Question 1

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

Accepted Answer

Level Two of the National Dysphagia Diet permits finely minced or chopped cooked meats and soft-textured cooked vegetables. Level Two Dysphagia diet, also known as the Mechanical Altered Diet, is intended for use by those with minimal chewing ability. Raw fruits and vegetables as well as hard-to-chew foods and hard-to-swallow foods are prohibited.

Question 2

The most common pediatric food allergies are:

Accepted Answer

The most common pediatric food allergies are milk, soy, and peanuts. Allergic reactions to the other foods listed have been reported but are much less common.

Question 3

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

Accepted Answer

Ileal resection, removal of part or all of the ileum, has the most detrimental effect on nutritional status because it causes decreased absorption of many nutrients, including fat-soluble vitamins, and interferes with bile salt activity needed for fat metabolism. In jejunal resection surgery, the ileum is able to compensate and take over some of the jejunum's absorptive functions. The Billroth I and Billroth II surgeries are gastric resections in which part of the stomach is removed for the purpose of promoting weight loss. In both of these surgeries the small intestine is able to compensate and handle activities related to digestion and absorption.

Question 4

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

Accepted Answer

The level of sodium restriction recommended for congestive heart failure depends on the level of cardiac decompensation; as cardiac output decreases, the level of sodium restriction becomes stricter. The maximum sodium load tolerated by individuals with acute CHF is usually 1-2 grams a day. One to grams of sodium equals 43 to 87 mEq (milliequivalents).

Question 5

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

Accepted Answer

The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) uses nutritional risk (low birth weight, underweight, anemia, poor maternal weight gain, etc.) and income to qualify potential recipients. Proof of US citizenship is not a requirement.

Question 6

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

Accepted Answer

The herbal remedy St John's Wort, used to treat mild to moderate depression, may have adverse reactions with statin drugs, digoxin, and coumadin. It may decrease the effectiveness of all of these medications by interfering with the biochemical pathways by which they are metabolized.

Question 7

Low-salt syndrome may be caused by:

Accepted Answer

Low-salt syndrome is occasionally seen in individuals with congestive heart failure who are being treated with severe sodium restriction. It may also be caused by decreased glomerular filtration rate in renal disease, and by adrenal gland insufficiency, both of which affect the body's ability to retain sodium.

Question 8

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

Accepted Answer

Sodium, glucose, and BUN are used to calculate serum osmolality, which is a measure of osmotically active particles in the blood. Normal serum osmolality is about 300 mEq/liter.

Question 9

Which microorganism is involved in the etiology of peptic ulcer:

Accepted Answer

The microorganism which causes peptic ulcer is Heliobacter pylori, commonly known as H. pylori. H. pylori causes peptic ulcer by eroding the mucosal lining of the stomach.

Question 10

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

Accepted Answer

Dietary zinc may promote wound healing by increasing collagen synthesis at the site of the wound. Collagen synthesis is essential for tissue repair.

Question 11

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

Accepted Answer

The kidney is active in all of the listed bodily activities except oxidation. Renal functions include filtration of solutes (via the distal tubules), secretion (production of hormones that control blood pressure), and absorption (retention of glucose, water, and sodium).

Question 12

Stomatitis is treated with which of the following dietary interventions?

Accepted Answer

Stomatitis is an inflammation of the mucous membranes of the mouth. It may be caused by iron deficiency, in which case it is treated with iron supplementation. The usual dietary regimen is avoidance of acidic and spicy foods.

Question 13

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

Accepted Answer

A medication which may need to be discontinued in uremia is Triamterene, a potassium-sparing diuretic. Because serum potassium levels are high in uremia, use of potassium-sparing diuretics such as Triamterene is contraindicated. Epogen stimulates red blood cell production, Kayexelate is a potassium-binder, and Humulin is synthetic insulin, all of which may be indicated for use in uremia.

Question 14

The DASH diet is often used to treat:

Accepted Answer

The Dietary Approaches to Stop Hypertension, or DASH, diet was developed to treat hypertension by promoting intake of fruits and vegetables rich in potassium and magnesium, minerals which help lower blood pressure.

Question 15

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

Accepted Answer

Metabolic water, the water produced by the digestion and absorption of food, is not included in extracellular water, which is composed of plasma, lymph, and spinal fluid, as well as water from secretions.

Question 16

The usual dietary treatment for cholecystitis is:

Accepted Answer

The usual treatment for cholecystitis is a 25% fat diet with fat-soluble vitamin supplementation. Cholecystitis is inflammation of the gall bladder, usually caused by the accumulation of bile due to blockage of the bile duct or gallstone formation. Lower fat restriction is not used because some fat is needed to stimulate gallbladder constriction and drainage of bile.

Question 17

Antidiuretic hormone (ADH) is released in response to:

Accepted Answer

Antidiuretic hormone (ADH) is released in response to increased serum osmolality. ADH promotes retention of water by the kidneys, in response to increased osmolality, which causes increases the solute content of the blood.

Question 18

Food intolerance is distinguished from food allergy in what way:

Accepted Answer

Food intolerance is distinguished from food allergy by the lack of immunologic reaction, which involves release of an antibody in response to an antigen (allergen). Food allergy, not food intolerance, involves the reaction of the body's cellular immune system, and is often caused by the passage of intact proteins across the GI tract.

Question 19

Dumping syndrome is associated with:

Accepted Answer

Dumping syndrome is associated with the movement of water into the jejunum due to the presence of carbohydrate. It often accompanies gastric resection surgery and leads to diarrhea. Reactive hypoglycemia may result when carbohydrate in the gut is rapidly digested and absorbed, leading to over-secretion of insulin.

Question 20

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

Accepted Answer

Limiting animal protein to less than 1.7 g/kg per day is recommended for the treatment of hypercalcuria because excessive intakes of animal protein cause calcium loss from the bones. A moderate calcium intake of 600-800 mg of calcium per day is recommended, since lowering calcium intake results in increased absorption. Increasing fluid intake does not prevent hypercalcuria.

Quiz 1: American Clinical Board of Nutrition