloride Mutation of cystic fibrosis transmembrane conductance regulator gene (CFTR) on chromosome 7 results in the abnormal CFTR protein that transports chloride across the membranes of lungs, liver, pancreas, digestive tract, reproductive tract, and skin.

Which component of nutrition assessment is not reassessed during monitoring and evaluation? a. Anthropometric data b. Nutrition-focused physical findings c. Biochemical data, medical tests, and procedures d. Client history

d. Client history During the monitoring and evaluation step of the Nutrition Care Process, client history is not reassessed.

Which of the following types of fish is safest for consumption by someone who is trying to get pregnant? a. Orange roughy b. Swordfish c. Marlin d. Cod

d. Cod Orange roughy, swordfish, and marlin all have higher levels of mercury. Because it is low in mercury, cod is considered one of the safest fish choices for people who are pregnant, may become pregnant, or are breastfeeding

Which of the following should be limited in a patient with diarrhea? a. Oatmeal b. Potatoes c. Banana d. Coffee

d. Coffee The caffeine found in coffee can irritate the digestive system and worsen diarrhea that already is present.

If a person who has been on a gluten-free diet needs testing for celiac disease, what is included in the typical testing protocol? a. Continuing a gluten-free diet throughout the testing process b. Consuming at least 4 slices of wheat-containing bread 4 hours before blood tests and biopsies c. Consuming at least 4 slices of wheat-containing bread daily starting 48 hours before blood tests and biopsies d. Consuming at least 4 slices of wheat-containing bread daily for 4 weeks before blood tests and biopsies

d. Consuming at least 4 slices of wheat-containing bread daily for 4 weeks before blood tests and biopsies For a diagnostic test for celiac disease to be reliable, the individual must have gluten in their system. If the individual being tested has fully omitted gluten from the diet, a gluten challenge with intake of at least slices of wheat-containing bread daily for at least 4 weeks before testing is recommended.

What represents the ability to obtain an accurate and culturally relevant patient/client history and conduct an assessment? a. Cultural knowledge b. Cultural awareness c. Cultural desire d. Cultural skill

d. Cultural skill According to the Campinha-Bacote model, cultural skill is the the ability of health care providers to obtain an accurate and culturally relevant history and conduct a physical assessment.

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

d. Daily intake recommendations may be exceeded by consuming juice at home 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.

Xerostomia is a condition marked by which of the following? a. Abnormal smell and taste b. Cloudiness of cornea c. Inflammation of lips and gums d. Decreased salivary secretion and dry mouth

d. Decreased salivary secretion and dry mouth A person with xerostomia experiences decreased saliva production and dry mouth

Which of the following is an effect of lung disease on nutritional status? a. Increased appetite b. Increased intake due to fluid restriction c. Decreased energy expenditure, altered metabolism, decreased work of breathing d. Difficulty preparing food due to fatigue

d. Difficulty preparing food due to fatigue Shortness of breath related to lung disease can cause fatigue, which may affect a person's ability to procure and prepare food and could result in poor nutritional intake.

Polypharmacy most commonly affects which population? a. Infants b. Children c. Teenagers d. Elderly

d. Elderly Polypharmacy most commonly occurs in the older adult population.

Which of the following is an appropriate method to prevent aspiration in adults receiving enteral nutrition (EN)? a. Increase use of sedatives b. Use intermittent administration in the small bowel c. Monitor the patient every 6 hours d. Elevate the head of the bed at least 30°

d. Elevate the head of the bed at least 30° To prevent aspiration in adult patients receiving EN, maintain head of bed elevation to at least 30° or upright in a chair, unless contraindicated. Patients should be monitored every 4 hours and sedative use should be minimized. Method and optimal site of administration are based on patient need, medical condition, tolerance, goals, and available resources.

A patient with acute renal failure will have a higher need for which dietary component compared with a similar patient with optimal renal function? a. Protein b. Potassium c. Fluid d. Energy

d. Energy 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.

Which of the following would be higher in a patient with acute renal failure compared with a similar patient with optimal renal function? a. Protein needs b. Potassium needs c. Fluid needs d. Energy needs

d. Energy needs 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.

Which of the following is a nutrition-focused physical finding that could be an indicator for a diagnosis of physical inactivity? a. Infrequent, low-duration and/or low-intensity physical activity b. Depression and anxiety disorders c. Low cardiorespiratory fitness and/or low muscle strength d. Excessive subcutaneous fat and low muscle mass

d. Excessive subcutaneous fat and low muscle mass In the Nutrition Care Process, excessive subcutaneous fat and low muscle mass is a nutrition-focused physical finding that could indicate a physical inactivity diagnosis. Infrequent, low-duration and/or low-intensity physical activity and low cardiorespiratory fitness and/or low muscle strength are both parameters of food and nutrition-related history and psychological diagnoses such as depression and anxiety disorders are client history parameters.

