Questions 331-431 Flashcards by Jon C

You have determined that an infant should take 340 calories/24 hours. How many ounces of milk should be given to the baby every 6 hours?

a- 2 oz
b- 3 oz
c- 3.5 oz
d- 4.5 oz

d- 4.5 oz (need 85 cal every 6 hours)

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Which of the following self-assessment tools would be given to clients prior to screening at a congregate meal site?

a- PEACH survey
b- DETERMINE checklist
c- NSI Level 1 screen
d- NSI Level 2 screen

b- DETERMINE checklist

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A Crohn’s patient who was previously well-nourished has a fever and ileus 7 days PO. Which feeding method should you recommend?

a- central venous hyperalimentation
b- full liquids
c- peripheral IV infusion
d- half strength tube feeding

c- peripheral IV infusion (ileus)

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A clinical dietitian has successfully met an indicator for 6 months. The next step should be to:

a- establish a new indicator
b- report the successful completion of intervention
c- evaluate the need to continue monitoring the indicator
d- evaluate the need to revise the standard of care

c- evaluate the need to continue monitoring the indicator

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A nephrotic syndrome patient with edema has a serum albumin level that continues to fall. Recognize that:

a- liver dysfunction is causing decreased albumin synthesis
b- volume overload has diluted the albumin
c- the patient is getting sicker and eating less
d- protein is being lost in the urine

d- protein is being lost in the urine

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Intervention by a Dietitian conducting nutrition assessment is best determined by:

a- patients medical history
b- patients diagnosis
c- the case mix of the patient population
d- results of nutrition screening

d- results of nutrition screening

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The best way to justify continuation of WIC would be to show improvement in:

a- the number of participants enrolled
b- the infant morbidity rate
c- maternal weight gains during pregnancy
d- infant head circumference

b- the infant morbidity rate

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A patient with severe acute pancreatitis experiences nausea and vomiting and requires 2500 calories / day. Which of the following would you recommend?

a- 3000cc of a 1 cal/cc tube feeding through jejunum
b- 1500cc of a 2 cal/cc NG tube feeding
c- 1000cc of D50W, 1000cc of 7% AA, 650cc of 20% lipids
d- 1000cc of D50W, 1000cc of 7% AA, 500cc of 10% lipids

d- 1000cc of D50W, 1000cc of 7% AA, 500cc of 10% lipids

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Roman catholic dietary laws state that fish is:

a- to be served every Friday all year
b- to be served on Ash Wednesday and Good Friday
c- to be served on Ash Wednesday and Fridays during Lent
d- no longer required on Fridays

c- to be served on Ash Wednesday and Fridays during Lent

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A normal pregnancy requires supplementation of:

a- iron
b- Vit C, calcium, iron
c- iron and folic acid
d- calcium and zinc

c- iron and folic acid

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Which condition benefits from the use of indirect calorimetry?

a- post-gastrectomy
b- patient receiving chemotherapy
c- patient with third degree burns
d- post surgical patient

c- patient with third degree burns

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A Rabbi is admitted to the hospital. What question will he ask the dietitian?

a- What time are meals served?
b- Who cooks the food?
c- What is the mixture of foods in combination dishes?
d- Where will he eat?

c- What is the mixture of foods in combination dishes? (cant mix certain foods)

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Which of the following statements about cows milk is true?
I- it is high in protein II- it creates high solute load
III- it is low in iron and vitamin C

a- I
b- I, III
c- II, III
d- all of the above

d- all of the above

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A patient on parenteral nutrition is to be transitioned to enteral feeding. He should receive:

a- half strength EN initially
b- half strength and then 3/4 strength EN
c- half strength EN with low osmolality
d- full strength EN at a low rate

d- full strength EN at a low rate (low rate is key)

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A patient on a full liquid diet should not receive:

a- sherbet
b- strained cereal
c- pureed fruit
d- margarine

b- strained cereal

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What is the best practical way to measure energy balance?

a- evaluate weight gain and loss
b- utilize food intake records
c- use activity factors
d- calculate number of calories consumed

a- evaluate weight gain and loss

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Infants should be given solid foods at:

a- 1-3 months
b- 3-4 months
c- 5-8 months
d- 10-12 months

c- 5-8 months

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Iron preparations should be taken:

a- before meals
b- on an empty stomach
c- with meals
d- before bedtime

c- with meals (enhance absorption)

