Medical Nutrition Therapy
Mock Exam
Course Introduction
Medical Nutrition Therapy (MNT) focuses on the application of evidence-based nutritional strategies to prevent, manage, and treat health conditions and diseases. This course explores the physiological foundations of nutrition, metabolic responses to illness, and the role of diet in the management of chronic diseases such as diabetes, cardiovascular disease, renal disorders, and gastrointestinal conditions. Students learn to assess nutritional status, develop therapeutic diets, and create individualized nutrition care plans in collaboration with interdisciplinary healthcare teams. Practical components emphasize patient counseling, case study analysis, and the evaluation of current guidelines and research, preparing students to apply MNT principles effectively in clinical and community settings.
Recommended Textbook
Nutrition Therapy and Pathophysiology 3rd Edition by Marcia Nelms
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26 Chapters
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2080 Flashcards
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Page 2
Chapter 1: Role of the Dietitian in the Health Care System
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Sample Questions
Q1) An entry-level dietitian's level of critical thinking will most likely involve:
A) following rules set forth by authorities.
B) avoiding the use of critical thinking for decision-making.
C) assuming that the judgments of more seasoned dietitians are correct.
D) disconnecting from authorities and using her own judgment.
E) allowing others to make critical decisions until she is in a management position.
Answer: A
Q2) Dietetics practice should not be based on tradition but on _______________ research.
Answer: evidence-based
Q3) Attitudes reflect the dietitian's values and should ensure that clinical judgment is made _______________ and _______________.
Answer: fairly; responsibly responsibly; fairly
Q4) Methods used for problem solving that utilize competencies as a component of critical thinking include the scientific method, problem solving, evidence-based practice, diagnostic reasoning, and _______________.
Answer: decision making
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Chapter 2: The Nutrition Care Process
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Sample Questions
Q1) Describe the differences between using specific diets ('renal' diet vs. 'diabetic' diet, for example) and assessment of individual nutrition status.
Answer: Instead of providing nutrition care/education as a result of a diet order for a diabetic or renal diet, the dietitian should carefully assess the nutritional status of each patient to specifically identify what, if any, nutrition problems (diagnoses) exist.
Q2) Standardized nutrition language consists of:
A) concise phrases that are organized into groups.
B) broad terms that are categorized into sets.
C) a list of words that are available to use in documentation.
D) descriptive terms that cannot be used interchangeably.
E) a chart that provides terminology to choose for documentation.
Answer: A
Q3) First and foremost is the need to prioritize the _______________, before writing a nutrition prescription.
Answer: nutrition diagnoses, diagnoses
Q4) Interventions are derived from accurate diagnoses and largely driven by _______________.
Answer: client involvement, patient involvement
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Page 4
Chapter 3: Nutrition Assessment - Foundation of the Nutrition Care Process
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Sample Questions
Q1) Explain how to measure height for a client who is unable to stand up. Describe the pros and cons of the various methods available for measuring height.
Answer: One method is arm span: the client extends the arms from the body at a 90-degree angle and distance is measured between the tips of the two middle fingers. A limitation of this method is that it is an estimation of maximum adult height and not actual, current height. Knee height is another method of height estimation. Height may also be recorded from the patient's memory.
Q2) Today, in most developed countries, concern for nutritional status focuses on the effect of excessive intake of nutrients and energy.
A)True
B)False
Answer: True
Q3) Waist circumference of _______________ inches for women is considered to be predictive of obesity and chronic disease risk in Caucasian, African-American, Hispanic, and Native-American populations.
Answer: 35
Q4) _______________ protein refers to skeletal muscle.
Answer: Somatic
Page 5
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Chapter 4: Nutrition Intervention and Nutrition Monitoring and Evaluation
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Sample Questions
Q1) Which two steps make up nutrition intervention?
A) Monitoring and evaluation
B) Assessing and diagnosing
C) Analyzing and discussing
D) Planning and implementation
E) Prescribing and formulating outcomes
Q2) Which best describes a strategy that may be used to facilitate change?
A) Self-monitoring
B) Competing with others
C) Analyzing habits
D) Shifting responsibility
E) Maintaining routines
Q3) Which is an example of a nutrition diagnosis for which vitamin and mineral supplements might be appropriate?
A) Inadequate fluid intake
B) Increased nutrient needs
C) Increased energy expenditure
D) Food-medication interaction
E) Inconsistent carbohydrate intake
Q4) List the 10 categories in which problem etiologies can be classified.