Which of the following is present in steatohepatitis? a. Benign accumulation in the liver b. Excess glycogen in the liver c. Protein toxicity in the liver d. Fat accumulation and inflammation of the liver

d. Fat accumulation and inflammation of the liver Damage occurs to hepatocytes due to an excess of primary metabolic substrates (glucose, fructose, and fatty acids) in the liver, resulting in diversion of fatty acids into pathways that promote cellular injury and a dysfunctional response to that injury.

Which of the following is included in the American Academy of Pediatrics recommendations for fruit juice? a. Fruit drinks and fruit juice can be a healthy part of a child's diet. b. Fruit juice intake is acceptable at all ages if there are no added sugars. c. Fruit juice is recommended to treat dehydration and diarrhea. d. Fruit juice should not be introduced to the diet before 12 months of age

d. Fruit juice should not be introduced to the diet before 12 months of age The American Academy of Pediatrics recommendation for juice include the following: - Fruit juice offers no nutritional benefits for infants younger than 1 year. - Fruit juice offers no nutritional benefits over whole fruit for infants and children and has no essential role in healthy, balanced diets of children. - 100% fresh or reconstituted fruit juice can be a healthy part of the diet of children older than 1 year when consumed as part of a well-balanced diet. Fruit drinks, however, are not nutritionally equivalent to fruit juice. - Juice is not appropriate in the treatment of dehydration or the management of diarrhea.

Which of the following is an etiology of overweight? a. Body mass index of 25-29.9 b. Increased diabetes risk c. Being in precontemplative stage of change d. Genetic predisposition

d. Genetic predisposition Etiology is the cause of a condition or disease. Genetic factors are among the causes of overweight and obesity. Body mass index of 25-29.9 and increased risk of diabetes may result from overweight but they are not a cause of it.

Which of the following glucose-lowering medications would require patient education about treatment of hypoglycemia? a. Metformin (Glucophage) b. Sitagliptin (Januvia) c. Pioglitazone (Actos) d. Glimepiride (Amaryl)

d. Glimepiride (Amaryl) Among the options, glimepiride (Amaryl) is the only secretagogue, which means the mechanism of action is stimulating the pancreas to make insulin, thereby causing the possibility of low blood glucose.

What process includes the breakdown of protein in the presence of critical illness? a. Glycogenolysis b. Glycolysis c. Lipolysis d. Gluconeogenesis

d. Gluconeogenesis Gluconeogenesis is the process by which protein is converted to glucose in the liver and this occurs in the catabolic stress phase of critical illness. Glycolysis and glycogenolysis are the breakdown of glucose and lipolysis is the breakdown of fat.

Which of the following diabetes medications should not be prescribed to an elderly person as it has a higher risk of severe prolonged hypoglycemia and is listed in the 2015 Beers criteria? a. insulin degludec (Tresiba) b. Metformin c. Sitagliptin (Januvia) d. Glyburide

d. Glyburide Metformin and sitagliptin do not cause hypoglycemia. Insulin degludec is a long-acting insulin that can be safely used in elderly individuals. Glyburide is unsafe to use in an elderly population and is among the medications listed in the Beers criteria for medications potentially inappropriate for older adults.

Which of the following foods should be limited in women taking tamoxifen? a. Tofu b. Edamame c. Chickpeas d. Grapefruit juice

d. Grapefruit juice Grapefruit is known as interfering with a host of medications, including tamoxifen. Meanwhile, there is a lot of misinformation regarding soy and estrogens. Though there are concerns regarding "phytoestrogens" in soy foods that have led to recommendations that women who take tamoxifen should avoid soy foods (the hypothesis is that these foods could negate the medication's estrogen-blocking effects), research demonstrates that soy foods appear to enhance or improve tamoxifen's breast cancer-blocking actions.

When diagnosing malnutrition in older adults, what is the measurement for determining diminished functional status? a. Continence b. Ambulation c. Ability to self-feed d. Handgrip strength

d. Handgrip strength There are six characteristics recommended for identifying malnutrition in older adults: - Insufficient energy intake - Weight loss - Loss of muscle mass - Loss of subcutaneous fat - Localized or generalized fluid accumulation - Diminished functional status as measured by handgrip strength Because there is no single, definitive parameter for diagnosing adult malnutrition, it is recommended that diagnosis be contingent on presence of at least two of these parameters.

