CDR Practice Exam 1 (GRADED A) Questions and Answers Download To Score An A

What is the stored form of glucose? a. glycogen b. sucrose c. myoglobin d. monosaccharide A-Glycogen is the stored form of glucose and is classified as a polysaccharide. Sucrose is a disaccharide sugar. Monosaccharides are a class of sugar, but not the stored form of glucose. Myoglobin is not a sugar. Which of the following is the minimum for wet diapers and stools expected daily for a properly fed breastfed infant? a. 4 wet and 2 stools b. 5 wet and 3 stools c. 8 wet and 4 stools d. 10 wet and 7 stools B- Breastfed infants are expected to have at least 5 wet diapers and 3 stools per day. Monitoring the number of wet diapers and stools provides an indication of adequate intake. Typically, breastfed infants have more stools than formula-fed infants Registered dietitians must adhere to which of the following to avoid losing their credentials? a. code of ethics b. ethics and morality clause c. standards of professional conduct d. performance standards A- Like many professional organization, the Academy of Nutrition and Dietetics has a Code of Ethics that must be followed by professionals within the organization Which of the following is the appropriate first step in dealing with food recall at your foodservice organization? a. communicating within the organization? b. determining if food was served to the public? c. communicating with the public? d. providing a press release? A- Details of the recall need to first be communicated throughout the organization, including any satellite sites. Once everyone has the appropriate information, it can be determined whether any food was actually served to the public. If so, then the public should be notified if there is any danger. How does Crohn's Disease differ from Ulcerative Colitis? a. Crohn's disease involves inflammation only in the large intestine b. Ulcerative Colitis involves inflammation only in the large intestine c. Weight loss is common with Crohn's disease but not with Ulcerative Colitis d. Absorption is affected in Ulcerative Colitis but not in Crohn's disease B- Ulcerative Colitis involved inflammation of the large intestines Crohn's disease may involve inflammation in any part of the digestive tract. In both absorption is affected and weight loss is a concern What type of sugar is created from the hydrolysis of sucrose? a. granulated table sugar b. raw sugar c. invert sugar d. corn sugar C- Invert sugar is created from the breakdown of sucrose in water to form a mixture of glucose and fructose; invert sugars are often used in syrups. Sucrose is used to form granulated table sugar. Neither raw sugar or corn sugar are formed from a combination of two or more sugars You have a 23 year old female pt with a BMI of 16 along with reported recent weight loss. She appears very well educated and focused on nutrition; she also exercises intensely. Upon physical examination you notice the patient appears thin with lanugo hair on the skin. What do you suspect? a. anorexia nervosa b. bulimia nervosa c. type 1 diabetes d. the patient is thin because of the intense exercise A- Anorexia Nervosa is a possibility. A BMI less than 18.5 indicated that the pt is underweight. The pt also appears very informed about food and exercise intently. These are often characteristics of someone with anorexia (when coupled with other factors). Finally, the pt has lanugo- a fine body hair that often covers pt suffering with anorexia nervosa What process in necessary to ensure the safety of milk? a. homogenization b. freezing c. irradiation d. pasteurization D-Pasteurization kills microbes by heating the milk to high temperatures. Homogenization is a part of milk processing, but it does not destroy pathogens; rather it prevents the fat from separating from the liquid. There were complaints from customers about a cashier in the cafeteria. The cashier did not have a pleasant demeanor when dealing with customer. The cashier most likely lacked which of the following important skills? a. technical skills b. human skills c. leadership skills d. decision making skills B- The cashier probably lacked human skills, which are helpful when interacting and dealing with coworkers and customers. This employee may benefit from customer service training or placement in a role that does not directly interact with customers. What type of food additive might a food manufacturer use to prevent a lumpy texture? a. stabilizer b. humectant c. salt d. leavening agent A- Stabilizers such as gelatin are used to prevent lumps and separation. Humectants, salts and leavening agents are also food additives but their purposes are not to prevent lumpy texture. The phrase "calcium helps build strong bones" is an example of what type of label claim? a. health claim b. nutrient content claim c. structure/function calim d. cause/effect claim C- structure function claims relate to nutrient to a bodily function. A health claim is different in that it indicated a relationship between food and medical condition. You note from the labs that your pt has a eGFR of 14 mL per minute. What does this lab indicate? a. impaired kidney function b. normal kidney function c. chronic kidney function d. the patient is on dialysis C- Chronic kidney failure is indicated by an eGFR of less than 15 mL per minute. At this stage, dialysis or kidney transplantation are the only treatment options Which of the following individuals is most likely to have Fe deficiency anemia? a. an endurance athlete b. someone with congestive heart failure c. someone with IBS d. someone with celiac disease D- Celiac Disease can result in poor dietary absorption. IBS may cause discomfort when eating, but it does not automatically predispose someone to iron deficiency anemia, and the nutrient absorption is not affected. Which of the following is NOT the name of a specific test used to conduct sensory evaluations of food? a. duo-trio test b. hedonic scale c. descriptive testing d. texture scaling test D- The texture scaling test is not the name of a specific test used to conduct sensory evaluations. The other choices use a panel of judges to asses food qualities and characteristics. Consider