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Chapter 5: Enteral and Parental Nutrition Support
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Q1) Feeding access is achieved when a feeding tube is placed into the stomach or
Q2) Which describes recommended criteria for use of enteral feedings in a pediatric patient?
A) Weight loss of 5 pounds in 6 months
B) Unable to obtain 20% of caloric needs by mouth
C) Requiring over 4 hours a day to eat
D) Inadequate oral intake for over 48 hours
E) Persistent TSF below the 50th percentile
Q3) Give two examples of each of the following: short-term venous access, long-term venous access.
Q4) Which is an example of a research-supported reason to use enteral nutrition support?
A) Decreased risk of respiratory infections
B) Improved wound healing
C) Increased tolerance of formulas
D) Complete nutritional coverage
E) Ease of administration
Q5) Parenteral solutions are compounded under the supervision of a licensed _______________.
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Chapter 6: Documentation of the Nutrition Care Process
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Sample Questions
Q1) The personality or voice that comes through the text and characterizes the writer for the reader is known as the:
A) spirit.
B) nature.
C) ethos.
D) temperament.
E) philosophy.
Q2) Which describes a function of the patient's medical chart?
A) Communicating information between medical professionals and the public
B) Evaluating medical care for the client's family
C) Upholding the Joint Commission's standards
D) Keeping a record of what has been done for the patient
E) Supporting the need for funding the non-profit facility
Q3) List the three important areas of writing that are necessary for communication that must be understood for all writers.
Q4) The Academy of Nutrition and Dietetics has promoted the use of the _______________ format because it mirrors the steps of the nutrition care process.
Q5) List three examples of guidelines for charting that were stated in the text.
Q6) List each component of the following acronyms: SOAP, ADIME, IER.
Page 8
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Chapter 7: Fluid and Electrolyte Balance
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Q1) Vasopressin causes fluid to be reabsorbed in the tubules of the
Q2) What is the term for abnormal fluid accumulation in the peritoneal cavity (often due to liver disease)?
A) diuresis
B) ascites
C) hypernatremia
D) water intoxication
E) edema
Q3) What is the specific gravity of water?
A) 0.25
B) 0.5
C) 0.75
D) 1.0
E) 2.0
Q4) When blood volume increases, hydrostatic pressure _______________.
Q5) Hypocalcemia most commonly results from a deficit of _______________ or from abnormal vitamin _______________ metabolism.
Q6) Solutes that do not disperse in fluid, such as large protein molecules, are called
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Chapter 8: Acid Base Balance
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Sample Questions
Q1) List the 3 ways the body accommodates all the hydrogen ions it produces.
Q2) What ions do NOT cross the blood-brain barrier?
A) H+ and Ca2+
B) H+ and HCO3-
C) HCO3- and Cl-
D) Na+ and Cl-
E) Na+ and Ca2+
Q3) _______________ is the ion that moves in the opposite direction of HCO3-.
Q4) Acidemia is the actual decrease in pH within the body to:
A) <7.75
B) <7.6
C) <7.55
D) <7.45
E) <7.35
Q5) What is the normal value for oxygen saturation in the blood?
A) 95% or higher
B) between 94-96%
C) 97% or higher
D) between 97-99%
E) 99.1% or higher
10
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Chapter 9: Cellular and Physiological Response to Injury -
the Role of the Immune System
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Sample Questions
Q1) What vitamin is needed to make collagen during wound repair?
A) vitamin A
B) vitamin B5
C) vitamin C
D) vitamin D
E) vitamin E
Q2) What do chemotaxins attract to the site of injury?
A) interleukins and thromboxanes
B) prostaglandins and histamines
C) neutrophils and monocytes
D) T cells and B-lymphocytes
E) COX-1 and COX-2 enzymes
Q3) _______________ vaccines are live mutants that have lost their pathogenicity while retaining immunogenicity, and provide more natural protection.
Q4) What are transplants between identical twins called?
A) allografts
B) xenografts
C) halografts
D) autografts
E) isografts
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Chapter 10: Nutritional Genomics
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Sample Questions
Q1) In humans, the inheritance of blue eyes is classified as:
A) X-linked dominant
B) X-linked recessive
C) autosomal recessive
D) autosomal dominant
E) Y-linked
Q2) List the classifications of inherited genes.
Q3) There are predicted to be a few hundred _______________ genes in humans.
Q4) What is the nitrogenous base that pairs with adenine,in human DNA?
A) guanine
B) cytosine
C) arginine
D) thymine
E) lysine
Q5) What percentage of human DNA is non-coding DNA?