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An appropriate menu for a Kosher meal is:

a- macaroni and cheese, green beans
b- roast beef, potato, veg, cream soup
c- veal parmesan, noodles, green beans
d- crabmeat salad, lettuce, milk

a- macaroni and cheese, green beans (no dairy + meat)

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A hispanic woman needs more calcium in her diet, what do you recommend?

a- milk
b- plantains
c- avocados
d- pinto beans

d- pinto beans

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Which of the following would lacto-ovo vegetarian not eat?

a- eggs
b- halibut
c- cheese
d- beans

b- halibut

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Which provides the most Vitamin A for a Mexican?

a- tortillas and refried beans
b- cantaloupe and squash
c- cheese
d- tortillas and milk

b- cantaloupe and squash

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Which snack would you not give to an infant?

a- yogurt
b- cheese sticks
c- graham crackers
d- grapes

d- grapes (why?)

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Which hormone is involved in developing the placenta?

a- progesterone
b- estrogen
c- lactogen
d- testosterone

a- progesterone

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Which supplements should you give to a breast-fed baby? a- vit D and flouride b- flouride c- vit D d- Vit A and C

a- vit D and flouride

Which is the most useful for evaluating recent under-nutrition or over-nutrition? a- height for age b- weight for height c- weight for age d- length for weight

b- weight for height

Which is the least useful evaluation tool in a community assessment program? a- height for age b- weight for height c- weight for age d- length for weight

c- weight for age (dont know height!)

A child is below the 5th percentile weight for height. What can be said about the child? a- child is tall for their age b- child has a disease that inhibits growth c- it is an indication of long term under nutrition d- it is an indication of recent under nutrition

d- it is an indication of recent under nutrition

What would you first advise a constipated patient to do? a- take mild laxative b- eat less fat c- increase fluids and fiber d- eat more protein

c- increase fluids and fiber

A patient with dysphagia waiting for a swallow test may receive: a- thick liquids b- thin liquids c- peripheral parenteral nutrition d- parenteral nutrition

a- thick liquids (remember not thin)

At what age should children be measured standing up? a- 6 months b- 12 months c- 18 months d- 24 months

d- 24 months

What is normal weight gain during the first trimester? a- 1-2 lb b- 2-5 lb c- 5-8 lb d- 8-10 lb

b- 2-5 lb (2nd and 3rd trimester = 1 lb per wk)

The breast-fed infant is drinking primarily colostrum for: a- the first 24 hours b- the first few days c- 1-2 weeks d- 3 months

b- the first few days

Which of the following items is appropriate for a Muslim diet? a- sweet and sour pork b- salad with Bacos c- pork friend rice d- chicken in wine sauce

b- salad with Bacos (Bacos are not actual pork)

What would a vegan not eat? a- coleslaw made with oil and vinegar b- congealed fruit salad c- salad with tofu dressing d- peanut butter

b- congealed fruit salad

What is lacking in the traditional diet for Asians living in America? a- iron b- calcium c- folic acid d- thiamin

b- calcium

Which of the following indicates stunted growth? a- weight for height b- height for age c- weight for age d- weight for length

b- height for age

A patient comes to you with a diet that you know is not good to follow. What should you do? a- Tell him its not good b- explain why it is not good c- tell him to only follow what you have provided d- let him do as he wishes

b- explain why it is not good

Which hormone regulates beast milk production? a- prolactin b- progesterone c- estrogen d- oxytocin

a- prolactin (not oxytocin!)

How many grams does a low birth weight infant weight? a- less than 2500 b- between 500 and 1500 c- between 3000 and 4000 d- between 100 and 500

a- less than 2500

An 18 month old child should receive: a- whole milk b- 2% milk c- 1% milk d- skim milk

a- whole milk

Which of the following is true about SGOT: a- it is increased with hepatitis and diabetes b- it is increased with hepatitis, decreased with diabetes c- it is decreased in both hepatitis and diabetes d- it is decreased with hepatitis and increased with diabetes

b- it is increased with hepatitis, decreased with diabetes

What is the best way to increase attendance at a nutrition seminar for dentists? a- hold it in a location convenient to large numbers of dentists b- have it held in a medical facility c- hold it on weekends when offices are likely closed d- have it sponsored by a dental organization

d- have it sponsored by a dental organization

As a public health Nutritionist, you notice an increase in the percentage of obese Hispanic females in the community. What is the best way to educate them? ``` a- have a cooking class that they can participate in the cooking and then eat the food b- hold classes that teach low fat cooking c- develop posters with low fat cooking tips d- develop low fat recipes and instructional materials they can follow at home ```

a- have a cooking class that they can participate in the cooking and then eat the food

