Questions 331-431 Flashcards
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)
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
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)
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
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
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
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
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
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
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
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
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)
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
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)
A patient on a full liquid diet should not receive:
a- sherbet
b- strained cereal
c- pureed fruit
d- margarine
b- strained cereal
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
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
Iron preparations should be taken:
a- before meals
b- on an empty stomach
c- with meals
d- before bedtime
c- with meals (enhance absorption)
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)
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
Which of the following would lacto-ovo vegetarian not eat?
a- eggs
b- halibut
c- cheese
d- beans
b- halibut
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
Which snack would you not give to an infant?
a- yogurt
b- cheese sticks
c- graham crackers
d- grapes
d- grapes (why?)
Which hormone is involved in developing the placenta?
a- progesterone
b- estrogen
c- lactogen
d- testosterone
a- progesterone
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
