Domain II, Inman Review Points Flashcards
In community surveys, a frequent symptom of malnutrition is
low hemoglobin
Which is the least common symptom in the elderly? Osteomalacia osteoporosis obesity hypertension
Osteomalacia
What is included in the study of demographics?
Age, sex, population stats
Nutritional prescription for a patient with cardiac cachexia includes
Low sodium, low sat fat, low cholesterol, high calorie
An alcoholic patient has a low serum albumin, low hemooglobin, high ammonia, abnormal liver function tests and ascites. Why is he on a 500 mg sodium diet?
Hypoalbuminemia
The elderly need how many mL of water per Kg?
25 - 30
If a man normally consuming 2600 calories per day reduces his intake to 1500 calories per day, how much weight will he lose in one week?
1 Kg
For which of the following diseases is diet therapy the primary treatment? peptic ulcer diabetes Wilson's disease galactosemia
Galactosemia
Chemically defined formulas are used for:
Short bowel syndrome
Which set of health conditions s most commonly seen in American children?
Obesity, dental caries, anemia
Which is not a fiber in the diet? cellulose hemicellulose amylose pectin
Amylose
The program that provides nutrition education to teachers and food service personnel is the
NETP
Research suggest that in order to guard against cancer you should ingest
carotene and vitamin C
Which of the following may be the cause of loose stools in a tube fed patient
- Feeding was administered at too rapid a rate
- The osmolality of the feeding was too low
- The patient is constipated
- An inadequate amount of intestinal surface area
Feeding was administered at too rapid a rate AND an inadequate amount of intestinal surface area
Iron deficiency anemia has the following characteristics
small, pale cells, hypochromic, microcytic
Which hormone moves milk through the mammary ducts?
oxytocin
Which is a measure of somatic protein? serum albumin serum transferrin MAMC tricep skinfold
MAMC
Nutritional therapy for hepatits includes
high protein, high CHO, mod fat, high calories
Hormones that control blood pressure and blood components are produced in
the kidneys
An acid ash would be created by ingesting
corn, cranberries
Symptoms of nephrosis include
albuminuria, hypercholesterolemia
The catecholamines released during stress cause
Hyperglycemia
The diet for galactosemia should exclude
organ meats, MSG
The theory of obesity that refers to receptors in the hypothalamus is the
glucostatic theory
Closed enteral nutrition systems can be hanged for
24 - 48 hours
Iatrogenic manlnutrition is
protein, calorie malnutrition
What are the similarities between WIC and SNAP?
Regulated by the USDA, Have income criteria
A female who eats a wide variety of foods and takes supplemental iron and birth control pills may be
marginally deficient in folic acid
The immobilized state can lead to low levels of
albumin and calcium
Which nutrient may be absorbed during peritoneal dialysis and continuous renal replacement therapy, thus requiring a modification of his diet?
CHO
An infant formula for lactose intolerance might include
casein hydrolysate, corn oil, glucose, soy protein, and corn syrup solids
A patient with the nephrotic syndrome will likely exhibit
hypercholesterolemia, hypoalbuminemia, edema
A nephrotic syndrome patient should receive how many grams of protein per Kg
0.8 - 1
Fiber, like that found in oats, beans and bran cereals, result in
increased water absorption from the intestines
A patient suffering from bulimia may have all of the following symptoms except
- A sore throat
- dental problems
- extreme weight loss
- rectal bleeding
extreme weight loss
When conducting a physical assessment of a patient, which method is used to estimate fat stores?
Inspection
Current research on the relationship between cancer and diet includes all of the following except
- Cancer is associated with the intake of vitamin A
- It is related to demographic factors
- It is related to epidemiologic data
- It is related to epidemiologic data
- it is associated with ascorbic acid
It is related to demographic factors
Catecholamines have what physiological effect?
Cause sodium retention
A patient with dehydration exhibits the symptoms of
sunken eyes, decreased renal function, increased tachycardia
Which of the following is not a guideline for medicaid?
- Low income
- Over the age of 60 only
- Nutritional need
Over the age of 60 only, nutritional need
The healthy people 2020 goals are an outgrowth of a report by
the surgeon general, under HHS
When a starved patient begins to eat, they might expect
an increased workload on the heart
Which of the following is the appropriate diet for peritoneal dialysis
1.3 grams protein, 35 kcal/Kg
Which program provides food to needy individuals and families?
Food Banks
What is the goal of the dietary guidelines?
prevention of chronic disease
The allowance for SNAP is based on
the USDA thrifty food program
Nutritional advice to a parent with a child with autism spectrum disorder should include
normal intake based on age
A poor, healthy 19 year old mother is unsure how to feed her 4 year old child. Which program may offer the most help?
