Deck 1: Nutrition Support Clinician

Question 1

An effective nutrition screening program:

A)Involves all members of the health care team who want to participate
B)Is based on the principles of sensitivity and specificity
C)Always uses food frequency questionnaires
D)Is used only to screen for childhood diseases

Answer 1

Is based on the principles of sensitivity and specificity

Question 2

Which of the following gastrointestinal surgeries has the most detrimental effect on nutritional status?

A)Jejunal resection
B)Ileal resection
C)Billroth I
D)Billroth II

Answer 2

Ileal resection

Question 3

The DASH diet is often used to treat:

A)Diabetes mellitus
B)Hypertension
C)Nephritis
D)Hepatitis

Answer 3

Hypertension

Question 4

The National Health and Nutrition Examination Survey (NHANES) has which of the following objectives?

A)Ongoing collection of health data from Americans < 65 years of age
B)Identification of low birth weight infants
C)Treatment for elevated blood lipid levels
D)Collection of dietary data using 24-hour recalls

Question 5

Dumping syndrome is associated with:

A)Osmotic movement of water into the jejunum due to the presence of carbohydrate
B)Reactive hypoglycemia
C)Gastric resection surgery
D)All of the above

Question 6

Clinical signs of cirrhosis of the liver are:

A)Ascites and hypoalbuminemia
B)Portal hypotension and constriction of esophageal veins
C)Fat malabsorption and hyponatremia
D)Decreased hepatic plasma volume and high osmolality

Question 7

The Guthrie test is used to diagnose:

A)Galactosemia
B)Ornithine transcarboxylase deficiency
C)Glycogen storage disase
D)Phenylketonuria

Question 8

Treatment goals for cystic fibrosis include:

A)Pancreatic enzyme replacement
B)Increased energy, protein, and fat intakes
C)Sodium restriction
D)A & B

Question 9

Which of the following is not true about a low serum albumin level?

A)It may be associated with ascites.
B)It may be an indicator of kwashiorkor.
C)It may be used to diagnosis esophageal reflux.
D)It is commonly seen in nephrotic syndrome.

Question 10

Maple-syrup urine disease (MSUD) is an autosomal recessive disorder in infants caused by:

A)The inability to metabolize branched-chain amino acids
B)Plasma leucine levels exceeding 10 mg/dl
C)A defect in the gene that controls the activity of alpha-keto acid hydrogenase
D)A & C

Question 11

Impaired glucose tolerance is defined as:

A)Fasting plasma glucose (FPG) > 140 mg/dl
B)2-hour plasma glucose between 140-199 mg/dl
C)Casual plasma glucose of 200 mg/dl or greater
D)An HbA1c level of 6 or greater

Question 12

A 16-year old teenage girl with Type I diabetes seeks counseling for erratic blood glucose levels. She is on the school track team and works out in the afternoons for 1 ½ hours. Her meal plan consists of 3 meals, a pre-exercise snack of one fruit, and a bedtime snack of ½ cup cereal and 1 cup of milk. Her insulin regimen is 3 units of regular insulin before breakfast and 2 units of regular insulin before dinner, and equal amounts of NPH mid-morning and at bedtime. Lately her pre-dinner blood glucose levels have been low. What would be the most effective nutrition intervention for her?

A)Reduce the mid-morning NPH insulin by one unit and add a protein exchange to the afternoon snack.
B)Increase the bedtime insulin and add another bread exchange to the bedtime snack.
C)Reduce the afternoon exercise to 45 minutes and have her carry fruit juice with her in case she feels dizzy or weak.
D)A & B

Question 13

The digestive hormone gastrin exerts all of the following effects except:

A)Increased esophageal sphincter pressure
B)Decreased pepsinogen production by the stomach
C)Increased gallbladder contraction
D)Increased HCL production by the parietal cells

Question 14

Which of the following nutrition assessment methods is used to collect dietary information from a community?

A)Food record
B)24-hour recall
C)Food frequency questionnaire
D)Diet history

Question 15

Which of the following nutrients produces an RQ (Respiratory Quotient) of 1.0, as measured by indirect calorimetry?

A)Protein
B)Fat
C)Carbohydrate
D)All of the above

Question 16

The most common pediatric food allergies are:

A)Shellfish, citrus fruit, beef
B)Corn, rice, rye
C)Milk, soy, peanuts
D)Potatoes, bananas, tomatoes

Question 17

Level Two of the National Dysphagia Diet permits which of the following foods?

