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RD Exam > Nutrition Care for Individuals and Groups > Flashcards

Nutrition Care for Individuals and Groups Flashcards

1
Q

Name the affected blood lab values of anemia of chronic disease

A

Low RBC, Hgb, and Hct
Normal MCV (mean corpuscular volume) and MCHC (mean corpuscular hemoglobin concentration) = normocytic anemia
“normally seen in children”

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2
Q

How does the body compensate during respiratory acidosis?

A

Blood becomes very acidic since the lungs cannot remove all the CO2 the body produces, so the kidneys will excrete more hydrogen and retain more bicarb

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3
Q

Why would you see kwashiorkor in TPN patients receiving D5W?

A

*kwashiorkor= severe form of malnutrition; usually seen in children/babies in developing countries who don’t get enough protein/essential nutrients. Signs= fluid accumulation in body’s tissues, usually abdomen.

High dextrose with little protein in the mixture could cause kwashiorkor in TPN patients in 2+ weeks.

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4
Q

A high CO2 and low pH (acidic) is an indication of:

A

Respiratory acidosis

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5
Q

What is the renal solute load (RSL)?

A

The amount of nitrogenous waste and minerals that must be excreted by the kidneys. Proteins and electrolytes increase RSL.

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6
Q

What do you give a person after a 90-minute workout?

A

Fluids + carbs

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7
Q

What should be supplemented in women taking oral contraceptives?

A

Vitamin B6 and folacin (aka folic acid)

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8
Q

Explain positive and negative nitrogen (protein) balance

A

+: retention of nitrogen/protein > excretion (times of building and healing– anabolic)
-: excretion of nitrogen/protein > retention (times of sickness– catabolic)

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9
Q

Name the diet therapy that would be seen in epileptic children

A

Keto

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10
Q

Name a reaction to metabolic acidosis

A

Metabolic acidosis= build up of acid in the body d/t kidney disease/failure.

Reaction= Hyperventilation (rapid/shallow breathing)

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11
Q

How many kg would be lost in 1 week if a woman decreased her caloric intake from 2400 kcal to 1800 kcal?

A

1/2 kg per week (see answer sheet for solution)

2400-1800=600 kcal
600 kcal x 7 days = 4200 kcal/week
4200 kcal/3500 kcal/lb = 1.2 lbs per week
1.2lbs/ 2.2 kg/lb= 1/2kg per week

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12
Q

How much formula + water is needed for 3/4 strength TF at 50 ml/hr for 24 hours?

A

900 cc/d of formula, 300 ml water

See answer sheet for solution

50 ml/hr x 24 hours =1200 cc/d
1200cc/d x 0.75= 900cc/day of formula
1200 cc/d -900cc/d= 300 cc/day of water

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13
Q

Describe MSUD

A

Maple Syrup Urine Disease: genetic disease in which there is a defect in decarboxylation of BCAA causing thick brown urine.

Diet therapy: Low intake of BCAA (all protein-containing foods)

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14
Q

What is a neutropenic diet?

A

Low bacteria diet. Fresh fruits and vegetables are omitted

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15
Q

Describe galactosemia

A

Genetic disease affecting the body’s ability to convert galactose –> glucose.

Diet therapy: decreased galactose (milk products, organ meat, MSG)

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16
Q

List some symptoms of prolonged hyperglycemia in IDDM

A
  1. polyphagia (excess eating from increased appetite and excessive hunger)
  2. weight loss
  3. ketosis/acidosis (diabetic ketoacidosis– DKA)
  4. polyuria
  5. polydipsia (excessive thirst)

POLYPHAGIA: glucose can’t enter cells to be used for energy. This can be due to either low insulin levels or insulin resistance. Because your body can’t convert this glucose to energy, you’ll begin to feel very hungry. The hunger associated with polyphagia doesn’t go away after consuming food.

WEIGHT LOSS: insufficient insulin prevents the body from getting glucose from the blood into the body’s cells to use as energy. When this occurs, the body starts burning fat and muscle for energy, causing a reduction in overall body weight.

DKA: DKA develops when your body doesn’t have enough insulin to allow blood sugar into your cells for use as energy. Instead, your liver breaks down fat for fuel, a process that produces acids called ketones.

POLYDIPSIA/POLYURIA: Polydipsia is caused by high blood glucose levels in people with diabetes. When your blood sugar level levels rise, your kidneys release extra urine in an attempt to flush the excess glucose from your system. In the meantime, the brain urges you to drink more to replace the water the body is lacking.

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17
Q

Define Appropriation Bill

A

The bill that requests government funding for a community based program

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18
Q

In what phase of a community nutrition program should the budget be reviewed?

A

In the plan

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19
Q

What foods are in alkaline ash diet?

A

fruits and veggies

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20
Q

What foods are in the acid ash diet?

A

Cereals and Meats

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21
Q

Name the maximum time allowed outlined by Medicaid policy between the evening and morning meal

A

14 hours

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22
Q

Nutrition education programs should primarily be used as:

A

Change agents: “main goals of community programs are to promote change in a population.”

