NTR 495 OA Exam 2
Use the BMI calculation shown to find the BMI of a 5 foot 2 inch woman who weighs 172lbs (round to 1 decimal place).
172/(62x62) x 704.5 = 31.5
A food record of dietary intake normally is collected for how long?
3 or 7 days
Adults over the age of 65 should be physically active for how many hours per week?
3-3.5 hours/week
Routine screening for colorectal cancer by colonoscopy is recommended starting at age
45
What age qualifies for the congregate or home-delivered nutrition program?
60
Why might creatinine excretion decline in the older adult?
A. Decrease in lean body mass B. Decrease in proportion of muscle in lean body C. Decrease in meat intake
Which of the following is a consequence of malnutrition in the older adult?
A. Increased risk for infection B. Increased length of hospital stay C. Increased mortality
Body mass index (BMI) should be used cautiously in the older adult because:
A. obtaining an accurate height can be difficult in older adults.
A person's food preferences falls under which of the following?
Acceptability
A family moves to the United States from another country, and they begin to consume more processed snacks and sugar sweetened beverages. This would be considered
Acculturation
Which of the following could lead to an increased risk of developing GERD?
An overly relaxed lower esophageal sphincter, Excess intragastric pressure, Decreased peristaltic activity related to advanced age
Which of the following is considered to be an invasive test for coronary artery disease (CAD)?
Angiogram
During which stage of a nutrition assessment are body size, weight and proportions measured?
Anthropometric measurements
What does the mnemonic "ABCD" in nutrition assessment stand for?
Anthropometrics; Biochemical data; Clinical assessment; Dietary history
To participate in Title IIC meal programs a person must be
At least 60 years old
The MNA is useful in identifying which of the following?
B. Malnutrition risk
Factors that increase the risk of esophageal cancer include
Barrett's esophagus, smoking, processed foods
If a patient's albumin, hemoglobin, and hematocrit levels were recorded, which type of assessment was conducted?
Biochemical
In the development of nutritional deficiencies, __________ precede __________ of deficiency.
C. biochemical changes; clinical signs
Celiac disease can lead to malabsorption of what nutrient(s)?
Calcium, folate, iron, Vitamins A, D, E, K
An obese COPD patient has chronic cough and shortness of breath, and recently developed edema. What type of COPD does this patient likely have?
Chronic bronchitis
What is the leading cause of Pancreatic Insufficiency (PI) in the US?
Chronic pancreatitis
Which of the following is not a component of anthropometric assessments?
Cognitive function
Meals on Wheels is an example of what kind of government program?
Congregate meal program
Which biochemical marker is paired with its correct assessment.
Corpuscular volume: indicates some types of anemia
Which is a physiological change that affects exercise capacity in older adults?
Decreased muscle mass
Sandy has diverticula shown on a lower endoscopy. She presents to the hospital with fever and severe abdominal pain. She is likely experiencing
Diverticulitis
Pancreatic enzymes should be taken
During the meal
What type of program guarantees benefits for participants who meet the requirements set by law?
Entitlement program
What are some factors that influence the quality of life?
Environment, socialization - all of the above
Height should be measured how frequently in the older adult?
Every year
__________ is defined as "planned, structured, and repetitive and purposive in the sense that the improvement or maintenance of one or more components of physical fitness is the objective."
Exercise
Cultural humility encourages generalizations of cultures to increase awareness and cultural sensitivity, while cultural competence emphasizes learning about individual clients.
False
Hypoglycemia leads to delayed stomach emptying.
False
Lactose intolerance is most common among those of Eastern European descent.
False
Participants can buy personal care items like soap and shampoo using SNAP benefits
False
What is the most common upper gastrointestinal diagnosis for older adults?
GERD
Which of the following gastrointestinal issues is found in 23% of older adults who live in nursing homes?
GERD
Sonya has heartburn after she lays down at night, voice hoarseness, and regurgitation of stomach contents. She is most likely experiencing symptoms of
Gastroesophageal reflux disease
Delayed gastric emptying is called
Gastroparesis
Which of the following is not a modifiable health risk?