A)Crackers, toast, and baked potatoes
B)Finely chopped cooked meats and soft-textured cooked vegetables
C)Raw carrots, celery, and apple slices
D)Chunky peanut butter, rice pudding, fruited yogurt

Question 18

Nutritional therapy for AIDS/HIV infection includes which of the following?

A)Supplementation with ginseng and other herbs
B)Avoidance of raw fruits and vegetables
C)Protein intake of 0.8-1.2 g/kg per day
D)Use of milk-based shakes to boost caloric intake

Question 19

The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) uses which of the following criteria to qualify participants?

A)Nutritional risk
B)Income
C)Proof of US citizenship
D)A & B

Question 20

The level of sodium restriction recommended for congestive heart failure (CHF):

A)Depends on the level of cardiac decompensation
B)Is usually 2-3 grams per day
C)May range from 100-150 mEq
D)Is dependent on which diuretics are used

Question 21

A 25-year old female patient recovering from surgery to correct an intestinal obstruction needs complete bowel rest which necessitates the use of Total Parenteral Nutrition (TPN). The patient was 10 pounds underweight prior to surgery and is occasionally febrile. Which of the following formulations would be most appropriate for this patient?

A)30 kcals, 1 g protein, 30 ml fluid per kg/body weight;100 mg vitamin C, 5 mg zinc per day
B)45 kcals, 2 g protein, 35 ml fluid per kg/body weight; 200 mg vitamin C, 6 mg zinc per day
C)60 kcals, 3 g protein, 40 ml fluid per kg/body weight; 500 mg vitamin C, 10 mg zinc per day
D)None of the above

Question 22

Steatorrhea may be caused by:

A)Disruption in the activity of pancreatic enzymes
B)Excessive production of bile salts by the liver
C)Lack of intrinsic factor
D)Intake of more than 70 grams of fat per day

Question 23

The Thermic Effect of Food (TEF):

A)Is the amount of energy needed to digest and absorb food
B)Makes up a large percentage of total energy expenditure
C)Is unaffected by the nutritional composition of the diet
D)May be increased through weight loss

Question 24

Cow's milk is unsuitable for infants less than a year of age due to:

A)Large amounts of whey protein
B)Inadequate fat content
C)High cholesterol level
D)High renal solute load

Question 25

Addison's disease is caused by the deterioration of the adrenal cortex, and results in hypoglycemia, weight loss, and muscle wasting. Dietary intervention includes:

A)A high protein diet with liberal sodium
B)A high protein diet with restricted sodium
C)Frequent meals with 50-60 grams of complex carbohydrates
D)A & C

Question 26

Examples of foods avoided on a low-purine diet are:

A)Eggs, cheese, peanut butter
B)Sardines, broth, organ meats
C)Carrots, tomatoes, corn
D)Bread, crackers, cold cereal

Question 27

A medication which needs to be discontinued in a uremic patient is:

A)Epogen
B)Kayexelate
C)Humulin
D)Triamterene

Question 28

Stomatitis is treated with which of the following dietary interventions?

A)Supplementation with iron
B)Clear liquid diet
C)Avoidance of acidic and spicy foods
D)A & C

Question 29

Antidiuretic hormone (ADH) is released in response to:

A)Decreased serum osmolality
B)Increased serum osmolality
C)Decreased urinary urea nitrogen
D)Increased urinary urea nitrogen

Question 30

The usual dietary treatment for cholecystitis is:

A)Restriction of foods that stimulate pancreatic enzymes
B)20% fat diet with MCT supplementation
C)25% fat diet with fat-soluble vitamin supplementation
D)Lowering cholesterol intake to less than 300 mg/day

Question 31

Which of the following is not included in extracellular water (ECF)?

A)Plasma
B)Lymph
C)Metabolic water
D)Spinal fluid

Question 32

Which of the following measures are used to calculate serum osmolality?

A)Sodium, chloride, and glucose
B)Sodium, potassium, and magnesium
C)Sodium, lactic acid, and glutamine
D)Sodium, glucose, and BUN

Question 33

Low-salt syndrome may be caused by:

A)Extreme sodium restriction due to congestive heart failure
B)Decreased glomerular filtration rate
C)Adrenal gland insufficiency
D)All of the above

Question 34

The herbal remedy St John's Wort may interact with which of the following medications?