a lunch line where customers go through the line and are served what is available rather than placing an order or specifying preferences. What type of menu is used in this establishment? a. no-choice menu b. limited-choice menu c. single-use menu d. static menu A- A no-choice menu is being used because the the patrons have no choice about what foos will be plated for them. This type of menu is often used in school cafeterias. What is a potential advantage of genetically engineered foods? a. foods are proven safe b. foods are more natural c. foods may be more disease resistant d. foods are not FDA-regulated C- Genetically modified foods can be engineered to resist disease. This has economic benefits because of a greater crop yield. Th FDA does regulate genetically modified foods as they do other foods, but public concerns over safety remain. Although safety is not absolutely proven, there is evidence to suggest genetically modified foods are safe for consumption. Calculate the employee turnover ratio given a staff of 52 employees when 18 leave the organization? a. 34.6% b. 28.8% c. 25.2% d. 18% A- 34.6% (18/52 x 100= 34.6%) What mineral works in conjunction with calcium to help build strong bones? a. Vitamin D b. Magnesium c. Iron d.Sulfur B- Magnesium works with calcium in bone metabolism; magnesium is necessary for parathyroid hormone secretion. Vitamin D is important for strong bones, but it is a vitamin NOT a mineral In general, during the first trimester of pregnancy, how many more calories per day does a women need? a. 185kcal/day b. 340kcal/day c. 452kcal/day d. no additional calories are needed during the first trimester D- Energy requirements do not increase during the first trimester of pregnancy. During the second trimester an estimated 340kcal/ day are needed During the third trimester a women needs an additional 452kcal/day Which of the following represents the type of production system where food is prepared at one site and transported to another site for serving? a. conventional b. commissary c. ready prepared d. transferal B- Commissary production is where there is a central location for preparation, and the prepared foods are moved to different sites for serving. This setup is often used to avoid the cost of having multiple sites for food prep, thus commissary production can result in cost containment. Which process is most affected in individuals with type 1 diabetes? a. glycogenesis b. glycolysis c. Krebs cycle d. lactic acid cycle A- Glycogenesis is impacted the most because insulin, which stimulates glucokinase, is not readily available. Therefore, glucokinase levels are not sufficient; glucokinase is instrumental in the liver's metabolism of glucose Which of the following does NOT occur when oils are hydrogenated? a. melting point is increased b. fat becomes more saturated c. shelf life of the product is increased d. more molecular cis formations are created D- All the above occur except D, the creation of more cis formations. When oils are hydrogenated, more molecular trans formations are created, not molecular cis formations. You have decided to purchase sliced vegetables rather than whole vegetables for your restaurant. Which of the following parameters will be most affected? a. labor time b. quality c. cook time d. nutrient value A- Labor time will change most. Vegetables that are already sliced save the labor time which would have been spent slicing whole vegetables As a dietitian, you discover that your pt is having trouble meeting the weight loss goals set during your counseling session. What should you do? a. reinforce the goals b. consider altering the goals c. re-educate the patient d. discharge the patient B- You should consider altering the goals since goals are not set in stone. You may need to reassess and discover why the pt has not met his or her goals. Perhaps the goals were too aggressive and you need to set more realistic goals. Your department is working on the annual budget. You use last year's budget as a basis for the coming year. This type of budgeting is an example fo which of the following? a. Incremental budgeting b. Performance budgeting c. zero-based budgeting d. historical budgeting A- Using last year's budget as a basis for the upcoming budget is an example of incremental budgeting. An incremental budget is based on historical data and used when few changes are expected from year to year. Motivational counseling might be appropriate for which of the following clients? a. someone who has a high level of education b. someone who wants to change c. someone who is a newly-diagnosed diabetic d. someone who is in denial about their diagnosis B- Some who wanted to change would be good candidate for motivational counseling. People who have the desire to make changes often need to motivator to help facilitate those changes. Someone who is newly diagnosed or in denial about their diagnosis may not be ready for motivational counseling. As the food service director you notice productivity has been decreasing over the last 6 months. Which of the following actions would you first consider? a. hire more employees b. invest in new equipment c. evaluate the department training program d. look for ways to automate more processes C- You should first consider adequacy of the training program. A lack of proper training can have a negative impact on employee productivity. As a dietitian, what type of client might most benefit from a Telehealth option? a. a client with limited financial resources b. a client who lives in rural area c. a client who lives in the city d. a client who does not want to drive to the appt B- A client who lives in a rural area with limited access to a dietitian or other healthcare provider is most likely to benefit from Telehealth In which job is a smaller span of control appropriate? a. cook prep b. dishwashing c. nursing d. housekeeping C- A smaller span of control is appropriate with nursing care because nursing professional do many different tasks. When should a product or program analysis be conducted? a. before a product or program introduction b. during program or product sales c. throughout the product or program lifecycle d. after the product