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23
Q

What diet is desirable for Dumping Syndrome?

A

Small meals, decreased CHO. Separating fluids from meals.

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24
Q

What nutrients delay gastric emptying?

A

protein and fat

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25
Q

Why do bulimic often have tooth decay?

A

Gastric juices decay teeth from excessive vomitting

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26
Q

What is the best diet for peptic/stomach ulcer disease?

A

Any diet that is tolerated by the patient

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27
Q

If patients receive incorrect nutritional information from physicians, what is the first step the RD should take?

A

Consult the physician

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28
Q

List the criteria for enrollment into the Food Stamp Program

A

Income– income guidelines are based on the Thrifty Food Plan

(one of four food plans USDA develops that estimate the cost of a healthy diet across various price points )

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29
Q

How does exercise affect blood sugar?

A

Decreased blood sugar

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30
Q

With DM, how is insulin altered on sick days (ie fever)?

A

Increased insulin

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31
Q

List the most common reasons for weight gain amongst the US adult population

A
  1. sedentary lifestyle (#1 reason for weight gain in people 65+ y/o)
  2. overeating
  3. modern day conveniences replacing energy expending activities
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32
Q

Name the only circumstance when it is advised for pregnant women to lose weight

A

Never. RD should counsel the patient on how to slow the rate of weight gain, but NOT how to lose weight.

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33
Q

Name the initial reaction during the acute phase response (trauma)

A

Hypometabolism (decreased brain glucose consumption)

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34
Q

Name the AA that has been reported to aid healing in TPN patients

A

Glutamine

It is the most abundant amino acid found in the body. It’s made in the muscles and transferred by the blood into different organ systems. Glutamine is a building block for making proteins in the body. It’s also needed to make other amino acids and glucose.

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35
Q

Describe the feeding guidelines for formula fed newborn infants

A

6-8, 3 oz feeds/day

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36
Q

When plotting weight and height on growth charts and it appears a patient has decreased several percentiles, it is important to check what first?

A
  1. accuracy of plotted points

2. accuracy of wt and ht measurements

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37
Q

Name the most commonly seen indicator of malnutrition in the US

A

Low iron status levels (low Hgb or Hct)

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38
Q

What is the most accurate way to assess food intake?

A

Calorie count

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39
Q

What diet is appropriate for congestive heart failure (CHF)?

A

2 g sodium diet

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40
Q

Name the most appropriate tool for assessing ht and wt in children

A

National Center for Health Statistics (NCHS) Percentiles

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41
Q

What age do you measure a child’s ht, standing?

A

2

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42
Q

An HIV pt has a consistent 104 F temp. What % increase in kcals is needed to maintain body weight?

A

37.8%

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43
Q

Name a culturally acceptable grain for the Middle Eastern population

A

Bulgur or rice

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44
Q

What is the most important dietary concern with HIV/AIDS patients?

A

Food safety

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45
Q

Describe one factor that the RD needs to consider when obtaining food preferences from a culture other than her own.

A

Cultural beliefs about certain foods or eating practices

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46
Q

Describe the treatment for PCOS

A

Weight control and exercise

Diet Therapy: 30-40% lipids and lower CHO (higher fat compared to normal, 20-35%, to help decrease insulin secretion)

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47
Q

Describe cost-benefit analysis

A

Measures the amount of money saved due to a program’s outcome
Example: a weight-loss program costs $250 to run, but produces $1000 in reduced medical costs (savings), the cost-benefit ratio is 1:4.

Cost of program: Savings in Costs=Cost-Benefit Ratio

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48
Q

What is the recommended total weight gain for a pregnant woman that is underweight (BMI < 18.5) at baseline?

A

28-40 lbs

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49
Q

What nutrients are affected when taking Levodopa (typically used for tx of Parkinson’s)?

A

Protein and B6

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50
Q

Outline the food practices of those whom are Seventh Day Adventists

A
  1. no pork, shellfish, or rabbit
  2. no alcohol
  3. many avoid caffeine
  4. no meat broth
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51
Q

What is the main disadvantage of taking antidepressants?

A

weight gain and increased appetite

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52
Q

Name the food that must be included in a school breakfast funded by the USDA

A
  1. milk
  2. fruits or veggies
  3. 2 breads or bread+meat
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53
Q

Why would you see decreased serum calcium when serum albumin is low?

A

albumin is a carrier of calcium.

low calcium levels do not necessarily mean deficiency during low albumin status d/t active calcium not bound to albumin (reason for corrected calcium equation)

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54
Q

Who qualifies for Medicaid?

A

Those who are indigent (poor), blind, mentally or physically handicapped

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55
Q

Describe the difference between urea and creatinine excretion

A

Urea: r/t protein intake
Creatinine: r/t muscle mass

Both are waste products during protein metabolism. Can be increased during exercise but also when kidneys are not functioning properly. They are also used to measure how well the kidney is functioning

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56
Q

Name the best type of milk to recommend a breast feeding mom looking to supplement in addition to breast milk

A

Infant formula w/ iron. Cow’s milk isn’t recommended until 1 years old.