Which of the following is likely to be found in a burn patient? a. Hypothyroidism b. Hyperthermia c. Hypoplasia d. Hypermetabolism

d. Hypermetabolism Hypermetabolism is often noted in people with active disease processes, including in patients with burns.

In type 1 diabetes, what is the risk of trying to keep the blood sugars very low (as close to the non-diabetic range as possible)? a. Increase in occurrence of nephropathy b. Increase in occurrence of retinopathy c. Hyperglycemia d. Hypoglycemia

d. Hypoglycemia Attempts to keep blood glucose levels within a narrow range via aggressive insulin dosing will inevitably result in some low levels of blood glucose, which can have significant adverse effects, particularly in children.

According to which system would a soup made of thin broth and 1.2-cm soft carrot cubes be classified as "6-0"? a. EAL grading b. encpt coding c. ICD-10 coding d. IDDSI framework

d. IDDSI framework Per the International Dysphagia Diet Standardisation Initiative, or IDDSI, it is necessary to characterize both the liquid and the solid components of dual-consistency foods to ensure they are appropriate for a given patient. The IDDSI testing methods can be used to describe the texture of a dual-consistency food by separating the components. A soup with 1.2 cm sized cubes of carrot floating in a broth would be classified as 6-0 because the food (carrots) are Level 6 - soft and bite-sized and the liquid (broth) is Level 0 - thin.

Which immunoglobulin mediates the classical type of food allergy? a. IgA b. IgM c. IgG d. IgE

d. IgE IgE is involved in the hypersensitivity response. IgG is a "memory" antibody that engages after exposure to the allergen. IgA levels play a role in autoimmune conditions. IgM is the first antibody secreted when the body is fighting a new infection.

Which of the following is completed as part of the third step in the Nutrition Care Process? a. Identifying whether or not intake is inadequate or excessive compared to actual or estimated needs. b. Assessing nutrition problems that relate to medical or physical conditions. c. Interpreting laboratory data and tests. d. Implementing appropriate nutrition interventions that are tailored to the patient/client's needs.

d. Implementing appropriate nutrition interventions that are tailored to the patient/client's needs. The nutrition care process comprises ADIME (assessment, diagnosis, intervention, and monitoring and evaluation); intervention is the third step.

Which of the following is an example of a correctly formatted and complete PES statement? a. Inadequate intake as evidenced by decreased absorption related to a serum level of 190 ng/mL b. Decreased B12 absorption evidenced by laboratory reports and observation of physical symptoms c. Inadequate intake related to decreased absorption as evidenced by serum levels below normal d. Inadequate B12 intake related to decreased absorption as evidenced by a serum level of 190 ng/mL

d. Inadequate B12 intake related to decreased absorption as evidenced by a serum level of 190 ng/mL A complete PES (problem, etiology, signs and symptoms) statement is formatted as follows: "[Nutrition diagnosis term (problem)] related to [etiology] as evidenced by [signs/symptoms]." The nutrition diagnosis term, etiology, and signs/symptoms must all be specific. - The Problem describes alterations in the client's nutritional status or contributing factors to alterations in the client's nutritional status or contributing factors to alterations in the client's nutritional status. - The Etiology reflects the cause/contributing risk factors and is linked to the nutrition diagnosis term by the phrase "related to." - The Signs/Symptoms are the data or indicators that were used to determine the nutrition diagnosis and are linked to the etiology by the words "as evidenced by."

Which of the following is used to estimate body surface area related to severity of burns? a. Mifflin-St Jeor b. Curreri c. Ireton-Jones d. Rule of Nines

d. Rule of Nines The rule of nines is used to make a rapid estimation of body surface area that has been burned. Estimation of affected body surface area assists in assessment of the extent of the injury and helps provide the basis for prescribing fluids and medications.

Which one of the following is NOT included in the statin benefit group according to the 2013 American College of Cardiology (ACC)/American Heart Association (AHA) Guidelines on the Treatment of Blood Cholesterol to Reduce Atherosclerotic Cardiovascular Risk in Adults? a. Individuals with low-density lipoprotein cholesterol (LDL-C) elevations > 190 mg/dL b. Individuals 40 to 75 years of age with diabetes and LDL-C between 70 and 189 mg/dL c. Individuals with clinical atherosclerotic cardiovascular disease (ASCVD) d. Individuals without ASCVD, diabetes mellitus between the ages of 40 and 75 and who have a 10-year risk of 5.5%

d. Individuals without ASCVD, diabetes mellitus between the ages of 40 and 75 and who have a 10-year risk of 5.5% According to the ACC/AHA guidelines, the individuals listed in options A, B, and C are routinely prescribed a statin; the individuals listed in option D are not. Statin use is indicated in individuals whose ASCVD risk score is 7.5% and above.

