Clinical Nutrition
Final Exam Questions
Course Introduction
Clinical Nutrition is the study of how nutrients and dietary interventions impact human health, with a primary focus on the prevention, diagnosis, and management of disease. This course explores the principles of nutritional assessment, metabolic pathways, and the development of tailored nutrition care plans for diverse patient populations. Topics include the role of macronutrients and micronutrients in health and disease, nutritional therapy for specific medical conditions, the importance of evidence-based guidelines, and the integration of nutrition within interdisciplinary healthcare teams. Emphasis is placed on critical thinking, case-based learning, and application of nutritional science to clinical practice.
Recommended Textbook
Nutrition and Diet Therapy 9th Edition by Linda
Kelly DeBruyne
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Chapter 1: Overview of Nutrition and Health
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Sample Questions
Q1) You are advising a client on components of the Dietary Guidelines for Americans. Which of the following would you include in your advice?
A) Increase vegetable and fruit intake.
B) Decrease intake of milk and milk products to two servings per day.
C) Decrease intake of whole grains and other complex carbohydrates.
D) Increase intake of trans fats and saturated fats.
E) Increase intake of protein and decrease vegetable fibers.
Answer: A
Q2) Your friend always refers to meat as "protein." You try to correct her by stating that
A) nearly all foods contain mixtures of the energy-yielding nutrients
B) protein is not the predominant nutrient in meat
C) protein-rich foods are always high in fat
D) meat contains more carbohydrate than protein
E) protein is a catch-all term for all the organic nutrients
Answer: A
Q3) An excess intake of any energy nutrient can lead to weight gain.
A)True
B)False
Answer: True
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Chapter 2: Carbohydrates
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Sample Questions
Q1) Which of the following is the principal carbohydrate in milk?
A) maltose
B) fructose
C) sucrose
D) lactose
E) glucose
Answer: D
Q2) The Dietary Reference Intake for dietary fiber is approximately _____ grams per day.
A) 10-15
B) 15-20
C) 25-35
D) 45-50
E) 55-60
Answer: C
Q3) A person consumes 2000 kcalories per day and 200 grams of carbohydrate. This person meets the current dietary recommendations for carbohydrate intake.
A)True
B)False
Answer: False
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Chapter 3: Lipids
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Sample Questions
Q1) It is possible to consume too little fat.
A)True
B)False
Answer: True
Q2) Assuming that we eat plenty of vegetable cooking oils due to their increased production and use by food manufacturers, Americans need to consume more ____.
A) omega-3 fatty acids
B) omega-6 fatty acids
C) monounsaturated fatty acids
D) essential fatty acids
E) trans-fatty acids
Answer: A
Q3) Which statement characterizes cholesterol?
A) Cholesterol in food is the main influential factor in raising blood cholesterol.
B) Some vegetable fats can contribute to high blood levels of cholesterol.
C) Cholesterol is not usually found in animal foods.
D) Cholesterol is an ideal energy source for working muscles.
E) High blood levels of HDL cholesterol raise the risk of heart disease.
Answer: B
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Page 5
Chapter 4: Protein
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Sample Questions
Q1) Which statement characterizes enzymes?
A) They are redundant in most life processes.
B) They are not proteins.
C) They are all catalysts.
D) They are involved in synthesis reactions only.
E) They are destroyed as soon as they perform their function.
Q2) Although amino acids are a secondary source of energy, their primary function is to
A) build proteins needed by the body
B) provide essential water-soluble vitamins
C) produce insulin
D) supply most of the kcalories in the average American diet
E) denature proteins
Q3) Marasmus may best be described as a nutritional deficiency disease caused by
A) a chronic, severe deprivation of food
B) excess energy intake
C) a chronic, severe deprivation of protein
D) a deficiency of protein and vitamins
E) a chronic, severe deprivation of enzymes
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Chapter 5: Digestion and Absorption
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Q1) A nutrient or other substance must pass through the cells of the digestive tract wall before it actually enters the body.
A)True
B)False
Q2) Segmentation propels or pushes food through the GI tract, while peristalsis mixes the food, with a more gradual pushing motion.
A)True
B)False
Q3) The function of mucus in the stomach is to ____.