A five month old baby has changed from the 65th to the 95th percentile weight for height. The Dietitian should first: a- suggest the mother introduce more solid foods b- change the feeding formula c- check to see if weights have been plotted properly d- increase amount of formula given

c- check to see if weights have been plotted properly

What would you do to decrease fat intake for a Hispanic? a- change from whole milk to 2% b- change beans from refried to boiled c- change to low fat yogurt d- serve low fat cheese

b- change beans from refried to boiled (remember this)

When is breast feeding contraindicated? a- when the mother is underweight b- when the mother has AIDS c- when the mother has a breast infection d- when the mother has hyperlipidemia

b- when the mother has AIDS

Which test measures somatic protein? a- prealbumin, albumin b- creatinine clearance, serum creatinine c- serum transferrin d- prealbumin, albumin, transferrin

b- creatinine clearance, serum creatinine

Expected creatinine clearance is estimated from the clients: a- weight b- TSF, AMC c- height d- waist circumference

c- height

How much water does an athlete need if they have lost 2 pounds during a marathon? a- 8 oz b- 16 oz c- 24 oz d- 32 oz

d- 32 oz

High doses of which vitamin will interfere with Levodopa? a- pyridoxine b- cyanocobalamin c- thiamin d- riboflavin

a- pyridoxine (remember!)

Levodopa is used in the treatment of: a- rheumatoid arthritis b- parkinsons disease c- diabetic ketoacidosis d- nephrotic syndrome

b- parkinsons disease

Quickly stopping a 25% dextrose solution leads too: a- hyperglycemia b- hypoglycemia c- hypophosphatemia d- hyperkalemia

b- hypoglycemia

Infants born to mothers with diabetes may be: a- larger than normal, hypoglycemic shortly after birth b- smaller than normal, hyperglycemic shortly after birth c- larger than normal, hyperglycemic shortly after birth d- smaller than normal, hypoglycemic shortly after birth

a- larger than normal, hypoglycemic shortly after birth (hypo since extra sugars no longer available)

The mother of an infant who weighed 4.5kg at birth and was hypoglycemic may: a- have gained excessive amounts of weight during pregnancy b- not have gained enough weight during pregnancy c- have had gestational diabetes d- have reactive hypoglycemia

c- have had gestational diabetes

What is the most important advice to give a patient with a peptic ulcer? a- drink milk every 1-2 hours b- consume small portions c- eat everything in balance d- abstain from spicy food

d- abstain from spicy food

A tube fed patient develops diarrhea. What needs to be done first? a- review nutritional needs b- increase feeding rate c- review feeding osmolality d- discontinue feeding until diarrhea stops

c- review feeding osmolality

A patient admitted to the ICU is diagnosed with HIV and progressive infection. Which nutrients would be helpful? a- phosphorus and zinc b- sodium and potassium c- sodium and chromium d- potassium and magnesium

a- phosphorus and zinc (remember HIV- zinc)

A young girl who is HIV positive with Karposis sarcoma tells you she would like to take Vit C supplements. What should you tell her? a- ignore her request and talk about incorporating better balanced foods into her diet b- ignore her request and advise her to drink more juice c- explain the dangers of excess Vit C d- ask her to keep a food diary to see where she is lacking

d- ask her to keep a food diary to see where she is lacking

Why would you add bicarbonate to a solution for a person with hyperkalemia? a- it forces magnesium out of cells to attract potassium b- it forces chloride out of cells to attract potassium c- it exchanges phosphorus for potassium d- it exchanges hydrogen for potassium

d- it exchanges hydrogen for potassium (H is acidic, bicarbonate is basic)

A patient with parkinsons disease on Levodopa should: a- increase protein intake at breakfast b- consume no more than 40g protein per day c- evenly divide protein intake during the day d- minimize protein at breakfast and lunch, add it to evening meal

d- minimize protein at breakfast and lunch, add it to evening meal (remember this)

Which would you recommend for a patient with mild dysphagia? a- honey b- apple juice c- nectar d- pudding

d- pudding

Four patients are admitted to your service. Who would you address first? a- patient with recent MI b- patient with gastric distress c- patient with cancer d- patient admitted for an appendectomy

b- patient with gastric distress (more immediate of an issue)