A) 95%
B) 90%
C) 85%
D) 80%
E) 75%
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Chapter 11: Pharmacology
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Q1) The top selling dietary product in the Natural and Health Food Market is _______________.
Q2) Amitriptyline, a common antidepressant, may cause a decrease in _______________ production.
Q3) Medications that affect gastric emptying time include _______________ such as metoclopramide.
Q4) Considering Mrs. Z is takingwarfarin, which element in her diet is a concern for a negative drug-nutrient interaction?
A) cold tea
B) orange juice
C) eggs
D) bacon
E) spinach
Q5) Calcium supplements are absorbed best in an _______________ environment.
Q6) Willow bark acts like the common drug _______________.
Q7) Discuss the role of nutrition therapy in pharmacotherapy and provide an example of a drug-nutrient interaction.
Q8) Describe what excipients are. List some examples and what they do.
Q9) List the common CAM use for licorice root.
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Chapter 12: Diseases and Disorders of Energy Imbalance
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Q1) The most common type of bariatric surgery performed in the United States is:
A) laparoscopic adjustable gastric banding.
B) open adjustable gastric banding.
C) laparoscopic vertical sleeve gastrectomy.
D) Roux-en-Y gastric bypass.
E) the duodenal switch with biliopancreatic diversion.
Q2) Which is classified as a risk factor that would place a patient at high priority for treatment of overweight and obesity?
A) Increased high-density lipoprotein cholesterol
B) Family history of polycystic kidney disease
C) Alcohol consumption of more than 2 drinks per day
D) Impaired fasting glucose
E) Decreased low-density lipoprotein cholesterol
Q3) Which factor influences the thermic effect of food (TEF) during a meal?
A) The macronutrient composition of the meal
B) The setting in which the meal is consumed
C) The position of the person eating the meal
D) The total energy expenditure of the individual
E) The thermoregulation of the room where the meal is served
Q4) Describe the basic formula for calculating BMI in adults.
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Chapter 13: Diseases of the Cardiovascular System
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Sample Questions
Q1) List examples of foods to choose and foods to avoid when decreasing saturated fat and increasing unsaturated fats in the following categories: dairy products, fats and oils, breads and cereals.
Q2) The causes of an acute MI or unstable angina are plaque erosion, rupture of a plaque resulting in formation of a thrombus, and vasoconstriction.
A)True
B)False
Q3) Typically, heart failure begins with the _______________, the heart's primary pumping chamber.
Q4) Which is an example of a high-sodium product that should be limited in a patient with heart failure?
A) edamame
B) flour tortillas
C) chocolate milk
D) tuna
E) eggnog
Q5) _______________ are medications that affect the movement of calcium, which causes the blood vessels to relax and therefore reduces vasoconstriction.
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Chapter 14: Diseases of the Upper Gastrointestinal Tract
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Q1) Describe the process of a focused assessment of the upper gastrointestinal tract for a client, including relevant measurements and subjective data.
Q2) The post-gastrectomy diet encourages a well-balanced diet slightly higher in protein and fat than what is recommended by the U.S. Dietary Guidelines.
A)True
B)False
Q3) The most common symptoms of gastroparesis are:
A) abdominal pain and hematemesis.
B) nausea, vomiting, and postprandial fullness.
C) abdominal distention, nausea, and flatulence.
D) epigastric pain and blood in the stool.
E) heartburn and food impaction.
Q4) The gold standard for diagnosis of gastroparesis is the:
A) upper GI endoscopy.
B) endoscopic retrograde cholangiopancreatography (ERCP).
C) endoscopic ultrasound.
D) esophagography test.
E) scintigraphic gastric emptying test.
Q5) List the seven functions of saliva in the oral cavity.
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Chapter 15: Diseases of the Lower Gastrointenstinal Tract
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Q1) With chronic ulcerative colitis, the intestinal wall can become so thin that the mucosa is ulcerated, which is referred to as _______________.
Q2) More than 50% of the small intestine has to be removed before any significant reduction in its capability is observed.
A)True
B)False
Q3) The _______________ colon ends in the rectum where another sphincter (the anal sphincter) controls voluntary release of intestinal contents.
Q4) One nutritional intervention for treating IBS is the use of a traditional _______________ diet, which eliminates all possible foods related to the patient's symptoms.
Q5) At least two-thirds of IBS patients associate the signs and symptoms they experience with characteristics of the foods that they eat.
A)True
B)False
Q6) _______________ supplements, which are triglycerides that contain primarily caprylic (C8) and capric (C10) fatty acids, can be used to increase caloric intake.