or program has ended A- The analysis should occur before the product's release and before a program is introduced. Analysis prior to introduction helps improve the odds for success because it will identify barriers and facilitators for success. You are counseling a pregnant pt regarding wt gain during pregnancy. The pre-pregnancy BMI of your pt was 33.5. How much wt gain do you recommend for the pt? a. 11-20 # b. 15-25 # c. 25-35 # d. 28-40 # A- The patient is classified as obese, so a lower weight gain range of 11-20 # is recommended compared to individuals of underweight, normal or overweight status. During which of the follow steps of the Nutrition Care Process do you compare nutrition indicators against a comparative standard? a. assessment b. diagnosis c. intervention d. monitoring and evaluation A- Assessment is the phase where information on the pt is gathered. That information should be compared with the appropriate reference standard for comparison. Which of the following practices is most important in managing a diverse workforce? a. establishing rules b. having employee meetings c. practicing democratic leadership d. having an open dialogue D- Maintaining an open dialogue is probably most important when managing diverse workforce. Open dialogue can facilitate amicable, productive discussion. Your pt is 26 months of age. Which set of the following anthropometric measurements are important for this age? a. ht and wt b. length and weight c. ht, wt and muscle mass d. ht, wt and head circumference D- Height, weight, and head circumference should be measured in children under 36 months of age. After 36 months age, head circumference is no longer measured. For the Family Medical Leave Act to be effective, an employee must have worked at the organization for which of the following lengths of time? a. 6 months b. 12 months c. 8 months d. 24 months B- An employee who has worked for an organization for at least 12 months is eligible for family medical leave. Which of the following foods would be most likely to inhibit the absorption of the thyroid medication, Synthroid? a. white rice b. brussel sprouts c. peeled apples d. grapes B- Brussel sprouts are very high in fiber. Fiber can inhibit the absorption of the thyroid medication, Synthroid Which of the following could be considered the most important step in emergency management? a. response b. preparation c. coordination d. documentaiton B- preparation is likely the most important step in emergency management. You must first prepare for the emergency. An appropriate response would be unlikely if there is not adequate emergency preparation. Which of the following foods is the best source of dietary vitamin E? a. nuts rice c. cheese d. chicken A- Vitamin E is a fat-soluble vitamin which is abundant in nuts and oils. Although cheese may be high in fat, it is not a significant source of vitamin E. The other choices provide only a trace amount or insignificant amount of vitamin E. Your pt has poorly controlled type 2 DM. In the past, this pt expressed no desire to change her eating habits. During your latest consult, she mentioned that she is now thinking about making dietary changes to better control her DM. At what behavior change stage is your pt? a. precontemplation b. contemplation c. determination d. action B-Currently, the patient is in the contemplation phase. The pt is contemplating or thinking about making a change. Previously, the pt was in the precontemplation phase and not considering a change, but she has progressed since that time. Select the type of health surveillance that uses interviews and physical exams to ascertain information. a. NHANES b. BRFSS c. YRBSS d. CDCES A- NHANES is a unique surveillance program in that information is gathered through interviews and physical exams. The other programs do not include a physical exam, and CDCES is not a surveillance program. During a follow-up session with your client whom you are seeing for weight loss counseling, you weigh the client and determine that he has lost 7.5# since the last session. The client has achieved set wt loss goal. This is an example of which of the following? a. Nutrition assessment b. Nutrition dx c. Nutrition Intervention d. Monitoring and Evaluation D- Monitoring and evaluation is the correct answer because you are comparing outcomes (lost 7.5#) to interventions (wt loss counseling). You check the stockroom and notice there was only 10 cans of corn remaining. You are required to maintain a stock of at least 12, so you must immediately order more. The minimum level is referred to as which of the following? a. minimum level b. cut off level c. stock level d. par level D- Par level is the minimum amount allowed, in this case 12. When the stock falls below level, more items must be ordered. This helps avoid shortages. According to the FDA Food Code, hot foods that will be stored should be cooled to 70 degrees within how many hours? a. 1 hour b. 2 hours c. 3 hours d. 4 hours B- Food should be cooled to 70 degrees within 2 hours. Time within the 'danger zone' where bacteria can grow needs to be limited to maintain food safety. Cuts of meat with a lot of collagen are best prepared using what type of cooking methods? a. grilling b. frying c. stewing d. baking C- stewing is the correct answer. Foods with a lot of collage benefit from a moist heat type of cooking such as stewing. Collagen is a tough connective tissue which needs time to break down during the cooking process. The slower cooking time and moisture help soften the tough tissue. Which of the following criteria most likely indicated FTT in an 18 mo old child? a. weight loss of 1-2 # b. wt falls from the 50th %tile to below the 10%tile on the growth chart c. the wt for length plots between the 5th to 10th percentile d. wt is at the 10th %tile for length/height B- When the wt falls more than 2 growth curves, FTT should be suspected. Which of the following is an example of protein coagulation? a. cooking a scrambled egg b. baking an apple pie c. cooking refried beans d. sautéing onions A- Cooking scrambled egg is an example of protein coagulation. The liquid from the yolk and egg white turns solid in a process known as