Lactic acid is a result of: a- anaerobic glycolysis b- aerobic glycolysis c- TCA cycle d- Cori Cycle

a- anaerobic glycolysis

When counseling a diabetic with limited education, which would be the most appropriate question to ask in assessing her comprehension level? a- do you enjoy candy and sweets b- name a food that is fat c- do you have difficulty swallowing or chewing d- how many meals and snacks do you have per day

b- name a food that is fat

Based on the DRG's, Medicare reimbursement depend on: I- length of stay II- age of pt III- primary dx a- I b- II, III c- I, II d- I, II, III

b- II, III

A patient is diagnosed with iatrogenic malnutrition. Nutritional therapy should be: a- high calorie b- high protein c- high calorie high protein d- low calorie high protein

c- high calorie high protein

Within 2-3 hours of continuous exercise at 60-80% max effort: a- muscle glycogen is depleted b- muscle glycogen is main energy source c- AA begin to contribute as an energy source d- fatty acids are the favored energy source

a- muscle glycogen is depleted

To maintain hydration during continuous endurance physical activity of 4 hours, consume: a- fluids b- fluids and sodium c- fluids, sodium, carbs d- non CHO electrolyte solutions

c- fluids, sodium, carbs

To restore hydration after continuous endurance activity of 2 hours, consume: a- fluid, carb, sodium b- non CHO electrolyte solution c- fluids d- fluids and sodium

a- fluid, carb, sodium

The test that measures toxic levels of lead on heme synthesis is the: a- prothrombin test b- free erythrocyte protopophyrin test c- hemoglobin value test d- MCV

b- free erythrocyte protopophyrin test

Nutrition intervention with Alzheimers disease should include: a- eating with TV on to provide stimulation b- offer one food at a time and avoid distraction c- encourage eating meals with others d- several small meals and snacks throughout the day

b- offer one food at a time and avoid distraction

Anasarca is extreme generalized edema and swelling of the skin associated with: a- uncontrolled diabetes b- heart, liver, or renal failure c- short bowel syndrome d- pancreatitis

b- heart, liver, or renal failure

Glucophage (Metformin) functions by: a- stimulating insulin secretion b- inhibits digestive enzyme action c- decreases peripheral resistance d- enhances insulin action

d- enhances insulin action (remember this)

An 11 month old infant is constipated. The most likely nutrition diagnosis would be: a- GI distress b- lack of fruits c- inadequate fluid intake d- imbalanced intake

c- inadequate fluid intake

A client who primarily consumes frozen dinners and breakfast cereal because of limited access to transportation most likely would have a nutrition diagnosis of: a- not ready for diet change b- inability to manage self care c- impaired ability to prepare meals d- poor nutrition quality of foods

c- impaired ability to prepare meals

A patient complains of abdominal distention, mouth lesions, and 10% wt loss over 6 months. The nutrition diagnosis would be: a- impaired nutrient utilization b- inadequate vitamin intake c- involuntary weight loss d- altered GI function

a- impaired nutrient utilization

A cancer patient receiving radiation therapy to the head and neck present with weight loss. The nutrition diagnosis would be: a- swallowing difficulty b- involuntary weight loss c- impaired nutrient utilization d- hypermetabolism

a- swallowing difficulty

When working with patients who have food allergies in a pediatric GI clinic, which of the following outcomes should be measured? a- frequency of patient compliance with instructions b- reduction of food related reactions among patients c- level of knowledge about causes of food allergies d- patient satisfaction with Dietitian interaction

b- reduction of food related reactions among patients

Which of the following is an achievable outcome for a weight loss program? a- promote DBW among young adults b- increase by 25% the number of physicians who refer patients for weight-management counseling c- screen and refer for treatment within two years those whose body weight is 10% above desirable d- reduce by 10% the number of obese adults ages 25-49 within 2 years of starting the program

d- reduce by 10% the number of obese adults ages 25-49 within 2 years of starting the program

A child with cystic fibrosis has had a recent weight loss and several large, foul smelling stools each day for 2 months. To evaluate the situation, the first step should be to assess: a- calorie intake b- total fat intake c- compliance with PERT d- 24 hour fecal fat

c- compliance with PERT (pancreatic enzyme replacement therapy)