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57
Q

What causes a fatty liver in TPN patients?

A

Excess dextrose.

Excess dextrose –> hyperinsulinemia–> increased glucose being converted to fat in the liver –> fatty liver

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58
Q

What is the RD’s biggest concern with complications of tube feedings?

A

Diarrhea (usually will be cause by medications tube fed pt is receiving)

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59
Q

Name the most important anthro indicator of FTT?

A

Weight for height

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60
Q

What nutrient should be increased during times of decubitus ulcers (bed sores)?

A

protein

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61
Q

How long can an enteral formula be refrigerated after opening?

A

48 hrs

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62
Q

what weight is a low birth weight?

A

< 5.5 lbs (1500-2500 g)

VLBW = < 1500 g

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63
Q

Name the best indicator of proper growth and development in children

A

regular and consistent increments of growth as reflected on the growth charts

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64
Q

Define complimentary proteins

A

The various mixing of protein containing foods that provides a total mixture of essential AA when eaten in combination. This help ensure that there is adequate intake of all the essential AA. (ie- beans and rice)

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65
Q

Why should infants not consume honey for the first year of life?

A

May cause botulism

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66
Q

What aids in the absorption of iron from non-heme sources?

A 
Vitamin C (forms a chelating agent with iron) 
ie- OJ + iron fortified cereal
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67
Q

What nutrients are more important for HIV/AIDS patients?

A

protein and cals

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68
Q

What is the most influential factor in hypertension?

A

obesity (alcohol is also an important factor)

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69
Q

Aside from folic acid, what supplement should be considered when taking Methotrexate?

Methotrexate: chemotherapy drug (also used to treat rheumatoid arthritis and psoriasis)

A

B12 (cyanocobalamin) if at risk for deficiency

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70
Q

Name the report that provides information for formulation of the “10 leading causes of death in the US”

A

The Surgeon General Report

“Heart disease, stroke, and cancer are the top 3 and dietary factors play a role in each.”

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71
Q

What is usually the initial problem with HIV/AIDS patients?

A

Anemia

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72
Q

Describe the difference between the symbol U and the symbol K seen on food packages

A

U: Union of Orthodox Jews
K: Rabbi Supervised

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73
Q

What medication is affected by sodium consumption?

A

Lithium (psychiatric medication used for bipolar)

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74
Q

What is an entitlement program?

A

Qualifications of entitlement programs are based on income or other eligibility requirements

ie- school lunch and food stamps

Entitlement programs consist of government benefits that certain qualified individuals are entitled to by law, regardless of need.

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75
Q

What is the first thing a RD should do in most clinical and management situations?

A

Assess and Evaluate

on the exam, the answer will usually be assess or evaluate if given the choice on any question

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76
Q

As the outpatient RD, you have a f/u with a diabetic pt. During the appt you educate on carb counting. What would you chart as the intervention?

A

Comprehensive Nutrition Education (E-2). Pt was educated on CHO counting and demonstrated understanding of the topic.

CHO counting would be considered an advanced topic since previous diabetes education was provided during a previous consult

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77
Q

What is the purpose of the NIH?

A

Supports nutrition research as it relates to health maintenance, disease prevention and disease treatment

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78
Q

Compare surveys with surveillance programs.

A

Surveys: conducted once in a given timeframe

Surveillance programs: ongoing or continuous

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79
Q

If a pt didn’t know how to follow a 2 gram Na diet, what would you chart as the nutrition diagnosis?

A

Food, nutrition and nutrition-related knowledge deficit (NB-1.1).

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80
Q

What is deficient when cracked lips, spoon shaped nails and easily plucked hair is observed?

A

Cracked lips: B vitamins
Spoon-shaped nails: iron
Pluckable hair: protein

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81
Q

Why would you take iron preparations with meals?

A

to avoid gastric distress

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82
Q

Which nutrients are absorbed in the duodenum?

A

iron, calcium, magnesium and chloride

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83
Q

What lab test is used to evaluate hypo- or hyperthyroidism?

A

T3 and T4 (thyroid hormones)

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84
Q

How much water does the average adult excrete per day?

A

2 L

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85
Q

Describe the effect temperature has on BMR.

A

BMR rises 7% for each degree above 98.6 F.

BMR rises 13% for each degree above 37 C.

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86
Q

How does the body compensate during metabolic acidosis?

A

the lungs excrete more CO2 to raise the pH of the blood.

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87
Q

What is the normal value of the renal solute load and what value determines renal failure?

A

Normal RSL= > 55 ml/min
Renal failure= 12.5-30 ml/min

Protein requirements during renal insufficiency are 0.6-0.8 g/kg

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88
Q

Name the half-life of transferrin and the normal storage capacity

A

half life is 8-10 days

Normally saturated 30-40% with iron

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89
Q

What does MCV measure?