coagulation How is Celiac Disease definitively dx? a. sx investigation b. excluding gluten-containing foods from the diet c. intestinal biopsy d. blood lab test C- The definitive way to dx celiac disease is thru an intestinal biopsy. This is often not performed bc it is invasive and expensive. The presence of antibodies in the blood can suggest the presence of celiac disease, but it is not definitive indicator. Which of the following is NOT a function of management? ing ization ting ating D- delegating may be used as a means of leading or directing, but it is not a main function of management Which of the following factors will most affect the REE? a. fever b. moderate physical activity c. major surgery d. major burns D- Major burns will most affect resting energy expenditure, which is a measure o metabolic rate. burns have a tremendous effect on the body and can cause a significant stress response. Which of the following foods may interfere with dietary iron absorption? a. whole grain pasta b. oranges c. fruit juice d. white rice A- whole grain pasta is most likely to interfere with iron absorption because it is high in fiber content and fiber can inhibit the absorption of iron. Vitamin C may aid the absorption of iron An 81 year old pt has been hospitalized following a stroke. The pt is progressing well, but you noticed him pocketing foods at mealtime. What course of action would you recommend? a. none b. recommend a speech consult c. provide thickened liquids d. initiate a mechanically soft diet B- You suspect swallowing difficulties or dysphagia post-stroke. A speech consult should be recommended to assess if there is a swallowing problem. The diet order or recommendation should reflect the outcome of the speech therapy findings. Which of the following would NOT be permitted with a Kosher diet? a. beef b. salmon c. chicken d. shrimp D- Shrimp = shellfish which would not be permitted on a kosher diet An egg with a normal-appearing shell, a firm yolk, and same thinning of the white is what grade of egg? a. Grade AA b. Grade A c. Grade B d. Grade AB B- Grade A is typically what you see on the grocery store shelves. Grade AA is the highest quality while Grade B is lower quality and typically has more defects. Grade AB is not an egg grade. A pt has an LDL cholesterol of 159mg/dL and an HDL cholesterol of 39mg/dL. Which of the following dietary interventions would you most recommend? a. limit saturated fat intake and increase fiber intake b. eliminate trans fat and increase protein intake c. initiate a wt loss program d. limit simple sugar intake A- Saturated fats should be limited to less than 7% of calories and fiber intake should be increased by eating whole grains, fruits and vegetables You hav a supervisor who is very strict dictatorial. He or she likely believes in which of the following behavioral theories: a. Theory W b. Theory X c. Theory Y d. Theory Z B- This superior most likely subscribes to theory X. Theory X asserts that most control over employees in order to force them to work. What type of insulin injection is typically given prior to meals and works quickly to help control blood glucose levels? a. bolus b. short-acting c. intermediate-acting d. long-acting A- A bolus injection is generally given before meals. The dosage is based on planned amount of carbohydrates consumed at the meal. Which of the following food items would you discourage if the pt is following a low oxalate diet due to frequent kidney stone formation? a. wine b. milk c. grits d. beef C- Grits are high in oxalate the other choices are considered low-oxalate items Which of the following nutrients will be most affected (destroyed or reduce) by cooking? a. vitamin B6 b. Calcium c. Magnesium d. Vitamin C D- Vitamin C is greatly affected by heat, so losses of this nutrient can be expected during the cooking process. The B vitamins are generally more heat-stable. Minerals are less affected by heat than vitamins Your 72 yr old male pt has a recent lab result suggesting vitamin B12 deficiency. Which of the following is the appropriate initial recommendation from the dietitian? a. You recommend a vitamin B12 supplement b. You recommend foods high in vitamin B12 c. You refer the pt to his or her physician for follow-up d. You recommend a daily multivitamin C- You should refer the patient to his physician to discuss the appropriate treatment. In the elderly, vitamin B12 deficiency is often due to a lack of intrinsic factor. While a supplement containing B 12 or foods high in B12 may be useful, the pt will likely need B12 injections if absorption is altered due to lack of intrinsic factor. Which of the following interventions may be appropriate for a pt with COPD? a. increase sodium intake b. decrease fat intake c. reduce carbohydrate intake d. increase overall caloric intake D- An increase in caloric intake may be necessary because the metabolic rate increases in individuals with COPD. Malnutrition is often a problem among this population. Sodium should generally be limited and healthy fats can be liberalized. Restricting carbohydrates may not be beneficial. Medicare Part B covers which of the following? a. Hospital services b. Professional services c. Prescription drugs d. Vision services B- Medicare Plan B covers professional services such as doctor visits and durable medical equipment A clinical dietitian is considering expanding his or her clinical responsibilities in the hospital. Which of the following should first be considered. a. Standard of practice b. clinical standards c. scope of practice d. standards of professional performance C- dietitians must be careful to operate within their scope of practice. according to the academy, the scope of practice, "encompasses the range of roles, activities, and regulations within which nutrition and dietetics practitioners perform." The scope of practice takes into account many considerations including education, credentialing and competence. From the following choices, when should parenteral nutrition be considered? a. after there has been insufficient intake for 7-14 days b. when enteral nutrition is not successful c. When the pt is being discharged for home care d. After any type of