Question 1

Which of the following factors is most important to consider when selecting the most useful protein for the laboratory assessment of nutritional supplementation?

Accepted Answer

Response to protein supplementation is best evaluated by proteins with a short biological half-life.The quick turnover of these proteins provides the most rapid indication of successful protein supplementation.Proteins with longer half-lives require more time to demonstrate the impact of protein supplementation.

Question 2

The hypermetabolic state can be associated with all of the following except:

Accepted Answer

For patients with major burns, there is a 180% to 200% increase of the normal metabolic rate for as long as 50 days after the burn.In peritonitis, there is an increased metabolic rate of 140% or more for 10 to 20 days following onset.Patients with a bone fracture will have a peak in metabolic rate of 120% by 7 days after the fracture.Individuals who are suffering from starvation (i.e., a hypometabolic state) will experience a 60% to 70% decrease in metabolic rate.

Question 3

Which nutritionally important macromineral plays a major role in fluid and electrolyte balance, is the major extracellular fluid anion, and contributes to osmolality? A deficiency of this macromineral may occur as result of vomiting and diarrhea.

Accepted Answer

Chloride is the macromineral that plays a major role in fluid and electrolyte balance, is the major extracellular fluid anion, and contributes to osmolality.Chloride is derived from dietary intake, and vomiting and diarrhea may result in a deficiency in chloride.

Question 4

Nutrient deficiencies have been associated with the development of various medical conditions.A deficiency in ______ is a major cause of blindness.Additionally, a deficiency in ______ can be linked to perinatal mortality and mental retardation, and a deficiency in ______ is the leading cause of preventable mental retardation.

Accepted Answer

A deficiency in vitamin A, a major cause of blindness, affects up to 250 children under the age of 5 years.Iron deficiency affects approximately a third of the world's women and children, with resulting anemia.Globally, 20% of maternal mortality, 22% of perinatal mortality, and 18% of mental retardation can be attributed to iron deficiency.Iodine deficiency is still the leading cause of preventable mental retardation.

Question 5

Which of the following changes in mineral status may result in tissue hypoxia?

Accepted Answer

Hypophosphatemia can lead to decreased cellular levels of ATP and, in red blood cells, of 2,3-diphosphoglycerate (2,3-DPG).Decreased 2,3-DPG alters the shape of red blood cells, decreases their half-life, and alters the binding of oxygen to hemoglobin.This may result in diminished delivery of oxygen to peripheral cells and tissue hypoxia.

Question 6

Increased irritability of cardiac muscle may be associated with a decreased plasma concentration of which of the following macrominerals?

Accepted Answer

Potassium is a macromineral that functions to facilitate cardiac muscle contraction.In situations where potassium levels are decreased, cardiac muscle excitability is altered, resulting in the potential for the development of dysrhythmias.

Question 7

The essential fatty acids are:
1)linoleic acid
2)linolenic acid
3)arachidonic acid

Accepted Answer

Essential fatty acids are those the body cannot make on its own or cannot make rapidly enough to meet the body's needs.There are three essential fatty acids: linoleic acid, linolenic acid, and arachidonic acid.

Question 8

A patient with a body mass index of 27 is said to be ________________.

Accepted Answer

Body mass index (BMI) is a measure of body fat based on height and weight and applies to both males and females.BMI provides a reliable indicator of body "fatness" for most people and is used to screen for weight categories that may lead to health problems.A BMI of > 25 is considered overweight, and a BMI of > 30 is considered to be obese.

Question 9

Response to protein supplementation is reflected most rapidly by an increase in ______, but ______ has been found to be more useful for the laboratory indications of improved nutritional status.

Accepted Answer

Response to protein supplementation is reflected most rapidly by an increase in retinol-binding protein, but prealbumin has been found to be more predictive of improved status.Because prealbumin can be readily measured using routine laboratory equipment, its use as a rapid marker to screen for poor nutritional status and monitor treatment has been recommended; it is being used increasingly for this purpose.

Question 10

Which one of the lipid-soluble vitamins is not considered to be an essential vitamin in adults?

Accepted Answer

Only vitamin D can be produced by the body and is considered nonessential in the diet.All other water-soluble vitamins (the B vitamins and vitamin C) and lipid-soluble vitamins (vitamin A, vitamin E, and vitamin K) must be derived from the diet.Some consider vitamin D to be an essential vitamin in growing children, because the demand for vitamin D is high during childhood.In adults, when the demand is less, sufficient levels of vitamin D can be produced by the body from the precursor 7-dehydrocholesterol.

Question 11

What is the body mass index of a patient who weighs 250 pounds and is 1.828 meters tall?

Accepted Answer

Use this equation to calculate body mass index (BMI):
BMI = [weight (kg)]/[height(m)]²
Converting pounds to kg: 250 pounds/2.2 pounds/kg = 113.64 kg
BMI = 113.64 kg / (1.828 m)²
BMI = 113.64 kg / 3.341m² BMI = 34.01 kg/m²

Question 12

Select the correct order of events for the refeeding syndrome.
1)water and salt retention
2)patient is treated with excessive glucose
3)fluid overload and stress to heart
4)increased vascular space
5)exaggerated insulin response

Accepted Answer

The refeeding syndrome describes the negative sequelae that can result when patients who have been chronically starved and severely malnourished receive aggressive nutritional support.This syndrome may begin when the starved individual receives more glucose than can be physiologically processed.Under normal conditions, the maximal rate at which glucose can be metabolized is 2 to 4 mg/kg/min.Under stress, this metabolic rate can increase to 3 to 5 mg/kg/min.If these rates are exceeded, an exaggerated insulin response may occur.In addition to its hypoglycemic effect, insulin has strong antidiuretic properties.Thus in an exaggerated insulin response, which can occur if a malnourished patient is treated with excessive glucose, there will be water and salt retention, increasing the vascular space, leading to fluid overload and stress to the heart.