EFNEP
Which of the following affects bioelectrical impedance analysis?
water
Which correlates best with energy intake?
Body weight
Which of the following most affects osmolarity?
electrolytes
Which fiber is insoluble in water?
hemicellulose
Which of the following indicates protein calorie malnutrition?
- A creatine height index of 93%
- Height for weight ratio of 89%
- Triceps skinfold and arm muscle circumference of 79%
- Serum albumin of 4.5; transferrin of 410
Trcieps skinfold and arm muscle circumference of 79%
An appropriate measurement for iron status in a local community is
Hematocrit
Which of the following may help decrease cavities?
- Raisins
- Carrots
- Cheese
- Yogurt
Cheese
According to the ADA exchange lists, what is the nutrient content of the following: 1 cup raspberries, 1/2 cup cereal, 1 cup 1% milk,
1 tsp. matgarine, black coffee, 1 slice toast, 1 egg
Cal: 365
Pro 21
CHO 57
Fat 14
Which of the following diseases may lead to anemia?
- Myocardial infarction
- Galactosemia
- Renal Failure
- DM
Renal failure
Which of the following can be offered to a patient when his diet prescription is moved from NDD level 3 to level 2?
Soft pancake
A pork chop is which type of protein exchange?
lean protein
What should be encouraged in a headstart program?
Nutrition activities related to food
The stasis of pancreatic juice and bile could result in
- Autodigestion
- Fat malabsorption
- Obstructive jaundice
- All of the above
all of the above
Which of the following is not a governental agency?
- Health and human services
- FDA
- Food and Nutritional Board
- AHA
AHA
Low levels of folate, pyridoxine and cyanocobalamin are associated with
homocystinurias
A patient with low hemoglobin and low MCV might have:
Microcytic anemia
According to the Food Lists for Diabetes Exchanges, 2 T of peanut butter is equivalent to
2 high fat proteins
Who is the most appropriate candidate for parenteral nutrition?
- 12 year old girl with appendectomy
- Middle aged woman with chemotherapy
- Elderly lady with emphysema
- Young man with gall bladder surgery
young man with gall bladder surgery
In reviewing the patient’s medical record you note a hemoglobin of 10 g / dL and an MCV of 110 cu mm. You should document
anemia with larger than normal erythrocytes
A patient with hyperphosphatemia, hyperkalemia, and hypermagnesemia may have
renal disease
A common result of treating an AIDS patient with zidovudine is?
Macrocytic anemia
An obese person with type 2 diabetes should
achieve DBW
A tube fed patient receiving bolus feedings develops a distended abdomen. What should you recommend?
decrease the rate
The maximum hang time for an open enteral system is
4 hours
Following a colectomy, the absorption of which of the following would be of the most concern?
water and sodium
According to the diabetic exchange lists, which of the following is equivalent to one medium fat protein?
- 4 oz tofu
- 2 oz pork
- 2 eggs
- 2 T peanut butter
4 oz tofu
A long term care patient has normal intestinal function but cannot eat. What tube feeding should you provide?
high protein, high calorie
312 mL of 20% lipid emulsion provides ____ kcal
624
Which will cause the most delay in gastric emptying? -Lean baked meat -broiled cod shrimp - corned beef
corned beef
If a patient’s GFR is < 50 mL/minute, what should their protein intake be in g/kg?
0.6 - 0.8
Which program teaches good nutrition practices and provides foods with certain nutrients?
WIC
A PN patient is receiving 45 calories / Kg. What may be the result?
Hypokalemia
A tube fed patient develops diarrhea. What is the most likely cause?
Medications
The most useful data in evaluating the nutritional status of children is
energy intake an health history
Enteral feeding products that contain protein in the form of small peptides and amino acids may be recommended for patients who have
Short bowel syndrome
Which diet follows the AHA recommendations for healthy hearts?
=< 35% calories from fay, < 7% saturated fats, 5 - 10% PUFA, up to 20% MUFA, <200 mg cholesterol
A renal patient has come for dialysis on Monday morning with a serum sodium of 130 mEq/L, a BUN of 100 mg/dL, creatinine 8.0, and a 4 Kg weight gain since his last dialysis on friday morning. His lab indicators were in acceptable ranges on friday afternoon.