bowel surgery B- Parenteral nutrition should be considered after enteral nutrition is unsuccessful. Enteral nutrition should be the first choice following intake by mouth. Some types of bowel surgery may necessitate the need for parenteral nutrition, but this is not always the case. As a food service manager you order the needed items from various vendors based on their stated prices. This is an example of which of the following? a. competitive bidding b. open market bidding c. no bidding d. flexible bidding B- This is known as open market bidding because you are not tied to one vendor. With competitive bidding one vendor Is chosen to supply the food service needs. Regression analysis is used in what type of research? a. survey research b. qualitative research c. descriptive research d. analytical research D- Analytical research involves understanding and making predictions. Regression analysis is a method that attempts to show a correlation between variables. Which of the following is considered evidence for the presence of metabolic syndrome? a. rapid wt gain over 1-year period accompanied by hypertension b. presence of DM and HTN c. presence of DM, HTN and BMI over 36 d. presence of dyslipidemia and a BMI over 36 C- Metabolic syndrome is considered when there are multiple ( 3 or MORE) symptoms such as hyperglycemia, obesity or high waist circumference, htn, and dyslipidemia. The other answers include only 2 sx and choice "A" includes a characteristic that does not meet the criteria of rapid wt gain In addition to nutrition intervention, how are pressure ulcers best managed? a. with repositioning and proper wound care dressing b. with increased mobility c. throughout physical therapy d. with proper bed positioning A- Although a lack of mobility may contribute to pressure ulcers, the ulcer pt must be repositioned frequently and the wounds must be properly dressed in order to effectively be treated Which of the following is not a key aspect of a food service safety program? a. engineering b. education c. enforcement d. environment D- Environmental is not a key aspect of a food service safety program. The building should be engineered to promote safety, the staff should be educated, and the rules should be enforced to promote a safe environment Which of the following is the recommended time period for breastfeeding? a. 0-3 mo b. 0-6 mo c. 12 mo d. 18 mo C- The recommendation is for infants to be breastfed for the first 12 months of life, but any amount of breastfeeding is encouraged because f the numerous health benefits. What gas can hasten/quicken the ripening process in some fruits (such as apples)? a. ethylene b. mylene c. phosphorylase d. methane A- Fruits naturally produce ethylene gas, which speeds up the ripening process. Mylene is not a gas, and phosphorylase is an enzyme. Methane is a flammable gas that is a component of natural gas, which is often used for heating and cooking. Using a standard enteral formula, your pt requires 2,000 . Calculate bolus feeding amounts for 5 feedings daily. a. 300 ml b. 400 ml c. 450 ml d. 500 ml B- 2,000kcal = 2,000mL standard formula at 1 kcal/mL. 2,0000ml / 5 feedings = 400 ml/feeding What type of tube feeding would you recommend for a pt who needs some flexibility in feeding, but cannot tolerate large volumes in one sitting? a. bolus feeding b. continuous feeding c. intermittent feeding d. optional feeding C- Intermittent feeding would be appropriate because it is offered several times daily and is more flexible than continuous feeding. Bolus feeding would not be recommended bc the pt is unable to tolerate large volume Which food ingredients do NOT need prior approval before including in foods? a. ingredients on the GRAS list b. color additives c. new ingredient to market d. ingredients from an established food manufacturer A- Ingredients on the GRAS list do not need prior approval before inclusion in foods. Safety is assumed for these ingredients given the number of years on the market without adverse effect coupled with scientific support. What nutrition program uses nutritional risk as a criterion for receiving services? a. SNAP b. Congregate Meals Program c. Child and Adult Care Food Program d. WIC D- The special supplemental food program for women, infants and children (wic) is the only program that requires nutrition risk be established prior to receiving services. Which of the following groups has the highest BMR per body weight? a. Infants b. Children c. Adolescents d. Adults A- Infants have the highest basal metabolic rate based on their body wt. Infants grow very quickly and need a tremendous amount of energy. Which of the following foods would you recommend for someone with PKU? a. milk b. hamburger patties c. nuts d. apples D- fruits are low in phenylalanine, which must be limited in pts with PKU. Milk and dairy products, meats and nuts are higher in phenylalanine and should be avoided. A rural area with no grocery store within 30-minute drive is known as which of the following? a. food dessert b. food deprived area c. food challenged location d. food suburb A- A food dessert is an area without easy assess to fresh fruits and vegetables. A food dessert may be found in rural or more urban areas. In urban areas you might find stores that offer packaged or preserved food but lack healthy, fresh options. In rural areas there may be no food options Which agency coordinates the national surveillance programs? a. FDA b. CDC c. USDA d. BRFSS B- The CDC coordinate surveillance programs such as the Behavioral risk factor surveillance system (BRFSS) and the youth risk behavior surveillance system (YRBSS) Energy needs are typically greatest during which part of infancy? a. 0-3 mo b. 4-6 mo c. 7-12 mo d. energy needs are not age dependent A- During the first 3 months of life energy needs respective to wt are the greatest. energy needs for this age span are calculated with the following equation: EER (kcal/day) = (89 x infant wt in kg -100) + 175 A dietary supplement sold on TV claims to help you lose weight without exercise or calorie control. This is likely an example of which of the follow? a. health fraud b. health fad c. health claim d. health promise A- This