Nutrition and Diet Therapy
Mock Exam
Course Introduction
This course explores the fundamental principles of human nutrition and their application in the promotion of health and disease prevention. It examines the digestion, absorption, and metabolism of nutrients, including carbohydrates, proteins, fats, vitamins, and minerals. Students will learn to assess nutritional needs, understand the dietary requirements across the lifespan, and address nutrition-related disorders. Emphasis is placed on the role of diet therapy in managing conditions such as diabetes, cardiovascular diseases, gastrointestinal disorders, and obesity. The course integrates evidence-based dietary guidelines and therapeutic nutrition strategies to promote optimal health outcomes.
Recommended Textbook
Nutrition Therapy and Pathophysiology 3rd Edition by Marcia Nelms
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2080 Flashcards
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Chapter 1: Role of the Dietitian in the Health Care System
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Q1) The attitude of thinking independently is best demonstrated by:
A) listening to both sides of a discussion.
B) admitting limitations.
C) asking for help when needed.
D) not settling for quick solutions.
E) basing decisions on your own conclusions.
Answer: E
Q2) Medical doctors are commonly responsible for the initial nutrition screening of patients and for notifying the dietitian if a patient's intake is inadequate.
A)True
B)False
Answer: False
Q3) Dietitians continually use the process of _______________ to determine the nutrition diagnosis and monitor a patient's progress and/or response to nutrition therapy.
Answer: diagnostic reasoning
Q4) Nutritional care requires _______________ among members of the entire health care team.
Answer: collaboration
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Chapter 2: The Nutrition Care Process
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Q1) Evidence-based guidelines link external _______________ regarding nutrition care to a(n) _______________.
Answer: scientific evidence; specific health problem
Q2) Based on Ms. S's nutrition profile, the dietitian contacts the physician for recommendations for parenteral feedings. This action is an example of which domain of the nutrition intervention process?
A) Coordination of nutrition care
B) Food and nutrient delivery
C) Nutrition education
D) Anthropometric measurements
E) Nutrition counseling
Answer: A
Q3) The purpose of nutritional care is to:
A) cure the underlying medical problem or disease.
B) restore a state of nutritional balance.
C) impact all lifestyle, environmental, and food and nutrient factors.
D) increase supplementation.
E) maintain a focus on important vitamins and nutrients.
Answer: B
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Page 4
Chapter 3: Nutrition Assessment - Foundation of the Nutrition Care Process
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Q1) Explain food insecurity and its impact on residents of the United States. List interventions that the clinician can implement to assist patients who have food security issues.
Answer: Food security refers to the ability to obtain adequate food to maintain an active, healthy lifestyle. In 2012, 49 million Americans were unable to purchase or acquire enough food to sustain their families Most susceptible to food insecurity are single-parent households in rural or large cities, Black and Hispanic households, and families with incomes below the federal poverty line. Useful approaches and resources for practitioners: obtain thorough family and medical histories to assess risk and identify recent changes in health and/or mental status, health care access and screenings, insurance or employment status; identify at-risk households by utilizing the USDA Food Security Survey Module, or connect food-insecure families with food pantries and existing social services at the local, state, and federal levels.
Q2) Just as the physical examination is the cornerstone of medical assessment, _______________ provides the foundation for the nutrition care process.
Answer: nutrition assessment, nutritional assessment
Q3) _______________ protein refers to skeletal muscle.
Answer: Somatic
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Chapter 4: Nutrition Intervention and Nutrition Monitoring and Evaluation
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Q1) Describe two different theories that may be utilized in nutrition counseling and list examples of their clinical applications.
Q2) The fourth and last domain of nutrition interventions is _______________.
Q3) Nutrition interventions are intended to positively change:
A) food and nutrient delivery and intake.
B) the scope of practice for the dietitian.
C) the client's knowledge of vitamins and minerals.
D) beliefs surrounding food preparation.
E) cultural biases toward meal planning.
Q4) A nutrition diagnosis includes an etiology of the problem and:
A) examples of the effects of the problem.
B) a reason for solving the problem.
C) a statement describing the problem.
D) a plan for changing the problem.
E) signs and symptoms describing the problem.
Q5) _______________ are defined as commercial or prepared foods or beverages intended to supplement energy, protein, carbohydrate, fiber, and/or fat intake.
Page 6
Q6) Describe the limitations associated with clear liquid diets.