Which of the following is a concern in patients who are unable to initiate an oral diet or enteral nutrition and need to start parenteral nutrition? a. Decreased peristalsis b. Increased peristalsis c. Inadequate energy intake d. Infection from bacterial translocation

d. Infection from bacterial translocation Bacterial translocation is a common concern in patients without oral or enteral nutrition and can possibly result in infection.

What is the recommended medication for hyperglycemia in gestational diabetes mellitus (GDM)? a. Metformin b. Glyburide c. Non-insulin glucose-lowering medications d. Insulin

d. Insulin Insulin is the preferred medication for treating hyperglycemia in GDM. Metformin and glyburide cross the placenta to the fetus so they are not appropriate as first-line treatments. Currently there are no long-term safety data regarding use of oral and noninsulin injectable glucose-lowering medications in GDM.

Currently, which of the following nutrients is determined to be the most deficient among children and adolescents in the United States? a. Calcium b. Fiber c. Vitamin A d. Iron

d. Iron Of all nutrients listed, iron has shown to be the most deficient in US children and adolescents.

What is the primary purpose of the Nutrition Care Process? a. It mandates a required care delivery system to all RDNs b. It establishes responsibilities and professional norms for RDNs c. It advocates for RDNs to be included on health care teams d. It provides a framework for individualizing patient/client care

d. It provides a framework for individualizing patient/client care The Nutrition Care Process represents a framework for providing high-quality, individualized nutrition care. The Nutrition Care Process takes into account the patient's/client's needs and values while considering the best evidence available to make decisions about nutrition care.

According to the Fried criteria, which of the following is a criterion for diagnosing an elderly individual as frail? a. Shortness of breath, poor appetite, weight loss of >10 lbs. in 1 year b. Number of comorbid conditions, depression, needing assistance with activities of daily living c. Exhaustion, cognitive impairment, limited social support d. Loss of 10 lbs. or more in 1 year, weakness, slow walking pace

d. Loss of 10 lbs. or more in 1 year, weakness, slow walking pace The Fried criteria require that three of the five following criteria are present for a diagnosis of frailty: Unintended weight loss (measured as 10 pounds or more lost in 1 year), weakness (measured as grip strength in lowest 20% at baseline using dynamometer), exhaustion (self-reported exhaustion, identified by 2 questions on CES-D scale), slow walking speed (measured as slowest 20% of population at baseline based on 15 feet timed walk), and low physical activity level (based on weighted score of energy expended per week calculated from patient report of physical activity)

What component of serum cholesterol do plant stanols/sterols lower? a. Total cholesterol b. High-density lipoprotein (HDL) c. Triglycerides d. Low-density lipoprotein (LDL)

d. Low-density lipoprotein (LDL) Plant stanols are often used in place of statin therapy for lowering LDL, especially for those patients who are unable to tolerate statins.

Which of the following laboratory values would indicate a risk for developing atherosclerosis? a. High-density lipoprotein (HDL) level of 60 mg/dL b. Triglycerides level of 120 mg/dL c. Total cholesterol level of 150 mg/dL d. Low-density lipoprotein (LDL) level of 250 mg/dL

d. Low-density lipoprotein (LDL) level of 250 mg/dL A low-density lipoprotein (LDL) level of 250 mg/dL indicates risk for developing atherosclerosis.

Which of the following is the strongest predictor of an individual's health status? a. Age b. Employment c. Income d. Lower health literacy skills

d. Lower health literacy skills Age, employment, and income may affect a person's health status, but nothing is stronger a predictor than health literacy skills.

An adult with heart failure may reduce the risk of tachycardia if what deficiency is corrected? a. B12 b. Sodium c. Vitamin D d. Magnesium

d. Magnesium Research suggests magnesium supplementation may reduce ventricular ectopic beats, couplets, episodes of non-specific ventricular tachycardia, or premature ventricular contractions.

The DASH diet increases which of the following nutrients? a. Sodium b. Vitamin C c. Chloride d. Magnesium

d. Magnesium The Dietary Approaches to Stop Hypertension, or DASH, diet is rich in magnesium, potassium, calcium, protein, and fiber.