scenario is an example of health fraud. This product is not supported by science and attempts to make a profit using misinformation. Approximately how many grams of carbohydrates would you find in a meal consisting of a half of bagel, half a cup of orange juice and three-quarters of a cup of nonfat plain yogurt? a. 30 g b. 45 g c. 60 g d. 65 g B- Approximately 45g of carbohydrates will be included in this meal because each item contains about 15 g of carbohydrates. Which of the following is considered a risk factor for heart disease? a. having HDL cholesterol less than 40mg/dL b. having HDL cholesterol greater than 40mg/dL c. being a male over 40 years of age d. being a female over 45 years of age A- low HDL cholesterol is considered a risk factor for heart disease. HDL cholesterol is often referred to as "good" cholesterol because it helps remove harmful cholesterol from the body. Your organization is planning to build a new hospital wellness wing starting in 3 years. This example illustrates which type of planning? a. short term planning b. long-range planning c. operational planning d. structure planning B- This is an example of long-range planning, where planning looks into the future beyond a year Which of the following is an example of a departmental procedure? a. proper work attire b. specifications for how to properly document client information c. work day schedules d. behavior expectations B- Specifications for how to document client information is an example of a procedure. A procedure describes how something should be done; there are steps that must be followed for proper documentation. The other choices are examples of policies. Your 42 year old male pt has a Hgb of 12 with no significant medical hx. Which of the following foods would you recommend this pt to eat to address the hemoglobin? a. garden salad with cheese b. rice and beans c. toast and fruit d. chicken and broccoli D- A hemoglobin level of 12 is considered low for a male. Chicken and broccoli would be the best recommendation. Chicken is a good source of dietary iron, while broccoli contains a significant amount of vitamin C- which helps increase absorption of iron. Which of the following is an example of a staff role? a. accountant b. customer service representative c. nurse d. line server A- An accountant is an example of a staff role; he or she does not have a direct impact on the customer You have just completed a 6-wk educational series on cardiovascular health for your cardiac rehabilitation pts. What would you use to assess the program's success? a. periodic evaluation b. peer evaluation c. summative evaluation d. formative evaluation C- A summative evaluation is given at the end of a period or series of programs. It helps to evaluate or summarize the entire program rather than just one class within the program. A formative evaluation might be used for only one class or counseling session so changes can be made moving forward. Which of the following management styles would you choose to help a new employee who is very motivated but lacks experience? a. coaching b. directive c. supportive d. delegating A- You would likely choose a coaching style-utilized both support and direction; this is important for new inexperienced employees. Which or the following tends to be the most accurate and comprehensive method of obtaining dietary intake for a pt? a. 24-hour recall b. food frequency questionnaire c. food dairy d. food survey C- A food diary is generally more accurate than a 24-hour recall bc it relies less on a persons memory. A food frequency questionnaire provides limited information in that it looks at how frequently a food is eaten; whereas a food diary should include all intake. A food survey is not considered a method of obtaining intake information for specific patient. What process or processes can help preserve the bright green color in foods such as green beans? a. chlorophyll b. blanching and freezing c. heating d. ripening B- Blanching vegetables prior to freezing can help maintain their coloring that results from the pigment chlorophyll. Heating generally causes a loss of color in chlorophyll-pigmented foods. Colors usually become brighter during the ripening process. The line item SALES would be included in which of the following types of budgets? a. capital budget b. operating budget c. essential budget d. expenditure budget B- An operating budget includes line items such as sales and labor. A capital budget includes major expenses such as equipment and buildings. You just completed a training for a newly-dx DM pts. After the training, you discovered some of the participates have very low literacy and did not understand some of your educational materials. What should you have done to avoid this problem? a. asked the pmts if they could read or understand the material b. conducted a needs assessment c. involved family members in the training d. provided fewer handouts B- If you has conducted the needs assessment prior to the education session, you could have assessed the needs and education level of your group. This would have allowed you to provide hands aimed at a lower literacy level On which financial statement would you find the organizations assets listed? a. income statement b. balance sheet c. statement of cash flow d. statement of retained earnings B- A balance sheet is frequently used by outside entities or persons for investment decisions. It details information such as assets, liability and owner's equity. Healthcare facilities as hospitals often strive to achieve which of the following certifications? a. NCQA b. JCAHO c. HHS d. AHA B- The Joint Commission on Accreditation of Healthcare Agencies offers certification for healthcare facilities. While their accreditation is not a requirement, it is an industry standard for quality. What the of fish should pregnant women avoid eating? a. shrimp b. salmon c. swordfish d. tilapia C- Swordfish should be avoided because it is higher in mercury Opportunity cost are defined as which of the following? a. how much a new opportunity will cost in dollars? b. the cost of capital c. the loss of potential benefit when pursuing one option d. benefits that a new