Q7) "Nutrition problem no longer exists" would be recorded as "_______________."
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Chapter 5: Enteral and Parental Nutrition Support
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Q1) The outer lumen diameter of a feeding tube is described using a measurement called _______________ size.
Q2) Which best describes a common consequence of malnutrition?
A) increased gastric emptying
B) delayed wound healing
C) Cirrhosis
D) atrophic gastritis
E) hearing loss
Q3) Which describes an advantage of compounding parenteral solutions in the hospital pharmacy?
A) Cost effectiveness
B) Increased patient satisfaction
C) Decreased risk of infection
D) The ability to combine blood products with the solution, if necessary
E) Reduction in nursing requirements
Q4) Among infants, _______________ or _______________ are typically used for enteral feedings.
Q5) _______________ feeding tubes enter the gastrointestinal tract through the nose and reside in the duodenum or jejunum.
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Chapter 6: Documentation of the Nutrition Care Process
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Q1) One of the most important goals of documentation in the medical record is:
A) to be clear and concise.
B) to follow ADA format.
C) to develop a new method of charting.
D) to use medical abbreviations.
E) to demonstrate knowledge of medicine and dietetics.
Q2) Differences in the writing of different communities --different disciplines, different workplaces -- coalesce into what are referred to as _______________.
Q3) Using IER notes, _______________ refers to the assessment part of SOAP, the diagnosis and evaluation based on the data gathered.
Q4) Which factor is essential to keep in mind while documenting in a patient's chart?
A) Include less information, rather than too much
B) Only record assumptions at the end of documentation
C) Add a signature only with written documentation, not electronic
D) Avoid abbreviations unless it is clear that anyone can understand them
E) Only chart what others see as significant
Q5) List each component of the following acronyms: SOAP, ADIME, IER.
Q6) Name the elements involved with every rhetorical norm.
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Chapter 7: Fluid and Electrolyte Balance
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Q1) Negatively charged ions are called _______________.
Q2) Decreasing hydrostatic pressure stimulates the renin- angiotensin-aldosterone system regulation of fluids and electrolytes.
A)True
B)False
Q3) What hormone is released from the kidney and stimulates conversion of angiotensinogen to angiotensin I?
A) arginine vasopressin
B) antidiuretic hormone
C) renin
D) pepsin
E) aldosterone
Q4) What color of urine reflects dehydration?
A) clear and colorless
B) light yellow
C) red
D) dark amber
E) green
Q5) Vasopressin causes fluid to be reabsorbed in the tubules of the
Q6) Describe the functions of water in the body.
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Chapter 8: Acid Base Balance
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Q1) Sleep apnea can potentially cause which acid-base disorder?
A) respiratory alkalosis
B) respiratory acidosis
C) metabolic alkalosis
D) metabolic acidosis
E) kidney disease
Q2) Metabolic alkalosis and respiratory acidosis may occur when a patient with chronic obstructive pulmonary disease receives _______________.
Q3) The protein buffer system acts in the same fashion as what other buffer system?
A) phosphate buffer system
B) bicarbonate-carbonic acid buffer system
C) hemoglobin buffer system
D) monosodium buffer system
E) disodium buffer system
Q4) Discuss the etiology of metabolic alkalosis.
Q5) The primary buffer in extracellular fluid (ECF) is the _______________ buffer system.
Q6) Water is considered neutral pH at _______________.
Q7) Free hydrogen ions combine with _______________ to form ammonium.
Q8) Describe the role of acids in the human body.
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Chapter 9: Cellular and Physiological Response to Injurythe
Role of the Immune System
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Q1) What is the percentage of European and North American adults who suffer from autoimmune diseases?
A) 3%
B) 5-7%
C) 9%
D) 10-12%
E) 14%
Q2) A common cellular response to injury and disease is deposition of a substance called hyaline within and between the cells.
A)True
B)False
Q3) 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
Q4) Long term use of _______________ is associated with many possible side effects, including hyperglycemia, osteoporosis, and protein loss/muscle wasting.
11
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Chapter 10: Nutritional Genomics
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Sample Questions
Q1) The production of RNA from DNA is accomplished by what process?
A) reduction
B) expression
C) subscription
D) transcription
E) translation
Q2) Discuss what happens after transcription is complete.
Q3) DNA contains non-coding regulatory sequences called _______________ to which molecules can bind in order to signal unwinding of a specific region of DNA for creation of a needed protein.