A) neutralize stomach acid
B) activate pepsinogen to pepsin
C) protect stomach cells from gastric juices
D) emulsify fats
E) denature proteins
Q4) Describe the difference between low-density lipoproteins (LDL) and high-density lipoproteins (HDL). What is the relationship between blood levels of these lipoproteins and risk of heart disease?
Q5) Should antacids be taken to decrease the strong acidity of the stomach? Explain your answer.
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Chapter 6: Metabolism Energy Balance and Body
Composition
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Sample Questions
Q1) People can change their voluntary actions to spend more or less energy in a day, but they cannot change their basal metabolic rate.
A)True
B)False
Q2) Individuals with anorexia nervosa tend to _____.
A) come from families of lower economic means
B) be polite, controlled, and rigid, and exhibit unspontaneous behavior
C) come from families that value an inner sense of worth
D) be rebellious, with uncontrollable behavior
E) be narcoleptic
Q3) Describe how fat can be made from an excess of each of the energy nutrients-carbohydrate, protein, or fat.
Q4) A good indicator of fat distribution on an individual is _____.
A) BMI
B) body weight
C) hip circumference
D) waist circumference
E) underarm fat
Page 8
Q5) Discuss the characteristics of the female athlete triad?
Q6) Explain the difference between anaerobic and aerobic metabolism.
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Page 9
Chapter 7: Weight Management Overweight and Underweight
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Sample Questions
Q1) Jill has asked to be placed on a weight-loss diet that will allow her to lose two pounds per week. You tell Jill that she must cut about _____ kcalories/day in order to achieve this goal.
A) 500
B) 700
C) 1000
D) 1500
E) 2000
Q2) The prescription drug _____ is used to treat obesity by reducing the absorption of fat.
A) orlistat
B) topiramate
C) Olestra
D) Meridia
E) Qsymia
Q3) Discuss the nuances of over-the-counter weight-loss products, both in terms of what they promise and the federal regulatory climate.
Q4) Summarize how you might advise someone about the steps they could take to assess their current overall weight and health and make any necessary changes.
Page 10
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Chapter 8: The Vitamins
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Sample Questions
Q1) What is vitamin A's role in vision? What happens to your eyes when you don't get enough vitamin A?
Q2) Some vitamins are available from foods as precursors called _____.
A) provitamins
B) coenzymes
C) pre-enzymes
D) free radicals
E) oxidants
Q3) Vitamin A plays a role in cell differentiation, which means that it _____.
A) helps cells differentiate between the vitamins
B) allows cells to specialize and mature so they can perform their intended functions
C) promotes the storage of fat-soluble vitamins
D) aids in excretion of water-soluble vitamins
E) allows cells to undergo apoptosis so they can perform their intended functions
Q4) Describe the factors that may interfere with vitamin D synthesis.
Q5) How do the vitamins differ from carbohydrates, fats, and proteins?
Q6) Identify groups of people who are at risk for vitamin E deficiency, in addition to those with diseases.
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Chapter 9: Water and the Minerals
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Q1) People who eat mostly processed and fast foods have the highest sodium intakes.
A)True
B)False
Q2) Which statement describes the function of phosphorus in the body?
A) It does not participates in the transfer of energy during cellular metabolism.
B) It is not necessary for growth.
C) It is needed in the stomach for hydrochloric acid production.
D) It is found with calcium in bones and teeth.
E) It aids in blood glucose regulation.
Q3) Which protein carries iron to tissues throughout the body?
A) hemoglobin
B) ferritin
C) myoglobin
D) transferrin
E) hepcidin
Q4) Potassium deficiency is characterized by a decrease in blood pressure, salt sensitivity, kidney stones, and bone turnover.
A)True
B)False
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Chapter 10: Fitness and Nutrition
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Q1) The four minerals considered electrolytes are:
A) sodium, calcium, magnesium, and phosphorus.
B) chloride, selenium, sodium, and magnesium.
C) sodium, potassium, calcium, and magnesium.
D) chloride, magnesium, sodium, and selenium.
E) sodium, potassium, chloride, and magnesium.
Q2) Protein contributes at most about _____ percent of the total fuel used, both during activity and during rest.