What may develop as a result of excessive milk consumption? a. Megaloblastic anemia b. Hemolytic anemia c. Intestinal bleeding disorder d. Microcytic anemia

d. Microcytic anemia Milk is low in iron content and larger intakes of milk (cow, goat, and soy) may displace high-iron foods, leading to iron-deficiency anemia. The most common cause of microcytic anemia is iron-deficiency anemia. Megaloblastic anemia is caused by folate or vitamin B12 deficiency. Hemolytic anemia does not have nutrient-related etiology and can be caused by certain viral or bacterial infections, medications, and medical conditions.

A patient has developed vancomycin resistant enterococcus and is being treated with Linezolid. What type of food should be avoided? a. Non-nutritive sweeteners b. Shellfish c. Tree nuts d. Sauerkraut

d. Sauerkraut Linezolid is an antibiotic in the same class of medications as MAOI. As a result, a patient on Linezolid should avoid high-tyramine foods to prevent potential interaction.

What does measurably reduced grip strength indicate when assessing for malnutrition? a. No malnutrition present b. Mild malnutrition c. Moderate malnutrition d. Severe malnutrition

d. Severe malnutrition Measurably reduced grip strength indicates severe malnutrition in the contexts of acute illness/injury, chronic illness, and social and environmental circumstances.

Which of the following is an example of a care conference? a. A renal dietetics specialist at a national conference presents emerging evidence on a new treatment protocol b. Volunteers from across allied health convene to review hospital protocols and identify targets for reassessment c. Foodservice managers review the menus for patients with cancer to ensure they are aligned with treatment goals d. Multidisciplinary professionals meet to discuss the progress of a patient who has had laparoscopic surgery

d. Multidisciplinary professionals meet to discuss the progress of a patient who has had laparoscopic surgery A care conference convenes to discuss the at-home or in-facility health care a patient receives and involves the entire multidisciplinary team. This care conference may include health care professionals who have worked with this patient and experts who have not been part of the delivery of care.

Which religious population follows the dietary laws of Halal? a. Seventh-Day Adventists b. Jews c. Buddhists d. Muslims

d. Muslims Halal, which means "permissible," refers to Muslim dietary laws that dictate the proper way to slaughter animals for meat. Haram foods, on the other hand, are those foods that are prohibited according to Muslim dietary law.

What is deficient in patients with pellagra? a. Folate b. Vitamin D c. Sodium d. Niacin

d. Niacin Pellagra is a disease marked by niacin deficiency. It is characterized by the 4 Ds: diarrhea, dermatitis, dementia, and death.

What is the designation for a person with a body mass index of 30.0 kg/m2? a. Underweight b. Healthy weight c. Overweight d. Obese

d. Obese The BMI cutoff for overweight is 25.0 to 29.9 kg/m2. A person with a BMI of at least 30.0 kg/m2 is considered obese.

What is generally the route of transmission for hepatitis A? a. Blood b. Airborne particles c. Sharing of needles d. Oral-fecal

d. Oral-fecal Hepatitis A is generally transmitted through the oral-fecal route.

What term is defined as an obsession with avoiding unhealthful foods and eating a "correct" diet? a. Binge-eating disorder b. Bulimia nervosa c. Avoidant restrictive food intake disorder d. Orthorexia

d. Orthorexia Orthorexia was coined in 1998 and has been gaining awareness in the health community but it has not yet been recognized as a diagnosis in the Diagnostic and Statistical Manual of Mental Disorders. Orthorexia refers to behavior that may begin with the desire to eat healthy but then ultimately turns to fixated thoughts on healthful eating and drastically changed eating behaviors. The other answer options are eating disorders with specific diagnostic criteria and that are marked more by a fixation on the amount of food consumed rather than the source of food.

Decisions related to diabetes treatment should be based on prognoses, comorbidities, financial considerations, and which of the following? a. Calculations using the Harris-Benedict equation b. Dietary Reference Intakes c. US Dietary Guidelines d. Patient preferences

d. Patient preferences Individualized diabetes care yields optimal outcomes, so when making diabetes treatment decisions, it is recommended that these decisions be timely; rely on evidence-based guidelines; include social community support; and be made collaboratively with patients based on prognoses, comorbidities, informed financial considerations, and individual preferences.

Which of the following is an endocrine disorder? a. Cirrhosis b. Chronic kidney disease c. Congenital sucrase-isomaltase disease d. Polycystic ovary syndrome

d. Polycystic ovary syndrome Polycystic ovary disease, or PCOS, is an endocrine disorder with metabolic complications.