Q4) Low intake of what nutrient (particularly when combined with high alcohol intake) is associated with increased colon cancer risk?
A) thymine
B) riboflavin
C) niacin
D) folate
E) biotin
Q5) The Evaluation of Genomic Applications in Practice and Prevention initiative was developed by the Office of Public Health Genomics of the _______________.
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Chapter 11: Pharmacology
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Q1) What parts of the body have the largest surface areas for drug absorption?
A) mouth and throat
B) mouth and stomach
C) large intestine and bowel
D) small and large intestines
E) small intestine and lungs
Q2) Monoamine oxidase (MAO) is an intricate enzyme system distributed predominantly in nervous tissue, the heart, and the small intestine.
A)True
B)False
Q3) Aspirin is a good example of a medication that is absorbed in the _______________, but can also damage the gastric mucosa.
Q4) When MAO is blocked by MAO inhibitors, what amine is affected (levels rise)?
A) lysine
B) tyramine
C) arginine
D) glycine
E) glutamine
Q5) Willow bark acts like the common drug _______________.
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Chapter 12: Diseases and Disorders of Energy Imbalance
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Q1) If CP's BMI were above 50, she would most likely be a candidate for which type of bariatric surgery?
A) adjustable gastric banding
B) non-adjustable gastric banding
C) Roux-en-Y gastric bypass
D) vertical sleeve gastrectomy
E) duodenal switch with biliopancreatic diversion
Q2) Overweight and moderate obesity are characterized by _______________ of adipocytes.
Q3) A compensatory survival mechanism intended to conserve energy in the face of starvation is known as _______________.
Q4) Obesity is men is most likely associated with which condition?
A) cancer of the esophagus
B) bradycardia
C) hepatitis C
D) cancer of the gallbladder
E) diabetes insipidus
Q5) Lower body fat distribution is more often seen in females and is sometimes referred to as _______________.
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Chapter 13: Diseases of the Cardiovascular System
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Q1) Which describes a non-invasive test used in patients with symptoms of PAD that measures the blood pressure in the upper and lower extremities at rest and after exercise?
A) magnetic resonance angiography
B) radionucleotide imaging
C) positron emission tomography
D) ankle-brachial index
E) CT angiography
Q2) Post-surgery education on basic food safety after heart transplant should be provided since transplant patients are more susceptible to _______________ due to immunosuppressant therapy.
Q3) _______________ produced in the endothelial cells controls the normal relaxation of smooth muscle in the arteries and arterioles.
Q4) In the diet, _______________ appear to behave similarly to saturated fatty acids in that they increase total cholesterol and LDL levels and perhaps lower HDL levels.
Q5) Explain the components of the guide to therapeutic lifestyle changes (TLC), listing examples from each of the segments.
Q6) Describe the formula used for calculating blood flow and vessel resistance.
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Chapter 14: Diseases of the Upper Gastrointestinal Tract
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Q1) A patient with dysphagia aspirates food approximately 10% of the time while eating and has no cough reflex. According to the Dysphagia Severity Scale, which level of severity would this patient be classified as having?
A) 2
B) 3
C) 4
D) 5
E) 6
Q2) The Nissen fundoplication for treatment of GERD involves taking the fundus of the _______________ and wrapping it around the lower esophagus.
Q3) Which is a correct statement regarding late dumping syndrome?
A) It occurs 30-60 minutes after a meal.
B) It is especially common after eating protein.
C) It increases the risk of hypoglycemia.
D) It causes gas, cramping, and diarrhea.
E) It results in sweating, flushing, and dizziness.
Q4) Type A gastritis is a condition most often related to _______________.
Q5) Explain manifestations, clinical diagnosis, and treatment interventions of gastroesophageal reflux among infants.
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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) Which food would a patient with celiac disease most likely need to avoid?
A) popcorn
B) chicken tenders
C) butter
D) white rice
E) processed cheese
Q3) When defecation relieves cramping, diarrhea is generally from the small intestine.
A)True
B)False
Q4) The _______________ colon ends in the rectum where another sphincter (the anal sphincter) controls voluntary release of intestinal contents.
Q5) Define each of the four components currently under investigation to maintain health of the colon: resistant starches, prebiotics, probiotics, and synbiotics.
Q6) Describe how a dietitian would teach a client to increase fiber in his diet, listing examples of foods to include.