opportunity will provide C- Opportunity cost is what you give up when you pursue an alternative option. When you conduct cost/benefit analysis, part of the analysis includes opportunity cost. You received a referral because the hospital screening tool indicated a 78 year old male is malnourished. He was hospitalized for complications resulting from influenza. Upon assessment, you determine the pt has a BMI of 18 with recent wt loss. The pt has no hx of cardiovascular disease or DM. He lives along and is able to purchase and prepare foods, but he says his appetite is poor and food is lacking in taste. What first course of intervention might you recommend for this patient? a. DASH diet b. bolus feedings combined with oral intake c. normal diet with high calorie supplements d. liberalized diet C- Because there is no mention of contraindication to oral feeding, a normal diet combined with high calorie supplements is likely the best course of initial action. Tube feeding is initiated in a severely malnourished patients. You should carefully monitor for which of the following: a. weight loss b. fluid loss c. refeeding syndrome d. overfeeding syndrome C- You should monitor for refeeding syndrome. This life-threatening scenario may occur when initiating feeding after prolonged periods of malnourishment. The patient should be followed closely and labs should be monitored especially for increases in phosphate, potassium, glucose and magnesium. The pt is hospitalized post cholecystectomy. What type of diet would you first recommend post-surgery? a. Nothing by mouth b. high-fat diet c. low-fat diet d. regular diet C- Initially, the pt should be on a low fat diet and progress as tolerated to a regular diet. The gallbladder stores and releases bile; bile is important in the metabolism of fats. With the removal of the gallbladder this process is disturbed, so following a low-fat diet is important. Eventually, the liver will compensate for the absence of the gallbladder. Which of the following is the first step a dietitian should take to address the needs of a burn pt? a. replace fluids b. start enteral feeding c. start parenteral feeding d. begin supplemental zinc sulfate A- Much fluid is lost in burn patients; the appropriate first step is to replace fluids. Enteral nutrition may be necessary if the patient is unable to initiate feedings by mouth. Supplemental zinc sulfate should be recommended but these occur secondary to correcting fluid loss. You are a clinical manager for the food and nutrition department at your local hospital. Once of your clinical dietitians is being called away for active-duty military service, but she plans to return after 6 months. Upon her return from service, which of the following actions would you take? a. reemploy her in the same or equivalent position b. reemploy her if there is an opening c. assist the dietitian in finding a job at another hospital d. provide severance pay and a letter of recommendation A- Under the uniformed services employment and reemployment act, employees have the right to return to their previous position or an equivalent position if they remain qualified. Your 20 year old male pt has a BMI of 25.9. Which BMI classification is this pt in? a. underwt b. normal wt c. overwt d. obese C- a BMI of 25-29 is considered overweight for male and female adults You are managing a large foodservice operation and you need to be profitable to continue in business. Your net income is $50,000, your net sales are $90,000, and your cost of goods sole is $24,000. Calculate the profit margin (net income/ net sales): a. 48% b. 55% c. 180% d. 375% B- Profit margin = net income/ net sales 50,000/90,000 x 100 = 55.5% This means your food service operation has 55.5% of your revenue remaining after direct costs such as food are paid. Net income already has cost of goods sold subtracted, so you do not need this number. You the clinical dietitian, stop in to follow up with the 5th floor pt. the pt is feeling much better, but he complains of being hungry now that his appetite is returning. You note the pt is on a reduced sodium diet, but there are no other restrictions. Rather than ordering a food supplement or snack for the pt, you walk to the kitchen, pick up the food and deliver it to the pt. This scenario is best described as of which of the following? a. customer service b. team work c. outside scope of practice d. within the standards of care A- This is example of good customer service. The dietitian could have ordered a food supplement or snack to be delivered at a later time by the food service staff. Instead, he or she went above and beyond to provide excellent service to the patient. A patient is dx with galactosemia and referred to the dietitian. Which of the following foods would you recommend eliminating from the diet based on the dx?a. yogurt b. sugar meat A- Yogurt should be avoided because it contains lactose (galactose is found in lactose) Individuals with galactosemia lack the necessary enzymes to metabolize galactose. What monosaccharide jin to from sucrose? a. glucose and maltose b. fructose and galactose c. fructose and lactose d. glucose and fructose D- Fructose and glucose form sucrose when joined, which is commonly referred to as table sugar Your pt has ESRD and is on hemodialysis. Which of the following most likely reflects the appropriate amount of protein to be consumer by the patient? a. 1.6g/kg/day b. 1.4g/kg/day c. 1.2g/kg/day d. 0.8g/kg/day C- 1.2g/kg/day is the protein intake typically suggested for pts receiving hemodialysis. The protein needs may be higher for pts receiving peritoneal dialysis. You have an employee away on family medical leave. You need to hire someone to fill in for the employee while he is absent. This new hire is probably which of the following types of employees? a. probationary employee b. part-time c. short-term worker d. temporary worker D-Temporary workers are often hired on a short-term basis to fill in for someone who is absent or to supplement work for a particular period of time (for instance, to help fill the gaps during the busy season). Your 83 year old low income female pt is being discharged from the hospital. She has limited