A)Statin drugs
B)Digoxin
C)Coumadin
D)All of the above

Question 35

The kidney is active in all of the following bodily functions except:

A)Filtration
B)Secretion
C)Oxidation
D)Absorption

Question 36

Dietary zinc may promote wound healing by which of the following mechanisms?

A)Promotes epithelial cell differentiation
B)Reduces the inflammatory response
C)Prevents oxidation of lipids in cell membranes
D)Increases collagen synthesis

Question 37

Which microorganism is involved in the etiology of peptic ulcer:

A)Clostridium difficile
B)Heliobacter pylori
C)Heliobacter baculiformis
D)Vibrio vulnificus

Question 38

Food intolerance is distinguished from food allergy in what way:

A)Food intolerance is diagnosed by challenge tests.
B)One of the causes of food intolerance is the passage of intact proteins across the gastrointestinal tract.
C)There is no immunologic reaction with food intolerance.
D)The body uses cellular immunity to combat food intolerance.

Question 39

A food frequency questionnaire differs from a 24-hour recall in what way:

A)A food frequency questionnaire does not inquire about portion sizes.
B)The 24-hour recall asks about typical meal patterns.
C)A food frequency questionnaire allows open-ended responses.
D)A food frequency questionnaire always asks about the same types of foods.

Question 40

The dietary treatment which may be most effective for symptoms of polycystic ovary syndrome (PCOS) is:

A)Low glycemic index diet and supplementation with omega-3 fatty acids
B)Vegan diet with vitamin B12 supplementation
C)1200-calorie diet to promote weight loss
D)Low-salt diet with increased intake of potassium-rich fruits and vegetables

Question 41

Diets rich in omega-3 fatty acids reduce the inflammation of arthritis through the action of which intermediary:

A)Corticosteroids
B)Prostaglandin 3
C)Arachidonic acid
D)Ganglioside

Question 42

Which of the following is true for reactive hypoglycemia?

A)It is defined as a plasma glucose level less than 70 mg/dl.
B)It is treated with a diet high in complex carbohydrates.
C)It is diagnosed by measuring blood glucose levels one hour after eating.
D)Peak insulin activity occurs 90-180 minutes after food is eaten.

Question 43

Nutrient needs of infants diagnosed with bronchopulmonary dysplasia:

A)Are linked with linear growth
B)May include a resting energy expenditure 50% higher than that of normal infants
C)May include use of diuretics to regulate water balance
D)All of the above

Question 44

The following nutrition diagnosis is written in what type of format: "Poor glycemic control is related to skipping use of oral hypoglycemic agents as evidenced by random blood glucose levels greater than 200 mg/dl".

A)SOAP note
B)POMR
C)PES statement
D)Continuity of care record

Question 45

Which dietary measures are recommended for treating hypercalcuria that is not associated with renal stones?

A)Limiting calcium to 1000 mg per day
B)Increasing fluid intake to 2 liters per day
C)400 IU vitamin D per day
D)Limiting animal protein to less than 1.7 g/kg per day

Question 46

Which of the following is a common side effect of immunosuppressive drug therapy used in organ transplantation?

A)Sodium and fluid diuresis
B)Hyperphosphatemia
C)Hyperkalemia
D)Decreased vitamin C requirements

Question 47

Brown adipose tissue performs what function in the body:

A)Protects internal organs from injury
B)Storage site for triglycerides
C)Is considered to be "essential fat" that supports metabolic processes
D)Heat production and regulation of body temperature

Question 48

Age-associated bone loss among the elderly:

A)Is always reversed with calcium supplementation
B)Can be prevented by cardiovascular exercise such as swimming
C)Affects both trabecular and cortical bone
D)May be slowed by the use of steroid drugs

Question 49

Which of the following vitamins functions as a hormone?

A)Folic acid
B)Vitamin C
C)Vitamin E
D)Vitamin D

Question 50

Which of the following is true for athletic amenorrhea, the loss of menstrual periods caused by excessive exercise?

A)It results in irreversible bone loss
B)It may be successfully treated by increasing carbohydrate intake
C)It is treated by decreasing the intensity and amount of exercise
D)Both A and C
E)Both A and B