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Chapter 16: Diseases of the Liver - Gallbladder - and Exocrine Pancreas
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Q1) _______________ or steatosis occurs in about 25% of the general U.S. population and 90% of chronic alcohol abusers.
Q2) What complication most commonly occurs with folate deficiency?
A) reduced bone formation and mineralization
B) villous shortening in the intestine
C) retrograde amnesia
D) ataxia and sensory neuropathy
E) pancreatic insufficiency
Q3) _______________ is a manifestation of thiamin deficiency usually seen in individuals suffering from alcoholism.
Q4) How would the registered dietitian determine JB's caloric needs in this situation?
A) 15-20 kcal/kg IBW
B) 20-25 kcal/kg IBW
C) 25-30 kcal/kg IBW
D) 30-35 kcal/kg current body weight
E) 35-40 kcal/kg current body weight
Q5) The most common clinical sign of fatty liver is _______________.
Page 18
Q6) List three different causes of cirrhosis found in the United States.
Q7) Describe the major functions of the pancreas.
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Chapter 17: Diseases of the Endocrine System
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Q1) What is the fasting plasma glucose diagnostic criterion for diabetes?
A) greater than or equal to 95 mg/dL
B) greater than or equal to 106 mg/dL
C) greater than or equal to 116 mg/dL
D) greater than or equal to 126 mg/dL
E) greater than or equal to 145 mg/dL
Q2) Which glands secrete somatostatin?
A) pituitary and thalamus
B) hypothalamus and pancreas
C) pancreas and adrenals
D) hypothalamus and pineal
E) pituitary and adrenals
Q3) The pituitary gland is located in the bony cavity at the base of the brain just below the hypothalamus.
A)True
B)False
Q4) Continuous glucose monitoring uses a device that communicates with a sensor placed under the _______________.
Q5) Severe hypoglycemia is defined as blood glucose level of _______________ mg/dL.
Q6) Discuss pituitary tumors.
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Chapter 18: Diseases of the Renal System
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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) List the factors that increase protein requirements for people with chronic kidney disease.
Q3) Kidney stones typically consist of calcium salts, cystine, uric acid, or struvite.
A)True
B)False
Q4) Approximately how many grams of protein does KL require each day?
A) 66 g
B) 78 g
C) 87 g
D) 93 g
E) 110 g
Q5) Deficiency of the active form of vitamin D is associated with impaired intestinal calcium absorption and secondary _______________.
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Chapter 19: Diseases of the Hematological System
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Q1) Vitamin B12 is recycled and/or stored in the _______________.
Q2) Which of the following is the richest source of folate?
A) strawberries
B) blueberries
C) flour tortillas
D) corn tortillas
E) asparagus
Q3) Chronic toxicity from iron overload leads to functional _______________, hepatomegaly, and eventually cirrhosis.
Q4) What vitamin deficiency causes pernicious anemia?
A) B2
B) B5
C) B12
D) B7
E) B3
Q5) Plant sources of iron are the most bioavailable because they don't contain compounds that bind iron and render it less absorbable.
A)True
B)False
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Chapter 20: Diseases and Disorders of the Neurological System
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Q1) What medications act to reduce the breakdown of L-dopa outside the blood-brain barrier?
A) COMT inhibitors
B) dopamine agonists
C) MAO-B inhibitors
D) decarboxylase inhibitors
E) anticholinergic meds
Q2) The classic ketogenic diet is typically initiated with what macronutrient ratio?
A) 4 fat to 1 protein and carbohydrate
B) 4 carbohydrate to 1 protein
C) 4 protein to 1 carbohydrate
D) 4 protein to 1 fat
E) 4 carbohydrate to 1 fat
Q3) Describe the pathophysiology of primary and secondary traumatic brain injury.
Q4) Partial seizures can be further classified as simple partial or complex partial.
A)True
B)False
Q5) Explain the primary roles of the parietal lobe.
Q6) Define Guillain-Barré syndrome.
Q7) Endorphins are _______________ that naturally occur in the brain. Page 22
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Chapter 21: Diseases of the Respiratory System
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Q1) Pulmonary edema increases the thickness of the alveolar and capillary space, leading to impaired gas exchange, hypoxia, and overall increased work of breathing.
A)True
B)False
Q2) Cardiac complications of COPD include _______________ and _______________ ventricular failure.
Q3) Glucose intolerance and cystic fibrosis-related diabetes occur in approximately 80% of CF patients over the age of 10.