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Page 17
Chapter 16: Diseases of the Liver - Gallbladder - and Exocrine Pancreas
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Q1) Ammonia is absorbed and transported in the intestinal venous blood to the liver, where it is metabolized into what substance?
A) amino acids
B) urea
C) fatty acids
D) glucose
E) glycogen
Q2) Cystic fibrosis is an inherited disorder of epithelial transport and is one of the most common lethal inherited disorders of which ethnic group?
A) Asians
B) African Americans
C) Caucasians
D) Pacific Islanders
E) Native Americans
Q3) _______________ presents as small, brief, intermittent movements of individual fingers and may be seen in patients with hepatic encephalopathy.
Q4) Briefly describe the three major hypotheses that explain the impairment of neurotransmission involved with hepatic encephalopathy.
Page 18
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Chapter 17: Diseases of the Endocrine System
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Q1) What chemical class of hormones do the majority of endocrine hormones fall into?
A) steroid hormones
B) amine hormones
C) neurohormones
D) peptide hormones
E) sugar-based hormones
Q2) List the basic types of insulin delivery regimens.
Q3) The varieties of insulin available are made by genetically modifying the _______________ sequence so that there are varying pharmacokinetics.
Q4) Intensive insulin therapy requires multiple _______________ injections of rapid-acting insulin.
Q5) Of the four meal planning approaches used in the Diabetes Control and Complications Trial (DCCT), the most successful was _______________counting.
Q6) Explain the "dawn phenomenon."
Q7) T2DM is caused by a combination of abnormal insulin secretion and insulin resistance.
A)True
B)False
Page 19
Q8) Severe hypoglycemia is defined as blood glucose level of _______________ mg/dL.
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Chapter 18: Diseases of the Renal System
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Sample Questions
Q1) What vegetables are low in potassium?
A) beans, artichokes, beets
B) squash, broccoli, Brussels sprouts
C) cucumbers, celery, onions
D) carrots, lentils, parsnips
E) potatoes, pumpkin, legumes
Q2) Acute kidney injury is a disorder characterized by an abrupt increase in GFR that results in failure to maintain fluid, electrolyte, and acid-base balance.
A)True
B)False
Q3) What is a more common term for nephrolithiasis?
A) kidney necrosis
B) kidney cancer
C) kidney stones
D) viral kidney infection
E) bacterial kidney infection
Q4) Secondary hyperparathyroidism in dialysis patients can progress to severe, intractable forms of _______________ disease.
Q5) Describe the procedure of hemodialysis.
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Chapter 19: Diseases of the Hematological System
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Q1) If the MD were to prescribe folate for PS which of the following is a potential concern?
A) folate could mask a B12 deficiency
B) folate is very expensive and hard to find
C) folate is a blood thinner
D) folate negatively interacts with his iron supplement
E) folate could promote growth of H . pylori
Q2) Describe the dietary factors that regulate hemostasis.
Q3) What plasma protein factor is deficient in hemophilia A?
A) VIII
B) X
C) VI
D) V
E) IV
Q4) Disorders of porphyrin metabolism include the porphyria syndromes, where one or more of the intermediates for _______________ synthesis are abnormal or the enzymes for the steps are inactive.
Q5) The _______________ are inherited disorders of abnormal alpha or beta globin synthesis.
Q6) Discuss how aspirin impacts hemostasis.
Page 21
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Chapter 20: Diseases and Disorders of the Neurological System
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Q1) Approximately _______________ percent of Guillain-Barré syndrome (GBS) patients report onset of symptoms 1-3 weeks after an infection.
Q2) Because spinal cord injury patients have lower metabolic rates, preventing excessive _______________ is crucial.
Q3) Quadriplegia or tetraplegia refers to paralysis involving what part(s) of the body?
A) all four limbs
B) the entire body
C) the legs and feet
D) the arms and hands
E) hands and fingers
Q4) The _______________ status of patients at the onset of the injury is an important consideration for a successful recovery.
Q5) Paraplegia is defined as paralysis involving the lower body below the _______________.
Q6) _______________ is a term used to describe a cluster of symptoms including bradykinesia with rigidity and/or tremor.
Q7) Discuss the prevention of stroke and acute care following stroke.
Page 22
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Chapter 21: Diseases of the Respiratory System
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Q1) Asthma is usually divided into two types: sinus and bronchus asthma.
A)True
B)False
Q2) Malnutrition associated with poor intake appears to have an impact on the strength and endurance of respiratory muscles, particularly the diaphragm.