Genetics
What is one difference between dietary fructose intolerance (DFI) and hereditary fructose intolerance (HFI)?
HFI is rarer than DFI
Which of the following is NOT a factor that could influence lab data and possibly lead to a false interpretation?
Height and weight
What is the purpose of SNAP?
Help low-income families buy nutritional adequate food
In older adults, which disease is the major contributor to cardiovascular events such as myocardial infarction (MI), stroke, and heart failure (HF)?
Hypertension
Which of the following is true about gastroparesis?
It is more common in women
What enzyme is supplemented as part of pancreatic enzyme replacement therapy (PERT)?
Lipase
Joe is a generally healthy 75 year old man who lives alone. He tends to eat prepared foods (like microwave meals) because it is difficult for him to prepare and cook food. Joe does not drive and lives in a rural community; he has his groceries delivered weekly by the town grocery store. He is lactose intolerant, so he does not consume milk products and his prepared foods do not typically include fruits or vegetables. Based on this information, score his DETERMINE checklist and select from the following assessments.
Moderate nutritional risk, see what can be done to improve eating habits and lifestyle
Which of the following is true of Title IIIC of the OAA?
Must be 60 years of older and no other requirements to utilize programs
Mowing the lawn because your grass is too long is considered
Physical activity
Which are included in the healthy foods graphic for the Criollo plate?
Plantain, yam, beans
Reduced ability to perform daily acts of living, poor oral health, and dysphagia are risks for developing:
Pneumonia
Which ratio is the most important for controlling blood pressure.
Postassium:Sodium
Select which of the following skillls are considered instrumental activities of daily living (IADLs)
Preparing meals, doing laundry, basic home maintenance
Education about healthy habits would be considered
Primary prevention
Which of the following is considered to be a similarity between the DASH diet and the Mediterranean diet?
Promote the use of canola and olive oil
Which pairing of enzyme to macronutrient it digests is correct?
Protease/Protein
---------- status can be measured through albumin and prealbumin status.
Protein
__________ aging is defined by interchanges between a person and their psychological or social environments.
Psychological
Risk factors of ATHEROSCLEROTIC CARDIOVASCULAR DISEASE include
Race, genetics, age
What happens, respectively, to systolic and diastolic blood pressure functions when one has heart failure?
Reduced ejection fraction and preserved ejection fraction
Match the following levels of preventive care to the activities below.
Rehabilitation therapy - Tertiary Immunization - Primary Colonoscopy - Secondary
Which of the following does not contribute to the development of primary hypertension?
Renal disease
The anthropometric section of a nutrition assessment could include all of the following, except:
SGA rating
Which nutrition assistance program is the largest USA program and helps older adults to purchase food on a budget?
SNAP
What is the primary goal of the MUST nutrition screening method?
Screens for risk of malnutrition
An older woman checks her nutritional status using the tool DETERMINE, which factors increase her risk of malnutrition?
She has gained 15 pounds in the last 6 months
The following increase risk for gallstones:
Significant, rapid weight loss A diet high in animal fat, sugar, and refined carbohydrates
Treatment for gastroparesis includes which of the following?
Small frequent meals, soft or pureed foods, limiting alcohol
Which of the following is considered a good way to prevent or improve symptoms of diverticulosis?
Smoking cessation and regular physical activity
Which nutrients are considered to be the key dietary contributors to the development of hypertension?
Sodium, potassium, and alcohol
Someone with a blood pressure of 145/95 would be considered to have what class/degree of hypertension?
Stage 2 hypertension
Which of the following put you in a category for stage 2 hypertension?
Systolic greater than or equal to 140 and diastolic greater than or equal to 90
What impact do you think the pandemic has has on the socialization of older adults? What impact could that have on their quality of life?