A)True
B)False
Q4) The bronchioles end in small air sacs called _______________, which are paper thin.
Q5) Chronic bronchitis is characterized by increased air flow rates, dyspnea, hypoxemia, and hypocapnia.
A)True
B)False
Q6) Gas exchange occurs in the _______________ unit.
Q7) What are leukotrienes and how are they involved in asthma.
Q8) Describe the cause of cystic fibrosis (CF).
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Chapter 22: Metabolic Stress and the Critically Ill
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Q1) While the degree of hypermetabolism and catabolism correlates with the patient's level of burn injury, researchers agree that the level of hypermetabolism does not increase beyond that reached for a _______________ percent total body surface area burn.
Q2) How long, on average, does it take for a healthy patient to progress to protein-energy malnutrition (PEM)?
A) 48 hours
B) 1 week
C) 2 weeks
D) 4 weeks
E) 8 weeks
Q3) When providing nutrition support to the critically ill, it is crucial to avoid _______________ and its subsequent metabolic complications, which include increased _______________ production and hyperglycemia.
Q4) _______________ burns destroy all layers of the skin and can involve underlying muscle, organs, and bone.
Q5) In burn patients, enteral nutrition that is initiated within 24 hours of injury has been associated with prevention of Curling's _______________.
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Chapter 23: Neoplastic Disease
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Q1) The most _______________ chemotherapeutic agents include cisplatin, methotrexate, doxorubicin, and cyclophosphamide.
Q2) _______________ is the study of changes in gene activity that are not caused by changes in the DNA sequence.
Q3) There are two major types of genes that are thought to influence the development of cancer: oncogenes and _______________ genes.
Q4) Describe the main causes of dysgeusia.
Q5) _______________ involves the placement of radioactive sources either within an existing body cavity in close proximity to the tumor, or directly within a tumor.
Q6) Outline radiation therapy (RT) for cancer.
Q7) It is estimated that 60% of patients with head and neck cancers will present with malnutrition at the time of diagnosis.
A)True
B)False
Q8) Biological therapies that interfere with specific molecules involved in tumor growth and progression are also referred to as _______________ therapies.
Q9) Cancer is a disorder of cell _______________ and regulation.
Page 26
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Chapter 24: HIV and Aids
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Q1) How many virons per day can the HIV virus reproduce in the human body?
A) between 10,000 and 50,000 virons per day
B) between 50,000 and 200,000 virons per day
C) between 500,000 and 5 million virons per day
D) between 50 million and 200 million virons per day
E) between 1 billion and 1 trillion virons per day
Q2) What kind of virus is HIV?
A) retrovirus
B) DNA virus
C) bacteriophage
D) rhabdovirus
E) coronavirus
Q3) What kind of exercise is used to prevent muscle wasting, assuming an appropriate diet?
A) aerobic
B) anaerobic
C) isotonic
D) progressive resistance
E) fluctuating resistance
Q4) Describe a nutritional risk screening for a patient with HIV infection.
Page 27
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Chapter 25: Diseases of the Musculoskeletal System
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Q1) Compared with females, arthritic conditions are diagnosed more frequently in males, who account for 85% of cases in persons age 15 years and older.
A)True
B)False
Q2) Regular weight-bearing and muscle-strengthening exercise will reduce the risk of _______________ and fractures as well as increase _______________.
Q3) What is the best practical advice to give KL to help prevent future fractures?
A) supplement with vitamin D
B) move to a sunny climate
C) take more calcium
D) lose significant weight
E) supplement with glucosamine / chondroitin
Q4) What is the most abundant glycoprotein in the body?
A) chondroitin sulfate
B) glucosamine
C) collagen
D) arachidonic acid
E) hyaluronic acid
Q5) Describe the causes of secondary osteoporosis.
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Chapter 26: Metabolic Disorders
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Q1) Skin lymphocytes or peripheral blood fibroblasts can be used to determine the extent of enzymatic activity present.
A)True
B)False
Q2) People from what region seem to have much less incidence of fat metabolism disorders?
A) Africa
B) Asia
C) Europe
D) United States
E) Australia
Q3) What is a substrate needed for the normal metabolism of fat for energy?
A) carnitine
B) glucagon
C) raffinose
D) ribose
E) amylopectin
Q4) The urea cycle resides primarily in the _______________, but this process can also take place to a lesser extent in the kidneys and small intestine.
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