A

size of the RBC

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90
Q

Name the normal values for albumin, its half-life and reasons for a decreased albumin in patients

A

Normal= >3.5 g/dL
half life is 15-19 days

Decreased:

  1. post-op
  2. overhydration
  3. protein malnutrition
  4. chronic loss (nephrotic syndrome- kidney disorder that causes the body to excrete too much protein in the urine)
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91
Q

Normal Hgb and Hct values

A

Hgb: Men; > 14, Women; >12
Hct: Men; >44%, Women; >38%

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92
Q

Symptoms of kwashiorkor

A

mild muscle and fat wasting, very low albumin, edema and decrease in protein intake

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93
Q

What should be supplemented when taking Isoniazid (INH)?

Isoniazid (INH)- antibiotics for TB

A

Vitamin B6

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94
Q

Symptoms of marasmus

A

Severe malnutrition characterized my inadequate energy intake (different from kwashiorkor that’s characterized by inadequate protein intake)

Symptoms: muscle and fat wasting, tricep skin fold (TSF) of 10% or less, slightly low albumin, no edema and decrease in kcal intake

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95
Q

Name the onset time of Regular, NPH, and Glargine insulin

A

Regular/short acting: 0.5-1 hour onset (lasts for 3-6 hours)
NPH: 2-4 hours onset (lasts 12-18 hours)
Glargine (lantus): 1 hour onset (lasts up to 24 hours)

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96
Q

Describe the 10-State Nutrition Survey

A

Conducted only 1 time (between 1968-1970)

Limited to low income areas

97
Q

define morbidity and mortality

A

morbidity: incidence of illness
mortality: incidence of death

98
Q

A TF with 1.6 kcals/ml is to run from 10pm to 11 am (13 hrs). What rate is needed to deliver 1800 kcals?

A

86.5 or 87 cc/hr

1800 kcal/d / 1.6 kcals/cc= 1125 cc/d
1125cc/d/13hrs/d= 86.5 cc or 87 cc /hour

99
Q

Name the next step after a bill is introduced into Congress

A

assigned to a committee

100
Q

Name the population that has an increased incidence of obesity

A

African-American females age 44-65

101
Q

How many kcals in 2 pieces of bread and 2 oz of very lean turkey breast?

A

Bread: 2 exchanges = 30 grams CHO and 6 grams protein + 2 grams fat
[30 x 4] + [6x4] + [2 x 9] = 162 kcals from bread

Meat (turkey): 2 exchanges = 14 grams protein and 2 grams fat
[14 x 4] + [2x9] = 74 kcals from turkey

162+74= 236 kcals

102
Q

The current tube feeding rate is not meeting the pt’s estimated needs for kcals or protein. What would you chart as the intervention?

A

Enteral and Parenteral Nutrition (ND-1)

Recommend increasing TF rate to __ ml/hr to meet pt’s estimated needs for kcals and protein.

103
Q

Define Diagnostic Related Group (DRG)

A

DRGs assign fixed costs and lengths of hospital stay to specific illnesses.

Also called Prospective Payment System (DRGs stem from Medicare)

104
Q

Name the primary focus of HANES survey

A

To continually survey the nutritional status of the US population

105
Q

List general goals of community based nutrition program

A
  1. Meet the needs of the large demographic group within a population
  2. Address the communities’ largest problems
  3. Take into consideration the goals of the local government and public officials

A goal would NOT include meeting ALL the needs of the community.

106
Q

A pt with HIV/AIDs, has a CD4 cell count of 25, an albumin of 1.8 g/dL and a BMI of 15, may have what nutrition diagnosis?

A

Can chart any of the following:

  1. Increased protein needs (NI-5.1)
  2. Evident protein-energy malnutrition (NI 5.2)
  3. Underweight (NC-3.1)
  4. Altered nutrition-related lab values (NC-2.2)

________________
CD4 count is used to check the health of the immune system in people infected with HIV (human immunodeficiency virus). HIV attacks and destroys CD4 cells. If too many CD4 cells are lost, your immune system will have trouble fighting off infections

107
Q

What is the requirement for participation in the school lunch program?

A

Family income

108
Q

Describe the objective of HMOs (health maintenance organizations).

A

Focus on preventative medical care. The main objective is to prevent patients from being admitted to a hospital.

109
Q

Name the first step when developing an in-service, presentation, or workshop.

A

Assess the needs and interests of the audience

110
Q

Describe pernicious anemia and the affected blood lab values.

A

A decrease in red blood cells when the body can’t absorb enough vitamin B-12 (body needs B12 to make RBC).

Labs:

  1. low RBC, Hgb, Hct
  2. High MCV (RBC are too large) and normal MCHC–> macrocytic anemia
111
Q

Where in the intestinal tract is vitamin K FORMED?

A

In the colon (by bacterial action)

112
Q

Name the best test for malnutrition

A

body weight

113
Q

What is the protein requirements for someone on hemodialysis?

A

1.1-1.4 g/kg (ideal is 1.2 g/kg)

114
Q

Name the affected blood lab values in iron deficiency anemia

A

Low Hgb, MCV, MCHC–> microcytic anemia

RBC may be normal

115
Q

Which nutrients are absorbed in the ileum?