The pandemic has impacted older adults' socialization by limiting them to who they can see, talk to, where they can go, and ultimately limiting their already limited lifestlye from the basic things that really keep them alive. As it does not take long for their physical and mental health to decline if they do have accessibility to the care they need and/or not being able to see people (prevents stress and isolation), as mental health plays a greater role in this situation (the mindset depicts the outcome); ultimately, affecting their overall quality of life.
What are some reasons older adults who qualify may not use some federal support programs to purchase food?
There is a stigma around programs, application processes are long, there are few benefits associated with the program
Which of the following factors can influence lab results?
Tobacco use, stress, prescription medications, equipment calibration
True or False? Management of the chronic bronchitis form of COPD is similar to HF, and management of emphysema is similar to that of cardiac cachexia.
True
True or False? Most older adults with peripheral artery disease (PAD) are asymptomatic.
True
True or False? Older adults who have Barrett's esophagus are at increased risk for developing esophageal cancer.
True
True or False? Patients with IBS have a higher rate of psychological disorders such as depression and anxiety.
True
True or False? The Nutrition Services Incentive Program (NSIP) provides incentives in the form of cash or food commodities to programs that deliver meals efficiently to older adults.
True
True or False? The recommendation to eliminate nuts and seeds in the diet of patients with diverticulosis is not evidence-based.
True
True or False? When sedentary older adults decide to increase physical activity, it is important they implement changes gradually.
True
John, a 70 year old has gastroparesis. What dietary supplements might he need? What are we concerned about?
Vitamin A, B6, C, K, iron, potassium and zinc
PPIs can reduce the absorption of which of the following along with decreasing the symptoms of GERD?
Vitamin B12, iron, calcium
Which vitamin/mineral combination should be supplemented for people who are taking proton pump inhibitors (PPIs)?
Vitamin D/calcium
Which of the following has been shown to have the greatest reduction in foodborne illnesses?
Washing hands
Anthropometrics, Biochemical, Clinical and
dietary
Excessive intake of __________ can exacerbate heart failure and lead to edema.
fluids
People older than age 70 have a __________ optimal body mass index (BMI) than younger people.
higher
Biochemical data can be difficult to use in assessing an older adult's nutrition status for all of the following reasons, except:
most older adults are too dehydrated to use biochemical data.
A diet high in __________ may reduce the inflammation associated with COPD.
omega-3 fatty acids
An example of tertiary prevention is:
rehabilitation after a fall
Mean corpuscular volume measures
the average volume of a single red blood cell
24 hr recall intake methods tends to the __________ amount of food a person consumes.
underestimate
Which of the following is a risk factor for primary hypertension?
Family history
GERD occurs due to fluid coming back up from the stomach through the
Lower esophageal sphincter
True or False? Diverticulosis is more common in older adults in the United States than in older adults living in Asia or Africa.
True
You are working with a family that has recently immigrated from China. Describe how a provider would work with this family differently depending on if they were using the cultural humility vs cultural competence perspective.
****** A recently immigrated family from China would be dealt with by a provider in different ways if they used cultural humility perspective or cultural competence perspective. For the cultural humility perspective there is no achievement as it is an ongoing process whereas cultural competence perspective can be mastered. Moreover, for a family that has a cultural humility perspective a provider would be open and listen to their experiences, what is important to them and what can be avoided. They would also be self-aware and aware of others, meaning that that family's former lifestyle could be greatly influenced by their culture, including, beliefs, lifestyle, experiences (negative and positive), etc. To maintain and establish this relationship it must be known and respected that this life long process of learning, but will have support and understanding throughout the process. Whereas if this family had a culture competence perspective then a provider would highlight the existing practices, laws that are already in place that can be reflected across multiple cultures. Acknowledgment and respect should be shown by the provider based upon their specific culture, but also with acknowledgment of other cultures, how can they build upon ethnic and social diversity? This perspective is a prime example of how many cultures coexist with each other by learning and incorporating them all into different lifestyles.
During a nutrition assessment, how many nutrition diagnosis statements should be made per patient?
1-2