Gout is an inflammatory disease associated with which of the following? a. Protein b. Calcium c. Cholesterol d. Purine

d. Purine Gout is an accumulation of uric acid, which is the end-product of the metabolism of the purines adenine and guanine from DNA and RNA

Which of the following is the best option for a vegan menu? a. Honey-roasted carrots b. Coffee with nondairy creamer c. Cauliflower prepared with buffalo sauce d. Quinoa mixed with tamari

d. Quinoa mixed with tamari Among those listed, quinoa mixed with tamari is the best option for a vegan diet. Many nondairy creamers contain a small percentage of sodium caseinate, which is derived from milk; honey is derived from animals; and buffalo sauce often contains butter.

Which one of the following foods should be avoided in treatment of gout? a. Low-fat yogurt b. Rye bread c. Banana d. Regular soft drinks

d. Regular soft drinks 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.

Lost CO2 associated with hyperventilation can lead to which of the following conditions? a. Metabolic acidosis b. Metabolic alkalosis c. Respiratory acidosis d. Respiratory alkalosis

d. Respiratory alkalosis Reduced CO2 and excessive amount of base (bicarbonate) lead to a shift in acid-base balance, causing respiratory alkalosis.

Which of the following represents a formative evaluation of a community nutrition program designed to encourage more first-time mothers to breastfeed? a. Determine the percentage of first-time mothers who breastfeed because they watched a motivational video when they attended prenatal checkups b. Calculate the increase in first-time mothers who breastfeed because they watched a motivational video when they attended prenatal checkups c. Offer a take-home version of a motivational video to be watched at patient's leisure d. Respond to patient's questions after presenting a motivational video at prenatal checkups

d. Respond to patient's questions after presenting a motivational video at prenatal checkups Formative evaluation identifies learner misconceptions, struggles, and learning gaps before and during the educational process. Fielding questions after presenting a video will help to identify these patient challenges before giving birth.

Which of the following foods would be recommended for a patient being treated for gastroparesis? a. Ginger ale b. Oranges c. Bran cereal d. Rice

d. Rice High-fiber foods like oranges and bran cereal can delay gastric emptying and lead to early satiety, which may result in bezoar formation. Carbonated beverages like ginger ale are inappropriate as they may cause distension. Rice is recommended for patients with gastroparesis.

Listeriosis can be prevented if a pregnant person avoids which of the following foods? a. Cooked luncheon meats b. Pasteurized hard cheese c. Cooked ground beef d. Smoked fish

d. Smoked fish Listeria is found in raw or smoked fish, oysters, unpasteurized or soft cheese, raw or undercooked meat, or unpasteurized milk, as well as luncheon meats and hot dogs that are not cooked or stored properly.

Which of the following is a secondary characteristic of culture? a. Religion b. Age c. Gender d. Socioeconomic status

d. Socioeconomic status Socioeconomic status is a secondary characteristic of an individual's cultural identity.

Which of the following might be categorized as dairy according to MyPlate? a. Butter b. Cream c. Cream cheese d. Soy milk

d. Soy milk According to MyPlate, foods made from milk that have little to no calcium—including cream cheese, cream, and butter—are not included in the Dairy Group. Soy milk might be categorized as dairy if it is calcium fortified.

What feature of the Nutrition Care Process allows for drawing comparisons regarding nutrition problems and outcomes across health care systems? a. Research opportunities b. PES statements c. Information sharing technologies d. Standardized language

d. Standardized language Standardized language allows for a system of comparison of patient nutrition issues/problems across health care systems. No matter who is reading the patient note along the spectrum of care, all individuals will understand the terminology by this standard language that has been established for nutrition care.

Among the following foods, which would be reintroduced last after bowel resection? a. Mashed potatoes b. Tea c. Bananas d. Strawberries

d. Strawberries Fluids and soft foods are reintroduced to the diet first following bowel resection. Although caffeine-containing products are not recommended, decaffeinated tea is acceptable. It is recommended that eating any fresh fruit except bananas be delayed until 4-6 weeks post-surgery.

Metabolic syndrome greatly increases risk of developing which of the following? a. Renal failure b. Gastroesophageal reflux disease c. Cancer d. Stroke

d. Stroke An individual with metabolic syndrome has a cluster of risk factors related to cardiovascular disease. Metabolic syndrome greatly increases a person's risk of diabetes, heart disease, and stroke.