A) 15
B) 5
C) 30
D) 20
E) 10
Q3) Aerobically trained muscles burn _____ more readily than untrained muscles.
A) sodium
B) fat
C) protein
D) glycogen
E) oxygen
Q4) Why is it important to "refuel" as soon after physical activity as possible?
Page 13
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Chapter 11: Nutrition Through the Life Span Pregnancy and Lactation
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Sample Questions
Q1) Practices that should be avoided during pregnancy include _____.
A) smoking cigarettes and consuming alcohol
B) smoking cigarettes, consuming alcohol, and consuming caffeine
C) consuming alcohol only
D) smoking cigarettes, consuming alcohol, exercise, and consuming fat
E) smoking cigarettes only
Q2) Mothers should breastfeed their infants _____.
A) on demand
B) every four hours
C) as soon as she can feel that the milk has been replenished
D) no more than 5 times in a 24 hour period
E) every 30 minutes
Q3) The most common cause of maternal mortality in developed countries is _____.
A) gestational hypertension
B) eclampsia
C) gestational diabetes
D) preeclampsia
E) chronic hypertension
Q4) How should adolescents who become pregnant adjust their nutrient intakes and overall health strategy to meet the demands of a growing fetus?
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Chapter 12: Nutrition Through the Life Span Infancy
Childhood and Adolescence
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Sample Questions
Q1) Identify ways that watching television adversely affects children's nutritional health.
Q2) To prevent iron deficiency, a child needs _____ mg of iron per day.
A) 2-3
B) 3-5
C) 7-10
D) 10-12
E) 15
Q3) Snacks provide about _____ of the average teenager's total daily food energy intake.
A) one third
B) one fourth
C) two thirds
D) three fourths
E) half
Q4) Describe the relationship between hunger and school performance.
Q5) How might a pregnant woman's diet and health routine affect the health of her unborn fetus?
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Q6) Discuss the problems associated with providing nutritious lunches to students at school.
Chapter 13: Nutrition Through the Life Span Later Adulthood
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Q1) Even for older adults, _____ is still the best source of nutrients.
A) food
B) tea
C) an herbal supplement
D) a vitamin pill every morning
E) a timed-release capsule
Q2) Older adults face a greater risk of vitamin D deficiency than young people due to _____.
A) low consumption of meat
B) low intake of vegetables
C) limited exposure to sunlight
D) low intake of fiber
E) higher intakes of fat
Q3) Why is dehydration a risk for older adults?
Q4) The estimated energy requirements for adults decreases steadily after age _____.
A) 19
B) 30
C) 40
D) 51
E) 65
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Chapter 14: Illness and Nutrition Care
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Sample Questions
Q1) Which health care professional is part of the nutrition support team?
A) physician
B) registered dietician
C) registered dietician technician
D) nurse
E) pharmacist
Q2) Which item is not an anthropometric measurement commonly used to evaluate overnutrition and undernutrition?
A) height
B) arm length
C) waist circumference
D) head circumference
E) infant length
Q3) One disadvantage to using a food frequency questionnaire is that ____.
A) it does not take into account fluctuations in food intake
B) it cannot identify short-term changes in food intake
C) the results are not affected by seasonal changes in diet
D) it may not be reflective of a typical day's intake
E) it is not easy for the patient to answer
Q4) Describe how prolonged bed rest may compromise nutrition status.
Page 17
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Chapter 15: Medications - Diet Drug Interactions - and Herbal Supplements
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Sample Questions
Q1) Which herb can raise the likelihood of bleeding when used in conjunction with anticoagulant drugs?
A) ginseng
B) ephedra
C) kava
D) valerian
E) ginger
Q2) Licorice
A)used to treat erectile dysfunction
B)used to treat enlarged prostate
C)relieves menopausal symptoms
D)relieves insomnia with little side-effects
E)used to treat cancer and arthritis; may cause hepatitis and liver failure
F)used for wound healing; can cause liver damage
G)used to improve memory
H)treatment of anxiety, stress, insomnia
I)treatment of digestive system disorders; has possible interactions with diuretics, causing excessive potassium loss
J)used to reduce blood pressure and blood cholesterol; side effects include breath and body odor
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Chapter 16: Specialized Nutrition Support - Enteral and Parenteral Nutrition
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Q1) Aspirations associated with gastric feedings can lead to damage to the _____.