A

Fat soluble vitamins
Fat
Cholesterol

116
Q

Name a serious condition caused by hyperkalemia

A

Cardiac arrest

117
Q

Why is calcium absorption decreased in kidney disease?

A

Decreased active vitamin D formation

118
Q

What vitamins may be affected with frequent use of laxatives?

A

Fat soluble vitamins (ADEK)

119
Q

Describe creatinine

A

Waste product made by your muscles as part of regular, everyday activity. Normally, your kidneys filter creatinine from your blood and send it out of the body in your urine. If there is a problem with your kidneys, creatinine can build up in the blood and less will be released in urine.

Low value associated with decreased muscle mass.

It is a product of creatine found mainly in the muscle and aids in ATP during anaerobic conditions (absence of O2).

120
Q

What should be avoided when on MAO Inhibitors? Name some foods high in this.

MAO Inhibitors are used for treatment of depression.

A

Tyramine (AA) should be avoided.

Foods high in tyramine: cheese, smoked meat, non-fresh meats, chianti wines, broad beans, dry sausage. (fermented foods)

Cottage cheese, cream cheese, yogurt.

121
Q

Name the half-life of retinol-binding protein

A

12 hours

122
Q

Name some metabolic abnormalities seen in refeeding syndrome

A
  1. hypophosphatemia
  2. hypokalemia
  3. hypomagnesemia
123
Q

Describe complimentary medicine

A

Alternative medicine used in conjunction with conventional medicine.

Ie (yoga, acupuncture, chiropractic, and hypnotherapy)

124
Q

Calculate the BMI of a male who is 155 lbs and 5’10”

A

[weight (lbs) x 703] / height (in)^2

5 ft = 60 in.

[155 (703)] /70^2 = 108,965/4900= 22.24 (22.3)

125
Q

A patient is receiving 2 L of D5W; how many kcals would this provide?

A

2000 ml x 0.05 g/ml= 100 g CHO
100 g CHO x 3.4 kcals/g = 340 kcals

(0.05 g/ml= concentration of dextrose & there are 3.4 kcals/g of dextrose)

126
Q

What daily caloric intake will result in a weight loss of 2 lbs/month if currently consuming 2000 kcals/d?

A 
3500 kcals = 1 lb 
3599 kcals x 2 lbs = 7000 kcals 
1 month = 4 weeks 
7000 kcals/4 weeks = 1750 kcals/week 
1750 kcals/7 days = 250 kcals/day 
2000 kcals-250 kcals= 1750 kcals
127
Q

What is the kcal:N ratio of 1500 kcals and 20% protein?

A

1500 kcals x 0.2 = 300 kcals /4 kcals/g = 75 g protein
75 g protein / 6.25 protein/g Nitrogen = 12 g N
1500 kcals / 12 g N = 125:1

(N content of protein = ~16% or 6.25 protein/g of Nitrogen)

128
Q

Name the first step involved when making program changes due to funding cuts

A

Reassess program

129
Q

Reading the local newspaper will inform you on what stage of the passage of a bill?

A

The proposal stage

130
Q

Name one of the reasons why paraprofessionals are important to utilize in community nutrition programs.

A

Establish better rapport with low income patients

131
Q

Medicare policy states an elderly person nutritional status needs to be evaluated every…

A

90 days

Medicare recipients are not entitled to a yearly physical

132
Q

When would you contact your congressional representative to gain support in a piece of legislation?

A

After the bill has been introduced on the floor

133
Q

Name the most effective way to measure success of a community nutrition program

A

Meeting program objectives (example of a measurable objective would be a decrease in low-birth weight babies)

134
Q

When would it be advised for a breast feeding mom to stop breast feeding due to medications?

A

Never, the mother should first consult with physicians to find out what medications are safe.

(If mom is HIV+, it is recommended to not breast feed)

135
Q

Name the hormone that stimulated the production of breast milk

A

Prolactin

Oxytocin stimulates the let-down reflux of milk.

136
Q

The Child and Adult care Food Program serves what population?

A

Children and adults in day care facilities

137
Q

Define colostrum

A

Milk that’s produced just prior to and after childbirth; so babies are receiving this during the first 24 hours of life.

rich in antibodies.

138
Q

Name the method of infant feeding promoted by the WIC program

A

Breast feeding

139
Q

Describe who is responsible for 1st, 2nd, and 3rd party reimbursement

A

1st: user or purchaser
2nd: the provider
3rd: insurance company + patient’s family

140
Q

Name the most effective tool to assess an infant or child’s dietary intake

A

A 3-day food record

141
Q

Name the criteria for the Congregate Meals Program (also called Title III)

A
  1. 60 years or older
  2. no income criteria
  3. only one member of a couple must qualify
142
Q

Describe the appropriate rate of weight gain during pregnancy

A

1st trimester: 2-4 lbs total (weight gain is slow during this trimester)
2nd and 3rd trimesters: 1 lb/week

143
Q

Should a bottle be used to quiet or pacify a crying baby?