transportation and no family. Which of the following services would be most appropriate for this pt? a. USDA Commodity Supplemental Food Program b. WIC Program c. Senior Farmer's Market Nutrition Program d. Supplemental Nutrition Assistance Program A- The USDA Commodity Supplemental food program would be appropriate because it delivers food to the home (eg. meals on wheels). This is important bc the pt has limited means of transportation. When preparing a menu, which of the following is NOT a factor that would likely be considered? a. budget b. clientele c. food service equipment d. dining room ergonomics D- While dining room ergonomics are important while designing the space and for comfort, it is unlikely to be a factor you will consider when planning the menu Your patient is post-gastric bypass and experiencing dumping syndrome. Which of the following recommendations would you make? a. drink more fluids such as fruit juice b. chew more slowly c. add fluids, especially milk products d. provide protein foods D- Protein-containing foods such as chicken and beef are digested more slowly and should be emphasized. Fruit juice may make the dumping syndrome worse while lactose-containing products such as milk may be difficult to digest. Your restaurant changes menus every spring, summer, fall and winter. These menus are known as which of the following types of menus? a. seasonal b. yearly c. preferred d. evolving A- Menus that change based on the season are referred to as seasonal menus. Patrons often prefer different foods at different times of the year. When should you consider total parenteral nutrition? a. when feeding is short term (3-4 days in duration) b. When longer-term feeding is expected (over 7 days in duration) c. After bowel surgery that requires nothing by mouth for 1-2 days d. When the pt is reluctant to eat by mouth B- Total parenteral nutrition generally considered for long term situations. PPN should be used for shorter durations if the pt is unable to tolerate intake by mouth or enteral feeding by tube. Your hospital is adopting a new electronic medical record system. How would you best begin the training for the new system? a. new employee orientation b. written instructions c. in-service d. on-the-job training C- An in-service or a series of in-service session should be scheduled to train employees on how to use the new medical record system. Written instructions may be helpful, but they should not be the only mode of training. The employees should be comfortable with the system prior to implementation, therefore, on the job training is not the optimal choice Nutrition-related knowledge deficit is an example of which nutrition dx domain? a. intake b. clinical c. behavioral-environmental d. education C- Knowledge deficit falls into the behavioral environmental category of nutrition dx. While knowledge deficit might be related to lack of education, education is not considered a nutrition dx domain. To destroy which of the following bacteria, vegetables must be canned at a temperature above 212 degree F? a. Clostridium botulinum b. E. coli c. Salmonella d. Listeria A- vegetables, because they are lower in acid and prone to microbial growth, must be caned at very high temperatures to destroy harmful bacterium, clostridium botulinum. Which of the following is NOT a reason why a foodservice organization should follow standardized recipes? a. consistent product b. quality c. less time consuming d. cost control C-Following a standardized recipe may or may not be less time-consuming than the alternative. It is not a reason for using standardized recipes, but controlling costs and producing a high quality, consistent product are reasons. Which of the following is an example of a food fad? a. Mediterranean diet b. cardiac prudent diet c. low carbohydrate diet d. DASH diet C- A low carb diet is an example of a food fad. The low carb approach restricts carbs unnecessarily and is not based on sound scientific principles For how long should one scrub hands when following proper handwashing procedures? a. 60 seconds b. 30 seconds c. 20 seconds d. 15 seconds C- Proper hand washing procedures recommend scrubbing for 20 seconds A person is sick with diarrhea and cramping after eating a fresh salad at your restaurant 3 days ago. Which of the following food borne illnesses is most likely responsible for the symptoms? a. Salmonella b. E.Coli c. Trichinosis d. Listeria B- If the sx are from a food borne illness, the most likely culprit from our choices is E.Coli - can be found in beef products as well as fresh fruits and vegetables During which phase of the Nutrition care process does implementation take place? a. nutrition assessment b. nutrition dx c. nutrition intervention d. nutrition monitoring and evaluation C- During nutrition intervention the dietitian plus his/her plan into practice and implements the strategies You notice that blood levels are becoming acidic in a pt on a ventilator. This condition is known as which of the following? a. respiratory acidosis b. respiratory alkalosis c. metabolic acidosis d. metabolic alkalosis A- respiratory acidosis has likely resulted from inefficient breathing causing a build-up of carbon dioxide. Metabolic acidosis also results in a decreased ph, but metabolic acidosis is involved with kidney function. The act of trying to prevent bioterrorism that may occur through food supply contamination is known as which of the following? a. food safety b. supply safety c. food defense d. supply defense C- Preventative measures and training to prevent bioterrorism as related to food, is known as food defense Which of the following would NOT be found on a clear liquid diet? a. tea b. apple juice c. orange juice d. ice pops C- OJ would generally not be found on a clear diet- a clear diet can include fruit juices such as apple juice but it excluded juices with pulp such as OJ A commissary food product system will require which of the following? a. a large kitchen b. a large dining area c. limited storage d. specialized equipment A- A commissary system will require a large kitchen. Large quantities of food are being prepared on-site and transported to satellite locations for servings