Which of the following classes of medication would require patient education on hypoglycemia? a. SGLT2 b. DPP4 c. GLP1 d. Sulfonylureas

d. Sulfonylureas - Sulfonylureas work by increasing the amount of insulin the body produces and can lower blood sugar levels by approximately 20% and can cause hypoglycemia. - Sodium-glucose co-transporter 2 (SGLT2) inhibitors lower blood sugar by increasing the excretion of sugar in the urine. They do not cause low blood sugar. - DPP4 inhibitors lower blood sugar levels by increasing insulin release from the pancreas in response to a meal. These medicines do not cause hypoglycemia. - GLP-1 receptor agonists are given by injection that increase insulin release in response to a meal and slow digestion. They do not usually cause low blood sugar when used without other medications that cause low blood sugar.

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

d. Survey 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.

Eating seasonally is a principle of which of the following eating practices? a. Organic b. Orthorexic c. Biodiverse d. Sustainable

d. Sustainable Principles of sustainable eating include growing at home, shopping locally, and eating seasonally. Focusing on local, fresh, in-season foods supports sustainability because it helps to eliminate the need to ship foods from farther locales.

Why would increasing fortified grain intake be recommended to a pregnant person? a. Prenatal exposure to grains helps prevent celiac and gluten sensitivity b. Fortified grains help to prevent gestational diabetes mellitus c. Fortified grains effectively counter pregnancy-related nausea d. The folic acid in fortified grains helps to prevent neural tube defects

d. The folic acid in fortified grains helps to prevent neural tube defects Folic acid and folate help to prevent neural tube defects, so folate food and fortified foods are encouraged in pregnancy. Folate in foods is not sufficient on its own, however, and pregnant people are also encouraged to take a prenatal vitamin.

Why are mixed-consistency foods not recommended for patients with dysphagia? a. There is an increased risk of exposure to food allergens b. There is an increased risk of heartburn c. There is an increased risk of discomfort related to jaw fatigue d. There is an increased risk of aspiration

d. There is an increased risk of aspiration Mixed-consistency foods include both solids and liquids. Mixed-consistency foods can be more challenging to swallow, because adequate ability to handle both the solid and the liquid component of these items is required, which in turn requires more advanced oral control and swallowing coordination abilities. People with dysphagia have an increased aspiration risk when eating mixed-consistency foods.

What condition must be met to begin measuring and plotting stature-for-age in children aged 24 months? a. They are at least 34" tall b. They can sit up c. They weigh at least 20 pounds d. They can stand unassisted

d. They can stand unassisted Beginning at age 24 months, children who can stand unassisted and follow directions should be measured for stature and plotted using the stature-for-age chart for children. If a child age 24 to 36 months is unable to stand unassisted and follow directions, length can be used in place of stature.

What is the minimum number of weekly servings of red/orange vegetables required for children in grades K through 5 in accordance with the National School Lunch Program reimbursable lunch? a. One-quarter cup b. One-third cup c. One-half cup d. Three-quarter cup

d. Three-quarter cup According to the NSLP, it is required that children be served ¾ cup red/orange vegetables each week.

Home health agencies and long-term care hospitals are categorized as which of the following? a. Tertiary care settings b. Primary care settings c. Patient-centered settings d. Transitions of care settings

d. Transitions of care settings Transitions of Care settings include home health agencies, inpatient rehabilitation facilities, long-term care hospitals, and skilled nursing facilities.

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

d. Waist circumference 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.

What is a major difference between warfarin and newer anti-coagulants with regard to food intake? a. The newer medications have increased side effects for individuals who eat dairy. b. Bananas should be eliminated from the diet while on warfarin, but this isn't an issue with the newer medications. c. Warfarin doesn't require monitoring of vitamin K intake whereas the newer medications do. d. Warfarin requires monitoring of vitamin K intake whereas the newer medications don't.

d. Warfarin requires monitoring of vitamin K intake whereas the newer medications don't. Anticoagulation therapy has changed significantly since newer anticoagulants do not require monitoring of international normalized ratio (INR) or vitamin K. Warfarin or coumadin requires careful monitoring of INR and attention to consistent amounts of foods that contain vitamin K.

Which of the following statements regarding the concept of weight bias is true? a. Training in a health care field completely thwarts weight bias from developing. b. Perception of weight bias is almost always the result of patient misunderstanding. c. Weight bias is unpleasant but doesn't have an impact on health outcomes. d. Weight bias exists among registered dietitian nutritionists who work with obese clients.

d. Weight bias exists among registered dietitian nutritionists who work with obese clients. Weight bias exists in clinical settings and research from the Yale University Rudd Center for Food Policy and Obesity demonstrates that it is common among registered dietitian nutritionists. Even RDNs who work with obese clients have weight bias and may not recognize it.