Looking at this you would expect to see _______ bicarbonate, _________ potassium, _________ phosphorus
decreased, increased, increased
A renal patient has come for dialysis on Monday morning with a serum sodium of 130 mEq/L, a BUN of 100 mg/dL, creatinine 8.0, and a 4 Kg weight gain since his last dialysis on friday morning. His lab indicators were in acceptable ranges on friday afternoon.
If this patient had been nauseated and had averaged only 400 calories from primarily starchy foods over the weekend you would expect to see …
Little or no rise in potassium, BUN/creatinine ratio <10
Macrocytic, pernicious anemia resembles the anemia due to a deficiency of
folic acid
Who has the greatest water, protein, and calorie needs per unit of body weight
- 6 month old infant
- 50 year old female
- 16 year old male
- 25 year old male
6 month old infant
A patient with a redundant ileum may develop a deficiency of
vitamin B12
What change should be made in the following menu if to be served to a 7th Day Adventist?
Tomato juice, cottage cheese fruit plate or egg sandwich, milk, coffee, tea
offer decaf beverages
The best way to counsel a patient with anorexia nervosa is to
Emphasize the health benefits associated with increased intake
When measuring a child’s somatic protein mass, use the BMI and
Upper arm muscle area
Funding for public health program comes primarily from
General revenue
In acute hepatitis, you would likely see
Increase in both SGOT and SGPT
What should a Jewish patient include in his diet to increase intake of zinc
Turkey
A vegan with macrocytic anemia needs which of the following?
Fortified soy milk
Which of the following would likely be a cause of marasmus?
chemotherapy
A patient on parenteral support develops sepsis. What is the likely cause?
bacterial translocation
A critically ill patient will likely need hospitalization for many days. When should the discharge plan begin?
on the first day of admission
What is not a likely cause of failure to thrive in a child?
a vegetarian diet
A child with PKU can eat:
- spaghetti with tomato sauce
- vanilla ice cream
- carrots and celery sticks
- aspartame sweetened gelatin
carrots and celery sticks
Which of the following would be classified as NI in the NCP?
- Not ready for diet change
- Altered GI function
- Involuntary weight loss
- Increased energy expenditure
Increased energy expenditure
Which of the following would be appropriate for a hemodialysis patient on a 60 gram protein diet, with 75% from HBV protein?
- 2 eggs, 2 oz chicken, 3 oz beef, 1/2 cup milk
- 1 egg, 2 oz chicken, 3 slices bread, 3 oz beef
- 2 eggs, 3 oz chicken, 3 ounces beef, 1 cup milk
- 1 egg, 3 oz chicken, 2 cups milk, 5 slices of bread
1 egg, 3 oz chicken, 2 cups milk, 5 slices bread
A father needs help in feeding his children, ages 6 and 8. Which are the best options?
SNAP and school lunch
What would be an expected outcome of WIC?
Less anemia, increased HG and HT levels in women
A concern with parenteral feeding is
hypokalemia
An annual audiy shows that you have successfully met the indicator “95% of high risk patients area ssessed within 4 hours of admission” the next step is to
Evaluate the need to continue monitoring the indicator
Which outcome would justify continuing a WIC program?
- The number of participants enrolled increased
- The infant morbidity rate decreased
- Maternal weight gains during pregnancy increased
- The number of diverse cultures participating increased
The infant morbidity rate decreased
Which condition benefits from the use of indirect calorimetry?
Patient with third degree burns
In most patients a normal gastric residual volume would be
less than 250 mL
A patient on parenteral nutrition is to be transitioned to enteral feeding. He should receive
full strength enteral feeding at a low rate
Which supplements are recommended with peritoneal dialysis
Same as those for hemodialysis plus thiamin
Patients with cardiac cachexia on a loop diuretic should be evaluated for
Thiamin status
Following an ileal resection, which supplements are recommended?
calcium, magnesium, zinc, fat soluble vitamins
Which supplements are recommended with cirrhosis?
B complex, calcium, zinc, magnesium
What diet is typically recommended for a patient who has undergone a gastrectomy?
CHO, protein, and fat at each meal, and restriction of fluids with meals
Maple syrup urine disease and homocystinuria:
have protein as a nutrient of concern
Retrovir (NRTI) can lead to low levels of
vitamin B12, copper, zinc
Which guideline is used in planning meals for healthy people?
EAR
The dietitians analytical skills are needed most in which component of the NSI
Level II
The dietitians analytical skills are needed most in which component of the NSI?
Level III
A patient receives 1800 mL of a 1 cal/cc formula with 44 grams protein per liter. How much protein will he receive?
79 grams
Which tests measure somatic protein
creatine clearance, serum creatine
Expected creatinine clearance is estimated from the client’s
weight and height
How much water does an athlete need if they have lost 2 pounds?