A patient with diabetes has not eaten for more than three days. You should: a- liberalize the diet b- provide multivitamin/mineral supplements c- provide increased fluids d- stay with her plan and encourage small frequent feedings

a- liberalize the diet

Which of the following about nutrition screening in a hospital is true? a- provides direction for patient care b- cost effective for all patients c- it has universal criteria for all age groups d- it should be performed only when ordered

a- provides direction for patient care

A child has chronic non specific diarrhea without malabsorption. An increased intake of which of the following may be the cause: a- sorbitol b- fat c- protein d- fruit

a- sorbitol

A strict Muslim would not consume: a- fruited gelatin, shrimp, ham b- dairy c- non-carbonated drinks d- eggs and cheese

a- fruited gelatin, shrimp, ham (gelatin has pork)

With a CHO:Insulin ratio of 16:1, how much insulin is needed with this meal? 1 1/3 cup spaghetti, 1 cup spaghetti sauce 1 cup green beans, 1 slice bread 1 tsp butter, 1/2 cup ice cream a- 4 U b- 5 U c- 6 U d- 8 U

d- 8 U (spaghetti = 60 cho, sauce = 15 cho, green beans = 15 cho, bread = 15 cho, ice cream = 15 cho.... 120 cho / 16 = 7.5 round up to 8)

A newly diagnosed diabetic needs 2200 calories, 50% from CHO. How many CHO choices can he have at each meal if he has 3 snacks with 2 CHO choices each? a- 3 b- 4 c- 2 d- 1

b- 4 (1 choice = 15 CHO)

Which of the following outcomes would best indicate parental support of a childs weight loss effort in a program for obese pre teen children? a- eliminate sweets b- discuss wt loss indicators c- decide to defer action until after puberty d- enroll child in physical activity programs

d- enroll child in physical activity programs

A 9 month old infant being fed iron fortified milk based formula is obese. You should recommend: a- limiting formula feeding to 16 oz b- changing formula to 2% milk c- changing formula to whole milk d- monitoring weight and intake

d- monitoring weight and intake

A patient on warfarin should avoid: a- black cohosh b- thiamin supplements c- simple carbs d- B vitamin supplements

a- black cohosh

The best way for you to follow-up on a patients application of diet instruction provided is to: a- give pre and post tests on recommendations b- evaluate the food diary for one week c- ask him how he is doing with the new plan d- use body language to determine his interest in following the plan

b- evaluate the food diary for one week

A family receiving food stamps often runs out of food by the middle of the month. Obtain an emergency food voucher for them and refer them to: a- congregate meal plan b- social services agency c- WIC d- EFNEP

d- EFNEP

A 35 year old female with Type 1 diabetes received nutrition counseling and started NPH therapy one month ago. Today her fasting blood glucose is 290 mg/dl and cholesterol is 185 mg/dl. She eats 1 meal per day. What do you address first? a- instruction about relationship of diet to BG level b- instruction about maintaining current body wt c- advice to include various food groups d- advice about controlling cholesterol levels

a- instruction about relationship of diet to BG level

Which of the following would provide the most useful data when conducting nutrition screening on preschool children at a health fair? a- tricep skinfold thickness b- wt for age c- wt for stature d- stature for age

c- wt for stature

Which of the following nutrition diagnoses is most likely to be associated with Cyclosporine therapy? a- hyperphosphatemia b- hyperlipidemia c- hypoglycemia d- hypokalemia

b- hyperlipidemia (good guess)

An infant with milk hypersensitivity could safely consume: a- soy milk fortified with calcium b- goats milk fortified with folic acid c- modular formula with crystalline AA's d- casein hydrolysate formula

d- casein hydrolysate formula

Which of the following is included in a subjective global assessment? a- standard weight for height b- mid arm muscle circumference c- prealbumin d- dietary intake

d- dietary intake

Southeast Asian populations would likely consume the following foods: a- rice, veg, small amount of meat b- fruit, cheese, small amount of rice and meat c- large amount of rice and milk, small amount of meat and fruit d- large amount of meat and milk, small amount of fruit and veg

a- rice, veg, small amount of meat

An elderly obese patient has been diagnosed with Type 2 Diabetes. Which of the following is an appropriate nutrition diagnosis? a- elevated serum triglycerides b- high HDL cholesterol c- low blood pressure d- low serum insulin

a- elevated serum triglycerides (remember this)

An indication for use of a protein hydrolysate infant formula is: a- prematurity b- constipation c- PKU d- protein hypersensitivity

d- protein hypersensitivity

An appropriate source of folate for a female from Central America is: a- corn b- broccoli c- black beans d- raisins

c- black beans