A) heart
B) liver
C) stomach
D) mouth
E) lungs
Q2) Highly concentrated nutrient solutions are not suitable for peripheral parenteral nutrition.
A)True
B)False
Q3) What are the potential metabolic complications with her nutrition support regimen, and which one likely poses the greatest risk for Ms. Johnson at this time? What step can be taken to prevent it?
Q4) If a patient tolerates a formula after it is initiated, the rate of a continuous feeding should be increased by 30 milliliters per hour every 8 hours.
A)True
B)False
Q5) Describe the current procedure for administering a TPN feeding.
Q6) What is refeeding syndrome, and how can it be prevented?
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Chapter 17: Foods and Food Consistency for Upper Gi Disorders
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Q1) Many foods on a full-liquid diet contain lactose.
A)True
B)False
Q2) What types of medications might Kelly's doctor prescribe and why?
Q3) gastritis
A)the surgical removal of part of the stomach (partial) or the entire stomach (total).
B)a feeling of pain, bloating, or discomfort in the upper abdominal area.
C)inflammation of stomach tissue.
D)a class of drugs that inhibit the enzyme that pumps hydrogen ions into the stomach.
E)an absence of gastric acid secretions.
F)symptoms that result from the rapid emptying of an osmotic load from the stomach into the small intestine.
G)surgery that treats severe obesity.
H)a class of drugs that suppress acid secretion by inhibiting receptors on acid-producing cells.
I)inflammation or degeneration of the tissues that support the teeth.
J)a film of bacteria and bacterial by-products that accumulates on the tooth surface
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Chapter 18: Fiber-Modified Diets for Lower Gastrointestinal
Tract Disorders
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Q1) ileum
A)surgical passage through the abdominal wall into the colon
B)bacteria that normally reside in a person's body
C)indigestible substances in foods that stimulate the growth of nonpathogenic bacteria within the large intestine
D)site of vitamin B12 absorption
E)increase stool volume and reduce transit time in the large intestine
F)fat malabsorption associated with Crohn's disease
G)an inflammation of the surgical pouch created in some patients who have had an ileostomy or colostomy
H)live microorganisms provided in foods and dietary supplements for the purpose of preventing or treating disease
I)movement of bacteria across the intestinal mucosa, allowing access to body tissues
J)function by increasing stool weight, increasing the water content of stool, or stimulating peristaltic contractions
Q2) The patient with a colostomy or ileostomy should restrict fluid intake.
A)True
B)False
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Chapter 19: Carbohydrate - and Fat Modified Diets for
Malabsorption Disorders
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Q1) Which process is impacted by cystic fibrosis?
A) blood clotting
B) sweating
C) liver function
D) neuromuscular function
E) blood pressure regulation
Q2) The xylose test is used to diagnose _____.
A) impaired fat digestion
B) excess vitamin B absorption
C) lactose intolerance
D) problems with stomach emptying
E) nutrient malabsorption
Q3) Which organ senses low oxygen content and releases chemicals that stimulate RBC production?
A) lungs
B) kidney
C) bone marrow
D) heart
E) liver
Q4) Explain the process of intestinal adaptation.
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Chapter 20: Nutrition Therapy for Liver and Gallbladder Diseases
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Q1) Nutrients are carried from the digestive tract to the liver via small blood vessels called collaterals.
A)True
B)False
Q2) In liver disease, blood ammonia levels rise because the liver cannot convert the ammonia to _____.
A) nitrogen
B) amino acids
C) urea
D) sodium
E) cholesterol
Q3) The most common complication of alcohol abuse is _____.
A) chronic pancreatitis
B) alcoholic liver disease
C) chronic renal failure
D) heart arrhythmias
E) neuromuscular dysfunction
Q4) People with protein-energy malnutrition may experience fatty liver.