Question 13

Aldosterone antagonist diuretics may produce which of the following changes in mineral status?

Accepted Answer

Aldosterone antagonists are a group of diuretics that are also known as potassium-sparing diuretics.These diuretics may influence the status of the mineral potassium.Aldosterone antagonists function by blocking the aldosterone receptor in the late distal convoluted tubule of the nephron.Stimulation causes reabsorption of sodium from the tubule lumen and secretion of potassium into the tubule lumen for excretion.Blockage of this mechanism may result in potassium retention and thus hyperkalemia.

Question 14

Which of the following statements are true of fiber?
1)It cannot be digested by enzymes found in the gut.
2)Insoluble fibers include cellulose and lignin.
3)Insoluble fibers are associated with lowering blood cholesterol.
4)More soluble gums and pectins are found in fruits and vegetables.

Accepted Answer

Fiber comprises plant-cell components that cannot be digested by enzymes found in the gut.The more insoluble fibers, such as cellulose and lignin, are beneficial to colonic function, whereas the more soluble gums and pectins found in fruits and vegetables have been associated with the lowering of blood cholesterol.

Question 15

Which of the following proteins considered for laboratory use in nutritional assessment is present in highest concentration in the blood stream and has the longest half-life?

Accepted Answer

Albumin has a half-life of 21 days.Most other proteins, especially those considered by the laboratory for use in nutritional assessment, have half-lives of less than 10 days.Albumin has a normal reference range of 35 to 55 g/L, whereas most other proteins have concentrations at mg/L levels.

Question 16

Phosphorus:
1)is a major component with calcium in skeletal and dental tissue
2)when deficient, causes rickets in children and osteomalacia in adults
3)when deficient, symptoms include muscle weakness
4)is a component of nucleic acids

Accepted Answer

Phosphorus is a major component with calcium in skeletal and dental tissue.It is a component of nucleic acids, and when deficient causes rickets in children and osteomalacia in adults.Potassium and magnesium are macrominerals associated with muscle weakness when deficient.

Question 17

For infants, essential amino acids should make up ______ of the total amino-acid intake; for children 10 to 12 years of age, it should make up ______; and for adults, essential amino acids should make up ______ of the total amino-acid intake.

Accepted Answer

Dietary proteins are the source of amino acids, the building blocks for synthesis and maintenance of tissue proteins.Some amino acids either cannot be synthesized by the body at all or cannot be synthesized in sufficient amounts to satisfy requirements; these "essential" amino acids must be obtained in the diet.There is typically a higher demand for amino acids during the developmental years, and once development occurs, the demand decreases.For infants, essential amino acids should make up 43% of the total amino-acid intake.For children 10 to 12 years of age, essential amino acids should make up 36% of the total amino-acid intake.For adults, essential amino acids should make up 10% of the total amino-acid intake.

Question 18

All of the following laboratory observations are associated with a hypermetabolic state except:

Accepted Answer

Hormones and cytokines, such as tumor necrosis factor, may initiate a heightened metabolic response to injury or infection.The increased metabolism associated with physiological stress in these cases is termed a hypermetabolic state.The increased metabolic rate results in insulin insensitivity and hyperglycemia.In addition, stored triglycerides are mobilized, and the synthesis of acute-phase proteins, such as C-reactive protein, is increased.In a hypermetabolic state, there is a negative nitrogen balance which would be indicated by a decreased level of urine urea nitrogen.

Quiz 41: Human Nutrition

Which of the following factors is most important to consider when selecting the most useful protein for the laboratory assessment of nutritional supplementation?

The hypermetabolic state can be associated with all of the following except:

Which nutritionally important macromineral plays a major role in fluid and electrolyte balance, is the major extracellular fluid anion, and contributes to osmolality? A deficiency of this macromineral may occur as result of vomiting and diarrhea.

Which of the following changes in mineral status may result in tissue hypoxia?

Increased irritability of cardiac muscle may be associated with a decreased plasma concentration of which of the following macrominerals?

The essential fatty acids are: 1) linoleic acid 2) linolenic acid 3) arachidonic acid

A patient with a body mass index of 27 is said to be ________________.

Response to protein supplementation is reflected most rapidly by an increase in , but has been found to be more useful for the laboratory indications of improved nutritional status.

Which one of the lipid-soluble vitamins is not considered to be an essential vitamin in adults?

What is the body mass index of a patient who weighs 250 pounds and is 1.828 meters tall?

Select the correct order of events for the refeeding syndrome. 1) water and salt retention 2) patient is treated with excessive glucose 3) fluid overload and stress to heart 4) increased vascular space 5) exaggerated insulin response

Aldosterone antagonist diuretics may produce which of the following changes in mineral status?

Which of the following statements are true of fiber? 1) It cannot be digested by enzymes found in the gut. 2) Insoluble fibers include cellulose and lignin. 3) Insoluble fibers are associated with lowering blood cholesterol. 4) More soluble gums and pectins are found in fruits and vegetables.

Which of the following proteins considered for laboratory use in nutritional assessment is present in highest concentration in the blood stream and has the longest half-life?

Phosphorus: 1) is a major component with calcium in skeletal and dental tissue 2) when deficient, causes rickets in children and osteomalacia in adults 3) when deficient, symptoms include muscle weakness 4) is a component of nucleic acids

For infants, essential amino acids should make up of the total amino-acid intake; for children 10 to 12 years of age, it should make up ; and for adults, essential amino acids should make up __ of the total amino-acid intake.

All of the following laboratory observations are associated with a hypermetabolic state except: