Clinical Nutrition
Practice Exam
Course Introduction
Clinical Nutrition explores the role of nutrition in the prevention, diagnosis, and management of diseases. The course covers the principles of assessing nutritional status, developing therapeutic diets, and implementing evidence-based dietary interventions for various medical conditions such as diabetes, cardiovascular diseases, gastrointestinal disorders, and cancer. Students will learn how to interpret laboratory results, collaborate with healthcare teams, and tailor nutrition plans to meet individual patient needs, emphasizing the impact of nutrition on patient outcomes and overall health.
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) The 2010 Dietary Guidelines for Americans recommend keeping the consumption of trans fatty acids as low as possible. To do this, you should avoid eating _____.
A) tropical oils
B) dairy products
C) partially hydrogenated oils
D) avocadoes, olives, and nuts
E) peanut butter
Answer: C
Q2) Which food has the highest nutrient density for calcium?
A) cheddar cheese
B) fat-free milk
C) ice cream
D) frozen yogurt
E) butter
Answer: B
Q3) There is no nationally accepted definition for the term nutritionist.
A)True
B)False
Answer: True
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Page 3
Chapter 2: Carbohydrates
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Sample Questions
Q1) High-fructose corn syrup is composed of _____.
A) fructose and glucose
B) glucose and galactose
C) sucrose and maltitol
D) fructose and galactose
E) sucrose and syrulose
Answer: A
Q2) The primary source of energy for most cells in the body under normal conditions is _____.
A) sucrose
B) amino acids
C) fructose
D) glucose
E) fatty acids
Answer: D
Q3) All plant foods have attributes that may reduce the risks of colon and rectal cancers.
A)True
B)False
Answer: True
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Page 4
Chapter 3: Lipids
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Sample Questions
Q1) Which snack food (in a reasonable portion size) would be the best choice for a person wanting to decrease his or her risk of heart disease?
A) almonds
B) unsalted crackers
C) baked chips
D) popcorn
E) cookies
Answer: A
Q2) The compound that forms the backbone of triglycerides is called ____.
A) glycerol
B) fatty acid
C) acetic acid
D) glycogen
E) adipose
Answer: A
Q3) Olestra is fully absorbed by the body during digestion.
A)True
B)False
Answer: False
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Page 5
Chapter 4: Protein
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Sample Questions
Q1) Research supports the idea that a vegetarian diet may be healthier than a diet that includes meat.
A)True
B)False
Q2) A person is in positive nitrogen balance during ____.
A) growth
B) old age
C) exercise
D) adulthood
E) starvation
Q3) Vegetarians should eat iron-rich foods along with foods rich in ____ to increase iron absorption.
A) vitamin C
B) calcium
C) phytic acid
D) fiber
E) potassium
Q4) Under special circumstances, a nonessential amino acid can become essential.
A)True
B)False
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Chapter 5: Digestion and Absorption
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Sample Questions
Q1) The digestive tract begins at the ____ and ends at the ____.
A) stomach; large intestine
B) pharynx; rectum
C) lower esophageal sphincter; rectum
D) mouth; anus
E) tongue; renal glands
Q2) Describe the role of the stomach in the process of digestion.
Q3) Another name for the digestive tract is the ____.
A) urinary tract
B) exocrine system
C) gastrointestinal tract
D) muscular system
E) bolus reduction system
Q4) 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
Q5) Explain the benefits of intestinal flora to health.
Page 7
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Chapter 6: Metabolism Energy Balance and Body
Composition
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Sample Questions
Q1) A good indicator of fat distribution on an individual is _____.
A) BMI
B) body weight
C) hip circumference
D) waist circumference
E) underarm fat
Q2) Which health risk associated with obesity causes elevated fasting glucose levels?
A) hypertension
B) heart disease
C) sleep apnea
D) insulin resistance
E) low blood pressure
Q3) When carbohydrate consumption is in excess of body needs, the excess glucose is
A) not absorbed from the small intestine
B) excreted in the feces
C) stored as glycogen and fat
D) stored as glycogen only
E) stored temporarily as ATP
Page 8
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Chapter 7: Weight Management Overweight and Underweight
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Sample Questions
Q1) A lean person's fasting blood level of ghrelin is typically higher than in an obese person.
A)True
B)False
Q2) Which scenario illustrates the best example of the link between food behavior and emotions?
A) someone who eats fast food for lunch every day
B) someone who would rather sit home and eat than ask a friend to go to a movie and risk rejection
C) someone who always eats popcorn while watching a movie
D) a pregnant women who craves pickles
E) someone who eats funnel cake at the beach
Q3) Physical activity should be an _____ part of a weight-management program.
A) invitational
B) excessive
C) optional
D) integral
E) irrational
Q4) Describe why physical activity is very important in a weight-loss program.
Q5) Briefly describe the set-point theory and its role as a cause of obesity.
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Chapter 8: The Vitamins
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Sample Questions
Q1) Regarding vitamin E supplementation, scientists have concluded that _____.
A) there is not enough evidence to recommend taking supplements to prevent heart disease
B) sufficient evidence exists to recommend that everyone over 40 should take a supplement
C) large doses are more beneficial than low doses
D) all people who have had a heart attack should take a supplement
E) Vitamin E, in conjunction with fish oils, will prevent most cancers
Q2) Name the antioxidant vitamins and describe how they function in the body.
Q3) Excessive intakes of vitamin D by adults may result in _____.
A) greater bone density
B) mineral deposits in soft tissues such as the kidney
C) deformity of the leg bones, ribs, and skull
D) increased bone calcification
E) decreased bone calcification
Q4) In vegans, a deficiency of vitamin B may be masked by a high intake of folate.
A)True
B)False
Q5) What is riboflavin? Identify its chief functions in the body, the symptoms characteristic of a deficiency, and significant food sources.
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Chapter 9: Water and the Minerals
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Sample Questions
Q1) An important function of chloride in the body is to _____.
A) maintain fluid balance
B) regulate metabolism
C) develop bone cells
D) control blood glucose levels
E) strengthen bones and teeth
Q2) Low potassium and high sodium intakes can _____.
A) contribute to weight loss
B) block reabsorption of water
C) raise blood pressure
D) raise blood sugar
E) inhibit energy metabolism
Q3) Fluoride seems to be helpful in preventing _____.
A) cancer
B) diabetes
C) dental decay
D) heart disease
E) goiter
Q4) Discuss the functions of copper in the body.
Q5) Describe how the body regulates the absorption of calcium.
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Chapter 10: Fitness and Nutrition
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Sample Questions
Q1) Does lactate really cause muscle fatigue during intense exercise?
Q2) Trained muscles burn _____ fat and at higher intensities than untrained muscles, so they require _____ glucose to perform the same amount of work.
A) more; less
B) less; more
C) more; more
D) less; less
E) more; no
Q3) 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.
Q4) Which food would be the best choice for a pregame meal?
A) black beans and rice
B) pasta in marinara sauce
C) peanut butter and jelly sandwich
D) cheese and crackers
E) creamed corn
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Chapter 11: Nutrition Through the Life Span Pregnancy and Lactation
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Sample Questions
Q1) Women who develop gestational diabetes have a greater risk of developing _____ later in life.
A) heart disease
B) type 2 diabetes
C) gastrointestinal problems
D) osteoporosis
E) hyponatremia
Q2) How should adolescents who become pregnant adjust their nutrient intakes and overall health strategy to meet the demands of a growing fetus?
Q3) What can maternity facilities do to encourage women to breastfeed their infants?
Q4) Breastfeeding should not being until one month following birth.
A)True
B)False
Q5) If a lactating woman's diet is poor, her milk _____.
A) volume will be normal but the nutrient quality will be poor
B) will be thin and watery
C) quality will be maintained at the expense of maternal stores
D) will contain toxic products
E) quality will diminish exponentially over time
Q6) Discuss the potential health problems of a low-birthweight infant. Page 13
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Page 14
Chapter 12: Nutrition Through the Life Span Infancy
Childhood and Adolescence
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Sample Questions
Q1) Adolescents who eat at home with family members _____.
A) tend to gain more weight
B) are less influenced by their peers
C) consume a more nutritious diet
D) watch more television
E) are almost always vegan
Q2) One clear advantage of breastfeeding is the protection against _____.
A) oligosaccharides
B) excessive weight loss later in life
C) lysozyme infestations
D) intestinal infections
E) uncontrolled bleeding
Q3) Research conducted on preschool children's food intakes has shown that _____.
A) food energy intake varied very little from meal to meal
B) the total daily energy intake was highly inconsistent
C) if they ate more at one meal, they ate less at the next
D) energy intake decreases as children get older
E) they avoid fried food
Q4) Describe an ideal treatment program for childhood obesity.
Q5) Identify the nutrients most often found lacking in the diets of teenagers.
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Chapter 13: Nutrition Through the Life Span Later Adulthood
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Sample Questions
Q1) Life expectancy in the U.S. is _____ years.
A) 68
B) 72
C) 75
D) 79
E) 81
Q2) Severe fat restriction among older adults may lead to _____.
A) nutrient deficiencies
B) weight gain
C) greater risk of cancer
D) dehydration
E) depression
Q3) Basal metabolic rate declines _____ percent per decade, in part because lean body mass and thyroid hormones diminish.
A) 8-10
B) 2-3
C) ½ to 1
D) 5 to 6
E) 1 to 2
Q4) Why are some elderly people at risk of developing vitamin D deficiency?
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Chapter 14: Illness and Nutrition Care
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Sample Questions
Q1) Joe, a 69-year-old widower, has lost 27 pounds since his wife's death a year ago. He is 5'11" and his usual body weight is 173 pounds. What is his %UBW?
A) 15%
B) 69%
C) 84%
D) 90%
E) 101%
Q2) Which factor is not a limitation of a 24-hour dietary recall?
A) the previous day's intake may not be typical
B) they are difficult to obtain
C) the person may not be able to accurately report portion sizes
D) they provide data for one day only
E) variations in diet
Q3) A food frequency questionnaire is a survey of food consumption over one ____.
A) year
B) month
C) week
D) day
E) hour
Q4) Differentiate between regular and modified diets.
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Chapter 15: Medications - Diet Drug Interactions - and Herbal Supplements
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Q1) Grapefruit juice can increase the physiological effects of some drugs by _____.
A) affecting kidney excretion
B) decreasing blood concentration of some drugs
C) inactivating certain drugs
D) altering the action of certain drugs
E) inactivating enzymes that metabolize drugs
Q2) Which form of alternative medicine proposes that a person's "life force" can foster self-healing?
A) homeopathic medicine
B) naturopathic medicine
C) bioelectrical medicine
D) chiropractic medicine
E) acupuncture medicine
Q3) Which food should not be eaten in a tyramine-controlled diet?
A) tomatoes
B) liver
C) cucumbers
D) pork sausage
E) beef
Q4) What are three general ways in which diet and drugs can interact?
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Chapter 16: Specialized Nutrition Support - Enteral and Parenteral Nutrition
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Sample Questions
Q1) The advantages of a closed feeding system include _____.
A) less likelihood of contamination
B) lower initial cost
C) increased nurse contact with the patient
D) increased patient tolerance
E) less stress on the patient's digestive system
Q2) Which formula component is helpful in treating diarrhea and constipation and maintaining blood glucose levels?
A) glucose
B) hypertonicity
C) fiber
D) proteins
E) lipids
Q3) The use of PPN is not possible if a patient's peripheral veins are weak.
A)True
B)False
Q4) Carbohydrates will provide approximately 50% of Ms. Johnson's kcalories. What form of carbohydrate will be used and how is the caloric content different from that of glucose?
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Q5) What type of nutrition support is appropriate for Ms. Johnson at this time? Why?
Chapter 17: Foods and Food Consistency for Upper Gi Disorders
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Q1) Postgastrectomy diets limit the amounts of _____.
A) fat
B) sugar
C) protein
D) complex carbohydrate
E) water
Q2) The most effective medications for suppressing gastric acid secretion are _____.
A) antibiotics
B) proton-pump inhibitors
C) antacids
D) NSAIDs
E) steroids
Q3) Xerostomia is a side effect of many medications and can make speaking and swallowing more difficult.
A)True
B)False
Q4) What types of medications might Kelly's doctor prescribe and why?
Q5) It is possible to meet all nutrient needs with a mechanically altered diet.
A)True
B)False
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Chapter 18: Fiber-Modified Diets for Lower Gastrointestinal
Tract Disorders
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Q1) Mr. Taylor seeks medical treatment for frequent, urgent bowel movements streaked with mucus and blood, and tests reveal a large, continuous area of inflammation affecting the first two layers of tissue in his rectum. What is Mr. Taylor's likely diagnosis?
A) Crohn's disease
B) ulcerative colitis
C) celiac disease
D) irritable bowel syndrome
E) fistulas
Q2) Diverticular disease often occurs with _____.
A) a bacterial infection
B) aging
C) constipation
D) food intolerances
E) hypertension
Q3) Differentiate between diverticulosis and diverticulitis.
Q4) What causes diverticula to develop?
Q5) Describe potential problems associated with probiotic use.
Q6) Why was Mr. Fruge unaware of his condition until now?
Q7) Compare the causes of osmotic and secretory diarrhea.
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Chapter 19: Carbohydrate - and Fat Modified Diets for
Malabsorption Disorders
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Q1) Elevated levels of _____ are indicative of iron deficiency.
A) serum iron
B) serum ferritin
C) serum transferrin
D) bone marrow iron
E) RBC count
Q2) The initial diet order for the patient with acute pancreatitis should be _____.
A) clear liquids
B) a fat-controlled diet
C) nothing by mouth
D) a regular diet
E) high-kcalorie diet
Q3) Many lactose-intolerant individuals can tolerate up to 2 cups of milk per day, especially when intake is divided throughout the day and taken with food.
A)True
B)False
Q4) Explain the process of intestinal adaptation.
Q5) Explain how enzyme replacement preparations avoid digestion by the acid of the stomach.
Q6) Describe dietary concerns for someone who is lactose intolerant. Page 22
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Chapter 20: Nutrition Therapy for Liver and Gallbladder Diseases
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Q1) fatty liver
A)an accumulation of fat in the liver
B)enlargement of the liver
C)an advanced stage of liver disease in which extensive scarring replaces healthy liver tissue, causing impaired liver function and liver failure
D)elevated blood pressure in the portal vein due to obstructed blood flow through the liver
E)blood vessels that enlarge in order to allow an alternative pathway for diverted blood
F)abnormally dilated blood vessels
G)yellow discoloration of the skin and eyes due to an accumulation of bilirubin
H)liver inflammation that is associated with fatty liver
I)an abnormal accumulation of fluid in the abdominal cavity
J)excess triglycerides packaged and exported to the blood
Q2) People with protein-energy malnutrition may experience fatty liver.
A)True
B)False
Q3) Describe appropriate nutrition intervention before and after a liver transplant.
Q4) What is the cause of the pain associated with cholelithiasis?
Page 24
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Chapter 21: Carbohydrate Controlled Diets for Diabetes
Mellitus
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Sample Questions
Q1) Intensive insulin therapy can cause _____.
A) hyperglycemia
B) a loss of appetite
C) weight gain
D) low albumin levels
E) alkalosis
Q2) Define metabolic syndrome and describe the criteria for diagnosis.
Q3) The treatment of type 2 diabetes stresses _____ because of its beneficial effects on improving blood glucose control and blood lipids, and reducing blood pressure.
A) physical activity
B) a low-fat diet
C) sulfonylureas
D) a sodium-controlled diet
E) dopamine agonists
Q4) Describe the primary criteria used to confirm a diagnosis of diabetes.
Q5) In people with diabetes, claudication may be due to polyuria.
A)True
B)False
Q6) Describe hyperosmolar hyperglycemic syndrome of type 2 diabetes.
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Chapter 22: Fat Controlled - Mineral Modified Diets for
Cardiovascular Diseases
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Q1) Explain the medical nutrition therapy for hypertriglyceridemia.
Q2) To follow the DASH diet, patients should _____.
A) choose fruit and unsalted pretzels as snacks
B) use bouillon cubes and soy sauce to flavor foods
C) avoid nuts and seeds
D) reduce the amount of fiber consumed
E) use red meat and poultry as primary protein source
Q3) People with tremors, spasticity, and uneven or jerky movements may benefit from the use of _____.
A) a rocker knife
B) a cutout plastic cup
C) weighted utensils
D) a battery-powered feeding machine
E) flexible utensils
Q4) Adaptive utensils and adequate training enable some people with feeding disabilities to be independent.
A)True
B)False
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Q5) Summarize the therapeutic lifestyle changes for lowering the risk of coronary heart disease.
Chapter 23: Protein - Mineral - and Fluid Modified Diets for Kidney Diseases
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Q1) The various symptoms and complications that develop in the final stages of chronic kidney disease are collectively referred to as _____.
A) anemia
B) PEM
C) uremic syndrome
D) hyperkalemia
E) osteodystrophy
Q2) Calcium oxalate stones usually result from _____.
A) hypercalciuria
B) hyperkalemia
C) hyperphosphatemia
D) hypercholesterolemia
E) hypocalciuria
Q3) What are kidney stones and how do they develop?
Q4) Describe how drug therapy is used to control some of the complications of chronic kidney disease.
Q5) What are the possible causes of Mr. Forbes's calcium oxalate stone?
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Q6) Why is appropriate kcalorie intake important in the nutrition care of patients with chronic kidney disease?
Chapter 24: Energy - and Protein - Modified Diets for
Metabolic and Respiratory Stress
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Q1) Refeeding syndrome is characterized by _____.
A) fluid and electrolyte shifts
B) infections
C) respiration issues
D) sepsis
E) inflammation
Q2) A COPD patient who complains of abdominal discomfort and dyspnea may benefit from _____.
A) small, frequent meals
B) a low-fat diet
C) a high-fiber diet
D) consuming more liquids
E) lying down
Q3) A patient is admitted to the ER with multiple gunshot wounds. The initial treatment includes _____.
A) beginning enteral nutrition
B) administering intravenous (IV) fluids
C) beginning PPN
D) referral to the dietitian
E) anti-inflammatory medications
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Chapter 25: Energy - and Protein - Modified Diets for
Cancer and HIV Infection
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Q1) In order to increase Ms. Arther's protein intake, you suggest that she consume _____ freely.
A) fruit spreads
B) mayonnaise
C) cheese
D) butter
E) olive oil
Q2) A nurse is working with a cancer patient admitted to the hospital with complaints of loss of appetite and weight loss. An assessment of the client also reveals depletion of lean body mass and serum protein. The nurse accurately recognizes these as characteristics of _____.
A) graft-versus-host disease
B) human immunodeficiency virus
C) thrush
D) cancer cachexia
E) neutropenia
Q3) Describe HIV-lipodystrophy syndrome and discuss current treatment strategies.
Q4) Cancer cachexia affects over 80 percent of people with cancer.
A)True
B)False
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