A

No - an infant or child should only eat on demand. food should not be used as a reward or to pacify

144
Q

Define a low cariogenic value food

A

Foods that are low in sugar

cariogenic= causing tooth decay

145
Q

Name the NHANES population surveyed

A

2 mo to 74 years

146
Q

If an infant has consistently been at the 95th percentile weight-for-age, what would you recommend?

A

Nothing- you would want to “wait and see”

abnormal growth is <5th percentile to >95th percentile.

147
Q

Name what needs to be assessed if a formula fed child has low iron status

A

Assess if child is on an iron-fortified formula

Normal Hgb: 11.2

148
Q

Name the problematic nutrient that interferes with iron absorption

A

Calcium

excess milk consumption frequently causes iron deficiency anemia in children

149
Q

Name the most important anthropometric data when assessing children.

A

Height and weight

150
Q

Describe why sugar and food additives do not have proven effects on hyperactive children.

A

Some studies have proven that giving hyperactive children sugar has a soothing effect

151
Q

Name the most prevalent nutrition related problems among American children.

A

obesity, anemia, and dental caries

too much sugar and fat and not enough iron rich foods

152
Q

Define acculturation

A

Occurs when one culture adopts cultural habits of another culture (ie Mexicans adopting US eating habits)

153
Q

Name a calcium rich food that would be acceptable in a Mexican-American diet

A

Broccoli and cheese

154
Q

Describe the velocity of linear growth a newborn into teenage years.

A

Newborns grow at a very rapid rate and slow down with age.

155
Q

Name the groups of people that use very little milk in their diet.

A

Mexicans, Asians and Native Americans

156
Q

Name the food that a lactovegetarian would restrict

A

Meat, poultry, fish and eggs (milk and dairy products are allowed)

157
Q

Discuss the reasons why it is important for infants to not drink for a bottle while lying down

A

May cause ear infections and dental caries (includes not taking a bottle to bed. Sugars from the formula and juice collect on the teeth and in the ear canal providing food for bacteria to grown.)

158
Q

What is the least amount of weight a woman should gain during pregnancy?

A

15 lbs

If a women is obese (BMI >29.0) prior to pregnancy, she should gain between 11-20 lbs during pregnancy.

159
Q

Describe cost-effectiveness analysis

A

Measures the benefit of a program/service in monetary terms. (ie- $1 per point of cholesterol lowered. Usually, measured per outcome.)

160
Q

Compare the fat, protein, and CHO in 1 L of human breast milk compared to formula.

A

Human milk: 45 g fat, 9-11 g protein, 70 g CHO

Formula: 33-36 g fat, 15 g protein, 74-96g CHO

161
Q

Compare prevalence with incidence

A

Prevalence: # of cases of a disease at a particular time (ie 10% of the population has AIDS)
Incidence: # of new cases (ie 3000 new cases of HIV were reported in 1992)

162
Q

Describe the food practices that Roman Catholics may follow

A
  1. No meat on Fridays during Lent, Ash Wednesday and Good Friday
  2. No eating b.w meals on Ash Wednesday and Good Friday

not applicable for people on therapeutic diets or the elderly

163
Q

Name the food restrictions in Judaism

A
  1. no pork/ pork products (ie gelatin)
  2. fish must have fins/scales (no shellfish, squid, etc)
  3. no meat/poultry combined with dairy in the same meal (ie pepperoni pizza)
  4. no foods containing blood
164
Q

Name the function of the Federal Register

A

A daily publication (journal) that provides Federal agency regulations, proposed regulations and schedules of Federal Hearings

165
Q

Name the piece of legislation that provides home delivered meals, congregate meals and nutrition programs for senior citizens

A

Older American Act (aka Title III)

MoW is not a gov program

166
Q

Name the purpose of the Dietary Guidelines

A

to prevent chronic disease (also aid in planning for community nutrition programs)

167
Q

Describe the population who qualifies for Medicare

A

People who are 65 years+, who have paid into Social Security 40 quarters (4 quarters= 1 year)/10 years

168
Q

Name the population who is at greatest risk during pregnancy

A

Teens

an overweight, underweight, or anemic teen is more at risk than an adult with the same problems

169
Q

When planning a community nutrition program, with whom is it best to collaborate?

A

Similar programs and populations (WIC and Head Start often collaborate b/c they both serve the pediatric population)

170
Q

Name the nutrients needed to be supplemented if a woman who was taking oral contraceptives became pregnant.

A

Folic acid and B6

171
Q

Name the nutrient needs that increase during lactation

A

calories and protein

172
Q

A pregnant vegan’s diet may lack in which nutrients?

A

Calcium (dairy), B12 (fish) and Zinc (meat)

173
Q

Describe the feeding regime for a breast-fed infant

A

on demand

174
Q

At what age are table foods recommended to be first given to infants?

A

4-7 mo

175
Q

Describe the growth pattern seen in growth retardation.