A)True
B)False
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Chapter 21: Carbohydrate Controlled Diets for Diabetes
Mellitus
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Q1) fibrinogen
A)hormone produced by adipose cells that improves insulin sensitivity
B)liver protein that promotes blood clot formation
C)a hormone produced by adipose cells that promotes insulin resistance
D)the type of diabetes that accounts for 5 to 10% of diabetes cases and is caused by autoimmune destruction of pancreatic beta cells
E)the type of diabetes that accounts for 90 to 95% of diabetes cases and is a result of insulin resistance coupled with insufficient insulin secretion
F)transported in very-low-density lipoproteins (VLDL)
G)known as insulin resistance syndrome or syndrome X
H)protein that promotes blood clotting by inhibiting blood clot degradation within blood vessels
I)hyperglycemia that results from the release of counter regulatory hormones following nighttime hypoglycemia; also called the Somogyi effect
J)signaling proteins produced by the body's cells, including immune cells
Q2) Describe the appropriate medical nutrition therapy for pregnant women with diabetes.
Q3) Describe how glycated hemoglobin is used to evaluate long-term glycemic control.
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Chapter 22: Fat Controlled - Mineral Modified Diets for
Cardiovascular Diseases
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Q1) A patient has begun taking furosemide to manage heart failure. Which foods should she consume frequently?
A) legumes
B) peanut butter
C) bananas and other potassium-rich foods
D) milk and other milk products
E) proteins
Q2) Describe the DASH eating plan.
Q3) The formation of plaque is _____.
A) unrelated to high blood pressure
B) an inflammatory response
C) an autoimmune disorder
D) limited to smaller blood vessels
E) limited to the heart
Q4) The primary dietary recommendation for heart failure is protein restriction.
A)True
B)False
Q5) Coronary heart disease (CHD) is the leading cause of death in the United States. A)True
B)False
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Chapter 23: Protein - Mineral - and Fluid Modified Diets for Kidney Diseases
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Q1) Protein-restricted diets naturally curb the intake of _____.
A) sodium
B) phosphorus
C) potassium
D) vitamin B
E) calcium
Q2) Describe the medical nutrition therapy for calcium oxalate stones.
Q3) One of the effects of nephrotic syndrome is a loss of vitamin D. This can result in _____ in children.
A) growth failure
B) poor appetite
C) rickets
D) type 1 diabetes
E) acromegaly
Q4) The consequences of acute kidney injury include _____.
A) decreased BUN levels
B) increased serum creatine levels
C) azotemia, but not uremia
D) increased parathyroid hormone secretion
E) elevated sodium levels, which can lead to heart failure.
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Chapter 24: Energy - and Protein - Modified Diets for
Metabolic and Respiratory Stress
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Q1) Excessive kcalorie intake in COPD patients may _____.
A) increase respiratory distress
B) alter taste perception
C) interfere with drug therapy
D) increase gas formation
E) decreases carbon dioxide levels
Q2) Nutrition support plays a role in the therapy for MODS by _____.
A) preventing excessive wasting
B) maintaining blood pressure
C) improving gas exchange
D) preventing toxic build-up
E) maintaining cardiac output
Q3) Metabolic stress can result from uncontrolled infection or extensive tissue injury.
A)True
B)False
Q4) Describe the medications used to treat COPD and the possible metabolic side effects.
Q5) What are the potential diet-drug interactions Caroline might experience?
Q6) Describe the body's hormonal responses to stress.
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Chapter 25: Energy - and Protein - Modified Diets for
Cancer and HIV Infection
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Q1) Describe the metabolic changes associated with cancer that contribute to weight loss and nutrient depletion.
Q2) A nurse is working with a cancer client who needs to add kcalories and protein to his diet. The best advice the nurse could offer would be to _____.
A) try new foods and experiment with herbs and spices
B) eat nutrient-dense foods first
C) use plenty of butter and margarine and add milk powder to casseroles
D) do not eat with others, since the company will be too distracting
E) eat fish and poultry more often
Q3) Which nutrition intervention is most appropriate for a patient who complains that food doesn't taste right?
A) "Consume foods chilled or at room temperature."
B) "Let family members prepare food for you."
C) "Avoid foods with strong odors."
D) "Take a walk before you eat."
E) "Only eat foods you like."
Q4) Discuss the concept behind hematopoietic stem cell transplantation.
Q5) Discuss three strategies that might help a cancer patient cope with nausea.
Q6) Explain reasons why HIV patients have reduced food intake.
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