What is an adverse effect of carbohydrate loading? a. Immediate fatigue during endurance event b. Compromised endurance performance c. Minimized muscle glycogen stores d. Weight gain

d. Weight gain Carbohydrate loading is an evidence-based technique that can be beneficial for endurance athletes by delaying fatigue, enhancing endurance performance, and maximizing muscle glycogen stores. However, weight gain is a common outcome because the glycogen is stored with water. This weight gain may cause discomfort and the athlete's muscles may feel sluggish.

When is unintended weight loss a potentially inappropriate nutrition diagnosis? a. When there is decreased ability to consume sufficient energy b. When cultural practices affect ability to access food c. In the circumstance of prolonged hospitalization d. When body weight changes are caused by fluid

d. When body weight changes are caused by fluid Causes or contributing risk factors to unintended weight loss may include the following: - Physiological causes increasing nutrient needs - Decreased ability to consume sufficient energy - Lack of or limited access to food - Cultural practices that affect ability to access food - Prolonged hospitalization - Psychological causes such as depression and disordered eating - Lack of self-feeding ability However, unintended weight loss may not be an appropriate nutrition diagnosis when changes in body weight are the result of fluid.

Which of the following is an example of an impact evaluation in the final step of a community nutrition program for type 2 diabetes? a. Whether the age of participants reflected the target population b. Whether staff were trained using standardized patient education modules c. Whether patient data were accurately recorded and properly stored d. Whether participants learned the role of carbohydrate counting in managing their condition

d. Whether participants learned the role of carbohydrate counting in managing their condition An impact evaluation measures whether and to what extent a program or intervention achieved its stated goals and describes the specific effect of activities on the target population. Evaluating if participate age reflects target population or if staff were trained with standardized materials occurs during the process evaluation. Evaluating if data were recorded and stored properly occurs during structural evaluation.

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

d. Whole grain crackers and peanut butter 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.

What nutrient intake should be screened in older adults to identify susceptibility to infection? a. Riboflavin b. Selenium c. Calcium d. Zinc

d. Zinc Decreased consumption of dietary zinc has been associated with the aging process. Zinc is critical for the immune system, and deficiency can lead to depressed immunity and increased susceptibility to infection.

The ethical principle of autonomy is supported when a. a clinician treats all patients with similar attention. b. explaining the benefits and risks of enteral nutrition to the wife of a man in a persistent vegetative state. c. enteral nutrition is provided to a postoperative patient requiring mechanical ventilation. d. a patient at end of life is allowed to refuse parenteral nutrition.

d. a patient at end of life is allowed to refuse parenteral nutrition. Autonomy is the agreement to respect another's right to determine a course of action for himself or herself, or the support of another's independent decision making.

When working with adults with intellectual disabilities, it is suggested that the dietetics professional _____. a. use the MyPlate for kids because it contains pictures b. speak initially to the guardian rather than the client c. test the client to make sure they understand specific topics d. ask the client what they would like to be taught

d. ask the client what they would like to be taught Teaching rather than challenging is the most effective approach when working with this population. Frequently adults with intellectual disabilities are tested on what they know rather than asked what they want to be taught. Practitioners should treat this population the same as they would when working with adults without intellectual disabilities.

A child's weight is plotted at the 50th percentile on the growth chart. This means that the child's weight is a. greater than or equal to that of half the children of the same sex and ethnicity. b. greater than or equal to that of half the children of the same age. c. greater than or equal to that of half the children of the same ethnicity. d. greater than or equal to that of half the children of the same age and sex.

d. greater than or equal to that of half the children of the same age and sex. 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: a. identify the medical diagnosis of the client. b. plan interventions to address the nutrition problem. c. determine interventions, goals and expected outcomes. d. identify and label the nutrition problem.

d. identify and label the nutrition problem. Identification and labeling of the nutrition problem occur during the nutrition diagnosis step.

A diagnosis of hypersensitivity to food requires a. conducting a food challenge without restricting the suspected food. b. documented atopic dermatitis. c. using an elimination diet for 3 weeks. d. verifying the food that causes an adverse reaction and excluding other causes of adverse reactions.

d. verifying the food that causes an adverse reaction and excluding other causes of adverse reactions. To confirm a food hypersensitivity diagnosis, the clinician is required to verify that the food allergen alone causes the adverse reaction.

People with cystic fibrosis are most likely to become deficient in a. thiamine and iron b. vitamin B12 c. selenium and magnesium d. zinc and fat-soluble vitamins

d. zinc and fat-soluble vitamins Both zinc and fat-soluble vitamins are lost in the stool of individuals with cystic fibrosis due to pancreatic insufficiency.