A

As age increases, increments of linear growth are slowed. (on growth charts, height for age decreases slowly overtime)

176
Q

Name the most effective tool for assessing the nutritional status of the elderly population

A

Height and weight

177
Q

Name the most important foods that can be recommended to infants 6-12 mo with low iron

A
  1. iron fortified formula
  2. Infant cereal

for the first 6 mo, baby gets iron stores from maternal blood. After 6 mo, high iron foods aid in production of baby’s own iron stores

178
Q

Name the most dangerous ramification of pica seen in children

A

Pica= Craving and chewing substances that have no nutritional value, such as ice, clay, soil, or paper.

Lead poisoning

179
Q

List three considerations when planning for a nutrition program for the elderly

A
  1. transportation
  2. food myths (elderly are prone to buying into fad diets)
  3. lack of exercise
180
Q

One of your patients is an 8 yo who doesn’t eat much meat, what would be the first thing you would assess?

A

Iron status (Hgb and Hct); even if child is eating fruits, veggies and milk

181
Q

What is the normal range of percentiles on growth charts for children?

A

5-95%

182
Q

Until what age should children drink whole milk?

A

2 years old

183
Q

Name the most appropriate anthropometric parameter that would describe the prevalence of malnutrition amongst the US children

A

Height for age (stunting)

reflects the cumulative effects of undernutrition and infections since birth, and even before birth. Can be interpreted as an indication of poor environmental conditions or long-term restriction of a child’s growth potential

184
Q

Name the vitamin that tends to be low in breast milk

A

Vitamin D

185
Q

Name the best way to introduce a new food to a group of children.

A

With an activity (also helpful to get children involved in food prep)

186
Q

What population’s diet is often deficient in calcium, iron, and vitamin C

A

teenage girls

187
Q

Name the best possible way to attract low-income teenagers to nutrition education program

A

through radio advertisements

188
Q

Name the basics of the “Plate Method” developed by the USDA

A
  1. promotes a variety of foods
  2. half of the plate are fruits and veggies
  3. half of the grains should be whole grains
189
Q

List some common foods eaten by the Mexican-American population

A

Corn or flour tortilla, refried beans, peppers, burritos, and rice (if trying to reduce cholesterol, recommend boiled beans rather than refried beans)

190
Q

Name the populations that would most benefit from the use of the Hedonic Scale (dislike extremely to like extremely)

A
  1. Children

2. Non-English speaking people

191
Q

What is the total recommended weight gain for a pregnant woman who was the right weight for height prior to pregnancy?

A

25-35 lbs

normal height for weight is a BMI of 18.5 to 24.9

192
Q

List foods that would help increase vegan’s iron intake

A

baked beans, other dried beans, enriched cereals, raisins, etc

THE MOST COMMON FOOD ANSWER ON THE RD EXAM IS BAKED BEANS

193
Q

Name the foods that are not acceptable in a vegan diet

A

animal products (including eggs, milk, fish, poultry, etc)

194
Q

Name the primary goal of the Food and Agriculture Organization (FAO)

A

To increase the food supply through agriculture

195
Q

List some frequently eaten foods by the Native American population

A

variety of meats, nuts, berries, corn, jerky, maple syrup, tomatoes and squash

(high prevalence of lactose intolerance in this population)

196
Q

Describe the primary goal of the World Health Organization (WHO)

A

To improve the nutritional status of infants and pregnant women

197
Q

List the food limitations of The Church of Jesus Christ of Latter-day Saints populations

A

No alcoholic beverages, coffee or tea (black or green)

Caffeine containing sodas are permitted.

198
Q

While talking to an elderly patient on a regular diet, you discover that her dentures are not with her. She is having problems chewing certain foods and cannot tolerate meats at all.

What would you chart as the nutrition diagnosis, the supporting evidence and the intervention?

A

Chewing difficulty (NC-1.2) r/t missing dentures AEB conversation with pt.

Recommended changing diet to mechanical soft with ground meat.

199
Q

Name the services that the Expanded Food and Nutrition Education Program (EFNEP) provide.

A

EFNEP provides nutrition education to those families with children under the age of 19 who are at greatest nutritional risk and are low income.

200
Q

A pt is admitted with chest pains. After your assessment, you determine the only nutrition-related concern are his labs.

Total Chol= 256
LDL= 180
HDL=30

What is you nutrition diagnosis?

A

Altered nutrition relation lab values (NC-22) r/t chest pains AEB increased total chol, LDL and decreased HDL.

Normal Values:
Total Chol: <200
LDL: <100
HDL: 45-70 for men and 50-90 for women

201
Q

List the enrollment criteria for the WIC program

A
  1. low income
  2. nutrition risk
  3. either pregnant, postpartum (6 mo), lactating (1 yr) or a child < 5 years.
202
Q

Why would anemia be seen in renal patients?

A

Kidney are responsible for erythropoietin (making RBCs)

203
Q

What hormone controls hypertension by reabsorbing sodium in the kidneys?

A

Aldosterone

204
Q

What is the most important nutrition factor for endurance athletes?