A)True
B)False
Q3) How long after surgery can most lung transplant patients begin to eat solid food?
A) 12 hours
B) 1-2 days
C) 3-5 days
D) 1 week
E) 2 weeks
Q4) What are leukotrienes and how are they involved in asthma.
Q5) Cardiac complications of COPD include _______________ and _______________ ventricular failure.
Q6) _______________ are chemical mediators produced by the body that contribute to the development of asthma.
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Chapter 22: Metabolic Stress and the Critically Ill
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Q1) For normal-weight individuals, _______________ kcal/kg of actual body weight per day are recommended during critical illness.
Q2) What is the key difference between the body's physiological reaction to starvation and metabolic stress?
A) adaptation occurs during metabolic stress
B) adaptation occurs during starvation
C) starvation can lead to death
D) weight loss occurs with starvation
E) metabolic stress is not related to diet
Q3) What amino acid is the primary substrate required for gluconeogenesis?
A) lysine
B) arginine
C) alanine
D) glutamine
E) cysteine
Q4) Describe the effects general anesthesia can have on the GI tract and how this effects post-operative feeding recommendations.
Q5) List what four types of external forces can cause burns.
Q6) Provide a comprehensive definition of sepsis.
Page 24
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Chapter 23: Neoplastic Disease
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Q1) In the Tumor Node Metastases (TNM) Staging System, what does "N0" mean?
A) nearby lymph nodes do not contain cancer
B) nearby lymph nodes cannot be evaluated
C) tumor can't be measured
D) metastasis can't be evaluated
E) no distant metastases were found
Q2) Epidemiologic studies have found that heavy consumption of _______________ increase cancer risk, especially for colorectal, bladder, prostate, breast, gastric, oral, and pancreatic cancers.
Q3) Immune-enhancing enteral formulas containing mixtures of arginine, nucleic acids, and _______________ may be beneficial in malnourished patients undergoing major cancer operations.
Q4) What are the two agents that have been recognized as useful for appetite stimulation in cancer patients?
A) methotrexate and anti-diarrheal agents
B) sugar-free chewing gum and hard sour candy
C) methotrexate and prokinetics
D) megestrol acetate and corticosteroid agents
E) cisplatin and corticosteroid agents
Q5) Define cancer.
Page 25
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Chapter 24: HIV and Aids
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Q1) What kind of exercise improves insulin sensitivity?
A) aerobic
B) anaerobic
C) static resistance
D) progressive resistance
E) fluctuating resistance
Q2) What is the beneficial function of Glitazones for HIV-positive patients?
A) anabolic steroids
B) sleeping aids
C) insulin resistance reducers
D) appetite stimulants
E) energy boosters
Q3) A number of _______________ abnormalities can persist despite the suppression of HIV replication.
Q4) What does HIV target and how does it result in immunodeficiency syndrome?
Q5) HDL cholesterol levels are _______________ in AIDS patients.
Q6) In 2010, the FDA approved the daily injectable drug _______________ to treat accumulation of visceral fat around the liver, stomach, and other abdominal organs.
Q7) Proton pump inhibitors reduce acid and may affect absorption of
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Chapter 25: Diseases of the Musculoskeletal System
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Q1) Describe the etiology of osteoporosis.
Q2) Nicotine and cadmium in tobacco smoke are toxic to what type of cells?
A) chondrocytes
B) osteoclasts
C) osteoblasts
D) osteocytes
E) osteogenic cells
Q3) Willow bark may be helpful for osteoarthritis primarily due to what property?
A) antipyretic
B) analgesic
C) anti-inflammatory
D) blood thinning
E) anti-hypertensive
Q4) Carpopedal spasm results from tetany occurring in the hands and feet and can be a sign of what?
A) hypocalcemia
B) hypercalcemia
C) hypophosphatemia
D) hyperphosphatemia
E) hyperkalemia
Page 27
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Chapter 26: Metabolic Disorders
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Q1) What is the targeted blood Phe range, as recommended in the new ACMG guidelines, for all individuals with PKU?
A) 20-30 mol/L
B) 65-105 mol/L
C) 120-360 mol/L
D) 400-600 mol/L
E) 650-820 mol/L
Q2) What is the affected amino acid in the metabolic disorder isovaleric acidemia?
A) valine
B) tryptophan
C) leucine
D) isoleucine
E) arginine
Q3) What is the affected amino acid in the metabolic condition phenylketonuria (PKU)?
A) methionine
B) leucine
C) isoleucine
D) phenylalanine
E) cysteine
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Page 28