32 ounces (2 lbs)
Which vitamin will interfere with levodopa?
A
Which nutrients would be most helpful when treating a patient with a progressive infection?
Phosphorus and zinc
Why would you add bicarbonate to a solution for a person with hyperkalemia?
It exchanges hydrogen for potassium
A patient on levodopa should
minimize protein at a breakfast and lunch, and add it to dinner
Four patients are admitted to your service. Who would you address first?
- patient who had a recent MI
- patient with gastric distress
- patient with cancer
- patient admitted for an appendectomy
Patient with gastric distress
Which of the following is an example of a secondary prevention program?
- offer health risk appraisals with referrals as needed for follow up
- Bring fruits instead of sweet rolls to all weekly staff meetings
- Offer heart healthy eating cooking classes at civic centers
- set up walking programs during lunch breaks
Offer health risk appraisals with referrals as needed for follow up
Based on the DRG’s Medicare reimbursement depends on:
age of patient and primary diagnosis
Which is not included in a subjective goal assessment?
- Dietary intake information from a 24 hour recall
- Information from patient regarding weight changes
- serum albumin levels
- physical appearance
serum albumin levels
The Health Risk Appreaisal (HRA) calculates
A population’s general health status
Which of the following is an achievable outcome for a weight loss program?
- Promote desirable body weight among young adults
- Increase by 25% the number of physicians who refer patients for weight management counseling
- Screen and refer for treatment within two years those whose body weight is 10% above desirable
- Reduce by 10% the number of obese adults, ages 25 - 49, within two years of starting the program
Reduce by 10% the number of obese adults, ages 25 - 49, within two years of starting the program
If a child with cystic fibrosis has daily large, foul smelling stools you should first check their
compliance with PERT
A patient with diabetes has not eaten for more than three days. You should:
liberalize the diet
With a CHO:insulin ratio of 16:1, how much insulin is needed with this meal? 2 oz beef 2/3 cup steamed brown rice 1/2 cup cooked beets 1 slice bread 1 tsp butter 1/2 cup vanilla ice cream
4 units
A patient presents with the following lab values ALP 100 U/L AST 30 U/L ALT 35 U/L This indicates
Normal liver function
The oral glucose lowering medication glucotrol:
promotes insulin secretion
The immunosuppressant drug cyclosporine may cause
hyperlipidemia and hyperkalemia
A patient with heart failure on a loop diuretic needs to have the status of which vitamin evaluated?
Thiamin
In the TM model, which stage of change is represented by this comment: “Although I do not like and therefore do not eat many vegetables, I saw an interesting vegetable side dish at a friend’s cookout”
contemplation
You are planning a health promotion program for employees. To assess employee’s needs use information from
health risk appraisals
Which of the following guidelines should be used when you are estimating the prevalence of inadequate intake levels of vitamin A within a group of adults?
Estimated Average Requirement (EAR)
An 80 year old female receives Meals on Wheels. What other nutrition assistance program would she qualify for?
SFMNP
Skinfold thickness measurements are best for assessing
- 18 month old with growth failure
- 36 year old athlete
- 54 year old woman with significant weight loss
- 82 year old man with diabetes
36 year old athlete
Which of the following lab values would most likely indicate dialysis is necessary?
Creatinine 2, 3, 4, 6
BUN 80, 90, 100, 70
6, 70
Following a Roux en Y, whch should be recommended first?
- Potassium, magnesium
- Folate, B12, Iron
- Multivitamin with iron
- Calcium and multivitamin with iron
calcium and multivitamin with iron
Which of the following medications is an appetite suppressant?
- Prednisone
- Dextroamphetamine
- Erythromycin
Dextroamphetamine
Hemodialysis requires supplementation of:
pyridoxine, folic acid, 1-25-dihydroxyvitamin D3
Which of the following directly assists the greatest number of people?
- SNAP
- NSLP
- Child and Adult Care Program
- WIC
SNAP
Which program helps provide nutritious meals to an adolescent residential facility?
National School Breakfast Program
A primary use of the DRIs is to
Plan menus for healthy people
A client who takes orlistat may need to
take a multivitamin
A patient with diabetic gastroparesis should avoid foods that are
high in fat
How much protein is needed for a patient with a stage 3 burn?
20 - 25% of total calories
Which religious group can consume alcohol?
- Mormons
- Muslims
- Hindus
- Buddhists
Buddhists
To lose 1 lb per week, reduce intake by ___ calories per day.
500