A

Hydration during the event

205
Q

What system does lactic acid utilize to give up bound oxygen?

A

Cori Cycle

206
Q

Name the normal values for fecal fat, serum sodium and HgbA1c.

A

fecal fat: 5-7 g/24 hrs
serum sodium: 135-148 mEq/L
HgbA1c: 4.0-6.0% (3-4 month test evaluating blood glucose)

207
Q

Which nutrients are absorbed in the jejunum?

A

B vitamins, folic acid, vitamin C, monosaccharides

208
Q

Name the best type of food for a child with athetoid cerebral palsy

A

Nutritionally dense foods that can be eaten with their hands.

209
Q

Which nutrients have the greatest effect on osmolarity?

A

Electrolytes

210
Q

Describe alternative medicine

A

Practices used in place of conventional medical treatments (ie- traditional Chinese medicine, homeopathy, chiropractic and herbalism)

211
Q

What minerals are subject to drug-nutrient interactions when taking diuretics (Lasix and Furosemide)?

A

K+, Mg, Zinc, Ca

212
Q

Name the half-life of prealbumin

A

2-3 days

213
Q

What is glutathione peroxidase?

A

the active form of selenium

needs to be supplemented in TPN patients

214
Q

Describe the diet in Cystic Fibrosis

A

Increased protein and 35-40% fat (fat likely to be malabsorbed in CF)

215
Q

Why would children with PKU have an increased risk of cavities?

A

PKU diet is high in simple CHO.

PKU is a genetic disorder that causes a buildup of certain AA in the body.

216
Q

What should be the predominant protein source with hepatic encephalopathy?

A

foods high in BCAA.

(BCAA supplementation may reduce malnutrition and revert the loss of muscle cell mass that is common in severe liver disease and the breakdown of protein that occurs in people with hepatic encephalopathy (Córdoba 2004; Kachaamy 2011).

217
Q

Name the disease that alters copper metabolism

A

Wilson’s Disease (genetic disease)

218
Q

What is the reason for high fiber and fluids for quadriplegic?

A

to prevent constipation

219
Q

What do surveillance measure?

A

incidence

surveillance is used to assess and I.D. the nutritional related problems in a community

220
Q

What does the RD need first to release patients records to a physician?

A

written consent from the patient

221
Q

A TPN solution contains: 500 ml 20% dextrose, 500 ml 4% protein, 250 ml 20% lipids. Determine the non-protein kcals, total kcals and non-protein kcals:nitrogen ratio.

A

840 non-protein kcals
920 total kcals
263:1 ratio

SEE ANSWER SHEET

222
Q

What is the diet for a colon resection and what vitamin could be affected?

A

Adequate CHO and high fluids.

B12 could be affected

223
Q

Define regulation

A

the interpretation of a law

224
Q

Aside from advice from a RD, what else should an anorexic patient be getting?

A

psychiatric counseling

225
Q

What is removed in a gastrectomy?

A

all or part of the stomach

226
Q

What is excluded in a Celiac diet?

A

Wheat, rye, barley and gluten-free oats (oats can be an issue d/t cross-contamination)

227
Q

What is the max amount of hours prepared formula can be refrigerated?

A

24 hours

228
Q

Compare the WIC and Food Stamp Programs

A

WIC:

  • provides nutrition education
  • provides vouchers for certain foods
  • only serves pregnant/lactating women and infants+children

Food Stamps:

  • does NOT provide nutrition education
  • provides vouchers for a wider range of foods
  • serves people 18+

BOTH are funded by the USDA

229
Q

List some possible outcomes of WIC services

A
  1. increased Hct and Hgb
  2. less anemia
  3. less low birth weight babies
  4. more knowledgeable patients regarding nutrition information
230
Q

What is produced after a period of long starvation and in uncontrolled diabetes?

A

Ketones (used in place of glucose for the brain)

231
Q

What is a result of ketosis?

A

incomplete fatty acid oxidation and a depletion of Na and K

232
Q

List the two most common nutrients that are supplemented during pregnancy

A

Folic acid and iron

233
Q

Describe what happens when formula is heated in the microwave

A

There is a risk of burning the infant d/t uneven heating of the milk

234
Q

List 3 common nutritionally related disease states among the eldery

A
  1. obesity
  2. osteoporosis (greatest risk for elderly white women)
  3. high BP
235
Q

What is the best way to assess if a TF is working?

A

prealbumin

The use of prealbumin has been advocated as a nutritional marker, particularly during refeeding and in the elderly [32]. The main advantage of prealbumin compared to albumin is its shorter half-life (two to three days) (Table 2), making it a more favorable marker of acute changes of the nutritional state.

236
Q

Name some side effects of carb loading.

A

weight gain, sore muscles and fatigue

237
Q

Name the 4 steps in the Nutrition Care Process (NCP)

A

ADIME

  1. Assessment
  2. Diagnosis
  3. Intervention
  4. Monitoring and Evaluation
238
Q

What would be decreased in bedridden patients?

A

calcium and nitrogen

RD Exam (4 decks)

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